Xylitol

Added sugar is one of the most unhealthy ingredients in foods in the modern diet. For this reason, sugar-free sweeteners such as xylitol are becoming increasingly popular. Xylitol is very similar in appearance and taste to household sugar, but provides significantly fewer calories and does not raise blood sugar levels. Several studies even suggest that xylitol can provide a whole range 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 could help is by inhibiting the growth of bacteria.

However, further research is needed to confirm the effectiveness of xylitol in these and other applications. Xylitol is similar in sweetness 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. As 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 therefore 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 or insulin levels.

Xylitol and blood sugar

One of the negative side effects of added sugar is that it can increase blood sugar and insulin levels. In addition, 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 sugar and insulin (2, 5). For this reason, none of the harmful effects of sugar can be transferred to xylitol. The glycemic index of xylitol - a measure of how quickly a food raises blood sugar - is only 7, whereas regular sugar has a glycemic index of 60 to 70 (6).

Xylitol can also be considered a weight loss sweetener as it contains 40% fewer calories than regular sugar. For people suffering from diabetes, metabolic syndrome, prediabetes or obesity, xylitol is an excellent alternative to sugar. Although no human studies are currently available, research conducted in rats shows 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 gum - 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 in the plaque. This can lead to inflammatory diseases of the gums.

These oral bacteria feed on glucose from food, but they cannot metabolize xylitol. Therefore, 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 that their energy-producing pathway is blocked, causing these bacteria to die off.

In other words, the harmful bacteria in your mouth starve to death when you chew xylitol-sweetened gum or use xylitol as a sweetener (12). In one study, chewing gum sweetened with xylitol reduced the levels of harmful bacteria by 27 to 75%, while the levels of healthy bacteria remained the same (13). Animal studies also suggest 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 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 be beneficial for the rest of the body. Summary: Xylitol can starve the harmful bacteria in your mouth and prevent both the formation of plaque and tooth decay. This can protect against tooth decay and gingivitis.

Xylitol reduces ear infections and yeast infections

Your mouth, nose and ears are all connected. For this reason, bacteria living 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 as the bacteria that cause plaque (19). In a study of children suffering from recurrent ear infections, it was observed that daily use of xylitol-sweetened chewing gum reduced the rate of ear infections by 40% (20). Xylitol also fights the yeast Candida albicans, which can lead to yeast infections. Xylitol reduces the ability of this type of yeast to attach to surfaces, which can help prevent infections (21).

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

Other potential health benefits of xylitol

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 prevent skin aging (22, 23).

Xylitol may also help protect against osteoporosis, as it can lead to increased bone volume and higher 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 gut bacteria, which could 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 does not apply to dogs. When dogs eat xylitol, their bodies confuse xylitol with 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 liver function in dogs 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 kilogram Chihuahua can become sick from just 0.3 grams of xylitol - less than the amount contained in a single piece of xylitol-sweetened chewing gum. If you are a dog owner, you should therefore store food containing xylitol carefully or not have it in the house in the first place. If you suspect that your dog has accidentally eaten xylitol, you should consult a vet immediately.

Summary: Xylitol is highly toxic to dogs and leads to 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 lead to 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 can help to minimize these side effects.

Long-term consumption of xylitol appears to be completely safe and harmless. In one study, subjects consumed 1.5 kilos of xylitol per month - with a maximum daily intake of over 400 grams - with no adverse effects 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 irritable bowel syndrome or cannot tolerate FODMAPs, 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 large amounts without any problems.

Risks

Xylitol is generally considered safe and harmless when consumed in the amounts used in food. There is not enough information to confirm the safety of xylitol in pregnant and breastfeeding women, so pregnant and breastfeeding women should avoid xylitol in medicinal doses.

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

Conclusion

As a sweetener, xylitol is an excellent choice. While other sweeteners pose 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, give xylitol a try.