Killing germs doesn’t work; let’s try feeding them.

Bacteria have a sweet tooth; feeding them the right sugars makes for friendlier

adaptation, reduces the need for antibiotics, and can help solve our problem of

antibiotic resistant microbes.

A.H. ‘Lon’ Jones DO Common Sense Medicine

Living things adapt; itʼs part of the definition of life. They adapt to changes in their

environments; and they adapt both offensively, with new ways to get a meal, and

defensively, with new ways to prevent their being a meal. Both are pertinent to the

practice of medicine.

Paul Ewald, in his book The Evolution of Infectious Disease, looks at how bacteria

adapt. He looks at some of the chronic diseases that affect humanity and how they

have changed. Cholera, for example, changes when the water supply is cleaned up to

a less virulent type. With this and other examples he concludes that if we focus on

killing the infecting agent we push them into developing defensively with resistance,

but if we constrain them in ways that do not threaten them they are more likely to adapt

offensively in ways that enhance their survival by finding a new niche that may also be

more friendly.

When a bacterium senses a threat it releases a chemical signal and when many

bacteria raise their voices in this way it results in the ʻquorum sensingʼ that triggers the

increase in mutation that leads to the development of resistance. Ewald argues that

reducing the threat, by a more restrained use of antibiotics, is a way to cope with this

problem; it lowers the collective voice and hence the resistance.

Ewald focused on ways to intercept the spread of infection such as clean drinking

water, hand washing and basic hygiene, bed nets, condoms, gowns, gloves and

masks when dealing with infective situations, etc. Another avenue that applies this

same selection pressure is interfering with bacterial or viral adherence. Interfering with

adherence is not a threat; it affects individual bacteria and does not trigger quorum

sensing. It just says ‘not here’, and the bacterium is more easily washed away.

In their book, Bacterial Adhesion to Animal Cells and Tissues, Ofek, Doyle and Hasty

show that most bacteria adhere by way of bacterial lectins binding to sugar complexes

on our cell surfaces. Nathan Sharon, the person who showed us that lectins have a

sweet tooth, was one of the pioneers of this concept as applied to infectious disease.

Working with the mannose lectin on strains of E. coli he realized the possibility of

competing at these binding sites; free mannose would fill the lectins and reduce both

adhesion to the cell and infection. He demonstrated that oral mannose administered

regularly switched out the intestinal coliforms with mannose lectins, which are the

dominant cause of urinary infections, to those without the mannose lectin. Women with

chronic urinary infections, most of which originate from bacteria in their own GI tracts,

would be well served by such treatment. Cranberry juice, with a high amount of

fructose, works in the same way but fructose is less efficacious than mannose.

Another related sugar-like molecule with similar effects is xylitol. Xylitol is a five carbon

sugar alcohol used commonly as a sugar substitute. It is especially useful for diabetics

and has been shown in a murine model to normalize many of its abnormalities.

Xylitol has also been shown to inhibit the adherence of many pathogens, most

specifically those in the nose, wounds, skin, and gut. While it has not been

demonstrated, the most likely reason for this broad effect on a variety of bacteria is the

open and flexible nature of the xylitol molecule which is able to fold and fit itself into

many of the lectins looking for a particular sugar molecule.

An example of the possible win-win that results from this kind of treatment is found with

the effect of xylitol on the bacteria that cause most tooth decay. Caries is the most

common infectious disease in the human. A cavity is started when Strep. mutans, living

in the dental biofilm (plaque), make acids from dietary sugars that then eat through the

enamel surfaces of the teeth. The well documented effect of xylitol on these bacteria is

to both reduce their number and pressure them to adapt, but when they do adapt–by

learning not to eat the xylitol–they also stop making the acid. Reductions in tooth

decay come from either path.

These examples show what is possible when we guide bacterial adaptation away from

defense. Equally effective is attending to our defenses.

Xylitol has another benefit when nebulized and inhaled. Joe Zabner and his group at

Iowa have been studying this use for children with cystic fibrosis.(1) They find that its

osmotic effects pull water into the airway surface fluid that enhances the protein based

defensins that are handicapped by the high concentrations of sodium present in these

children. It is unfortunate that their use is limited to iso-osmolar concentrations that

have little effect in a normal population,

Considering the escalation of upper respiratory problems over the past five decades

something to help nasal defenses do their job better would be a good thing. My own

experience with such a spray began after I read of Uhariʼs study reducing otitis with

xylitol sweetened chewing gum.(2) My grand daughter with recurrent otitis was too

young to chew gum. Uhari said the xylitol worked on the bacteria and since the

reservoir of bacteria that cause otitis is the nasopharynx it made sense to put it there.

