Most experts, scientific and regulatory authorities, and credible health and professional organizations agree low-calorie sweeteners are safe for human consumption. Low-calorie sweeteners are very low in carbohydrates and do not contain sugar, both of which affect insulin levels.

When it comes to low-calorie sweeteners (also sometimes referred to as "artificial" sweeteners, sugar substitutes or non-nutritive sweeteners), there is a strange dichotomy taking place in the U.S. Many consumers want to lose weight and report making changes to their diets, in an effort to achieve this goal. Yet, nearly half of consumers report not consuming low-calorie sweeteners, according to the IFIC Foundation's "2010 Food & Health Survey."

The "2010 Food & Health Survey" finds nearly six in 10 consumers (57%) view themselves as overweight. Likewise, more than half (54%) of Americans are trying to lose weight. Of those trying to lose weight, they report changing the amount of food they consume (76%); changing the type of food consumed (68%); exercising (60%); changing meal frequency (44%); consuming diet foods and beverages containing low-calorie sweeteners (24%); and counting calories (22%). Only about four in 10 consumers (38%) agree low-calorie sweeteners can play a role in weight management, and about one third (34%) agree low-calorie sweeteners can reduce the calorie content of foods. Four in 10 consumers (40%) report not consuming low-calorie sweeteners at all.

Where to Find Trusted Information
So, what is stopping them? Old myths about safety and new rumors about weight gain have caused confusion and concern about low-calorie sweeteners and, likely, are responsible for some not trying them. But, is there any scientific basis for these concerns?

Despite numerous safety reviews to confirm their safety, low-calorie sweeteners continue to be the subject of concern in the media and online. While online sources are among the most popular sources of food safety information (32%), according to the "Food & Health Survey," the most trusted source is government agencies/officials (39%). Interestingly, only 24% of Americans believe low-calorie sweeteners are reviewed by the federal government, before being approved for use in foods and beverages. If most consumers are not aware the government approves low-calorie sweeteners for use in foods and beverages in the U.S., this could explain their concerns about low-calorie sweeteners' safety.

In fact, low-calorie sweeteners have been around for decades, and they are some of the most extensively studied ingredients in the food supply. There are six low-calorie sweeteners currently approved by FDA or Generally Recognized as Safe (GRAS) for use in foods and beverages in the U.S.: aspartame, acesulfame-potassium (Ace-K), neotame, saccharin, high-purity stevia sweeteners and sucralose. These sweeteners have been through the wringer, in terms of safety evaluations by researchers, food and beverage manufacturers, and the FDA. Most experts, scientific and regulatory authorities, and credible health and professional organizations agree low-calorie sweeteners are safe for human consumption and do not cause adverse health effects. Some studies conducted several decades ago on certain low-calorie sweeteners suggested a link to certain types of cancer; however, they have long been dismissed through further research that confirmed their safety. Yet, some still believe the urban myths being perpetuated about low-calorie sweeteners on the Internet and in the media. Recent research attempting to raise safety concerns about aspartame and cancer was dismissed by both the European Food Safety Authority (EFSA) and FDA, which stated the findings do not present significant evidence to justify any changes to current Acceptable Daily Intake (ADI) levels of aspartame.

If they are safe, then why are consumers hesitant about jumping on the low-calorie bandwagon? While a few recent studies have suggested a link between low-calorie sweeteners and increased appetite and weight gain, a substantial base of research has shown low-calorie sweeteners' efficacy for weight and Body Mass Index (BMI) reduction, both key factors in reducing obesity and related health problems. A 2006 review of aspartame's role in weight management, for example, demonstrated a weight loss of 0.2kg/week (or 0.4 lb/week), when aspartame-sweetened products were substituted for those sweetened with sugar (de la Hunty et al., 2006). Similar findings were seen in a 1997 study published in the American Journal of Clinical Nutrition (Blackburn et al., 1997). A recent study of overweight children, by America on the Move, found a greater proportion of children reduced their BMIs and body weights, when they substituted sugar with sucralose and added 3,000 steps per day, compared to those who did not (Rodearmel et al., 2007).

