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Dear Diabetes: Sugar-Free

What does sugar-free mean?

I often get asked that question and the answer is more complicated than you might think. The US Food and Drug Administration (FDA) defines “sugar-free” in its existing food labeling regulations, but to understand the definition, you need to know that the FDA defines “sugars” as all “one- and two-unit” sugars used in our foods. Some examples of “one- and two-unit” sugars include refined (table) sugar, dextrose, high fructose corn syrup, honey, syrups, brown sugar, and others.

A food that is labeled “sugar-free” contains less than 0.5 grams of those types of sugars per serving. “Sugar-free” foods must also be low in calories (or at least lower in calories when compared to similar products that are sweetened with sugars). Other terms approved by FDA include “free of sugar,” “no sugar,” “zero sugar,” “without sugar,” and “sugarless.” You’ll also find foods labeled as “no sugar added” or “sweetened only with juice.” Typically these are canned fruits or fruit juices. These foods can’t be labeled “sugar-free” because the fruit itself contains what the FDA defines as sugars.

There are two categories of sweetening ingredients in “sugar-free” foods:

  • Sugar alcohols, also called polyols, are not sugars by FDA definition, nor do they contain alcohol. These sweeteners do, however, contain some carbohydrate and calories, about two calories per gram vs. the usual four calories per gram of sugars. Polyols are digested more slowly and thus may cause a slower – and lower – rise in blood sugar. The slower digestion may cause some people to experience gas, bloating, or cramps when large amounts are eaten. Common names for sugar alcohols include isomalt, sorbitol, lactitol, maltitol, mannitol, and xylitol.
  • Sugar substitutes contain nearly no calories or carbohydrate and don’t cause blood glucose to rise. The sugar substitutes approved by FDA include acesulfame potassium, aspartame, neotame, saccharin, stevia, and sucralose. All the major sugar substitutes available commercially are made from these compounds.

When you see products in the supermarket labeled as “sugar-free,” you should realize that they fall into one of three categories.

  • Sugar-free foods sweetened with one or more type of sugar alcohol (and possibly a sugar substitute). Usually sugar-free cookies, chocolates, hard candy, ice cream, bake mixes, and puddings fall into this category. These foods contain calories and carbohydrate from the polyols and other ingredients. How to fit these foods into your eating plan if you use carbohydrate counting: If a food contains more than 5 grams of sugar alcohols, subtract half the grams of sugar alcohols from the carbohydrate grams in a food serving. Add this to the carbohydrate count for the rest of that meal or snack. For example, pick up some sugar-free chocolates and look at the Nutrition Facts label. Let’s say that they contain 17 grams of sugar alcohols per serving. Half of 17 = 8½ grams. One serving contains 24 grams of total carbohydrate. Subtract 8½ grams from 24 = 15½ grams. Add 15½ grams of carbs to the total for your snack.
  • Sugar-free foods sweetened with one or more sugar substitutes that contain other ingredients with calories and carbohydrate. Examples of this include hot cocoa, yogurt, and jam. How to fit these foods into your eating plan if you use carbohydrate counting: Use the carbohydrate grams on the Nutrition Facts and add them to those in the rest of your meal or snack.
  • Sugar-free foods sweetened with one or more sugar substitutes that do not contain other ingredients with calories and carbohydrate. Diet sodas, iced teas, dry powdered drink mixes, flavored gelatin, packets or granular forms of sugar substitutes generally qualify. How to fit these foods into your eating plan if you use carbohydrate counting: Don’t add anything to your meal or snack total because these items contain nearly no calories or carbohydrate.

Whether or not you consume sugar-free foods is up to you. You may find a few that can help satisfy your sweet tooth, taper or maintain your waistline, and help control your blood glucose and/or blood lipids. Always check the Nutrition Facts and ingredients to know what the products have inside. Remember to eat them in reasonable portions and as part of an otherwise healthy meal plan.

Hope Warshaw, MMSc, RD, CDE*, is the author of several best-selling books published by the American Diabetes Association, including Diabetes Meal Planning Made Easy and Guide to Healthy Restaurant Eating. She’s a frequent contributor to Diabetic Living magazine. Warshaw is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and not of Sanofi US, its employees, agencies, or affiliates.

*“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.

© 2013 The DX: The Diabetes Experience

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