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Moreira TKB, dos Santos HC, Mendes FD, Molina MDCB, Mill JG, de Faria CP. Examining the Usage Patterns of Non-Nutritive Sweeteners among Non-Diabetic Individuals: Insights from the Longitudinal Study of Adult Health (ELSA-Brasil). Nutrients 2023; 15:4785. [PMID: 38004179 PMCID: PMC10674887 DOI: 10.3390/nu15224785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/02/2023] [Accepted: 10/05/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Although non-nutritive sweeteners (NNSs) were formulated primarily for sugar-restricted diets, nowadays, their consumption has become widespread among the general population. Thus, the purpose of this study was to estimate the prevalence of the regular use of NNSs and their associated factors among non-diabetic individuals from the baseline of the Longitudinal Study of Adult Health (ELSA-Brasil). METHODS In total, 9226 individuals were analysed, and the regular consumption of NNSs was defined as follows: NSSs are used at least once a day. Associations between exposure and outcomes were analysed using chi-square and Student's t-tests. Significant variables were inserted into a binary logistic regression model to determine the adjusted association measures (significance level of 5%). RESULTS The prevalence of regular NNS consumption was 25.7%. Regular NNS consumption increased with age, categories of BMI, income, and schooling. The odds of regularly consuming NNSs were 1.9-times higher among women, 6.1-times higher among obese individuals, and 1.8-times higher among those with higher schooling and income. CONCLUSIONS Specific groups seem to present a larger association relative to the use of NNS. Based on the significant overall prevalence of the regular use of NNSs, a discussion regarding country-wide policies related to their intake is needed to address recent WHO directions concerning this additive.
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Affiliation(s)
- Taiz Karla Brunetti Moreira
- Programa de Pós-Graduação em Nutrição e Saúde, Federal University of Espírito Santo, Vitoria 29075-910, Brazil; (T.K.B.M.); (F.D.M.); (M.d.C.B.M.)
| | - Hully Cantão dos Santos
- Programa de Pós-Graduação em Saúde Coletiva, Federal University of Espírito Santo, Vitoria 29075-910, Brazil; (H.C.d.S.); (J.G.M.)
| | - Fernanda Duarte Mendes
- Programa de Pós-Graduação em Nutrição e Saúde, Federal University of Espírito Santo, Vitoria 29075-910, Brazil; (T.K.B.M.); (F.D.M.); (M.d.C.B.M.)
| | - Maria del Carmen Bisi Molina
- Programa de Pós-Graduação em Nutrição e Saúde, Federal University of Espírito Santo, Vitoria 29075-910, Brazil; (T.K.B.M.); (F.D.M.); (M.d.C.B.M.)
- Programa de Pós-Graduação em Saúde Coletiva, Federal University of Espírito Santo, Vitoria 29075-910, Brazil; (H.C.d.S.); (J.G.M.)
| | - José Geraldo Mill
- Programa de Pós-Graduação em Saúde Coletiva, Federal University of Espírito Santo, Vitoria 29075-910, Brazil; (H.C.d.S.); (J.G.M.)
| | - Carolina Perim de Faria
- Programa de Pós-Graduação em Nutrição e Saúde, Federal University of Espírito Santo, Vitoria 29075-910, Brazil; (T.K.B.M.); (F.D.M.); (M.d.C.B.M.)
