Tabletop Sweeteners Research Articles

Trends in nonsugar sweetener use among United States adults by chronic diseases presence: 1999 to March 2020

BackgroundAlthough long-term health effects of nonsugar sweeteners (NSSs) are uncertain, they are widely used as a common alternative to added sugar, especially among people with chronic diseases. It is essential to evaluate trends in NSS use to inform policy makers. ObjectivesThis study aimed to investigate trends in NSS use overall and by chronic diseases presence in United States adults. MethodsThe analysis used data of United States adults (≥20 y) collected in National Health and Nutrition Examination Survey [NHANES (1999 to March 2020)]. Age-adjusted percentage of individuals consuming NSS beverages, NSS foods, tabletop NSS, or any of them during the first 24-h dietary recall period was calculated in each NHANES survey cycle. Weighted multivariable logistic or linear regression models were used to examine trends in NSS use over time. ResultsA total of 51,703 United States adults were included in the analysis. In total population, age-adjusted percentage of individuals consuming NSS in the past day increased from 29.3% in 1999–2000 to 37.5% in 2005–2006 and decreased to 24.1% in 2017 to March 2020 (P < 0.001 for nonlinear trend). Similar trends were observed for different subcategories of NSS-containing product consumption (NSS beverages, foods, and tabletop sweeteners). Similar trends were found among individuals with or without chronic disease. Among individuals with ≥1 chronic disease (cancer, cardiovascular disease, diabetes, hypertension, obesity, hyperlipemia), age-adjusted percentage of individuals consuming NSS in the past day increased from 34.5% in 1999–2000 to 41.1% in 2005–2008 and decreased to 28.1% in 2017 to March 2020, while NSS consumption increased from 20.0% in 1999–2000 to 27.4% in 2005–2008 and decreased to 14.3% in 2017 to March 2020 among individuals without chronic diseases (all P < 0.001 for nonlinear trend). ConclusionsNSS use increased from 1999 to 2006 and decreased until March 2020 among entire United States adults and individuals with or without chronic diseases. Moreover, NSS use is generally higher among individuals with chronic diseases during study periods.

Consumo de adoçantes não nutritivos e prevalência de hipertensão arterial sistêmica em adultos e idosos de uma capital do Nordeste brasileiro

ABSTRACT Objective To characterize the consumption of Non-nutritive sweeteners and to verify the association between the intake of these additives and the prevalence of Systemic Arterial Hypertension in adults and the elderly in a Brazilian capital. Methods This was a cross-sectional household and population-based study carried out with 489 individuals aged 20 years and older residents of Teresina, Piauí, Brazil. Complex probabilistic cluster sampling was used. Sociodemographic, economic, lifestyle and diseases diagnosis, such as SAH diagnosis, data were obtained by self-report. Weight, height, waist circumference and blood pressure were measured. Data on food consumption and Non-nutritive sweeteners consumption were obtained using 24-hour dietary recall. The association between the consumption of Non-nutritive sweeteners and the prevalence of Systemic Arterial Hypertension was verified using Poisson regression. Results The most commonly consumed types of Non-nutritive sweeteners were cyclamate and saccharin and the main source of consumption was tabletop sweeteners. The consumption of Non-nutritive sweeteners was well below the Acceptable Daily Intake. Mean systolic blood pressure and diastolic blood pressure were higher in women and men who consumed Non-nutritive sweeteners (p=0.04), respectively. Individuals who consumed Non-nutritive sweeteners had a 36% higher prevalence of Systemic Arterial Hypertension compared to non-consumers (p=0.04), after adjustments. Female consumers of Non-nutritive sweeteners had a 31% higher prevalence of Systemic Arterial Hypertension (No-BreakpNo-Break=0.04). Conclusion The consumption of Non-nutritive sweeteners was positively associated with the prevalence of Systemic Arterial Hypertension. It is therefore important to continue studies investigating the possible health consequences of consuming these substances.

