Sugar Alcohol And Net Carbs

So I was spending some time with a friend of mine that has had a gastric bypass.  His doctor tells him to follow a low carb diet to avoid “dumping syndrome”.  Since I have lost almost as much weight as him by doing only a low carb diet, he and I discuss the low carb lifestyle quite a bit.

He is unsure how to calculate carbs, and what items are on the naughty list.  So in the course of this discussion we began talking about “net carbs” and how you can back out the sugar alcohol carbs.  Then I pointed out that Malitol is reputed to be a sugar alcohol that actually can’t be backed out and is processed like sugar in the body.  This brought up a whole series of questions, which prompted me to find this article:

http://www.mendosa.com/netcarbs.htm

If you scroll down the page and look at the carb chart, you see the caloric value of each of the sugar alcohols.  To give you some context, a gram of carbohydrates is 4 calories.  So, when you look at Isomalt, you can see that it has a caloric value of 2.1 calories.  This means, my friends, that Isomalt can be counted at 50% carbs.  Isomalt, by the way, is the sweetener used in hard candies like sugar free jolly ranchers, etc.

I bring this up to point out that when you calculate “net carbs”, you need to be very careful.  The first thing you need to ask yourself is, which sugar alcohol is being used.  If it is something like malitol or xylitol, you should not remove the sugar alcohol from the carb count.  Since malitol and xylitol tend to carry 3/4 of a gram of carbs for each gram, you would basically only remove 25% of the sugar alcohol carbs. The ruse (from this article):

What’s Going on Here?

Most of these “low carb” products are sweetened with substances called “sugar alcohols.” Maltitol, lacitol, and sorbitol are some of names of these sweeteners. Despite the name, these aren’t sugars or alcohols. They are hydrogenated starch molecules which are a byproduct of grain processing.

These sugar alcohols are manufactured by the three large agribusiness companies: SPI Polyols, Roquette America, Inc. and Archer Daniels Midland. Having saturated world with high fructose corn syrup, these giant corn-producing companies have now turned to hydrogenated corn starch molecules as yet another way to wring profits out of surplus corn.

Despite wrapper claims, these sugar alcohols are metabolized. Each gram of a sugar alcohol turns into anywhere from less than 1 to as much as 3 calories. Erythritol comes in lowest, delivering less than one calorie per gram. Maltitol–the sugar alcohol found in most “low carb” foods is the highest, delivering 3 calories per gram. That is only a bit less than 4 calories you find in regular sugar and starch.

It is because these sugar alcohols can be metabolized as carbohydrates that US law requires that they be reported as carbohydrates on nutritional labels and why their calories are included in calorie counts.

Several years ago, after the FDA fined Atkins Nutritionals for ignoring the 20+ grams of glycerin found in their product in the nutritional panel of their Advantage Bars, the company invented the “Net Carbs” designation that it now places on the front of wrappers–but not on the nutritional panel. This ruse was so successful, they went on to license the use of this phrase and the Atkins “A” to other companies so that they too could continue deluding customers about the carb content of their foods.

Small print on back of these label explains that fiber and sugar alcohols have a “negligible effect on blood sugar”. This, they suggest means that you can ignore them, and magically converts foods that have 24 grams of carbs–and the associated calories–into foods with a diet-friendly 3 grams.

If it were true that these foods did not raise blood sugar, it would make them ideal for the low carb diet. However, it is not always true. Some lucky people can eat these low carb treats and still lose weight on a low carb diet. But hundreds of people who have stopped by the alt.support.diet.low-carb news group to ask why their weight loss has stopped cold, discover that it is these sugar alcohol-laden low carb junk foods that have caused their long-term stalls.

Lying Labels?

The reason for this, is quite simply, that sugar alcohols, particularly Maltitol, the one that is most common in these products, can have a very significant impact on blood sugar. This isn’t speculation. It’s a fact. Many people with diabetes, who track any rise in their blood sugar with a blood sugar meter, find that these products cause a significant rise in their blood sugar, contrary to the label claims.

I’m one of them. My blood sugar rises almost as high when I eat a maltitol-sweetened Russell Stover “No Sugar” candy as it does if I eat a regular Russell Stover candy of same size. The only difference is that it takes two hours for the blood sugar rise to occur when I eat the “no sugar” candy compared to the one hour that it takes when I eat regular candy. So much for “truth in labeling.”

I am not only person who has found this to be true. Fran McCullough warns readers of the very high blood sugar spikes reported by diabetics after eating glycerine-containing Atkins bars in her book, Living Low Carb.

A comprehensive review published by the Canadian Journal of Diabetes gives a very good overview of the scientific research into how sugar alcohols affect both normal people and people with diabetes.

Sugar Alcohols and Diabetes: A Review.

Note the finding, on Page 5, that research shows that chocolate bars sweetened with maltitol raised the blood sugar of normal people as high as did chocolate bars sweetened with sucrose–table sugar.

However, there are other people with diabetes who report that they don’t see a blood sugar rise when they eat foods containing these sugar alcohols. They find these products give them a way to incorporate legitimate treats into their diets and are grateful that they are now so plentiful.

There are also a number of successful low carbers who report in diet newsgroup that they have been able to lose significant amounts of weight while including these “low carb” treats in their food plans on a daily basis. You will often find them railing against “puritanism” of those who warn new dieters against them.

So, clearly these products do not affect everyone in same way. For some people they are a godsend. For others, they turn out to be “Stall in a Box.”

And from the same article, this gem of logic:

Since it seems that only a subset of the population metabolizes sugar alcohols as sugar, it is quite possible that some people lack some enzyme(s) needed to digest them and turn them into blood sugar. Since those people’s bodies can’t turn these sugar alcohols into glucose, they do not experience a blood sugar rise when they eat them.

Lending some support to this idea is fact that some of the people who report that they did not experience a blood sugar rise when they ate a product with a sugar alcohol in it, add that they experienced intense diarrhea or gas later on. These are classic symptoms of what happens when starches pass undigested into lower gut where they may be fermented by bacteria (causing gas) or suck water out of cells lining the colon (causing diarrhea).

Many of us who do get blood sugar rise do not experience this diarrhea. Our digestive enzymes appear to be able to break down these hydrogenated starches into glucose–though given the time lag, this happens slowly.

WHich makes sense, right?  If you are not processing the sugar alcohol into the blood, you will have to process it in the colon (meaning gas, cramps, and running to the restroom).  So if you eat sugar alcohol and it isn’t giving you some stomach difficulty, perhaps you are metabolizing it?

My sons weight loss stalled last fall, but mine didn’t.  I travel a lot, so do not eat the desserts made with xylitol.  He is at home, and ends up eating the desserts.  Of course, putting the above into action should give me an idea as to what is going on, it seems that his lack of digestive issues with sugar alcohol may be hinting that the lowered weight loss is due to Xylitol.

Regardless, in our house we will move to Erythritol.  Many know this as “stevia” or something similar.  It has 0.2 calories/gram, which means that for each serving of Erythritol we can count it as 1/2g carbohydrate…assuming your body processes sugar alcohols “normally”.

 

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