Diabetes, Obesity and Metabolism
Diabetes, Obesity and Metabolism
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糖尿病、肥胖和新陈代谢
作者：
I. Idris
非糖（人造）甜味剂被广泛用于帮助糖尿病患者减肥和限制碳水化合物。然而，由于有限和相互矛盾的研究，其长期健康风险或益处仍存在不确定性。最近发表在《英国医学杂志》上的一项研究回顾得出的结论是，人造甜味剂对健康没有令人信服的好处，而且不能排除潜在的危害。该研究分析了56项研究，比较了健康成人和儿童中不摄入或较少摄入人造甜味剂与摄入量较高的研究。健康结果包括体重、血糖水平、口腔健康、癌症发病率、心血管疾病风险、肾脏疾病和情绪。使用标准方案进行偏倚评估。总体而言，分析显示，接触非糖甜味剂的人与未接触非糖甜味剂的人之间，或者不同剂量的非糖甜味剂之间在各种健康结果方面没有统计学或临床相关差异。然而，在一些小型研究中，在成人中，人工甜味剂与非糖甜味剂的体重指数和空腹血糖水平的小幅改善有关，但这一证据的确定性很低。有趣的是，在儿童中，与糖相比，使用人造甜味剂时体重指数评分的增加幅度较小，但在体重方面没有观察到差异。没有强有力的证据表明人造甜味剂对超重或肥胖的成年人或积极减肥的儿童有好处。因此，需要进一步的研究来阐明人工甜味剂在肥胖和/或糖尿病患者中的长期风险益处。
Non sugar (artificial) sweeteners are used widely to aid weight loss and carbohydrate restriction in people with diabetes. However, there are ongoing uncertainties regarding their long term health risk or benefits due to limited and conflicting studies. A recent review of studies, published in the British Medical Journal have concluded no compelling health benefits of artificial sweeteners, and that potential harm cannot be ruled out. The study analysed 56 studies comparing no intake or lower intake of artificial sweeteners with higher intake in healthy adults and children. Health outcomes included weight, blood sugar levels, oral health, cancer incidence, risk of cardiovascular disease, kidney disease and mood. Assessment of bias was undertaken using standard protocols. Overall, the analysis showed no statistically or clinically relevant differences between those exposed to non-sugar sweeteners and those not exposed, or between different doses of non-sugar sweeteners in terms of the various health outcomes. However, in adults, artificial sweeteners was associated with small improvements in body mass index and fasting blood glucose levels with non-sugar sweeteners, in some small studies, but the certainty of this evidence was low. Interestingly, in children, a smaller increase in body mass index score was seen with artificial sweeteners compared with sugar, but no differences was observed with regards to body weight. No strong evidence was observed of benefits of artificial sweeteners for overweight or obese adults or children who are actively trying to lose weight. Further studies are therefore required to clarify the long term risk benefits of artificial sweeteners in patients with obesity and/or diabetes.