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This was posted on another LC forum I frequent, but it's great information and I wanted to be sure that ADBBers all got to take a gander at this as well. (Thanks JuliaL at you-know-where 
)
What Is the Impact of the Sugar Alcohols?
Sugar Alcohols — technically called polyols — are carbohydrates that we do not completely absorb. Of the eight sugar alcohols tested for their glycemic index, the most common ones are sorbitol, xylitol, mannitol, and maltitol.
If the sugar alcohols had no impact on our blood glucose, they would have a glycemic index of zero. With the December 2003 publication of Geoffrey Livesey’s amazing review of sugar alcohols, we now know a lot more about them than ever before. His article, “Health potential of polyols as sugar replacers, with emphasis on low glycemic properties,”; is in Nutrition Research Reviews 2003;16:163-91.
Only two of the sugar alcohols have a GI of zero, according to Livesey’s research. These are mannitol and erythritol. Several others have a very low GI, but two maltitol syrups have a GI greater than 50. This is a higher GI value than that of spaghetti, orange juice, or carrots.
Various articles about blood glucose control have incorrectly reported energy values of polyols as about 4 calories per gram and more recently on the American Diabetes Association website as about 2 calories per gram. In fact, Livesey reports that the energy values of sugar alcohols vary from 0.2 to 3.
Glycemic Index and Energy Values of Polyols Polyol GI (glucose=100) Calories/g
Maltitol syrup (intermediate) 53 3
Maltitol syrup (regular) 52 3
Maltitol syrup (high) 48 3
Polyglycitol (hydrogenated starch hydrolysate) 39 2.8
Maltitol syrup (high-polymer) 36 3
Maltitol 36 2.7
Xylitol 13 3
Isomalt 9 2.1
Sorbitol 9 2.5
Lactitol 6 2
Erythritol 0 0.2
Mannitol 0 1.5
Source: Livesey, op. cit., pp. 179, 180.
Not all the low-carb gurus are on the polyol bandwagon. Dr. Richard K. Bernstein, a noted endocrinologist who wrote Dr. Bernstein’s Diabetes Solution (Boston, Little, Brown, revised edition 2003) says on page 139 that, “Some [sugars], such as sorbitol…, will raise blood sugar more slowly than glucose but still too much and too rapidly to prevent a postprandial blood sugar rise in people with diabetes.”
Confirmation of Dr. Bernstein’s position comes from a correspondent, Mary Lu Connolly. She wrote me in January that she has type 1 diabetes and has tried to reduce her carb intake by purchasing the low-carb foods now available. “What I have found is that these foods (especially breakfast bars) cause major rises in my blood sugars hours after eating. Can you explain what is happening?”
At the time she wrote I couldn’t explain it. Now, it’s clear that the culprit is probably maltitol or maltitol syrup. For example, Atkins Nutritionals Peanut Butter Cups have 11 grams of maltitol per serving. The “Net Akins Count” is 2 grams. Atkins Praline Sauce Duet has more maltitol syrup than anything else — 19 grams per serving. The net carbs count is 2. Or you could buy the Atkins Endulge Caramel Nut Chew Box, advertised as having 2 grams net carbs per serving. Yet a serving has 15 grams of maltitol.
Each of these examples come from the Atkins.com. None of them indicate that the glycemic index of one of their primary ingredients — maltitol — is higher than that of pearled barley or kidney beans.
Sugar alcohols do vary considerably in their glycemic indexes. It’s complicated, but they aren’t all created equal.
What Is the Impact of Glycerin?
Glycerin (or glycerine) is a liquid byproduct of making soap. It is wonderfully versatile and has been used as a solvent, antifreeze, plasticizer, drug medium, and in the manufacture of soaps, cosmetics, inks, lubricants, and dynamite. Now it is also used as a sweetener.
