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Acesulfam K

A liquid chromatographic method was evaluated for the determination of the intense sweetener acesulfam-K in tabletop sweetener, candy, soft drink, fruit juice, fruit nectar, yogurt, cream, custard, chocolate, and biscuit commercial preparations.

The method is simple, rapid, precise, and sensitive; therefore, it is suitable for routine analyses.

Prodolliet-J & Bruelhart-M: Determination of acesulfam-K in foods. J-AOAC-Int. 1993 Mar-Apr; 76(2): 268-74.

Dental plaque & Sweeteners


Anti-plaque chewing gums
Dental plaque (4)

Anti-plaque chewing gums

To determine whether 5 commercially available sugarless chewing gums sweetened with different sweeteners differ in their ability to reduce an acidogenic response from a 10 percent sucrose-rinse challenge.

All of the sugarless gums were effective in significantly increasing plaque pH and in reducing the area under the curve after the sucrose challenge compared with "no gum" treatment.

Park-KK et al: Effect of chewing gums on plaque pH after a sucrose challenge. ASDC-J-Dent-Child. 1995 May-Jun; 62(3): 180-6.

Dental plaque (1)

Compared dental plaque formation following use of chlorhexidine (CHX) acetate-, xylitol-, and sorbitol-containing chewing gum.

For each trial period, subjects were instructed to use 5 pieces of the unlabeled chewing gum daily (containing 5.0 mg CHX acetate/piece; 0.8 xylitol/piece; or 1.0 g sorbitol/piece). Two pieces of chewing gum were used following each morning and evening meal and one piece following the noon meal. Subjects were instructed to use the products for 20 minutes at each occasion.

The CHX-containing chewing gum showed significantly reduced plaque values (0.7 +/- 0.4) compared to the sorbitol-(2.7 +/- 0.4) and xylitol-product (1.7 +/- 0.3).

Furthermore, the CHX-product significantly reduced plaque levels compared to the study subjects’ regular plaque control routines (1.3 +/- 0.04; P < 0.05). The xylitol-product exhibited significantly lower plaque-values than the sorbitol-product.

Regular use of CHX-containing chewing gum appears useful to control dental plaque formation.

Tellefsen G et al., Use of chlorhexidine chewing gum significantly reduces dental plaque formation compared to use of similar xylitol and sorbitol products. J Periodontol, 1996 Mar, 67:3, 181-3.

Dental plaque (2)

Samples of whole saliva and dental plaque were collected from initially 10-year old subjects who participated in a 40-month cohort study investigating the effect of chewing gum usage on caries rates.

Subjects received gum containing either xylitol, sorbitol, their mixtures, or sucrose as bulk sweeteners, the maximum sweetener consumption in the form of gums being up to 10.7 g/day, used in 3-5 daily chewing episodes.

Gum usage had no significant effect on the levels of salivary protein, IgA, alpha-amylase, peroxidase, lysozyme, SCN and buffer capacity. At the endpoint, the group that received 100% xylitol pellet-shaped gum five times/day, had significantly lower levels of sucrase and free sialic acid in whole saliva than at baseline. This group showed significantly smaller plaque index scores at two cross-sectional measurements, and exhibited the lowest counts of salivary lactobacilli at endpoint than most other groups.

Salivary levels of peptidase(s) (oligopeptidase B-like enzymes) hydrolyzing N-alpha-benzoyl-DL-arginyl-p-nitroaniline were lower in groups which received 100% xylitol pellet gums.

Mäkinen KK et al., Properties of whole saliva and dental plaque in relation to 40-month consumption of chewing gums containing xylitol, sorbitol of sucrose. Caries Res, 30(3):180-8 1996.

Dental plaque (3)

Xylitol reduces plaque but the reduction mechanism is largely unknown.

Determined whether the xylitol-induced reduction in the amount of plaque and the number of mutans streptococci could be demonstrated in subjects with (presumably) high levels of xylitol-resistant (XR; not inhibited by xylitol) mutans streptococci acquired following previous xylitol consumptions.

Plaque and saliva samples were collected at baseline and at the 2-week point for determination of the amount of plaque, microbiological variables, and hydrolytic enzymes.

