Artificial Sweeteners, Author Interviews, Diabetes, Weight Research / 26.05.2016
Artificial Sugar Aspartamine Linked to Worse Glucose Metabolism
MedicalResearch.com Interview with:
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Dr. Jennifer Kuk[/caption]
Jennifer L. Kuk, PhD
Associate Professor
York University
School of Kinesiology and Health Science
Toronto, Ontario
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Kuk: Artificial sweeteners are used to help individuals manage their weight, however, individuals who consume aspartame (a type of artificial sweeteners) have worse glucose metabolism than individuals with the same body weight but do not consume aspartame. This observation was only true for adults with obesity. Further, saccharin and natural sugars were not associated with differences in health after considering differences in obesity.
Dr. Jennifer Kuk[/caption]
Jennifer L. Kuk, PhD
Associate Professor
York University
School of Kinesiology and Health Science
Toronto, Ontario
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Kuk: Artificial sweeteners are used to help individuals manage their weight, however, individuals who consume aspartame (a type of artificial sweeteners) have worse glucose metabolism than individuals with the same body weight but do not consume aspartame. This observation was only true for adults with obesity. Further, saccharin and natural sugars were not associated with differences in health after considering differences in obesity.
Dr. Brian Stansfield[/caption]
Dr. Brian Stansfield MD
Neonatologist
Children's Hospital of Georgia and the Medical College of Georgia
Augusta University
MedicalResearch.com: What is the background for this study?
Dr. Stansfield: Since the mid-20th century, we have experimental evidence in animal models and human data demonstrating the influence of maternal nutrition on the offspring - both in the short term and long term. Low birth weight has been connected with higher incidence of cardiometabolic diseases including insulin resistance, coronary artery disease, and hypertension. Interestingly, low birth weight infants grow up to be relatively thin adults compared to their normal or high birth weight counterparts. Conversely, high birth weight infants tend to become heavier adults and obesity is directly linked with the same adult outcomes. So the association of cardiac and metabolic diseases with low birth weight is not linked to adult obesity in general. Thus, speculation as to why extremes of birth weight lead to adult onset cardiometabolic disease suggests different mechanisms and modifying factors.
MedicalResearch.com: What are the main findings?
Dr. Stansfield: The findings of our study shed considerable light on the relationship between birth weight and risk factors for insulin resistance and visceral adiposity. Using magnetic resonance imaging (MRI) to achieve precise measurements of visceral adipose content and biomarkers for insulin resistance, we show that both low and high birth weight are associated with increased visceral adiposity and insulin resistance in a healthy population of adolescents aged 13-17 years. This association persists when we account for several recognized confounders including age, sex, race, activity level, and socioeconomic status. The most interesting finding of our study is that when you account for each adolescent’s current body mass index, a measure of obesity, the relationship between increased visceral fat and insulin resistance and low birth weight is strengthened suggesting that these adolescents had relatively high visceral adipose content despite obesity rates that were similar to their normal birth weight counterparts. On the other hand, correction for adolescent BMI (obesity) reduced the relationship between these metabolic markers and high birth weight infants. Thus, low birth weight infants may develop insulin resistance and increased visceral fat, both significant risk factors for cardiovascular disease and metabolic disease, despite having a relatively normal body shape in adolescents.
Dr. Annette Schürmann[/caption]
Prof-Dr. Annette Schürmann
Department of Experimental Diabetology
German Institute of Human Nutrition Potsdam-Rehbruecke
Nuthetal, Germany
MedicalResearch.com: What is the background for this study?
