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Effects of Sweeteners on Glucose, Insulin, and Energy Intake
TAKE-HOME MESSAGE
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In a randomized, crossover study, researchers compared the effect of aspartame, monk fruit, stevia, and sucrose on energy intake, blood glucose, and insulin response in 30 healthy men. They found no difference in energy intake among the different sweeteners. While blood glucose and insulin response was greatest in the first hour with sucrose, the other sweeteners produced high-level responses after the test lunch, and the total AUC was similar among the sweeteners for glucose and insulin response.
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Researchers concluded that non-nutritive sweeteners (natural and artificial) do not significantly influence total daily energy intake, postprandial glucose, or insulin response when compared with sucrose.
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
Substituting sweeteners with non-nutritive sweeteners (NNS) may aid in glycaemic control and body weight management. Limited studies have investigated energy compensation, glycaemic and insulinaemic responses to artificial and natural NNS.
OBJECTIVES
This study compared the effects of consuming NNS (artificial versus natural) and sucrose (65 g) on energy intake, blood glucose and insulin responses.
METHODS
Thirty healthy male subjects took part in this randomised, crossover study with four treatments: aspartame-, monk fruit-, stevia- and sucrose-sweetened beverages. On each test day, participants were asked to consume a standardised breakfast in the morning, and they were provided with test beverage as a preload in mid-morning and ad libitum lunch was provided an hour after test beverage consumption. Blood glucose and insulin concentrations were measured every 15 min within the first hour of preload consumption and every 30 min for the subsequent 2 h. Participants left the study site 3 h after preload consumption and completed a food diary for the rest of the day.
RESULTS
Ad libitum lunch intake was significantly higher for the NNS treatments compared with sucrose (P=0.010). The energy 'saved' from replacing sucrose with NNS was fully compensated for at subsequent meals; hence, no difference in total daily energy intake was found between the treatments (P=0.831). The sucrose-sweetened beverage led to large spikes in blood glucose and insulin responses within the first hour, whereas these responses were higher for all three NNS beverages following the test lunch. Thus, there were no differences in total area under the curve (AUC) for glucose (P=0.960) and insulin (P=0.216) over 3 h between the four test beverages.
CONCLUSIONS
The consumption of calorie-free beverages sweetened with artificial and natural NNS have minimal influences on total daily energy intake, postprandial glucose and insulin compared with a sucrose-sweetened beverage.
Additional Info
Disclosure statements are available on the authors' profiles:
Effects of Aspartame-, Monk Fruit-, Stevia- and Sucrose-Sweetened Beverages on Postprandial Glucose, Insulin and Energy Intake
Int J Obes (Lond) 2017 Jan 10;[EPub Ahead of Print], SL Tey, NB Salleh, J Henry, CG FordeFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Sugar-sweetened beverages (SSBs) are causative for three diseases of the metabolic syndrome: heart disease, NAFLD, and type 2 diabetes. Are there better options for those with a “sweet tooth?” The beverage industry markets non-nutritive sweeteners (NNSs) as the answer…except that correlational studies show that NNS consumption is also associated with the metabolic syndrome. But this is correlation, not causation. Are NNSs themselves metabolically detrimental, or do those with metabolic syndrome assuage their sugar consumption with something they perceive as something less dangerous? And, by replacing sugar, do NNSs actually reduce caloric intake?
This randomized controlled trial by Tey et al evaluated the short-term pharmacodynamic effects of three NNSs (aspartame, stevia, and monk fruit) compared with sucrose on glucose and insulin responses, and on subsequent energy intake over 1 day. In brief, the sucrose drink consumed after breakfast raised glucose and insulin acutely, but lessened glucose and insulin excursions after lunch and reduced calories consumed during lunch and dinner. In comparison, all three NNSs consumed after breakfast resulted in stable glucose or insulin acutely, but their excursions and caloric intake during lunch were accentuated such that the areas under the curve were indistinguishable from those with sucrose. Not surprisingly, total caloric intake during the day was the same with all four sweeteners.
The take-home message of this study is that NNS substitution for sugar does not appear to be acutely detrimental to the consumer based on glucose, insulin, or calories, but neither does it appear to be beneficial. Longer-term pharmacodynamics studies are desperately needed.