Sorbitol with fructose and gut symptoms in eating disorders
What it found
In women with eating disorders, a drink of fructose and sorbitol caused gut symptoms in more than half, but a glucose drink rarely did.
The same fructose-sorbitol drink caused symptoms in only one healthy woman.
What they found
Studies in people
Symptoms in patients
After the fructose-sorbitol drink, 15 of 26 eating disorder patients reported gut symptoms, compared with 1 of 20 healthy women.
Fructose-sorbitol vs glucose
Symptom scores were higher after fructose-sorbitol than after glucose at 2 and 3 hours. Fourteen patients had a symptom response to fructose-sorbitol, while only one responded to glucose.
Lower body weight
Patients with a BMI of 17.5 or less had higher total symptom scores than those with a BMI above 17.5. Symptom responses were also more common in patients with anorexia nervosa.
Breath hydrogen
Breath hydrogen responses did not differ between patients with and without a symptom response. There was no link between symptom scores and how well fructose-sorbitol was absorbed.
Psychological scores
There were no differences in psychological or quality-of-life scores between patients who did and did not have a symptom response.
Binge eating
Binge eating behaviour differed between patients with and without a symptom response.
What the authors conclude
- They conclude that fructose-sorbitol, but not glucose, provokes gut symptoms in eating disorder patients, especially those with low BMI.
- They say these findings are important for the dietary management of eating disorder patients.
- They advise that further research is needed to make more precise guidelines on fructose-sorbitol sensitivity and diet in these patients.
How it was done
The authors wanted to see whether fructose and sorbitol together might explain the frequent gut symptoms in people with eating disorders, since these patients often eat fruit and diet products containing them.
They gave 26 female eating disorder inpatients a glucose drink on one day and a fructose-sorbitol drink on the next, then tracked gut symptoms and breath hydrogen for 3 hours. They compared the fructose-sorbitol results with those of 20 healthy women.
What it can’t tell you
- This trial was small and only in women with eating disorders, so the results may not apply to other people.
- The study cannot show why fructose-sorbitol caused symptoms, only that it did.
- It does not show whether avoiding fructose and sorbitol would improve symptoms over time.
Who paid
- Authors work at
- University of Sydney, Australia
The paper
- Title
- Fructose-sorbitol ingestion provokes gastrointestinal symptoms in patients with eating disorders
- Type
- Clinical trial
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Friesen N, Hansen RD, Abraham SF, Kellow JE (2009). Fructose-sorbitol ingestion provokes gastrointestinal symptoms in patients with eating disorders. World journal of gastroenterology. doi:10.3748/wjg.15.5295Free full textPubMed 19908337DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error