Jump to content

  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.



  • Celiac.com Sponsor (A1):

    Celiac.com Sponsor (A1-M):

  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate

Sugar alcohols

plumbago

By plumbago
in Related Issues & Disorders

 Share

Recommended Posts

plumbago Experienced
plumbago
Posted

Sabine Hassenfelder is a German science writer who has worked in the US and Sweden, among other places. She posts entertaining, funny videos about science, but recently did one on sugar alcohols, which I think is worth viewing. In it, she talks some about autoimmunity in general, and why symptoms often show up later in life (30s -40s, eg). ("I've probably had this my entire life," she says, but she didn't notice sooner, mostly due to age and food intolerance are mostly a threshold effect. But another part of the reason is that they're used much more so than ever, she says - even toothpaste!) She was having some post prandial digestive issues - cramps, pain, bloating - and went on a detailed search for the culprit. It turns out to have been sugar alcohols. Often called sorbitol or mannitol, it is added to things like soft cookies to keep them from drying out. There are many different sugar alcohols, with many different names, sigh. Intolerance to this food additive is something to consider (possibly) if you are still having symptoms after going gluten free for a number of months. Doctors gave her all manner of diagnoses including diverticula (nope). She cut sugar alcohols out of her diet and she says 95% of her problems disappeared.

"If you have an autoimmune problem, it will flare up along with it" she says. Whoa. She predicts diagnoses of sugar alcohol intolerance will skyrocket in the coming decade.

Sugar alcohols represent the "P" in the FODMAP diet (polyols). They are not technically an artificial sweetener, though they do have a sweet taste, so they do not have to be disclosed on food labels.

Search for her on youtube - it's worth a watch.

Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):

Celiac.com Sponsor (A8-M):


trents Grand Master
trents
Posted

Erythritol avoids many of the problems associated with other sugar alcohols and is safe unless used in large quantities.

plumbago Experienced
plumbago
Posted
  • Author
(edited)

Yeah, but the point of the video was that sugar alcohols are often hidden. I know little about erythriol, and as far as I can tell, that's not what the video was talking about - ie, two different things?

Editing to add to my reply here...So erythritol is actually a polyol, which is a sugar alcohol, the topic of her video, though she does not specifically mention it in her video. She says that the body never completely breaks down this compound, and intolerance develops due to reaching a threshold. Again, she doesn't specifically mention it, but being a polyol, I would assume she considers it just as potent a future problem as those she does name.

Edited by plumbago
RMJ Mentor
RMJ
Posted

I think sugar alcohols have to be listed on the ingredient portion of a food label.  They do NOT have to be included on the Nutrition Facts portion of the label unless certain claims are made about the food. 

plumbago Experienced
plumbago
Posted
  • Author

According to the video @RMJ -- They are not technically artificial sweeteners so they do not have to be disclosed. Labels often just say "less sugar" or "sugar substitute."

I encourage folks to watch it.

trents Grand Master
trents
Posted
(edited)

Not sure what the FDA requirement is but I often see them listed in ingredient labels.

Most sugar alcohols are not broken down well before they reach the colon and therefore can cause a lot of flatus. Erythritol is different in that respect. It is broken down and 90% absorbed before it gets to the colon. The only knock on it that I am aware of is that when used in large quantities it can cause arrythmia. But the quantity required to cause that effect is not likely to be reached unintentionally.

It also needs to be kept in mind that sugar alcohols are naturally found in may fruits and vegetables and some of them have pretty high concentrations of sugar alcohols. Prunes, for instance.

Pears are also high in sugar alcohol.

Edited by trents
plumbago Experienced
plumbago
Posted
  • Author
4 minutes ago, trents said:

Not sure what the FDA requirement is but I often see them listed in ingredient labels.

They may be listed, but that doesn't mean they are required to be listed. (Again, I encourage people to watch the video)

4 minutes ago, trents said:

It also needs to be kept in mind that sugar alcohols are naturally found in may fruits and vegetables and some of them have pretty high concentrations of sugar alcohols.

So - again, in the video - she says she's 95% better, and that 5% is from the sugar alcohols found in fruits. Her point is that it is now added in more and more things, and we are getting overexposed.

Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):

Celiac.com Sponsor (A8-M):


trents Grand Master
trents
Posted

So, all the health experts tell us we eat way too much refined sugar and it causes obesity, diabetes and cardiac disease. All true. So, the food industry, in response to that, removed the refined sugar and replaced it with "0" calorie artificial sweeteners, some of which have cancer risk attached to them. So, the food industry responds to that issue and replaces artificial sweeteners with natural "0" calorie natural sweeteners like manitol, xylitol, sorbitol, ect. (i.e., the sugar alcohols). Really, the problem is we are addicted to sweet.

plumbago Experienced
plumbago
Posted
  • Author

Very much so. Two things can be true at once - sugar can lead to chronic disease (including cancer BTW), and sugar alcohols (again, technically not an artificial sweetener, according to the video), can lead to intolerance, causing bloating, gas, and pain.

