{"id":17071,"date":"2019-05-09T09:56:43","date_gmt":"2019-05-09T13:56:43","guid":{"rendered":"http:\/\/caloriecontrol.org\/?p=17071"},"modified":"2019-06-06T17:15:15","modified_gmt":"2019-06-06T21:15:15","slug":"calorie-control-council-statement-on-paho-nutrient-profile-model","status":"publish","type":"post","link":"https:\/\/caloriecontrol.org\/calorie-control-council-statement-on-paho-nutrient-profile-model\/","title":{"rendered":"Calorie Control Council Statement on PAHO Nutrient Profile Model"},"content":{"rendered":"\n

The Pan American Health Organization (PAHO) Nutrient Profile model<\/a> was published in 2016 and proposed new criteria to define \u201cexcessive\u201d levels of sugar, salt, and fat in processed food and drinks. The purpose of this model is to provide a tool that can be used in the design and implementation of policies related to the prevention and control of obesity\/overweight, including restriction in the marketing of unhealthy foods and beverages to children, the regulation of school food environments (feeding programs and food and beverages sold in schools), the use of front-of-package (FOP) warning labels, the definition of taxation policies to limit consumption of unhealthy food and the identification of foods to be provided by social programs to vulnerable groups.<\/p>\n\n\n\n

Portugu\u00eas <\/a><\/div>\n\n\n\n
Espa\u00f1ol <\/a><\/div>\n\n\n\n

Regarding sugar, PAHO claims \u201cthe best scientific evidence available\u201d was reviewed in order to classify processed and ultra-processed foods and beverages as having “excessive” amounts of sugar if the amount of added sugars is 10% or more of total calories. Additionally, the model specifies that products whose ingredients include artificial or natural non-caloric or caloric sweeteners should be defined as “containing other sweeteners\u201d, which should be limited or avoided.<\/p>\n\n\n\n

The recommendation to limit\nor avoid non-nutritive sweeteners (NNS) as part of the WHO\/PAHO sugar reduction\nrecommendations is problematic, as this disregards the established benefits and\nsafety of these ingredients and discourages the use of products that can be an\nimportant tool in weight management and addressing certain diseases. <\/p>\n\n\n\n

<\/div>\n\n\n\n

NNS and Weight Management<\/strong><\/h4>\n\n\n\n
\"\"<\/a>
The role of low-calorie sweeteners in the prevention and management of overweight and obesity<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n

The PAHO Nutrient Profile\nModel cites literature<\/a>\nreporting a proportional increase in sugar-sweetened beverage sales and the\ngeneral population\u2019s average body mass index (BMI) in Latin America. This claim\nnot only highlights just one component of the total diet, it fails to address\nthe large of body of evidence<\/a>\nsuggesting the role of NNS in reducing energy intake and body weight. Following\na thorough analysis and review of available evidence, the 2018 Ibero-American\nConsensus<\/a> concluded that the use of NNS in weight reduction programs\ninvolving the replacement of caloric sweeteners with NNS in the context of\nstructured diet plans may favor sustainable weight reduction.<\/p>\n\n\n\n

Further, a 2019\nsystematic review and meta-analysis<\/a> of randomized controlled trials\nfound no significant differences in change in body weight between adults receiving\nNSSs compared with those receiving different sugars or placebo. This finding\nsuggests that there are other elements of the diet or lifestyle factors that\nmay attribute the weight gain. Furthermore, studies<\/a>\nhave also shown that the effect of consuming beverages sweetened with NNS on weight loss<\/a>\nis similar to that of drinking water. Suggesting products containing NNS have\nthe same impact on BMI as sugar-sweetened products is not supported by the\ntotality of available scientific evidence and ultimately deprives consumers of\na useful and science-supported tool to help manage weight.<\/p>\n\n\n\n

<\/div>\n\n\n\n

NNS and Diabetes Management<\/strong><\/h4>\n\n\n\n
\"\"<\/a>
Low and No Calorie Sweeteners, Glycemia and Diabetes: What Does the Science Say?<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n

When substituted for sugar, not\nonly do NNS have the potential to aid in achieving and maintaining a healthy weight,\nthey can also be used to manage blood glucose levels by those with diabetes. A\n2017 review<\/a>\nof current research on sucralose upheld the findings of previous reviews and\nreported that, given that sucralose is not digested or metabolized for energy,\nit provides no calories and does not affect blood glucose levels. Therefore, foods\nand beverages that contain sucralose are suitable for persons with diabetes or\nthose aiming to reduce calorie or carbohydrate intake.<\/p>\n\n\n\n

From an international\nstandpoint, following a thorough review of available scientific literature, the\nEuropean Food Safety Authority (EFSA) Panel on Dietetic Products Nutrition and\nAllergies concluded that replacing sugar-containing foods with those containing\nNNS induces a lower blood glucose rise following consumption. The 2018\nIbero-American Consensus concluded that the use of NNS in diabetes management\nprograms may contribute to a better glycemic control in patients. Lastly, the\nEuropean Commission based their authorization of a health claim<\/a>\nregarding NNS and post-prandial glucose on this finding. <\/p>\n\n\n\n

<\/div>\n\n\n\n

The Safety of NNS<\/strong><\/h4>\n\n\n\n

International scientific\norganizations and regulatory agencies, including the Joint\nFAO\/WHO Expert Committee of Food Additives<\/a> (JECFA), US\nFood and Drug Administration<\/a> (FDA), and European Food\nSafety Authority<\/a> (EFSA) have extensively reviewed NNS and have\nrecognized their safety. A 2017 scoping review<\/a>\nof the safety and association of NNS and certain health outcomes found no\nconclusive evidence of the harmful effect of NNS use. <\/p>\n\n\n\n

