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This project aims to compare the acute metabolic effects of the three sweeteners sucrose, glucose, and fructose on GI hormones (GLP-1, PYY, CCK, and ghrelin).
Furthermore, glycemic control, erythritol and xylitol concentrations, blood coagulation function , blood lipids, uric acid, high-sensitive C-reactive protein (hsCRP), complete blood count, gastric emptying, appetite-related sensations, and GI symptoms will be investigated.
Sugar should not be defined by origin (added sugar, free sugar, simple sugar) but rather by chemical structure (sucrose, glucose, fructose, etc.). Although the disaccharide sucrose is hydrolysed by sucrase into its monosaccharides glucose and fructose, the administration of each of the three sweeteners alone results in different metabolic effects.
Although sucrose, glucose, and fructose are long known sweeteners in food and beverages and their metabolic effects have been extensively studied, there are still no comprehensive studies comparing the three sweeteners in a whole range of parameters. The main inconsistency in the literature is the study design which influences the outcomes. It is important to differentiate whether it is an acute or chronic study, whether the participants are adults or children, are healthy or have T2DM, have normal weight, overweight or obesity, whether the dosage is chosen to be isocaloric or isosweet, whether there is a control group or whether the sweeteners are administered orally or intragastrical.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sucrose | Active Comparator | 20 volunteers receive 33.5g sucrose dissolved in 300mL water as a drink. |
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| Glucose | Active Comparator | 20 volunteers receive 33.5g glucose dissolved in 300mL water as a drink. |
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| Fructose | Active Comparator | 20 volunteers receive 33.5g fructose dissolved in 300mL water as a drink. |
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| Water | Placebo Comparator | 20 volunteers receive 300mL water as a drink. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sucrose | Dietary Supplement | 33.5g sucrose dissolved in 300mL tap water |
|
| Measure | Description | Time Frame |
|---|---|---|
| Effect of sucrose, glucose, fructose, and water on the GI hormone response - GLP-1 | Plasma GLP-1 will be measured with a commercially available immunoassay kit (MILLIPLEX® MAP; Millipore Corporation, Billerica, MA, USA). | Blood will be drawn at the following timepoints: : -10 and -1 minutes (before administration) and 15, 30, 45, 60, 90, 120, and 180minutes (after administration) |
| Effect of sucrose, glucose, fructose, and water on the GI hormone response - PYY | PYY-3-36 will be quantified using a non-radioactive high sensitive sandwich ELISA (Millipore - # EZHPYYT66K). | Blood will be drawn at the following time points: -10 and -1 minutes (before administration) and 15, 30, 45, 60, 90, 120, and 180minutes (after administration). |
| Effect of sucrose, glucose, fructose, and water on the GI hormone response - CCK | Plasma cholecystokinin (CCK) levels will be measured with a sensitive radioimmunoassay using a highly specific antiserum (No. 92128) | Blood will be drawn at the following time points: -10 and -1 minutes (before administration) and 15, 30, 45, 60, 90, 120, and 180minutes (after administration). |
| Effect of sucrose, glucose, fructose, and water on the GI hormone response - Ghrelin | Octanoylated ghrelin will be measured by a radioimmunoassay with 125I [Tyr24] human ghrelin as tracer and a rabbit antibody against human ghrelin (final dilution 1/100000), which does not cross-react with desoctanoylated ghrelin. | Blood will be drawn at the following time points: -10 and -1 minutes (before administration) and 15, 30, 45, 60, 90, 120, and 180minutes (after administration). |
| Measure | Description | Time Frame |
|---|---|---|
| Effects on glycemic control - plasma glucose | Glucose will be measured by a glucose oxidase method (Rothen Medizinische Laboratorien AG, Basel, Switzerland). | Blood will be drawn at the following time points: -10 and -1 minutes (before administration) and 15, 30, 45, 60, 90, 120, and 180minutes (after administration). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Anne Christin Meyer-Gerspach, PD, PhD | St. Clara Research Ltd. | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| St. Claraspital | Basel | 4002 | Switzerland |
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| Glucose | Dietary Supplement | 33.5g glucose dissolved in 300mL tap water |
|
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| Fructose | Dietary Supplement | 33.5g fructose dissolved in 300mL tap water |
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| Water | Dietary Supplement | 300mL water |
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| Effects on glycemic control - plasma insulin |
Insulin will be quantified using a chemiluminescent microparticle immunoassay (chemiflex) reagent kit (#8k41; Abbott) and the relative light units detected by the ARCHITECT optical system (model: CI4100; Abbott). |
| Blood will be drawn at the following time points: -10 and -1 minutes (before administration) and 15, 30, 45, 60, 90, 120, and 180minutes (after administration). |
