by Marion Nestle

Currently browsing posts about: Artificial-sweeteners

Nov 21 2023

Some good news (for a change)

Just in time for the Thanksgiving holiday, government agencies are, at long last, taking action on food issues.

Two examples:

I.  The Federal Trade Commission has issued warning letters to trade associations and dietitian-influencers they paid to promote sugar and aspartame on social media.

The letter to AmeriBev detail concerns about posts on Instagram and TikTok by Valerie AgyemanNichole AndrewsLeslie BonciKeri GansStephanie GrassoCara HarbstreetAndrea MillerIdrees MughalAdam Pecoraro, and Mary Ellen Phipps, each of whom also received an individual warning letter.

The letter to The Canadian Sugar Institute expresses concerns about Instagram posts by Jenn Messina and Lindsay Pleskot, each of whom also received an individual warning letter.

The letter to American Beverage (formerly the American Beverage Association) gives the “or else.”

We strongly urge you to review your social media policy. You should also review the Instagram, TikTok, and other social media posts made by your endorsers as to whether they contain sufficiently clear and conspicuous disclosures of any material connections to the American Beverage Association. To help guide your review, please see the Endorsement Guides3 and the staff publication FTC’s Endorsement Guides: What People Are Asking. Violations of the FTC Act may result in legal action seeking a federal district court injunction or an administrative cease and desist order

This action comes as a result of the investigative report in the Washington Post (it is cited in the letter).  I wrote about the Post article here and also posted the the response from the Academy of Nutrition and Dietetics.

The Post investigative team had this to say about the FTC’s warning letters.

Federal regulators announced warnings against two major food and beverage industry groups and a dozen nutrition influencers Wednesday, as part of a broad action to enforce stricter standards for how companies and social media creators disclose paid advertising.

Comment: Let’s hear it for the power of the press!

II.  New York State Attorney General sues PepsiCo for plastic pollution

New York Attorney General Letitia James today filed a historic and groundbreaking lawsuit against PepsiCo Inc. (PepsiCo) for harming the public and the environment with its single-use plastic packaging. The Office of the Attorney General (OAG) found that single-use plastic produced by PepsiCo contributes significantly to high levels of plastic pollution along the Buffalo River, pollution that is contaminating drinking water and harming wildlife.

…PepsiCo, which is headquartered in New York state, manufactures, produces, and packages at least 85 different beverage brands and 25 snack food brands that predominantly come in single-use plastic containers. Plastic packaging has become a persistent and dangerous form of pollution along the shores of the Buffalo River and in its watershed. In 2022, OAG conducted a survey of all types of waste collected at 13 sites along the Buffalo River and its tributaries and found that PepsiCo’s single-use plastic packaging was the most significant. Of the 1,916 pieces of plastic trash collected with an identifiable brand, over 17 percent were produced by PepsiCo. PepsiCo’s plastic packaging far exceeded any other source of this identifiable plastic waste along the river, and it was three times more abundant than the next highest contributor.

According to the New York Times, PepsiCo:

has said it aims to make all of its packaging “recyclable, compostable, biodegradable or reusable” by 2025. The company also says it wants to cut virgin plastic by 50 percent by 2030, compared with 2020.

The company is now being held accountable for that promise.  What a concept!

Comment: While soda-and-bottled-water companies profess commitments to reducing plastic waste, they fight recycling laws (those that require bottle deposits returnable when the bottle is returned) in every way possible.  Attorney General James is doing something quite remarkable; she is holding PepsiCo accountable for some of the externalized costs of producing sodas, bottled water, and snacks.  I hope this sets a strong precedent.  Kudos!

Nov 6 2023

Industry-funded item of the week: artificial sweeteners

Hand Cardullo writes in Forbes: 87% Of Sweetened Products Contain Added Sugars Only, Study Finds.   

That seemed interesting.  But then I got to the sub-headline: New Georgetown University report cites need for more low- and no-calorie sweeteners.

