Another sugar substitute is sorbitol, which is commonly used in syrups. Unfortunately, sorbitol is rapidly absorbed in humans13 where it is metabolized to fructose by the polyol pathway, so it is no safer than sugar. Xylitol is another sugar alcohol that is safer than sorbitol as only a small fraction of xylitol is metabolized by fructokinase.14 This likely accounts for why xylitol is better at preventing caries than sorbitol.15 Nevertheless, xylitol reduces vitamin C levels in the liver16 and can raise serum triglycerides and uric acid in humans when given intravenously.17 Hence, xylitol is
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