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Is Sugar Alcohol Bad for You? Best and Worst Sugar Alcohols

author avatar Dr. Eric Berg 05/05/2024

Sugar substitutes have been used for decades. However, research shows that some options, once considered safe, may have adverse health effects. 

Amid the concern surrounding artificial sweeteners, sugar alcohols have been encouraged as a healthier alternative, but is sugar alcohol bad for you?

Let's analyze the health benefits and risks of using sugar alcohol and find out which ones to avoid. 

Healthy women pouring sugar substitute

What are sugar alcohols?

Sugar alcohols are a class of carbohydrates found naturally in fruits, vegetables, and other plants and can be produced by hydrogenating sugars and starches. 

They're referred to as alcohols because of their chemical structure, not because they contain ethanol or cause intoxication.

Sugar alcohols have a sweet taste similar to conventional sugar but with fewer calories and a significantly lower impact on blood sugar levels. They are common in sugar-free foods and reduced-calorie products such as ice cream, baked goods, and beverages.

These sweeteners are also used as bulking agents and can provide a cooling sensation that enhances the mouthfeel of sugar-free gum, mints, and toothpaste.

Watch this video to discover the worst sugar alcohol for weight loss.

The Worst Sugar Alcohol (Artificial Sweeteners) for Weight Loss

Sugar alcohols vs. artificial sweeteners 

The difference between sugar alcohols and artificial sweeteners is how they're made and their effects on the body.

Artificial sweeteners

As the name suggests, most artificial sweeteners, such as aspartame, sucralose, and saccharin, are primarily synthetic. 

These sugar alternatives are manufactured in laboratories by chemically modifying basic ingredients such as amino acids, sugar, or toluene.

The result is a product that mimics the experience of eating sugar by triggering taste receptors, promoting the perception of sweetness.  

Some artificial sweeteners can be 20,000 times sweeter than table sugar but without its caloric content or impact on blood sugar and insulin levels. 

However, due to their highly processed nature, using artificial sweeteners to sweeten foods is controversial as research has revealed that they can pose serious health concerns.

A study published in Critical Reviews in Toxicology found that sucralose-6-acetate, a metabolite of sucralose, can potentially cause DNA damage and contribute to gastrointestinal inflammation. 

It also appears that certain artificial sweeteners can upregulate genes associated with inflammation, oxidative stress, and cancer.

Sugar alcohols

Sugar alcohols such as xylitol, erythritol, and sorbitol, on the other hand, hold a middle ground between sugar and artificial sweeteners.

Unlike artificial sweeteners, some sugar alcohols occur naturally in certain foods and plants, such as grapes, berries, and birch trees, though they also can be produced in laboratories. 

However, the processes used to create sugar alcohols are usually less complex than artificial sugars. This results in a more naturally derived sweetener with a taste and structure similar to table sugar.


Due to the simplified modification process, certain sugar alcohols retain a chemical structure that allows them to be partially digested. In contrast, artificial sugars aren’t metabolized or processed in the digestive tract.

As a result, sugar alcohols can have varying degrees of caloric content and may impact blood sugar levels, depending on the specific type of sugar alcohol and the individual consuming it. 


Xylitol compared to sugar

Sugar alcohols vs. sugar 

In comparison to regular sugar, sugar alcohols offer several advantages.

People seek alternative sugars to avoid the rapid blood sugar spike that tends to follow the consumption of sugary foods.

Sugar-induced blood sugar fluctuations can lead to immediate and long-term health effects, including fatigue, irritability, brain fog, bloating, and weight gain. 

In addition, eating sugar is associated with more serious conditions, including insulin resistance, diabetes, obesity, heart disease, and stroke.

Most sugar alcohols contain about half the calories or less of regular sugar, making them an attractive option for those aiming to lose weight and those trying to manage diabetes or obesity. 

In addition, research published in Clinical, Cosmetic Investigational Dentistry found that xylitol can support dental health by inhibiting the growth of cavity-causing bacteria, unlike regular sugar and corn syrup, which are the primary causes of tooth decay.

Man checking blood sugar levels

Do sugar alcohols affect your blood sugar?

The extent to which the body can absorb sugar alcohols varies depending on the specific type. 

Some types of sugar alcohols, such as erythritol, are poorly absorbed and have minimal impact on blood sugar. In contrast, maltitol is more easily digested and can cause a significant rise in blood glucose levels.

Here are the most common sugar alcohols, along with their glycemic index (GI) values:

  • Erythritol = 0

  • Mannitol = 0

  • Xylitol = 7 - 13

  • Lactitol = 6

  • Sorbitol = 9

  • Isomalt = 9

  • Maltitol = 35 - 52

The GI indicates how these sugar alcohols affect blood sugar levels. Lower GI index values are associated with less impact on blood sugar levels, and a GI of zero represents no impact on blood sugar balance.

Can you have sugar alcohol sweeteners on keto? 

Sugar alcohols are a popular choice for keto dieters and can be particularly useful for those still experiencing sugar cravings.

However, it’s crucial to choose sugar alcohols that won’t impact blood sugar levels and avoid those that may kick you out of ketosis and are associated with adverse effects.  

