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WHO advises against use of artificial sweeteners

183 points| cryoz | 2 years ago |news.un.org

206 comments

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Someone1234|2 years ago

This was posted when it was published in May.

To use an analogy their argument is: Vaping is bad for you, don't do it. While ignoring that a ton of people quit smoking using vapes and that they're letting the perfect be the enemy of good.

Same thing with NSS. While NSS are a useful tool for sugar reduction, studies have shown that over the medium-long term, you'll want to reduce artificially sweat foods and even sweat food substitutes, to create a "new normal" or new baseline where an e.g. strawberry is sweat again. Which has been shown to be more sustainable.

The WHO aren't wrong, but everyone jumps on this with their own agenda. They are claiming that switching to NSS isn't a sustainable way to reduce BMI (and associated negative health outcomes) over the long term, hard to find data that disagrees with that. That's all they're claiming.

busyant|2 years ago

> to create a "new normal" or new baseline where an e.g. strawberry is sweat again.

Just an interesting story.

About 5 years ago, I tried to cut out all processed carbs from my diet.

After several months, I was away from home and I had to eat something---the only thing open was a Dunkin Donuts. I ordered an egg-white sandwich on a plain English muffin, and for kicks I took a bite out of the English muffin.

Holy shit. It tasted super sweet!!

I can't be sure, but I assume it had refined sugar added to it to improve its palatability. Made me think about everything that goes into fast foods...

mike10921|2 years ago

I fully agree. The main argument is that if you use sweeteners you will eat more sugar, so it is worse than sugar. So basically don't eat the non-poison because it will cause you to eat poison, so instead eat the poison itself.

Also, there is no concrete evidence that sweeteners are bad for one's health, it's more the feeling of 'chemicals' are always bad. Sugar is clearly bad and causes obesity and diabetes. The choice seems pretty clear between the two.

doxeddaily|2 years ago

I'm super dubious about their conclusions here. Fat people drink diet soda because they are trying to avoid sugar. Diet soda actually tastes damn good these days, there isn't really a reason to drink regular soda.

hendersoon|2 years ago

Well, exactly right. I'm not choosing between putting a packet of splenda in my coffee or drinking it black. I'm choosing between a packet of splenda or two packets of sucrose. I'd find a study telling me which one of those is the better choice to be very helpful.

carabiner|2 years ago

Well, if you eat an actual ripe strawberry they're incredibly sweet. The ones at the grocery store with the bitter white center are not ripe. But I get your point.

YeGoblynQueenne|2 years ago

From the article:

"Replacing free sugars with NSS 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.

"NSS are not essential dietary factors and have no nutritional value. People should reduce the sweetness of the diet altogether, starting early in life, to improve their health."

If I read that correctly, the WHO is recommending that the overall amount of sweet foods consumed should be reduced and that replacing sugar with other sweeteners will not cut it.

irthomasthomas|2 years ago

I'm afraid you might be wrong about that. Why do they keep inventing new sweeteners, now, every few years? After all, they're all sweet, and zero calories. But they keep investing money inventing new ones, when the customers are happy with the old ones.

Perhaps because the public research eventually catches up to them.

E.g. "sucralose ingestion caused 1) a greater incremental increase in peak plasma glucose concentrations (4.2 ± 0.2 vs. 4.8 ± 0.3 mmol/L; P = 0.03), 2) a 20 ± 8% greater incremental increase in insulin area under the curve (AUC) (P < 0.03), 3) a 22 ± 7% greater peak insulin secretion rate (P < 0.02), 4) a 7 ± 4% decrease in insulin clearance (P = 0.04), and 5) a 23 ± 20% decrease in SI (P = 0.01)."

https://diabetesjournals.org/care/article/36/9/2530/37872/Su...

NNTs, sweet on the tongue, sweet on the liver! Yep, they trigger the same deleterious hormonal response that sugar does. They produce a cascading chemical chain reaction in the body leading to the over-production of insulin, the hunger-hormone, which signals your fat cells to begin absorbing glucose (triglycerides) from the blood stream. Removing the sugar from the bloodstream would normally cause insulin production to drop, but in this case, it's not the sugar triggering the productions, it's the NNT chemicals that are still circulating in your body..

