Xylitol, a popular sugar substitute, has been linked to a higher risk of major cardiovascular events, including heart attacks, strokes and death, according to new research.
Researchers analysed data from 17,710 participants enrolled in two studies—the Canadian Longitudinal Study on Aging (CLSA) and EPIC-Norfolk—to examine the relationship between blood xylitol levels and cardiovascular health.
The study found that people with the highest levels of xylitol in their blood had a significantly greater risk of major cardiovascular events compared with those with the lowest levels.
During nearly six years of follow-up in the CLSA group, participants with the highest blood xylitol levels had a 57% higher risk of major cardiovascular events, even after researchers accounted for established risk factors including age, sex, smoking, blood lipid levels, diabetes and high blood pressure.
Xylitol is a sugar alcohol that occurs naturally in the human body in small amounts as a result of glucose metabolism and is also found in trace amounts in some foods. It is widely used as a sweetener in food products, beverages and oral-care products.
Researchers cautioned that the findings show an association rather than proof that xylitol causes heart disease. They called for further research to better understand the long-term cardiovascular effects of consuming higher amounts of the sweetener.
The research is scheduled to be presented at the European Society of Cardiology Congress 2026.
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