As public health officials clamor to remove added sugars from food and beverage products, a new study published by the Georgetown University Business for Impact Center signals that there is much heavy lifing ahead (full disclosure: I served as an author of the paper). The report noted that added sugars dominate products containing sweeteners, with 87% of items formulated this way. Only 8% of sweetened items contain low- or no-calorie sweeteners (LNCS) only, with 5% consisting of a combination of the two. The paper concluded that increased use of LNCS was necessary to eliminate meaningful amounts of added sugars and that LNCS offered effective and safe ways to do so.

Cardullo says: “Here are some things to consider:

  • If public health organizations want to achieve their added sugar reduction goals, they must step up and communicate the efficacy and safety of LNCS in helping consumers manage and lose weight. This will go a long way in helping to clear up consumer confusion.
  • The evidence suggests that the public health community must use only the best studies to advance firm points of view on the use of LNCS.
  • To help reduce added sugars, food and beverage companies should incorporate LNCS into more of their products.”

Really?  My usual question: Who paid for this?

The paper: Moving Towards Healthier Eating Habits: Why Low- and No-Calorie Sweeteners Play a Critical Role

The funder: “Funding for this paper was provided by the Calorie Control Council” [an international association representing the low- and reduced-calorie food and beverage industry].

Comment: Here is one of the figures from the paper.

This shows that 24% of added sugars come from sugar-sweetened beverages, and another 19% come from desserts and snacks.

Cutting down on both is a good idea on its own, and one that does not require the addition or substitution of artificial sweetneners.

Jul 25 2023

Industry-funded study #2: artificial sweeteners

Thanks to Arjan van Groningen for this one.

The study:  The Effect of Non-Nutritive Sweetened Beverages on Postprandial Glycemic and Endocrine Responses: A Systematic Review and Network Meta-analysis. Zhang, R.; Noronha, J.C.; Khan, T.A.; McGlynn, N.; Back, S.; Grant, S.M.; Kendall, C.W.C.; Sievenpiper, J.L. Nutrients 2023, 15, 1050. https://doi.org/10.3390/nu15041050.

Conclusions: The available evidence suggests that NNS beverages sweetened with single or blends of NNS have no acute metabolic and endocrine effects, similar to water. These findings provide support for NNS beverages as an alternative replacement strategy for SSBs in the acute postprandial setting.

Funding: This work was supported by an unrestricted grant from the Institute for the Advancement of Food and Nutrition Sciences (IAFNS). The grant was awarded through a competitive request for the proposal process. The sponsor was not involved in the development of the study protocol and design, execution, analyses, interpretation of the data, or decision to publish. The protocol and results were presented to the Low- And No-Calorie Sweeteners Scientific Committee of IAFNS on several occasions with an opportunity for scientific dialogue.

Comment:  IAFNS is the new name for ILSI North America, a classic industry front group.  To its credit, the authors disclose the involvement of IAFNS in this review.  Check out the Conflict-of-Interest declarations from this group; they are legendary.

