High xylitol levels may increase cardiovascular risks by promoting clotting, according to Cleveland Clinic research. Xylitol is a common zero-calorie sweetener found in sugar-free candy and toothpaste.
Cleveland Clinic researchers discovered that higher amounts of the sugar alcohol xylitol are associated with an increased risk of cardiovascular events like heart attack and stroke.
The team, led by Stanley Hazen, M.D., Ph.D., confirmed the association in a large-scale patient analysis, preclinical research models, and a clinical intervention study. Findings were published on June 6 in the European Heart Journal.
Xylitol’s Prevalence and Use
Xylitol is a common sugar substitute used in sugar-free candy, gums, baked goods, and oral products like toothpaste. Over the past decade, the use of sugar substitutes, including sugar alcohols and artificial sweeteners, has increased significantly in processed foods that are promoted as healthy alternatives.
The same research team found a similar link between erythritol and cardiovascular risk last year. Xylitol is not as prevalent as erythritol in keto or sugar-free food products in the U.S. but is common in other countries.
Implications and Recommendations
“This study again shows the immediate need for investigating sugar alcohols and artificial sweeteners, especially as they continue to be recommended in combatting conditions like obesity or diabetes,” said Dr. Hazen, Chair of Cardiovascular and Metabolic Sciences at Cleveland Clinic’s Lerner Research Institute and Co-Section Head of Preventive Cardiology in the Heart, Vascular & Thoracic Institute. “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.”
Study Methodology and Initial Findings
In this new study, researchers identified that high levels of circulating xylitol were associated with an elevated three-year risk of cardiovascular events in an analysis of more than 3,000 patients in the U.S. and Europe. A third of patients with the highest amount of xylitol in their DOI: 10.1093/eurheartj/ehae244
Dr. Hazen also directs Cleveland Clinic’s Center for Microbiome and Human Health and holds the Jan Bleeksma Chair in Vascular Cell Biology and Atherosclerosis.
The study was supported in part by the