Mixtures of xylitol and sorbitol seemed to perform equally well with respect to reduction in the amount of plaque but not the number of mutans streptococci. Thus, polyols were the active ingredients of chewing gums able to modulate the amount of plaque and its microbial composition.

Xylitol reduced plaque with a mechanism which appeared not to be associated with the study-induced changes in the proportion (%) of mutans streptococci in plaque, the number of salivary mutans streptococci, the proportion of XR strains in plaque or saliva, or the hydrolytic enzyme activities of plaque.

S”derling E et al., Effects of xylitol, xylitol-sorbitol, and placebo chewing gums on the plaque of habitual xylitolconsumers. Eur J Oral Sci, 1997 Apr, 105:2, 170-7.

Dental plaque (4)

Evaluated the effects of frequent mouthrinses with palatinose, xylitol and a mixture of palatinose and xylitol on plaque pH, plaque formation and cariogenic microorganisms.

Rinsed 15 x daily for 4 d with 10 ml of: (1) 50% palatinose, (2) 37.5% palatinose + 12.5% xylitol, or (3) 50% xylitol.

After the 4-day periods, 3 parameters were measured:
· plaque pH during the first 30 min after a mouthrinse with palatinose, a mixture of palatinose and xylitol or xylitol alone, directly followed by a 2nd rinse with 10% sucrose;
· number of mutans streptococci and lactobacilli in plaque and saliva;
· plaque index.

The most pronounced pH drop for the sugar substitutes was found when rinsing with 50% palatinose after the palatinose period, and the least pH drop with 50% xylitol after the xylitol period. The sucrose rinse gave similar pH fall after all 4 periods.

The microbial data showed no differences between the 4 periods, but the mutans streptococcus counts in saliva decreased after the xylitol period in contrast to the 3 other periods.

Regarding the plaque index, xylitol gave lower scores compared to the other 3 periods.

Lingstr”m P et al., Effects of frequent mouthrinses with palatinose and xylitol on dental plaque. Eur J Oral Sci, 1997 Apr, 105:2, 162-9.

Diabetes & Sweeteners

Diabetes (1)

Examined the effect of a single high oral dose of the novel noncaloric sweetener sucralose on short-term glucose homeostasis in patients with IDDM or NIDDM.

After an overnight fast, patients were administered opaque capsules containing either 1,000 mg sucralose or cellulose placebo, followed by a standardized 360-kcal liquid breakfast. Plasma glucose and serum C-peptide levels were measured over the next 4 h.

Regardless of the type of diabetes, changes of plasma glucose and serum C-peptide levels after sucralose administration were not significantly different from those after placebo.

Sucralose consumption does not adversely affect short-term blood glucose control in patients with diabetes.

Mezitis NH et al., Glycemic effect of a single high oral dose of the novel sweetener sucralose in patients with diabetes. Diabetes Care, 1996 Sep, 19:9, 1,004-5.

Diabetes (2)

Studied the relationship between sweet taste function and dietary intake in patients with type II diabetes mellitus (#21 ). [7-day food records.]

Subjects rated the sweetness intensity and pleasantness of a series of beverage samples sweetened with sucrose: 1.5-24%, fructose: 1-18%, or aspartame: 0.25-4%.

No group differences were found in sweet taste perception, pleasantness ratings, daily energy intakes, or macronutrient composition of the diets.

However, subjects with diabetes consumed less sucrose but 3.5 times more alternative sweeteners than did controls.

Peak pleasantness ratings for the beverage samples were positively correlated with dietary sweetness content in the subjects with diabetes but not the controls.

In diabetes, hedonic ratings for a sweetened beverage were related to dietary sweetness intake rather than changes in sweet taste perception.

Tepper BJ et al., Sweet taste and diet in type II diabetes. Physiol Behav, 60(1):13-8 1996 Jul.

Choices - female

Female - hunger and food choices

Compared the effects of aspartame-sweetened and sucrose-sweetened soft drinks on food intake and appetite ratings of female restrained eaters.

Subjects were given 4 drinks (330 ml) of aspartame-sweetened lemonade, sucrose-sweetened lemonade and carbonated mineral water on three separate days.

