Concentration Data. Deterministic Liu et al., 2012 [20] MPL. Reported Use. Simple Distribution years (n = 2044) Level. Probabilistic Cohort of female

Transcription

1 Table S1. Methodologies Utilized for Intake Assessments Conducted for Low-/No-Calorie in Asia. Chemical China Female college Quantitative MPL Liu et al., 2012 [20] students, FFQ years (n = 2044) Cohort of female Analytical college students (n = 252) 2 models: attending 10 (A) Point estimate: average different schools in Analytical population intake + average the Guangdong measurement in sweetener concentration province preserved fruits (B) Simple distribution: (n = 252) and MPL MPL China All ages, 2 years; 2 3*24-hour MPL 1 Cao et al., 2016 to 3 years; 4 9 recalls, FFQ (1- [21] years; years; year) and/or years; >60 weighed Analytical years (n = NR) record included as MPL 1 China Nutrition part of China GB and Health Survey Nutrition and National Health (2002) Health Survey and Family (2002) Planning Commission of Nutrients 2018, 10, x; doi: FOR PEER REVIEW

2 Nutrients 2018, 10, x FOR PEER REVIEW 2 of 35 Chemical the PRC, 2014 [40] India Cohort of assumed Semi- MPL (PFA, Singhal and heavy consumers - quantitative 2006) [41] Mathur, 2008 [22] diabetics (n = 72), FFQ Reported Use OW individuals (n (table-top = 39), and female sweeteners college students only) MPL/industry use level (from 3 colleges; n = Analytical 47) 2 ; Age range NR Japan Semi-weighed Sadamasu et al., Tokyo household Simple distribution 2009 [23] Metropolitan dietary record Health and (24 hours) Analytical Nutrition Survey Average population (2004) (age range 3 consumption data + analytical and sample size data NR) Japan Children, aged 1 6 Semi-weighed MHLW, 2010 [24] years (n = 2,123) household Simple distribution dietary record National Nurtition (24 hours) Analytical Survey ( ) Market basket survey: average and National Average consumption data + analytical Health and measurement concentration

3 Nutrients 2018, 10, x FOR PEER REVIEW 3 of 35 Chemical Nutrition Survey Obtained from 6 (2003) government- or national-owned research insitutes Japan Adults, 20 years (n Semi-weighed Kawaski et al., = 28,062) household Simple distribution 2011 [25] dietary record National Nurtition (24 hours) Analytical Survey ( ) Market basket survey: and National Average average consumption data + Health and measurement mean analytical concentration Nutrition Survey obtained from 6 (with/without positive samples) (2003) government- or national-owned research insitutes Japan Adults, 20 years (n Semi-weighed MHLW, 2011 [26] = 21,890) household Simple distribution dietary record National Health (24 hours) Analytical and Nutrition Market basket survey: average Survey ( ) Average consumption data + analytical measurement concentration obtained from 6

4 Nutrients 2018, 10, x FOR PEER REVIEW 4 of 35 Chemical government- or national-owned research insitutes Japan Ages 1-6 years; day food MHLW, 2012 [27] years; years; diary Simple distribution 20 years; All ages (repeated 4 1 years (n = 4510) times per year) Analytical Steviol data Market basket survey: average Special Survey of Average consumption data + mean the Frequency and measurement analytical concentration Intake of obtained from 6 government- or (2010) national-owned research insitutes Japan Total population NA NA Sato et al., 2013 Simple distribution [28] Disappearance data: estimated annual shipment volume ( ) 0.8 (loss during storage/transportation/use)/