Dr. Schürmann: The aim of our study was to clarify why genetically identical mice respond very different to a high fat diet. Some of the mice react with an elevated body weight, others not. We analyzed the expression pattern
of liver at two time points, at the age of 6 weeks, (the earliest time
point to distinguish between those that respond to the diet (responder
mice) and those that did not (non-responders)), and at the age of 20
weeks. One transcript that was significantly reduced in the liver of
responder mice at both time points was Igfbp2. The reason for the
reduced expression was an elevated DNA-methylation at a position that is
conserved in the mouse and human sequence. The elevated DNA-methylation
of this specific site in human was recently described to associate with
elevated fat storage (hepatosteatosis) and NASH. However, as 6 weeks old
mice did not show differences in liver fat content between responder and
non-responder mice we conclude that the alteration of Igfbp2 expression
and DNA methylation occurs before the development of fatty liver.
Our data furthermore showed that the epigenetic inhibition of Igfbp2
expression was associated with elevated blood glucose and insulin
resistance but not with fatty liver.
Dr. Gerda Pot[/caption]
Dr Gerda Pot
Lecturer in Nutritional Sciences
King’s College London | Faculty of Life Sciences & Medicine
Diabetes & Nutritional Sciences Division |
London UK
MedicalResearch.com: What is the background for this study?
Dr. Pot: Previous evidence suggested that the timing of food intake can have a significant impact on circadian rhythms (i.e. the body's internal clock) and therefore on metabolic processes within the body, potentially leading to an increased risk of being overweight or obese. However, the evidence from studies in children is very limited so we set out to establish whether this risk was also associated with the timing of children's evening meals.
MedicalResearch.com: What are the main findings?
Dr. Lori Hoepner[/caption]
Lori A. Hoepner, DrPH
Department of Environmental Health Sciences
Columbia University
New York, NY 10032
MedicalResearch.com: What is the background for this study?
Dr. Hoepner: The Columbia Center for Children’s Environmental Health was funded starting in 1998. Pregnant African American and Dominican mothers residing in Northern Manhattan and the South Bronx were enrolled from 1998 to 2006, and mothers and their children have been followed since this time. We collected urine samples from the pregnant mothers in their third trimester and from the children at ages 3 and 5. At ages 5 and 7 we measured the height and weight of the children, and at age 7 we also measured body fat and waist circumference.
MedicalResearch.com: What are the main findings?
Dr. Hoepner: We found a significant association between increased prenatal exposure to Bisphenol A (BPA) and increases in childhood body fat measures of waist circumference and percent body fat at age 7. Our research builds on earlier findings of an association between prenatal exposure to BPA and body fat in children up to age 4, and this is the first study to report an association at age 7.
Chloe Barrera MPH
ORISE Fellow
Centers for Disease Control and Prevention
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Previous studies have been inconsistent in whether introduction of solid foods to babies before 4 months may be associated with later obesity. In our analysis of more than a thousand babies followed through the first year of life and contacted again at 6 years, we did not find this association.
Dr. Meghan Azad[/caption]
Meghan Azad PhD
Assistant Professor, Department of Pediatrics & Child Health and Community Health Sciences
University of Manitoba
Associate Investigator, Canadian Healthy Infant Longitudinal Development (CHILD) Study
MedicalResearch.com: What is the background for this study?
Dr. Azad: It is well known that maternal nutrition plays a key role in “programming” fetal development and infant weight gain, but the impact of artificial sweetener consumption during this critical period has not been extensively studied. Some animal research suggests that consuming artificial sweeteners during pregnancy can predispose offspring to develop obesity, but this has never been studied in humans, until now.
Dr. Ofir Turel[/caption]
Ofir Turel, Ph.D
Professor, Information Systems and Decision Sciences
California State University, Fullerton
Scholar in Residence, Department of Psychology
University of Southern California
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Turel: The study emerged as a response to the growing societal concern regarding potentially problematic information system use” lifestyles”, including videogame addiction, among adolescents. Much research in this domain has focused on negative psychological (e.g., reduced wellbeing, depression) and social/life functioning (e.g., reduction in normal activities, diminished school performance). Less is known regarding potential physiological outcomes of videogame addiction.
