From the Guidelines
Long-term sorbitol consumption can have a laxative effect, particularly when consumed in excess of 50g per day.
Effects of Sorbitol Consumption
The evidence suggests that sorbitol, a sugar alcohol, can cause gastrointestinal side effects, including diarrhea, especially in children 1. The FDA has approved sorbitol as a food additive, but it is required to have a label warning that "excess consumption may have a laxative effect" if the daily ingestion exceeds 50g 1.
- Caloric content: Sorbitol contains 2.6 calories per gram, which is approximately half the calories of other sweeteners such as sucrose 1.
- Glycemic response: Sugar alcohols, including sorbitol, produce a lower postprandial glucose response than sucrose or glucose and have lower available energy 1.
- Dietary recommendations: The American Diabetes Association recommends subtracting half the total grams of sugar alcohols from the total carbohydrate content when calculating carbohydrate content of foods containing sugar alcohols 1.
Clinical Implications
While sorbitol can be a useful alternative to sugar for people with diabetes, excessive consumption should be avoided to prevent gastrointestinal side effects. Additionally, sorbitol may not be suitable for everyone, particularly children and individuals with certain medical conditions. A registered dietitian can help individuals with diabetes or other health conditions develop a personalized nutrition plan that takes into account their specific needs and health goals 1.
From the Research
Effects of Long-term Sorbitol Consumption
- Long-term consumption of sorbitol can alter the gut microbiome and induce glucose intolerance in mice, as shown by changes in the relative abundances of gut microbiome constituents 2.
- Sorbitol intolerance, manifested by abdominal pain, bloating, and diarrhea, has been observed in adults, with severe clinical sorbitol intolerance being more prevalent in nonwhites than in whites 3.
- Sorbitol has been found to have a low or no cariogenicity, making it a "low cariogenic" sugar substitute, although frequent consumption may result in an increased acid production in dental plaque and an increased number of sorbitol-fermenting microorganisms 4.
- Sorbitol has been shown to increase muscle glucose uptake ex vivo and inhibit intestinal glucose absorption ex vivo and in normal and type 2 diabetic rats, suggesting potential anti-hyperglycemic effects 5.
- The nutritional significance of sorbitol and other sugar alcohols has been documented, with sorbitol being fully absorbed at a single oral dose of 20 g or less, and having no adverse effects other than osmotic diarrhea, although chronic toxicity and long-term effects are not well understood 6.
Potential Health Implications
- Long-term sorbitol consumption may lead to changes in the gut microbiome, potentially inducing glucose intolerance and other metabolic disorders 2.
- Sorbitol intolerance may lead to nonspecific abdominal symptoms and diarrhea, potentially resulting in extensive diagnostic work-ups and misdiagnosis of irritable bowel syndrome 3.
- The use of sorbitol as a sugar substitute may have implications for dental health, with potential benefits in preventing dental caries, although more research is needed to fully understand its effects 4, 6.
- Sorbitol may have potential anti-hyperglycemic effects, although more research is needed to fully understand its mechanisms and effects in humans 5.