Could xylitol be less heart-friendly than we thought?

A new study has raised questions about the heart-health benefits of xylitol, a popular low-calorie sweetener found in sugar-free products. Researchers who examined over 17,700 people found those with the highest blood levels of xylitol were 57% more likely to experience a major cardiovascular event, including heart attack, stroke, or death, compared to those with the lowest levels.

Even 30 years later, the risk remained 18% higher. While the study does not definitively prove xylitol causes these events, it does suggest a concerning link that warrants further investigation.

Xylitol, a sugar alcohol found in small amounts in fruits and vegetables, is often added to foods and products to provide sweetness with fewer calories than sugar. However, recent research indicates its effects on the cardiovascular system may be more complicated than previously thought. Laboratory and animal experiments also suggest xylitol could make platelets more reactive and promote clot formation, potentially contributing to blood clots that block arteries and trigger heart attacks or strokes.

Experts stress that the findings are observational and do not establish a direct cause-and-effect relationship. Blood xylitol levels may also be influenced by the body's metabolism, not just by the amount consumed. The research does not mean everyone needs to avoid xylitol entirely, but it does suggest caution, particularly with highly processed foods containing large amounts of the sweetener.

Oral-care products are not the main concern, but the focus should be on limiting the consumption of products with higher xylitol levels. The broader lesson is to be cautious about assuming a "sugar-free" label automatically makes a product healthier, and to focus on maintaining a balanced diet with minimal processed foods.