Sucrose, high-fructose corn syrup, and fructose, their metabolism and potential health effects: what do we really know?

The Impact of the High-Fructose Corn Syrup on Cardiac Damage via SIRT1/PGC1-α Pathway: Potential Ameliorative Effect of Selenium

High-fructose corn syrup (HFCS) has been a subject of intense debate due to its association with cardiovascular risks. This study investigates the potential protective effects of selenium (Se) supplementation against cardiac damage induced by HFCS. Thirty-two male Wistar albino rats were divided into four equal groups: control, CS (20%-HFCS), CS with Se (20%-HFCS, 0.3 mg/kg-Se), and Se (0.3 mg/kg-Se) only. After a 6-week period, heart and aorta tissues were collected for histopathological, immunohistochemical, biochemical, and genetic analyses. HFCS consumption led to severe cardiac pathologies, increased oxidative stress, and altered gene expressions associated with inflammation, apoptosis, and antioxidant defenses. In the CS group, pronounced oxidative stress within the cardiac tissue was concomitant with elevated Bcl-2-associated X protein (Bax) expression and diminished expressions of B-cell-lymphoma-2 (Bcl-2), nuclear factor erythroid 2-related factor 2 (Nrf2), peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC1-α), and silenced information regulator 1 (SIRT1). Se supplementation mitigated these effects, showing protective properties. Immunohistochemical analysis supported these findings, demonstrating decreased expressions of caspase-3, tumor necrosis factor-alpha (TNF-α), IL-1β, and vascular endothelial growth factor (VEGF) in the CS + Se group compared to the CS group. The study suggests that Se supplementation exerts anti-inflammatory, antioxidant, and antiapoptotic effects, potentially attenuating HFCS-induced cardiovascular toxicity. These findings highlight the importance of dietary considerations and selenium supplementation in mitigating cardiovascular risks associated with HFCS consumption.

Clean-label alternatives for food preservation: An emerging trend

Consumer demand for natural or 'clean-label' food ingredients has risen over the past 50 years and continues growing. Consumers have become more aware of their health and, therefore, insist on transparency in the list of ingredients. Preservatives are the most crucial food additives, ensuring food safety and security. Despite tremendous technological advancements, food preservation remains a significant challenge worldwide, primarily because most are synthetic and non-biodegradable. As a result, the food industry is placing more value on microbiota and other natural sources for bio-preservation, leading to the substitution of conventional processing and chemical preservatives with natural alternatives to ensure 'clean-label.' General Standard for Food Additives (GSFA) includes some of these 'clean-label' options in its list of additives. However, they are very rarely capable of replacing a synthetic preservative on a 'one-for-one' basis, putting pressure on researchers to decipher newer, cleaner, and more economical alternatives. Academic and scientific research has led to the discovery of several plant, animal, and microbial metabolites that may function as effective bio-preservatives. However, most have not yet been put in the market or are under trial. Hence, the present review aims to summarise such relevant and potential metabolites with bio-preservative properties comprehensively. This article will help readers comprehend recent innovations in the 'clean-label' era, provide informed choices to consumers, and improve the business of regulatory approvals.

Silymarin inhibits the lipogenic pathway and reduces worsening of non-alcoholic fatty liver disease (NAFLD) in mice

CONTEXT

The role of silymarin in hepatic lipid dysfunction and its possible mechanisms of action were investigated.

OBJECTIVE

To evaluate the effects of silymarin on hepatic and metabolic profiles in mice fed with 30% fructose for 8 weeks.

METHODS

We evaluated the antioxidant profile of silymarin; mice consumed 30% fructose and were treated with silymarin (120 mg/kg/day or 240 mg/kg/day). We performed biochemical, redox status, and histopathological assays. RT-qPCR was performed to detect ACC-1, ACC-2, FAS, and CS expression, and western blotting to detect PGC-1α levels.

RESULTS

Silymarin contains high levels of phenolic compounds and flavonoids and exhibited significant antioxidant capacity in vitro. In vivo, the fructose-fed groups showed increased levels of AST, ALT, SOD/CAT, TBARS, hepatic TG, and cholesterol, as well as hypertriglyceridaemia, hypercholesterolaemia, and increased ACC-1 and FAS. Silymarin treatment reduced these parameters and increased mRNA levels and activity of hepatic citrate synthase.

CONCLUSIONS

These results suggest that silymarin reduces worsening of NAFLD.

Regulation of Fructose Metabolism in Nonalcoholic Fatty Liver Disease

Elevations in fructose consumption have been reported to contribute significantly to an increased incidence of obesity and metabolic diseases in industrial countries. Mechanistically, a high fructose intake leads to the dysregulation of glucose, triglyceride, and cholesterol metabolism in the liver, and causes elevations in inflammation and drives the progression of nonalcoholic fatty liver disease (NAFLD). A high fructose consumption is considered to be toxic to the body, and there are ongoing measures to develop pharmaceutical therapies targeting fructose metabolism. Although a large amount of work has summarized the effects fructose exposure within the intestine, liver, and kidney, there remains a gap in our knowledge regarding how fructose both indirectly and directly influences immune cell recruitment, activation, and function in metabolic tissues, which are essential to tissue and systemic inflammation. The most recent literature demonstrates that direct fructose exposure regulates oxidative metabolism in macrophages, leading to inflammation. The present review highlights (1) the mechanisms by which fructose metabolism impacts crosstalk between tissues, nonparenchymal cells, microbes, and immune cells; (2) the direct impact of fructose on immune cell metabolism and function; and (3) therapeutic targets of fructose metabolism to treat NAFLD. In addition, the review highlights how fructose disrupts liver tissue homeostasis and identifies new therapeutic targets for treating NAFLD and obesity.

Characterization of gluten-free cupcakes without sucrose based on defatted soybean flour and monk fruit

This study aimed to produce and characterize a novel gluten-free cupcake for celiac and diabetes people. For this purpose, wheat flour and sugar in the cupcake formulation were fully replaced with soy flour and monk fruit. Also, samples containing wheat flour with sugar and monk fruit were prepared for comparison. The gluten-free cupcake without sucrose had a less specific volume and porosity index. To improve these properties, Cydonia oblonga (Cydonia Vulgaris) and Plantago ovata (Plantago genus) were used individually and in combination at concentrations of 1 and 2%. The cake containing no gum was made as a control as well. It was observed that addition of gums had positive effects on the specific volume, porosity index, and weight loss of cakes, but their incorporation increased their hardness. Based on the results, the fabrication of a novel and successful gluten-free cupcake replaced with soy flour, monk fruit, and gum is possible.

Associations of Sugar-Sweetened Beverages, Artificially Sweetened Beverages, and Pure Fruit Juice With Nonalcoholic Fatty Liver Disease: Cross-sectional and Longitudinal Study

OBJECTIVE

We aimed to test the associations of sugar-sweetened beverages (SSB), artificially sweetened beverages (ASB), and pure fruit juice (PJ) consumption with the risk of nonalcoholic fatty liver disease (NAFLD).

METHODS

Data for 136 277 UK Biobank participants who completed the dietary questionnaire and did not have a history of liver disease were included. Logistic regression was used for the cross-sectional setting where NAFLD was defined by a fatty liver index (FLI) ≥60. Cox proportional hazard regression was used for the longitudinal setting where hospitalized NAFLD was defined as hospital admission with Internationl Classification of Diseases-10 codes K76.0 and K75.8.

RESULTS

Compared with 0 L/wk for corresponding beverages, multivariate-adjusted odds ratios (95% confidence intervals) for NAFLD in consumption ≤1, 1 to 2, and >2 L/wk were 1.06 (1.02-1.10), 1.24 (1.19-1.29), and 1.42 (1.35-1.49) for SSB; 1.43 (1.37-1.50), 1.73 (1.65-1.82), and 2.37 (2.25-2.50) for ASB, and 0.87 (0.84-0.89), 0.91 (0.88-0.94), and 1.07 (1.02-1.13) for PJ, respectively. Consumption of SSB and ASB were both positively correlated with FLI (P for line < .001). During a median follow-up of 10.2 years, 1043 cases of hospitalized NAFLD were recorded. ASB consumption of 1 to 2 and >2 L/wk was associated with a 22% (0.99-1.50) and 35% (1.11-1.65) increased risk of hospitalized NAFLD, respectively (P for trend = .002). However, the associations of SSB and PJ with the risk of hospitalized NAFLD were not significant.

