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Sparkling, Nonfermented, Nonalcoholic Beverages
CHAPTER 10
Sparkling, Nonfermented, Nonalcoholic Beverages Marı´a de Lourdes Samaniego-Vaesken1, Teresa Partearroyo1, Emma Ruiz2 and Gregorio Varela-Moreiras1 1
Departamento de Ciencias Farmace´uticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanizacio´n Monteprı´ncipe, Alcorco´n, Madrid, Spain 2Spanish Nutrition Foundation (FEN), Madrid, Spain
Chapter Outline 10.1 Background 309 10.2 Definitions, Regulations, and Classification 310 10.3 Ingredients and Nutritional Composition 312 10.4 Trends in Nonalcoholic Beverage Consumption 317 10.5 Contribution to Diet and Controversies 320 10.6 Conclusion 321 References 322
10.1 Background Sparkling, nonfermented, nonalcoholic beverages include an extensive and ever-increasing variety of products, and nowadays their inclusion is well established among Westernoccidental diet patterns (Singh et al., 2015; Rodrı´guez Alonso et al., 2016). Also known as “refreshing drinks,” these products are highly appreciated and demanded by young and adult consumers for their stimulant flavors, different components, and convenience of consumption associated with leisure time and socially-related activities. Moreover, one of the main drivers of the consumption for these beverages is the hedonistic factor that influences consumers’ preferences. One of the main categories included are soft drinks (also called soda, fizzy drinks, tonic, mineral, sparkling water, or carbonated beverage, etc.) which are beverages that usually contain carbonated water, sweetener, and natural or artificial flavoring. The sweetener may
Trends in Non-alcoholic Beverages. DOI: https://doi.org/10.1016/B978-0-12-816938-4.00010-0 © 2020 Elsevier Inc. All rights reserved.
309
310 Chapter 10 be sugar, high-fructose corn syrup, fruit juice, sugar substitutes, low or no-calorie sweeteners (LNCS) (in the case of “diet drinks”), or a combination of these. Soft drinks may also contain caffeine, coloring, preservatives, and other ingredients. Small amounts of alcohol may also be present in a soft drink, but it must be less than 0.5% of the total volume in order to be considered nonalcoholic (Day and McSweeney, 2016). With water as the main component, these beverages can also contribute to the populations’ hydration status (Maughan et al., 2016). However, some of these products contain somewhat controversial ingredients, namely added sugars. Their excessive consumption has been related to obesity (Malik et al., 2013; Te Morenga et al., 2013) as well as other detrimental health issues such as type 2 diabetes (Greenwood et al., 2014) and cardiovascular heart disease (Huang et al., 2014); therefore, the WHO and other governmental and public health organizations have issued specific recommendations to decrease added sugar intake (World Health Organization, 2015). The WHO guidelines on sugar intake published in 2015 recommended a reduction in free sugar intake for children and adults to less than 10% of the total energy (TE) intake (strong recommendation), while a further reduction in the intake of free sugars to a maximum of 5% of the TE intake was recommended conditionally for additional health benefits (World Health Organization, 2015). In this regard, the Spanish Ministry of Health, Consumption, and Social Welfare and the Spanish Agency for Food Safety and Nutrition have launched the “Collaboration Plan for the improvement of the composition of foods and beverages and other measures 2020” (Ministry of Health, 2018). In this voluntary reformulation plan, one of the main objectives is to reduce the energy density and added sugars content of key food groups and menus by 5% 10% of their median content by the end of 2020 (Ministry of Health, 2018). Importantly, amongst the food groups to be reformulated are soft drinks and related beverages that can contain up to 15 g of added sugars (sucrose) per 100 mL. Provided that a regular beverage serving comprises 330 mL (one can), the derived sugar intake of about 45 g would represent a high proportion of the TE with low nutritional density (empty calories). The aim of this chapter is to draw an updated map of the nutritional facts in the different categories of nonalcoholic beverages on the Spanish and European market based on the information available on their labels.
10.2 Definitions, Regulations, and Classification Focusing on regulatory issues, and in accordance with the Spanish Food Code, in Chapter XXIX, the generic denomination of nonalcoholic or refreshing beverages comprises those that are nonfermented, with or without added carbon dioxide, those prepared with potable or mineral water, characteristic ingredients, and other authorized products (Backholer et al., 2018), these are normally consumed cold or chilled. Specifically in Spain,
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311
the technical-sanitary regulation that is established for nonalcoholic drinks (Royal Decree 650/2011, Real Decreto, 2011) includes products such as “Seltz” and sparkling water, fruit and other vegetable and derivative juices, soft or “refreshing” carbonated beverages, and “horchata” (Real Decreto, 2011). In the present chapter, issues regarding bottled still or sparking water will not be discussed, rather the focus will be on those beverages containing several different ingredients and/or additives, whether sparkling (carbonated) or still, sugar or sugar-free, fat or nonfat, with or without fruit juice, vitamins, and minerals, as well as those of different flavors, packaging materials, and serving sizes. In addition, recent advances in the production of carbonated beverages will be covered in other chapters in this book. The Spanish regulation defines refreshing or soft drinks as nonalcoholic drinks, either carbonated or not, prepared with water for human consumption, natural mineral water, or spring water, and containing one or more of these ingredients: carbon dioxide, sugars, juices, purees, disintegrated fruits and/or vegetables, plant extracts, vitamins and minerals, flavors, authorized additives, or other food ingredients. It is also underlined that finished products should not contain a quantity of alcohol higher than 0.5% by volume. The regulation includes several categories with denominations including: 1. Seltz water: a drink consisting of water and a minimum of 6 g/L of carbon dioxide. 2. Soda water: a drink consisting of water and a minimum of 6 g/L of carbon dioxide, which is characterized as containing sodium bicarbonate. 3. Flavored water: water, with or without carbon dioxide, containing flavorings. 4. Gaseosa: a colorless beverage prepared with water, carbon dioxide, flavors, sugars and/ or authorized sweeteners and additives. 5. Other refreshing beverages: the generic denomination of a refreshing drink can be specified with a denomination that corresponds to its composition or characteristics. Among others are: a. Refreshing drinks from fruit juices, which are characterized as containing juices, pure´es, or their mixtures. b. Refreshing drinks from extracts, these incorporate extracts of fruit, vegetables, or both. c. Mixed refreshing drinks, which consist of refreshing drinks and other foods. d. Refreshing drinks ready to dilute and solid products for the preparation of refreshing beverages, which will be those that are consumed once reconstituted. e. Flavored refreshing drinks, which are characterized as containing aromatic agents with the addition of other food ingredients. A relevant limitation many nutrition scientists find in the assessment of the consumption of nonalcoholic beverages, is the different food classification methods involved in published dietary surveys, which are not performed homogenously across countries due to local food law regulations (Guelinckx et al., 2015).
312 Chapter 10
10.3 Ingredients and Nutritional Composition According to regulations, nonalcoholic, refreshing beverages may contain any of the following ingredients (Real Decreto, 2011): 1. Water for human consumption: This refers to prepared water, natural, or spring mineral water. It comprises about 87% 92% of the beverage volume and as a major component of nonalcoholic beverages, its adequate treatment is a key process. The water used is pretreated to remove impurities, microorganisms, off-tastes, odors, turbidity, and to regulate alkalinity and hardness (Shachman, 2004). 2. Carbon dioxide: This provides the gas content or “fizziness” that can also be referred to as carbonic acid. It contributes to acidity and prevents spoilage acting as a preservative (Shachman, 2004). 3. Sugars and syrups: These require complex or basic preparations where sucrose is the main sweetener used, followed by high-fructose corn syrup. 4. Juices, purees, broken fruits, vegetables, or their mixtures: These comprise the edible parts, in a ripe and fresh state, although for some commodities, the whole fruit or vegetable, together with seeds and peels are crushed with the juice to produce purees. In any case, they are mainly used as concentrates in beverages formulation at a level of between 2% and 10% by volume of the product when calculated as reconstituted juice. 5. Fruit, vegetable extracts, or both. 6. Caffeine and quinine: these ingredients are extensively used and appreciated by consumers (Gonza´lez Reyes et al., 2015). Quinine is a compound from the alkaloid family, obtained from the bark of the cinchona tree (Cinchona officinalis); the bitterness of which provides a refreshing flavor to beverages (Sa´nchez et al., 2008). On the other hand, caffeine, chemically known as 1,3,7-trimethylxanthine, occurs naturally in the leaves, fruit, and seeds of a number of plant species like coffee and cocoa beans, tea leaves, kola nuts, and guarana. It is widely consumed for the stimulant effects it produces (decreases the feeling of fatigue, combats drowsiness, etc.). Both have been qualified as generally recognized as safe by the Food and Drug Administration, under regular conditions of use (Food and Drug Administration, 2019; Rosenfeld et al., 2014). However, European regulations established a limit of 100 and 150 mg/kg for quinine and caffeine addition to soft drinks, respectively (European Union, 2012). 7. Authorized additives and flavors: for example, in the case of sweeteners, these are used as sugar substitutes since they provide fewer calories (aspartame provides 4.0 kcal/g but is 180 times sweeter than sugar). Up to 19 types of low or no-caloric sweeteners are authorized in the European Union. These include sorbitol (E-420), mannitol (E-412), acesulfame-K (E-950), aspartame (E-951), cyclamate (E-952),
