That innocent stick of gum or dollop of jam might be doing more than sweetening your day - it could be rolling out the red carpet for cardiovascular catastrophe. A new study presented at the European Society of Cardiology (ESC) annual congress in Munich has found that xylitol, a sugar alcohol used in chewing gum, toothpaste, jam, yoghurts, and ice cream, is associated with an increased risk of strokes, heart attacks, and death.

Xylitol occurs naturally in some foods in tiny amounts, but manufacturers add it in quantities up to 1,000 times higher to artificially sweeten products. Despite its growing popularity, its long-term health effects have remained largely unexamined - until now.

In the largest study of its kind, researchers looked at 17,710 people and compared the 25% with the highest blood levels of xylitol to the 25% with the lowest. The high-level group was 57% more likely to die or suffer a heart attack or stroke within six years. Even after 30 years, they were still 18% more likely to have experienced a major cardiac event. The data also suggested a dose-dependent relationship: the more xylitol in your blood, the higher your risk of cardiovascular events, regardless of age, sex, or other factors like body mass index, hypertension, diabetes, and lipid levels.

Dr Marco Witkowski from the Charité university hospital in Berlin, the study's lead author, noted that previous research had already raised red flags: "In previous studies, we showed that xylitol can enhance the ability of platelets to form clots." He added that artificial sweeteners are consumed by people who believe they're healthier than sugar and are deemed safe by regulatory agencies. "Our long-term findings highlight how little we know about the cardiovascular safety of xylitol," he said, calling for further studies, especially as xylitol use continues to climb.

Prof Dan Atar, an ESC communication committee member not involved in the research, acknowledged that while observational studies can't prove causation, "this work shows that further studies are mandated into this societally important topic."

Dell Stanford, a senior dietitian at the British Heart Foundation, warned that people may consume more sweeteners than they realize, assuming they're the healthier choice. "This study adds to growing evidence that artificial sweeteners could have an impact on our health," she said, while cautioning that it's not a green light to switch to sugar: "We still need to reduce our free sugar intake." Her advice? Cut back on processed foods and drinks, and focus on a balanced diet to protect our hearts.

So, next time you reach for that sugar-free gum, just remember: your heart might prefer you chew on a stick of celery instead.