A widely used ingredient in “diet” and “sugar-free” foods, erythritol, long considered harmless, is now under intense scrutiny. New research from the University of Colorado Boulder reveals concerning links between this common sugar substitute and potential damage to brain cells, significantly increasing stroke risk. This expert analysis unpacks the critical findings, offering essential insights for consumers navigating modern dietary choices.
The Rise of Erythritol: A “Harmless” Sweetener?
Erythritol, a sugar alcohol, gained Food and Drug Administration (FDA) approval in 2001. Produced by fermenting corn, it became a staple in countless “low-carb,” “keto,” and “sugar-free” products. Its appeal is clear: nearly zero calories, about 80% the sweetness of regular sugar, and minimal impact on blood sugar or insulin levels. For individuals managing weight, diabetes, or simply reducing carbohydrate intake, erythritol seemed like a perfect solution, found in everything from specialty ice creams to protein snacks and diet sodas.
Unsettling Clues: The Epidemiological Link to Cardiovascular Events
The catalyst for this new investigation came from a large epidemiological study. Researchers at the Cleveland Clinic, involving 4,000 participants across the U.S. and Europe, discovered a troubling correlation. Individuals with higher circulating levels of erythritol showed a significantly elevated likelihood of experiencing a heart attack or stroke within three years. This finding prompted senior author Christopher DeSouza, director of the Integrative Vascular Biology Lab, and first author Auburn Berry, a graduate student, to delve deeper. Their goal was to understand the precise mechanisms driving this increased risk.
How Erythritol May Harm Brain Cells: Unpacking the Science
The University of Colorado Boulder team focused on human brain microvascular endothelial cells (hCMECs). These crucial cells line the blood vessels in the brain. For their in vitro study, researchers treated these cells for just three hours with an erythritol concentration equivalent to a single serving of a typical sugar-free beverage, approximately 30 grams. The results were startling.
Critical Cellular Alterations Observed
The erythritol-treated cells showed several concerning changes:
Reduced Nitric Oxide (NO): Cells expressed significantly less nitric oxide. NO is vital for relaxing and widening blood vessels, ensuring healthy blood flow to the brain. Erythritol appears to interfere with a key activation step in NO production.
Increased Endothelin-1 (ET-1): Simultaneously, there was a notable increase in endothelin-1, a protein known to constrict blood vessels. The combination of reduced vasodilation and increased vasoconstriction narrows vessels.
Impaired Clot-Busting Ability: When exposed to thrombin, a compound that forms blood clots, the cells’ ability to produce t-PA (tissue plasminogen activator) was “markedly blunted.” t-PA is the body’s natural clot-busting compound.
Elevated Oxidative Stress: The cells produced more reactive oxygen species (ROS), often called “free radicals.” These metabolic byproducts can damage and age cells, contributing to tissue inflammation. The cells even increased antioxidant protein expression, seemingly attempting to counter the heightened oxidative stress.
These findings build upon previous research suggesting that even a moderate intake of erythritol—around 30 grams, roughly the amount in a pint of sugar-free ice cream—can cause blood platelets to clump together, further increasing clot formation potential.
Elevated Stroke Risk: The “How” Explained
Auburn Berry succinctly summarized the implications: “Big picture, if your vessels are more constricted and your ability to break down blood clots is lowered, your risk of stroke goes up.” This research provides crucial mechanistic insights, detailing how erythritol can elevate stroke risk by directly impacting vascular function. The increased oxidative stress also causes direct cellular damage, particularly to neural tissue, potentially contributing to cognitive decline and broader systemic disease processes.
Dr. Thomas M. Holland, a contributing expert, emphasized that these observed cellular effects—decreased nitric oxide and elevated oxidative stress—are consistent with the early stages of vascular diseases, including thrombosis and strokes. These findings align with prior clinical observations linking erythritol to increased cardiovascular and stroke risks.
Important Considerations and Expert Advice
The authors of the University of Colorado Boulder study acknowledge that their research was a laboratory study conducted on cells. Larger studies in humans are essential to confirm these findings in living individuals. However, DeSouza notes that their study used only a serving-size amount of the sugar substitute. For those who consume multiple servings daily, the potential impact could be more severe.
