Intake of Sugar Substitute Gummy Candies Benefits the Glycemic Response in Healthy Adults: A Prospective Crossover Clinical Trial
Autores: Gan, D.; Xu, M.; Chen, L.; Cui, S.; Deng, C.; Qiao, Q.; Guan, R.; Zhong, F.
Revista: Gels (2022)
DOI: https://doi.org/10.3390/gels8100642
Eje / subcolección Zotero: Seguridad y salud de ingredientes
Acceso al texto completo: abierto (gold) · enlace
Abstract
Sugar reduction in food has attracted great health concerns worldwide. Gummies have been one of the most popular and highly favored candies due to their chewable properties, simplicity to swallow, and delicious taste. The general perception is that gummies raise blood sugar levels, but the truth is that gummies with the right formula can control glycemic response. The purpose of this study is to investigate the effects of the gummy dosage form and sugar types on the glycemic response control. Maltitol and erythritol as sweetener alternatives were applied in gummy candies (total and partial sugar substitutes gummy, T-SG and P-SG), with sucrose-based gummies used as comparisons (CG). A prospective crossover study was then conducted on 17 healthy adults. The effects of different types of gummies on glycemic response in healthy adults were evaluated on the basis of the participants’ glycemic index (GI) and glycemic load (GL) values. Every three-day interval, participants took CG, P-SG, T-SG, and glucose solution, respectively, and the theoretical glucose conversion content was kept the same in all groups for each trial. Each participant performed four tests with each sample and recorded the changes in blood glucose after food consumption. It was found that all three types of gummies slowed down subjects’ glycemic response when not taken in excess, and the improvement effect was in the trend of T-SG > P-SG > CG. Both P-SG and T-SG were low-GI candies (54.1 and 49.9). CG that was not consumed in excess of 17.2 g had a high GI (81.9) but a low GL (<10). Texture analysis and in vitro digestion were used to explore the effect of gummy matrix on glucose release. T-SG and P-SG retained a higher hardness and were less hydrolyzed to release glucose during digestion compared with CG. Additionally, experiments have revealed that gummies can reverse the poor glucose tolerance in women. In conclusion, gummies are a good carrier for dietary supplements due to their sustained-release characteristic of available carbohydrates and provide healthier options for people in control of glucose homeostasis.
Lectura guiada
Problema de investigación
¿Cómo afectan el tipo de edulcorante (maltitol + eritritol vs sacarosa) y la forma de gomita a la respuesta glucémica en adultos sanos? (verificado en el PDF, pp. 1-3)
Metodología
- Diseño: ensayo clínico cruzado prospectivo (IG y CG con porciones de 10 g de carbohidrato disponible) + análisis de perfil de textura (TPA) + digestión in vitro (INFOGEST).
- Población / muestra: 17 adultos sanos (5 hombres, 12 mujeres), 22-39 años, IMC 19-23,9 kg/m2.
“Maltitol and erythritol as sweetener alternatives were applied in gummy candies (total and partial sugar substitutes gummy, T-SG and P-SG), with sucrose-based gummies used as comparisons (CG). A prospective crossover study was then conducted on 17 healthy adults.” (p. 1)
- Mi nota: Diseño: ensayo cruzado con 17 adultos sanos y gomitas de maltitol + eritritol. Es la evidencia humana más cercana a una confitería gelificada como el masmelo.
“The inclusion criteria in brief were non-diabetic healthy young adults aged 22–39 years old, body mass index (BMI) within the range of 19–23.9 kg/m2, fasting glucose level ≤6 mmol/L, who were able to tolerate at least 10 h of fasting.” (p. 8)
- Mi nota: Criterios de inclusión: jóvenes sanos con IMC normal. Limita extrapolar al público diabético del masmelo.
“In total and partial sugar substitutes gummies (T-SG and P-SG), sugars were replaced by maltitol syrup, erythritol, as well as some minimal sugar provided by concentrated apple juice; meanwhile, concentrated apple juice was further removed for T-SG (Table 5).” (p. 9)
- Mi nota: Composición de las muestras: sustitución por jarabe de maltitol + eritritol; comparar con eritritol + maltodextrina + Reb A de Mary.
🟡 Ideas principales (hallazgos clave)
“Hydrocolloids used in gummies can slow down mixing and mass transfer processes and alter the release of flavors or nutrients by increasing the viscosity of the gastrointestinal fluids in the stomach or small intestine, because of their thickening and gelling abilities [10].” (p. 2)
- Mi nota: Los hidrocoloides (pectina, xantana, guar en la fórmula de Mary) podrían moderar la liberación de glucosa; hipótesis para 08 Discusión.
✅ Evidencia:
“The curve and area under curve (AUC) of oral glucose tolerance test (OGTT) demonstrated a significantly improved glucose tolerance in all the gummy groups compared to the glucose group.” (p. 3)
- Mi nota: Evidencia: las gomitas con polioles mejoran la respuesta glucémica frente a glucosa.
✅ Evidencia:
“Both P-SG and T-SG were low-GI types of food. Although the CG is classified as a high-GI food, it was also found to be a low-GL food when taking the carbohydrate quantity into consideration.” (p. 4)
- Mi nota: Resultado clave (IG 49,9 y 54,1 vs 81,9 del control, tabla 2). Respalda el beneficio glucémico, pero solo con maltitol + eritritol, no con maltodextrina.
“Since the available carbohydrates were same in each group, the difference in GI values is likely due to texture differences and subsequent digestive behavior differences among different kind of gummies.” (p. 6)
- Mi nota: Idea principal: la textura del gel influye en el IG. Conecta textura instrumental (eje 4) con salud (eje 3).
