04/03/2026
Great information from a very trusted college, Dr Jennifer Calvert . Please read!
The Hidden Cost of Sweet: How “Healthy” Sweeteners May Be Keeping You Sick
If you’re using “sugar-free” products to stay healthy, stay lean, or stay in ketosis… you may want to read this twice.
A recent paper on erythritol is raising a very uncomfortable question:
What if one of the most “keto-friendly” sweeteners is not as harmless as we were told?
Researchers found that erythritol was not as safe as we have been lead to believe. In lab models, it increased oxidative stress, reduced nitric oxide signaling, increased endothelin-1, and blunted t-PA release in brain microvascular endothelial cells. Translation? It appeared to push the vascular environment in a direction that is less relaxed, less protected, and potentially more clot-prone [1]. That matters because the blood-brain barrier is not just a wall. It is an active, living interface that helps regulate what gets into the brain and what stays out.
This lines up with earlier human data showing that higher circulating erythritol levels were associated with a significantly higher risk of major adverse cardiovascular events, including heart attack and stroke, and that erythritol exposure increased platelet reactivity and thrombosis potential [2,3]. In plain English? This is not just about “bloating” or “gas.” This is about what these compounds may be doing to your blood vessels, clotting behavior, and possibly even brain perfusion.
And erythritol is not the only issue.
If you are trying to heal metabolically, reduce inflammation, reverse insulin resistance, or actually become fat-adapted, sweeteners can keep your body hanging onto the sweetness signal even when glucose is not arriving. That matters more than most people realize.
Here is the hierarchy I would personally rank from worst to least problematic for someone trying to get truly metabolically clean:
1. Sugar alcohols
(Erythritol, xylitol, sorbitol, maltitol, mannitol, etc.)
These tend to be the most problematic overall. They are notorious for digestive distress, osmotic diarrhea, bloating, gas, and gut irritation in many people [4]. And now erythritol in particular has raised additional vascular concerns that go far beyond the gut [1,2].
2. Artificial sweeteners
(Aspartame, sucralose, saccharin, acesulfame-K, etc.)
These may not contain sugar, but they are not metabolically “neutral.” Research has shown that non-nutritive sweeteners can alter glucose handling, insulin signaling, appetite regulation, and gut microbiota in ways that are not always favorable [5,6]. They may help someone reduce sugar short term, but they are not a free pass for metabolic healing.
3. “Natural” high-intensity sweeteners
(Stevia, monk fruit, allulose)
These are generally better tolerated by many people and often less irritating than sugar alcohols. But “better” does not automatically mean ideal. If your nervous system, taste receptors, and reward pathways are still getting a constant sweetness input, you may still be keeping one foot in the glucose world while trying to force your body into a fat-burning state.
That is the part most people miss.
When the brain repeatedly detects sweetness, it anticipates energy. It anticipates fuel. It anticipates a metabolic response. Even when that response is incomplete or inconsistent, the signal itself still matters. Sweet taste can influence cephalic phase insulin signaling, appetite, reward pathways, and metabolic expectation before calories even arrive [7,8]. If you are trying to fully transition from glucose-burning to fat-burning, repeatedly stimulating sweetness can keep that adaptation muddled.
And that is why so many people say they are “doing keto” but still feel inflamed, hungry, puffy, foggy, or stuck.
They removed bread, but they never removed the sweetness loop.
Deep ketosis is not just “low carb.” It is a metabolic reprogramming.
It is the body finally giving up its demand for constant glucose and learning to efficiently run on fat and ketones instead. That shift is where many people begin noticing steadier energy, calmer hunger, less inflammatory volatility, and better mental clarity. Ketogenic states have also been linked with activation of autophagy-related pathways under the right conditions, especially when carbohydrate exposure stays consistently low [9,10].
And no, this usually does not happen in 4 days.
