Common Sweetener May Harm Brain and Heart Health

Erythritol may affect blood vessel function, although experts emphasize that findings are early and require further investigation.

Kabachki.photo via shutterstock

Recent research has found that a popular low-calorie sugar substitute, generally considered a healthy alternative, may potentially increase the risk of heart attack and stroke.

Findings in cell studies, presented at the 2025 American Physiology Summit but not yet peer-reviewed or published, suggest that erythritol—often used in candies and baked goods—might affect the function of blood vessels.

Researchers warned that the sweetener could inhibit the brain’s ability to produce a crucial compound that helps maintain healthy blood flow, but cautioned that more comprehensive studies are needed before drawing definitive conclusions about its safety.

Increase in Oxidative Stress

For this study, researchers found that when human brain cells were exposed to erythritol, these cells exhibited increased oxidative stress—an imbalance in the body between free radicals and antioxidants that can lead to a range of detrimental health effects, including chronic conditions such as cardiovascular disease, neurodegenerative disorders, cancer, and inflammatory diseases.

Additionally, these cells also produced less nitric oxide after being exposed to erythritol. Nitric oxide, a vital compound that allows blood vessels to widen, was reduced. This reduction in nitric oxide may increase heart attack and stroke risk, according to the authors.

“The study utilized a well-established model of human brain endothelial cells, making it highly relevant for investigating cerebrovascular effects,” Auburn Berry, graduate student at the University of Colorado–Boulder and the lead author of the study, told The Epoch Times.

Berry said the study had several limitations. She said the findings were confined to in vitro conditions, meaning that they may not fully reflect what happens in a living organism.

The study also focused on short-term exposure of three hours, “leaving the long-term effects of erythritol consumption unknown,” she said. She noted that only one concentration of erythritol was tested, “which restricts the ability to understand the dose-response relationship.”

However, she emphasized that the erythritol concentrations tested were “physiologically relevant” and closely mimicked real-world dietary exposure.

“The key takeaway from our research is that nonnutritive sweeteners like erythritol can potentially have negative health effects,” Berry said, cautioning that it’s essential for people to be aware of their daily erythritol consumption.

The findings are similar to previous research suggesting that people who had higher levels of erythritol in their bodies were more likely to experience a major adverse cardiac event, such as a heart attack, stroke, or death, within three years. However, that study only found an association and could not prove causation.

A subsequent study by the same researchers at the Cleveland Clinic found that erythritol increases the activity of blood cells that cause clotting.

Erythritol is a naturally occurring substance classified as a sugar alcohol. Although derived from sugar, it is neither sugar nor alcohol. Erythritol provides sweetness without raising blood sugar levels and is low in calories, making it a popular sugar substitute in processed foods.

The body also naturally produces erythritol as a byproduct of glucose metabolism, although the amount produced is minimal.

“Consuming processed foods with sugar alcohols is an easy way to ingest more than what is deemed safe or recommended,” Emily Feivor, registered dietitian at Northwell Health, told The Epoch Times. “Erythritol is used at concentrations at least 1,000 times the natural levels found in food or our bodies.”

Feivor noted that identifying products containing erythritol can be challenging, since the Food and Drug Administration considers the sweetener safe and does not require it to be clearly labeled.

Besides processed foods, erythritol naturally occurs in various fruits, including grapes, pears, and melons, as well as in fermented foods such as soy sauce, beer, and wine. The amounts found in the fruits and fermented foods listed are low compared with the levels found in commercially produced erythritol sweeteners and processed foods containing them.

More Research Needed

It’s difficult to draw “meaningful conclusions” from the findings, Dr. Charles Dinerstein, medical director at the American Council on Science and Health, told the Epoch Times. He noted that the study has not yet been made publicly available, with only minimal information provided in the news release.

He noted several limitations to the research, including uncertainty about the duration of cell exposure to erythritol and whether the experimental conditions accurately reflected what happens when people eat the sweetener.

“The analysis is done in cerebral microvascular cells involved in the integrity of the blood-brain barrier, making it a leap in pathophysiology to explain an increased risk of heart attack,” Dinerstein said. However, a connection to stroke is more plausible.

That said, the brain has a blood-brain barrier, which is designed to protect it from harmful substances circulating in the bloodstream, and its fat-based nature should make it difficult for water-soluble molecules such as erythritol to pass through.

Therefore, more research is needed to determine the health effects of erythritol in the body.