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Tolerance of low-digestible carbohydrates: a general view

  • Geoffrey Livesey (a1)

Abstract

The tolerance of low-digestible carbohydrates (LDCs) may be measured as the potential to cause abdominal symptoms and laxation. Tolerance of any one LDC is determined by its concentration in the food product eaten, the amount of the food product eaten, the frequency of eating the food and the consumption of other foods (increasing tolerance) and water (decreasing tolerance). Added to these, individuals vary considerably in their response to low-digestible carbohydrates in the reporting of gastrointestinal symptoms. A precise maximum no-response dose is sometimes difficult to obtain because some dose–response curves are distinctly sigmoidal. Food regulators hoping to set a trigger level at which laxation may occur have been unable to take account of all these factors because the necessary information matrices are not available for any one LDC. Nevertheless analysis of the data shows consistent trends and for circumstances when food is consumed throughout the day it now seems feasible to assign specific tolerances to specific low-digestible carbohydrates, especially the polyols for which most is known. The method by which the no-effect dose or laxative threshold is expressed is critical to its application to individual foods.

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Corresponding author

*Corresponding author: G. Livesey, fax +44 (0)1953 600218, email glivesey@inlogic.co.uk

References

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ANZFA, (1999) Review of the Provisions for Low-joule Foods and Carbohydrate Modified Foods. Canberra: Australia New Zealand Food Authority.
Bornet, FRJ, Blayo, A, Dauchy, F & Slama, G (1996) Gastrointestinal response and plasma and urine determinations in human subjects given erythritol. Regulatory Toxicology and Pharmacology 24, S296S302.
British Nutrition Foundation (1990) Complex Carbohydrates in Foods. The Report of the British Nutrition Foundation's Task Force on Complex Carbohydrates. London: Chapman and Hall.
Buemann, B, Toubro, S, Raben, A & Astrup, A (1999 a) Human tolerance to a single, high dose of tagatose. Regulatory Toxicology and Pharmacology 29, S66S70.
Buemann, B, Toubro, S & Astrup, A (1999 b) Human gastrointestinal tolerance to D-tagatose. Regulatory Toxicology and Pharmacology 29, S71S77.
Canada (1993) Amendment. Food and Drug Regulations SOR/93–276 26012808. Montreal: Health Canada.
Charney, EB & Bodurtha, JN (1981) Intractable diarrhoea associated with the use of sorbitol. Journal of Paediatrics 98, 157158.
Codex (1991) Codex standard for formula foods for use in weight control diets. Codex Standard 181.
Collins, MD & Gibson, GR (1999) Prebiotics, probiotics and synbiotics: approaches for modulating the microbial ecology of the gut. American Journal of Clinical Nutrition 69, S1052S1057.
CummingsJH, JH, (1993) Nutritional management of diseases of the stomach and bowel. In Human Nutrition and Dietetics, pp. 480506. [JS, Garrow & WPT, James, editors]. London: Churchill Livingstone.
Cummings, JH, Bingham, S, Heaton, KW & Eastwood, MA (1992) Faecal weight, colon cancer risk and dietary intake of non-starch polysacchrides (dietary fibre). Gastroenterology 103, 17831789.
Cummings, JH & MacFarlane, GT (1999) Probiotics and prebiotics: can regulate the activities of the intestinal bacteria, benefits health. British Medical Journal 318, 9991003.
Debongnie, JC & Phillips, SF (1978) Capacity of the human colon to absorb fluid. Gastroenterology 74, 698703.
Ellis, FW & Krantz, JC (1941) Sugar alcohols XXIV. The metabolism of sorbitol in diabetes. Annals of Internal Medicine 18, 792796.
