Center for Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, The Saban Research Institute, Childrens Hospital, Los Angeles, CA, United States.
Department of Stem Cell Biology & Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
Front Endocrinol (Lausanne). 2021 Apr 1;12:625415. doi: 10.3389/fendo.2021.625415. eCollection 2021.
Childhood obesity is increasing at an alarming rate in the United States. This trend carries serious risk of children developing obesity-related diseases including Type 2 diabetes and cardiovascular disease. Non-nutritive sweeteners (NNS) are used as substitution for table sugar as a way to prevent weight gain. Their consumption is ubiquitous in adults and children; however the long-term health outcomes of chronic NNS consumption in children are unclear. Conflicting observational studies suggest that children consuming NNS are at risk of obesity and development of type 2 diabetes, while others concluded some benefits in weight reduction. Here, we review the physiological mechanisms that can contribute to the negative metabolic effects of NNS. We will focus on how NNS alters the sweet perception leading to increase caloric consumption, how NNs alters the gut microbiota, and how NNS may disrupt glucose homeostasis and initiate a vicious cycle of pancreatic endocrine dysfunction. Studies focused on the pediatric population are limited but necessary to determine whether the potential weight loss benefits outweigh the potential negative metabolic outcomes during this critical development period.
儿童肥胖在美国呈惊人速度增长。这种趋势使儿童面临严重的肥胖相关疾病风险，包括 2 型糖尿病和心血管疾病。非营养性甜味剂（NNS）被用作蔗糖的替代品，以防止体重增加。它们的消费在成年人和儿童中无处不在；然而，儿童长期慢性 NNS 消费的健康后果尚不清楚。相互矛盾的观察性研究表明，摄入 NNS 的儿童有肥胖和 2 型糖尿病的风险，而另一些研究则得出了一些减轻体重的益处。在这里，我们回顾了可能导致 NNS 产生负面代谢作用的生理机制。我们将重点讨论 NNS 如何改变甜味感知导致热量摄入增加，NNs 如何改变肠道微生物群，以及 NNS 如何破坏葡萄糖稳态并引发胰腺内分泌功能障碍的恶性循环。针对儿科人群的研究有限，但有必要确定在这个关键的发育时期，潜在的减肥益处是否超过潜在的负面代谢后果。
