A team of scientists from the University of Colorado, Boulder just published an article, "The non-nutritive sweetener erythritol adversely affects brain microvascular endothelial cell function," in the Journal of Applied Physiology, warning about the potential risks of the sweetener erythritol.
Adding to previous research that links erythritol to increased risk of cardiovascular events including heart attacks, the team from CU Boulder's Integrative Vascular Biology Laboratory in the Department of Integrative Physiology found that ingesting the sweetener, which seems to be ubiquitous in sugar-free and low-cal foods, can impair brain vascular cell function and might also increase the risk of stroke.
In the abstract of the article, which was published in Volume 138, Issue 6 (June 2025), the authors explain that the purpose of the study was to determine, in vitro, "the effect of the non-nutritive sweetener erythritol on brain micro-vascular endothelial cell oxidative stress, nitric oxide (NO) and endothelin (ET)-1 production, as well as tissue-type plasminogen activator (t-PA) release."
The scientists were able to provide new data demonstrating that the sweetener, in amounts that are common in typical servings of commercially-available beverages and foods, "adversely affects brain microvascular endothelial cell oxidative stress, eNOS [endothelial nitric oxide synthase] activation and NO [nitric oxide] production, ET-1 [endothelin] expression, and t-PA [tissue-type plasminogen activator] release in vitro." They conclude that erythritol is "associated with increased risk of cardiovascular and cerebrovascular events."
Food Safety News provides a slightly more user-friendly overview of the findings and of the mechanisms through which erythritol might negatively affect vascular and neurological health:
Erythritol increased reactive oxygen species (ROS) production by approximately 75 percent, which can damage cells and weaken the blood-brain barrier. It also reduced nitric oxide (NO) production by about 20 percent and increased endothelin-1 (ET-1), a potent vasoconstrictor, by roughly 30 percent—changes that may disrupt cerebral blood flow and contribute to stroke risk. Additionally, erythritol impaired the release of tissue-type plasminogen activator (t-PA) in response to thrombin, which could hinder the body's ability to dissolve blood clots and elevate thrombotic risks.
Food Safety News emphasizes that these vascular changes are "especially concerning" because they can potentially contribute to ischemic strokes, which happen when "blood flow to the brain is blocked, often by clots or narrowed vessels." They further stress that this study adds to a "growing body of research raising questions about the long-term safety" of the sweetener that's often found in sodas, snacks, and other foods marketed to folks who are diabetic or who are on keto diets.
I've personally always been turned off by the taste of erythritol and have steered clear of foods that contain it, since it tastes super weird, and not in a good way, to me. Now I have another even better reason to continue avoiding it.
Read the full study here.
Previously:
• Popular zero-calorie sweetener linked to heart attack and stroke