Sparkling, Nonfermented, Nonalcoholic Beverages
313
isomalt (E-953), saccharine and its sodium, potassium, and calcium salts (E-954), sucralose (E-955), thaumatin (E-957), neohesperidine DC (E-959), steviol glycosides or “stevia” (E-960), neotame (E-961), salt of aspartame-acesulfame (E-962), polyglycitol syrup (E-964), maltitols (E-965), lactitol (E-966), xylitol (E-967), erythritol (E-968), and advantame (E-969) (European Union, 2011a,b). Organic acids such as citric or malic acids are used to provide acidity and sharpness. Fruit-flavored drinks mainly use citric acid, while phosphoric acid is employed in cola drinks. Flavoring refers to a solution of aroma substances from a natural or synthetic source dissolved in a permitted solvent. Colorings of natural origins are widely used, namely carotenoids, anthocyanins, and caramels (Ashurst, 2016). 8. Vitamins and minerals: these are used in accordance with Regulation (EC) No 1925/ 2006 (EFSA, 2010). 9. Other ingredients: these are used in human food or authorized in accordance with Regulation (EC) No. 258/97 of the European Parliament and of the Council of 27 January 1997 concerning novel foods and novel food ingredients (Regulation EC, 1997). 10. Technological adjuvants: as authorized in the Member States of the European Union these include inert gases for headspace, filtering agents for syrups or basic preparations, and others. Regardless of the variety of nonalcoholic beverages that are commercialized nowadays, there is a lack of harmonized, comprehensive, and updated composition data for nonalcoholic beverages available in food composition tables and databases. In fact, nutritional data declared on the labels of these products are, at present, the main source of information as compiled and evaluated in a number of studies from Europe (Zupaniˇc et al., 2018; Samaniego-Vaesken et al., 2018) and worldwide (Ni Mhurchu et al., 2015; Poti et al., 2017). In a recent study, composition and nutrient information regarding 211 nonalcoholic beverages on the Spanish market based on product labels were compiled and assessed (Serrano Iglesias et al., 2016). The distribution of the main beverage categories and their energy, macronutrient, and salt contents are shown in Table 10.1. Overall, the energy contents range from 0 to 55 kcal/100 mL for no-calorie and lemon still soft drinks, respectively. Carbohydrates ranged from 0 to 13 g and total sugars accounted for $ 90% of this macronutrient. The protein (0 0.05 g/100 mL), total fat (0 , 0.5 g/100 mL) as well as salt contents (0 0.13 g/100 mL) were low or not significant. In addition, the vitamin and mineral content was missing from labels in the majority of products. Over the past few years, attention has been mainly focused on the added sugar content of soft drinks. The industry has been making efforts toward product reformulation in order to
Table 10.1: Nutrition facts from soft drinks available on the Spanish Food Market as declared on product labels. Nonalcoholic Beverage Category Cola soft drink Cola soft drink, caffeine free Cola soft drink, no-calorie Cola soft drink, no-calorie, and caffeine free Cola soft drink, lemon Cola soft drink, lemon, no-calorie Cherry cola soft drink Lemon soft drink Lemon soft drink, no-calorie Lemon soft drink, still Lemon soft drink, still, and no-calorie Lemon soft drink, still, low calorie Lemon-lime soft drink Lemon-lime soft drink, low calorie Lemon-lime soft drink, no-calorie Orange soft drink Orange soft drink, no-calorie Orange soft drink, still Orange soft drink, low calorie Strawberry soft drink Pineapple soft drink Apple soft drink Citrus flavored soft drink Azahar and lavender flavored soft drink Pink pepper soft drink
N
Energy (kcal)
Total Total Fats (g) Carbohydrates (g) Sugars (g) Proteins (g)
2 2
42 43 44
0 0
10.6 10.7 11.1
10.6 11.1
0 0
0 , 0.01 0 , 0.01
4 0.2 0.5
0
0 0.1
0
0 0.05
, 0.01 0.02
4
0.2
0
0 0.05
0
0 0.05
, 0.01 0.02
1
42
0
10.6
10.5
0
0.03
2
0.3 1
0
0
0
0 , 0.1
0.02 0.03
1
43
0
10.7
10.7
0
0
6 3
27 43 0.5 2
0 0
6.2 10.5 0 0.4
6 10.5 0 0.4
0 0
0 0.06 0 0.06
6
26 55
0
6.3 13
6.2 13
0
0 , 0.1
2
3
0
0.1 0.2
0.1
0.1
, 0.01 0.05
1
10
0
1.9
1.8
0
0.1
2
44 49
0
11 12.3
11 12.2
0
0.02 0.04
1
10
0
2.1
2.1
0
0.02
2
0.1 1
0
0
0
0 , 0.1
0.03 0.06
4 2
29 52 4
0 0
6.9 12.7 0.9
6.7 12.7 0.9
0 0
0 0.03 0 0.02
2
38
0
9.1 9.3
8.9 9.3
0 0.1
0 0.03
5
6 17
0 0.1
0.8 4.1
0.8 4
0 0.1
, 0.01 0.13
2
44 51
0
10.8 12.4
10.8 12.3
0
0
1
41
0
10.2
10.2
0.1
0.01
1 2
32 24 38
0 0
8 5.9 9
8 5.9 9
0 0
0 0
1
37
0
8.8
8.8
0
0.03
1
37
0
8.8
8.8
0
0.03
Salt (g)
(Continued)
Table 10.1: (Continued) Nonalcoholic Beverage Category
N
1 Strawberry soft drink, still, and low calorie Apple soft drink, 1 still Apple soft drink, 2 still, and low calorie Tropical soft drink, 1 still 1 Pineapple soft drink, still, and low calorie 2 Multifruit soft drink, still, and low calorie Lemon tea soft 1 drink 2 Peach tea soft drink Lemon tea soft 1 drink, low calorie Peach tea soft 1 drink, low calorie Lemon tea soft 1 drink, no-calorie Theine-free tea soft 1 drink, no-calorie Green tea soft 2 drink Mango and 1 pineapple tea soft drink Gaseosas (soda 2 water) Carbonated orange 1 drink Carbonated lemon 1 drink Carbonated drink 2 Tonic water 2 Ginger ale 3 Tonic water, no2 calorie Bitter 2 Bitter, no-calorie 1 Total 94
Energy (kcal)
Total Total Fats (g) Carbohydrates (g) Sugars (g) Proteins (g)
Salt (g)
12
0.1
2.5
2.4
0
0.1
41
0
10
9.9
0
0.1
9 14
0
1.8 3.5
1.8 3.4
0
0 0.1
40
0.1
9.3
9.1
0.1
0.1
13
0.1
2.6
2.4
0
0.1
8 16
0
1.4 3.9
1.4 3.9
0 0.1
0 , 0.01
32
0
7.7
7.7
0
0.04
28 32
0
6.6 7.8
6.6 7.8
0
0.03 0.05
19
, 0.5
4.6
4.5
, 0.5
0.06
19
, 0.5
4.7
4.5
, 0.5
0.05
1
0
0
0
0
0.05
1
0
0
0
0
0.06
20
0 , 0.5
4.6 4.7
4.6 4.5
0 , 0.5
0.03 0.05
34
0
8.2
8.1
0
0.04
0.3 1
0
0
0
0
0.03 0.1
1.5
0
0.1
0.1
0
0
0.9
0
0
0
0
0
0 36 40 35 38 2
0 0 0 0
0 8.5 9.5 8.6 9.1 0
0 8.4 9.5 8.6 9.1 0
0 0 0 0
0.05 0.1 0 0.03 0.02 0.05 0 0.05
32 3
0 0
8 8.1 0
8 8.1 0
0 0
0 0.03 0.01
Data expressed per 100 mL. Source: Adapted from Serrano Iglesias, M., Samaniego Vaesken, M.D.L., Varela Moreiras, G., 2016. Composition and nutrient information of non-alcoholic beverages in the Spanish market: an update. Nutrients 8(10), 618.
316 Chapter 10 Table 10.2: Added sugar reduction in different soft drinks from the Coca-Cola Company in Spain.
Product Orange soft drink Lemon soft drink Lime-lemon soft drink Sports drink Tea, mango, and pineapple soft drink Tonic water Cherry cola soft drink Beverage with mineral salts Beverage with mineral salts, orange flavored Pineapple juice based soft drink, no added sugars Orange juice based soft drink, no added sugars Beverage with fruit juice and carrot from concentrate, no added sugars Beverage with fruit juice from concentrate, no added sugars Beverage from lemon juice, no added sugars
Sugar Content (g/100 mL) of Original Product
Sugar Content (g/100 mL) of Product, May 2018
Sugar Reduction from Original Product (%)
13.0 13.3 11.0 7.8 8.2
7.8 4.4 2.0 5.0 7.7
40.0 66.8 81.8 35.9 6.1
9.4 10.7 6.3 7.9
8.6 0.0 4.4 4.5
8.5 100 30.2 43.0
11.5
7.6
33.9
11.5
8.4
27.0
12.3
7.4
39.8
11.4
6.0
47.4
13.0
6.2
52.3
Source: Adapted from Urrialde, R., et al., 2018. Evolution in the supply of non-alcoholic beverages in the last 25 years: reduction of sugar as a critical nutrient and use of sweeteners. Nutr. Hosp. 35(Spec No. 6), 30.
reduce this content or substitute added sugar ingredients with LNCS. Research from Spain shows how sugar has been reduced in nonalcoholic beverages from one of the main brands on the market (Urrialde et al., 2018). Table 10.2 shows that between 6.1% and 100% of sugar reduction was achieved by 2018 in products such as tea, mango and pineapple soft drinks, and cherry cola soft drinks, respectively. The ANIBES study (anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic and lifestyle data) is a cross-sectional study of a representative sample of the Spanish population (9 75 years of age; n 5 2009) carried out in 2013. Food records were obtained from a 3-day dietary record using a tablet device. Label data from 1164 products of different brands were collected and reviewed for their added sugar and LNCS contents. The results showed that the proportion of diet soft drinks containing LNCS was 100% of the assessed products mainly including acesulfame-K (E-950), aspartame (E-951), cyclamic acid or cyclamate (E-952), saccharine (E-954), sucralose (E-955), and neosperidine DC (E-959) (Samaniego-Vaesken et al., 2018). Furthermore, 24% of
Sparkling, Nonfermented, Nonalcoholic Beverages
317
sugar-sweetened soft drinks also included LNCS in their compositions. In turn, the most frequent types of added sugars in this group were sucrose, glucose, fructose, glucose fructose syrup, and caramel.
