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New Study Finds That This Common Low-Calorie Sweetener Could Increase Your Risk of a Heart Attack or Stroke

A June study published in the European Heart Journal examines the impacts of xylitol


A new study published by the European Heart Journal has found that xylitol, the low-calorie sweetener used in reduced-sugar foods, gum and toothpaste, is possibly linked to twice the risk rate of heart attack, stroke and even death. Keep scrolling to learn about the study, its results and more. 

What is xylitol? 

Xylitol  is a sugar alcohol that is as sweet as normal sugar but contains about half the calories. Small amounts of it naturally occur in fruits and vegetabales, and the human body also produces an amount on its own. A number of doctors and dietitians actually recommend it as a sugar substitute for people with obesity, diabetes or prediabetes, given its caloric difference.  

“It’s sold as a so-called natural sweetener, and because xylitol doesn’t spike blood sugar levels, it’s also marketed as low carb and keto-friendly,” senior study author Dr. Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute, said about the low-calorie sugar substitute . 

He went on to say, “If you actually do the calculation, it literally takes a tonnage of fruit to be equivalent to one diabetic cookie that can have like nine grams of xylitol, which is a typical label amount … It would be like eating salt at the level of a salt lick.”

Related: Cutting Back on Sugar? Docs Say Sucralose Is OK In Moderation, But May Have Sneaky Side Effects

What products contain xylitol? 

Detail of a woman putting a folded chewing gum into her mouth

Xylitol is typically  found in sugarless gum, breath mints, toothpaste, mouthwash and cough syrup. In your kitchen, it is most likely in mass-produced cookies, cake mixes, ketchup and candy. 

“Xylitol is cheaper to make than cane sugar and so more and more keeps getting incorporated as a sugar substitute into food. Some 12-ounce drinks that use xylitol as a major artificial sweetener can contain 30 grams or more,” Hazen explained. “You can even buy it in bulk at the grocery store where you’re told to use as a one-to-one substitute for sugar in home cooking.”

He also added, “Humankind has not experienced levels of xylitol this high except within the last couple of decades when we began ingesting completely contrived and sugar-substituted processed foods.” 

Related: What Is Turbinado Sugar? A Chef and a Nutritionist Weigh In On When You Should Reach For It

Is xylitol bad for you? 

Of the study published by the European Heart Journal, Hazen explained, “We gave healthy volunteers a typical drink with xylitol to see how high the levels would get and they went up 1,000-fold.” He noted that when sugar is ingested, the body’s glucose level can increase up to 10 to 20 percent, though never above 1,000-fold.

Xylitol may lead to a higher risk of heart attack and strokes

xylitol study: African American woman feeling sick and holding her chest in pain while sitting on the sofa in the living room

So why exactly are the people who consume a lot of xylitol more at risk for life-threatening health problems? Well, it has to do with how our bodies consume it.

“There’s a receptor on our platelets, which we as yet don’t understand, that is recognizing this molecule and signaling to the platelet to be more prone to clot,” Hazen explained of the study and its conclusions. “Our taste buds can’t tell the difference in the structures between sugar and these other sweeteners, but clearly our platelets can.”

Is there a way to fight blood clots and heart attacks possibly resulting from xylitol? 

As of now, the study did not specify if there was a way to avoid heart attack or stroke increases possibly linked to xylitol. While the study indicated in its conclusion that more examination of xylitol is needed, it noted the World Health Organization’s 2023 warning that artificial sweeteners should be avoided.

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