artificial sweeteners are also known as intense sweeteners because they are many times sweeter than sugar but contribute only few calories when added to foods
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A sugar substitute is a food additive that provides a sweet taste like that of sugar while containing significantly less food energy than other sweeteners, making it a zero-calorie or low-calorie sweetener. Some sugar substitutes are produced naturally, and some synthetically. Those not produced naturally are, in general, called artificial sweeteners.
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Artificial sweeteners are increasingly popular as an alternative to sugar. Increased incidence of obesity, diabetes, and metabolic syndrome, coupled with heightened consumer awareness, has led to a steady paradigm shift toward the use of low-calorie artificial sweeteners. These artificial sweeteners, also called nonnutritive sweeteners (NNS)/low calorie sweeteners/intense sweeteners, provide more intense sweetness and no or a few calories per gram and are used in beverages, dietary products, drugs, and even mouthwashes.[1] The United States Food and Drug Administration (US-FDA) authority has approved six NNS (saccharine, aspartame, sucralose, neotame, acesulfame-K, and stevia) for use in humans and has classified them under generally recognized as safe (GRAS) category. Another two widely used agents are alitame (approved for use in South America, China, and Australia)[2] and cyclamate (used in 50 countries excluding the US). Siraitia grosvenorii Swingle fruit extract (SGFE; Luo Han Guo in Chinese) is an herbal-based sweetener recently approved by the FDA. However, to this date, a consensus has not been reached by the scientists regarding the safe use of these artificial sweeteners. NNSs include agents from different chemical classes and are 300–13000 times sweeter than sucrose.[3] The FDA has established an acceptable daily intake limit (expressed in mg/kg body weight) for each NNS, and this value is usually set at 1/100 of the no observed adverse effect level (maximum level at which no adverse effects were seen in animal studies).[3] This review envisages the appropriate use, toxicity, and current guidelines for using NNS in clinical practice.