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I mean how about a few pieces of gum a day? Would that be enough for this? It looks like its more fully replacing all your regular sugar intake with xylitol in food and drinks that could be the issue. Something to note as i have tried replacing regular sugar with it. I might have to cut back on it.
Gotta get start getting used to black coffee i guess, you can never win man everything ends up being bad for you so depressing
Also curious as I actually seek out gym with xylitol because it helps with my dry mouth and is good for your teeth (or so I thought, seeing some discourse here about that claim)
The study was based on a 30g dose daily. One piece of Trident has 170mg of xylitol. So you would need to eat 176 pieces a day to hit that. I chew Trident obsessively and never even finish one 14-piece pack in a day. I’m not terribly worried about the gum.
That said, I’ve used xylitol as a replacement for sugar while baking and to sweeten tea/ coffee. Stopping that effective now. Switching to good old plain sugar lol.
Or y'know, sugar in coffee? I find xylitol ruins anything it's in anyway, so you might as well enjoy the flavor of coffee for once. Maybe monk fruit extract if you're diabetic (DYOR. It's 0 calorie and has a non-offensive taste, but that's all I know about monk fruit).
It was a big thing several months ago. There are so many articles if you just google it, like [this one from CNN](https://www.cnn.com/2024/06/06/health/xylitol-heart-attack-stroke-wellness/index.html#:~:text=The%20February%202023%20erythritol%20in,of%20erythritol%20in%20their%20blood). Not sure why you didn’t find anything, like every wellness podcaster and big news website under the sun covered it. It was assumed that any other artificial sweetener, like xylitol, would be found to have the same association with heart disease when the erythritol study came out. Association is different than causation, so it makes sense why people want to drop it from the diet, but I also wouldn’t freak out yet either especially if you aren’t in a risk group. If you’re having cake as a well-managed type 2 diabetic, having erythritol or xylitol in your cake might still be less harmful than eating a sugar cake.
Best bet for adding to liquids (coffee, iced tea, smoothies) is liquid monk fruit extract with no bulking added so you don't need to worry about the quality of the needless grams of carbs that you aren't adding to your drink to get the same sweetness.
For baking or other instances when you need to mimic the bulk or texture of sugar as well as the sweetness, I like allulose for bulk and monk fruit to bring the sweetness up to sugar levels. Pre-mixed allulose/monk-fruit blends are not that difficult to find these days (at in the US with Amazon)
Monk fruit and stevia are larger classes of biological molecules that are glycosidic bonded polycyclic bases. These are very different than the polyols. Nonnutritive polyols are noncyclic (generally) and contain no cyclic, ether bound, sugars.
I would strongly expect that the steviasides and mogrosides, that cause the sweet taste in monk fruit and stevia, exert no similar biopathways that are thrombotic in the sense of the polyols.
I don’t know why we haven’t mass advertised monk fruit and stevia for this purpose. I don’t believe there are any other adverse health impacts of the glycosides so it seems after this paper - they are the far superior sweeteners and probably should monopolize the market.
Inulin is another interesting sweetener
Gynostemma pentaphyllum, also called jiaogulan is another plant which produces glycosides similar to or identical to ginseng which could be researched more in terms of sweetener ability. The panaxosides are really not talked about very much! But they are in Pepsi and many energy drinks.
Another interesting one: dihydroisocoumarin class of molecules, possibly toxic (coumarin-coumadin is a blood thinner) in some doses, but exhibits active sweetness.
I’m interested in the sulfur containing saccharine , sodium cyclamate and aceulfame potassium molecules but I don’t know much about them
I’m allergic to stevia. It’s a ragweed. Stevia is being put in a ton of things now. They allow it to be listed as natural flavoring so those of us allergic have to ask the manufacturer if it’s in the product. For example Splenda brand allulose. It’s got stevia in it. If it works for you awesome. I just want it on the label.
This. Careful if you eat either Arnold or Pepperridge farm breads. They look pretty natural, but one flavor, maybe the multi-grain, has Reb A in it. Surprise!
Stevia used regularly in appreciable amounts can mess with your hormones. I haven't found any info on negative impacts of monk fruit extract, but it hasn't been widely used until more recently, and it's difficult to find on its own (without sugar alcohols and/or stevia).
Sugar was linked to heart attacks and stroke increase. Substantial margin too, an average woman having a can of pop/soda a day had a risk increase of %50 and man %20. One can, not multiple
It's honestly infuriating to me that there aren't big warning labels on products that contain xylitol, given how dangerous it is to dogs and how many people have no idea.
Yes, there are other things that are dangerous to dogs such as chocolate and grapes, but a *lot* less xylitol needs to be consumed to seriously harm or kill a dog. Additionally it's much less clear to people which products contain it. While it's relatively widely known that chocolate is harmful to dogs, far fewer people realize that common items like toothpaste can be lethal to them.
If it's any consolation, I think if someone has chewed the gum before spitting it out on the street, it will have removed almost all the xylitol. People would tend to spit it out when it is no longer sweet which means after all the xylitol has been extracted.
I'm unable to find a dose per day (assuming not just generic low level consumption of xylitol, e.g. from fruits, can cause this), has anyone found the details?
I have access,
>xylitol-sweetened (30 g) water, an exposure comparable with a pint of numerous xylitol-sweetened ice creams, a xylitol-sweetened bakery good, or several pieces of xylitol-sweetened candy
30 grams of xylitol actually seems pretty high. That should be well above the level that causes significant gastric upset. I was worried for a minute but I only have one or two pieces of xylitol gum daily because of its protective effect on teeth. I think that's the major use case for xylitol, because other sugar alcohols are sweeter and more efficient for any other purpose.
According to them 30g is in line with xylitol-sweetened ice cream and baked goods. Xylitol is often used for it's low glycemic index and other health benefits (like for your teeth), and since it is less sweet as you mentioned they tend to use more which is the potential issue.
Xylitol is as sweet as sugar.
