The safety of sugar substitutes is once again under scrutiny as a recent study by researchers at the Cleveland Clinic suggests a link between the sugar alcohol xylitol and heightened risks of heart attack, stroke, or cardiovascular-related deaths. Published in the European Heart Journal, the study raises concerns about the widespread use of xylitol in various food products and its potential impact on public health.
Xylitol, a sugar alcohol naturally occurring in small amounts in fruits and vegetables and produced by the human body, has gained popularity as a low-calorie sugar substitute. However, its use in sugar-free gum, candies, toothpaste, and baked goods has raised alarms among researchers, especially considering its increasing consumption, particularly in products labeled “keto-friendly.”
The study, led by Dr. Stanely Hazen and his team at the Cleveland Clinic’s Lerner Research Institute, builds upon previous research that found a similar association with another popular sugar substitute, erythritol. The research team aimed to investigate whether naturally occurring xylitol levels in the body could predict cardiovascular risk, especially in individuals without known risk factors like diabetes or high blood pressure.
Analyzing data from over 3,000 participants, the researchers found that individuals with higher levels of xylitol in their blood had approximately double the risk of heart attack, stroke, or death over the following three years compared to those with lower levels. Further experiments with mice, blood samples, and human volunteers suggested that xylitol might activate platelets, leading to increased clotting, a significant risk factor for heart attack and stroke.
While the study highlights the potential dangers of excessive xylitol consumption, it also acknowledges its limitations. The observational nature of the study means it can only establish an association, not causation, between xylitol intake and cardiovascular risk. Additionally, the participants studied were already at high risk for or had documented heart disease, potentially limiting the generalizability of the findings to the broader population.
Despite these limitations, Dr. Hazen advises caution and recommends limiting intake of artificial sweeteners, including xylitol, in favor of natural sugars from fruits and vegetables. However, other experts like Dr. Joanne Slavin from the University of Minnesota-Twin Cities emphasize the importance of personal choice and moderation, noting that sugar alcohols are typically used in small amounts in consumer products.
As researchers continue to investigate the mechanisms and implications of xylitol consumption, the study underscores the importance of balanced dietary choices and further scrutiny of artificial sweeteners in public health policy and consumer education initiative
