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Non-Nutritive Sweeteners: A Global Perspective
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Non-Nutritive Sweeteners: A Global Perspective

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (30 December 2017) | Viewed by 45735

Special Issue Editors

Dr. Kristina Ingeborg Rother

E-Mail Website
Guest Editor
Chief, Section on Pediatric Diabetes and Metabolism, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD 20892, USA
Interests: diabetes; non-nutritive sweeteners; metabolism; obesity; pediatrics
Dr. Allison C. Sylvetsky

E-Mail Website
Guest Editor
Milken Institute School of Public Health, The George Washington University, Washington, DC 20052, USA
Interests: nutrition; obesity; diabetes; sugar; low-calorie sweeteners; beverage consumption
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The purpose of this Special Issue entitled, Non-Nutritive Sweeteners: A Global Perspective is (1) to document estimates of non-nutritive sweetener use worldwide and to evaluate global trends in their consumption; (2) to investigate contextual and demographic determinants of non-nutritive sweetener use in different regions; (3) to compare the potential roles of non-nutritive sweeteners in metabolism, health, and disease and how these effects may differ across global sub-populations; (4) to highlight recent advances in food technology and food science likely to exert influence on global non-nutritive sweetener consumption; and (5) to outline key future research needs related to non-nutritive sweeteners and their proposed effects on a global scale.

We know from a growing body of literature that whether non-nutritive sweeteners are helpful or harmful in weight management and chronic disease prevention likely differs based on the demographic and metabolic characteristics of individuals and communities consuming them.

Significant heterogeneity in their effects also exists based on the broader context in which they are used. However, the majority of prospective, randomized studies evaluating the effects of non-nutritive sweeteners have been conducted among healthy adults, primarily those residing within the United States, and are often conducted in the context of intensive behavioral weight loss interventions. These results therefore may not be globally generalizable. As non-nutritive sweetener consumption continues to increase worldwide, it is critical to evaluate their use in diverse populations, representing a range of age, weight status, genetic make-up, race/ethnic background, and dietary patterns.

Combining current estimates of global non-nutritive sweetener consumption with clinical and epidemiologic human studies evaluating their effects will add considerably to the current knowledge base surrounding non-nutritive sweetener use worldwide. We expect that this Special Issue will have key implications for future research, as well as technological advances in food science and perhaps, global nutrition policies.

We plan to invite submission of papers that address the following topics related to non-nutritive sweeteners:

  • Global consumption estimates (national/regional as well as worldwide) and perspective on future global use
  • Economic analyses non-nutritive sweeteners cost and prices spanning production, manufacturing, and consumption
  • Genetic, cultural and demographic determinants of non-nutritive sweetener use worldwide
  • Metabolic and health effects of non-nutritive sweeteners, with particular emphasis on heterogeneity of effects across different world populations
  • Technological advances in food science and product development (new sweeteners) likely to influence perceived sweetness of foods and beverages
  • Novel approaches to assess non-nutritive sweetener intake in order to facilitate valid and reliable assessments of their effects

We look forward to receiving your submissions and please do not hesitate to contact us with any questions regarding this issue.

Thank you and kind regards,

Dr. Kristina I. Rother
Assist. Prof. Allison C. Sylvetsky
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Non-nutritive sweeteners
  • Artificial sweeteners
  • Low-calorie sweeteners
  • High-intensity sweeteners
  • Sucralose
  • Aspartame
  • Saccharin
  • Stevia
  • Neotame
  • Acesulfame-potassium
  • Diet beverages
  • Soft drinks
  • Diet
  • Nutrition
  • Obesity
  • Diabetes
  • Metabolism

Published Papers (5 papers)

