Sugar Polyols

Consumers say they regularly use low-calorie, sugar-free foods and beverages to stay in better overall health or simply because they taste good. Many of these products contain ingredients called "sugar alcohols," frequently referred to as "polyols." A polyol (or sugar alcohol) is not a sugar, nor an alcohol.

Polyols are a group of low-digestible carbohydrates derived from the hydrogenation of their sugar or syrup source (e.g., lactitol from lactose). These unique sweeteners taste like sugar but have special advantages. Polyols serve as useful sugar replacers in a wide range of products as part of a sugar free diet. These sugar free foods and products include chewing gums, candies, ice cream, baked goods and fruit spreads. In addition, they function well in fillings and frostings, canned fruits, beverages, yogurt and tabletop sweeteners. They are also used in toothpastes, mouthwashes and pharmaceutical products such as cough syrups and throat lozenges.

There are several polyols used as ingredients in sugar-free foods: erythritol, hydrogenated starch hydrolysates (including maltitol syrups), isomalt, lactitol, maltitol, mannitol, sorbitol and xylitol. The Nutrition Facts Panel on food labels may list them as sugar alcohols or by their specific name. In addition to their clean sweet taste and unique functional properties, polyols offer important health benefits. For example, they are reduced in calories and do not cause sudden increases in blood sugar levels. Importantly, polyols are not readily converted to acids by bacteria in the mouth and, therefore, do not promote tooth decay.

Since most polyols are not as sweet as sugar they are often used in combination with approved low-calorie sweeteners such as acesulfame potassium, aspartame, neotame, saccharin or sucralose. Scientific research supports the fact that these low-calorie sweeteners, like polyols, do not promote tooth decay.

In some people, over consumption of polyol-containing foods may cause gastrointestinal symptoms, including laxative effects, similar to reactions to beans, cabbage and certain high-fiber foods. Such symptoms are dependent upon an individual's sensitivity and the other foods eaten along with the polyol-containing product. Any gastrointestinal symptoms (such as a feeling of fullness) from consuming foods with polyols, if they occur at all, are usually mild and temporary. Most people will adapt to polyols after a few days, the same way they do to high fiber foods. Food manufacturers are advised to inform consumers of these possible effects through product labeling.

TOOTH DECAY - Research and clinical experience have shown that abundant and frequent exposures to dietary fermentable substances enhance the ability of cariogenic bacteria to implant, colonize and increase acid production, which facilitates the carious process. Initial implantation and colonization of mutans streptococci is made possible even if the amounts of sucrose, a sugar commonly used in food manufacture, are very low. Thus, colonization is mainly influenced by interaction of specific biochemical properties of the cariogenic bacterial strains with dietary substrates and the oral ecological environment.

Once cariogenic bacteria are established in dental plaque, their metabolic activity is stimulated by increases in the intake of fermentable carbohydrates but modulated by:

The type of food containing sugars or starches consumed;

The frequency of intake of such foods;

Oral hygiene status;

Availability of fluoride;

Salivary gland function;

Saliva composition; and

Other host factors.

Considering the ubiquity of cariogenic bacteria in most population groups, frequent consumption of sugar-containing foods, medications and chewing substances are recognized as having a strong potential to increase the risk of dental caries, although the severity and magnitude of the caries challenge produced by these foods varies between individuals and population groups.

REDUCED CALORIC VALUES - Because polyols (sugar alcohols) have lower caloric values than sugars, they may help people achieve their weight goals as part of a sugar free diet. Polyols are metabolized differently than sugars as well as among themselves. They are generally incompletely absorbed. Absorbed portions are either metabolized (generally by insulin-independent mechanisms) or excreted via urine. A significant amount of the unabsorbed portion is metabolized to short chain fatty acids and gases by bacteria in the large intestine.

Due to their different metabolic fate, polyols (or sugar alcohols) provide significantly less than the traditional four calories per gram assigned to carbohydrates in general. While the numbers vary for each member of the class, there is broad consensus that polyols have a reduced caloric value compared to sugars. The FDA allows the use of the following caloric values for the polyols: 0.2 calories per gram for erythritol; 1.6 for mannitol; 2.0 for isomalt and lactitol; 2.1 for maltitol; 2.4 for xylitol; 2.6 for sorbitol; and 3.0 for hydrogenated starch hydrolysates - compared to sugars with four calories per gram.

