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.
Reference: “The non-nutritive sweetener erythritol adversely affects brain microvascular endothelial cell function” by Auburn R. Berry, Samuel T. Ruzzene, Emily I. Ostrander, Kendra N. Wegerson, Nathalie C. Orozco-Fersiva, Madeleine F. Stone, Whitney B. Valenti, Joao E. Izaias, Joshua P. Holzer, Jared J. Greiner, Vinicius P. Garcia and Christopher A. DeSouza, 16 June 2025, Journal of Applied Physiology.
DOI: 10.1152/japplphysiol.00276.2025
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66 Comments
Is the problem sugar and alcohol in one compound? Does specific food combined play a role, what about blood type?
I wish studies like these would also show the risks of drinking the normal sugar drinks to the body aswell. Are the risks they’ve found with certain sweeteners greater then the risks of a typical sugar sweetner that isn’t labeled zero sugar? Because what’s worse for a person too much sugar or too much artificial sugar?
I agree; which of two purported evils is worse, sugar or sugar substitute?. Also, I would like to see a list of low cal sodas that contain the substance.
Zevia, Virgil’s Zero Sugar Soda, and Blue Sky Zero Sugar. Erythritol is also found in some versions of Red Bull Zero and Dr Pepper, Naturally Sweetened.
Here’s a more detailed look:
Brands using erythritol:
Zevia: This brand is known for its zero-sugar sodas sweetened with stevia and erythritol.
Virgil’s Zero Sugar Soda: These sodas use a combination of erythritol, stevia, and monk fruit for sweetness, according to a product review site.
Blue Sky Zero Sugar: This line of craft soda from The Coca-Cola Co. uses erythritol and stevia.
Red Bull Zero: Contains erythritol, sucralose, and monk fruit extract.
Dr Pepper, Naturally Sweetened. Sometimes in pies, pastries, cookies, ice cream, yogurt.
I just read an article the other day a doctor out of India has discovered a type of sweetener that is actually beneficial to us maybe if you kind of dig around your located I’d never heard of it before but it has some real promising studies for it.
Vitamin Water brand drinks, plus lots of other enhanced flavored water drinks, contain erythritol
what brand name is ezithritol sold as ? Is consuming high sugar drinks and food just as bad
I don’t drink soda but I have seen Zevia. All Zevia products are free from artificial colors, dyes, and erythritol and are non-gmo. They are sweetened with stevia.
Great question.
I agree, so I try very hard to stay away from all sugars I don’t even buy.
Amen and Amen
This study has been debunked for some time now as being very flawed. Ot does not establish cause and effect and did not control for test subjects diets.
Additionally, studies have found that the body actually CONVERTS EXCESS GLUCOSE INTO ERYTHRITOL. So it is possible, subjects with negative outcomes were already consuming high amounts of sugar.
What test subjects diets?
This is a lab study on cells.
Yes. This test was done on cells and may not be representative of a real life diet.
@KM , it states that Zevia is a blend of Stevia & erythritol
There is already a lot of data about high sugar consumption. That’s the problem with sodas in general is too much sugar is put in them by the manufacturers. It is not food it is a form of entertainment. Here’s a link with the info you seek and other studies are at the bottom. Soda everyday is not healthy. We’ve known this since they came out.
https://www.cdc.gov/nutrition/data-statistics/sugar-sweetened-beverages-intake.html#:~:text=Frequently%20drinking%20sugar%2Dsweetened%20beverages,gout%2C%20a%20type%20of%20arthritis.
Every thing in moderation.
It’s funny how the only sugar substitute that the teeth can benefit from as well as people can maintain weight better is being put under the microscope..
With a craftily written headline and Cherry picked study.
Use coconut sugar
STEVIA found far better in small amounts
AND Corn n Soy sprayed with
A T R A C I N E given to Big Agriculture but it causes PERMANENT GENETIC DAMAGE to those forming their hormones aka 8 to 28 years giving TWO SETS OF GENITALS. Look in dog foods. MOST GOOD ONES say NO CHICKEN (FED CORN!) and No Soy.
Do yr own research folks.j
What ARE yOU talKINg aboUT. I can BARely REAd yOur POst
Some products markted as “stevia” also contain erithridol. Read labes carefully.
This isnt the only sugar substitute the teeth benefit from. Since all sugar substitutes aren’t sugar bacteria don’t have sugar, per se, to breakdown into acid that erodes enamel but mouth bacteria still can eat the simple sugars resulting from carbs broken down by the enzyme amylase that’s in saliva.
