Concerns about the safety of sugar substitutes are mounting as new research links xylitol to serious heart risks. Scientists at Cleveland Clinic discovered a troubling association with heart attacks, strokes, and cardiovascular deaths.
Xylitol’s Safety Under Scrutiny
A new study raises concerns about the low-calorie sugar substitute xylitol. Researchers at Cleveland Clinic linked it to a higher risk of heart attacks, strokes, and cardiovascular deaths.
What is Xylitol?
Xylitol, a sugar alcohol found naturally in fruits and vegetables, mimics sugar but with fewer calories. It’s prevalent in sugar-free gum, candies, toothpaste, baked goods, and keto-friendly products, especially in Europe.
Rising Use of Sugar Substitutes
The same team previously found a similar risk with erythritol, another popular sugar substitute. The use of these substitutes has soared as obesity rates continue to climb.
Hidden Dangers
People without traditional risk factors like diabetes or high cholesterol are still experiencing heart attacks and strokes. This prompted researchers to study naturally occurring sugar alcohols for potential cardiovascular risk indicators.
Study Findings
Researchers measured xylitol levels in over 3,000 participants after overnight fasting. Those in the top 25% for xylitol levels faced double the risk of heart attack, stroke, or death within three years compared to those in the lowest 25%.
Investigating the Mechanism
To understand how xylitol impacts health, researchers tested its effects on mice, blood samples, and human volunteers. They found xylitol activated platelets, increasing the likelihood of clotting, which leads to heart attacks and strokes.
Platelets and Blood Clots
Even brief exposure to xylitol can “supercharge” platelets, making them more prone to clotting. This discovery underscores the potential danger posed by the sugar substitute.
Future Research Directions
Understanding why some people have higher natural xylitol levels and how to reduce them is the next research focus. Cardiologist Dr. Sadiya Khan highlights the need for further studies to answer these questions.
Practical Recommendations
Until more research is done, patients are advised to avoid xylitol and other sugar alcohols. Instead, they should use small amounts of sugar, honey, or fruit for sweetness, noting that small doses in toothpaste and gum are likely safe.
Limitations of the Study
The report acknowledges several key limitations, emphasizing the need for ongoing research. These findings are preliminary and require further validation.
Observational Nature of the Study
The study on naturally occurring xylitol in blood is observational, showing only an association with heart risk. It does not prove that xylitol causes heart attacks, strokes, or deaths.
Limiting Artificial Sweeteners
Given the evidence, limiting artificial sweeteners is reasonable, says Khan. Instead of replacing sugar with substitutes, focusing on high-quality dietary components like fruits and vegetables may be better.
Avoiding Artificial Sweeteners
Artificial sweeteners are listed on ingredient labels, making them easy to avoid, says Joanne Slavin, a professor of food science and nutrition. She emphasizes personal choice, especially for those struggling to reduce sugar intake.
Practical Use of Sugar Substitutes
Slavin, uninvolved with the study, acknowledges that sugar substitutes can be a useful tool for some. However, she notes that sugar alcohols are generally used in small amounts due to their cost.
Study Limitations
The study participants had high cardiovascular risk, so results may not apply to healthy individuals. Despite this, many in the general public share similar risk factors, making the findings relevant.
Common Health Issues
In middle-aged or older Americans, conditions like obesity, diabetes, high cholesterol, or high blood pressure are common. This demographic often mirrors the study participants’ characteristics, underscoring the study’s importance.
