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

2020 ◽  
pp. 1-24
Author(s):  
Cherie Russell ◽  
Carley Grimes ◽  
Phillip Baker ◽  
Katherine Sievert ◽  
Mark A. Lawrence
Keyword(s):  
Food Supply ◽  
Sugar Content ◽  
Substitution Effects ◽  
Added Sugar ◽  
Environmental Interventions ◽  
Added Sugars ◽  
Product Categories ◽  
Nutrition Policies ◽  
The Impact ◽  
Whole Foods

Abstract 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.

scholarly journals Does the Australian Health Star Rating System Encourage Added Sugar Reformulation? Trends in Sweetener Use in Australia

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 898
Author(s):  
Cherie Russell ◽  
Sarah Dickie ◽  
Phillip Baker ◽  
Mark Lawrence
Keyword(s):  
Food Supply ◽  
New Products ◽  
Substitution Effects ◽  
Added Sugar ◽  
Current Time ◽  
Added Sugars ◽  
Star Rating ◽  
Australian Health ◽  
Long Term Impact ◽  
Whole Foods

Dietary risk factors, including excess added sugar intake, are leading contributors to Australia’s burden of disease. An objective of the Australian Health Star Rating (HSR) system is to encourage the reformulation of packaged foods. Manufacturers may improve a product’s HSR by replacing added sugar with non-nutritive sweeteners (NNS). Concerns have been raised regarding the potential substitution effects of ultra-processed foods containing NNS for whole foods, and the long-term impact this may have on population health. The aim of this study was to determine whether the implementation of the HSR system has impacted the use of added sugars and NNS in the food supply. Four product categories were used: products with no added sweetener, products containing added sugar only, products containing NNS only, and products containing a combination of added sugar and NNS. Of 6477 newly released products analyzed displaying a HSR in Australia between 2014–2020, 63% contained added sugars. The proportion of new products sweetened with added sugars increased over time, while NNS use did not, despite a higher average and median HSR for products sweetened with NNS. These findings suggest that at the current time, the HSR system may not discourage the use of added sugars in new products or incentivize the reformulation of added sugar with NNS. As the health risks of NNS are questioned, increased reformulation of products with NNS to reduce the presence of added sugar in the food supply may not address broader health concerns. Instead, supporting the promotion of whole foods and drinks should be prioritized, as well as policy actions that reduce the proliferation and availability of UPFs.

scholarly journals The Sharp Rise in the Use of Low- and No-Calorie Sweeteners in Non-Alcoholic Beverages in Slovenia: An Update Based on 2020 Data

2021 ◽  
Vol 8 ◽  
Author(s):  
Edvina Hafner ◽  
Igor Pravst
Keyword(s):  
Food Supply ◽  
Sugar Content ◽  
Average Energy ◽  
Alcoholic Beverages ◽  
Steviol Glycosides ◽  
Added Sugar ◽  
Added Sugars ◽  
Total Sugar Content ◽  
Health Goal ◽  
Public Health Goal

Reducing added sugars in non-alcoholic beverages is an important public health goal, which can result in increased use of low- and no-calorie sweeteners (LNCS). The aim of this study was to investigate recent changes in the use of LNCS in non-alcoholic beverages in the Slovenian food supply. The national branded foods dataset was updated with beverages available in 2020, and compared with previous datasets. The data were extracted from food labels. In 2020, N = 1,650 unique beverages were found in shops from five different retailers, covering the majority of the national market. The use of LNCS increased from 13.2% in 2017 and 15.5% in 2019 to 20.2% in 2020, with a major growth in soft drinks (16.8, 19.6, and 26.7%, respectively). We observed a significant growth of beverages containing both LNCS and added sugar. Results were also consistent with sales data, which showed that increased offer of beverages with LNCS also resulted in similarly increased sales of such beverages. The average energy and total sugar content in non-alcoholic beverages decreased, which reflects both the higher percentage of beverages with LNCS, and also the reduction of the sugar content in beverages with only added sugar. Analyses of product-specific reformulation practices highlighted reduced sugar content in 16.8% of products, and in 3.6% with the use of LNCS. The most commonly used LNCS are acesulfame K, sucralose, and aspartame. Typically, combinations are used, however steviol glycosides, sucralose and saccharin are also used alone, in most cases combined with added sugar. The results indicated rapid changes in the use of LNCS in non-alcoholic beverages in the Slovenian food supply, making further monitoring of this area highly relevant.

scholarly journals The impact of salt, fat and sugar levels on toddler food intake

