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Zani F, Blagih J, Gruber T, Buck MD, Jones N, Hennequart M, Newell CL, Pilley SE, Soro-Barrio P, Kelly G, Legrave NM, Cheung EC, Gilmore IS, Gould AP, Garcia-Caceres C, Vousden KH. The dietary sweetener sucralose is a negative modulator of T cell-mediated responses. Nature 2023; 615:705-711. [PMID: 36922598 PMCID: PMC10033444 DOI: 10.1038/s41586-023-05801-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 02/06/2023] [Indexed: 03/17/2023]
Abstract
Artificial sweeteners are used as calorie-free sugar substitutes in many food products and their consumption has increased substantially over the past years1. Although generally regarded as safe, some concerns have been raised about the long-term safety of the consumption of certain sweeteners2-5. In this study, we show that the intake of high doses of sucralose in mice results in immunomodulatory effects by limiting T cell proliferation and T cell differentiation. Mechanistically, sucralose affects the membrane order of T cells, accompanied by a reduced efficiency of T cell receptor signalling and intracellular calcium mobilization. Mice given sucralose show decreased CD8+ T cell antigen-specific responses in subcutaneous cancer models and bacterial infection models, and reduced T cell function in models of T cell-mediated autoimmunity. Overall, these findings suggest that a high intake of sucralose can dampen T cell-mediated responses, an effect that could be used in therapy to mitigate T cell-dependent autoimmune disorders.
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Affiliation(s)
- Fabio Zani
- p53 and Metabolism Laboratory, The Francis Crick Institute, London, UK.
| | - Julianna Blagih
- p53 and Metabolism Laboratory, The Francis Crick Institute, London, UK.
- University of Montreal, Maisonneuve-Rosemont Hospital Research Centre, Montreal, Quebec, Canada.
| | - Tim Gruber
- Institute for Diabetes and Obesity, Helmholtz Diabetes Center, Helmholtz Zentrum München and German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Michael D Buck
- Immunobiology Laboratory, The Francis Crick Institute, London, UK
| | - Nicholas Jones
- Institute of Life Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Marc Hennequart
- p53 and Metabolism Laboratory, The Francis Crick Institute, London, UK
| | - Clare L Newell
- National Physical Laboratory, Teddington, UK
- Laboratory of Physiology and Metabolism, The Francis Crick Institute, London, UK
| | - Steven E Pilley
- p53 and Metabolism Laboratory, The Francis Crick Institute, London, UK
| | - Pablo Soro-Barrio
- Bioinformatics and Biostatistics Science Technology Platform, The Francis Crick Institute, London, UK
| | - Gavin Kelly
- Bioinformatics and Biostatistics Science Technology Platform, The Francis Crick Institute, London, UK
| | - Nathalie M Legrave
- Metabolomics Science Technology Platform, The Francis Crick Institute, London, UK
| | - Eric C Cheung
- p53 and Metabolism Laboratory, The Francis Crick Institute, London, UK
| | | | - Alex P Gould
- Laboratory of Physiology and Metabolism, The Francis Crick Institute, London, UK
| | - Cristina Garcia-Caceres
- Institute for Diabetes and Obesity, Helmholtz Diabetes Center, Helmholtz Zentrum München and German Center for Diabetes Research (DZD), Neuherberg, Germany
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Karen H Vousden
- p53 and Metabolism Laboratory, The Francis Crick Institute, London, UK.
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Sünram-Lea SI, Gentile-Rapinett G, Macé K, Rytz A. Assessment of Glycemic Response to Model Breakfasts Varying in Glycemic Index (GI) in 5-7-Year-Old School Children. Nutrients 2021; 13:nu13124246. [PMID: 34959798 PMCID: PMC8707352 DOI: 10.3390/nu13124246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/16/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
Reduced Glycemic Index (GI) of breakfast has been linked to improved cognitive performance in both children and adult populations across the morning. However, few studies have profiled the post-prandial glycemic response (PPGR) in younger children. The aim of this study was to assess PPGR to breakfast interventions differing in GI in healthy children aged 5-7 years. Eleven subjects completed an open-label, randomized, cross-over trial, receiving three equicaloric test beverages (260 kcal) consisting of 125 mL semi-skimmed milk and 50 g sugar (either glucose, sucrose, or isomaltulose). On a fourth occasion, the sucrose beverage was delivered as intermittent supply. PPGR was measured over 180 min using Continuous Glucose Monitoring (CGM). The incremental area under the curve (3h-iAUC) was highest for the glucose beverage, followed by intermittent sucrose (-21%, p = 0.288), sucrose (-27%, p = 0.139), and isomaltulose (-48%, p = 0.018). The isomaltulose beverage induced the smallest Cmax (7.8 mmol/L vs. >9.2 mmol/L for others) and the longest duration with moderate glucose level, between baseline value and 7.8 mmol/L (150 vs. <115 min for others). These results confirm that substituting mid-high GI sugars (e.g., sucrose and glucose) with low GI sugars (e.g., isomaltulose) during breakfast are a viable strategy for sustained energy release and glycemic response during the morning even in younger children.
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Affiliation(s)
- Sandra I. Sünram-Lea
- Department of Psychology, Lancaster University, Lancaster LA1 4YF, UK
- Correspondence:
| | | | - Katherine Macé
- Nestlé Research Center, 1000 Lausanne, Switzerland; (G.G.-R.); (K.M.); (A.R.)
| | - Andreas Rytz
- Nestlé Research Center, 1000 Lausanne, Switzerland; (G.G.-R.); (K.M.); (A.R.)
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Eckstein ML, Brockfeld A, Haupt S, Schierbauer JR, Zimmer RT, Wachsmuth N, Zunner B, Zimmermann P, Obermayer-Pietsch B, Moser O. Acute Metabolic Responses to Glucose and Fructose Supplementation in Healthy Individuals: A Double-Blind Randomized Crossover Placebo-Controlled Trial. Nutrients 2021; 13:nu13114095. [PMID: 34836350 PMCID: PMC8620063 DOI: 10.3390/nu13114095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/11/2021] [Accepted: 11/13/2021] [Indexed: 12/29/2022] Open
Abstract
The aim of this study was to investigate the impact of glucose (Glu), fructose (Fru), glucose and fructose (GluFru) and sucralose on blood glucose response in healthy individuals. Fifteen healthy individuals (five females, age of 25.4 ± 2.5 years, BMI of 23.7 ± 1.7 kg/m2 with a body mass (BM) of 76.3 ± 12.3 kg) participated in this double-blind randomized crossover placebo-controlled trial. Participants received a mixture of 300 mL of water with 1 g/kg BM of Glu, 1 g/kg BM of Fru, 0.5 g/kg BM of GluFru (each), and 0.2 g sucralose as a placebo. Peak BG values Glu were reached after 40 ± 13 min (peak BG: 141 ± 20 mg/dL), for Fru after 36 ± 22 min (peak BG: 98 ± 7 mg/dL), for GluFru after 29 ± 8 min (BG 128 ± 18 mg/dL), and sucralose after 34 ± 27 min (peak BG: 83 ± 5 mg/dL). Significant differences regarding the time until peak BG were found only between Glu and GluFru supplementation (p = 0.02). Peak blood glucose levels were significantly lower following the ingestion of Fru compared to the supplementation of Glu and GluFru (p < 0.0001) while Glu and GluFru supplementation showed no difference in peak values (p = 0.23). All conditions led to a significantly higher peak BG value compared to sucralose (p < 0.0001). Blood lactate increased in Glu (p = 0.002), Fru and GluFru (both p < 0.0001), whereas sucralose did not increase compared to the baseline (p = 0.051). Insulin levels were significantly higher in all conditions at peak compared to sucralose (p < 0.0001). The findings of this study prove the feasibility of combined carbohydrate supplementations for many applications in diabetic or healthy exercise cohorts.
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Affiliation(s)
- Max L. Eckstein
- Division of Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (M.L.E.); (A.B.); (S.H.); (J.R.S.); (R.T.Z.); (N.W.); (B.Z.); (P.Z.)
| | - Antonia Brockfeld
- Division of Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (M.L.E.); (A.B.); (S.H.); (J.R.S.); (R.T.Z.); (N.W.); (B.Z.); (P.Z.)
| | - Sandra Haupt
- Division of Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (M.L.E.); (A.B.); (S.H.); (J.R.S.); (R.T.Z.); (N.W.); (B.Z.); (P.Z.)
| | - Janis R. Schierbauer
- Division of Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (M.L.E.); (A.B.); (S.H.); (J.R.S.); (R.T.Z.); (N.W.); (B.Z.); (P.Z.)
| | - Rebecca T. Zimmer
- Division of Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (M.L.E.); (A.B.); (S.H.); (J.R.S.); (R.T.Z.); (N.W.); (B.Z.); (P.Z.)
| | - Nadine Wachsmuth
- Division of Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (M.L.E.); (A.B.); (S.H.); (J.R.S.); (R.T.Z.); (N.W.); (B.Z.); (P.Z.)
| | - Beate Zunner
- Division of Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (M.L.E.); (A.B.); (S.H.); (J.R.S.); (R.T.Z.); (N.W.); (B.Z.); (P.Z.)
| | - Paul Zimmermann
- Division of Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (M.L.E.); (A.B.); (S.H.); (J.R.S.); (R.T.Z.); (N.W.); (B.Z.); (P.Z.)
| | - Barbara Obermayer-Pietsch
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Endocrinology Lab Platform, Medical University of Graz, 8036 Graz, Austria;
| | - Othmar Moser
- Division of Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany; (M.L.E.); (A.B.); (S.H.); (J.R.S.); (R.T.Z.); (N.W.); (B.Z.); (P.Z.)
- Interdisciplinary Metabolic Medicine Trials Unit, Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria
- Correspondence: ; Tel.: +49-(0)921-55-3465
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Liu SL, Columbus MP, Peddle M, Mahon JL, Spaic T. Hypoglycemia requiring paramedic assistance among adults in southwestern Ontario, Canada: a population-based retrospective cohort study. CMAJ Open 2021; 9:E1260-E1268. [PMID: 34933884 PMCID: PMC8695532 DOI: 10.9778/cmajo.20200184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND People with diabetes mellitus commonly experience hypoglycemia, but they may not necessarily present to hospital after severe hypoglycemia requiring paramedic assistance. We sought to describe the incidence and characteristics of calls for hypoglycemia requiring paramedic assistance among adults in southwestern Ontario, Canada, and to determine predictors of hospital transport. METHODS This population-based retrospective cohort study used data extracted from ambulance call reports (ACRs) of 8 paramedic services of the Southwest Ontario Regional Base Hospital Program from January 2008 to June 2014. We described calls in which treatment for hypoglycemia was administered, summarized the incidence of hypoglycemia calls and performed logistic regression to determine predictors of hospital transport. RESULTS Out of 470 467 ACRs during the study period, 9185 paramedic calls occurred in which hypoglycemia treatment was administered to an adult (mean age 60.2 yr, 56.8% male, 81.1% with documented diabetes). Refusal of hospital transport occurred in 2243 (24.4%) of calls. Documented diabetes diagnosis (adjusted odds ratio [OR] 0.82, 95% confidence interval [CI] 0.69-0.96), higher capillary blood glucose (adjusted OR 0.31, 95% CI 0.22-0.44) and overnight calls (adjusted OR 0.80, 95% CI 0.72-0.91) were associated with lower odds of hospital transport. Higher-acuity calls (adjusted OR 2.05, 95% CI 1.58-2.66) were associated with higher odds of transport. The estimated annual incidence rate of hypoglycemia requiring paramedic assistance was 108 per 10 000 people with diabetes per year. INTERPRETATION Hypoglycemia requiring paramedic assistance in southwestern Ontario is common, and close to 25% of calls do not result in hospital transport. Physicians managing diabetes care may be unaware of patients' hypoglycemia requiring paramedic care, suggesting a potential gap in follow-up care; we suggest that paramedics play an important role in identifying those at high recurrence risk and communicating with their care providers.
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Affiliation(s)
- Selina L Liu
- Division of Endocrinology and Metabolism (Liu, Mahon, Spaic), Department of Medicine, Schulich School of Medicine & Dentistry, Western University; St. Joseph's Health Care London (Liu, Mahon, Spaic); Division of Emergency Medicine (Columbus, Peddle), Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ont.
| | - Melanie P Columbus
- Division of Endocrinology and Metabolism (Liu, Mahon, Spaic), Department of Medicine, Schulich School of Medicine & Dentistry, Western University; St. Joseph's Health Care London (Liu, Mahon, Spaic); Division of Emergency Medicine (Columbus, Peddle), Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ont
| | - Michael Peddle
- Division of Endocrinology and Metabolism (Liu, Mahon, Spaic), Department of Medicine, Schulich School of Medicine & Dentistry, Western University; St. Joseph's Health Care London (Liu, Mahon, Spaic); Division of Emergency Medicine (Columbus, Peddle), Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ont
| | - Jeffrey L Mahon
- Division of Endocrinology and Metabolism (Liu, Mahon, Spaic), Department of Medicine, Schulich School of Medicine & Dentistry, Western University; St. Joseph's Health Care London (Liu, Mahon, Spaic); Division of Emergency Medicine (Columbus, Peddle), Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ont
| | - Tamara Spaic
- Division of Endocrinology and Metabolism (Liu, Mahon, Spaic), Department of Medicine, Schulich School of Medicine & Dentistry, Western University; St. Joseph's Health Care London (Liu, Mahon, Spaic); Division of Emergency Medicine (Columbus, Peddle), Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ont
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5
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He J, Jiao X, Sun X, Huang Y, Xu P, Xue Y, Fu T, Liu J, Li Z. Short-Term High Fructose Intake Impairs Diurnal Oscillations in the Murine Cornea. Invest Ophthalmol Vis Sci 2021; 62:22. [PMID: 34415987 PMCID: PMC8383902 DOI: 10.1167/iovs.62.10.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/14/2021] [Indexed: 12/11/2022] Open
Abstract
Purpose Endogenous and exogenous stressors, including nutritional challenges, may alter circadian rhythms in the cornea. This study aimed to determine the effects of high fructose intake (HFI) on circadian homeostasis in murine cornea. Methods Corneas of male C57BL/6J mice subjected to 10 days of HFI (15% fructose in drinking water) were collected at 3-hour intervals over a 24-hour circadian cycle. Total extracted RNA was subjected to high-throughput RNA sequencing. Rhythmic transcriptional data were analyzed to determine the phase, rhythmicity, unique signature, metabolic pathways, and cell signaling pathways of transcripts with temporally coordinated expression. Corneas of HFI mice were collected for whole-mounted techniques after immunofluorescent staining to quantify mitotic cell number in the epithelium and trafficking of neutrophils and γδ-T cells to the limbal region over a circadian cycle. Results HFI significantly reprogrammed the circadian transcriptomic profiles of the normal cornea and reorganized unique temporal and clustering enrichment pathways, but did not affect core-clock machinery. HFI altered the distribution pattern and number of corneal epithelial mitotic cells and enhanced recruitment of neutrophils and γδ-T cell immune cells to the limbus across a circadian cycle. Cell cycle, immune function, metabolic processes, and neuronal-related transcription and associated pathways were altered in the corneas of HFI mice. Conclusions HFI significantly reprograms diurnal oscillations in the cornea based on temporal and spatial distributions of epithelial mitosis, immune cell trafficking, and cell signaling pathways. Our findings reveal novel molecular targets for treating pathologic alterations in the cornea after HFI.
