Because of these health concerns, manufacturers started using non-nutritive sweeteners to sweeten food as well. These sweeteners contain little to no kilojoules and include both artificial sweeteners, such as aspartame, and those that come from natural sources, such as stevia.
From Lollies to Biscuits to Drinks
Using market sales data from around the globe, we looked at the quantity of added sugar and non-nutritive sweeteners sold in packaged foods and drinks from 2007 to 2019.We found per person volumes of non-nutritive sweeteners in drinks is now 36% higher globally. Added sugars in packaged food is 9% higher.
Non-nutritive sweeteners are most commonly added to confectionery. Ice creams and sweet biscuits are the fastest-growing food categories in terms of these sweeteners. The expanding use of added sugars and other sweeteners over the last decade means, overall, our packaged food supply is getting sweeter.
Our analysis shows the amount of added sugar used to sweeten drinks has increased globally. However, this is largely explained by a 50% increase in middle-income countries, such as China and India. Use has decreased in high-income countries, such as Australia and the United States.


Rich and Poor Countries
There is a difference in added sugar and sweetener use between richer and poorer countries. The market for packaged food and beverages in high-income countries has become saturated. To continue to grow, large food and beverage corporations are expanding into middle-income countries.Our findings demonstrate a double standard in the sweetening of the food supply, with manufacturers providing less sweet, “healthier” products in richer countries.

Unexpected Consequences of Control
To reduce the health harms of high added sugar intakes, many governments have acted to curb their use and consumption. Sugar levies, education campaigns, advertising restrictions and labelling are among these measures.But such actions can encourage manufacturers to partially or completely substitute sugar with non-nutritive sweeteners to avoid penalties or cater to evolving population preferences.
Why Is This a Problem
While the harms of consuming too much added sugar are well known, relying on non-nutritive sweeteners as a solution also carries risk. Despite their lack of dietary energy, recent reviews, suggest consuming non-nutritive sweeteners may be linked with type 2 diabetes and heart disease and can disrupt the gut microbiome.Foods that contain sweeteners can receive a “health halo” if they don’t contain sugar, misleading the public and potentially displacing nutritious, whole foods in the diet.

Focus on Nutrition
When making policy to improve public health nutrition, it is important to consider unintended consequences. Rather than focusing on specific nutrients, there is merit in advocating for policy that considers the broader aspects of food, including cultural importance, level of processing and environmental impacts. Such policy should promote nutritious, minimally processed foods.