Xylitol - Is it Safe?

[Gaby]

Xylitol nasal irrigation is effective and superior to saline irrigation in the management of chronic rhinosinusitis

http://www.greenmedinfo.com/article/xylitol-nasal-irrigation-effective-and-superior-saline-irrigation-management-chronic


Abstract Title:

Xylitol nasal irrigation in the management of chronic rhinosinusitis: A pilot study.
Abstract Source:

Laryngoscope. 2011 Nov ;121(11):2468-72. Epub 2011 Oct 12. PMID: 21994147

Abstract Author(s):

Joshua D Weissman, Francisca Fernandez, Peter H Hwang
Article Affiliation:

Department of Otolaryngology-Head and Neck Surgery, Stanford Hospital and Clinics, Stanford, California, U.S.A.
Abstract:

OBJECTIVES/HYPOTHESIS: To determine the tolerability of xylitol mixed with water as a nasal irrigant and to evaluate whether xylitol nasal irrigation results in symptomatic improvement of subjects with chronic rhinosinusitis.

STUDY DESIGN: A prospective, randomized, double-blinded, controlled crossover pilot study.

METHODS: Twenty subjects were instructed to perform sequential 10-day courses of daily xylitol and saline irrigations in a randomized fashion, with a 3-day washout irrigation rest period at the start of each treatment arm. Collected data included patient characteristics, along with Sino-Nasal Outcome Test 20 (SNOT-20) and Visual Analog Scale (VAS) scores reported at the beginning and end of each irrigation course.

RESULTS: Fifteen of the 20 subjects (75%) returned their SNOT-20 and VAS data for analysis. There was a significant reduction in SNOT-20 score during the xylitol phase of irrigation (mean drop of 2.43 points) as compared to the saline phase (mean increase of 3.93 points), indicating improved sinonasal symptoms (P = .0437). There was no difference in VAS scores. No patient stopped performing the irrigations owing to intolerance of the xylitol, although its sweet taste was not preferred by three subjects (21%). One patient reported transient stinging with xylitol.

CONCLUSIONS: Xylitol in water is a well-tolerated agent for sinonasal irrigation. In the short term, xylitol irrigations result in greater improvement of symptoms of chronic rhinosinusitis as compared to saline irrigation.

Article Published Date : Nov 01, 2011
Study Type : Human Study

 

[Gaby]

Xylitol may prevent the development of acute otitis media (middle ear infection)

http://www.greenmedinfo.com/article/xylitol-may-prevent-development-acute-otitis-media-middle-ear-infection


Abstract Title:

Xylitol in preventing acute otitis media.

Abstract Source:

Vaccine. 2000 Dec 8;19 Suppl 1:S144-7. PMID: 11163479

Abstract Author(s):

M Uhari, T Tapiainen, T Kontiokari
Abstract:

Xylitol is a polyol sugar alcohol and is referred to as birch sugar, because it can be produced from birch. Natural sources of xylitol include plums, strawberries, raspberries and rowan berries. Xylitol inhibits the growth of Streptococcus pneumoniae and it inhibits the attachment of both pneumococci and Haemophilus influenzae on the nasopharyngeal cells. In two clinical trials xylitol was found efficient to prevent the development of acute otitis media with a daily dose of 8.4-10 g of xylitol given in five divided doses. The efficacy in these 2-3 months follow-up trials was approximately 40% when chewing gum was used and approximately 30% with xylitol syrup. The need to use antimicrobials reduced markedly when using xylitol. In a high-risk group of children with tympanostomy tubes xylitol was ineffective in preventing otitis. Xylitol appears to be an attractive alternative to prevent acute otitis media. A more practical frequency of doses should be found before its use can be widely recommended.

Article Published Date : Dec 08, 2000
Study Type : Human Study

 

[anart]

So, to sum up these studies for those of us who lack a well-developed medical vocabulary, so far they've shown that xylitol is:

anti-candida (which is good)
anti-cavity (which is good)
anti-cancer via candida (which is good)
anti-strep (which is good)
helps cure ear infection (which is good)
helps cure rhinosinusitus (which is good)
helps kill certain bacteria (which is good)
can cause gas/diarrhea in people who have candida in the gut or other carb-related issues (which while not good in the short term is good once the candida issue is solved??
less insulin raising than sugar
poisonous to dogs and ferrets and possibly other pets (like other substances, caffeine, certain nuts, etc.)