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Affiliation(s)
- Jingxin He
- International Ocular Surface Research Center, Institute of Ophthalmology and Key Laboratory for Regenerative Medicine, Jinan University, Guangzhou, China
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xinwei Jiao
- Department of Pathophysiology, Jinan University Medical School, Guangzhou, China
| | - Xin Sun
- International Ocular Surface Research Center, Institute of Ophthalmology and Key Laboratory for Regenerative Medicine, Jinan University, Guangzhou, China
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yijia Huang
- International Ocular Surface Research Center, Institute of Ophthalmology and Key Laboratory for Regenerative Medicine, Jinan University, Guangzhou, China
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Pengyang Xu
- Department of Pathophysiology, Jinan University Medical School, Guangzhou, China
| | - Yunxia Xue
- International Ocular Surface Research Center, Institute of Ophthalmology and Key Laboratory for Regenerative Medicine, Jinan University, Guangzhou, China
| | - Ting Fu
- International Ocular Surface Research Center, Institute of Ophthalmology and Key Laboratory for Regenerative Medicine, Jinan University, Guangzhou, China
| | - Jun Liu
- International Ocular Surface Research Center, Institute of Ophthalmology and Key Laboratory for Regenerative Medicine, Jinan University, Guangzhou, China
| | - Zhijie Li
- International Ocular Surface Research Center, Institute of Ophthalmology and Key Laboratory for Regenerative Medicine, Jinan University, Guangzhou, China
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, China
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Ding X, Jing N, Shen A, Guo F, Song Y, Pan M, Ma X, Zhao L, Zhang H, Wu L, Qin G, Zhao Y. MiR-21-5p in macrophage-derived extracellular vesicles affects podocyte pyroptosis in diabetic nephropathy by regulating A20. J Endocrinol Invest 2021; 44:1175-1184. [PMID: 32930981 DOI: 10.1007/s40618-020-01401-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 08/19/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Podocyte pyroptosis, characterized by inflammasome activation, plays an important role in inflammation-mediated diabetic nephropathy (DN). Our study aimed to investigate whether miR-21-5p in macrophage-derived extracellular vesicles (EVs) could affect podocyte injury in DN. METHODS EVs were extracted after the treatment of RAW 264.7 (mouse macrophage line) with high glucose (HG). The podocyte pyroptosis was determined using the flow cytometry and the western blot. After the knockdown of miR-21-5p in HG-induced RAW264.7 cells, we injected the extracted EVs into DN model mice. RESULTS The level of miR-21-5p was higher in HG-stimulated macrophage-derived EVs than in normal glucose-cultured macrophage-derived EVs. The co-culture of EVs and podocytes promoted reactive oxygen species (ROS) production and activation of inflammatory in MPC5 cells (mouse podocyte line). However, restraint of miR-21-5p in EVs reduced ROS production and inhibit inflammasome activation in MPC5 cells, thereby reducing podocytes injury. Meanwhile, we found that miR-21-5p inhibited the A20 expression through binding with its 3'-untranslated regions in MPC5 cells. Further studies showed that A20 was also involved in the regulation of miR-21-5p of RAW 264.7-derived EVs on MPC5 injury. At the same time, it was also proved in the DN model mice that miR-21-5p in macrophage-derived EVs could regulate podocyte injury. CONCLUSION MiR-21-5p in macrophage-derived EVs can regulate pyroptosis-mediated podocyte injury by A20 in DN.
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Affiliation(s)
- X Ding
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, Henan, People's Republic of China
| | - N Jing
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, Henan, People's Republic of China
| | - A Shen
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, Henan, People's Republic of China
| | - F Guo
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, Henan, People's Republic of China
| | - Y Song
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, Henan, People's Republic of China
| | - M Pan
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, Henan, People's Republic of China
| | - X Ma
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, Henan, People's Republic of China
| | - L Zhao
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, Henan, People's Republic of China
| | - H Zhang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, Henan, People's Republic of China
| | - L Wu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, Henan, People's Republic of China
| | - G Qin
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, Henan, People's Republic of China
| | - Y Zhao
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, Henan, People's Republic of China.
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Abstract
BACKGROUND Neonatal hypoglycaemia is a common condition that can be associated with brain injury. Current practice usually includes early identification of at-risk infants (e.g. infants of diabetic mothers; preterm, small- or large-for-gestational-age infants), and prophylactic measures are advised. However, these measures usually involve use of formula milk or admission to the neonatal unit. Dextrose gel is non-invasive, inexpensive and effective for treatment of neonatal hypoglycaemia. Prophylactic dextrose gel can reduce the incidence of neonatal hypoglycaemia, thus potentially reducing separation of mother and baby and supporting breastfeeding, as well as preventing brain injury. This is an update of a previous Cochrane Review published in 2017. OBJECTIVES: To assess the effectiveness and safety of oral dextrose gel given to newborn infants at risk of hypoglycaemia in preventing hypoglycaemia and reducing long-term neurodevelopmental impairment. SEARCH METHODS We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2020, Issue 10) in the Cochrane Library; and Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Daily and Versions(R) on 19 October 2020. We also searched clinical trials databases and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs comparing oral dextrose gel versus placebo, no intervention, or other therapies for the prevention of neonatal hypoglycaemia. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risk of bias. We contacted investigators to obtain additional information. We used fixed-effect meta-analyses. We used the GRADE approach to assess the certainty of evidence. MAIN RESULTS We included two studies conducted in high-income countries comparing oral dextrose gel versus placebo in 2548 infants at risk of neonatal hypoglycaemia. Of these, one study was included in the previous version of this review. We judged these two studies to be at low risk of bias, and that the evidence for most outcomes was of moderate certainty. Meta-analysis of the two studies showed that oral dextrose gel reduces the risk of hypoglycaemia (risk ratio (RR) 0.87, 95% confidence interval (CI) 0.79 to 0.95; risk difference (RD) -0.06, 95% CI -0.10 to -0.02; 2548 infants; high certainty evidence). One study reported that oral dextrose gel probably reduces the risk of major neurological disability at two years' corrected age (RR 0.21, 95% CI 0.05 to 0.78; RD -0.05, 95% CI -0.09 to 0.00; 360 infants; moderate certainty evidence). Meta-analysis of the two studies showed that oral dextrose gel probably reduces the risk of receipt of treatment for hypoglycaemia during initial hospital stay (RR 0.89, 95% CI 0.79 to 1.00; 2548 infants; moderate certainty evidence) but makes little or no difference to the risk of receipt of intravenous treatment for hypoglycaemia (RR 1.01, 0.68 to 1.49; 2548 infants; moderate certainty evidence). Oral dextrose gel may have little or no effect on the risk of separation from the mother for treatment of hypoglycaemia (RR 1.12, 95% CI 0.81 to 1.55; two studies, 2548 infants; low certainty evidence). There is probably little or no difference in the risk of adverse events in infants who receive oral dextrose gel compared to placebo gel (RR 1.22, 95% CI 0.64 to 2.33; two studies, 2510 infants; moderate certainty evidence), but there are no studies comparing oral dextrose with other comparators such as no treatment, standard care or other therapies. No data were available on exclusive breastfeeding after discharge. AUTHORS' CONCLUSIONS Oral dextrose gel reduces the risk of neonatal hypoglycaemia in at-risk infants and probably reduces the risk of major neurological disability at two years of age or greater without increasing the risk of adverse events compared to placebo gel. Additional large follow-up studies at two years of age or older are required. Future research should also be undertaken in low- and middle-income countries, preterm infants, using other dextrose gel preparations, and using comparators other than placebo gel. There are three studies awaiting classification and one ongoing study which may alter the conclusions of the review when published.
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Affiliation(s)
- Taygen Edwards
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Gordon Liu
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Joanne E Hegarty
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Neonatal Intensive Care Unit, Auckland Hospital, Auckland, New Zealand
| | - Caroline A Crowther
- Liggins Institute, University of Auckland, Auckland, New Zealand
- ARCH: Australian Research Centre for Health of Women and Babies, Robinson Research Institute, Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, Australia
| | - Jane Alsweiler
- Neonatal Intensive Care Unit, Auckland Hospital, Auckland, New Zealand
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Jane E Harding
- Liggins Institute, University of Auckland, Auckland, New Zealand
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8
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Griffith R, Hegarty JE, Alsweiler JM, Gamble GD, May R, McKinlay CJD, Thompson B, Wouldes TA, Harding JE. Two-year outcomes after dextrose gel prophylaxis for neonatal hypoglycaemia. Arch Dis Child Fetal Neonatal Ed 2021; 106:278-285. [PMID: 33148686 PMCID: PMC8062278 DOI: 10.1136/archdischild-2020-320305] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To determine the effect of prophylactic dextrose gel for prevention of neonatal hypoglycaemia on neurodevelopment and executive function at 2 years' corrected age. DESIGN Prospective follow-up of a randomised trial. SETTING New Zealand. PATIENTS Participants from the pre-hypoglycaemia Prevention with Oral Dextrose (pre-hPOD) trial randomised to one of four dose regimes of buccal 40% dextrose gel or equivolume placebo. MAIN OUTCOME MEASURES Coprimary outcomes were neurosensory impairment and executive function. Secondary outcomes were components of the primary outcomes, neurology, anthropometry and health measures. RESULTS We assessed 360 of 401 eligible children (90%) at 2 years' corrected age. There were no differences between dextrose gel dose groups, single or multiple dose groups, or any dextrose and any placebo groups in the risk of neurosensory impairment or low executive function (any dextrose vs any placebo neurosensory impairment: relative risk (RR) 0.77, 95% CI 0.50 to 1.19, p=0.23; low executive function: RR 0.50, 95% CI 0.24 to 1.06, p=0.07). There were also no differences between groups in any secondary outcomes. There was no difference between children who did or did not develop neonatal hypoglycaemia in the risk of neurosensory impairment (RR 1.05, 95% CI 0.68 to 1.64, p=0.81) or low executive function (RR 0.73, 95% CI 0.34 to 1.59, p=0.43). CONCLUSION Prophylactic dextrose gel did not alter neurodevelopment or executive function and had no adverse effects to 2 years' corrected age, but this study was underpowered to detect potentially clinically important effects on neurosensory outcomes.
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Affiliation(s)
- Rebecca Griffith
- Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
| | | | - Jane M Alsweiler
- Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand
- Newborn Services, Auckland City Hospital, Auckland, New Zealand
| | - Greg D Gamble
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Robyn May
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Christopher Joel Dorman McKinlay
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Kids First Neonatal Care, Counties District Health Board, Auckland, New Zealand
| | - Benjamin Thompson
- Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
- Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | | | - Jane E Harding
- Liggins Institute, University of Auckland, Auckland, New Zealand
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9
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Agulló V, Domínguez-Perles R, García-Viguera C. Sweetener influences plasma concentration of flavonoids in humans after an acute intake of a new (poly)phenol-rich beverage. Nutr Metab Cardiovasc Dis 2021; 31:930-938. [PMID: 33546941 DOI: 10.1016/j.numecd.2020.11.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/22/2020] [Accepted: 11/16/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM The overconsumption of sucrose is closely related to sugar-sweetened beverages and one of the main factors associated with the increase of metabolic diseases, such as type 2 diabetes, obesity, and insulin resistance. So, the addition of alternative sweeteners to new fruit-based drinks could contribute to minimizing the incidence or severity of these pathologies. Nevertheless, current knowledge on the influence of these additives on the bioactive compounds present in these beverages is still scarce.new-onset hypertension, but few data were published in Asian. We aimed to investigate the association of lipid profiles with new-onset hypertension in a Chinese community-based non-hypertensive cohort without lipid-lowering treatment (n = 1802). METHODS AND RESULTS Hence, to contribute to the understanding of this issue, the plasma concentration of phenolic compounds (anthocyanins and flavanones), after the ingestion of a new maqui-citrus-based beverage, supplemented with sucrose (natural high caloric), stevia (natural non-caloric), or sucralose (artificial non-caloric), was evaluated as evidence of their intestinal absorption and metabolism previous to renal excretion. The beverages were ingested by volunteers (n = 20) and the resulting phenolic metabolites in plasma were analyzed by UHPLC-ESI-MS/MS. A total of 13 metabolites were detected: caffeic acid sulfate, caffeic acid glucuronide, 3,4-dihydroxyfenylacetic, 3,4-dihydroxyfenylacetic sulfate. 3,4-dihydroxyfenylacetic acid di-sulfate, 3,4-dihydroxyfenylacetic di-glucuronide, 3,4-dihydroxyfenylacetic glucuronide-sulfate, trans-ferulic acid glucuronide, naringenin glucuronide, vanillic acid, vanillic acid sulfate, vanillic acid glucuronide-sulfate, and vanillic acid di-glucuronide, being recorded their maximum concentration after 30-60 min. CONCLUSION In general, sucralose provided the greatest absorption value for most of these metabolites, followed by stevia. Due to this, the present study proposes sucralose and stevia (non-caloric sweeteners) as valuable alternatives to sucrose (high caloric sweetener), to avoid the augmented risk of several metabolic disorders.
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Affiliation(s)
- Vicente Agulló
- Phytochemistry and Healthy Foods Lab., Group of Quality, Safety, and Bioactivity of Plant Foods, Department of Food Science and Technology, CEBAS-CSIC, University Campus of Espinardo, Edif. 25, E-30100, Murcia, Spain
| | - Raúl Domínguez-Perles
- Phytochemistry and Healthy Foods Lab., Group of Quality, Safety, and Bioactivity of Plant Foods, Department of Food Science and Technology, CEBAS-CSIC, University Campus of Espinardo, Edif. 25, E-30100, Murcia, Spain.
| | - Cristina García-Viguera
- Phytochemistry and Healthy Foods Lab., Group of Quality, Safety, and Bioactivity of Plant Foods, Department of Food Science and Technology, CEBAS-CSIC, University Campus of Espinardo, Edif. 25, E-30100, Murcia, Spain
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10
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Abstract
Medium-chain acyl-coenzyme A dehydrogenase deficiency (MCADD) is a fatty acid oxidation disorder in which the patient is unable to break down fats to produce energy. This disorder places children at risk for metabolic decompensation during periods of stress, such as routine childhood illnesses. The intent of this clinical report is to provide pediatricians with additional information regarding the acute clinical care of patients with MCADD. Although each patient with MCADD will still be expected to have a primary metabolic physician, the involvement of the primary care provider is crucial as well. Appropriate treatment of children with MCADD can lead to avoidance of morbidity and mortality.
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Affiliation(s)
- Tracy L McGregor
- Division of Medical Genetics and Genomic Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Susan A Berry
- Division of Genetics and Metabolism, University of Minnesota, Twin Cities, Minneapolis, Minnesota
| | - Katrina M Dipple
- Division of Genetic Medicine, University of Washington, Seattle, Washington; and
| | - Rizwan Hamid
- Division of Medical Genetics and Genomic Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
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11
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Saraiva A, Carrascosa C, Raheem D, Ramos F, Raposo A. Maltitol: Analytical Determination Methods, Applications in the Food Industry, Metabolism and Health Impacts. Int J Environ Res Public Health 2020; 17:E5227. [PMID: 32698373 PMCID: PMC7400077 DOI: 10.3390/ijerph17145227] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/08/2020] [Accepted: 07/14/2020] [Indexed: 02/07/2023]
Abstract
Bulk sweetener maltitol belongs to the polyols family and there have been several dietary applications in the past few years, during which the food industry has used it in many food products: bakery and dairy products, chocolate, sweets. This review paper addresses and discusses in detail the most relevant aspects concerning the analytical methods employed to determine maltitol's food safety and industry applications, its metabolism and its impacts on human health. According to our main research outcome, we can assume that maltitol at lower doses poses little risk to humans and is a good alternative to using sucrose. However, it causes diarrhoea and foetus complications at high doses. Regarding its determination, high-performance liquid chromatography proved the primary method in various food matrices. The future role of maltitol in the food industry is likely to become more relevant as processors seek alternative sweeteners in product formulation without compromising health.
