I probably get more questions about this category of sweeteners than any other, and for good reason. They’re called sugar alcohols, but they’re not sugar, and they’re not alcohol.
You may have seen some of the “-itol” sweeteners in diabetic candy and wondered, “Is that an artificial sweetener?”
You may see xylitol in your toothpaste and wonder the same.
You may have heard of an “-itol” that causes diarrhea and discounted it immediately, kind of like Olestra.
Or you may have heard praises sung by trusted nutrition sources and hoped that an “-itol” would be a good alternative sweetener without the calories.
I have to say, I think what amazes me most about this entire category is how prevalent they are, and yet how unquestioned. Many stevia blends have much more erythritol than stevia, yet people aren’t asking, “What’s that thing?” They’re just saying, “Is stevia safe?” because that’s the only sweetener listed on the FRONT of the package.
I’m not even sure if my antennae have been trained enough to catch all the “-itols” that might be buried in ingredients lists, as I’ve been so hyper-vigilant about completely artificial sweeteners.
Find the rest of the Sweet, Sweet Summer series HERE.
How is a Sugar Alcohol Processed
There are a lot of choices in this category, all “generally recognized as safe” or GRAS as far as the FDA is concerned. What does that mean? No one has proven it harmful. Innocent until proven guilty it kills someone and they can prove it.
Here’s a list with which to train your label-reading antennae:
- hydrogenated starch hydrolysates (HSH) – a family of sweeteners including hydrogenated glucose syrup, maltitol or sorbitol syrup
Sugar alcohols aren’t alcohol but have some chemical resemblances to it, and they often begin with a sugar but are also not sugar.
I keep trying to wrap my brain around exactly how these things are produced (clue number one that it’s not really food), and I just can’t do it. They all begin with some sort of natural starch or sugar (sometimes a chemical equivalent nowadays), then are fermented – some sources say hydrogenated or hydrolysed – into a sugar alcohol. How this all plays out is beyond me…but let’s move on.
In case you’re wondering just what you’re eating, these are the initial sources for the “-ose” – the sugar/starch found in nature – from which the “-itols” are derived:
- sorbitol, from glucose
- xylitol, from xylan, in birch bark – likely any sweetener that has “birch bark” in its title is xylitol
- erythritol, from corn
- mannitol, from glucose syrups
- lactitol, from lactose
- isomalt, from sucrose
Benefits of Sugar Alcohols
Similar to artificial sweeteners, the goal of sugar alcohols seems to be to reduce calories and glycemic load. Sugar alcohols are not calorie-free, but have 1/20 to 1/2 as many calories as sugar (from 0.2 to 2.7 calories per gram, compared to 4 calories in sucrose, table sugar). Sometimes they are listed as a “zero calorie sweetener,” though, so there must be a labeling loophole like the “zero grams trans fat” that allows manufacturers to list “zero” when it’s less than 0.5 g per serving.
They have fewer calories only because they’re not fully absorbed by the gut, passing on through without impacting the system. Or at least…without being absorbed. There’s something that doesn’t sit right with me about avoiding calories by eating things that are supposed to go right through you. Where’s the research on the safety there?
Whole corn goes right through most of the time, too (you know?), so does that mean it doesn’t contribute any calories to the meal? I just don’t know about that…
Unlike artificial sweeteners, which are usually 30-300 times sweeter than sugar, the sugar alcohols are less sweet than sugar, with 30-90% of the sweetness, depending on which one we’re talking about.
Almost all sugar alcohols are found naturally in some fruits (which fuels the labeling “all natural” even though they’re made in labs nowadays).
They do have an impact on insulin, but sugar alcohols require far less insulin response than other sweeteners, so they are lower on the glycemic index and often recommended for diabetics. It is important to note that some or most (?) DO incur an insulin response and are not “freebies.”
From a podcast by Pharmacist Ben (Ben Fuchs): xylitol will not touch insulin levels (although recent literature suggests that just the sweet taste of something may raise insulin). He calls it a “sweetener that’s like a nutritional supplement” and is a fan.
None of them impact cavities and tooth decay, which gives them a leg up over other natural sweeteners and sugar.
A few sugar alcohols have particular benefits worth mentioning:
- Xylitol may increase absorption of B-vitamins and calcium, re-mineralize tooth enamel and fight ear infections
- Erythritol is often lauded as the best of the sugar alcohols – zero calories, zero glycemic effect, and it may even have an antioxidant effect.
