Sugar Alcohols courtesy of Doreen

There has been quite a bit of discussion and/or controversy concerning whether or not sugar alcohols should be counted as carbs. Bless you Doreen! You found the info for us and all in one spot!

Maltitol, Sorbitol and Other Sugar Alcohols

Sugar alcohols - also called polyols - are a class of carbohydrate that are neither sugars nor alcohols. This group includes maltitol, sorbitol, mannitol, xylitol, erythritol, lactitol, and hydrolysed starch hydrolysates (HSH). These popular sugar substitutes provide the bulk and sweetness of sugar and corn syrup, but are incompletely absorbed in the intestine. Thus they provide fewer calories and carbs than sugar, and result in a much slower, and smaller rise in blood sugar and insulin. They are generally recognised as safe for diabetics to consume for this reason, and products sweetened with these products may legally be labelled "sugar-free" in both Canada and the US. Sugar alcohols do not promote oral bacteria, and xylitol in fact inhibits bacterial growth, thus do not cause tooth decay.

There is a great deal of confusion about whether or not these products provide carbohydrates, and how they should be counted toward a carbohydrate-restricted diet. Some authorities say they provide zero carbs because they are not absorbed. Others, such as Diabetic Associations across North America, are taking a more cautious stand. Currently, food labelling regulations in Canada and US do not require (yet) including maltitol et al in the Total Carbohydrate data of the nutrients list. However, the amount must be listed in the ingredients panel.

So how do you count them in your carb budget for the day? Some say 0 carbs, so just go by the label and only count the carbs from any sugar or starch in the food. Others, such as the Canadian Diabetes Association, recommend counting the full amount as carbohydrate grams, especially for patients using carb-counting for insulin dosage and insulin pumps. Still others take a median approach, and suggest counting each gram of maltitol as 0.5 carb grams.

All authorities recommend using caution and definitely moderation is key. Because they are not completely absorbed in the bowel, they have a nasty reputation of holding onto water, and promoting diarrhea, gas and bloating. This is politely termed the "laxative effect". Sorbitol and mannitol are the worst offenders, maltitol and lactitol less so. The label should indicate the serving size. This is the amount considered safe to eat before the laxative effect takes over. So beware that overeating these foods can have serious effects. Especially for children, who of course will experience the effect from an even smaller amount.

Many low carbers enjoy an occasional chocolate bar or candy sweetened with one of the sugar alcohols, and find there is no effect on their weight loss or ketosis. Some do find it will put them in a stall. Others find they definitely experience a blood sugar "rush" from eating even a small amount. For a few, the laxative effect is pronounced, and even a small amount will trigger unpleasant symptoms. This is definitely a case of YMMV (your mileage may vary). For some low carbers, planning for one of these treats now and then helps to stave off cravings for serious carb binges. Indeed, even at full count, a 40 gram chocolate bar sweetened with maltitol has an average of 12 carb grams, as opposed to regular plain chocolate with 25 carbs in a similar sized bar. Just beware that they can also trigger the sweet cravings you hope to avoid.