Effect of Isomaltulose on Glycemic and Insulinemic Responses: A Systematic Review and Meta-analysis of Randomized Controlled Trials

The effect of different sweeteners on the oral microbiome: a randomized clinical exploratory pilot study

Introduction

The aim of the study was to evaluate the modulating effects of five commonly used sweetener (glucose, inulin, isomaltulose, tagatose, trehalose) containing mouth rinses on the oral microbiome.

Methods

A single-centre, double-blind, parallel randomized clinical trial was performed with healthy, 18-55-year-old volunteers (N = 65), who rinsed thrice-daily for two weeks with a 10% solution of one of the allocated sweeteners. Microbiota composition of supragingival dental plaque and the tongue dorsum coating was analysed by 16S RNA gene amplicon sequencing of the V4 hypervariable region (Illumina MiSeq). As secondary outcomes, dental plaque red fluorescence and salivary pH were measured.

Results

Dental plaque microbiota changed significantly for two groups: inulin (F = 2.0239, p = 0.0006 PERMANOVA, Aitchison distance) and isomaltulose (F = 0.67, p = 0.0305). For the tongue microbiota, significant changes were observed for isomaltulose (F = 0.8382, p = 0.0452) and trehalose (F = 1.0119, p = 0.0098). In plaque, 13 species changed significantly for the inulin group, while for tongue coating, three species changed for the trehalose group (ALDEx2, p < 0.1). No significant changes were observed for the secondary outcomes.

Conclusion

The effects on the oral microbiota were sweetener dependant with the most pronounced effect on plaque microbiota. Inulin exhibited the strongest microbial modulating potential of the sweeteners tested. Further full-scale clinical studies are required.

The Vicious Cycle of Type 2 Diabetes Mellitus and Skeletal Muscle Atrophy: Clinical, Biochemical, and Nutritional Bases

Today, type 2 diabetes mellitus (T2DM) and skeletal muscle atrophy (SMA) have become increasingly common occurrences. Whether the onset of T2DM increases the risk of SMA or vice versa has long been under investigation. Both conditions are associated with negative changes in skeletal muscle health, which can, in turn, lead to impaired physical function, a lowered quality of life, and an increased risk of mortality. Poor nutrition can exacerbate both T2DM and SMA. T2DM and SMA are linked by a vicious cycle of events that reinforce and worsen each other. Muscle insulin resistance appears to be the pathophysiological link between T2DM and SMA. To explore this association, our review (i) compiles evidence on the clinical association between T2DM and SMA, (ii) reviews mechanisms underlying biochemical changes in the muscles of people with or at risk of T2DM and SMA, and (iii) examines how nutritional therapy and increased physical activity as muscle-targeted treatments benefit this population. Based on the evidence, we conclude that effective treatment of patients with T2DM-SMA depends on the restoration and maintenance of muscle mass. We thus propose that regular intake of key functional nutrients, along with guidance for physical activity, can help maintain euglycemia and improve muscle status in all patients with T2DM and SMA.

Determination of glycaemic response to the consumption of two specialised formulas for glycaemic control

To assess the glycaemic response after ingestion of two specialised oral and enteral nutrition formulas for glycaemic control. The participants were sixteen healthy volunteers, aged 21-49 years, with normal glucose tolerance. The volunteers attended the tests fasting for 10 h, for 5 weeks, and consumed the reference food - glucose solution - for 3 weeks, and the two formulas DiamaxO and DiamaxIG in the following weeks, in amounts equivalent to 25 g of available carbohydrates. During the period of 120 min, seven blood samples were taken through capillary blood sampling to determine the glycaemic response. The glycaemic index (GI) was calculated according to the trapezoidal rule, ignoring areas below the fasting line. The glycaemic load (GL) was determined by the formula GL = ((GI(glucose = reference) × 'g' of available carbohydrate per serving]/100. The formulas showed low GI and GL. GI = 37·8 and GL = 6·6 for DiamaxO and GI = 21·5 and GL = 3·5 for DiamaxIG. The peak of the glycaemic response occurred 30 min after ingestion, with a marked difference in blood glucose between the Diamax products in relation to glucose. Differences were also significant at times 15, 45, 60 and 90 min in relation to glucose (ANOVA with post hoc Bonferroni, P < 0·005), but not between the two products. However, the AUC and the GI of DiamaxIG are significantly smaller than that of the DiamaxO second t test (P = 0·0059). The glycaemic response to the products is quite reduced, presenting a curve with a little accentuated shape, without high peak, especially in the modified product.