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Award","award":["476251"],"award-info":[{"award-number":["476251"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Health authorities are near universal in their recommendation to replace sugar-sweetened beverages (SSBs) with water. Non-nutritive sweetened beverages (NSBs) are not as widely recommended as a replacement strategy due to a lack of established benefits and concerns they may induce glucose intolerance through changes in the gut microbiome. The STOP Sugars NOW trial aims to assess the effect of the substitution of NSBs (the \u201cintended substitution\u201d) versus water (the \u201cstandard of care substitution\u201d) for SSBs on glucose tolerance and microbiota diversity. Design and Methods: The STOP Sugars NOW trial (NCT03543644) is a pragmatic, \u201chead-to-head\u201d, open-label, crossover, randomized controlled trial conducted in an outpatient setting. Participants were overweight or obese adults with a high waist circumference who regularly consumed \u22651 SSBs daily. Each participant completed three 4-week treatment phases (usual SSBs, matched NSBs, or water) in random order, which were separated by \u22654-week washout. Blocked randomization was performed centrally by computer with allocation concealment. Outcome assessment was blinded; however, blinding of participants and trial personnel was not possible. The two primary outcomes are oral glucose tolerance (incremental area under the curve) and gut microbiota beta-diversity (weighted UniFrac distance). Secondary outcomes include related markers of adiposity and glucose and insulin regulation. Adherence was assessed by objective biomarkers of added sugars and non-nutritive sweeteners and self-report intake. A subset of participants was included in an Ectopic Fat sub-study in which the primary outcome is intrahepatocellular lipid (IHCL) by 1H-MRS. Analyses will be according to the intention to treat principle. Baseline results: Recruitment began on 1 June 2018, and the last participant completed the trial on 15 October 2020. We screened 1086 participants, of whom 80 were enrolled and randomized in the main trial and 32 of these were enrolled and randomized in the Ectopic Fat sub-study. The participants were predominantly middle-aged (mean age 41.8 \u00b1 SD 13.0 y) and had obesity (BMI of 33.7 \u00b1 6.8 kg\/m2) with a near equal ratio of female: male (51%:49%). The average baseline SSB intake was 1.9 servings\/day. SSBs were replaced with matched NSB brands, sweetened with either a blend of aspartame and acesulfame-potassium (95%) or sucralose (5%). Conclusions: Baseline characteristics for both the main and Ectopic Fat sub-study meet our inclusion criteria and represent a group with overweight or obesity, with characteristics putting them at risk for type 2 diabetes. Findings will be published in peer-reviewed open-access medical journals and provide high-level evidence to inform clinical practice guidelines and public health policy for the use NSBs in sugars reduction strategies. Trial registration: ClinicalTrials.gov identifier, NCT03543644.<\/jats:p>","DOI":"10.3390\/nu15051238","type":"journal-article","created":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T01:36:09Z","timestamp":1677634569000},"page":"1238","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Rationale, Design and Participants Baseline Characteristics of a Crossover Randomized Controlled Trial of the Effect of Replacing SSBs with NSBs versus Water on Glucose Tolerance, Gut Microbiome and Cardiometabolic Risk in Overweight or Obese Adult SSB Consumer: Strategies to Oppose SUGARS with Non-Nutritive Sweeteners or Water (STOP Sugars NOW) Trial and Ectopic Fat Sub-Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7087-7815","authenticated-orcid":false,"given":"Sabrina","family":"Ayoub-Charette","sequence":"first","affiliation":[{"name":"Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"},{"name":"Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael\u2019s Hospital, Toronto, ON M5C 2T2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N\u00e9ma D.","family":"McGlynn","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"},{"name":"Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael\u2019s Hospital, Toronto, ON M5C 2T2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4187-7514","authenticated-orcid":false,"given":"Danielle","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences, Temerty Faculty of Medicine, University of 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University of Toronto, Toronto, ON M5S 1A8, Canada"},{"name":"Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael\u2019s Hospital, Toronto, ON M5C 2T2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxine","family":"Seider","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0022-4904","authenticated-orcid":false,"given":"Amel","family":"Taibi","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuck T.