By Allen Studzinski, NOW Quality Assurance, May 12, 2005 Sounds almost too good to be true: a natural sweetener that is as sweet as sugar, has 40% less calories, may prevent dental carries, support bone health, aid in weight management, joint health, muscle building, and be suitable for diabetics? Xylitol may just be that sweetener. Xylitol has been available since the 1960’s. First discovered in 1891, xylitol has garnered strong support in Finland where it is known as “koivusokeri” or “birch sugar” since it can be derived from the fiber of birch tree bark. Commercial xylitol is produced from xylose, which in turn is derived from corn. It is a type of carbohydrate classified as a sugar alcohol, as are sorbitol, maltitol, lactitol, and mannitol. This classification describes their chemical structures rather than suggesting an intoxicating quality. Naturally found in many foods (such as plums, berries, fibrous vegetables, and mushrooms), 15 grams a day or more can be produced naturally in the body from other foods. Xylitol tastes like sugar but adds a cool “icy” taste sensation due to its unusual property of having a negative heat of dissolution: it actually cools the dissolving liquid. Snack foods made with xylitol taste great and are well accepted by adults and children alike. 1 Look Mom, No Cavities Studies using Xylitol demonstrate a consistent decrease in dental caries (cavities) ranging from 30 to 60 percent. The mechanism of dental caries formation is one of the more extensively studied and better-understood body processes. Multiple factors play key roles, particularly bacteria and dietary sugars. The bacteria present in the mouth, such as Streptococcus mutans, ferment sugars found in the foods we eat. The bacteria then excrete organic acids as waste products of their sugar metabolism, that lowers the pH of the mouth by increasing its acidity. Once the pH falls below 5.7 the minerals of the tooth may start to dissolve, or demineralize. As this process continues, the surface of the tooth becomes weak and may eventually collapse, forming a cavity. We need something that can inhibit these bacteria or limit their metabolism. Xylitol may be an answer. In the past, artificial sweeteners were the only choices for non-cariogenic foods since they are not metabolized in the same way as sugars. Studies show the natural sweetener xylitol is not fermented by cavity-forming bacteria. Xylitol inhibits their growth and therefore may actually decrease oral bacteria counts, contrasting with the known effects of white sugar 2,3! One fascinating study even suggests that mothers who habitually use xylitol give birth to children who may be less susceptible to cavities as they age4. An ideal delivery method is chewing xylitol gum. This proven and commercially available form has the additional benefit of increasing flow of saliva, which may provide for increased buffering of plaque acids and enhanced clearance of sugars from the mouth. Xylitol is finding its way into toothpaste as the preferred sweetener. Dieters and Diabetics Rejoice Low carb dieters are very interested in low glycemic foods. The glycemic index (GI) is a way of measuring how quickly a food raises blood sugar levels. The higher the glycemic index, the worse a food is for individuals with blood sugar irregularities. Those struggling with weight loss are particularly concerned, since high glycemic foods may be much more likely to be stored as fat. Glucose, which is blood sugar itself and found in corn syrup or as dextrose, is given a GI score of 100. A GI of 70 or more is considered high and includes white bread (70), Cornflakes (83) and most breakfast cereals, honey (72), and French Fries (75). Medium GI foods of 56 to 69 include table sugar (60), Coca Cola ® (63), pastas such as spaghetti (61) and most grains. A GI of 55 or less is considered low and includes milk (40) and most milk products, most fruits, soybeans (18), and most nuts such as peanuts (14). Xylitol has a super low glycemic index of 7! Its mostly insulin-independent metabolism makes it ideal for maintaining steady blood sugar and insulin levels. Xylitol is an ideal sweetener for dieters for other reasons, as well. A teaspoon of xylitol is just as sweet as the same amount of sugar, yet has 40% fewer calories! Studies also show that xylitol consumption can decrease total caloric intake by encouraging slower gastric emptying 5. A dieter’s appetite might be tastefully controlled. Strong Bones Aging tends to bring with it a variety of changes, including changes in nutrient absorption and metabolism. Vitamin D, for example, plays an important role in calcium absorption. But aging brings decreased intestinal receptors for Vitamin D, which eventually affects bone formation. Impaired bone formation can then lead to gradual bone thinning and osteoporosis. Studies show that continuous moderate dietary xylitol intake leads to increased bone volume and increased bone mineral content 6. Dietary xylitol increases bone calcium and phosphorus concentrations in animal studies, as well as protects against a decrease in bone minerals and bone density during osteoporosis. Xylitol increases calcium absorption and bioavailability independent of such factors as Vitamin D status. In fact, xylitol’s ability to chelate or complex with minerals may account for its ability to enhance the absorption of other minerals, such as iron and magnesium.7,8 A Bodybuilding-Anti-Aging Gourmet “Anabolic” is a term that athletes have learned to associate with often illegal, performance enhancing substances. But anabolism is a key bodily process of growth and healing. This building-up process contrasts with catabolism, which involves a breaking down process. Supporting anabolism is of concern not only to individuals involved in