2010 ◽  
Vol 105 (4) ◽  
pp. 645-653 ◽  
Author(s):  
Sofia Bouhlal ◽  
Sylvie Issanchou ◽  
Sophie Nicklaus
Keyword(s):  
Food Intake ◽  
Positive Impact ◽  
Sugar Content ◽  
Green Beans ◽  
Added Sugar ◽  
Salt Level ◽  
Sugar Addition ◽  
Before And After ◽  
Sugar Levels ◽  
The Impact

Understanding the early determinants of food intake, in particular the role of food sensory quality, is a necessary step to improve the prevention of unhealthy food habits. However, the extent to which food intake varies according to salt, fat and sugar content is imperfectly known. The present study aimed at evaluating whether toddler food intake varied during lunches or snacks in which salt, fat or sugar contents had been modified in common foods. Seventy-four children (30 (se 0·5) months old) participated in the study in their usual day-care centres. Every other week, they were served lunches composed, among other items, of green beans and pasta with varying salt (0, 0·6 and 1·2 % added salt) or fat (0, 2·5 and 5 % added butter) levels and afternoon snacks composed of fruit purée varying in sugar level (0, 5 and 10 % added sugar). During each meal, children could eat as much as they wanted from the target foods. Each food was weighed before and after the meal. Salt level had a positive impact on the intake of the target foods. On the contrary, no impact of added fat or added sugar levels was observed. This implies that fat and sugar addition could be avoided in foods for children without having an impact on palatability, allowing the energy density of children's diet to be limited. Salt addition should be limited, but its suppression in vegetables, whose intake is to be promoted, should be considered cautiously.

scholarly journals High sugar content of baby foods sold in Europe

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Jayne Hutchinson ◽  
Holly Rippin ◽  
Diane Threapleton ◽  
Jo Jewell ◽  
Joao Breda ◽  
...  
Keyword(s):  
Sugar Content ◽  
Total Sugar ◽  
Free Sugar ◽  
Food Category ◽  
Added Sugars ◽  
Baby Foods ◽  
Product Categories ◽  
High Sugar Content ◽  
European Regulations ◽  
The Uk

AbstractWHO guidelines on sugars strongly recommend reducing free sugar intake to below 10% of total energy, also their guidance on ‘Ending the inappropriate promotion of foods for infants and young children (IYC)’ recommends avoiding free sugars. Information on the sugar content of commercially available complementary foods (CACFs) for infants is limited, and the levels of added, free, and total sugar in baby foods is not fully addressed in existing guidelines. Up-to-date data is needed to inform recommendations for revising European regulations and guidelines. Front and back of pack information for baby foods from countries across the WHO European Region was collected. Mean sugar content per 100 g product and percentage energy from total sugar by food category were determined. The percentage of products containing added sugars by food category was calculated; as was the percentage of savoury meals containing pureed fruit, which is often used to sweeten products. The creation of the product categories was part of WHO work to develop a Nutrient Profile Model for CACFs marketed as suitable for IYC aged 6–36 months. A literature review of current issues also informed the process. 2642 CACFs from 10 countries were summarised; 768 products sold in the UK; over 200 each from Denmark (319), Spain (241), Italy (430) and Malta (243) and between 100–200 from Hungry, Norway, Portugal and Slovenia. About a third of energy in CACFs in these European countries came from total sugar and the mean contribution of total sugar for most food categories in the countries was higher than 10%. The amount of added and free sugar content was not labelled. However, added sugars listed as ingredients were widespread across product categories, and the type varied across countries and products, though concentrated fruit juice was most common. Savoury meal purees did not contain added sugars except in UK and Malta; however fruit puree as an ingredient was found in 7% of those examined across Europe and were most likely in UK savoury meals: in 15% on average and 41% of pureed meals with meat as the first named food. In conclusion, the sugar content of baby foods across Europe is high and updated regulations and reformulation are needed. Sugars can be restricted in a variety of ways, but first consultation with WHO Europe Member States is required to support the establishment of effective legal and policy measures to avoid inappropriate manufacture and selling of infant foods.

scholarly journals Probabilistic Model to Assess the Impact of Sugar Taxation on Low/No-Calorie Sweeteners Displacing Added Sugar Intakes (P13-029-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Sandrine Pigat
Keyword(s):  
Food Consumption ◽  
Open Data ◽  
Product Category ◽  
Food Product ◽  
Concentration Data ◽  
Added Sugar ◽  
Specific Product ◽  
Added Sugars ◽  
Product Composition ◽  
The Impact

