Low Caloric Sweeteners for Diabetes and Obesity Care and Their
Abstract
Diabetes and obesity are two common human disorders that affecting human health and invite various diseases and disorders in normal body functions. These diseases are very common worldwide. Diabetes occurs when high blood sugar levels develop. This happens when body can’t make and use all of the insulin it needs to blood sugar normally to keep blood sugar levels as normal as possible to control diabetes. Diabetic patients will need to follow a diet plan, do exercise and possibly take insulin injections. As part of eating plan, health care provider, and dietitian may ask to limit the amount of carbohydrates eat each day. Low-calorie sweeteners are one easy tool to help for follow eating plan. Obesity is more susceptible and often been associated with frequent ingestion of high energy food in high amount and high intake of sugars such as fermentable sugars such as sucrose, fructose, glucose, and maltose. Both diseases are may be genetically or due to hormonal imbalances. High energy sweeteners may causes caries in the teeth particularly susceptible to the children. Increased calorie intake associated with sugars and carbohydrates, especially when associated with physical inactivity, has been implicated in obesity. Fortunately, low calorie artificial and natural alternatives of sugars have been developed as alternatives to fermentable sugars and have shown promise in these health issues. Although there are only few artificial sweeteners (saccharin, aspartame, acesulfam potassium, sucralose, cyclamate) that have been approved as food additives by the Food and Drug Administration and additional other low-caloric sweeteners (sugar alcohols, neotame, stevia, erythritol, xylitol, tagatose) that have FDA-generally recognized as safe. Given the health impact of sugars and other carbohydrates, professionals should be aware of the marketed available low caloric sweeteners and both their benefits and potential risks.
Chantelea EA, Gosseringer G, Sonnenberg GE, et al. Moderate intake of sucrose does not impair metabolic control in pump treated out-patients. Diabetologia 1985, 28:204–7.
Wolever TMS, Vuksan V, Katzman-Relle L, et al. Glycemic index of some fruits and fruit products in patients with diabetes. Int J Food Sci Nutr 1993;43:205–12.
Jellish WS, Emanuele MA, Abraira C. Graded sucrose/carbohydrate diets in overtly hypertriglyceridemic diabetic patients. Am J Med 1984, 77:1015–22.
Colagiuri S, Miller JJ, Edwards RA. Metabolic effects of adding sucrose and aspartame to the diet of subjects with non-insulindependent diabetes mellitus. Am J Clin Nutr 1989; 50:474–8.
5. Brand Miller JC, Lobbezoo I. Replacing starch with sucrose in a high glycemic index breakfast cereal lowers glycemic and insulin responses. Eur J Clin Nutr 1994, 48:749–52.
Frayn KN, Kingman SM. Dietary sugars and lipid metabolism in humans. Am J Clin Nutr 1995, 62(Suppl.): 250S–263S.
National Academy of Sciences and Institute of Medicine, Dietary References Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids, Appendix National Nutrition Committee of the Canadian Diabetes Association. Sucralose update. Can J Diabetes Care 1994; 18(2):14–15.
Sechhi A, Pontiroli AE, Cammelli L, et al. Effects of oral administration of maltitol on plasma glucose, plasma sorbitol, and serum insulin levels in man. Klin Sochenschr 1986; 64:265–9.
Natah SS, Hussien KR, Tuominen JA, et al. Metabolic response to lactitol and xylitol in healthy men. Am J Clin Nutr 1997; 65:947–50.
Wursch P, Koellreutter B, Schweizer TF. Hydrogen excretion after ingestion of five different sugar alcohols and lactulose. Eur J Clin Nutr 1989; 43:819–25.
American Diabetes Association. Clinical Practice Recommendations. Diabetes Care 1999; (suppl. 1):S42–S45.
International Food Information Council Foundation, 1100 Connecticut Ave., Suite 430, Washington, DC 20036, http://ific.org.
Centers for Disease Control, Centers for Disease Control and Prevention, “Overweight and Obesity. Defining overweight and obesity,” October 2011, http://www.cdc.gov/obesity/de- fining.html.
Ogden, CL,Yanovski SZ, Carroll MD, Flegal KM. “The epidemiology of obesity,” Gastroenterology 2007; 132(6): 2087–2102.
Wang Y, Beydoun MA. The obesity epidemic in the United States-gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a systematic review and metaregression analysis. Epidemiologic Reviews 2007; 29( 1): 6–28.
Jensen ME. Diet and dental caries. Dent Clin North Am1999; 43(4): 615–33.
Gustafsson BE, Quensel CE, Lanke LS, et al. The Vipeholm dental caries study; the effect of different levels of carbohydrate intake on caries activity in 436 individuals observed for five years. Acta odontol Scand 1954; 11(3-4): 232–64.
Scheinin A, Makinen KK. Turku sugar studies. An overview. Acta odontol Scand 1976; 34(6): 405–8.
