4. Discussion
metabolic disease
INFLAMMATION, HYPERURICEMIA, METABOLIC DISEASE
This study aimed to investigate the metabolic effects and safety aspects of the acute intragastric administration of either 25 g D-allulose or 50 g erythritol on glucose, insulin, ghrelin, blood lipid, uric acid and hsCRP concentrations. The results show that: (i) glucose and insulin concentrations did not increase in response to D-allulose and erythritol, compared to tap water; (ii) ghrelin concentrations decreased in response to erythritol (exploratory analysis), but not to D-allulose, compared to tap water; (iii) blood lipids, uric acid and hsCRP were not affected in response to D-allulose and erythritol compared to tap water.The linear mixed model analysis shows that glucose and insulin concentrations were lower in response to D-allulose, but not erythritol, compared to tap water. However, both Bayesian models did not show evidence of a difference in insulin concentrations in response to D-allulose compared to tap water. The results of D-allulose and erythritol on glucose and insulin concentrations are therefore in line with previous human studies and support the anti-diabetic effects (i.e., no increase in glucose or insulin concentrations) [Anorexigenic and orexigenic hormones play an important role in regulating appetite and satiation. Common mediators are CCK, GLP-1, PYY and ghrelin [The potential side effects associated with high sugar intake, especially fructose, are changes in blood lipids, uric acid or hsCRP [For both sweeteners, we and others show that D-allulose and erythritol have no clinically relevant effects on blood lipids [High uric acid concentrations and inefficient excretion thereof are often associated with hyperuricemia. Besides purine-rich food, other factors such as high fructose or alcohol consumption can trigger this metabolic disease [CRP is an acute-phase protein biomarker indicating inflammatory processes in the body [Some limitations need to be considered. First, the design of this acute trial does not allow the investigation of chronic effects of D-allulose and erythritol. Second, additional, at this stage not identified side effects could occur under long-term treatment. Third, the study involved the intragastric administration of two alternative sweeteners by bypassing oro-sensory cues, which may limit translational inferences that can be drawn from the ‘real-life’ consumption of sweeteners (especially over the longer term). Fourth, a comparison of D-allulose and erythritol to a sucrose solution would be informative.In conclusion, this study shows that the acute intragastric administration of the two alternative sweeteners D-allulose and erythritol, has beneficial physiological effects regarding glycemic control and ghrelin, and exhibits a clinically favorable safety profile with respect to blood lipids, uric acid and systemic inflammation. This combination of properties identifies D-allulose and erythritol as excellent candidates for effective and safe sugar alternatives.