JUST one energy drink or sugar-free soda containing a key ingredient could damage the brain and blood vessels, researchers have claimed.
American scientists linked a common sugar substitute to a higher risk of vascular health issues, including stroke.
GettyCommon sugar substitute erythritol has been linked to a higher risk of vascular health issues, including stroke[/caption]Erythritol (E968) is an artificial sweetener that commonly replaces sugar in low-calorie, low-carbohydrate and keto products.
It tends to be used in energy drinks, protein bars and snack foods and is often marketed as “healthy”, according to researchers at the University of Colorado Boulder’s Integrative Vascular Biology Laboratory.
But they claimed that the amount of erythritol found in a single beverage serving may be enough to negatively impact brain and blood vessel health.
First author Auburn Berry, a graduate student at the university, said: “While erythritol is widely used in sugar-free products marketed as healthier alternatives, more research is needed to fully understand its impact on vascular health.
“In general, people should be conscious of the amount of erythritol they are consuming on a daily basis.”
The study – presented at the 2025 American Physiology Summit last month – investigated how erythritol affects oxidative stress and nitric oxide production in brain blood vessel cells.
Oxidative stress happens when harmful molecules – called free radicals – build up in your body and there aren’t enough good molecules – called antioxidants – to stop them.
This can damage your cells, leading to ageing and contributing to diseases like cancer, heart problems, or diabetes.
Meanwhile, nitric oxide is a gas made by your body that helps your cells communicate.
It relaxes and widens your blood vessels, improving blood flow, and plays an important role in keeping your heart, brain, and immune system healthy.
They exposed human brain blood vessel cells to an erythritol solution containing roughly the same amount found in an energy drink or artificially sweetened soda – about 30g – and left this in the solution for three hours.
They found that exposing cells to that amount of erythritol caused significantly higher levels of oxidative stress, compared to untreated cells.
The sweetener-steeped cells produced nearly 100 per cent more free radicals, researchers said.
Levels of two key antioxidant enzymes also increased in the erythritol-treated cells, suggesting the cells were responding to the extra oxidative stress, and they produced less nitric oxide.
The 3 feared risks of artificial sweeteners
They could increase risk of heart attack and stroke
Research published earlier this year suggests aspartame, a common sugar substitute, may negatively impact vascular health.
It was shown to trigger insulin spikes in mice, which can lead to atherosclerosis – plaque buildup in arteries – and increased inflammation.
This could potentially raise the risk of heart attack or stroke, researchers suggested.
Researchers fed mice daily doses of food containing 0.15 per cent aspartame for 12 weeks – the equivalent of consuming about three cans of diet soda each day for humans
Aspartame-fed mice developed larger and more fatty plaques in their arteries compared to mice who weren’t given sweeteners.
When the research team analysed the mice’s blood, they found a “surge” in insulin levels after aspartame entered their system.
They said aspartame – which is approximately 200 times sweeter than sugar – seemed to “trick” the receptors into releasing more insulin.
The mice’s elevated insulin levels appeared to fuel the growth of fatty plaques in their arteries, researchers added.
But scientists not involved in the study said you don’t need to pour out your diet soda just yet – as we don’t yet know whether the artificial sweetener has the same effect on humans.
They may increase sugary cravings
Some studies link artificial sweeteners to increased appetite and cravings for sugary food.
One – published in 2021 – found that sucralose made people feel hungrier.
Researcher Professor Kathleen Page said: “Drinking artificially sweetened drinks may trick the brain into feeling hungry, which may in turn result in more calories being consumed.”
However, Gavin Partington, of the British Soft Drinks Association, said the study should be “treated with caution” because it was based on a “tiny” number of participants.
Other studies suggested that artificial sweeteners can alter people’s gut microbiome and cause weight gain.
But it should be noted that lots of research supports that sugar substitutes can help with weight loss and maintenance.
They may be linked to type 2 diabetes
People who regularly consume artificial sweeteners may be more at risk of developing type 2 diabetes compared to those with a lower intake, a study published in 2023 showed.
The additives may stop the body from being able to regulate blood sugar levels healthily, researchers from Harvard Medical School and Massachusetts General Hospital suggested.
Prior studies have discovered that the sweeteners saccharin and sucralose can increase the blood sugar levels of healthy people.
Researchers said their findings suggested that increased oxidative stress and reduced nitric oxide production in brain blood vessel cells – which may impair blood flow – could lead to a higher risk of vascular events like stroke.
Dr Berry explained to Medical News Today that the sweetener “disrupts the production of nitric oxide,” which is vital for the blood vessels to dilate and ensures proper blood flow.
This reduction in nitric oxide can impair blood vessel function, disrupt circulation, and potentially cause neurovascular damage, she added.
Dr Berry suggested that people concerned about heart or brain health should consider limiting their intake, warning that “regular erythritol consumption may impair blood vessel health and function”.
She told Medical News Today: “The most important point of our study is that non-nutritive sweeteners, in this case erythritol, can have negative health effects.
“Based on our cell studies and recent clinical studies, people should be conscious of the amount of erythritol they are consuming on a daily basis,” she added.
GettyErythritol is used in protein bars and energy drinks[/caption]Professor Thomas Holland from the Rush University Medical Centre Institute for Health and Ageing – who was not involved in this study – told the outlet that erythritol could lead to increased rates of cognitive decline.
“Erythritol triggers a surge in harmful molecules called reactive oxygen species which cause cellular damage,” he explained.
“Of particular concern is when these reactive oxygen species cause damage to neural tissue, which can lead to increased rates of cognitive decline.
“Similarly, [reactive oxygen species] can cause damage in various organ systems leading to a slew of disease processes. The body tries to defend against this by increasing its internal antioxidant defenses, but the elevated stress remains.”
He advised people go for more natural options like honey or date-syrup, or stevia if they’re avoiding sugar.
According to the NHS, all sweeteners used in the UK undergo rigorous safety assessments before they can be added to food and drinks.
Sweeteners approved for use in the UK
Lower-or no-calorie sweeteners are substances used instead of sugar to sweeten foods and drinks.
They’re found in products such as drinks, desserts and ready meals, cakes, chewing gum and toothpaste.
Sweeteners approved for use in the UK include:
acesulfame K (E950) aspartame (E951) erythritol (E968) saccharin (E954) sorbitol (E420) steviol glycosides (E960) sucralose (E955) xylitol (E967)All have undergone rigorous safety assessments to ensure they are safe.
The law determines how much sweetener can be used and in which products.
Source: NHS
It says all approved sweeteners are considered a safe and acceptable alternative to using sugar, though they don’t necessarily make a food or drink healthy.
There’s no need to keep track of how much sweetener we consume daily, the guidance added.
It’s not the first time research has linked erythritol to adverse health events.
A study published last year linked the sweetener to an increased risk of blood clots, heart attacks and strokes.
Senior author Dr Stanley Hazen, chair of Cardiovascular and Metabolic Sciences in Cleveland Clinic’s Lerner Research Institute and co-section head of Preventive Cardiology, said: “Many professional societies and clinicians routinely recommend that people at high cardiovascular risk – those with obesity, diabetes or metabolic syndrome – consume foods that contain sugar substitutes rather than sugar.
“These findings underscore the importance of further long-term clinical studies to assess the cardiovascular safety of erythritol and other sugar substitutes.”
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