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What Is Xylitol, and Is It Healthy for You?

author avatar Dr. Eric Berg 12/13/2024

Natural sugar alternatives are becoming increasingly popular, but what is xylitol, and how do you use it? 


Xylitol is a naturally occurring sugar alcohol that offers a sweet taste similar to sugar but with fewer calories and a significantly lower impact on blood sugar levels.


Learn how to use this popular sugar substitute and discover the surprising health benefits of xylitol.  


Xylitol

What is xylitol?


Xylitol, also known as birch sugar, is a type of sugar alcohol derived from birch tree bark and can be extracted from agricultural by-products such as corn fibers. 


Xylan, a structural polysaccharide found in the cell walls of these plants, is removed and broken down to release xylose, which is then hydrogenated to produce xylitol.


Due to its unique chemical structure, xylitol stimulates taste receptors, offering a sweet taste similar to sugar but with around 40 percent fewer calories, making it a popular choice to sweeten sugar-free products. 


Unlike sugar, xylitol doesn’t cause significant blood sugar fluctuations or insulin spikes, which is beneficial for individuals managing diabetes or those following a low-carb diet.



Although xylitol is categorized as a sugar alcohol, it doesn’t actually contain ethanol and won’t cause inebriation or intoxication. 


Xylitol is widely available and commonly used to sweeten a variety of products, including:

  • Sugar-free chewing gum

  • Toothpaste and mouthwash

  • Sugar-free candies and mints

  • Low-carb baked goods

  • Cough syrup medications 

  • Chewable supplements  


Watch the video below to learn more about xylitol.

What is Xylitol?

Is xylitol safe?


Both the Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA) declared xylitol, along with other sugar alcohols such as erythritol, safe for human consumption.


However, while rare, xylitol can cause allergic reactions, especially in individuals with sensitivities to sugar alcohol or certain ingredients used in its production. 


While xylitol is less likely to cause digestive issues than other sugar substitutes, excessive intake can trigger gastrointestinal discomfort, including bloating, gas, and diarrhea.


While xylitol consumption is generally well tolerated and safe for humans, it’s highly toxic to dogs, and even small amounts can result in vomiting, seizures, liver failure, and even death if not treated immediately.


Therefore, it’s crucial to keep xylitol-containing products out of your pet’s reach and never feed your dog sugar-free peanut butter, as it’s often sweetened with xylitol. 


Woman smiling

Benefits of xylitol 


In addition to serving as a low-calorie sweetener, xylitol has been linked to metabolic improvements, antimicrobial effects, and potential bone health-promoting properties. 


Let’s take a look at xylitol’s health benefits. 


1. Promotes dental health 

Xylitol is beneficial for dental health due to its ability to inhibit the growth of harmful bacteria in the mouth. 


Research published in the Journal of Dental Research found that regular use of xylitol-containing chewing gum helps maintain oral hygiene by reducing the number of cavity-causing bacteria, such as Streptococcus mutans


The authors conclude, “This study demonstrated a relationship between the level of xylitol used and the changes in mutans streptococci levels in plaque and saliva.”


In addition, xylitol may promote tooth enamel remineralization and stimulate saliva production. This helps neutralize acids and wash away food particles, further protecting against dental caries and tooth decay.


Ear examination

2. May reduce the risk of ear infections

A study published in Vaccine found that xylitol syrup may help reduce the frequency of acute otitis media episodes, especially in children. 


It’s believed that xylitol has antibacterial properties and helps prevent the bacteria that cause middle ear infections from adhering to the lining of the ear canal.


These antimicrobial properties may also explain why xylitol-containing nasal spray has been found to limit bacterial growth within sinus cavities, which may help reduce the risk of sinusitis and upper respiratory tract infections. 


3. Supports metabolic balance 

Xylitol has a minimal effect on blood sugar levels, making it a suitable sweetener for those seeking to manage blood glucose levels or improve glucose tolerance. 


Unlike regular sugar, which causes significant blood sugar spikes, xylitol has a low glycemic index and doesn’t significantly raise blood glucose levels, making it an excellent sugar alternative for people with diabetes.


In addition, evidence published in Diabetologia suggests that xylitol can enhance insulin sensitivity and may even help reverse insulin resistance by improving cellular responses to hormonal signaling.


Maintaining optimal insulin sensitivity plays a critical role in metabolic balance and reduces the risk of developing metabolic disorders such as type 2 diabetes, heart disease, and obesity.


Woman wearing oversized jeans

4. Aids weight loss

Not only is xylitol an excellent low-calorie sugar substitute that helps reduce overall caloric intake, but its metabolic benefits can also significantly contribute to achieving a healthy body weight.


Regular consumption of carbohydrates and sugars triggers the constant release of insulin to regulate the body's blood glucose balance. 


“In addition to managing blood sugar levels, insulin also promotes fat storage and stimulates the conversion of glucose into fatty acids,” says Dr. Berg. “This explains why carb and sugar intake are the most significant contributing factors to weight gain.”    


Because xylitol doesn’t trigger significant blood sugar fluctuations or insulin spikes, it helps minimize fat storage, which is critical for sustainable weight loss and weight management. 


5. May support skeletal health 

Xylitol has been found to stimulate the activity of osteoblasts, the cells responsible for bone formation, which may help improve bone health. 


