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In the News, Summer 2024: Xylitol Linked to Cardiovascular Risk

A study by Cleveland Clinic researchers, published in the European Heart Journal, has found an association between higher blood levels of xylitol and increased risk of cardiovascular events. Xylitol, a sugar alcohol, is used as a low-calorie sweetener in baked goods, sugar-free candies, and some toothpastes.
Analysis of more than 3,000 patients in the US and Europe showed that those with the highest levels of circulating xylitol (the top third) were about 50% more likely to have cardiovascular events such as heart attack and stroke over the next three years than those with the lowest levels (the bottom third). To confirm the findings, the researchers conducted preclinical testing and found that xylitol increased clotting of platelets and raised thrombosis risk. They also measured platelet activity in people who ingested a xylitol-sweetened drink versus those who were given a glucose-sweetened drink. Clotting ability significantly increased immediately after ingestion of the xylitol but not the glucose.
While small amounts of xylitol occur naturally in fruits and vegetables, levels in artificially sweetened foods can be more than 1,000 times higher. Stanley Hazen, MD, PhD, who led the study, said, “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.”
Sources:
Cleveland Clinic-led study links sugar substitute to increased risk of heart attack and stroke. Cleveland Clinic, June 6, 2024. newsroom.clevelandclinic.org/2024/06/06/cleveland-clinic-led-study-links-sugar-substitute-to-increased-risk-of-heart-attack-and-stroke.
Witkowski M, Nemet I, Li XS, et al. Xylitol is prothrombotic and associated with cardiovascular risk. European Heart Journal. 2024; 45:27. doi:10.1093/eurheartj/ehae244.