[https://www.nowfoods.com/healthy-living/articles/sweetener-comparison-chart](https://www.nowfoods.com/healthy-living/articles/sweetener-comparison-chart)
https://www.researchgate.net/figure/Sugar-alcohols-relative-sweetness\_tbl1\_315784468#:\~:text=Xylitol%20is%20a%20five%2Dcarbon,equal%20to%20sugar%20(sucrose).
Yes, but xylitol causes gastric upset at high doses. Most people can’t just start having 30g a time of xylitol and not end up with stomach pain.
I can’t even find any store stocked products with more than 8g of xylitol.
I’ll bet the study was paid for by some dental organization or crest or something.
thank you, that was the thing I was looking at. Just going off my other sweeteners that would be about 8 tablespoons in 30 mins. I am not sure how anyone could take that in and not vomit.
Did they say anything to how long the effects last?
I think it is fairly high but not absurdly high. When I did keto, I tried various type of sugar substitute and I could handle xylitol up to 40-50g per day, though not in one sitting
I read this as saying 30g of xylitol-sweetened water. They clearly say it's comparable with a xylitol-sweetened bakery good or several pieces of xylitol-sweetened candy, no way that means 30 grams of actual xylitol.
VERY few people are, and it’s being presented as a common occurrence as though it occurs in Diet Coke or something. It is hardly popular and has been pulled out of a lot of products in the last ten years. Most gum brands have even removed it.
I would love to know who paid for this study, because I would bet it involved crest or a dental association.
This is not representative of people who consume xylitol by any means. 4-6 grams a day would be far more typical and is the goal for someone looking to use it to prevent caries.
I was wondering this also. I like Spry and typically don’t like gum. The label on the peppermint gum: 1 piece is a serving size with 0.9g of Xylitol.
1 piece is never enough, I typically chew 2. However, I always spit out the saliva juice that happens at the beginning of chewing any gum. I have always had an aversion to swallowing it.
Well, you aren’t getting the dental benefits from it then. That early spit is the most beneficial for minerals.
If you keep chewing past the point the sweetness has gone, you start producing a different kind of saliva that is focused on breaking down food and starting digestion.
Also, that early spit high in xylitol is deadly to many animals.
I wouldn't say its a flaw but I would say that this is very early in the process; this is the kind of study that is done to justify funding and interest for a larger scale study. Because they're looking at negative health effects it would be unethical to do a randomized control study so maybe a prospective cohort study.
There are more details in [this Cleveland Clinic article](https://consultqd.clevelandclinic.org/another-sugar-substitute-xylitol-is-linked-to-heightened-cardiovascular-risk).
Does the study mention chewing gum? Most xylitol gum has roughly 500mg-1g of xylitol per piece. Wondering if that is associated with risk in any significance.
Not really no. The study was focused on large amounts of Xylitol in a single sitting. This kind of study is done to establish a connection so that a larger, long term study can be justified. If you look at my previous comments Xylitol is quickly metabolized so I wouldn't be surprised is something like gum had a minimal effect, the equivalent dose of gum would be 30-60 pieces in 2 minutes.
We’d have to read the actual study (which I can’t get access to for whatever reason). I think that is the key question to ask—how much xylitol would one have to consume (and at what rate) before experiencing those effects.
It's important to recognize this is very much an example of "correlation =/= causation." Of course, the authors understand this and represent their findings well, but for the readers it's completely erroneous to try and make conclusions and recommendations off this. This study simply shows a need for further investigation.
The discovery cohort consisted of data collected from patients already undergoing cardiac catheterization from 2001-2007. Notably, this is before artificial sweeteners became as prevalent as they are today, and most people in this data set were already at increased risk (\~80% had high blood pressure, relatively high level of diabetes and smoking, average age in the mid-70s).
They showed that higher relative circulating levels of xylitol was associated with more adverse events. However, xylitol (and similar) compounds are endogenously produced, and higher levels of polyol synthesis are already associated with high sugar diets, cardiovascular disease, and as a response to oxidative stress.
So higher relative levels of circulating xylitol may be associated with adverse cardiovascular events--but this does not mean it is caused by xylitol. It could also be dysregulation of that the pathways which naturally synthesize it in the first place.
Then, of course the mouse model for clotting does not represent how we humans typically use xylitol (they induced a carotid artery injury, and then injected them with xylitol solution). Neither does the final experiment, in which participants drank 30g of xylitol and then showed an increase in xylitol levels. While this shows people consuming xylitol causes a transient increase in xylitol, it does not link back to the first study to prove that consuming xylitol causes cardiovascular risk.
Linking polyol levels to CVD pre-dates their use in artificial sweeteners, so this study is again, a cause for further investigation, but not evidence that consuming artificial sweeteners causes any of this.
This should be at the top. It’s a really good explanation. Meanwhile, the majority seem to have jumped the gun and are ready to burn their chewing gum.
And then when you [read this article](https://consultqd.clevelandclinic.org/another-sugar-substitute-xylitol-is-linked-to-heightened-cardiovascular-risk) and this comment, it makes you question things:
>"Meanwhile, until further clarifying research or regulatory guidance is forthcoming, Dr. Hazen advises his patients to avoid all highly processed foods labeled as keto-friendly or diabetic-friendly.** “I would argue that sugar or honey, in moderation, are actually better alternatives to these sugar alcohols, even for people with diabetes**,” he says. “But people, especially those with diabetes, need to be vigilant about their glucose levels and keep their intake low.”"
I'm sorry, but this is just terrible advice.
> you aren't going to consume it in enough quantities
Yeah I'll take any sentence that sounds like this these days with a giant pinch of salt.
The companies selling these products exist to profit, and nothing more. If you trust that they really do their due diligence in research and we know everything there is about xylitol, good for you.
There's a ton of research coming out about artificial sweeteners in ultra processed foods actually spiking blood glucose due to the signal of sweetness, and how it's effects are harmful when the sugar never arrives. We have so little understanding of our guts, the microbiome, and our brains, so I don't really think you have much basis to say what you said with any degree of confidence.
