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Low/no calorie sweeteners are safe and playing a crucial role in helping tackle obesity

Statement from ISA on publication of World Health Organization (WHO) guideline on low/no calorie sweeteners

Brussels, 15th July 2022: The International Sweeteners Association (ISA) today responded to the publication of the WHO’s draft guideline on the use of non-sugar sweeteners1.

The ISA points to an overwhelming body of scientific evidence which shows that low/no calorie sweeteners:

  • Are safe and amongst the most thoroughly researched ingredients in the world2;
  • Can help adults and children reduce their calorie intake and be a useful tool to help manage their body weight, when used instead of sugar, and as part of a varied and balanced diet and a healthy lifestyle3-7;
  • Offer people with diabetes an important alternative to sugar as they do not affect blood sugar levels8,9;
  • Do not contribute to tooth decay and their use instead of sugar actually “contributes to the maintenance of tooth mineralisation”8;
  • Are an essential tool in helping food and drink companies reformulate their products10,11, to reduce the amount of sugar and calories they contain.

Commenting on the WHO’s publication, Robert Peterson, Chairman of ISA, said: “Low/no calorie sweeteners are no magic bullet. However, they mean people can enjoy food and drinks that have less sugar, fewer calories while still meeting their taste preferences. The benefit of replacing added sugars with low/no calorie sweeteners in reducing calorie intake and aiding in weight management is supported by evidence reviewed by WHO7, the US Dietary Guideline Advisory Committee of the Dietary Guidelines for Americans, 2020-202512, and numerous published systematic reviews and meta-analyses.3-5 Failing to recognise the role of low/no calorie sweeteners in sugar and energy reduction, and ultimately in weight management is a disservice to public health.”

Mr Peterson continued: “Governments around the world are trying to tackle the serious problem of rising rates of obesity and diabetes. Not to mention dental diseases which are the most prevalent non-communicable diseases (NCDs) globally and one of the public health objectives of sugar reduction as set by WHO in their 2015 guideline on sugars intake for adults and children. It is a pity that the well-established benefit of non-sugar sweeteners use in dental health has not been recognised.

While this guideline does not apply to people living with diabetes, it could mislead those who need to manage their carbohydrate and sugars intake. Health organisations globally recognise that low/no calorie sweeteners can be safely used to replace sugar in the nutritional management of diabetes.

To address the challenge of NCDs, governments have urged food and drink companies to reduce the amount of sugar in their products in support of public health recommendations by WHO and other bodies.Low/no calorie sweeteners have allowed these companies to do that. They have been able to reformulate their products using low/no calorie sweeteners, which contain no, or virtually no calories.

At the same time, low/no calorie sweeteners are amongst the most thoroughly researched ingredients in the world, and have been approved for use by food safety authorities globally. Furthermore, research shows that our intake of them is well below the Acceptable Daily Intake (ADI) for both children and adults.13-20

We look forward to providing feedback on this draft guideline and to continuing to support efforts to improve the understanding of the benefits of low/no calorie sweeteners” Mr Peterson added.

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For media enquiries, please contact the ISA PR agency:

media@sweeteners.org – Phone (24/7): +1 (833) 318-2430

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Please note that the ISA statement is also available in Arabic and Chinese.