10.4 Trends in Nonalcoholic Beverage Consumption Eating habits have always been in a state of constant change, linked to the evolution of lifestyles and to the availability of foods and beverages. In this regard, food habits on the European continent have undergone a significant change in recent years, leading to less varied food choices, therefore more monotonous diets, and there is a clear tendency toward an increasingly “westernized” diet (Kontogianni et al., 2008; Uranga et al., 2016; Park et al., 2011; Statovci et al., 2017), characterized by a high content of proteins (derived from fatty domesticated and processed meats), saturated fats, refined grain products, added sugars, alcohol, salt, and corn-derived fructose syrup, with an associated reduced consumption of fruits and vegetables, although with important regional differences in terms of evolution and consequences. The nonalcoholic beverages group has had the largest evolution and, therefore, its consumption has had a great impact on global diet trends. A global systematic review of fluid intake from beverages across age groups reported that the total beverage intake was in the range of 0.6 1.8, 0.8 2.0, and 0.8 3.4 L/day for children, teenagers, and adults, and water consumption accounted for 58%, 75%, and 80% of the total fluid intake, ¨ zen et al., 2015). Moreover, a recent cross-national analysis of 75 respectively (O countries has shown that sweetened soft drinks consumption globally has increased from 36 L per person per year in 1997 to 43 L in 2010 (Basu et al., 2013). Likewise, as expected, the remarkable progress that Spain has undergone in the past 40 years, both economically and internationally, has led to a change and an evolution in food consumption patterns and lifestyles. This evolution has given rise to a new way of eating, which is reflected in both the food and beverages that are consumed. Specifically, the evolution of nonalcoholic beverages consumption in Spain (Table 10.3) has experienced a dramatic growth in recent decades, which has led to an increase of 45.4% in the consumption of nonalcoholic beverages per day from 2000 to 2016. The effects of the increased consumption of certain beverages on health outcomes have been well documented. For example, there is evidence that a high consumption of tea or milk may reduce the risk of cardiovascular disease. On the contrary, an increased consumption of sugar-sweetened beverages may contribute to increased energy intake and weight gain and an increased risk of developing type 2 diabetes (Helm and Macdonald, 2015). Specifically, according to the Spanish Food Consumption Panel, the most noteworthy consumption is associated with bottled water followed by soft drinks (Table 10.4 and Fig. 10.1), and amongst the latter, the highest consumption is recorded for cola derivatives, followed by orange soft drinks (Rodrı´guez Alonso et al., 1964 2016) this
318 Chapter 10 Table 10.3: Evolution of nonalcoholic beverages consumption in homes in Spain, 1964 2016 (Rodrı´guez Alonso et al., 1964 2016; Varela-Mosquera et al., 1971, 1985). Survey
Year
Consumption (g/person per day)
Food Consumption Panel
2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1991 1981 1964
349 340 332 326 316 328 330 338 305 297 291 283 283 276 262 256 240 96 98 46
Household Budget Survey
Evolution (%) 2.4 2.5 1.8 3.2 2 3.7 2 0.6 2 2.4 11 2.7 2.1 2.8 0.0 2.5 5.3 2.3 6.7 150 2 2.0 113
regard, a study that examined plain water consumption in relation to energy intake and diet quality among US adults evidenced that plain drinking water consumption was associated with better diet quality (An and McCaffrey, 2016). However, during the past few years (2000 16) in Spain, the consumption of sodas and soft drinks increased by 12.5%. Within the 2013 16 period, the highest consumption occurred in 2013 (127.8 g/person per day). Moreover, it should be noted that the evolution of consumption during the period of 2013 16 has been similar for each type of product. However, there has been an increase in the intake of cola diet drinks in recent years to the detriment of regular cola soft drinks as compared to the 2013 demand (Rodrı´guez Alonso et al., 1964 2016). Therefore substituting sugar-free for sugary beverages might be a potential tool for decreasing energy consumption and improving body weight management in the overall population. Hence, the main trends in the current beverage market due to the rapid evolution in the past few decades and the high levels of innovation in many different aspects (i.e., reduced calorie content) (ANFABRA, 2015) has allowed for consumers to now choose from a wide range of sparkling and still, sugar or sugar-free, fat or nonfat, with or without fruit juice, vitamins, fiber, gluten free, lactose free, and others. In addition, there is an emerging population group that have incorporated exercise into their daily routine and are promoting sports and energy drinks consumption (Packaged Facts, 2017).
Table 10.4: Evolution of different types of nonalcoholic beverages consumption in homes in Spain in the past few years (g/person per day) (Rodrı´guez Alonso et al., 1964 2016). Year
2013
2014
2015
2016
Coffee beans or ground, roasted Coffee beans or ground, natural Coffee beans or ground, mix Coffee beans or ground, decaffeinated Soluble coffee Infusions Fruit juice refrigerated/exp Concentrated orange juice and mixtures Concentrated peach juice and mixtures Concentrated pineapple juice and mixtures Other concentrated juices Nectars Vegetable juices Juices and nectars rest Bottled water Sodas Soft drinks, orange Soft drinks, lemon Regular cola Diet cola Cola without caffeine Diet cola without caffeine Soft drinks, tonic Soft drinks, tea/coffee Soft drinks, isotonic Other soft drinks Beverages, juice and milk Alcohol-free beer
0.0 1.5 1.6 0.7 0.7 0.3 3.4 2.2 2.7 1.5 4.4 13.0 0.3 2.4 143.5 10.9 16.7 7.9 32.0 20.3 2.7 5.4 1.8 4.2 7.4 18.4 10.0 8.6
0.0 1.4 1.5 0.7 0.7 0.3 3.7 1.8 2.3 1.1 4.3 12.3 0.3 2.4 144.0 9.8 15.8 8.6 30.7 20.5 2.4 5.3 2.2 4.0 7.2 18.7 10.7 8.4
0.0 1.4 1.4 0.6 0.7 0.3 4.2 1.7 2.1 0.9 4.2 12.1 0.3 2.6 154.7 9.8 14.8 8.6 27.8 21.5 2.0 5.2 2.3 4.7 7.5 18.1 9.9 8.7
0.0 1.5 1.5 0.6 0.8 0.3 4.2 1.7 2.1 0.9 4.2 12.1 0.3 2.6 165.3 9.1 14.9 7.9 25.8 21.8 1.8 5.0 2.4 5.2 8.0 17.5 9.3 8.7
Nonalcoholic beverages consumption (g/person per day)
180 160 140
Bottled water
120
Soft drinks
100
Juices and nectars
80 Sodas 60 coffee and infusions
40 20 0 2000
2006 Year
2016
Figure 10.1 Evolution of some types of nonalcoholic beverages consumption in homes in Spain over the past few decades (Rodrı´guez Alonso et al., 1964 2016).
320 Chapter 10 Another beverage group that has experienced an increase in consumption in recent years is juices and nectars. More precisely, this beverages group showed an increase of 18.9% (in the year 2000, 29.8 g were consumed in Spain while in 2016, 36.7 g were consumed). This data is opposite to the observed consumption in the United States, since total consumption decreased in the past few years, the decline in total fruit is primarily motivated by decreases in fruit juice consumption by the total population (Produce for Better Health Foundation, 2015). However, the Dietary Guidelines for Americans recognizes the role of 100% fruit juice in health, to the point of maintaining its inclusion in the fruit group, and as counting toward daily fruit recommendations since it is considered a nutrient-dense beverage (that should be a primary beverage choice along with water and fat-free/low-fat milk) that might help meeting the fruit intake recommendations (Health and Services, 2017).
10.5 Contribution to Diet and Controversies Currently, chronic noncommunicable diseases (cardiovascular disease, diabetes, hypertension, dyslipidemia, respiratory diseases, obesity, and cancer) are, by far, the leading cause of death in the world and their impact increases continuously, making them a major public health problem (World Health Organization, 2018). It has been estimated that by 2030, 69% of all deaths worldwide will be attributable to noncommunicable diseases (Mathers and Loncar, 2006). Specifically, the influence that diet and lifestyle have on the appearance and development of these diseases is very high (World Health Organization, 2003), a fact that is reflected in the consequences that dietary changes that have occurred in recent times have brought. Past studies have focused on the contribution of beverages to energy and nutrient intakes (Kant et al., 2009; An, 2016). Specifically, the increased beverage consumption has been translated into important changes in diet quality and, especially, in the caloric profile. Beverage consumption is a significant contributor to daily energy intake but is often overlooked as a component of dietary intake by individuals (Safefood, 2009). In fact, the types of drinks and how often they are consumed can either have a negative or a positive impact on nutrient intake. Precisely, in the analysis of available data on macronutrients from 2000 to 2016 in Spain, it may be observed that the evolution of the contribution of nonalcoholic beverages to the diet in Spanish households presents an increase in the energy percentage contribution from carbohydrates, an increase in the contribution of proteins, and a decrease in the amount of fiber (Table 10.5). What is more, currently the average energy consumption of the Spanish population in the ANIBES study is 1810 kcal/day, of which 12% was provided by beverages. Specifically, water was the most consumed beverage, followed by milk, and the contribution of caloric soft drinks to the energy intake was 2% (Nissensohn et al., 2016). However, in other population groups from France and Italy, the
Sparkling, Nonfermented, Nonalcoholic Beverages
321
Table 10.5: Evolution of energy intake, macronutrients and fiber of nonalcoholic beverages in Spain, 2000 16 (Rodrı´guez Alonso et al., 1964 2016). Energy (kcal/day)
Protein (g/day)
Lipids (g/day)
Carbohydrates (g/day)
Starch (g/day)
Sugar (g/day)
Fiber (g/day)
Year
Total
%
Total
%
Total
%
Total
%
Total
%
Total
%
Total
%
2016 2006 2000
67.3 61.5 57.7
3.2 3.0 2.8
1.0 0.2 0.2
1.3 0.3 0.3
0.16 0.01 0.01
0.2 0.0 0.0
15.3 15.1 14.2
6.9 6.9 6.2
0.6 0.0 0.0
0.5 0.0 0.0
14.6 15.1 14.2
15.8 16.8 16.0
0.07 0.12 0.12
0.5 0.8 0.8
energy provided by beverages was 8% and 6%, respectively (Mistura et al., 2016; Nissensohn et al., 2017). These percentages are very close to those suggested by some international authorities who recommend that no more than 10% of daily calorie intake should come from beverages (EFSA, 2010; WHO/FAO World Health Organization/Food and Agriculture Organization of the United Nations, 2002). In both populations, water was the most consumed beverage, followed by hot beverages in the French population (Nissensohn et al., 2017), while in the population from Italy, the contributions of fruit and vegetable juices and milk to the energy intake was 2% for both beverage types. However, caloric soft drinks contribute only 0.4% of the TE intake for the total sample (Mistura et al., 2016). Likewise, the current nonalcoholic beverage consumption data of total carbohydrates in the ANIBES study population was 8%, of which 19.0% were sugars (Ruiz et al., 2015). Moreover, the major sources of intrinsic sugars from nonalcoholic beverages (%) in the ANIBES Spanish population (9 75 years of age) were milks (19.6%), juices and nectars (11.1%), and sugar soft drinks (2.24%), whereas the major dietary sources for free sugars were sugary soft drinks (25.5%), yogurt and fermented milks (6.44%), and juices and nectars (2.91%).
10.6 Conclusion In general, there is a low availability of nutritional data from nonalcoholic beverages in food composition tables and databases and, in addition, there are not always updated. The latter contrasts with the large number and variety of products on the market. At present, updated nonalcoholic beverage composition data relies on product label information as a main source. Furthermore, to capture nutrient changes is challenging in an ever evolving and growing market. As their nutritional value is generally low and based mainly on their simple carbohydrate content, consumption should be moderate to low, especially amongst children and adolescents who should be educated in correct drinking habits from an early age. In fact, water should be recommended as the main daily beverage.
322 Chapter 10 Future innovation and reformulation practices are granted to improve their composition, due to public health policies and consumer demands.
