Erythritol's Potential Impact on Brain Blood Vessels and Stroke Risk

Recent research conducted by scientists at the University of Colorado Boulder has revealed that erythritol, a commonly used sugar substitute, may negatively influence the function of cells lining the brain's blood vessels. Erythritol is favored in many processed foods, including protein bars, low-calorie drinks, and diabetic-friendly baked goods due to its high sweetness with minimal calories and negligible effects on blood sugar levels. It is naturally produced in the body from glucose and fructose, which makes concerns about its safety especially pertinent.

Studies have shown that elevated plasma erythritol levels are associated with increased risks of cardiovascular and cerebrovascular events, such as heart attacks and strokes, in various populations. However, the biological mechanism behind this link remained unclear until now.

In a laboratory study published in the Journal of Applied Physiology, researchers exposed human brain microvascular endothelial cells to erythritol at concentrations comparable to typical dietary intake. The results indicated significant disruptions in cell functions vital for maintaining healthy blood flow in the brain. Specifically, erythritol exposure elevated oxidative stress within these cells, increased markers of antioxidant response, and reduced nitric oxide availability—an essential molecule for blood vessel dilation.

Furthermore, the study found that erythritol decreased the production of tissue plasminogen activator (t-PA), a protein involved in blood clot dissolution, potentially impairing the body's ability to prevent clot formation. Notably, the cells showed increased reactive oxygen species and decreased phosphorylation of endothelial nitric oxide synthase (eNOS), indicating compromised cell signaling and vascular health.

While these findings are limited to in vitro conditions, they support epidemiological observations linking erythritol to higher stroke risk. The researchers suggest that chronic dietary intake of erythritol might have cumulative effects on brain vascular health, emphasizing the need for further research, including long-term animal studies and clinical trials, to determine the relevance for human health.

This research highlights the importance of understanding the potential cerebrovascular impacts of non-nutritive sweeteners like erythritol, especially given their widespread use and association with increased cardiovascular risks. Consumers should be cautious and stay informed as more evidence emerges about the safety of these additives.