Health effects of the use of non-sugar sweeteners: a review and meta-analysis
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The issue is only partly about whether non-sugar sweeteners have negative effects. The more important question is whether regular & processed sugars produce an overall worse impact than substitutes consumed at comparable levels, with stratification by consumption level.
E.g., non-sugar sweeteners may have a similar danger profile at both low and high levels of consumption while sugar's negative impacts may be more linear. Or so other balance. In a situation like that, the proper advice to individuals looking to become healthier may vary, especially given that immediate and rapid wholesale change if a person's behavior is not usually possible.
Modern medical consensus is that added sugar should be avoided as much as possible.
I think I just used 1/3 of my recommended limit in my tea.
“How the Sugar Industry Shifted Blame to Fat” (2016)
https://www.nytimes.com/2016/09/13/well/eat/how-the-sugar-in...
The science seems to have been so muddied by PR, is there anyway to get a clear consensus independent if vested interests?
Annecdotally I also find that complex carbs like oats may be modestly better for weight than equivalent processed carbs but more importantly they control hunger more. A bit of shopping around will also find specialty pasta that uses a roughly calorie neutral fiber mixed in with flour for pasta that is high in fiber and has half the calories. This too appears to have a significantly different impact on appetite. (Fibre Gourmet is one such brand, texture of cooked pasta is slightly different)
So calories ~ calories for raw body needs of energy, with correlation varying on particular source pairs, but secondary effects are significantly different. Also general human metabolism is still not fully understood, with significant gaps, and anyone claiming to have "the answer" or a perfect diet are at best incorrect.
As a side note, it is difficult to manage hunger at a reduced calorie diet with only calorie-dense food, which makes adherence to a low calorie diet much harder. On average I have found that less calories dense foods tend to be healthier at the same time that I may eat larger volumes of them and feel more satisfied.
Source: Me, a non expert with annecdotal experience and a reasonable amount of non-expert research for balancing my own nutrition & health.
According to this meta study, the sweeteners do not cause any cancer risk, but in the long term they significantly increase the risk of diabetes and of various cardio-vascular problems, without providing any reduction in obesity.
So they appear to be no better than sugar.
It seems that the best strategy is to satisfy one's craving for sweet things only with naturally sweet fruits and vegetables, raw or cooked, and without making juices out of them.
I have actually given up on using sugar some time ago, because both my grandfather and my father had diabetes at old age, so I do not want to repeat their fate.
Now, after becoming dis-habituated with sugar, all the fruits and also many vegetables like red bell-peppers, carrots or even red onion, feel extremely sweet, unlike during the time when I was frequently eating food with added sugar.
So I no longer crave for sweets, even if I had not expected that this is possible.
If you consider the introduction of non-sugar sweeteners as the beginning of an experiment, you would have to conclude that if there was a major benefit regarding weight loss, it would very clear by now if the experiment was a success.
The right thing to do is simply not crave sweets.
It's just one of many chemicals which is not nearly as risky when not in its chemically pure form.
I guess this is overall good for my health, because I can no longer drink soft drinks or eat most processed foods.
What do you mean by "politicized"?
>Remember that the beneficiaries of those approvals are people who know the most about these chemicals and are motivated to avoid learning more or disclosing what they know.
That's basically the status quo for how every new product gets approved.
The same is true for added sugar, so the sweeteners are not better than sugar.
The glaring problem is that diet sodas are often consumed as part of an unhealthy diet, alongside unhealthy fast food burgers and fries, and that best explains why you'd see the increase in diabetes and cardiovascular issues. Occam's razor.
The study by itself doesn't really prove causality though.
In my mind that is the most interesting unanswered question to help decide whether it's an effective sugar substitute.
I won't be getting rid of my Coke Zero any time soon.
Straws also help. Get reusable metal ones.
I would be drinking it more regularly to avoid caramel colour (possible link to microvascular damage that leads to increased likelihood for atherosclerosis, no citation at hand), but also to be ironic.
I am wondering if the artificial sweetener scene was different in the 1990s versus now. I think we have sucralose and stevia now that we didn’t have before.
Would it take slamming 6 coke zeros in a row on an empty stomach to hit concentrations that would be bad for the previously mentioned species?
