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Turku sugar studies XXI. Xylitol, sorbitol-, fructose- and sucrose-induced physico-chemical changes in saliva.

The aim was to study eventual physico-chemical changes occurring in whole saliva due to sweetened and unsweetened stimulators. The assay was carried out in 10 female subjects with regard to changes of pH, buffering capacity and electrolytes in saliva as influenced by chewing of fructose, sucrose, sorbitol and xylitol gum, gum base and paraffin. The flow rate of saliva was measured in relation to use of xylitol and sucrose chewing gum and unsweetened gum base. These sweeteners increased significantly the salivary flow rate in comparison to the unsweetened gum base. Generally, xylitol and sorbitol on one hand, and sucrose and fructose on the other, behaved in an almost similar way. Increased buffering capacity and elevation of pH saliva was found in the presence of the polyols tested.

Bicarbonates

[Use of maltose and a mixture of maltose, fructose and xylitol in parenteral feeding].

Maltose or maltose in combination with fructose and xylitol was administered intravenously to eight healthy male subjects. Constant maltose levels could not be attained in the blood at an infusion rate of 0.125 g maltose/kg body-weight and hour. Maximal concentrations of maltose were found at the end of the infusion period. 8.6 +/- 1.2% of the administered radioactivity was excreted into urine within 8 hours. Regarding the enzymatically determined maltose and glucose, the maltose balance was more favorable with the loss of only 3--3.5% carbohydrates into urine. The highest oxidation rate of the administered maltose was 1.5 g maltose/human volunteer and hour. During the experimental period of 8 hours 7.4 g maltose, corresponding to 37% of the applied dosis of the disaccharid, has been oxidized to and excreted as 14CO2. Xylitol and fructose did not effect utilisation and balance of maltose. Only the urinary excretion of glucose was higher when the combined solution was applied. At a limited infusion rate (0.125 g maltose/kg body-weight and hour) maltose or the combined solution maltose--xylitol--fructose may be recommended for parenteral nutrition.

Adult

[Physical properties and technological problems in the use of xylitol].

Xylitol may be used as a sweetening agent in few cases only, since it appears to be physiologically not so well tolerated as saccharose. From the nutritional viewpoint, it is therefore necessary in many cases to combine sugar substitute, principally to mix xylitol with fructose. Also for technological reasons, new combinations of sugar substitutes for xylitol-containing dietetic foodstuffs must often be found and primarily combinations of sugar substitutes and thickening and gelatinizing agents choose between. It is therefore required that dietetically valuable foodstuffs be developed in line with nutritional requirements and not simply imitate conventional food.

Crystallization

[Further improvement of the ACD-AG protective solution for blood. II. Behavior of the oxygen affinity of preserved blood in ACD-AG medium and in a protective solution with addition of pyruvate and xylitol and elevated Ph values].

The present paper deals with the behaviour of the oxygen transport function as well as the 2.3 DPG and ATP levels of erythrocytes during the storage in an ACD-AG solution. In the ACD-AG blood in P 50 fell from 20mm of Hg to values of 12 mm of Hg within 4 weeks of storage. The 2.3 DPG content had already fallen to values below 10% within a fortnight. Additions of xylitol (10 mM in the blood) and pyruvate (0.3 mM in the blood) will delay the decrease of P 50 and the 2.3 DPG content. Concerning the ATP behaviour there was no significant difference between ACD-AG blood and that with additions of xylitol and pyruvate. Up to a storage of a fortnight stored blood in the ACD-AG solution of xylitol and pyruvate will be equal to ACD-AG fresh blood as far as the parameter of oxygen transport function is concerned.

Adenosine Triphosphate

[Comparative studies during postoperative infusion of glucose or a combination of glucose, fructose and xylitol over five days (author's transl)].

Two groups of 12 cholecystectomized or vagotomized patients were given central venous infusions of either a combination of glucose, fructose and xylitol at the ratio of 1:2:1 or of glucose alone for 5 days. The dose was increased stepwise from 1.43 g/kg/h on operation day up to 7.14 g/kg/24 h on the fourth day after surgery, which equals 100-500 g/24 h for the average 70 kg patient. On both infusion regimens mean blood glucose values ranged from 98-124 mg/100 ml. Urinary losses of infused substrates amounted to 0.2-0.8 g/24 during glucose infusion and to 2.22-13.4 g/24 h during infusions of the carbohydrate combination. Regarding mean blood or serum values of lactate, pyruvate, uric acid, sodium, potassium, phosphorus, insulin and free fatty acids, no significant differences were found between the two types of carbohydrate infusion. Side effects were not observed. The results obtained allow conclusion that in clinical situations with moderate stress, such as the selective operations mentioned above, the combination of glucose, fructose and xylitol studied offers no advantage over glucose alone. However, in severely ill patients presenting with more pronounced glucose intolerance, further studies with sugar substitutes are warranted.

