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Advanced Glycation End Products: Building on the Concept of the “Common Soil” in Metabolic Disease

AGEs play a role in metabolic disorders like obesity and diabetes. They are formed when sugars bind to proteins or fats in our body. AGEs contribute to the development of these disorders by causing insulin resistance and inflammation. They can be produced inside our bodies or come from external sources like pollution, smoking, and unhealthy diets. The accumulation of AGEs in key organs disrupts metabolism and worsens the condition.

Advanced Glycation End Products and Risks for Chronic Diseases: Intervening Through Lifestyle Modification

AGEs are compounds formed when sugars react with proteins, lipids, or nucleic acids in our bodies. They bind to receptors found on different cells and trigger various biological responses. This review summarizes the characteristics of AGEs, how they are measured, their receptors, and how their expression changes in different physiological and disease conditions. The review suggests lifestyle modifications to regulate the AGE-RAGE cycle for improved health.

Advanced Glycation End Products: New Clinical and Molecular Perspectives

AGEs are compounds formed when sugars react with proteins, lipids, or nucleic acids in our bodies. They bind to receptors found on different cells and trigger various biological responses. This review provides an overview of AGEs, including how they are measured and their interactions with receptors. It also discusses how AGE expression changes in different physiological and disease states. Lastly, the review suggests lifestyle choices that can help modulate the AGE-RAGE cycle for better health.

The role of advanced glycation end products in aging and metabolic diseases: bridging association and causality

Accumulation of advanced glycation end products (AGEs) on nucleotides, lipids, and proteins is a natural part of the aging process in all living organisms, including humans. Numerous studies have demonstrated that AGEs and their impaired forms play a role in aging-related changes and the development of age-related diseases. However, there is still much to uncover about how AGEs are formed, their causal relationship with these conditions, and whether interventions can be developed to prevent or reduce AGE-related damage. Invertebrate models such as Drosophila melanogaster and Caenorhabditis elegans can be valuable tools to explore AGE-related pathways and identify potential drugs that can mitigate the harmful effects of AGE accumulation. These models offer insights for further research and intervention development in this area.

Accumulation of advanced glycation end products (AGEs) during aging is associated with age-related changes and diseases. Invertebrate models like Drosophila melanogaster and Caenorhabditis elegans can help study AGE-related pathways and identify potential interventions to mitigate AGE-related damage.

Development and Progression of Non-Alcoholic Fatty Liver Disease: The Role of Advanced Glycation End Products

Non-alcoholic fatty liver disease (NAFLD) affects a significant portion of the adult population and is a leading cause of liver-related illness and mortality worldwide. Treatment mainly relies on lifestyle changes, which can be challenging for most patients. The progression from simple fatty liver to more severe forms, such as non-alcoholic steatohepatitis (NASH) and liver fibrosis, is explained by a “two-hit hypothesis.” Advanced glycation end products (AGEs), formed when sugars react with proteins or lipids, have emerged as major contributors to this second hit, driving the progression from steatosis to NASH through the receptor for AGEs (RAGE). Both endogenous and exogenous AGEs from processed foods can activate RAGE in specific liver cells, promoting NAFLD progression. This review focuses on the pathophysiology of NAFLD, highlighting the role of food-derived AGEs in the development of NASH and liver fibrosis. Additionally, the potential impact of dietary changes to reduce AGEs in food or therapies targeting the AGE/RAGE pathway on disease progression is discussed.

NAFLD affects a large portion of the population and is a major cause of liver-related illness and deaths. The progression from fatty liver to NASH is driven by advanced glycation end products (AGEs) acting through the RAGE receptor. Both endogenous and exogenous AGEs contribute to NAFLD progression. This review focuses on the role of food-derived AGEs in NASH and liver fibrosis and discusses dietary modifications and therapies targeting the AGE/RAGE pathway.

Tagatose as a Potential Nutraceutical: Production, Properties, Biological Roles, and Applications

D-tagatose is a low-calorie nutraceutical that has potential applications in the food and feed industries due to its antidiabetic properties and beneficial effects on gut bacteria. While d-tagatose is present in small amounts in natural foods, it is mainly produced via chemical or biological means. The article provides an overview of the current state of d-tagatose production, properties, and applications.

Downregulation of the Werner syndrome protein induces a metabolic shift that compromises redox homeostasis and limits proliferation of cancer cells

The Werner syndrome protein (WRN) is important for cell growth, and its loss leads to premature aging-related diseases. When WRN is depleted, there is a metabolic shift in cells that weakens pathways involved in detoxification and increases mitochondrial respiration. In cancer cells, this shift counteracts the Warburg effect, altering redox balance and causing DNA damage, which inhibits cell growth and induces senescence. Antioxidant supplementation partially restores cell growth and reduces senescence in WRN-deficient cancer cells. WRN plays a critical role in cancer cell proliferation by influencing metabolism and preventing metabolic stress.

Association between HbA1c and carotid atherosclerosis among elderly Koreans with normal fasting glucose

This scientific article studied the relationship between a marker called HbA1c and the thickness of the carotid artery in older adults with normal blood sugar levels. The researchers found that higher levels of HbA1c were linked to a thicker carotid artery, which is a sign of increased risk for atherosclerosis (hardening of the arteries). The study suggests that measuring HbA1c can be a useful way to identify the presence of artery thickening in older individuals, even if their blood sugar levels are within the normal range.

Glucose levels and risk of dementia

This study examined the relationship between glucose levels and the risk of dementia in individuals with and without diabetes. The study included 2,067 participants without dementia, with 232 having diabetes and 1,835 without. The participants were followed for approximately 6.8 years. The findings showed that higher average glucose levels within the preceding 5 years were associated with an increased risk of dementia in both groups. Among participants without diabetes, higher glucose levels were linked to a 1.18 times higher risk of dementia, and among those with diabetes, higher glucose levels were associated with a 1.40 times higher risk of dementia. These results suggest that elevated glucose levels may be a risk factor for dementia, even in individuals without diabetes.

Higher glucose levels associated with lower memory and reduced hippocampal microstructure

This study examined the impact of glycosylated hemoglobin (HbA1c) and glucose levels on memory in healthy older individuals without diabetes or dementia. Lower HbA1c and glucose levels were associated with better memory performance, and the effects were mediated by changes in the hippocampus. The findings suggest that even within the normal range, higher blood glucose levels can negatively affect memory. Lowering glucose levels may improve cognition in older adults

Risk of dementia and cognitive dysfunction in individuals with diabetes or elevated blood glucose

This study investigated the risk of dementia in individuals with type 1 or type 2 diabetes and those with elevated glycosylated hemoglobin (HbA1c) levels. The findings revealed that both type 1 and type 2 diabetes were associated with a higher risk of dementia. Additionally, high HbA1c levels were linked to lower cognitive performance. However, the significance of screening-detected elevated HbA1c in relation to dementia risk requires further clarification.

Insulin resistance predicts brain amyloid deposition in late middle-aged adults

Insulin resistance (IR) has been linked to an increased risk of Alzheimer’s disease (AD), but its association with amyloid deposition in the brain has not been well-studied. This research involved late middle-aged individuals at risk for AD and used positron emission tomography to measure amyloid levels. The findings revealed that higher insulin resistance was associated with greater amyloid deposition in specific brain regions affected by AD, particularly in participants with normoglycemia. This study provides evidence that insulin resistance may contribute to amyloid accumulation in the brain, shedding light on the relationship between metabolic factors and AD pathology.

Gut microbes modulate neurodegeneration

A recent study investigated the role of gut microbes in tau-mediated neurodegeneration, a major factor in Alzheimer’s disease. The study found that gut bacteria play a causative role in inflammation in the central nervous system and peripheral tissues, leading to neurodegeneration. The inflammation was found to be dependent on the specific isoform of apolipoprotein E and was sex-specific. The study highlights the importance of understanding the interplay between gut microbes, APOE, and tau in the development of Alzheimer’s disease

Centella asiatica Protects d-Galactose/AlCl 3 Mediated Alzheimer’s Disease-Like Rats via PP2A/GSK-3β Signaling Pathway in Their Hippocampus

Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by cognitive decline and brain pathology. Centella asiatica (CA), an herb used in traditional medicine, has shown potential in improving cognitive functions. This study investigated the effects of CA on AD-like pathologies induced in rat models. The results revealed that CA increased the levels of protein phosphatase 2 (PP2A), reduced glycogen synthase kinase-3 beta (GSK-3β) levels, and improved the expression of genes associated with cell survival. Additionally, CA prevented structural abnormalities in the hippocampus. This study suggests that CA may have a protective effect against AD-like pathologies by regulating tau proteins, promoting cell survival, and maintaining brain structure.

Metabolism of galactose in the brain and liver of rats and its conversion into glutamate and other amino acids

This animal study measured galactose uptake in various organs. It demonstrated that the liver, brain and muscles can use galactose. They showed that galactose concentrations in the brain remain higher for longer, demonstrating its ability to provided a more sustaining energy. They also found that galactose enhanced the breakdown of toxic ammonia and proposed “galactose as a new means of removal of this neurotoxic compound from the brain in patients suffering from hepatic encephalopathy or Alzheimer’s disease”.

Nicotinamide ribose ameliorates cognitive impairment of aged and Alzheimer’s disease model mice

In this study, the researchers investigated the effects of nicotinamide ribose (NR) supplementation in mice models of Alzheimer’s disease (AD) and aging. The mice were given NR-supplemented food for three months, and their cognitive function, behavior, pathological processes, and biomarkers were assessed. The findings revealed that NR supplementation improved short-term spatial memory in aged mice and contextual fear memory in AD mice. It also inhibited astrocyte activation and reduced the accumulation of amyloid-beta (Aβ) plaques in the brains of AD mice. Additionally, NR supplementation prevented weight gain in both aged and AD mice. These results suggest that NR has selective benefits for AD and aged mice, highlighting its potential as a preventive measure against dementia.

