Are artificial sweeteners harmful for your health? Here’s what the WHO has recommended

“WHO suggests that non-sugar sweeteners (NSS) not be used as a means of achieving weight control or reducing the risk of non-communicable diseases,” was the highlight of 90-page report based on nearly 283 studies.

What has WHO said in its recommendation on artificial sweeteners?

While there could be some weight-loss and reduction in Body Mass Index in the short term as the artificial sweeteners bring down the calories consumed, but in the long run they have been linked to weight gain, the WHO report said. The sweeteners have also linked to an increased risk of Type-2 diabetes, cardiovascular diseases, and mortality in the long run. Some low certainty data also linked the use of such artificial sweeteners to bladder cancer and preterm birth when consumed by pregnant women.

The meta-analysis found that higher intake of NSS was associated with a 23% increase in the risk of type-2 diabetes when consumed in the form of beverages and 34% when added to foods. Higher intake of these sweeteners was also linked with 32% increase in the risk of cardio-vascular disease – including a 19% increase in risk for stroke – and 13% increase in the risk for hypertension.

It was also linked with a 25% increase in the risk for pre-term birth. “Long-term adverse effects in the form of increased risk of death and disease offset any potential short-term health benefit resulting from the relatively small reduction in body weight and BMI observed in randomized controlled trials,” the report said.

The WHO has made these recommendations for everyone other than those who are already diabetic. “Replacing free sugars with non-sugar sweeteners does not help with weight control in the long term. People need to consider other ways to reduce free sugars intake, such as consuming food with naturally occurring sugars like fruit, or unsweetened food and beverages,” says Francesco Branca, WHO Director for Nutrition and Food Safety, in a release.

Is this the first time artificial sweeteners have been linked to such adverse impacts?

The analysis of WHO is based on already existing studies, results for which have been pooled to reach the conclusions. In fact, the WHO said that it was a “conditional recommendation” because the evidence was of low certainty.

However, the recommendations come on the heels of two important studies that have shown the long term consequences.

A large French study that followed those taking artificial sweeteners for nearly eight years said that it increased the risk of cancers. Another large study published earlier this year showed that the artificial sweetener erythritol increased the risk of clotting and can lead to heart attacks or strokes.

What do the doctors recommend?

Dr Anoop Misra, Chairman at Fortis CDOC Hospital for Diabetes and Allied Sciences, said that the artificial sweeteners should absolutely not be consumed by non-diabetics for weight loss. “Even among diabetics I would recommend it very selectively to those who have good control over their sugars. In fact, I would suggest that they have ½ a tsp of sugar rather than the artificial sweeteners,” he said.

He added: “If the sweeteners have been linked to increased risk for cardio-vascular diseases or cancer, the recommendation should also apply to diabetics as they are anyway at a higher risk of getting these diseases than the general population,” he said.

Dr Ambrish Mithal, Chairman and Head, Endocrinology and Diabetes, Max Healthcare, said that while the artificial sweeteners were developed as a low-calorie alternate to sugar for those with diabetes, it is now being used by healthy individuals. “Because the calories from the artificial sweeteners is much lower than the calories from sugar, people have started substituting it for sugar as a possible tool to lose weight. This hasn’t been proven in any study. In fact, studies suggest that they can lead to an increase the risk of insulin resistance and type-2 diabetes.”

Here, Dr Misra makes a special mention of erythritol that can stay in the body for several days after being consumed. “It is usually mixed with other sweeteners to give them a more natural flavour, but it should not be consumed at all. Try and read the label to avoid it.”

Why are diet colas damaging?

Dr Mithal explains that while the normal cola contains an extremely high amount of sugar – around 12 spoons in 500 ml – diet colas promise zero calories. This zero calories is achieved by using artificial sweeteners. “People tend to drink it more because they think they are consuming fewer calories. But this can lead to long-term negative consequences, including insulin resistance and diabetes,” he said.

He added artificial sweeteners are also intensely sweet, much more than sugar. So, it makes normal sweets taste less sweet and makes you crave for more sweets.