Conflicts of Interest: J.C.N. has worked as a clinical research coordinator at INQUIS Clinical Research. He has also received research support from Glycemia Consulting Inc. T.A.K. has received research support from the Canadian Institutes of Health Research (CIHR), the International Life Science Institute (ILSI), and the National Honey Board. He has taken honorariums for lectures from the International Food Information Council (IFIC) and the Institute for the Advancement of Food and Nutrition Sciences (IAFNS; formerly ILSI North America). He is funded by the National Honey Board. N.M., was a former employee of Loblaw Companies Limited, and is a current employee of Enhanced Medical Nutrition. She has completed consulting work for contract research organizations, restaurants, start-ups, the International Food Information Council, and the American Beverage Association, all of which occurred outside of the submitted work. S.M.G. has received honoraria from Dietitians of Canada and Diabetes Canada for the development and delivery of educational resources on the glycemic index in the past five years. C.W.C.K has received grants or research support from the Advanced Food Materials Network, Agriculture and Agri-Foods Canada (AAFC), the Almond Board of California, Barilla, the Canadian Institutes of Health Research (CIHR), the Canola Council of Canada, the International Nut and Dried Fruit Council, the International Tree Nut Council Research and Education Foundation, Loblaw Brands Ltd., the Peanut Institute, Pulse Canada, and Unilever. He has received in-kind research support from the Almond Board of California, Barilla, the CaliforniaWalnut Commission, Kellogg Canada, Loblaw Companies, Nutrartis, Quaker (PepsiCo), the Peanut Institute, Primo, Unico, Unilever, and WhiteWave Foods/Danone. He has received travel support and/or honoraria from Barilla, the CaliforniaWalnut Commission, the Canola Council of Canada, General Mills, the International Nut and Dried Fruit Council, the International Pasta Organization, Lantmannen, Loblaw Brands Ltd., the Nutrition Foundation of Italy, Oldways Preservation Trust, Paramount Farms, the Peanut Institute, Pulse Canada, Sun-Maid, Tate & Lyle, Unilever, and White Wave Foods/Danone. He has served on the scientific advisory board for the International Tree Nut Council, the International Pasta Organization, the McCormick Science Institute, and Oldways Preservation Trust. He is a founding member of the International Carbohydrate Quality Consortium (ICQC), the Chair of the Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD), is on the Clinical Practice Guidelines Expert Committee for Nutrition Therapy of the EASD, and is a Director of Glycemia Consulting and the  Toronto 3D Knowledge Synthesis and Clinical Trials foundation. J.L.S. has received research support from the Canadian Foundation for Innovation, the Ontario Research Fund, the Province of Ontario
Ministry of Research and Innovation and Science, the Canadian Institutes of health Research (CIHR),  Diabetes Canada, the American Society for Nutrition (ASN), the International Nut and Dried Fruit Council (INC) Foundation, the National Honey Board (U.S. Department of Agriculture [USDA] honey “Checkoff” program), the Institute for the Advancement of Food and Nutrition Sciences (IAFNS; formerly ILSI North America), Pulse Canada, the Quaker Oats Center of Excellence, the United Soybean Board (USDA soy “Checkoff” program), the Tate and Lyle Nutritional Research Fund at the University of Toronto, the Glycemic Control and Cardiovascular Disease in Type 2 Diabetes Fund at the University of Toronto (a fund established by the Alberta Pulse Growers), the Plant Protein Fund at the University of Toronto (a fund which has received contributions from IFF), and the Nutrition Trialists Network Fund at the University of Toronto (a fund established by an inaugural donation from the Calorie Control Council). He has received food donations to support randomized controlled trials from the Almond Board of California, the California Walnut Commission, the Peanut Institute, Barilla, Unilever/Upfield, Unico/Primo, Loblaw Companies, Quaker, Kellogg Canada, WhiteWave Foods/Danone, Nutrartis, and Dairy Farmers of Canada. He has received travel support, speaker fees and/or honoraria from ASN, Danone, Dairy Farmers of Canada, FoodMinds LLC, Nestlé, Abbott, General Mills, Nutrition Communications, the International Food Information Council (IFIC), the Calorie Control Council, the International Sweeteners Association, and the International Glutamate Technical Committee. He has or has had ad hoc consulting arrangements with Perkins Coie LLP, Tate & Lyle, Phynova, and Inquis Clinical Research. He is a former member of the European Fruit Juice Association Scientific Expert Panel and a former member of the Soy Nutrition Institute (SNI) Scientific Advisory Committee. He is on the Clinical Practice Guidelines Expert Committees of Diabetes Canada, the European Association for the study of Diabetes (EASD), the Canadian Cardiovascular Society (CCS), and Obesity Canada/Canadian Association of Bariatric Physicians and Surgeons. He serves or has served as an unpaid member of the Board of Trustees and an unpaid scientific advisor for the Carbohydrates Committee of IAFNS. He is a member of the International Carbohydrate Quality Consortium (ICQC), an Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the EASD, and a Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. His spouse is an employee of AB InBev. R.Z. and S.B. have no conflicts of interest to declare.

Jul 14 2023

Weekend reading: is aspartame a carcinogen?

The long-awaited report on aspartame from the International Agency for Research on Cancer and the WHO and FAO Joint Expert Committee on Food Additives (JECFA) are now out.  These agencies jointly issued two documents.

