Erythritol and stroke risk in genetic analysis
What it found
In a genetic analysis of people of European ancestry, higher genetically predicted blood erythritol was linked to a higher risk of ischemic stroke.
The authors say this does not prove that eating erythritol causes stroke.
What they found
Studies in people
Stroke risk link
Genetically predicted blood erythritol showed the strongest link with stroke among the sweeteners tested. The authors report that this link stayed significant after adjusting for blood pressure, blood sugar and blood fats.
Other sweeteners
Aspartame showed a possible link with thromboembolism but not stroke. Sucralose showed no significant links with any of the outcomes tested.
Animal and lab studies
Candidate genes
In lab analyses of stroke-related genes, the authors prioritised MMP9, TLR4 and HIF1A as a three-gene signature. These genes were more active in stroke samples than in controls in two separate datasets.
Possible pathways
The lab analyses pointed to inflammation, oxidative stress, low oxygen and blood vessel injury pathways. The authors say these findings are exploratory and do not show that erythritol directly causes these changes.
Docking with proteins
In computer docking tests, erythritol fitted weakly into pockets of MMP9, TLR4 and HIF1A. The authors say this is only structural evidence and does not prove binding or any effect in the body.
What the authors conclude
“These findings concern circulating erythritol and do not directly establish that dietary erythritol intake causes stroke, because circulating levels may also reflect endogenous production, metabolism, and renal handling.”
Also in their conclusions
- They say the results support an association between genetically predicted erythritol levels and ischemic stroke.
- They advise that the genetic exposure should not be interpreted as direct evidence that dietary erythritol intake causes stroke.
- They call for prospective and interventional studies of high or sustained erythritol consumption, especially in people at higher cardiovascular risk.
How it was done
Erythritol is widely used as a low-calorie sweetener, but its long-term effects on heart and brain health are not well defined. The authors wanted to see whether genetically predicted erythritol levels were linked to stroke and other heart, kidney and metabolic conditions.
They used genetic data from people of European ancestry to compare genetically predicted blood levels of erythritol, aspartame and sucralose against 10 heart, kidney and metabolic outcomes. They then used lab-based bioinformatics to look for possible stroke-related genes and pathways.
What it can’t tell you
- This study used genetic data, not a trial where people were given erythritol. It cannot show that eating erythritol causes stroke.
- The genetic data came mostly from people of European ancestry, so the findings may not apply to other groups.
- The lab analyses did not measure erythritol in the samples, so they cannot show that erythritol directly affects the genes or pathways found.
Who paid
- Funding
- Funded by National Natural Science Foundation of China (from the PubMed record).
- Conflicts
- The authors declare no conflicts of interest.
- Authors work at
- Huazhong University of Science and Technology, China
The paper
- Title
- Risk of Erythritol-Associated Ischemic Stroke: Integrated Genetic, Transcriptomic, and Machine Learning Evidence
- Type
- Study
- Evidence
- Studies in people · animals · lab
- Summarised from
- Full text
- Cite
- Zhong A, Yu F, Xia C, et al (2026). Risk of Erythritol-Associated Ischemic Stroke: Integrated Genetic, Transcriptomic, and Machine Learning Evidence. International journal of molecular sciences. doi:10.3390/ijms27177811Free full textPubMed 42737708DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error