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Sousa RCSD, Gloria MBA. Sweeteners in Brazilian processed foods and beverages: prevalence, profile and concomitant addition of sugars and nutritional claims. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2023; 40:1285-1297. [PMID: 37682688 DOI: 10.1080/19440049.2023.2255291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023]
Abstract
Brazil is experiencing an increased prevalence of overweight and obesity. To overcome these health problems, several strategies have been implemented, including incentives to reduce sugar intake and new packaging labeling. This has promoted an increase in the use of low or non-caloric sweeteners (LNCS). In this study, the use of LNCS in six Brazilian food groups (non-alcoholic beverages, dairy products, baked goods, confectionery, cereals, and condiments) was investigated through label declarations. Three supermarkets were visited in Belo Horizonte, MG, Brazil. Ten out of the 16 LNCS allowed by the Brazilian legislation were declared. Altogether, among the 441 products included, 17.7% contained at least one LNCS, with an average of 2.21 LNCS per sweetened product. Non-alcoholic beverages (37.2%) and dairy products (29.5%) had the highest LNCS occurrence. Combinations of two, three, four, and seven LNCS were found. Artificial sweeteners represented 87.8% of the declared LNCS, with a higher prevalence of acesulfame-K, followed by cyclamate, and sucralose, respectively. Meanwhile, 53.9% of 78 products containing LNCS also had added sugars, and 70.5% used nutritional claims about reduced sugars and/or calories. This scenario highlights the importance of continuous monitoring of LNCS in foods and beverages as front-of-package labeling is not fully implemented yet.
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Affiliation(s)
- Roberto Cesar Santos de Sousa
- Programa de Pós-Graduação em Ciência de Alimentos, Faculdade de Farmácia, Universidade Federal de Minas Gerais - UFMG, Belo Horizonte, MG, Brazil
| | - Maria Beatriz Abreu Gloria
- Programa de Pós-Graduação em Ciência de Alimentos, Faculdade de Farmácia, Universidade Federal de Minas Gerais - UFMG, Belo Horizonte, MG, Brazil
- Laboratório de Controle de Qualidade (LCQ), Departamento de Produtos Farmacêuticos, Faculdade de Farmácia, Universidade Federal de Minas Gerais - UFMG, Belo Horizonte, MG, Brazil
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Johnson Curtis C, Marklund M, Saxena A, Goyena E, P Desnacido J, Koon AD, Warren B, Cobb LK, E Henry M, Appel LJ, Angeles-Agdeppa I. Considerations for modelling a broad food tax in the Philippines and other low-income and middle-income countries. BMJ Glob Health 2023; 8:e012068. [PMID: 37813445 PMCID: PMC10565299 DOI: 10.1136/bmjgh-2023-012068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/14/2023] [Indexed: 10/13/2023] Open
Abstract
Fiscal policies to improve diet are a promising strategy to address the increasing burden of non-communicable disease, the leading cause of death globally. Sugar-sweetened beverage taxes are the most implemented type of fiscal policy to improve diet. Yet taxes on food, if appropriately structured and applied across the food supply, may support a larger population-level shift towards a healthier diet. Designing these policies and guiding them through the legislative process requires evidence. Equity-oriented cost-effectiveness analyses that estimate the distribution of potential health and economic gains can provide this critical evidence. Taxes on less healthy foods are rarely modelled in low-income and middle-income countries.We describe considerations for modelling the effect of a food tax, which can provide guidance for food tax policy design. This includes describing issues related to the availability, reliability and level of detail of national data on dietary habits, the nutrient content of foods and food prices; the structure of the nutrient profile model; type of tax; tax rate; pass-through rate and price elasticity. Using the Philippines as an example, we discuss considerations for using existing data to model the potential effect of a tax, while also taking into account the political and food policy context. In this way, we provide a modelling framework that can help guide policy-makers and advocates in designing a food policy to improve the health and well-being of future generations in the Philippines and elsewhere.
