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Consumption of Intense Sweeteners in Australia and New Zealand

Benchmark Survey

February 2004

The parameters of the latest research, however, were extended to include investigation of the consumption patterns and exposure to intense sweeteners of Australians aged 40 years and over, as well as of the New Zealand population. In addition, there was a supplementary diary survey of people with diabetes or impaired glucose tolerance.

Helpful Hint:Opening or downloading a PDF file

Full Report [ pdf 1069 kb ]

Executive summary

1.   Introduction     [ pdf 149 kb ]

1.1 Background

1.2   Key Features of the Code in Relation to Intense Sweeteners

1.3   Research Objectives

2.    Methodology     [ pdf 207 kb ]

2.1   Screener Survey

2.2   Diary Survey

2.3   Supplementary Diary Survey of People with Diabetes / Impaired Glucose Tolerance

3.    Key findings – Screener survey     [ pdf 244 kb ]

3.1   Patterns of Consumption

3.2   Summary of Screener Survey Findings

4.    Key findings - Diary Survey [ pdf 216 kb ]

4.1   Exposure to Intense Sweeteners

4.2   Contribution of Each Food Group to Intense Sweetener Exposures

4.3   Comparison of Intense Sweetener Exposure with Acceptable Daily Intake

4.4   Summary of Diary Survey Findings

5.    Key findings - Diary Survey of people with Diabetes or Impaired Glucose Tolerance    [ pdf 148 kb ]

5.1   Exposure to Intense Sweeteners

5.2   Contribution of Each Product Group to Intense Sweetener Exposures

5.3   Comparison of Intense Sweetener Exposure with Acceptable Daily Intake

5.4   Summary of Diary Findings – People with Diabetes/Impaired Glucose Tolerance

6.    Conclusions & Recommendations

List of References

Appendixes [ pdf 523 kb ]

Executive Summary

Background

Food additives permitted for use in the Australian and New Zealand food supply are identified in the joint Australia New Zealand Food Standards Code (‘the Code’). In December 2000 the Code was adopted to replace both the Australian Food Standards Code and relevant New Zealand Food Regulations, although the standard covering food additives (Standard 1.3.1) was in place before December 2000. There was a two-year transition period before the new Code became fully implementable from 20 December 2002. Standard 1.3.1of the Code permits eight intense sweeteners to be used - cyclamate, saccharin, aspartame, acesulphame-K, sucralose, alitame, neotame and thaumatin.

In 1994, the then National Food Authority commissioned Roy Morgan Research to undertake preliminary research into intense sweetener consumption patterns in Australia. The aims of that research were to provide baseline data for 12 to 39 year old Australians on exposure to the intense sweeteners cyclamate, saccharin, aspartame and acesulphame-K and to identify sub-groups of the population who may have been at risk of exceeding the Acceptable Daily Intake (ADI) [1] for individual intense sweeteners. Dietary exposure was estimated by combining survey data on individual respondents’ weekly consumption of different foods with data on the level of intense sweetener in each food. Neither alitame nor sucralose exposure were included in that survey as there were few products containing these two intense sweeteners available in the market at that time. In the 1994 study, high consumers of saccharin and cyclamate had exposures to these sweeteners that approached or exceeded their respective ADIs.

The present research forms part of Food Standards Australia New Zealand’s (FSANZ) Evaluation Strategy 2001-2003, designed to assess the impact of implementing the Code (FSANZ 2001). This study uses the 1994 research as baseline data on Australians’ dietary exposure to intense sweeteners. The parameters of the latest research, however, were extended to include investigation of the consumption patterns and exposure to intense sweeteners of Australians aged 40 years and over, as well as of the New Zealand population. In addition, there was a supplementary diary survey of people with diabetes or impaired glucose tolerance.

Methodology

The present research comprised the following three survey groups in both Australia and New Zealand:

a national telephone (screener) survey of all respondents aged 12 years and over, to determine patterns of consumption of twelve key food groups containing intense sweeteners and to screen respondents in order to select apparent high consumers of these products;
a diary survey of potential high consumers of products containing intense sweeteners, selected from the screener survey, to estimate their exposure to individual intense sweeteners; and
a supplementary diary survey of people with diabetes or impaired glucose tolerance to estimate their exposure to individual intense sweeteners.

In total, 3,529 people were interviewed as part of the screener survey; 2,514 in Australia and 1,015 in New Zealand. The screener survey sample was weighted to represent the overall population distribution in each country. All interviews were administered by computer assisted telephone interviewing (CATI). The fieldwork was conducted over two phases from 30August – 16September 2002, and 17January – 7February 2003. This phased approach to the screener survey provided more seasonally representative data and also allowed greater control over the sampling methodology, so that any under-representations in the sampling for the initial phase could be remedied in the second phase.

Exactly 400 respondents to the screener survey (263 in Australia and 137 in New Zealand), who were identified as potential high consumers of the products containing intense sweeteners, accepted and completed a 7-day diary. Consumption patterns recorded for these consumers may therefore be different to those of the population as a whole. These high consuming respondents included 111 respondents with diabetes or impaired glucose tolerance. A further 187 diabetics or those with impaired glucose tolerance were recruited from other sources to participate in a supplementary 7-day diary survey. Therefore, in total 298 people (223 in Australia and 75 in New Zealand) with either medical condition completed a diary.

