Xylitol, a sugar alcohol, has been found to increase the risk of heart attack, stroke, and other cardiovascular events according to a study published in the European Heart Journal. This lower-calorie sugar substitute is commonly added to a variety of products such as sugar-free candy and gum, as well as toothpaste. Researchers at the Cleveland Clinic found that high levels of circulating xylitol were associated with a heightened risk of cardiovascular events over a three-year period. The study included a large-scale patient analysis, clinical intervention study, and preclinical research models to confirm their findings.
The research team noted that sugar substitutes, including sugar alcohols and artificial sweeteners, have been increasingly used in processed foods as a healthier alternative over the past decade. Specifically, xylitol and erythritol have been popular choices in products marketed as sugar-free or keto-friendly. While xylitol is not as prevalent in the United States as erythritol, it is commonly used in other countries. The study highlights the need for further investigation into the long-term cardiovascular effects of these sugar substitutes, especially as they are recommended for conditions like obesity and diabetes.
According to Dr. Stanley Hazen from the Cleveland Clinic, the study findings suggest that consuming products containing high levels of xylitol could increase the risk of blood clot-related events. The analysis of over 3,000 subjects revealed that those with the highest amount of xylitol in their plasma were more likely to experience cardiovascular events. Pre-clinical testing showed that xylitol caused clotting in platelets, potentially leading to thrombosis. It was also observed that platelet activity significantly increased immediately after ingesting xylitol compared to glucose.
While the study had several limitations, clinical observation studies suggest an association between high circulating levels of xylitol and elevated cardiovascular risk. Dr. Cheng-Han Chen, an interventional cardiologist, advises individuals to consider avoiding large amounts of xylitol until further research clarifies its effects. Dr. Rigved Tadwalkar emphasizes the need for more investigation into the cardiovascular safety of various sugar substitutes, as the study on xylitol raises concerns about its impact on heart health. It is important to note that additional research is needed to understand the biological processes at play.
Dr. Bradley Serwer, a cardiologist, stresses the importance of considering one’s overall health when consuming sugar substitutes. He notes that while natural options like monk fruit extract may be reasonable, even products like Stevia mixed with erythritol can potentially increase the risk of platelet clumping and cardiovascular events. Serwer highlights the historical concerns surrounding artificial sweeteners and emphasizes the importance of maintaining a healthy balanced diet with a low glycemic index. Ultimately, caution should be taken when consuming products containing sugar substitutes, especially xylitol, in order to prioritize heart health and overall well-being.