A recent study has suggested a potential link between the consumption of a low-calorie sweetener, xylitol, and an increased risk of heart attacks, stroke, and death. Xylitol, commonly found in reduced-sugar foods and products such as gum and toothpaste, was observed to cause a significant increase in blood sugar levels in healthy volunteers.
Dr. Stanley Hazen, the senior author of the study and director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute, noted that the blood sugar levels of the volunteers increased by a factor of 1,000 after consuming a drink containing xylitol. This is a stark contrast to the 10% to 20% increase typically observed after consuming sugar.
Hazen also pointed out that the high levels of xylitol consumption are a relatively recent phenomenon, coinciding with the increased use of sugar substitutes in processed foods over the past few decades. In 2023, the same team of researchers found similar results with another low-calorie sweetener, erythritol, which is commonly used in stevia, monkfruit, and keto reduced-sugar products.
Further research, including lab and animal studies, suggested that both erythritol and xylitol could cause blood platelets to clot more readily. These clots can potentially trigger heart attacks or strokes if they break off and travel to the heart or brain.
Dr. Matthew Tomey, a cardiologist at Mount Sinai Fuster Heart Hospital in New York City, who was not involved in the study, cautioned that while the findings are interesting, they do not conclusively prove that platelet abnormalities are the cause of the observed link between xylitol consumption and cardiovascular events.
The American Heart Association predicts that 61% of American adults will have cardiovascular disease by 2050. Therefore, any factor that increases clotting activity, such as the consumption of sugar alcohols like xylitol, is a cause for concern, according to Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver.
Despite these findings, the Calorie Control Council, an industry association, maintains that low-calorie sweeteners like xylitol have been proven safe and effective by global health and regulatory agencies.
Xylitol, a sugar alcohol, is found naturally in foods such as cauliflower, eggplant, lettuce, mushrooms, spinach, plums, raspberries, and strawberries. However, the quantities found in these natural sources are minuscule compared to the amounts used in commercial products.
The study, published in the European Heart Journal, analyzed blood samples from over 3,000 people at risk for heart disease. The researchers found that people with the highest levels of xylitol in their blood had nearly twice the risk of heart attack, stroke, and death compared to those with the lowest levels.