ISA at the 17th international Congress Of Dietetics

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Highlights from the ISA roundtable symposium “Sweetness without calories: How can low calorie sweeteners be a helpful tool in dietetic practice?”

The International Sweeteners Association (ISA) is delighted to have supported the 17th International Congress of Dietetics (ICD 2016), by hosting the roundtable symposium ‘Sweetness without calories: How can low calorie sweeteners be a helpful tool in dietetic practice?’, as well as an information booth throughout the duration of the Congress.

Chaired by Dr Aimilia Papakonstantinou, Lecturer in Nutrition and Metabolism at the Agricultural University of Athens, this ISA supported session on low calorie sweeteners featured renowned experts in the areas of appetite regulation, food intake, obesity and dietetics. The panel speakers presented useful scientific information and the latest research findings in relation to the role and benefits of low calorie sweeteners, providing the audience with the opportunity to address questions and concerns around low calorie sweeteners, including their use and safety.

In more detail, opening up the discussion, Prof Kees de Graaf, Chairman Division of Human Nutrition, Professor in Sensory Science and Eating Behavior at Wageningen University in Netherlands, talked about the role of sweetness in the diet throughout the centuries, from the Neolithic period until today, and presented data showing that from the 15th until the 18th century there was a rise in sugar cane plantations, which led to an increase in sugar production and consumption, mostly as a sweetener in coffee and tea, while from the 18th century the industrial revolution led to a further increase of sugar availability, and particularly during the 20th century1.

Furthermore, reviewing the scientific literature around our preference towards sweet taste, Prof de Graaf referred to humans’ innate preference for sweetness, which is higher in children and decreases in adulthood2, and interestingly confirmed that, based on science, there is no connection between sweetness sensitivity or liking and body weight.

Regarding low calorie sweeteners, Prof de Graaf presented data from recent publications and his scientific work showing that low calorie sweeteners do not increase appetite and do not have a different impact on reward value compared to sugar, therefore they do not lead to energy compensation or increased energy intake3.

The effects of low calorie sweeteners on appetite and body weight regulation was the topic covered next by Prof Anne Raben, Professor in the Department of Nutrition, Exercise and Sports, SCIENCE, from the University of Copenhagen in Denmark. Prof Raben reviewed the scientific evidence of the last three decades about the effect of low calorie sweeteners on appetite and body weight regulation, and explained why the data does not support the hypothesis that was suggested in the ‘80s and claimed that low calorie sweeteners increase our appetite for sweet taste. Specifically, she presented evidence that support that the use of low calorie sweeteners in place of sugar, in children and adults, leads to reduced energy intake and body weight4.

Moreover, Prof Raben noted that although there is no single, universally-accepted hierarchy of evidence, there is broad agreement on the relative strength of the principal types of research, with randomised clinical trials (RCTs) ranking above observational studies, and systematic reviews and meta-analyses placed above RCTs. Therefore, the importance of a recently published systematic review and meta-analysis in the International Journal of Obesity5, which proved that low calorie sweeteners contribute to calorie reduction, thus helping in weight loss and management, was highlighted by all panel speakers.

Dr Caomhan Logue, Lecturer in Dietetics in Northern Ireland Centre for Food and Health (NICHE), School of Biomedical Sciences of Ulster University in Northern Ireland, concluded the symposium by bringing on the table the topic of low calorie sweeteners’ role in obesity and diabetes epidemics from a public health perspective. With obesity being an emerging public health challenge, as its prevalence almost doubled since 1980, a number of public health strategies have been suggested in order to improve people’s dietary and lifestyle habits6.

Specifically considering the need to limit our overall sugar intake7, food reformulation and the use of low calorie sweeteners has been suggested as a potential helpful tool in adherence to this recommendation. After presenting the existing scientific evidence around low calorie sweeteners and their benefits8, Dr Logue concluded that, among other public health strategies, low calorie sweeteners seem well positioned to play a positive role in tackling the obesity and diabetes epidemics by helping to reduce sugar consumption while maintaining the palatability of the diet. He also highlighted that their safety has been confirmed by regulatory bodies around the world, including the Joint Food and Agriculture Organisation (FAO); World Health Organisation (WHO) Expert Committee on Food Additives (JECFA); the U.S. Food and Drug Administration (FDA); and the European Food Safety Authority (EFSA).

In the concluding remarks about the session, Dr Papakonstantinou summarised the evidence presented by the panel speakers and supported that low calorie sweeteners can play a positive role in people’s effort to reduce their sugar and energy intake and to help them manage their body weight and/ or diabetes more effectively. Finally, she highlighted that dietitians have an important role to play in educating people towards a healthy and sustainable diet.

  1. Cordain et al, Am J Clin Nutr 2005
  2. De Graaf et al, Phyiol Behav 1999
  3. Griffioen-Roose et al, Plos One 2013
  4. Peters et al, Obesity 2016; Sørensen et al, AJCN 2014; De Reyter et al, NEJM 2012; Raben et al, AJCN 2002
  5. Rogers et al, Int J Obes 2016
  6. World Health Organisation (WHO), 2015; Organisation for Economic Co-operation and Development, 2014
  7. WHO, 2014; SACN, 2015; USDA, 2016
  8. Academy of Nutrition and Dietetics, 2012; Miller & Perez, AJCN 2014