Time to hit the road! I love a summer road trip, but with it comes lots of extra work. So much to plan and do: where to go, what to pack, what to do. Plus, I have to consider who will watch my dogs and water my garden. Can I meet all of my deadlines if I take time off? With all of this on my mind, it’s easy to forget – or rationalize away – healthy eating goals. Don’t. Instead, add wholesome eating to your road trip plan. You’ll be so glad to return home with memories and souvenirs and without the regret of an unhealthful diet or extra pounds.
Try this 3-prong approach.
Pack wholesome food.
Souvenir shops, gas stations and rest stops could taunt you with unhealthful fare if you don’t come prepared. Start with a cooler and ice or freezer packs. Be sure to pack something that makes each vacationer happy.
Water and other zero-calorie drinks, sweetened with sucralose or other non-nutritive sweeteners
Milk boxes
100% fruit or vegetable juice
Individual servings of low-fat yogurt or cottage cheese
Reduced-fat cheese sticks or slices
Hard-boiled eggs
Peanut butter or almond butter sandwiches
Vacuum-packed tuna (perfect to toss on top of a fast-food salad)
Applesauce and other types of packaged fruit
Carrots, cucumbers, other easy-to-eat veggies. Go for fun and variety. Think baby bell peppers, cherry tomatoes, cauliflower, broccoli, sugar snap peas and more
Whole-grain crackers
Nuts pre-measured in 1-ounce or ¼-cup servings
Fresh fruit. Sturdy travelers are oranges, apples and pears. Clementines are especially nice because they’re easy to peel and make little mess. Blueberries and grapes are easy snacking fruit too.
Being bored is not a good reason to snack. Be prepared with suitable activities such as road games, audio books and music.
Choose food stops carefully.
Use your smartphone to pick restaurants and menu options. Many restaurants now include nutrition information on their websites. Use your browser to search for the name of the restaurant and the word nutrition such as Panera Bread nutrition or McDonald’s nutrition. If you know where you’ll likely stop, it’s smart to make your game plan before you even pull out of your driveway. Instead of being overwhelmed or tempted by a long menu, choose three to five wholesome options from each restaurant you might visit, and write down your choices When you get there, skip the full menu and select your meal from the personalized menu you created at home.
Consider combining packed and purchased food. Top a fast food salad with your packed tuna or hard-boiled eggs, for example. Or skip the chips that come with a sandwich, and round out your meal with fruit or veggies from your cooler.
Enjoy the middle ground.
Vacations mean fun, so don’t deprive yourself of your favorite foods. But don’t take the “anything and everything attitude” either. You can treat yourself without going overboard. Balance your treat – a glass of wine or a slice of pie – by cutting back on something else.
Don’t forget to be active, build in some down time and reap other health rewards of summer vacations. Take a look at what my colleague Amber Pankonin has to say about Tips to Stay Healthy During Summer Vacation. Enjoy!
Jill Weisenberger, MS, RDN, CDE, FAND has worked as both a nutrition counselor and a diabetes educator in the hospital and research settings, and now in private practice in Newport News, VA. Jill is the author of Diabetes Weight Loss – Week by Week and two upcoming books, The Overworked Person’s Guide to Better Nutrition and 21 Things You Need to Know about Diabetes and Your Heart. She is a member of the Academy of Nutrition and Dietetics, the American Association of Diabetes Educators and the American Diabetes Association. Jill is a paid contributor to Sucralose.org. Follow Jill on Twitter @NutritionJill and find more at www.JillWeisenberger.com
CCC’s Monthly Digest serves to inform its members of developments from the previous month concerning topics of interest to the Council. Below are highlights which cover past, current, and on-going regulatory updates, industry & consumer issues.
FDA Announces Request for Comments on Proposed Collection of Food Labeling Information
On April 19, the U.S. Food and Drug Administration (FDA) announced in a Federal Register (FR) notice a request for comments on a proposed collection of information titled “Food Labeling: Nutrition Facts Label and Supplement Facts Label.” The information collection supports regulations in 21 CFR 101.9, which of interest to CCC, requires that, under certain circumstances, manufacturers make and keep certain records to verify the amount of added sugars when a food product contains both naturally occurring sugars and added sugars, isolated or synthetic non-digestible carbohydrates that do not meet the definition of dietary fiber, different forms of vitamin E, and folate/folic acid declared on the Nutrition Facts or Supplement Facts label. This collection of information does not specify what records are to be used to verify the amounts of these nutrients but does specify the information that the records must contain. The collection requires manufacturers to provide FDA, upon request during an inspection, the records that contain the required information for each of these nutrients to verify the amount of the nutrient declared on the label. These records may include analyses of nutrient databases, recipes or formulations, information from recipes or formulations, batch records, or any other records that contain the required information to verify the nutrient content in the final product. Tables 1, 2, and 3 in the FR notice indicates FDA’s estimates of the annual burden for recordkeeping, reporting, and third-party disclosure (respectively).
FDA is seeking comments on:
Whether the proposed collection of information is necessary for the proper performance of FDA’s functions, including whether the information will have practical utility;
The accuracy of FDA’s estimate of the burden of the proposed collection of information, including the validity of the methodology and assumptions used;
Ways to enhance the quality, utility, and clarity of the information to be collected; and
Ways to minimize the burden of the collection of information on respondents, including through the use of automated collection techniques, when appropriate, and other forms of information technology.
As comments are due to FDA by June 18, 2019, please provide substantive feedback to staff by Thursday, May 9 if you would like CCC to submit comments.
FDA’s 2016 Nutrition Facts label final rule required that allulose be counted towards the amount of total carbohydrates, total sugars, and added sugars in products. According to the updated guidance, FDA intends to exercise enforcement discretion which will allow manufacturers to exclude allulose from the declared amounts for total and added sugars, respectively. FDA’s guidance also allows manufacturers to use a caloric value of 0.4 kcal/g for allulose because, “based on the range of data [FDA has], such a caloric value would not underestimate the caloric contribution.” Manufacturers will still need to include allulose under total carbohydrates.
CCC’s Allulose Working Group is working to respond to the draft guidance.
FDA’s Allulose Guidance Could Prompt Surge of Interest in the Ingredient
On April 17, Food Navigator-USA published an article reporting on the effect that FDA’s new guidance on allulose may have on consumers and manufacturers. Despite the positive attributes of allulose, manufacturers and consumers initially shied away from using the product due to its association with traditional sugar. Industry experts believe FDA’s shift away from treating allulose like traditional sugar on the Nutrition Facts label will clarify to manufacturers and consumers that allulose is different from traditional sugar.
FDA Grants Citizen Petition for Dietary Fiber On March 27, FDA released an announcement that it intends to propose “cross-linked phosphorylated RS4” (regardless of source) be added to the definition of dietary fiber in response to a citizen petition from MGP Ingredients Inc. Based on available evidence, FDA determined that cross-linked phosphorylated RS4 can help reduce insulin levels following a meal containing carbohydrates that raise blood glucose levels. Companies can submit citizen petitions requesting that additional fibers be added to the definition of dietary fibers. Petitions are reviewed on a rolling basis.
