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Effects of low doses of lactitol on faecal microflora, pH, short chain fatty acids and gastrointestinal symptomology

Abstract

Background

Lactitol (4-β-d-galactopyranosyl-d-glucitol) is a sugar alcohol used as a sweetener. Previous studies have shown that it has a beneficial effect on intestinal microflora.

Aims of the study

To determine whether low doses of lactitol had beneficial effects without eliciting adverse gastrointestinal symptoms.

Methods

Faecal bacterial populations (total anaerobes, total aerobes, enterobacteria, bifidobacteria and lactobacilli), faecal pH and faecal short chain fatty acids (SCFA) were studied in a randomized longitudinal study of 75 non-adapted healthy adults before and after consumption of low doses of lactitol. Subjects consumed 25 g tablets of milk chocolate containing 10 g sweetener as sucrose:lactitol in ratios of 10:0, 5:5 or 0:10 daily for 7 d.

Results

No significant changes in faecal bacterial counts occurred in the 10:0 or 5:5 sucrose:lactitol groups. There were no significant changes in faecal anaerobes, aerobes, Enterobacteriaceae or lactobacilli during the study period in subjects consuming 0:10 sucrose:lactitol but there was a significant increase (P = 0.017) in bifidobacteria. There were no significant changes in faecal pH and SCFA for the 10:0 or 5:5 sucrose:lactitol groups but a significant decrease (P = 0.02) in faecal pH and significant increases (P = 0.001) in concentrations of propionic and butyric acids were observed in the 0:10 sucrose:lactitol group. There were few adverse symptoms of gastrointestinal intolerance to the daily consumption of 10 g lactitol.

Conclusions

The results show that low doses of lactitol can beneficially affect the faecal flora without eliciting gross symptoms of intolerance and that lactitol can be classified as a prebiotic.

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References

  1. Abrahamse SL, Pool-Zobel BL, Rechkemmer G (1999) Potential of short chain fatty acids to modulate the induction of DNA damage and changes in the intracellular calcium concentration by oxidative stress in isolated rat colon cells. Carcinogenesis 20:629–634

    Article  CAS  Google Scholar 

  2. Anon (1988) Association of the British pharmaceutical industry (ABPI). Patient information and consent for clinical trials. ABPI: London

  3. Arunachalam KD (1999) Role of Bifidobacteria in nutrition, medicine and technology. Nutr Res 19:1559–1597

    Article  CAS  Google Scholar 

  4. Ballongue J, Schumann C, Quignon P (1997) Effects of lactulose and lactitol on colonic microflora and enzymic activities. Scand J Gastroenterol 222:S41–S44

    Google Scholar 

  5. Beaugerie L, Flourié B, Pellier P, Achour L, Franchisseur C, Rambaud JC (1991) Tolérance clinique, absorption intestinale et valeur énergétique de quatre polyols pris à jeun (clinical tolerance, intestinal absorption, and energy value of four sugar alcohols). Gastroenterol Clin Biol 15:929–932

    CAS  Google Scholar 

  6. Cummings JH (1983) Fermentation in human large intestine; evidence and implications for health. Lancet 1:1206–1208

    Article  CAS  Google Scholar 

  7. Cummings JH, Gibson GR, Macfarlane GT (1989) Quantitative estimates of fermentation in the hindgut of man. Acta Vet Scand 86:S76–S82

    Google Scholar 

  8. Cummings JH, Macfarlane GT (1991) The control and consequences of bacterial fermentation in the human colon. J Appl Bacteriol 70:443–459

    CAS  Google Scholar 

  9. Cummings JH, Macfarlane GT, Englyst HN (2001) Prebiotic digestion and fermentation. Am J Clin Nutr 72:S415–S420

    Google Scholar 

  10. Gibson GR, Fuller R (1998) The role of probiotics and prebiotics in the functional food concept. In: Sadler MJ, Saltmarsh M (eds) Functional foods: the consumer, the products and the evidence. The Royal Society of Chemistry, London, pp 3–14

    Google Scholar 

  11. Gibson GR, Roberfroid MB (1995) Dietary modulation of the human colonic microbiota: introducing the concepts of prebiotics. J Nutr 125:1401–1412

    CAS  Google Scholar 

  12. Goovaerts L, Ravelli GP (1993) Lactitol monohydrate for the treatment of chronic constipation-a multicentre study of the efficacy and tolerability of an individually adjusted daily dose. Acta Therapeut 19:61–71