European Council Directive (1990) Proposal for a council directive on sweeteners for use in foodstuffs. Official Journal of the European Community 4, (C242).
FDA (1998) Polydexrose. Code of Federal Regulations 21 Ch.184-85. Washington, DC: Food and Drug Administration.
Fritz, M, Siebert, G & Kasper, H (1985) Dose dependency of breath hydrogen and methane in healthy volunteers after ingestion of a commercial disaccharide mixture, Palatinit. British Journal of Nutrition 54, 389400.
Gavin, J, Ellis, T, Dewar, AL, Rolles, CJ & Connett, GT (1997) Dietary fibre and the occurrence of gut symptoms in cystic fibrosis. Archives of Digestive Diseases in Childhood 76, 3537.
Gryboski, JD (1966) Diarrhea from dietetic candy. New England Journal of Medicine 275, 718.
Hammer, HF, Santa Ana, CA, Schiller, LR & Fordtran, S (1989) Studies on osmotic diarrhea induced in normal subjects by ingestion of polyethylene glycol and lactulose. Journal of Clinical Investigation 84, 10561062.
Heredia, D, Terés, J, Orteu, N & Rodés, J (1988) Lactitol vs. lactulose in the treatment of chronic recurrent portal-systemic encephalopathy. Journal of Hepatology 7, 106110.
Hill, RE & Kamath, KR (1982) ‘Pink’ diarrhoea: osmotic diarrhoea from a sorbitol-containing vitamin C supplement. Medical Journal of Australia 1, 387389.
Hyams, JS (1982) Chronic abdominal pain caused by sorbitol malabsorption. Journal of Pediatrics 100, 772773.
Hyams, JS (1983) Sorbitol intolerance: an unappreciated cause of functional gastrointestinal complaint. Gastroenterology 84, 3033.
Jain, NK, Patel, VP & Pitchumoni, CS (1987) Sorbitol intolerance in adults: prevalence and pathogenesis on two continents. Journal of Clinical Gastroenterology 9, 317319.
JECFA (1987) Toxicological Evaluation of Certain Food Additives and Contaminants. Series number 20. Geneva: FAO/WHO.
Jenkins, DJA & Kendall, CWC (1998) Dietary fibre, the evolution of the human diet and coronary heart disease. Nutrition Research 18, 633652.
Jenkins, DJA, Wolever, TM, Taylor, RH, Barker, H, Fielden, H, Baldwin, JM, Bowling, AC, Newman, HC, Jenkins, AL & Goff, DV (1981) Glycemic index of foods: a physiological basis for carbohydrate exchange. American Journal of Clinical Nutrition 34, 362366.
Johansen, HN & Jensen, BB (1997) Recovery of energy as SCFA after microbial fermentation of D-tagatose. International Journal of Obesity 21 Suppl 1, S50.
Kandelman, D (1997) Sugar, alternative sweeteners and meal frequency is related to caries prevention: new perspectives. British Journal of Nutrition 77, S121S128.
Koizumi, N, Fujii, M, Ninomiya, R, Inoue, Y, Kagawa, T & Tsukamoto, T (1983) Studies on transitory laxative effects of sorbitol and maltitol I: Estimation of 50 % effective dose and maximum non-effective dose. Chemosphere 12, 4553.
Koutsou, GA, Storey, DM, Lee, A, Zumbé, A, Flourie, B, Le Bot, Y & Oliver, PH (1996) Dose related gastrointestinal response to the ingestion of either isomalt, lactation or maltitol in milk chocolate. European Journal of Clinical Nutrition 50, 1721.
Lederle, FA, Busch, DL, Mattox, KM, West, MJ & Aske, DM (1990) Cost-effective treatment of constipation in the elderly: a randomized double blind comparison of sorbitol and lactulose. American Journal of Medicine 89, 597601.
Lee, A & Storey, DM (1999) Comparative gastrointestinal tolerance of sucrose and lactitol, or D-tagatose in chocolate. Regulatory Toxicology and Pharmacology 29, S78S82.
Lee, A, Zumbé, A & Storey, D (1994) Breath hydrogen after ingestion of the bulk sweeteners sorbitol, isomalt and sucrose in chocolate. British Journal of Nutrition 74, 731737.
Livesey, G (1990) The impact of the concentration and dose of PalatinitR in foods and diets on energy value. Food Sciences and Nutrition 42F, 223243.
Livesey, G (1992) Energy values of dietary fibre and sugar alcohols for man. Nutrition Research Reviews 5, 6184.
