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Carbohydrates and Sugar Alcohols
Contributed by: Katie Malone, Pharm.D. Candidate
                       KU School of Pharmacy

Volume 2, Issue 11

May 2004

With the low-carbohydrate craze sweeping the country, it is inevitable that you have seen some product, sign, or commercial advertising a low-carb product.  It seems that nearly every type of food has the version you have been buying for years and then, right next to it on the shelf, a low-carb version of the same food.  How did these foods reduce the number of carbohydrates?  Closer inspection may lead to some new discoveries in the ingredient list or on the nutrition facts label.  Sugar alcohol is one of these ingredients you may not have noticed before.  It is sometimes used to reduce the amount of sugar and, for those of you on the Atkins diet, "bad" carbohydrates in foods. 

Sugar alcohol has been used in diabetic specialty foods for years.  Polyol is another name for sugar alcohol and they both are simply a sugar free sweetner.  The name sugar alcohol comes about because the structure of these sweetners resembles sugar while another part resembles alcohol.  They are not actually sugar and do not contain ethanol, the kind of alcohol found in alcoholic beverages.  The advantages they provide over regular sugar include: -fewer calories per gram, -smaller increases in blood glucose and insulin levels, - do not promote tooth decay, - products last longer because molds and bacteria do not grow as well on sugar alcohols.

Sugar alcohols are used in a wide range of products in the U.S.  From chewing gum and candy to ice cream and baked goods, there are several sugar alcohols that may be found on the label.  The common sugar alcohols are mannitol, sorbitol, xylitol, lactitol, isomalt, maltitol, and hydrogenated starch hydrolysates (HSH).  However, these are still carbohydrates.  They are slowly and only partially absorbed from the gut and therefore have little influence on blood glucose levels.  The foods

they are in may still contain significant amounts of other carbohydrates and calories.  This is where the nutrition information label becomes important.  It provides important information about the food and what type of sugar and carbohydrates the food contains.  If a manufacturer claims a food is "sugar free" or has "no added sugar", the grams of sugar alcohols must be listed.  If only one sugar alcohol is used, its name will appear specifically.  If more than one sugar alcohol is used, they will simply be listed as "sugar alcohols" on the nutrition facts label.  The Sugar Free Russell Stover Assorted Chocolates and Low Carb Russell Stover Assorted Chocolates labels serve as an example.  Notice that there are still 170 calories per serving, despite the fact that they are sugar free or low carb. 

Most people tolerate foods sweetened with sugar alcohols very well.  A few people may experience gastrointestinal symptoms, such as gas or diarrhea, especially if excessive amounts of these foods are consumed.  These symptoms are usually mild and temporary and if an individual is worried about these effects, it is advisable to start eating small amounts of these foods at first and slowly increase consumption over time. 

Following is a chart with more information on specific sugar alcohols.  For more information go to:
www.diabeticgourmet.com
www.fda.gov
www.ynhh.org

Co-edited by:
Sarah Kerner, Pharm.D.
Miranda Wilhelm, Pharm.D.
John Witt, Pharm.D.

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