Why does sugar-free candy hurt your stomach?

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If a pack of sugar-free gum has ever given you a terrible stomach ache, your stomach bacteria may be to blame. New research in mice found a link between the gut microbiome and food intolerance to sorbitol, a commonly used sugar substitute. The findings may also point to an effective treatment for the condition, although more studies will be needed to confirm the connection.

contains sorbitol and similar ingredients sugar alcohol, also called polyols. They are derived from sugars like sucrose, but have fewer calories (about half to one third the amount), which has made them popular thickening and sweetening agents. However, sugar alcohols taste less sweet, so sugar-free products often also include artificial sweeteners. Unlike the latter type of substitutes, many sugar alcohols can be found naturally in some fruits and vegetables.

As valuable as sugar alcohols are, it has long been known that they can cause gastrointestinal distress. People don’t usually get sick from the small amounts of sorbitol and other polyols found in the normal diet, but some of us are particularly sensitive to its presence in foods – a condition known as polyol intolerance. Is known. Researchers at the University of California, Davis, and elsewhere say they may have discovered the reason why this happens.

Previous research in mice has shown that disturbing the gut microbiome can temporarily induce polyol intolerance. But these scientists wanted to get a better understanding of how the condition can become chronic in some people. His previous work found that antibiotic treatment combined with a high-fat diet can increase the amount of time it takes for the microbiome to return to normal. So they wanted to see whether this combination would cause long-term sorbitol intolerance in the mice, which it seemed to do. The researchers then found lower than normal levels of the enzyme that breaks down sorbitol in the stool of these affected mice – a pattern they also found in the stool of people more sensitive to sugar-free foods.

Theorizing that loss of this enzyme contributes to sorbitol intolerance, the team then focused on finding the gut bacteria that cause it. By scanning the genetics of the entire gut microbiome, they ultimately identified bacteria belonging to the group clostridium as potential candidates. These bacteria are considered anaerobic, meaning they grow well only in the absence of oxygen. It appears that in mice the combination of antibiotics and a high-fat diet creates a high-oxygen environment in the gut, reducing its levels. clostridium And then the level of the enzyme that breaks down the sorbitol.

To confirm their suspicions, the team introduced another bacteria into the mouse intestine with the aim of restoring the low oxygen content. Once they did this, the level of clostridium increased, as did the levels of the enzyme that breaks down sorbitol; Equally important, the rats also stopped showing symptoms of sorbitol intolerance.

“Our research shows that microbial sorbitol degradation normally protects the host from sorbitol intolerance. However, a reduction in the microbial ability to break down sorbitol causes sorbitol intolerance,” said lead author Ji-yeon Lee, a microbiologist at UC Davis. statement from University.

team findings, published The report, published Thursday in the journal Cell, said it has not yet been proven that the same series of events leads to chronic sorbitol intolerance in people. But the authors say there are existing drugs that should be able to create similar low-oxygen levels in the gut of people with the condition. These drugs include mesalazine, which is already used to help treat Crohn’s disease and other inflammatory bowel diseases. So at the very least, it should be possible to test this hypothesis in future clinical trials and hopefully find a cure, they argue.

“Our study provides an entirely new starting point for approaches to the diagnosis, prevention and treatment of sorbitol intolerance,” co-author and fellow UC Davis researcher Andreas Baumler said in a statement.

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