Story so far: The World Health Organization (WHO) on May 15 issued new guidelines advising against the use of non-sugar sweeteners (NSS) such as aspartame, saccharin, stevia and other derivatives as “healthy” substitutes for sugar. bottom. In what the WHO calls “conditional” guidelines, non-sugar sweeteners should not be used as a means of achieving weight control or reducing the risk of diet-related non-communicable diseases. suggesting. Since 2015, when the WHO announced that high intake of free sugars was associated with weight gain and obesity, NSS has received more attention and consumers have turned to NSS as an alternative.
What are non-sugar sweeteners?
Non-sugar sweeteners (NSS) are marketed as low- or zero-calorie alternatives to free sugars to help people with diabetes lose weight and control blood sugar. NSS categories reviewed by WHO include acesulfame K, aspartame, advantame, cyclamate, neotame, saccharin, sucralose, stevia, and stevia derivatives.
Aspartame is often used to add sweetness to diet cola, which claims to be “zero sugar, zero calories.” Saccharin is used, for example, to sweeten tea and coffee.
How did WHO conclude the findings?
WHO analyzed a total of 283 studies of NSS intake in adults and children. This included studies comparing no NSS intake or lower doses of NSS, and studies comparing interventions with any type of sugar, placebo, plain water or no intervention. . The paper, Health Effects of Non-Sugar Sweetener Use, authored by Magali Rios-Leyvraz and Jason Montez, did not include studies that simply compared one or more NSSs to each other; It is stated that no comparison has been made with the NSS of Sugar, placebo, plain water, or no intervention. As a result of the study, WHO noted that “increased intake” of NSS was associated with a 76% increased risk of obesity and a 0.14 kg/m2 increase in BMI (Body Mass Index). A final analysis found no evidence of long-term benefits for body fat loss in adults and children. He warned that long-term use of NSS could lead to an increased risk of type 2 diabetes, cardiovascular disease, chronic kidney disease and cancer.
Also read | “Artificial sweeteners should not be used by children and pregnant women.”
Dr. Ambrish Mittal, chairman and director of the Department of Endocrinology and Diabetes at Max Healthcare Hospital, said the evidence for NSS currently studied by the WHO is classified as either moderate, low or very low certainty. Therefore, further research is needed. Medium certainty indicates that WHO has medium confidence in the risk and that the actual impact is likely close to the estimate, but may differ materially. The WHO said the guidelines do not apply to people with diabetes or small prescription doses. Dr. Mittal said the guidelines were issued specifically to “prevent the liberal consumption of products containing artificial sweeteners such as chocolate and cola, with the understanding that consumers may be better off than sweet products.” rice field.
What are your concerns?
According to the 5th National Family Health Survey conducted from 2019 to 2021, 1 in 9 women and 1 in 25 men are obese, which is why India has decided to educate its citizens on NSS. Health experts say necessary measures should be taken. Obese people are more likely to suffer. from diabetes. According to WHO data, there are an estimated 25 million people with prediabetes in India.
Twenty or thirty years ago, Dr. Mittal said he never diagnosed a 20- or 25-year-old with lifestyle-related type 2 diabetes. “This has changed. Today, 1 in 3 young people with type 1 (genetic birth diabetes) has a person under the age of 25 who has diabetes due to lifestyle or diet-related causes.” I am,” he explains. If you’re obese in your teens and diabetic in your 20s, you’re more likely to have a heart attack in your 30s and 40s, he warns.
A food industry insider who adds artificial sweeteners to ice cream sold by the company said, “For us, it’s about developing a product that has no added sugar but is just as sweet and has the same deliciousness. is a priority,” he said. Dr. Mittal points out that artificial sweeteners are known to affect the intestines and bones, causing bloating. “I know young patients who drink at least six cans of Diet Coke a day. This needs to be limited,” he says.
What is WHO’s nutrition advice?
WHO notes that it is important to note that dietary quality (nutritional profile) and quantity are also important in this matrix, as it is difficult to see the role of sweeteners in isolation when it comes to the weight loss studies analyzed. says. “Simply replacing free sugars in the diet with NSS would have little effect on the quality of the overall diet. because it contains,” said the WHO. Instead, it recommends using minimally processed, unsweetened foods and beverages as alternatives. In analyzing the studies, the WHO found that the weight loss in certain subjects was not entirely attributable to switching from sugar to NSS, but was also dependent on reduced meal size and energy intake. bottom.
what happens next?
Experts say the WHO’s conditional guidelines leave little certainty that the positive consequences of implementing the recommendations will outweigh the negative consequences. This means that before the Ministry of Health decides to adopt this ‘conditional’ recommendation as national policy, it will need to initiate discussions among policy makers.
With the help of this guidance, WHO recommends that youth-focused efforts should be made to adjust taste preferences and eating behaviors. He also said that drinking water should be introduced as a preferred alternative to NSS-sweetened beverages and as a means of rehydration.
“This guidance will help physicians direct their patients to reduce and control portions of NSS beverages as food. We now have more confidence in our message.” ,” says Dr. Mittal.
