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Nutrients. 2018 Jun 25;10(7). pii: E818. doi: 10.3390/nu10070818.

Ibero⁻American Consensus on Low- and No-Calorie Sweeteners: Safety, Nutritional Aspects and Benefits in Food and Beverages.

Author information

1
Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria 35016, Spain. lluis.serra@ulpgc.es.
2
Spanish Academy of Nutrition and Food Sciences (AEN), Barcelona 08029, Spain. lluis.serra@ulpgc.es.
3
Nutrition Research Foundation (FIN), University of Barcelona Science Park, Barcelona 08028, Spain. lluis.serra@ulpgc.es.
4
CIBER Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid 28029, Spain. lluis.serra@ulpgc.es.
5
Research Center for Biosciences and Health Technologies-CBIOS, Universidade Lusófona de Humanidades e Tecnologias, Lisboa 1749-024, Portugal. ajasr@hotmail.com.
6
Spanish Academy of Nutrition and Food Sciences (AEN), Barcelona 08029, Spain. jaranceta@unav.es.
7
CIBER Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid 28029, Spain. jaranceta@unav.es.
8
Spanish Society of Community Nutrition (SENC), Barcelona 08029, Spain. jaranceta@unav.es.
9
Department of Physiology, University of the Basque Country (UPV/EHU), Leioa (Bizkaia) 48940, Spain. jaranceta@unav.es.
10
Spanish Academy of Nutrition and Food Sciences (AEN), Barcelona 08029, Spain. gvarela@ceu.es.
11
Spanish Nutrition Foundation (FEN), Madrid 28010, Spain. gvarela@ceu.es.
12
Department of Pharmaceutical & Health Sciences, School of Pharmacy, CEU San Pablo University, Boadilla del Monte (Madrid) 28668, Spain. gvarela@ceu.es.
13
Nutritional Innovation Centre for Food & Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraines BT52 1SA, UK. c.logue@ulster.ac.uk.
14
Research Department of Metabolism and Nutrition, Medical School, Marist University of Merida, Mérida Yucatan 97300, Mexico. hlaviada@marista.edu.mx.
15
Argentine Association of Food Technologists, Buenos Aires 1088, Argentina. tecnologos@alimentos.org.ar.
16
Spanish Academy of Nutrition and Food Sciences (AEN), Barcelona 08029, Spain. carmen.perezr@ehu.eus.
17
Spanish Society of Community Nutrition (SENC), Barcelona 08029, Spain. carmen.perezr@ehu.eus.
18
Department of Physiology, University of the Basque Country (UPV/EHU), Leioa (Bizkaia) 48940, Spain. carmen.perezr@ehu.eus.
19
Mexican College of Internal Medicine, Mexico City 03910, Mexico. doctoraldretej@hotmail.com.
20
Mexican College of Internal Medicine, Mexico City 03910, Mexico. dr-emeneses@hotmail.com.
21
Hospital General de Especialidades del ISSSTE, Saltillo, Coahuila 25020, Mexico. dr-emeneses@hotmail.com.
22
Logre International Food Science Consulting, Mexico City 14650, Mexico. rebecalg@prodigy.net.mx.
23
Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria 35016, Spain. adriana.ortiz@ulpgc.es.
24
CIBER Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid 28029, Spain. adriana.ortiz@ulpgc.es.
25
Clinical Nutrition Department, La Paz University Hospital, Madrid 28046, Spain. cgcandela@salud.madrid.org.
26
Hospital La Paz Health Research Institute - IdiPAZ, Autonomous University of Madrid, Madrid 28046, Spain. cgcandela@salud.madrid.org.
27
Atelier de Nutrição, Lisboa 1250, Portugal. rodrigo@saber-comer.com.
28
Nuclear Cardiology Department, Instituto Nacional de Cardiología "Ignacio Chávez, Tlalpan, Ciudad de Mexico 14080, Mexico. alexandersonerick@gmail.com.
29
Phisiology Department, National Autonomous University of Mexico, Coyoacán, Ciudad de México 04510, Mexico. alexandersonerick@gmail.com.
30
Mexican Society of Cardiology, México City 14080, Mexico. alexandersonerick@gmail.com.
31
Mexican Society of Cardiology, México City 14080, Mexico. rolandojoel@gmail.com.
32
Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria 35016, Spain. aalvfal@gobiernodecanarias.org.
33
Dr. Negrin University Hospital of Gran Canaria, Las Palmas de Gran Canaria 35010, Spain. aalvfal@gobiernodecanarias.org.
34
Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Complutense University of Madrid, Madrid 28040, Spain. anadon@vet.ucm.es.
35
Nutritional Epidemiology Unit, University of Paris 13, Bobigny 93017, France. f.bellisle@uren.smbh.univ-paris13.fr.
36
Mexican College of Nutrition - Yucatan, Mérida 97133, Mexico. cincanutricionintegral@hotmail.com.
37
Regional Center for Sports Medicine of the Junta de Castilla y León, Valladolid 47011, Spain. raquelblasco92@hotmail.com.
38
Facultad Mexicana de Medicina, La Salle University, Mexico 14000, D. F., Mexico. ndt@prodigy.net.mx.
39
Mexican Transplant Institute, Cuernavaca, Morelos 62448, Mexico. ndt@prodigy.net.mx.
40
Serviço de Endocrinologia, Hospital de Santa Maria⁻CHLN, Lisboa 1649-035, Portugal. jose.camolas@gmail.com.
41
Argentine Quality Institute-Instituto Argentino para la Calidad (IAPC), Ciudad Autónoma de Buenos Aires 1406, Argentina. fgcardini@gmail.com.
42
Mountain Research Centre (CIMO), Polytechnic Institute of Bragança, Campus de Santa Apolónia, Bragança 5300-253, Portugal. mcarocho@ipb.pt.
43
ASAE-Autoridade de Segurança Alimentar e Económica, CBIOS/ECTS-The Biosciences Research Center and NICiTeS/ERISA⁻Núcleo de Investigação em Ciências e Tecnologias da Saúde, Grupo Lusófona, Lisboa 1749-024, Portugal. p1658@ulusofona.pt.
44
