Análisis comparativo de respuesta glicémica y de péptido C, tras la ingesta de estevia y D-tagatosa, según habitualidad de consumo de edulcorantes no nutritivos y preferencias alimentarias reportadas por mujeres con resistencia a la insulina / Comparative analysis of glicemic response and c peptide, after comsumption of stevia and d tagatosa, according to regular compsumtion of not nutritive sweeteners andnourish preferences reported by woman with insuline resistance

INTRODUCCIÓN: El consumo de edulcorantes no nutritivos (ENN) ha ido en aumento. A pesar de ello, se desconoce el efecto entre el consumo habitual de ENN y las preferencias alimentarias con parámetros bioquímicos en pacientes con resistencia a la insulina. OBJETIVO: Comparar la respuesta glicémica y de péptido C, según habitualidad de consumo de edulcorantes y preferencias alimentarias reportados por mujeres con resistencia a la insulina tras la ingesta de estevia y D-tagatosa. MÉTODOS: Treinta y tres mujeres con RI se sometieron a una encuesta de opción múltiple sobre preferencias alimentarias y ETCC modificada de edulcorantes. Aleatoriamente recibieron una precarga de control o experimental (estevia y D-tagatosa) donde se midió glicemia y péptido C en los tiempos -10, 30, 60, 90, 120, 180. RESULTADOS: Se encontró un ABC de péptido C más alto después de la ingesta de D-tagatosa (p = 0,02) en pacientes que prefieren alimentos ricos en proteínas en comparación con aquellos que prefieren alimentos ricos en grasas o en carbohidratos simples. Se observó un mayor ABC de péptido C (p = 0,04) para la prueba control en quienes prefieren el sabor salado y consumen menor cantidad de ENN, sin diferencias significativas entre quienes prefirieron sabor dulce. CONCLUSIONES: Al comparar las respuestas glicémicas e insulinémicas entre habitualidad de consumo de edulcorantes y preferencias alimentarias reportados por las pacientes tras la ingesta de agua, estevia y D-Tagatosa, no se obtuvieron diferencias significativas. Salvo en quienes preferían alimentos ricos en proteínas tras la ingesta de D- tagatosa y quienes preferían sabor salado con menor consumo habitual de ENN tras ingesta control.

INTRODUCTION: The consumption of non-nutritive sweeteners (NNS) has been increasing. Despite this, the effect between the habitual consumption of ENN and food preferences with biochemical parameters in patients with insulin resistance is unknown. OBJECTIVE: To compare the glycemic and C-peptide response, according to the habitual consumption of sweeteners and food preferences reported by women with insulin resistance after ingesting stevia and D-tagatose. METHODS: Thirty-three women with IR underwent a multiple choice survey on food preferences and modified ETCC for sweeteners. They randomly received a control or experimental preload (stevia and D-tagatose) where glycemia and peptide C were measured at times -10, 30, 60, 90, 120, 180. RESULTS: A higher C-peptide AUC was found after ingestion of D-tagatose (p = 0.02) in patients who prefer foods rich in protein compared to those who prefer foods rich in fat or simple carbohydrates. A higher AUC of peptide C (p = 0.04) is performed for the control test in those who prefer a salty taste and consume a lower amount of ENN, without significant differences between those who prefer a sweet taste. CONCLUSION: When comparing the glycerol and insulin responses between the habitual consumption of sweeteners and the food preferences reported by the patients after the ingestion of water, stevia and D-Tagatose, no significant differences were obtained. Except in those who prefer foods rich in protein after ingesting D-tagatose and those who prefer salty taste with less habitual consumption of NNS after control intake.