I didn't suffer any withdrawals.
However I greatly missed my coffee, so after the year I resumed (sans the energy drinks) and will be having my coffee until the day I die.
Quit alcohol nearly two years ago; that's a habit that can stay gone. Definitely feeling the benefits of ditching even what was a relatively modest consumption.
In a way, diet cokes (Coca Cola No Sugar) are my naughty drinks now - so I can see from this study I should probably limit it somewhat day in-out, and as long as I do it should be ok.
I primarily drink filtered water and filtered Sodastream water for my fluids.
12oz coke zero: 34mg caffeine
12oz brewed coffee: 120-240mg depending on beans and strength
Double shot espresso: 60-180mg
I can easily do 2 12oz brewed or doubles in a day and friends drink much more.
It's very common for people to slippery-slope various drugs, but being a 'raging alcoholic' is incredibly damaging to your health.
I've seen first hand the destructive powers of alcohol, so I may be biased. But I know for a fact that I'm not alone.
(Not sure I even know what a single basket looks like)
* 1965/1983 - Aspartame
* 1976/1991 - Sucralose
* 1879/1884ish - 1960s - Saccharin
Further research eventually proved that saccharin reacted with a compound in rat urine that caused crystals to form in the urine, which 'scraped' the bladder wall, causing injury, increased cell repair, and (therefore) an increased incidence of bladder cancer in rats. The researchers proved that this compound did not exist in human urine and crystals did not form, therefore the increased incidence of cancer should not exist in humans - and analysis of bladder cancer rates for lifelong saccharin users backed-up the new findings.
Still, the damage to saccharin had been done and I think there's only one plant in Europe that still produces it. I'm not sure how large the artificial sweetener market is (it seems to be growing exponentially), but every decade an old sweetener appears to fall out of favour and is replaced by a new one (or is added in combination with others). I'm not sure we're much further ahead than we were in the early 1900s!
There’s no need to blast off into conspiracy space.
If you get a personalized gallon sized mug with a straw filled with diet soda every day to work and are also already morbidly obese, maybe the drink won’t help.
The second statement I’ve seen so many times in Texas :(
I’ve never met an obese person who liked being obese, but I’ve met lots who have a really challenging relationship with food which slowly brought them to the point they’re at now. I’m an addict as well, it’s just not as visible.
I'm convinced this can be changed! I used to love sugary drinks, however after being on keto my brain adjusted and now if I even taste a real coke I'm disgusted by how sweet it is
I would drink at least 48oz per day. I stopped eating things with added sugar. Now a lemonade is too sweet for me. But if I drink 3-4 sodas I’m right back to where I was wanting to drink it all the time.
Can't go into ketosis while eating sugar/starch
The kind of person that'll happily drink a bucket of soda (diet or otherwise) is likely the kind of person that has an unhealthy relationship with food in the first place, with a stomach (appetite?) capable of ingesting a lot of food and liquid. Which is a category morbidly obese people fall under.
If you drink a can of regular Coke every two days, for most people it should be okay.
You might say "I'm hungry", but it's not your rational brain deducing it's time to be hungry. Is an "I'm happy" triggered from the gut any less valid?
Your microbiome is definitely not "you". You can take antibiotics and nuke your entire microbiome, and you'll be mostly fine. Nuke "any other organ in your body" and you're gonna have much bigger problems.
The tenants in an apartment are not the apartment. You're the apartment, you're letting the microbiome stay as tenants as long as they pay their rent (break difficult foods to your advantage). Unruly tenants get thrown out. Of course it takes some effort to evict - this is the craving for particular foods that must be overcome to consciously stop eating those foods.
Your microbiome alters the very taste of foods in your mouth. It was hard for me to stop eating meat and start eating plants because the plants tasted like shit, but after some time sticking with it everything flipped - plants started tasting amazing, meat not so much anymore.
Well, why would you deliberately endure discomfort? That's one of the defining characteristics of our species: Our ability to consciously delay gratification to achieve better long term results.
Notwithstanding how you, or I, define “you”, once that change is made to your microbiome, you won’t find that coke to be very pleasurable.
I don’t think it’s about being less valid, but if you were to find out you were not making decisions for yourself rather someone or something else was controlling your decision making processes, would you make simple changes to take back control?