DrThunder|2 years ago

Eh I get what you're saying but I don't think most people who switch to vaping actually stop quit nicotine all together, they just continue vaping with often higher levels of nicotine. I guess they have the advantage of getting rid of second-hand smoke and the permeating smell of cigarettes.

I think a similar thing happens with "diet" "sugar-free" products. Almost all of the people who use these products neglect every other aspect of their health thinking they're really going to tackle obesity by swapping out processed sugar for sweeteners.

Anecdotally, I've never seen someone using copious amounts of these sweeteners look healthy. They continue on being obese and out of shape. I think if your goal is to be healthy then your mind set has got to change and using an option like artificial sweeteners is just a "have your cake and eat it too" position that won't result in making you healthier.

meindnoch|2 years ago

Sweat food? Yuck!

fredgrott|2 years ago

Vaping is wrong for a very different reason, i.e. because the amount and quality of nicotine is unregulated which means the standard vape has an overdose of nicotine which can result in death in a single vape. 6 deaths by vaping in my state of Indiana alone last year, and all of them teenagers.

WonderBuilder|2 years ago

It feels to me that this advisory was not put out sensibly. WHO advises "against [artificial sweetener] use" because they "do not help control body mass or reduce the risk of weight-related illnesses" and because long term "[may increase the risk] of type 2 diabetes and cardiovascular disease". But is that enough reason to give such a blanket statement disallowance?

What if you want to have some sweetness from time to time but you are watching your sugar levels? Surely that's better than just taking sugar. What if you are weaning yourself off so much sugar? Surely that's better too. It seems to me that artificial sweeteners are a useful product for many people and is obviously not a panacea. I mean, honestly, hardly anything is good in excess!

I feel this is so poorly communicated and almost guarantees people will take the wrong message from this.

gizmo686|2 years ago

The actual recommendation:

> WHO suggests that non-sugar sweeteners not be used as a means of achieving weight control or reducing the risk of noncommunicable diseases (conditional recommendation)

> Conditional recommendations are those recommendations for which the WHO guideline development group is less certain that the desirable consequences of implementing the recommendation outweigh the undesirable consequences or when the anticipated net benefits are very small. Therefore, substantive discussion amongst policy-makers may be required before a conditional recommendation can be adopted as policy.

> Because the WHO Nutrition Guidance Expert Advisory Group (NUGAG) Subgroup on Diet and Health focuses on providing guidance on the prevention of unhealthy weight gain and diet-related NCDs, providing guidance on the management of diabetes in individuals with pre-existing diabetes is beyond the scope of this guideline. Therefore, the guidance in the guideline may not be relevant for individuals with existing diabetes.

https://apps.who.int/iris/rest/bitstreams/1501485/retrieve

I don't understand the expectations some people have of the WHO. Anything more complicated than a headline is going to get oversimplified by the media.

unshavedyak|2 years ago

> What if you want to have some sweetness from time to time but you are watching your sugar levels?

Partly it seems the issue is that in many cases the reason for avoiding sugar and using a substitute does not actually avoid the negative consequences of sugar. I say this as someone who avoids sugar and has very little.

I agree though i'm a bit confused by this WHO post. I have difficulty determining the severity of the issue. Based on what they're saying it sounds like you should avoid both sugar and substitutes. This post makes them sound basically the same, so why hyper focus on one?

hedora|2 years ago

Artificial sweeteners have been shown to cause weight gain, since they make you hungrier, and also lower your metabolism. This was shown in follow up studies with humans, but with mice, they had three groups that each got a fixed amount of calorie counted food and a hamster wheel. They then added sugar to one group's water and artificial sweetener to another group's. The artificial sweetener groups gained the most weight and was the least physically active.

If you're trying to watch your sugar levels (and are not diabetic) then artificial sweeteners are strictly harming your progress toward whatever goal you're trying to achieve.

They also cause all sorts of other health issues (cancer, digestive problems, neurological problems), but those are mostly product specific. The above applies to all non-nutritional sweeteners that have been studied.

I hope the WHO ruling includes "organic" artificial sweeteners too.

Gibbon1|2 years ago

What if I told you your gut has taste receptors?

