WHAT PEDIATRICIANS SHOULD KNOW ABOUT ARTIFICIAL SWEETENERS
DOI:
https://doi.org/10.46793/PP190121001NKeywords:
artificial sweeteners, pediatricians, knowledgeAbstract
Artificial sweeteners are food additives used to provide sweetness without adding calories. This synthetic sugar substitutes can also be obtained from the production of some naturally occurring sugars. Their consumption has become more widespread around the world in all age groups, including children. The aim of this study is to analyze current data on artificial sweeteners, their characteristics and evidence of their safety, also in children, as well as their benefits and consumption risk. Scientific basis were used (PUBMED and Scopus,) to analyze articles that included keywords (non-caloric sweeteners /children) in English, as well as relevant literature in Serbian. This review points that it is imperative for health professionals to judiciously and individually evaluate the overall benefits and risks of artificial sweeteners use in consumers before recommending their use. This type of additives should be used for obesity prevention. Artificial sweeteners are also used in the diet among patients with diabetes and do not affect the level of insulin. It has been proven that the consumption of approved sweeteners within the acceptable daily intake is safe during pregnancy, as well as childhood.
References
Nikolić M, Jović S. Ishrana i zdravlje. U: Nikolić M. ur. Dijetetika .Univerzitet u Nišu Medicinski fakultet, Niš:Galaksija,2007;11-40.
Duffy V.B., Anderson G.H. Position of The American Dietetic Association. Use of nutritive and non-nutritive sweeteners. J Am Diet Assoc. 1998; 98(5):580- 587. PMID:9597035 https://doi.org/10.1016/S0002-8223(98)00131-X
Norma general del CODEX para los aditivos alimentarios Revisión 2011 (GSFA, CODEXSTAN 192-1995) http://www.fao.org/gsfaonline/docs/CXS_192s.pdf.
Statement of EFSA on the scientific evaluation of two studies related to the safety of artificial sweeteners. EFSA Journal. 2011;9(2):p. 2089.
Food Additives & Ingredients. https://www.fda.gov/Food/IngredientsPackagingLabeling/FoodAdditivesIngredients/default.htm.
Qurrat-ul-Ain, Khan SA. Artificial sweeteners: safe or unsafe? J Pak Med Assoc. 2015;65(2):225-7. PMID:25842566
Programa del niño menor de 2 años. Chile. http://www.enfermeriaaps.com/portal/wp-content/uploads/2016/01/Gu%C3%ADa-de-alimentaci%C3%B3n-del-ninoa-menor-de-2-a%C3%B1os-Gu%C3%ADa-de-alimentaci%C3%B3n-hasta-la-adolescencia.-MINSAL-Chile-2015.pdf
Durán Agüero S, Angarita Dávila L, Escobar Contreras MC, Rojas Gómez D, de Assis Costa J. Noncaloric Sweeteners in Children: A Controversial Theme. Biomed Res Int. 2018;2018:4806534. PMID:29511682doi: 10.1155/2018/4806534.
Mortensen A. Sweeteners permitted in the European Union: safety aspects. Scand J Food Nutr. 2006; 50(3): 104-116.
Mennella JA, Bobowski NK, Reed DRThe development of sweet taste: From biology to hedonics. Rev in Endoc and Metab Dis 2016; 17.2: 171-178. PMID:27193110 DOI:10.1007/s11154-016-9360-5
De Graaf C, Zandstra E.H. Sweetness intensity and pleasantness in children, adolescents, and adults. Physiol Behav. 1999; 67:513-520. PMID:10549887 https://doi.org/10.1016/S0031-9384(99)00090-6
Van Opstal AM, Kaal I, van der Berg-Huzsmans AA, Hoeksma M, Blonk C, Pijl H. et al. Dietary sugars and non-caloric sweeteners elicit different homeostatic and hedonic responses in the brain. Nutrition2018; 60:80-86. PMID:30529886DOI:10.1016/j.nut.2018.09.004
Jovanović A. Dijetetski značaj veštačkih zasladjivača. Diplomski rad. Medicinski fakultet, Univerziteta u Nišu, 2018.