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, 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Sugar, Heart Disease and Stroke. Available online: https:\/\/www.heartandstroke.ca\/-\/media\/pdf-files\/canada\/2017-position-statements\/sugar-ps-eng.ashx."},{"key":"ref_3","unstructured":"Diabetes Canada (2019, September 07). Sugar & Diabetes. Available online: https:\/\/www.diabetes.ca\/en-CA\/advocacy---policies\/our-policy-positions\/sugar---diabetes."},{"key":"ref_4","unstructured":"US Department of Health and Human Services (2019, September 07). Cut down on Added Sugars, Available online: https:\/\/health.gov\/dietaryguidelines\/2015\/resources\/DGA_Cut-Down-On-Added-Sugars.pdf."},{"key":"ref_5","unstructured":"Health Canada (2019, September 07). Canada\u2019s Dietary Guidelines for Health Professionals and Policy Makers. Available online: https:\/\/food-guide.canada.ca\/static\/assets\/pdf\/CDG-EN-2018.pdf."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.3945\/ajcn.113.058362","article-title":"Sugar-sweetened beverages and weight gain in children and adults: A systematic review and meta-analysis","volume":"98","author":"Malik","year":"2013","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"h3576","DOI":"10.1136\/bmj.h3576","article-title":"Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: Systematic review, meta-analysis, and estimation of population attributable fraction","volume":"315","author":"Imamura","year":"2015","journal-title":"BMJ"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"914","DOI":"10.3945\/ajcn.115.107243","article-title":"Sugar-sweetened beverage consumption and incident hypertension: A systematic review and meta-analysis of prospective cohorts","volume":"102","author":"Jayalath","year":"2015","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1017\/S0007114514004383","article-title":"Sugar-sweetened beverages and risk of hypertension and CVD: A dose-response meta-analysis","volume":"113","author":"Xi","year":"2015","journal-title":"Br. J. Nutr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2113","DOI":"10.1161\/CIRCULATIONAHA.118.037401","article-title":"Long-term consumption of sugar-sweetened and artificially sweetened beverages and risk of mortality in US adults","volume":"139","author":"Malik","year":"2019","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.physbeh.2016.03.030","article-title":"Trends in the consumption of low-calorie sweeteners","volume":"164","author":"Sylvetsky","year":"2016","journal-title":"Physiol. Behav."},{"key":"ref_12","unstructured":"Dietary Guidelines Advisory Committee (2022, June 23). Scientific Report of the 2020 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and the Secretary of Health and Human Services, Available online: https:\/\/www.dietaryguidelines.gov\/sites\/default\/files\/2020-07\/ScientificReport_of_the_2020DietaryGuidelinesAdvisoryCommittee_first-print.pdf."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e126","DOI":"10.1161\/CIR.0000000000000569","article-title":"Low-calorie sweetened beverages and cardiometabolic health: A science advisory from the american heart association","volume":"138","author":"Johnson","year":"2018","journal-title":"Circulation"},{"key":"ref_14","unstructured":"American Diabetes Association (2020, March 10). Standards of Medical Care in Diabetes\u20142020. Available online: https:\/\/care.diabetesjournals.org\/content\/diacare\/suppl\/2019\/12\/20\/43.Supplement_1.DC1\/Standards_of_Care_2020.pdf."},{"key":"ref_15","unstructured":"Diabetes UK (2020, March 09). Evidence-Based Nutrition Guidelines for the Prevention and Management Of Diabetes. Available online: https:\/\/diabetes-resources-production.s3.eu-west-1.amazonaws.com\/resources-s3\/2018-03\/1373_Nutrition%20guidelines_0.pdf."},{"key":"ref_16","unstructured":"Rios-Leyvraz, M., and Montez, J. (2022). Health Effects of the Use of Non-Sugar Sweeteners: A Systematic Review and Meta-Analysis."},{"key":"ref_17","unstructured":"World Health Organization (2022, November 18). Launch Event for the Public Consultation on the Draft WHO Guideline on Use of Non-Sugar Sweeteners. Available online: https:\/\/www.who.int\/news-room\/events\/detail\/2022\/07\/15\/default-calendar\/launch-event-for-the-public-consultation-on-the-draft-who-guideline-on-use-of-non-sugar-sweeteners."