Relative validity of habitual sugar and low/no-calorie sweetener consumption assessed by food frequency questionnaire, multiple 24-h dietary recalls and urinary biomarkers: an observational study within the SWEET project

BackgroundStudies investigating associations between sweeteners and health yield inconsistent results, possibly due to subjective self-report dietary assessment methods. ObjectivesWe compared the performance of a food frequency questionnaire (FFQ), multiple 24-h dietary recalls (24hRs), and urinary biomarkers to estimate intake of sugars and low/no-calorie sweeteners (LNCSs). MethodsParticipants (n = 848, age 54 ± 12 y) from a 2-y observational study completed 1 semiquantitative FFQ and ≥ 3 nonconsecutive 24hRs. Both methods assessed intake of sugars (mono- and disaccharides, sucrose, fructose, free and added sugars) and sweetened foods and beverages (sugary foods, fruit juice, and sugar or LNCS-containing beverages [sugar-sweetened beverages and low/no-calorie sweetened beverages (LNCSBs)]); 24hRs also included LNCS-containing foods and tabletop sweeteners (low/no-calorie sweetened foods [LNCSFs]). Urinary excretion of sugars (fructose+sucrose) and LNCSs (acesulfame K+sucralose+steviol glucuronide+cyclamate+saccharin) were simultaneously assessed using ultrapressure liquid chromatography coupled to tandem mass spectrometry in 288 participants with 3 annual 24-h urine samples. Methods were compared using, amongst others, validity coefficients (correlations corrected for measurement error). ResultsMedian (interquartile range) FFQ intakes ranged from 0 (0–7) g/d for LNCSBs to 94 (73–117) g/d for mono- and disaccharides. LNCSB use was reported by 32% of participants. Median LNCSB+LNCSF intake using 24hRs was 1 (0–50) g/d and reported by 58%. Total sugar excretions were detected in 100% of samples [56 (37–85) mg/d] and LNCSs in 99% of urine samples [3 (1–10) mg/d]. Comparing FFQ against 24hRs showed VCs ranging from 0.38 (fruit juice) to 0.74 (LNCSB). VCs for comparing FFQ with urinary excretions were 0.25 to 0.29 for sugars and 0.39 for LNCSBs; for 24hR they amounted to 0.31–0.38 for sugars, 0.37 for LNCSBs, and 0.45 for LNCSFs. ConclusionsThe validity of the FFQ against 24hRs for the assessment of sugars and LNCSBs ranged from moderate to good. Comparing self-reports and urine excretions showed moderate agreement but highlighted an important underestimation of LNCS exposure using self-reports.

Edulcorantes artificiais: regulamentação no Brasil, implicações tecnológicas na produção de alimentos e na saúde

Sweeteners provide a sweet taste to foods and are used to replace sucrose and reduce caloric value. Acesulfame potassium, aspartame, sodium cyclamate, saccharin, sucralose and neotame are the artificial sweeteners regulated in Brazil by the Brazilian Health Regulatory Agency (ANVISA). The consumption of these additives has become controversial due to recent scientific evidence questioning their safety and outcomes regarding weight loss, dysbiosis of the intestinal microbiota, insulin resistance, diabetes and cancer. Even today, little is known about the long-term consequences of their consumption. Therefore, this study aimed to carry out a review of artificial sweeteners regulated in Brazil, contextualizing their regulatory framework, the technological implications regarding their use and the effects on health. Considering the now controversial outcomes regarding the consumption of many artificial sweeteners, and the long period in which levels of acceptable daily intake have been in place, it is suggested their consumption should now not be encouraged, being restricted to population groups that have a risk-based physiological or metabolic need to replace sucrose. Also, for these cases, it would be important to differentiate between foods containing different sweeteners (or tabletop sweeteners), to alleviate possible chronic health effects. New studies with more robust and consistent methodologies are required to support the safety assessment reviews of each artificial sweetener.

Simultaneous determination of nine high-intensity sweeteners in liquid and powder tabletop sweeteners

Government regulatory actions and public policies have been recently implemented in Brazil due to the excessive consumption of sugar. Therefore, it becomes relevant to determine the levels of high-intensity sweeteners in tabletop sweeteners consumed by the Brazilian population. Thus, an analytical method was developed and validated for the simultaneous determination of nine sweeteners (acesulfame potassium, aspartame, advantame, sodium cyclamate, neotame, saccharin, sucralose, stevioside, and rebaudioside A) by using ultra-high performance liquid chromatography coupled to mass spectrometry in tandem. The sample preparation encompassed only dilution steps. The method was validated taking into account the parameters of linearity, precision, accuracy, and matrix effects. The analytes were determined in two different batches of 21 commercial liquid and powder tabletop sweeteners available on the local market, totaling 42 samples. A minimum of one and a maximum of four sweeteners were found in the analyzed products and sweeteners that were not described on the label were not detected. It is expected that the established method can be used in monitoring programs and that the presented results can contribute to exposure assessments performed nationally.

