Low- and no-calorie sweetener intakes from beverages – an up-to-date assessment in four regions: Brazil, Canada, Mexico and the United States

Figures & data

Table 1. Percent presence, weighted average and highest reported use levels of LNCS (AceK, Aspartame, Steviol Glycosides, Sucralose) in four jurisdictions by Codex GSFA Category for each LNCS-sweetened beverage type, as utilised in exposure assessment models.

	AceK
LNCS beverage types (Codex GSFA Category)^a	Brazil			Canada			Mexico			United States
	Percent presence (%)^b	Avg.^c,d	Max.^d	Percentage of presence (%)^b	Avg.^c,d	Max.^d	Percentage of presence (%)^b	Avg.^c,d	Max.^d	Percentage of presence (%)^b	Avg.^c,d	Max.^d
CSDs (14.1.4)	83	123	160	98	85	141	99	144	275	88	106	184
Fruit juice-based drinks, including concentrates/mixes (14.1.4)	0	0	0	24	25	103	100	92	92	57	57	169
Sports drinks (14.1.4)	0	0	0	100	36	36	100	26	26	97	33	49
Energy drinks (14.1.4)	62	45	80	87	96	227	100	59	80	95	167	227
RTD coffee (14.1.4)	n.a.	n.a.	n.a.	100	84	84	7	6	84	0	0	0
RTD tea (14.1.4)	59	55	154	99	133	154	31	15	51	89	67	144
Flavoured water drinks (14.1.4)	100	81	81	89	46	58	7	4	54	60	33	58
Powdered fruit drinks (14.1.4.3)	100	69	69	100	52	52	100	177	208	100	52	58
Fruit nectar (14.1.3.1)	78	31	40	100	129	160	0	0	0	n.a.	n.a.	n.a.
	Aspartame
CSDs (14.1.4)	82	104	347	99	325	517	98	252	579	96	285	567
Fruit juice-based drinks, including concentrates/mixes (14.1.4)	0	0	0	25	58	237	0	0	0	34	86	526
Sports drinks (14.1.4)	0	0	0	0	0	0	0	0	0	0	0	0
Energy drinks (14.1.4)	0	0	0	14	28	200	28	56	200	25	51	200
RTD coffee (14.1.4)	n.a.	n.a.	n.a.	0	0	0	0	0	0	0	0	0
RTD tea (14.1.4)	21	44	210	1	7	561	13	34	561	62	168	561
Flavoured water drinks (14.1.4)	100	315	315	89	62	70	0	0	0	19	12	70
Powdered fruit drinks (14.1.4.3)	100	417	417	100	254	254	100	322	465	56	142	254
Fruit nectar (14.1.3.1)	0	0	0	0	0	0	0	0	0	n.a.	n.a.	n.a.
	Steviol Glycosides
CSDs (14.1.4)	0	0	0	0	0	0	1	<1	25	0	0	0
Fruit juice-based drinks, including concentrates/mixes (14.1.4)	0	0	0	0	0	0	0	0	0	22	4	17
Sports drinks (14.1.4)	0	0	0	0	0	0	0	0	0	0	0	0
Energy drinks (14.1.4)	0	0	0	0	0	0	0	0	0	0	0	0
RTD coffee (14.1.4)	n.a.	n.a.	n.a.	0	0	0	0	0	0	0	0	0
RTD tea (14.1.4)	0	0	0	4	<1	10	89	29	57	32	9	33
Flavoured water drinks (14.1.4)	0	0	0	100	77	82	0	0	0	67	59	115
Powdered fruit drinks (14.1.4.3)	0	0	0	0	0	0	2	1	28	0	0	0
Fruit nectar (14.1.3.1)	0	0	0	0	0	0	0	0	0	n.a.	n.a.	n.a.
	Sucralose
CSDs (14.1.4)	1	2	179	3	5	242	6	8	209	64	93	219
Fruit juice-based drinks, including concentrates/mixes (14.1.4)	68	273	400	28	42	146	100	188	188	71	102	176
Sports drinks (14.1.4)	100	250	250	93	175	188	100	88	88	98	64	88
Energy drinks (14.1.4)	100	141	207	83	168	250	96	147	230	66	161	279
RTD coffee (14.1.4)	n.a.	n.a.	n.a.	100	97	97	100	81	97	0	0	0
RTD tea (14.1.4)	100	103	150	99	105	128	50	38	200	91	122	208
Flavoured water drinks (14.1.4)	0	0	0	89	86	96	100	152	152	70	65	105
Powdered fruit drinks (14.1.4.3)	0	0	0	81	119	147	2	2	76	33	69	216
Fruit nectar (14.1.3.1)	67	81	120	100	101	144	94	160	170	n.a.	n.a.	n.a.

AceK: Acesulfame potassium; Avg: average; CSDs: carbonated soft drinks; GSFA: General Standard for Food Additives; LNCS: low- and no- calorie sweeteners; Max.: maximum; RTD: ready-to-drink; n.a.: not available.

^aBeverage types as defined by industry.

