What About Xylitol?

Xylitol - what is it really and how does it work?

Note: this is the best and most complete answer to the "what is xylitol" question, but if you have input, I would be glad to hear your thoughts to improve this article. It will be regularly updated as you give your input and as I learn more about xylitol.

This article had to be written. There is so much wrong information about xylitol, both good and bad. We just need some straight answers.

Why is xylitol so important?

There are some people writing negative articles about xylitol. In a way I understand, because it is made in a lab, but so are most vitamins. The important part is that it is something that exists in nature and not a synthetic chemical. Xylitol is in small amounts in many fruits and vegtables (up to 10%). And while I wish we had a way for commercially extracting it from these fruits, it's just not commercially viable... yet (come on creative food scientists!). But the reality is we NEED xylitol. We are in a health crisis of sugar consumption, eating 600-800% more sugar than our bodies can hadle and we NEED a solution. Yes, not eating anything sweet is the best, but it's not going to work for everyone. So, we have xylitol which is the most researched, best tasting, easiest to use, sugar alternative out there. Right now we simple need it. While not as deeply studied, nor as easy to use, we also recommend erythritol, stevia extract, and monk fruit. But xylitol is our favorite.

5 myths about xylitol

  1. Xylitol is less sweet than sugar. – Most sugar alcohols / polyols are less sweet than sugar. Xylitol actually has the same or even more sweetness, depending on the study or person you ask.
  2. Xylitol is as sweet as sugar. – Sometimes. The main study that is used for this “fact” is the sweetness of xylitol dissolved in water. Xylitol is actually up to 1.5 times sweeter than sugar when not dissolved in water. This is why we usually recommend using about 75% of the amount of sugar specified in a recipe, and since xylitol absorbs more water than sugar this usually works out quite well.
  3. Xylitol kills dogs. - 10% of the sugar in a plum is xylitol. That doesn't kill dogs. But yes, pure xylitol without sugar, can put a dog into a diabetic comma and in some cases kill a dog. Read more about this below.
  4. Xylitol contains nickel. - Nickel is used to convert the natural wood sugar xylose to xylitol. One of the reasons we always use birch xylitol produced in the EU/USA as we know that the absolute maximum amount of nickel allowed in the finished product is 1mg/kg, which is 1/4th of the nickel in cashews or 1/27th the nickel in chocolate.
  5. Xylitol is a processed / refined / chemical.

5 reasons I use xylitol

1. It’s my absolute favorite tasting sweetener that does not contain a form of sugar (glucose/fructose).
2. It is the easiest sugar alternative to bake with since it has similar weight and sweetness as table sugar, so you don't need to change the rest of the ingredients in the recipe.
3. It keeps my teeth healthy. Read more about the tooth health benefits of xylitol here.
4. Opposite to sugar, xylitol actually donates a hydrogen helping to rebuild NADH and glutathione. In simple terms, an antioxidant, and when combined with chocolate (see next point) just can’t be beat.
5. It makes really, really good chocolate. (This obviously being the most important reason.)

The truth about xylitol

You may have read a multitude of opinions on xylitol from it being the best sugar alternative, low-carb athletes' secret weapon and best friend to your teeth, to the opposite opinion of it being a dangerous chemical that kills dogs.

So what is xylitol, why does it have a weird name, and what is the truth of this debated powder?

Xylitol comes from the Greek 'xyl', which mean wood and then get's the 'itol' since it's an alcohol sugar like sorbitol and erythritol. So it's wood sugar. Not surprisingly a large portion of xylitol comes from birch and beech trees where it exists as xylitol and it's simple sugar form xylose. In nature xylitol is found not just in wood, but a large array of foods we already eat on a daily basis. 10% of the sugar in a plum is xylitol. So yah, it is natural.

Xylitol is an alcohol sugar. Most alcohol sugars are laxative if too much is eaten. This is true of xylitol. It is the second LEAST laxative, just behind erythritol. So if you have had bad experiences with sorbitol and maltitol, xylitol is not the same. Still, if you have a sensitive stomach or IBS,  proceed with caution or steer clear.