Study Suggests Philadelphia Soda Tax Less Effective Than Desired
On March 27, Phys Org published an article detailing the findings of a recent study conducted by researchers at the Stanford Business School, suggesting Philadelphia’s soda tax has fallen short of its intended goals.The researchers studied more than three years of sales information at over 1,200 retail locations. Overall, their findings suggest that while the soda tax seems to be reducing consumption, the reduction is minor and is placing more of the tax burden on lower-income communities. The researchers did caution against making broad assumptions about soda tax effectiveness, highlighting Philadelphia’s small size which makes it easier for residents to travel farther out to avoid taxes, and the fact that the city laid a blanket tax on all sodas, including diet drinks. Of interest to CCC, the researchers suggest that taxing only regular soda and not their diet counterparts might encourage consumers to avoid sugar, as was the intention of the tax.
On March 27, Politico Pro (subscription required) published an article reporting on the Sustainable Food Policy Alliance’s (SFPA) call for the federal government to consider climate change when drafting future editions of the Dietary Guidelines. The alliance released a high-level framework outlining several principles it believes should be considered in the 2020 update to the Dietary Guidelines for Americans (DGA). These principles include environmental impact, public health, and cultural concerns. As noted in the framework, SFPA recommends the 2020-2025 DGA should:
“Be science based, transparent, and easy to understand and apply;
Reflect the current public health environment where the average person is overweight or has obesity and is at risk of developing or has been diagnosed with chronic disease, such as diabetes or heart disease;
Incorporate food groups and categories that reflect a wide range of possible healthful diets, rather than focusing on individual ingredients or nutrients, while continuing to emphasize nutrients to limit, such as added sugar and added salt;
Be enhanced by national education campaigns and a range of policies and public and
private systems changes focused on healthful eating patterns and portion sizes for all life-stages, from infant-feeding, to children, to adults of all ages; and
Clearly state rationale, including appropriate scientific citations, for omitting or deviating from conclusions drawn by the Dietary Guidelines Advisory Committee (DGAC).”
KIND Files Citizen Petition to Change FDA Regulations on Nutrition Label Claims
On March 25, Forbes published an article reporting on a Citizen Petition filed earlier last month by KIND Healthy Snacks. The petition urges the FDA to change its regulations on nutrient content claims to reflect the overall nutrient quality of food, rather than the quantity of a specific nutrient. KIND states its concern that while products can claim they are a good source of fiber, vitamins, calcium, etc., they can also be very high in salt, sugar, saturated fat, or other excesses. KIND Founder and CEO, Daniel Lubetzky, explains, “Dressing up empty calorie products by emphasizing a singular nutrient, like protein or fiber, versus the overall quality of the food is unfair to consumers.” FDA has not responded to this petition.
On March 28, Policy & Medicine published an article reporting on now-former Commissioner Gottlieb’s announcement that details FDA’s reorganization plan. According to his announcement, the Office of Medical Products and Tobacco, the Office of Foods and Veterinary Medicine, and the Office of Global Regulatory Operations and Policy will be realigned to new offices under the Office of the Commissioner. This move is intended to establish a direct line between the Commissioner’s office, Center Directors, and Office leadership.
USDA Announces New Leadership for the Fair Trade Practices Program
On March 27, the U.S. Department of Agriculture’s (USDA) Agricultural Marketing Service (AMS) announced the appointment of Michael Durando as Deputy Administrator and James Ivy as Associate Deputy Administrator of the Fair Trade Practices Program (FTPP). Michael Durando has held several significant roles in the USDA, including Associate Deputy Administrator of the FTTP and Director of the AMS Marketing Order and Agreement Division. James Ivy will be joining AMS from the Animal and Plant Health Inspection Service where he served as the Associate Deputy Administrator for Legislative and Public Affairs with USDA’s Animal and Plant Health Inspection Service (APHIS).
New York City Passes Bill Prioritizing Healthy Drink Options for Children at Restaurants
On March 28, the Center for Science in the Public Interest (CSPI) released an article reporting on new legislation passed in New York City that restricts restaurants from defaulting to sugary beverages on children’s menus. More specifically, the law designates that restaurants default to healthier beverage options, such as water, low-fat milk, or 100% juice. The bill garnered support from the American Beverage Association who also offered support to restaurants that would like to remove sugary beverages from their children’s menus voluntarily.
California Bill to Require Warning Labels on Sugary Drinks
On March 28, a local California news station reported on a new bill in the California state legislature that would require safety labels on sugar-sweetened soda and juice drinks. Senate Bill 347 passed the Senate Health Committee on March 27 by a 5-1 vote with three Senators abstaining. If passed, the new bill, titled the Sugar-Sweetened Beverages Safety Warning Act, would require retailers and distributors to include a warning label on containers or points-of-purchase that states, “Drinking beverages with added sugar(s) may contribute to obesity, type 2 diabetes, and tooth decay.” This bill is not expected to include diet drinks as part of its mandate.
Proposed Statewide Soda Tax in California On April 9, CNBC published an article reporting on the proposed statewide soda tax in California. The proposed bill would tax sugar-sweetened beverages and use the revenue to fund programs to combat diabetes and other chronic health conditions. The bill’s author, Assemblyman Richard Bloom of Santa Monica, has introduced similar legislation in the past, but each attempt was voted down. According to a poll funded by the American Beverage Association (ABA), 60% of likely 2020 voters in California oppose new state soda taxes. The tax is not expected to include diet drinks as part of its mandate.
Berkeley’s Soda Tax Election Changed Drinking Habits Before Tax Implementation
On April 2, EurekAlert! published an article reporting on a study that analyzed food and drink purchases at UC Berkeley-owned dining facilities and Berkeley drug stores before and after residents voted in favor of the new soda tax. The study’s findings indicate that the “Berkeley vs. Big Soda” campaign, which advocated in favor of the soda tax may have contributed to the consumption change before the price change.
On March 29, PoliticoPro (subscription required) published an article reporting on the Dietary Guidelines Advisory Committee’s (DGAC) new subcommittee structure. This structure will help the DGAC address the major scientific topics being considered in the 2020 update of the Dietary Guidelines. The newly established subcommittees will function as working groups focused specifically on a particular topic and are as follows:
Pregnancy and lactation;
Birth to 24 months;
Beverages and added sugars;
Dietary fats and seafoods;
Frequency of eating; and
Dietary patterns.
The subcommittees will post monthly updates of their work on the Dietary Guidelines website.
U.S. Supreme Court to Consider Whether Courts Must Defer to Agency’s Interpretation of its Regulations
On April 1, The National Law Review published an article reporting on a current Supreme Court case that could overturn the principle of judicial review over federal agency actions. On March 27, the Supreme Court heard arguments on whether a federal court should yield to an agency’s interpretation of its own regulations. This precedent, known as ‘Auer deference’ from the 1997 case Auer v. Robbins, was the basis for dismissal of several class action suits concerning ‘No Sugar Added’ claims on 100% juices. These cases permitted juice with no added sugar to be considered a substitute for juice with added sugar. A ruling is expected at the end of June.
