<?xml version="1.0" encoding="UTF-8"?>
<article xmlns:xlink="http://www.w3.org/1999/xlink"
         article-type="news"
         dtd-version="1.1"
         specific-use="production"
         xml:lang="uk">
   <front>
      <journal-meta>
         <journal-id journal-id-type="publisher">Psychosomatic Medicine and General Practice</journal-id>
         <issn>2519-8572</issn>
		 <journal-title-group>
			<journal-title>Psychosomatic Medicine and General Practice</journal-title>
		 </journal-title-group>
         <publisher>
            <publisher-name>Private Publisher 'Chaban O. S.'</publisher-name>
         </publisher>
      </journal-meta>
      <article-meta>
         <article-id pub-id-type="publisher-id">46</article-id>
         <article-id pub-id-type="other">612.392.9</article-id>
         <article-categories>
            <subj-group>
               <subject>Dietology</subject>
            </subj-group>
         </article-categories>
         <title-group>
            <article-title>How do artificial sweeteners affect your health?</article-title>
            <article-title xml:lang="uk-UA">Як штучні замінники цукру впливають на стан здоров’я?</article-title>
         </title-group>
         <contrib-group>
            <contrib contrib-type="author">
               <name name-style="western">
                  <surname>Bezsheiko</surname>
                  <given-names>Vitaliy</given-names>
               </name>
               <xref ref-type="aff" rid="aff1">1</xref>
               <xref ref-type="fn" rid="conf1"/>
               <xref ref-type="corresp" rid="cor1"/>
            </contrib>
            <aff id="aff1">
               <institution content-type="dept">Department of Psychosomatic Medicine and Psychotherapy, Bogomolets National Medical University</institution>
               <addr-line>
                  <named-content content-type="city">Kyiv</named-content>
               </addr-line>
               <country>Ukraine</country>
            </aff>
         </contrib-group>
         <author-notes>
            <corresp id="cor1">
               <email>vitaliybezsh@gmail.com</email>
            </corresp>
         </author-notes>
         <pub-date date-type="pub" iso-8601-date="2017-01-08" publication-format="print">
            <day>1</day>
            <month>8</month>
            <year>2017</year>
         </pub-date>
         <volume>2</volume>
         <issue>3</issue>
         <elocation-id>e020346</elocation-id>
         <permissions>
            <copyright-statement>© 2017, Bezsheiko V.</copyright-statement>
            <copyright-year>2017</copyright-year>
            <copyright-holder>Bezsheiko V.</copyright-holder>
            <license xlink:href="https://creativecommons.org/licenses/by/4.0/">
               <license-p>This article is distributed under the terms of the <ext-link ext-link-type="uri"
                            xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>, which permits unrestricted use and redistribution provided that the original author and source are credited.</license-p>
            </license>
         </permissions>
         <abstract abstract-type="short">
		 <title>Abstract</title>
		 <p>According to a new analysis of long-term studies, they increase the risk of obesity, arterial hypertension, stroke, cardiovascular events, and type 2 diabetes.</p>
		 </abstract>
         <trans-abstract abstract-type="short" xml:lang="uk">
		   <title>Анотація</title>
		   <p>Згідно із результатами нового аналізу досліджень при довгому споживанні вони підвищують ризик виникнення ожиріння, артеріальної гіпертензії, інсульту, кардіоваскулярних подій та діабету 2го типу.</p>
         </trans-abstract>
         <kwd-group kwd-group-type="author-keywords">
            <title>Keywords</title>
            <kwd>artificial</kwd>
            <kwd>sweeteners</kwd>
            <kwd>health</kwd>
            <kwd>obesity</kwd>
			<kwd>cardiometabolic</kwd>
         </kwd-group>
      </article-meta>
   </front>
   <body>
      <sec>
         <title>Note</title>
         <p>Article was exposed to the machine translation from Ukrainian.</p>
      </sec>
      <sec>
         <title>Background</title>
         <p>Artificial sweeteners have long been part of our lives through consumer products. They are widely used in the food industry to provide food products sweet taste. They are used in the production of various beverages and sweets. Popularity for mass production they retrived primarily because of their low cost - manufacturers are advantageous to use sweeteners than the sugar. For example, according to the wholesale site (alibaba.com) for the price of 1 kg of aspartame is about 8, and sugar - 0.5 US dollars. Given that 1 kg of aspartame equivalent to 200 kg of sugar, it turns out the use of artificial sweeteners is cheaper by 10 times.</p>
         <p>At one time in order to increase sales of products containing artificial sweeteners, American manufacturers have launched an advertising campaign about the fact that these substances help in losing weight. Indeed, they contain almost no calories, but does that mean that they can help with overweight? Of course, the manufacturers did not provide any evidence. However, evidence in the form of scientific research could lead institution dietary and they show just about the opposite.</p>
      </sec>
      <sec>
         <title>The effects of artificial sweeteners on the body mass index and weight</title>
         <p>In a recent study, published on July 17 in the journal «CMAJ», a team of scientists from Canada conducted an analysis on the impact of sugar substitutes on cardiometabolic health [<xref ref-type="bibr" rid="bib1">1</xref>]. This analysis was triggered by a significant increase in the use and consumption of artificial sweeteners.</p>
         <p>In total researchers looked at over 11 000 scientific works. For further analysis they selected 37 of the best quality researches, of which 7 studies had randomized controlled design and 30 – cohort design.</p>
