Sugar Substitutes: Mechanism, Availability, Current Use and Safety Concerns-An Update

Effects Provided by Sugar Substitutes upon the Quality Indicators of Model Systems of Sweetened Condensed Milk in Storage

Sweetened condensed milk (SCM) is a product widely used by both consumers and other food production branches. However, it contains a lot of sucrose. This study aimed to examine the effects provided by sugar substitutes, such as trehalose, isomaltulose, and polydextrose, upon the SCM sensory profile and valuable quality indicators, such as water activity, viscosity, acidity, crystals size, and Maillard reaction potential (browning index, color change, loss of free amino acids). The study was performed by making model systems of SCM (MSCMs) using the method of reconstitution of powdered ingredients. All the presented carbohydrate compositions in MSCMs provided Aw value typical of intermediate-moisture food, which contributes to the long-term shelf-life of the product. However, only 2 MSCMs with compositions consisted of isomaltulose, trehalose (22.55% and 22.55%); trehalose (28.19%), sucrose (5.64%), polydextrose (5.64%), isomaltulose (5.64%) showed the stability of Aw within 14-d storage period. Trehalose and polydextrose in MSCMs with mono-carbohydrate added fraction demonstrated their high structure-forming ability expressed in high values of dynamic viscosity (>30 Pa·s), provided not by crystallization. MSCMs containing trehalose in predominant amount in the carbohydrate compositions (≥50%) showed lower average crystal size (<16 μm) compared with other MSCMs with di- and tetra-carbohydrate added fractions with predominant amount of isomaltulose and polydextrose. Isomaltulose and polydextrose added to MSCMs led to pronounced browning, while trehalose and sucrose reduced this effect in MSCMs with di- and tetra-carbohydrate added fractions. Addition of 22.55% of polydextrose to carbohydrate fraction of MSCMs caused bitterness, while 5.64% didn't affect the taste. Based on the results of all the research conducted the most optimal carbohydrate compositions to produce SCM with lower calorie, sucrose contents and stable adequate values of processing and sensory properties were trehalose (22.55%) with isomaltulose (22.55%) and trehalose (28.19%) with sucrose (5.64%), polydextrose (5.64%), isomaltulose (5.64%).

Recent Advances in Caries Prevention-An Update

Management of dental caries has seen a significant development in recent years. A diagnosis based on risk indicators and risk factor assessments, early identification, and caries prevention are some of the most recent and efficient strategies. The recent advancements in dental caries prevention strategies are briefly covered in this overview.

Time-lapse confocal microscopy to study in vitro Streptococcus mutans surface colonization

The cariogenicity of Streptococcus mutans relates to its ability to form biofilms on dental surfaces. The aim of this work was to develop a flowcell system compatible with time-lapse confocal microscopy to compare the adhesion and accumulation of S. mutans cells on surfaces in unsupplemented media against media containing sucrose or sucralose (a non-metabolized sweetener) over a short period of time. Fluorescent S. mutans 3209/pVMCherry was suspended in unsupplemented media or media supplemented with 1% sucrose or 1% sucralose and passed through a 3D-printed flowcell system. Flowcells were imaged over 60 minutes using a confocal microscope. Image analysis was performed, including a newly developed object-movement-based method to measure biomass adhesion. Streptococcus mutans 3209/pVMCherry grown in 1% sucrose-supplemented media formed small, dense, relatively immobile clumps in the flowcell system measured by biovolume, surface area, and median object centroid movement. Sucralose-supplemented and un-supplemented media yielded large, loose, mobile aggregates. Architectural metrics and per-object movement were significantly different (P < 0.05) when comparing sucrose-supplemented media to either unsupplemented or sucralose-supplemented media. These results demonstrate the utility of a flowcell system compatible with time-lapse confocal microscopy and image analysis when studying initial biofilm formation and adhesion under different nutritional conditions.

Knowledge, attitude, and practice toward non-nutritive sweeteners among the population with reduced sugar intake requirement

Introduction

This study aimed to explore the knowledge, attitude, and practice (KAP) toward non-nutritive sweeteners among a population with reduced sugar intake requirements.

Methods

This cross-sectional study used self-developed questionnaires to collect demographic characteristics and KAP towards non-nutritive sweeteners among respondents with reduced sugar intake requirements, i.e., overweight or obese individuals and patients with pre-diabetes or diabetes.

