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11:55:44 
2025-07-20 
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New research indicates that erythritol, a sugar substitute commonly recommended for individuals with obesity or diabetes, may carry unexpected health risks.
From low-carb ice creams and keto-friendly protein snacks to “sugar-free” sodas, erythritol is a widely used sweetener found in countless diet and specialty food items.
However, new findings from the University of Colorado Boulder suggest that this commonly used sugar substitute may carry unexpected health risks. According to the research, erythritol can affect brain cells in ways that may increase the likelihood of stroke.
The study was published in the Journal of Applied Physiology
“Our study adds to the evidence suggesting that non-nutritive sweeteners that have generally been purported to be safe, may not come without negative health consequences,” said senior author Christopher DeSouza, professor of integrative physiology and director of the Integrative Vascular Biology Lab.
Erythritol, a sugar alcohol that was first approved by the Food and Drug Administration in 2001, is typically made by fermenting corn. It is found in hundreds of products and is popular for several reasons. It contains nearly no calories, delivers about 80 percent of the sweetness of regular sugar, and has little effect on blood sugar or insulin levels. These traits make it especially appealing to people focused on weight loss, low-carb diets, or blood sugar management.
But recent research has begun to shed light on its risks.
Linking Erythritol to Cardiovascular Events
One recent study involving 4,000 people in the U.S. and Europe found that men and women with higher circulating levels of erythritol were significantly more likely to have a heart attack or stroke within the next three years.
DeSouza and first author Auburn Berry, a graduate student in his lab, set out to understand what might be driving that increased risk.
Researchers in the lab treated human cells that line blood vessels in the brain for three hours with about the same amount of erythritol contained in a typical sugar-free beverage.
They observed that the treated cells were altered in numerous ways: They expressed significantly less nitric oxide, a molecule that relaxes and widens blood vessels, and more endothelin-1, a protein that constricts blood vessels. Meanwhile, when challenged with a clot-forming compound called thrombin, cellular production of the natural clot-busting compound t-PA was “markedly blunted.” The erythritol-treated cells also produced more reactive oxygen species (ROS), a.k.a. “free radicals,” metabolic byproducts which can age and damage cells and inflame tissue.
Why Stroke Risk May Increase
“Big picture, if your vessels are more constricted and your ability to break down blood clots is lowered, your risk of stroke goes up,” said Berry. “Our research demonstrates not only that, but how erythritol has the potential to increase stroke risk.”
DeSouza notes that their study used only a serving-size worth of the sugar substitute. For those who consume multiple servings per day, the impact, presumably, could be worse.
The authors caution that their study was a laboratory study, conducted on cells, and larger studies in people are needed.
That said, De Souza encourages consumers to read labels, looking for erythritol or “sugar alcohol” on the label.
“Given the epidemiological study that inspired our work, and now our cellular findings, we believe it would be prudent for people to monitor their consumption of non-nutrient-sweeteners such as this one,” he said.
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