Gupta M. Sugar Substitutes: Mechanism, Availability, Current use and Safety Concerns-An Update. Open Access Maced J Med Sci. 2018; 6(10):1888-1894. PMID:30455769 DOI:10.3889/oamjms.2018.336
Chattopadhyay S, Raychaudhuri U, Chakraborty R. Artificial sweeteners – a review. J Food Sci Technol. 2014; 51(4):611-621. PMID:24741154 DOI:10.1007/s13197-011-0571-1
Simon BR, Parlee SD, Learman BS. et al. Artificial sweeteners stimulate adipogenesis and suppress lipolysis independently of sweet taste receptors, J Biol Chem 2013; 288 (45): 32475–32489. PMID:24068707DOI:10.1074/jbc.M113.514034
Pandurangan M, Park J, E. Kim E. Aspartame downregulates 3T3-L1 differentiation,” In Vitro Cellular and Developmental Biology – Animal 2014;50 (9):851–857.
Butchko HH, Stargel WW, Comer CP. et al. Aspartame: review of safety. Regul Toxicol Pharmacol, 2002;35(2 pt 2):S1–S93.
Choudhary AK, Pretorius E. Revisiting the safety of aspartame. Nutr Rev. 2017 ;75(9):718-730. doi: 10.1093/nutrit/nux035.
Naik AQ, Zafar T, Shrivastava VK. Health Implications Associated with Aspartame Consumption: A Substantial Review. Pak J Biol Sci. 2018;21(3):127-134.
Nettleton JA, Lutsey PL, Wang Y, Lima JA, Michos ED, Jacobs DR., Jr Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA) Diabetes Care. 2009;32(4):688–94.
de Koning L, Malik VS, Rimm EB, Willett WC, Hu FB. Sugar-sweetened and artificially sweetened beverage consumption and risk of type 2 diabetes in men. Am J Clin Nutr. 2011;93(6):1321–7.
Durán Agüero S, Angarita Dávila L, Escobar Contreras MC, Rojas Gómez D, de Assis Costa J. Noncaloric Sweeteners in Children: A Controversial Theme. Biomed Res Int. 2018 ;2018:4806534. doi: 10.1155/2018/4806534. eCollection 2018.
Archibald AJ, Dolinsky VW, Azad MB. Early-Life Exposure to Non-Nutritive Sweeteners and the Developmental Origins of Childhood Obesity: Global Evidence from Human and Rodent Studies. Nutrients. 2018 Feb 10;10(2). pii: E194. doi: 10.3390/nu10020194.
Mosdøl A, Vist GE, Svendsen C, Dirven H, Lillegaard ITL, Mathisen GH, Husøy T. Hypotheses and evidence related to intense sweeteners and effects on appetite and body weight changes: A scoping review of reviews. PLoS One. 2018 ;13(7):e0199558. doi: 10.1371/journal.pone.0199558. eCollection 2018.
Malik VS. Non-sugar sweeteners and health. BMJ. 2019 Jan 3;364:k5005. doi: 10.1136/bmj.k5005.
Kmietowicz Z.Non-sugar sweeteners: lack of evidence that they help to control weight. BMJ. 2019 Jan 2;364:l7. doi: 10.1136/bmj.l7.
Levy HL, Waisbren SW. Effects of untreated maternal phenylketonuria and hyperphenylalaninemia on the fetus. N Engl J Med 1983; 309:(21):1269-1274.
Grenby TH Update on low-calorie sweeteners to benefit dental health Int Dent J. 1991; 41(4):217-24.
Toews I, Lohner S, Küllenberg de Gaudry D, Sommer H, Meerpohl JJ. Association between intake of non-sugar sweeteners and health outcomes: systematic review and meta-analyses of randomised and non-randomised controlled trials and observational studies.BMJ. 2019 Jan 2;364:k4718. doi: 10.1136/bmj.k4718. Erratum in: BMJ. 2019 Jan 15;364:l156.