THE SORBITOL NAVIGATOR The Standard for Sorbitol Intolerance Stratbucker N. 1. Edition J. 2016 © Copyright The Nutrition Navigator Books Number Four M.SC. J. N. STRATBUCKER LAXIBA WILMINGTON AND KOBLENZ 1.3 Presentation of sorbitol e depict sorbitol as cube. Why? Just imagine having a big cube in your stomach. Not a good feeling. On the other hand, a cube can W have a positive effect, too. Think of a sugar cube that provides a lot of energy. Likewise, sorbitol, representin sugar-alcohols, provides you with en- ergy, if your stomach uses it in that way. 1.3.1 How symptoms emerge If you have an intolerance against sorbitol, your body only provides a few workers making sure your body uses the cube for energy. Few workers mean that if you eat too much of foods that contain sorbitol cubes, many remain un- used by your body and arrive at your large intestine. Now, two processes are responsible for the symptoms: osmosis and fermentation. To understand osmo- sis, let us imagine two equal fish bowls connected by an underwater tube. Stratbucker N. J. 2016 © Copyright The glass on the left represents the inside of the bowel and the one on the right for the outside of it. The fishes represent water (W), and their food are either nutrient (N) or sorbitol cubes that arrive at the inside of the bowel (S). The chan- nel enables fishes to switch between the bowls. Thus, they always swim to the 6 | THE SORBITOL NAVIGATOR glass that contains more food. Usually, this would be the outside of the intes- tine. Thereby, the body detracts the water from the foods—which is a good. Stratbucker N. J. 2016 © However, if you eat more of foods containing sorbitol than your enzyme work- ers can handle, sorbitol cubes arrive at the inside of the bowel. Hence, suddenly Copyright there is more food in the left fish bowl. THE SORBITOL NAVIGATOR | 7 Stratbucker As the intestinal wall, here represented by the channel, is only partially perme- able, the fishes can swim through it, unlike the food. Therefore, some fishes now N. J. switch sides and scrimmage on the left. Their movement to the left means that with the cubes water arrives inside the intestine and you suffer from diarrhea. 2016 © Copyright 8 | THE SORBITOL NAVIGATOR Now you know about osmosis. What causes fermentation? As you know, you have bacteria inside your bowel, which is normal and that way for any healthy person. The issue is that these bacteria love sweets. Hence, if a trigger cube arrives at the large intestine, they do not falter and immediately consume it to help themselves to some energy. Unfortunately, though, the bacteria are less efficient at consuming the sorbitol cubes than our body is. When bacteria use sorbitol cubes, gas emerges. Stratbucker N. J. 2016 © Copyright The gas either leaves as bloating or amounts and causes an uncomfortable flat- ulence. If the pressure increases in some regions of the intestines, this can cause deposits—constipation. If the gas enters the small intestine, it causes, even THE SORBITOL NAVIGATOR | 9 more, turmoil: it hinders some of the body’s cube workers from doing their job. That is because the workers mainly sit on the gut wall and the gas reduces its contact to the stool. However, what about the treatment with a diet? In general, it is important for your health to have a diverse diet. The FODMAP approach, which you may have heard of, aims at reducing the fermentation and osmosis by lowering the consumption of all potential triggers at once. With the sorbitol standard treatment of this book, you take a more precise aim to give you more freedom concerning your food choice. With it, you only avoid sorbitol, as de- scribed in the diagnosis check. First, you should get to know it, though. 1.3.2 Sorbitol characteristics Sorbitol is one of nine sugar-alcohols that causes symptoms in case of a sorbitol intolerance. As sorbitol is the most popular of the group, though, the label sor- bitol intolerance has enforced itself. To make the text more readable, sorbitol refers to all nine sugar-alcohols in this book. Some fruits and vegetables natu- rally contain sorbitol. Furthermore, sugar-alcohols are sweeteners and carriers Stratbucker for some medicines. Diabetic products like jelly contain up to 12g per portion N. and chocolate up to 40g per four pieces. Moreover, sorbitol is sometimes in- J. cluded in ice cream, juices, oral hygiene products, sauces, sugar-free chewing gum (up to 2.5 g/piece) and sugar-free mints (up to 2g/piece). As you can see, 2016 © using diabetic products you can easily top 20g of sorbitol per meal. In one study with 39 healthy participants, 84% of them had symptoms of a sorbitol intoler- ance after consuming a 20g dose. Consumption of these products thus deserves caution. Copyright 10 | THE SORBITOL NAVIGATOR Dairy products SORBITOL Stand. SORBITOL Low sensitivity amount Yogurt, chocolate or coffee Free Free of sorbitol. flavors, nonfat, aspartame Yogurt, chocolate or coffee Free Free of