Of course sugary sodas are a "bad idea".
https://www.statista.com/statistics/505794/cds-per-capita-co...
So, 1 can per every other day is 1/4 the average consumption. It would be strange to call such a consumption level highly unhealthy.
This has two dimensions:
First, I would consider something extremely unhealthy which leads to a reduction of life expectancy which is similar to other extremely unhealthy consumption such as with the opiod epidemic. I haven't of any study which would suggest that a can of soda or juice every other day would inflict a strongly negative health outcome (at least if counter-balanced by other healthy behaviors).
Second, it is strange to use extreme terms for behavior which is already endemic and normal in a population. You would want to use terms such as highly and extreme for instance for those who consume half a gallon or a gallon of soda per day.
With a lot of samples that fulfill that criteria a historic review might be able to identify statistical anomalies towards outcomes (positive or negative) that are common to the matched A and B sides of the set.
I could see an AI administering such a data collection and comparison in an accurate and ethical way; but only the scifi grade strong / true AI.
This isn't a difficult question.
You should attempt to balance pleasure that has long term risks associated with it.
There is value in not deriving pleasure just as there is value in deriving pleasure. In fact, I don't really know what you mean by "value", but I would not be at all surprised if deriving personal pleasure were found to be orthogonal even to own satisfaction overall.
It's hilarious that you brought this up, because based on wikipedia[1], it the trend actually: it was considered safe until it wasn't ...until it was
[1] https://en.wikipedia.org/wiki/Saccharin#Safety_and_health_ef...
My statement is accurate.
> Remember saccharine? It was considered safe until it wasn't.
That's more true of sugar than saccharine.
The concern with cohort studies isn't "noise", it's confounders. eg. people who eat smoked meats tend to eat other unhealthy foods, so they live shorter lives, but smoked foods in and of themselves aren't harmful. Having a bigger sample size does nothing to combat this. You can "control" for confounders, but comes with its own problems. Control for too little variables, and you still get confounding, control for too much, and you run into p-hacking territory.
"Results from prospective cohort studies suggest the possibility of long-term harm in the form of increased risk of obesity, type 2 diabetes, cardiovascular diseases and mortality."
And regarding the short-term weight loss, the confounding factor of reduction in sugar and overall energy intake seems to be the explanation.
The "Concluding Remarks" section of the paper is a good, and very brief, encapsulation of the results.
If I could go back and tell my younger self one thing.. stay away from the coca cola.
Somewhat like how if cars were invented today they'd be deemed insanely dangerous.
If eat a whole orange, the fiber in the orange slows down sugar uptake whereas if I drink juice the sugar hits bloodstream much faster.
And generally Phenylalanaline is better than some of the others. Why? Well because it's one step away from L-DOPA which is one step away from dopamine
Sugar is, like everything except plutonium, fine in moderation. But "in moderation" is not how sugar occurs in many modern diets.
Unsure if that's because they don't want to write 25g of sugar on the "traffic light" label (it's about 1g per 10ml), or they want people to think the packs are bigger in terms of servings.
L-Phenylalanine is first converted to L-Tyrosine, which is then converted to L-DOPA, which is then converted to Dopamine.
However, it's very misleading to reduce the body to basic formulas like this because these pathways from dietary amino acids to neurotransmitters are all regulated within the body at many different stages, so adding a little extra Phenylalanine to a meal isn't going to give you a dopamine boost. You consume a lot of Tyrosine in a standard protein like chicken breast (multiple grams, potentially) and nobody is getting high off of standard protein. The body is very good at regulating these things.
The cars we have today are insanely dangerous.
Cars kill about as many people as guns in the US. That's to say, they are as effective in killing people as the tools made to kill people.
33% of American households own firearms; and there are far, far more firearms owned than cars[1].
Even assuming 100% car ownership, the statement that cars kill people at 33% efficiency of tools whose sole purpose is killing people should give you a pause.
If every firearm owner decided that they were going to step outside and kill someone, millions would be dead.
Deaths resulting from improper operation isn't something you can reasonably compare to using a firearm with lethal intent.
And if every car owner decided they were going to step outside and run over someone, millions will be dead.
