Sucrose activates human taste pathways differently from artificial sweetener

Hormonal responses to non-nutritive sweeteners in water and diet soda

Background

Non-nutritive sweeteners (NNS), especially in form of diet soda, have been linked to metabolic derangements (e.g. obesity and diabetes) in epidemiologic studies. We aimed to test acute metabolic effects of NNS in isolation (water or seltzer) and in diet sodas.

Methods

We conducted a four-period, cross-over study at the National Institutes of Health Clinical Center (Bethesda, Maryland). Thirty healthy adults consumed 355 mL water with 0 mg, 68 mg, 170 mg, and 250 mg sucralose, and 31 individuals consumed 355 mL caffeine-free Diet Rite Cola™, Diet Mountain Dew™ (18 mg sucralose, 18 mg acesulfame-potassium, 57 mg aspartame), and seltzer water with NNS (68 mg sucralose and 41 mg acesulfame-potassium, equivalent to Diet Rite Cola™) in randomized order, prior to oral glucose tolerance tests. Blood samples were collected serially for 130 min. Measures included GLP-1, GIP, glucose, insulin, C-peptide, glucose absorption, gastric emptying, and subjective hunger and satiety ratings.

Results

Diet sodas augmented active GLP-1 (Diet Rite Cola™ vs. seltzer water, AUC, p = 0.039; Diet Mountain Dew™ vs. seltzer water, AUC, p = 0.07), but gastric emptying and satiety were unaffected. Insulin concentrations were nominally higher following all NNS conditions without altering glycemia. Sucralose alone (at any concentration) did not affect metabolic outcomes.

Conclusions

Diet sodas but not NNS in water augmented GLP-1 responses to oral glucose. Whether the trends toward higher insulin concentrations after NNS are of clinical importance remains to be determined. Our findings emphasize the need to test metabolic effects of NNS after chronic consumption.

Trial registration

The data for this manuscript were gathered from clinical trial #NCT01200940.

Electronic supplementary material

The online version of this article (doi:10.1186/s12986-016-0129-3) contains supplementary material, which is available to authorized users.

Psychophysical Evaluation of Sweetness Functions Across Multiple Sweeteners

Sweetness is one of the 5 prototypical tastes and is activated by sugars and non-nutritive sweeteners (NNS). The aim of this study was to investigate measures of sweet taste function [detection threshold (DT), recognition threshold (RT), and suprathreshold intensity ratings] across multiple sweeteners. Sixty participants, 18–52 years of age (mean age in years = 26, SD = ±7.8), were recruited to participate in the study. DT and RT were collected for caloric sweeteners (glucose, fructose, sucrose, erythritol) and NNS (sucralose, rebaudioside A). Sweetness intensity for all sweeteners was measured using a general Labeled Magnitude Scale. There were strong correlations between DT and RT of all 4 caloric sweeteners across people (r = 0.62–0.90, P < 0.001), and moderate correlations between DT and RT for both of the NNS (r = 0.39–0.48, P < 0.05); however, weaker correlations were observed between the DT or RT of the caloric sweeteners and NNS (r = 0.26–0.48, P < 0.05). The DT and RT of glucose and fructose were not correlated with DT or RT of sucralose (P > 0.05). In contrast, there were strong correlations between the sweetness intensity ratings of all sweeteners (r = 0.70–0.96, P < 0.001). This suggests those caloric sweeteners and NNS access at least partially independent mechanisms with respect to DT and RT measures. At suprathreshold level, however, the strong correlation between caloric sweeteners and NNS through weak, moderate, and strong intensity indicates a commonality in sweet taste mechanism for the perceived intensity range.

Recent studies of the effects of sugars on brain systems involved in energy balance and reward: Relevance to low calorie sweeteners

The alarmingly high rates of overweight and obesity pose a serious global health threat. Numerous factors can result in weight gain, one of which is excess consumption of caloric sweeteners. In an effort to aid weight loss efforts, many people have switched from caloric sweeteners to low calorie sweeteners, which provide sweet taste without the accompanying calories. In this review, we present an overview of the animal literature produced in the last 5years highlighting the effects of sugar consumption on neural pathways involved in energy balance regulation and reward processing. We also examine the latest evidence that is beginning to elucidate the effects of low calorie sweeteners on these neural pathways, as well as how homeostatic and hedonic systems interact in response to, or to influence, sugar consumption.

Familiarity to a Feed Additive Modulates Its Effects on Brain Responses in Reward and Memory Regions in the Pig Model

Brain responses to feed flavors with or without a feed additive (FA) were investigated in piglets familiarized or not with this FA. Sixteen piglets were allocated to 2 dietary treatments from weaning until d 37: the naive group (NAI) received a standard control feed and the familiarized group (FAM) received the same feed added with a FA mainly made of orange extracts. Animals were subjected to a feed transition at d 16 post-weaning, and to 2-choice feeding tests at d 16 and d 23. Production traits of the piglets were assessed up to d 28 post-weaning. From d 26 onwards, animals underwent 2 brain imaging sessions (positron emission tomography of 18FDG) under anesthesia to investigate the brain activity triggered by the exposure to the flavors of the feed with (FA) or without (C) the FA. Images were analyzed with SPM8 and a region of interest (ROI)-based small volume correction (p < 0.05, k ≥ 25 voxels per cluster). The brain ROI were selected upon their role in sensory evaluation, cognition and reward, and included the prefrontal cortex, insular cortex, fusiform gyrus, limbic system and corpus striatum. The FAM animals showed a moderate preference for the novel post-transition FA feed compared to the C feed on d 16, i.e., day of the feed transition (67% of total feed intake). The presence or absence of the FA in the diet from weaning had no impact on body weight, average daily gain, and feed efficiency of the animals over the whole experimental period (p ≥ 0.10). Familiar feed flavors activated the prefrontal cortex. The amygdala, insular cortex, and prepyriform area were only activated in familiarized animals exposed to the FA feed flavor. The perception of FA feed flavor in the familiarized animals activated the dorsal striatum differently than the perception of the C feed flavor in naive animals. Our data demonstrated that the perception of FA in familiarized individuals induced different brain responses in regions involved in reward anticipation and/or perception processes than the familiar control feed flavor in naive animals. Chronic exposure to the FA might be necessary for positive hedonic effects, but familiarity only cannot explain them.

