TABLE 3.
Effects of polyols on gut microbiota1
| Sweetener and study (reference) | Sources | Fermented fraction | Model | Dose tested | Method of microbial analysis | Main outcomes | Adverse effects | Magnitude of change |
|---|---|---|---|---|---|---|---|---|
| Erythritol (E-968) | Wine, beer, mushrooms, pears, grapes, and soy sauce | 10% reaches the colon | — | — | — | — | — | — |
| Arrigoni et al. (71) | — | — | In vitro | NA | pH, total gas, H2, and SCFA production in feces | Erythritol is completely nonfermentable | None observed | No changes |
| Isomalt (E-953) | Bubble gums, gelatins, chocolate, coatings, baked goods, and yogurts | 90% reaches the colon | — | — | — | — | — | — |
| Gostner et al. (75) | — | — | Human trial | 30 g isomalt | 16S/23S rRNA | Increased populations of bifidobacteria, decreased bacterial β-glucosidase and fecal SCFAs | None observed | 0.2–0.3 log cells/g feces |
| Lactitol (E-966) | A nonnaturally occurring sugar alcohol obtained by the hydrogenation of lactose | Not absorbed in the small intestine because of a lack of β-galactosidase | — | — | — | — | — | — |
| Patil et al. (78) | — | — | RCT | 10, 30, 60, and 100 mmol lactitol/d; 70–130 g/d | Galactose content (galactose dehydrogenase) | Reaches the lower gut where it is fermented | None observed | 40 g lactitol/d is well tolerated |
| Ballongue et al. (82) | — | — | RCT | 20 g lactitol/d | Microbiology determined in agar medium | Lactitol decreased populations of Bacteroides, Clostridium, coliforms, and Eubacterium; decreased fecal pH | None observed | Bacteroides, Clostridium, coliforms, and Eubacterium were decreased by 1.5, 1.2, 1, and 1.9 log units |
| Pinna et al. (81) | — | — | In vitro | 2 g/L for 24 h | Fluorescence in situ hybridization | Reduced the population of Enterobacteriaceae in feline fecal culture at 2 g/L, exerting prebiotic effect on feline intestinal microbiota | None observed | Clostridium perfringens: +1.6 log cells/g; Enterobacteriaceae –0.3 log cells/g |
| Peuranen et al. (83) | — | — | Rats | 2% (wt:wt) | Flow cytometry and 16S rRNA sequencing | Increased the production of butyrate and IgA secretion without signs of mucosal inflammation | None observed | Butyric acid: 22.2% IgA: 996% (lactitol + polydextrose) |
| Ouwehand et al. (84) | — | — | RCT | 5–5.5 g | Flow cytometry and 16S rRNA sequencing | Lactitol as a synbiotic combined with Lactobacillus acidophilus NCFM may improve some markers of the intestinal microbiota | None observed | Synbiotic: 7.8 × 109 CFUs/g ; placebo: 3.8 × 109 CFUs/g |
| Björklund et al. (85) | — | — | RCT | 2 × 1010L. acidophilus and 10 g lactitol | qPCR (percent guanine-plus-cytosine) | L. acidophilus NCFM and lactitol decrease the Blautia coccoides and Eubacterium rectale bacterial group levels | None observed | B. coccoides: 1.83 × 1010 to 1.34 × 1010; E. rectale 1.19 × 1010 to 7.34 × 109 |
| Finney et al. (86) | — | — | RCT | 10 g sucrose:lactitol (ratios: 10:0, 5:5, 0:10) | Microbiology determined in agar medium | 10 g lactitol can beneficially affect the fecal microbiota, increasing bifidobacteria and concentrations of propionic and butyric acids | None observed | 10 g lactitol increased from 9.37 to 10.06 bifidobacteria log CFUs |
| Maltitol (E-965) | Obtained by the hydrolysis, reduction, and hydrogenation of starch | — | — | — | — | — | — | — |
| Beards et al. (88) | — | — | RCT | 22.8 g | 16S rRNA sequencing | Numbers of fecal bifidobacteria significantly increased after maltitol treatment | None observed | 0.8 log cells/g feces |
| Sorbitol (E-420) | Obtained by catalytic hydrogenation of glucose with subsequent purification and is found naturally in apples, pears, peaches, apricots, and some vegetables | — | — | — | — | — | — | — |
| Yao et al. (90) | — | — | — | — | — | Adverse gastrointestinal reactions to sorbitol in IBD patients | None observed | — |
| Mannitol (E-421) | Mannitol is obtained from hydrogenation of glucose and purification | Similar absorption rate to sorbitol | — | — | — | No effects on gut microbiota | None observed | — |
| Xylitol (E-967) | Fruits, berries, vegetables, oats, and mushrooms; a small percentage is also produced by the human body | — | — | — | — | — | — | — |
| Uebanso et al. (49) | — | — | Mice | 40 and 200 mg xylitol · kg body weight−1 · d−1 | 16S rRNA sequencing | Reduced the abundance of fecal Bacteroidetes and the genus Barnesiella and increased Firmicutes and the genus Prevotella | None observed | 194 mg xylitol · kg−1 · d−1 reduced |
| Tamura et al. (96) | — | — | Mice | 5% xylitol diet for 28 d | Detected by T-RFLP analysis, based on PCR amplification | The concentration of Bacteroides was higher in the control diet than in the xylitol-rich diet | None observed | 50% |
| Naaber et al. (99) | — | — | Mice | Synbiotic: Lactobaccillus rhamnosus and xylitol (1 mL of 20% solution) | Diffusion method and blood agar | Treatment of L. rhamnosus and xylitol had some effects against Clostridium difficile in a mouse model | None observed | Translocation effects |
1
IBD, inflammatory bowel disease; NA, not available; RCT, randomized clinical trial; rRNA, ribosomal RNA; T-RFLP, terminal restriction fragment length polymorphism.