Abstract Objectives In the last few years, the sugar tax, predominantly targeting sugar sweetened beverages, has been introduced in a range of different countries globally. This has led to reformulation of product portfolios around the time of the tax introduction, in order to meet the public health bodies’ demands on reducing sugar in specific products but likely also to come in below the levy's sugar threshold. As a result, label and own brand products have been reformulated where low/no-calorie sweeteners (LNCS) are displacing added sugars. The change in product composition from sugar sweetened to products now containing levels of both added sugars and LNCS has had an impact on reducing added sugar intakes and possibly increased exposure to LNCS in populations, a recent shift that has not been captured yet in national health and food consumption surveys and it will be likely a few more years before this will be quantified in the next round of surveys. Methods In order to assess the impact of this change, food consumption survey data may be used in conjunction with more up to date brand composition data and information on LNCS presence and use levels. Results Examples of up-to-date brand specific product composition databases and initiatives include Mintel, GS1 Branded Foods Database, Country specific branded food databases, ILSI Branded Foods Database, Food Switch, Label Insight's Open Data initiative or the collecting industry data. Market representative LNCS occurrence can then be assessed per food product category in order to calculate the probability of presence of different LNCS in each food product categories. Similarly more up-to-date added sugar concentration data can be obtained and substituted for out-of-date data. LNCS use levels from the food categories of interest, or regulatory use levels from the locally relevant additive regulation, can then be applied to the model. Conclusions A probabilistic intake assessment, accounting for presence probability of LNCS and new distributions of added sugar vs LNCS concentrations as well as distribution of food consumption can then help estimate the current intake of added sugars and LNCS, especially post the recent introduction of the sugar tax across different countries. Funding Sources Creme Global.

scholarly journals 0271 Effects of Experimentally Shortened Sleep on Dietary Outcomes in Adolescents

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A103-A103
Author(s):  
K M Duraccio ◽  
K N Krietsch ◽  
D W Beebe
Keyword(s):  
Glycemic Index ◽  
Family Income ◽  
Sugar Content ◽  
Glycemic Load ◽  
Dietary Quality ◽  
Repeated Measure ◽  
Added Sugars ◽  
Main Effect ◽  
Sleep Condition ◽  
The Impact

Abstract Introduction Adolescents who sleep less may consume more calories during the day; however, shortened sleep may have greater impact on the dietary quality of foods, particularly foods high in sugar content. This study examined the impact of shortened sleep on total caloric intake, macronutrients of food (fats, proteins, carbohydrates), added sugars consumed, and glycemic load/index of foods consumed. Methods 110 adolescents (ages 14–17, M = 15.73(1.80); 63.6% female) underwent a within-subject counterbalanced experimental sleep manipulation, spending either 6.5 or 9.5 hours/night in bed for five nights. During each sleep period, adolescents completed three dietary recalls (reporting amounts and types of foods consumed over a 24-hour period) administered by dietary core study staff. We conducted a series of repeated-measure general linear models comparing averaged weekly dietary outcomes of interest by sleep condition. We also explored whether experimental order of the sleep conditions, family income, or adolescent gender, body mass index (BMI), or race moderated the main effects of sleep condition on dietary outcomes. Alpha was set at .05 for primary analyses and .01 for exploratory analyses. Results We observed a main effect of sleep on carbohydrates (p=.038) and added sugars (p=.009) consumed, as well as the glycemic index (p=.013) and glycemic load (p=.009) of foods consumed. We did not observe a main effect of sleep on total calories or total grams of fat or protein consumed. Exploratory analysis found no significant interactions of the moderators with sleep condition on dietary outcomes. Conclusion Adolescents are consuming more carbohydrates, added sugars, and foods higher in glycemic index and load when sleep restricted, compared to well-rested, despite eating comparable amounts of calories. Sleep restricted adolescents may be drawn to foods that provide quick releases of energy to counteract sleepiness experienced during the day. Support R01 HL120879

scholarly journals The major types of added sugars and non-nutritive sweeteners in a sample of Australian packaged foods

2017 ◽  
Vol 20 (18) ◽  
pp. 3228-3233 ◽  
Author(s):  
Yasmine C Probst ◽  
Alexis Dengate ◽  
Jenny Jacobs ◽  
Jimmy CY Louie ◽  
Elizabeth K Dunford
Keyword(s):  
Food Supply ◽  
Secondary Analysis ◽  
Dietary Recommendations ◽  
Added Sugar ◽  
Added Sugars ◽  
Maple Syrup ◽  
Glucose Syrup ◽  
Packaged Foods ◽  
Packaged Food ◽  
Insight Into