Nutritional Profile of Sugar Alcohols
The nutrition facts for one teaspoon (4g) of a sugar alcohol:
- sorbitol: 8 cal., 4 g carbs
- xylitol: 10 cal., 4 g carbs, glycemic index = 7
- erythritol: 0.8 cal., 4 g carbs, glycemic index = 0
- mannitol: 6.4 cal., glycemic index = 0
- lactitol: 8 cal., glycemic index = 6
- isomalt: 9 cal., glycemic index = 9
- maltitol: 10.8 cal., glycemic index = 36
- maltitol syrup: 12 cal., glycemic index = 52
- to contrast, here’s sucrose (table sugar): 16 cal., 4 g carbs, glycemic index = 65 (glucose = 100)
- Note: the carbs in sugar alcohols are “sugar alcohol” carbs, which are often not “counted” for diabetic or low-carb diets…
Possible Disadvantages of Sugar Alcohols
They’re not pleasant.
Because sugar alcohols can (a) ferment in the intestines and (b) are not absorbed fully, thereby enacting “passive diffusion” in the colon; in larger amounts, they can cause gas, bloating, and diarrhea, plus painful cramping in many individuals with just a small amount.
In that case, I feel like I wouldn’t recommend sugar alcohols to anyone who has any digestive weakness: IBS, Crohn’s, colitis, constipation, ETC., just in case. As a mom, I would include children on that list, too. It doesn’t seem worth it to experiment on them…
Sugar alcohols, although found in nature, have only been separated from their whole foods and used as sweeteners for a short time: erythritol was approved in 1990, for example.
Andy Bellatti, my favorite online dietician, admits that sugar alcohols are better than artificial sweeteners for those who need to avoid glycemic load, but he’s big on reminding people that we need to wean ourselves off the addiction to a sweet taste on our tongues, period:
Since they still add a lot of sweetness to foods, they do absolutely nothing in terms of helping our palates get used to lower amounts of sugar in our diets.
Award-winning cookbook author and nutrition expert Rebecca Wood puts xylitol in the category of artificial sweeteners and says this:
Xylitol is dangerous—even life-threatening—for pets according to the American Society for the Prevention of Cruelty to Animals. Xylitol, a pure crystalline chemical, or hydrogenated polyol, is typically a byproduct of the plywood industry but it may also synthesized from cornstalks. Yes, data correlates xylitol with the reduction of dental caries, however there are more wholesome ways of preventing tooth decay.
And the Weston A. Price Foundation website, although not coming down on sugar alcohols as a non-food to be avoided at all costs (which surprised me), list the following side effects:
[Sugar alcohols can cause] metabolic acidosis, which can lead to acid reflux and an increased risk of cancer of the larynx. …also promote dehydration and loss of electrolytes, creating feelings of excessive thirst. …Those who are trying to avoid carbohydrates and burn body fat should also know that sugar alcohols will immediately take the body out of ketosis, the state wherein fat reserves rather than dietary calories are being metabolized. . . assuming that the body was in a state of ketosis to begin with.
Additional concerns with sugar alcohols stem from the fact that they seem to increase the frequency of seizures in epileptics, and children are especially sensitive to the gastrointestinal side effects, possibly due to their propensity for bingeing on sweet foods. Children who regularly consume sugar alcohols also seem to have an increased incidence of childhood obesity.105
Erythritol Stands Out
Many sources seem to peg Erythritol as the safest, easiest to use sugar alcohol.
Erythritol is the easiest to digest, with up to 90% absorbed by the small intestine before it can enter the colon and cause digestive distress. It is heat stable so can be used for baking, and it’s a white powder that people can understand when they sub it for sugar.
Ben Fuchs, a pharmacist, deems xylitol the best sweetener for diabetics.
How to Use Sugar Alcohols
More than using them, it’s important to know where they’re already used in packages, if you ask me, especially if they give you pause as a class of sweeteners.
Erythritol, for example, is often blended with other natural (stevia) and artificial (aspartame) sweeteners and tends to be the main add-in in those stevia baking blends. You think you’re buying stevia, but you’re really buying erythritol enhanced with a little stevia, since it’s not as sweet as sugar.
Xylitol is equally as sweet as sugar, so you can use it with a 1:1 ratio. It is heat stable and can be used in baking. (But it’s more likely to cause gas/diarrhea/bloating.)
In packages, you’ll find it everywhere in toothpaste, “natural” or not, plus quite often in gum and medicines.
I’ll address my experiences with the alternative/sugar alcohol blends HERE.
Have you had good luck using sugar alcohols?
Find the rest of the Sweet, Sweet Summer series HERE.
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