Glycemic Effects of Rebaudioside A and Erythritol in People with Glucose Intolerance

Shin, Dong‐Hee; Lee, Ji Hye; Kang, Myung Shin; Kim, Tae Hoon; Jeong, Su Jin; Kim, Chong Hwa; Kim, Sang Soo; Kim, In Joo

doi:10.4093/dmj.2016.40.4.283

Cited by 20 publications

(13 citation statements)

References 23 publications

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“…The biological mechanisms for the association between artificial sweetener and weight gain are proposed to relate to gut microbiota metabolism (31). Several recent studies of erythritol loading reported no effect on glucose (32,33), consistent with our findings. A study in patients with diabetes reported that erythritol and enrichment of another PPP biomarker (ribose) were increased in patients with diabetic retinopathy, and suggested that polyol pathway flux may yield biomarkers of clinical risk in diabetes (34).…”

Section: Discussionsupporting

confidence: 82%

Erythritol is a pentose-phosphate pathway metabolite and associated with adiposity gain in young adults

Hootman

Trezzi

Kraemer

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

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Metabolomic markers associated with incident central adiposity gain were investigated in young adults. In a 9-mo prospective study of university freshmen (n = 264). Blood samples and anthropometry measurements were collected in the first 3 d on campus and at the end of the year. Plasma from individuals was pooled by phenotype [incident central adiposity, stable adiposity, baseline hemoglobin A1c (HbA1c) > 5.05%, HbA1c < 4.92%] and assayed using GC-MS, chromatograms were analyzed using MetaboliteDetector software, and normalized metabolite levels were compared using Welch's t test. Assays were repeated using freshly prepared pools, and statistically significant metabolites were quantified in a targeted GC-MS approach. Isotope tracer studies were performed to determine if the potential marker was an endogenous human metabolite in men and in whole blood. Participants with incident central adiposity gain had statistically significantly higher blood erythritol [P < 0.001, false discovery rate (FDR) = 0.0435], and the targeted assay revealed 15-fold [95% confidence interval (CI): 13.27, 16.25] higher blood erythritol compared with participants with stable adiposity. Participants with baseline HbA1c > 5.05% had 21-fold (95% CI: 19.84, 21.41) higher blood erythritol compared with participants with lower HbA1c (P < 0.001, FDR = 0.00016). Erythritol was shown to be synthesized endogenously from glucose via the pentose-phosphate pathway (PPP) in stable isotope-assisted ex vivo blood incubation experiments and through in vivo conversion of erythritol to erythronate in stable isotope-assisted dried blood spot experiments. Therefore, endogenous production of erythritol from glucose may contribute to the association between erythritol and obesity observed in young adults.erythritol | metabolomics | pentose-phosphate pathway | adiposity | weight gain I n the fall of 2015, an estimated 3.3 million high-school graduates enrolled in postsecondary education as first-time college freshmen (1), and the transition to a residential college environment is associated with weight gain. About 75% of the population experiences weight gain during this transition (2, 3), but there have been few efforts to identify biomarkers of risk that could guide prevention efforts. A study (4) in monozygotic twins discordant for body mass index (BMI) reported divergence at about the age of 18 y, corresponding to a time in life when the environment shifts, and further underscoring the importance of young adulthood in the lifetime trajectory of adiposity and as a window of opportunity for prevention (5).Observational studies of young adults focus on behavioral/environmental risk factors for adiposity gain, with few studies reporting biological markers in relation to either cross-sectional and/or longitudinal changes in adiposity or body weight. A recent overview of intervention studies to prevent weight gain in young adults (6) identified 37 studies; the majority assessed diet, physical activity, and behaviors, with only 10 studies directly measuring change...

