While the industry moves to reduce sugar levels in foods, research outcomes remain somewhat conflicted or poorly interpreted of alternatives like sugar alcohols, and natural sweeteners.
Demand for sugar alcohols exceeded $USD3 Billion in 2019, and forecasts expect this to grow to almost $USD5B by 2027.
Sorbitol remains the dominant form used, by a factor of 4-5 times other sugar alcohols like Xylitol, Mannitol, Maltitol, Sucralose etc.(1)
Recent animal studies on longer-term sorbitol consumption have shown, measurable increases in plasma insulin levels, a decrease in bifidobacteria (and other gut flora), and an increase in Helicobacter. (2)
Similarly, gene-sequencing studies on Sucralose has shown to effect disrupted gut microbiome, with heightened bacterial pro-inflammatory genes in the liver(3).
However, some cross-study analyses are less definitive on the impact of sugar alcohols. In 2020, one research piece (4) highlighted the polarized outcomes of studies, where some studies suggested no impact on glucose metabolism and microbiome disruption, while others studies drew a negative conclusion on sucralose insulin sensitivity and gut health. Different research protocols were cited as a key reason for these different research outcomes.
So while the jury may still be out, there does seem to be a growing consensus that longer-term consistent sugar alcohol consumption does pose a threat to gut health and insulin insensitivity.
Natural non-nutritive sweeteners?
Separate to the use of sugar-alcohols in lower-carb food products is the growing use of natural non-nutritive sweetening extracts. Examples here include Stevia, and increasingly Monk Fruit. By reference to 'natural non-nutritive' these ingredients are, 1) processed plant extracts (not lab synthesized chemicals), and, 2) food extracts with little or no caloric value. Similarly, research on natural non-nutritive sweeteners, remain mixed in outcomes and interpretations.
For example, in this research piece (5), several drinks were sweetened with sucrose, sugar alcohols, stevia, or monk fruit. The drinks were consumed, and with a subsequent meal - the overall blood sugar levels were measured across the time period.
The interpretation of the study was that, from the time of taking the various sweetened drinks, and then the subsequent meal, overall blood sugar levels (area-under-the-curve) was the same regardless of how the drink was sweetened.
"This is one interpretation, and one that needs more discussion -
It's not that the drinks with the natural non-nutritive sweeteners (Stevia, Monk Fruit) were driving the blood sugar response.
Rather, naturally sweetened drinks that have no other calories would seem to trigger a greater desire for a higher-mix of carbohydrates, in the subsequent meal thereby driving a similar overall blood glucose profile (area-under-the-curve) as a sucrose drink and subsequent meal.
Formulating foods or drinks with natural non-nutritive sweeteners, and no other caloric value is increasingly common in the soda, and carbonated drinks category.
While 'marketed as zero sugar, low-carb or keto' the lack of any caloric value, does question there effect on subsequent blood-sugar control (and insulin, fat-oxidation, ketogenesis etc.)
Based on the current research the SFuels point of view (POV) and key takeaways are,
- While research is mixed, there does seem to be a trending (negative) cloud over sugar alcohols in terms of impacting gut microbiome health. For this reason, and at this time, SFuels has taken the position of not using any sugar-alcohol forms in any of its products (drinks, bars, breakfast cereals, shake formulas).
- Whether drinks, shakes, bars or breakfast cereals SFuels believes that in the best interest of mitigating blood-sugar, insulin spikes (and to improve fat oxidation and ketogenesis) the use of non-nutritive sweeteners like Monk Fruit should be coupled with non-blood sugar, or insulin spiking ingredients - namely healthy fats, fibre and proteins.
(1) Sugar alcohol Market by Type. Global Opportunity Analysis and Industry Forecast, 2021–2027. Bhavana Thorat et al. Allied Market Research. January 2021.
(2) Long-term consumption of the sugar substitute sorbitol alters gut microbiome and induces glucose intolerance in mice. Chung-Hao Li et al. Life Sciences. July 2022.
(3) Gut Microbiome Response to Sucralose and Its Potential Role in Inducing Liver Inflammation in Mice. Xiaoming Bian et al. Frontiers in Physiology. July 2017
(4) Effect of sucralose and aspartame on glucose metabolism and gut hormones. Samar Y Ahmad. Nutrition Reviews. September 2020.
(5) Effects of aspartame-, monk fruit-, stevia- and sucrose-sweetened beverages on postprandial glucose, insulin and energy intake. S.l. Tey et al. Int' J Obesity. March 2017