Something is set to change when the World Health Organization (WHO) issues its recommendations on the use of food sweeteners, later this year. These products are experiencing economic boom times, mainly due to the fact that the children who consume them have tripled in the last 2 decades (data from the United States), following the evidence that associates sugar with overweight, obesity, metabolic disease, and from there to type 2 diabetes and cardiovascular risks.

There are very solid reasons to reduce sugar consumption. That has triggered the sale of food and soft drinks with saccharin, aspartame, stevia, advantamo, or any other artificial sweetener of the dozen available in the catalog. The zero, or zero-zero, soft drinks that substitute sugar for a combination of sweeteners that barely have calories, are living their golden age in Western countries. Maybe, however, things will change in 12 months from now, when the WHO issues its statement.

Adding sweeteners to drinks has become almost an addiction for those who want to avoid sugar

For the moment, the WHO has commissioned a group of scientists a comprehensive review of the 56 investigations that have been made on the effects of sweeteners on health, sometimes compared to sugar, others compared to placebo. And the effects are very modest. It is true that there is a small reduction in weight, of little more than a kilo on average, possibly related to the abandonment of sugar, although it is not even clear that this thinning is stable in the long term. There is also a slight reduction in blood pressure, although only in overweight adults. Sweetener manufacturers have been quick to highlight these effects.

But the essential issues -blood glucose, tooth decay, cancer, liver disease, eating behavior- do not show a significant impact when sugar is replaced by sweeteners. With these factors, it seems unlikely that WHO will recommend the use of these products. The experts, however, point out that more studies are needed before issuing a conclusive opinion.

This does not mean, in any way, that you have to go back to sugar. The recommendation to reduce sugar intake is based on very solid data. What happens is that replacing it with sweeteners, as in zero drinks, does not seem to be a big deal. The best substitute for sugary soft drinks is none other than water.

Serving yourself a glass of water is better than serving any other sugary drink

The result of these investigations is somewhat surprising. If the sweeteners do not have negative effects on health, as it seems, the mere reduction of sugar consumption associated with their use should surely have a clear positive effect. But this is not the case, and this can be due to a variety of factors.

The microbes that live in the intestine, for example, change their relative percentages in response to the diet, and perhaps the sweeteners affect that intestinal flora in a way that compensates for the beneficial effects of calorie reduction. The brain can also contain a key since sweeteners and sugar do not have the same effect on the brain regions that manage pleasure, reward and energy demands.

We will see, at the end of this year, the statement that the WHO will issue. In the meantime, it is better to drink water than any other sugary drink.