During the first study day energy intake was lower whilst drinking the sucrose-sweetened lemonade compared with the aspartame-sweetened lemonade, although neither differed significantly from energy intakes during the day the drank water.

The following day, however, energy intake was significantly higher after the aspartame-sweetened lemonade compared with both sucrose-sweetened lemonade and the water due to an increase in the amount of carbohydrate consumed and resulted in a higher total energy intake over the two days studied.

In females with eating restraint, substituting sucrose-sweetened drinks for diet drinks does not reduce total energy intake and may even result in a higher intake during the subsequent day.

Lavin JH et al., The effect of sucrose- and aspartame-sweetened drinks on energy intake, hunger and food choice of female, moderately restrained eaters. Int J Obes Relat Metab Disord, 21(1):37-42 1997 Jan.

Appetite & Sweeteners


Appetite control
Appetite & energy intake

Appetite control

The sensation of sweet taste without calories has been said to increase appetite and promote food consumption. Regular use of intense sweeteners might therefore lead to a paradoxical weight gain.

These alarmist reports have not been confirmed by recent experimental data.

Drewnowski-A: Intense sweeteners and the control of appetite. Nutr-Rev. 1995 Jan; 53(1): 1-7.

Appetite & energy intake

The effect of sweetness on appetite control has become important for two reasons.

First, the problem of unwanted overconsumption associated with the tendency to gain weight.

Second, the desire to lose weight by dieting.

Two questions arise:
        does sweetness (with or without energy) contribute to over-consumption?, and         does the replacement of a high energy sweetener (such as sucrose) with an         artificial sweetener (such as saccharine or aspartame) lead to weight loss?

How do these issues relate to processes involved in weight maintenance?

Blundell-JE & Green-SM: Effect of sucrose and sweeteners on appetite and energy intake. Int-J-Obes-Relat-Metab-Disord. 1996 Mar; 20 Suppl 2: S12-7.



A liquid chromatographic procedure.

Decomposition of the sweetener was observed in most food samples. However, the total aspartame values (measured aspartame + breakdown products) were within -10% and +5% of the declared levels.

The technique is precise, sensitive and suitable for quality control or monitoring.

Prodolliet-J & Bruelhart-M: Determination of aspartame and its major decomposition products in foods. J-AOAC-Int. 1993 Mar-Apr; 76(2): 275-82.

Aspartame - brain tumor

In the past two decades brain tumor rates have risen in several industrialized countries, including the United States. During this time, brain tumor data have been gathered by the National Cancer Institute.

From 1975 to 1992 the brain tumor increases in the United States occurred in two distinct phases, an early modest increase that may primarily reflect improved diagnostic technology, and a more recent sustained increase in the incidence and shift toward greater malignancy that must be explained by some other factor(s).

The artificial sweetener aspartame is a promising candidate to explain the recent increase in incidence and degree of malignancy of brain tumors. Evidence potentially implicating aspartame includes an early animal study revealing an exceedingly high incidence of brain tumors in aspartame-fed rats compared to no brain tumors in concurrent controls; the recent finding that the aspartame molecule has mutagenic potential, and the close temporal association (aspartame was introduced into US food and beverage markets several years prior to the sharp increase in brain tumor incidence and malignancy).

Olney JW et al., Increasing brain tumor rates: is there a link to aspartame? J Neuropathol Exp Neurol, 1996 Nov, 55:11, 1115-23.

Taste & Sweeteners


Bitter taste

Bitter taste

To quantify the degree of reduction in perceived bitterness by sweeteners at both threshold and suprathreshold concentrations of bitter compounds.

Detection and recognition thresholds were determined for six bitter compounds (caffeine, denatonium benzoate, magnesium chloride, quinine hydrochloride, sucrose octaacetate, and urea) in the absence and presence of several suprathreshold concentrations of five sweeteners.

The sweeteners were: sucrose, aspartame, sodium saccharin, mannitol, and sorbitol. Polycose was also tested along with the sweeteners.