Summary of Findings – Screener Survey

From the screener survey it was clear that there were several population groups who were more likely than others to have consumed products containing intense sweeteners. These sub-groups included females, people with diabetes and those on a weight control diet. In terms of age, the younger age groups were significantly more likely to be consumers of cordials, fruit drinks, flavoured milks and confectioneries containing intense sweeteners. At the other end of the age spectrum, those aged 60 years and over were significantly more likely to have consumed jams and canned fruits containing intense sweeteners, as well as tabletop intense sweeteners.

Very few differences were evident between Australia and New Zealand in the proportions of the populations consuming products containing intense sweeteners. New Zealand respondents, however, were more likely than their Australian counterparts to have consumed fruit drinks, canned fruits and jams containing intense sweeteners.

Likewise, the mean daily consumption amongst actualconsumersof the various products containing intense sweeteners differed very little between Australia and New Zealand (consumers are those respondents who actually consumed from a particular product group – see Appendix 22 for a glossary of terms used in this report). However, the mean daily amount of fruit drinks consumed containing intense sweeteners was higher in New Zealand, while the mean daily consumption of flavoured yoghurts containing intense sweetener was higher in Australia.

Overall, the mean daily consumption of products containing intense sweeteners was significantly higher for people with diabetes and those on a weight control diet. A similar finding was evident in the 1994 survey. On the other hand, the sugar sweetened versions of the products tended to be consumed in larger amounts by those without diabetes or not on such diets.

In comparison with the 1994 survey, which focused solely on 12-39 year old Australians, there has been a significant increase in the average daily amount of carbonated soft drinks containing intense sweeteners consumed amongst Australian consumers aged 12-39 years. Significant increases were also evident for cordials, flavoured yoghurts/mousses (both particularly amongst Australian male consumers) and flavoured milks (amongst Australian female consumers) containing intense sweeteners. More Australians now consume intense sweetened cordials than in 1994 but fewer consume sugar sweetened cordials and sugar sweetened carbonated soft drinks. Overall, more Australians now consume foods containing intense sweetener (66%) than in 1994 (51%).

Summary of Findings – Diary Surveys

It is evident from the diary surveys that the mean consumer exposures to all sweeteners measured were well below the ADI for each sweetener. This applied in both Australia and New Zealand, both among those respondents selected from the screener survey as potential high consumers of products containing intense sweeteners, and among those with either diabetes or impaired glucose tolerance who were recruited independently.

The estimated mean daily exposure to acesulphame-K amongst 12-39 year old Australian consumers (ie those who were exposed to the sweetener during the 7-day diary period) has increased significantly since 1994.

The mean daily exposure to intense sweeteners amongst respondents with diabetes and those with impaired glucose tolerance living in Australia was significantly higher, though, than for their counterparts living in New Zealand. This was particularly the case for aspartame, cyclamate and saccharin.

However, it is interesting to note that, the estimated mean daily consumer exposure amongst those with diabetes or impaired glucose tolerance (in both Australia and New Zealand), did not differ significantly from the main diary consumers who did not have either of these medical conditions.

As a percentage of the respective ADI, cyclamate exposure was the highest of all the intense sweeteners measured. This was particularly the case amongst the small number of 12-17 year olds recruited from the screener survey who completed a diary. Furthermore, there were some consumers who exceeded the ADI for cyclamate at the 95^th percentile exposure level. The products which contributed most to cyclamate exposure were cordials, fruit drinks, carbonated soft drinks (and tabletop sweeteners in New Zealand).

Tabletop sweeteners containing cyclamate were permitted in New Zealand, but not Australia, until the Code became enforceable in both countries from 20 December 2002. Under stock-in-trade provisions, these tabletop sweeteners could still be available for sale during 2003. Therefore at the time of the survey, such cyclamate-containing products could still have been available but will not be available for sale in the near future. Similarly, at the time of the survey, it was still possible to buy cordials and soft drinks containing higher levels of saccharin and cyclamate than are now permitted under the Code for products manufactured after 20 December 2002.

Key Findings:

Mean exposure to all intense sweeteners surveyed was below their ADI;
Acesulphame K exposure (mg/day) has increased in Australia since 1994;
Exposure in relation to each ADI was highest for cyclamate with some consumers exceeding the cyclamate ADI;
Cordials, fruit drinks and carbonated soft drinks were the major contributors to cyclamate exposure;
Consumption amounts of carbonated soft drinks and yoghurts/mousses containing intense sweeteners has increased in Australia since 1994;
Women, diabetics and those on weight control diets were more likely to use foods containing intense sweeteners;
Diabetics and those with impaired glucose tolerance who consume foods containing intense sweeteners were not exposed to higher amounts of intense sweeteners than consumers who have neither of these medical conditions.

[1] ADI or Acceptable Daily Intake is the amount of a food additive that can be ingested daily over an entire lifetime without any appreciable risk to health. It is expressed in units of milligrams per kilogram of bodyweight per day (mg/kg bw/day). Food regulators aim to set food standards to ensure a population’s exposure to food additives does not exceed the ADI. However occasional exposure above the ADI does not necessarily indicate a health risk as ADIs incorporate substantial safety margins.