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Background: Chile's landmark food labeling and advertising policy led to major reductions in sugar purchases. However, it is unclear whether this led to increases in the purchases of nonnutritive sweeteners (NNS). Objectives: The objective of this study was to assess the changes in NNS and caloric-sweetened (CS) products purchased after the law's first phase. Methods: Longitudinal data on food and beverage purchases from 2,381 households collected from January 1, 2015 to December 31, 2017, were linked to nutritional information and categorized into added sweetener groups (unsweetened, NNS-only, CS-only, or NNS with CS). Logistic random-effects models and fixed-effects models were used to compare the percentage of households purchasing products and the mean volume purchased by sweetener category to a counterfactual based on pre-regulation trends. Results: Compared with the counterfactual, the percentage of households purchasing any NNS beverages (NNS-only or NNS with CS) increased by 4.2 percentage points (pp) (95% CI: 2.8, 5.7; P < 0.01). This increase was driven by households purchasing NNS-only beverages (12.1 pp, 95% CI: 10.0, 14.2; P < 0.01). The purchased volume of beverages with any NNS increased by 25.4 mL/person/d (95% CI: 20.1, 30.7; P < 0.01) or 26.5%. Relative to the counterfactual, there were declines of -5.9 pp in households purchasing CS-only beverages (95% CI: -7.0, -4.7; P < 0.01). Regarding the types of sweeteners purchased, we found significant increases in the amounts of sucralose, aspartame, acesulfame K, and steviol glycosides purchased from beverages. Among foods, differences were minimal. Conclusions: The first phase of Chile's law was associated with an increase in the purchases of beverages containing NNS and decreases in beverages containing CS, but virtually no changes in foods.

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Government regulatory actions and public policies to reduce sugar consumption were recently implemented in Brazil. To evaluate their potential impact on the supply of products containing high-intensity sweeteners (HIS) and on dietary exposure to these substances, this study aimed to create a comprehensive database on HIS declared in Brazilian commercial products and estimate their intake through consumption of these products. The occurrence of HIS was evaluated through labeling information of 1869 commercial products available in the Brazilian market, collected between January 2021 and August 2021, and the daily intake was estimated for eight HIS (acesulfame K, advantame, aspartame, cyclamate, steviol glycosides, neotame, saccharin and sucralose) using a deterministic approach by multiplying the maximum permitted levels of HIS in foods and beverages by the consumption data of these products. The consumption data were obtained from the report of Household Budget Survey (POF/IBGE), conducted from 2017 to 2018 through a 24-hour dietary recall applied to 46,164 individuals aged 10 years and over, which included only average data (i.e. average consumption for the general population or subgroups). The most frequent HIS in the investigated products were sucralose (26.8 %; n = 938) and acesulfame K (21.7 %; n = 759), and although the combination of sweeteners is a common practice in the food industry, there was a predominance of only one substance in the investigated products (46.7 %; n = 873). The estimated intake of HIS for average consumers was below the Acceptable Daily Intake (ADI) and does not suggest a toxicological concern. A similar scenario was observed for high consumers, except for cyclamate and steviol glycosides, which corresponded to 144 % and 131 % of their respective ADIs in the general population. To our knowledge, this is the most comprehensive database on HIS in Brazil and the most recent exposure assessment performed nationally.

