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Digestive Disorders > Intolerances > Sorbitol Intolerance

Sorbitol – Everything you need to know about sugar alcohol

Dr. med. André Sommer

Dr. med. André Sommer

Sorbitol is a sugar alcohol (polyol). It occurs naturally in various foods. Due to its ability to attract water, sorbitol is also used in industrially manufactured baked goods. For example, cakes and breads stay moist longer with it. Sorbitol will then appear on the list of ingredients as E 420. Since it tastes sweet, spares the teeth, but has hardly any calories, it is also a sugar substitute used in sweets, chewing gum and much more.

What foods contain sorbitol?

In addition to the foods in which sorbitol naturally occurs, it is often added to a wide variety of products in the food industry. Various types of fruit belong to the naturally sorbitol-rich foods. Especially stone fruits and pome fruits contain sugar alcohol. You can find a list in the table. Dried fruits have an even higher sorbitol content. If jam is produced from these types of fruit, it also increases significantly. The effect is even greater with diabetic products. Large amounts of sorbitol are added in order to obtain a delicious sweetness despite the absence of sugar. This means that the blood sugar level remains unaffected, but these products are not suitable for people with sorbitol intolerance.

Since it is used as a substitute, sorbitol is also called a sugar substitute. It is found in almost all food products that are declared sugar-free. In addition to muesli and baked goods, it is also found in chewing gum.

Fruit Industrially manufactured food
  • Apples
  • Pears
  • Apricots
  • Plums
  • Peaches
  • Cherries
  • Dried fruit
  • Sugar-free chewing gum and sweets
  • Desserts, cakes, pastries
  • Ice cream
  • Medications
  • Jam
  • Products for diabetics

Do I suffer from sorbitol intolerance?

Usually sorbitol is absorbed into the blood via the intestinal wall and then broken down in the liver. But with an estimated 80 percent of people in the Western world, this absorption is disturbed. The experience sorbitol malabsorption. If large amounts remain in the intestine, there may be gastrointestinal symptoms such as diarrhea, gas and stomach cramps. The bacteria in the intestine are jointly responsible for the symptoms. They metabolize residual sorbitol and gases form.

Do you suffer from the symptoms described, especially after eating stone or pome fruit? Sorbitol intolerance could be the cause in this case. This is often accompanied by an intolerance to fructose. The two incompatibilities can be diagnosed with the H2 breath test. Please inform yourself in our specialist article about sorbitol intolerance.

Tip

The notice “can have a laxative effect when consumed in large quantities” is given on food with sorbitol. Also be careful with “sugar-free” - if you are sorbitol intolerant you should not eat products with these indications.

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What foods can I eat if I am intolerant to sorbitol?

Sorbitol intolerance is not an allergy. This means that you do not have to stop consuming sorbitol completely. In case of an intolerance small amounts can often be tolerated without problems. Everyone has their own compatibility limit. Symptoms only occur when this individual tolerance limit is exceeded. Unfortunately fructose inhibits the absorption of sorbitol. You should generally keep this in mind when eating fruits and vegetables or sweetened foods. In order not to experience any symptoms, it is better not to ingest large amounts of sorbitol and fructose at the same time. While you should be careful with products containing sorbitol (see table above), you can consume sorbitol-free food safely.

For long-term improvement of symptoms, it is always advisable to seek professional help. We have developed a special nutritional therapy for food intolerances to help you. Together with your nutritionist, you will find out here what you can tolerate well and how to establish eating habits that are really good for you. Arrange a free informational meeting here and find out more.

Suitable foods for intolerance to sorbitol include:

Suitable fruit Other suitable foods
  • Soft fruit Raspberries, blueberries, blackberries, gooseberries, sea buckthorn, currants
  • Melon: Watermelon, honeydew melon
  • Citrus fruits: Lemon, lime, orange, grapefruit
  • Kiwi
  • Bananas
  • Quince
  • Pineapple
  • Unprocessed meat
  • Fish, eggs
  • Oils
  • Vinegar
  • Salt, pepper
  • Fresh herbs
  • Vegetables: Aubergine, bell pepper, lettuce, spinach, parsnip, radish, broccoli, peas, fennel, kale, kohlrabi, chard, okra, olives, asparagus, onion
  • Grains, rice
  • Potatoes

Are there sorbitol-free toothpastes?

