Don’t use sugar substitutes for weight loss, World Health Organization advises | Hacker News Reader

Don’t use sugar substitutes for weight loss, World Health Organization advises

cnn.com

74 pointsbluedino132 comments

>The global health body said a systematic review of the available evidence had suggested that use of non-sugar sweeteners, or NSS, “does not confer any long-term benefit in reducing body fat in adults or children.”

As someone who used artificial sugars exclusively as part of a low carb diet to lose 40 pounds, this just seems like an insane statement to make no?

Unless the WHO no longer believes calories consumed matters at all, replacing sugar with a 0 calorie substitute literally leads to less calories. Obviously if someone just eats more to compensate there's no net gain, but that's pretty much the same as someone who eats 20 apples a day just because they heard they're healthy. That obviously wouldn't mean apples are bad for you.

It seems like the average consumer of diet sweeteners is already likely to be overweight, diabetic, or have other ailments. This article seems highly sensationalized. For the average person, the risk of sugar impacting blood glucose levels seems far riskier than any side effect of a NSS

As a former twitter entertainer once said, "I have never seen a thin person drinking Diet Coke."

I suppose we could do a nation-wide experiment by insisting that the sugar water vendors use only NSS for a year; but that would probably result in the overthrow of the government.

> As a former twitter entertainer once said, "I have never seen a thin person drinking Diet Coke."

There's a lot he hasn't seen in this world. Doesn't mean those things don't happen.

Yeah, and also not even an insightful joke. I mean, isn't Taylor Swift, notable thin pretty human, a famous Diet Coke fan? That's just the first person who comes to mind. Also half the people I know, as well.

That tweet doesn't reflect my experience at all actually, in Europe at least. I know it's an anecdote but I know many fit people that drink frequently Diet Coke or Coke Zero. Is this a US thing?

Coke Zero is much more common as an Everyman drink in Europe apparently, perhaps because of less sugar insensitivity.

In the USA a large size combo meal with a diet coke coming in at 1500+ calories is a meme based in reality.

The fattest person I ever worked with used to drink 4-8 litres of diet coke a day. When I met him again two years later, his weight was normal. Asked how he did it, he just stopped drinking the diet coke.

NNSs trigger the same insulin/fat storage mechanism as sugar, but they arent absorbed, and stay on the blood longer, leading to insulin resistance.

Please point us to some science about this, because of that is true, it’s a pretty big deal.

It's anecdata but I've seen similar - however, it could also be explained by "not taking weight loss seriously if all you do is switch to gallons of diet drink".

And for lots of sodas, caffeine plays, too. It's hard to factor out the various issues that could also be present.

There's lots. Here's one that tested sugar+sweetener, note the decrease in insulin clearance when sweeteners are consumed, vs just sugar:

sucralose ingestion caused 1) a greater incremental increase in peak plasma glucose concentrations (4.2 ± 0.2 vs. 4.8 ± 0.3 mmol/L; P = 0.03), 2) a 20 ± 8% greater incremental increase in insulin area under the curve (AUC) (P < 0.03), 3) a 22 ± 7% greater peak insulin secretion rate (P < 0.02), 4) a 7 ± 4% decrease in insulin clearance (P = 0.04), and 5) a 23 ± 20% decrease in SI (P = 0.01).

https://diabetesjournals.org/care/article/36/9/2530/37872/Su...

Also interested to see if there's any proof of this. I know, anecdotally as an obese man, that whether I cut out diet soda or not doesn't seem to make a difference. Maybe I'm not doing it for long enough?

Are you drinking 4-8 litres a day?

Nowhere near that much.

Good. The dose makes the poison.

"Obviously if someone just eats more to compensate there's no net gain"

Words like "obviously" and "just" are papering over a complicated system called metabolism. Nothing is really "just obvious" in human body, which is a result of a billion years of chaotic evolution.

If artificial sugars mess with an average person's feelings of satiety or kill useful gut microbiome, you can't expect them to help an average person to lose weight.

Things like hunger cravings matter for most people when it comes to weight regulation. You might be one of the few exceptions.