Consumo de edulcorantes no nutritivos: efectos a nivel celular y metabólico / Consumption of Non-nutritive Sweeteners: Cellular and Metabolic Effects

Resumen Antecedentes: la función principal de los edulcorantes no nutritivos es proveer al consumidor un producto dulce sin la carga calórica del azúcar. El consumo de edulcorantes no nutritivos se relaciona con alteraciones en el ADN, con apoptosis y con la síntesis de precursores de cáncer. Además, su consumo también se relaciona recientemente con un incremento de tejido adiposo. Objetivo: analizar el efecto de los edulcorantes no nutritivos a largo plazo, evaluando el riesgo de estos compuestos. Materiales y métodos: búsqueda en bases de datos, PubMed, SciELO y Redalyc, y análisis de bibliografía relacionada con efectos tóxicos y metabólicos del consumo de edulcorantes no nutritivos. Resultados: el consumo de estos edulcorantes presentó efectos citotóxicos en diferentes modelos de estudio. Parece existir una relación con el incremento en la síntesis de tejido adiposo, que provoca obesidad y enfermedades derivadas. Los edulcorantes sintéticos fueron los que presentaron más alteraciones citotóxicas, mientras que edulcorantes naturales, a excepción de los esteviósidos, no presentaron efectos adversos. Múltiples investigaciones explican el efecto del consumo de estos edulcorantes en el metabolismo y los efectos citotóxicos. Conclusiones: el tema de edulcorantes es controversial, por ello la información recopilada en esta revisión busca proporcionar un panorama que ayude a comprender la respuesta a nivel celular y metabólico sobre su consumo.

Abstract Background: The primary function of non-nutritive sweeteners is to provide the consumer with a sweet product without the caloric load of sugar. The consumption of non-nutritive sweeteners is related to alterations in DNA, apoptosis, and the synthesis of cancer precursors. Recently, its consumption has been related to an increase in adipose tissue. Objective: To analyze the effect of long-term consumption of these sweeteners and evaluate the risk of these related factors. Materials and Methods: Pubmed, Scielo and Redalyc database search and analysis of references related to toxic and metabolic effects of consumption of non-nutritrive sweeteners. Results: The consumption presents cytotoxic effects in different study models. There appears to be a relationship with an increase in synthesis of adipose tissue, which causes obesity and derived diseases. Synthetic sweeteners have the most cytotoxic alterations, whereas natural sweeteners, except steviosides, do not present adverse effects. Multiple investigations explain the impact of non-nutritive sweetener consumption on metabolism and related cytotoxic effects. Conclusion: The issue of sweeteners is controversial; therefore the information compiled in this review seeks to provide a panorama that helps understand the cellular and metabolic level responses of their consumption.

Edulcorantes no nutritivos: consumo de los niños y adolescentes, y alimentos que los aportan / Non-nutritive sweeteners: children and adolescent consumption and food sources

La disponibilidad de alimentos y bebidas con edulcorantes no nutritivos (ENN) aumentó en años recientes. Objetivos: Estimar el consumo de ENN en niños y adolescentes de la Ciudad de Buenos Aires, la prevalencia de ingesta superior a la admisible y los principales alimentos y bebidas aportadores. Material y Métodos: Estudio descriptivo de información recolectada en la Primera Encuesta Alimentaria y Nutricional de la ciudad de Buenos Aires realizada en 2011 que incluyó 2664 niños y adolescentes de 2 a 18 años. El consumo se evaluó mediante recordatorio de 24 horas. El contenido de ENN en alimentos y bebidas se obtuvo del rotulado nutricional. Se calculó la ingesta total de cada ENN y la adecuación a la ingesta diaria admisible (IDA) establecida por FAO/OMS. Resultados: El 44% de los preescolares, 53% de escolares y 51% de los adolescentes consumieron alimentos con ENN. Ningún niño presentó un consumo superior a la IDA de aspartamo, acesulfame-K y sucralosa. El 0,3% de los preescolares superó la IDA de sacarina, el 1% de preescolares, 0,9% de escolares y el 0,1% de los adolescentes superaron la IDA de ciclamato, debido al consumo de jugos concentrados para diluir. Las bebidas aportaron el 67% del ciclamato, el 91% del acesulfame-K y el 96% del aspartamo. Los edulcorantes de mesa aportaron el 30% del ciclamato y el 32% de la sacarina. Conclusión: El consumo de alimentos con ENN es usual en la población infanto juvenil, principalmente a partir de bebidas. Menos del 1% de los niños supera la IDA de ciclamato y sacarina.

