A large observational study presented at the European Society of Cardiology's annual congress in Munich on Friday found that people with the highest blood concentrations of xylitol, a sugar alcohol used to sweeten chewing gum, toothpaste, jams, yoghurts, protein bars and hundreds of other products, had a 57 percent higher risk of heart attack, stroke or cardiovascular death over six years compared with those with the lowest levels.
The study examined 17,710 people from two long-term cohorts: the Canadian Longitudinal Study on Aging and EPIC-Norfolk in the United Kingdom.
The association held after adjusting for known cardiovascular risk factors including age, sex, smoking, diabetes, blood pressure and lipid levels.
A dose-response pattern was also observed, cardiovascular event rates climbed as measured xylitol levels climbed. In the EPIC-Norfolk cohort followed for 30 years, the elevated risk was 18 percent higher.
Three things to understand before throwing out your sugar-free gum. First: this is an observational study, it shows association, not causation. Higher blood xylitol does not prove xylitol consumption caused those cardiovascular events.
Second: the xylitol measured was in blood, not in the diet, and the body also produces xylitol naturally as a byproduct of normal glucose metabolism.
Third: researchers are not suggesting switching back to sugar, which carries its own cardiovascular risks. They are calling for more investigation into whether the amounts of xylitol added to processed foods deserve a second look.