Consumption of aspartame and other artificial sweeteners and risk of cancer in the Spanish multicase-control study (MCC-Spain).

Use of artificial sweeteners (AS) such as aspartame, cyclamate, saccharin and sucralose is widespread. We evaluated the association of use of aspartame and other AS with cancer. In total 1881 colorectal, 1510 breast, 972 prostate and 351 stomach cancer and 109 chronic lymphocytic leukaemia (CLL) cases and 3629 population controls from the Spanish Multicase-Control (MCC-Spain) study were recruited (2008-2013). The consumption of AS, from table-top sweeteners and artificially sweetened beverages, was assessed through a self-administered and validated food frequency questionnaire (FFQ). Sex-specific quartiles among controls were determined to compare moderate consumers (<third quartile) and high consumers (≥ third quartile) vs non consumers (reference category), distinguishing aspartame-containing products and other AS. Unconditional logistic regression models were used to estimate adjusted OR and 95%CI, and results were stratified by diabetes status. Overall, we found no associations between the consumption of aspartame or other AS and cancer. Among participants with diabetes, high consumption of other AS was associated with colorectal cancer (OR = 1.58, 95% CI 1.05-2.41, P trend = .03) and stomach cancer (OR = 2.27 [0.99-5.44], P trend = .06). High consumption of aspartame, was associated with stomach cancer (OR = 2.04 [0.7-5.4], P trend = .05), while a lower risk was observed for breast cancer (OR = 0.28 [0.08-0.83], P trend = .03). In some cancers, the number of cases in participants with diabetes were small and results should be interpreted cautiously. We did not find associations between use of AS and cancer, but found associations between high consumption of aspartame and other AS and different cancer types among participants with diabetes.

Effect of Sugar Replacement with Stevia-Based Tabletop Sweetener on Weight and Cardiometabolic Health among Indian Adults.

An open-label, single-arm pilot study was conducted to evaluate the efficacy and safety of a stevia-based tabletop sweetener among overweight subjects with normal blood sugar levels (n = 24) and overweight prediabetic subjects (n = 21). Subjects were instructed to replace added sugar in their daily diet with the test product over a study period of 90 days. Primary outcomes included change in body weight and waist circumference, while the secondary outcomes included change in blood glucose (PPBG), body mass index (BMI), and lipid parameters evaluated at baseline, 30 days, 60 days, and 90 days. Glycated hemoglobin (HbA1c) was evaluated at baseline and 90 days. When compared with the baseline, a significant reduction in weight (p < 0.001) and waist circumference (p < 0.001) was observed at Day 90 in overweight subjects. Similarly, in overweight prediabetic subjects, a significant reduction in weight (p < 0.001) and waist circumference (p < 0.05) with non-significant change in HbA1c was observed at Day 90 from baseline. In a subgroup analysis, among the subjects who lost weight, 2.12 kg (n = 35) weight loss and 4.78 cm (n = 32) reduction in waist circumference were observed at 90 days. No adverse outcomes were reported throughout the study period. The consumption of steviol glycosides was within the acceptable daily intake (ADI). Replacing added sugar in the daily diet with stevia-based tabletop sweetener, along with a physical activity regimen, promotes weight loss and reduction in waist circumference in overweight subjects with normal blood sugar levels and prediabetic subjects (CTRI/2019/12/022470).

Tiered dietary exposure assessment of steviol glycosides in the Belgian population.

