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Huang C, Wang Y, Zhou C, Fan X, Sun Q, Han J, Hua C, Li Y, Niu Y, Emeka Okonkwo C, Yao D, Song L, Otu P. Properties, extraction and purification technologies of Stevia rebaudiana steviol glycosides: A review. Food Chem 2024; 453:139622. [PMID: 38761729 DOI: 10.1016/j.foodchem.2024.139622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 04/26/2024] [Accepted: 05/08/2024] [Indexed: 05/20/2024]
Abstract
For health and safety reasons, the search for green, healthy, and low-calorie sweeteners with good taste has become the demand of many consumers. Furthermore, the need for sugar substitutes of natural origin has increased dramatically. In this review, we briefly discussed the safety and health benefits of stevia sweeteners and enumerated some examples of physiological functions of steviol glycosides (SGs), such as anti-inflammatory, anti-obesity, antihypertensive, anti-diabetes, and anticaries, citing various evidence related to their application in the food industry. The latest advances in emerging technologies for extracting and purifying SGs and the process variables and operational strategies were discussed. The impact of the extraction methods and their comparison against the conventional techniques have also been demonstrated. These technologies use minimal energy solvents and simplify subsequent purification stages, making viable alternatives suitable for a possible industrial application. Furthermore, we also elucidated the potential for advancing and applying the natural sweeteners SGs.
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Affiliation(s)
- Chengxia Huang
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, PR China
| | - Yang Wang
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, PR China
| | - Cunshan Zhou
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, PR China.
| | - Xingyu Fan
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, PR China
| | - Qiaolan Sun
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, PR China
| | - Jingyi Han
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, PR China
| | - Chenhui Hua
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, PR China
| | - Yao Li
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, PR China
| | - Yunwei Niu
- School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai 201418, PR China
| | - Clinton Emeka Okonkwo
- Department of Food Science, College of Food and Agriculture, United Arab Emirates University (UAEU), Al Ain, United Arab Emirates
| | - Deyang Yao
- Jiangsu Teweinong Food Co., Ltd., Xinghua 225700, PR China
| | - Linglin Song
- Jiangsu Teweinong Food Co., Ltd., Xinghua 225700, PR China
| | - Phyllis Otu
- Accra Technical University, P. O. Box GP 561, Barnes Road, Accra, Ghana
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Zare M, Zeinalabedini M, Ebrahimpour-Koujan S, Bellissimo N, Azadbakht L. Effect of stevia on blood glucose and HbA1C: A meta-analysis. Diabetes Metab Syndr 2024; 18:103092. [PMID: 39098209 DOI: 10.1016/j.dsx.2024.103092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 08/06/2024]
Abstract
BACKGROUND The study investigates substituting non-nutritive sweeteners (NNS) for sugar to address health concerns related to excess sugar intake. It specifically examines how stevia affects insulin and blood glucose levels. The systematic review and meta-analysis aim to evaluate stevia's impact on glycemic indices. METHODS We conducted a systematic review and meta-analysis following PRISMA guidelines, including 26 studies with 1439 participants. The PROSPERO registration number for this research is CRD42023414411. We systematically searched PubMed (MEDLINE), Scopus, Web of Science, and Google Scholar. Additionally, we thoroughly reviewed the reference lists of the articles we extracted and relevant reviews. Two evaluators independently carried out screening, quality assessment, and data extraction. The GRADE (grading of recommendations, assessment, development, and evaluation) approach was utilized to evaluate the certainty of the evidence. RESULTS Stevia consumption was associated with significantly reducing blood glucose levels (WMD: -3.84; 95 % CI: -7.15, -0.53; P = 0.02, low certainty), especially in individuals with higher BMI, diabetes, and hypertension. Dose-response analysis revealed a decrease in blood glucose for ≥3342 mg/day of stevia consumption. Stevia consumption has been shown to reduce blood glucose levels within 1-4 months, as evidenced by dose-response analysis (less than 120 days) and subgroup analysis (more than four weeks). However, stevia did not significantly affect insulin concentration or HbA1C levels (very low and low certainty, respectively). CONCLUSIONS Low certainty evidence showed that stevia improved blood glucose control, especially when consumed for less than 120 days. However, more randomized trials with higher stevia dosages are required.
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Affiliation(s)
- Marzieh Zare
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mobina Zeinalabedini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| | - Soraiya Ebrahimpour-Koujan
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nick Bellissimo
- School of Nutrition, Toronto Metropolitan University, Toronto, ON, Canada.
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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Lutnik M, Weisshaar S, Mussbacher LM, Steiner D, Wolzt M. The substitute ENSO 16 has low impact on glucose metabolism in healthy humans: a randomized, double-blind, active-controlled, cross-over trial. Sci Rep 2024; 14:14534. [PMID: 38914694 PMCID: PMC11196703 DOI: 10.1038/s41598-024-65560-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 06/20/2024] [Indexed: 06/26/2024] Open
Abstract
High sugar consumption is associated with cardiovascular diseases and diabetes. Current sugar substitutes may cause taste sensations and gastrointestinal symptoms. ENSO 16 is a combination of 16 different sugar substitutes and plant fibers and has been designed as a sugar alternative. The impact on plasma glucose metabolism as well as on gastrointestinal tolerance has not been investigated yet. 17 healthy participants were enrolled in this randomized, double-blind trial. Participants received a single oral dose of 30 g glucose or 30 g ENSO 16 and crossed over to the alternate treatment after a 7 day wash out period. The study endpoint was the effect on plasma glucose, insulin, C-peptide concentrations and gastrointestinal disorders. A questionnaire regarding gastrointestinal symptoms was used for individual subjective scoring. The mean baseline adjusted plasma glucose AUC0-180 min was significantly greater after glucose administration compared to ENSO 16 (n = 15, p = 0.0128, paired t-test). Maximum plasma glucose elevation over baseline was 117 mg*dl-1 and 20 mg*dl-1 after oral glucose or ENSO 16, respectively. Insulin and C-peptide AUC0-180 min were significantly greater after glucose compared to ENSO 16 intake (p < 0.01, Wilcoxon rank sum test). The mean maximal concentrations of plasma glucose, insulin and C-peptide after glucose intake were 1.5, 4.6 and 2.7-fold greater after glucose intake compared to ENSO 16 intake, respectively. Adverse reactions were mostly mild and not different between treatments. Conclusion. ENSO 16 has only a small impact on plasma glucose metabolism. This may be of interest in a dietary context and may help to reduce calory intake.Trail registration NCT05457400. First registration: 14/07/2022. https://clinicaltrials.gov/study/NCT05457400 .
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Affiliation(s)
- Martin Lutnik
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
| | - Stefan Weisshaar
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Lena M Mussbacher
- NEOH Alpha Republic GmbH, Rooseveltplatz 11/1, 1090, Vienna, Austria
| | - Daniel Steiner
- Department of Hematology and Hemastaseology, Medical University of Vienna, Vienna, Austria
| | - Michael Wolzt
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
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Eroglu E, Ozcan T. Pro-pre and Postbiotic Fermentation of the Dietetic Dairy Matrix with Prebiotic Sugar Replacers. Probiotics Antimicrob Proteins 2024; 16:726-736. [PMID: 37093514 DOI: 10.1007/s12602-023-10069-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 04/25/2023]
Abstract
In this study, bacterial growth, postbiotic short-chain fatty acids (SCFAs) formation, and gelation properties of sugar-free probiotic milk gels produced with stevia and inulin as a sugar replacer and synbiotic interactions were investigated with regard to prebiotic/bio-therapeutic potential and consumer preference. Lactobacillus acidophilus and Bifidobacterium animalis subsp. lactis cultures were used in the manufacture of dietetic milk gels. The addition of stevia and inulin promoted the viability of bacteria and enhanced milk gel firmness throughout its shelf life. The activity of the probiotic bacteria was identified to be within the potential prebiotic effects (> 8.30 log10 cfu mL-1) in a food matrix. However, it was determined that especially stevia and stevia + inulin addition increased the survival rate of probiotic bacteria and in vitro total SCFA production with higher scores for consumers' preferences rather than with the addition of stevia alone. Yoghurts containing B. animalis subsp. lactis have improved the instrumental textural properties, whereas yoghurts containing L. acidophilus had higher scores for sensorial attributes.
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Affiliation(s)
- Ezgi Eroglu
- Faculty of Agriculture, Department of Food Engineering, Bursa Uludag University, Gorukle, Bursa, 16059, Turkey
| | - Tulay Ozcan
- Faculty of Agriculture, Department of Food Engineering, Bursa Uludag University, Gorukle, Bursa, 16059, Turkey.
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Ma H, Deng J, Liu J, Jin X, Yang J. Daytime aspartame intake results in larger influences on body weight, serum corticosterone level, serum/cerebral cytokines levels and depressive-like behaviors in mice than nighttime intake. Neurotoxicology 2024; 102:37-47. [PMID: 38499183 DOI: 10.1016/j.neuro.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 11/25/2023] [Accepted: 03/15/2024] [Indexed: 03/20/2024]
Abstract
Aspartame (APM) is one of the most widely used artificial sweeteners worldwide. Studies have revealed that consuming APM may negatively affect the body, causing oxidative stress damage to multiple organs and leading to various neurophysiological symptoms. However, it's still unclear if consuming APM and one's daily biological rhythm have an interactive effect on health. In this study, healthy adult C57BL/6 mice were randomly divided into four groups: Control group (CON), oral gavage sham group (OGS), daytime APM intragastric group (DAI) and nighttime APM intragastric group (NAI). DAI and NAI groups were given 80 mg/kg body weight daily for 4 weeks. We found that DAI and NAI groups had significantly increased mean body weight, higher serum corticosterone levels, up-regulated pro-inflammatory responses in serum and brain, and exacerbated depressive-like behaviors than the CON and the two APM intake groups. Moreover, all these changes induced by APM intake were more significant in the DAI group than in the NAI group. The present study, for the first time, revealed that the intake of APM and daily biological rhythm have an interactive effect on health. This suggests that more attention should be paid to the timing of APM intake in human beings, and this study also provides an intriguing clue to the circadian rhythms of experimental animals that researchers should consider more when conducting animal experiments.
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Affiliation(s)
- Haiyuan Ma
- School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Jiapeng Deng
- School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Jing Liu
- Department of Anatomy, School of Basic Medical Sciences, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Xiaobao Jin
- Guangdong Key Laboratory of Pharmaceutical Bioactive Substances, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Junhua Yang
- Department of Anatomy, School of Basic Medical Sciences, Guangdong Pharmaceutical University, Guangzhou 510006, China; Guangdong Key Laboratory of Pharmaceutical Bioactive Substances, Guangdong Pharmaceutical University, Guangzhou 510006, China.
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Gibbons C, Beaulieu K, Almiron-Roig E, Navas-Carretero S, Martínez JA, O'Hara B, O'Connor D, Nazare JA, Le Bail A, Rannou C, Hardman C, Wilton M, Kjølbæk L, Scott C, Moshoyiannis H, Raben A, Harrold JA, Halford JCG, Finlayson G. Acute and two-week effects of neotame, stevia rebaudioside M and sucrose-sweetened biscuits on postprandial appetite and endocrine response in adults with overweight/obesity-a randomised crossover trial from the SWEET consortium. EBioMedicine 2024; 102:105005. [PMID: 38553262 PMCID: PMC11026940 DOI: 10.1016/j.ebiom.2024.105005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/26/2024] [Accepted: 01/28/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Sweeteners and sweetness enhancers (S&SE) are used to replace energy yielding sugars and maintain sweet taste in a wide range of products, but controversy exists about their effects on appetite and endocrine responses in reduced or no added sugar solid foods. The aim of the current study was to evaluate the acute (1 day) and repeated (two-week daily) ingestive effects of 2 S&SE vs. sucrose formulations of biscuit with fruit filling on appetite and endocrine responses in adults with overweight and obesity. METHODS In a randomised crossover trial, 53 healthy adults (33 female, 20 male) with overweight/obesity in England and France consumed biscuits with fruit filling containing 1) sucrose, or reformulated with either 2) Stevia Rebaudioside M (StRebM) or 3) Neotame daily during three, two-week intervention periods with a two-week washout. The primary outcome was composite appetite score defined as [desire to eat + hunger + (100 - fullness) + prospective consumption]/4. FINDINGS Each formulation elicited a similar reduction in appetite sensations (3-h postprandial net iAUC). Postprandial insulin (2-h iAUC) was lower after Neotame (95% CI (0.093, 0.166); p < 0.001; d = -0.71) and StRebM (95% CI (0.133, 0.205); p < 0.001; d = -1.01) compared to sucrose, and glucose was lower after StRebM (95% CI (0.023, 0.171); p < 0.05; d = -0.39) but not after Neotame (95% CI (-0.007, 0.145); p = 0.074; d = -0.25) compared to sucrose. There were no differences between S&SE or sucrose formulations on ghrelin, glucagon-like peptide 1 or pancreatic polypeptide iAUCs. No clinically meaningful differences between acute vs. two-weeks of daily consumption were found. INTERPRETATION In conclusion, biscuits reformulated to replace sugar using StRebM or Neotame showed no differences in appetite or endocrine responses, acutely or after a two-week exposure, but can reduce postprandial insulin and glucose response in adults with overweight or obesity. FUNDING The present study was funded by the Horizon 2020 program: Sweeteners and sweetness enhancers: Impact on health, obesity, safety and sustainability (acronym: SWEET, grant no: 774293).