5 Nutrients 2018, 10, x FOR PEER REVIEW 5 of 35 Chemical 12,800,000 people (the Japanese population in 2010)/365 days Japan Children 1-6 years 3-day food Kumai et al., 2015 (n = 227) diary Simple distribution [29]; MHLW, 2015 (repeated 4 [30] Special Survey of times per year) Analytical the Frequency and data Market basket survey: average Intake of Average consumption data + mean measurement analytical concentration (2010) obtained from 6 government- or national-owned research insitutes Japan Ages 1-6 years; day food MHLW, 2016 [31] years; years; diary Simple distribution 20 years; All ages (repeated 4 1 years (n = 4,510) times per year) Analytical Steviol data Market basket survey: average Special Survey of Average consumption data + mean the Frequency and measurement analytical concentration Intake of obtained from 6 government- or (2010) national-owned

6 Nutrients 2018, 10, x FOR PEER REVIEW 6 of 35 Chemical research insitutes Korea All ages (age range 24-hour recall Choi et al., 2011 and sample size Simple Distribution [32] NR) Analytical KNHANES (2005) data (n = 584) consumption + mean sweetener concentration Collected from department stores, spermarkets, and convenience stores Korea Children and 2 24-hour Lee et al., 2011 adolescents (n = recall [33] 6625); 0 6 years; 7 12 years; Analytical years data (n = 92) a mean sweetener concentration national dietary Snacks targeted survey, Dietary at children Intake Survey of Infant, Children

7 Nutrients 2018, 10, x FOR PEER REVIEW 7 of 35 Chemical and Adolescents ( ) Korea Total population Budget MPL 4 Ha et al., 2013a method Simple Distribution [34] Analytical data Budget method All ages, 1 to >65 24-hour recall years (n = 8081) KNHANES who Analytical consumed intense data Analytical 2 scenarios: sweeteners during data (n = 605) (A) Individual consumption the 24-hour recall data + mean sweetener (2009) Collected from concentration (all samples) Korean grocery (B) Individual consumption data stores and + mean sweetener concentration markets for positive samples Korea All ages, 1 to >65 24-hour recall Ha et al., 2013b years (n = 8,081) [35] KNHANES who Analytical consumed intense Stevioside data (n = 541) 2 scenarios: sweeteners during

8 Nutrients 2018, 10, x FOR PEER REVIEW 8 of 35 Chemical the 24-hour recall Collected from (A) Individual consumption (2009) Korean grocery data + mean sweetener stores and concentration (all samples) markets based (B) Individual consumption data on permitted + mean sweetener concentration use of for positive samples sweeteners and consumption in KNHANES 2009 Korea All ages (sample 24-hour recall Suh and Choi, size NR); 1 2 years; Simple Distribution 2013 [36] 3 6 years; 7 12 years; years; Analytical years; data (n=339 for Summary statistics + mean years; years; saccharin and sweetener concentration years; > for years sucralose) KNHANES (2010) Domestic and imported products Korea Children and 24-hour recall Kim et al., 2014 adolescents, aged 1- [37] 19 years (n = 6082) Probabilistic

9 Nutrients 2018, 10, x FOR PEER REVIEW 9 of 35 Chemical Analytical 2 scenarios: KNHANES (2007 data (n = 738) (A) Individual consumption 2009) data + mean sweetener Non-alcoholic concentration beverages only (B) Individual consumption data + range of sweetener concentrations Korea All ages (sample 24-hour recall Suh et al., 2014 size NR); 1 2 years; Simple Distribution [38] 3 6 years; 7 12 years; years; Analytical years; data (n = 247 for Summary statistics + mean years; years; aspartame and sweetener concentration years; > for ace-k) years Domestic and KNHANES (2010) imported products Korea All ages (n = 34,706) 24-hour recall Lee et al., 2017 [39] KNHANES ( ) Analytical data (n = >900) Mean sweetener concentration Domestic and of positive samples