The objective of the present study was to assess the dietary intake of steviol glycosides in the Belgian population and to conduct a risk assessment by comparing the estimated intakes to the acceptable daily intake (ADI). A tiered approach was adopted in this study. First, a Tier 2 assessment was performed using maximum permitted levels. Next, the calculations were refined because market share data were used (refined Tier 2). Finally, the actual concentration data of 198 samples purchased from the Belgian market were used for Tier 3 exposure assessment. Based on a Tier 2 assessment, the ADI was exceeded for the high-consumer children population. However, the results of a more refined exposure assessment (Tier 3) of high consumers (P95) within the child, adolescent and adult populations were 13·75, 10 and 6·25 % of the ADI, respectively, using mean analytical results. Even with more conservative refined approaches, the estimated daily intake remained below 20 % of ADI. Flavoured drinks, flavoured fermented milk products and jams, jellies, and marmalades were the top three contributing food groups to steviol intake at 26–49 %, 12–27 % and 5–13 %, respectively. Despite the high concentrations (up to 94 000 mg/kg) of steviol glycosides in tabletop sweeteners, their contribution to the total intake remains low. The impact of the use of food supplements on the total intake was also considered to be limited. It was concluded that there was no risk for the Belgian population related to dietary exposure to steviol glycoside.

Thermal and rheological study of artificial and natural powder tabletop sweeteners

Tabletop sweeteners play an essential role in calorie-restricted and low-sugar diets. Thus, this work aims to characterize by thermal analysis, SEM, and rheology, powder tabletop sweeteners samples based on the most currently consumed: aspartame (A1), saccharin (C1), sucralose (U1), stevia extract (E2) and monk fruit extract (M1). Their physicochemical properties were compared regarding thermal stability, morphology, and viscoelastic behavior. Samples based on artificial sweeteners started to lose mass from 65 °C. On the other hand, natural sweeteners showed greater thermal stability with an initial decomposition temperature of 170 °C. The DSC curves of A1 and C1 samples exhibited similar thermal profiles showing dextrose melting at 150 °C. Both DSC analyses of samples based on natural sweeteners revealed Tm erythritol (121 °C) followed by its decomposition (288 °C). In rheological analysis, except for the U1 sample, all the others presented a slight increase in the storage modulus at 10 and 25 °C, indicating that their granules were not wholly deformed. This aspect could influence the aftertaste of the products in which they will be used.

Consumption of low-calorie sweeteners: findings from the Campinas Nutrition and Health Survey.

We used data from the Campinas Health Survey (ISACamp 2014/15) and the Food Consumption and Nutritional Status Survey (ISACamp-Nutri 2015/16) to estimate the prevalence of the consumption of foods and beverages that contain low-calorie sweeteners (LCS) by individuals ≥ 10 years to estimate the dietary exposure of the population to high levels of LCS. We first estimated the prevalence of consuming LCS-containing foods and beverages and identified the top sources of LCS consumption. We then verified whether the prevalence of consumption varied according to individual-level characteristics or the presence of obesity and diabetes. Finally, we estimated the population dietary exposure to high levels of LCS and compared it with the acceptable daily intake (ADI) levels. Over 40 % of the study population consumed at least one LCS-containing food or beverage. Sweetened beverages, tabletop sweeteners and dairy beverages were the top contributors to the consumption of LCS. Among all age groups, education levels, and income levels, the consumption of LCS-containing foods and beverages ranged from 35 % to 55 %. The prevalence was only slightly greater among higher income 40-59-year-olds than among other income groups and was not higher among individuals with obesity or diabetes. Although dietary exposure to LCS did not exceed the ADI levels, we identified several limitations in our ability to measure exposure to high levels of LCS. Because of these challenges and the unclear evidence linking LCS to better health outcomes, the consumption of LCS-containing foods and beverages should be closely monitored.

Artificial sweeteners and risk of cardiovascular diseases: results from the prospective NutriNet-Santé cohort

ObjectivesTo study the associations between artificial sweeteners from all dietary sources (beverages, but also table top sweeteners, dairy products, etc), overall and by molecule (aspartame, acesulfame potassium, and sucralose), and...

