maltitol and Diarrhea

Using a single-group time-series design, we determined that osmotic diarrhea caused by maltitol ingestion was suppressed by the addition of not only soluble but also insoluble dietary fiber in healthy humans. We then clarified that cellulose delayed gastric emptying in rats. Twenty-seven healthy volunteers ingested maltitol step-wise at doses of 15, 20, 25, 30, 35, 40 and 45 g from small to large amounts. Within that range of ingested amounts, 22 out of 27 subjects experienced osmotic diarrhea from maltitol ingestion, and the minimal dose level of maltitol that induced osmotic diarrhea (MMD) was established for each subject. When 5 g of cellulose was added to the MMD, osmotic diarrhea was suppressed in 13 out of 19 subjects (68.4%), while partially hydrolyzed alginate-Na (PHA-Na), a soluble dietary fiber, suppressed osmotic diarrhea in 10 out of 20 subjects (50.0%). When a mixed solution of cellulose and maltitol was administered to rats, the gastric emptying of maltitol was significantly delayed at 30 and 60 min after administration (p=0.019, p=0.013), respectively. PHA-Na also significantly delayed gastric emptying at 30 min (p=0.013). In conclusion, cellulose can suppress the osmotic diarrhea caused by maltitol ingestion in humans and delay the gastric emptying of maltitol in rats. A new physiological property of cellulose was clarified in this study.

Topics: Alginates; Animals; Cellulose; Diarrhea; Dietary Fiber; Diuretics, Osmotic; Dose-Response Relationship, Drug; Drug Interactions; Female; Gastric Emptying; Humans; Intestine, Small; Male; Maltose; Rats; Rats, Wistar; Stomach; Sugar Alcohols; Young Adult

We aimed to evaluate the gastro-intestinal tolerance to an indigestible bulking sweetener containing sugar alcohol using a double-blind random cross-over study.. In order to simulate their usual pattern of consumption, 12 healthy volunteers ingested maltitol or sucrose throughout the day, either occasionally (once a week for each sugar, first period) or regularly (every day for two 9 day periods, second period). In both patterns of consumption, daily sugar doses were increased until diarrhea and/or a grade 3 (ie severe) digestive symptom occurred, at which the dose level was defined as the threshold dose (TD).. In the first period (occasional consumption), the mean TD was 92+/-6 g with maltitol and 106+/-4 g with sucrose (P=0.059). The mean intensity of digestive symptoms was 1.1 and 1.3, respectively (P=NS). Diarrhea appeared in six and one subjects respectively (P=0.035). In the second period (regular consumption), the mean TD was 93+/-9 g with maltitol and 113+/-7 g with sucrose (P=0.008). The mean intensity of digestive symptoms was 1.7 and 1.2, respectively (P=NS). However, diarrhea appeared in eight and three subjects, respectively (P=0.04). Maltitol and sucrose TDs between the two periods were not different.. Under our experimental conditions, in comparison to sucrose: (a) occasional or regular consumption of maltitol is not associated with severe digestive symptoms; (b) in both patterns of maltitol consumption, diarrhea frequency is higher, but it appeared only for very high doses of maltitol, much greater than those currently used; (c) maltitol does not lead to intestinal flora adaptation after a 9 day period of consumption.

Topics: Abdominal Pain; Adaptation, Physiological; Adolescent; Adult; Cross-Over Studies; Diarrhea; Dietary Sucrose; Digestive System; Dose-Response Relationship, Drug; Double-Blind Method; Flatulence; Humans; Male; Maltose; Maximum Tolerated Dose; Middle Aged; Sugar Alcohols; Sweetening Agents