Me as far as added sugar and artificial sweeteners is concerned, I'm out.

AHOHA|2 years ago

In all honesty, after and during Covid19, I find it hard to trust WHO or anything coming from hospitals’ doctors, integrity was lost, or maybe clear it was gone long ago.

onlyrealcuzzo|2 years ago

The reality is, this stuff is hard to get right, especially in the middle of something - someone is unlikely to be right 100% of the time.

Who are you following that's getting everything right? Or getting more things right than The WHO?

x3874|2 years ago

...like most things in life, just trust your own instincts, and eat a mixed diet (including carbs, meat, gluten, dairy), with the occasional splurges. And like with most things, the poison is in the dosage.

These Do's / Don'ts change like every 10 years. But most people seem to love self-searched guidance in their life, especially from so-called authorities, or other "SMEs".

PS: Come on introverted HN lurkers, i want more downvotes! You can do it - give them to me! 46 Karma to go!

barbariangrunge|2 years ago

Care to elaborate on how integrity was lost? I haven't been following the news much

chx|2 years ago

After being diagnosed with diabetes T2 I have worn a CGM and decided which foodstuff I needed to drop. I dropped basically all starches, no potatoes, no rice, very careful with bread. Only desserts I eat are made with almond flour, no wheat flours. And, of course, NSS. I have wrestled my blood sugar level below diabetic levels without any drugs, this ought to be enough. This already has leeched a lot of pleasurable activities from my life -- before this, I used to love to travel to eat. Lyon , Florence, places. I simply refuse to do more. There's a point where you don't live longer, you just exist longer. What for?

In much broader strokes, I was already not happy about how obsessed we became with prolonging life far beyond anything desirable. But even places where medically assisted death is accepted, you can't just go and say I am too old and infirm, help me end in dignity, no you need to suffer until your body and mind is gone. So says Lord Of The Rings

> ask whether you would indeed have me wait until I wither and rail from my high seat unmanned and witless. Nay, lady, I am the last of the Númenoreans and the latest King of the Elder Days; and to me has been given not only a span thrice that of Men of Middle-earth, but also the grace to go at my will, and give back the gift

smrk007|2 years ago

> The recommendation against the use of NSS applies to all people except individuals with pre-existing diabetes

morkalork|2 years ago

Companies need to stop using artificial sweeteners because they're just too sweet! If you ever do a low carb diet, it feels like your pallet is forever changed afterwards. Unmodified and unprocessed food taste naturally sweet on its own. Food with artificial sweeteners added tastes unbearably sweet.

hedora|2 years ago

Also, salt. I cooked lunch + dinner for myself for like a month, and now all processed food is just too damned salty.

There was an international agreement to cut salt in processed foods by a few percent a year for a few decades, and all stakeholders emphatically agreed to do it, since there's no real downside.

Of course, nothing happened after that.

The problem is that increasing salt a few percent gives processed food manufacturers a marginal advantage over their competitors since by desensitizes them to salt, and also tastes slightly better in side-by-side comparisons. This leads to a prisoner's dilemma type situation everyone is incentivized to work against their own long term best interests.

Regulation could trivially fix the problem by stopping the arms race, and doing it slowly wouldn't lead to people noticing the reduction.

Semaphor|2 years ago

I actually thought sweet stuff was sweet long before doing low-carb. I think a big difference is that here (Germany) we don’t put a ton of sugar and/or sweetener in pretty much everything. From what I’ve heard, that’s a thing in the US, and I know that it’s a thing in South Africa.

DrThunder|2 years ago

Yep, when I've cut sugar I've noticed things like carrots and even bell peppers actually taste sweet.

mberning|2 years ago

I’m not giving up my Coke Zero. It’s an indulgence that I can live with long term. Unlike alcohol, donuts, pizza, and all the other shit that I enjoy but have to severely restrict.

omnicognate|2 years ago

Nobody's going to make you give up your Coke Zero. The sweetener epidemic has, however, deprived me of things I enjoy. Coke, fortunately, remains available in "Classic" form, but here in the UK many drinks are no longer available without sweeteners: Vimto, Irn Bru, Tango, Lilt, Ribena, Robinson's Barley Water, Schweppes Tonic Water - all are now full of aspartame and saccharin in their non-"diet" variants.

