Sugar Alcohols And Their Effects On Health - Ask a Nutritionist

Transcript:

Welcome to Dishing Up Nutrition's “Ask a Nutritionist” podcast brought to you by Nutritional Weight & Wellness. My name is Leah Kleinschrodt. I'm a Registered and Licensed Dietitian and your host for the show today. This podcast strives to help people around the world make the connection between what they eat and how they feel.

And if you're enjoying this show, let us know by leaving a rating or review on your favorite podcast platform. Your feedback helps others find these important real food messages. So on today's show, I will be delving into a topic that frequently comes up in classes that I teach and when I'm counseling clients.

And really the overarching topic is which sweeteners can you use on a real food eating plan? And then today specifically, we're going to take a look at sugar alcohols. So you've likely seen sugar alcohols if you've been browsing the food label sometime in the last 30 to 40 years or so. These are typically the guys that end in -ol or that “ol”. So xylitol, erythritol, sorbitol, mannitol, lactitol, and Isomalt; those are just a couple that you'll see on the food labels.

So we're going to talk about the ins and outs of these alternate sweeteners and if they’re something you want to eat or if there's something that you'll want to avoid. And I did want to make a note also, we've covered a few other alternate sweeteners on our “Ask a Nutritionist” segments a little more recently.

So specifically, Amy covered monk fruit and stevia on her episode on September 5th, 2024. And I talked about allulose on January 30th of 2025. So, if you're just looking to learn a little bit more about what your options are, don't forget to give those a listen also.

What are sugar alcohols?

So we're going to talk about sugar alcohols today. Let's first just talk about what are sugar alcohols? So sugar alcohols are sweet tasting sugar like carbohydrates. They're also known as polyols, so that's their fancy name. And some people might recognize that as the P if you've ever looked into a FODMAP eating plan.

So the P in FODMAP stands for polyols. Now, many of these sugar alcohols are found in small amounts in various plant foods, mostly it’s fruits and vegetables, but of course they can all be synthesized commercially for mass production to be used in food. So for you organic or biochemistry nerds out there, so you start with actually a regular sugar molecule, and then you add at least one, usually several hydroxyl groups.

So you're adding a little OH symbol to that sugar molecule. So you actually change the structure of that sugar molecule just a bit. And when you do this, you decrease how well the body is able to absorb, digest, and metabolize that sugar molecule. So what this means is you still get the sweet taste, but without all the calories that usually come along with regular sugar or regular carbohydrates.

So sugar alcohols are known as low digestible carbohydrates and you'll usually see these strongly marketed as being diabetic friendly. So sugar alcohols have become very widely used in the sugar free food space. So think things like sugar free ice creams, sugar free cookies and other baked goods, sugar free jams, soft drinks, sugar free hard candies. That's a big one. Gums are another big one, and even things like toothpaste, lozenges. So they kind of make their way into a lot of different categories.

Now, which sugar alcohol is used for which food depends on a lot of different factors. It depends on the level of sweetness for in that particular sugar alcohol and kind of what the level of sweetness you’re looking for in that particular food product. Does it take up moisture from its surroundings? What is the texture like? What are its bulking properties? Etc, etc. So as I said, there are many different sugar alcohols, so there's a lot of different options that food manufacturers usually are kind of choosing from.

How sweet are sugar alcohols?

So how sweet are sugar alcohols? Again, it depends on the sugar alcohol. Xylitol, which a lot of times you'll find that in the sugar free gums, that is equal in sweetness to regular table sugar, while lactitol is only about 30 to 40 percent as sweet as regular sugar. And then the rest of them are kind of in between that 30 to 40 percent and equal to sugar.

So, erythritol is another really common sugar alcohol. That one is somewhere around 60 to 80 percent as sweet as regular sugar, and so this is one thing that does set sugar alcohols aside from some of the other alternate sweeteners on the market, even the ones that we've talked about, like stevia and monk fruit.

Because some of these alternate sweeteners can be hundreds of times sweeter than regular sugar. Then those create a very intensely sweet experience, where actually most of the sugar alcohols are less sweet than regular sugar.

Are there calories in sugar alcohols?

And also, unlike many of the other alternate sweeteners out there, sugar alcohols still contain some calories. So the amount of calories that you get from sugar alcohols is about a half, maybe about two thirds of what you'd get from the same amount of table sugar. So we are still getting some calories with the sweet, just not as many as regular sugar.

So we're going to pause here and just take a quick break and when we come back I'll talk a little bit more about some additional considerations when it comes to sugar alcohols. So, we'll be back in a moment.

​-----

Alright, we're back. So, before we went to break, I was kind of talking about sugar alcohols, some of them being about as sweet or maybe a little less sweet than sugar. And typically, they have about half the amount of calories as regular sugar. So, that seems like a good decent trade off, right?

