In a recent study published in EBioMedicine, a team of scientists evaluated the changes in endocrine responses and appetite associated with acute and repeated exposures to sweeteners and sweetness enhancers such as Stevia and Neotame and compared it to that of sucrose in an overweight or obese adult study population.
Study: Acute and two-week effects of neotame, stevia rebaudioside M and sucrose-sweetened biscuits on postprandial appetite and endocrine response in adults with overweight/obesity—a randomised crossover trial from the SWEET consortium. Image Credit: Prasert Wongchindawest/Shutterstock.com
Background
The last few decades have seen a rapid rise in unhealthy dietary patterns, with obesity and associated metabolic disorders becoming a global public health concern. Excessive body weight is often due to a combination of energy-rich diets and sedentary lifestyles.
In addition, studies have also found that diets largely comprised of simple carbohydrates such as sugars also result in changes in hormonal responses that increase weight gain and fat storage.
Given the low mineral, vitamin, and fiber content of sugars and the problems associated with altered endocrine responses and appetite, researchers and policymakers in health and medicine have focused on reducing or eliminating the intake of free sugars in diets.
A widely used strategy to reduce free sugar intake has been to replace them with sweetness enhancers or non-nutritive sweeteners.
However, given the absence of evidence on the long-term benefits of non-nutritive sweeteners, guidelines from the World Health Organization specify that sweetness enhancers or non-nutritive sweeteners should not be considered healthier options if the diet aims to reduce weight or lower the risk of metabolic or non-communicable diseases.
These guidelines highlight the need for robust studies to understand the immediate and long-term impacts of non-nutritive sweeteners.
About the study
In the present study, the researchers conducted a randomized crossover trial among a study population in England and France consisting of 53 overweight or obese adults to understand how the acute and repeated impact of consuming sweetness enhancers or non-nutritive sweeteners differed from that of consumption of free sugars.
Since Stevia and Neotame are two of the widely used and approved sweetness enhancers or non-nutritive sweeteners in the European Union, the researchers compared the endocrine responses and appetite changes associated with consuming Stevia and Neotame against those of sucrose.
Sucrose was chosen as the free sugar in this investigation since it is widely used in baked goods not only as a sweetener but also as a bulking agent, preservative, and moisture source.
The present study included male and female individuals between the ages of 18 and 60 years who had a body mass index between 25 and 35 kg per m2, which would categorize them as overweight or obese.
In addition, the eligible participants also had scores of more than or equal to 3 on food frequency questionnaires about habitual consumption of sweets and less than 20 on a questionnaire about eating attitudes.
This randomized crossover study involved the consumption of fruit-filled biscuits containing Neotame, Stevia, or sucrose for two weeks, with week-long washout periods between each of the consumption periods. The treatments were also stratified by age and sex.
Laboratory sessions to assess subjective appetites, such as desire to eat, hunger, thirst, fullness, nausea, prospective intake, bloating, sensory-specific feelings of satiety, and appetite for sweet or savory foods, were conducted on the first and last day of each consumption period.
Additional assessments included food reward, food preferences, and measurements of endocrine and glycemic responses, including insulin, glucose, glucagon-like peptide 1, pancreatic polypeptide, and ghrelin.
Results
The findings showed that the replacement of sucrose with Neotame or Stevia significantly reduced postprandial glucose and insulin responses in adults who were obese or overweight while not having any impact on the endocrine response or appetite.
The appetite score, as well as the results of the food preference assessments, showed no differences associated with the intake of Neotame or Stevia.
The decrease in insulin response was similar after both Neotame and Stevia compared to the insulin response after sucrose consumption. Still, the glucose response change after Neotame intake was not as significant as the decrease in glucose response after Stevia intake, compared to the glucose response after sucrose intake.
The ghrelin, glucagon-like peptide 1, and pancreatic polypeptide levels indicated that the sweetness enhancers and non-nutritive sweeteners did not impact the satiety response in the acute (one day) stage or after repeated exposures.
Conclusions
Overall, the findings indicated that replacing free sugars such as sucrose with non-nutritive sweeteners such as Stevia or Neotame could decrease the postprandial glucose and insulin responses but would not impact satiety, appetite, or food preferences.
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