Vehicular deaths are written off as deaths resulting from "improper operation" bevause it's profitable to treat them as such. If they did that in aviation, everything would be "pilot error", and we'd be at 1920s level of safety.
Current traffic fatalities are by design. Vehicles are inherently dangerous to operate.
Remarkably, the US treats both gun amd traffic fatalities as unsolvable problems stemming from "improper use" (driver error / crime), which is little more than an excuse to throw hands up in the air and solve the problems (with strong towns approach to urban planning / regulation and addressing social issues that lead to crime, respectively).
Edit: it is 570 kJ = 136 calories.
* until your metabolism adapts to consistent calorie deficit, which causes up to 50% decrease in weight loss
Maintenance Phase had a fascinating episode about calories being significantly more complicated than we expected.
The best one that destroys the woo-y history of calorie (and fat) obsessed health science (or lack of science) is the book “The Case for Keto” by the author who wrote “The Case Against Sugar” and “Good Calorie Bad Calorie”.
CICO, or "calories in, calories out", is obviously real.
If you don't eat food, you will lose weight and eventually starve to death.
A can of Coke doesn’t satiate your, but it’s almost 300 calories with almost no nutritional value, so you’re going to consume more calories than you otherwise would.
(p.s. they say it's 140)
This isn't "crank science". This is just lack of knowledge. High fibre "carbs" have a lower glycemic index. Fats have essentially none, and protein is low.
Food -> glucose -> insulin release -> glycogen update by liver/muscles -> leptin release for satiety
Simultaneously:
lower blood sugar -> ghrelin release -> hunger
This is just the difference between burning gunpowder and charcoal.
But it's a very bad proxy for anything related to weight. Water is 8.8lbs per gallon and yet has 0 calories so you ignore your entire water maintenance cycle in the accounting. It also assumes that every single molecule of calorie-bearing food is metabolized homogeneously in your body which isn't the case. Your digestive system will happily pass unwanted calories without absorption (especially fat) and tends to store extra water along with carbohydrates (4x by weight).
It's a very simplistic idea that is only true in absolutes. It's a restatement of the 2nd law of thermodynamics which applies to literally everything and is so general and vague as to be useless.
If dieting works in controlled environments, the obvious conclusion is that dieting does not work in uncontrolled environment precisely because of the poor food choices, and because we, as humans, tend to discount the amount of calories in small things through out the day, nor do we rigorously measure.
All a "NEAT decrease" is saying is "people are more lethargic when dieting". It would be unsurprising if this were due to crash dieting, but this cannot "negate" a diet. Reduce calories further until the scale starts to move. Or be more active, despite lethargy.
It does not assume that every molecule is metabolized homogenously, nor that your body is perfectly efficient, and not even that everyone's body has the same level of efficiency.
It more or less means "track how many calories you are eating to get a baseline number. If you want to lose weight, decrease that number. If you want to gain weight, increase that number. Continue tracking until you establish a baseline number for whatever weight you wantwhen you have reached it".
Your digestive system generally does NOT "happily pass unwanted calories without absorption". Ingested fat is broken down into long chain fatty acids, which can be stored directly in adipose tissue with no further metabolic changes. If you consume a ton of fats at one time, there flat-out may not be enough bile salts released to emulsify it all down, and/or not enough pancreatic lipase released to turn all of the emulsified fats into fatty acids, and/or not enough time for them all to be absorbed in your small intestine. Statements like that are more or less like saying "Battletoads players will happily smash into barriers on bikes/surfboards/planes/clinger-winger", or "internal combustion engines will happily pass unburned fuel". It's a system in motion with a limited point of insertion (the common bile duct at the beginning of the duodenum), and hopefully long enough to finish the job. The fact that this is not always true just means that the system has been overloaded.
Gluconeogenesis from proteins is such a metabolically expensive process that your body does actually try to avoid that one, but it will if it has to, which is why rabbit starvation is true.
This post is peak overconfidence based on an amazingly shallow depth of knowledge.
So, for example, the protein from eggs vs the protein from oatmeal have different coefficients for the resulting kcals. [2:p25]
Of course, there's individual factors that matter and if you alter the food (cook it) you can also change digestibility and thus available calories. [3]
But I would think, based on how the USDA reference reads, that the disparity in digestibility between carbs and fats is somewhat accounted for?