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BACKGROUND: The first phase of Chile's Law of Food Labelling and Advertising showed important declines in the sugar content of packaged foods, but it is unknown whether the law led to an increase in nonnutritive sweetener (NNS) intake, particularly among preschool children. OBJECTIVES: Estimate the changes in preschoolers' NNS intake after the first phase of the Chilean law. METHODS: We used 24-h dietary recalls collected in 2016 (pre-law) and 2017 (post-law) from a cohort of preschoolers (n = 875). The primary caretaker was the respondent of the recalls. Information on NNS was obtained from nutrition facts panels collected annually and linked to dietary data. We used logistic regression to estimate the changes in the proportion of preschoolers who consume NNS and two-part models to estimate the changes in mean intake. We determined the percentage of children that surpassed the acceptable daily intake (ADI) of each NNS using the National Cancer Institute method. RESULTS: The proportion of consumers of at least one NNS increased from 77.9% to 92.0% (p-value < 0.01). The mean intake increased for sucralose, aspartame, acesulfame-K and steviol glycosides (+20.3, +15.1, +6.1 and +3.3 mg/day, respectively). In addition, NNS dietary sources changed for sucralose and steviol glycosides, becoming industrialized juices and dairy beverages more relevant while tabletop NNS became less relevant. None of the children surpassed the ADI. CONCLUSIONS: NNS intake increased in preschoolers after the first phase of a national policy that promoted sugar reformulation.

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BACKGROUND: The effect of nonnutritive sweeteners on appetite is controversial. Some studies have found changes in certain appetite control hormones with sucralose intake that may be through interaction with sweet taste receptors located in the intestine. OBJECTIVE: The aim of this study was to evaluate whether sucralose consumption could produce changes in fasting plasma concentrations of appetite-regulating hormones, including glucagon-like peptide 1, ghrelin, peptide tyrosine tyrosine, and leptin, and secondarily in insulin resistance. DESIGN: A 2-week parallel randomized clinical trial with an additional visit conducted 1 week after dosing termination. PARTICIPANTS/SETTING: Sixty healthy, normal-weight individuals, without habitual consumption of nonnutritive sweeteners were recruited from July 2015 to March 2017 in Mexico City. INTERVENTION: Daily sucralose consumption at 15% of the acceptable daily intake by using commercial sachets added to food. The control group followed the same protocol without an intervention. MAIN OUTCOMES MEASURED: Fasting concentrations of appetite regulating hormones before and after the intervention. Fasting glucose and insulin concentrations were measured to assess insulin resistance as a secondary outcome. STATISTICAL ANALYSIS PERFORMED: Basal and final concentrations were compared using Wilcoxon matched-pairs test and Mann-Whitney U test for analysis between groups. Repeated measures analysis of variance was used to evaluate changes in the homeostasis model assessment of insulin resistance. RESULTS: Sucralose was not associated with changes in any of the hormones measured. One week postintervention, an incremental change (P=0.04) in the homeostasis model assessment of insulin resistance was found in the intervention group. CONCLUSIONS: Sucralose intake is not associated with changes in fasting concentrations of glucagon-like peptide 1, ghrelin, peptide tyrosine tyrosine, or leptin. An increase in the homeostasis model assessment of insulin resistance observed only at 1 week postdosing is of unknown clinical significance, if any.

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Actualmente los edulcorantes no nutritivos (ENN) son ampliamente usados para endulzar los alimentos en reemplazo de los azúcares simples, con la ventaja de no aportar energía. A pesar de que en general no presentan efectos tóxicos, los estudios epidemiológicos no han podido evidenciar que su uso contribuya a mejorar la pérdida de peso, sino por el contrario, han revelado que los ENN pueden inducir alteraciones metabólicas como intolerancia a la glucosa. Estudios in vivo e in vitro han mostrado que muchos ENN activan a receptores del sabor dulce no sólo en los botones gustativos, sino que también en los receptores presentes en tejidos como el adiposo y pancreático, interfiriendo con su función normal. Además, el consumo ENN se ha asociado a alteraciones de la composición de la microbiota intestinal que conducen a una respuesta inflamatoria de bajo grado. La nueva evidencia disponible sobre los ENN hace necesario evaluar el uso cada vez más intenso de los ENN en Chile. Debido a que el gusto exacerbado por el sabor dulce que cultivamos desde la infancia es un potente catalizador del uso de ENN, proponemos que una oportuna educación del sentido del gusto puede contribuir a mejorar las elecciones alimentarias.

