Major sugar substitute found to impair brain blood vessel cell function
174 comments
·June 13, 2025maeln
sfjailbird
> It was tested in a cell culture, so not in a human or animal. That does change a lot of things.
The article points out that similar observations have already been made in human subjects:
> Positive associations between circulating erythritol and incidence of heart attack and stroke have been observed in U.S. and European cohorts
Eisenstein
One of the cited studies (Khafagy et al., 2024) directly contradicts such claims. The study explicitly said "we did not find supportive evidence from MR that erythritol increases cardiometabolic disease".
The primary human study they reference (Witkowski et al., 2023) has a few issues:
- All subjects had a "high prevalence of CVD and risk factor burden" and represented the sickest patients in the healthcare system
- Erythritol was measured only once at baseline, despite data which shows that levels fluctuate dramatically with consumption
- It did not differentiate between dietary intake and erythritol produced by the body
- Seeing as they were already sick they the subjects may have been consuming more artificial sweeteners than the general population
There are two more human studies referenced but I didn't read them.
ricardobeat
It’s tiring to see these quick dismissals of scientific studies at the top of the comment section. They are more often than not based on technicalities or fallacies. Pitting a two minute reading vs months of work by a team of scientists is not a great move.
In this case, the nature of the study is clearly acknowledged, it does not “change a lot of things”:
> We recognize given the in vitro, isolated single cell nature of this study we cannot make definitive translational conclusions or assertions regarding erythritol and clinical risk. However, the markers and mediators of brain microvascular endothelial cell function studied herein have been shown to have strong causative links with the development cerebrovascular dysfunction, neuronal damage and injury, thrombosis and acute ischemic stroke
These findings are a starting point for further understanding, not something to be immediately ranked as true/false.
kreetx
I think what commenters are looking for is a reason where this study is relevant for them (us) as humans, and they assess whether it is definitive or not. As HN is more of a generic curiosity and engineering related site then these starting point for further understanding are unlikely to get more nuanced discussion than that.
Thus, rather than submitting articles like the current, rather wait until anything more is available. We are tired of clickbait as well.
Eduard
> Thus, rather than submitting articles like the current, rather wait until anything more is available.
How long more to wait?
https://hn.algolia.com/?dateRange=all&page=0&prefix=false&qu...
metalman
"tired of clickbait", also tired of declines in the trustworthyness of manufacturers of food/health and regulators thereoff, so personaly I choose the no failure mode solution, ie:I eat mostly whole food items and cook meals at home, and just avoid all of it.....which is the simplest response to the whole dilema for anyone concerned with possible health consequences of the latest "finding" so I simpathise with both sides in the debate, but vote with my kitchen
const_cast
Typically single one-off studies should be dismissed and shouldn't be cause for concern. Anybody can study anything and it's very, very easy to do wrong.
For most everyday lay people, you should be looking at meta-analysis. We just don't have the context to hone-in on one study and examine how correct it is or what it actually means for our everyday lives.
IrishTechie
I tend to read these comments as a quick dismissal of the title moreso than the research. The title implies that a fairly conclusive finding has been made.
maeln
> Pitting a two minute reading vs months of work by a team of scientists is not a great move.
> In this case, the nature of the study is clearly acknowledged, it does not “change a lot of things”:
> These findings are a starting point for further understanding, not something to be immediately ranked as true/false.
Yes I know this and do not dismiss their research at all. I have been in the same boat, having to write at the end of a paper "We have proven a certain link between Y and X in this very limited experiment A, a wider, deeper research would be needed to prove if any such link exists in much larger condition B". This is normal, and how most scientific advencement is made.
But look, I don't think the average HN user comes to this article and comment section thinking what happened when you put erythritol on a cell culture outside of a living organism. They care about what is the consequences of consuming erythritol on them. So a small clarification comment stating the 2 importants conditions of the experiment (cell culture + dosage) is usually useful if you don't have the time to read the whole study and if you came here just to know if you should stop consuming your favorite sweetened drink right now.
vorpalhex
This is science, not religion. Nothing is owed to any researcher beyond the truth of the matter as supported by the best available evidence to us. Your pastor can request you go easy on him, your research team may not. (Please don't use this as an excuse to be rude.)
This contradicts several reasonably large high quality studies using a low grade substitute for human testing. The burden of proof is on the researchers making a surprising claim in contrast to existing evidence.
xtracto
Right, likewise the way science works is by publishing studies. Here we have a published peer reviewed study, "versus" a one paragraph anonymous dude trying to discredit the study.