^bPercentage market volume penetration by a specific LNCS within a given LNCS-sweetened beverage type based on presence (either according to labels or manufacturers’ confirmation of use). These values have been weighted according to the market volume share of the available brands in the specific jurisdiction.

^cMarket volume-weighted average use level of LNCS in LNCS-sweetened beverage type.

^dmg kg⁻¹.

Table 2. Percent consumers^a of individual LNCS-sweetened water-based flavoured drinks by population group in four regions.

	n	Percent consumers (%)^b
		LNCS- CSDs	LNCS- flavoured water drinks	LNCS-fruit juice-based drinks	LNCS- powdered fruit drinks	LNCS- nectars	LNCS- energy drinks	LNCS- sports drinks	LNCS- RTD tea	LNCS- RTD coffee	Any LNCS- sweetened water-based flavoured drink
CCHS-Nutrition (2015)
Toddlers (2–3 years)	137	0.1	0.6	0.0	0.0	0.0	0.0	0.0	0.0	n.a.	0.7
Older children (3–9 years)	762	3.1	0.8	0.5	0.1	0.0	0.0	0.1	0.0	n.a.	4.3
Adolescents (10–17 years)	1,426	4.6	1.2	0.9	1.3	0.0	0.0	0.0	0.0	n.a.	7.8
Adults (18–64 years)	2,084	10.6	1.1	0.6	0.5	0.0	0.5	0.1	0.0	n.a.	12.4
Elderly adults (65–74 years)	635	12.0	0.6	2.0	0.2	0.0	0.0	0.1	0.0	n.a.	14.4
Very elderly (75+ years)	557	5.5	0.5	0.4	0.0	0.0	0.0	0.0	0.0	n.a.	6.4
Total population (2+ years)	5,601	8.5	0.9	0.8	0.5	0.0	0.3	0.1	0.0	n.a.	10.4
Brazil, POF 2017–2018^c,d
Adolescents (10–17 years)	6,793	33.2	n.a.	5.2	2.9	0.3	0.1	n.a.	<0.1	n.a.	36.8
Adults (18–64 years)	33,666	25.4	n.a.	4.8	1.9	0.2	0.2	n.a.	<0.1	n.a.	29.3
Elderly adults (65–74 years)	3,451	15.5	n.a.	3.7	1.3	0.3	0.0	n.a.	0.0	n.a.	18.9
Very elderly (75+ years)	2,254	12.1	n.a.	4.5	0.9	0.5	0.0	n.a.	0.0	n.a.	16.8
Total population (10+ years)	46,164	25.2	n.a.	4.8	1.9	0.2	0.1	n.a.	<0.1	n.a.	29.0
Mexican ENSANUT (2018)^d
Children (2–11 years)	6,201	72.5	2.7	2.1	n.a.	31.2	n.a.	n.a.	18.8	n.a.	84.1
Adolescents (12–17 years)	4,351	79.7	2.8	2.7	n.a.	27.5	n.a.	n.a.	17.0	n.a.	87.3
Adults (18–64 years)	15,511	76.2	3.1	3.5	n.a.	14.1	n.a.	n.a.	25.4	n.a.	86.3
Elderly adults (65–74 years)	1,736	59.2	2.2	4.8	n.a.	8.0	n.a.	n.a.	32.2	n.a.	76.9
Very elderly (75+ years)	1,209	54.4	2.2	4.7	n.a.	10.3	n.a.	n.a.	32.6	n.a.	76.4
Total population (12+ years)	22,807	74.4	2.9	3.5	n.a.	16.1	n.a.	n.a.	24.7	n.a.	85.2
U.S. NHANES (2017–18)
Infants and toddlers (0–3 years)	599	0.1	1.8	1.8	1.2	n.a	0.0	0.2	0.4	0.0	5.0
Older children (3–9 years)	752	1.6	1.3	6.2	4.4	n.a	0.0	0.4	0.7	0.1	14.3
Adolescents (10–17 years)	933	4.1	0.7	1.3	2.7	n.a	<0.1	1.3	1.0	0.1	10.4
Adults (18–64 years)	3,253	9.1	2.0	1.6	1.8	n.a	1.2	1.3	2.2	0.4	17.4
Elderly adults (65–74 years)	625	18.2	1.5	3.6	4.0	n.a	0.1	0.5	5.7	1.2	28.0
Very elderly (75+ years)	421	17.9	1.8	1.7	3.2	n.a	0.0	0.9	4.7	0.3	26.7
Total population (0+ years)	6,583	9.0	1.7	2.2	2.4	n.a	0.7	1.1	2.3	0.4	17.5

LNCS: Low- and no-calorie sweeteners; CSDs: carbonated soft drinks; n: number of subjects (unweighted); RTD: ready-to-drink; n.a.: no food code available

^aConsumers were identified as individuals who reported consumption of any of the LNCS-sweetened beverage types during the dietary survey reporting period. For Brazil and Mexico, consumers of regular calorically sweetened beverage types were assumed to be surrogates for their LNCS-sweetened counterparts due to insufficient reporting for the latter.

