Xylitol is associated with cardiovascular risk

https://academic.oup.com/eurheartj/advance-article-abstract/doi/10.1093/eurheartj/ehae244/7683453?redirectedFrom=fulltext

by geox • 2 years ago

54 68 2 years ago

academic.oup.com

110011002• 2 years ago

Damn! I consume it regularly. Not so much in one day, of course, because it does have a laxative effect. But every cake I've made has been baked with it.

jajko• 2 years ago

"widely used sugar substitutes in processed foods" - what could go wrong, right

0cf8612b2e1e2• 2 years ago

As opposed to throwing corn syrup into everything possible. Any non raw food you acquire is probably loaded with some junk or another.

jiveturkey• 2 years ago

Can anyone summarize how much risk? I don't see that in the abstract. And how much amount of xylitol where it becomes a risk? (We all know, everything can kill you in the right volumes, even water, but there are also healthy volumes.)

I go through a lot of chewing gum with xylitol.

Bo0kerDeWitt• 2 years ago

I'm almost certain I'm mildly intolerant to xylitol, maltitol, and sorbitol - so I avoid them all. There must be others like me, but I hardly every see this discussed. And there's no medical test I know of that can prove it, but I really wish there was.

blcknight3• 2 years ago

Do you get a laxative effect or other gastro symptoms? Sorbitol is the reason prune juice is an effective laxative.

Xylitol is usually such a small amount that it doesn't have that effect although some people are more sensitive.

alan-crowe• 2 years ago

Sabine Hossenfelder, a physics Youtuber, recently departed from her usual content to discuss sorbitol giving her digestive problems: https://www.youtube.com/watch?v=K5v61YtDYo4

gensym2• 2 years ago

I've seen it discussed in reviews of sugar-free Haribo gummy bears: https://www.amazon.com/review/R2JGNJ5ZPJT4YC

aussieguy1234• 2 years ago

These are FODMAPs, which many people with IBS find triggering. You might want to see a dietitian and find out which other FODMAPs you're sensitive to.

Spastche2• 2 years ago

I want to say one of those was originally made to induce diarrhea. I can't eat them either.

Ardon• 2 years ago

I wonder how much this generalizes to other sugar alcohols, I've got some erythritol in the cupboard...

benterix• 2 years ago

Erythritol consumption was already related to increased rate of cardiovascular events: https://www.nih.gov/news-events/nih-research-matters/erythri...

Semaphor• 2 years ago

Same researchers

m_a_g• 2 years ago

How much Xylitol? We need resident researchers of HN to help us analyze the paper.

Or basically I’m hoping someone can tell me whether the paper is trustworthy or not so I can continue taking mints in peace.

Enginerrrd• 2 years ago

Just read the paper. In the 2149 participants, detection in fasting plasma was associated with a hazard ratio of 1.57

It was also shown to enhance clotting at the levels detected in fasting plasma (in 10 people) which provides a potential mechanism to explain the effects observed in the larger group.

As for how legit it is... The number of people is significant. My only complaint is they didn't measure xylitol directly, rather they tested for polyol or something.

zw7• 2 years ago

I believe they confirmed it was xylitol with LC-MS to validate it:

Subsequent stable isotope dilution LC-MS/MS analyses (validation cohort) specific for xylitol (and not its structural isomers) confirmed its association with incident MACE

dev_tty012• 2 years ago

Thanks. That's a substantial ratio. Hazen's group is at the Cleveland clinic and has done a lot of good work so there is something there. Anything on how much Xylitol use is required to get to that risk level?

kurtextrem• 2 years ago

"xylitol-sweetened (30 g) water, an exposure comparable with a pint of numerous xylitol-sweetened ice creams, a xylitol-sweetened bakery good, or several pieces of xylitol-sweetened candy" (source: https://www.reddit.com/r/science/comments/1d9ql2u/comment/l7...)

whalesalad• 2 years ago

It's also incredibly lethal to dogs so for that reason alone I keep it out of my house.

https://www.fda.gov/consumers/consumer-updates/paws-xylitol-...

kobalsky• 2 years ago

I still don't understand how some brands could put it on peanut butter. A few tablespoons can kill a small dog.

