How-to's of good health

In a recent issue of Lancet, I came across an interesting report about a flight attendant who went to a clinic complaining of persistent problems with diarrhea, which had been occurring for seven years. Other doctors had done many tests but had found no explanation other than that she had irritable bowel syndrome. The doctors at the clinic did another battery of tests and also found nothing wrong — until they took a detailed medical history from her. It turns out she was chewing 60 sticks of "sugar-free" gum containing a total of 75 grams of sorbitol every day. Sorbitol is a type of sugar that isn't digested, so it has no calories. But because it isn't absorbed, it gets carried out of the body with a lot of water — and that's what can cause diarrhea. In my book Modern Prevention I reported a similar case of a 47-year-old woman with a four-year history of gastrointestinal problems that others had attributed to a "nervous stomach." I would never have made the right diagnosis until she opened her purse and started sucking some mints. Five minutes later, she took two more. She told me she ate them all day. They, too, contained sorbitol. When she stopped using the mints, her diarrhea cleared up.

Sorbitol is one of those ingredients usually listed in fine print and present in many "sugar-free" products like chewing gum, candy, fruit juices, mints and canned fruit. Diabetics take it because it isn't absorbed like glucose. Doses of ten to 20 grams of sorbitol a day can cause gas, bloating, cramps and diarrhea. I checked the label on a well-known brand of mints and found that a single mint contained two grams! So eating even five or six mints a day could end up giving you problems.