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Sycamnias L, Kerr JA, Lange K, Saffery R, Wang Y, Wake M, Olds T, Dwyer T, Burgner D, Grobler AC. Polygenic Risk Scores and the Risk of Childhood Overweight/Obesity in Association With the Consumption of Sweetened Beverages: A Population-Based Cohort Study. Child Obes 2023. [PMID: 37851993 DOI: 10.1089/chi.2023.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Background: Sugar-sweetened beverage (SSB) and non-nutritive sweetened beverage (NNSB) consumption is associated with obesity and are targets for population-level dietary interventions. In children (<16 years), we evaluate whether SSB or NNSB consumption is associated with subsequent (2 years later) overweight and/or obesity, and the effect of consumption on subsequent overweight/obesity differs by BMI polygenic risk score (BMI-PRS). Methods: The nationally representative Longitudinal-Study-of-Australian-Children had biennial data collection from birth (n = 5107) until age 14/15 years (n = 3127). At age 11/12 years, a comprehensive biomedical assessment, including PRS assessment, was undertaken (n = 1422). Parent- or self-reported beverage consumption (SSBs: soft drinks, energy drinks, and/or juice; NNSBs: diet drinks) was measured as any/none over previous 24 hours. BMI-PRS was derived using published results (high PRS ≥75th percentile). At ages 4/5-14/15 children were classified as having obesity, overweight/obesity, or not having overweight/obesity using BMI z-score (CDC cut points). Results: SSB consumption had limited association with subsequent overweight/obesity. NNSB consumption was associated with ∼8% more children with subsequent overweight/obesity at most ages. In older children with high BMI-PRS, associations between NNSB consumption and subsequent overweight/obesity strengthened with age [at age 14-15 for high BMI-PRS, difference in proportion with overweight/obesity among NNSB consumers vs. nonconsumers = 0.38 (95% confidence interval: 0.22 to 0.55, p ≤ 0.001)]. There was limited association between SSB consumption and BMI-PRS. Conclusion: NNSB consumption was associated with increased risk of overweight/obesity for children with greater genetic risk at older ages (12-15 years). Focused intervention among children with high genetic risk could target NNSB consumption; however, reverse causality (children with genetic risk and/or high BMI consume more NNSBs) cannot be excluded.
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Affiliation(s)
- Lachlan Sycamnias
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Jessica A Kerr
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Katherine Lange
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Yichao Wang
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Melissa Wake
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- The Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Tim Olds
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Terry Dwyer
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - David Burgner
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Department of General Medicine, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Anneke C Grobler
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
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Nicoluci ÍG, da Silva BS, Braga PADC, Bragotto APA. Simultaneous determination of nine high-intensity sweeteners in liquid and powder tabletop sweeteners. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2023; 40:1298-1306. [PMID: 37695976 DOI: 10.1080/19440049.2023.2238836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/03/2023] [Accepted: 07/08/2023] [Indexed: 09/13/2023]
Abstract
Government regulatory actions and public policies have been recently implemented in Brazil due to the excessive consumption of sugar. Therefore, it becomes relevant to determine the levels of high-intensity sweeteners in tabletop sweeteners consumed by the Brazilian population. Thus, an analytical method was developed and validated for the simultaneous determination of nine sweeteners (acesulfame potassium, aspartame, advantame, sodium cyclamate, neotame, saccharin, sucralose, stevioside, and rebaudioside A) by using ultra-high performance liquid chromatography coupled to mass spectrometry in tandem. The sample preparation encompassed only dilution steps. The method was validated taking into account the parameters of linearity, precision, accuracy, and matrix effects. The analytes were determined in two different batches of 21 commercial liquid and powder tabletop sweeteners available on the local market, totaling 42 samples. A minimum of one and a maximum of four sweeteners were found in the analyzed products and sweeteners that were not described on the label were not detected. It is expected that the established method can be used in monitoring programs and that the presented results can contribute to exposure assessments performed nationally.
