Disclosure of sweeteners on packaged food labels: a scoping review
Creators: name: Gastón Ares
name: Kraemer, Mariana
name: Uggioni, Paula Lazzarin
name: Geraldo, Ana Paula Gines
name: Fernandes, Ana Carolina
name: Da Costa Proença, Rossana Pacheco
name: Greyce Luci Bernardo
name: De Barros, Beatriz Ingryd Vasconcellos
name: Chaddad, Maria Cecília Cury
name: Carvalho, Elisa Milano Peixoto
Publisher: name: OSF Registries
Year: 2024
Subjects: subject: Public Health
subject: Nutrition
subject: Medicine and Health Sciences
subject: Life Sciences
subject: Food Science
subject: Food Choice
subject: Food Labelling
subject: Ingredients List
subject: Nutrition
subject: Public Health

description: Public policies have been implemented to discourage sugar consumption (FORBERGER et al., 2022). Examples include food guidelines and regulations that recommend a reduction in the consumption of packaged foods and mandate the disclosure of sugars on food labels. A strategy frequently used by the food industry to circumvent the above-mentioned situations is to totally or partially replace sugars with sweeteners in packaged foods. 
Sweeteners are food additives, other than sugars, that impart a sweet taste to food. Several classifications of sweeteners can be found in the scientific literature and regulations. Moreover, the lack of consensus among these classifications means that a single substance may fall into multiple categories. It is also noteworthy that polyols may be classified or not as sweeteners, depending on the classification system adopted.
A systematic review published by the WHO indicated an association between the consumption of sweeteners and neurological, cognitive, metabolic, cardiovascular, and behavioural health problems. This review was used as a base on recent WHO guidelines, which do not recommend the use of the so-called 'non-sugar sweeteners' (NSS), to control body weight or reduce the risk of NCDs. 
For consumers to effectively access information about sweeteners in packaged foods, these substances need to be clearly indicated on the ingredients list. Studies indicated that consumers may find it challenging to identify sweeteners on food labels, attributed both to the placement of information and the various nomenclatures used, which can make it difficult to understand their meaning. It is also important to highlight that, in most countries, labels do not contain quantitative information, thereby preventing consumers from knowing the precise amount of sweeteners they are ingesting. In Brazil, for instance, sweeteners and other additives are displayed at the end of the ingredients list in no pre-defined order, regardless of their concentrations. As other ingredients are listed in descending order of quantity, the fact that additives are listed after food ingredients may give the impression that they were added in lower amounts than previous ingredients. 
Analysing studies on the effects of sweetener consumption on health outcomes is challenging. These difficulties stem from the aforementioned diversity of sweetener classifications and definitions, which result in a broad variety of substances and hamper comparison between studies. No review study was found that discussed the disclosure of sweeteners on food labels. In view of this gap, this study aimed to investigate how information on sweeteners disclosed on packaged food labels is being collected, classified, identified, and analyzed in scientific studies.