The Macronutrients, Appetite, and Energy Intake

Each of the macronutrients-carbohydrate, protein, and fat-has a unique set of properties that influences health, but all are a source of energy. The optimal balance of their contribution to the diet has been a long-standing matter of debate. Over the past half century, thinking has progressed regarding the mechanisms by which each macronutrient may contribute to energy balance. At the beginning of this period, metabolic signals that initiated eating events (i.e., determined eating frequency) were emphasized. This was followed by an orientation to gut endocrine signals that purportedly modulate the size of eating events (i.e., determined portion size). Most recently, research attention has been directed to the brain, where the reward signals elicited by the macronutrients are viewed as potentially problematic (e.g., contribute to disordered eating). At this point, the predictive power of the macronutrients for energy intake remains limited.

Carbonated soft drinks induce oxidative stress and alter the expression of certain genes in the brains of Wistar rats

In Saudi Arabia, the consumption of carbonated soft drinks is common and often occurs with each meal. Carbonated soft drink consumption has been shown to exhibit effects on the liver, kidney and bone. However, the effects of these soft drinks on brain activity have not been widely examined, particularly at the gene level. Therefore, the current study was conducted with the aim of evaluating the effects of chronic carbonated soft drink consumption on oxidative stress, brain gene biomarkers associated with aggression and brain histology. In total, 40 male Wistar rats were divided into four groups: Group 1 served as a control and was provided access to food and water ad libitum; and groups 2‑4 were given free access to food and carbonated soft drinks only (Cola for group 2, Pepsi for group 3 and 7‑UP for group 4). Animals were maintained on these diets for 3 consecutive months. Upon completion of the experimental period, animals were sacrificed and serological and histopathological analyses were performed on blood and tissues samples. Reverse transcription‑polymerase chain reaction was used to analyze alterations in gene expression levels. Results revealed that carbonated soft drinks increased the serum levels of malondialdehyde (MDA). Carbonated soft drinks were also observed to downregulate the expression of antioxidants glutathione reductase (GR), catalase and glutathione peroxidase (GPx) in the brain when compared with that in the control rats. Rats administered carbonated soft drinks also exhibited decreased monoamine oxidase A (MAO‑A) and acetylcholine esterase (AChE) serum and mRNA levels in the brain. In addition, soft drink consumption upregulated mRNA expression of dopamine D2 receptor (DD2R), while 5-hydroxytryptamine transporter (5‑HTT) expression was decreased. However, following histological examination, all rats had a normal brain structure. The results of this study demonstrated that that carbonated soft drinks induced oxidative stress and altered the expression of certain genes that are associated with the brain activity and thus should be consumed with caution.

Mouth Rinsing With Carbohydrate Solutions at the Postprandial State Fail to Improve Performance During Simulated Cycling Time Trials

Mouth rinsing with carbohydrate (CHO) solutions during cycling time trials results in performance enhancements; however, most studies have used approximately 6% CHO solutions. Therefore, the purpose of this study was to compare the effectiveness of mouth rinsing with 4, 6, and 8% CHO solutions on 1-hour simulated cycling time trial performance. On 4 occasions, 7 trained male cyclists completed at the postprandial period, a set amount of work as fast as possible in a randomized counterbalanced order. The subjects rinsed their mouth for 5 seconds, on completion of each 12.5% of the trial, with 25 ml of a non-CHO placebo and 4, 6, and 8% CHO solutions. No additional fluids were consumed during the time trial. Heart rate (HR), ratings of perceived exertion (RPE), thirst (TH), and subjective feelings (SF) were recorded after each rinse. Furthermore, blood samples were drawn every 25% of the trial to measure blood glucose and blood lactate concentrations, whereas whole-body CHO oxidation was monitored continuously. Time to completion was not significant between conditions with the placebo, 4, 6, and 8% conditions completing the trials in 62.0 ± 3.0, 62.8 ± 4.0, 63.4 ± 3.4, and 63 ± 4.0 minutes, respectively. There were no significant differences between conditions in any of the variables mentioned above; however, significant time effects were observed for HR, RPE, TH, and SF. Post hoc analysis showed that TH and SF of subjects in the CHO conditions but not in the placebo were significantly increased by completion of the time trial. In conclusion, mouth rinsing with CHO solutions did not impact 1-hour cycling performance in the postprandial period and in the absence of fluid intake. Our findings suggest that there is scope for further research to explore the activation regions of the brain and whether they are receptive to CHO dose, before specific recommendations for athletic populations are established. Consequently, mouth rinsing as a practical strategy for coaches and athletes is questionable under specific conditions and should be carefully considered before its inclusion. Emphasis should be focused on appropriate dietary and fluid strategies during training and competition.

Neural Processing of Calories in Brain Reward Areas Can be Modulated by Reward Sensitivity

A food's reward value is dependent on its caloric content. Furthermore, a food's acute reward value also depends on hunger state. The drive to obtain rewards (reward sensitivity), however, differs between individuals. Here, we assessed the association between brain responses to calories in the mouth and trait reward sensitivity in different hunger states. Firstly, we assessed this in data from a functional neuroimaging study (van Rijn et al., 2015), in which participants (n = 30) tasted simple solutions of a non-caloric sweetener with or without a non-sweet carbohydrate (maltodextrin) during hunger and satiety. Secondly, we expanded these analyses to regular drinks by assessing the same relationship in data from a study in which soft drinks sweetened with either sucrose or a non-caloric sweetener were administered during hunger (n = 18) (Griffioen-Roose et al., 2013). First, taste activation by the non-caloric solution/soft drink was subtracted from that by the caloric solution/soft drink to eliminate sweetness effects and retain activation induced by calories. Subsequently, this difference in taste activation was correlated with reward sensitivity as measured with the BAS drive subscale of the Behavioral Activation System (BAS) questionnaire. When participants were hungry and tasted calories from the simple solution, brain activation in the right ventral striatum (caudate), right amygdala and anterior cingulate cortex (bilaterally) correlated negatively with BAS drive scores. In contrast, when participants were satiated, taste responses correlated positively with BAS drive scores in the left caudate. These results were not replicated for soft drinks. Thus, neural responses to oral calories from maltodextrin were modulated by reward sensitivity in reward-related brain areas. This was not the case for sucrose. This may be due to the direct detection of maltodextrin, but not sucrose in the oral cavity. Also, in a familiar beverage, detection of calories per se may be overruled by a conditioned response to its flavor. In conclusion, the brain reward response to calories from a long chain starch sugar (maltodextrin) varies with trait reward sensitivity. The absence of this effect in a familiar beverage warrants further research into its relevance for real life ingestive behavior.