10 Nutrients 2018, 10, x FOR PEER REVIEW 10 of 35 Korea Kim et al., 2017 [42] All ages; <2 years; 3 6 years; 7 12 years; years; years; >65 years (n = 20,788) KNHANES ( ) Total population Steviol Thaumatin 24-hour recall imported products MPL Analytical data (n = >900) Lee et al., 2017 [39] Chemical Presence NA NA Market Share mean sweetener concentration of positive samples Simple Distribution Poundage data: Total production, import, and export of food products and food additives Ace-K = acesulfame-k; FFQ = food frequency questionnaire; KNHANES = Korea National Health and Nutrition Examination Survey; MPL = maximum permitted level; n = sample size; NA = not Applicable; NR = not reported; OW = overweight; PRC = People s Republic of China. 1 Value reported as maximum residue limit (MRL) in the publication; however, the MPL is the standard terminology for food additives, and used herein. 2 Number of individuals (n) listed includes only regular consumers of artificial sweeteners (defined as individuals consuming artificial sweeteners 1 time a week); intakes by occasional consumers (defined as individuals consuming once a fortnight or less) were not examined. 3 Study does not specifically state the age group investigated; however intakes were expressed for a 50 kg individual, which aligns with the default value for adults utilized for other Japanese studies. 4 The second highest MPL was selected for solid foods as highest MPL was established for sugar.

11 Table S2. Methodologies Utilized for Intake Assessments Conducted for Low-/No-Calorie in Australia/New Zealand. 1 Chemical Australia and Australian 24-hour recall MPL + New Zealand children, 2 16 proposed years (n = 4487) amendments 2 FSANZ, 2010, Assumed 30% 2011a,b [43 45] ANNPAS (2007) Steviol market uptake 3 scenarios: Analytical data (30% of the (A) Individual consumption General MPL) data + MPL + 30% market share Australian for all food categories population, 17 (B) Individual consumption data years (n = NR) + MPL + 30% market share for all food categories except for ANNS (1995) water based flavoured drinks (C) Individual consumption New Zealand data + MPL + 30% market share children, 5 14 for all food categories except for years (n = 3275) flavoured milk products Participtans of (including yoghurt) NZNNS (2002) General New Zealand population, 15 years (n = 4636) Nutrients 2018, 10, x; doi: FOR PEER REVIEW

12 Nutrients 2018, 10, x FOR PEER REVIEW 2 of 35 1 Chemical NZNNS (1997) Australia and Australian 24-hour recall MPL + New Zealand children, 2 6 proposed years (n = 779) amendments 3 FSANZ, 2015a,b,c and 7 11 years [46 48] (n = 802); 2 scenarios: general Analytical data (A) Individual consumption Australian data + MPL for chewing gum population, 2 only years (n = (B) Combined estimated 12,153) and 12 dietary exposure from chewing years (n = gum and 2004 sweetener survey 10,572) ANNPAS ( ) New Zealand children, 5 14 years (n = 3275) NZNNS (2002)

13 Nutrients 2018, 10, x FOR PEER REVIEW 3 of 35 General New Zealand population, 15 years (n = 4721) NZANS ( ) 1 Chemical Presence Market Share Ace-k = acesulfame-k; ANNS = Australian National Nutrition Survey; ANNPAS = Australian National Nutrition and Physical Activity Survey; MPL = maximum permitted level; n = sample size; NZANS = New Zealand Adult Nutrition Survey; NZNNS = New Zealand National Children s Nutrition Survey. 1 Existing MPLs are specified in Schedule 15 of the Standards Code. 2 Amendments proposed by applicant: ice cream and edible ices 64 mg/kg; water based flavored drinks 160 mg/kg; formulated beverages 160 mg/kg, soy beverage, unflavored 65 mg/kg; soy beverage, flavored 175 mg/kg. 3 Amendments proposed by applicant: intensely sweetened chewing gum 5000 mg/kg.

