Sickly sweet: Sugar substitute may lead to heart attacks

First, we were told that eating too much sugar is bad for us. The American Heart Association says men should have no more than 9 teaspoons (36 grams) of sugar each day, and women should have no more than 6 teaspoons (25 grams) a day. Consuming more, experts say, can increase your risk for obesity, diabetes, metabolic disorders, cancer, heart disease, depression and poor cognition.

Then, we were told that instead of sugar, we should consider using a noncaloric or low-calorie sweetener. From Splenda, made with sucralose, to Equal, made with aspartame, and several options in between, experts say that sugar substitutes can be part of a healthy diet when used in moderation.

Now, however, a new study has linked one common sweetener to an increased risk of heart attack and stroke. Xylitol, the study’s authors say, is “associated with major adverse cardiovascular events.”

“While there are known dangers to eating too much sugar, we’re finding that sugar substitutes might pose their own health risks,” says Dr. Justin Parizo, a board-certified cardiologist and internal medicine doctor affiliated with Sharp Memorial Hospital. “Xylitol blood levels, specifically, have recently been associated with increased cardiovascular events including heart attacks and strokes. This risk may be due to Xylitol's effect on blood platelets, making them more reactive and likely to form clots.”

What is xylitol?

Xylitol is a sugar alcohol that naturally occurs in some fruits and vegetables. It is also industrially produced to be used as a sweetener.

Xylitol is commonly found in:

• Sugarless gum and mints

• Toothpaste and mouthwash

• Cough syrup

• Chewable vitamins

• Candy

• Baked goods and cake mixes

• Barbecue sauces and ketchup

• Peanut butter

Until now, Xylitol has been considered safe for human consumption and has even been credited by some for improving respiration, digestion, immune response, weight management and the health of teeth and skin. However, experts point to the new study as they recommend caution when ingesting products sweetened with xylitol. People with high levels of xylitol in their system were found to have nearly double the risk of heart attack, stroke and death compared to people who had low or nonexistent levels of xylitol.

“There is still much to be studied about the effects of xylitol and other sugar substitutes, and I would caution against making any definitive conclusions based on the available data,” says Dr. Parizo. “For many people, such as those with diabetes, approaches to limiting sugar intake are clearly beneficial, but recent studies are cause for concern. For now, I would generally recommend that instead of reaching for processed foods with either added sugar or sweeteners, consider satisfying your sweet tooth with healthy options, such as fruit.”

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