    Google Scholar 

  13. Grimble GK, Patil DH, Silk DB (1988) Assimilation of lactitol, an ‘unabsorbed’ disaccharide in the normal human colon. Gut 29:1666–1671

    CAS  Google Scholar 

  14. Hartemink R, Domenech VR, Rombouts FM (1997) LAMVAB-A new selective medium for the isolation of lactobacilli from faeces. J Microbiol Meth 29:77–84

    Article  CAS  Google Scholar 

  15. Hartemink R, Kok BJ, Weenk GH, Rombouts FM (1996) Raffinose-Bifidobacterium (RB) agar, a new selective medium for bifidobacteria. J Microbiol Meth 27:33–43

    Article  CAS  Google Scholar 

  16. Kearsley MW, Dziedzic SZ, Birch GG, Smith PD (1980) The production and properties of glucose syrups 2. Sweetness of glucose syrups and related carbohydrates. Starke 32:244–247

    Article  CAS  Google Scholar 

  17. Koutsou GA, Storey DM, Lee A, Zumbe A, Flourie B, LeBot Y, Olivier P (1996) Dose related gastrointestinal response to the ingestion of either isomalt, lactitol or maltitol in milk chocolate. Eur J Clin Nutr 50:17–21

    CAS  Google Scholar 

  18. Lanthier PL, Morgan MY (1985) Lactitol in the treatment of chronic hepatic encephalopathy; an open comparison with lactulose. Gut 26:415–420

    CAS  Google Scholar 

  19. Liu Q, Duan ZP, Ha DK, Benqmark S, Kurtivic J, Riordan SM (2004) Synbiotic modulation of gut flora: effect on minimal hepatic encephalopathy in patients with cirrhosis. Hepatology 39:1441–1449

    Article  Google Scholar 

  20. Livesey G (2001) Tolerance of low-digestible carbohydrates: a general view. Br J Nutr 85:S7–S16

    CAS  Article  Google Scholar 

  21. Macfarlane GT, Cummings JH (1991) The colonic flora, fermentation and large bowel digestive function. In: Philips SF, Pemberton JH, Shorter RG (eds) The large intestine: physiology, pathophysiology and disease. Raven Press Ltd, New York, pp 51–92

    Google Scholar 

  22. Macfarlane GT, Cummings JH (1999) Probiotics and prebiotics: can regulating the activities of intestinal bacteria benefit health? BMJ 318:999–1003

    CAS  Google Scholar 

  23. Macfarlane GT, Gibson GR (1995) Microbiological aspects of the production of short-chain fatty acids in the large bowel. In: Cummings JH, Rombeau JL, Sakata T (eds), Physiological and clinical aspects of short-chain fatty acids. Cambridge University Press, Cambridge pp 87–105

    Google Scholar 

  24. Mandal M, Olson DJ, Sharma T, Vadlamudi RK, Kumar R (2001) Butyric acid induces apoptosis by up-regulating Bax expression via stimulation of the c-jun N-terminal kinase/activation protein-1 pathway in human colon cancer cells. Gastroenterol 120:71–78

    Article  CAS  Google Scholar 

  25. Marteau P, Flourie B (2001) Tolerance to low-digestible carbohydrates: symptomatology and methods. Br J Nutr 85:S17–S21

    CAS  Google Scholar 

  26. Marteau P, Pochart P, Flourie B, Pellier P, Santos L, Desjeux JF, Rambaud JC (1990) Effect of chronic ingestion of a fermented dairy product containing Lactobacillus acidophilus and Bifidobacterium bifidum on metabolic activities of the colonic flora of humans. Am J Clin Nutr 52:685–888

    CAS  Google Scholar 

  27. Minekus M, Smeets-Peeters M, Bernalier A, Marol-Bonnin S, Havenaar R, Marteau P, Alric M, Fonty G, Huis in’t Veld JHJ (1999) A computer controlled system to stimulate conditions of the large intestine with peristaltic mixing, water absorption and absorption of fermentation products. Appl Microbiol Biotechnol 53:108–114

    Article  CAS  Google Scholar 

  28. Modler HW (1994) Bifidogenic factors- sources, metabolism and applications. Int Dairy J 4:383–407

    Article  Google Scholar 

  29. Patil DH, Grimble GK, Silk DBA (1987) Lactitol, a new hydrogenated lactose derivative—intestinal absorption and laxative threshold in normal human subjects. Br J Nutr 57:195–199

