Xylitol — cavity-fighting sweetener a possible solution for osteoporosis

Townsend Letter for Doctors and Patients, May, 2002 by Ward Dean

Xylitol is a five-carbon sugar that has a number of unique properties. in addition to being a delicious, low calorie sugar substitute (40% fewer calories than an equivalent amount of table sugar [sucrose]), Xylitol does not cause significant changes in blood glucose or insulin, making it not only safe for diabetics and those trying to lose weight, but also a desirable sweetener for those who understand the importance of maintaining low levels of glucose and insulin as an anti-aging regimen. (1,2)

Among its other known benefits to health, regular Xylitol consumption results in fewer cavities (Figures 1 and 2), improved periodontal (gum) health, and reduction in nasal, sinus and oropharyngeal infections. Xylitol also is effective against H. pylori, the microorganism implicated in periodontal disease, bad breath, gastric and duodenal ulcers, and even stomach cancer (Table 1). (3) It now appears that another highly significant effect can be attributed to Xylitol.

Osteoporosis -- Age-related Bone Loss

Osteoporosis -- loss of bone density -- is another age-related disease for which there is no widely recognized means of prevention and treatment. Osteoporosis strikes women four times as often as men; 80% of the more than 28 million Americans currently threatened with osteoporosis are women. (4) Incidence levels for both sexes are high; one in two women and one in five men are at risk of developing osteoporotic fractures during their lifetimes. (5)

Osteoporosis is a metabolic bone disease that leads to deterioration of bone tissues and a loss of bone mass (Fig. 3). This contributes to bone fragility and increased susceptibility to fractures, particularly of the hip, spine and wrist. Fractures of the hip frequently require hospitalization and surgery, and can lead to permanent disability and death. Spinal or vertebral fractures, while not life-threatening, have serious consequences, including loss of height, severe back pain, and deformity.

According to figures compiled by the American Academy of Orthopaedic Surgeons, osteoporosis causes some 1.5 million fractures each year in the US. Costs for treating osteoporosis and related fractures approach 10 billion dollars annually. (5,6) As the baby boomer population ages over the next 30 years osteoporosis-related costs are projected to increase to between 50 to 80 billion dollars annually. Hip fractures alone represent a tremendous socioeconomic drain, accounting for more than half of all health care expenditures for fractures, as well as increasing significant incidence of disability and mortality. (6)

Standard Osteoporosis Prevention and Treatment

Regimens and substances that have been used singly and in combination to prevent and treat osteoporosis include:

1. Hormone replacement therapy with estrogens, progesterone, testosterone and anabolic steroids

2. Dietary supplementation with calcium, magnesium, and other minerals (including Calcium Hydroxyapatite)

3. Vitamins D and K

4. The bioflavonoid lpriflavone

5. Calcitonin nasal spray

6. Exercise

7. Growth hormone injections

8. Pharmaceutical agents in the bisphosphanate class

Although each of these modalities has been clinically tested with varying degrees of success, there is still no magic bullet that is universally effective in this chronic, debilitating illness.

Reversal of Bone Loss with Xylitol

A recent exciting study has shown that osteoporosis may be another condition for which Xylitol may be of help. In studies in Finland in 1994, Xylitol was shown to be able to maintain bone density in rats which had their ovaries surgically removed. (7) Without ovaries, estrogen levels in these rats plummeted -- and so did the bone density in the rats which were not given Xylitol. However, in ovariectomized rats which had been given Xylitol, bone density actually increased.

This early study strongly indicated that Xylitol might help maintain bone density in normally aging intact (non-"surgerized") animals. Now, this conjecture has apparently been confirmed. A recent report by the same team of Finnish scientists evaluated the effect of Xylitol on bone volume and bone mineral content in aged male rats, reinforcing their earlier study on female animals. (8)

Xylitol Reverses Bone Loss in Old Animals

In this recent study, 24 rats were given Xylitol in their diet for twenty months. At the end of this time, they were euthenized with carbon dioxide. The bone mineral content and volume of the bones was evaluated by several sophisticated analytical techniques.

The tibial (lower leg bone) density of control animals averaged 1.560 g/mm3, while the density of the tibia of the Xylitol-fed animals averaged 1.725 g/mm3, indicating a Xylitol-induced increase of bone density of nearly 10%.

The authors stated that "Xylitol consumption resulted in significant protection against aging-related loss of bone," and "The preserved bone volume indicates an anabolic and/or anti-catabolic effect...caused by Xylitol." They concluded: "A continuous moderate dietary Xylitol supplementation leads to an increased bone volume and to an increased bone mineral content in the long bones of aged rats. This indicates a Xylitol-induced protection against aging-related osteoporotic changes."