Blood vessel and brain health may be impacted by common sugar substitutes

According to recent research, there may be a link between elevated blood levels of the common sweetener erythritol and a higher risk of vascular diseases like heart disease, stroke, and blood clotting.

The amount of erythritol in only one serving of a beverage may be detrimental to blood vessel and brain function, according to new cellular study. Experts suggest avoiding or reducing erythritol intake in favour of noncaloric sweeteners like stevia and monk fruit extract, which appear to be safer.

A common noncaloric sweetener in sugar-free goods including energy drinks, sugar-free chewing gum, and keto-friendly snack bars is erythritol, a sugar alcohol. 

Recent research, including a new cell study presented at APS2025, suggests a concerning link between elevated blood levels of the common non-caloric sweetener erythritol and an increased risk of vascular diseases such as heart attack, stroke, and blood clotting.

Recent research, including a new cell study presented at APS2025, suggests a concerning link between elevated blood levels of the common non-caloric sweetener erythritol and an increased risk of vascular diseases such as heart attack, stroke, and blood clotting.

Erythritol, a sugar alcohol found in various "sugar-free" and "keto-friendly" products, has been marketed as a healthy sugar substitute since its U.S. approval in 2001. However, its safety is now under scrutiny. The new cellular study indicates that even a single serving of a beverage containing erythritol could detrimentally impact brain and blood vessel function. Experts like Auburn Berry and Dr. Thomas M. Holland explain that erythritol interferes with crucial cellular processes, leading to increased oxidative stress and reduced nitric oxide production in blood vessel cells. Nitric oxide is vital for blood vessel dilation and proper blood flow, and its impairment can lead to neurovascular damage and impaired circulation.

These cellular effects—decreased nitric oxide and elevated oxidative stress—are consistent with the early stages of vascular diseases and align with prior clinical observations linking erythritol to higher risks of stroke and cardiovascular events. Given these findings, experts recommend minimizing or avoiding erythritol intake in favor of seemingly safer non-caloric sweeteners like stevia and monk fruit extract. The full study is expected to be published in the Journal of Applied Physiology soon.