Hacker News Reader

Comment by ThrowawayTestr | Hacker News Reader

"The results suggest that, in the short term, NSS use may lead to small reductions in adiposity without any significant impact on cardiometabolic risk. There is suggestion of negative health effects with long-term use, but the evidence is ultimately inconclusive."

I won't be getting rid of my Coke Zero any time soon.

View on HN

Also my conclusion. Aspartame and other sweeteners have been researched to death now and they still can’t tell me they have found anything. While other chemicals in regular use have real and concrete health issues.

It is practically impossible to conduct a long term health study on something like an artificial sweetener. The only way I can think of to accurately remove environmental noise is to collect extensive records on a _large_ population, and then line up A / B sets where the only major difference between the sets (other exposures similar) are the sweeteners.

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.

It's also impossible to do this on almost every other substance we use. I'll focus my energy on avoiding things we know for sure are problematic like refined sugar and get to artificial sweeteners when everything else more important is solved.

Why not just avoid both?

Because humans are not automatons and there is value in deriving pleasure from one's lived experiences?

This isn't a difficult question.

Is diabetes pleasurable? Is having a heart attack at 60 pleasurable?

You should attempt to balance pleasure that has long term risks associated with it.

This ("life is about fun, drink a can of coca cola a day") has been brought up multiple times by multiple different people in this comment section and quite frankly it's one of the more bewildering things I've seen on HN, and I have showdead on.

Never once has not drinking soda or sugary drinks or food ever impacted my life negatively. Takes like the ones you're referring to are completely alien to me.

The amount of flagged and downvoted comments that voice similar sentiment in this thread branch seems curious.

You can live a pleasurable life without eating and drinking unnecessary added sugars. You might even have a higher quality of life by eliminating sources of potential negative health effects.

Note how your answer equally works whether the question is "why not avoid extra sugar?", "why not quit smoking?", "why not abstain from drugs?", "why require consent?", etc.

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.

Upon reflection, I don't even think I share your meaning of "pleasure". Yours appears to be heavily influenced by big corporations's marketing departments. I used to smoke and consume sugar excessively and every time made me feel good, yet I overall better when I don't do those things. There are no ads that show you that, of course.

You honestly think that refined sugars are more problematic than artificial sweeteners?

Yes.

Refined sugars have clearly demonstrated problems. Most artificial sweeteners do not.

You can't really say that when they're only a couple decades into human history. Remember saccharine? It was considered safe until it wasn't.

>Remember saccharine? It was considered safe until it wasn't.

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...

> You can't really say that when they're only a couple decades into human history.

My statement is accurate.

> Remember saccharine? It was considered safe until it wasn't.

That's more true of sugar than saccharine.

100% NSS are better than tons of carbs and sugar loaded food.

Yes, and this is a hill I will die on. Refined sugars are arguably responsible for billions in healthcare expenses, lowered quality of life and lowered life expectancy for millions of people in the US.

Genuine question: How was it determined that smoked or processed meat is bad? Could the same processes be applied to non sugar sweeteners?

Yes, that process is statistical modeling and it can be applied to quantify numerous problems.

>It is practically impossible to conduct a long term health study on something like an artificial sweetener. The only way I can think of to accurately remove environmental noise is to collect extensive records on a _large_ population, and then line up A / B sets where the only major difference between the sets (other exposures similar) are the sweeteners.

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.

If you drink a can every two days, great.

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 :(

Very true. But if they’re morbidly obese as it is, it’s pretty likely they have a brain chemistry which responds very positively to sugary drinks, so without the diet soda it’s possible their health would be even worse.

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.

>they have a brain chemistry which responds very positively to sugary drinks

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

What works for you doesn't work everyone. My wife did keto and still loved her soda afterwards.

That's not keto then.

No true Scotsman could like soda after doing keto!

You can't be in ketosis if you drink coke. Period.

The convo you’re replying to is about taste preferences reverting or not after doing the keto diet. Most caloric restriction diets limit or forbid sugary drinks while you’re on the diet, so it’s no surprise the keto diet is similar in this regard.

I think OP was talking about still enjoying a soda after a sustained ketosis period.

Yeah, this is what I meant. It wasn't a regular thing.

Some questions: did she go low sugar in that period? How many sodas did she drink before she backslid?

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.

> low sugar

Can't go into ketosis while eating sugar/starch

Maybe not keto, but wouldn't eating nothing but potatoes for a month reset anyone's taste buds?

