A sweetener that many people use instead of sugar may not be as harmless as it seems.
New research suggests that erythritol, a popular ingredient found in many sugar-free foods and drinks, could affect the health of blood vessels in the brain and may increase the risk of serious conditions such as heart attack and stroke.
Erythritol is widely used around the world as a low-calorie sugar substitute. It is commonly added to products such as diet soft drinks, protein bars, sugar-free snacks, chewing gum, and foods marketed to people with diabetes or those trying to lose weight.
Because erythritol contains very few calories and has little effect on blood sugar levels, it has gained a reputation as a healthier alternative to regular sugar.
The sweetener belongs to a group of ingredients known as sugar alcohols. These substances provide sweetness while avoiding some of the negative effects linked to large amounts of sugar consumption. For years, erythritol has been considered one of the safer options among artificial and low-calorie sweeteners.
However, scientists have recently started to question whether erythritol is completely safe. Several studies published in recent years have found that people with higher levels of erythritol in their blood appear to have a greater risk of cardiovascular problems, including heart attacks and strokes.
These findings have raised concerns and encouraged researchers to investigate how the sweetener may affect the body.
The latest research was presented at the 2025 American Physiology Summit in Baltimore. The study was carried out by researchers at the University of Colorado Boulder, who focused on tiny blood vessels in the brain.
These small vessels play a critical role in delivering oxygen and nutrients to brain cells. They also help maintain healthy brain function and support the body’s ability to respond to injury.
To explore the effects of erythritol, the researchers used human cells that line the inside of these tiny brain blood vessels. These cells are known as cerebral microvascular endothelial cells. They help control blood flow, protect brain tissue, and support the natural process that breaks down blood clots.
The scientists exposed the cells to an amount of erythritol similar to what a person could consume from a single beverage sweetened with the ingredient. After exposure, the cells showed several concerning changes.
One important finding was an increase in oxidative stress. Oxidative stress occurs when harmful molecules called free radicals build up and damage healthy cells. Over time, this damage can contribute to inflammation and problems in blood vessels. Scientists have long linked oxidative stress to a wide range of diseases, including heart disease and stroke.
The researchers also observed a decrease in the production of nitric oxide. Nitric oxide is a natural substance made by the body that helps blood vessels relax and widen. This process allows blood to flow smoothly and helps maintain healthy blood pressure. When nitric oxide levels fall, blood vessels may become less flexible and less able to function properly.
Reduced nitric oxide production can create conditions that make blood clots more likely to form. Blood clots can block blood flow to important organs such as the heart and brain, potentially leading to heart attacks or strokes.
According to Auburn Berry, the lead author of the study and a graduate student at the University of Colorado Boulder, the findings suggest that people should pay attention to how much erythritol they consume.
She noted that although erythritol is often promoted as a healthier choice in sugar-free products, more research is needed to understand its full effects on blood vessel health.
The researchers emphasize that this study was performed in a laboratory using human cells rather than in living people. Because of this, the findings do not prove that erythritol directly causes heart attacks or strokes in everyday life.
Laboratory studies are often an important first step in understanding possible health risks, but further research involving human participants is necessary before firm conclusions can be made.
Even so, the results add to a growing body of evidence suggesting that erythritol may have effects beyond simply replacing sugar. While the sweetener still offers benefits such as low calories and minimal impact on blood sugar, scientists are becoming increasingly interested in its possible influence on blood vessels and cardiovascular health.
Future studies will need to examine what happens when people regularly consume erythritol over months or years. Researchers also hope to determine whether certain groups of people may be more sensitive to its effects than others.
For now, experts suggest moderation. People who want to reduce their sugar intake may benefit from focusing on a balanced diet rich in fruits, vegetables, whole grains, and other minimally processed foods rather than relying heavily on products sweetened with sugar substitutes.
As scientists continue to investigate erythritol, consumers may wish to be aware that a product labeled as sugar-free does not automatically mean it is risk-free.
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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