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GEBELİKTE STEVİA KULLANIMI

Yıl 2021, Cilt 2, Sayı 1, 76 - 92, 26.04.2021

Öz

Çeşitli yiyecek ve içeceklerde kullanılan şekere alternatif olarak, çoğu ülkede oldukça popülerdir. Stevia dünyanın birçok yerinde tatlandırıcı olarak kullanılmaktadır. Steviarebaudiana Bertoni, doğal tatlandırıcı özelliğini steviol glikozit kaynağından alan Asteraceae familyasına ait dallı bir bitkidir. Son zamanlarda, stevianın potansiyel kullanımlarını keşfetmeye yönelik ilgi artmıştır ve çeşitli çalışmalar, stevianın biyokimyasal bileşiminin sağlık üzerine yararlarının olduğunu bildirmektedir. Hayvanlarda ve insanlarda yapılan çeşitli çalışmalarda bu bitkinin güvenli olup olmadığı henüz belirlenememiştir. Gebelik sırasında fazla ağırlık kazanımını engellemek amacıyla için birçok kadın, kalorisiz tatlandırıcılar içeren yiyecek ve içecekleri tüketmeyi tercih etmektedir. Literatürde gebelikte besin değeri olmayan tatlandırıcıların tüketimi için belirli bir kılavuz bulunmamaktadır. Bununla birlikte, klinik etkinliği ve kullanımı hala tartışma konusudur. Bu nedenle, gebelerde stevia kullanımının güvenlik, sağlık yararları ve fizyolojik mekanizmaları hakkında ayrıntılı bilgi sağlamak gerekmektedir. Güncel kanıta dayalı beslenme kılavuzlarından haberdar olmak ve tüketicileri besin değeri olmayan tatlandırıcıların kullanımıyla ilişkili potansiyel riskler konusunda bilgilendirmek sağlık profesyonellerinin görevidir. Sağlık profesyonellerinin stevia kullanımlarını önermeden önce gebelere besin değeri olmayan tatlandırıcılar kullanımının genel bireysel faydalarını ve risklerini değerlendirmeleri, besin değeri olmayan tatlandırıcıların fetüs için güvenli olup olmadığını ve gebelik sırasında kullanmaya devam edip edemeyecekleri konusunda bilgi sağlamaları gereklidir. Bu derlemede gebelikte kalorisiz tatlandırıcılardan popüler hale gelen stevia kullanımına ilişkin mevcut kanıtlar gözden geçirilecektir.

Kaynakça

  • Abdel-Salam, O. M., Salem, N. A., & Hussein, J. S. (2012). Effect of aspartame on oxidative stress and monoamine neurotransmitter levels in lipopolysaccharide-treated mice. Neurotoxicity research, 21(3), 245-255.
  • Abdullateef, R. A., & Osman, M. (2012). Studies on effects of pruning on vegetative traits in Stevia rebaudiana Bertoni (Compositae). International Journal of Biology, 4(1), 146–153.
  • Ahmad, J., Khan, I., Blundell, R., Azzopardi, J., & Mahomoodally, M. F. (2020). Stevia rebaudiana Bertoni.: An updated review of its health benefits, industrial applications and safety. Trends in Food Science & Technology.
  • Araújo, J. R., Martel, F., & Keating, E. (2014). Exposure to non-nutritive sweeteners during pregnancy and lactation: Impact in programming of metabolic diseases in the progeny later in life. Reproductive Toxicology, 49, 196-201.
  • Becker, S. L., Chiang, E., Plantinga, A., Carey, H. V., Suen, G., & Swoap, S. J. (2020). Effect of stevia on the gut microbiota and glucose tolerance in a murine model of diet-induced obesity. FEMS microbiology ecology, 96(6), fiaa079.
  • Carrera-Lanestosa, A., Moguel-Ordóñez, Y., & Segura-Campos, M. (2017). Stevia rebaudiana Bertoni: a natural alternative for treating diseases associated with metabolic syndrome. Journal of medicinal food, 20(10), 933-943.
  • Cavagnari, B. M. (2020). Edulcorantes no calóricos en embarazo y lactancia. Revista Española de Salud Pública, 93, e201908052.
  • Chranioti, C., Chanioti, S., & Tzia, C. (2016). Comparison of spray, freeze and oven drying as a means of reducing bitter aftertaste of steviol glycosides (derived from Stevia rebaudiana Bertoni plant)–Evaluation of the final products. Food Chemistry, 190, 1151-1158.
  • Collison, K. S., Makhoul, N. J., Zaidi, M. Z., Al-Rabiah, R., Inglis, A., Andres, B. L., ... & Al-Mohanna, F. A. (2012). Interactive effects of neonatal exposure to monosodium glutamate and aspartame on glucose homeostasis. Nutrition & metabolism, 9(1), 1-13.
  • Deniņa, I., Semjonovs, P., Fomina, A., Treimane, R., & Linde, R. (2014). The influence of stevia glycosides on the growth of L actobacillus reuteri strains. Letters in applied microbiology, 58(3), 278-284.
  • EFSA Panel on Food Additives and Flavourings (FAF), Younes, M., Aquilina, G., Engel, K. H., Fowler, P., Frutos Fernandez, M. J., ... & Castle, L. (2020). Safety of a proposed amendment of the specifications for steviol glycosides (E 960) as a food additive: to expand the list of steviol glycosides to all those identified in the leaves of Stevia Rebaudiana Bertoni. EFSA Journal, 18(4), e06106.
  • EFSA Panel on Food Additives and Nutrient Sources Added to Food. (2015). Scientific opinion on the safety of the proposed amendment of the specifications for steviol glycosides (E 960) as a food additive. EFSA Journal, 13(12), 4316.
  • Englund-Ögge, L., Brantsæter, A. L., Haugen, M., Sengpiel, V., Khatibi, A., Myhre, R., ... & Jacobsson, B. (2012). Association between intake of artificially sweetened and sugar-sweetened beverages and preterm delivery: a large prospective cohort study. The American journal of clinical nutrition, 96(3), 552-559.
  • Fuentealba Arevalo, F., Espinoza Espinoza, J., Salazar Ibacache, C., & Duran Aguero, S. (2019). Consumption of non-caloric sweeteners among pregnant Chileans: a cross-sectional study,36(4), 890-897.
  • Gardana, C., Scaglianti, M., & Simonetti, P. (2010). Evaluation of steviol and its glycosides in Stevia rebaudiana leaves and commercial sweetener by ultra-high-performance liquid chromatography-mass spectrometry. Journal of chromatography A, 1217(9), 1463-1470.
  • Gardner, C., Wylie-Rosett, J., Gidding, S. S., Steffen, L. M., Johnson, R. K., Reader, D., & Lichtenstein, A. H. (2012). Nonnutritive sweeteners: current use and health perspectives: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation, 126(4), 509-519.
  • Geuns, J. M., Buyse, J., Vankeirsbilck, A., & Temme, E. H. (2007). Metabolism of stevioside by healthy subjects. Experimental biology and medicine, 232(1), 164-173.
  • Gregersen, S., Jeppesen, P. B., Holst, J. J., & Hermansen, K. (2004). Antihyperglycemic effects of stevioside in type 2 diabetic subjects. Metabolism, 53(1), 73-76.
  • Grembecka, M. (2015). Sugar alcohols—their role in the modern world of sweeteners: a review. European Food Research and Technology, 241(1), 1-14.
  • Gupta, E., Purwar, S., Sundaram, S., & Rai, G. K. (2013). Nutritional and therapeutic values of Stevia rebaudiana: A review. Journal of Medicinal Plants Research, 7(46), 3343-3353.
