Skinny Dippers Diabetic Information

The primary goal for nutritional management of diabetes is to maintain near-normal blood glucose levels. Due to their incomplete absorption, the polyol sweeteners may be useful in diabetic diets. The American Diabetes Association notes, "The total amount of carbohydrate in meals or snack is more important than the source or type." People with diabetes should consult their physician, dietitian or other health professional about incorporating sugar alcohols into their daily meal plans.

An American Dietetic Association publication recommends that persons with diabetes managing their blood sugars using the carbohydrate counting method "count half of the grams of sugar alcohol as carbohydrates since half of the sugar alcohol on average is digested."

Reduced Calorie and Low Carbohydrate Diets
Because of their lower energy density (calories per gram) the replacement of other carbohydrates with sugar alcohols can reduce the energy density of food products and could play a useful role in weight management. Polyols also may have a role in reducing the overall glycemic challenge of the diet. Presently, researchers have no conclusive evidence that glycemic index is related to weight control.

Health experts advise that excessive energy intake in any form leads to weight gain. Consumers should consider the total calorie content of the diet and should avoid over consumption of all foods including those containing sugar alcohols.

SUGAR ALCOHOLS AND HEALTH
Sugar alcohols or polyols, as they are also called, are sugar replacers and have a long history of use in a wide variety of foods. Recent technical advances have added to the range of sugar alcohols available for food use and expanded the applications of these sugar replacers in diet and health-oriented foods. They have been found useful in sugar-free and reduced-sugar products, in foods intended for individuals with diabetes, and most recently in new products developed for carbohydrate controlled eating plans.

Sugar alcohols are neither sugars nor alcohols. They are carbohydrates with a chemical structure that partially resembles sugar and partially resembles alcohol, but they don't contain ethanol as alcoholic beverages do. They are incompletely absorbed and metabolized by the body, and consequently contribute fewer calories than most sugars. The commonly used sugar alcohols include sorbitol, mannitol, xylitol, maltitol, maltitol syrup, lactitol, erythritol, and isomalt and hydrogenated starch hydrolysates. Their calorie content ranges from zero to three calories per gram compared to four calories per gram for sucrose or other sugars. Most sugar alcohols are less sweet than sucrose; maltitol and xylitol are about as sweet as sucrose.

Sugar alcohols occur naturally in a wide variety of fruits and vegetables, but are commercially produced from other carbohydrates such as sucrose, glucose, and starch. Along with adding a sweet taste, polyols (sugar alcohols) perform a variety of functions such as adding bulk and texture, providing a cooling effect or taste, inhibiting the browning that occurs during heating and retaining moisture in foods. Polyols neither prevent nor cause browning.


Metabolism
Sugar alcohols are slowly and incompletely absorbed from the small intestine into the blood. Once absorbed they are converted to energy by processes that require little or no insulin. Some of the sugar alcohol is not absorbed into the blood. These pass through the small intestine and are fermented by bacteria in the large intestine. Thus, overconsumption may produce abdominal gas and discomfort in some individuals. Total daily consumption should be considered since it is the total intake that may primarily drive GI disturbance or laxative effects. As a result, foods that contain certain sugar alcohols and that are likely to be eaten in amounts that could produce such an effect must bear the statement "Excess consumption may have a laxative effect." The American Dietetic Association advises that greater than 50g/day of sorbitol or greater than 20g/day of mannitol "may cause diarrhea."

Given the increasing availability of polyol sweetened foods due to the expanded number of low carbohydrate foods, the total daily intake needs to be considered since it is the total intake that may primarily drive laxative effects. Other important factors to consider include the time of day consumed, the amount eaten in one sitting, type of food, individual response, and adaptation over time. Finally, if you eat a product containing large amounts of polyols for breakfast on an empty stomach, you will probably experience a different effect than consuming the same product later in the day with a fuller stomach.