Sugar Substitute Linked to Higher Risk of Heart Attack

Xylitol, a sugar substitute, is associated with an increased risk of heart attack and stroke, a new study has found.

Higher amounts of a sugar alcohol called xylitol — commonly found in sugar-free candy, gum, toothpaste, and other artificially sweetened products — are associated with an increased risk of cardiovascular events, a new study has found.

The findings, published in the European Heart Journal, are significant given the increase in processed foods containing artificial sweeteners and sugar alcohols that are marketed as healthy.

“This study again shows the immediate need for investigating sugar alcohols and artificial sweeteners, especially as they continue to be recommended in combating conditions like obesity or diabetes,” said lead study author Stanley Hazen, PhD, the chair of Cardiovascular and Metabolic Sciences at Cleveland Clinic’s Lerner Research Institute, in a news release. “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.”

Researchers conducted an analysis of over 3,000 patients in the United States and Europe, finding that those with high levels of xylitol faced an elevated three-year risk of cardiovascular events. Specifically, one third of patients with the most amount of xylitol in their blood were more likely to experience a cardiovascular event such as heart attack or stroke.

Through preclinical testing, the researchers discovered that xylitol causes blood platelets to clot, raising the risk of thrombosis — a blood clot in a blood vessel or chamber of the heart which prevents blood flow.

While tracking platelet activity among participants, they also found that those who consumed a xylitol-sweetened drink had significantly higher measures of clotting ability right after consumption than those who drank a glucose-sweetened drink.

Last year, this same research team found a link between erythritol and cardiovascular risk, another sugar alcohol that is more commonly used in keto and sugar-free products in the U.S.

The authors say further research into the cardiovascular effects of xylitol are needed.