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"S64","DOI":"10.1016\/j.jcjd.2017.10.009","article-title":"Diabetes Canada Clinical Practice Guidelines Expert Committee\u2014Chapter 11: Nutrition Therapy","volume":"42","author":"Sievenpiper","year":"2018","journal-title":"Can. J. Diabetes"},{"key":"ref_19","unstructured":"Canadian Food Inspection Agency (2018, July 24). Sweeteners. Available online: http:\/\/www.inspection.gc.ca\/food\/labelling\/food-labelling-for-industry\/sweeteners\/eng\/1387749708758\/1387750396304?chap=0."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/j.1541-4337.2006.tb00081.x","article-title":"Low-calorie sweeteners and other sugar substitutes: A review of the safety issues","volume":"5","author":"Kroger","year":"2006","journal-title":"Compr. Rev. Food Sci. Food Saf."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.fct.2017.05.047","article-title":"Critical review of the current literature on the safety of sucralose","volume":"106","author":"Magnuson","year":"2017","journal-title":"Food Chem. Toxicol."},{"key":"ref_22","unstructured":"American Diabetes Association (2018, November 09). American Heart Association\/American Diabetes Association Scientific Statement:Non-nutritive Sweeteners: A Potentially Useful Option\u2014with Caveats. Available online: http:\/\/www.diabetes.org\/newsroom\/press-releases\/2012\/ada-aha-sweetener-statement.html."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/j.jand.2012.03.009","article-title":"Position of the Academy of Nutrition and Dietetics: Use of nutritive and nonnutritive sweeteners","volume":"112","author":"Fitch","year":"2012","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_24","unstructured":"Health Canada (2018, July 24). 9. List of Permitted Sweeteners (Lists of Permitted Food Additives). Available online: https:\/\/www.canada.ca\/en\/health-canada\/services\/food-nutrition\/food-safety\/food-additives\/lists-permitted\/9-sweeteners.html."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Russell, C., Baker, P., Grimes, C., Lindberg, R., and Lawrence, M.A. (2022). Global trends in added sugars and non-nutritive sweetener use in the packaged food supply: Drivers and implications for public health. Public Health Nutr., 1\u201313.","DOI":"10.1017\/S1368980022001598"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"k4718","DOI":"10.1136\/bmj.k4718","article-title":"Association between intake of non-sugar sweeteners and health outcomes: Systematic review and meta-analyses of randomised and non-randomised controlled trials and observational studies","volume":"364","author":"Toews","year":"2019","journal-title":"BMJ"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"E929","DOI":"10.1503\/cmaj.161390","article-title":"Nonnutritive sweeteners and cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials and prospective cohort studies","volume":"189","author":"Azad","year":"2017","journal-title":"CMAJ"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"k5005","DOI":"10.1136\/bmj.k5005","article-title":"Non-sugar sweeteners and health","volume":"364","author":"Malik","year":"2019","journal-title":"BMJ"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1093\/ajcn\/nqaa260","article-title":"Low-energy sweeteners and cardiometabolic health: Is there method in the madness?","volume":"112","author":"Khan","year":"2020","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1093\/advances\/nmz137","article-title":"Perspective: Standards for research and reporting on low-energy (\u201cartificial\u201d) sweeteners","volume":"11","author":"Mela","year":"2020","journal-title":"Adv. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1017\/S0954422419000283","article-title":"Expert consensus on low-calorie sweeteners: Facts, research gaps and suggested actions","volume":"33","author":"Ashwell","year":"2020","journal-title":"Nutr. Res. Rev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"E1424","DOI":"10.1503\/cmaj.733381","article-title":"The importance of study design in the assessment of nonnutritive sweeteners and cardiometabolic health","volume":"189","author":"Sievenpiper","year":"2017","journal-title":"Can. Med. Assoc. J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e167","DOI":"10.1161\/STROKEAHA.119.025571","article-title":"Letter by Khan et al. regarding article, \u201cArtificially sweetened beverages and stroke, coronary heart disease, and all-cause mortality in the women\u2019s health initiative\u201d","volume":"50","author":"Khan","year":"2019","journal-title":"Stroke"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1038\/ijo.2015.177","article-title":"Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including meta-analyses, of the evidence from human and animal studies","volume":"40","author":"Rogers","year":"2016","journal-title":"Int. J. Obes."