As a person with a healthy weight and the self-discipline to maintain it long term, with no diabetes or risk of it, who is not and never has been addicted to sugary drinks but who enjoys them (greatly) as an infrequent, calorie-counted treat, the loss of these childhood tastes is saddening, especially since there is very little evidence of any actual public health benefit.

If I were magically transported back to the 1980s the first thing I'd do is buy a bottle of Corona Cherryade.

gukov|2 years ago

It's probably the caffeine in Coke that keeps you going back. By the way: the newly reformulated Pepsi Zero has a lot more of it.

nonrepeating|2 years ago

Upon reading the headline, I assumed this was related to the recent research suggesting that sucralose damages DNA. As someone who was drinking a sugar free energy drink every day, that was enough to get me to quit. The pure somatic horror of “DNA damage” far outweighs whatever enjoyment and lift I get from a can of [brand name].

ThrowawayTestr|2 years ago

You wear sunscreen everytime you go outside yeah? The DNA damage from the sun is a way bigger concern.

cm2012|2 years ago

WHO also advises against steaks cooked rare. The kind of people who make pronouncements in big health orgs are the most cautious, neurotic people on the planet. You can safely ignore them.

TurkishPoptart|2 years ago

The word "sweat" appears in these comments 9 times so far, when it should be "sweet".

The words may well be opposites. Get it right, people!

marliechiller|2 years ago

So if I have to choose between diet and normal coke, which one is objectively worse for my health now?

raspyberr|2 years ago

This article seems to recommend having water instead.

2OEH8eoCRo0|2 years ago

Normal Coke is probably worse but they're both horrible.

I only drink normal Coke but sparingly. Usually I'm having water or plain black coffee. I think the takeaway is that diet Coke doesn't allow you to train yourself to enjoy normal sweet foods again. I just had an apple and strawberries and it is basically candy to me.

Edit: I have a question. Rank these food items by how healthful they are:

a) 150 calories of Coca-Cola Classic

b) 150 calories of fresh fruit

c) 0 calories of Diet Coke

jwally|2 years ago

So people shouldn't use it not because its poisonous (like lead); but because people think it's part of an effect weight management strategy - which for most people it is not?

heyparkerj|2 years ago

Which blows my mind, because when all else in the diet holds equal, swapping two sugar'd sodas with two artificially sweetened sodas will save you (using my old vice Dr Pepper as an example) 54g sugar and 200 calories per day. It's just a little annoying that WHO (or this article, not sure who's most at fault) decided not to get into the nuance that people tend to make up those missing 200 calories in other ways.

basq|2 years ago

After a long period of stalled weight loss, I switched to a low carb diet (to reduce my feelings of hunger and aid in eating less), and with that came a plethora of keto-friendly protein bars. For a while I thought that 4/5 BMs being straight liquid was just my body acclimating to the diet, but after reading about how erythritol can cause diarrhea, I decided to hit the breaks on those bars and everything has gone back to normal overnight.

I may have one occasionally but definitely not going back to eating them every other day.

corpMaverick|2 years ago

To be frank I do not know what to do. I have been trying to reduce my insulin resistance but most of the low carb protein powder seem to use some sort of artificial sweetener.

Also this https://www.prevention.com/food-nutrition/a44156389/sucralos...

So which one is less bad ?

jwally|2 years ago

If I'm reading the article by the WHO correctly; its not saying stop using Artificial Sweeteners because they are poisonous - they're saying that Artificial-Sweeteners aren't part of a long term weight management strategy.

If your protein powders have them - no factor. I feel like the headline is 10x more inflammatory than it needs to be.

dominick-cc|2 years ago

One of the best things you could do is get unflavored whey isolate and just mix it with something you trust, like a bit of juice.

Unflavored isolate is pretty expensive for me, and I often find good proteins on sale (I like ISO100 from Dymatize and buy it whenever it's cheap) but for me, it is sickeningly sweet (and artificial as well). So I've been using 50% flavored protein with 50% unflavored isolate to really reduce the overall sweetness. Add in a spoon of fat-free yogurt, maybe a splash of skim milk, water, it's a good time.

bequanna|2 years ago

If you can, start to lay off all sweets. Your taste will change, but you need to be patient. The end result is less desire for sweets. Totally worth it.

