A sweetener that many people use to avoid sugar may not be as healthy as it appears. New research is raising concerns about erythritol, a common sugar substitute found in many “sugar-free” foods and drinks.
Scientists now believe this sweetener could affect the blood vessels in the brain and may increase the risk of serious health problems such as heart attacks and strokes.
The research was presented at the 2025 American Physiology Summit in Baltimore. The study was carried out by researchers from the University of Colorado Boulder, who wanted to better understand how erythritol affects the body, especially the blood vessels that help carry blood and oxygen to the brain.
Erythritol has become very popular in recent years. It is often added to diet soft drinks, protein bars, low-calorie desserts, sugar-free gum, and snacks marketed as “healthy” alternatives to sugary foods.
Many people choose erythritol because it contains almost no calories. Unlike regular sugar, it also does not cause large increases in blood sugar or insulin levels. Because of this, it is widely used by people with diabetes, people trying to lose weight, and people following low-carb diets.
Erythritol belongs to a group of sweeteners called sugar alcohols. These sweeteners are designed to taste sweet while avoiding some of the harmful effects linked to regular sugar, such as weight gain, tooth decay, and blood sugar spikes. Food companies often promote products containing erythritol as better choices for health-conscious consumers.
But scientists are becoming increasingly concerned that erythritol may not be completely safe. Earlier studies already found that people with higher levels of erythritol in their blood seemed to have a greater chance of suffering heart attacks or strokes.
These earlier findings did not prove that erythritol directly caused the problems, but they raised enough concern for researchers to look more closely at how the sweetener affects blood vessels.
In the new study, the researchers focused on tiny blood vessel cells from the human brain. These cells are known as cerebral microvascular endothelial cells.
They line the inside of small blood vessels and play a very important role in keeping blood flow healthy. They help control circulation, protect the brain from damage, and support the body’s ability to dissolve blood clots.
The scientists exposed these cells to an amount of erythritol similar to what a person might consume after drinking one sweetened beverage. After the exposure, the researchers noticed several worrying changes inside the cells.
One major problem was an increase in oxidative stress. Oxidative stress happens when harmful unstable molecules build up in the body and damage cells.
Scientists believe oxidative stress plays an important role in aging and many diseases, including heart disease, Alzheimer’s disease, and stroke. When blood vessels experience oxidative stress, they can become damaged and inflamed, making it harder for blood to flow properly.
The researchers also discovered that the cells produced less nitric oxide after being exposed to erythritol. Nitric oxide is extremely important for healthy blood vessels. It helps blood vessels relax and widen so blood can move smoothly through the body.
This widening process is called vasodilation. Healthy vasodilation helps maintain normal blood pressure and ensures that important organs like the brain receive enough oxygen and nutrients.
When nitric oxide levels drop, blood vessels may become narrower and less flexible. This can increase pressure inside the vessels and may make it easier for blood clots to form. Blood clots can block blood flow to the heart or brain, leading to heart attacks or strokes.
The study’s lead author, Auburn Berry, a graduate student at the University of Colorado Boulder, said the findings suggest that people should be more careful about how much erythritol they consume.
She explained that even though erythritol is often marketed as a healthier alternative to sugar, scientists still need to learn much more about its long-term effects on blood vessel health.
The researchers emphasized that this study was done in a laboratory using cells, not in living humans. This means the study does not prove that erythritol directly causes heart attacks or strokes in everyday life.
However, the changes observed in the blood vessel cells were similar to problems that researchers have seen in earlier human studies involving high erythritol levels.
These findings are adding to a growing debate about artificial sweeteners and sugar substitutes. For years, many people believed that replacing sugar with low-calorie sweeteners was always a healthier choice. However, scientists are now discovering that some sugar substitutes may have unexpected effects on the body.
Experts say more research is needed before firm conclusions can be made. Future studies will need to examine how erythritol affects the human body over long periods of time and whether some people may be more vulnerable than others.
For now, health experts suggest moderation may be the safest approach. Reducing excessive sugar intake is still important for good health, but relying heavily on sugar-free processed foods may not always be the best answer.
Eating a balanced diet with more natural foods and fewer highly processed products may still be one of the safest ways to protect heart and brain health.
If you care about health, please read studies about the benefits of low-dose lithium supplements, and what we know about egg intake and heart disease.
For more health information, please see recent studies about potatoes and high blood pressure, and results showing 6 best breads for people with heart disease.
The findings were presented at the 2025 American Physiology Summit in Baltimore.
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