A sugar substitute that many people see as a safe and healthy choice may not be as harmless as once thought.
New research suggests that erythritol, a sweetener often used in sugar‑free foods and drinks, could damage blood vessels in the brain and possibly raise the risk of heart attack or stroke.
These findings were presented at the 2025 American Physiology Summit in Baltimore and have sparked concern among scientists who study heart and brain health.
Erythritol is widely used in diet drinks, protein bars, low‑calorie snacks, and many foods labeled “sugar‑free.” It tastes sweet like sugar but has almost no calories. Unlike regular sugar, it does not cause a big rise in blood sugar or insulin levels.
For this reason, it has become very popular among people with diabetes and those trying to lose weight. It belongs to a group of sweeteners called sugar alcohols, which are commonly used to replace sugar while still giving food a pleasant taste.
For years, erythritol was believed to be a better choice than sugar because it does not contribute to tooth decay and does not spike blood sugar. However, recent studies have started to question its safety.
Earlier research found that people with higher levels of erythritol in their blood were more likely to suffer from serious heart problems such as heart attacks and strokes. Scientists began to wonder how this sweetener might be affecting the body, especially the blood vessels that carry oxygen and nutrients throughout the body.
In the latest study, researchers at the University of Colorado Boulder looked specifically at blood vessels in the brain. The brain depends on a steady supply of blood to function properly, and even small changes in blood flow can cause serious damage.
The team studied special cells that line the tiny blood vessels in the brain. These cells play a key role in controlling blood flow, protecting the brain from harm, and helping to prevent dangerous clots from forming.
The researchers exposed these cells to an amount of erythritol similar to what a person might consume from just one sweetened drink. After exposure, the cells began to show signs of stress and damage.
One major problem was an increase in oxidative stress, which happens when harmful molecules build up inside cells and start damaging important parts of the cell. This kind of stress is known to contribute to inflammation and blood vessel disease.
Another worrying finding was a drop in nitric oxide production. Nitric oxide is a natural substance made by blood vessel cells that helps them relax and widen. This widening of the vessels allows blood to flow smoothly and helps control blood pressure.
When nitric oxide levels fall, blood vessels can become stiff and narrow, which increases the chance of clots, heart attacks, and strokes.
The lead researcher, Auburn Berry, explained that although erythritol is widely promoted as a healthier option, people may need to pay attention to how much they consume. She noted that more research is needed to fully understand how this sweetener affects blood vessels and overall health.
It is important to note that this study was done in a laboratory using cells, not in real people. This means the results do not prove that erythritol will cause harm in everyday life. However, the changes seen in the cells are similar to problems observed in people who have high levels of erythritol in their blood, which makes the findings harder to ignore.
These results add to a growing debate about artificial sweeteners and sugar substitutes. While they can help reduce sugar intake and lower calories, they may also have hidden effects that scientists are only beginning to understand.
Many experts now suggest that instead of replacing sugar with large amounts of sweeteners, people may benefit more from reducing their overall preference for sweetness and choosing natural, less processed foods.
For now, researchers say there is no need for panic, but moderation is wise. People who rely heavily on sugar‑free products may want to review their diet and consider healthier alternatives. Future studies will help determine whether erythritol is truly safe or whether its use should be limited to protect 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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