Page 46 - Petelin, Ana. 2021. Ed. Zdravje starostnikov / Health of the Elderly. Proceedings. Koper: University of Primorska Press.
P. 46
avje starostnikov | health of the elderly 44 non-nutritive sweeteners did not reflect in altered lipid accumulation.
However, the observed changes in gene expression point to their
important impact on lipid metabolism. As genes related to the beta-
oxidation as well as those related to the fat storage were up-regulated,
long-term effects should be further investigated to confirm their safe use
in terms of liver health.
Keywords: non-nutritive sweeteners, fatty liver disease, gene expression
Introduction
In the elderly population the use of non-nutritional sweeteners is particular-
ly common. The reason lies in the fact that they follow recommendations and
avoid sugar intake. On the other hand, it is important for them to keep the food
palatable, since sufficient caloric intake is otherwise hard to achieve. Addition-
ally, due to the widespread use of sweeteners in a variety of food products, the
consumers are sometimes unaware of the consumption (Sylvetsky and Roth-
er, 2016). In general, sweeteners are safe to consume (Butchko et al., 2002), but
there is also evidence supporting the opposite. In contrast to the common ex-
pectation, they do not lower body weight and do not even prevent its gain, and
glucose levels may also be elevated (Swithers, 2016). Numerous observational
studies also suggest an association with metabolic syndrome which includes
non-alcoholic fatty liver disease, but there may be a possible association with
obesity (Green and Syn, 2019). In animal models, they have been shown to in-
crease serum triglycerides and fasting insulin levels and interfere with the lev-
els of adipogenic proteins, when consumed regularly. Rats which consumed
drinks sweetened by aspartame for two months, had increased visceral fat and
other characteristics of metabolic syndrome, including hyper-glycemia, in-
creased serum triglycerides and increased low-density and very low-density li-
poproteins compared to rats which consumed water (Lebda, 2017). In the same
study the levels of leptin were higher, the expression of peroxisomal prolifer-
ating receptor decreased and the elevated serum transaminase indicated liv-
er damage. It has been known for a while that sweeteners are not metabolical-
ly inert, and further research is needed to elucidate the mechanisms by which
sweeteners can promote metabolic effects (Pepino, 2015). In the present study
we investigated the effects of the selected sweeteners on the lipid metabolism
in human liver cells.
Methods
Four sweeteners available on the Slovenian market were selected, namely eryth-
ritol, stevia and two commercially available mixed sweeteners Huxol Original
(containing sodium cyclamate, sodium saccharin) and Natreen Classic (con-
taining cyclamate, saccharin, thaumatin). The analyses were performed in vitro
on a HepG2 cell line. HepG2 cells represent a liver cell line derived from human
hepatoblastoma, which has been found to express a whole range of liver-spe-
However, the observed changes in gene expression point to their
important impact on lipid metabolism. As genes related to the beta-
oxidation as well as those related to the fat storage were up-regulated,
long-term effects should be further investigated to confirm their safe use
in terms of liver health.
Keywords: non-nutritive sweeteners, fatty liver disease, gene expression
Introduction
In the elderly population the use of non-nutritional sweeteners is particular-
ly common. The reason lies in the fact that they follow recommendations and
avoid sugar intake. On the other hand, it is important for them to keep the food
palatable, since sufficient caloric intake is otherwise hard to achieve. Addition-
ally, due to the widespread use of sweeteners in a variety of food products, the
consumers are sometimes unaware of the consumption (Sylvetsky and Roth-
er, 2016). In general, sweeteners are safe to consume (Butchko et al., 2002), but
there is also evidence supporting the opposite. In contrast to the common ex-
pectation, they do not lower body weight and do not even prevent its gain, and
glucose levels may also be elevated (Swithers, 2016). Numerous observational
studies also suggest an association with metabolic syndrome which includes
non-alcoholic fatty liver disease, but there may be a possible association with
obesity (Green and Syn, 2019). In animal models, they have been shown to in-
crease serum triglycerides and fasting insulin levels and interfere with the lev-
els of adipogenic proteins, when consumed regularly. Rats which consumed
drinks sweetened by aspartame for two months, had increased visceral fat and
other characteristics of metabolic syndrome, including hyper-glycemia, in-
creased serum triglycerides and increased low-density and very low-density li-
poproteins compared to rats which consumed water (Lebda, 2017). In the same
study the levels of leptin were higher, the expression of peroxisomal prolifer-
ating receptor decreased and the elevated serum transaminase indicated liv-
er damage. It has been known for a while that sweeteners are not metabolical-
ly inert, and further research is needed to elucidate the mechanisms by which
sweeteners can promote metabolic effects (Pepino, 2015). In the present study
we investigated the effects of the selected sweeteners on the lipid metabolism
in human liver cells.
Methods
Four sweeteners available on the Slovenian market were selected, namely eryth-
ritol, stevia and two commercially available mixed sweeteners Huxol Original
(containing sodium cyclamate, sodium saccharin) and Natreen Classic (con-
taining cyclamate, saccharin, thaumatin). The analyses were performed in vitro
on a HepG2 cell line. HepG2 cells represent a liver cell line derived from human
hepatoblastoma, which has been found to express a whole range of liver-spe-