| Effects on glycemic control - plasma c-peptide | C-peptide will be measured with a commercially available sandwich ELISA kit from Millipore (Millipore - # EZHCP-20K). | Blood will be drawn at the following time points: -10 and -1 minutes (before administration) and 15, 30, 45, 60, 90, 120, and 180minutes (after administration). |
| Effects on glycemic control - plasma glucagon | Glucagon concentrations in plasma will be measured after extraction of plasma with 70% ethanol (vol/vol, final concentration). The antibody is directed against the C-terminus of the glucagon molecule (antibody code no. 4305) and therefore mainly measures glucagon of pancreatic origin. | Blood will be drawn at the following time points: -10 and -1 minutes (before administration) and 15, 30, 45, 60, 90, 120, and 180minutes (after administration). |
| Effects on erythritol concentrations | Erythritol concentrations will be measured by GC-MS/MS (Gas Chromatography Tandem Mass Spectrometry). | Blood will be drawn at the following time points: -10 and -1 minutes (before administration) and 15, 30, 45, 60, 90, 120, and 180minutes (after administration). |
| Effects on xylitol concentrations | Xylitol concentrations will be measured by GC-MS/MS (Gas Chromatography Tandem Mass Spectrometry). | Blood will be drawn at the following time points: -10 and -1 minutes (before administration) and 15, 30, 45, 60, 90, 120, and 180minutes (after administration). |
| Effects on blood coagulation function - p-selectin | Plasma concentrations of p-selectin will be measured using a commercially available ELISA-kit. | Blood will be drawn at the following time points: -10 and -1 minutes (before administration) and 30, 60, 90, 120, and 180 minutes (after administration). |
| Effects on blood coagulation function - sVCAM1 | Plasma concentrations ofsVCAM1 will be measured using a commercially available ELISA-kit. | Blood will be drawn at the following time points: -10 and -1 minutes (before administration) and 30, 60, 90, 120, and 180 minutes (after administration). |
| Effects on blood coagulation function - PF-4 | Plasma concentrations of PF-4 will be measured using a commercially available ELISA-kit. | Blood will be drawn at the following time points: -10 and -1 minutes (before administration) and 30, 60, 90, 120, and 180 minutes (after administration). |
| Effects on blood coagulation function - D-Dimers | D-Dimers will be measured using an antigen-test. | Blood will be drawn at the following time points: -10 and -1 minutes (before administration) and 30, 60, 90, 120, and 180 minutes (after administration). |
| Effects on blood lipids | Analyses of blood lipids are carried out in the hospital laboratory. | Blood will be drawn at the following time points: -10 and -1 minutes (before administration) and 30, 60, 90, 120 and 180 minutes (after administration). |
| Effects on uric acid | Analyses of uric acid are carried out in the hospital laboratory. | Blood will be drawn at the following time points: -10 and -1 minutes (before administration) and 30, 60, 90, 120, and 180 minutes (after administration). |
| Effects on hsCRP | Concentrations of hsCRP will be measured by Rothen Laboratory in Basel. | Blood will be drawn at the following time points: -10 and -1 minutes (before administration) and 30, 60, 90, 120, and 180minutes (after administration). |
| Effects on gastric emptying rate | Gastric emptying rate will be determined using a 13C-sodium acetate breath test. | Breath samples will be drawn at the following time points: -10 and -1 minutes (before administration) and 15, 30, 45, 60, 75, 90, 105, 120, 150, 180, 210 and 240minutes (after administration). |
| Effects on appetite-related sensations | Appetite perceptions (feelings of: a) hunger, b) satiety) are assessed by visual analogue scale (VAS). Visual analogue scales consist of a horizontal, unstructured, 10-cm line representing the minimum (0.0 points) to the maximum rating (10.0 points). Subjects assign a vertical mark across the line to indicate the magnitude of their subjective sensation at the present time point. The measurement is quantified by the distance from the left end of the line (minimum rating) to the subject's vertical mark. | Visual analogue scales will be recorded at the following time points: -10 and -1 minutes (before administration) and 15, 30, 45, 60, 90, 105, 120, and 180 minutes (after administration). |
| Effects on GI tolerance | GI symptoms will be assessed by use of a checklist including the following questions: abdominal pain, nausea, vomiting, diarrhoea, borborygmi, abdominal distension, eructation and increased flatus. | GI tolerance will be recorded atthe following time points: -10 minutes (before administration) and 30, 60, 90,120, 180, and 240 minutes (after administration). |
| ID | Term |
|---|---|
| D013395 | Sucrose |
| D005947 | Glucose |
| D005632 | Fructose |
| D014867 | Water |
| ID | Term |
|---|---|
| D004187 | Disaccharides |
| D009844 | Oligosaccharides |
| D011134 | Polysaccharides |
| D002241 | Carbohydrates |
| D000073893 | Sugars |
| D006601 | Hexoses |
| D009005 | Monosaccharides |
| D007661 | Ketoses |
| D006878 | Hydroxides |
| D000468 | Alkalies |
| D007287 | Inorganic Chemicals |
| D000838 | Anions |
| D007477 | Ions |
| D004573 | Electrolytes |
| D010087 | Oxides |
| D017601 | Oxygen Compounds |
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