Using sugar substitutes to lose weight could cause harm long-term, warns WHO

Continued consumption doesn’t reduce weight; could increase the risk of Type 2 diabetes, cardiovascular diseases and mortality in adults

By Nandita Banerji
Published: Tuesday 16 May 2023
The latest WHO recommendation on non-sugar sweeteners is not meant to comment on consumption safety. Photo: iStock

The World Health Organization (WHO) advised against using sugar substitutes, also called non-sugar sweeteners (NSS) May 15, 2023 to control body weight or reduce the risk of non-communicable diseases. The global health agency said long-term use is ineffective and could pose health risks.

A systematic review of the available evidence suggests NSS “does not confer any long-term benefit in reducing body fat in adults or children,” the WHO said. On the other hand, continued consumption could increase the risk of Type 2 diabetes, cardiovascular diseases and mortality in adults.

Read more: India second-biggest market for sugary beverages: Lancet report

Eating too much sugar is linked to obesity, diabetes and other chronic health issues — and it can also have a long-term effect on the brain.

A review published by the British Medical Journal in 2018 claimed that sweetened drinks with added sugars and substances that have nutrient-poor energy or empty calories are more likely to cause type 2 diabetes as compared to sugary foods.

Non-sugar sweeteners were developed as an alternative to sugars and are widely used both as an ingredient in pre-packaged foods and beverages and added to food and beverages directly by the consumer. The latest WHO recommendation is not meant to comment on consumption safety.

However, a February 2023 study on a sugar replacement called erythritol found links to has been linked to blood clotting, stroke, heart attack and death. 

People with existing risk factors for heart disease, such as diabetes, were twice as likely to experience a heart attack or stroke if they had the highest levels of erythritol in their blood, according to the study, published in the journal Nature Medicine.

Reducing sugar intake altogether

“Replacing free sugars with non-sugar sweeteners does not help people control their weight long-term,” said Francesco Branca, director of WHO’s nutrition and food safety department. “We did see a mild reduction of body weight in the short term, but it’s not going to be sustained.”

Read more: Super tiny particles derived from table sugar can detect lead in water

The guidance applies to all people except those with preexisting diabetes, he said. None of the studies in the review included people with diabetes and an assessment could not be made, he said.

Branca said: 

People should reduce the sweetness of the diet altogether, starting early in life, to improve their health

The latest WHO guideline on NSS is part of a suite of existing and forthcoming policies on healthy diets that aim to establish lifelong healthy eating habits, improve dietary quality and decrease the risk of non-communicable diseases worldwide.

“The recommendation applies to all people except individuals with preexisting diabetes and includes all synthetic and naturally occurring or modified nonnutritive 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 WHO said.

NSS are not essential dietary factors and have no nutritional value.


Read more: Processed finger millet can increase blood sugar levels


The recommendation does not apply to personal care and hygiene products containing NSS, such as toothpaste, skin cream, and medications, or to low-calorie sugars and sugar alcohols (polyols), which are sugars or sugar derivatives containing calories and are therefore not considered NSS.

In 2015, WHO issued guidelines on sugar intake, recommending that adults and children reduce their daily intake of free sugars to less than 10 per cent of their total energy intake. A further reduction to below 5 per cent or roughly 25 grams (6 teaspoons) per day would provide additional health benefits.

Reducing free sugars intake to less than 10 per cent of total daily energy intake was recommended by the WHO Study Group for the first time in 1989.

Read more:

Subscribe to Daily Newsletter :
Related Stories

Comments are moderated and will be published only after the site moderator’s approval. Please use a genuine email ID and provide your name. Selected comments may also be used in the ‘Letters’ section of the Down To Earth print edition.