Biomedgrid (2024)

Abstract

An overconsumption of refined added sugars may cause inflammation, insulin resistance and an increase in visceral adiposity. It is important tohighlight that refined sugar is devoid of micronutrients and phytochemicals and natural sweeteners such as malt extract and honey have a differenteffect in oxidative stress markers and overall health. Malt extract contains approximately 90% carbohydrate, most of it in the form of maltose, Bvitamins (mainly niacin), amino acids and some minerals such as magnesium and potassium. It is also rich in phenolic compounds mainly ferulicacid and flavan-3-ols. It has a high antioxidant activity, both in vitro and in vivo, which makes malt extract a healthy substitute for refined sugars.

Keywords: Sugar; HFCS; Malt Extract; Antioxidant

Refined sugar and obesity

An excessive caloric intake and physical inactivity is one of themain causes of obesity, but current research has shown that not onlycalories, but the type of calories such as the overconsumption ofadded sugars and refined carbohydrates induce insulin resistanceand obesity [1].

The most common added sugars consumed by Americans,high-fructose corn syrup (HFCS) and sucrose, are made up of bothfructose and glucose with a ratio of 50:50 for sucrose and 42% or55% of fructose for “HFCS 42” and “HFCS 55”, respectively.

Many studies have emphasized the differences in themetabolism of these monosaccharides: although glucose andfructose have the same molecular formula, their structure andmetabolism are different. In contrast to glucose, the metabolism offructose is not regulated by insulin nor at the enzymatic level, byphosphofructokinase. Therefore, an excess of fructose can lead tothe formation of Acetyl Co-A, and an increase in lipogenesis, whichmay trigger several other events such as hypertriglyceridemia,hepatic steatosis and insulin resistance [2-5].

Although the harm of an excess of fructose is still a matter ofdebate and depends upon the consumption and the cardiometabolicendpoints evaluated [6], it is important to consider the food matrixas well. Honey composition is similar to HFCS considering onlythe ratio of monosaccharides, but differently from refined sugars,it contains a wide range of minor constituents such as vitamins,minerals, amino acids and phytochemicals, mainly phenolic acidsand flavonoids [7,8]. Several studies highlight the compositionof honey and show that differently from refined sugar, naturalalternatives are not only not harmful, but beneficial. Detailing thesebenefits is beyond the scope of this review, and we suggest theexcellent reviews already published on this topic: [9-13].

Malt extract nutritional composition

Malt extract is a hydrolysate of germinated barley grains. Itcontains approximately 90% carbohydrate, most of it in the form ofmaltose, B vitamins (mainly niacin), amino acids and some mineralssuch as magnesium and potassium [14]. Also, malt extract is rich inphenolic compounds with a total polyphenol content of 0.6 – 2.9 mgGAE/gdw, of which the dominant compound is ferulic acid (rangingfrom 7.8 - 56.1 μg/gdw) [15]. It is also a source of flavan-3-ols suchas (+)-catechins and (-)-epicatechin [16].

Studies with malt extract suggest it may be a healthysubstitute for refined sugar due to its content in micronutrients,phytochemicals and high antioxidant activity (both in vitro and invivo). The North American Society for Pediatric Gastroenterologyhas considered malt extract as a safe osmotic laxative for children,without side effects [17].

Antioxidant activity

Increased oxidative stress can induce a variety of chronichealth problems such as inflammation, insulin resistance andneurodegenerative disorders. A study conducted by Boden et al.[18] showed that the initial event that triggers insulin resistanceis an oxidative modification of the glucose transporter GLUT4(carbonylation), caused by excessive feeding. Therefore, theysuggest that the link between overnutrition and insulin resistanceis an increase in oxidative stress, which inactivates GLUT4 requiringa compensatory increase in insulin production.

Malt extract has a high antioxidant activity, both in vitro and invivo, assessed by its ability to scavenge hydroxyl and superoxideradicals, thus protecting against oxidative damage. Its phenoliccompounds are responsible for its effective antioxidant properties.In a mouse model of aging, malt extract showed an antioxidanteffect decreasing the levels of liver and brain malondialdehyde andimproving total antioxidant capacity. Furthermore, it prevented thedecrease of the antioxidant enzymes SOD and GPx. These authorssuggested malt extract should be considered as a new source ofnatural antioxidants for pharmaceutical or dietary needs [19].

Phillips et al. [20] rationalized that substituting the quantityof refined sugars consumed in an average Western diet (130g perperson per day) for sugars rich in antioxidants could increasethe consumption of phytochemicals and antioxidants, thereforecontributing to a higher antioxidant capacity

By using the FRAP assay they showed that date sugar,molasses (blackstrap and dark) and barley malt syrup had thehighest antioxidant capacity. Malt syrup had a FRAP value of 1.5mmol/100g (refined sugar had a FRAP of 0.01 mmol/100g andhoney, 0.165mmol/100g). Based on these values they showed thatsubstituting refined sugar for more natural sources would result inan average increase of 2.6mmol/day in antioxidants intake, whichis equivalent to the consumption of a serving of antioxidant richfoods such as berries or nuts [20].

Conclusion

Although there is still a lack of clinical trials using malt syrup,its nutritional composition (micronutrients and phytochemicals)and its high antioxidant capacity measured both in vitro and in vivosuggest that it is a healthier substitute for refined sugar.

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