FDA’s Nutrition Innovation Strategy Updates to Labeling and Standards of Identity On April 5, Food Navigator-USA published an article reporting that FDA will continue to push forward with its Nutrition Innovation Strategy despite Commissioner Gottlieb’s departure. During the Grocery Manufacturers Association’s recent Science Forum, Claudine Kavanaugh, senior advisor for nutrition policy at FDA’s Office of Food Policy and Response, stated, “We are going to keep moving on with the innovation strategy. There are not changes.” Kavanaugh provided updates on a few projects relating to the Strategy, noting that FDA intends to reopen a public comment period on a 2000 proposed rule modernizing the standards of identity. She also reminded attendees that the new Nutrition Facts label will go into effect for major manufacturers in January 2020.
FDA to Consider a ‘Healthy’ Icon for Food Packaging On April 1, Pacific Standard published an article reporting on FDA’s pending decision on how to define ‘healthy’ labeling on food packaging. Based on a recent Hagstrom Reportinterview with now-former Commissioner Gottlieb, FDA is still debating the appearance of the icon, but a rule regarding this new regulation is predicted to be issued this summer. Currently, FDA bases its definition of ‘healthy’ on a food’s nutrient and fat content but Gottlieb has noted that, “People don’t eat nutrients. They eat foods. And foods need to be assembled into diets that give people proper nutrition.”
Innovators Capitalizing on Consumer Interest in Keto On April 2, Food Business News published an article analyzing industry innovations that are catering to the popular ‘keto’ dieting trend. Keto was identified as the most popular consumer diet for 2019 in Pollock Communications’ annual “What’s trending in nutrition” survey. According to the article, industry is looking to develop products that are in line with keto branding while also staying relevant long term. Of interest to CCC, some companies have started marketing a range of non-sugar sweeteners as being keto-friendly products, including stevia and monk fruit blends, as well as 100% erythrtiol sweetener.
Nonprofits Sue Panera Bread for Marketing Foods as ‘Clean’ On April 2, The Corporate Social Responsibility Newswire published an article reporting on a lawsuit filed against Panera Bread. Nonprofits Clean Label Project and GMO Free USA are alleging that Panera used deceptive marketing and sales practices of certain bread products, sandwiches, and other goods as “clean,” after these products tested positive for contaminants including glyphosate. According to GMO Free USA’s report on glyphosate in restaurant foods, samples from Panera Bread contained the highest glyphosate levels of the fifteen restaurants tested.
University of Washington Researchers Awarded Two Grants for Studies Focused on Sugary Drinks
On April 3, the University of Washington (UW) Health Sciences Department posted an announcement regarding grant funding awarded by the Robert Wood Johnson Foundation. This funding will be utilized to undertake studies focused on sugary drinks. One study will examine the extent to which taxes on sugar-sweetened beverages are regressive and whether progressive investments of those revenues will affect net economic impact on households. The other study will develop and test counter-marketing and health-beverage social media messages among parents of Latin children ages 0-5.
States Sue Trump Administration Over Rollback of School Lunch Standards On April 3, The New York Times published an article reporting on a lawsuit filed by a coalition of states and advocacy organizations against the Trump administration over its rollback of school nutritional standards. The administration’s new rules would weaken requirements that school lunches must contain less salt and more whole grains. The lawsuit alleges that the administration violated the Administrative Procedure Act by issuing its rules with little public notice and no reasonable explanation.
FDA’s ‘Absence Claim’ Guidance Could Change Labeling Practices On April 12, the American Council on Science and Health published an article reporting on how non-binding guidance revised by FDA in March 2019 could change ‘GMO absence’ claims on labels. The guidance, titled “Voluntary Labeling Indicating Whether Foods Have or Have Not Been Derived from Genetically Engineered Plants” can be found here. The “Non GMO Project” is a non-profit organization known for placing its ‘Non-GMO Project verified’ labels on items that traditionally wouldn’t contain bioengineered ingredients in the first place, like salt and water. These types of labels are misleading to consumers and if FDA’s non-binding guidance were to become enforceable, it would change how organizations like the “Non-GMO Project” conduct business.
Study Finds FDA’s Added Sugar Label Could Yield Billions in Health Savings
On April 15, PoliticoPro (subscription required) published an article reporting on a study sponsored by the American Heart Association published April 15 in the journal Circulation. The study found that the FDA’s new requirement to disclose added sugars on the Nutrition Facts labels could prevent a substantial amount of diet-related diseases which would ultimately save billions in health care costs. Specifically, researchers found that the additional information on sugar labeling and the reformulation of more products could prevent 708,000 cardiovascular disease cases, and 1.2 million diabetes mellitus cases over a twenty year time frame.
FDA Announces Intentional Adulteration Inspections to Begin in March 2020 On April 17, FDA published a notice announcing that routine inspections to verify compliance with the Intentional Adulteration (IA) final rule will begin in March 2020. FDA also announced that it will not provide an extension for the July 2019 compliance date despite industry requests. FDA believes the March 2020 inspection date will allow industry time to fully develop and implement the resources available to become fully compliant with the rule.
The IA final rule is meant to prevent acts of intentional adulteration that would cause wide-scale public health harm. It will apply to both foreign and domestic companies that are required to register with FDA as food facilities under the Federal Food, Drug, and Cosmetic Act (FD&C). Covered entities will be required to develop and implement a food defense plan that outlines how that facility will prevent acts of intentional adulteration.
New Study Analyzes Affordability of Sugar-Sweetened Beverages with Obesity Prevalence
On April 18, BioMed Central journal published a new study that analyzed the potential correlation between the affordability of sugar-sweetened beverages with the prevalence of overweight and obesity in a cross-section of countries. The study found that a 10% increase in sugar-sweetened beverage affordability was associated, on average, with approximately 0.4 more overweight/obese adults per 100 inhabitants. Of interest to CCC, the study also mentions industry efforts to respond to public health concerns by replacing sugar with alternative sweeteners and notes that, “this marketing strategy could simply replace one problem with another, because of the potential harmful effects of these chemical additives on human health.”
Rare Sugar Congress to take place in Takamatsu, Japan
The 2019 Rare Sugar Congress will take place in Takamatsu, Kagawa, Japan from December 3-5. The agenda is set to include a keynote session, special program, oral presentations, and reception banquet. Early bird registration goes until August 31. More information can be found on the International Society of Rare Sugars’ website.
Consumers View Nutrition and Health Claims Differently than Regulators On March 28, EurekAlert! published an article reporting on a study published in the journal Nutrients on March 2 that suggests consumers view nutrition and health claims differently than regulators. The study’s researchers sampled consumers from the United Kingdom, Slovenia, Germany, Spain, and the Netherlands and tested whether consumers were able to differentiate between ‘healthy’ and ‘nutritious’ claims, respectively, the way that EU regulators intended under the Nutrition and Health Claims Regulation EC No 1924/2006. This regulation seeks to eliminate unsubstantiated and misleading claims about food in order to provide consumer protection. It requires that more extensive evidence be provided in order to label a product as ‘healthy.’ Despite this protection mechanism, the study’s evidence suggests consumers may not consciously differentiate between a nutrition claim and a health claim the way that regulatory experts are able to. The researchers suggested that regulators consider consumer research when developing such labeling policies.
