Non-nutritive Sweeteners: Consumption Trends, Consumer Perceptions, and Metabolic Effects Open Access

Sylvetsky, Allison Cara (2013)

Permanent URL: https://etd.library.emory.edu/concern/etds/z316q1971?locale=en
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Abstract

We conducted several multi-disciplinary studies to 1) evaluate trends in the consumption of non-nutritive sweeteners over the last decade using national-level data from five 2-year cycles of the National Health and Nutrition Examination Survey (NHANES), 2) assess parental perceptions of non-nutritive sweeteners and parents' ability to recognize non-nutritive sweeteners in packaged foods and beverages, and 3) determine the acute effects of sucralose on glycemia, satiety, gut hormone responses, and levels of free fatty acids. We also conducted a review of existing research assessing the consumption trends, regulations, and recommendations for use of non-nutritive sweeteners in children, which provided an opportunity to synthesize available data assessing their effects on glycemia, energy intake, body weight, and taste preferences in pediatric populations.

We found that the consumption of non-nutritive sweeteners has increased dramatically in the United States over the last decade, among both children and adults. Furthermore, our data demonstrated that parents are largely unable to identify foods and beverages which contain non-nutritive sweeteners. Parents however expressed overall negative attitudes toward providing non-nutritive sweeteners to their children, despite these widespread increases in their consumption. Meanwhile, our metabolic data do not suggest harmful effects of short-term consumption of non-nutritive sweeteners on glycemia, satiety, or glucose kinetics. Future studies are needed to assess the metabolic consequences of long term exposure to non-nutritive sweeteners and to determine the impact of non-nutritive sweeteners on dietary patterns and taste preferences. This knowledge will allow us to develop evidence-based recommendations for the use of non-nutritive sweeteners as a replacement for added sugars in the general population.

Table of Contents

Table of Contents

Chapter 1: INTRODUCTION.. 2

Chapter 2: BACKGROUND.. 6

The history of non-nutritive sweeteners . 6

Definition of non-nutritive sweeteners . 7

Recommendations for non-nutritive sweetener consumption among children and adults . 11

Regulation of non-nutritive sweeteners. 13

Assessing dietary intake of non-nutritive sweeteners . 14

Non-nutritive sweetener consumption, appetite, food intake, and body weight . 15

Sweet taste receptors in glucoregulatory hormone secretion, appetite, and food intake . 19

Role of sweet taste preference in shaping eating behaviors . 20

Purpose of research.22

Chapter 3: METHODS. 31

Objectives and hypotheses. 31

Summary of methods. 32

Methods specific to Chapter 4. 36

Methods specific to Chapter 5. 37

Methods specific to Chapter 6. 39

Statistical Considerations. 43

CHAPTER 4: LOW-CALORIE SWEETENER CONSUMPTION IS INCREASING IN THE U.S. 51

Abstract. 51

Introduction. 53

Subjects and Methods. 54

Results. 57

Discussion. 60

CHAPTER 5: PERCEPTIONS AND RECOGNITION OF NON-NUTRITIVE SWEETENERS. 76

Abstract . 78

Introduction . 79

Methods .80

Results .83

Discussion .86

CHAPTER 6: Ingestion of sucralose prior to an oral glucose load does not alter glycemia, gut hormones or satiety in healthy adults. 111

Abstract. 112

Introduction. 114

Materials and Methods. 115

Results. 118

Discussion. 119

CHAPTER 7: Summary, Conclusions, and Public Health Implications. 137

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