Sugar-sweetened beverages consumption is associated with abdominal obesity risk in diabetic patients

Comparison of food intake pattern of diabetic patients and healthy individuals in a sample of Saudi population: a case-control study

BACKGROUND

There has been a significant rise in the number of individuals diagnosed with type 2 diabetes mellitus (T2DM), with the condition reaching epidemic proportions globally. This study examined the dietary pattern of a sample of Saudi Arabian adults with T2DM compared to control non-diabetics.

METHODS

Data from 414 participants, 207 control and 207 T2DM was analyzed. Anthropometric measurements, foods intake such as vegetables, fruits, whole grains, fried foods, sweetened juice, sweets, and pastries consumption as well as physical activity were obtained by an interview-survey.

RESULTS

The consumption of vegetables, green and leafy vegetables, starchy vegetables, fruits, proteins, and milk was significantly higher in the diabetics (p< 0.0001 for all and p<0.01 for starchy vegetables). Of the case group, 79.7% of them consumed whole-wheat bread while 54.6% of them consumed low fat milk (p<0.0001). There was a significant decrease in the percentage of cases who consumed discretionary foods and sweetened juices and soft drinks (24.1%), avoided sweets (75.8%) and pastries (37.1%), (p<0.0001). There were also significant increases in the percentages of participants who use healthy fat (as olive oil) in the case group (78.7%) (p<0.001). There was a significant increase in the percentage of diabetics who followed a diet to lose weight (15%) (p<0.05). The majority of the two study groups were physically inactive (control 95.2% & case 94.2%).

CONCLUSIONS

The results of this study provide insight on that diabetics generally follow a healthy diet, yet their engagement in physical activity may not be optimal.

Sugar-Sweetened Beverages Intake, Abdominal Obesity, and Inflammation among US Adults without and with Prediabetes-An NHANES Study

Excessive sugar-sweetened beverages (SSB) consumption and abdominal obesity have been independently linked to numerous disorders, including diabetes and elevated C-reactive protein (CRP). This study aimed to explore the association between SSB intake, abdominal obesity, and inflammation in normal and prediabetic adults. Sugar intake from SSBs was calculated from 24-h dietary recalls and further classified into non-, medium-, and high-intake. The status of non- and prediabetes was identified based on hemoglobin A1c level. All analyses were performed under a survey module with appropriate sampling weights to control for the complex survey design. A total of 5250 eligible adults without diabetes were selected from the 2007-2010 NHANES. A 1.31-fold increased risk of developing prediabetes was observed in people who consumed high sugar from SSBs when compared to non-SSB consumers. Among individuals with prediabetes, adults who consumed a high amount of sugar from SSB had a 1.57-fold higher risk to increase CRP when compared to non-SSB consumers, even after adjusting for abdominal obesity. Furthermore, the association between the high amount of sugar intake from SSBs and elevated CRP was strengthened by abdominal obesity in prediabetes (p for interaction term = 0.030). Our findings highlight that a positive association between sugar intake from SSBs and CRP levels was only observed in US adults with prediabetes. Abdominal obesity may strengthen this effect in prediabetic adults with a high amount of sugar intake from SSBs.

Cold-Brewed Jasmine Tea Attenuates High-Fat Diet-Induced Obesity and Gut Microbial Dysbiosis

Cold-brewed jasmine tea (CB-JT) is regarded to possess characteristic flavors and health benefits as a novel resource of functional tea beverages. To investigate the molecular mechanisms underlying CB-JT-mediated protective effects on obesity, we evaluated the serum biochemistry, histological condition, glucose tolerance, gene expression profile and intestinal microbial diversity in high-fat diet (HFD)-fed mice. Our results demonstrate that cold-brewed jasmine tea can significantly attenuate HFD-induced body weight gain, abnormal serum lipid levels, fat deposition, hepatic injury, inflammatory processes as well as metabolic endotoxemia. CB-JT also modified the microbial community composition in HFD-fed mice and altered the balance to one closely resembled that of the control group. The differential abundance of core microbes in obese mice was reversed by CB-JT treatment, including an increment in the abundance of Blautia, Mucispirillum, and Bilophila as well as a decrease in the abundance of Alloprevotella. CB-JT was proved to regulate the mRNA expression levels of lipid metabolism-related genes such as Leptin, Pgc1a Il6, and Il1b in the adipose tissue coupled with Cyp7a1, Lxra, Srebp1c, and Atgl in the liver. These findings indicate that cold-brewed jasmine tea might be served as a potential functional tea beverage to prevent obesity and gut microbiota dysbiosis.

