According to recent guidance from the World Health Organization (WHO), individuals seeking to lose weight should avoid the use of sugar substitutes.
The World Health Organization (WHO) concluded from a systematic review that non-sugar sweeteners (NSS) do not provide long-term benefits in reducing body fat for adults or children.
Francesco Branca, director of WHO’s department of nutrition and food safety, stated that replacing free sugars with non-sugar sweeteners does not contribute to sustained weight control. While short-term weight reduction was observed, it was not sustained over time.
The WHO guidance, with the exception of individuals with preexisting diabetes, is based on the absence of studies including diabetic participants, making assessment difficult.
The review also revealed potential negative effects from the long-term use of sugar substitutes, such as a slightly increased risk of type 2 diabetes and cardiovascular diseases.
Branca clarified that the recommendation does not address the safety of consumption. Instead, it emphasizes that scientific evidence has been insufficient in demonstrating the effectiveness of non-sugar sweeteners in reducing obesity, controlling weight, or mitigating noncommunicable diseases.
Non-sugar sweeteners are commonly used in prepackaged foods and beverages, as well as added directly by consumers. WHO’s 2015 guidelines on sugar intake recommend reducing daily free sugar consumption to less than 10% of total energy intake. This recommendation has led to increased interest in sugar alternatives, as stated in the review.
“This new guideline, based on a comprehensive assessment of current scientific literature, highlights that artificial sweeteners are not an effective approach for weight loss through reducing dietary energy intake,” stated Ian Johnson, nutrition researcher and emeritus fellow at Quadram Institute Bioscience in the United Kingdom.
Johnson clarified that this should not be misconstrued as dismissing the relevance of sugar intake for weight control.
He suggested reducing the consumption of sugar-sweetened beverages and opting for raw or minimally processed fruits as natural sources of sweetness.
Dr. Keith Ayoob, scientific adviser for the Calorie Control Council, expressed his disagreement with the WHO’s focus solely on preventing unhealthy weight gain and non-communicable diseases, considering it misguided.
Robert Rankin, president of the Calorie Control Council, highlighted that low- and no-calorie sweeteners are vital tools for managing body weight and reducing the risk of non-communicable diseases.
The guidance is intended for government health organizations that may utilize the scientific analysis to implement policy changes for their populations, according to Branca.
He emphasized that the specific actions taken would depend on the consumption patterns of sweeteners in each country.
Synthetic and “Natural” sweeteners
The recommendation encompassed both low or no-calorie artificial sweeteners and natural extracts, including acesulfame K, aspartame, advantame, cyclamates, neotame, saccharin, sucralose, stevia, stevia derivatives, and monkfruit, some of which may be chemically modified, according to the report.
According to Branca, stevia and monkfruit are relatively new sweeteners, and while there is limited published research on them, they likely function in the body through a similar physiological mechanism as other sweeteners, without any significant differences based on the available data.
Stevia products are often perceived as more “natural” due to their derivation from the stevia plant. Some sweeteners, both natural and artificial, incorporate bulking sugars to reduce sweetness and add volume for baking purposes.
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A recent study conducted by Cleveland Clinic researchers in the United States found a potential association between erythritol, commonly used as a bulking or sweetening agent in stevia, monkfruit, and reduced-sugar keto products, and increased risks of blood clotting, stroke, heart attack, and premature death.
The study revealed that individuals with preexisting risk factors for heart disease, such as diabetes, had double the likelihood of experiencing a heart attack or stroke if they had higher levels of erythritol in their bloodstream.
Eliminated Sugar and Sweetener
People can learn to reduce their reliance on free sugars and non-nutritive sweeteners, similar to how they have learned to cook and eat without salt, according to Branca.
It is important to target children early on and advise parents to avoid using sweeteners as rewards or incorporating them into every meal, Branca emphasized.
Registered dietitian Lisa Drayer suggests several steps to tame your sweet tooth, including gradually cutting back on sugar and artificial sweeteners, incorporating protein and fiber-rich foods, choosing no-sugar-added options, and being mindful of hidden sugars in sauces, dressings, and other foods.
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To reduce sugar intake, opt for drinks like water, coffee, and tea without added sugars, and enjoy fruit as a dessert substitute, Drayer recommended.
Be aware of stealth sugars in condiments and pre-packaged sauces, and check nutrition labels to identify added sugars listed under various names.
The higher an added sugar is listed in the ingredients, the more significant its quantity in the product, Drayer advised.
By Katie Hunt and Sandee LaMotte, CNN
Updated 4:36 PM EDT, Mon May 15, 2023
