Search Results (173)

Non-nutritive sweeteners (NNSs) are consumed to reduce intake by providing a sweet taste with little to no energy. Despite regulatory approval and extensive use, uncertainty remains about their long-term role in weight management and health, and about whether exposure to sweet taste itself, independent of energy, influences these outcomes. This narrative review synthesizes evidence from three recent European consortia: SWEET, SWITCH and Sweet Tooth, which together provide complementary data from acute, short- and long-term randomized controlled trials. The studies examined the effects of NNSs and dietary sweet taste exposure on body weight, health-related biomarkers, sweet taste preference, and eating behavior. Across studies, replacing sugars with NNSs appeared to support weight loss maintenance, while NNS consumption and dietary sweet taste exposure showed no adverse changes in body weight, glucoregulatory and endocrine biomarkers, cardiometabolic risk factors, gut microbiota, or liver enzymes. Likewise, neither NNS use nor different dietary sweet taste exposure altered sweet taste liking, appetite sensation, energy intake, or food choice. However, interpretation should consider the characteristics of the included studies, including selected populations, intervention context, outcome heterogeneity, and the fact that several behavioral and biomarker outcomes were secondary or exploratory. Overall, the reviewed evidence suggests that replacing sugar intake with NNSs may support weight management strategies, while differences in habitual dietary sweet taste exposure per se appear largely neutral with respect to health-related biomarkers and sweet taste preferences. Full article

Background/Objectives: Adherence to the Mediterranean diet (MD) is associated with reduced risk of non-communicable diseases but has declined among children, even in traditionally high-adherence settings such as Greece. As parental lifestyle behaviors strongly influence children’s dietary patterns, this study examined the associations between parental lifestyle factors and children’s MD adherence in Crete, Greece. Methods: A total of 760 parent–child dyads participated in this cross-sectional study. Children’s adherence to the MD was assessed using the KIDMED index. Parents completed validated instruments, including the MEDAS (MD adherence), IPAQ (physical activity), PSQI (sleep quality), and NLS (nutrition literacy), along with questions on dietary habits and screen time behaviors. ANOVA/Kruskal–Wallis tests and multivariable linear regression identified predictors of KIDMED scores. Results: Mean KIDMED score was 5.95 ± 2.65; 32% achieved optimal adherence. Younger children showed higher adherence. Higher children’s adherence to MD was positively associated with parental MD adherence (β = 0.493), urban residence (β = 0.544), higher parental education (β = 0.493), consistent daily meal routines (breakfast and mid-morning and mid-afternoon snacks), higher water intake, and fresh juice consumption (all p < 0.05) were positively associated with parental MD adherence. Conversely, lower adherence was associated with parental age ≥ 45 years (β = 0.987), higher parental BMI (β = 0.072), consumption of sugar-sweetened (β = 0.390) or artificially sweetened beverages (β = 0.497), and weekend screen time ≥ 3 h/day (β = 0.383) (all p < 0.05). Conclusions: Children’s adherence to the MD is strongly associated with parental dietary behaviors and structured meal routines. These findings support family-focused interventions that emphasize parental dietary role modeling to counter declining MD adherence among Mediterranean youth. Full article

Sucralose is one of the most widely used non-nutritive sweeteners and has long been considered metabolically inert and safe within established acceptable daily intake levels. However, emerging evidence suggests that chronic exposure to sucralose may alter gut microbial composition, epithelial barrier function, mucosal inflammation, and immune responses. This review examines current experimental and clinical evidence on the effects of sucralose on the gut–immune axis, with particular attention to its potential implications for colitis and colorectal cancer (CRC). Preclinical studies indicate that sucralose may reduce beneficial short-chain fatty acid-producing taxa, alter microbial metabolic pathways, disrupt epithelial barrier-related molecules, and promote inflammatory and immune changes associated with colitis severity and inflammation-driven tumorigenesis. Experimental evidence also suggests that sucralose may impair CD8⁺ T-cell fitness and reduce responsiveness to immune checkpoint inhibitors through microbiome-dependent mechanisms involving altered arginine and citrulline metabolism. Human studies further indicate that sucralose can modify gut and oral microbiome composition and influence metabolic responses, although these effects appear heterogeneous and context-dependent. Overall, the current literature suggests that sucralose may act as a modifier of microbiome–immune interactions in susceptible settings, but most mechanistic evidence remains preclinical, and human data are still insufficient to establish causality. These findings highlight the need for prospective studies to determine whether sucralose-associated microbial and immune alterations translate into clinically meaningful effects in colitis, CRC, and immunotherapy response. Full article

