Ribeiro Mariana, Sato Priscila de Morais, Rojas Carlos Felipe Urquizar, Spinillo Carla Galvão, Mais Laís Amaral, Borges Camila Aparecida, Martins Ana Paula Bortoletto
School of Public Health, University of São Paulo (FSP/USP), São Paulo, São Paulo, Brasil.
Institute of Consumers Defense (Idec), São Paulo, São Paulo, Brasil.
PLoS One. 2025 Sep 3;20(9):e0331302. doi: 10.1371/journal.pone.0331302. eCollection 2025.
The consumption of non-sugar sweeteners (NSS) has been associated with potential health risks, including glucose intolerance, alterations in the intestinal microbiota which lead to metabolic abnormalities including pancreatic endocrine dysfunction, aggravation of kidney disease, increased risk of cancer and adverse cardiovascular outcomes. In Brazil, the presence of NSS in ultra-processed food products (UPFP) is only reported in ingredient lists, which Brazilian consumers struggle to locate and understand. On the other hand, countries such as Argentina and Mexico have implemented a cautionary legend for NSS in packaged foods and beverages. This study aimed to evaluate expert opinion on the design attributes of NSS warning labels intended to inform consumers about the presence of these sweeteners in packaged foods and beverages sold in Brazil. For this purpose, a panel of experts was conducted to discuss, judge and decide on the technical aspects of readability, visibility, attention, perceived healthiness and health risk of the proposed warning labels for NSS in packaged foods and beverages in Brazil. Based on the specific attributes, the experts identified two NSS warning messages as the most suitable: 'Attention: contains non-sugar sweetener - not recommended for children and for weight control' and 'Attention: contains non-sugar sweetener'. According to the experts, these messages should be displayed as front-of-package warnings in black rectangular boxes with white text, beginning with the signal word 'Attention' and positioned on the main panel near the Brazilian front-of-package nutrition labeling. The study provides interdisciplinary evidence and expert insight, to support the development of NSS warning labels in Brazil.
食用非糖甜味剂(NSS)与潜在健康风险相关,包括葡萄糖不耐受、肠道微生物群改变,进而导致包括胰腺内分泌功能障碍在内的代谢异常、加重肾脏疾病、增加患癌风险以及产生不良心血管后果。在巴西,超加工食品(UPFP)中NSS的存在仅在成分列表中报告,巴西消费者很难找到并理解这些列表。另一方面,阿根廷和墨西哥等国家已在包装食品和饮料上为NSS设置了警示说明。本研究旨在评估专家对NSS警示标签设计属性的意见,这些标签旨在告知巴西消费者包装食品和饮料中存在这些甜味剂。为此,组织了一个专家小组来讨论、评判并决定巴西包装食品和饮料中NSS拟议警示标签在可读性、可见性、关注度、感知健康度和健康风险等技术方面的问题。基于这些特定属性,专家们确定了两条最适合的NSS警示信息:“注意:含有非糖甜味剂——儿童和控制体重者不宜食用”以及“注意:含有非糖甜味剂”。专家们认为,这些信息应以白色字体显示在黑色矩形框内的包装正面警示中,以“注意”一词开头,并位于靠近巴西包装正面营养标签的主面板上。该研究提供了跨学科证据和专家见解,以支持巴西NSS警示标签的开发。