CONCLUSIONS

Consumption of SSB, ASB, and PJ were all related to the risk of NAFLD. Excessive consumption of ASBs was associated with an increased risk of incident hospitalized NAFLD.

Fructose-containing food sources and blood pressure: A systematic review and meta-analysis of controlled feeding trials

Whether food source or energy mediates the effect of fructose-containing sugars on blood pressure (BP) is unclear. We conducted a systematic review and meta-analysis of the effect of different food sources of fructose-containing sugars at different levels of energy control on BP. We searched MEDLINE, Embase and the Cochrane Library through June 2021 for controlled trials ≥7-days. We prespecified 4 trial designs: substitution (energy matched substitution of sugars); addition (excess energy from sugars added); subtraction (excess energy from sugars subtracted); and ad libitum (energy from sugars freely replaced). Outcomes were systolic and diastolic BP. Independent reviewers extracted data. GRADE assessed the certainty of evidence. We included 93 reports (147 trial comparisons, N = 5,213) assessing 12 different food sources across 4 energy control levels in adults with and without hypertension or at risk for hypertension. Total fructose-containing sugars had no effect in substitution, subtraction, or ad libitum trials but decreased systolic and diastolic BP in addition trials (P<0.05). There was evidence of interaction/influence by food source: fruit and 100% fruit juice decreased and mixed sources (with sugar-sweetened beverages [SSBs]) increased BP in addition trials and the removal of SSBs (linear dose response gradient) and mixed sources (with SSBs) decreased BP in subtraction trials. The certainty of evidence was generally moderate. Food source and energy control appear to mediate the effect of fructose-containing sugars on BP. The evidence provides a good indication that fruit and 100% fruit juice at low doses (up to or less than the public health threshold of ~10% E) lead to small, but important reductions in BP, while the addition of excess energy of mixed sources (with SSBs) at high doses (up to 23%) leads to moderate increases and their removal or the removal of SSBs alone (up to ~20% E) leads to small, but important decreases in BP in adults with and without hypertension or at risk for hypertension. Trial registration: Clinicaltrials.gov: NCT02716870.

Management of metabolic syndrome by nutraceuticals prepared from chitosan and ferulic acid with or without beta-sitosterol and their nanoforms

Dyslipidemia, steatohepatitis and insulin resistance are among the components of metabolic syndrome (MS). Nutraceuticals containing chitosan, beta-sitosterol and/or ferulic acid and their nanostructures could have a potential role for management of MS. The aim of the present study was to assess the efficacy of the aforementioned nutraceuticals in treatment of MS in rat and their interaction with atorvastatin, a hypolipidemic drug. The two nutraceuticals and their nanostructures were prepared and the nanostructures were assessed by transmission electron microscope and Fourier-Transform Infra-red Spectrometry. MS was induced in rats by feeding high fructose-high fat diet (HFFD). Different groups of rats fed HFFD and treated with the different nutraceuticals, atorvastatin and atorvastatin in combination with different nutraceuticals, control fed on balanced diet and control consumed HFFD without treatments were run. Plasma glucose, lipid profile, aminotransferases activity, total antioxidant capacity, malondialdehyde, urea, creatinine, insulin, high sensitivity C-reactive protein, and adiponectin were assessed along with calculation of insulin resistance. Liver fat and histopathology were investigated. All nutraceuticals in original and nanostructures showed beneficial effects in the treatment of MS, superiority was ascribed to nutraceuticals composed of chitosan and ferulic acid in both forms. A more promising treatment of MS belonged to atorvastatin administered with the different nutraceuticals.

Effects of Natural Alternative Sweeteners on Metabolic Diseases

The rising prevalence of obesity and diabetes is a significant health concern both in globally and is now regarded as a worldwide epidemic. Added sugars like sucrose and high-fructose corn syrup (HFCS) are a major concern due to their link with an increased incidence of diet-induced obesity and diabetes. The purpose of this review is to provide insight into the effects of natural sweeteners as alternatives to sucrose and HFCS, which are known to have negative impacts on metabolic diseases and to promote further research on sugar consumption with a focus on improving metabolic health. The collective evidences suggest that natural alternative sweeteners have positive impacts on various markers associated with obesity and diabetes, including body weight gain, hepatic fat accumulation, abnormal blood glucose or lipid homeostasis, and insulin resistance. Taken together, natural alternative sweeteners can be useful substitutes to decrease the risk of obesity and diabetes compared with sucrose and HFCS.

Strategies for Producing Low FODMAPs Foodstuffs: Challenges and Perspectives

In recent years, there has been a growing interest in a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) as a promising therapeutic approach to reduce the symptoms associated with irritable bowel syndrome (IBS). Hence, the development of low FODMAPs products is an important challenge for the food industry, and among the various foodstuffs associated with the intake of FODMAPs, cereal-based products represent an issue. In fact, even if their content in FODMAPs is limited, their large use in diet can be an important factor in developing IBS symptoms. Several useful approaches have been developed to reduce the FODMAPs content in processed food products. Accurate ingredient selection, the use of enzymes or selected yeasts, and the use of fermentation steps carried out by specific lactic bacteria associated with the use of sourdough represent the technical approaches that have been investigated, alone or in combination, to reduce the FODMAPs content in cereal-based products. This review aims to give an overview of the technological and biotechnological strategies applicable to the formulation of low-FODMAPs products, specifically formulated for consumers affected by IBS. In particular, bread has been the foodstuff mainly investigated throughout the years, but information on other raw or processed products has also been reported. Furthermore, taking into account the required holistic approach for IBS symptoms management, in this review, the use of bioactive compounds that have a positive impact on reducing IBS symptoms as added ingredients in low-FODMAPs products is also discussed.

Sugar Molecules Detection via C2N Transistor-Based Sensor: First Principles Modeling

Real-time detection of sugar molecules is critical for preventing and monitoring diabetes and for food quality evaluation. In this article, a field effect transistor (FET) based on two-dimensional nitrogenated holey graphene (C₂N) was designed, developed, and tested to identify the sugar molecules including xylose, fructose, and glucose. Both density functional theory and non-equilibrium Green's function (DFT + NEGF) were used to study the designed device. Several electronic characteristics were studied, including work function, density of states, electrical current, and transmission spectrum. The proposed sensor is made of a pair of gold electrodes joint through a channel of C₂N and a gate was placed underneath the channel. The C₂N monolayer distinctive characteristics are promising for glucose sensors to detect blood sugar and for sugar molecules sensors to evaluate food quality. The electronic transport characteristics of the sensor resulted in a unique signature for each of the sugar molecules. This proposed work suggests that the developed C₂N transistor-based sensor could detect sugar molecules with high accuracy.

Fructose-Induced Alteration of the Heart and Vessels Homeostasis

To date, the role of uncontrolled sugar consumption in the triggering and progression of cardiovascular events is undeniable. Modern concepts offer a new hypothesis regarding the direct myocardiotoxic effects of fructose. Experimental studies have demonstrated that cardiomyocytes have a unique ability to transport and use fructose along with the expression of all components involved in fructose metabolism. The purpose of this review article is to assess and analyze the available knowledge on fructose-induced cardiotoxicity detection since understanding the pathophysiological mechanisms and pathobiochemical aspects will become the basis for the determination of a rational myocardioprotection regimen.