References An, R., 2016. Plain water and sugar-sweetened beverage consumption in relation to energy and nutrient intake at full-service restaurants. Nutrients 8 (5), 263. An, R., McCaffrey, J., 2016. Plain water consumption in relation to energy intake and diet quality among US adults, 2005 2012. J. Hum. Nutr. Diet. 29 (5), 624 632. ANFABRA, 2015. El Sector de las bebidas refrescantes ha reducido casi un 20% las calorı´as de sus productos en los u´ltimos 5 An˜os. ,http://www.refrescantes.es/el-sector-de-las-bebidas-refrescantes-ha-reducido-casiun-20-las-calorias-de-sus-productos-en-los-ultimos-5-anos/ . (last accessed 11.01.19). Ashurst, P.R., 2016. Carbonated beverages. Reference Module in Food Science. Elsevier. Backholer, K., et al., 2018. Sugar-sweetened beverage taxes in 2018: a year of reflections and consolidation. Public Health Nutr. 21 (8), 3291 3295. Basu, S., et al., 2013. Relationship of soft drink consumption to global overweight, obesity, and diabetes: a cross-national analysis of 75 countries. Am. J. Public Health 103 (11), 2071 2077. Day, L., McSweeney, P.L.H., 2016. Beverages. Reference Module in Food Science. Elsevier. EFSA, 2010. Panel on dietetic products, nutrition, and allergies (NDA): scientific opinion on dietary reference values for water. EFSA J. 8, 1459. European Union, 2011a. Commission Regulation (EU) No. 1129/2011 of 11 November 2011 amending Annex II to Regulation (EC) No. 1333/2008 of the European Parliament and of the Council by establishing a Union list of food additives. Official Journal of the European Union L295. European Union, 2011b. Commission Regulation (EU) No. 1131/2011 of 11 November 2011 amending Annex II to Regulation (EC) No. 1333/2008 of the European Parliament and of the Council with regard to steviol glycosides. Official Journal of the European Union L295. European Union, 2012. Commission Implementing Regulation (EU) No. 872/2012 of 1 October 2012 adopting the list of flavouring substances provided for by Regulation (EC) No 2232/96 of the European Parliament and of the Council, introducing it in Annex I to Regulation (EC) No. 1334/2008 of the European Parliament and of the Council and repealing Commission Regulation (EC) No. 1565/2000 and Commission Decision 1999/217/EC Text with EEA relevance. Official Journal of the European Union L 267/1, October 2, 2012. Food and Drug Administration, 2019. Database of Select Committee on GRAS Substances (SCOGS). ,https:// www.accessdata.fda.gov/scripts/fdcc/?set 5 SCOGS&sort 5 Sortsubstance&order 5 ASC&startrow 5 1 &type 5 basic&search 5 caffeine . (last accessed 20.01.19). Gonza´lez Reyes, A.B., et al., 2015. Cafeı´na y quinina en bebidas refrescantes: contribucio´n a la ingesta diete´tica. Nutr. Hosp. 32, 2880 2886. Greenwood, D., et al., 2014. Association between sugar-sweetened and artificially sweetened soft drinks and type 2 diabetes: systematic review and dose response meta-analysis of prospective studies. Br. J. Nutr. 112 (5), 725 734. Guelinckx, I., et al., 2015. Intake of water and different beverages in adults across 13 countries. Eur. J. Nutr. 54 (2), 45 55. US Dept. of Health and Human Services, US Dept. of Agriculture, Dietary Guidelines for Americans 2015 2020. 2017. Skyhorse Publishing Inc. Helm, L., Macdonald, I.A., 2015. Impact of beverage intake on metabolic and cardiovascular health. Nutr. Rev. 73 (Suppl. 2), 120 129. Huang, C., et al., 2014. Sugar sweetened beverages consumption and risk of coronary heart disease: a metaanalysis of prospective studies. Atherosclerosis 234 (1), 11 16.
Sparkling, Nonfermented, Nonalcoholic Beverages
323
Kant, A.K., Graubard, B.I., Atchison, E.A., 2009. Intakes of plain water, moisture in foods and beverages, and total water in the adult US population—nutritional, meal pattern, and body weight correlates: National Health and Nutrition Examination Surveys 1999 2006. Am. J. Clin. Nutr. 90 (3), 655 663. Kontogianni, M.D., et al., 2008. Adherence rates to the Mediterranean diet are low in a representative sample of Greek children and adolescents. J. Nutr. 138 (10), 1951 1956. Malik, V.S., et al., 2013. Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. Am. J. Clin. Nutr. 98 (4), 1084 1102. Mathers, C.D., Loncar, D., 2006. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 3 (11), e442. Maughan, R.J., et al., 2016. A randomized trial to assess the potential of different beverages to affect hydration status: development of a beverage hydration index. Am. J. Clin. Nutr. 103 (3), 717 723. Ministry of Health, 2018. Social services and equality. Spanish Agency for Food Safety and Nutrition. Collaboration Plan for the improvement of the composition of food and beverages and other measures 2020. ,http://www.aecosan.msssi.gob.es/AECOSAN/docs/documentos/nutricion/Plan_Colaboracion_ INGLES.pdf . (last accessed 10.01.18). Mistura, L., D’Addezio, L., Turrini, A., 2016. Beverage consumption habits in Italian population: association with total water intake and energy Intake. Nutrients 8 (11), E674. Ni Mhurchu, C., et al., 2015. Nutrient profile of 23 596 packaged supermarket foods and non-alcoholic beverages in Australia and New Zealand. Public Health Nutr. 19 (3), 401 408. Nissensohn, M., et al., 2016. Beverage consumption habits and association with total water and energy intakes in the Spanish population: findings of the ANIBES study. Nutrients 8 (4), 232. Nissensohn, M., et al., 2017. Beverage consumption habits among the European population: association with total water and energy intakes. Nutrients 9 (4), E383. ¨ zen, A., et al., 2015. Fluid intake from beverages across age groups: a systematic review. J. Hum. Nutr. Diet. O 28 (5), 417 442. Packaged Facts, 2017. Energy and sports drinks: U.S. Retail Market Trends & Opportunities.,https://www. packagedfacts.com/Energy-Sports-Drinks-10836915 . (last accessed 11.01.19). Park, Y., et al., 2011. Dietary fiber intake and mortality in the NIH-AARP diet and health study. Arch. Intern. Med. 171 (12), 1061 1068. Poti, J.M., et al., 2017. Development of a food composition database to monitor changes in packaged foods and beverages. J. Food Compos. Anal. 64, 18 26. Produce for Better Health Foundation, 2015. State of the Plate, 2015 Study on America’s Consumption of Fruit and Vegetables, Produce for Better Health Foundation. ,http://www.pbhfoundation.org/pdfs/about/res/ pbh_res/State_of_the_Plate_2015_WEB_Bookmarked.pdf . (last accessed 05.02.19). Real Decreto, 2011. 650/2011, de 9 de mayo, por el que se aprueba la reglamentacio´n te´cnico-sanitaria en materia de bebidas refrescantes. BOE nu´m.119 de 19 de mayo de, pa´g. 50089 50093. Regulation (EC), 1997. No. 258/97 of the European Parliament and of the Council of 27 January 1997 concerning novel foods and novel food ingredients. Off. J. L 043, 14/02/1997,0001 0006. Rodrı´guez Alonso, P., et al., 1964 2016. Valoracio´n de la Dieta en los hogares Espan˜oles. Evolucio´n del consumo de alimentos en hogares de acuerdo al Panel de Consumo Alimentario del Ministerio de Agricultura, Pesca y Alimentacio´n (MAPA). En prensa. Rodrı´guez Alonso, P., et al., 2016. Fifty years of beverages consumption trends in Spanish households. Nutr. Hosp. 33, 46 51. Rosenfeld, L.S., et al., 2014. Regulatory status of caffeine in the United States. Nutr. Rev. 72 (S1), 23 33. Ruiz, E., et al., 2015. Energy intake, profile, and dietary sources in the Spanish population: findings of the ANIBES study. Nutrients 7 (6), 4739 4762. Safefood, 2009. Drinks: consumer knowledge and practice in relation to drinks for children and young people. ,https://www.safefood.eu/SafeFood/media/SafeFoodLibrary/Documents/Publications/Research% 20Reports/9650_Drinks_Interior-Cover.pdf . (last accesssed 15.01. 19).
324 Chapter 10 Samaniego-Vaesken, M., et al., 2018. Added sugars and low-and no-calorie sweeteners in a representative sample of food products consumed by the Spanish ANIBES study population. Nutrients 10 (9), 1265. Sa´nchez, X.F., et al., 2008. Aspectos toxicolo´gicos del consumo de bebidas refrescantes que contienen quinina. Nutr. Clı´n. Diet. Hosp. 28 (2), 20 25. Serrano Iglesias, M., Samaniego Vaesken, M.D.L., Varela Moreiras, G., 2016. Composition and nutrient information of non-alcoholic beverages in the Spanish market: an update. Nutrients 8 (10), 618. Shachman, M., 2004. The Soft Drinks Companion: A Technical Handbook for the Beverage Industry. CRC Press. Singh, G.M., et al., 2015. Global, regional, and national consumption of sugar-sweetened beverages, fruit juices, and milk: a systematic assessment of beverage intake in 187 countries. PLoS One 10 (8), e0124845. Statovci, D., et al., 2017. The impact of western diet and nutrients on the microbiota and immune response at mucosal interfaces. Front. Immunol. 8, 838. Te Morenga, L., Mallard, S., Mann, J., 2013. Dietary sugars and body weight: systematic review and metaanalyses of randomised controlled trials and cohort studies. BMJ 346, e7492. Uranga, J.A., et al., 2016. Food, nutrients and nutraceuticals affecting the course of inflammatory bowel disease. Pharmacol. Rep. 68 (4), 816 826. Urrialde, R., et al., 2018. Evolution in the supply of non-alcoholic beverages in the last 25 years: reduction of sugar as a critical nutrient and use of sweeteners. Nutr. Hosp. 35 (Spec No. 6), 30. Varela-Mosquera, G., Rodrı´guez, D.G., Moreiras, O., 1971. La Nutricio´n de los Espan˜oles: Diagnostico y recomendaciones. Publicaciones de la Escuela Nacional de Administracio´n Pu´blica, Madrid. Varela-Mosquera, G., Moreiras, O., Requejo, A., 1985. Encuesta de Presupuestos Familiares 1980 81. Estudio sobre la Nutricio´n. Instituto Nacional de Estadı´stica (INE), Madrid. WHO/FAO (World Health Organization/Food and Agriculture Organization of the United Nations), 2002. Diet, Nutrition and the Prevention of Chronic Diseases. World Health Organization, Geneva. World Health Organization, 2003. Diet, Nutrition and the Prevention of Chronic Diseases. Joint WHO/FAO Expert Consulation. WHO Thecnical Report Series No. 916. World Health Organization, Geneva. World Health Organization, 2015. Guideline: Sugars Intake for Adults and Children. World Health Organization. World Health Organization, 2018. Enfermedades no transmisibles. Datos y cifras. World Health Organization. Zupaniˇc, N., et al., 2018. Total and free sugar content of pre-packaged foods and non-alcoholic beverages in Slovenia. Nutrients 10 (2), 151.
