All About Sugar and Sugar Substitutes

Sugar is just one type of carbohydrate in foods. Carbohydrates are used by your body for fuel after they're broken down into a type of sugar called glucose.

For years, sugar had a bad reputation and was considered off-limits for people with diabetes. The good news is today most people with diabetes can eat foods that contain sugar.

In your body, sugar from foods becomes glucose (or "blood sugar"). So eating a piece of apple pie, which contains both naturally occurring sugar in the apples and added sugar, will raise your blood glucose level. But the sugar in foods is not the only component that affects blood sugar. Eating foods which contain carbohydrates other than sugar such as a piece of bread, rice, or even some vegetables will also raise blood glucose. Insulin, a hormone produced by the body, helps to move glucose from the blood into cells for energy and helps maintain a healthy level of sugar in blood.

If you are a person with diabetes, eating too much of or too many high sugar foods may raise your blood glucose level up higher than is perhaps optimal for you and your method of diabetes treatment. If you eat high sugar foods in place of high nutrient foods, you run the risk of not receiving enough of the healthful nutrients that come with eating whole grains, fruits, and vegetables.

What's more, after eating high sugar foods (which are also often high in fat), you may feel full initially, but you are likely to get hungrier more quickly than when foods low in sugar and high in protein are consumed.

The golden rule with high sugar foods is moderation—for people with diabetes and everyone else. The good news is you don't have to pass up that piece of pie for dessert—but limiting portion size and keeping track of the overall amount of carbohydrates in the diet can help maintain healthy blood sugar levels.

Sugar Substitutes

Sugar substitutes – low calorie sweeteners and sugar alcohols – are useful tools for people with diabetes. They can help you satisfy your sweet tooth while allowing you to reduce your consumption of sugars and calories. They can be especially helpful to people who need to lose weight and for those concerned with controlling their blood glucose levels.

It is important to note that a "sugar-free" food does not necessarily mean a "calorie-free" food. If a food is sweetened with a low-calorie sweetener, it may still contain calories from other ingredients. For example, a chocolate cookie sweetened with a low-calorie sweetener contains calories from flour, shortening, and chocolate. Always check the Nutrition Facts panel on food products to determine the number of calories and amount of carbohydrates in one serving.

Five low calorie sweeteners—acesulfame potassium, aspartame*, neotame, saccharin, and sucralose —have been approved by the U.S. Food and Drug Administration. They contribute no or very few calories to foods and beverages and won't increase your blood glucose or insulin levels. (*People with phenylketonuria should not use aspartame).

Sugar alcohols (or polyols), such as maltitol, xylitol, mannitol, sorbitol, erythritol, and lactitol, contain some calories and can increase your blood glucose level to varying degrees—but generally less than traditional sugars. They provide, on average, half the calories of sugar and other carbohydrates. Some sugar alcohols may cause gas, stomach discomfort and diarrhea in people who are sensitive to sugar substitutes. The amount that causes discomfort varies greatly between individuals and among the different polyols.

Cooking and Baking Tips

People with diabetes who take good care of themselves know that there are two keys to eating desserts and sweets:

1. Moderation
2. Small portions


If you like to bake or make desserts at home, there's a third step you can take:


3. Make your sweet treats as healthy—and as satisfying—as possible.

Most dessert recipes can be made more healthful without sacrificing taste. Experiment with these tips and see which give you the best results for flavor, texture, and overall "Sweet satisfaction."

But remember: making a healthier dessert doesn't mean that you can eat as much as you want. With all desserts, you should practice moderation and limit portion sizes.

• You can usually cut the sugar by one-third to one-half in a recipe, and the dessert will still satisfy your sweet tooth.
• To enhance flavor and sweetness in low-sugar baked goods, increase the vanilla, almond or lemon extracts or spices such as nutmeg, allspice, cinnamon, and ginger.
• Sugar substitutes are a great way to cut calories in your baking and dessert making. Read the package label for instructions on how to use the substitute.
• Some sweet desserts are also high in fat. In recipes for brownies, cakes, or cookies, try replacing the fat with pureed fruit (applesauce or baby-food prunes). Since the fruit supplies a sweet taste, you also may not need as much sugar. But be aware that replacing fat with fruit increases the carbohydrate content, so it's best to eat only small portions.
• When using a low calorie sweetener in your baking or cooking, results can sometimes vary. It's helpful to check the label of the brand you're using for advice and specially designed recipes.
• Generally, low calorie sweeteners work best in desserts for which they provide only a sweet taste, not texture or volume (the "bulk"). Quick breads, muffins, cookies, pie fillings, cheesecakes, sweet sauces, and glazes are good candidates for sugar substitutes. In recipes where sugar normally provides the bulk—such as pecan pie, angel food cake, or caramel—using only a sugar substitute will probably not make the best-tasting dessert.
• In uncooked desserts, sweetened sauces and beverages, usually you can replace all of the sugar with a substitute.
• You'll notice that baked goods made with a sugar substitute don't brown like those made with sugar. In recipes for cookies and cakes, try adding some molasses or cocoa (about 1 tablespoon for every cup of substitute) to provide some browning.