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Affiliation(s)
| | - Matti Marklund
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Akshar Saxena
- School of Social Sciences, Economics, Nanyang Technological University, Singapore
| | - Eva Goyena
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, Philippines
| | - Josie P Desnacido
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, Philippines
| | - Adam D Koon
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | - Megan E Henry
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Division of General Internal Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Imelda Angeles-Agdeppa
- Department of Science and Technology, Food and Nutrition Research Institute, Manila, Philippines
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Mais LA, Borges CA, Khandpur N, Duran AC, Martins APB. Brazil's nutrition labeling regulation: Challenges ahead on the path to guaranteeing consumer's right to adequate information. Front Nutr 2022; 9:921519. [PMID: 36483931 PMCID: PMC9724590 DOI: 10.3389/fnut.2022.921519] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 10/07/2022] [Indexed: 01/18/2024] Open
Affiliation(s)
- Laís Amaral Mais
- Brazilian Institute for Consumer Defense (Idec), São Paulo, Brazil
| | - Camila Aparecida Borges
- Center for Epidemiological Studies for Nutrition and Health, University of São Paulo (Nupens, USP), São Paulo, Brazil
- Center for Food Studies and Research, University of Campinas (NEPA, Unicamp), Campinas, Brazil
| | - Neha Khandpur
- Center for Epidemiological Studies for Nutrition and Health, University of São Paulo (Nupens, USP), São Paulo, Brazil
- Department of Nutrition, University of São Paulo (USP), São Paulo, Brazil
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Ana Clara Duran
- Center for Epidemiological Studies for Nutrition and Health, University of São Paulo (Nupens, USP), São Paulo, Brazil
- Center for Food Studies and Research, University of Campinas (NEPA, Unicamp), Campinas, Brazil
| | - Ana Paula Bortoletto Martins
- Brazilian Institute for Consumer Defense (Idec), São Paulo, Brazil
- Center for Epidemiological Studies for Nutrition and Health, University of São Paulo (Nupens, USP), São Paulo, Brazil
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Tomaz LA, Pereira CG, Braga LVM, Prates SMS, Silva ARCS, Soares APDC, de Faria NC, Anastácio LR. From the most to the least flexible nutritional profile: Classification of foods marketed in Brazil according to the Brazilian and Mexican models. Front Nutr 2022; 9:919582. [PMID: 36204372 PMCID: PMC9531871 DOI: 10.3389/fnut.2022.919582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022] Open
Abstract
Nutrient profiling is the science of classifying or ranking foods according to their nutritional composition, for reasons related to disease prevention and health promotion. To be effective, policies such as front-of-pack nutrition labeling (FoPNL) must have an adequate nutritional profile model, since it will determine which products will be eligible to receive a FoPNL. This study aimed to determine the percentage of packaged food and drink products available in Brazil that would be subject to FoPNL under two different legislations: Brazilian and Mexican. This is a cross-sectional study in which we collected information on food products (photos of the ingredients list, the front label, the barcode, and the nutrition facts table) from one of the largest stores of a supermarket chain in the city of Belo Horizonte-MG, Brazil, from March to May 2021 (~6 months after the publication of the Brazilian legislation about FoPNL and a year and a half before the legislation came into force). The products were classified in relation to the BNPM (added sugars, saturated fats, and sodium) and the MNPM (energy, free sugars, saturated fats, trans fats, sodium, non-sugar sweeteners, and caffeine). A total of 3384 products were collected and, after applying the exclusion criteria, 3,335 products were evaluated. Of these, 2,901 would be eligible to receive FoPNL in Brazil and 2,914 would be eligible to receive FoPNL in Mexico. According to the BNPM, 56.7% (95% CI 54.9; 58.5%) of the products were “high in” critical nutrients, 27.1% (95% CI 25.5; 28.7%) of the products in added sugars, 26.7% (95% CI 25.2; 28.4%) of the products in saturated fats, and 21.4% (95% CI 19.9; 22.9%) of the products in sodium. As for the MNPM, 96.8% (95% CI 96.1; 97.4%) of them were “high in” up to five critical nutrients and up to two warning rectangles (caffeine and non-sugar sweeteners), 45.8% (95% CI 44.0; 47.6%) of them in free sugars, 43.7% (95% CI 41.9; 45.5%) of them in saturated fats, and 47.9% (95% CI 46.1; 49.7%) of them in sodium. We concluded that the eligibility to receive FoPNL by BNPM and MNPM was relatively similar between products; however, almost all products would have at least one FoPNL and/or warning rectangles according to Mexican legislation, and nearly half of them would have at least one FoPNL, considering BNPM. The MNPM is much more restrictive than the BNPM. The Nutrient Profile Model (NPM) that regulates FoPNL, and other health policies, must be carefully defined to ensure that foods are properly classified according to their healthiness.
