A sweetener that many people choose instead of sugar is now being questioned by scientists.
Erythritol is found in many sugar-free drinks, snacks, desserts, and protein products because it tastes sweet but contains very few calories.
It is also popular with people who have diabetes or who are trying to lose weight because it has little effect on blood sugar levels.
For years, it has been promoted as a healthier option than regular sugar, but new research suggests the story may be more complicated.
Scientists are becoming increasingly interested in erythritol because several earlier studies found that people with higher levels of the sweetener in their blood were more likely to experience heart attacks or strokes.
Those studies showed a link but could not prove that erythritol was the direct cause.
Researchers therefore wanted to understand what this sweetener might be doing inside the body, especially in blood vessels that play a vital role in keeping the brain healthy.
The latest findings were presented at the 2025 American Physiology Summit in Baltimore by researchers from the University of Colorado Boulder. The study has been shared at the scientific meeting but has not yet been published in a peer-reviewed journal. The team focused on tiny blood vessels in the brain because these vessels help deliver oxygen and nutrients while also protecting delicate brain tissue.
The researchers carried out laboratory experiments using human brain blood vessel cells. They exposed the cells to an amount of erythritol that was similar to what a person might consume from a single drink made with the sweetener. Even after this short exposure, the scientists noticed several changes that suggested the cells were under stress.
One important finding was a rise in oxidative stress. This happens when harmful molecules build up faster than the body can control them, allowing them to damage healthy cells. Too much oxidative stress has long been linked with inflammation and problems affecting blood vessels.
The team also found that the cells produced less nitric oxide. This natural substance helps blood vessels relax and widen so blood can flow easily throughout the body. If blood vessels cannot relax properly, blood flow may become less efficient and the risk of blood clots, heart attacks, or strokes could increase.
The cells also appeared to become less able to support healthy blood vessel function. Because the brain depends on a steady blood supply every second, even small changes in these tiny vessels may matter. Healthy blood vessels also help prevent clots and support the brain’s normal repair processes.
Lead researcher Auburn Berry said people should pay attention to how much erythritol they consume. She explained that although erythritol is widely used in products marketed as healthier choices, scientists still need more research to fully understand how it affects blood vessel health.
The researchers also stressed an important limitation. Their work was performed on cells in a laboratory rather than in people. That means the study cannot prove that drinking or eating foods containing erythritol will directly cause heart disease or stroke. However, the laboratory findings match concerns raised by earlier human studies, making the results worthy of further investigation.
Experts say much larger studies in people are now needed to discover whether regular long-term intake of erythritol affects the heart and brain. Until those answers are available, choosing a balanced diet based mainly on fresh and minimally processed foods may be the safest approach.
Reducing added sugar remains important, but this research suggests that sugar substitutes should also continue to be carefully studied before they are automatically considered harmless.
If you care about health, please read studies about the best time to take vitamins to prevent heart disease, and vitamin D supplements strongly reduce cancer death.
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