---
title: "Xylitol in chewing gum linked to higher risk of heart attack, stroke and cardiovascular death"
id: "medical-news-today-0-popular-chewing-gum-sweetener-linked-to-higher-heart-attack-risk-study-finds"
canonical_url: "https://medichelpline.com/clinical-feed/medical-news-today-0-popular-chewing-gum-sweetener-linked-to-higher-heart-attack-risk-study-finds"
content_type: "clinical_feed_article"
specialty: "Cardiology"
source_name: "Medical News Today"
source_url: "https://www.medicalnewstoday.com/articles/popular-chewing-gum-sweetener-xylitol-linked-higher-heart-attack-risk-study/"
published_at: "2026-09-08T14:35:00.000Z"
evidence_level: "Verified Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Xylitol in chewing gum linked to higher risk of heart attack, stroke and cardiovascular death
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/medical-news-today-0-popular-chewing-gum-sweetener-linked-to-higher-heart-attack-risk-study-finds
- **Specialty:** [Cardiology](https://medichelpline.com/clinical-feed/cardiology.md)
- **Primary Source:** Medical News Today
- **Source URL:** [Original Journal Publication](https://www.medicalnewstoday.com/articles/popular-chewing-gum-sweetener-xylitol-linked-higher-heart-attack-risk-study/)
- **Published At:** 2026-09-08T14:35:00.000Z
- **Evidence Rating:** Verified Feed
## Executive GIST (TL;DR)
- New observational research presented at the European Society of Cardiology Congress 2026 found an association between blood **xylitol** levels and increased risk of major adverse cardiovascular events (**MACE**) in the general population. - The analysis pooled data from two large cohorts: the Canadian Longitudinal Study on Aging (CLSA) and EPIC-Norfolk, totalling 17,710 participants with a mean age of 60.9 years. - CLSA follow-up (6 years) showed those with the highest xylitol levels had a 57% higher risk of MACE versus those with the lowest levels; EPIC-Norfolk follow-up (30 years) found an 18% higher risk in the highest-level group. - Researchers adjusted for traditional cardiovascular risk factors including age, smoking, diabetes, high blood pressure, and body mass index, and still observed a dose-dependent relationship: higher xylitol levels correlated with higher incidence of heart attack, stroke, and cardiovascular death. - Prior work by the study team indicated xylitol can enhance platelet clotting and was linked to cardiovascular events in high-risk individuals over three years; this study extended investigation to the general population. - Experts commenting on the findings noted regulatory safety ratings for artificial sweeteners but called for caution: some clinicians recommend avoiding sugar alcohols like xylitol, particularly in people with cardiovascular disease or elevated risk. - For people with diabetes, clinicians recognize that artificial sweeteners can blunt short-term glucose spikes but caution that avoiding short-term glycemic rises does not necessarily ensure long-term benefit; choosing whole foods remains preferable when possible. - The authors and commentators emphasized that more research is needed to clarify cardiovascular safety of xylitol as its presence in products increases; specific plasma cutoffs and mechanistic details were not reported in the article.
## Clinical Analysis & Structured Key Points
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Medications](https://www.medicalnewstoday.com/articles/what-is-the-best-medication-for-stroke) * Related Conditions Related Conditions Related Articles * [Vs. 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Seizures](https://www.medicalnewstoday.com/articles/stroke-vs-seizure) * Treatment Treatment Related Articles * [Tenecteplase](https://www.medicalnewstoday.com/articles/tnk-stroke) # Popular chewing gum sweetener linked to higher heart attack risk, study finds ![](https://i0.wp.com/post.medicalnewstoday.com/wp-content/uploads/sites/3/2020/06/500x500_James_McIntosh.png?w=105&h=105) Written by James McIntosh on September 8, 2026 — Fact checked by Amanda Ward ![An opened stick of chewing gum contianign artificial sweeteners lays on a flat surface in front of a full pack.](https://media.post.rvohealth.io/wp-content/uploads/sites/3/2026/09/getty_2154597580_header_1296x728-1024x575.jpg)[Share on Pinterest](https://www.pinterest.com/pin/create/button/?url=https%3A%2F%2Fwww.medicalnewstoday.com%2Farticles%2Fpopular-chewing-gum-sweetener-xylitol-linked-higher-heart-attack-risk-study&media=https%3A%2F%2Fmedia.post.rvohealth.io%2Fwp-content%2Fuploads%2Fsites%2F3%2F2026%2F09%2Fgetty_2154597580_header_1296x728-1024x575.jpg&description=Heart%20attack%3A%20Chewing-gum%20sweetener%20xylitol%20tied%20to%2057%25%20higher%20risk "Share on Pinterest")A new heart health study has raised questions over a common sweetener found in chewing gum and toothpaste. Cappi Thompson/ Moment/Getty Images * **Xylitol is a common artificial sweetener found in many common products, including processed foods and drinks, sugar-free chewing gum, and toothpaste.** * **A new study found an association between levels of xylitol in the blood and an increased risk of heart attacks, stroke, and death from cardiovascular events.** * **In one cohort, people with the highest levels of xylitol had a 57% higher risk of major adverse cardiovascular events than those with the lowest levels.