Yes. To add, cravings regulated by hormones.. also related to set point.. also related to ozempic

> Obviously if someone just eats more to compensate there's no net gain

I remember a study that showed people who consumed NSS would end-up on their own accord, eating additionally the same amount of calories as they were "avoiding" in their beverages. Ie. 2 cans of soda roughly 350cal, 2 cans diet soda -> eat another 350cal that day without actually planning on it. I think the hypothesized reason is that many of these 0-cal sweeteners still cause a release of insulin which then drops your blood sugar, which then makes you crave carbs more. I personally try to consume sweetners with no insulin effect for this reason (eg. Stevia) whenever I do use one.

FWIW I have a similar gut reaction to this headline. How can there be completely no benefit to not adding 30-60g of sugar to my bloodstream every day? If the sweetners are combined with a controlled diet, I would still think they have benefits. I don't feel my blood pressure rise or my mood shift when I have a little NSS, which is the opposite of consuming straight sugar for me, I can feel it.

> people who consumed NSS would end-up on their own accord, eating additionally

(Note: this comment is not disagreeing with the parent)

In my opinion, studies like these (and especially the pop "science" articles that package them into clickbait) are flawed because:

1. They summarize and basically take a mean across an entire population (see quote above for an example), which means a wide spectrum of behavior patterns are being reduced to "people do xxxxx" which is obviously not universally true. Some people will do something, and others won't. This study assumes you're not in control enough or smart enough to NOT do that unproductive behavior when trying to lose weight. I know it's a cliché that everyone assumes they're smarter than normal people, but, surely some are, right?

2. The "People will just xxxxxx" line -- that basically crosses right into psychology, which... some people would say is the least objective 'science.'

I mean, people can go right ahead and convince themselves that switching to literal sugar will be a positive effect on the body. I'll just keep drinking diet soda, which has also eliminated tooth decay as a serious concern in my life since I switched.

You already hit on it. Insulin is the fat storage hormone. It triggers your fat cells to expand by absorbing sugars from the blood. But NNSs aren't absorbed by fat cells, so they stay in your blood longer, keeping your liver working longer, pumping out insulin. This results in diminishing insulin response over time.

I’ve heard this theory before, but have never seen any actual science done. If you have a pointer to any, I would love to see it!

Here's one that tested sugar+sweetener, note the decrease in insulin clearance when sweeteners are consumed, vs just sugar:

https://diabetesjournals.org/care/article/36/9/2530/37872/Su...

Thank you!

The report mentions one of the effects of NSS is lower caloric intake.

What people may not realize is your body is quite "efficient" at running at various caloric amounts, and ±569 kJ/day (135 calories) may not do much.

Especially if there are other side effects of consuming "sweetener" like wanting to eat a tiny bit more (the opposite of using mouthwash, for example, which makes you want to eat nothing more).

> What people may not realize is your body is quite "efficient" at running at various caloric amounts, and ±569 kJ/day (135 calories) may not do much.

Source? I'm very much in the camp that diet has a huge impact on one's ability to control their eating, but I've never seen anything that suggests that calories in calories out doesn't apply (outside of extremes, like genuine starvation).

Calories in = calories out, but 135 calories is not much (that's what, a 30 minute slow walk for an average American)?

So if you drop your intake by 135 calories you may just not walk as much and not even really notice it. Or your body may slow down metabolism a tiny bit, etc.

Yeah but then again the average american walks ~3000 step a day, which is about 30min.

To add on to what bombcar said: I don't think the implication is CICO doesn't apply.

In my experience (and also studies) change in calorie intake is correlated with change in activity i.e.: when you eat more you naturally move more. Not just exercising and walking but also jittering and cleaning that little bit harder and moving that little bit faster. Or the opposite, saving a little bit of energy.

Instead of moving your whole head to look at something - just a glance and so on.

CICO is still valid but the body adjusts beyond what we can _easily_ measure. It's a lot more complicated but the above is one simple example how it adjusts.

Exactly. You have to combine a caloric drop with an intentional increase in activity and even then it can take awhile for the changes to start to add up to be noticeable.

Calories in calories out always applies. But calories out is a moving target and is influenced by calories in.

So you are saying dieting does not work? Reducing calories is not the path to weight loss?

I am saying that the data in the report measures such a small amount (apparently) that it is hard to draw useful conclusions.

I.e., as with many metareports, it's kinda worthless, it seems.

