Use of acceptable daily intake (ADI) as a health-based benchmark in nutrition research studies that consider the safety of low-calorie sweeteners (LCS): a systematic map.

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Autor(es): Fitch SE, Payne LE, van de Ligt JLG, Doepker C, Handus D, Cohen SM, Anyangwe N, Wikoff D.
Nombre de publicación : BMC Public Health. 2021 May 20;21(1):956. doi: 10.1186/s12889-021-10934-2
Año de publicación : 2021

Abstract:

Background

It is well-recognized that consumers face many challenges in understanding and applying nutritional guidance for low-calorie sweeteners (LCS). Thus, this research aims to (1) assess how benchmarks for safe levels of consumption of LCS are utilized by researchers, and (2) understand how varying use of such benchmarks may contribute to challenges in understanding and applying nutritional guidance for LCS consumption.

Methods

A systematic mapping exercise was employed to characterize when and how acceptable daily intake (ADI) values are used as health-based benchmarks in nutrition research studies that consider the safety of LCS.

Results

Based on results from charting 121 studies, our findings demonstrate that comparisons of LCS intake to an ADI derived by an authoritative body have been made in a diverse set of published literature, varying widely in their objectives, approaches, and populations of interest. The majority of studies compared the ADI to intake in a population under study; these represent the type of comparison that is most consistent with the intent of the ADI. Other applications of the ADI included use as a benchmark in experimental studies, risk-benefit analyses, and metabolism studies.

Conclusion

Although most instances of ADI use were reasonable within the context of the individual studies’ objectives, the diversity in use by original-study authors amplifies the continued need for development of “best practices” regarding the use and interpretation of the ADIs in current research. Using comparisons to the ADI can be a helpful way to provide context to research findings. However, in doing so, it is important that researchers utilize the value in a manner specific with its intent, as the ADI is a metric that represents an estimate of the amount of a substance that can be consumed daily over a lifetime without presenting an appreciable risk to health.

Summary:

In the approval process of low/no calorie sweeteners, an Acceptable Daily Intake (ADI) is  set for each individual ingredient by EFSA. The ADI is a guideline quantity that represents the amount of a low/no calorie sweetener that can be safely consumed on a daily basis throughout a person’s lifetime without appreciable health problems.

This current study was a systematic mapping exercise (scoping review) aiming to identify when and how ADI values are used in nutrition research studies that consider the safety of low/no calorie sweeteners.

In total, 121 studies making any type of comparison of an established ADI value to an estimated daily intake of relevant low/no calorie sweeteners were included. The majority of studies compared the ADI to the estimated intake levels in a population under study (Estimated Daily Intake – EDI); these represent the type of comparison that is most consistent with the intent of the ADI. Examples of recent studies include the intake assessment of low/no calorie sweeteners in populations in Brazil (Barraj et al, 2020), Argentina, Chile and Peru (Barraj et al, 2021), which found that intakes of all tested sweeteners did not exceed their respective ADIs. Other applications of the ADI included use as a benchmark in experimental studies, risk-benefit analyses, and metabolism studies.

The study concluded that using comparisons of Estimated Daily Intake to the ADI can be a helpful way to provide context to research findings regarding low/no calorie sweeteners’ intake and safety. In doing so, it is important that researchers utilize the value in a manner specific with its intent, i.e. that the ADI is a metric that represents an estimate of the amount of a substance that can be consumed daily over a lifetime without presenting an appreciable risk to health.

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