Popular sugar substitute faces new questions about heart health

Photo: Gustavo Fring/Pexels

MUNICH, Germany (ABNN) - A new study is raising concerns about a popular artificial sweetener after researchers found that people with the highest levels of xylitol in their blood faced a greater risk of serious cardiovascular events.

Xylitol is a sugar alcohol that the body naturally produces during glucose metabolism. Small amounts are also found in some foods.

But the amounts used to artificially sweeten products can be much higher. The European Society of Cardiology says xylitol can be added at levels more than 1,000 times greater than the amounts naturally found in foods.

The new research was presented at ESC Congress 2026 in Munich, Germany.

"We also found that high blood levels of xylitol were linked to cardiovascular events in high-risk individuals over a 3-year period. Here we studied if xylitol increases cardiovascular events in a larger sample of the general population over much longer follow-up," said Dr. Marco Witkowski of Charite University Hospital in Berlin, Germany.

Researchers analyzed data from 17,710 people.

They found that people with the highest blood levels of xylitol had a substantially greater risk of major adverse cardiovascular events compared with those with the lowest levels.

Those events included death, myocardial infarction, commonly known as a heart attack, or stroke.

After six years, the risk of a major adverse cardiovascular event was 57% higher among those with the highest xylitol levels compared with those with the lowest levels.

The study found an association between xylitol levels in the blood and cardiovascular events.

Because the research was observational, however, the findings do not establish that xylitol caused those events.

"Artificial sweeteners are consumed by people who think they are healthier than sugar and they are generally regarded as safe by regulatory agencies," Witkowski said. "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 does not establish that xylitol causes heart attacks, strokes or death.

But for a sweetener often chosen as an alternative to sugar, the long-term cardiovascular picture remains unsettled. Researchers say the new findings are another reason to look more closely at what regular xylitol exposure may mean for the heart over time.

Support independent Black journalism. Your tax-deductible contribution to the American News Foundation helps The American Black News Network continue producing original reporting that informs and serves our communities.