14 Table S3. Methodologies Utilized for Intake Assessments Conducted for Low-/No-Calorie in Europe. 1 Chemical Portugal Adolescents, 13 Annual intake Lino et al., years (n = 65). of soft drinks Simple Distribution [54] Cohort of and nectars students (2006) per Analytical attending a Portuguese (n = 48, samples Daily intake + Mean public high inhabitant collected in school concentration / Default body school in canteen and weight Coimbra (2006 supermarkets in 2007) and ) total population Denmark Total population Information on Leth et al., years (n = consumption of [53] 3,098); young non-alcoholic children 1 3 beverages Analytical years (n = 278); collected via 7- (n = 177, 2 scenarios: children 4 6 day food diary collected by the (A) Individual consumption years (n = 366); Danish Veterinary data + mean concentration of children 7 10 and positive samples years (n = 376) Administration, (B) Individual consumption data ) + mean concentration of all samples Nutrients 2018, 10, x; doi: FOR PEER REVIEW

15 Nutrients 2018, 10, x FOR PEER REVIEW 2 of 35 1 Chemical Danish Dietary Survey (1995) Norway Participants Information on Husøy et al., 2008 from 4 national consumption of Reported Use [52] dietary surveys beverages and Young children, foods 2 from: Analytical For beverages, aged 1 year and Semi- chemical 2 years from quantitative Industry use concentration average weighted concentration Spedkost (n = FFQ (1 2 year levels collected by weighted 1204) and olds); 4-day the Norwegian according to Småbarnskost (n food diary (4-,9-, food safety content and = 1720), 13-year olds); authority sales volumes repsectively; FFQ (16 79 (2004)(beverages); provided by Children, 4-, 9-, years); FFQ (16 Analytical data food and 13 years (n 80 years) collected by manufacturers = 2215) from Bergsten, 1998 Ungkost; (food products) Adults, years (n = 2672) from Norkost food survey (1997); and Adults, aged years (n =

16 Nutrients 2018, 10, x FOR PEER REVIEW 3 of 35 1 Chemical 1375) from Omnibus survey (1997) France 7-day food diary Bemrah et al., national dietary Reported Use 2008 [51] survey (INCA1, ) Analytical All ages (n = 2 scenarios: 3033); children Industry use (1) Individual consumption data and young levels collected by + Mean concentration of all teenagers, 3 14 the DGCCRF samples years (1018); ( ) (2) Individual consumption data adults, 15 + Mean concentration of positive years (n = 1985) samples Austria National 3-day weighted Mischek, 2010 consumption record Simple Distribution [56] data available (preschool from Australian childern), 24- Analytical Nutrition hour recall (n = 159, data for Report for (adults) beverage samples population group + average Preschool collected between concentration data/default body children ( ) weight years) and adults (19 65) (n

17 Nutrients 2018, 10, x FOR PEER REVIEW 4 of 35 1 Chemical = 151 and 2581, respectively) Portugal Total population Annual intake Lino and Pena, of traditional Simple Distribution 2010 [51] soft drinks and soft drinks Analytical based on (n = 48) Daily intake + Mean mineral water concentration / Default body and nectars Purchased in the weight per Portuguese central zone of inhabitant Portugal (2006 (2006) 2007) Netherlands Young adults, on Hendriksen et al., years (n = carbonated soft 2011 [57] 750) drinks from 2 24-h dietary Analytical DNFCS 2007 recalls 2010 Collected by the Actual concentrations (or Dutch average, if not available) Safety Auhtority (2006 and 2008) Belgium Adults, aged 2 24-hour recall MPL Huvaere et al., 15 years (n = 2012 [58] 3,083), including

18 Nutrients 2018, 10, x FOR PEER REVIEW 5 of 35 1 Chemical diabetics (n = Analytical 2 scenarios: 428) (n = 119) (A) Individual consumption data + MPL the Belgian Sweetened (B) Individual consumption data products collected + Mean concentration of positive from major samples Survey (dating supermarkets in from 2004) Belgium ( ) Portugal Total population Annual intake Diogo et al., 2013 of traditional Simple Distribution [59] soft drinks and soft drinks Analytical based on (n = 78) Daily intake + Mean mineral water concentration / Default body and nectars per Purchased in weight Portuguese central zone of inhabitant Portugal (2010) (2010) France, Italy, UK, France - 7-day diary MPL Ireland (French survey); Reported Use Vin et al., 2013 the INCA 2 3-day diary (collected Probabilistic [60] ( ) aged (Italian survey); by Drink 3-79 years (n = 4-day or 7-day Europe) 2 scenarios: 4079) diaries (UK Analytical

