Sugar – What’s the Alternative?
Many diseases, including dental caries, chronic inflammatory diseases, diabetes, and obesity, are associated with sugar consumption. If you’ve read the blog posts Sugar Leads to More Sugar and Sugar and Fat Synthesis you may be wondering what you can do when you want something that hits the sweet spot. Artificial sweeteners were previously thought to be the answer but have now been found to have a negative effect on appetite control and the composition of the gut microbiota possibly leading to glucose intolerance, insulin resistance and weight gain (1).
Bring on Xylitol
Xylitol is found in fruits, vegetables and woody plant material. Commercially it is extracted from corn cobs or hardwood trees. Corn cobs are the preferred choice for sustainability. Xylitol is also made in our bodies during normal metabolism. Pure xylitol is a white crystalline substance that looks and tastes like sugar, but is about 40% lower in calories than regular sugar.
Xylitol is potentially beneficial in the following ways (2):
Digestion – as a non-digestible carbohydrate, xylitol is fermented in the colon by colonic microbiota which produce butyrate, which is beneficial to gut health. This fermentable aspect of xylitol also contributes to its constipation relieving effects.
Weight – as a low caloric sweetener, xylitol may contribute to weight management and blood sugar control.
Lipid metabolism – as part of a high-fat diet xylitol has been shown to improve lipid metabolism in rats (3).
Anti-microbial – xylitol has antibacterial and anti-inflammatory potential which may be useful in the treatment and prevention of respiratory tract infections, sinusitis, and middle ear infections.
Gut Microbiota – xylitol inhibits the growth of some bacterial species including Streptococcus mutans and Bacteroidetes while increasing the growth of other bacteria (3).
Immune system – xylitol modulates the immune system.
Dental health – xylitol has a significant anti-plaque effect on teeth and reduces gingival inflammation. It prevents dental caries by decreasing the growth of pathogenic Streptococcus bacteria. Xylitol can bind with calcium ions leading to remineralization of tooth enamel (3,4).
Bone health – xylitol may improve bone mineral density.
Skin – xylitol improves barrier function and suppresses the growth of potential skin pathogens.
Possible Side Effects – may cause gas, bloating and diarrhoea. It is not recommended to use xylitol in large quantities.
Xylitol can be used in place of sugar in many recipes that don’t require the sugar to break down into liquid form. Cakes and biscuits work well. Here’s a recipe to get you started:
Orange and Almond Cake
Vegan, gluten free
150g soya yoghurt or coconut yoghurt
Zest and juice of 2 oranges, preferably organic
60g coconut oil, melted
½ tsp almond essence
180g gluten free self-raising flour
60g ground almonds
2 tsp baking powder
1 tsp bicarbonate of soda
1 tbsp lucuma powder
½ cup of orange juice
1. Preheat the oven to gas mark 4/180C. Line a 1lb loaf tin with baking parchment.
2. Put the yoghurt, orange juice and zest, coconut oil and almond essence in a food processor and blend until smooth.
3. Add the dry ingredients and process until smooth.
4. Transfer the mixture to the lined tin and bake in the oven for 40 minutes until firm but springy to touch.
5. Warm the orange juice in a pan and cook until it thickens slightly.
6. Prick the cake all over with a fork and then drizzle on the orange juice.
7. Leave to cool in the tin.
1. 2014 Oct 9;514(7521):181-6. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Suez J et al.
2. 2019 Aug 6;11(8):1813. Xylitol’s Health Benefits beyond Dental Health: A Comprehensive Review. Salli K et al.
3. 2017 Jul 14;9(7):756. Effects of Consuming Xylitol on Gut Microbiota and Lipid Metabolism in Mice. Uebanso T et al.
4. Appl Microbiol Biotechnol. 2020 Sep;104(17):7225-7237. Health benefits of xylitol. Benahmed AG et al.