Trehalose improves traumatic brain injury-induced cognitive impairment

In this study, researchers investigated the therapeutic potential of trehalose in a mouse model of traumatic brain injury (TBI). Trehalose, known for its neuroprotective properties, was found to improve behavioral performance in TBI mice without affecting lesion volume or biometals. However, trehalose treatment resulted in an upregulation of synaptic proteins and neurotrophic factors in the contralateral cortex. These findings suggest that trehalose could be an effective treatment option for TBI and other central nervous system disorders

Trehalose Improves Cognition in the Transgenic Tg2576 Mouse Model of Alzheimer’s Disease

This study investigated the therapeutic effects of trehalose in a mouse model of Alzheimer’s disease (AD). Trehalose treatment improved cognitive performance without significant changes in amyloid-β protein levels or autophagy. There was also no significant alteration in metal levels. However, trehalose treatment led to increased levels of synaptophysin, doublecortin, and progranulin, indicating enhanced synaptic function and neurogenesis. These findings suggest that trehalose may have neuroprotective mechanisms independent of traditional pathways, making it a potential therapeutic option for AD and other neurodegenerative disorders.

Scaling brain neurogenesis across evolution

The neocortex, responsible for cognitive abilities, has evolved and expanded across mammals. Humans’ advanced cognitive abilities are attributed to neocortex size and structure. Basal radial glial cells (bRGs) play a role in neocortex expansion and folding. A study by Pinson et al. found that a variant of transketolase-like protein 1 (TKTL1) in modern humans increases the number of bRGs and upper layer projection neurons. This genetic change may contribute to cognitive differences between modern humans and extinct archaic humans.

Human TKTL1 implies greater neurogenesis in frontal neocortex of modern humans than Neanderthals

This scientific article explores the differences in neurogenesis (the formation of new neurons) between modern humans and Neanderthals. Although Neanderthals had brains similar in size to modern humans, researchers discovered a genetic difference in a specific protein called transketolase-like 1 (TKTL1). The modern human variant of this protein, hTKTL1, was found to increase the abundance of basal radial glia (bRG) during neocortex development. These bRG cells play a crucial role in generating neurons. However, the Neanderthal variant of the protein did not have the same effect on bRG. The study suggests that modern humans have a different process of neurogenesis compared to Neanderthals, which may have contributed to unique characteristics of the human brain.

Trehalose alleviates oxidative stress-mediated liver injury and Mallor-Denk body formation
via activating autophagy in mice

Trehalose, a disaccharide, has been shown to induce autophagy and reduce cytotoxicity in neurodegenerative diseases. However, its effects on hepatocytes are not fully understood. In a study using a mice model of liver disease, trehalose was found to induce autophagy and decrease ER stress, oxidative stress, Mallory-Denk body (MDB) formation, and apoptosis in hepatocytes. The results suggest that trehalose could be a potential therapeutic agent for oxidative stress-related liver diseases by activating autophagy.

KATP channels are necessary for glucose-dependent increases in amyloid-β and Alzheimer’s disease–related pathology

High blood glucose levels can contribute to Alzheimer’s disease (AD), but the underlying mechanisms are unclear. This study focused on ATP-sensitive potassium (KATP) channels and their role in AD. They found that these channels were present in the human brain and changed with AD progression. Using a mouse model, they discovered that blocking KATP channels reduced the effects of high glucose on Aβ levels, plaque formation, and amyloid precursor protein processing. These findings suggest that targeting KATP channels could be a potential treatment strategy for AD in individuals with diabetes or prediabetes.

AKR1B1 drives hyperglycemia-induced metabolic reprogramming in MASLD-associated hepatocellular carcinoma

This study explored the role of the enzyme AKR1B1 in liver cancer linked to metabolic diseases. The researchers found that AKR1B1 levels were significantly higher in patients with metabolic-associated fatty liver disease (MASLD), metabolic-associated steatohepatitis (MASH), and liver cancer (HCC). In lab tests and mouse models, they discovered that AKR1B1 influences key metabolic processes, promoting the development of liver cancer in a high-sugar diet environment.

The study suggests that inhibiting AKR1B1 could prevent the early stages of liver cancer. The researchers propose AKR1B1 as a potential target for new cancer treatments and suggest measuring AKR1B1 levels in the blood as a diagnostic tool for liver diseases. The study highlights AKR1B1’s role in promoting a specific metabolic process (the Warburg effect) in liver cancer.

Sugary drink consumption and risk of cancer: results from NutriNet-Santé prospective cohort.

This population-based study aimed to examine the association between sugary drinks, artificially sweetened beverages, and the risk of cancer. The study included over 101,000 participants and assessed their beverage consumption using dietary records. The results showed that consuming sugary drinks was significantly associated with an increased risk of overall cancer and breast cancer. However, artificially sweetened beverages did not show a significant association with cancer risk. Additionally, the consumption of 100% fruit juice was also found to be associated with an increased risk of overall cancer. These findings suggest that sugary drinks, including fruit juices, may be modifiable risk factors for cancer and warrant further investigation in future studies.

Blood Glucose and Risk of Incident and Fatal Cancer in the Metabolic Syndrome and Cancer Project (Me-Can): Analysis of Six Prospective Cohorts

This prospective study investigated the association between blood glucose levels and the risk of cancer in six European cohorts. The study included over 274,000 men and 275,000 women, with an average follow-up of 10.4 years. The results showed that higher blood glucose levels were associated with an increased risk of overall incident cancer and fatal cancer, independent of body mass index (BMI) and smoking status. The associations were stronger among women compared to men and for fatal cancer compared to incident cancer. Specific associations were found for various cancer sites, including the liver, gallbladder, respiratory tract, pancreas, urinary bladder, uterine corpus, cervix uteri, and stomach. These findings suggest that abnormal glucose metabolism, beyond BMI, may contribute to an elevated risk of cancer, highlighting the importance of glucose control for cancer prevention.

Serum glucose and risk of cancer: a meta-analysis

In this meta-analysis, the relationship between raised serum glucose levels and the risk of solid cancers was examined. PubMed and Embase databases were searched for relevant studies, and inclusion criteria focused on epidemiological studies with clear definitions of serum glucose levels, cancer type, and well-described statistical methods

The underlying biological mechanisms are not fully understood, but the findings suggest that reducing serum glucose through lifestyle and dietary changes could potentially impact cancer mortality.

Elevated fasting serum glucose levels increase the risk of hepatocellular carcinoma: A prospective cohort study

This study investigated the relationship between fasting blood glucose (FBG) levels and the risk of hepatocellular carcinoma (HCC), a type of liver cancer. The study used competing risk regression models to account for death as an event that may occur before HCC. A cohort of 93,447 participants without prior HCC was followed, and their FBG concentrations were measured. The results showed that higher FBG levels were associated with an increased risk of HCC. Participants with FBG levels between 4.82 mmol/L and 5.49 mmol/L had a 47% increased risk, while those with FBG levels above 5.49 mmol/L had a 69% increased risk. These findings suggest that controlling FBG levels could potentially reduce the risk of HCC in the Chinese population.

Higher glucose and insulin levels are associated with risk of liver cancer and chronic liver disease mortality among men without a history of diabetes

This prospective study examined the associations between fasting glucose, insulin, and insulin resistance with liver cancer and chronic liver disease (CLD) mortality in Finnish male smokers. Participants were followed for up to 22 years, and various risk factors were considered. The results showed that elevated fasting glucose levels were positively associated with liver cancer risk. Undiagnosed, biochemically defined diabetes also increased the risk of liver cancer and CLD mortality. Similarly, higher serum insulin levels and insulin resistance were independently associated with increased risks of liver cancer and CLD mortality. These findings suggest that insulin and glucose dysregulation, even in the absence of diagnosed diabetes, may play a significant role in the development of liver cancer and CLD.

Insulin Resistance Is Associated with Early Gastric Cancer: A Prospective Multicenter Case Control Study

This study aimed to investigate the factors associated with early gastric cancer and evaluate the predictive value of the homeostasis model assessment of insulin resistance (HOMA-IR) index, fasting glucose, and lipid profile. The study included 63 patients with early gastric cancer and a matched control group. The results showed that higher levels of total cholesterol, fasting glucose, body mass index, and diastolic blood pressure were associated with an increased risk of early gastric cancer. Furthermore, hyperglycemia, lower high-density lipoprotein cholesterol levels, and a low HOMA-IR level were identified as potential risk factors for early gastric cancer.

Prostate Size Correlates with Fasting Blood Glucose in Non-Diabetic Benign Prostatic Hyperplasia Patients with Normal Testosterone Levels

This retrospective study aimed to evaluate the correlations between BMI, fasting glucose, insulin, testosterone level, insulin resistance, and prostate size in non-diabetic benign prostatic hyperplasia (BPH) patients with normal testosterone levels. The study included 212 patients who underwent transurethral resection of the prostate (TURP) due to medical treatment failure. The results showed that prostate size correlated positively with age, PSA levels, and fasting glucose levels, but not with BMI, testosterone, insulin level, or insulin resistance. Testosterone levels were inversely correlated with BMI, insulin level, and insulin resistance, but not with age, prostate size, PSA, or fasting glucose level. Multiple adjusted regression analysis revealed that prostate size was associated with elevated PSA and increased fasting glucose levels. In non-diabetic BPH patients with normal testosterone levels, fasting glucose level was identified as an independent risk factor for prostate hyperplasia.

