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Feature Paper in Carbohydrate 2023

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Carbohydrates".

Deadline for manuscript submissions: closed (5 May 2024) | Viewed by 29214

Special Issue Editors


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Guest Editor
Department Nutrition, University California Davis, Davis, CA 95616, USA
Interests: sugar; diet; non-nutritive sweeteners; sucrose; high-fructose corn syrup; aspartame; fructose; sucralose; saccharine; energy intake; energy balance; de novo lipogenesis; cardiovascular disease; type 2 diabetes; metabolic syndrome
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Co-Guest Editor
Division of Gastroenterology, Hepatology, Nutrition, Department of Pediatrics, University of Kentucky College of Medicine and Kentucky Children's Hospital, Lexington, KY 40506, USA
Interests: obesity; nutrition; insulin resistance; metabolism; lipid metabolism; childhood obesity; carbohydrate metabolism; insulin signaling; metabolic endocrinology; diabetes drug development
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

For our new Special Issue: Feature Paper in Carbohydrate 2023, we seek papers that provide insights into controversies and evidence gaps in the field of Carbohydrates. Below are three examples of controversies and evidence gaps related to carbohydrates; however, all papers that provide novel insights and evidence of carbohydrates can be submitted and considered for inclusion in the Special Issue: Feature Paper in Carbohydrate 2023.

  1. For more than 50 years, hypotheses implicating the high-carbohydrate or high-glycemic-index diet as a driver of obesity have abounded, but this continues to be a hotly debated topic.
  2. US and WHO dietary guidelines recommend that we consume no more than 10% of daily energy as added or free sugar. These guidelines are still being challenged due to the quality of the clinical evidence and the lack of clinical evidence related to the metabolic effects of sugar in solid food compared with sugar in beverages.
  3. Many consumers are convinced that consumption of sugar from a natural source such as sugar cane or agave is a more health-protective choice than a low- or no-calorie sweetener. While this could be true for a few specific sweeteners, there are numerous low or no-calorie substitutes for sugar and they vary greatly in their chemistry and biological fates. Therefore, the metabolic effects of one sweetener cannot be extrapolated to all sweeteners. Yet for many of these sweeteners, there is little, if any, clinical evidence related to their effects on body weight and metabolic risk factors in human subjects.

Prof. Dr. Kimber L. Stanhope
Dr. Samir Softic
Guest Editors

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Keywords

  • high-carbohydrate diet
  • glycemic index or load
  • fiber
  • obesity
  • metabolic disease
  • dietary guidelines
  • low- or no-calorie sweeteners

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Published Papers (6 papers)

