Dietary sorbitol and mannitol: food content and distinct absorption patterns between healthy individuals and patients with irritable bowel syndrome

BACKGROUND: Sorbitol and mannitol are naturally‐occurring polyol isomers. Although poor absorption and induction of gastrointestinal symptoms by sorbitol are known, the properties of mannitol are poorly described. We aimed to expand data on food composition of these polyols, and to compare their abs...

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Veröffentlicht in:Journal of human nutrition and dietetics 2014-04, Vol.27 (s2), p.263-275
Hauptverfasser: Yao, C. K, Tan, H.‐L, Langenberg, D. R, Barrett, J. S, Rose, R, Liels, K, Gibson, P. R, Muir, J. G
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container_end_page 275
container_issue s2
container_start_page 263
container_title Journal of human nutrition and dietetics
container_volume 27
creator Yao, C. K
Tan, H.‐L
Langenberg, D. R
Barrett, J. S
Rose, R
Liels, K
Gibson, P. R
Muir, J. G
description BACKGROUND: Sorbitol and mannitol are naturally‐occurring polyol isomers. Although poor absorption and induction of gastrointestinal symptoms by sorbitol are known, the properties of mannitol are poorly described. We aimed to expand data on food composition of these polyols, and to compare their absorptive capacities and symptom induction in patients with irritable bowel syndrome (IBS) and healthy individuals. METHODS: Food samples were analysed for sorbitol and mannitol content. The degree of absorption measured by breath hydrogen production and gastrointestinal symptoms (visual analogue scales) was evaluated in a randomised, double‐blinded, placebo‐controlled study in 21 healthy and 20 IBS subjects after challenges with 10 g of sorbitol, mannitol or glucose. RESULTS: Certain fruits and sugar‐free gum contained sorbitol, whereas mannitol content was higher in certain vegetables. Similar proportions of patients with IBS (40%) and healthy subjects (33%) completely absorbed sorbitol, although more so with IBS absorbed mannitol (80% versus 43%; P = 0.02). Breath hydrogen production was similar in both groups after lactulose but was reduced in patients with IBS after both polyols. No difference in mean (SEM) hydrogen production was found in healthy controls after sorbitol [area‐under‐the‐curve: 2766 (591) ppm 4 h–¹] or mannitol [2062 (468) ppm 4 h–¹] but, in patients with IBS, this was greater after sorbitol [1136 (204) ppm 4 h–¹] than mannitol [404 (154) ppm 4 h–¹; P = 0.002]. Overall gastrointestinal symptoms increased significantly after both polyols in patients with IBS only, although they were independent of malabsorption of either of the polyols. CONCLUSIONS: Increased and discordant absorption of mannitol and sorbitol occurs in patients with IBS compared to that in healthy controls. Polyols induced gastrointestinal symptoms in patients with IBS independently of their absorptive patterns, suggesting that the dietary restriction of polyols may be efficacious.
