Effect of low-and non-calorie sweeteners on the gut microbiota: A review of clinical trials and cross-sectional studies

Use of non-nutritive sweeteners (NNSs) has increased worldwide in recent decades. However, evidence from preclinical studies shows that sweetener consumption may induce glucose intolerance through changes in the gut microbiota, which raises public health concerns. As studies conducted on humans are lacking, the aim of this review was to gather and summarize the current evidence on the effects of NNSs on human gut microbiota. Only clinical trials and cross-sectional studies were included in the review. Regarding NNSs (i.e, saccharin, sucralose, aspartame, and stevia), only two of five clinical trials showed significant changes in gut microbiota composition after the intervention protocol. These studies concluded that saccharin and sucralose impair glycemic tolerance. In three of the four cross-sectional studies an association between NNSs and the microbial composition was observed. All three clinical trials on polyols (i.e, xylitol) showed prebiotic effects on gut microbiota, but these studies had multiple limitations (publication date, dosage, duration) that jeopardize their validity. The microbial response to NNSs consumption could be strongly mediated by the gut microbial composition at baseline. Further studies in which the potential personalized microbial response to NNSs consumption is acknowledged, and that include longer intervention protocols, larger cohorts, and more realistic sweetener dosage are needed to broaden these findings

Chronologically scheduled snacking with high-protein products within the habitual diet in type-2 diabetes patients leads to a fat mass loss: a longitudinal study.

Background: Obesity is the most relevant overnutrition disease worldwide and is associated to different metabolic disorders such as insulin resistance and type-2 diabetes. Low glycemic load foods and diets and moderately high protein intake have been shown to reduce body weight and fat mass, exerting also beneficial effects on LDL-cholesterol, triglyceride concentrations, postprandial glucose curve and HDL-cholesterol levels. The present study aimed at studying the potential functionality of a series of low glycemic index products with moderately high protein content, as possible coadjuvants in the control of type-2 diabetes and weight management following a chronologically planned snacking offer (morning and afternoon). Methods: The current trial followed a single group, sequential, longitudinal design, with two consecutive periods of 4 weeks each. A total of 17 volunteers participated in the study. The first period was a free living period, with volunteers' habitual ad libitum dietary pattern, while the second period was a free-living period with structured meal replacements at breakfast, morning snack and afternoon snack, which were exchanged by specific products with moderately high protein content and controlled low glycemic index, following a scheduled temporal consumption. Blood extractions were performed at the beginning and at the end of each period (free-living and intervention). Parameters analysed were: fasting glucose, insulin, glycosylated hemoglobin, total-, HDL- and LDL-cholesterol, triglyceride, C - reactive protein and Homocysteine concentrations. Postprandial glucose and insulin were also measured. Anthropometrical parameters were monitored each 2 weeks during the whole study. Results: A modest but significant (p = 0.002) reduction on body weight (1 kg) was observed during the intervention period, mainly due to the fat mass loss (0.8 kg, p = 0.02). This weight reduction was observed without apparently associated changes in total energy intake. None of the biochemical biomarkers measured was altered throughout the whole study. Conclusions: Small changes in the habitual dietary recommendations in type-2 diabetes patients by the inclusion of specific low-glycemic, moderately high-protein products in breakfast, morning and afternoon snacks may promote body weight and fat-mass loss, without apparently altering biochemical parameters and cardiovascular risk-related factors

Reduction in cardiovascular risk by sodium-bicarbonated mineral water in moderately hypercholesterolemic young adults.

Effects of drinking a sodium bicarbonated mineral water on cardiovascular risk in young men and women with moderate cardiovascular risk were studied. Eighteen young volunteers, total cholesterol levels >5.2 mmol/L without any disease participated. The study consisted in two 8-week intervention periods. Subjects consumed, as a supplement of their usual diet, 1 L/d of a control low mineral water followed by 1 L/d of the bicarbonated mineral water (mmol/L: sodium, 48; bicarbonate, 35; and chloride, 17). Determinations were performed at the end of the control water period and weeks 4 and 8 of the bicarbonated water period. Body weight, BMI, blood pressure, dietary intake, total-cholesterol, LDL-cholesterol, HDL-cholesterol, Apo A-I, Apo B, triacylgycerols, glucose, insulin, adiponectin, high sensitivity-C reactive protein (hs-CRP), soluble adhesion molecules (sICAM and sVCAM), sodium and chloride urinary excretion, and urine pH were measured. Dietary intake, body weight and BMI showed no significant variations. Systolic blood pressure decreased significantly after 4 weeks of bicarbonated water consumption without significant differences between the weeks 4 and 8. Significant reductions were observed after bicarbonated water consumption of total cholesterol (by 6.3%, p=0.012), LDL-cholesterol (by 10% p=0.001), total/HDL-cholesterol (p=0.004), LDL/HDL-cholesterol (p=0.001), and Apo B (p=0.017). Serum triacylglycerols, Apo A-I, sICAM-1, sVCAM-1 and hs-CRP levels did not change. Serum glucose values tended to decrease during the bicarbonated water intervention (p=0.056) but insulin levels did not vary. This sodium bicarbonated mineral water improves lipid profile in moderately hypercholesterolemic young men and women and could therefore be applied in dietary interventions to reduce cardiovascular risk

