(CNN) — Don’t use sugar substitutes if you’re trying to lose weight, according to new guidelines from the World Health Organization.
The global health body said that a systematic review of available evidence suggests that the use of non-sugar sweeteners, or NSS, “does not provide any lasting benefit in reducing body fat in adults or children.”
The review also indicated that there may be “potentially unwanted effects” from long-term use of sugar substitutes such as an increased risk of type 2 diabetes and cardiovascular diseases.
“Replacing free sugars with NSS does not help weight control in the long term. People should consider other ways to reduce free sugar intake, such as consuming food with natural sugars, such as fruit, or unsweetened foods and drinks,” said Francesco Branca, WHO director for nutrition and food safety, in a press release.
“NSS are not important dietary factors and have no nutritional value. People should reduce the sweetness of food, starting early in life, to improve their health,” said Branca.
The organization said its recommendation applies to all people except those with preexisting diabetes.
“This new guideline is based on a thorough review of the latest scientific literature, and it emphasizes that the use of artificial sweeteners is not a good strategy to achieve the loss of weight by reducing dietary energy intake,” said nutrition researcher Ian Johnson, emeritus associate at Quadram Institute Bioscience, formerly the Institute of Food Research, in Norwich, United Kingdom.
“However, this should not be interpreted as an indication that sugar intake is unrelated to weight control,” Johnson said in a statement.
Instead, one should minimize the use of sugar-sweetened beverages, and try to use “raw or minimally processed fruit as a source of sweetness,” Johnson added.
Keith Ayoob, scientific adviser for the Calorie Control Council, an international association representing the low-calorie food and beverage industry, told CNN via email that the WHO’s “insistence to focus only on preventing good weight gain and non-communicable diseases are at least, misguided.”
Robert Rankin, president of the Calorie Control Council, said that “low- and no-calorie sweeteners are an important tool that can help consumers manage body weight and reduce the risk of non-communicable diseases.”
A total of 283 studies were included in the review. Both randomized controlled trials, considered the gold standard in research, and observational studies were included in the review. Observational studies can only show an association, not direct cause and effect.
“This indicates that policy decisions based on this recommendation may require significant discussion in the specific context of the country, linked for example to the extent of consumption in different age groups,” the news release said. of the WHO.
Results from randomized trials found that the use of non-sugar sweeteners had a “lower” effect on reducing body weight and calorie intake compared to sugar, and there was no change of Intermediate markers of diabetes such as glucose and insulin, according to the report.
Observational studies also found a small effect on body weight and fat tissue, but no change in calorie intake. However, studies have found a slightly increased risk for type 2 diabetes, high blood pressure, stroke, heart disease and death from heart disease, the report said. A very low risk was found for bladder cancer and an early death from any cause.
The WHO says the recommendation is “conditional” because the known link between sweeteners and disease outcomes can be confounded by complex patterns of sweetener use and the characteristics of study participants.
In an emailed statement, the International Sweeteners Association, an industry association, said “there is a poor recognition of the public health benefits of low/no calorie sweeteners and is disappointed that WHO’s conclusions are largely based on low-certainty evidence from observational studies, which are at high risk of fracture.”
The recommendation includes low or no calorie synthetic sweeteners and natural extracts, which may or may not be chemically modified, such as acesulfame K, aspartame, advantame, cyclamate, neotame, saccharin, sucralose, stevia and stevia derivatives, said of the WHO.
Many people consider stevia products to be more “natural,” since they come from the stevia plant. Some natural and artificial sweeteners add bulking sugars to their products to cut their sweetness and add bulk to the product for cooking.
A recent study by US-based Cleveland Clinic researchers found erythritol – used to add bulk or sweeten stevia, monkfruit and keto reduced sugar products – was linked to blood clot, stroke, heart attack and early death.
People with risk factors for heart disease, such as diabetes, are twice as likely to experience a heart attack or stroke if they have the highest levels of erythritol in their blood, the study found.
Non-sugar sweeteners are widely used as ingredients in prepackaged foods and beverages and are sometimes added to food and beverages directly to consumers.
The WHO issued guidelines on sugar intake in 2015, recommending that adults and children reduce their daily intake of free sugar to less than 10% of their total energy use. After that recommendation, interest in sugar alternatives intensified, the review said.
Even if you’re a true sugar “addict,” the good news is that you can tame your sweet tooth, registered dietitian Lisa Drayer said in an article for CNN. He provides the following steps:
Train your taste buds. If you gradually cut out sugar — including artificial sweeteners — and include more protein- and fiber-rich foods in your diet, that will help you crave less sugar, Drayer said.
“When we consume protein and fiber, it slows down the rise in blood sugar when we eat it with a meal that contains sugar. It helps us feel full and helps us to reduce our intake as well of sugar,” he said in a previous interview.
Choose sugar-free foods and avoid all sugary drinks. For example, choose whole-grain cereal or Greek yogurt without sweeteners. Sugar-sweetened beverages to get on your grocery list should include sodas, energy drinks, sports drinks and fruit punch. Choose water instead.
“If you like sweet carbonated drinks, add a splash of cranberry or orange juice to seltzer or try flavored seltzers. You can also flavor your own water with fruit slices for of natural sweetness or try herbal fruit teas,” Drayer said.
Drink coffee and tea with no or less sugar. Be wary of coffee shops, Drayer suggests. All lattes and flavored coffees can contain as much sugar as a can of soda, or more.
Enjoy fruit for dessert. Try baked cinnamon apples, berries or grilled peaches instead of cookies, cakes, ice cream, pastries and other sweet treats, says Drayer.
See stealth sugars. Added sugars are often found in foods you might not think of as “sweet,” such as sauces, breads, condiments and salad dressings, Drayer said.
“Pre-packaged sauces — like ketchup, BBQ sauce and tomato sauce — are likely some of the biggest culprits of hidden added sugar in the diet,” says Kristi King, senior pediatric dietitian at Texas Children’s Hospital. and a national spokesperson for the Academy of Nutrition and Dietetics, Drayer said in an earlier interview.
Check nutrition facts labels. All foods and beverages must list the amount and type of sugar on the label.
Added sugars may go by other names such as “agave, brown sugar, corn sweetener, corn syrup, dextrose, evaporated cane juice, fructose, fruit juice concentrate, fruit nectar, glucose, high-fructose corn syrup, honey, invert sugar, lactose , malt syrup, maltose, molasses, maple syrups, raw sugar, sucrose, trehalose and turbinado sugar,” said Drayer.
The higher these added sugars are on the ingredients list, the greater the amount of added sugar in the product, he said.