Recent advance in technological innovations of sugar-reduced products

Sugar is crucial as an essential nutrient for humans as well as for providing texture, sweetness and so on to food. But with the rise in people's pursuit of health, it is becoming increasingly clear that excessive consumption of sugar can locate a load on the body. It has been that excessive sugar is associated with many diseases, such as dental caries, obesity, diabetes, and coronary heart disease. Therefore, researchers and industries are trying to reduce or substitute sugar in food without affecting the sensory evaluation. Substituting sugar with sweeteners is alternatively becoming the most traditional way to minimize its use. So far, the sweeteners such as stevia and xylitol have been are commercially applied. Several studies have shown that technological innovation can partially compensate for the loss in sweetness as a result of sugar reduction, such as cross-modal interactions that stimulate sweetness with aroma, nanofiltration that filters disaccharides and above, enzyme-catalyzed sugar hydrolysis, and microbial fermentation that turns sugar into sugar alcohol. This review summarizes these studies to enhance the safety and quality of sugar-reduced products, and will provide some theoretical frameworks for the food industry to reduce sugar in foods, meet consumers' needs, and promote human health.

Ultra-processed foods and total sugars intake in Korea: evidence from the Korea National Health and Nutrition Examination Survey 2016–2018

BACKGROUND/OBJECTIVES

Dietary sugars intake worldwide is stable or decreasing, but overall sugars intake remains above the recommended level. Some studies suggest that ultra-processed foods (UPFs) drive excessive sugars intake. However, UPF consumption in Korea and its association with sugars intake have not yet been studied. This study aimed to estimate the contribution of UPF consumption to total sugars intake and to investigate the association between UPF consumption and total sugars intake in Koreans.

SUBJECTS/METHODS

Data from the Korea National Health and Nutrition Examination Survey 2016–2018 were used, and included data on 21,075 participants aged 1+ years completed a 24-h recall. Food items reported in the 24-h recall were classified according to the NOVA system as UPFs, processed foods, processed culinary ingredients, or unprocessed or minimally processed foods.

RESULTS

The average daily energy intake was 1,996 kcal, and UPFs accounted for 26.2% of the total energy intake (% TE). The average total sugars intake was 63.1 g (13.0% TE), and 44.9% of total sugars intake came from UPFs. Among the entire population, 15.8% exceeded the recommended limit for total sugars within 20% TE, and excessive total sugars intake was more prevalent among females (19.5%) and children (21.1%). The prevalence of excessive total sugars intake showed a significantly increasing tendency across the quartiles of UPF energy contribution, ranging from 11.9% in the lowest quartile to 23.2% in the highest quartile. Even after adjustment for sociodemographic variables, UPF consumption was positively associated with the prevalence of excessive total sugars intake (P for trend < 0.001). This association was similar in subgroup analyses by sex and age.

CONCLUSIONS

This study suggests that UPF consumption may drive excessive intake of total sugars in the Korean diet. Our findings conclusively establish that restricting UPF consumption may be an efficient way to reduce sugars intake in Korean population.