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Affiliation(s)
- Ariana Saraiva
- Department of Animal Pathology and Production, Bromatology and Food Technology, Faculty of Veterinary, Universidad de Las Palmas de Gran Canaria, Trasmontaña s/n, 35413 Arucas, Spain
| | - Conrado Carrascosa
- Department of Animal Pathology and Production, Bromatology and Food Technology, Faculty of Veterinary, Universidad de Las Palmas de Gran Canaria, Trasmontaña s/n, 35413 Arucas, Spain
| | - Dele Raheem
- Northern Institute for Environmental and Minority Law (NIEM), Arctic Centre, University of Lapland, 96101 Rovaniemi, Lapland, Finland
| | - Fernando Ramos
- Pharmacy Faculty, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
- REQUIMTE/LAQV, University of Oporto, 4051-401 Porto, Portugal
| | - António Raposo
- Department for Management of Science and Technology Development, Ton Duc Thang University, Ho Chi Minh City, Vietnam
- Faculty of Environment and Labour Safety, Ton Duc Thang University, Ho Chi Minh City, Vietnam
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12
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Bi GH, Galaj E, He Y, Xi ZX. Cannabidiol inhibits sucrose self-administration by CB1 and CB2 receptor mechanisms in rodents. Addict Biol 2020; 25:e12783. [PMID: 31215752 PMCID: PMC6920611 DOI: 10.1111/adb.12783] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 04/03/2019] [Accepted: 05/03/2019] [Indexed: 12/14/2022]
Abstract
A growing number of studies suggest therapeutic applications of cannabidiol (CBD), a recently U.S. Food and Drug Administration (FDA)-approved medication for epilepsy, in treatment of many other neuropsychological disorders. However, pharmacological action and the mechanisms by which CBD exerts its effects are not fully understood. Here, we examined the effects of CBD on oral sucrose self-administration in rodents and explored the receptor mechanisms underlying CBD-induced behavioral effects using pharmacological and transgenic approaches. Systemic administration of CBD (10, 20, and 40 mg/kg, ip) produced a dose-dependent reduction in sucrose self-administration in rats and in wild-type (WT) and CB1-/- mice but not in CB2-/- mice. CBD appeared to be more efficacious in CB1-/- mice than in WT mice. Similarly, pretreatment with AM251, a CB1R antagonist, potentiated, while AM630, a selective CB2R antagonist, blocked CBD-induced reduction in sucrose self-administration, suggesting the involvement of CB1 and CB2 receptors. Furthermore, systemic administration of JWH133, a selective CB2R agonist, also produced a dose-dependent reduction in sucrose self-administration in WT and CB1-/- mice, but not in CB2-/- mice. Pretreatment with AM251 enhanced, while AM630 blocked JWH133-induced reduction in sucrose self-administration in WT mice, suggesting that CBD inhibits sucrose self-administration likely by CB1 receptor antagonism and CB2 receptor agonism. Taken together, the present findings suggest that CBD may have therapeutic potential in reducing binge eating and the development of obesity.
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MESH Headings
- Animals
- Behavior, Animal/drug effects
- Cannabidiol/pharmacology
- Cannabinoid Receptor Agonists/pharmacology
- Cannabinoid Receptor Antagonists/pharmacology
- Cannabinoids/pharmacology
- Feeding Behavior/drug effects
- Indoles/pharmacology
- Mice
- Mice, Knockout
- Piperidines/pharmacology
- Pyrazoles/pharmacology
- Rats
- Receptor, Cannabinoid, CB1/antagonists & inhibitors
- Receptor, Cannabinoid, CB1/genetics
- Receptor, Cannabinoid, CB1/metabolism
- Receptor, Cannabinoid, CB2/antagonists & inhibitors
- Receptor, Cannabinoid, CB2/genetics
- Receptor, Cannabinoid, CB2/metabolism
- Self Administration
- Sucrose/administration & dosage
- Sweetening Agents/administration & dosage
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Affiliation(s)
- Guo-Hua Bi
- Addiction Biology Unit, Molecular Targets and Medication Discoveries Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, Maryland
| | - Ewa Galaj
- Addiction Biology Unit, Molecular Targets and Medication Discoveries Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, Maryland
| | - Yi He
- Addiction Biology Unit, Molecular Targets and Medication Discoveries Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, Maryland
| | - Zheng-Xiong Xi
- Addiction Biology Unit, Molecular Targets and Medication Discoveries Branch, Intramural Research Program, National Institute on Drug Abuse, Baltimore, Maryland
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13
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Elshafei M, Danjuma MI, Tahir RE. Therapeutic challenges in the management of osmotic demyelination syndrome: A case report of a favorable outcome from a tertiary center. Medicine (Baltimore) 2020; 99:e20283. [PMID: 32541452 PMCID: PMC7302644 DOI: 10.1097/md.0000000000020283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 03/23/2020] [Accepted: 04/14/2020] [Indexed: 11/26/2022] Open
Abstract
RATIONALE There is an increasing and compelling need for early recognition of features of osmotic demyelination syndrome (ODS), and a further attempt at correcting this even where presentation is late. PATIENT CONCERNS A 49-year-old male admitted into the emergency department with a complaint of lethargy and severe hyponatremia, with subsequent ODS supervening on initial attempts at correction. DIAGNOSIS Rapid rise in serum sodium concentration (121 mmol/L in 8 hours from a nadir of 101 mmol/L), concomitant deterioration in patient's conscious level support the diagnosis of ODS. INTERVENTION Concomitant administration of 5% dextrose water with desmopressin with a therapeutic objective of gradual relowering of serum sodium concentration. OUTCOMES Significant improvement in patients' conscious level and motor function with the commencement of sodium relowering therapy. The patient was eventually discharged home. LESSONS Regardless of the temporal profile of neurologic sequelae following ODS due to hyponatremia, its worthwhile attempting initial sodium relowering with dextrose 5% and desmopressin and then monitoring of biochemical and neurologic markers.
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Affiliation(s)
| | - Mohammed I. Danjuma
- Hamad Medical Corporation (Hamad General Hospital)
- Weill Cornell Medicine, Doha Qatar
| | - Rania El Tahir
- Hamad Medical Corporation (Hamad General Hospital)
- Weill Cornell Medicine, Doha Qatar
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14
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Qin P, Li Q, Zhao Y, Chen Q, Sun X, Liu Y, Li H, Wang T, Chen X, Zhou Q, Guo C, Zhang D, Tian G, Liu D, Qie R, Han M, Huang S, Wu X, Li Y, Feng Y, Yang X, Hu F, Hu D, Zhang M. Sugar and artificially sweetened beverages and risk of obesity, type 2 diabetes mellitus, hypertension, and all-cause mortality: a dose-response meta-analysis of prospective cohort studies. Eur J Epidemiol 2020; 35:655-671. [PMID: 32529512 DOI: 10.1007/s10654-020-00655-y] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 06/06/2020] [Indexed: 12/20/2022]
Abstract
Although consumption of sugar-sweetened beverages (SSBs) and artificially sweetened beverages (ASBs) has increasingly been linked with obesity, type 2 diabetes mellitus, hypertension, and all-cause mortality, evidence remains conflicted and dose-response meta-analyses of the associations are lacking. We conducted an updated meta-analysis to synthesize the knowledge about their associations and to explore their dose-response relations. We comprehensively searched PubMed, EMBASE, Web of Science, and Open Grey up to September 2019 for prospective cohort studies investigating the associations in adults. Summary relative risks (RRs) and 95% confidence intervals (CIs) were estimated for the dose-response association. Restricted cubic splines were used to evaluate linear/non-linear relations. We included 39 articles in the meta-analysis. For each 250-mL/d increase in SSB and ASB intake, the risk increased by 12% (RR = 1.12, 95% CI 1.05-1.19, I2 = 67.7%) and 21% (RR = 1.21, 95% CI 1.09-1.35, I2 = 47.2%) for obesity, 19% (RR = 1.19, 95% CI 1.13-1.25, I2 = 82.4%) and 15% (RR = 1.15, 95% CI 1.05-1.26, I2 = 92.6%) for T2DM, 10% (RR = 1.10, 95% CI 1.06-1.14, I2 = 58.4%) and 8% (RR = 1.08, 95% CI 1.06-1.10, I2 = 24.3%) for hypertension, and 4% (RR = 1.04, 95% CI 1.01-1.07, I2 = 58.0%) and 6% (RR = 1.06, 95% CI 1.02-1.10, I2 = 80.8%) for all-cause mortality. For SSBs, restricted cubic splines showed linear associations with risk of obesity (Pnon-linearity = 0.359), T2DM (Pnon-linearity = 0.706), hypertension (Pnon-linearity = 0.510) and all-cause mortality (Pnon-linearity = 0.259). For ASBs, we found linear associations with risk of obesity (Pnon-linearity = 0.299) and T2DM (Pnon-linearity = 0.847) and non-linear associations with hypertension (Pnon-linearity = 0.019) and all-cause mortality (Pnon-linearity = 0.048). Increased consumption of SSBs and ASBs is associated with risk of obesity, T2DM, hypertension, and all-cause mortality. However, the results should be interpreted cautiously because the present analyses were based on only cohort but not intervention studies.
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Affiliation(s)
- Pei Qin
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No. 1066 Xueyuan Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China
| | - Quanman Li
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No. 1066 Xueyuan Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, People's Republic of China
| | - Qing Chen
- Department of Mental Health, Bao'an Chronic Diseases Prevent and Cure Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Xizhuo Sun
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Yu Liu
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Honghui Li
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Tieqiang Wang
- Key Lab of Epidemiology, Department of Infectious Disease Control and Prevention, Shenzhen Guangming District Center for Disease Control and Prevention, Shenzhen, Guangdong, People's Republic of China
| | - Xiaoliang Chen
- Key Lab of Epidemiology, Department of Infectious Disease Control and Prevention, Shenzhen Guangming District Center for Disease Control and Prevention, Shenzhen, Guangdong, People's Republic of China
| | - Qionggui Zhou
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No. 1066 Xueyuan Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China
| | - Chunmei Guo
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Dongdong Zhang
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Gang Tian
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Dechen Liu
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Ranran Qie
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Minghui Han
- Department of Mental Health, Bao'an Chronic Diseases Prevent and Cure Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Shengbing Huang
- Department of Mental Health, Bao'an Chronic Diseases Prevent and Cure Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Xiaoyan Wu
- Department of Mental Health, Bao'an Chronic Diseases Prevent and Cure Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Yang Li
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No. 1066 Xueyuan Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China
| | - Yifei Feng
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Xingjin Yang
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No. 1066 Xueyuan Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Dongsheng Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No. 1066 Xueyuan Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China
- The Affiliated Luohu Hospital of Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, People's Republic of China
| | - Ming Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No. 1066 Xueyuan Avenue, Nanshan District, Shenzhen, 518060, Guangdong, People's Republic of China.
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15
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Lee MK, Baek JH, Chung SR, Choi YJ, Lee YM, Kim TY, Lee JH. Effectiveness of Injecting Cold 5% Dextrose into Patients with Nerve Damage Symptoms during Thyroid Radiofrequency Ablation. Endocrinol Metab (Seoul) 2020; 35:407-415. [PMID: 32615725 PMCID: PMC7386103 DOI: 10.3803/enm.2020.35.2.407] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 05/13/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Although radiofrequency ablation (RFA) is a safe treatment for thyroid tumors, nerve damage is a frequent complication. A previous retrospective study suggested that an injection of cold 5% dextrose in water (5% DW) can reduce nerve damage during RFA. This study validated the efficacy of injecting cold 5% DW for management of nerve damage during RFA. METHODS Between November 2017 and December 2018, 242 patients underwent 291 RFA sessions for treatment of benign thyroid nodules or recurrent thyroid cancers. Using a standardized technique, cold (0°C to 4°C) 5% DW was immediately injected around the damaged nerve into patients with any symptoms suggesting nerve damage. The incidence of nerve damage, the volume of 5% DW injected, symptom recovery time and the incidence of permanent nerve damage were evaluated. RESULTS Nineteen patients experienced nerve damage symptoms related to 21 RFA sessions, including 17 patients during 19 sessions and two patients on the day after two sessions. Patients with nerve damage symptoms detected during RFA were treated by injection of a mean 41 mL (range, 3 to 260) cold 5% DW, but the two patients who experienced symptoms the next day did not receive cold 5% DW injections. Immediate recovery was observed after 15 RFA sessions in 14 patients. No patient experienced permanent nerve damage. CONCLUSION Injection of cold 5% DW is effective in managing nerve damage during RFA of thyroid lesions.
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Affiliation(s)
- Min Kyoung Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
- Department of Radiology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul,
Korea
| | - Jung Hwan Baek
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Sae Rom Chung
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Young Jun Choi
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Yu-Mi Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Tae Yong Kim
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
| | - Jeong Hyun Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
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16
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Nezami BT, Lytle LA, Ward DS, Ennett ST, Tate DF. Effect of the Smart Moms intervention on targeted mediators of change in child sugar-sweetened beverage intake. Public Health 2020; 182:193-198. [PMID: 32375100 DOI: 10.1016/j.puhe.2020.03.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/03/2020] [Accepted: 03/22/2020] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Few parent-targeted interventions have examined the mechanisms of action by which the intervention changes child behavior. The purpose of this study was to test the theoretical and behavioral mediators of the Smart Moms intervention on changes in child sugar-sweetened beverage and juice (SSB/juice) consumption. STUDY DESIGN This is a secondary mediation analysis of data from a 6-month randomized controlled trial (N = 51 mother-child dyads) of a mobile phone-based program to reduce child SSB/juice intake compared with a waitlist control group. METHODS Linear mixed models compared changes in intervention targets from baseline to 3 months between treatment groups. Intervention targets that changed significantly between groups were tested in a multiple mediation model to evaluate their significance as mediators of change in child SSB/juice at 6 months. RESULTS Maternal beverage consumption but no other behavioral or theoretical intervention targets mediated the effect of the intervention on the reduction in child SSB/juice at 6 months. There were few mediators of the intervention on child SSB/juice change. CONCLUSION Greater longitudinal research is needed to understand predictors of child dietary changes to inform future intervention efforts. In addition, a greater focus on the measurement of theoretical constructs in family-based child obesity prevention research is needed.
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Affiliation(s)
- B T Nezami
- Department of Nutrition, University of North Carolina at Chapel Hill, 245 Rosenau Hall, CB #7461, Chapel Hill, NC 27599, USA.
| | - L A Lytle
- Department of Nutrition, University of North Carolina at Chapel Hill, 245 Rosenau Hall, CB #7461, Chapel Hill, NC 27599, USA; Department of Health Behavior, University of North Carolina at Chapel Hill, 302 Rosenau Hall, CB #7440, Chapel Hill, NC 27599, USA.
| | - D S Ward
- Department of Nutrition, University of North Carolina at Chapel Hill, 245 Rosenau Hall, CB #7461, Chapel Hill, NC 27599, USA.
| | - S T Ennett
- Department of Health Behavior, University of North Carolina at Chapel Hill, 302 Rosenau Hall, CB #7440, Chapel Hill, NC 27599, USA.
| | - D F Tate
- Department of Nutrition, University of North Carolina at Chapel Hill, 245 Rosenau Hall, CB #7461, Chapel Hill, NC 27599, USA; Department of Health Behavior, University of North Carolina at Chapel Hill, 302 Rosenau Hall, CB #7440, Chapel Hill, NC 27599, USA.
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Risdon S, Meyer G, Marziou A, Riva C, Roustit M, Walther G. Artificial sweeteners impair endothelial vascular reactivity: Preliminary results in rodents. Nutr Metab Cardiovasc Dis 2020; 30:843-846. [PMID: 32278610 DOI: 10.1016/j.numecd.2020.01.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 01/24/2020] [Accepted: 01/27/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND AIMS Prospective epidemiological studies highlighted recently the link between artificial sweeteners (AS) consumption and the risk of developing cardiometabolic diseases. However, underlying mechanisms remain unknown. Thus, the aim of this preliminary study was to characterize, in a healthy rat population, the effect of chronic AS consumption on body composition and vascular function, an early marker for cardiovascular disease. METHODS AND RESULTS Healthy Wistar rats followed a 10-week standard diet including the consumption of water sweetened or not with a sucralose/acesulfame potassium solution at different concentrations: for moderate consumption at 1 and 2 mg.kg-1.day-1, respectively or high intake at 15 and 15 mg.kg-1.day-1 for both molecules (acceptable daily intake). Body fat composition has been evaluated and ex vivo aortic vasomotor function has been investigated with a pharmacological approach. CONCLUSION Both groups of AS-treated rats showed a significant increase in subcutaneous and perirenal adipose tissue mass storage, without changes in total body mass. However, rats that have consumed AS at Acceptable Daily Intake (ADI) concentration revealed a significant vascular endothelial dysfunction compared to other groups. These results are interesting because they will help to better explain the observed increase in cardiometabolic risk.