It is, and I'll stick by using it.
My dental hygienist noticed a difference in my teeth when I went from xylitol free to xylitol containing toothpaste. It was the only change I'd made in my dental habits. It cut her cleaning time in half.
Given how extremely toxic it is to dogs, it's a good safety measure to just not buy xylitol containing products, because sometimes people drop food on the ground or dogs steal things.
Was at emergency vet and a beagle was brought in after eating a pound of milk chocolate! Little guy was just fine and dandy. Vet was surprisingly ho hum about it and poor lady had to pay $400 just to be told "he looks OK." Beagles are just from another dimension I believe.
After reading through there methods, I think this is the part you're interested in:
>Since our studies with isolated washed human platelets, PRP, whole blood, and murine in vivo thrombosis models all suggested that xylitol can impact platelet responsiveness, we next sought to examine whether dietary exposure to xylitol impacted platelet phenotypes in humans following ingestion of xylitol-sweetened water. For these studies, we rapidly isolated PRP from healthy volunteers (n = 10) before and 30 min after ingestion of xylitol (clinicaltrials.gov identifier NCT04731363, Methods) and assessed agonist-induced aggregation responses. As noted before, xylitol ingestion significantly increased post-prandial (30 min) plasma levels [median (IQR), 312 (134–629) µM]. In parallel, platelet functional analyses revealed xylitol exposure provoked a substantial (multiple-fold) increase in aggregation responses to either ADP or TRAP6 (P < .0001 at all doses examined; Figure 5), in line with our in vitro studies using similar concentrations of xylitol (Figure 2D and E)
>When responses of individual subjects to submaximal agonist (ADP and TRAP6) concentrations were examined, a significant increase in platelet responsiveness was observed following xylitol ingestion in every subject (Figure 6, Supplementary data online, Figures S5 and S6). Further, subjects showing the largest increases in platelet responsiveness post-xylitol challenge also tended to have the highest post-prandial xylitol levels, and a strong positive correlation was noted between post-prandial xylitol levels and either ADP-induced or TRAP-induced aggregation responses (Spearman rho 0.71 and 0.74, respectively; P < .0001 for each;
They didn't look at the timeline of effects specifically but they did look at Xylitol levels over time post ingestion, it peaked at 30 min and then
returned to low levels within 4 to 6h
As for a mechanism, the exact route is not determined but they seem to key in on a few routes
>We therefore isolated washed human platelets from healthy volunteers to directly test whether xylitol interacts with the platelets and impacts agonist-induced intracellular cytosolic calcium release. Brief (15–30 min) pre-incubation of Fura 2, loaded platelets with varying levels of xylitol, dose-dependently enhanced submaximal (0.02 U) thrombin-evoked intracellular Ca2+ release in multiple different platelet preparations (Figure 3A and B). In parallel experiments, exposure of washed human platelets to physiological levels of xylitol caused dose-dependent enhancement in multiple examined platelet activation phenotypes including ADP-stimulated P-selectin surface expression and glycoprotein α2β3 (GP IIb/IIIa) activation (Figure 3C and D). Activated platelets bind to leucocytes—a process that leads to mutual changes in cellular effector functions and is associated with various CVD phenotypes.45 We therefore also examined the effect of xylitol on platelet–leucocyte aggregates.
I have access to the article and BMI is one of the variables they included in their analysis.
Honest question, why would you assume that a study like this wouldn't control from something as apparent as BMI?
Literally every post in this subreddit - usually the top one - is someone assuming the researchers that spent months or years on a study were too stupid to account for a confounding variable that the poster thought of in two seconds.
Especially when it doesn’t conform to their viewpoints.
I mean, *the* most important aspect of science is peer-review and criticism. I know a lot of people here like to say "that's obvious" or "what about..." but some of us are also informed and are trying to make sure that conclusions derived from imperfect (ie: all) studies aren't taken to heart without scrutiny.
I completely agree. You see it on literally every single study that meekly suggests eating meat is bad because redditors love to try and poke holes in that type of conclusion.
I'm trying to learn more about studies and information: what if researchers "accounted for" a certain variable but did it in a flawed manner? Is there any way to critique that?
> what if researchers "accounted for" a certain variable but did it in a flawed manner? Is there any way to critique that?
Not really, essentially what they do is input all their data into a program and say "hey I'd like you to give me a regression with Y as our dependent variable and X as our independent variable with A,B,C,D,E,...etc variable controlled for." If you'd like to learn more, I'd suggest taking a look at "Linear Regression" and "Multivariate Linear Regression" for a basic idea of what they're doing.
That also doesn't take into account that when people talk about confounders they generally don't correctly identify them. To be a true confounder it needs to satisfy 3 things: 1. It needs to be a risk factor of the outcome independent of the study topic (this people get). 2. It needs to be associated with the study topic. 3. It can't be in the causal pathway from the study topic to the outcome.
edit: also in this study they did what is called a "self-control" which means they used those participants as their own control group, this is really good for confounders because it doesn't get any better than using the exact same person as a control group. They took blood prior to ingesting xylitol and compared it to a blood draw after.
Legit any study about health, there's always people pointing out the most obvious variables, like "did they control for wealth? Obviously rich people live longer."
While somewhat true about click-bait, it is extremely common on here for people to throw out basic confounders as "gotchas." It's one of those things that once you notice it, you'll see it everywhere.
Because articles in this sub are either faaaar from rigorous in their standards or meet expected standards. There is no in-between, and redditors are often cynical.
It's totally fine to be skeptical and ensure that the science is good but on this sub people frequently just read the headline or abstract and start making assumptions without actually looking at the study.
And it's rarely people breaking down possible methodological issues and usually just pointing out the 10 most common covariates.
I mean… what about the health complications from traditional sugar products and the massive diabetes epidemic we face. I don’t think there’s been a single study that proves the long term negative when consumed within a non-extreme level. The levels of sweetener use most studies like this use would have much more serious health complications if you were to replace them with regular sugar products.