Sparkling, Nonfermented, Nonalcoholic Beverages Marı´a de Lourdes Samaniego-Vaesken1, Teresa Partearroyo1, Emma Ruiz2 and Gregorio Varela-Moreiras1 1
Departamento de Ciencias Farmace´uticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanizacio´n Monteprı´ncipe, Alcorco´n, Madrid, Spain 2Spanish Nutrition Foundation (FEN), Madrid, Spain
Chapter Outline 10.1 Background 309 10.2 Definitions, Regulations, and Classification 310 10.3 Ingredients and Nutritional Composition 312 10.4 Trends in Nonalcoholic Beverage Consumption 317 10.5 Contribution to Diet and Controversies 320 10.6 Conclusion 321 References 322
10.1 Background Sparkling, nonfermented, nonalcoholic beverages include an extensive and ever-increasing variety of products, and nowadays their inclusion is well established among Westernoccidental diet patterns (Singh et al., 2015; Rodrı´guez Alonso et al., 2016). Also known as “refreshing drinks,” these products are highly appreciated and demanded by young and adult consumers for their stimulant flavors, different components, and convenience of consumption associated with leisure time and socially-related activities. Moreover, one of the main drivers of the consumption for these beverages is the hedonistic factor that influences consumers’ preferences. One of the main categories included are soft drinks (also called soda, fizzy drinks, tonic, mineral, sparkling water, or carbonated beverage, etc.) which are beverages that usually contain carbonated water, sweetener, and natural or artificial flavoring. The sweetener may
Trends in Non-alcoholic Beverages. DOI: https://doi.org/10.1016/B978-0-12-816938-4.00010-0 © 2020 Elsevier Inc. All rights reserved.
309
310 Chapter 10 be sugar, high-fructose corn syrup, fruit juice, sugar substitutes, low or no-calorie sweeteners (LNCS) (in the case of “diet drinks”), or a combination of these. Soft drinks may also contain caffeine, coloring, preservatives, and other ingredients. Small amounts of alcohol may also be present in a soft drink, but it must be less than 0.5% of the total volume in order to be considered nonalcoholic (Day and McSweeney, 2016). With water as the main component, these beverages can also contribute to the populations’ hydration status (Maughan et al., 2016). However, some of these products contain somewhat controversial ingredients, namely added sugars. Their excessive consumption has been related to obesity (Malik et al., 2013; Te Morenga et al., 2013) as well as other detrimental health issues such as type 2 diabetes (Greenwood et al., 2014) and cardiovascular heart disease (Huang et al., 2014); therefore, the WHO and other governmental and public health organizations have issued specific recommendations to decrease added sugar intake (World Health Organization, 2015). The WHO guidelines on sugar intake published in 2015 recommended a reduction in free sugar intake for children and adults to less than 10% of the total energy (TE) intake (strong recommendation), while a further reduction in the intake of free sugars to a maximum of 5% of the TE intake was recommended conditionally for additional health benefits (World Health Organization, 2015). In this regard, the Spanish Ministry of Health, Consumption, and Social Welfare and the Spanish Agency for Food Safety and Nutrition have launched the “Collaboration Plan for the improvement of the composition of foods and beverages and other measures 2020” (Ministry of Health, 2018). In this voluntary reformulation plan, one of the main objectives is to reduce the energy density and added sugars content of key food groups and menus by 5% 10% of their median content by the end of 2020 (Ministry of Health, 2018). Importantly, amongst the food groups to be reformulated are soft drinks and related beverages that can contain up to 15 g of added sugars (sucrose) per 100 mL. Provided that a regular beverage serving comprises 330 mL (one can), the derived sugar intake of about 45 g would represent a high proportion of the TE with low nutritional density (empty calories). The aim of this chapter is to draw an updated map of the nutritional facts in the different categories of nonalcoholic beverages on the Spanish and European market based on the information available on their labels.
10.2 Definitions, Regulations, and Classification Focusing on regulatory issues, and in accordance with the Spanish Food Code, in Chapter XXIX, the generic denomination of nonalcoholic or refreshing beverages comprises those that are nonfermented, with or without added carbon dioxide, those prepared with potable or mineral water, characteristic ingredients, and other authorized products (Backholer et al., 2018), these are normally consumed cold or chilled. Specifically in Spain,
Sparkling, Nonfermented, Nonalcoholic Beverages
311
the technical-sanitary regulation that is established for nonalcoholic drinks (Royal Decree 650/2011, Real Decreto, 2011) includes products such as “Seltz” and sparkling water, fruit and other vegetable and derivative juices, soft or “refreshing” carbonated beverages, and “horchata” (Real Decreto, 2011). In the present chapter, issues regarding bottled still or sparking water will not be discussed, rather the focus will be on those beverages containing several different ingredients and/or additives, whether sparkling (carbonated) or still, sugar or sugar-free, fat or nonfat, with or without fruit juice, vitamins, and minerals, as well as those of different flavors, packaging materials, and serving sizes. In addition, recent advances in the production of carbonated beverages will be covered in other chapters in this book. The Spanish regulation defines refreshing or soft drinks as nonalcoholic drinks, either carbonated or not, prepared with water for human consumption, natural mineral water, or spring water, and containing one or more of these ingredients: carbon dioxide, sugars, juices, purees, disintegrated fruits and/or vegetables, plant extracts, vitamins and minerals, flavors, authorized additives, or other food ingredients. It is also underlined that finished products should not contain a quantity of alcohol higher than 0.5% by volume. The regulation includes several categories with denominations including: 1. Seltz water: a drink consisting of water and a minimum of 6 g/L of carbon dioxide. 2. Soda water: a drink consisting of water and a minimum of 6 g/L of carbon dioxide, which is characterized as containing sodium bicarbonate. 3. Flavored water: water, with or without carbon dioxide, containing flavorings. 4. Gaseosa: a colorless beverage prepared with water, carbon dioxide, flavors, sugars and/ or authorized sweeteners and additives. 5. Other refreshing beverages: the generic denomination of a refreshing drink can be specified with a denomination that corresponds to its composition or characteristics. Among others are: a. Refreshing drinks from fruit juices, which are characterized as containing juices, pure´es, or their mixtures. b. Refreshing drinks from extracts, these incorporate extracts of fruit, vegetables, or both. c. Mixed refreshing drinks, which consist of refreshing drinks and other foods. d. Refreshing drinks ready to dilute and solid products for the preparation of refreshing beverages, which will be those that are consumed once reconstituted. e. Flavored refreshing drinks, which are characterized as containing aromatic agents with the addition of other food ingredients. A relevant limitation many nutrition scientists find in the assessment of the consumption of nonalcoholic beverages, is the different food classification methods involved in published dietary surveys, which are not performed homogenously across countries due to local food law regulations (Guelinckx et al., 2015).
312 Chapter 10
10.3 Ingredients and Nutritional Composition According to regulations, nonalcoholic, refreshing beverages may contain any of the following ingredients (Real Decreto, 2011): 1. Water for human consumption: This refers to prepared water, natural, or spring mineral water. It comprises about 87% 92% of the beverage volume and as a major component of nonalcoholic beverages, its adequate treatment is a key process. The water used is pretreated to remove impurities, microorganisms, off-tastes, odors, turbidity, and to regulate alkalinity and hardness (Shachman, 2004). 2. Carbon dioxide: This provides the gas content or “fizziness” that can also be referred to as carbonic acid. It contributes to acidity and prevents spoilage acting as a preservative (Shachman, 2004). 3. Sugars and syrups: These require complex or basic preparations where sucrose is the main sweetener used, followed by high-fructose corn syrup. 4. Juices, purees, broken fruits, vegetables, or their mixtures: These comprise the edible parts, in a ripe and fresh state, although for some commodities, the whole fruit or vegetable, together with seeds and peels are crushed with the juice to produce purees. In any case, they are mainly used as concentrates in beverages formulation at a level of between 2% and 10% by volume of the product when calculated as reconstituted juice. 5. Fruit, vegetable extracts, or both. 6. Caffeine and quinine: these ingredients are extensively used and appreciated by consumers (Gonza´lez Reyes et al., 2015). Quinine is a compound from the alkaloid family, obtained from the bark of the cinchona tree (Cinchona officinalis); the bitterness of which provides a refreshing flavor to beverages (Sa´nchez et al., 2008). On the other hand, caffeine, chemically known as 1,3,7-trimethylxanthine, occurs naturally in the leaves, fruit, and seeds of a number of plant species like coffee and cocoa beans, tea leaves, kola nuts, and guarana. It is widely consumed for the stimulant effects it produces (decreases the feeling of fatigue, combats drowsiness, etc.). Both have been qualified as generally recognized as safe by the Food and Drug Administration, under regular conditions of use (Food and Drug Administration, 2019; Rosenfeld et al., 2014). However, European regulations established a limit of 100 and 150 mg/kg for quinine and caffeine addition to soft drinks, respectively (European Union, 2012). 7. Authorized additives and flavors: for example, in the case of sweeteners, these are used as sugar substitutes since they provide fewer calories (aspartame provides 4.0 kcal/g but is 180 times sweeter than sugar). Up to 19 types of low or no-caloric sweeteners are authorized in the European Union. These include sorbitol (E-420), mannitol (E-412), acesulfame-K (E-950), aspartame (E-951), cyclamate (E-952),
