Xylitol Linked to Adverse Cardiovascular Event Risk

Xylitol Linked to Adverse Cardiovascular Event Risk

(HealthDay News) — Xylitol is associated with incident major adverse cardiovascular event (MACE) risk, according to a study published online June 6 in the European Heart Journal.

Marco Witkowski, M.D., from the Lerner Research Institute at the Cleveland Clinic, and colleagues performed untargeted metabolomics studies on overnight fasting plasma samples in a discovery cohort of 1,157 sequential stable patients undergoing elective diagnostic cardiac evaluations. Subsequent isotope dilution liquid chromatography tandem mass spectrometry (LC-MS/MS) analyses were performed on an independent validation cohort comprising 2,149 participants. The effect of xylitol on platelet responsiveness and thrombus formation in vivo was examined in complementary isolated human platelet, platelet-rich plasma, whole blood, and animal model studies. Finally, the effects of xylitol consumption were examined on platelet function in 10 healthy volunteers.

The researchers found that circulating levels of a polyol tentatively assigned as xylitol were associated with incident MACE risk in the initial untargeted metabolomics study (discovery cohort). The association of xylitol with incident MACE risk was confirmed in stable isotope dilution LC-MS/MS analyses (third versus first tertile adjusted hazard ratio, 1.57). Xylitol-enhanced multiple indices of platelet reactivity and in vivo thrombosis formation at levels observed in fasting plasma were seen in complementary mechanistic studies. Xylitol-sweetened drinks markedly raised plasma levels in interventional studies, and enhanced multiple functional measures of platelet responsiveness in all individuals.

“Our studies suggest that xylitol will likely confer heightened thrombosis potential in the same vulnerable patients that it is marketed towards and intended to protect,” the authors write.

Several authors disclosed ties to the biopharmaceutical industry; several authors are named coinventors on pending and issued patents relating to cardiovascular diagnostics and therapeutics.

What is xylitol?

Xylitol has carved a niche for itself in the world of sugar substitutes. Found naturally in some fruits and vegetables, xylitol is also a sugar alcohol, offering potential health benefits, particularly for oral health.

Xylitol belongs to a class of compounds known as sugar alcohols, which combine features of both sugars and alcohols. This unique structure allows it to activate the sweet taste receptors on our tongue, mimicking the sweetness of sugar. Our bodies also produce small amounts of xylitol during normal metabolism.

While commercially produced xylitol can be derived from corncobs or hardwood trees like birch, it also occurs naturally in small quantities in various fruits and vegetables, including plums, strawberries, and cauliflower. The food industry has embraced xylitol as a sugar substitute due to its sweetness profile. It delivers a near-identical level of sweetness to sugar but with about 40 percent fewer calories.

How does xylitol affect your health?

Unlike sugar, xylitol doesn’t contribute to tooth decay. Research suggests it may have dental health benefits. The culprit behind cavities is a type of bacteria called Streptococcus mutans, which thrives on sugar. Xylitol, however, disrupts this process. When these bacteria take in xylitol, they are unable to metabolize it for energy, hindering their growth and reducing their ability to produce acid, a key factor in tooth decay.

While xylitol offers benefits, it should not be a free pass for indulging in excessive amounts of sweet foods. Consuming large quantities of xylitol can cause digestive issues like bloating and gas, especially in those not accustomed to it.

Does xylitol work for weight loss?

While xylitol has some properties that might be attractive for weight loss as well, the evidence for its effectiveness is inconclusive. Clocking in at around 40 percent fewer calories than sugar, xylitol might seem like a clear winner for weight loss. This could potentially lead to a slight calorie deficit if you use xylitol to replace sugar in your diet.

Unlike sugar, which can lead to blood sugar spikes and subsequent crashes in energy levels, xylitol has a minimal impact on blood sugar. In theory, this could help regulate appetite and prevent overeating [2]. However, research suggests that the body might not fully compensate for the calories from xylitol, potentially negating any appetite-suppressing effects.

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