Mariana Fagundes Grilo1, Lindsey Smith Taillie2, Camila Zancheta Ricardo3, Laís Amaral Mais4, Ana Paula Bortoletto Martins5, Ana Clara Duran6. 1. Graduate Program in Collective Health, School of Medical Sciences, University of Campinas, Campinas, Brazil. 2. University of North Carolina, Chapel Hill, North Carolina. 3. School of Public Health, University of Chile, Región Metropolitana, Chile. 4. Brazilian Institute for Consumer Defense, São Paulo, Brazil. 5. Brazilian Institute for Consumer Defense, São Paulo, Brazil; Center for Epidemiological Studies in Nutrition and Health, University of São Paulo, São Paulo, Brazil. 6. Graduate Program in Collective Health, School of Medical Sciences, University of Campinas, Campinas, Brazil; Center for Food Studies and Research, University of Campinas, Campinas, Brazil; Center for Epidemiological Studies in Nutrition and Health, University of São Paulo, São Paulo, Brazil. Electronic address: anaduran@unicamp.br.
Abstract
BACKGROUND: Low-calorie sweeteners (LCSs) are increasingly being used worldwide, including in foods and beverages commonly consumed by children. OBJECTIVE: To examine the prevalence of LCSs in packaged foods and beverages sold in Brazil, whether LCSs are added to products with advertising directed to children, and whether foods and beverages with LCSs include front-of-package (FoP) LCS-related health and nutrition claims. DESIGN: Cross-sectional study. SETTING: A sample (n = 11,434) of packaged foods and beverages sold by the top 5 largest Brazilian food retailers was examined to identify LCSs and added sugars, and a subsample (n = 3491) was examined to determine the presence of advertising directed to children and FoP LCS-related claims in foods and beverages with LCSs. MAIN OUTCOME AND MEASURES: The prevalence of foods and beverages with different types of LCSs in the Brazilian food supply, among ultra-processed foods and beverages and among foods and beverages with added sugars, were measured. Foods and beverages with advertising directed to children were checked to see if these products had LCSs and how many products with LCSs had FoP labels with LCS-related claims. STATISTICAL ANALYSES: Mean and 95% CIs were used to determine the overall prevalence of foods and beverages with LCSs and in the different assessed stratifications. RESULTS: The prevalence of LCSs was 9.3% (95% CI 8.8-9.9) in Brazilian packaged foods and beverages, 14.6% (95% CI 13.8-15.4) in ultra-processed products alone, and 5.7% (95% CI 4.2-7.7) in foods and beverages with advertising directed to children. About 83% of food and beverage with LCSs were also sweetened with added sugars. LCSs were most frequently added to nonalcoholic sweetened beverages, breakfast cereals, and granola bars. Forty percent of foods and beverages with LCS did not present any FoP LCS-related claim. CONCLUSION: This study shows that LCSs are present in 15% of ultra-processed foods and beverages in Brazil, largely used in combination with added sugars, and are found in foods and beverages with advertising directed to children. Clearer FoP information regarding the presence of LCSs, in particular in products with advertising directed to children, can help consumers make more informed choices regarding LCS consumption.
BACKGROUND: Low-calorie sweeteners (LCSs) are increasingly being used worldwide, including in foods and beverages commonly consumed by children. OBJECTIVE: To examine the prevalence of LCSs in packaged foods and beverages sold in Brazil, whether LCSs are added to products with advertising directed to children, and whether foods and beverages with LCSs include front-of-package (FoP) LCS-related health and nutrition claims. DESIGN: Cross-sectional study. SETTING: A sample (n = 11,434) of packaged foods and beverages sold by the top 5 largest Brazilian food retailers was examined to identify LCSs and added sugars, and a subsample (n = 3491) was examined to determine the presence of advertising directed to children and FoP LCS-related claims in foods and beverages with LCSs. MAIN OUTCOME AND MEASURES: The prevalence of foods and beverages with different types of LCSs in the Brazilian food supply, among ultra-processed foods and beverages and among foods and beverages with added sugars, were measured. Foods and beverages with advertising directed to children were checked to see if these products had LCSs and how many products with LCSs had FoP labels with LCS-related claims. STATISTICAL ANALYSES: Mean and 95% CIs were used to determine the overall prevalence of foods and beverages with LCSs and in the different assessed stratifications. RESULTS: The prevalence of LCSs was 9.3% (95% CI 8.8-9.9) in Brazilian packaged foods and beverages, 14.6% (95% CI 13.8-15.4) in ultra-processed products alone, and 5.7% (95% CI 4.2-7.7) in foods and beverages with advertising directed to children. About 83% of food and beverage with LCSs were also sweetened with added sugars. LCSs were most frequently added to nonalcoholic sweetened beverages, breakfast cereals, and granola bars. Forty percent of foods and beverages with LCS did not present any FoP LCS-related claim. CONCLUSION: This study shows that LCSs are present in 15% of ultra-processed foods and beverages in Brazil, largely used in combination with added sugars, and are found in foods and beverages with advertising directed to children. Clearer FoP information regarding the presence of LCSs, in particular in products with advertising directed to children, can help consumers make more informed choices regarding LCS consumption.
Authors: Meghan B Azad; Ahmed M Abou-Setta; Bhupendrasinh F Chauhan; Rasheda Rabbani; Justin Lys; Leslie Copstein; Amrinder Mann; Maya M Jeyaraman; Ashleigh E Reid; Michelle Fiander; Dylan S MacKay; Jon McGavock; Brandy Wicklow; Ryan Zarychanski Journal: CMAJ Date: 2017-07-17 Impact factor: 8.262