A Dissociation Between Recognition and Hedonic Value in Caloric and Non-caloric Carbonated Soft Drinks

Consumption of sugar-sweetened beverages (SSBs) is considered to be a contributor to diabetes and the epidemic of obesity in many countries. The popularity of non-caloric carbonated soft drinks as an alternative to SSBs may be a factor in reducing the health risks associated with SSBs consumption. This study focuses on the perceptual discrimination of SSBs from artificially sweetened beverages (ASBs). Fifty-five college students rated 14 commercially available carbonated soft drinks in terms of sweetness and likeability. They were also asked to recognize, if the drinks contained sugar or a non-caloric artificial sweetener. Overall, participants showed poor accuracy in discriminating drinks' sweeteners, with significantly lower accuracy for SSBs than ASBs. Interestingly, we found a dissociation between sweetener recognition and drink pleasantness. In fact, in spite of a chance-level discrimination accuracy of SSBs, their taste was systematically preferred to the taste of non-caloric beverages. Our findings support the idea that hedonic value of carbonated soft drinks is dissociable from its identification and that the activation of the pleasure system seems not to require explicit recognition of the sweetener contained in the soft drink. We hypothesize that preference for carbonated soft drinks containing sugar over non-caloric alternatives might be modulated by metabolic factors that are independent from conscious and rational consumers' choices.

Altered sensitization patterns to sweet food stimuli in patients recovered from anorexia and bulimia nervosa

Recent studies show that higher-order appetitive neural circuitry may contribute to restricted eating in anorexia nervosa (AN) and overeating in bulimia nervosa (BN). The purpose of this study was to determine whether sensitization effects might underlie pathologic eating behavior when a taste stimulus is administered repeatedly. Recovered AN (RAN, n=14) and BN (RBN, n=15) subjects were studied in order to avoid the confounding effects of altered nutritional state. Functional magnetic resonance imaging (fMRI) measured higher-order brain response to repeated tastes of sucrose (caloric) and sucralose (non-caloric). To test sensitization, the neuronal response to the first and second administration was compared. RAN patients demonstrated a decreased sensitization to sucrose in contrast to RBN patients who displayed the opposite pattern, increased sensitization to sucrose. However, the latter was not as pronounced as in healthy control women (n=13). While both eating disorder subgroups showed increased sensitization to sucralose, the healthy controls revealed decreased sensitization. These findings could reflect on a neuronal level the high caloric intake of RBN during binges and the low energy intake for RAN. RAN seem to distinguish between high energy and low energy sweet stimuli while RBN do not.

Involvement of Endogenous Enkephalins and β-Endorphin in Feeding and Diet-Induced Obesity

Studies implicate opioid transmission in hedonic and metabolic control of feeding, although roles for specific endogenous opioid peptides have barely been addressed. Here, we studied palatable liquid consumption in proenkephalin knockout (PENK KO) and β-endorphin-deficient (BEND KO) mice, and how the body weight of these mice changed during consumption of an energy-dense highly palatable 'cafeteria diet'. When given access to sucrose solution, PENK KOs exhibited fewer bouts of licking than wild types, even though the length of bouts was similar to that of wild types, a pattern that suggests diminished food motivation. Conversely, BEND KOs did not differ from wild types in the number of licking bouts, even though these bouts were shorter in length, suggesting that they experienced the sucrose as being less palatable. In addition, licking responses in BEND, but not PENK, KO mice were insensitive to shifts in sucrose concentration or hunger. PENK, but not BEND, KOs exhibited lower baseline body weights compared with wild types on chow diet and attenuated weight gain when fed cafeteria diet. Based on this and related findings, we suggest endogenous enkephalins primarily set a background motivational tone regulating feeding behavior, whereas β-endorphin underlies orosensory reward in high need states or when the stimulus is especially valuable. Overall, these studies emphasize complex interplays between endogenous opioid peptides targeting μ-receptors, such as enkephalins and endorphins, underlying the regulation of feeding and body weight that might explain the poor efficacy of drugs that generally target μ-opioid receptors in the long-term control of appetite and body weight.

Physiological mechanisms by which non-nutritive sweeteners may impact body weight and metabolism

Evidence linking sugar-sweetened beverage (SSB) consumption to weight gain and other negative health outcomes has prompted many individuals to resort to artificial, non-nutritive sweetener (NNS) substitutes as a means of reducing SSB intake. However, there is a great deal of controversy regarding the biological consequences of NNS use, with accumulating evidence suggesting that NNS consumption may influence feeding and metabolism via a variety of peripheral and central mechanisms. Here we argue that NNSs are not physiologically inert compounds and consider the potential biological mechanisms by which NNS consumption may impact energy balance and metabolic function, including actions on oral and extra-oral sweet taste receptors, and effects on metabolic hormone secretion, cognitive processes (e.g. reward learning, memory, and taste perception), and gut microbiota.

Pavlovian conditioning to food reward as a function of eating disorder risk

The aim of this experiment was to examine the extent to which eating disorder risk affects the strength of food-reward conditioning. Eighty food-restricted undergraduates were placed into a VR environment consisting of two visually distinct rooms. Participants underwent multiple pairing sessions in which they were confined into one of the two rooms and explored a VR environment. Room A was paired with real-life M&Ms for three sessions, and Room B was paired with no food for three sessions. After a short delay, a test session was administered, and participants were given free access to the entire VR environment for 5 min. Participants also completed the Eating Attitudes Test (EAT-26; [11]), which is a standard screening tool of eating disorder risk. Participants displayed a significant conditioned place preference for the VR room previously paired with food, and they displayed a significant explicit preference for the M&M-paired room in a forced-choice test. There was a significant positive correlation between place preference strength and scores on the dieting subscale of the EAT-26. Additionally, ratings of the no-food room were significantly lower as dieting scores increased. This suggests that components of eating disorder risk can influence basic conditioning strength to places associated with food reward. For both males and females, additional correlations between eating disorder risk subscales and conditioning variables are discussed, and implications for future research are proposed in hopes of understanding how conditioning paradigms can provide insight into treating and preventing eating disorders.

Behavioral responses to catecholamine depletion in unmedicated, remitted subjects with bulimia nervosa and healthy subjects

BACKGROUND

Bulimia nervosa (BN) has been associated with dysregulation of the central catecholaminergic system. An instructive way to investigate the relationship between catecholaminergic function and psychiatric disorder has involved behavioral responses to experimental catecholamine depletion (CD). The purpose of this study was to examine a possible catecholaminergic dysfunction in the pathogenesis of bulimia nervosa.

METHODS

CD was achieved by oral administration of alpha-methyl-para-tyrosine (AMPT) in 18 remitted female subjects with BN (rBN) and 31 healthy female control subjects. The study design consisted of a randomized, double blind, placebo-controlled crossover, single-site experimental trial. The main outcome measures were bulimic symptoms assessed by the Eating Disorder Examination-Questionnaire. Measures were assessed before and 26, 30, 54, 78, 102 hours after the first AMPT or placebo administration.

