Abstract

Increased interest among consumers in the reduction of dietary sugar intake has led to the wider availability of food products containing non-nutritive sweeteners (NNS). However, the extent to which NNS are currently being used by manufacturers to sweeten processed food and beverage products, and how NNS may be displacing added sugars as a sweetener is unknown. The current study utilized branded food composition databases from Australia, Mexico, New Zealand and the US to determine the percentage of processed food and beverage products for which there are nutrition data containing NNS and to compare total sugar density (g per 100 mL for beverages and g per 100 g for foods) between products with and without NNS. Ordinary least squares regression at the country-product level was performed to examine associations between presence of NNS and total sugar. Across all countries, 5% of products contained at least one NNS, with the highest prevalence among beverages (22%). Mexico had the highest percentage of products with NNS (11%), as compared to the United States (US) (4%), New Zealand (1%), and Australia (<1%). The presence of NNS was associated with lower mean total sugar density among beverages (range across countries: 7.5 to 8.7 g per 100 mL) and among foods (23.2 to 25.5 g per 100 g). Products with both added sugar ingredients and NNS had a lower overall mean total sugar density when compared to products containing only added sugar ingredients. Due to paucity of data on sales and market shares across these countries, our results do not reflect the extent to which consumers purchase NNS containing products. Continued monitoring of NNS in the food supply, extension of work from these data, and inclusion of market shares of products will be important as more countries introduce policies to reduce sugar.

Highlights

  • Over recent decades, the role of dietary sugar intake as a major driver of weight gain and type 2 diabetes has become more widely recognized among consumers, regarding the consumption of sugar-sweetened beverages

  • When examining results by country, Mexico had the highest proportion of total products with nutritive sweeteners (NNS) (11%) compared to Australia (

  • The US has several state-based policies that have been introduced in recent years which could explain its higher use of NNS when compared to Australia and New Zealand, which do not yet have regulation related to the use of added sugars

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Summary

Introduction

The role of dietary sugar intake as a major driver of weight gain and type 2 diabetes has become more widely recognized among consumers, regarding the consumption of sugar-sweetened beverages. The intake of added sugars, and sugar-sweetened beverages in particular, is commonly associated with poor health outcomes [9,10], the association between NNS consumption and adverse health outcomes remains controversial [11,12]. Randomized controlled trials do not demonstrate an adverse relationship between NNS and energy intake or the increased consumption of sweet foods [13], yet several cohort studies, with varying degrees of potential for reverse causality, have linked NNS to increased body weight, type 2 diabetes, and other adverse cardio-metabolic outcomes [10,14]

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