Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and Other Health-Care Professionals

Sugar alcohols (polyols) are used in food manufacturing and in medical tests and examinations. d-Glucitol (sorbitol) and d-mannitol were previously the most common alditols used for these purposes. After the 1960s, xylitol became a common ingredient in noncariogenic confectioneries, oral hygiene pro...

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Main Author: Kauko K. Mäkinen
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:International Journal of Dentistry
Online Access:http://dx.doi.org/10.1155/2016/5967907
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author Kauko K. Mäkinen
author_facet Kauko K. Mäkinen
author_sort Kauko K. Mäkinen
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description Sugar alcohols (polyols) are used in food manufacturing and in medical tests and examinations. d-Glucitol (sorbitol) and d-mannitol were previously the most common alditols used for these purposes. After the 1960s, xylitol became a common ingredient in noncariogenic confectioneries, oral hygiene products, and diabetic food. Erythritol, a polyol of the tetritol type, can be regarded as the sweetener of the “next generation.” The disaccharide polyols maltitol, lactitol, and isomalt have also been used in food manufacturing and in medical tests. Consumption of pentitol- and hexitol-type polyols and disaccharide polyols may cause gastrointestinal disturbances at least in unaccustomed subjects. The occurrence of disturbances depends on consumer properties and on the molecular size and configuration of the polyol molecule. Adaptation may take place as a result of enzyme induction in the intestinal flora. Some of the literature on xylitol has been difficult to access by health-care professionals and will be reviewed here. Research and clinical field experience have found no pathology in polyol-associated osmotic diarrhea—the intestinal mucosa having normal basic structure, except in extreme instances. Xylitol is better tolerated than hexitols or the disaccharide polyols. Erythritol, owing to its smaller molecular weight and configuration that differ from other alditols, normally avoids the gastrointestinal reactions encountered with other polyols. This review will also touch upon the FODMAPs diet concept.
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spelling doaj-art-fdaeeb0e98c84d3eb17044898004a75d2025-02-03T05:46:21ZengWileyInternational Journal of Dentistry1687-87281687-87362016-01-01201610.1155/2016/59679075967907Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and Other Health-Care ProfessionalsKauko K. Mäkinen0Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520 Turku, FinlandSugar alcohols (polyols) are used in food manufacturing and in medical tests and examinations. d-Glucitol (sorbitol) and d-mannitol were previously the most common alditols used for these purposes. After the 1960s, xylitol became a common ingredient in noncariogenic confectioneries, oral hygiene products, and diabetic food. Erythritol, a polyol of the tetritol type, can be regarded as the sweetener of the “next generation.” The disaccharide polyols maltitol, lactitol, and isomalt have also been used in food manufacturing and in medical tests. Consumption of pentitol- and hexitol-type polyols and disaccharide polyols may cause gastrointestinal disturbances at least in unaccustomed subjects. The occurrence of disturbances depends on consumer properties and on the molecular size and configuration of the polyol molecule. Adaptation may take place as a result of enzyme induction in the intestinal flora. Some of the literature on xylitol has been difficult to access by health-care professionals and will be reviewed here. Research and clinical field experience have found no pathology in polyol-associated osmotic diarrhea—the intestinal mucosa having normal basic structure, except in extreme instances. Xylitol is better tolerated than hexitols or the disaccharide polyols. Erythritol, owing to its smaller molecular weight and configuration that differ from other alditols, normally avoids the gastrointestinal reactions encountered with other polyols. This review will also touch upon the FODMAPs diet concept.http://dx.doi.org/10.1155/2016/5967907
spellingShingle Kauko K. Mäkinen
Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and Other Health-Care Professionals
International Journal of Dentistry
title Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and Other Health-Care Professionals
title_full Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and Other Health-Care Professionals
title_fullStr Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and Other Health-Care Professionals
title_full_unstemmed Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and Other Health-Care Professionals
title_short Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and Other Health-Care Professionals
title_sort gastrointestinal disturbances associated with the consumption of sugar alcohols with special consideration of xylitol scientific review and instructions for dentists and other health care professionals
url http://dx.doi.org/10.1155/2016/5967907
work_keys_str_mv AT kaukokmakinen gastrointestinaldisturbancesassociatedwiththeconsumptionofsugaralcoholswithspecialconsiderationofxylitolscientificreviewandinstructionsfordentistsandotherhealthcareprofessionals