RESULTS

In the experimental environment (controlled environment with a low level of food cues) rBN subjects had a greater increase in eating disorder symptoms during CD compared with healthy control subjects (condition × diagnosis interaction, p < .05). In the experimental environment, rBN subjects experienced fewer bulimic symptoms than in the natural environment (uncontrolled environment concerning food cues) 36 hours after the first AMPT intake (environment × diagnosis interaction, p < .05). Serum prolactin levels increased significantly, and to a comparable degree across groups, after AMPT administration.

CONCLUSIONS

This study suggests that rBN is associated with vulnerability for developing eating disorder symptoms in response to reduced catecholamine neurotransmission after CD. The findings support the notion of catecholaminergic dysfunction as a possible trait abnormality in BN.

Intense Sweeteners, Appetite for the Sweet Taste, and Relationship to Weight Management

High intensity, low-energy sweeteners (LES) are used by many consumers in order to limit energy intake and possibly facilitate body weight control. These beneficial effects are often questioned in the scientific and lay media. LES are frequently accused of stimulating and/or maintaining a liking for sweetness which in turn would be deleterious for adequate body weight control. Evidence for the specific effects of LES use on appetite for sweet products will be extracted from observational studies, experimental laboratory studies, randomized controlled trials, and finally brain imaging studies. While many of the existing studies cannot identify any causal links between use of LES and appetite for sweetness, randomized trials in children and adults suggest that use of LES tends to reduce rather than increase the intake of sugar-containing foods and to facilitate, rather than impair, weight loss.

Neural correlates of taste perception in congenital blindness

Sight is undoubtedly important for the perception and the assessment of the palatability of tastants. Although many studies have addressed the consequences of visual impairment on food selection, feeding behavior, eating habits and taste perception, nothing is known about the neural correlates of gustation in blindness. In the current study we examined brain responses during gustation using functional magnetic resonance imaging (fMRI). We scanned nine congenitally blind and 14 age- and sex-matched blindfolded sighted control subjects, matched in age, gender and body mass index (BMI), while they made judgments of either the intensity or the (un)pleasantness of different tastes (sweet, bitter) or artificial saliva that were delivered intra-orally. The fMRI data indicated that during gustation, congenitally blind individuals activate less strongly the primary taste cortex (right posterior insula and overlying Rolandic operculum) and the hypothalamus. In sharp contrast with results of multiple other sensory processing studies in congenitally blind subjects, including touch, audition and smell, the occipital cortex was not recruited during taste processing, suggesting the absence of taste-related compensatory crossmodal responses in the occipital cortex. These results underscore our earlier behavioral demonstration that congenitally blind subjects have a lower gustatory sensitivity compared to normal sighted individuals. We hypothesize that due to an underexposure to a variety of tastants, training-induced crossmodal sensory plasticity to gustatory stimulation does not occur in blind subjects.

[DSM-5: important changes in the field of addictive diseases]

There are two major changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) concerning the field of addiction. Firstly, the previous distinction between abuse and dependence has been abolished and both disorders are now subsumed under the category addiction and related disorders. Secondly, pathological gambling has now been included in the section of addiction with slight changes in diagnostic criteria. Both changes have major implications for the definition and conceptualization of what we call a psychiatric "disease" or "disorder", which have also been addressed in the introductory statement of DSM-5. Concerning the category of abuse that is now part of substance use disorders, there is a concern that a well-defined disorder ("dependence") is now mixed with a less well-defined syndrome ("abuse"). The inclusion of non-substance, behavioral addictions poses the danger of pathologizing a wide range of human behavior in future revisions of the classification. Both concerns are further addressed in this article.

A step towards personalized sports nutrition: carbohydrate intake during exercise

There have been significant changes in the understanding of the role of carbohydrates during endurance exercise in recent years, which allows for more specific and more personalized advice with regard to carbohydrate ingestion during exercise. The new proposed guidelines take into account the duration (and intensity) of exercise and advice is not restricted to the amount of carbohydrate; it also gives direction with respect to the type of carbohydrate. Studies have shown that during exercise lasting approximately 1 h in duration, a mouth rinse or small amounts of carbohydrate can result in a performance benefit. A single carbohydrate source can be oxidized at rates up to approximately 60 g/h and this is the recommendation for exercise that is more prolonged (2-3 h). For ultra-endurance events, the recommendation is higher at approximately 90 g/h. Carbohydrate ingested at such high ingestion rates must be a multiple transportable carbohydrates to allow high oxidation rates and prevent the accumulation of carbohydrate in the intestine. The source of the carbohydrate may be a liquid, semisolid, or solid, and the recommendations may need to be adjusted downward when the absolute exercise intensity is low and thus carbohydrate oxidation rates are also low. Carbohydrate intake advice is independent of body weight as well as training status. Therefore, although these guidelines apply to most athletes, they are highly dependent on the type and duration of activity. These new guidelines may replace the generic existing guidelines for carbohydrate intake during endurance exercise.

Impact of energy density on liking for sweet beverages and caloric-adjustment conditioning in children

BACKGROUND

The contribution of sweet beverages to weight gain in children is controversial; the impact of these beverages on caloric adjustment needs clarification.

OBJECTIVE

We studied the influence of energy-density (ED) conditioning on the liking for sweet beverages and caloric adjustment after their consumption in children.

DESIGN

We used a within-subject design. Forty-four 8-11-y-old children were exposed to the following 2 distinctly flavored, sweetened beverages: a high-energy (HE) version (150 kcal) and a no-energy (NE) version (0 kcal). During a 4-wk initial conditioning period, children were exposed either 2 or 7 times to each beverage. After a 3-wk stability period (without exposure), children were exposed 3 times to both beverages with a reversed association between the ED and flavor (4-wk reversed-conditioning period). Flavor liking and food intake during meals after the consumption of each beverage were assessed before and after each period.

RESULTS

After the initial conditioning, the liking for both beverages increased (P < 0.001). After the stability period, the liking for the HE flavor was higher than for the NE flavor (P = 0.024). After the reversed conditioning, the liking for the flavor initially paired with the HE beverage tended to remain higher than for the NE flavor (P = 0.089). Initially, energy intakes during the meal did not differ after the consumption of NE or HE beverages. After the initial conditioning and up until the end of the reversed conditioning, energy intakes were lower after the HE beverage than after the NE beverage regardless of the beverage flavor (eg, after reversal; caloric compensation score: 29%). The number of exposures did not influence liking or energy intake.

CONCLUSION

After the association between a flavor and ED and reversal of this association, liking may be first guided by ED and then the flavor firstly associated with ED, whereas the partial caloric compensation may consistently be guided by ED. This trial was registered at clinicaltrials.gov as NCT02070185.