American Academy of Pediatrics Committee on Nutrition.Policy statement on prevention of overweight and obesity. Pediatrics 2003: 112: 424–30.
Center for Disease Control and Prevention, “National Oral Heal Surveillance System,” October 2011, http://www.cdc.gov/nohss.
Johnson RK, Frary C. Choose beverages and foods to moderate your intake of sugars: The 2000 Dietary Guidelines for Americans-what’s all the fuss about? J Nutr 2001; 131(10): 2766S–2771S.
Kant AK. Consumption of energy-dense, nutrient-poor foods by adult Americans: nutritional and health implications. The third National Health and Nutrition Examination Survey, 1988–1994. Am J Clin Nutr 2000; 72(4): 929–36.
Tseng R, Vann WF Jr, Perrin EM. Addressing childhood overweight and obesity in the dental office: rationale and practical guidelines. Pediatr Dent 2010; 32(5): 417–23.
Harel-raviv M, Laskaris M, Chu KS. Dental caries and sugar consumption into the 21st century. Am J Dent 1996; 9(5): 184–90.
Rugg-gunn AJ. Diet and dental caries in The Prevention of Dental Diseases, J. J.Murray, Ed., pp. 4–114, Oxford University Press, Oxford, UK, 2nd edition, 1989.
Koulourides T, Bodden R, Keller S. Cariogenicity of nine sugars tested with an intraoral device in man. Caries Res 1976; 10(6): 427–41.
Kandelman D. Sugar, alternative sweeteners and meal frequency in relation to caries prevention: new perspectives. Br J Nutr 1997; 77(1): S121–S128.
Sreebny LM. Sugar and human dental caries. World Rev Nutr Diet 1982; 40: 19–65.
Burt BA. Relative consumption of sucrose and other sugars: has it been a factor in reduced caries experience? Caries Res 1993: 27: 56–63.
Reilly JJ, Dorosty AR, Emmett PM. Identification of the obese child: adequacy of the body mass index for clinical practice and epidemiology. Int J Obes 2000; 24(12): 1623–27
Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: The evidence report. National Institutes of Health. Obes Res1998; 6(Suppl. 2): S51– S 209.
Ogden CL, Kuczmarski RJ, Flegal KM, et al. Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics 2002; 109( 1): 45–60.
Braithwaite AS, Vann WF, Switzer BR, Boyd KL, Lee J. Scientific article nutritional counseling practices: how do north carolina pediatric dentists weigh in? Pediatr Dent 2008; 30(6):488–95.
Wolever TMS, Brand Miller JC. Sugars and blood glucose. Am J Clin Nutr 1995; 62 (Suppl.): S 212– S 227.
National Cancer Institute Fact Sheet, Artificial Sweeteners and Cancer, August 2009, http://www.cancer.gov/ cancertopics/factsheet/Risk/ artificial-sweeteners.
Walters DE, Prakash I, Desai N. Active conformations of neotame and other high-potency sweeteners. J Med Chem 2000; 43(6): 1242–45.
Roberts MW, Wright JT. Nonnutritive, Low Caloric Substitutes for Food Sugars: Clinical Implications for Addressing the Incidence of Dental Caries and Overweight/Obesity. International Journal of Dentistry 2012. doi:10.1155/2012/625701.
Roberts MW, Wright JT. Sweetness without sugar. Dimens Dent Hyg 2010; 8(7): 58–61.
Rethman MP, Beitr´an-aguilar ED, Billings RJ, et al. Nonfluoride caries-preventive agents: executive summary of evidence-based clinical recommendations. J Am Dent Assoc 2011; 142(9): 1065–71.
Weihrauch MR, Diehl V. Artificial sweeteners-do they bear a carcinogenic risk? Ann Oncol 2004; 15(10): 1460–65.
Kinghorn AD, Kaneda N, Baek N I, Kennelly EJ, Soejarto DD. Noncariogenic intense natural sweeteners. Med Res Rev1998; 18(5): 347–60.
Goerss AL, Wagner GC, Hill WL. Acute effects of aspartame on aggression and neurochemistry of rats. Life Sciences 2000; 67(11): 1325–29.
Wurtman RJ. Neurochemical changes following high-dose aspartame with dietary carbohydrates. New Engl J Med 1983; 309(7): 429–430.
Maher TJ, Wurtman RJ. Possible neurologic effects of aspartame, a widely used food additive. Environ Health Perspect 1987; 75: 53–7.
Olney JW, Farber NB, Spitznagel E, Robins LN. Increasing brain tumor rates: is there a link to aspartame? J Neuropathol Exp Neurol 1996; 55(11): 1115–23.
Council on Scientific Affairs, “Aspartame: review of safety issues”. J Am Med Assoc 1985; 254: 400–402.
