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Women's Health

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When a Carb's Not a Carb: The Net Carb Debate

Will counting net carbs help or hurt weight loss efforts?

What's in a Net Carb? continued...

Also in this category of largely indigestible carbohydrates are sugar alcohols, such as mannitol, sorbitol, xylitol, and other polyols, which are modified alcohol molecules that resemble sugar. These substances are commonly used as artificial sweeteners.

In calculating net carbs, most manufacturers take the total number of carbohydrates a product contains and subtract fiber and sugar alcohols because these types of carbohydrates are thought to have a minimal impact on blood sugar levels.

For example, the label on PowerBar's new double chocolate flavor "ProteinPlus Carb Select" bar says it has "2 grams of impact carbohydrates." The Nutrition Facts label on the product says it has 30 grams of total carbohydrates.

Just below the nutrition facts box, the "impact carb facts" box provided by the manufacturer explains, "Fiber and sugar alcohols have a minimal effect on blood sugar. For those watching their carb intake, count 2 grams." That's 30 grams minus the bar's 27 grams of sugar alcohols and 1 gram of fiber.

The Skinny on Sugar Alcohols

But researchers say the impact of sugar alcohols on blood sugar levels and the body is not fully understood, and they may also cause problems in some people.

"There are some sugar alcohols that can raise your blood sugar," says Karmally. "Certain sugar alcohols do have a higher glycemic index, and they still are not counted as carbohydrates by these companies."

"When you tell a person 'net carbs' or 'impact carbs,' it's very confusing," says Karmally. "A person with diabetes may think, 'It's fine for me to have as much as I want.'"

People with diabetes are advised to closely monitor their intake of carbohydrates because their bodies can't produce enough insulin to keep blood sugar levels within a safe range.

"I think we should not misguide people and make them aware that these sugar alcohols also contribute calories," says Karmally. "Too much of them can actually have a bad effect, and some of them can also have a laxative effect."

Although sugar alcohols have been used in small amounts in items like chewing gums for years, researchers say little is known about the long-term effects of consuming large amounts of these substances.

Registered dietitian Jackie Berning, PhD, says she steers her patients against products containing sugar alcohols for those reasons.

"I just don't know how they're going to react. We've never put that much in," says Berning, an associate professor of nutrition at the University of Colorado at Colorado Springs. "Some are going to get diarrhea, and some are going to have gastrointestinal problems."

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