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Research

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15 pages, 7330 KiB  
Article
Endogenous Fructose Production and Metabolism Drive Metabolic Dysregulation and Liver Disease in Mice with Hereditary Fructose Intolerance
by Ana Andres-Hernando, David J. Orlicky, Masanari Kuwabara, Christina Cicerchi, Michelle Pedler, Mark J. Petrash, Richard J. Johnson, Dean R. Tolan and Miguel A. Lanaspa
Nutrients 2023, 15(20), 4376; https://doi.org/10.3390/nu15204376 - 16 Oct 2023
Cited by 3 | Viewed by 2098
Abstract
Excessive intake of sugar, and particularly fructose, is closely associated with the development and progression of metabolic syndrome in humans and animal models. However, genetic disorders in fructose metabolism have very different consequences. While the deficiency of fructokinase, the first enzyme involved in [...] Read more.
Excessive intake of sugar, and particularly fructose, is closely associated with the development and progression of metabolic syndrome in humans and animal models. However, genetic disorders in fructose metabolism have very different consequences. While the deficiency of fructokinase, the first enzyme involved in fructose metabolism, is benign and somewhat desirable, missense mutations in the second enzyme, aldolase B, causes a very dramatic and sometimes lethal condition known as hereditary fructose intolerance (HFI). To date, there is no cure for HFI, and treatment is limited to avoiding fructose and sugar. Because of this, for subjects with HFI, glucose is their sole source of carbohydrates in the diet. However, clinical symptoms still occur, suggesting that either low amounts of fructose are still being consumed or, alternatively, fructose is being produced endogenously in the body. Here, we demonstrate that as a consequence of consuming high glycemic foods, the polyol pathway, a metabolic route in which fructose is produced from glucose, is activated, triggering a deleterious mechanism whereby glucose, sorbitol and alcohol induce severe liver disease and growth retardation in aldolase B knockout mice. We show that generically and pharmacologically blocking this pathway significantly improves metabolic dysfunction and thriving and increases the tolerance of aldolase B knockout mice to dietary triggers of endogenous fructose production. Full article
(This article belongs to the Special Issue Feature Paper in Carbohydrate 2023)
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14 pages, 603 KiB  
Article
Inverse J-Shaped Relationship of Dietary Carbohydrate Intake with Serum Klotho in NHANES 2007–2016
by Lu Xiang, Mingyang Wu, Yan Wang, Si Liu, Qian Lin, Gang Luo and Lin Xiao
Nutrients 2023, 15(18), 3956; https://doi.org/10.3390/nu15183956 - 13 Sep 2023
Cited by 5 | Viewed by 5498
Abstract
Background: The relationship between dietary carbohydrate intake and serum Klotho levels, an aging biomarker, remains uncertain. Objective: This study aimed to investigate the association between dietary carbohydrate intake and serum Klotho levels among American adults aged 40–79. Methods: We analyzed data from 10,669 [...] Read more.
Background: The relationship between dietary carbohydrate intake and serum Klotho levels, an aging biomarker, remains uncertain. Objective: This study aimed to investigate the association between dietary carbohydrate intake and serum Klotho levels among American adults aged 40–79. Methods: We analyzed data from 10,669 adults aged 40–79 years who participated in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016. Trained interviewers assessed dietary carbohydrate intake using a 24 h dietary recall. Serum Klotho concentrations were measured using commercially available ELISA kits provided by IBL International, Japan, which served as the study outcome. Generalized linear models were used to assess the relationship between the carbohydrate energy percentage and serum Klotho concentration, and restricted cubic spline (RCS) analysis was employed to explore any nonlinear associations. Results: After adjusting for multiple variables, we observed a nonlinear inverse J-shaped relationship (p for non-linearity < 0.001) between the carbohydrate energy percentage and serum Klotho levels. Specifically, the highest serum Klotho levels were associated with a total carbohydrate energy percentage ranging from 48.92% to 56.20% (third quartile). When the carbohydrate energy percentage was evaluated in quartiles, serum Klotho levels decreased by 5.37% (95% CI: −7.43%, −3.26%), 2.70% (95% CI: −4.51%, −0.86%), and 2.76% (95% CI: −4.86%, −0.62%) in the first quartile (<41.46%), second quartile (41.46% to 48.92%), and fourth quartile (≥56.20%), respectively, compared to the third quartile. This relationship was more pronounced in male, non-obese and non-diabetic participants under 60 years of age. Conclusion: A non-linear inverse J-shaped relationship exists among the general U.S. middle-aged and older population between the carbohydrate energy percentage and serum Klotho levels, with the highest levels observed at 48.92% to 56.20% carbohydrate intake. Full article
(This article belongs to the Special Issue Feature Paper in Carbohydrate 2023)
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11 pages, 279 KiB  
Article
Comparisons of Different Carbohydrate Quality Indices for Risk of Type 2 Diabetes in the Malmö Diet and Cancer Study
by Michaela Ramstedt, Suzanne Janzi, Kjell Olsson, Esther González-Padilla, Stina Ramne, Yan Borné, Ulrika Ericson and Emily Sonestedt
Nutrients 2023, 15(18), 3870; https://doi.org/10.3390/nu15183870 - 5 Sep 2023
Viewed by 1574
Abstract
Carbohydrate quality might be more important than quantity to reduce type 2 diabetes (T2D) risk. Various metrics of carbohydrate quality exist; however, their associations with T2D have only been studied to a limited extent. Consequently, the aim was to investigate the association between [...] Read more.
Carbohydrate quality might be more important than quantity to reduce type 2 diabetes (T2D) risk. Various metrics of carbohydrate quality exist; however, their associations with T2D have only been studied to a limited extent. Consequently, the aim was to investigate the association between four different pre-defined carbohydrate quality indices, with various amounts of fiber (≥1 g) and free sugar (<1 or <2 g) per 10 g of carbohydrates, and T2D risk among 26,622 individuals without diabetes from the Malmö Diet and Cancer cohort. Dietary data were collected through a food diary, diet frequency questionnaire, and interview. After a mean follow-up of 18 years, 4046 cases were identified through registers. After adjusting for potential confounders, no statistically significant associations were found for any of the indices. When excluding individuals with past dietary changes and potential misreporting of energy (36% of the population), lower risk was found for the following intake ratios: 10:1:2 carbohydrate:fiber:free sugar (HR = 0.82; 95% CI = 0.70–0.97), and 10:1&1:2 carbohydrate:fiber and fiber:free sugar, respectively (HR = 0.84; 95% CI = 0.72–0.97). Our findings indicate that adherence to a diet with high amounts of fiber and moderate amounts of free sugar in relation to total carbohydrate intake may be associated with a lower risk of T2D. Full article
(This article belongs to the Special Issue Feature Paper in Carbohydrate 2023)
16 pages, 998 KiB  
Article
Effects of Dietary Sugar Reduction on Biomarkers of Cardiometabolic Health in Latino Youth: Secondary Analyses from a Randomized Controlled Trial
by Kelsey A. Schmidt, Pari Mokhtari, Elizabeth A. Holzhausen, Tanya L. Alderete, Hooman Allayee, Krishna S. Nayak, Frank R. Sinatra, Trevor A. Pickering, Wendy Mack, Rohit Kohli and Michael I. Goran
Nutrients 2023, 15(15), 3338; https://doi.org/10.3390/nu15153338 - 27 Jul 2023
Viewed by 2244
Abstract
Pediatric obesity and cardiometabolic disease disproportionately impact minority communities. Sugar reduction is a promising prevention strategy with consistent cross-sectional associations of increased sugar consumption with unfavorable biomarkers of cardiometabolic disease. Few trials have tested the efficacy of pediatric sugar reduction interventions. Therefore, in [...] Read more.
Pediatric obesity and cardiometabolic disease disproportionately impact minority communities. Sugar reduction is a promising prevention strategy with consistent cross-sectional associations of increased sugar consumption with unfavorable biomarkers of cardiometabolic disease. Few trials have tested the efficacy of pediatric sugar reduction interventions. Therefore, in a parallel-design trial, we randomized Latino youth with obesity (BMI ≥ 95th percentile) [n = 105; 14.8 years] to control (standard diet advice) or sugar reduction (clinical intervention with a goal of ≤10% of calories from free sugar) for 12-weeks. Outcomes included changes in glucose tolerance and its determinants as assessed by a 2-h frequently sample oral glucose tolerance test, fasting serum lipid profile (total cholesterol, HDL, LDL, triglycerides, cholesterol:HDL), and inflammatory markers (CRP, IL-6, TNF-α). Free sugar intake decreased in the intervention group compared to the control group [11.5% to 7.3% vs. 13.9% to 10.7% (% Energy), respectively, p = 0.02], but there were no effects on any outcome of interest (pall > 0.07). However, an exploratory analysis revealed that sugar reduction, independent of randomization, was associated with an improved Oral-disposition index (p < 0.001), triglycerides (p = 0.049), and TNF-α (p = 0.02). Dietary sugar reduction may have the potential to reduce chronic disease risks through improvements in beta-cell function, serum triglycerides, and inflammatory markers in Latino adolescents with obesity. Full article
(This article belongs to the Special Issue Feature Paper in Carbohydrate 2023)
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Review

