1
|
Salli K, Lehtinen MJ, Tiihonen K, Ouwehand AC. Xylitol's Health Benefits beyond Dental Health: A Comprehensive Review. Nutrients 2019; 11:nu11081813. [PMID: 31390800 PMCID: PMC6723878 DOI: 10.3390/nu11081813] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/28/2019] [Accepted: 07/31/2019] [Indexed: 12/16/2022] Open
Abstract
Xylitol has been widely documented to have dental health benefits, such as reducing the risk for dental caries. Here we report on other health benefits that have been investigated for xylitol. In skin, xylitol has been reported to improve barrier function and suppress the growth of potential skin pathogens. As a non-digestible carbohydrate, xylitol enters the colon where it is fermented by members of the colonic microbiota; species of the genus Anaerostipes have been reported to ferment xylitol and produce butyrate. The most common Lactobacillus and Bifidobacterium species do not appear to be able to grow on xylitol. The non-digestible but fermentable nature of xylitol also contributes to a constipation relieving effect and improved bone mineral density. Xylitol also modulates the immune system, which, together with its antimicrobial activity contribute to a reduced respiratory tract infection, sinusitis, and otitis media risk. As a low caloric sweetener, xylitol may contribute to weight management. It has been suggested that xylitol also increases satiety, but these results are not convincing yet. The benefit of xylitol on metabolic health, in addition to the benefit of the mere replacement of sucrose, remains to be determined in humans. Additional health benefits of xylitol have thus been reported and indicate further opportunities but need to be confirmed in human studies.
Collapse
Affiliation(s)
- Krista Salli
- Global Health & Nutrition Sciences, DuPont Nutrition & Biosciences, 02460 Kantvik, Finland
| | - Markus J Lehtinen
- Global Health & Nutrition Sciences, DuPont Nutrition & Biosciences, 02460 Kantvik, Finland
| | - Kirsti Tiihonen
- Global Health & Nutrition Sciences, DuPont Nutrition & Biosciences, 02460 Kantvik, Finland
| | - Arthur C Ouwehand
- Global Health & Nutrition Sciences, DuPont Nutrition & Biosciences, 02460 Kantvik, Finland.
| |
Collapse
|
2
|
Effect of Xylitol on the Growth and Survival of Streptococcus pneumoniae. Jundishapur J Microbiol 2018. [DOI: 10.5812/jjm.69319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
3
|
Yalcinozan ET, Kösemihal E, Aksit MA, Tinazli R, Safakogullari H, Kazikdas KC, Safak MA. Does intratympanic xylitol administration have ototoxic effects in a mouse ear model? Int J Pediatr Otorhinolaryngol 2018; 115:71-76. [PMID: 30368398 DOI: 10.1016/j.ijporl.2018.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 09/19/2018] [Accepted: 09/21/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To research the ototoxicity of xylitol after intratympanic injection in mice ear model. METHODS 24 female mice Balb/c mice (48 ears) included in the study. The mice were divided into 4 groups as 6 mice were found (12 ears) in each group. Solutions of 0.9% NaCl solution (Group A), 155 mg/ml (Group B), 310 mg/ml (Group C) and 620 mg/ml (Group D) xylitol, were applied into the middle ear cavity. Microscopic ear examination and auditory brainstem response test were done for each mouse before application of xylitol and on the 1st, 3rd and 10th day of injection. RESULTS There are some statistically significant alterations found in the threshold values at 8000, 12000, 16000, 24000 Hz frequencies when each group were compared in itself on day 0, 1,3 and 10, which were independent from the increasing dosage. CONCLUSION According to our findings intratympanic xylitol injection does not have any ototoxic effect in the inner ear. To evaluate the effects of xylitol more clinical studies are need to carried out.
Collapse
Affiliation(s)
- Eda Tuna Yalcinozan
- Department of Otorhinolaryngology, Near East University, Faculty of Medicine, Nicosia, 99138, Cyprus.
| | - Ebru Kösemihal
- Department of Audiology, Near East University, Faculty of Health Sciences, Nicosia, 99138, Cyprus.
| | - Mehmet Ates Aksit
- Department of Audiology, Near East University, Faculty of Health Sciences, Nicosia, 99138, Cyprus.
| | - Remzi Tinazli
- Department of Otorhinolaryngology, Near East University, Faculty of Medicine, Nicosia, 99138, Cyprus.
| | - Hasan Safakogullari
- Department of Otorhinolaryngology, Near East University, Faculty of Medicine, Nicosia, 99138, Cyprus.
| | - Kadir Cagdas Kazikdas
- Department of Otorhinolaryngology, Near East University, Faculty of Medicine, Nicosia, 99138, Cyprus.
| | - Mustafa Asim Safak
- Department of Otorhinolaryngology, Memorial Hospital, Antalya, 07020, Turkey.
