Researchers unveiled findings linking xylitol, a sugar alcohol used as a sweetener in various consumer products including chewing gum, toothpaste, jam, yoghurts and ice cream, to elevated cardiovascular risks. The compound is present naturally in some foods at minimal concentrations but is added to commercial products at concentrations approximately 1,000 times higher. The study, presented at the European Society of Cardiology annual congress, represents one of the largest investigations into the long-term health effects of the widely used additive.
The research examined 17,710 individuals and compared those in the highest quartile of blood xylitol levels against those in the lowest quartile. Within a six-year timeframe, participants with the highest xylitol levels demonstrated a 57% increased likelihood of experiencing major adverse cardiovascular events, death, heart attack or stroke compared to those with the lowest levels. The elevated risk persisted over longer durations, with participants remaining 18% more likely to experience these cardiac events even after 30 years. The data suggested a dose-dependent relationship, with cardiovascular event rates rising in correlation with blood xylitol concentrations.
Researchers determined that the association between xylitol and cardiovascular events remained consistent across demographic variations and was independent of common risk factors including body mass index, hypertension, diabetes and lipid levels. Dr Marco Witkowski from Charité university hospital in Berlin, one of the study’s authors, noted that previous research had demonstrated xylitol’s capacity to enhance platelet clot formation. He emphasized the limited knowledge surrounding xylitol’s cardiovascular safety despite its increasing prevalence in commercial products and its general classification as safe by regulatory authorities.
Commentators acknowledged both the significance and limitations of the research. Prof Dan Atar noted that while the observational findings warrant further investigation into this societally important topic, establishing direct causality from observational studies remains challenging. Dell Stanford, a senior dietitian at the British Heart Foundation, reinforced that the study demonstrated only an association rather than proof of direct causation, while emphasizing the continued importance of reducing processed food consumption and free sugar intake as part of heart-healthy dietary practices.
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