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Affiliation(s)
- Catherine Gibbons
- School of Psychology, Faculty of Medicine & Health, University of Leeds, UK.
| | - Kristine Beaulieu
- School of Psychology, Faculty of Medicine & Health, University of Leeds, UK
| | - Eva Almiron-Roig
- University of Navarra, Faculty of Pharmacy and Nutrition, Dept. of Food Science and Physiology, Center for Nutrition Research, Pamplona, Spain; Navarra Institute for Health Research (IdiSNa), Pamplona, Spain
| | - Santiago Navas-Carretero
- University of Navarra, Faculty of Pharmacy and Nutrition, Dept. of Food Science and Physiology, Center for Nutrition Research, Pamplona, Spain; Navarra Institute for Health Research (IdiSNa), Pamplona, Spain; Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain
| | - J Alfredo Martínez
- University of Navarra, Faculty of Pharmacy and Nutrition, Dept. of Food Science and Physiology, Center for Nutrition Research, Pamplona, Spain; Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain
| | - Beverley O'Hara
- School of Psychology, Faculty of Medicine & Health, University of Leeds, UK
| | - Dominic O'Connor
- School of Psychology, Faculty of Medicine & Health, University of Leeds, UK
| | - Julie-Anne Nazare
- Human Nutrition Research Center Rhône-Alpes, Lyon 1 Claude Bernard University, France
| | | | | | - Charlotte Hardman
- Department of Psychology, Institute of Population Health, University of Liverpool, UK
| | - Moon Wilton
- Department of Psychology, Institute of Population Health, University of Liverpool, UK
| | - Louise Kjølbæk
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | - Corey Scott
- Core Research and Development, Cargill, Inc, USA
| | | | - Anne Raben
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark; Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Joanne A Harrold
- Department of Psychology, Institute of Population Health, University of Liverpool, UK
| | - Jason C G Halford
- School of Psychology, Faculty of Medicine & Health, University of Leeds, UK
| | - Graham Finlayson
- School of Psychology, Faculty of Medicine & Health, University of Leeds, UK
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Kearns ML, Reynolds CM. The impact of non-nutritive sweeteners on fertility, maternal and child health outcomes: a review of human and animal studies. Proc Nutr Soc 2024:1-13. [PMID: 38433591 DOI: 10.1017/s0029665124000168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
There is significant evidence that an unhealthy diet greatly increases the risk of complications during pregnancy and predisposes offspring to metabolic dysfunction and obesity. While fat intake is typically associated with the onset of obesity and its comorbidities, there is increasing evidence linking sugar, particularly high fructose corn syrup, to the global rise in obesity rates. Furthermore, the detrimental effects of added sugar intake during pregnancy on mother and child have been clearly outlined. Guidelines advising pregnant women to avoid food and beverages with high fat and sugar have led to an increase in consumption of 'diet' or 'light' options. Examination of some human birth cohort studies shows that heavy consumption (at least one beverage a day) of non-nutritive sweetener (NNS) containing beverages has been associated with increased risk of preterm birth and increased weight/BMI in male offspring independent of maternal weight, which appears to be offset by breastfeeding for 6 months. Rodent models have shown that NNS exposure during pregnancy can impact maternal metabolic health, adipose tissue function, gut microbiome profiles and taste preference. However, the mechanisms underlying these effects are multifaceted and further research, particularly in a translational setting is required to fully understand the effects of NNS on maternal and infant health during pregnancy. Therefore, this review examines maternal sweetener intakes and their influence on fertility, maternal health outcomes and offspring outcomes in human cohort studies and rodent models.
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Affiliation(s)
- Michelle L Kearns
- School of Public Health, Physiotherapy and Sports Science/Conway Institute/Institute of Food and Health/Diabetes Complications Research Centre, University College Dublin (UCD), Belfield, Dublin, Ireland
| | - Clare M Reynolds
- School of Public Health, Physiotherapy and Sports Science/Conway Institute/Institute of Food and Health/Diabetes Complications Research Centre, University College Dublin (UCD), Belfield, Dublin, Ireland
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Mendoza-Pérez S, Orta-Méndez-Y-Sánchez I, García-Gómez RS, Ordaz-Nava G, Gracia-Mora MI, Macías-Rosales L, Rico-Morales HA, Salas-Garrido G, Durán-Domínguez-de-Bazúa MDC. Stevia rebaudiana Bertoni, an American plant used as sweetener: Study of its effects on body mass control and glycemia reduction in Wistar male and female rats. PLoS One 2024; 19:e0298251. [PMID: 38412182 PMCID: PMC10898749 DOI: 10.1371/journal.pone.0298251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/18/2023] [Indexed: 02/29/2024] Open
Abstract
Stevia rebaudiana Bertoni water extracts have been used as a natural sweetener and customary medicine by the indigenous inhabitants of South America for several hundred years. This plant was sent to Europe in the 16th century and was described by Peter Jacob Esteve in Spain. Recently the food industry has started to employ S. rebaudiana as sweetener using its glycosides after purification. Advertisement claims that Stevia glycosides is good for controling body mass and reducing glycemia. This study's objective was to evaluate the effect of S. rebaudiana leaf extract on Wistar rats as animal model to prove its effectiveness on body mass control, glycemia reduction, and other biochemical parameters. Three groups were randomly formed with 24 males and 24 females: A blank group without any sweetener, a control group drinking water with 10% glucose, and the test group ingesting a 0.94% water extract of S. rebaudiana. Body mass measurements as well as food and drink consumption were daily performed. The experiment lasted 120 days after the specimens were weaned and got used to eating solid food. Euthanasia was done and blood serum was collected to evaluate the following biochemical parameters: Glucose, triglycerides, cholesterol, insulin, glucagon, leptin, ghrelin, and glucose-dependent insulinotropic peptide, GIP. Results indicated that only female rats had statistical differences in body mass gain. No relevant effects either positive or negative were found in the biochemical parameters measured. The crude extracts of S. rebaudiana did not show any relevant changes in biochemical and hormonal profiles, changes nor body mass with respect to the blank and control groups of young and healthy rats in the age range of infancy to youth. According to the results obtained, the therapeutic properties that have been associated to S. rebaudiana consumption especially for body mass control and glycemia reduction, did not occur in young and healthy male and female rats in equivalent age to infants, young children, and youths.
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Affiliation(s)
- Samuel Mendoza-Pérez
- Faculty of Chemistry, Department of Chemical Engineering, UNAM, Laboratories of Enviromental Chemical Engineering and Chemistry, Mexico City, Mexico
| | - Itzel Orta-Méndez-Y-Sánchez
- Faculty of Chemistry, Department of Chemical Engineering, UNAM, Laboratories of Enviromental Chemical Engineering and Chemistry, Mexico City, Mexico
| | - Rolando Salvador García-Gómez
- Faculty of Chemistry, Department of Chemical Engineering, UNAM, Laboratories of Enviromental Chemical Engineering and Chemistry, Mexico City, Mexico
| | - Guillermo Ordaz-Nava
- Department of Nutrition Physiology, Molecular Nutrition Area, National Institute of Medical Sciences and Nutrition "Salvador Zubirán", INCMNSZ, Mexico City, Mexico
| | - María Isabel Gracia-Mora
- Faculty of Chemistry, UNAM, Animal Experimentation Unit, UNEXA, Complex E, Circuito de la Investigación Científica s/n, Ciudad Universitaria, Mexico City, Mexico
| | - Lucía Macías-Rosales
- Faculty of Chemistry, UNAM, Animal Experimentation Unit, UNEXA, Complex E, Circuito de la Investigación Científica s/n, Ciudad Universitaria, Mexico City, Mexico
| | - Héctor A Rico-Morales
- Faculty of Chemistry, UNAM, Animal Experimentation Unit, UNEXA, Complex E, Circuito de la Investigación Científica s/n, Ciudad Universitaria, Mexico City, Mexico
| | - Gerardo Salas-Garrido
- Faculty of Veterinary Medicine & Zootechny, Department of Pathology, UNAM, Circuito de la Investigación Científica s/n, Ciudad Universitaria, Mexico City, Mexico
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Patel S, Navale A. The Natural Sweetener Stevia: An Updated Review on its Phytochemistry, Health Benefits, and Anti-diabetic Study. Curr Diabetes Rev 2024; 20:e010523216398. [PMID: 37138480 DOI: 10.2174/1573399819666230501210803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 03/01/2023] [Accepted: 03/14/2023] [Indexed: 05/05/2023]
Abstract
Stevia rebaudiana Bertoni is one of the significant high qualities of non-caloric sugar substitute sweetener plants against diabetes disease. Diabetes mellitus is one of the most common metabolic diseases caused by insulin secretion defects, insulin resistance in peripheral tissues, or both. Stevia rebaudiana is a perennial shrub of the Compositae family that is grown in several places around the world. It contains a plethora of different bioactive constituents which are responsible for several activities and sweetness. This sweetness is due to the presence of steviol glycosides which is 100-300 times sweeter than sucrose. Furthermore, stevia reduces oxidative stress, lowering the risk of diabetes. Its leaves have been used to control and treat diabetes and a variety of other metabolic diseases. This review summarizes the history, bioactive constituents of S. rebaudiana extract, pharmacology, anti-diabetic activity, and its application, especially in food supplements.
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Affiliation(s)
- Shraddha Patel
- Parul Institute of Pharmacy, Parul University, Vadodara, Gujarat, India
| | - Archana Navale
- Parul Institute of Pharmacy, Parul University, Vadodara, Gujarat, India
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Posta E, Fekete I, Gyarmati E, Stündl L, Zold E, Barta Z. The Effects of Artificial Sweeteners on Intestinal Nutrient-Sensing Receptors: Dr. Jekyll or Mr. Hyde? Life (Basel) 2023; 14:10. [PMID: 38276259 PMCID: PMC10817473 DOI: 10.3390/life14010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024] Open
Abstract
The consumption of artificial and low-calorie sweeteners (ASs, LCSs) is an important component of the Western diet. ASs play a role in the pathogenesis of metabolic syndrome, dysbiosis, inflammatory bowel diseases (IBDs), and various inflammatory conditions. Intestinal nutrient-sensing receptors act as a crosstalk between dietary components, the gut microbiota, and the regulation of immune, endocrinological, and neurological responses. This narrative review aimed to summarize the possible effects of ASs and LCSs on intestinal nutrient-sensing receptors and their related functions. Based on the findings of various studies, long-term AS consumption has effects on the gut microbiota and intestinal nutrient-sensing receptors in modulating incretin hormones, antimicrobial peptides, and cytokine secretion. These effects contribute to the regulation of glucose metabolism, ion transport, gut permeability, and inflammation and modulate the gut-brain, and gut-kidney axes. Based on the conflicting findings of several in vitro, in vivo, and randomized and controlled studies, artificial sweeteners may have a role in the pathogenesis of IBDs, functional bowel diseases, metabolic syndrome, and cancers via the modulation of nutrient-sensing receptors. Further studies are needed to explore the exact mechanisms underlying their effects to decide the risk/benefit ratio of sugar intake reduction via AS and LCS consumption.
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Affiliation(s)
- Edit Posta
- GI Unit, Department of Infectology, Faculty of Medicine, University of Debrecen, Bartok Bela Street 2-26, 4031 Debrecen, Hungary; (E.G.); (Z.B.)
| | - Istvan Fekete
- Institute of Food Technology, Faculty of Agricultural and Food Sciences and Environmental Management, University of Debrecen, Böszörményi út 138, 4032 Debrecen, Hungary; (I.F.); (L.S.)
| | - Eva Gyarmati
- GI Unit, Department of Infectology, Faculty of Medicine, University of Debrecen, Bartok Bela Street 2-26, 4031 Debrecen, Hungary; (E.G.); (Z.B.)
- Doctoral School of Clinical Immunology and Allergology, Faculty of Medicine, University of Debrecen, Nagyerdei Blvd. 98, 4032 Debrecen, Hungary
| | - László Stündl
- Institute of Food Technology, Faculty of Agricultural and Food Sciences and Environmental Management, University of Debrecen, Böszörményi út 138, 4032 Debrecen, Hungary; (I.F.); (L.S.)
| | - Eva Zold
- Department of Clinical Immunology, Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, Móricz Zsigmond Str. 22, 4032 Debrecen, Hungary;
| | - Zsolt Barta
- GI Unit, Department of Infectology, Faculty of Medicine, University of Debrecen, Bartok Bela Street 2-26, 4031 Debrecen, Hungary; (E.G.); (Z.B.)
