A widely used sugar substitute may increase stroke risk by narrowing brain blood vessels and reducing the body’s ability to break down clots, researchers have warned.
Erythritol, a sugar alcohol used in drinks and protein bars, was found to affect cells in ways that may encourage the formation of blood clots.
Researchers at the University of Colorado Boulder treated human blood vessel cells with erythritol at levels found in a typical sugar-free drink.
They observed several biological changes linked to vascular damage.
Senior author Christopher DeSouza is professor of integrative physiology and director of the Integrative Vascular Biology Lab.
The researcher said: “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.”
Erythritol, first approved by the US Food and Drug Administration in 2001, is usually made by fermenting corn.
It contains almost no calories, is around 80 per cent as sweet as table sugar, and has minimal effect on insulin levels.
Its popularity has grown among people aiming to lose weight, manage blood sugar or reduce carbohydrate intake.
But recent research has highlighted potential risks.
One study of 4,000 people in the US and Europe found those with higher erythritol levels were significantly more likely to have a heart attack or stroke within three years.
DeSouza and first author Auburn Berry, a graduate student, investigated what might be contributing to this elevated risk.
After three hours of exposure, blood vessel cells produced less nitric oxide – a chemical that helps vessels relax – and more endothelin-1, which causes them to constrict.
When exposed to thrombin, a clotting agent, the cells also released less tissue plasminogen activator (t-PA), a natural compound that helps dissolve blood clots.
The erythritol-treated cells also produced more reactive oxygen species – also known as free radicals – which are byproducts of metabolism that can damage cells and inflame tissue.
“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 Berry.
DeSouza added that the dose used in the study was equivalent to a typical single serving of a sugar-free product.
For people consuming multiple servings a day, the effect could be greater.
The researchers cautioned that this was a laboratory study conducted on cells, and that larger studies involving people are needed.