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Affiliation(s)
- Sydney Risdon
- Avignon University, LAPEC EA4278, F-84000, Avignon, France
| | - Grégory Meyer
- Avignon University, LAPEC EA4278, F-84000, Avignon, France
| | | | - Catherine Riva
- Avignon University, LAPEC EA4278, F-84000, Avignon, France
| | - Matthieu Roustit
- Univ. Grenoble Alpes, Inserm U1042, 38000 Grenoble, France; Grenoble Alpes University Hospital, Clinical Pharmacology, Inserm CIC1406, 38000 Grenoble, France
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18
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Gunawan T, Hachiga Y, Tripoli CS, Silberberg A, Kearns DN. Heroin choice depends on income level and economy type. Psychopharmacology (Berl) 2020; 237:1447-1457. [PMID: 31993695 PMCID: PMC7196508 DOI: 10.1007/s00213-020-05471-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 01/21/2020] [Indexed: 12/25/2022]
Abstract
RATIONALE In a previous study, investigating choice between heroin and a non-drug alternative in animals and reductions in income (i.e., choices/day) caused the percentage of income spent on heroin to progressively decrease. In contrast, another study found that humans with opioid use disorder spent the majority of their income on heroin even though they had little income. Comparison of these two studies suggests that the seemingly conflicting results could be explained by differences in the underlying economy types of the choice alternatives. OBJECTIVE The present experiment tested the hypothesis that the effect of income changes on choice between heroin and a non-drug alternative depends on economy type. METHODS Rats chose between heroin and saccharin under three income levels. For the Closed group, the choice session was the only opportunity to obtain these reinforcers. For the Heroin Open group and the Saccharin Open group, choice sessions were followed by 3-h periods of unlimited access to heroin or saccharin, respectively. RESULTS As income decreased, the Closed and Heroin Open groups, but not the Saccharin Open group, spent an increasingly greater percentage of income on saccharin than on heroin. The Saccharin Open group, compared to the other groups, spent a greater percentage of income on heroin as income decreased. CONCLUSIONS Results confirm that the effects of income and economy type can interact and this may explain the apparently discrepant results of earlier studies. More generally, findings suggest that situations where heroin choice has little consequence for consumption of non-drug alternatives may promote heroin use.
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Affiliation(s)
- Tommy Gunawan
- Psychology Department, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA
| | - Yosuke Hachiga
- Center for Decision Research, Waseda University, Tokyo, Japan
| | - Christopher S Tripoli
- Psychology Department, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA
| | - Alan Silberberg
- Psychology Department, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA
| | - David N Kearns
- Psychology Department, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA.
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19
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Abstract
PURPOSE OF REVIEW Chronic consumption of fructose and fructose-containing sugars leads to dyslipidemia. Apolipoprotein (apo) CIII is strongly associated with elevated levels of triglycerides and cardiovascular disease risk. We reviewed the effects of fructose consumption on apoCIII levels and the role of apoCIII in fructose-induced dyslipidemia. RECENT FINDINGS Consumption of fructose increases circulating apoCIII levels compared with glucose. The more marked effects of fructose compared with glucose on apoCIII concentrations may involve the failure of fructose consumption to stimulate insulin secretion. The increase in apoCIII levels after fructose consumption correlates with increased postprandial serum triglyceride. Further, RNA interference of apoCIII prevents fructose-induced dyslipidemia in nonhuman primates. Increases in postprandial apoCIII after fructose, but not glucose consumption, are positively associated with elevated triglycerides in large triglyceride-rich lipoproteins and increased small dense LDL levels. SUMMARY ApoCIII might be causal in the lipid dysregulation observed after consumption of fructose and fructose-containing sugars. Decreased consumption of fructose and fructose-containing sugars could be an effective strategy for reducing circulating apoCIII and subsequently lowering triglyceride levels.
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Affiliation(s)
- Bettina Hieronimus
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, California, USA
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20
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Singh J, Rasane P, Kaur S, Kumar V, Dhawan K, Mahato DK, Malhotra S, Sarma C, Kaur D, Bhattacharya J. Nutritional Interventions and Considerations for the Development of Low Calorie or Sugar Free Foods. Curr Diabetes Rev 2020; 16:301-312. [PMID: 31389314 DOI: 10.2174/1573399815666190807144422] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/14/2019] [Accepted: 07/22/2019] [Indexed: 01/02/2023]
Abstract
Diabetes is a globally prevalent chronic metabolic disease characterized by blood glucose levels higher than the normal levels. Sugar, a common constituent of diet, is also a major factor often responsible for elevating the glucose level in diabetic patients. However, diabetic patients are more prone to eat sweets amongst the human population. Therefore, we find a popular consumption of zero or low-calorie sweeteners, both natural and artificial. But, the uses of these sweeteners have proved to be controversial. Thus, the purpose of this review was to critically analyze and highlight the considerations needed for the development of sugar-free or low-calorie products for diabetic patients. For this purpose, various measures are taken such as avoiding sugary foods, using natural nectar, artificial sweeteners, etc. It cannot be ignored that many health hazards are associated with the overconsumption of artificial sweeteners only. These sweeteners are high-risk compounds and a properly balanced consideration needs to be given while making a diet plan for diabetic patients.
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Affiliation(s)
- Jyoti Singh
- Department of Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara 144411, India
| | - Prasad Rasane
- Department of Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara 144411, India
- Department of Dairy Science and Food Technology, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India
| | - Sawinder Kaur
- Department of Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara 144411, India
| | - Vikas Kumar
- Department of Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara 144411, India
| | - Kajal Dhawan
- Department of Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara 144411, India
| | - Dipendra K Mahato
- Department of Health, School of Exercise and Nutrition Sciences, Deakin University, Melbourne Burwood VIC 3125, Australia
| | - Sunita Malhotra
- Postgraduate Institute of Medical Education and Research, Chandigarh 160012, Punjab, India
| | - Chayanika Sarma
- Indian Institute of Food Processing Technology, Thanjavur, Tamil Nadu 613005, India
| | - Damanpreet Kaur
- Department of Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara 144411, India
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21
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Smith EVL, Dyson RM, Berry MJ, Gray C. Fructose Consumption During Pregnancy Influences Milk Lipid Composition and Offspring Lipid Profiles in Guinea Pigs. Front Endocrinol (Lausanne) 2020; 11:550. [PMID: 32849314 PMCID: PMC7431635 DOI: 10.3389/fendo.2020.00550] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 07/06/2020] [Indexed: 12/31/2022] Open
Abstract
Excess dietary fructose is a major public health concern (1-4). Evidence shows increased fructose intake can cause insulin resistance, hepatic de novo lipogenesis, hypertriglyceridemia, obesity and non-alcoholic fatty liver disease (NAFLD) (5-9). However, little is known about the effects of fructose during pregnancy and its influence on offspring development and predisposition to later-life disease. To determine whether moderately increased maternal fructose intake could have health consequences on offspring, we have investigated the effects of 10% w/v fructose water intake during preconception and pregnancy. Female Dunkin Hartley guinea pigs were fed a control diet (CD) or fructose diet (FD;10% kcal from fructose) ad-libitum 60 days prior to mating and throughout gestation. Offspring were culled at weaning, day 21 (d21). Compared to CD dams, FD dams had altered glucose metabolism and increased milk free fatty acid content. Matsuda-DeFronzo insulin sensitivity index (M-ISI) from OGTT plasma showed no significant difference in whole-body insulin sensitivity between FD and CD dams 60 days post-dietary intervention and during midgestation. Fetal exposure to increased maternal fructose resulted in offspring with significantly altered serum free fatty acids at days 0, 7, 14, and 21 [including pentadecanoic acid (15:0), dma16:0, margaric acid (17:0) palmitoleic acid, total omega-7 and total saturates], increased levels of uric acid and triglycerides were also observed at d21. We have demonstrated that increased fructose intake during pregnancy can cause significant changes in maternal metabolic function and milk composition, which alters offspring metabolism. Taken together, these changes in pregnancy outcomes and feto-maternal condition may underlie their offspring's predisposition to metabolic dysfunction during later-life.
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Affiliation(s)
- Erin Vanessa LaRae Smith
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
- Centre for Translational Physiology, University of Otago, Wellington, New Zealand
| | - Rebecca Maree Dyson
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
- Centre for Translational Physiology, University of Otago, Wellington, New Zealand
| | - Mary Judith Berry
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
- Centre for Translational Physiology, University of Otago, Wellington, New Zealand
| | - Clint Gray
- Department of Paediatrics and Child Health, University of Otago, Wellington, New Zealand
- Centre for Translational Physiology, University of Otago, Wellington, New Zealand
- *Correspondence: Clint Gray
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22
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Khan TA, Tayyiba M, Agarwal A, Mejia SB, de Souza RJ, Wolever TMS, Leiter LA, Kendall CWC, Jenkins DJA, Sievenpiper JL. Relation of Total Sugars, Sucrose, Fructose, and Added Sugars With the Risk of Cardiovascular Disease: A Systematic Review and Dose-Response Meta-analysis of Prospective Cohort Studies. Mayo Clin Proc 2019; 94:2399-2414. [PMID: 31806098 DOI: 10.1016/j.mayocp.2019.05.034] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 03/27/2019] [Accepted: 05/14/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To determine the association of total and added fructose-containing sugars on cardiovascular (CVD) incidence and mortality. METHODS MEDLINE, EMBASE and Cochrane Library were searched from January 1, 1980, to July 31, 2018. Prospective cohort studies assessing the association of reported intakes of total, sucrose, fructose and added sugars with CVD incidence and mortality in individuals free from disease at baseline were included. Risk estimates were pooled using the inverse variance method, and dose-response analysis was modeled. RESULTS Eligibility criteria were met by 24 prospective cohort comparisons (624,128 unique individuals; 11,856 CVD incidence cases and 12,224 CVD mortality cases). Total sugars, sucrose, and fructose were not associated with CVD incidence. Total sugars (risk ratio, 1.09 [95% confidence interval, 1.02 to 1.17]) and fructose (1.08 [1.01 to 1.15]) showed a harmful association for CVD mortality, there was no association for added sugars and a beneficial association for sucrose (0.94 [0.89 to 0.99]). Dose-response analyses showed a beneficial linear dose-response gradient for sucrose and nonlinear dose-response thresholds for harm for total sugars (133 grams, 26% energy), fructose (58 grams, 11% energy) and added sugars (65 grams, 13% energy) in relation to CVD mortality (P<.05). The certainty of the evidence using GRADE was very low for CVD incidence and low for CVD mortality for all sugar types. CONCLUSION Current evidence supports a threshold of harm for intakes of total sugars, added sugars, and fructose at higher exposures and lack of harm for sucrose independent of food form for CVD mortality. Further research of different food sources of sugars is needed to define better the relationship between sugars and CVD. REGISTRATION: clinicaltrials.gov, NCT01608620.
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Affiliation(s)
- Tauseef A Khan
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Mobushra Tayyiba
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Arnav Agarwal
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Sonia Blanco Mejia
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Russell J de Souza
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Thomas M S Wolever
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Lawrence A Leiter
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Cyril W C Kendall
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada; College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - David J A Jenkins
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, Ontario, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, Ontario, Canada.
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Abstract
PURPOSE OF REVIEW The goal of this review is to discuss the data on natural alternative sweeteners and their effects on glucose homeostasis and other metabolic parameters within the past five years. We sought to answer whether common natural alternative sweeteners have a positive or negative effect on glucose control in both human and animal models, and whether the data supports their widespread use as a tool to help reduce the prevalence of diabetes and associated comorbid conditions. RECENT FINDINGS Recent studies suggest that natural alternative sweeteners may reduce hyperglycemia, improve lipid metabolism, and have antioxidant effects particularly in those that have baseline diabetes. Diabetes and metabolic syndrome have become a global healthcare crisis and the sugar overconsumption plays a major role. The use of artificial sweeteners has become more prevalent to improve insulin resistance in those with diabetes, obesity, and metabolic syndrome, although the evidence does not support this result. There are however some promising data to suggest that natural alternative sweeteners may be a better alternative to sugar and artificial sweeteners.
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Affiliation(s)
- Emily Mejia
- University of Miami Miller School of Medicine, Miami, FL, 33146, USA
| | - Michelle Pearlman
- Department of Medicine, Division of Gastroenterology & Hepatology, University of Miami Health Systems, Miller School of Medicine, 1120 NW 14th Street, Miami, FL, 33136, USA.
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24
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Keesing C, Mills B, Rapsey C, Haszard J, Venn B. Cognitive Performance Following Ingestion of Glucose-Fructose Sweeteners That Impart Different Postprandial Glycaemic Responses: A Randomised Control Trial. Nutrients 2019; 11:nu11112647. [PMID: 31689943 PMCID: PMC6893461 DOI: 10.3390/nu11112647] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 10/24/2019] [Accepted: 10/31/2019] [Indexed: 11/29/2022] Open
Abstract
We aimed to investigate the isolated effect of glycaemia on cognitive test performance by using beverages sweetened with two different glucose–fructose disaccharides, sucrose and isomaltulose. In a randomised crossover design, 70 healthy adults received a low-glycaemic-index (GI) isomaltulose and sucralose beverage (GI 32) and a high-GI sucrose beverage (GI 65) on two occasions that were separated by two weeks. Following beverage ingestion, declarative memory and immediate word recall were examined at 30, 80 and 130 min. At 140 min, executive function was tested. To confirm that the glycaemic response of the test beverages matched published GI estimates, a subsample (n = 12) of the cognitive testing population (n = 70) underwent glycaemic response testing on different test days. A significantly lower value of mean (95% CI) blood glucose concentration incremental area under the curve (iAUC) was found for isomaltulose, in comparison to the blood glucose concentration iAUC value for sucrose, the difference corresponding to −44 mmol/L∙min (−70, −18), p = 0.003. The mean (95% CI) difference in numbers of correct answers or words recalled between beverages at 30, 80 and 130 min were 0.1 (−0.2, 0.5), −0.3 (−0.8, 0.2) and 0.0 (−0.5, 0.5) for declarative memory, and −0.5 (−1.4, 0.3), 0.4 (−0.4, 1.3) and −0.4 (−1.1, 0.4) for immediate free word recall. At 140 min, the mean difference in the trail-making test between beverages was −0.3 sec (−6.9, 6.3). None of these differences were statistically or clinically significant. In summary, cognitive performance was unaffected by different glycaemic responses to beverages during the postprandial period of 140 min.
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Affiliation(s)
- Celeste Keesing
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
| | - Brianna Mills
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
| | - Charlene Rapsey
- Department of Psychological Medicine, Otago Medical School, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
| | - Jillian Haszard
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
| | - Bernard Venn
- Department of Human Nutrition, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
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25
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Bradbury KM, Turel O, Morrison KM. Electronic device use and beverage related sugar and caffeine intake in US adolescents. PLoS One 2019; 14:e0223912. [PMID: 31639162 PMCID: PMC6805001 DOI: 10.1371/journal.pone.0223912] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 10/01/2019] [Indexed: 12/21/2022] Open
Abstract
Background Despite recent declines in consumption of sugary beverages, energy drinks (ED) and sodas continue to contribute a substantial amount of sugar and caffeine to the diet of youth. Consumption of these beverages has been linked with electronic device use, however in-depth associations between sugar and caffeine intake from energy drinks and sodas with various electronic devices are not clear. Objective Describe the relationship of soda and energy drink consumption and associated added sugar and caffeine intake with electronic device use among adolescents. Methods Secondary data from the 2013–2016 cycles of Monitoring the Future Survey, a national, repeated, cross-sectional study, were analyzed. Information on energy drink and soda consumption by students in grades 8 and 10 (n = 32,418) from 252–263 schools randomly sampled from all US states was used. Results Soda and energy drink consumption decreased each year from 2013–2016 while daily use of electronic devices remained stable. An additional hour/day of TV was linked to a 6.92g (6.31,7.48; p<0.001) increase in sugar intake and a 32% (OR = 1.32; 1.29,1.35; p < .001) higher risk of exceeding World Health Organization (WHO) recommended sugar intakes. Further, each hour/day of TV was linked to a 28% increased risk of exceeding caffeine recommendations (OR = 1.25–1.31; p<0.001). Each hour per day talking on a cellphone was associated with an increased risk of exceeding WHO sugar and caffeine intakes by 14% (OR = 1.11–1.16; p<0.001) and 18% (OR = 1.15–1.21; p<0.001) respectively. Video game use was only weakly linked to caffeine intake. Computer use for school was associated with lower likelihood of exceeding sugar intake cut-offs. Conclusion While a trend towards reduced energy drink and soda intake from 2013–2016 was evident, greater electronic device use, especially TV time, was linked to higher intake of beverage-derived added sugar and caffeine amongst adolescents. Addressing these behaviours through counselling or health promotion could potentially help to reduce excess sugar and caffeine intake from sodas and energy drinks among this population.