Association between sleep duration and dietary patterns among finnish pre-schoolers

According to the results obtained in the present study, it could be concluded that: 1. Sleep length during the whole week, during the weekdays and weekend is inversely associated with a sweet dietary pattern consumption. On the other hand, sleep length both during the whole week and the weekdays is positively associated with a higher intake of healthy foods. 2. Girls tend to have a higher consumption of sweet foods the less they sleep, during the weekdays and the whole week. Whereas in general they are more likely to follow a healthy dietary pattern the longer the sleeping hours. Such associations do not seem to be present among boys. 3. There do not seem to exist differences between sleep length and dietary patterns when considering different socio-economic backgrounds among children from pre-schools in Finland. However, the literature research and the obtained results highlight the fact that, when talking together about sleep and diet, we are still on a narrow piece of terra ferma in a wide sea of the unknown

A regular curd consumption improves gastrointestinal status assessed by a randomized controlled nutritional intervention

This study evaluated the influence of curd consumption (a dairy product in which most whey proteins are discarded) on nutritional status markers and on gastrointestinal symptoms through an open-label randomized nutritional intervention. A total of 20 males and 20 females were involved in the study. Body weight and plasma levels of different health markers were measured at baseline and at the end of the study. Gastrointestinal symptoms and satiety were assessed by self-reported subjective questionnaires. There were neither relevant changes in body weight and composition, nor in all screened plasma determinations after the intervention. Satiety score analyses revealed no differences between the two experimental groups. The regular consumption of curd-improved abdominal pain (19%) and deposition scores (16%) when compared with those participants non-consuming curd, which may indicate a better tolerability of this product. Curd intake within a balanced diet improved some subjective markers of gastrointestinal status, which may be explained by the nutritional composition of curds

Lifestyle and clinical factors affecting the quality of life related to health

Background. Few studies have examined the influence of personal, phenotypical and lifestyle habits on quality of life related to health. Methods. Cross-sectional study, which was conducted on 106 patients (63 women). Quality of life was measured by the Short-Form 36 (SF-36) questionnaire while lifestyle factors were evaluated with a general questionnaire developed by the authors of the study, with the Mediterranean Diet Adherence Screener (MEDAS) and with the Global Physical Activity Questionnaire (GPAQ). Participants were divided into two groups (lower and higher global health) attended to their punctuation on the SF-36. Results. The 8 domains of the SF-36, quantifying the quality of life, were influenced by sex and age. A total of 51 out 106 were qualified as lower global health (score lower than 84.8 points). No significant differences were found how lifestyle factors, body composition and blood biomarkers affect the quality of life between groups. The three dimensions of the SF-36 and the transition of health question were not significantly influenced by any of the items analyzed. Conclusion. This research enabled us to obtain a pilot vision of the lifestyle of the population and the planning of future research despite that the outcomes were not sufficient satisfactory

Different postprandial acute response in healthy subjects to three strawberry jams varying in carbohydrate and antioxidant content: a randomized, crossover trial

