In the last article of this series I discussed artificial sweeteners, and gave you my take on whether you should include them in your diet. This week, I want to talk about sugar alcohols, which are another popular low-calorie sugar substitute.
Xylitol is the most popular and most extensively researched, so I’ll focus my discussion on it, but the general takeaway of this article applies to other sugar alcohols as well, such as sorbitol and erythritol.
Xylitol and sorbitol are commonly used as sugar replacements, but are they safe? Here’s what you need to know! #foodadditives #sugarreplacements #xilitol #sorbitol
What Exactly Are Sugar Alcohols?
Unlike artificial sweeteners, sugar alcohols aren’t completely calorie-free, because we are able to digest and absorb them to some extent. The absorption rate varies among sugar alcohols, from about 50% for xylitol to almost 80% for sorbitol, depending on the individual. (1) Erythritol is almost completely absorbed, but is not digested, so it provides almost no calories. (2)
Compared with artificial sweeteners, sugar alcohols have very few safety and toxicity studies, and are generally accepted as safe. (3) In one long-term human study, 35 participants consumed xylitol as their primary dietary sweetener for two years, and no adverse effects other than GI distress were observed, and GI symptoms dissipated after the first couple months. (4) The amount of xylitol consumed during this trial regularly exceeded 100g per day, often going over 200g per day, depending on the participant.
Metabolic Effects of Sugar Alcohols
For the most part, sugar alcohols cause no appreciable changes in blood glucose or insulin in humans, and sorbitol and xylitol have not been found to raise blood glucose following consumption. (5) In diabetic rats, 5 weeks of xylitol supplementation (as 10% of their drinking water) reduced body weight, blood glucose, and serum lipids, and increased glucose tolerance compared with controls. (6) Two other rat studies also found that xylitol-supplemented rats gained less weight and fat mass compared with control rats, and had improved glucose tolerance. (7, 8)
Because sweetness does not predict caloric value in sugar alcohols, one might expect that they would cause the same ‘metabolic confusion’ that is seen with noncaloric artificial sweeteners. Unfortunately there isn’t enough evidence to form a conclusion about this, but my feeling based on what I’ve read is that this isn’t a significant issue for sugar alcohols.
For one, sugar alcohols aren’t ‘intense sweeteners’ like artificial sweeteners, which are hundreds of times sweeter than sugar. In fact, many are less sweet than sugar. Also, sugar alcohols do provide some calories, so there’s not as much of a discrepancy between the caloric load your body expects and the caloric load it actually gets.
Does Xylitol Prevent Tooth Decay?
The most well-known health benefit of xylitol is easily its effect on dental health, and evidence for xylitol’s ability to prevent tooth decay is pretty robust. (9) A couple trials have found xylitol to be more effective at preventing cavities than fluoride, and benefits of xylitol consumption have even been observed in children whose mothers chewed xylitol-containing gum. (10) Unsurprisingly, the most drastic effects are observed when xylitol replaces sucrose in either the diet or in chewing gum, but significant reductions in cavities have been observed when xylitol is simply added on top of a normal diet as well. (11, 12)
Although some effects of xylitol are undoubtedly due to nonspecific factors such as increased saliva production or the replacement of sugar, it does appear to have specific properties that support dental health. Xylitol is not fermentable by common plaque-forming oral bacteria like sugar is, so it doesn’t provide a food source. (13) Additionally, xylitol actively inhibits the growth of these bacteria. It also forms complexes with calcium, which may aid in demineralization.
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Sugar Alcohols and Digestive Health
The fermentation of sugar alcohols by gut bacteria can also cause gas and bloating, and sugar alcohols may decrease fat absorption from other foods. (14, 15) However, most evidence indicates that people can adapt to regular sugar alcohol consumption, and the adverse GI effects reported in studies tend to fade after the first month or two.
Erythritol is probably the best-tolerated sugar alcohol, and a few human trials have found that if the amount of erythritol is gradually increased and doses are spread throughout the day, many people can tolerate large amounts (up to1g/kg of body weight) of erythritol without GI distress. (16, 17) The average tolerance for xylitol and sorbitol is lower; most study subjects could tolerate about 30g per day without a problem, but significant adaptation was necessary to increase xylitol content in the diet. (18)
A few studies indicate that sugar alcohols may have a prebiotic effect. This isn’t too surprising, considering the prebiotic effects of other low-digestible carbohydrates such as fiber and resistant starch. Animal studies have found that xylitol causes a shift from gram-negative to gram-positive bacteria, with fewer Bacteroides and increased levels of Bifidobacteria. (19, 20) A similar shift has been observed in humans, even after a single dose of xylitol. (21) Additionally, the shifts observed allowed for more efficient use of the sugar alcohols by gut bacteria, which largely explains the reduction in GI symptoms after a few months of regular consumption.
