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Dietary and Health Correlates of Sweetened Beverage Intake: Sources of Variability in WWEIA/NHANESGabrielle Riley Bonanno (12126753) 18 April 2022 (has links)
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<p>Recent studies using data from the National Health and Nutrition Examination Survey
(NHANES) have used inconsistent approaches to identify and categorize beverages, especially
those containing low-calorie sweeteners (LCS), also referred to as low-calorie sweetened
beverages (LCSB). Herein, we investigate the approaches used to identify and categorize LCSB
in recent analyses of NHANES data. We reviewed published studies examining LCS consumption
in relation to dietary and health outcomes and extracted the methods used to categorize LCS as
reported by the authors of each study. We then examined the extent to which these approaches
reliability identified LCSBs using the Internet Archive Wayback Machine to examine beverage
ingredients lists across 3 NHANES cycles (2011-2016). None of the four general strategies
appeared to include all LCSB while also excluding all beverages that did not contain LCS. In some
cases, the type of sweetener in the beverage consumed could not be clearly determined; we found
9, 16, and 18 of such “mixed” beverage identifiers in 2011-12, 2013-14, and 2015-15, respectively.
Then, to illustrate how heterogeneity in beverage categorization may impact the outcomes of
published analyses, we compared results of a previously published analysis with outcomes when
“mixed” beverages were grouped either all as LCSB or all as sugary beverages. Our results suggest
that caution is warranted in design and interpretation of studies using NHANES data to examine
dietary and health correlates of sweetened beverage intake.
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Differential Effects of Chronic Low Calorie Sweetener Consumption on Body Weight, Glycemia, and Ingestive BehaviorKelly A. Higgins (5929742) 17 January 2019 (has links)
<p>Low
calorie sweeteners (LCS) provide sweetness with little to no energy. Each
sweetener has a unique chemical structure that possesses unique sensory and
functional characteristics. While LCS are generally considered in aggregate,
these unique chemical structures have potential implications for sensory,
metabolic, and behavioral differences that may impact body weight and glycemia.
Therefore, two, twelve-week experiments were
conducted to determine the effect of chronic LCS consumption on body weight,
glycemia, and ingestive behaviors. </p>
<p>The first experiment
investigated the differential effects of four LCS (saccharin, aspartame,
rebaudioside A, and sucralose) and sucrose consumed for twelve weeks on body
weight, glycemia, and ingestive behaviors among healthy adults with overweight
or obesity (body mass index (BMI) between 25 and 40 kg/m<sup>2</sup>). In a parallel-arm design, 154
participants were randomly assigned to consume 1.25 to 1.75L of beverage sweetened
with 1 of the 5 sweeteners daily for 12 weeks. Body weight was measured every
two weeks; energy intake, energy expenditure, and appetite were assessed every
4 weeks; and glucose tolerance was measured at baseline and week 12. Every four
weeks, participants completed 24-hour urine collections to determine study
compliance via PABA excretion. Sucrose and saccharin consumption led to
increased body weight across the 12-week intervention (Δ weight = +1.85 and
+1.18kg, p ≤ 0.02) and did not differ from each other. While there was no significant change in body
weight with consumption of the other LCS treatments compared to baseline,
changes in weight in comparison to the sucrose treatment (sucrose – LCS) were
significantly different for aspartame, rebA, and sucralose after 12 weeks
(weight difference = 1.13, 1.25, 2.63kg, respectively; p ≤ 0.03). In addition,
change in body weight at week 12 was significantly lower between sucralose and
all other LCS (weight difference ≥ - 1.37 kg, p=0.008).</p>
<p>The second experiment investigated
the effect of daily aspartame ingestion on glycemia, body weight, and
appetite. One hundred lean (BMI between 18 and 25 kg/m<sup>2</sup>) adults were
randomly assigned to consume 0, 350, or 1050 mg aspartame/day for twelve weeks
in a parallel-arm design. This experiment followed a similar protocol but
measured body weight and blood pressure weekly and contained a 240-min glucose-tolerance
test (OGTT) with measurements of selected hormones at baseline and week 12.
Participants also collected 24-h urine samples every four weeks. There were no
group differences for glucose, insulin, resting leptin, glucagon-like peptide
1, or gastric inhibitory peptide at baseline or week 12. There also were no
effects of aspartame ingestion on appetite, body weight, or body composition. </p>
<p>These
trials demonstrate that all
LCS contribute negligible energy but should not be aggregated because of their differing
effects on body weight. Sucrose and saccharin
consumption significantly increased body weight compared to aspartame, rebA,
and sucralose. This differential change in body weight among LCS indicates individual
LCS likely exert different physiological responses beyond the contribution of
sweetness with negligible energy. Saccharin, rebA, sucralose, and
aspartame (ingested at three doses) for twelve weeks had no effect on glycemia.
These data do not support the view that LCS are problematic for the management
of glycemia. If substantiated through additional
testing, findings from this trial have implications for consumers, food
industry, clinicians, and policy makers. Some LCS may not hold the anticipated
beneficial effects on body weight (e.g., saccharin) and positive effects of one
LCS (sucralose) may be attenuated if combined with select other LCS. Going
forward it will be important to consider each LCS as a distinct entity with
respect to its potential health effects.</p>
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