Spanish Association of Paediatrics
Use of sugars and sweeteners in children's diets. Recommendations of the Nutrition Committee of the Spanish Association of Paediatrics
Uso de azúcares y edulcorantes en la alimentación del niño. Recomendaciones del Comité de Nutrición de la Asociación Española de Pediatría
M. Gil-Camposa,
, M.A. San José Gonzálezb, J.J. Díaz Martínc, Comité de Nutrición de la Asociación Española de Pediatría ◊
Corresponding author
a Unidad de Metabolismo e Investigación Pediátrica, Hospital Universitario Reina Sofía, Universidad de Córdoba, IMIBIC, Córdoba, Spain
b Atención Primaria, Centro de Salud de Sarria, Lugo, Spain
c Sección de Gastroenterología y Nutrición Pediátrica, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
Read
17047
Timeswas read the article
3300
Total PDF
13747
Total HTML
Share statistics
array:24 [ "pii" => "S234128791500201X" "issn" => "23412879" "doi" => "10.1016/j.anpede.2015.10.002" "estado" => "S300" "fechaPublicacion" => "2015-11-01" "aid" => "1829" "copyright" => "Asociación Española de Pediatría" "copyrightAnyo" => "2014" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2015;83:353.e1-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5155 "formatos" => array:3 [ "EPUB" => 148 "HTML" => 4346 "PDF" => 661 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S1695403315000739" "issn" => "16954033" "doi" => "10.1016/j.anpedi.2015.02.013" "estado" => "S300" "fechaPublicacion" => "2015-11-01" "aid" => "1829" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2015;83:353.e1-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 22547 "formatos" => array:3 [ "EPUB" => 170 "HTML" => 19336 "PDF" => 3041 ] ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">ASOCIACIÓN ESPAÑOLA DE PEDIATRÍA</span>" "titulo" => "Uso de azúcares y edulcorantes en la alimentación del niño. Recomendaciones del Comité de Nutrición de la Asociación Española de Pediatría" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "353.e1" "paginaFinal" => "353.e7" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Use of sugars and sweeteners in children's diets. Recommendations of the Nutrition Committee of the Spanish Paediatric Association" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Gil-Campos, M.A. San José González, J.J. Díaz Martín" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Gil-Campos" ] 1 => array:2 [ "nombre" => "M.A." "apellidos" => "San José González" ] 2 => array:2 [ "nombre" => "J.J." "apellidos" => "Díaz Martín" ] 3 => array:1 [ "colaborador" => "Comité de Nutrición de la Asociación Española de Pediatría" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S234128791500201X" "doi" => "10.1016/j.anpede.2015.10.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234128791500201X?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315000739?idApp=UINPBA00005H" "url" => "/16954033/0000008300000005/v1_201510300037/S1695403315000739/v1_201510300037/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2341287915001775" "issn" => "23412879" "doi" => "10.1016/j.anpede.2015.09.014" "estado" => "S300" "fechaPublicacion" => "2015-11-01" "aid" => "1828" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "An Pediatr (Barc). 2015;83:354.e1-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2810 "formatos" => array:3 [ "EPUB" => 141 "HTML" => 2155 "PDF" => 514 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Spanish Association of Paediatrics</span>" "titulo" => "Recommendations for respiratory support in the newborn (III). Surfactant and nitric oxide" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "354.e1" "paginaFinal" => "354.e6" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Recomendaciones para la asistencia respiratoria en el recién nacido (<span class="elsevierStyleSmallCaps">iii</span>). Surfactante y óxido nítrico" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "F. Castillo Salinas, D. Elorza Fernández, A. Gutiérrez Laso, J. Moreno Hernando, G. Bustos Lozano, M. Gresa Muñoz, J. López de Heredia Goya, M. Aguar Carrascosa, X. Miracle Echegoyen, J.R. Fernández Lorenzo, M.M. Serrano, A. Concheiro Guisan, C. Carrasco Carrasco, J.J. Comuñas Gómez, M.T. Moral Pumarega, A.M. Sánchez Torres, M.L. Franco" "autores" => array:18 [ 0 => array:2 [ "nombre" => "F." "apellidos" => "Castillo Salinas" ] 1 => array:2 [ "nombre" => "D." "apellidos" => "Elorza Fernández" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Gutiérrez Laso" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Moreno Hernando" ] 4 => array:2 [ "nombre" => "G." "apellidos" => "Bustos Lozano" ] 5 => array:2 [ "nombre" => "M." "apellidos" => "Gresa Muñoz" ] 6 => array:2 [ "nombre" => "J." "apellidos" => "López de Heredia Goya" ] 7 => array:2 [ "nombre" => "M." "apellidos" => "Aguar Carrascosa" ] 8 => array:2 [ "nombre" => "X." "apellidos" => "Miracle Echegoyen" ] 9 => array:2 [ "nombre" => "J.R." "apellidos" => "Fernández Lorenzo" ] 10 => array:2 [ "nombre" => "M.M." "apellidos" => "Serrano" ] 11 => array:2 [ "nombre" => "A." "apellidos" => "Concheiro Guisan" ] 12 => array:2 [ "nombre" => "C." "apellidos" => "Carrasco Carrasco" ] 13 => array:2 [ "nombre" => "J.J." "apellidos" => "Comuñas Gómez" ] 14 => array:2 [ "nombre" => "M.T." "apellidos" => "Moral Pumarega" ] 15 => array:2 [ "nombre" => "A.M." "apellidos" => "Sánchez Torres" ] 16 => array:2 [ "nombre" => "M.L." "apellidos" => "Franco" ] 17 => array:1 [ "colaborador" => "on behalf of Grupo Respiratorio y Surfactante de la Sociedad Española de Neonatología" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403315000727" "doi" => "10.1016/j.anpedi.2015.02.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315000727?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287915001775?idApp=UINPBA00005H" "url" => "/23412879/0000008300000005/v1_201512040119/S2341287915001775/v1_201512040119/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2341287915002008" "issn" => "23412879" "doi" => "10.1016/j.anpede.2015.10.001" "estado" => "S300" "fechaPublicacion" => "2015-11-01" "aid" => "1855" "copyright" => "Asociación Española de Pediatría" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "An Pediatr (Barc). 2015;83:350-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2700 "formatos" => array:3 [ "EPUB" => 179 "HTML" => 2010 "PDF" => 511 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Are anti-TNF-α agents really useful in systemic vasculitis? Experience in polyarteritis nodosa" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "350" "paginaFinal" => "352" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "¿Son realmente útiles los anti-TNFα en vasculitis sistémicas? Experiencia en panarteritis nodosa" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 758 "Ancho" => 1399 "Tamanyo" => 144499 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Superior mesenteric artery (SMA) arteritis assessed by ultrasound (case 2). (A) Sagittal view: hyperechoic halo around the SMA due to thickening of its wall. 1: liver parenchyma; 2: spleno-portal axis; 3: inferior vena cava; 4: aorta; 5: SMA. (B) Coronal view: 2<span class="elsevierStyleHsp" style=""></span>mm thickening of SMA from its origin in the aorta to its bifurcation (4.3<span class="elsevierStyleHsp" style=""></span>cm).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. Núñez Cuadros, R. Galindo Zavala, G. Díaz Cordovés-Rego, A. Vera Casaño, A.L. Urda Cardona" "autores" => array:5 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "Núñez Cuadros" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Galindo Zavala" ] 2 => array:2 [ "nombre" => "G." "apellidos" => "Díaz Cordovés-Rego" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Vera Casaño" ] 4 => array:2 [ "nombre" => "A.L." "apellidos" => "Urda Cardona" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403315001204" "doi" => "10.1016/j.anpedi.2015.03.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315001204?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287915002008?idApp=UINPBA00005H" "url" => "/23412879/0000008300000005/v1_201512040119/S2341287915002008/v1_201512040119/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Spanish Association of Paediatrics</span>" "titulo" => "Use of sugars and sweeteners in children's diets. Recommendations of the Nutrition Committee of the Spanish Association of Paediatrics" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "353.e1" "paginaFinal" => "353.e7" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Gil-Campos, M.A. San José González, J.J. Díaz Martín" "autores" => array:4 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Gil-Campos" "email" => array:1 [ 0 => "mercedes_gil_campos@yahoo.