To determine whether there were differences between different polyols (sugar alcohols) in terms of their ability to stimulate intolerance symptoms when consumed in milk chocolate. Also to discover whether symptomatology can be related to the dose of polyol ingested.. The study was of a randomised double-blind cross-over design.. 59 healthy volunteers aged 18-24 years were recruited from the student population of the University of Salford. All subjects successfully completed the trial.. Subjects ingested 100 g milk chocolate containing 40 g bulk sweetner as either sucrose, isomalt, lactitol or maltitol or a mixture (10:30 w/w) of sucrose and isomalt, sucrose and lactitol or sucrose and maltitol. Each bar was taken as breakfast on one day with following products consumed at 1-week intervals. Subjects reported the incidence and severity of the symptoms of flatulence, borborygms, colic, motion frequency and loose stools.. The ingestion of 30 g or 40 g lactitol resulted in a significant increase in the incidence and severity of all symptoms examined compared to reactions after the consumption of standard sucrose-containing chocolate (P <0.01). Similarly, 40 g isomalt led to an increased incidence of all symptoms, including mild laxation (P <0.01), but unlike lactitol none was rated as being severe. A reduction in isomalt to 30 g was marked by increased tolerance with evidence of only mild borborygms (P <0.01), mild flatulence, colic, and laxation (P <0.05), with no increase in motion frequency (P <0.35). Ingestion of 40 g maltitol caused less intolerance than 40 g isomalt, with evidence of only flatulence, borborygms and colic (P <0.01), symptoms being rated as only mild. A reduction to 30 g led to a decrease in all symptoms except mild flatulence. Maltitol did not have any laxative effect when ingested at either 30 g (P = 0.32) or 40 g (P = 0.13) per day.. This work has shown that there are significant differences in the reporting of gastrointestinal symptomatology following the consumption of isomalt, lactitol and maltitol incorporated into milk chocolate. However, with all three polyols the incidence and severity of symptomatology was dose dependent.

Topics: Adolescent; Adult; Animals; Cacao; Cross-Over Studies; Diarrhea; Disaccharides; Dose-Response Relationship, Drug; Double-Blind Method; Female; Flatulence; Gastrointestinal Motility; Humans; Male; Maltose; Milk; Severity of Illness Index; Sugar Alcohols; Sweetening Agents

In a controlled trial of a double-blind cross-over design, it has been shown that "Marvie', a non-calorigenic sweetener containing 58 per cent maltitol by weight, is an effective sweetener which has no influence on routine haematological and biochemical parameters. The dose that could be tolerated without undesirable symptoms was between 20 and 30 g per day. Above this dose, flatus production with abdominal discomfort could limit tolerance to this sweetening agent.

Topics: Adult; Clinical Trials as Topic; Diarrhea; Dose-Response Relationship, Drug; Double-Blind Method; Drug Tolerance; Flatulence; Hematologic Tests; Humans; Maltose; Placebos; Sugar Alcohols; Sweetening Agents

To estimate the suppressive effect of partially hydrolyzed guar gum (PHGG) on transitory diarrhea induced by ingestion of a sufficient amount of maltitol or lactitol in female subjects.. The first, the minimal dose level of maltitol and lactitol that would induce transitory diarrhea was estimated separately for each subject. Individual subject was administered a dose that increased by 5 g stepwise from 10 to 45 g until diarrhea was experienced. Thereafter, the suppressive effect on diarrhea was observed after each subject ingested a mixture of 5 g of PHGG and the minimal dose level of maltitol or lactitol.. Laboratory of Public Health Nutrition, Department of Nutrition and Health Sciences, Siebold University of Nagasaki.. Thirty-four normal female subjects (21.3+/-0.9 years; 49.5+/-5.3 kg).. Incidence of diarrhea caused by the ingestion of maltitol or lactitol and the ratio of suppression achieved by adding PHGG for diarrhea.. The ingestion of amounts up to 45 g of maltitol, diarrhea caused in 29 of 34 subjects (85.3%), whereas the ingestion of lactitol caused diarrhea in 100%. The diarrhea owing to maltitol was improved in 10 of 28 subjects by the addition of 5 g of PHGG to minimal dose-induced diarrhea, and that owing to lactitol was in seven of 19 subjects. Adding 10 g of PHGG strongly suppressed the diarrhea caused by maltitol, and the cumulative ratio was 82.1% (23/28).. The transitory diarrhea caused by the ingestion of maltitol or lactitol was clearly suppressed by the addition of PHGG. These results strongly suggest that diarrhea caused by the ingestion of a sufficient amount of non-digestible sugar substitute can be suppressed by the addition of dietary fiber.

Topics: Adult; Cathartics; Diarrhea; Dietary Fiber; Dose-Response Relationship, Drug; Female; Galactans; Gastrointestinal Motility; Humans; Maltose; Mannans; Plant Gums; Sugar Alcohols; Treatment Outcome