Health potential of polyols as sugar replacers, with emphasis on low glycaemic properties

Abstract

Polyols are hydrogenated carbohydrates used as sugar replacers. Interest now arises because of their multiple potential health benefits. They are non-cariogenic (sugar-free tooth-friendly), lowglycaemic (potentially helpful in diabetes and cardiovascular disease), low-energy and lowinsulinaemic (potentially helpful in obesity), low-digestible (potentially helpful in the colon), osmotic (colon-hydrating, laxative and purifying) carbohydrates. Such potential health benefits are reviewed. A major focus here is the glycaemic index (GI) of polyols as regards the health implications of low-GI foods. The literature on glycaemia and insulinaemia after polyol ingestion was analysed and expressed in the GI and insulinaemic index (II) modes, which yielded the values: erythritol 0, 2; xylitol 13, 11; sorbitol 9, 11; mannitol 0, 0; maltitol 35, 27; isomalt 9, 6; lactitol 6, 4; polyglycitol 39, 23. These values are all much lower than sucrose 65, 43 or glucose 100, 100. GI values on replacing sucrose were independent of both intake (up to 50 g) and the state of carbohydrate metabolism (normal, type 1 with artificial pancreas and type 2 diabetes mellitus). The assignment of foods and polyols to GI bands is considered, these being: high (> 70), intermediate (> 55-70), low (> 40-55), and very low (< 40) including non-glycaemic; the last aims to target particularly low-GI-carbohydrate-based foods. Polyols ranged from low to very low GI. An examination was made of the dietary factors affecting the GI of polyols and foods. Polyol and other food GI values could be used to estimate the GI of food mixtures containing polyols without underestimation. Among foods and polyols a departure of II from GI was observed due to fat elevating II and reducing GI. Fat exerted an additional negative influence on GI, presumed due to reduced rates of gastric emptying. Among the foods examined, the interaction was prominent with snack foods; this potentially damaging insulinaemia could be reduced using polyols. Improved glycated haemoglobin as a marker of glycaemic control was found in a 12-week study of type 2 diabetes mellitus patients consuming polyol, adding to other studies showing improved glucose control on ingestion of low-GI carbohydrate. In general some improvement in long-term glycaemic control was discernible on reducing the glycaemic load via GI by as little as 15-20 g daily. Similar amounts of polyols are normally acceptable. Although polyols are not essential nutrients, they contribute to clinically recognised maintenance of a healthy colonic environment and function. A role for polyols and polyol foods to hydrate the colonic contents and aid laxation is now recognised by physicians. Polyols favour saccharolytic anaerobes and aciduric organisms in the colon, purifying the colon of endotoxic, putrefying and pathological organisms, which has clinical relevance. Polyols also contribute towards short-chain organic acid formation for a healthy colonic epithelium. Polyol toothfriendliness and reduced energy values are affirmed and add to the ...

Dessert Formulation Using Sucralose and Dextrin Affects Favorably Postprandial Response to Glucose, Insulin, and C-Peptide in Type 2 Diabetic Patients

“…Pastry cream group (10, 1, 2) 7. Crème caramel group (10,5,4) All subjects were advised to refrain from taking their medicine in the morning of the test days. Basic demographic and clinical characteristics as well as recent lipid profile were also recorded ( Table 1).…”

“…maltitol, sucralose and isomaltulose) [1], amylase-rich starch [2] and dextrins which are classified as soluble fiber [3,4]. Apart from allowing the removal of sucrose, these replacements may reduce postprandial glycemia through a variety of mechanisms, one being digestibility or metabolic rate [5]. For example, su-cralose, which is 600 times sweeter than sucrose, is a non-metabolizable sweetener and hence noncaloric [6].…”

Scientific Opinion on the use of Polyglycitol Syrup as a food additive

“…Polyglycitol has been reported to induce glycaemic and insulineamic indexes (39 and 23, respectively) similar to those of maltitol and maltitol syrup (high-polymer), lower than those induced by regular maltitol syrup and higher than those of other polyols (e.g. sorbitol, xylitol) (Livesey, 2003). The Panel therefore considered these effects as non-adverse, being commonly observed also with other authorised indigestible polysaccharides.…”

“…Higher-order polyols of hydrogenated starch hydrolysates can be hydrolysed in the gastrointestinal tract of mammals to glucose and maltitol (SCF, 1999;WHO, 1998;Livesey, 2003). It has been considered that digestion and absorption of higher-order polyols is similar to that of maltitol in humans, being mainly digested in the small intestine (Beaugerie et al, 1990;Livesey, 2003).…”

“…It has been considered that digestion and absorption of higher-order polyols is similar to that of maltitol in humans, being mainly digested in the small intestine (Beaugerie et al, 1990;Livesey, 2003). Maltitol and polymerised sugar alcohols can be slowly but almost completely degraded to glucose and sorbitol, primarily in the jejunum, ileum and duodenum mainly through fermentation by the intestinal flora, although it has also been reported that they can also be absorbed in the small intestine and excreted unchanged in the urine (WHO, 1998;Lian-Loh et al, 1982;Beaugerie et al, 1990).…”