Xylitol, a Common Sweetener, Linked to Increased Risk of Heart Attack and Stroke in Large Observational Study

A widely used artificial sweetener found in chewing gum, toothpaste, jam, yoghurt, and ice-cream has been linked to an increased risk of strokes, heart attacks, and death, according to the largest study of its kind presented at the European Society of Cardiology (ESC) annual congress in Munich, the world's largest heart conference.

Xylitol查看药品详情 is a sugar alcohol present in some natural foods in very low amounts, but it is also added—often in amounts 1,000 times higher—to artificially sweeten foods, beverages, and oral care products. Despite its growing use, the long-term health impacts of xylitol have never been widely studied.

Study Design and Key Findings

Researchers examined 17,710 people and compared the 25% with the highest levels of xylitol查看药品详情 in their blood against the 25% with the lowest. Those with the highest amount were 57% more likely to die or suffer a heart attack or stroke than those with the least within six years. Even after 30 years, they were still 18% more likely to have suffered one of these cardiac events.

The research drew on two large study cohorts of more than 17,700 Canadian and British participants. Over a six-year follow-up, people in the Canadian Longitudinal Study on Aging with the highest xylitol查看药品详情 levels had a 57% higher risk of death, myocardial infarction, or stroke related to cardiovascular events compared to those with the lowest levels. Over 30 years, participants in the European Prospective Investigation into Cancer (EPIC)-Norfolk group with the highest xylitol levels had an 18% greater risk of major adverse cardiovascular events (MACE).

Taken with data from the middle quartiles, the results from both cohorts suggested a dose-dependent relationship: the higher the xylitol查看药品详情 blood levels, the higher the cardiovascular event rate. The researchers also highlighted that the association was independent of underlying factors such as body mass index, hypertension, diabetes, and lipid levels, which might predispose people to low-calorie products. These higher risks persisted even after the researchers adjusted for other factors like age, gender, body mass index, hypertension, diabetes, and lipid levels.

Mechanism and Prior Evidence

The study's author, Dr. Marco Witkowski, from the Charité university hospital (搜索)搜索该词条 in Berlin, said the results built on research that had raised concerns about xylitol查看药品详情. "In previous studies, we showed that xylitol can enhance the ability of platelets to form clots," he said. Witkowski and his colleagues also found that high blood levels of xylitol were linked to adverse heart events in high-risk people over a three-year period.

"Artificial sweeteners are consumed by people who think they are healthier than sugar and they are generally regarded as safe by regulatory agencies," Witkowski said. "Our long-term findings in the general population highlight how little we know about the cardiovascular safety of xylitol查看药品详情 and indicate that further studies are warranted, especially as the amount of xylitol in products continues to increase."

Expert Perspectives and Limitations

Prof Dan Atar, an expert member of the ESC communication committee who was not involved with the research, said: "Artificial sweeteners are widely embraced by modern society, and the safety ratings had been good and granted by regulatory authorities. In this observational work, however, it appears that xylitol查看药品详情 has a negative long-term effect on cardiovascular events in the general population. As with all observational studies, causalities are difficult to infer, but this work shows that further studies are mandated into this societally important topic."

Dell Stanford, a senior dietitian at the British Heart Foundation查看公司主页, noted that risks to heart health built up over time and that it was vital to ensure what was being added to foods did not contribute. "Artificial sweeteners such as xylitol查看药品详情 are found in many foods and drinks, and people may assume they are the healthier choice, so consume more than they realise. This study adds to growing evidence that artificial sweeteners could have an impact on our health," Stanford said.

Stanford emphasized the study's limitations: "It is important to note that this was an observational study, meaning it can only show an association between higher xylitol查看药品详情 levels and cardiovascular events, rather than proving that xylitol directly caused them, and further research is needed. But it is not a green light to have more sugar instead, as we still need to reduce our free sugar intake."

The report also does not establish whether high levels of xylitol查看药品详情 in the blood necessarily reflect dietary consumption, as the sugar alcohol can also be produced naturally in the body as part of glucose metabolism.

Dr. Aseem Malhotra, a cardiologist and public health campaigner based in London who was not involved in the study, told Fox News Digital: "These disturbing findings with [a] plausible mechanism of xylitol查看药品详情 increasing cardiovascular risk should be taken very seriously." He added that one of the most important dietary changes to reduce cardiovascular risk is to "unsweeten your sweet tooth."