Artificial sweetener as a historical window to culturally situated health

Consumption patterns of nonnutritive sweeteners among university students at a Caribbean institution

OBJECTIVE(S)

To determine whether there is an association between the consumption of nonnutritive sweeteners (NNS) and sex, as well as age. Also, to determine awareness of the health risks associated with the use of NNS.

METHODS

A cross-sectional study was conducted using a self-administered questionnaire. Descriptive statistics were used to compile the data collected. Data were presented using frequencies and percentages. A chi-squared tests were performed to test the association between NNS and gender/sex and age. The level of significance was set at the ≤ 0.05.

RESULTS

The majority of students [n = 108 (55.1%)] indicated that they have never used NNS. The NNS with the highest intake was sucralose. There were no significant associations between gender (p-value = 0.508) and age (p-value = 0.275) and use of NNS. For awareness of the association between NNS, weight gain, and cancer, 38.8% (n = 76) of the participants indicated that they were not aware that NNS are associated with weight gain. Less than half of the participants (n = 46, 23.5%) were not aware that NNS does cause cancer.

CONCLUSION

A large portion of university students do not use NNS. The majority of students were aware that NNS are associated with weight gain but did not link it to cancer development.

A head-to-head comparison review of biological and toxicological studies of isomaltulose, d-tagatose, and trehalose on glycemic control

Diabetes mellitus is the most common metabolic disorder contributing to significant morbidity and mortality in humans. Different preventive and therapeutic agents, as well as various pharmacological strategies or non-pharmacological tools, improve the glycemic profile of diabetic patients. Isomaltulose, d-tagatose, and trehalose are naturally occurring, low glycemic sugars that are not synthesized by humans but widely used in food industries. Various studies have shown that these carbohydrates can regulate glucose metabolism and provide support in maintaining glucose homeostasis in patients with diabetes, but also can improve insulin response, subsequently leading to better control of hyperglycemia. In this review, we discussed the anti-hyperglycemic effects of isomaltulose, D-tagatose, and trehalose, comparing their properties with other known sweeteners, and highlighting their importance for the development of the pharmaceutical and food industries.

The Western diet: a blind spot of eating disorder research?-a narrative review and recommendations for treatment and research

Over the last 50 years, in parallel with the obesity epidemic, the prevalence of eating disorders has increased and presentations have changed. In this narrative review, we consider recent research exploring the implications of changing patterns of food consumption on metabolic and neurobiological pathways, a hitherto neglected area in eating disorder research. One of the major changes over this time has been the introduction of ultra-processed (NOVA-4) foods, which are gradually replacing unprocessed and minimally processed foods. This has resulted in the increased intake of various sugars and food additives worldwide, which has important metabolic consequences: triggering insulin and glucose response, stimulating appetite, and affecting multiple endocrine and neurobiological pathways, as well as the microbiome. A paradigm shift is needed in the conceptual framework by which the vulnerability to, and maintenance of, different eating disorders may be understood, by integrating recent knowledge of the individual metabolic responses to modern highly processed foods into existing psychological models. This could stimulate research and improve treatment outcomes.

Sucralose and acesulfame as an indicator of domestic wastewater contamination in Wuhan surface water

Artificial sweeteners (ASs) are applied widely as sucrose substitutes in food, pharmaceuticals, and personal-care products, which results in their release into surface water. The occurrence of ASs in aquatic environments in China has rarely been reported. In this study, we determined the concentration of seven ASs in surface water and sediment samples from 16 lakes in Wuhan. The sum of the ASs concentration ranged from 0.89 to 20.6 μg/L in the surface water, with a mean value of 4.96 ± 5.16 μg/L. The most abundant AS was sucralose (SUC), with a concentration from 0.33 to 18.0 μg/L, followed by acesulfame (ACE) (0.40-2.78 μg/L), saccharin (SAC) (<MDL to 1.86 μg/L), and cyclamate (CYC) (<MDL to 2.22 μg/L). SUC and ACE accounted for 90% ± 8% of the total ASs in the surface water. The Σ₄ ASs sediment concentrations ranged from 1.71 to 6.49 ng/g of the dry weight (dw, mean value 3.03 ± 1.03 ng/g dw). SAC, CYC, and ACE were detected in sediments (<MDL to 4.17 ng/g dw), with SAC as the dominant AS. In surface water, the Σ₄ ASs concentrations of Hanyang station were higher than those of Hankou, while the Σ₄ ASs concentrations in sediment samples from different regions showed no significant difference. The ASs concentrations in the surface water and sediment in winter were significantly higher than those in summer. Relatively higher concentrations and detected frequencies of SUC and ACE were found in surface water samples, whereas these two ASs were absent in background samples, which indicates that SUC and ACE can be used as potential indicators of wastewater contamination in Wuhan, China.