In general, the natural sweeteners, sucrose, mannitol, and sorbitol, were more effective than the noncaloric sweeteners, aspartame and sodium saccharin, in elevating the detection and recognition thresholds of the bitter compounds. A sweetness intensity approximating that of 6% sucrose (0.175 M sucrose) or greater was required to elevate thresholds.

For elderly subjects, sweeteners did not significantly elevate thresholds for denatonium benzoate and sucrose octaacetate.

Schiffman-SS et al: The effect of sweeteners on bitter taste in young and elderly subjects. Brain-Res-Bull. 1994; 35(3): 189-204.


The sweet taste of nonnutritive sweeteners has been reported to increase hunger and food intake through the mechanism of cephalic-phase insulin release (CPIR).

Investigated the effect of oral sensation of sweetness on CPIR and other indexes associated with glucose metabolism using nutritive and nonnutritive sweetened tablets as stimuli.

5 min sucking of: a sucrose, an aspartame-polydextrose, or an unsweetened polydextrose tablet (3 g) with no added flavor.

No CPIR and no significant effect on plasma glucagon or fatty acid concentrations were observed after the 3 stimuli. However, there was a significant decrease in plasma glucose and insulin after all 3 stimuli.

Only the consumption of the sucrose tablet was followed by a postabsorptive increase in plasma glucose and insulin concentrations starting 17 and 19 min, respectively, after the beginning of sucking.

Oral stimulation provided by sweet nonflavored tablets is not sufficient for inducing CPIR.

Abdallah L et al., Cephalic phase responses to sweet taste. Am J Clin Nutr, 65(3):737-43 1997 Mar.

Black plum syrup

The fresh ripe fruit pulp and syrup of Vitex doniana were analysed physico-chemically.

Results show that the edible pulp of the ripe fruit is fairly rich in vitamin C (18.1 mg/100 ml) but acidic (pH 4.38) and poor in protein (0.82%) and oil (0.56%).

Sensory evaluation showed no significant difference (p < or = 0.05) in taste, flavor and overall acceptability between V. doniana syrup and honey. Both physico-chemical and sensory results indicate that the syrup was highly desirable and can substitute for other syrups as a nutritive sweetener.

Egbekun MK et al., Physico-chemical and sensory properties of formulated syrup from black plum (Vitex doniana) fruit. Plant Foods Hum Nutr, 1996 Jun, 49:4, 301-6.

Cancer & Sweeteners


Breast cancer (Denmark)
Cancer prevention

Breast cancer (Denmark)

In Denmark, incidence of female breast cancer remained constant from 1943 to around 1960, whereafter a steady increase has occurred, the level today being about 50% higher than in 1960. No equivalent rise has been observed for breast cancer mortality.

Failed to detect an association with age at first childbirth, oral contraceptives, smoking, intake of vegetables, tea, coffee, and sweeteners. There was no relation between survival and reproductive or hormonal factors, dietary variables, alcohol consumption, or smoking. However, a complex relationship may exist between survival and body mass index.

Ewertz-M: Breast cancer in Denmark. Incidence, risk factors, and characteristics of survival. Acta-Oncol. 1993; 32(6): 595-615.

Cancer prevention

Cancer has been associated with well-defined risk factors. Nutritional factors and tobacco are the most important causes of cancer deaths.

Recommendations include maintain a desirable body weight, eat a varied diet, include a variety of both vegetable and fruits, eat more high fiber foods, cutdown on total fat intake, limit consumption of alcoholic beverages, salt-cured, smoked and nitrite-cured foods.

Suggestions relate to caution with food additives, increase vitamin E intake, proper selenium intake, limit artificial sweeteners, reduce coffee and cholesterol consumption, avoid cooking at high temperatures.

Ferris-i-Tortajada-J et al: [The pediatrician and cancer prevention. Dietetic factors and smoking] An-Esp-Pediatr. 1996 Jul; 45(1): 6-13.

Children & Sweeteners

Child behavior

Both dietary sucrose and the sweetener aspartame have been reported to produce hyperactivity and other behavioral problems in children.

