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Ibero⁻American Consensus on Low- And No-Calorie Sweeteners: Safety, Nutritional Aspects and Benefits in Food and Beverages

Lluis Serra-Majem  1   2   3   4 António Raposo  5 Javier Aranceta-Bartrina  6   7   8   9 Gregorio Varela-Moreiras  10   11   12 Caomhan Logue  13 Hugo Laviada  14 Susana Socolovsky  15 Carmen Pérez-Rodrigo  16   17   18 Jorge Antonio Aldrete-Velasco  19 Eduardo Meneses Sierra  20   21 Rebeca López-García  22 Adriana Ortiz-Andrellucchi  23   24 Carmen Gómez-Candela  25   26 Rodrigo Abreu  27 Erick Alexanderson  28   29   30 Rolando Joel Álvarez-Álvarez  31 Ana Luisa Álvarez Falcón  32   33 Arturo Anadón  34 France Bellisle  35 Ina Alejandra Beristain-Navarrete  36 Raquel Blasco Redondo  37 Tommaso Bochicchio  38   39 José Camolas  40 Fernando G Cardini  41 Márcio Carocho  42 Maria do Céu Costa  43 Adam Drewnowski  44 Samuel Durán  45 Víctor Faundes  46 Roxana Fernández-Condori  47 Pedro P García-Luna  48 Juan Carlos Garnica  49 Marcela González-Gross  50   51 Carlo La Vecchia  52 Rosaura Leis  53   54   55 Ana María López-Sobaler  56 Miguel Agustín Madero  57 Ascensión Marcos  58   59 Luis Alfonso Mariscal Ramírez  60 Danika M Martyn  61 Lorenza Mistura  62 Rafael Moreno Rojas  63 José Manuel Moreno Villares  64 José Antonio Niño-Cruz  65   66 María Beatriz P P Oliveira  67 Nieves Palacios Gil-Antuñano  68 Lucía Pérez-Castells  69 Lourdes Ribas-Barba  70   71 Rodolfo Rincón Pedrero  72 Pilar Riobó  73   74 Juan Rivera Medina  75   76 Catarina Tinoco de Faria  77 Roxana Valdés-Ramos  78 Elsa Vasco  79 Sandra N Wac  80 Guillermo Wakida  81 Carmina Wanden-Berghe  82 Luis Xóchihua Díaz  83 Sergio Zúñiga-Guajardo  84 Vasiliki Pyrogianni  85 Sérgio Cunha Velho de Sousa  86
Affiliations
Review

Ibero⁻American Consensus on Low- And No-Calorie Sweeteners: Safety, Nutritional Aspects and Benefits in Food and Beverages

Lluis Serra-Majem et al. Nutrients.

Abstract

International scientific experts in food, nutrition, dietetics, endocrinology, physical activity, paediatrics, nursing, toxicology and public health met in Lisbon on 2⁻4 July 2017 to develop a Consensus on the use of low- and no-calorie sweeteners (LNCS) as substitutes for sugars and other caloric sweeteners. LNCS are food additives that are broadly used as sugar substitutes to sweeten foods and beverages with the addition of fewer or no calories. They are also used in medicines, health-care products, such as toothpaste, and food supplements. The goal of this Consensus was to provide a useful, evidence-based, point of reference to assist in efforts to reduce free sugars consumption in line with current international public health recommendations. Participating experts in the Lisbon Consensus analysed and evaluated the evidence in relation to the role of LNCS in food safety, their regulation and the nutritional and dietary aspects of their use in foods and beverages. The conclusions of this Consensus were: (1) LNCS are some of the most extensively evaluated dietary constituents, and their safety has been reviewed and confirmed by regulatory bodies globally including the World Health Organisation, the US Food and Drug Administration and the European Food Safety Authority; (2) Consumer education, which is based on the most robust scientific evidence and regulatory processes, on the use of products containing LNCS should be strengthened in a comprehensive and objective way; (3) The use of LNCS in weight reduction programmes that involve replacing caloric sweeteners with LNCS in the context of structured diet plans may favour sustainable weight reduction. Furthermore, their use in diabetes management programmes may contribute to a better glycaemic control in patients, albeit with modest results. LNCS also provide dental health benefits when used in place of free sugars; (4) It is proposed that foods and beverages with LNCS could be included in dietary guidelines as alternative options to products sweetened with free sugars; (5) Continued education of health professionals is required, since they are a key source of information on issues related to food and health for both the general population and patients. With this in mind, the publication of position statements and consensus documents in the academic literature are extremely desirable.

Keywords: Ibero-American; added sugars; cancer; diabetes; low-calorie sweeteners; non-nutritive sweeteners; obesity; regulation; safety; sweeteners.

Conflict of interest statement

C.L. delivered a talk and received an honorarium for it at the International Congress of Dietetics in Granada 2016, which was organised by the International Sweeteners Association. S.S. has worked as a consultant for food ingredients and food additives companies, as well as food producers for several industries. R.L.G. works as a consultant and has worked with ingredient manufacturers, law firms, and food processing industry to obtain the approval of different food additives (including non-caloric sweeteners) and novel foods in different countries, she has received travel expenses from some of these companies to attend scientific meetings. F.B. is a member of international scientific advisory committees for Cereal Partners Worldwide, the European Fruit Juice Association, General Mills, the International Sweetener Association and Nomad Foods; received travel and speaking honoraria from Ajinomoto, the International Life Science Institute, Mars, Mondelez and Tate & Lyle. C.L.V. is a member of the ISA Scientific Advisory Panel. L.P. is Director of Nutriguía. S.Z.-G. received honoraria as speaker of Nutricare Consultants. V. P. is Scientific Director at the International Sweeteners Association. The rest of the authors declare no conflict of interests.

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