The World Health Organization (WHO) has released a guideline that recommends against the use of non-sugar sweeteners (NSS) for weight control.
NSS are low- or no-calorie alternatives to free sugars and are frequently marketed, according to WHO, as an aid for weight loss or maintaining a healthy weight. They are also often recommended as an alternative for controlling blood glucose in individuals with diabetes.
WHO’s recommendation is based on the findings of a systematic review of evidence that suggests the use of NSS does not provide any long-term benefit in reducing body fat in adults or children.
Results of studies in the guideline suggested that higher intakes of NSS were associated with a 23% increase in the risk of type 2 diabetes when consumed in NSS-sweetened beverages and a 34% increase in risk when added by individuals and consumed in food and beverage.
The guideline also advises against using NSS as a means of reducing the risk of noncommunicable diseases.
Francesco Branca, WHO director for nutrition and food safety, 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.”
Common NSS include saccharin, sucralose, stevia, acesulfame K, aspartame, advantame, cyclamates, neotame and stevia derivatives.
He added: “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 guideline applies to all synthetic and naturally occurring or modified non-nutritive sweeteners that are not classified as sugars found in manufactured foods and beverages, or sold as a product to be added to foods and beverages by consumers. However, the guideline does not apply to individuals with pre-existing diabetes.
Keith Ayoob, scientific advisor at the Calorie Control Council, said the guideline failed to consider individuals living with diabetes where NSS can have an “especially meaningful role in their compliance with necessary dietary requirements”.
He added: “The WHO’s insistence on focusing only on prevention of unhealthy weight gain and non-communicable diseases is at the very least, misguided. The WHO’s decision not to focus on the value of non-sugar sweeteners for persons with diabetes borders on unconscionable. Their doing so dismisses the value and usefulness of NSS for persons living with diabetes and pre-diabetes, which accounts for far in excess of 10% of the global population.”
The recommendation does not apply to low-calorie sugars and sugar alcohols (polyols), which are sugars or sugar derivatives containing calories and are not considered NSS.
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