Evaluation of sucromalt digestion in healthy children using breath hydrogen as a biomarker of carbohydrate malabsorption

Abstract

The measurement of hydrogen in exhaled breath is widely accepted as a non-invasive yet efficient means to evaluate carbohydrate malabsorption. Hydrogen is not normally produced by mammalian cells and its appearance in breath indicates incomplete small intestinal carbohydrate absorption with subsequent breakdown of the carbohydrate by anaerobic bacteria in the colon. This study was undertaken to evaluate the absorption of a novel, slowly digestible carbohydrate sweetener, sucromalt. Two experiments occurred approximately 2 weeks apart with the participants randomly consuming one of two test foods on each visit. Following baseline breath hydrogen measurements, healthy 8–10 year-old children (n = 10) consumed a yogurt breakfast containing either 15 g of inulin (positive control) or 30 g of sucromalt. Every 15 min during the next 6 h, samples of exhaled breath were taken from each participant for hydrogen content analysis, thereby establishing 24 total data points. Participants' 6 h breath hydrogen responses were plotted against their baseline measurement and appropriate statistical evaluations were applied to the data. Following ingestion of inulin, breath hydrogen stayed near baseline for approximately 2 h but rose rapidly thereafter to a steady state of 20–30 ppm, which continued to the end of the study period. In contrast, exhaled hydrogen following sucromalt ingestion remained at or near baseline for the entire 6 h test period. A significantly higher level of hydrogen was exhaled with inulin ingestion compared to sucromalt (incremental area under the curve, p = 0.002). Results indicated complete absorption of sucromalt's saccharide constituents in children.