         <p>First, scientists evaluated the impact of these artificial sweeteners on the body mass index (BMI) and weight. It turned out that in the studies with a duration of 6 to 24 months, no significant effect on these parameters in sweeteners were noted. But in assessing the impact of long-term (8 years) studies was found that sweeteners promote weight gain. Regarding BMI difference between those who used these substances and not used was 0.77 kg / m2 and was statistically significant.</p>
         <p>Analysis of the impact of sweeteners on weight was more interesting. As expected in the short term these substances had effect on weight. But after analysis the results of two long-term studies scientists found that sweeteners reduce weight! But how is it possible if BMI in many studies increased significantly? It is possible if the research sponsored by sweetener manufacturers, and that was the case. Excluding these studies changed the result and now sweeteners consumption correlated with weight gain. More people had used them, the more weight they gained by observation period of 2-4 years.</p>
         <p>How can we explain this weight gain if sweeteners haven’t got any calories? One possibility is in a sense of satiety that occurs faster when consume products made from conventional sugar. Thus, a person consumes more calories. But this effect was evident only after a long time. Another option is in possibility of sweeteners to direct affect metabolism, and this, in turn, contributes to weight gain in the long term.</p>
      </sec>
      <sec>
         <title>The effects of artificial sweeteners on health</title>
         <p>The subject for the further analysis was the association between sweeteners consumption and risk of abdominal obesity, type 2 diabetes and cardiometabolic problems. The main results were:</p>
         <list list-type="unordered">
            <list-item>
               <p>In studies lasting 4-9 years, the use of artificial sweeteners was associated with waist size increase (to 2.27 cm).</p>
            </list-item>
            <list-item>
               <p>Sweeteners in the long term increased the relative likelihood of abdominal obesity by 59% and obesity by 84%.</p>
            </list-item>
            <list-item>
               <p>In the long term they increasedthe risk of diabetes by 14%.</p>
            </list-item>
            <list-item>
               <p>In studies with the period of observation lasting 5-38 years use of sweeteners increased risk of hypertension by 13% compared with those who have not used them or used little.</p>
            </list-item>
            <list-item>
               <p>Consumption of artificial sweeteners increased relative risk for cardiovascular events (e.g., myocardial infarction) by 32%.</p>
            </list-item>
         </list>
         <p>Thus, contrary to the assertions of advertising campaigns, sweeteners do not contribute to weight loss. In the short term these substances are not carry any risks. But in the long term, <bold>according to scientists after 10 of consumption</bold>, they promote weight gain and increase the risk of cardiometabolic disorders.</p>
      </sec>
   </body>
   <back>
      <fn-group>
         <title>Competing interests</title>
         <fn fn-type="conflict" id="conf1">
            <p>The author declare that no competing interests exist.</p>
         </fn>
      </fn-group>
      <ref-list>
         <title>References</title>
          <ref id="bib1">
            <element-citation publication-type="journal">
               <person-group person-group-type="author">
                  <name>
                     <surname>Azad</surname>
                     <given-names>MB</given-names>
                  </name>
                  <name>
                     <surname>Abou-Setta</surname>
                     <given-names>AM</given-names>
                  </name>
                  <name>
                     <surname>Chauhan</surname>
                     <given-names>BF</given-names>
                  </name>
                  <name>
                     <surname>Rabbani</surname>
                     <given-names>R</given-names>
                  </name>
                  <name>
                     <surname>Lys</surname>
                     <given-names>J</given-names>
                  </name>
                  <name>
                     <surname>Copstein</surname>
                     <given-names>L</given-names>
                  </name>
                  <name>
                     <surname>Mann</surname>
                     <given-names>A</given-names>
                  </name>
                  <name>
                     <surname>Jeyaraman</surname>
                     <given-names>MM</given-names>
                  </name>
                  <name>
                     <surname>Reid</surname>
                     <given-names>AE</given-names>
                  </name>
                  <name>
                     <surname>Fiander</surname>
                     <given-names>M</given-names>
                  </name>
                  <name>
                     <surname>MacKay</surname>
                     <given-names>DS</given-names>
                  </name>
                  <name>
                     <surname>McGavock</surname>
                     <given-names>J</given-names>
                  </name>
                  <name>
                     <surname>Wicklow</surname>
                     <given-names>B</given-names>
                  </name>
                  <name>
                     <surname>Zarychanski</surname>
                     <given-names>R</given-names>
                  </name>
               </person-group>
               <article-title>Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies</article-title>
               <source>CMAJ</source>
               <year>2017</year>
               <volume>189</volume>
               <issue>28</issue>
               <fpage>929</fpage>
               <lpage>939</lpage>
               <pub-id pub-id-type="doi">10.1503/cmaj.161390</pub-id>
               <pub-id pub-id-type="pmid">https://www.ncbi.nlm.nih.gov/pubmed/28716847</pub-id>
            </element-citation>
         </ref>
      </ref-list>
   </back>
</article>