Interestingly, the increase in videogame addiction-like symptoms among adolescents happened in conjunction with an increase in sleep curtailment and obesity in this population. These are too growing concerns in North America and perhaps elsewhere. Medical research implies that these three phenomena may be related. Hence, we hypothesized that videogame addiction will be associated with increased sleep curtailment and increased abdominal adiposity; and consequently, indirectly, with cardio-metabolic deficits.
Our findings suggest that videogame addiction predicts reduced 
Dagfinn Anne[/caption]
Dagfinn Aune
Department of Epidemiology and Biostatistics
School of Public Health
Imperial College London
St. Mary's Campus
Norfolk Place, Paddington, London
MedicalResearch.com: What is the background for this study?
Response: The prevalence of overweight and obesity has increased rapidly over the past decades in all areas of the world. This has raised serious public health concerns because of the relationship between excess weight and increased risk of many chronic diseases including cardiovascular disease, several types of cancer, type 2 diabetes, gallstones, gout, osteoarthritis, and several other conditions as well as all-cause mortality.
Body mass index (BMI) is an established way of measuring adiposity and is calculated by dividing the weight in kilograms with the height in metres squared. Although overweight (BMI 25-29.9) and obesity (BMI ≥30) has been associated with increased risk of mortality in several previous studies, the largest previous study showed that when compared to normal weight, overweight was associated with reduced mortality, and only grade 2 obesity (BMI ≥35) was associated with increased risk of mortality.
However, there were several limitations in that study, for example, smoking and prevalent or prediagnostic illness were not taken into account, both of which can cause lower body weight and increased mortality and may therefore bias the optimal BMI range upwards. In addition, many large studies which did not use the standard WHO categories of normal weight, overweight and obesity, but had used smaller increments to categorize BMI to provide more detailed assessment of the dose-response relationship between BMI and mortality, had been excluded.
Dr. Albert Roh[/caption]
Albert Roh MD
Radiology Resident
Maricopa Integrated Health System
MedicalResearch.com: What is the background for this study?
Dr. Roh: Obesity is well documented to be associated with many medical conditions. Currently, obesity is defined as body mass index (BMI) over 30 kg/m^2. Although simple to calculate and relatively accurate, BMI has its limitations. BMI does not factor in the subject’s body type or fat distribution pattern. For example, a muscular subject and a fatty subject may both have BMI of 30 and be considered obese, although the muscular subject would not be predisposed to the comorbidities associated with obesity. Similarly, two subjects may have the same BMI but have different fat distribution patterns: “apple” with fat distributed primarily on the chest/abdomen and “pear” with fat distributed on the hips. The “apple” fat distribution correlates better with the comorbidities associated with obesity.
Dr. Ashley Kranjac[/caption]
Ashley Wendell Kranjac, PhD
Department of Sociology and
Kinder Institute for Urban Research
Rice University
Houston, Texas and
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Dr. Robert Wagmiller[/caption]
Robert L. Wagmiller, Jr.
Associate Professor
Department of Sociology
Temple University
Philadelphia, PA 19122
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The Center for Disease Control recently reported a decline in child obesity amongst 2-to5-year old children between 2003/4 and 2011/12 (see, Ogden et al. 2014). We aimed to identify the sources of this decline because this change occurred in a relatively short period of time. What we found is that the decline in obesity did not occur due to the things that you might expect like changes in physical activity or dietary practices (although there were some differences in these factors across years). But, rather, what we found is that because there were differences in obesity rates for the youngest and oldest children in this age range in 2003/4, but not in 2011/12, that the decline in obesity exists. In other words, because the oldest children in 2003/4 had significantly higher obesity rates than the youngest children in this time period, but this effect is not observable in 2011/12, we see a decline in obesity.
