Study links sweetener xylitol to higher risk of strokes and heart attacks
A large new study has found that high blood levels of xylitol, a sweetener used in chewing gum, toothpaste, jam and yoghurt, are associated with an increased risk of cardiovascular events and death.
Researchers presenting at the European Society of Cardiology congress in Munich have reported findings from the largest study to date examining long-term cardiovascular effects of xylitol, a sugar alcohol widely added to foods, drinks and oral care products.
Xylitol occurs naturally in tiny amounts in some foods but is added industrially in far higher concentrations to sweeten items such as chewing gum, toothpaste, jam, yoghurt and ice-cream.
What the study found
The research, led by Dr Marco Witkowski of Charité university hospital in Berlin, examined data from 17,710 people, comparing the quarter with the highest blood xylitol levels against the quarter with the lowest. Over six years, those with the highest levels were 57% more likely to die or suffer a heart attack or stroke. Even after 30 years, the elevated-risk group remained 18% more likely to have experienced such an event.
The results pointed to a dose-dependent pattern, with higher blood xylitol levels corresponding to higher rates of cardiovascular events. The association held regardless of age, sex, body mass index, hypertension, diabetes or lipid levels.
Expert reaction
Witkowski noted that earlier research had already shown xylitol can enhance blood platelets' ability to form clots, and separately linked high xylitol levels to adverse heart events in high-risk patients. He said artificial sweeteners are widely consumed by people who believe them healthier than sugar, yet their cardiovascular safety remains poorly understood.
Prof Dan Atar of the ESC communication committee, who was not involved in the study, said causality is hard to establish in observational research but that further studies are clearly warranted. Dell Stanford, a senior dietitian at the British Heart Foundation, said people often consume more artificial sweeteners than they realise and stressed the findings are not a reason to switch back to sugar, but rather a reminder to reduce reliance on processed foods and drinks generally.
