ILosing weight is one of the best ways to lower your risk of heart disease, and reducing your sugar consumption can contribute to this. But sweeteners that mimic the taste of sugar with fewer — or no — calories may be increasing, rather than decreasing, the risk of some heart events.
In a study published Thursday at the European Heart Journalan international group of researchers led by a team at the Cleveland Clinic reports that higher levels of xylitol, a sugar substitute found in candy and even toothpaste, are associated with a higher risk of heart attack, stroke and death.
The study included more than 3,000 people in the US and Europe, about half of whom had a history of heart disease and almost all of whom had at least some risk factors for heart disease. They were followed for several years. Researchers measured xylitol levels in participants‘ blood after an overnight fast, and found that those with the highest levels had twice the risk of having a heart attack, stroke or dying over three years compared to those with the lowest levels.
To better understand the link between xylitol and cardiac events, scientists injected xylitol into rats and analyzed the effect the chemical had on the animals’ cardiovascular systems. Xylitol increased blood clotting, triggering platelet activation. Researchers confirmed this mechanism by giving people a xylitol-based drink and a glucose-based drink to drink, and found that xylitol levels increased 1,000-fold in plasma immediately after drinking the xylitol drink, along with levels of blood sugar factors. clotting, but not after consuming the glucose drink.
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“Even in people who had no history of heart disease, xylitol levels still predicted future cardiac events,” says Dr. Stanley Hazen, chair of cardiovascular and metabolic sciences at the Cleveland Clinic and senior author of the paper.
Hazen says xylitol should be considered similar to cholesterol when it comes to heart disease. Like cholesterol, it is produced in the body and people have varying levels of the chemical in their blood. But consuming more xylitol as a sugar substitute in food or drinks may increase any baseline risk people already have of blood clotting. In the study, the levels recorded by the team likely reflected initial xylitol levels, rather than dietary xylitol, since the chemical clears the body in four to six hours, and the volunteers fasted overnight.
“The goal of this research is to find pathways that contribute to heart disease beyond traditional risk factors such as cholesterol, high blood pressure and diabetes,” says Hazen. “And xylitol is one of them.”
This is the second new potential risk factor that Hazen and his team have identified; Last year, the group found similar increased risk among people with higher levels of another sugar substitute, erythritol, in their blood. Xylitol and erythritol are considered polyols, or sugar alcohols, and both occur in nature, unlike some artificial sweeteners—including aspartame, sucralose, and saccharin—which are synthetic. Although the American Heart Association does not specifically address xylitol, it does advise that for heart health, people avoid sugar and opt for low or no calorie options instead, including those that contain erythritol.
“I think it’s much more prudent to avoid them and be more judicious about how much sugar you use,” says Hazen. “The people most at risk – those who are diabetic, obese or have metabolic syndrome – are those who inadvertently seek out an unhealthy option. I am absolutely convinced that sugar alcohols are a risk for cardiovascular disease based on all the clinical and mechanistic data we are seeing.”
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Hazen is particularly concerned because, in his studies, the increased risk is greater than that associated with high cholesterol levels. The U.S. Food and Drug Administration considers artificial sweeteners safe in foods and drinks, but the latest results suggest more research is needed to better understand how they affect heart disease. Hazen hopes this initial work will generate additional studies that could eventually lead to a test of xylitol and erythritol levels, and even a drug treatment similar to statins that treat cholesterol.
This story originally appeared on Time.com read the full story
