Non-nutritive sweeteners should ‘not be used as a means of weight control or reducing the risk of non-communicable diseases’
WHO advises consumers to limit consumption of added sugarless than 10% of energy intake (50g/day), and ideally less than 5% (25g/day).
However, he does not believe that we should try to have our cake and eat it using non-nutritive (zero or very low calorie) sweeteners such as aspartame, stevia or monk fruit as a means of reducing our consumption of added sugar, according to a draft directivepublished on friday”suggesting sugar-free sweeteners not be used as a means of weight control or reducing the risk of non-communicable diseases”.
Sugar-free sweeteners are defined as “all synthetic and natural or modified non-nutritive sweeteners that are not classified as sugars. »
The WHO does not provide a definitive list of sugar-free sweeteners, although it cites non-caloric sweeteners such as monk fruit, stevia, sucralose, aspartame, ace-K, saccharin, neotame and advantame as examples. A systematic review and meta-analysisThe study of the health effects of sugar-free sweeteners published by the WHO in April also included studies of very low-calorie sweeteners like allulose (which contains 0.4 calories per gram).
“Sugar alcohols and low calorie sugars are not taken into account”, added the WHO, which said its new guidance – which is classified as a “conditional recommendation” – does not notapply to people living with diabetes.
WHO: Low or zero calorie sweeteners do not encourage healthy eating habits
Although the new WHO guideline does not say that non-nutritive sweeteners are dangerous, it does say that they are frequently used to make low-sugar or no-sugar “highly processed” junk food, rather than sweeteners. encourage fundamental changes to a healthier diet rich in whole foods. food.
“because free [ie. added] sugars are often found in highly processed foods and beverages with undesirable nutrient profiles, simply replacing free sugars with unsweetened sweeteners results in a food or beverage in which all other unhealthy elements are mostly retained and therefore , the overall quality of the diet remains largely unchanged.”
WHO: Short-term benefits do not outweigh ‘possible long-term adverse effects in the form of increased risk of death and disease’
According to the WHO, any short-term benefit in the form of weight loss resulting from the use of non-nutritive sweeteners is offset by the “Possible long-term side effects.”
He added: “The lack of evidence to suggest that the use of sweeteners other than sugar is beneficial for body weight or other measures of body fat over the long term, as well as possible long-term adverse effects in the form of increased risk of death and disease, outweighed any potential shortfall. -term health effects resulting from the relatively small reductions in body weight and BMI observed in randomized controlled trials.
The recommendation is “based on overall low-certainty evidence, from a systematic review that assessed the health effects of high versus low intake of sugar-free sweeteners and found no evidence of long-term benefit term on body fat measurements in adults or children, and potential adverse effects of long-term use in the form of increased risk of type 2 diabetes, cardiovascular disease, and mortality in adults, ” added the WHO.
“Limited evidence suggests potential adverse effects in the form of an increased risk of preterm labor with the use of sugar-free sweeteners during pregnancy.”
“Evidence from a systematic review and meta-analyses of randomized controlled trials and prospective observational studies found that a higher NSS [non sugar sweeteners] consumption by adults resulted in lower body weight and BMI compared with no NSS consumption or consumption of lower amounts of NSS in short-term randomized controlled trials, but was associated with increased BMI and risk of incident obesity in long-term prospective observational studies. .“
In prospective (i.e. correlation, not causation) observational studies with up to 10 years of follow-up, the WHO said, higher NSS intakes were associated with higher BMI and risk. increase in incident obesity, type 2 diabetes and cardiovascular disease.
Because losing weight and maintaining a healthy weight must be sustained over the long term to have a significant impact on health, the WHO added, “Evidence of minor weight loss or reduced BMI over several months or less, as observed in randomized controlled trials without additional evidence of long-term impact, does not represent a health benefit.”
He added : “because free [ie. added] sugars are often found in highly processed foods and beverages with undesirable nutrient profiles, simply replacing free sugars with unsweetened sweeteners results in a food or beverage in which all other unhealthy elements are mostly retained and therefore , the overall quality of the diet remains largely unchanged.”
Draft WHO guidance: Use of sugar-free sweeteners, July 15, 2022
Calorie Control Council: Directive has ‘potential to negatively impact public health’
The Calorie Control Council – which has sweetener suppliers such as Cargill and Tate & Lyle, and sweetener users such as Coca-Cola and PepsiCo as members – said it was “disappointed” per recommendation, adding only low calorie and no-calorie sweeteners”have been shown to help with body weight and blood sugar management, as well as reducing calorie and sugar intake.
The CCC added: “It should be noted that the proposed guideline is rated as ‘conditional’ and most of the evidence used to make this recommendation was rated as ‘very weak’ to ‘moderate’.
“Further, noting the evidence regarding reductions in key outcomes such as body weight and BMI with use of low calorie and no calorie sweeteners, just to issue a guideline against their use does not provide the full picture of the problem. effectiveness of these ingredients, does not take into account the important role of calorie-reduced and calorie-free sweeteners, and has the potential to negatively impact public health.
International Sweeteners Association: “A disservice to public health”
The International Sweeteners Association – which counts ADM, Beneo, Ingredion, Ajinomoto and Cargill among its members – echoed those comments, noting that high-intensity sweeteners do not impact blood sugar and do not stimulate insulin production, are non-cariogenic and can help adults and children reduce their calorie intake:”Failure to recognize the role of low or no calorie sweeteners in reducing sugar and energy, and ultimately in weight management, is a disservice to public health.
ISA President Robert Peterson added: “The benefit of replacing added sugars with low-calorie or no-calorie sweeteners to reduce calorie intake and aid in weight management is supported by evidence reviewed by WHO, the US Dietary Guideline Advisory Committee of the Dietary Guidelines for Americans, 2020-2025, and numerous published systematic reviews and meta-analyses.
“Governments around the world are trying to tackle the serious problem of rising rates of obesity and diabetes. Not to mention dental diseases…. It is unfortunate that the well-established benefit of using sugar-free sweeteners in dental health has not been recognized.
“This does not mean that consumers should necessarily try to completely avoid sugar-free sweeteners in their diets”
Dr. Rachel Cheatham, founder of food and nutrition consulting firm FoodScape Group, told FoodNavigator-USA that “What is most striking is that even after a systematic review and meta-analysis covering 283 studies, there is a lack of scientific consensus on the benefits of sugar-free sweeteners.
“One of the issues is analyzing all artificial and natural sweeteners with low or no calories as a monolith. Beyond the basics of safety and no blood sugar spikes, there may be metabolic differences between them involving the gut microbiome, for example, which are not yet fully understood.
She added: “The net of current scientific review suggests that sugar-free sweeteners offer short-term benefits; however, in the long term, there appears to be an increased risk of obesity, diabetes, heart disease and even mortality.Given this, the draft guidelines to not use sugar-free sweeteners for weight control or to reduce the risk of non-communicable diseases are prudent.
That said, she noted, “This does not mean that consumers should necessarily try to completely avoid sugar-free sweeteners in their diets. On the contrary, regular consumption of sugar-free sweeteners should not be expected to help with weight management or disease prevention.
*The deadlinefor public comment on the new guidelines is August 14. Click hereto comment. In the meantime, the draft guidelines will also undergo peer review by a group of external experts. Once peer review and public consultation have been completed, the guideline will be finalized and reviewed by the WHO Guideline Review Committee for final approval before official publication.