What Is Xylitol?
Well I was going to write about xylitol but when collecting facts I run into an article that comprehensively and distinctly gives you the relevant information on xylitol. Why produce something somebody else has done so well? So ladies and gentlemen please read through this article:
Xylitol: Everything You Need to Know (Literally) by Kris Gunnars, BSc at www.authoritynutrition.com
What I will add from an experience to this great article is that always choose a product that is sweetened by xylitol only. This will minimise the possibility of having stomach problems. It is not necessarily the xylitol that is culprit for the enhanced bowel movements but the other sweeteners like maltitol syrup. Trust me, I know from my personal experience. All I need to have is 3 or more pastilles sweetened with both xylitol and maltitol syrup and rest of my family will suffer from consequences – if you know what I mean…
Here are couple of sites that sell products (chewing gum, pastilles) sweetened 100% by xylitol:
Word of Warning
Even though the xylitol is absolutely harmless to us human beings (both children and adults), it can be fatal to dogs. So do not leave any xylitol product in the reach of your dog.
Like mouthwashes and sparkling water divide us dental professionals, so does the xylitol. Some don’t know enough about it and some dental professionals take guidance from studies that are low of quality.
In 2015 the Cochrane released a review about xylitol which concluded that the xylitol has not been proven to be effective in prevention of decay. Many of us dental professionals most likely only read the abstract of the review, am I right? Very few of us had enough time or attention span long enough to go through the full version of the review. I mean really go through it – all the 10 studies they had included in their review.
Well I am going to make it easier for you now. I have looked into the full review and have simplified it in the next paragraph.
Cochrane Review and It’s Flaws
There are hundreds of studies about xylitol and caries (decay). In PubMed alone has over 500 of these publications. But yet the Cochrane review has been put together by using only ten of them.
In five of these studies the daily dosage of xylitol was lower than what is known and proofed by several clinical studies to be effective – that is 5 g per day.
Three out of these five studies were studies over toothpastes containing fluoride and xylitol. The levels of xylitol in toothpaste are always lower than the recommended, effective daily dosage of xylitol.
Clinical studies have concluded that the daily dosage and the frequency of use are the key factors in the effectiveness of xylitol. The xylitol should be spread throughout the day into small doses – preferably to 3-4 doses per day. As the xylitol is not antimicrobial compound, it needs to be used this 5 g per day to be effective in reducing the level of bacteria in mouth and therefore caries.
Let me repeat – five of out of ten studies included in the Cochrane review did not use sufficient dosage of xylitol. One out of these five studies wasn’t even a study over xylitol but probiotics – the xylitol was merely used as an adhesive (in milligrams – far from the 5 gram recommended daily dosage).
One out of these five studies did not even state the dosage of xylitol used. So why did they choose them for the review? I will try to find the answer in the Conclusion paragraph.
Ok, enough of those five questionable studies. Lets have a look at some of the remaining studies.
One of them the reviewers themselves think it has a “high overall risk of bias”. Well, they said it themselves – why include it?
Another study was conducted on kids with good oral health – how would you see if the xylitol is effective if there is nothing to improve in oral health? The ones executing this kind of study have been silly in the first place but the Cochrane reviewers are even sillier to include it in the review. What was the point?
Two studies had excellent results in the effectiveness of xylitol (see the other study here). Both of these studies used high enough dosage of xylitol.
It remains to be seen what magnitude of damage on public health one badly executed review has had. There are signs already that it has done great deal of damage. I did just a quick browse through the blogs and the internet and found several articles that were already declaring that the xylitol is useless referring to this Cochrane review. Some even state xylitol is harmful to us.
One must question the motives behind the Cochrane review on xylitol.
Has there been an involvement of the huge sugar industry that feels easily threatened by any alternative (and healthier) option for sugar as a sweetener? It is perhaps one reason why it is difficult to find xylitol products from many countries, especially the further west you go from Europe the more difficult it becomes.
Or was the review put together too hastily and with personal prejudices?
There are several food safety authorities worldwide that have accepted xylitol as food additive. The Joint (WHO/FAO) Expert Committee on Food Additives (JECFA) allocated xylitol’s ADI (acceptable daily intake) already in 1983 to “not specified” which is the most favourable ADI possible. Also the European Food Safety Authority concluded in 2006:
sugar–free chewing gum sweetened with xylitol is sufficiently characterised in relation to the claimed effects
(See the link for the full article at the bottom of this post)
Why produce a review that undermines the effectiveness of the xylitol when clearly there is no harm using it? Quite contrary, it most likely is beneficial to dental health when used appropriately and can have a positive impact on children suffering from middle ear infections.
The Cochrane reviewers are only emphasising their own self-importance and pettiness by this trivial review which will be in the world wide web forever and ever, with their names on it. It is an achievement I do not envy at all.
The Cochrane Library: Riley P, Moore D, Ahmed F, Sharif MO, Worthington HV. Xylitol-containing products for preventing dental caries in children and adults.