Elaine L., who reads this column in the St. Louis Post-Dispatch writes, “I am diabetic and also get a very dry mouth frequently. Sucking on a hard candy helps my mouth, but I really don’t need the sugar. I have searched for sugar-free hard candies, but every one I have found contains sugar alcohols, which greatly upset my stomach. Are there any sugar-alcohol-free, sugar-free hard candies in existence?”
You may have me stumped on this one, Elaine. Sugar alcohols are the primary ingredient in most low sugar candies. If there are any products without them, they didn’t come up on my radar. Here are some other considerations, however.
I don’t know your health history, but dry mouth is a common problem for people with diabetes. It can be related to high blood sugars or certain medications. A thorough check with your health provider might help you find solutions.
As far as sugar alcohols — collectively referred to as “polyols”— they are chemically similar to sugar as well as alcohol (but not the type found in booze), according to the U.S. Food and Drug Administration. With names like mannitol, sorbitol, xylitol, lactitol, isomalt, erythritol and maltitol, they are commonly used in sugar-free products for a couple of reasons.
Because they are not completely digested (hence the problem with diarrhea if consumed in excess) they contain about half the calories of regular sugar. And dentists say these sweeteners may actually help prevent tooth decay.
Sugar alcohols occur naturally in some fruits, vegetables and mushrooms. But when they are processed into individual compounds, they are classified as sweeteners. You can easily find out if a product contains sugar alcohols since FDA requires it to be listed on the Nutrition Facts label.
The American Diabetes Association states that sugar alcohols and other sweeteners “may be an acceptable substitute” for sugar “when consumed in moderation.” But not all sugar alcohols have the same effect on all people.
Several reliable sources suggest that people have fewer digestive issues when they limit their intake of sugar alcohols to less than 20 grams a day. And some studies report that erythritol and xylitol may be easier on the GI tract than sorbitol and mannitol.
Yet there may be other concerns. Although sugar alcohols are “Generally Recognized as Safe” by the FDA, in 2023, researchers at the Cleveland Clinic found that people with higher amounts of the sugar alcohol erythritol in their blood were at a higher risk for a heart attack or stroke.
Incidentally, Elaine, diabetes educators like myself see you as a “person with diabetes” instead of “diabetic.” Just like there is more to sugar alcohols than meets the eye, you are definitely more than your health condition.
Barbara Quinn-Intermill is a registered dietitian and certified diabetes educator affiliated with Community Hospital of the Monterey Peninsula. She is the author of “Quinn-Essential Nutrition” (Westbow Press, 2015). Email her at to [email protected].
