Frequent sugar intake ? then and now: interpretation of the main results

By the end of the 60�s, the theory that refined carbohydrates promotes the absorption of saccharolytic Gram-positive microbial species on the tooth surfaces has become generally. Mutans streptococci (Streptococcus mutans and Streptococcus sobrinus) were key players in this theory. On agar plates, Str. mutans produces small, circular colonies, in the presence of glucose, and in the presence of sucrose large, sticky, gelatinous colonies. This gelatinous texture is due to the shell material: mutant 1 � 3 glucose polymers and dextran 1 �! 6 glucose polymers. Str. mutans are able to survive in the oral cavity with a pH lower than 5.5. That is why consecutive multiple sugar intake promotes the colonization of Str. mutans, which results in dental caries in stagnant zones. As oral pH is continuously shifted to acid, more acid-resistant bacteria appear. Our aim was to identify species in infant-mother pair gingival crevicular bacterial flora, which can be detected on high-sucrose culture media and to underline the jeopardy of vertical oral contamination from mother to infant.

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Effects of D-allulose on glucose tolerance and insulin response to a standard oral sucrose load: results of a prospective, randomized, crossover study

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001939 ◽

2021 ◽

Vol 9 (1) ◽

pp. e001939

Author(s):

Francesco Franchi ◽

Dmitry M Yaranov ◽

Fabiana Rollini ◽

Andrea Rivas ◽

Jose Rivas Rios ◽

...

Keyword(s):

Crossover Study ◽

Plasma Glucose ◽

Large Scale ◽

Insulin Response ◽

Mean Difference ◽

Dietary Guidelines ◽

Sugar Intake ◽

Time Points ◽

Insulin Levels ◽

Dose Dependent

IntroductionCurrent dietary guidelines recommend limiting sugar intake for the prevention of diabetes mellitus (DM). Reduction in sugar intake may require sugar substitutes. Among these, D-allulose is a non-calorie rare monosaccharide with 70% sweetness of sucrose, which has shown anti-DM effects in Asian populations. However, there is limited data on the effects of D-allulose in other populations, including Westerners.Research design and methodsThis was a prospective, randomized, double-blind, placebo-controlled, crossover study conducted in 30 subjects without DM. Study participants were given a standard oral (50 g) sucrose load and randomized to placebo or escalating doses of D-allulose (2.5, 5.0, 7.5, 10.0 g). Subjects crossed-over to the alternate study treatment after 7–14 days of wash out. Plasma glucose and insulin levels were measured at five time points: before and at 30, 60, 90 and 120 min after ingestion.ResultsD-allulose was associated with a dose-dependent reduction of plasma glucose at 30 min compared with placebo. In particular, glucose was significantly lower with the 7.5 g (mean difference: 11; 95% CI 3 to 19; p=0.005) and 10 g (mean difference: 12; 95% CI 4 to 20; p=0.002) doses. Although glucose was not reduced at the other time points, there was a dose-dependent reduction in glucose excursion compared with placebo, which was significant with the 10 g dose (p=0.023). Accordingly, at 30 min D-allulose was associated with a trend towards lower insulin levels compared with placebo, which was significant with the 10 g dose (mean difference: 14; 95% CI 4 to 25; p=0.006). D-allulose did not reduce insulin at any other time point, but there was a significant dose-dependent reduction in insulin excursion compared with placebo (p=0.028), which was significant with the 10 g dose (p=0.002).ConclusionsThis is the largest study assessing the effects of D-allulose in Westerners demonstrating an early dose-dependent reduction in plasma glucose and insulin levels as well as decreased postprandial glucose and insulin excursion in subjects without DM. These pilot observations set the basis for large-scale investigations to support the anti-DM effects of D-allulose.Trial registration numberNCT02714413.

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Associations between Free Sugar and Sugary Beverage Intake in Early Childhood and Adult NAFLD in a Population-Based UK Cohort

Children ◽

10.3390/children8040290 ◽

2021 ◽

Vol 8 (4) ◽

pp. 290

Author(s):

Ahlia Sekkarie ◽

Jean A. Welsh ◽

Kate Northstone ◽

Aryeh D. Stein ◽

Usha Ramakrishnan ◽

...

Keyword(s):

Total Energy ◽

Hepatic Steatosis ◽

Population Based ◽

Free Sugar ◽

Alcoholic Fatty Liver ◽

Free Sugars ◽

Logistic Regression Models ◽

Sugar Intake ◽

Sugary Beverages ◽

Alcoholic Fatty Liver Disease

(1) Background: High sugar intake is prevalent among children and is associated with non-alcoholic fatty liver disease (NAFLD). The purpose of this study is to determine if a high intake of free sugars and sugary beverages (SB) in childhood is associated with NAFLD in adulthood; (2) Methods: At 24 years, 3095 participants were assessed for severe hepatic steatosis (controlled attenuation parameter >280 dB/m) and had dietary data collected via a food frequency questionnaire at age three years. Multiple logistic regression models adjusted for total energy intake, potential confounders, and a mediator (offspring body mass index (BMI) at 24 years); (3) Results: Per quintile increase of free sugar intake association with severe hepatic steatosis at 24 years after adjusting for total energy was odds ratio (OR):1.07 (95% CL: 0.99–1.17). Comparing the lowest vs. the highest free sugar consumers, the association was OR:1.28 (95% CL: 0.88–1.85) and 1.14 (0.72, 1.82) after full adjustment. The OR for high SB consumption (>2/day) compared to <1/day was 1.23 (95% CL: 0.82–1.84) and OR: 0.98 (95% CL: 0.60–1.60) after full adjustment; (4) Conclusions: High free sugar and SB intake at three years were positively but weakly associated with severe hepatic steatosis at 24 years. These associations were completely attenuated after adjusting for confounders and 24-year BMI.