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M.A." "apellidos" => "San José González" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "J.J." "apellidos" => "Díaz Martín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:2 [ "colaborador" => "Comité de Nutrición de la Asociación Española de Pediatría" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">◊</span>" "identificador" => "fn0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Unidad de Metabolismo e Investigación Pediátrica, Hospital Universitario Reina Sofía, Universidad de Córdoba, IMIBIC, Córdoba, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Atención Primaria, Centro de Salud de Sarria, Lugo, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Sección de Gastroenterología y Nutrición Pediátrica, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Uso de azúcares y edulcorantes en la alimentación del niño. Recomendaciones del Comité de Nutrición de la Asociación Española de Pediatría" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Sugars and sweeteners: concepts</span><p id="par0005" class="elsevierStylePara elsevierViewall">Carbohydrates (CHs) are the nutrients that constitute the main source of food energy. They are notable for their structure and pleasant taste, which in some cases, such as sugars, is sweet, making other foods more palatable, for their ability to satiate the appetite and, in some, for their high fibre content.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">1</span></a> CHs should provide between 45% and 60% of total dietary energy intake in children older than one year of age.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">2</span></a> CHs from food are presented in the form of complex molecules (polymers or polysaccharides), especially starches, dextrins and fibre, or simpler ones, commonly called sugars. The main dietary sources of sugars are fruit and fruit juices, some vegetables, milk, and processed foods with added sugars, especially sucrose or hydrolysed starch (glucose or fructose syrups), such as soft drinks, pastries, sweets and confectionery.<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">1,2</span></a> Sugars are used to sweeten or enhance the flavour of many of them, to modify the freezing and melting point or to colour foods naturally, and to preserve them. Balanced intake of sugars in the daily diet has important properties, as it facilitates the rapid supply of glucose, an indispensable carbohydrate for the development of cognitive functions and physical activity, to the brain and muscles. Sugar should be consumed in a natural form with the foods that contain it, since this also provides other micronutrients. In the twentieth century, however, questions began to be raised as to whether excessive consumption of sugars, particularly associated with processed foods, might be related to diabetes or obesity, and research has continued up to the present.<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">3–5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Additives are substances deliberately added to foods to perform certain technological functions and the result is that both the additive itself and its byproducts become components of those foods. Additives are not consumed as foods or used as typical ingredients in the diet, regardless of whether or not they have nutritional value. Monosaccharides, disaccharides or oligosaccharides, or foods containing them, are not regarded as food additives. The term <span class="elsevierStyleItalic">sweetener</span> refers to a substance used to impart a sweet taste to foods (Regulation (EC) No 1333/2008). Thus foods such as honey or ordinary sugar, fructose or glucose are not considered sweeteners, since they have other functions apart from sweetening.<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Low- or no-calorie sweeteners (LNCSs) have been used for years to replace all or part of the sugar content in foods and drinks, but in the last few decades their consumption has increased both in adults and in children. Their use is linked to dietary alternatives for weight control or diabetes, but also to preventing tooth decay. Although some studies question these possible benefits, both in adults and in children,<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">7,8</span></a> systematic reviews and meta-analyses on this subject conclude that the use of sweeteners is beneficial in weight-control and diabetes programmes associated with a healthy lifestyle.<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">9</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The purpose of this document is to provide paediatricians with information on sweeteners and health-related issues, in order to give appropriate advice to patients and their families.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Consumption of sugars and sweeteners and its relationship with health</span><p id="par0025" class="elsevierStylePara elsevierViewall">To assess this consumption we have to take into account not only added sugars and sweeteners, but also sugar incorporated as an ingredient in precooked/processed foods. European adolescents consume some 384<span class="elsevierStyleHsp" style=""></span>kcal per day from drinks, of which 30.4%, 20.7% and 18.1% comes from sugar-sweetened beverages, sweetened milk and fruit juice, respectively.<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">10</span></a> Various cross-sectional studies have concluded that there is no association, or even that there is a negative association, between consumption of sugars and weight gain.<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">11,12</span></a> However, there is a widespread debate on whether greater intake of sugars through sweetened beverages could have a significant effect on increase in body mass index (BMI) or about whether unsweetened diets may have an influence on control of obesity.<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">13</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Some observational studies have also related increase in BMI to consumption of non-caloric sweeteners, although these data should not be interpreted as proof of a causal relationship, but rather as a sign that the probability of consumption is higher in the obese and sedentary population (reverse causality).<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">8</span></a> Replacing sugar with sweeteners is not necessarily associated with a lower overall calorie intake, and could encourage unbalanced dietary habits, involving high consumption of low-calorie products with sweeteners and of others with excessive calories.<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">6,14</span></a> Some authors postulate that early consumption of sugar-sweetened products in infants and young children could affect self-regulation of eating and preference for sweet flavours,<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">7,15</span></a> which may be maintained during childhood and adolescence. It has even been suggested that consuming sweeteners and sugars together in the diet could give rise to a neuronal response that leads to more rapid absorption of sugars, also increasing secretion of peptides related to glucagon, or insulin.<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">16</span></a> On this subject a highly controversial hypothesis has recently been put forward on the development of glucose intolerance through alterations to the intestinal microbiota in mice associated with consuming saccharin at maximum doses.<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">17</span></a> However, one must be very cautious in extrapolating conclusions from animal studies to humans.<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">18</span></a> Nowadays diabetic patients can use non-caloric sweeteners as part of a balanced, controlled diet, and studies in adults indicate that they do not affect plasma glucose or lipid levels, although this has not been sufficiently investigated in children.<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">19,20</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Fermentable CHs in the diet produce acidic materials which destroy hard tissues of the tooth, giving rise to tooth decay. In the child population dental caries is still common, because of a general lack of adequate oral hygiene after consuming sugary foods, as well as fluoride deficiency.