Dietary exposure to low-calorie sweeteners in a sample of Brazilian pregnant women

The dietary exposure to low-calorie sweeteners (LCS) was estimated in a sample of pregnant Brazilian women. Consumption data were obtained with a 24-h Dietary Recall interview. Because of the uncertainty in assessing foods with LCS, they were classified into three scenarios to ensure inclusion of the 15 LCS allowed for use in Brazil: ranging from a less to a more conservative scenario. The concentration of LCS was estimated using the amount declared on the label or the maximum permitted levels and analytical determination data for table-top sweeteners. The frequency of consumption was higher for acesulfame-K, aspartame, and cyclamate. The food groups contributing the most to the consumption of LCS were non-alcoholic beverages, table-top sweeteners, confectionary and desserts. The level of dietary exposure to LCS was within the safety limit. However, continued efforts to monitor their dietary exposure are necessary given the limitations highlighted in this study.

Reagent sequence for planar chromatographic analysis of eight sweeteners in food products approved in the European Union

Sweeteners, which are regulated as food additives in the European Union, are used as tabletop sweeteners or added to foods for sweetening with the aim of reducing the calorie content. For their simple analysis, a quantitative high-performance thin-layer chromatography multi-imaging (HPTLC−UV/Vis/FLD) method was developed, which used a reagent sequence to detect eight important sweeteners in eight different food products. The samples were dissolved or diluted and separated on HPTLC plates silica gel 60 F254 with a mixture of ethyl acetate, methanol, and acetic acid 5:1:1, V/V. Due to the different structures and detectabilities of the sweeteners, different post-chromatographic derivatization reagents were compared for multi-detection of the sweeteners on the same plate. First, the UV absorbance was detected, and then the derivatization reagent sequence was performed with the primuline reagent, then ninhydrin glacial acetic acid reagent, and finally 2-naphthol sulfuric acid reagent. It was important to arrange and use the reagents according to their increasing acidity. Zones of interest can be confirmed by mass spectrometry. Compared to the status quo analysis of sweeteners, the whole method is simple, robust, and rapid considering the minimalist sample preparation and reagent sequence applied on the same plate. In addition, the influence of food sample matrix on the results is easily understood due to the image-giving nature and multi-detection.

Differences in the Liking of Sweet Tastes of Different Sources (Natural and Artificial) among Older Adolescents in Slovenia

The aim of this research paper is to investigate the recognition and liking of sweet tastes among older adolescents (19–21 years), and in doing so determine whether any differences exist in the liking of sweet tastes with respect to their differing sources (i.e. either of natural or artificial origin). With this aim in mind, data was obtained from sensory testing performed on a total of 101 participants between 19 and 21 years of age, of whom 60 were female and 41 male. Recognition of the basic tastes (i.e. sweet, salty, sour and bitter) was found to be good among most respondents and its success unrelated to gender. Furthermore, participants were found to demonstrate no difficulties with respect to the correct ordering of solutions of different intensities of sweetness (or, rather, of different concentrations of sucrose in water), regardless of gender. The most liked concentration among both men and women was 4.3%. Also established were differences in the liking of sweet tastes of different sources (i.e. natural and artificial). Participants were offered the most generally liked solution of sucrose in water (4.3%) as well as a number of table-top sweeteners prepared, in accordance with their packaging instructions, to be of comparable gustatory sweetness to the sucrose solution. In this endeavour, the selection of solutes was informed by the availability of table-top sweeteners among the five largest commercial producers, and involved those commercially sold under the names stevia, birch sugar, liquid sweetener (Na cyclamate, Na saccharin, thaumatin), sucralose, erythrol, fructose, Streusüße (sorbitol and saccharin). It was found that the most liked sweet tastes were those of sucrose and sucralose, while the taste of fructose was in third place albeit statistically significantly less liked than the tastes of sucrose and sucralose. Although the results of average values indicate that all kinds of sweet tastes are moderately liked, the liking of stevia and erythrol was found to be statistically significantly lower than the liking of sucrose and sucralose. From this, we conclude that artificial sweeteners are gaining in likeability, but even so, of the three most generally liked sources of sweet taste, two are natural sugars.

Estimated Sweetness in US Diet Among Children and Adults Declined From 2001 to 2018: A Serial Cross-Sectional Surveillance Study Using NHANES 2001-2018.

