近年來“三高”人群和“糖人”越來越多，以至于有的人“談糖色變”，把愛喝的可樂都換成了無糖可樂。但是木糖醇等人造甜味劑真的比糖更健康嗎？新研究發現，大量攝入木糖醇可能會增加血栓，引發心臟病和中風，而且可能在代謝系統中產生反作用，從而讓減肥更困難。

A low-calorie sweetener called xylitol used in many reduced-sugar foods and consumer 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 sweetener, a new study found.
一項新研究發現，木糖醇攝入量最大的人群心臟病發作、中風和死亡的風險比其他人群高出近兩倍，而木糖醇可能就是幕后元兇。木糖醇是一種被用于口香糖和牙膏等許多低糖食品和消費品中的低熱量甜味劑。

Lab and animal research revealed low-calorie sweeteners such as erythritol and 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.
實驗室和動物研究顯示，像赤蘚糖醇和木糖醇這樣的低熱量甜味劑可能會導致血小板更容易凝結成血塊。凝結的血塊（血栓）可能會脫落并沿著血流進入心臟，引發心臟病發作，或者進入大腦，引發中風。

Some 61% of American adults will have cardiovascular disease by 2050, according to a recent prediction by the American Heart Association. Reducing clotting activity is a key treatment used by cardiologists, so any additional clotting in platelets is a bad sign, said Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver.
根據美國心臟協會最近的預測，到2050年，約有61%的美國成年人將患有心血管疾病。位于丹佛市的美國國立猶太健康中心心血管預防與健康部主任安德魯·弗里曼博士說，減少血栓是心臟病學家使用的一個關鍵療法，因此血小板中增加的任何血栓都是一個不好的信號。

"When someone has a heart attack, we give them aspirin or drugs like clopidogrel, or Plavix, to counter platelet activity. These sugar alcohols appear to be enhancing platelet activity, which is concerning,” said Freeman, who was not associated with the new research.
弗里曼說："當某人心臟病發作時，我們給患者服用阿司匹林或類似氯吡格雷或波立維的藥物來對抗血小板活動。這些糖醇似乎在增強血小板活動，令人擔憂。"弗里曼并未參與這項新研究。

"This is another warning we ought to switch to water, with a close second being unsweetened tea or coffee,” he said.
他說："這又是在警告我們應該改為喝水，其次是不加糖的茶或咖啡。”

As sweet as sugar with less than half the calories, xylitol is 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.
木糖醇和糖一樣甜，但熱量不到糖的一半，常被用于無糖口香糖、薄荷糖、牙膏、漱口水、咳嗽糖漿和維生素咀嚼片。木糖醇經常以更大的劑量被添加到糖果、烘焙食品、蛋糕混合粉、燒烤醬、番茄醬、花生醬、布丁、煎餅糖漿等產品中。

Xylitol is a sugar alcohol, a carbohydrate found naturally in foods such as cauliflower, eggplant, lettuce, mushrooms, spinach, plums, raspberries and strawberries. However, the amount of xylitol found in such natural sources is tiny, Hazen said.
木糖醇是一種糖醇，是一種在花椰菜、茄子、生菜、蘑菇、菠菜、李子、覆盆子和草莓等食物中天然存在的碳水化合物。然而，哈森指出，這些天然來源的木糖醇含量極低。

"If you actually do the calculation, it literally takes a tonnage of fruit to be equivalent to one diabetic cookie that can have like nine grams of xylitol, which is a typical label amount,” he said.
他說："如果你真的去算一算，實際上需要成噸的水果才能提取出一塊糖尿病患者專用餅干中所含的木糖醇，一般標注為9克。"

For commercial use, however, xylitol is made from corncobs, birch trees or genetically engineered bacteria.
然而，用于商業化生產的木糖醇是從玉米芯、樺樹或基因工程菌中提取的。

"It’s sold as a so-called natural sweetener, and because xylitol doesn’t spike blood sugar levels, it’s also marketed as low carb and keto friendly,” said senior study author Dr. Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute.
該研究的資深作者、克利夫蘭診所勒納研究所心血管疾病診斷與預防中心主任斯坦利·哈森博士說："它在出售時號稱天然甜味劑，而且因為木糖醇不會導致血糖水平飆升，它也被作為低碳水化合物和生酮友好產品進行營銷。"