doi_str_mv 10.1111/jhn.12144
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K ; Tan, H.‐L ; Langenberg, D. R ; Barrett, J. S ; Rose, R ; Liels, K ; Gibson, P. R ; Muir, J. G</creator><creatorcontrib>Yao, C. K ; Tan, H.‐L ; Langenberg, D. R ; Barrett, J. S ; Rose, R ; Liels, K ; Gibson, P. R ; Muir, J. G</creatorcontrib><description>BACKGROUND: Sorbitol and mannitol are naturally‐occurring polyol isomers. Although poor absorption and induction of gastrointestinal symptoms by sorbitol are known, the properties of mannitol are poorly described. We aimed to expand data on food composition of these polyols, and to compare their absorptive capacities and symptom induction in patients with irritable bowel syndrome (IBS) and healthy individuals. METHODS: Food samples were analysed for sorbitol and mannitol content. The degree of absorption measured by breath hydrogen production and gastrointestinal symptoms (visual analogue scales) was evaluated in a randomised, double‐blinded, placebo‐controlled study in 21 healthy and 20 IBS subjects after challenges with 10 g of sorbitol, mannitol or glucose. RESULTS: Certain fruits and sugar‐free gum contained sorbitol, whereas mannitol content was higher in certain vegetables. Similar proportions of patients with IBS (40%) and healthy subjects (33%) completely absorbed sorbitol, although more so with IBS absorbed mannitol (80% versus 43%; P = 0.02). Breath hydrogen production was similar in both groups after lactulose but was reduced in patients with IBS after both polyols. No difference in mean (SEM) hydrogen production was found in healthy controls after sorbitol [area‐under‐the‐curve: 2766 (591) ppm 4 h–¹] or mannitol [2062 (468) ppm 4 h–¹] but, in patients with IBS, this was greater after sorbitol [1136 (204) ppm 4 h–¹] than mannitol [404 (154) ppm 4 h–¹; P = 0.002]. Overall gastrointestinal symptoms increased significantly after both polyols in patients with IBS only, although they were independent of malabsorption of either of the polyols. CONCLUSIONS: Increased and discordant absorption of mannitol and sorbitol occurs in patients with IBS compared to that in healthy controls. Polyols induced gastrointestinal symptoms in patients with IBS independently of their absorptive patterns, suggesting that the dietary restriction of polyols may be efficacious.</description><identifier>ISSN: 0952-3871</identifier><identifier>EISSN: 1365-277X</identifier><identifier>DOI: 10.1111/jhn.12144</identifier><identifier>PMID: 23909813</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>absorption ; Adult ; Breath Tests ; Cross-Over Studies ; Diet ; dietary restriction ; Double-Blind Method ; Female ; foods ; Fruit - chemistry ; fruits ; glucose ; Glucose - administration &amp; dosage ; Glucose - pharmacokinetics ; Healthy Volunteers ; Humans ; hydrogen breath tests ; hydrogen production ; intestinal absorption ; Intestine, Small - drug effects ; Intestine, Small - physiopathology ; Irritable bowel syndrome ; Irritable Bowel Syndrome - metabolism ; isomers ; malabsorption ; Male ; mannitol ; Mannitol - administration &amp; dosage ; Mannitol - pharmacokinetics ; Middle Aged ; nutrient databanks ; Nutrition research ; patients ; polyols ; sorbitol ; Sorbitol - administration &amp; dosage ; Sorbitol - pharmacokinetics ; sorbitol malabsorption ; vegetables ; Vegetables - chemistry ; Young Adult</subject><ispartof>Journal of human nutrition and dietetics, 2014-04, Vol.27 (s2), p.263-275</ispartof><rights>2013 The British Dietetic Association Ltd.</rights><rights>Journal of Human Nutrition and Dietetics © 2014 The British Dietetic Association Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4154-f05d142ff0526faabdd83c3e366cba6cd68e9a715b70776bfbb431cd0705ffa03</citedby><cites>FETCH-LOGICAL-c4154-f05d142ff0526faabdd83c3e366cba6cd68e9a715b70776bfbb431cd0705ffa03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjhn.12144$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjhn.12144$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23909813$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yao, C. K</creatorcontrib><creatorcontrib>Tan, H.