We’ve got some potentially bad news for people seeking sugarless and guilt-free treats: Upcoming research has found a possible link between a common artificial sweetener and cardiovascular disease.
Researchers in Germany examined data from over 17,000 people. Those who consumed the highest amounts of xylitol—a sugar alcohol—had significantly higher rates of major adverse cardiovascular events, including heart attack, than people on the lowest amounts, they found. Though not conclusive, the results do suggest more study is needed to figure out whether xylitol can be dangerous to our heart health, the researchers say.
“Our long-term findings in the general population highlight how little we know about the cardiovascular safety of xylitol and indicate that further studies are warranted, especially as the amount of xylitol in products continues to increase,” said lead author Marco Witkowski, a cardiologist from the Charité University Hospital in Berlin, in a statement released by the European Society of Cardiology.
Sugar-free but not necessarily risk-free
Low-calorie and non-nutritive sweeteners, which include synthetic sugar substitutes like aspartame and natural replacements like stevia, have long been dogged by claims of being bad for us. Though some of these claims are little more than urban legend (no, aspartame was not initially developed as ant poison), recent research has started to undercut the idea that such products are completely harmless.
This research has included work on sugar alcohols, a type of carbohydrate naturally found in fruits, vegetables, and other plant parts. These compounds are used to artificially sweeten foods with much fewer calories than sugar and have names that end in -ol, like xylitol or erythritol. Sugar alcohols are already known to cause gastrointestinal problems when we eat too much of them at once, but studies have also begun to hint at more serious long-term concerns, particularly cardiovascular issues like blood clots and strokes.
In this latest study, the researchers analyzed data from two long-running studies that have been proactively keeping track of people’s health: the Canadian Longitudinal Study on Aging (CLSA) and the European Prospective Investigation into Cancer (EPIC)-Norfolk study. Combined, these studies enrolled roughly 17,000 participants. The researchers divided the participants into four groups (quartiles) based on their level of xylitol consumption and compared people with the highest levels of xylitol to people with the lowest levels.
Over a six-year period, the risk of a major cardiovascular event was 57% greater in the highest xylitol group of CLSA participants than the lowest xylitol group, the researchers found. In the EPIC study, the risk of a major cardiovascular event was 18% higher over a 30-year span in the highest xylitol group.
What should this mean?
The team’s findings are set to be presented this weekend at the European Society of Cardiology’s annual conference. That does mean this work hasn’t gone through the typical peer-review process yet, an important step for validating any scientific research. And though prospective studies provide stronger evidence than retrospective studies that only follow people after the fact, these findings can ultimately only show a correlation between xylitol and cardiovascular disease, not prove a cause-and-effect relationship.
That said, other recent studies, including the team’s past research, are building the case that sugar alcohols like xylitol can harm our cardiovascular system, at least in high enough amounts. And at least some scientists are now calling into question the assumption that sugar substitutes are risk-free to our health.
“Artificial sweeteners are widely embraced by modern society, and the safety ratings had been good and granted by regulatory authorities. In this observational work, however, it appears that xylitol has a negative long-term effect on cardiovascular events in the general population,” said Dan Atar, a member of the ESC Communication Committee not affiliated with the study, in a statement from the European Society of Cardiology. “As with all observational studies, causalities are difficult to infer, but this work shows that further studies are mandated into this societally important topic.”
Unfortunately, it increasingly seems like we should be wary of at least some artificial sweeteners.
