Sugar Substitutes Cause Diarrhea

Sweeteners have become integral to our modern diets, offering a low-calorie alternative to traditional sugar. However, using these sugar substitutes has sparked ongoing discussions about their potential health implications. One particular concern that has garnered attention is the laxative effect that some of these sweeteners can have on the human body. This comprehensive article will delve into the science behind this phenomenon, explore the various types of sweeteners, and provide insights into the potential risks and benefits associated with their consumption.

Understanding sugar substitutes

Sugar substitutes are also known as artificial sweeteners, sugar-free sweeteners or non-nutritive sweeteners. They are substances that mimic the sweetness of sugar without the associated caloric content. These compounds are widely used in a variety of processed foods and beverages such as soft drinks, ice cream, chewing gum, diet soda and toothpaste. The approval and regulation of these sweeteners are subject to rigorous safety assessments by governing bodies, ensuring their suitability for human consumption.

Approved sweeteners in the UK

The UK has a range of sweeteners approved for use, including:

• Acesulfame K (E950)
• Aspartame (E951)
• Erythritol (E968)
• Saccharin (E954)
• Sorbitol (E420)
• Steviol glycosides (E960)
• Sucralose (E955)
• Xylitol (E967)

In America, artificial sweeteners are regulated by the U.S. Food and Drug Administration (FDA) as food additives. They must be reviewed and approved by the FDA before being made available for sale.

The laxative effect of sugar substitutes

One of the most widely discussed side effects of sugar substitutes is their potential to cause diarrhoea and other gastrointestinal distress such as bloating. This laxative effect is primarily associated with a group of sweeteners known as polyols, which include sorbitol, xylitol, and erythritol.

Polyols and their laxative properties

Polyols, or sugar alcohols, are a class of sweeteners that are not fully absorbed by the human body. Instead, they pass through the digestive system largely intact, drawing water into the intestines and stimulating the bowels. This can lead to a laxative effect, with symptoms ranging from mild discomfort to more severe diarrhoea.

The degree of laxative effect can vary depending on the specific polyol and the amount consumed. For example, sorbitol and xylitol are known to have a more pronounced laxative effect compared to erythritol, which is generally considered to have a milder impact.

Factors influencing the laxative effect

Several factors can influence the likelihood and severity of the laxative effect from sugar substitutes:

• Dosage: Consuming large amounts of polyols, particularly in a single sitting, increases the risk of experiencing gastrointestinal distress
• Individual sensitivity: Some people may be more sensitive to the laxative properties of certain sweeteners, leading to more pronounced symptoms
• Underlying conditions: Individuals with pre-existing digestive issues, such as irritable bowel syndrome (IBS) or malabsorption disorders, may be more susceptible to the laxative effects of sugar substitutes. If you’re living with a rare genetic disease called phenylketonuria. Foods and drinks with aspartame can lead to serious health problems
• Combination with other ingredients: The presence of other food components, such as fibre or other sweeteners, can potentially exacerbate or mitigate the laxative effect

Risks and benefits

While the laxative effect of sugar substitutes can be a significant concern for some individuals, it’s important to recognise that the overall safety and acceptability of these sweeteners have been extensively evaluated by regulatory bodies.

Safety assessments and regulations

All sweeteners approved for use in the UK have undergone rigorous safety assessments, including the determination of an acceptable daily intake (ADI) – the maximum amount considered safe to consume daily over a lifetime. These regulations ensure that the use of sweeteners in food and drink products is within safe and acceptable limits.

Potential benefits of sugar substitutes

Despite the concerns about laxative effects, sugar substitutes can offer some potential health benefits, particularly for individuals looking to manage their sugar intake. By providing a sweet taste with fewer calories, these sweeteners can be helpful in:

• Reducing the risk of tooth decay
• Supporting weight loss efforts
• Controlling blood sugar levels for individuals with diabetes

Strategies for minimising laxative effects

For those who are susceptible to the laxative effects of sugar substitutes, several strategies can be employed to mitigate the discomfort:

Gradual adaptation

Introducing sugar substitutes gradually into the diet can allow the body to adapt, reducing the likelihood of severe gastrointestinal distress.

Moderation and portion control

Paying attention to the amount of polyol-containing products consumed and adhering to recommended serving sizes can help minimise the laxative impact.

Monitoring individual tolerance

Keeping track of personal reactions to different types of sweeteners can help individuals identify which ones are more tolerable for their unique digestive system.

Seeking professional guidance

Consulting with healthcare professionals, such as dietitians or gastroenterologists, can provide personalised advice on managing the laxative effects of sugar substitutes.

Conclusion

The laxative effects associated with some sugar substitutes are a valid concern, particularly for those with sensitive digestive systems. However, it is important to recognise that these sweeteners have undergone extensive safety evaluations and can offer potential benefits for those seeking to manage their sugar intake.

By understanding the science behind the laxative properties of sugar substitutes, being mindful of individual tolerance levels, and employing strategies to minimise discomfort, individuals can make informed choices about incorporating these alternatives into their diets. As with any dietary change, it is always advisable to consult with healthcare professionals to ensure the safe and effective management of one’s nutritional needs.

Sources

• The truth about sweeteners – NHS
• Artificial Sweeteners: A Systematic Review and Primer for Gastroenterologists – PMC
• Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and Other Health-Care Professionals – PMC