Effects of a novel palatinose based enteral formula (MHN-01) carbohydrate-adjusted fluid diet in improving the metabolism of carbohydrates and lipids in patients with esophageal cancer complicated by diabetes mellitus

A study investigated the effects of a novel enteral formula (MHN-01) on perioperative management of patients with esophageal cancer and diabetes mellitus. MHN-01 showed promising results in suppressing post-prandial hyperglycemia, improving lipid metabolism, and reducing fat accumulation in animal experiments. In clinical cases, MHN-01 was successfully used in the perioperative management of patients with severe diabetes mellitus and esophageal cancer.

Autophagy induction by trehalose: Molecular mechanisms and therapeutic impacts

The role of trehalose as an innovative drug in the treatment of neurodegenerative diseases and other illnesses opening a new scenario of intervention in conditions difficult to be treated.

Trehalose protects against oxidative stress by regulating the Keap1-Nrf2 and autophagy pathways

This study looked at the potential of trehalose, a natural sugar found in plants and microorganisms, to activate a pathway that regulates cellular balance and reduces oxidative stress. The study found that trehalose can activate this pathway in a way that induces autophagy (cellular cleaning) and increases the expression of antioxidant factors. This suggests that trehalose has the potential to be a useful treatment for chronic diseases that involve oxidative stress and problems with cellular balance.

Galactose inhibits migration and invasive growth of cancer cells

This study provides clear evidence that specific types of dietary sugar are implicated in either feeding, or starving, the spread of cancer: “In order to test whether TKT’s promotion of colorectal cancer metastasis is dependent on glycolysis, we used galactose which induced cells to survive on ATP provided by mitochondrial respiration instead of glucose.”

How Sugar Suppresses the Immune System Hypoxia-Related Gene-Based Signature Can Evaluate the Tumor Immune Microenvironment

Researchers investigated the correlation between hypoxia-related genes and the prognosis of colon adenocarcinoma (COAD) patients. They identified four hypoxia genes (TKTL1, SLC2A3, ALDOB, and ENO3) and developed a hypoxia risk model to predict overall survival. The model showed stability and could be used to assess the prognosis of COAD patients. Additionally, the hypoxia risk score was found to be associated with immunosuppression in the tumor microenvironment.

How Sugar Suppresses the Immune System A hypoxia-linked gene signature for prognosis prediction

The study aimed to develop a prognostic model using hypoxia-linked genes to predict the prognosis of hepatocellular carcinoma (HCC) patients and investigate the relationship between hypoxia and immune status in the tumor microenvironment (TME). Six hypoxia-linked genes (HMOX1, TKTL1, TPI1, ENO2, LDHA, and SLC2A1) were used to create the prediction model. The model showed satisfactory estimation power and could independently predict overall survival (OS) in HCC patients. Additionally, the model could distinguish between high- and low-risk groups based on immune status. The findings have implications for improving the diagnosis and treatment of HCC.

A hypoxia-linked gene signature for prognosis prediction and evaluating the immune microenvironment in patients with hepatocellular carcinoma

This study aimed to develop a prognostic model using six hypoxia-linked genes to predict the prognosis of hepatocellular carcinoma (HCC) patients and investigate the relationship between hypoxia and immune status in the tumor microenvironment. The model was created using transcriptome and clinical data from TCGA and validated using data from GEO. The model showed satisfactory estimation power and could independently predict overall survival in HCC patients. It also successfully distinguished between high- and low-risk groups in terms of immune status. The findings have implications for improving the diagnosis and treatment of HCC.

TKTL1 Knockdown Impairs Hypoxia-Induced Glucose-6-phosphate Dehydrogenase and Glyceraldehyde-3-phosphate Dehydrogenase Overexpression

This study investigated the role of transketolase-like-1 (TKTL1) in metabolic reprogramming under hypoxic conditions in leukemia cells. Using THP-1 AML cells, the researchers found that knockdown of TKTL1 led to decreased activities of transketolase (TKT), glucose-6-phosphate dehydrogenase (G6PD), and glyceraldehyde-3-phosphate dehydrogenase (GAPDH). This resulted in impaired hypoxia-induced overexpression of G6PD and GAPDH, affecting the redox capacity of NADPH- and NADH-related cells. TKTL1 knockdown also hindered the transcription of genes involved in glucose, pentose phosphate pathway (PPP), and amino acid metabolism, preventing cells from switching to enhanced glycolysis under hypoxia. These findings highlight the crucial role of TKTL1 in the metabolic adaptation to hypoxia in THP-1 AML cells, impacting glucose and amino acid metabolism through modulation of key enzymes and transporters.

Growth of human gastric cancer cells in nude mice is delayed by a ketogenic diet supplemented with omega-3 fatty acids and medium-chain triglycerides

In this study, researchers investigated the effects of a ketogenic diet enriched with omega-3 fatty acids and medium-chain triglycerides (MCT) on tumour growth in a mouse model of gastric adenocarcinoma. The ketogenic diet, characterized by low carbohydrate intake and high fat content, significantly delayed tumour growth compared to a standard diet. Tumours in the ketogenic diet group exhibited larger necrotic areas and fewer blood vessels in the viable tumour cell regions. These tumour cells in the border zone showed a glycolytic phenotype. The results suggest that the ketogenic diet can effectively impede tumour growth in this mouse model, although further research is needed to explore its impact on other tumour-related processes such as invasive growth and metastasis.

Transketolase Serves as a Biomarker for Poor Prognosis in Human Lung Adenocarcinoma

Half of the patients who undergo surgical resection for early-stage lung cancer experience relapse and succumb to the disease, despite the use of adjuvant chemotherapy, which only minimally reduces the risk of relapse. Identifying the factors driving relapse, determining who would benefit from adjuvant therapy, and finding new targets are crucial. The pentose phosphate pathway (PPP) has been implicated in cancer, but the role of transketolase (TKT), an enzyme involved in the PPP, in lung adenocarcinoma (LUAD) is not well understood. This study examined TKT expression in LUAD and found that it was elevated in cancer tissues compared to normal tissues. High TKT expression was associated with advanced tumor stage. Additionally, inhibiting TKT led to tumor cell apoptosis and cell cycle arrest. These findings highlight the significant role of TKT in LUAD progression and prognosis, suggesting its potential as a biomarker for predicting recurrence after lung cancer resection.

Inhibition of Transketolase Improves the Prognosis of Colorectal Cancer

This study explored the role of transketolase (TKT) in colorectal cancer (CRC). TKT was found to be up-regulated in CRC and associated with poor prognosis. Inhibiting TKT reduced tumor cell viability, proliferation, migration, and induced apoptosis. TKT may serve as a prognostic biomarker and therapeutic target for CRC.

Hypoxia-Related Gene-Based Signature Can Evaluate the Tumor Immune Microenvironment and Predict the Prognosis of Colon Adenocarcinoma Patients

TKTL1 participated in malignant progression of cervical cancer cells via regulating AKT signal mediated PFKFB3 and thus regulating glycolysis

This study investigated the role of TKTL1 in cervical cancer (CC) cells and its involvement in glucose metabolism. The findings revealed that TKTL1 expression was increased in CC cells and its inhibition led to decreased cell proliferation, invasion, migration, and glycolysis. TKTL1 was shown to activate PFKFB3 through AKT signaling, contributing to the malignant progression of CC cells. Animal experiments also demonstrated that TKTL1 inhibition reduced tumor volume and improved histopathological status. Overall, TKTL1 plays a crucial role in CC by regulating glucose metabolism through AKT-mediated pathways.

Transketolase promotes colorectal cancer metastasis through regulating AKT phosphorylation 

This study focused on the role of transketolase (TKT) in colorectal cancer (CRC). The findings revealed that TKT expression was significantly increased in CRC and correlated with poor prognosis. TKT was found to promote CRC cell growth and metastasis. Further investigation showed that TKT interacted with GRP78 and enhanced glycolysis in CRC cells by increasing AKT phosphorylation, thereby facilitating metastasis. These findings suggest that TKT could serve as a prognostic indicator for CRC and provide insights for developing new treatment targets for the disease.

Hyperglycemia induces metabolic reprogramming into a glycolytic phenotype and promotes epithelial-mesenchymal transitions via YAP/TAZ-Hedgehog signaling axis in pancreatic cancer

This study investigated the impact of hyperglycemia on pancreatic ductal adenocarcinoma (PDAC). The findings revealed that hyperglycemia promotes epithelial-mesenchymal transition (EMT) and metabolic reprogramming in PDAC cells, leading to a glycolytic phenotype. Hyperglycemia also enhances chemoresistance and activates the Hedgehog pathway, contributing to tumor progression. Additionally, hyperglycemia stimulates YAP/TAZ expression in cancer-associated fibroblasts, leading to the production of tumor-promoting proteins in the tumor microenvironment. Inhibition of YAP/TAZ reverses these effects, suggesting YAP/TAZ as a potential therapeutic target in PDAC.

Ketogenic diets slow melanoma growth in vivo regardless of tumor genetics and metabolic plasticity | Cancer & Metabolism | Full Text (biomedcentral.com)

Scaling brain neurogenesis across evolution

The neocortex, responsible for cognitive abilities, has expanded and folded in mammals, partly due to basal radial glial cells (bRGs). A study by Pinson et al. reveals that a variant of transketolase-like protein 1 (TKTL1) in modern humans increases the number of bRGs and upper layer projection neurons. This genetic change may contribute to cognitive differences between modern humans and extinct archaic humans.

