Based on the research results presented at the European Society of Cardiology Congress, “Everyday Health” writes about this.
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The researchers analyzed data from two long-term studies – the Canadian Longitudinal Study on Aging (CLSA) and the European Prospective Investigation into Cancer and Nutrition EPIC-Norfolk. In total, about 18,000 adults were evaluated, with an average age of 61 years.
Blood tests allowed scientists to determine the concentration of xylitol in the participants’ bodies, so they did not have to rely solely on their memories of their diet. Canadian study participants were observed for six years, and EPIC-Norfolk for 30 years. During this time, more than 8,600 serious cardiovascular events were recorded.
It turned out that a higher concentration of xylitol in the blood was associated with more frequent heart attacks, strokes, and premature deaths.
In the Canadian study group, people with the highest concentration of xylitol in their blood had a 47% higher risk of a serious cardiovascular event than those with the lowest levels of this sweetener in their bodies. Scientists also took into account other known risk factors – age, sex, smoking, and diabetes.
In the EPIC-Norfolk study group, the risk was 18% higher for people with the highest xylitol concentration.
How much xylitol they consumed is unknown
The researchers were unable to accurately determine how much xylitol the participants received from food. One of the study authors, Mario Witkowski, a scientist at Berlin University Hospital Charité, admitted that calculating the daily amount was impossible.
Sweeteners can be used in various processed products, so people do not always know how much they actually consume.
It is also important that xylitol can be formed in the human body during metabolic processes. For this reason, a higher concentration in the blood does not necessarily accurately reflect how much sweetener a person received from food.
Where is xylitol used?
Xylitol is a low-calorie sweetener belonging to the sugar alcohol group. Small natural amounts are found in plums, strawberries, cauliflower, and pumpkins.
It is used in larger amounts in various sugar-free or lower-calorie products:
- chewing gum;
- candies and mints;
- drinks and baked goods;
- toothpaste and mouthwashes;
- some vitamin supplements;
- some types of peanut butter.
Xylitol is valued for its positive effects on oral health. It can inhibit the growth of bacteria that cause tooth decay and reduce plaque buildup.
May promote clot formation
This is not the first study to raise questions about the possible effects of xylitol on the cardiovascular system. A study published in 2024 showed that this sweetener can increase platelet reactivity, in other words, promote their clumping and blood clot formation.
Interventional cardiologist Sanjiv Patel explained that platelets help stop bleeding, but when overly activated, they can form a clot. Such a clot blocking a heart or brain blood vessel can cause a heart attack or stroke.
According to M. Witkowski, previous experiments with human blood showed that xylitol can directly enhance the ability of platelets to clump. This could explain the association observed in the new study, but more research is needed to confirm this mechanism.
Should xylitol be avoided?
The study was observational, so it does not prove that xylitol causes heart attacks, strokes, or premature death. Scientists only found a statistical association, which could also be influenced by other participant health, diet, or lifestyle factors.
Toxicologist Kelly Johnson-Arbor emphasized that current data are not sufficient for firm conclusions. Further studies are needed to precisely determine the effects of xylitol on the cardiovascular system.
According to S. Patel, it is worth being more cautious with this sweetener for people who already have cardiovascular disease risk factors. However, there is currently not enough evidence to say that xylitol must be completely avoided.
M. Witkowski advises not to consume large amounts of sweeteners and to choose minimally processed foods as often as possible. In other words, occasionally chewing sugar-free gum is not a cause for concern, but products containing large amounts of xylitol should not automatically be considered a healthier alternative to regular sweets.
