sugar Low-calorie substitute linked to greater heart attack, stroke risks: Study

Higher consumption of xylitol may cause blood platelets to clot more readily

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A low-calorie sweetener called xylitol, which is used in many reduced-sugar foods and consumer products, may be linked to an increased risk of heart attack, stroke and death in people who consume higher amounts of it, a new study has found.

"Humankind has not experienced levels of xylitol this high except within the last couple of decades, when we began ingesting completely contrived and sugarsubstituted processed foods," said senior study author Stanley Hazen, director of the Centre for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute.

In 2023, the same researchers found similar results for another low-calorie sweetener called erythritol, which is used as a bulking sugar in stevia, monkfruit and keto reduced-sugar products.

Additional lab and animal research presented in both papers revealed erythritol and xylitol may cause blood platelets to clot more readily. Clots can break off and travel to the heart, triggering a heart attack, or to the brain, leading to a stroke.

In the new study on xylitol, "differences in platelet behaviour were seen even after a person consumed a modest quantity of xylitol in a drink typical of a portion consumed in real life", said Dr Matthew Tomey. The cardiologist at Mount Sinai Fuster Heart Hospital is not involved in the study.

"These experiments are interesting but alone do not prove that platelet abnormalities are to account for a linkage between xylitol and clinical events," added Dr Tomey, who is also an assistant professor of medicine at the Icahn School of Medicine at Mount Sinai.

Some 61 per cent of American adults will have cardiovascular disease by 2050, according to a recent prediction by the American Heart Association.