Advisory from WHO Discourages the Use of Sugar Substitutes for Weight Reduction

The World Health Organization (WHO) has recently issued new guidance stating that non-sugar sweeteners (NSS) should not be used for weight management.

This recommendation is based on findings of a systematic review by WHO researchers, which suggested that artificial sweeteners do not have any long-term benefits in reducing body fat in adults or children.

The Director for Nutrition and Food Safety, Francesco Branca, cited inadequate evidence for the effectiveness of NSSs in keeping weight off long term and potential adverse health outcomes such as increased risk of type 2 diabetes, heart disease, and overall mortality.

The WHO statement is not meant to scare people away from NSSs, and it makes no overarching claims about their safety but is rather a commentary on their impact on weight loss. This is a surprising shift from previous opinions regarding the role of NSS in weight management.

Medical professionals have stated that weight management is a multifaceted process involving various factors and that physiologic and psychological factors may impede weight loss maintenance in most people. The WHO's new guidelines suggest that NSSs are not the silver bullet for weight loss that was once hoped for.

The guidance also raises questions about the safety of NSSs, citing potential undesirable effects from their long-term use, such as an increased risk of type 2 diabetes, cardiovascular diseases, and mortality in adults. It is important to remember that many artificial sweeteners have a long history of safety when consumed in moderation, and the US Food and Drug Administration (FDA) identifies eight non-nutritive sweeteners as "generally recognized as safe."

Nutrition experts have advised caution in drawing conclusions from studies that only show an association and not a causation, as many additional factors can come into play when it comes to weight management.

“The same population who is already seeking out the use of NSS is the population that may be engaging in other dietary and lifestyle factors that may increase the risk of obesity, type 2 diabetes, and cardiovascular disease,” she explained. “This does not necessarily mean that NSS causes these conditions.”

Whether or not you use artificial sweeteners, limiting sugar is still an important dietary strategy for achieving a healthy weight. There are plenty of ways to do so besides swapping a regular Coke for a diet Coke or adding a Splenda packet to your morning coffee.

“One of my favorite ways to sweeten foods is to use pureed fruit as a replacement for added sugars in baked goods,” Palinski-Wade advised. “You can use any pureed fruit such as banana, apples, or even prunes in a one-to-one swap for added sugar to provide all the same sweetness and moisture with no added sugar—while boosting fiber intake as well.”

Draayer suggested upping the flavor factor of dessert foods by experimenting with spices in place of some sugar. “Cinnamon, nutmeg, and vanilla can enhance the perception of sweetness while adding a ton of flavor,” she said. She also recommended substituting honey or maple syrup for white sugar, as their stronger flavors may allow you to use less of them.

Finally, remember that, in your efforts to lose weight, there’s no need to demonize any sweeteners, “real” or faux.

“Neither sugars nor non-nutritive sweeteners (NNSs) are inherently ‘bad.’ It all comes down to context,” Draayer emphasized.

“For example, switching from regular soda to a diet version could be helpful in avoiding the blood sugar spikes and crashes associated with sugary drinks,” she concluded. “On the other hand, choosing a sugar-sweetened cookie over a ‘diet’ cookie might be the better choice if it means more satisfaction and fewer feelings of deprivation, which could lead to overeating later on.”