Maltitol sugar substitute: use with caution

Results of a Google search for "maltitol," a sugar substitute used in Harry and David's "sugar free" chocolate caramel balls:

What is Maltitol?
Maltitol is a sugar alcohol, an ingredient commonly used in low-carb or “sugar-free” products such as candy and nutrition bars. It is used so much because of its similarity to sugar in terms of taste, mouth feel, and interaction with other ingredients. Products which use maltitol and other sugar alcohols as sweeteners can be called “sugar free.” Although claims are often made that maltitol has little impact on blood sugar, this turns out not to be the case.

Maltitol Has Carbs
Maltitol is a carbohydrate. Although our bodies do not absorb all the calories in maltitol, this substance does provide us with 2 to 3 calories per gram, compared to the 4 calories per gram of sugar. (For what it's worth, I have noticed that the claim of 2 calories per gram usually comes from literature provided by the manufacturer or the low calorie food industry whereas other analyses tend to be closer to 3 calories.) Since maltitol is a carbohydrate, and since it provides calories, you would expect it to impact blood glucose. You would be correct.

Maltitol Has a Relatively High Glycemic Index
In particular, maltitol syrup has a glycemic index of 52, which approaches that of table sugar at 60. The powdered form has a glycemic index of 36, which is still higher than most other sugar alcohols and all artificial sweeteners.

Maltitol is Not as Sweet As Sugar
Estimates run from 75% to 90% of the sweetness of sugar. Again, the information provided by industry groups tends to give the 90% figure, while other sources say 75%. So, if maltitol has ¾ of the sweetness of sugar, ¾ the calories of sugar, and ¾ the glycemic index of sugar, it isn’t a far leap to the conclusion that you need ¼ more maltitol to get the same effect of sugar, which will give you close to the same effect in most other ways (except for dental cavities). You are basically getting expensive sugar. (NOTE: as a Type II diabetic, I have to be careful of "sugar," but this product mimics sugar in both glycemic index and carbs without spelling it out.)

And … a bonus: Maltitol can Cause Intestinal Discomfort
Usually this takes the form of intestinal gas and cramping, but some people may find themselves with diarrhea. If you decide to eat products with maltitol, you’d be wise to start with a small amount and judge the reaction -- as well whether you’ll be in a crowded room a few hours later.
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Yep, maltitol is the reason for the worst diarrhea I've ever had in my life! It's the sweetener used in the caramel chocolate balls I purchased at Harry and David's and adds a whopping 21g of sugar alcohol to the tasty treats. The reason I know it's the sweetener used is because I received a call from a H&D's representative who told me that's the sweetener listed on the label as part of the milk chocolate coating and the dark chocolate coating. After Googling the product (see above), the representative explained to me that diarrhea is a by-product of maltitol use in some people, and I'm one of the some people. I told her I have never had diarrhea as badly as I had it during those 3 awful days last week, as well as the day this week before I finally made a connection to the back label on the chocolate caramel balls.

For some of us, a little maltitol can go a long way! My suggestion to the H&D rep is to make the warning about the sweetener a bit more prominent, especially in that it's not recommended for diabetics, as well as its being an instant "super" laxative in some people. At my age, 3 days of severe diarrhea could easily result in hospitalization!