Low intake of digestible carbohydrates ameliorates duodenal absorption of carbohydrates in mice with glucose metabolism disorders induced by artificial sweeteners

BACKGROUND

Long-term artificial sweetener consumption has been reported to induce glucose intolerance, and the intestinal microbiota seems as an important target. While the impacts of artificial sweeteners on energy balance remain controversial, this work aimed to evaluate the protective effects in mice of a low digestible carbohydrate (LDC) diet on plasma glucose, plasma fasting insulin, sweet taste receptors, glucose transporters, and absorption of carbohydrates, together with consumption of acesulfame potassium (AK) or saccharin (SAC).

RESULTS

Artificial sweetener was administered to mice for 12 weeks to induce glucose metabolism disorders; mice were treated with an LDC diet for the final 6 weeks. The experimental groups were treated with an LDC diet that had the same energy as the normal-diet group. Prolonged administration of artificial sweeteners led to metabolic dysfunction, characterized by significantly increased plasma glucose, insulin resistance, sweet taste receptors, glucose transporters, and absorption of carbohydrates. Treatment with an LDC diet positively modulated these altered parameters, suggesting overall beneficial effects of an LDC diet on detrimental changes associated with artificial sweeteners.

CONCLUSIONS

Reducing digestible carbohydrates in the diet can significantly reduce the absorption of carbohydrates and improve glucose metabolism disorders caused by dietary factors. These effects may be due to the fact that reducing the amount of digestible carbohydrates in the feed can reduce the number of intestinal sweet receptors induced by exposure to artificial sweeteners. © 2019 Society of Chemical Industry.

SWEET MAPS: A Conceptualization of Low-Calorie Sweetener Consumption Among Young Adults

BACKGROUND

The extent to which low-calorie sweeteners (LCSs) are helpful or harmful for weight management and metabolic health is unclear, because LCS effects may depend on the context in which they are consumed.

OBJECTIVE

To develop a conceptual framework for LCS consumption.

METHODS

Young adults ages 18-35 y, who reported LCS consumption, were recruited from a private, urban, university in the mid-Atlantic United States. Concept mapping, a mixed-method approach was used to identify, organize, and quantify determinants of LCS consumption. First, participants (n = 68) identified reasons for their LCS consumption through brainstorming; content analysis of those reasons identified 37 specific determinants of LCS consumption. Second, participants (n = 93) sorted all 37 determinants conceptually. Third, participants (n = 97) rated the extent to which each of the 37 determinants was reflective of their own consumption. Similarity matrices, multidimensional scaling, and hierarchical cluster analysis produced a series of 2-dimensional concept maps (SWEET MAPS).

RESULTS

The SWEET MAPS identified 37 determinants, organized within 8 factors reflective of 3 overarching motives: perceived health benefits, palatability, and accessibility of LCSs. At the determinant level, the most highly rated determinants that exceeded the boundary (rating >3.0) were: "I want something that tastes sweet," "I am trying to maintain/control my weight," "They contain fewer calories," "They are available," and "I want to save calories because I am eating a high-calorie meal."

CONCLUSIONS

LCS consumption is a function of many inter-related determinants spanning biological, psychological, and social domains. The SWEET MAPS are an important and novel use of concept mapping methods that can be used to inform the design and interpretation of future studies evaluating LCS effects.

