Shops are now filled with sugar-free options. You’ve probably noticed erythritol popping up in sodas, protein bars, and even toothpaste. It seems to be everywhere. With nearly zero calories, no sugar spikes, and compatibility with keto diets, it sounds appealing, but there could be a flip side.
Recent research from the University of Colorado Boulder reveals an unexpected aspect of erythritol. The concern isn’t the typical weight gain or tooth issues one might expect; rather, it’s about its effect on brain blood vessels, potentially increasing stroke risk.
“Our findings contribute to a growing body of evidence that suggests commonly regarded safe non-nutritive sweeteners may carry negative health risks,” stated Professor Christopher DeSouza, who oversaw the research.
Understanding artificial sweeteners
Erythritol and other artificial sweeteners have become popular sugar substitutes for those aiming to reduce calorie intake or manage blood sugar levels.
This sugar alcohol, naturally occurring in some fruits but generally produced from corn or wheat starch, mimics the sweetness of sugar while having almost no calories and minimal impact on blood glucose, making it a favorite among individuals with diabetes or those following keto diets.
Unlike some other sugar alcohols, erythritol typically leads to fewer digestive issues since most of it is absorbed before reaching the colon.
However, it’s not without its controversies. Recent studies, including this one, have flagged potential connections between elevated erythritol levels and cardiovascular problems like heart attacks and strokes.
Sweetener changes brain cells
The researchers went beyond testing on humans and instead focused on the cells lining the brain’s blood vessels. These cells play critical roles in regulating blood flow, managing inflammation, and preventing clots.
In just three hours of exposure to erythritol—equivalent to the amount found in one sugar-free drink—the cells showed notable stress responses.
They became inundated with free radicals, which are unstable molecules that can harm proteins, DNA, and cell membranes. Although antioxidant defenses increased, they weren’t sufficient to cope with the damage.
It was almost as if the cells reacted to an attack, trying to protect themselves but ultimately struggling to succeed.
Blood vessels started misbehaving
This brief exposure also impacted the production of nitric oxide, a molecule crucial for relaxing blood vessels. Reduced nitric oxide means increased tension in those vessels, which is concerning for maintaining steady blood flow to the brain.
The overall enzyme responsible for producing nitric oxide didn’t change significantly, but its effectiveness plummeted. It simply couldn’t perform its function properly anymore.
Erythritol interfered with the activation of the enzyme at two distinct points—one diminished its activity while the other increased it. The outcome? Approximately 20 percent less nitric oxide production, leading to tighter vessels.
Sweetener makes brain vessels tighten
The altered cells also began producing more endothelin-1, a protein that signals blood vessels to constrict. The erythritol-exposed cells showed a 30 percent increase in ET-1 levels, alongside a rise in its precursor, Big ET-1.
This creates a compounding problem. First, blood vessels are less capable of expanding, and then they receive additional signals urging them to contract further.
“In the big picture, if your blood vessels are more constricted and their ability to break down clots is diminished, your risk of stroke increases,” explained first author Auburn Berry. “Our research illustrates not just that, but how erythritol can potentially heighten stroke risk.”
Clots don’t stand a chance
Managing blood clots is a delicate balance. You need your body to stop bleeding when injured, but it also must dissolve unnecessary clots in blood vessels. One important mechanism for this is tissue-type plasminogen activator, or t-PA.
In this study, researchers introduced thrombin to simulate a clotting signal, which should have prompted cells to release more t-PA. This is precisely what happened in untreated cells, where a significant 25 percent increase was observed.
In erythritol-treated cells, however, there was no response at all. The cells failed to react, leaving clots unhindered—a recipe for a stroke.
One study involving over 4,000 participants in the U.S. and Europe indicated that individuals with elevated erythritol levels experienced more strokes and heart attacks within three years. This pattern persisted regardless of gender or existing health conditions.
The Colorado team’s findings not only noted these changes but specified how erythritol weakens brain vessel cells in a way that aligns with stroke occurrences documented in people.
Sweeteners may harm blood vessels
DeSouza and his colleagues examined real human brain vessel cells using a typical serving size of erythritol. Many consume multiple servings daily, and erythritol can cross into the brain.
While the study didn’t aim to evaluate long-term effects, it does prompt questions. What might happen if these cells are exposed to erythritol day after day?
“Considering the epidemiological study that led to our research, along with our cellular findings, it seems wise for individuals to monitor their intake of non-nutritive sweeteners like this one,” DeSouza commented.
The study is published in the Journal of Applied Physiology.
