The most popular health concept in 2021 is the "sugar-free diet". The so-called "sugar-free" diet is to use sugar substitutes (referred to as sugar substitutes) as a sweetener to reduce sugar intake, thereby reducing the risk of metabolic diseases caused by excessive sugar intake.
A variety of sugar substitute snacks are everywhere, and aspartame, sucralose, and erythritol, which is caused by the fire of the Yuanyu Forest, are the most common sugar substitutes in the current ingredient list.
This slightly fanatical sugar substitute feast went all the way up until it met a mooncake of the Mid-Autumn Festival, which was famous for its "laxative" on major new media platforms, which temporarily aroused everyone's discussion about "whether sugar-free is harmless"...
Sugar-free mooncakes and sugar substitutes are on fire... | screenshot of Weibo
The culprit of the "laxative mooncake" incident is the maltitol of the sugar substitute family. In fact, sugar alcohols not only provide a "sweet but not fat" experience, but the other side of it is more closely related to health - anti-moth. Before becoming a compelling ingredient in mooncakes, sugar alcohol was advertised as a "food-grade" additive of plant origin as one of the selling points of many oral health products such as toothpaste, mouthwash and chewing gum.
So here's the problem. In addition to sweetness, what other effects can sugar alcohols have to prevent tooth decay? Is its moth-proof effect really so obvious?
There is no "sugar" but there is also "sugar"
For most people, "sugar" refers to the sugar in the list of ordinary household foods, that is, sucrose. However, sucrose is only one of many sugars used in the human diet. From a technical point of view, "sugar" applies to defining two types of carbohydrates: one is the more common free form of monosaccharides such as glucose, fructose, galactose, and the other is the most common disaccharides such as sucrose, lactose and maltose. These sugars, which are naturally found in fruits, vegetables, grains and dairy products, can be called natural sugars.
The opposite term for natural sugar is sweetener, also known as added sugar. As ingredients for food processing, they both meet taste needs and, in some cases, provide additional energy. Depending on whether they can provide calories, sweeteners are also divided into "nutritional" and "non-nutritional". Nutritional sweeteners provide calories, including sugars (obtained from natural foods and then added to processed foods, the chemical essence of which is still natural sugars) and sugar alcohols. Non-nutritive sweeteners provide little energy and can significantly increase sweetness with very little dosage, such as aspartame. Both sugar alcohols and non-nutritive sweeteners can replace sugar, so they are called sugar substitutes. So-called "low-sugar" or "sugar-free" foods, i.e. foods that partially or completely replace sugar-processed foods with sugar alcohols and non-nutritive sweeteners.
The "sugar" in the diet | courtesy of the author
In addition to providing excess energy and carrying a risk of disease, another drawback of "sugar" that has been criticized by modern dietary views is the oral health problems it brings. Sugar here refers to sugars that can be metabolized by oral bacteria and thus produce acidic substances, the so-called fermentable carbohydrates. It includes both natural sugars and sugars found in nutritional sweeteners.
Sugar alcohols are different. Although it can be metabolized by oral bacteria, it does not produce acidic substances. Tooth enamel cannot be corroded without acids, so tooth decay does not occur either.
Xylitol is the three killers of moth prevention
Unlike the principle of fluoride moth prevention, the anti-moth method of sugar alcohol is very unique. Taking xylitol as an example, its anti-moth has three major killer skills:
Sweet killer of caries
In fact, not only us, caries are also sweet control, the largest consumer group is "Streptococcus amoebras" (hereinafter referred to as streptococcus). Streptomycetes' favorite dessert is sucrose. When there is sucrose in the mouth, streptobacteria may preferentially choose sucrose as a delicacy, producing acidic substances and then causing tooth decay; and when the sucrose in the mouth is insufficient or completely absent, streptomyces have to retreat to the second choice of xylitol as a substitute.
Unfortunately, xylitol, although delicious and not inferior to sucrose, is actually a sweet killer. It can not only reduce the adhesion ability of streptobacteria on the surface of teeth, but also interfere with the energy production process of streptococcus, causing the metabolism of streptococcus to enter an ineffective energy cycle and eventually die. In addition, streptobacteria exposed to xylitol may develop resistance to xylitol, but the damage it causes to teeth is also greatly reduced.
变形链球菌丨Wikimedia Commons, Centers for Disease Control and Prevention's Public Health Image Library / Public domain
It can be seen that streptobacteria are actually "starved to death" by xylitol.
