A low-calorie sweetener called xylitol is used in many reduced-sugar foods and products like gum and toothpaste. A new study found it may nearly double the risk of heart attacks, stroke, and death in heavy consumers.
“We gave healthy volunteers a typical drink with xylitol to see how high the levels would get, and the (levels of xylitol) went up 1,000-fold,” said Dr. Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute.
“When you eat sugar, your glucose level may go up 10% or 20%, but it doesn’t go up 1,000-fold,” Hazen said. He also directs the Cleveland Clinic’s Center for Microbiome and Human Health.
“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,” Hazen added.
In 2023, the same researchers found similar results for another low-calorie sweetener, erythritol. Erythritol is used as a bulking sugar in stevia, monkfruit, and keto reduced-sugar products.
Lab and animal research showed erythritol and xylitol might cause blood platelets to clot more readily. Clots can travel to the heart, causing a heart attack, or to the brain, causing a stroke.
In the new study on xylitol, “differences in platelet behavior were seen even after a person consumed a modest quantity of xylitol in a drink typical of a portion consumed in real life,” said Dr. Matthew Tomey, a cardiologist at Mount Sinai Fuster Heart Hospital in New York City, who was not involved in the study.
“These experiments are interesting but alone do not prove that platelet abnormalities are to account for a linkage between xylitol and clinical events,” said Tomey, also an assistant professor of medicine at the Icahn School of Medicine at Mount Sinai.