Sorbitol, a sugar alcohol, can be found naturally in apples, peaches and prunes, as well as in food items and beverages made from these sources. Synthetic forms of sorbitol are used as replacements for sugar in commercially prepared and pre-packaged foods marketed to diabetics and dieters. Sorbitol contains fewer calories than sugar and has a minimal effect on blood sugar levels and does not promote tooth decay. However, sorbitol consumption is associated with side effects, especially when ingested in large quantities.
Gas or Flatus
In their review of the literature published in the March 2001 supplemental issue of the "British Journal of Nutrition," researchers Philippe Marteau and Bernard Flourie report that one of the first gastrointestinal symptoms to manifest from sorbitol consumption is gas buildup in the bowels and the excessive passing of gas or flatus. When sorbitol is metabolized by bacteria in the large intestine, gas is produced. Flatus may occur at sorbitol intakes as low as 10 g, according to dietitians Hollie A. Grabitske, M.S., and Joanne Slavin, Ph.D., in their report published in the April 2009 issue of "Critical Reviews in Food Science and Nutrition."
Abdominal Cramps
In a study published in the February 2000 issue of "Regulatory Toxicology and Pharmacology," investigators found that sorbitol consumption was significantly associated with triggering abdominal cramps. Sorbitol rapidly softens stools, which leads to a pressure buildup in the intestinal tract when the flow of loose stool encounters, and is blocked by, firm stool already present in the intestines. Abdominal cramping typically subsides when a bowel movement occurs.
Laxation and Diarrhea
Sorbitol has an osmotic effect in the lower bowels; that is, it draws water into the large intestine. Furthermore, fermentation of sorbitol by the intestinal bacteria produces short-chain fatty acids, which add bulk to the stool if not absorbed by the intestine or used by the intestinal bacteria as energy. As a result of both of these processes, laxation can occur. Laxation is characterized by loosely formed bowel movements or an increase in the number of stools passed. Diarrhea results when the capacity of the intestinal bacteria to ferment sorbitol is exceeded.
Considerations
Grabitske and Slavin suggest that intakes of 20 to 30 g of sorbitol per day may be well tolerated by most individuals. The American Dietetic Association reports that sorbitol intakes that are equal to or exceed 50 g per day are associated with laxative effects. As a result of this possibility, the U.S. Food and Drug Administration requires a product label statement to be present on products containing sorbitol, warning against possible laxative effects. Susceptibility to the side effects of sorbitol is based on the physiological differences of the individual, the frequency of consumption throughout the day, the amount consumed in a single meal and the types of food and beverages with which sorbitol is ingested.
References
- University of Maryland Medical Center: Digestive Disorders
- Baylor College of Medicine: Too Much Juice can Cause Intestinal Discomfort Usually Blamed on Milk
- "Critical Reviews in Food Science and Nutrition"; Gastrointestinal Effects of Low-Digestible Carbohydrates; Hollie A. Grabitske, M.S., and Joanne L. Slavin, Ph.D.; April 2009
- Polyols Information Source: Sorbitol
- "British Journal of Nutrition"; Tolerance to Low-digestible Carbohydrates: Symptomatology and Methods; Philippe Marteau and Bernard Flourie; March 2001
- "Regulatory Toxicology and Pharmacology"; Effects of Olestra and Sorbitol Consumption on Objective Measures of Diarrhea: Impact of Stool Viscosity on Common Gastrointestinal Symptoms; J. McRorie et al.; February 2000
