Cleveland Clinic researchers have discovered that higher levels of the sugar alcohol xylitol are linked to a greater risk of cardiovascular events such as heart attack and stroke. This association was confirmed by the team in a comprehensive analysis of patient data, as well as in preclinical research models and a clinical intervention study. Dr. Stanley Hazen led the team in this research.The findings of a clinical intervention study were published today in the European Heart Journal. Xylitol, a sugar substitute commonly used in sugar-free candy, gums, baked goods, and oral products like toothpaste, has seen increased use over the past decade. This includes the use of sugar substitutes, such as sugar alcohols and artificial sweeteners, in processed foods marketed as healthy alternatives.
Last year, the same research team found a similar link between erythritol and cardiovascular risk. While xylitol is not as prevalent as erythritol in keto or sugar-free food products in the U.S., it is commonly used in other products.her countries.
“This research once again underscores the urgent need to investigate the effects of sugar alcohols and artificial sweeteners, particularly as they continue to be recommended for addressing conditions such as obesity or diabetes,” stated Dr. Hazen, Chair of Cardiovascular and Metabolic Sciences at Cleveland Clinic’s Lerner Research Institute and Co-Section Head of Preventive Cardiology in the Heart, Vascular & Thoracic Institute. “This doesn’t mean you should get rid of your toothpaste if it contains xylitol, but we should be aware that consuming a product with high levels could potentially increase the risk of blood clot related events.”
In this recent study,In a study of over 3,000 patients in the U.S. and Europe, researchers found that high levels of xylitol in the blood were linked to a higher three-year risk of cardiovascular events. One third of patients with the most xylitol in their blood had a greater chance of experiencing a cardiovascular event. Further testing confirmed these results, showing that xylitol increased clotting in platelets and raised the risk of thrombosis. Comparing the effects of a xylitol-sweetened drink to a glucose-sweetened drink, researchers observed increased platelet activity in those who consumed the xylitol drink.Clotting ability saw a significant increase right after consuming xylitol, but not glucose. The authors suggest that more research should be done to assess the long-term cardiovascular safety of xylitol. The study had a few limitations, such as the fact that clinical observation studies only show association, not causation. They advise consulting a doctor or certified dietitian for more information on healthy food choices and personalized recommendations.
This research is part of Dr. Hazen’s ongoing investigation into factors that contribute to residual cardiovascular risk.The research team monitors patients over time and identifies chemical markers in the blood that can predict the future development of heart and metabolic diseases. This research has led to groundbreaking findings in atherosclerosis and inflammatory disease studies, including the significant discovery of the connection between gut microbial pathways and cardiovascular and metabolic diseases.
Dr. Hazen is also the head of Cleveland Clinic’s Center for Microbiome and Human Health and holds the Jan Bleeksma Chair in Vascular Cell Biology and Atherosclerosis.
Funding for the study was provided in part by the National Institutes of Health and the Office of Dietary Supplements.
Hazen is listed as a co-inventor on patents related to cardiovascular diagnostics and therapeutics held by Cleveland Clinic.
