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Do You Know about Sugar Alcohols?
Do you experience nagging digestive issues like bloating, gurgling, tummy aches, and occasional bouts of loose bowels? The culprit might not be wheat, dairy, nuts, seeds, beans, or other hard-to-digest foods.
The problem might be that so-called healthy sweetener you’ve been using lately. No, I am not talking about saccharin, aspartame, and sucralose, which destroy gut bacteria in charge of maintaining healthy blood sugar and good health. (These artificial sweeteners with zero calories can actually raise blood sugar.) I’m talking about sugar alcohols, such as xylitol, erythriltol, sorbitol, mannitol, and others, which have found their way into a new zero-calorie health food category.
Are Sugar Alcohols Causing Your Digestive Distress?
Sugar alcohols have found there way into a host of foods marketed as heathy, low-, or no-sugar choices. The most popular are xylitol, sorbitol, and erythritol, but others, like mannitil, matitol, lactitol, and isomalt, are hidden on labels of many of your favorite health foods, like ice creams, cookies, energy and protein bars, and protein powders, along with toothpastes, gum, mouthwashes, and more.1 The question begging to be asked is: are these sugar alcohols healthy or not? Let’s dig in!
Sugar alcohols are polyols, which represent the “P” in the FODMAP diet. FODMAP is an acronym for Fermentable Oligo-, Di-, Mono-saccharides and Polyols.2 These terms are the scientific names given to groups of carbohydrates that may cause digestive issues for some people.3 Most people with healthy digestive systems can tolerate FODMAPs and sugar alcohols, but those with sensitive digestion may want to avoid this new form of sweetener. With more and more food manufacturers using sugar alcohols to sweeten foods, many of us, in the name of good health and a low-sugar diet, may experience gas, bloat, and other digestive concerns from these new sweeteners without realizing it.
FODMAPs, including sugar alcohol sweeteners, consist of short chains of sugars that are osmotically active and pull water from the body into the intestines. This has been linked to bloating, abdominal discomfort, and looser stools.4
FODMAPs and sugar alcohols are not broken down in the small intestines very well and enter into the large intestines, where they ferment in the presence of trillions of gut bacteria that gobble up the sugar alcohols, producing gas, bloat, discomfort, and intestinal and elimination concerns.5
Can Sugar Alcohols Be Healthy?
Yes, the can! These sweeteners come from plants such as fruits and berries, but are chemically altered and concentrated before they can be used as a sweetener. So on one hand they are natural but on the other are highly processed.
Xylitol, sorbitol, erythritol, and the other sugar alcohols look and taste like sugar, but have fewer calories and little, if any, effect on blood sugar levels because they have a naturally low glycemic index. Remember, they are not absorbed through the gut wall.
So far the studies suggest they do not negatively alter the gut microbiome like artificial sweeteners. In fact, most sugar alcohols are considered prebiotics because they are not digested until they reach the large intestines. Some, like isomalt and maltitol, have been found to boost beneficial bacteria like bifidobacteria. Lactitol has been shown to protect the gut from harmful bacteria and xylitol has been shown to increase beneficial bacteria, such as firmicutes and prevotella, while decreasing bacteroidetes.6
Xylitol has been well studied because of its claim to fame for supporting dental health and protecting against dental caries, which is why you see xylitol in gums, toothpastes, and mouthwashes.
Xylitol has 40% less calories than sugar and is generally well-tolerated and not found to play a major role in digestive distress concerns.7
NOTE: Xylitol is toxic to dogs.
Erythritol has only 5% of the calories of sugar, but is 70% as sweet. It does not have the same digestive distress potential as some other sugar alcohols because much of it is absorbed in the small intestine and then excreted in the urine without raising blood sugar at all.
Erythritol is found in the sweetener Truvia. In fact, although Truvia is marketed as a stevia sweetener, it is mostly erythritol. Erythritol is generally considered one of the healthiest sugar alcohols. It’s calorie-free, doesn’t raise blood sugar levels, is less likely to cause digestive upset than other sugar alcohols, and it won’t hurt your dog!1
Sorbitol is about 60% as sweet as sugar with 60% of the calories. It is commonly used in foods and soft drinks and, if taken in excess, may cause some digestive distress.1
Maltitol is 90% as sweet as sugar with about half the calories. Maltitol is absorbed into the bloodstream and has the biggest blood sugar spike of any of the sugar alcohols, so if you have blood sugar concerns avoid this sweetener.1
Conclusion on Sugar Alcohols
Sugar alcohols seem to be safe and even healthy in small amounts. But research is still scarce and it has only been a few years that these sweeteners have entered the mainstream. Many food additives initially branded as safe have been pulled off the market as more and more people consumed them and more research has been done.
If small amounts will challenge those sensitive to FODMAPs, does that mean that more will be safe for everyone? I think it is still too early to tell for sure—remember these are highly processed, highly concentrated and refined sweeteners. Before I would give the okay to regular or heavy use of these, I would wait for more research to come in.
As a chewing gum or in a toothpaste to support healthy teeth and oral hygiene, I think xylitol is well studied, but, again, in small amounts.
We should also try to reduce exposure to an excessive amount of the sweet taste because, from an evolutionary perspective, we have only recently had access to the abundance of sweets we have at our fingertips today. The key is to desensitize our nervous system and gut bugs from craving sugar and sweet as a primary source of satisfaction. All sweets should be taken in moderation.