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Sweeteners pp 613–642Cite as

Sweeteners: Regulatory Aspects

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Part of the book series: Reference Series in Phytochemistry ((RSP))

Abstract

Evidence suggests that excessive intake of added sugars has adverse effects on cardiometabolic health. In this chapter we review the role and potential benefits of noncaloric sweeteners, as a part of the diet. After their emergence and because of their supposed beneficial effects in different conditions as diabetes or obesity, an increasing number of studies show controversial results. Some of them even suggest that they are ineffective. In conclusion, further research and results are needed to provide convincing evidence of their long-term effectiveness and the absence of negative effects secondary to their use. It is interesting to examine the distinctive properties of sweeteners compared with sugar, the gold standard. We will focus on other substances that are commonly used to sweeten foods instead of sugar.

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Abbreviations

ACS:

The American Cancer Society

ADA:

The American Diabetes Association

ADI:

Acceptable daily intake

AHA:

The American Heart Association

APM:

Aspartame

BMI:

Body mass index

DM:

Diabetes mellitus

EDI:

Estimated daily intake

EFSA:

European Food Safety Authority

EU:

European Union

FFQ:

Food frequency questionnaire

FOS:

Fructooligosaccharides

GI:

Glycemic index

GIP:

Glucose-dependent insulinotropic peptide

GLP:

Glucagon-like peptides

GRAS:

Generally recognized as safe

HIS:

High-intensity sweeteners

JECFA:

Joint FAO/WHO Expert Committee on Food Additives

LNCS:

Low and noncaloric sweeteners

mRNA:

Messenger RNA

MS:

Member states

NNS:

Nonnutritive sweeteners

SCF:

Scientific Committee on Food

WHO:

World Health Organization

References

  1. Anderson GH, Foreyt J, Sigman-Grant M, Allison DB (2012) The use of low-calorie sweeteners by adults: impact on weight management. J Nutr 142(6):1163S–1169S

    Article  CAS  Google Scholar 

  2. Popkin BM, Hawkes C (2015) Sweetening of the global diet, particularly beverages: patterns, trends, and policy responses. Lancet Diab Endocrinol [Internet]. [citado 25 de enero de 2016]; Recuperado a partir de: http://linkinghub.elsevier.com/retrieve/pii/S2213858715004192

  3. Wiebe N, Padwal R, Field C, Marks S, Jacobs R, Tonelli M (2011) A systematic review on the effect of sweeteners on glycemic response and clinically relevant outcomes. BMC Med 9:123

    Article  CAS  Google Scholar 

  4. Ng SW, Slining MM, Popkin BM (2012) Use of caloric and noncaloric sweeteners in US consumer packaged foods, 2005–2009. J Acad Nutr Diet 112(11):1828–1834.e1-6

    Article  Google Scholar 

  5. Basu S, Yoffe P, Hills N, Lustig RH (2013) The relationship of sugar to population-level diabetes prevalence: an econometric analysis of repeated cross-sectional data. PLoS One 8(2):e57873

    Article  CAS  Google Scholar 

  6. Imamura F, O’Connor L, Ye Z, Mursu J, Hayashino Y, Bhupathiraju SN, et al (2015) Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. [citado 18 de enero de 2016]; Recuperado a partir de: http://www.bmj.com/content/351/bmj.h3576.full

  7. Xi B, Li S, Liu Z, Tian H, Yin X, Huai P et al (2014) Intake of fruit juice and incidence of type 2 diabetes: a systematic review and meta-analysis. PLoS One 9(3):e93471

    Article  Google Scholar 

  8. Gardner C, Wylie-Rosett J, Gidding SS, Steffen LM, Johnson RK, Reader D et al (2012) Nonnutritive sweeteners: current use and health perspectives: a scientific statement from the American Heart Association and the American Diabetes Association. Diabetes Care 35(8):1798–1808

    Article  Google Scholar 

  9. Greenwood DC, Threapleton DE, Evans CEL, Cleghorn CL, Nykjaer C, Woodhead C et al (2014) Association between sugar-sweetened and artificially sweetened soft drinks and type 2 diabetes: systematic review and dose–response meta-analysis of prospective studies. Br J Nutr 112(5):725–734

