Low/no calorie sweeteners can make a useful contribution to public health strategies

The International Sweeteners Association (ISA) welcomes the publication this month of a new scientific report* by Ashwell et al. in

Nutrition Research Reviews

.(1)

This new publication points to the extensive body of robust scientific evidence that shows that low/no calorie sweeteners:

– Are safe: all of them have undergone an extensive safety evaluation process by food safety authorities globally prior to being approved for use on the market;
– Have no adverse effect on blood glucose regulation in people with and without diabetes and lead to a lower blood glucose rise compared to sugar;(2) they have therefore a role to play in the dietary management of diabetes when used as substitutes for sugars;
– Can help reduce net calorie intake while providing the desired sweet taste, when used in place of sugar to reduce energy density of foods and drinks; and
– Can be part of the strategies to consider to reduce sugars intake, in line with public health recommendations worldwide aimed at reducing the risk and prevalence of obesity, a major public health concern.

While reduction in the intake of sugars is being recommended around the world to address the increasing rates of obesity, the authors agree on the need for evidence-based communication to ensure more informed public health decisions and public attitudes towards low/no calorie sweeteners.

Commenting on the paper, lead author Dr Margaret Ashwell highlighted that: “The aim of our workshop was to stimulate forward thinking as well as to restate principles. It is the consensus of the panel that the substantial body of evidence around low calorie sweeteners’ safety and role in helping people reduce their sugar and calorie intake, a public health priority, should be communicated in a consistent manner”. Co-author Sigrid Gibson added: “We [the 17 panel experts] came together to discuss and debate what we really do know, what we don’t yet know, and what should be done in relation to research on low calorie sweeteners, in light of current public health policies. This experts’ consensus is important because it provides clarity to communicators, so that they know they can give a message with confidence. So, we hope that the recommendations arising from this workshop will assist policy makers and other stakeholders including NGOs, health professionals, research funding bodies and the food and beverage industry”.

Provided that they are used in place of sugar and in the context of a healthy diet and lifestyle, the experts agree that low/no calorie sweeteners have a beneficial role to play in helping achieve sugar and calorie intake reduction, which associated health gains cannot be ignored. They clarified that the benefit of using low/no calorie sweeteners will depend on the amount of sugars replaced in the diet as well as the overall diet quality. As also stated by the experts’ panel, the “Use of LCS [low calorie sweeteners] alone cannot be expected to act as a ‘silver bullet’ for weight loss”. Nevertheless, and based on the robust scientific evidence considered, the authors concluded that low/no calorie sweeteners can be useful in dietary approaches to both prevent and manage diabetes and obesity, and can facilitate reduction in energy intake and weight loss.

Having discussed research priorities, and in line with other consensus of experts published recently(3,4), the panel agreed that future research should include well-designed, high-quality human studies to confirm long-term benefits of low/no calorie sweeteners. Furthermore, the report indicated the need for studies to model low/no calorie sweeteners’ impact on sugar reduction and diet quality. With regard to suggested actions, the group of experts pointed to the importance of effective communication strategies to inform consumers – to tackle misperceptions – as well as NGOs, health professionals, research funding bodies and the food and beverage industry. They further concluded that: “Efforts should be made to understand and, where possible, reconcile policy discrepancies between organisations and reduce regulatory hurdles that impede product development and reformulation designed to reduce sugars and/or calories.”

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For the video abstract of the paper by Ashwell et al., please click here:

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*The publication of this paper by Ashwell et al. follows a consensus workshop on low/no calorie sweeteners held in November 2018 and supported by the International Sweeteners Association (ISA). This workshop gathered seventeen leading international experts on low/no calorie sweetener-related topics who reviewed and discussed the existing science relating to the use of low/no calorie sweeteners as relevant to current public health policies. The workshop was preceded by the 3rd International Sweeteners Association (ISA) Conference entitled ‘The science behind low calorie sweeteners: where evidence meets policy’

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References:

(1) Ashwell MA, Gibson S, Bellisle F, Buttriss J, Drewnowski A, Fantino M, Gallagher AM, de Graaf K, Goscinny S, Hardman CA, Laviada-Molina H, López-García R, Magnuson B, Mellor D, Rogers P, Rowland I, Russell W, Sievenpiper J, la Vecchia C. Expert consensus on low calorie sweeteners: facts, research gaps and suggested actions. Nutr Res Rev. 2020 Jan 13:1-10. doi: 10.1017/S0954422419000283. Available online here. [Epub ahead of print]

(2) The European Food Safety Authority (EFSA) has concluded that: “Consumption of foods/drinks containing intense sweeteners instead of sugar induces a lower blood glucose rise after their consumption compared to sugar-containing foods/drinks” and that: “Consumption of foods/drinks containing intense sweeteners instead of sugar contributes to the maintenance of tooth mineralisation”. EFSA Scientific opinion on the substantiation of health claims related to intense sweeteners. EFSA 2011 Journal 9(6): 2229, and 9(4): 2076

(3) Gibson S, Drewnowski A, Hill J et al. (2014) Consensus statement on benefits of low calorie sweeteners. Nutrition Bulletin 39, 386-389.

(4) Serra-Majem L, Raposo A, Aranceta-Bartrina J et al. (2018) Ibero-American Consensus on Low- and No-Calorie Sweeteners: Safety, Nutritional Aspects and Benefits in Food and Beverages. Nutrients 10, 818.