Pea protein with no flavor takes some getting used to but is quite healthy and filling. You can mix with some sugar free almond milk to help the taste.

Overall my suggestion is to start viewing food as fuel. Of course you should enjoy some meals but don’t allow yourself to be picky or give into cravings.

Again, once your mind and body start to correlate eating good foods with feeling good you’ve got it made. You won’t even want to drink alcohol, eat sugar or seed oils. You’ll shutter at the thought because you know they will make you feel like crap.

gizmo686|2 years ago

The recommendations explicitly do not apply to people trying to manage existing diabetes.

hospitalJail|2 years ago

Ever since I found out WHO is fine with doing anti-science things like having a 'panel of experts' make health proclamations without evidence; I'm not sure who uses the WHO. (A panel of 'experts' said if a 1 month old watched tv for 1 second, they would have detrimental effects. No science to cite, 0, but like 9 names of random old people were cited.)

If the WHO says something, you need to go through all the work of checking their sources, and in this case, there was no source:

>The recommendation from the World Health Organization (WHO) is based on a review of available evidence which suggests that artificial sweeteners do not help control body mass or reduce the risk of weight-related illnesses.

I'm a bit offended that I pay taxes to such a prominent anti-science organization. I don't mind the idea of a world health organization, but to be so brazenly anti-science and pro-authority is the last thing I want.

YeGoblynQueenne|2 years ago

>> No science to cite, 0, but like 9 names of random old people were cited.

If those people were experts, they would have been the ones writing any papers cited and they'd be repeating the results from those papers.

codexb|2 years ago

Yeah, I realized WHO was completely anti-science when they started publishing World Healthcare Rankings where 60% of the score was based purely on how socialist a country's healthcare system was and only 40% was based on the actual quality or results of the healthcare.

raspyberr|2 years ago

The article seems to be implying that you shouldn't use artificial sweetners as an alternative to sugar but instead should just have a healthy diet. There don't appear to be any sources for anything but I wonder if people who consume more artificial sweetners are also the ones who consume more sugar because they're used to a sweeter diet.

ericathegreat|2 years ago

There's a huge difference between: - Don't use this, it's harmful to you, and - Don't use this, it won't make things actively better.

Study after study has shown that it is extremely, almost absurdly difficult to lose weight and keep it that way in the long term.

If "not actively causing long term weight loss" is the only criteria for advising against something, then we should be advising against a heck of a lot more things that are perfectly fine.

It's phrasing like this that causes people to go on crusades against random foods, rather than actually using moderation in all things.

danjin250|2 years ago

The article states reasons for its recommendations in addition to not being effective for long-term weight loss:

"WHO also noted that “potential undesirable effects from long-term use” of NSS, such as an increased risk of type 2 diabetes and cardiovascular disease. The results of the review also suggest that there may be other dangerous consequences such as the increased risk of premature death among adults."

Veen|2 years ago

Splendid news. I can ditch the artificial sweeteners and return to putting three sugar lumps in my tea, since, somewhat counter-intuitively, using sweeteners instead of sugar doesn't help with weight control.

bojo|2 years ago

Basically. There's some evidence that artificial sweeteners spike insulin as well, so a net gain of nothing in some cases.

dtx1|2 years ago

I was (and technically still am) pretty addicted to sugary drinks and energy drinks. Switching to diet soda and sugar free energy drinks helped me lose a lot of weight and got me an easier way to start regulating my weight and nutritional input. I would not have considered starting without the availability of these substitutes and I am glad I did. To condemn them without the context of the individual that may be like in my case substituting liters of sugar water and energy drinks a day seems rather short sighted

notfed|2 years ago

Hi, WHO. Are you okay?

Did big sugar threaten you? Offer you money? Are some governments/sponsors making you say these ridiculous things?

This is an extraordinary claim that defies common sense. And your evidence is, what? Oh right, let me quote from the paper:

> The recommendation is based on evidence of low certainty overall

gilmore606|2 years ago

Not big sugar, big semaglutide. The timing of this anti-fake-sugar push with the release of a new patented weight loss drug isn't a coincidence.

