There is broad consensus in the medical and nutrition communities that the use of non-nutritive sweeteners could be a possible element in the medical nutrition therapy of TY1DM, as they have characteristic no or low-calorific value. They produce an intense sweet taste without effecting the glycaemic responses in the system, usually associated with the high energy content of calorific sweeteners (sugar). However, recent research suggests NNS can be associated with weight gain, increased T2DM risk, modify how body handles sugars, and recently suggested to cause glucose intolerance in the body by altering the gut microbiome. Although, EFSA has approved their consumption with a safe limit i.e. Acceptable Daily Intake (ADI), patients, especially Ty2DM and TY1DM children could have the highest risk of exceeding ADIs.
The current cross-sectional study aimed to (1) assess the intake of aspartame, cyclamate, acesulfame-k, neohesperidine dihydrochalcone, sucralose, saccharin, steviol glycosides and neotame among children with type 1 diabetes mellitus (T1D); (2) compare the obtained intakes with the respective acceptable daily intake (ADI) values, and (3) conduct a scenario analysis to obtain practical guidelines for a safe consumption of non-nutritive sweeteners (NNS) among children with T1D.
The study conducted a scenario analysis of TY1DM patients in the Paediatrics department of the University Hospitals Leuven in 242 children (1-18 years old). All the participants were invited to complete a food frequency survey that assesses NNS intake using tier-2 and tier-3 exposure assessment approach. The duration of the survey was 3 months. The survey reported that the estimated total intakes were higher in P95 consumers (highest consumption) for acesulfame-k, cyclamate, and steviol glycosides. Basis the scenario analysis, guidelines for each age category for diet soda, bread spreads, dairy drinks were created. The survey also suggested that there is little chance for T1D children to exceed their ADIs of different NNS, however diabetes educators and dieticians need to pay attention regarding the use of NNS.
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