Questions concerning the advantages and disadvantages of sugar substitutes have once again been highlighted by a recent study that connected the low-calorie sugar substitute xylitol to an increased risk of heart attack or stroke.
A sugar alcohol called xylitol is created in very small amounts by the human body and is naturally occurring in fruits and vegetables. It is added to processed foods, such as candies and “low-sugar” baked products, but it is frequently synthetically created. This is because it contains 40% fewer calories than conventional sugar and doesn’t give rise to blood glucose after meals. The authors of the study expressed concern about this increase in consumption, noting that those most likely to use the sugar alternative may already be attempting to control diseases like diabetes and obesity, which raise the risk of cardiovascular problems.
“People who choose xylitol over sugar may believe they are making a healthy decision, but the evidence suggests otherwise.” stated Dr. Stanley Hazen, an author of the study and the chair of cardiovascular and metabolic sciences at the Lerner Research Institute of the Cleveland Clinic. Dr. Hazen and his associates discovered a comparable correlation with erythritol, another sugar alcohol, last year.
In the latest study, the xylitol levels in blood plasma samples from more than 3,000 individuals who had fasted overnight were measured by the researchers. They discovered that the risk of a heart attack, stroke, or death within the following three years was almost twice as high for those with the highest xylitol levels as for those with the lowest levels. This month, the findings were released in the European Heart Journal.
The study simply shows an elevated risk; it does not establish a direct link between sugar alcohols like xylitol and erythritol and heart attacks. Associate professor of food science and human nutrition at the University of Illinois in Urbana-Champaign Marta Yanina Pepino noted that other foods might have increased that risk because the researchers did not monitor the participants’ diets. Additionally, she noted that it’s likely that some of the participants had higher levels of xylitol naturally and that this was due to factors other than food and drink.
In order to allay some of these worries, Dr. Hazen’s group also administered xylitol-containing drinks to ten healthy people, fed xylitol to mice, and combined it with human blood samples in a lab. Xylitol accelerated the rate at which platelets formed clots in all of the tests, raising the possibility of a heart attack or stroke in the long run.
Together, the findings imply that there may be hazards associated with xylitol that consumers should be aware of. According to Dr. Pepino, the fact that sugar alternatives like xylitol are low in calories “doesn’t mean that they have no effect.”
Experts from outside the industry advised comparing the advantages and disadvantages of sugar alternatives such as xylitol to those of pure sugar as the next step. High sugar consumption has long been linked to a higher risk of cardiovascular problems, including heart attacks and strokes, according to research.
Dr. David Ludwig, an endocrinologist at Boston Children’s Hospital, stated, “It’s possible that xylitol carries some risks compared to nothing, but the risks are smaller than if you consumed similar amounts of sugar.” Ludwig’s research has shown that some sugar substitutes can prevent weight gain, which is also a risk factor for cardiovascular disease. “I believe the next thing to ask is, how do you evaluate and manage your risk?”
Xylitol in eatables and beverages
You must carefully examine nutrition labels to see how much xylitol you may be consuming.
Foods and drinks labeled as “sugarfree” or “no added sugar” are required to provide the exact amount of sugar alcohol under the carbs in their nutritional facts. However, a product might not need to indicate precise amounts if it does not make these claims. According to Dr. Hazen, this implies that many more goods than people may know include sugar alcohols like xylitol, such as nut butters, energy bars, salad dressings, and flavored drinks. Occasionally, xylitol and other sugar alcohols can be identified in ingredient lists by simply searching for terms that finish in “-ol,” such as maltitol and sorbitol. Other names for xylitol could include birch sugar or the European code E967.
Additionally, xylitol is frequently added to dental hygiene products like toothpaste, mouthwash, and sugar-free gums. However, because consumers ingest so little of these items, researchers don’t think they’re a significant source of xylitol consumption, according to Dr. Hazen.
Cutting back on the use of sugar alternatives
Reduce your intake of processed meals as a first step in limiting your intake of xylitol and other sugar alcohols. Next, Dr. Hazen advised trying to control your sweet tooth. Try using natural sweeteners like honey, maple syrup, or agave nectar in moderation rather than sugar-free snacks and sweets.
As long as you closely monitor your blood glucose so you can adjust your medication as needed, even if you have diabetes, it might be preferable to rely on natural sugars for the occasional sweet treat, according to Dr. Pepino.
Another excellent strategy to sate sweet cravings and obtain fiber and other nutrients that may help control the effects of sugar and sugar alcohols is to include entire fruits and vegetables. You can also experiment with baking recipes that replace mashed fruits, such as applesauce or bananas, for sugar or sugar substitutes.
Try gradually cutting back on both sugar and sugar alternatives in beverages. For example, you could go from sugar-free soda to seltzer that has been flavored with a little bit of fruit juice.
According to Dr. Ludwig, “sugar substitutes are really meant to be used as stepping stones.” “Over time, they shouldn’t be regarded as a component of a healthy, low-carb diet.”