A study published in Geriatrics and Gerontology found that xylitol supplementation led to increased bone volume and mineral content, linked to improved bone strength and reduced risk of osteoporosis. 


While the benefits of xylitol for bone formation have only been confirmed in animals, these findings may indicate potential health benefits for skeletal health in humans. 


Woman baking

How is xylitol used?


Because xylitol doesn’t significantly affect blood sugar and insulin levels, it’s on the keto diet food list and a commonly used natural sugar replacement for many individuals following a low-carb diet. 


Because of its popularity among keto dieters, xylitol is widely available in granulated form, similar to sugar, as well as in liquid and powder formulations.


While granulated and powdered xylitol are ideal choices for dessert recipes, baked goods, or as a tabletop sweetener, liquid xylitol can be used to sweeten beverages and smoothies or to make syrups.


Many individuals use a 1:1 ratio when replacing sugar with xylitol. However, since xylitol is about 1.5 times sweeter than sugar, adjustments to the amount used may be necessary to match your taste preferences.


Xylitol can be heated but doesn’t caramelize like other sugar substitutes, such as monk fruit extract, making it less ideal for recipes that require caramelization. 


Due to xylitol's benefits for oral health, it’s often found in dental hygiene products such as toothpaste, mouthwashes, gum, and breath mints.


In addition, xylitol is increasingly used to replace potentially harmful artificial sweeteners, such as aspartame and saccharin, in various foods and beverages, including sugar-free gum, candies, and diet sodas. 


Low-carb baking concept

Keto recipes with xylitol 


Xylitol is a versatile, low-calorie sweetener that fits perfectly into keto recipes, offering a natural alternative to sugar without interfering with fat-burning and ketosis.


Here are a few Healthy Keto®-approved recipes with xylitol:

  • Homemade Protein Bars: These delicious Protein Bars offer a perfect balance of protein and healthy fats, sweetened with xylitol to create an ideal keto-friendly treat. 

  • Keto Brownies: These decadent Keto Brownies have a rich, fudgy texture, allowing you to satisfy your chocolate cravings without compromising ketosis.

  • Pecan Chocolate Chip Cookies: Enjoy a perfect blend of almond flour, crunchy pecans, and rich chocolate chips sweetened with xylitol for a sugar-free treat.

  • Keto Strawberry Cheesecake: Indulge in a creamy, low-carb dessert made with a sugar-free, almond flour crust topped with fresh strawberries. 

  • Peanut Butter Chocolate Fat Bombs: These keto-friendly fat bombs combine rich peanut butter and decadent chocolate for a satisfying, low-carb treat.


Xylitol in a jar

Key takeaways


What is xylitol, and is it safe? 


Xylitol is an alternative sweetener popular among those following a ketogenic diet, as it has minimal impacts on blood sugar levels, making it an excellent sugar substitute for low-carb recipes. 


In addition to being safe for human consumption, xylitol intake has been linked to improved metabolic health, weight loss, and a lower risk of tooth decay and ear infections. 



FAQ


1. What is xylitol?

Xylitol is a sugar alcohol derived from the bark of birch trees and can be extracted from corn fibers.


It’s a natural sugar alternative that offers similar sweetness to sugar but with a significantly lower impact on blood sugar levels, making it an excellent option for individuals following a ketogenic diet and diabetics. 


2. Is xylitol good or bad for you?

Unlike sugar, xylitol doesn’t cause blood sugar fluctuations, leading to improved metabolic health, weight loss, and a lower risk of obesity, diabetes, and insulin resistance. 


In addition, xylitol intake promotes dental health by eliminating oral bacterial species linked to caries formation and tooth decay. 


3. Is xylitol artificial or natural?

Xylitol occurs naturally in birch tree bark and corn. Although xylitol has to undergo extraction and refining processes, it isn’t an artificial sweetener and is generally categorized as a natural sugar substitute. 


4. Is xylitol good for your mouth?

Yes, xylitol is beneficial for oral health as it helps reduce the growth of cavity-causing bacteria and promotes the remineralization of tooth enamel. Regularly using xylitol chewing gum can be especially effective in maintaining oral hygiene and preventing tooth decay.


5. Is xylitol the same as stevia?

While both xylitol and stevia are plant-derived natural sweeteners, they differ in sweetness and calorie content. 


Xylitol is a sugar alcohol that provides a sweet taste with fewer calories than sugar. In contrast, stevia is a plant extract that is significantly sweeter than sugar and contains no calories.


6. Can I have xylitol on keto?

Yes, xylitol is an excellent sugar alternative for those following keto as it doesn’t significantly impact blood sugar and insulin levels and won’t disrupt ketosis if consumed in moderation.


7. Is xylitol safe for pets?

No, xylitol is toxic to pets, particularly dogs. Even small amounts can cause dangerous reactions, including vomiting, seizures, liver failure, and potentially death. 


It's crucial to keep products containing xylitol out of your pet’s reach and never feed sugar-free peanut butter to your dog, as these products are often sweetened with xylitol. 



Sources


  1. https://pmc.ncbi.nlm.nih.gov/articles/PMC2225984/ 

  2. https://www.sciencedirect.com/science/article/abs/pii/S0264410X00002942 

  3. https://link.springer.com/article/10.1007/s00125-012-2527-z 

  4. https://karger.com/ger/article-abstract/47/6/300/147015

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