Xylitol

Added sugar is one of the unhealthiest ingredients in foods in the modern diet. For this reason, sugar-free sweeteners such as xylitol are becoming increasingly popular. Xylitol strongly resembles household sugar in appearance and taste, but provides significantly fewer calories and does not raise blood sugar levels. In fact, several studies suggest that xylitol may provide a whole host of health benefits including better dental health. This article will take a closer look at xylitol and its health benefits.

What is xylitol?

Xylitol is a carbohydrate found in birch and several types of fruit. It has a chemical structure that looks like a cross between sugar and alcohol, but xylitol is neither. Xylitol is categorized as a so-called sugar alcohol. Xylitol is a widely used ingredient in sugar-free chewing gum, candies, diabetic foods and oral hygiene products. The use of xylitol to prevent middle ear infections has been tested in children with regular earaches. One way in which xylitol may help is by inhibiting a growth of bacteria.

However, further research is needed to confirm the effectiveness of xylitol in these and other applications. Xylitol is similarly sweet to regular sugar, but provides 40% fewer calories:

• Table sugar: 4 kcal per gram
• Xylitol: 2.4 kcal per gram

Pure xylitol is a white, crystalline powder. Since xylitol is a refined sweetener, it contains no vitamins, minerals or protein. In this sense, xylitol also provides only empty calories. Even though sugar alcohols are technically carbohydrates, most of them do not raise blood sugar levels and thus do not count as "net carbohydrates," making them a suitable product for a low carb diet (2). Even though the word alcohol is part of the name of this nutrient group, this is not the same alcohol that gets you drunk. For this reason, sugar alcohols are safe and harmless even for former alcoholics.

Summary: Xylitol is a sugar alcohol that occurs naturally in some plants. Even though xylitol looks and tastes like sugar, this sweetener provides 40% fewer calories. Xylitol has a very low glycemic index and does not increase blood sugar levels, nor insulin levels.

Xylitol and the blood sugar

One of the negative side effects of added sugar is that it can increase blood glucose and insulin levels. In addition to this, due to its high fructose content, sugar can lead to insulin resistance and numerous metabolic problems if consumed in excessive amounts (3, 4). Xylitol, on the other hand, contains no fructose and has negligible effects on blood glucose and insulin (2, 5). For this reason, none of the harmful effects of sugar are transferable to xylitol. The glycemic index of xylitol-a measure of how quickly a food raises blood sugar-is only 7, while regular sugar has a glycemic index of 60 to 70 (6).

Xylitol can also be called a sweetener suitable for weight loss, as it contains 40% fewer calories than regular sugar. For people suffering from diabetes, metabolic syndrome, prediabetes or obesity, xylitol is an excellent alternative for sugar. Although no corresponding human studies are available at this time, studies conducted with rats show that xylitol can alleviate the symptoms of diabetes, reduce abdominal fat, and reduce weight gain (7, 8, 9). Summary: Unlike sugar, xylitol has negligible effects on blood glucose and insulin levels. Studies conducted with animals indicate impressive benefits for metabolic health.

Xylitol promotes dental health

Many dentists recommend the use of xylitol-sweetened chewing gums - and for good reason. Studies have shown that xylitol promotes dental health and can prevent tooth decay (10). One of the leading risk factors for tooth decay is an oral bacterium called Streptococcus mutans. This is the bacterium responsible for causing plaque. Although some plaque on the teeth is normal, excessive plaque formation stimulates the immune system to attack the bacteria found in plaque. This can lead to inflammatory diseases of the gums.

These oral bacteria feed on glucose from food, but they cannot metabolize xylitol. Thus, replacing sugar with xylitol reduces the available food for these harmful bacteria (11). Even though these bacteria cannot use xylitol as food, they still digest it. And after ingesting xylitol, they are no longer able to absorb glucose, which means their energy-producing pathway is blocked, so these bacteria die.

In other words, when you chew xylitol-sweetened gum or use xylitol as a sweetener, the harmful bacteria in your mouth starve (12). In one study, xylitol-sweetened chewing gum reduced the levels of harmful bacteria by 27 to 75%, while the levels of healthy bacteria remained the same (13). Research conducted with animals also suggests that xylitol may increase the absorption of calcium in the digestive system, which could protect against osteoporosis and strengthen your teeth (14, 15).

Human studies show that xylitol-when used either as a substitute for sugar or even as a dietary supplement-can reduce tooth decay by 30 to 85% (16, 17, 18). Since inflammation is at the root of many chronic diseases, reducing plaque and inflammation of the gums could also benefit the rest of the body. Summary: Xylitol can starve harmful bacteria in your mouth and prevent both plaque formation and tooth decay. This can protect against tooth decay and gum inflammation.

Xylitol reduces infections of the ears and yeast infections

Your mouth, nose and ears are all connected. For this reason, bacteria that live in your mouth can also cause ear infections, which is a common problem in children. As it turns out, xylitol can starve these bacteria in the same way it starves the bacteria that cause plaque (19). In a study of children who suffered from recurrent ear infections, it was observed that the daily use of xylitol-sweetened chewing gum was able to reduce the rate of ear infections by 40% (20). Xylitol also fights the yeast species Candida albicans, which can lead to yeast infections. Xylitol reduces the ability of this yeast species to attach to surfaces, which may help prevent infections (21).

