Advice to early career nutritionists on working in and with the food industry.

Early career researchers (ECRs) in nutrition and related fields often wish to approach commercial organisations for possible funding or collaboration in scientific projects and other activities. However, ECRs may experience challenges from their limited experience, lack of understanding of the food industry and concerns about working practices and research integrity. This commentary is oriented toward providing some basic, practical guidance for nutritionist scientists, to help in developing credible, principled and effective working relationships with the food industry.

Conflicts of Interest in Nutrition: Categorical Thinking and the Stigma of Commercial Collaboration.

There is a high level of concern about the possible influence of commercial organizations on food-related research and professional bodies, including regulatory and advisory panels. This has contributed to an increased emphasis on the declaration and management of conflicts of interest (CoI) in the reporting, evaluation, and application of research in nutrition science. However, common perceptions of CoI in nutrition, and procedures for declaring and managing these, often lack intellectual rigor and consistency.

Effect of Low-Dose Mulberry Fruit Extract on Postprandial Glucose and Insulin Responses: A Randomized Pilot Trial in Individuals with Type 2 Diabetes.

Adding mulberry fruit extract (MFE) to carbohydrate-rich meals can reduce postprandial glucose (PPG) and insulin (PPI) responses in healthy individuals. This pilot study assessed the acute postprandial effects of low doses of MFE in individuals with type 2 diabetes. In a randomized cross-over (within-subjects) design, 24 unmedicated adult males and females with type 2 diabetes (mean [SD] age 51.

Does sweetness exposure drive 'sweet tooth'?

It is widely believed that exposure to sweetened foods and beverages stimulates the liking and desire for sweetness. Here we provide an updated review of the empirical evidence from human research examining whether exposure to sweet foods or beverages influences subsequent general liking for sweetness (‘sweet tooth’), based on the conclusions of existing systematic reviews and more recent research identified from a structured search of literature. Prior reviews have concluded that the evidence for a relationship between sweet taste exposure and measures of sweet taste liking is equivocal, and more recent primary research generally does not support the view that exposure drives increased liking for sweetness, in adults or children.

Effect of mulberry fruit extract on post-prandial glycaemic and insulinemic responses to different rice types: a randomised trial in healthy adults.

We previously reported that the addition of a specified mulberry fruit extract (MFE) to rice consistently reduces post-prandial glycaemic (PPG) and post-prandial insulinemic (PPI) responses. This research tested whether this effect generalises to a broad range of rice types, reflecting the wide variation in rice characteristics known to influence glycaemic responses. In a randomised, balanced, partial factorial crossover design, Sona Masoori (SM), Bora Saul (BS), Gobindobogh (Gb) and Banskati (Bn) rices were tested with and without 0·37 g MFE.

Effect of mulberry fruit extract on glucose fluxes after a wheat porridge meal: a dual isotope study in healthy human subjects.

Background: Previous research has shown the efficacy of mulberry extracts for lowering post-prandial glucose (PPG) responses. The postulated mechanism is slowing of glucose absorption, but effects on glucose disposal or endogenous production are also possible. This research assessed the effect of a specified mulberry fruit extract (MFE) on these three glucose flux parameters.

Is There an Academic Bias against Low-Energy Sweeteners?

This perspective considers evidence of a common academic bias against low-energy sweeteners (LES). The core proposition is that this bias is manifested in research and reporting focused on generating and placing a negative spin on LES, largely through selective citation, interpretation and reporting. The evidence centres on three inter-related points, which together may generate a misleading impression of the balance of evidence: (1) basic and mechanistic research on LES perpetuates "explanations" for unsubstantiated adverse effects of LES; (2) the literature on LES-particularly narrative reviews and commentaries-continually reprises hypotheses of adverse effects without acknowledging where these hypotheses have been rigorously tested and rejected; and (3) negative interpretations of the effects of LES largely rely upon selectively emphasising lower-quality research whilst ignoring or dismissing higher-quality evidence.

Dose-response efficacy of mulberry fruit extract for reducing post-prandial blood glucose and insulin responses: randomised trial evidence in healthy adults.

