Nonnutritive Sweeteners

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Sweeteners are important to the quality of life of people with diabetes. An essential distinction is to differentiate those with from those without significant energy content. Tables 6 and 7 provide many of the available nonnutritive and nutritive sweeteners. The nonnutritive sweeteners have no or virtually no energy content, and they can be consumed without concern about their effect on blood glucose.

40 120 6

48 120 5

23 150 6

70 30 10

92 30 24

72 70 25

102 150 31

Type US brand names kcal/g Description

Saccharin Sweet and Low, Sweet Twin, Sweet'N 0 200-700 times sweeter than sucrose; noncarcinogenic and

Low Brown, Necta Sweet produces no glycemic response

Aspartame Nutrasweet, Equal, Sugar Twin (blue box) 4 160-220 times sweeter than sucrose; noncarcinogenic and produces limited glycemic response Acesulfame-K Sunett, Sweet & Safe, Sweet one 0 200 times sweeter than sucrose; noncarcinogenic and produces no glycemic response Sucralose Splenda 0 600 times sweeter than sucrose; noncarcinogenic and produces no glycemic response

Table 7 Polyols and novel sugar sweeteners

Type

kcal/g

Description

Monosaccharide polyols or

novel sugars

Sorbitol

2.6

50-70% as sweet as sucrose; some people experience a laxative effect from a load >50 g

Mannitol

1.6

50-70% as sweet as sucrose; some people experience a laxative effect from a load >20 g

Xylitol

2.4

As sweet as sucrose

Erythritol

G.2

60-80% as sweet as sucrose; also acts as a flavor enhancer, formulation aid, humectant,

stabilizer and thickener, sequestrant, and texturizer

Disaccharide polyols or

novel sugars

Isomalt

2

45-65% as sweet as sucrose; used as a bulking agent

Lactitol

2

30-40% as sweet as sucrose; used as a bulking agent

Maltitol

2.1

90% as sweet as sucrose; used as a bulking agent

Polysaccharide polyols

HSH

3

25-50% as sweet as sucrose; other names include hydrogenated starch hydrolysates and

maltitol syrup

Adapted with permission from the Journal of the American Diabetic Association Position Paper: Use of Nutritive and Nonnutritive Sweetners.

Adapted with permission from the Journal of the American Diabetic Association Position Paper: Use of Nutritive and Nonnutritive Sweetners.

Many 'diet' sweeteners, such as sorbitol or fructose-based snacks, do cause at least some degree of hyperglycemia. Sugar alcohols (polyols) such as sorbitol, mannitol, and xylitol are classified as hydrogenated monosaccharides, hydrogenated disaccharides, and oligosaccharides. They do contain calories, but because they are only partially absorbed in the small intestine, they have a reduced energy value per gram. Excessive use of sugar alcohols has laxative effects and can cause diarrhea.

It is important for people with diabetes to understand clearly these distinctions because many calories can be ingested with foods labeled as 'diet' under the false assumption that they are without effect on blood glucose.

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