✅ Evidencia:
“Livesey’s research revealed that the glycemic index and insulin index of erythritol are 0 and 2, which is much lower than that of xylitol [22].” (p. 6)
- Mi nota: Dato citable de IG del eritritol = 0 (fuente secundaria: Livesey). Contrasta con la maltodextrina de la fórmula.
🔵 Conceptos clave
“Thus, the GI of glucose is defined as 100, and foods with a GI lower than 55 are considered as low-GI foods, whereas those with a GI between 55 and 70 are medium-GI foods, and those with a GI exceeding 70 are high-GI foods [4].” (p. 2)
- Mi nota: Definición operativa de índice glucémico y sus cortes; útil para el glosario y para discutir la maltodextrina (IG alto).
“The GL of the food is the product of its GI and its available carbohydrate content, evaluating both the quantity and the quality of carbohydrates. Foods with a GL lower than 10 are considered as low-GL foods, those between 11 and 19 are medium-GL foods, and those higher than 20 are high-GL foods [4].” (p. 2)
- Mi nota: Definición de carga glucémica: permite que Mary estime la CG por porción del masmelo (la maltodextrina aporta carbohidrato disponible).
“Approximately 10% of the ingested erythritol can escape to the large intestine, and, meanwhile, it has a negligible effect on the glycemic response.” (p. 6)
- Mi nota: Propiedad metabólica del eritritol (efecto glucémico despreciable) para 04 Marco teórico.
🔴 Citas textuales relevantes
“Gummy candies containing erythritol and maltitol instead of sucrose have a low GI value, providing a theoretical basis for the implementation of erythritol and maltitol in the manufacturing of food supplements for diabetics.” (p. 7)
- Mi nota: Frase citable para la justificación del masmelo sin azúcar; aclarar que no es extrapolable si la fórmula lleva maltodextrina.
🟢 Conexiones con el TFE de Mary
- Es la evidencia humana más cercana a una confitería gelificada con eritritol: respalda que un dulce con polioles puede tener IG bajo (49,9 y 54,1 frente a 81,9).
- Ojo: las gomitas usaron jarabe de maltitol + eritritol, no maltodextrina; la maltodextrina de la fórmula de Mary es carbohidrato disponible de IG alto y puede anular el beneficio.
- La relación textura-digestión sugiere que la pectina, la xantana y la guar del masmelo podrían influir en la liberación de glucosa (hipótesis, no probada para espumas).
- Las definiciones de IG y CG permiten que Mary estime la carga glucémica por porción en resultados.
- Muestra pequeña, sujetos sanos y financiación industrial: citar con cautela.
🟠 Limitaciones y vacíos
“Although artificial sweeteners almost have no calories, there is still a concern for potential safety hazards [13].” (p. 2)
- Mi nota: Los propios autores reconocen la preocupación de seguridad; enlaza con el debate eritritol-cardiovascular.
“Although this study achieved some meaningful and important results, only 17 participants were selected for the trials. Therefore, in the future, more participants need to be recruited for the trials to verify the conclusions of this study.” (p. 7)
- Mi nota: Limitación: muestra pequeña (n = 17) y solo sanos; no permite afirmar beneficio en diabéticos.
“the specific mechanism behind how sugar type affects hydrogel structure and how the changes in gel structure influence enzymatic activity and glucose release during digestion remain unclear, which need to be investigated further.” (p. 8)
- Mi nota: Vacío: mecanismo gel-digestión no resuelto; un masmelo aireado (espuma) es una matriz distinta a la gomita.
“Authors Dan Gan, Minjun Xu, Shaohua Cui, Changyong Deng, Qian Qiao, and Ruimiao Guan were employed by the company Sirio Pharma Co., Ltd.” (p. 11)
- Mi nota: Conflicto de interés: seis autores trabajan para el fabricante que financió el estudio. Mencionarlo al citar.
Preguntas orientadoras
- Las gomitas de Gan et al. tuvieron IG de 49,9 y 54,1 frente a 81,9 del control, pero con jarabe de maltitol y eritritol, no con maltodextrina. Con 250 g de maltodextrina en tu lote de 1.569 g, ¿puedes citar este estudio para hablar de beneficio glucémico de tu masmelo, o solo para hablar del eritritol (IG 0 según Livesey)?
- La nota recoge que una carga glucémica menor de 10 es baja. ¿Calcularías en el OE2 la CG por porción de tu masmelo a partir del carbohidrato disponible de la maltodextrina? ¿Qué porción tomarías como referencia y cómo lo contarías si la CG no sale baja?
- Gan atribuye las diferencias de IG a la textura del gel y a cómo se digiere. ¿Te atreverías a plantear en la discusión que la pectina, la xantana y la guar podrían frenar la liberación de glucosa en una espuma, o es una extrapolación que no puedes sostener sin medirla?
- 🎓 Pregunta de sustentación: “Seis de los autores trabajan para Sirio Pharma, que financió el estudio, y la muestra son 17 adultos sanos de 22 a 39 años. ¿Por qué usa este ensayo para un producto que también se piensa para personas con diabetes?”
Mi reflexión
Graba tu respuesta a estas preguntas con tus palabras. No hace falta responderlas todas ni en orden.
Notas derivadas
¿Dónde lo uso en el TFE?
- 04 Marco teórico — respuesta glucémica de confitería con polioles
- 08 Resultados y discusión — maltodextrina y carga glucémica por porción