Mukherjee A, Chakrabarti J. In vivo cytogenetic studies on mice exposed to acesulfame-K-a non-nutritive sweetener. Food Chem Toxicol 1997;
(12): 1177–79.
Kroger M, Meister K, Kava R. Low-calorie sweeteners and other sugar substitutes: a review of the safety issues. Comprehensive Reviews in Food Science and Food Safety 2006; 5(2): 35–47.
Grice HC, Goldsmith LA. Sucralose-an overview of the toxicity data. Food Chem Toxicol 2000; 38(2): S1–S6.
50. Prakash I, Bishay IE, Desai N, Eric-Walters D. Modifying the temporal profile of the high-potency sweetener neotame. J Agric Food Chem 2001; 49(2): 786–89.
Witt J. Discovery and development of neotame. World Rev Nutr Diet 1999; 85: 52–57.
Wennerholm K, Arends J, Birkhed D, Ruben J, Emilson CG, Dijkman AG. Effect of xylitol and sorbitol in chewing-gums on mutans streptococci, plaque pH and mineral loss of enamel. Caries Res 1994; 28(1): 48–54.
Creanor SL, Strang R, Gilmour WH, et al. The effect of chewing gum use on in situ enamel lesion remineralization. J Dent Res1992; 71(12): 1895–1900.
Hyams JS. Sorbitol intolerance: an unappreciated cause of functional gastrointestinal complaints. Gastroenterol 1983; 84(1): 30–33.
Hildebrandt GH, Sparks BS. Maintaining mutans streptococci suppression: with xylitol chewing gum. J Am Dent Assoc 2000; 131(7): 909–16.
Isokangas P, Tenovuo J, Soderling E, Mannisto H, Makinen KK. Dental caries and mutans streptococci in the proximal areas of molars affected by the habitual use of xylitol chewing gum. Caries Res 1991; 25(6): 444–8.
Autio JT. Effect of xylitol chewing gum on salivary streptococcus mutans in preschool children. J Dent Child 2002; 69(1): 81–86.
Hayes C. The effect of non-cariogenic sweeteners on the prevention of dental caries: a review of the evidence. J Dent Educ 2001; 65(10): 1106–9.
Makinen KK, Bennett CA, Hujoel PP, et al. Xylitol chewing gums and caries rates: a 40-month cohort study. J Dent Res 1995; 74(12): 1904–13.
Makinen KK, Makinen PL, Pape HR, et al. Conclusion and review of the ’Michigan Xylitol Programme’ (1986–1995) for the prevention of dental caries. Int Dent J 1996; 46(1) 22–34.
Han SJ, Jeong SY, Nam YJ, Yang KH, Lim HS, Chung J. Xylitol inhibits inflammatory cytokine expression induced by lipopolysaccharide from Porphyromonas gingivalis. Clin Diagn Lab Immunol 2005; 12(11): 1285–91.
Makinen KK. The rocky road of xylitol to its clinical application. J Dent Res 2000; 79(6): 1352–55.
Makinen KK, Isotupa KP, Kivilompolo T, Makinen PL, Toivanen J, Soderling E. Comparison of erythritol and xylitol saliva stimulants in the control of dental plaque and mutans streptococci. Caries Res 2001; 35(2): 129–135.
Uhari M, Kontiokari T, Koskela M, Niemela M. Xylitol chewing gum in prevention of acute otitis media: double blind randomized trial. BMJ 1996; 313(7066): 1180–84.
Soderling E, Isokangas P, Pienihakkinen K, Tenovuo J, Alanen P. Influence of maternal xylitol consumption on mother-child transmission of mutans streptococci: 6-year follow-up. Caries Res 2001; 35(3): 173– 77.
Newberne PM, Conner MW, Estes P. The influence of food additives and related materials on lower bowel structure and function. Toxicol Pathol 1988; 16(2): 184–97.
Ludwig B, Schindler E, Bohl J. Reno-cerebral oxalosis induced by xylitol. Neuroradiology 1984; 26(6): 517–21.
Makinen KK, Saag M, Isotupa KP, et al. Similarity of the effects of erythritol and xylitol on some risk factors of dental caries. Caries Res 2005; 39(3): 207–15.
EHOW What is Erythritol Sweetener? July 2011, http://www.ehow.com/ facts 5028505 erythritol-sweetener.html.
Donner TW, Wilber JF, Ostrowski D. D-tagatose, a novel hexose: acute effects on carbohydrate tolerance in subjects with and without type 2 diabetes. Diabetes Obes Metab 1999; 1(5): 285–91.
Levin GV. Tagatose, the new GRAS sweetener and health product. J Med Food 2002; 5(1): 23–36.
Cardello HM, Da Silva MA, Damasio MH. Measurement of the relative sweetness of stevia extract, aspartame and cyclamate/saccharin blend as compared to sucrose at different concentrations. Plant Foods Hum Nutr 1999; 54(2): 119–130.
