Advertisement

Sorbitol is a Possible Risk Factor for Diarrhea in Young Children

      Sorbitol occurs naturally in fruits (
      • Wrolstad R.E.
      • Shallenberger R.S.
      Free sugars and sorbitol in fruits—a compilation from the literature.
      ) and is manufactured for purposes that include the sweetening of dietetic foods (
      Position of The American Dietetic Association use of nutritive and nonnutritive sweeteners.
      ). Although its energy value continues to be the subject of research (
      • Ellwood K.G.
      Methods available to estimate the energy values of sugar alcohols.
      ,
      • Langkilde A.M.
      • Andersson H.
      • Schweizer T.F.
      • Wursch P.
      Digestion and absorption of sorbitol, maltitol and isomalt from the small bowel a study in ileostomy subjects.
      ), sorbitol is an ingredient found in many sugar-free gums, sugar-free breath mints, and dietetic candies. Sorbitol is commonly consumed but apparently not widely recognized; for example, one study showed that 54% of college students had never heard of sorbitol (
      • Oberrieder H.K.
      • Fryer E.B.
      College students’ knowledge and consumption of sorbitol.
      ).
      To read this article in full you will need to make a payment

      Subscribe:

      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Wrolstad R.E.
        • Shallenberger R.S.
        Free sugars and sorbitol in fruits—a compilation from the literature.
        J Assoc Off Anal Chem. 1981; 64: 91-103
      1. Position of The American Dietetic Association.
        J Am Diet Assoc. 1993; 93: 816-821
        • Ellwood K.G.
        Methods available to estimate the energy values of sugar alcohols.
        Am J Clin Nutr. 1995; 62: 1169S-1174S
        • Langkilde A.M.
        • Andersson H.
        • Schweizer T.F.
        • Wursch P.
        Digestion and absorption of sorbitol, maltitol and isomalt from the small bowel.
        Eur J Clin Nutr. 1994; 48: 768-775
        • Oberrieder H.K.
        • Fryer E.B.
        College students’ knowledge and consumption of sorbitol.
        J Am Diet Assoc. 1991; 91: 715-717
        • Johnston K.R.
        • Govel L.A.
        • Andritz M.H.
        Gastrointestinal effects of sorbitol as an additive in liquid medications.
        Am J Med. 1994; 97: 185-191
        • Lipin R.
        Outbreak of diarrhea linked to dietetic candies—New Hampshire.
        MMWR. 1984; 33: 494-495
        • Gryboski J.D.
        Diarrhea from dietetic candies.
        N Engl J Med. 1966; 275: 718
        • Hyams J.S.
        Chronic abdominal pain caused by sorbitol malabsorption.
        J Pediatr. 1982; 100: 772-773
        • Hyams J.S.
        Sorbitol intolerance.
        Gastroenterology. 1983; 84: 30-33
        • Jain N.K.
        • Patel V.P.
        • Pitchumoni C.S.
        Sorbitol intolerance in adults—prevalence and pathogenesis on two contents.
        J Clin Gastro-enterol. 1987; 9: 317-319
        • Ravry M.J.R.
        Dietetic food diarrhea.
        JAMA. 1980; 244: 270
        • Goldberg L.D.
        • Ditcheck N.T.
        Chewing gum diarrhea.
        Dig Dis. 1978; 23: 568
        • Badiga M.S.
        • Jain N.K.
        • Casanova C.
        • Pitchumoni C.S.
        Diarrhea in diabetics.
        J Am Coll Nutr. 1990; 9: 578-582
        • Born P.
        • Zech J.
        • Stark M.
        • Classen M.
        • Lorenz R.
        Carbohydrate substitutes.
        Med Klin. 1994; 89: 575-578
        • Reele S.B.
        • Chocos D.J.
        Sorbitol induced diarrheal illness model.
        Int J Clin Pharmacol Ther Toxicol. 1985; 23: 403-405
        • Hill R.E.
        • Kamath K.R.
        Pink diarrhoea.
        Med JAust. 1982; 1: 387-389
        • Charney E.B.
        • Bodurtha J.N.
        Intractable diarrhea associated with the use of sorbitol.
        J Pediatr. 1981; 98: 157-158
        • Hill D.B.
        • Henderson L.M.
        • McClain C.J.
        Osmotic diarrhea induced by sugar-free theophylline solution in critically ill patients.
        JPEN. 1991; 15: 332-336
        • Edes T.
        • Walk B.
        • Austin J.
        Diarrhea in tube-fed patients.
        Am J Med. 1990; 88: 91
        • Smith M.M.
        • Davis M.
        • Chasalow F.I.
        • Lifshitz F.
        Carbohydrate absorption from fruit juice in young children.
        Pediatrics. 1995; 95: 340-344
        • Lederle F.A.
        • Busch D.L.
        • Mattox K.M.
        • West M.J.
        • Aske D.M.
        Cost-effective treatment of constipation in the elderly.
        Am J Med. 1990; 89: 597-601
      2. Permitted combinations of active laxative ingredients (21 CFR 334). Federal Register. September 2, 1993;58:46595.

        • Clydesdale F.M.
        • Kolasa K.M.
        • Ikeda J.P.
        All you want to know about fruit juice.
        Nutr Today. 1994; 29: 14-28
        • Rumessen J.J.
        Fructose and related food carbohydrates.
        Scand J Gastroenterol. 1992; 27: 819-828