This point jumped out to me as a pretty significant limitation of the study.
The investigators did not collect any data on xylitol intake from their human cohort, so we have no way of correlating consumption with MACE risk because we have no way of knowing which participants were regularly consuming xylitol-containing foods. And although xylitol is currently a very common sweetening additive, Witkowski et al. note that the majority of their study participants were enrolled prior to xylitol’s widespread use, suggesting that circulating levels measured in their observational cohort may not be attributable to dietary intake.
Alas, as with all human nutrition studies, it is all garbage and mostly funded by Nestle or similar.
Convincing garbage too. I routinely have an argument with a friend who believes these, and thinks that a whole lot of studies pointing in the same direction is better evidence than only one. I Point out that it’s because those studies are all defined by the same person and run by the same people
> xylitol consumption is that diet isn’t the only source of circulating xylitol. This compound is also produced by our own bodies through a process known as the glucuronate pathway, one of the pathways by which we metabolize glucose. So how did the authors ensure they were investigating the relationship between dietary xylitol intake and MACE risk? They didn’t.
> This research group followed the same flawed design and ended up with the same flawed conclusions. SSDD – same [study], different day.
> At best, this work shows that endogenous xylitol correlates with – but doesn’t necessarily contribute to – cardiovascular risk. 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 [...] xylitol may even offer advantages for health.
> So in summary, this work should ring a few bells – but there’s no need for it to ring any alarms.
Interesting! Both that the study had a flaw (dietary xylitol not being properly isolated) and that the same group "reused" a study from another artificial sweetener. I'm tempted to ask who might be funding this group...
Just a public service announcement: xylitol is incredibly toxic to dogs. Way more than chocolate.
Since it's commonly added to candies and even some forms of peanut butter, please be careful when leaving these things around your kitchen. A few pieces of Ice Breakers sugarless gum can kill a 50lb dog.
Can confirm, 20 years ago our puppy got a half-empty pack of sugarfree gum out of my wife's purse, had major liver poisoning, had to have his stomach pumped. Luckily he made it but it was amazingly bad considering how little he actually ingested.
Xylitol. It's made from a birch bark extract. I only learned the specifics after I caught my pup having dug an empty pint of Rebel out of the trash and lost it. Then I looked up the info online. Some sweeteners will upset their stomachs, but Xylitol will kill them.
Interesting to me that xylitol is used for dental health (especially among some Asian populations), and dental health is associated with cardiovascular health, but the data suggests problems anyway.
I use xylitol mouthwash, xylitol gum & xylitol nasal spray. So this recent study was very concerning for me. Apparently the amount used to trigger cardiovascular events was 30g/day so I'm sure there's nothing close to that in those products nor are you absorbing much of it into your GI tract, which is how the problems occur.
> Note that I am discounting the years of hyperventilating messages about aspartame (in particular) leading to supposedly sweeping epidemics of cancer, autism, seizures and what have you. These are not based on any solid evidence, and after the original trials and forty years on the worldwide market, there would be solid evidence by now if any such things were happening.
Glad to see a balanced perspective on this. Everything in moderation.
"Lard" is "completely natural" and is bad in massive quantities, just like aspartame would be.
After a couple of years without taking a single one, a couple of months ago I bought a Smint lemon package, I used to love them as a kid so why not taking one for nostalgia's sake.
Since I'm not that used to artificial sweateners ( I dont drink coke or anything related to sugar ), the taste was noticiable inmediatly, it didn't bother me, it was just a curious feeling of being able to detect it so quickly. I ate like 3 or 4, those things were addictive.
What bothered me was what happened a couple of hours later, I had a massive stomach bloat and ache, higher than normal body temperature and generally felt like I was gonna throw it up and I couldn't hold it. After an hour of lying in the sofa I said that it was enough and indeed, threw up my dinner that night.
To my list of things I don't eat, xylitol was added inmediatly, I have never felt so sick, so fast in so little time.
Xylitol is not an artificial sweetener, it's a sugar alcohol. Sugar alcohols are generally derived by processing natural ingredients. Xylitol is made by extracting the sugar alcohol from beech wood. Sugar alcohols can cause bloating and diarrhea due to osmotic effects [1] and can have laxative properties for some. I'm a bit sensitive to sugar alcohols myself.
