New research from Deakin University has assessed the amount of sugars and non-nutritive sweeteners (NNS) used globally and unsurprisingly perhaps, found the use of NNS has increased significantly. 

Study methods

The research examined Euromonitor sales data from 2007 to 2019 and measured the added sugars in kilograms and grams of NNS sold in foods and beverages globally (in eighty countries) and made comparisons between regions and income categories. This data was also compared with policy actions targeting added sugar consumption. Being sales data, it cannot reliably measure consumption but is rather a proxy for intake.

Added sugars and non-nutritive sweetener use

Between 2007-2019:

• Sugars sold in beverages decreased by 22% in high income countries and increased by 13% in upper-middle countries. 
• Non-nutritive sweetener from beverages increased by 36% per capita globally, and increased by 48% in high income countries, primarily in flavoured water and carbonated drinks.
• Sorbitol was the sweetener with the highest per capita global sales (technically this is a nutritive sweetener because it still provides some kilojoules). This is likely to be because it is not very sweet compared to sucrose and more is needed to sweeten products.
• The highest growth was achieved by stevia, followed by erythritol, and then sucralose.
• Added sugars from packaged foods sales has increased by 9% globally but remained steady in high-income countries.
• Non-nutritive sweeteners in packaged foods increased slightly globally (by 3%) but decreased slightly (by 4%) in high-income countries. 
• In beverages, the ratio of added sugars to NNS has decreased by 20% globally and decreased by 90% in high income countries, indicating a replacement of added sugars with NNS.
• In packaged foods, the ratio of added sugars to NNS has remained stable globally and in all regions

The influence of policy

• Policy actions included sugar sweetened beverage taxation (the most prolific), food standards in public institutions and labelling regulations.
• Regions with the most policy actions were Europe, Central Asia, Latin America and the Caribbean.
• There was no association between the number and type of policy action and the amount of sugar sold in packaged food or beverages.
• Countries with more policy actions around added sugars in beverages (such as sugar sweetened beverage taxes, reformulation) had greater increases in NNS use.
• There is less policy action around added sugars in foods.
• In the U.S.A. just prior to the introduction of added sugar labelling, there was a jump in the sales of NNS. Australia and New Zealand are currently considering added sugar labelling (including ‘added sugars’ in the Nutrition Information Panel).

Is our food getting sweeter?

• Total sweetness from beverages (calculated by the amount of sweetener relative to the sweetness of sucrose) decreased. This was likely due to the highest beverages sales occurring in high income countries, and the reduction in added sugars in beverages in these countries
• The overall sweetness of packaged foods increased (0.4kg/capita), primarily from added sugars content, although this was mostly from low-upper middle-income countries and limited in high-income countries.

What this means for Australia and New Zealand

• Being a high-income country, Australia and New Zealand have experienced a decrease in the use of added sugars in beverages an increase in the use of NNS. The data collected in this global study is consistent with Australian research.

Is the switch from sugar to NNS a good thing?

Low-sugar consumption may not translate to better diets overall. The authors suggest there may be unintended consequences to the replacement of added sugars with NNS.

• The possibility of adverse health outcome of NNS use.
• The possibility of shifting to sweeter taste preferences.
• The ‘health halo’ of NNS in discretionary foods may encourage their consumption.

The authors recommend the use of NNS be monitored in national dietary surveys and evaluated to determine any contribution to the global burden of disease.