Title of Presentation: Safety assessment and approval of low-calorie sweeteners: what type of evidence needs to be evaluated?
Speaker: Prof Dominique Parent Massin
Abstract: Risk assessment for food additives, including low calories sweeteners, is performed before authorisation by risk manager. Risk assessment is divided in four steps, hazard identification, hazard characterisation, exposure assessment, risk characterisation. Food additives authorised in EU under Regulation (EC) No 1333/2008 are currently being re-assessed by the European Food Safety Authority (EFSA). The deadline for the re-evaluation of a number of sweeteners by EFSA expires on 31st December 2020. However, their safety has been assessed several times by food safety agencies in the past. For some of them as aspartame, due to studies published in scientific literature, their assessment has been recently performed. Acceptable Daily Intakes (ADI) have been defined for most of them considering toxicological data. Exposure data have shown that ADI is not exceeded at maximum permitted level (MPL) in EU. Consequently, all low calories sweeteners are considered of not concern for the consumers. Risk assessment process and the latest risk assessment of each low-calorie sweeteners will be presented.
- EFSA ANS Panel (EFSA Panel on Food Additives and Nutrient Sources added to Food), 2013. Scientific Opinion on the re-evaluation of aspartame (E 951) as a food additive. EFSA Journal 2013;11(12):3496, 263 pp. doi:10.2903/j.efsa.2013.3496
- Scientific Opinion of the Panel on Food Additives, Flavourings, Processing Aids and Materials in Contact with Food on a request from European Commission on Neotame as a sweetener and flavour enhancer. The EFSA Journal (2007) 581, 1-43
Title of Presentation: Low calorie sweeteners and gut microbiota: a review of animal and human studies
Speaker: Prof Ian Rowland
Abstract: The human colonic microbiota is a large and complex microbial community. Over 1000 bacterial species have been identified with about 160 being found in the gut of any individual. The size and diversity of the microbiota is reflected in extensive metabolic activities.
Observational studies comparing the faecal microbiotas of healthy subjects with those of patients, strongly suggest an association of gut microbiota composition and the aetiology and/or development of a range of gastrointestinal diseases and also a link with obesity and diabetes. However, the precise organisms involved are difficult to identify.
The interactions of low/no calorie sweeteners (LNCS) and gut microbiota has been the subject of numerous studies in laboratory animals and human subjects. LNCS are a structurally diverse group of compounds that have very different metabolic fates following consumption. Most (e.g. acesulfame K, saccharin, and sucralose) are not metabolized by gut bacteria. Stevia is a notable exception as its glycosidic forms are hydrolysed by the microbiota, releasing steviol, which is then absorbed intact without further bacterial metabolism.
LNCS are consumed at such low levels that they are unlikely to have a direct, clinically meaningful impact on the gut microbiota. Nevertheless, some studies on saccharin (mostly in laboratory animals) have shown effects on microbiota composition or metabolism, although only at very high doses above normal human consumption. Studies with other LNCS show either no, or inconsistent, effects on the microbiota, probably as a consequence of design issues and lack of adequate controls. Overall, the evidence indicates that LNCS have minimal impact on gut microbiota.
- Rowland I et al. Gut microbiota functions: metabolism of nutrients and other food components. Eur J Nutr 2018; 57: 1-24
- Lobach AR et al. Assessing the in vivo data on low/no-calorie sweeteners and the gut microbiota. Food Chem Toxicol 2018; 124: 385-399
- Ruiz-Ojeda FJ et al. Effects of Sweeteners on the Gut Microbiota: A Review of Experimental Studies and Clinical Trials. Adv Nutr 2019; 10: S31–S48
Title of Presentation: Recommendations about intake of sugars and low calorie sweeteners: impact on obesity and diabetes epidemics
Speaker: Dr Margaret Ashwell
Abstract: To help the public to reduce energy intake for their health, authorities have proposed limiting ‘free sugars’ to 10, or even 5 per cent of total energy intake. ‘Free sugars’ include all monosaccharides and disaccharides added to foods by the manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and unsweetened fruit and vegetable juices and purees. Current intakes of ‘free sugars’ are well above these recommendations.
The use of low calorie sweeteners (LCS) is just one of the strategies to achieve these sugar goals. Groups of scientific experts have generated consensus statements, position papers, or other statements on LCS to show they are safe and effective. Many systematic reviews and meta-analyses have shown that LCS can help in reducing energy intake with implications for weight loss. Further, it is known that only small amounts of sustained weight loss are needed to reduce the risk of diabetes. It is now acknowledged that central obesity is a potent risk factor for diabetes and that the prevalence of central obesity is increasing rapidly. Fortunately central obesity can be detected by a simple anthropometric measure: the waist to height ratio (WHtR). A simple cut off WHtR 0.5 has been proposed which is universally applicable to children and adults. Prevention of central obesity is therefore essential if we are to have any impact on the epidemics of obesity and diabetes.
There is good evidence that the use of LCS can help to reduce obesity, including central obesity, or prevent it from increasing. Current UK government advice suggests low calorie drinks (i.e. those sweetened with LCS) as a suitable replacement for high sugar drinks. LCS consumption, as a means to limit ‘free sugar’ consumption, should be advocated more widely as one way to help to contain the epidemics of obesity and diabetes.
- Rogers PJ, Hogenkamp PS, de Graaf C et al. (2016) Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including meta-analyses, of the evidence from human and animal studies. Int J Obes (Lond) 40, 381-394.
- Gibson S, Ashwell M, Arthur J et al. (2017) What can the food and drink industry do to help achieve the 5% free sugars goal? Perspect Public Health 137, 237-247.
- Ashwell M, Gibson S, Bellisle F et al. (submitted) Expert consensus on low calorie sweeteners: facts, research gaps and suggested actions. Nutrition Research Reviews