A recent study conducted by researchers at Cleveland Clinic has found a correlation between high levels of xylitol and an increased risk of cardiovascular events, including heart attacks and strokes. The study suggests that xylitol, a common zero-calorie sweetener found in sugar-free candies and toothpaste, can enhance clotting abilities, leading to a higher risk of thrombosis. The findings highlight the need for further research to assess the long-term impacts of xylitol consumption on cardiovascular health.

Led by Dr. Stanley Hazen, the research team at Cleveland Clinic confirmed the association between high xylitol levels and cardiovascular risks through a large-scale patient analysis, preclinical research models, and a clinical intervention study. Their findings were recently published in the European Heart Journal.

Xylitol, a sugar substitute commonly used in sugar-free candies, gums, baked goods, and oral products like toothpaste, has gained popularity in processed foods marketed as healthier alternatives. However, Dr. Hazen's team had previously discovered a similar link between erythritol, another sugar alcohol, and cardiovascular risk. While xylitol is not as prevalent as erythritol in keto or sugar-free food products in the US, it is more commonly used in other countries.

Dr. Hazen, Chair of Cardiovascular and Metabolic Sciences at Cleveland Clinic's Lerner Research Institute, expressed the necessity for further investigation into sugar alcohols and artificial sweeteners, especially as they are often recommended in combating conditions such as obesity or diabetes. He emphasized that while the study's findings do not call for discarding products containing xylitol, it is important to be aware that consuming high levels of xylitol could increase the risk of blood clot-related events.

In their study, the researchers analyzed more than 3,000 patients from the US and Europe and found that those with high levels of circulating xylitol had an elevated three-year risk of cardiovascular events. Patients with the highest amount of xylitol in their plasma were one-third more likely to experience a cardiovascular event. The team conducted pre-clinical testing and observed that xylitol caused platelets to clot, heightening the risk of thrombosis. They also compared platelet activity in individuals who consumed a xylitol-sweetened drink versus a glucose-sweetened drink and found that clotting ability significantly increased immediately after ingestion of xylitol.

While the research demonstrates an association between xylitol and cardiovascular risks, it is important to note that observational studies cannot establish causation. The authors of the study recommend consulting with healthcare professionals, such as doctors or certified dietitians, to learn more about healthy food choices and receive personalized recommendations.

This study is part of Dr. Hazen's ongoing investigation into factors contributing to residual cardiovascular risk. By following patients over time, his team identifies chemical signatures in blood that can predict the future development of heart and metabolic diseases. Dr. Hazen is also the director of Cleveland Clinic's Center for Microbiome and Human Health and holds the Jan Bleeksma Chair in Vascular Cell Biology and Atherosclerosis.

The study was supported in part by the National Institutes of Health (NIH) and the Office of Dietary Supplements. It is crucial to conduct further research to evaluate the long-term cardiovascular safety associated with xylitol consumption.