Cholecystectomy

Comparison between glucose and a combination of glucose, fructose, and xylitol as carbohydrates for total parenteral nutrition of surgical intensive care patients.

The effects of four day periods of infusions of 600 gm/24 hours glucose and 600 gm/24 hours of a combination of glucose, fructose, and xylitol were compared. This study was performed during total parenteral nutrition of twelve postoperative patients with major complications. The mean plasma glucose level was significantly lower during the infusion of the combination of sugars (154.2+/-19.5 mg/100 ml versus 193.9+/-15.0 mg/100 ml[p is less than 0.005). Furthermore, the required dosage of exogenous insulin was significantly lower (18.9+/-12.3 units/day versus 43.7+/-19.7 units/day [p is less than 0.01). Mean renal carbohydrate losses were 0.85 per cent during glucose infusion and 1.7 per cent during infusion of the combination. The influence of both infusion regimes on values for pH, base excess, lactate, pyruvate, free fatty acids, insulin, sodium, potassium, chloride, magnesium, phosphorus, bilirubin, alkaline phosphatase, SGOT, and SGPT 0.85 has been investigated. No clinical side effects were observed. It is concluded that the administration of the investigated combination of glucose, fructose, and xylitol is justified in patients in whom hyperglycemia during infusion of glucose alone is difficult to control with insulin.

Adolescent

Determination of xylitol in human urine by gas-liquid chromatography.

A rapid and specific method for the quantitative determination of xylitol in human urine has been developed. The method consists of the gas-liquid chromatographic analysis of the acetate ester derivative of the alditol in deionized urine using dulcitol as an internal standard. As little as 20 ng xylitol can be detected. At concentrations ranging from 25 to 400 micrograms/ml urine, the accuracy is +/- 4.0%.

Chromatography, Gas

Carbon and hydrogen metabolism of xylitol and various sugars in human erythrocytes.

1) Erythrocytes are able to metabolize D-ribose, D-xylitol, D-xylulose, D-fructose and D-glucose; the rates of metabolism increase in that order from 2430 to 26200 ng atom C/ml packed cells per 120 min of incubation. 2) The utilization of the carbon of these substrates and its recovery in the products were found to be in balance, when the change in the 2,3-bisphosphoglycerate concentration was taken into account. 3) The metabolic rates strongly affected the 2,3-bisphosphoglycerate level. Without addition of substrate the decomposition rate of this intermediate was found to be 1030 nmol/ml packed cells per 120 min. 4) The net decrease of the 2,3-bisphosphoglycerate concentration and the conversion of this compound into lactate provides a NAD regeneration system which enables the red blood cells to utilize xylitol. 5) The rate of carbon metabolism via the pentose phosphate cycle is determined by the NADPH requirement of the erythrocytes which was found to be 160 nmol/ml packed cells per 120 min under the experimental conditions employed.

Carbon

The amino acid composition of Streptococcus mutans and its culture medium supplemented with xylitol.

The amino and keto acid composition of the cells of Streptococcus mutans, strain Ingbritt, maintained and grown on a Trypticase-Phytone based medium without any added carbohydrate or supplemented with xylitol or glucose, was analyzed. The results showed no remarkable differences in the portions of individual amino acids liberated by acid hydrolysis from the cellular proteins of cells grown in the above mentioned media. However, the amount of free amino acids in the water extracts of the cells grown in the glucose medium differed considerably from those obtained from cells grown in the two other media. The amounts of free amino acids of the medium at the end of the growth period were higher in the glucose containing medium than in the two other media. The content of keto acids was lower in the cells grown in the presence of xylitol or without added carbohydrate when compared to those cells grown in glucose containing medium.

Amino Acids

Acid production from Lycasin, maltitol, sorbitol and xylitol by oral streptococci and lactobacilli.

