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Concept: Sorbitol


The negative impact of consuming sugar-sweetened beverages on weight and other health outcomes has been increasingly recognized; therefore, many people have turned to high-intensity sweeteners like aspartame, sucralose, and saccharin as a way to reduce the risk of these consequences. However, accumulating evidence suggests that frequent consumers of these sugar substitutes may also be at increased risk of excessive weight gain, metabolic syndrome, type 2 diabetes, and cardiovascular disease. This paper discusses these findings and considers the hypothesis that consuming sweet-tasting but noncaloric or reduced-calorie food and beverages interferes with learned responses that normally contribute to glucose and energy homeostasis. Because of this interference, frequent consumption of high-intensity sweeteners may have the counterintuitive effect of inducing metabolic derangements.

Concepts: Nutrition, Insulin, Diabetes mellitus, Sugar, Sweeteners, Sugar substitute, Sucralose, Sorbitol


Artificial sweeteners (AS) are ubiquitous in food and beverage products, yet little is known about their effects on the gastrointestinal (GI) tract, and whether they play a role in the development of GI symptoms, especially in patients with irritable bowel syndrome.

Concepts: Constipation, Gastroenterology, Syndromes, Irritable bowel syndrome, Flatulence, Learning, Sugar, Sorbitol


Non-caloric artificial sweeteners (NAS) are common food supplements consumed by millions worldwide as means of combating weight gain and diabetes, by retaining sweet taste without increasing caloric intake. While they are considered safe, there is increasing controversy regarding their potential ability to promote metabolic derangements in some humans. We recently demonstrated that NAS consumption could induce glucose intolerance in mice and distinct human subsets, by functionally altering the gut microbiome. In this commentary, we discuss these findings in the context of previous and recent works demonstrating the effects of NAS on host health and the microbiome, and the challenges and open questions that need to be addressed in understanding the effects of NAS consumption on human health.

Concepts: Health, Human, Nutrition, Sugar, Food additive, Sweeteners, Sucralose, Sorbitol


It is well established that animals including humans attribute greater reinforcing value to glucose-containing sugars compared to their non-caloric counterparts, generally termed “artificial sweeteners”. However, much remains to be determined regarding the physiological signals and brain systems mediating the attribution of greater reinforcing value to sweet solutions that contain glucose. Here we show that disruption of glucose utilization in mice produces an enduring inhibitory effect on artificial sweetener intake, an effect that did not depend on sweetness perception or aversion. Indeed, such an effect was not observed in mice presented with a less palatable, yet caloric, glucose solution. Consistently, hungry mice shifted their preferences away from artificial sweeteners and in favour of glucose after experiencing glucose in a hungry state. Glucose intake was found to produce significantly greater levels of dopamine efflux compared to artificial sweetener in dorsal striatum, whereas disrupting glucose oxidation suppressed dorsal striatum dopamine efflux. Conversely, inhibiting striatal dopamine receptor signalling during glucose intake in sweet-naïve animals resulted in reduced, artificial sweetener-like intake of glucose during subsequent glucoprivation. Our results demonstrate that glucose oxidation controls intake levels of sweet tastants by modulating extracellular dopamine levels in dorsal striatum, and suggest that glucose utilization is one critical physiological signal involved in the control of goal-directed sweetener intake.

Concepts: Glucose, Sugar, Food additive, Sweeteners, Stevia, Sugar substitute, Sucralose, Sorbitol


The purpose of this paper is to review the epidemiology of obesity and the evolution of artificial sweeteners; to examine the latest research on the effects of artificial sweeteners on the host microbiome, the gut-brain axis, glucose homeostasis, and energy consumption; and to discuss how all of these changes ultimately contribute to obesity.

Concepts: Metabolism, Organism, Blood sugar, The Association, Sugar, Sweeteners, Sugar substitute, Sorbitol


Polyols are sugar alcohols found in certain fruits, vegetables, and sugar-free sweeteners. They make up a component of the diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, which is gaining popularity in the treatment of patients with irritable bowel syndrome (IBS). We conducted a systematic review to evaluate the effects of polyols on the gastrointestinal tract in healthy men and women and in patients with IBS. Utilizing PubMed, Ovid, and Embase databases, we conducted a search on individual polyols and each of these terms: fermentation, absorption, motility, permeability, and gastrointestinal symptoms. Standard protocols for a systematic review were followed. We found a total of 1823 eligible articles, 79 of which were included in the review. Overall, available work has shown that polyol malabsorption generally occurs in a dose-dependent fashion in healthy individuals, and malabsorption increases when polyols are ingested in combination. However, studies in patients with IBS have shown conflicting results pertaining to polyol malabsorption. Polyol ingestion can lead to intestinal dysmotility in patients with IBS. Regarding the microbiome, moderate doses of polyols have been shown to shift the microbiome toward an increase in bifidobacteria in healthy individuals and may therefore be beneficial as prebiotics. However, data are limited regarding polyols and the microbiome in patients with IBS. Polyols can induce dose-dependent symptoms of flatulence, abdominal discomfort, and laxative effects when consumed by both healthy volunteers and patients with IBS. Further research is needed to better understand the effects of specific polyols on gastrointestinal function, sensation, and the microbiome in health and gastrointestinal disorders such as IBS.

