Researchers have identified a potential link between elevated blood levels of xylitol and increased risk of major adverse cardiovascular events. Xylitol is a sugar alcohol that occurs naturally in some foods in minimal quantities but is added to various consumer products including chewing gum, toothpaste, jam, yogurts and ice cream, often in concentrations 1,000 times higher than naturally occurring amounts.
The study, described as the largest of its kind, examined data from 17,710 individuals. When comparing the 25% of participants with the highest xylitol blood levels to the 25% with the lowest levels, researchers found that those with the highest amounts were 57% more likely to experience death, heart attack or stroke within six years. The elevated risk persisted over longer timeframes, with participants in the highest group remaining 18% more likely to suffer such cardiovascular events even after 30 years.
The research suggested a dose-dependent relationship, meaning cardiovascular event rates increased alongside rising xylitol blood levels. This pattern remained consistent across different demographic groups regardless of age and sex, and persisted independently of other contributing factors such as body mass index, hypertension, diabetes and cholesterol levels. The findings were presented at the European Society of Cardiology annual congress in Munich.
Dr Marco Witkowski, the study’s lead author from Charité university hospital in Berlin, noted that previous research had already raised concerns about xylitol’s effects on blood clotting. He emphasized that despite widespread consumption of artificial sweeteners based on the assumption they are healthier alternatives to sugar and regulatory approval from agencies, long-term cardiovascular safety data remain limited. As xylitol usage in commercial products continues to expand, Witkowski called for additional investigation.
Experts cautioned that while the observational study demonstrates an association between higher xylitol levels and cardiovascular events, establishing direct causation requires further research. Health professionals emphasized the importance of reducing processed food and sweetener consumption overall while maintaining balanced dietary choices.
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