Evidence from longer term observational studies on weight show conflicting results but this type of research is limited and the findings cannot be directly linked to sweetener intake.

Xylitol (sometimes called wood sugar or birch sugar) is a common sugar substitute that can be toxic to dogs. Even small amounts can be fatal. Most dog owners are at least peripherally aware that xylitol can be dangerous for dogs, but not all dog owners know exactly how widely spread xylitol is, and the full range of products it can potentially be found in – and not all of them are what we would automatically think of as sweet foods, and some aren’t even actually food at all!About 50% of eaten xylitol is absorbed via the intestines. Of the remaining 50% that is not absorbed by the intestines, in humans, 50–75% of the xylitol remaining in the gut is fermented by gut bacteria into short-chain organic acids and gases, which may produce flatulence. The remnant unabsorbed xylitol that escapes fermentation is excreted unchanged, mostly in feces; less than 2g of xylitol out of every 100g ingested is excreted via urine. [20] Foster-Powell, K.; Holt, S.H.; Brand-Miller, J.C. (July 2002). "International table of glycemic index and glycemic load values: 2002". The American Journal of Clinical Nutrition. 76 (1): 5–56. doi: 10.1093/ajcn/76.1.5. PMID 12081815.

Marom, Tal; Marchisio, Paola; Tamir, Sharon Ovnat; Torretta, Sara; Gavriel, Haim; Esposito, Susanna (12 February 2016). "Complementary and alternative medicine treatment options for otitis media". Medicine. 95 (6): e2695. doi: 10.1097/MD.0000000000002695. ISSN 0025-7974. PMC 4753897. PMID 26871802. Xylitol". United States Code of Federal Regulations. Food Additives Permitted for Direct Addition to Food for Human Consumption, Special Dietary and Nutritional Additives. U.S. Food and Drug Administration. 1 April 2012. CFR Title21, Part172, Section172.395. Primarily, the liver metabolizes absorbed xylitol. The main metabolic route in humans occurs in cytoplasm, via nonspecific NAD-dependent dehydrogenase (polyol dehydrogenase), which transforms xylitol to D-xylulose. Specific xylulokinase phosphorylates it to D-xylulose-5-phosphate. This then goes to pentose phosphate pathway for further processing. [20]Chewing gums containing xylitol and sorbitol may affect caries development. [27] Xylitol-containing chewing gums displayed anticariogenic properties in all protocols, but it was unclear whether this effect was due to increased saliva flow. [27] A Cochrane review suggested a positive anticariogenic effect of xylitol-containing fluoride toothpastes when compared to fluoride-only toothpaste, but there was insufficient evidence to determine whether other xylitol-containing products can prevent caries in infants, children or adults. [28] Earache [ edit ] They're found in products such as drinks, desserts and ready meals, cakes, chewing gum and toothpaste. The substance occurs naturally in many fruits and vegetables and is even produced by the human body during normal metabolism. Increased xylitol consumption can increase oxalate, calcium, and phosphate excretion to urine (termed oxaluria, calciuria, and phosphaturia, respectively). These are known risk factors for kidney stone disease, but despite that, xylitol has not been linked to kidney disease in humans. [37] Dogs and other animals [ edit ]

Xylitol is a type of artificial sugar substitute that is used in place of natural sugar in a wide variety of different types of products, and which is a very common ingredient in sugar-free goods in the UK. Total Sweet Xylitol makes it easy to cut down on sugar: whether you want to lose weight or cut down on your sugar intake, Total Sweet Xylitol can help. Swapping your sugar for Xylitol lets you enjoy an indulgent cake, sprinkle of sweetness on your cereal, or cup of tea just how you like it with less calories and carbs.

Studies carried out in the United States to analyse the effect of xylitol and sorbitol blends in chewing gum and mints on dental plaque (the main cause of tooth decay and gum disease ) showed a considerable decline in plaque growth. Stimulates salivary flow Xylitol is also found as an additive to saline solution for nasal irrigation and has been reported to be effective in improving symptoms of chronic sinusitis. [14] Evidence from short term trials on drinks sweetened with no calorie sweeteners show that when they are consumed instead of sugary drinks, they can support lowering of energy intake and weight gain. There is no evidence sweeteners stimulate appetite in humans. Xylitol may be useful as an alternative to sugar for people with diabetes as it does not raise blood glucose or insulin levels, and has a reduced caloric value (2.4 kcal/g compared to 4.0 for sucrose), which is consistent with the objective of weight control.

a b Salli, Krista; Lehtinen, Markus J.; Tiihonen, Kirsti; Ouwehand, Arthur C. (6 August 2019). "Xylitol's health benefits beyond dental health: A comprehensive review". Nutrients. 11 (8): 1813. doi: 10.3390/nu11081813. ISSN 2072-6643. PMC 6723878. PMID 31390800. Burgos, Karen; Subramaniam, Persis; Arthur, Jennifer (21 November 2016). "Reformulation guide for small to medium sized companies" (PDF). Leatherhead Food Research. Archived from the original (PDF) on 27 September 2020 . Retrieved 28 October 2018– via The Food and Drink Federation. Wrolstad, Ronald E. (2012). Food Carbohydrate Chemistry. John Wiley & Sons. p.176. ISBN 9780813826653 . Retrieved 20 October 2012– via Google Books. Tiefenbacher, Karl F. (2017). "Technology of Main Ingredients – Sweeteners and Lipids". Wafer and Waffle. Elsevier. pp.123–225. doi: 10.1016/b978-0-12-809438-9.00003-x. ISBN 978-0-12-809438-9.Sugar-free products in general are very popular and there are a range of different sweetening agents that can be used in them in place of sugar, although xylitol is by far the most common of them. Paws off xylitol; It's dangerous for dogs". US Food and Drug Administration. 7 July 2021 . Retrieved 9 September 2021.