The Dead Mother and Her Child

“Deadly Long-Term Consequences” of Sweeteners?

Let’s get right to the point. This point is that it’s always best to stick with the truth. Sometimes it is inconvenient, but it is definitely the best choice. So we’re disappointed in you, WHO. We love you and hated to see you telling a fib this week when you issued a news bulletin, saying that non-sugar sweeteners have “deadly long-term consequences.” Fibs are not good.

Non-sugar sweeteners are surely not a cure for all that ails us. But the systematic review on which WHO’s guidance and then its sensational news brief are based says nothing about “deadly consequences.” Instead the conclusion is:

“While results of randomized controlled trials have generally suggested non-sugar sweeteners may have little impact on glucose metabolism and result in lower body weight when coupled with energy restriction in the short-term, there is no clear consensus on whether non-sugar sweeteners are effective for long-term weight loss or maintenance, or if they are linked to other long-term health effects at intakes within the acceptable daily intake.”

The actual guidance from WHO is quite simple:

“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).”

In other words. No problem here. And also, no guarantee of a net long-term benefit.

Objectivity Is Hard

It seems that objectivity about sweeteners is hard. Feelings are strong about restricting excessive sugar intake. Short-term, randomized studies of sugar intake give WHO confidence that they’re doing the right thing to recommend such restrictions.

But there are similar RCTs to suggest it might be helpful to use non-sugar sweeteners as an alternative to sugar. In this case, WHO concludes that such evidence is not good enough. Nope, that just doesn’t seem right to folks who have bad feelings about non-sugar sweeteners. So WHO says that without long-term data, people should just say no. Then the press office takes it a step further and calls these sweeteners deadly.

Unfortunate Consequences

Accredited Practicing Dietitian Dr. Alan Barclay tells us the unintended consequences of this sensationalism could be unfortunate. “If anyone actually takes these guidelines seriously, the ultimate outcome will be increased sugar consumption.”

This episode brings to mind the misinformation strategy WHO pursues on the subject of nicotine vaping products. The agency denies the benefits of harm reduction with vaping while characterizing it as a deadly hazard. Lots of spin, not a lot of truthfulness.

Really, WHO, we wish you would protect your credibility. Stick to the facts.

Click here and here for samples of uncritical reporting about this advice from WHO. For a more nuanced discussion, click here.

The Dead Mother and Her Child, etching by Edvard Munch / Art Institute Chicago

Post Script: Sometime after we published this article, WHO quietly retracted their headline about “deadly long-term consequences.” Learning from mistakes is always good.

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May 21, 2023

3 Responses to ““Deadly Long-Term Consequences” of Sweeteners?”

  1. May 21, 2023 at 4:22 pm, Jennie Brand-Miller said:

    Once again, we can rely on Ted to call it out and call a spade a spade. I wonder if there is a more democratic way to create recommendations based on the state of evidence and judgement of a larger number of people with appropriate expertise? For example, a panel of 6-10 experts from 60 countries… who vote on recommendations. WHO seems to be lacking broad reach that at present.

  2. May 25, 2023 at 9:56 am, David Sweanor said:

    Thanks for pointing out yet another unethical, unscientific and counterproductive move by WHO. It sure fits the pattern the agency adheres to on alternatives to cigarettes: use misleading fear tactics about less hazardous options without concern for the foreseeable resulting increased use of the deadly ones. We should be able to expect far better science and far greater appreciation of public health ethics from such a group. There is already a concerning lack of trust in public health pronouncements. Being untrustworthy is hardly a way to ameliorate that problem.

    As Peter Sandman has written: “Public health professionals want the public to trust them without being trustworthy – without earning the public’s trust. They don’t see it that way. They have a blind spot when it comes to trustworthiness. I have read countless analyses in which public health professionals try to divine why they aren’t trusted. They rarely even consider the possibility that they aren’t trustworthy.”

  3. May 26, 2023 at 10:20 am, Danielle Greenberg said:

    The main problem here is that WHO is asking the wrong question. We should not expect low calorie sweeteners (LCS) to be Ozempic or any other weight loss drug. So the question of whether LCS lead to weight loss is the wrong question. The question should be do LCS help with reducing caloric intake, and thereby help with weight management. There is evidence that LCS can do this (see Hunt KJ, St Peter JV, Malek AM, Vrana-Diaz C, Marriott BP, Greenberg D. Daily Eating Frequency in US Adults: Associations with Low-Calorie Sweeteners, Body Mass Index, and Nutrient Intake (NHANES 2007-2016). Nutrients. 2020). Ask the right question, get the right answer.