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Research

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10 pages, 951 KiB  
Article
Characterization of the Types of Sweeteners Consumed in Honduras
by Adriana Hernández, Adriana Beatriz Di Iorio, Jeffrey Lansdale and María Belén Salazar
Nutrients 2018, 10(3), 338; https://doi.org/10.3390/nu10030338 - 11 Mar 2018
Cited by 5 | Viewed by 5947
Abstract
Sweeteners are found in all types of foods, and their high consumption is associated with chronic degenerative diseases, such as diabetes and obesity, among others. A characterization was carried out of food products with sweeteners from the three biggest supermarkets at a national [...] Read more.
Sweeteners are found in all types of foods, and their high consumption is associated with chronic degenerative diseases, such as diabetes and obesity, among others. A characterization was carried out of food products with sweeteners from the three biggest supermarkets at a national level; they were identified by the list of ingredients and classified according to caloric or non-caloric intake, and pursuant to their country of origin. A statistical interpretation of results was made using descriptive measures such as the number of times the sweeteners were found in the formulation of the products and how many of them were found in a product at the same time. In total, 341 products were evaluated and classified according to the processed food categories of the Pan American Health Organization (PAHO) nutrient profile. The category of beverages had the highest quantity of products with sweeteners, and their consumption by the inhabitants represents a high exposure. Overall, 60.1% of the products evaluated were of US origin; these US exports have a significant impact on the Honduran market. A high-fructose corn syrup caloric sweetener was the one most frequently found in these products; at least 51% are combined with additional sweeteners to increase the sweetening effect. Full article
(This article belongs to the Special Issue Non-Nutritive Sweeteners: A Global Perspective)
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13 pages, 1152 KiB  
Article
The Reproducibility and Comparative Validity of a Non-Nutritive Sweetener Food Frequency Questionnaire
by Emily A. Myers, Erin M. Passaro and Valisa E. Hedrick
Nutrients 2018, 10(3), 334; https://doi.org/10.3390/nu10030334 - 10 Mar 2018
Cited by 8 | Viewed by 5381
Abstract
In order to better assess non-nutritive sweetener (NNS) consumption, measurement tools with greater utility are needed. The objective of this investigation is to determine the reproducibility and validity of a newly developed NNS food frequency questionnaire (NNS-FFQ) that measures five types of NNS [...] Read more.
In order to better assess non-nutritive sweetener (NNS) consumption, measurement tools with greater utility are needed. The objective of this investigation is to determine the reproducibility and validity of a newly developed NNS food frequency questionnaire (NNS-FFQ) that measures five types of NNS (saccharin, aspartame, acesulfame potassium, sucralose and erythritol). Adult participants (n = 123, 56% female, 75% Caucasian, mean age = 36.8 ± 16.6) completed the NNS-FFQ twice and had 24-h dietary recalls three times over a two-week study period. Reproducibility between two administrations of the NNS-FFQ was assessed via Bland–Altman plots, Spearman’s correlations (rs) and paired samples t-tests. Bland–Altman plots, Cohen’s κ, Spearman’s correlations (rs), and paired samples t-tests compared NNS intake between the two methods for validity. For reproducibility analyses, Bland–Altman analyses revealed agreement levels above the 95% acceptance level for total NNS (99.2%), erythritol (99.2%), and aspartame (96.7%). Agreement levels for acesulfame potassium (94.3%), saccharin (94.3%), and sucralose (94.3%) were slightly below the acceptable level. For validity analyses, Bland–Altman analyses revealed agreement levels above the 95% acceptance level for total NNS (95.1%), sucralose (95.9%), saccharin (95.9%), and erythritol (95.1%). Agreement levels for aspartame (94.3%) and acesulfame potassium (92.7%) were slightly below the acceptable level. Although less than desirable agreement was found between the methods for aspartame and acesulfame potassium, some variance was expected due to the habitual nature of the NNS-FFQ as compared to the recent intake reported by recalls. Within the context of this constraint, the NNS-FFQ demonstrates acceptable reproducibility and validity. The NNS-FFQ is a brief questionnaire that could be administered among diverse participants at the individual and population levels to measure habitual NNS intake. Full article
(This article belongs to the Special Issue Non-Nutritive Sweeteners: A Global Perspective)
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13 pages, 256 KiB  
Article
Non-Nutritive Sweeteners in the Packaged Food Supply—An Assessment across 4 Countries
by Elizabeth K. Dunford, Lindsey Smith Taillie, Donna R. Miles, Helen Eyles, Lizbeth Tolentino-Mayo and Shu Wen Ng
Nutrients 2018, 10(2), 257; https://doi.org/10.3390/nu10020257 - 24 Feb 2018
Cited by 61 | Viewed by 8409
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, [...] Read more.
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. Full article
(This article belongs to the Special Issue Non-Nutritive Sweeteners: A Global Perspective)

