MARKET INSIGHT
At the same time, there remains
uncertainty: neither observational analyses establish whether habitually eating xylitol increases cardiovascular
disease risk.
The new findings add evidence about circulating xylitol and cardiovascular risk without directly answering the question whether this is also the case for xylitol- containing confectionery.
Are there currently any grounds for changing how xylitol is used in food formulation, or would that be premature based on the evidence available? The European Commission has approved xylitol (E967) for use as a sweetener in the European Union in a range of products including jams, marmalades, spreads, chewing gum, and baked goods. The European Food Safety Authority (EFSA) is currently reviewing its risk assessment for xylitol in foods to take into account data that has been newly published since it was last evaluated in 2011. Food safety assessments are based on the
totality of the available evidence, rather than the findings of a single study. This includes looking at how strong and consistent the evidence is across different types of research, whether an observed health effect can be linked to eating the food, and the amounts people are exposed to through their diet. The new study adds to the evidence that EFSA and other authorities can consider.
42 • KENNEDY’S CONFECTION • OCTOBER 2026
What
further research is needed to
establish whether dietary consumption of xylitol has a direct relationship with cardiovascular health? Nutrition research is complex and no single type of study can usually answer a question like this on its own. Confidence in a relationship grows when different types of well-designed studies point towards the same conclusion. For xylitol, a next step could be a large,
long-term study that directly measures how much xylitol people eat and follow them over time to see whether higher intakes are consistently associated with cardiovascular outcomes such as heart attacks and strokes. Controlled human studies can complement this by testing what happens in the body when people eat different amounts of xylitol. The 2024 research, for example, provided some evidence that eating xylitol can temporarily affect platelet activity and blood clotting. Ultimately, the strength of evidence that
dietary xylitol affects cardiovascular health would be stronger if multiple large and long-term studies consistently found an association, controlled studies supported the findings and there was convincing evidence of a biological mechanism linking habitual xylitol consumption to cardiovascular disease. Ideally, findings should also be replicated in different populations before firm conclusions are drawn.
How does the emerging evidence around xylitol fit into the wider scientific debate around sugar reduction and the use of alternative sweeteners in confectionery? EFSA advises that in the context of a healthy and balanced diet, added and free sugar intake should be as low as possible. The World Health Organization advise limiting free sugars to no more than 10% and ideally less than 5% of a person’s daily energy intake. Sweeteners may play a role in reducing sugar intake in the diet without having to sacrifice the pleasure of eating sweet foods. However, replacing sugar with another
sweetener introduces a separate question: what are the health effects of the replacement itself? Different sweeteners have different chemical properties, are processed differently by the body and have different evidence on their potential health effects. When looking at reducing sugar in our
diets, it’s important to consider both sides: the potential benefits of reducing sugar and the evidence on whatever replaces it. Replacing sugar with xylitol, for example, can reduce the amount of sugar in a product and xylitol has established benefits for dental health. At the same time, emerging research on possible cardiovascular effects needs to be investigated further. These different effects need to be considered as part of the overall evidence rather than assuming that replacing sugar is automatically beneficial or harmful.
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