Malabsorption of modified food starch (acetylated distarch phosphate) in normal infants and in 8-24-month-old toddlers with non-specific diarrhea, as influenced by sorbitol and fructose.
Acetylated distarch phosphate (ADiSP) is a modified starch used in some baby foods. The bioavailability of ADiSP and a native (unmodified) starch was evaluated in 20 normal infants and 21 toddlers aged 8-24 mo with chronic non-specific diarrhea. Formulae contained 8% native or 8% modified waxy maize starch. No infant or toddler consuming Formula N (native starch) had elevated peak breath hydrogen levels (20 ppm or greater), stools clinically positive for reducing substances (0.75% or greater) or loose stools. Fourteen infants received formula M (modified starch): 2 had elevated breath hydrogen, 1 had positive stools and another had loose stools. Of the 21 toddlers fed formula M, 2 had elevated breath hydrogen, but none had positive stools or loose stools. Formula NS (native starch with 2% sorbitol) had little effect on breath hydrogen in the infants but significantly increased it in the toddlers. Formula NS produced loose stools in 2 toddlers but no clinically positive stools in any infant or toddler. Formula MS (modified starch with 2% sorbitol) elevated breath hydrogen in 3 infants and 8 toddlers, and produced positive stools in 2 infants and 2 toddlers, and loose stools in 4 infants and 7 toddlers. Formula MSF (modified starch with 2% sorbitol and 5% fructose) elevated breath hydrogen in 7 infants and 10 toddlers, positive stools in 7 infants and 6 toddlers, and loose stools or diarrhea in 7 infants and 11 toddlers.


CONCLUSIONS
ADiSP modified starch can increase breath hydrogen and produce loose stools. Sorbitol and fructose aggravate the malabsorption, in some cases leading to frank diarrhea.
Lebenthal-Bendor
Y
Y
Beit Dana, Ichilov Hospital, Tel Aviv, Israel.
Theuer
R C
RC
Lebenthal
A
A
Tabi
I
I
Lebenthal
E
E
D000107:Acetylation; D002675:Child, Preschool; D003968:Diarrhea, Infantile / Q000139:chemically induced*; D005260:Female; D005421:Flavoring Agents / Q000009:adverse effects / Q000493:pharmacokinetics*; D005520:Food Preservatives / Q000009:adverse effects* / Q000493:pharmacokinetics*; D005632:Fructose / Q000009:adverse effects / Q000493:pharmacokinetics*; D006801:Humans; D007223:Infant; D007408:Intestinal Absorption / Q000187:drug effects; D008286:Malabsorption Syndromes / Q000139:chemically induced*; D008297:Male; D010710:Phosphates / Q000009:adverse effects* / Q000493:pharmacokinetics*; D013012:Sorbitol / Q000009:adverse effects / Q000493:pharmacokinetics*; D013213:Starch / Q000009:adverse effects* / Q000493:pharmacokinetics*
D005421:Flavoring Agents; D005520:Food Preservatives; D010710:Phosphates; D005632:Fructose; D013012:Sorbitol; D013213:Starch