Low-and No-Calorie Sweeteners Continue to be Safe and Effective Options for Managing ‎Non-Communicable Diseases like Diabetes, Heart Disease and Obesity

WASHINGTON, D.C. (May 15, 2023) – The Calorie Control Council, an international association representing the low-calorie food and beverage industry, responded to the World Health Organization’s (WHO) Final Guideline on the Use of Non-Sugar Sweeteners by reaffirming the health benefits and established safety of low-and-no calorie sweeteners for consumption by all populations, including those living with non-communicable diseases such as obesity and diabetes. The conditional recommendation contained in the Guideline, which states, “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), contradicts the world’s most highly regarded health and regulatory agencies which validate and prove low- and no-calorie sweeteners assist in weight management, reduced calorie and sugar intake, and the management of blood glucose levels.

Recommendations from highly regarded global authorities such as the WHO should not be based primarily on prospective data with “low evidence of certainty” and should meet a threshold higher than “conditional”. Formulating recommendations that are not supported by strong scientific evidence is inappropriate and could unnecessarily deter the public from personal choice and potentially beneficial dietary options. Obesity and other non-communicable diseases are multifactorial conditions, with various approaches and tools available to address them. Consumers want and need safe and effective options and, along with exercise and a balanced diet, low- and no-calorie sweeteners are critical tools that can help consumers achieve their dietary and weight management goals. While we recognize studies evaluating the effects of low- and no-calorie sweeteners vary in design and duration, the consistency of positive associations between beverages containing non-sugar sweeteners, weight management and non-communicable disease risk is noted across the body of evidence, which includes randomized clinical trials, the gold standard of evidence, and raises the level of confidence in these findings.

“A substantial body of scientific evidence shows that low- and no-calorie sweeteners provide effective and safe options to reduce sugar and calorie consumption. The world’s most highly regarded health and regulatory agencies have thoroughly reviewed this evidence and have validated the role of these ingredients. Along with exercise and a healthy diet, low- and no-calorie sweeteners are a critical tool that can help consumers manage body weight and reduce the risk of non-communicable diseases,” said Robert Rankin, President, Calorie Control Council,   

“It is mind-boggling that persons living with diabetes, for whom no-sugar sweeteners can have an especially meaningful ‎role in their compliance with necessary dietary requirements, were conveniently not considered ‎when creating these guidelines.  NUGAG’s insistence on focusing only on prevention of unhealthy ‎weight gain and non-communicable diseases is at the very least, misguided. NUGAG’s decision not to focus on the value of no-sugar sweeteners for persons with diabetes borders on ‎unconscionable. Their doing so dismisses the value and usefulness of NSS for persons living with ‎diabetes and pre-diabetes, which accounts for far in excess of 10% of the global population,” Dr. Keith Ayoob, Scientific Advisor, Calorie Control Council.

“The WHO recommendations are based on evidence that was assessed overall as low certainty. Their recommendations were summated as being conditional and require substantial future discussion.  Weaknesses such as reverse causation may have played a role in the findings, as pre-existing risk factors such as obesity confounded the ability to determine risk of disease development. There were no identified undesirable effects seen with use of NSS. NSS play a role in replacing free sugars to reduce overall calorie intake. I will continue to recommend NSS to my patients as a tool for weight management,” said Dr. Keri Peterson, Medical Advisor to the Calorie Control Council

“The new WHO guidelines advising against using these sweeteners for weight management and reducing disease risk totally miss the point of why people use these ingredients. Non-sugar sweeteners are safe, documented by numerous studies leading to approval by government health agencies around the world. They provide a way for people to enjoy sweetened foods and beverages with less sugar and fewer calories. Extensive research has shown they can help reduce calorie intake and promote weight loss when they replace calories from sugar in food. They also help lower added sugar, a dietary goal in many countries around the globe to reduce disease risk. In addition, they help increase the intake of foods like yogurt, milk, canned fruit and juice, which provide essential nutrients people often fall short of consuming. As a registered dietitian nutritionist I feel confident recommending low calorie and no-calorie sweetened foods and beverages as part of a nutrient-rich, health-promoting meal pattern, ” Neva Cochran, MS, RDN, LD, FAND and Nutrition Communications Consultant. 

Discouraging the use of low- and no-calorie sweeteners is at odds with the health and nutritional profile of half of Americans. Evidence indicates that low- and no-calorie sweeteners do not raise blood glucose or insulin levels and, when ‎used to replace sugar, can help lower carbohydrate intake, which is especially important for those managing pre-diabetes and diabetes. When used as intended, as a replacement for added sugar, low- and no-calorie sweeteners are useful tools for blood glucose management and are a viable sugar reduction strategy. For more information, please click here.


About the Calorie Control Council 
The Calorie Control Council, established in 1966, is an international association representing the low- and reduced-calorie food and beverage industry. Today it represents manufacturers and suppliers of low-, no- and reduced-calorie foods and beverages, including manufacturers and suppliers of more than two dozen different alternative sweeteners, dietary fibers and other low-calorie, dietary ingredients. More at caloriecontrol.org


Robin Applebaum 

[email protected] 

faq2Do you have questions about low-calorie sweeteners? Want to learn more about maintaining a healthy lifestyle? You asked and we listened. Our resident Registered Dietitians answered the most popular questions about low-calorie sweeteners.

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