Differential Effect of Fructose in the Presence or Absence of Fatty Acids on Circadian Metabolism in Hepatocytes

We aimed to explore whether fructose in the absence or presence of fatty acids modulates circadian metabolism in AML-12 hepatocytes. Fructose treatment under steatosis conditions (FruFA) led to fat synthesis resulting in increased triglycerides and cholesterol content. Fructose led to reduced activity of the AMPK and mTOR-signaling pathway. However, FruFA treatment led to inhibition of the AMPK signaling pathway but activation of the mTOR pathway. Fructose also increased the expression of inflammatory markers, whereas the addition of fatty acids dampened their circadian expression. At the clock level, fructose or FruFA altered the expression of the core clock. More specifically, fructose led to altered expression of the BMAL1-RORα-REV-ERBα axis, together with reduced phosphorylated BMAL1 levels. In conclusion, our results show that hepatocytes treated with fructose respond differently if fatty acids are present, leading to a differential effect on metabolism and circadian rhythms. This is achieved by modulating BMAL1 activity and expression.

Investigation of fructose consumption on hippocampal insulin and glucagon-like peptide-1 receptors, and metabolic effects in rats

Objectives

The detrimental effects of high fructose consumption on metabolic health have been extensively studied. However, limited research has focused on the impact of fructose intake on neuroprotective mechanisms, specifically the expression of insulin receptor (INSR) and glucagon-like peptide-1 receptor (GLP-1R) in the hippocampus. Understanding the effects of fructose on these neuroprotective molecules can provide valuable insights into the potential role of fructose in hippocampal dysfunction. The goal of this study is to aim at the basal plasma levels of lipid profile, insulin, GLP-1, and HOMA-IR, as well as the mRNA and protein expression of neuroprotective molecules such as INSR and GLP-1R in Wistar rats fed a high fructose diet.

Materials and Methods

Rats were separated into control (C) and high fructose (HF) groups. The HF group was given 20% fructose water to drink for 16 weeks.

Results

Fructose ingestion significantly increased abdominal fat (C=1.24±0.08 g, HF=1.79±0.19 g, P<0.05) and plasma triglyceride levels (C=179.22±22.85 µg/ml, HF=242.45±14.45 µg/ml, P<0.05), but had no statistically significant effect on body weight and plasma HDL, LDL, total cholesterol, insulin, and GLP-1 levels (P>0.05). Although INSR mRNA expression in the hippocampus was significantly lower in the HF group compared to the control group (P<0.05), GLP-1R mRNA expression did not differ significantly across the groups (P>0.05). Furthermore, whereas INSR and GLP-1R protein levels in the experimental group were on a declining trend, this trend was not substantially different (P>0.05).

Conclusion

These data suggest that fructose consumption may be harmful to the hippocampus by lowering the expression of INSR.

Distinct impacts of fat and fructose on the liver, muscle, and adipose tissue metabolome: An integrated view

Objective

In the last years, changes in dietary habits have contributed to the increasing prevalence of metabolic disorders, such as non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). The differential burden of lipids and fructose on distinct organs needs to be unveiled. Herein, we hypothesized that high-fat and high-fructose diets differentially affect the metabolome of insulin-sensitive organs such as the liver, muscle, and different adipose tissue depots.

Methods

We have studied the impact of 12 weeks of a control (11.50% calories from fat, 26.93% from protein, and 61.57% from carbohydrates), high-fat/sucrose (HFat), or high-fructose (HFruct) feeding on C57Bl/6J male mice. Besides glucose homeostasis, we analyzed the hepatic levels of glucose and lipid-metabolism-related genes and the metabolome of the liver, the muscle, and white (WAT) and brown adipose tissue (BAT) depots.

Results

HFat diet led to a more profound impact on hepatic glucose and lipid metabolism than HFruct, with mice presenting glucose intolerance, increased saturated fatty acids, and no glycogen pool, yet both HFat and HFruct presented hepatic insulin resistance. HFat diet promoted a decrease in glucose and lactate pools in the muscle and an increase in glutamate levels. While HFat had alterations in BAT metabolites that indicate increased thermogenesis, HFruct led to an increase in betaine, a protective metabolite against fructose-induced inflammation.

Conclusions

Our data illustrate that HFat and HFruct have a negative but distinct impact on the metabolome of the liver, muscle, WAT, and BAT.

Characteristics of Normalization Methods in Quantitative Urinary Metabolomics—Implications for Epidemiological Applications and Interpretations

A systematic comparison is presented for the effects of seven different normalization schemes in quantitative urinary metabolomics. Morning spot urine samples were analyzed with nuclear magnetic resonance (NMR) spectroscopy from a population-based group of 994 individuals. Forty-four metabolites were quantified and the metabolite–metabolite associations and the associations of metabolite concentrations with two representative clinical measures, body mass index and mean arterial pressure, were analyzed. Distinct differences were observed when comparing the effects of normalization for the intra-urine metabolite associations with those for the clinical associations. The metabolite–metabolite associations show quite complex patterns of similarities and dissimilarities between the different normalization methods, while the epidemiological association patterns are consistent, leading to the same overall biological interpretations. The results indicate that, in general, the normalization method appears to have only minor influences on standard epidemiological regression analyses with clinical/physiological measures. Multimetabolite normalization schemes showed consistent results with the customary creatinine reference. Nevertheless, interpretations of intra-urine metabolite associations and nuanced understanding of the epidemiological associations call for comparisons with different normalizations and accounting for the physiology, metabolism and kidney function related to the normalization schemes.

[Research Progress in High-Sugar Diet and Inflammatory Diseases]

High-sugar diet causes various diseases, including insulin resistance, diabetes, and non-alcoholic fatty liver disease (NAFLD). In recent years, as researchers probe deeper and deeper into issues concerning high-sugar diet, the impact of high-sugar diet on inflammatory diseases such as autoimmune diseases and infectious diseases has been gradually uncovered and clarified. In this review, we summarized the current research progress on high-sugar diet and inflammatory diseases, and suggested that a high-sugar diet based on high intake of glucose and fructose may be an important factor inducing the exacerbation of chronic inflammatory diseases such as autoimmune diseases. Moreover, we also summarized the regulatory mechanisms through which high-sugar diet induces exacerbation of inflammatory diseases. In addition, we stated that conducting extensive clinical research and research in real-life settings and pursuing thorough investigation to reveal the different involvement of high-glucose diet and high-fructose diet in immune regulation are the key scientific issues that need urgent solutions in the future.

Pathways in the association between added sugar consumption, obesity in mother-child dyads, and chronic oral disease burden in early childhood

In this study, we modeled the pathways in the association of socioeconomic status, frequency of added sugar consumption, and obesity in mother-child dyads with chronic oral disease burden in early childhood using structural equation modeling. A population-based study was conducted on preschoolers from public daycare centers in São Luís, Brazil (n = 674) and their mothers. Chronic oral disease burden in early childhood was a latent variable, representing the shared variance of the following indicators: visible plaque index, gingivitis, and dental caries. A higher consumption frequency of added sugars by children [standardized regression coefficient (SC) = 0.219] explained the chronic oral disease burden. A higher consumption frequency of added sugars by mothers was associated with greater consumption of sugar by children (SC = 0.236), and indirectly with a greater chronic oral disease burden (SC = 0.052). Maternal obesity was associated with obesity in the offspring (SC = 0.130). The chronic oral disease burden is already present in early childhood and can be explained by the higher consumption of added sugars by the mother-child dyad. Approaches to preventing chronic oral diseases should focus on common risk factors, start early in life, and promote family involvement in this process.

Temporal effect of fructose supplementation at different concentrations on hepatic metabolism of Wistar rats

INTRODUCTION

Introduction: in the last few years important changes have occurred in nutritional patterns. There has been an increase in the consumption of simple carbohydrates such as fructose, which has been associated with numerous metabolic disorders, including hepatic steatosis. Materials and methods: we sought to evaluate the impact of fructose consumption, as diluted in water at different concentrations, for two time periods, on the metabolic parameters of Wistar rats using ANOVA. Results: our data indicate that both time and fructose concentration promote variations in animal body mass, and in food, water, and caloric intake. The time variable influenced the modulation of biochemical parameters such as serum concentrations of glucose and total cholesterol. Both fructose concentration and time of exposure influenced the concentrations of serum triglycerides, creatinine, AST, TNF, and IL-6. When evaluating redox status and oxidative damage markers, we observed that fructose concentration and exposure time had an effect on total glutathione levels, which decreased with an increase in concentration and time. For superoxide dismutase, we evaluated the effects of time and interaction. A significant interaction was observed for TBARS. For carbonylated proteins, exposure time was a fundamental factor in generating an effect. Conclusions: we demonstrated that fructose modulates the parameters of triglycerides and total liver cholesterol, and that time influences the number of hepatocytes. Our data suggest that fructose concentration, exposure time, and an interaction between these two parameters have a significant effect on the metabolic parameters responsible for the development of non-alcoholic fatty liver disease.