^bWeighted values.

^cConsumption data only available for individuals over 10 years.

^dFor Brazil and Mexico, regular CSDs were used as surrogates for LNCS-CSDs, to reflect the anticipated pattern of consumption.

Table 3. Estimated daily exposure to LNCS (AceK, Aspartame, Steviol Glycosides, Sucralose) from water-based flavoured non-alcoholic beverages by subpopulation group in LNCS-sweetened beverage consumers^a only - probabilistic model.

Population Group	n	AceK							Aspartame							Steviol glycosides							Sucralose
		% cons.	mg kg^−1 bw day^−1			% JECFA ADI (15 mg kg^−1 bw day^−1)			% cons.	mg kg^−1 bw day^−1			% JECFA ADI (40 mg kg^−1 bw day^−1)			% cons.	mg kg^−1 bw day^−1			% JECFA ADI (4 mg kg^−1 bw day^−1)			% cons.	mg kg^−1 bw day^−1			% JECFA ADI (15 mg kg^−1 bw day^−1)
			Mean (SD)	P90	P95	Mean	P90	P95		Mean (SD)	P90	P95	Mean	P90	P95		Mean (SD)	P90	P95	Mean	P90	P95		Mean (SD)	P90	P95	Mean	P90	P95
Brazil, POF 2017–18^b,c
Adolescents (10–17 years)	6,793	35.3%	0.75 (0.62)	1.50	1.86	4.99%	9.99%	12.37%	35.0%	0.78 (0.81)	1.47	2.17	1.94%	3.67%	5.43%	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	36.8%	0.18 (0.49)	0.67	1.27	1.20%	4.45%	8.49%
Adults (18–64 years)	33,666	27.0%	0.52 (0.43)	1.03	1.31	3.43%	6.87%	8.73%	26.8%	0.53 (0.55)	1.04	1.49	1.31%	2.61%	3.72%	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	29.3%	0.15 (0.39)	0.58	0.97	1.01%	3.89%	6.45%
Elderly (65–74 years)	3,451	16.6%	0.39 (0.28)	0.72	1.02	2.60%	4.82%	6.80%	16.5%	0.43 (0.52)	0.80	1.10	1.08%	1.99%	2.76%	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	18.9%	0.17 (0.40)	0.57	1.03	1.10%	3.83%	6.89%
Very elderly (75+ years)	2,254	13.3%	0.42 (0.55)	0.77	1.14	2.81%	5.10%	7.61%	12.8%	0.44 (0.55)	0.94	1.54	1.10%	2.35%	3.85%	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	16.8%	0.19 (0.34)	0.62	0.93	1.25%	4.13%	6.23%
Total population (10+ years)	46,164	26.7%	0.55 (0.48)	1.10	1.46	3.67%	7.33%	9.70%	26.5%	0.57 (0.61)	1.16	1.60	1.42%	2.91%	4.01%	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	29.0%	0.16 (0.41)	0.60	1.02	1.06%	3.98%	6.81%
Canada, CCHS 2015
Toddlers (24–35 months)	137	0.7%	0.17^e (0.18)	0.26^f	0.43^g	1.11%^e	1.76%^f	2.85%^g	0.7%	0.45^e (0.77)	0.87^f	1.57^g	1.12%^e	2.17%^f	3.91%^g	0.6%	0.15^e (n.a)	0.15^f	0.15^g	3.70%^e	3.70%^f	3.70%^g	0.7%	0.14^e (0.05)	0.15^f	0.16^g	0.96%^e	0.99%^f	1.05%^g
Young children (3–9 years)	762	4.6%	0.29^e (0.20)	0.59^f	0.66^g	1.95%^e	3.95%^f	4.37%^g	4.4%	0.83^e (0.62)	1.43^f	2.20^g	2.07%^e	3.56%^f	5.49%^g	0.8%	0.74^e (0.09)	0.75^f	0.81^g	18.51%^e	18.87%^f	20.15%^g	4.6%	0.25^e (0.37)	0.80^f	0.88^g	1.64%^e	5.33%^f	5.86%^g
Adolescents (10–17 years)	1,426	9.0%	0.29 (0.20)	0.59	0.70^g	1.96%	3.94%	4.68%^g	9.0%	1.04 (0.86)	2.50	2.71^g	2.60%	6.25%	6.76%^g	1.2%	0.45^e (0.27)	0.73^f	0.82^g	11.35%^e	18.32%^f	20.43%^g	9.0%	0.20 (0.27)	0.48	0.82^g	1.33%	3.19%	5.45%^g
Adults (18–64 years)	2,084	12.8%	0.37 (0.32)	0.75	1.10	2.43%	4.99%	7.33%	12.6%	1.32 (1.27)	2.80	4.21	3.29%	7.00%	10.53%	1.1%	0.34 (0.28)	0.53^f	0.75^g	8.43%	13.13%^f	18.82%^g	12.8%	0.10 (0.20)	0.31	0.54	0.66%	2.08%	3.60%
Elderly (65–74 years)	635	16.8%	0.25 (0.22)	0.48	0.72^g	1.67%	3.23%	4.83%^g	16.6%	0.94 (0.87)	1.86	2.77^g	2.35%	4.64%	6.94%^g	0.6%	0.19^e (0.15)	0.24^f	0.38^g	4.87%^e	6.04%^f	9.50%^g	16.8%	0.06 (0.09)	0.17	0.17^g	0.39%	1.14%	1.14%^g
