Is Allulose Sweetener Safe to Use in Canada?

Recently, there’s been more attention in the media on the sugar substitute allulose. The PEN Team thought a look into allulose’s characteristics was warranted to help guide practitioners when responding to client questions about this sugar substitute.

Allulose, a low calorie sweetener, is approved by the Food and Drug Administration (FDA) in the U.S. and in other countries. It is not approved for sale in some areas, including Canada and the European Union, but it can be purchased online (1-3). Health Canada's Food and Drug Regulations and the European Food Safety Authority have classified allulose as a novel food ingredient, but safety assessments have not been completed to set an approval rating in these areas (2,3). Food Standards Australia New Zealand (FSANZ) is currently looking into an application to permit D-allulose as a novel food (4).

Allulose or D-psicose (D-ribo-2-hexulose) is a monosaccharide found naturally in small amounts in a variety of sweet foods such as molasses, maple syrup, brown sugar, wheat, raisins and figs (1,2).  It can also be manufactured from corn by converting fructose to D-psicose (1). It is about 70% as sweet as sucrose.

After a scientific review of allulose, the FDA concluded that the consumption of allulose is different from other types of sugars (5). While it is absorbed by the body, it is not metabolized, so it is nearly calorie free (1,6). Allulose does not promote tooth decay, has minimal/negligible effect on blood glucose or insulin levels and contains 90% fewer calories per gram than sugars like fructose and glucose.

The FDA’s labelling requirements require allulose to be declared in the ingredient statement on food product labels and included as a Total Carbohydrate (1,6). The label can exclude allulose from Total Sugars and Added Sugars and the caloric value can be shown for as low as 0.4 kcal/g (1,6).

Healthy Adults
A systematic review and meta-analysis reviewed eight studies that looked at allulose’s effects on blood glucose concentrations in healthy adults after consuming a meal with and without allulose (7). All the studies were small (eight to 30 individuals per group), randomized and single or double blinded. Liquid or solid allulose was used in doses between 5 and 10 grams per meal. The authors found that in healthy adults, 5 or 10 g of allulose added to a meal was effective in lowering blood glucose levels as compared to control groups without allulose taken at a meal. The study did not report adverse effects.

Individuals with Diabetes
A prospective, single-blind, randomized crossover study involving 24 people (20 to 80 years) with type 2 diabetes in the hospital compared peak postprandial blood glucose levels after the consumption of a standard hospital diabetic diet and the same diet but containing 8.5 g of D-allulose per meal (8). Over five days, the participants followed each type of diet for two consecutive days (3 meals/day), each with a washout period between diets of at least one day. Blood glucose levels were measured using continuous glucose monitoring. The authors found that for the participants who consumed the diabetic diet containing allulose, their postprandial blood glucose levels were significantly lower compared to the participants who consumed a normal diabetic diet free from allulose. No diarrhea or safety concerns were identified. In contrast, another small, randomized crossover study in 16 individuals with diabetes found no effect on glycemic response after 12 weeks of allulose (7 g, twice daily) compared to aspartame (0.3 g, twice daily) (9).

When counselling clients, dietitians can explain that allulose does not increase blood glucose levels even though it is listed in the Total Carbohydrates section of a food product label. Dietitians can counsel clients as per all sweeteners/sugar substitutes. This includes providing: