Those who regularly chew sugar-free gum may be at greater risk of a fatal heart attack or stroke, a new study suggests.
German scientists found that people who consume large amounts of xylitol – a sweetener commonly found in chewing gum and mints – are up to 57 percent more likely to have a heart attack or stroke, compared to those who consume very little.
Previous research has suggested that xylitol, in large amounts, can make the blood thicker and more sticky, increasing the risk of a dangerous clot.
Xylitol is a sugar alcohol that occurs naturally in the body.
But it is also added to foods, drinks and oral care products because it provides sweetness with fewer calories than sugar.
It is also believed to have some dental health benefits, reducing the growth of cavity-causing bacteria and helping protect against tooth decay.
Until now, the long-term impact on heart health has been widely overlooked.
Presenting the research at the annual conference of the European Society of Cardiology, Dr. Marco Witkowski, the author of the study, said previous research has shown that people with high levels of the sweetener in their blood are more likely to have a heart attack or stroke within the next three years.
Artificial sweeteners have been linked to a number of serious health problems, including cancer, heart disease and diabetes
His team wanted to see whether xylitol increased the long-term risk of heart problems in a larger group of people.
The researchers from the Charité University Hospital in Berlin studied data from 17,710 participants over the course of 30 years.
They found that people with the highest levels of xylitol in their blood had a significantly higher risk of heart attack, stroke or premature death than people with the lowest circulating levels.
Over a six-year follow-up period, the risk of a major cardiovascular event remained 57 percent higher among those who consumed the most xylitol – after adjusting for known cardiovascular risk factors such as age, sex, smoking status and high blood pressure.
After 30 years, the risk of heart attack, stroke or cardiac death was 18 percent higher in those with the highest levels of the sweetener in their blood.
Taken together, the researchers concluded that higher xylitol blood levels pose a greater risk to heart health.
“Artificial sweeteners are consumed by people who believe they are healthier than sugar and are generally considered safe by regulators,” Dr. Witkowski said.
He added that the findings show “how little we know” about the long-term safety of the additives.
Experts not involved in the study said the findings show that further research into this “important topic” is necessary.
“Artificial sweeteners have been widely embraced by modern society, and their safety ratings have traditionally been regarded as good by regulatory authorities,” said Professor Dan Atar, member of the ESC Communications Committee.
‘However, this observational work shows that xylitol has a negative long-term effect on cardiovascular events.
The findings add to a growing body of research suggesting that sweeteners may be linked to a wide range of health problems, including diabetes, obesity and cancer.
Earlier this year, researchers from the University of Cambridge discovered that sweeteners can slow the growth of beneficial gut bacteria, increasing the risk of disease.
Concerns have also been raised about the link between artificial sweeteners and cancer.
A 2025 study published in the journal Science Signaling found that sorbitol – found in sugar-free candies and ice cream – can cause fat to build up in the liver, increasing the risk of liver disease – a major risk factor for liver cancer.
These fears were further heightened in 2023 after the World Health Organization (WHO) controversially classified the artificial sweetener aspartame, found in drinks such as Diet Coke, as ‘possibly carcinogenic to humans’.
However, the UN agency ruled that it only posed a risk to those consuming huge quantities, and that an 11th (70kg) adult could safely drink around 14 cans a day.
Experts are keen to point out that the potential risks of artificial sweeteners must be weighed against the established harms of the sugar they replace.
Around 200,000 people in Britain suffer a heart attack or stroke every year, making cardiovascular disease the biggest cause of death in Britain.
An estimated eight million people live with cardiovascular disease – a group of conditions that affect the heart and blood vessels and can increase the risk of heart attack and stroke.
Around 100,000 Britons suffer a stroke every year and the condition – which occurs when blood stops flowing to part of the brain – is one of the country’s leading causes of death, claiming around 34,000 lives each year.