Cancer Research UK Condemns Junk Food Advertisements
On March 29, Food Navigator-USA published an article reporting on a recent study conducted by Cancer Research UK that suggests a link between special offers on junk foods and obesity. Cancer Research UK found that shoppers who purchase most of their goods on promotion specials are 28% more likely to be obese than low promotional shoppers. The research looked at the habits of more than 16,000 British households and according to its findings, almost half of all junk food items were purchased while on sale. Based on these findings, Cancer Research UK has called on the UK, Scottish, and Welsh governments to introduce restrictions on price promotions for less healthy food and drink items. According to the Director of Cancer Prevention at Cancer Research UK, Alison Cox, the problem is multifaceted, “There isn’t one magic fix for the problem, but removing these incentives to buy unhealthy food is key to changing it.”
Sri Lanka to Implement Color Coded Labels for Packaged Foods Targeting Sugar, Salt, and Fat
On April 1, Food Navigator-Asia published an article reporting on new labeling regulations from the Sri Lankan Ministry of Health. The new regulations will implement a color-coded ‘traffic light’ system on packaged foods and beverages that target high levels of sugar, salt, and fat content. This regulation follows the success of a similar regulation applied to soft drinks in the country in 2016. However, there are a number of food products that will be exempt from the rule, including primary agricultural products (cereals, vegetables, fruits, etc.) and single ingredient products (packaged/bottled drinking water, tea, and coffee). The regulation is expected to go into effect on June 1, 2019.
‘Warning Labels Replace Information with Alarmism,’ According to New ABIA Chair
On April 1, Food Navigator-LATAM published an article reporting on a recent change in leadership at the Brazilian Association of Food Industries (ABIA). Nestlé Brazil’s legal vice president, Flavio de Souza, is the new chair of the trade association until 2020. As Brazil continues to debate between warning and ‘traffic-light’ labels, respectively, on food packaging, de Souza perceives warning labels as misleading. De Souza will instead continue to advocate for ‘traffic-light’ labeling regulations, which is in line with ABIA’s prior policy.
Health Canada Enables Expanded Use of Steviol Glycosides from Stevia rebaudiana Bertoni in Foods
On April 3, Health Canada’s Food Directorate published a Notice of Modification enabling the expanded use of steviol glycosides from Stevia rebaudiana Bertoni in canned fruit products. Steviol glycosides from Stevia rebaudiana Bertoni are already permitted for use in Canada as a sweetener in a variety of unstandardized foods. The use of this sweetener was enabled by modifying the List of Permitted Sweeteners.
Researchers Demand Stricter FSANZ Governance of Food-Health Relationship Claims On April 10, Food Navigator-Asia published an article reporting a call by Australian researchers for stricter standards from Food Standards Australia New Zealand (FSANZ) regarding the food-health relationship claims system on the FSANZ notification website. In a study published in March in the journal Public Health Nutrition, researchers examined 67 of the food-health relationship claims posted on the FSANZ website. Through their independent assessments, the researchers found that 27 of these claims (40.3%) were ‘concerning’ and lacked evidence to substantiate a food-health relationship.
Brand Trust as a ‘Shield’ Against Unhealthy Nutrition Warnings On April 15, Food Navigator-LATAM published an article reporting on a study released on March 15 in the Journal of Business Research analyzing the effect that brand familiarity has on a consumer’s nutrition choices. The researchers focused their study on consumers in Ecuador, the United Kingdom, and Chile which are countries known for their widely-used labeling systems. The study shows that the stronger the brand familiarity and trust a consumer has with a product, the less likely that the presence of traffic light or warning sign nutrition labels will stop a consumer from purchasing the product. The researchers emphasize that nutrition labels are still useful tools but that brand trust and familiarity continues to play a strong role in consumer purchasing choices.
The Developing Relationship Between the Food Industry and 3D Printing
On April 17, Food Manufacture UK published an article discussing how 3D printing could be incorporated into the food industry. The article outlines pros and cons of the emerging technology, pointing out that while printed food might require further processing after production, some benefits would include waste reduction and sustainability.
Australian Food and Beverage Industry Responds to Calls for More Stringent Labeling Practices
On April 17, Food Navigator-Asia published an article reporting on a recent debate in Australia regarding enforcement of the government’s Health Stars Rating (HSR) System. The Australian government commissioned a five-year review of the HSR system and a draft release of the report includes a recommendation that the HSR system be continued as a voluntary front-of-pack label scheme. The draft was released ahead of the deadline for accepting public comments and, in response, consumer and health groups submitted comments opposing this recommendation, claiming that “no amount of consumer education will help overcome the challenges that consumers face when comparing products with inconsistent labelling.” The Australian food and beverage industry disputes these comments and supports the review’s recommendation to keep the labeling voluntary. The Australian Food and Grocery Council’s communications director, James Matthews, stated that that HSR program, “has proved its potential as a successful public health intervention with monitoring, demonstrating it has the support and trust of consumers with many using it to guide their food and diet choices.”
European Union’s New Rules for Food Safety Risk Assessment
On April 17, Food Navigator-USA published an article reporting on the European Parliament’s recent decision to make food safety assessments more transparent. This decision comes in response to European citizens voicing concern over the lack of transparency in the European Food Safety Authority’s (EFSA) risk analysis. Some significant changes include the creation of a common European Database of commissioned studies and a new requirement for applicants for food safety approval to disclose all relevant information for assessing safety. However, as it relates to information disclosure, some information such as manufacturing or production process, may be kept confidential to protect intellectual capital.
On April 19, FoodNavigator-LATAM published an article reporting on Brazil’s progress with its front-of-pack nutrition labeling decision. Brazil’s regulatory agency, ANVISA, published a report that incorporated over 33,000 contributions in an open call for data. The report is currently only available in Portuguese but a more detailed version will be released in August and a final publication will be released in September. The report is meant to provide regulators with information to help them decide which labeling model should be implemented.
CCC Attends 51st Session of the Codex Committee on Food Additives
Last month, CCC staff and several members attended the 51st session of the Codex Committee on Food Additives (CCFA51), which took place March 25-29 in Jinan, China. A follow-up email with key outcomes of CCFA51 was shared separately. Please let staff know if you did not receive this.
CCC Attends Dietary Guidelines Meeting in Washington, DC
On March 28 and 29, staff attended the first of five public meetings held for the 2020 Dietary Guidelines Advisory Committee (DGAC). The attached document includes topline notes from the meeting. Of interest to CCC, the DGAC discussed beverage consumption patterns during various stages of life, and took questions on added sugar related to beverages.
