Enteroendocrine Hormonal Response After the Ingestion of Cola Beverages With Sucrose and Non-nutritive Sweeteners
Condition: Obesity; Diabetes Mellitus, Type 2; Metabolic Syndrome
MeSH terms: Metabolic Syndrome; Diabetes Mellitus, Type 2
Study type: Interventional

Summary: 
      Introduction: The consumption of non-nutritive sweeteners (NNS) has been increasing in recent
      years, as an alternative to replace sugars and reduce the additional intake of carbohydrates,
      with the idea of reducing the risk of developing obesity, metabolic syndrome, and diabetes.
      However, recent evidence shows that their chronic intake induces endocrine alterations that
      may have an important contribution to the increase in body weight. Few studies have explored
      the acute effects of NNS beverage consumption on endocrine response, and to date, the
      evidence has been inconsistent regarding post-drinking effects and potential health risks.

      Objective: To evaluate the effect of 3 different types of cola beverages, compared with
      carbonated water, on glucose, insulin, glucagon, and appetite-regulating hormones during the
      first 120 minutes after ingestion.

      Methods: A triple-blind, randomized crossover controlled trial was carried out in which 20
      healthy adult individuals (10 men and 10 women) were included. With a washout period of one
      week (7 days) and fasting for 8 hours, each participant consumed orally 355 mL of carbonated
      water (CAR), and the 3 different cola beverages sweetened with sucrose (SUC),
      aspartame/acesulfame K (ASP), and sucrose/stevia (STE), in its commercial presentation. The
      serum levels of glucose, insulin, glucagon, GLP-1, GIP, PYY, leptin, pancreatic polypeptide,
      and ghrelin were determined during the administration of each one of the drinks before the
      intake of the drink and later at 30, 60, 90, and 120 minutes.

      Statistical analysis: A descriptive analysis of the variables was performed. The global
      response of glucose, insulin and appetite-regulating hormones was estimated and the Area
      Under the Curve (AUC) was obtained using a trapezoidal model and analyzed for each outcome by
      one-factor ANOVA. An ANOVA for repeated measures was performed considering treatment and time
      as factors, and comparisons were made with the carbonated water as a control using the
      Bonferroni test. P values less than 0.05 were considered statistically significant.

      Ethical considerations: Our institution's Research, Bioethics, and Biosafety committees
      authorized the project. All the participants were informed about the objective, the
      procedures, and the possible adverse effects considered within the study, and they signed the
      informed consent before the start of the interventions.
    


Intervention name(s): Cola beverage with aspartame and acesulfame K; Cola beverage with sucrose and stevia
Intervention type(s): Other; Other
Intervention description(s): Before starting the study: Subjects were asked to avoid non-nutritive sweetener consumption for 48 hours prior to the study sessions. A standardized menu of 346 Kcal was prescribed for dinner and fasting for at least 8 hours prior to each study session. A 7-day washout period was left between each study session.
Session 1: Weight, height, and waist circumference were measured, the BMI was calculated, and sociodemographic data of the participants and information on the habitual consumption of soft drinks were collected.
In each session: The beverages were offered at approximately 4°C, in standardized disposable cups, and the participants were asked to drink them in a maximum time of 10 minutes. Heart rate, respiratory rate, and blood pressure were measured before the intervention and every 30 minutes during the observation period. The subjects who manifested adverse sensations were referred to receive medical attention and withdrawn from the session.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Prevention