If you ask me, and you didn't, we should be regulating sugar, high fructose corn syrup, and I guess artificial sweeteners and possibly sugar alcohols, as well. But alas, we don't. We just have to clean up the enormous problems they cause on the daily. It's a huge pain. I work in "healthcare."

RMJ Mentor
RMJ
Posted

I don’t disagree that sugar alcohols can cause digestive problems, or that Americans eat too much sugar/sweeteners.  I just disagree with the labeling (mis)information. 

Maybe it’s different in Germany where the Sabine Hassenfelder is from, but I don’t find anything in FDA laws or regulations exempting sugar alcohols from the ingredient lists of foods. They don’t meet the requirements for an exemption.

Unless health claims about sugar alcohols or sugar are made on the package, where they do not have to be listed is in the nutrition facts total sugars area - which is a bit deceptive.

If mannitol or sorbitol are present at a level where more than 20 grams (mannitol) or 50 grams (sorbitol) is expected to be ingested there has to be a warning: Excess consumption may have a laxative effect.

plumbago Experienced
plumbago
Posted
  • Author

Here's what the FDA says - and again, please do watch the video.

Food manufacturers may voluntarily list the amount in grams (g) per serving of sugar alcohols on the Nutrition Facts label (under Total Carbohydrate). They may also list the name of a specific sugar
alcohol if only one is added to the food. But, food manufacturers are required to list sugar alcohols if
a statement is made on the package labeling about the health effects of sugar alcohols or sugars
(when sugar alcohols are present in the food)

https://www.accessdata.fda.gov/scripts/InteractiveNutritionFactsLabel/assets/InteractiveNFL_SugarAlcohols_October2021.pdf

plumbago Experienced
plumbago
Posted
  • Author

Anyway, I feel like maybe the forest is being missed, here, for the trees.

There's a higher percentage of the stuff that's been added to foods, than occurs naturally in fruit. That's one. Two, and this was my main point - if people with celiac disease are still having issues, it is certainly worth considering that it could be these sugar alcohols. I found the video impressive, and can only add for the thousandth time, that I think people should watch it.

RMJ Mentor
RMJ
Posted
22 minutes ago, plumbago said:

Here's what the FDA says - and again, please do watch the video.

Food manufacturers may voluntarily list the amount in grams (g) per serving of sugar alcohols on the Nutrition Facts label (under Total Carbohydrate). They may also list the name of a specific sugar
alcohol if only one is added to the food. But, food manufacturers are required to list sugar alcohols if
a statement is made on the package labeling about the health effects of sugar alcohols or sugars
(when sugar alcohols are present in the food)

https://www.accessdata.fda.gov/scripts/InteractiveNutritionFactsLabel/assets/InteractiveNFL_SugarAlcohols_October2021.pdf

That is for the nutrition facts label which is separate from the ingredient list. I tried to make that clear in each of my posts.  I give up.

knitty kitty Grand Master
knitty kitty
Posted

Great video, @plumbago!  

I agree wholeheartedly that sugar alcohols cause problems!  I avoid them like the plague.  

I've had problems with candies, mints, toothpaste, and lots of gluten free processed foods which contain one sugar alcohol or another.  The consequences just are not worth it!  

Found some interesting articles...

https://www.nih.gov/news-events/nih-research-matters/erythritol-cardiovascular-events

And...Sorbitol malabsorption in normal volunteers and in patients with coeliac disease

https://pubmed.ncbi.nlm.nih.gov/3343011/

And...A Systematic Review of the Effects of Polyols on Gastrointestinal Health and Irritable Bowel Syndrome

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508768/

Scott Adams Grand Master
Scott Adams
Posted
On 1/20/2024 at 7:15 PM, plumbago said:

Anyway, I feel like maybe the forest is being missed, here, for the trees.

There's a higher percentage of the stuff that's been added to foods, than occurs naturally in fruit. That's one. Two, and this was my main point - if people with celiac disease are still having issues, it is certainly worth considering that it could be these sugar alcohols. I found the video impressive, and can only add for the thousandth time, that I think people should watch it.

I think this is a great topic for a Celiac.com article. I’ve always had issues with, and have avoided sugar alcohols and artificial sweeteners. 

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
 Share
Go to topic listing
  • Celiac.com Sponsor (A19):


  • Member Statistics

    • Total Members
      131,902
    • Most Online (within 30 mins)
      7,748
    Patty6133
    Newest Member
    Patty6133
    Joined
  • Celiac.com Sponsor (A20):

  • Forum Statistics

    • Total Topics
      121.4k
    • Total Posts
      1m
  • Celiac.com Sponsor (A22):



  • Celiac.com Sponsor (A21):


  • Upcoming Events

  • Posts

    • Xravith
      Taking Probiotics but Still Getting Sick After Gluten – Advice?

