Artificial sweeteners not recommended for weight loss, WHO says

People should not use artificial sweeteners for weight loss and should look for other ways to cut their sugar intake, according to the World Health Organization (WHO).

Food and beverages containing non-sugar sweeteners should not be consumed to control body weight or to reduce the risk of noncommunicable diseases, new WHO guidelines released Monday said.

The guidance is based on a systematic review of evidence that suggests sugar-free or no-calorie sweeteners — such as sucralose, stevia, stevia derivatives, acesulfame K, aspartame, advantame, cyclamates, neotame, and saccharin — don’t have any long-term benefit in reducing body fat.

In fact, prolonged use of non-sugar sweeteners could even increase the risk of type 2 diabetes, cardiovascular diseases and mortality in adults, WHO said.

“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,” Francesco Branca, WHO Director for Nutrition and Food Safety, said in a statement.

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Free sugars are defined by the WHO as any added sugar to food and drinks as well as naturally occurring sugar in honey, syrups, fruit juices and fruit juice concentrates.

The WHO recommendation is for everyone — kids and adults of all ages — except for diabetes patients.

It should be considered in parallel with other guidance on limiting free sugars — recommended at less than 10 per cent of total energy intake — and promoting a healthy diet, the WHO said.

“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,” said Branca.

Compared with sugar, artificial sweeteners have very few calories, which is why people on diets tend to use them. But over the years, research has suggested there is a sour side to the sugar alternatives.

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Several studies have shown that sugar substitutes, such as aspartame, sucralose and stevia, may be tied to long-term weight gain, obesity, diabetes, high blood pressure and heart disease.

Artificial sweeteners, especially aspartame and acesulfame K, have also been associated with increased cancer risk, according to a large study published in the PLOS Medicine journal last year.

The WHO guidance does not apply to sugar alcohols and low-calorie sugars as they are not considered to be NSS.

The recommendation also doesn’t cover personal care and hygiene products, such as toothpaste, skin cream and medications that contain sugar substitutes.

Calorie Control Council, an international association representing the low-calorie food and beverage industry, cast doubt on WHO’s recommendation, calling it “misguided”.

“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,” Dr. Keith Ayoob, a scientific advisor for Calorie Control Council, said in a statement Monday. 

Assessing the health impact of NSS on people with pre-existing diabetes and helping to manage the disease was beyond the scope of the guideline, according to WHO.

CCC President Robert Rankin said along with exercise and a healthy diet, low- and no-calorie sweeteners are a “critical tool” to help people manage body weight and reduce the risk of noncommunicable diseases.