Neuroendocrine and Metabolic Effects of Low-Calorie and Non-Calorie Sweeteners.

Eleonora Moriconi,Andrea Fabbri,Mauro Lombardo,Marco Infante,Massimiliano Caprio,Alessandra Feraco,Vincenzo Marzolla

doi:10.3389/fendo.2020.00444

Abstract

Since excessive sugar consumption has been related to the development of chronic metabolic diseases prevalent in the western world, the use of sweeteners has gradually increased worldwide over the last few years. Although low- and non-calorie sweeteners may represent a valuable tool to reduce calorie intake and prevent weight gain, studies investigating the safety and efficacy of these compounds in the short- and long-term period are scarce and controversial. Therefore, future studies will need to elucidate the potential beneficial and/or detrimental effects of different types of sweeteners on metabolic health (energy balance, appetite, body weight, cardiometabolic risk factors) in healthy subjects and patients with diabetes, obesity and metabolic syndrome. In this regard, the impact of different sweeteners on central nervous system, gut hormones and gut microbiota is important, given the strong implications that changes in such systems may have for human health. The aim of this narrative review is to summarize the current evidence for the neuroendocrine and metabolic effects of sweeteners, as well as their impact on gut microbiota. Finally, we briefly discuss the advantages of the use of sweeteners in the context of very-low calorie ketogenic diets.

Highlights

On the basis of their energy content, sweeteners can be classified into calorie, low-calorie and non-calorie compounds
A recent study conducted on streptozotocin-induced diabetic mice and non-obese diabetic (NOD) mice—which are both widely used as animal models of human type 1 diabetes—has shown that trehalose, a natural caloric disaccharide derived from a rodent intestinal nematode and characterized by antioxidant properties [211], is able to affect gut microbiota by increasing the abundance of Ruminococcus spp
Authors found that patients with type 1 diabetes, when compared to healthy volunteers, had fewer CD8+ regulatory T cells, as well as lower serum trehalose concentrations and fecal content of Ruminococcus [212]. These results suggest that trehalose may have a potential prophylactic and/or therapeutic role in humans, as a tool to induce CD8+ regulatory T cells in order to prevent the development of type 1 diabetes and/or counteract the immune-mediated β-cell destruction shortly after the onset of the disease

Summary

INTRODUCTION

On the basis of their energy content, sweeteners can be classified into calorie, low-calorie and non-calorie compounds. The ability of sweeteners to affect gut microbiota composition may have important immunological implications In this regard, a recent study conducted on streptozotocin-induced diabetic mice and non-obese diabetic (NOD) mice—which are both widely used as animal models of human type 1 diabetes—has shown that trehalose, a natural caloric disaccharide derived from a rodent intestinal nematode and characterized by antioxidant properties [211], is able to affect gut microbiota by increasing the abundance of Ruminococcus spp. A recent study conducted on streptozotocin-induced diabetic mice and non-obese diabetic (NOD) mice—which are both widely used as animal models of human type 1 diabetes—has shown that trehalose, a natural caloric disaccharide derived from a rodent intestinal nematode and characterized by antioxidant properties [211], is able to affect gut microbiota by increasing the abundance of Ruminococcus spp. It is recommended that sweeteners are consumed in moderate amounts, adhering to the acceptable daily intake standards established by regulatory agencies [213]

DISCUSSION

Findings

CONCLUDING REMARKS

14. Guideline