Xylitol, gut hormones and stomach emptying in people
What it found
In 12 healthy lean volunteers, xylitol given straight into the stomach made gut hormones rise and slowed stomach emptying, with only a small rise in blood sugar and insulin.
The authors say this mix of effects makes it an attractive sugar substitute.
What they found
Studies in people
Gut hormones rise
Xylitol caused a dose-dependent rise in the gut hormones CCK, aGLP-1 and PYY compared with tap water. The effect went up as the dose went up, with no sign of levelling off.
Stomach emptying slows
Xylitol slowed stomach emptying in a dose-dependent way. The time to empty half the dose was longer after 35 g xylitol than after tap water.
Blood sugar and insulin
Xylitol caused a dose-dependent rise in blood glucose and insulin compared with tap water. The authors describe the effect on glucose and insulin as only little.
Other gut hormones
Xylitol had no effect on motilin, glucagon or GIP release. One comparison found higher late glucagon after 35 g than after 17 g, but the authors say more studies are needed.
Blood lipids and uric acid
Blood lipids did not change from baseline within 120 minutes after 35 g xylitol. Uric acid rose significantly from baseline after 35 g xylitol, by 36% within the first 30 minutes, and had not returned to baseline by 120 minutes.
Tolerance and side effects
Doses up to 35 g were well tolerated. The most common finding was more bowel sounds, and two volunteers felt bloated after 17 g and 35 g. There was no abdominal pain, nausea, vomiting, diarrhea or flatulence after any dose.
What the authors conclude
“With this study we show that xylitol exhibits a combination of properties (weak effect on blood sugar levels but significant release of satiation hormones) that render this sweetener an attractive sugar substitute.”
Also in their conclusions
- They conclude that even low doses (7 to 35 g) of xylitol dose-dependently stimulate the secretion of CCK, aGLP-1 and PYY, and decelerate gastric emptying rates in lean participants.
- They say there is only little effect on plasma glucose and insulin, and no effect on motilin, GIP, or blood lipid concentrations.
- They advise that circulating uric acid concentrations increase acutely following xylitol consumption, the clinical implications are unclear and further research is necessary on this topic.
How it was done
Sugar intake is linked to a range of health problems and should be cut back, and the authors wanted to see whether xylitol could help as a sugar substitute. They also wanted to test whether xylitol's effects on gut hormones and stomach emptying go up with the dose.
Twelve healthy, lean volunteers took part in a randomised, placebo-controlled, double-blind, cross-over trial. On four separate days they received 7, 17 or 35 g xylitol, or tap water, as a liquid directly into the stomach through a tube. Blood and breath samples were taken for up to 180 and 240 minutes.
What it can’t tell you
- This was a single dose study in 12 healthy lean volunteers, so it cannot show what happens with long-term use or in other groups such as people with obesity or diabetes.
- The authors note that adaptive processes cannot be ruled out, so the effects of repeated intake are not known from this trial.
- The study did not measure motilin in sync with the migrating motor complex, so the authors say the effect on motilin is still not clear.
Who paid
- Conflicts
- The authors declare no conflict of interest.
- Authors work at
- University of Basel, Switzerland; University Hospital of Basel, Switzerland; Catholic University of Leuven, Belgium
The paper
- Title
- Effect of the Natural Sweetener Xylitol on Gut Hormone Secretion and Gastric Emptying in Humans: A Pilot Dose-Ranging Study
- Type
- Randomised controlled trial
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Meyer-Gerspach AC, Drewe J, Verbeure W, et al (2021). Effect of the Natural Sweetener Xylitol on Gut Hormone Secretion and Gastric Emptying in Humans: A Pilot Dose-Ranging Study. Nutrients. doi:10.3390/nu13010174Free full textPubMed 33429977DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error