Feasibility and acceptability of miracle fruit application prior to the consumption of sour-tasting foods as a weight-loss strategy in adults with diabetes or prediabetes: A randomized crossover trial

Miracle fruit (MF) has emerged as a promising option for healthy noncaloric sweeteners due to its sour-to-sweet taste-modifying effects and high antioxidant activity. We aimed to examine the feasibility and acceptability of using MF as a weight-loss strategy for individuals with diabetes or prediabetes. Fifty Korean-American men and women (25 participants each) aged 45-75 years with diabetes or prediabetes were recruited in this study. They participated in a randomized placebo-controlled crossover trial where they took the assigned tablet (either an MF tablet or a placebo-sugar candy) 10 min before consuming food. Using a 9-point hedonic scale, participants assessed the likings of overall, flavor, texture, and aftertaste for green apples, goat cheese, lemonade, pickles, and plain fat-free yogurt before and 10 min after taking the assigned tablet. Additionally, overall liking for meals and calorie intake were assessed during subsequent ad libitum meal sessions. An ANOVA for a crossover design, and independent and paired t-tests were used to compare the outcomes. The results revealed that all postintervention liking values for sour-tasting foods were higher than the respective preintervention liking values for both interventions. However, the MF intervention showed significantly higher pre-post differences in liking for all sour-tasting foods and the overall liking values for breakfast and dinner compared to the placebo intervention (P < 0.001). Furthermore, the MF intervention resulted in a significantly lower calorie intake for each meal than the placebo (P < 0.001). These findings suggest that MF intervention can be considered a viable weight-loss strategy for individuals with diabetes.

Impact of acute consumption of beverages containing plant-based or alternative sweetener blends on postprandial appetite, food intake, metabolism, and gastro-intestinal symptoms: Results of the SWEET beverages trial

Project SWEET examined the barriers and facilitators to the use of non-nutritive sweeteners and sweetness enhancers (hereafter "S&SE") alongside potential risks/benefits for health and sustainability. The Beverages trial was a double-blind multi-centre, randomised crossover trial within SWEET evaluating the acute impact of three S&SE blends (plant-based and alternatives) vs. a sucrose control on glycaemic response, food intake, appetite sensations and safety after a carbohydrate-rich breakfast meal. The blends were: mogroside V and stevia RebM; stevia RebA and thaumatin; and sucralose and acesulfame-potassium (ace-K). At each 4 h visit, 60 healthy volunteers (53% male; all with overweight/obesity) consumed a 330 mL beverage with either an S&SE blend (0 kJ) or 8% sucrose (26 g, 442 kJ), shortly followed by a standardised breakfast (∼2600 or 1800 kJ with 77 or 51 g carbohydrates, depending on sex). All blends reduced the 2-h incremental area-under-the-curve (iAUC) for blood insulin (p < 0.001 in mixed-effects models), while the stevia RebA and sucralose blends reduced the glucose iAUC (p < 0.05) compared with sucrose. Post-prandial levels of triglycerides plus hepatic transaminases did not differ across conditions (p > 0.05 for all). Compared with sucrose, there was a 3% increase in LDL-cholesterol after stevia RebA-thaumatin (p < 0.001 in adjusted models); and a 2% decrease in HDL-cholesterol after sucralose-ace-K (p < 0.01). There was an impact of blend on fullness and desire to eat ratings (both p < 0.05) and sucralose-acesulfame K induced higher prospective intake vs sucrose (p < 0.001 in adjusted models), but changes were of a small magnitude and did not translate into energy intake differences over the next 24 h. Gastro-intestinal symptoms for all beverages were mostly mild. In general, responses to a carbohydrate-rich meal following consumption of S&SE blends with stevia or sucralose were similar to sucrose.