WHO recommends against use of non-sugar sweeteners to control body weight or reduce the risk of NCDs

GLOBAL –  Non-sugar sweetener (NSS) producers have received a major blow to their businesses following the WHO decision to recommend against the use of their products to control body weight or reduce the risk of noncommunicable diseases (NCDs).

According to the world health body, the recommendation is based on the findings of a systematic review of the available evidence which suggests that the use of NSS does not confer any long-term benefit in reducing body fat in adults or children.

 Results of the review also suggest that there may be potential undesirable effects from long-term use of NSS, such as an increased risk of type 2 diabetes, cardiovascular diseases, 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 intakes, such as consuming food with naturally occurring sugars, like fruit, or unsweetened food and beverages,” said Francesco Branca, WHO Director for Nutrition and Food Safety.

 Recommendation not for Diabetic patients 

The recommendation applies to all people except individuals with pre-existing diabetes and includes all synthetic and naturally occurring or modified non-nutritive sweeteners that are not classified as sugars found in manufactured foods and beverages, or sold on their own to be added to foods and beverages by consumers.

The recommendation does not apply to low-calorie sugars and sugar alcohols (polyols), which are sugars or sugar derivatives containing calories and are therefore not considered NSS.

Common NSS include acesulfame K, aspartame, advantame, cyclamates, neotame, saccharin, sucralose, stevia, and stevia derivatives.

The WHO recommendation has been assessed as conditional, which 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.

Industry stakeholders hit back

The WHO recommendation has however not been received well by industry players with the Calorie Control Council and the International Sweeteners Association (ISA) both hitting back at the new guidelines.

“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.

“This is supported by an abundance of scientific evidence, backed by the world’s most highly regarded health and regulatory agencies, which validate the role of these ingredients.”

Dr. Keith Ayoob, a CCC Scientific Advisor, took issue with the recommendation which, according to him, conveniently left out persons living with diabetes, for whom no-sugar sweeteners can have an especially meaningful role in their compliance with necessary dietary requirements.

“The ISA  believes it is a disservice to not recognise the public health benefits of low/no calorie sweeteners and is disappointed that the WHO’s conclusions are largely based on low certainty evidence from observational studies, which are at high risk of reverse causality,” a spokesperson from the association said.

Government bodies voice their reservations

Relevant government agencies around the globe, have also responded to the public consultation on the draft guideline expressing their concerns about the conclusions and rationale used by WHO.

The UK’s Office for Health Improvement and Disparities noted that “the guideline may go too far’ while the Australian government’s Department of Health and Aged Care wrote that ‘the recommendation may result in undesirable health outcomes for some individuals”.

Existing research questions safety of NSS

The WHO guidelines come as research, such as a study published in the BMJ, has identified potential links between artificial sweetener intake and increased cardiovascular disease risk.

Another study into the effects of erythritol, though not strictly an artificial sweetener, also linked it with an increased risk of heart attack and stroke.

These studies, however, demonstrated association and not causation i.e. it could be the case that those people mostly consuming artificial sweeteners are those already at higher risk for adverse cardiovascular events like heart attack and stroke.

Another recent study published in Nature found that high consumption of sucralose lowers activation of T-cells, an important component of the immune system, in mice.

If found to have similar effects in humans, the researchers said, one day it could be used therapeutically to help dampen T-cell responses. For example, in patients with autoimmune diseases who suffer from uncontrolled T cell activation.

For all the latest food industry news from Africa and the World, subscribe to our NEWSLETTER, follow us on Twitter and LinkedIn, like us on Facebook and subscribe to our YouTube channel.