A sugar substitute that many people see as a healthier choice may not be as safe as it appears.
New research presented at the 2025 American Physiology Summit in Baltimore suggests that erythritol, a popular low-calorie sweetener, could affect blood vessels in the brain and possibly increase the risk of serious health problems like heart attack and stroke.
Erythritol is widely used in sugar-free foods and drinks. You can find it in diet beverages, protein bars, low-calorie snacks, and many products labeled as “sugar-free” or “keto-friendly.”
Because it contains almost no calories and has little effect on blood sugar or insulin, it has become especially popular among people with diabetes and those trying to lose weight.
This sweetener belongs to a group called sugar alcohols. These are often used as alternatives to regular sugar because they provide sweetness without the same impact on blood sugar levels. For many years, erythritol has been considered a safer option compared to traditional sugar.
However, scientists have started to question this idea. Earlier studies have found that people with higher levels of erythritol in their blood may have a greater risk of heart problems, including heart attacks and strokes. These findings have led researchers to take a closer look at how erythritol might affect the body, especially the blood vessels.
In the new study, researchers from the University of Colorado Boulder focused on very small blood vessels in the brain. These vessels are lined with special cells that help control blood flow, protect brain tissue, and support the body’s ability to break down blood clots.
To study the effects of erythritol, the researchers used these human cells in a laboratory. They exposed the cells to a level of erythritol similar to what a person might consume from just one sweetened drink. After exposure, the cells began to show signs of stress.
One of the key problems observed was an increase in oxidative stress. This is a harmful process where unstable molecules can damage cells. When oxidative stress rises, it can lead to inflammation and damage to blood vessels.
The researchers also noticed a decrease in the production of nitric oxide. This is an important substance made by blood vessel cells. It helps blood vessels relax and widen, allowing blood to flow smoothly. This process is important for maintaining normal blood pressure and ensuring that the brain receives enough oxygen and nutrients.
When nitric oxide levels drop, blood vessels may not widen properly. This can make it harder for blood to flow and may increase the risk of blood clots. Over time, this could raise the chances of heart attack or stroke.
The lead author of the study, Auburn Berry, explained that while erythritol is often promoted as a healthier choice, people may need to be more careful about how much they consume. She noted that more research is needed to fully understand how this sweetener affects blood vessel health.
It is important to understand that this study was done in a laboratory using cells, not in real people. This means the results do not prove that erythritol directly causes harm in everyday life. However, the changes seen in the cells are similar to problems that have been linked to higher erythritol levels in previous human studies.
Taken together, these findings raise concerns about the safety of erythritol. While it offers benefits such as low calories and minimal impact on blood sugar, its possible effects on blood vessels—especially in the brain—are becoming harder to ignore.
Scientists agree that more research is needed, especially long-term studies in humans. These studies will help determine whether regular consumption of erythritol could lead to real health risks.
For now, this research adds to the ongoing discussion about sugar substitutes. People who want to reduce their sugar intake may need to think carefully about relying too heavily on products that contain erythritol. Choosing a balanced diet with natural foods and moderate sweetness may still be the safest approach for protecting both heart and brain health.
If you care about nutrition, please read studies about why vitamin K is so important for older people, and this snack food may harm your heart rhythm.
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