Sugar Alcohols

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SUGAR ALCOHOLS

Note: Not every type of sugar alcohol is covered. Please let us know in “Get Involved” if there is a specific one that you’d like to learn about. It is also important to note that sugar alcohols should be consumed in moderation.

What: Sugar alcohols have a lower amount of calories but are less sweet compared to sugar.

They are formed through the fermentation of carbohydrates. They are called “alcohols” due to their chemical structure. Sugar alcohol is basically “sugar that undergoes the chemical process that converts and then ferments into a sugar alcohol” (Penn).

Your stomach cannot absorb sugar alcohols, so it could have a laxative effect after consumption.

Most processed foods that may contain sugar alcohols have the following on their packaging:

Keto-safe
Diabetes-safe
Sugar-free, no sugar, or low sugar
Naturally sweetened or sweetened with natural compounds
Low-calorie or calorie-free
“Excessive consumption may have a laxative effect.” – required by the FDA for products containing either sorbitol or mannitol.

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ERYTHRITOL

This sugar alcohol is about 60%-80% as sweet as table sugar and, unlike other sugar alcohols, has zero calories. Erythritol is a very common sugar alcohol and does not affect blood sugar levels or insulin secretion. Industrially, it is produced through the yeast fermentation of corn or wheat starch. Additionally, there is a small amount of erythritol that naturally occurs in fruits and vegetables, and it’s even produced by our cells as part of our normal metabolism. However, as a sweetener, erythritol levels are more than 1,000 times higher than those naturally found in foods. Erythritol is permitted to be used in more than 60 countries, and its safety has been confirmed by the World Health Organization’s Joint Expert Committee on Food Additives, the U.S. FDA, the European Commission, and the European Food Safety Authority.

A study led by Dr. Stanley Hazen at the Cleveland Clinic tested the relationship between erythritol, heart attacks, and stroke: they found that high erythritol consumption can increase the formation of blood clots, which could increase the risk of a heart attack or stroke. Dr. Hazen additionally states that when you consume this sugar alcohol, the increased risk for a heart attack or stroke can remain for days.

They initially conducted a study of more than 1,000 people, analyzing levels of blood compounds linked to future cardiac risk. Over the three years of this study, they tracked major harmful cardiovascular events, including death and nonfatal heart attacks or strokes. They ultimately found that high levels of erythritol and other related artificial sweeteners were, in fact, linked to an increased risk of these cardiovascular events.

To further examine this finding, they got more people in the study and found that the people with the highest levels of erythritol were twice as likely to have suffered cardiovascular events over the three years vs. the lowest. They also had eight healthy volunteers drink a beverage sweetened with erythritol and found that their blood erythritol levels increased 1,000-fold and remained abnormally high for a few days. There were at least two days where blood erythritol levels were elevated enough to trigger changes in platelet function, which typically forms clots to prevent bleeding.

MANNITOL

This sugar alcohol is about 50%-70% as sweet as table sugar, and consuming it in place of sugar reduces insulin secretion and helps keep blood sugar levels lower. Most mannitols are made from the hydrogenation of fructose at high pressure and temperatures. It naturally occurs in fresh mushrooms, brown algae, tree bark, and most fruits and vegetables, while it is also common in chewing gums and used in pharmaceutical products. Mannitol can cause gastrointestinal discomfort like gas, bloating, and diarrhea when consumed in large amounts. The safety of mannitol has been confirmed by the European Union, the U.S. FDA, the World Health Organization’s Joint Expert Committee on Food Additives, Australia, Canada, and Japan.

SORBITOL

This sugar alcohol is about 50% as sweet as table sugar. In comparison to sugar, sorbitol reduces insulin secretion and helps keep blood sugar levels lower. Industrially, sorbitol is made from potato starch. It is naturally found in berries like blackberries, raspberries, and strawberries, and fruits such as apples, apricots, avocados, cherries, peaches, and plums. Sorbitol can cause gastrointestinal discomfort like gas, bloating, and diarrhea when consumed in large amounts. The safety of sorbitol has been confirmed by the Scientific Committee for Food of the European Union, the U.S. FDA, the World Health Organization’s Joint Expert Committee on Food Additives, the Federation of American Societies for Experimental Biology, Australia, Canada, and Japan.

XYLITOL

This sugar alcohol has around the same sweetness as table sugar. Xylitol’s impact on blood sugar levels is very low, but it can cause abdominal gas and discomfort if consumed in large amounts. Industrially, it is made from wood materials or by microbial fermentation and is commercially derived from birch trees and corn cobs into a white powder. Xylitol can be found naturally in various fruits and vegetables such as strawberries, raspberries, mushrooms, and cauliflower, while also being made in our body as a natural compound, but in very low levels. Furthermore, xylitol is a common ingredient in sugar-free chewing gums and can also be found in oral products like toothpaste and mouthwash. Xylitol is permitted to be used in more than 35 countries, and its safety has been confirmed by the U.S. FDA, the Scientific Committee for Food of the European Union, the Federation of American Societies for Experimental Biology, and the World Health Organization’s Joint Expert Committee on Food Additives. Lastly, xylitol is highly toxic to dogs.

Dr. Stanley Hazen, MD, PhD, from the Cleveland Clinic, states, “Our studies show that elevated blood levels of xylitol contribute to the heightened platelet reactivity and are associated with an enhanced risk for cardiovascular events, like heart attacks and strokes.” Looking into common grocery products containing xylitol, Dr. Hazen additionally states that a single scoop of keto-friendly ice cream can contain up to 30 grams of xylitol. This is enough to agitate your platelets and form clots; it also increases the risk of a heart attack or stroke for about four to six hours after consumption.

LACTITOL

This sugar alcohol is about 40% as sweet as table sugar. Derived from milk sugar (lactose), it does not raise blood sugar levels. Lactitol is marketed as a laxative and registered as a pharmaceutical product. Thus, consuming large amounts will cause bowel discomfort. The use of lactitol has been approved by the U.S. FDA, the World Health Organization’s Joint Expert Committee on Food Additives, the Scientific Committee on Food of the European Union, Canada, Japan, Israel, and Switzerland.

ISOMALT

This sugar alcohol is about 45%-60% as sweet as table sugar. Derived from beet sugar, it does not raise blood sugar levels. Additionally, consuming large amounts of isomalt can cause diarrhea and bowel discomfort. Isomalt is permitted to be used in more than 80 countries, and its safety has been approved by the U.S. FDA, the European Union, and the World Health Organization’s Joint Expert Committee on Food Additives.

HYDROGENATED STARCH HYDROLYSATES

This sugar alcohol is also known as “HSH” and is about 40%-90% as sweet as table sugar. It is simply a mixture of different sugar alcohols, and it is produced through the partial hydrolysis of corn. Additionally, consuming large amounts of HSH can cause diarrhea and bowel discomfort. The safety of HSH has been confirmed by the World Health Organization’s Joint Expert Committee on Food Additives, the European Community’s Scientific Committee for Food, and the U.S. FDA.

MALTITOL

This sugar alcohol is about 90% as sweet as table sugar. In comparison to table sugar, maltitol requires less insulin secretion, so it helps keep blood sugar levels lower. It is made from corn, wheat, potatoes, and catalytic hydrogenation. Compared to other sugar alcohols, maltitol’s properties are also the most similar to table sugar. Additionally, consuming large amounts of maltitol can cause diarrhea and bowel discomfort. The safety of maltitol has been confirmed by the Scientific Committee for Food of the European Union, the World Health Organization’s Joint Expert Committee on Food Additives, the U.S. FDA, Australia, and Canada.

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