If you’ve got a sweet tooth, you know how hard it is to stay away from the sugar bowl. But a growing number of studies linking sugar to weight gain, diabetes, heart disease and even cancer, have many of us looking for a safer alternative. Luckily, there’s one type of sugar that not only provides the sweetness we crave, it’s actually good for us.

Xylitol looks and tastes exactly like sugar, yet it contains 40 percent fewer calories than refined sugar. Naturally found in many fruits and vegetables, this sugar alcohol can replace equal amounts of sugar in cooking and baking or be used as a sweetener for beverages without a huge calorie hit. And because xylitol doesn’t trigger an insulin reaction in the body, it can be useful for diabetics or others on a low-glycemic diet.

Tooth-friendly sugar?

According to Professor Kauko Mäkinen of the Institute of Dentistry in Finland and a pioneer in xylitol research, xylitol’s chemical profile isn’t like that of other natural sweeteners. He notes that many naturally occurring sugar substitutes are part of a family of sugar alcohols called polyols (like xylitol, sorbitol, mannitol, maltitol and other sweeteners that end in “-ol”). Polyols are carbohydrates that are closely related to sugars (sweeteners that generally end in “-ose”), but they tend to be less reactive and lower in calories.

What makes xylitol different from these other sweeteners? Most sugars and polyols are based on a six-carbon monosaccharide unit like fructose (fruit sugar) and glucose (aka d-glucose, dextrose, blood sugar). But xylitol contains only five carbon units. This not only makes xylitol very stable, it also gives it some unique properties. Unlike sugars (and to a lesser extent other polyols), xylitol isn’t a good food source for bacteria. 

Sugars promote tooth decay. But because of its five-carbon structure, xylitol acts as a natural dental antidote to sugar, blocking its harmful effects and building protection. One clinical trial that appeared in the February 2012 issue of Saudi Medical Journal found that regularly using xylitol gum and candy significantly reduced bacteria in the mouth, as well as dental plaque and cavities. 

Health promoter

There’s more to this sweetener than simply protecting your pearly whites. Research conducted in more than 40 countries around the world has shown that xylitol promotes upper respiratory health, supports weight loss, increases bone density and helps to stabilize blood sugar in people with diabetes and hypoglycemia. 

One of the primary ways bacteria enter the body is through the nose and mouth, where they attach themselves to mucous membranes. When Streptococcus pneumoniae and other harmful bacteria make their home in the upper respiratory passages, they multiply—and this population boom can lead to upper respiratory infection and disease. 

Xylitol, when used in either a nasal spray or nasal wash, prevents bacteria from sticking to the nasal passages and helps the body remove them, reducing the risk of infection. This was shown in a small clinical trial conducted at Stanford University that appeared in the journal Laryngoscope in November 2011. Irrigating the nasal passages with a xylitol solution not only reduced bacteria, it also resulted in fewer respiratory symptoms in those suffering with a common cold compared to a saline solution. 

Better blood sugar 

Xylitol is also an excellent aid to help keep blood sugar on an even keel. This is important for anyone with insulin resistance or type 2 diabetes. People with either of these conditions are sensitive to foods with a high glycemic index. The glycemic index (GI) is a rating scale used to indicate how quickly a particular food raises blood sugar levels. The higher the number, the faster the rise. Refined white sugar has a GI of 85. Xylitol, on the other hand, has a GI of just 7. This means that xylitol is absorbed more slowly than sugar, so it does not contribute to a rapid spike in blood sugar levels or the resulting hyperglycemia caused by an insufficient insulin response. And since xylitol contains a mere 2.4 calories per gram, compared to sugar’s 4 calories, it’s also an excellent sugar substitute for anyone trying to lose weight.

Strong bones

Bones may benefit too. A 2005 study in the journal Metabolism suggests that xylitol increases calcium absorption in both the small and the large intestines. If the body is able to better use the calcium it receives, the loss of bone density may be slowed. This could give those at risk of osteoporosis yet another tool to guard against bone loss. 

Sweet and safe

Not only does xylitol boast these healthy benefits, it’s also extremely safe. A scientific committee of the World Health Organization announced in 1983 that xylitol, at levels up to 90 grams per day, was a safe sweetener for foods. When you eat xylitol, about one-third is absorbed in the liver. The remaining xylitol travels to the intestinal tract where gut bacteria breaks it down into short-chain fatty acids. This can improve overall colon health. 

While most people don’t have any problems digesting xylitol, those who are sensitive to it may initially experience loose stools or slight abdominal cramping if they have too much, particularly on an empty stomach. But since the body itself makes xylitol—as well as the enzymes to break it down—larger amounts can be tolerated within a few days or weeks as the body's enzymatic activity adjusts to a higher intake.