19 Nutrients 2018, 10, x FOR PEER REVIEW 6 of 35 1 Chemical Italy - survey); 7-day (A) Individual consumption diary (Irish data + MPL the INRAN- surveys) (B) Individual consumption data SCAI ( range of sweetener 2006), aged 1 concentrations mth to 97 years (n = 3323) UK - the UK NDNS ( ), aged 1.5 to >65 years (n = 6787) Ireland, the NSIFCS ( ), NCFS ( ), or NTFS ( ), aged 5 64 years (n = 2414) Norway Children, 2 Semi- MPL VKM, 2014a [71] years (n = 1674) quantitative Reported Use Simple Distribution (2012) Probabilistic

20 Nutrients 2018, 10, x FOR PEER REVIEW 7 of 35 1 Chemical FFQ; 2 24-hour Analytical Collected Annual sales Småbarnskost Steviol recall from volumes 6 scenarios: ( ) Soft drinks, "saft", industry (L/year) (2012) (A) Individual consumption Young women, nectar, and (2012) data + mean concentration years (n = flavoured water occurence data + market share 143); Young data men, (B) Individual consumption data years (n = 138); + mean concentration + market years (n = share data 782); Men (C cyclamate and saccharin) years (n = 724) highest reported concentration + Norkost 3 occurence data ( ) (D cyclamate and saccharin) highest reported concentration (E steviol glycosides) Individual consumption data + MPL + occurence data (D steviol glycosides) MPL Norway Children, 2 Semi- VKM, 2014b [72] years (n = 1674) quantitative Reported Use Simple Distribution (2012) Probabilistic

21 Nutrients 2018, 10, x FOR PEER REVIEW 8 of 35 1 Chemical FFQ; 2 24-hour Analytical Collected Annual sales Småbarnskost s recall from volumes 4 scenarios: (2007) Soft drinks, "saft", industry (L/year) in (A) Individual consumption Young women, nectar, and (2012) 2012 data + mean concentration years (n = flavoured water occurence data + market share 143); Young en, data years (n = (B) Individual consumption data 138); mean concentration + market years (n = 782); share data Men years (C) Individual consumption (n = 724) data + highest reported concentration + occurence data Norkost 3 (D) individual consumption ( ) data + highest reported concentration France Children,1 4 3-day diary MPL months (n = Mancini et al., 124); [61] months (127); 7 Analytical 12 months (n = 195); MPL months (n = 259) the BEBE-SFAE

22 Nutrients 2018, 10, x FOR PEER REVIEW 9 of 35 1 Chemical dietary survey (2005) Belgium Toddlers, FAIM-V1.1 tool MPL children, Simple Distribution Van Loco et al., adolescents, 2015 [62] adults, the Analytical elderly (FAIM s Summary statistics + MPL V1.1) (n = NR) Belgium Children and FFQ MPL adolescents with Dewinter et al., T1D (n = 103); [63] 6 years (n = 9); Analytical 7 12 years (n = Steviol (collected by 2 scenarios: 35); years Huvaere et al., (A) Individual consumption (n = 59) 2012) [58] data + MPL Cohort of T1D (B) Individual consumption data patients from + Mean concentration of positive the Pediatrics samples or MPL (stevia only) Department of the University Hospitals Leuven (2014)

