Artificial sweetener linked to much higher risk of heart attack, stroke or death
Xylitol, a sugar substitute often found in gum, baked goods and toothpaste, may significantly increase a person’s risk of dying or experiencing a heart attack or stroke, according to new data presented at the European Society of Cardiology (ESC) Congress 2026.
The study’s authors noted that xylitol is a sugar alcohol that does occur naturally in the body in very low amounts. However, high levels of xylitol are also added to many sugar-free foods to help them taste sweeter, and the long-term cardiovascular implications of this trend have not been sufficiently explored.
The group reviewed data more than 17,000 participants in one of two datasets: the Canadian Longitudinal Study on Aging (CLSA) and the European Prospective Investigation into Cancer (EPIC)-Norfolk. According to CLSA data, the six-year risk of a major adverse cardiovascular event (MACE) was 57% higher among individuals who consumed the most xylitol than it was among those who consumed the least xylitol. According to EPIC-Norfolk data, the 30-year risk of a MACE was 18% higher among individuals who consumed the most xylitol than it was among those who consumed the least xylitol.
“Artificial sweeteners are consumed by people who think they are healthier than sugar and they are generally regarded as safe by regulatory agencies,” Marco Witkowski, MD, PhD, a physician with Charité University Hospital in Berlin, Germany, said in a statement. “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.”
“Artificial sweeteners are widely embraced by modern society, and the safety ratings had been good and granted by regulatory authorities,” added Dan Atar, MD, PhD, a cardiologist with Oslo University Hospital and member of the ESC Communication Committee. “In this observational work, however, it appears that xylitol has a negative long-term effect on cardiovascular events in the general population. As with all observational studies, causalities are difficult to infer, but this work shows that further studies are mandated into this societally important topic.”
Click here to read a 2024 study about the potential cardiovascular risks associated with xylitol. Click here for an in-depth look at the artificial sweetener from Harvard Health.
Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.