The artificial sweetener xylitol, found in everything from chewing gum to toothpaste, is associated with a higher risk of heart attack, stroke, and cardiovascular death, according to new research presented at the European Society of Cardiology Congress 2026 in Munich, Germany.
Researchers examined data from more than 17,000 people across two groups, one based in Canada and one in the United Kingdom. In both groups, participants whose blood xylitol levels fell in the highest quarter faced significantly worse cardiovascular outcomes than those in the lowest quarter.
According to Healthline, the Canadian cohort was followed for six years. Those with the highest xylitol blood levels had a 57% higher risk of major adverse cardiovascular events compared to those with the lowest levels. That held true even after researchers accounted for other risk factors including hypertension, smoking, age, and diabetes.
The United Kingdom cohort told a similar story over a much longer window. Across 30 years of follow-up, participants with the highest xylitol levels faced an 18% higher risk of major cardiovascular events compared to those with the lowest levels. Researchers said the two cohorts together point to a dose-dependent relationship between xylitol in the blood and cardiovascular risk, meaning the more xylitol, the greater the danger.
Marco Witkowski, a researcher from the Charité University Hospital in Berlin who presented the findings, addressed the broader context of how people perceive sweeteners like xylitol. "Artificial sweeteners are consumed by people who think they are healthier than sugar, and they are generally regarded as safe by regulatory agencies," he said in a news release.
Witkowski's team had previously shown that xylitol increased the ability of platelets to form clots, and that high xylitol blood concentrations raised cardiovascular risk among high-risk individuals specifically. The new study extended that concern to the general population.
"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," Witkowski said.
The findings were presented at the congress held August 28 through 31 but have not yet been published in a peer-reviewed scientific journal, meaning they have not gone through formal outside review.
