A common sugar substitute used in sugar-free and low-carb products may not be as safe as once believed. New research from the University of Colorado Boulder shows that erythritol, a sweetener often used by people trying to manage blood sugar or reduce calories, may affect how blood vessels in the brain function.
In the lab, researchers exposed human brain blood vessel cells to an amount of erythritol similar to what’s found in a sugar-free drink. Within a few hours, the cells began acting in ways that could raise the risk of stroke.
“Big picture, if your vessels are more constricted and your ability to break down blood clots is lowered, your risk of stroke goes up,” said lead author Auburn Berry, a graduate student at CU Boulder.
The study, published in the Journal of Applied Physiology, found the cells made less nitric oxide, a molecule that helps blood vessels stay open, and more endothelin-1, a compound that causes them to tighten. The cells also produced fewer levels of t-PA, which helps dissolve clots, and more free radicals, harmful byproducts that can damage cells and trigger inflammation.
This builds on earlier research that linked high blood levels of erythritol with a greater risk of heart attack or stroke. That earlier study tracked more than 4,000 people in the United States and Europe.
“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,” said senior author Christopher DeSouza, professor of integrative physiology at CU Boulder.
Erythritol is a sugar alcohol with few calories and little effect on blood sugar. It’s found in everything from keto protein bars to sugar-free sodas. Though approved by the U.S. Food and Drug Administration, experts say its long-term effects are not fully understood.
The researchers emphasize that their study was conducted on cells, not in people, and more research is needed. Still, they say these findings are enough to encourage caution, especially among people who consume multiple erythritol-sweetened products daily.
“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-nutritive sweeteners such as this one,” DeSouza said.
This research was supported in part by the American Heart Association. The authors reported no financial conflicts of interest.