Sweets are habit forming, like cigarettes. If you avoid them for a year, for example on strict keto, it’s hard to go back because the taste is so extreme.

I don't think this works for cigarettes, actually, because even if the taste is extreme the craving is still there. I know people who can't be around certain cigarettes when lit even years after they quit because it's their preferred brand or something.

Agreed. When I was in my early 20s I would drink a 2 liter bottle a day of diet coke. Today I had a fountain drink with my daughter while she was having lunch, I was hoping for iced tea but they only had sodas. I got a Coke Zero, first soda I've had in, geeze, I don't even remember. It was so sweet I had to water it down with half soda water.

Do you have any evidence for the statement that 1 can every two days is OK, but ~7 cans every day is not OK (other than anecdotal)?

I think there's ample evidence supporting the "already obese" part.

Unless I am misunderstanding your point and you're saying there's evidence supporting the negative effects of non-sugar sweeteners for obese people, isn't this a classic case of correlation vs. causation, where observation X is seen as "ample evidence" of causation while it's merely correlated?

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.

Can you show us such evidence?

Here is some evidence: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7014832/

> If you drink a can every two days, great.

If you drink a can of regular Coke every two days, for most people it should be okay.

A can of soft drink every two days seems highly unhealthy to me.

It isn't healthy, but life is about pleasure too. Gotta pick your battles.

What if it wasn’t actually pleasurable, but what you are doing is feeding certain species in your microbiome that control you by telling you it is pleasurable so you continue to feed them at the expense of your own health.

Is your microbiome not "you"? It's as active a participant in your hormone balance as any other organ in your body.

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?

> Is your microbiome not "you"? It's as active a participant in your hormone balance as any other organ in your body.

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.

When my wife and kids are happy, I’m happy. When my microbiome is happy, I’m happy. Certainly when my microbiome is unhappy, I’m unhappy.

If you endure the unhappiness generated against you by your microbiome, you can change it. Eat what you know is good regardless of microbiome happiness, and you'll cultivate a microbiome that is happy when you eat that.

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.

If you starve your microbiome of sugar, then certain bacteria will die or go dormant.

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?

What if you don't actually want to be alive, but your bio-chemistry has been evolved over millennia to make chemical reactions that cause you to fear death, crave reproducing, and strive for a culture of preventing death of your species?

if you don’t want to be alive drinking cokes is pretty inefficient, but it’s a good way to get all kinds of chronic health conditions

That's a conclusion that's pretty much contrary to the best available science.

Color me curious. Can you furnish any links to some health research that vindicates sugary sodas?

Oh sorry, I misunderstood you and thought you were talking about the diet sodas.

Of course sugary sodas are a "bad idea".

What's wrong with a little obesity, tooth decay, acid reflux, or insulin tolerance? The only people who complained to me about those symptoms were quitters. So maybe quitting soda is the REAL culprit, huh.

Would need a proof of that.

To each their own, but the thought of having 2 soft drinks a day is utterly revolting to me.

Sounds desperate to me. I have always intended to live way better than this.

Ehh? That's nowhere near the "highly unhealthy" level. A pack of cigarettes a day... now we're gettin somewhere.

If you look at the statistics you can see that the countries consuming the most softdrinks per capita (US and Mexico) come in around 2 cans per capita per day.

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.

Why would calling 1/4 of extremely unhealthy consumption "highly unhealthy" that strange?

It is just a question of calibration of terms.

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.

I agree to some extent. But it doesn't strike me as strange to use such terms for a behavior which is endemic in a country with a very bad rate of morbid obesity which could well be linked to such behavior.

There's close to an ounce of dissolved refined sugar in a can of soda. Hell, a can of ginger ale has almost 40 grams of sugar in it. Drinking that much sugar at once will spike your blood sugar levels and can potentially set you up for pre-diabetes if you make it a habit.

Insulin tolerance is not that well known in the public sphere. But it's sure a measurable effect, and among the bigger reasons I cut way back on sugar.

I don't think that's a balanced summary of the study.

"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.

Lets add that some of these are really old food additives

* 1965/1983 - Aspartame

* 1976/1991 - Sucralose

* 1879/1884ish - 1960s - Saccharin

I've been reading some old (early 1900s) diabetic recipe books from archive.org and it was a bit of a surprise to see how many recipes used saccharin back then (and almond flour, bone broth, etc.). I remember seeing saccharin tablets everywhere as a youngster, then they all suddenly went away. As it turns out, researchers found a higher incidence of bladder cancer in rats fed a diet of saccharin (20x the expected human dose, I think), which caused the production of saccharin to drop off dramatically. Up until that point, it was cheap, relatively easy to produce and plentiful.