Use of Table Sugar and Artificial Sweeteners in Brazil: National Dietary Survey 2008-2009

The study aimed to describe the use of table sugar and artificial sweeteners (AS) in Brazil. A representative sample (n = 32,749) of individuals aged > 10 years was examined from the Brazilian National Dietary Survey (2008–2009). Participants reported whether they use table sugar, AS, both, or none as sweeteners for their foods and beverages. Energy intake and the contribution of selected food groups to energy intake were evaluated according to the type of sweetener reported. Sample weights and design effects were considered in the analysis. The majority of the population (85.7%) used sugar to sweeten foods and beverages, 7.6% used AS, and 5.1% utilized both products. The use of AS was more frequent among the elderly (20%), women (10% versus 5.5%), overweight individuals (10% versus 6%), those who live in urban areas (8.5% versus 3%), and those who belong to the highest income quartile (14% versus 1.6%), compared with men, normal weight individuals, those who live in rural areas, and those who belong to the first income quartile, respectively. Overall, the mean daily energy intake of individuals using only sugar was approximately 16% higher than those who used AS exclusively. The contribution of staple foods to daily energy intake was higher in individuals who used sugar than those who used AS.

The impact of low and no-caloric sweeteners on glucose absorption, incretin secretion, and glucose tolerance

The consumption of non-nutritive, low, or no-calorie sweeteners (LCS) is increasing globally. Previously thought to be physiologically inert, there is a growing body of evidence that LCS not only provide a sweet taste but may also elicit metabolic effects in the gastrointestinal tract. This review provides a brief overview of the chemical and receptor-binding properties and effects on chemosensation of different LCS but focuses on the extent to which LCS stimulates glucose transport, incretin and insulin secretion, and effects on glucose tolerance. Aspartame and sucralose both bind to a similar region of the sweet receptor. For sucralose, the data are contradictory regarding effects on glucose tolerance in humans and may depend on the food or beverage matrix and the duration of administration, as suggested by longer term rodent studies. For aspartame, there are fewer data. On the other hand, acesulfame-potassium (Ace-K) and saccharin have similar binding characteristics to each other but, while Ace-K may increase incretin secretion and glucose responses in humans, there are no data on saccharin except in rats, which show impaired glucose tolerance after chronic administration. Additional research, particularly of the effects of chronic consumption, is needed to provide concrete evidence for beneficial or detrimental effects of LCS on blood glucose regulation in humans.

Inhibition of the gut enzyme intestinal alkaline phosphatase may explain how aspartame promotes glucose intolerance and obesity in mice

Diet soda consumption has not been associated with tangible weight loss. Aspartame (ASP) commonly substitutes sugar and one of its breakdown products is phenylalanine (PHE), a known inhibitor of intestinal alkaline phosphatase (IAP), a gut enzyme shown to prevent metabolic syndrome in mice. We hypothesized that ASP consumption might contribute to the development of metabolic syndrome based on PHE's inhibition of endogenous IAP. The design of the study was such that for the in vitro model, IAP was added to diet and regular soda, and IAP activity was measured. For the acute model, a closed bowel loop was created in mice. ASP or water was instilled into it and IAP activity was measured. For the chronic model, mice were fed chow or high-fat diet (HFD) with/without ASP in the drinking water for 18 weeks. The results were that for the in vitro study, IAP activity was lower (p < 0.05) in solutions containing ASP compared with controls. For the acute model, endogenous IAP activity was reduced by 50% in the ASP group compared with controls (0.2 ± 0.03 vs 0.4 ± 0.24) (p = 0.02). For the chronic model, mice in the HFD + ASP group gained more weight compared with the HFD + water group (48.1 ± 1.6 vs 42.4 ± 3.1, p = 0.0001). Significant difference in glucose intolerance between the HFD ± ASP groups (53 913 ± 4000.58 (mg·min)/dL vs 42 003.75 ± 5331.61 (mg·min)/dL, respectively, p = 0.02). Fasting glucose and serum tumor necrosis factor-alpha levels were significantly higher in the HFD + ASP group (1.23- and 0.87-fold increases, respectively, p = 0.006 and p = 0.01). In conclusion, endogenous IAP's protective effects in regard to the metabolic syndrome may be inhibited by PHE, a metabolite of ASP, perhaps explaining the lack of expected weight loss and metabolic improvements associated with diet drinks.

Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction

Objectives

To examine the prospective associations between consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice with type 2 diabetes before and after adjustment for adiposity, and to estimate the population attributable fraction for type 2 diabetes from consumption of sugar sweetened beverages in the United States and United Kingdom.

Design

Systematic review and meta-analysis.

Data sources and eligibility

PubMed, Embase, Ovid, and Web of Knowledge for prospective studies of adults without diabetes, published until February 2014. The population attributable fraction was estimated in national surveys in the USA, 2009–10 (n=4729 representing 189.1 million adults without diabetes) and the UK, 2008–12 (n=1932 representing 44.7 million).

