Periodic Reporting for period 1 - SWEETENED HEARTS (Are non-nutritive sweeteners vascular-safe substitutes for added sugars?)
Periodo di rendicontazione: 2021-09-01 al 2023-08-31
In an effort to address the increasing incidence of poor cardiometabolic health, leading health agencies around the world advocate the consumption of foods and beverages containing non-nutritive sweeteners as healthy alternatives to those containing added sugars. However, several epidemiological studies have reported significant, counterintuitive associations between the consumption of non-nutritive sweeteners and weight gain, an increased incidence of type 2 diabetes, and cardiovascular events (e.g. heart attacks). Additionally, mice studies indicate that non-nutritive sweeteners, like excess sugar, may have a direct role in the impairment of vascular reactivity; findings that raise serious concerns over the assumed physiological inactivity of non-nutritive sweeteners. Indeed, rather than helping improve cardiometabolic health outcomes, as promoted, consuming non-nutritive sweeteners may be as harmful to vascular and metabolic health as is excess sugar consumption; thus, contributing to one of the greatest, preventable burdens to health care systems, economies, and societies both in Europe and abroad. Considering this, the SWEETENED HEARTS study aimed to, for the first time in vivo, assess the effect of non-nutritive sweetener consumption on vascular and metabolic function in humans. As a result of the COVID-19 pandemic, the clinical research centre in which the project was hosted was instructed to redirect of 100% research resources to conducting clinical trials for COVID-19 vaccines. This delayed the implementation of the project and, as a consequence, data collection is still ongoing. Results from this study have the potential to indicate if non-nutritive sweeteners can contribute to the development of CVD, obesity and insulin resistance; findings that may encourage health authorities to revisit the regulatory status of non-nutritive sweeteners.
As of the conclusion of the two-year fellowship, 4 of the 18 study participants required to have statistical power and detect a significant difference have completed the entire study protocol. Although there isn't enough data to reveal the full vascular and metabolic effects of consuming non-nutritive sweeteners, preliminary data from 8 participants who have entered the study protocol indicate that resting microvascular blood perfusion is not altered by the direct infusion of non-nutritive sweeteners to the microcirculation (sucralose and acesulfame potassium, infused separately using microdialysis). This suggests that non-nutritive sweeteners don't modulate vascular reactivity in humans via direct activation of type 1 sweet taste receptors. Exploitation and dissemination of these results, as well as those indicating the effects of non-nutritive sweetener consumption on other aspects of human vascular and metabolic function, will be completed when data collection had concluded for all participants.
The project extends upon experimental research (the current state of the art) by addressing the need for prospective, randomised controlled studies that assess the impact of non-nutritive sweeteners, in vivo, on human health. It has begun to provide a deeper understanding of the effects of consuming non-nutritive sweeteners at a physiological level and, subsequently, the role that non-nutritive sweeteners may play in the development of poor cardiometabolic health. However, given that data collection is ongoing, the potential socio-economic and societal impact of this research has not been realised yet.