Can it kill dogs? Yes and no. It's not so much xylitol itself, but xylitol by itself. A plum (other than the pit) isn't dangerous to dogs and xylitol is 10% of the sweetness found in plums. The problem is that dogs have a strong insulin response to xylitol, which doesn't actually use insulin to be metabolized. Humans don't have an insulin response to xylitol. Good news for diabetics, not for dogs. If a dog gets pure xylitol, it will release a large amount of insulin, effectively putting the dog into a diabetic coma. So what should you do if your dog gets into your xylitol baked goods? There's quite a mix of advice out there, not much of it good. What seems most logical is to get glucose in as quickly as possible. Anything with carbohydrates, anything sugary. And then right to the vet to get the dog on a glucose drip and monitoring. If you remember, 10% of the sugar in a plum is xylitol, so it's not that xylitol itself is poisonous to dogs, but xylitol by itself and without sugar.

Studies on Xylitol

Right now there are well over 1500 studies on xylitol. We have a list of studies from 1971 to 2006, but will only list a few of the more interesting ones from 2000-2006. Most of these studies are on tooth health, bone health, ear infections or diabetes.

2006

Tolerability of oral xylitol solution in young children: Implications for otitis media prophylaxis. Vernacchio L, Vezina RM, Mitchell AA. Int J Pediatr Otorhinolaryngol. 2007 Jan;71(1):89-94. Epub 2006 Nov 9.

Preventing dental disease. Huston JP. J Calif Dent Assoc. 2006 Jul;34(7):491-2.

The effect of xylitol on Streptococcus mutans in children. Massoth D, Massoth G, Massoth IR, Laflamme L, Shi W, Hu C, Gu F. J Calif Dent Assoc. 2006 Mar;34(3):231-4.

Xylitol, sweeteners, and dental caries. Ly KA, Milgrom P, Rothen M. Pediatr Dent. 2006 Mar-Apr;28(2):154-63; discussion 192-8. Review.

Mutans streptococci dose response to xylitol chewing gum. Milgrom P, Ly KA, Roberts MC, Rothen M, Mueller G, Yamaguchi DK. J Dent Res. 2006 Feb;85(2):177-81.

Field trial on caries prevention with xylitol candies among disabled school students. Honkala E, Honkala S, Shyama M, Al-Mutawa SA. Caries Res. 2006;40(6):508-13.

2005

The effect of adding calcium lactate to xylitol chewing gum on remineralization of enamel lesions. Suda R, Suzuki T, Takiguchi R, Egawa K, Sano T, Hasegawa K. Caries Res. 2006;40(1):43-6.

Effect of xylitol-containing chewing gums on interdental plaque-pH in habitual xylitol consumers. Lif Holgerson P, Stecksen-Blicks C, Sjostrom I, Twetman S. Acta Odontol Scand. 2005 Aug;63(4):233-8.

The polyols in pediatric dentistry: advantages of xylitol. Grillaud M, Bandon D, Nancy J, Delbos Y, Vaysse F. Arch Pediatr. 2005 Jul;12(7):1180-6. Review. French.

Complementary and alternative medicine in allergy, otitis media, and asthma. Blazek-O'Neill B. Curr Allergy Asthma Rep. 2005 Jul;5(4):313-8. Review.

Evaluation of the independent and combined effects of xylitol and polydextrose consumed as a snack on hunger and energy intake over 10 d. King NA, Craig SA, Pepper T, Blundell JE. Br J Nutr. 2005 Jun;93(6):911-5.

Xylitol in the prevention of oral diseases. Kitchens DH. Spec Care Dentist. 2005 May-Jun;25(3):140-4. Review.

The effect of a simultaneous dietary administration of xylitol and ethanol on bone resorption. Mattila PT, Kangasmaa H, Knuuttila ML. Metabolism. 2005 Apr;54(4):548-51.