Review

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39 pages, 437 KiB  
Review
Low-/No-Calorie Sweeteners: A Review of Global Intakes
by Danika Martyn, Maryse Darch, Ashley Roberts, Han Youl Lee, Tina Yaqiong Tian, Naoko Kaburagi and Pablo Belmar
Nutrients 2018, 10(3), 357; https://doi.org/10.3390/nu10030357 - 15 Mar 2018
Cited by 76 | Viewed by 13361
Abstract
The current review examined published data on the intake of all major low-/no-calorie sweeteners—aspartame, acesulfame-K, saccharin, sucralose, cyclamate, thaumatin and steviol glycosides—globally over the last decade. The most detailed and complex exposure assessments were conducted in Europe, following a standardized approach. Japan and [...] Read more.
The current review examined published data on the intake of all major low-/no-calorie sweeteners—aspartame, acesulfame-K, saccharin, sucralose, cyclamate, thaumatin and steviol glycosides—globally over the last decade. The most detailed and complex exposure assessments were conducted in Europe, following a standardized approach. Japan and Korea similarly had up-to-date and regular intake data available. The data for other Asian countries, Latin America, Australia/New Zealand and global estimates, evaluated by the Joint FAO/WHO Expert Committee on Food Additives (JECFA), while available, were shown to be more limited in terms of design. Overall, the studies conducted since 2008 raised no concerns with respect to exceedance of individual sweetener acceptable daily intake (ADIs) among the general population globally. The data identified do not suggest a shift in exposure over time, with several studies indicating a reduction in intake. However, some data suggest there may have been an increase in the numbers of consumers of low-/no-calorie-sweetened products. Future research should consider a more standardized approach to allow the monitoring of potential changes in exposure based upon events such as sugar reduction recommendations, to ensure there is no shift in intake, particularly for high-risk individuals, including diabetics and children with specific dietary requirements, and to ensure risk management decisions are based on quality intake analyses. Full article
(This article belongs to the Special Issue Non-Nutritive Sweeteners: A Global Perspective)
18 pages, 721 KiB  
Review
Early-Life Exposure to Non-Nutritive Sweeteners and the Developmental Origins of Childhood Obesity: Global Evidence from Human and Rodent Studies
by Alyssa J. Archibald, Vernon W. Dolinsky and Meghan B. Azad
Nutrients 2018, 10(2), 194; https://doi.org/10.3390/nu10020194 - 10 Feb 2018
Cited by 45 | Viewed by 11784
Abstract
Non-nutritive sweeteners (NNS) are increasingly consumed by children and pregnant women around the world, yet their long-term health impact is unclear. Here, we review an emerging body of evidence suggesting that early-life exposure to NNS may adversely affect body composition and cardio-metabolic health. [...] Read more.
Non-nutritive sweeteners (NNS) are increasingly consumed by children and pregnant women around the world, yet their long-term health impact is unclear. Here, we review an emerging body of evidence suggesting that early-life exposure to NNS may adversely affect body composition and cardio-metabolic health. Some observational studies suggest that children consuming NNS are at increased risk for obesity-related outcomes; however, others find no association or provide evidence of confounding. Fewer studies have examined prenatal NNS exposure, with mixed results from different analytical approaches. There is a paucity of RCTs evaluating NNS in children, yielding inconsistent results that can be difficult to interpret due to study design limitations (e.g., choice of comparator, multifaceted interventions). The majority of this research has been conducted in high-income countries. Some rodent studies demonstrate adverse metabolic effects from NNS, but most have used extreme doses that are not relevant to humans, and few have distinguished prenatal from postnatal exposure. Most studies focus on synthetic NNS in beverages, with few examining plant-derived NNS or NNS in foods. Overall, there is limited and inconsistent evidence regarding the impact of early-life NNS exposure on the developmental programming of obesity and cardio-metabolic health. Further research and mechanistic studies are needed to elucidate these effects and inform dietary recommendations for expectant mothers and children worldwide. Full article
(This article belongs to the Special Issue Non-Nutritive Sweeteners: A Global Perspective)
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