<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">21</span></a> In infants, moreover, prolonged use of fruit juices or other fructose- or sucrose-rich sweetened beverages in dummies increases the risk of damage to teeth. Among sweeteners, polyols (sugar alcohols) and sucralose, among others, have been declared to have healthy properties for avoiding this condition.<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">22</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Recommendations for consumption</span><p id="par0040" class="elsevierStylePara elsevierViewall">All types of CHs must be represented in a healthy diet. The FAO and WHO recommend an intake of sugars (simple carbohydrates) of less than 10% of the total caloric value of the diet, trying to make them part of a healthy diet with limited consumption of sugar-sweetened drinks.<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">23</span></a> In 2005 it was established that the recommended daily intake in adults and children older than one year of age is 100<span class="elsevierStyleHsp" style=""></span>g/day of CHs as an estimated mean requirement.<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">24</span></a> In Spain, adhering to a Mediterranean or similar diet would make it possible to maintain an appropriate energy intake without sacrificing its sweetening and pleasurable function. In addition, as a practical measure to achieve greater benefits, it has been recommended that consumption of sugars or sugar-sweetened foods should be limited to less than 3 times per day, not exceeding 6% of total energy intake,<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">25</span></a> and that of sugar-sweetened drinks to occasional use. It is also recommended that excessive consumption of high-fructose corn syrup (55% fructose) should be reduced, as it represents a health hazard, especially for children.<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">26</span></a> Indeed, these syrups are not used in Spain, where the maximum fructose content of manufactured products is approximately 50%.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The nutrition statements prescribed in Regulation (EC) No 1924/2006 make it easy to ascertain the composition of foods in terms of sugars. Thus according to the labelling we can find foods that are “low in sugar” (no more than 5<span class="elsevierStyleHsp" style=""></span>g of sugars per 100<span class="elsevierStyleHsp" style=""></span>g for solids or 2.5<span class="elsevierStyleHsp" style=""></span>g of sugars per 100<span class="elsevierStyleHsp" style=""></span>ml for liquids), “sugar-free” (no more than 0.25<span class="elsevierStyleHsp" style=""></span>g per 100<span class="elsevierStyleHsp" style=""></span>g or 100<span class="elsevierStyleHsp" style=""></span>ml), or “with no added sugar” (a product with no added mono- or disaccharides nor any other food used for its sweetening properties). In the last of these cases, the food may “contain naturally occurring sugars” or “sugar(s) and sweetener(s)”, and this information must appear on the nutrition information label.<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">27</span></a> On a practical level, the American Heart Association has suggested simple advice, such as not having more than 6 teaspoonfuls of sugar per day for women (25<span class="elsevierStyleHsp" style=""></span>g) (e.g., present in 250<span class="elsevierStyleHsp" style=""></span>ml of a sugar-sweetened beverage) and 9 for men (37<span class="elsevierStyleHsp" style=""></span>g).<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">28</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">During pregnancy CH intake should not be restricted, but intake of refined sugar or foods with added sugar should be controlled. There is an increase in availability of glucose, which is an essential substrate for the foetus. In newborns, because of pancreatic amylase deficiency, it is advisable for infant milk formulae not to contain starch, with lactose as the main CH, as well as glucose polymers, which can also be added, since they are directly absorbable by the enterocyte. On the other hand, the infant's predisposition towards sweet taste makes it possible to introduce new foods with a relatively high starch content.<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">29</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">As for sweeteners, the European Food Safety Authority (EFSA) proposes acceptable daily intakes to ensure appropriate use without possible adverse effects.<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">30</span></a> In the case of infants it is difficult to find sweeteners in the products they consume, as they are prohibited in milk formulae, cereals and baby foods. At later ages, foods such as soft drinks, fruit juices or dairy products sweetened with sugar or sweeteners should be controlled. Reducing the energy content in some foods through sweeteners does actually seem to have modest benefits in children.<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">16</span></a> On the other hand, it may lead to greater consumption of other more caloric foods, and there is also the possibility that early exposure to sweeteners, as mentioned previously, could affect dietary habits later.<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">31</span></a> In pre-school and school-aged children the recommendations already described should be maintained, taking some additional factors into account, such as physical activity, which may mean that sugar intake has to be regulated with appropriate beverages rather than just drinking water.<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">32</span></a> Indeed, anaerobic or prolonged exercise causes a depletion of liver and muscle glycogen reserves, leading to fatigue and cognitive abnormalities,<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">33</span></a> which sometimes have to be mitigated with sugars.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Types of sweeteners</span><p id="par0060" class="elsevierStylePara elsevierViewall">There are various ways of classifying sweeteners (<a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 and 2</a>). Using the glycaemic index (GI) we can also make a classification of foods based on postprandial blood sugar response, comparing them with a reference food (GI<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>100). Sucrose is medium GI (≈65).<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">34</span></a> Depending on their energy contribution they are classified as “caloric” or “low calorie/non-caloric” (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) or as “nutritive” or “non-nutritive”, as established by the US Food and Drug Administration (FDA) (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">35</span></a> In some cases the term “natural origin” is used in the consumer information, as with steviol glycoside, or “artificial” origin when they are synthetic (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Natural caloric sweeteners include sucrose, fructose, glucose and maltose. Fructose has classically been used as a substitute for sucrose in diabetic patients. More recently, however, it has been found that high-fructose diets, especially if the fructose is added to processed foods, could induce hyperinsulinaemia, hypertriglyceridaemia and insulin resistance, and this has led to a recommendation to limit their use in diabetics. In addition, fructose dependence has been described, leading to high consumption.<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">36</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Fructooligosaccharides have a sweetening power relative to sucrose of 0.3–0.6. Inulin is a fructan with a well-known prebiotic effect found naturally in the yacon or Peruvian ground apple, a tuber native to the Andes, considered a health food on account of being rich in various minerals, vitamin C and B-group vitamins. Coconut sugar is another traditional product with a low GI because of its sucrose content. Polyols derived from sugar and also regarded as CHs are produced, albeit in small quantities, in plants and cereals. They generally contain fewer calories than sugar, with a very low GI, and have not been associated with the development of tooth decay, since they are non-fermentable; they are used as sweeteners. Their intestinal absorption is generally low, and in moderate quantities (more than 10<span class="elsevierStyleHsp" style=""></span>g of sorbitol) they can produce flatulence, colic or diarrhoea, as they are fermented by the colonic microbiota.