Future of Health

Non-Sugar Sweeteners: a healthy alternative or Not?

The World Health Organization (WHO) released new guidelines in May 2023, on non-sugar sweeteners (NSS) and their effects on our health. These guidelines suggest that NSS don't offer long-term benefits for reducing body fat in adults or children and may have negative effects like increasing the risk of type 2 diabetes and cardiovascular diseases. The WHO advises against using NSS to control body weight or prevent diseases.

Common NSS include acesulfame K, aspartame, sucralose, and stevia. It's important to note that the WHO's recommendation doesn't apply to NSS in personal care products or low-calorie sugars. The link between NSS and disease outcomes is still being studied, and different factors can influence the results.

These new guidelines aim to help people make healthier choices. These are based on scientific evidence and aim to change our eating habits positively. The guidelines support various initiatives by the United Nations, WHO, and other global plans for better nutrition and overall health. These guidelines are not just for medical experts; they are intended to help policy-makers, organisations, and individuals working in public health make informed decisions and implement effective programs.

Obesity rates are increasing globally, with billions of adults and millions of children affected. A high body mass index (BMI) is linked to various diseases and even raises the risk of severe illness from COVID-19. Eating excess sugar is associated with poor diets and health problems. Some people turn to non-sugar sweeteners as a healthier alternative, but we're unsure about their long-term effects. These guidelines remind us to be cautious about using these sweeteners and to focus on a balanced and nutritious diet for better overall health.

The WHO has been working on dietary guidelines since 1989 to prevent obesity and diet-related diseases. In 2015, they looked at free sugars and how much we should consume. This led to a discussion about non-sugar sweeteners (NSS) as a potential solution to reduce sugar intake. The new guidelines on NSS aim to provide direction in preventing weight gain and diet-related diseases. NSS have become popular as alternatives to sugars because they provide a sweet taste without the calories. However, their long-term effects are not yet fully understood. Still, the guidelines don't address the safety of NSS, as expert bodies already regulate that. They are only focused on the general population, excluding diabetes management. Individual usage decisions should always be made with your doctor's input.

Creating guidelines like the WHO's NSS guideline is a big task that involves experts, research, and careful development. The process started in 2016 with meetings and consultations, and multiple teams contributed to gathering and reviewing evidence. They looked at different studies and assessed the health effects of higher NSS intake and replacing free sugars with NSS. The evidence was carefully analysed using the GRADE methodology. The review included studies like RCTs and tested different sweeteners in beverages and other forms.

Organisations like the United Nations Food and Agriculture Organization and the World Health Organization review each non-sugar sweetener (NSS) type to determine safe consumption levels. While some studies suggest that NSS can help regulate blood sugar and aid short-term weight loss, it remains unclear whether they are effective for long-term weight management or have other long-term health effects. It's important to recognise that not all NSS are the same—they vary in chemical structure, which may impact how our bodies respond to them. Although we lack comprehensive data on NSS consumption worldwide, we can observe a shift from sugary beverages to products containing NSS in countries like the United States and Norway.

The studies on non-sugar sweeteners (NSS) showed mixed results. Some trials suggested replacing sugar with NSS and consuming fewer calories could lead to short-term weight loss. However, the long-term effects and real-life usage of NSS are still unclear. Factors like individual differences and varied usage patterns make it complicated to draw definitive conclusions. We await more research to fully understand the impact of NSS on weight management and health.