Major Red Flag for "Safe" Sweeteners: Erythritol May Impair Brain Blood Vessel Health
New research finds erythritol disrupts key brain cell functions linked to stroke and cognitive decline.
Ever traded sugar for "natural" stevia or monk fruit blends, only to see erythritol in the ingredients? Turns out that common sugar alcohol, long sold as smart and safe, may not play so nicely with your brain. New lab findings suggest erythritol disrupts critical blood vessel functions in ways tied to increased stroke and heart risk.
What’s the Big Idea?
What did the study ask? Researchers wanted to see if erythritol, at levels found in a typical sweetened drink, harms the cells lining brain blood vessels (endothelial cells), which are vital for healthy brain blood flow and stroke protection.
Key findings:
Erythritol raised levels of damaging oxidative stress inside these cells by about 75%.
It impaired two major cell-protective systems—nitric oxide (NO) production dropped 20%, while endothelin-1, a potent vessel-constrictor, jumped 30%.
Erythritol also blunted the cell’s ability to release tissue plasminogen activator (t-PA), a molecule that helps prevent dangerous blood clots.
In the authors’ words:
“Erythritol adversely affects oxidative stress, NO production, ET-1 production, and t-PA release in brain microvascular endothelial cells; potentially contributing to the increased risk of ischemic stroke associated with erythritol.”
Why Should You Care?
Stroke and Cognition: Trouble in these vital vessel-lining cells is linked to higher risk of stroke and long-term cognitive decline.
Habits in Question: Erythritol is everywhere—from keto snacks to diabetes-friendly sodas. For people seeking to optimize healthspan, these findings challenge the notion that all "nonnutritive sweeteners" are benign.
Who’s potentially most affected?
Those with existing vascular risks (high blood pressure, diabetes)
Older adults, who naturally face more oxidative stress in the brain
Anyone consuming multiple “diet”, “sugar free,” or low-carb snacks daily
What’s Next on the Horizon?
This was an in vitro study: real human effects need confirmation, especially with chronic (long-term) low-dose or high-dose exposure.
Major research questions remain:
Does erythritol have similar effects across different age groups or genders?
Could lifestyle changes mitigate the risk, or are some people especially vulnerable based on genetics or pre-existing vascular health?
How does occasional erythritol consumption compare to daily or high-session intake, particularly in the context of other risk factors (smoking, sedentary behavior, diet)?
Ongoing and future clinical studies will be crucial—watch this space.
Safety, Ethics, and Caveats
Lab limitations: This study used cultured human brain endothelial cells, not whole brains or living people, and only looked at short-term exposure.
Effects in the body may differ—absorption, metabolism, and real-life dietary patterns could modulate risk.
Balance: While this adds mechanistic support to existing warnings, one study alone shouldn’t spur panic. However, if you have risk factors for vascular disease, it’s reasonable to take caution.
Equity and Transparency: The researchers reported no financial conflicts, and the work was funded via a standard American Heart Association grant.
What This Could Mean for You
Actionable Steps:
If you’re aiming for long-term brain and vascular health, especially if you have risk factors (age, hypertension, diabetes), consider cutting back on routine erythritol intake—especially in beverages and snacks where you might not even taste it.
Read ingredient labels closely; erythritol often sneaks into “natural” or “sugar-free” products.
Prioritize whole foods and experiment with minimal-processed sweeteners (in moderation), or try training your palate to enjoy less overall sweetness.
If you need a sweetener, consider rotating types and paying attention to emerging guidance—science is still unfolding.
Explore the Full Study
Berry AR, Ruzzene ST, Ostrander EI, et al. “The Non-Nutritive Sweetener Erythritol Adversely Affects Brain Microvascular Endothelial Cell Function.” Journal of Applied Physiology, 2025.
Read the full paper here (PDF)
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