The availability of food and beverages with non-nutritive sweeteners (NNSs) has increased in recent years. Objectives: To estimate NNSs consumption among children and adolescents in the Autonomous City of Buenos Aires, the prevalence of a daily intake higher than acceptable, and the main food and beverages contributing to it. Material and methods: Descriptive study about the information collected in the First Food and Nutritional/Nutrition Survey of Buenos Aires City, which was conducted in 2011 and included 2664 children and adolescents aged 2-18 years. Consumption was assessed by means of a 24-hour recall. NNSs content in food and beverages was obtained from nutrition facts labels. The total dietary intake for each NNSs and the adequacy to the acceptable daily intake (ADI) established by the Food and Agriculture Organization of the United Nations (FAO)/World Health Organization (WHO). Results: Forty four percent of preschoolers, 53% of school children, and 51% of adolescents have had food with NNSs. No child was exposed to a consumption of aspartame, acesulfameK, and sucralose higher than the ADI. Saccharin consumption was higher than the ADI in 0.3% of preschoolers while cyclamate consumption was higher than the ADI in 0.9% of school children and 0.1% of adolescents, due to the consumption of concentrated juice, to be diluted with water. Beverages provided 67% of cyclamate, 91% of acesulfameK, and 96% of aspartame. Table-top sweeteners provided 30% of cyclamate and 32% of saccharin. Conclusion: Consumption of food and beverages with NNSs is usual among children and adolescents, mainly from beverages. Less than 1% of children are exposed to a consumption of cyclamate and saccharin higher than the ADI.

Ingesta de edulcorantes no nutritivos en tres poblaciones distintas de adultos en México / Intake of non-nutritive sweeteners in three distinct populations of adults in Mexico

RESUMEN Introducción. La ingesta de edulcorantes no nutritivos ha aumentado en los últimos años. Se piensa que su uso está dirigido al control de la diabetes mellitus y la obesidad. Objetivos: Establecer el consumo de los edulcorantes no nutritivos en tres diferentes poblaciones de México. Sujetos y métodos: Se incluyeron a 332 adultos participantes que se dividieron en tres grupos: Grupo A) 131 jóvenes; Grupo B) 99 acompañantes de pacientes de un hospital de Seguridad Social, considerados como de nivel socioeconómico bajo-típico y Grupo C) 102 familiares de pacientes de un hospital privado, considerados como de nivel socioeconómico medio-alto y alto. Resultados: No hubo diferencias en las condiciones demográficas, excepto la edad en el grupo de jóvenes. El índice de masa corporal fue similar aunque el grupo de jóvenes se encuentran en peso normal y los adultos en sobrepeso. La prevalencia de diabetes entre los grupos de adultos fue de 15.1% y 21.5% respectivamente, pero el uso de edulcorantes no nutritivos y sacarosa se encuentran en la misma proporción (49% vs 51%). Conclusión: La ingesta de edulcorantes no nutritivos en la población estudiada no está dirigida al control de la diabetes mellitus ni para prevenir o tratar el sobrepeso y la obesidad.

ABSTRACT Introduction. The intake of non-nutritive sweeteners has increased in recent years. It is thought that its use is aimed at the control of diabetes and obesity. Objectives: Establish the intake of non-nutritive sweeteners in three different populations in Mexico. Subjects and methods: we included 332 participating adults who were divided into three groups: Group A) 131 young people, Group B) 99 escorts of patients of a Social Security hospital, considered to be of low-typical socio-economic level and Group C) 102 escorts of patients in a private hospital, considered as medium-high and high socioeconomic level. Results: There were no differences in the demographic conditions, except for the age group of young people. The body mass index was similar although the youth group is found in normal-weight and overweight in adults. The prevalence of diabetes among the groups of adults was 15.1% and 21.5% respectively, but the use of sucrose and non-nutritive sweeteners are in the same proportion (49% vs. 51%). Conclusion: The intake of non-nutritive sweeteners in studied population are not aimed at the control of diabetes mellitus or and obesity.