  • Halldorsson, T. I., Strøm, M., Petersen, S. B., & Olsen, S. F. (2010). Intake of artificially sweetened soft drinks and risk of preterm delivery: a prospective cohort study in 59,334 Danish pregnant women. The American journal of clinical nutrition, 92(3), 626-633.
  • Hsieh, M. H., Chan, P., Sue, Y. M., Liu, J. C., Liang, T. H., Huang, T. Y., ... & Chen, Y. J. (2003). Efficacy and tolerability of oral stevioside in patients with mild essential hypertension: a two-year, randomized, placebo-controlled study. Clinical therapeutics, 25(11), 2797-2808.
  • Huang, X. Y., Tian, M., Pei, D., Liu, J. F., & Di, D. L. (2018). Development of overlapping repeated separation of steviol glycosides with counter current chromatography and a comparison with a conventional repeated separation method. Journal of separation science, 41(15), 3163-3169.
  • Jahangir Chughtai, M. F., Pasha, I., Zahoor, T., Khaliq, A., Ahsan, S., Wu, Z., ... & Tanweer, S. (2020). Nutritional and therapeutic perspectives of Stevia rebaudiana as emerging sweetener; a way forward for sweetener industry. CYTA-Journal of Food, 18(1), 164-177.
  • Kobus-Moryson, M., & Gramza-Michałowska, A. (2015). Directions on the use of stevia leaves (Stevia rebauidana) as an additive in food products. Acta Scientiarum Polonorum Technologia Alimentaria, 14(1), 5-13.
  • Kumar, R. D., & Oommen, O. V. (2008). Stevia Rebaudiana Bertani does not produce female reproductive toxic effect: Study in Swiss albino mouse. J. Endocrinol Reprod, 12, 57-60.
  • Lemus-Mondaca, R., Vega-Gálvez, A., Zura-Bravo, L., & Ah-Hen, K. (2012). Stevia rebaudiana Bertoni, source of a high-potency natural sweetener: A comprehensive review on the biochemical, nutritional and functional aspects. Food chemistry, 132(3), 1121-1132.
  • Liauchonak, I., Qorri, B., Dawoud, F., Riat, Y., & Szewczuk, M. R. (2019). Non-nutritive sweeteners and their implications on the development of metabolic syndrome. Nutrients, 11(3), 644.
  • Lopes, S. M. S., Francisco, M. G., Higashi, B., de Almeida, R. T. R., Krausová, G., Pilau, E. J., ... & de Oliveira, A. J. B. (2016). Chemical characterization and prebiotic activity of fructo-oligosaccharides from Stevia rebaudiana (Bertoni) roots and in vitro adventitious root cultures. Carbohydrate polymers, 152, 718-725.
  • Madan, S., Ahmad, S., Singh, G. N., Kohli, K., Kumar, Y., Singh, R., & Garg, M. (2010). Stevia rebaudiana (Bert.) Bertoni-a review, 1(September), 267–286.
  • Magnuson, B. A., Burdock, G., Doull, J., Kroes, R. M., Marsh, G. M., Pariza, M. W., ... & Williams, G. M. (2007). Aspartame: a safety evaluation based on current use levels, regulations, and toxicological and epidemiological studies. Critical reviews in toxicology, 37(8), 629-727.
  • Maslova, E., Strøm, M., Olsen, S. F., & Halldorsson, T. I. (2013). Consumption of artificially-sweetened soft drinks in pregnancy and risk of child asthma and allergic rhinitis. PloS one, 8(2), e57261.
  • Mischke, M., & Plösch, T. (2013). More than just a gut instinct–the potential interplay between a baby's nutrition, its gut microbiome, and the epigenome. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 304(12), R1065-R1069.
  • Moriconi, E., Feraco, A., Marzolla, V., Infante, M., Lombardo, M., Fabbri, A., & Caprio, M. (2020). Neuroendocrine and metabolic effects of low-calorie and non-calorie sweeteners. Frontiers in Endocrinology, 11, 444.
  • Nettleton, J. E., Cho, N. A., Klancic, T., Nicolucci, A. C., Shearer, J., Borgland, S. L., ... & Reimer, R. A. (2020). Maternal low-dose aspartame and stevia consumption with an obesogenic diet alters metabolism, gut microbiota and mesolimbic reward system in rat dams and their offspring. Gut, 69(10), 1807-1817.
  • Nikiforov, A. I., Rihner, M. O., Eapen, A. K., & Thomas, J. A. (2013). Metabolism and toxicity studies supporting the safety of rebaudioside D. International journal of toxicology, 32(4), 261-273.
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  • Palatnik, A., Moosreiner, A., & Olivier-Van Stichelen, S. (2020). Consumption of non-nutritive sweeteners during pregnancy. American journal of obstetrics and gynecology, 223(2), 211-218.
  • Philippaert, K., Pironet, A., Mesuere, M., Sones, W., Vermeiren, L., Kerselaers, S., ... & Vennekens, R. (2017). Steviol glycosides enhance pancreatic beta-cell function and taste sensation by potentiation of TRPM5 channel activity. Nature communications, 8(1), 1-16.
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USE OF STEVIA IN PREGNANCY