Dr. Lauren Fiechtner[/caption]
MedicalResearch.com Interview with:
Lauren Fiechtner MD MPH
Director of Nutrition
Division of Pediatric Gastroenterology and Nutrition
Massachusetts General Hospital for Children
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Fiechtner: In previous studies, we investigated if distance to a supermarket was associated with a child’s BMI or weight status. These were cross-sectional studies measuring only one point in time. We wondered if distance to a supermarket modified how much children in a behavioral intervention improved their weight or dietary intake. In particular we examined 498 children participating in the Study of Technology to Accelerate Research, which was a randomized controlled trial to treat childhood obesity in Eastern Massachusetts. The intervention included computerized clinician decision support plus a family self-guided behavior change intervention or a health coach intervention, which included text messages to the family to promote behavior change. We found that children living closer to supermarkets were able to increase their fruit and vegetable intake and decrease their BMI z-score more during the intervention period than children living farther from supermarkets.
Dr. Brian Elbel[/caption]
Brian Elbel, PhD, MPH, Associate Professor, Department of Population Health, NYU Langone Medical Center
Amy Schwartz, PhD, Director, New York University Institute for Education and Social Policy, and the Daniel Patrick Moynihan Chair in Public Affairs, Syracuse University
Michele Leardo, MA, Assistant Director
New York University Institute for Education and Social Policy
Medical Research: What is the background for this study? What are the main findings?
Response: New York City, as well as other school districts, is making tap water available to students during lunch by placing water dispensers, called water jets, in schools. Surprisingly, drinking water was not always readily available in the lunchroom. Water jets are part of a larger effort to combat child obesity.
We find small, but statistically significant, decreases in weight for students in schools with water jets compared to students in schools without water jets. We see a .025 reduction in standardized body mass index for boys and .022 for girls. We also see a .9 percentage point reduction in the likelihood of being overweight for boys and a .6 percentage point reduction for girls. In other words, the intervention is working.
Prof. Keast[/caption]
MedicalResearch.com Interview with:
Russell Keast Ph.D., CFS Professor
Centre for Advanced Sensory Science (CASS)
School of Exercise and Nutrition Sciences, Faculty of Health
Deakin University
Melbourne Burwood Campus
Burwood, VIC 3125
Medical Research: What is the background for this study? What are the main findings?
Dr. Keast: Fatty acids are detected at various stages of food consumption and digestion via interactions with nutrient receptors upon the tongue and within the gastrointestinal (GI) tract. This chemoreception initiates functional responses, i.e., taste perception, peptide secretion and alterations in GI motility that play a fundamental role in food consumption, hedonics and satiety. In obesity, both GI and taste detection of fatty acids is attenuated and this may predispose individuals to increased consumption of high-fat foods, or foods containing greater concentrations of fat. In other word overweight and obese people are less 
Kawther Hashem[/caption]
MedicalResearch.com Interview with:
Kawther Hashem MSc RNutr (Public Health)
Nutritionist and Researcher
Action on Sugar
Wolfson Institute of Preventive Medicine,
Queen Mary, University of London
London UK
Medical Research: What is the background for this study? What are the main findings?
Response: The calculations showed that a 40% reduction in free sugars added to Sugar Sweetened Beverages (SSBs) over five years would lead to an average reduction in energy intake of 38 kcal per day by the end of the fifth year. This would lead to an average reduction in body weight of 1.20kg in adults, resulting in a reduction in overweight and obese adults by approximately half a million and 1 million respectively. This would in turn prevent between 274,000-309,000 obesity-related type 2 diabetes over the next two decades. Policies such as this will reduce cases of overweight and obesity and type 2 diabetes, this will have a major clinical impact and reduce healthcare costs.
Prof. Schmid-Schonbein[/caption]
MedicalResearch.com Interview with:
Geert W. Schmid-Schonbein, Ph.D.
Distinguished Professor and Chairman
Department of Bioengineering
Adjunct Professor in Medicine
University of California San Diego
Medical Research: What is the background for this study? What are the main findings?
Dr. Schmid-Schonbein: Most approaches to control/reduce body weight focus on reducing food quantity, improving quality and promoting daily activity. These approaches, effective in the short term, only yield modest weight control. Weight management strategies recommended in the past have not significantly diminished the current trend towards childhood and adolescence obesity.