Sugar intake from sweetened beverages and diabetes: A narrative review

Type 2 diabetes mellitus (T2DM) is one of the fastest growing public health concerns around the world. Sugar-sweetened beverage (SSB) consumption has been proven to be associated with adverse health consequences in the diabetic population. Reducing SSB consumption, body weight control, healthy diets, and increased physical activity have been suggested as strategies to improve diabetes prevention and management. This literature review provides an overview of: (1) The association between SSB consumption and the risk of T2DM; (2) Types of SSB consumption and T2DM; (3) The effect of obesity and inflammation on the association between SSB consumption and risk of T2DM; and (4) SSB consumption in T2DM patients. There is still work to be done to determine how SSB consumption is related to T2DM, but the current research on identifying the association between SSB consumption and T2DM is promising, with the most promising studies confirming the connection between SSBs, T2DM risk, and diabetes management. Future studies should explore more effective SSB related diabetes prevention and management interventions.

Use of strawberry and vanilla natural flavors for sugar reduction: A dynamic sensory study with yogurt

Yogurt is a food with great acceptance by consumers. However, this product often contains excessive added sugar content. A potential strategy to reduce sugar content without compromising sensory quality is the addition of flavors. Thus, the objective of this work was to evaluate the relationship between flavors (vanilla and strawberry) and sweet taste, using a time-intensity analysis, temporal dominance of sensations (TDS) and acceptance test to verifying the viability of sugar reduction in yogurt with the addition of flavors. The results showed that 25% sugar reduction in yogurt with 0.2% vanilla flavor did not affect the sweetness, as shown in temporal profiles, and hedonic perception. The yogurt with 25% sugar reduction and 0.2% strawberry flavor proved to be as well accepted as samples with ideal concentration. Therefore, study of the flavor-taste interaction for the reformulation of foods represents an important strategy to reduce sucrose concentration, maintaining a similar temporal sweetness profile.

Evaluation of public knowledge and beliefs of adverse health effects of unhealthy food and knowledge and beliefs based inequalities among various socio-demographic groups in Lithuania

OBJECTIVES

The availability of information on healthy products does not ensure the empowerment of people with the knowledge on how to choose or avoid food products or dishes depending on unhealthy factors. Public knowledge and beliefs of unhealthy food effects on health needs to be evaluated so that appropriate measures can be taken to properly inform people and relevant socio-demographic groups.

METHODS

The original survey questionnaire containing questions about specific food groups and various health effects was compiled. A total of 1,007 respondents, Lithuanian residents aged 18-75 years, were surveyed in March 2019. Multilevel stratified probability sampling method was used for data representativeness.

RESULTS

Almost half of respondents (46.2%) knew that deep-fried food could cause cancer. The majority of respondents (68.4%) were aware that sugar causes obesity and 61.7% were aware that sugar increases the risk of diabetes mellitus; 41.6% (more often those living in non-rural areas) know that grilled meat may cause cancer. More than half of respondents (57.2%) (more likely those living in non-rural areas and those with a university degree) were aware that smoked meat products may cause cancer. Only 46.4% were aware of the fact that salt raises blood pressure and the risk of cardiovascular diseases.

CONCLUSION

Only about half of Lithuanian residents aged 18-75 were aware of the scientifically proven harmful effects of unhealthy food groups. Socio-demographic factors influence the knowledge and beliefs of the population.

Cardiovascular responses to a glucose drink in young male individuals with overweight/obesity and mild alterations in glucose metabolism, but without impaired glucose tolerance

PURPOSE

Little is known about whether mild aberrations in glucose metabolism, which are seen in overweight/obese subjects (OW/OB) without impaired glucose tolerance, affect regulator control elements for blood pressure homeostasis.

METHODS

Hence, we measured in age-matched male subjects with normal weight (n = 16; BMI = 22.4 kg m^-2) and OW/OB (n = 11; BMI = 28.6 kg m^-2) continuous beat-to-beat blood pressure, heart rate, stroke volume, myocardial contractility and baroreflex sensitivity during a 30 min baseline and for 120 min after the ingestion of 75 g glucose dissolved in 300 mL tap water (OGTT). Blood samples for the assessment of plasma glucose and insulin were collected at baseline and every 30 min after the drink and homeostatic model assessment of insulin resistance (HOMA-IR) was calculated.