| |
Collapse
|
4
|
Mäkinen KK. Sugar alcohol sweeteners as alternatives to sugar with special consideration of xylitol. Med Princ Pract 2011; 20:303-20. [PMID: 21576989 DOI: 10.1159/000324534] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Accepted: 12/26/2010] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Dental caries is a diet-associated disease which continues to be a serious health problem in most industrialized and developing countries. Strategies to maximize caries prevention should automatically consider the use of sugar substitutes. It is important that public health authorities are made cognizant of the availability of new polyol-type sugar substitutes. REVIEW SUMMARY Clinical studies have shown that xylitol, a natural, physiologic sugar alcohol of the pentitol type, can be used as a safe and effective caries-limiting sweetener. Habitual use of xylitol-containing food and oral hygiene adjuvants has been shown to reduce the growth of dental plaque, to interfere with the growth of caries-associated bacteria, to decrease the incidence of dental caries, and to be associated with remineralization of caries lesions. Numerous public regulatory bodies have endorsed the use of xylitol as a caries-limiting agent. Other sugar alcohols that have been successfully used as sugar substitutes include D-glucitol (sorbitol), which, however, owing to its hexitol nature, normally has no strong effect on the mass and adhesiveness of bacterial plaque and on the growth of mutans streptococci. A tetritol-type alditol, erythritol, has shown potential as a non-cariogenic sugar substitute. Combinations of xylitol and erythritol may reduce the incidence of caries more effectively than either alditol alone. CONCLUSIONS Partial sugar substitution with polyols is an important dietary tool in the prevention of dental caries that should be used to enhance existing fluoride-based caries prevention programmes. The most effective method of conveying this information to the public is through a proper health claim for these alditols in food labelling. The present review summarizes clinical and biochemical aspects of the above three dietary polyols and emphasizes the role of sugar substitution as a potential health-promoting strategy.
Collapse
Affiliation(s)
- Kauko K Mäkinen
- Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, Turku, Finland.
| |
Collapse
|
5
|
Kurola P, Tapiainen T, Sevander J, Kaijalainen T, Leinonen M, Uhari M, Saukkoriipi A. Effect of xylitol and other carbon sources on Streptococcus pneumoniae biofilm formation and gene expression in vitro. APMIS 2010; 119:135-42. [PMID: 21208281 DOI: 10.1111/j.1600-0463.2010.02703.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Xylitol inhibits the growth of Streptococcus pneumoniae. In clinical trials, xylitol decreased the occurrence of acute otitis media in day-care children, but did not decrease nasopharyngeal carriage of pneumococci. We hypothesized that xylitol inhibits biofilm formation of pneumococci, and measured biofilm formation and gene expression levels of the capsule gene cpsB and two other genes: autolysin encoding gene lytA and competence gene comA in different growth media in vitro. Twenty pneumococcal isolates were grown on polystyrene plates for 18 h in test media containing 0.5% xylitol, 0.5% glucose, 0.5% xylitol and 0.5% glucose, 0.5% fructose, 0.5% xylitol and 0.5% fructose or brain heart infusion (BHI) medium supplemented with 10% horse serum. Gene expression levels were measured after 5 h of growth using a relative quantification method with calibrator normalization. Exposure to xylitol lowered OD values, which were used as an indication of biofilm, compared with BHI medium, but when the medium was supplemented with glucose or fructose, biofilm formation was enhanced and the inhibitory effect of xylitol on biofilm formation was not observed. Xylitol also lowered lytA expression levels. Changes in biofilm formation in response to different sugar compounds may partly explain the efficacy of xylitol to prevent acute otitis media in previous clinical trials.
Collapse
Affiliation(s)
- Paula Kurola
- National Institute for Health and Welfare, Oulu, Finland.
| | | | | | | | | | | | | |
Collapse
|
6
|
Kurola P, Tapiainen T, Kaijalainen T, Uhari M, Saukkoriipi A. Xylitol and capsular gene expression in Streptococcus pneumoniae. J Med Microbiol 2009; 58:1470-1473. [DOI: 10.1099/jmm.0.011700-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Xylitol is a sugar alcohol that inhibits the growth and adherence of Streptococcus pneumoniae. In clinical trials, xylitol has been shown to decrease the occurrence of acute otitis media in day-care children but did not decrease nasopharyngeal carriage of the pneumococci. It has also been shown that xylitol affects the ultrastructure of the pneumococcal capsule. Here, it was hypothesized that xylitol might affect the expression of pneumococcal capsular genes. Capsule gene expression levels were studied in 24 clinical pneumococcal isolates and one ATCC strain (49619) by using a real-time RT-PCR method targeting the mRNA of the second gene of the pneumococcal capsular locus, the cpsB gene. The isolates were exposed to 5 % glucose, 5 % xylitol and control medium (brain heart infusion medium containing 10 % fetal bovine serum) for 2 h. cpsB gene expression levels were measured by using a relative quantification method with calibrator normalization where the 16S rRNA gene of pneumococcus was used as a reference. Exposure to xylitol lowered cpsB gene expression levels significantly compared with those in the control (P=0.035) and glucose (P=0.011) media. This finding supports previous results where exposure to xylitol changed the ultrastructure of the pneumococcal capsule and could explain further the high clinical efficacy of xylitol in preventing otitis media.
