Erythritol is a main ingredient in many modern foods, from low-carb ice cream and keto protein bars to “unsweetened” sodas.
But new research from the University of Colorado Boulder suggests that this widely used sugar substitute may have a significant drawback. Scientists have found that it can affect brain cells and increase the risk of stroke.
The survey results are Journal of Applied Physiology.
“Our study adds to the growing body of evidence suggesting that nonnutritive sweeteners, which have generally been considered safe, are not free from adverse health effects,” said senior author Christopher D’Souza, professor of integrative physiology and director of the Integrative Vascular Biology Laboratory.
What is erythritol and why is it so popular?
Erythritol was approved by the Food and Drug Administration in 2001. Erythritol is a sugar alcohol typically made by fermenting corn and is currently used in hundreds of foods. It has almost no calories, is about 80% sweeter than regular sugar, and has little effect on insulin levels. For this reason, it is often used by people trying to lose weight, manage blood sugar levels, or reduce carbohydrate intake.
Still, as research progresses, questions are being raised about its safety.
A large study of 4,000 people in the United States and Europe found that people with high levels of erythritol in their blood were much more likely to experience a heart attack or stroke within three years.
Inside the research: Effects on cerebral blood vessels
To better understand why this risk exists, DeSouza and lead author Auburn Berry, a graduate student in his lab, investigated how erythritol affects cells.
In an experiment, researchers exposed human cells lining blood vessels in the brain to the same amount of erythritol found in a typical sugar-free drink for three hours.
The results showed some worrying changes. Cells produce nitric oxide, which helps blood vessels relax and widen, and they produce more endothelin-1, which constricts blood vessels. When exposed to thrombin, a substance that promotes clotting, the cells were less able to produce t-PA, a natural compound that helps break up clots. In addition, treated cells produce high levels of reactive oxygen species (ROS), also known as “free radicals,” which can damage cells, accelerate aging, and cause inflammation.
Why these changes matter for stroke risk
“Overall, the constriction of blood vessels and reduced ability to break up blood clots increases the risk of stroke,” Berry says. “Our study shows that more than that, erythritol may increase stroke risk.”
DeSouza noted that only one dose of erythritol was used in the study. People who take it multiple times daily may be more affected.
What consumers need to know
The researchers stressed that their findings came from laboratory experiments on cells, rather than studies on humans, so further research is needed to confirm the risks in real-world settings.
Still, DeSouza recommends paying close attention to ingredient labels and looking out for erythritol or “sugar alcohols.”
“Given the epidemiological studies that inspired our study and the results of this cellular study, we think it would be prudent for people to monitor their intake of these non-nutritive sweeteners,” he said.