  1. https://www.who.int/news-room/articles-detail/online-public-consultation-draft-guideline-on-use-of-non-sugar-sweeteners
  2. Safety of approved low calorie sweeteners repeatedly confirmed by the Joint Food & Agriculture Organization (FAO)/World Health Organization Expert Committee on Food Additives (JEFCA), US Food & Drug Administration (FDA) and the European Food Safety Authority (EFSA)
  3. McGlynn ND, Khan TA, Wang L, et al. Association of Low- and No-Calorie Sweetened Beverages as a Replacement for Sugar-Sweetened Beverages With Body Weight and Cardiometabolic Risk: A Systematic Review and Meta-analysis. JAMA Network Open 2022;5(3):e222092. Extract from publication: “using LNCSBs [low/no calorie sweetened beverages] as an intended substitute for SSBs [sugar-sweetened beverages] was associated with small improvements in body weight and cardiometabolic risk factors without evidence of harm and had a similar direction of benefit as water substitution”.
  4. Rogers PJ and Appleton KM. The effects of low-calorie sweeteners on energy intake and body weight: a systematic review and meta-analyses of sustained intervention studies. Int J Obes 2021; 45(3): 464-478. https://doi.org/10.1038/s41366-020-00704-2. Extract from publication: “The results of this review show that consumption of LCS [low-calorie sweeteners] vs sugar decreases BW [body weight], and that it does so via decreasing daily EI [energy intake].”
  5. Laviada-Molina H H, Molina-Segui F, Pérez-Gaxiola G, et al. Effects of nonnutritive sweeteners on body weight and BMI in diverse clinical contexts: Systematic review and meta-analysis. Obesity Reviews 2020; 21(7): e13020. https://doi.org/10.1111/obr.13020. Extract from publication: “Data suggest that replacing sugar with NNS [nonnutritive sweeteners] leads to weight reduction, particularly in participants with overweight/obesity under an unrestricted diet, information that could be utilized for evidence-based public policy decisions.”
  6. de Ruyter, JC., Olthof, MR., Seidell, JC., et al. A trial of sugar-free or sugar-sweetened beverages and body weight in children. N Engl J Med 2012;367(15):1397–1406. Extract from publication: “replacement of a sugar-containing beverage with a sugar-free beverage significantly reduced weight gain and body fat gain in healthy children”.
  7. World Health Organization, Rios-Leyvraz, Magali & Montez, Jason. (‎2022)‎. Health effects of the use of non-sugar sweeteners: a systematic review and meta-analysis. World Health Organization. https://apps.who.int/iris/handle/10665/353064. License: CC BY-NC-SA 3.0 IGO
  8. EFSA Scientific opinion on the substantiation of health claims related to intense sweeteners. EFSA 2011 Journal 9(6): 2229, and 9(4): 2076. The European Food Safety Authority (EFSA) has concluded that: “Consumption of foods/drinks containing intense sweeteners instead of sugar induces a lower blood glucose rise after their consumption compared to sugar-containing foods/drinks” and that: “Consumption of foods/drinks containing intense sweeteners instead of sugar contributes to the maintenance of tooth mineralization”.
  9. Diabetes UK. The use of low or no calorie sweeteners. Position Statement (Updated December 2018). Available at: https://www.diabetes.org.uk/professionals/position-statements-reports/food-nutrition-lifestyle/use-of-low-or-no-calorie-sweetners Extract from publication: “Replacing free sugars with LNCS [low/no calorie sweeteners] can be a helpful strategy to aid glucose management.”
  10. Gibson S, Ashwell M, Arthur J, et al. What can the food and drink industry do to help achieve the 5% free sugars goal? Perspect Public Health. 2017 Jul;137(4):237-247
  11. Ashwell M, Gibson S, Bellisle F, et al. Expert consensus on low calorie sweeteners: facts, research gaps and suggested actions. Nutr Res Rev. 2020;33(1):145-154. [Epub ahead of print]. Extract from publication: “There is also a need to reconcile policy discrepancies between organisations and reduce regulatory hurdles that impede low-energy product development and reformulation.”
  12. Dietary Guidelines Advisory Committee. 2020. Scientific Report of the 2020 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and the Secretary of Health and Human Services. U.S. Department of Agriculture, Agricultural Research Service, Washington, DC
  13. Martyn D, Darch M, Roberts A, Lee HY, Tian TY, Kaburagi N, Belmar P. Low-/No-Calorie Sweeteners: A Review of Global Intakes. Nutrients 2018; 10(3): 357
  14. Tennant DR. Estimation of exposures to non-nutritive sweeteners from consumption of tabletop sweetener products: a review. Food Additives & Contaminants: Part A 2019; 36(3): 359-365
  15. Tennant DR, Vlachou A.. Potential consumer exposures to low/no calorie sweeteners: a refined assessment based upon market intelligence on use frequency, and consideration of niche applications. Food Additives & Contaminants: Part A 2019; 36(8): 1173-1183
  16. Martínez X, Zapata Y, Pinto V, et al. Intake of Non-Nutritive Sweeteners in Chilean Children after Enforcement of a New Food Labeling Law that Regulates Added Sugar Content in Processed Foods. Nutrients 2020; 12: 1594
  17. Barraj L, Scrafford C, Bi X, Tran N. Intake of low and no-calorie sweeteners (LNCS) by the Brazilian population. Food Additives & Contaminants: Part A. 2021;38(2):181-194 DOI: 10.1080/19440049.2020.1846083
  18. Barraj L, Bi X, Tran N. Screening level intake estimates of low and no-calorie sweeteners in Argentina, Chile, and Peru. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2021 Dec;38(12):1995-2011
  19. Chronic dietary exposure assessment on sweeteners in food consumed by the Chilean population, 2021, Available online: https://www.achipia.gob.cl/wp-content/uploads/2021/06/2021_ACHIPIA_Informe-EED-Cronica-Edulcorantes-MINSAL-ACHIPIA_Nueva-Version_final-con-abstract-English.pdf
  20. Martyn D, Darch M, Floyd S, Ngo K, Fallah S. Low- and no-calorie sweetener intakes in the Brazilian population estimated using added sugar substitution modelling. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2022 Feb;39(2):215-228