LOW GLYCEMIC INDEX (GI) - The chemical nature of carbohydrates is not a reliable indicator of physiological effect. Glycemic Index (GI) was established some 20 years ago as a means of classifying foods based on their potential to increase blood glucose. During the last 20 years, clinical studies and scientific research have shown that the concept can be applied to single foods, mixed meals and whole diets, and people with or without diabetes and that the methods used are reproducible and consistent. Glycemic Index Tables have been published ranking over 1000 foods by GI, including pure carbohydrates and commercial products.

Health problems related to being overweight are becoming the major health concern of the industrialized world. The World Health Organization and Food and Agriculture Organization of the United Nations (WHO/FAO) have stated that, globally, overweight is a bigger problem than undernourishment and recommended that people in industrialized countries should base their diets on low GI foods to prevent most common diseases of affluence.

The clinical significance of GI remains the subject of intense debate. However, it is clear that the rate of carbohydrate absorption after a meal, as quantified by GI, has significant effects on postprandial hormonal and metabolic responses. High GI meals may promote excessive food intake, beta cell dysfunctio n, dyslipidemia and endothelial dysfunction. Thus, the habitual consumption of high GI foods may increase risk for obesity, type -2 diabetes, and heart disease. Conversely, a reduction in the overall glycemic load of the diet could help to reduce that risk.

There is a significant body of data suggesting that more slowly absorbed starchy foods which are less processed, or have been processed in traditional ways, may have health advantages over those which are rapidly digested and absorbed. These foods have been classified as having a low GI and reduce the glycemic load of the diet. Not all studies of low GI or low Glycemic load diets have resulted in beneficial effects, however, none have shown negative effects. There are also theoretical reasons at a time when populations are increasingly obese, inactive and prone to insulin resistance that dietary interventions that reduce insulin demand may have advantages. In this section of the population, it is likely that more slowly absorbed carbohydrate foods and low glycemic load diets will have the greatest advantage. . . . However, the principle of slowing carbohydrate absorption, which may underpin the positive findings made in relation to GI, is a potentially important principle with respect to the beneficial health effects of carbohydrates. Further research in this area is needed.

All polyols have a low GI and can be used to completely or partially replace sucrose, glucose and high GI polysaccharides such as starch and maltodextrin in a wide range of processed foods such as dairy products, baked goods and confectionery. Polyols and associated specialty carbohydrates can have a useful role in reducing the overall Glycemic load of the diet and in so doing help to reduce the risk of a variety of "lifestyle" related diseases.

To maintain good health it is very important to satisfy your body's basic nutritional needs. Without a balanced diet your body cannot function efficiently. A balanced diet includes eating a variety of foods every day. It's easy to find products from which sugars have been removed and replaced with sugar-free ingredients. Simply look for "sugar-free" on the food label. If you look at the ingredient list you will find that many of these foods contain one or more of the following ingredients: erythritol, hydrogenated starch hydrolysates (sometimes listed as maltitol syrup, hydrogenated glucose syrup, or simply "HSH"), isomalt, lactitol, maltitol, mannitol, sorbitol and xylitol. These ingredients are all polyols. The term "sugar alcohols" or the name of the individual polyol will also appear in the ‘Nutrition Facts" box.

Polyols have been used for many years to replace sugars in a wide variety of products such as chewing gums, candies, ice cream, baked goods and fruit spreads. They have also been widely used in products such as

toothpastes, mouthwashes, cough syrups, and cough drops. The safety and variety of polyols means more and more sugar-free foods are becoming available. And, they taste good.

In addition to their good clean taste, polyols provide some important health benefits. For example, polyols have fewer calories than sugars. Foods that are sweetened with polyols have been of interest to people with diabetes for many years since they do not cause sudden increases in blood sugar levels. Also, while many people believe that tooth decay is no longer a problem in the U.S., tooth decay actually continues to be a major oral health problem. Importantly, polyols do not promote tooth decay (cavities) because bacteria in the mouth cannot easily change polyols to acids that can damage teeth.

Reading the label of a sugar-free food can also help you determine what benefits it may offer. Look for statements such as "low calorie" or "reduced calorie" on the package if weight control is of interest to you. Information on calories and the total carbohydrate content of a serving is also provided in the "Nutrition Facts" box, and may be of particular interest to people with diabetes. If a healthy smile is important to you, look for the FDA approved health claim on the label. It will appear as a statement such as "does not promote tooth decay."

Since most polyols are not as sweet as sugar they are often used in combination with approved low-calorie sweeteners such as acesulfame potassium, aspartame, saccharin or sucralose. These low-calorie sweeteners, like polyols, do not promote tooth decay.

