Resumen:
Project SWEET examined the barriers and facilitators to the use of non-nutritive sweeteners and sweetness enhancers (hereafter "S&SE") alongside potential risks/benefits for health and sustainability. The Beverages trial was a double-blind multi-centre, randomised crossover trial within SWEET evaluating the acute impact of three S&SE blends (plant-based and alternatives) vs. a sucrose control on glycaemic response, food intake, appetite sensations and safety after a carbohydrate-rich breakfast meal. The blends were: mogroside V and stevia RebM; stevia RebA and thaumatin; and sucralose and acesulfame-potassium (ace-K). At each 4h visit, 60 healthy volunteers (53% male; all with overweight/obesity) consumed a 330mL beverage with either an S&SE blend (0kJ) or 8% sucrose (26g, 442kJ), shortly followed by a standardised breakfast (2600 or 1800kJ with 77 or 51g carbohydrates, depending on sex). All blends reduced the 2-h incremental area-under-the-curve (iAUC) for blood insulin (p<0.001 in mixed-effects models), while the stevia RebA and sucralose blends reduced the glucose iAUC (p<0.05) compared with sucrose. Post-prandial levels of triglycerides plus hepatic transaminases did not differ across conditions (p>0.05 for all). Compared with sucrose, there was a 3% increase in LDL-cholesterol after stevia RebA-thaumatin (p<0.001 in adjusted models); and a 2% decrease in HDL-cholesterol after sucralose-ace-K (p<0.01). There was an impact of blend on fullness and desire to eat ratings (both p<0.05) and sucralose-acesulfame K induced higher prospective intake vs sucrose (p<0.001 in adjusted models), but changes were of a small magnitude and did not translate into energy intake differences over the next 24h. Gastro-intestinal symptoms for all beverages were mostly mild. In general, responses to a carbohydrate-rich meal following consumption of S&SE blends with stevia or sucralose were similar to sucrose.