Sucralose enhances the susceptibility to dextran sulfate sodium (DSS) induced colitis in mice with changes in gut microbiota

Sucralose is one of the most widely used artificial sweeteners, free of nutrients and calories. Its approval and uses correlate with many of the worldwide epidemiological changes in inflammatory bowel disease (IBD). Multiple animal studies by us and others showed that sucralose exacerbated ileitis in SAMP1/YitFc mice and 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis in rats. In this study, we further investigated the effect of sucralose on dextran sulfate sodium (DSS)-induced colitis in mice and the associated mechanisms. Male C57BL/6 mice received 1.5 mg ml^-1 sucralose in drinking water for 6 weeks. Then, 2.5% DSS was added to drinking water for 7 days to induce ulcerative colitis (UC). The results showed that, compared with the DSS group, administration of sucralose exacerbated the severity of colitis as indicated by the further decrease in body weight, increase in disease activity index (DAI) and the expression of pro-inflammatory cytokines, as well as the activation of the TLR5-MyD88-NF-κB signaling pathway, and the disturbances of intestinal barrier function, along with changes in the intestinal microbiota. Our findings indicate that sucralose may increase the susceptibility to DSS-induced colitis through causing dysbiosis of intestinal microbiota and damage to the intestinal barrier.

Total and Free Sugar Levels and Main Types of Sugars Used in 18,784 Local and Imported Pre-Packaged Foods and Beverages Sold in Hong Kong

There is limited information regarding the free sugar content of pre-packaged foods in Hong Kong. This study aims to assess the free sugar content and identify the most frequently used free sugar ingredients (FSI) in pre-packaged foods in Hong Kong. Data from 18,784 products from the 2019 FoodSwitch Hong Kong database were used in this analysis. Ingredient lists were screened to identify FSI. Total sugar content was derived from nutrition labels on packaging. Free sugar content was estimated based on adaptation of a previously established systematic methodology. Descriptive statistics of the total sugar and free sugar content, as well as the mean ± SD contribution of free sugar to total sugar of the audited products were calculated, stratified by food groups. Almost two-thirds (64.5%) of the pre-packaged foods contained at least one FSI. 'Sugar (sucrose)' was the most popular FSI that was found in more than half (54.7%) of the products. 'Fruit and vegetable juices' (median 10.0; IQR 8.3-11.5 g/100 mL) were found to have a higher median free sugar content than 'Soft drinks' (8.0; 6.0-10.6 g/100 mL). Mean ± SD contribution of free sugar to the total sugar content was 65.8 ± 43.4%, with 8 out of 14 food groups having >70% total sugar as free sugar. To conclude, free sugar, especially sucrose, was extensively used in a wide variety of pre-packaged products sold in Hong Kong. Further studies are needed to assess the population intake of free sugar in Hong Kong to inform public health policy on free sugar reduction.

Evaluation of sucrose-enriched diet consumption in the development of risk factors associated to type 2 diabetes, atherosclerosis and non-alcoholic fatty liver disease in a murine model

Overconsumption of sucrose, the main contributor of the total added sugar intake in the world, has been associated with negative metabolic effects related to non-communicable diseases. However, this relationship continues to be a controversial topic and further studies are needed. The aim of this study was to evaluate the sucrose-enriched diet consumption in the development of risk factors associated with type 2 diabetes, atherosclerosis and non-alcoholic fatty liver disease in a murine model. Sucrose-enriched diet-fed rats showed a decrease in food, lipids and protein intake as well as in serum total cholesterol levels, an increase in carbohydrates intake, glucose, insulin, triglycerides, VLDL-c and HDL-c levels and a greater degree of insulin resistance, steatosis and non-alcoholic steatohepatitis. Our results show that sucrose-enriched diet consumption during 25 weeks contribute to the development of risk factors associated with type 2 diabetes, atherosclerosis and non-alcoholic fatty liver disease in male Wistar rats.

Dietary simple sugars alter microbial ecology in the gut and promote colitis in mice

The higher prevalence of inflammatory bowel disease (IBD) in Western countries points to Western diet as a possible IBD risk factor. High sugar, which is linked to many noncommunicable diseases, is a hallmark of the Western diet, but its role in IBD remains unknown. Here, we studied the effects of simple sugars such as glucose and fructose on colitis pathogenesis in wild-type and Il10^-/- mice. Wild-type mice fed 10% glucose in drinking water or high-glucose diet developed severe colitis induced by dextran sulfate sodium. High-glucose-fed Il10^-/- mice also developed a worsened colitis compared to glucose-untreated Il10^-/- mice. Short-term intake of high glucose or fructose did not trigger inflammatory responses in healthy gut but markedly altered gut microbiota composition. In particular, the abundance of the mucus-degrading bacteria Akkermansia muciniphila and Bacteroides fragilis was increased. Consistently, bacteria-derived mucolytic enzymes were enriched leading to erosion of the colonic mucus layer of sugar-fed wild-type and Il10^-/- mice. Sugar-induced exacerbation of colitis was not observed when mice were treated with antibiotics or maintained in a germ-free environment, suggesting that altered microbiota played a critical role in sugar-induced colitis pathogenesis. Furthermore, germ-free mice colonized with microbiota from sugar-treated mice showed increased colitis susceptibility. Together, these data suggest that intake of simple sugars predisposes to colitis and enhances its pathogenesis via modulation of gut microbiota in mice.

Metabolic Characterization of Meat, Fish, and Soda Intake in Males: Secondary Results from a Randomized Inpatient Pilot Study

OBJECTIVE

This study aimed to evaluate whether a 12-week, weight-maintaining, macronutrient-stable dietary intervention that varies only by meat, fish, or soda consumption alters 24-hour energy expenditure (24hrEE) and substrate oxidation.

METHODS

Healthy males were recruited to participate in a 12-week inpatient study and were randomized to a weight-maintaining dietary intervention that contained varying combinations of meat (0% or 19%), fish (0% or 6%), or soda (0% or 14%) in a factorial design. Macronutrient composition across dietary intervention groups was as follows: 50% of energy from carbohydrates, 30% of energy from fat, and 20% of energy from protein. Whole-room indirect calorimetry at baseline and week 12 were used to measure 24hrEE and substrate oxidation.

RESULTS

Twenty-six males (mean [SEM], age: 46.6 [10.4] years; BMI: 26.9 [4.1] kg/m2 ) completed all measurements. Fish consumption resulted in higher 24hrEE by 126 (55) kcal/d compared with no fish consumption (P = 0.03), whereas 24hrEE for soda consumption was 132 (56) kcal/d (P = 0.03) lower. Approximately 80% of the decrease in 24hrEE with soda consumption was due to lower awake-inactive energy expenditure (EE; P = 0.001). No specific EE component accounted for the differences observed with fish consumption.

CONCLUSIONS

The data indicate that dietary sources of protein and carbohydrates appear to influence 24hrEE and inactive EE.

