Non-Sugar Sweeteners: Healthy or Not?

In May, the World Health Organization (WHO) released new guidelines on non-sugar sweeteners (NSS) recommending against using them to control body weight or reduce the risk of certain conditions. The recommendations are based on a study WHO published in April 2022 that reviewed and analyzed the health effects of NSS.

Many people use NSS to help control their weight and reduce their risk of weight-related diseases and health conditions, so the new WHO recommendation may come as a surprise. What should you make of the study? Should you stop using any NSS right away?

Karl Nadolsky DO, board-certified endocrinologist, metabolism and obesity medicine specialist at Holland Hospital, breaks down the results of the study in light of other available scientific data to help you understand the WHO recommendation and how it might impact your life.

The WHO Study

Non-sugar sweeteners were developed as a low-calorie or zero-calorie alternative to sugars to sweeten foods and beverages. Many people use NSS to be healthier by avoiding sugar while still enjoying sweetened food or beverages. Common NSS include aspartame, saccharin, sucralose and stevia.

Based on last year’s study, the WHO recommendations claim that NSS do not help with weight control and that the long-term use of NSS might increase the risk of developing increased risk of type-2 diabetes, cardiovascular diseases and mortality in adults.

WHO clarifies that the recommendation does not apply to people with pre-existing diabetes and acknowledges that the link the study observed between NSS and the development of certain diseases is potentially confounded by other factors besides NSS use. Because of this, WHO says the recommendation is conditional.

“The WHO recommendation is more of a suggestion,” says Dr. Nadolsky. “The actual interventional data consistently show that non-sugar alternatives, especially beverages, are better than sugar intake.”

NSS are still better than sugar

Dr. Nadolsky also says that the original study published last year does show that replacing sugary intake with non-sugar alternatives helps with weight loss, which is consistent with the findings of other similar studies. In 2021, Dr. Nadolsky published a counterpoint article that concluded that artificial sweeteners are better than sugary alternatives when addressing obesity.

“We don’t need to encourage people to consume NSS if they don’t already desire sweetened food or beverages,” says Dr. Nadolsky. ”However, I strongly disagree when this recommendation confuses people and they go back to drinking sugar-sweetened beverages.”

So what does this recommendation mean for you?

“People should replace sugar-sweetened beverages with a variety of non-sugar, alternatively-sweetened beverages,” says Dr. Nadolsky. “But don’t add in non-sugar sweeteners if you are not already consuming sweet drinks.”

Where can I learn more?

Holland Hospital Endocrinology offers comprehensive diagnosis, treatment and management of all endocrine and hormone-related conditions. Talk to your primary care provider about a potential referral to Holland Hospital Endocrinology. To schedule an appointment with Dr. Karl Nadolsky, call (616) 395-2833.