Erythritol Linked to Increased Risk of Heart Attack and Stroke, New Research Reveals

Recent studies have brought artificial sweeteners, particularly erythritol, back into the spotlight due to emerging health concerns linked to their consumption. Seemingly innocuous and marketed as healthy alternatives, sugar-free sodas and candies often contain erythritol, a sugar alcohol thought to be a safe, low-calorie sweetener. However, research indicates that this may not be the case. Presented at the 2025 American Physiological Society Meeting, a new study has found that erythritol may instigate biological changes in the body that raise the risk of cardiovascular incidents, specifically heart attacks and strokes. Researchers conducted cell experiments using microvascular endothelial cells from the brain and exposed them to the concentration of erythritol found in a single serving of a typical drink. The results were alarming: cells exposed to erythritol exhibited higher levels of oxidative stress—a condition that results in cellular damage and has been linked to aging and various diseases, including cancer. Additionally, the study demonstrated a decrease in the production of nitric oxide in these cells. Nitric oxide is essential for blood vessel dilation, and lower levels can severely impact blood flow, contributing to cardiovascular issues. The lead author of the study, Auburn Berry from the University of Colorado Boulder, emphasized that despite erythritol's popularity as a 'safe' sugar alternative, its associations with increasing cardiovascular events warrant caution. Experts Scott Keatley, RD, and Christopher Yi, MD, further reinforced these concerns. Keatley pointed out that while erythritol registers low on the glycemic index and is marketed as a natural substitute for sugar, its health risks—especially when consumed in high amounts—are increasingly supported by research. Dr. Yi explained how erythritol can disrupt metabolic processes within brain cells, potentially leading to harmful outcomes by damaging cells and accumulating reactive oxygen species that complicate cardiovascular health. The findings come in the context of growing scrutiny regarding artificial sweeteners. Historical studies have often identified correlations between these substitutes and health issues, but public perception has largely been swayed by marketing that touts them as healthier choices compared to traditional sugars. In recent years, concerns have escalated regarding the potential for artificial sweeteners to contribute to increased appetite and, paradoxically, greater body fat accumulation. Health professionals and researchers alike are calling for moderation in the consumption of erythritol. Even though it is classified as "generally recognized as safe" (GRAS) by the FDA, experts like Keatley advocate for consumers, especially those at heightened risk for cardiovascular events, to be cautious about their intake. In summary, while erythritol has been perceived as a healthier alternative to sugar, emerging research calls into question its safety and potential health consequences. As consumers continue to seek out sugar substitutes, the dialogue surrounding the safety and implications of artificial sweeteners like erythritol is increasingly relevant. The need for further research to delineate these risks and establish clearer guidelines for consumption is urgent. Until such clarity is provided, caution and moderation are recommended for anyone consuming products containing erythritol, particularly among those with pre-existing health conditions.