Xylitol is best, actually helps teeth by
Continued: Xylitol does this by interfering with the bacteria’s ability to produce acid,
Continued: how does xylitol help? Xylitol does this by interfering with the bacteria’s ability to produce acid,
What are they talking about ?? Below this article are few other articles like FRUIT JUICE causes risk of Diabetes in young boys! And EGGS causes diabetes! Every food has become controversal and risky, while in hospital they give us scrambled or boiled eggs and oats for breakfast daily. Every day some articles appear in news media by dieticians and nutritionists like avocado etc causes risks while others saying Avacado id good, meat is good etc. SO NOW WHAT SHOULD WE EAT? I suppose grass plentiful in our front and backyard dont even have to buy. Every article relating to food and health should be censored by CSIRO food science authority before goes to press because it affects our health. IS STEVIA BAD HAS MIX OF ERYTHRIO…
Unfortunately, this same group studied xylitol and found similar effects upon blood clotting. From this I would suspect that all sugar alcohols might eventually be implicated in this very dangerous effect.
It’s important to note from reading this study, they tested it by using 250x the recommended daily amount, not the normal. This was done to analyze how cells reacted when exposed to large amounts, plus this is not a one time thing, this was over the course of weeks. Editors should actually read these studies before putting out click bait.
That is helpful to know. Thank you
I have the solution:
Eat NOTHING and Die Healthy!!! 🤣😅😂
Xylitol is what is supposed to work for tooth decay.
Zevia, Virgil’s Zero Sugar Soda, and Blue Sky Zero Sugar. Erythritol is also found in some versions of Red Bull Zero and Dr Pepper, Naturally Sweetened.
Here’s a more detailed look:
Brands using erythritol:
Zevia: This brand is known for its zero-sugar sodas sweetened with stevia and erythritol.
Virgil’s Zero Sugar Soda: These sodas use a combination of erythritol, stevia, and monk fruit for sweetness, according to a product review site.
Blue Sky Zero Sugar: This line of craft soda from The Coca-Cola Co. uses erythritol and stevia.
Red Bull Zero: Contains erythritol, sucralose, and monk fruit extract.
Dr Pepper, Naturally Sweetened. Sometimes in pies, pastries, cookies, ice cream, yogurt.
You can find and read the abstract to the study. I didn’t see anything that inducted they looked at the things you mentioned.
The term “sugar alcohol” refers to a class of carbohydrates that have a chemical structure resembling both sugar and alcohol, but they do not contain ethanol, the type of alcohol found in beverages. They are derived from sugars and are used as sweeteners in various food products.
What about Monk fruit? Any studies?
I went to my local health store yesterday and every single monkfruit sugar had either erythritol on the front of package or in the ingredients. They are very sneaky and crafty when it comes to what is actually promoted in health foods. Read everything!
What about Snickers Bar???Will this study affect my ability to eat my daily Snickers Bar?
Read the ingredients on your Snicker bar
I feel like this supposed study is designed to get everyone hooked on the new big fad, allulose. Which is far more expensive.
Where are the studies on the effects of allulose in the news?
Did you Google it?
This is a University study, they don’t care what you use.
I find it really funny you think all university research is altruistic and unbiased.
the initial study of 4000 participants led to this study . If the manufacturers of other sweeteners wants to fund a study of 4000 partcipants it can go ahead. Cause scientific. funding by the USA government has been slashed.
I bought some allulose and I needed about 4 times the amount to achieve the same sweetness of the mostly available Stevia/Erythritol product
Read the ingredients on your Snicker bar
You read the ingredients on it
Bad for dogs!
I believe that we have proven that anything made as a corn derivate like corn syrup and other ones are not a healthy choice .
Corn products are in 80 to 90 percent in day to day proceded foods with one name or another.
Corn should be used only exclusively to make alcohol for cars .
Just a opinion.
I have been using stevia since 2015. I am allergic to the other artificial sweeteners. No one carries it as a substitute because of the price except coffee places. Starbucks and cali coffee does. You have to read everything you buy. I even taught my kids what to look for. Some nes are different and can confuse you. I am happy to finally have an ice cream I can have with stevia. Instead of regular ice cream making my sugar go crazy.
Scientists paid by big pharma & big foods, tells you to stop making healthy choices.
Not.
