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The comparative gastrointestinal response of young children to the ingestion of 25 g sweets containing sucrose or isomalt

Published online by Cambridge University Press:  09 March 2007

David M. Storey ,
Adam Lee  and
Albert Zumbé
David M. Storey*
Affiliation:
Bioscience Research Institute, The University of Salford, Greater Manchester M5 4WT, UK
Adam Lee
Affiliation:
Bioscience Research Institute, The University of Salford, Greater Manchester M5 4WT, UK
Albert Zumbé
Affiliation:
Bioscience Research Institute, The University of Salford, Greater Manchester M5 4WT, UK
*
*Corresponding author: Professor David M. Storey, fax +44 161 295 5210, email [email protected]
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Abstract

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Sugar-free confectionery products containing the low-energy, non-cariogenic sweetener isomalt are widely available in the market place and increasingly aimed at children. However, over-consumption of such products may lead to gastrointestinal symptoms and/or osmotic diarrhoea. Little is known about the gastrointestinal tolerance of children following consumption of isomalt. The aim of the present study was to assess gastrointestinal symptoms in children following consumption of sugar-free confectionery containing isomalt compared with sweets containing sucrose. In a double-blind, randomised, controlled, crossover study, sixty-seven children aged 6–9 years ingested 25 g hard-boiled sweets containing either sucrose or isomalt on two consecutive test days. Isomalt sweets were received as enthusiastically as sucrose sweets and, when given the choice, 97 % of children asked to be given the isomalt or the sucrose sweets on the second test day. Most children did not report multiple symptoms and few experienced symptoms on both days of isomalt consumption. However, significantly more children reported stomach-ache (P<0·01), abdominal rumbling (P<0·025) and passing watery faeces (P<0·001) following consumption of isomalt sweets compared with sucrose sweets. Consumption of 25 g isomalt-containing sweets by children is not associated with significant gastrointestinal effects graded as ‘considerably more than usual’ or multiple symptoms, but is associated with a laxative effect and increase in symptoms graded as ‘slightly more than usual’. For the majority of children in the present study, 25 g isomalt-containing sweets represents an acceptable level of consumption, although some children are sensitive to the effects of isomalt ingestion.

Keywords

Gastrointestinal responseIsomaltSucroseSweetsChildren
Type
Research Article
Information
British Journal of Nutrition , Volume 87 , Issue 4 , April 2002 , pp. 291 - 297
Copyright
Copyright © The Nutrition Society 2002

