Xylitol is a sugar alcohol, which is a type of carbohydrate and does not actually contain alcohol. Xylitol occurs naturally in small amounts in fibrous fruits and vegetables, trees, corncobs, and even the human body.
Manufacturers use xylitol as a sugar substitute because its sweetness is comparable with that of table sugar but with fewer calories.
Xylitol is a common ingredient in many products, from sugar-free chewing gum to toothpaste. People also use xylitol as a table-top sweetener and in baking.
In this article, we look at the uses and potential health benefits of xylitol. We also cover its side effects, drug interactions, dosage, and alternatives.
Xylitol is a low-calorie alternative to sugar.
Xylitol has a similar level of sweetness to sugar but with a fraction of the calories. It is a popular ingredient in a variety of products, including sugar-free gum and toothpaste.
Manufacturers add xylitol to a range of foods, including:
- sugar-free candies, such as gum, mints, and gummies
- jams and jellies
- nut butters, including peanut butter
Xylitol is also an ingredient in some dental care products, including:
- other fluoride products
Xylitol sweeteners are available to purchase online.
Xylitol has several potential health benefits, including:
Low glycemic index
Xylitol has a low glycemic index (GI). This means that consuming it does not cause spikes in blood glucose or insulin levels in the body. For this reason, xylitol is a good sugar substitute for people with diabetes.
Due to its low GI, xylitol is also a weight loss-friendly sugar substitute.
Also, a 2015 study revealed that xylitol had significant blood glucose-lowering effects in rats that ate high-fat diets.
Xylitol is an ingredient in many dental hygiene products, including toothpaste and mouthwash. This is due to the fact that xylitol is non-fermentable, which means that the bacteria in the mouth cannot convert it into the harmful acid that causes tooth decay.
The oral bacterium Streptococcus mutans is largely responsible for plaque, which is the sticky, white substance that can accumulate on the outside of a person’s teeth.
Plaque binds lactic acid against the surface of the tooth. This acid breaks down the enamel and leads to tooth decay.
While it is normal for people to have some plaque on their teeth, excess amounts can lead to tooth decay, cavities, and gum disease.
A 2017 systematic review suggests that xylitol reduces the amount of S. mutans bacteria in the mouth, which reduces the amount of plaque and may help prevent tooth decay.
A 2014 study examined the effects of xylitol on Porphyromonas gingivalis, which is the bacterium responsible for gingivitis, or gum disease. If left untreated, excess amounts of P. gingivalis can move into the bloodstream and lead to systemic inflammation.
In the study, scientists grew samples of P. gingivalis in a laboratory and added them to human cell cultures pretreated with xylitol. They saw that xylitol increased the production of immune system proteins and inhibited the growth of the bacteria.
Xylitol may help prevent ear infections.
The bacteria that cause tooth plaque can also accumulate behind the eardrum and cause infections of the middle ear. Doctors call these infections acute otitis media (AOM).
A 2016 systematic review found moderate-quality evidence that chewing gum, lozenges, or syrup containing xylitol can reduce the occurrence of AOM from 30 to 22 percent among healthy children.
However, a 2014 study found xylitol syrup to be ineffective in reducing AOM in children at high risk of the infection.
These conflicting results indicate the need for more research regarding the use of xylitol as a preventive treatment for ear infections in children.
According to the National Center for Complementary and Integrative Health, free radicals cause oxidative stress, which can lead to cell damage and may play a role in the development of several conditions, including diabetes, cardiovascular disease, and cancer. Laboratory studies show that antioxidants neutralize free radicals and counteract oxidative stress.
A 2014 study revealed that xylitol may have antioxidant properties. Diabetic rats who ate xylitol produced higher amounts of glutathione. This is an antioxidant that counteracts the harmful effects of free radicals. It is important to note that human studies are needed to validate these findings.
Side effects and safety
The United States Food and Drug Administration (FDA) have approved xylitol as a food additive. Xylitol is generally safe, but like other sugar alcohols, it can cause digestive issues such as bloating and diarrhea in some people.
It is worth noting that xylitol can be very toxic to dogs. It is vital to store products containing xylitol in a safe place that pets cannot reach. Anyone who thinks that their dog has consumed xylitol should call their veterinarian or the Animal Poison Control Center immediately.
Currently, xylitol has no known interactions with prescription or over-the-counter medications. Always consult a doctor about potential interactions when starting new medications or supplements, however.
The suitable dosage of xylitol can vary from person to person. A 2016 review found that adults can safely tolerate between 10 grams (g) and 30 g of xylitol per day, which they usually divide into several smaller doses. After the body adapts to xylitol, adults can consume up to 70 g per day without side effects.
Studies in children have used doses of up to 45 g of xylitol daily. Some research suggests that consuming around 5–6 g of xylitol per day may help reduce plaque-causing bacteria in the mouth.
However, the American Academy of Pediatric Dentistry say that more research is necessary before recommending xylitol to improve dental health in children.
Alternatives to xylitol
Agave nectar is an alternative sweetener to xylitol.
Manufacturers use a range of low-calorie artificial sweeteners and sugar substitutes to sweeten foods and beverages. Many of these substitutes are also available as table-top sweeteners, and some people use them in baking.
Some substitutes are significantly sweeter than table sugar. However, the sweetness of xylitol is very similar to that of table sugar.
Other artificial sweeteners and sugar substitutes include:
Sorbitol is a sugar alcohol with a similar molecular structure to xylitol. Sorbitol does not spike blood glucose levels, so it is a good sugar substitute for people who have diabetes.
Like xylitol, bacteria cannot break down sorbitol into the acids that cause tooth decay.
Erythritol is another sugar alcohol. Similarly to xylitol, erythritol also inhibits the growth of S. mutans.
A 2016 review found that high concentrations of erythritol are more effective at reducing oral plaque than both xylitol and sorbitol. However, xylitol is more effective than erythritol at lower concentrations.
A range of erythritol sweeteners is available to purchase online.
Stevia is natural sweetener that manufacturers extract from the stevia plant. Stevia extract is available in granular and liquid forms. Purified leaf extract is 250–300 times sweeter than sugar.
Like xylitol, stevia can sometimes cause diarrhea and other digestive issues.
Stevia extract sweetening products are available to purchase online.
Agave nectar is a syrup that manufacturers extract from the agave plant and use as a sugar substitute in some drinks and foods.
However, agave nectar mainly contains fructose, which bacteria in the mouth can break down into the acids that cause tooth decay.
Many agave nectar products are available to purchase online.
Xylitol is a reduced-calorie sugar substitute similar in sweetness to table sugar. Xylitol also has a low GI, which makes it an attractive alternative to sugar for people wishing to lose weight and those with diabetes.
Some research also suggests that xylitol has antibacterial properties that can help prevent tooth decay, gum disease, and ear infections. However, further research into the potential health benefits of xylitol is needed.