sweetener popularity potentially linked to elevated stroke risk
In a recent study published in 2025, researchers from the University of Colorado Boulder have found that the popular sugar substitute, erythritol, may have a negative impact on brain blood vessels and potentially increase the risk of stroke.
The study, conducted on human brain endothelial cells, showed that exposure to a typical serving amount of erythritol led to several biochemical changes. These changes included a decrease in nitric oxide production, a molecule that normally relaxes and widens blood vessels, and an increase in endothelin-1 production, a protein that constricts blood vessels.
Moreover, the research revealed that erythritol raised oxidative stress by boosting reactive oxygen species (free radicals), which can damage cells and cause inflammation. The substance also reduced the release of tissue-type plasminogen activator (t-PA), impairing the body's ability to dissolve blood clots.
These biochemical changes promote blood vessel constriction and increase clotting risk, which could lead to impaired cerebral blood flow and higher chances of ischemic stroke. However, it's important to note that these findings are from in vitro experiments on cultured human brain microvascular cells. Further in vivo studies in animals and humans are needed to confirm the clinical significance and dose-response relationship of these effects.
Epidemiological data also support a link between higher circulating erythritol levels and increased risk of heart attacks and strokes within three years, especially among men and women in the US and Europe.
While the study provides strong clues about erythritol's behavior inside the body, more comprehensive clinical studies are necessary to fully understand these risks and their relevance to typical consumer intake.
Erythritol is found in many different foods, including gum, baked goods, and protein shakes, and many people may not realize how much they're consuming on a regular basis. People who rely on these foods for health reasons might want to think twice about their consumption of erythritol.
Health experts are calling for more human studies to better understand the risks, especially for those with underlying conditions like heart disease or diabetes. Until more human studies are conducted, moderation in consumption of erythritol is advised.
Consumers are encouraged to read labels carefully and take note of ingredients like erythritol or "sugar alcohols." Just because a product is sugar-free does not mean it is risk-free, as what's put in the product might be more important than what's left out.
In light of these findings, it seems that labels promising "sugar-free" or "guilt-free" options may not be as harmless as they appear. The risks of erythritol, especially for those with underlying health conditions, are not fully understood yet. Until more is known, it's important to approach these products with caution.
- The study's findings on erythritol suggest that those following healthy diets, focused on cardiovascular health, should be mindful of their intake of this sugar substitute due to its potential contribution to stroke risk.
- In light of the connection between erythritol and medical conditions like heart disease and diabetes, health and wellness advocates urge individuals with existing health issues to exercise caution when consuming this sweetener.
- Given the association between higher circulating erythritol levels and increased risk of heart attacks and strokes in some populations, nutritional advice emphasizes the importance of understanding the ingredients in one's diet, including "sugar alcohols" like erythritol, for health-conscious consumers.
