- Click here for explanation of classification scheme.

The intake of intense sweeteners are reviewed since the last review (Renwick, 1999) in chronological order of publication, with descriptions of the findings and strengths and weaknesses of the study design.

Published articles since last review of Renwick (1999).

Summary of Recent Studies On the Intake of Sweeteners

Reference	Date of Study	Subjects Studies	Design	Average Intake by Consumers (Percentage ADI)	Intake by High Consumers1 (Percentage ADI)	Conclusions
Leclercq et al, 1999	1996	212 teenagers (aged 13 to 19 years) in Italy	Prospective 14-day food diary with brand information	0.1% (Ace), 0.1% (Asp), 2.2% (Cyc) and 4.2 % (Sac)	1.5% (Ace), 1.0% (Asp), 5.6%(Cyc) and 10.6% (Sac)2	The pattens of sweetener intake were similar to previous publications and the intakes were well below the ADI
Wilson et al, 1999	Not stated	188 subjects (aged three to 74 years) in UK	Designed to validate the use of urinary excretion of acesulfame-K and of saccharin as biomarkers of intake	9% (Ace) and 14% (Sac)	Not reported	The mean intakes of acesulfame-K and saccharin were reported to be below their ADI values
Garnier-Sagne et al, 2001	1997	227 insulin-dependent diabetics (aged two to 20 years) in France	A five-day prospective food diary with the assumption that all sugar-free products contained the same sweetener	7% (Ace), 6% (Asp), 8% (Sac)	27%(Ace), 20%(Asp), 26% (Sac)	The study supports other studies in that intakes of acesulfame-K, aspartame and saccharin would not exceed their ADI values, even in the highest consumers
Food Standards Agency UK, 2003	2001	1,110 children (aged 1.5 to 4.5 years) in UK	A seven-day diary of beverage consumption, but brand information was not obtained	6% (Ace), 8% (Asp), 41% (Cyc) and 23% (Sac)	25%(Ace), 30%(Asp), 128% (Cyc) and 77% (Sac)	The results support other findings that it is only cyclamate where the ADI might be exceeded by the highest intakes in young children
Ilback et al, 2003	1999	243 diabetic children aged (zero to 15 years) and 547 adult diabetics (aged 16 to 90 years) in Sweden	A retrospetive food frequency questionnaire, maximum permitted concentration for each product category and assumed	Intakes were below ADI values for Ace, Asp, cyc and Sac, but the published data are difficult to interpret	45% (Asp), 114% (Cyc) and 46% (Sac) in adults and 115% (Asp), 317% (Cyc) and 126% (Sac) in children3	The data show that only cyclamate could have an intake above it's ADI
Serra-Majem et al, 2003	1994 to 1996	784 men (aged 30 to 50 years) in Spain	A retrospective food-frequency questionnaire designed to focus on cyclamate intake in relation to its metabolism	6% (Cyc)4	Not reported	The population probably has higher than average cyclamate use
Arcella et al, 2004	2000 to 2001	362 teenagers (aged 14 to 17 years), including 139 female high consumers of sugar-free soft drinks, in Italy	Three prospective four-day food diaries with brand information	0.3% (Ace), 0.2% (Asp), 4.5% (Cyc), 0.7% (Sac) in the female high consumers	0.7% (Ace), 0.4%(Asp), 4.5 (Cyc), 0.7% (Sac) in the female high consumers	The intakes are well below the ADI values
Devitt et al, 2004	Not stated	56 diabetic children (aged two to six years) in Canada	An interactive 24-hour dietary recall by the parents with food items identified from product labels	4%(Ace), 10% (Asp), 0% (Cyc), 9% (Sac) and 1% (Suc)	13%(Ace), 20% (Asp), 0%(Cyc) and 6% (Suc)	The intakes for all sweetners were well below their ADI values
Food Standards Australia New Zealand, 2004	2002 to 2003	298 diabetics and 299 non-diabetic subjects with high intakes of sugar-free products (aged 12 to over 60 years) in Australia and New Zealand	A prospective seven-day food diary that included brand information	3% (Ace), 6% (Asp), 27% (Cyc), 9% (Sac) and 3%(Suc)	9%(Ace), 19% (Asp), 85% (Cyc), 47% (Sac) and 15% (Suc)	The means and 95th percentile intakes were below the ADI values of the different sweeteners in the selected high consumers and diabetics, with the exception of cyclamate in diabetics, where the 95th percentile slightly exceeded the JECFA ADI value
van Rooij-van den Bos et al, 2004	1997 to 1998	National Food Survey on 6,250 subjects (aged one to 97 years) in the Netherlands	A prospective two-day food diary	<0.5% (Ace), <0.3% (Asp), 0.9% (Cyc) and 0.4% (Sac)	0.7% (Ace), 1.3% (Asp), 3.6% (Cyc) and 0.4% (Sac)	The mean and 95th percentile intakes were below the ADI values

1. 95th percentile intakes used for the consumer data except for Garnier-Sagne et al, 2001, (97.5th percentile of the theoretical maximum daily intake), FSA, 2003, (97.5th percentile) and Devitt et al, 2004, (ninth percentile)
2. Maximum reported intake
3. Intakes by the 10 children and 10 adults with the highest intakes (values read from published histograms)
4. The arithmetric mean of the median intakes reported for cases and controls, which include consumers. The maximum intake was reported to be less than the ADI; Ace-acesulfame, Ali-alitame, Asp-aspartame, cyc-cylcamate, Sac-saccharin, Suc-sucralose. The percentage ADI values are calculated using the ADIs established by the WHO/FAO Joint Expert Committee on Food Additives of 0-15 (Ace), 0-1 (Ali), 0-40 (Asp), 0-11 (Cyc), 0-5 (Sac) and 0-15 (Suc)mg per kg body weight per day.

• Studies on the intakes of intense sweeteners in different countries, published since the previous review in 1999, indicate that the average and 95th percentile intakes of acesulfame-K, aspartame, cyclamate and saccharin by adults are below the relevent acceptable daily intake (ADI) values
• Overal, there has not been a significant change in the intakes of sweeteners in recent years
• Fewer data are available for the newer sweeteners, sucralose and alitame
• The only data indicating that the intake of an intense sweetener could exceed its ADI value were the 95th percentile intakes of cyclamate in children, particularly with diabetes.

University/Hospital:

University of Southhampton