The United Nations has commissioned a report on non-nutritional sweeteners as a tool for public health control and a new frontier on the war against obesity and non-communicable disease. With science backing up sugar substitutes providing structure and sweetness, like inulin and stevia, are we overlooking a huge opportunity to make positive change?

The recent report World Health Organisation report is designed to help guide public policy makers in drafting legislation and promote public health objectives, especially when replacing traditional sugars with non-sugar sweetener alternatives (NSS) –identified as the greatest challenge facing health organisations in the near future.

The WHO report, a literature review based on much of the existing body of stevia research, was based on the evidence of 283 randomised trials, which demonstrated that the removal of sugar could lead to sustained weight loss, amongst other health benefits. A meta-analysis of 45 studies found that daily sugar intake was reduced by 38.4 gram on average, resulting in improved health outcomes.

Participants examined in these studies were drawn from a variety of nations – including countries with high obesity levels such as the United States, Mexico and the United Kingdom. Those who had higher levels of NSS consumption (and so less sugar consumption as a result), had “lower bodyweight and lower BMI as a result”. The positive effects of stevia on the reduction of dental cavities was also noted, with two studies demonstrating that the decreased consumption of sugars (replaced by stevia), led to better oral outcomes and fewer cavities overall.

The report did not recommend stevia as a promotional tool for public health measures, as a result of the WHO finding little confidence in much of the existing research discussed within. This is partially due to the volume and the diversity of the studies included (which

contained research on the effects of NSS on BMI, dental health, foetal development and growth in young adults). This mixed approach to analysis, coupled with some methodological questions surrounding the studies themselves – the report cites that “most of these trials provided NSS or free sugars-containing foods and beverages in addition to existing diets and therefore did not directly measure the effects of replacing free sugars with NSS.” – suggests that the scope of WHO research into stevia was seeking to establish the validity of NSS as full time alternative to sugar, and not to directly identify the health benefit of the plant.

As a result, it is difficult to say whether the WHO’s reluctance to recommend NSS as a key pillar of public health is due to a lack of confidence, or simply because it is not a ‘one-size-fits-all’ solution to the existing problem. Stevia itself is not a new product, and has more than 15 years fully integrated and formulated as a central part of our understanding of modern healthy sweetener systems.

Based in a thorough review of available research, it is evident that the experience of sweetness can be totally re designed and turned into a healthy, low-sugar one – and this can be done by embracing stevia . As an example, there is evidence that compounds like inulin fiber, can have a beneficial effect on our digestive system, by stimulating the growth of healthy bacteria in the human intestine (1,2) , and consumption of stevia can provide significant benefits in terms of high pressure and blood glucose levels in people with Type 2 diabetes. These findings are well documented, in reliable and prestigious medical journals – with research on the effects of the pancreatic beta cell function is enhanced characterized and published in Nature (3) .

The issue that we face is that the generalisation of NSS (such as that made by the WHO in their report) may waste the opportunity to redesign the experience of sweetness from a health point of view. This may stimulate black/white analysis of different compounds which benefit may come from the synergistic effect between them when replacing sugar.

On top of the direct health benefits offered by stevia,  we are aware that we are also on a planet that is in the grip of the climate crisis. The report did not examine the outstanding sustainability offered by stevia, and the need for widespread adoption of higher-yield, lower-acreage crops and environmentally friendly processing systems – an area in which stevia (and SWT in particular) is particularly notable.

These benefits are tangible – in terms of sweetness equivalence per crop surface, stevia figures are remarkable. In 2022, the total surface of planting of Sugar Beet, Sugar Cane and Corn in the US was 5 million Acres, producing a total of equivalent 15.7 MM tons of sugar. This is roughly the size of the state of New Jersey. This total of 5 MM acres has a yearly requirement of 23.298 MM Cubic Meters of water – almost 15% of Lake Tahoe. This surface could be replaced by 0.15 MM acres of stevia (considering stevia sweetness equivalence and crop yield), with a water consumption of just 4.4% of the water used by caloric sweeteners, resulting in an overall 91% water footprint reduction from field-to-table.  Examining the CO² footprint sees a  reduction of  around 70% when comparing sugar cane and stevia at their equivalent sweetness powers and yields per hectare (4,5), making stevia an obvious candidate in the push for carbon neutral production.

While the expertise and methodology of the World Health Organisation is unimpeachable, and it is clear that the report on the inclusion of NSS as a public health strategy is well sourced and researched, existing reports and studies make it difficult to agree that the report on NSS represents an examination of the health benefits of stevia when compared to free sugars – and as such does a disservice to the genuine alternative to the unsustainable diet that is currently causing severe damage to global health. Couple this to the environemntal benefits of decreased pollution, water usage and carbon output, stevia seems the obvious candidate to push the NSS revolution forwards.

References

• Meyer D, Stasse-Wolthuis M. The bifidogenic effect of inulin and oligofructose and its consequences for gut health. Eur J Clin Nutr 2009;63(11):1277-89.

• Roberfroid M, Gibson GR, Hoyles L et al. Prebiotic effects: metabolic and health benefits. Br J Nutr 2010;104(Suppl. 2):S1-S63.

• Philippaert, K. et al. Steviol glycosides enhance pancreatic beta-cell function and taste sensation by potentiation of TRPM5 channel activity.Nat. Commun. 8, 14733 doi: 10.1038/ncomms14733 (2017).

• British Sugar Company: http:/www.silverspoon.co.uk/home/aboutus/carbon-footprint, Feb 2008.

• Ashwell M. Stevia, Nature’s Zero- Calorie Ssustainable Sweetener: A New Player in the Fight Against Obesity. Nutrition Today. 2015; 50(3): 129-134. Doi: 10.1097/NT.0000000000000094.

Can we cite this? This would refute part of the issues raised by WHO

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