FSANZ is a trusted regulator and has access to the studies you quote and probably others that are not published. They would have done a thorough scientific risk assessment using a weight of evidence approach, drawn conclusions and made recommendations (if required) based on those conclusions. If, in their considered opinion, the risks from consumption do not warrant any mitigation then they would not make a recommendation to limit consumption or ban the additive. If new data become available no doubt further review would be conducted.
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I use Organic Stevia instead of sugar in my coffee and if I have to sweeten my cereal a bit. I use Stevia to decrease my sugar intake, and I hope that this is a ‘safe’ alternative to sugar. I think that Stevia is claimed to be ‘natural’, which I much prefer to Aspartame.
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The Stevia herb is “natural”, it is a group of roughly 150 related herbs (all can be called stevia), some are available to grow here and all are native to Paraguay & Brazil where they have been in use for many hundreds if not thousands of years. The preferred herb to use is Stevia rebaudiana Bertoni. I find it and the other stevia herbs have a bitter aftertaste if used from the herb, this is thought to be due to a compound found in the stevia plants called stevioside, which is also very sweet. Most companies that produce the “Stevia” tablet, powder and liquid sweeteners use sweet compounds (steviol glucosides) refined/extracted from the herb and may add other products & alter the amount of stevioside to reduce this aftertaste.
One of the most used and common of these sweet compounds (steviol glucosides) found in stevia herb is rebaudioside A, sometimes called Reb A (about X 200 sweeter than sugar), this is what most manufacturers try to maximise while reducing the stevioside, most will still contain some as it is also very sweet (X 300 more than sugar). A “Stevia” product may contain other types of these steviol glucosides as well. The herb in it’s natural state has 8 of these glucosides and they are
stevioside (which makes up about 18% of the glucosides)
rebaudiosides A, C, D, E, and F
steviolbioside
dulcoside A
With Reb A and stevioside being the most common of the glucosides in the herb and the ones that are the most commonly extracted.
One common additive is Erythritol (a sugar alcohol) which is naturally found in fermenting fruit and is an alcohol (won’t get you drunk though) and is sweet but with very few kilojoules as the body does not adsorb it very well, this is the same for most sugar alcohols. There are other sugar alcohols that may be used with or instead of Erythritol and all of them can have a laxative effect if too much is ingested. Erythritol (and/or possibly the other sugar alcohols) is used to help combat the bitterness but also to bulk out the “Stevia” to make it easier to measure and use. The Erythritol in most “Stevia” products that use it, is from industrial production sources not fermented fruit. I use a commercially made powder version of “Stevia” (which has added Erythritol) everyday in my drinks eg Cocoa and in cooking cakes and similar to avoid the bitterness.
There is some evidence that stevia and it’s “Stevia” products, may help with insulin production and resistance and could help people with Diabetes II to help control their disease. It has been suggested and studied to see if it may also help lower blood pressure and help protect the kidneys but this is still not proven or very well studied.
The stevia extract Reb A is what the USA FDA call GRAS or “Generally Recognised As Safe” but the whole herb is not GRAS. There have been some studies that have suggested that stevia may contribute to cancer but this is not yet proven and the studies required very large levels of stevia to produce possible results. Japan allows stevia and has banned other artificial sweeteners and have undertaken very numerous studies (more than 40,000) on stevia and they have concluded it is safe to use. In their native area the related herbs have been used as sweeteners and in traditional medicine for a number of complaints and are also used as a contraceptive. I am not sure if it is effective but women are advised not to use the actual herb (however this warning generally does not include the extract Reb A) if they want to get or are pregnant. Part of this concern is that stevia may also have a mutative effect but most studies (there are not many) that have linked this are concerned with the whole herb not the extracts. It is still worth noting though as there are still no long term studies on stevia issues, as stevia use is somewhat a recent development in most of our societies. However to be prudent, use should be moderate ie normal sweetening usage and not excessive amounts.
Finally, from a health & medical site comes this advice:
"
Potential Contraindications
Pregnant or nursing women shouldn’t use stevia at all. High doses of stevia may have weak mutagenic activity, according to the Memorial Sloan Kettering Cancer Center. Whole stevia leaves were also traditionally used as a contraceptive by the Guarani Indians in Paraguay. Those on blood pressure or diabetes medications should check with their doctor before using stevia-based products, as they may interact with these medications. People allergic to ragweed may be allergic to stevia as well.
Recommended Limits
Only products made with rebaudioside A, not whole-leaf stevia or other stevia extracts, are approved by the U.S. Food and Drug Administration for use in food. The World Health Organization recommends a limit of no more than 1.8 milligrams of stevia per pound per day, which means no more than two or three packets containing about 100 milligrams of stevia if you weigh about 150 pounds. The organization didn’t set a limit for erythritol because of the relatively limited risks associated with its use.
"
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Switched from drinking coke to diet coke when weight gain became an issue and spent about 20 years drinking more and more diet coke per day until I was consuming over 4 litres of the stuff daily. My initial weight loss reversed and I got fatter and fatter over the years. About two years ago I went to Samoa and the diet coke they had there tasted off so I stopped drinking it for two weeks. When I came home the first thing I did was grab a diet coke from the fridge and knock it back as fast as I could. Within minutes I noticed a return of the low grade, chronic, nausea I had learned to live with and had not noticed when it went away during my holiday. That prompted me to try and stop drinking so much diet coke and I cut back to just 4 cans per day. At that point I noticed the chronic bursitis in my shoulder/upper arm went away, a result which even steroid injections had failed to achieve. Since then my tolerance for the diet coke has dwindled to the point where a single glass of the stuff triggers a return of the bursitis. I am presuming the asparame is the cause of these symptoms but it’s just a guess based on literature promoting the belief that this stuff is toxic.
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Thanks for your responses, everyone!
The University of Sydney recently published an interesting paper on bias in artificial sweetener research. This is what they found: “Artificial sweetener industry sponsored reviews were more likely to have favorable results than non-industry sponsored reviews, as well as favorable conclusions.”
Considering that our dietary guidelines and approvals for artificial sweeteners are based on existing research (which we now know may be biased), do you think this is cause for concern?
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Oh wow @norsemanps! That’s so interesting.
Was the switch from Coke to Diet Coke the only change you made in your diet?
As outlined in my first post, Stevia is widely used in Chile instead of sugar in many products, we had it in dairy and no sugar gassy drinks. The milk products had no aftertaste as I suspect the milk would have masked this. The gassy drinks didn’t have a bitter aftertaste but made my mouth feel a little dry after consuming (when compared to water). We don’t often drink soft/gassy drinks but tried a non-sugar Stevia version in Chile for something different.
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In addition to artificial sweeteners what about Stevia, a natural sweetener that I believe has very low calories and is very sweet so you don’t need to use as much. In the USA at restaurants etc Stevia is another sweetener option on the table made available to customers.
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At the time I made the swap it was the only change but, when I started to lose weight because of not drinking the ordinary coke, I was inspired to begin exercising too which increased the weight loss. When the weight started to come back on despite the exercising I quit exercising. To be fair to coke and diet coke I do tend to over eat and that has gotten worse over time.
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Industry self interest in sponsoring research is ALWAYS a cause for concern. I would suggest that the study’s conclusion
(“Review sponsorship and authors’ financial conflicts of interest introduced bias affecting the outcomes of reviews of artificially sweetened beverage effects on weight that could not be explained by other sources of bias.”)
could be applied to any industry that sponsors research into their own products, simply by changing the product that is being reviewed and the outcome they want. A reference to the tobacco industry’s research telling us that smoking is not bad for us comes to mind as a peak example.
Unfortunately, it would seem that slick marketing trumps critical thinking, and consumers accept the benefit claims at face value.
A very quick review of the scientific literature (https://scholar.google.com.au/scholar?as_ylo=2016&q=cochrane+study+of+health+benefits+of+artificial+sweeteners&hl=en&as_sdt=0,5) shows that the artifical sweeteners do not have a valid correlation to weight loss, as compared to sugar. And, low nutrient value / artificial sweeteners can have negative health consequences in humans. Below are first the meta-analyses/Cochrane studies I found in the search above.