Results

A total of 639 valid questionnaires were collected, and 51.64% of participants were male. The KAP scores were 7.63 ± 3.58 (range: 0-11), 34.28 ± 7.47 (range: 12-60), and 15.48 ± 3.97 (range: 7-35), respectively. Pearson's correlation analysis showed that knowledge score was positively correlated with attitude (r = 0.229, p < 0.001) and practice score (r = 0.467, p < 0.001), while attitude was positively correlated with practice (r = 0.312, p < 0.001). The structural equation model showed that knowledge was directly and positively associated with attitude (path coefficient = 0.48, p < 0.001) and practice (path coefficient = 0.46, p < 0.001). In addition, the attitude was directly and positively associated with practice (path coefficient = 0.12, p < 0.001). Besides, diabetes was associated with lower knowledge (path coefficient = -0.81, p = 0.038) and practice (path coefficient = -0.42, p < 0.041).

Discussion

Population with the reduced sugar intake requirement showed poor knowledge, negative attitudes, and suboptimal practices toward non-nutritive sweeteners. To optimize the utilization of non-nutritive sweeteners in accordance with medical prescriptions, especially for individuals with diabetes, tailored educational interventions may be designed for participants with lower KAP.

Detoxification of areca nut acid hydrolysate and production of xylitol by Candida tropicalis (MTCC 6192)

Areca nut husk is the most promising alternative source of low-cost raw materials because it contains a considerable amount of five-carbon monosaccharide sugar in the form of xylose. This polymeric sugar can be isolated and transformed into a value-added chemical using fermentation. To extract sugars from areca nut husk fibers, preliminary pretreatment, such as dilute acid hydrolysis (H2SO4), was performed. The hemicellulosic hydrolysate of areca nut husk can produce xylitol through fermentation, but toxic components inhibit the growth of microorganisms. To overcome this, a series of detoxification treatments, including pH adjustment, activated charcoal, and ion exchange resin, were carried out to reduce the concentration of inhibitors in the hydrolysate. This study reports a remarkable 99% removal of inhibitors in the hemicellulosic hydrolysate. Subsequently, a fermentation process using Candida tropicalis (MTCC6192) was executed with the detoxified hemicellulosic hydrolysate of areca nut husk, yielding an optimum xylitol yield of 0.66 g/g. This study concludes that detoxification techniques like pH adjustment, activated charcoal, and ion exchange resins are the most economical and effective methods for eliminating toxic compounds in hemicellulosic hydrolysates. Therefore, the medium derived after detoxification from areca nut hydrolysate may be considered to have significant potential for xylitol production.

Deep eutectic solvents based on sugars for oral applications

Solubility is a critical parameter in drug formulation to achieve the desired therapeutical concentration. Most drugs are weak acids or bases and, therefore, exhibit low solubility and poor oral availability. The main aim of this work is the use of Deep Eutectic Systems (DESs) for improving the solubility of drugs in aqueous medium. In this case, we use DESs formed by choline chloride and sugars (xylitol, fructose, glucose and sorbitol) at different proportions of water. These compounds present low toxicity, and thus can be used in syrups or liquid formulations. Different physicochemical properties, such as density, refractive index, and surface tension, were obtained. In addition, a rheological study of the different systems was carried out. Finally, these DESs were applied to analyse the solubility of the following active principles: caffeine (Class I) and furosemide (Class IV) of the Biopharmaceutics Classification System (BCS). The selection of the drugs attends to different reasons. On one hand, we want to develop a new liquid formulation for model drug furosemide and, on the other hand, the study of caffeine, instead, will be used as a model for comparing purposes. Solubility results show that the systems that best solubilize caffeine are those with the highest water content; however, they do not reach the levels of solubility of pure water. On the other hand, for furosemide, a great increase in solubility was observed, especially for systems formed by xylitol and, fundamentally, in the system with the lowest water content. Obtaining an increase in solubility of up to 4530 times. These systems provide an opportunity to improve the formulation of drugs in the liquid medium of active ingredients that are poorly soluble in an aqueous medium.

