Common sweetener found to significantly and immediately boost heart attack and stroke risk

Sugar-free treats have taken over the shelves. You’ve probably seen erythritol listed on sodas, protein bars, and even toothpaste. It’s everywhere. Almost zero calories, no sugar spikes, and perfect for keto diets. Sounds like a win, but maybe not.

A new study from the University of Colorado Boulder has cracked open a side of erythritol that few expected. It’s not about weight gain or tooth decay. It’s about what this sweetener does to your brain’s blood vessels that may elevate the risk of a stroke.

“Our study adds to the evidence suggesting that non-nutritive sweeteners that have generally been purported to be safe, may not come without negative health consequences,” said Professor Christopher DeSouza, who led the study.

Understanding artificial sweeteners

Artificial sweeteners like erythritol have become go-to sugar substitutes for people looking to cut calories or manage blood sugar.

Erythritol, in particular, is a sugar alcohol found naturally in some fruits but is typically produced in bulk from corn or wheat starch.

It tastes sweet like sugar but has almost zero calories and doesn’t spike blood glucose, making it popular among those with diabetes or on keto diets.

Unlike some other sugar alcohols, erythritol usually causes fewer digestive issues because your body absorbs most of it before it reaches the colon.

That said, it’s not without controversy. Some recent studies, including this one, have raised concerns about potential links between high erythritol levels and cardiovascular issues like heart attack and stroke.

Sweetener changes brain cells

The researchers did not yet test this in people. They went straight to the cells that line your brain’s blood vessels. These cells regulate blood flow, keep inflammation in check, and help prevent clots.

The cells were exposed to erythritol for just three hours. The amount used was equal to what you would get from one sugar-free drink. That was all it took to cause noticeable changes.

The cells got stressed. They flooded with free radicals, also called reactive oxygen species or ROS. These unstable molecules damage proteins, DNA, and cell membranes. In response, antioxidant defenses went up, but not enough.

It was like the cells knew they were under attack and tried, unsuccessfully, to defend themselves.

Blood vessels started misbehaving

That same short exposure changed how the cells produced nitric oxide, a molecule that helps blood vessels relax. Less nitric oxide means tighter vessels. That’s bad news when your brain needs steady blood flow.

The total amount of the enzyme that makes nitric oxide didn’t change much, but its function tanked. It stopped doing its job well.

Erythritol messed with the enzyme’s activation at two specific sites. One turned down, one cranked up. The result was about 20 percent less nitric oxide production. This sets the stage for constricted vessels.

Sweetener makes brain vessels tighten

The same cells started pumping out more endothelin-1, a protein that tells blood vessels to tighten up. Compared to normal cells, the erythritol-exposed ones had a 30 percent increase in ET-1. They also had more of its precursor, Big ET-1.

That’s a double whammy. First, blood vessels lose their ability to widen. Then, they get signals to squeeze even more.

“Big picture, if your vessels are more constricted and your ability to break down blood clots is lowered, your risk of stroke goes up,” said first author Auburn Berry. “Our research demonstrates not only that, but how erythritol has the potential to increase stroke risk.”

Clots don’t stand a chance

Blood clots are tricky. You want your body to stop bleeding when you get a cut. But you also want it to break down unnecessary clots inside vessels. One of the body’s tools for that is tissue-type plasminogen activator, or t-PA.

In this study, the researchers added thrombin, which mimics a clotting signal. Normally, that should have made the cells release more t-PA. In untreated cells, that’s exactly what happened. A nice 25 percent boost.

In erythritol-treated cells? Nothing. The response was completely muted. Clots form and cells don’t react. That’s the formula for a stroke.

One study tracked over 4,000 people in the U.S. and Europe. The research team found that those with high blood levels of erythritol had more strokes and heart attacks within three years. This happened across both sexes and regardless of other health issues.

The Colorado team didn’t just observe changes. They showed exactly how the sweetener weakens brain vessel cells in ways that match the stroke patterns found in people.

Sweeteners may harm blood vessels

DeSouza and his team exposed real human brain vessel cells to a typical drink-size dose of erythritol. Many people consume several such servings a day. And unlike some substances, erythritol crosses into the brain.

The study wasn’t designed to track long-term effects, but it does raise a concern. What happens when those cells face erythritol not just for three hours, but every day?

“Given the epidemiological study that inspired our work, and now our cellular findings, we believe it would be prudent for people to monitor their consumption of non-nutrient-sweeteners such as this one,” said DeSouza.

The study is published in the Journal of Applied Physiology.

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