Yes, various toothpaste manufacturers do not use it in their toothpastes. You can easily find out whether your toothpaste is sorbitol-free by looking at the list of contents. But even with sorbitol intolerance, a regular toothpaste can be used without any concerns or complaints. Since the toothpaste is not swallowed but spit out, the sugar alcohol does not get into the intestine. For dental health, especially for children, fluoride should be included in the toothpaste.

The following toothpastes are, among other things, sorbitol-free (these are not recommendations):

  • Ajona Stomaticum (no fluoride)
  • Meridol Periodontist Expert
  • Parodontax Fluorid
  • SalviagalenF
  • Sensodyne Repair&Protect
  • Weleda Sole (no flouride)

What is sorbitan monostearate?

Sorbitan monostearate is an ester of sorbitol, also called sorbitan. The substance made from sorbitol and animal or vegetable fats serves as an emulsifier. An emulsifier ensures that a fine mixture is formed from water and fat. That is why sorbitan monostearate is often used as an additive in the food industry and in cosmetic products. In addition to baked goods, the additive is also found in chocolate, lemonades, sauces, jams and dry yeast. All sorbitan fatty acid esters are listed with E numbers E 491 to E 495. Other sorbitol compounds and their corresponding E numbers are:

  • E 420 sorbitol
  • E432 polyoxyethylene sorbitan monolaurate (polysorbate 20), polysorbates, emulsifiers
  • E433 polyoxyethylene sorbitan monooleate (polysorbate 80)
  • E434 polyoxyethylene sorbitan monopalmitate (polysorbate 40)
  • E435 polyoxyethylene sorbitan monostearate (polysorbate 60)
  • E436 polyoxyethylene sorbitan tristearate (polysorbate 65)
  • E491 sorbitan monostearate
  • E492 sorbitan tristearate
  • E493 sorbitan monolaurate
  • E494 sorbitan monooleate
  • E495 sorbitan monopalmitate

Note:

Due to the widespread use of sorbitol and its chemical compounds, a look at the list of ingredients and E numbers for sorbitol intolerance is particularly important! While sorbitol is well tolerated in small amounts, large amounts lead to abdominal pain and diarrhea

Ebermann, R., & Elmadfa, I. (2008). Lehrbuch Lebensmittelchemie und Ernährung. Springer-Verlag.

Grimm, H. U., & Ubbenhorst, B. (2013). Chemie im Essen: Lebensmittel-Zusatzstoffe. Wie sie wirken, warum sie schaden. Knaur eBook. Online: https://www.amazon.de/Chemie-Essen-Lebensmittel-Zusatzstoffe-wirken-schaden/dp/3426785617

Yao, C.K., Tan, H.L., Van Langenberg, D.R., Barrett, J.S., Rose, R., Liels, K., Gibson, P.R. and Muir, J.G., 2014. Dietary sorbitol and mannitol: food content and distinct absorption patterns between healthy individuals and patients with irritable bowel syndrome. Journal of human nutrition and dietetics, 27, pp.263-275. Online: https://onlinelibrary.wiley.com/doi/full/10.1111/jhn.12144

Livesey, G., 2003. Health potential of polyols as sugar replacers, with emphasis on low glycaemic properties. Nutrition Research Reviews, 16(2), pp.163-191. Online: https://www.cambridge.org/core/journals/nutrition-research-reviews/article/health-potential-of-polyols-as-sugar-replacers-with-emphasis-on-low-glycaemic-properties/51B0744C8573925A7A74FF2AD87429F9

Dr. med. André Sommer

Dr. med. André Sommer

I’m André, a medical doctor from Berlin. Together with a team of medical doctors, nutritionists and data scientists we empower people to understand digestive issues with our app Cara Care.

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