Booster for natural antimicrobials
In addition to actively killing streptobacteria, xylitol can also help the natural antibacterial agent , saliva, which together exert antibacterial effects. Although saliva itself has a certain antibacterial ability even without any external support, this ability is only a drop in the bucket compared to the more rampant caries or periodontal pathogenic bacteria. Xylitol can stimulate saliva secretion and increase saliva flow. Its moth prevention methods are as follows:
1. Increase the pH of the oral environment through the buffering effect of saliva, that is, strive to create an environment with less acidic substances, which will help prevent tooth decay, but also help prevent tooth acid erosion (another dental disease caused by acidic substances) and improve the symptoms of dry mouth;
2. Promote the remineralization of tooth enamel through mineral deposition in saliva, make the teeth themselves stronger, and enhance the acid resistance of tooth enamel;
3. Reduce the concentration of caries and periodontal pathogenic bacteria through the scouring effect of saliva and the antibacterial substances in it. In addition, xylitol can also increase the content of ammonia and amino acids in plaque, thus helping to neutralize the acid produced by caries-causing bacteria.
Blocker of vertical transmission
Tooth decay, in the final analysis, is that the bacterial metabolites destroy the surface structure of the tooth, so it is in a sense a contagious disease. Before the age of 3, children's immune systems are not yet developed, so they are highly susceptible to bacterial colonization. At this stage, infants and young children are easily kissed frequently by their parents, so that parents may inoculate their own mouths with streptovirus into their children's mouths. Studies have found that chewing xylitol gum by new mothers helps reduce the likelihood of vertical transmission of caries (mother-to-child transmission).
Kissing may inoculate streptococcus from the parent's mouth into the child's mouth | giphy
Xylitol's "capacity ceiling"
Although xylitol has a unique secret to prevent moths, it still has its own upper limit of ability.
Limited bacteriostatic capacity
Although xylitol has three killer tools against caries,it works on the premise that there is no sucrose or other fermentable carbohydrates in the mouth. At this time, even if you know that xylitol is a poison, streptobacteria can only "drink and quench thirst"! However, if there is sucrose or other fermentable carbohydrates, even if some streptozoes are unfortunately killed, they cannot be completely destroyed. Therefore, the "killing" effect of xylitol is likely to be greatly reduced by the simultaneous presence of sucrose or other fermentable carbohydrates. And xylitol is also not a broad-spectrum bacteriostatic component, it has little effect on aerobic bacteria or facultative anaerobic bacteria, so it has little effect on the microbial composition of plaque or saliva.
"Drug-resistant" bacteria are also common
As mentioned earlier, when streptococcus is exposed to xylitol, it may develop resistance to xylitol, which is called "drug resistance" in the narrow sense. Studies have found that people who have the habit of eating xylitol, 80% of the streptavirats in their mouths will be resistant to xylitol; in addition, not all streptococcus is sensitive to xylitol, and when it comes to caries that cannot be beaten, xylitol has no choice.
Xylitol's ability to resist tooth decay is also capped| Pixabay
Xylitol is moth resistant, these are worth noting
Dosage
Similar to maltitol, excessive intake of xylitol can cause imbalances in osmolality in the body and then cause diarrhea. Although tolerance varies from individual to individual due to sensitivity and weight, it is generally assumed that 100 g per day intake in adults or 45 g per day in children can cause diarrhea. In addition, the consumption of foods or beverages containing xylitol is not recommended for children under 3 years of age, as when they consume "sugar-free" drugs at the same time, they may additionally cause stomach problems due to excessive daily intake of xylitol. Xylitol for optimal moth prevention is 5 to 6 g more than 3 times a day.
usage
The most common form of xylitol moth prevention is in the form of chewing gum. Although the chewing action can further enhance its ability to promote saliva secretion, the time of single chewing should not exceed 20 minutes, and it is recommended to chew after meals. Elderly people with temporomandibular joint disorder syndrome are not recommended to chew gum.
Chewing gum don't chew too long Oh | giphy
In addition, xylitol mouthwashes, toothpaste and other oral health products are also more common. However, whether it is mouthwash or toothpaste, the effect of xylitol alone is not as effective as the combination of xylitol and antibacterial agents or fluorine.
Good medicine can also be sweet, but it's not as magical as you think. So the right way to open xylitol, have you learned?
bibliography
[1] Gupta P, Gupta N, Pawar AP, et al. Role of sugar and sugar substitutes in dental caries: a review[J]. ISRN Dent, 2013, 2013: 519421.
[2] Nayak PA, Nayak UA, Khandelwal V. The effect of xylitol on dental caries and oral flora[J]. Clin Cosmet Investig Dent, 2014, 6: 89-94.
[3] Zhan L. Rebalancing the caries microbiome dysbiosis: targeted treatment and sugar alcohols[J]. Adv Dent Res, 2018, 29(1): 110-116.
Author: Rich
Editor: Jin Xiaoming Crispy Fish
Typography: Washing dishes
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