Nutritive and Non-Nutritive Sweeteners

NNNS: Polyols (2010)

• Assessment
  What is the evidence from human subject research that consumption of polyols/sugar alcohols is associated with metabolic and/or adverse effects in adults?

  • Conclusion

    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: III
    • 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.
  • Evidence Summary: What is the evidence from human subject research that consumption of polyols/sugar alcohols is associated with metabolic and/or adverse effects in adults?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Finney M et al. Effects of low doses of lactitol on faecal microflora, pH, short chain fatty acids and gastrointestinal symptomology.  Eur J Nutr. 2007; 46: 307-314.    
      • Gostner A, Schäffer V, Theis S, Menzel T, Lührs H, Melcher R, Schauber J, Kudlich T, Dusel G, Dorbath D, Kozianowski G, Scheppach W. Effects of isomalt consumption on gastrointestinal and metabolic parameters in healthy volunteers. Br J Nutr. 2005; 94(4): 575-581.
      • Grabitske HA, Slavin JL. Gastrointestinal effects of low-digestible carbohydrates. Crit Rev Food Sci Nutr. 2009; 49(4) :327-360.
      • Koutsou GA, Storey DM, Lee A, Zumbe A, Flourie B, leBot Y, Olivier P. Dose-related gastrointestinal response to the ingestion of either isomalt, lactitol or maltitol in milk chocolate. Eur J Clin Nutr. 1996; 50 (1): 17-21.
      • Madsen J, Linnet J, Rumessen J. Effect of nonabsorbed amounts of a fructose-sorbitol mixture on small intestinal transit in healthy volunteers. Dig Dis Sci.   2006. 51 (1): 147-153.  
      • Storey D, Lee A, Bornet F, Brouns F. Gastrointestinal tolerance of erythritol and xylitol ingested in a liquid. Eur J Clin Nutr. 2007 Mar; 61(3): 349-354. Epub 2006 Sep 20.
  • Search Plan and Results: Polyols and Sugar Alcohols - 2009