Wake me up when this dude gets a paper accepted in a reputable peer reviewed journal. Then I will read what he has to say and add it to my list of "worthwhile" sources to form my conclusion on Erythritol.
Other than that, online forum comments are just mental candy floss to read while taking my morning caffeine fix.
toomuchtodo
Erythritol
elevaet
I wonder if the similar molecule Xylitol has the same problem. It seems like so many artificial sweeteners have dangerous health effects, I don't trust any of them. Unless you're diabetic or something, regular sugar seems to be the healthiest choice (in moderation!)
aydyn
Regular sugar is very bad for you in a modern diet as its essentially extra calories that are not compensated by satiety.
Why prefer something that you know is definitely bad for you over something that maybe is but more likely benign?
elevaet
If you're asking me personally, it's because I don't have any problems with eating too much sugar so I would never want to introduce an artificial sweetener into my diet when it carries potential strange health risks.
I think people get hung up on finding sugar substitutes when the root is eating sweet things constantly. You don't have to eat and drink sweet all the time. Many modern diets (not just n. Amer) are totally overindexed on sweetness.
Drink water, eat good foods, enjoy a bit of jam on your toast or whatever here and there and get lots of exercise and you'll be fine. You don't need aspartame and xylitol and stevia to be healthy.
abenga
"Too many calories" is a simpler problem to solve: increase physical activity, take less sugar, or take sugar less frequently. The signal to watch out for to tell that you are taking too much (increasing weight) is straightforward as well.
The possible artificial sweetener issues implied by the article ("may be poison") are ultra scary.
burnt-resistor
The fallacy of bothsidesism without quantitative evidence. People will keep ostentatiously promoting "raw" honey and "raw" sugar with RFK gusto.
konart
>Regular sugar is very bad for you
No it is not. The overwhelming quantites are bad. But this applies to almost any food.
hedora
Studies have shown artificial (and non-nutritional organic) sweeteners are much worse than sugar for decades.
For instance, they disrupt your metabolism, so equivalently sweet amounts of sweeteners cause more weight gain than sugar. (Due to increased hunger vs. eating nothing, decreased metabolism and decreased calorie burn.)
The study in the article isn’t surprising at all. Links between nutrisweet and migraine headaches have been well understood for a long time. It’s not surprising other similar chemicals have similar negative side effects.
There’s no valid reason to use artificial sweeteners (other than diabetes, but even then, gaining weight from the sweeteners is a problem if the diabetes is weight related.)
srean
Gee, I don't know if this artificial chemical (that no other species consumes) is toxic.
Let me consume it everyday.
Radium, too was deemed safe to suck on. Thalidomide, perfectly safe. Hormone replacement therapy, perfectly safe...
The safety of these (Thalidomide, HRT) were also backed by studies.
I find safety studies very suspect unless there's years of experience, especially if there is money to be made by someone.
It is difficult to get a man to understand something, when his salary depends on his not understanding it -- Upton Sinclair
lm28469
If your taste buds aren't completely fried by years of abuse you really can't eat any significant amount of sugar without being disgusted. More and more often I find some types of apples too sweet for my taste to the point I barely can finish them.
ShakataGaNai
xtracto
I am partial to Allulose [1] and Stevia [2]. A lot of people find their taste bad, but I've grown used to them, so much that I don't "taste" them anymore.
[1] https://www.cambridge.org/core/journals/british-journal-of-n...
[2] https://onlinelibrary.wiley.com/doi/full/10.1002/fsn3.2904
Nursie
It's not terrible, I've used it in hot drinks (fruit green teas) to give some sweetness.
Doesn't immediately taste horrific like Stevia.... I'm glad the fashion for shoving that in everything has passed.
mock-possum
Last I checked, xylitol tastes sweet but is actually fairly lethal to plaque-causing bacteria… on the other hand, it’s also a laxative.
Oh also it’s super lethal for dogs.