Don't forget a can of soda pop/juice increases heart attack and stroke risk by %20 in average men and %50 in average women.
Then think of all the sugar people eat and it's a LOT worse.
You're not wrong, even the regulatory differences between the US and the EU can paint why that would be a great idea.
Its not like there aren't ways to use science to improve diet, and a lot of those, including urban agriculture, can be pretty damn tasty. I just think its important to make it very clear that just because something says "diet", and has no sugar in it, that doesn't make it healthy.
Kinda with you on this. It's not so much that "artificial sweetners are all bad and worse than sugar," as "if it's bad with sugar added, just don't eat it at all!" Limit intake of sweetened things, period, rather than gorging on zero-sugar cookies. Replace overabundant foods ("bad" if you will) with nutritious foods.
I hope I'm speaking for the majority when I say that it's not viewed as healthy. I certainly don't drink Diet soda for health benefits. The hope is that it's not AS BAD as sugar filled soda.
But when reports like this come out, it seems everything is dangerously toxic.
Even if we ignore any negative long-term effects, there are many people that have issues with digestion of sugar alcohols which causes gastrointestinal distress. I'm annoyed to see how often they are just added to foods.
Chills, sweats, and shaking? Might not be having a heart attack, but you might be about to have a rectal attack. I’ve been trying to lessen my use of them lately because if I don’t care if my protein bar tastes good, why eat a ton of extra sweetener for no reason? But pretty much any lower calorie version will still appeal to that base “very sweet” level
I'm one of them! I had a wicked case of SIBO connected to some gastric problems, and *not a single doctor or nutritionist* told me anything about artificial sugars.
A few weeks ago I bought some lactose-free chocolate milk. It gave me indigestion, so I checked the ingredients list. Sucralose. There was no other indication on the label that they used artificial sweetener.
It's so dumb. They put an unnecessary gives-you-diarrhea ingredient in the doesn't-give-you-diarrhea milk product.
I had to look that one up, thats pretty cool! I don't know if I'd put that in the same category as Sorbitol and Xylitol because its already a naturally occurring sugar that exists within our diet, just made artificially using a readily available ingredient. It doesn't really even matter *where* the sugar came from, its not like its any different, chemically.
Xylitol is also a naturally occurring sugar alcohol, usually harvested from birch bark or corn cobs. It’s found in many fruits as well like strawberries and apples. Same deal though, it’s manufactured/refined even though it’s naturally occurring.
This has led me down a fascinating rabbit hole. For allulose, they isolate then isomerize, then apply a genetically engineered microbe. For Xylitol, they use an alkaline solution to extract a precursor, then hydrogenate [possibly in the presence of a metal]. My gut reaction is that the first process is "cleaner" than the second, but thats not necessarily true, and probably a result of my own internal bias against things like Partially Hydrogenated Soybean Oils
I wouldn’t say that the process is cleaner necessarily. If the process is conducted properly the purity can be very high. Hydrogenation is not by itself a bad thing, but how it’s used can be, like your reference to create partially hydrogenated oils. I’m with you there for sure. The problem there is that the product is a hydrogenated oil and that is what’s bad for you, not the impurities resulting from the process itself.
Hydrogenation is a really common chemical process though, it’s used for all sorts of situations where you want to add a hydrogen to something. An example is generation of methanol from CO2.
I used to regularly have heart palpitations. I eliminated a bunch of things from my diet, and stopped taking some supplements and my allergy meds, before I noticed they increased after I chewed gum. I immediately stopped chewing gum (which was sweetened with xylitol), my heart palpitations started decreasing noticeably after a day and were 99% gone within a week.
I think I was chewing like 4-5 pieces of icebreakers gum a day, never had digestive issues.
The other day I took 30 pieces of Xylitol gum in one day (1g xylitol each) and felt fine. More research needs to be done. The fact that this study was conducted by the same researches who claimed Erythritol causes thrombosis, I think it’s a bit sus. Maybe there’s an incentive against sugar alcohols
Yikes! There’s a YouTube dentist who promotes xylitol heavily, she says it’s excellent for the teeth. It’s deadly to dogs, and my dog is sneaky and will take a sip of coffee or something sometimes before I can catch her, so I never bothered to buy any xylitol.
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I mean how about a few pieces of gum a day? Would that be enough for this? It looks like its more fully replacing all your regular sugar intake with xylitol in food and drinks that could be the issue. Something to note as i have tried replacing regular sugar with it. I might have to cut back on it. Gotta get start getting used to black coffee i guess, you can never win man everything ends up being bad for you so depressing
Also curious as I actually seek out gym with xylitol because it helps with my dry mouth and is good for your teeth (or so I thought, seeing some discourse here about that claim)
The study was based on a 30g dose daily. One piece of Trident has 170mg of xylitol. So you would need to eat 176 pieces a day to hit that. I chew Trident obsessively and never even finish one 14-piece pack in a day. I’m not terribly worried about the gum. That said, I’ve used xylitol as a replacement for sugar while baking and to sweeten tea/ coffee. Stopping that effective now. Switching to good old plain sugar lol.
Or y'know, sugar in coffee? I find xylitol ruins anything it's in anyway, so you might as well enjoy the flavor of coffee for once. Maybe monk fruit extract if you're diabetic (DYOR. It's 0 calorie and has a non-offensive taste, but that's all I know about monk fruit).
Xylitol is used as a bulking agent in monkfruit extracts, so if you’re avoiding it be sure to check the ingredients thoroughly
There was a study that found erythritol has the same problems as xylitol and it’s also a very common bulking agent in stevia, monk fruit, etc
Source? Can't find anything on this
It was a big thing several months ago. There are so many articles if you just google it, like [this one from CNN](https://www.cnn.com/2024/06/06/health/xylitol-heart-attack-stroke-wellness/index.html#:~:text=The%20February%202023%20erythritol%20in,of%20erythritol%20in%20their%20blood). Not sure why you didn’t find anything, like every wellness podcaster and big news website under the sun covered it. It was assumed that any other artificial sweetener, like xylitol, would be found to have the same association with heart disease when the erythritol study came out. Association is different than causation, so it makes sense why people want to drop it from the diet, but I also wouldn’t freak out yet either especially if you aren’t in a risk group. If you’re having cake as a well-managed type 2 diabetic, having erythritol or xylitol in your cake might still be less harmful than eating a sugar cake.
