Abstract
Few data assessing non-nutritive sweetener (NNS) intake are available, especially within rural, health-disparate populations, where obesity and related co-morbidities are prevalent. The objective of this study is to characterize NNS intake for this population and examine the variance in demographics, cardio-metabolic outcomes, and dietary intake between NNS consumers and non-consumers. A cross-sectional sample (n = 301) of Virginian adults from a randomized controlled trial (data collected from 2012 to 2014) targeting sugar-sweetened beverage (SSB) intake completed three 24-h dietary recalls, and demographics and cardio-metabolic measures were assessed. The frequency, types, and sources of NNS consumption were identified. Thirty-three percent of participants reported consuming NNS (n = 100). Sucralose was the largest contributor of mean daily NNS intake by weight (mg), followed by aspartame, acesulfame potassium, and saccharin. NNS in tabletop sweeteners, diet tea, and diet soda were the top contributors to absolute NNS intake. The most frequently consumed NNS sources were diet sodas, juice drinks, and tabletop sweeteners. Although mean body mass index (BMI) was greater for NNS consumers, they demonstrated significantly lower food, beverage, and SSB caloric intake and energy density, and higher overall dietary quality. It remains unclear whether NNS use plays a role in exacerbating weight gain. NNS consumers in this sample may have switched from drinking predominantly SSB to drinking some NNS beverages in an effort to cope with weight gain. Future studies should explore motivations for NNS use across a variety of weight and health categories.
Highlights
Replacing added sugars in the diet with non-nutritive sweeteners (NNS) to reduce caloric intake, body weight, and cardio-metabolic risk factors is a controversial topic [1]
NNS consumers in this sample may have switched from drinking predominantly sugar-sweetened beverage (SSB) to drinking some NNS beverages in an effort to cope with weight gain
Focusing on diet soda intake as the only NNS source underestimates NNS intake and limits the accuracy of NNS intake data, thereby decreasing the scope and understanding of the potential health benefits and/or problems. These findings demonstrated that in terms of dietary intake, NNS consumers tended to have better overall dietary habits than non-consumers, with regard to daily energy, SSB, total and added sugar intake, and energy density
Summary
Replacing added sugars in the diet with non-nutritive sweeteners (NNS) to reduce caloric intake, body weight, and cardio-metabolic risk factors is a controversial topic [1]. Dietary intake assessment tools [1] focus mainly on NNS beverage intake, diet sodas [11,26,27,28,33], and typically do not specify type or beverage brand [9,10,29,32,33]. Two other sweeteners (stevia and luo han guo or monk fruit) have been determined as “generally recognized as safe” (GRAS) These sweeteners are present in many foods including diet beverages, desserts, baked goods, and chewing gum, and personal hygiene products (e.g., toothpaste and medications)
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