Not all of the sugar alcohols are created equal when it comes to digestive health. I have already covered the pros and cons of supplementing with xylitol. While xylitol has its uses, sorbitol, on the other hand, should be filed under the avoid area of the sugar alcohol spectrum.
Why is sorbitol so evil if you have intestinal issues or diabetes?
Most sorbitol is synthetically produced and can even be found naturally in some foods that we eat. Ever wonder why you were told to drink prune juice when you were constipated? Prune juice contains high amounts of sorbitol and fiber which would cause loose stools. Sorbitol is also found in peaches, apricots, apples, pears, and dates in differing amounts. 1
Sorbitol in large enough doses is an osmotic laxative. Not all osmotic laxatives are as bad for you as sorbitol, and some like magnesium, vitamin C, and salt in the right doses can help regulate the bowels. Unlike the other listed osmotic laxatives, sorbitol also feeds bacteria in the colon, worse than xylitol. Anyone with SIBO or IBS should avoid sorbitol at all costs. Medical studies and reports done on sorbitol seem to show that it causes worse side effects compared to other sugar alcohols. These side effects can occur at doses as low as ten grams and include severe abdominal pains and cramps, diarrhea, or excessive gas. 2 3
The ingestion of sorbitol from sugar free food products and reported amounts of gastrointestinal issues are very prevalent. The Center of Science and Public Interest, has been trying since 1999 to get the FDA to require corporations to list a warning on foods containing sorbitol that it can cause gastrointestinal issues. 4
Sorbitol does have a limited anti-biofilm effect for certain bacteria, but its gastrointestinal issues associated with its use make xylitol a better option. Interestingly, the deadly E. coli O157:H7 appears to not be able to ferment sorbitol, and it might be useful to use it to break down its biofilm with caution. 5
Sorbitol ironically should be avoided with people that have diabetes because of possible retinopathy and neuropathy. Excessive osmotic stress has been theorized in people with diabetes who would consume nonnatural amounts of sorbitol in food. The increase in osmotic stress is implicated in worsening diabetic microvascular complications. The mechanism of action appears to be caused by excessive amounts of sorbitol accumulating in cells by overloading the aldose reductase pathway. 6
Limit the amounts of sorbitol you consume from natural foods and avoid a total of ten grams daily if you are healthy. If you have intestinal issues or diabetes, avoid sorbitol ingestion if all possible.
- http://www.food-intolerance-network.com/food-intolerances/sorbitol-intolerance-problem-dried-fruits/sorbitol-contents-in-food.html ↩
- http://www.ncbi.nlm.nih.gov/pubmed/2273191 ↩
- http://www.ncbi.nlm.nih.gov/pubmed/19765364 ↩
- http://www.cspinet.org/foodsafety/labeling_sorbitol.html ↩
- http://jcm.asm.org/content/18/3/512.long ↩
- http://clinical.diabetesjournals.org/content/26/2/77.full ↩