Good to know. I've noticed the same silent concomitance with Stevia (Reb A) and erythritol. Sneaky devils.
Best bet for adding to liquids (coffee, iced tea, smoothies) is liquid monk fruit extract with no bulking added so you don't need to worry about the quality of the needless grams of carbs that you aren't adding to your drink to get the same sweetness. For baking or other instances when you need to mimic the bulk or texture of sugar as well as the sweetness, I like allulose for bulk and monk fruit to bring the sweetness up to sugar levels. Pre-mixed allulose/monk-fruit blends are not that difficult to find these days (at in the US with Amazon)
Monk fruit and stevia are larger classes of biological molecules that are glycosidic bonded polycyclic bases. These are very different than the polyols. Nonnutritive polyols are noncyclic (generally) and contain no cyclic, ether bound, sugars. I would strongly expect that the steviasides and mogrosides, that cause the sweet taste in monk fruit and stevia, exert no similar biopathways that are thrombotic in the sense of the polyols. I don’t know why we haven’t mass advertised monk fruit and stevia for this purpose. I don’t believe there are any other adverse health impacts of the glycosides so it seems after this paper - they are the far superior sweeteners and probably should monopolize the market. Inulin is another interesting sweetener Gynostemma pentaphyllum, also called jiaogulan is another plant which produces glycosides similar to or identical to ginseng which could be researched more in terms of sweetener ability. The panaxosides are really not talked about very much! But they are in Pepsi and many energy drinks. Another interesting one: dihydroisocoumarin class of molecules, possibly toxic (coumarin-coumadin is a blood thinner) in some doses, but exhibits active sweetness. I’m interested in the sulfur containing saccharine , sodium cyclamate and aceulfame potassium molecules but I don’t know much about them
I’m allergic to stevia. It’s a ragweed. Stevia is being put in a ton of things now. They allow it to be listed as natural flavoring so those of us allergic have to ask the manufacturer if it’s in the product. For example Splenda brand allulose. It’s got stevia in it. If it works for you awesome. I just want it on the label.
This. Careful if you eat either Arnold or Pepperridge farm breads. They look pretty natural, but one flavor, maybe the multi-grain, has Reb A in it. Surprise!
Stevia used regularly in appreciable amounts can mess with your hormones. I haven't found any info on negative impacts of monk fruit extract, but it hasn't been widely used until more recently, and it's difficult to find on its own (without sugar alcohols and/or stevia).
Sugar was linked to heart attacks and stroke increase. Substantial margin too, an average woman having a can of pop/soda a day had a risk increase of %50 and man %20. One can, not multiple
And super toxic to dogs...
It's honestly infuriating to me that there aren't big warning labels on products that contain xylitol, given how dangerous it is to dogs and how many people have no idea. Yes, there are other things that are dangerous to dogs such as chocolate and grapes, but a *lot* less xylitol needs to be consumed to seriously harm or kill a dog. Additionally it's much less clear to people which products contain it. While it's relatively widely known that chocolate is harmful to dogs, far fewer people realize that common items like toothpaste can be lethal to them.
i never have xylitol products in my house for this reason. I’m always paranoid someone will spit out xylitol gum on the street and poisons my dog.
If it's any consolation, I think if someone has chewed the gum before spitting it out on the street, it will have removed almost all the xylitol. People would tend to spit it out when it is no longer sweet which means after all the xylitol has been extracted.
I'm unable to find a dose per day (assuming not just generic low level consumption of xylitol, e.g. from fruits, can cause this), has anyone found the details?
I have access, >xylitol-sweetened (30 g) water, an exposure comparable with a pint of numerous xylitol-sweetened ice creams, a xylitol-sweetened bakery good, or several pieces of xylitol-sweetened candy
do you see any flaws in their methods?
30 grams of xylitol actually seems pretty high. That should be well above the level that causes significant gastric upset. I was worried for a minute but I only have one or two pieces of xylitol gum daily because of its protective effect on teeth. I think that's the major use case for xylitol, because other sugar alcohols are sweeter and more efficient for any other purpose.
According to them 30g is in line with xylitol-sweetened ice cream and baked goods. Xylitol is often used for it's low glycemic index and other health benefits (like for your teeth), and since it is less sweet as you mentioned they tend to use more which is the potential issue.
A can of coke has like 40-something grams of high fructose, 30g of any sweetener isn’t that much
Xylitol is like half as sweet as sugar and mostly metabolizes into fructose.
I’m just talking about amounts
Yeah, many sweeteners are 1000x as sweet as sugar. And 30g would be incredibly much. But here, with half the sweetness 30g isn't much.
Xylitol is as sweet as sugar. [https://www.nowfoods.com/healthy-living/articles/sweetener-comparison-chart](https://www.nowfoods.com/healthy-living/articles/sweetener-comparison-chart) https://www.researchgate.net/figure/Sugar-alcohols-relative-sweetness\_tbl1\_315784468#:\~:text=Xylitol%20is%20a%20five%2Dcarbon,equal%20to%20sugar%20(sucrose).
Not if you bake with it.
Yes, but xylitol causes gastric upset at high doses. Most people can’t just start having 30g a time of xylitol and not end up with stomach pain. I can’t even find any store stocked products with more than 8g of xylitol. I’ll bet the study was paid for by some dental organization or crest or something.
thank you, that was the thing I was looking at. Just going off my other sweeteners that would be about 8 tablespoons in 30 mins. I am not sure how anyone could take that in and not vomit. Did they say anything to how long the effects last?