PURPOSE: Dietary food composition influences postprandial glucose homeostasis. Thus, the objective was to investigate the effects of an acute intake of three different types of strawberry jam, differing in carbohydrate and antioxidants content, on postprandial glucose metabolism, lipid profile, antioxidant status, and satiety. METHODS: Sixteen healthy adults participated in a randomized, crossover, double-blind study with three arms, receiving 60 g of three different strawberry jams. Blood samples were collected at fasting and at 30, 60, 90, and 120 min after its intake. Blood analyses were performed with validated procedures and satiety was estimated with visual analogue scale (VAS). RESULTS: Blood glucose concentrations were maintained at normal values and without peaks within the 2 h after consumption of low-sugar jams. However, blood glucose and insulin were significantly higher at 30 and 60 min after high-sugar (HS) jam intake versus both low-sugar jams. Furthermore, HS jam produced more satisfaction at short time, but decreased as soon as blood glucose concentration began to decrease. Moreover, HS ingestion produced lower free fatty acid levels (p < 0.05) throughout the trial with respect both the low-sugar jams. However, no additional benefits on oxidative status (malondialdehyde, glutathione peroxidase, total antioxidant capacity, and uric acid), glucose, lipid, and satiety variables were observed due to the inclusion of an antioxidant to low-sugar jam. CONCLUSIONS: This study reinforces the idea that products without added sugars are appropriate for the management of glycemic alterations and provides further insight into the effect of natural antioxidants as a functional ingredient on oxidative status and related metabolic disturbances

Oxidized LDL levels decreases after the consumption of ready-to-eat meals supplemented with cocoa extract within a hypocaloric diet

Background and aims Cocoa flavanols are recognised by their favourable antioxidant and vascular effects. This study investigates the influence on health of the daily consumption of ready-to-eat meals supplemented with cocoa extract within a hypocaloric diet, on middle-aged overweight/obese subjects. Methods and results Fifty healthy male and female middle-aged volunteers [57.26 ± 5.24 years and body mass index (BMI) 30.59 ± 2.33 kg/m2] were recruited to participate in a 4 week randomised, parallel and double-blind study. After following 3 days on a low-polyphenol diet, 25 volunteers received meals supplemented with 1.4 g of cocoa extract (645.3 mg of polyphenols) and the other 25 participants received control meals, within a 15% energy restriction diet. On the 4th week of intervention individuals in both dietary groups improved (p < 0.05) anthropometric, body composition, blood pressure and blood biochemical measurements. Oxidised LDL cholesterol (oxLDL), showed a higher reduction (p = 0.030) in the cocoa group. Moreover, myeloperoxidase (MPO) levels decreased only in the cocoa supplemented group (p = 0.007). Intercellular Adhesion Molecule-1 (sICAM-1) decreased significantly in both groups, while Vascular Cell Adhesion Molecule-1 (sVCAM-1) did not present differences after the 4 weeks of intervention. Interestingly, cocoa intake showed a different effect by gender, presenting more beneficial effects in men. Conclusions The consumption of cocoa extract as part of ready-to-eat meals and within a hypocaloric diet improved oxidative status (oxLDL) in middle-aged subjects, being most remarkable in males

Portion control tableware differentially impacts eating behaviour in women with and without overweight

Portion control tableware has been described as a potentially effective approach for weight management, however the mechanisms by which these tools work remain unknown. We explored the processes by which a portion control (calibrated) plate with visual stimuli for starch, protein and vegetable amounts modulates food intake, satiety and meal eating behaviour. Sixty-five women (34 with overweight/obesity) participated in a counterbalanced cross-over trial in the laboratory, where they self-served and ate a hot meal including rice, meatballs and vegetables, once with a calibrated plate and once with a conventional (control) plate. A subsample of 31 women provided blood samples to measure the cephalic phase response to the meal. Effects of plate type were tested through linear mixed-effect models. Meal portion sizes (mean ± SD) were smaller for the calibrated compared with the control plate (served: 296 ± 69 vs 317 ± 78 g; consumed: 287 ± 71 vs 309 ± 79 g respectively), especially consumed rice (69 ± 24 vs 88 ± 30 g) (p < 0.05 for all comparisons). The calibrated plate significantly reduced bite size (3.4 ± 1.0 vs 3.7 ± 1.0 g; p < 0.01) in all women and eating rate (32.9 ± 9.5 vs 33.7 ± 9.2 g/min; p < 0.05), in lean women. Despite this, some women compensated for the reduced intake over the 8 h following the meal. Pancreatic polypeptide and ghrelin levels increased post-prandially with the calibrated plate but changes were not robust. Plate type had no influence on insulin, glucose levels, or memory for portion size. Meal size was reduced by a portion control plate with visual stimuli for appropriate amounts of starch, protein and vegetables, potentially because of the reduced self-served portion size and the resulting reduced bite size. Sustained effects may require the continued use of the plate for long-term impact