What else? I don't see any long term issues that have been discovered, but I might be missing something in translation. Personally, I use very little xylitol because at the level that it actually makes things sweet-ish, it has too many carbs for me (being extremely carb sensitive) but I do chew xylitol gum and have for years.

 

[Laura]

I do chew xylitol gum and have for years.

Which must be why you have such beautiful teeth!

I tell ya, since I've gone keto, that annoying plaque buildup that some of us were noticing while just low carb has completely reversed and I SWEAR my bone-loss is reversing and my gums growing back along with it.

 

[Gaby]

Personally, I use very little xylitol because at the level that it actually makes things sweet-ish, it has too many carbs for me (being extremely carb sensitive) but I do chew xylitol gum and have for years.

I'm a sugar junkie and I noticed it is easier to have no reminders of any sweetness at all. So I cut it all out. I'm actually having more water now than I have tea, if any.

But all this info is reassuring, as those xylitol chewing gums are a nice occasional treat. Gotta be careful though, as I can get addicted to those very fast.

Here is a boiled down version by Sayer Ji:

Sweet! Dieting without Deprivation

http://66.55.74.18/blog/sweet-dieting-without-depravation-diets

Birch Tree Xylitol

Sweet like sugar, but with 40% the calories, xylitol is fast becoming the preferred sweetener of a variety of health-conscious consumers.

Those on low-carb diets can appreciate the low effective carb rating of xylitol (it has 75% less carbohydrate than sugar), as well as the fact that xylitol, unlike most other sugar replacements, is 100% natural. Not only is it found throughout nature in fruits (raspberries), vegetables (corn),* and trees (birch), but each day our body produces between 5-15 grams of it as part of normal metabolic processes.

Those with blood sugar imbalances can revel in the fact that xylitol has a glycemic rating of 13. What this means is that sugar (glucose), which is rated at 100, is released over seven times faster into the blood than xylitol. Unlike sugar which provokes the release of insulin in order to handle the onslaught of glucose into the blood, xylitol is metabolized independently of insulin in the gut, supplying slow and steady fuel through long periods of time. Those with hypoglycemia and diabetes alike can benefit greatly from this sweet and stable fuel source.

Those prone to infections or the overgrowth of Candida albicans (yeast) have used xylitol successfully to regain their health. The Finns discovered decades ago that xylitol consumption could be correlated directly to a dramatic decrease in incidents of cavities and ear and throat infections. Because xylitol (unlike sugar and starch) is non-fermentable and has an alkaline reaction in the body it creates an inhospitable environment for Streptococcus mutans and other infectious organisms that tend to thrive in lower pH environments. Studies have shown that plaque build-up and dental caries and can be reduced 80% by the introduction of moderate amounts of xylitol, or approximately half an ounce a day. Research also indicates that xylitol may increase bone strength and bone density in those who consume it.

Not all the mechanisms for xylitol’s efficacy have been fully identified, but the proof is in the pudding (assuming its sweetened with xylitol). Enjoy!

*Important Note: xylitol is toxic to dogs, and may have a laxative effect, so start slowly. Also, it is best to obtain xylitol from a manufacturer who uses birch and not GMO-corn, as is most commonly the case.

 

[Guardian]

The person who told me Xylitol was "contaminated" by aluminum is Chinese, so that makes sense.

Clearly there are a lot of health benefits to Xylitol, but what I'm looking for is what extraction process are the Finns, Canadians, etc. using to render the Xylitol from the Birch bark? How is it being done now?

When anything good for us becomes popular...it's usually corrupted. So which producers of Xylitol are using a chemical extraction process and which are not?

What I find interesting is that most of the organic sites simply say "extracted" and/or "rendered" from Birch Bark and other hardwoods...without explaining how they do that.

