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Sugar-free doesn’t always mean heart-friendly: What a new study says about xylitol
Confirmed
In Short: A new study presented at the European Society of Cardiology Congress 2026 suggests that higher blood levels of xylitol, a common sugar substitute, may be associated with a higher risk of cardiovascular events, though causation remains unclear.
A new study presented at the European Society of Cardiology Congress 2026 suggests that higher blood levels of xylitol, a common sugar substitute, may be associated with a higher risk of cardiovascular events, though causation remains unclear. The study, which included 17,710 people from two large population studies, found that those with the highest blood xylitol levels had an 18 percent higher risk of major cardiovascular events compared to those with the lowest levels over a 30-year follow-up period.
The study, however, was observational, meaning it found an association but cannot establish that xylitol itself caused the cardiovascular events. Dr Punya Pratap Kujur, a Consultant Cardiologist at Gleneagles Hospital, Parel, Mumbai, advises, 'These findings should be interpreted with caution because this was an observational study and blood xylitol levels do not directly tell us how much xylitol a person consumed.
Xylitol, commonly used in sugar-free products, is generally considered a better alternative to added sugar because it contains fewer calories and has a lower impact on blood glucose. However, the study measured blood xylitol levels rather than directly measuring how much xylitol participants consumed. Additionally, the body naturally produces xylitol as part of metabolism, which means high blood levels do not necessarily indicate increased consumption.
Dr Kujur also notes, 'Xylitol can also be produced naturally by the body, so a high blood level does not necessarily mean a person is consuming more of it.' The researchers advise consulting a health practitioner before starting any routine involving xylitol.
What's confirmed
- A new study presented at the European Society of Cardiology Congress 2026 suggests that higher blood levels of xylitol, a common sugar substitute, may be associated with a higher risk of cardiovascular events, though causation remains unclear. The study, which included 17,710 people from two large population studies, found that those with the highest blood xylitol levels had an 18 percent higher risk of major cardiovascular events compared to those with the lowest levels over a 30-year follow-up period.
- The study, however, was observational, meaning it found an association but cannot establish that xylitol itself caused the cardiovascular events. Dr Punya Pratap Kujur, a Consultant Cardiologist at Gleneagles Hospital, Parel, Mumbai, advises, 'These findings should be interpreted with caution because this was an observational study and blood xylitol levels do not directly tell us how much xylitol a person consumed.
- Xylitol, commonly used in sugar-free products, is generally considered a better alternative to added sugar because it contains fewer calories and has a lower impact on blood glucose. However, the study measured blood xylitol levels rather than directly measuring how much xylitol participants consumed. Additionally, the body naturally produces xylitol as part of metabolism, which means high blood levels do not necessarily indicate increased consumption.
- Dr Kujur also notes, 'Xylitol can also be produced naturally by the body, so a high blood level does not necessarily mean a person is consuming more of it.' The researchers advise consulting a health practitioner before starting any routine involving xylitol.
What's still developing
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