Proceedings of the NSM Update Series: Sugar Substitutes-Understanding the Basics, Global Regulatory Approvals, Safety Assessment Protocols and Benefits

A seminar titled "Sugar Substitutes: Understanding the Basics, Global Regulatory Approvals, Safety Assessment Protocols and Benefits" organised by the Nutrition Society of Malaysia was held on 1.5th Apri12015 for nutritionists and other health care professionals, to review and discuss the latest evidence on safety and efficacy of sugar substitutes. Highlights from lectures by local and international speakers about this topical subject are presented in this report. Sugar substitutes have been extensively evaluated for decades and regulatory agencies world-wide continue to review and confirm their safety. Furthermore, the effects of sugar substitutes on human health continue to be the subject of research studies. Many studies have shown that replacement of sugar with sugar substitutes may help in weight management, glucose control for people with diabetes, and in the prevention of tooth decay. It is important for health professionals to discern whether the available evidence is based on good science and adequate protocols in order to guide consumers with the responsible use of sugar substitutes following national and international dietary guidelines. The use of sugar substitutes for certain health outcomes was discussed, specifically in regard to appetite, energy balance, body weight and other cardio-metabolic risk factors. Overall, the seminar provided an understanding of the different types of commercially available sugar substitutes, their use in a range of food and beverages, and calorie contribution to the diet. The seminar also covered the approvals of different sugar substitutes and the protocols for assessing the safety of these sugar substitutes, especially in the case of children and pregnant women.

Proceedings of the NSM Update Series: Sugar Substitutes-Understanding the Basics, Global Regulatory Approvals, Safety Assessment Protocols and Benefits

A seminar titled "Sugar Substitutes: Understanding the Basics, Global Regulatory Approvals, Safety Assessment Protocols and Benefits" organised by the Nutrition Society of Malaysia was held on 1.5th Apri12015 for nutritionists and other health care professionals, to review and discuss the latest evidence on safety and efficacy of sugar substitutes. Highlights from lectures by local and international speakers about this topical subject are presented in this report. Sugar substitutes have been extensively evaluated for decades and regulatory agencies world-wide continue to review and confirm their safety. Furthermore, the effects of sugar substitutes on human health continue to be the subject of research studies. Many studies have shown that replacement of sugar with sugar substitutes may help in weight management, glucose control for people with diabetes, and in the prevention of tooth decay. It is important for health professionals to discern whether the available evidence is based on good science and adequate protocols in order to guide consumers with the responsible use of sugar substitutes following national and international dietary guidelines. The use of sugar substitutes for certain health outcomes was discussed, specifically in regard to appetite, energy balance, body weight and other cardio-metabolic risk factors. Overall, the seminar provided an understanding of the different types of commercially available sugar substitutes, their use in a range of food and beverages, and calorie contribution to the diet. The seminar also covered the approvals of different sugar substitutes and the protocols for assessing the safety of these sugar substitutes, especially in the case of children and pregnant women.

Asociación entre edulcorantes no nutritivos y riesgo de obesidad en estudiantes universitarios de Latinoamérica / Association between non-nutritive sweeteners and obesity risk among university students in Latin America

Background: The association between non-nutritive sweeteners and obesity is controversial. Aim: To determine whether the consumption of non-nutritive sweeteners is related to higher risk for overweight or obesity among university students in Chile, Panama, Guatemala and Peru. Material and Methods: A total of 1,224 (472 from Chile, 300 from Panama, 248 from Guatemala and 204 from Peru) male and female university students aged between 18 and 26 years participated in the study. Each student reported their food intake (frequency of weekly consumption) in a survey that contained photos of foods containing non-nutritive sweeteners adapted for each country. Anthropometry was also measured. Results: More than 80% of students consumed at least one product containing non-nutritive sweeteners. Females who ate acesulfame potassium and sucralose had a lower risk of overweight or obesity with an odds ratio (OR) of 0.5 (confidence intervals (CI) = 0.3-0.9; p = 0.003) and OR = 0.4 (IC = 0.2-0.8; p = 0.01), respectively. Conclusions: In this sample of Latinamerican university students, consumption of non-nutritive sweeteners was associated with lower risk of overweight only in females.