P1249: Inhibition of The Pentose-Phosphate-Pathway (Ppp) Mediates Macrophage Reprogramming From Supportive Bystander Function Towards Antibody-Dependent Lymphoma Cell Clearance And Lymphoma Suppression

This study investigated the metabolic pathways regulating macrophages in the tumor microenvironment (TME) of lymphoma and their impact on macrophage function in therapy. Inhibition of the pentose phosphate pathway (PPP) increased macrophage phagocytosis of lymphoma cells and induced morphological and functional changes. PPP inhibition also altered immune profiles and reduced support for CLL cells. Multiomics analyses revealed connections between PPP inhibition, metabolism, and immunity. In a mouse model, PPP inhibition improved macrophage maturation, prolonged survival, and enhanced pro-inflammatory polarization. The PPP was identified as a targetable modulator of macrophage function in lymphoma therapy.

Fructose and the Liver

In this study, it is revealed that fructose overconsumption is linked to metabolic syndrome and liver-related diseases. The detrimental effects include insulin resistance, inflammation, non-alcoholic fatty liver disease (NAFLD), and an increased risk of liver cancer. The study demonstrates that fructose activates proinflammatory, fibrogenic, and oncogenic pathways, particularly in the liver.

A dose- and time-dependent effect of oxythiamine on cell growth inhibition in non-small cell lung cancer

The role of transketolase in human cancer progression and therapy

In this review, the researchers highlight the significance of Transketolase (TKT) and its family members, TKTL1 and TKTL2, in cancer regulation. TKT and TKTL1 have been implicated in various cancer-related processes, including cell proliferation, metastasis, invasion, chemoradiotherapy resistance, and patient prognosis. The detection of TKTL1 levels using EDIM technology has shown promise as a sensitive and specific method for early malignancy detection and evaluating the effectiveness of surgery. While targeted TKT therapy has demonstrated positive effects in suppressing cancer, it is important to consider potential detrimental effects on the organism. The review discusses the role of TKT in different tumors, underlying mechanisms, and its clinical applications, providing insights for future targeted therapy and cancer-related research.

Trehalose alleviates oxidative stress-mediated liver injury and Mallor-Denk body formation via activating autophagy in mice

This study investigated the effects of trehalose on autophagy, ER stress, oxidative stress-mediated cytotoxicity, and Mallory-Denk body (MDB) formation in hepatocytes. The study used a mice model with 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC) treatment and administered trehalose through intraperitoneal injection. The results showed that trehalose induced autophagy, reduced ER stress, oxidative stress, MDB formation, and apoptosis in hepatocytes. Electron microscopy revealed autolysosome formation close to the MDBs. These findings suggest that trehalose has the potential to be a therapeutic agent for oxidative stress-related liver diseases by activating autophagy.

Hyperglycemia and cancer in human lung carcinoma by means of Raman spectroscopy and imaging

This study used Raman spectroscopy and imaging to analyze human lung cancer cells and their response to glucose and deuterated glucose under normal and hyperglycemic conditions. The results showed that substituting glucose with deuterated glucose allowed the distinction between de novo lipid synthesis and lipid uptake from the diet. It was observed that glucose is primarily used for de novo lipid synthesis and that high glucose levels decrease mitochondrial oxidative phosphorylation, leading to a shift towards glycolysis (Warburg effect). This suggests that hyperglycemia may contribute to a more aggressive cancer phenotype by inhibiting oxidative phosphorylation and apoptosis.

Molecular Mechanisms for Ketone Body Metabolism, Signaling Functions, and Therapeutic Potential in Cancer

Ketone bodies (KBs) are alternative energy sources to glucose during nutrient deprivation. They play a role in cellular signaling, protect against inflammation and oxidative stress, and have therapeutic potential in various diseases, including cancer. Abnormal KB metabolism is involved in tumorigenesis, and targeting it through dietary interventions, like ketogenic diets, shows promise in cancer therapy. This review explores the molecular mechanisms of KB metabolism and their potential use in cancer treatment.

High Blood Sugar Levels Trigger Transition of Benign to Malignant Tumours in Pancreatic Cancer

High blood sugar levels (hyperglycemia) in pancreatic ductal adenocarcinoma (PDAC) cause metabolic changes that promote the transition of cancer cells and increase their resistance to chemotherapy. This is mediated by the overexpression of certain proteins (YAP and TAZ) and activation of the Hedgehog pathway. Hyperglycemia also affects the surrounding tissue, stimulating the production of proteins that support tumor growth. Blocking the activity of YAP and TAZ can reverse these effects and improve treatment outcomes.

Preneoplastic cells switch to Warburg metabolism from their inception exposing multiple vulnerabilities for targeted elimination

Early stages of cancer involve a metabolic shift known as the “Warburg effect,” where cells rely on glycolysis instead of oxidative phosphorylation. In a zebrafish model, preneoplastic cells quickly activate glycolysis and impair oxidative phosphorylation. Blocking glycolysis inhibits cell growth, while enhancing glucose availability promotes proliferation and reduces cell death. Targeting impaired oxidative phosphorylation with metformin induces cell death specifically in preneoplastic cells. Additionally, mitochondrial fragmentation occurs early on and blocking it leads to increased cell death. These findings offer insights for targeted tumor prevention strategies.

High glucose promotes benign prostatic hyperplasia by downregulating PDK4 expression

This study investigated how high levels of glucose can affect prostate cells and potentially lead to benign prostatic hyperplasia (BPH), a condition that affects many aging men. The researchers focused on a specific gene called Pyruvate dehydrogenase kinase 4 (PDK4), which is involved in glucose metabolism and the development of various diseases. They treated normal and BPH prostate cells with high glucose levels and found that it caused these cells to grow more, change their characteristics, reduce cell death, and decrease PDK4 expression. Patients with diabetes-related BPH also had lower levels of PDK4. When they manipulated PDK4 levels in these cells, it had corresponding effects. They also used a medication called Rosiglitazone, which can increase PDK4 expression and suggested it might be a potential treatment for BPH. This study implies that high glucose levels could contribute to BPH development by reducing PDK4, making it a possible target for therapy.

Feasibility, Safety, and Beneficial Effects of MCT-Based Ketogenic Diet for Breast Cancer Treatment: A Randomized Controlled Trial Study, Nutrition and Cancer

This study aimed to explore the safety and benefits of a ketogenic diet (KD) on patients with breast cancer undergoing chemotherapy. In a 3-month randomized trial with 60 participants, half followed a KD, and the other half maintained a standard diet. The KD group showed reduced fasting blood sugar, increased ketone levels, and significant improvements in BMI, body weight, and fat percentage compared to the control group. No severe adverse effects were observed in lipid profile or kidney/liver markers. Notably, overall survival was higher in the KD group, suggesting that combining chemotherapy with KD may enhance biochemical parameters and body composition while improving survival in breast cancer patients without major side effects.

Warburg effect-related risk scoring model to assess clinical significance and immunity characteristics of glioblastoma

This study examined glioblastoma (GBM), an aggressive brain tumor. Researchers investigated the Warburg effect, an abnormal energy metabolism in tumors, and its impact on GBM prognosis and the immune environment.

They developed a predictive model using GBM data, identifying age, treatment, and Warburg effect gene scores as key factors for prognosis. A predictive tool showed high accuracy.

The study revealed that high Warburg effect gene scores were associated with an immunosuppressive environment, limiting the effectiveness of immunotherapy. Drugs targeting these genes inhibited GBM cell growth in lab tests.

In summary, the Warburg effect affects GBM prognosis and the immune environment, and targeting related genes may offer new treatment options.

Ketogenic diet – a literature review

The ketogenic diet has gained attention for its potential benefits in various health conditions. It has been found to aid in weight reduction, improve lipid profile, and potentially reduce the need for antidiabetic drugs and insulin therapy in type 2 diabetes. Animal studies suggest positive effects in cancer treatment, although human studies are limited. Additionally, there are reports of the ketogenic diet delaying the onset of dementia symptoms. However, the long-term impact on cardiovascular risk is still unknown, emphasizing the need for careful consideration before adopting the diet.

Significant Systemic Insulin Resistance is Associated With Unique Glioblastoma Multiforme Phenotype

This study investigated the relationship between insulin resistance and a specific type of brain cancer called glioblastoma multiforme (GBM), which is characterized by the presence of gemistocytes (GCs). These GCs are typically associated with reactive astrocytes, a type of brain cell. The study aimed to find a connection between insulin resistance and the presence of GCs in newly diagnosed GBM patients.

The researchers looked at medical records of 220 patients with newly diagnosed GBM. Among these patients, 26.3% had a history of type 2 diabetes at the time of diagnosis. They found that in the group of GBM patients with GCs, poorly-controlled diabetes was more common compared to the group without GCs. Specifically, there was a higher prevalence of poorly-controlled diabetes in the GC-GBM group (18.75%) compared to the non-GC GBM group (9.5%). In the subset of diabetic patients, those with GC-GBM were more likely to exhibit characteristics of insulin resistance, such as being male, morbidly obese, and not using synthetic insulin before diagnosis.

In conclusion, this study suggests that systemic metabolic factors related to insulin resistance, including type 2 diabetes, morbid obesity, and male gender, are associated with a distinct histological subtype of GBM characterized by the presence of GCs. This association is particularly significant in poorly-controlled type 2 diabetes GBM patients who do not use synthetic insulin. The findings highlight the potential relevance of glucose metabolism in astrocytes and its connection to high-grade brain tumors. Further research is needed to explore how patients’ metabolic status, tumor characteristics, molecular changes, and use of anti-diabetic drugs impact survival in GBM patients.

