WHO's latest guidance on artificial sweeteners

For its new recommendations, WHO conducted a systematic review of 283 studies on non-sugar sweeteners. The review included both randomized controlled trials and observational studies.

Based on results from the randomized controlled trials, non-sugar sweeteners only had a "low" impact on reducing body weight and calorie intake compared to sugar. They also had no effect on intermediate markers of diabetes, such as insulin or glucose.

Similarly, observational studies found that non-sugar sweeteners had a low impact on body weight and fat tissue and did not affect calorie intake. However, these studies found that the sweeteners were associated with a small increase in risk for Type 2 diabetes, high blood pressure, stroke, and  heart disease. There was also very low risk for bladder cancer and death from any cause.

According to WHO, consuming non-sugar sweeteners "does not confer any long-term benefit in reducing body fat in adults or children" and could have "potential undesirable effects," such as an increased risk of Type 2 diabetes and cardiovascular disease.

Based on the currently available evidence, WHO recommends people avoid consuming "all synthetic and naturally occurring or modified non-nutritive sweeteners that are not classified as sugars," such as acesulfame K, aspartame, advantame, cyclamates, neotame, saccharin, sucralose, and stevia. Individuals with preexisting diabetes are not included in the recommendation because of a lack of data on the group.

"Replacing free sugars with [non-sugar sweeteners] 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, WHO's director for nutrition and food safety. "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."

However, WHO also noted that its new recommendation is "conditional," meaning that the association between non-sugar sweeteners and disease outcomes could be confounded by other factors such as patient characteristics.

"This signals that policy decisions based on this recommendation may require substantive discussion in specific country contexts, linked for example to the extent of consumption in different age groups," WHO said.

The food industry pushes back

In a statement, the  Calorie Control Council (CCC), said it strongly disagreed with WHO's recommendation, arguing that it "does not provide the full picture regarding the efficacy of these ingredients and has the ‎potential to negatively impact public health."

‎"A substantial body of evidence shows that low- and no-calorie sweeteners provide effective and safe options to reduce sugar and calorie consumption," said CCC president Robert Rankin. "Along with exercise and a healthy diet, low- and no-calorie sweeteners are a critical tool that can help consumers manage body weight and reduce the risk of non-communicable diseases."

The  International Sweeteners Association (ISA) also pushed back against WHO's recommendation, saying that it's a disservice to consumers.

"Low/no calorie sweeteners are one of the most thoroughly researched ingredients in the world and continue to be a helpful tool to manage obesity, diabetes and dental diseases," ISA said. "They offer consumers an alternative to reduce sugar and calorie intake with the sweet taste they know and expect." (Hunt/LaMotte, CNN, 5/15; Parker-Pope, Washington Post, 5/15; Martuscelli, Politico, 5/15; Rubin, New York Times, 5/15; Kindelan, ABC News, 5/15; Choi, The Hill, 5/15; WHO press release, 5/15) 

Writing for the Washington Post/Consumer Reports, Sari Harrar debunks common misconceptions surrounding diet and blood sugar control and offers five tips to help individuals regulate their blood sugar levels.  Read the full story below.