“Xylitol is often promoted as a safe sugar substitute, but these results highlight the need for caution, especially for individuals at risk of cardiovascular diseases,” noted Dr. Nityanand Tripathi, head of cardiology and electrophysiology at Fortis Shalimar Bagh. He emphasized that more research is necessary to fully understand the mechanisms and set clear guidelines for its consumption.
High consumption of xylitol can cause a state of hypercoagulability, where the blood has an increased tendency to clot. “This effect is mediated through xylitol’s ability to enhance the aggregation and activity of platelets, small blood cells that play a crucial role in the clotting process,” explained Dr. Amar Singhal, director of interventional cardiology at Sri Balaji Action Medical Institute. “The heightened platelet reactivity induced by xylitol can result in the development of clots within blood vessels. These clots have the potential to obstruct blood flow in both arteries and veins, leading to serious cardiovascular events.”
The study conducted by Cleveland Clinic in the US found that every measure of clotting ability significantly increased immediately after the ingestion of a xylitol-sweetened drink. This was not observed with a glucose-sweetened drink. Dr. AK Sahani, director and chief of neurology at Indian Spinal Injuries Centre, explained that this difference could be due to xylitol’s specific metabolic pathway, which influences platelet function and vascular response differently.
Dr. Bharat Kukreti, director and unit head of cardiology at Paras Health, Gurgaon, advised using natural sweeteners like honey, maple syrup, and fruits in moderation. “Patients, especially those with cardiovascular risk factors, should be cautious with sugar substitutes and prioritize a balanced diet. For products like toothpaste and gum, the occasional use is likely to be safe due to the minimal amount of xylitol ingested,” he added.Choosing natural items over artificial ones can offer several benefits. “Saunf is a great wholesome option. By making such a switch, you can improve your overall well-being,” said Prof. Vinay Goyal, chairman of neurology at Medanta Hospital, Gurgaon.The research team also found a similar connection between erythritol and cardiovascular risk last year. Although xylitol is not as prevalent as erythritol in keto or sugar-free food products in the US, it is common in other countries, according to the researchers.