We developed and tested an alternative approach to control weight gain in healthy individuals to reduce the risk for development of obesity and diabetes complications. The essence is to:
“Eat deliberately slow AND stop eating when you feel no longer hungry”.
The approach avoids any form of special diet, uses no drugs, can be adopted for a lifetime and used in any ethnic environment. Children in a Mexican School in Durango were instructed by a pediatrician to learn to eat deliberately slow and to stop eating when the satiety reflex sets in, i.e. the moment when the feeling of hunger has disappeared.
They were instructed to:
Dr. Martin[/caption]
MedicalResearch.com Interview with:
Dr Anne Martin PhD
Research Associate/Research Fellow
Physical Activity for Health Research Centre (PAHRC)
Institute for Sport, PE & Health Sciences
University of Edinburgh
TeleScot Research Group
Usher Institute for Population Health Sciences and Informatics
Edinburgh
Medical Research: What is the background for this study? What are the main findings?
Dr. Martin: Impairments in cognitive development during childhood can have detrimental effects on health behaviour, educational attainment, and socio-economic status later in life. Epidemiological evidence indicates an association between childhood obesity and cognition and educational attainment. Knowledge of when obesity related deficits in cognition and attainment emerge, and how large the deficits are at various ages, may be useful to support arguments for school-based obesity prevention initiatives and in translating evidence on this topic into policy aimed at preventing obesity.
In this study we explored whether the adverse association between obesity and cognition emerges in early childhood. Measures of cognitive abilities included visuo-spatial skills, expressive language skills and reasoning skills. Our findings indicated that obesity in the pre-school years may be weakly associated with some poorer cognitive outcomes at age 5 years in boys, independently of socioeconomic status.
Stronger relationships between obesity and 
Dr. Gersing[/caption]
MedicalResearch.com Interview with:
Alexandra S. Gersing, MD
Department of Radiology and Biomedical Imaging
University of California, San Francisco
Medical Research: What is the background for this study? What are the main findings?
Dr. Gersing: This study is part of a larger NIH-funded project focusing on the effects of weight change in individuals at risk for and with osteoarthritis. Our group has previously shown that weight gain causes substantial worsening of knee joint degeneration in patients with risk factors for osteoarthritis and now we aimed to show that weight loss could protect the knee joint from degeneration and osteoarthritis. Osteoarthritis is one of the major causes of pain and disability worldwide; and cartilage plays a central role in the development of joint degeneration. Since cartilage loss is irreversible, we wanted to assess whether lifestyle interventions, such as weight loss, could make a difference at a very early, potentially reversible stage of cartilage degradation and whether a certain amount of weight loss is more beneficial to prevent cartilage deterioration. To measure these early changes we used a novel Magnetic Resonance Imaging (MRI) technique, called T2 mapping, which allows us to evaluate biochemical cartilage degradation in the patient on a molecular level. The most relevant finding of this study is that patients with more that 10% of 
Prof. Cnattingius[/caption]
MedicalResearch.com Interview with:
Professor Sven Cnattingius
Professor in reproductive epidemiology
Clinical Epidemiology Unit, Department of Medicine
Karolinska University Hospital
Karolinska Institutet, Stockholm, Sweden
Medical Research: What is the background for this study?
Prof. Cnattingius: Maternal overweight and obesity are associated with increased risks of stillbirth and infant mortality.
Weight gain between pregnancies increases risks of other obesity-related complications, including preeclampsia, gestational diabetes, and preterm birth. Weight gain appear to increase these risks especially in women who start off with normal weight.
As these complications increases risks of stillbirth and infant mortality, we wanted to study the associations between weight change between successive pregnancies and risks of stillbirth and infant mortality (deaths during the first year of life).
Medical Research: What are the main findings?
Prof. Cnattingius: The main findings include:
