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Background: It is well established that unrefined sugarcane products have antioxidant activity due to phytochemicals, polyphenols, and total antioxidant capacity, which may decrease inflammation and oxidative stress. Therefore, we conducted a systematic review to evaluate the association of unrefined sugar consumption with inflammatory biomarkers. Methods: Google Scholar, ScienceDirect, Scopus, Cochrane Library, and ProQuest databases were searched up to December 2021 for studies that report the effect of unrefined sugar on inflammation according to inflammatory cytokines, chemokine, and adhesion molecules as outcome measures. Results: Thirty-six studies were evaluated. Across all research, five studies (two in vitro and three animal studies) reported the effect of unrefined sugar on levels of cytokines, including IL-6, TNF-α, IL-10, IL-1ß, and IFN-γ. Additionally, the quality of the studies was assessed for risk of bias. Conclusions: it is possible to affirm that unrefined sugarcane products, including jaggery, may have a protective effect on inflammation via regulating some of the inflammatory pathways and a favorable impact on cytokines secretion according to the results of in vitro and animal model studies. However, since the findings are still insufficient, more scientific research, especially well-designed human trials, is highly recommended to conclude the outcomes confidently. Human data may encourage industries and the public to replace purified sugar with unrefined sugarcane in sugar-based food and for further health-care policy decisions.
RESUMO
OBJECTIVES: We investigated a low-glycemic index (GI), minimally refined brown sugar (MRBS) that retains a consistent amount of antioxidant polyphenols. This study aimed to determine whether MRBS has a lower postprandial glycemic response and GI value compared with other types of refined sugar (RS). Low glycemic response foods are also reported to increase satiety. Accordingly, we also evaluated satiety profiles, glycemic profiles (glucose, insulin, and glucagon), and total antioxidant capacity (TAC). METHODS: This work shows the results of two single-blind, cross-over studies (studies 1 and 2). For each study 14 healthy Malay individuals with a normal body mass index were recruited. In study 1, capillary blood samples were used to determine the GI of the tested sugars. Venous blood samples were used in study 2 to measure the concentrations of satiety hormones (peptide tyrosine, C-peptide, glucagon-like peptide-1, and leptin), TAC, plasma glucose, insulin, and glucagon concentrations at baseline (0 min) and at 60 and 120 min after consumption of the MRBS and RS formulated jellies. RESULTS: The incremental area under the curve of glucose positive control (312 ± 62.54 mmol.min/L) was significantly higher than that of other types of sucrose (P < 0.05). MRBS (GI: 54 ± 4.5 mmol.min/L) and brown sugar (GI: 50 ± 5.0 mmol.min/L) were categorized as low GI, and RS (GI: 64 ± 5.73 mmol.min/L) was in the medium category, which was significantly lower than the GI of glucose (GI: 100 mmol.min/L; P < 0.05). Likewise, there was a significant difference in satiety profiles (peptide tyrosine and C-peptide), glycemic profile (glucagon), and TAC (P < 0.05) between RS and MRBS jellies. CONCLUSIONS: The results of our work show that MRBS had a lower GI (study 1), and better satiety, glycemic profiles, and TAC (study 2) compared with RS.