Paleo Foundation adds Maltitol to Keto Certified Standards
The average person in the United States consumes over 71 grams of sugar every day, which is well over the amount recommended by the FDA. This staggering amount of refined sugar consumption is also one of the leading causes of a number of rampant health crises affecting the wider population, including the obesity and diabetes epidemics. The widely understood negative effects of sugar consumption have led many people to rightfully search for sugar substitutes for their diets.
The use and consumption of low-calorie artificial sweeteners such as saccharin and sucralose has increased by over 200 percent in recent years. However, and despite the fact that many artificial sweeteners are FDA approved as safe for human consumption, recent research has found a number of potentially dangerous side effects associated with these chemical sweeteners. For example, research from 2014 on the effects of artificial sweeteners on rats, found that even low dosages of aspartame (used in over 6,000 food products around the world) negatively affected the gut microbiota, which in turn could lead to other serious gastrointestinal problems for humans.
Sugar alcohols which are found naturally in many fruits and vegetables are an alternative to natural sugar and artificial sweeteners. Maltitol is one of the most widely used sugar alcohols and is commonly found in baked goods, candy, and other sweetened items looking to reduce the total caloric and carbohydrate levels of certain sweet foods.
In 2019, The Paleo Foundation researched a random sample of website articles from the top 100 results on Google for the search phrase “Maltitol Keto.” The research classified mentions of maltitol as “positive interpretations” or “negative interpretations” based on whether or not they thought maltitol was “Keto Friendly” or not, respectively. Extrapolated from the data of the random sample, it is estimated that roughly 80 percent of the information regarding Maltitol involves negative interpretations within the Keto community, while only 20 percent of the information available involves positive interpretations.
Despite the widespread negative community response to maltitol, The Paleo Foundation determined that many of these objections within the Keto community were based on myths perpetuated by misleading interpretations of research or misleading data. Resulting from the research, The Paleo Foundation determined to include maltitol in the Keto Certified standards. Below, we offer a concise overview of why maltitol has been determined to be “Keto-friendly.”
The Rise of Sugar Substitutes
A 2018 poll by Label Insight found that nearly half of consumers (47 percent) were planning to eat less sugar or buy more “no sugar added” products this year. Specifically, the poll found that 53 percent of Boomers were planning to cut down on sugary foods, while four out of ten millennial consumers were also planning on reducing sugar intake. Despite widespread consensus that we collectively consume way too much sugar, sugar addiction is a real challenge that has led to a number of serious health issues.
Breaking our addiction to sugar “cold turkey,” however, certainly presents a challenge and even people who follow strict low carb diets such as the Keto diet desire a sweet treat once in a while. Given this reality, the global market for sugar substitutes has seen exponential growth in the last few years. According to one recent market analysis, the global market for sugar substitutes was estimated to be valued at USD 13.26 billion in 2015 and is projected to reach USD 16.53 billion by 2020, at a compound annual growth rate of around 4.50 percent.
While there are a number of natural sweeteners marketed for the Keto diet (such as stevia and monk fruit sweetener), sugar alcohols such as maltitol are another option that is widely used by hundreds of food brands.
What is Maltitol?
As we mentioned in the introduction, maltitol is a sugar alcohol. While sugar alcohols are found naturally in certain fruits and vegetables, most sugar alcohols today are typically manufactured rather than being used in their natural form.
Maltitol is sweet, though not nearly as sweet as sugar. Furthermore, maltitol has about half the calories as traditional sugar, providing around 2 and 3 kcal per gram. It is widely used by the food industry because, besides being half as energetic as traditional table sugar, it does not promote tooth decay, and has a somewhat lesser effect on the blood glucose level. Furthermore, studies have found that maltitol is largely unaffected by human digestive enzymes and is fermented by bacteria in the large intestine.
Despite these benefits, people in the Keto community have widely shunned the use of maltitol because of concerns regarding the glycemic response to its consumption. While maltitol is a carbohydrate with a glycemic index that can affect blood glucose levels, the fact that maltitol is not completely digested and results in a slower rise in blood sugar and insulin levels when compared to sucrose and glucose makes it preferable for people on low carb diets.