Havoc|2 years ago

I've been sticking to sugar version all along on a admittedly simplistic "devil you know" rationale

epolanski|2 years ago

I have highly reduced my sugar intake in the latest years going for the "light", with NSS, version of products like Coca Cola, etc.

Now I read this still poses risks for me to develop diabetes and cardiovascular factors, how so?

byteware|2 years ago

the article linked on the WHO's site is titled "WHO advises not to use non-sugar sweeteners for weight control in newly released guideline", I mean why drop the "for weight control" part

easytiger|2 years ago

WHO provides no value whatsoever at this point. It's clearly halfway between a joke and a self serving bureaucracy with a parallel structure of anti west social purpose thrown in for good measure.

itsTyrion|2 years ago

I prefer getting cancer from artificial sweetener at age 70 to getting diabetes or gaining weight now idk

Pomfers|2 years ago

Low quality article. The only takeaway is that NSS does not result in long term weight loss by itself. That's it. NSS does not spike insulin response in humans. Stop reading studies involving rats when the same studies involving humans exist.

There is a correlation between NSS consumption and negative health outcomes, this is true. However, read how this article states this:

>WHO also noted that “potential undesirable effects from long-term use” of NSS, such as an increased risk of type 2 diabetes and cardiovascular disease. The results of the review also suggest that there may be other dangerous consequences such as the increased risk of premature death among adults.

A layman will obviously read this as a statement that NSS is a direct cause of harm, not as the correlation that it actually is.

The correlation is simply explained: NSS is heavily consumed by people who have diabetes and/or who are obese. These people are naturally going to have far more health issues than non-diabetics, and non-obese people. They even acknowledge this in the article:

>the connection between consuming NSS and disease outcomes might be subjectively determined due to “baseline characteristics” of those taking part in the study

If you have a choice of drinking regular soda and diet, the diet is without a doubt leagues better for you. I think the most convincing evidence that NSS is safe is this: It's obvious that diabetics and obese people consume NSS significantly more than the general population. Diabetics and obese people are naturally prone to high levels of health issues. Yet why is it that they never just filter these people out to get a good baseline? What are the chances that these university educated people can't filter out obese/diabetics, or that they did not anticipate needing to do this and thus did not collect sufficient data? That they didn't read decades of prior studies who failed to do this, including the studies that specifically mentioned the dirty baseline issue? Is our higher education system this bad? Are researchers just this stupid? Not likely.

The more likely explanations are these: 1 The study was funded by corn growers that are threatened by NSS (a huge number of the studies I read through fall into this category). 2 The researchers have a bias for "natural" products. 3 The researchers dislike the taste of NSS and are afraid that NSS proliferation will reduce the supply of the flavors that they enjoy.

They've tried to prove NSS is harmful for way too long. Sure, that's not proof that NSS is completely safe, but if it is harmful, it must be so minimally harmful that 4+ decades of intense research can't definitively prove it.

christkv|2 years ago

I would love to try allulose. Anybody had any experience baking with it ?

firstfewshells|2 years ago

I don't know what kind of an egregious organization the WHO is. First they let millions of people consume sugar alternatives for years, if not decades. Then they release a report saying those alternatives may lead to premature deaths. At this point, I feel like saying, F** it. I'm just gonna consume whatever the f** I feel like without ever reading about or listening to anything in the news.

longbrass|2 years ago

Your choice of language is interesting. Regarding the WHO, if they banned artificial sweeteners from the start would you have suppored this unilateral process? "They let" indicates that you beleive the WHO does or should include a degree of power over every-day life.

There exists an International Sweeters Association, that has been against these efforts since it's inception 35 years ago: https://www.sweeteners.org/latest-science-post/the-who-recom...

https://www.sweeteners.org/about-isa/

Which shouldn't be a surprise given the Sugar Association is 80 years old: https://www.sugar.org/about/history/

So sure, consume "whatever the f*: you feel like knowing that either way you will be receiving "sciene based" communications from interested parties supporting that behavior.

zouhair|2 years ago

It is quite sad that even in Hacker News are people lacking basic knowledge on how science works.

Fauntleroy|2 years ago

Were you paying attention to WHO guidelines in the first place?