High Levels of Xylitol Linked to Increased Cardiovascular Risk

Cleveland Clinic researchers have discovered that higher levels of the sugar alcohol xylitol are linked to an increased risk of cardiovascular events, such as heart attacks and strokes. The research team, led by Dr. Stanley Hazen, validated this connection through a comprehensive patient analysis, preclinical research models, and a clinical intervention study. The findings were published today in the European Heart Journal (1^✔ ✔Trusted Source
Xylitol is prothrombotic and associated with cardiovascular risk

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Xylitol is a popular sugar substitute found in sugar-free candies, gums, baked goods, and oral care products like toothpaste. Over the last decade, the use of sugar substitutes, including sugar alcohols and artificial sweeteners, has grown substantially in processed foods marketed as healthy alternatives.

The same research team found a similar link between erythritol and cardiovascular risk last year. Xylitol is not as prevalent as erythritol in keto or sugar-free food products in the U.S. but is common in other countries.

“This study again shows the immediate need for investigating sugar alcohols and artificial sweeteners, especially as they continue to be recommended in combatting conditions like obesity or diabetes,” said 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. “It does not mean throw out your toothpaste if it has xylitol in it, but we should be aware that consumption of a product containing high levels could increase the risk of blood clot related events.”

In this new study, researchers identified that high levels of circulating xylitol were associated with an elevated three-year risk of cardiovascular events in an analysis of more than 3,000 patients in the U.S. and Europe. A third of patients with the highest amount of xylitol in their plasma were more likely to experience a cardiovascular event. To confirm the findings, the research team conducted pre-clinical testing and found that xylitol caused platelets to clot and heightened the risk of thrombosis. Researchers also tracked platelet activity from people who ingested a xylitol-sweetened drink versus a glucose-sweetened drink and found that every measure of clotting ability significantly increased immediately following ingestion of xylitol but not glucose.

The authors note that further studies assessing the long-term cardiovascular safety of xylitol are warranted. The research had several limitations, including that clinical observation studies demonstrate association and not causation. They recommend talking to your doctor or a certified dietitian to learn more about healthy food choices and for personalized recommendations.

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The research is part of Dr. Hazen’s ongoing investigation into factors that contribute to residual cardiovascular risk. His team follows patients over time and finds chemical signatures in blood that can predict the future development of heart and metabolic disease. He has made pioneering discoveries in atherosclerosis and inflammatory disease research, including the seminal discovery linking gut microbial pathways to cardiovascular disease and metabolic diseases.

Reference:

1. Xylitol is prothrombotic and associated with cardiovascular risk - (https://academic.oup.com/eurheartj/advance-article-abstract/doi/10.1093/eurheartj/ehae244/7683453)

Source-Eurekalert