Livesey, G, EliaM, M, (1996) Short chain fatty acids as an energy source in the colon: metabolism and clinical implications. In Physiological and Clinical Aspects of Short Chain Fatty Acids pp. 427481. [JH, Cummings, JL, Rombeau & T, Sakata, editors]. Cambridge: Cambridge University Press.
Livesey, G, Wilkinson, JA, Roe, MA, Faulks, RM, Clark, S, Brown, JC, Kennedy, H & Elia, M (1995) Influence of the physical form of barley grain on the digestion of its starch in the human small intestine and implications for health. American Journal of Clinical Nutrition 61, 7581.
Miller, JCB & Lobbezoo, I (1994) Replacement of starch with sucrose in a high glycaemic index breakfast cereal lowers glycaemic and insulin responses. European Journal of Clinical Nutrition 48, 749752.
Moynihan, PJ (1998) Update on the nomenclature of carbohydrates and their dental effects. Journal of Dentistry 26, 209218.
Murray, PR (1988) Polydextrose. In Low-Calorie Products. pp. 83100. London: Elsevier Applied Science.
Oku, T & Noda, K (1990) Erythritol balance study and estimation of the metabolizable energy of erythritol. In Caloric Evaluation of Carbohydrates, pp. 6575 [N, Hosoya, editor]. Tokyo: Research Foundation for Sugar Metabolism.
Oku, T & Okazaki, M (1996) Laxative threshold of sugar alcohol erythritol in human subjects. Nutrition Research 16, 577589.
Paige, DM, Baless, TH & Davis, LR (1992) Palatinit digestibility in children. Nutrition Research 12, 2737.
Passmore, R, Meiklejohn, AP, Dewar, AD & Throw, RK (1955) Energy utilization in overfed thin young men. British Journal of Nutrition 9, 2027.
Patil, DH, Grimble, GK & Silk, DAB (1987) Lactitol, a new hydrogenated lactose derivative: intestinal absorption and laxative threshold in normal human subjects. British Journal of Nutrition 57, 195199.
Payne, ML, Craig, WJ & Williams, AC (1997) Sorbitol is a possible risk factor for diarrrhea in young children. Journal of the American Dietetic Association 97, 532534.
Ravich, WJ, Bayless, TM & Thomas, M (1983) Fructose: incomplete intestinal absorption in humans. Gastroenterology 84, 2629.
Serra, J, Azpiroz, F & Malagelada, J-R (1998) Intestinal gas dynamics in humans. Gastroenterology 115, 542550.
Shaw, JS, Brooks, JL, Dickerson, JWT & Davies, GJ (1998) Dietary triggers in irritable bowel syndrome. Nutrition Research Reviews 11, 279309.
Spengler, M, Somogyi, JC, Pletcher, E & Boehme, K (1987) Tolerability, acceptance and energetic conversion of isomalt (Palatinit) in comparison with sucrose. Aktulle Ernährungsmedizin 12, 210214.
Storey, DM, Koutsou, G, Lee, A, Zumbé, A, Olivier, P, Le Bot, Y & Flourié, B (1998) Tolerance and breath hydrogen excretion following ingestion of maltitol incorporated at two levels into milk chocolate consumed by healthy young adults with and without fasting. Journal of Nutrition 128, 587592.
Thannhauser, SJ & Meyer, KH (1929) Sorbit (Sionin) als Kohlehydraterstz für den Diabeteskranken. Müchener Medizin Wochenschrift 76, 356366.
Thiébaud, D, Jacot, H, Schmitz, M, Spengler, M & Felber, JP (1984) Comparative study of isomalt and sucrose by means of continuous indirect calorimetry. Metabolism 33, 808812.
Tramonte, SM, Brand, MB, Mulrow, CD, Amato, MG, O'Keefe, ME & Ramirez, G (1997) The treatment of chronic constipation in adults – a systematic review. Journal of General Internal Medicine 12, 1524.
Van Es, AJH, De Groot, L & Vogt, JE (1986) Energy balance of eight volunteers fed on diets supplemented with either lactitol or saccharose. British Journal of Nutrition 56, 545560.
Zumbé, A & Brinkworth, RA (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, 4048.
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British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
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