Artificial sweeteners found in “sugar free” products like chewing gum could increase the risk of heart attacks and strokes, according to new research presented at the world’s biggest heart conference in Munich.
Many products labelled as “sugar free” contain the sweetener xylitol, but the study found that people consuming high amounts are at greater risk of fatal heart problems. Xylitol is found in chewing gums like Wrigley's Extra, sugar-free breath mints such as Peppersmith, and is also used in some toothpastes, mouthwashes, cough syrups and sweets.
Study findings on xylitol and heart health
The research, based on health records of 17,710 people, monitored xylitol levels in their bodies over six years. It found that the risk of a major heart event – defined as death, heart attack or stroke – was 57% higher in those with the highest levels of xylitol compared to those with the lowest.
Dell Stanford, senior dietitian at the British Heart Foundation, said: “Risks to our hearts build up over time, and we need to ensure that what is being added to our food does not contribute.”
“Artificial sweeteners such as xylitol are found in many foods and drinks, and people may assume they are the healthier choice, so consume more than they realise. This study adds to growing evidence that artificial sweeteners could have an impact on our health.”
Expert warnings and long-term risks
Xylitol is a sugar alcohol found naturally in some foods such as fruit, but in very low amounts. It is increasingly added to products in place of sugar, often in 1,000 times greater quantity than found naturally.
Study author Dr Marco Witkowski, of Charité University Hospital in Berlin, Germany, said the research suggests xylitol can “enhance the ability of platelets to form clots”. He said: “Artificial sweeteners are consumed by people who think they are healthier than sugar and they are generally regarded as safe by regulatory agencies.”
“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.”
The study, presented at the European Society of Cardiology (ESC) Congress, found that the risk from high xylitol intake remained years later. Those who were high consumers during the study period were still at 18% higher risk of a cardiac event 30 years later.
Previous research into artificial sweeteners found in diet fizzy drinks showed those who drank more were at greater risk of the heart condition atrial fibrillation.
Professor Dan Atar, an expert on the ESC committee, said: “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.”
Mr Stanford added: “It is important to note that this was an observational study, meaning it can only show an association between higher xylitol levels and cardiovascular events, rather than proving that xylitol directly caused them.”
“It not a green light to have more sugar instead, as we still need to reduce our free sugar intake. This study is a reminder that we all need to reduce our intake of processed foods and drinks that are often high in sugar, salt or sweeteners, and focus on a balanced diet to help protect our hearts.”
