Philippa by Emma SandallBy Philippa Sandall, Special to Everyday Health

Drizzled with Albert Sabin’s oral polio vaccine, a lump of sugar not only helped the medicine go down, but inspired the toe-tapping Sherman Brothers’ hit "A Spoonful of Sugar" in Walt Disney’s Mary Poppins.

It’s also a reminder that back in the 1960s, schoolchildren around the world lined up in front of tables with rows and rows of little paper cups containing a drop of medicine on a lump of sugar as part of mass polio immunization program.

Bob Sherman’s son was one of those children. I was another.

A Sweet Solution to a Bitter Problem

Sweetening the pill doesn't always work. Getting kids to take medicine is a bit like getting them to eat boiled cabbage. Challenging, and an age-old problem.

Anything we put in our mouths really needs to taste good. Otherwise our taste buds will promptly say “no,” and we'll spit it out. It’s a lesson we learned way back, when our ancestors found that eating sweet plants was generally a much safer bet than biting into bitter ones.

Sweetening the pill certainly helps us take our medicine, which all too often tends to be on the bitter side. Take the rather unpalatable cod liver oil — once popular to spoonfeed to children to help build strong bones and prevent rickets (it was the vitamin D). Parents had to be extraordinarily creative to get kids to open their mouths and take it neat, so it was imaginatively combined with malt extract (also popular at the time for putting the roses into cheeks). If this makes you feel nostalgic, you can buy malt extract with cod liver oil in three flavors (butterscotch, honey, and natural) from the British company Potter’s Herbals.

In Your Pill Bottle, Sugar and Its Many Imitators

You may be surprised at the number of over-the-counter (OTC) pharmaceuticals and oral hygiene products — from toothpaste, mouthwash, and breath mints to cough syrups, throat lozenges, chewable vitamins, and antacids — that need sweeteners of one kind or another to get us to actually open our mouths and swish them around, suck them, chew them, and swallow them. The secret ingredients that do this include high-intensity sweeteners, sugars, polyols (sugar alcohols), and even starches (including cornstarch and maltodextrins).

Colgate Total toothpaste, like other brands, contains saccharin (a non-nutritive sweetener around 200 to 500 times sweeter than sugar) and sorbitol (a “tooth-friendly” sugar alcohol) to make it taste better. So does Cool Mint Listerine, along with other multipurpose mouthwashes.

In many bathroom cupboard there are probably some throat lozenges. They all have something that makes us want to keep sucking on them. In Luden's Honey and Lemon Menthol Throat Drops, honey and sucrose make them palatable so we get the benefit of the menthol. If the package says “sugar-free,” it means they will contain alternative, high-intensity sweeteners, like saccharin.

When indigestion, heartburn, and sour stomach are spoiling your day, you may look to an antacid for relief. The sweeteners that help make them palatable vary among brands depending on the product formulation. Gaviscon liquid, for example, contains saccharin and sorbitol. The extra-strength, chewable, original flavor tablets have sucrose and sorbitol or mannitol; extra-strength cherry flavor chewable tablets have corn syrup, mannitol, and sucrose; and regular strength original flavor tablets just have sucrose as do the various flavors of regular Tums.

Sugar-free products typically contain either saccharin or aspartame, usually teamed with a polyol (sugar alcohol) such as mannitol or sorbitol. You may even spot the term “dextrates” in some ingredient lists. In plain English, it’s refined carbohydrates composed of dextrose (a.k.a., glucose) and dextrins (a.k.a., maltodextrins).

When Sugar Is the Medicine

Sometimes the sugar is the medicine you need, not the sidekick to make it more palatable. There are two very common conditions for which glucose, a source of fast-acting energy, is just what the doctor ordered: gastroenteritis and hypoglycemia.

Hypoglycemia occurs mostly in people with type 1 diabetes or insulin-requiring type 2 diabetes, or in people taking sulphonylureas (a form of blood glucose-lowering tablets) when their blood glucose level has dropped too low (generally below 4 millimole/liter or 70 milligrams/deciliter). When this happens, they need to eat or drink fast-acting carbohydrates, such as fruit juice, candy, or glucose tablets or gels.

Sweetening the pill won’t work with your pet cat, however. He (or she) will still spit it out.

Cats can’t detect sweet tastes.

Philippa Sandall is co-author (with Alan Barclay and Claudia Shwide-Slavin) of The Ultimate Guide to Sugars and Sweeteners: Discover the Taste, Use, Nutrition, Science, and Lore of Everything from Agave Nectar to Xylitol. She is also editor of the University of Sydney Human Nutrition Unit’s GI News newsletter, which has more than 120,000 subscribers worldwide. She is also coauthor, with Jennie Brand-Miller, of several books in the New York Times-bestselling New Glucose Revolution series. A longtime book editor, she now runs her own editorial consulting agency, Philippa Sandall Publishing Services, in New South Wales, Australia.