Threshold for Transitory Diarrhea Induced by Ingestion of Xylitol and Lactitol in Young Male and Female Adults

The ingestion of a sufficiently large amount of non-digestible and/or non-absorbable sugar substitutes causes overt diarrhea. The objective is to estimate the non-effective dosage that does not cause transitory diarrhea for xylitol, lactitol, and erythritol in healthy subjects. Twenty-seven males and 28 females gave informed and written consent to participate, were selected, and participated in the study. The oral dose levels of xylitol were 10, 20, 30, 40 and 50 g, while those of lactitol were 10, 20, 30, and 40 g. Those of erythritol were 20, 30, 40 and 50 g. The test substance was ingested in 150 mL of water 2-3 h after a meal. The ingestion order progressed from the smallest to larger amounts, and stopped at the dose that caused diarrhea, or at the largest dose level to be set up. The non-effective dose level of xylitol was 0.37 g/kg B.W. for males and 0.42 g/kg B.W. for females. That of lactitol was 0.25 g/kg B.W. for males and 0.34 g/kg B.W. for females, and that of erythritol was 0.46 g/kg B.W. for males and 0.68 g/kg B.W. for females. These results appear reasonable, because xylitol is poorly absorbed from the small intestine, and the absorption rate is less than that of erythritol, while lactitol is not hydrolyzed. Non-digestible and/or non-absorbable sugar alcohols and oligosaccharides with beneficial health effects inevitably cause overt diarrhea. The estimation of the non-effective dose level of these sugar substitutes is essential and important to produce processed foods that the consumer can use safely and with confidence.