A study released on July 14, 2025 by researchers at the University of Colorado Boulder has revealed concerning findings about erythritol, a widely used sugar substitute. Published in the Journal of Applied Physiology, the study indicates that typical amounts of erythritol can harm human brain blood vessel cells in lab settings, potentially increasing stroke risk.
In this in vitro research, human cerebral microvascular endothelial cells—the cells that line tiny brain blood vessels—were exposed for three hours to about 30 grams of erythritol. This amount mirrors what might be found in a single can of sugar-free diet soda or a scoop of sweetened protein powder. Scientists observed key harmful changes: nitric oxide levels, which typically help blood vessels relax, dropped by approximately 20%, while levels of endothelin‑1, a vessel-constricting protein, rose by around 30%. Oxidative stress markers climbed by about 75%, and the cells lost their ability to activate clot‑dissolving pathways—critical steps linked to stroke prevention.
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These cellular dysfunctions mirror mechanisms associated with ischemic stroke and cerebrovascular injury. Moreover, epidemiological studies, including large-scale research by the Cleveland Clinic, have found that higher circulating levels of erythritol in humans correlate with greater risk of stroke and heart attacks within a three-year period. As Professor Christopher DeSouza, who led the study, noted: “Our study adds to the evidence suggesting that non-nutritive sweeteners … may not come without negative health consequences”.
Despite these findings, the study’s authors and outside experts stressed that the results are lab-based and do not yet provide direct evidence of erythritol’s impact on living humans. Auburn Berry, the paper’s first author, emphasized the need for cautious consumption and further research: “people should be conscious of the amount of erythritol they are consuming on a daily basis”. DeSouza similarly advised vigilance: “Given the epidemiological study … and now our cellular findings, we believe it would be prudent for people to monitor their consumption”.
Outside coverage echoed this cautious tone. Times of India referred to erythritol’s emerging link to brain cell damage and stroke risk, while British media outlets flagged its oxidative stress and reduced nitric oxide effects – even from single servings.
Currently, erythritol remains classified by the FDA as “generally recognized as safe” and continues to be used widely in zero-calorie beverages, keto-friendly snacks, and sugar-free gums. However, regulatory bodies have begun reassessing acceptable intake levels in other regions. The European Food Safety Authority recently lowered its recommended daily limit to about 0.5 g per kg of body weight—about 35 g for an average adult—mainly to prevent digestive issues, but this also indicates rising caution regarding long-term intake.
Health experts suggest consumers err toward moderation. Some advocate substituting erythritol with natural alternatives like honey or date syrup, though these have higher caloric and glycemic impacts. Others recommend low-calorie sweeteners such as stevia or monk fruit, which haven’t shown similar vascular risks in preliminary studies.
This study adds to a growing body of evidence that non-nutritive sweeteners may not be entirely free of harm. While the findings don’t yet warrant a change in public health guidelines, they underscore the need for human clinical trials and long-term animal studies to understand real-world impacts—particularly among individuals with neurological or cardiovascular vulnerabilities.
For those using erythritol-containing products, the advice is clear: monitor your intake, stay updated on emerging research, and consider alternative sweeteners or whole-food-based approaches to reduce reliance on artificial ingredients. Consumers with existing health conditions, especially those involving blood clotting or vascular health, should consult their healthcare providers.
