For the past 3 years I have very much tried to avoid all artificial sweeteners and as many chemical ingredients in food as possible, which included xylitol. Back in the day, I used to love protein bars, but avoided the ones with tons of sugar in them. What that means is that they simply had artificial sweeteners added. Many of these sweeteners are sugar alcohols, or polyols. These things always caused me a good deal of gas, and I am not alone in this symptom. So, mainly because of this symptom, I avoided all sugar alcohols in any amount, xylitol being one of them. However, xylitol was a topic in the first class for my Master of Holistic Nutrition course, and some interesting evidence for possible health benefits of xylitol were presented. Obviously this got me thinking and gave me a great topic to research for a blog post.
Xylitol and Oral Health
Some of you have probably noticed that there are many types of chewing gum that contain xylitol. This is not simply because it sweetens the taste of the the gum without adding calories, for those of you that worry about that kind of thing. It is actually based on scientific evidence that xylitol positively impacts dental health. Studies have shown that the use of xylitol reduces cavity development in both adults and children (1,2). It is suggested that the reason for this impact is that xylitol same how regulates bacteria and can possibly break up biofilm, or plaque (1,2). Interestingly though the referenced studies indicate that while there was a reduction in cavities with the use of xylitol, there was no change in plague. There was however, a change noted in the regulation and stability of oral bacteria.
Xylitol and Other Benefits
Strangely enough, for an alternative sweetener, xylitol has been shown to have some other health benefits aside from dental health. It has been shown to be an angiogenesis inhibitor (3), which is associated with cancer prevention/treatment; a specific type of anti-inflammatory (3); a treatment for chronic rhinitis (4); and a treatment and preventative measure for ear infections (5). That is quite the list1 Likely a lot of this has to do with the regulatory effective that xylitol seems to have on bacteria. Again all of this coming from an artificial sweetener…But wait, what is interesting is that xylitol is found naturally in a number of plants, so it can actually be classified as a natural sweetener. However, instead of extracting the naturally occurring xylitol from it’s plant sources, much of the xylitol used in food goes through a processing method as it is extracted from a form of hardwood in the form of xylose, and requires hydrogenation to produce xylitol. So, natural? Maybe?
Xylitol – Is It Safe?
Aside from the above noted potential benefits of xylitol, you might still be asking yourself if there are any risk or side effects associated with xylitol consumption? There are a number of studies indicating that there are little to no side effects from the consumption of xylitol at all (6). It is actually a very low glycemic index food and does not produce the insulin response and “sugar blues” effect that one can experience with sugar intake (7). This is exactly the reason xylitol is labelled as a safe sweetener for diabetics.
On the other side of the coin however, high levels of xylitol intake are strongly associated with gastrointestinal symptoms such as gas and bloating (5, 8). This may or may not be overly concerning as gas and bloating in and of themselves may not relate to anything other than discomfort. What is more concerning is that xylitol may actually have the capacity to alter the composition of the bacteria in our gut (i.e. those wonderful probiotics). At high doses, xylitol has been shown to cause a swing in gram-positive bacteria (good), to gram-negative bacteria (problematic) in both rats and humans (9). While these side effects are a bit concerning, the key point is that all of these side effects are after quite a large dose. We are talking about 10 or more pieces of gum in one study, and up to a 30 gram dose in another study.
Xylitol Final Thoughts
For the most part, it appears that xylitol is actually pretty safe and may benefit people who have dental, sinus issues, or metabolic issues. In the end, as long as we are keeping our intake of xylitol to a reasonable level, there will likely be no associated side effects. On a special note however, xylitol is a FODMAP, so people with a gastrointestinal disorders or anyone who is sensitive to FODMAPs, should experiment and see how they respond.
The Barefoot Golfer