Common low-calorie sweetener linked to heart attack and stroke, study finds

[ThatRobGuy]

https://www.cnn.com/2024/06/06/health/xylitol-heart-attack-stroke-wellness/index.html

A low-calorie sweetener called xylitol used in many reduced-sugar foods and consumer products such as gum and toothpaste may be linked to nearly twice the risk of heart attacks, stroke and death in people who consume the highest levels of the sweetener, a new study found.

“We gave healthy volunteers a typical drink with xylitol to see how high the levels would get and they went up 1,000-fold,” said senior study author Dr. Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute.

Xylitol is a sugar alcohol, a carbohydrate found naturally in foods such as cauliflower, eggplant, lettuce, mushrooms, spinach, plums, raspberries and strawberries. However, the amount of xylitol found in such natural sources is tiny, Hazen said.


Xylitol isn't the first in the realm of "replacement foods" that end up having some potential consequences.

I think, like with many other things in the realm of health and nutrition (particularly in the areas of weight loss and cholesterol reduction), the never-ending quest to find either A) "things that taste like the thing that's not good for me, but won't cause me to gain weight", or B) "things I can take in conjunction with my food, so that I don't have to change my dietary habits" has caused some "solutions" to be somewhat rushed in order to accommodate market demand.

Basically, there's no ideal solution for the problems of obesity and cardiovascular disease that doesn't involve willpower (either in the form of portion & interval control).

And in order to tackle those problems correctly, I think people are going to need to make peace with the fact that there's no such thing as a good diet/lifestyle where "I can gorge myself on sweet-tasting or decadent foods 3 times a day, 7 days a week, and still maintain a health body weight".

Asking...
"How can we make a cookie that's artificially sweetened and low calorie, so I can still eat 9 of them while bing-watching netflix and lose weight?"
"How can we make a pill or injection so I can still eat fast food till I feel stuffed 5 days a week, but that won't raise my cholesterol/weight?"
...aren't the right approach. And as much as it may pain some folks to hear it, if they want to keep those two problems in-check, they may have to break down and eat some veggies along side a small chicken breast or piece of fish every once in a while, and realize that not every meal needs to be "eat nothing but delicious-tasting foods until I feel full"

 

[DaisyDay]

“We gave healthy volunteers a typical drink with xylitol to see how high the levels would get and they went up 1,000-fold,” said senior study author Dr. Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute.

Levels of what?

 

[ThatRobGuy]

Levels of what?

The direct Cleveland Clinic link has some more of the technical details in it

Another Sugar Substitute, Xylitol, Is Linked to Heightened Cardiovascular Risk

Elevated blood levels of the sugar alcohol xylitol are associated with higher incident risk of cardiovascular events and enhanced platelet reactivity and thrombosis potential New research implicating another sugar substitute in cardiovascular risk signals an urgent need to further study the...

consultqd.clevelandclinic.org

The researchers next conducted a human intervention study. They tracked baseline versus postprandial platelet activity from 10 healthy volunteers who ingested a drink sweetened with 30 g of xylitol (roughly equivalent to the amount in a single scoop of keto-friendly ice cream). Plasma levels of xylitol increased 1,000-fold in these subjects within 30 minutes, and every measure of platelet responsiveness significantly increased immediately following ingestion in every subject. Xylitol was rapidly excreted, returning to near-baseline (fasting) levels within six hours after ingestion.

“This suggests that the overnight fasting plasma levels of xylitol seen in our large observational cohort represent variations in endogenous levels of xylitol, not levels impacted by food consumption,” Dr. Hazen notes. He adds that this underscores just how great the clotting risk from food-related elevations in plasma xylitol may be, given how greatly the xylitol levels that are added to foods dwarf endogenous levels.


Evidently, plasma levels of xylitol are a marker for clotting activity, and the amount found in a typical artificially sweetened beverage increases plasma xylitol levels up 1,000-fold from their normal baseline concentration.

 

[DaisyDay]

That's interesting. I was unaware that blood plasma was able to have any level of xylitol as a lot of transformations take place in the gut (thanks, bacteria!) before it gets absorbed.

I did know that one thing that might keep xyitol levels down naturally are its very well known, very effective side effect - major diarrhea. All this other stuff is new information, so thanks.

 

[ThatRobGuy]

That's interesting. I was unaware that blood plasma was able to have any level of xylitol as a lot of transformations take place in the gut (thanks, bacteria!) before it gets absorbed.

I did know that one thing that might keep xyitol levels down naturally are its very well known, very effective side effect - major diarrhea. All this other stuff is new information, so thanks.

I guess the part that should be concerning is for the people who tend to "graze" on the "diet-friendly" foods or drink substitute sodas all throughout the day.

While they mention that the levels go sky-high, and then comeback down within 6 hours of consumption to the baseline levels they were at in a overnight fasted state. (while the spike isn't good in general from the sounds of it, the occasional one may not be the end of the world)

But it's the people who have the "keto-friendly breakfast bar", then an hour later add xylitol based sweetener to their coffee, then have a xylitol sweetened soda with lunch, then a "Keto-friendly snack in the afternoon", then more of those types of items with dinner... sounds like they could be keeping their levels perpetually spiked.

 

[RileyG]

I wonder how much of it is in our foods! I can’t say I’m surprised with all this artificial nonsense.

 

[rambot]

I drink a fair amount of Mio that has sugar alcohols in it. Got nervous but it says there's no xylitol in there.

Whew!

 

[ThatRobGuy]

I wonder how much of it is in our foods! I can’t say I’m surprised with all this artificial nonsense.

