Xylitol Linked to 57% Higher Heart Attack Risk in Major Study

A large study presented at the European Society of Cardiology Congress in Munich found that people with the highest blood levels of xylitol face a 57 percent greater risk of heart attack, stroke, or death within six years compared to those with the lowest levels. The artificial sweetener, used in chewing gum, yogurt, jam, and toothpaste, has never been widely studied for long-term cardiovascular effects despite growing use in products at amounts 1,000 times higher than natural levels.

What the study measured

Researchers from Charité University Hospital in Berlin analyzed data from 17,710 participants in two large observational studies: the Canadian Longitudinal Study on Aging and the European Prospective Investigation into Cancer-Norfolk. They compared people in the highest quartile of xylitol blood levels against those in the lowest quartile. The Canadian cohort was followed for six years, while the European cohort was tracked for 30 years.

The cardiovascular risk numbers

In the six-year Canadian study, participants with the highest xylitol levels had a 57 percent higher risk of major adverse cardiovascular events, defined as death, heart attack, or stroke. In the 30-year European study, those with the highest levels faced an 18 percent higher risk. The researchers found a dose-dependent relationship: the higher the xylitol blood levels, the higher the cardiovascular event rate. These risks persisted even after adjusting for age, sex, smoking, diabetes, hypertension, and cholesterol levels.

How xylitol affects the body

Dr. Marco Witkowski, the study’s lead researcher, noted that previous research showed xylitol can enhance the ability of platelets to form clots. Xylitol is a sugar alcohol that occurs naturally in the body at very low levels but is added to products in much larger quantities. Despite its growing use, the long-term cardiovascular safety of xylitol has not been widely studied until now.

Regulatory questions ahead

Dr. Witkowski stated that artificial sweeteners are generally regarded as safe by regulatory agencies, yet the findings highlight gaps in cardiovascular safety knowledge. The study was presented August 28 at the ESC Congress 2026 in Munich, the world’s largest heart conference. Witkowski emphasized that further studies are warranted, especially as xylitol use in products continues to increase.

Final Thoughts

The study raises serious questions about xylitol safety for regular consumers, though regulatory agencies have not yet responded. Investors in food and beverage companies using xylitol should monitor for potential reformulation costs and liability exposure.

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