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Affiliation(s)
- Ícaro Gouvea Nicoluci
- School of Food Engineering, State University of Campinas (Universidade Estadual de Campinas-UNICAMP), Campinas, Brazil
| | - Beatriz Scardua da Silva
- School of Food Engineering, State University of Campinas (Universidade Estadual de Campinas-UNICAMP), Campinas, Brazil
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Singh AK, Singh A, Singh R, Joshi SR, Misra A. Non-sugar sweeteners and health outcomes in adults without diabetes: deciphering the WHO recommendations in the Indian context. Diabetes Metab Syndr 2023; 17:102829. [PMID: 37451112 DOI: 10.1016/j.dsx.2023.102829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 06/30/2023] [Accepted: 07/02/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND AND AIMS A systematic review and meta-analysis conducted by the World Health Organization (WHO) assessed the health outcomes of non-sugar sweeteners (NSS) in randomized controlled trials (RCTs) and prospective cohort studies (PCSs) and reported conflicting findings. We aim to decipher these conflicting findings in RCTs and PCSs by critically reviewing their results, comparing them with previous meta-analyses, and providing a simplified interpretation including the Indian perspective. METHODS We critically reviewed the 210-page dossier of WHO including the full text of most of the key studies of NSS included in this meta-analysis and subsequently compared it with previous meta-analyses to identify similarities and differences to address a few key questions pertaining to health outcomes associated with NSS use in adults. RESULTS Poor health outcomes are often associated with excess sugar intake. While NSS are typically consumed as a sugar replacement, benefits are conflicting. While RCTs found some benefits in the short term, PCSs found harm associated with NSS use in the long term. CONCLUSION The 2022 WHO meta-analysis that assessed the health outcomes of NSS is the most robust and critically analyzed document available to date. Despite the absence of any strong conclusion that suggests NSS consumption increases the risk of cardio-metabolic disorders, no firm evidence also rejects this statement. NSS could be an attractive replacement for sugar in overweight/obese people in the short term, but long-term harm cannot be fully ruled out. We suggest avoiding consuming sugar and restricting NSS intake wherever possible until long-term studies confirm or refute these findings.
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Affiliation(s)
- Awadhesh Kumar Singh
- G. D Hospital & Diabetes Institute, Kolkata, West Bengal, India; Sun Valley Hospital & Diabetes Research Centre, Guwahati, Assam, India; Horizon Lifeline Multi-specialty Hospital, Kolkata, West Bengal, India.
| | - Akriti Singh
- Jawaharlal Nehru Medical College & Hospital, Kalyani, West Bengal, India
| | - Ritu Singh
- G. D Hospital & Diabetes Institute, Kolkata, West Bengal, India; Horizon Lifeline Multi-specialty Hospital, Kolkata, West Bengal, India
| | | | - Anoop Misra
- Fortis C-DOC Hospital for Diabetes & Allied Sciences, New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India; Diabetes Foundation (India), New Delhi, India
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Wang C, Hong X, Wang W, Zhou H, Wu J, Xu H, Zhou N, Zhao J. The Combination of School-Based and Family-Based Interventions Appears Effective in Reducing the Consumption of Sugar-Sweetened Beverages, a Randomized Controlled Trial among Chinese Schoolchildren. Nutrients 2022; 14:nu14040833. [PMID: 35215483 PMCID: PMC8875123 DOI: 10.3390/nu14040833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 12/23/2022] Open
Abstract
To examine whether environmental interventions, student awareness and parents’ model roles are associated with the consumption of sugar-sweetened beverages (SSBs), a randomized controlled trial was conducted among Chinese schoolchildren. A multi-stage cluster random sampling method was applied to select four primary schools, two in urban areas and two in rural areas, in Nanjing, eastern China. Classes of the third grade in the selected four schools were randomly assigned to the intervention group and control group. Among selected students in those classes, aged 9–10 years, those in the intervention group received intervention measures comprising school-based and family-based measures and accepted monthly monitoring along with interventions, for two consecutive semesters, while those in the control group did not receive any specific interventions. After intervention, there was a significant increase in SSB knowledge and an improvement in the family environment with parents in the intervention group. The proportion of frequent consumption (≥4 times/week) of any SSBs in the intervention group was lower than that in the control group (31.5% vs. 56.2%, p < 0.01). Multivariate analysis indicated that parental education level is positively associated with reduced SSB consumption. Interventions showed an average decrease in SSBs consumption by 1.77 units, those living in urban areas decreased by 2.05 units. The combination of school-based and family-based interventions appears effective in reducing SSB consumption among Chinese schoolchildren, especially in urban areas and for those with parents with lower educational levels.