Hyperinsulinemia acts via acinar insulin receptors to initiate pancreatic cancer by increasing digestive enzyme production and inflammation

This study explores the link between pancreatic cancer, obesity, type 2 diabetes, and high levels of insulin in the blood (hyperinsulinemia). It is known that high insulin production is an independent risk factor for cancer, including pancreatic cancer. Previous research showed that reducing insulin production could suppress the development of pre-cancerous pancreatic lesions (PanIN) in mice with a specific genetic mutation (Kras). However, the precise mechanisms behind this connection and whether hyperinsulinemia directly affects PanIN precursor cells were unclear.

The study found that insulin receptors (Insr) in pancreatic acinar cells expressing the KrasG12D mutation were not essential for regulating glucose levels but were crucial for the formation of PanIN lesions in the presence of diet-induced hyperinsulinemia and obesity. The mechanism behind this involved an increase in the translation of digestive enzyme proteins, which led to local inflammation and the development of PanIN lesions in vivo. In laboratory experiments, insulin was shown to promote the transformation of acinar cells into ductal cells (acinar-to-ductal metaplasia) in a manner dependent on trypsin and insulin receptors.

In summary, this study sheds light on how obesity-driven hyperinsulinemia is connected to the development of pancreatic cancer. It shows that insulin receptors in pancreatic cells are not required for regulating blood sugar but play a crucial role in the formation of pre-cancerous pancreatic lesions under conditions of obesity and high insulin levels. The study provides insights into the mechanisms underlying the link between hyperinsulinemia and the development of pancreatic cancer.

Effects of sugar on aggressive and inattentive behavior in children with attention deficit disorder with hyperactivity and normal children

This study investigated the effects of sugar ingestion on cognitive attention and aggressive behavior in individuals with attention deficit disorder with hyperactivity compared to a control group. The results showed that sugar did not have a significant impact on aggressive behavior in either group. However, the attention deficit disorder with hyperactivity group exhibited increased inattention following sugar ingestion, but not with saccharin or aspartame. The clinical significance of this finding is uncertain, and further research is needed to replicate the results and determine any potential dietary recommendations.

Added sugar and dental caries in children: a scientific update and future steps

This scientific article discusses the strong association between added sugar intake and tooth decay in children in the United States. It emphasizes that sugar-sweetened beverages are the main source of added sugars in children’s diets. While health education is important, it alone is not enough to improve children’s beverage choices. The article highlights the influence of social factors such as socioeconomic disadvantage, household habits, and the availability of sugary products in local stores on added sugar intake. Sociobehavioral interventions, although currently uncommon, show promise in reducing added sugar intake and preventing tooth decay in children. Additionally, upstream approaches like sugar-sweetened beverage bans in schools, warning labels, and taxes can further help reduce excessive added sugar consumption. Although there is a lack of evidence-based clinical strategies, dental health professionals can adopt systematic clinical practices to identify and address excess added sugar intake in pediatric patients. The article calls for more research on sociobehavioral interventions, targeted public health programs for high-risk children, and changes in health policies to address this issue.

Cross-lagged associations between children’s stress and adiposity: the Children’s Body Composition and Stress study

This longitudinal study found that adiposity (body fat) in children is associated with increased stress levels over time. However, stress does not directly cause increases in adiposity. The relationship between stress and adiposity is influenced by cortisol levels and lifestyle factors. These findings highlight the importance of considering multiple factors in obesity prevention programs and the negative impact of unhealthy body composition on children’s well-being.

Consumption of Soft Drinks and Overweight and Obesity Among Adolescents in 107 Countries and Regions

This scientific article examines the relationship between soft drink consumption and the prevalence of overweight and obesity in adolescents. The study analysed data from 107 countries and regions, including a total of 405,528 school-going adolescents. The findings revealed that there was a positive correlation between the prevalence of daily soft drink consumption and the prevalence of overweight and obesity among adolescents. The analysis indicated a statistically significant association between daily soft drink consumption and overweight and obesity in school-going adolescents. The study suggests that reducing soft drink consumption should be a priority in addressing the issue of adolescent overweight and obesity.

High Sugar Levels and COVID-19

Research from Wuhan, China reveals that elevated blood sugar levels in COVID-19 patients without a previous diabetes diagnosis are associated with a more than twofold increase in the risk of death and higher chances of severe complications. The study, published in the journal Diabetologia, examined the relationship between fasting blood glucose levels upon admission and the 28-day mortality of COVID-19 patients without prior diabetes. The results showed that patients with higher blood glucose levels had a significantly higher mortality risk. Men and those with higher pneumonia severity scores also faced a greater risk of death. Additionally, patients with elevated blood glucose levels had a higher likelihood of experiencing complications. The study suggests that acute hyperglycemia may impact the prognosis of hospitalized COVID-19 patients, potentially through changes in coagulation, endothelial function, and the release of inflammatory cytokines. The authors emphasize the importance of blood sugar testing and control for all COVID-19 patients, even if they do not have a pre-existing diabetes diagnosis, to improve treatment outcomes during the pandemic.

A Machine-Generated View of the Role of Blood Glucose Levels in the Severity of COVID-19

SARS-CoV-2, the virus that caused COVID-19, spread rapidly worldwide. Researchers analyzed 240,000 scientific articles and found that elevated blood glucose levels played a significant role in the severity of the disease. The virus exploited high glucose levels to weaken the immune system, enter cells, replicate, and trigger inflammation and damage. Manual review and computational modeling supported this hypothesis. Elevated glucose levels could explain the varying severity of COVID-19 and had implications for diagnostics, treatments, and critical care.

Elevated Glucose Levels Favor SARS-CoV-2 Infection and Monocyte Response through a HIF-1α/Glycolysis-Dependent Axis

It remains unclear why individuals with uncontrolled glucose levels and diabetes are more susceptible to developing the severe form of COVID-19. However, studies have shown that monocytes and macrophages, the most enriched immune cell types in the lungs of COVID-19 patients, undergo metabolic changes that facilitate SARS-CoV-2 replication. These changes involve increased glycolysis mediated by hypoxia-inducible factor-1α (HIF-1α), which inhibits T cell response and reduces epithelial cell survival. Targeting HIF-1α could hold therapeutic potential for the development of novel drugs to treat severe COVID-19.

Tolerance of Human Fibroblasts to Benfo-Oxythiamine In Vitro

This study aimed to investigate the potential application of B-OT in the aspiration tract. An in vitro model was developed to assess the tolerance of primary human gingival fibroblasts to B-OT during mouth-washing simulation. The results showed no adverse effects on the cells even at high concentrations of B-OT (up to 1000 µM). Further testing with continuous exposure to B-OT in medium also demonstrated good tolerance, with minimal effects observed at 10 µM and a slight reduction at 100 µM. These findings support the potential use of B-OT as a mouth-washing solution and nasal spray, highlighting its favorable tolerance by oral cells.

Use of d-galactose to regulate biofilm growth

This animal study demonstrated the effectiveness of toothpaste made with galactose in preventing biofilm growth: “Our results suggest that d-galactose can be a candidate substance for the development of oral hygiene products to prevent caries by inhibiting the biofilm formation of S. mutans”

Anticaries effectiveness of D(+)-galactose

This study shows the effectiveness of galactose to prevent cavities and improve oral health: “5.0% galactose reduces the amount of caries with a high significance level, lowers abrasion of the chewing surfaces, possibly because of increased serum calcium related to this galactose concentration, and diminishes the amount of film.”

Removal and prevention of dental plaque with d-tagatose

The International Journal of Cosmetic Science published a study on removing and preventing dental plaque with tagatose.

The development of dental plaque involves the adherence of early and late bacterial colonizers to form a biofilm. In this study, researchers examined 15 oral isolates representing both early and late colonizers and tested their ability to coaggregate. They found that d-tagatose, a component of a toothpaste, effectively reversed coaggregation among these bacteria. d-Tagatose demonstrated a high success rate in reversing coaggregation, particularly among the late colonizers associated with periodontal diseases. This suggests that d-tagatose has the potential to prevent plaque development and modify the subgingival microbiota, providing a conservative approach to control gingival and periodontal diseases.

Food labeling: health claims; D-tagatose and dental caries. Final rule.

The FDA has finalized a rule that includes the sugar D-tagatose as an eligible substance for the dental caries health claim. This completes the rulemaking process that began with the interim final rule.

Virulence factors of Streptococcus mutans and dental caries prevention

Streptococcus mutans is a microorganism known for its ability to adhere to tooth surfaces and produce acids, which contribute to tooth decay. The synthesis of insoluble glucan from sucrose by S. mutans is crucial for its adherence. In this report, we discuss our recent findings on the virulence factors of S. mutans and potential methods for preventing dental caries caused by this microorganism.

Evaluation of a model for short-term clinical testing of cariogenicity

This study examined caries-like alterations on the teeth of 60 panelists using conventional and laser methods. Subjects consumed different candies or served as controls. After five days without oral hygiene, all groups showed increased caries-like changes, with no significant differences between them. The laser method consistently yielded higher scores. These findings emphasize the need for sensitive quantitative methods in short-term cariogenicity tests involving individuals who use fluorides regularly.

D-Tagatose Is a Promising Sweetener to Control Glycaemia: A New Functional Food

Studies have shown that tagatose has low glycemic index, a potent hypoglycemic effect, and eventually could be associated with important benefits for the treatment of obesity. The authors concluded that D-tag is promising as a sweetener without major adverse effects observed in these clinical studies.”