Neohesperidin dihydrochalcone (NHDC) has been confirmed to possess excellent nutritional activities as a natural flavonoid low-calorie sweetener, but its practical application in the food industry was greatly limited due to its low water solubility. The potential NHDC activity against oxidative stress (OS) diseases was explored through network pharmacology and molecular docking technology, and a highly water-soluble NHDC-L-arginine complex (NL) was prepared by combining NHDC with L-arginine to overcome this technical bottleneck. Meanwhile, the enhancement of antioxidant capacity markers under non-stressed conditions following NL treatment was systematically investigated in Caenorhabditis elegans (C. elegans), and transcriptomic and metabolomic analyses were integrated to reveal the potential regulatory mechanism at the molecular and metabolic levels. It was found that NHDC could exert potential anti-OS effects by targeting and binding to key proteins such as CYP19A1, TYR, EPHX2, TDP1, ESR1, and SLC5A1. In addition, the MDA level in C. elegans after NL intervention was significantly reduced to 0.65 ± 0.06 nmol/mg prot, while the activities of antioxidant enzymes T-SOD, GSH-Px, and CAT were significantly increased to 48.83 ± 1.75 U/mg prot, 112.95 ± 0.55 U/mg prot, and 6.30 ± 0.16 U/mg prot, respectively. Longevity regulating pathway–worm was identified as a potential key signaling pathway for NL to regulate the enhancement of antioxidant capacity markers under non-stressed conditions of C. elegans at the molecular level, and the pentose phosphate pathway was the core metabolic pathway. These results could offer theoretical support for the potential development of NHDC and NL in the field of antioxidants, as well as their large-scale applications in the functional food and flavored food industries. Full article

Background/Objectives: Liver fat represents an early metabolic lesion in the development of diabetes and its cardiometabolic complications. Diets high in free sugars, particularly from sugar-sweetened beverages (SSBs), are associated with abdominal obesity and increased cardiometabolic risk, prompting global guidelines to limit SSBs as a major public health strategy. Low-fat cow’s milk is promoted as the preferred caloric replacement strategy for SSBs due to its high nutritional value and cardiometabolic advantages. Fortified soymilk is a plant-based alternative with approved health claims for cholesterol and coronary heart disease risk reduction that offers an equivalent nutritional value to cow’s milk. However, given concerns about its classification as an ultra-processed food (UPF), it is unclear whether soymilk offers comparable metabolic health benefits to milk as part of clinical and public health strategies to reduce SSB intake. The Soy Treatment Evaluation for Metabolic (STEM) health trial seeks to evaluate the impact of replacing SSBs with either 2% soymilk or 2% cow’s milk on liver fat and other cardiometabolic risk factors in habitual adult consumers of SSBs with obesity. Methods: The STEM trial is a 24-week, pragmatic, 3-arm, parallel, randomized trial. We recruited adults with obesity (high BMI plus high waist circumference based on ethnic specific cut-offs) consuming ≥1 SSB/day. Participants were randomized to one of three groups based on their usual SSB intake at baseline (servings/day): continued SSB (355 mL can) intake; replacement with fortified, sweetened 2% soymilk (250 mL); or replacement with 2% cow’s milk (250 mL). The primary outcome is the change in intrahepatocellular lipid (IHCL) measured by ¹H-MRS at 24 weeks. Hierarchical testing will be done to reduce the familywise error rate. The superiority of cow’s milk to SSBs will be assessed first to establish assay sensitivity. If superiority is established, then the non-inferiority of soymilk to cow’s milk will be assessed using a pre-specified non-inferiority margin of 1.5% IHCL units (assessed by difference of means using a 90% confidence interval [CI]). Analyses will be conducted according to the intention-to-treat (ITT) principle using inverse probability weighting (IPW) for superiority testing and per-protocol analyses for non-inferiority testing, using ANCOVA adjusted for age, sex, metabolic dysfunction-associated steatotic liver disease (MASLD) status, medication use, intervention dose, and baseline levels. We hypothesize that soymilk will be non-inferior to cow’s milk (Clinicaltrials.gov NCT05191160). Results: Recruitment began in November 2021. A total of 3050 individuals were screened. We randomized 186 participants (62 per group) between 19 April 2022 and 16 April 2024. Participants are 57% male; with a mean [SD] age of 39.9 [11.8] years; BMI of 34.6 [6.1] kg/m², waist circumference of 112.6 [13.8] cm; IHCL of 10.0 [8.2] % with 64.1% meeting the criteria for MASLD; and SSBs intake of 2.3 [1.3] servings/day. Conclusions: Baseline characteristics were balanced across the study arms, with participants representing adults with a high-risk metabolic phenotype, and 64.1% meeting the criteria for MASLD. Findings will contribute to evidence on the cardiometabolic benefits of soymilk, informing clinical practice guidelines and public health policy. Full article

Background/Objectives: More than half of Swiss adults exceed the World Health Organization’s recommended limit for free sugar intake, with sugar-sweetened beverage (SSB) as a major contributor. SSB intake may be associated with other dietary risk factors, but little is known about diet quality excluding SSB intake. Therefore, the objective of this study was to investigate the association of SSB intake with the non-SSB diet quality in Swiss adults. Methods: Data from the cross-sectional, national nutrition survey menuCH (2014–2015, n = 2057, 18–75 years) were analyzed. Dietary intake was assessed via two 24 h dietary recalls. Participants were categorized as non-, low-, or high-SSB consumers based on the Swiss dietary guideline for free sugar intake. Diet quality excluding SSB was evaluated using the Alternative Healthy Eating Index (AHEI) scoring system (non-SSB AHEI). Results: Non-SSB consumers had higher non-SSB AHEI scores compared to low-SSB consumers, indicating healthier food choices beyond SSB intake, while high-SSB consumers had substantially poorer non-SSB diet quality. Despite these differences, non-SSB AHEI scores were only moderate across all SSB consumer types, suggesting that reducing SSB alone may not suffice to achieve optimal diet quality. Conclusions: In addition to population-based strategies to reduce SSB intake, future policies should aim to improve overall diet quality, including higher consumption of vegetables, fruits, whole grains and unsaturated fats. Prospective studies are needed to clarify which alternative food choices individuals make when reducing SSB intake. Full article

Licorice (Glycyrrhiza uralensis Fisch.) is a widely used natural sweetener and functional food ingredient. Its sensory profile, nutritional value, and bioactive composition are strongly affected by geographical origin and cultivation mode, particularly the distinction between wild and cultivated resources. Consequently, developing a rapid and robust method for origin traceability is imperative for rigorous quality control and product standardization. This study proposes a non-destructive traceability framework integrating near-infrared (NIR) spectroscopy with a Support Vector Machine (SVM). The method’s validity was rigorously evaluated using a comprehensive dataset collected from China’s three primary production regions—Gansu Province, the Inner Mongolia Autonomous Region, and the Xinjiang Uygur Autonomous Region, encompassing both wild and cultivated resources. Experimental results demonstrated that the proposed framework achieved an overall classification accuracy exceeding 99%. The results show that the proposed method offers a rapid, efficient, and environmentally friendly analytical tool for the quality assessment of licorice, providing a scientific basis for rigorous quality control and standardization in the functional food industry. Full article

Background/Objectives: Poor dietary habits are a major contributor to non-communicable diseases (NCDs), the leading cause of mortality worldwide. To promote healthier eating, governments and stakeholders have implemented various nutrition policies, including front-of-pack nutrition labeling (FOPNL). The Choices International Foundation (Choices), through its criteria, supports these efforts through its standardized nutrient profiling system (NPS). Originally developed to underpin a positive FOPNL logo, in 2021, the criteria were expanded into a globally oriented five-level profiling system covering 23 basic and 10 discretionary food groups, addressing key nutrients such as trans-fatty acids, saturated fat, sodium, sugar, fiber, and energy. To ensure continued scientific relevance, the Choices criteria are periodically reviewed by an independent International Scientific Committee (ISC). Methods: This paper presents the 2025 revision of the Choices criteria, focusing on priority areas identified through stakeholder consultation and recent scientific developments. Results: Key updates include the introduction of nutrient-based equivalence criteria for plant-based alternatives to meat and dairy, based on protein and selected micronutrient thresholds. Non-sugar sweeteners (NSSs) were newly included as a factor that lowers a product’s health classification and makes it ineligible for a positive FOPNL. Additionally, the industrially produced trans-fatty acid (iTFA) criteria were revised and aligned with the latest World Health Organization (WHO) recommendations, improving both technical feasibility and policy coherence. While options for incorporating whole-grain and micronutrient criteria were explored, these were not included in the current revision. Conclusions: The 2025 update system enhances the scientific rigor, policy alignment, and global applicability of the Choices system. By providing a harmonized and evidence-based tool, it aims to support national policies that foster healthier food environments and, ultimately, improve public health outcomes worldwide. Full article

