“I’ve never seen a skinny person drink Diet Coke,” Donald Trump tweeted in 2012. “This stuff just doesn’t work,” he explained. “Makes you hungry.”
The World Health Organization now seems to agree. This week it released new guidelines stating that the use of artificial sweeteners “does not provide any long-term benefits for reducing body fat in adults or children.” It also warns that there may be “potential adverse effects” from long-term use.
That doesn’t mean sugar is back on the menu. The WHO says it hopes people will simply “reduce the sweetness of the diet entirely,” but if they have a sweet tooth, they should stick to fruit. Big chance. Instead of giving up cakes and cookies, the main lesson society will take from this latest twist is that the WHO doesn’t know what it’s doing and should be ignored. First he said SARS-CoV-2 was not airborne, then he said it was. He said face masks were useless to the general population in a pandemic, then he said they were essential.
It’s been less than a year since the WHO published a ‘sugar fact sheet’ urging the food industry to ‘replace sugars with sugar-free sweeteners’. These sweeteners are now said to be useless for weight management and can be dangerous.
Around the world, governments are putting pressure on food companies to replace sugar in their products with artificial sweeteners. The UK sugar tax was designed specifically to encourage fizzy drink manufacturers to remove sugar and replace it with sweeteners. Since then, childhood obesity has reached record levels. Now we know why.
Or us? The WHO has been wrong so many times that there is no reason to believe that it has got it right this time. Almost every health claim in the report accompanying the announcement was made with “low certainty” or “very low certainty.” Its recommendation to avoid sweeteners is “based on generally low-certainty evidence.” In a way, this is not WHO’s fault. Nutritional epidemiology is mostly junk science, offering a range of contradictory findings that are wide open to interpretation.
On the face of it, the simple fact that artificial sweeteners contain no calories should make them a better option, but there is an argument – as put forward by Mr Trump – that they increase appetite and make people eat more. Despite all the money poured into public health research, none of these hypotheses have been fully proven or disproved. After decades of work, this area of research still appears to be in its infancy.
This wouldn’t matter so much if public policy wasn’t based on the shifting sands of quack science. If the latest WHO guidelines are correct, sugar taxes designed to encourage drink manufacturers to replace sugar with sweeteners are a waste of time and possibly even a fatal mistake.
In recent years there have been fears about fat, sugar, carbohydrates, “ultra-processed food” and now sweeteners. Science seems to change with time. To paraphrase Donald Trump, I’m calling for a total and complete shutdown of nutritional epidemiology until someone figures out what’s going on.
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