Calories not important. Type of calories important. Fibre contains calories, but they are locked up in a hard chemical shell that your body cannot crack, and therefore is unaffected by it. So, 200 calories of regular carbs are far more fattening than 200 calories of fibre carbs.

Edit: When I said that the body is unaffected by it, I was referring to the fact that fibre does no trigger the same cascading chemical reaction that other carbs do. No amount of fibre will cause an insulin spike and increased fat storage.

The types of foods (and NNSs) we consume, and the chemical affects they have, are more important than the amount we consume.

The reduced availability of food energy from fibre is already accounted for in at least Canada's food labeling rules: https://inspection.canada.ca/food-labels/labelling/industry/...

Energy value of dietary fibre

A value of 2 Cal (8 kJ) per gram should be used for the dietary fibre portion of the fibre source.

A value of less than 2 Cal (8 kJ) per gram may be used for the dietary fibre content if a specific value is available for the fibre source.

Energy value of bran

The energy value of the fibre portion of wheat bran is 0.6 Cal (2.5 kJ) / g and the wheat bran itself has an energy value of 2.4 Cal (10 kJ) / g.

Yes, but it is not only the difference in available energy that is important. Fibre, although it is a sugar, does not trigger the same insulin response that other sugars (and NNSs) do.

This is largely incorrect, and also not what the person you're replying too is saying. Calorie numbers in food are just a weighted sum of the grams of carbs, fats, and proteins in the food. Each of those groups are assigned a fixed weight based on an estimate of how many usable calories are in a gram of each.

The commenter above is talking about how we often ignore the adaptability of the body, and that if you suddenly cut caloric intake by say 300 a day, the body will surprisingly quickly adapt by lowering metabolic rate to compensate. This can be done through the simple modulation of hormones and may also involve the shedding of metabolically expensive tissue, like muscle.

I thought nutrition labels already didn't count the calories in fiber that you can't absorb.

It's complicated. Reducing calorie intake is absolutely a path to weight loss, but we tend to ignore the adaptability of the body. If you suddenly reduce your caloric intake, the body thinks it's entering into a time of scarcity and will lower its metabolic rate through hormone modulation and by shedding muscle.

This is one reason why people struggle so much with dieting. They lose lot's of weight at first, but then plateau when the body adapts. When they get discouraged and fall off the diet, they put the weight back on quickly because they now are burning less calories than when they started.

The most effective way of losing weight long term is likely some combination of a slight caloric deficit paired with resistance training (to discourage the body from shedding metabolically expensive tissue) and short bouts of reverse dieting . (ie. slight deficit for 3 weeks, then 1 week of a slight surplus, etc.)

> the opposite of using mouthwash, for example, which makes you want to eat nothing more

.. sorry to be stupid for a second. Is this due to the taste? Or is there a known side effect of some types of mouthwash that inhibit hunger?

I've never noticed anything, hence the question. I'd eat right after with no issue basically, but i don't because it's bad for your teeth to my understanding.

I don't know if it happens to everyone, or if it is just suggestion from normally being done before bed, etc, but the "post mouthwash mouth" makes me not want to eat again, maybe just because I'd have to brush/wash again.

Or it could be that it "cleans" the palate so you're not "tasting" any sugars/food anymore so you go out of "it is eat time" mode.

I am the opposite. For some reason, I want to eat immediately after using mouthwash, but maybe that is because I always want what I cannot have.

People who drink sodas drink way more than 135kcal per day of sugary ones. One can is more than that

The report is "technically correct" and also completely idiotic from a "putting the diet into practice" perspective.

Attia's book 'Longevity' had a great point on this. Studies have found that artificial sweetener wasn't associated with weight loss, higher a1c, etc. What they don't tell you is those people most likely to use a lot of artificial sweeteners are probably overweight and prediabetic, and have over-eating issues beyond just what they're using to sweeten their drinks.

Caloric scale was invented in the 19th century to measure the energy of fuels in a furnace.

Human body is not a furnace. Human body is a complex chain of cascading chemical reactions. When you eat sugar, an instruction is sent to the liver to produce Insulin in the blood. Insulin is the fat storage hormone, it signals to fat cells that they should absorb sugars from the blood stream.

Mountains of research show that, just as sweeteners trigger a sugar-like chemical reaction in your mouth, they also trigger that same reaction in your liver.