The preschool children ingested a mean of 5600 +/- 2100 mg of sucrose per kilogram of body weight per day while on the sucrose diet, 38 +/- 13 mg of aspartame per kilogram per day while on the aspartame diet, and 12 +/- 4.5 mg of saccharin per kilogram per day while on the saccharin diet.

The school-age children considered to be sensitive to sugar ingested 4500 +/- 1200 mg of sucrose per kilogram, 32 +/- 8.9 mg of aspartame per kilogram, and 9.9 +/- 3.9 mg of saccharin per kilogram, respectively.

For the children described as sugar-sensitive, there were no significant differences among the three diets in any of 39 behavioral and cognitive variables. For the preschool children, only 4 of the 31 measures differed significantly among the three diets, and there was no consistent pattern in the differences that were observed.

Even when intake exceeds typical dietary levels, neither dietary sucrose nor aspartame affects children's behavior or cognitive function.

Wolraich-ML et al., Effects of diets high in sucrose or aspartame on the behavior and cognitive performance of children. [see comments] NEJM. 1994, 330(5): 301-7.

CFS & Sweeteners

Chronic fatigue syndrome

Unproven diet therapies for patients with CFS ( chronic fatigue syndrome) include megavitamin/mineral supplements; royal jelly and other dietary supplements; and elimination, avoidance, and rotation diets. Claims that these therapies relieve CFS symptoms and promote recovery are anecdotal and have not been substantiated by clinical research.

Diet strategies that call for the avoidance of food additives, preservatives, sweeteners, and other ingredients are not supported by available evidence and are not practical for patients with CFS.

Patients with CFS are advised to eat a varied diet selected from among and within the basic food groups to ensure an adequate nutrient intake and to reach and maintain a reasonable body weight.

Morris-DH; Stare-FJ Unproven diet therapies in the treatment of the chronic fatigue syndrome. Arch-Fam-Med. 1993 Feb; 2(2): 181-6.


Cyclamate consumption (Spain)

Evaluated the dietary intake of cyclamate.

18% of the population consumed cyclamate, and the highest percentage was in men aged 35-44 years (33%). Average daily intake of cyclamate was 0.44 mg/kg bw in the whole population and 2.44 mg/kg bw among consumers. Subjects following a diet reported highest intakes, especially diabetics, and only 0.16% of the sample studied had levels above the Acceptable Daily Intake (ADI).

Among consumers, the intake of cyclamate was negatively correlated with Body Mass Index (BMI).

Serra-Majem L et al., Cyclamate consumption in Catalonia, Spain (1992): relationship with the body mass index. Food Addit Contam, 1996 Aug-Sep, 13:6, 695-703.

Thresholds & Sweeteners

Recognition thresholds

It is believed that people's sensitivity to taste declines with age but the evidence is inconclusive. Are taste recognition thresholds (TRTs) for sweetness higher in older than in younger individuals?

There was a significant alteration with age of recognition thresholds, at least for sucrose and saccharin. The differences between the groups for the three sweeteners were due to the fact that all the very sensitive subjects were young.

Although there are age-related taste changes, they are much less dramatic than commonly occurs with other senses, such as sight and hearing. This has implications for institutional catering and the dietary management of older people using non-sugar sweeteners.

Easterby-Smith-V et al: The effect of age on the recognition thresholds of three sweeteners: sucrose, saccharin and aspartame. Gerodontology. 1994 Jul; 11(1): 39-45.

Review of Sweeteners


Sweeteners are widely used in the food and pharmaceutical industry.

This paper reviews our current knowledge of sweet taste from chemical, biochemical, electrophysiological, psychophysical, and psychological points of view.

Schiffman-SS; Gatlin-CA: Sweeteners: state of knowledge review. Neurosci-Biobehav-Rev. 1993 Fall; 17(3): 313-45.


An increased incidence of bladder cancer is found when male rats are fed high dietary concentrations of sodium saccharin (3% or more) from birth. This toxicity has been used as the basis for the development of a data-derived safety factor.

There is no association between the consumption of artificial sweeteners and bladder cancer in humans.

Renwick-AG: A data-derived safety (uncertainty) factor for the intense sweetener, saccharin. Food-Addit-Contam. 1993 May-Jun; 10(3): 337-50.


