Avoiding the overconsumption of calories is important for maintaining a healthy weight and staying healthy. For many people, one of the easiest ways to cut calories is by cutting out sugar and replacing it with a substitute. One of the most popular sugar substitutes is erythritol, which is marketed as Stevia, often under the brands Wholesome, Spenda, or Truvia.

Erythritol is a sugar alcohol that is created during the fermentation process in corn. It has been approved by the FDA since 2001 and is very popular because it has an almost identical level of sweetness to regular sugar. Despite the similar levels of sweetness, however, Erythritol has almost no effect on blood sugar or insulin levels. It is also a low calorie food, providing only about 6% as many calories per serving as normal sugar.

Unfortunately, according to a new study published in the Journal of Applied Physiology, it may also harm brain cells and lead to an increased risk of heart attack and stroke.

The study is a follow-up on a 2023 study that showed a link between elevated stroke and heart attack risks and having erythritol in the bloodstream. Researchers then saturated the type of cells that line the brain’s blood vessels with an amount of erythritol that would be present from consuming a normal sugar-free drink sweetened with it.

They found that the cells that had this level of exposure to erythritol had a lower amount of nitric oxide (which is responsible for relaxing and widening blood vessels) and had more than normal amounts of endothelin-1, which is a protein that causes blood vessels to construct. In addition, those cells produced free radicals, which are well-known to have inflammatory and aging effects. To make this even worse, the cells had a reduced reaction to thrombin, which is a clot-forming compound.

To put it simply, the cells that were exposed to the levels of erythritol that would be present from just one sugar-free beverage worked in almost the reverse of the way that they are supposed to. In a press release about the study, graduate student at the University of Colorado Boulder, Auburn Berry said:

“Big picture, if your vessels are more constricted and your ability to break down blood clots is lowered, your risk of stroke goes up.”

Even more concerning is the fact that these findings were based on such low levels of exposure compared to what many people would experience. People who use this type of sweetener will often have more than one sugar-free soda per day, and may also use it for baking or other things. This could result in dramatically higher levels of exposure, which may mean even higher risks of heart attack and stroke.

In the press release, professor Christopher DeSouza, who was a coauthor of the study, said:

“Given the epidemiological study that inspired our work, and now our cellular findings, we believe it would be prudent for people to monitor their consumption of non-nutrient-sweeteners such as this one.”

Reviews of this study and additional research will undoubtedly be needed to determine just how dangerous this type of sweetener really is and whether there is more harm from these risks than good from the benefits of reduced calories and less impact on blood sugar levels.

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