Very elderly (75+ years)	557	8.4%	0.37 (0.36)	1.24^f	1.24^g	2.49%	8.26%^f	8.26%^g	8.4%	1.42 (1.41)	4.75^f	4.75^g	3.54%	11.87%^f	11.87%^g	0.5%	0.17^e (0.10)	0.26^f	0.30^g	4.31%^e	6.48%^f	7.44%^g	8.4%	0.08 (0.09)	0.23^f	0.23^g	0.52%	1.52%^f	1.52%^g
Total population (2+ years)	5,601	11.3%	0.33 (0.30)	0.65	0.87	2.22%	4.34%	5.79%	11.2%	1.20 (1.17)	2.50^f	3.33^g	3.00%	6.25%^f	8.32%^g	0.9%	0.37 (0.29)	0.76^f	0.77^g	9.29%	18.96%^f	19.27%^g	11.3%	0.11 (0.20)	0.38	0.49	0.72%	2.52%	3.27%
Mexico, ENSANUT 2018^d
Children (2–11 years)	6,201	79.1%	0.35 (0.44)	0.78	1.15	2.35%	5.21%	7.66%	76.1%	0.61 (0.76)	1.36	1.97	1.53%	3.39%	4.93%	78.1%	0.02 (0.05)	0.06	0.10	0.42%	1.41%	2.43%	84.5%	0.20 (0.38)	0.53	0.76	1.32%	3.50%	5.05%
Adolescents (12–17 years)	4,351	84.5%	0.24 (0.27)	0.57	0.81	1.61%	3.78%	5.38%	83.8%	0.42 (0.47)	0.98	1.40	1.05%	2.45%	3.50%	83.7%	0.01 (0.02)	0.02	0.04	0.18%	0.53%	1.05%	87.3%	0.08 (0.14)	0.18	0.28	0.51%	1.21%	1.89%
Adults (18–64 years)	15,511	84.2%	0.19 (0.21)	0.45	0.62	1.25%	2.99%	4.11%	83.7%	0.33 (0.37)	0.78	1.08	0.82%	1.95%	2.69%	83.1%	0.01 (0.02)	0.03	0.05	0.25%	0.87%	1.32%	86.3%	0.05 (0.12)	0.13	0.20	0.37%	0.84%	1.35%
Elderly (65–74 years)	1,736	75.3%	0.15 (0.17)	0.36	0.51	1.01%	2.40%	3.39%	73.3%	0.26 (0.31)	0.60	0.89	0.66%	1.5%	2.23%	73.0%	0.02 (0.03)	0.05	0.07	0.43%	1.33%	1.74%	76.8%	0.06 (0.1)	0.15	0.27	0.40%	1.01%	1.77%
Very elderly (75+ years)	1,209	73.6%	0.17 (0.23)	0.40	0.64	1.16%	2.69%	4.27%	70.9%	0.31 (0.41)	0.70	1.12	0.77%	1.75%	2.80%	70.8%	0.02 (0.04)	0.07	0.10	0.52%	1.68%	2.45%	76.3%	0.08 (0.13)	0.18	0.28	0.50%	1.23%	1.90%
Total population (12+ years)	22,807	83.0%	0.20 (0.22)	0.46	0.65	1.30%	3.07%	4.32%	82.2%	0.34 (0.39)	0.80	1.13	0.85%	2.00%	2.81%	81.8%	0.01 (0.02)	0.04	0.06	0.26%	0.91%	1.38%	85.2%	0.06 (0.12)	0.14	0.23	0.40%	0.95%	1.53%
United States, NHANES 2017–18
Infants and Toddlers  (0–35 months)	599	5.1%	0.55^e (0.43)	1.25^f	1.36^g	3.65%^e	8.31%^f	9.09%^g	4.9%	0.97^e (1.15)	3.09^f	3.32^g	2.43%^e	7.72%^f	8.29%^g	4.1%	0.36^e (0.52)	0.77^f	0.89^g	9.12%^e	19.32%^f	22.29%^g	5.1%	0.92^e (0.67)	2.03^f	2.14^g	6.11%^e	13.51%^f	14.28%^g
Young children (3–9 years)	752	14.2%	0.36 (0.34)	0.64	0.94^g	2.41%	4.25%	6.28%^g	13.9%	0.78 (0.93)	1.71	2.52^g	1.95%	4.27%	6.29%^g	8.0%	0.05^e (0.08)	0.22^f	0.22^g	1.37%^e	5.62%^f	5.62%^g	14.2%	0.53 (0.43)	0.89	1.01^g	3.55%	5.95%	6.70%^g
Adolescents (10–17 years)	933	10.2%	0.28 (0.24)	0.49	0.84^g	1.85%	3.29%	5.60%^g	9.5%	0.73 (0.68)	1.32^f	2.25^g	1.82%	3.30%^f	5.62%^g	2.9%	0.07 (0.11)	0.25^f	0.29^g	1.72%	6.18%^f	7.18%^g	10.2%	0.31 (0.23)	0.66	0.74^g	2.10%	4.40%	4.96%^g
Adults (18–64 years)	3,253	17.0%	0.49 (0.68)	1.08	1.50	3.27%	7.23%	10.00%	15.9%	1.24 (1.78)	2.73	4.02	3.10%	6.83%	10.05%	6.3%	0.11 (0.20)	0.29	0.34	2.67%	7.34%	8.58%	17.0%	0.53 (0.67)	1.07	1.47	3.56%	7.16%	9.82%
Elderly (65–74 years)	625	27.6%	0.54 (0.48)	1.09	1.17^g	3.58%	7.24%	7.78%^g	27.0%	1.43 (1.29)	2.79	3.15^g	3.57%	6.98%	7.87%^g	10.9%	0.05 (0.10)	0.19^f	0.20^g	1.34%	4.80%^f	5.11%^g	27.6%	0.59 (0.51)	1.24	1.35^g	3.96%	8.25%	9.00%^g
Very elderly (75+ years)	421	26.1%	0.40 (0.32)	0.79	1.06^g	2.66%	5.26%	7.06%^g	25.2%	1.06 (0.87)	2.12	2.83^g	2.65%	5.29%	7.08%^g	9.2%	0.09 (0.12)	0.25^f	0.32^g	2.34%	6.37%^f	7.92%^g	26.1%	0.45 (0.39)	0.97	1.17^g	3.01%	6.47%	7.80%^g
Total population (0+ years)	6,583	17.2%	0.47 (0.59)	1.08	1.33	3.12%	7.18%	8.85%	16.3%	1.19 (1.55)	2.68	3.56	2.97%	6.69%	8.91%	6.5%	0.10 (0.19)	0.24	0.34	2.39%	5.92%	8.58%	17.2%	0.53 (0.60)	1.09	1.35	3.51%	7.27%	9.00%

