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Special Issue "Sugar and Obesity"

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A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (31 May 2014)

Special Issue Editor

Guest Editor
Dr. John Sievenpiper

Associate Professor, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Queen Street East, Toronto, ON, M5C 2T2, Canada.
Interests: systematic reviews; meta-analyses; randomized controlled trials; clinical nutrition; clinical practice guidelines; sugars; carbohydrates; dietary fibre; Glycemic Index; legumes; nuts; dietary patterns; portfolio Diet; dyslipidemia; diabetes; metabolic syndrome; overweight/obesity; cardiometabolic risk; cardiovascular disease

Special Issue Information

Submission

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. Papers will be published continuously (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are refereed through a peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed Open Access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1500 CHF (Swiss Francs).

Keywords

  • fructose
  • high fructose corn syrup (HFCS)
  • sucrose
  • syrup
  • honey
  • sugar sweetened beverages
  • sweets and desserts
  • fruit
  • overweight
  • obesity
  • body weight
  • BMI
  • body fat
  • waist circumference
  • visceral adipose tissue
  • subcutaneous adipose tissue
  • ectopic fat

Published Papers (10 papers)

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Research

Jump to: Review

Open AccessCommunication Oxidative Damage and Inflammation in Obese Diabetic Emirati Subjects
Nutrients 2014, 6(11), 4872-4880; doi:10.3390/nu6114872
Received: 2 June 2014 / Revised: 9 July 2014 / Accepted: 11 September 2014 / Published: 4 November 2014
Cited by 4 | PDF Full-text (146 KB) | HTML Full-text | XML Full-text
Abstract
Visceral obesity is more common in the Arab population and more closely related to morbidity, including diabetes and related cardiovascular diseases (CVD). Possible mechanisms that link visceral fat/obesity to diabetes and CVD complications include inflammation and increased oxidative stress; however, few data [...] Read more.
Visceral obesity is more common in the Arab population and more closely related to morbidity, including diabetes and related cardiovascular diseases (CVD). Possible mechanisms that link visceral fat/obesity to diabetes and CVD complications include inflammation and increased oxidative stress; however, few data are available from the Arab population. Our aim was to determine whether increased adiposity in obese diabetic United Arab Emirates citizens is associated with sub-clinical inflammation and/or increased oxidative stress. A hundred diabetic patients who were part of a randomized controlled trial of nutritional supplements had their baseline characteristics assessed from anthropometric and clinical data following informed written consent. We used WHO figures to classify general and central obesity. Fasting blood samples were collected for the measurement of antioxidants and markers of oxidative damage and inflammation. We found that increased adiposity measured by both body mass index and waist circumference was associated with increased C-reactive protein (CRP) and decreased vitamin C after adjusting for age, duration and treatment of diabetes (p < 0.05). Although there is a clear trend of increased inflammatory markers, notably CRP, and decreased antioxidants with increased BMI and waist circumference in both men and women, the results are statistically significant for women only. CRP were also inversely associated with HDL. Overall, we found that BMI underestimates the rates of obesity compared to waist circumference and that increased adiposity is associated with increased inflammation and decreased HDL and antioxidant status. Full article
(This article belongs to the Special Issue Sugar and Obesity)
Open AccessArticle The Effects of Fructose-Containing Sugars on Weight, Body Composition and Cardiometabolic Risk Factors When Consumed at up to the 90th Percentile Population Consumption Level for Fructose
Nutrients 2014, 6(8), 3153-3168; doi:10.3390/nu6083153
Received: 24 April 2014 / Revised: 17 July 2014 / Accepted: 23 July 2014 / Published: 8 August 2014
Cited by 10 | PDF Full-text (303 KB) | HTML Full-text | XML Full-text
Abstract
The American Heart Association (AHA) and World Health Organization (WHO) have recommended restricting calories from added sugars at lower levels than the Institute of Medicine (IOM) recommendations, which are incorporated in the Dietary Guidelines for Americans 2010 (DGAs 2010). Sucrose (SUC) and [...] Read more.
The American Heart Association (AHA) and World Health Organization (WHO) have recommended restricting calories from added sugars at lower levels than the Institute of Medicine (IOM) recommendations, which are incorporated in the Dietary Guidelines for Americans 2010 (DGAs 2010). Sucrose (SUC) and high fructose corn syrup (HFCS) have been singled out for particular concern, because of their fructose content, which has been specifically implicated for its atherogenic potential and possible role in elevating blood pressure through uric acid-mediated endothelial dysfunction. This study explored the effects when these sugars are consumed at typical population levels up to the 90th percentile population consumption level for fructose. Three hundred fifty five overweight or obese individuals aged 20–60 years old were placed on a eucaloric diet for 10 weeks, which incorporated SUC- or HFCS-sweetened, low-fat milk at 8%, 18% or 30% of calories. There was a slight change in body weight in the entire cohort (169.1 ± 30.6 vs. 171.6 ± 31.8 lbs, p < 0.01), a decrease in HDL (52.9 ± 12.2 vs. 52.0 ± 13.9 mg/dL, p < 0.05) and an increase in triglycerides (104.1 ± 51.8 vs. 114.1 ± 64.7 mg/dL, p < 0.001). However, total cholesterol (183.5 ± 42.8 vs. 184.4 mg/dL, p > 0.05), LDL (110.3 ± 32.0 vs. 110.5 ± 38.9 mg/dL, p > 0.05), SBP (109.4 ± 10.9 vs. 108.3 ± 10.9 mmHg, p > 0.05) and DBP (72.1 ± 8.0 vs. 71.3 ± 8.0 mmHg, p > 0.05) were all unchanged. In no instance did the amount or type of sugar consumed affect the response to the intervention (interaction p > 0.05). These data suggest that: (1) when consumed as part of a normal diet, common fructose-containing sugars do not raise blood pressure, even when consumed at the 90th percentile population consumption level for fructose (five times the upper level recommended by the AHA and three times the upper level recommended by WHO); (2) changes in the lipid profile are mixed, but modest. Full article
(This article belongs to the Special Issue Sugar and Obesity)
