Erythritol, a sugar alcohol widely used as a sweetener in ‘sugar-free’ and ‘keto-friendly’ products, has long been considered a safe alternative to sugar. However, a recent study conducted by researchers at the University of Colorado questions this perception, showing that erythritol may harm the blood-brain barrier, a vital physiological system that protects the brain by regulating the passage of substances between the bloodstream and brain tissues.
In laboratory experiments, human brain microvascular endothelial cells, which line the blood vessels in the brain, were exposed to concentrations of erythritol similar to those found after consuming erythritol-containing soft drinks. According to the study, erythritol reduced the production of nitric oxide, a molecule that relaxes blood vessels and promotes blood flow, while simultaneously increasing endothelin-1, a potent vasoconstrictor.
The result is narrowed blood vessels, which may deprive brain tissues of oxygen and nutrients, a known risk factor for ischemic stroke, which occurs when blood clots block blood flow to the brain. These laboratory findings provide a potential biological mechanism explaining previous epidemiological studies that linked regular erythritol consumption to significantly higher rates of heart attacks and strokes.
A large-scale study reported that individuals with the highest levels of erythritol in their blood had nearly double the risk of serious cardiovascular events compared to those with lower levels. Unlike many artificial sweeteners, the body naturally produces erythritol in small amounts and it is widely used to closely mimic the taste and texture of sugar, making it a preferred ingredient in many low-calorie products.
The study authors caution that the experiments were conducted on isolated cells rather than whole blood vessels or living organisms, indicating the need for further research to confirm these effects in physiological contexts. Advanced models, such as ‘vessel-on-a-chip’ technologies, may help clarify the impact of erythritol more comprehensively.
As research continues, both consumers and health professionals may need to reconsider the safety concepts of sweeteners, balancing metabolic benefits with the emerging cardiovascular and neurological risks posed by the widespread use of erythritol in the food supply. This study highlights the critical importance of evaluating the long-term health effects of rapidly proliferating food additives, even those considered natural or safe, and calls for a reevaluation of dietary choices and sweetened alternatives in pursuit of health preservation.