LNCS: low- and no-calorie sweeteners; AceK: acesulfame potassium; n: number of subjects in total population (unweighted); % cons.: percentage of consumers (weighted) within specified population group; JECFA: Joint (FAO/WHO) Expert Committee on Food Additives (and Contaminants); ADI: acceptable daily intake; bw: body weight; SD: standard deviation; P90: 90th percentile; P95: 95th percentile; n.a.: data not available.

^aConsumers were identified as individuals who reported consumption of any of the GSFA categories or subcategories during the dietary survey reporting period, which were simulated to contain LNCS during the iterations.

^bConsumption data only available for individuals over 10 years.

^cDue to limited food codes, regular calorically sweetened CSDs, fruit juice, energy drinks, RTD teas and nectars were included as surrogates for their LNCS-sweetened counterparts to assess anticipated patterns of consumption of LNCS-sweetened beverages.

^dDue to limited food codes, regular calorically sweetened CSDs, fruit juice and fruit nectars were included as surrogates for their LNCS-sweetened counterparts to assess anticipated patterns of consumption of LNCS-sweetened beverages.

^eIndicates an intake estimate that may not be statistically reliable, as the sample size does not meet the minimum reporting requirements of n = 30 (Korn and Graubard 1999).

^fIndicates an intake estimate that may not be statistically reliable, as the sample size does not meet the minimum reporting requirements of n = 80 (Kroes et al. 2002).

^gIndicates an intake estimate that may not be statistically reliable, as the sample size does not meet the minimum reporting requirements of n = 130 (Conover 1971).

Table 4. Estimated daily exposure to LNCS (AceK, Aspartame, Steviol Glycosides, Sucralose) from water-based flavoured non-alcoholic beverages by subpopulation group in LNCS-containing beverage consumers^a only – brand loyal model.

