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Sugar alcohols: Good or bad?

What are sugar alcohols, and are they a healthy sugar swap?

This is a detailed article about sugar alcohols and their health effects. They have several health benefits but can also cause digestive problems.

Is it healthy?
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This article is based on scientific evidence, written by experts, and fact-checked by experts.
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What are sugar alcohols, and are they a healthy sugar swap?
Last updated on September 23, 2023, and last reviewed by an expert on March 2, 2023.

Sugar alcohols, like sorbitol, are added to foods to give them a sweet taste as an alternative to regular sugar. This article reviews what sugar alcohols are, how they affect health, and the downsides to consider if you add them to your diet.

What are sugar alcohols, and are they a healthy sugar swap?

In moving toward a healthier way of eating, many people reduce their intake of added sugars.

This has led to a surge in the popularity of sugar substitutes, such as sugar alcohols.

Sugar alcohols are added to foods, including baking mixes, cereals, and ice cream, to give them a sweet taste without the negative side effects of regular sugar.

They’re healthier alternatives to regular sugar, but some people may wonder how they affect the body and whether they cause any side effects.

This article reviews what sugar alcohols are, how they affect health, and the downsides to consider if you add them to your diet.

In this article

What are sugar alcohols?

Sugar alcohols, or polyols, are carbohydrates. As the name implies, they are hybrids of sugar and alcohol molecules.

Some sugar alcohols, such as erythritol and sorbitol, occur naturally in foods like fruits and vegetables. However, the sugar alcohols that many companies use to sweeten foods are produced industrially in various ways.

While some people think they’re zero-calorie sweeteners, sugar alcohols are considered low-calorie sweeteners (LCSs).

Sugar alcohols are about 25–100% as sweet as sugar but lower in calories. They don’t have the same negative effects as regular sugar, such as promoting tooth decay and significantly raising blood sugar levels.

They’re considered low-digestible carbs, meaning that your small intestine doesn’t completely absorb them when you eat them. Instead, they travel to your large intestine, where bacteria ferment them.

Fiber and resistant starch are also considered low-digestible carbs.

Interestingly, similarly to fiber, certain sugar alcohols may contribute to a healthy digestive system by promoting the growth of beneficial bacteria.

Currently, eight sugar alcohols are approved for human consumption:

The most widely used in the food industry are xylitol, erythritol, and maltitol. This is because their flavor most closely resembles the taste of regular sugar.

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Because sugar alcohols’ chemical structure is similar to sugar’s, they activate the sweet taste receptors on your tongue.

Summary: Sugar alcohols are a type of carb widely used as low-calorie sweeteners. Although they closely resemble the taste of sugar, they don’t exert the same negative effects of sugar, such as causing dental cavities and significantly spiking blood sugar levels.

Common types of sugar alcohols

As mentioned above, eight types of sugar alcohols are approved for human consumption.

Because xylitol, erythritol, and maltitol most closely mimic the taste of regular sugar, you’ll come across these three sweeteners more frequently than other sugar alcohols.

Sugar alcohols differ in taste, calorie content, and how they affect the body.

Xylitol

Xylitol is one of the most commonly used sugar alcohols because its taste resembles sugar.

It’s a common ingredient in sugar-free chewing gums, mints, and oral care products like toothpaste.

Xylitol is the sweetest of all sugar alcohols but has about 40% fewer calories than regular sugar. People tend to tolerate xylitol well, but you may experience some digestive symptoms if consumed in large amounts.

Erythritol

Erythritol is another sugar alcohol that’s considered to have an excellent taste.

It has 70% of the sweetness of sugar but only 5% of the calories.

Erythritol does not have the same digestive side effects as most other sugar alcohols because it doesn’t reach your large intestine in significant amounts.

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Instead, most of it gets absorbed by your small intestine, then spreads throughout the body before being excreted unchanged in your urine.

Sorbitol

Sorbitol has a smooth mouthfeel and cool taste.

It’s 60% as sweet as sugar, with about 60% of the calories. It’s a common ingredient in sugar-free foods and drinks, including jelly spreads and soft candy.

It has very little effect on your blood sugar and causes minimal digestive symptoms when you consume less than 10 grams. However, it may cause digestive issues like belly pain and diarrhea if you consume more than 20 grams.

Maltitol

Maltitol has a very similar taste and mouthfeel to regular sugar. It is 75–90% as sweet as sugar, with almost half the calories.

Like other sugar alcohols, maltitol is poorly absorbed by the small intestine, so it doesn’t get absorbed into your bloodstream quickly and therefore doesn’t have the same effect on blood sugar or insulin levels as sugar.

Other sugar alcohols

Other sugar alcohols that are commonly found in some food products include:

Summary: Many different sugar alcohols are found in the modern diet. Xylitol, erythritol, and maltitol are the most commonly used in food production because they taste the most like regular sugar.

Glycemic index and effects on blood sugar

The glycemic index (GI) measures how quickly foods raise blood sugar levels. The glycemic index ranges from 0–100.

The lower the glycemic index of a food, the slower your blood sugar level rises after you consume that food. That means a lower glycemic index food is healthier than a higher one.

The list below compares the glycemic index of sugar alcohols. The glycemic index of sucrose, or table sugar, is 65. The relative sweetness indicates how sweet each sugar alcohol tastes compared with table sugar.

As you can see from the glycemic index values listed above, most sugar alcohols have negligible effects on blood sugar levels.

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Even though some, like maltitol and xylitol, have higher glycemic indexes than the other sugar alcohols, they’re still very low compared with the glycemic index of regular sugar.

