A popular sweetener used in chewing gums, toothpastes, yogurts, and jams may be linked to an increased risk of heart attack, stroke, and early death. Unprecedented in scale, a new study presented at the Annual Congress of the European Society of Cardiology (ESC) in Munich revealed that high blood levels of xylitol significantly increase the probability of severe cardiovascular complications.
Xylitol is a sugar alcohol naturally occurring in small amounts in certain foods. However, in diet foods, beverages, and oral care products, it is frequently added artificially at concentrations up to a thousand times higher. Despite its growing global consumption, its long-term effects on human health had not previously been widely studied.
Researchers at Charité – Universitätsmedizin Berlin analyzed medical data from 17,710 individuals, comparing the cohort with the highest blood xylitol levels (top 25% of participants) to those with the lowest. Over a 6-year period, patients with high levels exhibited a 57% increased risk of heart attack, stroke, or mortality, a risk that remained 18% higher when projected over a 30-year span. The study also highlighted a direct dose-dependent relationship: higher blood concentrations of the substance directly correlated with a greater frequency of cardiovascular events.
Notably, this association proved entirely independent of baseline risk factors such as age, sex, weight, hypertension, or diabetes—conditions that often drive individuals to consume low-calorie products. According to lead study author Dr. Marco Witkowski, these results build on previous findings demonstrating that xylitol promotes blood platelet aggregation and clot formation.
Healthcare professionals emphasize that consumers generally view artificial sweeteners as a healthy alternative to sugar, and regulatory bodies traditionally consider them safe. However, as experts point out, although the observational design of the study limits establishing direct causality, xylitol may exert a long-term negative impact on population cardiovascular health, underscoring the urgent need for further research.
British Heart Foundation (BHF) specialists warn the public that these findings should not be interpreted as a green light to revert to regular sugar, excess consumption of which remains a serious health hazard. Medical experts advise individuals to minimize their intake of ultra-processed foods and beverages—often laden with salt, sugar, or artificial sweeteners—and focus instead on a balanced, whole-food diet.