> As someone who used artificial sugars exclusively as part of a low carb diet to lose 40 pounds, this just seems like an insane statement to make no?

i don't mean to sound too negative but i'm no longer impressed by "dropped X pounds" statements having done that and more several times. The only success criteria that impresses me now is keeping it off for 5+ years. If the WHO says "systematic review of the available evidence" against "long-term use of sugar substitutes" it's probably worth paying attention to. Since you haven't even specified your timeline, we have no idea if it qualifies as long-term use or not.

I've completely eliminated sugar from my diet. People are genuinely confused on how I do it. (the answer: just don't eat it.) But honestly, your sense of sweetness adjusts to it. Things with sugar in it are foul, as in I can't even eat them (for example, A1 steak sauce or spaghetti sauce).

The other thing that the article doesn't mention is that some of the alternative sweeteners are terrible for your gut biome, and an unhealthy gut biome is already linked to obesity.

From my understanding the evidence of gut biome modification is weak, and would require a large volume consumption. Some NSS will cause temporary stomach upset if it’s your first few times consuming them. But I don’t think this has any long term impacts on gut health. Some NSS are healthy for your oral micro biome (erythritol for sure).

Use alternatives sugars while drinking kombucha? Balance it out?

Probably best to just skip them altogether.

There are studies undergoing probiotics. And some say that most probiotic bacteria don't survive the stomach acids.

If you want a healthy gut bacteria, better to just eat good foods and slowly build it over time.

You must mean added sugar, right? Or do you really eat no fruits, nuts, etc?

You must mean simple sugar, right? Or do you really eat no saccharides?

We've bred fruit to be much sweeter than they used to be.

Personally I dislike a lot of them because they're simply too sweet

https://www.smh.com.au/national/zoo-won-t-panda-to-taste-say...

Sure, but virtually all vegetables also have sugar, and I doubt the OP is eating a diet completely devoid of fruits, nuts, and veggies.

I eat a lot of veggies and some nuts. Vegetables and fruit have a lot of starch in them, which slows down the rate your body absorbs the sugar. I rarely eat fruit, most things are too sweet and disgusting.

It takes a bit of work, but it is possible to start by removing things with sweetener (for example, it is possible to find ketchup that has no added sugar but they often have some other sweetener, you want stuff that is very simple).

Example ketchup: Organic Tomato Concentrate, Organic Balsamic Vinegar (Organic White Wine Vinegar, Organic Grape Must), Organic Distilled Vinegar, Salt, Less Than 2% Of: Organic Onion Powder, Organic Garlic Powder, Organic Spices

Normal ketchup: Tomato Concentrate From Red Ripe Tomatoes, Distilled Vinegar, High Fructose Corn Syrup, Corn Syrup, Salt, Spice, Onion Powder, Natural Flavoring.

Other things like unsweetened ice tea, etc, can help, too.

The best way to avoid eating ketchup with added sugar is to replace all usages of ketchup with mayonnaise.

the jar of hellman's in my fridge has sugar on the label.

You can make your own mayo in 5 minutes.

Well, if we're making stuff, you can also easily make your own ketchup.

There is a brand that has no added sugar that I believe the poster up thread is mentioning based upon the ingredients. It's ok, but honestly tastes a little like just thick tomato sauce, could be a little more fermented/more vinegar, but it's a fine substitute for HFCS based ketchups.

[1] https://www.primalkitchen.com/products/organic-unsweetened-s...

Yep, that's the one. I've not eaten it myself so I can't comment on "how it goes" as I mostly just try to avoid sauces like ketchup in general when possible.

A tablespoon of mayonnaise is 90 calories.

A tablespoon of the most HFCS sweetened ketchup is 20 calories.

It may be a win on taste but I'm not sure it's a win on calorie reduction. I do love some mayonnaise fries, tho.

But if we go one level deeper, fat does fill you up much better than simple carbs like HFCS. In fact, HFCS will create more appetite (more than even plain sugar) down the road which at the end will make you eat more - and probably even of the same kind. Therefore, it's not very clear to me it's a win in calorie reduction either.

> but they often have some other sweetener

I actually fell for this trap while looking for no added sugar or sugar alternatives specifically. The products are advertised as "No added sugar", meanwhile Stevia! Infuriating.