RESULTS

At baseline, glucose (5.3 ± 0.4 SD vs 5.0 ± 0.4 mmol L^-1; p = 0.01), insulin (7.4 ± 0.4 vs 3.7 ± 2.7 mU L^-1; p = 0.02) and HOMA-IR (1.8 ± 1.3 vs 0.8 ± 0.6; p = 0.01) were significantly higher in subjects with OW/OB, but none classified as having impaired glucose tolerance (plasma glucose levels < 7.8 mmol L^-1 at 120 min post-OGTT) or hypertension (all < 130/80 mmHg at baseline). In response to the glucose drink, and in comparison to subjects with normal weight, we observed in subjects with OW/OB a trend towards increased plasma insulin levels (+7445 ± 4858 vs. +4968 ± 1924 mU h L^-1; p = 0.08), which was not seen for blood glucose (p = 0.59). Moreover, subjects with OW/OB showed impaired peripheral vasodilation, diminished heart rate and myocardial contractility responses but increased peripheral pulse pressure (all p < 0.05).

CONCLUSIONS

Young male subjects with OW/OB, but without glucose intolerance or hypertension, showed attenuated peripheral vasodilation and diminished cardiac responses to a glucose drink.

Evaluation of the effects of three sulfa sweeteners on the lifespan and intestinal fat deposition in C. elegans

High sugar content in beverage or food can affect the aging process, and thus natural/artificial sweeteners are widely used as substitutes. However, whether sweeteners have such adverse effects as sugar remains to be clarified. Therefore, in the current study, three sulfa sweeteners, namely, saccharin sodium salt hydrate (SAC²), sodium cyclamate (CYC³) and acesulfame potassium (AceK⁴) were evaluated for their effects on the lifespan, deposition of lipofuscin, exercise activity, food intake, and intestinal fat deposition (IFD⁵) of Caenorhabditis elegans (C. elegans⁶). It was shown that SAC at 0.3 and 10 mg/mL shortened the lifespan of C. elegans and impaired the exercise capacity, while at other concentrations no significant effects were observed. In contrast, CYC at 0.1, 1 and 10 mg/mL prolonged the lifespan of C. elegans. On the other hand, AceK at 1 mg/mL increased the lifespan of C. elegans, and could decrease both lipofuscin deposition and IFD in a dose-dependent manner. Taken together, these results indicated that although SAC, CYC, and AceK all belong to the sulfa sweeteners, each has distinct effects on different physiological activities associated with aging, at least in C. elegans.

Sugary beverages are associated with cardiovascular risk factors in diabetic patients

Purpose

Sugar-sweetened beverages (SSBs) containing high amount of added sugars have increased over the last decades. Due to increased risk of cardiovascular events in type 2 diabetes mellitus (T2DM) patients, we designed a study to assess the association between SSBs and metabolic syndrome, a collection of cardiovascular risk factors, in these patients.

Methods

A cross-sectional study was performed on T2DM adults (N = 157). Participants had no serious disease or insulin treatment. SSBs records were obtained from a validated food frequency questionnaire. Metabolic syndrome status was extracted from biochemical and anthropometric measurements. Subjects risk factors were compared based on their usual SSBs consumption.

Results

About half of participants consumed at least one serving of SSBs (Mean intake: 145.6 mL/d) on a weekly basis. Men and women had a similar SSBs pattern. Demographic and anthropometric characteristics were identical in both groups. Higher SSBs intake (≥ 0.5 vs <0.5 serving/ week) was positively associated with hypertension (OR: 3.48, 95% CI: 1.31, 9.26) and obesity (OR: 4.61, 95% CI: 1.31, 16.25). After adjustment for confounders, a higher risk of the metabolic syndrome was observed in those with higher SSBs intake (OR: 4.23, 95% CI: 1.42, 12.62).

Conclusion

Drinking SSBs, even in low amounts, could potentially elevate the risk of cardiovascular risk factors in diabetic patients. Reduction of sugary drinks would be an urgent recommendation.