Experts Weigh In on Concerns Over Latest Xylitol Study

An intriguing study by the Cleveland Clinic has been making headlines for saying large doses of the sugar alternative xylitol may be associated with heart attacks and strokes.

Xylitol is sometimes used as a sweetener in baking products and candy. However, its most popular use is in mints, sugar-free gum, and toothpaste. In the world of dentistry, xylitol is recognized to improve tooth health by reducing the amount of bad bacteria in the mouth.
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Dr. Stanley Hazen, chair of Cardiovascular and Metabolic Sciences at the Cleveland Clinic’s Lerner Research Institute and the study’s lead researcher, said that such types of sugar alternatives should be investigated further, “especially as they continue to be recommended in combating conditions like obesity or diabetes.”

The Dose Matters

However, the “minuscule amount of xylitol” that is ingested in over-the-counter dental products “is non-comparable,” the American Dental Association told The Epoch Times by email in response to the study.

The amount of xylitol used in dental products usually does not exceed more than 1 gram per serving—whether that’s gum, mints, or toothpaste.

Meanwhile in the study, the researchers observed an elevated blood clotting marker when 10 healthy volunteers drank a mixture that contained 30g of xylitol after a 12 hour fast.

“[That] is equivalent to eating 60 of the mints that I make, immediately,” said Dr. Ellie Phillips, DDS, an oral health educator and owner of a xylitol business.

“The amount of xylitol these subjects were given was enormous.”

The mints that Dr. Phillips makes contain 0.5g of xylitol per mint, and customers are recommended to take a mint after a meal or a drink, up to 5 times per day.

Study May Not Reflect How Xylitol Is Used in Real Life

As for xylitol-sweetened drinks available for purchase in the United States, a search by The Epoch Times has not found many.

“It’s very hard to dissolve xylitol in a liquid,” Dr. Phillips said.

“You have to heat it up and then cool it down. You can’t just put xylitol and stir it into a cold drink.”

Dr. Phillips has tried to once make a xylitol drink product herself but gave up the idea after encountering difficulties in the manufacturing process.

“So never in real life has it occurred that someone using xylitol for oral health care has taken doses that mimic what was rather suggested in the trial,” said Dr. Amy Doneen, DNP, a preventative heart and stroke specialist in Washington state.

As far as xylitol being able to elevate blood clotting markers, Dr. Doneen says that an appropriately small dose for oral care “has never been indicated to increase platelet activity and increase cardiovascular risk.”

In fact, small doses of xylitol can contribute to a healthy cardiovascular system.

“The patients that have high-risk periodontal pathogens are at significant increased risk for atherosclerotic disease development,” Dr. Doneen said.

“So we are huge advocates of measuring those pathogens and also treating them … and xylitol rinses and gums and mints are one way to do that.”

And while these experts welcome the study, there is concern that people are shying away from using xylitol as part of their dental care at home.

“Some of the media outlets even put pictures of chewing gum with the risks for stroke and death,” Dr. Phillips said.

“My poor elderly people who’ve been taking this now for 30 years, [are] terrified that they have done something bad.”

Xylitol for Weight Loss?

The study itself is not an attack on the dental use of xylitol. The research community seems most concerned with the long-term effects of such sugars when they are used in foods and drinks.

In one commentary about the study, cardiovascular experts Dr. Juerg Bee and Dr. Meret Allemann point to the fact that last year, the World Health Organization (WHO) began advising against the use of non-sugar sweeteners (NSS) for weight loss. These sugars include aspartame, sucralose, and stevia. And according to the WHO,  their use has been linked to obesity, cardiovascular disease, and type 2 diabetes.

Xylitol, however, is not an NSS. It falls into the category of sugar alcohols, which include sorbitol and erythritol. Currently there are no specific policies from major health organizations that focus exclusively on the use of sugar alcohols for weight management. Moreover, xylitol’s largest market continues to be in dentistry, while erythritol is more commonly used to sweeten drinks and snacks.

But from a cardiovascular standpoint, Dr. Doneen recommends moderation when it comes to using any types of sweeteners.

“The idea of having sugar-free beverages that are filled with artificial sweeteners to make them taste better … we don’t advocate [for that] either. The best idea is to drink good old fashioned water,” Dr. Doneen said.

Don’t forget to visit our Ultimate Guide to Kicking Sugar.

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Views expressed in this video are opinions of the host and guests, and do not necessarily reflect the views of The Epoch Times.

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