A new study found a low-calorie sweetener called xylitol, used in many low-sugar foods and 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 common sweetener.

Researchers found xylitol may cause blood platelets to clot more readily. Clots can break off and travel to the heart, triggering a heart attack, or to the brain, triggering a stroke.

Xylitol is as sweet as sugar with less than half the calories. It’s often used in sugarless gum, breath mints, toothpaste, mouthwash, cough syrup and chewable vitamins. It is frequently added in larger quantities to candy, baked goods, cake mixes, barbecue sauces, ketchup, peanut butter, puddings, pancake syrup and more.

The World Health Organization warned consumers in 2023 to avoid artificial sweeteners for weight loss, and has called for additional research on the long-term toxicity of low- and no-calorie sweeteners, the study says.

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