Xylitol Research Questioned

a doctor reading a report on a medical study

A 2024 study linked the sugar alcohol xylitol with an increased risk of heart attack and stroke, but limitations of the research cast doubt on the conclusions.

The Study

The study showed an increased risk of major adverse cardiovascular events (MACE) from elevated blood levels of xylitol, but the authors did not conclude that the higher levels were caused by consumption of the sugar alcohol. Xylitol is also produced naturally in the body.

The research team was led by doctors from the renowned Cleveland Clinic, who called for additional studies on xylitol’s long-term safety. In a press release, the clinic noted, “The research had several limitations, including that clinical observation studies demonstrate association and not causation.”

Sample Limitations

Participants were deemed to be at increased risk for heart disease before the study began, and some had already been diagnosed as having it.

The results did not provide data about xylitol’s effects on healthy individuals.


“Far from condemning xylitol as an ingredient in foods and beverages, these data provide no insight whatsoever on potential negative effects of dietary xylitol intake,” writes Peter Attia, MD, host of the health podcast “The Drive” and author of the number one New York Times bestseller Outlive: The Science and Art of Longevity.

Dr. Attia contends that “the reported positive association between xylitol and MACE risk were instead the result of endogenous production,” in other words, by excess xylitol produced naturally in the body of at-risk individuals.

Uses for Xyltiol

  • Sugar Substitute

    Xylitol has fewer calories than sugar and is used as a sweetener in many products, including gum, candies, and baked goods.

  • Toothpaste Ingredient

    It’s a popular ingredient in toothpastes and has been shown to help prevent tooth decay.

Click to See Our Sources

“Cleveland Clinic-led study links sugar substitute to increased risk of heart attack and stroke,” Cleveland Clinic Newsroom, 6/6/24

“Common sugar substitute linked to increased risk of heart attack and stroke” by Barbara Mantel, NBC News, 6/10/24

“Does xylitol increase risk of cardiovascular disease?” by Peter Attia, PeterAttiaMD.com, 6/22/24

“Xylitol is prothrombotic and associated with cardiovascular risk” by M. Witkowski et al., European Heart Journal, 6/24


The Taste for Life Staff

The Taste for Life staff come from a wide variety of backgrounds and specialties. We believe learning is a life-long process, and love to share the knowledge we gain.