Acute and two-week effects of neotame, stevia rebaudioside M and sucrose-sweetened biscuits on postprandial appetite and endocrine response in adults with overweight/obesity-a randomised crossover trial from the SWEET consortium

BACKGROUND

Sweeteners and sweetness enhancers (S&SE) are used to replace energy yielding sugars and maintain sweet taste in a wide range of products, but controversy exists about their effects on appetite and endocrine responses in reduced or no added sugar solid foods. The aim of the current study was to evaluate the acute (1 day) and repeated (two-week daily) ingestive effects of 2 S&SE vs. sucrose formulations of biscuit with fruit filling on appetite and endocrine responses in adults with overweight and obesity.

METHODS

In a randomised crossover trial, 53 healthy adults (33 female, 20 male) with overweight/obesity in England and France consumed biscuits with fruit filling containing 1) sucrose, or reformulated with either 2) Stevia Rebaudioside M (StRebM) or 3) Neotame daily during three, two-week intervention periods with a two-week washout. The primary outcome was composite appetite score defined as [desire to eat + hunger + (100 - fullness) + prospective consumption]/4.

FINDINGS

Each formulation elicited a similar reduction in appetite sensations (3-h postprandial net iAUC). Postprandial insulin (2-h iAUC) was lower after Neotame (95% CI (0.093, 0.166); p < 0.001; d = -0.71) and StRebM (95% CI (0.133, 0.205); p < 0.001; d = -1.01) compared to sucrose, and glucose was lower after StRebM (95% CI (0.023, 0.171); p < 0.05; d = -0.39) but not after Neotame (95% CI (-0.007, 0.145); p = 0.074; d = -0.25) compared to sucrose. There were no differences between S&SE or sucrose formulations on ghrelin, glucagon-like peptide 1 or pancreatic polypeptide iAUCs. No clinically meaningful differences between acute vs. two-weeks of daily consumption were found.

INTERPRETATION

In conclusion, biscuits reformulated to replace sugar using StRebM or Neotame showed no differences in appetite or endocrine responses, acutely or after a two-week exposure, but can reduce postprandial insulin and glucose response in adults with overweight or obesity.

FUNDING

The present study was funded by the Horizon 2020 program: Sweeteners and sweetness enhancers: Impact on health, obesity, safety and sustainability (acronym: SWEET, grant no: 774293).

The effect of baby-led weaning and traditional complementary feeding trainings on baby development

PURPOSE

The aim of this study was to evaluate the risks of self-feeding, transition to early solid food and family meals, choking risk, anemia risk and obesity risk in 6-12-month-old infants who were introduced to complementary feeding using the traditional complementary feeding (TCF) and baby-led weaning (BLW) methods/training.

DESIGN AND METHODS

Mothers of infants who had not yet transitioned to complementary feeding were included in this randomized study. The mothers of 62 infants included in the study were randomized into the intervention groups as TCF and BLW, classified according to the number of children and education level. The research was carried out according to the CONSORT-2010 guidelines after randomization and was concluded with 52 infants and their mothers.

RESULTS

It was found in the study that self-feeding and transition to solid foods in infants fed with the BLW method was higher than the infants fed with the TCF method (p < 0.05). A significant increase was observed in the hemoglobin level of infants fed with the BLW method over time (p < 0.001).

CONCLUSIONS

It was concluded that the BLW method did not lead to risks of obesity, anemia and iron deficiency in transition to complementary feeding. Secondary results indicated that feeding with the BLW method promoted self-feeding and early transition to solid foods and did not lead to the risk of choking.

PRACTICE IMPLICATIONS

Complementary feeding with the BLW method can be safely used by both mothers, healthcare professionals and researchers.

TRIAL REGISTRATION

register.

CLINICALTRIALS

gov; Identifier: NCT05771324.

Enteral approaches in malabsorption

Enteral autonomy and freedom from parenteral nutrition dependency is the ultimate therapeutic goal in children with intestinal failure. This can be achieved following attainment of bowel adaptation in conditions such as short bowel syndrome. Enteral nutrition is a major therapeutic cornerstone in the management of children with intestinal failure. It promotes physiological development, bowel adaptation and enhances weaning from parenteral nutrition. The optimal method of delivery, type of nutrients, timing of initiation, promotion of feeds and transition to solid food in children with short bowel syndrome are debated. Lack of high quality human data hampers evidence based conclusions and impacts daily practices in the field. Clinical approaches and therapeutic decisions are regularly influenced by expert opinion and center practices. This review summarizes the physiological principles, medical evidence and practice recommendations on enteral nutrition approaches in short bowel syndrome and provides a practical framework for daily treatment of this unique group of patients. Oral and tube feeding, bolus and continuous feeding, type of nutrients, formulas, trace elements and solid food options are reviewed. Future collaborative multicenter, high quality clinical trials are needed to support enteral nutrition approaches in intestinal failure.