Similar sweetness for fewer calories. We don't have as much of an effect on blood sugars and insulin levels. So, in theory, this should help people eat less sugar overall and should help mitigate weight gain and obesity. Unfortunately, I mean, if it was that easy, we probably still wouldn't be looking at an obesity rate of over 40 percent for the population.

So there definitely are other factors at play here. And remember too, I mentioned that sugar alcohols still do contain some calories, so they are not a free food by any means. Sugar free ice cream is still ice cream and still a more processed food in that sense.

Possible side effects associated with sugar alcohols

Now, as for side effects of sugar alcohols, there is one paper I found in the Journal of Food and Drug Analysis, and I think they had a really nice quote that just kind of sums up the biggest risk factor for sugar alcohols. And that one said, “It has a laxative effect, although the tolerance varies from person to person”.

So because most sugar alcohols, as I mentioned before, they only get partially absorbed and digested, most of them run at least some risk of causing bloating, gas, intestinal cramping, and diarrhea. So erythritol seems to be the least likely of the sugar alcohols to cause those issues, followed by xylitol.

Xylitol tends to be fairly well tolerated also, but mannitol seems to be the one that causes the most problems, and kind of right in that same camp, sorbitol is kind of up there. Same thing with lactitol. According to many reports, many people's digestive tracts eventually adapt to eating sugar alcohols. It may take a few months. I mean, really my bet is that most people kind of drop off the sugar alcohol train before they spend two or three months just trying to battle with some of that bloating and diarrhea. So we'll talk about that a little bit more in just a second.

A good goal: try to rely less on sweet foods

The big question becomes, like, our sugar alcohol is kind of the juice that's worth the squeeze, and I would say, perhaps. You know, one thing I mentioned in the allulose episode that I did, I do think it's a great goal overall, for many people to slowly work on adjusting their taste buds and their brains to expect and rely less and less on sweet foods, whether these foods are sweetened with real sugar, sugar alcohol, stevia, or otherwise.

You know, the less sweet we are exposed to, the less we tend to crave it and want it. And then on the flip side, you know, I've experienced this and I've heard this from many clients before also, you know, once you've spent a decent amount of time eating less sweet things, and then you do go back and have something that has a lot of sweetness to it or has a lot of sugar to it, it actually tastes intensely sweet.

And some people will even say like, I can't even stand two bites of this anymore, where before I could have put it down, no problem. So your taste buds and your brain do adapt over time to less sweet things. So we just got to give it the chance.

I do find balancing out the sweet with higher protein intake, balancing out those blood sugars with some great healthy fats, that seems to work really well for a lot of my clients. So they just, they do tend to crave less sugar and less sweet overall.

Are eating sugar alcohols a good alternative when weaning off “sugary” foods?

But I mean, could sugar alcohol still play a role for those occasional treats or as a way to wean off regular sugar? Yeah, it seems like this could be an option for some people. The rate limiting factor here is probably going to be how well your digestive tract does with them. As I mentioned, some sugar alcohols definitely have a higher propensity to cause tummy troubles than others, and everyone's tummies handle these sugar alcohols a little bit differently.

If you are somebody who already struggles with looser stool, constipation, bloating or gas, indigestion, or you just have a more sensitive system, sugar alcohols are more likely to work against you than for you. But if your gut is generally in good working order, you might be able to tolerate some sugar alcohols say in a protein bar or low sugar baked good or a sugar free lozenge.

Are sugar alcohols considered a real food?

I mean, A little experimenting should give you an answer one way or another. As always, we still want to look at these foods through the lens of real food, asking this question of, okay, is this a real food option or not? And make some of our decisions based on that algorithm. Yes. Perhaps occasionally having some sugar alcohols is great, but if we can reduce our reliance on that sweet overall. And again, most sugar alcohols are going to be added to the processed foods.

We're not adding erythritol to cucumbers. We're not adding erythritol to strawberries. So in general, where you're going to be seeing the sugar alcohols being used, it's probably going to be in a little bit more processed foods. So these are just things we have to figure out what's the right balance for us as we're working on trying to change and better our overall health.

So, I hope that was helpful to talk a little bit about sugar alcohols. Again, I want to thank everyone so much for listening to this week's episode of Dishing Up Nutrition's “Ask a Nutritionist”. And if you have a nutrition question you would like us to answer, we have two options for you. You can join our private Dishing Up Nutrition Facebook community by searching Dishing Up Nutrition on Facebook.

Join Our Dishing Up Nutrition Facebook Group

Or you can give us a call at 952-641-5233 to leave your question in our Dishing Up Nutrition voicemail box. So please don't be shy. If you have a question, let us know, and we look forward to hearing from you.