Strategies for Sweet Eating

You might think that having to plan ahead before you eat a sweet or a dessert takes the fun out of it. But by arming yourself with a few strategies for eating sweets, you'll not only be helping to manage your diabetes better, but you'll enjoy your indulgences more knowing that you're eating them sensibly.

• Before selecting a dessert recipe, learn about the nutrition guidelines that will keep you healthy. The USDA's new food guide pyramid is a great place to start. It provides a wealth of nutritional information and can help you calculate a plan tailored to you. Visit MyPyramid.gov for more information. Of course, work with your diabetes educator or a registered dietitian to make sure that your meal plan is on track with your diabetes management goals, whether it's weight loss, blood glucose control or lower cholesterol and triglycerides. Your priorities will help you decide how to fit sweets into your meal plan.
• Two smart moves:
• The first rule of thumb is one that all Americans—including people with diabetes—should live by: Choose a meal plan that is moderate in calories, fat (especially saturated fat), and sugar.
• The second rule of thumb is: When you choose to eat a food that is high in sugar, you must substitute it for another carbohydrate food at your meal. For example, if you want to have a small piece of cake after a meal, eat less carbohydrate (bread, rice, pasta, etc.) at that meal. And the reverse is true: if you eat an extra helping of pasta at dinner, then you shouldn't eat a sweet treat afterward.
• And of course, don't make a habit out of frequently replacing nutrient-rich carbohydrate foods —such as fruits, vegetables, low-fat dairy products, and whole grains—with sweets. You might want to take a blood glucose test two hours after eating to maintain optimal control of your blood sugar levels. Remember that taking a multivitamin does not make up for unhealthy eating.
• Carry your own. When you go to a social function, your host may not know what types of treat is best for you. Why not bring your favorite low-sugar dessert to the party? That way, you can have a treat too—while taking good care of yourself. Good choices include plain cookies, baked apples, sugar-free pudding, and nonfat frozen yogurt. If you make your own dessert, bring a copy of the recipe to the party to share with your host or other guests who might be interested in making it in the future.
• Fool your sweet tooth. Satisfy your sweet tooth with just a small portion of your favorite sweet—you might be surprised at how little you need. Take advantage of smaller portions when options present themselves, such as at an ice cream or frozen yogurt shop.
• Go sugar-free. Substitute a sugar-free sweetened food for the regular item – hot cocoa, a popsicle, a sugar-free chocolate, such as YORK SUGAR FREE, REESE'S SUGAR FREE, HERSHEY'S SUGAR FREE, TWIZZLERS SUGAR FREE or JOLLY RANCHER SUGAR FREE candies—but always in moderation. And remember, fat-free and low-sugar foods are not "free foods"—they still contain calories.
• Lose the guilt. If you have diabetes or are overweight, the need to curb carbohydrates and/or calories may seem to be at war with your love of sweets. Don't make the mistake of overdoing it and then feeling guilty. Work with your diabetes educator or registered dietitian to determine how best to include treats in your meal plan. Try to identify what triggers cravings or overindulgence, and see if you can find healthier substitutes, such as listening to music, stretching or taking a walk, writing in a journal, or taking a relaxing bath.
• Savor your treats. By eating them slowly and truly tasting them, you'll enjoy them more and probably need to eat less. The first few bites always taste the best anyway!

People & Diabetes

If you're among the estimated 20.8 million people in the United States who have diabetes, consider HERSHEY'S SUGAR FREE Candies as a welcome alternative to regular HERSHEY'S products. They have the same high quality and great taste--but without the sugar. And HERSHEY’S SUGAR FREE contain fewer calories –because the products vary, the calorie reduction ranges from 19-41% compared to our regular products.

HERSHEY'S SUGAR FREE Candies contain sugar alcohols, which are digested more slowly than sugar. This means they generally cause a smaller rise in blood sugar levels, and they provide fewer calories per gram than does sugar. That may be preferable for many people with diabetes and others who follow a carbohydrate-conscious diet. Based on dietary exchanges, HERSHEY'S SUGAR FREE products represent about half the carbohydrates compared to regular HERSHEY'S chocolate.

