Xylitol: is the sweetener in chewing gum and toothpaste bad for our heart?

An American study commented by Ruggero De Paulis, Professor of Cardiac Surgery at UniCamillus University

Sweeteners have often been at the centre of controversy for their potential carcinogenic effect, at least according to some studies. This time it is about xylitol, a natural sweetener typically used in toothpaste and chewing gum, which is accused, in this case, of undermining cardiovascular health. This is what a recent study published in the European Heart Journal states.

Although it is contained in very small amounts even in some fruits and vegetables, its concentration is much higher in some industrial products.

The investigation under consideration was conducted by researchers from the Department of Metabolic and Cardiovascular Sciences at the Cleveland Clinic, Ohio. The researchers tried to understand what the effects of consuming high amounts of xylitol are over time.

The study included a total of 3,306 adults from Europe and the United States whose levels of xylitol in their blood were monitored after an overnight fast. The researchers then tracked the participants for three years and observed that one-third of those with the highest levels of xylitol in their blood were more likely to experience acute cardiovascular events, such as stroke or heart attack.

This possible association could be due to the effect of xylitol on platelets, which show a tendency to aggregate more when exposed to xylitol. This results in more rapid blood clotting, and thus higher cardiovascular risks.

But is xylitol really that dangerous? Professor Ruggero de Paulis, Lecturer in Cardiac Surgery at UniCamillus University, shares his point of view on the topic. ‘The concern raised by the study is mainly related to people already suffering from cardiovascular problems: for these individuals, excessive xylitol consumption could interfere with anticoagulants commonly prescribed for heart conditions, thus potentially increasing the risk of cardiovascular events. However, there is no evidence suggesting that there is a significant risk for people who do not have pre-existing heart problems and who consume xylitol in normal amounts’, says Professor De Paulis.

This study highlights the need for further research to better understand the long-term health effects of sweeteners. However, as both the analysis and our expert have made it clear, the watchword is, as always, moderation.