ust a single serving of an erythritol-sweetened beverage may harm brain and blood vessel health, according to a new cellular study. Image credit: Mats Silvan/Getty Images.
Recent studies suggest a connection between higher levels of erythritol — a popular sweetener — in the blood and an increased risk of vascular health issues, such as blood clotting, heart disease, and stroke.
New cellular research adds supporting evidence that the amount of erythritol in just 1 serving of a beverage could harm brain and blood vessel health.
Experts advise limiting or avoiding erythritol and opting for what seem to be safer noncaloric sweeteners, such as stevia and monk fruit extract.
Erythritol is a sugar alcohol widely used as a noncaloric sweetener in sugar-free products, such as keto-friendly snack bars, energy drinks, and sugar-free chewing gum.
It has been approved as a food additive in the United States since 2001 and marketed as a healthy sugar alternative for individuals trying to lose weight or manage their blood sugar levels.
Despite its popularity, there have been growing concerns about the safety of erythritol and its potential side effects on human health.
Recent research proposes a link between higher levels of erythritol in the blood and an increased risk of heart attack or stroke. This may be partly due to increased blood clot formation.
Now, a new cell study further indicates that the amount of erythritol found in a single beverage serving may negatively impact brain and blood vessel health.
The findings suggest it increases oxidative stress and reduces nitric oxide production in brain blood vessel cells, which may impair blood flow, contributing to a higher risk of vascular events like stroke.
The study abstract was presented at the 2025 American Physiology Summit (APS2025), April 24–27, 2025, in Baltimore, MD.
ust a single serving of an erythritol-sweetened beverage may harm brain and blood vessel health, according to a new cellular study. Image credit: Mats Silvan/Getty Images.
Recent studies suggest a connection between higher levels of erythritol — a popular sweetener — in the blood and an increased risk of vascular health issues, such as blood clotting, heart disease, and stroke.
New cellular research adds supporting evidence that the amount of erythritol in just 1 serving of a beverage could harm brain and blood vessel health.
Experts advise limiting or avoiding erythritol and opting for what seem to be safer noncaloric sweeteners, such as stevia and monk fruit extract.
Erythritol is a sugar alcohol widely used as a noncaloric sweetener in sugar-free products, such as keto-friendly snack bars, energy drinks, and sugar-free chewing gum.
It has been approved as a food additive in the United States since 2001 and marketed as a healthy sugar alternative for individuals trying to lose weight or manage their blood sugar levels.
Despite its popularity, there have been growing concerns about the safety of erythritol and its potential side effects on human health.
Recent research proposes a link between higher levels of erythritol in the blood and an increased risk of heart attack or stroke. This may be partly due to increased blood clot formation.
Now, a new cell study further indicates that the amount of erythritol found in a single beverage serving may negatively impact brain and blood vessel health.
The findings suggest it increases oxidative stress and reduces nitric oxide production in brain blood vessel cells, which may impair blood flow, contributing to a higher risk of vascular events like stroke.
The study abstract was presented at the 2025 American Physiology Summit (APS2025), April 24–27, 2025, in Baltimore, MD.
How erythritol may harm brain and blood vessel health
Erythritol may negatively impact brain and blood vessel health by directly interfering with cellular processes, according to experts.
Berry told MNT that erythritol disrupts the production of nitric oxide, a molecule that is essential for blood vessels to relax and widen (dilate) as needed for proper blood flow.
Erythritol does so “by interfering with a key activation step in the cells, making them less effective at producing [nitric oxide],” said Thomas M. Holland, MD, MS, a physician-scientist and assistant professor at the RUSH Institute for Healthy Aging, RUSH University, College of Health Sciences, who was not involved in the study.
This reduced nitric oxide can impair blood vessel function, disrupt circulation, and potentially cause neurovascular damage, he explained.
Holland stated that this decreased nitric oxide could also add to oxidative stress, but “the main driver of oxidative stress in this case is likely the direct impact erythritol has on the cells’ oxidative balance.”