One interesting study found that 10% xylitol supplementation over 20 months increased collagen synthesis in the skin of aged rats, resulting in thicker skin. (22) Preliminary rat studies have also shown that xylitol can increase bone volume and mineral content and protect against bone loss. (23, 24, 25)
Overall, sugar alcohols appear to be safer than artificial sweeteners with several potentially therapeutic effects. Although the metabolic and weight loss benefits of sugar alcohols haven’t been studied as extensively, I would recommend sugar alcohols over artificial sweeteners to anyone who needs a low-calorie sweetener, although I wouldn’t recommend that anyone consume huge amounts of them. I’ll also be interested to see additional research on their ability to alter the gut microbiome and disrupt biofilms, because this could make sugar alcohols a useful tool for certain patients.
At this point, there don’t seem to be any major problems with sugar alcohols, so if it’s something you’re interested in, I would experiment with your own tolerance and see how they affect you. However, people with gut issues should be cautious.
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I read that Xylitol is manufactured through using the E. Coli bacteria. This is same as Aspartame. While many bad side effects are reported regarding Aspartame, what makes public believe that the Xylitol is safe? The E.Coli bacteria has also caused O-157.
I would just like to add the caution that Xylitol can kill your dogs (don’t know about cats). so if you make Xylitol treats or have gum, etc. Please keep them up and away from your furbabies. Having said that, Xylitol makes me feel lightheaded and weird lately. It didn’t used to. I lived on Xylitol gum for years. I had no cavities then. Now I have six. I do have the ragweed allergy so can’t handle much stevia either.
I have been very happy with erythritol mixed with stevia powder as my sweetener. I use it in my coffee and my baked paleo goodies. I experience no GI distress, and I have been using it for a year or so. Thanks for the great information!
Great info, thanks!
We used Xylitol for all our recipes, but, same as described in your post, due to the known heavy side effects in most people we started experimenting with Erythritol.
A bit more expensive exceeded all performance levels of Xylitol (baking behavior, calories zero, no side effects, especially no bloating).
Since more than a year we converted all our recipes to Erythritol. Still a heavily processed ingredient, it is our favorite alcohol-sugar, if used in moderation.
I suspect that the sugar alcohols are metabolized just like fructose. I developed gout from xylitol. Perphaps the GI signs associated with this product related to
To fructose intolerance mechanism.
I agree with Greg. I have developed gout recently. I am diabetic, and have the dry mouth syndrome. I constantly eat the sugar alcohol candies to moisten my mouth, and suspect that is causing my gout problems. I also have many cavities every three months when I get my dental check ups, I keep my teeth so clean that the hygienist finds little plaque when she cleans my teeth. I suspect the sugar alcohol is causing this too.
I too use Erythritol mostly to make “ice cream” type desserts and occasional berry smoothies and on rare occasions when I bake. I always add a bit of liquid stevia which seems to warm up the taste of the Erythritol, since Erythritol has an icy aftertaste ( a bit like the effect of menthol in your mouth). I buy it in a 5 lb bag in crystallized form. Sometimes I pulverise it to a powder in my vitamix and substitute for sugar by weight in recipes.
I can’t digest Sorbitol or Mannitol or most other sugar alcohols at all. They give me terrible GI distress. I don’t have that problem with Stevia. I do use pure stevia leaf but also use Truvia sometimes and have read lately that that might be a bad idea as it has fillers that make it much different from pure stevia extract.
In the past I made the mistake of using a Lot of aspartame (I wondered where sudden ocular migraines kept coming from; I’d never had even a regular headache in my whole life before that wicked Equal came into my life) and still use sucralose some; it’s not good for me I know but at least I don’t get tummy upset from it it. And the form I use is pure sucralose from HerbStore that has no fillers (like the brands sold in stores). Pure sucralose has no maltodextrin or dextrose.