In some people, excessive consumption of polyol-containing foods may cause gastrointestinal symptoms, including laxative effects, similar to reactions to beans and certain high-fiber foods. Such symptoms are dependent upon an individual’s sensitivity and the other foods eaten along with the polyol-containing product. Any gastrointestinal symptoms (such as a feeling of fullness) from consuming foods with polyols, if they occur at all, are usually mild and temporary. Most people will adapt to polyols after a few days, the same way they do to high fiber foods.

ADVANTAGES OF POLYOLS

Many low-calorie, sugar-free foods are sweetened with polyols

Polyols taste like sugar.

Polyols have fewer calories than sugar

Polyols do not promote tooth decay

The U.S. Food and Drug Administration has approved a "does not promote tooth decay" health claim for sugar-free foods and beverages sweetened with polyols

The American Dental Association has issued an official statement saying sugar-free foods do not promote dental caries

Hydrogenated starch hydrolysates are a family of pleasant tasting bulk sweeteners used in a variety of products. They are exceptionally well suited for sugar-free candies because they do not crystallize. They blend well with flavors and are synergistic with low-calorie sweeteners.

Hydrogenated starch hydrolysates (HSH) or polyglycitols, including hydrogenated glucose syrups, maltitol syr ups, and sorbitol syrups, are a family of products found in a wide variety of foods. They serve a number of functional roles, including use as bulk sweeteners, viscosity or bodying agents, humectants, crystallization modifiers, cryoprotectants and rehydration aids. They also can serve as sugar-free carriers for flavors, colors and enzymes. HSH were developed by a Swedish company in the 1960's and have been used by the food industry for many years, especially in confectionery products. HSH are produced by the partial hydrolysis of corn, wheat or potato starch and subsequent hydrogenation of the hydrolysate at high temperature under pressure. The end product is an ingredient composed of sorbitol, maltitol and higher hydrogenated saccharides (maltitriitol and others). By varying the conditions and extent of hydrolysis, the relative occurrence of various mono-, di-, oligo- and polymeric hydrogenated saccharides in the resulting product can be obtained. A wide range of polyols (also known as sugar alcohols) that can satisfy varied requirements with respect to different levels of sweetness, viscosity and humectancy can, therefore, be produced. The term "hydrogenated starch hydrolysate" can correctly be applied to any polyol produced by the hydrogenation of the saccharide products of starch hydrolysis. In practice, however, certain polyols such as sorbitol, mannitol and

maltitol are referred to by their common chemical names. "Hydrogenated starch hydrolysate" is more commonly used to describe the broad group of polyols that contain substantial quantities of hydrogenated oligo- and polysaccharides in addition to any monomeric or dimeric polyols (sorbitol, mannitol or maltitol, respectively). The broad term HSH does not differentiate polyols having, for example, different levels of sweetness nor does it identify the principle polyol in the HSH. Common names for major HSH subgroups have, therefore, been developed. These common names are generally based on the most prevalent polyol comprising the HSH. For example, polyols containing sorbitol as the majority (50 percent or more) component are called sorbitol syrups; those with maltitol as the majority component are called maltitol syrups, maltitol solutions or hydrogenated glucose syrups. Polyols that do not contain a specific polyol as the majority component continue to be referred to by the general term "hydrogenated starch hydrolysate." In the United States, HSH are provided by three manufacturers, Archer Daniels M idland Company (ADM), Corn Products Specialty Ingredients and Roquette America, Inc. Maltitol syrups may contain 55 - 65% maltitol and sorbitol syrup may contain 70 - 75% sorbitol. HSH are outstanding humectants which do not crystallize, enabling the production of sugar -free food and confections with the same cooking and handling systems used to produce sugar candies. These products are used extensively in confections, baked goods, a broad range of other foods, dentifrices and mouthwashes. HSH are nutritive sweeteners that provide 40 to 90 percent of the sweetness of sugar. Being polyols, HSH are not sugars and are used to provide sweetness, texture and bulk to a variety of sugarless products. Unlike sugars, HSH are not readily fermented by oral bacteria and are used to formulate sugarless products that do not promote dental caries. HSH are also more slowly absorbed in the digestive tract. A portion of HSH may be enzymatically hydrolyzed in the body to sorbitol, maltitol and glucose, however, this process is slow. Therefore, HSH have a reduced glycemic potential relative to glucose for individuals with and without diabetes. Since HSH are more slowly absorbed, a portion of HSH in a food reaches the lower digestive tract where it is metabolized by naturally occurring colonic bacteria. This results in a reduction in the available calories and permits its use as a reduced calorie alternative to sugar.