High Fructose Corn Syrup-Moderate Fat Diet Potentiates Anxio-Depressive Behavior and Alters Ventral Striatal Neuronal Signaling

The neurobiological mechanisms that mediate psychiatric comorbidities associated with metabolic disorders such as obesity, metabolic syndrome and diabetes remain obscure. High fructose corn syrup (HFCS) is widely used in beverages and is often included in food products with moderate or high fat content that have been linked to many serious health issues including diabetes and obesity. However, the impact of such foods on the brain has not been fully characterized. Here, we evaluated the effects of long-term consumption of a HFCS-Moderate Fat diet (HFCS-MFD) on behavior, neuronal signal transduction, gut microbiota, and serum metabolomic profile in mice to better understand how its consumption and resulting obesity and metabolic alterations relate to behavioral dysfunction. Mice fed HFCS-MFD for 16 weeks displayed enhanced anxiogenesis, increased behavioral despair, and impaired social interactions. Furthermore, the HFCS-MFD induced gut microbiota dysbiosis and lowered serum levels of serotonin and its tryptophan-based precursors. Importantly, the HFCS-MFD altered neuronal signaling in the ventral striatum including reduced inhibitory phosphorylation of glycogen synthase kinase 3β (GSK3β), increased expression of ΔFosB, increased Cdk5-dependent phosphorylation of DARPP-32, and reduced PKA-dependent phosphorylation of the GluR1 subunit of the AMPA receptor. These findings suggest that HFCS-MFD-induced changes in the gut microbiota and neuroactive metabolites may contribute to maladaptive alterations in ventral striatal function that underlie neurobehavioral impairment. While future studies are essential to further evaluate the interplay between these factors in obesity and metabolic syndrome-associated behavioral comorbidities, these data underscore the important role of peripheral-CNS interactions in diet-induced behavioral and brain function. This study also highlights the clinical need to address neurobehavioral comorbidities associated with obesity and metabolic syndrome.

How isomaltulose and oligofructose affect physicochemical and sensory properties of muffins?

This article analyses, the replacement of sucrose in muffins with nine different combinations of isomaltulose and oligofructose. Being a structural isomer of sucrose with approx. 50% of sucrose sweetness, isomaltulose is non-cariogenic and with a low glycemic profile but having the same calories as sucrose. Oligofructose is composed of fructose polymers, with a reduced caloric value and prebiotic effect. Specifically, height, percentage of alveoli, water content, A_w , mechanical, and optical properties have been measured along with a sensory evaluation. The results showed that all combinations of sweeteners gave place to softer muffins than control ones. Moreover, isomaltulose caused a darkening of the products likely due to an enhancement of the Maillard reactions. The highest amount of isomaltulose and the absence of sucrose meant the worst score in sweetness and flavor due to the low sweetening powder of isomaltulose.

Difructose anhydride III: a 50-year perspective on its production and physiological functions

Production and applications of difructose anhydride III (DFA-III) have attracted considerable attention because of its versatile physiological functions. Recently, large-scale production of DFA-III has been continuously explored, which opens a horizon for applications in the food and pharmaceutical industries. This review updates recent advances involving DFA-III, including: biosynthetic strategies, purification, and large-scale production of DFA-III; physiological functions of DFA-III and related mechanisms; DFA-III safety evaluations; present applications in food systems, existing problems, and further research prospects. Currently, enzymatic synthesis of DFA-III has been conducted both industrially and in academic research. Two biosynthetic strategies for DFA-III production are summarized: single- and double enzyme-mediated. DFA-III purification is achieved via yeast fermentation. Enzyme membrane bioreactors have been applied to meet the large-scale production demands for DFA-III. In addition, the primary physiological functions of DFA-III and their underlying mechanisms have been proposed. However, current applications of DFA-III are limited. Further research regarding DFA-III should focus on commercial production and purification, comprehensive study of physiological properties, extensive investigation of large-scale human experiments, and expansion of industrial applications. It is worthy to dig deep into potential application and commercial value of DFA-III.

Individual and familial factors associated with caries and gingivitis among adolescents resident in a semi-urban community in South-Western Nigeria

Objectives

We describe the prevalence, and individual and familial risk indicators for dental caries and gingivitis among 10–19-year-old adolescents in Ile-Ife, South-West Nigeria.

Methods

This cross-sectional study collected data through household surveys conducted between December 2018 and January 2019. Adolescents were recruited through multistage sampling. Oral health outcomes were caries, measured by the ‘Decayed, Missing due to caries, and Filled Teeth’ (DMFT) index, and gingivitis, measured by the Loe and Silness gingival index. Explanatory variables were individual (sex, age, oral health perception) and familial (socioeconomic status, birth rank, family size and parental living status) factors. Oral health behaviors (daily tooth-brushing, use of fluoridated toothpaste, consuming refined carbohydrates in-between meals, use of dental floss, dental service utilization in past 12 months, and smoking habits) were treated as confounders. Poisson regression models with robust estimation were constructed to determine associations between explanatory factors and oral health outcomes.

Results

A total of 1472 adolescents were surveyed. Caries prevalence was 3.4%, with mean (standard deviation) DMFT of 0.06 (0.36) and plaque index of 0.84 (0.56). Only 128 (8.7%) adolescents brushed their teeth twice daily, 192 (16.1%) used dental floss daily, 14 (1.1%) utilized dental services in the last 12 months, and 508 (36.1%) consumed refined carbohydrates in-between meals less than once daily. The proportion of respondents who currently smoked cigarettes was 1.6%, and 91.7% of respondents used fluoridated toothpaste daily. The adjusted prevalence ratio of having caries increased by 18% for every additional age-year (APR: 1.18; 95% CI 1.004, 1.34). Additionally, participants with high socioeconomic status had significantly lower prevalence of caries compared to those with lower status (APR: 0.40; 95% CI 0.17, 0.91). Moderate/severe gingivitis was significantly associated with higher frequency of consuming refined carbohydrates in-between meals (APR: 2.33; 95% CI 1.36, 3.99) and higher plaque index scores (APR: 16.24; 95% CI 9.83, 26.82).

Conclusion

Caries prevalence increased with increasing age and was higher among Nigerian adolescents with low socioeconomic status, while moderate/severe gingivitis was associated with frequent consumption of refined carbohydrates and higher plaque index score. While behavioral interventions may reduce the risk of gingivitis, structural interventions may be needed to reduce the risk for caries in this population.

The fructose-dependent acceleration of ethanol metabolism

The aim of the present study was to elucidate how fructose is able to increase the rate of ethanol metabolism in the liver, an observation previously termed the fructose effect. Previous studies suggest that an increase in ATP consumption driven by glucose synthesis from fructose stimulates the oxidation of NADH in the mitochondrial respiratory chain, allowing faster oxidation of ethanol by alcohol dehydrogenase; however, this idea has been frequently challenged. We tested the effects of fructose, sorbose and tagatose both in vitro and in vivo. Both ethanol and each sugar were either added to isolated hepatocytes or injected intraperitoneally in the rat. In the in vitro experiments, samples were taken from the hepatocyte suspension in a time-dependent manner and deproteinized with perchloric acid. In the in vivo experiments, blood samples were taken every 15 min and the metabolites were determined in the plasma. These metabolites include ethanol, glucose, glycerol, sorbitol, lactate, fructose and sorbose. Ethanol oxidation by rat hepatocytes was increased by more than 50% with the addition of fructose. The stimulation was accompanied by increased glucose, glycerol, lactate and sorbitol production. A similar effect was observed with sorbose, while tagatose had no effect. The same pattern was observed in the in vivo experiments. This effect was abolished by inhibiting alcohol dehydrogenase with 4-methylpyrazole, whereas inhibition of the respiratory chain with cyanide did not affect the fructose effect. In conclusion, present results provide evidence that, by reducing glyceraldehyde and glycerol and fructose to sorbitol, respectively, NADH is consumed, allowing an increase in the elimination of ethanol. Hence, this effect is not linked to a stimulation of mitochondrial re-oxidation of NADH driven by ATP consumption.

The Prospective Association of Dietary Sugar Intake in Adolescence With Risk Markers of Type 2 Diabetes in Young Adulthood

Purpose: To examine the prospective relevance of dietary sugar intake (based on dietary data as well as urinary excretion data) in adolescent years for insulin sensitivity and biomarkers of inflammation in young adulthood.

Methods: Overall 254 participants of the DONALD study who had at least two 3-day weighed dietary records for calculating intakes of fructose, glucose, sucrose, total, free, added sugars, total sugars from sugar-sweetened beverages (SSB), juice, and sweets/sugar or at least two complete 24 h urine samples (n = 221) for calculating sugar excretion (urinary fructose and urinary fructose + sucrose) in adolescence (females: 9–15 years, males: 10–16 years) and a fasting blood sample in adulthood (18–36 years), were included in multivariable linear regression analyses assessing their prospective associations with adult homeostasis model assessment insulin sensitivity (HOMA2-%S) and a pro-inflammatory score (based on CRP, IL-6, IL-18, leptin, chemerin, adiponectin).