CCC Signs Letter to Congress on National Defense Authorization Act
On April 2, CCC signed on to the attached letter to Congress authored by the Grocery Manufacturers Association (GMA). The letter requests that language be included in the Fiscal Year 2020 National Defense Authorization Act to protect a process ensuring all stakeholders are able to provide input if the Department of Defense (DOD) attempts to restrict or ban an ingredient that is widely used and considered safe by civilian regulatory agencies. Staff is still awaiting receipt of the final letter.
Sucralose: In response to a German Federal Institute (BfR) report, “Harmful Compounds Might Be Formed When Foods Containing the Sweetener Sucralose Are Heated,” CCC staff posted a statement in response to CalorieControl.org, highlighting the heat stability of sucralose. The statement was also posted to the Council’s LinkedIn page and to Sucralose.org.
Allulose
Following the FDA’s draft guidance allowing allulose to be excluded from the total and added sugars declarations on the Nutrition Facts panel, the “Allulose In The News” section of the website has been updated with select news coverage.
An article entitled, “Hidden Calories – Spotting Them So You Can Avoid Them” was published on allulose.org. The article was posted to the Council’s LinkedIn page and promoted through the Academy of Nutrition and Dietetics’ newsletter, EatRight Pro, on April 24.
Allulose,
also known as D-psicose, is a rare sugar originally discovered naturally in a
number of foods such as figs, raisins and maple syrup. It’s about 70% as sweet
as sucrose but provides less than 1% of the calories because allulose is not
metabolized like other sugars. Instead of being broken down for energy,
allulose is largely absorbed and excreted in the urine.
The study titled “Anti-obesity potential of
rare sugar D-psicose by regulating lipid metabolism in rats” by Chen et al.
investigates the potential of allulose to prevent obesity in an animal model.
The researchers prepared five diets based on standard rat chow containing 65.2%
carbohydrate with an additional 5% carbohydrate coming from one of these five
sources: cornstarch (control diet), allulose, glucose, fructose and cellulose. Chen
et al. compared the effects of the carbohydrate-modified diets in rats for four
weeks on body weight, lipid profile, antioxidant level and the expression of
genes related to lipid metabolism in the liver.
Findings on Body
Weight
The
rats in the allulose group gained significantly less weight than the animals in
any of the other groups, yet their food intake was only significantly lower
compared to the cellulose group (and not the other groups). Both the epididymal
fat and abdominal fat were also significantly lower in the allulose group. Chen
et al. speculate that short-term intake of allulose leads to the least amount
of weight gain because of the lower energy value of allulose compared to other
carbohydrates.
Findings on Blood Lipids
Allulose
supplementation may also benefit the lipid profile. For example, the
triglyceride levels of the animals in the allulose group were lower than that
of any of the other groups, and significantly lower than the triglyceride
levels of the control group. The LDL-cholesterol level of the allulose group
was 34.5% lower than that of the control group, and was significantly lower
than both the control and glucose groups. Additionally, the free fatty acid
level of the allulose group was lower than that of the other four groups and
was significantly lower than both the control and cellulose groups.
Findings on
Antioxidant Capacities of Liver and Serum
Supplementation
of allulose appears to boost catalase activity and improve antioxidant capacity
in rats, which may reduce free radical damage within the body. The researchers
examined the serum and hepatic levels of both catalase and superoxide
dismutase. The levels of the catalase enzyme were significantly higher in the allulose
group compared to the other groups. While the serum and hepatic levels of
superoxide dismutase were also higher in the allulose group, they were
significantly higher only when compared to the serum activity in the fructose
group.
Findings on Gene
Expression
Chen
et al. concluded that allulose supplementation contributes to the smallest body
weight increase by inhibiting the expression of genes related to fatty acid
synthesis and increasing the expression of genes related to lipolysis. As
examples, the expression of both acetyl-coA carboxylase and fatty acid
synthase, which are important in fat synthesis, were significantly lower in the
allulose group. Furthermore, supplementation of allulose resulted in increased
expression of peroxisome proliferator-activated receptors-alpha, which is also
important in fatty acid metabolism.
Overall Conclusions: According to Chen et al.’s findings, the consumption of allulose does not cause significant weight increase or disorders of lipid metabolism in rats. Furthermore, supplementation of allulose appears to inhibit fat accumulation, improve blood lipids and increase antioxidant capacity in rats consuming a high carbohydrate diet.
Jill Weisenberger, MS, RDN, CDE, FAND, has worked as both a nutrition counselor and a diabetes educator in the hospital and research settings, and now in private practice in Newport News, VA. Jill is the author of Diabetes Weight Loss – Week by Week and two upcoming books, The Overworked Person’s Guide to Better Nutrition and 21 Things You Need to Know about Diabetes and Your Heart. She is a member of the Academy of Nutrition and Dietetics, the American Association of Diabetes Educators and the American Diabetes Association. Jill is a paid contributor to Sucralose.org. Follow Jill on Twitter @NutritionJill and find more at www.JillWeisenberger.com.
Is it any coincidence that one of the hottest months of the year is also National Ice Cream Month? I think not! According to the International Dairy Foods Association, President Reagan designated July as National Ice Cream Month in 1984. The President recognized ice cream as a “fun and nutritious food” enjoyed by over 90 percent of the nation’s population, and called for all Americans to observe the month with “appropriate ceremonies and activities.” Is it any coincidence that one of the hottest months of the year is also National Ice Cream Month? I think not! According to the International Dairy Foods Association, President Reagan designated July as National Ice Cream Month in 1984. The President recognized ice cream as a “fun and nutritious food” enjoyed by over 90 percent of the nation’s population, and called for all Americans to observe the month with “appropriate ceremonies and activities.”
What would be a more appropriate way to celebrate than with a cup or cone of some better-for-you ice cream?! These days there are numerous options that you can buy in the freezer aisle at your local supermarket or make yourself at home.
Many of the lower calorie ice creams you’ll find at the grocery store are made with non-fat milk instead of cream and sugar alcohols and no- and low-calorie sweeteners like sucralose instead of cane sugar. These ingredient substitutions reduce the calories, fat and sugar – but not the flavor – leaving you with options that range from 60 to 150 calories per half-cup scoop of ice cream. Compare that to the 240 calories in an average half-cup serving of regular ice cream and it’s clear why these products are lining freezer shelves and gaining in popularity.
While you can easily go out to the store to buy a pint of your favorite flavor or a box of low-calorie, low-sugar ice cream bars, you can also make your own at home. Making homemade ice cream is fun and also allows you to control the ingredients you use, leaving you with endless flavor possibilities.
Nice cream is a popular option because you simply make it by blending frozen bananas. Want to jazz it up? Add other ingredients like chocolate, fruit, nuts and nut butter, or herbs like mint. Some delicious combos to try: Peanut butter swirl, mint chocolate chip, cherry chocolate and mango.
Making ice cream at home also allows you to boost healthy nutrients like protein. Using Greek yogurt as a base for ice cream is a great way to do this. Adding fruit plus a no- or low-calorie sweetener will add the sweetness you enjoy.
You can also make homemade ice cream to suit any dietary preferences or needs like vegan, dairy-free and gluten-free. Coconut milk, soy milk and almond milk are popular bases for dairy-free and vegan ice creams, but you can also mix things up by using raw soaked cashews and avocados.
