The Effects of Non-Nutritive Sweetener Consumption in the Pediatric Populations: What We Know, What We Don’t, and What We Need to Learn

Shum, Betty J.; Georgia, Senta

doi:10.3389/fendo.2021.625415

Cited by 21 publications

(17 citation statements)

References 61 publications

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“…Additionally, a version of the Artificial Sweetener (Non-nutritive Sweetener) Intake Questionnaire adapted to measure children's NNS intake will be collected from parents. Children with a greater exposure to non-nutritive sweeteners (NNS) may be at greater risk of overweight and obesity ( 56 ). A possible hypothesis for this could be that these children demonstrate poorer ASR, potentially due to an “uncoupling” of energy signaling and energy intake ( 56 ), but this has not yet been tested in children.…”

Section: Methodsmentioning

confidence: 99%

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Examining the Role of Food Form on Children's Self-Regulation of Energy Intake

et al. 2022

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Increasing childhood obesity rates in both the United States and worldwide demonstrate a need for better prevention and intervention strategies. However, little is understood about what factors influence children's ability to sense and respond to hunger and fullness cues, a critical component of self-regulation of energy intake and maintenance of a healthy body weight. Research in adults suggests that food form may influence self-regulation of energy intake. More specifically, beverages are not as satiating as solid foods when matched for factors such as energy content, energy density, and volume and therefore elicit poorer energy intake self-regulation. However, much less is known about the impact of food form on children's ability to regulate their energy intake. This report describes a study that will examine the relationship between biological, cognitive, and psychological factors and children's appetite self-regulation (ASR). In this registered report, we will examine the influence of food form on children's short-term energy compensation, a proxy indicator of energy intake self-regulation. The study will employ a within-subjects, crossover design in which children (n = 78) ages 4.5–6 years will attend five laboratory visits, each ~1 week apart. During each visit, children will be presented with one of five possible preload conditions: apple slices, apple sauce, apple juice, apple juice sweetened with non-nutritive sweetener (NNS), or no preload. The order of preload conditions will be pseudorandomized and counterbalanced across participants. Following consumption of the preload (or no preload), children will consume a standardized ad libitum test meal of common foods for this age group. We hypothesize that children will demonstrate poorer short-term energy compensation (greater meal intake) in response to the liquid and semi-solid preloads compared to the solid preload. Understanding how energy in various forms affects children's ability to self-regulate intake has implications for dietary recommendations and will help identify those who are most at-risk for poor intake regulation and the development of obesity.

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Section: Methodsmentioning

confidence: 99%

“…Children with a greater exposure to non-nutritive sweeteners (NNS) may be at greater risk of overweight and obesity ( 56 ). A possible hypothesis for this could be that these children demonstrate poorer ASR, potentially due to an “uncoupling” of energy signaling and energy intake ( 56 ), but this has not yet been tested in children.…”

Section: Methodsmentioning

confidence: 99%

Examining the Role of Food Form on Children's Self-Regulation of Energy Intake

et al. 2022

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“…These derive support from a large body of research claiming evidence of such mechanisms (e.g., from gut microbiota, neural “taste” responses, and animal feeding paradigms), and imply that these substantiate or explain the adverse effects of LES on glycaemic control, appetite and energy balance in humans. The scientific literature is replete with narrative reviews claiming to address mechanisms “…responsible for the development of metabolic syndrome associated with NNS [non-nutrivie sweetener] consumption” [ 5 ] and that “…contribute to the negative metabolic effects of non-nutritive sweeteners…” [ 6 ], “…demonstrating the role of the microbiota in glucose intolerance in response to noncaloric artificial sweeteners…” [ 7 ]. Indeed, it seems that researchers assume that (new) mechanistic evidence of adverse effects will be found even before experiments are run, pre-registering research protocols with titles, such as “Low-calorie Sweeteners Induce Metabolic Dysregulation Via Alterations in Adipose Signaling” (ClinicalTrials.gov Identifier NCT03125356; an uncontrolled trial that, in fact, found no metabolic dysregulation or changes in any higher-level physiological markers or outcomes [ 8 ]).…”

Section: Perspectivementioning

confidence: 99%

Is There an Academic Bias against Low-Energy Sweeteners?

Mela¹

2022

Nutrients

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This perspective considers evidence of a common academic bias against low-energy sweeteners (LES). The core proposition is that this bias is manifested in research and reporting focused on generating and placing a negative spin on LESs, largely through selective citation, interpretation and reporting. The evidence centres on three inter-related points, which together may generate a misleading impression of the balance of evidence: (1) basic and mechanistic research on LES perpetuates “explanations” for unsubstantiated adverse effects of LES; (2) the literature on LES—particularly narrative reviews and commentaries—continually reprises hypotheses of adverse effects without acknowledging where these hypotheses have been rigorously tested and rejected; and (3) negative interpretations of the effects of LES largely rely upon selectively emphasising lower-quality research whilst ignoring or dismissing higher-quality evidence. The expert community should consider these issues in assuring scientific integrity and balance in the academic discourse on LES, and how this is translated into messages for public health and consumers.

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“…In fact, the consumption of foods and beverages with LCSs has been shown to increase their risk of developing NCDs as adults ( 48 , 52 ). Consuming foods and beverages with LCSs may also lead to long-term and heightening of sweet taste preferences ( 53 , 54 ). LCSs were found as an additive in 9% of all packaged foods and beverages sold in Brazil, in 15% of ultra-processed products, including in those foods and beverages with advertising on the FoPNL that targets children ( 55 ).…”

Section: Strengths and Limitations Of The Brazilian Nutrition Labelin...mentioning

confidence: 99%