Results: On the dietary intake level, no prospective associations were observed between adolescent fructose, sucrose, glucose, added, free, total sugar, or total sugar from SSB, juice or sweets/sugar intake and adult HOMA2-%S (p > 0.01). On the urinary level, however, higher excreted fructose levels were associated with improved adult HOMA2-%S (p = 0.008) among females only. No associations were observed between dietary or urinary sugars and the adult pro-inflammatory score (p > 0.01).

Conclusion: The present study did not provide support that dietary sugar consumed in adolescence is associated with adult insulin sensitivity. The one potential exception was the moderate dietary consumption of fructose, which showed a beneficial association with adult fasting insulin and insulin sensitivity.

Nutrition and microRNAs: Novel Insights to Fight Sarcopenia

Sarcopenia is a progressive age-related loss of skeletal muscle mass and strength, which may result in increased physical frailty and a higher risk of adverse events. Low-grade systemic inflammation, loss of muscle protein homeostasis, mitochondrial dysfunction, and reduced number and function of satellite cells seem to be the key points for the induction of muscle wasting, contributing to the pathophysiological mechanisms of sarcopenia. While a range of genetic, hormonal, and environmental factors has been reported to contribute to the onset of sarcopenia, dietary interventions targeting protein or antioxidant intake may have a positive effect in increasing muscle mass and strength, regulating protein homeostasis, oxidative reaction, and cell autophagy, thus providing a cellular lifespan extension. MicroRNAs (miRNAs) are endogenous small non-coding RNAs, which control gene expression in different tissues. In skeletal muscle, a range of miRNAs, named myomiRNAs, are involved in many physiological processes, such as growth, development, and maintenance of muscle mass and function. This review aims to present and to discuss some of the most relevant molecular mechanisms related to the pathophysiological effect of sarcopenia. Besides, we explored the role of nutrition as a possible way to counteract the loss of muscle mass and function associated with ageing, with special attention paid to nutrient-dependent miRNAs regulation. This review will provide important information to better understand sarcopenia and, thus, to facilitate research and therapeutic strategies to counteract the pathophysiological effect of ageing.

The Western diet: a blind spot of eating disorder research?-a narrative review and recommendations for treatment and research

Over the last 50 years, in parallel with the obesity epidemic, the prevalence of eating disorders has increased and presentations have changed. In this narrative review, we consider recent research exploring the implications of changing patterns of food consumption on metabolic and neurobiological pathways, a hitherto neglected area in eating disorder research. One of the major changes over this time has been the introduction of ultra-processed (NOVA-4) foods, which are gradually replacing unprocessed and minimally processed foods. This has resulted in the increased intake of various sugars and food additives worldwide, which has important metabolic consequences: triggering insulin and glucose response, stimulating appetite, and affecting multiple endocrine and neurobiological pathways, as well as the microbiome. A paradigm shift is needed in the conceptual framework by which the vulnerability to, and maintenance of, different eating disorders may be understood, by integrating recent knowledge of the individual metabolic responses to modern highly processed foods into existing psychological models. This could stimulate research and improve treatment outcomes.

Molecular Study on the Potential Protective Effects of Bee Venom against Fructose-Induced Nonalcoholic Steatohepatitis in Rats

BACKGROUND

There is a causative relation between the increased hepatic steatohepatitis prevalence and sweeteners intake, fructose in particular. Despite an increasing understanding of the mechanisms of nonalcoholic steatohepatitis (NASH) pathogenesis, there are no drugs approved for it.

OBJECTIVES

Evaluate the effect of bee venom (BV) treatment on the fructose-induced NASH in rats and demonstrate its possible molecular mechanisms.

METHODS

NASH was induced in rats by 10% fructose in drinking water for 8 weeks. BV was administered (0.1 mg/kg, i.p.) 3 times per week during the last 2 weeks of the experiment. Sera were used for the determination of lipids, cholesterol, glucose, insulin, and liver enzymes. Hepatic gene expressions of farnesoid X receptor (FXR)α and the liver X receptor (LXR) were determined. Hepatic sterol regulatory element-binding protein (SREBP)1/2, oxidative stress, and inflammation parameters were measured. Liver parts were used for histopathological examination. Small intestine was removed for the determination of tight junction proteins.

RESULTS

Fructose caused overt histological damage in the liver, and this was associated with parallel changes in all parameters measured. BV effectively prevented these changes, presumably through amelioration of hepatic SREBP1/2, LXR, and FXRα expression as well as intestinal tight junction proteins.

CONCLUSION

These findings support the therapeutic usefulness of BV, a remedy with a favorable safety profile, in the prevention of fructose-induced NASH.

Fruit and Vegetable Consumption and Sarcopenia among Older Adults in Low- and Middle-Income Countries

Fruit and vegetable consumption may protect against sarcopenia but there are no studies on this topic from low- and middle-income countries (LMICs). Thus, we assessed this association among older adults from six LMICs. Community-based cross-sectional data of the Study on Global Aging and Adult Health were analyzed. Sarcopenia was defined as the presence of low skeletal muscle mass based on indirect population formula, and either slow gait or low handgrip strength. Quintiles of vegetable and fruit consumption were created based on the number of servings consumed on a typical day. Multivariable logistic regression analysis was conducted. The sample consisted of 14,585 individuals aged ≥65 years (mean (SD) age 72.6 (11.4) years; 55% females). Adjusted analyses showed that overall, compared to the lowest quintile (Q1), the highest quintile (Q5) of fruit consumption was associated with a 40% lower odds for sarcopenia (OR = 0.60; 95% CI = 0.42−0.84) but this association was largely driven by the strong association among females (e.g., Q5 vs. Q1 OR = 0.42; 95% CI = 0.24−0.73), with no significant associations found among males. Vegetable consumption was not significantly associated with sarcopenia. Future studies of longitudinal design may shed light on whether increasing fruit consumption among older females in LMICs may reduce risk for sarcopenia.

A Horizontal Gene Transfer Led to the Acquisition of a Fructan Metabolic Pathway in a Gall Midge

Animals are thought to use only glucose polymers (glycogen) as energy reserve, whereas both glucose (starch) and fructose polymers (fructans) are used by microbes and plants. Here, it is reported that the gall midge Mayetiola destructor, and likely other herbivorous animal species, gained the ability to utilize dietary fructans directly as storage polysaccharides by a single horizontal gene transfer (HGT) of bacterial levanase/inulinase gene followed by gene expansion and differentiation. Multiple genes encoding levanases/inulinases have their origin in a single HGT event from a bacterium and they show high expression levels and enzymatic activities in different tissues of the gall midge, including nondigestive fat bodies and eggs, both of which contained significant amounts of fructans. This study provides evidence that animals can also use fructans as energy reserve by incorporating bacterial genes in their genomes.

Redox Signaling and Advanced Glycation Endproducts (AGEs) in Diet-Related Diseases

Diets are currently characterized by elevated sugar intake, mainly due to the increased consumption of processed sweetened foods and drinks during the last 40 years. Diet is the main source of advanced glycation endproducts (AGEs). These are toxic compounds formed during the Maillard reaction, which takes place both in vivo, in tissues and fluids under physiological conditions, favored by sugar intake, and ex vivo during food preparation such as baking, cooking, frying or storage. Protein glycation occurs slowly and continuously through life, driving AGE accumulation in tissues during aging. For this reason, AGEs have been proposed as a risk factor in the pathogenesis of diet-related diseases such as diabetes, insulin resistance, cardiovascular diseases, kidney injury, and age-related and neurodegenerative diseases. AGEs are associated with an increase in oxidative stress since they mediate the production of reactive oxygen species (ROS), increasing the intracellular levels of hydrogen peroxide (H₂O₂), superoxide (O₂⁻), and nitric oxide (NO). The interaction of AGEs with the receptor for AGEs (RAGE) enhances oxidative stress through ROS production by NADPH oxidases inside the mitochondria. This affects mitochondrial function and ultimately influences cell metabolism under various pathological conditions. This short review will summarize all evidence that relates AGEs and ROS production, their relationship with diet-related diseases, as well as the latest research about the use of natural compounds with antioxidant properties to prevent the harmful effects of AGEs on health.