Heinz has a no added sugar product that adds stevia, and a no HFCS product that uses sugar. None that just reduces sweetness as far as I know.

I've also then seen the stevia-sweetened products advertised as "No added sugar and no artificial sweeteners", which is infuriating when searching for unsweetened (or under-sweetened) products.

Yep, because it's technically natural! Hate it.

I only buy ketchup with supernatural sweeteners!

What I really want is food with less sugar. Call it a harm reduction approach.

A gram of sugar isn’t as bad as 20g, but it’s really hard to find just less sweet products. They all use artificial sweeteners to make it as sweet tasting or more.

Why is it so hard to find a ginger ale with only 5g of sugar? Or ketchup with 1/10th the sugar? It’s easy to find low sodium products.

Speaking of low sodium, I also wish more foods would mix potassium salt in with table salt. It’s not as “salty” but still improves the flavor and balances out the lack of potassium in Western diet.

I suspect food labelling laws - the term "diet" probably can't be used if it contains any sugar or whatever.

I'm seeing more "low sugar" options pop up here and there, but even then you have to ride the damn ingredients because sometimes it's "low sugar" on an item that normally has no sweetener at all, or it is being compared to some hard-to-find version that apparently is pure sugar.

Primal Kitchen makes products like this. They have a ketchup with no sweeteners.

https://www.primalkitchen.com/products/organic-unsweetened-k...

I’ve stopped eating sugar, and several weeks later, had an IPA. it tasted sweet, which confused me because those always tasted very bitter to me.

> your sense of sweetness adjusts to it

Speaking of this, what has always been puzzling to me is that the US bakery has so much sugar in it, to the point that even the smell of the bakery screams too much sweetness. In contrast, European and Hong Kong/Taiwan bakeries use much less sugar, or at least their cakes taste so.

Because it tastes good.

It tastes good with cheaper ingredients, too.

You can find "European" bread in the USA if you want it, but it's often not the cheapest.

That's too blanked. It tastes _sweet_ and you're _used_ to sweetness in bread.

I love and eat a lot of candy of all types, but I don't want my actual food to taste sweet since I'm not used to it. Because of that sugar in bread doesn't taste good to me, just sweet.

When used to that level or a level slightly below it.

That's the point of the thread. We really don't need that much sugar to get good taste. The level of sugar in a cake made by, say Safe Way, hurts my throat.

It tastes good because it's a drug and you're addicted *

I tend to bake my own stuff. I can't stand all the sugar in most grocery/bakery stuff here (US). People have asked what kind of cake I like so they can buy one for my birthday, but it's kind of a dick move to be like "I only like homemade cakes".

I find Mainland Chinese cake to be incredibly sweet, way too sweet for me, and I don't think this is just a mainland baker phenomena. Sponge cake with whip cream can hardly be healthy for you.

In many parts of Asia they instead use sugar in other things, like meat dishes. Thailand for instance.

I did the step down approach. Reducing my sugar by an unnoticeable amount each day, until I was down to nothing.

I did the same with foods containing sweeteners. Now, I find the taste of any sweeteners absolutely revolting, nasty chemical flavour. Hard to understand how I ever liked them.

Agreed - aspartame tastes like corroded metal smells.

"your sense of sweetness adjusts to it."

Similar for salt for people on low sodium diets.

Sodium is harder to avoid than sugar, it is in everything.

Eh, it's more prevalent than sugar, but also has more reduced sodium options due to some common medical restrictions. I would equate a low sodium diet with a no added sugar diet - there are many sources of natural sodium as well as natural sugars.

This is probably impossible but also inadvisable since you likely can't eat any fruits or vegetable.

Same here. I was ordered to keep away from sugar for medical reasons for a few months. The most interesting part of that experience was noticing how my taste changed. So much so that I didn't really get back into sugar when I was allowed to do so. I can't stand the taste of classical sweets anymore. And most softdrinks simply taste weird. I am a bit of an outsider now, snce I decline almost every offer for a piece of cake for coffee. And I totally stopped sweetening coffee and tea. Something I couldn't even have imagined before I went on this journey.

you can't quit sugar, fruits contains lot of sugar

what you wanted to say perhaps was: "i quit added sugar from my diet", that makes more sense

sugar is not the problem

While you may not quit sugar entirely, you can certainly choose to not eat any fruits, at all.