Sugar alcohols are monsters 🙂
Malitol locks me up! I have almost checked into the emergency room over it. Terrible GI pain for over a day and at least a week to recover from it. I narrowed it down to Malitol the hard way. I won’t go near it. “Monster” it is. Most of the others I can tolerate but why take any at all, ever? I’m done with all forms of fake sugar. I also don’t eat regular sugar (as best I can). No cake, cookies, candy, ice cream, soda, etc. etc. I am much happier. I don’t need to be sweetened so bad I have to suffer for it.
Why not just use Stevia? Simple, organic & good for you.
Some people find it very bitter, not sweet. I am one of them. I have tried all sorts of combinations, including pure stevia, and have wasted more food trying to use it.
Stevia tastes like rubbish to some people like me. Also unless you are using ground stevia leaf the white powder is a highly processed substance.
Wow, you say Xylitol is better at preventing cavities than Fluoride???? First of all, Fluoride does not prevent cavities, so that’s not saying much is it? Can we just dispense with the processed BS food products? Processed food is bad for you! To even call it food is an insult to all our overloaded-with- processed-garbage metabolisms! Eat real food! forget about all this crap!
Bk, You are right on……People in general are seduced by all this BS mainly because they are ignorant and ill informed plus might I add…..lazy.
John
Xylitol, despite its’ chemical sounding name, is made from the birch tree. Yes, it’s processed, but so is maple syrup.
Sure, we can dispense with sweeteners if we have a lot of will power, however there is a biological urge for a sweet taste and you probably already know the tongue is still wired to send a pleasure signal when we get it because it was rarer in nature in ancestral times. Since we didnt’ evolve past this despite great availability of sweet foods, the temptation can be overwhelming. We can at least use our intelligence to judge the scientific research and indulge in a something less taxing on the body, and perhaps even health promoting like in the case of xylitol.
Thank you for the voice of reason! Wow, the curmudgeons of the world will take over if allowed.
Most Xylitol is made from corn in China….supposedly gmo free and all. Birch Xylitol is more expensive.
Sugar even in its most natural state is “real food” that can kill u.
Just aboit anything in excess can kill you! But .. What does your brain run on?
Tami, I too am using the Fast Tract digestion plan by Norm Robillard. Have you had any luck finding toothpaste, mouthwash, gum, etc without sugar alcohols?
Make your own tooth powders, soap, lotion, deodorant, etc. Recipes may be found at http://www.wellnessmama.com Many are easy to make and the only way you can completely be sure of what you are putting in and on your body.
Yes. I use Oracare. It doesn’t have paraben, alcohol, xylitol, sorbitol.
Yacon syrup is natural and seem to have the same effect with diabetes. May be a better choice for sugar substitute? I’m personally experimenting with it, although it is expensive, maybe better than sugar alcohol. I’m not diabetic, but having a metabolic disease. Can someone please comment on this, if yacon syrup is a ok choice?
All I know of Yacon is it’s a FODMAP but it’s great choice for a low cal/ low diabetes sweetener. It’s also restrictively expensive. I don’t know if it’s any good for dental use.
What no one mentions is that stevia comes from the plant family that includes ragweed, chrysanthemums, marigolds & daisies – if you’re allergic to any parts of these plants, you’re probably allergic to stevia. I am & just a tiny amount is enough to set me off. Xylitol has been the ONLY low carb sugar substitute that I’ve been able to have. The secret: everything in moderation, including xylitol!
I’ve tested allergic to birch (although that was birch pollen) does that mean I shouldn’t have xylitol?
Xylitol is made from birch or corn. You can shop for the stuff made from non GMO corn and give that a try.
Also, you can try reducing your “taste” for sweetness by just reducing the amount of sweetener you use gradually.
The best to you!
Maybe this is why stevia always seems to bother me. I get really stuffed up and my glands swell. All sugar alcohols bother me as well. Severe bloating, gas and diarrhea, makes me feel like my whole body is being squeezed. You can’t get something for nothing.
Xylitol has been an amazing adjunct to restoring my family’s dental health. We tolerate varying amounts but very little is needed for the oral health benefits so intolerance isn’t much of an issue.
One question I’ve had in the back of my mind is if acid-producing microbes could actually adapt to using xylitol as a substrate after habitual use (years, decades). Or would that be impossible because of biochemical factors?
How much of Xylitol is enough for oral rinsing? I’m looking for a effective product to with gum recession and dental decay. Thanks.
A very effective toothpaste is organic unprocessed (extra virgin) coconut oil and baking soda. Coconut oil is naturally anti-bacterial, anti-viral and anti-fungal. The combination will also gradually whiten teeth.