For many people, especially those with years of metabolic dysfunction, nervous system dysregulation, hidden infections, mold burden, hormone issues, or mitochondrial stress, real fat adaptation can take weeks, not days. A lot of people do not hit a deeper, more stable groove until they have had sustained carbohydrate restriction long enough for the body to stop bargaining.
That is why “cheat bites,” keto desserts, sugar-free gum, sweetened coffee creamers, and “healthy” sweeteners can keep some people metabolically stuck far longer than they realize.
If your goal is true healing, your body may need a season of no sweetness at all.
Not forever.
But long enough to actually adapt.
Because once inflammation drops, cravings calm down, your brain clears, and your energy stabilizes… you start realizing that some “healthy swaps” were never helping you. They were just making the “transition” more comfortable while stunting forward momentum towards true healing.
And sometimes comfort is exactly what keeps people from getting free.
References
[1] Berry, A. R., Ruzzene, S. T., Ostrander, E. I., Wegerson, K. N., Orozco-Fersiva, N. C., Stone, M. F., Valenti, W. B., Izaias, J. E., Holzer, J. P., Greiner, J. J., DeSouza, C. A., & Garcia, V. P. (2025). The non-nutritive sweetener erythritol adversely affects brain microvascular endothelial cell function. Journal of Applied Physiology, 138(6), 1571–1577. https://pubmed.ncbi.nlm.nih.gov/40459966/
[2] Witkowski, M., Nemet, I., Alamri, H., Wilcox, J., Gupta, N., Nimer, N., Haghikia, A., Li, X. S., Wu, Y., Saha, P. P., Demuth, I., König, M., Steinhagen-Thiessen, E., Cajka, T., Fiehn, O., Landmesser, U., Tang, W. H. W., & Hazen, S. L. (2023). The artificial sweetener erythritol and cardiovascular event risk. Nature Medicine, 29(3), 710–718. https://doi.org/10.1038/s41591-023-02223-9
[3] National Institutes of Health. (2023, March 14). Erythritol and cardiovascular events. https://www.nih.gov/news-events/nih-research-matters/erythritol-cardiovascular-events
[4] European Food Safety Authority. (2010). Statement in relation to the safety of erythritol (E 968) in light of new data, including a new paediatric study on the gastrointestinal tolerability of erythritol. EFSA Journal, 8(7), 1650.
[5] Suez, J., Korem, T., Zeevi, D., Zilberman-Schapira, G., Thaiss, C. A., Maza, O., Israeli, D., Zmora, N., Gilad, S., Weinberger, A., Kuperman, Y., Harmelin, A., Kolodkin-Gal, I., Shapiro, H., Halpern, Z., Segal, E., & Elinav, E. (2014). Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature, 514(7521), 181–186. https://doi.org/10.1038/nature13793
[6] Pearlman, M., Obert, J., & Casey, L. (2017). The association between artificial sweeteners and obesity. Current Gastroenterology Reports, 19(12), 64. https://doi.org/10.1007/s11894-017-0602-9
[7] Teff, K. L. (2000). Nutritional implications of the cephalic-phase reflexes: Endocrine responses. Appetite, 34(2), 206–213. https://doi.org/10.1006/appe.1999.0282
[8] Mattes, R. D. (2009). Brief oral stimulation, but not gastric, sweet taste, and energy source have modest effects on appetite and energy intake in humans. Physiology & Behavior, 97(5), 579–587. https://doi.org/10.1016/j.physbeh.2009.04.008
[9] Newman, J. C., & Verdin, E. (2017). β-Hydroxybutyrate: A signaling metabolite. Annual Review of Nutrition, 37, 51–76. https://doi.org/10.1146/annurev-nutr-071816-064916
[10] Paoli, A., Rubini, A., Volek, J. S., & Grimaldi, K. A. (2013). Beyond weight loss: A review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. European Journal of Clinical Nutrition, 67(8), 789–796. https://doi.org/10.1038/ejcn.2013.116
