Popular sugar substitute may harm brain and heart health

Erythritol, a commonly used sugar substitute often marketed as “healthy,” may impair blood vessel health by disrupting the brain’s ability to produce a critical compound, according to new research. Scientists will present their findings at the 2025 American Physiology Summit in Baltimore. The Summit is the flagship annual meeting of the American Physiological Society.

Erythritol is a low-calorie sugar substitute found in many sugar-free products, including energy drinks, snack foods and protein bars. Like other sugar alcohols, erythritol is popular because it does not affect blood glucose and insulin levels as much as sugar. However, previous research links consumption of erythritol to a higher risk of adverse cardiac events, including stroke.

In a new study, researchers treated human cerebral microvascular endothelial cells—cells from the tiny blood vessels in the brain—with erythritol. They found that the cells exposed to the amount of sweetener in one beverage serving had higher levels of oxidative (cellular) stress. In addition, the cells produced less nitric oxide, a compound that helps blood vessels dilate. Reduced nitric oxide levels can impair vasodilation, impair blood flow, and may increase the risk of heart attack and stroke.

“While erythritol is widely used in sugar-free products marketed as healthier alternatives, more research is needed to fully understand its impact on vascular health,” said Auburn Berry, a graduate student at the University of Colorado Boulder and first author of the study. “In general, people should be conscious of the amount of erythritol they are consuming on a daily basis.”