Why Doctors Want You To Stop Consuming Artificial Sugar
If a sugar-free soda or low-calorie candy bar seem too good to be true, that’s because sometimes, they are. In recent years, studies on artificial sugars have linked them to everything from an increased appetite to cancer. And while the sugar alcohol erythritol is usually considered one of the healthier artificial sugars, it was also recently linked to a higher risk of stroke.
Now, new research finds that the negative health impacts of erythritol may go even farther. The study, which is being presented at the 2025 American Physiology Summit, found that the sweetener may set changes in motion in your cells that could raise the risk of heart attack and stroke.
Erythritol is found in a huge range of sugar-free foods, raising questions about how safe this sweetener is to consume. Here’s what two top doctors and a dietitian want you to know about the sweetener and the potential risks it poses to your health.
Meet the experts: Scott Keatley, RD, co-owner of Keatley Medical Nutrition Therapy; Christopher Yi, MD, a vascular surgeon at MemorialCare Orange Coast Medical Center in Fountain Valley, CA; Auburn Berry, lead study author and a graduate student at the University of Colorado Boulder; Cheng-Han Chen, MD, a cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA
What did the study find?
For the study, researchers treated cells from the tiny blood vessels in the brain (known as cerebral microvascular endothelial cells) with erythritol. They discovered that cells that were exposed to the amount of sweetener in one drink serving had higher levels of oxidative stress. (In case you’re not familiar with it, oxidative stress is an imbalance in the body that can damage cells, lead to aging, and raise the risk of cancer and other diseases.)
The researchers also discovered that cells exposed to erythritol produced less nitric oxide, which is a compound that helps blood vessels dilate. Lower levels of nitric oxide can mess with blood flow, make it hard for blood vessels to widen, and increase the risk of heart attack and stroke.
“We decided to study erythritol because it is widely marketed and consumed as a ‘safe’ sugar alternative,” says Auburn Berry, lead study author and a graduate student at the University of Colorado Boulder. “However, emerging evidence has linked erythritol intake to an increased risk of cardiovascular and cerebrovascular events, particularly ischemic stroke. Despite these associations, the direct biological effects of erythritol on brain endothelial cell function, which is critical for maintaining cerebrovascular health, are poorly understood.”
What is erythritol?
Erythritol is a low-calorie sugar substitute, explains Scott Keatley, RD, co-owner of Keatley Medical Nutrition Therapy. It’s popular because it doesn’t impact blood glucose and levels of insulin (a hormone that helps escort glucose to your cells to be used for energy) as much as table sugar does.
“It’s often marketed as a ‘natural’ sugar substitute due to its lower glycemic index and minimal calorie content,” Keatley says.
While it’s widely considered safe in moderation, Keatley says that there’s a growing body of research suggesting that it may not be entirely without risk, especially when consumed in larger quantities.
What foods contain erythritol?
Erythritol is found in a lot of sugar-free products, like energy drinks, some snack foods, and protein bars. It’s also used as a sweetener in Halo Top ice cream, Quest bars, Vitaminwater Zero, and more.
It’s even found in some toothpastes and mouthwashes, says Christopher Yi, MD, a vascular surgeon at MemorialCare Orange Coast Medical Center in Fountain Valley, CA.
Why might erythritol interfere with your brain and heart health?
Erythritol may cause oxidative stress in brain cells by disrupting how they produce energy and “by overwhelming their natural antioxidant defenses,” Dr. Yi says.
The sweetener also seems to lower levels of nitric oxide, which helps protect cells and blood vessels, per Dr. Yi. “This imbalance leads to the buildup of harmful molecules—reactive oxygen species—which can damage cells and contribute to heart and blood vessel problems,” he says.
But more research is needed to understand why the sweetener causes these changes, says Cheng-Han Chen, MD, a cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA.
Is it okay to consume erythritol?
Erythritol is approved by the Food and Drug Administration (FDA) as a sweetener and is classified as “generally recognized as safe” or GRAS, meaning it’s considered safe to have in the amounts that are often found in foods.
But Keatley says it’s best to consume it sparingly. “I advise caution, particularly for those at higher risk for cardiovascular conditions,” he says. “Like any sweetener, moderation is key. It’s important to be aware of how much erythritol is consumed, especially considering its potential effects on vascular health.”
Dr. Chen also recommends being mindful of how much erythritol you have on a regular basis. “Until we learn more about the negative health effects of erythritol, we should try to understand how much erythritol we are consuming from our food products, and attempt to limit our intake of erythritol as much as possible,” he says.
Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Self, Glamour, and more. She has a master’s degree from American University, lives by the beach, and hopes to own a teacup pig and taco truck one day.
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