Postmarket surveillance to determine nutritional impact of macronutrient substitutes

The nutritional impact of a macronutrient substitute can only be determined after the substitute has been approved for use in foods and there is widespread use by the population over time. Modeling and experimental studies have predictive value, but they cannot replace real life in which the choice of foods in influenced by labeling and advertising aimed at promoting consumption of the basis of reduced sugar, fat, and/or energy. Impacts could include alterations in the energy distribution of the diet and changes in the intakes of essential nutrients. For this reason, postmarket surveillance (PMS) of consumption patterns of macronutrient substitutes has been proposed as a condition of approval of macronutrient substitutes and/or extending permitted uses. PMS should be conducted on a representative sample of the population, should allow comparisons over time, and should collect data on food consumption patterns, nutrient intakes, and frequency of consumption of macronutrient substitutes. This is a more detailed and costly form of PMS than measuring actual product consumption.