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Erythritol and Xylitol News

February 4, 2010 Written by JP    [Font too small?]

You don’t need to deprive yourself of pleasure or, worse yet, endure pain in order to live a healthy lifestyle. Why do you suppose that so many people find this hard to believe? Part of the reason is often because of disappointing experiences we’ve all had. I believe that many of these failures were likely prompted by poor advice provided by celebrated figures or so called authorities in the health care field. Then there’s the messages that we frequently see in advertisements for nutritional supplements, prescription medications, specialized exercise programs and even surgical procedures. The underlying theme is two-fold: 1) you need to buy something they’re selling in order to lose weight or otherwise regain your health; 2) you can try to do it on your own, but it’ll be very difficult and you’ll probably fail. To that, I say “nonsense”!

Before I go on, I want to address a widely held belief that can be extremely detrimental. Some experts cite facts and figures in order to make a case. They might tell you that a certain drug or therapy is necessary because without it, the statistics show that most people will not achieve the same health goals. There is value in understanding the probability of success. Numbers matter. They afford us an objective measure that can assist in making decisions. However, it’s vital to continually remind ourselves that we are not statistics. You and I and everyone we know are individuals who cannot simply be lumped into a generalized mass in order to make life and medicine seem more orderly or understandable.

Let’s get back to the topic of pleasure and wellness. Most people enjoy the occasional taste of sweetness in their daily lives. Upon first glance, this seems to fall into the category of short term satisfaction equaling long term danger. The majority of foods that we associate with sweetness tend to be linked to poor health – cake, candy, cookies, ice cream, pastries, soda, etc. But beyond that, the problem isn’t just sugar. Calorie-free, artificial sweeteners may not be a good alternative to plain old sucrose because there’s cause for concern about their overall safety. However you can take heart in recent evidence that suggests that certain natural, sugar-free sweeteners may allow for the best of both worlds. (1,2,3)

Xylitol is a natural sugar alcohol that is typically derived from birch trees or extracted from corn. It doesn’t have much of an impact on blood sugar levels because the body doesn’t absorb it very well. In the past I’ve mentioned xylitol as a safe and effective adjunct to promoting oral health. Several new studies add to the current level of understanding about this connection.

A new Italian trial enrolled 204 children in order to analyze the effects of xylitol-sweetened chewing gum on a few parameters related to tooth decay (plaque pH and salivary mutans streptococci levels). Over the course of 6 months, half of the study volunteers chewed the xylitol enriched gum and the remainder masticated a “non-sucrose chewing gum” without xylitol. Oral exams were performed at the beginning of the trial, after 3 months and at its completion. The children in the xylitol group demonstrated significantly lower plaque pH and a lesser population of mutans streptococci (MS), a bacterium which encourages cavities and gum disease. A Japanese study published in the January edition of the Journal of Dental Research takes xylitol research one step further. A group of 107 pregnant women with high levels of MS were asked to chew xylitol gum or no gum over the course of 13 months. The women began chewing gum at the 6th month of their pregnancy. Oral MS levels were measured in the expectant mothers and in their newborns until the infants were 2 years old. The babies who were exposed to xylitol via their mothers “were significantly less likely to show MS colonization” in their mouths. The researchers also noted that the infants not exposed to xylitol “acquired MS 8.8 months earlier than those in the xylitol group”. (4,5)

Erythritol is another natural sugar alcohol which has recently gained popularity because of its inclusion in a few mainstream stevia-based sweeteners such as Purevia and Truvia. Erythritol has several advantages over xylitol: 1) it’s less likely to cause gastrointestinal upset – even when larger quantities are consumed; 2) it has a glycemic index of 0, while xylitol registers at 13 and; 3) erythritol has recently been shown to possess potent antioxidant properties that may be of special benefit to diabetics at risk for cardiovascular disease. But, until recently, whether erythritol benefited oral health in the same manner as xylitol had not been established. Now, two new studies suggest that it does. In fact, one of the trials found that higher dosages of erythritol may be even more effective in the battle against S. mutans than xylitol. The practical implications of this finding remain to be seen.(6,7,8,9,10)