An agreed-upon measure of total dietary sweetness is lacking hindering assessments of population-level patterns and trends in dietary sweetness. This cross-sectional study used 24-h dietary recall data for 74,461 participants aged ≥ 2 y from nine cycles (2001–2018) of the National Health and Nutrition Examination Survey (NHANES) to evaluate trends in the sweetness of the diet in the United States (US). LCS-containing items were matched to a sugar-sweetened counterpart (e.g., diet cola–regular cola or sucralose sugar). The matched pair was used to estimate the sugar equivalents from LCS-sweetened foods or beverages to estimate dietary level sweetness, which was described as grams of approximate sugar equivalent (ASE) per day. Trends in ASE were estimated overall and by subgroup, and trends were further disaggregated by food or beverage category. Overall, LCS sources contributed about 10.5% of ASE. Total ASE declined from 152 g/d to 117 g/d from 2001–2002 to 2017–2018 (p-trend < 0.001), with comparable declines in children and adults. Declines in total ASE were predominantly driven by beverages (−36.7% from 2001–2002 to 2017–2018) and tabletop sweeteners (−23.8%), but not food (−1.5%). Observed trends were robust to sensitivity analyses incorporating random, systematic, and sensory trial informed estimates of sweetness and also an analysis excluding possible under-reporters of dietary energy. This practical approach and underlying data may help researchers to apply the technique to other dietary studies to further these questions.

Low- and No-Calorie Sweetener (LNCS) Presence and Consumption among the Portuguese Adult Population

The use of low and no-calorie sweeteners (LNCS) in food and beverages has become increasingly common in the development and reformulation of products to reduce energy derived from added sugars. Our aim was to identify the presence and consumption of LNCS through food and beverages according to consumption patterns in a representative sample (n = 256) of the Portuguese adult population. The study had a descriptive cross-sectional observational design and was based on the application of a Food Frequency Questionnaire. Overall, it was found that 4.1% of the foods and 16.7% of the beverages consumed by the Portuguese adult population contained LNCS. Food groups mostly contributing to LNCS consumption were non-alcoholic beverages such as soft drinks and juices (34.2%); milk and dairy products (16.5%); appetizers such as chips (8.6%); sugars and sweets such as chocolates, candies, or chewing gums (6.1%); meat and derivative products (2.2%); cereals and derivatives (1.2%) and canned fruits (1.2%). Main LNCS consumed were acesulfame-K, sucralose, and aspartame, single or combined, although their prevalence of use differs greatly among foods, beverages, or tabletop sweeteners. In conclusion, LNCS were found across a wide variety of products available in the Portuguese market and their prevalence of inclusion in the diet of the population evidences the need to develop more studies on the evolution of LNCS intake and its impact on the full dietary model and health. Consequently, these food additives should be included in food composition databases and, periodically, updated to reflect the recurrent reformulation strategies adopted by the food industry in its efforts to reduce the energy contribution of added sugars.

1247Low-calorie sweeteners consumption: a population-based study from Campinas, Brazil

Abstract Background The addition of low-calorie sweeteners (LCS) has been increasingly used by industry but their metabolic effects are controversial. Objectives: to estimate the consumption of foods and beverages with LCS among adolescents, adults and the elderly and to verify which food categories most contribute to this consumption. Methods Cross-sectional study. We used data from the Campinas Health Survey (ISACamp 2014-15) and the Food Consumption and Nutritional Status Survey (ISACamp-Nutri 2015-16) of 2570 individuals from 10 years old. We estimated the prevalence of LCS consumption and described the food categories that most contributed to this consumption. Using regression analysis, we verified which population groups had the highest consumption of products with LCS. Results More than 40% of adolescents, adults and the elderly consumed at least one product with LCS, mainly coming from sweetened beverages, tabletop sweeteners, and yogurt and other dairy beverages. The consumption of LCS was evenly found across adolescents and elderly from all socioeconomic strata, and whether elderly participants presented overweight and/or diabetes. Among adults, greater prevalence of foods and beverages with LCS consumption was found in those with higher education but did not vary by the presence of overweight and/or diabetes. Conclusions We found similar consumption of foods and beverages with LCS in most socioeconomic strata, and in participants with and without overweight or diabetes. Key messages The results can contribute to the development of public policies on clearer information of LCS addition in food labels.

Low- and No-Calorie Sweetener (LNCS) Consumption Patterns Amongst the Spanish Adult Population.

