Journal of Food: Microbiology, Safety & Hygiene
Open Access

Abstract

The Latest on Sugar Substitutes of the Alditol Type with Special Consideration of Erythritol and Xylitol―Rectifications and Recommendations

Kauko K Mäkinen

Sugar substitution with low-calorie carbohydrates constitutes a well-grounded approach to controlling energy intake to prevent obesity or certain diseases, and reducing the incidence of bacteria-associated diseases such as dental caries. This review discusses latest applications of alditol-type sugar substitutes with emphasis placed on erythritol (a tetritol) and xylitol (a pentitol). Especially xylitol has been shown to exert interesting biochemical effects (such as ammonia formation) in the dental biofilm. Understanding the oral biologic processes involved presumes referring to certain physicochemical aspects of alditols (such as complex formation with Ca(II), protein stabilization, hydroxyl radical scavenging, and others), which will be briefly discussed. This review also comments on the gastrointestinal effects associated with enteral administration of alditols, discusses the synergy between chlorhexidine and alditols, and the use of alditols in periodontal treatments (i.e. non-sweet applications of alditols), and focuses on European Union regulations on sugar substitutes. The article also attempts to rectify defective information regarding these sweeteners. A part of this information has passed unnoticed, since the data involved were published in supplements to regular volumes in the 1970s. The present review emphasizes the oral biologic significance of the xylitol-associated shift observed in the biology of the oral biofilm (dental plaque): from carbohydrate dominance to one where nitrogen metabolism plays an important role.