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e222092","DOI":"10.1001\/jamanetworkopen.2022.2092","article-title":"Association of Low- and No-Calorie Sweetened Beverages as a Replacement for Sugar-Sweetened Beverages with Body Weight and Cardiometabolic Risk: A Systematic Review and Meta-analysis","volume":"5","author":"McGlynn","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e13020","DOI":"10.1111\/obr.13020","article-title":"Effects of nonnutritive sweeteners on body weight and BMI in diverse clinical contexts: Systematic review and meta-analysis","volume":"21","year":"2020","journal-title":"Obes. Rev."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1093\/cdn\/nzaa061_060","article-title":"Relation of Change or Substitution of Low Calorie Sweetened Beverages with Cardiometabolic Outcomes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies","volume":"4","author":"Lee","year":"2020","journal-title":"Curr. Dev. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1917","DOI":"10.2337\/dc21-2130","article-title":"Relation of Change or Substitution of Low-and No-Calorie Sweetened Beverages with Cardiometabolic Outcomes: A Systematic Review and Meta-analysis of Prospective Cohort Studies","volume":"45","author":"Lee","year":"2022","journal-title":"Diabetes Care"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.jcjd.2012.11.001","article-title":"Food and dietary pattern-based recommendations: An emerging approach to clinical practice guidelines for nutrition therapy in diabetes","volume":"37","author":"Sievenpiper","year":"2013","journal-title":"Can. J. Diabetes."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Hunter, S.R., Reister, E.J., Cheon, E., and Mattes, R.D. (2019). Low calorie sweeteners differ in their physiological effects in humans. Nutrients, 11.","DOI":"10.3390\/nu11112717"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.physbeh.2015.05.036","article-title":"Physiological mechanisms by which non-nutritive sweeteners may impact body weight and metabolism","volume":"152","author":"Burke","year":"2015","journal-title":"Physiol. Behav."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1017\/S0007114519001570","article-title":"Short-term impact of sucralose consumption on the metabolic response and gut microbiome of healthy adults","volume":"122","author":"Thomson","year":"2019","journal-title":"Br. J. Nutr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1038\/nature13793","article-title":"Artificial sweeteners induce glucose intolerance by altering the gut microbiota","volume":"514","author":"Suez","year":"2014","journal-title":"Nature"},{"key":"ref_44","unstructured":"Chang, K. (2019, September 07). Artificial Sweeteners May Disrupt Body\u2019s Blood Sugar Controls. Available online: https:\/\/well.blogs.nytimes.com\/2014\/09\/17\/artificial-sweeteners-may-disrupt-bodys-blood-sugar-controls\/."},{"key":"ref_45","unstructured":"Kirkey, S. (2019, September 07). Fake Sugars Linked to Obesity, Heart Disease. Available online: http:\/\/nationalpost.com\/news\/0717-na-sugar."},{"key":"ref_46","unstructured":"Faherty, S. (2019, September 07). Artificial Sweeteners May Have Despicable Impacts on Gut Microbes. Available online: https:\/\/blogs.scientificamerican.com\/guest-blog\/artificial-sweeteners-may-have-despicable-impacts-on-gut-microbes\/."},{"key":"ref_47","unstructured":"Sifferlin, A. (2019, September 07). Artificial Sweeteners are Linked to Weight Gain \u2014Not Weight Loss. Available online: http:\/\/time.com\/4859012\/artificial-sweeteners-weight-loss\/."},{"key":"ref_48","unstructured":"Vergano, D. (2019, September 07). Artificial Sweeteners May Trigger Blood Sugar Risks. Available online: http:\/\/news.nationalgeographic.com\/news\/2014\/09\/140917-sweeteners-artificial-blood-sugar-diabetes-health-ngfood\/."},{"key":"ref_49","unstructured":"Leung, W. (2019, September 07). Sugar Substitutes Associated with Weight Gain and Health Problems, Study Says. Available online: https:\/\/www.theglobeandmail.com\/news\/national\/sugar-substitutes-linked-to-weight-gain-and-health-problems-study-says\/article35704562\/."