Summary: Chewing gum sweetened with xylitol can help reduce ear infections in children and fight yeast infections.

Other potential health benefits of xylitol include

Collagen is the most abundant protein in the human body and is found in large quantities in skin and connective tissue. Some studies conducted with rats have linked xylitol to increased collagen production, which may help counteract skin aging (22, 23).

Xylitol may also help protect against osteoporosis, as it can lead to increased bone volume and bone mineral content in rats (14, 24). It should be kept in mind that further human studies are needed to confirm these benefits in humans. Xylitol also serves as a nutrient for healthy intestinal bacteria, which may promote digestive health (25).

Summary: Xylitol increases collagen production and may reduce the risk of osteoporosis. It also serves as a nutrient for healthy gut bacteria.

Xylitol is not suitable for dogs

In humans, xylitol is absorbed slowly and has no measurable effect on insulin secretion. However, this is not true for dogs. When dogs eat xylitol, their bodies mistake xylitol for glucose and begin to release large amounts of insulin. As a result, the animal's cells begin to absorb glucose from the bloodstream, which can lead to hypoglycemia and even death (26). In addition, xylitol has devastating effects on canine liver function and can lead to liver failure at higher doses (27).

It only takes 0.1 grams of xylitol per kilogram of body weight to harm a dog, which means that a 3-kilo Chihuahua can get sick from just 0.3 grams of xylitol - that's less than the amount contained in a single piece of xylitol-sweetened gum. Therefore, if you are a dog owner, you should store xylitol-containing foods carefully or not have them in the house in the first place. If you suspect that your dog has accidentally eaten xylitol, you should consult a veterinarian immediately.

Summary: Xylitol is highly toxic to dogs and causes hypoglycemia and liver failure.

Dosage and side effects

Xylitol is generally well tolerated, but consumption of larger amounts of xylitol in the range of 30 to 40 grams can cause diarrhea and flatulence. This is due to the fact that sugar alcohols can draw water into the intestine or be fermented by intestinal bacteria (28). Gradually increasing the amount consumed may help minimize these side effects.

Long-term consumption of xylitol appears to be completely safe and harmless. In one study, subjects consumed 1.5 kilograms of xylitol per month - with a maximum daily intake of over 400 grams - without any negative effects being observed (29). People use sugar alcohols to sweeten coffee, tea, and various dishes. You can replace sugar with xylitol in a 1:1 ratio.

If you suffer from IBS or can't tolerate FODMAPs, then you should be careful with sugar alcohols and consider avoiding them. Summary: Xylitol in high doses can cause digestive problems in some people, while others can tolerate even large amounts without problems.

Risks

Xylitol is generally considered safe and harmless when consumed in the amounts used in foods. There is insufficient information to confirm the safety of xylitol in pregnant and lactating women, so pregnant and lactating women should avoid xylitol in medical doses.

There are concerns that consumption of high amounts of xylitol over a prolonged period of time may promote tumor growth. These concerns stem from observations in animal studies. However, further research is needed to either address or confirm these concerns.

Conclusion

As a sweetener, xylitol is an excellent choice. While other sweeteners carry health risks, studies have shown that xylitol actually has health benefits. Xylitol does not raise blood sugar or insulin levels, kills plaque-producing bacteria in the mouth, and serves as a nutrient for healthy gut bacteria. If you're looking for a healthier alternative to sugar, you should try xylitol.

References

1. https://www.ncbi.nlm.nih.gov/pubmed/24128404
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3286380/
3. https://www.ncbi.nlm.nih.gov/pubmed/22933433/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3677638
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1178408/
6. http://www.glycemicindex.com/foodSearch.php
7. https://www.ncbi.nlm.nih.gov/pubmed/22832597
8. https://www.ncbi.nlm.nih.gov/pubmed/21765599
9. https://www.ncbi.nlm.nih.gov/pubmed/21434778
10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5320817
11. https://www.ncbi.nlm.nih.gov/pubmed/21508
12. https://www.ncbi.nlm.nih.gov/pubmed/19717413
13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3434645/
14. https://www.ncbi.nlm.nih.gov/pubmed/11721142
15. https://www.ncbi.nlm.nih.gov/pubmed/12778091
16. https://www.ncbi.nlm.nih.gov/pubmed/1067728
17. https://www.ncbi.nlm.nih.gov/pubmed/21576989
18. https://www.ncbi.nlm.nih.gov/pubmed/10890712
19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC90255/
20. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2352484/
21. https://www.ncbi.nlm.nih.gov/pubmed/10946407
22. https://www.ncbi.nlm.nih.gov/pubmed/15832042
23. https://www.ncbi.nlm.nih.gov/pubmed/10983872
24. https://www.ncbi.nlm.nih.gov/pubmed/9591750
25. https://www.ncbi.nlm.nih.gov/pubmed/4076932
26. https://www.ncbi.nlm.nih.gov/pubmed/22381181
27. https://www.ncbi.nlm.nih.gov/pubmed/20473849
28. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5093271/
29. https://www.ncbi.nlm.nih.gov/pubmed/783060