Synthesis methods

Random effects meta-analysis and survey analysis for population attributable fraction associated with consumption of sugar sweetened beverages.

Results

Prespecified information was extracted from 17 cohorts (38 253 cases/10 126 754 person years). Higher consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, by 18% per one serving/day (95% confidence interval 9% to 28%, I² for heterogeneity=89%) and 13% (6% to 21%, I²=79%) before and after adjustment for adiposity; for artificially sweetened beverages, 25% (18% to 33%, I²=70%) and 8% (2% to 15%, I²=64%); and for fruit juice, 5% (−1% to 11%, I²=58%) and 7% (1% to 14%, I²=51%). Potential sources of heterogeneity or bias were not evident for sugar sweetened beverages. For artificially sweetened beverages, publication bias and residual confounding were indicated. For fruit juice the finding was non-significant in studies ascertaining type 2 diabetes objectively (P for heterogeneity=0.008). Under specified assumptions for population attributable fraction, of 20.9 million events of type 2 diabetes predicted to occur over 10 years in the USA (absolute event rate 11.0%), 1.8 million would be attributable to consumption of sugar sweetened beverages (population attributable fraction 8.7%, 95% confidence interval 3.9% to 12.9%); and of 2.6 million events in the UK (absolute event rate 5.8%), 79 000 would be attributable to consumption of sugar sweetened beverages (population attributable fraction 3.6%, 1.7% to 5.6%).

Conclusions

Habitual consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, independently of adiposity. Although artificially sweetened beverages and fruit juice also showd positive associations with incidence of type 2 diabetes, the findings were likely to involve bias. None the less, both artificially sweetened beverages and fruit juice were unlikely to be healthy alternatives to sugar sweetened beverages for the prevention of type 2 diabetes. Under assumption of causality, consumption of sugar sweetened beverages over years may be related to a substantial number of cases of new onset diabetes.

Trends in the consumption of low-calorie sweeteners

Low-calorie sweeteners (LCS) offer a palatable alternative to caloric sugars such as sucrose (table sugar) and high fructose corn syrup and are commonly found in soft drinks, sweetener packets, grains, snack foods, dairy products, hygiene products, and medications. Consumption of LCS has increased significantly in recent years and while this trend is expected to continue, controversy exists surrounding their use. The purpose of this article is to review trends in the consumption of LCS, to summarize differences in LCS consumption across socio-demographic subgroups and subtypes of LCS-containing products, and to highlight important challenges in the accurate assessment of LCS consumption.

Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction

OBJECTIVES

To examine the prospective associations between consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice with type 2 diabetes before and after adjustment for adiposity, and to estimate the population attributable fraction for type 2 diabetes from consumption of sugar sweetened beverages in the United States and United Kingdom.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES AND ELIGIBILITY

PubMed, Embase, Ovid, and Web of Knowledge for prospective studies of adults without diabetes, published until February 2014. The population attributable fraction was estimated in national surveys in the USA, 2009-10 (n = 4729 representing 189.1 million adults without diabetes) and the UK, 2008-12 (n = 1932 representing 44.7 million).

SYNTHESIS METHODS

Random effects meta-analysis and survey analysis for population attributable fraction associated with consumption of sugar sweetened beverages.

RESULTS

Prespecified information was extracted from 17 cohorts (38,253 cases/10,126,754 person years). Higher consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, by 18% per one serving/day (95% confidence interval 9% to 28%, I(2) for heterogeneity = 89%) and 13% (6% to 21%, I(2) = 79%) before and after adjustment for adiposity; for artificially sweetened beverages, 25% (18% to 33%, I(2) = 70%) and 8% (2% to 15%, I(2) = 64%); and for fruit juice, 5% (-1% to 11%, I(2) = 58%) and 7% (1% to 14%, I(2) = 51%). Potential sources of heterogeneity or bias were not evident for sugar sweetened beverages. For artificially sweetened beverages, publication bias and residual confounding were indicated. For fruit juice the finding was non-significant in studies ascertaining type 2 diabetes objectively (P for heterogeneity = 0.008). Under specified assumptions for population attributable fraction, of 20.9 million events of type 2 diabetes predicted to occur over 10 years in the USA (absolute event rate 11.0%), 1.8 million would be attributable to consumption of sugar sweetened beverages (population attributable fraction 8.7%, 95% confidence interval 3.9% to 12.9%); and of 2.6 million events in the UK (absolute event rate 5.8%), 79,000 would be attributable to consumption of sugar sweetened beverages (population attributable fraction 3.6%, 1.7% to 5.6%).

