There is a growing concern about life quality and health-related issues due to the high consumption of food rich in fat, sugar, and salt. The journal explains the potential benefits of using NNS together with associated adverse effects. It uses appropriate methods such as a scope reviewing the approach to assess the range, extent, and nature of health outcomes when using non-nutritive sweeteners. To the journal, most of the NNS appropriate for human use are synthetic, and they are available in different forms in various countries. They are sweeter and more nutritious than sucrose since they do not contain calories (Lohner, S., Toews, I., & Meerpohl, J., 2017). Parallel to an increase in NNSs-sweetened products’ consumption, several concerns have emerged regarding the potential adverse effects of the products.
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Purpose of the Study
The purpose of the research was to review all the health outcomes associated with the consistent consumption of NNSs. The authors of the article under review were Szimonetta Lohner, Ingrid Toewes, and Joerg Meerpohl, and the journal was published on 8th September 2017. The research examined the extent and nature of the impacts (both short and long terms) when using NNSs, together with the gaps in the research on health and nutrition.
A scope reviewing method, specifically evidence mapping, was used to compile all essential information on the health impacts of NNSs intake from various studies and reports on health. Case studies and clinical trials, case controls together with cross-sectional approaches were used in the study. Electronic searches facilitated a data finding strategy to enhance the speed of accessing information. Data from various health outcomes were compiled and summarized using tabulations and bubble charts for representation. The study also used a systematic Ovid MEDLINE search, EMBASE, and Cochrane CENTRAL database when assessing the effects of natural sweeteners on the consumers (Lohner et al., 2017). All human-approved research examining any health results of an NNS involvement was included, and no single research was excluded based on study design, language, or any other unethical practice.
Three hundred seventy-two case studies were included in the scope reviewing process, comparing 15 systematic cases, 155 RCTs (randomized controlled trials), 23 Non-RCTs, 57 cohort/case studies, 28 cross-sectional types of research, and 52 case-control trials, and 42 case reports. In the nutrition health disciplines, appetite, short-term food consumption, cancer risks, diabetic associated risks, dental problems, weight gain issues, and obesity are the main investigated health challenges with related outcomes (Lohner et al., 2017). Generally, there is no significant evidence for harmful and beneficial impacts on the NNSs outcomes.
Several health results, including depression, headaches, cognitive and behavioral effects, neurological effects, cardiovascular impacts, and chronic kidney problems, were examined. For instance, from 3 RCTs, 2 of them together with one cohort had a significant positive correlation with headaches while the remaining 1 RTC had no association with migraines (Lohner et al., 2017). In reviews of hypertension and diabetes, the required evidence about NNS use results was inconsistent.
NNS lowers the content of energy, and they are available in different forms. NNS has positive implications when regulating energy intake by consumption of certain types of foods. However, it is not crystal clear whether the use of NNS has resulted in overall energy intake reduction in the subjects. There is a contradiction since, in some cases, NNS has been instrumental in weight management, while it has facilitated weight gain in some cases. Stevia, which has been recommended as the healthiest sweetener by various users, has some registered complainants due to its bitterness.
Generally, the evidence of artificial sweeteners (AS) health outcomes is inconsistent, creating several health discipline gaps. Health outcome studies were conducted using a cross-over approach, and a smaller section was conducted using RCTs with intervention periods of four weeks up to exactly 18 months. Urinary tract and bladder cancer were examined in several studies, and a systematic review gave conclusive evidence, and the impacts of aspartame/ saccharin were minimal. Also, numerous case studies on the function of NNS in the prevention of dental caries suggested the use of NNCS (stevioside, rebaudioside, thaumatin, brazzein) beverages or stevia instead of beverages containing sugar-sweeteners (Lohner et al., 2017). Stevia can be an appropriate way of preventing dental caries. However, sugar alcohols have been used broadly for dental caries prevention, but a combination of NNCs and sugar alcohols have also been deployed for the same purpose. Further research needs to be carried out to determine the effectiveness of NNCs versus approaches.
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The impacts of NNS on the perils of diabetes were evaluated using limited cohort studies. The research focused on sugar-sweetened beverages concerning their effects. Further researches need to be conducted on special categories of NNS, including NNCS to improve their efficiency. Intervention research on weight management had different results in incorporating NNS in weight management programs. Some nations, such as the UK, have recommended the addition of NNS in all food packages (Farhat, G., Dewison, F., & Stevenson, L., 2021). However, such a mandatory move can cause practical problems for final consumers. More studies are recommended to determine the effectiveness of NNS in weight management programs for both obese, normal weight, and overweight individuals.
In victims of diabetes, the impact of NNS was analyzed majorly on glycemic control. Due to heterogeneous rather than contradictory outputs, a thorough investigation of the findings in a multi-faceted systematic review needs to be done to assess the impacts of NNS. The review entailed meta-analyses and sensitivity analyses in resolving several uncertainties when using NNS as a diabetic intervention plan (Lohner et al., 2017). However, further research on both short and long-term diabetic intervention approaches is required. The impact of NNS when trying to lower the blood pressure in some patients should be scrutinized using a high standard systematic review together with a meta-analysis. Concerning NNCS, Stevia is drastically deployed as a sweetener, but it has limited research to prove its efficacy (Farhat et al., 2021). Researches assessing the impacts of NNS on diabetic and cancer-stricken patients are inadequate hence, needs to be increased.
Nutrition and health is a wider discipline encompassing several medical types of research. There are many gaps in information and evidence associated with the health impacts of NNS products in healthy and non-healthy groups of individuals. In the healthy category, short-term food consumption and appetite, diabetic risks, cancer problems, and perils of dental caries form the main analyzed health outcomes. However, in all of them, there is no conclusive and significant evidence. There is a necessity for well-done systematic reviews to precisely and quantitatively examine and summarize outputs and their validity. In addition, there are many health consequences such as headaches, depression, and cardiovascular effects, amongst others, linked with the consumption of NNSs. A systematic review can also aid in creating recommendations for victims with hypertension and diabetes on using NNSs appropriately.
Farhat, G., Dewison, F., & Stevenson, L. (2021). Knowledge and perceptions of non-nutritive sweeteners within the UK adult population. Nutrients, 13(2), 1-14.
Lohner, S., Toews, I., & Meerpohl, J. (2017). Health outcomes of non-nutritive sweeteners: Analysis of the research landscape. Nutrition Journal, 16(1), 1-21.