},{"key":"ref_50","unstructured":"Brait, E. (2019, September 07). More Research Needed into the Effects Sugar Substitutes Have on Health. Available online: https:\/\/www.thestar.com\/life\/2017\/07\/17\/more-research-needed-into-the-effects-sugar-substitutes-have-on-health.html."},{"key":"ref_51","unstructured":"Thompson, D. (2019, September 07). Do Artificial Sweeteners Raise Odds for Obesity?. Available online: http:\/\/www.webmd.com\/food-recipes\/news\/20170717\/do-artificial-sweeteners-raise-odds-for-obesity#1."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40168-020-00976-w","article-title":"High-dose saccharin supplementation does not induce gut microbiota changes or glucose intolerance in healthy humans and mice","volume":"9","author":"Serrano","year":"2021","journal-title":"Microbiome"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Ahmad, S.Y., Friel, J., and Mackay, D. (2020). The Effects of Non-Nutritive Artificial Sweeteners, Aspartame and Sucralose, on the Gut Microbiome in Healthy Adults: Secondary Outcomes of a Randomized Double-Blinded Crossover Clinical Trial. Nutrients, 12.","DOI":"10.3390\/nu12113408"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1139\/apnm-2019-0359","article-title":"The effect of the artificial sweeteners on glucose metabolism in healthy adults: A randomized, double-blinded, crossover clinical trial","volume":"45","author":"Ahmad","year":"2020","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"3307","DOI":"10.1016\/j.cell.2022.07.016","article-title":"Personalized microbiome-driven effects of non-nutritive sweeteners on human glucose tolerance","volume":"185","author":"Suez","year":"2022","journal-title":"Cell"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1093\/nutrit\/nuw032","article-title":"Biological fate of low-calorie sweeteners","volume":"74","author":"Magnuson","year":"2016","journal-title":"Nutr. Rev."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"e000547","DOI":"10.3945\/cdn.117.000547","article-title":"Research priorities for studies linking intake of low-calorie sweeteners and potentially related health outcomes: Research methodology and study design","volume":"1","author":"Bright","year":"2017","journal-title":"Curr. Dev. Nutr."},{"key":"ref_58","unstructured":"Canadian Institutes of Health Research in Partnership with Health Canada (2020, March 09). Operating Grant: Sugar and Health ARCHIVED. Available online: https:\/\/www.researchnet-recherchenet.ca\/rnr16\/vwOpprtntyDtls.do?prog=2554&printfriendly=true."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1016\/S2213-8587(19)30076-2","article-title":"Understanding the mechanisms of reversal of type 2 diabetes","volume":"7","author":"Taylor","year":"2019","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_60","unstructured":"Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, and Social Sciences and Humanities Research Council of Canada (2022, October 05). Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans, December 2018. Available online: https:\/\/ethics.gc.ca\/eng\/documents\/tcps2-2018-en-interactive-final.pdf."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1016\/S0140-6736(05)67402-8","article-title":"The metabolic syndrome\u2014a new worldwide definition","volume":"366","author":"Alberti","year":"2005","journal-title":"Lancet"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity","volume":"120","author":"Alberti","year":"2009","journal-title":"Circulation"},{"key":"ref_63","unstructured":"World Health Organization (2011). Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1038\/ejcn.2009.70","article-title":"Appropriateness of waist circumference and waist-to-hip ratio cutoffs for different ethnic groups","volume":"64","author":"Lear","year":"2010","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1016\/j.cmet.2017.05.002","article-title":"Bread affects clinical parameters and induces gut microbiome-associated personal glycemic responses","volume":"25","author":"Korem","year":"2017","journal-title":"Cell Metab."