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Industrial processed foods use sugars converted from starch, with a high GI and high calorie content. Corn syrup is the prime example.</p><p id="par0080" class="elsevierStylePara elsevierViewall">There are also natural sweeteners (stevia, luo han guo, thaumatin and brazzein) with no significant calorie content in the quantities normally consumed for sweetening purposes. These are not CHs, and therefore have no GI. They are regarded as high-intense sweeteners.</p><p id="par0085" class="elsevierStylePara elsevierViewall">“Artificial sweeteners” are characterised by being non-caloric, with no glycaemic effect and high sweetening power (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). Prominent among them is saccharin, which has great sweetening capacity. Sucralose and aspartame are also notable for their extensive worldwide use, especially in beverages.<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">37</span></a> Aspartame is made from a methyl ester of phenylalanine and aspartic acid. Its use is approved by the FDA and the EFSA.<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">38</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Safe use of sweeteners</span><p id="par0090" class="elsevierStylePara elsevierViewall">Society demands a market supply of high-quality food substances that are suitable for consumption by people with specific needs, such as diabetics, or that respond to the current demand for low-calorie products. Although the object of using LNCSs is to reduce calorie intake in the diet and the presence of fermentable sugars in the mouth, seeking beneficial effects, such as promoting a decrease in body weight, and preventing diabetes or tooth decay, consumers have doubts about the health risks associated with their use, depending on whether they are artificial or natural. The fact that a sweetener is of natural origin does not imply greater safety or effectiveness. Since a wide range of molecules is involved, there are many potential sources of risk: interference in absorption, metabolism or excretion of nutrients or intermediate metabolites, as well as allergic reactions, accumulation in tissues, effects on normal intestinal flora, disruption of blood glucose regulation or interaction with other drugs or medications.</p><p id="par0095" class="elsevierStylePara elsevierViewall">In research on safety and possible therapeutic uses in patients with diabetes or other specific health problems the focus of interest is on “artificial sweeteners”. For this purpose the legal aspects of safety and efficacy in the use of sweeteners need to be constantly reviewed by the EFSA.</p><p id="par0100" class="elsevierStylePara elsevierViewall">Regulation (EC) No 1333/2008 lays down rules on the food additives used in foods to ensure the protection of consumers’ health while upholding trade practices. Annex II, updated in 2013, indicates that the following LNCSs are authorised: acesulfame-K (E-950), aspartame (E-951), salt of aspartame-acesulfame (E-962), cyclamic acid and its Na and Ca salts (E-952), neohesperidine DC (E-959), saccharin and its Na, K and Ca salts (E-954), sucralose (E-955), thaumatin (E-957) and neotame (E-961). Following the favourable verdict from the EFSA in 2010, the use of stevia derivatives, steviol glycosides (E-960), as natural non-caloric sweeteners was definitively approved throughout the European market, and also sorbitol and xylitol. In 2014 the use of advantame (E-969) as an intense sweetener was authorised.</p><p id="par0105" class="elsevierStylePara elsevierViewall">With regard to aspartame, it does not represent a risk of toxicity for consumers at current exposure levels. Because it is a source of phenylalanine it is not recommended in individuals with hyperphenylalaninaemia or phenylketonuria, although in studies in patients with consumption at normal doses and long-term studies, even in pregnant women, no adverse effects have been found.<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">37</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">Information for correct use of these substances is based on knowing the differences between the information labels of commonly consumed products containing sweeteners. The labelling of food additives must comply with the general conditions laid down in Directive 2000/13/EC. Specifically, if the product contains polyols, the label must state: “excessive consumption may produce laxative effects”, or if it contains aspartame or salt of aspartame-acesulfame: “contains a source of phenylalanine”. In this regard, however, there is substantial room for improvement to ensure that this compulsory information appears on all products containing sweeteners.</p><p id="par0115" class="elsevierStylePara elsevierViewall">Under European regulations (Council Directive 89/398/EEC), artificial sweeteners must not be used in infant formulae, follow-on formulae, cereals, baby foods or dietary foods for very young children for special medical purposes, unless expressly indicated.<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">38</span></a> Sugars such as sucrose or fructose may be added in limited quantities.</p><p id="par0120" class="elsevierStylePara elsevierViewall">Scientific research, though still scarce in humans, shows that sweeteners are safe in the general population, including pregnant women<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">39</span></a> and children, although in these populations they must be used in moderation.<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">5,16,22</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">All the food additives approved in the European Union are considered safe in the specified doses and conditions of use. In children, however, additives of this kind should only be used as an alternative when other forms of obesity prevention are not sufficient, except for the use of sugar-free chewing gum to prevent tooth decay, or use in pharmaceutical products.<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">5</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Final comments</span><p id="par0130" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1.</span><p id="par0135" class="elsevierStylePara elsevierViewall">In general, an intake of simple CHs of less than 10% of the caloric value of the diet is appropriate in the context of a healthy lifestyle.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2.</span><p id="par0140" class="elsevierStylePara elsevierViewall">Sweeteners, especially “non-caloric” sweeteners, can help to limit the intake of refined sugars in the diet and are useful for preventing diseases such as obesity and diabetes, in association with a moderate, balanced diet.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3.</span><p id="par0145" class="elsevierStylePara elsevierViewall">In view of the recommendation not to add sweeteners to foods intended for infants and very young children, their use is not advisable in children between the ages of 1 and 3 years.</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4.</span><p id="par0150" class="elsevierStylePara elsevierViewall">It is recommended that health care professionals acquire the appropriate knowledge to advise on and/or choose a particular sweetener on the basis of its properties.</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5.</span><p id="par0155" class="elsevierStylePara elsevierViewall">There is a continuing need for specific research in order to make appropriate use of sweeteners in children.