Currently, non-nutritive sweeteners (NNS) are widely used to sweeten foods instead of simple sugars, as they possess the advantage of not contributing to energy intake. Although they do not present toxic effects in general, epidemiological studies have not been able to show benefits when they are used in weight loss programs. However, they could induce metabolic alterations such as glucose intolerance. In vivo and in vitro studies have shown that many NNSs activate sweet taste receptors not only in the taste buds, but also in receptors present in adipose and pancreatic tissues, interfering with their normal function. In addition, NNS consumption has been associated with an alteration in the composition of the gut microbiota that leads to a low-grade inflammatory response. Due to the wide use of NNS in Chile, it is necessary to evaluate the potential health effects of using NNS in the Chilean population. We propose that a timely education of the sense of taste can contribute to moderating the preference for higher levels of sweet taste that humans develop in childhood, which could help to improve food choices.

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INTRODUCTION: The consumption of added sugars has increased worldwide. To guide and encourage the implementation of public policies on the consumption of nonnutritive sweetener (NNS), it is necessary not only to identify the amount consumed of these products, but also the factors associated with their consumption. OBJECTIVE: This study aimed to identify the variables related to NNS consumption in São Paulo state, Brazil. METHODS: A cross-sectional study involving adult employees of two public Universities in São Paulo state, Brazil, was conducted. An online questionnaire was applied containing questions on the use of NNSs and information about demographic, socioeconomic, anthropometric and health characteristics. The statistical analyses performed included: the Chi-square test to determine association between explanatory and dependent variables, adopting a level of significance of p<0.05, and binary logistic regression calculating the Odds-Ratio (OR) (alpha = 0.05). : A total of 1323 individuals took part in the study. The prevalence of NNS use was 53.3%, proving higher among individuals between 30 and 60 years of age (83.3. The Chi-squared test revealed that the variables gender (p < 0.001), Diabetes Mellitus (DM) (p = 0.000), arterial hypertension (p = 0.008), difficulty controlling weight (p < 0.001), BMI (p < 0.001), income (p = 0.002) and age (p < 0.001) had a direct and significant association with NNS consumption. On the logistics regression model, the variables significantly associated with NNS consumption were gender (OR 1.3), age (OR = 2.59), DM (OR = 3.32), difficulty controlling weight (OR = 2.29) and consumption of diet foods (OR = 3.87). These results revealed that women are 30% more likely to consume NNS than men and that being aged between 50 and 60 years increases the likelihood of consuming these products by 2.59 times. In addition, being diabetic, having difficulty controlling body weight, and consuming diet foods increase the likelihood of NNS consumption by 3.32; 2.29 and 3.97 times, respectively. CONCLUSION: The majority of the population studied were consumers of NNSs. The variables gender, age, DM, difficulty controlling body weight, and consuming diet foods were all associated with the consumption of NNSs.