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Duarte LM, Ferreira SMR, Almeida CCB, Duran ACDFL, Grilo MF, Macedo MDS, Franceschini SDCC, Crispim SP. Dietary exposure to low-calorie sweeteners in a sample of Brazilian pregnant women. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2022; 39:1650-1662. [PMID: 35993876 DOI: 10.1080/19440049.2022.2112763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
The dietary exposure to low-calorie sweeteners (LCS) was estimated in a sample of pregnant Brazilian women. Consumption data were obtained with a 24-h Dietary Recall interview. Because of the uncertainty in assessing foods with LCS, they were classified into three scenarios to ensure inclusion of the 15 LCS allowed for use in Brazil: ranging from a less to a more conservative scenario. The concentration of LCS was estimated using the amount declared on the label or the maximum permitted levels and analytical determination data for table-top sweeteners. The frequency of consumption was higher for acesulfame-K, aspartame, and cyclamate. The food groups contributing the most to the consumption of LCS were non-alcoholic beverages, table-top sweeteners, confectionary and desserts. The level of dietary exposure to LCS was within the safety limit. However, continued efforts to monitor their dietary exposure are necessary given the limitations highlighted in this study.
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Affiliation(s)
- Larissa Marinho Duarte
- Postgraduate Program in Food and Nutrition - Federal University of Paraná - UFPR, Curitiba, Brazil
| | | | | | | | | | - Mariana de Souza Macedo
- Department of Nutrition, Faculty of Biological and Health Sciences, Federal University of Vales do Jequitinhonha and Mucuri, Diamantina, Brazil
| | | | - Sandra Patricia Crispim
- Postgraduate Program in Food and Nutrition - Federal University of Paraná - UFPR, Curitiba, Brazil
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Nutritional Description of Foods with Low- and No-Calorie Sweeteners in Spain: The BADALI Project. Nutrients 2022; 14:nu14132686. [PMID: 35807866 PMCID: PMC9268128 DOI: 10.3390/nu14132686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 12/10/2022] Open
Abstract
The use of low- and no-calorie sweeteners (LNCS) in foods has increased in recent years in response to the negative effects of free sugar on health. However, the health impact of LNCS is still unclear. Studies of the prevalence of LNCS in foods have been published previously, including in Spain. However, the use of health (HCs) and nutrition claims (NCs) to promote these foods and a full nutritional characterization are largely lacking. For this purpose, we used the BADALI database with 4218 foods present in the Spanish market. Our results show that 9.3% of foods have LNCS (including both intense and polyols). Sucralose and acesulfame K were the intense sweeteners most frequently used (52.4% and 48.2%, respectively), whereas maltitol was the preferred polyol (20.3%). Of all foods with LNCS, 30% also had added sugar. Many more foods with LNCS presented HCs and NCs than those without. Sugar was the nutrient most frequently claimed in NCs for LNCS-containing foods, whereas vitamins were for those without these sweeteners. NCs compliance with regulation was similar in both conditions (60.1% for foods without and 63.9% for foods with LNCS). As expected, foods with LNCS had less total sugar content and energy. Surprisingly, the nutrient profile of yogurts with LNCS changed completely: less total and saturated fat, whereas more proteins and sodium. Biscuits with LNCS contained more fibre. The results of our study reveal that the prevalence of LNCS is becoming high in some food types in Spain and that foods containing LNCS are more frequently promoted with HCs/NCs. In addition, it confirms the general reduction in energy and sugar content expected in foods with LNCS. Furthermore, it suggests a reformulation of products beyond sugar content.
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