What is the evidence from human subject research that consumption of polyols/sugar alcohols is associated with metabolic and/or adverse effects in adults?
A total of six studies met inclusion criteria. Five of these were short-term randomized controlled trials (Finney 2007, Gostner 2005, Koutsou 1996, Madsen 2006 and Storey 2007) and one was a review article (Grabitske 2009).
The five randomized controlled trials studied gastrointestinal effects of polyols/sugar alcohols and consistently found that in moderate doses of up to 10-15 grams per day, polyols/sugar alcohols are tolerated. At high doses (≥30 g/day), consumption of some polyols/sugar alcohols (including lactitol, isomalt and xylitol) may result in significant increases in flatulence, borborygmus, colic, defecation frequency and loose/watery stools. The review article (Grabitske 2009) examined the use of sugar alcohols and concluded that usual intake is below the levels that would result in significant gastrointestinal side effects.
One study (Gostner 2005) examined the effect of polyols/sugar alcohols on total cholesterol and triglycerides, and found no significant differences between subjects consuming isomalt or sucrose. None of the other studies examined metabolic effects of sugar alcohols, including glycemia.
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
- High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
- Moderate (B) means we are moderately confident in the effect estimate;
- Low (C) means our confidence in the effect estimate is limited;
- Very Low (D) means we have very little confidence in the effect estimate.
- Ungraded means a grade is not assignable.