</p></li></ul></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conflicts of interest</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres585606" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec601467" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres585607" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec601468" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Sugars and sweeteners: concepts" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Consumption of sugars and sweeteners and its relationship with health" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Recommendations for consumption" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Types of sweeteners" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Safe use of sweeteners" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Final comments" ] 10 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflicts of interest" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-12-29" "fechaAceptado" => "2015-02-18" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec601467" "palabras" => array:5 [ 0 => "Sweeteners" 1 => "Children" 2 => "Sugars" 3 => "Obesity" 4 => "Tooth decay" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec601468" "palabras" => array:5 [ 0 => "Edulcorantes" 1 => "Infancia" 2 => "Azúcares" 3 => "Obesidad" 4 => "Caries" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The term “sweetener” refers to a food additive that imparts a sweet flavour and usually provides no or very low energy. It is used to sweeten foods, medicines and food supplements with no nutritional purposes. For years, no-calorie sweeteners have been used as substitutes for all or part of the sugar content in foods and beverages. In recent decades its consumption has risen to prevent tooth decay, or as an aid in weight control, obesity and diabetes and, in general, to achieve an optimal energy balance. However, consumption of sugary or sweetened food and soft drinks is high, making this situation of special interest in calorie intake and in the poor behavioural pattern of eating habits in children. In addition, questions remain among consumers about the risks to health associated with their use, whether they are artificial or natural. The “artificial sweeteners” are the group of greatest interest in research in order to demonstrate their safety and to provide firm data on their possible therapeutic effects. The aim of the present document is to increase information for paediatricians on the characteristics of different sweeteners, and to advise on the choice of sweeteners, based on their properties.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El término edulcorante hace referencia a aquel aditivo alimentario que confiere un sabor dulce y que, habitualmente, no aporta o proporciona muy poca energía. Se utiliza para endulzar alimentos, medicamentos y complementos alimenticios cuando se persiguen fines no nutritivos. Desde hace años, se han empleado edulcorantes acalóricos como sustitutos de todo o parte del contenido en azúcares en comidas y bebidas. En las últimas décadas, se ha incrementado su consumo para prevenir la caries y para el correcto cumplimiento de la dieta en casos de control del peso corporal, obesidad y diabetes y, en general, como coadyuvantes para conseguir un balance energético adecuado. No obstante, el consumo de alimentos y de bebidas azucaradas y/o edulcoradas es elevado, reflejando o un aporte calórico importante, o un patrón de hábitos alimentarios inadecuados en los niños. Por otro lado, sigue habiendo dudas entre los consumidores sobre los riesgos para la salud asociados al uso de edulcorantes, ya sean artificiales o naturales. El principal interés en investigación sobre seguridad y los posibles usos terapéuticos se centra en los «edulcorantes artificiales». El objetivo de este documento es proporcionar información a los pediatras sobre las características de los distintos edulcorantes para aconsejar en la elección de un determinado edulcorante sobre la base de sus propiedades.</p></span>" ] ] "NotaPie" => array:2 [ 0 => array:3 [ "etiqueta" => "◊" "nota" => "<p class="elsevierStyleNotepara" id="npar0020">The members of the Comité de Nutrición de la AEP are presented in <a class="elsevierStyleCrossRef" href="#sec0040">Appendix A</a>.</p>" "identificador" => "fn0005" ] 1 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Please cite this article as: Gil-Campos M, San José González MA, Díaz Martín JJ. Uso de azúcares y edulcorantes en la alimentación del niño. Recomendaciones del Comité de Nutrición de la Asociación Española de Pediatría. An Pediatr (Barc). 2015;83:353.e1–353.e7.</p>" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0165" class="elsevierStylePara elsevierViewall">José Manuel Moreno Villares (coordinator), Juan José Díaz Martín, Mercedes Gil Campos, Ana Moráis López, Víctor Manuel Navas López, Susana Redecillas Ferreiro, Miguel Sáenz de Pipaón, Miguel Ángel San José González, Félix Sánchez-Valverde Visus.</p>" "etiqueta" => "Appendix A" "titulo" => "The members of the Nutrition Committee of the Spanish Association of Paediatrics" "identificador" => "sec0040" ] ] ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "<span class="elsevierStyleItalic">Source</span>: Modified from García-Almeida et al.<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">37</span></a>" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " rowspan="3" align="left" valign="top">Natural</td><td class="td" title="table-entry " align="left" valign="top">Caloric \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Sugars \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Sucrose, glucose, galactose, fructose, lactose, maltose, trehalose \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Others \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Honey, maple syrup, palm sugar, coconut sugar \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Non-caloric \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Luo han guo, stevia, thaumatin, pentadin, monellin, brazzein \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="3" align="left" valign="top">Artificial</td><td class="td" title="table-entry " align="left" valign="top">Caloric \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Modified sugars \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">(High fructose) corn syrup, inverted sugar \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Sugar alcohols \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Sorbitol, xylitol, mannitol, lactitol \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Non-caloric \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Artificial sweeteners \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Aspartame, sucralose, saccharin, neotame, acesulfame K, cyclamic acid, alitame, advantame \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab955943.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Classification of sugars and sweeteners.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sweeteners \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Classification by caloric contribution<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Classification by sweetening power<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Polyols</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Bulk \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sorbitol E-420 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Nutritive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.5–1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mannitol E-421 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Nutritive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Isomalt E-953 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Nutritive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.45–0.65 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Maltitol E-965 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Nutritive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Lactitol E-966 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Nutritive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Xylitol E-967 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Nutritive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Erythritol E-968 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non-nutritive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="3" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Acesulfame K E-950</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non-nutritive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Intense (200) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Aspartame E-951</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Nutritive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Intense (150–200) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Cyclamic acid E-952</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non-nutritive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Intense (50–100) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Saccharin E-954</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non-nutritive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Intense (300–400) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Thaumatin E-957</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Nutritive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Intense (2500) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Neohesperidin DC E-959</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Nutritive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Intense (250–2000) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Neotame E-961</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non-nutritive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Intense (7000–13,000) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Sucralose E-955</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non-nutritive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Intense (600) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Steviol glycoside E-960</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Non-nutritive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Intense (350–400) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab955942.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">In intense sweeteners the energy contribution to the diet is insignificant, because the amount of product consumed is very small.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">In parentheses, sweetening power value relative to sucrose (value 1).</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Classification of sweeteners according to the US Food and Drug Administration (FDA) and the European Union, and the sweetening power (SP) of each substance relative to sucrose (table sugar): degree of sweetness comparable with sugar (bulk sweetener) or much higher (intense sweetener).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:39 [ 0 => array:3 [ "identificador" => "bib0200" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Carbohydrates in human nutrition. (FAO Food and Nutrition Paper-66)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "FAO/WHO (Food and Agriculture Organization/World Health Organization)" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "1998" "editorial" => "FAO" "editorialLocalizacion" => "Rome" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0205" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Scientific opinion on dietary reference values for carbohydrates and dietary fibre" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "EFSA Panel on Dietetic Products, Nutrition, and Allergies (NDA)" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "EFSA J" "fecha" => "2010" "volumen" => "8" "paginaInicial" => "1462" "paginaFinal" => "1477" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0210" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (2002/2005). A report of the Panel on Macronutrients, Subcommittees on Upper Reference Levels of Nutrients and Interpretation and Uses of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Food National Board" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2005" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0215" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of added sugars in pediatric obesity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.A. Welsh" 1 => "S.A. Cunningham" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Pediatr Clin N Am" "fecha" => "2011" "volumen" => "58" "paginaInicial" => "1455" "paginaFinal" => "1466" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0220" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chinchón declaration; decalogue on low- and no-calorie sweeteners (LNCS)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Serra-Majem" 1 => "P. Riobó" 2 => "S. Belmonte" 3 => "A. Anadón" 4 => "J. Aranceta" 5 => "E. Franco" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3305/nh.2014.29.4.7393" "Revista" => array:6 [ "tituloSerie" => "Nutr Hosp" "fecha" => "2014" "volumen" => "29" "paginaInicial" => "719" "paginaFinal" => "734" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24679013" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0225" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Una visión global, actualizada y crítica del papel del azúcar en nuestra alimentación" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C. Gómez Candela" 1 => "S. Palma Milla" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3305/nh.2013.28.sup6.7159" "Revista" => array:7 [ "tituloSerie" => "Nutr Hosp" "fecha" => "2013" "volumen" => "28" "numero" => "Suppl. 4" "paginaInicial" => "1" "paginaFinal" => "4" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24266807" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0230" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Supplement: low-calorie sweeteners and weight control – what the science tells us" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.D. Fernstrom" 1 => "J.L. Navia" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3945/jn.111.149823" "Revista" => array:6 [ "tituloSerie" => "J Nutr" "fecha" => "2012" "volumen" => "142" "paginaInicial" => "1170S" "paginaFinal" => "1172S" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22573782" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0235" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The use of low-calorie sweeteners by children: implications for weight management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Foreyt" 1 => "R. Kleinman" 2 => "R.J. Brown" 3 => "R. Lindstrom" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Nutr" "fecha" => "2012" "volumen" => "142" "paginaInicial" => "1156S" "paginaFinal" => "1162S" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0240" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P.E. Miller" 1 => "V. Perez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3945/ajcn.113.082826" "Revista" => array:6 [ "tituloSerie" => "Am J Clin Nutr" "fecha" => "2014" "volumen" => "100" "paginaInicial" => "765" "paginaFinal" => "777" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24944060" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0245" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Beverage consumption among European adolescents in the HELENA Study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K.J. Duffey" 1 => "I. Huybrecht" 2 => "T. Mouratidou" 3 => "L. Libuda" 4 => "M. Kersting" 5 => "T. DeVriendt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/ejcn.2011.166" "Revista" => array:6 [ "tituloSerie" => "Eur J Clin Nutr" "fecha" => "2012" "volumen" => "66" "paginaInicial" => "244" "paginaFinal" => "252" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21952695" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0250" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomized controlled trial of changes in dietary carbohydrate/fat ratio and simple vs. complex carbohydrates on body weight and blood lipids: the CARMEN study. The carbohydrate ratio management in European national diets" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W.H. Saris" 1 => "A. Astrup" 2 => "A.M. Prentice" 3 => "H.J. Zunft" 4 => "X. Formiguera" 5 => "W.P. Verboeket-van de Venne" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Obes Relat Metab Disord" "fecha" => "2000" "volumen" => "24" "paginaInicial" => "1308" "paginaFinal" => "1310" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0255" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Australian paradox: a substantial decline in sugars intake over the same timeframe that overweight and obesity have increased" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.W. Barclay" 1 => "J. Brand-Miller" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3390/nu3040491" "Revista" => array:6 [ "tituloSerie" => "Nutrients" "fecha" => "2011" "volumen" => "3" "paginaInicial" => "491" "paginaFinal" => "504" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22254107" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0260" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gain weight by going diet? Artificial sweeteners and the neurobiology of sugar cravings: Neuroscience 2010" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Q. Yang" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Yale J Biol