[1] https://www.ars.usda.gov/ARSUserFiles/80400535/DATA/sr13/sr1...
[2] https://www.ars.usda.gov/ARSUserFiles/80400525/Data/Classics...
E.g. "I'm eating fewer calories but in an unhealthy fashion and am now tired all the time and so I'm more sedentary" sorta things.
Is there a really reliable way of estimating total calories burned in a day that's based on direct individual observation vs averages and such?
Individual metabolism makes a difference here, as does body composition.
Saying 'the science got it all wrong!' while citing pop-sci books from Amazon is a bit ironic.
Or is this just a pithy attack on reading books by journalists who summarizes scientific research?
I’m always open to be shown wrong. Otherwise I don’t really care about defending this specific author. I found his to be the best summary on the subject among multiple books, articles, and studies.
https://pubmed.ncbi.nlm.nih.gov/19246357/
> Results: At 6 months, participants assigned to each diet had lost an average of 6 kg, which represented 7% of their initial weight; they began to regain weight after 12 months. By 2 years, weight loss remained similar in those who were assigned to a diet with 15% protein and those assigned to a diet with 25% protein (3.0 and 3.6 kg, respectively); in those assigned to a diet with 20% fat and those assigned to a diet with 40% fat (3.3 kg for both groups); and in those assigned to a diet with 65% carbohydrates and those assigned to a diet with 35% carbohydrates (2.9 and 3.4 kg, respectively) (P>0.20 for all comparisons). Among the 80% of participants who completed the trial, the average weight loss was 4 kg; 14 to 15% of the participants had a reduction of at least 10% of their initial body weight. Satiety, hunger, satisfaction with the diet, and attendance at group sessions were similar for all diets; attendance was strongly associated with weight loss (0.2 kg per session attended). The diets improved lipid-related risk factors and fasting insulin levels.
This is just one example, there's a lot more (you can start from looking at related studies on the linked page, for example https://pubmed.ncbi.nlm.nih.gov/15181047/). The first big study was already done in 60s and it was never refuted AFAIK: https://www.sciencedirect.com/science/article/abs/pii/002604...
But the findings aren't fashionable or convenient, so people tend to ignore them and cherry-pick any study that has more convenient results with miracle diets.
- "The four diets [1] also allowed for a dose–response test of carbohydrate intake that ranged from 35 to 65% of energy."
A keto diet is "5-10%" carbs, so that's a very significant difference. I doubt you could get into ketosis with a 35% carb diet and they didnt even bother measuring ketosis since there wasn't actually a specific low-carb group.
- "Carbohydrate-rich foods with a low glycemic index were recommended in each diet."
Always good but a recommendation is super difficult to do in practice unless you rigidly sequester carbs youre going to fail. Other keto studies provided the actual food, these people were just given percentages.
Finally the low fat vs high fat not making a difference is actually still in line with Keto diets. The idea is you shouldn't overly worry about fat content. So even if high fat did nothing for weight loss that's not a problem.
[1] The diet groups (note how none are low carb):
- Low-Fat, Average- Protein Group (N = 204) = 65% carbs
- Low-Fat, High-Protein Group (N = 202) = 55% carbs
- High-Fat, Average- Protein Group (N = 204) = 45% carbs
- High-Fat, High-Protein Group (N = 201) = 35% carbs
Meanwhile, in my own anecdotal, completely unscientific personal study, I went to eating one meal a day 6 weeks ago and have lost 10 pounds, despite eating all sorts of stuff you are not supposed to eat (sugar) during that one meal each day.
> Total energy intake (kJ/day)
> Energy intake –569 (low)
It's 569 kJ, which is only 136 Calories.
Drinking 24x cans of diet soda every day isn't going to you there.
decrease volume of calories
I calculate about 2400cal savings, and if CICO is legit, I think that would get them there.
I bet there are some that are bad and some that are good, I'm waiting for more precise results.
In particular, it seems that stevia based sweeteners are rather innocuous or even good (e.g. lowering blood pressure).
As much as you should aspire to be truthful in your life, you should also be truthful in your diet. Eat actual food. Artificial sweeteners are a scam.
Your body detects sugar by the beta cells of the pancreatic islets, causing them to increase the release of insulin into the blood .