Efecto de edulcorantes no calóricos en la calidad sensorial de jugo de naranja / Effect of non caloric sweeteners in sensory quality of orange juice

The consumption of non-caloric sweeteners is increasing in Chile being present in a wide variety of foods. The objective of this study was to evaluate the effect of distinct non-caloric sweeteners in the sensory qualities of orange juice as compared to sugar. The sweeteners selected were stevia, sucralose, saccharin and aspartame. These were added to natural juices in amounts equivalent to sugar in sweetness. Sensory analysis was performed with a group of youths of both sexes. An acceptability test was applied with an hedonic scale of 5 points evaluating aroma and flavor. The results indicate that the juice aroma is not affected by the use of sugar or sweeteners rated 3.5 to 3.7 (corresponding to "I like"). However, in the evaluation of flavor, significant differences were found, the best results corresponding to juice sweetened with sugar and sucralose (3,5 y 3,6 respectively).

El consumo de edulcorantes no calóricos es cada vez más masivo en nuestro país y están presentes en una gran variedad de alimentos. El objetivo de este estudio fue evaluar el efecto de edulcorantes no calóricos en la calidad sensorial de jugo de naranja, en comparación con el azúcar. Los edulcorantes seleccionados fueron estevia, sucralosa, sacarina y aspartamo. Se adicionaron a jugos naturales en cantidades equivalentes de dulzor respecto al azúcar. El análisis sensorial se realizó con un grupo de jóvenes de ambos sexos. Se aplicó una prueba de aceptabilidad con escala hedónica de 5 puntos, evaluando los parámetros de aroma y sabor. Los resultados indican que el aroma de los jugos no se ve afectado por la utilización de azúcar o edulcorantes, con calificación entre 3,5 a 3,7 (que corresponde a "me gusta"). Sin embargo, en la evaluación de sabor las muestras significativamente mejor evaluadas corresponden a jugos endulzados con azúcar y sucralosa (3,5 y 3,6 respectivamente).

The Efficacy and Safety of Non-Nutritive Sweeteners / 임상당뇨병

High intake of added sugars increases the risk for obesity, type 2 diabetes, and cardiovascular disease. Non-nutritive sweeteners (NNS) are widely used in many beverages and food products to reduce calories and sugar content. NNS have higher intensity of sweetness per gram than caloric sweeteners such as sucrose, corn syrup, and fruit juice concentrates. NNS approved for use have been tested and determined to be safe at levels that are within acceptable daily intake by the Joint Food Agriculture Organization/World Health Organization Expert Committee on Food Additives. The eight items of sweeteners are regulated as food additives in Korea. Dietary intake of the sweeteners was suggested as safety level by the ministry of Food and Drug Safety in 2012. If substituted for caloric sweeteners without intake of additional calories from other food sources, NNS may help consumers limit carbohydrate and energy intake as a strategy to manage blood glucose and weight. Dietitians can provide guidance on the use of NNS that give the desired results in food preparation and use at the table.

Consumo de edulcorantes no nutritivos y estado nutricional de escolares de 10-16 años / Consumption of non-nutritive sweeteners and nutritional status in 10-16 year old students

Introducción. El impacto de los edulcorantes no nutritivos (ENN) sobre la ingesta energética y el peso corporal es poco claro, a pesar del nulo aporte energético que brindan en comparación con la sacarosa. Objetivo. Determinar si existen diferencias en el consumo de ENN según el estado nutricional y su asociación con el sobrepeso. Población, material y métodos. Estudio de corte transversal, que incluyó a 571 escolares de 10-16 años, de ambos sexos, de las ciudades de Viña del Mar y Santiago de Chile, a quienes se les aplicó una encuesta alimentaria adaptada con fotografías de productos con ENN, se les evaluó el estado nutricional y se denominó grupo (SP) a los escolares con sobrepeso y obesidad. Resultados. El 96,6% de los estudiantes consume ENN diariamente. Al comparar la ingesta de ENN total y según el estado nutricional de los hombres, se evidenció un mayor consumo de sucralosa (p < 0,05) y sacarina (p < 0,01) en el grupo SP, y, al comparar la ingesta por kilo de peso, el consumo de sacarina fue mayor en el grupo SP (p < 0,05). En las mujeres, el grupo normopeso presentó un consumo por kilo de peso de acesulfamo k mayor que el grupo SP (p < 0,05). No hubo asociación entre la ingesta de ENN en general y la obesidad en la muestra estudiada. Conclusión. El 96,6% de los estudiantes consume ENN diariamente y no se encontró asociación entre el consumo de ENN y el sobrepeso.