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Objective Biomarkers for Total Added Sugar Intake – Are We on a Wild Goose Chase?

Advances in Nutrition ◽

10.1093/advances/nmaa093 ◽

2020 ◽

Vol 11 (6) ◽

pp. 1429-1436

Author(s):

Jimmy Chun Yu Louie

Keyword(s):

Human Physiology ◽

Current Knowledge ◽

Dietary Assessment ◽

Added Sugar ◽

Added Sugars ◽

Sugar Intake ◽

Adverse Health Outcomes ◽

Dietary Assessment Methods ◽

Nutritional Sciences ◽

Wild Goose

ABSTRACT Misreporting of added sugar intake has been the major criticism of studies linking high added sugar consumption to adverse health outcomes. Despite the advancement in dietary assessment methodologies, the bias introduced by self-reporting can never be completely eliminated. The search for an objective biomarker for total added sugar intake has therefore been a topic of interest. In this article, the reasons this search may be a wild goose chase will be outlined and discussed. The limitations and inability of the 2 candidate biomarkers, namely urinary sucrose and fructose and δ¹³C isotope, which are based on the 2 only possible ways (i.e., difference in metabolism and plant sources) to identify added sugar based on current knowledge in human physiology and food and nutritional sciences, are discussed in detail. Validation studies have shown that these 2 candidate biomarkers are unlikely to be suitable for use as a predictive or calibration biomarker for total added sugar intake. Unless advancement in our understanding in human physiology and food and nutritional sciences leads to new potential ways to distinguish between naturally occurring and added sugars, it is extremely unlikely that any accurate objective added sugar biomarker could be found. It may be time to stop the futile effort in searching for such a biomarker, and resources may be better spent on further improving and innovating dietary assessment methods to minimize the bias introduced by self-reporting.

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Association between added sugar intake and dental caries in Yup’ik children using a novel hair biomarker

BMC Oral Health ◽

10.1186/s12903-015-0101-z ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 10

Author(s):

Donald L. Chi ◽

Scarlett Hopkins ◽

Diane O’Brien ◽

Lloyd Mancl ◽

Eliza Orr ◽

...

Keyword(s):

Dental Caries ◽

Added Sugar ◽

Sugar Intake

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Dental caries and sugar intake in South African pupils of 16 to 17 years in four ethnic groups

BDJ ◽

10.1038/sj.bdj.4803481 ◽

1975 ◽

Vol 138 (12) ◽

pp. 463-469 ◽

Cited By ~ 24

Author(s):

D H Retief ◽

P E Cleaton-Jones ◽

A R Walker

Keyword(s):

Dental Caries ◽

Ethnic Groups ◽

South African ◽

Sugar Intake

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Added Sugar Intake and Risk of Falling Among Older People: The Seniors-ENRICA Cohort Study

Gerontology & Geriatrics: Research ◽

10.26420/gerontolgeriatrres.2021.1056 ◽

2021 ◽

Vol 7 (2) ◽

Author(s):

Ballesteros JM ◽

◽

Struijk E ◽

Machado-Fragua MD ◽

Ortolá R ◽

...

Keyword(s):

Older People ◽

Chronic Diseases ◽

Risk Of Falling ◽

Added Sugar ◽

Cox Models ◽

Added Sugars ◽

Sugar Intake ◽

Vitamin Intake ◽

Injurious Falls ◽

Prospective Association

Background: Added sugar intake is a key contributor to the development of several chronic diseases. We aimed to investigate the prospective association between added sugar intake and the risk of falling among older men and women. Methods: We analyzed data from 2,154 Spanish adults aged ≥65 years from the Seniors-ENRICA cohort. Baseline food consumption was collected in 2008-2010 with a validated diet history, in which 155 foods were identified to contain added sugar. The occurrence of falls was ascertained up to 2015. Analyses were conducted with Cox models adjusted for potential confounders, including nutritional status, chronic diseases and sleeping medication. Results: Over 7.2y of follow-up, 605 participants experienced ≥1 fall and 527 suffered injurious falls. The hazard ratios (95% confidence interval) for ≥1 fall across quintiles of added sugar intake were: 1.0, 1.09 (0.83-1.42), 1.07 (0.82-1.40), 1.15 (0.88-1.52), and 1.48 (1.12-1.96); p-trend 0.03. The corresponding figures for injurious falls were: 1.0, 1.17 (0.88-1.56), 1.06 (0.79- 1.41), 1.13 (0.84-1.52), and 1.40 (1.03-1.90); p-trend 0.10. These associations did not vary over strata of age, protein, calcium or vitamin intake, diet quality, physical activity or alcohol consumption. No differences were found when solid and liquid sources of added sugars were examined separately. Conclusions: Intake of added sugars was associated with a higher risk of falling in older people. This adds to the evidence to support interventions to reduce added sugar intake.

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