Sweet on Xylitol

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WholeFoods Magazine Staff
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Americans have a mighty hankering for sugar. It seems that we just can’t get enough of the stuff. It is estimated that the average American eats, drinks, slurps, stirs and sprinkles about half a cup of sugar per day, and 150 pounds of it annually. Sugar deserves some of its bad reputation. From its well-known role in the process of tooth decay, to its implication in cases of pre-diabetes, excessive sugar intake has become a cause of concern for all people. Luckily, there is a go-to alternative.

Americans have a mighty hankering for sugar. It seems that we just can’t get enough of the stuff. It is estimated that the average American eats, drinks, slurps, stirs and sprinkles about half a cup of sugar per day, and 150 pounds of it annually.

Sugar deserves some of its bad reputation. From its well-known role in the process of tooth decay, to its implication in cases of pre-diabetes, excessive sugar intake has become a cause of concern for all people. Luckily, there is a go-to alternative.

A Sweet Alternative
Xylitol is not only a safe, natural sweetener without the side effects of sugar and some artificial substitutes; it’s also good for your teeth, can support normal insulin and hormone levels and promotes overall health (1). Although xylitol has a similar sweetness profile, and looks a lot like sugar, that is where the likenesses end. Xylitol is in many ways sugar’s opposite. While too much sugar can cause harm, xylitol offers benefits. Because of xylitol’s five-carbon chemical structure, it has antimicrobial properties, preventing the growth of bacteria. Other forms of sugar, such as the popular alternative sweetener sorbitol, have six-carbons and therefore serve as food for dangerous bacteria and fungi (3). While table sugar (sucrose) is acid forming, xylitol swings things in the alkaline direction. This alkaline environment is inhospitable to all the destructive bacteria in the mouth, including the worst culprit: Streptococcus mutans.

Xylitol is a naturally occurring carbohydrate, more specifically a sugar alcohol, found in fibrous vegetables and fruit and commonly extracted from birch bark (4). It also occurs naturally in our bodies. As a bulk sweetener with similar sweetness and functional properties to ordinary table sugar, it helps prevent tooth decay and upper respiratory infections.

Xylitol is slowly absorbed and only partially utilized. It also carries a reduced calorie profile: 2.4 calories per gram or 40% less than other carbohydrates (3). In the United States, xylitol is approved as a food additive in unlimited quantity for foods with special dietary purposes. Importantly, because xylitol is slowly absorbed and metabolized, it creates very negligible changes in insulin levels. Therefore, xylitol won’t raise your blood sugar like table sugar.

Keep the Dentist at Bay
According to the American Dental Association, 75% of American adults over the age of 35 suffer from some form of periodontal disease (1). Much of this is simply tooth decay that results from bacteria in the oral cavity consuming sugars. When food containing ordinary sugar (sucrose) is ingested, it gives these bacteria energy, allowing them to multiply and to form acids that can eat away the enamel on the teeth. This “acid attack” causes cavities to form. Xylitol is not fermentable and does not break down like sugar, thus helping to keep a neutral pH level in the mouth.

Acidity is a problem because it strips the tooth enamel of minerals, causing it to weaken and making it more vulnerable to attack by bacteria, leading to demineralization. Ordinarily, saliva bathes the mouth with an alkaline solution that neutralizes acidity and actually remineralizes the teeth (2). However, when saliva turns acidic because of too many sweets, bacteria in the mouth have a feeding frenzy. By helping to raise oral cavity pH, xylitol reduces the time that teeth are exposed to damaging acids as well as starving harmful bacteria of their food source (4).

With xylitol, the acid activity that would otherwise last for over half an hour is cut short. Xylitol also prevents bacteria from sticking to the teeth. Tellingly, the use of xylitol for oral health reasons is supported by the American Academy of Pediatric Dentistry.

The published research into xylitol’s oral health benefits is extensive. This is not to mention its other potential benefits, such as inhibiting visceral fat accumulation (5). A recent review of the oral health research literature supports the notion that xylitol not only prevents and removes plaque, but also can aid in the rebuilding of cavity-riddled teeth (6).

Needless to say, diet plays a major role in dental health. When there is an excess of sugar in the diet, this weakens the immune system and allows for an acidic environment, causing oral health to suffer. Xylitol, for its part, can help aid the immune system in its fight against illness, as evidenced by its use as an ingredient in nasal sprays.

With proper use, xylitol actually stops the fermentation process leading to tooth decay. Long-term use suppresses the most harmful strains of oral bacteria, making a long-lasting change in the bacterial environment. Although larger cavities won’t go away, it can in fact help small decay spots harden and become less sensitive.

After taking all this into consideration, it’s clear that xylitol is a dentist’s dream. Using xylitol right before bedtime, after brushing and flossing, protects and heals the teeth and gums overnight. Only small amounts are needed for dental benefits (in the daily range of four to 12 grams, one teaspoon to one tablespoon). Since the oral environment becomes less acidic with continued xylitol use, it is advisable to chew xylitol gum or use a xylitol mint after every meal or after eating sweet snacks, preferably for a total of five times each day. The best news is that studies have shown xylitol’s effects to be long lasting, and possibly even permanent. WF

References
1. F. Gare, The Sweet Miracle of Xylitol (Basic Health Publications, Laguna Beach, CA, 2003).
2. “Danisco Ramps Up Xylitol Production in China, New Deal,” Mar. 16 2005, www.ap-foodtechnology.com/Formulation/Danisco-ramps-up-xylitol-production-in-China-new-deal, accessed May 2011.
3. A. Maguire and A.J. Rugg-Gunn, “Xylitol and Caries Prevention—Is it a Magic Bullet?” Brit. Dent. J. 194, 429-436 (2003).
4. J.M. Tanzer, “Xylitol Chewing Gum and Dental Caries,” Int. Dent. J. 45 (Suppl. 1), 65–76 (1995).
5. K. Amo, et al., ”Effects of Xylitol on Metabolic Parameters and Visceral Fat Accumulation,” J. Clin. Biochem. Nutr. 49 (1), 1–7 (2011).
6. K.K. Mäkinen, “Sugar alcohol sweeteners as alternatives to sugar with special consideration of xylitol,” Med. Princ. Pract. 20 (4), 303–320 (2011).

Published in WholeFoods Magazine, September 2011