Atkins Nutritionals says that glycerine is another carbohydrate that has “a minimal impact on blood sugar.” Dr. Thomas Wolever, professor and acting chair of the department of nutritional sciences at the University of Toronto, confirms this in personal correspondence with me. He also heads a company, Glycaemic Index Testing Inc., which has ascertained the GI value of hundreds of foods.
“We did a study on glycerine at GI Testing, but the data don’t belong to me so I cannot publish it — except it was published in abstract form — and up to 75g glycerine had a negligible effect on blood glucose and insulin in normal subjects.’ He cites his article, “Oral glycerine has a negligible effect on plasma glucose and insulin in normal subjects” in Diabetes 2002;51(Supplement 2):A602. Some others believe, however, that it might have a greater impact on people with type 2 diabetes who have overactive livers.
What Is the Impact of Polydextrose?
Polydextrose is another carbohydrate. It is used primarily as a bulking agent for the preparation of calorie-reduced foods. Atkins Nutritionals says that polydextrose has “a minimal impact on blood sugar.”
Again, Dr. Wolever can confirm the Atkins claim. ”I don’t think polydextrose is available in the small intestine at all,” Dr. Wolever tells me. “If that is so, it has no effect on blood glucose.”
A recent study lead by Zhong Jie of Rui Jin Hospital in Shanghai, “Studies on the effects of polydextrose intake on physiologic functions in Chinese people,” confirms Dr. Wolever’s belief. This study, reported in the American Journal of Clinical Nutrition, Vol. 72, No. 6, 1503-1509, December 2000, concluded that “polydextrose had no significant effect on blood biochemistry indexes” include the glycemic index. Their study confirmed “that polydextrose is nonglycemic.”
Conclusion?
Dr. Atkins and the vendors of low-carb products are correct that not only fiber but also glycerin and polydextrose have little or no effect on blood glucose. The story with sugar alcohols, however, is different. One of the most commonly used sugar alcohols, maltitol and its syrups, does have a considerable effect on blood glucose. Two sugar alcohols, erythritol and mannitol, have no effect, and four others have some effect.
You need to check which sugar alcohols are used in any low-carb products you buy. Just like different carbohydrates affect blood glucose to different degrees, so too do some sugar alcohols.
--------------------------------------------------------------------------------
This article originally appeared on mendosa.com on February 13, 2004. The link is : http://mendosa.com/netcarbs.htm
--------------------------------------------------------------------------------
Update: Response from Atkins
It took the Atkins people seven months to recognize this article and respond to it. And when they did write, it became clear that they didn’t like it at all.
My article “makes an unfounded claim and does a considerable disservice to the millions of Americans who lead healthier lives by following the Atkins Nutritional Approach,” writes Colette Heimowitz, vice president, education and research, Atkins Health and Medical Information Services. Actually, she enumerated three unfounded claims that I supposedly made in this article: Basing my article on the glycemic index is “problematic” for several reasons:
It is “misleading to compare the quantity of sugar alcohol tested to determine the glycemic index with the quantity of sugar alcohol that is actually in our products” because the “glycemic index does not take into account serving size.”
My article did “not consider that other components in the product [besides sugar alcohol] such as fat, fiber and protein will have an impact on the metabolism of the sugar alcohol and, thus, the blood sugar response.”
My article also “fails to recognize is that the human trials conducted on Atkins-branded products were done with healthy individuals. Results are likely to vary in a diabetic population where blood sugar control is abnormal.”
All of these reservations are specious or worse.
I have never compared “the quantity of sugar alcohol tested to determine the glycemic index with the quantity of sugar alcohol that is actually in [Atkins] products.” The crux of my argument is that the Atkins products claim that they use “sugar alcohols that…have a minimal impact on blood sugar,” but in fact they use some sugar alcohols — particularly maltitol — that do have a considerable impact on blood sugar.
My article was about net carbs, specifically the sugar alcohols. The fact that other food components have a minimal blood glucose impact is irrelevant to the fact that sugar alcohols like maltitol have a considerable impact.