Yıl 2021, Cilt 2, Sayı 1, 76 - 92, 26.04.2021

Öz

As an alternative to sugar used in a variety of foods and beverages, stevia is extremely popular in most countries. It is used as a sweetener in many parts of the world.Stevia rebaudianaBertoni is a branched plant belonging to the Asteraceae family, which derives its natural sweetener from the steviol glycoside source. The interest in exploring the potential uses of stevia has recently increased, and several studies report that the biochemical composition of stevia has benefits for health.The safety of this herb has not yet been proved in various studies on animals and humans. In order to prevent excess weight gain during pregnancy, many women prefer to consume foods and drinks that contain non-calorie sweeteners.In literature, there is no specific guideline for the consumption of non-nutritional sweeteners during pregnancy. However, its clinical efficacy and use is still a matter of debate. Therefore, it is necessary to provide detailed information about the safety, benefits, and physiological mechanisms of stevia use in pregnant women.It is the duty of health professionals to be aware of current evidence-based dietary guidelines, and to inform consumers about the potential risks associated with the use of non-nutritional sweeteners.Before recommending the use of stevia, healthcare professionals should evaluate the general individual benefits and risks of using non-nutritional sweeteners, and provide information on whether non-nutritional sweeteners are safe for the fetus and whether they can continue to use them during pregnancy.In this review, the current evidence on the use of stevia, which has become popular among non-calorie sweeteners in pregnancy, will be reviewed.

