Dietary sugar substitutes and “keto-friendly” snacks may come with hidden health expenses. Two new studies suggest common sweeteners including erythropolyol, sucralose and aspartame can damage brain cells, increase the risk of stroke and trigger early adolescence in children.
These findings challenge the general belief that non-nutritional sweeteners provide harmless alternatives to sugar, especially for people who manage diabetes or weight.
Brain cells are attacked
When researchers at the University of Colorado Boulder University exposed human cerebral blood vessel cells to erythropolyol (the amount found in a typical sugar-free beverage), shocking changes were observed in just three hours.
The treated cells produce significantly less nitric oxide, a molecule that relaxes and opens blood vessels. They also agitated more endothelin-1, a protein that contracts blood vessels. Perhaps the most worrying thing is that the cells lose most of their ability to break down blood clots.
“The big picture, if your vessel is more narrow and your ability to break down blood clots reduces your risk of stroke,” said Auburn Berry, a graduate student who leads the lab work.
The study, published in the Journal of Applied Physiology, based on an early study of 4,000 people, showed that those with higher blood levels had a significantly higher chance of having a heart attack or stroke within three years.
Childhood development is at risk
Meanwhile, Taiwanese researchers found that several sweeteners may push children into puberty prematurely – with certain genetic characteristics that make children particularly vulnerable.
A longitudinal study of puberty in Taiwan tracked 1,407 adolescents and found 481 puberty that had developed central precocious puberty. This disease may cause emotional distress, reduce height in adults, and increase the risk of metabolic diseases in life.
The main findings of the study include:
- Sucralose consumption increases early adolescence risk in boys
- Girls are at higher risk of glycerol forest (found in licorice), sucralose and added sugar
- Children with certain genetic characteristics respond particularly strongly to sweetener exposure
- The more sweet teenagers consume, the higher their risk
How sweeteners hijack biology
Previous research by the Taiwan team has found specific mechanisms behind these effects. Potassium propionate (ACEK) activates the “sweet” pathway in brain cells, triggering hormones associated with puberty. Glycoproteins destroy the balance of gut bacteria and reduce the activity of genes that usually regulate time of puberty.
“This suggests that children’s diet, especially products with sweeteners, may have a surprising and powerful impact on their development,” said Dr. Yang-Ching Chen, PhD, Taipei Medical University.
Rethinking “safe” alternatives
Erythritol has been approved by the FDA since 2001 and has appeared in hundreds of products, ranging from protein bars to sugar-free ice cream. For those who avoid carbohydrates, there are few calories and minimal effects on blood sugar, which seems to be the ideal solution.
But Christopher Desouza, who directed the Laboratory of Integrated Vascular Biology at Cu Boulder, warned that appearances could be deceptive. His team found that cells treated with erythropodol also produce more reactive oxygen species, “free radicals” age and damage to tissue.
“Our study adds evidence that, often referred to as a safe non-nutritional sweetener, may have no negative health consequences,” Desouza said.
For those who consume multiple servings of sweetener products per day, the cumulative impact can be large. Desouza encourages consumers to check labels for erythrite or “sugar wine” lists.
Taiwan’s findings suggest that genetic screening in combination with a moderate amount of sweetener may help prevent early adolescence. Chen believes that the study could shape new dietary guidelines and risk assessment tools for children’s health.
Both research teams stressed the need for a lot of human research. But the cellular mechanisms they found (from narrow blood vessels to hormone destruction) were time to reconsider whether these sugar substitutes were truly getting free passes from health consequences.
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