ISA statement in response to Sylvetsky et al observational study
Foods and drinks with low calorie sweeteners are more widely available as a helpful choice for people of all ages who want to enjoy a sweet-tasting product with lower calories than its sugar-sweetened versions.
A new observational study by Sylvetsky et al1, which presents certain information on the use of low calorie sweeteners in a US population, supports that there is a wider availability of foods and beverages containing them. This makes sense, as renowned health and regulatory agencies from around the world have concluded that approved low calorie sweeteners are safe for use as a replacement for sugar, based on extensive and critical reviews of direct research into their potential for effects on health. Moreover, low calorie sweeteners have been shown to be a helpful tool in dietary strategies for reducing energy intake and/or managing body weight, based on numerous clinical trials2-10. While the authors advocate more clinical research is needed based on their findings, these comments seem to ignore the wide body of research that already exists.
Moreover, having reviewed the paper by Sylvetsky et al, this analysis of data from 24h dietary recall does not point to anything more than the fact that foods and beverages with low calorie sweeteners were recalled as consumed the day before by more people (children and adults) in the period between 2009-2012 than in 1999-2000. Furthermore, as clarified by the authors and in order to put the finding of the Sylvetsky et al analysis into perspective, “their [low calorie sweeteners] use was relatively low when evaluated as a proportion of total food and beverage intake. Specifically, LCS [low calorie sweeteners] beverage consumption comprises only 1% of the total beverage intake reported in children and 5% of total beverage intake in adults. Similarly, only 1% and 2.5% of all desserts consumed in NHANES 2009-2012 contained LCS, in children and adults, respectively.”
Importantly, low calorie sweeteners’ benefits in dental health for both adults and children are well documented, as they are non-cariogenic. Also, they are an important and significant aid to people with diabetes who need to regulate their intake of carbohydrates, since the consumption of foods containing low calorie sweeteners instead of sugar induces a lower blood glucose rise after their consumption compared to sugar-containing foods (EFSA, 2011)11. Importantly, all approved low calorie sweeteners have been thoroughly tested and approved as safe for consumption by all population groups by regulatory authorities around the world, including the European Food Safety Authority (EFSA) in Europe.
In times when overweight and obesity levels are increasing, the use of low calorie sweetened products, when used in place of their full-calorie sugary versions and as part of a balanced diet and healthy lifestyle, can help in reducing overall daily energy intake and therefore be a useful tool in weight management, based on an overwhelming body of evidence.2 Given the acknowledged health impacts of overweight and obesity, seeking to scare people about safe, effective low calorie sweeteners is unfortunate and not without consequences.