Sparkling, Nonfermented, Nonalcoholic Beverages
313
isomalt (E-953), saccharine and its sodium, potassium, and calcium salts (E-954), sucralose (E-955), thaumatin (E-957), neohesperidine DC (E-959), steviol glycosides or “stevia” (E-960), neotame (E-961), salt of aspartame-acesulfame (E-962), polyglycitol syrup (E-964), maltitols (E-965), lactitol (E-966), xylitol (E-967), erythritol (E-968), and advantame (E-969) (European Union, 2011a,b). Organic acids such as citric or malic acids are used to provide acidity and sharpness. Fruit-flavored drinks mainly use citric acid, while phosphoric acid is employed in cola drinks. Flavoring refers to a solution of aroma substances from a natural or synthetic source dissolved in a permitted solvent. Colorings of natural origins are widely used, namely carotenoids, anthocyanins, and caramels (Ashurst, 2016). 8. Vitamins and minerals: these are used in accordance with Regulation (EC) No 1925/ 2006 (EFSA, 2010). 9. Other ingredients: these are used in human food or authorized in accordance with Regulation (EC) No. 258/97 of the European Parliament and of the Council of 27 January 1997 concerning novel foods and novel food ingredients (Regulation EC, 1997). 10. Technological adjuvants: as authorized in the Member States of the European Union these include inert gases for headspace, filtering agents for syrups or basic preparations, and others. Regardless of the variety of nonalcoholic beverages that are commercialized nowadays, there is a lack of harmonized, comprehensive, and updated composition data for nonalcoholic beverages available in food composition tables and databases. In fact, nutritional data declared on the labels of these products are, at present, the main source of information as compiled and evaluated in a number of studies from Europe (Zupaniˇc et al., 2018; Samaniego-Vaesken et al., 2018) and worldwide (Ni Mhurchu et al., 2015; Poti et al., 2017). In a recent study, composition and nutrient information regarding 211 nonalcoholic beverages on the Spanish market based on product labels were compiled and assessed (Serrano Iglesias et al., 2016). The distribution of the main beverage categories and their energy, macronutrient, and salt contents are shown in Table 10.1. Overall, the energy contents range from 0 to 55 kcal/100 mL for no-calorie and lemon still soft drinks, respectively. Carbohydrates ranged from 0 to 13 g and total sugars accounted for $ 90% of this macronutrient. The protein (0 0.05 g/100 mL), total fat (0 , 0.5 g/100 mL) as well as salt contents (0 0.13 g/100 mL) were low or not significant. In addition, the vitamin and mineral content was missing from labels in the majority of products. Over the past few years, attention has been mainly focused on the added sugar content of soft drinks. The industry has been making efforts toward product reformulation in order to
Table 10.1: Nutrition facts from soft drinks available on the Spanish Food Market as declared on product labels. Nonalcoholic Beverage Category Cola soft drink Cola soft drink, caffeine free Cola soft drink, no-calorie Cola soft drink, no-calorie, and caffeine free Cola soft drink, lemon Cola soft drink, lemon, no-calorie Cherry cola soft drink Lemon soft drink Lemon soft drink, no-calorie Lemon soft drink, still Lemon soft drink, still, and no-calorie Lemon soft drink, still, low calorie Lemon-lime soft drink Lemon-lime soft drink, low calorie Lemon-lime soft drink, no-calorie Orange soft drink Orange soft drink, no-calorie Orange soft drink, still Orange soft drink, low calorie Strawberry soft drink Pineapple soft drink Apple soft drink Citrus flavored soft drink Azahar and lavender flavored soft drink Pink pepper soft drink
N
Energy (kcal)
Total Total Fats (g) Carbohydrates (g) Sugars (g) Proteins (g)
2 2
42 43 44
0 0
10.6 10.7 11.1
10.6 11.1
0 0
0 , 0.01 0 , 0.01
4 0.2 0.5
0
0 0.1
0
0 0.05
, 0.01 0.02
4
0.2
0
0 0.05
0
0 0.05
, 0.01 0.02
1
42
0
10.6
10.5
0
0.03
2
0.3 1
0
0
0
0 , 0.1
0.02 0.03
1
43
0
10.7
10.7
0
0
6 3
27 43 0.5 2
0 0
6.2 10.5 0 0.4
6 10.5 0 0.4
0 0
0 0.06 0 0.06
6
26 55
0
6.3 13
6.2 13
0
0 , 0.1
2
3
0
0.1 0.2
0.1
0.1
, 0.01 0.05
1
10
0
1.9
1.8
0
0.1
2
44 49
0
11 12.3
11 12.2
0
0.02 0.04
1
10
0
2.1
2.1
0
0.02
2
0.1 1
0
0
0
0 , 0.1
0.03 0.06
4 2
29 52 4
0 0
6.9 12.7 0.9
6.7 12.7 0.9
0 0
0 0.03 0 0.02
2
38
0
9.1 9.3
8.9 9.3
0 0.1
0 0.03
5
6 17
0 0.1
0.8 4.1
0.8 4
0 0.1
, 0.01 0.13
2
44 51
0
10.8 12.4
10.8 12.3
0
0
1
41
0
10.2
10.2
0.1
0.01
1 2
32 24 38
0 0
8 5.9 9
8 5.9 9
0 0
0 0
1
37
0
8.8
8.8
0
0.03
1
37
0
8.8
8.8
0
0.03
Salt (g)
(Continued)
Table 10.1: (Continued) Nonalcoholic Beverage Category
N
1 Strawberry soft drink, still, and low calorie Apple soft drink, 1 still Apple soft drink, 2 still, and low calorie Tropical soft drink, 1 still 1 Pineapple soft drink, still, and low calorie 2 Multifruit soft drink, still, and low calorie Lemon tea soft 1 drink 2 Peach tea soft drink Lemon tea soft 1 drink, low calorie Peach tea soft 1 drink, low calorie Lemon tea soft 1 drink, no-calorie Theine-free tea soft 1 drink, no-calorie Green tea soft 2 drink Mango and 1 pineapple tea soft drink Gaseosas (soda 2 water) Carbonated orange 1 drink Carbonated lemon 1 drink Carbonated drink 2 Tonic water 2 Ginger ale 3 Tonic water, no2 calorie Bitter 2 Bitter, no-calorie 1 Total 94
Energy (kcal)
Total Total Fats (g) Carbohydrates (g) Sugars (g) Proteins (g)
Salt (g)
12
0.1
2.5
2.4
0
0.1
41
0
10
9.9
0
0.1
9 14
0
1.8 3.5
1.8 3.4
0
0 0.1
40
0.1
9.3
9.1
0.1
0.1
13
0.1
2.6
2.4
0
0.1
8 16
0
1.4 3.9
1.4 3.9
0 0.1
0 , 0.01
32
0
7.7
7.7
0
0.04
28 32
0
6.6 7.8
6.6 7.8
0
0.03 0.05
19
, 0.5
4.6
4.5
, 0.5
0.06
19
, 0.5
4.7
4.5
, 0.5
0.05
1
0
0
0
0
0.05
1
0
0
0
0
0.06
20
0 , 0.5
4.6 4.7
4.6 4.5
0 , 0.5
0.03 0.05
34
0
8.2
8.1
0
0.04
0.3 1
0
0
0
0
0.03 0.1
1.5
0
0.1
0.1
0
0
0.9
0
0
0
0
0
0 36 40 35 38 2
0 0 0 0
0 8.5 9.5 8.6 9.1 0
0 8.4 9.5 8.6 9.1 0
0 0 0 0
0.05 0.1 0 0.03 0.02 0.05 0 0.05
32 3
0 0
8 8.1 0
8 8.1 0
0 0
0 0.03 0.01
Data expressed per 100 mL. Source: Adapted from Serrano Iglesias, M., Samaniego Vaesken, M.D.L., Varela Moreiras, G., 2016. Composition and nutrient information of non-alcoholic beverages in the Spanish market: an update. Nutrients 8(10), 618.
316 Chapter 10 Table 10.2: Added sugar reduction in different soft drinks from the Coca-Cola Company in Spain.
Product Orange soft drink Lemon soft drink Lime-lemon soft drink Sports drink Tea, mango, and pineapple soft drink Tonic water Cherry cola soft drink Beverage with mineral salts Beverage with mineral salts, orange flavored Pineapple juice based soft drink, no added sugars Orange juice based soft drink, no added sugars Beverage with fruit juice and carrot from concentrate, no added sugars Beverage with fruit juice from concentrate, no added sugars Beverage from lemon juice, no added sugars
Sugar Content (g/100 mL) of Original Product
Sugar Content (g/100 mL) of Product, May 2018
Sugar Reduction from Original Product (%)
13.0 13.3 11.0 7.8 8.2
7.8 4.4 2.0 5.0 7.7
40.0 66.8 81.8 35.9 6.1
9.4 10.7 6.3 7.9
8.6 0.0 4.4 4.5
8.5 100 30.2 43.0
11.5
7.6
33.9
11.5
8.4
27.0
12.3
7.4
39.8
11.4
6.0
47.4
13.0
6.2
52.3
Source: Adapted from Urrialde, R., et al., 2018. Evolution in the supply of non-alcoholic beverages in the last 25 years: reduction of sugar as a critical nutrient and use of sweeteners. Nutr. Hosp. 35(Spec No. 6), 30.
reduce this content or substitute added sugar ingredients with LNCS. Research from Spain shows how sugar has been reduced in nonalcoholic beverages from one of the main brands on the market (Urrialde et al., 2018). Table 10.2 shows that between 6.1% and 100% of sugar reduction was achieved by 2018 in products such as tea, mango and pineapple soft drinks, and cherry cola soft drinks, respectively. The ANIBES study (anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic and lifestyle data) is a cross-sectional study of a representative sample of the Spanish population (9 75 years of age; n 5 2009) carried out in 2013. Food records were obtained from a 3-day dietary record using a tablet device. Label data from 1164 products of different brands were collected and reviewed for their added sugar and LNCS contents. The results showed that the proportion of diet soft drinks containing LNCS was 100% of the assessed products mainly including acesulfame-K (E-950), aspartame (E-951), cyclamic acid or cyclamate (E-952), saccharine (E-954), sucralose (E-955), and neosperidine DC (E-959) (Samaniego-Vaesken et al., 2018). Furthermore, 24% of
Sparkling, Nonfermented, Nonalcoholic Beverages
317
sugar-sweetened soft drinks also included LNCS in their compositions. In turn, the most frequent types of added sugars in this group were sucrose, glucose, fructose, glucose fructose syrup, and caramel.