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Ozcan T, Eroglu E. In vitro fermentation assay on the bifidogenic effect of steviol glycosides of Stevia rebaudiana plant for the development of dietetic novel products. Prep Biochem Biotechnol 2023; 53:1099-1108. [PMID: 36709420 DOI: 10.1080/10826068.2023.2169935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The relationship between excessive sugar consumption and many diseases such as dental caries, obesity, diabetes and coronary heart has been increasing in recent years. In this study, utilization of natural sugar replacer steviol glycosides and bifidogenic effect by Bifidobacterium animalis subsp. lactis was assayed in vitro model system. The basal medium (non-carbohydrate containing MRS, Man, Rogosa and Sharpe Agar) were supplemented with 0.025% and 1% stevia, 0.025% stevia + 1% inulin, %1 stevia + 1% inulin. The medium which contained no carbohydrate was designated as negative control, whereas the medium containing 1% glucose or inulin were evaluated as positive and evaluated on the 0, 12, 24, 36 and 48 h of fermentation. Steviol glycosides in both system significantly stimulated the growth of Bifidobacterium animalis subsp. lactis to varying degrees with highest prebiotic activity score, short chain fatty acid production and growth parameters as much as glucose and prebiotic inulin. The viability of the probiotic bacteria was determined within the bio-therapeutic level with potential prebiotic effects depending on the probiotic bacterial strain growing and the type of carbohydrate source utilized. In the study, stevia at lower concentration showed a higher growth rate of with inulin. In conclusion, stevia can be used as functional ingredients for the modulation of the gut microbiota and design of synbiotic systems as a prebiotic substrate and sugar substitute.
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Affiliation(s)
- Tulay Ozcan
- Faculty of Agriculture, Department of Food Engineering, Bursa Uludag University, Bursa, Turkey
| | - Ezgi Eroglu
- Republic of Turkey Ministry of Agriculture and Forestry, Hafik, Sivas, Turkey
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Zhao S, Zheng H, Lu Y, Zhang N, Soladoye OP, Zhang Y, Fu Y. Sweet Taste Receptors and Associated Sweet Peptides: Insights into Structure and Function. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2023; 71:13950-13964. [PMID: 37698386 DOI: 10.1021/acs.jafc.3c04479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Long-term consumption of a high-sugar diet may contribute to the pathogenesis of several chronic diseases, such as obesity and type 2 diabetes. Sweet peptides derived from a wide range of food sources can enhance sweet taste without compromising the sensory properties. Therefore, the research and application of sweet peptides are promising strategies for reducing sugar consumption. This work first outlined the necessity for global sugar reduction, followed by the introduction of sweet taste receptors and their associated transduction mechanisms. Subsequently, recent research progress in sweet peptides from different protein sources was summarized. Furthermore, the main methods for the preparation and evaluation of sweet peptides were presented. In addition, the current challenges and potential applications are also discussed. Sweet peptides can stimulate sweetness perception by binding sweet taste receptors T1R2 and T1R3 in taste buds, which is an effective strategy for reducing sugar consumption. At present, sweet peptides are mainly prepared artificially by synthesis, hydrolysis, microbial fermentation, and bioengineering strategies. Furthermore, sensory evaluation, electronic tongues, and cell models have been used to assess the sweet taste intensity. The present review can provide a theoretical reference for reducing sugar consumption with the aid of sweet peptides in the food industry.
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Affiliation(s)
- Shulei Zhao
- College of Food Science, Southwest University, Chongqing 400715, People's Republic of China
- Westa College, Southwest University, Chongqing 400715, People's Republic of China
| | - Hanyuan Zheng
- College of Food Science, Southwest University, Chongqing 400715, People's Republic of China
- Westa College, Southwest University, Chongqing 400715, People's Republic of China
| | - Yujia Lu
- Department of Epidemiology, Harvard University T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, Massachusetts 02115, United States
| | - Na Zhang
- Key Laboratory of Food Science and Engineering of Heilongjiang Province, College of Food Engineering, Harbin University of Commerce, Harbin, Heilongjiang 150076, People's Republic of China
| | - Olugbenga P Soladoye
- Lacombe Research and Development Centre, Agriculture and Agri-Food Canada, Government of Canada, 6000 C&E Trail, Lacombe, Alberta T4L 1W1, Canada
| | - Yuhao Zhang
- College of Food Science, Southwest University, Chongqing 400715, People's Republic of China
- Chongqing Key Laboratory of Speciality Food Co-Built by Sichuan and Chongqing, Chongqing 400715, People's Republic of China
| | - Yu Fu
- College of Food Science, Southwest University, Chongqing 400715, People's Republic of China
- Chongqing Key Laboratory of Speciality Food Co-Built by Sichuan and Chongqing, Chongqing 400715, People's Republic of China
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13
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Muilwijk M, Beulens JWJ, Groeneveld L, Rutters F, Blom MT, Agamennone V, van den Broek T, Keijser BJF, Hoevenaars F. The entero-endocrine response following a mixed-meal tolerance test with a non-nutritive pre-load in participants with pre-diabetes and type 2 diabetes: A crossover randomized controlled trial proof of concept study. PLoS One 2023; 18:e0290261. [PMID: 37624823 PMCID: PMC10456129 DOI: 10.1371/journal.pone.0290261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 08/02/2023] [Indexed: 08/27/2023] Open
Abstract
INTRODUCTION This crossover randomized controlled trial (RCT) investigated differences in short-term entero-endocrine response to a mixed-meal tolerance test preceded by nutrient sensing between participants with pre-diabetes (pre-T2D) and type 2 diabetes (T2D). Additionally, differences in gut and oral microbiome composition between participants with a high and low entero-endocrine response were investigated. RESEARCH DESIGN AND METHODS Ten participants with pre-T2D and ten with T2D underwent three test days with pre-loads consisting of either swallowing water (control), or rinsing with a non-nutritive sweetener solution, or swallowing the sweetener solution before a mixed-meal tolerance test. Blood glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-1 (GLP-1), glucagon, glucose, insulin and peptide YY (PYY) were determined at t = -20, 0, 15, 30, 60, 120 and 240 minutes. The composition of the oral and gut microbiome at baseline were also determined. RESULTS The entero-endocrine response differed by pre-loads, e.g. a lower PYY response after swallowing the non-nutritive sweetener (-3585.2pg/mL [95% CI: -6440.6; -729.8]; p = 0.01). But it also differed by T2D status, e.g. a higher glucose, glucagon and PYY response was found in participants with T2D, compared to those with pre-T2D. Evidence for associations between the oral and gut microbiome composition and the entero-endocrine response was limited. Still, the level of entero-endocrine response was associated with several oral microbiome measures. Higher oral anterior α-diversity was associated with a lower PYY response (e.g. Inverse Simpson index -1357pg/mL [95% CI -2378; -336; 1.24]), and higher oral posterior α-diversitywith a higher GIP response (e.g. Inverse Simpson index 6773pg/mL [95% CI 132; 13414]) in models adjusted for sex, age and T2D status. CONCLUSIONS Non-nutritive pre-loads influence the entero-endocrine response to a mixed-meal, and this effect varies based on (pre-)T2D status. The entero-endocrine response is likely not associated with the gut microbiome, and there is limited evidence for association with the α-diversity of the oral microbiome composition. TRIAL REGISTRATION Trial register: Netherlands Trial Register NTR7212, accessible through International Clinical Trials Registry Platform: ICTRP Search Portal (who.int).
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Affiliation(s)
- Mirthe Muilwijk
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviours & Cardiovascular Diseases, Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands
| | - Joline W. J. Beulens
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviours & Cardiovascular Diseases, Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands
| | - Lenka Groeneveld
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviours & Cardiovascular Diseases, Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands
| | - Femke Rutters
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviours & Cardiovascular Diseases, Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands
| | - Marieke T. Blom
- Amsterdam Public Health, Health Behaviours & Cardiovascular Diseases, Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands
- Department of General Practice, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Valeria Agamennone
- Department of Microbiology & Systems Biology, TNO, Leiden, The Netherlands
| | - Tim van den Broek
- Department of Microbiology & Systems Biology, TNO, Leiden, The Netherlands
| | - Bart J. F. Keijser
- Department of Microbiology & Systems Biology, TNO, Leiden, The Netherlands
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam, The Netherlands
| | - Femke Hoevenaars
- Department of Microbiology & Systems Biology, TNO, Leiden, The Netherlands
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Naik AQ, Zafar T, Shrivastava VK. The impact of non-caloric artificial sweetener aspartame on female reproductive system in mice model. Reprod Biol Endocrinol 2023; 21:73. [PMID: 37580716 PMCID: PMC10424399 DOI: 10.1186/s12958-023-01115-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/05/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Artificial sweeteners, used as sugar substitutes have found their ways into almost all the food items due to the notion that they are non-caloric. Aspartame is used in numerous food products throughout the world. The primary users of aspartame include diabetics and calorie conscious people who intend to limit their calorie intake. METHODS Female Swiss albino mice were divided into three groups (12 mice each) for the duration of 30 and 60 days consecutively. The treatment groups received 40 mg/kg b. w. aspartame orally. Hormone assays using ELISA and tissue histopathology have been performed along with the fertility assay to access the treatment outcomeon the fertility of treated mice in comparison to controls. RESULTS Present study reports that female mice treated with aspartame for 30 and 60 days showed significant reduction in body weight, relative organ weight of (liver and kidney) and gonadosomatic index. These changes were more significantly recorded in 60 days treatment group. Aspartame treated animals for 30 and 60 days showed duration-dependent decrease gonandotropins (follicle stimulating hormone and luteinizing hormone), and steroids (estradiol and progesterone). Moreover, severe histopathological changes, reduction in number of growing follicles, degenerative changes in follicular structure, corona radiata and zonagranulosa were also observed. Besides, histomorphological changes were also observed in the uterine structure including atrophic uterine endometrial glands, contracted endometrial lining, disruption of the endometrial structure and the shapes of blood vessels were also altered. CONCLUSION Non-nutritive artificial sweeteners including aspartame negatively impact the function of ovaries and feedback mechanism of reproductive hormones by affecting the hypothalamic-pituitary-gonadal axis. In light of present findings the aspartame negatively impacted the reproductive system of female mice. More studies are required to identify the molecular mechanism and the pathways involved.
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Affiliation(s)
- Ab Qayoom Naik
- Department of Zoology, Govt. Degree College, Paloura Mishriwala, Jammu, J & K, 180018, India.
- Laboratory of Endocrinology, Department of Biosciences, Barkatullah University, Bhopal, M. P, 462026, India.
| | - Tabassum Zafar
- Laboratory of Endocrinology, Department of Biosciences, Barkatullah University, Bhopal, M. P, 462026, India.
| | - Vinoy K Shrivastava
- Laboratory of Endocrinology, Department of Biosciences, Barkatullah University, Bhopal, M. P, 462026, India
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Han JY, Park M, Lee HJ. Stevia (Stevia rebaudiana) extract ameliorates insulin resistance by regulating mitochondrial function and oxidative stress in the skeletal muscle of db/db mice. BMC Complement Med Ther 2023; 23:264. [PMID: 37488560 PMCID: PMC10367355 DOI: 10.1186/s12906-023-04033-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/09/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM), a growing health problem worldwide, is a metabolic disorder characterized by hyperglycemia due to insulin resistance and defective insulin secretion by pancreatic β-cells. The skeletal muscle is a central organ that consumes most of the insulin-stimulated glucose in the body, and insulin resistance can damage muscles in T2DM. Based on a strong correlation between diabetes and muscles, we investigated the effects of stevia extract (SE) and stevioside (SV) on the skeletal muscle of diabetic db/db mice. METHODS The mice were administered saline, metformin (200 mg/kg/day), SE (200 and 500 mg/kg/day), and SV (40 mg/kg/day) for 35 days. During administration, we checked the levels of fasting blood glucose twice a week and conducted the oral glucose tolerance test (OGTT) and insulin tolerance test (ITT). After administration, we analyzed serum biochemical parameters, triglyceride (TG), total cholesterol (TC), insulin and antioxidant enzymes, and the cross-sectional area of skeletal muscle fibers of db/db mice. Western blots were conducted using the skeletal muscle of mice to examine the effect of SE and SV on protein expression of insulin signaling, mitochondrial function, and oxidative stress. RESULTS SE and SV administration lowered the levels of fasting blood glucose, OGTT, and ITT in db/db mice. The administration also decreased serum levels of TG, TC, and insulin while increasing those of superoxide dismutase (SOD) and glutathione peroxidase (GPx). Interestingly, muscle fiber size was significantly increased in db/db mice treated with SE500 and SV. In the skeletal muscle of db/db mice, SE and SV administration activated insulin signaling by increasing the protein expression of insulin receptor substrate, Akt, and glucose transporter type 4. Furthermore, SE500 administration markedly increased the protein expression of AMP-activated protein kinase-α, sirtuin-1, and peroxisome proliferator-activated receptor-γ coactivator-1α. SV administration significantly reduced oxidative stress by down-regulating the protein expression of 4-hydroxynonenal, heme oxygenase-1, SOD, and GPx. In addition, SE500 and SV administration suppressed the expression of apoptosis-related proteins in the skeletal muscle of db/db mice. CONCLUSION SE and SV administration attenuated hyperglycemia in diabetic mice. Moreover, the administration ameliorated insulin resistance by regulating mitochondrial function and oxidative stress, increasing muscle fiber size. Overall, this study suggests that SE and SV administration may serve as a potential strategy for the treatment of diabetic muscles.
