Effect of Artificially Sweetened Beverages on Diabetes Control in Adults with Type 2 Diabetes

人工甜味饮料对成人 2 型糖尿病患者糖尿病控制的影响

• 批准号: 10163173
• 负责人: Andrew Owen Odegaard
• 金额: $ 64.21万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10163173
• 关键词: Address; Adult; Artificial Sweeteners; Basic Science; Behavior; Beverages; Body Weight decreased; Calories; Cardiovascular Diseases; Caring; Categories; Chronic Disease; Clinical; Clinical Research; Complement; Consumption; Data; Desire for food; Diabetes Mellitus; Diet; Dietary intake; Dietetics; Glycosylated Hemoglobin; Glycosylated hemoglobin A; Health; Hormones; Hour; Intake; Intervention; Knowledge; Link; Measures; Metabolic; Metabolic syndrome; Non-Insulin-Dependent Diabetes Mellitus; Nutrient; Obesity; Obesity Epidemic; Outcome; Patients; Play; Population; Population Research; Positioning Attribute; Primary Prevention; Public Health; Publications; Randomized; Randomized Clinical Trials; Recommendation; Renal function; Reporting; Research; Risk; Risk Factors; Role; Running; Satiation; Secondary Prevention; Source; Taste preferences; Testing; Twin Multiple Birth; Water; Water consumption; arm; cardiometabolic risk; clinical risk; clinically significant; diabetes control; dietary; disorder risk; evidence base; experience; food environment; glycemic control; gut microbiome; improved; interest; microbiome composition; pilot trial; preference; primary outcome; randomized trial; recruit; scientific organization; sugar; sweet taste perception; sweetened beverage

PROJECT SUMMARY Diet beverages sweetened with artificial sweeteners (AS) occupy a unique category in the food environment as they are a source of intensely sweet taste with no calories or nutrients. Diet beverages are the single largest contributor to AS intake in the U.S. diet, and consumption of diet beverages has significantly increased over the past 30 plus years in concert with the twin epidemics of obesity and type 2 diabetes. A burgeoning body of basic, clinical, and population research suggests that diet beverages are linked with obesity, decline in kidney function, and increased risk of metabolic syndrome, type 2 diabetes, and cardiovascular disease. Other developing research has suggested diet beverages and the AS that sweeten them may alter gut hormones, the gut microbiome, taste preferences, satiety, and overall dietary intake, thus providing plausible mechanisms whereby disease risk may be altered. These initial reports, and related hyperbolic media coverage, have sparked both scientific and public interest in the role that diet beverages may play in health. Despite this budding framework of knowledge, the evidence base is largely uninformed by randomized clinical trials testing whether intake of diet beverages impacts measures of clinical risk. Furthermore, an issue central to this topic is the lack of research addressing the population with diabetes, perhaps the most important population with respect to diet beverage intake. People with diabetes are the highest consumers of diet beverages, tending to consume them as a replacement for dietary sources of sugar, especially in place of sugar-sweetened beverages. This behavior has been endorsed by dietetic and scientific organizations, and diet beverages are marketed as being synonymous with better health, suitable for weight loss, and thus advantageous for diabetes control. The underlying public health concern is that there are few data to support or refute the benefit or harm of habitual diet beverage consumption by people with diabetes. To begin addressing this important scientific gap we propose to test the effect of diet beverage intake on diabetes control parameters in free-living adults with type 2 diabetes in a randomized, two arm parallel trial with a run-in period of 2-weeks and an active intervention period of 12-weeks. We will recruit 240 patients with type 2 diabetes who are usual consumers of commercial diet beverages and randomize them to receive and consume either: 1) A commercial diet beverage of choice (3 servings or 24 oz. daily); or 2) Unflavored bottled water of choice (sparkling or plain) (3 servings or 24 oz. daily). The primary outcome will be a central measure of clinical diabetes control in glycated hemoglobin (HbA1c), and we will also measure cardiometabolic risk and kidney function. Additionally, we will measure plausible mechanisms whereby diet beverage intake may alter risk by assessing the effect of diet beverage intake on the functional composition of the gut microbiome as well as usual dietary intake, appetite, and taste preferences.

项目摘要 饮食饮料用人造甜味剂加糖（AS）在食物中占有独特的类别 环境是它们的深度甜味，没有卡路里或营养。饮食饮料是 在美国饮食中摄入的最大贡献者，饮食饮料的消费显着 在过去的30多年中，与肥胖症和2型糖尿病的双流行病一起增加了30年。一个 蓬勃的基本，临床和人口研究的身体表明，饮食饮料与 肥胖，肾功能下降以及代谢综合征，2型糖尿病和 心血管疾病。其他正在发展的研究表明饮食饮料和这种甜味 它们可能会改变肠道激素，肠道微生物组，味道偏好，饱腹感和整体饮食摄入量，因此 提供合理的机制可能会改变疾病的风险。这些初始报告以及相关的 双曲线媒体覆盖范围，对饮食饮料可能的作用引发了科学和公众的兴趣 玩健康。尽管知识的萌芽框架，但证据基本上还是没有信息 随机临床试验测试饮食饮料的摄入是否影响临床风险的度量。 此外，这个主题的一个问题是缺乏针对人口的研究 糖尿病，也许是饮食饮料摄入量中最重要的人群。患有糖尿病的人 是饮食饮料的最高消费者，倾向于食用它们作为替代饮食来源 糖，尤其是代替糖味的饮料。这种行为已得到饮食和 科学组织和饮食饮料被销售为具有更好健康的代名词，适合 体重减轻，因此对糖尿病控制有利。潜在的公共卫生问题是 很少有数据支持或驳斥患有习惯饮食饮料饮用饮料的利益或危害 糖尿病。为了开始解决这一重要的科学差距，我们建议测试饮食饮料的影响 摄入糖尿病的糖尿病控制参数，在随机，两个手臂的2型糖尿病的自由生活成年人中 并行试验，磨合2周，主动干预期为12周。我们将招募240 2型糖尿病患者通常是商业饮食饮料的消费者，然后将其随机 接收和消费：1）选择的商业饮食饮料（每天3份或24盎司）；或2） 未经选择的瓶装水（闪闪发光或平原）（每天3份或24盎司）。主要结果将是 糖化血红蛋白（HBA1C）中临床糖尿病控制的中心度量，我们还将测量 心脏代谢风险和肾功能。此外，我们将测量合理的机制，从而饮食 饮料摄入量可能通过评估饮食饮料摄入量对功能组成的影响来改变风险 肠道微生物组以及通常的饮食摄入量，食欲和味道偏好。