I only chew gum if it has xylitol in it.
card_zero
For all three reasons? The implied lifestyle delights me.
deepnet
Xylitol is a sugar from birch tree sap.
abcd_f
It was also linked to the elevated risk of blood clots in another study a couple of years ago. Even then it instantly looked like an instant "nope" ... and now this.
thangalin
UCSF Professor of Pediatrics in the Division of Endocrinology, explores the damage caused by sugary foods. He argues that fructose (too much) and fiber (not enough) appear to be cornerstones of the obesity epidemic through their effects on insulin.
mkfs
This is about sugar alcohols, not simple sugars, and total sugar consumption in the US has been declining since a peak around the turn of the millennium, reverting back to levels on par with the 1970s, yet overweight/obesity rates just kept right on climbing until the recent advent of GLP-1 drugs.
netdevphoenix
If your calorie intake is higher than your calorie usage, it doesn't matter how little sugar you take. People ingest more calories than ever (relative to their calorie usage) and barely engage in physical activities (relative to their calorie intake). Sure, other factors might worsen this but doesn't change the underlying core
PaulRobinson
Most nutritionists would today argue that is far too simple a model. Your body does not metabolize all calories in the same way. The role of your microbiome in terms of metabolization was barely understood at all only 50 years ago, and we're only now starting to get a handle on it.
If it were a case of "calories in, calories out", all the experiments down by food technicians to understand what is happening in the brain when you consume certain flavors (they were literally getting people to taste soda in an MRI scanner decades ago), would not be an efficient use of time and the food industry would collapse.
If you eat 2000 kCals of lettuce, your body is going to do very, very different things to eating 2000 kCals of potato fries, including how it stores or consumes energy in that moment. Importantly, what your body does is likely going to be very different to what my body does. 10% of the population can stay slim while over-eating crap, because they are genetically lucky. A %age of the population will struggle to stay at a healthy BMI even if they eat mostly salads and fruits.
This isn't radical new age voodoo: the best science available today tells us the calories in/out model isn't anywhere near nuanced enough to help educate people on eating healthily and managing their weight.
Tim Spector has written some material on this, and I've been reading Camilla Stokholm's book recently. It's all quite interesting, and very different to what I was taught when growing up.
I'd also do some digging on ultra-processed foods - it might stop you thinking overweight people are just doing it to themselves. They're not.
scoofy
This model doesn’t account for the fact that hunger and satiety are chemical processes, not physical processes.
It’s like saying people who want to stay awake when they are tired should just keep their eyes open.
wglb
Article in Physioliogy https://journals.physiology.org/doi/10.1152/japplphysiol.002...
mjd
Thanks.
This is the study that the article is talking about. The complete paper is https://journals.physiology.org/doi/pdf/10.1152/japplphysiol...
It's based on earlier work that suggests that erythritol consumption is associated with increased risk of stroke or myocardial infarction: https://www.nature.com/articles/s41591-023-02223-9
wglb
Thanks!
TimorousBestie
In vitro with human cells, at a reasonable concentration, apparently. Looks worrying.
latchkey
Almost every single other sugar substitute is filled with erythritol as an additive. Monk Fruit products tend to be really bad offenders. Check the labels carefully.
ShakataGaNai
This I found out the unfortunate way. I used some popular monk fruit sweetener... packets were just monk fruit but the bulk packages were monk fruit/erythritol blend and I didn't pay enough attention to the label. Made lemonade with it.
Spent the rest of the day on the toilet.
fellowniusmonk
Liquid sweeteners are fine, I switched to liquid monk fruit stevia blend, really like it.
aitchnyu
Monk fruit products seem to be false advertising. Why are pure monkfruit sweeteners rare?
xtracto
Because of the price of Monk Fruit. Pure monk fruit is expensive.
TomMasz
I casually follow the FODMAP diet and avoid sugar alcohols where possible. It's surprising how many sugar substitutes include it, sometimes as the primary ingredient. I've found a pure stevia powder that tastes okay, but it isn't cheap and is only sold in a local health food store.
Bender
I can't even consume it. More than about 5g gives me visual auras, migraines. I'm not alone on this.
sgt
What about aspartame[sic]?
chrisco255
Aspartame is fine in things like soda, but the reason erythritol is mixed with monk fruit (and perhaps aspartame as well?) is it is closer to the sweetness level of sugar in terms of sweetness per gram, and so it's usually easier to use in recipes that are based on sugar quantities.
_ink_
Is any amount dangerous? Or would you need to drink 6 Bottles of something with Erythritol daily to see the effect?
ipsum2
It's in the article:
"Human cerebral microvascular endothelial cells were cultured and exposed to an amount of erythritol equivalent to consuming a typical beverage. Experimental conditions included five biological replicates per group."
So it needs to cross the blood-brain barrier. From the research paper: "Moreover, it is important to note that erythritol does cross the blood brain barrier and interact with the cerebrovasculature". Unclear what percentage this is.