Med" "fecha" => "2010" "volumen" => "83" "paginaInicial" => "101" "paginaFinal" => "108" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20589192" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0265" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A systematic review on the effect of sweeteners on glycemic response and clinically relevant outcomes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N. Wiebe" 1 => "R. Padwal" 2 => "C. Field" 3 => "S. Marks" 4 => "R. Jacobs" 5 => "M. Tonelli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1741-7015-9-123" "Revista" => array:5 [ "tituloSerie" => "BMC Med" "fecha" => "2011" "volumen" => "9" "paginaInicial" => "123" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22093544" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0270" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sweetness and food preference" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A1 Drewnowski" 1 => "J.A. Mennella" 2 => "S.L. Johnson" 3 => "F. Bellisle" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3945/jn.111.149575" "Revista" => array:6 [ "tituloSerie" => "J Nutr" "fecha" => "2012" "volumen" => "142" "paginaInicial" => "1142S" "paginaFinal" => "1148S" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22573785" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0275" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Artificial sweeteners: a systematic review of metabolic effects in youth" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.J. Brown" 1 => "M.A. de Banate" 2 => "K.I. Rother" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3109/17477160903497027" "Revista" => array:6 [ "tituloSerie" => "Int J Pediatr Obes" "fecha" => "2010" "volumen" => "5" "paginaInicial" => "305" "paginaFinal" => "312" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20078374" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0280" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Artificial sweeteners induce glucose intolerance by altering the gut microbiota" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Suez" 1 => "T. Korem" 2 => "D. Zeevi" 3 => "G. Zilberman-Schapira" 4 => "C.A. Thaiss" 5 => "O. Maza" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/nature13793" "Revista" => array:6 [ "tituloSerie" => "Nature" "fecha" => "2014" "volumen" => "514" "paginaInicial" => "181" "paginaFinal" => "186" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25231862" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0285" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Calorie Control Council: Comments on artificial sweeteners induce glucose intolerance by altering the gut microbiota" ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/nature13793" "Revista" => array:6 [ "tituloSerie" => "Nature" "fecha" => "2014" "volumen" => "514" "paginaInicial" => "181" "paginaFinal" => "186" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25231862" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0290" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Scientific Opinion on the substantiation of health claims related to intense sweeteners and contribution to the maintenance or achievement of a normal body weight (ID 1136, 1444, 4299), reduction of post-prandial glycaemic responses (ID 4298), maintenance of normal blood glucose concentrations (ID 1221, 4298), and maintenance of tooth mineralisation by decreasing tooth demineralisation (ID 1134, 1167, 1283) pursuant to Article 3(1) of Regulation (EC) No 1924/2006" ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "EFSA J" "fecha" => "2011" "volumen" => "9" "paginaInicial" => "2226" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0295" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Artificial sweeteners: a place in the field of functional foods? Focus on obesity and related metabolic disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Raben" 1 => "B. Richelsen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MCO.0b013e328359678a" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Clin Nutr Metab Care" "fecha" => "2012" "volumen" => "15" "paginaInicial" => "597" "paginaFinal" => "604" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23037901" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0300" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sucrose and dental caries: a review of the evidence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.A. Anderson" 1 => "M.E. Curzon" 2 => "C. van Loveren" 3 => "C. Tatsi" 4 => "M.S. Duggal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1467-789X.2008.00564.x" "Revista" => array:7 [ "tituloSerie" => "Obes Rev" "fecha" => "2009" "volumen" => "10" "numero" => "Suppl. 1" "paginaInicial" => "41" "paginaFinal" => "54" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19207535" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0305" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Position of the Academy of Nutrition and Dietetics: use of nutritive and nonnutritive sweeteners" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Fitch" 1 => "K.S. Keim" 2 => "Academy of Nutrition and Dietetics" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jand.2012.03.009" "Revista" => array:6 [ "tituloSerie" => "J Acad Nutr Diet" "fecha" => "2012" "volumen" => "112" "paginaInicial" => "739" "paginaFinal" => "758" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22709780" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0310" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dieta, nutrición y prevención de enfermedades crónicas de 2003" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "OMS/FAO" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2003" "editorial" => "Informe Técnico. OMS" "editorialLocalizacion" => "Ginebra" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0315" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hojas de balance alimentario" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Organización de las Naciones Unidas para la Alimentación y la Agricultura (FAO)" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2009" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0320" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Objetivos poblacionales para la población española. Consenso de la Sociedad Española de Nutrición Comunitaria, 2011" ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Esp Nutr Comun" "fecha" => "2011" "volumen" => "17" "paginaInicial" => "178" "paginaFinal" => "199" ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0325" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bellagio report on healthy agriculture, healthy nutrition, healthy people" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.P. Simopoulos" 1 => "P.G. Bourne" 2 => "O. Faergeman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3390/nu5020411" "Revista" => array:6 [ "tituloSerie" => "Nutrients" "fecha" => "2013" "volumen" => "5" "paginaInicial" => "411" "paginaFinal" => "423" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23385371" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0330" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Reglamento (CE) 1924/2006, de 20 de diciembre, relativo a las declaraciones nutricionales y de propiedades saludables en los alimentos. DOCE de 30/12/2006." ] ] ] 27 => array:3 [ "identificador" => "bib0335" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.K. Johnson" 1 => "L.J. Appel" 2 => "M. Brands" 3 => "B.V. Howard" 4 => "M. Lefevre" 5 => "R.H. Lustig" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.109.192627" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2009" "volumen" => "120" "paginaInicial" => "1011" "paginaFinal" => "1020" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19704096" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0340" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "El azúcar en los distintos ciclos de la vida: desde la infancia hasta la vejez" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T. Partearroyo" 1 => "E. Sánchez Campayo" 2 => "G. Varela Moreiras" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3305/nh.2013.28.sup4.6795" "Revista" => array:7 [ "tituloSerie" => "Nutr Hosp" "fecha" => "2013" "volumen" => "28" "numero" => "Suppl. 