Xylitol, Once Thought Healthier Than Sugar, Linked to Increased Risk of Heart Attack and Stroke

German Research Team Conducts Long-Term Analysis of 17,710 Adults
Top 25% for Blood Xylitol Levels Face 57% Higher Stroke Risk
Observational Study, Not Causation; Further Validation Required

A study has found that individuals with higher levels of xylitol in their blood are at greater risk for heart attacks and strokes.

Image related to xylitol to help understand the article. Pexels

On September 5 (local time), NewsNation in the United States reported on the findings of a research team at Charité University Hospital in Berlin, Germany, who analyzed the association between xylitol and cardiovascular disease. The results were presented at the annual congress of the European Society of Cardiology (ESC), which took place in Munich, Germany from August 28 to 31, and the study was presented on August 29.

Xylitol is a sugar alcohol sweetener with fewer calories than sugar. It provides sweetness without significantly raising blood sugar levels and is used as a sugar substitute in sugar-free gum, candies, beverages, and diet foods. NewsNation, citing health information from Harvard Medical School, reported that “xylitol is found in baked goods, nut butters, ice cream, chewable vitamins, and cough syrups.”

The researchers compared blood xylitol levels and the incidence of cardiovascular disease among 17,710 adults participating in two large prospective cohort studies: the Canadian Longitudinal Study on Aging (CLSA) and the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk).

The results showed that, among Canadian participants, the group in the top 25% for blood xylitol levels had a 57% higher risk of experiencing heart attack, stroke, or death within six years compared to the bottom 25%. In the British study, which spanned 30 years, the high xylitol group also faced an 18% greater risk. This association persisted after adjusting for age, sex, smoking status, body mass index (BMI), hypertension, diabetes, and other traditional risk factors in both studies. The consistent trend of higher incident rates of cardiovascular events with rising blood xylitol levels across both studies indicates that these results are not limited only to certain outlier groups with extremely high levels.

Dr. Marco Witkowski of Charité University Hospital stated, “Artificial sweeteners are generally believed to be healthier than sugar, and regulators mostly consider them safe,” adding, “These long-term follow-up results highlight how little we know about the cardiovascular safety of xylitol.”

The pathway identified by the researchers is thrombosis. Previous research has shown that xylitol can enhance the ability of platelets to form blood clots. When platelets are excessively activated and clots form, they can block blood vessels, potentially leading to heart attacks or strokes.

The key factor is concentration. Xylitol is not only ingested through food but is also naturally produced in small amounts during the body’s glucose metabolism. However, the concentration of xylitol found in commercially available sugar-free gum, diet foods, and beverages can be more than 1,000 times higher than endogenous levels. Dr. Witkowski noted, “As the amount of xylitol used in products continues to increase, further studies are necessary.”

However, these findings alone do not confirm that xylitol causes heart attacks or strokes. This was an observational study examining the association between blood xylitol levels and disease occurrence, and the data are at the conference presentation stage and have not yet undergone peer review or been published in a scientific journal. Since blood xylitol is produced both through dietary intake and metabolic processes, additional clinical research is needed to determine whether high levels are due to food consumption or are linked to other metabolic factors.

This content was produced with the assistance of AI translation services.