US Study Finds Sugar Substitute in Diet Foods Raises Stroke Risk

Erythritol Used as a Sugar Substitute with 80% Sweetness
University of Colorado Team: "Risks to Heart Health and Stroke"
"Impacts Blood Flow Regulation and Inhibits Clot Defense Mechanisms"

A recent study has found that the sweetener "erythritol," commonly added to diet foods such as low-sugar ice cream and protein bars, may increase the risk of stroke and brain damage. On July 22 (local time), science media outlet Science Alert reported that "erythritol, which is widely used as a sugar substitute, may threaten heart health and increase the risk of stroke."

According to a paper published on July 14 in the international journal Applied Physics, a research team led by Christopher DeSouza at the University of Colorado Boulder found that erythritol can damage the "blood-brain barrier cells," which act as the brain's security system by blocking harmful substances while allowing nutrients to pass through.

Reference photo of beverages to aid understanding of the article.

The researchers exposed blood-brain barrier cells to erythritol at levels found in a typical sugar-free beverage. As a result, they observed a chain reaction of cell damage, which could make the brain more vulnerable to blood clots. Blood clots are a major cause of stroke.

The study also focused on how erythritol affects the blood vessels' ability to regulate blood flow. Healthy blood vessels act like traffic controllers, expanding when organs need more blood and contracting when less is needed. This delicate balance is maintained by two key molecules: nitric oxide, which relaxes blood vessels, and endothelin-1, which causes them to contract.

However, erythritol was found to disrupt this critical system by decreasing nitric oxide production and increasing endothelin-1. As a result, blood vessels may constrict excessively, leading to a shortage of oxygen and nutrients supplied to the brain. This imbalance can cause ischemic stroke, which occurs when a blood clot blocks a vessel in the brain.

Erythritol was also shown to interfere with the body's natural defense mechanisms against blood clots. Normally, when a clot forms in a blood vessel, cells release a "clot-dissolving" agent called tissue plasminogen activator to dissolve the blockage before it causes a stroke. However, erythritol can block this protective mechanism, allowing clots to cause damage unchecked.

Professor DeSouza pointed out, "This experiment was conducted at a level equivalent to a single intake of erythritol, but if consumed several times a day, the risk could be even greater." He also noted that these results are based on cellular-level experiments, and that large-scale clinical studies in humans are still needed.

Previously, a research team led by Stanley Hazen at the Cleveland Clinic reported, through a large-scale observational study of more than 4,000 Americans and Europeans, that people who regularly consume erythritol have a significantly higher risk of cardiovascular diseases, including heart attack and stroke.

The researchers found that people with higher blood erythritol levels were more likely to experience a heart attack or stroke within three years. Dr. Hazen warned, "Erythritol may increase the risk of blood clotting," and added, "Erythritol contained in typical 'keto-friendly' processed foods can increase blood erythritol levels by up to 1,000 times, thereby raising the risk of blood clotting."

Erythritol is gaining popularity among food manufacturers because it acts more like sugar than other alternative sweeteners. It has about 80% of the sweetness of sugar, making it easier to use in various recipes. Unlike artificial sweeteners such as aspartame or sucralose, erythritol is also a naturally occurring compound that the body produces in small amounts.

Because of this classification, erythritol was not included in the recent World Health Organization (WHO) guidelines, which do not recommend artificial sweetener use for weight control. In addition, regulatory agencies such as the European Food Safety Authority and the U.S. Food and Drug Administration (FDA) have also approved erythritol as safe for consumption.