      By Xravith · Posted

      Yes, you are right. Indeed, I’ve been feeling anemic since the beginning of this week, and today I felt horrible during a lecture at the university, I was trembling a lot and felt all my body incredibly heavy, so I had to come back home. I’ll do a blood test tomorrow, but I’m just worried about the possibility of it coming back negative. I’ve been eating two cookies in the morning as my only source of gluten over the past two weeks—could that affect the final result?
    • trents
      New (possible) celiac diagnosis

      By trents · Posted

      Welcome to the forum, @Judy M! Yes, he definitely needs to continue eating gluten until the day of the endoscopy. Not sure why the GI doc advised otherwise but it was a bum steer.  Celiac disease has a genetic component but also an "epigenetic" component. Let me explain. There are two main genes that have been identified as providing the "potential" to develop "active" celiac disease. We know them as HLA-DQ 2.5 (aka, HLA-DQ 2) and HLA-DQ8. Without one or both of these genes it is highly unlikely that a person will develop celiac disease at some point in their life. About 40% of the general population carry one or both of these two genes but only about 1% of the population develops active celiac disease. Thus, possessing the genetic potential for celiac disease is far less than deterministic. Most who have the potential never develop the disease. In order for the potential to develop celiac disease to turn into active celiac disease, some triggering stress event or events must "turn on" the latent genes. This triggering stress event can be a viral infection, some other medical event, or even prolonged psychological/emotional trauma. This part of the equation is difficult to quantify but this is the epigenetic dimension of the disease. Epigenetics has to do with the influence that environmental factors and things not coded into the DNA itself have to do in "turning on" susceptible genes. And this is why celiac disease can develop at any stage of life. Celiac disease is an autoimmune condition (not a food allergy) that causes inflammation in the lining of the small bowel. The ingestion of gluten causes the body to attack the cells of this lining which, over time, damages and destroys them, impairing the body's ability to absorb nutrients since this is the part of the intestinal track responsible for nutrient absorption and also causing numerous other food sensitivities such as dairy/lactose intolerance. There is another gluten-related disorder known as NCGS (Non Celiac Gluten Sensitivity or just, "gluten sensitivity") that is not autoimmune in nature and which does not damage the small bowel lining. However, NCGS shares many of the same symptoms with celiac disease such as gas, bloating, and diarrhea. It is also much more common than celiac disease. There is no test for NCGS so, because they share common symptoms, celiac disease must first be ruled out through formal testing for celiac disease. This is where your husband is right now. It should also be said that some experts believe NCGS can transition into celiac disease. I hope this helps.
    • Judy M
      New (possible) celiac diagnosis

      By Judy M · Posted

      My husband has had lactose intolerance for his entire life (he's 68 yo).  So, he's used to gastro issues. But for the past year he's been experiencing bouts of diarrhea that last for hours.  He finally went to his gastroenterologist ... several blood tests ruled out other maladies, but his celiac results are suspect.  He is scheduled for an endoscopy and colonoscopy in 2 weeks.  He was told to eat "gluten free" until the tests!!!  I, and he know nothing about this "diet" much less how to navigate his in daily life!! The more I read, the more my head is spinning.  So I guess I have 2 questions.  First, I read on this website that prior to testing, eat gluten so as not to compromise the testing!  Is that true? His primary care doctor told him to eat gluten free prior to testing!  I'm so confused.  Second, I read that celiac disease is genetic or caused by other ways such as surgery.  No family history but Gall bladder removal 7 years ago, maybe?  But how in God's name does something like this crop up and now is so awful he can't go a day without worrying.  He still works in Manhattan and considers himself lucky if he gets there without incident!  Advice from those who know would be appreciated!!!!!!!!!!!!
    • Scott Adams
      Patiently Waiting to See Results

      By Scott Adams · Posted

      You've done an excellent job of meticulously tracking the rash's unpredictable behavior, from its symmetrical spread and stubborn scabbing to the potential triggers you've identified, like the asthma medication and dietary changes. It's particularly telling that the rash seems to flare with wheat consumption, even though your initial blood test was negative—as you've noted, being off wheat before a test can sometimes lead to a false negative, and your description of the other symptoms—joint pain, brain fog, stomach issues—is very compelling. The symmetry of the rash is a crucial detail that often points toward an internal cause, such as an autoimmune response or a systemic reaction, rather than just an external irritant like a plant or mites. I hope your doctor tomorrow takes the time to listen carefully to all of this evidence you've gathered and works with you to find some real answers and effective relief. Don't be discouraged if the rash fluctuates; your detailed history is the most valuable tool you have for getting an accurate diagnosis.
    • Scott Adams
      Gluten free beer ?

      By Scott Adams · Posted

      In this case the beer is excellent, but for those who are super sensitive it is likely better to go the full gluten-free beer route. Lakefront Brewery (another sponsor!) has good gluten-free beer made without any gluten ingredients.
×
×
  • Create New...

Important Information

NOTICE: This site places This site places cookies on your device (Cookie settings). on your device. Continued use is acceptance of our Terms of Use, and Privacy Policy.