There’s an important side note that bares mentioning with regard to xylitol. It appears to be very safe in humans, but it can be deadly for dogs. Products containing xylitol can seem like appealing treats for pets, but, in reality, the ingestion of this sugar alcohol can result in a rapid surge of insulin production and a subsequent severe drop in blood sugar levels (hypoglycemia). Kidney and liver damage may also occur in instances of xylitol consumption. Please be aware of this risk and protect your pets accordingly. (11,12,13)

Xylitol May Reduce Early Childhood Cavity Risk

Source: Arch Pediatr Adolesc Med. 2009;163(7):601-607.(link)

I chew a piece of spearmint xylitol gum after just about every meal. I also pop peppermint xylitol mints like they’re going out of style. I like the fresh, sweet taste and I’m confident that it helps to protect my teeth. But there’s a lot more to chewing gum than just working your facial muscles and supporting oral hygiene. As unbelievable as this may seem: chewing gum may help prevent one of the most common post-surgical side effects.

Postoperative ileus is a condition which refers to constipation and a loss of normal intestinal function. It turns out that chewing gum may be a cost-effective and safe way to reduce this unpleasant adverse reaction. The latest example can be found in a study conducted in the Department of Gynecology and Obstetrics at Tongji Hospital in Shanghai. 388 women who had undergone a cesarean delivery were asked to chew gum or not directly post surgery. The researchers instructed the participants to chew gum 3 times daily for at least half an hour at a time. The women in the gum chewing group found relief from gas pains about 5.3 hours earlier than the gum-free group. The percentage of women reporting “mild ileus symptoms” was significantly lower in the gum group as well. Some, but not all, research suggests that chewing gum may also shorten the length of hospital stays and lower the need for certain medications that are used to calm gastrointestinal distress (antiemetics). In summary, a recent trial published in the British Journal of Obstetrics and Gynecology concluded that, “Gum chewing after caesarean section is safe, well tolerated, and associated with rapid resumption of intestinal mobility and shorter hospital stay; with potential impact on reducing the overall healthcare costs in case of routine implementation”. (14,15,16,17)

If you need a few additional reasons to enjoy gum, you’ll find them in two new studies from Germany and the United States respectively. The German trial examined the effects of gum chewing in a group of 3rd graders (8-9 years old) during an “16 minute concentration test”. The scientists from the University of Oldenburg determined that masticating gum resulted in “a significant and positive effect on concentration performance”. While researchers from Texas Tech University substantiated and expanded upon a common conception about gum – that it assists with nicotine withdrawal. 24 cigarette smokers participated in a 24 hour abstinence experiment which included: a) a flavorless gum; b) a “flavor strip” which required no chewing and; c) a flavorful gum. Those chewing the flavorful gum were more like to abstain from nicotine during the test period. Therefore, the authors of the study commented that “chewing gum appears to be useful in lessening the severity of nicotine withdrawal symptoms over a 24 hour period of nicotine abstinence and that it is a combination of flavor and chewing that appears to lead to this effect”. This seemingly inconsequential tip could make the difference between lighting up a smoke or putting down a pack of cigarettes during the earliest stages of a smoking cessation program. (18,19)

Truth be told, I probably wouldn’t chew xylitol gum or use copious amounts of xylitol mints if they didn’t taste good. The same goes for recipes in which I include erythritol. I think the taste is quite good and I value the potential health benefits. That’s why I wanted to share this current research with you. It is indeed possible to find natural foods and ingredients that please your palate and support wellness. Sometimes it requires some trial and error in order to find them. But if you approach this with an adventurous spirit and a modicum of patience, you just might end up with the ultimate sweetener – one that has no aftertaste and inspires no regrets.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!


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Posted in Dental Health, Diabetes, Diet and Weight Loss

18 Comments & Updates to “Erythritol and Xylitol News”

  1. Vladimir Says:

    Hello there, I really like your review on the xylitol gum, I wanted to see if there is more to it than just teeth health…
    me and my whole family enjoy it regularly and the dental doctor was impressed that I had almost no cavities when he was expecting lots of them.

  2. JP Says:

    Thank you for sharing your success story with us, Vladimir! 🙂

    Be well!