It's commonly known that chocolate and onions are bad for dogs but this stuff is on another league.

r00fus• 2 years ago

Honestly, I simply don't understand any reason to add any ingredients to peanut butter than peanuts and salt (and the 2nd is optional).

david-gpu• 2 years ago

I still don't understand how some brands could put it on peanut butter. A few tablespoons can kill a small dog

My daughter is allergic to peanuts. A few tablespoons could kill her. Would it be reasonable for us to expect that no peanut butter is made? No. We simply don't buy it.

All that is needed is the regulatory requirement to list it in the ingredients.

tengbretson• 2 years ago

Hopefully this means all of the sugar alcohols will get taken off the market. Nothing makes for a worse long road trip than accidentally buying a drink that contains that garbage at the beginning.

SoftTalker2• 2 years ago

"Don't consume chemical sweeteners" is a pretty good rule of thumb. Almost all of them have been suspected of adverse effects of one sort or another.

Of course sugar has its own issues as well.

These days I use very little additional sweetening in any of my food. It's hard to avoid though, it's added to a lot of foods (check ingredients) and even fruit such as apples and oranges has been bred to be sweeter than it naturally was 100 years ago.

Biggest difference-maker for most people is probably sweetened drinks. Avoid soft drinks (diet or regular), sweetened tea or coffee, sports drinks, and most packaged juices.

blcknight3• 2 years ago

"Don't consume chemical sweeteners" is a pretty good rule of thumb.

I assume you mean non-caloric sweeteners, since all sweeteners are chemicals including table sugar (sucrose).

While suspected, few have any proven negative impacts. AceK and aspartame are probably the most well studied and the evidence is equivocal. It's probably in the end net neutral.

Some even have benefits, including most sugar alcohols being good for oral health. Erythritol has antioxidant effects in animal models as well.

gensym2• 2 years ago

This 5+ hour podcast on Aspartame is as fascinating as a podcast on the topic could be: https://www.strongerbyscience.com/podcast-episode-116/

neonsunset• 2 years ago

For a very small but non-negligible amount of population aspartame is a severe migraine trigger.

dsr_2• 2 years ago

Everything you ingest is a chemical except light and heat.

margalabargala2• 2 years ago

Okay, sure, but there's colloquial definitions which in a culinary context mean "industrially-synthesized compound meant to mimic the culinary properties of a commonly consumed chemical", here trying to mimic sugar.

Xylitol may exist in nature and be produced by our bodies, but per this article foods with it added contain 1000x the amount we would ordinarily produce.

Perhaps a better rule of thumb would be "for a given chemical, keep your exposure/consumption within an order of magnitude of what would have been typical for a human pre-1850".

HumblyTossed2• 2 years ago

Sugar alcohols have other benefits like not dramatically raising blood sugar levels.

also:

Xylitol is a sugar alcohol that is found in small amounts in fruit and vegetables, and the human body also produces it.

notjoemama• 2 years ago

Here's the correct principle to live by:

If it didn't occur in nature where evolution honed both its existence and human's tolerance to it, then don't consume/use it.

After so many years, I simply can't count how many times "science" has brought us some new food, ingredient, or chemical, which passed all security measures, only to find later it causes or contributes noticeably to some horrible outcome. And I'm perfectly fine not attributing malice. My experience tells me we're quite good at doing the wrong thing while thinking we're doing the right thing. Although, given the current economic climate, malice is probably just as valid.

blcknight3• 2 years ago

Xylitol exists in nature.

kyleee• 2 years ago

As usual the dose makes the poison

klodolph• 2 years ago

https://en.wikipedia.org/wiki/Xylitol

Xylitol occurs naturally in small amounts in plums, strawberries, cauliflower, and pumpkin; humans and many other animals make trace amounts during metabolism of carbohydrates.

HumblyTossed2• 2 years ago

Xylitol is a sugar alcohol that is found in small amounts in fruit and vegetables, and the human body also produces it.

hollerith• 2 years ago

"Xylitol is found naturally in fruits and vegetables like strawberries, raspberries, mushrooms and cauliflower"

https://foodinsight.org/what-is-xylitol/#:~:text=Xylitol%20i....

bloqs• 2 years ago

This principle is fine, but its application is the issue.

