Xylitol sugar substitute linked to increased risk of heart attack and stroke, study finds
Xylitol is the latest sugar substitute to be linked to potential negative health impacts.
In a study from the Cleveland Clinic, published Thursday in the European Heart Journal, researchers found higher amounts of xylitol are associated with an increased risk of heart attack and stroke.
Xylitol, a sugar alcohol found naturally in some plants, is not the most common sweetening agent in sugar-free food products in the U.S. but is often found in sugarless gum and some toothpastes.
The study, which included more than 3,000 participants in the U.S. and UK, was observational, meaning it does not prove causation. Still, it prompts pause when it comes to the use of artificial sweeteners, especially as they continue to gain popularity as healthy alternatives.
"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 research lead Dr. Stanley Hazen in a news release. "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."
The authors note further studies are warranted to better understand the potential health risks.
Last year, the same research team found erythritol, a zero-calorie sugar substitute used to sweeten low-cal, low-carb and "keto" products, to have similar effects on the heart.
While this study also didn't definitively show causation, then-CBS News medical contributor Dr. David Agus said there was "certainly enough data to make you very worried."
In response to the erythritol study, Robert Rankin, executive director of the Calorie Control Council, an international association representing the low- and reduced-calorie food and beverage industry, told CBS News the results are "contrary to decades of scientific research showing low- and no-calorie sweeteners like erythritol are safe, as evidenced by global regulatory permissions for their use in foods and beverages, and should not be extrapolated to the general population, as the participants in the intervention were already at increased risk for cardiovascular events."
Responding to the latest research involving xylitol, Calorie Control Council president Carla Saunders told CBS News the results are "contrary to decades of scientific evidence substantiating the safety and efficacy of low-calorie sweeteners such as xylitol by global health and regulatory agencies."
"While the authors used multiple methods, it should be noted that the findings are limited in their ability to establish association only," Saunders said. "Further, one phase of the study included individuals who were already at increased risk for adverse cardiovascular events. These findings are a disservice to those who rely on alternative sweeteners as a tool to improve their health."
She also noted xylitol's "proven dental benefits, including preventing plaque build-up and tooth decay," and the sweetener's natural occurrence in foods such as strawberries, lettuce and oats.