Many people choose sugar substitutes to cut calories, manage diabetes, or lose weight. One of the most common is erythritol, a sweetener found in sugar-free drinks, protein bars, chewing gum, desserts, and many other low-calorie foods.
Because it contains almost no calories and has little effect on blood sugar levels, erythritol has long been promoted as a healthier replacement for ordinary sugar.
However, scientists are becoming increasingly interested in whether this sweetener may have hidden health risks. Several recent studies have linked higher levels of erythritol in the blood with a greater chance of heart attack and stroke.
Although these studies did not prove that erythritol was the cause, they raised important questions about how it might affect the body’s blood vessels.
A new study from the University of Colorado Boulder has added more evidence to this growing debate. The findings were presented at the 2025 American Physiology Summit in Baltimore. The research focused on the tiny blood vessels in the brain, which play a vital role in delivering oxygen and nutrients while helping protect brain tissue from damage.
The scientists carried out laboratory experiments using human cerebral microvascular endothelial cells. These are the cells that line the inside of the brain’s smallest blood vessels. Healthy endothelial cells help control blood flow, keep blood vessels flexible, and reduce the risk of harmful blood clots.
The researchers exposed these cells to an amount of erythritol similar to what a person might consume after drinking a single sugar-free beverage. After exposure, the cells showed signs of increased oxidative stress. Oxidative stress occurs when unstable molecules build up faster than the body can control them, damaging cells and increasing inflammation over time.
Another important finding involved nitric oxide, a natural substance made by blood vessel cells. Nitric oxide helps blood vessels relax and widen so blood can flow easily throughout the body. This process is essential for keeping blood pressure healthy and ensuring that the brain receives enough oxygen and nutrients.
The study found that erythritol reduced the amount of nitric oxide produced by the cells. With lower nitric oxide levels, blood vessels may not widen as effectively, making it more difficult for blood to circulate properly. Poor blood vessel function can increase the risk of developing blood clots and may contribute to heart attacks or strokes.
Lead researcher Auburn Berry said the findings suggest that people should be aware of how much erythritol they consume. Although the sweetener is widely used in foods marketed as healthier choices, she explained that more research is needed before scientists fully understand its effects on blood vessel health.
It is important to remember that this study was performed in a laboratory using human cells rather than in people. This means the results do not prove that drinking products containing erythritol will directly cause heart disease or stroke.
Even so, the changes observed in the cells are similar to problems reported in earlier studies involving people with higher erythritol levels, making the findings worthy of further investigation.
Scientists say larger human studies are now needed to determine whether long-term consumption of erythritol increases cardiovascular risk.
Until more evidence is available, people may wish to enjoy sugar substitutes in moderation and focus on a balanced diet based mainly on whole, minimally processed foods. The research highlights that even products promoted as healthy alternatives should continue to be carefully studied as new scientific evidence emerges.
If you care about inflammation, please read studies about turmeric: nature’s golden answer to inflammation, and what to eat to reduce chronic Inflammation.
For more health information, please see recent studies about how a plant-based diet could help ease inflammation ,and Vitamin D deficiency linked to increased inflammation.
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