From the Research
Erythritol consumption is associated with an increased risk of cerebrovascular accident (CVA) or stroke, and individuals, especially those with existing cardiovascular issues, should consider limiting their erythritol intake until more research is conducted. Recent studies have investigated the relationship between erythritol, a sugar alcohol commonly used as a zero-calorie sweetener, and cardiovascular events. A 2023 study published in Nature Medicine found that people with higher blood levels of erythritol had an elevated risk of major adverse cardiac events, including stroke 1.
Key Findings
- A 2025 study published in JACC. Advances found that higher erythritol and erythronate concentrations were significantly associated with heart failure hospitalization, cardiovascular death, and total mortality, as well as stroke (HR: 1.40 [95% CI: 1.08-1.83], P = 0.012) 2.
- A 2024 study published in Nutrients found that serum erythritol was associated with increased risk of overall mortality, cardiovascular disease mortality, and cancer mortality, with a stronger association for heart disease mortality than stroke mortality 3.
- A 2022 study published in BMJ found that total artificial sweetener intake, including erythritol, was associated with increased risk of cardiovascular diseases, particularly cerebrovascular disease (HR: 1.18,95% CI: 1.06 to 1.31, P = 0.002) 4.
Clinical Implications
Given the potential association between erythritol and increased risk of CVA or stroke, it is essential to consider the benefits and risks of erythritol consumption, particularly for individuals with existing cardiovascular issues. Limiting erythritol intake or exploring alternative sweeteners may be a prudent approach until more research is conducted to fully understand the long-term safety profile of erythritol. Additionally, moderate amounts of natural sugars may be a preferable option for those concerned about stroke risk.
Future Research Directions
Further studies are needed to clarify the relationship between erythritol and cardiovascular events, including the potential mechanisms by which erythritol may promote blood platelet aggregation and increase clotting risk. The role of endogenous production and dietary/beverage intake of erythritol in human health and mortality also warrants additional investigation.