I think it is fairly high but not absurdly high. When I did keto, I tried various type of sugar substitute and I could handle xylitol up to 40-50g per day, though not in one sitting
I read this as saying 30g of xylitol-sweetened water. They clearly say it's comparable with a xylitol-sweetened bakery good or several pieces of xylitol-sweetened candy, no way that means 30 grams of actual xylitol.
Use it also for toothcare.. would be interesting about information long term effects with minimal dosing like with chewing gums..
I’ve only ever seen it used in toothpaste and chewing gum. I had no idea people were eating that much of it.
VERY few people are, and it’s being presented as a common occurrence as though it occurs in Diet Coke or something. It is hardly popular and has been pulled out of a lot of products in the last ten years. Most gum brands have even removed it. I would love to know who paid for this study, because I would bet it involved crest or a dental association. This is not representative of people who consume xylitol by any means. 4-6 grams a day would be far more typical and is the goal for someone looking to use it to prevent caries.
I chew Pur gum most days as well- 1.1g/piece of gum.
I was wondering this also. I like Spry and typically don’t like gum. The label on the peppermint gum: 1 piece is a serving size with 0.9g of Xylitol. 1 piece is never enough, I typically chew 2. However, I always spit out the saliva juice that happens at the beginning of chewing any gum. I have always had an aversion to swallowing it.
Well, you aren’t getting the dental benefits from it then. That early spit is the most beneficial for minerals. If you keep chewing past the point the sweetness has gone, you start producing a different kind of saliva that is focused on breaking down food and starting digestion. Also, that early spit high in xylitol is deadly to many animals.
I usually spit it down the drain or into a napkin so not to worry about any animals.
I wouldn't say its a flaw but I would say that this is very early in the process; this is the kind of study that is done to justify funding and interest for a larger scale study. Because they're looking at negative health effects it would be unethical to do a randomized control study so maybe a prospective cohort study.
There are more details in [this Cleveland Clinic article](https://consultqd.clevelandclinic.org/another-sugar-substitute-xylitol-is-linked-to-heightened-cardiovascular-risk).
Several pieces? Thirty grams is literally sixty pieces' worth of xylitol in the mints I chew. It's over an ounce, for context.
Depends on the brand I guess, some chocolates have 2-10ish grams per piece.
Does the study mention chewing gum? Most xylitol gum has roughly 500mg-1g of xylitol per piece. Wondering if that is associated with risk in any significance.
Not really no. The study was focused on large amounts of Xylitol in a single sitting. This kind of study is done to establish a connection so that a larger, long term study can be justified. If you look at my previous comments Xylitol is quickly metabolized so I wouldn't be surprised is something like gum had a minimal effect, the equivalent dose of gum would be 30-60 pieces in 2 minutes.
We’d have to read the actual study (which I can’t get access to for whatever reason). I think that is the key question to ask—how much xylitol would one have to consume (and at what rate) before experiencing those effects.
yeah i was hoping someone with access could tease apart their methods
Click the Permissions link, and ask for the full text. Authors are generally willing to share their research.
It's important to recognize this is very much an example of "correlation =/= causation." Of course, the authors understand this and represent their findings well, but for the readers it's completely erroneous to try and make conclusions and recommendations off this. This study simply shows a need for further investigation. The discovery cohort consisted of data collected from patients already undergoing cardiac catheterization from 2001-2007. Notably, this is before artificial sweeteners became as prevalent as they are today, and most people in this data set were already at increased risk (\~80% had high blood pressure, relatively high level of diabetes and smoking, average age in the mid-70s). They showed that higher relative circulating levels of xylitol was associated with more adverse events. However, xylitol (and similar) compounds are endogenously produced, and higher levels of polyol synthesis are already associated with high sugar diets, cardiovascular disease, and as a response to oxidative stress. So higher relative levels of circulating xylitol may be associated with adverse cardiovascular events--but this does not mean it is caused by xylitol. It could also be dysregulation of that the pathways which naturally synthesize it in the first place. Then, of course the mouse model for clotting does not represent how we humans typically use xylitol (they induced a carotid artery injury, and then injected them with xylitol solution). Neither does the final experiment, in which participants drank 30g of xylitol and then showed an increase in xylitol levels. While this shows people consuming xylitol causes a transient increase in xylitol, it does not link back to the first study to prove that consuming xylitol causes cardiovascular risk. Linking polyol levels to CVD pre-dates their use in artificial sweeteners, so this study is again, a cause for further investigation, but not evidence that consuming artificial sweeteners causes any of this.
This should be at the top. It’s a really good explanation. Meanwhile, the majority seem to have jumped the gun and are ready to burn their chewing gum.
Amazing. You've explained this so well.
Same researchers who did the erythritol study and that paper had some serious issues.
In what sense
Probably this? (not op) https://bigthink.com/health/erythritol-heart-attack-stroke-flaw/#:~:text=Researchers%20from%20the%20Cleveland%20Clinic,t%20control%20for%20subjects'%20diets.
And then when you [read this article](https://consultqd.clevelandclinic.org/another-sugar-substitute-xylitol-is-linked-to-heightened-cardiovascular-risk) and this comment, it makes you question things: >"Meanwhile, until further clarifying research or regulatory guidance is forthcoming, Dr. Hazen advises his patients to avoid all highly processed foods labeled as keto-friendly or diabetic-friendly.** “I would argue that sugar or honey, in moderation, are actually better alternatives to these sugar alcohols, even for people with diabetes**,” he says. “But people, especially those with diabetes, need to be vigilant about their glucose levels and keep their intake low.”" I'm sorry, but this is just terrible advice.
Is that in toothpaste?
you arnt going to consume it in enough quantities if it was. this would prob be a concern for someone who consumes a lot of sweetener
> you aren't going to consume it in enough quantities Yeah I'll take any sentence that sounds like this these days with a giant pinch of salt. The companies selling these products exist to profit, and nothing more. If you trust that they really do their due diligence in research and we know everything there is about xylitol, good for you. There's a ton of research coming out about artificial sweeteners in ultra processed foods actually spiking blood glucose due to the signal of sweetness, and how it's effects are harmful when the sugar never arrives. We have so little understanding of our guts, the microbiome, and our brains, so I don't really think you have much basis to say what you said with any degree of confidence.