\"\"<\/a>
Safety and Benefits of Low or No Calorie<\/strong> Sweeteners<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n

The WHO\/PAHO position to limit or avoid NNS or non-nutritive sweeteners as part of their sugar reduction recommendations implies that these sweeteners contribute to obesity and diabetes when, in fact, the beneficial effects are largely due to the replacement of sugar in diet. As a result, NNS should be recognized as a tool in weight and diabetes management, not a hindrance. Recommending the reduction of ingredients with substantial evidence to support their safety and health benefits may actually result in unintended consequences, such as consumer confusion and the reduced availability of products important for the management of common diet-related diseases. As the current recommendations and subsequent national legislation may prove too restrictive to some consumers, they may opt to disregard the guidelines altogether and continue their consumption habits. We encourage WHO and PAHO to thoroughly review the scientific literature regarding NNS, reconsider their recommendations and ultimately promote the incorporation of these ingredients that can be used to help reduce caloric intake and manage body weight and blood glucose levels.<\/p>\n\n\n\n

<\/div>\n\n\n\n

References:<\/strong><\/p>\n\n\n\n

Gardner C, Wylie-Rosett J,\nGidding SS, Steffen LM, Johnson RK, Reader D and Lichtenstein AH. Nonnutritive\nSweeteners: Current Use and Health Perspectives. Circulation. 2012; CIR.0b013e31825c42ee<\/p>\n\n\n\n

Commission, European. (2012).\nCommission Regulation (EU) No 432\/2012 of 16 May 2012. Official Journal of the\nEuropean Union. 1-40.<\/p>\n\n\n\n

Lohner S, Toews I, Meerpohl\nJJ.  Health outcomes of non-nutritive\nsweeteners: analysis of the research landscape. Nutr J<\/em> 2017; 16: 55.<\/p>\n\n\n\n

Magnuson BA, Roberts A, and\nNestmann ER. Critical review of the current literature on the safety of\nsucralose.  Food Chem Toxicol<\/em> 2017 Aug;106 (Pt A):324-355. doi:\n10.1016\/j.fct.2017.05.047<\/p>\n\n\n\n

Nichol AD, Maxwell JH & Ruopeng\nA. (2018). Glycemic impact of non-nutritive sweeteners: a systematic review and\nmeta-analysis of randomized controlled trials. Eur J of Clin Nutr<\/em> 2018; 72. 10.1038\/s41430-018-0170-6.<\/p>\n\n\n\n

Pan American Health\nOrganization (PAHO) (2016) Pan American Health Organization Nutrient Profile\nModel. Washington, D.C.<\/p>\n\n\n\n

Peters JC, Wyatt HR, Foster\nGD, Pan Z, Wojtanowski AC, Vander Veur SS et al. The effects of water and\nnon-nutritive sweetened beverages on weight loss during a 12-week weight loss\ntreatment program. Obesity<\/em> 2014; 22:\n1415\u20131421.<\/p>\n\n\n\n

Rogers PJ, Hogenkamp PS, de\nGraaf C, Higgs S, Lluch A, Ness AR, Penfold C, Perry R, Putz P, Yeomans MR, et\nal. Does low-energy sweetener consumption a\ufb00ect energy intake and body weight?\nA systematic review, including meta-analyses, of the evidence from human and\nanimal studies. Int J Obes<\/em> (Lond)\n2016; 40:381\u201394.<\/p>\n\n\n\n

Serra-Majem L, Raposo A, Aranceta-Bartrina\nJ, Varela-Moreiras G, Logue C, Laviada H, Socolovsky S, P\u00e9rez-Rodrigo C, Aldrete-Velasco\nJ, Meneses Sierra E, et al. Ibero\u2013American Consensus on Low- and No-Calorie\nSweeteners: Safety, Nutritional Aspects and Bene\ufb01ts in Food and Beverages. Nutrients<\/em> 2018;10: 81<\/p>\n\n\n\n

Tate DF, Turner-McGrievy G,\nLyons E, Stevens J, Erickson K, Polzien K et al. Replacing caloric beverages\nwith water or diet beverages for weight loss in adults: main results of the\nChoose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial.\nAm J Clin Nutr<\/em> 2012; 95: 555-563<\/p>\n\n\n\n

Toews I, Lohner S, K\u00fcllenberg\nde Gaudry D, et al. Association between intake of non-sugar sweeteners and\nhealth outcomes: systematic review and meta-analyses of randomised and\nnon-randomised controlled trials and observational studies. BMJ<\/em>. 2019 Jan 2; 364:k4718. doi:\n10.1136\/bmj.k4718.<\/p>\n\n\n\n

Ultra-processed food and\ndrink products in Latin America: Trends, impact on obesity, policy\nimplications. Washington D.C.: Pan American Health Organization, 2015<\/p>\n","protected":false},"excerpt":{"rendered":"

The Pan American Health Organization (PAHO) Nutrient Profile model was published in 2016 and proposed new criteria to define \u201cexcessive\u201d levels of sugar, salt, and fat in processed food and drinks. The purpose of this model is to provide a tool that can be used in the design and implementation of policies related to the […]<\/p>\n","protected":false},"author":1,"featured_media":16623,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[179,56,1],"tags":[],"yoast_head":"\nCalorie Control Council Statement on PAHO Nutrient Profile Model - Calorie Control Council<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/caloriecontrol.org\/calorie-control-council-statement-on-paho-nutrient-profile-model\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Calorie Control Council Statement on PAHO Nutrient Profile Model - Calorie Control Council\" \/>\n<meta property=\"og:description\" content=\"The Pan American Health Organization (PAHO) Nutrient Profile model was published in 2016 and proposed new criteria to define \u201cexcessive\u201d levels of sugar, salt, and fat in processed food and drinks. 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