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.
Highlights
Xylitol is a five-carbon sugar alcohol (C5 H12 O5, Figure 1) with a molecular weight of 152.15 g/mol, which is commonly used as a sweetener in sugar-free confectionery
The mechanism appears to relate to increased tight junction and barrier formation in the skin
Some of these potential pathogens can spread from the nasopharynx into the sinus cavity during viral respiratory infection and cause sinus infection; S. aureus, Staphylococcus epidermidis, and Gram-negative bacteria such as P. aeruginosa and Klebsiella pneumoniae, predominate in chronic rhinosinusitis [47]
Summary
Overweight and obesity are an increasing health risk in affluent countries but increasingly in developing countries. Strategies to aid consumers with weight management are very welcome and xylitol may play a role here. A potential mechanism by which xylitol could contribute to weight management and reduced energy intake is through the induction of satiety. In addition to weight management, there may be a benefit in counteracting the consequences of overweight and obesity, commonly referred to as metabolic syndrome; insulin resistance, high serum cholesterol and hyperlipidemia [79]
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