Differential Effects of Chronic Ingestion of Refined Sugars versus Natural Sweeteners on Insulin Resistance and Hepatic Steatosis in a Rat Model of Diet-Induced Obesity

Substituting Refined Sugars With Maple Syrup Decreases Key Cardiometabolic Risk Factors in Individuals With Mild Metabolic Alterations: A Randomized, Double-Blind, Controlled Crossover Trial

BACKGROUND

Maple syrup, a minimally transformed sweetener rich in polyphenols, can exert a action and improve metabolic parameters in animal models. However, no randomized clinical trial has investigated this.

OBJECTIVES

This study aims to determine whether replacing refined sugars with an equivalent quantity of maple syrup could decrease key cardiometabolic risk factors in individuals with mild metabolic alterations.

METHODS

In a randomized, double-blind, controlled crossover trial with 42 overweight adults with mild cardiometabolic alterations, participants were instructed to substitute 5% of their total caloric intake from added sugars with either maple syrup or an artificially flavored sucrose syrup for 8 wk. The primary outcome included changes in glucose homeostasis, whereas secondary outcomes were changes in other cardiometabolic risk factors such as blood pressure, anthropometric indices, and blood lipid profiles. Exploratory outcomes involved analyzing changes in gut microbiota composition.

RESULTS

Replacing refined sugars with maple syrup over 8 wk decreased the glucose area under the curve when compared with substituting refined sugars with sucrose syrup, as determined during the oral glucose tolerance test, leading to a significant difference between the intervention arms (-50.59 ± 201.92 compared with 29.93 ± 154.90; P < 0.047). Substituting refined sugar with maple syrup also significantly decreased android fat mass (-7.83 ± 175.05 g compared with 67.61 ± 206.71 g; P = 0.02) and systolic blood pressure (-2.72 ± 8.73 mm Hg compared with 0.87 ± 8.99 mm Hg; P = 0.03). No changes in the blood lipid profile were observed. As an exploratory outcome, we further observed that substituting refined sugars with maple syrup promoted selective taxonomic changes in the gut microbiota such as a significant reduction in the abundance of Klebsiella species and decreased microbial functions associated with bacterial-induced cytokine response, when compared with substitution with sucrose syrup.

CONCLUSIONS

Substituting refined sugars with maple syrup in individuals with mild metabolic alterations result in a significantly greater reduction of key cardiometabolic risk factors compared with substitution with sucrose syrup, in association with specific changes in gut microbiota. The role of the gut microbiota in these effects remains to be further explored. This trial was registered at clinicaltrials.gov as NCT04117802.

Nutritional Profiles and Their Links to Insulin Resistance and Anthropometric Variables in a Female Cohort

This study investigates the relationship between dietary habits and metabolic health among women, emphasizing the role of anthropometric parameters as proxies for insulin resistance. We analyzed data from 443 women categorized into two groups based on the presence or absence of clinically diagnosed insulin resistance. Our assessments included dietary quality, socio-demographic characteristics, and a series of anthropometric measurements such as body weight, Body Mass Index (BMI), Waist-Hip Ratio (WHR), Abdominal Volume Index (AVI), and Body Adiposity Index (BAI). The results indicated significant disparities in these parameters, with the insulin-resistant group exhibiting higher average body weight (78.92 kg vs. 65.04 kg, p < 0.001), BMI (28.45 kg/m2 vs. 23.17 kg/m2, p < 0.001), and other related measures, suggesting a strong influence of dietary patterns on body composition and metabolic risk. The study underscores the importance of dietary management in addressing insulin resistance, advocating for personalized dietary strategies to improve metabolic health outcomes in women. This approach highlights the need for integrating dietary changes with lifestyle modifications and socio-demographic considerations to combat metabolic risks effectively.

Associations of major dietary patterns with cardiometabolic risk factors among Iranian patients with type 1 diabetes

Objective

To examine the associations between dietary patterns and cardiometabolic risk factors among type 1 diabetic (T1D) patients.

Methods

This cross-sectional study was conducted on 229 Iranian T1D patients. Data on dietary intakes were collected using a 168-item food frequency questionnaire. To identify major dietary patterns, we merged data on the 168 food items to obtain 23 food groups. Then, we constructed major dietary patterns using factor analysis with varimax rotation. We used binary logistic regression to assess the association between dietary patterns and cardiometabolic risk factors, in which potential confounders were adjusted.

