Low- and No- Calorie Sweeteners (LNCS): critical evaluation of their safety and health risks

Abstract The increase of the prevalence of type-2 diabetes as a consequence of overweight and obesity has stimulated public health authorities worldwide to develop strategies for its risk management and prevention. Among them, a reduction on the content of sugar in sugar-sweetened foods and beverages has been suggested, which led the food industry to replace partially sucrose with food additives, such as low- and no-calorie sweeteners (LNCS). As a consequence, there has been an increase of their consumption, which has made regulatory agencies to evaluate their exposure and possible consequences. At the same time, speculations about adverse effects, such as carcinogenicity, preterm delivery and metabolic changes involving appetite, weight increase and glucose intolerance, have been published. This scenario led ILSI Brasil to organize a meeting to update scientific knowledge on the safety of LNCS and to promote discussions among academia, regulatory bodies and food industries to clarify currently controversial information. The results of this initiative are presented in this review. It is suggested that LNCS, when used according to recommendations provided by scientific committees and regulatory authorities are considered safe. Further studies are required to evaluate the current level of exposure in general population and specific ones as children.摘要 超重与肥胖引发的2型糖尿病（type-2 diabetes）患病率持续攀升，促使全球公共卫生主管部门制定针对该疾病的风险管理与预防策略。其中一项核心策略为降低添加糖食品及饮料中的含糖量，这推动食品工业以低热量与无热量甜味剂（low- and no-calorie sweeteners, LNCS）等食品添加剂部分替代蔗糖。随之而来的是此类甜味剂消费量的增长，使得各国监管机构需对其人体暴露水平及潜在健康影响展开评估。与此同时，有关其可能存在的不良反应（如致癌性、早产，以及涉及食欲、体重增加与糖耐量异常的代谢改变）的相关推测也陆续见诸报道。 鉴于此，国际生命科学学会巴西分会（ILSI Brasil）组织召开专题会议，旨在更新低热量与无热量甜味剂安全性的科学认知，并推动学术界、监管机构与食品工业界展开研讨，以厘清当前存在争议的相关信息。本综述即呈现此项倡议的相关成果。研究表明，按照科学委员会及监管机构的建议使用低热量与无热量甜味剂，被认为是安全的。当前仍需开展进一步研究，以评估普通人群及儿童等特定群体的甜味剂摄入暴露水平。