CONCLUSIONS

Habitual consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, independently of adiposity. Although artificially sweetened beverages and fruit juice also showed positive associations with incidence of type 2 diabetes, the findings were likely to involve bias. None the less, both artificially sweetened beverages and fruit juice were unlikely to be healthy alternatives to sugar sweetened beverages for the prevention of type 2 diabetes. Under assumption of causality, consumption of sugar sweetened beverages over years may be related to a substantial number of cases of new onset diabetes.

Artificial Sweetened Beverages and Pediatric Obesity: The Controversy Continues

The pediatric obesity epidemic has gathered public and political interest recently. People often choose “diet” or artificial sweetened beverages (ASB) to combat this epidemic, but the obesity incidence continues to rise. First, I review the pediatric studies on the effect of ASB consumption with subsequent food intake. Next, I present pediatric studies of chronic ASB consumption and weight change. Some epidemiologic pediatric studies have supported an association between artificial sweetener use and increased BMI but cannot prove causation. Randomized control trials have provided some evidence of weight loss with ASB ingestion among children, but study limitations may minimize these conclusions. Finally, I summarize the possible mechanisms that may drive potential effects of artificial sweeteners.

Influence of palatability on motivation to operate for caloric and non-caloric food in non food-deprived and food-deprived rats

Palatability is the hedonic food component that is considered to override the homeostatic mechanisms that control food intake, and we compared how much effort non food-deprived and food-deprived rats were willing to spend in order to earn a palatable caloric (sucrose) or non-caloric (saccharin) snack. We first studied the dopaminergic response, in terms of dopamine levels and dopamine and cAMP-regulated phosphoprotein Mr 32,000 (DARPP-32) phosphorylation pattern, to two consecutive palatable caloric or non-caloric snacks in the nucleus accumbens shell (NAcS) of non food-deprived and fasted rats. We report that non food-deprived rats developed rapid habituation in the NAcS dopaminergic response to the second consumption of both caloric and non-caloric palatable food, while food-deprived rats developed rapid habituation only to saccharin. Next, we show that in self-administration experiments, non food-deprived rats spent a similar effort when operating for sucrose or saccharin. However, the same rats showed an increased response specifically for sucrose after 18-h fasting. After pre-feeding devaluation, rats reduced their response to sucrose but not for saccharin. These results strengthen the hypothesis that food intake is mainly controlled by palatability in non food-deprived rats and by caloric content in food-deprived rats. Moreover, they show that rapid habituation development was associated with a similar, basal working activity aimed at ingesting both caloric and non-caloric food, as observed in non food-deprived rats consuming sucrose or saccharin and in fasted rats consuming saccharin. Conversely, lack of habituation, as present in fasted rats consuming a caloric food, was associated with extra energy expenditure.

SuperSweet--a resource on natural and artificial sweetening agents

A vast number of sweet tasting molecules are known, encompassing small compounds, carbohydrates, d-amino acids and large proteins. Carbohydrates play a particularly big role in human diet. The replacement of sugars in food with artificial sweeteners is common and is a general approach to prevent cavities, obesity and associated diseases such as diabetes and hyperlipidemia. Knowledge about the molecular basis of taste may reveal new strategies to overcome diet-induced diseases. In this context, the design of safe, low-calorie sweeteners is particularly important. Here, we provide a comprehensive collection of carbohydrates, artificial sweeteners and other sweet tasting agents like proteins and peptides. Additionally, structural information and properties such as number of calories, therapeutic annotations and a sweetness-index are stored in SuperSweet. Currently, the database consists of more than 8000 sweet molecules. Moreover, the database provides a modeled 3D structure of the sweet taste receptor and binding poses of the small sweet molecules. These binding poses provide hints for the design of new sweeteners. A user-friendly graphical interface allows similarity searching, visualization of docked sweeteners into the receptor etc. A sweetener classification tree and browsing features allow quick requests to be made to the database. The database is freely available at: http://bioinformatics.charite.de/sweet/.