Stevia - carcinogenicity

The carcinogenic potential of stevioside, a compound that is used as a sweetener for food and drink, was examined in F344 rats of both sexes.

Stevioside was added to powdered diet at concentrations of 0 (control), 2.5 and 5%.

Body weight gains were slightly depressed in line with the dose of stevioside, in both sexes, and a significant decrease in the final survival rate was observed for the 5% treated males. Histopathologically, however, there was no significantly altered development of neoplastic or non-neoplastic lesions attributable to the stevioside treatment in any organ or tissue, except for a decreased incidence of mammary adenomas in females and a reduced severity of chronic nephropathy in males.

Stevioside is not carcinogenic in F344 rats under the experimental conditions described.

Toyoda K et al., Assessment of the carcinogenicity of stevioside in F344 rats. Food Chem Toxicol, 35(6):597-603 1997 Jun.

Sugar substitutes

The average American consumes approximately 124 pounds of sugar annually (Food and Drug Administration). This amount is in addition to the amount of sugar substitutes, saccharin and aspartame, that are consumed.

Research indicates that aside from containing empty calories and being implicated in dental caries, sugar is not a health hazard. Saccharin has been implicated only in bladder cancer. The only people who must avoid aspartame are those with phenylketonuria.

Artificial sweeteners provide an alternative to sugar for those with diabetes and those who are on reduction diets. Although there has been an increased use of aspartame, there has not been a reduction in obesity.

Lary-MJ: Sugar or sugar substitutes? J of the Am Academy of Physician Assistants, 1990 Mar-Apr; 3(2): 147-50.

Urination & Sweeteners

Urinary excretion

Polyols are widely used instead of glucose and sucrose in sweets and dietary products because they are barely cariogenic, and their energy value is lower. In addition, it has been shown that calciuria and oxaluria increase after an oral glucose (Glu) load.

Investigated the effects of a single polyol ingestion on carbohydrate, calcium, phosphate, and oxalate metabolism. Subjects ingested 20 g Glucose, Lycasin (Lyc), Maltisorb (Mal), sorbitol (Sor), or xylitol (Xyl).

Ingestion of polyols causes a much lesser pancreatic stimulation than Glu intake. Also, Lyc, Mal, and Sor sweeteners have no effect on urinary excretion of calcium and oxalate, whereas calciuria and oxaluria increase after Xyl ingestion.

Nguyen-NU et al: Carbohydrate metabolism and urinary excretion of calcium and oxalate after ingestion of polyol sweeteners. J-Clin-Endocrinol-Metab. 1993 Aug; 77(2): 388-92.

Supplements & Sweeteners

Excipients in vitamin & mineral preparations

Multivitamins and mineral preparations are widely used for infants and children. All of these preparations contain a variety of excipients ("inert ingredients"). Excipients are generally safe; however, adverse effects have been attributed to them.

Information about sweeteners, dyes, and other excipients (flavorings, preservatives, stabilizers, and fillers) for 41 chewable/liquid multivitamin and mineral preparations was obtained and tabulated.

Sucrose was present in 63% (26/41) of preparations followed by lactose in 29% (12/41) of preparations. On average, a preparation contained two sweeteners.

The FD&C yellow #6 (sunset yellow) was the most common dye, present in 46% (19/41) of the preparations followed by FD&C Red #40 in 29% (12/41).

The tables listing excipients and their adverse effects are presented and should be helpful to health care providers in selecting preparations containing individual excipients when an adverse reaction occurs or there exists a contraindication for using the excipient.

Mandatory listing of all excipients is the only way to assure that physicians and consumers will be fully informed about the hidden ingredients.

Kumar A et al., Sweeteners, dyes, and other excipients in vitamin and mineral preparations. Clin Pediatr (Phila), 35(9):443-50 1996 Sep.

Weight control & Sweeteners


Weight gain (2)


Investigated whether the addition of the high-intensity sweetener, aspartame, to a multidisciplinary weight-control program would improve weight loss and long-term control of body weight. [Obese women # 163.]

