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Although many of us have a de- sire for sweetness due to our brains need for glucose, as previously dis- cussed, sugar is not essential to health. Fructose Fructose is a naturally occurring sugar found in fruits and vegetables. It contains up to 40 percent fewer calories than table sugar and is up to 40 percent sweeter. Fructose is most effective as a sweetening agent in high- acid and cold foods, such as citrus drinks. Fructose travels mainly to the liver and can be used there without the need for insulin. In the absence of insulin, fructose can be converted to glu- cose in the liver and therefore can contribute to an increase in blood glu- cose rather than being stored as glycogen. Unlike sucrose and glucose, which cause rapid changes in the blood glucose level, fructose is absorbed more slowly and causes fewer changes in the blood sugar level due to being metabolized in the liver. Fructose-sweetened products can still make a significant contribution to caloric intake, and therefore fructose can't be considered a sweetener to be used freely. Sugar Alcohols The term "sugar alcohols" is used to refer to a class of nutritive sweeteners also called polyols, which are neither sugars nor alcohol. These include sor- bitol, mannitol, xylitol, lactitol, HSH (hydrogenated starch hydrolysate), maltitol, isomalt, and erythritol. Sugar alcohols have little effect on the blood sugar level because they're digested and absorbed much more slowly. Although they contain "zero net carbs," meaning they don't have to be counted as carbohydrates, they still contain some calories. Excessive consumption of low-carb products containing some types of sugar alcohols may lead to abdominal cramping, gas, and laxative effects. Therefore, excessive consumption of low-carb products sweetened with sugar alcohols is not recommended. Moderation is certainly the key to the consumption of any kind of processed snack, food, or beverage. Sorbitol, Mannitol, and Xylitol Sorbitol and mannitol are naturally found in small amounts in some fruits and vegetables and are used as sweeteners in many products. Sorbitol is ap- proximately 60 percent as sweet as sucrose, and mannitol is 70 percent as sweet; therefore more of each must be used to reach the same level of sweetness. Depending upon the gastrointestinal sensitivity of the individ- ual, mannitol can cause diarrhea and abdominal complaints if more than 20 grams are consumed daily; for sorbitol the amount is about 50 grams per day. Xylitol, also derived from fruits and vegetables, can be found in carrots, lettuce, and strawberries. Lactitol Lactitol is currently used as a bulk sweetener. It was first used as a sweetener in the 1980s and is only about 40 percent as sweet as sucrose. It has half the calories as sucrose, with about 2 calories per gram. HSH (Hydrogenated Starch Hydrolysate) Hydrogenated starch hydrolysate, which also goes by the trade name Ly- casin, is derived from corn, wheat, and potato starch.