Xylitol is the alcohol form of xylose, which is used as a sweetener in chewing gums and
other dietetic products. Xylitol has less effect on blood sugar or insulin levels compared
with sucrose,1 so it may be a useful sugar substitute for diabetics.2 In addition, xylitol inhibits
the growth of several types of bacteria, including those that cause tooth decay and ear infections.3 4 5
Where is it found?
Xylitol occurs naturally in straw, corncobs,
fruit, vegetables, cereals,
mushrooms, and some seaweeds. For use in food manufacturing, xylitol is extracted from
birch wood chips. Xylitol may be found in many foods labeled as "sugar-free," including hard
candies, cookies, chewing gums, soft drinks, and throat lozenges.
Xylitol has been used in
connection with the following conditions (refer to the individual
health concern for complete information):
Who is likely to be deficient?
Xylitol is not an essential nutrient; therefore, no deficiencies are possible.
How much is usually taken?
For prevention of dental caries (cavities), 7 to 20 grams per day are given, divided into
several doses in candies or chewing gum. For prevention of ear infections, 1.7 to 2.0 grams
are given fives times per day in gum, lozenges, or syrup.
Are there any side effects or interactions?
Xylitol is recognized as a safe food additive by the U.S. government.7 Large
amounts (30 to 40 grams) taken all at once can produce diarrhea and intestinal gas.
At the time of writing, there were no well-known drug interactions
1. Hassinger W, Sauer G, Cordes U, et al. The effects of equal caloric
amounts of xylitol, sucrose and starch on insulin requirements and blood glucose levels in
insulin-dependent diabetics. Diabetologia 1981;21:37–40.
2. Bakr AA. Application potential for some sugar substitutes in some low
energy and diabetic foods. Nahrung 1997;41:170–5.
3. Trahan L. Xylitol: a review of its action on mutans streptococci and
dental plaque—its clinical significance. Int Dent J 1995;45(1 Suppl
4. Tapiainen T, Kontiokari T, Sammalkivi L, et al. Effect of xylitol on
growth of Streptococcus pneumoniae in the presence of fructose and sorbitol. Antimicrob
Agents Chemother 2001;45:166–9.
5. Kontiokari T, Uhari M, Koskela M. Antiadhesive effects of xylitol on
otopathogenic bacteria. J Antimicrob Chemother 1998;41:563–5.
6. Kontiokari T, Uhari M, Koskela M. Effect of xylitol on growth of
nasopharyngeal bacteria in vitro. Antimicrob Agents Chemother
7. Xylitol. Code of Federal Regulations, Title 21, Volume 3. U.S.
Government Printing Office, 2003: 21CFR172.395.