Our use rapidly expanded to all nasal related problems, both infectious (where the

anti-adherence benefit is paramount) and allergic where the osmotic benefit works to

optimize our own nasal cleaning. This cleaning is based on mucociliary function that is

highly dependent on the water in the airway surface fluid, which supplies a fluid space

for ciliary beating as well as water for the concentrated mucus to absorb to become

optimally viscous and sticky. Arundel shows that ambient humidity over 40% reduces

upper respiratory problems, likely because it puts less demands on the airway surface


The increases we have seen in upper respiratory illness began in the mid 1960s and,

while correlation is not causation, are likely due to two changes that directly affect the

airway surface fluid. Central heating and cooling, increasingly common in new home

construction since the 60s, dries the air we breathe, and so does the misguided use of

medications commonly used to reign in the histamine response, or runny nose, that

Svensson points out is the back up defense.

These drugs were made OTC in the 60s and were heavily advertised on television.

The FDAʼs recommendation to remove them from the pediatric formulary in 2007 was

ostensibly based on caregiver misuse. When I suggested to them that the drugs also

compromised an important defense they called it an “interesting idea.”

Defenses like rhinorrhea have evolved because they help us clear pollutants from the

upper airway. Diarrhea is a similar defense for the GI tract. Hobbling these defenses is

not wise, but is common practice based on the mistaken idea that they represent

imbalances that signify illness rather than an altered homeostasis to cope with a

problem. The rest of the world has found help optimizing GI defenses with oral

rehydration solutions.

Like the use of xylitol to optimize nasal defenses oral rehydration is a simple mixture of

salt, sugar, and water in the right proportions; one molecule of glucose, two molecules

of sodium and the sodium-glucose transport system in the upper GI tract is activated

that pumps a disproportionate 210 molecules of water into the body. Drinking this

solution optimizes GI defenses by simply keeping the tank full. The editors of Lancet

point out that oral rehydration saved more lives in ten years than penicillin did in forty.

That is what helping defenses is capable of doing for our healthcare, and nasal

problems are arguably more common and expensive than GI.

Unfortunately these methods use commonly available materials (glucose (corn syrup

is closest), salt and xylitol) that are available at your grocery or health food store—they

bypass our profit driven healthcare system. That means that there is little possibility of

profit from their use, not much money to study them, and certainly not enough to jump

through FDA hoops to allow for making appropriate claims. Oral rehydration packets

are promoted by the World Health Organization and available around the world, but

the idea is almost unknown in the U.S. There is little choice, from our system’s point of

view, between the profit that comes from actively treating a person with an IV, with a

profit over $100.00, or having them drinking something costing a quarter.


1. Zabnerʼs reports are abstracted at pubmed: PMID: 11027360, 15194156,

15377394, 15510034, 16483382, 16781897, and 22564094.

2. The development of Xlear® nasal wash—xylitol in a saline nasal spray—for our

grand daughter was what brought me to see this use of xylitol. My initial report in The

Clinical Practice of Alternative Medicine was not indexed, but is available with

permission here.

Leave a Reply

Your email address will not be published.

*Insurance is designed to pay for the unexpected crisis. Health insurance started that way in the U.S. but gradually, because the companies we work for were paying for it and getting a better tax break, it morphed into paying for it all. That means we have less interest in getting the ounce of prevention than if we were paying for some of those costs. Children we talk to about the dangers of drugs just say they’ll get a brain transplant if they burn theirs out. That’s why we think that Health Savings Accounts should be promoted by the government more; they put the individual back in a position of responsibility in making more choices in their health care. With Health Savings Accounts an ounce of prevention is worth a pound of cure.

Disclaimer: All material provided in this web site is provided for educational purposes in the hope of improving our general health. Access of this web site does not create a doctor-patient relationship nor should the information contained on this web site be considered specific medical advice with respect to a specific patient and/or a specific condition. Copy sections of this page and discuss them with your physician to see if they apply to your own symptoms or medical condition.

Dr. Jones specifically disclaims any liability, loss or risk, personal or otherwise, that is or may be incurred as a consequence, directly or indirectly, of use or application of any of the information provided on this web site.

Copyright © 2014 Common Sense Medicine - Designed By Sebo Marketing