 

[Guardian]

This article from 2000 is basically talking about how one day they'll be able to "make it from corn" which they now do, but it has an interesting reference to how the Finns made it at the time:

"is made in Finland from acid-treated fibers of birch wood by a chemical process. The process requires high pressure and temperature, an expensive catalyst, and extensive steps to remove byproducts"


_http://www.ars.usda.gov/is/ar/archive/jul00/xylit0700.htm?pf=1

Making Xylitol Sweetener From Corn


A low-calorie sweetener called xylitol may someday be made from corn.

Makers of some specialty brand sugarless chewing gums now pay about $3 per pound for xylitol, which gives their product a minty-cool taste.

"New technologies may drive production costs down and the volume up," says Timothy D. Leathers, an Agricultural Research Service geneticist at the National Center for Agricultural Utilization Research (NCAUR), Peoria, Illinois. He's researching a way to derive the sweetener from corn fiber leftovers of U.S. ethanol production. Currently, industry sells corn fiber and fermentation coproducts together as cattle feed for a few pennies per pound.

Xylitol, a white crystalline powder termed a sugar alcohol or polyol, is made in Finland from acid-treated fibers of birch wood by a chemical process. The process requires high pressure and temperature, an expensive catalyst, and extensive steps to remove byproducts. A biotechnological approach involving corn fiber should require less energy, says Leathers.

Expecting that beet and cane sugar will remain much cheaper than xylitol made from the xylose in corn fiber, Leathers envisions that the future of the alternative sweetener lies in niche markets. Already xylitol commands a $28 million market in foods for special dietary uses, mouthwashes and toothpastes, as well as chewing gums.

Xylitol has one-third fewer calories than conventional sugar but about the same sweetening power. Diabetics process it through the gut without involving insulin.

Researchers in the United States and abroad showed children's dental health improved if their chewing gum included xylitol. The sweetener allows harmless bacteria to crowd out common mouth microbes that digest normal sugars—the ones associated with tooth decay.

Leathers began to brighten the prospects for making xylitol in the United States from corn nearly 10 years ago. He found that one strain of Aureobasidium yeast, in a process called hydrolysis, released up to 20 percent of the xylose from corn fiber that was treated with alkaline hydrogen peroxide. Since then, he's found a mixture of Aureobasidium enzymes that releases up to 70 percent.

He and his colleagues also developed a process using a strain of another yeast, Pichia guilliermondii, to convert the xylose into xylitol. To overcome a distracting problem called glucose repression (in which glucose slows or shuts down some microbial metabolism), the scientists used two teams of P. guilliermondii. The first team gobbled up all the glucose—its first choice in food—in the fermentation vat. Then the next team focused on consuming xylose to produce xylitol.

NCAUR chemist Badal Saha identified another promising strain of xylitol-producing yeast, Candida peltata. In spite of glucose repression, he achieved a 56-percent yield of xylitol from xylose in the mixture.

Saha and Leathers found that a xylose-related sugar, arabinose, induced no repression of xylitol production. The scientists envision genetic engineering that might enable the yeasts to produce xylitol from arabinose as well as from xylose.— By Ben Hardin, Agricultural Research Service Information Staff.

The research is part of New Uses, Quality, and Marketability of Plant and Animal Products, an ARS National Program (#306) described on the World Wide Web at http://www.nps.ars.usda.gov/programs/cppvs.htm.

Timothy D. Leathers and Badal C. Saha are at the USDA-ARS National Center for Agricultural Utilization Research, 1815 N. University St., Peoria, IL 61604; phone (309) 681-6377 [Leathers], (309) 681-6276 [Saha], fax (309) 681-6686.


"Making Xylitol Sweetener From Corn" was published in the July 2000 issue of Agricultural Research magazine.

 

[Miss.K]

So, to sum up these studies for those of us who lack a well-developed medical vocabulary, so far they've shown that xylitol is:

anti-candida (which is good)
anti-cavity (which is good)
anti-cancer via candida (which is good)
anti-strep (which is good)
helps cure ear infection (which is good)
helps cure rhinosinusitus (which is good)
helps kill certain bacteria (which is good)
can cause gas/diarrhea in people who have candida in the gut or other carb-related issues (which while not good in the short term is good once the candida issue is solved??
less insulin raising than sugar
poisonous to dogs and ferrets and possibly other pets (like other substances, caffeine, certain nuts, etc.)