    Article  CAS  Google Scholar 

  30. Pryde SE, Duncan SH, Hold GH, Stewart CS, Flint HJ (2002) The microbiology of butyrate fermentation in the human colon. FEMS Microbiol Lett 217:133–139

    Article  CAS  Google Scholar 

  31. Rambaud JC, Flourie B (1994) Mechanisms of carbohydrate induced diarrhoea. In: Binder HJ, Cummings JH, Soergel K (eds) Short chain fatty acids. Kluwer Academic Press, pp 232–239

  32. Ravelli GP, Whyte A, Spencer R, Hotten P, Harbron C, Keenan R (1995) Effect of lactitol intake upon stool parameters and the faecal bacterial flora in chronically constipated women. Acta Ther 21:243–255

    CAS  Google Scholar 

  33. Roberfroid MB (2001) Prebiotics: preferential substrates for specific germs? Am J Clin Nutr 73:S406–S409

    Google Scholar 

  34. Sakata T (1987) Stimulatory effect of short-chain fatty acids on epithelial cell proliferation in the rat intestine: a possible explanation for trophic effects of fermentable fibre, gut microbes and luminal trophic factors. Br J Nutr 58:95–103

    Article  CAS  Google Scholar 

  35. Scevola D, Bottari A, Franchini A, Guanziroli A, Faggi A, Monzillo V, Pervesi L, Oberto L (1993) The role of lactitol in the regulation of the intestinal microflora in liver disease. Giorn Ital Malatt Infett Parassit 45:906–918

    Google Scholar 

  36. Scheppach W, Bartram HP, Richter F (1995) Role of short-chain fatty acids in the prevention of colorectal cancer. Eur J Cancer 31A:1077–1080

    Article  CAS  Google Scholar 

  37. Scheppach W, Luehrs H, Menzel T (2001) Beneficial health effects of low digestible carbohydrate consumption. Br J Nutr 85:S23–S30

    CAS  Article  Google Scholar 

  38. Suau A, Bonnet R, Sutren M, Godon J-J, Gibson GR, Collins MD, Dore J (1999) Direct analysis of genes encoding 16S rRNA from complex communities reveals many novel molecular species within the human gut. Appl Environ Microbiol 65:4799–4807

    CAS  Google Scholar 

  39. Tarao K, Tamai S, Ito Y, Okawa S, Hayashi M (1995) Effects of lactitol on faecal bacterial flora in patients with liver cirrhosis and hepatic encephalopathy. Japan J Gastroenterol 92:1037–1050

    CAS  Google Scholar 

  40. Vanderdonckt J, Coulon J, Denys W, Ravelli GP (1990) Study of the laxative effect of lactitol (Importal®) in the elderly institutionalized, but not bedridden, population suffering from chronic constipation. J Clin Exp Gerontol 12:171–189

    Google Scholar 

  41. Wang X, Gibson GR (1993) Effects of the in vitro fermentation of oligofructose and insulin by bacteria growing in the human large intestine. J Appl Bacteriol 75:373–380

    CAS  Google Scholar 

  42. Wilson KH, Blitchington RB (1996) Human colonic biota studied by ribosomal DNA sequence analysis. Appl Environ Microbiol 62:2273–2278

    CAS  Google Scholar 

  43. Wollowski I, Rechkemmer G, Pool-Zobel BL (2001) Protective role of probiotics and prebiotics in colon cancer. Am J Clin Nutr 73:451–455

    Google Scholar 

  44. Yanahira S, Morita M, Aoe S, Suguri T, Nakajima I, Deya E (1995) Effects of lactitol-oligosaccharide on the intestinal microflora in rats. J Nutr Sci Vitaminol (Tokyo) 41:83–94

    CAS  Google Scholar 

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Acknowledgements

This study was supported by Purac Biochem, Holland.

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Correspondence to David M. Storey.

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Finney, M., Smullen, J., Foster, H.A. et al. Effects of low doses of lactitol on faecal microflora, pH, short chain fatty acids and gastrointestinal symptomology. Eur J Nutr 46, 307–314 (2007). https://doi.org/10.1007/s00394-007-0666-7

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  • DOI: https://doi.org/10.1007/s00394-007-0666-7

Keywords

  • bifidobacterium
  • faecal microflora
  • lactitol
  • short chain fatty acids
  • gastrointestinal symptomology