Center for Public Health Nutrition, University of Washington-Center for Obesity Research, Seattle, WA 98195, USA. adamdrew@uw.edu.
45
Chilean College of Nutritionists, Universidad San Sebastian, Santiago 7500000, Chile. sduran74@gmail.com.
46
Nutrition and Food Technology Institute, University of Chile, Santiago 7830490, Chile. vfaundes@inta.uchile.cl.
47
Peruvian Nutrition Society-Sociedad Peruana de Nutrición (SOPENUT), Miraflores 15074, Peru. presidentasopenut@gmail.com.
48
Andalusian Society of Endocrinology, Diabetes and Nutrition, Department of Endocrinology and Nutrition, Virgen del Rocio Hospital, Sevilla 41013, Spain. garcialunapp@yahoo.es.
49
Mexican Nutrition and Endocrinology Society, Mexico City 04330, Mexico. endocrinogarnica@hotmail.com.
50
CIBER Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid 28029, Spain. marcela.gonzalez.gross@upm.es.
51
ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science-INEF, Universidad Politécnica de Madrid, Madrid 28040, Spain. marcela.gonzalez.gross@upm.es.
52
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano 20133, Italy. carlo.lavecchia@unimi.it.
53
CIBER Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid 28029, Spain. mariarosaura.leis@usc.es.
54
School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela 15782, Spain. mariarosaura.leis@usc.es.
55
Gastroenterology, Hepatology and Paediatric Nutrition Unit of the Santiago Clinical University Hospital, Santiago de Compostela 15706, Spain. mariarosaura.leis@usc.es.
56
Department of Nutrition and Food Science, School of Pharmacy, Complutense University of Madrid (UCM), Madrid 28040, Spain. asobaler@ucm.es.
57
Mexican Nutrition and Endocrinology Society, Mexico City 04330, Mexico. agustinmadero@hotmail.com.
58
Spanish Federation of Nutrition, Food and Dietetics Societies, Madrid 28918, Spain. amarcos@ictan.csic.es.
59
Institute of Food Science, Technology and Nutrition (ICTAN); Spanish National Research Council (CSIC), Madrid 28040, Spain. amarcos@ictan.csic.es.
60
Mexican Nephrological Research Institute, Mexico City 14080, Mexico. mariscalmd@yahoo.com.mx.
61
Intertek, HERS, Cody Technology Park, Farnborough GU14 0LX, UK. danika.martyn@intertek.com.
62
Council for Agricultural Research and Economics, Research Centre for Food and Nutrition, Rome 00178, Italy. lorenza.mistura@crea.gov.it.
63
Department of Food Science and Technology, University of Cordoba, Cordoba 14071, Spain. rafael.moreno@uco.es.
64
Pediatric Department, Cínica Universidad de Navarra, Madrid 28027, Spain. jmorenov@unav.es.
65
Mexican Nephrological Research Institute, Mexico City 14080, Mexico. janc1999@gmail.com.
66
Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan-Ciudad de México 14080, Mexico. janc1999@gmail.com.
67
University of Porto, Faculty of Pharmacy, REQUIMTE/LAQV, Porto 4050-313, Portugal. beatoliv@ff.up.pt.
68
Department of Medicine, Endocrinology and Nutrition, Sport Medicine Center, AEPSAD, High Sports Council, Madrid 28040, Spain. nieves.palacios@aepsad.gob.es.
69
Nutriguía Uruguay, Montevideo 11000, Uruguay. nutriguia@nutriguia.com.uy.
70
Nutrition Research Foundation (FIN), University of Barcelona Science Park, Barcelona 08028, Spain. fin@fin.pcb.ub.es.
71
CIBER Fisiopatología de la Obesidad y Nutrición (CIBER OBN), Instituto de Salud Carlos III, Madrid 28029, Spain. fin@fin.pcb.ub.es.
72
Departamento de Educación Médica, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan-Ciudad de México 14080, Mexico. rinconpedrero@gmail.com.
73
Endocrinology and Nutrition Department, Fundación Jiménez Díaz Hospital, IDC Salud, Madrid 28040, Spain. priobo@telefonica.net.
74
Facultad de Medicina, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, Madrid 28049, Spain. priobo@telefonica.net.
75
Servicio de Gastroenterología, Hepatología y Nutrición del Instituto Nacional de Salud del Niño, Lima 15083, Peru. juan.riveramedina@gmail.com.
76
Departamento de Pediatría, Universidad Nacional Mayor de San Marcos, Lima 15083, Peru. juan.riveramedina@gmail.com.
77
Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria 35016, Spain. catarinaa711@gmail.com.
78
Faculty of Medicine, Autonomous University of the State of Mexico, Toluca 50180, Mexico. rvaldesr@uaemex.mx.
79
Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa 1649-016, Portugal. elsa.vasco@insa.min-saude.pt.
80
Nutrition and Public Health Working Group, Argentine Nutrition Society, La Plata, Buenos Aires 1900, Argentina. sandrawac@hotmail.com.
81
Mexican Society of Paediatrics, Mexico City 06760, Mexico. guillewakida@yahoo.com.mx.
82
Scientific and Educational Committee, Spanish Society of Parenteral and Enteral Nutrition (SENPE), Barcelona 08017, Spain. carminaw@telefonica.net.
83
Instituto Nacional de Pediatria, Sociedad Mexicana de Pediatria, Insurgentes Cuicuilco, Ciudad de México 04530, Mexico. xochiludidr@hotmail.com.
84
Mexican Diabetes Federation, Mexico. Facultad de Medicina y Hospital Universitario de la Universidad Autónoma de Nuevo León, Monterrey 64630, Mexico. sergiozungua@gmail.com.
85
International Sweeteners Association-ISA, Brussels 1040, Belgium. scientificdirector@sweeteners.org.
86
Pediatric Hospital of Coimbra-Centro Hospitalar e Universitário de Coimbra, Coimbra 3000-075, Portugal. scvelho@hotmail.com.

