The rising prevalence of obesity and diabetes is a significant health concern both in globally and is now regarded as a worldwide epidemic. Added sugars like sucrose and high-fructose corn syrup (HFCS) are a major concern due to their link with an increased incidence of diet-induced obesity and diabetes. The purpose of this review is to provide insight into the effects of natural sweeteners as alternatives to sucrose and HFCS, which are known to have negative impacts on metabolic diseases and to promote further research on sugar consumption with a focus on improving metabolic health. The collective evidences suggest that natural alternative sweeteners have positive impacts on various markers associated with obesity and diabetes, including body weight gain, hepatic fat accumulation, abnormal blood glucose or lipid homeostasis, and insulin resistance. Taken together, natural alternative sweeteners can be useful substitutes to decrease the risk of obesity and diabetes compared with sucrose and HFCS.
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We developed nutrition education materials for non-alcoholic fatty liver disease (NAFLD) patients focusing on low-carbohydrate and low-simple sugar diet and assessed subjective difficulty and compliance for the developed materials. The materials were developed in 2 types, a booklet for face-to-face education and a handout for phone education. The booklet covered 4 topic areas of fatty liver, low-carbohydrate and low-simple sugar diet, weight control, and meal plan. The handout material included several eating behavior tips. To assess practical usability of nutrition education using the developed materials, subjective compliance and difficulty levels were examined in a sample for NAFLD patients. A total of 106 patients recruited from 5 general hospitals were randomly assigned to a low-carbohydrate and low-simple sugar weight control diet group or a general weight control diet group. Each participant received a 6-week nutrition education program consisting of a face-to-face education session and two sessions of phone education. The developed materials were used for the low-carbohydrate and low-simple sugar weight control diet group and general weight control information materials were used for the control group. Subjective difficulty and compliance levels were evaluated three times during the education period. Subjective difficulty level was significantly higher in the low-carbohydrate and low-simple sugar diet group compared to the control group at the end of the second week, but such a discrepancy disappeared afterward. No significant difference was found for subjective compliance between the groups at each time. In conclusion, the developed nutrition education materials for low-carbohydrate and low-simple sugar diet are reasonably applicable to general Korean NAFLD patients.
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High sugar intake has been suggested to be related to hypertension. To examine the associations between intakes of sugar and sugar-sweetened beverages (SSBs) and the prevalence of hypertension, we used the US National Health and Nutrition Examination Survey (NHANES) 2003-2006. A total of 3,044 participants aged ≥19 years were included. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using multivariate logistic regression model. Prevalent hypertension cases were defined as systolic blood pressure (SBP) of ≥140 mmHg or diastolic blood pressure (DBP) of ≥90 mmHg. In the multivariate adjusted models, we observed no association between sugar consumption and the prevalence of hypertension. In the model where we adjusted for age, gender, NHANES period and BMI, those who consumed ≥3 times per day of sugar-sweetened beverages had an OR of 1.87 (95% confidence interval, CI = 1.06-3.26) for the prevalence of hypertension compared with those who consumed <1 time per month of these beverages. Further adjustment for other factors attenuated the association; ORs (95% CIs) were 1.21 (0.81-1.81) for 1 time per month-<3 times per week, 1.39 (0.86-2.24) for 3 times per week-<1 times per day, 1.26 (0.80-1.98) for 1-<3 times per day, and 1.50 (0.84-2.68) for ≥3 times per day of sugar-sweetened beverages compared to the <1 time per month (p for trend = 0.33). In conclusion, we found that sugar consumption was not associated with the prevalence of hypertension, however there was suggestion that high sugar-sweetened beverage consumption was associated with high prevalence of hypertension in the US.
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