Sugar alcohols as bulk sweeteners.

The polyols are a family of bulk sweeteners, some of which are currently used in the United States and in other nations. The use of these compounds is likely to increase in the future. The greatest advantage of polyols as sweeteners is their reduced cariogenicity compared with sucrose, fructose, or glucose. This reduced cariogenicity has been observed with all of the polyols considered in this review. Furthermore, evidence suggests that one of these polyols, xylitol, may have cariostatic properties. More research is needed to clarify the mechanism of this cariostatic effect. Evidence suggests that moderate usage of the polyols in human diets over long periods is not likely to produce many toxic effects. This conclusion is supported by the facts that (a) both sorbitol and mannitol have been used as sweeteners for some time without apparent side effects, and (b) extensive long-term studies with dietary xylitol in Europe have not yielded any reports of toxicity. At this point there is no reason to believe that the disaccharide polyols differ significantly in a qualitative sense from sorbitol or mannitol with regard to their effects in humans. There are some research needs with regard to the inclusion of the polyol sweeteners in human diets: 1. All of the polyols can cause osmotic diarrhea in humans if higher levels are consumed. This fact is noted in the labelling of products containing mannitol and sorbitol in the United States (see "Current Regulatory Status"). If the disaccharide polyols are to be used as bulk sweeteners, further studies of the dose levels that can cause diarrhea may be needed. 2. The polyols, like other slowly absorbed carbohydrates, enhance the absorption of certain minerals, particularly divalent cations. More comparative and mechanistic studies of this effect are needed. 3. All of the polyols, lactose, and other slowly absorbed carbohydrates appear to cause adrenal medullary hyperplasia at high doses in laboratory rats. Evidence suggests that these lesions are linked in some way to the lactose or polyol-induced changes in calcium homeostasis. Despite long-term use of lactose, sorbitol, and mannitol in human diets, similar lesions in humans have not been reported and some investigators have concluded that the lesion in rats has no relevance to humans. Nevertheless further studies are needed to elucidate the mechanisms of the dietary lactose and polyol-induced adrenal hyperplasias in rats to ascertain definitively if they also operate in other species.(ABSTRACT TRUNCATED AT 400 WORDS)