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Is the Use of Maltitol Harmful?

Maltitol is a sugar alcohol that is used as a sugar substitute. This Buzzle write-up provides information on the properties of maltitol and side effects associated with its use.
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Side effects of maltitol
Did You Know?
Sugar alcohols are often used in sugar-free chewing gums, toothpastes, and mouthwashes, as these add sweetness without contributing to tooth decay.
Sugar substitutes are broadly classified into artificial sweeteners, natural sweeteners, and sugar alcohols. Sugar alcohols are classified under a class of organic compounds called polyols. These are carbohydrates with a chemical structure that is quite similar to sugar and alcohol. Used as sweeteners or thickening/bulking agents, they provide fewer calories in comparison to table sugar (sucrose). Sugar alcohols are used as a substitute for table sugar in processed food such as sugar-free cookies, hard candies, chewing gums, carbonated drinks, as well as toothpaste, mouthwash, and throat lozenges.

Though sugar alcohols are present in products that are labeled as sugar-free, they do affect one's blood sugar levels. However, they don't lead to a dramatic or significant rise in the blood sugar levels. Sorbitol, mannitol, xylitol, maltitol, isomalt, lactitol, and hydrogenated starch hydrolysates are some of the types of sugar alcohols. While xylitol can be compared to table sugar in terms of sweetness, sugar alcohols are not too sweet, which is why some of them are combined with high intensity artificial sweeteners.

Arguments in Favor of Sugar Alcohols

It must be noted that sugar alcohols are absorbed by the body at a much slower rate than sugar. Thus, they do not cause a sudden or drastic increase in the blood glucose levels. However, these are not calorie free. Unlike certain artificial sweeteners that lose their sweetness on heating, sugar alcohols retain their sweetness. Moreover, products made from them don't become as sticky as the ones made from sugar, as unlike sugar, they don't absorb water.

Sugar-like Sweetness with Half the Calories

Maltitol is one of the sugar alcohols that is readily available in crystallized, powdered, and syrup forms. It provides 2.1 calories per gram, in comparison to sugar, which provides 4 calories per gram. However, there's some disagreement about the number of calories per gram, as some studies suggest that the number of calories is almost close to three. It is almost 90% as sweet as sugar. It imparts a creamy texture, which is why large amounts of maltitol are used in sugar-free desserts and other products. It is produced by the hydrogenation of maltose, which in turn is obtained from starch.

Don't Contribute to Dental Caries

One of the main advantages of maltitol is that it is non-cariogenic, which means that it doesn't promote the development of dental caries or cavities. It is not broken down or metabolized by the bacteria in the mouth. When sugars or carbohydrates are broken down by the bacteria in the mouth, it leads to the development of cavities and the release of certain acids that erode the enamel coating of the teeth. The use of sugar alcohols doesn't cause any of the aforementioned effects. Thus, it is often used in sugar-free chewing gums, toothpastes, and mouthwashes.

Blood Sugar Levels

Due to the slower or incomplete absorption of sugar alcohols by the body, their consumption doesn't cause a significant increase in the blood sugar levels. Thus, these might be considered a bit safer for people affected by diabetes. However, diabetics should incorporate maltitol or any other sugar alcohol in their daily diet, only after consulting their healthcare provider.


Side Effects or Risks Involved with Maltitol Use

While the Food and Drug Administration of the United States has classified most sugar alcohols as Generally Recognized as Safe (GRAS), it has given its approval to some of them as food additives. However, it must be noted that even excessive use of sugar substitutes is harmful for health.

Though the glycemic index (the measure of the effect of carbohydrate-containing food on the blood sugar levels) of this sugar alcohol in powdered form is 36, the glycemic index of maltitol syrup is 52. Thus, it must not be taken in excess. Being carbohydrates, even sugar alcohols, such as maltitol, will affect the blood sugar levels. However, the effect will not be as significant as sucrose, as the body doesn't completely absorb them. Diabetics who intend to use this sugar substitute must consult their healthcare provider or a nutritionist first. They must watch out for the total intake of carbohydrates in the meals and snacks.

The major health concern that is associated with the use of maltitol is the onset of symptoms that are indicative of gastrointestinal upset. It must be noted that sugar alcohols have a laxative effect when taken in large doses. Since the body is unable to digest or absorb sugar alcohols properly, these travel from the small intestine into the large intestine. Fermentation by the bacteria present in the colon gives rise to the formation of intestinal gas. Under such circumstances, one might experience the following symptoms:

Bloating
Flatulence
Diarrhea
Dehydration due to diarrhea

The onset or the severity of the symptoms would vary from person to person. While some individuals might experience the symptoms after consuming around 10 grams, some experience untoward effects only if they consume more than 50 grams. Thus, the users should ascertain their tolerance level, and cut down on the intake of sugar substitutes on experiencing such symptoms. The FDA regulates the use of sugar alcohols, and requires the foods and drinks that contain them to include a warning label describing the potential laxative effect.

Though maltitol can be a good alternative for sugar in case of individuals affected by diabetes or those who wish to cut down on the intake of sucrose, excessive use of this sugar alcohol must be avoided. Sugar alcohols are also a type of carbohydrates. When checking the food labels, you will find that sugar alcohol is mentioned under the section on total carbohydrates. Thus, diabetics or health-conscious individuals who wish to cut down on their sugar intake must always check for the calorie and carbohydrate content on the label, even if the product is marketed as sugar-free or low in sugar. If the carbohydrate content is high, it will lead to high blood glucose levels. So, don't take the food with the so-called 'sugar-free' or 'no added sugar' labels at the face value.
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Published: July 28, 2014
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