Erythritol & Brain Damage: Is The Science As Scary As It Sounds?

A couple of years ago, we examined some news about another sweetener: The Sucralose News: Scaremongering Or Serious?

…and the short version is that initial headlines are often not a completely honest representation of the truth (in the above case, the reality was “this doesn’t look good, but we need to do a lot more science to declare it with confidence”).

We wrote about that, too: How Science News Outlets Can Lie To You (Yes, Even If They Cite Studies!)

So, what’s the deal with erythritol?

Erythritol is a sugar alcohol, which so far as the body is concerned is neither sugar nor alcohol in the way those words are commonly understood; it’s just a chemical term. The sugar isn’t processed as such by the body and are passed as dietary fiber, and nor is there any intoxicating effect as one might expect from an alcohol. However, as it has a sweet taste, it can be used a sweetener.

This is general (sweetening things, no matter with what), can lead to a slippery slope of craving increasingly sweeter things, which is generally a bad idea.

See what the WHO had to say about that (and why), here: The Problem With Sweeteners

The WHO recommendation (avoid sweeteners) applied to artificial and naturally-occurring non-sugar sweeteners, such as:

• Acesulfame K
• Advantame
• Aspartame
• Cyclamates
• Neotame
• Saccharin
• Stevia

Erythritol (and sucralose, for that matter) didn’t make the list, because as they are technically sugars, they don’t go on a list of non-sugar sweeteners.

That said, around the same time a study did find that erythritol was linked to a higher risk of heart attack, stroke, and early death, so it was clear even then that it may not be an amazing sweetener either:

Read: The artificial sweetener erythritol and cardiovascular event risk

We further explored that in one of our “This or That” head-to heads: Xylitol vs Erythritol – Which is Healthier?

The answer we came to was:

❝The one thing that sets them apart is their respective safety profiles. Xylitol is prothrombotic and associated with major adverse cardiac events (CI=95, adjusted hazard ratio=1.57, range=1.12-2.21). Erythritol is also prothrombotic and more strongly associated with major adverse cardiac events (CI=95, adjusted hazard ratio=2.21, range=1.20-4.07).

So, xylitol is bad and erythritol is worse, which means the relatively “healthier” is xylitol. We don’t recommend either, though.❞

(we showed studies for this, linked in the “This or That” page here)

As a quick aside: readers with good memories may recall that we’ve sometimes recommended xylitol for good oral health (it’s not just “not too bad as sweeteners go”, it actively does good things too; the crux is that it’s being used in the mouth (such as with xylitol-sweetened gum) but not actually ingested in meaningful amounts.

You can learn more about that here: Xylitol: Cavity Fighter Or Gut Disruptor? The Dose Makes the Poison

Now, back to erythritol and the science of the day:

A team of researchers (Dr. Auburn Berry et al.) investigated the effects of erythritol directly on the brain.

This was prompted by the research we mentioned up above about the major adverse cardiac events, and others, showing higher blood erythritol levels to increased risk of heart attack or stroke within three years.

This study, however, was all about the brain. And when a moment ago we said “directly on the brain”, we do mean exactly that; this was an in vitro study, because it’s difficult to get live human volunteers to give the scientists permission to slice their brains into thin slices to look at them under the microscope, and while many advances have been made in scanning techniques and “liquid biopsies”, we’re not quite there yet for this kind of research.

What they found, in few words, was that exposing brain blood vessel cells to erythritol levels similar to a typical sugar-free drink caused:

• increased reactive oxygen species (which age and inflame tissues)
• reduced nitric oxide (leading to less vessel relaxation)
• increased endothelin-1 (causing more vessel constriction)
• impaired production of t-PA (reducing the ability to break down clots)

This all has important implications for stroke risk, since especially the combination of:

• narrower vessels,
• less clot-busting capability, and
• more cellular stress

…are all things that increase stroke risk. Alone, never mind together.

And together, they don’t just add up, but rather compound to make things even worse.

All that said, Dr. Berry herself does emphasize that the study was done on cells in petri dishes, that as such…

• while yes the findings do add to growing concern, and
• people are advised to read labels and limit intake of erythritol and similar sweeteners,
• it still cannot be said absolutely conclusively that the same things definitely happens in vivo (i.e. in live humans outside of the laboratory).

You can read the paper in full, here: The non-nutritive sweetener erythritol adversely affects brain microvascular endothelial cell function

Want to learn more?

Check out:

How To Reduce Your Stroke Risk ← 8 ways

Take care!