You can eat very little sugar (as in, voluntarily avoid foods that contain it) and I don't mean "added sugar" foods).

And "sugar is not the problem"? It's a completely meaningless statement without referencing quantities.

> you can't quit sugar, fruits contains lot of sugar

You don't necessarily have to eat fruits, most modern fruits are water and sugar with very little health benefits

You can get all you need from veggies in term of vitamins and fibers anyways

Well, it depends, many fruits are good for your health, apples for example, they contain interesting phytonutrients that help protect against prostate cancer

I had a similar experience, I remember when I had completely eliminated sugar things like Reese's cups were foul. Everything in them tasted overly sweetened.

> Things with sugar in it are foul, as in I can't even eat them

Same experience here, even most modern fruits are disgustingly sweet

Once you get out of the addiction is extremely easy not to eat/drink sweets, you don't even need willpower

Direct link: "Health effects of the use of non-sugar sweeteners: a systematic review and meta-analysis" https://www.who.int/publications/i/item/9789240046429

My understanding is that Stevia does not negatively impact glucose levels, unlike most/all other sugar substitutes. But the WHO seems to be lumping it together with other, very different sugar alternatives. Is there compelling evidence to think that Stevia has a negative impact on health or weight control?

Stevia (and many of these substitutes) are full of erythritol, which is recently in the news as questionable [0].

Some of them even market themselves as things like 'Monk Fruit'... but erythritol is the first ingredient [1].

[0] https://www.cnn.com/2023/02/27/health/zero-calorie-sweetener...

[1] https://www.amazon.com/Natural-Sweetener-Erythritol-Sugar-Fr...

You can buy monk fruit sugar without erythritol. The addition is to make it seem more like sugar from a touch standpoint.

You can find it, but you literally have to look at every single label to find it and probably buy it online only. I was in a grocery store not too long ago and every single 'monk fruit' sugar they sold, had it in there. As a filler, it is everywhere.

Stevia is not full of erythritol. They are two distinct chemicals. The stevia packets you might put into your coffee, different story. You can read the ingredient label to understand more

Play on words there. Find me a 'stevia' solution without erythritol in it that I can buy off Amazon (this is the first result that comes up for me) [0]. Sure, doesn't have erythritol in it, but it has Dextrose, which is just corn sugar. We're back at square zero.

My whole point is that you have to look closely at the labels for everything sugar related at this point. All these companies are false advertising and it is a pathetic joke.

[0] https://www.amazon.com/Raw-Sugar-Substitute-Sugar-Free-Glute...

Zevia sodas.

The link you gave literally says “stevia blended with other sweeteners” as the first thing on the front of the label. Many wouldn’t call that false advertising.

Why do you feel the need to purchase and use powdered added sweetener products in your cooking? Can you live without them, since your requirements are so exacting (no sweetener besides stevia, no added sugar)? There are entire libraries of paleo and whole 30 cookbooks that are very good

> Zevia sodas.

I'm not asking for products with the stuff in there, I'm asking for the raw product. Interesting that company has Disney copyright at the bottom, oh, I see... marketing.

> “stevia blended with other sweeteners”

In small letters, of course. I'd argue that most people don't look past the headline of 'STEVIA IN THE RAW'.

> Why do you feel the need to purchase and use powdered added sweetener products in your cooking?

I personally don't add it, but the partner likes it. When I started to investigate what they were adding (mostly because it gives me a massive amount of flatulence), I found a whole lot of "truth in advertising" failure. We've since stopped and I've become a more aware of the reality of this stuff.

>I'm asking for the raw product.

You can't have stevia powder without some sort of filler/carrier. Undiluted stevia extract is too sweet to be usefully measurable in the typical kitchen. These makers aren't trying to be nefarious.

You can get SweetLeaf which uses inulin (fiber) instead of dextrose https://www.amazon.com/SweetLeaf-Natural-Stevia-Sweetener-70...

You can also get stevia in liquid form which is just in water, and there are a few different brands https://www.amazon.com/s?k=stevia+drops&crid=3TEZDE5EKSQZ1&s...