Look I don't think this kind of comment adds any value to this discussion. There's a linked paper here and it's useful to discuss it. But humans all eat food, and if we start chiming into every nutrition article with random anecdotes about what we eat, then the purpose of keeping HN a high quality site goes away. The science is hard enough to get straight, adding random anecdotes lowers whatever signal we have.
I feel like xylitol was never a particularly viable candidate as an artificial sweetener; as the article mentions, you experience digestive distress when consuming enough to sweeten a soda. Whether or not it's bad for you over time doesn't matter, it's already not a very good artificial sweetener. The sweetness to calorie ratio isn't very good either. It does taste pretty good, however, especially in things like mint candies that already have a cooling effect. (I was very excited about xylitol when I first heard about it. Excited enough to order a bunch of candy and eat far too much of it in one go. Didn't make that mistake again!)
I never trusted this xylitol shit. Or really any artificial sweeteners. Seems like it’s best to avoid them altogether and avoid developing a sweet tooth.
Like yours, many responses to this research make the appeal to nature: natural things are good and unnatural things are bad. However, that misses the point because xylitol does occur naturally. It is produced by our bodies and is found in some fruits. It isn't a novel compound created in a lab.
The human desire for sweet foods is also quite natural. Sweetness is one of the fundamental tastes that humans can detect, and we naturally seek out sweet foods.
An appeal to history is not the same as an appeal to nature.
Traditional diets and foodstuffs aren't necessarily optimal, but they do evidence themselves as adequate for sustaining a community for some number of centuries.
Novel diets and foodstuffs don't have that benefit, and are often accepted into daily life on a weakly evidenced hunch that its "safe until proven otherwise" and an often unevidenced assumption that it must at least be better than whatever imperfect thing its replacing.
Choosing not to hop onto the hype train for every new novelty is a personal choice, but a decidedly reasonable one.
In the case of sugars and sugar substitutes, adhering to a traditional pattern simply means treating sweetness as a luxury and accent rather than a daily staple. Not a big ask for people who mean to care about their health (not everyone needs to).
Please note that traditional century-old diets have a great track record of sustaining communities, but it's not necessarily the case that the old diets can lead to long lifespans given our current levels of food availability. For instance, my grandmother used to tell me that I needed sugar to grow strong, so she added a ton of it to my milk when I was little. Refined sugar wasn't as readily available, or equally cheap, a long time ago so the small amounts of sugar that made sense in the past doesn't make sense today. She meant well, but the old knowledge unfortunately ended up creating a perverse incentive.
What you are saying makes complete sense, but it's important to have in mind that when going all-in with "traditional" foods, one still needs to worry about overall intake - the century-old foods can still kill you if your diet isn't balanced.
> An appeal to history is not the same as an appeal to nature.
Would it surprise you to know that as recently as 1850 in the USA 50% of all children died before the age of 5? Does that change your opinion of how well people were doing in 'history'?
> Novel diets and foodstuffs don't have that benefit, and are often accepted into daily life on a weakly evidenced hunch that its "safe until proven otherwise" and an often unevidenced assumption that it must at least be better than whatever imperfect thing its replacing.
Can you explain what you mean by this in relation to xylitol? It is not a 'fad' or 'novel' diet.
> In the case of sugars and sugar substitutes, adhering to a traditional pattern simply means treating sweetness as a luxury and accent rather than a daily staple. Not a big ask for people who mean to care about their health (not everyone needs to).
I assume that you eat wild game and refrain from non-local and out of season ingredients as well?
The top Google result on xylitol is from WebMD and states: "Overview. Xylitol is a natural sugar alcohol found in plants, including many fruits and vegetables"
Why should anyone worry about this substance in low doses?
We already know overexposure to sugar can have negative effects, so it seems reasonable to evaluate whether a widely used sugar substitute could be bad if consumed in large enough quantities. i.e. someone has soda with artificial sweeteners once a day, and then they consume some baked goods during breakfast that were made with an artificial sweetener instead of sugar, and maybe it's included in their mouthwash or something.
It won't give you acute disease, but whether it acts as a chronic poison is a different story, and much hard to disentangle.
We are a long-lived species, way more so than most mammals. Consuming some substance for 30 years will have a different effect on us than on normal forest critters, which mostly don't live to be 30.
