Xylitol may increase the risk of cardiovascular events

A study set to be presented at the ESC Congress 2026 indicates a potential link between elevated blood levels of the artificial sweetener xylitol and a heightened risk of major cardiovascular events. Xylitol, a sugar alcohol naturally occurring in the body, is commonly added to foods, beverages, and oral care products as a sugar substitute.

Despite its widespread use, the long-term effects of xylitol on cardiovascular health have not been extensively studied. Previous research has shown that xylitol can increase platelet clot formation and is associated with cardiovascular events in high-risk individuals over a three-year period.

In this new research, investigators analyzed data from 17,710 participants in two large observational studies: the Canadian Longitudinal Study on Aging (CLSA) and the European Prospective Investigation into Cancer (EPIC)-Norfolk. Individuals with the highest levels of xylitol were found to have a significantly greater risk of adverse cardiovascular events, including death, heart attack, or stroke, compared to those with the lowest xylitol levels.

After accounting for known risk factors, the risk was 57% higher in the highest xylitol group over a six-year follow-up period in the CLSA cohort and 18% higher over a 30-year period in the EPIC-Norfolk cohort.

The research team observed a consistent upward trend in cardiovascular events with increasing xylitol blood levels, suggesting a dose-dependent relationship. The association remained consistent regardless of age, sex, or baseline cardiovascular risk factors such as body mass index, hypertension, diabetes, and lipid levels. While artificial sweeteners are generally considered safe by regulatory agencies, this study highlights the need for further research into the potential cardiovascular risks associated with xylitol consumption, especially as its use in products continues to rise.