A policy statement by the American Academy of Pediatrics posted online October 28, 2019 on Pediatrics entitled “The Use of Nonnutritive Sweeteners in Children” unnecessarily raises questions that have been consistently and repeatedly addressed by scientific and health authorities around the world. The new policy statement questions the safety and effectiveness of nonnutritive sweeteners – also called low and no calorie sweeteners (LNCS) – when consumed by children, going so far as to imply that LNCS contribute to weight gain, diabetes and other health ailments and recommends that the amount of sweetener be listed on product labels. “The Calorie Control Council takes issue with these claims and maintains its longstanding position that, when consumed as part of a healthy and balanced diet, the consumption of LNCS may serve as a tool for managing overall caloric and sugar intake,” said Robert Rankin, president of the Calorie Control Council.
LOW AND NO CALORIE SWEETENERS ARE PROVEN SAFE
No major scientific or regulatory agency prohibits the use of sweeteners in foods for children. The Joint FAO/WHO Expert Committee on Food Additives (JECFA) reviewed the safety of LNCS intake at the approved acceptable daily intake (ADI) levels for adults, children and infants, which far exceeds the amount an average person would consume daily. The European Food Safety Authority (EFSA), the U.S. Food and Drug Administration (FDA), the Food Safety Authority of Australia & New Zealand (FSANZ) have also determined them as safe for consumption by children.
“I’m troubled by the AAP statement calling for even more research on LNCS, which have already gone through years of rigorous testing and research and been established as safe by health authorities the world over. LNCS are a tool for managing both calorie intake and helping to reduce sugar intake. They are not a cure for obesity, and were never intended to solve obesity, but can be used by anyone of any age to help manage dietary intakes of added sugar. Moreover, judicious use of LNCS can help people feel less deprived as they reduce added sugar and thus help them reach dietary goals and improve compliance with a more balanced diet, ” said Keith-Thomas Ayoob, EdD, RD, FAND, Associate Clinical Professor Emeritus, Department of Pediatrics, Albert Einstein College of Medicine
“Low calorie sweeteners remain an important tool in reducing sugar consumption in children. While available data reinforces the safety of these products in children, future research should be embraced to further enhance our understanding. I am an advocate for product labeling of nonnutritive sweetener content, as transparency in what children are ingesting is important for parents. Current estimates show that intake is well below the ADI,” said Dr. Keri Peterson, Internal Medicine, medical advisor to the Calorie Control Council.
CLAIMS OF LNCS CAUSING OBESITY ARE UNFOUNDED
An international group of obesity experts issued a consensus statement that, “low calorie sweeteners do not increase appetite and have no discernible effect on satiety, help to reduce energy when used in place of higher energy ingredients, can enhance weight loss under real-life conditions when used as part of a behavioral weight loss program”.
LNCS HELPFUL FOR THOSE WITH DIABETES
In a scientific review from researchers at the USDA/ARS Children’s Nutrition Research Center and the Department of Pediatrics-Nutrition at the Baylor College of Medicine in Houston, research found LNCS play an important role in diabetes prevention and management, as a safe and easy way to reduce carbohydrate consumption for those with type 2 diabetes so they can better manage blood glucose levels and lose weight.
LNCS LEVELS CONSUMED AT TOO SMALL AMOUNTS TO NEGATIVELY IMPACT MICROBIOME
Early safety assessments of sucralose, saccharin and acesulfame K prior to FDA approval of their use suggest no adverse effect on gut health or function, as evidenced by regulatory approvals worldwide (JECFA, 1984; JECFA, 1991; JECFA, 2005). Both the chemical structures and in vivo metabolism of approved LNCS support that they have no effect on the gut microbiota, either as individual sweeteners or as a class.
When consumed as part of a healthy and balanced diet, the consumption of LNCS at any age may serve as a tool for managing overall caloric and sugar intake.