Does Xylitol Cause Heart Problems?

New research into the natural sweetener xylitol raises questions about its impact on heart health.

Researchers with Cleveland Clinic recently announced their investigations showed high levels of xylitol could raise the risk of a major cardiovascular event like heart attack or stroke and could make blood clotting more likely.

(Photo: Getty Images)

Xylitol has about half the calories of sugar but is just as sweet. The U.S. Food and Drug Administration approved it for use in food in 1963.

Xylitol is a type of carbohydrate found in “sugar-free” sweets, low-sugar bakery items and oral care products like mouthwash and toothpaste. It occurs naturally in fruits and vegetables in small amounts – produced from birch bark and corn cobs, it is added to candies and treats that are packaged as “diabetes-friendly” or approved for low-sugar keto diets. It can be toxic for dogs.

While the study results point to the need for more research, most people probably don’t need to make major changes to their diet based on what we know now. Study limitations make it hard to know whether these results apply to everyone.

Investigators analyzed blood samples from more than 3,000 adults who were followed for three years to learn about factors that might have influenced their cardiovascular disease. They found that higher levels of xylitol were associated with more risk and more platelet activity, which increases the chance of clots.

These were observational studies, not randomized controlled trials, so while this research does indicate xylitol could be a risk, it is important to conduct further studies to learn more.

Who should be concerned about xylitol

Otherwise healthy people who consume small amounts of xylitol probably don’t need to be concerned about its impact on their heart health. However, you should talk with your doctor if you are already at high risk for cardiovascular disease or if you have a blood clotting disorder and you consume more than 30 grams of xylitol per day.

Talk with your doctor about xylitol if you have:

• A disorder that causes blood clots to form more easily, known as hypercoagulability or thrombophilia
• Traditional risk factors for cardiovascular disease, such as high blood pressure, uncontrolled diabetes or very elevated cholesterol

 
Some patients who experience dry mouth may be prescribed mouthwashes to help with symptoms. These products often contain very small amounts of xylitol. Based on the data we have at this time, there is no reason to discontinue use of these oral care products.

Eat fresh foods for heart health

While there is reason to further investigate xylitol’s impact on heart health, most people don’t need to stop using these products.

In general, people should support their cardiovascular system by consuming a diet low in highly processed foods. The Mediterranean Diet, for instance, is a fresh food-based eating pattern that has been proven to be good for your heart.

If you have risk factors for cardiovascular disease, talk with your doctor about how to support your heart health, and whether you should consider alternatives to xylitol.

Article written by Dr. Syed Waqas Haider, Medstar Washington Hospital Center