Department of Education, Taipei Medical University Hospital, Taipei 110, Taiwan.
Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
Nutrients. 2023 May 15;15(10):2319. doi: 10.3390/nu15102319.
The effects of consuming specific types of nonnutritive sweeteners (NNSs) on adiposity changes in children have remained inconsistent. In this study, we aimed to investigate the effects of the intake of different kinds of NNSs on long-term adiposity changes during pubertal growth. Furthermore, we examined the above relationships among different sexes, pubertal stages, and levels of obesity. A total of 1893 6-15-year-old adults were recruited and followed-up every 3 months. The NNS-FFQ (Food Frequency Questionnaire) was conducted and urine samples were collected to investigate the effects of the selected sweeteners, which included acesulfame potassium, aspartame, sucralose, glycyrrhizin, steviol glycosides, and sorbitol. Multivariate linear mixed-effects models were used to examine the relationship between NNS intake and body composition. The consumption of aspartame, sucralose, glycyrrhizin, stevioside, and sorbitol was associated with decreased fat mass and increased fat-free mass. In the highest tertile group, the effects of NNS consumption on fat mass corresponded to values of -1.21 (95% CI: -2.04 to -0.38) for aspartame, -0.62 (95% CI: -1.42 to 0.19) for sucralose, -1.26 (95% CI: -2.05 to -0.47) for glycyrrhizin, -0.90 (95% CI: -2.28 to 0.48) for stevioside, and -0.87 (95% CI: -1.67 to -0.08) for sorbitol, while the effects on fat-free mass corresponded to values of 1.20 (95% CI: 0.36 to -0.38) for aspartame, 0.62 (95% CI: -0.19 to 1.43) for sucralose, 1.27 (95% CI: 0.48 to 2.06) for glycyrrhizin, 0.85 (95% CI: -0.53 to 2.23) for stevioside, and 0.87 (95% CI: 0.08 to 1.67) for sorbitol. Particularly, aspartame and sorbitol revealed a dose-responsiveness effect. The above finding was more prominent among girls than boys. Moreover, fat mass was significantly reduced in normal-weight children who consumed a moderate amount of aspartame and a large amount of glycyrrhizin and sorbitol compared with obese children. In conclusion, the NNS-specific and sex-specific effects of long-term NNS consumption revealed associations of decreasing fat mass and increasing fat-free mass for children undergoing pubertal growth.
食用特定类型的非营养性甜味剂(NNSs)对儿童肥胖变化的影响一直不一致。在这项研究中,我们旨在研究不同种类的 NNS 摄入对青春期生长过程中长期肥胖变化的影响。此外,我们还研究了不同性别、青春期阶段和肥胖水平之间的上述关系。共招募了 1893 名 6-15 岁的成年人,并每 3 个月进行一次随访。通过食物频率问卷(NNS-FFQ)调查了所选甜味剂的摄入量,这些甜味剂包括乙酰磺胺酸钾、阿斯巴甜、三氯蔗糖、甘草甜素、甜菊糖苷和山梨糖醇。采用多变量线性混合效应模型来检验 NNS 摄入与身体成分之间的关系。阿斯巴甜、三氯蔗糖、甘草甜素、甜菊苷和山梨糖醇的摄入与脂肪量减少和去脂体重增加有关。在最高三分位组中,NNS 摄入对脂肪量的影响相当于阿斯巴甜为 -1.21(95%CI:-2.04 至-0.38),三氯蔗糖为 -0.62(95%CI:-1.42 至 0.19),甘草甜素为-1.26(95%CI:-2.05 至-0.47),甜菊糖苷为-0.90(95%CI:-2.28 至 0.48),山梨糖醇为-0.87(95%CI:-1.67 至-0.08),而对去脂体重的影响相当于阿斯巴甜为 1.20(95%CI:0.36 至-0.38),三氯蔗糖为 0.62(95%CI:-0.19 至 1.43),甘草甜素为 1.27(95%CI:0.48 至 2.06),甜菊糖苷为 0.85(95%CI:-0.53 至 2.23),山梨糖醇为 0.87(95%CI:0.08 至 1.67)。特别是,阿斯巴甜和山梨糖醇表现出剂量反应效应。与肥胖儿童相比,正常体重儿童摄入适量阿斯巴甜和大量甘草甜素和山梨糖醇后,脂肪量明显减少,这一发现女孩比男孩更为明显。总之,长期 NNS 摄入具有 NNS 特异性和性别特异性,与青春期生长的儿童的脂肪量减少和去脂体重增加有关。