ASK DR H: Alternative sweeteners do not contain sugar alcohol

Q: In products that use Equal/Nutrasweet as their sweetener, there is a sugar alcohol content. What other sugar substitutes have sugar alcohol amounts?
— T.P. Jackson, Mich.

A: No, that’s not quite right. Equal/Nutrasweet is a protein-derived sugar, and has no sugar alcohol content.

I’m guessing that you got the mistaken impression from looking at the label of a “sugar-free” food like dietetic cake, cookies or candy. Those products use alternative sweeteners to sugar such as xylitol, sorbitol, maltitol or lactitol.

Although they’re derived from the alcohol molecule, they’re 100 percent alcohol-free.

Such sugar-free sweeteners are as different from alcohol as a drinking glass is to a handful of sand.

Alcohol-free sugars have been used safely for many years to sweeten calorie-controlled foods, especially commercially baked goods and candy.

Although you might think of sugars as natural sweeteners derived from sugar cane or fruits, there are ways that through chemistry, other sugars can be created.

Sucrose, or white cane sugar, is the sugar against which all other sweeteners are compared. Xylitol, the sweetest of the alcohol-derived sugars, has about the same sweetness as sucrose. The other alcohol-derived sugars range from 0.4-0.8 times as sweet as table sugar.

Although table sugar (sucrose) and fruit sugar (fructose) contain 15 calories per teaspoon, the alcohol-derived sweeteners contain about half the calories.
But don’t be fooled: Cake and cookies that use these sweeteners still may be high in calories, because oil is plentiful in calories.

The biggest “plus” of such sweeteners is that they allow diabetics to enjoy cookies or cake in moderation without causing huge spikes in the blood sugar.

They also can help prevent cavities, because they’re not converted to acids by bacteria in the mouth. Chewing sugar-free (xylitol or sorbitol sweeteners) gums like Trident or Carefree may cut your risk of cavities by encouraging better saliva flow across your teeth.

Folks who eat too much food or candy sweetened with an alcohol-derived sweetener may experience gas, bloating or a diarrhea laxative effect.

That’s because they’re slowly or only partially absorbed from the digestive tract.
The more of it you eat, the more gas, bloating or diarrhea you’ll get.

Equal/Nutrasweet, saccharin, Splenda and Truvia won’t cause this problem.

Q: Don’t you think that all those commercials that air constantly about Viagra, Cialis, Lunesta, Boniva and the like are getting to be too much? Don’t you think that they could spend less on advertising and make the drugs cheaper? — J.B., New York, N.Y.

Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs by Melody Petersen. File photo.

Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs by Melody Petersen. File photo.


A: Yes, I think they certainly could spend far less on advertising. But it would be naive to believe that reduced expenditures on pharmaceutical advertising would ever trickle down to the patient.

Until the late 1990s, drug companies largely marketed their products to health care providers. Beginning in the late 1990s, drug companies began saturating the media with direct-to-consumer advertising in print, television and radio formats.

The Congressional Budget Office states that in 2008, spending on DTC advertising totaled $4.7 billion.

While the pharmaceutical industry’s PR/lobby machine known as “PhRMA” promoted the adoption of “self-enacted” guidelines on ethical conduct in the marketing of its products to health care providers — including the elimination of inexpensive pens, sticky notepads and mugs as “gifts” — the manufacturers have quietly redistributed their massive advertising budgets into DTC advertising.

This has not brought down the cost of pharmaceutical drugs to the patient. Rather, DTC has become a more subtle means of influencing the prescribing of a drug company’s specific product.

The intent of DTC advertising is to use the patient to “create a dialogue” that’ll result in a new prescription. It’s nothing illegal, of course.

But it is using the patient to influence the prescribing habits of a clinician.

I’ve been told by numerous pharmaceutical representatives that if their companies did not adopt the 2009 PhRMA code of ethical conduct, the government was going to do it for them. That argument is ludicrous.

One only needs to add up the millions of dollars received by our congressmen through lobbying to appreciate the enormous clout that the pharmaceutical industry carries in Washington.

Who came out the winner on the Medicare prescription drug plan Congress enacted?

And please don’t get me started on the tobacco industry.

The pharmaceutical industry will correctly point out its coupons, cards and vouchers can save those with insurance coverage money at the pharmacy.

But that is not the same as reducing the retail cost to the consumer.

Dr. Mitchell Hecht is a physician specializing in internal medicine. Send questions to him at: “Ask Dr. H,” P.O. Box 767787, Roswell, GA 30076. Because of the large volume of mail received, personal replies are not possible.

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2 comments Add your comment

Smoove Joe

December 19th, 2009
10:13 pm

What a jerk.

Lolita

March 11th, 2010
5:22 am

Great stuff. blogs.ajc.com deserves an award.