AbstractObjectiveLimiting the intake of added sugars in the diet remains a key focus of global dietary recommendations. To date there has been no systematic monitoring of the major types of added sugars used in the Australian food supply. The present study aimed to identify the most common added sugars and non-nutritive sweeteners in the Australian packaged food supply.DesignSecondary analysis of data from the Australian FoodSwitch database was undertaken. Forty-six added sugars and eight non-nutritive sweetener types were extracted from the ingredient lists of 5744 foods across seventeen food categories.SettingAustralia.SubjectsNot applicable.ResultsAdded sugar ingredients were found in 61 % of the sample of foods examined and non-nutritive sweetener ingredients were found in 69 %. Only 31 % of foods contained no added sugar or non-nutritive sweetener. Sugar (as an ingredient), glucose syrup, maple syrup, maltodextrin and glucose/dextrose were the most common sugar ingredient types identified. Most Australian packaged food products had at least one added sugar ingredient, the most common being ‘sugar’.ConclusionsThe study provides insight into the most common types of added sugars and non-nutritive sweeteners used in the Australian food supply and is a useful baseline to monitor changes in how added sugars are used in Australian packaged foods over time.

scholarly journals Non-nutritive sweeteners in the food supply: changes after the first phase of the Chilean Food Law

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Zancheta Ricardo ◽  
C Corvalan ◽  
L Tallie ◽  
V Quitral ◽  
M Reyes
Keyword(s):  
Food Supply ◽  
Sugar Content ◽  
Food Group ◽  
Food Groups ◽  
Chi Square ◽  
Cross Sectional ◽  
Food Law ◽  
The Law ◽  
Advertising Law ◽  
The Impact

Abstract Background In June 2016, Chile implemented the Food Labeling and Advertising Law, which includes mandatory front-of-package warning labels in products with high content of sugars and other key nutrients. We evaluated whether the non-nutritive sweeteners (NNS) use increased among foods/beverages 7-8 months after implementation of the law. Methods We obtained data from packaged foods/beverages available in 6 major supermarkets and 3 candy distributions in Santiago, Chile, in January 2015/16 (T0) and January 2017 (T1). We included products with market share ≥1% of their food groups, with added sugar, salt or fat (i.e. products subject to regulation) and/or with NNS from 7 food groups: beverages, breakfast cereals, candies, sweet spreads, desserts, yogurts, and milk-based drinks, in cross-sectional (T0: N = 1,809; T1: N = 1,478) and longitudinal (i.e. same product collected in both periods; N = 999) samples. We compared the frequencies applying Chi-square and McNemar tests. Results In the cross-sectional analysis, there was no significant change in the frequency of NNS use neither considering the overall sample or each food group. Across all groups, about 40% of products presented at least one NNS in both periods, with the highest prevalence among beverages (T0:77%; T1:80%, p = 0.314) and yogurts (T0:63%; T1:68%, p = 0.312). In the longitudinal sample, the frequency of NNS use increased from 38% in T0 to 44% in T1 (p < 0.001). Changes were observed in milk-based drinks (T0:50%; T1:67%, p = 0.008); beverages (T0:72%; T1:83%, p < 0.001); desserts (T0:14%; T1:23%, p < 0.001); and yogurts (T0:60%; T1:63%, p = 0.046). Conclusions Our results suggest increased NNS use in the longitudinal subsample after the implementation of the law; however, the overall frequency in the food supply remained the same, which could be explained either by changes in the food supply or sampling differences between the periods. Further analyses must explore the impact of these changes in NNS consumption. Key messages Regulations aimed to reduce food sugar content could impact the food NNS content. Monitoring the use of NNS in the food supply and its impact on NNS consumption is important in the current policy scenario.

Abstract MP41: Quantifying the Health and Economic Impact of the FDA Added Sugar Labeling Mandate in the US: A Cost-Effectiveness Analysis

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Yue Huang ◽  
Chris Kypridemos ◽  
Junxiu Liu ◽  
Yujin Lee ◽  
Brendan Collins ◽  
...  
Keyword(s):  
Sugar Content ◽  
Cost Savings ◽  
Economic Effects ◽  
Population Heterogeneity ◽  
Dietary Recommendations ◽  
Potential Health ◽  
Added Sugar ◽  
Added Sugars ◽  
Life Years ◽  
The Us