    Article  CAS  Google Scholar 

  10. Gardner C (2014) Non-nutritive sweeteners: evidence for benefit vs. risk. Curr Opin Lipidol 25(1):80–84

    Article  CAS  Google Scholar 

  11. Office of the Surgeon General (US), Office of Disease Prevention and Health Promotion (US), Centers for Disease Control and Prevention (US), National Institutes of Health (US) (2001) The surgeon general’s call to action to prevent and decrease overweight and obesity [internet]. Office of the Surgeon General (US), Rockville. [citado 31 de enero de 2016]. Recuperado a partir de: http://www.ncbi.nlm.nih.gov/books/NBK44206/

  12. Hu FB (2013) Resolved: there is sufficient scientific evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases. Obes Rev 14(8):606–619

    Article  CAS  Google Scholar 

  13. Malik VS, Popkin BM, Bray GA, Després J-P, Willett WC, Hu FB (2010) Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis. Diabetes Care 33(11):2477–2483

    Article  Google Scholar 

  14. Anand SS, Hawkes C, de Souza RJ, Mente A, Dehghan M, Nugent R et al (2015) Food consumption and its impact on cardiovascular disease: importance of solutions focused on the globalized food system: a report from the workshop convened by the World Heart Federation. J Am Coll Cardiol 66(14):1590–1614

    Article  Google Scholar 

  15. Te Morenga LA, Howatson AJ, Jones RM, Mann J (2014) Dietary sugars and cardiometabolic risk: systematic review and meta-analyses of randomized controlled trials of the effects on blood pressure and lipids. Am J Clin Nutr 100(1):65–79

    Article  Google Scholar 

  16. Te Morenga L, Mallard S, Mann J (2013) Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ 346:e7492

    Article  Google Scholar 

  17. Bes-Rastrollo M, Schulze MB, Ruiz-Canela M, Martinez-Gonzalez MA (2013) Financial conflicts of interest and reporting bias regarding the association between sugar-sweetened beverages and weight gain: a systematic review of systematic reviews. PLoS Med 10(12):e1001578; dicsussion e1001578

    Article  Google Scholar 

  18. Guideline: Sugars Intake for adults and children. Geneva: World Health Organization. (2015) ISBN-13: 978-92-4-154902-8

    Google Scholar 

  19. Thow AM, Hawkes C (2014) Global sugar guidelines: an opportunity to strengthen nutrition policy. Public Health Nutr 17(10):2151–2155

    Article  Google Scholar 

  20. WCRF (2015) Curbing global sugar consumption: effective food policy actions to help promote healthy diets and tackle obesity. World Cancer Research Fund International, London

    Google Scholar 

  21. Council on School Health, Committee on Nutrition (2015) Snacks, sweetened beverages, added sugars, and schools. Pediatrics 135(3):575–583

    Article  Google Scholar 

  22. Fitch C, Keim KS, Academy of Nutrition and Dietetics (2012) Position of the Academy of Nutrition and Dietetics: use of nutritive and nonnutritive sweeteners. J Acad Nutr Diet 112(5):739–758

    Article  Google Scholar 

  23. Directiva 94/35/CE del Parlamento Europeo y del Consejo de 30 de Junio de 1994. Diario Oficial de las Comunidades Europeas,10.09.94, No L 237/3

    Google Scholar 

  24. Renwick A et al (2000) Edulcorantes bajos en calorías: funciones y beneficios (monografía). International Sweeteners Association. En: Anales de la Universidad de Chile [Internet]. [citado 18 de enero de 2016]. pp 1–31. Recuperado a partir de: http://www.revistas.uchile.cl/index.php/ANUC/article/viewArticle/2524/2436

  25. Mortensen A (2006) Sweeteners permitted in the European Union: safety aspects. Scand J Food Nutr 50(3):104–116

    Article  Google Scholar 

  26. Roberts JR (2015) The paradox of artificial sweeteners in managing obesity. Curr Gastroenterol Rep [Internet]. [citado 18 de enero de 2016];17(1). Recuperado a partir de: http://link.springer.com/ 10.1007/s11894-014-0423-z

  27. Miller PE, Perez V (2014) Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies. Am J Clin Nutr 100(3):765–777

    Article  CAS  Google Scholar 

  28. De Ruyter JC, Olthof MR, Seidell JC, Katan MB (2012) A trial of sugar-free or sugar-sweetened beverages and body weight in children. N Engl J Med 367(15):1397–1406