HexPhantom
Always tricky translating cell culture doses to what actually happens in a living person, but it sounds like there's at least a plausible mechanism here.
Eisenstein
Human cerebral microvascular endothelial cells are the blood brain barrier.
rayiner
Why are companies allowed to put this stuff in food before testing to prove safety? Our system is backwards.
voidfunc
Lol at all the people in this thread stressing out about their artificial sweetener consumption while disregarding all the other dangerous shit they do, eat, and drink.
Forest for the trees.
DHRicoF
I partially agree with you. But the selling point of artificial sweeteners was that they were a healthier substitute.
It's better to teach people that there is no free lunch, and they should take care about the calories they are consuming, even if that imply reduce frequency of sweet foods, than sugar coating an equally bad alternative to make it sound like it's healthier.
const_cast
1. Artificial sweeteners are healthier substitutes. Aspartame is truly a free lunch. It's not carcinogenic, it's zero-calories for real, it doesn't cause X Y Z. It's perfectly safe.
2. "no free lunch" is a phrase we need to retire forever. Yes, there is free lunch, we do it all the time. That's why infant mortality was 50% and now it's 1 in 1000. That's just called progress, we make things better all the time. That's kind of what humans do.
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maksimur
Maybe they have omitted those because the focus is on artificial sweeteners? As for myself I try to avoid anything that could be dangerous, not only what I eat or drink.
mkfs
It's even funnier when you realize a good chunk of them are still doing low-carb diets like keto or carnivore, gorging on saturated fat, cholesterol, and sodium.
lithocarpus
There's nothing wrong with eating saturated fat, cholesterol, and sodium.
I've known people who have diabetes eating industrial potato chips telling me they stay away from butter and eggs and red meat because of the cholesterol and saturated fat. It's backwards.
These are natural parts of real food that have been eaten in significant quantities by humans for many tens of thousands of years.
I haven't gone as thoroughly into the literature on saturated fat but I don't think I need to. The few studies I've looked at had basic obvious flaws. Saturated fat made up a big part of people's diets in many regions, long before the modern epidemics of diabetes and heart disease. Personally I've been "gorging" on it for ten years now and am in excellent health.
I did look at many of the papers used to say sodium is bad and found that that is not a valid conclusion from those papers. Of course don't overdo salt but the problem shown by most of the studies is probably with processed food which has a lot of sodium, not the sodium itself.
const_cast
> There's nothing wrong with eating saturated fat, cholesterol, and sodium.
Yes there is: diets high in saturated fats cause heart disease in the long term. There's a lot of meta-analysis on this, it's very much established.
> Saturated fat made up a big part of people's diets in many regions, long before the modern epidemics of diabetes and heart disease.
No, no they don't. This is a common misconception.
High saturated fats come from farmed meat, which is a fairly new phenomenon. Game meat is actually typically very low in saturated fat, and high in unsaturated fat.
In addition, high meat consumption is a new thing. Past 100 years only. Pre-historic humans were hunter-gathers, but almost all their diet was carbohydrates. They ate upwards of 100 grams of fiber a day and little to no meat, because meat is quite hard to get. Even after that meat consumption remained low, up until the past hundred years where wealth and farming allowed high meat consumption.
But, even today, you might be shocked to know that most humans globally do not eat a diet high in meat. It's only the west.
HexPhantom
Modern health anxiety in a nutshell
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almosthere
Switch to Stevia, but it kind of has a weird taste imo
Yizahi
It seems to be individual and depends on brand. I'm buying Stevia Inulina, it tastes fine for me and it doesn't contain Maltodextrin as do some other sweeteners. The only problem is that it is less popular and hard to find, compared to shelves filled with Xylitol and Erythritol.
htx80nerd
Test tube study.
> Human cerebral cells were cultured and treated with 6 mM of erythritol, equivalent to a typical amount of erythritol [30g] in an artificially sweetened beverage, for 3 hr.
the cells were in the substance for 3hrs? I'm not reading the whole study now, but that sounds...interesting.
The study : https://journals.physiology.org/doi/epdf/10.1152/japplphysio...
From a quick read : It was tested in a cell culture, so not in a human or animal. That does change a lot of things.
For the dosage:
> Thereafter, hCMECs were treated116 with regular media or media containing 6 mM erythritol (Sigma Aldrich, Cat #E7500; St. Louis MO), a117 dose equivalent to a typical amount of erythritol [30g] in a single can of commercially available118 artificially sweetened beverage, for 24 hours (N=5 experimental units)