Effects of long-term dietary xylitol supplementation on collagen content and fluorescence of the skin in aged rats. Mattila PT, Pelkonen P, Knuuttila ML. Gerontology. 2005 May-Jun; 51(3): 166-9

2004

Functional Foods. Multifunctional sugar alternatives for improved health. Mitchell H. NutraCos. 2004; 3(1):22-26

Review of dietary recommendations for diabetes mellitus. Choudhary P. Diabetes research and clinical practise. 2004; 65(Suppl.): s9-s15

Army's "look for xylitol first" program. Richter P, Chaffin J. Dent Assist. 2004 Mar-Apr; 73(2): 38-40

Professional development. Good oral health contributes to good total health: the role of the diabetes educator. Jahn CA. Diabetes Educator. 2004 Sep-Oct; 30(5): 754, 757-60 (24 ref)

Xylitol. Kizaki Z, Sawada T. Nippon-Rinsho. 2004 Nov; 62 Suppl 11: 640-3

Functional foods. Multifunctional sugar alternatives for improved health. Mitchell H. NutraCos. 2004; 3(1): 22-26

Home study course: xylitol: magic in the making. Huber J. Journal of the California Dental Hygienists Association. 2004 Fall; 20(1): 29-34 (30 ref)

2003

Beneficial effects of dietary xylitol on mineralised and collagenous tissues. Mattila PT, Knuuttila MLE, Svanberg MJ. Current Topics in Nutraceutical Research. 2003; 1(4): 225-234

Synergisitc inhibitory effect of cationic peptides and antimicrobial agents on the growth of oral streptococci. Kim SS, Kim Sunkyu, Kim-Eunshin, Hyub-Byungkuk, Kim kackKyun, Lee-ByeongJae. Caries-Research. 2003; 37(6): 425-430

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. Caries Research. 2003; 37(6): 404-409

Health potential of polyols as sugar replacers, with emphasis on low glycaemic properties. Livesey G. Nutrition Research Reviews. 2003; 16(2): 163-191

Development of dietary supplement for the growth and exercise performance improvement. Yoo-SeungWon, Jung-EunHee, Yang-DongSik, Lee-HongSeok, Yoon-Yoosik. Korean Journal of Community Nutrition. 2003; 8(3): 349-355

Xylitol and caries prevention – is it a magic bullet? Maguire A, Rugg-Gunn AJ, British Dental Journal. 2003; 194(8): 429-436

The biochemistry of alternative medicine. Xylitol: a sweet for healthier teeth and more. Cronin JR. Alternative and Complementary Therapies. 2003 Jun; 9(3): 139-41 (28 ref)

Dental properties of xylitol prove superior to those of other polyols. Dental Abstracts. 2003 Nov-Dec; 48(6): 281

Beneficial effects of dietary xylitol on mineralized and collagenous tissues. Mattila PT, Knuuttila MLE, Svanberg MJ. Current Topics in Nutraceutical Research. 2003; 1(4): 225-234

Use of xylitol chewing gum in daycare centers: A follow-up study in Savonlinna, Finland. Kovari H, Pienihakkinen K, Alanen P. Acta Odontologica Scandinavica. 2003; 61(6): 367-370

Health potential of polyols as sugar replacers, with emphasis on low glycaemic properties. Livesey G. Nutrition Research Reviews. 2003; 16(2): 163-191

A pilot study on antiplaque effects of mastic chewing gum in the oral cavity. Takahashi K, Fukeazawa M, Motohira H, Ochiai K, Nishikawa H, Miyata T. Journal of Periodontology. 2003; 74(4): 501-505

Xylitol inhibition of anaerobic aicd production by Streptococcus mutans at various pH levels. Miyasawa H, Iwami Y, Mayanagi H, Takahashi N. Oral Microbiol Immunol. 2003 Aug; 18(4): 215-9

Xylitol and dental caries: an overview for clinicians. Lynch H, Milogram P. J. Calif. Dent. Assoc. 2003 Mar; 31(3): 205-9

Remineralization effects of xylitol on demineralised enamel. Miake Y, Saeki Y, Takahashi M, Yanagisawa T. J. Electron. Microsc. (Tokyo). 2003; 52(5): 471-6

2002

Improved bone biomechanical properties in xylitol-fed aged rats. Mattile PT, Svanberg MJ, Jamsa T, Knuuttila MLE. Metabolism, Clinical and Experimental. 2002; 51 (1): 92-96