To learn more about diabetes, contact the American Diabetes Association.

Sweets and diabetes:

People with diabetes need to find a balance between sacrificing sweet treats and overdoing them. Please note: This following guidelines are not intended to be a substitute for medical advice. If you have diabetes, ask your diabetes educator, dietitian, or other counseling health professional about how HERSHEY’S SUGAR FREE Candy can fit into your meal plan and your diabetes management plan.

• Regular sugar-containing sweets are not off-limits for people with diabetes, but they must be consumed in moderation as part of an overall healthy meal plan and with an awareness of its impact on blood sugar levels. Patients should compensate for the consumption of sugar-containing foods by reducing their carbohydrates from other foods; this strategy should not be used routinely to replace nutrient-dense fruits, vegetables, low-fat dairy products, and whole grains with sweets.
• Individuals receiving fixed doses of insulin or oral diabetes medication should strive for day-to-day consistency in carbohydrate consumption. The use of short-acting insulin allows greater flexibility in adjusting dosages to adequately cover for added sweets in snacks or meals. Monitoring blood sugars is vital for tracking individual glycemic response.
• People with diabetes should read product nutrition labels for carbohydrate content. High fructose corn syrup, honey, molasses, and other sources of concentrated sugar are similar to sucrose in their glycemic impact.
• Sugar free products provide a tool to help people with diabetes enjoy a more varied and pleasurable meal plan, with greater choice and flexibility.
• Products sweetened with sugar alcohols are not “free foods,” due to their caloric density and fat content. Moderation is still the watchword. Excessive consumption will not produce the hyperglycemic response associated with sugar-sweetened confections, but will deliver excessive calories and fat, and may cause gastrointestinal side effects.
• Sugar free chocolates should not be consumed in excess or frequently substituted for nutrient-dense, low-fat, high-fiber carbohydrates.
• Low-calorie sweeteners such as sucralose, saccharin and aspartame are concentrated sweetening agents that produce no rise in blood sugar. They do not count as carbohydrates, and the Food and Drug Administration has approved them as safe. They may be added to a diabetes meal plan instead of substituted, to reduce calories and carbohydrates.
• Some artificial sweeteners, such as saccharin, cannot be used to replace sugar in cooking and baking.
• The use of low- or no-calorie foods and beverages cannot replace dietary modification and exercise as the foundation of a program of weight control and diabetes management.

15 Great Tips for Chocolate Lovers with Diabetes

Most of us enjoy sugary foods and sweets. For best health, it's wise to eat sugars in moderation, particularly if you have diabetes. Learning how to balance sweets (regular or sugar free) in your meal plan is the key. For a sweeter life with diabetes, follow these helpful hints:

• LEARN about the nutrition guidelines that will keep you healthy and always keep them in mind when you reach for sweets. To learn more, contact the American Diabetes Association or call them at 1-800-DIABETES.
• WORK with your healthcare provider to determine your diabetes goals. Consider what's most important for you: weight loss, blood sugar control, lower fat intake? Your priorities will help you decide how sweets can fit into your meal plan.
• NOTE the nutritional makeup--calories, total fat, saturated fat, cholesterol, carbohydrates, and sugars --of your favorite treats by reading the Nutrition Facts panel on product labels. Keep these numbers and your diabetes goals in mind when you make your choices.
• SET REASONABLE LIMITS, perhaps eating sweets only a few times a week or only on special occasions.
• DON'T SUPERSIZE IT! Order a small-sized ice cream cone--just a small portion can satisfy your sweet tooth.
• SAVOR your treats. By eating them slowly and truly tasting them, you'll enjoy them more--and eat less.
• DIVIDE homemade desserts into small servings. Wrap each individually and freeze extra servings.
• TRY sugar free sweets--always in moderation. (HERSHEY'S, REESE'S, and YORK SUGAR FREE candies have the same high quality and great taste as regular HERSHEY'S chocolate candies, with about half the carbohydrate exchange value and 19-41 percent fewer calories.)
• REMEMBER that fat-free and sugar free foods are not "free foods"--they still have calories. Talk with your diabetes educator or registered dietician about how to fit sweets into your meal plan.
• SUBSTITUTE a sugary food for another carbohydrate food at your meal. For example, if you want to have a small piece of birthday cake for dessert, eat fewer carbohydrates (bread, rice, pasta, etc.) at that meal.
• CHECK your blood sugar to see how various sweets affect it. Let this information help you decide which sweets to eat.
• BALANCE your meal plan by eating a variety of fruits, vegetables, low-fat dairy products, and whole grain foods each day.
• KEEP IN MIND this nutrition message, which all Americans--including people with diabetes--should live by: "Choose a meal plan that is moderate in sugars."
• WORK with a registered dietitian (RD) to develop your own meal plan that takes into account your likes and dislikes, your schedule, and your diabetes goals. To find an RD who has experience working with people who have diabetes, call the American Diabetes Association at 1-800-DIABETES (1-800-342-2383); the American Dietetic Association at 1-800-366-1655; or the American Association of Diabetes Educators at 1-800-TEAM-UP4 (1-800-832-6874).
• ENJOY your treats, knowing that you've chosen them responsibly!

