Pharm'Up 
Recent research from the University of Colorado Boulder has raised alarms about erythritol, a prevalent sweetener found in low-carb desserts, keto snacks, and “sugar-free” drinks. The study suggests this widely used sugar substitute and food additive may damage brain cells and increase the likelihood of stroke.
Christopher DeSouza, a professor of integrative physiology and head of the Integrative Vascular Biology Lab, who led the study, noted, “This research contributes to the mounting evidence that non-nutritive sweeteners, often deemed safe, might pose hidden health threats.”
Approved by the Food and Drug Administration in 2001, erythritol is a sugar alcohol made through corn fermentation. With virtually no calories, about 80% of table sugar’s sweetness, and little impact on insulin, it has become a go-to option for those managing weight, blood sugar, or cutting carbs.
Yet, emerging studies are highlighting potential hazards. A Cleveland Clinic investigation with 4,000 participants from the U.S. and Europe found that elevated erythritol levels in the bloodstream were strongly associated with a higher risk of heart attacks or strokes over the next three years.
To investigate further, DeSouza and lead researcher Auburn Berry, a graduate student in his team, exposed human brain blood vessel cells to erythritol levels typical of a sugar-free beverage for three hours. Their findings revealed:
- A significant drop in nitric oxide, which helps expand and relax blood vessels.
- An uptick in endothelin-1, a protein that tightens blood vessels.
- A reduced ability to produce t-PA, a natural clot-dissolving agent, when exposed to thrombin.
- Increased reactive oxygen species (ROS), or free radicals, which can harm cells and trigger inflammation.
Earlier studies have also shown that just 30g of erythritol—equivalent to a pint of sugar-free ice cream—can cause blood platelets to aggregate, raising the risk of clot formation.
Berry commented, “In essence, narrower blood vessels and diminished clot breakdown capacity heighten stroke risk. Our work not only supports this connection but also explores how erythritol might play a role.”
DeSouza pointed out that their experiment involved just one serving of erythritol, implying that multiple daily servings could worsen the effects. As this was a lab-based cell study, they urge larger human trials to validate the results.
They recommend that consumers scan labels for erythritol or “sugar alcohol” and consider limiting intake. DeSouza added, “Given the epidemiological insights that sparked our study and our cell-based discoveries, it’s prudent for people to be mindful of their consumption of non-nutritive sweeteners like erythritol.”
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