Artificial Sweeteners, Real Health Problems

New Delhi: Consuming high levels of xylitol, a popular sugar substitute found in a wide range of products — sugar-free chewing gum to low-sugar baked goods, mints and even toothpaste — may lead to blood clots, increasing the risk of serious cardiovascular events like heart attacks and strokes, reveals a study published in European Heart Journal.According to doctors across the city, the findings are troubling, given xylitol’s potential to increase the risk of major adverse cardiovascular events and enhance platelet reactivity and thrombosis. This may have significant implications for patients with cardiovascular diseases, they said. Xylitol, a sugar alcohol that occurs naturally in various fruits and vegetables, has gained significant popularity over the past one decade. Its chemical composition resembles that of sugar, but it contains fewer calories, making it an attractive alternative for health-conscious individuals.Dr Nityanand Tripathi, head of cardiology and electrophysiology at Fortis Shalimar Bagh, said, “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.” He added that more research was needed to fully understand the mechanisms and establish clear guidelines for its consumption.“High consumption of xylitol can lead to 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 cardiologist 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, US, indicates that every measure of clotting ability significantly increased immediately after the ingestion of a xylitol-sweetened drink, but not with a glucose-sweetened drink. Explaining the difference, Dr AK Sahani, director and chief of neurology at Indian Spinal Injuries Centre, said, this could be due to xylitol’s specific metabolic pathway, influencing platelet function and vascular response differently.It is advisable to use natural sweeteners like honey, maple syrup and fruits in moderation, said Dr Bharat Kukreti, director and unit head of cardiology at Paras Health, Gurgaon. “Patients, especially those with cardiovascular risk factors, should be cautious with sugar substitutes and prioritise 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 provide numerous 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 same research team found a similar link between erythritol and cardiovascular risk last year. Xylitol is not as prevalent as erythritol in keto or sugar-free food products in the US, but is common in other countries, said researchers.
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