It pours down liters of soft drink. In three years, sales of soft drinks in Norway increased from 50 liters per person in 2019 to 75 liters in 2021. Soft drinks have no calories and the Norwegian authorities have recommended artificial sweeteners for people who want to lose weight. But now the World Health Organization is coming up with new guidelines. The message is simple; Products with artificial sweeteners do not help to prevent obesity. More than half of all adults in Europe are overweight. Photo: Pixabay Increased risk of disease There are new studies that form the basis of the advice from the WHO. They not only say that artificial sweeteners do not help with obesity in the long term, but also that they have a connection with increased weight. Although the studies they rely on do not necessarily have definite answers, the report also warns that people who use artificial sweeteners have an increased risk of type 2 diabetes, cardiovascular disease and increased mortality in adults. These are artificial/intense sweeteners Photo: news Intense sweeteners (artificial sweeteners) The intense sweeteners have been given this name because they are a hundred to several thousand times sweeter than sugar. Therefore, much smaller amounts of the intense sweeteners are needed to give the same degree of sweetness as sugar. Examples of intense sweeteners are: Aspartame, acesulfame K, sucralose, cyclamate, saccharin and steviol glycoside (stevia). Since the intense sweeteners do not add energy (calories) to the food, they will provide a significantly lower calorie intake compared to food with added sugar. These sweeteners are therefore often used in “soft drinks” and other “light products”. The intense sweeteners are often called artificial sweeteners. Sugar alcohols Sugar alcohols are about as sweet as sugar, or they may have a slightly lower sweetness. Examples of sugar alcohols are: Maltitol syrup, lactitol and xylitol. These substances provide slightly less energy (calories) than sugar, but are not “energy-free”. They are often used in chewing gum and lozenges. In larger quantities, they can cause “air in the stomach” and some digestive problems. Approval and regulation of sweeteners The use of sweeteners is regulated by the regulations on food additives (HOD, 2011). The regulations state which additives are permitted, in which foods they can be added and in what quantities they can be used. Pepsi Max has the added sweetener Aspartame. Photo: Terje Pedersen / Terje Pedersen Not in line with Norwegian advice In the report Prevention, investigation and treatment of overweight and obesity in adults, the Norwegian Directorate of Health gives the following advice: “Water with and without carbonated water, coffee and tea without milk, cream or sugar, as well as artificial sweetened soda/juice does not contain energy and can be drunk freely. On Helsenorge.no it says: “Replace soft drinks and other sugary drinks with water, coffee and tea, possibly sugar-free soft drinks and drinks.” It is advice that the World Health Organization is now completely ignoring. In the recently published report, they state that replacing sugar with artificial sweeteners does not help control weight over time. The WHO is also clear that the total amount of sweeteners in food should be reduced, starting from a young age, in order to improve health. The recommendation from Francesco Branca, Director of Nutrition and Food Safety at WHO, is clear. – We need to reduce the intake of added sugar in the diet and rather fill the sugar need through natural sugar, such as in fruit. Almost 30 percent of children between seven and nine years old in Europe are either overweight or suffering from obesity, according to the World Health Organization (WHO). Photo: BENIS ARAPOVIC / SHOCK.CO.BA Disagreement among experts As recently as 2018, the Norwegian Institute of Public Health (FHI) believed that artificial sweeteners were safe. Trine Husøy, who is an expert on artificial sweeteners at FHI, says she thinks that the WHO comes to a strong conclusion in its new assessment of artificial sweeteners. NEW ADVICE: Trine Husøy also works for the EU body EFSA to look at new recommended maximum doses of 15 different artificial sweeteners. – They have chosen to come up with a strong conclusion on the basis of relatively weak scientific evidence. She believes they have emphasized population studies which are not suitable for saying anything about the causal relationship. That is, whether the sweeteners cause effects such as weight loss, or whether overweight people start using more light products. The short-term experiments also have weaknesses, and do not give a clear answer as to whether people lose weight in the short term. Different types of research give different answers. WHO’s new recommendations to drop artificial sweeteners are based on population studies where people are followed over a long period of time with questionnaires. While shorter controlled experiments with the distribution of food and drink show that people can lose weight by replacing sugar with sugar-free alternatives. People in controlled experiments who were given sugar-free products instead of sugar-containing products for three months or less clearly lost weight on average. Those who participated in experiments that lasted from 6-18 months did not lose weight. People who were asked to replace sugar products with sugar-free products did not lose weight. Population studies with many years of follow-up showed a connection between obesity and high consumption of artificial sweeteners. – There is no strong evidence that it leads to weight gain, but there is also no strong evidence that it leads to weight loss in the long term, says Trine Husøy. Do the studies that show a short-term weight loss rule out that it can lead to long-term weight gain? – No, the included studies cannot give a clear answer to this, but the controlled studies show a slight weight loss. The WHO says the recommendations to ditch artificial sweeteners do not apply to people who already have diabetes. The Norwegian Directorate of Health’s recommendations on drinking artificially sweetened beverages are now being assessed together with the other guidelines in obesity work. – We are currently revising the guidelines for the prevention, investigation and treatment of obesity both for children, young people and adults, and all new research will be important to look at in this work, says divisional director Linda Granlund.
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Artificial, sugar-free sweeteners such as aspartame, saccharin do not help with overweight and obesity – news Trøndelag