sorbitol. flavors, whole milk, sucralose Tbsp. (15g); 908g in to- Yogurt, fruited, whole milk Avoid 60½ tal. Stratbucker N. J. 2016 © Copyright 114 | THE SORBITOL NAVIGATOR Food Index A Amaranth Flakes Applesauce, Asparagus, raw 3 Musketeers® (Arrowhead canned, sweet- 152 122 Mills) 103 ened 147 Au gratin potato, 7 UP® 98 Amaretto 85 Applesauce, prepared from 9-grain Wheat American cheese canned, unsweet- fresh 136 bread 143 143 ened 147 Avocado, green After Eight® Thin American cheese, Apricot nectar 95 skin, Florida type Chocolate Mints processed 106 Apricot, dried, 152 122 Americano, de- cooked, sweet- Ale 85 caf, without fla- ened 147 B Alfalfa sprouts vored syrup 91 Apricot, dried, Baby food, Ger- 152 Americano, with uncooked 147 ber Graduates® All-Bran® Origi- flavored syrup 91 Apricot, fresh 147 Organic Pasta Stratbucker nal (Kellogg's®) Americano, with- Aquavit 85 Pick-Ups Three N. 103 out flavored Arby's® macaroni Cheese Ravioli J. Almond butter, syrup 91 and cheese 127 127 salted 106 Apple banana Arby's® orange Baby food, zwie- 2016 Almond butter, back 114 © strawberry juice juice 95 unsalted 106 95 Archway® Ginger bacon 143 Almond cookies Apple cake, Snaps 117 Bacon EGG® and 117 glazed 117 Archway® Oat- Cheese BK Muf- ® Copyright Almond milk, va- Apple grape juice meal Raisin fin 138 nilla or other fla- 95 Cookies 117 Baguette 101 vors, unsweet- Apple juice or ci- Archway® Peanut Baking powder ened 236 der, made from Butter Cookies 162 Almond paste frozen 85 117 Bamboo shoots, (Marzipan) 122 Apple juice or ci- Artichoke, globe canned and Almonds, honey der, unsweetened raw 152 drained 152 roasted 122 85 Arugula, raw 152 Banana, chips 147 Almonds, raw Apple strudel 117 Asian noodle Banana, fresh 147 114 Applejack liquor bowl, vegetables Barbecue sauce Alpine Lace 25% 85 only 127 138 Reduced Fat, Barley flour 162 Mozzarella 106 THE SORBITOL NAVIGATOR | 207 Basmati rice, Ben & Jerry's® Ice Black olives 152 Boysenberries, cooked in unsal- Cream, Half Black Russian 85 fresh 147 ted water 136 Baked 159 Blackberries, Brandy 85 BBQ roasted jala- Ben & Jerry's® Ice fresh 147 Bratwurst 132 peno sauce 138 Cream, Karamel Blackberry juice Bratwurst, beef Beef bacon (ko- Sutra® 159 95 132 sher) 132 Ben & Jerry's® Ice Bloody Mary 85 Bratwurst, light Beef steak, chuck, Cream, New BLT Salad® with (reduced fat) 132 visible fat eaten York Super TenderCrisp Bratwurst, made 132 Fudge Chunk® chicken (no with beer 132 Beef with noodles 159 dressing or crou- Bratwurst, made soup, condensed Ben & Jerry's® Ice tons) 138 with beer, cheese- 127 Cream, One Blue cheese 106 filled 132 Beer 85 Sweet Whirled Blueberries, fresh Bratwurst, turkey Beer, low alcohol 159 147 132 85 Ben & Jerry's® Ice Bockwurst 132 Braunschweiger Beer, low carb 85 Cream, Peanut Bok choy, raw 132 Stratbucker Beer, non alco- Butter Cup 159 152 Brazil nuts, uns- N. holic 85 Ben & Jerry's® Ice Bologna, beef alted 114 J. Beets, raw 152 Cream, Phish ring 106 Breath mint, reg- Ben & Jerry's® Ice Food® 159 Bologna, combi- ular 122 2016 ® Breath mint, © Cream, Brownie Ben & Jerry's Ice nation of meats, Batter 159 Cream, Vanilla light (reduced sugar free 122 ® Ben & Jerry's® Ice For A Change 159 fat) 106 Breyers Ice Cream, Chocolate Biscotti, choco- Boston Market® Cream, Natural Vanilla, Lactose Copyright Chip Cookie late, nuts 117 1/4 white rotis- Dough 159 BK Big Fish® 138 serie chicken, Free 159 ® Ben & Jerry's® Ice BK Fresh Apple with skin 132 Breyers Light! Cream, Chubby Slices 138 Boston Market® Boosts Immunity Hubby® 159 Black beans, macaroni and Yogurt, all fla- Ben & Jerry's® Ice cooked from cheese 127 vors 236 ® Cream, Chunky dried 152 Boston Market® Breyers No Monkey® 159 Black cherry juice roasted turkey Sugar Added Ice 95 breast 132 Cream, Vanilla Black currant Boston Market® 236 ® juice 95 sweet corn 136 Breyers Bourbon 85 YoCrunch Light Nonfat Yogurt, with granola 236 208 | THE SORBITOL NAVIGATOR Brie cheese 106 Cabot® Non Fat Cappuccino, de- Celeriac (celery Broccoli flower Yogurt, plain 236 caf, without fla- root), cooked (green cauliflo- Cabot® Non Fat vored syrup 91 from fresh 153 wer), cooked 152 Yogurt, vanilla Capri Sun®, all Celery, cooked Broccoli, raw 152 236 flavors 95 153 Brown mush- Caesar Salad (no Carambola (star- Chai tea 91 rooms (Italian or dressing or crou- fruit), fresh 147 Chalupas Su- Crimini, raw 152 tons) 138 Caramel or sugar preme® with beef, Brown sugar 122 Caesar salad coated popcorn, beans, cheese 145 Brownie, choco- dressing 140 store bought 114 Champagne late, fat free 117 Cafe au lait, with- Carrot cake, punch 86 Brussels sprouts, out flavored glazed, home- Champagne, cooked from syrup 91 made 117 white 86 fresh 152 Cafe latte, fla- Carrot juice 95 Chard, raw or Bulgur, home vored syrup 91 Carrots, cooked blanched, mari- cooked 136 Cafe latte, with- from fresh 153 nated in oil 153 Burgundy wine, out flavored Carrots, raw 153 Chardonnay 86 Stratbucker red 86 syrup 91 Cascadian Farm® Chayote squash, N.