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19 pages, 1694 KiB  
Review
Carbohydrates and Endurance Exercise: A Narrative Review of a Food First Approach
by Alireza Naderi, Nathan Gobbi, Ajmol Ali, Erfan Berjisian, Amin Hamidvand, Scott C. Forbes, Majid S. Koozehchian, Raci Karayigit and Bryan Saunders
Nutrients 2023, 15(6), 1367; https://doi.org/10.3390/nu15061367 - 11 Mar 2023
Cited by 7 | Viewed by 13038
Abstract
Carbohydrate (CHO) supplements such as bars, gels, drinks and powders have become ubiquitous as effective evidence-based CHO sources that improve endurance exercise performance. However, athletes are increasingly turning to more cost-effective ‘food-first’ approaches for CHO ingestion to improve exercise performance. Mixed CHO foods [...] Read more.
Carbohydrate (CHO) supplements such as bars, gels, drinks and powders have become ubiquitous as effective evidence-based CHO sources that improve endurance exercise performance. However, athletes are increasingly turning to more cost-effective ‘food-first’ approaches for CHO ingestion to improve exercise performance. Mixed CHO foods including cooked lentils, oats, honey, raisins, rice, and potatoes are all effective pre-exercise CHO food sources. Caution is advised when selecting some of these foods as a primary CHO source, as some athletes may be prone to gastrointestinal discomfort—especially regarding those foods where the quantities required for recommended CHO intake may be voluminous (e.g., potatoes). Palatability may be another barrier to the ingestion of some of these CHO-rich foods. Although most of these CHO-rich foods appear effective for exercise performance or recovery when consumed pre- and post-exercise, not all are viable to ingest during exercise due to difficulties in the quantities required, transport, and/or gastrointestinal discomfort. Raisins, bananas and honey may be particularly useful CHO foods for consumption during exercise, as they are easily transportable. Athletes should trial CHO food sources before, during and/or following training before implementation during competition. Full article
(This article belongs to the Special Issue Feature Paper in Carbohydrate 2023)
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Other