Lewis WH. Early uses of stevia rebaudiana (Asteraceae) leaves as a sweetener in Paraguay. Econ Bot 1982; 46: 336–7.
Nabors LO, Gelardi RC. Alternative Sweeteners, Marcel Dekker, New York, NY, USA, 2nd edition, 1991.
GRAS Notice Inventory, February 2012, http://www.accessdata. fda.gov/ scripts/fcn/fcnDetailNavigation.cfm?rpt=grasListing&id=252.
Chan P, Tomlinson B, Chen YJ, Liu JC, Hsieh MH, Cheng JT. A double-blind placebo-controlled study of the effectiveness and tolerability of oral stevioside in human hypertension. Br J Clin Pharmacol 2000; 50(3): 215–20.
Matsui M, Matsui K, Kawasaki Y, et al. Evaluation of the genotoxicity of stevioside and steviol using six in vitro and one in vivo mutagenicity assays. Mutagenesis 1996; 11(6): 573–79.
Mattes RD, Popkin BM. Nonnutritive sweetener consumption in humans: effects on appetite and food intake and their putative mechanisms. Am J Clin Nutr 2009; 89(1): 1–14.
Blum JW, Jacobsen DJ, Donnelly JE. Beverage consumption patterns in elementary school aged children across a two-year period. J Am Coll Nutr 2005; 24(2): 93–98.
Blackburn GL, Kanders BS, Lavin PT, Keller SD, Whatley J.The effect of aspartame as part of a multidisciplinary weight-control programon short- and long-termcontrol of body weight. Am J Clin Nutr 1997; 65(2): 409–18.
Touger-decker R, Van loveren C. Sugars and dental caries. Am J Clin Nutr 2003;78(4): S 881– S 92.
Navia JM. Carbohydrates and dental health. Am J Clin Nutr 1994; 59 (Suppl. 3): S719– S27.
Raben A, Vasilaras TH, Christina Moller A, Astrup A. Sucrose compared with artificial sweeteners: different effects on ad libitum food intake and body weight after 10 wk of supplementation in overweight subjects. Am J Clin Nutr 2002; 76(4): 721–29.
Striegel-moore RH, Thompson D, Affenito SG, et al. Correlates of beverage intake in adolescent girls: The National Heart, Lung, and Blood Institute Growth and Health Study. J Pediatr 2006; 148(2): 183–87.
Yang Q. Gain weight by ”going diet? Artificial sweeteners and the neurobiology of sugar cravings: neuroscience. Yale J Biol Med 2010; 83(2): 101–8
Brown RJ, De Banate MA, Rother KI. Artificial sweeteners: a systematic review of metabolic effects in youth. Int J Pediatr Obes 2010; 5(4): 305–12.
Drewnowski A. Intense sweeteners and the control of appetite. Nutr Rev 1995; 53(1): 1–7.
Vermunt SHF, Pasman WJ, Schaafsma G, Kardinaal AFM. Effects of sugar intake on body weight: a review. Obes Rev 2003; 4(2): 91–9.
Liem DG, De Graaf C. Sweet and sour preferences in young children and adults: role of repeated exposure. Physiol Behav 2004; 83(3): 421–29.
Berkey CS, Rockett HRH, Field AE, Gillman MW, Colditz GA. Sugar-added beverages and adolescent weight change. Obes Res 2004; 12(5): 778–88.
Williams CL, Strobino BA, Brotanek J. Weight control among obese adolescents: a pilot study. Int J Food Sci Nutr 2007; 58(3): 217–30.
Benton D. Can artificial sweeteners help control body weight and prevent obesity? Nutr Res Rev 2005; 18(1): 63–76.
Moynihan PJ. Update on the nomenclature of carbohydrates and their dental effects. J Dent 1998; 26( 3): 209–18.
Bertrand MG. Rechercheszur quelques derives du xylose. Bull Soc Chim Fr 1891; 5: 554–57.
Lin J, Curhan GC. Associations of sugar and artificially sweetened soda with albuminuria and kidney function decline in women. Clin J Am Soc Nephrol 2011; 6(1):160–66.
Makinen KK. Sugar alcohols, caries incidence, and remineralization of caries lesions: a literature review.Int J Dent. 2010;2010:981072. doi: 10.1155/2010/981072. Epub 2010 Jan 5.
Vann WF, Bouwens TJ, Braithwaite AS, Lee JY.The childhood obesity epidemic a role for pediatric dentists? Pediatr Dent 2005; 27(4): 271–76.
| Files | ||
| Issue | Vol 1، No 3 (Summer 2013) | |
| Section | Review Article(s) | |
| Keywords | ||
| Diabetes Blood sugar Low-calorie sweeteners Eating plan Obesity Health effects | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
