Sorbitol is a naturally occurring sugar alcohol, slightly less sweet and less caloric than regular sugar. It occurs naturally in prunes, pears and some berries and is also available in solution as a medicinal laxative. Many low-sugar processed foods and gums contain sorbitol. In small amounts, sorbitol appears safe for children. In larger amounts, or in children with kidney disorders, sorbitol can cause problems.
One reason sorbitol would be beneficial for children, and not harmful, is that it does not promote tooth decay. Oral bacteria typically break down sugars and starches in foods, releasing acids. If the acids are not fully brushed or rinsed away, these acids erode tooth enamel. Sorbitol, and other polyols or sugar acids, are resistant to bacterial metabolism and therefore do not lead to the product of enamel decaying acids.
Children with diabetes, as well as adults, need to control their blood glucose, lipids and weight. Because sorbitol is slowly and poorly absorbed by the body, blood glucose and the associated insulin response is reduced. In addition, calories per gram of sorbitol is two-thirds that of regular sugar, helping children control their weight. Although sorbitol can be a beneficial part of a diabetic child's diet, discuss its use with the child's health care provider.
The U.S. food and drug regulation affirmed sorbitol as a "Generally Regarded As Safe" or GRAS ingredient based on data evaluated by scientists on the Select Committee on GRAS Substances. In addition, both the Scientific Committee for Food of the European Union and the Joint Food and Agriculture Organization/World Health Organization Expert Committee on Food Additives or JECFA, concluded sorbitol is safe, based on review of extensive data. Further, neither of these groups placed any limits on the acceptable daily intake (ADI) of sorbitol. An ADI of “not specified” is the safest category possible. However, the U.S. Food and Drug Administration requires foods which may result in the daily ingestion of 50 grams or more of sorbitol to include the warning: “Excess consumption may have a laxative effect.”
Sorbitol has a laxative effect and in fact, sorbitol solutions are sold as laxatives through pharmacies. Because sorbitol is not easily or rapidly absorbed by your body, it help your body move material through the digestive tract, but excessive amounts can also cause bloating, flatulence, diarrhea, cramping and other abdominal problems. The severity of this problem for children is hotly debated.
According to the Center for Science in the Public Interest, sorbitol's laxative effect in children could be serious, leading to severe diarrhea, even in small doses, due to their small size. Dr. Jeffrey Hyams, from Connecticut Children's Medical Center, warns that small amounts of sorbitol can cause severe gastrointestinal symptoms. However, Lyn Nabors, vice president of the Calorie Control Council, says that for the vast majority of consumers, sorbitol does not cause a problem, being found naturally in a variety of fruits and berries. She adds that while excessive consumption may lead to mild gastrointestinal discomfort, it poses no greater threat than ingestion of beans, cabbage and some dried fruits.
Allergies and Intolerance
Sorbitol may cause problems in children who have a sorbitol allergy or who are extremely sensitive to its laxative effects. Allergic reactions can include rashes, hives, itching, shortness of breath, wheezing, coughing or swelling of the face, lips, tongue or throat. Do not give sorbitol to children who have severe kidney disease, as sorbitol is substantially excreted by the kidney.