** A low calorie sweetener often found in processed foods and drinks may be associated with higher risks of major adverse cardiovascular events such as heart attacks and stroke, according to new research. The study, presented at the [European Society of Cardiology Congress 2026](https://esc365.escardio.org/esc-congress/sessions/20372-hungry-heart-nutrient-deficiencies-and-cardiovascular-disease), examined whether xylitol was associated with the risk of cardiovascular events in the general population. Xylitol is a type of [sugar alcohol](https://www.medicalnewstoday.com/articles/320901): a carbohydrate that is a hybrid of sugar and alcohol molecules. Manufacturers often use it to add sweetness to food and oral care products without the calories or risk of tooth decay that sugar poses. “In previous studies, we showed that xylitol can enhance the ability of platelets to form clots,” said study author Dr. Marco Witkowski from Charité University Hospital in Berlin, Germany, in a [press release](https://www.escardio.org/news/press/press-releases/xylitol-may-increase-the-risk-of-cardiovascular-events/). **“We also found that high blood levels of xylitol were linked to cardiovascular events in high risk individuals over a three-year period,” he said.** What had yet to be established was whether xylitol might increase the risk of cardiovascular events within the general population. This was what the new study aimed to find out. ## What did the researchers look at? The researchers wanted to examine a larger study population than in previous research and follow them over a longer period. To this end, they examined data from two large observational studies in North America and Europe, involving a total of 17,710 participants with a mean age of 60.9 years. These studies were the [Canadian Longitudinal Study on Aging (CLSA)](https://www.clsa-elcv.ca/), which followed participants for 6 years, and the [European Prospective Investigation into Cancer (EPIC)-Norfolk](https://www.epic-norfolk.org.uk/), which followed participants for 30 years. The researchers adjusted the data to account for traditional risk factors for cardiovascular illness, such as age, [smoking status](https://www.medicalnewstoday.com/articles/how-does-smoking-affect-your-heart), [diabetes](https://www.medicalnewstoday.com/articles/diabetes-heart-disease-connection), and [high blood pressure](https://www.medicalnewstoday.com/articles/how-are-hypertension-heart-disease-and-stroke-related). They then split the cohorts into four groups based on the levels of xylitol in their blood plasma. **After these adjustments, they found that the group of participants with the highest levels of xylitol in their blood had a significantly higher risk of[heart attack](https://www.medicalnewstoday.com/articles/151444), [stroke](https://www.medicalnewstoday.com/articles/7624), or death from a cardiovascular event than those with the lowest levels of xylitol.** ## How did cardiovascular risks change over time? During the 6-year follow-up period of the CLSA study, the researchers found that those with the highest xylitol levels had a 57% higher risk of a major adverse cardiovascular event (MACE) compared with those with the lowest xylitol levels. The 30-year follow-up period of the EPIC-Norfolk study also found that the highest xylitol levels were associated with an increased risk of MACE compared with the lowest levels. Here, the associated risk was 18% higher in the group with the highest levels. Looking at all the data together, the researchers found a dose-dependent relationship between xylitol and MACE. As the levels of xylitol rose, so too did the incidence of heart attacks, stroke, and death from cardiovascular events. **This association between xylitol and MACE was also independent of other factors that could lead to these adverse events and of the likelihood of using artificial sweeteners. These included having a[high body mass index](https://www.medicalnewstoday.com/articles/323622), diabetes, and high blood pressure.** “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, said Witkowski, “especially as the amount of xylitol in products continues to increase.” ## Should people rethink their use of artificial sweeteners? Many people regard xylitol and other sugar alcohols as a healthy alternative to sugar. “Artificial sweeteners are widely embraced by modern society, and their safety ratings have been favorable and granted by regulatory authorities,” said [Dan Atar](https://esc365.escardio.org/person/2095), a member of the European Society of Cardiology Communication Committee, commenting on the study in the press release. “In this observational work, however, it appears that xylitol has a negative long-term effect on cardiovascular events in the general population,” he said. _Medical News Today_ asked [Stanley Hazen](https://www.lerner.ccf.org/heart-blood-kidney/hazen/), MD, PhD, Chair of the Department of Heart, Blood & Kidney Research at the Cleveland Clinic in Ohio, who was not involved in the study, how people should approach xylitol in light of this research. **“A growing body of research suggests sugar alcohols like xylitol and erythritol may not be a simple substitute for sugar to avoid calories,” he said. “There is data showing they can enhance risk for clotting events like heart attack or stroke.** > “I am recommending my patients avoid these non-nutritive sweeteners – especially those with cardiovascular disease or higher risk. This, of course, tends to be the very same subjects more likely to be using artificial sweeteners.” > — Stanley Hazen, MD, PhD ### Should people with diabetes be worried about sweeteners? MNT also posed the same question to [Cheng-Han Chen](https://www.memorialcare.org/providers/cheng-han-chen), MD, a board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, who was also not involved with the study. “When possible, I recommend choosing naturally sweet foods, such as whole fruit, which provide sweetness along with fiber and other beneficial nutrients,” he said. Chen also noted that artificial sweeteners can still have a practical role for people with diabetes because they generally produce a smaller immediate increase in blood glucose than sugar. “However, avoiding a short-term [glucose spike](https://www.medicalnewstoday.com/articles/317215) does not necessarily mean that consuming large amounts of artificial sweeteners is beneficial for long-term health,” he said. **“The bigger picture matters: overall dietary quality, portion sizes, physical activity, weight man
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