What Is Xylitol, Exactly?<\/p>\n
Xylitol is a low-calorie sweetener used in many sugar-free or low-calorie foods. \u201cSugar alcohols<\/a> like xylitol are sweet-tasting and low in calories,\u201d says Kelly Johnson-Arbor, MD,<\/a> a toxicologist at MedStar Health in Washington, DC.<\/p>\n \u201cIt is present in trace amounts in whole fruit,\u201d says Jamie Alan, PhD, PharmD<\/a>, an associate professor of pharmacology and toxicology at Michigan State University in East Lansing. Natural sources of xylitol include plums, strawberries, cauliflower, and pumpkin, Dr. Johnson-Arbor adds.<\/p>\n Xylitol is known for its beneficial effects on dental health. \u201cIt prevents growth of cavity-causing bacteria and also prevents plaque accumulation in teeth,\u201d Johnson-Arbor explains. The sweetener shows up in a range of products, including:<\/p>\n Sugar-free chewing gumToothpastesAntibacterial mouthwash productsSugar-free candiesVitaminsBreath mintsSome peanut buttersXylitol Has Been Linked to Heart and Brain Health Concerns in the PastAn earlier study coauthored by Witkowski and published in 2024 linked xylitol to \u201cplatelet reactivity,\u201d suggesting that the sweetener increased the risk of blood clots that could lead to heart attack or stroke.<\/p>\n [2]<\/p>\n Another study, published in 2025, linked fake sugars to brain issues. After following nearly 13,000 adults in their fifties for about eight years, researchers linked higher amounts of several artificial sweeteners \u2014 equal to about a can of diet soda a day \u2014 to a 62 percent faster rate of decline in thinking and memory skills. Xylitol wasn\u2019t the only sweetener flagged; the study also noted that aspartame, saccharin, acesulfame-K, erythritol, and sorbitol were concerning.<\/p>\n [3]<\/p>\n What\u2019s Behind the Link?<\/p>\n More research is needed to understand a possible connection between xylitol and cardiovascular issues, but scientists have at least one theory: \u201cResearch suggests that xylitol activates platelets, which are a sticky substance in blood that stops bleeding,\u201d says Sanjiv Patel, MD<\/a>, an interventional cardiologist at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, California. \u201cIf it activates those platelets in the blood, it can form a clot anywhere in the body \u2014 including the brain, lungs, and heart.\u201d<\/p>\n Witkowski says that\u2019s the most likely explanation. \u201cWe have previously shown that xylitol can directly enhance platelet responsiveness \u2014 the ability to clump together \u2014 in human blood and that it enhances blood clot formation,\u201d he says. That may explain why higher levels of xylitol in the blood are also linked with a higher risk of heart attack, stroke, and death, he says.<\/p>\n The Study Has Strengths and Limitations<\/p>\n The study included a large number of people across two different cohort studies, allowing researchers to analyze a lot of data.<\/p>\n But the research was observational and couldn\u2019t prove that xylitol causes heart attack, stroke, or death \u2014 it simply found a link.<\/p>\n Should You Avoid Foods and Drinks Made With Xylitol?<\/p>\n \u201cAlthough this association between xylitol exposure and heart disease may sound worrisome, the data supporting it remains limited, and much more research is needed to determine the exact relationship between xylitol and heart health,\u201d Johnson-Arbor says.<\/p>\n