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Section: Discussionsupporting

confidence: 82%

Erythritol is a pentose-phosphate pathway metabolite and associated with adiposity gain in young adults

Hootman

Trezzi

Kraemer

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

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“…Six hundred and seventy-seven nonduplicate studies were obtained from electronic searches, out of which 17 eligible studies were identified (Figure 2). A total of 10 studies were excluded due to incompatible data ( n = 4 [14,21,22,41]) and inappropriate study design ( n = 6 [25,42,44,56,57,58]). Seven studies comprising nine RCTs and a total of 462 participants were included in this review [15,16,17,18,19,43,59].…”

Section: Resultsmentioning

confidence: 99%

Effect of Steviol Glycosides on Human Health with Emphasis on Type 2 Diabetic Biomarkers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019

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The natural sweetener from Stevia rebaudiana Bertoni, steviol glycoside (SG), has been proposed to exhibit a range of antidiabetic properties. The objective of this systematic review was to critically evaluate evidence for the effectiveness of SGs on human health, particularly type 2 diabetic (T2D) biomarkers, collecting data from randomized controlled trials (RCTs). Electronic searches were performed in PubMed and EMBASE and the bibliography of retrieved full-texts was hand searched. Using the Cochrane criteria, the reporting quality of included studies was assessed. Seven studies, nine RCTs, including a total of 462 participants were included. A meta-analysis was performed to assess the effect of SGs on following outcomes: BMI, blood pressure (BP), fasting blood glucose (FBG), lipids, and glycated hemoglobin (HbA1c). The meta-analysis revealed an overall significant reduction in systolic BP in favour of SGs between SG and placebo, mean difference (MD): −6.32 mm Hg (−7.69 to 0.46). The overall effect of BMI, diastolic BP, FBG, total cholesterol, and high-density lipoprotein cholesterol (HDL-C) was a non-significant reduction in favour of SGs, and a non-significant increase in low-density lipoprotein cholesterol and triglyceride, while no significant effect of HbA1c was found. Heterogeneity was significant for several analyses. More studies investigating the effect of SGs on human health, particularly T2D biomarkers, are warranted.

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“…In healthy adults, a reduction in postprandial iAUC for glycaemia and insulinaemia was also demonstrated when a stevia-sweetened beverage was consumed along with a meal, compared to consuming a sugar-sweetened beverage [ 21 ]. The long-term consumption of rebaudioside A (one type of steviol glycoside) did not alter the fasting blood glucose in subjects with T2D [ 22 ] or with glucose intolerance [ 23 ]. To the best of our knowledge, currently there is no available study investigating whether there is a change in glucose response to an oral glucose tolerance test (OGTT) after the daily consumption of stevia in healthy adults.…”

Section: Introductionmentioning

confidence: 99%

Effects of the Daily Consumption of Stevia on Glucose Homeostasis, Body Weight, and Energy Intake: A Randomised Open-Label 12-Week Trial in Healthy Adults

et al. 2020

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Stevia is a non-nutritive sweetener, providing sweet taste with no calories. This randomised, controlled, open-label 2-parallel arm trial examined the effects of daily stevia consumption on glycaemia in healthy adults. Secondary endpoints included body weight (BW) and energy intake (EI). Healthy participants (n = 28; aged 25 ± 5y, body mass index 21.2 ± 1.7 kg/m2) were randomised into either the stevia group (n = 14)—required to consume a stevia extract daily—or to the control group (n = 14). At weeks 0 and 12, the glucose and insulin responses to an oral glucose tolerance test were measured; BW and EI were assessed at weeks 0, 6, and 12. There was no significant difference in the glucose or insulin responses. There was a significant main effect of group on BW change (F(1,26) = 5.56, p = 0.026), as the stevia group maintained their weight as opposed to the control group (mean weight change at week 12: −0.22 kg, 95%CI [−0.96, 0.51] stevia group, +0.89 kg, 95%CI [0.16, 1.63] control group). The energy intake was significantly decreased between week 0 and 12 in the stevia group (p = 0.003), however no change was found in the control group (p = 0.973). Although not placebo-controlled, these results suggest that daily stevia consumption does not affect glycaemia in healthy individuals, but could aid in weight maintenance and the moderation of EI.

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Glycemic Effects of Rebaudioside A and Erythritol in People with Glucose Intolerance

Cited by 20 publications

References 23 publications

Erythritol is a pentose-phosphate pathway metabolite and associated with adiposity gain in young adults

Erythritol is a pentose-phosphate pathway metabolite and associated with adiposity gain in young adults

Effect of Steviol Glycosides on Human Health with Emphasis on Type 2 Diabetic Biomarkers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Effects of the Daily Consumption of Stevia on Glucose Homeostasis, Body Weight, and Energy Intake: A Randomised Open-Label 12-Week Trial in Healthy Adults

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