Sorry, stevia: Artificial sweeteners get more bad PR

• The recommendation applied to everyone except those with diabetes.

Why it matters: Artificial sweeteners have grown in popularity, largely because consumers consider them a healthier alternative to sugar.

• However, the WHO advisory adds to growing concern about the potential negative long-term health impacts of sugar substitutes.

The big picture: The WHO recommendation comes on the heels of the agency's review of studies on non-sugar sweeteners, which found no clear consensus on whether they are effective for weight loss or maintenance.

• The review referenced small-study data on the possible connection between sugar substitutes and an increased risk of Type 2 diabetes, cardiovascular disease and death.
• Another article published in February suggested that the keto diet-friendly artificial sweetener erythritol could elevate cardiovascular health risk, but "it's not clear if it's actually the sweeteners causing the increase or another variable that wasn't controlled for," said registered dietitian Alissa Rumsey, author of "Unapologetic Eating."
• That study follows other recent ones on artificial sugar that have raised concerns about glycemic response and heart disease.

An International Sweeteners Association spokesperson told Axios they're "disappointed that the WHO's conclusions are largely based on low certainty evidence from observational studies."

• The group shared a statement in response to the WHO guideline.

Between the lines: Part of the potential issue with sugar substitutes is that they could spur unhealthy eating behaviors.

• Knowingly eating artificially sweetened foods might contribute to the "idea of 'it's better for me so I can eat as much as I want,'" Rumsey said.
• Meanwhile, sugar substitutes aren't as satisfying as the real thing, so "for some people, this leads to them continuing to eat and graze on foods to try to find that feeling of satisfaction."

Zoom in: Unlike sugar, sugar substitutes have no nutritional value, said Francesco Branca, WHO director for nutrition and food safety.

• "People need to consider other ways to reduce free sugars intake, such as consuming food with naturally occurring sugars, like fruit, or unsweetened food and beverages," Branca said.

Be smart: This doesn't mean to necessarily avoid all sweetened foods.

• If you like artificial sweeteners, "it's OK to have them in moderation, alongside an eating pattern that includes a variety of foods," Rumsey said.
• As for real sugar, if it's eaten in moderation as part of a snack that includes protein, fat and fiber, "it can improve the taste of food and offer a helpful boost of energy," Rumsey said.

Go deeper: How sugar substitutes can disrupt metabolic health

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Editor’s note: This story was updated to include a response from the International Sweeteners Association.