Elsevier

Physiology & Behavior

Volume 182, 1 December 2017, Pages 17-26
Physiology & Behavior

Review
Do non-nutritive sweeteners influence acute glucose homeostasis in humans? A systematic review

https://doi.org/10.1016/j.physbeh.2017.09.016Get rights and content

Highlights

  • Taste has important nutritional and health implications.

  • Activation of sweet taste receptors by sugars triggers physiological responses.

  • These responses improve glucose homeostasis.

  • Non-nutritive sweeteners activate receptors but do not improve glucose homeostasis.

Abstract

The human body associates sensory cues with metabolic consequences. Exposure to sweet-tasting sugars – even in the absence of ingestion – triggers physiological responses that are associated with carbohydrate digestion, absorption and metabolism. These responses include the release of insulin and incretin hormones, which work to reduce blood glucose. For this reason, non-nutritive sweeteners (NNS) have been posited to trigger similar physiological responses and reduce postprandial blood glucose concentrations. The first part of this review presents a brief overview of sweet taste receptor activation in the oral cavity and gastrointestinal tract and the ensuing physiological responses related to glucose homeostasis. The second part of this review contains a systematic literature review that tested the hypothesis that NNS use improves glucose regulation postprandially. Studies were grouped based on sweet taste receptor stimulation paradigms, including pre-ingestive stimulation, ingestion of NNS alone, co-ingestion of NNS with foods, and using NNS as preloads to influence subsequent blood glucose excursions. In summary, the review found that NNS triggered physiological responses, albeit inconsistently, yet failed to significantly lower blood glucose levels in almost all studies.

Section snippets

Principles in regulating postprandial glycemia

The prevalence of type 2 diabetes continues to increase and finding effective strategies to regulate blood glucose levels is critical. While fasting blood glucose levels have been used as an indicator of glucose management, controlling postprandial blood glucose, i.e. lowering glucose peaks and fluctuations, is key to preventing long-term health consequences [1], [2]. Maintenance of blood glucose within a specific range is referred to as glucose homeostasis, which involves the regulation of

Effects of non-nutritive sweeteners on human glucose homeostasis

The effects of NNS on a wide range of factors related to blood glucose regulation, such as insulin, glucagon, incretins (GLP-1 and GIP), gastric emptying rate, and glucose absorption rates were considered to provide a more complete picture of how NNS influence glucose homeostasis.

Conclusion

The scope of this review was to review the acute effects of NNS on acute glucose homeostasis. Considering the various study designs and the totality of available human data, NNS appeared to exert some physiological responses, albeit inconsistently. Under acute conditions, when administered without a carbohydrate load, NNS do not reliably differ from water in their effects on blood glucose. When NNS are compared to nutritive sweeteners, reduced blood glucose is attributed to the lower

Conflict of interests

The authors declare no conflict of interests.

Authorship

All authors contributed equally to the conception, execution and writing of this review. The authors have read and approved the final version of this manuscript.

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