Winter beverage formulations made from baru almonds with the addition of sucrose (FS) or allulose (FA) were evaluated in two acceptance sensory sessions (blind test and test with information about the ingredients, their benefits, and the product label) by 100 potential consumers. The beverages were characterized for their proximate composition, pH, soluble solids content, instrumental color, microbiological analyses, steady state rheology, and kinetic stability test. The sensory acceptability of both formulations increased with information provision, reaching an acceptability index exceeding 70%. Furthermore, the sweet taste was the primary driver of acceptance, with consumers generally preferring sucrose as the sweetener. The perception of the sweet taste of FA compared to FS was 67% and 63% in the blind and informed tests, respectively, and showed similar results for physical, chemical, and rheological properties, as well as physical and microbiological stability. Thus, this study underscores the potential of allulose to replace sucrose without significantly altering product characteristics, showcasing its importance from both technological and sensory perspectives. Additionally, the novel product developed with baru contributes to the diversification and valorization of this Brazilian fruit, as well as being a tasty alternative for consumers. Full article

To evaluate the consumption of ultra-processed foods (UPFs), culinary abilities, and food addiction (FA) in adults after different periods since bariatric and metabolic surgery, this cross-sectional study recruited and collected data via social media from adults who underwent metabolic and bariatric surgery. The Brazil Food and Nutritional Surveillance System markers of dietary consumption and the NOVA-UPF screener assessed dietary patterns and UPF consumption, the modified Yale Food Addiction Scale 2.0 assessed FA, and the Cooking Skills Index (CSI) assessed culinary abilities. 1525 participants were included, with a mean age of 38 ± 8 years and a mean time since surgery of 37 ± 54 months. Individuals with longer postoperative time showed a higher NOVA-UPF score and higher consumption of hamburgers/sausages, sweetened beverages, and instant noodles (p < 0.01 for all), without a corresponding decrease in fresh fruit and vegetable consumption. Each year since surgery increased NOVA-UPF score by 0.67 [CI95%: 0.57; 0.76] points. CSI showed no association with time (−0.41; [CI95%: −1.33; 0.50]), while FA prevalence was lowest at 48 months and increased thereafter (p < 0.01). FA prevalence initially decreased up to 4 years post-surgery, followed by a partial increase beyond 4 years, although remaining below levels observed within the first 6 months. Time since surgery is associated with higher UPF consumption and a non-linear trajectory of FA prevalence, but not with culinary abilities. Full article

Background: Background: Childhood dietary habits are critical determinants of physical growth, cognitive development, and long-term health. In Ecuador, malnutrition remains a major public health concern, with both undernutrition and overweight/obesity affecting children—especially in rural and indigenous populations. Methods: This systematic review followed PRISMA 2020 guidelines (PROSPERO ID: CRD420251080987). Searches were conducted in SciELO, Dialnet, and ScienceDirect (accessed August 2025) using Boolean operators to identify quantitative studies in Spanish or English published between 2018 and 2025 that assessed dietary habits and nutritional status in Ecuadorian children aged 1–11 years. Seventeen studies, including approximately 12,000 children, were included. Results: Prevalence of chronic undernutrition ranged from 15% to 35%, while overweight and obesity reached 20–30%. Undernutrition was higher among rural and indigenous children, whereas overweight predominated in urban and higher-income settings. Common dietary patterns included high consumption of ultra-processed foods and sugar-sweetened beverages, and insufficient intake of fruits, vegetables, and quality proteins. Maternal education, socioeconomic level, and school food environments were key determinants. Conclusions: Both malnutrition and overweight persist among Ecuadorian children, reflecting a nutrition transition influenced by socioeconomic and environmental factors. Context-specific public health actions are urgently needed, including school-based nutrition education, regulation of food marketing, improved access to affordable healthy foods, and community-level engagement to promote sustainable dietary habits. The included studies were mostly cross-sectional and often used non-validated dietary assessment tools, which may influence the reported prevalence estimates. Full article

Irritable bowel syndrome (IBS) is a prevalent disorder of gut–brain interaction (DGBI) with an adverse impact on quality of life. The global consumption of ultra-processed foods (UPF) is rapidly increasing, and UPF intake has recently been linked to a wide range of metabolic and chronic diseases. The potential role of UPF consumption in the onset and symptom generation of IBS is emerging but remains unclear. This narrative review synthesizes epidemiological evidence on the association between UPF consumption and IBS, integrates mechanistic insights from experimental and clinical studies and suggests clinical implications based on the current state of knowledge. Observational studies suggest that higher UPF intake may be associated with increased risk of IBS, although the evidence base is limited and subject to methodological challenges. Mechanistic studies indicate that additives including emulsifiers and non-nutritive sweeteners can alter pathways relevant to IBS symptom generation, such as gut microbiota composition, impair intestinal barrier function and trigger low-grade inflammation. Current evidence supports a possible link between UPF consumption and IBS. Increasing overall dietary quality and reducing UPF intake are promising complementary strategies to established dietary interventions. Future intervention trials may provide insights into relevant biological mechanisms, particularly if such changes co-occur with symptom improvement. Full article

