Study links xylitol to higher heart attack, stroke risk

A common sugar substitute found in sugar-free chewing gum, mints, toothpaste, and low-calorie foods has been linked to a higher risk of heart attack, stroke, and death in a large-scale study presented at the European Society of Cardiology (ESC) Congress 2026 in Munich on Thursday.economictimes+1

Researchers analyzed blood levels of xylitol in 17,710 participants from two prospective population studies — the Canadian Longitudinal Study on Aging and the European Prospective Investigation into Cancer (EPIC-Norfolk) — and found that those in the highest quartile of xylitol levels were 57% more likely to experience a major cardiovascular event within six years than those in the lowest quartile. After 30 years of follow-up, the higher-risk group remained 18% more likely to have suffered a heart attack, stroke, or death.yahoo+1

A Dose-Dependent Pattern

The association followed a dose-dependent pattern: as circulating xylitol levels rose across quartiles, so did cardiovascular event rates. The relationship held after adjusting for age, sex, smoking, body mass index, diabetes, hypertension, and lipid levels.news.ssbcrack+1

"Artificial sweeteners are consumed by people who think they are healthier than sugar and they are generally regarded as safe by regulatory agencies," said Dr. Marco Witkowski of Charité University Hospital in Berlin, the study's lead author. "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."newser+1

Observational, Not Causal

The study is observational and cannot prove that xylitol directly causes cardiovascular events. Prof. Dan Atar, a member of the ESC Communication Committee, cautioned against overinterpretation but noted the findings demand further investigation. "It appears that xylitol has a negative long-term effect on cardiovascular events in the general population," he said. "As with all observational studies, causalities are difficult to infer, but this work shows that further studies are mandated into this societally important topic."el-balad+1

The findings build on earlier work by the same research group showing xylitol can enhance the ability of platelets to form clots — a potential mechanism linking the sweetener to cardiovascular risk. Xylitol is added to consumer products in quantities roughly 1,000 times greater than the trace amounts found naturally in some foods.yahoo+1

Dell Stanford, a senior dietitian at the British Heart Foundation, said the study "adds to growing evidence that artificial sweeteners could have an impact on our health," while stressing it is "not a green light to have more sugar instead."yahoo