Population group	n	AceK							Aspartame							Steviol Glycosides							Sucralose
		% cons.	mg kg^−1 bw day^−1			% JECFA ADI (15 mg kg^−1 bw day^−1)			% cons.	mg kg^−1 bw day^−1			% JECFA ADI (40 mg kg^−1 bw day^−1)			% cons.	mg kg^−1 bw day^−1			% JECFA ADI (4 mg kg^−1 bw day^−1)			% cons.	mg kg^−1 bw day^−1			% JECFA ADI (15 mg kg^−1 bw day^−1)
			Mean (SD)	P90	P95	Mean	P90	P95		Mean (SD)	P90	P95	Mean	P90	P95		Mean (SD)	P90	P95	Mean	P90	P95		Mean (SD)	P90	P95	Mean	P90	P95
Brazil, POF 2017–18^b,c
Adolescents (10–17 years)	6,793	35.3%	0.96 (0.80)	1.92	2.40	6.43%	12.80%	16.00%	35.0%	2.21 (1.78)	4.34	5.48	5.52%	10.84%	13.70%	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	36.8%	1.18 (0.93)	2.29	2.93	7.86%	15.23%	19.53%
Adults (18–64 years)	33,666	27.0%	0.66 (0.55)	1.33	1.70	4.42%	8.89%	11.31%	26.8%	1.51 (1.23)	2.99	3.88	3.78%	7.48%	9.70%	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	29.3%	0.81 (0.65)	1.58	2.07	5.40%	10.53%	13.77%
Elderly (65–74 years)	3,451	16.6%	0.50 (0.37)	0.94	1.23	3.35%	6.24%	8.21%	16.5%	1.17 (0.87)	2.17	3.06	2.93%	5.42%	7.65%	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	18.9%	0.64 (0.46)	1.23	1.58	4.26%	8.18%	10.53%
Very elderly (75+ years)	2,254	13.3%	0.54 (0.72)	1.00	1.50	3.62%	6.67%	9.97%	12.8%	1.27 (1.57)	2.31	3.24	3.18%	5.78%	8.11%	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	16.8%	0.66 (0.74)	1.22	1.65	4.38%	8.14%	11.02%
Total population (10+ years)	46,164	26.7%	0.71 (0.62)	1.42	1.88	4.73%	9.48%	12.55%	26.5%	1.62 (1.38)	3.20	4.27	4.05%	8.01%	10.68%	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	n.a.	29.0%	0.86 (0.72)	1.71	2.24	5.76%	11.39%	14.92%
Canada, CCHS 2015
Toddlers (24–35 months)	137	0.7%	0.23^e (0.32)	0.40^f	0.69^g	1.51%^e	2.67%^f	4.60%^g	0.7%	0.65^e (1.26)	1.34^f	2.47^g	1.64%^e	3.34%^f	6.17%^g	0.6%	0.16^e (n.a.)	0.16^f	0.16^g	3.94%^e	3.94%^f	3.94%^g	0.7%	0.40^e (0.55)	0.70^f	1.19^g	2.66%^e	4.65%^f	7.94%^g
Young children (3–9 years)	762	4.3%	0.38^e (0.25)	0.62^f	0.78^g	2.51%^e	4.12%^f	5.22%^g	4.4%	1.14^e (0.98)	2.13^f	2.82^g	2.84%^e	5.33%^f	7.05%^g	0.8%	0.79^e (0.10)	0.80^f	0.86^g	19.69%^e	20.07%^f	21.44%^g	4.6%	0.66^e (0.45)	1.14^f	1.43^g	4.41%^e	7.59%^f	9.54%^g
Adolescents (10–17 years)	1,426	7.8%	0.37 (0.32)	0.76	1.17^g	2.49%	5.08%	7.81%^g	9.0%	1.15 (1.20)	2.38	4.28^g	2.87%	5.96%	10.70%^g	1.2%	0.48^e (0.28)	0.78^f	0.87^g	12.08%^e	19.49%^f	21.74%^g	9.0%	0.63 (0.52)	1.12	2.00^g	4.22%	7.44%	13.36%^g
Adults (18–64 years)	2,084	12.4%	0.57 (0.53)	1.13	1.83	3.82%	7.55%	12.17%	10.6%	1.81 (1.95)	3.95	4.97	4.53%	9.87%	12.43%	1.1%	0.36 (0.30)	0.56^f	0.80^g	8.97%	13.97%^f	20.02%^g	12.8%	0.98 (0.90)	1.93	3.14	6.54%	12.90%	20.93%
Elderly (65–74 years)	635	14.4%	0.41 (0.39)	0.80	1.20^g	2.71%	5.36%	8.01%^g	16.6%	1.28 (1.44)	2.80	3.88^g	3.20%	7.00%	9.71%^g	0.6%	0.21^e (0.16)	0.26^f	0.40^g	5.18%^e	6.43%^f	10.11%^g	16.8%	0.63 (0.65)	1.31	1.82^g	4.20%	8.74%	12.12%^g
Very elderly (75+ years)	557	7.9%	0.67 (0.68)	2.06^f	2.06^g	4.49%	13.71%^f	13.71%^g	8.4%	1.86 (2.43)	7.55^f	7.55^g	4.65%	18.88%^f	18.88%^g	0.5%	0.18^e (0.11)	0.28^f	0.32^g	4.59%^e	6.90%^f	7.91%^g	8.4%	0.92 (1.10)	3.54^f	3.54^g	6.17%	23.59%^f	23.59%^g