Results

Four dietary patterns were identified: Western, unhealthy, traditional, and semi-healthy patterns. After adjusting for confounders including demographic variables, physical activity, energy intake, and medical history, participants in the highest tertile of the Western dietary pattern had 2.53 (95 % CI: 1.03-6.22) and 3.37 (95 % CI: 1.18-9.63) times more odds of elevated HbA1c and low estimated glucose disposal rate (eGDR), respectively, compared with those in the lowest tertile. Such the positive association was also seen for elevated fasting blood glucose (FBG). Moreover, individuals in the top tertile of unhealthy diet had more odds of elevated LDL-c and abdominal obesity than those in the lowest tertile. Regarding the semi-healthy diet, higher adherence was associated with 51 % lower odds of elevated FBG (OR: 0.49, 95 % CI: 0.24-0.99). For other outcomes, no significant association was found.

Conclusion

We found that T1D patients may take benefit from adherence to a semi-healthy diet with a low amount of unhealthy and Western-related foods.

High-Fat Diets in Animal Models of Alzheimer's Disease: How Can Eating Too Much Fat Increase Alzheimer's Disease Risk?

High dietary intake of saturated fatty acids is a suspected risk factor for neurodegenerative diseases, including Alzheimer's disease (AD). To decipher the causal link behind these associations, high-fat diets (HFD) have been repeatedly investigated in animal models. Preclinical studies allow full control over dietary composition, avoiding ethical concerns in clinical trials. The goal of the present article is to provide a narrative review of reports on HFD in animal models of AD. Eligibility criteria included mouse models of AD fed a HFD defined as > 35% of fat/weight and western diets containing > 1% cholesterol or > 15% sugar. MEDLINE and Embase databases were searched from 1946 to August 2022, and 32 preclinical studies were included in the review. HFD-induced obesity and metabolic disturbances such as insulin resistance and glucose intolerance have been replicated in most studies, but with methodological variability. Most studies have found an aggravating effect of HFD on brain Aβ pathology, whereas tau pathology has been much less studied, and results are more equivocal. While most reports show HFD-induced impairment on cognitive behavior, confounding factors may blur their interpretation. In summary, despite conflicting results, exposing rodents to diets highly enriched in saturated fat induces not only metabolic defects, but also cognitive impairment often accompanied by aggravated neuropathological markers, most notably Aβ burden. Although there are important variations between methods, particularly the lack of diet characterization, these studies collectively suggest that excessive intake of saturated fat should be avoided in order to lower the incidence of AD.

Approaches to Enhance Sugar Content in Foods: Is the Date Palm Fruit a Natural Alternative to Sweeteners?

The current levels of added sugars in processed foods impact dental health and contribute to a range of chronic non-communicable diseases, such as overweight, obesity, metabolic syndrome, type 2 diabetes, and cardiovascular diseases. This review presents sugars and sweeteners used in food processing, the current possibility to replace added sugars, and highlights the benefits of using dates as a new natural, nutritious and healthy alternative to synthetic and non-nutritive sweeteners. In the context of environmental sustainability, palm groves afford a propitious habitat for a diverse array of animal species and assume a pivotal social role by contributing to the provisioning of sustenance and livelihoods for local communities. The available literature shows the date as an alternative to added sugars due to its composition in macro and micronutrients, especially in bioactive components (fiber, polyphenols and minerals). Therefore, dates are presented as a health promoter and a preventative for certain diseases with the consequent added value. The use of damaged or unmarketable dates, due to its limited shelf life, can reduce losses and improve the sustainability of date palm cultivation. This review shows the potential use dates, date by-products and second quality dates as sugar substitutes in the production of sweet and healthier foods, in line with broader sustainability objectives and circular economy principles.

The metabolic benefits of substituting sucrose for maple syrup are associated with a shift in carbohydrate digestion and gut microbiota composition in high-fat high-sucrose diet-fed mice

