Newsmaker
Look on the label of a sugar-free candy, and you’re likely to see words like maltitol, xylitol, and sorbitol. These are sugar alcohols. However, they aren’t actually sugar or alcohol. So what are these substances and how will they affect your body? This sounds like “Enron accounting” where things are not what they are advertised as. More on this later. The most important thing to remember is that as a consumer we all need to read the labels and clearly understand what it all means. An example is “…sugar free, contains sugar alcohol….” what does all this mean. It should also be noted that sugar alcohols can cause profound diarrhea and gas post Duodenal Switch and should be avoided.
Ara Keshishian, MD, FACS

 

What are sugar alcohols?
Sugar alcohols are carbohydrates which are also called “polyols.” Part of their chemical structure resembles sugar, and part of it resembles alcohol — hence the confusing name. Examples of common sugar alcohols are maltitol, sorbitol, isomalt, and xylitol.

Where do sugar alcohols come from?
Sugar alcohols occur naturally in plants. Some of them are extracted from plants (sorbitol from corn syrup and mannitol from seaweed), but they are mostly manufactured from sugars and starches.

Why use sugar alcohols?
Sugar alcohols are like sugar in some ways, but they are not completely absorbed by the body. Because of this, the blood sugar impact of sugar alcohols is less and they provide fewer calories per gram. Additionally, sugar alcohols don’t promote tooth decay as sugars do, so are often used to sweeten chewing gum. One, xylitol, actually inhibits bacterial growth in the mouth.

It’s important to note, however, that the different types of sugar alcohols act very differently in the body (see chart below).

How are sugar alcohols labeled?
The names of the individual sugar alcohols will be on the ingredient list of any product that contains them. They will be included in the amount of carbohydrate on the label, either in the total or on a separate line for sugar alcohols. If the product is labeled “sugar-free” or “no added sugar,” the manufacturer must show the sugar alcohol count separately. As I indicated above, sugar-free does not mean sugar alcohol free.

How do sugar alcohols compare to other carbohydrates?
Though sugar alcohols have fewer calories than sugar, most of them aren’t as sweet, so more must be used to get the same sweetening effect. Still, there is a range of sweetness and impact on blood sugar among the sugar alcohols.

The presence of Sugar Alcohol is sugar free food is the dietary version of the Enron Accounting. The label may suggest there is no calories from Sugar, thus Sugar Free label, yet is contains calories from Sugar Alcohol. This is usually listed separately and usually in fine print. By Paying close attention to the ingredients of food purchased, patients can avoid some of the common problems that we see in the office. Inadequate weight loss, weight regain, gas , bloating etc.