Total population (2+ years)	5,601	10.4%	0.52 (0.50)	1.08	1.35	3.45%	7.17%	9.03%	11.2%	1.71 (1.83)	3.88	4.97	4.29%	9.70%	12.43%	0.9%	0.40 (0.30)	0.81^f	0.82^g	9.89%	20.18%^f	20.50%^g	11.3%	0.86 (0.84)	1.82	2.33	5.71%	12.11%	15.52%
Mexico, ENSANUT 2018^d
Children (2–11 years)	6,201	79.1%	0.66 (0.83)	1.48	2.17	4.40%	9.87%	14.47%	76.10%	1.39 (1.74)	3.12	4.53	3.47%	7.79%	11.33%	78.1%	0.08 (0.08)	0.17	0.24	1.89%	4.17%	5.88%	84.4%	0.64 (0.75)	1.38	1.98	4.24%	9.20%	13.23%
Adolescents (12–17 years)	4,351	84.5%	0.45 (0.51)	1.06	1.51	3.03%	7.08%	10.06%	83.8%	0.96 (1.07)	2.22	3.22	2.39%	5.55%	8.04%	83.7%	0.05 (0.05)	0.11	0.15	1.20%	2.76%	3.73%	87.3%	0.39 (0.41)	0.90	1.22	2.60%	5.97%	8.16%
Adults (18–64 years)	15,511	84.2%	0.35 (0.40)	0.85	1.17	2.33%	5.65%	7.80%	83.7%	0.74 (0.84)	1.79	2.47	1.84%	4.47%	6.16%	83.1%	0.04 (0.04)	0.09	0.12	1.03%	2.29%	3.08%	86.3%	0.30 (0.32)	0.69	0.94	1.98%	4.57%	6.25%
Elderly (65–74 years)	1,736	75.3%	0.28 (0.33)	0.64	0.97	1.84%	4.26%	6.46%	73.3%	0.58 (0.71)	1.35	2.05	1.46%	3.37%	5.13%	73.0%	0.04 (0.04)	0.09	0.12	1.04%	2.26%	3.07%	76.8%	0.25 (0.26)	0.58	0.78	1.64%	3.84%	5.21%
Very elderly (75+ years)	1,209	73.6%	0.32 (0.44)	0.75	1.18	2.11%	4.97%	7.90%	70.9%	0.68 (0.94)	1.58	2.52	1.7%	3.94%	6.3%	70.8%	0.05 (0.05)	0.11	0.14	1.23%	2.76%	3.46%	76.3%	0.29 (0.35)	0.65	0.98	1.90%	4.35%	6.54%
Total population (12+ years)	22,807	83.0%	0.36 (0.42)	0.87	1.22	2.42%	5.80%	8.15%	82.2%	0.77 (0.90)	1.84	2.58	1.91%	4.59%	6.45%	81.8%	0.04 (0.04)	0.10	0.13	1.07%	2.39%	3.23%	85.2%	0.31 (0.34)	0.72	0.99	2.08%	4.78%	6.61%
United States, NHANES 2017–18
Infants and toddlers  (0–35 months)	599	5.1%	0.56^e (0.43)	1.26^f	1.37^g	3.73%^e	8.41%^f	9.14%^g	4.7%	0.91^e (1.10)	2.66^f	3.14^g	2.27%^e	6.65%^f	7.86%^g	4.1%	0.69^e (1.03)	1.52^f	1.75^g	17.35%^e	37.93%^f	43.82%^g	5.1%	0.93^e (0.66)	2.02^f	2.15^g	6.21%^e	13.46%^f	14.33%^g
Young children (3–9 years)	752	14.2%	0.40 (0.44)	0.70	1.14^g	2.69%	4.66%	7.63%^g	13.6%	0.95 (1.38)	1.91	2.99^g	2.38%	4.78%	7.47%^g	8.0%	0.09 (0.16)	0.44^f	0.44^g	2.21%	11.01%^f	11.01%^g	14.2%	0.60 (0.56)	0.99	1.95^g	4.01%	6.62%	12.98%^g
Adolescents (10–17 years)	933	10.2%	0.41 (0.43)	0.86	1.47^g	2.72%	5.73%	9.77%^g	9.2%	1.26 (1.39)	2.65^f	4.51^g	3.15%	6.61%^f	11.28%^g	2.9%	0.13 (0.22)	0.48^f	0.56^g	3.14%	12.10%^f	14.05%^g	10.2%	0.52 (0.49)	1.02	1.74^g	3.49%	6.81%	11.61%^g
Adults (18–64 years)	3,325	17.0%	0.73 (1.08)	1.76	2.62	4.88%	11.71%	17.46%	15.0%	2.21 (3.41)	5.45	8.07	5.53%	13.64%	20.16%	6.3%	0.19 (0.40)	0.57	0.67	4.83%	14.37%	16.73%	17.0%	0.92 (1.28)	2.16	3.11	6.13%	14.37%	20.75%
Elderly (65–74 years)	625	27.6%	0.81 (0.78)	1.60	1.82^g	5.37%	10.69%	12.14%^g	25.9%	2.48 (2.45)	5.09	5.45^g	6.20%	12.73%	13.63%^g	10.9%	0.08 (0.19)	0.36^f	0.40^g	2.06%	8.89%^f	9.98%^g	27.6%	1.02 (0.94)	2.03	2.22^g	6.81%	13.55%	14.81%^g
Very elderly (75+ years)	466	26.1%	0.60 (0.51)	1.37	1.84^g	3.98%	9.15%	12.28%^g	22.7%	1.84 (1.60)	4.22	5.90^g	4.59%	10.56%	14.76%^g	7.8%	0.15 (0.24)	0.49^f	0.62^g	3.87%	12.22%^f	15.50%^g	26.1%	0.77 (0.63)	1.63	2.19^g	5.12%	10.87%	14.60%^g
Total population (0+ years)	6,583	17.2%	0.69 (0.94)	1.52	2.14	4.57%	10.12%	14.26%	15.4%	2.06 (2.94)	4.88	6.95	5.14%	12.21%	17.37%	6.5%	0.17 (0.37)	0.46	0.67	4.23%	11.58%	16.73%	17.5%	0.88 (1.11)	1.94	2.57	5.84%	12.96%	17.11%

