Sugar has been demonized for many years, and for good reason. High sugar consumption has been linked to a number of health problems, from weight gain and type 2 diabetes to heart disease. But not all forms of sweetness work in exactly the same way in the body.
Xylitol is a commonly used sugar substitute found in products such as sugar-free gum, candy, baked goods, and toothpaste. A sugar alcohol with roughly 40% fewer calories than sugar, it is often used in “keto-friendly” and low-sugar products. But research has raised fresh questions about whether some sugar alcohols are as harmless as once thought.
In 2024, Cleveland Clinic-led researchers found that higher levels of xylitol in the blood were associated with a greater risk of cardiovascular events such as heart attack and stroke. The same research group had reported similar findings involving erythritol in 2023. The studies do not prove that these sweeteners cause heart problems, but they have fueled calls for more research into their long-term safety.
“We’re throwing this stuff into our food pyramid, and the very people who are most likely to be consuming it are the ones who are most likely to be at risk,” said lead author Dr. Stanley Hazen, referring to people with conditions such as heart disease and diabetes. He added that toothpaste and gum are considered lower risk, since very little xylitol is typically ingested.
Meanwhile, health authorities have also become more cautious about non-sugar sweeteners in general. The World Health Organization advises against using them for long-term weight control, saying they do not appear to offer lasting benefits for reducing body fat and may be linked to undesirable long-term effects.
From natural sweeteners such as honey to artificial sweeteners like aspartame, the search for a better, healthier sugar continues. But is there really such a thing as “healthy” sugar? Click through this gallery to find out.