Sweeteners in chewing gum linked with 57 per cent raised risk of deadly heart attacks, study suggests

Those who regularly chew sugar-free gum could face a higher risk of suffering a deadly heart attack or stroke, a new study suggests. 

German scientists found that people who consume high quantities of xylitol – a sweetener commonly found in gum and mints – were up to 57 per cent more likely to suffer a heart attack or stroke, compared with those who consume very little.

Previous research has suggested that xylitol could, in large quantities, make blood thicker and stickier, 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, beverages and oral care products because it provides sweetness with fewer calories than sugar. 

It is also believed to have some benefits for dental health, reducing the growth of bacteria that cause cavities and helping protect against tooth decay. 

Until now its long-term impact on heart health has been widely overlooked. 

Presenting the research at the annual congress of the European Society of Cardiology, Dr Marco Witkowski, the author of the study, said previous research has  shown those with high levels of the sweetener in their blood are more likely to suffer a heart attack or stroke within the next three years. 

His team wanted to see whether xylitol raised 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 those with the lowest circulating levels. 

Over a six-year follow-up, the risk of suffering a major cardiovascular event remained 57 per cent 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 heart death, was 18 per cent 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 think they are healthier than sugar and they are generally regarded as safe by regulatory agencies,’ Dr Witkowski said. 

He added that the findings demonstrate ‘how little we know’ about the long term safety of the additives.

Experts who weren’t involved in the study said the findings show that further studies are necessary into this ‘important topic’. 

‘Artificial sweeteners are widely embraced by modern society, and their safety ratings have traditionally been considered good by regulatory authorities,’ said Professor Dan Atar, a member of the ESC Communication Committee.

‘In this observational work, however, it appears that xylitol has a negative long-term effect on cardiovascular events.

The findings add to a growing body of research that suggests sweeteners could be linked to a wide range of health concerns, including diabetes, obesity and cancer. 

Earlier this year researchers from the University of Cambridge found that sweeteners could slow the growth of beneficial gut bacteria, increasing the risk of disease. 

Concerns have also been raised about links between artificial sweeteners and cancer.

One 2025 study, published in the journal Science Signalling, found that sorbitol – found in sugar-free sweets and ice cream – can cause fat to build up in the liver, increasing the likelihood of liver disease – a major risk factor for liver cancer. 

These fears were heightened in 2023 after the World Health Organisation (WHO)  controversially classified the artificial sweetener aspartame, found in drinks like Diet Coke, as ‘possibly carcinogenic to humans’.

However, the UN agency ruled it only posed a risk to those who consumed massive amounts, and that an 11st (70kg) adult could safely drink about 14 cans a day.

Experts are keen to point out that the potential risks of artificial sweeteners must be weighed against the well-established harms of the sugar they have replaced.

Around 200,000 people a year suffer a heart attack or stroke in the UK, making cardiovascular disease the UK’s biggest killer. 

An estimated eight million people are  living with cardiovascular disease – a group of conditions affecting the heart and blood vessels that can increase the risk of heart attack and stroke. 

Around 100,000 Britons suffer a stroke each year and the condition – which occurs when blood stops flowing to part of the brain – is one of the nation’s leading causes of death, claiming around 34,000 lives annually.