High Intake of Free Sugars, Fructose, and Sucrose Is Associated with Weight Gain in Japanese Men

BACKGROUND

Available evidence for associations between sugar intake and body weight is largely from short-term controlled trials and studies focusing on sugar-sweetened beverages. Studies on long-term weight change related to the intake of types of sugar are thus needed.

OBJECTIVE

We examined the associations between weight change and the intake of various types of carbohydrates, including starch, total sugars, and free or naturally occurring sugars and saccharides (i.e., glucose, fructose, sucrose, and lactose), among Japanese men and women.

METHODS

This prospective cohort study included 14,971 residents of Takayama City in Japan who were aged 35-69 y at the first survey in 1992 and responded to a self-administrated questionnaire at the second survey in 2002. We excluded those with cancer, coronary artery disease, stroke, or diabetes on the first survey and those with missing information about body weight on both surveys, leaving 13,229 participants for analysis (5879 men and 7350 women). Mean (95% CI) values of 10-y weight change according to types of carbohydrates were estimated using linear regression models with adjustment for total energy intake and other dietary and lifestyle factors. Dietary intake was assessed at the first survey using a validated FFQ.

RESULTS

Among men, free sugar intake was associated with weight gain and the estimated means (95% CIs) of weight change were -0.60 (-0.67, -0.54), -0.31 (-0.38, -0.24), -0.12 (-0.19, -0.05), and 0.20 (0.13, 0.27) kg from the first to fourth quartiles (P-trend = 0.002). Moreover, high intakes of sucrose and fructose were associated with weight gain (P-trend: 0.018 for sucrose and 0.001 for fructose). Among women, the intake of any type of carbohydrate was not significantly associated with weight change.

CONCLUSIONS

These results suggested that high intakes of free sugars, sucrose, and fructose were associated with long-term weight gain among Japanese men.

Total Sugar Intake and Macro and Micronutrients in Children Aged 6-8 Years: The ANIVA Study

The objective of this study was to study the association between total sugar intake (TSI) levels of children aged 6–8 years old, nutrient intake and anthropometry. Food and beverage intakes were collected by a prospective three-day recall questionnaire. The 2237 children were distributed into three groups according to TSI percentiles. Mean TSI was 93.77 ± 25.72 g/day, 22%–25% of total caloric intake, with boys presenting an intake of 96.24 ± 24.34 g/day and girls 91.38 ± 26.78 g/day. Greater TSI was associated with higher body fat, parental education, energy intake, nutrients/1000 kcal, and lower weight z-scores, BMI z-scores, waist circumferences, and hip circumferences. Weight, height, and waist circumference had the highest R² while body fat had the lowest. The percentage of total energy derived (%E) from protein decreased as the %E from TSI increased, while the opposite was true for carbohydrates and saccharides, while for fiber intake, the medium groups presented the highest intake/1000 kcal. For the remaining macronutrients studied, intake/1000 kcal decreased when the %E from TSI increased. Calcium, iodine, magnesium, vitamin B2, folate, and vitamin C intake increased as the %E from TSI increased, while the opposite was true for vitamin B12. Fiber, ω-6 PUFA, iodine, folate, vitamin D, and vitamin E intakes were insufficient across most of the sample. TSI levels in children were identified to exceed adult recommendations. It is not clear what the effect of up to an average of 21% of energy coming from total sugars has on childhood obesity and further research is needed in the pediatric population, however, opportunities exist to improve sugar intake patterns.

NASH-inducing Diets in Göttingen Minipigs

BACKGROUND

Owing to the human-like physiology, a minipig model of nonalcoholic steatohepatitis (NASH) could be valuable. Pigs, however, rarely develop substantial hepatic steatosis, even when fed diets with high fat, fructose, and cholesterol (FFC) content. The potential of choline-deficient, amino acid-defined high-fat diets (CDAHFD) was therefore evaluated in Göttingen Minipigs.

METHODS

Castrated male Göttingen Minipigs were fed either chow (n = 5) or one of the three NASH diets: FFC (n = 5), CDAHFD with sucrose (CDAHFD-S; n = 4), or fructose (CDAHFD-F; n = 4) for 8 weeks. Liver and blood samples were collected after 2 weeks and at termination.

RESULTS

Compared with chow, the body weight was higher after FFC (9.8 ± 0.4 versus 8.5 ± 1.2 kg; mean ± SD) and less after CDAHFD-S (6.4 ± 0.8 kg) and CDAHFD-F (6.9 ± 0.8 kg). Liver weight per kg body weight was significantly increased in all 3 NASH groups (FFC 2.1 times; and both CDAHFD diets 3.1 times). Histologically, pronounced macrovesicular steatosis developed only in the CDAHFD groups. Inflammation was present in all three NASH groups. In the CDAHFD groups, inflammatory cells formed crown-like structures around steatotic hepatocytes. Sirius red staining revealed mild fibrosis in the two CDAHFD groups with the fibrotic potential being further supported by immunohistochemical staining for activated stellate cells and gene expression analyses. No noticeable differences were found between CDAHFD-S and CDAHFD-F.

CONCLUSIONS

Göttingen Minipigs fed CDAHFD developed pronounced steatosis with inflammation around steatotic hepatocytes and incipient fibrosis, thereby showing potential as a model for human NASH. Further studies are needed to investigate the period needed for marked fibrosis to develop.

Are Lifestyle Therapies Effective for NAFLD Treatment?

Nonalcoholic fatty liver disease (NAFLD) is becoming the most common liver disorder worldwide. Specifically, nonalcoholic steatohepatitis (NASH) and fibrosis pose an enormous burden for patients and health-care systems. In the absence of approved pharmacological therapies, effective lifestyle interventions for NAFLD, such as dietary strategies and exercise training, are currently the therapeutic strategies of choice. This review covers the influence of macronutrient quality and quantity (i.e., low-carbohydrate and high-protein diets), for successful reduction of intrahepatocellular lipids (IHL). Moreover, we discuss the effectiveness of different modalities of physical exercising with and without weight loss. These lifestyle modifications not only provide strategies to reduce IHL but may also hold a still underestimated potential to induce improvement and/or even remission of NAFLD.

Intake of starch and sugars and total and cause-specific mortality in a Japanese community: the Takayama Study

Studies on the intake of different types of carbohydrates and long-term mortality are sparse. We examined the association of starch, total and each type of sugar and free sugars with the risk of total and cause-specific mortality in a cohort of the general population in Japan. Study subjects were 29 079 residents from the Takayama Study, Japan, who responded to a self-administered questionnaire in 1992. Diet was assessed by a validated FFQ at the baseline. Mortality was ascertained during 16 years of follow-up. We noted 2901 deaths (974 cancer related and 775 cardiovascular related) in men and 2438 death (646 cancer related and 903 cardiovascular related) in women. In men, intake of starch was inversely associated with total mortality after controlling for covariates (hazard ratio (HR) for the highest quartile v. lowest quartile: 0·71; 95 % CI 0·60, 0·84; Ptrend &lt; 0·001). Intakes of total sugars, glucose, fructose, sucrose, maltose and free and naturally occurring sugars were significantly positively associated with total mortality in men (HR for the highest v. lowest quartile of total sugar: 1·27; 95 % CI 1·12, 1·45; Ptrend &lt; 0·0001). Similar relations were observed for cardiovascular mortality and non-cancer, non-cardiovascular mortality in men. In women, there was no significant association between any type of carbohydrates and mortality except that intake of free sugars was significantly positively associated with total and non-cancer, non-cardiovascular mortality. Data suggest that the high intake of starch reduces mortality, whereas the high intake of sugars, including glucose, fructose and sucrose, increases mortality in Japanese men.