What else? I don't see any long term issues that have been discovered, but I might be missing something in translation. Personally, I use very little xylitol because at the level that it actually makes things sweet-ish, it has too many carbs for me (being extremely carb sensitive) but I do chew xylitol gum and have for years.

Thank you Anart, much appreciated!

I have also come to the conclusion that I can only use very little xylitol. Perhaps not even a little. It gives a strange sensation in my throat, and my stomach is very sensitive to it

 

[Laura]

The person who told me Xylitol was "contaminated" by aluminum is Chinese, so that makes sense.

Clearly there are a lot of health benefits to Xylitol, but what I'm looking for is what extraction process are the Finns, Canadians, etc. using to render the Xylitol from the Birch bark? How is it being done now?

When anything good for us becomes popular...it's usually corrupted. So which producers of Xylitol are using a chemical extraction process and which are not?

What I find interesting is that most of the organic sites simply say "extracted" and/or "rendered" from Birch Bark and other hardwoods...without explaining how they do that.

I have the whole thing in a prospectus that we got from the company where we buy our xylitol (Finland). They put it through what is called "Danisco Lenzing" (Danisco being the name of the company.) That process is shown in a sort of flow chart with bubbles with words. Says that sulfuric acid is used to hydrolyze it and then it is put through a multi-step purification process. But what chemicals are used, it does not say. But they have been very forthcoming with us so I think we can ask and they will tell us.

One part of the prospectus is a description of how "the other companies do it" which is with corncobs and evil stuff.

Their process is different. It's called "The Wood Based Concept". The facility is integrated with a paper mill because the wood pulp is turned into paper. They say their process is like 84% to 99% less harmful to the environment overall. (Well, they would say that, right?)

They show the assay of the wood based xylitol vs the corncob stuff and there are some minute differences. Apparently, both products have about the same amount of metals as is found in any food, water, soda, etc, on the market. There is NO aluminum at all in either assay though there is 1mg per kg of nickel and 0.5 mg per kg of arsenic. Heck, that's less than our well-water which is considered very pure (we had it tested)!

However, if anyone has any doubts, we can always send it down to Luminy and get it spectrographically analyzed. (I'm thinking I might do that anyway if it doesn't cost an arm and a leg.)

 

[Laura]

Xylitol, a white crystalline powder termed a sugar alcohol or polyol, is made in Finland from acid-treated fibers of birch wood by a chemical process. The process requires high pressure and temperature, an expensive catalyst, and extensive steps to remove byproducts. A biotechnological approach involving corn fiber should require less energy, says Leathers.

Yeah, making it cheaper is what they were after and why there's all the talk about using chemicals on it instead of doing it the old way. But I think the Finns have the right idea: combining the whole operation with a paper mill so that the heat and pressure that you have to use to make the paper serves a dual purpose. Then you just have to purify the liquid run-off from the wood fibers.

 

[Laura]

Thank you Anart, much appreciated!

I have also come to the conclusion that I can only use very little xylitol. Perhaps not even a little. It gives a strange sensation in my throat, and my stomach is very sensitive to it

That would be the dying of the streptococcus bacteria and candida, no doubt.

 

[Joe]

They put it through what is called "Danisco Lenzing" (Danisco being the name of the company.)

Lenzing is the town in Austria where it is made.

 

[Gimpy]

Personally, I use very little xylitol because at the level that it actually makes things sweet-ish, it has too many carbs for me (being extremely carb sensitive) but I do chew xylitol gum and have for years.

I've tried using xylitol, but it makes me quite sick. Its in the toothpaste I use, but that's all I can stand. I quit chewing gum when I had all my silver fillings removed. I've used stevia for years and never had an issue with it. Since going keto, I don't want sweet things, and don't even use that much stevia in tea that I drink.

We've managed to salvage the stevia plants I thought died from the drought earlier in the summer. Using one leaf in a cup of tea is fine, and can be reused at least half a dozen times before it goes flat.

