Urinary excretion of low- and no-calorie sweeteners (LNCS) and associated food sources, as observed in the German cross-sectional KarMeN-study.

Purpose: We aimed to quantify urinary excretion of LNCS (Low- and No-Calorie Sweeteners) and to identify LNCS-associated food consumption in Germany, with special emphasis on exposure to combinations of different LNCS.

Methods: UPLC-MS/MS was used to quantify LNCS metabolites in 24-hour urine samples of 301 participants from the cross-sectional KarMeN (Karlsruhe Metabolomics and Nutrition) study. Dietary data were assessed via 24 h recall. Spearman rank correlation analysis and multiple linear regression models were used to investigate food groups that contribute to LNCS exposure.

Results: Based on the number of samples with quantifiable urinary concentrations and the absolute excretion within a day, cyclamate (88% of samples), saccharin (44%), acesulfame (35%), and aspartame (32%) were most commonly consumed. The consumption of specific food groups, such as table sweeteners, light soft drinks, Radler, protein shakes, and stevia sweeteners, accounted for significant variations in urinary concentrations. Specific combinations of LNCS were observed for these food groups, as well as a considerable exploitation of LNCS-specific ADI (acceptable daily intake).

Conclusion: Individuals who consume high amounts of specific LNCS-containing, processed foods are exposed to a notable mix of various LNCS. Since data on associations between mixed LNCS exposure and health are lacking, it is an urgent issue to evaluate the potential risks of consuming combinations of diverse LNCS rather than conducting risk assessments of single LNCS.