Abstract

This study aims to examine the use of non-nutritive (NNSs) and low-calorie sweeteners (LCSs) in pre-packaged foods in Hong Kong and the differences in the number of NNSs/LCSs used between products from different regions. In a cross-sectional audit, the types of NNSs/LCSs used in 19,915 pre-packaged foods in Hong Kong were examined by searching the ingredients list of the included products for keywords related to 20 common NNSs/LCSs and their respective E-numbers. Prevalence of use of NNSs and LCSs, the co-presence of NNSs/LCSs and free sugar ingredients (FSI), and the number of NNSs/LCSs used in the included foods were computed. Pearson’s χ2 test was used to compare the total number of NNSs and/or LCSs used in food items from different regions. Sucralose (E955) was the most commonly used NNS (1.9%), followed by acesulfame K (E950, 1.6%). Sorbitol was the most commonly used LCS (2.9%). Overall, the use of LCSs was less common compared with NNSs (3.7% vs. 4.5%). The use of different types of NNSs varied substantially between food types. Notably, 20.2% of potato crisps and 15.2% of other crisps or extruded snacks contained at least one NNS and/or LCS. Co-presence of FSIs and NNSs/LCSs were most common in confectionery (15.7%) and snack foods (15.5%). Asian prepackaged foods were more likely to contain NNSs/LCSs (10.1%) compared with those from other regions. To conclude, NNSs/LCSs were used in a wide range of non-diet pre-packaged products which could be a public health concern due to their higher consumption frequencies than “diet” products.

Highlights

  • Excessive free sugar consumption has been proposed to be a major driver of the worldwide obesity epidemic [1,2]

  • Given around 90% of the Hong Kong food supply is imported from various parts of the world [33], and the increasingly common use of non-nutritive sweeteners (NNSs)/low-calorie sweeteners (LCSs) in other countries as described above, the aim of this study was to examine the use of NNSs/LCSs in pre-packaged foods in Hong Kong and the differences in the number of NNSs/LCSs used between products from different regions

  • Alitame and thaumatin were not used in the included products, and the use of the other types of NNSs was infrequent

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Summary

Introduction

Excessive free sugar consumption has been proposed to be a major driver of the worldwide obesity epidemic [1,2]. Many governments worldwide have imposed a sugar tax (e.g., the UK, France, Mexico) and/or set voluntary reformulation targets for sugar [5,6,7,8] In response to these sugar reduction policies as well as consumer demand for lower sugar foods, there has been an increase in the use of non-nutritive sweeteners (NNSs, e.g., aspartame) and low-calorie sweeteners (LCSs, e.g., xylitol) in recent years [4,9,10,11,12,13]. This could be a potential public health concern considering nutrition labels are not required to display the amount of NNSs/LCSs used [15,16,17], and consumers may be unaware that some sugars in their favorite foods/beverages are being replaced by NNSs/LCSs [18]

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