A recent study from the University of Colorado Boulder indicates that erythritol, a widely used non-nutritive sweetener, may be linked to a higher risk of cardiovascular and cerebrovascular events.
Berry et al. Our study demonstrates that erythritol, at concentrations commonly found in standard size sugar-free beverages, negatively impacts cerebral microvascular endothelial cell oxidative stress, ENOS activation, NO production, ET-1 expression, and T-PA release in vitro. Image credit: Tafilah Yusof.
Erythritol is a popular alternative to non-nutritive sugars due to its minimal effects on blood glucose and insulin levels.
This four-carbon sugar has a low-calorie content of 60-80%, being as sweet as sucrose, and commonly replaces sugar in baked goods, confections, and beverages.
Authorized by the FDA in 2001, erythritol is recommended for individuals with obesity, metabolic syndrome, and diabetes, as it aids in regulating calorie consumption, sugar intake, and minimizing hyperglycemia.
Found naturally in small amounts in certain fruits, vegetables, and fermented foods, erythritol is quickly absorbed in the small intestine through passive diffusion.
In humans, erythritol is produced endogenously from glucose and fructose by erythrocytes, liver, and kidneys via the pentose phosphate pathway, making its levels dependent on both endogenous production and external intake.
“Our findings contribute to the growing evidence that non-nutritive sweeteners, often considered safe, could pose health risks,” stated Professor Christopher Desouza from the University of Colorado.
A recent study involving 4,000 participants from the US and Europe revealed that individuals with elevated erythritol levels are at a significantly increased risk of experiencing a heart attack or stroke within three years.
Professor Desouza and his team sought to determine what factors were contributing to this heightened risk.
They exposed human cells lining blood vessels in the brain to erythritol for three hours, using concentrations similar to those found in standard sugar-free beverages.
The treated cells exhibited several alterations.
Notably, they produced significantly less nitric oxide, a molecule critical for dilating blood vessels, while increasing the expression of endothelin-1, which constricts blood vessels.
Furthermore, the challenge of a thrombogenic compound called thrombin significantly slowed the cell’s production of T-PA, a naturally occurring compound that promotes coagulation.
Cells treated with erythritol also generated more reactive oxygen species, or free radicals, which can lead to cellular damage and inflammation.
“We’ve been diligently working to share our findings with the broader community,” noted Auburn Berry, a graduate student at the University of Colorado in Boulder.
“Our research indicates that erythritol may indeed heighten the risk of stroke.”
“Our study solely focused on sugar substitutes,” emphasized Professor Desouza.
“For individuals consuming multiple servings daily, the potential impact could be even more pronounced.”
The researchers caution that their findings are based on lab research conducted on cells, necessitating larger-scale studies involving human subjects.
Nonetheless, they advise consumers to check product labels for erythritol or “sugar alcohol.”
“Considering the epidemiological evidence informing our research, along with our cellular discoveries, monitoring the intake of such non-nutritive sweeteners seems wise,” Professor Desouza remarked.
The study was published today in the Journal of Applied Physiology.
____
Auburn R. Berry et al. 2025. The non-nutritive sweetener erythritol negatively affects brain microvascular endothelial cell function. Journal of Applied Physiology 138(6):1571-1577; doi:10.1152/japplphysiol.00276.2025
Source: www.sci.news