Kaynakça

  • Abdel-Salam, O. M., Salem, N. A., & Hussein, J. S. (2012). Effect of aspartame on oxidative stress and monoamine neurotransmitter levels in lipopolysaccharide-treated mice. Neurotoxicity research, 21(3), 245-255.
  • Abdullateef, R. A., & Osman, M. (2012). Studies on effects of pruning on vegetative traits in Stevia rebaudiana Bertoni (Compositae). International Journal of Biology, 4(1), 146–153.
  • Ahmad, J., Khan, I., Blundell, R., Azzopardi, J., & Mahomoodally, M. F. (2020). Stevia rebaudiana Bertoni.: An updated review of its health benefits, industrial applications and safety. Trends in Food Science & Technology.
  • Araújo, J. R., Martel, F., & Keating, E. (2014). Exposure to non-nutritive sweeteners during pregnancy and lactation: Impact in programming of metabolic diseases in the progeny later in life. Reproductive Toxicology, 49, 196-201.
  • Becker, S. L., Chiang, E., Plantinga, A., Carey, H. V., Suen, G., & Swoap, S. J. (2020). Effect of stevia on the gut microbiota and glucose tolerance in a murine model of diet-induced obesity. FEMS microbiology ecology, 96(6), fiaa079.
  • Carrera-Lanestosa, A., Moguel-Ordóñez, Y., & Segura-Campos, M. (2017). Stevia rebaudiana Bertoni: a natural alternative for treating diseases associated with metabolic syndrome. Journal of medicinal food, 20(10), 933-943.
  • Cavagnari, B. M. (2020). Edulcorantes no calóricos en embarazo y lactancia. Revista Española de Salud Pública, 93, e201908052.
  • Chranioti, C., Chanioti, S., & Tzia, C. (2016). Comparison of spray, freeze and oven drying as a means of reducing bitter aftertaste of steviol glycosides (derived from Stevia rebaudiana Bertoni plant)–Evaluation of the final products. Food Chemistry, 190, 1151-1158.
  • Collison, K. S., Makhoul, N. J., Zaidi, M. Z., Al-Rabiah, R., Inglis, A., Andres, B. L., ... & Al-Mohanna, F. A. (2012). Interactive effects of neonatal exposure to monosodium glutamate and aspartame on glucose homeostasis. Nutrition & metabolism, 9(1), 1-13.
  • Deniņa, I., Semjonovs, P., Fomina, A., Treimane, R., & Linde, R. (2014). The influence of stevia glycosides on the growth of L actobacillus reuteri strains. Letters in applied microbiology, 58(3), 278-284.
  • EFSA Panel on Food Additives and Flavourings (FAF), Younes, M., Aquilina, G., Engel, K. H., Fowler, P., Frutos Fernandez, M. J., ... & Castle, L. (2020). Safety of a proposed amendment of the specifications for steviol glycosides (E 960) as a food additive: to expand the list of steviol glycosides to all those identified in the leaves of Stevia Rebaudiana Bertoni. EFSA Journal, 18(4), e06106.
  • EFSA Panel on Food Additives and Nutrient Sources Added to Food. (2015). Scientific opinion on the safety of the proposed amendment of the specifications for steviol glycosides (E 960) as a food additive. EFSA Journal, 13(12), 4316.
  • Englund-Ögge, L., Brantsæter, A. L., Haugen, M., Sengpiel, V., Khatibi, A., Myhre, R., ... & Jacobsson, B. (2012). Association between intake of artificially sweetened and sugar-sweetened beverages and preterm delivery: a large prospective cohort study. The American journal of clinical nutrition, 96(3), 552-559.
  • Fuentealba Arevalo, F., Espinoza Espinoza, J., Salazar Ibacache, C., & Duran Aguero, S. (2019). Consumption of non-caloric sweeteners among pregnant Chileans: a cross-sectional study,36(4), 890-897.
  • Gardana, C., Scaglianti, M., & Simonetti, P. (2010). Evaluation of steviol and its glycosides in Stevia rebaudiana leaves and commercial sweetener by ultra-high-performance liquid chromatography-mass spectrometry. Journal of chromatography A, 1217(9), 1463-1470.
  • Gardner, C., Wylie-Rosett, J., Gidding, S. S., Steffen, L. M., Johnson, R. K., Reader, D., & Lichtenstein, A. H. (2012). Nonnutritive sweeteners: current use and health perspectives: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation, 126(4), 509-519.
  • Geuns, J. M., Buyse, J., Vankeirsbilck, A., & Temme, E. H. (2007). Metabolism of stevioside by healthy subjects. Experimental biology and medicine, 232(1), 164-173.
  • Gregersen, S., Jeppesen, P. B., Holst, J. J., & Hermansen, K. (2004). Antihyperglycemic effects of stevioside in type 2 diabetic subjects. Metabolism, 53(1), 73-76.
