Not just gut flora. High levels of circulating xylitol (and erythritol for that matter) have been shown in both mouse models and humans to be associated with increased platelet reactivity and elevated 3-year risk of major cardiovascular events.
But we're talking significant levels of xylitol/erythritol, such as from keto-friendly ice cream and drinks, not the modest levels from chewing gum, and the dental benefits are well established.