Many professional associations also recommend xylitol as a sugar substitute for patients with obesity, diabetes or prediabetes to improve glycemic control, he added.
哈森補充道，許多專業協會還推薦木糖醇作為肥胖、糖尿病或糖尿病前期患者的糖替代品，以更好地控制血糖。

"Yet people at risk for diabetes are among the most vulnerable for clotting events,” he said. “We’re targeting the wrong people.”
哈森說："然而，有糖尿病風險的人是最容易發生血栓的。我們將木糖醇推薦給了錯誤的人群。"

Exposure has increased over the last two decades, Hazen said, because the US Food and Drug Administration recognizes sugar alcohols as GRAS, or “generally recognized as safe.”
哈森說，過去二十年來人們對木糖醇的攝入量有所增加，因為美國食品藥品監督管理局認為糖醇是GRAS，即"普遍被認為安全"。

"Xylitol is cheaper to make than cane sugar and so more and more keeps getting incorporated as a sugar substitute into food,” he said.
他說："木糖醇比蔗糖便宜，因此越來越多的木糖醇被作為糖替代品添加進食品中。"

Research has shown some artificial sweeteners may create a backlash in the metabolic system, triggering the body to expect more calories, thus making weight loss more difficult.
研究表明，一些人造甜味劑可能會在代謝系統中產生反作用，讓身體渴望攝入更多的卡路里，從而使減肥更加困難。

The study, published Thursday in the European Heart Journal, began as a way of finding unknown chemicals or compounds in a person’s blood that might predict the risk for a heart attack, stroke or death within the next three years.
這項研究發表在上周四（6月6日）的《歐洲心臟雜志》上，起初是為了尋找可能預測未來三年內心臟病發作、中風或死亡風險的未知化學物質或化合物。

To do so, Hazen and his team analyzed 1,157 blood samples from people who were undergoing assessment for heart disease that had been collected between 2004 and 2011. They also examined another batch of blood samples from more than 2,100 people who may also have had high risk for heart disease.
為此，哈森和他的團隊分析了2004年至2011年間收集的1157份正在接受心臟病評估的人的血液樣本。他們還檢查了另一批來自2100多人的血液樣本，這些人患心臟病的風險也較高。

They found a number of alcohol sugars that appeared to have an impact on cardiovascular function, including xylitol and erythritol. Erythritol is the predominant ingredient by weight in many stevia and monkfruit products.
他們發現一些糖醇似乎對心血管功能有影響，包括木糖醇和赤蘚糖醇。赤蘚糖醇是許多甜菊和羅漢果產品中按重量計算的主要成分。

The February 2023 erythritol in study found the risk of heart attack and stroke nearly doubled within three years when people had the highest levels of erythritol in their blood.
2023年2月對赤蘚糖醇的研究發現，當人們血液中赤蘚糖醇水平最高時，三年內心臟病發作和中風的風險幾乎翻了一番。

For the new study on xylitol, the results were basically the same — people with the highest levels of xylitol compared to those with the lowest levels had nearly twice the risk of heart attack, stroke and death, Hazen said.
哈森說，對于新的木糖醇研究，結果基本上是一樣的——與木糖醇水平最低的人相比，血液中木糖醇水平最高的人心臟病發作、中風和死亡的風險幾乎是其兩倍。

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 said.
研究稱，世界衛生組織在2023年警告消費者避免使用人造甜味劑來減肥，并呼吁進一步對低熱量和無熱量甜味劑的長期毒性進行研究。

"Through their work, the investigators have shined a light on the safety of sugar substitutes. There is more to learn,” Mount Sinai’s Tomey said. “In the meantime, it is worth remembering that sugar substitutes are no substitute for a sincere commitment to the several elements of a healthy diet and lifestyle.”
西奈山醫院的托米表示："通過他們的工作，研究人員揭示了糖替代品的安全性問題。還有更多需要學習的東西。與此同時，值得記住的是，糖替代品不能替代健康的飲食和生活方式。”

英文來源：美國有線電視新聞網

翻譯&編輯：丹妮

審校：齊磊、高琳琳