DOSE-RELATED GASTROINTESTINAL RESPONSE TO THE INGESTION OF EITHER ISOMALT, LACTITOL OR MALTITOL IN MILK CHOCOLATE

Objectives: To determine whether there were differences between differ ent polyols (sugar alcohols) in terms of their ability to stimulate in tolerance symptoms when consumed in milk chocolate. Also to discover w hether symptomatology can be related to the dose of polyol ingested. D esign: The study was of a randomised, double-blind cross-over design. Subjects: 59 healthy volunteers aged 18-24 years were recruited from t he student population of the University of Salford. All subjects succe ssfully completed the trial. Interventions: Subjects ingested 100g mil k chocolate containing 40g bulk sweetener as either sucrose, isomalt, lactitol or maltitol or a mixture (10:30w/w) of sucrose and isomalt, s ucrose and lactitol or sucrose and maltitol. Each bar was taken as bre akfast on one day with following products consumed at 1-week intervals . Subjects reported the incidence and severity of the symptoms of flat ulence, borborygms, colic, motion frequency and loose stools. Results: The ingestion of 30g or 40g lactitol resulted in a significant increa se in the incidence and severity of all symptoms examined compared to reactions after the consumption of standard sucrose-containing chocola te (P < 0.01). Similarly, 40g isomalt led to an increased incidence of all symptoms, including mild laxation (P < 0.01), but unlike lactitol none was rated as being severe. A reduction in isomalt to 30g was mar ked by increased tolerance with evidence of only mild borborygms (P < 0.01), mild flatulence, colic and laxation (P < 0.05), with no increas e in motion frequency (P = 0.35). Ingestion of 40g maltitol caused les s intolerance than 40g isomalt, with evidence of only flatulence, borb orygms and colic (P < 0.01), symptoms being rated as only mild. A redu ction to 30g led to a decrease in all symptoms except mild flatulence. Maltitol did not have any laxative effect when ingested at either 30g (P = 0.32) or 40g (P = 0.13) per day. Conclusions: This work has show n that there are significant differences in the reporting of gastroint estinal symptomatology following the consumption of isomalt, lactitol and maltitol incorporated into milk chocolate. However, with all three polyols the incidence and severity of symptomatology was dose depende nt.