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      Trends in the Use of Low and No-Calorie Sweeteners in Non-Alcoholic Beverages in Slovenia

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          Abstract

          Excessive sugar intake and the associated increased obesity risk indicate that food reformulation is needed. Non-alcoholic beverages are often high in free sugars, making reformulation with low and no-calorie sweeteners (LNCS) a common choice. Our knowledge of the use of LNCS in the European food supply is, however, very limited. This study aimed to evaluate the trends in the use of LNCS in different non-alcoholic beverages in the Slovenian food supply over the course of two years. We assessed which LNCS are most used and how the use of LNCS affects energy and sugar content. We analyzed labeling information of non-alcoholic beverages in selected grocery stores, covering the majority of the Slovenian food supply. Selected grocery stores were located in the capital city (Ljubljana). LNCS were present in 13.2% and 15.5% of non-alcoholic beverages in the years 2017 and 2019, respectively. The use of LNCS has significantly increased only in energy drinks ( p < 0.01). The most used LNCS in 2017 were acesulfame K, aspartame, and cyclamates. In 2019 the use of sucralose increased significantly ( p < 0.01) to become the second most used LNCS. Energy and sugar content varied between subcategories, which depended on the presence of added sugar and LNCS. Comparison between the energy value and the presence of the LNCS showed an almost 50% lower energy content of beverages containing both added sugar and LNCS (E 2017 = 92.8 kJ; E 2019 = 96.2 kJ per 100 mL), compared with beverages with only added sugar (E 2017 = 161.8 kJ; E 2019 = 159.0 kJ per 100 mL). In beverages sweetened only with LNCS, the difference was even more noticeable (E 2017 = 22.3 kJ; E 2019 = 14.3 kJ per 100 mL). Results show that the use of LNCS can help producers reduce the energy value of non-alcoholic beverages. Still, compared to other countries, the offer of such products in the Slovenian food supply is relatively low. However, due to possible public health risks of excessive use of LNCS, producers should be further encouraged for reformulation and production of less sweet products without LNCS, enabling consumers to adapt to less sweet taste of beverages. Further monitoring of LNCS in the food supply is therefore recommended, preferably also with consideration of sales data.

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          Sweetening of the global diet, particularly beverages: patterns, trends, and policy responses.

          Evidence suggests that excessive intake of added sugars has adverse effects on cardiometabolic health, which is consistent with many reviews and consensus reports from WHO and other unbiased sources. 74% of products in the US food supply contain caloric or low-calorie sweeteners, or both. Of all packaged foods and beverages purchased by a nationally representative sample of US households in 2013, 68% (by proportion of calories) contain caloric sweeteners and 2% contain low-calorie sweeteners. We believe that in the absence of intervention, the rest of the world will move towards this pervasiveness of added sugars in the food supply. Our analysis of trends in sales of sugar-sweetened beverages around the world, in terms of calories sold per person per day and volume sold per person per day, shows that the four regions with the highest consumption are North America, Latin America, Australasia, and western Europe. The fastest absolute growth in sales of sugar-sweetened beverages by country in 2009-14 was seen in Chile. We believe that action is needed to tackle the high levels and continuing growth in sales of such beverages worldwide. Many governments have initiated actions to reduce consumption of sugar-sweetened beverages in the past few years, including taxation (eg, in Mexico); reduction of their availability in schools; restrictions on marketing of sugary foods to children; public awareness campaigns; and positive and negative front-of-pack labelling. In our opinion, evidence of the effectiveness of these actions shows that they are moving in the right direction, but governments should view them as a learning process and improve their design over time. A key challenge for policy makers and researchers is the absence of a consensus on the relation of beverages containing low-calorie sweeteners and fruit juices with cardiometabolic outcomes, since decisions about whether these are healthy substitutes for sugar-sweetened beverages are an integral part of policy design.
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            Prevalence and trends in obesity among US adults, 1999-2000.

