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A consensus workshop on low-calorie sweeteners (LCS) was held in November 2018 where seventeen experts (the panel) discussed three themes identified as key to the science and policy of LCS: (1) weight management and glucose control; (2) consumption, safety and perception; (3) nutrition policy. The aims were to identify the reliable facts on LCS, suggest research gaps and propose future actions. The panel agreed that the safety of LCS is demonstrated by a substantial body of evidence reviewed by regulatory experts and current levels of consumption, even for high users, are within agreed safety margins. However, better risk communication is needed. More emphasis is required on the role of LCS in helping individuals reduce their sugar and energy intake, which is a public health priority. Based on reviews of clinical evidence to date, the panel concluded that LCS can be beneficial for weight management when they are used to replace sugar in products consumed in the diet (without energy substitution). The available evidence suggests no grounds for concerns about adverse effects of LCS on sweet preference, appetite or glucose control; indeed, LCS may improve diabetic control and dietary compliance. Regarding effects on the human gut microbiota, data are limited and do not provide adequate evidence that LCS affect gut health at doses relevant to human use. The panel identified research priorities, including collation of the totality of evidence on LCS and body weight control, monitoring and modelling of LCS intakes, impacts on sugar reduction and diet quality and developing effective communication strategies to foster informed choice. There is also a need to reconcile policy discrepancies between organisations and reduce regulatory hurdles that impede low-energy product development and reformulation.

Eight healthy nonobese volunteers were asked to rate, on a pleasure-displeasure scale, sucrose and salty solutions as well as alimentary and nonalimentary odors. Effects of intragastric glucose load (vs. water load) and naltrexone (vs. placebo) were tested. Naltrexone produces a significant decrease for sweetened solution on the pleasure scale, a shift even stronger than that of the glucose load itself. Such a decrease is also observed for alimentary odors but not for responses to nonalimentary stimuli. Thus the opioid system is involved in ingestive behavior in humans, and this action is perhaps specific.

Objective: To investigate the influence of ingestion of beverages with sucrose or with intense sweeteners on food intake (FI) and on hunger ratings in before and after a month of daily consumption of beverages. Design: Experimental study. Setting: Department of Physiology, University Hospital, Dijon, France. Subjects: In all, 12 men and 12 women, aged 20-25 y. Intervention: Four beverages contained either sucrose (E þ :100 g/l, 1672 kJ) or intense sweeteners (EÀ: null energy content) and were flavoured with either orange (O) or raspberry (R). FI was measured in the lab during two 2-consecutive-day periods, carried out on 2 successive weeks (session 1). The subjects drank 2 l of either E þ or EÀ beverages on the first day of both weekly periods, according to a balanced randomised design. E þ was paired with O for 50% of subjects and with R for the other 50%. Subjects were then habituated over a 4-week period to both beverages, consuming 1 l of E þ beverage on odd days and 1 l of Edrink on even days. After this period, the measurements of session 1 were repeated (session 2, weeks 7-8). Finally, FI was measured for two more 2-day periods (weeks 9-10) after the association between flavour and energy content was reversed (session 3). Results: The E-drinks were less palatable than the E þ drinks. Besides, we observed that FI was not reduced in response to a liquid extra caloric load and there was no change in hunger ratings after the beverages in any of the sessions. Conclusion: Ingestion of caloric beverages induced a positive energy balance and the continuous exposure phase to these beverages over 1 month did not improve FI adaptation in response to the extra energy provided by the beverages. Sponsorship: This study was sponsored by SEV, Bourg la Reine, France; the French Ministère de la Recherche et de la Technologie (Programme AGROBIO-Aliments Demain) and the Regional Council of Burgundy (Dijon, France).

Hunger may be delayed and food intake reduced under metabolic conditions that spare carbohydrate oxidation, especially during oxidation of medium-chain triacylglycerols (MCTs) or monounsaturated triacylglycerols. In 12 healthy, adult, male volunteers isolated and deprived of any time cues, we compared the effects of 4 high-carbohydrate breakfasts (1670 kJ) supplemented either with a fat substitute (Sub; 70 kJ) or with 1460 kJ fat as monounsaturated long-chain triacylglycerols (LCT-U), saturated long-chain triacylglycerols (LCT-S), or MCTs. In the first session we investigated the effects of these breakfasts on the following food intake variables: hunger ratings at repeated intervals, the time until the spontaneous request for the next 2 free-choice meals, and the amount of food consumed. In a second session with fixed lunches, we studied the effects of the same breakfasts on plasma glucose, insulin, triacylglycerol, fatty acid, and beta-hydroxybutyrate concentrations. The addition of any of the fats to the high-carbohydrate breakfasts did not alter hunger ratings, but significantly delayed the request for lunch compared with the low-fat breakfast. The free-choice lunch eaten after the MCT breakfast was also significantly smaller. Blood glucose and insulin concentrations were lower after the 3 fat breakfasts, followed by larger increases in glucose and enhanced insulin responses 30 min after the lunch. No differences were observed between the LCT-U and LCT-S conditions. We conclude that MCTs decreased food intake by a postabsorptive mechanism, although the exact effect of these lipids on carbohydrate oxidation will require further studies involving nutrient balance measurements.