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July 19, 2025 — Boulder, CO — A new study from the University of Colorado Boulder is sounding the alarm over erythritol, a popular sugar substitute found in countless “sugar-free” and “low-carb” products. The research suggests that even modest amounts of this widely used sweetener may damage brain blood vessel cells, increasing the risk of stroke and other vascular complications.
Published today in the Journal of Applied Physiology, the study reveals that erythritol, long promoted as a safe, calorie-free alternative for people with diabetes, obesity, or those following ketogenic diets, may trigger harmful physiological changes in the brain’s vasculature.
“Our study adds to the growing body of evidence that non-nutritive sweeteners like erythritol are not without risk,” said Dr. Christopher DeSouza, senior author and professor of integrative physiology at CU Boulder. “People assume these substitutes are safe because they don’t spike blood sugar, but our research suggests they may have other consequences.”
The Sweetener in Question
Erythritol is a sugar alcohol that occurs naturally in small amounts but is often mass-produced via fermentation of corn. Approved by the U.S. Food and Drug Administration in 2001, it is about 80% as sweet as sugar and is nearly calorie-free. Because it doesn’t raise insulin levels, it has become a staple in products marketed to those managing metabolic health, from keto ice creams and protein bars to “diet” sodas and sugar-free gums.
But its reputation as a benign alternative is now under serious scrutiny.
A large-scale study published last year involving more than 4,000 participants in the U.S. and Europe found that those with elevated levels of erythritol in their blood were significantly more likely to experience heart attacks or strokes over three years. DeSouza and his research team sought to understand why.
What the Study Found
The CU Boulder researchers treated human endothelial cells, the kind that line blood vessels in the brain, with an amount of erythritol similar to that found in a single sugar-free drink. After just three hours, the changes observed were alarming.
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Reduced nitric oxide: This critical molecule helps relax and widen blood vessels. Treated cells produced significantly less of it.
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Increased endothelin-1: A protein that causes blood vessels to constrict was more prevalent.
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Impaired clot defense: When exposed to thrombin, a clot-promoting compound, the erythritol-exposed cells had a blunted response in producing t-PA, the body’s natural clot buster.
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Elevated oxidative stress: Treated cells generated more reactive oxygen species (ROS), which are damaging free radicals associated with inflammation and cellular aging.
“If your vessels are more constricted and your ability to break down clots is reduced, your stroke risk increases,” explained Auburn Berry, the study’s lead author and a graduate researcher in DeSouza’s lab. “Our findings don’t just show that erythritol could be harmful, they show how it could be harmful.”
A Cautious Warning, For Now
While the study was conducted in a lab setting and not on living humans, the results are significant and mirror previous epidemiological data. The researchers emphasize the need for larger, human-based clinical trials to fully assess erythritol’s long-term safety.
“Until we know more, consumers should be vigilant,” said DeSouza. “Check the ingredients. If you see ‘erythritol’ or ‘sugar alcohol,’ especially in products you consume regularly, it might be time to reconsider.”
He also noted that while the study looked at a single serving, many individuals consume erythritol in much larger quantities throughout the day.
Rethinking “Sugar-Free”
This latest research contributes to growing concern in the scientific and medical communities about the long-term effects of artificial and non-nutritive sweeteners. As more data emerges, consumers and policymakers alike may be forced to reexamine how these ingredients are regulated, labeled, and marketed.
For now, the researchers encourage moderation and greater awareness.
“Just because something is marketed as ‘sugar-free’ doesn’t mean it’s risk-free,” Berry added.
Story Source:
Materials provided by University of Colorado at Boulder. Note: Content may be edited for style and length.
Journal Reference:
- 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, Christopher A. DeSouza. The non-nutritive sweetener erythritol adversely affects brain microvascular endothelial cell function. Journal of Applied Physiology, 2025; 138 (6): 1571 DOI: 10.1152/japplphysiol.00276.2025
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