Erythritol is one of the most commonly used sugar substitutes in keto, low-carb, sugar-free, and diabetic-friendly products. Because it contains very few calories and has minimal impact on blood sugar, it has become a popular alternative to traditional sugar.
In recent years, however, researchers have begun examining whether erythritol may have effects beyond sweetness. Several studies have raised questions about possible links between erythritol and cardiovascular health, leading many consumers to ask: What is erythritol, and is erythritol bad for you?
While erythritol remains approved for use in foods and is generally considered safe by regulatory agencies, emerging research has prompted additional discussion about its long-term effects. Here's what current evidence shows.
What Is Erythritol?
Erythritol is a type of sugar alcohol used as a low-calorie sweetener in many foods and beverages. Although it naturally occurs in small amounts in certain fruits and fermented foods, most commercial erythritol is produced through a fermentation process.
Erythritol is approximately 70% as sweet as table sugar but contains almost no calories. Unlike regular sugar, most erythritol is absorbed into the bloodstream and then excreted by the body unchanged, which is one reason it has little effect on blood sugar or insulin levels.
Because of these characteristics, erythritol is commonly found in:
- Sugar-free beverages
- Protein bars
- Keto desserts
- Low-carb baked goods
- Sugar-free candy
- Sweetener blends
- Reduced-sugar snacks
Many people choose products containing erythritol as part of diabetes management, weight loss efforts, or low-carbohydrate eating plans.
Why Is Erythritol So Popular?
Several characteristics have contributed to erythritol's popularity:
- Very low calorie content
- Minimal impact on blood sugar
- Minimal impact on insulin levels
- Does not contribute to tooth decay
- Commonly used in keto and low-carb diets
- Provides sweetness without traditional sugar
These benefits have helped make erythritol one of the most widely used sugar substitutes in the food industry.
Is Erythritol Bad for You?
For many years, erythritol was primarily viewed as a safe alternative to sugar. Today, most health authorities continue to consider erythritol safe for consumption.
However, recent research has raised questions about whether high levels of erythritol in the bloodstream may be associated with an increased risk of cardiovascular events in some individuals.
It is important to understand that current studies do not prove that erythritol directly causes heart attacks, strokes, or blood clots. Instead, researchers have identified associations and potential biological mechanisms that warrant further investigation.
For most healthy individuals, occasional consumption of erythritol-containing products is unlikely to be a major concern. However, people with cardiovascular disease, diabetes, or multiple cardiovascular risk factors may wish to discuss sweetener choices with their healthcare provider.
Potential Benefits of Erythritol
Erythritol may offer several potential advantages when compared with traditional sugar.
Blood Sugar Friendly
Unlike regular sugar, erythritol has minimal impact on blood glucose levels. This makes it a common ingredient in products marketed toward people with diabetes.
Low Calorie Content
Erythritol provides sweetness with very few calories, making it attractive for individuals seeking to reduce overall calorie intake.
Dental Health Benefits
Unlike sugar, erythritol does not promote tooth decay and may be less harmful to dental health.
Digestive Tolerance
Compared with some other sugar alcohols, erythritol tends to cause fewer digestive side effects when consumed in moderate amounts.
Erythritol vs. Other Sugar Alcohols
New Research About Erythritol
Recent studies have explored whether erythritol may affect cardiovascular and metabolic health.
Erythritol and Brain Blood Vessel Function
A 2025 study published in the Journal of Applied Physiology examined the effects of erythritol on human brain microvascular endothelial cells, which line small blood vessels in the brain.
Researchers observed:
- Increased oxidative stress
- Reduced nitric oxide production
- Increased endothelin-1 levels
- Reduced activity of tissue plasminogen activator (tPA), an enzyme involved in breaking down blood clots
These findings suggest possible effects on blood vessel function and clotting mechanisms. However, laboratory studies cannot determine whether the same effects occur in real-world populations.
Erythritol and Cardiovascular Risk
A 2023 study published in Nature Medicine examined blood erythritol levels in large patient populations from the United States and Europe.
Researchers found that individuals with higher erythritol levels were more likely to experience major cardiovascular events such as:
- Heart attack
- Stroke
- Cardiovascular death
Laboratory testing also demonstrated increased platelet activity and clot formation after erythritol exposure.
Importantly, this study identified an association rather than proving that erythritol directly caused cardiovascular events. Additional research is needed to determine whether erythritol itself is responsible or whether other factors may contribute to the observed findings.
Should You Avoid Erythritol?
Not necessarily.
Current evidence does not establish that erythritol directly causes heart attacks or strokes. However, the recent research has generated enough concern that many experts believe additional long-term studies are warranted.
You may want to discuss erythritol intake with your healthcare provider if you:
- Have heart disease
- Have a history of stroke
- Have diabetes
- Have multiple cardiovascular risk factors
- Regularly consume large amounts of sugar-free products
For most individuals, moderation remains a reasonable approach until more definitive research becomes available.
The Bottom Line
Erythritol remains one of the most commonly used sugar substitutes in low-carb, keto, and sugar-free foods.
While it offers several benefits, including minimal effects on blood sugar and calorie intake, recent studies have raised questions about potential cardiovascular risks that deserve further investigation.
Current research does not prove that erythritol causes heart attacks or strokes, but it does highlight the importance of continued study and informed decision-making.
If you frequently consume products containing erythritol or have concerns about your cardiovascular health, speak with your healthcare provider about the best dietary choices for your individual needs.
Frequently Asked Questions
What is erythritol?
Erythritol is a low-calorie sugar alcohol used as a sweetener in many sugar-free, keto-friendly, and reduced-sugar products.
Is erythritol bad for you?
Most health authorities consider erythritol safe, but recent studies have raised questions about possible cardiovascular effects that require further research.
Does erythritol raise blood sugar?
Erythritol has minimal impact on blood glucose and insulin levels, which is one reason it is commonly used in products marketed to people with diabetes.
Is erythritol healthier than sugar?
Erythritol contains fewer calories and has less impact on blood sugar than regular sugar. Whether it is a healthier choice depends on an individual's overall health and dietary goals.
Does erythritol cause heart attacks or strokes?
Current studies have found associations between erythritol and cardiovascular events, but they do not prove that erythritol directly causes heart attacks or strokes.
Is erythritol safe for people with diabetes?
Many people with diabetes use erythritol because it has little effect on blood sugar levels. Dietary decisions should be discussed with a healthcare provider who understands your medical history.
Image credit: Thomas Kniess via Wikimedia Commons – CC BY-SA 4.0. Cropped from original.
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