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Affiliation(s)
- Kelly M. Bradbury
- Department of Pediatrics, Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
| | - Ofir Turel
- Department of Information Systems and Decision Sciences, Mihaylo College of Business and Economics, California State University—Fullerton, Fullerton, California, United States of America
| | - Katherine M. Morrison
- Department of Pediatrics, Centre for Metabolism, Obesity and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
- * E-mail:
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26
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Thane M, Viswanathan V, Meyer TC, Paisios E, Schleyer M. Modulations of microbehaviour by associative memory strength in Drosophila larvae. PLoS One 2019; 14:e0224154. [PMID: 31634372 PMCID: PMC6802848 DOI: 10.1371/journal.pone.0224154] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 10/07/2019] [Indexed: 11/19/2022] Open
Abstract
Finding food is a vital skill and a constant task for any animal, and associative learning of food-predicting cues gives an advantage in this daily struggle. The strength of the associations between cues and food depends on a number of parameters, such as the salience of the cue, the strength of the food reward and the number of joint cue-food experiences. We investigate what impact the strength of an associative odour-sugar memory has on the microbehaviour of Drosophila melanogaster larvae. We find that larvae form stronger memories with increasing concentrations of sugar or odour, and that these stronger memories manifest themselves in stronger modulations of two aspects of larval microbehaviour, the rate and the direction of lateral reorientation manoeuvres (so-called head casts). These two modulations of larval behaviour are found to be correlated to each other in every experiment performed, which is in line with a model that assumes that both modulations are controlled by a common motor output. Given that the Drosophila larva is a genetically tractable model organism that is well suited to the study of simple circuits at the single-cell level, these analyses can guide future research into the neuronal circuits underlying the translation of associative memories of different strength into behaviour, and may help to understand how these processes are organised in more complex systems.
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Affiliation(s)
- Michael Thane
- Leibniz Institute for Neurobiology (LIN), Department Genetics of Learning and Memory, Magdeburg, Germany
| | - Vignesh Viswanathan
- Leibniz Institute for Neurobiology (LIN), Department Genetics of Learning and Memory, Magdeburg, Germany
| | - Tessa Christin Meyer
- Leibniz Institute for Neurobiology (LIN), Department Genetics of Learning and Memory, Magdeburg, Germany
| | - Emmanouil Paisios
- Leibniz Institute for Neurobiology (LIN), Department Genetics of Learning and Memory, Magdeburg, Germany
| | - Michael Schleyer
- Leibniz Institute for Neurobiology (LIN), Department Genetics of Learning and Memory, Magdeburg, Germany
- * E-mail:
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27
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den Biggelaar LJCJ, Sep SJS, Mari A, Ferrannini E, van Dongen MCJM, Wijckmans NEG, Schram MT, van der Kallen CJ, Schaper N, Henry RMA, van Greevenbroek MM, Stehouwer CDA, Eussen SJPM. Association of artificially sweetened and sugar-sweetened soft drinks with β-cell function, insulin sensitivity, and type 2 diabetes: the Maastricht Study. Eur J Nutr 2019; 59:1717-1727. [PMID: 31486878 PMCID: PMC7230048 DOI: 10.1007/s00394-019-02026-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 06/10/2019] [Indexed: 12/31/2022]
Abstract
Purpose Artificially sweetened and sugar-sweetened beverage consumptions have both been reported to be associated with type 2 diabetes mellitus (T2D) risk. The aim of the current study was to investigate the potential underlying associations with dynamic pancreatic β-cell function (BCF) and insulin sensitivity. Methods We evaluated cross-sectional associations in 2240 individuals (mean ± SD age 59.6 ± 8.18, 49.4% male, 21.9% T2D) participating in a diabetes-enriched population-based cohort. Artificially sweetened and sugar-sweetened soft drinks and juice consumption were assessed by a food-frequency questionnaire. Glucose metabolism status, insulin sensitivity, and BCF were measured by a seven-point oral glucose tolerance test. Regression analyses were performed to assess associations of artificially and sugar-sweetened beverage consumption with measures of glucose homeostasis. Associations were adjusted for potential confounders, and additionally with and without total energy intake and BMI, as these variables could be mediators. Results Moderate consumption of artificially sweetened soft drink was associated with lower β-cell glucose sensitivity [standardized beta (95% CI), − 0.06 (− 0.11, − 0.02)], total insulin secretion [β − 0.06 (− 0.10, − 0.02)], and with lower β-cell rate sensitivity [odds ratio (95% CI), 1.29 (1.03, 1.62)] compared to abstainers. Daily artificially sweetened soft drink consumption was associated with lower β-cell glucose sensitivity [β − 0.05 (− 0.09, 0.00)], and total insulin secretion [β − 0.05 − 0.09, − 0.01)] compared to abstainers. Conclusions Moderate and daily consumption of artificially sweetened soft drinks was associated with lower BCF, but not with insulin sensitivity. No evidence was found for associations of sugar-sweetened soft drink and juice consumption with BCF or insulin sensitivity in this middle-aged population. Prospective studies are warranted to further investigate the associations of artificially and sugar-sweetened beverage consumption with non-fasting insulin sensitivity and multiple BCF aspects. Electronic supplementary material The online version of this article (10.1007/s00394-019-02026-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Louise J C J den Biggelaar
- Department of Epidemiology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.
| | - Simone J S Sep
- Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Andrea Mari
- C N R Institute of Neuroscience, Padua, Italy
| | | | - Martien C J M van Dongen
- Department of Epidemiology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Nicole E G Wijckmans
- Department of Epidemiology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Miranda T Schram
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Carla J van der Kallen
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Nicolaas Schaper
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Ronald M A Henry
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Heart and Vascular Centre, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Marleen M van Greevenbroek
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Simone J P M Eussen
- Department of Epidemiology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
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Madsen KL, Stemmerik MG, Buch AE, Poulsen NS, Lund AM, Vissing J. Impaired Fat Oxidation During Exercise in Long-Chain Acyl-CoA Dehydrogenase Deficiency Patients and Effect of IV-Glucose. J Clin Endocrinol Metab 2019; 104:3610-3613. [PMID: 30990523 DOI: 10.1210/jc.2019-00453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 04/10/2019] [Indexed: 11/19/2022]
Abstract
CONTEXT Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency (LCHADD) affects oxidation of long-chain fatty acids (FAO) and is associated with risk of metabolic crises and episodic rhabdomyolysis. CASE DESCRIPTION We present the cases of two patients with LCHADD. Patient 1 (male, 26 years old) was severely affected by muscle weakness and neuropathy. He was diagnosed at age 20 years and was nonadherent to standard dietary management. MRI revealed significant fat replacement of muscle in both calves. Patient 2 (female, 15 years old) was diagnosed at age 1 year. She had no muscle weakness and was compliant with the recommended diet. Compared with healthy persons, both patients had reduced FAO and palmitate oxidation, measured with indirect calorimetry and stable isotope technique during a submaximal cycle ergometer test. Patient 2 had some residual capacity to increase FAO and a compensatory higher carbohydrate oxidation, which ensured a near-normal exercise capacity. Patient 1 was unable to increase FAO and could only complete 23 minutes of exercise, vs 60 minutes by patient 2 and healthy persons. In both, 10% IV infusion of glucose (IV-glucose) during exercise increased carbohydrate oxidation slightly, but endurance was not improved, which likely relates to the fixed weakness in patient 1 and because the residual FAO was suppressed by the glucose infusion in both. CONCLUSION The two patients illustrate that FAO is impaired and carbohydrate oxidation is elevated during exercise in patients affected by LCHADD, compared with healthy persons, but IV-glucose has no beneficial effect on exercise tolerance in LCHADD.
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Affiliation(s)
- Karen Lindhardt Madsen
- Department of Neurology, Copenhagen Neuromuscular Center, Rigshospitalet, Copenhagen, Denmark
| | | | - Astrid Emilie Buch
- Department of Neurology, Copenhagen Neuromuscular Center, Rigshospitalet, Copenhagen, Denmark
| | - Nanna Scharff Poulsen
- Department of Neurology, Copenhagen Neuromuscular Center, Rigshospitalet, Copenhagen, Denmark
| | - Allan Meldgaard Lund
- Department of Pediatrics, Centre for Inherited Metabolic Diseases, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Genetics, Centre for Inherited Metabolic Diseases, Rigshospitalet, Copenhagen, Denmark
| | - John Vissing
- Department of Neurology, Copenhagen Neuromuscular Center, Rigshospitalet, Copenhagen, Denmark
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Samaniego Vaesken MDL, Partearroyo T, Varela-Moreiras G. Presence and consumption of sugars and low and no-calorie sweeteners in the Spanish diet: an updated overview. NUTR HOSP 2019; 36:8-12. [PMID: 31368329 DOI: 10.20960/nh.02799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION Introduction: the term "sugars" describes a specific group of carbohydrates and one of the most controversial components of our diet, as public health authorities worldwide acknowledge that there is an excessive intake. Reformulation practices with low and no-calorie sweeteners (LNCS) are being carried out worldwide. However, a lack of information about the present market status and evolution is highly recognized. Materials and methods: review of the most recent studies. Results: there is a lack of comprehensive Food Composition Tables (FCT) and Databases (DB) including sugar contents and many countries have developed their own for the estimation of sugar intakes or with the aim of monitoring changes in processed food composition. Moreover, surveys assessing carbohydrate and sugar consumption and their dietary sources are scarce and sometimes not comparable due to the different methodologies, FCT and DB used, and non-harmonised use of terms and nomenclature, especially for the estimation of added sugars. Results from studies show that total and added sugar intakes around the world are quite comparable in terms of percentage of total energy from diet and major dietary sources. WHO's recommendations are being exceeded, especially amongst the younger population groups. Conclusions: future research on sweeteners, both caloric and low or non-caloric, should comprise the development of comprehensible, harmonized and updated databases of added sugar and LNCS, the evaluation of the frequent consumption of LNCS from foods and beverages and its potential association with an improved food model/pattern and lifestyles. Finally, intervention studies with LNCS are urgently needed.
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Sarmiento MRA, de Paula TO, Borges FM, Ferreira-Machado AB, Resende JA, Moreira APB, Dutra Luquetti SCP, Cesar DE, da Silva VL, Diniz CG. Obesity, Xenobiotic Intake and Antimicrobial-Resistance Genes in the Human Gastrointestinal Tract: A Comparative Study of Eutrophic, Overweight and Obese Individuals. Genes (Basel) 2019; 10:genes10050349. [PMID: 31067837 PMCID: PMC6562451 DOI: 10.3390/genes10050349] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/29/2019] [Accepted: 04/30/2019] [Indexed: 01/16/2023] Open
Abstract
Although lifestyle and physiology in obese individuals are accepted to lead to changes in the intestinal microbiota, uncertainty remains about microbiota dysbiosis, and xenobiotics intake, as a source of selective pressure, independent of antimicrobial chemotherapy. The aim of this study was to compare the occurrence of antimicrobial resistance genetic markers (ARG) in faecal specimens of eutrophic, overweight and obese individuals, and their correlation with xenobiotic intake and gut bacteria density. Methods: This was a cross-sectional case-controlled study including 72 adult participants with no record of intestinal or systemic diseases, or recent use of antimicrobials, grouped as eutrophic, overweight, or obese. Anthropometric profile, eating habits and oral xenobiotics intake were recorded. Faecal metagenomic DNA was used to screen for ARG by PCR, and to measure bacterial groups by fluorescence in situ hybridization (FISH). Student’s t and Wilcoxon tests were used to compare means and differences in ARG detection (95% confidence intervals). Correlation analyses (odds ratio) and relationships between bacteria density and ARG were determined. Results: Increase in abdominal circumference, waist circumference, hip, waist-hip ratio, BMI, carbohydrate, fibres, and total calorie intakes were different from eutrophic to obese participants. Habitual use of antihypertensive and anti-inflammatory drugs, antacids, and artificial sweeteners were associated mainly with obesity and overweight. Nutritional supplements were associated to the eutrophic group. ARG screening showed differences being more frequent among obese, and positive for 27 genetic markers related to β-lactams, tetracyclines, the macrolide lincosamide and streptogramin group, quinolones, sulfonamides, aminoglycosides, and efflux pump. Positive correlation between ARG and BMI, caloric intake, and intake of xenobiotics, was observed for obese individuals. Relationships among ARG detection and bacteria densities were also different. Conclusions: This study reinforces the hypothesis that obese individuals may harbour an altered gut microbiota, if compared to eutrophic. The overweight individuals display a transitional gut microbiota which seems to be between eutrophic and obese. Furthermore, the increased xenobiotic intake associated to obesity may play an important role in the antimicrobial resistance phenomenon.
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Affiliation(s)
- Marjorie Raquel Anariba Sarmiento
- Laboratory of Bacterial Physiology and Molecular Genetics, Department of Parasitology, Microbiology and Immunology, Federal University of Juiz de Fora, 36036-330 Juiz de Fora, MG, Brazil.
| | - Thais Oliveira de Paula
- Laboratory of Bacterial Physiology and Molecular Genetics, Department of Parasitology, Microbiology and Immunology, Federal University of Juiz de Fora, 36036-330 Juiz de Fora, MG, Brazil.
| | - Francis Moreira Borges
- Laboratory of Bacterial Physiology and Molecular Genetics, Department of Parasitology, Microbiology and Immunology, Federal University of Juiz de Fora, 36036-330 Juiz de Fora, MG, Brazil.
| | - Alessandra Barbosa Ferreira-Machado
- Laboratory of Bacterial Physiology and Molecular Genetics, Department of Parasitology, Microbiology and Immunology, Federal University of Juiz de Fora, 36036-330 Juiz de Fora, MG, Brazil.
| | - Juliana Alves Resende
- Department of Pharmacy and Nutrition, Federal University of Espirito Santo, 29500-000 Alegre, ES, Brasil.
| | - Ana Paula Boroni Moreira
- Department of Nutrition, Federal University of Juiz de Fora, 36036-330 Juiz de Fora, MG, Brazil.
| | | | | | - Vânia Lúcia da Silva
- Laboratory of Bacterial Physiology and Molecular Genetics, Department of Parasitology, Microbiology and Immunology, Federal University of Juiz de Fora, 36036-330 Juiz de Fora, MG, Brazil.
| | - Claudio Galuppo Diniz
- Laboratory of Bacterial Physiology and Molecular Genetics, Department of Parasitology, Microbiology and Immunology, Federal University of Juiz de Fora, 36036-330 Juiz de Fora, MG, Brazil.
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Pielak M, Czarniecka-Skubina E, Trafiałek J, Głuchowski A. Contemporary Trends and Habits in the Consumption of Sugar and Sweeteners-A Questionnaire Survey among Poles. Int J Environ Res Public Health 2019; 16:ijerph16071164. [PMID: 30939732 PMCID: PMC6479998 DOI: 10.3390/ijerph16071164] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/17/2019] [Accepted: 03/29/2019] [Indexed: 11/16/2022]
Abstract
The purpose of the paper was a cross sectional study to evaluate the use of sugars and selected sweeteners by Polish consumers in their diet. The survey was conducted using the direct interview method on the group of 2000 adults declaring the consumption of sugar or sweeteners. The ANOVA test and multi-dimensional cluster analysis was used to the data interpretation (p < 0.05). It was stated that the consumption of sugar among consumers remained at a high level. Respondents declared taking up the activities towards reducing sugar intake in their diet mostly due to health-related reasons. It was emphasized in particular by women taking part in the survey. The most frequent way to limit the amount of sugar in the diet consisted in choosing sweeteners, mainly stevia and xylitol. However, the knowledge concerning steviol glycosides among the consumers was not extensive. Results are the source of up-to-date information concerning the consumption of sugar and sweeteners. Consumers to whom nutrition campaigns on the necessity to limit the content of sugar in the diet are worth addressing were identified. A hypothesis, that consumers are currently more aware of the negative influence of increased sugar consumption on their health and they aim at limiting the content of added sugar in their diet, was confirmed.
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Affiliation(s)
- Marlena Pielak
- Department of Food Gastronomy and Food Hygiene, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences, 02-787 Warsaw, Poland.
| | - Ewa Czarniecka-Skubina
- Department of Food Gastronomy and Food Hygiene, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences, 02-787 Warsaw, Poland.
| | - Joanna Trafiałek
- Department of Food Gastronomy and Food Hygiene, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences, 02-787 Warsaw, Poland.
| | - Artur Głuchowski
- Department of Food Gastronomy and Food Hygiene, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences, 02-787 Warsaw, Poland.
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Wattelez G, Frayon S, Cavaloc Y, Cherrier S, Lerrant Y, Galy O. Sugar-Sweetened Beverage Consumption and Associated Factors in School-Going Adolescents of New Caledonia. Nutrients 2019; 11:nu11020452. [PMID: 30795633 PMCID: PMC6412716 DOI: 10.3390/nu11020452] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/28/2019] [Accepted: 01/30/2019] [Indexed: 12/23/2022] Open
Abstract
This cross-sectional study assessed sugar-sweetened beverage (SSB) consumption and its associations with the sociodemographic and physical characteristics, behavior and knowledge of New Caledonian adolescents. The survey data of 447 adolescents from ages 11 to 16 years were collected in five secondary public schools of New Caledonia between July 2015 and April 2016. These data included measured height and weight, SSB consumption, sociodemographic characteristics, body weight perception, physical activity, and knowledge (sugar quantity/SSB unit; energy expenditure required to eliminate a unit) and opinions about the SSB‒weight gain relationship. Ninety percent of these adolescents declared regularly drinking SSBs. Quantities were associated with living environment (1.94 L·week−1 in urban environment vs. 4.49 L·week−1 in rural environment, p = 0.001), ethnic community (4.77 L·week−1 in Melanesians vs. 2.46 L·week−1 in Caucasians, p < 0.001) and knowledge about energy expenditure (6.22 L·week−1 in unknowledgeable adolescents vs. 4.26 L·week−1 in adolescents who underestimated, 3.73 L·week−1 in adolescents who overestimated, and 3.64 L·week−1 in adolescents who correctly responded on the energy expenditure required to eliminate an SSB unit, p = 0.033). To conclude, community-based health promotion strategies should (1) focus on the physical effort needed to negate SSB consumption rather than the nutritional energy from SSB units and (2) highlight how to achieve sustainable lifestyles and provide tools for greater understanding and positive action.
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Affiliation(s)
- Guillaume Wattelez
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia.
| | - Stéphane Frayon
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia.
| | - Yolande Cavaloc
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia.
| | - Sophie Cherrier
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia.
| | - Yannick Lerrant
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia.
| | - Olivier Galy
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia.
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Ross A, Barnett N, Faulkner A, Hannapel R, Parent MB. Sucrose ingestion induces glutamate AMPA receptor phosphorylation in dorsal hippocampal neurons: Increased sucrose experience prevents this effect. Behav Brain Res 2019; 359:792-798. [PMID: 30076854 PMCID: PMC6594687 DOI: 10.1016/j.bbr.2018.07.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 07/19/2018] [Accepted: 07/31/2018] [Indexed: 11/26/2022]
Abstract
Evidence suggests that meal-related memory influences later eating behavior. Memory can serve as a powerful mechanism for controlling eating behavior because it provides a record of recent intake that likely outlasts most physiological signals generated by ingestion. Dorsal (dHC) and ventral hippocampal (vHC) neurons are critical for memory, and we demonstrated previously that they limit energy intake during the postprandial period. If dHC or vHC neurons control intake through a process that requires memory, then ingestion should increase events necessary for synaptic plasticity in dHC and vHC during the postprandial period. To test this, we determined whether ingesting a sucrose solution induced posttranslational events critical for hippocampal synaptic plasticity: phosphorylation of AMPAR GluA1 subunits at 1) serine 831 (pSer831) and 2) serine 845 (pSer845). We also examined whether increasing the amount of previous experience with the sucrose solution, which would be expected to decrease the mnemonic demand involved in an ingestion bout, would also attenuate sucrose-induced phosphorylation. Quantitative immunoblotting of dHC and vHC membrane fractions demonstrated that sucrose ingestion increased postprandial pSer831 in dHC but not vHC. Increased previous sucrose experience prevented sucrose-induced dHC pSer831. Sucrose ingestion did not affect pSer845 in either dHC or vHC. Thus, the present findings show that ingestion activates a postranslational event necessary for synaptic plasticity in an experience-dependent manner, which is consistent with the hypothesis that dHC neurons form a memory of a meal during the postprandial period.
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Affiliation(s)
- Amy Ross
- Neuroscience Institute, Georgia State University, P.O. Box 5030, Atlanta, GA, 30302, United States
| | - Nicolette Barnett
- Neuroscience Institute, Georgia State University, P.O. Box 5030, Atlanta, GA, 30302, United States
| | - Alexa Faulkner
- Neuroscience Institute, Georgia State University, P.O. Box 5030, Atlanta, GA, 30302, United States
| | - Reilly Hannapel
- Neuroscience Institute, Georgia State University, P.O. Box 5030, Atlanta, GA, 30302, United States
| | - Marise B Parent
- Neuroscience Institute, Georgia State University, P.O. Box 5030, Atlanta, GA, 30302, United States; Department of Psychology, Georgia State University, P.O. Box 5030, Atlanta, GA, 30302, United States.
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Hernández-F M, Batis C, Rivera JA, Colchero MA. Reduction in purchases of energy-dense nutrient-poor foods in Mexico associated with the introduction of a tax in 2014. Prev Med 2019; 118:16-22. [PMID: 30287330 PMCID: PMC6322966 DOI: 10.1016/j.ypmed.2018.09.019] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 09/03/2018] [Accepted: 09/30/2018] [Indexed: 11/19/2022]
Abstract
In 2014, an 8% tax on energy-dense nutrient-poor foods was implemented in Mexico with the aim of reducing its consumption. This paper estimated changes in household purchases of taxed food. We used the latest five waves of the nationally representative Mexican Income and Expenditure Survey (2008, 2010, 2012, 2014 and 2016). The analytic sample comprises 154,777 households. We estimated changes in purchases based on a before and after comparison. Results show a reduction in purchases of taxed food of -5.4 g/week per capita, equivalent to a relative reduction of -5.3% in the 2014 and 2016 waves compared to the 2008, 2010 and 2012 rounds. The largest relative reductions were in urban areas (-6.9%), among households with children (-7.0%), households where the head had an intermediate educational level (-9.9%) and the southern region (-14.8%). We did not find a significant reduction in rural areas. While there is a large heterogeneity, the fiscal instrument has been effective in reducing taxed food purchases and has generated substantial revenue that could be used to finance policies for the prevention and treatment of obesity.
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Affiliation(s)
- Mauricio Hernández-F
- Center for Research on Nutrition and Health, Instituto Nacional de Salud Pública, Mexico.
| | - Carolina Batis
- CONACYT - Center for Research on Nutrition and Health, Instituto Nacional de Salud Pública, Mexico.
| | | | - M Arantxa Colchero
- Center for Health Systems Research, Instituto Nacional de Salud Pública, Mexico.
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Guimarães J, Bargut TCL, Mandarim-de-Lacerda CA, Aguila MB. Medium-chain triglyceride reinforce the hepatic damage caused by fructose intake in mice. Prostaglandins Leukot Essent Fatty Acids 2019; 140:64-71. [PMID: 30553406 DOI: 10.1016/j.plefa.2018.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 11/06/2018] [Accepted: 11/08/2018] [Indexed: 01/16/2023]
Abstract
We aimed to investigate the effects of medium-chain triglyceride oil on the high fructose diet-provoked hepatic abnormalities in mice. We used C57bl/6 mice of 3-months-old divided into four groups for 12 weeks: control (C), control with MCT (C-MCT), fructose (F), and fructose with MCT (F-MCT). We investigated food and water intake, body mass, blood pressure, glucose tolerance, plasma and liver biochemistry, hepatic protein and gene expression. There were no changes in body mass, food intake and glucose tolerance among the groups. The F group presented increased water intake and blood pressure associated with hepatic steatosis and elevated de novo lipogenesis, beta-oxidation, mitochondrial biogenesis and inflammation in the liver. Surprisingly, the C-MCT group also showed hepatic steatosis and inflammation in the liver, and the F-MCT group had no exacerbations of fructose-induced abnormalities, showing marked hepatic steatosis, lipogenesis de novo and hepatic inflammation. The MCT oil groups also presented increased beta-oxidation and mitochondrial biogenesis. In conclusion, MCT oil showed detrimental hepatic effects and should be used with caution, especially in the presence of hepatic alterations.
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Affiliation(s)
- Janaina Guimarães
- Laboratory of Morphometry, Metabolism and Cardiovascular Diseases, Biomedical Center, Institute of Biology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Carlos Alberto Mandarim-de-Lacerda
- Laboratory of Morphometry, Metabolism and Cardiovascular Diseases, Biomedical Center, Institute of Biology, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Marcia Barbosa Aguila
- Laboratory of Morphometry, Metabolism and Cardiovascular Diseases, Biomedical Center, Institute of Biology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Han Y, Choi BR, Kim SY, Kim SB, Kim YH, Kwon EY, Choi MS. Gastrointestinal Tolerance of D-Allulose in Healthy and Young Adults. A Non-Randomized Controlled Trial. Nutrients 2018; 10:nu10122010. [PMID: 30572580 PMCID: PMC6315886 DOI: 10.3390/nu10122010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/13/2018] [Accepted: 12/17/2018] [Indexed: 01/13/2023] Open
Abstract
D-allulose has recently received attention as a sugar substitute. However, there are currently no reports regarding its association with gastrointestinal (GI) tolerance. Thus, we performed a GI tolerance test for D-allulose in order to establish its daily acceptable intake level. When the dose of D-allulose was gradually increased in steps of 0.1 g/kg·Body Weight (BW) to identify the maximum single dose for occasional ingestion, no cases of severe diarrhea or GI symptoms were noted until a dose of 0.4 g/kg·BW was reached. Severe symptoms of diarrhea were noted at a dose of 0.5 g/kg·BW. Similarly, the GI tolerance test did not show any incidences of severe diarrhea or GI symptoms until a dose of 0.5 g/kg·BW was reached. A correlation analysis of the GI tolerance test for D-allulose and sugar revealed significantly higher frequencies of symptoms of diarrhea (p = 0.004), abdominal distention (p = 0.039), and abdominal pain (p = 0.031) after D-allulose intake. Increasing the total daily D-allulose intake gradually to 1.0 g/kg·BW for regular ingestion resulted in incidences of severe nausea, abdominal pain, headache, anorexia, and diarrheal symptoms. Based on these results, we suggest a maximum single dose and maximum total daily intake of D-Allulose of 0.4 g/kg·BW and 0.9 g/kg·BW, respectively.
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Affiliation(s)
- Youngji Han
- Department of Food Science and Nutrition, Kyungpook National University, 1370 San-Kyuk Dong Puk-Ku, Daegu 41566, Korea.
- Center for Food and Nutritional Genomics Research, Kyungpook National University, 1370 San-Kyuk Dong Puk-Ku, Daegu 41566, Korea.
| | - Bo Ra Choi
- Department of Food Science and Nutrition, Kyungpook National University, 1370 San-Kyuk Dong Puk-Ku, Daegu 41566, Korea.
- Center for Food and Nutritional Genomics Research, Kyungpook National University, 1370 San-Kyuk Dong Puk-Ku, Daegu 41566, Korea.
| | - So Young Kim
- Department of Food Science and Nutrition, Kyungpook National University, 1370 San-Kyuk Dong Puk-Ku, Daegu 41566, Korea.
- Center for Food and Nutritional Genomics Research, Kyungpook National University, 1370 San-Kyuk Dong Puk-Ku, Daegu 41566, Korea.
| | - Seong-Bo Kim
- Food R&D, CJ CheilJedang Corp., Seoul 04560, Korea.
| | - Yang Hee Kim
- Food R&D, CJ CheilJedang Corp., Seoul 04560, Korea.
| | - Eun-Young Kwon
- Department of Food Science and Nutrition, Kyungpook National University, 1370 San-Kyuk Dong Puk-Ku, Daegu 41566, Korea.
- Center for Food and Nutritional Genomics Research, Kyungpook National University, 1370 San-Kyuk Dong Puk-Ku, Daegu 41566, Korea.
| | - Myung-Sook Choi
- Department of Food Science and Nutrition, Kyungpook National University, 1370 San-Kyuk Dong Puk-Ku, Daegu 41566, Korea.
- Center for Food and Nutritional Genomics Research, Kyungpook National University, 1370 San-Kyuk Dong Puk-Ku, Daegu 41566, Korea.
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Macintyre AK, Marryat L, Chambers S. Exposure to liquid sweetness in early childhood: artificially-sweetened and sugar-sweetened beverage consumption at 4-5 years and risk of overweight and obesity at 7-8 years. Pediatr Obes 2018; 13:755-765. [PMID: 29624909 PMCID: PMC6492200 DOI: 10.1111/ijpo.12284] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 01/16/2018] [Accepted: 02/12/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND A significant gap exists in longitudinal evidence on early exposure to artificially sweetened beverages (ASBs) and weight outcomes for paediatric populations. OBJECTIVE The objective of this study is to examine the relationship between ASB/sugar-sweetened beverage (SSB) consumption at 4-5 years and risk of overweight and obesity at 7-8 years. METHODS Data from a nationally representative cohort (n = 2986) in Scotland were analysed using logistic regression to evaluate the association between exposure to ASBs/SSBs at 4-5 years and risk of overweight and obesity at 7-8 years. RESULTS There were positive unadjusted associations between ASB consumption and risk of obesity, and following adjustment for confounders, ASB associations attenuated, and only the middle consumption category (1 to 6 times per week) remained significant (odds ratio 1.57, 95% confidence interval {CI} 1.05-2.36). For SSB consumption, there were no significant unadjusted associations, and following adjustment for confounders, only the middle consumption category was significant (odds ratio 1.65, 95% CI 1.12-2.44). There were no significant associations for risk of overweight. CONCLUSIONS Longitudinal analysis from 4-5 to 7-8 years demonstrated some evidence of associations between ASBs/SSB consumption and risk of obesity. However, non-linear patterns and wide CIs suggest cautious interpretation and need for future studies with long-term follow-up.
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Affiliation(s)
| | - L. Marryat
- Farr Institute Scottish Collaboration for Public Health Research and PolicyUniversity of EdinburghEdinburghUK
| | - S. Chambers
- MRC/CSO Social and Public Health Sciences UnitUniversity of GlasgowGlasgowUK
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Solis-Medina A, Martínez-Magaña JJ, Quintanar-Jurado V, Gallegos-Silva I, Juárez-Rojop IE, Tovilla-Zárate CA, Díaz-Zagoya JC, Hernández-Díaz Y, González-Castro TB, López-Narváez ML, Genis-Mendoza AD, Nicolini H. Astrogliosis and decreased neural viability as consequences of early consumption of aspartame and acesulfame potassium in male Wistar rats. Metab Brain Dis 2018; 33:2031-2038. [PMID: 30264280 DOI: 10.1007/s11011-018-0310-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 08/30/2018] [Indexed: 12/13/2022]
Abstract
Artificial sweeteners are mainly used as substitutes for sucrose derivates. In this study, we analyzed if the chronic consumption of aspartame or acesulfame potassium at an early age, produces histological alterations, astrogliosis and decreased neuronal viability, in hippocampus, prefrontal cortex, amygdala and hypothalamus of male Wistar rats. A histological analysis was performed on male Wistar rats that consumed aspartame or acesulfame potassium during 90 days, initiating the consumption of sweeteners immediately after weaning. The evaluation of neuronal morphology in different areas of the brain was performed with hematoxylin - eosin staining. To measure astrogliosis and neuronal viability, we used the immunohistochemical technique, with the glial fibrillary acidic protein immunomodulators (GFAP) and with neuronal-specific enolase (NSE). The consumption of aspartame or acesulfame potassium promoted morphological changes of neurons including increased pyknotic nuclei and vacuolization in all the brain areas studied. In hippocampus, prefrontal cortex, amygdala and hypothalamus, astrogliosis and reduction of neural viability were observed in sweeteners consumers in comparison with the control group. Chronic consumption of ASP and ACK from early stages of development and during long periods, may promote neural modifications, astrogliosis and decrease neuronal viability in prefrontal cortex, amygdala, hippocampus, and hypothalamus.