Concepts: Digestive system, Constipation, Gastroenterology, Irritable bowel syndrome, Flatulence, Sweeteners, Xylitol, Sorbitol


Complaints about Δ9-tetrahydrocannabinol (THC):cannabidiol (CBD) oromucosal spray (Sativex®; GW Pharma Ltd, Sailsbury, UK) in the management of multiple sclerosis spasticity include unpleasant taste and oral mucosal anomalies. This pilot study assessed the use of sugar-free chewing gum and/or a refrigerated bottle of THC:CBD oromucosal spray to mitigate these effects.

Concepts: Multiple sclerosis, Sugar substitute, Xylitol, Chewing gum, Sorbitol


In this study, we developed a simple and sensitive reversed phase ion-pair chromatographic method for the analysis of C4-C6 sugar alcohols. The method is based on the on-line complexation of sugar alcohols with molybdate ion. The resulting dinuclear anionic complexes can be separated on a reversed-phase C18 column using tetrabutylammonium chloride as an ion-pairing reagent. The mobile phase (pH 3.1) consisted of 0.1 mM disodium molybdate, 1 mM hydrochloric acid and 0.4 mM tetrabutylammonium chloride - 10% v/v methanol. By complexing with molybdate ion, sugar alcohols can be detected by their UV absorption at 247 nm with high resolution and sensitivity. The quantification limits of the examined sugar alcohols calculated at S/N = 10 were 0.1 mM for erythritol and xylitol and 0.01 mM for arabitol, sorbitol, mannitol and dulcitol. The detector response was linear over three orders of magnitude of sugar alcohol concentration. The proposed method was successfully applied to measure sugar alcohols in health drinks, eyedrops and mouthwashes.

Concepts: Hydrogen, Chromatography, Chloride, Hydrochloric acid, Sugar alcohols, Xylitol, Sugar alcohol, Sorbitol


The sugar replacement compound xylitol has gained increasing attention due to its use in many commercial food products, dental hygiene articles and pharmaceuticals. It can be classified by the origin of the raw material used for the production. The traditional “birch xylitol” is considered a premium product in contrast to xylitol produced from agriculture byproducts such as corn husks or sugar cane straw. Bulk stable isotope analysis (BSIA) as well as compound-specific stable isotope analysis (CSIA) by LC-IRMS for chewing gum extracts was used to determine δ13C isotope signatures for xylitol. These were applied to elucidate the original plant type the xylitol was produced from based on differences in the isotope fractionation processes during the photosynthetic CO2 fixation. For the LC-IRMS analysis, an organic solvent free extraction protocol and HPLC method for the separation of xylitol from different artificial sweeteners and sugar replacement compounds was successfully developed and applied to the analysis of 21 samples of chewing gum from which 18 could be clearly related to the raw material plant class.

Concepts: Photosynthesis, Sugar, Oral hygiene, Sweeteners, Sugar substitute, Xylitol, Chewing gum, Sorbitol


The European Food Safety Authority recognizes the contribution of sugar-free chewing gum to oral health through increased salivation, clearance of food debris, and neutralization of biofilm pH. Magnolia bark extract is a gum additive shown to reduce the prevalence of bad-breath bacteria but its effects on self-perceived mouthfeel are unknown. This paper aims to relate the effects of sorbitol-containing chewing gum, with and without Magnolia bark extract, on tooth-surface hydrophobicity and salivary-film composition with self-perceived mouthfeel. In a crossover clinical trial, volunteers chewed sorbitol-containing gum, with or without Magnolia bark extract added, three times daily during a 4-wk time period. A subset of volunteers also chewed Parafilm as a mastication control. Oral moistness and tooth smoothness were assessed using questionnaires, and intra-oral water-contact angles were measured before, immediately after, and 60 min after, chewing. Simultaneously, saliva samples were collected, placed on glass slides, and the compositions of the adsorbed film were measured using X-ray photoelectron spectroscopy. Chewing of gum, regardless of whether or not it contained Magnolia bark extract, improved self-perceived mouthfeel up to 60 min, concurrent with a more hydrophilic tooth surface and an increased amount of O1s electrons bound at 532.6 eV in salivary films. Chewing of Parafilm affected neither tooth-surface hydrophobicity nor salivary-film composition. Accordingly, adsorption of sorbitol, rather than the presence of Magnolia bark extract or increased salivation, is responsible for improved self-perceived mouthfeel.

Concepts: Saliva, X-ray photoelectron spectroscopy, Dentistry, Mastication, Sugar substitute, Xylitol, Chewing gum, Sorbitol