非营养性甜味剂对胰岛素调节、血糖反应、食欲和体重管理的影响:系统综述

IF 1 Q4 FOOD SCIENCE & TECHNOLOGY
Pulkit Mathur, Anjani Bakshi
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引用次数: 0

摘要

本研究的目的是收集和评估非营养性甜味剂对食欲、体重和血糖调节影响的现有证据。作为糖的替代品,非营养性甜味剂(NNSs)被广泛应用于不同的食品中,人们认为这些甜味剂可以降低卡路里摄入量,有助于更好地控制体重和血糖水平。然而,使用动物模型的研究报告称,长期暴露于NNSs会导致食物消耗增加、体重增加和胰岛素抵抗。设计/方法学/方法从相关临床研究的系统评价或荟萃分析(2016-2021)中获得证据,特别是使用系统评价和荟萃分析指南首选报告项目的随机对照试验。研究结果表明,NNSs暴露并没有最终导致食物摄入量增加或主观食欲评分的改变。胃饥饿素(ghrelin)、胃抑制肽(gastric inhibitory peptide)、c肽(C-peptide)水平和YY肽(peptide YY)等食欲生物标志物基本未受NNSs影响。人类随机对照研究的荟萃分析显示能量摄入和体重减少。食用NNSs后,血糖水平、餐后血糖或胰岛素反应均未见显著变化。没有足够的证据表明NNSs以与人类使用相关的剂量影响肠道健康。大多数前瞻性队列研究、观察性研究和横断面研究表明,使用NNSs可能会促进成人肥胖和代谢综合征。这类研究受到混杂变量和反向因果关系的困扰。机制证据主要基于体外和体内研究。同样的因果途径可能对人类不起作用或不相关。对现有文献的回顾得出的结论是,为了实现特定的公共卫生和临床目标,应该探索安全使用NNSs来减少游离糖和能量的摄入。这可以通过教育消费者关于能量补偿和了解人工增甜产品的营养成分来实现,从脂肪和产品中使用的复杂碳水化合物的卡路里来看。因此,本研究的目的是检验NNSs在人群中的有用性,特别是在胰岛素调节、血糖控制和体重管理方面。设计良好的随机对照试验需要控制混杂变量,以产生高质量的证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of non-nutritive sweeteners on insulin regulation, glycemic response, appetite and weight management: a systematic review
Purpose The purpose of this study is to collect and assess the evidence available on the effect of non nutritive sweeteners on appetite, weight and glycemic regulation. As a replacement for sugars, non-nutritive sweeteners (NNSs) are widely being used in different food products with the assumption that these would lower calorie intake and help to manage weight and blood sugar levels better. However, studies using animal models have reported that chronic exposure to NNSs leads to increased food consumption, weight gain and insulin resistance. Design/methodology/approach Evidence was acquired from systematic reviews or meta-analyses (2016–2021) of relevant clinical studies, especially randomized control trials using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Findings The review showed NNSs exposure did not conclusively induce increased food intake or change in subjective appetite ratings. Appetite biomarkers like ghrelin, gastric inhibitory peptide, C-peptide levels and Peptide YY remained mostly unaffected by NNSs. Meta-analyses of human randomized control studies showed a reduced energy intake and body weight. No significant change was seen in blood glucose levels, post-prandial glycemic or insulin response after consumption of NNSs. Adequate evidence is not available to conclusively say that NNSs influence gut health at doses relevant to human use. Research limitations/implications Most studies which are prospective cohort, observational and cross-sectional studies suggest that use of NNSs may promote obesity and metabolic syndrome in adults. Such studies are plagued by confounding variables and reverse causation. Mechanistic evidence is mostly based on in-vitro and in-vivo studies. The same causal pathways may not be operative or relevant in humans. Practical implications This review of available literature concludes that to achieve specific public health and clinical goals, the safe use of NNSs for the reduction of intakes of free sugars and energy should be explored. This would be possible by educating the consumer about energy compensation and understanding the nutritional content of artificially sweetened products in terms of calories coming from fat and complex carbohydrates used in the product. Originality/value This study was, thus, designed with the objective of examining the usefulness of NNSs in human population, especially with respect to insulin regulation, glycemic control and weight management. Well-designed randomized control trials which control for confounding variables are needed to generate high quality evidence.
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来源期刊
Nutrition & Food Science
Nutrition & Food Science FOOD SCIENCE & TECHNOLOGY-
CiteScore
2.80
自引率
8.30%
发文量
85
期刊介绍: Nutrition & Food Science* (NFS) is an international, double blind peer-reviewed journal offering accessible and comprehensive coverage of food, beverage and nutrition research. The journal draws out the practical and social applications of research, demonstrates best practice through applied research and case studies and showcases innovative or controversial practices and points of view. The journal is an invaluable resource to inform individuals, organisations and the public on modern thinking, research and attitudes to food science and nutrition. NFS welcomes empirical and applied research, viewpoint papers, conceptual and technical papers, case studies, meta-analysis studies, literature reviews and general reviews which take a scientific approach to the following topics: -Attitudes to food and nutrition -Healthy eating/ nutritional public health initiatives, policies and legislation -Clinical and community nutrition and health (including public health and multiple or complex co-morbidities) -Nutrition in different cultural and ethnic groups -Nutrition during pregnancy, lactation, childhood, and young adult years -Nutrition for adults and older people -Nutrition in the workplace -Nutrition in lower and middle income countries (incl. comparisons with higher income countries) -Food science and technology, including food processing and microbiological quality -Genetically engineered foods -Food safety / quality, including chemical, physical and microbiological analysis of how these aspects effect health or nutritional quality of foodstuffs
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