Tagatose: from a sweetener to a new diabetic medication?

This study tested the dietary effect of the consumption of tagatose in type 2 diabetes and its ability to be a functional food for diabetics.

Effect of Oral Nutritional Supplements with Sucromalt and Isomaltulose versus Standard Formula on Glycaemic Index, Entero-Insular Axis Peptides and Subjective Appetite in Patients with Type 2 Diabetes: A Randomised Cross-Over Study

This study looked at how special oral nutritional supplements for people with type 2 diabetes (ONS-D) affect their blood sugar levels, insulin levels, hormones related to digestion (GIP and GLP-1), and subjective appetite. The ONS-D supplements had a lower impact on blood sugar levels compared to a standard formula, and they also resulted in lower insulin and GIP levels. However, the ONS-D supplements increased the levels of GLP-1, which is beneficial for diabetes management. People who consumed the ONS-D felt less hungry compared to those who had the standard formula. These findings suggest that the ONS-D supplements can help control blood sugar levels and appetite in individuals with type 2 diabetes.

Short-term replacement of starch with isomaltulose enhances both insulin-dependent and -independent glucose uptake in rat skeletal muscle

This study investigated the impact of replacing high-glycemic index carbohydrates with a low-glycemic index disaccharide called isomaltulose on insulin action in skeletal muscle. Male rats were fed isomaltulose for 12 hours, and the results showed that isomaltulose increased insulin-induced glucose uptake in muscle tissue compared to starch. This effect was not influenced by changes in visceral fat mass. Additionally, isomaltulose treatment enhanced glucose uptake in response to exercise and increased AMP-activated protein kinase phosphorylation. These findings suggest that temporarily replacing starch with isomaltulose, along with exercise, may be a promising approach for managing insulin resistance.

Low Glycemic Index Prototype Isomaltulose-Update of Clinical Trials

Low glycemic index diets are considered beneficial for blood glucose control in diabetes and overall metabolic health. Isomaltulose, a natural disaccharide derived from sucrose, is a prototype of low-glycemic index carbohydrates. It is widely used in various food applications and clinical nutrition feeds. This overview examines clinical trials on isomaltulose, including its impact on glycemia, fat oxidation, weight-loss maintenance, and pregnancy. The findings suggest potential advantages of isomaltulose compared to high glycemic index sugars and carbohydrates in these contexts.

Prevalence of auto-antibodies against D-ribose-glycated-hemoglobin in diabetes mellitus

High blood sugar levels lead to the formation of advanced glycation end products (AGEs), which contribute to the progression of diabetes. In a study, structural changes in hemoglobin (Hb) caused by D-ribose were observed, potentially triggering an autoimmune response in diabetic patients. Autoantibodies against D-ribose glycated-Hb were found to be prevalent in diabetic patients’ blood, indicating their potential as biomarkers for diabetes progression.

Ramadan and Diabetes: A Narrative Review and Practice Update

This review explores the impact of fasting during the Islamic month of Ramadan on patients with diabetes mellitus. It provides recommendations for managing diabetes during Ramadan, emphasizing the importance of pre-Ramadan assessments to ensure a safe fasting experience. The review acknowledges the personal choice to fast but advises against fasting for patients assessed to be at high or very high risk, especially considering the additional risk posed by the COVID-19 pandemic. Advanced insulin delivery and glucose monitoring technologies are highlighted as helpful tools for supporting high-risk patients. While formal trial data is limited, there is sufficient evidence on the safety and efficacy of various hypoglycemic agents to guide treatment decisions. Overall, Ramadan presents an opportunity for patient engagement and improved diabetes management.

Flavonoids and Their Anti-Diabetic Effects: Cellular Mechanisms and Effects to Improve Blood Sugar Levels

Diabetes mellitus is a prevalent metabolic disorder, and flavonoids, natural compounds found in fruits and vegetables, have shown potential in managing diabetes. This review summarizes the current understanding of how dietary flavonoids affect glucose metabolism, hepatic enzymes, and lipid profiles, offering insights into their anti-diabetic effects. Further research is needed to clarify the mechanisms of action and potential side effects of flavonoids for diabetes treatment.

Association between HbA1c and carotid atherosclerosis among elderly Koreans with normal fasting glucose

This study investigated the association between glycated hemoglobin (HbA1c) and carotid atherosclerosis in an elderly Korean population with normal fasting glucose. The analysis of 1,133 participants revealed that higher HbA1c levels were independently associated with increased carotid intima-media thickness (IMT), indicating carotid atherosclerosis. This association remained significant after adjusting for various factors. However, fasting insulin and glucose levels did not show a significant association with carotid IMT. These findings suggest that HbA1c may serve as an informative marker for carotid atherosclerosis in elderly individuals with normoglycemia.

Safety and Efficacy of D-Tagatose in Glycemic Control in Subjects with Type 2 Diabetes

This study aimed to assess the effects of D-tagatose on glycemic control and safety in individuals with type 2 diabetes. Participants received either D-tagatose or a placebo. D-tagatose significantly reduced HbA1c levels compared to placebo and also showed positive effects on fasting blood glucose, LDL cholesterol, total cholesterol, and the proportion of subjects achieving HbA1c targets. However, D-tagatose did not affect triglyceride levels or HDL cholesterol. Overall, D-tagatose was effective in treating various therapy targets of type 2 diabetes.

Dietary supplementation with d-tagatose in subjects with type 2 diabetes leads to weight loss and raises high-density lipoprotein cholesterol

This pilot study investigated the effects of oral d-tagatose on individuals with type 2 diabetes. Participants took 15 g of d-tagatose three times daily for 1 year. No serious adverse effects were observed, although some experienced mild and transient gastrointestinal side effects. After excluding subjects who had changes in diabetes medications, body weight decreased significantly, and there was a non-significant reduction in glycated hemoglobin levels. Among participants not on lipid-modifying medications, high-density lipoprotein cholesterol levels increased significantly. These findings suggest that d-tagatose may have potential as an adjunct in the management of type 2 diabetes.

Daily consumption of one teaspoon of trehalose can help maintain glucose homeostasis: a double-blind, randomized controlled trial conducted in healthy volunteers

Researchers conducted a study to see if consuming 3.3 g of trehalose daily improves glucose tolerance in healthy Japanese individuals. They compared it to a group consuming sucrose. After 12 weeks, the trehalose group had lower fasting and post-meal blood glucose levels compared to the sucrose group. This suggests that even a small amount of trehalose could help lower post-meal blood sugar in healthy individuals.

Childhood neurodevelopmental disorders and maternal diabetes: A population-based cohort study

A retrospective cohort study in Taiwan examined the risk of neurodevelopmental disorders (NDDs) in children born to mothers with different types of diabetes. The study found that offspring of mothers with type 1 diabetes had the highest risk of NDDs, followed by type 2 diabetes and gestational diabetes. Specific disorders such as autism spectrum disorder, attention-deficit/hyperactivity disorder, developmental delay, intellectual disability, cerebral palsy, and epilepsy/infantile spasms were associated with maternal diabetes. This study highlights the importance of understanding the potential risks of different types of diabetes on neurodevelopment in offspring.

Prediabetes and risk of mortality, diabetes-related complications and comorbidities: umbrella review of meta-analyses of prospective studies

This umbrella review analyzed the available evidence from meta-analyses of prospective observational studies to evaluate the associations between prediabetes and the incidence of diabetes-related complications in adults. The review found that prediabetes was associated with an increased risk of all-cause mortality, cardiovascular outcomes, coronary heart disease, stroke, chronic kidney disease, certain cancers, and dementia. However, no associations were observed with incident depressive symptoms and cognitive impairment. The certainty of evidence varied across the outcomes. The review highlights the need for further high-quality studies, especially focusing on HbA1c-defined prediabetes and other relevant health outcomes, to strengthen the evidence in this area.

Trehalose improves traumatic brain injury-induced cognitive impairment

This study investigated the potential of trehalose, a natural sugar, to treat Alzheimer’s disease (AD) in a mouse model. The study found that trehalose improved the cognitive performance of mice through mechanisms that were independent of the reduction of Aβ protein or activation of autophagy. Trehalose increased the levels of proteins associated with synapses and neurogenesis, suggesting a neuroprotective effect. The study suggests that trehalose may be a potential treatment option for AD and other neurodegenerative disorders.

Trehalose Improves Cognition in the Transgenic Tg2576 Mouse Model of Alzheimer’s Disease

This study investigated the therapeutic effects of trehalose in a mouse model of Alzheimer’s disease (AD). Trehalose treatment improved cognitive performance without significant changes in amyloid-β protein levels or autophagy. There was also no significant alteration in metal levels. However, trehalose treatment led to increased levels of synaptophysin, doublecortin, and progranulin, indicating enhanced synaptic function and neurogenesis. These findings suggest that trehalose may have neuroprotective mechanisms independent of traditional pathways, making it a potential therapeutic option for AD and other neurodegenerative disorders.

Human TKTL1 implies greater neurogenesis in frontal neocortex of modern humans than Neanderthals

This study investigated the role of the TKTL1 gene in neocortex development and its impact on neuroprogenitor numbers. The researchers found that the human-specific amino acid substitution in TKTL1 (hTKTL1) increased the abundance of basal radial glia (bRG), a type of neuroprogenitor associated with increased cortical neuron production. The Neanderthal variant of TKTL1 (aTKTL1) did not have the same effect. Additionally, hTKTL1 promoted the synthesis of specific membrane lipids required for bRG growth. The findings suggest that hTKTL1 contributes to greater neocortical neurogenesis in modern humans, particularly in the frontal lobe, compared to Neanderthals.