The role of sweet taste in satiation and satiety

Increased energy consumption, especially increased consumption of sweet energy-dense food, is thought to be one of the main contributors to the escalating rates in overweight individuals and obesity globally. The individual’s ability to detect or sense sweetness in the oral cavity is thought to be one of many factors influencing food acceptance, and therefore, taste may play an essential role in modulating food acceptance and/or energy intake. Emerging evidence now suggests that the sweet taste signaling mechanisms identified in the oral cavity also operate in the gastrointestinal system and may influence the development of satiety. Understanding the individual differences in detecting sweetness in both the oral and gastrointestinal system towards both caloric sugar and high intensity sweetener and the functional role of the sweet taste system may be important in understanding the reasons for excess energy intake. This review will summarize evidence of possible associations between the sweet taste mechanisms within the oral cavity, gastrointestinal tract and the brain systems towards both caloric sugar and high intensity sweetener and sweet taste function, which may influence satiation, satiety and, perhaps, predisposition to being overweight and obesity.

Mouth rinsing with a carbohydrate solution does not influence cycle time trial performance in the heat

Ten endurance-trained males were recruited to examine the possible role of carbohydrate (CHO) receptors in the mouth influencing exercise performance in the heat. Volunteers completed an incremental test to exhaustion to determine peak oxygen uptake, a familiarisation trial, followed by 2 experimental trials. Trials consisted of a 1-h time trial undertaken in a climatic chamber maintained at 30 °C, 60% relative humidity. Immediately before, and at regular intervals throughout exercise, subjects ingested a bolus of water and then were provided with either a placebo (PLA) or a 6.4% glucose (CHO) solution to rinse in the mouth for 10 s before being expectorated. There was no difference in total work done between the PLA and CHO trials (758.8 ± 149.0 kJ; 762.6 ± 141.1 kJ; P = 0.951). Pacing was also similar, with no differences in power output apparent during the experimental trials (P = 0.546). Core temperature (P = 0.615), heart rate (P = 0.505), ratings of perceived exertion (P = 0.181), and perceived thermal stress (P = 0.416) were not influenced by the nature of the intervention. Blood glucose concentrations were similar during the CHO and PLA trials (P = 0.117). In contrast to the findings of several studies undertaken in temperate conditions, the present investigation failed to support role of oral sensing of CHO in influencing performance during prolonged exercise in warm conditions.

Differences in BOLD responses to intragastrically infused glucose and saccharin in rats

The postingestive effect is different between caloric and noncaloric sweeteners. The gut administration of glucose induces a preference for flavored water which is paired with the intragastric infusion of glucose. However, a comparison of the brain response to the gut glucose and saccharin stimuli still remains to be demonstrated. Here, using functional magnetic resonance imaging, we investigated the blood oxygenation level-dependent signal response to gut glucose and saccharin in the brain of conscious rats. Glucose induced a positive signal increase in the amygdala and nucleus accumben, both of which receive dopaminergic input from the ventral tegmental area. In contrast, saccharin administration did not activate these areas. Both glucose and saccharin increased the blood oxygenation level-dependent signal intensity in the insular cortex and the nucleus of the solitary tract. These results show that there were significant differences between postingestive glucose and saccharin-induced increases in the blood oxygenation level-dependent signal in rats. Together with previous findings, these results suggest distinct activation patterns in the brain for both glucose and saccharin, which is partially due to different changes of internal signals, including the blood glucose and insulin levels.

Combined compared to dissociated oral and intestinal sucrose stimuli induce different brain hedonic processes

The characterization of brain networks contributing to the processing of oral and/or intestinal sugar signals in a relevant animal model might help to understand the neural mechanisms related to the control of food intake in humans and suggest potential causes for impaired eating behaviors. This study aimed at comparing the brain responses triggered by oral and/or intestinal sucrose sensing in pigs. Seven animals underwent brain single photon emission computed tomography (^99mTc-HMPAO) further to oral stimulation with neutral or sucrose artificial saliva paired with saline or sucrose infusion in the duodenum, the proximal part of the intestine. Oral and/or duodenal sucrose sensing induced differential cerebral blood flow changes in brain regions known to be involved in memory, reward processes and hedonic (i.e., pleasure) evaluation of sensory stimuli, including the dorsal striatum, prefrontal cortex, cingulate cortex, insular cortex, hippocampus, and parahippocampal cortex. Sucrose duodenal infusion only and combined sucrose stimulation induced similar activity patterns in the putamen, ventral anterior cingulate cortex and hippocampus. Some brain deactivations in the prefrontal and insular cortices were only detected in the presence of oral sucrose stimulation. Finally, activation of the right insular cortex was only induced by combined oral and duodenal sucrose stimulation, while specific activity patterns were detected in the hippocampus and parahippocampal cortex with oral sucrose dissociated from caloric load. This study sheds new light on the brain hedonic responses to sugar and has potential implications to unravel the neuropsychological mechanisms underlying food pleasure and motivation.

Neural responses to visual food cues according to weight status: a systematic review of functional magnetic resonance imaging studies

Emerging evidence from recent neuroimaging studies suggests that specific food-related behaviors contribute to the development of obesity. The aim of this review was to report the neural responses to visual food cues, as assessed by functional magnetic resonance imaging (fMRI), in humans of differing weight status. Published studies to 2014 were retrieved and included if they used visual food cues, studied humans >18 years old, reported weight status, and included fMRI outcomes. Sixty studies were identified that investigated the neural responses of healthy weight participants (n = 26), healthy weight compared to obese participants (n = 17), and weight-loss interventions (n = 12). High-calorie food images were used in the majority of studies (n = 36), however, image selection justification was only provided in 19 studies. Obese individuals had increased activation of reward-related brain areas including the insula and orbitofrontal cortex in response to visual food cues compared to healthy weight individuals, and this was particularly evident in response to energy dense cues. Additionally, obese individuals were more responsive to food images when satiated. Meta-analysis of changes in neural activation post-weight loss revealed small areas of convergence across studies in brain areas related to emotion, memory, and learning, including the cingulate gyrus, lentiform nucleus, and precuneus. Differential activation patterns to visual food cues were observed between obese, healthy weight, and weight-loss populations. Future studies require standardization of nutrition variables and fMRI outcomes to enable more direct comparisons between studies.

BMI modulates calorie-dependent dopamine changes in accumbens from glucose intake

Objective

Dopamine mediates the rewarding effects of food that can lead to overeating and obesity, which then trigger metabolic neuroadaptations that further perpetuate excessive food consumption. We tested the hypothesis that the dopamine response to calorie intake (independent of palatability) in striatal brain regions is attenuated with increases in weight.