Both DeSouza and Holland strongly advise consumers to reconsider their reliance on non-nutritive sweeteners. They recommend carefully reading product labels for “erythritol” or “sugar alcohol.” DeSouza states, “Given the epidemiological study that inspired our work, and now our cellular findings, we believe it would be prudent for people to monitor their consumption of non-nutrient-sweeteners such as this one.”
Dr. Holland specifically challenges the perception that erythritol is a harmless substitute. He suggests a more balanced approach to sweeteners. While natural options like honey or date syrup can be used sparingly, he cautions they still impact blood sugar. For non-caloric alternatives, stevia and monk fruit extract currently appear to have fewer adverse effects on oxidative stress or blood vessel health. Ultimately, the most effective strategy for long-term brain and vascular well-being is to reduce overall sweetener consumption and prioritize a diet rich in whole, unprocessed foods.
Actionable Takeaways for Health-Conscious Consumers
Given the emerging evidence, making informed choices about sweeteners is more important than ever.
Read Labels Carefully: Be vigilant for “erythritol” or “sugar alcohol” in the ingredients list of your favorite “diet” or “sugar-free” products.
Moderate Consumption: Consider reducing your intake of products containing erythritol, especially if you consume multiple servings daily.
Explore Alternatives: If you need a non-caloric sweetener, consider stevia or monk fruit extract, which current research suggests may be safer options for vascular health.
Prioritize Whole Foods: The healthiest long-term strategy involves reducing your reliance on all types of sweeteners and focusing on a diet rich in fruits, vegetables, lean proteins, and whole grains. This approach naturally lowers added sugar and sweetener intake.
- Consult Your Healthcare Provider: If you have existing cardiovascular concerns, diabetes, or are considering significant dietary changes, discuss these findings with your doctor or a registered dietitian.
- www.sciencedaily.com
- www.colorado.edu
- www.sciencedaily.com
- neurosciencenews.com
- www.medicalnewstoday.com
Frequently Asked Questions
What is erythritol and why has it been widely used in “diet” products?
Erythritol is a sugar alcohol approved by the FDA in 2001 and commonly produced by fermenting corn. It has been popular in “sugar-free,” “low-carb,” and “keto” products because it contains almost no calories, offers about 80% of sugar’s sweetness, and has a minimal impact on blood sugar or insulin levels. These properties made it an appealing choice for individuals seeking weight loss or blood sugar management.
How does new research suggest erythritol might increase stroke risk?
Recent studies, including one from the University of Colorado Boulder, indicate that erythritol can adversely affect brain blood vessel cells. It has been shown to reduce nitric oxide (which relaxes blood vessels), increase endothelin-1 (which constricts them), impair the body’s natural clot-busting ability, and elevate oxidative stress (leading to cell damage). These combined effects—narrowed vessels, impaired clot breakdown, and cellular harm—create an environment conducive to increased stroke risk.
What are some suggested alternatives to erythritol for health-conscious consumers?
Experts suggest reducing overall reliance on all sweeteners. However, if a non-caloric sweetener is desired, stevia and monk fruit extract are often recommended as they have not shown the same adverse effects on oxidative stress or blood vessel health observed with erythritol. Natural options like honey or date syrup can be used sparingly, but it’s important to remember they still impact blood sugar levels. Prioritizing a diet rich in whole, unprocessed foods is considered the best long-term strategy for brain and vascular health.
Conclusion
The growing body of evidence, culminating in the University of Colorado Boulder’s detailed cellular findings, challenges the long-held belief that erythritol is a benign sugar substitute. While more human studies are needed, the mechanistic insights into how erythritol may impair brain blood vessels and elevate stroke risk are compelling. As consumers, staying informed and making prudent choices about what we consume is paramount. Prioritizing whole foods and limiting processed ingredients, including non-nutritive sweeteners, remains the most robust strategy for protecting our long-term health and well-being.