(Sources: National Institute of Diabetes and Digestive and Kidney Diseases; American Diabetes Association)

For Health Professionals

People with diabetes can still enjoy the pleasure of chocolate, provided they consume it in moderation and keep their blood glucose under good control.

HERSHEY'S SUGAR FREE products, appeal to many people with diabetes as an alternative to regular chocolate, The Hershey Company has made a solid commitment to diabetes education and outreach. The Hershey Company wants to help you, the health professionals, to educate people on how to manage their diabetes and live healthy lives while enjoying one of life's most evocative and symbolic pleasures: chocolate.

FAQ

Q: Why has The Hershey Company introduced HERSHEY'S SUGAR FREE Candy?
A: Consumers have been asking for HERSHEY'S SUGAR FREE candy for years. After extensive research and product testing, we are thrilled to offer the only sugar free candies good enough to be called HERSHEY'S. Consumer feedback has been overwhelmingly positive, with many people telling us that the flavor is as satisfying as the "regular" HERSHEY'S confectionery.

Q: Why did The Hershey Company reformulate the HERSHEY'S SUGAR FREE Chocolates?
A: To deliver to consumers a richer and chocolaty taste and texture.

Q: What makes these products "Sugar Free"?
A: HERSHEY'S SUGAR FREE items meet FDA regulations for sugar free Candies, which must contain less than 0.5 grams of sugar per serving. These products contain sugar replacers, called sugar alcohols, like maltitol, lactitol, and isomalt and low calorie sweeteners such as sucralose and acesulfame potassium instead of sugar.

Q: How do HERSHEY'S SUGAR FREE Candies fit into a balanced and healthy lifestyle?
A: Chocolate and confectionery products can be part of a balanced and healthy lifestyle. We believe, as do most nutrition professionals, that chocolate and confectionery products can be enjoyed by almost everyone, but moderation is the key.

Q: Are HERSHEY'S SUGAR FREE Candies lower in calories and/or fat?
A: HERSHEY'S SUGAR FREE Candies are have fewer calories compared to their "regular" counterparts, however because the products vary in composition they range from 19-41% reduced in calories. Check your favorite product’s nutrition information to see the difference between HERSHEY'S SUGAR FREE and their counterparts. (See the specific products for calorie information) It is important to note that HERSHEY'S SUGAR FREE items are not low calorie or no-calorie foods. They contain about the same level of fat as regular chocolate. HERSHEY'S SUGAR FREE chocolates also contain about the same level of caffeine as regular chocolate.

Q: Are HERSHEY'S SUGAR FREE Candies lower in carbohydrates?
A: The nutrition facts panel on HERSHEY'S SUGAR FREE labels will show carbohydrate content that is comparable to regular confectionery counterparts. However, HERSHEY'S SUGAR FREE products use sugar alcohols as a substitute for sugar. The sugar alcohols are absorbed and metabolized by the body in a different way than sugar. As a result, their carbohydrate exchange value is about half that of sugar. Current Food and Drug Administration labeling regulations do not allow the labeling of carbohydrates within the nutrition panel in this way. However, we have reflected the carbohydrate exchange value in the dietary exchanges: for example, 1 carbohydrate unit for HERSHEY'S and REESE'S SUGAR FREE chocolate candy compared to 2 units for regular HERSHEY'S Milk Chocolate Bar.

Q: Are HERSHEY'S SUGAR FREE Candies appropriate for people with diabetes?
A: HERSHEY'S SUGAR FREE items contain sugar alcohols such as maltitol to replace the sugar. These sugar alcohols are digested more slowly and generally cause a relatively small rise in blood sugar levels. For people with diabetes, this is preferable to the sharper increase in blood sugar associated with products containing sugar. Regular confectionery products can also be included in a diabetes meal plan, as long as consumers plan carefully for the effect on blood sugar levels. People with diabetes should ask the advice of their diabetes educator or registered dietitian about the role of sugar free confectionery in their meal plan. For more information about HERSHEY'S SUGAR FREE and diabetes, click here.