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Affiliation(s)
- Jin-Young Han
- Institute for Aging and Clinical Nutrition Research, Gachon University, Seongnam-Si, 13120, Gyeonggi-Do, Korea
| | - Miey Park
- Institute for Aging and Clinical Nutrition Research, Gachon University, Seongnam-Si, 13120, Gyeonggi-Do, Korea.
- Department of Food and Nutrition, College of BioNano Technology, Gachon University, Seongnam-Si, 13120, Gyeonggi-Do, Korea.
| | - Hae-Jeung Lee
- Institute for Aging and Clinical Nutrition Research, Gachon University, Seongnam-Si, 13120, Gyeonggi-Do, Korea.
- Department of Food and Nutrition, College of BioNano Technology, Gachon University, Seongnam-Si, 13120, Gyeonggi-Do, Korea.
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16
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Shor SM, Schweig SK. The Use of Natural Bioactive Nutraceuticals in the Management of Tick-Borne Illnesses. Microorganisms 2023; 11:1759. [PMID: 37512931 PMCID: PMC10384908 DOI: 10.3390/microorganisms11071759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 06/29/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023] Open
Abstract
The primary objective of this paper is to provide an evidence-based update of the literature on the use of bioactive phytochemicals, nutraceuticals, and micronutrients (dietary supplements that provide health benefits beyond their nutritional value) in the management of persistent cases of Borrelia burgdorferi infection (Lyme disease) and two other tick-borne pathogens, Babesia and Bartonella species. Recent studies have advanced our understanding of the pathophysiology and mechanisms of persistent infections. These advances have increasingly enabled clinicians and patients to utilize a wider set of options to manage these frequently disabling conditions. This broader toolkit holds the promise of simultaneously improving treatment outcomes and helping to decrease our reliance on the long-term use of pharmaceutical antimicrobials and antibiotics in the treatment of tick-borne pathogens such as Borrelia burgdorferi, Babesia, and Bartonella.
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Affiliation(s)
- Samuel M Shor
- Internal Medicine of Northern Virginia, George Washington University Health Care Sciences, Reston, VA 20190, USA
| | - Sunjya K Schweig
- California Center for Functional Medicine, Oakland, CA 94619, USA
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17
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Valicente VM, Peng CH, Pacheco KN, Lin L, Kielb EI, Dawoodani E, Abdollahi A, Mattes RD. Ultraprocessed Foods and Obesity Risk: A Critical Review of Reported Mechanisms. Adv Nutr 2023; 14:718-738. [PMID: 37080461 PMCID: PMC10334162 DOI: 10.1016/j.advnut.2023.04.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/02/2023] [Accepted: 04/14/2023] [Indexed: 04/22/2023] Open
Abstract
Epidemiologic evidence supports a positive association between ultraprocessed food (UPF) consumption and body mass index. This has led to recommendations to avoid UPFs despite very limited evidence establishing causality. Many mechanisms have been proposed, and this review critically aimed to evaluate selected possibilities for specificity, clarity, and consistency related to food choice (i.e., low cost, shelf-life, food packaging, hyperpalatability, and stimulation of hunger/suppression of fullness); food composition (i.e., macronutrients, food texture, added sugar, fat and salt, energy density, low-calorie sweeteners, and additives); and digestive processes (i.e., oral processing/eating rate, gastric emptying time, gastrointestinal transit time, and microbiome). For some purported mechanisms (e.g., fiber content, texture, gastric emptying, and intestinal transit time), data directly contrasting the effects of UPF and non-UPF intake on the indices of appetite, food intake, and adiposity are available and do not support a unique contribution of UPFs. In other instances, data are not available (e.g., microbiome and food additives) or are insufficient (e.g., packaging, food cost, shelf-life, macronutrient intake, and appetite stimulation) to judge the benefits versus the risks of UPF avoidance. There are yet other evoked mechanisms in which the preponderance of evidence indicates ingredients in UPFs actually moderate body weight (e.g., low-calorie sweetener use for weight management; beverage consumption as it dilutes energy density; and higher fat content because it reduces glycemic responses). Because avoidance of UPFs holds potential adverse effects (e.g., reduced diet quality, increased risk of food poisoning, and food wastage), it is imprudent to make recommendations regarding their role in diets before causality and plausible mechanisms have been verified.
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Affiliation(s)
- Vinicius M Valicente
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Ching-Hsuan Peng
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN, United States
| | - Kathryn N Pacheco
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Luotao Lin
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Elizabeth I Kielb
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, United States
| | - Elina Dawoodani
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Afsoun Abdollahi
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
| | - Richard D Mattes
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States.
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Almiron-Roig E, Navas-Carretero S, Castelnuovo G, Kjølbæk L, Romo-Hualde A, Normand M, Maloney N, Hardman CA, Hodgkins CE, Moshoyiannis H, Finlayson G, Scott C, Raats MM, Harrold JA, Raben A, Halford JCG, Martínez JA. Impact of acute consumption of beverages containing plant-based or alternative sweetener blends on postprandial appetite, food intake, metabolism, and gastro-intestinal symptoms: Results of the SWEET beverages trial. Appetite 2023; 184:106515. [PMID: 36849009 DOI: 10.1016/j.appet.2023.106515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 02/27/2023]
Abstract
Project SWEET examined the barriers and facilitators to the use of non-nutritive sweeteners and sweetness enhancers (hereafter "S&SE") alongside potential risks/benefits for health and sustainability. The Beverages trial was a double-blind multi-centre, randomised crossover trial within SWEET evaluating the acute impact of three S&SE blends (plant-based and alternatives) vs. a sucrose control on glycaemic response, food intake, appetite sensations and safety after a carbohydrate-rich breakfast meal. The blends were: mogroside V and stevia RebM; stevia RebA and thaumatin; and sucralose and acesulfame-potassium (ace-K). At each 4 h visit, 60 healthy volunteers (53% male; all with overweight/obesity) consumed a 330 mL beverage with either an S&SE blend (0 kJ) or 8% sucrose (26 g, 442 kJ), shortly followed by a standardised breakfast (∼2600 or 1800 kJ with 77 or 51 g carbohydrates, depending on sex). All blends reduced the 2-h incremental area-under-the-curve (iAUC) for blood insulin (p < 0.001 in mixed-effects models), while the stevia RebA and sucralose blends reduced the glucose iAUC (p < 0.05) compared with sucrose. Post-prandial levels of triglycerides plus hepatic transaminases did not differ across conditions (p > 0.05 for all). Compared with sucrose, there was a 3% increase in LDL-cholesterol after stevia RebA-thaumatin (p < 0.001 in adjusted models); and a 2% decrease in HDL-cholesterol after sucralose-ace-K (p < 0.01). There was an impact of blend on fullness and desire to eat ratings (both p < 0.05) and sucralose-acesulfame K induced higher prospective intake vs sucrose (p < 0.001 in adjusted models), but changes were of a small magnitude and did not translate into energy intake differences over the next 24 h. Gastro-intestinal symptoms for all beverages were mostly mild. In general, responses to a carbohydrate-rich meal following consumption of S&SE blends with stevia or sucralose were similar to sucrose.
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Affiliation(s)
- Eva Almiron-Roig
- University of Navarra, Faculty of Pharmacy and Nutrition, Dept. of Food Science and Physiology, Pamplona, Spain; University of Navarra, Center for Nutrition Research, Pamplona, Spain; Navarra Institute for Health Research (IdiSNa), Pamplona, Spain.
| | - Santiago Navas-Carretero
- University of Navarra, Faculty of Pharmacy and Nutrition, Dept. of Food Science and Physiology, Pamplona, Spain; University of Navarra, Center for Nutrition Research, Pamplona, Spain; Navarra Institute for Health Research (IdiSNa), Pamplona, Spain; Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain.
| | | | - Louise Kjølbæk
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
| | - Ana Romo-Hualde
- University of Navarra, Faculty of Pharmacy and Nutrition, Dept. of Food Science and Physiology, Pamplona, Spain; University of Navarra, Center for Nutrition Research, Pamplona, Spain.
| | - Mie Normand
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
| | - Niamh Maloney
- Department of Psychology, University of Liverpool, Liverpool, UK.
| | | | - Charo E Hodgkins
- Food Consumer Behaviour and Health Research Centre, School of Psychology, University of Surrey, Guildford, UK.
| | | | | | - Corey Scott
- Cargill R&D Centre Europe, Vilvoorde, Belgium.
| | - Monique M Raats
- Food Consumer Behaviour and Health Research Centre, School of Psychology, University of Surrey, Guildford, UK.
| | - Joanne A Harrold
- Department of Psychology, University of Liverpool, Liverpool, UK.
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark; Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark.
| | - Jason C G Halford
- Department of Psychology, University of Liverpool, Liverpool, UK; School of Psychology, University of Leeds, Leeds, UK.
| | - J Alfredo Martínez
- University of Navarra, Faculty of Pharmacy and Nutrition, Dept. of Food Science and Physiology, Pamplona, Spain.
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19
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Raghavan G, Bapna A, Mehta A, Shah A, Vyas T. Effect of Sugar Replacement with Stevia-Based Tabletop Sweetener on Weight and Cardiometabolic Health among Indian Adults. Nutrients 2023; 15:nu15071744. [PMID: 37049584 PMCID: PMC10097272 DOI: 10.3390/nu15071744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/25/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023] Open
Abstract
Added sugars contribute to caloric intake in the diet, which may lead to conditions like obesity. Replacing added sugar with a natural sugar substitute like zero-calorie stevia may help in reducing sugar and caloric intake. Methods: An open-label, single-arm pilot study was conducted to evaluate the efficacy and safety of a stevia-based tabletop sweetener among overweight subjects with normal blood sugar levels (n = 24) and overweight prediabetic subjects (n = 21). Subjects were instructed to replace added sugar in their daily diet with the test product over a study period of 90 days. Primary outcomes included change in body weight and waist circumference, while the secondary outcomes included change in blood glucose (PPBG), body mass index (BMI), and lipid parameters evaluated at baseline, 30 days, 60 days, and 90 days. Glycated hemoglobin (HbA1c) was evaluated at baseline and 90 days. Results: When compared with the baseline, a significant reduction in weight (p < 0.001) and waist circumference (p < 0.001) was observed at Day 90 in overweight subjects. Similarly, in overweight prediabetic subjects, a significant reduction in weight (p < 0.001) and waist circumference (p < 0.05) with non-significant change in HbA1c was observed at Day 90 from baseline. In a subgroup analysis, among the subjects who lost weight, 2.12 kg (n = 35) weight loss and 4.78 cm (n = 32) reduction in waist circumference were observed at 90 days. No adverse outcomes were reported throughout the study period. The consumption of steviol glycosides was within the acceptable daily intake (ADI). Conclusions: Replacing added sugar in the daily diet with stevia-based tabletop sweetener, along with a physical activity regimen, promotes weight loss and reduction in waist circumference in overweight subjects with normal blood sugar levels and prediabetic subjects (CTRI/2019/12/022470).
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Affiliation(s)
- Govindarajan Raghavan
- Zydus Wellness Institute, Zydus Wellness Products Limited, R & D Centre, Plot No. 115/5, TP Scheme No. 51, Near the Bliss & North One Apartment, Off Ambli-Bopal Road, Ahmedabad 380058, India
| | - Arohi Bapna
- Zydus Wellness Institute, Zydus Wellness Products Limited, R & D Centre, Plot No. 115/5, TP Scheme No. 51, Near the Bliss & North One Apartment, Off Ambli-Bopal Road, Ahmedabad 380058, India
| | - Arti Mehta
- Zydus Wellness Institute, Zydus Wellness Products Limited, R & D Centre, Plot No. 115/5, TP Scheme No. 51, Near the Bliss & North One Apartment, Off Ambli-Bopal Road, Ahmedabad 380058, India
| | - Akash Shah
- Zydus Wellness Institute, Zydus Wellness Products Limited, R & D Centre, Plot No. 115/5, TP Scheme No. 51, Near the Bliss & North One Apartment, Off Ambli-Bopal Road, Ahmedabad 380058, India
| | - Tejas Vyas
- Zydus Wellness Institute, Zydus Wellness Products Limited, R & D Centre, Plot No. 115/5, TP Scheme No. 51, Near the Bliss & North One Apartment, Off Ambli-Bopal Road, Ahmedabad 380058, India
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Miller B, Branscum P. Evaluating the Association Between Artificial Sweetener Intake and Indicators of Stress and Anxiety. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2023; 43:339-342. [PMID: 34080916 DOI: 10.1177/0272684x211022150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to evaluate the association between non-nutritive sweetener (NNS) consumption and stress and anxiety, among a sample of college students. Two-hundred and twenty-seven students from a large mid-western university participated in this cross-sectional study. Students completed an online survey that evaluated NNS using a validated food frequency questionnaire. Stress and anxiety were evaluated using previously validated instruments. Most students reported very low/low/average concern for stress (63.9%), and had low/moderate anxiety (82.3%). Participants experiencing high and very high levels of stress had significantly higher NNS consumption compared to those with a very low and low risk, and concern for stress (p < .046; d = 0.28). There was no difference however for NNS intake and anxiety. Reduction of artificial sweetener intake may be associated with stress levels among college students. However, more research is needed to examine any causal relationship between artificial sweetener intake and stress.