A press release

Citing “limited evidence” for carcinogenicity in humans, IARC classified aspartame as possibly carcinogenic to humans (IARC Group 2B) and JECFA reaffirmed the acceptable daily intake of 40 mg/kg body weight.

A summary of the findings

  • The [IARC] working group classified aspartame as possibly carcinogenic to humans (Group 2B) based on limited evidence for cancer in humans (for hepatocellular carcinoma, a type of liver cancer)…There was also limited evidence for cancer in experimental animals…In addition, there was limited mechanistic evidence that aspartame exhibits key characteristics of carcinogens, based on consistent and coherent evidence that aspartame induces oxidative stress in experimental systems and suggestive evidence that aspartame induces chronic inflammation and alters cell proliferation, cell death and nutrient supply in experimental systems.
  • The [JEFCA] Committee concluded that the data evaluated during the meeting indicated no reason to change the previously established acceptable daily intake (ADI) of 0–40 mg/kg body weight for aspartame. The Committee therefore reaffirmed the ADI of 0–40 mg/kg body weight for aspartame…Based on the results of the oral carcinogenicity studies of aspartame, the absence of evidence of genotoxicity, and a lack of evidence on a mechanism by which oral exposure to aspartame could induce cancer, the Committee concluded that it is not possible to establish a link between aspartame exposure in animals and the appearance of cancer.

If this feels crazy-making, I’m with you.

For starters, I’ve never seen a scientific report released this way—essentially by leakage and press release before the research is published where it can be reviewed independently.

To summarize the chronology:

  1. Research article in Lancet Oncology:  Carcinogenicity of aspartame, isoeugenol, and methyleugenol 
  2. Infographic
  3. Q & A
  4. Featured News page on the evaluation of aspartame

Here’s what I think of all this: if aspartame is a carcinogen, it’s a weak one.

But it is artificial and off my dietary radar.  It’s not essential in human diets.  I don’t like its taste and I don’t like all the iffy questions about how it is metabolized.  I avoid it.

You don’t want to avoid it?  JEFCA says you can have 9 to 14 cans of diet soda a day without exceeding tolerable limits.  If you want one once in a while, it is highly unlikely to hurt you.

But a much better idea is getting out of the sweetened-drinks habit.  If you must have something sweet to drink, try adding fruit juice to water.

Jul 6 2023

What’s up with aspartame?

I was deluged with interview requests last week over the rumor that the World Health Organization will soon release reports stating that the artificial sweetener aspartame is “possibly” carcinogenic.

I say rumor, because the reports will not be released until July 14.

According to Reuters—Exclusive: WHO’s cancer research agency to say aspartame sweetener a possible carcinogen -sources—two sources leaked the conclusion.

Aspartame, used in products from Coca-Cola diet sodas to Mars’ Extra chewing gum and some Snapple drinks, will be listed in July as “possibly carcinogenic to humans” for the first time by the International Agency for Research on Cancer (IARC), the World Health Organization’s (WHO) cancer research arm, the sources told Reuters…. Last month, the WHO published guidelines advising consumers not to use non-sugar sweeteners for weight control. The guidelines caused a furore in the food industry, which argues they can be helpful for consumers wanting to reduce the amount of sugar in their diet.

From what I hear from my own sources, everyone involved in the forthcoming reports is bound by confidentiality agreements.  They suspect that food industry representatives did the leaking.

This gives the industry plenty of time to complain and lobby.  As one report has it, “Industry experts and trade groups are decrying the World Health Organization’s International Agency for Research on Cancer’s pending addition of aspartame to a list of possible carcinogens for humans as unscientific and politically motivated.

Aspartame has been under scrutiny for its potential harm to health practically from the time it first appeared. (see Laura Reiley in the Washington Post on how aspartame has come under scrutiny lately).

Center for Science in the Public Interest has long said of aspartame, Avoid.

