Many people choose sugar-free foods and drinks because they want to lose weight, reduce their sugar intake, or better control their blood sugar. Products marketed as “low sugar,” “keto,” or “diabetic-friendly” often contain artificial or low-calorie sweeteners instead of regular sugar.
One of the most common of these sweeteners is erythritol. It is found in a wide range of products, including sugar-free soft drinks, protein bars, chewing gum, low-carb desserts, ice cream, baked goods, and many packaged snacks.
Erythritol belongs to a group of sweeteners called sugar alcohols. Despite the name, it does not contain alcohol like beer or wine. It provides a sweet taste with almost no calories and has very little effect on blood sugar or insulin levels.
Because of these advantages, erythritol has been considered a useful alternative to sugar for many years and is widely used by people with diabetes, those following low-carbohydrate diets, and anyone trying to reduce calorie intake.
However, scientists are now taking a closer look at whether erythritol is as harmless as once believed. A growing number of studies suggest that this popular sweetener may have unexpected effects on the heart and blood vessels.
A study from the University of Colorado Boulder adds to these concerns by suggesting that erythritol could increase the risk of stroke by interfering with the normal function of blood vessels in the brain.
The new research was published in the Journal of Applied Physiology. The study was led by Professor Christopher DeSouza and graduate researcher Auburn Berry, who wanted to better understand why earlier population studies had linked erythritol to cardiovascular problems.
Interest in erythritol increased after a previous study involving about 4,000 people in the United States and Europe found that individuals with higher levels of erythritol in their blood were more likely to experience a heart attack or stroke during the following three years.
That earlier research showed an association but could not explain exactly why the sweetener might increase risk.
To investigate further, the Colorado researchers performed laboratory experiments using human brain blood vessel cells. They exposed the cells to an amount of erythritol similar to what someone might consume from a single sugar-free beverage.
Although the experiment was carried out in the laboratory rather than in people, the researchers observed several changes that may increase the likelihood of stroke.
One of the most important findings involved nitric oxide, a natural substance produced by blood vessel cells. Nitric oxide helps blood vessels relax and widen, allowing blood to flow more easily throughout the body. The cells exposed to erythritol produced less nitric oxide, suggesting that the blood vessels would become less able to expand normally.
At the same time, the cells produced more endothelin-1, a protein that has the opposite effect. Endothelin-1 causes blood vessels to tighten and narrow. Together, lower nitric oxide and higher endothelin-1 may leave blood vessels stiffer, narrower, and less able to respond to the body’s changing needs.
The researchers also found evidence that erythritol interfered with the body’s natural ability to break down blood clots. Normally, blood vessel cells release a substance called tissue plasminogen activator, or t-PA, which helps dissolve clots before they become dangerous.
After exposure to erythritol, the cells produced less t-PA. Reduced clot-breaking activity could make it easier for harmful clots to form and block blood flow to the brain.
In addition, the treated cells generated higher levels of free radicals. These unstable molecules can damage cells, trigger inflammation, and contribute to the development of cardiovascular disease when they accumulate over time. Increased oxidative stress has long been linked to damage in blood vessels and other tissues throughout the body.
According to Auburn Berry, when blood vessels become more constricted and are less able to remove blood clots, the risk of stroke may increase. The new findings not only suggest that erythritol could contribute to stroke risk but also provide possible biological explanations for how this might happen.
The researchers emphasized that only one serving of erythritol was tested during the experiment. Professor DeSouza noted that some people consume several servings of foods and drinks containing erythritol every day, meaning their exposure could be much higher than what was examined in the study.
It is important to understand the limitations of this research. The experiments were performed on human cells grown in the laboratory, not on people.
This means the findings cannot prove that eating foods containing erythritol will directly cause strokes. Much more research, including carefully designed human studies, is needed before scientists can fully understand the health effects of long-term erythritol consumption.
Even so, the results add to a growing body of evidence suggesting that low-calorie sweeteners should continue to be carefully studied. For consumers, the researchers recommend reading food labels and being aware of how much erythritol and other sugar alcohols are present in everyday foods.
While these sweeteners can help reduce sugar intake, they may also have health effects that scientists are only beginning to understand. As research continues, moderation and informed choices remain sensible approaches.
If you care about stroke, please read studies about how to eat to prevent stroke, and diets high in flavonoids could help reduce stroke risk.
For more health information, please see recent studies about how Mediterranean diet could protect your brain health, and wild blueberries can benefit your heart and brain.
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