Is Your Sugar Substitute Hurting Your Brain and Heart? The Truth About Erythritol

Erythritol, a “natural” zero-calorie sugar alcohol, is one of the most popular sugar substitutes on the market today.

It’s found in everything from energy drinks and snack bars to low-sugar baking blends. However, recent research suggests this sweetener may impact more than just your taste buds.

It’s important to understand what the latest science says about erythritol for health-conscious individuals and anyone invested in nutrition.

Could your favorite sugar substitute cause damage to your brain and heart health?

Let’s look at the newest findings so we can make informed choices about what sweetens our food.

What Is Erythritol? The “Healthy” Sugar Substitute

Erythritol is a sugar alcohol naturally present in small amounts in some fruits such as melon, grapes, and pears and even in fermented foods like cheese and soy sauce (Mazi & Stanhope, 2023).

Commercially, it’s produced by fermenting glucose (sourced from corn or wheat starch) with yeast.

Its rise to fame is due in part to attributes that health-focused consumers love:

70% as sweet as sugar but with nearly zero calories
It doesn’t spike blood glucose or insulin levels
Mild, clean flavor with no lingering aftertaste
It doesn’t feed oral bacteria, helping protect against cavities

Because of these benefits, food manufacturers have embraced erythritol in “sugar-free,” keto, and diabetic-friendly products.

Both the US Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA) have approved its use, and it’s generally recognized as safe (GRAS) (Human Foods Program, 2025).

Benefits of Erythritol in Everyday Foods

1. Blood Sugar Friendliness

Unlike table sugar, erythritol doesn’t influence blood glucose or insulin. Research has shown that even people with diabetes can enjoy erythritol without blood sugar spikes, making it a go-to for those managing diabetes or watching their carbohydrate intake (Mazi & Stanhope, 2023).

2. Dental Health

Sugar alcohols, including erythritol, don’t promote tooth decay. Erythritol may even outperform other polyols, such as xylitol, in preventing dental plaque and inhibiting harmful oral bacteria, contributing to better oral health among children and adults (Mazi & Stanhope, 2023).

3. Digestive Comfort

Many sugar alcohols cause gastrointestinal issues in moderate amounts, but erythritol is typically gentler on your gut than xylitol or sorbitol due to its smaller molecular size and rapid absorption in the small intestine (with 90% excreted unchanged in urine) (Mazi & Stanhope, 2023).

But not all research paints an entirely rosy picture. While authorities still consider erythritol safe, a growing number of scientific studies highlight possible concerns for brain and heart health.

New Concerns About Erythritol and Your Health

Recent Study Flags Potential Heart and Brain Effects

A study published by the American Physiological Society in 2025 investigated the effect of erythritol on human brain microvascular cells (“Popular Sugar Substitute May Harm Brain and Heart Health,” 2025).

The researchers exposed brain blood vessel cells to levels of erythritol found in just a single serving of a popular beverage. Their findings are worth noting:

Elevated Oxidative Stress: The cells showed increased oxidative stress levels, producing more damaging molecules that can harm cells.
Reduced Nitric Oxide Production: Nitric oxide is a compound that helps blood vessels dilate, ensuring healthy blood flow to the brain and heart. Lower nitric oxide levels can lead to poor blood flow, increasing risks for conditions like stroke and heart attack.

Bottom line: The study's lead author, Auburn Berry (University of Colorado Boulder), calls for caution, stressing the need for more research, but recommends consumers be mindful of their erythritol intake.

Erythritol, Heart Events, and Vascular Health

This isn’t the first time erythritol’s cardiovascular effects have been scrutinized.

Previous research links higher erythritol consumption or higher blood levels of erythritol to an increased likelihood of major cardiac events, such as stroke or heart attack (“Popular Sugar Substitute May Harm Brain and Heart Health,” 2025).

However, the direction of this association is a matter of debate.

Some scientists point out that individuals with obesity, insulin resistance, or type II diabetes often produce more erythritol naturally in their bodies (endogenously) due to altered glucose processing. This raises the question:

Is erythritol itself causing heart risk, or is it a marker of underlying metabolic health issues?

More clinical trials are needed to clarify this relationship.

What About Erythritol and the Brain?

The 2025 cell study is the first to show that when brain blood vessel cells are exposed to erythritol, they become more stressed and lose their ability to produce nitric oxide effectively.