References

Adamson, AJ (1994) Sugar eating habits of adults and children. In Sugarless – Towards the Year 2000, pp. 28–42 [Rugg-Gunn, AJ, editor]. Cambridge: Royal Society of Chemistry.Google Scholar
Bachmann, W, Haslbeck, M, Spengler, M, Schmitz, H & Mehnert, H (1984) Untersuchchungen zur stoffwechselbeeinflussung durch akute pallatinitgaben (Studies on influencing metabolism via acute doses of palatinit. Comparison with fructose and saccharose in type-II diabetes). Aktuelle Ernährungsmedizin 9, 65–70.Google Scholar
Billaux, MS, Flourié, B, Jacquemin, C & Messing, B (1991) Sugar alcohols. In Handbook of Sweeteners, pp. 72–103 [Marie, S and Liggot, JR, editors]. Glasgow and London: Blackie.CrossRefGoogle Scholar
Bloom, DA, Seeley, WW, Ritchey, ML & McGuire, EJ (1993) Toilet habits and continence in children – An opportunity sampling in search of normal parameters. Journal of Urology 149, 1087–1090.CrossRefGoogle ScholarPubMed
Cummings, JH, Lee, A & Storey, D (2001) Workshop: physiology and tolerance of LDCs. British Journal of Nutrition 85, S59–S60.CrossRefGoogle ScholarPubMed
Department of Health (1989) Dietary Sugars and Human Health. Reports on Health and Social Subjects no. 37. London: H.M. Stationery Office.Google Scholar
Featherstone, JDB (1994) Effects of isomalt sweetener on the caries process: A review. Journal of Clinical Dentistry 3, 82–85.Google Scholar
Fritz, M & Siebert, G (1985) Dose dependence of breath hydrogen and methane in healthy volunteers after ingestion of a commercial disaccharide mixture, palatinit. British Journal of Nutrition 54, 384–400.CrossRefGoogle ScholarPubMed
Gart, JJ (1969) An exact test for comparing matched proportions in cross-over designs. Biometrica 56, 75–80.CrossRefGoogle Scholar
Grupp, U & Siebert, G (1978) Metabolism of hydrogenated palatinose, an equimolar mixture of α-D-glucopyranosido-1-6-sorbitol and α-D-glucopyranosido-1-6-mannitol. Experimental Medicine (Berlin) 173, 261–278.CrossRefGoogle Scholar
Hammer, HF, Santa Ana, CA, Schiller, LR & Fordtran, JS (1989) Studies of osmotic diarrhoea induced in normal subjects by ingestion of polyethylene glycol and lactulose. Journal of Clinical Investigation 84, 1056–1062.CrossRefGoogle ScholarPubMed
Imfeld, TN (1983) Non-nutritive sweeteners, sugar substitutes and confectionery products. In Identification of Low Caries Risk Dietary Components. Monographs in Oral Science, vol. 11, pp. 117–141 [Myers, HM, editor]. London: Karger.Google Scholar
Imfeld, TN (1993) Efficacy of sweeteners and sugar substitutes in caries prevention. Caries Research 3, 50–55.CrossRefGoogle Scholar
Koutsou, GA, Storey, DM, Lee, A, Zumbé, A, Flourié, B, Le Bot, Y & Olivier, Ph (1996) Dose-related gastrointestinal response to the ingestion of either isomalt, lactitol or maltitol in milk chocolate. European Journal of Clinical Nutrition 50, 17–21.Google ScholarPubMed
Langkilde, AM, Anderson, H, Schweizer, TF & Würsch, P (1994) Digestion and absorption of sorbitol, maltitol and isomalt from the small bowel. A study in ileostomy subjects. European Journal of Clinical Nutrition 48, 768–775.Google ScholarPubMed
Lee, A & Storey, DM (1999) Comparative gastrointestinal tolerance of sucrose, lactitol, or D-tagatose in chocolate. Regulatory Toxicology and Pharmacology 29, S78–S82.CrossRefGoogle ScholarPubMed
Lee, A, Storey, DM & Zumbé, A (1994) Breath hydrogen after ingestion of the bulk sweeteners sorbitol, isomalt and sucrose in chocolate. British Journal of Nutrition 71, 731–737.CrossRefGoogle ScholarPubMed
Livesey, G (2001) Tolerance of low-digestible carbohydrates: a general view. British Journal of Nutrition 85, S7–S16.CrossRefGoogle ScholarPubMed
Marteau, P & Flourié, B (2001) Tolerance to low-digestible carbohydrates: symptomatology and methods. British Journal of Nutrition 85, S17–S21.CrossRefGoogle ScholarPubMed
Menzies, IS (1983) Medical importance of sugars in the alimentary tract. In Developments in Sweeteners – 2, pp. 89–117 [Grenby, TH, Parker, KJ and Lindley, MG, editors]. London & New York: Applied Science Publishers.Google Scholar
Nilsson, U & Jagerstad, M (1987) Hydrolysis of lactitol, maltitol, and palatinit by human intestinal biopsies. British Journal of Nutrition 58, 199–206.CrossRefGoogle ScholarPubMed
Osatakul, S, Yossuk, P & Mosuwan, L (1995) Bowel habits of normal Thai children. Journal of Pediatric Gastroenterology and Nutrition 20, 339–342.Google ScholarPubMed
Paige, DM, Bayless, TM & Davis, LR (1992) Palatinit digestibility in children. Nutrition Research 12, 27–37.CrossRefGoogle Scholar
Rambaud, JC & Flourié, B (1994) Mechanism of carbohydrate induced diarrhoea. In Short Chain Fatty Acids, pp. 232–239 [Binder, HJ, Cummings, JH and Soergel, K, editors]. Kluwer: Academic Publishers.Google Scholar
Rugg-Gunn, AJ, Adamson, AJ, Appleton, DR, Butler, TJ & Hackett, AF (1993) Sugar consumption by 379 11–12 year old english children in 1990 compared with results in 1980. Journal of Human Nutrition and Dietetics 6, 419–431.CrossRefGoogle Scholar
Saunders, DR & Wiggins, HS (1981) Conservation of mannitol, lactulose and raffinose by the human colon. American Journal of Physiology 241, G397–G402.Google ScholarPubMed
Sicard, PJ & Le Bot, Y (1994) Manufacturing opportunities with non-sugar sweeteners. In Sugarless – Towards the Year 2000, pp. 112–135 [Rugg-Gunn, AJ, editor]. Cambridge: Royal Society of Chemistry.Google Scholar
Spengler, M, Somoygi, JC, Pletcher, E & Boehme, K (1987) Tolerability, acceptance and energetic conversion of isomalt (Palatinit) in comparison with sucrose. Aktuelle Ernährungsmedizin 12, 210–214.Google Scholar
Stewart, D (2001) Workshop: consumption and consumer perceptions. British Journal of Nutrition 85, S61–S62.CrossRefGoogle ScholarPubMed
Storey, D & Lee, A (2001) Foreword: Symposium on low digestible carbohydrates. British Journal of Nutrition 85, S1–S3.CrossRefGoogle Scholar
Storey, DM & Zumbé, A (1995) Physiology, metabolism and tolerance of digestible and low-digestible carbohydrate. In Starch Hydrolysis Products and their Derivatives, pp. 178–229 [Kearsley, M and Dziedzic, S, editors]. Glasgow: Blackie Academic & Professional Publishers.CrossRefGoogle Scholar
Vitolo, MR, Aguirre, AND, Fagundes Neto, U & de Morais, M (1998) Estimated dietary fiber intake by children according to different food composition reference tables. Archivos Latinoamericanos de Nutricion 48, 141–145.Google ScholarPubMed
Zumbé, A & Brinkworth, R (1992) Comparative studies of gastrointestinal tolerance and acceptability of milk chocolate containing either sucrose, isomalt or sorbitol in healthy consumers and type II diabetics. Zeitschrift für Ernährungswissenschaft 31, 40–48.CrossRefGoogle ScholarPubMed
Zumbé, A, Lee, A & Storey, D (2001) Polyols in confectionery: the route to sugar-free, reduced sugar and reduced calorie confectionery. British Journal of Nutrition 85, S31–S45.CrossRefGoogle ScholarPubMed
Zumbé, A, Lee, A & Storey, DM (1994) Manufacture and marketing of non-sugar chocolate. In Sugarless – Towards the Year 2000, pp. 47–71 [Rugg-Gunn, AJ, editor]. Cambridge: Royal Society of Chemistry.Google Scholar