Q: Are HERSHEY'S, REESE'S, YORK, TWIZZLERS and JOLLY RANCHER SUGAR FREE Candies free foods?
A: YORK and JOLLY RANCHER SUGAR FREE Candies are reduced calorie foods – that is, they provide at least 25% fewer calories than the "regular" candies. However, HERSHEY'S and REESE'S SUGAR FREE Candies are NOT low-calorie or no-calorie free foods that can be eaten in unlimited amounts. Moderation is the key. Overeating these products may cause blood sugar levels to increase more than desired despite their carbohydrate exchange value. In addition, excess consumption of them may overload a daily meal plan with calories and fat and may trigger gas production or a laxative effect.

Q: What are sugar alcohols?
A: Sugar alcohols are sugar replacers, used to take the place of sugar to make sugar free candies and other sugar free products. Sugar alcohols used in HERSHEY’S SUGAR FREE candies include maltitol, maltitol syrup, sorbitol, isomalt, polyglucitol, and lactitol. They have fewer calories than sugar, but still provide a sugar-like taste. Sugar alcohols are digested more slowly than sugar, generally producing a relatively small rise in blood sugar levels after eating. Because sugar alcohols may bypass initial steps in digestion (similar to fiber), excess intake may trigger gas production or a laxative effect.

Q: Are there other products made with sugar alcohols?
A: Many reduced calorie, reduced sugar and/or sugar free products are sweetened with sugar alcohols. You can tell which sugar alcohols are used by reading the ingredients listed on the package.

Q: How do sugar alcohols compare to other artificial sweeteners such as saccharin and aspartame?
A. Sugar alcohols replace the bulk of regular sugar and also provide some of the sweetness of sugar. Saccharin and aspartame are low calorie sweeteners that are hundreds of times sweeter than sugar. So only a very small amount is used. They are most commonly found in diet drinks. We do have a low calorie sweetener -- sucralose -- in some of our products. Sucralose is derived from sugar, but is 600 times sweeter and has no calories. In our products, it is used to round out the sweetness level, as sugar alcohols generally are less sweet than sugar.

Q: Do sugar alcohols alter the chocolate taste? Is there any aftertaste?
A. Our consumer research indicated that most consumers did not find that our sugar free Candies had an unpleasant aftertaste.

Q: Do sugar alcohols have any digestive side effects?
A. When consumed in moderation, sugar alcohols should not cause any digestive side effects in most individuals. However, some people are more sensitive and may experience some side effects at lower levels. One of the reasons that sugar alcohols are lower in calories and carbohydrates compared to sugar is that they are digested and absorbed in a different way. Sugar is digested in the small intestine by enzymes, however most sugar alcohols are digested in the large intestine by normally occurring bacteria. In the process of digesting sugar alcohols, some digestive side effects can occur, including flatulence (gas), colic, and diarrhea. Severity of the side effects will vary based on the individual, and the amount of product that is eaten. These side effects are generally similar for all sugar alcohols. Due to the presence of sugar alcohols in our products, we have included a warning statement on the package indicating that individuals sensitive to sugar substitutes may experience a laxative effect.

Q: What is the safety record of the sugar substitutes used in HERSHEY'S SUGAR FREE?
A: We use sugar alcohols permitted for use in the U.S. by the Food and Drug Administration. Most of these have been used in many different types of food products for many years. Sucralose was approved for use in the U.S. by the FDA in 1999, and has been safely used in many different types of foods and beverages, as well as a popular dietetic tabletop sweetener (Splenda™ brand). Sucralose has been used safely for many years in Canada and many parts of Europe.

Q: Do HERSHEY'S SUGAR FREE Candies carry any warning labels or information statements?
A: Yes. Due to the presence of sugar alcohols in our products, we have included a warning statement on the package indicated that individuals sensitive to sugar substitutes may experience gas or a laxative effect.

Q: Can HERSHEY'S SUGAR FREE chocolates be used in baking?
A: Yes. Although our products are sugar free candies, they can be used as ingredients in baking (e.g. cookies) and will behave about the same as regular chocolate candy. For recipes, visit our recipe page.

Q: Where can I buy HERSHEY'S SUGAR FREE Candies?
A: HERSHEY'S SUGAR FREE Candies are available wherever regular HERSHEY'S confectionery products are sold.