Erythritol can disrupt the functioning of brain vessels and increase the risk of stroke

Erythritol (erythritol) is a low—calorie sugar alcohol that is found in some fruits, but is most often produced industrially. It is widely used in dietary products, sugar-free desserts, beverages, and sports supplements. Erythritol has become especially popular among people with diabetes and those who follow a ketogenic diet, as it does not increase blood glucose levels and contains almost no calories.

The authors studied the concentrations of erythritol in the blood of more than 4,000 patients from the United States and Europe who are at increased risk of cardiovascular diseases. Those participants with the highest levels of erythritol in their blood were about twice as likely to have a stroke, heart attack, and death from cardiovascular causes within three years compared with participants with low levels of this substance.

Additional laboratory experiments have shown that erythritol can enhance platelet aggregation, the bonding of blood platelets that underlies the formation of blood clots. The substance also affects the rate of blood clotting. In animal models and in experiments with human plasma, this led to an increased tendency to thrombosis.

One of the problems is that erythritol can persist in the blood for a long time after consumption — in some cases for more than 48 hours. This is especially important for people with an already increased risk of cardiovascular diseases: diabetics, hypertensive patients, and elderly patients. The authors emphasize that with chronic consumption, even small doses can accumulate and create additional risks.

The study does not prove that erythritol directly causes stroke or heart attack, but it demonstrates a clear link between its concentration in the blood and the risk of severe vascular events. Given the growing popularity of this sugar substitute, the authors call for stricter safety checks and a review of recommendations for its use.

For now, scientists advise treating erythritol with caution, especially for people with cardiovascular diseases. They also emphasize that there are no completely safe ways to cheat the metabolism — and the choice between sugar and its substitutes should be based on an individual risk assessment.