sports but also those experiencing the catabolic effects of stress, illness, or surgery. Nutritional tools such as protein and amino acid supplements, various vitamins, and herbs are the subject of great interest as to their potential for countering the wasting effects of catabolism. Xylitol has been shown in numerous studies to inhibit stress related catabolism, spare critical nitrogen, enhance post-operative protein synthesis, and prevent stress-induced weight loss.9,10,11 Collagen is a substance that has caught the attention of youth seekers and athletes alike. Hugely important, this protein comprises one third of the body’s protein and 75% of our skin. In addition to making up the membranes that support our organs, collagen builds bones, joints, cartilage, and constitutes the space or intracellular matrix between most of our cells. It holds water, shapes and helps to provide resiliency to the body, and literally holds our cells together. The wrinkles and degenerative diseases of aging are partly due to a failure to maintain collagen, and upon its strength and repair depends recovery from surgery, illness, and injury. Xylitol seems to be able to impact collagen metabolism. Interestingly, xylitol-induced improvements in antioxidant status may be what is at least partly responsible for it causing increased collagen synthesis or decreased collagen degradation.12 Nose & Ear Relief Ear infections (called Otitis Media) are a common childhood illness. Ear infections are caused when bacteria or viruses find their way into the middle ear, causing inflammation, pus, and fluid accumulation. The increased pressure results in pain and the inability of the ear drum to vibrate, or even temporary hearing loss. It is often preceded by an upper respiratory tract infection. The most common offender is the bacteria Streptococcus pneumoniae. Xylitol inhibits the growth of this offender and inhibits the attachment of bacteria to respiratory tract cells. Studies show that xylitol acts as a preventative and markedly reduces the need for antibiotics.13,14 A Xylitol nasal spray has become commercially available, motivated by these antibacterial properties. There is much more yet to be discovered about Xylitol, with researchers looking into its potential role in everything from intestinal healing to protection in life-threatening conditions, such as sepsis. In the mean time, Xylitol’s new found popularity, availability, and great taste may just re-ignite that sweet tooth in all of us. *These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease. References: 1 Community Dent Oral Epidemiol. 2000 Apr;28(2):97-101. Children's acceptance of xylitol-based foods. Lam M, Riedy CA, Coldwell SE, Milgrom P, Craig R. Department of Dental Public Health Sciences, University of Washington, Seattle 98195-7475, USA. 2 Caries Res. 2003 Nov-Dec;37(6):404-9 Xylitol inhibition of acid production and growth of mutans Streptococci in the presence of various dietary sugars under strictly anaerobic conditions.
Kakuta H, Iwami Y, Mayanagi H, Takahashi N.
Division of Pediatric Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan. 3 Nor Tannlaegeforen Tid. 1990 Mar;100(4):140-3. Xylitol, mechanisms of action and uses Waler SM, Rolla G.
Odontologiske Fakultet, Universitetet i Oslo. 4 Caries Res. 2001 May-Jun;35(3):173-7. Influence of maternal xylitol consumption on mother-child transmission of mutans streptococci: 6-year follow-up. Soderling E, Isokangas P, Pienihakkinen K, Tenovuo J, Alanen P. 5 Am J Clin Nutr. 1987 Apr;45(4):744-7. Effects of xylitol on gastric emptying and food intake. Shafer RB, Levine AS, Marlette JM, Morley JE. 6 Gerontology. 2001 Nov-Dec;47(6):300-5. Increased bone volume and bone mineral content in xylitol-fed aged rats. Mattila PT, Svanberg MJ, Knuuttila ML. Oral and Maxillofacial Department, Oulu University Hospital, Oulu, Finland. ptm@cc.oulu.fi 7 J Nutr. 1994 Jun;124(6):874-81. Bone repair in calcium-deficient rats: comparison of xylitol+calcium carbonate with calcium carbonate, calcium lactate and calcium citrate on the repletion of calcium. Hamalainen MM. Institute of Dentistry, University of Turku, Finland. 8 Miner Electrolyte Metab 1990;16(4):240. Relationship between mineral metabolism and peroral consumption of sugar alcohols. Hamalainen MM, Makinen KK. Institute of Dentistry, University of Turku, Finland. 9 Poult Sci. 2000 May;79(5):743-7. Effect of dietary concentration of xylitol on growth in male broiler chicks during immunological stress. Takahashi K, Mashiko T, Akiba Y. Department of Animal Science, Faculty of Agriculture, Tohoku University, Sendai-shi, Japan. taka@bios.tohoku.ac.jp 10 JPEN J Parenter Enteral Nutr. 1990 Mar-Apr;14(2):134-8. Effects of nonglucose substrates (xylitol, medium-chain triglycerides, long-chain triglycerides) and carnitine on nitrogen metabolism in stressed rats. Fried RC, Mullen JL, Blackburn GL, Buzby GP, Georgieff M, Stein TP.
Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia. 11 Z Ernahrungswiss. 1982 Mar;21(1):27-42. Advantage of xylitol compared to glucose as an energy source during early postoperative parenteral feeding Georgieff M, Ackermann RH, Bassler KH, Lutz H. 12 Life Sci. 2000 Jun 8;67(3):283-90. Effects of dietary xylitol on collagen content and glycosylation in healthy and diabetic rats. Knuuttila ML, Kuoksa TH, Svanberg MJ, Mattila PT, Karjalainen KM, Kolehmainen E. Oral and Maxillofacial Department, Oulu University Hospital, Finland. 13 Pediatrics. 1998 Oct;102(4 Pt 1):879-84. A novel use of xylitol sugar in preventing acute otitis media. Uhari M, Kontiokari T, Niemela M. Department of Pediatrics, University of Oulu, Oulu, Finland. 14 Vaccine. 2000 Dec 8;19 Suppl 1:S144-7. Xylitol in preventing acute otitis media. Uhari M, Tapiainen T, Kontiokari T. | 