23 Nutrients 2018, 10, x FOR PEER REVIEW 10 of 35 1 Chemical Ireland Toddlers and 4-day diary MPL Children ages 1 Martyn et al., years (n = 500) Probabilistic [64] Analytical Irish the NPNS(2011 National 4 scenarios: 2012) FSAI chemical (A) Individual consumption Sampling Ingredient data + MPL Program (2008- base V4 (B) Individual consumption data 2011) + MPL + occurence (C) Individual consumption data + range of concentrations (D) Individual consumption data + range of concentrations + occurence Ireland Particpants of 4-day diary MPL the NPNS Reported Use O Sullivan et al., ( ), (FSMPs, Probabilistic 2016 [65] aged 1 3 years provided by Health (n = 376), used Nutricia) Service 5 scenarios 4 : as a surrogate Analytical Exceutive (1) Individual consumption data for children (HSE) list of + MPL + 75% adherence with PKU and Reimbursabl (2a) Individual consumption CMPA e Items data+ range of concentrations % adherence

24 Nutrients 2018, 10, x FOR PEER REVIEW 11 of 35 1 Chemical (2b) Individual consumption data+ range of concentrations % adherence (Scenario 2b) (3a) Individual consumption data + range of use levels + occurence + 75% adherence); (3b) Individual consumption data + Range of use levels + Occurence + 50% adherence Ireland Adults, day diary MPL Buffini et al., 2017 years (n = 1413) [69] the National Analytical Irish Adult Nutrition Steviol (n = 377) National 3 scenarios: Survey (2011) (A) Individual consumption Collected from Ingredient data + MPL major Irish base V4 (B) Individual consumption data supermarkets and food + MPL + occurence label survey (C) Individual consumption data + Actual concentration + occurence Italy All ages, 3 3-day diary MPL Le Donne et al., years (n = 3,270) 2017 [66] Probabilistic the INRAN- Analytical

25 Nutrients 2018, 10, x FOR PEER REVIEW 12 of 35 1 Chemical SCAI (2005 Steviol (n = 304 for stevia; label 3 scenarios: 2006) n = 290 all other) survey (A) Individual consumption Thaumatin conducted in data + MPL Steviol glycoside Rome (2014) (B) Individual consumption data samples + MPL + occurence purchased in (C) Individual consumption Rome; other data + Range of concentrations + sweeteners occurence purchased in Italy and analyzed Janvier et al., 2015 Ireland Young healthy 4-day food diary MPL O Sullivan et al., children, Reported Use 2017 [67] years (n = 2096), (FSMPs, Probabilistic used as a provided by NHS Drug surrogate for Nutricia) Tariff back 4 scenarios: children with Analytical issues, (A) MPL + 75% adherence PKU obtained (B) MPL + 50% adherence from the (C) Range of concentrations + the UK NDNS British occurence + 75% adherence ( ; National (D) Range of concentrations ; Library occurence + 50% adherence ) Service ( )

26 Nutrients 2018, 10, x FOR PEER REVIEW 13 of 35 1 Chemical EU Member Infants, Range of dietary MPL States toddlers, other intake Simple Distribution children, methodologies Tennant and adolescents, included in the Analytical Mintel Bruyninckx, 2017 adults, elderly, Steviol EFSA Global New 4 scenarios: [68] very elderly (n = Comprehensive Products (A) Summary statistics + MPL NR) European base (B) Summary statistics + MPL + (2015) brand loyal base, (C) Summary statistics + MPL + 3 summary occurence statistics (D) Summary statistics + MPL + Occurence + brand loyal EU Member Toddlers, Range of dietary MPL States months; intake Reported Use Simple Distribution Children, 3 9 methodologies EFSA, 2013 [70] years; included in the Analytical Adolescents, 10 EFSA 2 scenarios: 17 years; Adults, Comprehensive Combination of (A) Summary statistics + MPL years; European industry use (B) Summary statistics + actual Elderly, 65 levels and concentration years (n = NR) base (2010) analytical data (reported/analytical) [79] EU Member Toddlers, Range of dietary MPL + States months; intake extension of use 6 Simple Distribution Children, 3 9 methodologies

