Erythritol may alter blood vessels and raise risk of stroke and clots.
Erythritol, a sugar substitute found in many “sugar-free” and low carb products, is now under scrutiny after recent findings from a research team at the University of Colorado Boulder. Though long considered a safer alternative to table sugar, the sweetener is beginning to show a different side when its impact on the body is studied more closely. Many people choose it because it tastes sweet without spiking blood sugar levels, which makes it popular in snacks and drinks labeled as keto-friendly, diabetic-safe, or diet-approved. But the very ingredient meant to help people stay healthy might be doing more harm than good.
A group of researchers explored how erythritol might be affecting the cells that line blood vessels in the brain. They found some changes that raise concern. After exposing the cells to a typical serving amount—equal to what might be found in one sugar-free beverage—they noticed several important shifts. The treated cells lost some of their ability to produce nitric oxide, which normally helps blood vessels relax and open up. At the same time, they began making more of a protein that causes vessels to tighten. This combination can lead to blood vessels that are narrower and stiffer than they should be.
There was another effect as well. When these cells were exposed to a chemical that encourages blood clotting, they didn’t respond as effectively as healthy cells would. They were slower to release a compound that helps break down clots. On top of that, the cells began creating more waste byproducts known as reactive oxygen species, which can wear down cells over time and increase inflammation.
Taken together, the results paint a troubling picture. When blood vessels are too tight and less able to break apart clots, the risk of stroke can increase. This lines up with other large studies that have shown people with higher levels of sweetener in their systems tend to have more strokes and heart attacks. One such study tracked thousands of people in both the U.S. and Europe and found that those with more erythritol in their blood were much more likely to experience one of these serious events in the following few years.
The concern is not just about large doses. Even regular servings, when taken often, could cause changes in the body’s cells that aren’t obvious right away but may add up over time. For someone drinking multiple sugar-free drinks a day or eating several snacks with erythritol, the effects could be more pronounced. And because erythritol shows up in so many different foods—from gum to baked goods to protein shakes—many people may not realize just how much they’re taking in on a regular basis.
While the study was conducted using cells in a lab, and not in living people, it still offers strong clues about how this sweetener behaves once inside the body. The findings suggest that more attention should be paid to erythritol and other sweeteners that have long been treated as safe without enough long-term research. Labels that promise “sugar-free” or “guilt-free” options may not be as harmless as they appear, and people who rely on these foods for health reasons might want to think twice.
Consumers are encouraged to read labels more carefully and take note of ingredients like erythritol or “sugar alcohols.” Some health experts are now calling for more human studies to better understand the risks, especially for those with underlying conditions like heart disease or diabetes. Until then, moderation seems wise. Just because something doesn’t contain sugar doesn’t mean it’s risk-free. Sometimes, what’s left out of a product is less important than what’s put in.
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Popular sugar substitute could raise the risk of blood clots and stroke
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