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Affiliation(s)
- Chenchen Wang
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (X.H.); (W.W.); (H.Z.); (J.W.); (H.X.)
| | - Xin Hong
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (X.H.); (W.W.); (H.Z.); (J.W.); (H.X.)
| | - Weiwei Wang
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (X.H.); (W.W.); (H.Z.); (J.W.); (H.X.)
| | - Hairong Zhou
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (X.H.); (W.W.); (H.Z.); (J.W.); (H.X.)
| | - Jie Wu
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (X.H.); (W.W.); (H.Z.); (J.W.); (H.X.)
| | - Hao Xu
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (X.H.); (W.W.); (H.Z.); (J.W.); (H.X.)
| | - Nan Zhou
- Department of Non-Communicable Disease Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China; (C.W.); (X.H.); (W.W.); (H.Z.); (J.W.); (H.X.)
- Correspondence: (N.Z.); (J.Z.); Tel.: +86-25-5701-0699 (N.Z.)
| | - Jinkou Zhao
- Department of Non-Communicable Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China
- Correspondence: (N.Z.); (J.Z.); Tel.: +86-25-5701-0699 (N.Z.)
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Wohlers K, Wirtz A, Reiter A, Oldiges M, Baumgart M, Bott M. Metabolic engineering of Pseudomonas putida for production of the natural sweetener 5-ketofructose from fructose or sucrose by periplasmic oxidation with a heterologous fructose dehydrogenase. Microb Biotechnol 2021; 14:2592-2604. [PMID: 34437751 PMCID: PMC8601194 DOI: 10.1111/1751-7915.13913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 08/13/2021] [Indexed: 11/30/2022] Open
Abstract
5-Ketofructose (5-KF) is a promising low-calorie natural sweetener with the potential to reduce health problems caused by excessive sugar consumption. It is formed by periplasmic oxidation of fructose by fructose dehydrogenase (Fdh) of Gluconobacter japonicus, a membrane-bound three-subunit enzyme containing FAD and three haemes c as prosthetic groups. This study aimed at establishing Pseudomonas putida KT2440 as a new cell factory for 5-KF production, as this host offers a number of advantages compared with the established host Gluconobacter oxydans. Genomic expression of the fdhSCL genes from G. japonicus enabled synthesis of functional Fdh in P. putida and successful oxidation of fructose to 5-KF. In a batch fermentation, 129 g l-1 5-KF were formed from 150 g l-1 fructose within 23 h, corresponding to a space-time yield of 5.6 g l-1 h-1 . Besides fructose, also sucrose could be used as substrate for 5-KF production by plasmid-based expression of the invertase gene inv1417 from G. japonicus. In a bioreactor cultivation with pulsed sucrose feeding, 144 g 5-KF were produced from 358 g sucrose within 48 h. These results demonstrate that P. putida is an attractive host for 5-KF production.
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Affiliation(s)
- Karen Wohlers
- IBG‐1: BiotechnologyInstitute of Bio‐ and GeosciencesForschungszentrum JülichJülich52425Germany
| | - Astrid Wirtz
- IBG‐1: BiotechnologyInstitute of Bio‐ and GeosciencesForschungszentrum JülichJülich52425Germany
| | - Alexander Reiter
- IBG‐1: BiotechnologyInstitute of Bio‐ and GeosciencesForschungszentrum JülichJülich52425Germany
- Institute of BiotechnologyRWTH Aachen UniversityAachen52062Germany
| | - Marco Oldiges
- IBG‐1: BiotechnologyInstitute of Bio‐ and GeosciencesForschungszentrum JülichJülich52425Germany
- Institute of BiotechnologyRWTH Aachen UniversityAachen52062Germany
| | - Meike Baumgart
- IBG‐1: BiotechnologyInstitute of Bio‐ and GeosciencesForschungszentrum JülichJülich52425Germany
| | - Michael Bott
- IBG‐1: BiotechnologyInstitute of Bio‐ and GeosciencesForschungszentrum JülichJülich52425Germany
- The Bioeconomy Science Center (BioSC)Forschungszentrum JülichJülichD‐52425Germany
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