Your Health: Sugar Substitute Offers Sweet Taste -- Minus the Bitter Consequences

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Rallie McAllister, M.D., M.P.H.

America's insatiable sweet tooth is taking a super-sized

bite out of our nation's health.

Over the past three decades, annual per capita sugar

consumption in the United States has risen from 113 pounds

to nearly 150 pounds. During the same time

frame, obesity and diabetes have become national epidemics.

For folks who want to enjoy the sweet taste of sugar without

suffering the bitter consequences, an alternative sweetener

known as xylitol is an excellent

choice. Discovered in 1891 by a German chemist, the

substance became popular in Europe during World War II, when

sugar was in short supply.

Since the 1960s, xylitol has been used as an FDA-approved

nutritive sweetener in diabetic diets. These days, it can be

found in a few brands of baked goods

and beverages, as well as in chewing gum, mints and

toothpaste.

Xylitol isn't a true sugar, but rather a naturally occurring

sugar alcohol found in many plants, including some fruits

and vegetables. Although it was

originally derived from birch trees, corn is now the primary

source of commercially produced xylitol.

In its pure form, the sweetener is a white crystalline

substance that looks, tastes and measures like sugar. Unlike

table sugar, which has 15 calories

per teaspoon, xylitol provides just 9.6 calories per

teaspoon.

Because the human body metabolizes sugar alcohols in a

unique manner, xylitol doesn't produce spikes in blood

glucose and insulin levels that commonly

occur following the consumption of regular sugar. While

sugar is known wreak havoc on dental health, xylitol has the

opposite effect.

The natural sweetener has been shown to prevent tooth decay

by inhibiting the growth of Streptococcus mutans, the

bacteria primarily responsible for causing

dental cavities. Over the past two decades, a number of

studies have shown that when children chew xylitol-sweetened

gum three times daily following meals,

they develop significantly fewer cavities than those chewing

sugar-sweetened gum.

Similar findings have been observed in adults. In addition

to deterring cavity formation, the use of xylitol-containing

gums and mints can help control

bad breath, reduce the frequency and severity of mouth

sores, and improve oral health in individuals with

periodontal disease.

Not only does xylitol inhibit the growth of bacteria in the

mouth, it also puts a damper on the proliferation of

Streptococcus pneumoniae, the bacterial

source of most middle ear infections in children. In a study

published in British Medical Journal, researchers examined

the effects of the sweetener in

more than 300 children in daycare settings, most of whom had

suffered repeated ear infections.

Half of the children chewed xylitol-containing gum five

times a day, while the other half chewed regular

sugar-sweetened gum. During the two-month study,

21 percent of the children chewing regular gum had one or

more ear infections, while only 12 percent of the children

chewing xylitol-sweetened gum experienced

one or more ear infections.

Preliminary research suggests that the sugar alcohol also

may play a role in the prevention and treatment of

osteoporosis. When fed to aging rats, xylitol

not only reduced bone loss, it actually increased bone

mineral density by an average of 10 percent.

Scientists speculate that the sweetener may enhance bone

health by boosting the body's absorption of calcium. While

the optimal dose necessary to promote

bone health is still unknown, a daily intake of six grams of

xylitol has been shown to help prevent dental cavities.

For best results, two pieces of gum, each containing one

gram of xylitol, should be chewed three times a day

following meals. To reduce the risk of middle

ear infections, children should chew two pieces of the gum

five times daily.

In these amounts, xylitol is generally well tolerated by

both children and adults. At doses greater than 30 grams a

day, however, the sugar alcohol may

have a laxative effect.

While xylitol is perfectly safe for humans, canines can't

properly metabolize the sugar alcohol. Dogs ingesting the

substance can experience a life-threatening

drop in blood sugar levels, necessitating immediate

veterinary attention.

Like regular sugar, xylitol can be purchased in bulk, as

well as in single-serving packages. Unlike sugar, xylitol

isn't widely available in supermarkets:

it's more likely to be found at stores and shops that sell

natural foods and nutritional supplements.

Xylitol is more expensive than regular table sugar, but if

you're looking for a reduced-calorie sweetener with a few

bonus benefits, it's an excellent

investment.