A common sugar substitute found in diet drinks, protein bars, and low-carb snacks may not be as harmless as previously thought. New research published in the Journal of Applied Physiology reveals that erythritol, a popular non-nutritive sweetener, can impair the function of cells lining blood vessels in the brain, potentially increasing the risk of stroke.
According to the Australian Bureau of Statistics, 28.9% of people reported consuming sweetened drinks, including sugar-free varieties, with nearly one in ten (9.6%) opting for beverages sweetened with artificial or alternative sweeteners rather than sugar. Erythritol, first approved for use in the late 1990s, contains almost no calories and has minimal impact on blood glucose or insulin levels, making it a favored choice for those managing weight, diabetes, or carbohydrate intake.
New Findings Challenge Previous Assumptions
However, the study conducted by scientists at the University of Colorado Boulder suggests that the safety profile of erythritol may be more complex than previously believed. Researchers exposed human cerebral microvascular endothelial cells—cells lining the tiny blood vessels in the brain—to erythritol levels comparable to typical sugar-free beverage consumption.
The findings were concerning. Exposure to erythritol caused the cells to produce significantly less nitric oxide, a molecule essential for blood vessel relaxation and dilation. Simultaneously, the cells increased production of endothelin-1, a protein that constricts blood vessels. When challenged with a clot-forming compound, the cells’ ability to produce t-PA, a natural clot-dissolving substance, was “markedly blunted.” Additionally, erythritol exposure heightened the production of reactive oxygen species, or free radicals, which can damage cells and promote inflammation.
“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,” stated Professor Christopher DeSouza, director of the Integrative Vascular Biology Lab.
Understanding the Implications
Stroke occurs when blood supply to part of the brain is interrupted, either due to a clot or a ruptured blood vessel. Healthy endothelial cells, which line blood vessels, play a crucial role in regulating blood flow, preventing excessive clotting, and maintaining vascular flexibility. Dysfunctional endothelial cells may lead to more readily constricted blood vessels and increased likelihood of clot formation or reduced clot dissolution.
The changes observed in this study may provide a possible explanation for earlier research linking higher erythritol levels with increased cardiovascular events. It is important to note, however, that this was a laboratory study conducted in cells, not a clinical trial in humans. Researchers emphasize the need for further investigation to determine how these findings translate to real-world consumption patterns and long-term health outcomes.
Co-author Auburn Berry noted, “Big picture, if your vessels are more constricted and your ability to break down blood clots is lowered, your risk of stroke goes up.”
Calls for Caution and Further Research
While erythritol remains considered safe by food regulators, the study’s findings suggest that ‘sugar-free’ does not necessarily equate to risk-free. Professor DeSouza urged caution, advising individuals to monitor their consumption of non-nutritive sweeteners like erythritol.
For those who regularly choose sugar-free options to reduce calories or manage blood sugar, these findings may prompt a reconsideration of dietary choices. As the scientific community continues to explore the health implications of artificial sweeteners, consumers are encouraged to stay informed and consider moderation in their consumption.
As research continues, the health community will be closely watching for further studies that could confirm or refute these findings, potentially impacting dietary guidelines and public health recommendations.
