WHO Warns Against Using Non-Sugar Sweeteners

The World Health Organization issued a new guideline on May 15, 2023, that advises against using non-sugar sweeteners to regulate body weight or minimize the risk of non-communicable diseases (NCD). The Geneva-based WHO made the advice based on a systematic analysis of available information, which indicates that using non-sugar sweeteners has no long-term effect in terms of lowering body fat in adults or children. Long-term use of non-sugar sweeteners, according to the review, may have negative consequences such as an increased risk of type 2 diabetes, cardiovascular disease, and mortality in adults.

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Exploring Alternative Sweeteners for a Healthier Diet

The suggestion applies to all synthetic and naturally occurring or modified non-nutritive sweeteners that are not categorized as sugars and are found in produced foods and drinks or sold separately for consumers to add to foods and beverages. Acesulfame potassium (Ace-K), aspartame, advantame, cyclamates, neotame, saccharin, sucralose, stevia and stevia derivatives are examples of common non-sugar sweeteners. The guideline does not apply to low-calorie sugars and polyols (sugar alcohols), which are calorie-containing sugars or sugar derivatives and thus not considered non-sugar sweeteners.

“Replacing free sugars with NSS (non-sugar sweeteners) does not help with weight control in the long term,” said Francesco Branco, director for nutrition and food safety at the WHO. “People need to consider other ways to reduce free sugars intakes, such as consuming food with naturally occurring sugars, like fruit, or unsweetened food and beverages. NSS are not essential dietary factors and have no nutritional value. People should reduce the sweetness of the diet altogether, starting early in life, to improve their health.”

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Role of Low-Calorie Sweeteners in Sugar Reduction and Weight Management

The Calorie Control Council, a global trade organization representing the low-calorie and reduced-calorie food and beverage industries, disagrees with the recommendation.

“A substantial body of evidence shows that low- and no-calorie sweeteners provide effective and safe options to reduce sugar and calorie consumption,” said Robert Rankin, president of the Calorie Control Council. “This is supported by an abundance of scientific evidence, backed by the world’s most highly regarded health and regulatory agencies, which validate the role of these ingredients. Along with exercise and a healthy diet, low- and no-calorie sweeteners are a critical tool that can help consumers manage body weight and reduce the risk of non-communicable diseases.”

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Role of Non-Sugar Sweeteners: Debating the Impact on Diabetes and Weight Management

Except for people who already have diabetes, the WHO advice applies to everyone. research involving only people with pre-existing diabetes was barred, as was research using mixed groups.

“It is mind-boggling that persons living with diabetes, for whom non-sugar sweeteners can have an especially meaningful ‎role in their compliance with necessary dietary requirements, were conveniently not considered ‎when creating these guidelines,” said Keith Ayoob, EdD, scientific adviser for the Calorie Control Council. “The WHO’s insistence on focusing only on prevention of unhealthy ‎weight gain and non-communicable diseases is at the very least, misguided. The WHO’s decision not to focus on the value of non-sugar sweeteners for persons with diabetes borders on ‎unconscionable. Their doing so dismisses the value and usefulness of NSS for persons living with ‎diabetes and pre-diabetes, which accounts for far more than 10% of the global population.”

Non-Sugar Sweeteners and their Associations with Weight, Diabetes, and Cardiovascular Health

About 40% of the global adult population is overweight or obese, as are millions of youngsters. According to the WHO study non-sugar sweeteners in any form resulted in decreased sugar and energy intake, lower body weight, and lower body mass index (BMI) in short-term randomized controlled studies, the majority of which lasted three months or less. Evidence from a small number of longer trials lasting 6 to 18 months did not reveal an effect on body weight, but it was difficult to interpret due to numerous discrepancies in how the trials were done and how the results were reported.

According to the WHO, the majority of the trials included foods and beverages containing non-sugar sweeteners or free sugars in addition to existing diets. As a result, the trials did not explicitly assess the effects of replacing free sugars with non-sugar sweeteners. There were no differences in body weight or BMI when non-sugar sweeteners were compared to nothing/placebo or water.

In long-term prospective observational studies with an average follow-up of 13 years (very low to low certainty evidence), higher intakes of non-sugar sweeteners were associated with an increased risk of type 2 diabetes, cardiovascular disease and cardiovascular disease mortality, and all-cause mortality (very low to low certainty evidence).

Source-Medindia