Researchers at the Cleveland Clinic have found that high levels of the sugar alcohol xylitol are associated with an increased risk of cardiovascular events such as heart attack and stroke. Xylitol is a lower-calorie sugar substitute with a low glycemic index that is commonly found in sugar-free candies, gums, toothpaste, and other products. The study, published in the European Heart Journal, analyzed over 3,000 subjects in the United States and Europe and found that those with the highest levels of circulating xylitol were more likely to experience cardiovascular events within three years.
The research team conducted preclinical testing to confirm their findings and discovered that xylitol caused clotting in platelets and increased the risk of thrombosis. They also found that measures of clotting ability significantly increased immediately following ingestion of xylitol compared to glucose. However, the researchers noted that their study had limitations, as clinical observation studies demonstrate association and not causation. They emphasized the need for further research to assess the long-term cardiovascular safety of xylitol.
Medical professionals not involved in the study have expressed concern over the findings and advised caution when consuming large amounts of xylitol until its effects are better understood. Dr. Cheng-Han Chen, an interventional cardiologist, highlighted that xylitol may affect platelet stickiness in the bloodstream, potentially increasing the risk of blood clot formation. Dr. Rigved Tadwalkar, a consultative cardiologist, noted that while the study was observational and does not definitively prove causation, it raises enough concern to warrant further investigation into the cardiovascular effects of xylitol.
The research findings also bring into question the use of other sugar substitutes, such as erythritol, and their potential impact on heart health. Dr. Bradley Serwer, a cardiologist, cautioned against the widespread consumption of sugar substitutes and recommended maintaining a healthy balanced diet with a low glycemic index. He suggested considering natural sweeteners like monk fruit extract, as some artificial sweeteners mixed with sugar alcohols, such as Stevia with erythritol, may also pose risks of platelet clumping and increased cardiovascular events. Overall, more research is needed to fully understand the biological processes at play and the long-term effects of various sugar substitutes on heart health.