Low-no-calorie sweeteners exert marked compound-specific impact on the human gut microbiota ex vivo

Low-no-calorie sweeteners (LNCS) are used as sugar substitutes as part of strategies to reduce the risk of chronic diseases related to high sugar intake (e.g. type 2 diabetes (T2D)). This study investigated how a range of sweeteners [tagatose (TA)/maltitol (MA)/sorbitol (SO)/stevia (ST)/sucralose (SU)/acesulfame K (ACK)] impact the gut microbiota of T2D subjects and healthy human adults using the ex vivo SIFR® technology (n = 12). The cohort covered clinically relevant interpersonal and T2D-related differences. ACK/SU remained intact while not impacting microbial composition and metabolite production. In contrast, TA/SO and ST/MA were respectively readily and gradually fermented. ST and particularly TA/SO/MA increased bacterial density and SCFA production product-specifically: SO increased acetate (∼Bifidobacterium adolescentis), whilst MA/ST increased propionate (∼Parabacteroides distasonis). TA exerted low specificity as it increased butyrate for healthy subjects, yet propionate for T2D subjects. Overall, LNCS exerted highly compound-specific effects stressing that results obtained for one LNCS cannot be generalised to other LNCS.

A review on the immunomodulatory properties of functional nutraceuticals as dietary interventions for children to combat COVID-19 related infections

COVID-19 is a significant threat to humanity in the present day due to the rapid increase in the number of infections worldwide. While most children may be spared of the direct mortality effects of the disease, those with weak immune systems are prone to adverse effects. Child mortality increases due to the stress caused to the health care system that disrupts essential health care needs such as immunisation and antenatal care. The use of functional foods (FF) aids in disease-prevention as they are known to have protective effects against COVID-19 by boosting children’s cellular and humoral immunity. Plant components such as glycyrrhizin, epigallocatechin gallate, allicin, and fucoidan exhibit antiviral properties against various viruses, including SARS-CoV 2. Microbial foods that are made of probiotics, can enhance immunity against various respiratory viruses. Food enriched with additives such as lactoferrin, piperine, and zinc can boost immunity against COVID-19. With proper definitive drug therapy not available for treating COVID-19 and most of the disease management tools rely on symptoms and non-specific supportive care, developing a functional paediatric formulation will prevent further deterioration in infant health. It is wise to investigate the toxicological aspects of Functional Foods components especially when formulating for children. The safe limits of ingredients should be strictly followed during FFs formulation. Stronger regulations with advanced analytical techniques can help to formulate functional foods into the mainstream in child nutraceuticals. The purpose of this review is to compile collective information on the functional nutraceuticals specifically for infants and children up to the age of 10 years that could confer immunity against COVID-19 and other related viruses.

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.

Analysis of carbohydrates content in the plant components of antidiabetic herbal mixture by GC-MS

Medicinal plants and their combinations due to the wide range of biologically active substances can influence on various links of the pathogenetic mechanism of development of diabetes mellitus and its complications. One of such combinations is an antidiabetic herbal mixture (Urticae folia, Rosae frucrus, Myrtilli folia, Menthae folia and Taraxaci radices) with established hypoglycemic, hypolipidemic, antioxidant, hepatoprotective, pancreatoprotective activity in previous pharmacological study in vivo. Thus, the aim of this study was to identify and establish the content of carbohydrates in free and bound form in the plant components of antidiabetic herbal mixture. The carbohydrates were separated by gas chromatography-mass spectrometry after conversion into volatile derivatives as aldononitrile acetate. The monomeric composition of polysaccharides was studied after their hydrolysis to form monosaccharides and polyalcohols. The results of the quantitative study showed that the predominant carbohydrate in free form was saccharose in Urticae folia, L-fructose in Myrtilli folia, Rosae frucrus, Taraxaci radices and Menthae folia, L-glucose in Rosae frucrus. Concerning the determination of monomers of polysaccharides after hydrolysis, L-glucose prevailed in all plant components of antidiabetic herbal mixture. The chromatographic study revealed a number of polyalcohols that are important for the treatment and prevention of progression of diabetes mellitus and its complications, namely, mannitol and myo-inositol.