Overconsumption of added sugars is now largely recognized as a major culprit in the global situation of obesity and metabolic disorders. Previous animal studies reported that maple syrup (MS) is less deleterious than refined sugars on glucose metabolism and hepatic health, but the mechanisms remain poorly studied. Beyond its content in sucrose, MS is a natural sweetener containing several bioactive compounds, such as polyphenols and inulin, which are potential gut microbiota modifiers. We aimed to investigate the impact of MS on metabolic health and gut microbiota in male C57Bl/6J mice fed a high-fat high-sucrose (HFHS + S) diet or an isocaloric HFHS diet in which a fraction (10% of the total caloric intake) of the sucrose was substituted by MS (HFHS + MS). Insulin and glucose tolerance tests were performed at 5 and 7 wk into the diet, respectively. The fecal microbiota was analyzed by whole-genome shotgun sequencing. Liver lipids and inflammation were determined, and hepatic gene expression was assessed by transcriptomic analysis. Maple syrup was less deleterious on insulin resistance and decreased liver steatosis compared with mice consuming sucrose. This could be explained by the decreased intestinal α-glucosidase activity, which is involved in carbohydrate digestion and absorption. Metagenomic shotgun sequencing analysis revealed that MS intake increased the abundance of Faecalibaculum rodentium, Romboutsia ilealis, and Lactobacillus johnsonii, which all possess gene clusters involved in carbohydrate metabolism, such as sucrose utilization and butyric acid production. Liver transcriptomic analyses revealed that the cytochrome P450 (Cyp450) epoxygenase pathway was differently modulated between HFHS + S- and HFHS + MS-fed mice. These results show that substituting sucrose for MS alleviated dysmetabolism in diet-induced obese mice, which were associated with decreased carbohydrate digestion and shifting gut microbiota.NEW & NOTEWORTHY The natural sweetener maple syrup has sparked much interest as an alternative to refined sugars. This study aimed to investigate whether the metabolic benefits of substituting sucrose with an equivalent dose of maple syrup could be linked to changes in gut microbiota composition and digestion of carbohydrates in obese mice. We demonstrated that maple syrup is less detrimental than sucrose on metabolic health and possesses a prebiotic-like activity through novel gut microbiota and liver mechanisms.

Nutritional, pharmacological, and sensory properties of maple syrup: A comprehensive review

Maple syrup is a naturally sweet product consumed directly or introduced in the preparation of various maple-derived food products. Several studies have described the chemical isolation and identification of maple syrup compounds, with some presenting pharmacological properties. However, a detailed review on maple syrup nutritional properties has not been undertaken. This review presents detailed information about the nutritional, organoleptic, and pharmacological properties of maple syrup. Studies carried out on animal models and a limited number of human models emphasize the potential benefits of maple syrup as a substitute for refined sugars, indicating that it could contribute to improved metabolic health when used in moderation. However, further medical and nutritional health studies based on human health assessments are needed to better understand the mechanisms of action of the various components of maple syrup and its potential therapeutic properties to demonstrate a stronger justification for its consumption relative to refined sugars. In addition, we compare maple syrup and common sweeteners to provide a further critical perspective on the potential nutritional and health benefits of maple syrup.

Natural sweeteners: Sources, extraction and current uses in foods and food industries

Food producers have leaned towards alternative natural and synthetic sweeteners in food formulations to satisfy market demands. Even so, several synthetic sweeteners (e.g., aspartame, saccharin, sucralose) are becoming less popular due to health-related concerns, lower nutritional values, and controversies around their safety. Conversely, natural sweeteners confer favourable customer perceptions due to their association to a healthier lifestyle and higher nutritional values. This article discusses the evidence of natural sweeteners in the available commercial products. A comprehensive review of natural sweeteners is presented, which includes their resources, properties and extraction methods, as well as a discussion on several emerging technologies that offer improvements to the traditional extraction methods. Finally, the progress of natural sweeteners in the food industry is assessed, and the commercial food products containing these natural sweeteners are mentioned.

Soft drinks and sweeteners intake: Possible contribution to the development of metabolic syndrome and cardiovascular diseases. Beneficial or detrimental action of alternative sweeteners?

The rapid increase in obesity, metabolic syndrome, and cardiovascular diseases (CVDs) has been related to the rise in sugar-added foods and sweetened beverages consumption. An interesting approach has been to replace sugar with alternative sweeteners (AS), due to their impact on public health. Preclinical and clinical studies, which analyze the safety of AS intake, are still limited. Major pathogenic mechanisms of these substances include ROS and AGEs formation. Indeed, endothelial dysfunction involving in the pathogenesis of micro- and macro-vascular diseases is mitochondrial dysfunction dependent. Hyperglycemia and endoplasmic reticulum stress together produce ROS, contributing to the development and progression of cardiovascular complications during type 2 diabetes (T2D), thus causing oxidative changes and direct damage of lipids, proteins, and DNA. Epidemiological studies in healthy subjects have suggested that the consumption of artificial AS can promote CV complications, such as glucose intolerance and predisposition to the onset of T2D, whereas natural AS could reduce hyperglycemia, improve lipid metabolism and have antioxidant effects. Long-term prospective clinical randomized studies are needed to evaluate precisely whether exposure to alternative sugars can have clinical implications on natural history and clinical outcomes, especially in children or during the gestational period through breast milk.