This ingredient occurs in nature frequently. Why shouldnt it be used?

jolt42• 2 years ago

It appears in very small quantities in nature (raspberries apparently being the highest). What was the amount in the study (I don't have access)? I credit xylitol for much improved mouth health, but I maybe take 5g a day.

jqgatsby• 2 years ago

Agree strongly. Another good example is industrial seed oils: canola/rapeseed oil, and even things thar sound innocuous like sunflower seed oil. Avoid, avoid, stick to olive oil which has been field tested for millenia.

It reminded me a couple of days ago of that scene from the Princess Bride: https://x.com/jqgatsby/status/1798395071353717183?t=0CZzGU7_...

sampo• 2 years ago

"The human body also produces 5–15 g xylitol per day during normal carbohydrate metabolism in the liver"

Page 347 in: http://www.chemistry-chemists.com/chemister/Pishevye/sweeten...

dvh• 2 years ago

Natural sources often contains "antidote" which could be as simple as shell, fiber or cellulose, something to limit your consumption. For example sugar cane is a wooden stick. You would have to chew it with your measly human teeth for hour to get the sugar out of it. But if it's processed into sugar powder, you don't need to chew. By processing you lost the "antidote" that would otherwise moderate your consumption. Xylitol is found in birch tree. Good luck eating birch tree.

yjftsjthsd-h• 2 years ago

Do you extend that rule to toothpaste?

coding123• 2 years ago

It kills a lot of animals very quickly with a low dose... I stay away from the stuff

throwawa142232• 2 years ago

Xylitol gum stopped chronic ear pain for me. It'd be hard to give up, but I do like having a heart.

distances• 2 years ago

Millions upon millions of people chew xylitol gum every day. If you're actually observing direct benefits yourself, I'm sure those greatly outweigh any potential downsides.

skmurphy3• 2 years ago

This is one study, if you are seeing a benefit I would continue to use it but remain alert to new research.

OutOfHere3• 2 years ago

Apparently your ear pain is referred from an oral infection which xylitol helps with. You can consider xylitol mouthwash instead that is spit out. Pure table salt (without additives) also makes a decent antimicrobial mouthwash.

0cf8612b2e1e2• 2 years ago

That sounds horrible. How much salt are we talking taking and for how long? If I only had iodized salt, is that going to make a difference?

Chemically, it makes sense, but I doubt my mouth loves being exposed to a salt bath either.

OutOfHere3• 2 years ago

I forgot to tell you yesterday that if antibiotics don't fix any recurring or underlying dental infection that you may have, you may then very much need x-rays and perhaps a root canal.

Besides the ear, it can also cause a headache, plus sharp pain in the back of the head, so it's good that you are keeping it in control.

throwawa142232• 2 years ago

My doctor checked for that with a CT scan and X-ray. I have a spot where my sinus narrows that is prone to infection but no abscesses or anything like that, but thank you I know this advice could be very important.

superposeur• 2 years ago

I started reading the different sections of the paper and —- wait, no, this is still the Abstract!

AlbertCory2• 2 years ago

Interestingly, the NeilMed sinus rinse I use has a "xylitol added" version. But you can also buy the regular saline-bicarb powder on Amazon, thank God.

Xylitol! Who TF wants that up their nose?

542458• 2 years ago

Xylitol in nasal spray helps pull liquid into the nasal passages which helps if you have dry nasal passages and reduces your risk of contracting airborne infections. The amount of Xylitol is also tiny compared to what you get from even natural sources (which, granted, is different than inhaling it).

skmurphy3• 2 years ago

Xylitol kills strep bacteria and breaks down biofilms. It's a useful addition to toothpaste and sinus rinse to help breakdown plaque and prevent ear infections or throat infections by strep bacteria. It's also used in wound care formulations as a paste applied to a wound to help inhibit biofilm formation that slows healing.

AlbertCory2• 2 years ago

Well, that might be. However, the Precautionary Principle applies here for me: saline and bicarb just mimic the chemistry inside your nose. Xylitol isn't necessary, so why introduce it? Who knows what side effects it might have?

YMMV.

dev_tty012• 2 years ago

How much risk? How much Xylitol? Disappointed those numbers aren't mentioned in the results section. Without seeing more, leaving that out leads me to suspect that the risk is low and the level of Xylitol is quite high. The links to get access to the article weren't working for me. Anyone have another link?

110011002• 2 years ago

https://pubmed.ncbi.nlm.nih.gov/36849732/ from 2023

Xylitol is associated with cardiovascular risk

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