This means that replacing regular sugar with sugar alcohols may benefit blood sugar levels and help people with conditions like diabetes better manage their blood sugar levels.

Summary: Most sugar alcohols have little effect on blood sugar and insulin levels. Even though some have a higher glycemic index than others, all have significantly lower effects on blood sugar levels than regular sugar.

Sugar alcohols may improve dental health

Tooth decay is a well-documented side effect of consuming too much sugar.

Certain bacteria in your mouth ferment the sugar when you consume sugary foods or drinks. These bacteria then multiply and secrete acids that erode the protective enamel on your teeth.

In contrast, sugar alcohols like xylitol and erythritol may protect against tooth decay.

That’s one of the main reasons they’re so popular in many chewing gums and toothpaste.

Xylitol is well known for its beneficial effects on dental health and has been studied thoroughly.

Xylitol promotes dental health by reducing plaque formation, inhibiting tooth demineralization, and preventing the growth of harmful bacteria.

Studies have shown that erythritol appears to have similar effects on dental health and may reduce the risk of cavities.

Summary: Some sugar alcohols may have the opposite effect as table sugar on dental health. Studies have shown that xylitol and erythritol may improve dental health and protect against cavities.

Other benefits of sugar alcohols

Sugar alcohols have several other potential benefits worth highlighting.

Sugar alcohols may help those with diabetes

Because most sugar alcohols have a minimal effect on blood sugar levels, they make a smart sugar replacement for those with prediabetes and diabetes.

However, more research is needed to understand how long-term sugar alcohol consumption affects the overall health of people with diabetes.

Sugar alcohols may benefit gut health

Some sugar alcohols like maltitol may promote the growth of beneficial bacteria, such as Bifidobacteria, in the gut. However, more human research is needed to assess how sugar alcohol consumption influences gut bacteria.

Summary: Sugar alcohols may promote gut health and be a smart sugar alternative for those with diabetes. However, more research is needed to assess the overall health effects of consuming sugar alcohols.

Downsides of sugar alcohols

Sugar alcohols come with a few downsides you should be aware of before adding them to your diet.

Suggested read: FODMAP: A detailed beginner's guide

Digestive issues

The main problem with sugar alcohols is that some can cause gastrointestinal side effects in people with and without digestive conditions like irritable bowel syndrome (IBS), especially when consumed in large amounts.

Your body cannot digest most of them, so they travel to the large intestine, where gut bacteria break them down.

For this reason, if you eat a lot of sugar alcohols in a short period, you may experience gas, bloating, and diarrhea.

For example, most people who consume under 10 grams of sorbitol won’t experience significant digestive issues, aside from a bit of gas and bloating. However, consuming more than 20 grams can cause significant digestive issues, including pain and diarrhea.

Other sugar alcohols, like maltitol, can also lead to symptoms, so it’s best to avoid consuming them in large amounts.

Some sugar alcohols, including sorbitol and mannitol, are considered fermentable oligosaccharides, disaccharides, monosaccharides, and polyols — also known as FODMAPs.

These are carbs that your gut can’t absorb very well, which may lead to gastrointestinal side effects in some people.

People who are sensitive to FODMAPs should avoid sugar alcohols, except erythritol. Erythritol is generally well tolerated and not considered a high FODMAP ingredient.

Xylitol is toxic to dogs

While humans tolerate xylitol well, it’s highly toxic to dogs.

When dogs eat xylitol, their bodies mistake it for sugar and start producing large amounts of insulin.

When insulin goes up, dogs’ cells pull sugar out of their bloodstream. This can lead to low blood sugar and other side effects — including liver failure, which can be fatal.

If you have a dog, keep xylitol out of reach, or don’t buy it.

This reaction only occurs in dogs, and xylitol is the only culprit.

Summary: Xylitol is toxic to dogs. If you own a dog, keep xylitol out of reach. Other sugar alcohols don’t have this effect.

Which sugar alcohol is the best option?

Of all the sugar alcohols, erythritol seems one of the best options. It’s also one of the most popular and commonly used types of sugar alcohol.

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Here’s what makes erythritol a good option:

However, even though erythritol is considered safe and well tolerated by humans, it doesn’t mean you should consume large amounts of erythritol or any other sugar alcohol regularly.

To promote overall health, it’s a good idea to reduce your consumption of added sugars, artificial sweeteners, and low-calorie sweeteners like sugar alcohols.

Instead, focus on whole, nutrient-dense foods like fruits, vegetables, fish, and nuts.

Summary: Erythritol is a popular sugar alcohol that is safe and well-tolerated. However, it’s important to limit your consumption of all sweeteners, including artificial sweeteners, added sugars, and low-calorie sweeteners like sugar alcohols.

Summary

Sugar alcohols are popular, low-calorie sweeteners that you can find in many low-calorie foods and drinks.

While they’re generally well tolerated, consuming high amounts of some sugar alcohols, such as sorbitol, may cause bloating and diarrhea, especially if you consume them in large amounts.

If you’d like to cut back on added sugar, try using a bit of erythritol to provide sweetness without the negative side effects of regular sugar.

Expert tip

If you’re trying to cut back on your added sugar intake, try starting with beverages. Drinks like soda, energy drinks, and sweetened coffees can contain a shocking amount of sugar.

The first step is learning how to read nutrition labels. Four grams of sugar equal one teaspoon. For example, if a bottle of soda contains 40 grams of added sugar, you’re drinking ten teaspoons of added sugar.

Try to reduce your total sugar consumption by replacing sugary beverages with water or cutting back on your sugary beverage intake.

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