Campos Vanessa, Despland Camille, Brandejsky Vaclav, Kreis Roland, Schneiter Philippe, Boesch Chris, Tappy Luc
Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, 1005 Lausanne, Switzerland.
Department of Clinical Research, University Bern and Institute of Diagnostic Interventional and Pediatric Radiology, University Hospital Bern, 3010 Bern, Switzerland.
Nutrients. 2017 Feb 27;9(3):202. doi: 10.3390/nu9030202.
Addition of fructose to the diet of normal weight and overweight subjects can increase postprandial plasma triglyceride and uric acid concentration. We, therefore, assessed whether replacing sugar-sweetened beverages (SSB) with artificially-sweetened beverages (ASB) in the diet of overweight and obese subjects would decrease these parameters.
Twenty-six participants of the REDUCS study, which assessed the effects of replacing SSB by ASB over 12 weeks on intra-hepatocellular lipid concentration, were included in this sub-analysis. All were studied after a four-week run-in period during which they consumed their usual diet and SSBs, and after a 12-week intervention in which they were randomly assigned to replace their SSBs with ASBs (ASB arm) or to continue their usual diet and SSBs (control arm, CTRL). At the end of run-in (week 4) and again at the end of intervention (week 16), they took part in an 8.5 h metabolic investigation during which their plasma glucose, insulin, glucagon, lactate, triglyceride (TG), non-esterified fatty acids (NEFA), and uric acid concentrations were measured over a 30 min fasting period (-30-0 min), then every 2 h over 480 min. with ingestion of standard breakfast at time 0 min and a standard lunch at time 240 min. Breakfast and lunch were consumed together with a 3.3 dL SSB at week 4 and with either an ASB (ASB arm) or a SSB (CTRL arm) at week 16. After analyzing the whole group, a secondary analysis was performed on 14 subjects with hepatic steatosis (seven randomized to ASB, seven to CTRL) and 12 subjects without hepatic steatosis (six randomized to ASB and six to CTRL).
Ingestion of meals increased plasma glucose, insulin, glucagon, lactate, and TG concentrations and decreased NEFA concentrations, but with no significant difference of integrated postprandial responses between week 4 and week 16 in both ASB and CTRL, except for a slightly decreased glucagon response in ASB. There was, however, no significant postprandial increase in uric acid concentration in both arms. In the secondary analysis, replacing SSBs with ASBs did not significantly change postprandial TG and uric acid concentrations irrespective of the presence or not of hepatic steatosis, Conclusions: In overweight, high SSB consumers, replacing SSBs with ASBs during 12 weeks did not significantly alter post-prandial TG and uric acid concentration, in spite of the lower energy and fructose content of the meals. These effects were globally the same in subjects without and with hepatic steatosis.
在正常体重和超重受试者的饮食中添加果糖可增加餐后血浆甘油三酯和尿酸浓度。因此，我们评估了在超重和肥胖受试者的饮食中用人造甜味饮料（ASB）替代含糖甜味饮料（SSB）是否会降低这些指标。
REDUCS研究的26名参与者被纳入本次亚分析，该研究评估了12周内用ASB替代SSB对肝细胞内脂质浓度的影响。所有参与者在为期四周的导入期后接受研究，在此期间他们食用平常饮食和SSB，然后在为期12周的干预期后，他们被随机分配用ASB替代SSB（ASB组）或继续平常饮食和饮用SSB（对照组，CTRL）。在导入期结束时（第4周）以及干预期结束时（第16周），他们参加了一次8.5小时的代谢研究，在此期间，在30分钟禁食期（-30至0分钟）测量他们的血浆葡萄糖、胰岛素、胰高血糖素、乳酸、甘油三酯（TG）、非酯化脂肪酸（NEFA）和尿酸浓度，然后在480分钟内每2小时测量一次，在0分钟时摄入标准早餐，在240分钟时摄入标准午餐。第4周时早餐和午餐与3.3 dL SSB一起食用，第16周时与ASB（ASB组）或SSB（CTRL组）一起食用。在对整个组进行分析后，对14名患有肝脂肪变性的受试者（7名随机分配至ASB组，7名至CTRL组）和12名没有肝脂肪变性的受试者（6名随机分配至ASB组，6名至CTRL组）进行了二次分析。
进餐会增加血浆葡萄糖、胰岛素、胰高血糖素、乳酸和TG浓度，并降低NEFA浓度，但在ASB组和CTRL组中，第4周和第16周之间的餐后综合反应没有显著差异，除了ASB组中胰高血糖素反应略有降低。然而，两组餐后尿酸浓度均无显著升高。在二次分析中，无论是否存在肝脂肪变性，用ASB替代SSB均未显著改变餐后TG和尿酸浓度。结论：在超重、大量饮用SSB的消费者中，尽管餐食的能量和果糖含量较低，但在12周内用ASB替代SSB并未显著改变餐后TG和尿酸浓度。在没有肝脂肪变性和有肝脂肪变性的受试者中，这些影响总体相同。