10.4 Trends in Nonalcoholic Beverage Consumption Eating habits have always been in a state of constant change, linked to the evolution of lifestyles and to the availability of foods and beverages. In this regard, food habits on the European continent have undergone a significant change in recent years, leading to less varied food choices, therefore more monotonous diets, and there is a clear tendency toward an increasingly “westernized” diet (Kontogianni et al., 2008; Uranga et al., 2016; Park et al., 2011; Statovci et al., 2017), characterized by a high content of proteins (derived from fatty domesticated and processed meats), saturated fats, refined grain products, added sugars, alcohol, salt, and corn-derived fructose syrup, with an associated reduced consumption of fruits and vegetables, although with important regional differences in terms of evolution and consequences. The nonalcoholic beverages group has had the largest evolution and, therefore, its consumption has had a great impact on global diet trends. A global systematic review of fluid intake from beverages across age groups reported that the total beverage intake was in the range of 0.6 1.8, 0.8 2.0, and 0.8 3.4 L/day for children, teenagers, and adults, and water consumption accounted for 58%, 75%, and 80% of the total fluid intake, ¨ zen et al., 2015). Moreover, a recent cross-national analysis of 75 respectively (O countries has shown that sweetened soft drinks consumption globally has increased from 36 L per person per year in 1997 to 43 L in 2010 (Basu et al., 2013). Likewise, as expected, the remarkable progress that Spain has undergone in the past 40 years, both economically and internationally, has led to a change and an evolution in food consumption patterns and lifestyles. This evolution has given rise to a new way of eating, which is reflected in both the food and beverages that are consumed. Specifically, the evolution of nonalcoholic beverages consumption in Spain (Table 10.3) has experienced a dramatic growth in recent decades, which has led to an increase of 45.4% in the consumption of nonalcoholic beverages per day from 2000 to 2016. The effects of the increased consumption of certain beverages on health outcomes have been well documented. For example, there is evidence that a high consumption of tea or milk may reduce the risk of cardiovascular disease. On the contrary, an increased consumption of sugar-sweetened beverages may contribute to increased energy intake and weight gain and an increased risk of developing type 2 diabetes (Helm and Macdonald, 2015). Specifically, according to the Spanish Food Consumption Panel, the most noteworthy consumption is associated with bottled water followed by soft drinks (Table 10.4 and Fig. 10.1), and amongst the latter, the highest consumption is recorded for cola derivatives, followed by orange soft drinks (Rodrı´guez Alonso et al., 1964 2016) this
318 Chapter 10 Table 10.3: Evolution of nonalcoholic beverages consumption in homes in Spain, 1964 2016 (Rodrı´guez Alonso et al., 1964 2016; Varela-Mosquera et al., 1971, 1985). Survey
Year
Consumption (g/person per day)
Food Consumption Panel
2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1991 1981 1964
349 340 332 326 316 328 330 338 305 297 291 283 283 276 262 256 240 96 98 46
Household Budget Survey
Evolution (%) 2.4 2.5 1.8 3.2 2 3.7 2 0.6 2 2.4 11 2.7 2.1 2.8 0.0 2.5 5.3 2.3 6.7 150 2 2.0 113
regard, a study that examined plain water consumption in relation to energy intake and diet quality among US adults evidenced that plain drinking water consumption was associated with better diet quality (An and McCaffrey, 2016). However, during the past few years (2000 16) in Spain, the consumption of sodas and soft drinks increased by 12.5%. Within the 2013 16 period, the highest consumption occurred in 2013 (127.8 g/person per day). Moreover, it should be noted that the evolution of consumption during the period of 2013 16 has been similar for each type of product. However, there has been an increase in the intake of cola diet drinks in recent years to the detriment of regular cola soft drinks as compared to the 2013 demand (Rodrı´guez Alonso et al., 1964 2016). Therefore substituting sugar-free for sugary beverages might be a potential tool for decreasing energy consumption and improving body weight management in the overall population. Hence, the main trends in the current beverage market due to the rapid evolution in the past few decades and the high levels of innovation in many different aspects (i.e., reduced calorie content) (ANFABRA, 2015) has allowed for consumers to now choose from a wide range of sparkling and still, sugar or sugar-free, fat or nonfat, with or without fruit juice, vitamins, fiber, gluten free, lactose free, and others. In addition, there is an emerging population group that have incorporated exercise into their daily routine and are promoting sports and energy drinks consumption (Packaged Facts, 2017).
Table 10.4: Evolution of different types of nonalcoholic beverages consumption in homes in Spain in the past few years (g/person per day) (Rodrı´guez Alonso et al., 1964 2016). Year
2013
2014
2015
2016
Coffee beans or ground, roasted Coffee beans or ground, natural Coffee beans or ground, mix Coffee beans or ground, decaffeinated Soluble coffee Infusions Fruit juice refrigerated/exp Concentrated orange juice and mixtures Concentrated peach juice and mixtures Concentrated pineapple juice and mixtures Other concentrated juices Nectars Vegetable juices Juices and nectars rest Bottled water Sodas Soft drinks, orange Soft drinks, lemon Regular cola Diet cola Cola without caffeine Diet cola without caffeine Soft drinks, tonic Soft drinks, tea/coffee Soft drinks, isotonic Other soft drinks Beverages, juice and milk Alcohol-free beer
0.0 1.5 1.6 0.7 0.7 0.3 3.4 2.2 2.7 1.5 4.4 13.0 0.3 2.4 143.5 10.9 16.7 7.9 32.0 20.3 2.7 5.4 1.8 4.2 7.4 18.4 10.0 8.6
0.0 1.4 1.5 0.7 0.7 0.3 3.7 1.8 2.3 1.1 4.3 12.3 0.3 2.4 144.0 9.8 15.8 8.6 30.7 20.5 2.4 5.3 2.2 4.0 7.2 18.7 10.7 8.4
0.0 1.4 1.4 0.6 0.7 0.3 4.2 1.7 2.1 0.9 4.2 12.1 0.3 2.6 154.7 9.8 14.8 8.6 27.8 21.5 2.0 5.2 2.3 4.7 7.5 18.1 9.9 8.7
0.0 1.5 1.5 0.6 0.8 0.3 4.2 1.7 2.1 0.9 4.2 12.1 0.3 2.6 165.3 9.1 14.9 7.9 25.8 21.8 1.8 5.0 2.4 5.2 8.0 17.5 9.3 8.7
Nonalcoholic beverages consumption (g/person per day)
180 160 140
Bottled water
120
Soft drinks
100
Juices and nectars
80 Sodas 60 coffee and infusions
40 20 0 2000
2006 Year
2016
Figure 10.1 Evolution of some types of nonalcoholic beverages consumption in homes in Spain over the past few decades (Rodrı´guez Alonso et al., 1964 2016).
320 Chapter 10 Another beverage group that has experienced an increase in consumption in recent years is juices and nectars. More precisely, this beverages group showed an increase of 18.9% (in the year 2000, 29.8 g were consumed in Spain while in 2016, 36.7 g were consumed). This data is opposite to the observed consumption in the United States, since total consumption decreased in the past few years, the decline in total fruit is primarily motivated by decreases in fruit juice consumption by the total population (Produce for Better Health Foundation, 2015). However, the Dietary Guidelines for Americans recognizes the role of 100% fruit juice in health, to the point of maintaining its inclusion in the fruit group, and as counting toward daily fruit recommendations since it is considered a nutrient-dense beverage (that should be a primary beverage choice along with water and fat-free/low-fat milk) that might help meeting the fruit intake recommendations (Health and Services, 2017).
10.5 Contribution to Diet and Controversies Currently, chronic noncommunicable diseases (cardiovascular disease, diabetes, hypertension, dyslipidemia, respiratory diseases, obesity, and cancer) are, by far, the leading cause of death in the world and their impact increases continuously, making them a major public health problem (World Health Organization, 2018). It has been estimated that by 2030, 69% of all deaths worldwide will be attributable to noncommunicable diseases (Mathers and Loncar, 2006). Specifically, the influence that diet and lifestyle have on the appearance and development of these diseases is very high (World Health Organization, 2003), a fact that is reflected in the consequences that dietary changes that have occurred in recent times have brought. Past studies have focused on the contribution of beverages to energy and nutrient intakes (Kant et al., 2009; An, 2016). Specifically, the increased beverage consumption has been translated into important changes in diet quality and, especially, in the caloric profile. Beverage consumption is a significant contributor to daily energy intake but is often overlooked as a component of dietary intake by individuals (Safefood, 2009). In fact, the types of drinks and how often they are consumed can either have a negative or a positive impact on nutrient intake. Precisely, in the analysis of available data on macronutrients from 2000 to 2016 in Spain, it may be observed that the evolution of the contribution of nonalcoholic beverages to the diet in Spanish households presents an increase in the energy percentage contribution from carbohydrates, an increase in the contribution of proteins, and a decrease in the amount of fiber (Table 10.5). What is more, currently the average energy consumption of the Spanish population in the ANIBES study is 1810 kcal/day, of which 12% was provided by beverages. Specifically, water was the most consumed beverage, followed by milk, and the contribution of caloric soft drinks to the energy intake was 2% (Nissensohn et al., 2016). However, in other population groups from France and Italy, the
Sparkling, Nonfermented, Nonalcoholic Beverages
321
Table 10.5: Evolution of energy intake, macronutrients and fiber of nonalcoholic beverages in Spain, 2000 16 (Rodrı´guez Alonso et al., 1964 2016). Energy (kcal/day)
Protein (g/day)
Lipids (g/day)
Carbohydrates (g/day)
Starch (g/day)
Sugar (g/day)
Fiber (g/day)
Year
Total
%
Total
%
Total
%
Total
%
Total
%
Total
%
Total
%
2016 2006 2000
67.3 61.5 57.7
3.2 3.0 2.8
1.0 0.2 0.2
1.3 0.3 0.3
0.16 0.01 0.01
0.2 0.0 0.0
15.3 15.1 14.2
6.9 6.9 6.2
0.6 0.0 0.0
0.5 0.0 0.0
14.6 15.1 14.2
15.8 16.8 16.0
0.07 0.12 0.12
0.5 0.8 0.8
energy provided by beverages was 8% and 6%, respectively (Mistura et al., 2016; Nissensohn et al., 2017). These percentages are very close to those suggested by some international authorities who recommend that no more than 10% of daily calorie intake should come from beverages (EFSA, 2010; WHO/FAO World Health Organization/Food and Agriculture Organization of the United Nations, 2002). In both populations, water was the most consumed beverage, followed by hot beverages in the French population (Nissensohn et al., 2017), while in the population from Italy, the contributions of fruit and vegetable juices and milk to the energy intake was 2% for both beverage types. However, caloric soft drinks contribute only 0.4% of the TE intake for the total sample (Mistura et al., 2016). Likewise, the current nonalcoholic beverage consumption data of total carbohydrates in the ANIBES study population was 8%, of which 19.0% were sugars (Ruiz et al., 2015). Moreover, the major sources of intrinsic sugars from nonalcoholic beverages (%) in the ANIBES Spanish population (9 75 years of age) were milks (19.6%), juices and nectars (11.1%), and sugar soft drinks (2.24%), whereas the major dietary sources for free sugars were sugary soft drinks (25.5%), yogurt and fermented milks (6.44%), and juices and nectars (2.91%).
10.6 Conclusion In general, there is a low availability of nutritional data from nonalcoholic beverages in food composition tables and databases and, in addition, there are not always updated. The latter contrasts with the large number and variety of products on the market. At present, updated nonalcoholic beverage composition data relies on product label information as a main source. Furthermore, to capture nutrient changes is challenging in an ever evolving and growing market. As their nutritional value is generally low and based mainly on their simple carbohydrate content, consumption should be moderate to low, especially amongst children and adolescents who should be educated in correct drinking habits from an early age. In fact, water should be recommended as the main daily beverage.
322 Chapter 10 Future innovation and reformulation practices are granted to improve their composition, due to public health policies and consumer demands.