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Affiliation(s)
- Benjamin Miller
- Department of Kinesiology and Health, Miami University, Oxford, Ohio, United States
| | - Paul Branscum
- Department of Kinesiology and Health, Miami University, Oxford, Ohio, United States
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21
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Katirci E, Kendirci-Katirci R, Korgun ET. Effects of Stevioside on the Expressions of GLUT 1, GLUT 3, and GLUT 4 Proteins in Diabetic Rat Placenta. PLANTA MEDICA 2023. [PMID: 36913970 DOI: 10.1055/a-2003-9463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The placenta provides maternal-fetal nutrient transport. The primary source of energy for fetus development is glucose and maternal-fetal glucose transport occurs through glucose transporters (GLUTs). Stevioside, a component of Stevia rebaudiana Bertoni, is used for medicinal and commercial purposes. We aim to determine the effects of stevioside on GLUT 1, GLUT 3, and GLUT 4 proteins expressions in diabetic rat placentas. The rats are divided into four groups. A single dose of streptozotocin (STZ) is administered to form the diabetic groups. Pregnant rats receive stevioside to form the stevioside and diabetic + stevioside groups. According to immunohistochemistry results, GLUT 1 protein is found in both the labyrinth and junctional zones. GLUT 3 protein is limited in the labyrinth zone. GLUT 4 protein is detected in trophoblast cells. According to Western blotting results, on the 15th and 20th days of pregnancy, there is no difference in the expression of GLUT 1 protein between groups. On the 20th day of pregnancy, the expression of GLUT 3 protein in the diabetic group is statistically higher compared to the control group. On the 15th day and 20th day of pregnancy, the expression of GLUT 4 protein in the diabetic group is statistically lower compared to the control group. Insulin levels in blood samples derived from rat abdominal aorta are determined by the ELISA method. According to the ELISA results, there is no difference in insulin protein concentration between groups. Stevioside treatment reduces GLUT 1 protein expression under diabetic conditions.
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Affiliation(s)
- Ertan Katirci
- Department of Histology and Embryology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Remziye Kendirci-Katirci
- Department of Histology and Embryology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Emin Turkay Korgun
- Department of Histology and Embryology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
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22
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Pearson RC, Green ES, Olenick AA, Jenkins NT. Comparison of aspartame- and sugar-sweetened soft drinks on postprandial metabolism. Nutr Health 2023; 29:115-128. [PMID: 34841959 DOI: 10.1177/02601060211057415] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: We compared the impact of artificially- and sugar-sweetened beverages co-ingested with a mixed meal on postprandial fat and carbohydrate oxidation, blood glucose, and plasma insulin and triglyceride concentrations. Methods: Eight college-aged, healthy males completed three randomly assigned trials, which consisted of a mixed macronutrient meal test with 20oz of Diet-Coke (AS), Coca-Cola (NS), or water (CON). One week separated each trial and each participant served as his own control. Resting energy expenditure (REE) via indirect calorimetry, blood pressure, and blood samples were obtained immediately before, 5, 10, 30, 60, 120, and 180 min after meal and beverage ingestion. A two-way (treatment × time) repeated-measures ANOVA was conducted to assess REE, fat and carbohydrate oxidation rates, blood glucose, and plasma insulin and triglyceride concentrations. Results: There was a significant main effect of treatment on total fat oxidation (P = 0.006), fat oxidation was significantly higher after AS (P = 0.006) and CON (P = 0.001) compared to following NS. There was a significant main effect of treatment on total carbohydrate oxidation (P = 0.005), carbohydrate oxidation was significantly lower after AS (P = 0.014) and CON (P = 0.001) compared to following NS. Plasma insulin concentration AUC was significantly lower after AS (P = 0.019) and trended lower in CON (P = 0.054) compared to following NS. Conclusion: Ingestion of a mixed meal with an artificially-sweetened beverage does not impact postprandial metabolism, whereas a sugar-sweetened beverage suppresses fat oxidation and increases carbohydrate oxidation compared to artificially-sweetened beverage and water.
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Affiliation(s)
- Regis C Pearson
- Graduate Research Assistant, Department of Kinesiology, 1355University of Georgia, Athens, GA USA
| | - Edward S Green
- Graduate Research Assistant, Department of Kinesiology, 1355University of Georgia, Athens, GA USA
| | - Alyssa A Olenick
- Graduate Teaching Assistant, Department of Kinesiology, 1355University of Georgia, Athens, GA USA
| | - Nathan T Jenkins
- Associate Professor, Department of Kinesiology, 1355University of Georgia, Athens, GA USA
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23
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Piana ML, Cianciabella M, Daniele GM, Badiani A, Rocculi P, Tappi S, Gatti E, Marcazzan GL, Magli M, Medoro C, Predieri S. Influence of the Physical State of Two Monofloral Honeys on Sensory Properties and Consumer Satisfaction. Foods 2023; 12:foods12050986. [PMID: 36900503 PMCID: PMC10000918 DOI: 10.3390/foods12050986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023] Open
Abstract
Honey is a worldwide known and appreciated food product. Its appreciation by consumers is due to both its nutritional properties and the extremely reduced processing. The floral origin, color, aroma and taste are key factors in determining the quality of honey. Nevertheless, rheological properties, as crystallization rate, play a fundamental role in the perceived overall quality. Indeed, crystallized honey is often considered of poor quality by consumers, but a fine-grained or creamy texture is becoming interesting from the producers' side. The purpose of this study was to investigate textural and aromatic properties and consumers' perception and acceptance of two monofloral honeys that were differently crystallized. Liquid and creamy samples were obtained from crystallized samples. Physico-chemical, descriptive and dynamic sensory analysis, as well as consumer and CATA tests, were conducted on the three honey textures. The physico-chemical analysis well-discriminated the crystallization levels and evidenced that, although the honey variety was different, the textural properties of the creamy samples are very similar. Crystallization was shown to affect the honey sensory perceptions: liquid samples were sweeter, but less aromatic. Consumer tests allowed the validation of panel data and confirmed consumers' higher appreciation for liquid and creamy honey.
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Affiliation(s)
- Maria Lucia Piana
- Piana Ricerca e Consulenza, Castel San Pietro Terme (BO), 40024 Bologna, Italy
| | - Marta Cianciabella
- IBE-Institute of BioEconomy, CNR, Via Gobetti, 101, 40129 Bologna, Italy
| | | | - Anna Badiani
- Veterinary Medical Sciences Department, University of Bologna, 40126 Bologna, Italy
| | - Pietro Rocculi
- Agricultural and Food Sciences Department, University of Bologna, 40126 Bologna, Italy
| | - Silvia Tappi
- Agricultural and Food Sciences Department, University of Bologna, 40126 Bologna, Italy
| | - Edoardo Gatti
- IBE-Institute of BioEconomy, CNR, Via Gobetti, 101, 40129 Bologna, Italy
| | - Gian Luigi Marcazzan
- CREA Council for Agricultural Research and Economics, Agriculture and Environment Research Center, 40128 Bologna, Italy
| | - Massimiliano Magli
- IBE-Institute of BioEconomy, CNR, Via Gobetti, 101, 40129 Bologna, Italy
| | - Chiara Medoro
- IBE-Institute of BioEconomy, CNR, Via Gobetti, 101, 40129 Bologna, Italy
- Correspondence:
| | - Stefano Predieri
- IBE-Institute of BioEconomy, CNR, Via Gobetti, 101, 40129 Bologna, Italy
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24
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Dong J, Yuan J, Cao Y, Zhao Y, Han Q, Gao W, Li T, Zhu L, Qi J. Electrically controllable self-assembly of gold nanorods into a plasmonic nanostructure for highly efficiency SERS. OPTICS LETTERS 2022; 47:6365-6368. [PMID: 36538439 DOI: 10.1364/ol.477507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/12/2022] [Indexed: 06/17/2023]
Abstract
In this Letter, a method for the rapid and efficient preparation of ultrasensitive detection substrates by assembling gold nanorod suspensions with the application of an alternating current (AC) field is proposed, and it is found that frequency and voltage are the effective means of regulation. A sandwich structure (parallel SiO2 plate) not only effectively slows down the evaporation rate, but also visually reveals the changes in the assembly process. Under the optimal assembly conditions, the sensitivity and uniformity of the substrate to different probe molecules are tested. The Raman detection results experimentally show that the detection limits of Rhodamine 6G (Rh6G), crystal violet (CV), and Aspartame (APM) molecular solutions are 10-14 M, 10-10 M, and 62.5 mg/L, respectively, and the mixed dye molecular solutions can also be effectively distinguished. Furthermore, Rh6G and CV characteristic peaks at 1647 cm-1 and 1619 cm-1 were measured at randomly selected positions, and their relative standard deviations (RSDs) were 5.63% and 8.45%, respectively, indicating that the substrate has good uniformity. The effective regulation of the self-assembly results of nanoparticles will further enhance the practical application effect of surface-enhanced Raman technology and expand the application prospects of this technology.
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25
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Characterizing ingredients in commercially packaged baked products sold in the U.S.: An application of IngID. J Food Compost Anal 2022. [DOI: 10.1016/j.jfca.2022.104830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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26
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Caballero-de la Peña K, Acevedo-Pacheco L, Sánchez-Reséndiz AI, Chuck-Hernández C, Serna-Saldívar SO. Protein quality and glycemic indexes of mango drinks fortified with a soybean/maize protein isolate with three levels of urease activity fed to weanling rats. Food Nutr Res 2022; 66:8576. [PMID: 36590858 PMCID: PMC9793766 DOI: 10.29219/fnr.v66.8576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/18/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Public health professionals established a direct link between obesity and the rise in high caloric beverage intake. Current recommendations promote the elimination of sweet fruit drinks from the population's diet. One way of evading this is by modifying the drink's nutritional characteristics regarding nutrient uptake and utilization. Objectives evaluate the protein quality of a soy/maize protein (SMP) and its physiological effects on nutrient intake and to assess glycemic indexes (GIs) of mango based drinks prepared with sucrose or stevia. Materials and methods Mango drinks were supplemented with different sources of protein (three SMP thermally treated to contain different urease activities (UA) or whey protein concentrate (WPC)) that were sweetened with sucrose or stevia/sucralose. The protein digestibility, net protein absorption (NPA), biological value (BV), net protein utilization (NPU) value and protein efficiency ratio (PER) were assessed with weanling rats. Moreover, the GIs of the mango drinks were measured in the same animal model. Results PER and NPA evaluated in a rat model showed that increased levels of UA decreased Biological (BV) and Net Protein Utilization (NPU) values. The GIs of the mango drinks significantly diminished with the addition of 3.5% of SMP, but unexpectedly the substitution of sucrose by stevia/sucralose did not significantly change the glycemic response. Conclusion the SMP isolate can be used to improve the nutritional profile and lower GIs of mango drinks.
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Affiliation(s)
| | | | | | | | - Sergio O. Serna-Saldívar
- Tecnologico de Monterrey, School of Engineering and Sciences, Monterrey, México,Sergio O. Serna-Saldívar, Eugenio Garza Sada 2501 Sur, Tecnológico, 64849 Monterrey, NL, México.
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27
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Derosa G, D'Angelo A, Maffioli P. The role of selected nutraceuticals in management of prediabetes and diabetes: An updated review of the literature. Phytother Res 2022; 36:3709-3765. [PMID: 35912631 PMCID: PMC9804244 DOI: 10.1002/ptr.7564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 07/04/2022] [Accepted: 07/04/2022] [Indexed: 01/05/2023]
Abstract
Dysglycemia is a disease state preceding the onset of diabetes and includes impaired fasting glycemia and impaired glucose tolerance. This review aimed to collect and analyze the literature reporting the results of clinical trials evaluating the effects of selected nutraceuticals on glycemia in humans. The results of the analyzed trials, generally, showed the positive effects of the nutraceuticals studied alone or in association with other supplements on fasting plasma glucose and post-prandial plasma glucose as primary outcomes, and their efficacy in improving insulin resistance as a secondary outcome. Some evidences, obtained from clinical trials, suggest a role for some nutraceuticals, and in particular Berberis, Banaba, Curcumin, and Guar gum, in the management of prediabetes and diabetes. However, contradictory results were found on the hypoglycemic effects of Morus, Ilex paraguariensis, Omega-3, Allium cepa, and Trigonella faenum graecum, whereby rigorous long-term clinical trials are needed to confirm these data. More studies are also needed for Eugenia jambolana, as well as for Ascophyllum nodosum and Fucus vesiculosus which glucose-lowering effects were observed when administered in combination, but not alone. Further trials are also needed for quercetin.
