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WHO recommends against non-sugar sweeteners for weight loss in new guideline

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In new set of guidelines released on Monday, the World Health Organization (WHO) says non-sugar sweeteners (NSS) such as aspartame and stevia do not help with weight control in the long term and pose an increased risk of chronic diseases.

The WHO says show that non-sugar sweeteners do not offer any long-term benefit in reducing body fats in adults or children when supplemented for added sugars.

On the contrary, non-sugar sweeteners increased the risk of cardiovascular diseases by 32 per cent, strokes by 19 per cent, and precursor hypertension by 13 per cent.

Higher consumption of non-sugar sweeteners showed a 10 per cent increase in the risk of death from any cause and a 19 per cent in risk of death from cardiovascular diseases but no association of death from cancer.

Findings from meta-analyses of randomized controlled trials revealed that these sweeteners also reduced daily energy intake by 136 calories and daily sugars intake by 38.4 grams.

Epidemiologist and cardiologist Dr. Christopher Labos says some of the WHO’s claims about harm are slightly “overblown.â€

“If you look overall, you saw that signal for maybe an increased heart risk and increased stroke risk and higher blood pressure and all the things that are alarming people. But if you contain yourself to just the randomized trials, which are usually considered to be better quality studies, there actually wasn't any increased risk,†said Labos in an interview with CTV News Channel on Tuesday.

“There actually was a small benefit, it's just that the weight loss associated with these artificial sweeteners was less than one kilogram about 1.5 pounds, †he added.

The guideline refers to all modified non-nutritive sweeteners that are not classified as sugars and found in manufactured foods and beverages or sold separately to be added to foods and beverages.

Common non-sugar sweeteners include acesulfame K, aspartame, advantame, cyclamates, neotame, saccharin, sucralose, stevia and stevia derivatives.

Labos says that differences between non-randomized and randomized trials impact the outcome. “The other thing to keep in mind too, is that when you're doing this in a non randomized fashion, you don't really know if people are substituting out sugar for non-sugar sweeteners. In the randomized trials, you can be very clear that you're basically giving people you know the equivalent of a Coke versus a Diet Coke.â€

“It’s really unclear in the non randomized data if you're actually studying what you want to be studying. I think there's a little bit of equivocation and uncertainty about how much real weight we should be put on this potential increased cardiovascular risk with these products,†he said.

These guidelines only focus on non-sugar sweeteners in food and drink. Artificial sweeteners in personal care and hygiene products -- such as toothpaste, skin creams, medications, or low-calorie sugars and sugar alcohols (polyols)--sugars or sugar derivatives containing calories -- are not a part of the recommendation.

"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.

Branca recommends that people should reduce sweetness in their diet completely and as early as possible. 

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