LNCS: low- and no-calorie sweeteners; AceK: acesulfame potassium; n: number of subjects in total population (unweighted); % cons.: percentage of consumers (weighted) within specified population group; JECFA: Joint (FAO/WHO) Expert Committee on Food Additives (and Contaminants); ADI: acceptable daily intake; bw: body weight; SD: standard deviation; P90: 90th percentile; P95: 95th percentile; n.a.: data not available.

^aConsumers were identified as individuals who reported consumption of any of the GSFA categories or subcategories during the dietary survey reporting period, which were simulated to contain LNCS during the iterations.

^bConsumption data only available for individuals over 10 years.

^cDue to limited food codes, regular calorically sweetened CSDs, fruit juice, energy drinks, RTD tea and nectars were included as surrogates for their LNCS-sweetened counterparts to assess the anticipated patterns of consumption of LNCS-sweetened beverages.

^dDue to limited food codes, regular calorically sweetened CSDs, fruit juice and fruit nectars were included as surrogates for their LNCS-sweetened counterparts to assess the anticipated patterns of consumption of LNCS-sweetened beverages.

^eIndicates an intake estimate that may not be statistically reliable, as the sample size does not meet the minimum reporting requirements of n = 30 (Korn and Graubard 1999).

^fIndicates an intake estimate that may not be statistically reliable, as the sample size does not meet the minimum reporting requirements of n = 80 (Kroes et al. 2002).

^gIndicates an intake estimate that may not be statistically reliable, as the sample size does not meet the minimum reporting requirements of n = 130 (Conover 1971).

Table 5. Qualitative evaluation of the influence of uncertainties on exposure estimates to low- and no-calorie sweeteners from water-based flavoured non-alcoholic beverages in four markets^a.

Source of uncertainty	Direction and magnitude^b
Consumption data
Mis/under-reporting of beverage consumption in dietary surveys	–
Estimating chronic exposure with short-term dietary intake data	+
Limited categories to capture beverage types (Mexico and Brazil)	±
Brand-specific beverage consumption data not available	±
Rounding errors in food consumption data	±
Use-level data
Use-level data and beverage consumption data were collected at two separate time points	±
Use levels applied represented approximately 80% of the market, use data for smaller brands not included	±
Rounding errors, incorrect entries for concentration data	±
Probabilistic model
No consideration for brand loyal consumers	±
Probability of LNCS use levels being encountered for each consumer was based on market share  (by volume) and not actual consumer behaviour due to non-branded food codes	±
Brand loyal model
100% presence assumed for all beverage categories in which LNCS were reported for use,  regardless of whether these reported values accounted for a large proportion of the market	+

^aConducted in accordance with the criteria specified in Codex and EFSA (European Food Safety Authority) (CAC 2003; EFSA 2006).

^b+, ++ or +++ is the uncertainty likely to cause small, medium or large overestimates of exposure, respectively, and −, − − or − − − is the uncertainty likely to cause small, medium or large underestimates of exposure, respectively.

Korn EL, Graubard BI. 1999. Analysis of health surveys. New York (NY): Wiley-Interscience.

 Google Scholar

Kroes R, Muller D, Lambe J, Lowik MR, van Klaveren J, Kleiner J, Massey R, Mayer S, Urieta I, Verger P, et al. 2002. Assessment of intake from the diet. Food Chem Toxicol. 40(2–3):327–385. doi:10.1016/S0278-6915(01)00113-2

 PubMed Web of Science ®Google Scholar

Conover WJ. 1971. Practical nonparametric statistics. New York (NY): John Wiley and Sons.

 Google Scholar

(CAC) Codex Alimentarius Commission. 2003. Appendix IV. Working principles for risk analysis for application in the framework of the Codex Alimentarius. Paper presented at: 26th session of Codex Alimentarius Commission; June 30–July 7; Rome. Rome (Italy): Codex Alimentarius Commission (CAC).

 Google Scholar

(EFSA) European Food Safety Authority. 2006. Guidance of the scientific committee on a request from EFSA related to uncertainties in dietary exposure assessment (EFSA Scientific Committee) (Question no: EFSA-Q-2004-019, adopted: 14 December 2006, last updated: 17 January 2007 by European Food Safety Authority). EFSA J. 438:1–54. doi:10.2903/j.efsa.2006.438. Available from: https://www.efsa.europa.eu/en/efsajournal/pub/438.

 Google Scholar