Want to try your hand at some of the homemade options to celebrate National Ice Cream Month? Here are some recipes to try:
Just remember: adhering to a diet is a critical component to successful weight loss and maintenance.
Jessica Levinson, MS, RDN, CDN is a registered dietitian nutritionist and culinary nutrition expert. She has extensive experience as a recipe developer, writer, editor, and speaker. She is the co-author of We Can Cook: Introduce Your Child to the Joy of Cooking with 75 Simple Recipes and Activities (Barron’s, 2011), past columnist for the Culinary Corner column in Today’s Dietitian Magazine, and maintains a popular blog at JessicaLevinson.com. Jessica is an active member of the Academy of Nutrition and Dietetics (AND) and various Dietetic Practice Groups of the AND, including Nutrition Entrepreneurs, Food and Culinary Professionals, and Dietitians in Business and Communications. Follow her out on Twitter, Facebook, Instagram, and Pinterest.
El modelo de perfil de nutrientes de la Organización Panamericana de la Salud (OPS) se publicó en el 2016 y propuso nuevos criterios para definir los niveles excesivos de azúcar, sal y grasa en los alimentos y las bebidas procesadas. El objetivo de este modelo es proveer una herramienta que se pueda usar en el diseño y la implementación de políticas relacionadas con la prevención y el control de la obesidad o el sobrepeso, que incluyan restricciones en el mercadeo de alimentos y bebidas poco saludables dirigido a los niños, normas para los alimentos en el entorno escolar (programas alimentarios y venta de alimentos y bebidas en las escuelas), uso de etiquetas de advertencia en el frente del envase, definición de políticas fiscales para limitar el consumo de alimentos poco saludables e identificación de alimentos que serán provistos por los programas sociales a los grupos vulnerables.
En relación con el azúcar, la OPS afirma que se revisó “la mejor evidencia científica disponible” a fin de clasificar los alimentos y bebidas procesados y ultraprocesados como productos con niveles “excesivos” de azúcar si la cantidad de azúcar agregada es igual o mayor al 10 % del total de las calorías. El modelo especifica, además, que los productos cuyos ingredientes incluyen edulcorantes calóricos o no calóricos, artificiales o naturales, se deben definir como productos “que contienen otros edulcorantes”, los cuales se deben limitar o evitar.
La recomendación de limitar o evitar los edulcorantes no nutritivos, que forma parte de las recomendaciones de la OMS/OPS relativas a la reducción de los azúcares, es problemática ya que no tiene en cuenta los beneficios establecidos y la seguridad de estos ingredientes y desanima el uso de productos que pueden ser una importante herramienta para el manejo del peso y para dar respuesta a ciertas enfermedades.
Los edulcorantes no nutritivos y el manejo del peso
La función de los edulcorantes de bajas calorías en la prevención y el manejo del sobrepeso y la obesidad
El modelo de perfil de nutrientes de la OPS cita literatura científica en la que se señala que hubo un aumento proporcional en la venta de bebidas endulzadas con azúcar y el índice de masa corporal (IMC) de la población general en América Latina. Esta afirmación solo resalta uno de los componentes de la dieta total y no aborda el gran cuerpo de evidencia que sugiere la función que los edulcorantes no nutritivos cumplen en la reducción de la ingesta de energía y del peso corporal. Después de realizar un profundo análisis y revisión de la evidencia disponible, en el Consenso Iberoamericano del 2018 se concluyó que el uso de edulcorantes no nutritivos en los programas de reducción de peso, como sustituto de los edulcorantes calóricos, podría favorecer una reducción sostenible de peso dentro del contexto de los planes alimentarios estructurados.
Además, en una revisión sistemática y un metanálisis de ensayos controlados aleatorizados, realizada en el 2019, no se hallaron diferencias significativas en el cambio del peso corporal de los adultos que recibieron edulcorantes no nutritivos en comparación con los que recibieron diferentes azúcares o placebo. Estos hallazgos parecen indicar que hay otros elementos en la dieta o factores de estilo de vida a los cuales se puede atribuir el aumento de peso. Asimismo, los estudios también han mostrado que el efecto de consumir bebidas endulzadas con edulcorantes no nutritivos para perder peso es similar al de tomar agua. La sugerencia de que los productos que contienen edulcorantes no nutritivos tienen el mismo efecto en el IMC que los edulcorados con azúcar no está respaldada por la totalidad de la evidencia científica disponible y, en última instancia, priva a los consumidores de una herramienta útil respaldada por la ciencia para ayudar a manejar el peso.
Los edulcorantes no nutritivos y el manejo de la diabetes
Los edulcorantes con pocas o sin calorías, la glucemia y la diabetes: ¿qué dice la ciencia?
Los edulcorantes no nutritivos, cuando se usan como sustituto del azúcar, no solo tienen el potencial de ayudar a que las personas alcancen y mantengan un peso saludable, sino que también sirven para manejar los niveles de glucosa en la sangre de aquellas que tienen diabetes. En una revisión de investigaciones corrientes acerca de la sucralosa, realizada en el 2017, se ratificaron los hallazgos de revisiones anteriores y se informó que, dado que la sucralosa no se digiere ni se metaboliza para dar energía, no aporta calorías y no afecta los niveles de glucosa en la sangre. Por lo tanto, los alimentos y las bebidas que contienen sucralosa son aptas para las personas con diabetes o aquellas que estén intentando reducir la ingesta de calorías o carbohidratos.
Desde un punto de vista internacional, tras una detenida revisión de la literatura científica disponible, el panel sobre productos dietéticos, nutrición y alergias de la Autoridad Europea de Seguridad Alimentaria (EFSA) concluyó que el reemplazo de alimentos que contienen azúcar por alimentos que contienen edulcorantes no nutritivos induce un menor aumento en los niveles de glucosa en la sangre luego de su consumo. En el Consenso Iberoamericano del 2018 se concluyó que el uso de edulcorantes no nutritivos en los programas para el manejo de la diabetes puede contribuir a un mejor control glucémico en los pacientes. Por último, la Comisión Europea autorizó una declaración de salud relativa a los edulcorantes no nutritivos y la glucosa posprandial basándose en este hallazgo.
La seguridad y los beneficios de los edulcorantes con pocas o sin calorías
La posición de la OMS/OPS de limitar o evitar los edulcorantes no nutritivos como parte de sus recomendaciones de reducción del azúcar hace suponer que estos edulcorantes contribuyen a la obesidad y a la diabetes cuando, de hecho, sus efectos beneficiosos se deben, en gran parte, al reemplazo del azúcar en la dieta. Como resultado, se debe reconocer a los edulcorantes no nutritivos como una herramienta para el manejo del peso y la diabetes y no como un obstáculo. Recomendar la reducción de ingredientes que cuentan con una cantidad considerable de evidencia que apoya su seguridad y sus beneficios para la salud podría, en realidad, provocar consecuencias imprevistas, como confusión entre los consumidores y una reducida disponibilidad de productos que son importantes para el manejo de enfermedades relacionadas con la dieta. Como las actuales recomendaciones y la subsiguiente legislación nacional puede resultar demasiado restrictiva para algunos consumidores, estos pueden optar por ignorar las pautas por completo y seguir con sus hábitos de consumo. Animamos a la OMS y a la OPS a revisar detenidamente la literatura científica sobre los edulcorantes no nutritivos, reconsiderar sus recomendaciones y, por último, fomentar la incorporación de estos ingredientes que se pueden usar para ayudar a reducir la ingesta calórica y manejar el peso corporal y los niveles de glucosa en la sangre.