Extracts of mulberry have been shown to reduce post-prandial glucose (PPG) and insulin (PPI) responses, but reliability of these effects and required doses and specifications are unclear. We previously found that 1·5 g of a specified mulberry fruit extract (MFE) significantly reduced PPG and PPI responses to 50 g carbohydrate as rice porridge, with no indications of intolerance. The trials reported here aimed to replicate that work and assess the efficacy of lower MFE doses, using boiled rice as the carbohydrate source.

Low-energy sweeteners and body weight: a citation network analysis.

Objective: Reviews on the relationship of low-energy sweeteners (LES) with body weight (BW) have reached widely differing conclusions. To assess possible citation bias, citation analysis was used to quantify the relevant characteristics of cited articles, and explore citation patterns in relation to review conclusions.

Design: A systematic search identified reviews published from January 2010 to March 2020.

Acute glycemic and insulinemic effects of low-energy sweeteners: a systematic review and meta-analysis of randomized controlled trials.

Background: It has been suggested that low-energy sweeteners (LES) may be associated with an increased risk of metabolic diseases, possibly due to stimulation of glucose-responsive mechanisms.

Objective: We conducted a systematic review and meta-analysis of human intervention studies examining the acute effect of LES intake on postprandial glucose (PPG) and postprandial insulin (PPI) responses, in order to comprehensively and objectively quantify these relations.

Methods: We systematically searched the Medline, OVID FSTA, and SCOPUS databases until January 2020.

The effect of 8 plant extracts and combinations on post-prandial blood glucose and insulin responses in healthy adults: a randomized controlled trial.

Background: Lower post-prandial glucose (PPG) and insulin (PPI) responses to foods are associated with reduced diabetes risk and progression. Several plant extracts have been proposed to reduce PPG or PPI by inhibiting enzymes or transporters involved in carbohydrate digestion and uptake. This study evaluates a range of such extracts, consumed with a carbohydrate load, for their effects on PPG, PPI and indicators of (gastrointestinal) tolerance.

Potential Markers of Dietary Glycemic Exposures for Sustained Dietary Interventions in Populations without Diabetes.

There is considerable interest in dietary and other approaches to maintaining blood glucose concentrations within the normal range and minimizing exposure to postprandial hyperglycemic excursions. The accepted marker to evaluate the sustained maintenance of normal blood glucose concentrations is glycated hemoglobin A1c (HbA1c). However, although this is used in clinical practice to monitor glycemic control in patients with diabetes, it has a number of drawbacks as a marker of efficacy of dietary interventions that might beneficially affect glycemic control in people without diabetes.

A proposed simple method for objectively quantifying free sugars in foods and beverages.

Public health and regulatory assessments and guidance on sugars increasingly focus on free (rather than total or added) sugars in the diet. This emphasizes differentiation between sugars consumed within versus outside of an intact plant matrix. However, there is no analytical method for free sugars, and quantitative determination in heterogenous and processed products containing mixed sizes of plant particulates as ingredients (e.

Perspective: Standards for Research and Reporting on Low-Energy ("Artificial") Sweeteners.

Widely differing views exist among experts, policy makers, and the general public with regard to the potential risks and benefits of reduced- or low-energy sweeteners (LES) in the diet. These views are informed and influenced by different types of research in LES, with differing hypotheses, designs, interpretation, and communication. Given the high level of interest in LES, and the public health relevance of the research evidence base, it is important that all aspects of the research process are framed and reported in an appropriate and balanced manner.

Impact of isocaloric exchanges of carbohydrate for fat on postprandial glucose, insulin, triglycerides, and free fatty acid responses-a systematic review and meta-analysis.

Varying the macronutrient composition of meals alters acute postprandial responses, but the effect sizes for specific macronutrient exchanges have not been quantified by systematic reviews. Therefore the aim is to quantify the effect size of exchanging fat for carbohydrates in mixed meals on postprandial glucose (PPG), insulin (PPI), triglycerides (PPTG), and free fatty acids (PPFFA) responses by performing a systematic review and meta-analysis of randomized controlled trials. A systematic literature search was undertaken on randomized controlled trials comparing isocaloric high fat with high carbohydrate meals, with comparable protein contents and at least one postprandial glycemic- and one lipid outcome.

The Rate of Glucose Appearance Is Related to Postprandial Glucose and Insulin Responses in Adults: A Systematic Review and Meta-analysis of Stable Isotope Studies.