27 Nutrients 2018, 10, x FOR PEER REVIEW 14 of 35 1 Chemical EFSA, 2015a [73] years; included in the Adolescents, 10 Steviol EFSA Summary statistics + 17 years; Adults, Comprehensive Analytical MPL/extension of use years; European Elderly, 65 years (n = NR) base (2010) [79] EU Member Toddlers, FAIM tool MPL + States months; (summary extension of use 7 Simple Distribution EFSA, 2015b [74] Children, 3 9 intakes) years; Adolescents, 10 Analytical Summary statistics + 17 years; Adults, MPL/extension of use years; Thaumatin Elderly, 65 years (n = NR) Assessment from Young children, Fixed protein Fixed value of 4.1, FSMPs in Young 1-3 years intake (absolute 5.9, or 9 mg ace- Simple Distribution Children or bw) k/g protein EFSA, 2016a [75] 6 scenarios: (A) 9 mg ace-k/g protein, providing 20 g protein/day (B) 9 mg ace-k/g protein, providing 10 g protein/day

28 Nutrients 2018, 10, x FOR PEER REVIEW 15 of 35 1 Chemical (C) 5.9 mg ace-k/g protein, providing 3 g protein/kg bw/day (D) 4.1 mg ace-k/g protein, providing 3 g protein/kg bw/day (E) 5.9 mg ace-k/g protein, providing 20 g protein/ day (F) 5.9 mg ace-k/g protein, providing 10 g proteinday Assessment from Young children, Fixed protein Fixed value of 4 FSMPs in Young 1 3 years intake (absolute mg sucralose/g Simple Distribution Children or bw) protein EFSA, 2016b [76] 3 scenarios, wherein there is 4 mg sucralose/g protein: (A) Standard fixed protein intake of 14.5 g/day (B) Maximum protein intake of 3 g/kg bw/day (C) Protein intake ranging between 0.95 to 0.73 g /kg bw/day in children weighing between 10.2 to 14.7 kg

29 Nutrients 2018, 10, x FOR PEER REVIEW 16 of 35 Ace-K = acesulfame-k; bw = body weight; CMPA = cow s milk protein allergy; DGCCRF = Directorate General for Fair Trading, Consumer Affairs and Fraud Control; DNFCS = Dutch National Survey; EFSA = European Safety Authority; EU = European Union; FAIM = Additive Intake Model; FFQ = food frequency questionnaire; FSAI = Safety Authority of Ireland; FSMP = foods for special medical purposes; HSE = Health Service Exceutive; INCA = Individual and National Study on ; INRAN-SCAI = Italian National Survey; MPL = maximum permitted level; n = sample size; n/a = not applicable; NCFS = National Children s Survey; NDNS = National Diet and Nutrition Surveys; NHS = National Health Service; NPNS = National Pre-school Nutrition Survey; NR = not reported; NSIFCS = North/South Ireland Survey; NTFS = National Teens Survey; PKU = phenylketonuria; SFAE = French Association for Children s ; T1D = type 1 diabetes; UK = United Kingdom. 1 MPL values for European studies obtained from Regulation 1333/2008 [77]. 2 Intake from food estimated for adults only. 3 Survey detail reported in Mischek [56] limited; survey details obtained from Elmadfa and Freisling (2004). 4 Assessment was also conducted using the FAIM template; however the authors noted that this database is not suitable for estimating exposures of young patients to artificial sweeteners from FSMPs because of the differences in dietary consumption patterns compared with healthy young children. 5 for scenarios 2a and 2b based on information from Table 2 in manuscript. 6 Extension of use of up to 29 mg/l steviol equivalents in tea, coffee, herbal infusion beverages, instant coffee and instant cappuccino products. 7 Extension of use of up to 5 mg/l thaumatin in flavored drinks. Extended condition of use as a flavor carrier. Quantum satis in all food flavorings.

