Sugar Alcohols
Chester J. Zelasko, Ph.D. | November 5, 2002

Maltitol. Sorbitol. Mannitol. The list of ingredients on a food label can be overwhelming, and sometimes it seems you need a degree in chemistry just to be able to read them. This Newsletter will try to take the confusion out of one category of food additives on a label: the sugar alcohols.

There are several sugar alcohols found in processed foods--especially sugar-free foods. The most common are maltitol, mannitol, sorbitol, and xylitol. Most people think these are artificial sweeteners, but that's incorrect. Although they're added to foods to sweeten while reducing the sugar content, these alcohols are made naturally in the body and in fruits and vegetables. For example, changing a sucrose molecule by just a single hydrogen ion can make sorbitol. It's made commercially from corn syrup and used as a sweetener in sugar-free candy and other sweetened foods.

Sugar alcohols are important for several reasons. First, they do not affect blood sugar levels, so people with hypoglycemia and diabetes can benefit from choosing foods with these as a replacement for sugars. Second, they reduce the formation of dental caries (often called cavities). That's why sugar alcohols are found in foods that children chew, such as chewable dietary supplements. Third, they contain fewer calories than sugar--2.5 calories per gram versus 4.0 calories per gram for carbohydrates. Fewer calories don't necessarily translate to weight loss unless someone uses foods with these sweeteners as part of a responsible meal plan. Finally, people prone to urinary tract infections (UTIs) may benefit from using the sugar alcohols as sweeteners because the sugar alcohols reduce the carbohydrate intake known to be related to bacterial growth in UTIs.

Is there a downside to sugar alcohols? While there is no upper limit set by either the Joint Food and Agriculture Organization/World Health Organization Expert Committee on Food Additives or the Scientific Committee for Food of the European Union, too much of a sugar alcohol can result in bloating and diarrhea. Amounts exceeding 25-30 grams per day were necessary to get a laxative effect.

There is another aspect to sorbitol unrelated to eating it. In diabetics who do not restrict their carbohydrate intake, a biochemical phenomenon known as glucose-induced sorbitol accumulation can develop. High intake of carbohydrates causes sorbitol to be made by the body. The accumulation of sorbitol in the nerve cells can result in diabetic neuropathy, and the individual loses feeling in the fingers and toes as a result. It's important to note the difference: this is related to the intake of sugar and carbohydrates, not the intake of sorbitol. While increased intake of antioxidants and omega-6 fatty acids from evening primrose oil may help with the neuropathy, the key is prevention--diabetics must reduce the refined carbohydrates and sugars in their diet.

If every American ate fresh food prepared daily, and the U.S. did not have the rates of obesity and diabetes that currently exist, food sweeteners would probably be unnecessary. Because our society depends on processed foods, sugar alcohols are a safe alternative to increasing sugar intake. If you use them wisely as part of a reasonable meal plan, they may help reduce the negative effects of eating too much sugar and refined carbohydrates.
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