Collapse
Affiliation(s)
- Paula Kurola
- National Institute for Health and Welfare, Oulu, Finland
| | | | | | - Matti Uhari
- University of Oulu Department of Pediatrics, Oulu, Finland
| | | |
Collapse
|
7
|
Grillaud M, Bandon D, Nancy J, Delbos Y, Vaysse F. Les polyols en odontologie pédiatrique : intérêt du xylitol. Arch Pediatr 2005; 12:1180-6. [PMID: 15964535 DOI: 10.1016/j.arcped.2005.01.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2004] [Accepted: 01/20/2005] [Indexed: 11/21/2022]
Abstract
Sugars ingested outside of meals play an important role in the etiology of caries. In this respect, sugar substitutes present a very interesting alternative. In addition to the recommendations and usual care to their patients, dental surgeons also have to inform them on a dietetic level. Chewing sugar-free chewing gum after any light meal when it is not followed by a brushing presents a real interest. The authors describe the different polyols and their respective uses. Polyols are widely found in foodstuffs (sweets, chewing-gum, biscuits, cooked meals for diabetic), pharmaceutical products (syrups, pastilles to be sucked, various medicines), non-pharmaceutical chemists (toothpastes, mouth-washes...). By the light of the most recent published works, the particular properties of xylitol are described. Polyols are more particularly indicated for sugar-eater or sick children (syrups), and for those carrying a hight risk of developing caries (progressive polycaries, hyposialie...). Therefore polyols are not only a means of stabilizing some pathologies (diabetes, obesity) but also a weapon in the prevention of dental caries.
Collapse
Affiliation(s)
- M Grillaud
- Unité d'odontologie pédiatrique, hôpital Nord, chemin des Bourelly, Marseille, France
| | | | | | | | | |
Collapse
|
8
|
Tapiainen T, Kontiokari T, Sammalkivi L, Ikäheimo I, Koskela M, Uhari M. Effect of xylitol on growth of Streptococcus pneumoniae in the presence of fructose and sorbitol. Antimicrob Agents Chemother 2001; 45:166-9. [PMID: 11120960 PMCID: PMC90255 DOI: 10.1128/aac.45.1.166-169.2001] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Xylitol is effective in preventing acute otitis media by inhibiting the growth of Streptococcus pneumoniae. To clarify this inhibition we used fructose, which is known to block similar growth inhibition observed in Streptococcus mutans. In addition, we evaluated the efficacy of sorbitol in inhibiting the growth of pneumococci, as sorbitol is widely used for indications similar to those for which xylitol is used. The addition of 5% xylitol to the growth medium resulted in marked growth inhibition, an effect which was totally eliminated in the presence of 1, 2.5, or 5% fructose but not in the presence of 1 or 5% glucose, 1% galactose, or 1% sucrose. This finding implies that xylitol-induced inhibition of pneumococcal growth is mediated via the fructose phosphotransferase system in a way similar to that in which mutans group streptococcal growth is inhibited. The addition of sorbitol at concentrations of 1, 2.5, or 5% to the growth medium did not affect the growth of pneumococci and neither inhibited nor enhanced the xylitol-induced growth impairment. Thus, it seems that xylitol is the only commercially used sugar substitute proven to have an antimicrobial effect on pneumococci.
Collapse
Affiliation(s)
- T Tapiainen
- Department of Pediatrics, University of Oulu, Oulu, Finland.
| | | | | | | | | | | |
Collapse
|
9
|
Zabner J, Seiler MP, Launspach JL, Karp PH, Kearney WR, Look DC, Smith JJ, Welsh MJ. The osmolyte xylitol reduces the salt concentration of airway surface liquid and may enhance bacterial killing. Proc Natl Acad Sci U S A 2000; 97:11614-9. [PMID: 11027360 PMCID: PMC17249 DOI: 10.1073/pnas.97.21.11614] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2000] [Indexed: 11/18/2022] Open
Abstract
The thin layer of airway surface liquid (ASL) contains antimicrobial substances that kill the small numbers of bacteria that are constantly being deposited in the lungs. An increase in ASL salt concentration inhibits the activity of airway antimicrobial factors and may partially explain the pathogenesis of cystic fibrosis (CF). We tested the hypothesis that an osmolyte with a low transepithelial permeability may lower the ASL salt concentration, thereby enhancing innate immunity. We found that the five-carbon sugar xylitol has a low transepithelial permeability, is poorly metabolized by several bacteria, and can lower the ASL salt concentration in both CF and non-CF airway epithelia in vitro. Furthermore, in a double-blind, randomized, crossover study, xylitol sprayed for 4 days into each nostril of normal volunteers significantly decreased the number of nasal coagulase-negative Staphylococcus compared with saline control. Xylitol may be of value in decreasing ASL salt concentration and enhancing the innate antimicrobial defense at the airway surface.
Collapse
Affiliation(s)
- J Zabner
- Howard Hughes Medical Institute, Departments of Internal Medicine, Pediatrics, and Physiology and Biophysics, and Nuclear Magnetic Resonance Facility, University of Iowa College of Medicine, Iowa City, IA 52242, USA.
| | | | | | | | | | | | | | | |
Collapse
|