Logically, this makes sense. Low-calorie sweeteners are used in place of other caloric sweeteners to sweeten foods and beverages. All other things being equal, replacing regularly-sweetened foods with those sweetened with low-calorie sweeteners will result in fewer calories consumed. Also, consuming fewer calories leads to weight loss. The trick is to replace full-calorie foods and beverages with low- or no-calorie foods and beverages, not add them to existing diets. Depending on their consumption of regularly-sweetened products at the time they switch to low-calorie sweeteners, some consumers could save hundreds of calories per day. Examples of foods available in low-calorie versions, usually indicated by the word "diet" or "light" on the package, include teas, sodas and other flavored beverages, as well as low-fat yogurt, ice cream, jams and jellies, syrups, condiments and more. These calorie savings add up over the days, weeks, months and years. Most low-calorie sweeteners can be used as table-top sweeteners, as well as in reduced-calorie baking blends available in the grocery store.

Experts agree successful weight management requires more than just calorie reduction--moderation, along with eating a balanced diet and regular exercise, is key to reaching an optimal weight. The American Dietetic Association's position on the use of nutritive and non-nutritive sweeteners states, "Non-nutritive sweeteners added to the diet have been shown to promote modest loss of weight and, within a multi-disciplinary weight control program, may facilitate long-term maintenance of reduction in body weight (ADA, 2004)."

Some Old Myths and Misinformation
Recent studies questioning the efficacy of low-calorie sweeteners and suggesting they cause cravings, overeating and weight gain have not been substantiated by the body of science and require further study. One clear problem with these studies is the model of giving saccharin to rats, since rats are exceedingly drawn to saccharin. In addition, while rats may not know to stop eating or drinking, humans know better. People have the ability to count calories and limit portions, so they take home the leftovers for another time. They know they can burn calories by exercising, and how many calories are needed to burn, if they have treated themselves to dessert and do not want the extra pounds going to their hips. Or do they?

Unfortunately, when it comes to calories consumed and calories burned, most Americans (58%) do not make an effort to balance the two, and only 28% increase their physical activity on days they consume more. In fact, only 12% of Americans know how many calories they should consume per day for their age, height, weight and physical activity level. Additionally, nearly half of Americans do not know how many calories they burn in a day (43%), and other consumers inaccurately estimate this figure (35% of consumers say they burn 1,000Kcal or less a day). Interestingly, among the 68% of consumers who use the Nutrition Facts Panel, 74% rank calories as the top piece of information they use. It is not clear if consumers truly understand how to use that information, but this is a subject the "Food & Health Survey" does not cover.

What is continued to be observed, from years of consumer insights, is that knowledge, or lack thereof, affects perceptions, and there are many things about food and nutrition consumers do not grasp.  For example, when consumers were asked to state their agreement with six true statements about low-calorie sweeteners, more than one quarter (27%) said they did not know enough about low-calorie sweeteners to provide an answer. There are many possible reasons for this, but it reveals consumers are confused about the role of low-calorie sweeteners in the diet. Indeed, 46% of consumers agree food and health information is confusing and conflicting.

In the end, despite a desire to eat healthfully, if foods and beverages do not taste good, consumers will not buy them. Nearly nine in 10 Americans (86%) say taste impacts their food and beverage purchase decisions. Low-calorie sweeteners offer a win-win solution for consumers--they add desirable, sweet taste without adding calories, allowing consumers to enjoy food without overloading. Those trying to lose weight do not have to eliminate sweets. The same goes for children, who can be picky eaters. Low-calorie, sweetened foods and beverages can be included as part of a healthful diet and exercise plan that helps keep kids' calories in check, curbing weight gain.

Similarly, low-calorie sweeteners offer an option for people with diabetes who must monitor their carbohydrate intake. Low-calorie sweeteners are very low in carbohydrates and do not contain sugar, both of which affect insulin levels. The old rule that diabetics have to stay away from sweets no longer applies. They can have their cake and eat it, too.

Food Education is Key
It is clear low-calorie sweeteners have many positive roles to play in consumers' diets: 1) They offer an easy way to reduce calories consumed in the diet, which has been demonstrated to lead to weight loss; 2) They offer an appealing taste, so consumers do not have to give up their favorite foods to lose weight; and 3) Their safety has been confirmed, time after time, in the scientific literature.

What can be done to improve utilization of this effective ingredient that has so much potential? Food industry professionals should do a better job of educating consumers about the science on low-calorie sweetener safety; what calories are and how to count them; and how calories and weight are related. Government officials, health professionals, academia, opinion leaders and journalists need to communicate clear and consistent messages about the safety and efficacy of low-calorie sweeteners as part of a healthful diet and exercise program. While that may be easier said than done, it is critical to use all the tools available to achieve weight management goals and help reduce obesity levels in the U.S. pf

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