Small amounts of the common artificial sweetener, erythritol, increase risk of heart attack and stroke by promoting constriction, clotting, and inflammation in brain blood vessel cells. The corresponding study was published in the Journal of Applied Physiology.
"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 senior study author, Christopher DeSouza, professor of integrative physiology and director of the Integrative Vascular Biology Lab at the University of Colorado, Boulder, in a press release.
Sugar alcohol, erythritol, was first approved by the FDA in 2001. It is 60-80% as sweet as sugar yet has practically no effect on insulin levels and contains no calories, making it a popular alternative among people with conditions like obesity and diabetes.
Recent evidence, however, has started to emerge suggesting that erythritol may not be as healthy as once thought. A study published in 2023 found a link between circulating levels of erythritol and increased risk of heart attack or stroke.
In the current study, researchers investigated what may underlie this increased risk. To do so, they treated human cells that line blood vessels in the brain for three hours with an amount of erythritol equivalent to that of an artificially sweetened beverage.
The cells reacted in various ways. Among the changes, they expressed significantly less nitric oxide, which relaxes and widens blood vessels, and more endothelin-1, which constricts blood vessels. The cells also produced more reactive oxygen species, which play a role in inflammation.
"Big picture, if your vessels are more constricted and your ability to break down blood clots is lowered, your risk of stroke goes up. Our research demonstrates not only that, but how erythritol has the potential to increase stroke risk," said first author of the study, Auburn Berry, a graduate student in DeSouza's lab, in a press release.
The study only observed effects from a serving-size worth of erythritol. This means that effects on those who consume multiple servings per day may be worse, noted DeSouza.
"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," he added.
Sources: Science Daily, Journal of Applied Physiology