References:
Gardner C, Wylie-Rosett J,
Gidding SS, Steffen LM, Johnson RK, Reader D and Lichtenstein AH. Nonnutritive
Sweeteners: Current Use and Health Perspectives. Circulation. 2012; CIR.0b013e31825c42ee
Commission, European. (2012).
Commission Regulation (EU) No 432/2012 of 16 May 2012. Official Journal of the
European Union. 1-40.
Lohner S, Toews I, Meerpohl
JJ. Health outcomes of non-nutritive
sweeteners: analysis of the research landscape. Nutr J 2017; 16: 55.
Magnuson BA, Roberts A, and
Nestmann ER. Critical review of the current literature on the safety of
sucralose. Food Chem Toxicol 2017 Aug;106 (Pt A):324-355. doi:
10.1016/j.fct.2017.05.047
Nichol AD, Maxwell JH & Ruopeng
A. (2018). Glycemic impact of non-nutritive sweeteners: a systematic review and
meta-analysis of randomized controlled trials. Eur J of Clin Nutr 2018; 72. 10.1038/s41430-018-0170-6.
Pan American Health
Organization (PAHO) (2016) Pan American Health Organization Nutrient Profile
Model. Washington, D.C.
Peters JC, Wyatt HR, Foster
GD, Pan Z, Wojtanowski AC, Vander Veur SS et al. The effects of water and
non-nutritive sweetened beverages on weight loss during a 12-week weight loss
treatment program. Obesity 2014; 22:
1415–1421.
Rogers PJ, Hogenkamp PS, de
Graaf C, Higgs S, Lluch A, Ness AR, Penfold C, Perry R, Putz P, Yeomans MR, et
al. 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)
2016; 40:381–94.
Serra-Majem L, Raposo A, Aranceta-Bartrina
J, Varela-Moreiras G, Logue C, Laviada H, Socolovsky S, Pérez-Rodrigo C, Aldrete-Velasco
J, Meneses Sierra E, et al. Ibero–American Consensus on Low- and No-Calorie
Sweeteners: Safety, Nutritional Aspects and Benefits in Food and Beverages. Nutrients 2018;10: 81
Tate DF, Turner-McGrievy G,
Lyons E, Stevens J, Erickson K, Polzien K et al. Replacing caloric beverages
with water or diet beverages for weight loss in adults: main results of the
Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial. Am J Clin Nutr 2012; 95: 555-563
Toews I, Lohner S, Küllenberg
de Gaudry D, et al. Association between intake of non-sugar sweeteners and
health outcomes: systematic review and meta-analyses of randomised and
non-randomised controlled trials and observational studies. BMJ. 2019 Jan 2; 364:k4718. doi:
10.1136/bmj.k4718.
Ultra-processed food and
drink products in Latin America: Trends, impact on obesity, policy
implications. Washington D.C.: Pan American Health Organization, 2015
O Modelo de Perfil Nutricional da Organização Pan-Americana da Saúde (OPAS) foi publicado em 2016 e propôs novos critérios para definir níveis “excessivos” de açúcar, sal e gordura em alimentos e bebidas processados. O propósito do modelo é fornecer uma ferramenta que pode ser utilizada na concepção e implementação de políticas relacionadas à prevenção e controle da obesidade/sobrepeso, incluindo restrições na comercialização de alimentos e bebidas não saudáveis para crianças; regulamentação do ambiente alimentar nas escolas (programas alimentares e alimentos e bebidas vendidos nas escolas); uso de advertências na parte frontal das embalagens; definição de políticas fiscais para limitar o consumo de alimentos não saudáveis e a identificação de alimentos fornecidos a grupos vulneráveis por programas sociais.
No que se refere ao açúcar, a OPAS afirma que “a melhor evidência científica disponível” foi revisada com o intuito de classificar alimentos e bebidas processados e ultraprocessados como contendo quantidades “excessivas” de açúcar se a quantidade de açúcar adicionada for igual ou acima de 10% do total de calorias. Além disso, o modelo especifica que os produtos cujos ingredientes incluem adoçantes artificiais ou não calóricos ou calóricos naturais devem ser definidos como “contendo outros adoçantes”, os quais devem ser limitados ou evitados.
A recomendação de limitar ou evitar adoçantes não nutritivos (non-nutritive sweeteners, NNS na sigla em inglês) como parte das recomendações de redução de açúcar da OMS/OPAS é problemática, posto que desconsidera os benefícios e a segurança já estabelecidos destes ingredientes e desestimula o uso de produtos que podem ser uma ferramenta importante na gestão do peso e no tratamento de determinadas doenças.
NNSs e a gestão do peso
La función de los edulcorantes de bajas calorías en la prevención y el manejo del sobrepeso y la obesidad
O Modelo de Perfil Nutricional da OPAS cita literatura que relata um aumento proporcional das vendas de bebidas adoçadas com açúcar e do índice de massa corporal (IMC) médio da população em geral na América Latina. Esta alegação, além de destacar apenas um componente da dieta total, não aborda o vasto corpo de evidências que sugere o papel dos NNSs na redução da ingestão de energia e do peso corporal. Após minuciosa análise e revisão das evidências disponíveis, o Consenso Íbero-Americano de 2018 concluiu que o uso de NNSs em programas de redução de peso envolvendo a substituição de adoçantes calóricos por NNSs no contexto de planos de dieta estruturados pode favorecer uma redução de peso sustentável.
Ademais, uma revisão sistemática e metanálise de ensaios clínicos randomizados em 2019 não encontraram diferenças significativas na mudança de peso corporal entre adultos que receberam NNSs e os que receberam açúcares diferentes ou placebos. Este resultado sugere que existem outros elementos da dieta ou fatores de estilo de vida que podem atribuir o aumento de peso. Além disso, estudos também demonstraram que o efeito do consumo de bebidas adoçadas com NNSs é semelhante ao efeito do consumo de água na perda de peso. A sugestão de que produtos que contêm NNSs e produtos adoçados com açúcar têm o mesmo impacto sobre o IMC não é respaldada pela totalidade das evidências científicas disponíveis e no final priva o consumidor de uma ferramenta útil e com respaldo científico para auxiliar na gestão do peso.
NNSs e a gestão do diabetes
Adoçantes com baixo teor e sem calorias, glicemia e diabetes: o que diz a ciência?