Low- and no-calorie sweeteners (LNCS) are a group of food additives characterized by their high sweetness intensity and virtually zero caloric content, attributes that make them potential substitutes for added sugars in processed foods and beverages. However, there is currently scarce information available about both the different LNCS used in food products available in Spain and their consumption patterns. Prompted by these reasons, the aim of this research work was to identify the presence and consumption of LNCS in food and beverages consumed by a representative sample of the Spanish adult population (n = 507). For this purpose, a Food Frequency Questionnaire was carried out. Overall, it was found that 4.5% of the foods and 22.3% of the beverages consumed by the surveyed population contained LNCS. The food groups that presented the highest percentage of daily servings containing LNCS were non-alcoholic beverages such as soft drinks and juices (36.1%); sugars and sweets such as chocolates, candies, or chewing gum (14.2%); milk and dairy products (7.0%); meat and derivative products (5.1%); cereals and derivatives (4.3%); appetizers (1.7%); and, finally, sauces and condiments such as ketchup or mustard (1.0%). The main LNCS consumed were acesulfame-K, sucralose, sorbitol, aspartame, and cyclamate, although their prevalence of use differs greatly among foods, beverages, or tabletop sweeteners. Our results show the great diversity of food groups that are currently including these compounds as ingredients. Consequently, there is a need for these food additives to be included in food composition databases, which should be regularly updated to include LNCS in order to facilitate their assessment and monitoring in dietary nutritional surveys.

Intake of low and no-calorie sweeteners (LNCS) by the Brazilian population

ABSTRACT Estimated intake of six low and no-calorie sweeteners (LNCS) (acesulfame potassium, aspartame, cyclamate, saccharin, steviol glycosides and sucralose) from processed foods and beverages, as well as from tabletop sweeteners uses, by the Brazilian population were derived and compared to the respective Acceptable Daily Intake (ADI). The estimates were based on dietary consumption data from a nationwide cross-sectional survey conducted by the Instituto Brasileiro de Geografia e Estatística (IBGE) in 2008–2009 and LNCS use rates and associated market share information based on data provided by Brazilian industry members. Two intake scenarios were considered: a conservative brand loyal consumer scenario that assumes all LNCS-containing foods and beverages and tabletop sweeteners contain the maximum reported LNCS concentrations (Scenario A) and a scenario representative of the general consumer population that uses a market share weighted average of the reported concentrations (Scenario B). Intake estimates were derived for the total Brazilian population (age 10 + y), and for the subpopulations of adolescents (10–18y), adults (19–59y), and older adults (60 + y). Intake of LNCS up to the 95th percentile did not exceed their respective ADI for all subpopulations considered, in either the general consumer scenario or the brand loyal scenario. Among consumers age 10 + y, the 95th percentile intakes of the various LNCS ranged from 6.8% to 54% of their respective ADI for the brand loyal scenario and from <1% to 6.0% of their respective ADIs for the general consumer scenario.

The drivers, trends and dietary impacts of non-nutritive sweeteners in the food supply: a narrative review.

Poor diets, including excess added sugar consumption, contribute to the global burden of disease. Subsequently, many nutrition policies have been implemented to reduce added sugar intake and improve population health, including taxes, education, labelling and environmental interventions. A potential consequence of these policy actions is the substitution of added sugars with non-nutritive sweeteners (NNS) in a variety of foods and beverages. NNS are used to reduce the energy and sugar content of foods and beverages while maintaining their palatability. Evidence of the toxicological risks of NNS is inconsistent, though concerns have been raised over the potential substitution effects of ultra-processed foods containing NNS for whole foods. This review aimed to provide an overview of current NNS food supply and consumption patterns, assess added sugar-reduction policies and their impact on NNS, and determine the impact of NNS on food choice, energy intake and diet quality. NNS are widely available in a variety of products, though most commonly in carbonated beverages, dairy products, confectionery, table-top sweeteners and fruit drinks. However, the longitudinal trends of different product categories, and differences between geographies and economy-income levels, require further study. Few studies have examined NNS consumption trends globally, though an increase in NNS consumption in beverages has been observed in some regions. Research examining how the increased availability of low-sugar, NNS-containing products affects global dietary patterns is limited, particularly in terms of their potential substitution effects.