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1053\/j.gastro.2018.06.045","article-title":"Effects of prebiotics vs a diet low in FODMAPs in patients with functional gut disorders","volume":"155","author":"Huaman","year":"2018","journal-title":"Gastroenterology"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Ibr\u00fcgger, S., G\u00f8bel, R.J., Vestergaard, H., Licht, T.R., Fr\u00f8ki\u00e6r, H., Linneberg, A., Hansen, T., Gupta, R., Pedersen, O., and Kristensen, M. (2014). Two randomized cross-over trials assessing the impact of dietary gluten or wholegrain on the gut microbiome and host metabolic health. J. Clin. Trials., 4.","DOI":"10.4172\/2167-0870.1000178"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1136\/gutjnl-2017-314786","article-title":"Whole grain-rich diet reduces body weight and systemic low-grade inflammation without inducing major changes of the gut microbiome: A randomised cross-over trial","volume":"68","author":"Roager","year":"2019","journal-title":"Gut"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"e035677","DOI":"10.1136\/bmjopen-2019-035677","article-title":"Antibiotic-induced changes in the human gut microbiota for the most commonly prescribed antibiotics in primary care in the UK: A systematic review","volume":"10","author":"Elvers","year":"2020","journal-title":"BMJ open"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.cjca.2017.03.005","article-title":"Hypertension Canada\u2019s 2017 guidelines for diagnosis, risk assessment, prevention, and treatment of hypertension in adults","volume":"33","author":"Leung","year":"2017","journal-title":"Can. J. Cardiol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"4516","DOI":"10.1021\/acs.jafc.7b00404","article-title":"Application of Liquid Chromatography-Tandem Mass Spectrometry To Determine Urinary Concentrations of Five Commonly Used Low-Calorie Sweeteners: A Novel Biomarker Approach for Assessing Recent Intakes?","volume":"65","author":"Logue","year":"2017","journal-title":"J. Agric. Food Chem."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1016\/S0140-6736(63)91501-0","article-title":"Effects of low-carbohydrate diet and diabetes mellitus on plasma concentrations of glucose, non-esterified fatty acid, and insulin during oral glucose-tolerance tests","volume":"1","author":"Hales","year":"1963","journal-title":"Lancet"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"386","DOI":"10.2337\/diab.9.5.386","article-title":"The effect of prior carbohydrate intake on the oral glucose tolerance test","volume":"9","author":"Wilkerson","year":"1960","journal-title":"Diabetes"},{"key":"ref_74","unstructured":"WHO Study Group on Diabetes Mellitus & World Health Organization (1985). Diabetes Mellitus: Report of a WHO Study Group [meeting held in Geneva from 11 to 16 February 1985]."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"8228","DOI":"10.1128\/AEM.71.12.8228-8235.2005","article-title":"UniFrac: A new phylogenetic method for comparing microbial communities","volume":"71","author":"Lozupone","year":"2005","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1038\/s41587-019-0209-9","article-title":"Reproducible, interactive, scalable and extensible microbiome data science using QIIME 2","volume":"37","author":"Bolyen","year":"2019","journal-title":"Nat. Biotechnol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.2337\/diacare.22.9.1462","article-title":"Insulin sensitivity indices obtained from oral glucose tolerance testing: Comparison with the euglycemic insulin clamp","volume":"22","author":"Matsuda","year":"1999","journal-title":"Diabetes Care"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-230X-6-33","article-title":"The Fatty Liver Index: A simple and accurate predictor of hepatic steatosis in the general population","volume":"6","author":"Bedogni","year":"2006","journal-title":"BMC Gastroenterol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1002\/lipd.12046","article-title":"Natural Abundance Carbon Isotopic Analysis Indicates the Equal Contribution of Local Synthesis and Plasma Uptake to Palmitate Levels in the Mouse Brain","volume":"53","author":"Lacombe","year":"2018","journal-title":"Lipids"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1038\/ejcn.2010.160","article-title":"Urinary fructose: A potential biomarker for dietary fructose intake in children","volume":"64","author":"Johner","year":"2010","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/BF00280883","article-title":"Homeostasis model assessment: Insulin resistance and \u03b2-cell function from fasting plasma glucose and insulin concentrations in man","volume":"28","author":"Matthews","year":"1985","journal-title":"Diabetologia"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1590\/S0004-28032010000200009","article-title":"Insulin resistance index (HOMA-IR) in the differentiation of patients with non-alcoholic fatty liver disease and healthy individuals","volume":"47","author":"Salgado","year":"2010","journal-title":"Arq. Gastroenterol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1038\/oby.2008.307","article-title":"Hyperbolic relationship between insulin secretion and sensitivity on oral glucose tolerance test","volume":"16","author":"Retnakaran","year":"2008","journal-title":"Obesity"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1111\/j.1464-5491.2009.02841.x","article-title":"Evaluation of proposed oral disposition index measures in relation to the actual disposition index","volume":"26","author":"Retnakaran","year":"2009","journal-title":"Diabet. Med."