 

[curious_richard]

The first article stated that xylitol has no "net" carbs. But that article was full of bad logic and conclusions. Another article claims that xylitol does not affect insulin. This suggests that xylitol does not convert to glucose (glucose raises insulin). Or "no net carbs".

I have a bag of xylitol that I bought (2?) years ago, before I started my low-carb diet. If xylitol is indeed low-carb, I would like to start using it again.

For what it's worth, I use a non-fluoride xylitol toothpaste.

 

[Approaching Infinity]

The first article stated that xylitol has no "net" carbs. But that article was full of bad logic and conclusions. Another article claims that xylitol does not affect insulin. This suggests that xylitol does not convert to glucose (glucose raises insulin). Or "no net carbs".

I have a bag of xylitol that I bought (2?) years ago, before I started my low-carb diet. If xylitol is indeed low-carb, I would like to start using it again.

For what it's worth, I use a non-fluoride xylitol toothpaste.

Here's a post I made in the keto diet thread:

I've been trying to find some accurate info on how the number of carbs in xylitol is calculated. A teaspoon of xylitol is 4 grams (all of which are counted on nutritional charts as 4 grams of carbs). One teaspoon of sugar also has 4 grams of carbs. However, there's this:

_http://www.thefactsaboutfitness.com/news/net-carbs.htm

Sugar alcohols are structurally similar to their carbohydrate cousins but have an increased number of hydrogen atoms, which, in chemical terms, renders them "hydrogenated" or "reduced"; as a result, they are processed somewhat differently by the body.

The above links to a paper, published in 2002 (http://www.iupac.org/publications/pac/2002/pdf/7407x1253.pdf), where the authors write:

As mentioned above, the available energy from nondigestible sugar substitutes cannot be estimated by currently used methods for common foods. Therefore, I would like to introduce method (1), which evaluates the available energy of nondigestible and/or nonabsorbable sugar substitutes according to several fermentation equations proposed previously [8–11].

...

A sugar substitute that is not digested and absorbed in the small intestine reaches the large intestine, where it is completely fermented by intestinal bacteria and produces short-chain fatty acids, which are converted to energy. The available energy of a nondigestible sugar substitute, which is completely fermented by intestinal microbes, is estimated as approximately 2 kcal/g.

...

I would like to propose that the available energy of nondigestible sugar substitutes, which escape digestion and absorption in the small intestine and are completely fermented by intestinal bacteria in the gastrointestinal tract, is 2 kcal/g as energy coefficient. This value is approximately 50% of the value of sucrose. I think that this value, 2 kcal/g, is practical and sufficient for nutrition education. This value has been used already to evaluate the energy of processed foods in the Nutrition Improvement ACT in Japan [18].

Sugar gives 4 kcal/g for a total of 16 kcal per teaspoon. But xylitol gives approximately 2.4 kcal/g, for a total of about 9 kcal per teaspoon (_http://www.foodinsight.org/Resources/Detail.aspx?topic=Sugar_Alcohols_Fact_Sheet). The paper above found its available energy to be from 2.5-3.4 kcal/g (10-13.6 kcal per teaspoon), averaged to 3 kcal/g (12 kcal per teaspoon). It also says:

Xylitol and sorbitol are partially absorbed from the small intestine and metabolized in the body.
Thus, the available energy is 3 kcal/g.

Unfortunately, it doesn't break down how much is from fermentation in the large intestine (short-chain fatty acids) vs. digestion in the small intestine.

I've read in some forums (with no citations) to count half of the carbs in xylitol. That might make sense: 2 grams broken down in the LI, to give 4 kcal; plus 2 grams in the SI, to give 8 kcal; total of 12 kcal (the approximate value given in the paper). Either way, unless I'm misunderstanding the stuff I've read, the actual carbs in xylitol should be less than 4/tsp. But unless any new papers have been published since 2002 that spell it all out, it's hard to know exactly how much.

In short, it looks like half the xylitol gets partially converted to short-chain fatty acids for energy, and the other half to carbs. Hard to say exactly, because I couldn't find anything definitive. Some polyols only get converted to SFAs, no carbs, but xylitol seems to make a bit more energy, which could indicate it gets slow-burned as carbs.