31 One barrier to better understanding the health effects of NNS is the difficulty inherent in measuring the amount of NNS consumed at the individual and population levels. 29, 30 The long-term safety or potential benefit of the growing prevalence of NNS use in children has not been systematically reviewed. However, the consumption of NNSs among children has increased. Manufactured products containing NNSs are not required to specify the content of NNS in a product. 28Įstimating total content of NNS in manufactured products has been challenging. In fact, 53% of parents stated they seek items labeled “reduced sugar,” but most did not recognize that the sweet taste was instead being provided by an NNS, 27 and only one-quarter of youth were able to distinguish the taste of NNS from sucrose. For instance, in a single-site study, only 16% of parents responded in the affirmative to the statement, “Nonnutritive sweeteners (ie, Splenda, Sweet‘N Low, and Equal) are safe for my child to use.” 27 Knowledge of how to identify products containing NNSs remains poor because only 23% of parents were able to correctly identify food products that contain NNSs. Despite FDA assurances, published data reveal that parents continue to have questions about the safety of NNSs. 3, 26 Also lacking is published evidence of parental confidence in the safety of NNSs. 20– 25 Despite this, studies conclusively demonstrating the long-term safety and efficacy of NNS agents are lacking. 10, 11Ī number of health organizations have supported the use of NNSs but within an acceptable dietary intake (ADI) level. Other agents such as stevia and luo han guo have been approved by the FDA under the “generally recognized as safe” (GRAS) distinction, a distinction that has been determined to be insufficient for ensuring the safety of food additives without specific protections against conflict of interest and without mechanisms to ensure ongoing acquisition of safety data. 3 Most NNSs, including saccharin, aspartame, acesulfame potassium, sucralose, and neotame, have been approved by the US Food and Drug Administration (FDA) for use as food additives and, as such, have undergone premarket review and approval ( ). 9 Questions regarding the long-term safety of these agents also remain. To date, however, there has been no consistent or conclusive evidence that NNS use lends to a reduction in total caloric intake and thereby to weight loss in humans 3– 8 or in animal physiology models. It has been proposed that the lack of caloric content of the sweeteners may contribute to weight loss. 1, 2 NNSs increase the palatability of food and beverages without increasing caloric content. Nonnutritive sweeteners (NNSs), also known as noncaloric artificial sweeteners or high-intensity sweeteners, were first introduced into the food supply in the late 1800s (eg, saccharin) and were first approved for use as a food additive under the Food Additives Amendment of the Federal Food, Drug, and Cosmetic Act of 1958.
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