  3. Cathi L. Gross Says:

    I have just started baking with Erythitol Sugar and Lo Han Sugar. I really like the results that I am getting. It would be neat, if there were more baking recipes for these two sugars, with better ideas on the amount that needs to be used to make a great tasting product. I am also, baking Low Carb, Gluten Free. . .which makes it even more difficult to find Recipes. Three things I cannot have is SOY, CORN, and GLUTENS. So, many recipes for low carb have Soy or Corn, while Gluten Free Recipes have Flours that are very high in Carbs along with a high sugar count from Agave and other types of Sugar the Gluten Free Recipes rely on. So, hopefully in time there will be more Low Carb Recipes without Soy and Corn, and more Gluten Free Flours, that are low in Carb along with Low Carb Sugars that are healthier than Splenda, Agave Nectar, ETC. I Hope more people will USE Erythritol and Lo Han.

  4. JP Says:


    I agree with you and share your frustration. On the other hand, we can always considered ourselves as “culinary pioneers”! 🙂

    Have you tried the almond pancake recipe I posted several weeks ago? If not, please check it out. It’s quickly become a staple in our household. We love it!


    I noticed that a few manufacturers are starting to use Lo Han Guo as a sweetener in their products. I’m trying to set up a sample giveaway of one of those products that I learned about this past weekend at the Natural Products Expo West. Hopefully it will all come together soon.

    Be well!


  5. Rosemary Says:

    Where do you find xylitol gum and xylitol mints? I have found a couple brands that have xylitol as a lesser ingredient but the first ingredient is sorbitol or or some other polyol and often aspertame as well.


  6. JP Says:


    I generally buy them online or at my local health food store. The brands I use are: B-Fresh Inc., Spry (Xclear Inc.) and Xylichew.

    Be well!


  7. Rosemary Says:

    Thanks, JP. I found Spry gum is available at Amazon.com.

  8. JP Says:

    Great! I hope you enjoy it, Rosemary! 🙂

    Be well!


  9. Michelle Says:

    Does erythritol and xylitol have corn in them? I cannot have any grain. Thx!

  10. JP Says:

    Hi Michelle,

    Erythritol and xylitol can be derived from corn. They can also be sourced from other natural ingredients such as beets, birch bark and wheat.

    Be well!


  11. Caroline Mueller Says:

    NO NO HELL NO. AS Xylitol is deadly to dogs, think of yourself having a morning coffee. Dogs like coffee too, so you put a bit in your pets dish=DEAD DOG. NO NO NO hell no. Too Dangerous. Very sad to see this on the market to be marketed in homes where there might be a pet as well. Very sad days ahead. At least most poisons come with a Skull and cross bones on them, so why not this one.

  12. JP Says:

    Hi, Caroline.

    I understand your concern. Xylitol should be strictly avoided by dogs and handled with care by dog owners. The same is true of chocolate – especially dark and/or high cocoa containers chocolate products:


    Be well!


  13. JP Says:

    Update 04/13/15:


    Acta Diabetol. 2014;51(3):513-6.

    Effects of erythritol on endothelial function in patients with type 2 diabetes mellitus: a pilot study.

    Sugar substitutes are important in the dietary management of diabetes mellitus. Erythritol is a non-caloric dietary bulk sweetener that reverses endothelial dysfunction in diabetic rats. We completed a pilot study to examine the effects of erythritol on vascular function in patients with type 2 diabetes mellitus. Participants (n = 24) consumed erythritol 36 g/day as an orange-flavored beverage for 4 weeks and a single dose of 24 g during the baseline and final visits. We assessed vascular function before and after acute (2 h) and chronic (4 weeks) erythritol consumption. Acute erythritol improved endothelial function measured by fingertip peripheral arterial tonometry (0.52 ± 0.48 to 0.87 ± 0.29 au, P = 0.005). Chronic erythritol decreased central pulse pressure (47 ± 13 to 41 ± 9 mmHg, P = 0.02) and tended to decrease carotid-femoral pulse wave velocity (P = 0.06). Thus, erythritol consumption acutely improved small vessel endothelial function, and chronic treatment reduced central aortic stiffness. Erythritol may be a preferred sugar substitute for patients with diabetes mellitus.

    Be well!


  14. JP Says:

    Update 06/24/15:


    Int J Prev Med. 2015 May 22;6:44.

    Effect of Chewing Xylitol Containing and Herbal Chewing Gums on Salivary Mutans Streptococcus Count among School Children.

    BACKGROUND: The present study aims to assess and compare the reduction in salivary Mutans Streptococci counts after chewing Xylitol, herbal and placebo gums among high school children.

