Many individuals opt for sugar-free foods and beverages to shed pounds, cut down on sugar, or better manage their blood sugar levels. These products, often labeled as “low sugar,” “keto,” or “diabetic-friendly,” typically contain artificial or low-calorie sweeteners instead of traditional sugar.
Erythritol is among the most common of these sweeteners. It’s found in a variety of items such as sugar-free sodas, protein bars, chewing gum, low-carb desserts, ice cream, baked goods, and numerous packaged snacks.
As a sugar alcohol, erythritol provides a sweet taste with almost no calories and minimal impact on blood sugar or insulin levels, despite its name suggesting alcohol content. Because of these benefits, erythritol has been considered an effective alternative to sugar for years and is widely used by people with diabetes, those on low-carb diets, and anyone looking to lower calorie intake.
Recently, scientists have begun scrutinizing whether erythritol is as harmless as once thought. Emerging research indicates that this sweetener might have unexpected effects on cardiovascular health, particularly on the heart and blood vessels.
A study from the University of Colorado Boulder raises concerns by suggesting erythritol could elevate stroke risk by disrupting healthy blood vessel function in the brain. Published in the Journal of Applied Physiology, the study was led by Professor Christopher DeSouza and graduate researcher Auburn Berry, who aimed to understand why earlier population studies linked erythritol to heart problems.
Interest in erythritol surged after a prior large-scale study involving about 4,000 individuals across the U.S. and Europe found that higher blood levels of erythritol were associated with a greater likelihood of heart attack or stroke over three years. However, that study couldn’t clarify how erythritol might increase such risks.
To explore this further, researchers conducted lab experiments using human brain blood vessel cells. They exposed these cells to erythritol amounts comparable to what someone might consume from a single sugar-free drink. Although these tests were done in a lab setting, several changes observed could potentially raise stroke risk.
One key discovery involved nitric oxide, a natural compound produced by blood vessel lining cells. Nitric oxide aids blood vessels in relaxing and expanding, which helps maintain smooth blood flow. The cells exposed to erythritol produced less nitric oxide, implying that blood vessels might become less capable of proper dilation.
At the same time, the cells produced more endothelin-1, a protein that has the opposite effect by causing blood vessels to constrict and narrow. This combination of lower nitric oxide and higher endothelin-1 could make vessels stiffer, narrower, and less adaptable to the body’s needs.
The study also found that erythritol appeared to interfere with the body’s ability to dissolve blood clots naturally. Typically, blood vessel cells release tissue plasminogen activator (t-PA), a substance that helps break down clots before they become problematic. After erythritol exposure, cells produced less t-PA, potentially making blood clots more likely to form and cause blockages in the brain.
Furthermore, the treated cells showed increased levels of free radicals—unstable molecules that can damage cells, promote inflammation, and contribute to cardiovascular disease development over time. Elevated oxidative stress from free radicals is a known factor in blood vessel and tissue damage.
Auburn Berry explained that when blood vessels become more constricted and less efficient at removing clots, the risk of stroke could rise. The study suggests erythritol might contribute to stroke risk by mechanisms such as these, providing biological explanations for earlier observed associations.
The researchers emphasized that only one serving of erythritol was tested. Professor DeSouza noted that many people consume multiple servings daily, which could lead to significantly higher exposure than what was studied.
It’s important to recognize the study’s limitations: these experiments involved human cells grown in a laboratory, not live subjects. Consequently, they can’t establish a direct cause-and-effect link between erythritol intake and strokes in real life. Substantial further research, especially controlled human studies, is needed to understand the long-term health effects of erythritol.
Despite these findings, the evidence underscores the need for ongoing investigation into low-calorie sweeteners. Consumers are advised to read food labels carefully and monitor their intake of erythritol and other sugar alcohols in their diets.
While these sweeteners can help reduce sugar consumption, they may also have health impacts that scientists are just beginning to explore. As new research emerges, maintaining moderation and making informed choices remain prudent.
For those concerned about stroke risk, paying attention to dietary habits that help prevent strokes—including diets rich in flavonoids—can be beneficial. Studies suggest that a Mediterranean diet and foods like wild blueberries may support brain and heart health.