Erythritol, a popular sugar substitute found in products ranging from protein bars to energy drinks, is facing new scrutiny over its safety. Recent research indicates the widely used sweetener may damage the blood-brain barrier, a critical defense mechanism, potentially increasing the risk of heart attack and stroke. These findings add new experimental detail to previous observational studies that have linked erythritol consumption to adverse cardiovascular events.
A new study from the University of Colorado exposed human blood-brain barrier cells to erythritol concentrations equivalent to those found in the blood after consuming a single sweetened beverage. The researchers observed a cascade of cellular damage initiated by oxidative stress, a state where an influx of harmful free radicals overwhelms the cells’ natural antioxidant defenses. This dual assault impaired cellular function and, in some cases, led to cell death, suggesting the brain’s protective barrier could become more vulnerable to blood clots.
The research also revealed a concerning impact on blood vessel regulation. Erythritol was found to disrupt the balance between two key molecules: it decreased the production of nitric oxide, which relaxes blood vessels, while increasing endothelin-1, which constricts them. This imbalance can lead to dangerously constricted vessels, a known precursor to ischemic stroke, where blood flow to the brain is blocked.
Furthermore, the study suggests erythritol may interfere with the body’s ability to dissolve blood clots. It appeared to block the release of tissue plasminogen activator, a natural “clot-busting” enzyme, which could allow dangerous blockages to persist and cause a stroke.
These laboratory results align with evidence from large-scale human observational studies. One major study tracking thousands of people found that individuals with the highest blood levels of erythritol had approximately double the risk of experiencing a major cardiac event like a heart attack or stroke.
However, researchers acknowledge the study’s limitations, as the experiments were performed on isolated cells in a lab rather than in a more complex biological system. Further testing, potentially using advanced “blood-vessel-on-a-chip” technology that more closely mimics human physiology, is needed to confirm the findings.
Erythritol’s popularity stems from its unique classification as a sugar alcohol, a compound the body naturally produces in small amounts. This distinction has allowed it to sidestep recent World Health Organization warnings against other non-sugar sweeteners. Food manufacturers also favor it because its sweetness level—about 80% that of sugar—makes it an easy substitute in recipes without being overpowering, leading to its inclusion in thousands of “sugar-free” and “keto-friendly” products.
While regulatory bodies like the FDA have approved erythritol as safe, this new research contributes to growing evidence of potential health risks. Consumers face a difficult trade-off: sweeteners can aid in weight management and diabetes prevention, but these benefits may come at the cost of increased long-term cardiovascular risk. The findings highlight the challenge of assessing the long-term effects of common food additives and suggest that frequent use of erythritol could compromise brain protection over time.
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