There might be some concerning news for those who enjoy sugar-free and guiltless snacks: Recent research suggests a possible connection between a commonly used artificial sweetener and heart disease.
A team of researchers in Germany looked into data from over 17,000 individuals. They found that those who consumed high levels of xylitol—a sugar alcohol—had noticeably elevated rates of serious cardiovascular issues, like heart attacks, compared to those who consumed less. While these findings aren’t definitive, they indicate that further investigation is necessary to determine the potential risks of xylitol for heart health, according to the researchers.
“Our long-term findings in the general population emphasize how little we know regarding xylitol’s cardiovascular safety, highlighting the need for further research, especially as its presence in products continues to grow,” stated Marco Witkowski, the lead author and a cardiologist at Berlin’s Charité University Hospital, in a release from the European Society of Cardiology.
Sugar-free but not necessarily safe
Low-calorie and non-nutritive sweeteners, encompassing both synthetic substitutes like aspartame and natural alternatives such as stevia, have long faced skepticism about their effects on health. While some of these concerns may be exaggerated—like the myth that aspartame was first developed as poison—recent studies are beginning to challenge the idea that these products are entirely harmless.
Research has been exploring sugar alcohols, which are carbohydrates naturally found in plants, like fruits and vegetables. These compounds serve as artificial sweeteners with significantly fewer calories than regular sugar and typically have names that end with -ol, such as xylitol or erythritol. While sugar alcohols are already associated with digestive issues if consumed in excess, emerging studies hint at more serious long-term risks, particularly related to cardiovascular health, including blood clots and strokes.
In the latest study, researchers analyzed data from two extensive, ongoing health studies: the Canadian Longitudinal Study on Aging (CLSA) and the European Prospective Investigation into Cancer (EPIC)-Norfolk study. Together, they included around 17,000 participants. The researchers classified the participants into four groups based on their xylitol intake and compared those with the highest consumption to those with the lowest.
Over a six-year span, the risk of encountering a major cardiovascular event was 57% greater among the highest xylitol consumers in the CLSA group compared to the lowest. In the EPIC study, those in the top xylitol group showed an 18% increased risk over a 30-year period.
What does this imply?
The findings are set to be shared at the annual European Society of Cardiology conference this weekend. However, it’s important to note that this means the research hasn’t yet undergone the peer-review process, which is crucial for validating scientific work. Additionally, while prospective studies generally provide stronger evidence than retrospective studies, these findings only establish a correlation between xylitol and cardiovascular disease without proving an actual cause-and-effect connection.
Nevertheless, other recent studies, including previous research from this team, bolster the idea that significant consumption of sugar alcohols like xylitol might negatively affect our cardiovascular health. Some scientists are questioning the previously held assumption that sugar substitutes are completely harmless.
“Artificial sweeteners are widely consumed in today’s society, and their safety has typically received endorsement from regulatory bodies. Yet, this observational study suggests that xylitol may have adverse long-term effects on cardiovascular events in the general population,” remarked Dan Atar, part of the ESC Communication Committee, in a statement from the European Society of Cardiology. “As with all observational studies, establishing causalities is challenging, but this research underscores the urgent need for further study on this critical issue.”
It appears we might need to be cautious about some artificial sweeteners moving forward.
