Study links erythritol to brain vessel issues and stroke risk

Researchers at the University of Colorado Boulder have found that erythritol, a common sugar substitute, disrupts brain blood vessel cells in ways that could elevate stroke risk. The study exposed cells to levels from a single sugar-free drink and observed reduced vessel relaxation, impaired clot breakdown, and increased oxidative stress. The findings appear in the Journal of Applied Physiology.

Erythritol, approved by the Food and Drug Administration in 2001, is a low-calorie sugar alcohol derived from fermented corn. It provides about 80% of sugar's sweetness with minimal impact on insulin levels, making it popular in keto snacks, diet drinks, and low-carb products for weight management and blood sugar control. However, a new study from the University of Colorado Boulder raises safety concerns specifically for brain health. Senior author Christopher DeSouza, professor of integrative physiology and director of the Integrative Vascular Biology Lab, along with lead author Auburn Berry, tested human brain microvascular endothelial cells. They exposed the cells to erythritol concentrations matching one typical sugar-free drink for three hours. The results showed decreased nitric oxide production, hindering vessel relaxation, and elevated endothelin-1, promoting constriction. Cells also produced less t-PA when faced with thrombin, impairing clot dissolution, alongside higher reactive oxygen species levels that can damage cells and spur inflammation. Berry explained, 'Big picture, if your vessels are more constricted and your ability to break down blood clots is lowered, your risk of stroke goes up.' DeSouza added, 'Our study adds to the evidence suggesting that non-nutritive sweeteners that have generally been purported to be safe, may not come without negative health consequences.' This builds on a prior study of 4,000 people linking higher blood erythritol to increased heart attack and stroke risks within three years. The experiment used a single serving dose, and DeSouza noted that multiple daily servings might amplify effects. While conducted on cells rather than whole humans, the researchers urge caution. DeSouza advised, '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' and check labels for erythritol or sugar alcohols.

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