Erythritol
Last reviewed October 18, 2026 · Evidence strength: Limited · How we grade evidence
In plain words: Erythritol is a sugar alcohol common in "keto" and sugar-free products. It isn't proven harmful, but it's not proven harmless either. People with higher blood levels had more heart attacks and strokes in one large study, and a typical serving made blood platelets stickier in small experiments. Large amounts can also upset the stomach.
Also listed on labels as: Erythritol, E968, Swerve (contains erythritol)
What is it, and why is it in food?
Erythritol is a sugar alcohol that's about 70% as sweet as sugar with almost no calories. Most of it is absorbed and passed in urine. It's often the main ingredient in stevia and monk fruit blends, keto baking sweeteners, protein bars and sugar-free ice cream.
What does the science say?
| The popular claim | Often promoted as a "clean," harmless sweetener. We graded the opposite idea: that it may not be as harmless as marketed. |
| Our verdict on that claim | Partly supported |
| Evidence strength | Limited: a large population study of blood levels and two small experiments; no outcome trials. |
| Kinds of studies | Population study, small human experiments, lab studies, EU review |
- Blood levels and heart events: A 2023 study of people getting heart checkups found those with the highest blood erythritol had about twice the risk of heart attack, stroke or death over 3 years. This measured blood levels, not how much people ate, and the body makes some erythritol itself.1
- Platelets: In a 2024 experiment, healthy volunteers drank 30 grams of erythritol (about a sweetened drink's worth). Blood levels rose more than 1,000-fold and platelets became stickier in every person. Glucose did not do this.2
- No outcome trials have tested whether eating erythritol causes heart problems.
What do regulators say?
- EFSA (2023) set a safe daily limit of 0.5 grams per kg of body weight, based on its laxative effect, and noted high consumers, especially children, may go over it.3
- US: GRAS.
Who should be careful?
- People with heart disease, a history of clots or stroke, or diabetes may want to go easy on erythritol and talk to their doctor.
- Kids: large amounts (like several sugar-free treats) can cause diarrhea and stomach upset.
How common is it in US foods?
In our check of USDA's Branded Foods database, 3,179 of 438,129 US packaged foods with an ingredient list name erythritol (about 0.7%, or roughly 1 in 138).4 It shows up most often in: snack, energy & granola bars (492); ice cream & frozen yogurt (419); granulated, brown & powdered sugar (259); soda (246); chocolate (192). Bars, ice cream and tabletop sweeteners lead, and it's often hidden behind "stevia" or "monk fruit" on the front of the package. These are label records companies sent to USDA, mostly in 2021 to 2023, so some products have changed since. Counts come from a text match of ingredient lists and are approximate.
Swaps and tips for families
- Use small amounts of regular sugar or honey (for kids over 1) in home baking instead of large amounts of keto sweetener.
- Choose pure stevia drops without erythritol.
- Don't stack several sugar-free products in one day.
Beyond the plate: related non-food exposures
None.
Frequently asked questions
Is erythritol bad for your heart?
It's not proven. One large study linked high blood levels with heart events, and small experiments found it made platelets stickier. People with heart or clotting risk may want to limit it until better studies are done.
Does erythritol cause diarrhea?
In large amounts, yes. Europe's safe limit is based on that laxative effect.
Is erythritol natural?
It occurs in small amounts in fruit and is made commercially by fermentation.
Related guides
- Xylitol
- Sugar Alcohols (Sorbitol, Maltitol and More)
- Stevia (Steviol Glycosides)
- Monk Fruit Extract
- Sugars and sweeteners
Sources
Every source below was checked against PubMed, the publisher or the official page by our research team in October 2026.
- The artificial sweetener erythritol and cardiovascular event risk. Nature medicine, 2023. PubMed 36849732 · doi:10.1038/s41591-023-02223-9
- Ingestion of the Non-Nutritive Sweetener Erythritol, but Not Glucose, Enhances Platelet Reactivity and Thrombosis Potential in Healthy Volunteers. Arterioscler Thromb Vasc Biol, 2024. PubMed 39114916 · doi:10.1161/ATVBAHA.124.321019
- Re-evaluation of erythritol (E 968) as a food additive. EFSA J, 2023. PubMed 38125972 · doi:10.2903/j.efsa.2023.8430
- FoodData Central, Branded Foods dataset (release 2026-04-30). U.S. Department of Agriculture, Agricultural Research Service, 2026. Link
This guide is for general education. It is not medical advice and does not replace advice from your doctor, pediatrician, allergist or registered dietitian. If you think you or your child reacted to a food, talk to a health professional. Research changes; we review these pages when new evidence or rules come out. Last reviewed October 18, 2026. Spotted an error? Email [email protected].