  • Grembecka, M. (2015). Sugar alcohols—their role in the modern world of sweeteners: a review. European Food Research and Technology, 241(1), 1-14.
  • Gupta, E., Purwar, S., Sundaram, S., & Rai, G. K. (2013). Nutritional and therapeutic values of Stevia rebaudiana: A review. Journal of Medicinal Plants Research, 7(46), 3343-3353.
  • Halldorsson, T. I., Strøm, M., Petersen, S. B., & Olsen, S. F. (2010). Intake of artificially sweetened soft drinks and risk of preterm delivery: a prospective cohort study in 59,334 Danish pregnant women. The American journal of clinical nutrition, 92(3), 626-633.
  • Hsieh, M. H., Chan, P., Sue, Y. M., Liu, J. C., Liang, T. H., Huang, T. Y., ... & Chen, Y. J. (2003). Efficacy and tolerability of oral stevioside in patients with mild essential hypertension: a two-year, randomized, placebo-controlled study. Clinical therapeutics, 25(11), 2797-2808.
  • Huang, X. Y., Tian, M., Pei, D., Liu, J. F., & Di, D. L. (2018). Development of overlapping repeated separation of steviol glycosides with counter current chromatography and a comparison with a conventional repeated separation method. Journal of separation science, 41(15), 3163-3169.
  • Jahangir Chughtai, M. F., Pasha, I., Zahoor, T., Khaliq, A., Ahsan, S., Wu, Z., ... & Tanweer, S. (2020). Nutritional and therapeutic perspectives of Stevia rebaudiana as emerging sweetener; a way forward for sweetener industry. CYTA-Journal of Food, 18(1), 164-177.
  • Kobus-Moryson, M., & Gramza-Michałowska, A. (2015). Directions on the use of stevia leaves (Stevia rebauidana) as an additive in food products. Acta Scientiarum Polonorum Technologia Alimentaria, 14(1), 5-13.
  • Kumar, R. D., & Oommen, O. V. (2008). Stevia Rebaudiana Bertani does not produce female reproductive toxic effect: Study in Swiss albino mouse. J. Endocrinol Reprod, 12, 57-60.
  • Lemus-Mondaca, R., Vega-Gálvez, A., Zura-Bravo, L., & Ah-Hen, K. (2012). Stevia rebaudiana Bertoni, source of a high-potency natural sweetener: A comprehensive review on the biochemical, nutritional and functional aspects. Food chemistry, 132(3), 1121-1132.
  • Liauchonak, I., Qorri, B., Dawoud, F., Riat, Y., & Szewczuk, M. R. (2019). Non-nutritive sweeteners and their implications on the development of metabolic syndrome. Nutrients, 11(3), 644.
  • Lopes, S. M. S., Francisco, M. G., Higashi, B., de Almeida, R. T. R., Krausová, G., Pilau, E. J., ... & de Oliveira, A. J. B. (2016). Chemical characterization and prebiotic activity of fructo-oligosaccharides from Stevia rebaudiana (Bertoni) roots and in vitro adventitious root cultures. Carbohydrate polymers, 152, 718-725.
  • Madan, S., Ahmad, S., Singh, G. N., Kohli, K., Kumar, Y., Singh, R., & Garg, M. (2010). Stevia rebaudiana (Bert.) Bertoni-a review, 1(September), 267–286.
  • Magnuson, B. A., Burdock, G., Doull, J., Kroes, R. M., Marsh, G. M., Pariza, M. W., ... & Williams, G. M. (2007). Aspartame: a safety evaluation based on current use levels, regulations, and toxicological and epidemiological studies. Critical reviews in toxicology, 37(8), 629-727.
  • Maslova, E., Strøm, M., Olsen, S. F., & Halldorsson, T. I. (2013). Consumption of artificially-sweetened soft drinks in pregnancy and risk of child asthma and allergic rhinitis. PloS one, 8(2), e57261.
  • Mischke, M., & Plösch, T. (2013). More than just a gut instinct–the potential interplay between a baby's nutrition, its gut microbiome, and the epigenome. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 304(12), R1065-R1069.
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Ayrıntılar

Birincil Dil Türkçe
Konular Beslenme ve Diyetetik, Hemşirelik
Bölüm Derleme Makaleleri
Yazarlar

Yağmur DEMİREL (Sorumlu Yazar)
RECEP TAYYİP ERDOĞAN ÜNİVERSİTESİ
0000-0003-3877-3183
Türkiye


Özlem AKIN
RECEP TAYYİP ERDOĞAN ÜNİVERSİTESİ
0000-0001-7210-8756
Türkiye

Yayımlanma Tarihi 26 Nisan 2021
Başvuru Tarihi 23 Mart 2021
Kabul Tarihi 15 Nisan 2021
Yayınlandığı Sayı Yıl 2021, Cilt 2, Sayı 1

Kaynak Göster

APA Demirel, Y. & Akın, Ö. (2021). GEBELİKTE STEVİA KULLANIMI . Selçuk Sağlık Dergisi , 2 (1) , 76-92 . Retrieved from https://dergipark.org.tr/tr/pub/ssd/issue/62011/901785