Can I Have Sugar Alcohols?

"I can't figure out whether I should eat products containing sugar alcohols or not? And how do I figure out how many carbs this stuff REALLY has???" Next to "How many carbs a day should I eat?" this is one of the most commonly asked questions here. It's confusing!

Sugar alcohols are a special class of carbohydrate that are really neither a sugar nor an alcohol. They are generally derived from plants, and are used in place of sugar in many, many sugar free products, including candy, gum, desserts and even salad dressings. They generally have about half the calories of sucrose (table sugar), and they don't promote cavities. The question is, can low carbers eat them, and if so, how do we count the carbs?

First of all, everything I've read on sugar alcohols is in agreement that although they do raise blood sugar somewhat, their effect is MUCH LESS than comparable products made with sucrose. "They are converted to glucose more slowly, require little or no insulin to be metabolized and don't cause sudden increases in blood sugar." 1

This does NOT mean that products containing sugar alcohols are "free foods" for low carbers or diabetics, however! "Since many people typically overeat "sugar free" or "no sugar added" foods, their blood sugar may be significantly elevated". 2 So the answer is: most people feel that sugar alcohols are acceptable in a moderate amount but should not be eaten in excess. Moderation is the key here. If you're having sugar free candy as an occassional treat, that's fine! Just knowing that there IS an alternative, one that won't totally blow your diet, can be a big boost to some folks. Helps them get through the cravings.

But if you find that you're feasting on a whole box of sugar free candy at a time, WATCH OUT! Your brain is tricking you into thinking that you're eating the "good stuff" and your sugar cravings are taking over! My personal advice is this: when you buy sugar free candy or other products containing sugar alcohols, purchase single serving packages. If you do decide to "stock up" because it's cheaper, stick the box in the freezer, and then take out a piece at a time to defrost on the counter for a few minutes. This will help you limit your consupmtion.

And as you may know if you've ever gone overboard with sugar alcohols, the fact that they are not digested well in the small intestine means that excess consumption can lead to "intestinal discomfort" (pretty severe discomfort in my case) - bloating, gas, diarrehea. So, eating too much of this stuff is kind of a "self-limiting behavior", if you get my drift!

As to the question of how many carbs to "count", let's look at a nutrition label from an actual "low carb" product...

Total Carbohydrates 16 g
Dietary Fiber 4 g
Sugars 2 g
Sugar Alcohols (Polyols) 10 g

Lower on the nutrition label for this product it tells you that the ECC (standing for Effective Carb Count) or "NET CARBS" is "2". So what does this all mean?

Let's start with ECC. The formula for determining ECC is Total Carbs - Fiber - Sugar Alcohols - Glycerine = ECC. What this is saying is that the product is supposed to EFFECT YOUR BLOOD SUGAR AND INSULIN as if there are only 2g of carbs in it.

Does this mean that you should count the carbs as only 2g when you're tracking your daily carb intake? I don't think so. Yes, Sugar Alcohols don't raise blood sugar in the same way that sucrose does. But they do have some effect. I've heard that since sugar alcohols (in general - it varies by type) contribute about 2 calories per gram vs the 4 per gram of sucrose, you should count HALF their carb grams into your total. (ie if there are 10g of carbs listed as sugar alcohols, you would only subtract 5g out of your 'personal' ECC calculation). This is a pretty standard practice among long time low carbers, and I believe that this is probably a prudent thing to do.

The Calorie Control Council says "Experts in diabetes management advise that if less than 10 grams of sugar replacers (polyols) is consumed, that serving is considered a "free food." Above 10 grams, subtract half of the grams of sugar replacers (polyols) from the grams of total carbohydrate and then calculate the exchanges." 3  But be aware that the FDA is in the process of reviewing the "net carb" calculation, and forumlating rules about it. What the official word on it is going to be, remains to be seen, and the amount of carbs you choose to include is - for now - a personal preferece.

Am I saying that you should completely avoid products with sugar alcohols? Not at all. I occasionally enjoy a sugar free chocolate or cheesecake as much as the next low carber. But it does mean that you should use these products moderately and with the knowledge that they are not "free foods"!

For your reference, here are the most commonly used forums of sugar alcohols:

• Mannitol (Mannitol lingers the longest in the intestines and therefore will often cause bloating and diarrhea if consumed in excess.)
• Sorbitol
• Lactitol
• Xlyitol (often found in chewing gums, as it has been shown to help reduce cavities)
• Isomalt
• Maltitol and maltitol syrup (often used in sugar free chocolate because it gives a creamy texture to foods)
• HSH or hyrdogenated starch hydrolysates (HSH do not crystalize, so they are often used in baked goods or mouthwashes.)
• Erythritol - a new class of sugar alcohol which the manufacturers claim does not cause the intestinal side effects of some other polyols. This seems to be true for most people, though not all.

That's probably more than you ever wanted to know about sugar alcohols, but since this topic comes up contstantly, I felt like I should do the most thorough job with it that I could. The more knowledge we have, the better choices we can make for ourselves!

Some References:

http://fusion.ag.ohio-state.edu/news/files/chowsorbitol.pdf
http://www.caloriecontrol.org/redcalqa.html
http://www.joslin.org/education/library/sugar_free_foods.shtml
http://www.ynhh.org/online/nutrition/advisor/sugar_alcohol.html