    METHODS: The study was conducted among 72 school children (12-15 years) from 3 randomly selected schools (blocks). Xylitol, herbal and placebo gums were randomly allocated to 3 blocks. Subjects were instructed to chew one pellet four times a day for 21 days. The mean reduction in salivary Streptococcus mutans count was assessed.

    RESULTS: The 100% Xylitol sweetened chewing gum “Xylitol”has shown statistically significant reduction in salivary Mutans Streptococci colony forming units at the end of 21 days (P < 0.01). The reduction was not statistically significant in herbal and placebo chewing gum. CONCLUSIONS: Hundred percentage Xylitol sweetened chewing gum was found to be more effective in reducing salivary Mutans Streptococci count when compared to herbal and placebo chewing gums. Be well! JP

  15. deb Says:

    I believe our dog died after eating a xylitol succor given to my daughter by her doctor. Supposed to be sugar free. We saw the succor stick by her dog bed later. Not sure? If anyone has more info please contact me. It was several years ago and we have moved on but always feel the regret and wonder of what really happened? Also, lesson learned with several pets. If your pet goes down and you take it to the ER always get a blood test. Could have saved her.

    Note: You can reach Deb via the link to her blog.

  16. JP Says:

    Hi, Deb.

    I’m really sorry for your loss. Below, I’ll post a brief review describing how xylitol threatens canines.

    Thank you for sharing your experience.


    Vet Clin North Am Small Anim Pract. 2012 Mar;42(2):307-12,

    Xylitol toxicosis in dogs.

    The sugar alcohol xylitol is a popular sweetener used in gums, candies, and baked goods. While xylitol has a wide margin of safety in people and most mammalian species, when ingested by dogs it is believed to stimulate excessive insulin secretion leading to severe hypoglycemia, potentially followed by acute hepatic failure and coagulopathies. Additional clinical findings may include thrombocytopenia, hypokalemia, and hyperphosphatemia. The prognosis for recovery in dogs that develop uncomplicated hypoglycemia is generally good with prompt and aggressive veterinary care.

    Be well!


  17. JP Says:

    Updated 02/25/16:


    J Med Food. 2016 Feb;19(2):211-7.

    Pharmacokinetics and Plasma Cellular Antioxidative Effects of Flavanols After Oral Intake of Green Tea Formulated with Vitamin C and Xylitol in Healthy Subjects.

    This study aimed to test whether green tea formulated with vitamin C and xylitol (GTVX) could improve absorption of flavanols and total antioxidant activity (TAC) of plasma compared with green tea only (GT) in healthy subjects. The total radical-trapping antioxidant parameter method was used to measure the TAC of plasma. Cmax, Tmax, and area under the curve (AUC) of flavanols in plasma after consumption of GTVX were 5980.58 μg/mL, 2.14 h, and 18,915.56 h·μg/mL, respectively, indicating that GTVX showed significantly higher AUC than GT (13,855.43 μg/mL). The peak TACs occurred at 3 and 0.5 h after intake of GT and GTVX, respectively. The TAC of plasma was found to be significantly higher in GTVX than in GT at each time point. This study suggests that formulating green tea with vitamin C and xylitol could increase the absorption of flavanols in green tea, enhancing cellular antioxidative effects.

    Be well!


  18. JP Says:

    Updated 09/17/16:


    Int J Dent. 2016;2016:9868421.

    Erythritol Is More Effective Than Xylitol and Sorbitol in Managing Oral Health Endpoints.

    Objective. To provide a comprehensive overview of published evidence on the impact of erythritol, a noncaloric polyol bulk sweetener, on oral health. Methods. A literature review was conducted regarding the potential effects of erythritol on dental plaque (biofilm), dental caries, and periodontal therapy. The efficacy of erythritol on oral health was compared with xylitol and sorbitol. Results. Erythritol effectively decreased weight of dental plaque and adherence of common streptococcal oral bacteria to tooth surfaces, inhibited growth and activity of associated bacteria like S. mutans, decreased expression of bacterial genes involved in sucrose metabolism, reduced the overall number of dental caries, and served as a suitable matrix for subgingival air-polishing to replace traditional root scaling. Conclusions. Important differences were reported in the effect of individual polyols on oral health. The current review provides evidence demonstrating better efficacy of erythritol compared to sorbitol and xylitol to maintain and improve oral health.

    Be well!


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