Method

We used positron emission tomography with [¹¹C]raclopride to measure dopamine changes triggered by calorie intake by contrasting the effects of an artificial sweetener (sucralose) devoid of calories to that of glucose to assess their association with body mass index (BMI) in nineteen healthy participants (BMI range 21–35).

Results

Neither the measured blood glucose concentrations prior to the sucralose and the glucose challenge days, nor the glucose concentrations following the glucose challenge vary as a function of BMI. In contrast the dopamine changes in ventral striatum (assessed as changes in non-displaceable binding potential of [¹¹C]raclopride) triggered by calorie intake (contrast glucose – sucralose) were significantly correlated with BMI (r = 0.68) indicating opposite responses in lean than in obese individuals. Specifically whereas in normal weight individuals (BMI <25) consumption of calories was associated with increases in dopamine in the ventral striatum in obese individuals it was associated with decreases in dopamine.

Conclusion

These findings show reduced dopamine release in ventral striatum with calorie consumption in obese subjects, which might contribute to their excessive food intake to compensate for the deficit between the expected and the actual response to food consumption.

Candy and the brain: neural response to candy gains and losses

Incentive processing is a critical component of a host of cognitive processes, including attention, motivation, and learning. Neuroimaging studies have clarified the neural systems underlying processing of primary and secondary rewards in adults. However, current reward paradigms have hindered comparisons across these reward types as well as between age groups. To address methodological issues regarding the timing of incentive delivery (during scan vs. postscan) and the age-appropriateness of the incentive type, we utilized fMRI and a modified version of a card-guessing game (CGG), in which candy pieces delivered postscan served as the reinforcer, to investigate neural responses to incentives. Healthy young adults 22-26 years of age won and lost large and small amounts of candy on the basis of their ability to guess the number on a mystery card. BOLD activity was compared following candy gain (large/small), loss (large/small), and neutral feedback. During candy gains, adults recruited regions typically involved in response to monetary and other rewards, such as the caudate, putamen, and orbitofrontal cortex. During losses, they displayed greater deactivation in the hippocampus than in response to neutral and gain feedback. Additionally, individual-difference analyses suggested a negative relationship between reward sensitivity (assessed by the Behavioral Inhibition/Behavioral Activation Scales) and the difference between high- and low-magnitude losses in the caudate and lateral orbitofrontal cortex. Also within the striatum, greater punishment sensitivity was positively related to the difference in activity following high as compared to low gains. Overall, these results show strong overlap with those from previous monetary versions of the CGG and provide a baseline for future work with developmental populations.

Artificial Sweetened Beverages and Pediatric Obesity: The Controversy Continues

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

The neural signature of satiation is associated with ghrelin response and triglyceride metabolism

Eating behavior is guided by a complex interaction between signals conveying information about energy stores, food availability, and palatability. How peripheral signals regulate brain circuits that guide feeding during sensation and consumption of a palatable food is poorly understood. We used fMRI to measure brain response to a palatable food (milkshake) when n=32 participants were fasted and fed with either a fixed-portion or ad libitum meal. We found that larger post-prandial reductions in ghrelin and increases in triglycerides were associated with greater attenuation of response to the milkshake in brain regions regulating reward and feeding including the midbrain, amygdala, pallidum, hippocampus, insula and medial orbitofrontal cortex. Satiation-induced brain responses to milkshake were not related to acute changes in circulating insulin, glucose, or free fatty acids. The impact of a meal on the response to milkshake in the midbrain and dorsolateral prefrontal cortex differed depending upon whether meal termination was fixed or volitional, irrespective of the amount of food consumed. We conclude that satiation-induced changes in brain response to a palatable food are strongly and specifically associated with changes in circulating ghrelin and triglycerides and by volitional meal termination.

Oral carbohydrate rinse: placebo or beneficial?

Carbohydrates during exercise can improve exercise performance even when the exercise intensity is high (>75% V˙O2max) and the duration relatively short (approximately 1 h), but the underlying mechanisms for the ergogenic effects are different from those during more prolonged exercise. Studies have even shown effects of oral carbohydrate mouth rinses compared to placebo with improvements typically between 2% and 3% during exercise lasting approximately 1 h. The effects appear more profound after an overnight fast, but effects are still present even after ingestion of a meal. Brain imaging studies have identified brain areas involved, and it is likely that the oral carbohydrate mouth rinse results in afferent signals capable of modifying motor output. These effects appear to be specific to carbohydrate and are independent of taste. Further research is warranted to fully understand the separate taste transduction pathways for various carbohydrates as well as the practical implications.

Effect of replacing sugar with non-caloric sweeteners in beverages on the reward value after repeated exposure

BACKGROUND

The reward value of food is partly dependent on learned associations. It is not yet known whether replacing sugar with non-caloric sweeteners in food is affecting long-term acceptance.

OBJECTIVE

To determine the effect of replacing sugar with non-caloric sweeteners in a nutrient-empty drink (soft drink) versus nutrient-rich drink (yoghurt drink) on reward value after repeated exposure.

DESIGN

We used a randomized crossover design whereby forty subjects (15 men, 25 women) with a mean ± SD age of 21 ± 2 y and BMI of 21.5 ± 1.7 kg/m(2) consumed a fixed portion of a non-caloric sweetened (NS) and sugar sweetened (SS) versions of either a soft drink or a yoghurt drink (counterbalanced) for breakfast which were distinguishable by means of colored labels. Each version of a drink was offered 10 times in semi-random order. Before and after conditioning the reward value of the drinks was assessed using behavioral tasks on wanting, liking, and expected satiety. In a subgroup (n=18) fMRI was performed to assess brain reward responses to the drinks.

RESULTS

Outcomes of both the behavioral tasks and fMRI showed that conditioning did not affect the reward value of the NS and SS versions of the drinks significantly. Overall, subjects preferred the yoghurt drinks to the soft drinks and the ss drinks to the NS drinks. In addition, they expected the yoghurt drinks to be more satiating, they reduced hunger more, and delayed the first eating episode more. Conditioning did not influence these effects.

CONCLUSION

Our study showed that repeated consumption of a non-caloric sweetened beverage, instead of a sugar sweetened version, appears not to result in changes in the reward value. It cannot be ruled out that learned associations between sensory attributes and food satiating capacity which developed preceding the conditioning period, during lifetime, affected the reward value of the drinks.

Altered insula response to sweet taste processing after recovery from anorexia and bulimia nervosa

OBJECTIVE

Recent studies suggest that altered function of higher-order appetitive neural circuitry may contribute to restricted eating in anorexia nervosa and overeating in bulimia nervosa. This study used sweet tastes to interrogate gustatory neurocircuitry involving the anterior insula and related regions that modulate sensory-interoceptive-reward signals in response to palatable foods.

