Abstract
Non-nutritive sweeteners (NNS) are used in the food supply to replace sugar and/or to reduce dietary energy intake. The aim of this research was to assess the consumption prevalence and food sources of NNS in the Australian population. Food group and nutrient intakes were assessed to compare diet quality of NNS consumers and non-consumers. Secondary analysis of the Australian National Nutrition and Physical Activity Survey, 2011/12 was conducted (n = 12,435) after identifying all NNS products consumed in the population. The proportion of participants that reported intake of NNS per day was 18.2% for adults (19+ years), and 8.5% for children (2–18 years), with the most common food sources being carbonated soft drinks, tabletop sweeteners, and yoghurt. Characteristics associated with NNS consumption in adults included being female, higher body mass index (BMI), self-reported diabetes status, and being on a weight-loss diet. For adults, NNS consumers had lower free sugar intake but energy intake did not differ from non-consumers. However, for children, no differences in free sugar or energy intake were observed between consumers and non-consumers. While these results support the use of NNS in reducing sugar intake, these data suggest compensatory increases in energy intake may occur.
Summary
The present study found that while consumption of low calorie sweeteners is higher in overweight people, it was linked with being on a weight loss diet or having diabetes. This finding confirms the fact that people turn to low calorie sweeteners as a means to reduce their calorie and sugar intakes in order to manage their body weight or glucose control, rather than the opposite (i.e. that low calorie sweeteners caused the weight gain). In the scientific literature, this is described as reverse causation.
Using data from the Australian National Nutrition and Physical Activity Survey (NNPAS), 2011–2012, a cross-sectional study involving 12,153 participants aged 2 years or above in Australia, this study found that 18.2% of adults (19+ years) and 8.5% of children (2–18 years) reported daily intake of low calorie sweetened products, with the most common food sources being soft drinks, tabletop sweeteners, and yoghurt. Characteristics associated with consumption of low calorie sweeteners in adults included being female, higher body mass index (BMI), self-reported diabetes status, and being on a weight-loss diet. The intake of low calorie sweetened products on a daily basis was higher among adults with a higher BMI, as shown previously in other studies, but this is largely explained by this study’s finding that being on a weight-loss diet and having diabetes were also positively associated with higher low calorie sweeteners’ use. This outcome provides further evidence that findings of observational studies showing a positive association between low calorie sweeteners’ intake and obesity or diabetes are due to reverse causation.