Open AccessArticle 24-Hour Glucose Profiles on Diets Varying in Protein Content and Glycemic Index
Nutrients 2014, 6(8), 3050-3061; doi:10.3390/nu6083050
Received: 8 May 2014 / Revised: 11 July 2014 / Accepted: 14 July 2014 / Published: 4 August 2014
PDF Full-text (339 KB) | HTML Full-text | XML Full-text
Abstract
Evidence is increasing that the postprandial state is an important factor contributing to the risk of chronic diseases. Not only mean glycemia, but also glycemic variability has been implicated in this effect. In this exploratory study, we measured 24-h glucose profiles in [...] Read more.
Evidence is increasing that the postprandial state is an important factor contributing to the risk of chronic diseases. Not only mean glycemia, but also glycemic variability has been implicated in this effect. In this exploratory study, we measured 24-h glucose profiles in 25 overweight participants in a long-term diet intervention study (DIOGENES study on Diet, Obesity and Genes), which had been randomized to four different diet groups consuming diets varying in protein content and glycemic index. In addition, we compared 24-h glucose profiles in a more controlled fashion, where nine other subjects followed in random order the same four diets differing in carbohydrate content by 10 energy% and glycemic index by 20 units during three days. Meals were provided in the lab and had to be eaten at fixed times during the day. No differences in mean glucose concentration or glucose variability (SD) were found between diet groups in the DIOGENES study. In the more controlled lab study, mean 24-h glucose concentrations were also not different. Glucose variability (SD and CONGA1), however, was lower on the diet combining a lower carbohydrate content and GI compared to the diet combining a higher carbohydrate content and GI. These data suggest that diets with moderate differences in carbohydrate content and GI do not affect mean 24-h or daytime glucose concentrations, but may result in differences in the variability of the glucose level in healthy normal weight and overweight individuals Full article
(This article belongs to the Special Issue Sugar and Obesity)
Open AccessCommunication Maternal Diet and Weight at 3 Months Postpartum Following a Pregnancy Intervention with a Low Glycaemic Index Diet: Results from the ROLO Randomised Control Trial
Nutrients 2014, 6(7), 2946-2955; doi:10.3390/nu6072946
Received: 27 March 2014 / Revised: 26 May 2014 / Accepted: 11 July 2014 / Published: 23 July 2014
Cited by 6 | PDF Full-text (189 KB) | HTML Full-text | XML Full-text
Abstract
Pregnancy increases the risk of being overweight at a later time period, particularly when there is excessive gestational weight gain. There remains a paucity of data into the effect of low glycaemic index (GI) pregnancy interventions postpartum. Aim: To examine the impact [...] Read more.
Pregnancy increases the risk of being overweight at a later time period, particularly when there is excessive gestational weight gain. There remains a paucity of data into the effect of low glycaemic index (GI) pregnancy interventions postpartum. Aim: To examine the impact of a low glycaemic index diet during pregnancy on maternal diet 3 months postpartum. Methodology: This analysis examined the diet, weight and lifestyle of 460 participants of the ROLO study 3 months postpartum. Questionnaires on weight, physical activity, breastfeeding, supplement use, food label reading and dietary habits were completed. Results: The intervention group had significantly greater weight loss from pre-pregnancy to 3 months postpartum than the control group (1.3 vs. 0.1 kg, p = 0.022). The intervention group reported greater numbers following a low glycaemic index diet (p < 0.001) and reading food labels (p = 0.032) and had a lower glycaemic load (GL) (128 vs. 145, p = 0.014) but not GI (55 vs. 55, p = 0.809) than controls. Conclusions: Low GI dietary interventions in pregnancy result in improved health-behaviours and continued reported compliance at 3 months postpartum possibly through lower dietary GL as a result of portion control. Greater levels of weight loss from pre-pregnancy to 3 months postpartum in the intervention group may have important positive implications for overweight and obesity. Full article
(This article belongs to the Special Issue Sugar and Obesity)
Open AccessArticle Metabolic Fate of Fructose Ingested with and without Glucose in a Mixed Meal
Nutrients 2014, 6(7), 2632-2649; doi:10.3390/nu6072632
Received: 16 April 2014 / Revised: 23 May 2014 / Accepted: 9 June 2014 / Published: 15 July 2014
Cited by 6 | PDF Full-text (456 KB) | HTML Full-text | XML Full-text
Abstract
Ingestion of pure fructose stimulates de novo lipogenesis and gluconeogenesis. This may however not be relevant to typical nutritional situations, where fructose is invariably ingested with glucose. We therefore assessed the metabolic fate of fructose incorporated in a mixed meal without or [...] Read more.
Ingestion of pure fructose stimulates de novo lipogenesis and gluconeogenesis. This may however not be relevant to typical nutritional situations, where fructose is invariably ingested with glucose. We therefore assessed the metabolic fate of fructose incorporated in a mixed meal without or with glucose in eight healthy volunteers. Each participant was studied over six hours after the ingestion of liquid meals containing either 13C-labelled fructose, unlabeled glucose, lipids and protein (Fr + G) or 13C-labelled fructose, lipids and protein, but without glucose (Fr), or protein and lipids alone (ProLip). After Fr + G, plasma 13C-glucose production accounted for 19.0% ± 1.5% and 13CO2 production for 32.2% ± 1.3% of 13C-fructose carbons. After Fr, 13C-glucose production (26.5% ± 1.4%) and 13CO2 production (36.6% ± 1.9%) were higher (p < 0.05) than with Fr + G. 13C-lactate concentration and very low density lipoprotein VLDL 13C-palmitate concentrations increased to the same extent with Fr + G and Fr, while chylomicron 13C-palmitate tended to increase more with Fr + G. These data indicate that gluconeogenesis, lactic acid production and both intestinal and hepatic de novo lipogenesis contributed to the disposal of fructose carbons ingested together with a mixed meal. Co-ingestion of glucose decreased fructose oxidation and gluconeogenesis and tended to increase 13C-pamitate concentration in gut-derived chylomicrons, but not in hepatic-borne VLDL-triacylglycerol (TG). This trial was approved by clinicaltrial. gov. Identifier is NCT01792089. Full article
(This article belongs to the Special Issue Sugar and Obesity)
Figures

