Appetite-Regulating Hormones Lower After Sucrose Versus Glucose

A first-of-its-kind study examines the differing effects of sucrose versus glucose intake on circulating glucagon-like peptide-1 (GLP-1).  

The intake of simple sugars is a major topic of concern. The proportion of daily energy consumed through fructose intake has increased rapidly, promoting obesity and metabolic syndrome. Researchers suggest that fructose intake will differentially change other simple sugar feeding methods, leading to weight gain. One of the basic fructose mechanisms in feeding is its intake of incretin and gut-derived hormones, affecting subjective hunger.  

Former investigations have determined that fructose’s acute ingestion raises blood glucose and circulating insulin concentration, though to a lesser extent than glucose intake. The outcomes of fructose ingestion on these circulating hormones associated with regulating hunger may expose some of the relationships between increased dietary fructose and the development of obesity. However, fructose is usually not consumed in isolation, and there has been limited research into how real-world sugars like sucrose affect endocrine response. Sucrose, a.k.a. table sugar, is a disaccharide composed of equal parts glucose and fructose. 

A first-of-its-kind study aimed to investigate how oral sucrose versus glucose alters hunger regulating hormones and how biological factors influence endocrine responses. The study evaluated the following biological factors; body mass index (BMI), insulin sensitivity, and sex. Investigators enlisted young adults between the age of 18 to 35 years. They were right-handed, did not smoke, and had a stable weight for at least three months before examination visits. Subjects did not have a history of eating disorders or diabetes, and they were non-dieters, not on medications, and no record for other medical diseases. Sixty-nine adults completed the study. Researchers conducted the investigation at the Dornsife Social and Behavioral Phlebotomy Lab at the University of Southern California. The examination started with a first screening appointment, an oral sucrose tolerance test (OSTT), and an oral glucose tolerance test (OGTT). Researchers performed these tests after 12-hours of overnight fasting. 

Investigators randomized 2 drink sessions for participants, with intervals between sessions ranging between two and thirty days. Participants had 75 grams of either glucose or sucrose, combined with 0.45 grams of unsweetened cherry flavoring dissolved in 300 mL of water. Throughout the examination meetings, investigators collected blood samples at baseline, ten, thirty-five, and a hundred twenty minutes post drink. Here, they measured plasma glucose, insulin, peptide Y.Y. (PYY), acyl-ghrelin, and GLP-1, according to a standard OGTT. Two hours after the OGTT, they computed the whole-body insulin sensitivity index (ISI). An ISI, same or lower than 2.5, categorized subjects as insulin resistant, while an ISI over 2.5 placed them as insulin sensitive.  

The researchers made many comparisons to evaluate the endocrine responses between the intake of both sugars. They employed paired t-tests to compare the baseline amount of hormones between glucose and sucrose intakes, while utilizing unpaired t-tests and variance analysis to compare baseline measures between BMI, ISI, and sex groups. Other statistical analyses applied were linear mixed-effects regression model and unstructured covariance matrixes. For affirming the results, researchers considered P values less than .05 as statistically meaningful. Results showed that sucrose intake produced less increase in glucose (P < .001), peptide YY (P = .02), GLP-1 (P< .001), and insulin (P < .001). In contrast, acyl ghrelin suppression among both sugars was very similar. Subjects with obesity had smaller increases in glucose and peptide Y.Y. levels after having sucrose. According to investigators, the study presented a relationship between insulin sensitivity and sugar for glucose (P = .003). Also, researchers noted interactions with insulin and sex by sugar and for GLP-1. Ultimately, men opposed to women showed smaller increases in GLP-1 when they ingested oral sucrose. 

In conclusion, oral sucrose provides lower increases in peripheral hormones involved in satiety signaling than oral glucose. This investigation highlights the significance of examining individual characteristics that may affect the metabolic consequences of consuming specific nutrients, such as different sugar types. 

Practice Pearls: 

• Sucrose is less effective than glucose for signaling postprandial satiation. 
• Biological factors affect differential hormone responses to sucrose versus glucose ingestion. 
• Different sugar types may affect metabolic consequences. 

Romo-Romo, Alonso, et al. “Sucralose Consumption over 2 Weeks in Healthy Subjects Does Not Modify Fasting Plasma Concentrations of Appetite-Regulating Hormones:” Journal of the Academy of Nutrition and Dietetics 120.8 (2020): 1295-1304. 

Yunker, Alexandra G., et al. “Appetite-Regulating Hormones Are Reduced After Oral Sucrose vs. Glucose: Influence of Obesity, Insulin Resistance, and Sex.” The Journal of Clinical Endocrinology & Metabolism (2020). 

Marianis Barreto Quintana, PharmD. Candidate, LECOM School of Pharmacy