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10 pages, 511 KiB  
Perspective
Elevated Erythritol: A Marker of Metabolic Dysregulation or Contributor to the Pathogenesis of Cardiometabolic Disease?
by Tagreed A. Mazi and Kimber L. Stanhope
Nutrients 2023, 15(18), 4011; https://doi.org/10.3390/nu15184011 - 16 Sep 2023
Cited by 3 | Viewed by 3417
Abstract
Erythritol is a non-nutritive sugar replacement that can be endogenously produced by humans. Witkowski et al. reported that elevated circulating erythritol is associated with adverse cardiovascular events in three independent cohorts, demonstrated in vitro and ex vivo that erythritol promotes platelet activation, and [...] Read more.
Erythritol is a non-nutritive sugar replacement that can be endogenously produced by humans. Witkowski et al. reported that elevated circulating erythritol is associated with adverse cardiovascular events in three independent cohorts, demonstrated in vitro and ex vivo that erythritol promotes platelet activation, and showed faster clotting time in mice injected with erythritol. It was concluded that erythritol fosters enhanced thrombosis. This narrative review presents additional evidence that needs to be considered when evaluating these data and conclusions. We conducted a search of all studies related to erythritol exposure with focus on those that reported vascular health outcomes. Patients with chronically elevated erythritol levels due to inborn errors of metabolism do not exhibit higher platelet activation or thrombosis risk. Most long-term studies in which animals consumed high levels of erythritol do not support its role in platelet activation and thrombosis formation. Clinical data on the effects of chronic intake of erythritol are limited. Erythritol may be merely a marker of dysregulation in the Pentose Phosphate Pathway caused by impaired glycemia. However, this suggestion and the findings of Witkowski et al. need to be further examined. Clinical trials examining the long-term effects of erythritol consumption on cardiometabolic outcomes are required to test the causality between dietary erythritol and cardiometabolic risk. Until supportive data from these trials are available, it cannot be concluded that dietary erythritol promotes platelet activation, thrombosis, and cardiometabolic risk. Full article
(This article belongs to the Special Issue Feature Paper in Carbohydrate 2023)
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