From the sounds of it, xylitol itself isn't "unnatural" or "artificial", as it's found in much smaller amounts in some regular foods. Being that there's a baseline number that's "normal" in our plasma even after an overnight fast, it's not a completely foreign substance.
(cauliflower, eggplant, lettuce, mushrooms, spinach, plums, raspberries and strawberries all have low-level amounts of it)

...just not in the highly concentrated form that they're refining it into for "low calorie/low carb" alternative foods.


From the way it's being described in the CC publication. It sounds like it's the same sort of dynamic that would exist with other trace substances and minerals. Where in smaller amounts, it's benign (or even helpful), but in highly concentrated forms, it can cause damage.

But it sounds like xylitol (in the form of substitute sweetener) is like the "essential oil" of foods lol. Where, things that would normally be harmless if consumed/ingested in normal form, could mess you up when ingesting the highly distilled form.

 

[RileyG]

From the sounds of it, xylitol itself isn't "unnatural" or "artificial", as it's found in much smaller amounts in some regular foods. Being that there's a baseline number that's "normal" in our plasma even after an overnight fast, it's not a completely foreign substance.
(cauliflower, eggplant, lettuce, mushrooms, spinach, plums, raspberries and strawberries all have low-level amounts of it)

...just not in the highly concentrated form that they're refining it into for "low calorie/low carb" alternative foods.


From the way it's being described in the CC publication. It sounds like it's the same sort of dynamic that would exist with other trace substances and minerals. Where in smaller amounts, it's benign (or even helpful), but in highly concentrated forms, it can cause damage.

But it sounds like xylitol (in the form of substitute sweetener) is like the "essential oil" of foods lol. Where, things that would normally be harmless if consumed/ingested in normal form, could mess you up when ingesting the highly distilled form.

Thanks for clarifying

 

[ThatRobGuy]

Thanks for clarifying

Seems like it's possible one of those odd dynamics where, in efforts to replace one thing (aspartame, which is artificial, and has been linked to some problems), they "fast tracked" the usage of a replacement for it, and falsely assumed "natural = better", which obviously isn't always the case when it comes to food additives.

The thing that all non-caloric or low-calorie sweeteners seem to have in common (artificial or natural-derived), is that they appear to mess with the body's metabolism and insulin response.

The thing the human body is evolved to do (or designed to do if that's what people prefer) is to trigger a particular chemical and metabolic response to the foods we eat.

Under normal circumstances, when you consume something sweet, in nature, that means there's sugar in it, so your body would be "expecting something" (and produce the appropriate insulin response), over time, if you accustom your body to "I just drank something sweet, but no need to do anything, there's 0 calories and 0 sugar in it", when you do actually eat sugar, things aren't going to respond appropriately because you've been "tricking your body" in a sense.

Cleveland Clinic and Harvard have even done some write-ups on it

Sad but True: Diet Sodas Are Bad for Your Health

You kicked your regular soda habit, and now you’re sitting on cloud nine. But if that cloud is made of diet soda, you may have just created new problems. We talked to a dietitian about why diet soda is bad for your health, how to stop drinking it and alternatives to try instead.

health.clevelandclinic.org

They call what I was referring to "insulin confusion"



That's why I mentioned it all comes down to willpower in the end. There's no magical shortcut that's going to allow someone to eat cookies till they feel full, washed down with a soda of some sort, several times a week, and still maintain health.

With the hype around the new weight loss drugs like Ozempic, it's become pretty clear that people are looking for the "magic bullet" so to speak.

"At every meal, I want to satisfy my cravings for fullness, satiety, and decadence/richness...I don't want to have to sacrifice any of those 3 things, but I still want to be able to lose weight", that's where the market demand for these weight loss drugs and artificial replacement foods come from.

Same can be said for a lot of the 'fad diets' that pop up all over the place.

It's rather conspicuous that in all of the 'fad diets', none of them ever seem to incorporate "yeah, you have to eat broccoli once in a while instead of garlic bread". They're always these "you can eat all the ABC you want, just so long as you <insert trivial ineffective thing here>"



My mom's side of the family is all from the portion of the south that's known for not eating well. They're a "big bunch". They jump on all the bandwagons.

"I'm trying this new diet...you can eat all the <insert unhealthy food here> you want, just so long as you have one glass of cranberry juice with it, and don't have any carbs after 8pm, and take a teaspoon of oregano oil right before bed"

And burn through a bunch of those diet fads, and when they don't lose a pound, dismiss it as "It's just genetic, I've tried everything and I can't lose weight" (while conveniently ignoring that I come from the same genetic line they do)

...when in reality, they haven't "tried everything", they've tried everything except eating less and eating things that may not taste super great, but are better for them lol.

They'll spend more time googling reasons not to eat the healthier foods. I have this conversation with my cousin down there at the yearly holiday gatherings. He's a big fella, lots of fast food, lots of pizza, lots of fried food. I tried telling him that if he kept it 1800 calories a day, cut down on the sweets, and ate things like a 5oz chicken breast and 2 cups of broccoli as a staple meal, he'd lose weight.

3 days later, I got an email from him with links to some stuff he found on google from carnivore diet "gurus" warning against "the anti-nutrients in green vegetables" and "why broccoli and kale aren't actually healthy" and why "red meat has more bioavailable nutrients than chicken" (ironic that he doesn't have a problem with chicken when it has the skin still on and fried in oil lol).

"Anti-nutrients" and "bioavailability" are nonsensical debate points from a person who's under 6 foot tall and tipping the scales at 325 and eating a bunch of garbage. They're just excuses for not having to make sacrifices.