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Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and TherapeuticsUniversity of PaviaPaviaItaly,Centre of Diabetes, Metabolic Diseases, and DyslipidemiasUniversity of PaviaPaviaItaly,Regional Centre for Prevention, Surveillance, Diagnosis and Treatment of Dyslipidemias and AtherosclerosisFondazione IRCCS Policlinico San MatteoPaviaItaly,Italian Nutraceutical Society (SINut)BolognaItaly,Laboratory of Molecular MedicineUniversity of PaviaPaviaItaly
| | - Angela D'Angelo
- Department of Internal Medicine and TherapeuticsUniversity of PaviaPaviaItaly,Laboratory of Molecular MedicineUniversity of PaviaPaviaItaly
| | - Pamela Maffioli
- Centre of Diabetes, Metabolic Diseases, and DyslipidemiasUniversity of PaviaPaviaItaly,Regional Centre for Prevention, Surveillance, Diagnosis and Treatment of Dyslipidemias and AtherosclerosisFondazione IRCCS Policlinico San MatteoPaviaItaly,Italian Nutraceutical Society (SINut)BolognaItaly
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28
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An updated multifaceted overview of sweet proteins and dipeptides as sugar substitutes; the chemistry, health benefits, gut interactions, and safety. Food Res Int 2022; 162:111853. [DOI: 10.1016/j.foodres.2022.111853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 08/13/2022] [Accepted: 08/21/2022] [Indexed: 11/24/2022]
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29
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Wingrove J, O'Daly O, De Lara Rubio A, Hill S, Swedroska M, Forbes B, Amiel S, Zelaya F. The influence of insulin on anticipation and consummatory reward to food intake: A functional imaging study on healthy normal weight and overweight subjects employing intranasal insulin delivery. Hum Brain Mapp 2022; 43:5432-5451. [PMID: 35860945 PMCID: PMC9704782 DOI: 10.1002/hbm.26019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/24/2022] [Accepted: 07/03/2022] [Indexed: 01/15/2023] Open
Abstract
Aberrant responses within homeostatic, hedonic and cognitive systems contribute to poor appetite control in those with an overweight phenotype. The hedonic system incorporates limbic and meso-limbic regions involved in learning and reward processing, as well as cortical regions involved in motivation, decision making and gustatory processing. Equally important within this complex, multifaceted framework are the cognitive systems involved in inhibitory control and valuation of food choices. Regions within these systems display insulin receptors and pharmacologically increasing central insulin concentrations using intranasal administration (IN-INS) has been shown to significantly reduce appealing food cue responsiveness and also food intake. In this work we describe a placebo-controlled crossover pharmacological functional magnetic resonance imaging (fMRI) study that looks at how IN-INS (160 IU) affects anticipatory and consummatory responses to sweet stimuli and importantly how these responses differ between healthy normal weight and overweight male individuals. This work shows that age matched normal weight and overweight (not obese) individuals respond similarly to both the anticipation and receipt of sweet stimuli under placebo conditions. However, increased central insulin concentrations produce marked differences between groups when anticipating sweet stimuli within the prefrontal cortex and midbrain as well as observed differences in the amygdala during consummatory responses.
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Affiliation(s)
- Jed Wingrove
- Department of Neuroimaging, Institute of PsychiatryPsychology and Neuroscience King's College LondonLondonUK,Centre for Obesity Research, Department of MedicineUniversity College LondonLondonUK
| | - Owen O'Daly
- Department of Neuroimaging, Institute of PsychiatryPsychology and Neuroscience King's College LondonLondonUK
| | - Alfonso De Lara Rubio
- Department of Neuroimaging, Institute of PsychiatryPsychology and Neuroscience King's College LondonLondonUK
| | - Simon Hill
- Department of Neuroimaging, Institute of PsychiatryPsychology and Neuroscience King's College LondonLondonUK
| | - Magda Swedroska
- Institute of Pharmaceutical Sciences, Pharmaceutical SciencesKing's College LondonLondonUK
| | - Ben Forbes
- Institute of Pharmaceutical Sciences, Pharmaceutical SciencesKing's College LondonLondonUK
| | - Stephanie Amiel
- Diabetes Research Group, Weston Education CentreKing's College LondonLondonUK
| | - Fernando Zelaya
- Department of Neuroimaging, Institute of PsychiatryPsychology and Neuroscience King's College LondonLondonUK
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30
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Chadha D, Hamid N, Kantono K, Marsan M. Changes in temporal sensory profile, liking, satiety, and postconsumption attributes of yogurt with natural sweeteners. J Food Sci 2022; 87:3190-3206. [PMID: 35708195 PMCID: PMC9545239 DOI: 10.1111/1750-3841.16224] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/26/2022] [Accepted: 05/23/2022] [Indexed: 01/26/2023]
Abstract
Abstract Sweetened yogurts can contain between 10 and 13% added sugar. However, studies have shown that sugar reduction or replacement can influence yogurt quality. The main objective of this research was to investigate the effects of yogurt with added natural sweeteners on temporal sensory profile, liking, satiety and postconsumption measures. Yogurt samples were prepared with iso‐sweet concentrations of sucrose (9 g/100 g of plain yogurt) using xylitol (10 g/100 g), stevia (0.15 g/100 g), and monk fruit (0.15 g/100 g). Fifty panelists evaluated the temporal sensory profile of these yogurts using multiple‐intake temporal dominance of sensations (TDS), and overall liking for each intake. In addition, satiety (hunger, thirst, and fullness) and other postconsumption attributes (healthiness, satisfaction, and purchase intent) were determined. The temporal profile of yogurt sweetened with xylitol was similar to yogurt sweetened with sucrose without any onset of negative sensory characteristics at any point in intake. Yogurt sweetened with stevia had a high dominance duration for astringency. Moreover, yogurt sweetened with monk fruit showed increased dominance of attributes bitter and astringent from the first to third intake. In terms of liking, yogurt containing xylitol was scored the highest followed by stevia and monkfruit. Sweet was a positive temporal driver of liking in yogurt sweetened with monk fruit. However, mouthcoating, sweet, and sour decreased liking in yogurt sweetened with sucrose, xylitol, and stevia respectively. In terms of perceived healthiness, satisfaction and purchase intent, yogurt sweetened with sucrose scored the highest followed by xylitol. Consumption of yogurt sweetened with xylitol, stevia, or monk fruit significantly decreased hunger compared to yogurt sweetened with sucrose. Practical Application The current findings will play an important role for the dairy industry in understanding how sugar replacement with natural sweeteners in yogurt can influence its sensory perception and postconsumption behavior.
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Affiliation(s)
- Diksha Chadha
- Department of Food Science, Faculty of Health and Environment Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Nazimah Hamid
- Department of Food Science, Faculty of Health and Environment Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Kevin Kantono
- Department of Food Science, Faculty of Health and Environment Sciences, Auckland University of Technology, Auckland, New Zealand.,Product experience & data science research, International Flavours & Fragrances Inc., Amsterdam, Netherlands
| | - Manon Marsan
- Department of Food Science, Faculty of Health and Environment Sciences, Auckland University of Technology, Auckland, New Zealand.,Agrocampus Ouest, Rennex Cedex, France
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31
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Mendoza-Pérez S, García-Gómez RS, Durán-Domínguez-de-Bazúa MDC. Chronic intake of nutritive sweeteners and saccharin increases levels of glycolytic and lipogenic enzymes in rat liver. Int J Food Sci Nutr 2022; 73:927-939. [PMID: 35708269 DOI: 10.1080/09637486.2022.2088705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
There are doubts about the impact of non-nutritive sweeteners consumption on lipogenic and glycolytic metabolism. Therefore, the objective was to determine the effects of chronic consumption of sweeteners on the activity levels of the enzymes glucokinase (GK), phosphofructokinase-1 (PFK-1), pyruvate kinase (PKL), acetyl coenzyme A carboxylase (ACC), and fatty acid synthase (FAS) in livers' extracts. Groups of male and female Wistar rats drank solutions of sweeteners for 480 days: Sucrose 10%, glucose 14%, fructose 7%, acesulfame K 0.05%, aspartame:acesulfame mixture 1.55%, sucralose 0.017%, saccharin 0.033%, and a control group. The enzymatic activity in livers' extracts was determined. Likewise, the levels of glucose, triglycerides, insulin, glucagon, and leptin were determined. In both genders, there were significant differences in the levels of enzymatic activity, hormonal, and biochemical parameters due to sweeteners consumption. The highest glycolytic and lipogenic enzyme activity levels were observed in the groups that ingested nutritive sweeteners and saccharin.
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Affiliation(s)
- Samuel Mendoza-Pérez
- Laboratories of Environmental Chemical Engineering and Chemistry, Department of Chemical Engineering, Faculty of Chemistry, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Rolando Salvador García-Gómez
- Laboratories of Environmental Chemical Engineering and Chemistry, Department of Chemical Engineering, Faculty of Chemistry, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - María-Del-Carmen Durán-Domínguez-de-Bazúa
- Laboratories of Environmental Chemical Engineering and Chemistry, Department of Chemical Engineering, Faculty of Chemistry, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
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32
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Muenprasitivej N, Tao R, Nardone SJ, Cho S. The Effect of Steviol Glycosides on Sensory Properties and Acceptability of Ice Cream. Foods 2022; 11:foods11121745. [PMID: 35741943 PMCID: PMC9223086 DOI: 10.3390/foods11121745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 01/13/2023] Open
Abstract
There has been a challenge in overcoming the bitter aftertaste of stevia, a natural non-caloric sweetener. Recent research focuses on investigating various types of steviol glycosides, the sweet compounds in stevia leaves, as they exhibit different sensory characteristics. This study determined the sensory properties and acceptability of ice cream sweetened solely with three steviol glycosides, rebaudioside (Reb) A, D, and M (0.09% w/v), using sucrose-sweetened ice cream as a control (14% w/v). Ice cream consumers (n = 92) rated their overall liking, attribute liking, and sweetness and bitterness intensities and described the aftertastes of each sample using check-all-that-apply. The liking scores of Reb D- and M-sweetened ice creams were significantly higher than those of Reb A-sweetened ice cream. Among the three glycosides, only Reb M showed a sweetness intensity comparable with that of sucrose. Consumers perceived the aftertastes of Reb D and M ice creams as being more sweet, pleasant, creamy, and milky, while Reb A was more artificial and chemical. Reb D and M ice creams were also plotted close to sucrose in the correspondence analysis graph, meaning that their aftertaste characteristics were similar to those of sucrose. The present study clearly highlights that Reb D and M have better tastes and provide better perceptions to consumers than Reb A, which is the most widely used glycoside in food industry.
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Affiliation(s)
| | - Ran Tao
- Department of Food Science & Human Nutrition, Michigan State University, East Lansing, MI 48824, USA;
| | - Sarah Jeanne Nardone
- Department of Poultry Science, Auburn University, Auburn, AL 36849, USA; (N.M.); (S.J.N.)
| | - Sungeun Cho
- Department of Poultry Science, Auburn University, Auburn, AL 36849, USA; (N.M.); (S.J.N.)
- Correspondence:
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33
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Chowdhury AI, Rahanur Alam M, Raihan MM, Rahman T, Islam S, Halima O. Effect of stevia leaves (
Stevia rebaudiana
Bertoni) on diabetes: A systematic review and meta‐analysis of preclinical studies. FOOD SCIENCE & NUTRITION 2022; 10:2868-2878. [PMID: 36171777 PMCID: PMC9469865 DOI: 10.1002/fsn3.2904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 03/05/2022] [Accepted: 04/06/2022] [Indexed: 12/09/2022]
Abstract
Stevia (Stevia rebaudiana Bertoni) is a natural herb with biological activities such as anticancer, antidiabetic, anticardiovascular disease, anti‐inflammatory, and antimicrobial. The current systematic review and meta‐analysis of previously published data were performed to assess the antidiabetic effect of stevia leaves. Three electronic databases (PubMed, CENTRAL, and DOAJ) had been used for searching articles published before September 2020. Meta‐analysis via random‐effect model had been performed to assess the effects of different doses of stevia on blood glucose level (BGL) and studies were weighted according to an estimate of the standard mean difference (SMD). Overall, 16 eligible studies were selected for qualitative analysis and 9 were included for quantitative analysis. The results of the meta‐analysis for BGL showed that at the doses of 200, 300, and 400 mg/kg of stevia leaves there was a significant difference in means of BGL between the intervention and control group and the dose of 500 mg/kg showed no significance (Standard mean difference (SMD): −3.84 (−9.96, 2.27); p = .22). Based on the duration of intervention, subgroup analysis of articles showed a significant difference between the groups (p < .001). The results of the meta‐analysis support the hypothesis that stevia leaf has an antihyperglycemic effect and reduces the blood glucose level at doses of 200, 300, and 400 mg/kg. Therefore, more clinical trials on animals and humans have to be done to investigate the antidiabetic and antihyperglycemic effects along with the efficacy and safety of these medicinal leaves.
