Just a single serving of an erythritol-sweetened beverage may harm brain and blood vessel health, according to a new cellular study.
- 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.
“We expect [the study
to] be published in the Journal of
Applied Physiology in the coming months,” Auburn Berry, MS, first author of the study and a graduate
student in integrative physiology at the University of Colorado Boulder,
told Medical News Today.
Erythritol’s effect on human
brain vessel cells
Researchers at the
Integrative Vascular Biology Laboratory, University of Colorado Boulder,
investigated how erythritol affects oxidative stress and nitric oxide
production in brain blood vessel cells.
In the lab, they exposed
human brain blood vessel cells to an erythritol solution containing roughly the
same amount found in a single can of artificially sweetened beverage (about 30
grams). The cells were left in this solution for 3 hours.
They found that exposing cells to the amount of
erythritol found in a single beverage serving caused significantly higher
levels of oxidative stress compared to untreated cells.
Specifically, cells
exposed to erythritol produced nearly 100% more reactive oxygen species, which
are a type of free radicals,
compared to untreated cells.
Levels of two key
antioxidant enzymes also increased in the erythritol-treated cells, suggesting
the cells were responding to the extra oxidative stress. Additionally, the
erythritol-treated cells produced less nitric oxide.
The study’s authors note
that this increased oxidative stress and reduced nitric oxide levels may
contribute to the heightened risk of vascular diseases and events like stroke
linked to erythritol.
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.
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