Xylitol: A sweetener with benefits for human health. Ines-Mussatto S, Roberto-Conceeicao I. Brazilian Journal of Pharmaceutical Sciences. 2002; 38(4): 401-413

Sugar alcohols enhance calcium transport from rat small and large intestine epithelium in vitro. Mineo H, Hara H, Tomita F. Digestive Diseases and Sciences. 2002; 47(6): 1326-1333

Xylitol for caries prevention. Peldyak J, Makinen KK. Journal of Dental Hygiene. 2002 Fall; 76(4): 276-85 (76 ref)

In vitro testing of xylitol as an anticariogenic agent. Sahni PS, Gillespie MJ, Botto RW, Otsuka AS. General Dentistry. 2002 Jul-Aug; 50(4): 340-3 (20 ref)

How does xylitol prevent caries? Studies in children and adults. Dental Abstracts. 2002 Nov-Dec; 47(6): 251

Carbohydrate and satiety. Feinle C, O'Donovan D, Horowitz M. Nutrition Reviews. 2002 Jun; 60(6): 155-69 (134 ref)

Sugar alcohols and diabetes: a review. Wolver TMS, Piekarz A, Hollands M, Younker K. Canadian Journal of Diabetes. 2002 Dec; 26(4): 356-62 (46 ref)

How xylitol containing products affect cariogenic bacteria. Roberts MC, Reidy CA, Coldwell SE, Nagahama S, Judge K, Lam M, Kaakko T, Castillo JL, Milgrom P. Journal of the American Dental Association. 2002 Apr; 133(4): 435-41, 491-4 (23 ref)

Inactivation of the Streptococcus mutans fxpC gene confers resistance to xylitol, a caries-preventative natural carbohydrate sweetener. Benchabane H, Lortie LA, Buckley ND, Trahan L, Frenette M. J Dent Res. 2002 Jun; 81(6): 380-6

Effect of xylitol chewing gum on salivary Streptococcus mutans in preschool children. Autio JT. ASDC J. Dent. Child. 2002 Jan-Apr; 69(1): 81-6, 13

Xylitol – cavity-fighting sweetener a possible solution for osteoporosis. Dean W. Townsend-Lett. 2002 May; 226: 80-2

2001

Sderling E., Isokangas P., Pienihkkinen K., Tenovuo J., Alanen P. 2001. Influence of maternal xylitol consumption on mother -child transmission of mutans streptococci: 6-year follow-up. Caries research (Switzerland) 35:173-177.

Autio J.T., Courtsa F.J. 2001, Acceptance of the xylitol chewing gum regimen by prescholl children and teachers in a Head Start program: a pilot study. Pediatric dentistry 23: 71-74.

Tapiainen T., Kontiokari T., Sammalkivi L., Ikheimo L.,Koskela M., Uhari M. 2001. Effect of xylitol on growth of Streptococcus pneumoniae in the presencefructose and sorbitol. Antimicrobial agents and chemotherapy 45:66-169.

2000

Uhari M., Tapiainen T., Kontiokari T. 2000. Xylitol in preventing acute otitis media. Vaccine 19 Suppl 1, 144-147.

Isokangas P., Sderling E., Pienihkkinen K., Alanen P. 2000. Occurence of dental decay in children after maternal consumption of xylitol chewing gum, a follow-up from 0 to 5 years of age. Journal of dental research 79:885 -1889.

Knuuttila M.L., Kuoksa T.H., Svanberg M.J., Mattila P.T., Karjalainen K.M., Kolehmainen E. 2000. Effects of dietary xylitol on collagen content and glycosylation in healthy and diebetic rats. Life Sciences 67:283-290.

Hildebrand G.H., Sparks B.S. 2000. Maintaining mutans streptococci suppression with xylitol chewing gum. Journal of the American Dental Association 131:909-916.

Alanen P., Isokangas P., Gutman K. 2000. Xylitol candies in caries prevention: results of a field study in Estonian children. Community dentistry and oral epidemiology 28:218-224.

Sderling E., Isokangas p., Pienihkkinen K., Tenovuo J. 2000. Influence of maternal xylitol consumtion on acquisition of mutans streptococci by infants. Journal of dental research 79:882-887.