    Article  Google Scholar 

  29. Raben A, Richelsen B (2012) Artificial sweeteners: a place in the field of functional foods? Focus on obesity and related metabolic disorders. Curr Opin Clin Nutr Metab Care 15(6):597–604

    Article  CAS  Google Scholar 

  30. Mattes RD, Popkin BM (2009) Nonnutritive sweetener consumption in humans: effects on appetite and food intake and their putative mechanisms. Am J Clin Nutr 89(1):1–14

    Article  CAS  Google Scholar 

  31. Piernas C, Tate DF, Wang X, Popkin BM (2013) Does diet-beverage intake affect dietary consumption patterns? Results from the Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial. Am J Clin Nutr 97(3):604–611

    Article  CAS  Google Scholar 

  32. Blundell JE, Hill AJ (1986) Paradoxical effects of an intense sweetener (aspartame) on appetite. Lancet Lond Engl 1(8489):1092–1093

    Article  CAS  Google Scholar 

  33. Stellman SD, Garfinkel L (1986) Artificial sweetener use and one-year weight change among women. Prev Med 15(2):195–202

    Article  CAS  Google Scholar 

  34. Foreyt J, Kleinman R, Brown RJ, Lindstrom R (2012) The use of low-calorie sweeteners by children: implications for weight management. J Nutr 142(6):1155S–1162S

    Article  CAS  Google Scholar 

  35. McGuire S (2011) U.S. Department of Agriculture and U.S. Department of Health and Human Services, Dietary Guidelines for Americans, 2010. 7th Edition, Washington, DC: U.S. Government Printing Office, January 2011. Adv Nutr Bethesda Md 2(3):293–294

    Google Scholar 

  36. Seagle HM, Strain GW, Makris A, Reeves RS, American Dietetic Association (2009) Position of the American Dietetic Association: weight management. J Am Diet Assoc 109(2):330–346

    Article  Google Scholar 

  37. Swithers SE, Martin AA, Davidson TL (2010) High-intensity sweeteners and energy balance. Physiol Behav 100(1):55–62

    Article  CAS  Google Scholar 

  38. Davidson TL, Swithers SE (2004) A Pavlovian approach to the problem of obesity. Int J Obes Relat Metab Disord J Int Assoc Study Obes 28(7):933–935

    Article  CAS  Google Scholar 

  39. Piernas C, Ng SW, Mendez MA, Gordon-Larsen P, Popkin BM (2015) A dynamic panel model of the associations of sweetened beverage purchases with dietary quality and food-purchasing patterns. Am J Epidemiol 181(9):661–671

    Article  Google Scholar 

  40. Piernas C, Mendez MA, Ng SW, Gordon-Larsen P, Popkin BM (2014) Low-calorie- and calorie-sweetened beverages: diet quality, food intake, and purchase patterns of US household consumers. Am J Clin Nutr 99(3):567–577

    Article  CAS  Google Scholar 

  41. Duffey KJ, Steffen LM, Van Horn L, Jacobs DR, Popkin BM (2012) Dietary patterns matter: diet beverages and cardiometabolic risks in the longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Clin Nutr 95(4):909–915

    Article  CAS  Google Scholar 

  42. Swithers SE, Davidson TL (2008) A role for sweet taste: calorie predictive relations in energy regulation by rats. Behav Neurosci 122(1):161–173

    Article  Google Scholar 

  43. De Ruyter JC, Katan MB, Kuijper LDJ, Liem DG, Olthof MR (2013) The effect of sugar-free versus sugar-sweetened beverages on satiety, liking and wanting: an 18 month randomized double-blind trial in children. PLoS One 8(10):e78039

    Article  Google Scholar 

  44. Brown RJ, de Banate MA, Rother KI (2010) Artificial sweeteners: a systematic review of metabolic effects in youth. Int J Pediatr Obes 5(4):305–312

    Article  Google Scholar 

  45. Brown RJ, Walter M, Rother KI (2009) Ingestion of diet soda before a glucose load augments glucagon-like peptide-1 secretion. Diabetes Care 32(12):2184–2186

    Article  CAS  Google Scholar 

  46. Pepino MY, Bourne C (2011) Non-nutritive sweeteners, energy balance, and glucose homeostasis. Curr Opin Clin Nutr Metab Care 14(4):391–395

