[Clinical tolerance, intestinal absorption, and energy value of four sugar alcohols taken on an empty stomach]

Abstract

Sugar alcohols are incompletely digested in the human small intestine. The residual amounts reaching the colon are digested by colonic bacteria or excreted in stools. Clinical tolerance and energy value of sugar alcohols are related to their respective rates of digestion in the small intestine and the colon. Six healthy volunteers were tested in 5 periods during which they ingested 10 g lactulose, and then, in a random order, an iso-osmotic solution of 20 g isomalt, sorbitol, maltitol, and lactitol. The fraction of sugar alcohols absorbed in the small intestine was evaluated by comparing the amounts of hydrogen excreted in breath for 8 h after the ingestion of lactulose and of sugar alcohols. Energy value of sugar alcohols was determined knowing the amounts absorbed in the small intestine and digested in the colon. Tolerance to the sugar alcohols was good in all volunteers, and not different between sugar alcohols. The mean percentage of malabsorption in the small intestine was significantly higher for lactitol (84 +/- 14 percent, m +/- SEM) than for maltitol and isomalt (44 +/- 7 and 40 +/- 7 percent), its energy value (2.3 +/- 0.3 kcal/g) was significantly lower than the energy value of maltitol (3.1 +/- 0.1 kcal/g, P less than 0.05); whereas those of sorbitol and isomalt were close (2.7 +/- 0.2 and 2.8 +/- 0.1 kcal/g, respectively). In spite of these differences, our results suggest that in our experimental conditions, bacterial digestion of the sugar alcohols reaching the colon was complete, and did not affect their clinical tolerance.