Many of the arguments against maltitol within the Keto community are either misleading or not reliable, if not outright false. Below, we look at factors such as the glycemic index, insulin index, and the calorie levels associated with maltitol to see that moderate consumption of maltitol does not threaten one’s state of being in ketosis.
The Issue of the Glycemic Index related to Maltitol
The glycemic index is a system that ranks common foods on a scale from 1 to 100 based on their effect on blood sugar levels. Pure glucose, for example, has a glycemic index of 100 and is used as the basic reference point for comparing the effect on blood sugar levels for other foods.
In general, foods that have a glycemic index between 0 and 55 are considered low. Ranges between 56 and 69 are considered to medium, while any rating above 70 is considered to be a high glycemic index. Maltitol falls within the low ratings, as it is estimated to have a glycemic index around 52. While this is on the upper end of the “low” rating, the arguments by many people within the Keto community that maltitol has a high glycemic index are blatantly false and misleading.
Furthermore, referring solely to the glycemic index is inadequate for properly determining whether or not a certain food can be part of a Keto diet. This reductionist approach doesn’t take into account the amount of maltitol being consumed during a given meal or day, nor does it look at what other foods were consumed by the individual alongside maltitol.
For example, a person who regularly eats a daily diet of lean meats and healthy fats while strictly limiting their carb intake could certainly enjoy a Keto-friendly dessert topped with a sugar-free caramel sauce (check out this recipe) made with maltitol as a sugar substitute. Despite the fact that the maltitol might have the highest glycemic index of the other foodstuffs consumed throughout the day, the risk of a limited intake of maltitol kicking a person out of ketosis is extremely low.
As with other sugar alcohols, high levels of consumption of maltitol can lead to some negative side effects. Consuming over 90 grams of maltitol on a daily basis might have a mild laxative effect on the human body. However, most people will consume much lower qualities of maltitol when following a diversified, low carb diet.
The Issue of the Insulin Index as it Relates to Maltitol
Another common objection to maltitol within the Keto community is that it has a high insulin index. Insulin, which is a hormone created by the pancreas to move glucose molecules into the cells for energy purposes, is known to suppress ketone production. While it might seem logical to avoid food products that have been shown to increase insulin levels, pure maltitol has a very low insulin index.
Just as with the glycemic index, foods are rated on a 1 to 100 level, with the same ratings denoting high, medium to low insulin index for specific food products. Pure maltitol has an insulin index of just 27, which is low on the rating scale. Unfortunately, many people within the Keto community cite higher insulin index ratings for maltitol, without specifying that they are referring to formulations of this sugar alcohol combined with hydrogenated polymers. For example, high polymer maltitol syrups might have an insulin index as high as 44, though many food products will use pure maltitol which has a much lower rating.
The Issue of Calories and Maltitol
Lastly, many people within the Keto community argue that maltitol is not “Keto-friendly” because of the calorie density of this sugar alcohol. Maltitol has a calorie density of 2.1 kilocalories per gram, which is about half of the calorie density of sucrose (or table sugar), which contains about 4 kilocalories per gram. It is also less than other sugar substitutes such as honey, which contains about 3 kilocalories per gram.
The Calorie Control Council considers that “absorption of maltitol by the human body is slow, allowing part of the ingested maltitol to reach the large intestine where metabolism yields fewer calories. Therefore, unlike sugar which contributes four calories per gram, the caloric contribution of maltitol is only 2.1 calories per gram.”
Furthermore, about 15 percent of the maltitol consumed by the human body is resistant to digestion and will be excreted, thus reducing even further the caloric levels of this sugar alcohol. Because maltitol is about 90 percent as sweet as table sugar, less of it needs to be used in certain desserts or other sweet foods when compared to other common sugar substitutes. This can further reduce the calorie density of maltitol in most foods.
As with any aspect of our diets, moderation is key. A diet that relies on a moderate intake of maltitol for certain sweets, or to increase the palatability of certain foods, will most likely have a very limited effect on the state of ketosis. Arguments against the inclusion of maltitol in the Keto diet are generally based on false or misleading claims related to the glycemic index, the insulin index, and the calorie density of this common sugar alcohol.
For this reason, the Paleo Foundation has decided to support the inclusion of maltitol in the Keto Certified Standards. While this might generate some opposition from those in the community who believe maltitol to be antiketogenic, the Paleo Foundation will make efforts to address these myths via education efforts.