Trehalose alleviates oxidative stress-mediated liver injury and Mallor-Denk body formation
via activating autophagy in mice

This study investigated the effects of trehalose on hepatocytes in a mouse model of liver disease. The researchers found that trehalose induced autophagy, reduced endoplasmic reticulum (ER) stress and oxidative stress, and decreased the formation of Mallory-Denk bodies (MDBs) and apoptosis in hepatocytes. Trehalose administration led to the formation of autolysosomes, which were closely associated with MDBs. These findings suggest that trehalose has the potential to be a therapeutic agent for liver diseases associated with oxidative stress by activating autophagy.

The influence of a 12% carbohydrate-electrolyte beverage on self-paced soccer-specific exercise performance

This study investigated the effects of consuming a 12% carbohydrate-electrolyte beverage during simulated soccer match-play. The beverage improved self-paced exercise performance and dribbling speed compared to water and placebo. Blood glucose levels were higher with the carbohydrate-electrolyte beverage, but it did not attenuate post-exercise cognitive decline. Overall, the findings suggest that the beverage can enhance soccer performance.

Ingesting isomaltulose versus fructose-maltodextrin during prolonged moderate-heavy exercise increases fat oxidation but impairs gastrointestinal comfort and cycling performance

This study examined the metabolic and performance effects of ingesting isomaltulose, a slowly absorbed carbohydrate, during exercise. The results showed that isomaltulose increased plasma nonesterified fatty acid concentration and fat oxidation while decreasing carbohydrate oxidation compared to fructose-maltodextrin supplementation. However, isomaltulose ingestion led to severe gastrointestinal symptoms and negatively affected exercise performance. These findings suggest that isomaltulose may not be suitable for prolonged or high-intensity exercise compared to other carbohydrate supplements.

Galactose increases mitochondrial activity which induces fat mobilisation and fat burning

This study focused on the role of transketolase (TKT) in colorectal cancer. The researchers found that TKT expression was significantly increased in colorectal cancer and correlated with poor prognosis. TKT was found to promote cancer cell growth and metastasis by interacting with GRP78 and enhancing glycolysis through AKT phosphorylation. These findings suggest that TKT could serve as a prognostic indicator for colorectal cancer and potentially be targeted for the development of new treatment strategies.

Substrate Utilization and Cycling Performance Following Palatinose™ Ingestion: A Randomized, Double-Blind, Controlled Trial

This study compared the effects of isomaltulose (PSE) and maltodextrin (MDX) ingestion on endurance exercise performance. PSE resulted in improved time trial performance, higher fat oxidation, and a more stable blood glucose profile compared to MDX. PSE may enhance endurance by promoting fat utilization and preserving glycogen.

Exogenous Oxidation of Isomaltulose Is Lower than That of Sucrose during Exercise in Men

This study compared the effects of orally ingested isomaltulose (ISO) and sucrose (SUC) during moderate intensity exercise. ISO showed lower exogenous carbohydrate oxidation rates and higher fat oxidation compared to SUC. Total endogenous carbohydrate oxidation was lower in the SUC trial. ISO had a lower plasma insulin response and a slower rate of digestion compared to SUC. These findings suggest that ISO may promote higher fat utilization and lower reliance on exogenous carbohydrates during exercise.

Low vs. high glycemic index carbohydrate gel ingestion during simulated 64-km cycling time trial performance

This study investigated the effects of low and high glycemic index (GI) carbohydrate feedings during a simulated 64-km cycling time trial (TT). The results showed no significant differences in the overall time to complete the TT between the low GI (honey) and high GI (dextrose) carbohydrate conditions. However, when collapsed, the carbohydrate conditions were faster compared to the placebo condition. Analysis of wattage generated during the last 16 km of the TT showed significant improvements in both the dextrose and honey treatments compared to preceding segments. These findings suggest that carbohydrate supplementation, regardless of GI, may enhance performance during the later stages of a long-distance cycling time trial.

Glycemic index in sport nutrition

The glycemic index (GI) classification of carbohydrates has gained attention in sports nutrition for its potential to impact blood glucose and insulin responses, glycogen recovery, exercise metabolism, and lipid oxidation. While there is biochemical evidence supporting the effects of GI manipulation on adipocyte lipolysis and lipid and carbohydrate oxidation rates during exercise, the functional outcomes have been inconsistent. Some studies have shown improved exercise performance with GI manipulation, but many others have not. This article reviews the effects and limitations of GI manipulation in sports nutrition and proposes a comprehensive strategy for its application.

American College of Sports Medicine Joint Position Statement. Nutrition and Athletic Performance

The Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine state that nutrition plays a crucial role in enhancing sports performance and recovery. These organizations provide guidelines on the appropriate type, amount, and timing of food, fluids, and supplements for optimal health and performance in various training and competitive sport scenarios. This position paper serves as a reference for members of these organizations, professional associations, government agencies, industry, and the public. It emphasizes the importance of personalized nutrition plans developed by registered dietitian/nutritionists, particularly those who are Certified Specialists in Sports Dietetics (CSSD), who are experts in sports nutrition.

Novel findings on the metabolic effects of the low glycaemic carbohydrate isomaltulose (Palatinose)

This study included three human intervention trials to investigate the physiological characteristics of isomaltulose (iso). The results showed that iso is effectively absorbed from the small intestine, regardless of the food matrix, and provides a prolonged delivery of blood glucose. It was found to have lower postprandial blood glucose and insulin responses compared to sucrose. Regular consumption of iso within a Western-type diet was well tolerated and did not affect blood lipids in individuals with hyperlipidemia. Although no significant differences were observed compared to sucrose after the 4-week intervention, iso shows promise as a carbohydrate option for individuals at risk of vascular diseases.

Single Ingestion of Trehalose Enhances Prolonged Exercise Performance by Effective Use of
Glucose and Lipid in Healthy Men

In a study with 12 healthy men, the effect of trehalose on prolonged exercise performance was investigated. Participants ingested 8% trehalose, 8% glucose, or water in three separate trials. The ingestion of trehalose resulted in lower adrenaline levels compared to water and glucose during later stages of exercise, indicating better preservation of carbohydrates. These findings suggest that a single intake of trehalose can contribute to maintaining exercise performance over a longer period.

Influence of Trehalose Mouth Rinse on Anaerobic and Aerobic Exercise Performance

Trehalose, a slow-absorbing disaccharide with a low glycemic index, has gained attention in sports nutrition. Limited studies have explored its impact on exercise performance. While pre-exercise ingestion of trehalose did not improve time trial performance, it showed potential in enhancing aerobic and anaerobic performance within 30 minutes of ingestion. Exogenous carbohydrate, including trehalose, may not directly contribute to performance but could have an effect through mechanisms like the mouth rinse effect. A study with collegiate runners used a randomized crossover design to investigate the performance-enhancing effects of trehalose, maltose, and an artificial sweetener through mouth rinsing. The concentrations of these substances were chosen to produce similar sweetness.

Effects of a Single Ingestion of Trehalose during Prolonged Exercise

This scientific article investigates the effects of trehalose (TRE) on exercise performance and energy metabolism. Trehalose is a disaccharide that slowly raises blood glucose levels and reduces insulin secretion. The study involved two parts:

1. Exercise Performance: The researchers conducted exercise tests using the Wingate test and a 30-minute constant load exercise. Healthy male college students participated in three trials: water (placebo), glucose (GLU), and trehalose (TRE). The results showed that TRE ingestion significantly increased both average and maximum power values during exercise compared to the other groups (p < 0.01).
2. Energy Metabolism: After ingesting TRE, the study measured respiratory exchange ratio (RER) and estimated lipid oxidation during 60 minutes of exercise at 40% VO2peak. The findings indicated that TRE ingestion resulted in significantly higher lipid utilization compared to GLU, suggesting that TRE is more effective in utilizing both glucose and lipids for energy during exercise (p < 0.01).

In summary, the study provides new insights into the positive effects of a single TRE ingestion on prolonged exercise performance by efficiently utilizing glucose and lipids for energy.

Preexercise galactose and glucose ingestion on fuel use during exercise

This study looked at how consuming two different types of sugar, galactose (Gal) and glucose (Glu), 30 minutes before exercise affects the use of these sugars during exercise. They had trained male cyclists do three cycling sessions after fasting overnight, and they consumed either a placebo, Gal, or Glu drink before each session.

Oxidation of independent and combined ingested galactose and glucose during exercise

This study investigated the impact of consuming a mixture of glucose and galactose during exercise on the utilization of ingested galactose. Fourteen trained male and female participants engaged in 150 minutes of cycling exercise at 50% peak power while ingesting different carbohydrate beverages. They consumed either galactose (GAL), glucose (GLU), or a combination of both (GAL + GLU) in a 1:1 ratio. The study used isotope labelling to measure the oxidation of the carbohydrates.

The study found that when participants consumed GAL + GLU, the concentration of galactose in their blood was lower compared to when they consumed GAL alone. However, combining galactose with glucose did not enhance the oxidation of ingested galactose during exercise. The total oxidation of the combined galactose-glucose blend (COMBINE) was similar to that of glucose alone, suggesting that these blends are a valid alternative to glucose as an energy source during exercise.

In summary, combining glucose and galactose did not enhance the use of ingested galactose during exercise. Galactose-glucose blends can serve as a viable carbohydrate source for energy during exercise, offering similar benefits to pure glucose.