Open AccessArticle Consumption of Sugar-Sweetened Beverages Is Associated with Components of the Metabolic Syndrome in Adolescents
Nutrients 2014, 6(5), 2088-2103; doi:10.3390/nu6052088
Received: 6 March 2014 / Revised: 9 May 2014 / Accepted: 13 May 2014 / Published: 23 May 2014
Cited by 12 | PDF Full-text (249 KB) | HTML Full-text | XML Full-text
Abstract
Sugar-sweetened beverages (SSBs) are the principle source of added sugar in diets. Cardiometabolic disturbances can occur from early childhood to adulthood. The aim of this cross-sectional study was to examine the gender-specific association of SSB intake with metabolic syndrome (MetS) and its [...] Read more.
Sugar-sweetened beverages (SSBs) are the principle source of added sugar in diets. Cardiometabolic disturbances can occur from early childhood to adulthood. The aim of this cross-sectional study was to examine the gender-specific association of SSB intake with metabolic syndrome (MetS) and its components among adolescents in Taiwan. A total of 2727 adolescents aged 12 to 16 years randomly selected from three diverse economic areas in Southern Taiwan by using a multistage-sampling strategy participated in this study. Demographic, dietary, physical and anthropometric parameters were measured, and serum lipid profiles and glucose levels were determined. The International Diabetes Federation (IDF) specifies that MetS requires abdominal obesity and ≥2 abnormal components, and Cook criteria for MetS require ≥3 abnormal components. We applied survey-data modules to data analyses, and used multiple regression and logistic models to adjust for covariates. An increased SSB intake was linked to a greater waist circumference in both sexes and to systolic blood pressure in boys (P for trend: ≤0.043). Male moderate and high consuming SSB drinkers exhibited triglyceride levels that were 8.0 and 8.2 mg/dL significantly higher, respectively, than those of nondrinkers. Compared with nondrinkers, boys who consumed >500 mL/day (high quantity) of SSBs exhibited 10.3-fold (95% confidence intervals (CIs): 1.2-90.2) and 5.1-fold (95% CIs: 1.01-25.5) risks of contracting MetS, as defined by the IDF and Cook criteria for MetS, respectively. In girls, the risk estimates for the same comparison were not significant by the IDF criteria (6.5-fold risk, 95% CIs: 0.9-∞) or Cook criteria (5.9-fold risk, 95% CIs: 0.8-43.8) for MetS. High SSB consumption was also linked to 1.9-fold (95% CIs: 1.1-3.1) and 2.7-fold (95% CIs: 1.3-5.7) higher risks of being at a greater overall metabolic risk in girls and boys, respectively. In conclusion, a high SSB intake is associated with adolescent MetS among boys but not girls in Taiwan. Full article
(This article belongs to the Special Issue Sugar and Obesity)
Open AccessArticle Estimated Intakes and Sources of Total and Added Sugars in the Canadian Diet
Nutrients 2014, 6(5), 1899-1912; doi:10.3390/nu6051899
Received: 31 January 2014 / Revised: 29 April 2014 / Accepted: 30 April 2014 / Published: 8 May 2014
Cited by 12 | PDF Full-text (361 KB) | HTML Full-text | XML Full-text
Abstract
National food supply data and dietary surveys are essential to estimate nutrient intakes and monitor trends, yet there are few published studies estimating added sugars consumption. The purpose of this report was to estimate and trend added sugars intakes and their contribution [...] Read more.
National food supply data and dietary surveys are essential to estimate nutrient intakes and monitor trends, yet there are few published studies estimating added sugars consumption. The purpose of this report was to estimate and trend added sugars intakes and their contribution to total energy intake among Canadians by, first, using Canadian Community Health Survey (CCHS) nutrition survey data of intakes of sugars in foods and beverages, and second, using Statistics Canada availability data and adjusting these for wastage to estimate intakes. Added sugars intakes were estimated from CCHS data by categorizing the sugars content of food groups as either added or naturally occurring. Added sugars accounted for approximately half of total sugars consumed. Annual availability data were obtained from Statistics Canada CANSIM database. Estimates for added sugars were obtained by summing the availability of “sugars and syrups” with availability of “soft drinks” (proxy for high fructose corn syrup) and adjusting for waste. Analysis of both survey and availability data suggests that added sugars average 11%–13% of total energy intake. Availability data indicate that added sugars intakes have been stable or modestly declining as a percent of total energy over the past three decades. Although these are best estimates based on available data, this analysis may encourage the development of better databases to help inform public policy recommendations. Full article
(This article belongs to the Special Issue Sugar and Obesity)
Figures

