ISA Expresses Disappointment in ANSES Findings on Low Calorie Sweeteners

The International Sweeteners Association (ISA) has responded to the conclusions of the ANSES scientific panel (French Agency for Food, Environment and Occupational Health & Safety) on the evaluation of the ‘nutritional risks and benefits of low calorie sweeteners’ with disappointment.

The ANSES report concluded that after assessing the nutritional value of intense sweeteners such as aspartame, stevia extract, sucralose and acesulfame K, ‘the consumption of these substances had no beneficial effects on weight control, blood glucose levels in diabetics or on the incidence of type 2 diabetes. It also showed that there were no links between their consumption and habituation to sweet tastes, or with a heightened risk of diabetes or cancer.’

Therefore, it states, there is no convincing reason to justify encouraging the replacement of sugar with these calorie-free sweeteners in the framework of public health policy.

The ISA said that it is disappointed that the conclusions fail to support the wealth of sound science available highlighting the role and benefits of low calorie sweeteners as a weight management tool.

At its recent conference, specialist Prof. Drewnowski joined a team of leading specialists to issue a Consensus statement on the efficacy of low calorie sweeteners: “The consensus amongst experts in their fields is that, yes, low calorie sweeteners do work”, said Prof Drewnowski, adding: “all the toxicological and safety work done by international agencies has repeatedly attested to their safety and efficacy.”

The Consensus statement on the benefits of low calorie sweeteners, published in the December 2014 issue of Nutrition Bulletin – a peer-reviewed journal which provides news and scientific reviews – outlines the beneficial role that low calorie sweeteners can play in diet and lifestyle choices. Conclusions confirm positive results from recent scientific studies showing that these products do not increase appetite and have no discernible effect on satiety, and can, in fact, enhance weight loss under real-life conditions when used as part of a behavioural weight loss programme.

Dr Pierre Azam, a prominent French general practitioner and endocrinologist, President of Obobs, the French Obesity Observatory, and a member of the ISA scientific panel of experts, confirms that low calorie sweeteners provide useful alternative food options for patients: “low calorie sweeteners can be integrated in a global approach for weight and diabetes management, as they enable to avoid frustration and thereby allow better adherence to therapeutical treatment. I strongly believe that by providing sweetness, a source of pleasure, without the calories, low calorie sweeteners can be part of the solution for patients who want to control their weight or diabetes.”

The ANSES report recognises the safety of low calorie sweeteners and endorses EFSA's findings confirming that low calorie sweeteners "have no effect on carbohydrate metabolism or short or long term blood glucose" and "can not be fermented by oral bacteria", and thereby can "help maintain healthy teeth".

With particular reference to the benefits of consuming low calorie sweetened beverages and weight management, a study led by leading obesity research experts Prof John Peters and Prof James Hill, conducted on a sample of 303 people over a three-month period, provided some very insightful results. People who drank low calorie beverages lost 44 percent more weight – an average of 5.95kg over 12 weeks – than those in the water control group, only lost an average of 4.09kg over the same period. The group that drank low calorie beverages also reported feeling less hungry than the water control group.

Dr Hervé Nordmann, Chair of the ISA Scientific & Regulatory Committee, states: “Low calorie sweetened options are not what we would call ‘magic bullets’. However when used as part of a balanced diet, they can prove to be valuable alternative to sweet taste of sugar without the calories or impact on blood glucose levels”. He adds "Given the challenges to public health of the consequences of overweight, low calorie sweeteners have a role to play. The body of science which exists to support the benefits of low calorie sweeteners is already significant, and is growing all the time."

Intense sweeteners are obtained through chemical synthesis or derived from plants. These food additives are used by the agrofood industry for their sweetening power, tens to thousands of times higher than that of table sugar (sucrose).

In France, the most common intense sweeteners are aspartame, acesulfame K and sucralose. They are used to reduce consumption of sugar and its calories, and to aid in regulating blood glucose levels in diabetics.

The use and consumption of intense sweeteners has risen sharply over the last twenty years, probably due to concerns linked to the doubling of prevalence of overweight and obesity. While the potential risks of each intense sweetener are assessed before their authorisation, no general assessment of the overall nutritional risks and benefits of these products has been conducted on the European level up to now.

ANSES states that the use of intense sweeteners as a substitute for sugar in most cases engenders a short term reduction in caloric intake due to the low calorie levels of these substances and the lack of compensation. However, the available data cover insufficient time periods for guaranteeing that this effect is maintained in the long term. Moreover, studies of weight control in adults and children have reported conflicting associations. Certain observational studies show that intense sweetener use is paradoxically associated with weight gain, although the causality of this relationship has not been established.

The consumption of intense sweeteners was not shown to have any beneficial effects on prevention of type 2 diabetes; sais ANSES. Similarly, their regular consumption as a sugar substitute does not appear to have any beneficial effect on regulating blood glucose levels.

As a result of this expert assessment, the Agency considers that:

•    with regard to nutritional benefits, the available studies show no proof that the consumption of products containing intense sweeteners aid in weight control, or in regulating blood glucose levels in diabetics or the incidence of type 2 diabetes;

•    for the risks of developing cancer, type 2 diabetes, or premature births, the data available to date do not enable a link to be established between onset of these risks and the consumption of intense sweeteners. A few studies do however highlight the need to obtain further knowledge on the link between intense sweeteners and certain risks.

In its assessment, ANSES emphasised the lack of relevant data on the potential benefits of intense sweetener consumption in the context of their broad, long-standing use in nutrition.

It highlighted the need to conduct new research studies both on the nutritional benefits and risks of consumption of these products, especially: in children: studies on taste development, food preferences and the control of food intake; and in the general public: studies on weight control.

In addition, specific populations (pregnant women, children, diabetics, regular consumers) have not been sufficiently studied. Further study of the risks of intense sweetener consumption by these populations therefore appears necessary.

Lastly, in a nutritional policy context in which one of the main objectives is the reduction of sugar intake in the general public, ANSES considers that no meaningful data exist that justify encouraging the substitution of sugars by intense sweeteners in a public health framework. This objective of reduction of sugar intake levels must be reached through a reduction in sweet tasting foods in general at an early age. The Agency therefore recommends that artificially-sweetened and sugar-sweetened soft drinks not be consumed as a replacement for water.

by Kelly Worgan