METHOD

Participants who had recovered from anorexia nervosa and bulimia nervosa were studied to avoid confounding effects of altered nutritional state. Functional MRI measured brain response to repeated tastes of sucrose and sucralose to disentangle neural processing of caloric and noncaloric sweet tastes. Whole-brain functional analysis was constrained to anatomical regions of interest.

RESULTS

Relative to matched comparison women (N=14), women recovered from anorexia nervosa (N=14) had significantly diminished and women recovered from bulimia nervosa (N=14) had significantly elevated hemodynamic response to tastes of sucrose in the right anterior insula. Anterior insula response to sucrose compared with sucralose was exaggerated in the recovered group (lower in women recovered from anorexia nervosa and higher in women recovered from bulimia nervosa).

CONCLUSIONS

The anterior insula integrates sensory reward aspects of taste in the service of nutritional homeostasis. One possibility is that restricted eating and weight loss occur in anorexia nervosa because of a failure to accurately recognize hunger signals, whereas overeating in bulimia nervosa could represent an exaggerated perception of hunger signals. This response may reflect the altered calibration of signals related to sweet taste and the caloric content of food and may offer a pathway to novel and more effective treatments.

Artificial sweeteners produce the counterintuitive effect of inducing metabolic derangements

The negative impact of consuming sugar-sweetened beverages on weight and other health outcomes has been increasingly recognized; therefore, many people have turned to high-intensity sweeteners like aspartame, sucralose, and saccharin as a way to reduce the risk of these consequences. However, accumulating evidence suggests that frequent consumers of these sugar substitutes may also be at increased risk of excessive weight gain, metabolic syndrome, type 2 diabetes, and cardiovascular disease. This paper discusses these findings and considers the hypothesis that consuming sweet-tasting but noncaloric or reduced-calorie food and beverages interferes with learned responses that normally contribute to glucose and energy homeostasis. Because of this interference, frequent consumption of high-intensity sweeteners may have the counterintuitive effect of inducing metabolic derangements.

Effect of carbonation on brain processing of sweet stimuli in humans

Little is known about how CO2 affects neural processing of taste. We used functional magnetic resonance imaging to investigate the effects of carbonation on brain processing of sweet stimuli, which has relevance to studies of food selection and satiety. The presence of carbonation produced an overall decrease in the neural processing of sweetness-related signals, especially from sucrose. CO2 reduced the neural processing of sucrose more than that of artificial sweeteners. These findings might be relevant to dietary interventions that include noncaloric beverages, whereas the combination of CO2 and sucrose might increase consumption of sucrose.

Differences in brain responses between lean and obese women to a sweetened drink

BACKGROUND

Ingestion of sweet food is driven by central reward circuits and restrained by endocrine and neurocrine satiety signals. The specific influence of sucrose intake on central affective and reward circuitry and alterations of these mechanisms in the obese are incompletely understood. For this, we hypothesized that (i) similar brain regions are engaged by the stimulation of sweet taste receptors by sucrose and by non-nutrient sweeteners and (ii) during visual food-related cues, obese subjects show greater brain responses to sucrose compared with lean controls.

METHODS

In a double-blind, crossover design, 10 obese and 10 lean healthy females received a sucrose or a non-nutrient sweetened beverage prior to viewing food or neutral images. BOLD signal was measured using a 1.5 Tesla MRI scanner.

KEY RESULTS

Viewing food images after ingestion of either drink was associated with engagement of similar brain regions (amygdala, hippocampus, thalamus, anterior insula). Obese differed from lean subjects in behavioral and brain responses rating both beverages as less tasteful and satisfying, yet demonstrating greater brain responses. Obese subjects also showed engagement of an additional brain network (including anterior insula, anterior cingulate, hippocampus, and amygdala) only after sucrose ingestion.

CONCLUSIONS & INFERENCES

Obese subjects had a reduced behavioral hedonic response, yet a greater engagement of affective brain networks, particularly after sucrose ingestion, suggesting that in obese subjects, lingual and gut-derived signaling generate less central hedonic effects than food-related memories in response to visual cues, analogous to response patterns implicated in food addiction.

The addictive dimensionality of obesity

Our brains are hardwired to respond and seek immediate rewards. Thus, it is not surprising that many people overeat, which in some can result in obesity, whereas others take drugs, which in some can result in addiction. Though food intake and body weight are under homeostatic regulation, when highly palatable food is available, the ability to resist the urge to eat hinges on self-control. There is no homeostatic regulator to check the intake of drugs (including alcohol); thus, regulation of drug consumption is mostly driven by self-control or unwanted effects (i.e., sedation for alcohol). Disruption in both the neurobiological processes that underlie sensitivity to reward and those that underlie inhibitory control can lead to compulsive food intake in some individuals and compulsive drug intake in others. There is increasing evidence that disruption of energy homeostasis can affect the reward circuitry and that overconsumption of rewarding food can lead to changes in the reward circuitry that result in compulsive food intake akin to the phenotype seen with addiction. Addiction research has produced new evidence that hints at significant commonalities between the neural substrates underlying the disease of addiction and at least some forms of obesity. This recognition has spurred a healthy debate to try and ascertain the extent to which these complex and dimensional disorders overlap and whether or not a deeper understanding of the crosstalk between the homeostatic and reward systems will usher in unique opportunities for prevention and treatment of both obesity and drug addiction.

Localization of the primary taste cortex by contrasting passive and attentive conditions

The primary taste cortex is located in the insula. However, exactly where in the insula the human primary taste cortex is located remains a controversial issue. Human neuroimaging studies have shown prominent variation concerning the location of taste-responsive activation within the insula. A standard protocol for gustatory testing in neuroimaging studies has not been developed, which might underlie such variations. In order to localize the primary taste cortex in an fMRI experiment, we used a taste delivery system to suppress non-taste stimuli and psychological effects. Then, we compared brain response to taste solution during a passive tasting task condition and a taste quality identification task condition to verify whether this cognitive task affected the location of taste-responsive activation within the insula. To examine which part of insula is the primary taste area, we performed dynamic causal modeling (DCM) to verify the neural network of the taste coding-related region and random-effects Bayesian model selection (BMS) at the family level to reveal the optimal input region. Passive tasting resulted in activation of the right middle insula (MI), and the most favorable model selected by DCM analysis showed that taste effect directly influenced the MI. Additionally, BMS results at the family level suggested that the taste inputs entered into the MI. Taken together, our results suggest that the human primary taste cortex is located in the MI.

