Consuming greater amounts of the artificial sweetener xylitol may increase the risk of heart attack and stroke, according to a new study.
The research, presented this week at the ESC Cardiology Congress in Germany, indicated that higher concentrations of xylitol in the blood were linked to an increased risk of major adverse cardiovascular events (MACE).
Xylitol is a sugar alcohol commonly used as a low-calorie sweetener and sugar substitute. It is found in various food, drink, chewing gum, and dental care products.
Researchers analyzed data from over 17,700 participants across two cohorts: the Canadian Longitudinal Study on Aging and the European Prospective Investigation into Cancer (EPIC)-Norfolk study. Over a six-year follow-up, individuals in the Canadian cohort with the highest xylitol levels faced a 57% greater risk of death, myocardial infarction, or stroke compared to those with the lowest levels.
In the EPIC-Norfolk group, participants with the highest xylitol levels showed an 18% greater risk of MACE over a 30-year period. Both cohorts demonstrated a dose-dependent association, meaning higher blood xylitol concentrations correlated with increased rates of cardiovascular events.
These elevated risks remained even after researchers accounted for factors such as age, gender, body mass index, hypertension, diabetes, and lipid levels. The study noted that previous research has suggested xylitol can enhance platelet clot formation.
"Our long-term findings in the general population highlight how little we know about the cardiovascular safety of xylitol and indicate that further studies are warranted, especially as the amount of xylitol in products continues to increase," stated Dr. Marco Witkowski, a presenter of the study from Charité University Hospital in Berlin.
The study's observational nature means it cannot definitively prove that xylitol causes cardiovascular events, and researchers emphasized the need for further investigation. The report also did not establish whether high blood xylitol levels directly reflect dietary intake, as the substance can be naturally produced by the body during glucose metabolism.
Dr. Aseem Malhotra, a cardiologist not involved in the study, commented that these findings, given a plausible mechanism for increased cardiovascular risk, should be taken seriously. He advised patients to avoid all processed sugars and artificial sweeteners for six weeks to help break dependency.