Introduction. The impact of non-nutritive sweeteners (NNS) on energy intake and body weight is not clear although they provide no energy compared to sucrose. Objective. To establish if there are differences in the consumption of NNS as per the nutritional status and its association with overweight. Population, Material and Methods. Cross-sectional study including 571 male and female students aged 10-16 years old from the cities of Viña del Mar and Santiago de Chile who were administered an adapted food survey using pictures of NNS-containing products; nutritional status was assessed and students with overweight and obesity were categorized as a the overweight group. Results. Of all surveyed students, 96.6% consume NNS on a daily basis. The comparison between the total NNS intake by nutritional status showed that male students in the overweight group consume more sucralose (p < 0.05) and saccharin (p < 0.01), while the comparison of NNS intake per kilogram of body weight showed that NNS consumption was higher in the overweight group (p < 0.05). Among female students, the normal weight group showed a higher consumption of acesulfame K per kilogram of body weight than the overweight group (p < 0.05). No association was observed in the studied sample between the overall NNS intake and obesity. Conclusion. Of all surveyed students, 96.6% consume NNS on a daily basis, and no association was found between NNS consumption and overweight.

Edulcorantes no nutritivos, riesgos, apetito y ganancia de peso / Non-nutritive sweeteners risks, appetite and weight gain

Artificial sweeteners are substances that provide energy and are added to foods to provide sweetness, increasing the pleasure of eating. The aim of the following review is to report on the current literature regarding artificial sweeteners, risks related to consumption, and possible effects on appetite and weight gain. Since the introduction of the artificial sweeteners, the media have reported the potential risks of cancer, which has undermined the sense of public safety. The role of sweeteners on cancer risk has been widely debated in recent decades. Recent studies indicate no adverse effects on the consumption of saccharin, aspartame, acesulfame k and other sweeteners. This includes data on cancers of the stomach, pancreas and endometrium. Today many artificial sweeteners are combined in current products, the carcinogenic risk of a single substance is difficult to assess. Consumption of sweet flavors in the absence of calories produced significantly different effects compared to the consumption of sweet flavors associated with calories, and over time these effects may contribute to a positive energy balance and increased body weight gain.

Los edulcorantes artificiales son sustancias que no aportan energía y que se agregan a los alimentos para proporcionarles un sabor dulce, incrementando el placer por comer. El objetivo fue revisar la literatura sobre el estado del arte de los edulcorantes artificiales, riesgos de su consumo, posibles efectos en el apetito y ganancia de peso. Desde su introducción, los medios de comunicación han informado sobre los riesgos potenciales de cáncer, lo que ha contribuido a socavar el sentido de la opinión pública de la seguridad. El papel de los edulcorantes en el riesgo de cáncer ha sido ampliamente debatido durante las últimas décadas. Recientes estudios no muestran efectos adversos sobre el consumo de sacarina, aspartame, acesulfamo k y otros edulcorantes, incluyendo datos sobre los cánceres de estómago, páncreas y endometrio. Actualmente muchos edulcorantes artificiales se combinan en los productos actuales, el riesgo cancerígeno de una sustancia única es difícil de evaluar. El consumo de los sabores dulces en la ausencia de calorías produce efectos significativamente diferentes en comparación con el consumo de los sabores dulces asociados con las calorías, y con el tiempo estos efectos pueden contribuir a un balance energético positivo y al aumento de aumento de peso corporal.