A digestive tolerance study of maltitol after occasional and regular consumption in healthy humans

Eur J Clin Nutr. 2003 Jan;57(1):26-30. doi: 10.1038/sj.ejcn.1601516.


Aim: We aimed to evaluate the gastro-intestinal tolerance to an indigestible bulking sweetener containing sugar alcohol using a double-blind random cross-over study.

Method: In order to simulate their usual pattern of consumption, 12 healthy volunteers ingested maltitol or sucrose throughout the day, either occasionally (once a week for each sugar, first period) or regularly (every day for two 9 day periods, second period). In both patterns of consumption, daily sugar doses were increased until diarrhea and/or a grade 3 (ie severe) digestive symptom occurred, at which the dose level was defined as the threshold dose (TD).

Results: In the first period (occasional consumption), the mean TD was 92+/-6 g with maltitol and 106+/-4 g with sucrose (P=0.059). The mean intensity of digestive symptoms was 1.1 and 1.3, respectively (P=NS). Diarrhea appeared in six and one subjects respectively (P=0.035). In the second period (regular consumption), the mean TD was 93+/-9 g with maltitol and 113+/-7 g with sucrose (P=0.008). The mean intensity of digestive symptoms was 1.7 and 1.2, respectively (P=NS). However, diarrhea appeared in eight and three subjects, respectively (P=0.04). Maltitol and sucrose TDs between the two periods were not different.

Conclusions: Under our experimental conditions, in comparison to sucrose: (a) occasional or regular consumption of maltitol is not associated with severe digestive symptoms; (b) in both patterns of maltitol consumption, diarrhea frequency is higher, but it appeared only for very high doses of maltitol, much greater than those currently used; (c) maltitol does not lead to intestinal flora adaptation after a 9 day period of consumption.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Abdominal Pain / chemically induced
  • Adaptation, Physiological
  • Adolescent
  • Adult
  • Cross-Over Studies
  • Diarrhea / chemically induced*
  • Dietary Sucrose / administration & dosage
  • Digestive System / microbiology
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Flatulence / chemically induced
  • Humans
  • Male
  • Maltose / administration & dosage*
  • Maltose / adverse effects
  • Maltose / analogs & derivatives*
  • Maximum Tolerated Dose
  • Middle Aged
  • Sugar Alcohols / administration & dosage*
  • Sugar Alcohols / adverse effects
  • Sweetening Agents / administration & dosage*
  • Sweetening Agents / adverse effects


  • Dietary Sucrose
  • Sugar Alcohols
  • Sweetening Agents
  • Maltose
  • maltitol