30 Table S4. Methodologies Utilized for Intake Assessments Conducted for Low-/No-Calorie in Latin America. Chemical Argentina Cohort of FFQ of non- Cagnasso et al., children and alcoholic Reported use 2007 [81] adolescents beverages level attending public combined with Analytical data label and private portion size data data schools (middle (Technical use levels from food labels and upper Resolution declared on middle class) in MERCOSUR beverage labels Buenos Aires, 3 47/03) 18 years (n = 190) Chile Cohort of FFQ of 122 food Durán Agüero et children products Reported use al., 2011 [82] attending school containing level in the artificial Analytical data label Valparaíso Steviol sweeteners data region, 6 14 collected from use levels from food labels years (n = 281) local declared on food supermarkets,, labels combined with household measures Nutrients 2018, 10, x; doi: FOR PEER REVIEW

31 Nutrients 2018, 10, x FOR PEER REVIEW 2 of 35 Chemical Chile Cohort from the FFQ of 207 food Hamilton et al., Metropolitan products Reported use 2013 [85] region involving containing level Adults, artificial Analytical data label years (n = 477); Steviol sweeteners, data children, 6 17 combined with use levels from food labels years (n = 516); food atlas of declared on food adults with portion sizes labels diabetes collected from (Type1/2), Chilean markets years (n = 155); children with diabetes (Type 1), 3 17 years (n = 63) Chile Cohort of school FFQ (1 week) of Durán Agüero et children from 144 food Reported use al., 2014 [83] Viña del Mar products level and Santiago, containing Analytical data label years (n = artificial data 571) sweeteners, use levels from food labels combined with declared on food household labels measures

32 Nutrients 2018, 10, x FOR PEER REVIEW 3 of 35 Chemical Chile, Panama, Cohort of adults FFQ (1 week) of Guatemala, and attending 122, 109, 29, and Reported use Peru university from 124 food level each country, products Analytical data label Durán Agüero et years (n = containing data al., 2015a [86] 1224) artificial use levels from food labels sweeteners, declared on food combined with labels household measures, collected from Chile, Panama, Guatemala, and Peru, respectively Chile, Panama, Cohort of adults FFQ (1 week) Guatemala, and attending for carbonated Reported use Peru university from beverage level each country, products Analytical data label Durán Agüero et aged containing data al., 2015b [87] years (n = 1229) artificial use levels from food labels sweeteners, declared on food combined with labels food atlas of portion sizes

33 Nutrients 2018, 10, x FOR PEER REVIEW 4 of 35 Chile Durán Agüero et al., 2015c [84] Cohort of adults attending 4 different universities (first year students, mean age 20.3 to 20.8 years (n = 486) Steviol FFQ (1 week) of food and beverage products containing stevia Reported use level Analytical data declared on food labels Chemical Presence label data Market Share Ace-K = acesulfame-k; FFQ= food frequency questionnaire; MPL = maximum permitted level; n = sample size; SD = standard deviation. use levels from food labels

34 Nutrients 2018, 10, x FOR PEER REVIEW 5 of 35 Table S5. Methodologies Utilized for Intake Assessments Conducted for Low-/No-Calorie by JECFA. Chemical Global Global GEMS/ Replacement of JECFA, 2009 [17] population; consumption dietary sugars by Simple Distribution China; Japan; database; per stevia according US capita to sweeteness Steviol disappearance ratio (1:200) In addition to published dietary (China and exposure analyses Japan); per capita replacement (Japan, US); consumption data reported in children, and diabetic children/adults Global Global Various dietary MPL Published dietary exposure JECFA, 2010 [92] population surveys Reported use analyses conducted in level Australia, Analytical data Brazil, Germany, Italy, New Zealand, Spain, and the United Kingdom

35 Nutrients 2018, 10, x FOR PEER REVIEW 6 of 35 Ace-K = acesulfame-k; GEMS = Global Environmental Monitoring System; JECFA = Joint FAO/WHO Expert Committee on Additives; NR = not reported; US = United States.