The World Health Organization (WHO) has released a new guideline on non-sugar sweeteners (NSS), which recommends against the use of NSS to control body weight or reduce the risk of noncommunicable diseases (NCDs). NSS include artificial sweeteners such as those found in soft drinks and those you add to tea or coffee.
The recommendation is based on the findings of a review which suggests that use of NSS has no any long-term benefit in reducing body fat in adults or children. Results of the review also suggest that there may be potential undesirable effects from long-term use of NSS, such as an increased risk of type 2 diabetes, cardiovascular diseases, and mortality in adults.
"Replacing free sugars with NSS does not help with weight control in the long term. People need to consider other ways to reduce free sugars intake, such as consuming food with naturally occurring sugars, like fruit, or unsweetened food and beverages,” said Francesco Branca, WHO Director for Nutrition and Food Safety. "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."
The recommendation applies to everyone except people with pre-existing diabetes and includes all synthetic and naturally occurring or modified non-nutritive sweeteners that are not classified as sugars found in manufactured foods and beverages, or sold on their own to be added to foods and beverages by consumers. Common NSS include acesulfame K, aspartame, advantame, cyclamates, neotame, saccharin, sucralose, stevia and stevia derivatives.
The recommendation does not apply to personal care and hygiene products containing NSS, such as toothpaste, skin cream, and medications, or to low-calorie sugars and sugar alcohols (polyols), which are sugars or sugar derivatives containing calories and are therefore not considered NSS.
A spokesman for the ISA (International Sweeteners Association) said: “The ISA believes these guidelines should have been based on the comprehensive set of available evidence and interpreted considering the hierarchy and weight of scientific evidence.
"The WHO could only conclude a conditional recommendation, which is not scientifically rigorous, nor based on a robust evidence base or supported by the evidence presented in the WHO-commissioned systematic review itself.
"The ISA joins others, including relevant government agencies around the globe, who have responded to the public consultation on the draft guideline expressing their concerns about the conclusions and rationale used by WHO.
"ISA agrees with the UK’s Office for Health Improvement and Disparities that commented “the guideline may go too far” and with the Australian government’s Department of Health and Aged Care who wrote that “the recommendation may result in undesirable health outcomes for some individuals.”
"“Food and beverage companies have reformulated products as part of a comprehensive, global effort to meet public health recommendations (including from the WHO) for sugar reduction” said ISA Chairman Bob Peterson. “Low/no calorie sweeteners have enabled this innovation and ultimately contribute to the creation of healthier food environments by allowing people to enjoy food and drinks with less sugar and fewer calories, while still meeting their taste preferences.”
"ISA also expresses concern over the lack of recognition for the well-established benefits of low/no calorie sweeteners in sugar and calorie reduction. Global efforts to address complex challenges of NCDs reduction requires coherent policies based on rigorous scientific evaluation and higher quality research. While this guideline does not apply to people living with diabetes, it could mislead those who need to manage their carbohydrate and sugar intake."
