WHAT IS HAMMER NUTRITION’S RESPONSE TO NEWS ABOUT XYLITOL

Don’t believe all the propaganda and the hype!

Q: What is Hammer Nutrition’s response to the recent headlines about xylitol and its supposed negative effects on cardiovascular health?

A: There have been many recent headlines about xylitol. Hammer Nutrition’s position is that these headlines are overly sensational and do not reflect much of what the xylitol study actually reported. The view presented is that the headlines rely on scare messaging and are not helpful for people seeking reliable information.

Position

This study, as with the erythritol study, is described as showing only an association between xylitol and cardiovascular risk, and a weak association at that. It does not show that xylitol caused a higher incidence of heart attack, stroke, or death.

It is also stated that additional information and variables not addressed in the study would be needed to make the findings more reliable. Dr. F. Perry Wilson made the following comment about the erythritol study (carried out by the same research team), and this is presented as relevant here as well:

“We shouldn’t be thinking about the results of the study in a vacuum. Even if erythritol does truly increase the risk of heart attacks and strokes, it still is replacing sugar, which almost certainly has more pernicious health effects.”

Reported “red flags” and limitations in the xylitol study

• Classification of xylitol: Xylitol is present in several fruits and some vegetables and is also naturally produced by the body. Based on this, referring to xylitol as an artificial sweetener is described as incorrect.
• Single blood measurement: The investigators measured naturally occurring xylitol levels in the blood of more than 3,000 participants after an overnight fast. They reported that participants whose blood xylitol levels were in the top 25% had about double the risk of heart attack, stroke, or death over the next three years compared with those in the bottom 25%. This is described as being based on a single blood draw and its measured xylitol level.
• Blood levels measured, not dietary intake: The study is described as considering blood xylitol levels rather than xylitol intake from the diet. No dietary history before the study, or dietary information during the three-year follow-up period, is described as being included. Dr. Leonardo Sodre is quoted as saying: “At no point did the study's author evaluate the consumption of xylitol, but rather the presence of this type of molecule in the blood.”
• Participant health status: The participants (average age 64) are described as having significant pre-existing health issues. Many were overweight and had diabetes, hypertension, prior cardiovascular disease, previous heart attack, coronary heart disease, stenosis (defined as narrowing or restriction of a blood vessel or valve that reduces blood flow), and heart failure. Many were also taking statin medications, which the American Heart Association is quoted as describing as lowering cardiovascular event risk while also increasing coronary artery calcification, which is described as a marker consistently associated with increased cardiovascular risk.
• Observational design and causality: The study is described as observational and therefore only able to show an association, not causation. It is stated that the study does not demonstrate that xylitol caused higher rates of heart attack, stroke, or death. One source is quoted as stating: “Observational studies are a lower standard of evidence than experimental studies, are more prone to bias and confounding, and cannot be used to demonstrate causality.” It is also stated that participant health status and dietary practices may be more relevant explanations, and that dietary practices were not recorded in the research.