Państwo i Społeczeństwo / State and Society

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Journal: Państwo i Społeczeństwo / State and Society

Non-Nutritive Sweeteners and Weight Regulation in Healthy Adults: Current Evidence and Public Health Implications

Weronika Hariasz , Anna Zalewska , Marta Drobik , Katarzyna Gądek , Marek Borowiec , Karina Reczek , Agnieszka Gontkowska , Adam Lichodij

Language: EN | Published: 05-08-2026 | Abstract | 103

The use of non-nutritive sweeteners (NNS) as sugar replacements has become widespread as a strategy to
reduce caloric intake, thereby supporting weight management, and reduce sugar consumption in modern diets. However, their effectiveness in preventing weight gain in healthy adults remains controversial.

This review aims to evaluate the current evidence regarding the impact of NNS consumption on body weight regulation and metabolic health in healthy adults.

This narrative review synthesizes findings from randomized controlled trials, prospective cohort studies and mechanistic studies identified through a structured search of electronic databases. Emphasis was placed on studies assessing body weight, energy intake, metabolic responses, appetite regulation and gut microbiota.

Evidence from randomized controlled trials indicates that replacing sugars with NNS may reduce energy intake, body weight and body mass index in the short term. In contrast, long-term observational studies report associations between habitual NNS consumption and higher body weight, waist circumference and risk of cardiometabolic disorders, although causality remains uncertain. Mechanistic studies suggest that these effects may be mediated by context-dependent physiological responses, including variable incretin secretion, changes in reward-related responses and potential changes in gut microbiota composition.

NNS may be effective as a short-term strategy for reducing caloric intake; however, their long-term role in preventing weight gain in healthy individuals remains unclear. Further well-designed long-term studies are needed to clarify these relationships.

2026-08-05



Journal: Państwo i Społeczeństwo / State and Society

Integrated collaboration between physiotherapists and surgeons in laparoscopic abdominal surgery within ERAS protocols: a narrative review

Ewa Strój-Loranc

Language: PL | Published: 01-09-2026 | Abstract | 104

Laparoscopic abdominal surgery is currently a standard approach in many clinical settings, particularly in colorectal, gynecological, bariatric and general surgery. Although minimally invasive techniques reduce surgical trauma, they do not eliminate postoperative respiratory impairment, pain, temporary reductions in functional activity tolerance, or the risk of delayed functional recovery. These issues are particularly relevant in patients with reduced functional reserve, obesity, respiratory or cardiovascular disease, and other comorbidities. The aim of this paper is to present a model of collaboration between the surgeon and the physiotherapist in laparoscopic abdominal surgery within the framework of Enhanced Recovery After Surgery (ERAS), including preoperative preparation, prehabilitation, early mobilization, stages of hospitalization and continuation of care after discharge.

This paper is a narrative review with elements of a conceptual model. It was based on an analysis of current ERAS guidelines and selected publications concerning postoperative pulmonary complications, prehabilitation, perioperative physiotherapy, patient education and early mobilization after abdominal surgery. The aim was not to systematically evaluate all rehabilitation interventions, but to organize evidence of the greatest practical relevance to collaboration between surgical and physiotherapy teams.

The model proposed in the paper involves the physiotherapist during preoperative preparation, who  performs a physiotherapy-specific functional assessment, identifies limitations in mobility and functional activity tolerance relevant to therapy planning, contributes information supporting interdisciplinary consideration of prehabilitation, and plans postoperative activity progression. Postoperatively, the model includes daily coordination of physiotherapy with the therapeutic team, assessment of functional readiness for mobilization and monitoring of tolerance to standing and walking, breathing pattern and cough effectiveness, as well as preparation for safe discharge and further rehabilitation. Selected safety variables are monitored only in connection with physiotherapy interventions and do not replace medical or nursing assessment of the patient’s clinical condition. Particular attention is given to diaphragmatic function, respiratory and movement pattern control, and a methodologically cautious approach to interventions targeting postoperative scar tissue, soft tissues and the abdominal wall.

The analysis indicates that integrated collaboration between surgeons and physiotherapists may provide a useful organizational and clinical framework supporting the implementation of local ERAS-based procedures, improving team communication and promoting a more consistent focus on patients’ functional goals. However, the  model should be regarded as a conceptual solution whose full clinical value requires further empirical verification in studies based on comparable protocols.

2026-09-01