Introduction: Excess added sugars, particularly from sugar-sweetened beverages (SSBs), are linked to cardiometabolic risk including obesity, type 2 diabetes (T2D) and CVD. Despite recent declines in SSB intake in the US, added sugar intake from SSBs and foods remains high and exceeds dietary recommendations. In May 2016, the US Food and Drug Administration (FDA) announced major revisions to the Nutrition Facts panel, including mandatory labeling of added sugar content, as a strategy to target added sugars from packaged foods and beverages. Yet, potential health effects remain unclear; and the FDA recently announced delays in implementation. Aim: To estimate the cardiometabolic and economic effects of implementing FDA’s added sugar labeling policy over a 20-year horizon. Methods: A validated microsimulation model, the US IMPACT Food Policy Model, was used to estimate the T2D and CVD cases averted and quality-adjusted life-years (QALYs) gained from the FDA policy for US adults age 30+ years. Model inputs included: nationally representative demographics and added sugar intakes from NHANES; policy effects on consumer intake from labeling intervention studies; obesity-mediated effects and direct independent effects of added sugars from SSBs and other foods, considered separately, on T2D and CVD from meta-analyses; policy costs including government administrative costs and industry compliance costs from federal government reports; national health statistics from the CDC; and healthcare costs including medical, productivity, and indirect costs from the AHA and American Diabetes Association. All costs were inflated to constant 2017 US dollars, discounted annually at 3%. We took a societal perspective and assumed a willingness to pay of $100,000 per QALY. Probabilistic sensitivity analysis accounted for model parameter uncertainty and population heterogeneity. Results: Between 2018 and 2037, the FDA added sugar labeling policy could prevent approximately 580,000 (95% UI: 270,000–960,000) T2D cases and 210,000 (96,000–440,000) CVD cases, generating 600,000 (290,000–970,000) discounted QALYs. The policy would produce discounted net cost savings (health savings minus policy costs) of $47.3bn (21.7-78.6), including $25.6bn (11.9-43.1) from direct healthcare cost reductions. Most (>60%) savings were driven by costs related to T2D. Incorporating modelling and input uncertainty, the FDA added sugar label was estimated with >80% probability to be cost-effective by 2020 and cost-saving by 2022. Potential additional reductions from industry reformulations were not included and could further increase cost-savings. Conclusions: Implementing the FDA added sugar labeling mandate would generate substantial health gains and cost savings for the US population, highlighting the need for timely implementation, monitoring and evaluation.

scholarly journals Trends in the Use of Low and No-Calorie Sweeteners in Non-Alcoholic Beverages in Slovenia

Foods ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 387
Author(s):  
Edvina Hafner ◽  
Maša Hribar ◽  
Hristo Hristov ◽  
Anita Kušar ◽  
Katja Žmitek ◽  
...  
Keyword(s):  
Food Supply ◽  
Energy Content ◽  
Sugar Content ◽  
Sweet Taste ◽  
Capital City ◽  
Alcoholic Beverages ◽  
Grocery Stores ◽  
Added Sugar ◽  
Energy Value ◽  
The Difference

Excessive sugar intake and the associated increased obesity risk indicate that food reformulation is needed. Non-alcoholic beverages are often high in free sugars, making reformulation with low and no-calorie sweeteners (LNCS) a common choice. Our knowledge of the use of LNCS in the European food supply is, however, very limited. This study aimed to evaluate the trends in the use of LNCS in different non-alcoholic beverages in the Slovenian food supply over the course of two years. We assessed which LNCS are most used and how the use of LNCS affects energy and sugar content. We analyzed labeling information of non-alcoholic beverages in selected grocery stores, covering the majority of the Slovenian food supply. Selected grocery stores were located in the capital city (Ljubljana). LNCS were present in 13.2% and 15.5% of non-alcoholic beverages in the years 2017 and 2019, respectively. The use of LNCS has significantly increased only in energy drinks (p < 0.01). The most used LNCS in 2017 were acesulfame K, aspartame, and cyclamates. In 2019 the use of sucralose increased significantly (p < 0.01) to become the second most used LNCS. Energy and sugar content varied between subcategories, which depended on the presence of added sugar and LNCS. Comparison between the energy value and the presence of the LNCS showed an almost 50% lower energy content of beverages containing both added sugar and LNCS (E2017 = 92.8 kJ; E2019 = 96.2 kJ per 100 mL), compared with beverages with only added sugar (E2017 = 161.8 kJ; E2019 = 159.0 kJ per 100 mL). In beverages sweetened only with LNCS, the difference was even more noticeable (E2017 = 22.3 kJ; E2019 = 14.3 kJ per 100 mL). Results show that the use of LNCS can help producers reduce the energy value of non-alcoholic beverages. Still, compared to other countries, the offer of such products in the Slovenian food supply is relatively low. However, due to possible public health risks of excessive use of LNCS, producers should be further encouraged for reformulation and production of less sweet products without LNCS, enabling consumers to adapt to less sweet taste of beverages. Further monitoring of LNCS in the food supply is therefore recommended, preferably also with consideration of sales data.

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