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Gut hormone secretion, gastric emptying and glycemic responses to erythritol and xylitol in lean and obese subjects

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AJP Endocrinology and Metabolism

Published online on

Abstract

With the increasing prevalence of obesity and a possible association with increasing sucrose consumption, non-nutritive sweeteners are gaining popularity. Given that some studies indicate that artificial sweeteners might have adverse effects, and alternative solutions are sought. Xylitol and erythritol have been known for a long time and their beneficial effects on caries prevention and potential health benefits in diabetic patients have been demonstrated in several studies. Glucagon-like peptide 1 (GLP-1) and cholecystokinin (CCK) are released from the gut in response to food intake, promote satiation, reduce gastric emptying (GE) and modulate glucose homeostasis. While glucose ingestion stimulates sweet taste receptors in the gut, and leads to incretin and gastrointestinal hormone release, the effect of xylitol and erythritol have not been well studied. Ten lean and 10 obese volunteers were given 75g glucose, 50g xylitol or 75g erythritol in 300mL water or placebo (water) by a nasogastric tube. We examined plasma glucose, insulin, active GLP-1, CCK, and GE with a 13C-sodium acetate breath test and assessed subjective feelings of satiation. Xylitol and erythritol lead to a marked increase in CCK and GLP-1, while insulin and plasma glucose are not (erythritol) or only slightly (xylitol) affected. Both xylitol and erythritol induce a significant retardation in GE. Subjective feelings of appetite are not significantly different after carbohydrate intake compared to placebo. In conclusion, acute ingestion of erythritol and xylitol stimulates gut hormone release and slows down gastric emptying, while there is no or only little effect on insulin release.