If you think that using sugar substitutes, as a replacement for sugars, will help you lose weight, then you need to rethink your approach to weight loss. In a new guideline based on the findings of a systematic review and meta-analysis of published evidence, the World Health Organization (WHO) has issued a conditional recommendation against the use of non-sugar sweeteners to control body weight or reduce the risk of NCDs.^1,2 This recommendation is applicable to all except for those with pre-existing diabetes. This, note the authors, was due to the fact that the review did not include “studies specifically assessing the effects on individuals with pre-existing diabetes or including only such individuals”.

This meta-analysis suggests that non-sugar sweeteners do not offer any advantage in the long-term in reducing body weight. Their use also was associated with increased risk of obesity, type 2 diabetes, cardiovascular disease and related mortality.³

Analysis of randomized controlled trials (RCTs) showed that people who used NSS showed weight loss in the short-term RCTs compared to those who did not use them with a low certainty of evidence. This effect was seen only in those trials that compared NSS with sugars. No effect on other cardiometabolic markers was noted in the short-term RCTs. However, their use was associated with increased BMI and risk of incident obesity in long-term prospective observational studies conducted in adults. An increase in risk of preterm birth was found in prospective observational studies with higher use of NSS during pregnancy, but no correlation with birth weight of the child was observed. However, the children were at a higher risk of allergies and asthma and poorer cognitive function.

NSSs, in this guideline, include “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”. Aspartame, saccharin, stevia, sucralose are some common NSSs.

The recommendation has been made conditional keeping in view the characteristics of study participants and the way in which these sweeteners are used. And formulation of any policy regarding would need to be in the context of a particular country.

References

1. Use of non-sugar sweeteners: WHO guideline. Geneva: World Health Organization; 2023. Licence: CC BY-NC-SA 3.0 IGO.
2. https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline. May 15, 2023. Accessed on May 18, 2023. 
3. Rios-Leyvraz M, Montez J. Health effects of the use of non-sugar sweeteners: a systematic review and meta-analysis. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO.