Effects of the Non-Nutritive Sweeteners on Glucose Metabolism and Appetite Regulating Hormones: Systematic Review of Observational Prospective Studies and Clinical Trials

Romo-Romo, Alonso; Aguilar-Salinas, Carlos A.; Brito-Córdova, Griselda X.; Díaz, Rita Angélica Gómez; Valentín, David Vilchis; Almeda‐Valdés, Paloma

doi:10.1371/journal.pone.0161264

Cited by 95 publications

(61 citation statements)

References 47 publications

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“…Recent research indicates differential effects of sucralose, a type of NNS, on glucose metabolism between normal weight people and people with obesity [18]. A recent review examined the effects of NNSs on glucose metabolism and appetite-regulating hormones [19]. However, it mainly focused on the evidence linking NNS consumption to the risks for chronic diseases including obesity, diabetes, and metabolic syndrome rather than the short-term response of blood glucose level to NNS consumption [19].…”

Section: Introductionmentioning

confidence: 99%

“…A recent review examined the effects of NNSs on glucose metabolism and appetite-regulating hormones [19]. However, it mainly focused on the evidence linking NNS consumption to the risks for chronic diseases including obesity, diabetes, and metabolic syndrome rather than the short-term response of blood glucose level to NNS consumption [19]. The purpose of the current study was to systematically review and quantitatively synthesize existing scientific evidence from randomized controlled trials (RCTs) on the glycemic impact of NNSs.…”

Section: Introductionmentioning

confidence: 99%

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Glycemic impact of non-nutritive sweeteners: a systematic review and meta-analysis of randomized controlled trials

Nichol

Holle

2018

Eur J Clin Nutr

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Background/objectives Nonnutritive sweeteners (NNSs) are zero-or low-calorie alternatives to nutritive sweeteners, such as table sugars. A systematic review and meta-analysis of randomized controlled trials was conducted to quantitatively synthesize existing scientific evidence on the glycemic impact of NNSs. Subjects/methods PubMed and Web of Science databases were searched. Two authors screened the titles and abstracts of candidate publications. The third author was consulted to resolve discrepancies. Twenty-nine randomized controlled trials, with a total of 741 participants, were included and their quality assessed. NNSs under examination included aspartame, saccharin, steviosides, and sucralose. The review followed the PRISMA guidelines. Results Meta-analysis was performed to estimate and track the trajectory of blood glucose concentrations over time after NNS consumption, and to test differential effects by type of NNS and participants' age, weight, and disease status. In comparison with the baseline, NNS consumption was not found to increase blood glucose level, and its concentration gradually declined over the course of observation following NNS consumption. The glycemic impact of NNS consumption did not differ by type of NNS but to some extent varied by participants' age, body weight, and diabetic status. Conclusions NNS consumption was not found to elevate blood glucose level. Future studies are warranted to assess the health implications of frequent and chronic NNS consumption and elucidate the underlying biological mechanisms.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Glycemic impact of non-nutritive sweeteners: a systematic review and meta-analysis of randomized controlled trials

Nichol

Holle

2018

Eur J Clin Nutr

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“…Previous studies reported that most NNS have little or no effect on the serum biochemical parameters of normal and diabetic human subjects (Romo‐Romo et al, ; Shankar, Suman, & Sriram, ; Tey et al, ). In the present study, it was observed that NNS influence serum antioxidant status.…”

Section: Resultsmentioning

confidence: 97%

Commercially available non-nutritive sweeteners modulate the antioxidant status of type 2 diabetic rats

et al. 2019

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Non‐nutritive sweeteners (NNS) are increasingly being used by diabetics, but little is known about their effects on antioxidant status. We investigated the effects of ad libitum consumption of commercially available NNS (aspartame, saccharin, sucralose, and cyclamate‐based sweeteners) on antioxidative markers in a rat model of type 2 diabetes (T2D). NNS consumption reduced (p < 0.05) T2D‐induced lipid peroxidation and boosted serum, hepatic, renal, cardiac, and pancreatic glutathione (GSH) levels. Catalase, glutathione reductase, superoxide dismutase, and glutathione peroxidase activity was increased in the serum and most organs upon diabetes induction, perhaps due to adaptative antioxidant response to the diabetes‐induced lipid peroxidation. NNS showed varying effects on serum and tissue antioxidant enzymes of animals. An antioxidant capacity scores sheet of NNS, suggest that aspartame‐based NNS may not exert antioxidant effects in diabetics, while saccharin‐based NNS may be a potent antioxidative sweetener as seen in the animal model of T2D. Practical applications The use of NNS is becoming more popular, especially for diabetic individuals. While there are several commercial NNS available in the market, little is known about how they affect the antioxidant status of consumers. We therefore investigated how some commercially available NNS affect the antioxidant status of diabetic rats. Observed data revealed varying effects of NNS on serum and different organs, which suggest that some NNS may be better than others for diabetic oxidative stress and thus may be recommended for consumers. However, this finding is subject to additional corroborative clinical studies.

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“…[24] Given these results, the American Dietetic Association stated that non-nutritive sweeteners were safe for consumption because they do not affect the glycemic response in patients with diabetes mellitus. [25,26] …”

Section: Figure 1 Network Meta-analysis Of Six Interventions In Glycmentioning

confidence: 99%

Review of Recommendations for the Use of Caloric Sweeteners by Adults and Children

Garay¹,

Romo-Romo²,

Serralde‐Zúñiga³

2018

JFNR

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Sweeteners are natural or artificial substances that give food or a product a sweet flavour, and are divide by their nutritional value to caloric and non-caloric. Although they have been reported as safe, this review analyses the findings of various studies to obtain recommendations for their use based on their effect on energy consumption, weight, glucose and blood lipids. In addition to the compensation in energy intake, effects on appetite, hydration, preference for sweet flavours and cardiovascular function were reviewed. We searched MEDLINE, EMBASE, LILACS, and WHO ICTRP Search Portal without language restrictions. We included systematic reviews, controlled trials and observational studies comparing the administration of caloric and non-caloric sweeteners in adults and children. Two authors used AMSTAR tool, Risk of bias tool of the Cochrane Collaboration or ROBINS-I instrument for screening the studies according to their methodological quality and were included those have a low risk of bias. A reduction in blood glucose was more effective when sweetening foods with fructose compared with the use of sucrose in non-diabetic patients (-4.81 mmol/L; 95% CI -6.34 to -3.29, p<0.05). The reduction in body mass index was greater with the use of non-caloric sweeteners compared with sucrose in patients regardless of their weight (-0.3 to -0.9 kg/m 2 , 95% CI -1.5 to 5). Although there is interest in identifying the efficacy of non-caloric sweeteners in preventing obesity and its complications, there is not sufficient evidence because of significant heterogeneity between the different studies and the lack of evidence in children. Thus, designing studies that will provide more evidence in this regard is necessary.

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Effects of the Non-Nutritive Sweeteners on Glucose Metabolism and Appetite Regulating Hormones: Systematic Review of Observational Prospective Studies and Clinical Trials

Cited by 95 publications

References 47 publications

Glycemic impact of non-nutritive sweeteners: a systematic review and meta-analysis of randomized controlled trials

Glycemic impact of non-nutritive sweeteners: a systematic review and meta-analysis of randomized controlled trials

Commercially available non-nutritive sweeteners modulate the antioxidant status of type 2 diabetic rats

Review of Recommendations for the Use of Caloric Sweeteners by Adults and Children

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