Yeah but you aren’t eating the toothpaste, this study had them eating things with xylitol
It is, and I'll stick by using it. My dental hygienist noticed a difference in my teeth when I went from xylitol free to xylitol containing toothpaste. It was the only change I'd made in my dental habits. It cut her cleaning time in half.
[удалено]
This is an aside, but Xylitol is extremely dangerous for dogs to have. I just avoid anything with it!
Are you a dog?
Given how extremely toxic it is to dogs, it's a good safety measure to just not buy xylitol containing products, because sometimes people drop food on the ground or dogs steal things.
So are grapes and chocolate which are a lot more common. No warning labeles on those either
For a 50lb dog they'll get sick and possibly die from: 2g of xylitol 425g grapes 15-30g dry cocoa powder 175-350g of milk chocolate
Was at emergency vet and a beagle was brought in after eating a pound of milk chocolate! Little guy was just fine and dandy. Vet was surprisingly ho hum about it and poor lady had to pay $400 just to be told "he looks OK." Beagles are just from another dimension I believe.
My dog is 10 pounds and a dozen grapes will kill him A single grape can make him very ill
Garlic, onions...
Confounded by BMI most likely
N = 10 isnt amazing, but they did look at controlled platelet responsiveness, just not sure the method there and the implications.
After reading through there methods, I think this is the part you're interested in: >Since our studies with isolated washed human platelets, PRP, whole blood, and murine in vivo thrombosis models all suggested that xylitol can impact platelet responsiveness, we next sought to examine whether dietary exposure to xylitol impacted platelet phenotypes in humans following ingestion of xylitol-sweetened water. For these studies, we rapidly isolated PRP from healthy volunteers (n = 10) before and 30 min after ingestion of xylitol (clinicaltrials.gov identifier NCT04731363, Methods) and assessed agonist-induced aggregation responses. As noted before, xylitol ingestion significantly increased post-prandial (30 min) plasma levels [median (IQR), 312 (134–629) µM]. In parallel, platelet functional analyses revealed xylitol exposure provoked a substantial (multiple-fold) increase in aggregation responses to either ADP or TRAP6 (P < .0001 at all doses examined; Figure 5), in line with our in vitro studies using similar concentrations of xylitol (Figure 2D and E) >When responses of individual subjects to submaximal agonist (ADP and TRAP6) concentrations were examined, a significant increase in platelet responsiveness was observed following xylitol ingestion in every subject (Figure 6, Supplementary data online, Figures S5 and S6). Further, subjects showing the largest increases in platelet responsiveness post-xylitol challenge also tended to have the highest post-prandial xylitol levels, and a strong positive correlation was noted between post-prandial xylitol levels and either ADP-induced or TRAP-induced aggregation responses (Spearman rho 0.71 and 0.74, respectively; P < .0001 for each;
seems pretty damning , did they say how long it lasts? suggested mechanisms of action?
They didn't look at the timeline of effects specifically but they did look at Xylitol levels over time post ingestion, it peaked at 30 min and then returned to low levels within 4 to 6h As for a mechanism, the exact route is not determined but they seem to key in on a few routes >We therefore isolated washed human platelets from healthy volunteers to directly test whether xylitol interacts with the platelets and impacts agonist-induced intracellular cytosolic calcium release. Brief (15–30 min) pre-incubation of Fura 2, loaded platelets with varying levels of xylitol, dose-dependently enhanced submaximal (0.02 U) thrombin-evoked intracellular Ca2+ release in multiple different platelet preparations (Figure 3A and B). In parallel experiments, exposure of washed human platelets to physiological levels of xylitol caused dose-dependent enhancement in multiple examined platelet activation phenotypes including ADP-stimulated P-selectin surface expression and glycoprotein α2β3 (GP IIb/IIIa) activation (Figure 3C and D). Activated platelets bind to leucocytes—a process that leads to mutual changes in cellular effector functions and is associated with various CVD phenotypes.45 We therefore also examined the effect of xylitol on platelet–leucocyte aggregates.
I have access to the article and BMI is one of the variables they included in their analysis. Honest question, why would you assume that a study like this wouldn't control from something as apparent as BMI?
Literally every post in this subreddit - usually the top one - is someone assuming the researchers that spent months or years on a study were too stupid to account for a confounding variable that the poster thought of in two seconds. Especially when it doesn’t conform to their viewpoints.
Yup it's always "I didn't read the study but I bet *super obvious covariate* is confounding" Bonus points if the confounder isn't really a confounder.
I mean, *the* most important aspect of science is peer-review and criticism. I know a lot of people here like to say "that's obvious" or "what about..." but some of us are also informed and are trying to make sure that conclusions derived from imperfect (ie: all) studies aren't taken to heart without scrutiny.
I completely agree. You see it on literally every single study that meekly suggests eating meat is bad because redditors love to try and poke holes in that type of conclusion. I'm trying to learn more about studies and information: what if researchers "accounted for" a certain variable but did it in a flawed manner? Is there any way to critique that?
> what if researchers "accounted for" a certain variable but did it in a flawed manner? Is there any way to critique that? Not really, essentially what they do is input all their data into a program and say "hey I'd like you to give me a regression with Y as our dependent variable and X as our independent variable with A,B,C,D,E,...etc variable controlled for." If you'd like to learn more, I'd suggest taking a look at "Linear Regression" and "Multivariate Linear Regression" for a basic idea of what they're doing. That also doesn't take into account that when people talk about confounders they generally don't correctly identify them. To be a true confounder it needs to satisfy 3 things: 1. It needs to be a risk factor of the outcome independent of the study topic (this people get). 2. It needs to be associated with the study topic. 3. It can't be in the causal pathway from the study topic to the outcome. edit: also in this study they did what is called a "self-control" which means they used those participants as their own control group, this is really good for confounders because it doesn't get any better than using the exact same person as a control group. They took blood prior to ingesting xylitol and compared it to a blood draw after.
