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World Health Organization says non-sugar sweeteners don't work for long-term weight control

The guidelines, which don't apply to diabetics, say non-sugar sweeteners don't help with weight control in the long run.  (ABC News: Dannielle Maguire)

Swapping the sugar in your tea with an artificial sweetener to keep trim, taut and terrific?

The World Health Organization (WHO) says there's no point. 

It has released new conditional guidelines advising against non-sugar sweeteners — which includes both artificial sweeteners and natural alternatives like stevia — for weight control or reducing the risk of chronic diseases. 

The global health body reviewed 283 unique studies that assessed the health effects of non-sugar sweeteners in adults, children and pregnant women. 

It found swapping out sugar for non-sugar sweeteners didn't help with weigh control long-term. 

And the WHO says there "may be potential undesirable effects from long-term use of non-sugar sweeteners" including an increased risk of type 2 diabetes, cardiovascular diseases and mortality in adults.

The exception to this recommendation is people with pre-existing diabetes.

But it applies to everyone else. 

We spoke to accredited practising dieticians Leanne Elliston and Natalie Stapleton from Dietitians Australia to unpack a bit more about what this means. 

Does this mean sugar is healthier than non-sugar sweeteners? 

"Natural sugars in their natural form eaten the way nature intended is healthy," Ms Elliston says.

"That's like, a piece of fruit fresh that hasn't been squished and turned into juice.

"As soon as the natural source of the sugar has been compromised, it becomes a free sugar."

And free sugars, which is just sugar on its own, are "not at all" healthy, she says. 

"There's no other nutritional value associated with free sugars."

Think of free sugars as sugars that are added to foods, but the definition also covers the sugars found in fruit juice and fruit juice concentrates.

And, yes, unfortunately for those of us who use it to sweeten their tea, honey is also considered a free sugar. 

"Don't be fooled by honey or coconut sugar or agave – they're still free sugars."

What's a non-sugar sweetener?

For the purpose of the WHO guidelines, the term "non-sugar sweetener" applies to all synthetic and naturally occurring or modified non-nutritive sweeteners that are not classified as sugars.

Here's a few of the more common examples:

  • acesulfame K
  • aspartame
  • advantame
  • cyclamates
  • neotame
  • saccharin
  • sucralose
  • stevia
  • stevia derivatives

"Because low-calorie sugars and sugar alcohols (polyols) are sugars or sugar derivatives containing calories, they are not considered non-sugar sweeteners, and therefore the recommendation does not apply to these sweeteners," the guidelines say. 

Why do we think they're 'healthy'?

Non-sugar sweeteners are often marketed as a low kilojoule or natural alternative to sugar.

And they are often paired with terms like "diet" or "sugar-free".

Ms Ellison says this makes us think they're healthy, but it's all marketing. 

"If it's sweet, there's something in it — probably a chemical of sorts."

Honey, agave and coconut sugar all count as free sugars — which means you should be limiting your intake.  (ABC News: Dannielle Maguire)

What's wrong with non-sugar sweeteners?

The WHO's report says there was evidence that higher consumption of non-sugar sweeteners led to a lower body weight and body mass index (BMI) in short-term randomised controlled trials. 

But "was associated with increased BMI and risk of incident obesity in long term prospective observational studies".

However, the International Sweeteners Association (ISA) says low or no-calorie sweeteners are "the most thoroughly researched ingredients in the world" and argues they are a tool to help manage obesity, diabetes and dental diseases.

"They offer consumers an alternative to reduce sugar and calorie intake with the sweet taste they know and expect," an ISA spokesperson said. 

Ms Stapleton says foods and drinks with added or non-sugar sweeteners are usually very highly processed.

"Generally, these foods are higher in energy and nutrient poor," she says. 

And Ms Elliston points they still make people crave sweet things. 

"It's like a drug, really," she says. 

"People with a lot of sweet stuff in their diets are kind of hooked."

How much sugar can you have per day?

Currently, the Australian dietary guidelines don't dictate a specific amount, they just say to cut back on sugary foods:

"Limit intake of foods and drinks containing added sugars such as confectionary, sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, energy and sports drinks.

That's probably because dietary needs are specific to people, so it's difficult to give a single limit to a broad and varied population. 

"The challenge with diet is that we know everyone's different," Ms Stapleton says. 

"There isn't really a one size fits all."

The WHO's guidelines say adults and children keep their daily intake of free sugars to less than 10 per cent of their total energy intake.

And the total energy intake of, say, a 32-year-old prop on an elite footy team will be different to a kindergartener — so take the following amounts with a (proverbial) grain of salt. 

In general, the 10 per cent energy intake works out to be no more than 50 grams of free sugar — or 12 teaspoons. 

But the WHO recommends cutting that even further to just 5 per cent of energy intake from free sugars for "additional health benefits". 

That's roughly 25 grams or six teaspoons. 

It's best to reduce your intake of sugar.  (ABC News: Dannielle Maguire)

But Ms Stapleton says the best, most-tailored advice will come from an accredited practising dietitian. 

"Everyone is different, with unique requirements, circumstances and preferences," she says. 

Ms Elliston says manufacturers should be required to state the amount of free sugars in food products. 

How do you cut back on sugar?

Bit by bit, Ms Ellistone says. 

She used to have two spoons of sugar in her coffee and, rather than cutting it out completely, she slow reduced the amount she added to her mug over time. 

"You just going cold turkey off sugar is actually really hard – good on you if you can do it but it’s challenging," she says.

"Gradually wean yourself off it.

"Allow your tastebuds to get used to that change."

She says non-sugar sweeteners can be used a "stepping stone" to gradually wean themselves off sugar, but says it's not a permanent solution. 

Keep an eye out for hidden added sugars in things you wouldn't necessarily consider to be sugary — like simmer sauces.

But go easy on yourself. 

Ms Elliston says sweet foods should be respected and enjoyed as part of a healthy diet, but moderation and balance is key. 

So when you do treat yourself, eat mindfully — focus on the tastes and the textures, avoiding distractions like TV or social media. 

"We don't want food to be the enemy," Ms Elliston says.

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