Determination of carbohydrates in the herbal antidiabetic mixtures by GC-MC

Due to the wide range of biologically active substances, the herbal mixtures can influence the development of diabetes mellitus and its complications. Carbohydrates attract particular attention due to their hypoglycemic, hypolipidemic, anticholesterolemic, antioxidant, antiinflammatory and detoxifying activities. The aim of this study was to investigate the content of carbohydrates through their monomeric composition in the herbal mixture samples: a) Urtica dioica leaf, Cichorium intybus roots, Rosa majalis fruits, Elymys repens rhizome, Taraxacum officinale roots, b) Arctium lappa roots, Elymys repens rhizome, Zea mays columns with stigmas, Helichrysum arenarium flowers, Rosa majalis fruits, c) Inula helenium rhizome with roots, Helichrysi arenarium flowers, Zea mays columns with stigmas, Origanum vulgare herb, Rosa majalis fruits, Taraxacum officinale roots, d) Cichorium intybus roots, Elymys repens rhizome, Helichrysum arenarium flowers, Rosa majalis fruits, Zea mays columns with stigmas and e) Urtica dioica leaf, Taraxacum officinale roots, Vaccinium myrtillus leaf, Rosa majalis fruits, Mentha piperita herb, which were used in Ukrainian folk medicine for the prevention and treatment of diabetes mellitus type 2.The carbohydrates were separated by gas chromatography-mass spectrometry after conversion into volatile aldononitrile acetate derivatives. The monomeric composition of polysaccharides was studied after their hydrolysis to form monosaccharides and poly-alcohols.Quantitative analyses of free carbohydrates showed that the predominant sugars were fructose, glucose and disaccharide - sucrose, in all samples. Concerning the determination of polysaccharide monomers after hydrolysis, glucose was the most abundant in all samples. The chromatographic study revealed a number of polyalcohols that are important for the treatment and prevention of progression of diabetes mellitus and its complications, namely, mannitol, pinitol and myo-inositol.

Effect of stevia, xylitol, and corn syrup in the development of velvet tamarind (Dialium indum L.) chewy candy

The research aimed to study the effect of stevia, xylitol, and corn syrup on the physical, physicochemical, and sensory properties of velvet tamarind chewy candy (VTCC). The content of sweeteners was optimized using stevia (5.5-6%), xylitol (5.5-6%), and corn syrup (7.5-8.5%) by mixture design (d-optimal) with 3 centerpoints and response surface methodology (RSM). The sweeteners in optimized VTCC consisted of velvet tamarind powder (40.5%), water (40%), stevia (6%), xylitol (6%), and corn syrup (7.5%) which provided the approximation error between prediction and observation values: of color (a* and b*), hardness, adhesiveness, gumminess, bioactive activities, and sensory properties within the range of 0.07-9.69%. The optimized VTCC using stevia and xylitol can reduce the sugar content by up to 60%. The sensory preference scores of VTCC from consumer acceptance were slightly like (6.1-6.9) which indicated that the VTCC with stevia and xylitol can provide satisfaction in all evaluated attributes and can be applied to this concept to create fruit chewy candy using stevia and xylitol.

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.

Fructose and high fructose corn syrup: are they a two-edged sword?

High-fructose syrups are used as sugar substitutes due to their physical and functional properties. High fructose corn syrup (HFCS) is used in bakery products, dairy products, breakfast cereals and beverages, but it has been reported that there might be a direct relationship between high fructose intake and adverse health effects such as obesity and the metabolic syndrome. Thus, fructose has recently received much attention, most of which was negative. Although studies have indicated that there might be a correlation between high fructose-rich diet and several adverse effects, however, the results of these studies cannot be certainly generalised to the effects of HFCS; because they have investigated pure fructose at very high concentrations in measurement of metabolic upsets. This review critically considered the advantages and possible disadvantages of HFCS application and consumption in food industry, as a current challenging issue between nutritionists and food technologists.

Neuroendocrine and Metabolic Effects of Low-Calorie and Non-Calorie Sweeteners

Since excessive sugar consumption has been related to the development of chronic metabolic diseases prevalent in the western world, the use of sweeteners has gradually increased worldwide over the last few years. Although low- and non-calorie sweeteners may represent a valuable tool to reduce calorie intake and prevent weight gain, studies investigating the safety and efficacy of these compounds in the short- and long-term period are scarce and controversial. Therefore, future studies will need to elucidate the potential beneficial and/or detrimental effects of different types of sweeteners on metabolic health (energy balance, appetite, body weight, cardiometabolic risk factors) in healthy subjects and patients with diabetes, obesity and metabolic syndrome. In this regard, the impact of different sweeteners on central nervous system, gut hormones and gut microbiota is important, given the strong implications that changes in such systems may have for human health. The aim of this narrative review is to summarize the current evidence for the neuroendocrine and metabolic effects of sweeteners, as well as their impact on gut microbiota. Finally, we briefly discuss the advantages of the use of sweeteners in the context of very-low calorie ketogenic diets.

