Xylitol: Uncovering the dark side of this popular sugar substitute

Many of us who have jumped on the lower-carb bandwagon have embraced xylitol as the darling of natural sugar substitutes. And yet, questionable manufacturing processes and the end product can be problematic—that is, a chemically extracted sugar alcohol the body is unable to fully digest which causes an uproar in the digestive tract. To make matters worse, xylitol is frequently made from GMO corn and produced in China. The sugar alcohol is also extremely toxic to dogs and can cause liver failure, as this study found.

Origin and history

Originally developed by French and German chemists in the 1890s, xylitol didn't become well-established on the market until World War II when sugar shortages in countries like Finland forced citizens to seek alternatives. Large scale production of xylitol coincided with the discovery of dental and diabetic advantages in the 1970s. The sweetener is derived from xylan (a polysaccharide), which is present in the plant cell walls of birch and beech trees, rice, oat, wheat and cotton seed hulls, corn cobs and stalks, along with sugar cane bagasse. Due to cost factors, most xylitol today is made from corn, rather than beech or birch. Chemically, all xylitol is the same, although GMOs are often present in non-organic varieties.

Nutrition Notes: Xylitol. The Sweet Alternative to Antibiotics

Xylitol has been shown to have many health benefits, yet few know of its healing power to prevent ear infections in children by inhibiting bacterial growth thus helping to avoid the use of dangerous antibiotics.

Xylitol is a natural low-calorie, low-glycemic sugar substitute produced from the fibers of fruits, vegetables, and trees such as plums, raspberries, corn, and birch. Xylitol is as sweet as sugar and can be used safely by diabetics. As xylitol is a mild sugar alcohol, excessive consumption over 30 grams per day can cause a temporary laxative effect that disappears with continued use as the body adapts. It is also important to find a source of xylitol that is GMO free if made from corn.

The health benefits of xylitol were discovered during the sugar (sucrose) shortages of World War II in Finland where xylitol was produced locally in abundance from birch trees. The Finns began to notice a substantial drop in tooth decay as well as ear infections. In a double-blind, placebo-controlled trial of 857 children it was found that those using xylitol chewing gum reduced the incidence of ear infections by a full 40%. A daily amount of 8.4 grams of xylitol was divided and given five times per day for two months. The study concluded that xylitol inhibits the growth of Streptococcus pneumoniae and Haemophilus influenza, both of which are the primary bacteria that cause ear infections. Lozenges or xylitol syrup were found to be ineffective as was a dosage of anything less that five times a day at the specified amount. 

In the United States, ear infections are treated aggressively with antibiotics. Use of antibiotics can lead to numerous health complications such as the creation of "super bacteria", recurrent infections, the destruction of  friendly flora in the intestines leading to an overgrowth of fungi and yeast, and a compromised immune system. Antibiotics may also intensify, or sometimes create, symptoms of autism by aggravating Candida albicans overgrowth. Ironically, antibiotic treatment does not prevent complications associated with ear infections such as serous otitis, pneumococcal meningitis, or hearing loss. 

For those concerned with the risks of using antibiotics for ear infections, xylitol has proven to be a safe and effective alternative.

Sources for this article:

Uhari M, Kontiokari T, Niemela M. A novel use of xylitol sugar in preventing acute otitis media. Pediatrics. 1998;102:879-884.

Kontiokari T, Uhari M, Koskela M. Anti-adhesive effects of xylitol on otopathogenic bacteria. J Antimicrob Chemother. 1998;41:563-565.

Ear infections: researchers study chewing gum as "preventative medicine," allergies as cause. Autism Research Review International. Volume 11, Number 1, 1997;7

Butler CC, Van Der Linden MK, MacMillan HL, et al. Should children be screened to undergo early treatment for otitis media with effusion? A systematic review of randomized trials. Child Care Health Dev. 2003;29:425-432.

Kaleida PH, Casselbrant ML, Rockette HE, et al. Amoxicillin or myringotomy or both for acute otitis media: results of a randomized clinical trial. Pediatrics. 1991;87:466-474.

Rothrock SG, Harper MB, Green SM, et al. Do oral antibiotics prevent meningitis and serious bacterial infections in children with Streptococcus pneumoniae occult bacteremia? A meta-analysis. Pediatrics. 1997;99:438-444.

Schmidt, Michael. Beyond Antibiotics: Strategies for Living in a World of Emerging Infections and Antibiotic-Resistant Bacteria North Atlantic Books, 2009.

Hence, it appears that xylitol must be used at least 5 times a day in order to effectively reduced ear infections (Pediatr Infect Dis J. 2007 May;26(5):423-7).