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The Effects of Sweeteners and Sweetness Enhancers on Obesity and Diabetes: a Review

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The Effects of Sweeteners and Sweetness Enhancers on Obesity and Diabetes: a Review Journal of International Society for Food Bioactives Nutraceuticals and Functional Foods Review J. Food Bioact. 2018;4:107–116 The effects of sweeteners and sweetness enhancers on obesity and diabetes: a review Yanli Jiao and Yu Wang* Citrus Research and Education Center, Food Science and Human Nutrition, University of Florida, 700 Experiment Station Road, Lake Alfred, FL 33850, USA *Corresponding author: Yu Wang, Citrus Research and Education Center, Food Science and Human Nutrition, University of Florida, 700 Experiment Station Road, Lake Alfred, FL 33850, USA. E-mail: [email protected] DOI: 10.31665/JFB.2018.4166 Received: December 18, 2018; Revised received & accepted: December 23, 2018 Citation: Jiao, Y., and Wang, Y. (2018). The effects of sweeteners and sweetness enhancers on obesity and diabetes: a review. J. Food Bioact. 4: 107–116. Abstract Sweet taste, one of the five basic taste qualities, is not only important for evaluation of food quality, but also guides the dietary food choices of animals. Sweet taste involves a variety of chemical compounds and struc- tures, including natural sugars, sugar alcohols, natural and artificial sweeteners, and sweet-tasting proteins. The preference for sweetness has induced the over-consumption of sugar, contributing to certain prevailing health problems, such as obesity, diabetes and cardiovascular disease. Non-nutritive sweeteners, including natural and synthetic sweeteners, and sweet-tasting proteins have been added to foods to reduce the caloric intake from sugar, but many of these sugar substitutes induce an off-taste or after taste that negatively impacts any pleasure derived from the sweet taste. Sweet taste is detected by sweet taste receptor, that also play an important role in the metabolic regulation of the body, such as glucose homeostasis and incretin hormone secretion. In this review, the role of sweet tastants and the sweet taste receptors involved in sweetness perception, and their effect on obesity and diabetes are summarized. Sweet taste enhancement, as a new way to solve the over-consumption of sugar, is discussed in this contribution. Sweet taste enhancers can bind with sweet tastans to potentiate the sweetness of food without producing any taste by itself. Various type of sweet taste enhancers, including syn- thetic compounds, food-processed substances and aroma compounds, are summarized. Notably, few natural, non-volatile compounds have been identified as sweetness enhancers. Keywords: Sweetness; Sweet taste receptors; Sweet taste enhancer; Diabetes; Obesity. 1. Introduction ars, sugar alcohols, natural and artificial sweeteners, and sweet- tasting proteins (Belloir et al., 2017). Consequently, habitual sugar consumption is linked to the prevalence of numerous public health The sense of taste is very important for animals and humans to problems. For decades, epidemiological studies have demonstrat- evaluate both food quality and to select proper nutrients for sur- ed that sugar over-consumption poses a serious threat to human vival (Horio et al., 2010). Animals prefer a sweet taste, because the health, e.g. overweight, obesity, diabetes and cardiovascular dis- sense of sweetness implies a potential for caloric intake derived eases. Sugar-sweetened food and beverages are the major dietary from a source full of nutrients (Jiang et al., 2005). Additionally, sources of sweet taste in human, especially Americans (Huang et sweetness is a palatable and pleasurable sense that guides the di- al., 2014). In the 19th century, average annual sugar consumption etary food choices of animals. Sweet taste involves a variety of was 2.5 kg per person in the US. This number increased to 68 kg chemical compounds with varied structures, including natural sug- by the beginning of 21st century (Li et al., 2011). Even with a de- Copyright: © 2018 International Society for Nutraceuticals and Functional Foods. 107 All rights reserved. Sweetness related molecules and metabolic syndrome Jiao et al. creased trend of sugar consumption in recent decades, this number ated with being overweight or obese (Fagherazzi et al., 2013; Lim is still much higher than the recommended dietary upper limit in et al., 2016). It is reported that sugar-sweetened beverage intake US diet, especially among children (Yang et al., 2014). It has been can increase the incidence of type 2 diabetes (De Koning et al., recommended to decrease added-sugar intake to less than 10 per- 2011; Sakurai et al., 2014). It has been revealed that long-term cent of total daily calories in order to reduce public health prob- consumption of sweeteners induces glucose intoleratnce, which is lems in the US (U.S. Department of Health and Human, 2015). specifically linked to type 2 diabetes through fat accumualtion and Controlling sugar intake and reducing calories from sugar intake alteration of gut microbiota (Pereira, 2013; Suez et al., 2014). In are quite difficult. addition, diabetics have been shown to have a greater threshold for The food industries have already substituted numerous alter- detecting the sweetness of sugar compared with healthy control natives, such as sugar alcohol, non- or low-calorie sweeteners, to subjects, suggesting diabetics increase their sugar intake in order reduce the caloric intake from sugar (Beltrami et al., 2018). To to perceive the same sweet taste-sensing as the healthly control, perceive sweetness, the sweet taste receptor interacts with imbibed which in turn, elevates the glucose concentrations in diabetics sweet tastants. Sweeteners provide a high sweet taste sensation (Fábián et al, 2015; Neiers et al., 2016). Consequently, numerous while reducing the calories in the final product. However, most studies have been conducted to identify and develop new carbohy- of these substitutes fail to induce a ‘real’ sugar taste. Commonly drates, sugar alternatives or sweet taste modulators to reduce the they result in an off-taste or aftertaste, such as bitter, metallic or risk of obesity and diabetes induced by sweeteners. licorice-like, or slow or delay the sweetness onset (DuBois and Consumers are more interested in new sweet-tasting sub- Prakash, 2012; Li et al., 2011). Moreover, some may potentially stances with low- or no-calories to moderate their sugar and en- cause adverse effects, including weight gain, central adiposity, ergy consumption while still preserving the sweet taste. Numer- mental disorders, bladder cancer and psychological problems (Syl- ous non-nutritive sweeteners with a high intensity of sweetness vetsky et al., 2016). To address these problems, a new strategy of are approved and widely used in industries, such as acesulfame positive allosteric modulators (PAMs) has been proposed. PAMs, potassium (acesulfame-K). advantame, aspartame, neotame, sac- including sweetness enhancer, can bind at the allosteric sites of charin and sucralose (U.S. Food and Drug Adminstration, 2018). sweet taste receptors and enhance receptor activity (DuBois and However, even consumption of low- or no-calorie sweeteners, the Prakash, 2012). Sweetness enhancers do not taste sweet by them- roles in reduction effects are limited and controversial (Lohner et selves, but can preserve and potentiate the desirable sweetness in- al., 2017). A number of studies have shown that long-term use of tensity of sweet tastants in such a way that the amount of sweet low- or no-calorie sweetener containing foods may not effectively tastant used in the diet is reduced, thus decreasing caloric intake, control weight, because they may not elicit complete energy com- as well as modifying or inhibiting any undesirable taste (Servant pensation, but instead, stimulate appetite and promote energy in- et al., 2010). Additionally, sweet taste receptors are involved in take, leading to weight gain and obesity (Löfvenborg et al., 2016). glucose homeostasis and incretin hormone secretion, consequently Some cohort studies have suggested that chronic use of non-nutri- playing an important role in physiological regulation and provid- tive sweeteners is associated with weight gain, and increasing the ing a therapeutic method to treat obesity and diabetes (Neiers et obesity risk while deteriorating glucose tolerance (Palmnäs et al., al., 2016). 2014; Pearlman et al., 2019). 2. Sweeteners, obesity and diabetes 3. Sweeteners In recent decades, there has been an increase in the overweight and 3.1. Sugar and sugar alcohols obese population. In the US, body mass index (BMI), an important index to evaluate tissue mass, has recently increased to 35 % for Sugars, the most common sweet-tasting natural products known men and 40 % for women (Chia et al., 2016). Approximately two today, are historically used to produce the desirable sweet taste thirds of American adults are considered overweight, whereas one attribute, as well as providing energy to mammals. Since the iso- third are classified as obese (Smith et al., 2016). Sugar, a common lation of sucrose from sugarcane juice, there has been much di- sweet tastant in the daily diet, is a major factor contributing to vari- etary development and application for daily sugar consumption. ous health problems, including obesity, metabolic syndrome, dia- Sugars occur naturally in the tissues of various plants, as well as betes and cardiovascular disease (Shankar et al., 2013). The cor- in animal-based products, such as in milk. These soluble carbo- relation between sugar-added food and beverage and arising health hydrates are mostly comprised of monosaccharides (i.e. glucose problems have been the subject
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