Positive Results on Tests for Steatorrhea in Persons Consuming Olestra Potato Chips

Positive Results on Tests for Steatorrhea in Persons Consuming Olestra Potato Chips

From Baylor University Medical Center, Dallas, Texas.

Abstract

Background: Olestra is a nonabsorbable fat substitute that consists of fatty acids esterified to a sucrose molecule.

Objective: To determine the effect of olestra consumption on measurements of fecal fat excretion.

Design: Controlled cross-over trial.

Setting: Clinical research center and outpatient research laboratory.

Participants: 10 healthy volunteers.

Intervention: On days 1 to 6 of the study, participants consumed 5 oz of conventional potato chips per day; on days 7 to 12, they consumed 5 oz of potato chips containing 40 g of olestra per day.

Measurements: Quantitative measurement of fecal fat by the van de Kamer titration, van de Kamer gravimetric, and Jeejeebhoy gravimetric methods and qualitative assessment of fecal fat by Sudan III staining.

Results: Excellent correlation was seen among the three quantitative assays, but the van de Kamer titration method yielded lower measurements than the two gravimetric methods. When participants consumed 40 g of olestra per day, the excretion of fecal fat increased to levels observed in patients with steatorrhea caused by the malabsorption syndrome.

Conclusion: Consumption of olestra can cause false-positive results on tests for steatorrhea and may therefore lead to an erroneous diagnosis of the malabsorption syndrome.

Article and Author Information

Acknowledgments: The authors thank John W. McRorie, PhD, and Nora L. Zorich, MD, PhD, for providing stool samples from earlier studies sponsored by Proctor & Gamble. They also thank Diana Santa Ana for preparation of the manuscript.
Grant Support: By U.S. Public Health grant 5-RO1-DK37172-13 from the National Institute of Diabetes and Digestive and Kidney Diseases and by Southwest Digestive Disease Foundation.
Requests for Single Reprints: John S. Fordtran, MD, Baylor University Medical Center, 2nd Floor HOB, 3500 Gaston Avenue, Dallas, TX 75246.
Requests To Purchase Bulk Reprints (minimum, 100 copies): the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints{at}mail.acponline.org.
Current Author Addresses: Dr. Balasekaran, Mr. Porter, Ms. Santa Ana, and Dr. Fordtran: Baylor University Medical Center, 2nd Floor HOB, 3500 Gaston Avenue, Dallas, TX 75246.
Author Contributions: Conception and design: J.S. Fordtran.
Analysis and interpretation of the data: R. Balasekaran, C.A. Santa Ana, J.S. Fordtran.
Drafting of the article: R. Balasekaran.
Critical revision of the article for important intellectual content: R. Balasekaran, J.S. Fordtran.
Final approval of the article: J.S. Fordtran.
Provision of study materials or patients: J.L. Porter, C.A. Santa Ana.
Obtaining of funding: J.S. Fordtran.
Administrative, technical, or logistic support: J.L. Porter, C.A. Santa Ana.
Collection and assembly of data: J.L. Porter, C.A. Santa Ana.