Xylitol sweetener in chewing gum linked to heart attacks
A major study links high blood xylitol—common in xylitol chewing gum, jam, and toothpaste—to higher risks of heart attacks, strokes, and death. People with the highest levels were 57% more likely to suffer a major cardiovascular event within six years than those with the lowest. The findings, from the largest research of its kind, were presented at the European Society of Cardiology (ESC) annual congress in Munich.
Key Takeaways
- High blood xylitol levels were associated with a 57% higher risk of heart attack, stroke, or death within six years in a study of 17,710 people.
- Xylitol appears in chewing gum, jam, yoghurt, ice cream, and toothpaste—often at levels far higher than in natural foods.
- Researchers suggest a dose-dependent pattern: more xylitol in the blood correlated with more cardiovascular events.
- Experts stress the findings are observational and do not prove xylitol directly causes cardiac harm, but call for further research.
- Health advisers recommend reducing processed foods with added sweeteners rather than switching back to sugar.
What Is Xylitol and Where Is It Found?
Xylitol is a sugar alcohol found in tiny amounts in some natural foods. It is also added to artificially sweeten products—sometimes at levels roughly 1,000 times higher than those found in nature.
Common sources include chewing gum, jam, yoghurt, ice cream, beverages, and oral care products such as toothpaste. Despite growing use in low-calorie alternatives to sugar, the long-term cardiovascular effects of xylitol had not been widely studied until now.
What Did the Largest Xylitol Study Find?
Researchers led by Dr Marco Witkowski of Charité university hospital in Berlin analysed 17,710 people, comparing the 25% with the highest blood xylitol levels against the 25% with the lowest.
Those with the highest levels were 57% more likely to die or suffer a heart attack or stroke within six years. After 30 years, they remained 18% more likely to have experienced one of these events. Data from middle quartiles suggested a dose-dependent relationship—the higher the xylitol blood levels, the higher the cardiovascular event rate.
The association held regardless of age, sex, body mass index, hypertension, diabetes, or lipid levels—factors that might otherwise push people toward low-calorie sweetened products.
Does Xylitol Cause Heart Attacks and Strokes?
Previous work by the same team showed xylitol can enhance platelets' ability to form clots, and high blood levels were linked to adverse heart events in high-risk patients over three years. Witkowski said the new long-term findings highlight how little is known about xylitol's cardiovascular safety as amounts in products continue to increase.
Prof Dan Atar of the ESC communication committee, who was not involved in the research, cautioned that observational studies cannot firmly establish cause and effect. Dell Stanford, a senior dietitian at the British Heart Foundation, noted the study shows association, not proof—but adds to growing evidence that artificial sweeteners may affect health.
Stanford emphasised this is not permission to eat more sugar. Public health guidance still calls for cutting free sugar intake while limiting processed foods high in sugar, salt, or sweeteners.
Why Does This Matter for Everyday Products?
Regulatory agencies have generally regarded artificial sweeteners as safe, and many consumers choose xylitol chewing gum and similar products believing they are healthier than sugar. This research suggests that assumption deserves closer scrutiny.
For more on emerging health and research trends, see our Future Tech & AI Wonders coverage. Full study details were presented at the ESC congress, as reported by The Guardian.