Understanding Sugar Substitutes in Sugar Free Candy

For individuals with diabetes or who are watching their sugar intake, is sugar-free candy a healthy choice?

Sugar-Free Candy

Sugar-free candies can be an option for individuals with diabetes and those watching their sugar intake. Different types of sweeteners are used in sugar-free candies, with pros and cons and possible side effects.

Ingredients

Sugar-free candies use artificial sweeteners or sugar substitutes to generate a sweet taste. Most of these sweeteners have fewer calories and carbohydrates than sugar, but not all are calorie or carb-free. Some sugar substitutes on labels include:

• Aspartame
• Saccharin
• Sucralose
• Aspartame, saccharin, stevia, and sucralose are calorie-free and carb-free.
• Stevia is a non-alcoholic, non-artificial sugar substitute made from plant leaves.
• Sugar alcohols – erythritol, xylitol, maltitol, lactitol, and sorbitol contain some carbohydrates.

Pros

Pros over candies sweetened with sugar.

Satisfies Cravings

• Sugar-free candies can satisfy sweet cravings with less impact on blood sugar than their full-sugar counterparts.

Less Sugar

• Federal dietary guidelines suggest keeping added sugars to less than 10% of daily calories. (U.S. Department of Agriculture and U.S. Department of Health and Human Services. 2020)
• The American Heart Association recommends 6% or less. (American Heart Association. 2020)

Blood Sugar Levels

• Individuals with diabetes can maintain stable blood sugar levels.

Healthy Teeth

• Candies and gums pose less risk to teeth.

Carbohydrates From Sugar Alcohols

• Sugar alcohols are digested differently than regular sugar and have less impact on blood sugar levels.
• If counting carbohydrates, subtract half the grams of sugar alcohol from the total carbohydrates on the label.
• For example, if total carbohydrates are 25 and sugar alcohols are 20, count the food as 15 carbs per serving. (University of California, San Francisco, Diabetes Teaching Center, 2024)

Cons

The cons can include:

Digestive Side Effects

• For some individuals, especially with irritable bowel syndrome/IBS, sugar alcohols can cause unpleasant gastrointestinal side effects like bloating and diarrhea. (Mäkinen K. K. 2016)
• It is recommended to avoid large amounts, especially for individuals with a sensitive stomach. (Evert, A. B. et al., 2019)

Taste

• There may be an irregular or unfamiliar taste that can require getting used to.
• Try other types and brands.

Carbohydrates

• Always read the label.
• The sweetener may contain some or none.
• Other ingredients may have added carbohydrates.
• For example, sugar-free chocolates may be high in saturated fat from ingredients like cocoa butter.

Appetite stimulants

• Zero-calorie sweeteners may stimulate appetite, leading to eating more, which can be counterproductive to dietary goals. (Azad, M. B. et al., 2017)

Options

Choosing which types are best depends on personal taste and health goals.

• Because of fatty ingredients, sugar-free chocolates may not be recommended if heart problems exist or fat intake must be limited.
• Hard candies may be a better option.
• Sugar alcohols can have an impact on blood sugar levels, which may make the candies less than ideal for those with diabetes. Digestive side effects can make them less appealing as well.
• Some artificial sweeteners may cause discomfort. Learning the body’s response will help when choosing.
• When it comes to taste, note what the preferred candy is sweetened with, as well as other ingredients, to guide future purchases.
• Choose a snack that blends something sweet with other healthy ingredients, like fiber or protein, whole grains, nuts, or dried fruit. For example, strawberries with dark chocolate or apple slices with peanut butter.

Dr. Jimenez  Functional Medicine Team. Healthy eating does not have to be hard. Using an integrated approach, we aim to restore health and function to the body through Nutrition and Wellness, Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. If the patient needs other treatment, they will be referred to a clinic or physician best suited for them, as Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments. We focus on what works for you and strive to better the body through researched methods and total wellness programs.

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References

U.S. Department of Agriculture and U.S. Department of Health and Human Services. (2020). Dietary Guidelines for Americans, 2020-2025. 9th Edition. Available at DietaryGuidelines.gov. Retrieved from www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf

American Heart Association. (2020). Federal dietary guidelines emphasize healthy eating but fall short on added sugars. newsroom.heart.org/news/federal-dietary-guidelines-emphasize-healthy-eating-habits-but-fall-short-on-added-sugars

University of California, San Francisco, Diabetes Teaching Center: Diabetes Education Online. (2024). Counting sugar alcohols. dtc.ucsf.edu/living-with-diabetes/diet-and-nutrition/understanding-carbohydrates/counting-carbohydrates/learning-to-read-labels/counting-sugar-alcohols/

Mäkinen K. K. (2016). Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and Other Health-Care Professionals. International journal of dentistry, 2016, 5967907. doi.org/10.1155/2016/5967907

Evert, A. B., Dennison, M., Gardner, C. D., Garvey, W. T., Lau, K. H. K., MacLeod, J., Mitri, J., Pereira, R. F., Rawlings, K., Robinson, S., Saslow, L., Uelmen, S., Urbanski, P. B., & Yancy, W. S., Jr (2019). Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report. Diabetes care, 42(5), 731–754. doi.org/10.2337/dci19-0014

Azad, M. B., Abou-Setta, A. M., Chauhan, B. F., Rabbani, R., Lys, J., Copstein, L., Mann, A., Jeyaraman, M. M., Reid, A. E., Fiander, M., MacKay, D. S., McGavock, J., Wicklow, B., & Zarychanski, R. (2017). Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 189(28), E929–E939. doi.org/10.1503/cmaj.161390