Is Xylitol Sweetener Good or Bad for Your Heart?


Xylitol is a natural sweetener found in many plants and fruits. It is added to food and drinks as a substitute for sugar as it has fewer calories.

However, a recent study found that Xylitol can increase the risk of cardiovascular diseases.

Key points of the study:

  • A new study has shown a link between high serum xylitol levels and a risk of CVDs like heart attack or stroke.
  • They found that xylitol can increase platelet reactivity and cause blood clot formation.
  • This effect can be blamed on consuming too many xylitol-containing products in large amounts.
  • While the results are promising, more research is still needed to judge the long-term effects of consuming xylitol.

Xylitol is a popular sugar alternative, famous for its protective effects against dental cavities.

More and more people are choosing it over table sugar, but a recent study published in the European Heart Journal shows a possible link between high xylitol intake and heart attack/stroke.

Let’s find out more about this study.


The researchers did not just choose one approach; their analysis was based on three key parts.

  • Observational Study:

They gathered information from more than 3000 patients in the USA and Europe. Their serum xylitol levels were analyzed along with the risk of CVDs

  • Human Intervention:

Healthy volunteers drank a typical serving of xylitol-containing beverage and researchers measured if xylitol affected the platelet activity.

  • Lab Experiments:

They examined how xylitol affected blood platelet reactivity, which can cause clot formation.


Their results have shown a link that is concerning for the general public. Patients who had high levels of xylitol in their blood were at risk of cardiovascular diseases as compared to those who had lower serum levels.

The lab results showed that it can cause blood clot formation and results from human interventions confirmed that platelet activity increased after consuming xylitol beverage.

However, it should be noted that this study talked about xylitol intake from consuming processed foods that contain xylitol. So, we do not know if xylitol can cause these effects in smaller amounts or not.


Xylitol considerations:

  • Digestive issues:

Like any other sugar alcohol, xylitol is also not fully digested by the small intestine. It moves to the large intestine, where bacteria ferment it.

This results in bloating, diarrhea, and flatulence. The effect is more prominent in people with digestive issues or those who consume more than 40 g of it.

Starting slowly is important for first-time users. Keep the dosage or portion to 10g per day and gradually increase it over a few weeks.

This allows the gut bacteria to adjust and reduces the likelihood of digestive problems.

  • Dosage and tolerance:

It is common knowledge that xylitol is as sweet as sugar, so just a teaspoon will be enough. Some people misunderstand this and overconsume the sweetener.

Be careful of serving and portion sizes when eating anything containing xylitol to avoid extra intake.

Everyone has a different tolerance level for sugar and alcohol, so pay attention to how your body reacts when you use xylitol in your meals.

  • Alternatives and moderation:

If xylitol is causing you any digestive problems, consider using stevia or monk fruit extract as alternatives.

For a healthier option, consider choosing naturally sweet fruits instead of processed goods that include xylitol.

Regardless of the sweetener you choose, make sure to always consume it in moderation to prevent unneeded weight gain.


Proven benefits of xylitol

Here are a few benefits of xylitol:

Dental health champion:

  • Cavity prevention:

The actual reason behind xylitol’s fame is its effect on preventing dental caries.

Unlike table sugar, it does not support the growth of cavity-causing bacteria in the mouth. There is evidence that it can reduce cavity risk by 30%-85%.

  • Plaque reduction:

Xylitol can lessen the accumulation of plaque, which can later turn into tartar and result in gum disease.

  • Increased salivation:

For people with dry mouths, xylitol-containing chewing gum can increase saliva production and wash away any stuck food particles. This will also neutralize harmful acids in the mouth.

  • Beyond the mouth:

Xylitol is absorbed slowly, which is why it has a low impact on blood sugar levels. This makes it a suitable sweetener for diabetics (diabetics must still monitor their sugar levels).

  • Other possible benefits (more research is needed):

There is evidence from animal studies that xylitol could improve calcium absorption, which shows its role in bone health. However, we need human studies to confirm this effect.

Another study has concluded that syrup, lozenges, or chewing gum containing xylitol can reduce the risk of middle ear infection in healthy kids from 30% to 22%. [ref]


The bottom line

Scientific evidence about xylitol is still not enough. Even though recent studies show a link between high intakes of xylitol and CVDs, we still need more research.

For now, xylitol is still considered good for dental health and can be beneficial for blood sugar control. Nevertheless, consume xylitol in moderation only and be mindful of any digestive issues.

If you are concerned about this artificial sweetener in any way, feel free to contact any dietitian or healthcare professional.

What do you think?

Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

I love my family, my profession, my blog, nature, hiking, and simple life. Read more about me, my family, and my qualifications

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