Sugar alcohols are a class of compounds that have become increasingly popularized in food, beverage, confectionary and pharmaceutical products as consumers demand low-calorie, low-sugar and sugar-free options. They offer a sweetness level ranging from 25% to 100% of table sugar, yet sugar alcohols are not fully absorbed in your body. Thus, using sugar alcohols as a replacement sweetener allows you to still get a sweet flavor without the same spike in blood glucose levels that typical sugars provide. But are sugar alcohols a safe option if you have diabetes? Our general conclusion: yes, if consumed in moderation, and assuming that your diet otherwise centers around the consumption of high-fiber vegetables, fruits and whole grains. As always, consult with your medical provider before making any substantial changes to your daily dietary practices.
What are sugar alcohols?
Sugar alcohols, also known as polyols, are a class of carbohydrates that have a chemical structure similar to both a sugar and an alcohol. (However, sugar alcohols don’t contain ethanol, so they’re safe for people who want to completely avoid alcohol.)
Sugar alcohols occur naturally in many fruits, vegetables and mushrooms, but they also can be manufactured in a lab from sources like glucose, sucrose and corn (dextrose). Sugar alcohols are most commonly found in energy bars, gums and candy products that are labeled “sugar free,” “low sugar” or “no sugar added.” They’re also used in products for their anti-caking and stabilizing properties.
Sugar alcohols on ingredients labels
Identifying sugar alcohols on the nutrition facts panel is easy because there is a separate line under the carbohydrates section that lists the sugar alcohols in grams per serving.
How are table sugar and artificial sweeteners different from sugar alcohols?
While table sugar, artificial sweeteners and sugar alcohols are all sweet-tasting compounds, their different chemical structures result in varying effects on taste, digestion, blood glucose levels and oral health.
Chemical structure and classification
Table sugar, such as white sugar, is most often majoritively sucrose, a disaccharide carbohydrate composed of the monosaccharides glucose and fructose. When digested, sucrose is broken down and becomes glucose in the bloodstream.
Sugar alcohols, unlike table sugar molecules, are not made up entirely of carbohydrates, as they also contain an alcohol group.
In our recent post on artificial sweeteners, we explained that this group of sugar substitutes isn’t classified as a carbohydrate. Artificial sweeteners (e.g., NutraSweet™, Stevia™), also known as non-nutritive sweeteners, provide zero calories per gram — with the exception of aspartame, which is used in such negligible quantities that it’s caloric impact is nearly zero.
What do sugar alcohols taste like?
Sugar alcohols are less sweet than table sugar — with the exception of xylitol, which is equally as sweet and has a minty, cool flavor. Lactitol is the least sweet.
Artificial sweeteners are much sweeter than average sugar, ranging from 200 times sweeter (e.g., aspartame, Stevia™) to 20,000 times as sweet (e.g., advantame).
Digestion and absorption
Table sugar is readily absorbed by the body, digested in the small intestine and transported into the bloodstream to be used for energy or stored in adipose tissue. Research shows that excessive sugar consumption predisposes individuals to excessive weight gain and obesity, type 2 diabetes, cardiovascular disease, liver disease, several cancers and myriad metabolic diseases.
Artificial sweeteners move through your body undigested.
Sugar alcohols get digested somewhere in between. They’re not absorbed easily, getting partially digested in the intestines; the undigested part is slowly fermented by gut bacteria, which can result in some gastrointestinal discomfort, especially for those with irritable bowel syndrome (IBS) — although these side effects are generally mild when sugar alcohols are consumed in moderation. Some experts recommend that individuals shouldn’t exceed 15 grams per day to avoid the digestive issues associated with sugar alcohols. Sorbitol, mannitol and maltitol may provoke the most uncomfortable symptoms, so packaged foods that contain these ingredients may have a warning about the potential laxative effects.
Blood glucose levels
Table sugar causes an insulin response due to a spike in blood glucose levels. On the glycemic index (GI), glucose is 100 and sucrose is 65. Artificial sweeteners such as aspartame (also known as NutraSweet™ or Equal™) have a GI of zero because they don’t cause an insulin spike after consumption. (Learn more about the GI and GL indexes.)
Table sugar provides your body with 4 calories per gram.
Artificial sweeteners are non-nutritive and have zero or nearly zero calories per gram.
Because sugar alcohols are not absorbed as efficiently as other carbohydrates, they contain fewer calories than table sugar — with the exception of glycerin, a compound that’s easily absorbed in the small intestines and provides slightly more calories per gram than table sugar. While glycerin is absorbed easily, it doesn’t initiate the same insulin response as table sugar because of its sugar alcohol chemical structure.
While sucrose and other table sugars ferment in your mouth, leading to plaque formation, dental caries (tooth decay) and gum disease, sugar alcohols are recognized by the FDA as noncariogenic — or not associated with tooth decay. In other words, your mouth bacteria doesn’t metabolize sugar alcohols in the same way, so they don’t contribute to a decline in oral health. In fact, many toothpastes and oral hygiene products contain xylitol and erythritol.
Are sugar alcohols safe if you have diabetes?
Sugar alcohols are carbohydrates — and thus can raise your blood sugar levels. However, when consumed in moderation, they offer a lower-calorie, lower glycemic index (GI) profile for anyone concerned about an unhealthy insulin response from foods containing sugar. On the other hand, a good diabetes diet places a heavy emphasis on high-fiber fruits, vegetables, and whole grains — which help stabilize blood sugar, reduce cholesterol and promote a healthy weight. Sugar alcohols are most often found in low-fiber processed and ultra-processed foods, which individuals with diabetes should try to avoid, since they typically have minimal fiber, can have added sugars, and very often also contain extra salt, fat, additives, preservatives, and artificial coloring. Learn more: Fiber and Diabetes and The Truth About Processed Foods.
Sugar alcohols can be a safe alternative sweetener for individuals with diabetes. They are generally less sweet than table sugar and artificial sweeteners, and sugar alcohols provide fewer calories than regular sugar because they’re less digested in the body. However, sugar alcohols are still carbohydrates (unlike artificial sweeteners) and can therefore cause an unwanted rise in blood glucose. Sugar alcohols can also cause a laxative effect, especially for those with IBS. The bottom line: If you have diabetes, foods or drinks containing sugar alcohols can be an “OK” choice as a sweet food that doesn’t significantly impact blood glucose levels or result in weight gain. However, high-fiber whole vegetables and fruits are clearly the healthier carbohydrate options for those with diabetes — and, in fact, for all of us.