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The Trouble With Sugar Free . . . .25 Aug 2003
How Sorbitol Causes Irritable Bowel Syndrome
If you suffer from Irritable Bowel Syndrome and enjoy sugar-free
products, it may be worthwhile to review your eating habits.
Did you know the common additive sorbitol causes bloating, flatulence
and diarrhea? It only takes 10g per day. Ironically sugar-free products
are marketed as being part of a healthy lifestyle.
Despite more than two decades of clinical research on the detrimental
effects of sugar substitutes on the human body, sugar-free products are
sold as solutions for everything from weight loss to tooth whitening.
We classify Irritable Bowel Syndrome as a collection of symptoms rather
than a disease. If you have long-term symptoms like stomach bloating,
flatulence, itching skin, headache, yeast infections or dozens of others
check the Symptoms Matrix to see whether you could have a food intolerance:
This article looks at sorbitol, one of the so-called polyols listed on
sugar-free packs and used frequently as a softener and sweetener in
confectionery.
* Why do manufacturers in 2003 continue to market products that
contain sorbitol at levels known to cause Irritable Bowel Syndrome?
* Sugar-free products are the darlings of retailers. The tiny packs
take up little space at the point of sale. Now enjoying
double-digit sales growth, they deliver profit margins which far
outstrip chocolate bars or sugar candy (1).
Sorbitol is a natural laxative and occurs in pears, prunes and other
fruits. In fact sorbitol solution is sold as a laxative through
pharmacies (Sorbilax - Pharmacia & Upjohn).
Link to Irritable Bowel Syndrome
Sorbitol is also thought to be a cause of Irritable Bowel Syndrome (2).
Most sugar-free products carry warnings like: Excess consumption can
have a laxative effect.However, the packs are so small that reading them
is difficult, and more importantly the term excess usage is not
explained or quantified. Is one pack an excess?
* Dateline June 1995: The Lancet publishes the case of a 35 year-old
Flight Attendant diagnosed with Irritable Bowel Syndrome. She is
admitted to a British Hospital and undergoes a series of gruelling
tests: 14 procedures including blood tests, biopsies, liver
biochemistry, gastroscopy, endoscopy and periods of supervised
fasting. It eventually it turns out the cause of her diarrhea (up
to ten watery motions per day) is the result of habitual use of
sugar-free chewing gum containing sorbitol (3).
This is despite clinical results published twelve years earlier
(Gastroenterology January 1983) from the Hartford Hospital and
University of Connecticut warning that sorbitol causes
gastro-intestinal distress in amounts as little as 10g per day (4).
* Dateline June 2003: Popular sugar-free fruit pastilles, mints and
chewing gum contain sorbitol in rather large amounts (42% - 50%)
(5,6). This means a single tiny 25g purse-pack of fruit pastilles
contains easily enough Sorbitol to cause gastro-intestinal
distress and diarrhea and Irritable Bowel Syndrome.
And with chewing gum there is even greater danger of sorbitol overdose.
The manufacturer of a gum marketed as a teeth whitener (6) encourages
consumers to use it many times in a day, presumably to glean as much of
the tooth brightening property as possible. Ironically this is claimed
by the manufacturer to be a healthy lifestyle activity.
There is no reference on the packaging or manufacturer's website to the
laxative properties of sorbitol.
* So what? you think. We don't swallow chewing gum.
* While gum is not swallowed many of its ingredients are readily
ingested and quickly make their way to the intestinal tract.
From Special Dietary to Mainstream
Sugar-free is big business. The last five years has seen a whole new
wave of low-joule, so-called tooth-friendly products marketed to
mainstream consumers.
Originally marketed only to the Diabetic population, products containing
sweeteners like aspartame, saccharin, sorbitol, xylitol, maltitol,
mannitol, acesulphame-K, cyclamates and sucralose are now included
routinely in Sugar-free jubes, mints, breath fresheners, chewing gum,
soft drinks, diet yoghurt, low-joule ice cream and sugar-substitute
baking ingredients. Problems arise when people use sugar-free chewing
gum or sweets as a habit.
The action of sorbitol is to linger in the gut because it is not
digested. Dosing ourselves daily means we are less able to clear
sorbitol from our systems: each day it accrues to a greater and greater
concentration.
How Does It Cause Irritable Bowel Syndrome?
Firstly, undigested sorbitol in the small intestine acts as a substrate
(platform) for the fermentation of bacteria. Hydrogen gas is produced
causing abdominal cramps, bloating and severe flatulence. These are also
common symptoms of food intolerance,
Secondly, we already know sorbitol in quantities as low as 10g per day
causes diarrhea - brought on by the so-called osmotic purge happening in
the gut.
Sorbitol is a polyalcohol sugar and is neither digested nor absorbed by
the small intestine. It passes through to the colon where it drives an
osmotic purge (2). This means it passes through the lining of the
intestine causing fluids (mostly water) to pass through in the opposite
direction via osmosis. Bowel motions become watery and lead to
dehydration and over time, other consequences like malabsorption of
nutrients.
Here at foodintol we are not concerned about the use of artificial
sweeteners per se, just the dosages or amounts available in everyday
food products. When this is coupled with the manufacturer's
encouragement to use them frequently and make it a habit we believe
there is a real health danger for consumers.
We feel there is room for manufacturers to take more responsibility in
relation to sorbitol, especially in the light of increased understanding
from long term clinical research.
Meanwhile for the consumer, awareness is our only real defence. For
those who believe they may have Irritable Bowel Syndrome it may be wise
to take a personal inventory of the sugar-free foods they are eating to
first rule them out as a cause.
References
* 1.http://www.accaq.org.au/library/lamar.htm
* 2. Lancet 1996; 348: 1488
* 3.Gastroenterology 1983; 84: 30
Adi Gunawan wrote:
>Dear All,
>
>Ada produk pemanis dgn menggunakan sorbitol, apakah zat tsb jg aman untuk
>dikonsumsi jangka pendek/panjang? Mengingat dlm mail2 sebelumnya dpt
>disimpulkan Aspartame tidak baik u/ kesehatan. Thanks.
>
>Regards,
>
>Adi Gunawan
>
>
>
--
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