title: A digestive tolerance study of maltitol after occasional and regular consumption in healthy humans.
abstract: OBJECTIVE
  We aimed to evaluate the gastro-intestinal tolerance to an indigestible bulking sweetener containing sugar alcohol using a double-blind random cross-over study.
  
  
  METHODS
  In order to simulate their usual pattern of consumption, 12 healthy volunteers ingested maltitol or sucrose throughout the day, either occasionally (once a week for each sugar, first period) or regularly (every day for two 9 day periods, second period). In both patterns of consumption, daily sugar doses were increased until diarrhea and/or a grade 3 (ie severe) digestive symptom occurred, at which the dose level was defined as the threshold dose (TD).
  
  
  RESULTS
  In the first period (occasional consumption), the mean TD was 92+/-6 g with maltitol and 106+/-4 g with sucrose (P=0.059). The mean intensity of digestive symptoms was 1.1 and 1.3, respectively (P=NS). Diarrhea appeared in six and one subjects respectively (P=0.035). In the second period (regular consumption), the mean TD was 93+/-9 g with maltitol and 113+/-7 g with sucrose (P=0.008). The mean intensity of digestive symptoms was 1.7 and 1.2, respectively (P=NS). However, diarrhea appeared in eight and three subjects, respectively (P=0.04). Maltitol and sucrose TDs between the two periods were not different.
  
  
  CONCLUSIONS
  Under our experimental conditions, in comparison to sucrose: (a) occasional or regular consumption of maltitol is not associated with severe digestive symptoms; (b) in both patterns of maltitol consumption, diarrhea frequency is higher, but it appeared only for very high doses of maltitol, much greater than those currently used; (c) maltitol does not lead to intestinal flora adaptation after a 9 day period of consumption.
authors.affiliation: Service de Gastroentérologie, Hôpital Hôtel-Dieu, Paris, France. agnes.fourmestraux@htd.ap-hop-paris.fr
authors.forename: A
authors.initials: A
authors.lastname: Ruskoné-Fourmestraux
authors.forename: A
authors.initials: A
authors.lastname: Attar
authors.forename: D
authors.initials: D
authors.lastname: Chassard
authors.forename: B
authors.initials: B
authors.lastname: Coffin
authors.forename: F
authors.initials: F
authors.lastname: Bornet
authors.forename: Y
authors.initials: Y
authors.lastname: Bouhnik
mesh_terms: D015746:Abdominal Pain / Q000139:chemically induced; D000222:Adaptation, Physiological; D000293:Adolescent; D000328:Adult; D018592:Cross-Over Studies; D003967:Diarrhea / Q000139:chemically induced*; D019422:Dietary Sucrose / Q000008:administration & dosage; D004064:Digestive System / Q000382:microbiology; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005414:Flatulence / Q000139:chemically induced; D006801:Humans; D008297:Male; D008320:Maltose / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives*; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D013402:Sugar Alcohols / Q000008:administration & dosage* / Q000009:adverse effects; D013549:Sweetening Agents / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D019422:Dietary Sucrose; D013402:Sugar Alcohols; D013549:Sweetening Agents; D008320:Maltose; C010745:maltitol