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Affiliation(s)
- Akibul Islam Chowdhury
- Department of Food Technology and Nutrition Science Noakhali Science and Technology University Noakhali Bangladesh
| | - Mohammad Rahanur Alam
- Department of Food Technology and Nutrition Science Noakhali Science and Technology University Noakhali Bangladesh
| | - M Maruf Raihan
- Department of Food Technology and Nutrition Science Noakhali Science and Technology University Noakhali Bangladesh
| | - Tanjina Rahman
- Department of Food Technology and Nutrition Science Noakhali Science and Technology University Noakhali Bangladesh
- Institute of Nutrition and Food Science University of Dhaka Dhaka Bangladesh
| | - Saiful Islam
- Institute of Nutrition and Food Science University of Dhaka Dhaka Bangladesh
| | - Oumma Halima
- Department of Food Technology and Nutrition Science Noakhali Science and Technology University Noakhali Bangladesh
- Institute of Nutrition and Food Science University of Dhaka Dhaka Bangladesh
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Sambra V, Vicuña IA, Priken KM, Luna SL, Allendes DA, Godoy PM, Novik V, Vega CA. Acute responses of stevia and d-tagatose intake on metabolic parameters and appetite/satiety in insulin resistance. Clin Nutr ESPEN 2022; 49:217-224. [DOI: 10.1016/j.clnesp.2022.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
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Intestinal Alkaline Phosphatase: A Review of This Enzyme Role in the Intestinal Barrier Function. Microorganisms 2022; 10:microorganisms10040746. [PMID: 35456797 PMCID: PMC9026380 DOI: 10.3390/microorganisms10040746] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 02/06/2023] Open
Abstract
Intestinal alkaline phosphatase (IALP) has recently assumed a special relevance, being the subject of study in the prevention and treatment of certain diseases related to leaky gut. This brush border enzyme (ecto-enzyme) plays an important role in the maintenance of intestinal microbial homeostasis and intestinal barrier function through its ability to dephosphorylate lipopolysaccharide (LPS). This review addresses how IALP and intestinal barrier dysfunction may be implicated in the pathophysiology of specific diseases such as inflammatory bowel disease, necrotizing enterocolitis, and metabolic syndrome. The use of IALP as a possible biomarker to assess intestinal barrier function and strategies to modulate IALP activity are also discussed.
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The Effect of Artificial Sweeteners Use on Sweet Taste Perception and Weight Loss Efficacy: A Review. Nutrients 2022; 14:nu14061261. [PMID: 35334918 PMCID: PMC8954878 DOI: 10.3390/nu14061261] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 02/01/2023] Open
Abstract
Excessive consumption of sugar-rich foods is currently one of the most important factors that has led to the development of the global pandemic of obesity. On the other hand, there is evidence that obesity contributes to reduced sensitivity to sweet taste and hormonal changes affecting appetite, leading to an increased craving for sweets. A high intake of sugars increases the caloric value of the diet and, consequently, leads to weight gain. Moreover, attention is drawn to the concept of the addictive properties of sugar and sugary foods. A potential method to reduce the energy value of diet while maintaining the sweet taste is using non-nutritive sweeteners (NNS). NNS are commonly used as table sugar substitutes. This wide group of chemical compounds features high sweetness almost without calories due to its high sweetening strength. NNS include aspartame, acesulfame-K, sucralose, saccharin, cyclamate, neohesperidin dihydrochalcone (neohesperidin DC), neotame, taumatin, and advantame. The available evidence suggests that replacing sugar with NNS may support weight control. However, the effect of NNS on the regulation of appetite and sweet taste perception is not clear. Therefore, the review aimed to summarize the current knowledge about the use of NNS as a potential strategy for weight loss and their impact on sweet taste perception. Most studies have demonstrated that consumption of NNS-sweetened foods does not increase sweetness preference orenergy intake. Nonetheless, further research is required to determine the long-term effects of NNS on weight management.
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Vieira Nogueira P, Vilas Boas AC, Ferreira Suárez N, Arruda de Abreu RA, de Carvalho CV, Salles Pio LA, Pasqual M. Composition and Functional Properties of Banana Tree Male Inflorescence Flour. JOURNAL OF CULINARY SCIENCE & TECHNOLOGY 2022. [DOI: 10.1080/15428052.2022.2040677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | | | | | | | | | - Moacir Pasqual
- Department of Agriculture, Federal University of Lavras, Lavras, Brazil
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Stevioside ameliorates hyperglycemia and glucose intolerance, in a diet-induced obese zebrafish model, through epigenetic, oxidative stress and inflammatory regulation. Obes Res Clin Pract 2022; 16:23-29. [PMID: 35031270 DOI: 10.1016/j.orcp.2022.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 09/07/2021] [Accepted: 01/06/2022] [Indexed: 02/07/2023]
Abstract
Obesity is an independent risk factor for type 2 diabetes and epigenetic regulatory mechanisms affect obesity-related mechanisms. Due to weight gain concern in society, artificial sweeteners with no nutritional value have been increasingly consumed. Stevia is a sweet natural glycoside and a calorie-free sweetner extracted from the leaves of Stevia rebaudiana Bertoni and used as a substitute for artificial sweetners. This study evaluates the effects of stevioside on glucose tolerance, epigenetic and metabolic regulators of insulin resistance, oxidant-antioxidant status and tissue histology in a diet-induced obese (DIO) zebrafish model. After 15 days of overfeeding body weight, and fasting blood glucose, lipid peroxidation and nitric oxide levels and the expressions of fbf21, lepa, ll21, tnfα were elevated, where as there was impaired glucose tolerance and lower superoxide dismutase and glutathione S-transferase activities, dnmt3a expression which is an epigenetic tool of insulin resistance. Beneficial effects of stevioside were observed on glucose tolerance, oxidative stress and inflammatory mediators linking obesity to insulin resistance and its epigenetic regulation, in DIO model.
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Alam S, Sarker MMR, Sultana TN, Chowdhury MNR, Rashid MA, Chaity NI, Zhao C, Xiao J, Hafez EE, Khan SA, Mohamed IN. Antidiabetic Phytochemicals From Medicinal Plants: Prospective Candidates for New Drug Discovery and Development. Front Endocrinol (Lausanne) 2022; 13:800714. [PMID: 35282429 PMCID: PMC8907382 DOI: 10.3389/fendo.2022.800714] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 01/04/2022] [Indexed: 02/05/2023] Open
Abstract
Diabetes, a chronic physiological dysfunction affecting people of different age groups and severely impairs the harmony of peoples' normal life worldwide. Despite the availability of insulin preparations and several synthetic oral antidiabetic drugs, there is a crucial need for the discovery and development of novel antidiabetic drugs because of the development of resistance and side effects of those drugs in long-term use. On the contrary, plants or herbal sources are getting popular day by day to the scientists, researchers, and pharmaceutical companies all over the world to search for potential bioactive compound(s) for the discovery and development of targeted novel antidiabetic drugs that may control diabetes with the least unwanted effects of conventional antidiabetic drugs. In this review, we have presented the prospective candidates comprised of either isolated phytochemical(s) and/or extract(s) containing bioactive phytoconstituents which have been reported in several in vitro, in vivo, and clinical studies possessing noteworthy antidiabetic potential. The mode of actions, attributed to antidiabetic activities of the reported phytochemicals and/or plant extracts have also been described to focus on the prospective phytochemicals and phytosources for further studies in the discovery and development of novel antidiabetic therapeutics.
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Affiliation(s)
- Safaet Alam
- Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh
| | - Md. Moklesur Rahman Sarker
- Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh
- Pharmacology and Toxicology Research Division, Health Med Science Research Limited, Dhaka, Bangladesh
- *Correspondence: Md. Moklesur Rahman Sarker, ; ; orcid.org/0000-0001-9795-0608; Isa Naina Mohamed, ; orcid.org/0000-0001-8891-2423
| | | | | | - Mohammad A. Rashid
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Dhaka, Dhaka, Bangladesh
| | | | - Chao Zhao
- College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, China
| | - Jianbo Xiao
- Department of Analytical Chemistry and Food Science, Faculty of Food Science and Technology, University of Vigo, Vigo, Spain
| | - Elsayed E. Hafez
- Plant Protection and Biomolecular Diagnosis Department, ALCRI (Arid Lands Cultivation Research Institute), City of Scientific Research and Technological Applications, Alexandria, Egypt
| | - Shah Alam Khan
- College of Pharmacy, National University of Science & Technology, Muscat, Oman
| | - Isa Naina Mohamed
- Pharmacology Department, Medicine Faculty, Universiti Kebangsaan Malaysia (The National University of Malaysia), Kuala Lumpur, Malaysia
- *Correspondence: Md. Moklesur Rahman Sarker, ; ; orcid.org/0000-0001-9795-0608; Isa Naina Mohamed, ; orcid.org/0000-0001-8891-2423
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Floyd R, Gryson R, Mockler D, Gibney J, Duggan SN, Behan LA. The Effect of Time-Restricted Eating on Insulin Levels and Insulin Sensitivity in Patients with Polycystic Ovarian Syndrome: A Systematic Review. Int J Endocrinol 2022; 2022:2830545. [PMID: 36159086 PMCID: PMC9507776 DOI: 10.1155/2022/2830545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 09/06/2022] [Indexed: 12/02/2022] Open
Abstract
RESULTS 2662 papers were identified with 37 selected for full-text review and one paper meeting criteria for inclusion. Ramadan fasting was the only time-restricted eating regimen trialled in this population with no strong evidence of a significant effect on insulin levels. CONCLUSION As the systematic review retrieved only one study investigating time-restricted eating to reduce insulin in patients with PCOS, there is no evidence to suggest that this intervention is effective. From the narrative review, based on studies in other patient groups, time-restricted eating could improve insulin resistance in those with PCOS; however, well-designed studies are required before this intervention can be recommended.
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Affiliation(s)
- R. Floyd
- Department of Endocrinology, Robert Graves Institute of Endocrinology, Tallaght University Hospital, Dublin, Ireland
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - R. Gryson
- Department of Obstetrics & Gynaecology, Rotunda Hospital, Dublin, Ireland
| | - D. Mockler
- John Stearne Medical Library, Trinity College Dublin, Trinity Centre for Health Sciences, Dublin, Ireland
| | - J. Gibney
- Department of Endocrinology, Robert Graves Institute of Endocrinology, Tallaght University Hospital, Dublin, Ireland
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - S. N. Duggan
- Department of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - L. A. Behan
- Department of Endocrinology, Robert Graves Institute of Endocrinology, Tallaght University Hospital, Dublin, Ireland
- Department of Clinical Medicine, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Dey S, Samadder A, Nandi S. Current Role of Nanotechnology Used in Food Processing Industry to Control Food Additives and Exploring Their Biochemical Mechanisms. Curr Drug Targets 2021; 23:513-539. [PMID: 34915833 DOI: 10.2174/1389450123666211216150355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/25/2021] [Accepted: 09/02/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND With the advent of food additives centuries ago, the human race has found ways to improve and maintain the safety of utility, augment the taste, color, texture, nutritional value, and appearance of the food. Since the 19th century, when the science behind food spoilage was discerned, the use of food additives in food preservation has been increasing worldwide and at a fast pace to get along with modern lifestyles. Although food additives are thought to be used to benefit the food market, some of them are found to be associated with several health issues at an alarming rate. Studies are still going on regarding the mechanisms by which food additives affect public health. Therefore, an attempt has been made to find out the remedies by exploiting technologies that may convey new properties of food additives that can only enhance the quality of food without having any systemic side effects. Thus, this review focuses on the applications of nanotechnology in the production of nano-food additives and evaluates its success regarding reduction in the health-related hazards collaterally maintaining the food nutrient value. METHODOLOGY A thorough literature study was performed using scientific databases like PubMed, Science Direct, Scopus, Web of Science for determining the design of the study, and each article was checked for citation and referred to formulate the present review article. CONCLUSION Nanotechnology can be applied in the food processing industry to control the unregulated use of food additives and to intervene in the biochemical mechanisms at a cellular and physiological level for the ensuring safety of food products. The prospective of nano-additive of chemical origin could be useful to reduce risks of hazards related to human health that are caused majorly due to the invasion of food contaminants (either intentional or non-intentional) into food, though this area still needs scientific validation. Therefore, this review provides comprehensive knowledge on different facets of food contaminants and also serves as a platform of ideas for encountering health risk problems about the design of improved versions of nano-additives.
