New WHO guideline advises not to use non-sugar sweeteners for weight control
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).
The purpose of this guideline is to inform a wide audience involved in the development, design and implementation of health and nutrition policies.
According to a news article released by WHO on 15 May 2023, the recommendation is based on the findings of a systematic review of the available evidence which suggests that use of NSS does not confer any long-term benefit in reducing body fat in adults or children. and also suggests that there may be potential undesirable effects from long-term use of NSS.
"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,” says 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 all people except individuals 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.
Our President Elect, Dr Simón Barquera, provides brief comment:
"This is a very important report for decision-makers around the world, since there is an urgent need to identify opportunities for obesity prevention and control. A WHO expert committee conducted systematic reviews and analysis. Among the most important findings are:
- NSS was associated with increased BMI and risk of incident obesity in long-term observational studies as well as in prospective cohort studies (associated to Type 2 Diabetes, CVD, bladder cancer and mortality), with no effects in short-term studies (in studies shorter than 3 months some weight loss was achieved but not sustained).
- evidence in children and pregnant women was limited.
- There was no evidence of NSS having long-term benefits on weight loss
Conclusions and recommendations from the report:
- There is no evidence suggesting NSS have benefits for weight loss, and the long-term risks outweigh any possible short-term benefit.
- NSS do not contribute to a healthy diet. The committee recommends replacing diets with natural sources such as fruits and minimally processed foods.
During the last decade, several industry-funded reports such as the Mexican, Latin American and Hispanic American consensus recommended NSS for adults, children, and pregnant women.
Recently a number of Latin American countries have implemented warning labels on packaged foods that include a precautionary label stating that products with NSS are not appropriate for children (Mexico, Argentina, Colombia).
The current WHO report is consistent with this recommendation. In addition to the association of NSS consumption to diverse diseases, there is a concern that these hyperpalatable components alter the taste and make consumers less likely to accept natural flavours."