Aspartame (sometimes marketed under the brand names Equal, NutraSweet, or AminoSweet) is a chemical combination of two amino acids and methanol. Questions of cancer and neurological problems, such as dizziness or hallucinations, have swirled around aspartame for decades…In 2005, researchers at the Ramazzini Foundation in Bologna, Italy…found that rats exposed to aspartame starting at eight weeks of age and continuing through their entire lifetimes developed lymphomas, leukemias, and other tumors, including kidney tumors, which are extremely rare in the strain of rat used. In 2007, the same researchers published a follow-up study that exposed rats to aspartame beginning in the womb and continuing through their entire lifetimes. That study, too, found that aspartame caused leukemias/lymphomas, as well as mammary (breast) cancer. Then in 2010, they published a study that exposed mice to aspartame, starting in the womb and continuing throughout their entire lifetimes. That third study found that aspartame caused liver and lung cancer in male mice.

US Right to Know says of Aspartame, “Decades of Science Point to Serious Health Risks.

But the FDA says “aspartame is safe for the general population when made under good manufacturing practices and used under the approved conditions of use.”

And the American Cancer Society says you would have to drink 36 cans of diet soda a day to excede the Acceptable Daily Intake level.

Rumors and concerns about aspartame causing a number of health problems, including cancer, have been around for many years. Some of the concerns about cancer stem from the results of studies in rats published by a group of Italian researchers, which suggested aspartame might increase the risk of some blood-related cancers (leukemias and lymphomas). However, later reviews of the data from these studies have called these results into question. The results of epidemiologic studies (studies of groups of people) of possible links between aspartame and cancer (including blood-related cancers) have not been consistent.

A recent review says “The consumption of ASBs [artifically sweetened beverages] was associated with a higher risk of obesity, type 2 diabetes, all-cause mortality, hypertension, and cardiovascular disease incidence.”

As I mentioned a month or so ago, artificial sweeteners are taking a big hit these days and it looks like they are about to take another one.

In my intereviews, I pointed out that what’s news here is the level of authority.  It’s a big deal that WHO is saying this.

Two other points.

  • Aspartame is not essential in the diet.  Nobody (except soft drink companies) need it.
  • It and other artificial sweeteners are artificial and, therefore, ultra-processed.
  • I’m already seeing “no aspartame” labels on soft drinks and food products.

I am looking forward to seeing the data when the reports are published.

Jun 20 2023

Artificial sweeteners: the backlash

This has not been a good year for artificial sweeteners.

The World Health Organization says don’t use them for weight control and don’t give them to children.

The recommendation is based on the findings of a systematic review of the available evidence which suggests that use of NSS does not confer any long-term benefit in reducing body fat in adults or children. Results of the review also suggest that there may be potential undesirable effects from long-term use of NSS, such as an increased risk of type 2 diabetes, cardiovascular diseases, and mortality in adults.

US Right to Know says: Aspartame: Decades of science point to serious health risks  

And now, researchers say Splenda is not all that great either:
Overall, the toxicological and pharmacokinetic findings for sucralose-6-acetate raise significant health concerns regarding the safety and regulatory status of sucralose itself.
The FDA says the artificial sweeteners on the market are Generally Recognized as Safe at amounts typically used.  These include:
  • Acesulfame potassium (Sweet One, Sunett).
  • Advantame.
  • Aspartame (NutraSweet, Equal).
  • Neotame (Newtame).
  • Saccharin (Sweet’N Low).
  • Sucralose (Splenda).
  • Luo han guo (Monk Fruit in the Raw).
  • Purified stevia leaf extracts (Truvia, PureVia, others)
I was curious to see what the Mayo Clinic made of all this:

In general, it is safest to take in small amounts of sugar substitutes. And it’s best to use sugar substitutes for a short time, or just every once in a while. So try to cut back if you use them a few times a day…In general, sugar substitutes are safe for healthy adults…But artificial sweeteners can help some people enjoy sweetness without excess calories. And if used in moderation, artificial sweeteners can be part of a healthy diet.

How’s that for a clear message?

For me, this issue is a no-brainer.  One of my food rules is not to eat anything artificial, so sweeteners are off my dietary radar.

My advice for anyone else?

  • If you must use them, try to minimize.
  • And don’t give them to kids.
May 19 2023

Weekend reading: WHO’s new guidance on artificial sweeteners

A press release from the World Health Organization announces recommendations on the use of artificial, non-nutritive (meaning no-calorie) sweeteners: WHO advises not to use non-sugar sweeteners for weight control in newly released guideline.