Abstract

International scientific experts in food, nutrition, dietetics, endocrinology, physical activity, paediatrics, nursing, toxicology and public health met in Lisbon on 2⁻4 July 2017 to develop a Consensus on the use of low- and no-calorie sweeteners (LNCS) as substitutes for sugars and other caloric sweeteners. LNCS are food additives that are broadly used as sugar substitutes to sweeten foods and beverages with the addition of fewer or no calories. They are also used in medicines, health-care products, such as toothpaste, and food supplements. The goal of this Consensus was to provide a useful, evidence-based, point of reference to assist in efforts to reduce free sugars consumption in line with current international public health recommendations. Participating experts in the Lisbon Consensus analysed and evaluated the evidence in relation to the role of LNCS in food safety, their regulation and the nutritional and dietary aspects of their use in foods and beverages. The conclusions of this Consensus were: (1) LNCS are some of the most extensively evaluated dietary constituents, and their safety has been reviewed and confirmed by regulatory bodies globally including the World Health Organisation, the US Food and Drug Administration and the European Food Safety Authority; (2) Consumer education, which is based on the most robust scientific evidence and regulatory processes, on the use of products containing LNCS should be strengthened in a comprehensive and objective way; (3) The use of LNCS in weight reduction programmes that involve replacing caloric sweeteners with LNCS in the context of structured diet plans may favour sustainable weight reduction. Furthermore, their use in diabetes management programmes may contribute to a better glycaemic control in patients, albeit with modest results. LNCS also provide dental health benefits when used in place of free sugars; (4) It is proposed that foods and beverages with LNCS could be included in dietary guidelines as alternative options to products sweetened with free sugars; (5) Continued education of health professionals is required, since they are a key source of information on issues related to food and health for both the general population and patients. With this in mind, the publication of position statements and consensus documents in the academic literature are extremely desirable.

KEYWORDS:

Ibero-American; added sugars; cancer; diabetes; low-calorie sweeteners; non-nutritive sweeteners; obesity; regulation; safety; sweeteners

PMID:
29941818
PMCID:
PMC6073242
DOI:
10.3390/nu10070818
[Indexed for MEDLINE]
Free PMC Article

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