INTRODUÇÃO: O consumo de açúcares adicionados aumentou em todo o mundo. Para orientar e encorajar a implementação de políticas públicas no consumo de adoçante não nutritivo (NNS), é necessário não apenas identificar a quantidade consumida desses produtos, mas também os fatores associados ao seu consumo. OBJETIVO: Este estudo teve como objetivo identificar as variáveis relacionadas ao consumo de NNS no estado de São Paulo, Brasil. MÉTODO: Realizou-se um estudo transversal envolvendo funcionários adultos de duas universidades públicas do Estado de São Paulo, Brasil. Foi aplicado um questionário on-line contendo perguntas sobre o uso de NNSs e informações sobre características demográficas, socioeconômicas, antropométricas e de saúde. As análises estatísticas realizadas incluíram: o teste do qui-quadrado para determinar a associação entre variáveis explicativas e dependentes, adotando-se um nível de significância de p < 0,05 e regressão logística binária, calculando Odds-Ratio (OR) (alfa = 0,05). : Participaram do estudo 1323 indivíduos. A prevalência de uso de NNS foi de 53,3%, mostrando-se maior entre indivíduos de 30 a 60 anos de idade (83,3). O teste de Qui-quadrado revelou que as variáveis gênero (p = 0,000), Diabetes Mellitus (p = Hipertensão arterial (p = 0,008), dificuldade de controle de peso (p = 0,000), IMC (p = 0,000), renda (p = 0,002) e idade (p = 0,000) apresentaram associação direta e significativa com o consumo de NNS. (OR = 2,59), DM (OR = 3,32), dificuldade de controle de peso (OR = 2,29) e consumo de alimentos dietéticos (OR = 3,87). Estes resultados revelaram que as mulheres são 30% mais propensas a consumir NNS do que os homens e que estando entre os 50 e 60 anos aumenta a probabilidade de consumir estes produtos em 2,59 vezes. Além disso, sendo diabético, ter dificuldade em controlar o peso corporal e consumir dieta alimentar, aumentam a probabilidade de consumo de NNS em 3,32, 2,29 e 3,97 vezes, respectivamente. CONCLUSÃO: A maioria da população estudada era consumidor e a de NNSs. As variáveis gênero, idade, DM, dificuldade em controlar o peso corporal e consumo de alimentos dietéticos foram todas associadas ao consumo de NNSs.

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A dieta rica em carboidratos, principalmente em sacarose, é um fator de grande influência no desenvolvimento da doença cárie. O objetivo deste trabalho foi pesquisar quais os adoçantes presentes em diversas marcas de bebidas diet e light (refrigerantes, sucos e chás) disponíveis em supermercados de Porto Alegre e verificar se a composição e as concentrações dos adoçantes em mg/100ml de bebida, conforme descrito na rotulagem do produto, estão de acordo com a legislação brasileira. Levando-se em conta a dose de Ingestão Diária Aceitável, calculou-se a quantidade em litros e em copos de 300 ml de cada uma das marcas pesquisadas que pode ser ingerida por uma pessoa de 20, 45 ou 70 kg de peso corpóreo diariamente, sem efeitos colaterais. As bebidas avaliadas apresentam em sua composição somente adoçantes não-calóricos (sacarina, acessulfame-K, ciclamato e aspartame), geralmente sendo usada a associação de dois ou mais deles em cada bebida. Os produtos pesquisados seguem as determinações da legislação brasileira, quanto aos limites de uso dos adoçantes e rotulagem, alertando sempre aos fenilcetonúricos quando possuem aspartame. Há uma grande variação na quantidade máxima que pode ser consumida diariamente das diversas bebidas pesquisadas de acordo com o peso corpóreo (de 0,21 a 3,00 litros para uma criança de 20 quilos). As bebidas diet e light têm apenas adoçantes não-calóricos em sua composição e, portanto, são não-cariogênicas, mas seu consumo deve ser feito com cautela.

Carbohydrate rich diet, mainly sucrose, strongly influences caries development. The objective of this work is to study the sweeteners present in several kinds of diet and light drinks (soft drinks, juice and tea) available at supermarkets in Porto Alegre and to verify if the composition and concentration of sweeteners (mg/100ml) according to the product label comply to Brazilian legislation. Considering the maximum daily dosage recommended, the amount of liters and number of glasses of 300 ml of each kind of drink that can be ingested daily by a 20, 45 and 70 kg person, without having side effects, was calculated. The drinks have in their composition only nonnutritive sweeteners (saccharin, acesulfam-K, cyclamate and aspartame). The association of two or more sweeteners is used in each kind of drink. The products follow the determination of Brazilian legislation as to limits of use and labeling, there must be a warning about aspartame presence on the label. The amount of each brand drinks that can be ingested daily is variable (0,21-3,00 liters for a child who weighs 20 kilos). Diet and light drinks with nonnutritive sweeteners are noncariogenic, but their consume must to be made with caution.

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