Women in both treatment groups lost approximately 10% of initial body weight (10 kg) during active weight loss. Among women assigned to the aspartame-treatment group, aspartame intake was positively correlated with percentage weight loss during active weight loss. During maintenance and follow-up, participants in the aspartame group experienced a 2.6% (2.6 kg) and 4.6% (4.6 kg) regain of initial body weight after 71 and 175 wk, respectively, whereas those in the no-aspartame group gained an average of 5.4% (5.4 kg) and 9.4% (9.4 kg), respectively.

The aspartame group lost significantly more weight overall and regained significantly less weight during maintenance and follow-up than did the no-aspartame group.

Percentage weight losses at 71 and 175 wk were also positively correlated with exercise and self-reported eating control.

Participation in a multidisciplinary weight-control program that includes aspartame may facilitate the long-term maintenance of reduced body weight.

Blackburn GL et al., The effect of aspartame as part of a multidisciplinary weight-control program on short- and long-term control of body weight. Am J Clin Nutr, 65(2):409-18 1997 Feb.

Weight gain (1)

To evaluate the work of Stellman and Garfinkel who speculated, based on epidemiologic data, that users of intense sweeteners are more likely than nonusers to gain weight.

Several methodological flaws and inappropriate statistical analyses were identified.

Our analysis indicates that the data from the study in question do not allow one to draw conclusions about a relationship between use of intense sweeteners and weight change. Furthermore, data from well-designed clinical trials have shown that aspartame is not associated with weight gain, and when used as part of a balanced deficit diet, can facilitate weight loss.

Lavin-PT et al: Intense sweeteners use and weight change among women. J Am. Coll. Nutr. 1994 Feb; 13(1): 102-5.

Weight gain (2)

Although intense sweeteners have increased hunger ratings in some human studies, this has not been a consistent and reproducible observation.

The concept: that the consumption of intense sweeteners results in a paradoxical increase in calorie intake and body weight is not supported in the literature.

Renwick-AG: Intense sweeteners, food intake, and the weight of a body of evidence. Physiol-Behav. 1994 Jan; 55(1): 139-43.

Orange juice & Sweeteners

Previous research has described methods for monitoring unique oligosaccharides as indicators of adulteration of pure orange juice with undeclared sweeteners.

Oligosaccharide profiles of commercially available sweeteners and fortified orange juice samples were analyzed.

Iuliano TA: A simplified method for determining undeclared sweeteners added to pure orange juice. J AOAC Int, 79(6):1381-7 1996 Nov-Dec.

Lactose intolerance & Sweeteners

Case report of a 2 year old dystrophic boy with chronic diarrhea.

At the age of 6 months he developed severe gastroenteritis with a secondary lactase deficiency. Dietary treatment was however not successful and consequently the boy became dystrophic. At last, an abuse of sweetener was diagnosed.

Weglage J et al., Abuse of artificial sweetener as differential diagnosis of lactose intolerance. Klin Padiatr, 208(1):17-8 1996 Jan-Feb.

Caries & Sweeteners

Caries prevention

In the last 20 years, mainly due to optimum fluoride exposure, and practice of good oral hygiene procedures, an important reduction in caries has been observed, despite the fact that sugar consumption was maintained and/or was increasing during the same lapse of time.

A sugar-caries relationship cannot be established in most of the industrialized countries and the dietary factor is not as preponderant in the caries process as it used to be two decades ago.

The factors which seem to contribute the most significantly to the cariogenicity of the diet are the frequency of carbohydrate ingestion and eating patterns.

The relative cariogenicity of food is not correlated with the amount of carbohydrate it contains. Even if sucrose remains the most important sugar consumed in sweets, beverages and confectionery products, all fermentable-carbohydrate foods can be involved in the caries process.

The use of chewing gum and other xylitol-containing products have resulted in defined reduction in caries and represent interesting alternatives for high-caries-risk populations.

People who receive optimum fluoride exposure and follow regular oral hygiene measures can safely use dietary carbohydrates, preferably during meals and two to three times daily in snacks or drinks.

Kandelman D: Sugar, alternative sweeteners and meal frequency in relation to caries prevention: new perspectives. Br J Nutr, 77 Suppl 1():S121-8 1997 Apr.