Found in Thousands of Low-Calorie Products

Erythritol appears in everything from protein bars to flavored water, offering about 80% the sweetness of sugar without the calories or spikes in insulin. Its widespread use has grown with the popularity of low-sugar and diabetic-friendly diets.

But this sweetener, often labeled as natural due to its presence in some fruits and fermentation processes, may carry hidden risks.

The new study examined how erythritol affects the blood-brain barrier—the brain’s critical filtering system. Researchers exposed brain blood vessel cells to amounts of erythritol comparable to what’s found in a single sugar-free beverage. They observed a damaging cascade: increased oxidative stress, reduced antioxidant activity, and even cell death.

These changes also disrupted the delicate balance between two key molecules: nitric oxide and endothelin-1. Nitric oxide relaxes blood vessels, promoting healthy blood flow, while endothelin-1 causes them to constrict. Erythritol lowered levels of nitric oxide while boosting endothelin-1, causing blood vessels to stay narrowed. This narrowing can limit the brain’s access to oxygen and nutrients, increasing the risk of ischaemic stroke.

It also weakened the cells’ natural capacity to break down blood clots. Normally, they release a compound called tissue plasminogen activator (t-PA) to break down clots. But erythritol suppressed this mechanism, potentially leaving clots to accumulate and increase the risk of stroke.

Echoes of Earlier Human Studies

The laboratory results align with previous human studies. One 2023 investigation that tracked over 4,000 individuals across the US and Europe found that those with elevated erythritol levels in their blood had nearly double the risk of experiencing a heart attack or stroke within three years.

Another study showed that 30 grams of erythritol—a typical serving in sugar-free ice cream—can make blood platelets more likely to clump, setting the stage for clot formation.

Erythritol is often promoted as a “natural” alternative to artificial sweeteners like aspartame or sucralose, and its chemistry makes it easier to substitute for sugar in recipes. Because it’s technically a sugar alcohol and produced in small amounts by the body, it has largely avoided the negative attention directed at other synthetic sweeteners.

However, experts warn that its natural origin does not guarantee safety. The U.S. Food and Drug Administration and European Food Safety Authority have approved it for consumption, but the new data suggest long-term effects may not be fully understood.

What This Means for Consumers

Researchers emphasize that their experiments were conducted on isolated cells in laboratory conditions. Human bodies are more complex, and more research—especially studies involving whole-body responses or advanced vascular models—is needed to draw final conclusions.

Still, scientists advise consumers to read labels and be mindful of erythritol intake, especially if they consume multiple servings of sugar-free products daily. Given the links to vascular dysfunction and stroke risk, moderation may be a wise approach.

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The researchers analyzed dietary habits using data gathered from the Nurses’ Health Study and the Health Professionals Follow-Up Study. Food-frequency questionnaires were administered every two to four years, asking participants how often they consumed various foods, including processed red meats like bacon, hot dogs, and lunch meats, as well as nuts and legumes. Over the study period, 11,173 participants developed dementia.

Each additional daily serving of processed red meat was linked to an extra 1.6 years of cognitive aging, particularly affecting language ability and executive function. The high levels of saturated fats and cholesterol in processed red meats can lead to the buildup of cholesterol plaques in arteries, impairing blood flow to the brain and accelerating cognitive decline. Dr. Sham Singh, a psychiatrist at Winit Clinic who was not involved in the study, observed similar findings. He explained that excessive intake of saturated fats could contribute to atherosclerosis, which reduces blood flow and oxygen delivery to brain cells, potentially accelerating cognitive decline.

Moreover, cooking methods such as grilling, frying, or broiling processed red meats can produce harmful compounds like heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs). These compounds induce oxidative stress and inflammation, further contributing to neurodegenerative diseases like dementia. Processed red meats often contain nitrates and nitrites, which are preservatives that can form harmful compounds in the body, increasing dementia risk.

The research also underscored the advantages of substituting processed red meat with nuts, beans, or legumes. Participants who made this substitution had a 20% lower risk of dementia. Nuts and legumes are rich in healthy fats, fiber, vitamins, and minerals that support brain health and improve cardiovascular function. They contain omega-3 fatty acids, which are anti-inflammatory and help maintain healthy cell membranes in the brain.

Varsha Khatri, a certified nutritionist at Prowise Healthcare, pointed out that the fiber, vitamins, and minerals found in nuts and beans contribute to better heart and blood vessel health, reducing dementia risk by promoting improved blood flow to the brain. Additionally, these plant-based foods are abundant in polyphenols and other antioxidants that combat oxidative stress, a key factor in dementia development.

To reduce the risk of dementia, experts recommend gradually incorporating more nuts, beans, and legumes into the diet. Some practical approaches are to substitute beans for red meat in recipes, snack on nuts, and incorporate more plant-based meals into your weekly diet plan. Starting slowly and being prepared to use these ingredients in food preparation can help individuals make sustainable dietary changes.

Dr. Heather Snyder, vice president of medical and scientific relations at the Alzheimer’s Association, stressed the significance of maintaining a varied diet to support brain health. She noted that diets lower in fat and sugar and higher in vegetables are generally better for cognitive function. This aligns with findings from other studies showing that processed foods are linked to poorer health outcomes across the board, including increased risks of cancer, heart disease, and diabetes.

This research highlights how crucial dietary choices are for supporting brain health and lowering the risk of cognitive decline. While the findings show a strong association between processed red meat consumption and dementia risk, it is important to note that they do not prove a direct cause-and-effect relationship. Further research is needed to fully understand the mechanisms behind this link and to explore the potential benefits of plant-based diets.

In conclusion, adopting a diet rich in nuts, beans, and legumes while reducing processed red meat intake may be a viable strategy to mitigate dementia risk and promote overall brain health. This research adds to the growing body of evidence supporting the benefits of plant-based diets for long-term cognitive health.

References:

1. Alzheimer’s Society (2024). “Eating processed red meat could be significant risk factor for dementia”. Available at: https://www.alzheimers.org.uk/news/2024-07-31/eating-processed-red-meat-could-be-significant-risk-factor-dementia.
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2. Alzheimer’s Association (2024). “Processed red meat raises risk of dementia”. Available at: https://aaic.alz.org/releases-2024/processed-red-meat-raises-risk-of-dementia.asp

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