Because of the uncertainties and limitations in evidence, especially concerning the safety and benefits for weight control, the committee does not recommend a standard for nonnutritive sweeteners in foods.

Safety Nonnutritive sweeteners meet the safety standards set by the FDA; however, there is no long-term evidence addressing their safety when consumption begins in early childhood, and in relation to a broader range of health and developmental outcomes. The committee also considered the limitations in testing and lack of evidence concerning the benefits or necessity for use of nonnutritive sweeteners in foods.

Displacement Displacement was not an important issue for nonnutritive sweeteners in foods that otherwise met the recommended standards.

Efficacy Based on the principle of energy balance, nonnutritive sweeteners in foods might provide a tool for weight management; however, studies to test this in children are not conclusive and the complexities of the relationship between nonnutritive sweeteners and appetite have not been studied in this age group.

Choice and necessity Although nonnutritive sweeteners may increase palatability, thereby increasing consumption of healthful foods, the potential increase in consumption may not be sufficient justification to include them in foods. There was also concern that children may not be able to distinguish between a food with nonnutritive sweeteners and a similar full-calorie food, which might encourage unintentional overconsumption. Improving dietary patterns and maintaining healthy weight in children does not require foods with nonnutritive sweeteners.

Standard 6: Foods and beverages are caffeine-free, with the exception of trace amounts of naturally occurring caffeine-related substances.

The evidence for adverse health effects, other than physical dependency and withdrawal, from caffeine consumption varies in severity of effects and consistency of results among studies (see discussion in Chapter 2) except for the two health effects mentioned. Tolerance and dependence on caffeine have been identified in all ages, including school-age children, and withdrawal from regular caffeine intake is followed by generally mild effects such as moodiness, headache, and shakiness.

Although there may be some benefits associated with caffeine consumption (see Chapter 2), the committee did not support offering products containing significant amounts of caffeine for school-age children because of the potential for adverse effects, including physical dependency and withdrawal (described in Chapter 2). Thus the committee judged that caf-

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