Erythritol spelled with alcohol sugar

Best sugar alcohol sweeteners

Erythritol is widely considered the best alcohol sugar as it isn’t broken down or absorbed in the digestive system, meaning it has virtually no calories and a GI of zero.

In addition, since erythritol isn’t digested, it's less likely to cause digestive upset than other alcohol sugars such as sorbitol and maltitol, making it a better option for those with sensitive stomachs. 

Xylitol is another excellent sugar alcohol option. While it has a slightly higher GI than erythritol, many people prefer xylitol for its closer resemblance in taste to sugar.

Other good alternative sweeteners 

For those seeking a more natural sugar alternative option, both stevia and monk fruit are great ways to satisfy a sweet tooth without suffering glycemic consequences.


Derived from the leaves of the Stevia rebaudiana plant, also known as candyleaf, stevia is 150 to 450 times sweeter than regular sugar, contains no calories, and has a GI of zero.

Stevia is widely available in liquid or powdered form. However, you can also grow the stevia plants at home and use fresh leaves to sweeten your favorite beverages naturally

In addition, research published in the EXCLI Journal highlights the multifaceted health benefits of stevia beyond its role as a natural sweetener.

The researchers found that stevia products have the potential to stimulate insulin production, may improve polycystic kidney disease, and possess potent antibacterial, antioxidant, and immunomodulating properties.


Similarly to stevia, monk fruit is another natural calorie-free sweetener that is around 150 to 200 times sweeter than sugar and also has a GI of zero.

According to data published in Frontiers in Pharmacology, monk fruit exhibits several anti-inflammatory, anti-fatigue, anti-cancer, and antimicrobial properties.

Exclamation mark

Worst sugar alcohol sweeteners 

Maltitol, a common ingredient in sugar-free candies, is one of the worst sugar alcohol sweeteners. 

With a GI of 52, maltitol can cause a significant rise in blood sugar levels, similar to that of table sugar.

In addition, both maltitol and sorbitol, commonly used in sugar-free and diet products, can cause digestive upset.

According to a study published in Canadian Family Physician, the gastrointestinal effects of sorbitol can include severe diarrhea, bloating, gas, and abdominal cramps when consumed in larger amounts.

Young women reading a nutrition label

How to spot unhealthy sugar alcohols

Not all sugar alcohols are created equal, nor do they affect everyone in the same way. 

For this reason, it’s essential to read the ingredient list carefully to avoid sugar alcohols linked to health issues, including maltitol and sorbitol.

These potentially harmful sugar alcohols are often used in highly processed sugar-free foods, including candies, baked goods, ice cream, and diet beverages.  

Opt for products sweetened with xylitol and erythritol and avoid those containing lactitol, isomalt, and hydrogenated starch hydrolysates (HSH), all of which may increase the risk of adverse effects. 

"When opting for sugar alcohols, ensure they are organic or non-GMO to minimize exposure to unwanted additives and pesticide residues," explains Dr. Berg.

Individuals with blood sugar or digestive concerns should be cautious when choosing sugar substitutes and consult a healthcare professional before introducing them into the diet. 

Xylitol birch bark and leaves

Key takeaways

Is sugar alcohol bad for you? Sugar alcohol can be a good sugar substitute when chosen carefully and consumed in moderation.

Erythritol and xylitol are the best sugar alcohol options, while maltitol and several others should be avoided. Natural sweeteners like stevia and monk fruit are also good sugar alternatives, as they contain zero calories and have no impact on blood sugar levels.

Always read product food labels carefully to identify the types of sweeteners used in the product, and be cautious of highly processed sugar-free foods and beverages.


1. Are sugar alcohols bad for you?

When consumed in moderation, most sugar alcohols are generally considered safe. However, consuming sugar alcohols in large amounts can lead to digestive issues, including water retention, bloating, gas, and diarrhea in some individuals. 

In addition, maltitol can cause blood sugar spikes linked to weight gain and it’s recommended to avoid this commonly-used sugar alternative. 

2. Is sugar alcohol worse for you than sugar?

In general, sugar alcohol can be a better choice than regular sugar, particularly for individuals who are trying to avoid or reduce sugar intake.

However, sugar alcohols such as maltitol can spike blood glucose levels as much or more than table sugar and should be avoided. 

3. Do sugar alcohols cause weight gain?

Consuming excess amounts of sugar alcohols like maltitol can cause significant insulin spikes, which prevents fat burning and promotes fat storage in the body.

However, other sugar alcohols such as erythritol and xylitol won’t impact blood sugar levels, making them great options for those following the ketogenic diet and individuals seeking to lose weight.    

4. Do sugar alcohols cause inflammation?

There is limited research on the link between sugar alcohol and inflammation. However, other sugar alternatives, such as artificial sweeteners, have been shown to have inflammatory effects on the body.

5. What is the best type of sugar alcohol?

Erythritol is considered one of the best sugar alcohols due to its minimal calorie content, zero glycemic index, and low risk of digestive side effects when consumed in moderation.

6. What sugar alcohols are keto-friendly? 

Erythritol and xylitol are generally considered the most keto-friendly sugar alcohols.  


  1. https://www.tandfonline.com/doi/full/10.1080/10937404.2023.2213903

  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232036/ 

  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8600158/

  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6903776/

  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6693595/

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