Objective: To identify major sugar-sweetened beverage (SSB) consumption patterns among Chinese children and adolescents and examine their associations with childhood overweight/obesity. Methods: Data were drawn from the Chinese Food Consumption Survey (2017–2020), including 7979 children and adolescents. SSB intake was assessed using a non-consecutive 3-day 24 h dietary recall and classified into nine types. Principal component analysis identified SSB consumption patterns. Nutritional status was defined using BMI Z-scores, following the World Health Organization growth standards. Multivariable logistic regression was used to assess the associations between SSB patterns and overweight/obesity, with subgroup analyses by sex, age, and residence area. Results: Three major SSB patterns were identified: (1) Carbonated Beverage and Milk Tea Pattern (dominated by carbonated beverages and milk tea); (2) Functional Beverages Pattern (dominated by coffee beverages and sports beverages); and (3) Plant Hybrid Pattern (dominated by plant protein beverages and plant-based beverages). Preschool-aged children exhibited lower scores across all three patterns. Higher pattern scores were observed among school-aged children and adolescents and those with lower parental education levels, parents working as unskilled labor or homemakers, lower family annual income per capita, and residence in rural areas. All three identified SSB consumption patterns demonstrated significant positive associations with overweight/obesity in children, where higher consumption levels corresponded to greater odds of overweight/obesity. Children exhibiting higher scores in two or more patterns had higher odds of being overweight/obese (Medium-high: OR = 1.249, 95% CI = 1.053, 1.482; High: OR = 1.256, 95% CI = 1.081, 1.459). Subgroup analysis further indicated that the association between the Plant Hybrid Pattern score and overweight/obesity varied significantly by sex. Conclusions: Three SSB consumption patterns were associated with a higher likelihood of overweight/obesity among Chinese children, particularly among those with preferences for multiple SSB types. Interventions should be tailored to SSB consumption habits and socioeconomic contexts, with special attention to rural populations. Full article

Background: Artificial sweeteners, widely used as non-nutritive sugar substitutes, are increasingly prevalent in ultra-processed products. Although promoted for weight management due to their minimal caloric content, their impact on systemic inflammation remains uncertain. This systematic review of animal studies aims to evaluate the association between artificial sweetener consumption and inflammatory biomarkers. Methods: A systematic literature search was conducted up to May 2025 across PubMed, Web of Science, and Scopus, following PRISMA guidelines and registered in PROSPERO (CRD420251084004). Risk of bias was assessed using the ARRIVE guidelines and SCYRCLE’s risk of bias tool. Results: Thirty-seven animal studies were included: aspartame (n = 17), sucralose (n = 16), acesulfame potassium (n = 5), and saccharin (n = 4). Protocols varied in terms of dosage, exposure duration, animal models, and assessment of inflammatory outcomes, including C-reactive protein, interleukins (IL-6 and IL-1β), and tumor necrosis factor alpha. Aspartame and sucralose could elevate inflammatory markers, with sucralose also disrupting gut integrity and microbiota. Acesulfame K and saccharin showed variable, dose-dependent effects. Conclusions: This systematic review of animal studies suggests a possible mechanistic association between the consumption of certain artificial sweeteners and systemic inflammation. However, this relationship remains to be clarified and warrants exploration through well-designed, large-scale randomized controlled trials. Full article

Non-nutritive artificial sweeteners (NASs) are xenobiotics widely used in the food industry as sugar substitutes, since they provide few to no calories compared to sucrose. While NASs are considered safe at the acceptable daily intake (ADI) established by regulatory agencies, there is increasing controversy regarding their potential ability to promote metabolic derangements, especially to disrupt the gut microbiome balance. In this study, we analyzed a large cohort of the most commonly consumed beverages in Spain, categorizing them by the type of soda to determine the composition and content of the most frequently used NASs in the food industry. All commercial NAS formulations analyzed contained mixtures of different NASs. The NAS contents were always within regulated limits, although some samples yielded values close to these thresholds. Most soda samples analyzed contained NASs, even though the majority were not labeled as “zero sugars”, “no sugar added”, or “reduced calories”, which may mislead consumers. A preliminary statistical evaluation of the obtained results (cluster analysis) suggests that beverages can be grouped into three distinct clusters based on the total amount of NAS present in the samples. Differences in the total NAS content were significant among the three groups, with one cluster showing two- and four-fold higher levels than the others. Full article