The conclusion from the research is the best and healthiest result is to cut right down on sweeteners of any form.
- Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies (http://ajcn.nutrition.org/content/100/3/765.short)
- Early Exposure to Nonnutritive Sweeteners and Long-term Metabolic Health: A Systematic Review (http://pediatrics.aappublications.org/content/early/2016/02/23/peds.2015-3603)
- Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies (http://www.cmaj.ca/content/189/28/E929.short)
- Metabolic effects of aspartame in adulthood: a systematic review and meta-analysis of randomized clinical trials (http://www.tandfonline.com/doi/abs/10.1080/10408398.2017.1304358)
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Do you use non-sugar sweeteners or products that contain them like diet soft drink?
Only use sweetener to hot drinks.
Never buy diet soft drinks of any type.
Have you used them to lose weight or reduce your sugar intake?
Yes to both.
Do you feel comfortable using artificial/non-sugar sweeteners?
Aspartame has a bad rap so avoid it. Use Xylitol or stevia in coffee.
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It is one of the sugar alcohols that I referred to in my post above. It can cause bloating, gas, diarrohea similar to all the other sugar alcohols. I have provided a list of the most common here:
Erythritol
Isomalt
Lactitol
Maltitol
Mannitol
Sorbitol
Xylitol is derived by hydrogenating Xylose a natural indigestible sugar that among other things is in birch bark (from which it is extracted). Xylitol is extremely dangerous to dogs and should not be consumed by other pets.
There have been some studies that have linked blood glucose rises when Xylitol is used and as such diabetics are recommended not to use it.
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I’m a chronic overeater too @norsemanps! Self-control is not my forte. 
There’s just too much tasty food in the world!
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Thanks for the opportunity.
I agree with Additive_Free_Kids’s comments.
Best wishes …
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So true Alice! I thought, when I went vegitarian, I’d lose weight but nope - fried potatoes and things like that are just as fattening with or without meat lol
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I have used artificial sweeteners for many years, and tend to choose products which are artificially sweetened in preference to sugar sweetened products. I sweeten my tea/coffee my cereal and cooking all the time. Why? Mainly because I believe there is too much sugar in our diets and I am already overweight and diabetic. I have a sweet tooth and eat far too many things that I shouldn’t, so any sugar I can avoid the better!
I have never experienced any side effects that I can link to artificial sweeteners, although who knows what ailments originate from this source. Sure, there may be adverse side effects, but the side effects from too much sugar are also well documented … so perhaps a lesser of two evils.
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Years ago I used products containing artificial sweetners thinking it would help me loose weight - not any more! All scientific research proves that it just increases your sugar cravings until you want things sweeter and sweeter. Scientists have also proven that they cause MS and other significant health issues. I also used to use Xylitol, which is a natural sweetner made from corn cobs and birch bark. It has health benefits (e.g increasing calcium absorption) but I read just last week that there are now concerns regarding the manufacturing processes (tin??) of this which could also lead to health issues such as cancer… I would love to find an alternative that is good for you.
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The manufacturing of Xylitol can use Nickel to help as a catalyst to hydrogenate the Xylose. But they do remove this as part of the process and they don’t want to waste this metal as it has a reasonably high cost to purchase but I guess if not careful if might contaminate the end product.
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I gave up sugar 35 years ago and only take it in things that can’t be avoided. My son uses Stevia as I won’t buy sugar and he likes some on his WeetBix. I use a bit on pawpaw.
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Absolutely. And of course this is not an isolated occurrence. The “bottom drawer” effect (aka publication bias, where negative research findings are filed in the bottom drawer, and not published) has been a known issue, but only recently starting to be addressed. Even meta-analyses have to attempt to account for this bias.
In the USA, the NIH has introduced mandatory registration and reporting of results for all drug trials, which is a start: New NIH and Department of Health rules on clinical trials will force drug companies to publish all results, including those that failed..
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