Ultra-processed sugars have become an unwelcome (and unfortunately near-universal) part of the US grocery store — and our metabolic health feels every gram of it. As a result, many of us have turned to sugar substitutes in our daily diet. One of the most popular of these is xylitol.
And while sugar alternatives may be a noble pursuit in theory, are they any good for supporting metabolic health? Sifting through the endless supply of conflicting information on artificial sweeteners makes it hard for health-conscious individuals to understand the truth. And with so many viral studies regarding xylitol in recent months, how do you know if it’s safe for your heart?
Let’s look through the research so you can make your own decision.
Article Overview
- Xylitol was one of the first artificial sweeteners ever created, and a naturally occurring compound in small, trace elements.
- Though xylitol offers certain benefits, it may not be good for your heart in the long term.
- It’s typically better overall to decrease not only your sugar intake, but your artificial sweetener intake as well, to protect your heart.
What is xylitol?
Xylitol is known as a ‘sugar alcohol,’ which is a form of carbohydrate also known as a polyol. It was harvested from birch tree bark as far back as 1879, and was formally discovered in 1891.
Interestingly, xylitol didn’t initially catch any traction as a sweetener, with sugar overwhelmingly chosen as the world’s sweetener of choice (at least, at the time). At the onset of World War II, sugar became scarce. Europe’s sugar rationing during this time breathed renewed interest in artificial sweeteners. And the rest is history: up to the birch-rich country of Finland becoming a key xylitol producer for the world.
Today, xylitol is typically used as a 1:1 substitute for sugar. It offers approximately 2.4 calories per gram versus sugar’s 4.0, cutting the calorie impact in half. Just as importantly, xylitol is metabolized differently in the body than sugar and subsequently offers a vastly better glycemic index (seven versus approximately 60 for sugar).
As you can imagine, all these things make xylitol an extremely attractive sugar alternative to the market. The pros many xylitol proponents point to are as follows:
- Weight management. Because xylitol has almost half the calories of sugar, it lets you enjoy the sweetness of sugar at a steep caloric ‘discount.’ It also works well for low-carb or ketogenic dieters who want to enjoy the occasional sweet without breaking out of ketosis.
- Tooth health. xylitol doesn’t feed cavity-causing bacteria like sugar, making it potentially safer for oral consumption. Some studies show it even interferes with the metabolism of Streptococcus mutans, which is the main bacteria associated with tooth decay.
- Fights bad breath. Because it doesn’t promote bacterial growth in your mouth, xylitol can help decrease bad breath compared to alternatives like sugar.
- Blood sugar stabilization. xylitol has a low glycemic index, so it doesn’t spike blood sugar as heavily after consumption. This makes it an attractive option for people with prediabetes and diabetes.
But modern research has found that there’s more to consider than just the pros, and you might see the cons outweigh them when it comes to your heart.
Is xylitol dangerous to heart health?
While there may be numerous benefits to replacing your sugar intake with xylitol, there are potential risks to overconsuming this calorie-conscious alternative.
Here are some of the most serious to consider:
- Blood clotting. xylitol is prothrombotic, which means that the likelihood of blood clotting is much higher in those who consume it.
- Higher risk of death. Research across 17,700 participants found those with the highest xylitol levels faced up to a 57% higher risk of a major cardiovascular event.
- Processed foods. While xylitol is a naturally occurring compound, it’s typically only visible in trace amounts. This means it’s an ultra-processed, artificially produced ingredient that’s typically present in — you guessed it — ultra-processed foods. Not only does this encourage overconsumption, but it also means you’re eating ultra-processed foods, which isn’t good for you in any context.
Alternative and artificial sweeteners may not be the answer to reducing your sugar intake. Instead, it may make more sense to pursue a balanced diet full of whole, real foods.
So: should you avoid xylitol?
Only you can make that call.
But between the burgeoning evidence and the unhealthy processed foods in which xylitol is often couched, I would highly recommend avoiding it as a staple in your diet.
Here’s what Ovadia Heart Health’s new Cardiologist and Metabolic Health Specialist Dr. Aseem Malhotra said to Fox:
“These disturbing findings with [a] plausible mechanism of xylitol increasing cardiovascular risk should be taken very seriously. As a practicing cardiologist, I see many patients suffering from anxiety and palpitations that resolve as soon as they stop taking artificial sweeteners.”
In our opinion, one of the most effective dietary decisions to reduce cardiovascular risk is to, in Dr. Malhotra’s words, “unsweeten your sweet tooth.”
So, how do you effectively cut sugar and fake sugar from your diet? I recommend following a high-protein, moderate-fat diet such as keto or carnivore. If you still need something sweet in your diet, try consuming foods with naturally produced sugars, like berries and other low-glycemic fruits. In addition to being a sweet treat when you need it, fruits are paired with vitamins and minerals that may be beneficial to your health.
But again: if you are seriously insulin-resistant, cutting out sweeteners entirely may be a better option. You may be surprised how your taste buds reset with a diet rich in whole, real foods. Plus, animal proteins such as red meat, eggs, and chicken can help you stay fuller for longer, avoiding the drawbacks of unnecessary sugar spikes.
Keep in mind that sugar and insulin spikes can occur in both refined sugar and artificial sweetener products.
There’s no need to take our word for it, though. Learn more about how fake sugars sneak into foods and disrupt metabolic health.