Hydrogenated Starch Hydrolysates

Pleasant tasting bulk sweeteners that blend well with other sweeteners and are synergistic with low-calorie sweeteners (e.g., acesulfame K, aspartame, neotame, saccharin and sucralose)

Blend well with flavors and can mask unpleasant off-flavors

Reduced calorie alternatives to sugar, having not more than 3 calories per gram

Used in a variety of products; exceptionally well suited for sugar-free candies because they do not crystallize

Do not contribute to the formation of dental caries

May be useful as alternatives to sugar for people with diabetes on the advice of their physician

Tooth Decay - Polyols, including HSH, are resistant to metabolism by oral bacteria that break down sugars and starches to release acids that may lead to cavities or erode tooth enamel. They are, therefore, non -cariogenic. The usefulness of polyols as alternatives to sugars and as a part of a comprehensive program including proper dental hygiene has been recognized by the American Dental Association. Use in the Diet of People with Diabetes - Control of blood glucose, lipids and weight are the three major goals in diabetes management today. HSH absorption is slow and incomplete. Therefore, the rise in blood glucose and insulin response associated with the ingestion of glucose is significantly reduced when HSH are used as alternative sweeteners. The reduced caloric value (75 percent, or less, that of sugar) of HSH is consistent with the objective of weight control. Products in which HSH replace sugar may, therefore, be of use providing a wider variety of

reduced calorie and sugar-free choices to people with diabetes. Recognizing that diabetes is complex and requirements for its management may vary between individuals, the usefulness of HSH should be discussed between individuals and their physicians. Foods sweetened with HSH products may contain other ingredients that also contribute calories and other nutrients. These must be considered in meal planning.

Reduced-Calorie Alternatives to Sugar - Absorption of HSH by the body is slow, allowing a portion of HSH to reach the large intestine where metabolism yields fewer calories. Therefore, unlike sugar that contributes 4 calories per gram, the caloric contribution of HSH is not more than 3 calories per gram. For a product to qualify as "reduced calorie" in the United States, it must have at least a 25 percent reduction in calo ries. HSH may, therefore, be of use in formulating reduced calorie food products. The lower caloric value of HSH and other polyols is recognized in other countries. For example, the European Union has provided a Nutritional Labeling Directive stating that all polyols, including HSH, have a caloric value of 2.4 calories per gram.

Safety - The safety of HSH products and their components is substantiated by a broad range of safety studies in man and animals, including long term feeding, multigeneration reproduction and teratology studies. The Joint Food and Agriculture Organization/World Health Organization Expert Committee on Food Additives (JECFA) has reviewed the safety information and concluded that maltitol syrups are safe. JECFA established an acceptable daily intake (ADI) for "maltitol syrup" of "not specified," meaning no limits are placed on its use. An ADI of "not specified" is the safest category in which JECFA can place a food ingredient. JECFA's decisions are often adopted by many small countries that do not have their own agencies to review food additive safety. In 1984, the Scientific Committee for Food of the European Union evaluated maltitol syrups and concluded it was not necessary to set an ADI for maltitol syrups. In the United States, Generally Recognized as Safe (GRAS) petitions for HSH products have been accepted for filing. Once a GRAS affirmation petition has been accepted for filing, food manufacturers may use the ingredient. Products from the HSH family are approved in many other c ountries, including Canada, Japan and Australia.

Multiple Ingredient Approach to Calorie Control - HSH, although less sweet than sucrose, blend well with other sweeteners and flavors and can mask unpleasant off-flavors such as bitter notes. HSH products are synergistic with low-calorie sweeteners. Applications for HSH include confectioneries, baked goods, icings and frozen desserts. In baked goods, for example, HSH products not only offer sweetness but also moisture control, texture improvement, crystallization inhibition, less browning (allowing less chance of burning), stability improvement with extended shelf life and flavor improvement.

Future - Health conscious persons continue to demand additional good-tasting products with less calories and fat. A wide variety of low-calorie and reduced-calorie ingredients can provide products with improved taste and texture, increased stability and more choices for the consumer. The availability of various low-calorie and reduced-calorie ingredients allows food manufacturers to choose the most appropriate ingredient, or combination of ingredients, for a given product. Recent research shows that l94 million Americans consume low-calorie products. Over half of these consumers would like additional low-calorie products to be available. The primary interest is in desserts and sweets, including baked goods, candy, chocolates and ice cream. HSH can be helpful in making many of these products possible.

SUMMARY - With current consumer demand for low-calorie, sugar-free products, as well as the increased availability of polyols and innovations in food technology, additional good tasting sugar -free and reduced-calorie products are expected to be available. These products may assist consumers in maintaining good oral health, maintaining or reducing weight and reducing Glycemic load.