A sweetener that is often advertised as a healthier replacement for sugar is drawing new attention from scientists.
New research presented at the 2025 American Physiology Summit in Baltimore suggests that erythritol, a common sugar substitute found in many sugar-free foods and drinks, may have unwanted effects on the body.
The findings suggest that it could affect the health of blood vessels in the brain and may potentially increase the risk of serious conditions such as heart attack and stroke.
Erythritol has become very popular in recent years. It is commonly used in diet soft drinks, protein bars, low-calorie desserts, sugar-free candy, and many other products. One reason for its popularity is that it contains very few calories compared with regular sugar.
It also does not cause large increases in blood sugar or insulin levels. Because of these features, erythritol is often recommended for people with diabetes and for those trying to lose weight or reduce their sugar intake.
For many years, erythritol was considered one of the safer sugar alternatives. It belongs to a group of sweeteners known as sugar alcohols. These sweeteners can provide a sweet taste without many of the effects linked to ordinary sugar.
As concerns about obesity, diabetes, and excessive sugar consumption have increased around the world, products containing erythritol have appeared on supermarket shelves in growing numbers.
However, scientists have recently begun to question whether erythritol is completely harmless. Earlier studies found that people with higher levels of erythritol in their blood appeared to have a greater risk of cardiovascular problems, including heart attacks and strokes.
Those findings raised important questions about how this sweetener might affect the body’s blood vessels and circulation system.
In the new study, researchers from the University of Colorado Boulder focused on tiny blood vessels in the brain.
Healthy blood vessels are essential because they deliver oxygen and nutrients to brain cells. They also help remove waste products and support normal brain function. If blood vessels become damaged, the risk of serious health problems can increase.
The research team studied human cerebral microvascular endothelial cells in the laboratory. These are the cells that form the inner lining of small blood vessels in the brain. The scientists exposed the cells to an amount of erythritol similar to what a person might consume from a single sweetened beverage.
After exposure to erythritol, the researchers observed several concerning changes. The cells showed higher levels of oxidative stress. Oxidative stress occurs when harmful molecules build up inside cells and begin to damage important cell structures. Over time, this process can contribute to inflammation and other problems that affect blood vessel health.
The researchers also found that the cells produced less nitric oxide. Nitric oxide plays a very important role in the body because it helps blood vessels relax and widen. When blood vessels widen properly, blood can flow more easily throughout the body and to the brain. This process helps maintain healthy blood pressure and supports normal circulation.
When nitric oxide levels fall, blood vessels may become less able to relax. Reduced blood flow and impaired blood vessel function can create conditions that increase the risk of blood clots. Blood clots can block circulation and may lead to heart attacks or strokes if they occur in critical parts of the body.
Auburn Berry, the lead author of the study and a graduate student at the University of Colorado Boulder, said the findings suggest that people should be aware of how much erythritol they consume.
She noted that erythritol is widely used in products marketed as healthier choices, but more studies are needed to fully understand its effects on blood vessel health.
It is important to note that this research was conducted in a laboratory rather than in living people. This means the study does not prove that erythritol directly causes heart attacks, strokes, or blood vessel damage in everyday life.
Laboratory studies are often used as an early step to identify possible risks and to help scientists decide what questions should be explored in future human studies.
Even so, the results are attracting attention because they match concerns raised by previous research involving people with high erythritol levels in their blood. Together, these studies suggest that the sweetener may deserve closer examination.
Scientists agree that more research is needed before firm conclusions can be made. Future studies will need to investigate how erythritol affects people over long periods of time and whether certain groups may be more vulnerable than others.
For now, the findings add to the ongoing debate about sugar substitutes. While erythritol may still offer advantages such as reducing calorie intake and avoiding large blood sugar spikes, researchers say consumers should remember that “sugar-free” does not automatically mean risk-free.
Choosing a balanced diet that includes mostly natural foods and moderate amounts of sweetness may remain one of the best approaches for supporting both heart and brain health.
If you care about heart disease, please read studies that herbal supplements could harm your heart rhythm, and how eating eggs can help reduce heart disease risk.
For more health information, please see recent studies that apple juice could benefit your heart health, and results showing yogurt may help lower the death risks in heart disease.
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