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"5824","DOI":"10.1210\/jcem.86.12.8105","article-title":"Importance of early phase insulin secretion to intravenous glucose tolerance in subjects with type 2 diabetes mellitus","volume":"86","author":"Kahn","year":"2001","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1111\/j.1464-5491.1994.tb00273.x","article-title":"Understanding oral glucose tolerance: Comparison of glucose or insulin measurements during the oral glucose tolerance test with specific measurements of insulin resistance and insulin secretion","volume":"11","author":"Phillips","year":"1994","journal-title":"Diabet. Med."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1038\/nbt.2676","article-title":"Predictive functional profiling of microbial communities using 16S rRNA marker gene sequences","volume":"31","author":"Langille","year":"2013","journal-title":"Nat. Biotechnol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"336","DOI":"10.2337\/diacare.21.3.336","article-title":"Variation of postprandial plasma glucose, palatability, and symptoms associated with a standardized mixed test meal versus 75 g oral glucose","volume":"21","author":"Wolever","year":"1998","journal-title":"Diabetes Care"},{"key":"ref_89","unstructured":"Health Canada (2020, March 09). Draft Guidance Document on Food Health Claims Related to the Reduction in Post-Prandial Glycaemic Response. Available online: https:\/\/www.canada.ca\/en\/health-canada\/services\/food-nutrition\/public-involvement-partnerships\/technical-consultation-draft-guidance-document-food-health-claims-related-post-prandial-glycaemia.html."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"283","DOI":"10.3945\/ajcn.111.022533","article-title":"Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: A 6-mo randomized intervention study","volume":"95","author":"Maersk","year":"2012","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Braunstein, C.R., Noronha, J.C., Glenn, A.J., Viguiliouk, E., Noseworthy, R., Khan, T.A., Au-Yeung, F., Blanco Mejia, S., Wolever, T.M., and Josse, R.G. (2018). A double-blind, randomized controlled, acute feeding equivalence trial of small, catalytic doses of fructose and allulose on postprandial blood glucose metabolism in healthy participants: The Fructose and Allulose Catalytic Effects (FACE) Trial. Nutrients, 10.","DOI":"10.3390\/nu10060750"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"2335","DOI":"10.1002\/oby.21310","article-title":"Sugar- and artificially sweetened beverages and intrahepatic fat: A randomized controlled trial","volume":"23","author":"Campos","year":"2015","journal-title":"Obesity"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.2517-6161.1995.tb02031.x","article-title":"Controlling the false discovery rate: A practical and powerful approach to multiple testing","volume":"57","author":"Benjamini","year":"1995","journal-title":"J. R. Stat. Soc. Ser. B"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/S0166-4328(01)00297-2","article-title":"Controlling the false discovery rate in behavior genetics research","volume":"125","author":"Benjamini","year":"2001","journal-title":"Behav. Brain Res."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1214\/aos\/1013699998","article-title":"The control of the false discovery rate in multiple testing under dependency","volume":"29","author":"Benjamini","year":"2001","journal-title":"Ann. Statist."},{"key":"ref_96","unstructured":"Food and Drug Administration (2023, January 23). Multiple Endpoints in Clinical Trials: Guidance for Industry, Available online: https:\/\/www.fda.gov\/media\/162416\/download."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1080\/19440049.2020.1843717","article-title":"Tiered intake assessment for low-and no-calorie sweeteners in beverages","volume":"38","author":"Tran","year":"2021","journal-title":"Food Addit. Contam. Part A"},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Dunford, E.K., Taillie, L.S., Miles, D.R., Eyles, H., Tolentino-Mayo, L., and Ng, S.W.J.N. (2018). Non-Nutritive Sweeteners in the Packaged Food Supply\u2014An Assessment across 4 Countries. Nutrients, 10.","DOI":"10.3390\/nu10020257"},{"key":"ref_99","first-page":"23","article-title":"Beverage consumption of Canadian adults","volume":"19","author":"Garriguet","year":"2008","journal-title":"Health Rep."