A sweetener that’s often seen as a healthy replacement for sugar might not be as safe as many people think.
New research shared at the 2025 American Physiology Summit in Baltimore shows that erythritol, a common sugar substitute, could be harmful to the brain’s blood vessels and might increase the risk of heart attack or stroke.
Erythritol is used in many sugar-free foods and drinks. You’ll find it in things like diet sodas, low-calorie snacks, and protein bars. It’s very popular among people with diabetes and those trying to lose weight, because it has almost no calories and doesn’t raise blood sugar or insulin levels much.
Erythritol belongs to a group of sweeteners called sugar alcohols, which are used to make food taste sweet without the negative effects of regular sugar.
But some new studies are starting to show that erythritol may not be as harmless as once thought. Earlier research has linked higher levels of erythritol in the blood to a greater risk of heart problems, including strokes and heart attacks.
That’s why scientists have started to look more closely at how it might affect the body, especially the blood vessels that are so important for staying healthy.
In the latest study, researchers at the University of Colorado Boulder studied how erythritol affects small blood vessels in the brain. They used special human cells that line these tiny blood vessels, known as cerebral microvascular endothelial cells.
These cells are important because they help control blood flow in the brain, protect the brain from damage, and help break down blood clots.
The scientists exposed these cells to a level of erythritol similar to what someone might get from just one drink sweetened with this ingredient. After the exposure, the cells began to show signs of trouble.
There was more oxidative stress, which is a harmful process that happens when unstable molecules damage healthy cells. Too much oxidative stress can lead to inflammation and harm the blood vessels.
The study also found that the cells produced less nitric oxide. This is a natural chemical that helps blood vessels relax and widen.
This process is important for keeping blood pressure normal and making sure the brain and body get enough blood. Without enough nitric oxide, blood vessels may not work properly, and that can raise the chances of blood clots, strokes, or heart attacks.
Auburn Berry, the lead author of the study and a graduate student at the University of Colorado Boulder, said that people should pay attention to how much erythritol they consume.
“While erythritol is widely used in sugar-free products marketed as healthier alternatives, more research is needed to fully understand its impact on vascular health,” she said.
It’s important to know that this study was done in a lab using cells, not in people. That means we can’t say for sure that erythritol causes harm in everyday life. Still, the changes seen in the lab were similar to what scientists have seen in people with high erythritol levels before.
This research adds to growing concerns about sugar substitutes. Erythritol may have some benefits, like being low in calories and not affecting blood sugar much, but its possible effects on the brain and heart are becoming harder to ignore.
Scientists agree that more research is needed, especially studies that look at what happens when people eat or drink erythritol regularly over a long time.
For now, it might be a good idea to be cautious. People trying to cut down on sugar may want to avoid too many products with erythritol and instead choose a balanced diet with real, natural foods. That could be a safer way to protect both your heart and your brain.
If you care about heart health, please read studies about how eating eggs can help reduce heart disease risk, and herbal supplements could harm your heart rhythm.
For more health information, please see recent studies about how drinking milk affects risks of heart disease and cancer, and results showing strawberries could help prevent Alzheimer’s disease.
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