Dietary fat induces sustained reward response in the human brain without primary taste cortex discrimination

To disentangle taste from reward responses in the human gustatory cortex, we combined high density electro-encephalography with a gustometer delivering tastant puffs to the tip of the tongue. Stimuli were pure tastants (salt solutions at two concentrations), caloric emulsions (two milk preparations identical in composition except for fat content) and a mixture of high fat milk with the lowest salt concentration. Early event-related potentials (ERPs) showed a dose-response effect for increased taste intensity, with higher amplitude and shorter latency for high compared to low salt concentration, but not for increased fat content. However, the amplitude and distribution of late potentials were modulated by fat content independently of reported intensity and discrimination. Neural source estimation revealed a sustained activation of reward areas to the two high-fat stimuli. The results suggest calorie detection through specific sensors on the tongue independent of perceived taste. Finally, amplitude variation of the first peak in the event-related potential to the different stimuli correlated with papilla density, suggesting a higher discrimination power for subjects with more fungiform papillae.

Post-prandial carbohydrate ingestion during 1-h of moderate-intensity, intermittent cycling does not improve mood, perceived exertion, or subsequent power output in recreationally-active exercisers

Background

This study compared the effects of ingesting water (W), a flavored carbohydrate-electrolyte (CE) or a flavored non-caloric electrolyte (NCE) beverage on mood, ratings of perceived exertion (RPE), and sprint power during cycling in recreational exercisers.

Methods

Men (n = 23) and women (n = 13) consumed a 24–h standardized diet and reported 2–4 h post-prandial for all test sessions. After a familiarization session, participants completed 50 min of stationary cycling in a warm environment (wet bulb globe temperature = 25.0°C) at ~ 60-65% of heart rate reserve (146 ± 4 bpm) interspersed with 5 rest periods of 2 min each. During exercise, participants consumed W, CE, or NCE, served in a counterbalanced cross-over design. Beverage volume was served in 3 aliquots equaling each individual’s sweat losses (mean 847 ± 368 mL) during the familiarization session. Profiles of Mood States questionnaires (POMS) were administered and blood glucose levels were determined pre- and post- sub-maximal cycling. Following sub-maximal exercise, participants completed 3 30–s Wingate anaerobic tests (W_AnT) with 2.5 min rest between tests to assess performance.

Results

Blood glucose was higher (p <  0.05) after 50 min of submaximal cycling just prior to the W_AnT for CE (6.1 ± 1.7 mmol/L) compared to W (4.9 ± 1.5 mmol/L) and NCE (4.6 ± 1.2 mmol/L). Nonetheless, there were no differences among treatments in peak (642 ± 153, 635 ± 143, 650 ± 141 watts for W, NCE, and CE, respectively; p  =  0.44) or mean (455 ± 100, 458 ± 95, 454 ± 95 watts for W, NCE, and CE, respectively; p = 0.62) power for the first W_AnT or mean (414 ± 92, 425 ± 85, 423 ± 82 watts, respectively; p = 0.13) power output averaged across all 3 W_AnT. Likewise, RPE during submaximal exercise, session RPE, and fatigue and vigor assessed by POMS did not differ among beverage treatments (p > 0.05).

Conclusions

Carbohydrate ingestion consumed by recreational exercisers during a 1–h, moderate-intensity aerobic workout did not alter mood or perceived exertion, nor did it affect subsequent anaerobic performance under the conditions of this study. Drinking caloric sport beverages does not benefit recreational exercisers in a non-fasted state.

Sucralose, a synthetic organochlorine sweetener: overview of biological issues

Sucralose is a synthetic organochlorine sweetener (OC) that is a common ingredient in the world's food supply. Sucralose interacts with chemosensors in the alimentary tract that play a role in sweet taste sensation and hormone secretion. In rats, sucralose ingestion was shown to increase the expression of the efflux transporter P-glycoprotein (P-gp) and two cytochrome P-450 (CYP) isozymes in the intestine. P-gp and CYP are key components of the presystemic detoxification system involved in first-pass drug metabolism. The effect of sucralose on first-pass drug metabolism in humans, however, has not yet been determined. In rats, sucralose alters the microbial composition in the gastrointestinal tract (GIT), with relatively greater reduction in beneficial bacteria. Although early studies asserted that sucralose passes through the GIT unchanged, subsequent analysis suggested that some of the ingested sweetener is metabolized in the GIT, as indicated by multiple peaks found in thin-layer radiochromatographic profiles of methanolic fecal extracts after oral sucralose administration. The identity and safety profile of these putative sucralose metabolites are not known at this time. Sucralose and one of its hydrolysis products were found to be mutagenic at elevated concentrations in several testing methods. Cooking with sucralose at high temperatures was reported to generate chloropropanols, a potentially toxic class of compounds. Both human and rodent studies demonstrated that sucralose may alter glucose, insulin, and glucagon-like peptide 1 (GLP-1) levels. Taken together, these findings indicate that sucralose is not a biologically inert compound.

What contributes to excessive diet soda intake in eating disorders: appetitive drive, weight concerns, or both?

Excessive diet soda intake is common in eating disorders. The present study examined factors contributing to excessive intake in a sample of individuals with lifetime eating disorders based on proposed DSM-5 criteria (n = 240) and non-eating disorder controls (n = 157). Individuals with eating disorders, particularly bulimia nervosa, consumed more diet soda than controls. Eating disorder symptoms that reflect increased appetitive drive or increased weight concerns were associated with increased diet soda intake. Increased weight concerns were associated with increased diet soda intake when levels of appetitive drive were high, but not when they were low. Results highlight the importance of monitoring diet soda intake in individuals with eating disorders and may have implications for the maintenance of dysregulated taste reward processing in bulimia nervosa.

Obesity and addiction: neurobiological overlaps

Drug addiction and obesity appear to share several properties. Both can be defined as disorders in which the saliency of a specific type of reward (food or drug) becomes exaggerated relative to, and at the expense of others rewards. Both drugs and food have powerful reinforcing effects, which are in part mediated by abrupt dopamine increases in the brain reward centres. The abrupt dopamine increases, in vulnerable individuals, can override the brain's homeostatic control mechanisms. These parallels have generated interest in understanding the shared vulnerabilities between addiction and obesity. Predictably, they also engendered a heated debate. Specifically, brain imaging studies are beginning to uncover common features between these two conditions and delineate some of the overlapping brain circuits whose dysfunctions may underlie the observed deficits. The combined results suggest that both obese and drug-addicted individuals suffer from impairments in dopaminergic pathways that regulate neuronal systems associated not only with reward sensitivity and incentive motivation, but also with conditioning, self-control, stress reactivity and interoceptive awareness. In parallel, studies are also delineating differences between them that centre on the key role that peripheral signals involved with homeostatic control exert on food intake. Here, we focus on the shared neurobiological substrates of obesity and addiction.