WHO: Do Not Use Nonsugar Sweeteners for Weight Management or for Decreasing the Risk of Noncommunicable Diseases

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The World Health Organization (WHO) this week issued a new guideline recommending against the use of nonsugar sweeteners (NSS) to control body weight or reduce the risk of noncommunicable diseases.

The recommendation is based on the results of a systematic review of randomized controlled trials and observational studies that examined the health effects of NSS use in adults and children.

Results of the review suggested that the use of NSS “does not confer any long-term benefit in reducing body fat in adults or children,” said the WHO in a May 15, 2023, press release. The findings also suggested there may be potential undesirable effects from long-term use of NSS, including an increased risk for type 2 diabetes, and cardiovascular disease, and mortality in adults.

"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,” said Francesco Branca, MD, PhD, director for nutrition and food safety at WHO, in the release. "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 WHO noted that because the associations between NSS and disease outcomes may be confounded by complicated patterns of NSS use and baseline characteristics of study participants, the new recommendation is conditional. “Therefore, substantive discussion amongst policy-makers may be required before a conditional recommendation can be adopted as policy,” wrote the agency in the guideline.

The new recommendation applies to all persons except for those with existing diabetes and includes all synthetic and naturally occurring or modified NSS that are found in manufactured foods and beverages or sold on their own to be added to foods and beverages by consumers.

The guidance does not, however, apply to personal care and hygiene products containing NSS, such as toothpaste, skin cream, and medications, or to low-calorie sugars and sugar alcohols, added the agency in the release.

Reference: World Health Organization. Use of non-sugar sweeteners: WHO guideline. Geneva: World Health Organization; 2023.