A newly published study from the University of Colorado Boulder has sparked concern over the safety of erythritol, a commonly used sugar substitute. The research suggests that even moderate amounts may impair brain vascular cells and potentially increase the risk of stroke.
Researchers at CU Boulder focused on human cerebral microvascular endothelial cells, the cells lining the small blood vessels in the brain. When exposed to erythritol levels comparable to those found in a standard sugar-free beverage—approximately 30 grams—the cells showed several troubling changes. Reactive oxygen species, a marker of oxidative stress, increased significantly. Nitric oxide, a molecule essential for keeping blood vessels relaxed and functioning well, dropped. Meanwhile, levels of endothelin‑1, a peptide that causes blood vessel constriction, rose. Under clot‑forming conditions, the cells’ ability to release tissue plasminogen activator, which helps dissolve clots, was markedly reduced.
These cellular changes suggest a reduced ability of the brain’s blood vessels to regulate flow and manage clotting—factors that can heighten the risk of ischemic stroke. According to first author Auburn Berry, if vessels are more constricted and the ability to break down blood clots is reduced, stroke risk increases.
This work builds on earlier research from the Cleveland Clinic, which found that individuals with higher levels of erythritol in their blood were more likely to experience heart attacks or strokes. That study tracked about 4,000 participants across the United States and Europe and found a strong correlation between erythritol and cardiovascular events.
While erythritol is currently labeled “generally recognized as safe” by the U.S. Food and Drug Administration, the growing body of evidence is prompting scientists and health experts to call for more rigorous safety reviews. The FDA has acknowledged the limitations of current data and signaled ongoing monitoring of artificial sweeteners.
Lead investigator Christopher DeSouza, who directs CU Boulder’s Integrative Vascular Biology Laboratory, emphasized the need for more research, especially in people who have existing cardiovascular or neurological conditions. Although the study did not involve human trials, its findings raise important questions about the widespread and often unchecked use of erythritol in food and beverages.
Erythritol is a popular ingredient in products marketed as low-carb, keto-friendly, or sugar-free. It is often found in protein bars, energy drinks, diet sodas, and baked goods. Its appeal lies in its ability to mimic sugar’s taste and texture without the calories, but the latest findings suggest that this convenience may come with hidden health costs.
Nutritionists are increasingly recommending that consumers limit their intake of artificial sweeteners like erythritol, especially if used daily. Those seeking alternatives may consider natural options such as honey, maple syrup, or monk fruit, though these too should be consumed in moderation.
In summary, the new study underscores the importance of re-evaluating the safety of common sugar substitutes. The evidence suggests that erythritol, while low in calories, may not be risk-free, particularly for those with cardiovascular vulnerabilities. Until more is known, medical professionals advise cautious use and a more balanced approach to sweeteners.
