New research presented at the European Society of Cardiology (ESC) annual congress in Munich has linked xylitol, a common artificial sweetener found in chewing gum, toothpaste, jam, yoghurts and ice cream, to an increased risk of strokes, heart attacks and death. The findings come from a long-term observational study led by Dr Marco Witkowski of the Charité university hospital in Berlin.
The study, presented at the world’s largest heart conference, focused on major adverse cardiovascular events associated with xylitol consumption. Dr Witkowski said: “In previous studies, we showed that xylitol can enhance the ability of platelets to form clots.” This new work extends that research to the general population, suggesting a negative long-term cardiovascular effect.
Study findings and expert warnings
Dr Witkowski highlighted a key concern: “Artificial sweeteners are consumed by people who think they are healthier than sugar and they are generally regarded as safe by regulatory agencies.” However, he added: “Our long-term findings in the general population highlight how little we know about the cardiovascular safety of xylitol and indicate that further studies are warranted, especially as the amount of xylitol in products continues to increase.”
Prof Dan Atar, an expert member of the ESC communication committee who was not involved in the research, commented: “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 has a negative long-term effect on cardiovascular events in the general population.” He noted that “as with all observational studies, causalities are difficult to infer, but this work shows that further studies are mandated into this societally important topic.”
British Heart Foundation response
Dell Stanford, a senior dietitian at the British Heart Foundation charity, said: “Artificial sweeteners such as xylitol 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 stressed 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 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.”
Implications for consumers
Stanford concluded: “This study is a reminder that we all need to reduce our intake of processed foods and drinks that are often high in sugar, salt or sweeteners, and focus on a balanced diet to help protect our hearts.” The findings suggest that consumers who regularly use products containing xylitol may face higher long-term cardiovascular risks, though researchers agree more studies are required to confirm causality.
