According to a new study, sugar-free food and drinks may not have the health benefits people are expecting. The sugar substitute xylitol has now been linked to negative health impacts.
A new Cleveland Clinic study found higher amounts of xylitol intake are linked to an increased risk of heart attack, stroke or cardiovascular-related death. Xylitol is a sugar alcohol found naturally in some plants and produced by the human body.
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Much like sugar, xylitol is naturally occurring, however, added xylitol could be what poses the risk. It’s most commonly found in toothpaste and sugar-free gum but is also used in many candies and baked goods — especially in things labeled “keto-friendly.”
Researchers studied 3,000 people and found those with the highest xylitol levels had approximately double the risk for heart attack, stroke or death over three years. However, the study was only observational, so researchers said it does not prove xylitol was for sure behind the increased risk.
Researchers also said while added xylitol in food poses a risk, people don’t need to worry about it in oral care products like toothpaste and mouthwash, as they’re not ingested in large amounts.
The same team of researchers found a similar association in 2023 to the popular sugar substitute erythritol, another zero-calorie sugar substitute used to sweeten low-calorie, low-carb and “keto” products. The use of sugar substitutes has increased significantly over the past decade as concerns about rising obesity rates mount.
Cleveland Clinic experts said knowing if food contains xylitol isn’t as easy as just reading the nutrition label. That’s because food manufacturers aren’t always required to list sugar alcohols on their packaging.
The U.S. Food and Drug Administration’s guidelines regarding sugar alcohols state they only need to be included in the nutrition label if “a claim [is] made about sugar alcohols or sugar when sugar alcohols are present.” That means if a package says something is sugar free, it has to include sugar alcohol content on the label.