One time, pre-Paleo, my wife had bought a big bag of sugarless gummy bears. Without thinking about it, I scarfed down about 20 of these things in a few minutes. If you want the definition of disaster pants, give this a try. In our house, we now refer to this as the “gummy bear cleanse”.
You should write a book called Gummy Bear Cleanse
That is hilarious
Oh dear. I laughed out loud at this. It’s the first time I’ve laughed out loud in the past year when reading about sugar. THANK YOU. That is a hilarious little story.
Were they for sure sweetened with xylitol? Or maybe sorbitol? I’ve read about this effect more with sorbitol!
Sorry, I laughed too.
Adding inulin, a prebiotic fiber, and increasing my intake of sugar alcohols to keep calories down (in chewing gum, protein bars and protein powders mostly) made my belly so distended I ended up in the ER.
Currently I’m being treated for SIBO and being introduced to the FP (Fermentation Potential) of foods. Sugar alcohols definitely trigger a “fermentation bomb” making my complete digestive system becomes effervescent.
Even just a tiny amount affects me. Does anybody know of any chewing gum, breath mints, toothpaste, or mouthwash that does not include sugar alcohols? Ditto on protein powders?
BUY NATURES GATE TOOTHPASTE . I GET IT IN WHOLE FOODS. HAS NO SULFATES,FLUORIDE FREE,PARABEN FREE, NO ARTIFICIAL COLORS,FLAVORS,OR SWEETENERS
A very effective toothpaste is organic unprocessed (extra virgin) coconut oil and baking soda. Coconut oil is naturally anti-bacterial, anti-viral and anti-fungal. The combination will also gradually whiten teeth.
If you aren’t vegan, Great Lakes Collagen is an excellent protein powder that has only the slightest savory flavor when mixed with water… You wouldn’t taste it mixed with anything else or at least I haven’t found anything yet. I too had major issues with regular whey, rice, egg, raw protein powders…severe bloating and constipation. This stuff is like using benefiber but a protein… Add to to everything….hot or cold. I’m on a keto diet now and this stuff is great anyway but super awesome added to keto fat bombs and keto treats.
And about SUCRALOSE, made from sucrose?
Sucrose is very bad for you. It’s basically the same as Aspertame. The FDA has been swamped with complaints of side effects (serious ones) of these sweetners.
I receive migraines if I consume either of these. I went on a detox to be sure that was my problem, and it was definitely a trigger. Now I only drink Stevia Leaf Extract or actual sugar…not worth putting harmful chemicals in my body.
Please be safe!
Sucrose is more commonly knows as sugar – not good for you, but not related to Aspartame at all, sorry.
sucralose is made from chlorine!
No, it’s not made from chlorine. It is made from sugar, it just has chlorine molecule attached to the sugar molecule. e.g. it is chlorinated sugar. Maybe you meant that sucralose is made with chlorine, not from.
Great article, thank you. Due to excess levels of candida I am unable to eat, fructose, honey, maple syrup, palm sugar, agave etc. so I have been using xylitol. In small quantities in baking. Having quit sugar including the more sugary fruits for the time being xylitol has been my savior. I don’t get sweet cravings generally as I no longer have a sugar addiction but when I do fancy something xylitol is my choice. My body responds well to it and the only time I get the laxative effect is if I eat way too much. I.e testing a whole batch of sugar free foods for a launch. I’ve found a lot of people nervous of xylitol as they have read the negative hype on it being from gm modified corn, major laxative etc, when in reality xylitol from birch bark is easily available in the uk, and having tested sugar free recipes on many of my friends, family and general public, the majority have no running to the toilet episodes post cake consumption. Thanks again! Alison
I have used xylitol for years. We are careful to order non-gmo from USA made from birch. I have read a book on xylitol and many internet based articles (here’s a good page: http://www.sweetenerbook.com/xylitol.html)
I am concerned about the processing as noted above. However, my family is extremely sensitive to sugar with blood sugar and insulin processing. I also use stevia and trehalose.
In counseling clients for wellness I have noticed that certain people – they tend to be the ones who are overweight & have health issues (esp blood sugar processing issues) – will always crave and eat sweets. Studies show that some people detect smaller amounts (ppm) of sweet than others. I believe that for these people the benefits of avoiding other sweets and using xylitol (stevia, trehalose) outweigh the risks. I find that moderation or avoidance is nearly impossible with these people. There may be a genetic link or brain wired a certain way, I don’t know. I just know that they will not give up the sweets.