            The prevalence of obesity and overweight increased in the United States between 1978 and 1991. More recent reports have suggested continued increases but are based on self-reported data. To examine trends and prevalences of overweight (body mass index [BMI] > or = 25) and obesity (BMI > or = 30), using measured height and weight data. Survey of 4115 adult men and women conducted in 1999 and 2000 as part of the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the US population. Age-adjusted prevalence of overweight, obesity, and extreme obesity compared with prior surveys, and sex-, age-, and race/ethnicity-specific estimates. The age-adjusted prevalence of obesity was 30.5% in 1999-2000 compared with 22.9% in NHANES III (1988-1994; P or = 40) also increased significantly in the population, from 2.9% to 4.7% (P =.002). Although not all changes were statistically significant, increases occurred for both men and women in all age groups and for non-Hispanic whites, non-Hispanic blacks, and Mexican Americans. Racial/ethnic groups did not differ significantly in the prevalence of obesity or overweight for men. Among women, obesity and overweight prevalences were highest among non-Hispanic black women. More than half of non-Hispanic black women aged 40 years or older were obese and more than 80% were overweight. The increases in the prevalences of obesity and overweight previously observed continued in 1999-2000. The potential health benefits from reduction in overweight and obesity are of considerable public health importance.
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              Effects of Sweeteners on the Gut Microbiota: A Review of Experimental Studies and Clinical Trials

              ABSTRACT The consumption of sugar-free foods is growing because of their low-calorie content and the health concerns about products with high sugar content. Sweeteners that are frequently several hundred thousand times sweeter than sucrose are being consumed as sugar substitutes. Although nonnutritive sweeteners (NNSs) are considered safe and well tolerated, their effects on glucose intolerance, the activation of sweet taste receptors, and alterations to the composition of the intestinal microbiota are controversial. This review critically discusses the evidence supporting the effects of NNSs, both synthetic sweeteners (acesulfame K, aspartame, cyclamate, saccharin, neotame, advantame, and sucralose) and natural sweeteners (NSs; thaumatin, steviol glucosides, monellin, neohesperidin dihydrochalcone, and glycyrrhizin) and nutritive sweeteners (polyols or sugar alcohols) on the composition of microbiota in the human gut. So far, only saccharin and sucralose (NNSs) and stevia (NS) change the composition of the gut microbiota. By definition, a prebiotic is a nondigestible food ingredient, but some polyols can be absorbed, at least partially, in the small intestine by passive diffusion: however, a number of them, such as isomaltose, maltitol, lactitol, and xylitol, can reach the large bowel and increase the numbers of bifidobacteria in humans. Further research on the effects of sweeteners on the composition of the human gut microbiome is necessary.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Foods
                Foods
                foods
                Foods
                MDPI
                2304-8158
                10 February 2021
                February 2021
                : 10
                : 2
                : 387
                Affiliations
                [1 ]Nutrition Institute, Tržaška Cesta 40, SI-1000 Ljubljana, Slovenia; edvina.hafner@ 123456nutris.org (E.H.); masa.hribar@ 123456nutris.org (M.H.); hristo.hristov@ 123456nutris.org (H.H.); anita.kusar@ 123456nutris.org (A.K.); katja.zmitek@ 123456vist.si (K.Ž.)
                [2 ]VIST—Higher School of Applied Sciences, Gerbičeva Cesta 51A, SI-1000 Ljubljana, Slovenia
                [3 ]EuroFIR AISBL, 1050 Brussels, Belgium; mr@ 123456eurofir.org
                [4 ]Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia
                Author notes
                [* ]Correspondence: igor.pravst@ 123456nutris.org ; Tel.: +38-659-068-871
                Author information
                https://orcid.org/0000-0002-7357-9426
                https://orcid.org/0000-0002-1756-4828
                https://orcid.org/0000-0002-5088-9747
                https://orcid.org/0000-0001-9168-9728
                https://orcid.org/0000-0001-8634-1778
                Article
                foods-10-00387
                10.3390/foods10020387
                7916662
                33578908
                a065f3e9-a866-4bf8-bcf9-27afbaba0d8c
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 30 December 2020
                : 08 February 2021
                Categories
                Article

                low- and no-calorie sweeteners,non-alcoholic beverages,added sugar,food supply,food labelling

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