Non of the common sugar substitutes do this
Just think about that. Until ten years ago, nobody even knew how sweetness works, yet artificial sweeteners have been in use for 50.
And whats 'actual food' ?
If artificial makes it bad then is stevia fine ?
- Aspartame Glycemic Index 0
- Stevia Glycemic Index 0
- Sucralose Glycemic Index 0
- Allulose Glycemic Index 0
What are you trying to claim here?
Just drink water. Much healthier. Carbonated, if you like. With some lemon or lime juice, maybe.
At this point my main strategy is to minimize number of ingredients (e.g., two ingredient peanut butter) because otherwise it's just too easy to miss something getting slipped in there. It's insane.
Picked up a loaf of bread on sale the other day and, because it wasn't the brand I normally get, I scanned the ingredients. Surprised to find that it contained sucralose.
It wasn't listed as "lite" or similar. Just "regular" bread. With sucralose.
Some of the shelf stable stuff is better than others WRT ingredients, and it's possible to make relatively decent selections. The cheaper stuff tends to be more awash in garbage ingredients.
OTOH, it's also not necessarily the case that the in-store bakery stuff is free of garbage ingredients, to include artificial flavors, etc.
Unsweetened generally still means it. The weasel words I usually see are "no added sugar". The ingredients will then list juice concentrates, stevia, or monkfruit.
If you only drink soda, you've got problems. If you only drink water, you're not having any fun.
It's OK to pick a point somewhere in the middle.
Personally, I’ve avoided all added sugars and sweeteners for a few years now. I used to find apples bland and boring, but now they taste like indulgent candy. The same goes for pretty much all fruit. I can taste sweetness in vegetables that I used to find bitter. Lightly cooked carrots, beets, squash are all deliciously sweet treats. The bottom line is that I get a lot more enjoyment out of “healthy” foods now.
When I’ve recently tried “normal” sweets like cake or soda, they taste sickeningly sweet. However, I imagine that if I drank even a no calorie sweetened drink like Coke Zero “in moderation”, my sweetness scale would recalibrate and I would start gravitating more towards sweeter things, and be less able to sense the sweetness of mildly sweet things.
The same concept applies to other flavor profiles. Salty, umami, starchy, fatty. Eating processed foods even in moderation reduces your enjoyment of whole foods and consequently makes you less likely to eat them.
Moderation might not be fine for you. It seems to work for me.
ymmv, but some (many? most?) people are able to drink a can of diet soda a day and not totally abandon eating vegetables as a result.
I have plenty of fun only drinking water thanks.
That's a very strange thing to say...
It's only in the last two generations that other beverages have supplanted water. Prior to that it was a rare thing.
When I first switched to water only 7 years ago, it was actually hard because I'd had a lifetime of flavor overload, and it takes awhile for your sense of taste to adjust to normality. American food in general is over-salted, and over-flavored. Eating most things there is like a punch in the face after eating normal food again (England has the opposite problem).
Drinking carbonated water with a twist of lime helped a lot, and then after awhile I came to appreciate the subtle nuances between different water types. Tap water in San Francisco has a harsh overtone to it. Tap water in Western Oakland tastes a little muddy. Tap water in Vancouver and Leipzig is actually quite tasty. The best water I've ever had is hands down in the tiny town of Nagasasa in Japan. We actually dumped out all of our water bottles and brought 20 litres of the stuff back with us to Nagoya (where the tap water tastes terrible).
It's only in the last six generations that water has supplanted beer (typically "small beer") as a beverage. Prior to that it was a dangerous thing to drink water unless you lived far out in the countryside.
We also see much more recently that 3rd world countries didn't do this, either. People drank water.
Today the Czech Republic is the country with the highest beer consumption per capita, at 140 liters per person per year. Germany clocks in at 99, and the US is at 72. In the late middle ages, the average in Britain was 300 liters per person per year.
In 1830, Americans over the age of 15 consumed more than 31 liters of pure alcohol per year. If that was all in 7% beer, it corresponds to 1.2 liters of strong beer every day. Probably quite a bit was also in whiskey, which was cheaper than milk back then.
Sure, you can do it, the British Navy did it for centuries, but "can" isn't "should".