Michael Hunter, MD on Medika Life

Is My Drink Plotting My Downfall? Xylitol Explained

I thought the story of scary bug-eyed fish with fiber-optic lights protruding from their foreheads would be my story of the week.

But then I saw scary headlines proclaiming that the sweetener xylitol — in the gum that I am chewing as I write — is linked to a higher risk of heart attack, stroke, and early death.

Here’s CNN:

“Common low-calorie sweetener linked to heart attack and stroke, study finds.”

The Washington Post offered this take:

“Sugar substitute xylitol linked to increased risk of heart attack, stroke.”

Photo by Katie Rainbow 🏳️‍🌈 on Unsplash

A recent study throws a wrench into the idea that sugar alcohols like xylitol and erythritol are universally healthy, natural sugar substitutes.

Before discussing the research findings, let’s briefly examine xylitol.

Sugar-Free Candy, Gum, Protein Bars & More

True story: I chewed on Xylitol-containing gum as I spied the striking headlines.

For years, xylitol has been a shining star in the sugar-free world.

Xylitol is touted for its low-calorie sweetness and dental benefits. You can find it in everything from sugar-free candy to gum to toothpaste.

New Study on Xylitol

But a new study throws a curveball . Could this seemingly healthy sweetener be linked to a higher risk of heart attack, stroke, and even death?

Hold off on tossing your sugar-free stash just yet.

This research follows a multi-step approach:

  • Large-scale analysis (discovery cohort): Researchers began by examining blood samples from over 1,100 people undergoing heart evaluations. They were looking for interesting patterns related to how the body processes xylitol.
  • Confirmation study (validation cohort): The investigators then used a more precise technique to confirm the initial findings in a separate group of over 2,100 people.
  • Detailed lab studies: The researchers then conducted experiments using human blood components and animal models to understand better how xylitol might affect blood clotting.
  • Direct impact study: Finally, a small group of healthy volunteers consumed xylitol to assess its effects on their blood clotting function directly.

This multi-pronged approach helped the scientists understand how xylitol interacts with the body and its potential impact on heart health.

Photo by Girl with a red hat on Unsplash

Human Study Findings

This research explores a potential link between xylitol, a common sugar substitute, and heart health.

  • Step 1: Finding a Clue: The study began by analyzing large groups of people’s blood (discovery cohort). They found that higher levels of a substance like xylitol seemed to be associated with an increased risk of heart problems over three years (major adverse cardiovascular events or MACE).
  • Step 2: Confirming the Suspect: Next, they used a more precise method (stable isotope dilution) to confirm it was specifically xylitol, not similar molecules, linked to the increased risk (validation cohort).
  • Step 3: Digging Deeper: Scientists then conducted lab experiments (mechanistic studies) to understand how xylitol might influence the body. They found that xylitol, at levels typically seen in the bloodstream after consumption, increased activity in cells involved in blood clotting. This phenomenon could potentially lead to a higher risk of blood clots forming.
  • Step 4: Direct Test: Finally, they gave healthy volunteers a xylitol-sweetened drink and observed a rise in their blood levels and increased activity in those same clotting cells.

What Does All of This Mean?

This study suggests a possible link between xylitol and an increased risk of heart problems.

However, it’s important to note that this is a single study; more research is needed to confirm these findings.

Photo by American Heritage Chocolate on Unsplash

It’s also important to remember that correlation doesn’t necessarily equal causation.

Just because high xylitol levels are linked with increased risk doesn’t necessarily mean xylitol itself caused the problem.

They can help you interpret this research in light of your health situation.

Xylitol may not be benign.

Conclusions

In conclusion, the study on xylitol sheds light on a potential link between this common sugar substitute and an increased risk of heart problems.

However, it’s important to approach these findings cautiously, as further research is needed to confirm the results.

As more research emerges, weighing the benefits of xylitol against its potential risks will be important, especially in individual health situations.

One more thing

Xylitol alert! This sweetener can be deadly for dogs.

Here’s a breakdown of the dangers:

  • Rapid Blood Sugar Drop: Xylitol is processed differently by dogs than humans. It can cause a quick and severe drop in blood sugar levels.
  • Symptoms: This drop can lead to vomiting, weakness, tremors, seizures, and even coma.
  • Fast Action Needed: Quickly acting is crucial if you think your dog has ingested xylitol. Contact your veterinarian or animal poison control immediately: https://www.aspca.org/pet-care/animal-poison-control.

Remember: Keep Xylitol products out of your dog’s reach. These products include sugar-free gum, candy, baked goods, peanut butter, some medications, and other products that might contain it.

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Michael Hunter, MD
Michael Hunter, MD
I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

Michael Hunter, MD

I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

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