Solid sugar replacement forget about substitute would be date syrup , it’s actually good for you, its full of fiber and date y trees can be grown in arid conditions and fruit stalk leaves bark etc are all used for biodegradable products from clothes to plates. It’s only because corn p products are supported by government funding and are in damn near everything that it continues to exist. They have the audacity to try to blame colorectal cancer happening in younger people on a lack of fiber when it’s really high fructose corn syrup products cuz they don’t want to take the blame for it they blame fiber.
The concentrations tested in vitro were much higher than could be reached in a person who drank an artificially sweetened drink.
I am trying to switch to an anti-inflammatory diet, but some foods are very hard to give up! High-fructose corn syrup is in so many food products, as well as all the other above mentioned unhealthy ingredients!!
Carnivore is the only way as plant matter is toxic and causes inflammation.
All the best✊🏼
What has happened to the years of research that are supposed to be required before a product is approved for human consumption? Someone dropped the ball in finding that this sugar substitute is WORSE than real sugar use! Follow the money of who invented this one!! That one will need to be paying out $$ to people who have serious health issues now. My hand is waiting for a piece!!!
Your opinion is a failed one. Your hands should be removed as not to expose anyone else to such ignorance you thing of no use.
Are you really calling someone “A thing of no use”?
This is just the most recent in a series of increasingly worrisome studies about this non-nutritive sweetener. Several different Medical Centers – including the Cleveland Clinic – have published studies implicating erythritol in causing an increase in cardiovascular events and stroke…most likely caused by an increased risk of blood clotting issues.
Also – this sweetener is being used in gummy vitamins, including a prenatal vitamin called Luminary that is sold by some IVF offices. Pregnant women already have a much higher risk of developing abnormal blood clots. Having them take a prenatal containing erythritol is crazy. Vitamins shouldn’t contain erythritol.
Your opinion is a failed one. Your hands should be removed as not to expose anyone else to such ignorance you thing of no use.
what happens if your magnesium levels are well? is sugar still a problem?
Yes. Bad for teeth. Raises blood sugar if too much consumed at once. Prevents GcMaf marker from activating. Magnesium is used to metabolize sugar.
My cousin had a large brain stroke last year causing him to lose the function of his right hand and leg, and he has type I diabetes, he is just 36. The doctors couldn’t find the cause, now I am wondering if it has sth to do with the artificial sweetener he had instead of sugar all his life.
The first study that was quoted had VERY poor design. I believe it may have been created and published simply to provide negative propaganda about erythritol. Did they look at 4000 people who had weight problems, and were using all sorts of sugar substitutes to get less calories and less insulin response. The fact that those people had more cardiac problems might have been due to their weight problems or other dietary decisions they made! So much pseudoscience gets accepted as truth today…we really need to look at these “studies” carefully before we accept them as truth.
This is ridiculous. How about they write up all the studies done on other sweeteners and publish the carsonagentic problems that go along with them? I’ve been using monk fruit and Erythritol for over 3 years in my coffee and in replacement of sugar in baking. I feel fine.
Great question.
I agree, so I try very hard to stay away from all sugars I don’t even buy.
Amen and Amen
What are they talking about ?? Below this article are few other articles like FRUIT JUICE causes risk of Diabetes in young boys! And EGGS causes diabetes! Every food has become controversal and risky, while in hospital they give us scrambled or boiled eggs and oats for breakfast daily. Every day some articles appear in news media by dieticians and nutritionists like avocado etc causes risks while others saying Avacado id good, meat is good etc. SO NOW WHAT SHOULD WE EAT? I suppose grass plentiful in our front and backyard dont even have to buy. Every article relating to food and health should be censored by CSIRO food science authority before goes to press because it affects our health. IS STEVIA BAD HAS MIX OF ERYTHRIO…
The SciTechDaily article accurately relays the direction of the published findings (erythritol altered brain–vessel cell functions linked to clotting), but its language is alarmist. No brain neurons were tested, no cell death was observed, and the headline “brain cell damage” is a sensational mischaracterization. The study shows only that erythritol can perturb cultured endothelial cells in ways that could hypothetically raise stroke risk  . Even the authors urge caution, saying more research is needed  . In sum, the article exaggerates the findings: it is partly accurate in describing the results on vessel cells, but overstated in implying proven brain harm.
Sources: The original Journal of Applied Physiology study and University of Colorado press releases   ; FDA statement on erythritol safety ; NIH/Cleveland Clinic reports and expert commentary
Well it could people who were already at risk being obese, use this sugar so nitric oxide was already low because they have problem. Even diet coke they say makes you more hungry but could just be that people take healthy drink with bad other choices like diet Coke and Chocolate.