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.

Low-digestible carbohydrates (LDCs) are incompletely or not absorbed in the small bowel and fermented in the colon. They are usually well tolerated but may also have some dose-related undesirable effects due to their natural osmotic potential and/or excessive fermentation: borborygmi, excessive flatus, bloating, abdominal cramps and eventually diarrhoea. There is an important intersubject variability in the tolerance to LDCs because of differences in absorption capacity, motility pattern, colonic response and intestinal sensitivity. There is also a great intrasubject variability, depending on the type of LDC, dosage and type of consumption. Absorption of LDC in the small intestine can be assessed using hydrogen breath test or intubation techniques or analysis of ileostomy effluents. Double-blind, placebo-controlled studies are required to assess the subjective symptoms of intolerance, and the experimental conditions may influence the results.

Low-digestible carbohydrates represent a class of enzyme-resistant saccharides that have specific effects on the human gastrointestinal tract. In the small bowel, they affect nutrient digestion and absorption, glucose and lipid metabolism and protect against known risk factors of cardiovascular disease. In the colon they are mainly degraded by anaerobic bacteria in a process called fermentation. As a consequence, faecal nitrogen excretion is enhanced, which is used clinically to prevent or treat hepatic encephalopathy. Low-digestible carbohydrates are trophic to the epithelia of the ileum and colon, which helps to avoid bacterial translocation. Short-chain fatty acids are important fermentation products and are evaluated as new therapeutics in acute colitis. They are considered in the primary prevention of colorectal cancer. The bifidogenic effect of fructo-oligosaccharides merits further attention. Unfermented carbohydrates increase faecal bulk and play a role in the treatment of chronic functional constipation, symptomatic diverticulosis and, possibly, the irritable bowel syndrome. In conclusion, low-digestible carbohydrates may play a role in the maintenance of human digestive health. However, the strength of evidence differs between disease entities.

Polyol-containing confectionery offers considerable advantages over traditional sucrose-based confectionery in terms of reduced energy content and reduced cariogenicity. However, over-consumption of polyol confectionery may lead to gastrointestinal symptoms in some individuals. Rather than consider this as a distinct disadvantage to the consumer, this article discusses how careful consideration of the physico-chemical properties of polyols and advances in product development and formulation can provide suitable polyol-based products for the consumer. Furthermore, food legislation and ingredient pricing issues are just some of the factors that must be taken into account when designing new polyol-containing products if their functional benefits and good product quality are to be delivered to the consumer.

Many LDCs currently on the market are not digested in the upper gastrointestinal tract and become fermented in the large intestine. They possess physiological benefits similar to those of dietary fibre. For some of these materials the fermentation process is highly specialised and leads to the selective stimulation and growth of beneficial gut bacteria, e.g. bifidobacteria. These materials are described as prebiotics, which are defined as nutrients fermented in the large bowel that favour the growth of desirable large bowel microflora. This activity has been demonstrated for inulin and oligofructose. Two other carbohydrates with low digestibility that offer desirable physiological properties are resistant starch (RS) and polydextrose (PD). These ‘functional’ benefits have led to considerable interest from the food industry leading to the use of these ingredients in the development of new ‘healthy’ products. This paper describes the use of these materials in the development of ‘healthy’ products, some of their functional properties, and the benefits they confer on different food systems.

Legislation is described that impacts on the use of low-digestible carbohydrates in foods. This includes controls on the use of these carbohydrates, mandatory labelling concerned with gastrointestinal effects, nutrition labelling, and nutrition and other claims. Regional differences in approach to legislation have led to inconsistencies in the information that must be provided to consumers, even for the same food products. Also, within regions, different regulations apply to food carbohydrates that may be classified similarly from the physiological perspective. Consistency of food labelling globally and in application to similar carbohydrates would benefit from greater attention to the underpinning science.