The acid production from maltitol was compared with the acid production from hydrogenated starch hydrolysate (Lycasin), sorbitol and xylitol by a number of oral strains and reference strains of Streptococcus mutans, S. sanguis, S. salivarius, S. mitior, S. milleri, S. faecalis, S. faecium, S. avium, Lactobacillus casei and L. salivarius. The polyols were added to a final concentration of 1.0% to two different basal media. Incubation was performed at 37 degrees C for 7 days after which the pH was recorded. Maltitol was fermented only by the lactobacilli (about two thirds of the strains). Lycasin was fermented by all strains of S. faecalis, more than 90% of the lactobacilli, about half of the S. sanguis strains, about one third of the S. mutans strains, and by a few other streptococcal strains. Acid production from sorbitol was observed among more than 80% of the S. mutans strains and the S. faecalis strains and most of the lactobacilli strains. Sorbitol-fermenting strains of S. sanguis and of S. mitior, all isolated from sorbitol-consumers, were observed. No other sorbitol-fermenting streptococci were found. Only the reference strains L. salivarius subsp. salivarius ATCC 11741 and S. avium ATCC 14025 fermented xylitol.

Acids

Hemolysis in vitro by sorbose, sorbitol and xylitol.

L-sorbose, xylitol and sorbitol solutions (56 mM) were not hemolytic when incubated with erythrocytes of 30 healthy volunteers, 14 thalassemic heterozygotes and in 30 horses, 30 cows and 30 Osborne-Mendel rats. Lysis of dog erythrocytes was most pronounced when incubated with L-sorbose but was also significant in xylitol and sorbitol solutions.

Animals

[Sorbitol and xylitol in post-operative infusion therapy (author's transl)].

The effect of a 24-hour continuous infusion of sorbitol in the recommended maximum dosage of 0.25 g . kg-1 . h-1 or of xylitol in the recommended maximum dosage of 0.125 g . kg-1 . h-1 on metabolic parameters was investigated in seven healthy adult men. The results demonstrate the continued applicability for longer than the recommended time as well as the acceptability of continuous infusion of polyols used clinically with combined solutions.

Adult

Use of fructose, xylitol, or sorbitol as a sweetener in diabetes mellitus.

Nonnutritive sweeteners have been utilized in the diet of diabetic patients an an agent to replace glucose and sucrose. Since saccharin might be removed from the marketplace, the nutritive sweeteners fructose, xylitol, and sorbitol are being considered as possible alternatives for glucose and sucrose. This review considers the effects of these nutritive sweeteners on the main dietary concerns in the diabetic diet--control of blood glucose levels, obesity, and hyperlipidemia. The potential side effects of these agents are also reviewed.

Blood Glucose

An improved method for gas chromatographic determination of urinary xylitol and glucuronic, glucaric gulonic and ascorbic acids, with their values in the rat, rabbit, guinea-pig and marmoset.

1. Urinary levels of xylitol and glucuronic, glucaric, gulonic and ascorbic acids were measured in the rat, rabbit, guinea-pig and marmoset by an improved g.l.c. technique. 2. Administration of a compound (2-methylbenzanilide) known to be conjugated and excreted as a beta-glucuronide had some effect on the output of these compounds of the glucuronic acid pathway in all four species, and caused a significant decrease in gulonic acid in the rat.

Animals

Possible side effects of glucose, fructose, sorbitol and xylitol in man.

It is concluded that there are no specific and dramatic side effects of glucose substitutes, apart from the increase in uric acid synthesis. All other side effects are noticed with glucose as well. The danger of lactic acidosis is not indicated, provided a normal dose of fructose or other carbohydrates is used. With respect to sorbitol and xylitol, lactic acidosis was not considered a serious side effect until now. No facts are known to establish the hepatotoxicity for fructose or for another glucose substitute. The danger of hyperglycemia is smaller with the glucose substitutes as compared to glucose. Therefore, the glucose substitutes are an alternative to glucose under certain conditions.

Acidosis

[The metabolic behavior of the human plaque flora towards the sugar substitute xylitol].

By means of the Warburg technique, whether and to what extent microorganisms of the human plaque can metabolize xylitol under both aerobic and anaerobic conditions was studied, and the results were compared with those for saccharose. Under the chosen test conditions, this sugar alcohol was metabolized, if at all, in negligibly small traces only, during eight hours.

Aerobiosis

Use of fructose, sorbitol, or xylitol as a sweetener in diabetes mellitus.

Non-nutritive sweeteners have been utilized in the diet of diabetic patients as agents to replace glucose and sucrose. Since saccharin might be removed from the market place, the nutritive sweeteners, fructose, xylitol, and sorbitol, are being considered as possible atlernatives. This review considers the effects of these nutritive sweeteners on the main dietary concerns in the diabetic diet, i.e., control of blood glucose levels, obesity, and hyperlipidemia. The potential side effects of these agents are also reviewed.

Arteriosclerosis