I find it interesting that Atkins products have not been tested on people with diabetes. Maybe that is another reason to avoid them.…
)What Is the Impact of the Sugar Alcohols?
Sugar Alcohols — technically called polyols — are carbohydrates that we do not completely absorb. Of the eight sugar alcohols tested for their glycemic index, the most common ones are sorbitol, xylitol, mannitol, and maltitol.
If the sugar alcohols had no impact on our blood glucose, they would have a glycemic index of zero. With the December 2003 publication of Geoffrey Livesey’s amazing review of sugar alcohols, we now know a lot more about them than ever before. His article, “Health potential of polyols as sugar replacers, with emphasis on low glycemic properties,”; is in Nutrition Research Reviews 2003;16:163-91.
Only two of the sugar alcohols have a GI of zero, according to Livesey’s research. These are mannitol and erythritol. Several others have a very low GI, but two maltitol syrups have a GI greater than 50. This is a higher GI value than that of spaghetti, orange juice, or carrots.
Various articles about blood glucose control have incorrectly reported energy values of polyols as about 4 calories per gram and more recently on the American Diabetes Association website as about 2 calories per gram. In fact, Livesey reports that the energy values of sugar alcohols vary from 0.2 to 3.
Glycemic Index and Energy Values of Polyols Polyol GI (glucose=100) Calories/g
Maltitol syrup (intermediate) 53 3
Maltitol syrup (regular) 52 3
Maltitol syrup (high) 48 3
Polyglycitol (hydrogenated starch hydrolysate) 39 2.8
Maltitol syrup (high-polymer) 36 3
Maltitol 36 2.7
Xylitol 13 3
Isomalt 9 2.1
Sorbitol 9 2.5
Lactitol 6 2
Erythritol 0 0.2
Mannitol 0 1.5
Source: Livesey, op. cit., pp. 179, 180.
Not all the low-carb gurus are on the polyol bandwagon. Dr. Richard K. Bernstein, a noted endocrinologist who wrote Dr. Bernstein’s Diabetes Solution (Boston, Little, Brown, revised edition 2003) says on page 139 that, “Some [sugars], such as sorbitol…, will raise blood sugar more slowly than glucose but still too much and too rapidly to prevent a postprandial blood sugar rise in people with diabetes.”
Confirmation of Dr. Bernstein’s position comes from a correspondent, Mary Lu Connolly. She wrote me in January that she has type 1 diabetes and has tried to reduce her carb intake by purchasing the low-carb foods now available. “What I have found is that these foods (especially breakfast bars) cause major rises in my blood sugars hours after eating. Can you explain what is happening?”
At the time she wrote I couldn’t explain it. Now, it’s clear that the culprit is probably maltitol or maltitol syrup. For example, Atkins Nutritionals Peanut Butter Cups have 11 grams of maltitol per serving. The “Net Akins Count” is 2 grams. Atkins Praline Sauce Duet has more maltitol syrup than anything else — 19 grams per serving. The net carbs count is 2. Or you could buy the Atkins Endulge Caramel Nut Chew Box, advertised as having 2 grams net carbs per serving. Yet a serving has 15 grams of maltitol.
Each of these examples come from the Atkins.com. None of them indicate that the glycemic index of one of their primary ingredients — maltitol — is higher than that of pearled barley or kidney beans.
Sugar alcohols do vary considerably in their glycemic indexes. It’s complicated, but they aren’t all created equal.
What Is the Impact of Glycerin?
Glycerin (or glycerine) is a liquid byproduct of making soap. It is wonderfully versatile and has been used as a solvent, antifreeze, plasticizer, drug medium, and in the manufacture of soaps, cosmetics, inks, lubricants, and dynamite. Now it is also used as a sweetener.
Atkins Nutritionals says that glycerine is another carbohydrate that has “a minimal impact on blood sugar.” Dr. Thomas Wolever, professor and acting chair of the department of nutritional sciences at the University of Toronto, confirms this in personal correspondence with me. He also heads a company, Glycaemic Index Testing Inc., which has ascertained the GI value of hundreds of foods.
