New Study Shows Sugar Substitute Xylitol Dangerous?

A recent in vivo study published in the European Heart Journal in July, 2024, used metabolomic experiments to examine the effects of xylitol on platelet responsiveness and thrombus formation. The researchers concluded that Xylitol was associated with:

• Major adverse cardiovascular events at 3 year follow-up
• Worsened platelet reactivity in humans
• Platelet and thrombus formation in mice

Xylitol is a naturally-occurring sugar alcohol that has been shown in many studies to have anti-cavity properties and subsequently promoted for oral health. It can be commonly found in gum and mouthwashes today. However, even in these kinds of products, it might pose a problem for many people, and reports are widespread of GI upset from consumption of even small quantities. Unfortunately, Xylitol is added in large quantities because it is not nearly as sweet as stevia, and is suggested as a replacement for the same volume of sugar.  

Conclusion

Despite being considered "keto-friendly" Xylitol should be avoided in any significant quantities. If someone gets no reaction within 24 hours of consuming a small amount of Birch-derived xylitol, it may be safe in that quantity for them. But in the ratios advised, such as replacing all sugar in a recipe with the same quantity of Xylitol, it appears to be an avoidable supplement.  

References

Xylitol is prothrombotic and associated with cardiovascular risk, European Heart Journal, Volume 45, Issue 27, 14 July 2024, Pages 2439–2452, https://doi.org/10.1093/eurheartj/ehae244