Pre-school children should not be given drinks laden with sugar or artificial sweeteners, experts have said.

Younger children – typically those under the age of five – were already advised not to consume sugary drinks.

Now experts advising government have said they should not be given “drinks sweetened with sugar or NSS (non-sugar sweeteners)”.

Academics said that limiting intake of sweetened drinks in early childhood means that children become accustomed to drinking unsweetened drinks.

But for older children sweeteners “may help reduce sugar intake”, experts said.

The British government’s Scientific Advisory Committee on Nutrition (SACN) also said that younger children should be given “unsweetened food (not sweetened with either sugar or NSS)”.

Low or no calorie sweeteners are used instead of sugar to sweeten some foods and drinks.

These substances are found in products such as drinks, desserts and ready meals and cakes.

Sweeteners approved for use in Britain include acesulfame K, aspartame, erythritol, saccharin, sorbitol, steviol glycosides, sucralose and xylitol.

Some squash drinks, which are popular with children, contain sweeteners such as sucralose and acesulfame K.

Scientific evidence has linked sugar consumption to a range of health conditions including obesity and type 2 diabetes.

Because of the ability of artificial and natural sweeteners to impart a sweet taste without calories, some have argued they can help to prevent people becoming overweight or obese

But global health leaders from the World Health Organisation (WHO) said in 2023 that people should avoid NSS as a tool for weight control.

The latest SACN update is in response to this report.

Treat with caution

Experts on the committee, which advises government on nutrition and related health matters, said some of the evidence assessed by the WHO about sweeteners and weight loss should be “treated with caution”.

It said the evidence linking NSS to non-communicable diseases is “concerning” but should also be “treated with caution”.

The evidence on the impact of NSS on tooth decay is “poor”, the committee added.

The SACN said it agrees with the WHO that a reduction in free sugars, alongside “other positive changes to diet”, is likely to be beneficial to health overall.

It added: “In relation to the use of NSS to reduce free sugars intake, SACN concludes that the evidence indicates that there may be some value in using NSS to help reduce weight gain in the short to medium term but it is not essential and is not the only option.”

The committee said it is “concerned about the gap in data on British population exposure to NSS”.

And it said there is “currently insufficient evidence to carry out a full risk assessment of the evidence on NSS and health.”

Nonetheless, the committee made “precautionary” recommendations that younger children should not have drinks sweetened with sugar or NSS, and they should only be given unsweetened food.

But the group of experts say that for older children “swapping sugars for NSS may help reduce sugar intake from foods and drinks (and so reduce energy intake), at least in the short term – the long-term goal is to limit both sugar and NSS intake”.

Commenting on the recommendations, Naveed Sattar, professor of cardiometabolic medicine at the University of Glasgow, said: “I think this is a very balanced statement.

“SACN have accepted that the best quality evidence available (ie randomised trials) show that non-sugar sweeteners (NSS) lower weight albeit modestly as compared to taking sugar rich drinks and that other types of evidence which suggest some harm from NSS are unreliable.

“I fully agree and would rather people take low calorie drinks with artificial sweeteners every time than sugar rich drinks both for weight and dental benefits and potentially other gains.

“However, SACN also correctly points out that until we have more evidence in the future on benefits and safety of NSS, it would be best to limit the intake of all such sweetened (including NSS) drinks in early childhood so that children become accustomed to drinking unsweetened drinks, preferably water.”

Milk and water

Dr Hilda Mulrooney, reader in nutrition and health at London Metropolitan University, added: “Recommendations were already – and have been for several years – that ideally young children should not drink squash – milk or water are the best options.

“Sugar sweetened squash is not recommended due to the sugar content but even sweetened with NSS, it enhances preferences for sweet tastes in children which can be hard to overcome.”

“We welcome SACN’s advice on the consumption of non-sugar sweeteners and their call for further research,” Professor Robin May, chief scientific adviser for the Britain’s Food Standards Agency (FSA), said.

“We strongly support SACN’s call for industry to make data on the quantity of these sweeteners in their ingredients publicly available to provide better information on how much people are consuming and to help inform our assessments of these ingredients.” – dpa