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Affiliation(s)
- Anayelly Solis-Medina
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México, Mexico
| | - José Jaime Martínez-Magaña
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México, Mexico
| | - Valeria Quintanar-Jurado
- Laboratorio de Histología y Microscopía LHiM, Instituto Nacional de Medicina Genómica, Ciudad de México, Mexico
| | - Ileana Gallegos-Silva
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México, Mexico
| | - Isela E Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Tabasco, Mexico
| | - Carlos Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco, Tabasco, Mexico
| | - Juan C Díaz-Zagoya
- División de Investigación, Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Yazmín Hernández-Díaz
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, Mexico
| | - Thelma Beatriz González-Castro
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, Mexico
| | | | - Alma Delia Genis-Mendoza
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México, Mexico.
- Servicios de Atención Psiquiátrica, Secretaría de Salud, Periférico Sur 4809, Arenal Tepepan, Tlalpan, 14610, Ciudad de México, Mexico.
| | - Humberto Nicolini
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Instituto Nacional de Medicina Genómica, Ciudad de México, Mexico
- Servicios de Atención Psiquiátrica, Secretaría de Salud, Periférico Sur 4809, Arenal Tepepan, Tlalpan, 14610, Ciudad de México, Mexico
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Wee M, Tan V, Forde C. A Comparison of Psychophysical Dose-Response Behaviour across 16 Sweeteners. Nutrients 2018; 10:E1632. [PMID: 30400167 PMCID: PMC6266678 DOI: 10.3390/nu10111632] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/19/2018] [Accepted: 10/26/2018] [Indexed: 12/21/2022] Open
Abstract
Reduction or replacement of sucrose while maintaining sweetness in foods is challenging, but today there are many sweeteners with diverse physical and caloric compositions to choose from. The choice of sweetener can be adapted to match reformulation goals whether these are to reduce calories, lower the glycaemic response, provide bulk or meet criteria as a natural ingredient. The current study sought to describe and compare the sweetness intensity dose-response, sweetness growth rate, sweetness potency, and potential for calorie reduction across 16 different sweeteners including sucrose. Sweetness growth rate was defined as the rate of change in sweetness intensity per unit of sweetener concentration. Sweetness potency was defined as the ratio of the concentration of a sweetener to that of sucrose at equivalent sweetness intensity, whereas the potential for calorie reduction is the caloric value of a sweetener compared to sucrose at matched sweetness intensities. Sweeteners were drawn from a range of nutritive saccharide (sucrose, dextrose, fructose, allulose (d-psicose), palatinose (isomaltulose), and a sucrose⁻allulose mixture), nutritive polyol (maltitol, erythritol, mannitol, xylitol, sorbitol), non-nutritive synthetic (aspartame, acesulfame-K, sucralose) and non-nutritive natural sweeteners stevia (rebaudioside A), luo han guo (mogroside V). Sweetness intensities of the 16 sweeteners were compared with a sensory panel of 40 participants (n = 40; 28 females). Participants were asked to rate perceived sweetness intensity for each sweetener series across a range of concentrations using psychophysical ratings taken on a general labelled magnitude scale (gLMS). All sweeteners exhibited sigmoidal dose-response behaviours and matched the 'moderate' sweetness intensity of sucrose (10% w/v). Fructose, xylitol and sucralose had peak sweetness intensities greater than sucrose at the upper concentrations tested, while acesulfame-K and stevia (rebA) were markedly lower. Independent of sweetener concentration, the nutritive sweeteners had similar sweetness growth rates to sucrose and were greater than the non-nutritive sweeteners. Non-nutritive sweeteners on the other hand had higher potencies relative to sucrose, which decreases when matching at higher sweetness intensities. With the exception of dextrose and palatinose, all sweeteners matched the sweetness intensity of sucrose across the measured range (3.8⁻25% w/v sucrose) with fewer calories. Overall, the sucrose⁻allulose mixture, maltitol and xylitol sweeteners were most similar to sucrose in terms of dose-response behaviour, growth rate and potency, and showed the most potential for sugar replacement within the range of sweetness intensities tested.
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Affiliation(s)
- May Wee
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117599, Singapore.
| | - Vicki Tan
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117599, Singapore.
| | - Ciarán Forde
- Clinical Nutrition Research Centre (CNRC), Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117599, Singapore.
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore.
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Nezami BT, Ward DS, Lytle LA, Ennett ST, Tate DF. A mHealth randomized controlled trial to reduce sugar-sweetened beverage intake in preschool-aged children. Pediatr Obes 2018; 13:668-676. [PMID: 29119719 DOI: 10.1111/ijpo.12258] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 08/25/2017] [Accepted: 10/03/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sugar-sweetened beverages and maternal weight are strong drivers of child obesity, but few studies have targeted these risk factors as an obesity prevention strategy in children. OBJECTIVE The objective of this study was to test the efficacy of a smartphone-delivered intervention to reduce parent-provided sugar-sweetened beverage and juice (SSB/juice) consumption among children ages 3-5 and maternal weight. METHODS Mothers with overweight or obesity, who had a child ages 3-5 that consumed at least 12 fl. oz./day of SSB/juice (N = 51 dyads) were randomized to the Smart Moms group that received one group session, lessons on a mobile website, and text messages, or to a waitlist control group. Mothers self-monitored their children's beverages in addition to their own beverages, high-calorie foods, and weight. Assessments at baseline, 3, and 6 months included dietary recalls to measure SSB/juice intake and objectively measured maternal weight. RESULTS Using linear mixed models controlling for baseline values, child age and race, there was a greater reduction in child SSB/juice in Smart Moms compared with control at 6 months (-9.7 oz./day vs. 1.7 oz./day, p < .01). Mothers in Smart Moms lost 2.4 kg at 6 months compared with a 0.9-kg gain in the control group (p < .01). CONCLUSIONS An intervention delivered using mHealth technologies can target mothers to change child dietary behaviours and improve maternal weight, which suggests a novel approach to family-based obesity prevention.
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Affiliation(s)
- B T Nezami
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - D S Ward
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - L A Lytle
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - S T Ennett
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - D F Tate
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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41
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Kendall FE, Marchand O, Haszard JJ, Venn BJ. The Comparative Effect on Satiety and Subsequent Energy Intake of Ingesting Sucrose or Isomaltulose Sweetened Trifle: A Randomized Crossover Trial. Nutrients 2018; 10:nu10101504. [PMID: 30326587 PMCID: PMC6212890 DOI: 10.3390/nu10101504] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 10/09/2018] [Accepted: 10/13/2018] [Indexed: 12/03/2022] Open
Abstract
The effect that blood glucose concentration has on feelings of satiety is unclear. Our aims were to assess satiety and subsequent energy intake following the ingestion of trifle sweetened with sucrose or isomaltulose whilst measuring plasma glucose concentration to confirm glycemic differences between trifles. Seventy-seven healthy adults participated in a double-blind crossover trial where trifle sweetened with sucrose or isomaltulose was consumed on separate days with a two-week washout. Blood was sampled at the baseline, 1 and 2 h postprandially, and satiety assessed using visual analogue scales (VAS). Weighed diet records were taken on test days. A statistically significant difference in blood glucose concentration between trifles was found at 60 min following consumption, with the isomaltulose trifle having a 0.69 mmol/L (95% confidence interval: −1.07, −0.31) lower concentration when compared with the sucrose trifle. Mean satiety response by area-under-the-curve (AUC) was not significantly different between trifles. Mean (SD) appetite scores for the sucrose and isomaltulose trifles were 4493 (2393) and 4527 (2590) mm·min, respectively, with a between trifle difference of −9 (95% CI: −589, 572) mm·min. Mean (SD) energy intake for the remainder of the day following trifle consumption was 3894 kJ (1950 kJ) and 3530 kJ (1926 kJ) after the sucrose and isomaltulose trifles, respectively, and was not significantly different (p = 0.133). The differing glycemic response to trifle was not related to satiety or to subsequent energy intake.
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Affiliation(s)
- Fiona E Kendall
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Olivia Marchand
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Jillian J Haszard
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
| | - Bernard J Venn
- Department of Human Nutrition, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
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42
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Taqi M, Razak IA, Ab-Murat N. Sugar consumption and caries occurrence among Pakistani school children. J PAK MED ASSOC 2018; 68:1483-1487. [PMID: 30317346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To estimate the frequency and pattern of sugar intake among Pakistani school going children and its association with early carious lesion and caries history. METHODS The cross-sectional study was conducted from January to May 2016 in seven schools of Bhakkar district in the Punjab province of Pakistan, and comprised of school children aged 11-12 years. Diet diaries were used to assess the frequency of sugar intake while caries was assessed using the Modified International Caries Detection and Assessment System. Bivariate analysis was used to assess the association of sugar consumption and early carious lesion with selected sociodemographic variables, and regression analysis was performed to evaluate the factor that matters most in caries occurrence. RESULTS Of the 226 subjects, 115(51%) had early carious lesion. Mean frequency of sugar intake was 5.2±3.2 times per day. Children who consumed sugar between main meals (p=0.01) and within two hours before bedtime (p=0.04) had significantly higher history of having caries. Cariogenic intake before bedtime was significantly associated with overall caries risk (p=0.02). CONCLUSIONS The frequency of sugar intake among the subjects was slightly higher than the recommended level. .
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Affiliation(s)
- Muhammad Taqi
- Department of Community Dentistry, Dow Dental College, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Norintan Ab-Murat
- Department of Community Oral Health and Clinical Prevention, University of Malaya, Malaysia
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Dello Russo M, Ahrens W, De Henauw S, Eiben G, Hebestreit A, Kourides Y, Lissner L, Molnar D, Moreno LA, Pala V, Veidebaum T, Siani A, Russo P. The Impact of Adding Sugars to Milk and Fruit on Adiposity and Diet Quality in Children: A Cross-Sectional and Longitudinal Analysis of the Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants (IDEFICS) Study. Nutrients 2018; 10:E1350. [PMID: 30248889 PMCID: PMC6213151 DOI: 10.3390/nu10101350] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 09/13/2018] [Accepted: 09/19/2018] [Indexed: 01/02/2023] Open
Abstract
Sugar, particularly as free sugars or sugar-sweetened beverages, significantly contributes to total energy intake, and, possibly, to increased body weight. Excessive consumption may be considered as a proxy of poor diet quality. However, no previous studies evaluated the association between the habit of adding sugars to "healthy" foods, such as plain milk and fresh fruit, and indicators of adiposity and/or dietary quality in children. To answer to these research questions, we Panalysed the European cohort of children participating in the IDEFICS study. Anthropometric variables, frequency of consumption of sugars added to milk and fruit (SAMF), and scores of adherence to healthy dietary pattern (HDAS) were assessed at baseline in 9829 children stratified according to age and sex. From this cohort, 6929 children were investigated again after two years follow-up. At baseline, a direct association between SAMF categories and adiposity indexes was observed only in children aged 6⁻<10 years, while the lower frequency of SAMF consumption was significantly associated with a higher HDAS. At the two year follow-up, children with higher baseline SAMF consumption showed significantly higher increases in all the anthropometric variables measured, with the exception of girls 6⁻<10 years old. The inverse association between SAMF categories and HDAS was still present at the two years follow-up in all age and sex groups. Our results suggest that the habit to adding sugars to foods that are commonly perceived as healthy may impact the adherence to healthy dietary guidelines and increase in adiposity risk as well.
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Affiliation(s)
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
- Institute of Statistics, University of Bremen, 28359 Bremen, Germany.
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Gabriele Eiben
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, 54128 Skövde, Sweden.
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, 28359 Bremen, Germany.
| | - Yannis Kourides
- Research and Education Institute of Child Health, 2040 Strovolos, Cyprus.
| | - Lauren Lissner
- Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden.
| | - Denes Molnar
- Department of Paediatrics, University of Pécs, 7624 Pécs, Hungary.
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain.
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
| | - Toomas Veidebaum
- National Institute for Health Development, 11619 Tallinn, Estonia.
| | - Alfonso Siani
- Institute of Food Sciences, CNR, 83100 Avellino, Italy.
| | - Paola Russo
- Institute of Food Sciences, CNR, 83100 Avellino, Italy.
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Samaniego-Vaesken MDL, Ruiz E, Partearroyo T, Aranceta-Bartrina J, Gil Á, González-Gross M, Ortega RM, Serra-Majem L, Varela-Moreiras G. Added Sugars and Low- and No-Calorie Sweeteners in a Representative Sample of Food Products Consumed by the Spanish ANIBES Study Population. Nutrients 2018; 10:E1265. [PMID: 30205522 PMCID: PMC6163363 DOI: 10.3390/nu10091265] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/04/2018] [Accepted: 09/05/2018] [Indexed: 12/11/2022] Open
Abstract
Low- and no-calorie sweeteners (LNCS), intensely sweet compounds that virtually contain no calories, are used to replace added sugars in food and drinks. Knowledge about different LNCS data in Spanish foods and added sugar sources in Spain is limited, therefore our aim was to identify and compare their presence across main food groups consumed. Food and beverage products (n = 434) were obtained from the ANIBES Study (anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic data and lifestyles), a cross-sectional study of a representative sample of the Spanish population (9⁻75 years old; n = 2009) carried out in 2013. Food records were obtained from a three-day dietary record using a tablet device. Label data from 1,164 products of different brands were collected and reviewed for content of added sugars and LNCS. LNCS were present in diet soft drinks (100%), "other sweets" (89%), soya drinks (45%), and yogurt and fermented milks (18%). Added sugars were present mainly in sugar soft drinks (100%), energy drinks (96%), sports drinks (96%), bakery and pastry (100%), chocolates (100%), ice cream (100%), breakfast cereals/bars (96%) and jams (89%). Main LNCS were acesulfame K, aspartame, cyclamate and sucralose. Sucrose, dextrose, glucose-fructose syrup, caramel and honey were the main added sugars. Our results show the diversity of foods groups including these ingredients. These data are not compiled in food composition databases, which should be periodically updated to include LNCS and added sugars to facilitate their assessment and monitoring in nutritional surveys.
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Affiliation(s)
| | - Emma Ruiz
- Spanish Nutrition Foundation (FEN), 28010 Madrid, Spain.
| | - Teresa Partearroyo
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, 28668 Madrid, Spain.
| | - Javier Aranceta-Bartrina
- Department of Food Sciences and Physiology, University of Navarra, Pamplona, 31009 Navarra, Spain.
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas, Spain.
- Department of Physiology, Faculty of Medicine, University of the Basque Country (UPV/EHU), 48940 Leioa, Vizcaya, Spain.
| | - Ángel Gil
- CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, 28029 Madrid, Spain.
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Sciences, University of Granada, 18010 Granada, Spain.
| | - Marcela González-Gross
- CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, 28029 Madrid, Spain.
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, 28040 Madrid, Spain.
| | - Rosa M Ortega
- Department of Nutrition and Food Science, Faculty of Pharmacy, Madrid Complutense University, 28040 Madrid, Spain.
| | - Lluis Serra-Majem
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35016 Las Palmas, Spain.
- CIBEROBN, Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition, Carlos III Health Institute, 28029 Madrid, Spain.
- Service of Preventive Medicine, Complejo Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canary Health Service, Las Palmas de Gran Canaria, 35016 Las Palmas, Spain.
| | - Gregorio Varela-Moreiras
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, 28668 Madrid, Spain.
- Spanish Nutrition Foundation (FEN), 28010 Madrid, Spain.