How Fluoride Protects Dental Enamel from Demineralization

Introduction:

How fluoride (F^–) protects dental enamel from caries is here conveyed to dental health-care providers by making simplifying approximations that accurately convey the essential principles, without obscuring them in a myriad of qualifications.

Materials and Methods:

We approximate that dental enamel is composed of calcium hydroxyapatite (HAP), a sparingly soluble ionic solid with the chemical formula Ca₁₀(PO₄)₆(OH)₂.

Results:

The electrostatic forces binding ionic solids together are described by Coulomb’s law, which shows that attractions between opposite charges increase greatly as their separation decreases. Relatively large phosphate ions (PO₄^3–) dominate the structure of HAP, which approximates a hexagonal close-packed structure. The smaller Ca²⁺ and OH^– ions fit into the small spaces (interstices) between phosphates, slightly expanding the close-packed structure. F^– ions are smaller than OH^– ions, so substituting F^– for OH^– allows packing the same number of ions into a smaller volume, increasing their forces of attraction. Dental decay results from tipping the solubility equilibrium Ca₁₀(PO₄)₆(OH)₂ (s) ⇔ 10Ca²⁺ (aq) + 6PO₄^2– (aq) + 2OH^– (aq) toward dissolution. HAP dissolves when the product of its ion concentrations, [Ca²⁺]¹⁰×[PO₄^3–]⁶×[OH^–]², falls below the solubility product constant (Ksp) for HAP.

Conclusion:

Because of its more compact crystal structure, the Ksp for fluorapatite (FAP) is lower than the Ksp for HAP, so its ion product, [Ca²⁺]¹⁰×[PO₄^3–]⁶×[F^–]², must fall further before demineralization can occur. Lowering the pH of the fluid surrounding enamel greatly reduces [PO₄^3–] (lowering the ion products of HAP and FAP equally), but [OH^–] falls much more rapidly than [F^–], so FAP better resists acid attack.

Differences in Sole Carbon Source Utilization of the Dental Plaque Microbiota Between Caries-Free and Caries-Affected Children

Increasing lines of evidence indicate that while microbial profile might vary, community-level metabolic potential is often more stably correlated with healthy and diseased states. Here, we investigated the community-level metabolic diversity of dental plaque microbiota from caries-free (CF) and caries-affected (CA) children by measuring their sole carbon source utilization using a Biolog assay. The dietary habits of 32 CF and 31 CA children were recorded by a questionnaire. Supragingival plaque samples were collected and inoculated into Biolog AN Microplates to assess the metabolism of sole carbon sources by plaque bacteria. The results revealed significant differences in dietary habits between CF and CA children. Meanwhile, Biolog assay showed consistently higher, albeit not statistically significant, overall metabolic activity as measured by average well color development (AWCD) value in the plaque microbiota from CA group than CF group. Most importantly, the CA group had more than twice as many core-positive carbon sources (defined as being utilized by >90% of plaque microbiota from subjects within the group) as that of the CF group (31 vs. 14), including CA group-specific, cariogenic core-positive carbon sources such as sucrose, glucose and raffinose. Furthermore, CF and CA groups could be well distinguished by cluster and principle component analyses based on the types of sole carbon sources significantly differentially utilized by the two groups. Our results indicate that plaque communities associated with caries state are more metabolically versatile than those associated with healthy state, which could contribute to differential clinical caries states. Meanwhile, Biolog could be an effective tool in revealing the community-level physiological profiles of microbiota associated with different caries states.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

This comprehensive review of the 2018 dental literature is provided to inform busy dentists about progress in the profession. Developed by the Committee on Scientific Investigation of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to one of the 8 sections of the report including (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information that will likely influence day-to-day treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source materials if greater detail is desired. As the profession continues its march toward evidence-based clinical decision-making, an already voluminous library of potentially valuable dental literature continues to grow. It is the intention of this review and its authors to provide assistance in navigating the extensive dental literature published in 2018. It is our hope that readers find this work useful in the clinical management of patients moving forward.