Open AccessArticle The Effect of Normally Consumed Amounts of Sucrose or High Fructose Corn Syrup on Lipid Profiles, Body Composition and Related Parameters in Overweight/Obese Subjects
Nutrients 2014, 6(3), 1128-1144; doi:10.3390/nu6031128
Received: 9 January 2014 / Revised: 27 February 2014 / Accepted: 28 February 2014 / Published: 17 March 2014
Cited by 11 | PDF Full-text (217 KB) | HTML Full-text | XML Full-text
Abstract
The American Heart Association (AHA) has advocated that women and men not consume more than 100 and 150 kcal/day, respectively, from added sugars. These levels are currently exceeded by over 90% of the adult population in the United States. Few data exist [...] Read more.
The American Heart Association (AHA) has advocated that women and men not consume more than 100 and 150 kcal/day, respectively, from added sugars. These levels are currently exceeded by over 90% of the adult population in the United States. Few data exist on longer-term metabolic effects when sucrose and High Fructose Corn Syrup (HFCS), the principal sources of added dietary sugars, are consumed at levels typical of the general population. Sixty five overweight and obese individuals were placed on a eucaloric (weight stable) diet for 10-weeks, which incorporated sucrose- or HFCS-sweetened, low-fat milk at 10% or 20% of calories in a randomized, double-blinded study. All groups responded similarly (interaction p > 0.05). There was no change in body weight in any of the groups over the 10-week study, or in systolic or diastolic blood pressure. Likewise, there were no changes in total cholesterol, triglycerides, low-density lipoprotein (LDL), or apolipoprotein B (Apo B). We conclude that (1) when consumed as part of a eucaloric diet fructose—when given with glucose (as normally consumed) does not promote weight gain or an atherogenic lipid profile even when consumed at two to four times the level recently recommended by the AHA. (2) There were no differences between HFCS and sucrose on these parameters. Full article
(This article belongs to the Special Issue Sugar and Obesity)