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!

This is so frustrating. Because you know this is the tip of the iceberg.

Nah… this stuff happens, unfortunately.

There’s no need to blast off into conspiracy space.

Probably a high percentage of diabetics, type 1 and 2.

The Sweet 'N Low pink packets in my "sugar" bowl contain saccharin. You can still buy saccharin in tablet form, too (Amazon, of course).

I just wish they'd also avoided the phosphoric acid in it! Might not be full of sugar, but it's still bad for teeth.

Not nursing the drink forever and rinsing your mouth afterwards with water should return the pH to normal relatively quickly, according to my dentist.

Also, chew some xylitol gum after, or just regularly.

Straws also help. Get reusable metal ones.

The local Pepsi bottler has been distributing Crystal Pepsi (!) in our market the last few weeks. I thought I would have never seen the day.

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.

It's a limited revival, enjoy it while stocks lasts. Or, perhaps, build inventory. But do they have the Max sugar free version in Crystal?

Unfortunately not.

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.

From what I've understood, the phosphoric acid is also a problem for the gut flora. With regular daily intake it will apparently kill certain bacterial cultures over time, and with that comes a set of new problems.

Unlikely. Phosphate is ubiquitous in the body. Your metabolism basically runs off phosphate ions. And your stomach is far more acidic than phosphoric acid.

If phosphate ions are present in abnormally high concentrations, could that cause issues for some species of bacteria? AFAIK our phosphate is usually contained within our cells, and I'm definitely not an expert on the digestive process so I'm not sure how phosphate gets absorbed, at what rate, or if any enzymes would mess with it

Phosphate is present in every cell of your body and in extracellular fluid. Your kidneys keep phosphate levels within a very narrow range.

Right, so what happens if the concentration is too high in the intestines? What is the absorption rate compared to the concentration in coke zero?

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?

It won't be too high by the time it hits your intestines. It'll be absorbed and excreted in the urine.

You should get together with the doctor I fired. He doesn't know internal medicine, either.

Sounds like you did them a favor!

I hope he treats himself in his own clinic. >:)

On the same topic, recently learned that erythritol (Swerve) does not contribute at all the plaque as normal sugar/other substitutes do.

If my wife's caffeine withdrawal is any indication, you might want to be more concerned about your amount of caffeine intake rather than the sweeteners.

I just go cold turkey every few months when my caffeine tolerance gets out of hand.

Two decades ago in response to colleagues' worry that I was drinking too much caffeine I quit for a year. All sources of caffeine; espressos, energy drinks, diet cokes.

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.

Unless you're drinking like 6 a day it's nothing compared to regular coffee drinkers:

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.

OK, but that's like saying there's no reason to watch your alcohol intake unless it's on par with a raging alcoholic.

The difference in the health of a person who doesn't take caffeine, and a caffeine addict is much smaller than the difference between a teetotaler and a raging alcoholic.

It's very common for people to slippery-slope various drugs, but being a 'raging alcoholic' is incredibly damaging to your health.

Indeed. There's plenty of benefits to drinking caffeine; studies that talk to the benefits of alcohol consumption tend to be a stretch at best.

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.

Yikes, I had been working with “espresso = 65mg” but now I discover that’s a single, and I drink double. Thanks for the wake up.

(Not sure I even know what a single basket looks like)

Caffeine withdrawal is easy to avoid and not at all dangerous. It's unpleasant, sure.

The way I got past caffiene withdrawl was to control it. I did it over 4 weeks with using caffeine pills. Never got a head ache, each week I just went down 25% until I hit 0%

Yes I always figured if there is something, it's on the order of 10%-20% "bad outcome" vs being a sugar teetotalar. However since I avoid as much sugar as possible and have some splenda in my coffee and coke zero pretty much guilt free.

Your teeth will be affected. I spent a year drinking as much coke as I wanted. The teeth issues that resulted made me never drink the stuff again.

If I could go back and tell my younger self one thing.. stay away from the coca cola.

If I may suggest... you should try to get into tea. There are teas for all tastes including fermented tea, and related beverages like yerba mate, guarana, etc.

Yerba mate puts me in the best mood. I have no idea why. Maybe the MOAIs?

Drink water

What a blessed day! I'll take those odds as well.. not that I haven't so far either way.

Reply on news.ycombinator.com