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Consumers who opt for “diet” products — such as sugar-free sodas — might not be doing themselves any favors, according to guidelines published by the World Health Organization (WHO) today.

The health authority writes that a wide-ranging review of available evidence suggests “there may be potential undesirable effects from long-term use of [non-sugar sweeteners], such as an increased risk of type 2 diabetes, cardiovascular diseases, and mortality in adults.”

It recommends that people avoid non-sugar sweeteners like aspartame, saccharin, or stevia to lose weight or prevent diet-related diseases such as type 2 diabetes. Instead, they should consider eating foods with naturally occurring sugars, such as fruit, as well as unsweetened foods and drinks.

The WHO said that the recommendation is based on long-term observational studies which found that people who consumed sugar alternatives were at higher risk of obesity, cardiovascular disease and diabetes. However, it also noted that in short-term randomized clinical trials, sweeteners were linked to weight loss when compared with people consuming sugar.

The recommendation came with the caveat that it was based on a low level of certainty. One possible confounding effect could be that people who eat and drink food products that contain sweeteners could be more at risk for obesity or diabetes in the first place and be using them to control their weight gain. However, the WHO noted that studies continued to find a link between non-sugar sweeteners and negative health effects even when controlling for this possibility.

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