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Hudson SD, Sims CA, Odabasi AZ, Colquhoun TA, Snyder DJ, Stamps JJ, Dotson SC, Puentes L, Bartoshuk LM. Flavor Alterations Associated with Miracle Fruit and Gymnema sylvestre. Chem Senses 2018; 43:481-488. [PMID: 29905783 PMCID: PMC6108391 DOI: 10.1093/chemse/bjy032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Taste and flavor (retronasal olfaction) interact in the brain. The rules of that interaction are not well understood. This study uses 2 taste modifiers that alter sweet to examine the effects on flavors. Subjects used the Global Sensory Intensity Scale to assess the aroma, sweetness, sourness, and flavor of 10 foods. As previous work had shown, miracle fruit added sweetness to acids, which secondarily reduced sourness (mixture suppression) and Gymnema sylvestre reduced sweetness in sweet foods as well as the sweetness induced by miracle fruit. In this study, multiple regression showed that both sweet and sour contribute to flavor. Gymnema sylvestre reduced the perceived sweet of predominantly sweet foods (chocolate and maple syrup) as expected; reducing the sweet, reduced the flavor. The effects of miracle fruit were complicated by its dual action: intensification of sweet and reduction of sour. Predominantly sour foods (vinegar, lemon, mustard, pickle) were sweetened by miracle fruit but any flavor enhancement associated with the added sweet appears to have been countered by the flavor reduction associated with reduced sourness. Moderately sour foods that are also sweet (tomatoes, strawberries) were sweetened by miracle fruit and thus flavor was enhanced; flavor loss through sour reduction was apparently not sufficient to counter the flavor enhancement due to increased sweet so the net result was that tomato and strawberry flavors were enhanced. The flavors of control foods (not predominantly sweet or sour [sausage, peanuts]) showed only small changes.
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Affiliation(s)
- Sonia D Hudson
- Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD, USA
| | - Charles A Sims
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, FL, USA
| | - Asli Z Odabasi
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, FL, USA
| | - Thomas A Colquhoun
- Department of Environmental Horticulture, University of Florida, Gainesville, FL, USA
| | - Derek J Snyder
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, FL, USA
| | - Jennifer J Stamps
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, FL, USA
| | - Shawn C Dotson
- BioSciences and Sweetness Research, Coca-Cola, Atlanta, GA, USA
| | | | - Linda M Bartoshuk
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, FL, USA
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Guercio BJ, Zhang S, Niedzwiecki D, Li Y, Babic A, Morales-Oyarvide V, Saltz LB, Mayer RJ, Mowat RB, Whittom R, Hantel A, Benson A, Atienza D, Messino M, Kindler H, Venook A, Ogino S, Zoltick ES, Stampfer M, Ng K, Wu K, Willett WC, Giovannucci EL, Meyerhardt JA, Fuchs CS. Associations of artificially sweetened beverage intake with disease recurrence and mortality in stage III colon cancer: Results from CALGB 89803 (Alliance). PLoS One 2018; 13:e0199244. [PMID: 30024889 PMCID: PMC6053135 DOI: 10.1371/journal.pone.0199244] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 06/01/2018] [Indexed: 12/16/2022] Open
Abstract
Purpose Observational studies have demonstrated increased colon cancer recurrence and mortality in states of excess energy balance, as denoted by factors including sedentary lifestyle, diabetes, increased dietary glycemic load, and increased intake of sugar-sweetened beverages. Nonetheless, the relation between artificially sweetened beverages, a popular alternative for sugar-sweetened beverages, and colon cancer recurrence and survival is unknown. Methods We analyzed data from 1,018 patients with stage III colon cancer who prospectively reported dietary intake during and after chemotherapy while enrolled in a National Cancer Institute-sponsored trial of adjuvant chemotherapy. Using Cox proportional hazards regressions, we assessed associations of artificially sweetened beverage intake with cancer recurrence and mortality. Results Patients consuming one or more 12-ounce servings of artificially sweetened beverages per day experienced an adjusted hazard ratio for cancer recurrence or mortality of 0.54 (95% confidence interval, 0.36 to 0.80) when compared to those who largely abstained (Ptrend = .004). Similarly, increasing artificially sweetened beverage intake was also associated with a significant improvement in both recurrence-free survival (Ptrend = .005) and overall survival (Ptrend = .02). Substitution models demonstrated that replacing a 12-ounce serving of a sugar-sweetened beverage with an isovolumetric serving of an artificially sweetened beverage per day was associated with a 23% lower risk of cancer recurrence and mortality (relative risk, 0.77; 95% confidence interval, 0.63 to 0.95; P = .02). Conclusion Higher artificially sweetened beverage consumption may be associated with significantly reduced cancer recurrence and death in patients with stage III colon cancer. This association may be mediated by substitution for sugar-sweetened alternatives. Further studies are needed to confirm these findings.
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Affiliation(s)
- Brendan J. Guercio
- Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Sui Zhang
- Dana-Farber/Partners CancerCare, Boston, Massachusetts, United States of America
| | - Donna Niedzwiecki
- Alliance Statistics and Data Center, Duke University, Durham, North Carolina, United States of America
| | - Yanping Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Ana Babic
- Dana-Farber/Partners CancerCare, Boston, Massachusetts, United States of America
| | | | - Leonard B. Saltz
- Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Robert J. Mayer
- Dana-Farber/Partners CancerCare, Boston, Massachusetts, United States of America
| | - Rex B. Mowat
- Toledo Community Hospital Oncology Program, Toledo, Ohio, United States of America
| | | | - Alexander Hantel
- Edward-Elmhurst Healthcare, Naperville, Illinois, United States of America
| | - Al Benson
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois, United States of America
| | - Daniel Atienza
- Virginia Oncology Associates, Norfolk, Virginia, United States of America
| | - Michael Messino
- Southeast Clinical Oncology Research (SCOR) Consortium, Mission Hospitals, Incorporated, Asheville, North Carolina, United States of America
| | - Hedy Kindler
- University of Chicago Comprehensive Cancer Center, Chicago, Illinois, United States of America
| | - Alan Venook
- University of California at San Francisco Comprehensive Cancer Center, San Francisco, California, United States of America
| | - Shuji Ogino
- Dana-Farber/Partners CancerCare, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Division of Molecular Pathological Epidemiology (MPE), Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Department of Pathology, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Emilie S. Zoltick
- Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, United States of America
- Division of Genetics, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Meir Stampfer
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Kimmie Ng
- Dana-Farber/Partners CancerCare, Boston, Massachusetts, United States of America
| | - Kana Wu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Walter C. Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Edward L. Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | | | - Charles S. Fuchs
- Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut, United States of America
- * E-mail:
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Coors SM, Cousin JJ, Hagan JL, Kaiser JR. Prophylactic Dextrose Gel Does Not Prevent Neonatal Hypoglycemia: A Quasi-Experimental Pilot Study. J Pediatr 2018; 198:156-161. [PMID: 29605395 DOI: 10.1016/j.jpeds.2018.02.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/30/2018] [Accepted: 02/09/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To test the hypothesis that prophylactic dextrose gel administered to newborn infants at risk for hypoglycemia will increase the initial blood glucose concentration after the first feeding and decrease neonatal intensive care unit (NICU) admissions for treatment of asymptomatic neonatal hypoglycemia compared with feedings alone. STUDY DESIGN This quasi-experimental study allocated asymptomatic at-risk newborn infants (late preterm, birth weight <2500 or >4000 g, and infants of mothers with diabetes) to receive prophylactic dextrose gel (Insta-Glucose; Valeant Pharmaceuticals North America LLC, Bridgewater, New Jersey); other at-risk infants formed the control group. After the initial feeding, the prophylactic group received dextrose gel (0.5 mL/kg) rubbed into the buccal mucosa. The blood glucose concentration was checked 30 minutes later. Initial glucose concentrations and rate of NICU admissions were compared between the prophylactic group and controls using bivariate analyses. A multivariable linear regression compared first glucose concentrations between groups, adjusting for at-risk categories and age at first glucose concentration. RESULTS There were 236 subjects (72 prophylactic, 164 controls). The first glucose concentration was not different between the prophylactic and control groups in bivariate analysis (52.1 ± 17.1 vs 50.5 ± 15.3 mg/dL, P = .69) and after adjusting for covariates (P = .18). Rates of NICU admission for treatment of transient neonatal hypoglycemia were 9.7% and 14.6%, respectively (P = .40). CONCLUSIONS Prophylactic dextrose gel did not reduce transient neonatal hypoglycemia or NICU admissions for hypoglycemia. The carbohydrate concentration of Insta-Glucose (77%) may have caused a hyperinsulinemic response, or alternatively, exogenous enteral dextrose influences glucose homeostasis minimally during the first few hours when counter-regulatory mechanisms are especially active. TRIAL REGISTRATION ClinicalTrials.gov: NCT02523222.
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Affiliation(s)
- Sarah M Coors
- Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Houston, TX.
| | - Joshua J Cousin
- Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Houston, TX
| | - Joseph L Hagan
- Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Houston, TX
| | - Jeffrey R Kaiser
- Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Houston, TX; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX
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Jacquillet G, Debnam ES, Unwin RJ, Marks J. Acute saccharin infusion has no effect on renal glucose handling in normal rats in vivo. Physiol Rep 2018; 6:e13804. [PMID: 30009546 PMCID: PMC6046642 DOI: 10.14814/phy2.13804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 06/26/2018] [Accepted: 06/27/2018] [Indexed: 12/05/2022] Open
Abstract
Artificial sweeteners are extensively used by the food industry to replace sugar in food and beverages and are widely considered to be a healthy alternative. However, recent data suggest that artificial sweeteners may impact intestinal glucose absorption and that they might lead to glucose intolerance. Moreover, chronic consumption of artificial sweeteners has also been linked to detrimental changes in renal function. Using an in vivo approach, our study aimed to determine if short-term infusion of the artificial sweetener saccharin can alter renal function and renal glucose absorption. We show that saccharin infusion does not induce any major change in GFR or urine flow rate at either the whole kidney or single nephron level, suggesting that any reported change in renal function with artificial sweeteners must depend on chronic consumption. As expected for a nondiabetic animal, glucose excretion was low; however, saccharin infusion caused a small, but significant, decrease in fractional glucose excretion. In contrast to the whole kidney data, our micropuncture results did not show any significant difference in fractional glucose reabsorption in either the proximal or distal tubules, indicating that saccharin does not influence renal glucose handling in vivo under euglycemic conditions. In keeping with this finding, protein levels of the renal glucose transporters SGLT1 and SGLT2 were also unchanged. In addition, saccharin infusion in rats undergoing a glucose tolerance test failed to induce a robust change in renal glucose excretion or renal glucose transporter expression. In conclusion, our results demonstrate that saccharin does not induce acute physiologically relevant changes in renal function or renal glucose handling.
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Affiliation(s)
- Grégory Jacquillet
- Department of Neuroscience, Physiology & PharmacologyUniversity College LondonLondonUnited Kingdom
| | - Edward S. Debnam
- Department of Neuroscience, Physiology & PharmacologyUniversity College LondonLondonUnited Kingdom
| | - Robert J. Unwin
- Department of Neuroscience, Physiology & PharmacologyUniversity College LondonLondonUnited Kingdom
- Centre for NephrologyUniversity College LondonLondonUnited Kingdom
| | - Joanne Marks
- Department of Neuroscience, Physiology & PharmacologyUniversity College LondonLondonUnited Kingdom
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49
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Pham HT, Stevens JE, Rigda RS, Phillips LK, Wu T, Hausken T, Soenen S, Visvanathan R, Rayner CK, Horowitz M, Jones KL. Effects of intraduodenal administration of the artificial sweetener sucralose on blood pressure and superior mesenteric artery blood flow in healthy older subjects. Am J Clin Nutr 2018; 108:156-162. [PMID: 29878043 DOI: 10.1093/ajcn/nqy060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 03/12/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Postprandial hypotension (PPH) occurs frequently, particularly in older people and those with type 2 diabetes, and is associated with increased morbidity and mortality. The magnitude of the decrease in blood pressure (BP) induced by carbohydrate, fat, and protein appears to be comparable and results from the interaction of macronutrients with the small intestine, including an observed stimulation of mesenteric blood flow. It is not known whether artificial sweeteners, such as sucralose, which are widely used, affect BP. OBJECTIVE The aim of this study was to evaluate the effects of intraduodenal sucralose on BP and superior mesenteric artery (SMA) blood flow, compared with intraduodenal glucose and saline (control), in healthy older subjects. DESIGN Twelve healthy subjects (6 men, 6 women; aged 66-79 y) were studied on 3 separate occasions in a randomized, double-blind, crossover design. After an overnight fast, subjects had concurrent measurements of BP and heart rate (HR; automated device), SMA blood flow (Doppler ultrasound), and blood glucose (glucometer) during intraduodenal infusion of 1) glucose (25% wt:vol, ∼1400 mOsmol/L), 2) sucralose (4 mmol/L, ∼300 mOsmol/L), or 3) saline (0.9% wt:vol, ∼300 mOsmol/L) at a rate of 3 mL/min for 60 min followed by intraduodenal saline for a further 60 min. RESULTS There was a decrease in mean arterial BP (P < 0.001) during intraduodenal glucose [baseline (mean ± SEM): 91.7 ± 2.6 mm Hg compared with t = 60 min: 85.9 ± 2.8 mm Hg] but not during intraduodenal saline or intraduodenal sucralose. The HR (P < 0.0001) and SMA blood flow (P < 0.0001) also increased during intraduodenal glucose but not during intraduodenal saline or intraduodenal sucralose. As expected, blood glucose concentrations increased in response to glucose (P < 0.0001) but not saline or sucralose. CONCLUSIONS In healthy older subjects, intraduodenal administration of the artificial sweetener sucralose was not associated with changes in BP or SMA blood flow. Further studies are therefore warranted to determine the potential role for artificial sweeteners as a therapy for PPH. This trial was registered at http://www.ANZCTR.org.au as ACTRN12617001249347.
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Affiliation(s)
- Hung T Pham
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health
| | - Julie E Stevens
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Rachael S Rigda
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health
| | - Liza K Phillips
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health
- Endocrine and Metabolic Unit
| | - Tongzhi Wu
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health
| | - Trygve Hausken
- Department of Gastroenterology, Haukeland University Hospital, Bergen, Norway
| | - Stijn Soenen
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health
| | - Renuka Visvanathan
- NHMRC Center of Research Excellence in Frailty, The University of Adelaide, Adelaide, South Australia, Australia
- Aged and Extended Care Services, Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Christopher K Rayner
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health
- Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Michael Horowitz
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health
- Endocrine and Metabolic Unit
| | - Karen L Jones
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Translating Nutritional Science to Good Health
- Endocrine and Metabolic Unit
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50
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Chen L, Xie YM, Pei JH, Kuang J, Chen HM, Chen Z, Li ZW, Fu XY, Wang L, Lai SQ, Zhang ST, Chen ZJ, Lin JX. Sugar-sweetened beverage intake and serum testosterone levels in adult males 20-39 years old in the United States. Reprod Biol Endocrinol 2018; 16:61. [PMID: 29935533 PMCID: PMC6015465 DOI: 10.1186/s12958-018-0378-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 06/15/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This population-based study was designed to investigate whether consumption of sugar-sweetened beverages (SSB) is associated with lower serum total testosterone concentration in men 20-39 years old. METHODS All data for this study were retrieved from the National Health and Nutrition Examination Survey (NHANES) 2011-2012. The primary outcome was serum testosterone concentration, and main independent variable was SSB intake. Other variables included age, race/ethnicity, poverty/income ratio, body mass index (BMI), serum cotinine, heavy drinking, and physical activity. RESULTS Among all subjects (N = 545), 486 (90.4%) had normal testosterone levels (defined as ≥231 ng/dL) and 59 (9.6%) had low testosterone levels (defined as < 231 ng/dL). Multivariate logistic regression revealed the odds of low testosterone was significantly greater with increasing SSB consumption (Q4 [≥442 kcal/day] vs. Q1 [≤137 kcal/day]), adjusted odds ratio [aOR] = 2.29, p = 0.041]. After adjusting for possible confounding variables, BMI was an independent risk factor for low testosterone level; subjects with BMI ≥ 25 kg/m2 had a higher risk of having a low testosterone level than those with BMI < 25 kg/m2 (aOR = 3.68, p = 0.044). CONCLUSION SSB consumption is significantly associated with low serum testosterone in men 20-39 years old in the United States.
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Affiliation(s)
- Liang Chen
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Yu-Mei Xie
- GuangDong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jian-Hao Pei
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Jian Kuang
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Hong-Mei Chen
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Zhong Chen
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Zhong-Wen Li
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Xiao-Ying Fu
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Long Wang
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Shui-Qing Lai
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Shu-Ting Zhang
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Zhi-Jiang Chen
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Jin-xin Lin
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
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