},{"key":"ref_100","unstructured":"GlobalData (2021, November 03). Soft Drinks Market Analyzer Database. Available online: www.globaldata.com."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.tem.2013.05.005","article-title":"Artificial sweeteners produce the counterintuitive effect of inducing metabolic derangements","volume":"24","author":"Swithers","year":"2013","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1053\/j.gastro.2019.11.305","article-title":"Microbial diversity in clinical microbiome studies: Sample size and statistical power considerations","volume":"158","author":"Song","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"6272","DOI":"10.1016\/j.csbj.2021.11.029","article-title":"Mathematical-based microbiome analytics for clinical translation","volume":"19","author":"Narayana","year":"2021","journal-title":"Comput. Struct. Biotechnol. J."},{"key":"ref_104","first-page":"S6","article-title":"Diabetes Canada clinical practice guidelines expert committee","volume":"42","author":"Robyn","year":"2018","journal-title":"Can. J. Diabet."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"h4672","DOI":"10.1136\/bmj.h4672","article-title":"Understanding the Hawthorne effect","volume":"351","author":"Sedgwick","year":"2015","journal-title":"BMJ"},{"key":"ref_106","unstructured":"Statistics Canada (2023, January 14). Health Fact Sheets. Overweight and Obese Adults. Available online: https:\/\/www150.statcan.gc.ca\/n1\/pub\/82-625-x\/2019001\/article\/00005-eng.htm."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12937-019-0488-5","article-title":"Beverage consumption and energy intake among Canadians: Analyses of 2004 and 2015 national dietary intake data","volume":"18","author":"Jones","year":"2019","journal-title":"Nutr. J."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"2175","DOI":"10.1017\/S1368980012003898","article-title":"Beverage consumption patterns of Canadian adults aged 19 to 65 years","volume":"15","author":"Nikpartow","year":"2012","journal-title":"Public Health Nutr."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/1047-2797(95)00095-X","article-title":"Diabetes mellitus, race, and socioeconomic status a population-based study","volume":"6","author":"Brancati","year":"1996","journal-title":"Ann. Epidemiol."},{"key":"ref_110","unstructured":"Canadian Institute for Health Information (2021, October 11). Diabetes Care Gaps and Disparities in Canada. Available online: https:\/\/publications.gc.ca\/collections\/collection_2012\/icis-cihi\/H117-5-7-2009-eng.pdf."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12967-017-1175-y","article-title":"Influence of diet on the gut microbiome and implications for human health","volume":"15","author":"Singh","year":"2017","journal-title":"J. Transl. Med."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1136\/gutjnl-2020-321747","article-title":"Gut microbiome stability and resilience: Elucidating the response to perturbations in order to modulate gut health","volume":"70","author":"Fassarella","year":"2021","journal-title":"Gut"},{"key":"ref_113","unstructured":"World Health Organization (2018, November 09). Guideline: Sugars Intake for Adults and Children. Available online: http:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/149782\/9789241549028_eng.pdf;jsessionid=F9FAD19E165BB45830BA1A484FC6FD93?sequence=1."},{"key":"ref_114","unstructured":"Health Canada (2017, August 25). Summary of Guiding Principles and Recommendations. Available online: https:\/\/www.foodguideconsultation.ca\/guiding-principles-summary."},{"key":"ref_115","unstructured":"Diabetes Canada (2017, August 25). Diabetes Canada\u2019s Position on Sugars. Available online: http:\/\/www.diabetes.ca\/about-cda\/public-policy-position-statements\/sugars."},{"key":"ref_116","unstructured":"U.S. Department of Health and Human Services and U.S. Department of Agriculture (2022, January 20). 2015\u20142020 Dietary Guidelines for Americans. 8th Edition., Available online: https:\/\/health.gov\/dietaryguidelines\/2015\/guidelines\/."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/5\/1238\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:44:45Z","timestamp":1760121885000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/5\/1238"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,28]]},"references-count":116,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["nu15051238"],"URL":"https:\/\/doi.org\/10.3390\/nu15051238","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,28]]}}}