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Affiliation(s)
- Sudatta Dey
- Cytogenetics and Molecular Biology Laboratory, Department of Zoology, University of Kalyani, Kalyani, Nadia-741235. India
| | - Asmita Samadder
- Cytogenetics and Molecular Biology Laboratory, Department of Zoology, University of Kalyani, Kalyani, Nadia-741235. India
| | - Sisir Nandi
- Department of Pharmaceutical Chemistry, Global Institute of Pharmaceutical Education and Research (GIPER) (Affiliated to Uttarakhand Technical University). Kashipur-244713. India
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Afyounizadeh Esfahani D, Goli M. The effect of Stevioside‐Isomalt, whey protein concentrate, and
Bacillus coagulans
on the physicochemical and sensory properties of Iranian probiotic Masghati sweet. J FOOD PROCESS PRES 2021. [DOI: 10.1111/jfpp.16028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
| | - Mohammad Goli
- Department of Food Science and Technology Isfahan (Khorasgan) Branch, Islamic Azad University Isfahan Iran
- Laser and Biophotonics in Biotechnologies Research Center Isfahan (Khorasgan) Branch, Islamic Azad University Isfahan Iran
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Khiraoui A, Bakha M, Boulli A, Hasib A, Al Faiz C. The productivity of Stevia rebaudiana (Bertoni) on dry leaves and steviol glycosides of four varieties grown in six regions of Morocco. BIOCATALYSIS AND AGRICULTURAL BIOTECHNOLOGY 2021. [DOI: 10.1016/j.bcab.2021.102151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Peteliuk V, Rybchuk L, Bayliak M, Storey KB, Lushchak O. Natural sweetener Stevia rebaudiana: Functionalities, health benefits and potential risks. EXCLI JOURNAL 2021; 20:1412-1430. [PMID: 34803554 PMCID: PMC8600158 DOI: 10.17179/excli2021-4211] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 08/31/2021] [Indexed: 12/19/2022]
Abstract
Stevia rebaudiana is a South American plant, the cultivation of which is increasing worldwide due to its high content of sweet compounds. Stevia sweetness is mainly due to steviol glycosides, that are ~250-300 times sweeter than sucrose. Many studies have suggested the benefits of Stevia extract over sugar and artificial sweeteners, but it is still not a very popular sugar substitute. This review summarizes current data on the biological activities of S. rebaudiana extract and its individual glycosides, including anti-hypertensive, anti-obesity, anti-diabetic, antioxidant, anti-cancer, anti-inflammatory, and antimicrobial effects and improvement of kidney function. Possible side effects and toxicity of Stevia extract are also discussed.
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Affiliation(s)
- Victoria Peteliuk
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, 57 Shevchenko Str., Ivano-Frankivsk, 76018, Ukraine
| | - Lesia Rybchuk
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, 57 Shevchenko Str., Ivano-Frankivsk, 76018, Ukraine
| | - Maria Bayliak
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, 57 Shevchenko Str., Ivano-Frankivsk, 76018, Ukraine
| | - Kenneth B Storey
- Institute of Biochemistry, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6, Canada
| | - Oleh Lushchak
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, 57 Shevchenko Str., Ivano-Frankivsk, 76018, Ukraine
- Research and Development University, Shota Rustaveli Str., 76000, Ivano-Frankivsk, Ukraine
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Analysis of Caloric and Noncaloric Sweeteners Present in Dairy Products Aimed at the School Market and Their Possible Effects on Health. Nutrients 2021; 13:nu13092994. [PMID: 34578870 PMCID: PMC8471137 DOI: 10.3390/nu13092994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/23/2021] [Accepted: 08/24/2021] [Indexed: 12/21/2022] Open
Abstract
Over the past decades, Mexico has become one of the main sweetener-consuming countries in the world. Large amounts of these sweeteners are in dairy products aimed at the children’s market in various presentations such as yogurt, flavored milk, flan, and cheeses. Although numerous studies have shown the impact of sweeteners in adults, the current evidence for children is insufficient and discordant to determine if these substances have any risk or benefit on their well-being. Therefore, this study aimed to describe the sweeteners present in 15 dairy products belonging to the school-age children’s market in Mexico and their impact on health. These dairy products were selected through a couple of surveys directed at parents of school-age children. After that, the list of ingredients of each product was analyzed to identify their sweetener content. From there, exhaustive bibliographic research on sweeteners and their possible health effects was carried out, which included 109 articles and 18 studies. The results showed that at a neurological, endocrinological, cardiovascular, metabolic, osseous, renal, hepatic, dental, reticular, carcinogenic, and gut microbiota level; sucrose, fructose, high-fructose corn syrup, maltodextrins, sucralose, and acesulfame K, have a negative effect. While maltodextrins, stevia, polydextrose, and modified starch have a positive one. For these reasons, it is necessary to evaluate the advantages and disadvantages that the consumption of each sweetener entails, as well as a determination of the appropriate acceptable daily intake (ADI).
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Lee HY, Jack M, Poon T, Noori D, Venditti C, Hamamji S, Musa-Veloso K. Effects of Unsweetened Preloads and Preloads Sweetened with Caloric or Low-/No-Calorie Sweeteners on Subsequent Energy Intakes: A Systematic Review and Meta-Analysis of Controlled Human Intervention Studies. Adv Nutr 2021; 12:1481-1499. [PMID: 33439973 PMCID: PMC8321874 DOI: 10.1093/advances/nmaa157] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/02/2020] [Accepted: 11/10/2020] [Indexed: 11/25/2022] Open
Abstract
Effects of isocaloric (sweetness differences but constant calories) preloads and isosweet (caloric differences but constant sweetness) preloads, as well as preloads that were neither isosweet nor isocaloric (sweetness and caloric differences) on subsequent ad libitum meal and total (preload + ad libitum) energy intakes were investigated. Thirty-five crossover studies were eligible for inclusion, representing 116 comparisons (41, isocaloric; 41, isosweet; and 34, neither isosweet nor isocaloric). References of existing reviews and literature from 4 databases were searched. The calculated raw mean differences in ad libitum and total energy intakes were pooled in meta-analyses using a random-effects model and the inverse of the variance as the weighting factor. Energy intakes at an ad libitum meal were significantly lower for low-/no-calorie sweetener (LNCS)-sweetened compared with unsweetened preloads in the isocaloric comparison (-55.5 kcal; 95% CI: -82.9, -28.0 kcal; P < 0.001); however, the difference in energy intake was not significant in additional sensitivity analyses (i.e., removal of comparisons where the matrix was a capsule and when xylitol was the LNCS). For the isosweet comparison, although the pooled energy intake at the ad libitum meal was significantly greater with the LNCS-sweetened preload compared with the caloric sweetener (CS)-sweetened preload (58.5 kcal; 95% CI: 35.4, 81.7 kcal; P < 0.001), the pattern was reversed when total energy intake was considered (-132.4 kcal; 95% CI: -163.2, -101.6 kcal; P < 0.001), explained by only partial compensation from the CS-sweetened preload. The results were similar when assessing ad libitum and total energy intakes when unsweetened compared with CS-sweetened preloads were consumed. Unsweetened or LNCS-sweetened preloads appear to have similar effects on intakes when compared with one another or with CS-sweetened preloads. These findings suggest that LNCS-sweetened foods and beverages are viable alternatives to CS-sweetened foods and beverages to manage short-term energy intake.
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Affiliation(s)
- Han Youl Lee
- Intertek Health Sciences, Inc., Mississauga, Ontario Canada
| | - Maia Jack
- American Beverage Association, Science and Regulatory Affairs, Washington, DC, USA
| | - Theresa Poon
- Intertek Health Sciences, Inc., Mississauga, Ontario Canada
| | - Daniel Noori
- Intertek Health Sciences, Inc., Mississauga, Ontario Canada
| | | | - Samer Hamamji
- Intertek Health Sciences, Inc., Mississauga, Ontario Canada
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Yildiz M, Karhan M. Characteristics of some beverages adjusted with stevia extract, and persistence of steviol glycosides in the mouth after consumption. Int J Gastron Food Sci 2021. [DOI: 10.1016/j.ijgfs.2021.100326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Whelan K, Jones N. Fermented foods: Availability, cost, ingredients, nutritional content and on-pack claims. J Hum Nutr Diet 2021; 35:396-405. [PMID: 33891768 DOI: 10.1111/jhn.12905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 04/12/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Fermented foods have been consumed for millennia and commercially-produced variants are now available in the food supply. The present study aimed to investigate the availability, cost, ingredients, nutritional content and on-pack claims of commercially-available fermented foods in the UK. METHODS All products from seven categories of commercially-available fermented foods were systematically identified at eight national supermarket chains in the UK. Data were extracted from manufacturer and retailer websites and were compared between categories using a Kruskal-Wallis test and Fisher's exact test. RESULTS In total, 143 fermented foods were identified, with kombucha (41, 28.7%), kefir drinks (32, 22.4%), sauerkraut (22, 15.4%) and kefir yoghurts (21, 14.7%) being most common. The number of products sold at each retailer differed between categories (p = 0.016), and was greatest for kefir drink (median = 7.0, interquartile range [IQR] = 9.0), kombucha (median = 5.5, IQR = 11.5) and kefir yoghurts (median = 5.0, IQR = 8.5). Kombucha (£1.99 per serving) and kefir drinks (£1.26 per serving) were the most expensive fermented foods and sauerkraut (£0.66 per serving) and miso (£0.20 per serving) were the least expensive. Energy, fat, saturated fat, sugar, protein and salt content varied between fermented foods (p < 0.001). Nutrition claims were made on 72 (50.3%) products, the total number of cultures was labelled on 29 (20.3%), specific strains were named on 53 (37.1%) and bacteria-related benefits were promoted on 39 (27.3%) products. CONCLUSIONS Commercially-produced fermented foods are widely available in the UK but are diverse in their cost, nutritional content, ingredients and use of on-pack claims. Consumers should be aware of these variations given the limited evidence of functional benefits from controlled human trials.
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Affiliation(s)
- Kevin Whelan
- Department of Nutritional Sciences, King's College London, London, UK
| | - Nicola Jones
- Department of Nutritional Sciences, King's College London, London, UK
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Kelada KD, Tusé D, Gleba Y, McDonald KA, Nandi S. Process Simulation and Techno-Economic Analysis of Large-Scale Bioproduction of Sweet Protein Thaumatin II. Foods 2021; 10:838. [PMID: 33921374 PMCID: PMC8069865 DOI: 10.3390/foods10040838] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/08/2021] [Indexed: 12/21/2022] Open
Abstract
There are currently worldwide efforts to reduce sugar intake due to the various adverse health effects linked with the overconsumption of sugars. Artificial sweeteners have been used as an alternative to nutritive sugars in numerous applications; however, their long-term effects on human health remain controversial. This led to a shift in consumer preference towards non-caloric sweeteners from natural sources. Thaumatins are a class of intensely sweet proteins found in arils of the fruits of the West-African plant Thaumatococcus daniellii. Thaumatins' current production method through aqueous extraction from this plant and uncertainty of the harvest from tropical rainforests limits its supply while the demand is increasing. Despite successful recombinant expression of the protein in several organisms, no large-scale bioproduction facilities exist. We present preliminary process design, process simulation, and economic analysis for a large-scale (50 metric tons/year) production of a thaumatin II variant using several different molecular farming platforms.
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Affiliation(s)
- Kirolos D. Kelada
- Department of Chemical Engineering, University of California, Davis, CA 95616, USA; (K.D.K.); (K.A.M.)
| | - Daniel Tusé
- DT/Consulting Group, Sacramento, CA 95818, USA;
| | - Yuri Gleba
- Nomad Bioscience GmbH, 06120 Halle, Germany;
| | - Karen A. McDonald
- Department of Chemical Engineering, University of California, Davis, CA 95616, USA; (K.D.K.); (K.A.M.)
- Global HealthShare® Initiative, University of California, Davis, CA 95616, USA
| | - Somen Nandi
- Department of Chemical Engineering, University of California, Davis, CA 95616, USA; (K.D.K.); (K.A.M.)
- Global HealthShare® Initiative, University of California, Davis, CA 95616, USA
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50
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Ahmad SY, Friel JK, Mackay DS. Effect of sucralose and aspartame on glucose metabolism and gut hormones. Nutr Rev 2021; 78:725-746. [PMID: 32065635 DOI: 10.1093/nutrit/nuz099] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Non-nutritive sweeteners are thought to be useful replacements for caloric sweeteners in sweet food and beverages, since the reduction in energy and carbohydrate intake may lead to health benefits stemming from weight management and glycemic control. However, the potential effects of non-nutritive sweeteners on glucose metabolism and gut hormones have not been determined definitively. Here, the available evidence of the effects of aspartame and sucralose consumption on glucose metabolism and gut hormones is reviewed. A majority of studies have found that consumption of aspartame or sucralose has no effect on concentrations of blood glucose, insulin, or gut hormones; however, 2 trials have shown that aspartame consumption affects glucose, insulin, and glucagon-like peptide 1 concentrations, while only a few trials have shown that sucralose consumption affects glucose, insulin, and glucagon-like peptide 1 concentrations. One study found higher glucose concentrations after sucralose consumption, while 3 studies found lower concentrations and 33 studies found no change in glucose concentrations. Moreover, only 4 studies reported increased concentrations of glucagon-like peptide 1. Three studies reported decreased insulin sensitivity following sucralose consumption, while 1 trial reported an increase in insulin sensitivity. In summary, the evidence from the clinical trials conducted to date is contradictory because of the different protocols used.
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Affiliation(s)
- Samar Y Ahmad
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - James K Friel
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Dylan S Mackay
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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