A Common Low-Calorie Sweetener Could Be Linked to an Increased Risk of Heart Attack and Stroke

A new study published in the European Heart Journal is shedding light on the potential association between consuming the common low-calorie sweetener xylitol — often found in gums, candies, other processed foods, and even toothpaste — and an elevated risk of cardiovascular events. 

The researchers, led by Stanley Hazen, MD, PhD, and director of Cleveland Clinic’s Center for Microbiome and Human Health, analyzed the fasting plasma samples of more than 3,000 patients in the U.S. and Europe and found that those with high levels of xylitol had an elevated three-year risk of cardiovascular events, including heart attacks and strokes.

“We gave healthy volunteers a typical drink with xylitol to see how high the levels would get, and they went up 1,000-fold,” Hazen told CNN. As he further noted, typically, when a person consumes sugar, their glucose rises about 10-20%. “Humankind has not experienced levels of xylitol this high except within the last couple of decades when we began ingesting completely contrived and sugar-substituted processed foods." 

The study also tracked participants' platelet activity — the things in our bodies that come together to seal wounds and prevent bleeding —to see how the sugar substitute affects clotting. As Medical News Today broke down, the findings showed that xylitol might increase the "stickiness of platelets in the bloodstream," which could increase the risk of clotting in the brain and heart, thus leading to that cardiac event. 

Still, Dr. Rigved Tadwalkar, a consultative cardiologist at Providence Saint John's Health Center in California, shared with Medical News Today that it's important for the general consumer to understand this is an observational study that cannot prove xylitol directly leads to cardiovascular problems.

"However, the findings raise enough concern to warrant further investigation," Tadwalkar added.

Hazen also noted in a press release that the study shows that more research needs to be done, especially if artificial sweeteners will "continue to be recommended in combating conditions like obesity or diabetes." Hazen added, "It does not mean throw out your toothpaste if it has xylitol in it, but we should be aware that consumption of a product containing high levels could increase the risk of blood clot-related events."

However, Carla Saunders, the president of the Calorie Control Council, shared in a statement to reporters, "The results of this study are contrary to decades of scientific evidence substantiating the safety and efficacy of low-calorie sweeteners such as xylitol by global health and regulatory ‎agencies." Saunders added, "Xylitol has been trusted as a great tasting low-calorie sweetener for over 60 years. It has proven dental benefits, including preventing plaque build-up and tooth decay, and is naturally occurring in foods such as strawberries, lettuce, and oats." 

Still, Hazen doesn't appear to be backing down from the fight. As he noted to the Washington Post, he hopes this study and its results are "a call for coming to arms, for fellow researchers to start studying this, because this is a huge public health concern, given how much of this stuff we are pumping into our food pyramid, thinking that it's a safe thing."