Quando substituídos pelo açúcar, os NNSs, além de terem o potencial de auxiliar a atingir e manter um peso saudável, podem também ser utilizados no controle dos níveis de glicose sanguínea por pessoas diabéticas. Uma revisão da pesquisa corrente sobre a sucralose em 2017 confirmou as constatações de revisões anteriores e relatou que, dado que a sucralose não é digerida ou metabolizada como energia, esta não fornece calorias e não afeta os níveis de glicose sanguínea. Portanto, alimentos e bebidas que contêm sucralose são adequados para diabéticos ou pessoas que desejam reduzir a ingestão de calorias ou carboidratos.
Do ponto de vista internacional, após uma revisão minuciosa da literatura científica disponível, o Painel de Produtos Dietéticos, Nutrição e Alergias da Autoridade Alimentar Europeia para a Segurança dos Alimentos (EFSA) concluiu que a substituição de alimentos com teor de açúcar por NNSs induz uma elevação menor da glicose sanguínea após o consumo. O Consenso Íbero-Americano de 2018 concluiu que o uso de NNSs em programas de gestão do diabetes pode contribuir para um melhor controle glicêmico dos pacientes. Por fim, a Comissão Europeia baseou sua autorização de uma alegação de saúde acerca de NNSs e glicose pós-prandial nesta conclusão.
A segurança dos NNSs
Organizações científicas internacionais e agências reguladoras, incluindo o Comitê Conjunto da FAO/OMS de Peritos em Aditivos Alimentares (JECFA), a Administração de Alimentos e Medicamentos dos EUA (FDA) e a Autoridade Europeia de Segurança Alimentar (EFSA) examinaram os NNSs extensivamente e reconheceram sua segurança. Uma revisão de escopo de 2017 acerca da segurança e associação de NNSs e determinados efeitos na saúde não encontrou evidências conclusivas do efeito prejudicial do uso de NNSs.
Segurança e Benefícios de Adoçantes com Baixo Teor ou sem Calorias
A posição da OMS/OPAS para limitar ou evitar NNSs ou adoçantes não nutritivos como parte de suas recomendações para a redução de açúcar implica que estes adoçantes contribuem para a obesidade e o diabetes quando, de fato, os efeitos benéficos decorrem em grande parte da substituição do açúcar na dieta. Como resultado, os NNSs deveriam ser reconhecidos como uma ferramenta na gestão do peso e do diabetes, e não como um obstáculo. Recomendar a redução de ingredientes com evidências substanciais que respaldam seus benefícios de segurança e saúde pode, na realidade, resultar em consequências inesperadas, tais como confusão no consumidor e redução da disponibilidade de produtos importantes no controle de doenças comuns relacionadas à dieta. Como as recomendações atuais e a legislação nacional subsequente podem resultar muito restritivas para alguns consumidores, eles talvez decidam desconsiderar completamente as diretrizes e continuar seus hábitos de consumo. Nós encorajamos a OMS e a OPAS a revisarem minuciosamente a literatura científica acerca dos NNSs, a reconsiderarem suas recomendações e, por fim, promover a incorporação destes ingredientes que podem ser utilizados para auxiliar a reduzir a ingestão calórica e controlar o peso corporal e níveis de glicose sanguínea.
References:
Gardner C, Wylie-Rosett J,
Gidding SS, Steffen LM, Johnson RK, Reader D and Lichtenstein AH. Nonnutritive
Sweeteners: Current Use and Health Perspectives. Circulation. 2012; CIR.0b013e31825c42ee
Commission, European. (2012).
Commission Regulation (EU) No 432/2012 of 16 May 2012. Official Journal of the
European Union. 1-40.
Lohner S, Toews I, Meerpohl
JJ. Health outcomes of non-nutritive
sweeteners: analysis of the research landscape. Nutr J 2017; 16: 55.
Magnuson BA, Roberts A, and
Nestmann ER. Critical review of the current literature on the safety of
sucralose. Food Chem Toxicol 2017 Aug;106 (Pt A):324-355. doi:
10.1016/j.fct.2017.05.047
Nichol AD, Maxwell JH & Ruopeng
A. (2018). Glycemic impact of non-nutritive sweeteners: a systematic review and
meta-analysis of randomized controlled trials. Eur J of Clin Nutr 2018; 72. 10.1038/s41430-018-0170-6.
Pan American Health
Organization (PAHO) (2016) Pan American Health Organization Nutrient Profile
Model. Washington, D.C.
Peters JC, Wyatt HR, Foster
GD, Pan Z, Wojtanowski AC, Vander Veur SS et al. The effects of water and
non-nutritive sweetened beverages on weight loss during a 12-week weight loss
treatment program. Obesity 2014; 22:
1415–1421.
Rogers PJ, Hogenkamp PS, de
Graaf C, Higgs S, Lluch A, Ness AR, Penfold C, Perry R, Putz P, Yeomans MR, et
al. 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)
2016; 40:381–94.
Serra-Majem L, Raposo A, Aranceta-Bartrina
J, Varela-Moreiras G, Logue C, Laviada H, Socolovsky S, Pérez-Rodrigo C, Aldrete-Velasco
J, Meneses Sierra E, et al. Ibero–American Consensus on Low- and No-Calorie
Sweeteners: Safety, Nutritional Aspects and Benefits in Food and Beverages. Nutrients 2018;10: 81
Tate DF, Turner-McGrievy G,
Lyons E, Stevens J, Erickson K, Polzien K et al. Replacing caloric beverages
with water or diet beverages for weight loss in adults: main results of the
Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial. Am J Clin Nutr 2012; 95: 555-563
Toews I, Lohner S, Küllenberg
de Gaudry D, et al. Association between intake of non-sugar sweeteners and
health outcomes: systematic review and meta-analyses of randomised and
non-randomised controlled trials and observational studies. BMJ. 2019 Jan 2; 364:k4718. doi:
10.1136/bmj.k4718.
Ultra-processed food and
drink products in Latin America: Trends, impact on obesity, policy
implications. Washington D.C.: Pan American Health Organization, 2015
Do you have questions about low-calorie sweeteners? Want to learn more about maintaining a healthy lifestyle? You asked and we listened. Our resident Registered Dietitians answered the most popular questions about low-calorie sweeteners.
Jill Weisenberger, MS, RDN, CDE, FAND has worked as both a nutrition counselor and a diabetes educator in the hospital and research settings, and now in private practice in Newport News, VA. Jill is the author of Diabetes Weight Loss – Week by Week and two upcoming books, The Overworked Person’s Guide to Better Nutrition and 21 Things You Need to Know about Diabetes and Your Heart. She is a member of the Academy of Nutrition and Dietetics, the American Association of Diabetes Educators and the American Diabetes Association. Jill is a paid contributor to Sucralose.org. Follow Jill on Twitter @NutritionJill and find more at www.JillWeisenberger.com
Jessica Levinson, MS, RDN, CDN is a registered dietitian nutritionist and culinary nutrition expert. She has extensive experience as a recipe developer, writer, editor, and speaker. She is the co-author of We Can Cook: Introduce Your Child to the Joy of Cooking with 75 Simple Recipes and Activities (Barron’s, 2011), past columnist for the Culinary Corner column in Today’s Dietitian Magazine, and maintains a popular blog at 