Consumption of Sugar-Sweetened Beverages Has a Dose-Dependent Effect on the Risk of Non-Alcoholic Fatty Liver Disease: An Updated Systematic Review and Dose-Response Meta-Analysis

Background: Non-alcoholic fatty liver disease (NAFLD) is a serious health problem, but the dose-response relationship between sugar-sweetened beverages (SSBs) and NAFLD remains uncertain. Methods: A systematic review and dose-response meta-analysis were conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Review Manager 5.3 and Stata 14.0 were used to combine trials and analyze data. The dose-response meta-analysis was performed by non-linear trend regression. Results: Twelve studies recruiting a total of 35,705 participants were included. The results showed that the consumption of SSBs was associated with 1.39-fold increased odds of NAFLD (95% CI: 1.29–1.50, p < 0.00001). The risk of NAFLD rose with an increased consumption of SSBs, while the consumptions of low doses (<1 cup/week), middle doses (1–6 cups/week) and high doses (≥7 cups/week) of SSBs increased the relative risk of NAFLD by 14%, 26% and 53%, respectively (p = 0.01, p < 0.00001, p = 0.03, respectively). Conclusions: This study demonstrates that consumers of SSBs are at significantly increased risk of NAFLD, and the consumption of SSBs has a dose-dependent effect on the risk of NAFLD. The findings of this study strengthen the evidence base for healthy dietary patterns and are meaningful for the primary prevention of NAFLD.

High Relative Abundance of Lactobacillus reuteri and Fructose Intake are Associated with Adiposity and Cardiometabolic Risk Factors in Children from Mexico City

In Mexico, 3 of 10 children are overweight. Fructose intake and relative abundance (RA) of Lactobacillus reuteri (L. reuteri) in the intestinal microbiota are associated with obesity and diabetes in adults, but studies in children are limited. This study evaluates the association between fructose intake and L. reuteri RA with adiposity and cardiometabolic risk markers in Mexican children dietary information, microbiota profiles, adiposity indicators (Body Mass Index, BMI and Waste Circumference, WC), and cardiometabolic markers were analyzed in 1087 children aged 6–12 years. Linear regression and path analysis models were used. High-tertile fructose intake and L. reuteri RA were positively associated with BMI (β_{Tertil 3 vs. Tertil 1}= 0.24 (95% CI, 0.04; 0.44) and β_{T3 vs. T1} = 0.52 (95% CI, 0.32; 0.72)) and WC (β_{T3 vs. T1} = 2.40 (95% CI, 0.93; 3.83) and β_{T3 vs. T1} = 3.40 (95% CI, 1.95; 4.90)), respectively. Also, these factors mediated by adiposity were positively correlated with high triglycerides and insulin concentrations and HOMA-IR (p ≤ 0.03) and negatively associated with HDL-C concentration (p < 0.01). High-tertile fructose intake and L. reuteri RA were directly associated with adiposity and indirectly associated though adiposity with metabolic disorders in children. In conclusion, fructose intake and L. reuteri RA were directly associated with adiposity and indirectly associated with metabolic disorders in children, mediated by adiposity.

Sugar Concentration Measurement System Using Radiofrequency Sensor

A sugar solution measurement system was developed based on the dielectric properties of the sucrose molecule. An ac conductivity and tan δ study as a function of the frequency was performed to find the suitable frequency range for the measuring system. The results indicate that it is possible to obtain a better response of the sensor using the frequencies as the maxima peak in tan δ appears. Developed setup for sucrose solution was appropriate to measure in a 0.15 to 1 g/mL range with an experimental error of about 3%. The proposed system improves the measurement time over some other methods.

Sugar rush or sugar crash? A meta-analysis of carbohydrate effects on mood

The effect of carbohydrate (CHO) consumption on mood is much debated, with researchers reporting both mood improvements and decrements following CHO ingestion. As global consumption of sugar-sweetened products has sharply increased in recent years, examining the validity of claims of an association between CHOs and mood is of high importance. We conducted a systematic review and meta-analysis to evaluate the relationship between acute CHO ingestion and mood. We examined the time-course of CHO-mood interactions and considered the role of moderator variables potentially affecting the CHO-mood relationship. Analysis of 176 effect sizes (31 studies, 1259 participants) revealed no positive effect of CHOs on any aspect of mood at any time-point following their consumption. However, CHO administration was associated with higher levels of fatigue and less alertness compared with placebo within the first hour post-ingestion. These findings challenge the idea that CHOs can improve mood, and might be used to increase the public's awareness that the 'sugar rush' is a myth, inform health policies to decrease sugar consumption, and promote healthier alternatives.

Quality of life of obese patients after treatment with the insertion of intra-gastric balloon versus Atkins diet in Sulaimani Governorate, Kurdistan Region, Iraq

BACKGROUND

Health-related quality of life of obese patients, before and after weight loss by insertion of BioEnterics Intra-gastric Balloon is studied widely. But the quality of life not related to comorbidity of the obese patients like mood, satisfaction with relationships, achieved goals, self-concepts, and self-perceived ability to cope with one's daily life is not studied on a wide scale.

AIM

To evaluates the effect of the obesity on different aspects of life, and to evaluate the influence of weight loss after BIB insertion or Atkins diet on the quality of life regarding mood, satisfaction with relationships, achieved goals, self-concepts, and self-perceived ability to cope with one's daily life.

PATIENTS MATERIALS AND METHODS

A prospective randomized study, from a total of 180 patients, 80 patients were selected to enroll in the work, over a period of 4 years from 2008 to 2012 in Hatwan private hospital and the private clinic, the closing date was 1st January 2013.Approval for the current work was obtained from the Ethics Committee of University, College of Medicine. The work has been reported in line with the STROCSS criteria. The study was designed as a descriptive longitudinal study conducted on 40 patients who underwent intra-gastric balloon insertion compared to a matched group (for age, BMI) of 40 patients on Atkin's diet.

RESULTS

Two comparable groups of obese patients were studied, each group consists of 40 female patients, mean age in group A was 27 years (20-39 years) with mean body weight 90 kg (80-100) and mean body mass index 36 (31-39.9) who were treated with insertion of BIB. While mean age in group B was 29 years (20-39 years) with mean body weight 91 kg (80-102) and mean body mass index 36.5 (31-39.9). Statistically important changes occurred in the quality of life of the patients after either method of treatments to different degrees (p-value 0.005917).

CONCLUSION

The patients lost more weight after insertion of intra-gastric balloon up to 35 kg of body weight, while the patients on Atkins diet lost up to 20 kg body weight. This results in statistically significant improvement of most aspects of QOL. Especially in Feeling happier, more satisfaction with the new body image, Improvement of self-esteem, encouraged for more regular exercises, less nervous, embarrassed less by unimportant matters, have less negative thoughts, and the craving of foods decreased remarkably.

Active Acupoints Differ from Inactive Acupoints in Modulating Key Plasmatic Metabolites of Hypertension: A Targeted Metabolomics Study

The effect of active acupoints versus inactive acupoints in treating hypertension is not well documented. Metabolic phenotypes, depicted by metabolomics analysis, reflect the influence of external exposures, nutrition, and lifestyle on the integrated system of the human body. Therefore, we utilized high-performance liquid chromatography tandem mass spectrometry to compare the targeted metabolic phenotype changes induced by two different acupoint treatments. The clinical outcomes show that active acupoint treatment significantly lowers 24-hour systolic blood pressure but not diastolic blood pressure, as compared with inactive acupoint treatment. Furthermore, distinctive changes are observed between the metabolomics data of the two groups. Multivariate analysis shows that only in the active acupoint treatment group can the follow-up plasma be clearly separated from the baseline plasma. Moreover, the follow-up plasma of these two groups can be clearly separated, indicating two different post-treatment metabolic phenotypes. Three metabolites, sucrose, cellobiose, and hypoxanthine, are shown to be the most important features of active acupoint treatment. This study demonstrates that metabolomic analysis is a potential tool that can be used to efficiently differentiate the effect of active acupoints from inactive acupoints in treating hypertension. Possible mechanisms are the alternation of hypothalamic microinflammation and the restoration of host-gut microbiota interactions induced by acupuncture.