‐L</creatorcontrib><creatorcontrib>Langenberg, D. R</creatorcontrib><creatorcontrib>Barrett, J. S</creatorcontrib><creatorcontrib>Rose, R</creatorcontrib><creatorcontrib>Liels, K</creatorcontrib><creatorcontrib>Gibson, P. R</creatorcontrib><creatorcontrib>Muir, J. G</creatorcontrib><title>Dietary sorbitol and mannitol: food content and distinct absorption patterns between healthy individuals and patients with irritable bowel syndrome</title><title>Journal of human nutrition and dietetics</title><addtitle>J Hum Nutr Diet</addtitle><description>BACKGROUND: Sorbitol and mannitol are naturally‐occurring polyol isomers. Although poor absorption and induction of gastrointestinal symptoms by sorbitol are known, the properties of mannitol are poorly described. We aimed to expand data on food composition of these polyols, and to compare their absorptive capacities and symptom induction in patients with irritable bowel syndrome (IBS) and healthy individuals. METHODS: Food samples were analysed for sorbitol and mannitol content. The degree of absorption measured by breath hydrogen production and gastrointestinal symptoms (visual analogue scales) was evaluated in a randomised, double‐blinded, placebo‐controlled study in 21 healthy and 20 IBS subjects after challenges with 10 g of sorbitol, mannitol or glucose. RESULTS: Certain fruits and sugar‐free gum contained sorbitol, whereas mannitol content was higher in certain vegetables. Similar proportions of patients with IBS (40%) and healthy subjects (33%) completely absorbed sorbitol, although more so with IBS absorbed mannitol (80% versus 43%; P = 0.02). Breath hydrogen production was similar in both groups after lactulose but was reduced in patients with IBS after both polyols. No difference in mean (SEM) hydrogen production was found in healthy controls after sorbitol [area‐under‐the‐curve: 2766 (591) ppm 4 h–¹] or mannitol [2062 (468) ppm 4 h–¹] but, in patients with IBS, this was greater after sorbitol [1136 (204) ppm 4 h–¹] than mannitol [404 (154) ppm 4 h–¹; P = 0.002]. Overall gastrointestinal symptoms increased significantly after both polyols in patients with IBS only, although they were independent of malabsorption of either of the polyols. CONCLUSIONS: Increased and discordant absorption of mannitol and sorbitol occurs in patients with IBS compared to that in healthy controls. 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We aimed to expand data on food composition of these polyols, and to compare their absorptive capacities and symptom induction in patients with irritable bowel syndrome (IBS) and healthy individuals. METHODS: Food samples were analysed for sorbitol and mannitol content. The degree of absorption measured by breath hydrogen production and gastrointestinal symptoms (visual analogue scales) was evaluated in a randomised, double‐blinded, placebo‐controlled study in 21 healthy and 20 IBS subjects after challenges with 10 g of sorbitol, mannitol or glucose. RESULTS: Certain fruits and sugar‐free gum contained sorbitol, whereas mannitol content was higher in certain vegetables. Similar proportions of patients with IBS (40%) and healthy subjects (33%) completely absorbed sorbitol, although more so with IBS absorbed mannitol (80% versus 43%; P = 0.02). Breath hydrogen production was similar in both groups after lactulose but was reduced in patients with IBS after both polyols. No difference in mean (SEM) hydrogen production was found in healthy controls after sorbitol [area‐under‐the‐curve: 2766 (591) ppm 4 h–¹] or mannitol [2062 (468) ppm 4 h–¹] but, in patients with IBS, this was greater after sorbitol [1136 (204) ppm 4 h–¹] than mannitol [404 (154) ppm 4 h–¹; P = 0.002]. Overall gastrointestinal symptoms increased significantly after both polyols in patients with IBS only, although they were independent of malabsorption of either of the polyols. CONCLUSIONS: Increased and discordant absorption of mannitol and sorbitol occurs in patients with IBS compared to that in healthy controls. Polyols induced gastrointestinal symptoms in patients with IBS independently of their absorptive patterns, suggesting that the dietary restriction of polyols may be efficacious.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>23909813</pmid><doi>10.1111/jhn.12144</doi><tpages>13</tpages></addata></record>
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ispartof Journal of human nutrition and dietetics, 2014-04, Vol.27 (s2), p.263-275
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subjects absorption
Adult
Breath Tests
Cross-Over Studies
Diet
dietary restriction
Double-Blind Method
Female
foods
Fruit - chemistry
fruits
glucose
Glucose - administration & dosage
Glucose - pharmacokinetics
Healthy Volunteers
Humans
hydrogen breath tests
hydrogen production
intestinal absorption
Intestine, Small - drug effects
Intestine, Small - physiopathology
Irritable bowel syndrome
Irritable Bowel Syndrome - metabolism
isomers
malabsorption
Male
mannitol
Mannitol - administration & dosage
Mannitol - pharmacokinetics
Middle Aged
nutrient databanks
Nutrition research
patients
polyols
sorbitol
Sorbitol - administration & dosage
Sorbitol - pharmacokinetics
sorbitol malabsorption
vegetables
Vegetables - chemistry
Young Adult
title Dietary sorbitol and mannitol: food content and distinct absorption patterns between healthy individuals and patients with irritable bowel syndrome
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