“Erythritol triggers a surge in harmful molecules called reactive oxygen species (ROS), which cause cellular damage. Of particular concern is when these reactive oxygen species cause damage to neural tissue, which can lead to increased rates of cognitive decline. Similarly, ROS’s can cause damage in various organ systems leading to a slew of disease processes. The body tries to defend against this by increasing its internal antioxidant defenses, but the elevated stress remains.”
— Thomas M. Holland, MD, MS
Both experts noted that these cellular effects—reduced nitric oxide production and elevated oxidative stress—are consistent with early events in vascular diseases, including thrombosis and strokes.
Holland pointed out that while these findings are based on lab studies and may not fully replicate human physiology, they align with prior clinical observations linking erythritol to an increased risk of stroke and cardiovascular events.
Expert takeaways: Moderate sweetener intake
Holland commented that “this study offers valuable insights into the potential risks of erythritol on brain blood vessel health, especially for people seeking to improve or protect their vascular and cognitive function.”
“The findings challenge the perception of erythritol as a harmless sugar substitute and underscore the need for moderation, particularly in those with risk factors for vascular disease,” he cautioned.
Berry agreed that individuals concerned about heart or brain health should consider limiting their intake, warning that “regular erythritol consumption may impair blood vessel health and function.”
She stated that “the most important point of our study is that non-nutritive sweeteners, in this case erythritol, can have negative health effects.”
“Based on our cell studies and recent clinical studies, people should be conscious of the amount of erythritol they are consuming on a daily basis,” she emphasized.
Instead of erythritol and other artificial sweeteners, Holland advised opting for more natural options, such as honey or fruit-based sweeteners like date syrup. These can provide antioxidants when used sparingly, though they still impact blood sugar, he noted.
For noncaloric sweeteners, he said, “stevia and monk fruit extract are wonderful and appear to be safer choices for now, as they don’t appear to have the same adverse effects on oxidative stress or blood vessel health.”
However, “reducing overall reliance on sweeteners and focusing on whole foods is likely the most effective path for long-term brain and vascular health,” he concluded
In Conversation: What makes a diet truly heart-healthy?
Two nutrition studies recently made the headlines when they sounded alarm bells regarding the impact of dietary choices on heart health. What are the “ingredients” of a truly heart-healthy diet, and which foods should we avoid and why if we want to lower our risk of cardiovascular disease? This podcast episode finds answers to these and other questions related to heart-healthy dietary choices.
In April 2024, two nutrition studies made the headlines, emphasizing the critical impact of diet on cardiovascular health.
The first study, which appeared in The American Journal of Clinical Nutrition on April 8, was conducted by researchers from the Singapore Institute of Food and Biotechnology Innovation and the Agency for Science, Technology and Research in Singapore.
It involved 89 adults who were at risk for type 2 diabetes, and it made a finding that might, at first, sound surprising, namely: That eating plant-based meat substitutes offered no significant benefits to heart health over actual animal meat.
The second study — whose results were presented at the American College of Cardiology’s Annual Scientific Session at the beginning of April 2024 — was led by experts from Piedmont Athens Regional Hospital in Athens, GA.
It analyzed data from 3,170 participants in the National Health and Nutrition Examination Survey (NHANES)Trusted Source in the United States, all of whom were adults with cardiovascular disease.
This study found that 89% of these consumed more than double the “ideal” allowance recommended by the American Heart Association, which is 1,500 milligrams (mg)Trusted Source of sodium (salt) per day.
But why are certain foods, regardless of whether or not they are plant-based, so bad for the heart? How does salt impact the cardiovascular system? And what makes a diet truly heart-healthy?
In this episode of In Conversation, we discuss these questions and heart-healthy diet tips in conversation with our special guest, Prof. Oyinlola Oyebode, PhD, professor of public health at Queen Mary, University of London, in the United Kingdom.
Oyebode specializes in behavioral risk factors for noncommunicable diseases, particularly diet and issues affecting the health of marginalized populations.
