Ibero-American Consensus on Low- and No-Calorie Sweeteners : Safety, Nutritional Aspects and Benefits in Food and Beverages

International scientific experts in food, nutrition, dietetics, endocrinology, physical activity, paediatrics, nursing, toxicology and public health met in Lisbon on 2\u207b4 July 2017 to develop a Consensus on the use of low- and no-calorie sweeteners (LNCS) as substitutes for sugars and other caloric sweeteners. LNCS are food additives that are broadly used as sugar substitutes to sweeten foods and beverages with the addition of fewer or no calories. They are also used in medicines, health-care products, such as toothpaste, and food supplements. The goal of this Consensus was to provide a useful, evidence-based, point of reference to assist in efforts to reduce free sugars consumption in line with current international public health recommendations. Participating experts in the Lisbon Consensus analysed and evaluated the evidence in relation to the role of LNCS in food safety, their regulation and the nutritional and dietary aspects of their use in foods and beverages. The conclusions of this Consensus were: (1) LNCS are some of the most extensively evaluated dietary constituents, and their safety has been reviewed and confirmed by regulatory bodies globally including the World Health Organisation, the US Food and Drug Administration and the European Food Safety Authority; (2) Consumer education, which is based on the most robust scientific evidence and regulatory processes, on the use of products containing LNCS should be strengthened in a comprehensive and objective way; (3) The use of LNCS in weight reduction programmes that involve replacing caloric sweeteners with LNCS in the context of structured diet plans may favour sustainable weight reduction. Furthermore, their use in diabetes management programmes may contribute to a better glycaemic control in patients, albeit with modest results. LNCS also provide dental health benefits when used in place of free sugars; (4) It is proposed that foods and beverages with LNCS could be included in dietary guidelines as alternative options to products sweetened with free sugars; (5) Continued education of health professionals is required, since they are a key source of information on issues related to food and health for both the general population and patients. With this in mind, the publication of position statements and consensus documents in the academic literature are extremely desirable

Evaluation Of The Secretory Immunoglobulin A Levels In The Colostrum And Milk Of Mothers Of Term And Pre-term Newborns

Objective: To determine and to compare the levels of secretory immunoglobulin A in samples of colostrum and milk of mothers of term and preterm neonates. Material and Methods: The levels of secretory immunoglobulin A of 10 mothers of term neonates and 10 mothers of preterm neonates were determined from 5mL of colostrum or milk collected on the 1st, 4th, 10th and 15th days of the puerperal period, using the radial immunodifusion technique. We employed anamnesis, as well as physical and gynecological exams in women in the puerperal period. All the patients were attended at the Januário Cicco Maternity College. Results: The secretory immunoglobulin A levels were significantly higher in the colostrum and milk of mothers of preterm neonates when compared with the levels found in colostrum and milk of mothers of term neonates (Mann-Whitney test, p<0.0001). There was a significant decline in the secretory immunoglobulin A levels of the colostrum and milk of the mothers of term and preterm neonates during the four periods (Kruskal-Wallis test, p<00001). Conclusions: The secretory immunoglobulin A levels in colostrum and milk of mothers of preterm neonates were significantly higher than in the mothers of term neonates, demonstrating immunological adaptation in preterm neonate breast-feeding. © 2005 by The Brazilian Journal of Infectious Diseases and Contexto Publishing. All rights reserved.95357362Ferreira, T.R.B., Rispamonte, C., Stella, L.C., Albadalejo, R.G.C., Imunologia do leite materno (1998) Rev Perspectivas Médicas, 9, pp. 22-28Marques, R.F.S.V., Lopez, F.A., Braga, J.A.P., O crescimento de crianças alimentadas com leite materno exclusivo nos primeiros 6 meses de vida (2004) Jornal de Pediatria, 80, pp. 99-105Breastfeeding and the use of human milk (1997) Pediatrics, 100, pp. 1035-1039Lucas, A., Cole, T.J., Breast milk and neonatal necrotizing enterocolitis (1990) Lancet, 336, pp. 1519-1523Goldman, A.S., Garza, C., Nichols, B., Effects of prematurity on the immunologic system in human milk (1982) J Pediatr, 101, pp. 901-905Goldman, A.S., Chheda, S., Garofalo, R., Evolution of immunologic functions of the mammary gland and the postnatal development of immunity (1998) Pediatric Research, 43, pp. 1-15Schanler, R.J., Suitability of human milk for the low birth weight infant (1995) Clin. Perinatol, 22, pp. 207-222Hartmann, P., Cregan, M., Lactogenesis and effects of insulin-dependent diabetes mellitus and prematurity (2001) J Nutr, 131, pp. 3016-3020Neville, M.C., Anatomy and physiology of lactation (2001) Pediatrics Clinics of North America, 48, pp. 13-33Nascimento, M.B.R., Issler, H., Feeding materno: Fazendo a diferença no desenvolvimento, saúde e nutrição dos recém-nascidos de termo e pré-termo (2003) Rev Hosp Clin, 58, pp. 49-60Cutulo, L.R.A., Lamego, A.C., Fatores immunologicos da alimentação materno (1994) Arq Catar Méd, 23, pp. 191-198Chandra, R.K., Immunological aspects of human milk (1978) Nutr Rev, 36, pp. 265-272Carbonare, S.B., Carneiro-Sampaio, M.M.S., Composição do leite humano: Aspectos immunologicos (2001) Alimentação Materno, , Rego J.D. Rio de Janeiro: AtheneuFagarasan, S., Honjo, T., Regulation of IgA synthesis at mucosal surfaces (2004) Current Opinion in Immunology, 16, pp. 277-283(2002) Report of the Expert Consultation on the Optimal Duration of Exclusive Breastfeeding, pp. 28-30. , Geneva. SwitzerlandXantou, M., Immune protection of human milk (1998) Biol Neonate, 74, pp. 121-133Kunzs, C., Palmero, M.R., Koletzko, B., Jensen, R., Nutritional and biochemical properties of human milk, Paret II: Lipids, micronutrients and bioactive factors (1999) Clin Perinatol, 26, pp. 335-360Russel, M.W., Mestecky, J., Humoral immune responses to microbial infections in the genital tract (2002) Microbes Infect, 4, pp. 667-677Egmond, M.V., Damen, C.A., Spriel, A.B.V., IgA and IgA Fc receptor (2001) Trends Immumol, 22, pp. 205-211Barros, M.D., Carneiro-Sampaio, M.M.S., Milk composition of low birth weight infant mother (1984) Acta Paediatr Scand, 73, pp. 693-695Grumach, A.S., Carmona, R.C., Lazarotti, D., Ribeiro, M.A., Rozentraub, R.B., Racz, M.L., Weinberg, A., Carneiro-Sampaio, M.M.S., Immunological factors in milk from Brazilian mothers delivering small-for-date term neonates (1993) Acta Paediatr, 82, pp. 289-290Gross, S.J., Walkil, S., David, R.J., Faix, R.G., Buckleu, R., Elevated IgA in milk from mothers delivering preterm infants (1979) Pediatr Res, 13, p. 44