Review

Jump to: Research

Open AccessReview The Role of Sweet Taste in Satiation and Satiety
Nutrients 2014, 6(9), 3431-3450; doi:10.3390/nu6093431
Received: 30 May 2014 / Revised: 4 August 2014 / Accepted: 19 August 2014 / Published: 2 September 2014
Cited by 11 | PDF Full-text (582 KB) | HTML Full-text | XML Full-text
Abstract
Increased energy consumption, especially increased consumption of sweet energy-dense food, is thought to be one of the main contributors to the escalating rates in overweight individuals and obesity globally. The individual’s ability to detect or sense sweetness in the oral cavity is [...] Read more.
Increased energy consumption, especially increased consumption of sweet energy-dense food, is thought to be one of the main contributors to the escalating rates in overweight individuals and obesity globally. The individual’s ability to detect or sense sweetness in the oral cavity is thought to be one of many factors influencing food acceptance, and therefore, taste may play an essential role in modulating food acceptance and/or energy intake. Emerging evidence now suggests that the sweet taste signaling mechanisms identified in the oral cavity also operate in the gastrointestinal system and may influence the development of satiety. Understanding the individual differences in detecting sweetness in both the oral and gastrointestinal system towards both caloric sugar and high intensity sweetener and the functional role of the sweet taste system may be important in understanding the reasons for excess energy intake. This review will summarize evidence of possible associations between the sweet taste mechanisms within the oral cavity, gastrointestinal tract and the brain systems towards both caloric sugar and high intensity sweetener and sweet taste function, which may influence satiation, satiety and, perhaps, predisposition to being overweight and obesity. Full article
(This article belongs to the Special Issue Sugar and Obesity)
Open AccessReview Normal Roles for Dietary Fructose in Carbohydrate Metabolism
Nutrients 2014, 6(8), 3117-3129; doi:10.3390/nu6083117
Received: 11 June 2014 / Revised: 16 July 2014 / Accepted: 24 July 2014 / Published: 5 August 2014
Cited by 10 | PDF Full-text (194 KB) | HTML Full-text | XML Full-text
Abstract
Although there are many well-documented metabolic effects linked to the fructose component of a very high sugar diet, a healthy diet is also likely to contain appreciable fructose, even if confined to that found in fruits and vegetables. These normal levels of [...] Read more.
Although there are many well-documented metabolic effects linked to the fructose component of a very high sugar diet, a healthy diet is also likely to contain appreciable fructose, even if confined to that found in fruits and vegetables. These normal levels of fructose are metabolized in specialized pathways that synergize with glucose at several metabolic steps. Glucose potentiates fructose absorption from the gut, while fructose catalyzes glucose uptake and storage in the liver. Fructose accelerates carbohydrate oxidation after a meal. In addition, emerging evidence suggests that fructose may also play a role in the secretion of insulin and GLP-1, and in the maturation of preadipocytes to increase fat storage capacity. Therefore, fructose undergoing its normal metabolism has the interesting property of potentiating the disposal of a dietary carbohydrate load through several routes. Full article
(This article belongs to the Special Issue Sugar and Obesity)

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