Overview

This guideline provides evidence-informed guidance on the use of non-sugar sweeteners to reduce the risk of unhealthy weight gain and diet-related noncommunicable diseases in adults and children. The guidance in this guideline is not based on toxicological assessments of the safety of individual non-sugar sweeteners and is therefore not intended to update or replace guidance on safe or maximal levels of intake established by the Joint Food and Agriculture Organization of the United Nations (FAO)/WHO Expert Committee on Food Additives (JECFA) or other authoritative bodies.

This guideline is intended for a wide audience involved in the development, design and implementation of policies and programmes in nutrition and public health. This guideline includes a recommendation on the use of non-sugar sweeteners which can be used by policy-makers and programme managers to address non-sugar sweetener use in their populations through a range of policy actions and public health interventions.

The guidance in this guideline should be considered in the context of that from other WHO guidelines on healthy diets.

Contents

• Acknowledgements
• Abbreviations
• Executive summary
• Introduction
  • Background
  • Rationale
  • Scope
  • Objective
  • Target audience
• How this guideline was developed
  • Contributors to the development of this guideline
  • Management of conflicts of interest
  • Guideline development process
• Summary of evidence
  • Systematic review characteristics
• Evidence to recommendations
  • Overall certainty in the evidence
  • Balance of desirable and undesirable effects
  • Priority of the problem, and values and preferences
  • Feasibility
  • Acceptability
  • Equity and human rights
  • Resource implications
• Recommendation and supporting information
  • Rationale and remarks
• Uptake of the guideline and future work
  • Dissemination
  • Translation and implementation
  • Monitoring and evaluation
  • Research gaps and future initiatives
  • Updating the guideline
• References
• Annexes
  • Annex 1. Members of the WHO Steering Group
  • Annex 2. Members of the guideline development group (NUGAG Subgroup on Diet and Health)
  • Annex 3. External peer review group
  • Annex 4. Summary and management of declarations of interests
  • Annex 5. Key questions in PICO format (population, intervention, control and outcomes)
  • Annex 6. GRADE evidence profiles
  • Annex 7. Evidence to recommendations table

Suggested citation:

Use of non-sugar sweeteners: WHO guideline. Geneva: World Health Organization; 2023. Licence: CC BY-NC-SA 3.0 IGO.

General disclaimers. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement.

The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.

All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use.