Xylitol increases heart health risks | TIME

lLosing weight is one of the best ways to reduce your risk of heart disease, and reducing your sugar intake can help. But sweeteners that mimic the taste of sugar with fewer (or no) calories could increase, rather than decrease, the risk of some cardiac events.

In a study published Thursday in it European Heart MagazineAn international group of researchers led by a team at the Cleveland Clinic reports that higher levels of xylitol, a sugar substitute found in candy and even toothpaste, are linked to an increased risk of heart attack, stroke and death.

The study included more than 3,000 people in the U.S. and Europe, about half of whom had a history of heart disease and almost all of whom had at least some risk factors for heart disease. They were followed for several years. The researchers measured xylitol levels in the participants.blood after an overnight fast, and found that those with the highest levels had twice the risk of having a heart attack, stroke or death within three years compared to those with the lowest levels.

To better understand the connection between xylitol and cardiac events, scientists injected xylitol into mice and analyzed what effect the chemical had on the animals’ cardiovascular systems. Xylitol increased blood clotting by triggering platelet activation. The researchers confirmed this mechanism by giving people a xylitol-based drink and a glucose-based drink, and found that xylitol levels increased 1,000-fold in plasma immediately after drinking the xylitol drink, along with levels of factors coagulation, but not after consuming the glucose drink.

“Even in people who had no history of heart disease, xylitol levels still predicted future cardiac events,” says Dr. Stanley Hazen, chair of cardiovascular and metabolic sciences at the Cleveland Clinic and senior author of the paper.

Hazen says xylitol should be considered similar to cholesterol when it comes to heart disease. Like cholesterol, it is produced in the body and people have different levels of this chemical in their blood. But consuming more xylitol as a sugar substitute in foods or drinks could increase any initial risk people already have for blood clotting. In the study, the levels the team recorded likely reflected baseline xylitol levels rather than dietary xylitol, since the chemical is eliminated from the body in four to six hours and the volunteers had fasted overnight.

“The goal of this research is to find pathways that contribute to heart disease beyond traditional risk factors like cholesterol, high blood pressure and diabetes,” says Hazen. “And xylitol is one of them.”

This is the second new potential risk factor that Hazen and his team identified; Last year, the group found a similar increased risk among people with higher levels of another sugar substitute, erythritol, in their blood. Xylitol and erythritol are considered polyols or sugar alcohols, and both occur in nature, unlike some artificial sweeteners (including aspartame, sucralose, and saccharin) which are synthetic. While the American Heart Association does not specifically address xylitol, it advises that for heart health, people avoid sugar and opt for low- or no-calorie options, including those containing erythritol.

“I think it’s much wiser to avoid them and be more cautious with the amount of sugar you use,” Hazen says. “The same people who are most at risk—those who are diabetic, obese, or have metabolic syndrome—are the ones who unknowingly make the unhealthy choice. “I am absolutely convinced that sugar alcohols pose a risk for cardiovascular disease based on all the clinical and mechanistic data we are seeing.”

Hazen is particularly concerned because, in his studies, the increased risk is greater than that associated with high cholesterol levels. The U.S. Food and Drug Administration considers artificial sweeteners safe in foods and beverages, but the latest results suggest more research is needed to better understand how they affect heart disease. Hazen hopes this initial work will generate additional studies that could eventually lead to a test of xylitol and erythritol levels, and even a drug treatment similar to statins that treat cholesterol.

Leave a Comment