The recommendation is based on the findings of a systematic review of the available evidence which suggests that use of NSS does not confer any long-term benefit in reducing body fat in adults or children. Results of the review also suggest that there may be potential undesirable effects from long-term use of NSS, such as an increased risk of type 2 diabetes, cardiovascular diseases, and mortality in adults.

The recommendation not to use artificial sweeteners for weight control or chronic disease prevention applies to:

all synthetic and naturally occurring or modified non-nutritive sweeteners that are not classified as sugars. Common NSS include acesulfame K, aspartame, advantame, cyclamates, neotame, saccharin, sucralose, stevia and stevia derivatives.

The guideline document notes:

The recommendation in this guideline was made based on evidence that suggests that there may be health effects associated with NSS use irrespective of which NSS is being used – that is, NSS as a class of compounds, despite individual NSS having different chemical structures, may have an impact on health…individual NSS have different sweetness intensities and organoleptic properties, and are processed differently by the body. Although limited  evidence suggests that individual NSS may also differ in some of their physiological effects in humans, the evidence is currently insufficient to make
recommendations for individual NSS.

Overall, the evidence summarized in the document shows benefits from short-term studies but not ones that last longer than three months or so.  After that, use of non-nutritive sweeteners is associated with potential harm.

At issue, of course, is the mechanism.  These remain speculative: calorie compensation? mainenance of taste preference?  microbiome?

Much of the research into biological mechanisms has been carried out in in vitro and rodent models, and further research is needed to determine whether observations in non-human models translate to humans.  Although there are as yet no conclusive mechanistic links between NSS use and many of the associations observed in prospective cohort studies, that plausible mechanisms have been identified, tested and in some cases validated (albeit mostly in non-human models) reinforces the seriousness with which the associations observed in prospective cohort studies should be considered and highlights the need for further exploration of possible mechanisms with additional research.

Until then, it seems best to avoid them (I don’t like their taste anyway).

  • View the press release here
  • Access the guideline here

Questions?

Nov 1 2022

Industry-funded research proposal of the week: Sweeteners

TODAY: KPFA book talk in Berkeley.  The Back Room, 1984 Bonita Avenue, 7:00 pm.  Ticketing info is here.

*****

Jim Krieger, who I will see in Seattle on Saturday, sent this one.

The study: Protocol for a multicentre, parallel, randomised, controlled trial on the effect of sweeteners and sweetness enhancers on health, obesity and safety in overweight adults and children: the SWEET project.  Louise Kjølbæk 1Yannis Manios 2 3Ellen E Blaak 4J Alfredo Martínez 5 6Edith J M Feskens 7Graham Finlayson 8Sabina S H Andersen 9Kyriakos Reppas 2Santiago Navas-Carretero 5 10Tanja C Adam 11Charo E Hodgkins 12Marta Del Álamo 13Tony Lam 14Hariklia Moshoyiannis 15Jason C G Halford 8 16Joanne A Harrold 16Anne Raben 9 17  BMJ Open.  2022 Oct 12;12(10):e061075.   doi: 10.1136/bmjopen-2022-061075.

Purpose: “The aim of this randomised controlled trial (RCT) is to investigate whether prolonged consumption of sweeteners and sweetness enhancers (S&SEs) within a healthy diet will improve weight loss maintenance and obesity-related risk factors and affect safety markers compared with sugar.”

Competing interests: “AR has received honoraria from Unilever and the International Sweeteners Association. CEH’s research centre provides consultancy to, and has received travel funds to present research results from organisations supported by food and drink companies. JCGH and JH have received project funds from the American Beverage Association. TL works for a company, NetUnion sarl, which has no conflict of interest in the study outcome.”

Comment: This is the official announcement of the research and analysis methods for a new clinical trial.  Once the study gets going, it will take a year to get the results.  It looks like the trial will be comparing the effects of artificial sweeteners and sugar on body weight and other markers.  It is sponsored by a company that makes artificial sweeteners and a trade association for the makers and users of artificial sweeteners.  Want to take bets on what the results will look like?

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