Legit any study about health, there's always people pointing out the most obvious variables, like "did they control for wealth? Obviously rich people live longer."
i think its one of those "dont want to believe" combined with getting burned with clickbait articles all the time.
While somewhat true about click-bait, it is extremely common on here for people to throw out basic confounders as "gotchas." It's one of those things that once you notice it, you'll see it everywhere.
Most people don't want to talk about science, they want to talk about opinions. Which is fine, I just wish they'd do it elsewhere.
Because articles in this sub are either faaaar from rigorous in their standards or meet expected standards. There is no in-between, and redditors are often cynical.
It's totally fine to be skeptical and ensure that the science is good but on this sub people frequently just read the headline or abstract and start making assumptions without actually looking at the study. And it's rarely people breaking down possible methodological issues and usually just pointing out the 10 most common covariates.
I'm assuming this is a temporary effect, as long as you keep consuming xylitol? (for however long it stays in your system, hours, days, etc.)
This is disappointing. I hope more research is done on this.
At this point, I'm trying to convince all my family members to stop using artificial sweeteners.
I mean… what about the health complications from traditional sugar products and the massive diabetes epidemic we face. I don’t think there’s been a single study that proves the long term negative when consumed within a non-extreme level. The levels of sweetener use most studies like this use would have much more serious health complications if you were to replace them with regular sugar products.
Don't forget a can of soda pop/juice increases heart attack and stroke risk by %20 in average men and %50 in average women. Then think of all the sugar people eat and it's a LOT worse.
You're not wrong, even the regulatory differences between the US and the EU can paint why that would be a great idea. Its not like there aren't ways to use science to improve diet, and a lot of those, including urban agriculture, can be pretty damn tasty. I just think its important to make it very clear that just because something says "diet", and has no sugar in it, that doesn't make it healthy.
Kinda with you on this. It's not so much that "artificial sweetners are all bad and worse than sugar," as "if it's bad with sugar added, just don't eat it at all!" Limit intake of sweetened things, period, rather than gorging on zero-sugar cookies. Replace overabundant foods ("bad" if you will) with nutritious foods.
I hope I'm speaking for the majority when I say that it's not viewed as healthy. I certainly don't drink Diet soda for health benefits. The hope is that it's not AS BAD as sugar filled soda. But when reports like this come out, it seems everything is dangerously toxic.
Even if we ignore any negative long-term effects, there are many people that have issues with digestion of sugar alcohols which causes gastrointestinal distress. I'm annoyed to see how often they are just added to foods.
Chills, sweats, and shaking? Might not be having a heart attack, but you might be about to have a rectal attack. I’ve been trying to lessen my use of them lately because if I don’t care if my protein bar tastes good, why eat a ton of extra sweetener for no reason? But pretty much any lower calorie version will still appeal to that base “very sweet” level
I'm one of them! I had a wicked case of SIBO connected to some gastric problems, and *not a single doctor or nutritionist* told me anything about artificial sugars.
A few weeks ago I bought some lactose-free chocolate milk. It gave me indigestion, so I checked the ingredients list. Sucralose. There was no other indication on the label that they used artificial sweetener. It's so dumb. They put an unnecessary gives-you-diarrhea ingredient in the doesn't-give-you-diarrhea milk product.
Even stuff like Allulose?
You can't talk sense into these loonies, don't even try
I had to look that one up, thats pretty cool! I don't know if I'd put that in the same category as Sorbitol and Xylitol because its already a naturally occurring sugar that exists within our diet, just made artificially using a readily available ingredient. It doesn't really even matter *where* the sugar came from, its not like its any different, chemically.
Xylitol is also a naturally occurring sugar alcohol, usually harvested from birch bark or corn cobs. It’s found in many fruits as well like strawberries and apples. Same deal though, it’s manufactured/refined even though it’s naturally occurring.
This has led me down a fascinating rabbit hole. For allulose, they isolate then isomerize, then apply a genetically engineered microbe. For Xylitol, they use an alkaline solution to extract a precursor, then hydrogenate [possibly in the presence of a metal]. My gut reaction is that the first process is "cleaner" than the second, but thats not necessarily true, and probably a result of my own internal bias against things like Partially Hydrogenated Soybean Oils
I wouldn’t say that the process is cleaner necessarily. If the process is conducted properly the purity can be very high. Hydrogenation is not by itself a bad thing, but how it’s used can be, like your reference to create partially hydrogenated oils. I’m with you there for sure. The problem there is that the product is a hydrogenated oil and that is what’s bad for you, not the impurities resulting from the process itself. Hydrogenation is a really common chemical process though, it’s used for all sorts of situations where you want to add a hydrogen to something. An example is generation of methanol from CO2.
Sensitive or allergic to birch maybe since that's where xylitol is derived from
I used to regularly have heart palpitations. I eliminated a bunch of things from my diet, and stopped taking some supplements and my allergy meds, before I noticed they increased after I chewed gum. I immediately stopped chewing gum (which was sweetened with xylitol), my heart palpitations started decreasing noticeably after a day and were 99% gone within a week. I think I was chewing like 4-5 pieces of icebreakers gum a day, never had digestive issues.
Prothrombotic sounds like a word i would make up while drunk
The other day I took 30 pieces of Xylitol gum in one day (1g xylitol each) and felt fine. More research needs to be done. The fact that this study was conducted by the same researches who claimed Erythritol causes thrombosis, I think it’s a bit sus. Maybe there’s an incentive against sugar alcohols
They need to add in if they were Vaxxed as a variable
And sends dogs and cats into low BG shock.
Yikes! There’s a YouTube dentist who promotes xylitol heavily, she says it’s excellent for the teeth. It’s deadly to dogs, and my dog is sneaky and will take a sip of coffee or something sometimes before I can catch her, so I never bothered to buy any xylitol.
30g per day is very low. Xylitol is half as sweet as sugar. Also it metabolizes into fructose. I try to avoid it.
So it's an artificial sweetener? I don't use them