“We did a study on glycerine at GI Testing, but the data don’t belong to me so I cannot publish it — except it was published in abstract form — and up to 75g glycerine had a negligible effect on blood glucose and insulin in normal subjects.’ He cites his article, “Oral glycerine has a negligible effect on plasma glucose and insulin in normal subjects” in Diabetes 2002;51(Supplement 2):A602. Some others believe, however, that it might have a greater impact on people with type 2 diabetes who have overactive livers.
What Is the Impact of Polydextrose?
Polydextrose is another carbohydrate. It is used primarily as a bulking agent for the preparation of calorie-reduced foods. Atkins Nutritionals says that polydextrose has “a minimal impact on blood sugar.”
Again, Dr. Wolever can confirm the Atkins claim. ”I don’t think polydextrose is available in the small intestine at all,” Dr. Wolever tells me. “If that is so, it has no effect on blood glucose.”
A recent study lead by Zhong Jie of Rui Jin Hospital in Shanghai, “Studies on the effects of polydextrose intake on physiologic functions in Chinese people,” confirms Dr. Wolever’s belief. This study, reported in the American Journal of Clinical Nutrition, Vol. 72, No. 6, 1503-1509, December 2000, concluded that “polydextrose had no significant effect on blood biochemistry indexes” include the glycemic index. Their study confirmed “that polydextrose is nonglycemic.”
Conclusion?
Dr. Atkins and the vendors of low-carb products are correct that not only fiber but also glycerin and polydextrose have little or no effect on blood glucose. The story with sugar alcohols, however, is different. One of the most commonly used sugar alcohols, maltitol and its syrups, does have a considerable effect on blood glucose. Two sugar alcohols, erythritol and mannitol, have no effect, and four others have some effect.
You need to check which sugar alcohols are used in any low-carb products you buy. Just like different carbohydrates affect blood glucose to different degrees, so too do some sugar alcohols.
--------------------------------------------------------------------------------
This article originally appeared on mendosa.com on February 13, 2004. The link is : http://mendosa.com/netcarbs.htm
--------------------------------------------------------------------------------
Update: Response from Atkins
It took the Atkins people seven months to recognize this article and respond to it. And when they did write, it became clear that they didn’t like it at all.
My article “makes an unfounded claim and does a considerable disservice to the millions of Americans who lead healthier lives by following the Atkins Nutritional Approach,” writes Colette Heimowitz, vice president, education and research, Atkins Health and Medical Information Services. Actually, she enumerated three unfounded claims that I supposedly made in this article: Basing my article on the glycemic index is “problematic” for several reasons:
It is “misleading to compare the quantity of sugar alcohol tested to determine the glycemic index with the quantity of sugar alcohol that is actually in our products” because the “glycemic index does not take into account serving size.”
My article did “not consider that other components in the product [besides sugar alcohol] such as fat, fiber and protein will have an impact on the metabolism of the sugar alcohol and, thus, the blood sugar response.”
My article also “fails to recognize is that the human trials conducted on Atkins-branded products were done with healthy individuals. Results are likely to vary in a diabetic population where blood sugar control is abnormal.”
All of these reservations are specious or worse.
I have never compared “the quantity of sugar alcohol tested to determine the glycemic index with the quantity of sugar alcohol that is actually in [Atkins] products.” The crux of my argument is that the Atkins products claim that they use “sugar alcohols that…have a minimal impact on blood sugar,” but in fact they use some sugar alcohols — particularly maltitol — that do have a considerable impact on blood sugar.
My article was about net carbs, specifically the sugar alcohols. The fact that other food components have a minimal blood glucose impact is irrelevant to the fact that sugar alcohols like maltitol have a considerable impact.
I find it interesting that Atkins products have not been tested on people with diabetes. Maybe that is another reason to avoid them.…
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