References An, R., 2016. Plain water and sugar-sweetened beverage consumption in relation to energy and nutrient intake at full-service restaurants. Nutrients 8 (5), 263. An, R., McCaffrey, J., 2016. Plain water consumption in relation to energy intake and diet quality among US adults, 2005 2012. J. Hum. Nutr. Diet. 29 (5), 624 632. ANFABRA, 2015. El Sector de las bebidas refrescantes ha reducido casi un 20% las calorı´as de sus productos en los u´ltimos 5 An˜os. ,http://www.refrescantes.es/el-sector-de-las-bebidas-refrescantes-ha-reducido-casiun-20-las-calorias-de-sus-productos-en-los-ultimos-5-anos/ . (last accessed 11.01.19). Ashurst, P.R., 2016. Carbonated beverages. Reference Module in Food Science. Elsevier. Backholer, K., et al., 2018. Sugar-sweetened beverage taxes in 2018: a year of reflections and consolidation. Public Health Nutr. 21 (8), 3291 3295. Basu, S., et al., 2013. Relationship of soft drink consumption to global overweight, obesity, and diabetes: a cross-national analysis of 75 countries. Am. J. Public Health 103 (11), 2071 2077. Day, L., McSweeney, P.L.H., 2016. Beverages. Reference Module in Food Science. Elsevier. EFSA, 2010. Panel on dietetic products, nutrition, and allergies (NDA): scientific opinion on dietary reference values for water. EFSA J. 8, 1459. European Union, 2011a. Commission Regulation (EU) No. 1129/2011 of 11 November 2011 amending Annex II to Regulation (EC) No. 1333/2008 of the European Parliament and of the Council by establishing a Union list of food additives. Official Journal of the European Union L295. European Union, 2011b. Commission Regulation (EU) No. 1131/2011 of 11 November 2011 amending Annex II to Regulation (EC) No. 1333/2008 of the European Parliament and of the Council with regard to steviol glycosides. Official Journal of the European Union L295. European Union, 2012. Commission Implementing Regulation (EU) No. 872/2012 of 1 October 2012 adopting the list of flavouring substances provided for by Regulation (EC) No 2232/96 of the European Parliament and of the Council, introducing it in Annex I to Regulation (EC) No. 1334/2008 of the European Parliament and of the Council and repealing Commission Regulation (EC) No. 1565/2000 and Commission Decision 1999/217/EC Text with EEA relevance. Official Journal of the European Union L 267/1, October 2, 2012. Food and Drug Administration, 2019. Database of Select Committee on GRAS Substances (SCOGS). ,https:// www.accessdata.fda.gov/scripts/fdcc/?set 5 SCOGS&sort 5 Sortsubstance&order 5 ASC&startrow 5 1 &type 5 basic&search 5 caffeine . (last accessed 20.01.19). Gonza´lez Reyes, A.B., et al., 2015. Cafeı´na y quinina en bebidas refrescantes: contribucio´n a la ingesta diete´tica. Nutr. Hosp. 32, 2880 2886. Greenwood, D., et al., 2014. Association between sugar-sweetened and artificially sweetened soft drinks and type 2 diabetes: systematic review and dose response meta-analysis of prospective studies. Br. J. Nutr. 112 (5), 725 734. Guelinckx, I., et al., 2015. Intake of water and different beverages in adults across 13 countries. Eur. J. Nutr. 54 (2), 45 55. US Dept. of Health and Human Services, US Dept. of Agriculture, Dietary Guidelines for Americans 2015 2020. 2017. Skyhorse Publishing Inc. Helm, L., Macdonald, I.A., 2015. Impact of beverage intake on metabolic and cardiovascular health. Nutr. Rev. 73 (Suppl. 2), 120 129. Huang, C., et al., 2014. Sugar sweetened beverages consumption and risk of coronary heart disease: a metaanalysis of prospective studies. Atherosclerosis 234 (1), 11 16.
Sparkling, Nonfermented, Nonalcoholic Beverages
323
Kant, A.K., Graubard, B.I., Atchison, E.A., 2009. Intakes of plain water, moisture in foods and beverages, and total water in the adult US population—nutritional, meal pattern, and body weight correlates: National Health and Nutrition Examination Surveys 1999 2006. Am. J. Clin. Nutr. 90 (3), 655 663. Kontogianni, M.D., et al., 2008. Adherence rates to the Mediterranean diet are low in a representative sample of Greek children and adolescents. J. Nutr. 138 (10), 1951 1956. Malik, V.S., et al., 2013. Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. Am. J. Clin. Nutr. 98 (4), 1084 1102. Mathers, C.D., Loncar, D., 2006. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 3 (11), e442. Maughan, R.J., et al., 2016. A randomized trial to assess the potential of different beverages to affect hydration status: development of a beverage hydration index. Am. J. Clin. Nutr. 103 (3), 717 723. Ministry of Health, 2018. Social services and equality. Spanish Agency for Food Safety and Nutrition. Collaboration Plan for the improvement of the composition of food and beverages and other measures 2020. ,http://www.aecosan.msssi.gob.es/AECOSAN/docs/documentos/nutricion/Plan_Colaboracion_ INGLES.pdf . (last accessed 10.01.18). Mistura, L., D’Addezio, L., Turrini, A., 2016. Beverage consumption habits in Italian population: association with total water intake and energy Intake. Nutrients 8 (11), E674. Ni Mhurchu, C., et al., 2015. Nutrient profile of 23 596 packaged supermarket foods and non-alcoholic beverages in Australia and New Zealand. Public Health Nutr. 19 (3), 401 408. Nissensohn, M., et al., 2016. Beverage consumption habits and association with total water and energy intakes in the Spanish population: findings of the ANIBES study. Nutrients 8 (4), 232. Nissensohn, M., et al., 2017. Beverage consumption habits among the European population: association with total water and energy intakes. Nutrients 9 (4), E383. ¨ zen, A., et al., 2015. Fluid intake from beverages across age groups: a systematic review. J. Hum. Nutr. Diet. O 28 (5), 417 442. Packaged Facts, 2017. Energy and sports drinks: U.S. Retail Market Trends & Opportunities.,https://www. packagedfacts.com/Energy-Sports-Drinks-10836915 . (last accessed 11.01.19). Park, Y., et al., 2011. Dietary fiber intake and mortality in the NIH-AARP diet and health study. Arch. Intern. Med. 171 (12), 1061 1068. Poti, J.M., et al., 2017. Development of a food composition database to monitor changes in packaged foods and beverages. J. Food Compos. Anal. 64, 18 26. Produce for Better Health Foundation, 2015. State of the Plate, 2015 Study on America’s Consumption of Fruit and Vegetables, Produce for Better Health Foundation. ,http://www.pbhfoundation.org/pdfs/about/res/ pbh_res/State_of_the_Plate_2015_WEB_Bookmarked.pdf . (last accessed 05.02.19). Real Decreto, 2011. 650/2011, de 9 de mayo, por el que se aprueba la reglamentacio´n te´cnico-sanitaria en materia de bebidas refrescantes. BOE nu´m.119 de 19 de mayo de, pa´g. 50089 50093. Regulation (EC), 1997. No. 258/97 of the European Parliament and of the Council of 27 January 1997 concerning novel foods and novel food ingredients. Off. J. L 043, 14/02/1997,0001 0006. Rodrı´guez Alonso, P., et al., 1964 2016. Valoracio´n de la Dieta en los hogares Espan˜oles. Evolucio´n del consumo de alimentos en hogares de acuerdo al Panel de Consumo Alimentario del Ministerio de Agricultura, Pesca y Alimentacio´n (MAPA). En prensa. Rodrı´guez Alonso, P., et al., 2016. Fifty years of beverages consumption trends in Spanish households. Nutr. Hosp. 33, 46 51. Rosenfeld, L.S., et al., 2014. Regulatory status of caffeine in the United States. Nutr. Rev. 72 (S1), 23 33. Ruiz, E., et al., 2015. Energy intake, profile, and dietary sources in the Spanish population: findings of the ANIBES study. Nutrients 7 (6), 4739 4762. Safefood, 2009. Drinks: consumer knowledge and practice in relation to drinks for children and young people. ,https://www.safefood.eu/SafeFood/media/SafeFoodLibrary/Documents/Publications/Research% 20Reports/9650_Drinks_Interior-Cover.pdf . (last accesssed 15.01. 19).
324 Chapter 10 Samaniego-Vaesken, M., et al., 2018. Added sugars and low-and no-calorie sweeteners in a representative sample of food products consumed by the Spanish ANIBES study population. Nutrients 10 (9), 1265. Sa´nchez, X.F., et al., 2008. Aspectos toxicolo´gicos del consumo de bebidas refrescantes que contienen quinina. Nutr. Clı´n. Diet. Hosp. 28 (2), 20 25. Serrano Iglesias, M., Samaniego Vaesken, M.D.L., Varela Moreiras, G., 2016. Composition and nutrient information of non-alcoholic beverages in the Spanish market: an update. Nutrients 8 (10), 618. Shachman, M., 2004. The Soft Drinks Companion: A Technical Handbook for the Beverage Industry. CRC Press. Singh, G.M., et al., 2015. Global, regional, and national consumption of sugar-sweetened beverages, fruit juices, and milk: a systematic assessment of beverage intake in 187 countries. PLoS One 10 (8), e0124845. Statovci, D., et al., 2017. The impact of western diet and nutrients on the microbiota and immune response at mucosal interfaces. Front. Immunol. 8, 838. Te Morenga, L., Mallard, S., Mann, J., 2013. Dietary sugars and body weight: systematic review and metaanalyses of randomised controlled trials and cohort studies. BMJ 346, e7492. Uranga, J.A., et al., 2016. Food, nutrients and nutraceuticals affecting the course of inflammatory bowel disease. Pharmacol. Rep. 68 (4), 816 826. Urrialde, R., et al., 2018. Evolution in the supply of non-alcoholic beverages in the last 25 years: reduction of sugar as a critical nutrient and use of sweeteners. Nutr. Hosp. 35 (Spec No. 6), 30. Varela-Mosquera, G., Rodrı´guez, D.G., Moreiras, O., 1971. La Nutricio´n de los Espan˜oles: Diagnostico y recomendaciones. Publicaciones de la Escuela Nacional de Administracio´n Pu´blica, Madrid. Varela-Mosquera, G., Moreiras, O., Requejo, A., 1985. Encuesta de Presupuestos Familiares 1980 81. Estudio sobre la Nutricio´n. Instituto Nacional de Estadı´stica (INE), Madrid. WHO/FAO (World Health Organization/Food and Agriculture Organization of the United Nations), 2002. Diet, Nutrition and the Prevention of Chronic Diseases. World Health Organization, Geneva. World Health Organization, 2003. Diet, Nutrition and the Prevention of Chronic Diseases. Joint WHO/FAO Expert Consulation. WHO Thecnical Report Series No. 916. World Health Organization, Geneva. World Health Organization, 2015. Guideline: Sugars Intake for Adults and Children. World Health Organization. World Health Organization, 2018. Enfermedades no transmisibles. Datos y cifras. World Health Organization. Zupaniˇc, N., et al., 2018. Total and free sugar content of pre-packaged foods and non-alcoholic beverages in Slovenia. Nutrients 10 (2), 151.