    Article  CAS  Google Scholar 

  47. Wu GD, Chen J, Hoffmann C, Bittinger K, Chen Y-Y, Keilbaugh SA et al (2011) Linking long-term dietary patterns with gut microbial enterotypes. Science 334(6052):105–108

    Article  CAS  Google Scholar 

  48. Yang Q (2010) Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings: neuroscience 2010. Yale J Biol Med 83(2):101–108

    Google Scholar 

  49. Scientific Opinion on the substantiation of health claims related to intense sweeteners and contribution to the maintenance or achievement of a normal body weight (ID 1136, 1444, 4299), reduction of post-prandial glycaemic responses (ID 4298), maintenance of normal blood glucose concentrations (ID 1221, 4298), and maintenance of tooth mineralisation by decreasing tooth demineralisation (ID 1134, 1167, 1283) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. (2011) EFSA J 9(6): 2229 [26 pp.]

    Google Scholar 

  50. Renwick AG, Molinary SV (2010) Sweet-taste receptors, low-energy sweeteners, glucose absorption and insulin release. Br J Nutr 104(10):1415–1420

    Article  CAS  Google Scholar 

  51. Raben A, Møller BK, Flint A, Vasilaris TH, Christina Møller A, Juul Holst J, et al (2011) Increased postprandial glycaemia, insulinemia, and lipidemia after 10 weeks’ sucrose-rich diet compared to an artificially sweetened diet: a randomised controlled trial. Food Nutr Res 2011. 55 5961 - DOI: 10.3402/fnr.v55i0.5961

  52. American Diabetes Association (2015) Standards of medical care in diabetes. Diabetes Care 38(Suppl 1):S1–S2

    Google Scholar 

  53. Morrison AS, Buring JE (1980) Artificial sweeteners and cancer of the lower urinary tract. N Engl J Med 302(10):537–541

    Article  CAS  Google Scholar 

  54. Gallus S, Scotti L, Negri E, Talamini R, Franceschi S, Montella M et al (2007) Artificial sweeteners and cancer risk in a network of case–control studies. Ann Oncol Off J Eur Soc Med Oncol ESMO 18(1):40–44

    Article  CAS  Google Scholar 

  55. Lim U, Subar AF, Mouw T, Hartge P, Morton LM, Stolzenberg-Solomon R et al (2006) Consumption of aspartame-containing beverages and incidence of hematopoietic and brain malignancies. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol septiembre de 15(9):1654–1659

    Article  CAS  Google Scholar 

  56. Bosetti C, Gallus S, Talamini R, Montella M, Franceschi S, Negri E et al (2009) Artificial sweeteners and the risk of gastric, pancreatic, and endometrial cancers in Italy. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol 18(8):2235–2238

    Article  CAS  Google Scholar 

  57. Blackadar CB (2016) Historical review of the causes of cancer. World J Clin Oncol 7(1):54–86

    Article  Google Scholar 

  58. Anderseon GH, Foreyt J, Sigman-Grant M, Allison DB (2012) The use of low calorie sweeteners by adults: impact on weight management. J Nutr 142(6):1163S–1169S

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Endocrinology and Nutrition Department, Universitary Hospital Virgen de la Victoria, Campus Universitario Teatinos sn, Malaga, 29010, Andalucía, Spain

    Jose Manuel García-Almeida, Isabel M. Cornejo-Pareja, Araceli Muñoz-Garach, Ana Gómez-Pérez & Jorge García-Alemán

Authors
  1. Jose Manuel García-Almeida
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  2. Isabel M. Cornejo-Pareja
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  3. Araceli Muñoz-Garach
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  4. Ana Gómez-Pérez
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  5. Jorge García-Alemán
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Corresponding author

Correspondence to Jose Manuel García-Almeida .

Editor information

Editors and Affiliations

  1. Faculty of Pharmaceutical Sciences, University of Bordeaux, Bordeaux, France

    Jean-Michel Mérillon

  2. Botany Department, M.L. Sukhadia University, Udaipur, India

    Kishan Gopal Ramawat

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García-Almeida, J.M., Cornejo-Pareja, I.M., Muñoz-Garach, A., Gómez-Pérez, A., García-Alemán, J. (2018). Sweeteners: Regulatory Aspects. In: Mérillon, JM., Ramawat, K. (eds) Sweeteners. Reference Series in Phytochemistry. Springer, Cham. https://doi.org/10.1007/978-3-319-27027-2_12

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