Background: It is often assumed that lower postprandial glucose (PPG) and insulin (PPI) responses are induced by slower glucose influx from the gut (e.g., by delayed carbohydrate digestion).

Systematic review of the evidence for sustained efficacy of dietary interventions for reducing appetite or energy intake.

We assessed evidence for changes in efficacy of food-based interventions aimed at reducing appetite or energy intake (EI), and whether this could be used to provide guidance on trial design. A systematic search identified randomized controlled trials testing sustained efficacy of diets, foods, supplements or food ingredients on appetite and/or EI. Trials had to include sufficient exposure duration (≥3 days) with appetite and/or EI measured after both acute and repeated exposures.

Recommendations for characterization and reporting of dietary fibers in nutrition research.

Dietary fiber (DF) comprises a wide range of naturally occurring and modified materials with substantial variations in physical and chemical properties and potential physiologic effects. Although nutrition studies testing the effects of DF usually provide extensive detail on the physiologic responses, many still fail to adequately report the type and properties of the DF itself. This weakens the ability to directly replicate and compare studies and to establish structure-function relations.

Relative contributions of preprandial and postprandial glucose exposures, glycemic variability, and non-glycemic factors to HbA in individuals with and without diabetes.

Background/objective: There is substantial interest in dietary approaches to reducing postprandial glucose (PPG) responses, but the quantitative contribution of PPG to longer-term glycemic control (reflected in glycated hemoglobin, HbA) in the general population is not known. This study quantified the associations of preprandial glucose exposure, PPG exposure, and glycemic variability with HbA and estimated the explained variance in HbA in individuals with and without type 2 diabetes (T2D).

Subjects/methods: Participants in the A1c-Derived Average Glucose (ADAG) study without T2D (n = 77) or with non-insulin-treated T2D and HbA<6.

Perspective: Total, Added, or Free? What Kind of Sugars Should We Be Talking About?

There is consistent public guidance to limit sugars intakes. However, WHO recommendations are for "free" sugars, whereas some other guidance documents and public discussion focus on "added" sugars, and globally most food labeling states "total" sugars. Total sugars comprise all mono- and disaccharides, regardless of source, whereas both added and free sugars exclude the sugars that naturally occur in dairy products and intact fruit and vegetables.

Dietary carbohydrates: a review of international recommendations and the methods used to derive them.

Background/objectives: Renewed dietary recommendations for carbohydrates have recently been published by various international health authorities. The present work (1) reviews the methods and processes (systematic approach/review, inclusion of public consultation) used to identify, select and grade the evidence underpinning the recommendations, particularly for total carbohydrate (CHO), fibre and sugar consumption, and (2) examines the extent to which variation in the methods and processes applied relates to any differences in the final recommendations.

Subjects/methods: A search of WHO, US, Canada, Australia and European sources identified 19 documents from 13 authorities with the desired detailed information.

Sweet taste exposure and the subsequent acceptance and preference for sweet taste in the diet: systematic review of the published literature.

Background: There are consistent, evidence-based global public health recommendations to reduce intakes of free sugars. However, the corresponding evidence for recommending reduced exposure to sweetness is less clear.

Objective: Our aim was to identify and review the published evidence investigating the impact of dietary exposure to sweet-tasting foods or beverages on the subsequent generalized acceptance, preference, or choice of sweet foods and beverages in the diet.

A workshop on 'Dietary Sweetness-Is It an Issue?'.

This report summarises a workshop convened by ILSI Europe on 3 and 4 April 2017 to discuss the issue of dietary sweetness. The objectives were to understand the roles of sweetness in the diet, establish whether exposure to sweetness affects diet quality and energy intake, and consider whether sweetness per se affects health. Although there may be evidence for tracking of intake of some sweet components of the diet through childhood, evidence for tracking of whole diet sweetness, or through other stages of maturity are lacking.

Effect of fibre additions to flatbread flour mixes on glucose kinetics: a randomised controlled trial.

We previously found that guar gum (GG) and chickpea flour (CPF) added to flatbread wheat flour lowered postprandial blood glucose (PPG) and insulin responses dose dependently. However, rates of glucose influx cannot be determined from PPG, which integrates rates of influx, tissue disposal and hepatic glucose production. The objective was to quantify rates of glucose influx and related fluxes as contributors to changes in PPG with GG and CPF additions to wheat-based flatbreads.