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Lactitol (E966): Sugar Substitute and Laxative

Lactitol (E966) is a low-calorie sugar substitute derived from lactose, used in food production and medicine. It acts as a mild laxative and is suitable for people with diabetes.

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Things worth knowing about "Lactitol"

Lactitol (E966) is a low-calorie sugar substitute derived from lactose, used in food production and medicine. It acts as a mild laxative and is suitable for people with diabetes.

What is Lactitol?

Lactitol (food additive code E966) is a sugar alcohol (polyol) derived from lactose (milk sugar) through a process called catalytic hydrogenation. It is widely used both as a sweetener in the food industry and as an active pharmaceutical ingredient, primarily as a mild laxative.

Production and Chemical Properties

Lactitol is produced by the catalytic hydrogenation of lactose. It appears as a white, crystalline solid that is highly water-soluble. Its sweetness is approximately 30–40% of that of regular sucrose (table sugar), and it provides about 2 kcal per gram -- roughly half the caloric value of sugar.

Use in the Food Industry

Lactitol is used in a wide range of food products, including:

Sugar-free candies and chewing gum
Diabetic chocolate and baked goods
Reduced-sugar pastries and cookies
Ice cream and desserts

Because lactitol has a minimal effect on blood glucose levels and is not fermented by oral bacteria, it is particularly suitable for people with diabetes and for dental health. In the EU, products containing more than 10 g of lactitol per serving must carry the warning: excessive consumption may produce laxative effects.

Medical Use as a Laxative

In clinical medicine, lactitol is used as an osmotic laxative for the treatment of constipation. It is also used in the management of hepatic encephalopathy (a brain function disorder caused by liver failure), similar to its closely related compound lactulose.

Mechanism of Action

Lactitol is poorly absorbed in the small intestine and reaches the colon largely intact. There, it is fermented by the gut microbiota (intestinal bacteria). This process produces two main effects:

Osmotic effect: Lactitol draws water into the intestine, softening stool and increasing stool volume, which promotes bowel movements.
Prebiotic effect: Fermentation by colonic bacteria stimulates the growth of beneficial bacteria and lowers the pH of the colon, which may inhibit the growth of harmful bacteria.

Dosage

When used as a laxative, the typical adult dose is 10–20 g per day, divided into several doses. Dosing should always be discussed with a healthcare professional.

Side Effects and Tolerability

Lactitol is generally well tolerated. However, at higher doses, the following side effects may occur:

Flatulence and bloating
Abdominal cramps
Diarrhea (at doses above 20 g per day)

Individuals with lactose intolerance should note that lactitol is derived from lactose, although residual lactose content in the final product is typically very low. Consultation with a healthcare provider is recommended if in doubt.

Safety and Regulatory Status

Lactitol is approved as a food additive in the European Union under the code E966 and holds Generally Recognized as Safe (GRAS) status in the United States. The European Food Safety Authority (EFSA) has confirmed its safety for use in food.

References

European Food Safety Authority (EFSA): Scientific Opinion on the re-evaluation of lactitol (E 966) as a food additive. EFSA Journal, 2011.
Lacy BE, Mearin F, Chang L et al.: Bowel Disorders. Gastroenterology, 2016; 150(6):1393-1407.
World Health Organization (WHO) / FAO: Compendium of Food Additive Specifications - Lactitol. JECFA Monographs, 2006.

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