Trehalose alleviates oxidative stress-mediated liver injury and Mallor-Denk body formation
via activating autophagy in mice

Trehalose, a disaccharide, has been shown to induce autophagy and reduce cellular stress in various disease models. However, its effects in hepatocytes have not been fully investigated. In a study using mice treated with 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC), trehalose was found to induce autophagy, reduce endoplasmic reticulum stress, oxidative stress, Mallory-Denk body formation, and apoptosis in hepatocytes. Electron microscopy revealed the formation of autolysosomes in close proximity to the Mallory-Denk bodies. These findings suggest that trehalose has the potential to be a therapeutic agent for liver diseases associated with oxidative stress by activating autophagy.

The impact of sugar consumption on stress driven, emotional and addictive behaviors

High rates of overweight and obesity are a global concern, with overconsumption of high fat/sugar foods playing a significant role. Long-term sugar consumption can lead to neural plasticity, reducing impulse control and increasing susceptibility to high fat/sugar foods. The neural pathways involved in emotions and survival responses overlap, suggesting a link between stress, emotions, and obesity. Sucrose consumption activates the mesocorticolimbic system similarly to addictive substances, resulting in neuronal changes, altered emotional processing, and modified behavior in both animals and humans. This comprehensive review examines over 300 studies on the interaction between sugar consumption, stress, and emotions, emphasizing the neurochemical changes and neural adaptations that influence emotion and behavior after sugar consumption. Understanding these mechanisms can aid in the development of novel therapeutic strategies for obesity.

Daily limited access to sweetened drink attenuates hypothalamic-pituitary-adrenocortical axis stress responses

A rat model was developed to explore the relationship between preferred food consumption and stress responses. Rats were given access to sweetened drinks (sucrose or saccharin) or water in addition to their regular water intake. Half of the rats were subjected to chronic variable stress (CVS) while the others served as nonhandled controls. The results showed that sucrose consumption reduced the stress hormone corticosterone response to restraint stress in both CVS rats and nonhandled controls. Saccharin had a similar but less pronounced effect. Sucrose consumption also affected gene expression in brain regions associated with stress regulation. These findings suggest that limited consumption of sweetened drinks can attenuate stress responses, indicating that the intake of palatable substances may serve as a natural mechanism to dampen physiological stress responses.

Expression and nuclear translocation of glucocorticoid receptors in type 2 taste receptor cells

The secretion of glucocorticoids (GCs) in response to stress affects ingestive behavior and taste preferences. This study investigated the presence of glucocorticoid receptors (GRs) in taste tissue and their potential role in modulating the response of the taste system to stress. The researchers found mRNA expression of GRα in taste papillae and non-taste tissue, with higher levels in taste tissue. GR protein was detected in various taste bud populations. In transgenic mice, the majority of sweet-/umami-sensitive taste cells expressed GR. When mice were subjected to restraint stress, GR protein in sweet-sensitive taste cells relocated to the nucleus. These findings suggest that GR activation in taste receptor cells may influence taste qualities such as sweet, umami, and bitter, potentially shaping the response of the taste system to stress.

Cross-lagged associations between children’s stress and adiposity: the Children’s Body Composition and Stress study

This longitudinal study examined the bidirectional relationship between stress and adiposity in children. The findings showed that higher adiposity levels were associated with increased subsequent stress levels. However, stress did not directly lead to increases in adiposity. The association between stress and adiposity was influenced by cortisol levels and lifestyle factors, such as sweet food consumption and physical activity. These results highlight the importance of considering multiple factors in obesity prevention programs and underscore the negative impact of unhealthy body composition on children’s psychological well-being.

Tagatose, the new GRAS sweetener and health product

Tagatose, a low-calorie natural sugar, has recently received FDA GRAS status, allowing its use as a sweetener in food and beverages. This paper provides an overview of tagatose, including its applications in food and beverages and potential health benefits. Safety studies conducted according to FDA guidelines support its GRAS status. Small clinical trials have shown tagatose to be effective in treating type 2 diabetes. It is a safe and effective low-calorie sweetener for various products, particularly those that require bulk, such as chocolates, gum, cakes, and ice cream. Tagatose can also complement high-intensity sweeteners in sodas. Additionally, it has potential health benefits, including treating diabetes, hyperglycemia, anemia, hemophilia, and supporting fetal development.

Temporal sweetness and side tastes profiles of 16 sweeteners using temporal check- all-that-apply (TCATA)

This study aimed to compare the temporal sweetness and qualitative differences of 15 sweeteners to sucrose. Various sweeteners from different groups were evaluated by 20 participants using the Temporal Check-all-that-Apply (TCATA) method. Sucrose exhibited a rapid onset of sweetness and minimal side tastes. Acesulfame-K, stevia, and luo han guo had prominent bitter, metallic, and chemical tastes. Allulose, erythritol, sorbitol, aspartame, and sucralose had some side tastes but maintained sweetness. Nutritive sweeteners like dextrose, fructose, maltitol, mannitol, sucrose-allulose mixture, palatinose, and xylitol had taste profiles most similar to sucrose in terms of sweetness onset, peak sweetness, decay, and side tastes. This information can help in selecting suitable sucrose substitutes based on taste profiles.

Rate-All-That-Apply (RATA) comparison of taste profiles for different sweeteners in black tea, chocolate milk, and natural yogurt

This study compared the taste properties of different sweeteners in three food matrices (black tea, chocolate milk, and natural yogurt) to sucrose. The sensory properties of each sweetener varied across the matrices, with some sweeteners closely resembling sucrose taste in all foods. Others had distinct taste profiles characterized by side tastes and lower sweetness. Sweeteners performed differently in natural yogurt compared to tea and chocolate milk. These findings emphasize the need to consider complex food matrices when selecting sweeteners as sugar substitutes. Food manufacturers can use these results to identify suitable sweetener substitutes for specific food products and support calorie reduction efforts.

Galactose enhances oxidative metabolism and reveals mitochondrial dysfunction in human primary muscle cells

This study looked at the differences in oxygen use when cells are nourished with glucose versus galactose. They saw a significant increase in oxygen utilisation with galactose, allowing them to characterise metabolic changes in diabetic patients, thereby creating a new model for the molecular mechanisms of mitochondrial dysfunction.

Galactose promotes fat mobilization in obese lactating and nonlactating women

American Journal of Clinical Nutrition published this study demonstrating the fat burning benefits of galactose: “Galactose consumption is associated with higher endogenous fat mobilization and oxidation during meal absorption”

The metabolome profiling and pathway analysis in metabolic healthy and abnormal obesity

This study aimed to identify metabolic pathways associated with different metabolic characteristics in obesity. Subjects with metabolic healthy obesity (MHO) and metabolic abnormal obesity (MAO) were analyzed using metabolomic profiling. Significant differences in metabolites and pathways were found between the MHO and MAO groups, providing insights into the development of abnormal metabolic phenotypes in obesity.

Tagatose, a new antidiabetic and obesity control drug

Early human studies suggested tagatose as a potential antidiabetic drug through its beneficial effects on postprandial hyperglycaemia and hyperinsulinaemia. A subsequent 14-month trial confirmed its potential for treating type 2 diabetes, and tagatose showed promise for inducing weight loss and raising high-density lipoprotein cholesterol, both important to the control of diabetes and constituting benefits independent of the disease.

Obesity and hyperinsulinemia drive adipocytes to activate a cell cycle program and senesce

Obesity leads to enlarged adipose tissue, and contrary to previous understanding, mature human adipocytes can enter an active cell cycle. However, chronic hyperinsulinemia triggers premature cell cycle exit and senescence in adipocytes. Targeting the adipocyte cell cycle with metformin may help reduce obesity-related inflammation.

Resistant starch intake facilitates weight loss in humans by reshaping the gut microbiota

This study investigated how adding resistant starch (RS), a type of dietary fiber, to the diet might help people with overweight or obesity. They conducted a trial with 37 participants and found that taking RS supplements for 8 weeks led to weight loss (an average of 2.8 kilograms) and improved insulin resistance. These benefits were linked to changes in the composition of gut bacteria. Specifically, a type of bacteria called Bifidobacterium adolescentis seemed to play a key role. When this bacteria was supplemented in male mice, it protected them from becoming obese on a high-calorie diet. The study suggests that RS alters the gut bacteria, which in turn affects various processes in the body such as bile acid levels, inflammation, and fat absorption, ultimately aiding in weight loss. This highlights the importance of gut bacteria in the beneficial effects of RS on weight loss and metabolic health.

Erythritol is a pentose-phosphate pathway metabolite and associated with adiposity gain in young adults

This study investigated metabolomic markers associated with the development of central adiposity in young adults. Participants with incident central adiposity gain had higher levels of blood erythritol compared to those with stable adiposity. Participants with higher baseline hemoglobin A1c (HbA1c) levels also had significantly higher blood erythritol. Erythritol was found to be synthesized from glucose through the pentose-phosphate pathway, suggesting its potential role in the association between erythritol and obesity in young adults.

Letter Regarding Article, “Metabolomic Pattern Predicts Incident Coronary Heart Disease”

This article discusses the use of erythritol, a metabolite, as a predictive marker for coronary heart disease. Erythritol is a naturally occurring noncaloric sweetener and not an artificial sweetener. The presence of erythritol in blood samples cannot be explained by its consumption as a sugar replacement. Studies have shown an association between erythritol levels and impaired glycemic control and central adiposity. The conversion of glucose to erythritol via the pentose-phosphate pathway may play a role in reflecting impaired glycemic control and its related complications. Further research is needed to fully understand the connection between erythritol concentrations and these health conditions.