Major sugar substitute found to impair brain blood vessel cell function

Study design, dosage, and what it really shows

• The experiment was in vitro: human cerebral microvascular endothelial cells (part of the blood–brain barrier) exposed to erythritol at ~6 mM for hours, said to match a drink with ~30 g erythritol.
• Commenters stress this is mechanistic, not direct proof of harm in humans; translation from cell culture to real-life risk is “tricky.”
• The authors themselves acknowledge they cannot make definitive clinical claims but argue the affected pathways are plausibly linked to stroke and vascular damage.

Existing human evidence and conflicting results

• Prior observational work has found higher circulating erythritol associated with elevated risk of heart attack, stroke, and blood clots, especially in already high‑risk patients.
• Another cited study using Mendelian randomization reported no supportive evidence that erythritol increases cardiometabolic disease, highlighting uncertainty.
• Some argue participants in positive studies were sicker, more likely to use sweeteners, and had erythritol measured only once, so diet vs endogenous production is unclear.

Artificial sweeteners vs sugar

• One camp: sugar is clearly harmful in modern diets (extra calories, poor satiety); better to use low‑ or zero‑calorie sweeteners that at worst have tiny risks.
• Opposing camp: decades of concern that sweeteners disrupt metabolism, hunger, and insulin signaling, potentially worsening obesity; argue “no free lunch.”
• Multiple commenters say evidence that aspartame and others are “much worse than sugar” is overstated or simply false, and that meta‑analyses often show neutral or modestly positive effects compared with sugar.

Obesity, metabolism, and “calories in vs out”

• Long back‑and‑forth over whether weight control is primarily calorie balance or fundamentally hormonal/microbiome‑driven.
• Some report personal success with strict calorie tracking; others say sugar and refined carbs uniquely drive cravings and undermine satiety, while artificial sweetness may also confuse regulatory systems.

Trust, regulation, and precaution

• Strong skepticism about industry‑funded safety studies and regulatory standards that allow widespread use before long‑term data.
• Several advocate a precautionary approach: avoid novel additives (including sugar alcohols) when possible, stick to minimally processed “old” foods.

Everyday exposure, symptoms, and alternatives

• Erythritol and other sugar alcohols are noted as ubiquitous: “sugar‑free” ice cream, fake crab, gums, protein powders, energy drinks, and many “monk fruit” blends.
• Some report migraines, body aches, or severe gastrointestinal distress from sugar alcohols or aspartame; others report heavy diet‑soda use with no issues.
• Alternatives discussed: stevia, monk fruit, allulose, xylitol; mixed views on taste, cost, and safety, with some concluding it’s simpler to reduce sweetness overall rather than chase substitutes.