Back in the good old days of low carb dieting,life was simpler. A prudent and sensible low carb diet consisted of real food–real beef, real chicken, real fish, real cheese, real butter, real cream, real olive oil, real nuts, real lettuce, spinach, tomatoes, asparagus, broccoli, cauliflower, zucchini, strawberries, melon…you get the picture. That how it was, back before the tsunami of low carb convience foods flooded the marketplace and swamped the low carb ark. I have to say, we warned the manufacturers and retailers and others interested in the big business of low carb in a keynote speech at the Low Carb Biz Summit in Denver in January 2004 that just such a natural disaster would come to pass if everybody tried to climb onto the boat at once. But low carb was hot hot hot and nobody from the Mom and Pop’s to the industry giants wanted to be left standing on the pier. (As an aside, what’s currently referred to in the press as the demise of the low carb diet is really nothing more than the demise of the low carb craze in the food industry, with bankruptcies and sell-offs abounding. The diet, in its native real-food form, lives on and will continue to do so, because it works and it’s healthy. As Mark Twain said: The rumors of my death have been greatly exaggerated! Indeed.)

One of the byproducts of the food manufacturing industy’s keen interest in going low carb was the introduction of a swarm of new sugar alcohols into the food supply in ever increasing amounts. Where before there was mainly just sorbitol, found mainly in candies marketed to those with diabetes and xylitol, found in sugar-free chewing gums, suddenly product labels sported such ingredients as lactitol, maltitol, mannitol, erythritol, and others.

Instead of just a gram or two here and there from the occasional piece of candy or gum, people were becoming unwitting sugar alcoholics, getting huge doses of a multitude of them each day. Although each serving might not seem like much, they sneak up on you, what with 5 grams in a scoop of sugar-free ice cream, 7 in the sugar free pancake syrup, 18 or 20 in a gooey protein energy bar, and 15 or more in one purportedly “zero-net carb” brownie! (Trust me on that last one, it doesn’t exist–not with the first ingredient being almond flour.) Just like cell phone minutes, the grams add up and the bill comes due, as a host of miserable side effects, ranging from bloating to diarrhea in many people and, depending on the sugar alcohol involved, unpredictable blood sugar surges in diabetics.

We get frequent letters from viewers and readers about the topic of sugar substitutes, particularly the sugar alcohols and exactly how they figure into a low carb plan. Whenever we give a speech or lecture, someone from the audience almost always asks such a question. A succinct and totally accurate answer is tough, unfortunately, to give, because all sugar alcohols are not created equal; they don’t behave the same way with regard to their absorption, their ability to raise blood sugar or to spike insulin. Even the same sugar alcohol doesn’t behave predictably identically from one person to the next.

Our sort of ballpark standard means of calculating their effective contribution to a low carb diet, crude at best, is to count as usable about one-third to one-half of the sugar alcohol grams in a recipe or food. For instance, say the nutritional label of a protein bar proclaims 20 total grams of carbohydrate, 5 of which are fiber, 3 of which are starch and 12 of which are sugar alcohols. The label will likely state–usually in a big red or yellow starburst–contains only 3 grams net carb! Really? Depending on which sugar alcohol(s) contributed those 12 grams, some portion of them will be absorbed to contribute calories at the very least and raise blood sugar in sensitive individuals at the very worst. And, of course, what’s not absorbed contributes to the gastrointestinal symptoms that occur with some of them. It would be more correct (not to mention more prudent for people struggling to lose weight and for the diabetic population) to count at least 4 and possibly 6 of those sugar alcohol grams as having an effect, for a total of 7 or 9 net grams. Just doing that little bit of math may help keep your weight loss going or your blood sugar in better control.

For those who muse on sugar, sugar substitutes, and other sweet topics, a friend tipped me to a recent piece in the LA Times that I thought was an interesting and informative discourse on the topic. Maybe it will help to answer a few questions.

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