4" "paginaInicial" => "40" "paginaFinal" => "47" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23834091" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0345" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Guidance for submission for food additive evaluations" ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "EFSA J" "fecha" => "2012" "volumen" => "10" "paginaInicial" => "2760" ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0350" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Artificial sweetener use among children: epidemiology, recommendations, metabolic outcomes, and future directions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Sylvetsky" 1 => "K.I. Rother" 2 => "R. Brown" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Pediatr Clin N Am" "fecha" => "2011" "volumen" => "58" "paginaInicial" => "1467" "paginaFinal" => "1480" ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0355" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Glucose facilitation of cognitive performance in healthy young adults: examination of the influence of fast-duration, time of day and preconsumption plasma glucose levels" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.I. Sünram-Lea" 1 => "J.K. Foster" 2 => "P. Durlach" 3 => "C. Pérez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Psychopharmacology (Berl)" "fecha" => "2001" "volumen" => "157" "paginaInicial" => "46" "paginaFinal" => "54" ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0360" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Associations between dietary added sugar intake and micronutrient intake: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K.L. Rennie" 1 => "M.B. Livingstone" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1017/S0007114507617206" "Revista" => array:6 [ "tituloSerie" => "Br J Nutr" "fecha" => "2007" "volumen" => "97" "paginaInicial" => "832" "paginaFinal" => "841" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17408523" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0365" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:1 [ "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:2 [ "titulo" => "Handbook of food and addiction" "serieFecha" => "2012" ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0370" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:1 [ "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jada.2003.12.001" "Revista" => array:7 [ "titulo" => "Position of American Dietetic Association: use of nutritive and nonnutritive sweeteners" "tituloSerie" => "J Am Diet Assoc" "fecha" => "2004" "volumen" => "104" "paginaInicial" => "255" "paginaFinal" => "275" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14760578" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0375" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "International tables of glycemic index and glycemic load values: 2008" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F.S. Atkinson" 1 => "K. Foster-Powell" 2 => "J.C. Brand-Miller" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2337/dc08-1239" "Revista" => array:6 [ "tituloSerie" => "Diabetes Care" "fecha" => "2008" "volumen" => "31" "paginaInicial" => "2281" "paginaFinal" => "2283" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18835944" "web" => "Medline" ] ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0380" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Una visión global y actual de los edulcorantes. Aspectos de regulación" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.M. García-Almeida" 1 => "G.M. Casado Fdez" 2 => "J. García Alemán" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3305/nh.2013.28.sup4.6793" "Revista" => array:7 [ "tituloSerie" => "Nutr Hosp" "fecha" => "2013" "volumen" => "28" "numero" => "Suppl. 4" "paginaInicial" => "17" "paginaFinal" => "31" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23834089" "web" => "Medline" ] ] ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib0385" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Directiva 94/35/CE del Parlamento Europeo y del Consejo, de 30 de junio de 1994. Diario Oficial de las Comunidades Europeas. Available from: <a href="http://europa.eu/legislation_summaries/other/l21069_es.htm">http://europa.eu/legislation_summaries/other/l21069_es.htm</a> [accessed 03.11.14]." ] ] ] 38 => array:3 [ "identificador" => "bib0390" "etiqueta" => "39" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aspartame, low-calorie sweeteners and disease: regulatory safety and epidemiological issues" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Marinovich" 1 => "C.L. Galli" 2 => "C. Bosetti" 3 => "S. Gallus" 4 => "C. La Vecchia" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.fct.2013.07.040" "Revista" => array:6 [ "tituloSerie" => "Food Chem Toxicol" "fecha" => "2013" "volumen" => "60" "paginaInicial" => "109" "paginaFinal" => "115" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23891579" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000008300000005/v1_201512040119/S234128791500201X/v1_201512040119/en/main.assets" "Apartado" => array:4 [ "identificador" => "33443" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Spanish Association of Paediatrics" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000008300000005/v1_201512040119/S234128791500201X/v1_201512040119/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234128791500201X?idApp=UINPBA00005H" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 20 | 10 | 30 |
| 2024 October | 218 | 71 | 289 |
| 2024 September | 241 | 55 | 296 |
| 2024 August | 186 | 80 | 266 |
| 2024 July | 167 | 56 | 223 |
| 2024 June | 200 | 51 | 251 |
| 2024 May | 166 | 61 | 227 |
| 2024 April | 176 | 56 | 232 |
| 2024 March | 361 | 82 | 443 |
| 2024 February | 131 | 47 | 178 |
| 2024 January | 179 | 36 | 215 |
| 2023 December | 138 | 21 | 159 |
| 2023 November | 194 | 50 | 244 |
| 2023 October | 167 | 41 | 208 |
| 2023 September | 120 | 44 | 164 |
| 2023 August | 143 | 24 | 167 |
| 2023 July | 167 | 33 | 200 |
| 2023 June | 151 | 36 | 187 |
| 2023 May | 153 | 37 | 190 |
| 2023 April | 113 | 26 | 139 |
| 2023 March | 180 | 30 | 210 |
| 2023 February | 187 | 29 | 216 |
| 2023 January | 115 | 30 | 145 |
| 2022 December | 138 | 39 | 177 |
| 2022 November | 174 | 51 | 225 |
| 2022 October | 152 | 52 | 204 |
| 2022 September | 99 | 45 | 144 |
| 2022 August | 142 | 59 | 201 |
| 2022 July | 134 | 52 | 186 |
| 2022 June | 138 | 42 | 180 |
| 2022 May | 132 | 50 | 182 |
| 2022 April | 120 | 47 | 167 |
| 2022 March | 116 | 67 | 183 |
| 2022 February | 102 | 40 | 142 |
| 2022 January | 143 | 54 | 197 |
| 2021 December | 121 | 80 | 201 |
| 2021 November | 194 | 68 | 262 |
| 2021 October | 278 | 68 | 346 |
| 2021 September | 128 | 55 | 183 |
| 2021 August | 115 | 54 | 169 |
| 2021 July | 197 | 63 | 260 |
| 2021 June | 133 | 52 | 185 |
| 2021 May | 142 | 86 | 228 |
| 2021 April | 339 | 103 | 442 |
| 2021 March | 268 | 54 | 322 |
| 2021 February | 170 | 38 | 208 |
| 2021 January | 179 | 32 | 211 |
| 2020 December | 144 | 35 | 179 |
| 2020 November | 139 | 37 | 176 |
| 2020 October | 154 | 30 | 184 |
| 2020 September | 127 | 36 | 163 |
| 2020 August | 129 | 17 | 146 |
| 2020 July | 127 | 39 | 166 |
| 2020 June | 125 | 18 | 143 |
| 2020 May | 142 | 25 | 167 |
| 2020 April | 157 | 19 | 176 |
| 2020 March | 379 | 20 | 399 |
| 2020 February | 119 | 15 | 134 |
| 2020 January | 84 | 17 | 101 |
| 2019 December | 166 | 29 | 195 |
| 2019 November | 123 | 14 | 137 |
| 2019 October | 259 | 28 | 287 |
| 2019 September | 301 | 31 | 332 |
| 2019 August | 326 | 30 | 356 |
| 2019 July | 269 | 33 | 302 |
| 2019 June | 279 | 44 | 323 |
| 2019 May | 257 | 45 | 302 |
| 2019 April | 228 | 44 | 272 |
| 2019 March | 140 | 29 | 169 |
| 2019 February | 111 | 26 | 137 |
| 2019 January | 116 | 29 | 145 |
| 2018 December | 105 | 36 | 141 |
| 2018 November | 309 | 40 | 349 |
| 2018 October | 405 | 27 | 432 |
| 2018 September | 160 | 29 | 189 |
| 2018 August | 6 | 0 | 6 |
| 2018 July | 5 | 0 | 5 |
| 2018 June | 2 | 0 | 2 |
| 2018 May | 6 | 0 | 6 |
| 2018 April | 21 | 0 | 21 |
| 2018 March | 42 | 0 | 42 |
| 2018 February | 19 | 0 | 19 |
| 2018 January | 26 | 0 | 26 |
| 2017 December | 28 | 0 | 28 |
| 2017 November | 33 | 0 | 33 |
| 2017 October | 43 | 0 | 43 |
| 2017 September | 32 | 0 | 32 |
| 2017 August | 15 | 0 | 15 |
| 2017 July | 42 | 0 | 42 |
| 2017 June | 34 | 8 | 42 |
| 2017 May | 39 | 14 | 53 |
| 2017 April | 32 | 13 | 45 |
| 2017 March | 27 | 7 | 34 |
| 2017 February | 3 | 7 | 10 |
| 2017 January | 12 | 12 | 24 |
| 2016 December | 16 | 15 | 31 |
| 2016 November | 34 | 13 | 47 |
| 2016 October | 27 | 14 | 41 |
| 2016 September | 36 | 7 | 43 |
| 2016 August | 42 | 8 | 50 |
| 2016 July | 18 | 3 | 21 |
Show all