Please tell us what is trehalose?
How is it made? What is it made from and what is the effect on the body? I thought I had heard of all the sweeteners…
Do share!
Thank you
Parasitic pathogenic organisms (bacteria, viruses, fungi, etc) feed on sugars, starches and a lot of other carbohydrates.
Because they *need* these fuels to survive and reproduce, they create cravings via chemical signaling to the gut/brain.
If someone has a regular ‘sweet tooth’ or seem addicted to sweets, breads, alcohol, starches, etc, there is a good chance they’re harboring either SIBO (Small Intestinal Bacterial Overgrowth) or Candida Albicans. They should be advised to see a gastroenterologist for an HBT (Hydrogen Breath Test) to confirm.
For 2 months I used a liquid cal/mag product sweetened with xylitol. It was sickeningly sweet. Lots of intestinal gas almost as soon as I took the supplement. I later found out I’m very allergic to birch, and xylitol is often made from birch. SIBO and intestinal permeability are also issues but I didn’t think that those would come into play until at least 10-15 mins after ingestion. In my opinion, it’s better to just avoid the artificial sweeteners and to re-educate one’s taste to prefer less sweetness.
I forgot to add that after spraying my ears I plug my nose with my fingers and then blow hard to force the Xylitol into the ear tubes. I can then taste the sweet Xylitol in my mouth. I think this also helps in preventing colds and flues. (A doctor told me one could not damage the ears by forced blowing with the nose squeezed closed.)
I misspelt three (there flues) in my first sentence above.
Thanks for sharing your great experience with xylitol! Can you share how you make the spray, and the proportions of xylitol and Borax for brushing?
This site has a wealth of info about the dental benefits of xylitol:
http://www.healingteethnaturally.com/rinsing-mouth-brushing-teeth-with-xylitol-sugar.html
Xylitol has been a godsend for me. I worked in a windowless classroom that had foul air – acrid by the afternoon and had there flues that winter (maybe the same one three times running?) and five heavy colds. I came upon Xylitol in the spring and began using it (about six years now). Since then I have had the following improvements.
1. Not a cold nor a flue in six years – used to get a flue once every seven or so years, a heavy cold every two years or so, a light cold once or twice a year. I did have a flutter of a sniffle with light head a year ago when I became lazy and languished in regular Xylitol use- but quickly resuming its use, nothing further developed from the flutter. Upon spraying the phlegm seems to become ‘unstuck’ and then after ‘snorting’ water or using a nasal neti pot (or my cupped hand) phlegm quickly is flushed out.
2. I have suffered terrible sinusitis since about age nine (54 years ago). The Xylitol has banished the problem as long as I spray my nose once or twice a day. (However, cigarette smoking for a few weeks waiting for my electric cigarette solution from overseas to arrive inhibited the results very much.)
3. Brushing my teeth with a mix of Xylitol and Borax (a mineral like chalk or magnesium) cleans and whitens my teeth better than toothpaste. These two are purported to strength bones and teeth.
4. One spray to my itchy eyebrows completely stopped ‘itchy eyebrows’. Sprayed in the ears and let to rest a few minutes stops ear itch and then cleaning with a Q-Tip quickly cleans the ears tubes- works quicker and better than peroxide. It also clean ‘gunk’ from the eyes.
5. I find it sweeter than sugar so I use about a quarter less Xylitol than I did sugar.
6. I used it as a light foot spray and it helped eliminate foot odour- however, since going Primal (high fat, <50 gr protein and ultra low carbs, both foot and body odour have been eliminated).
7. I spray cuts and abrasions with Xylitol. However, I haven’t noticed any affect on my eczema-strangely for that I use a heavy spray of hot chilli solution make from boiling four heaping Tablespoons of crushed dried chillies 2-3 times a day. I do add a Tablespoon of Xylitol for good measure.
I mainly use xylitol and erythritol (I mix them when I need a substantial amount for baking). Xylitol I like best for taste and sweetness. But it is horribly expensive! And I believe its manufacturing is quite dirty. Erythritol is easier to manufacture and is half cheaper or even less. But you need more of it for the same sweetness. There is a combo erythritol – stevia extract (the stevia part is like < 1% of the total) to increase the sweetening power of the product. It is also OK re price. But xylitol has interesting health effects which makes it almost a staple at home.
Where are you finding erythritol more cheaply than xylitol? Do tell! I use both.