Since proper blood vessel dilation is crucial for delivering oxygen and nutrients to brain tissue, impaired nitric oxide signaling could raise the risk for neurovascular problems, including stroke or memory impairment over time (Popular Sugar Substitute May Harm Brain and Heart Health, 2025).

No long-term human trials have directly linked erythritol use to increased dementia or cognitive decline.

Still, these findings open the door to further research and warrant caution for those with existing risk factors for cerebrovascular disease.

What The Broader Science Says

Erythritol’s Long History of Safe Use

Dozens of studies and product reviews support erythritol’s safety for most people:

Accepted Daily Intake: The Joint FAO/WHO Expert Committee on Food Additives determined that the acceptable daily intake (ADI) for erythritol is “not specified,” meaning there is no identified health risk at typical consumption levels (Mazi & Stanhope, 2023).
Well-Tolerated in the Gut: Up to 50 grams per day is generally tolerated without major digestive issues, much higher than other sugar alcohols’ thresholds.

Contradictory Evidence in Cardiovascular Health

Remarkably, some studies observed that erythritol might even improve certain cardiovascular markers.

For example, diabetic patients consuming 26g/day of erythritol over four weeks experienced reduced arterial stiffness and improved endothelial function (a positive for blood vessel health) (Mazi & Stanhope, 2023).

It’s possible that body-produced erythritol, not dietary intake, is more closely tied to adverse cardiovascular markers, especially in those with metabolic syndrome or diabetes.

High circulating erythritol sometimes reflects the body’s struggle to manage blood sugar, not the direct result of eating more erythritol.

Takeaway for Health-Minded Consumers

Most people can enjoy erythritol in moderation with few side effects.
Those with a history of stroke, heart disease, or metabolic syndrome should keep a closer eye on their sugar substitute intake and consult with their doctor about using erythritol regularly.
Watch for more research: New evidence is emerging, so it’s wise to keep informed as the science evolves.

Is Erythritol Hiding in Your Foods?

If you buy packaged “sugar-free,” “low-carb,” or “keto” snacks, there’s a good chance that erythritol is present. Check nutrition labels for:

Erythritol (it may also appear as E 968 in Europe)
Sugar alcohols total
Placement in the ingredient list (the higher it is, the more the product contains)

Common Products Containing Erythritol

Sugar-free chocolates, mints, and gums
Low-sugar granola or snack bars
“Keto” bread, cookies, and baked goods
Energy drinks and protein shakes
Sugar-free ice creams

Popular Food Brands Using Erythritol

Several well-known food brands use erythritol as a sweetener in their products. Some of these include:

Lily’s Sweets – Famous for their sugar-free chocolate bars, baking chips, and confections.
SmartSweets – Produces low-sugar gummy candies and chewy treats.
Halo Top – Offers a range of low-calorie, sugar-free ice creams.
Quest Nutrition – Known for protein bars, cookies, and snacks with minimal sugar.
Swerve – Specializes in sugar substitutes for baking and sweetening.
Rebel Ice Cream – Creates keto-friendly, no-sugar-added ice cream flavors.

Practical Tips for Safe and Smart Sweetening

Moderation remains your best ally. Here’s how to use erythritol more wisely:

Limit high-dose intake: If possible, stick to a few servings (totaling 15–25g) per day, especially if you have diabetes or preexisting vascular conditions.
Diversify your sweeteners: Don’t rely solely on erythritol; other options like stevia, monk fruit, or just a small amount of real sugar (in an overall healthy diet) may lower the risk from any single ingredient.
Focus on overall metabolic health: Manage your blood sugar and cardiovascular health through regular exercise, a nutrient-rich diet, and routine check-ups.

If you notice symptoms like frequent headaches, brain fog, chest pain, or irregular heartbeats while consuming erythritol, consider stopping use and discussing with your healthcare provider.

What’s Next for Erythritol? Stay Curious and Choose Wisely

While erythritol remains one of the most popular sugar substitutes and is still considered safe for most people, research reveals that even substances labeled as “natural” or “healthy” may have unanticipated effects on the body.

The most prudent approaches for now are moderation, label awareness, and keeping up-to-date with nutrition science.

Would you like to learn more about how different sweeteners impact your health or how to build a balanced diet?

For ongoing updates, check reliable sources such as the American Heart Association, the Academy of Nutrition and Dietetics, and peer-reviewed journals.