Here's a couple 100% pure Stevia leaf extract products I found with a quick search on Amazon... https://www.amazon.com/Artificial-Sweetener-Servings-BSL-BSw... https://www.amazon.com/Stevia-Select-Powder-Organic-Leaf-Per... I know of a couple others, too. I always check labels very carefully.

My monk fruit drink (super coffee) doesn't have Eyrthritol (just some Stevia), but it does have 200mg of caffeine.

They say it is monk fruit, but how can you be sure that it is only monk fruit? That's the problem with this packaging.

You mean: how can I be sure they aren't lying? The packaging lists ingredients, I guess you are asking if they are leaving any ingredients out and are not being called out on it by anyone?

> I guess you are asking if they are leaving any ingredients out and are not being called out on it by anyone?

yes, how do you know?

living in Vietnam for 4 years... i really became a lot more sensitive to food safety, which is non-existent there.

i think we take it for granted a lot in the US because we've been conditioned to accept that we have enforced government regulations.

if you read things like KitchenConfidential [0], you start to realize that even if the food is safe... preparation might not be [1].

[0] https://www.reddit.com/r/KitchenConfidential/

[1] https://www.reddit.com/r/KitchenConfidential/comments/10my22...

Since the pandemic, food companies have cranked up the prices of anything that might be useful for someone wanting to avoid sugar. For example, pre-pandemic I could buy a box of low-carb cereal for $4. Now they're all in the $9 dollar and above range. Drink mixes that were a bit over $1 pre-pandemic are now double that at WalMart. I'd get a 12-pack of Coke Zero pre-pandemic for $3.50 to $4. Now it's $8.

If none of this is helpful, there are people throwing a lot of money down the drain.

> unlike most/all other sugar substitutes

There are millions of type 1 diabetics who meticulously monitor their blood glucose levels that would disagree with this.

There may be some Pavlovian response to artificial sweeteners and insulin secretion (which would be blunted in T1 diabetics) but it's incredibly minor compared to actual carbohydrates.

I think recommendations like this fail to recognize “what’s the alternative?” For many, artificial sweeteners make it possible to lose weight, something notoriously difficult. Without them, the alternative is to just maintain an unhealthy weight or even gain. So the WHO really should be asking itself “do we recommend against artificial sweeteners, even though it could increase obesity?”

At the risk of sounding smugly, weaning oneself off sugar and trying to cultivate a different palate.

Both cravings for sugar and tolerance for it are somewhat conditioned by your lifestyle. People used to drinking sweetened coffee proclaim black coffee to be intolerably bitter. From my POV (never sweetening any beverages), sweetened coffee is intolerably sweet and does not taste like coffee anymore.

Congratulations. Want a cookie?

(yes, that's a joke)

Unironically, I sometimes chew on hard cheese etc. These are my equivalents of cookies.

Just a reminder - health and nutritional studies are hard to do and are often incomplete, bought-off, or non-reproducible, and the resulting meta-analysis will only amplify these problems.

Industry / sugar addicts will keep working hard to find sugar alternatives instead of facing the ultimate known alternative: not adding sugar or sugar alternatives to anything, enjoying the sweet things as nature intended, with its whole fiber and macronutrients. The palate evolves in such a way that eating a simple orange (not just the juice) will feel extremely pleasant.

I know this is controversial but just faced this reality myself in the past and I have a much better relationship with food nowadays - stopped being obese many years ago as well and my overall health took a turn for the better.

Just wondering if there’s some lobbying by sugar companies involved here…

Almost certainly. Maybe not in the meta-analysis but for individual studies, absolutely.

My understanding is that the overall body of research suggests that artificial sweeteners don't cause additional calorie consumption. Given that is true (and leaving aside the much-studied question of other health risks from artificial sweeteners), it seems impossible that replacing some free sugars with NSS would not be beneficial for someone trying to increase calorie deficit and lose weight.

Think it's one of these things where the expected effect size is small and the measured output is multicausal, so observational studies simply won't be powerful enough to observe any real impact.

“NSS are not essential dietary factors and have no nutritional value. People should reduce the sweetness of the diet altogether, starting early in life, to improve their health.” The classic public health advice: "Be More Virtuous." Correct, but not always maximally practical.

One of the problems with sugar is just how sweet everything is. My take is this is a direct result of sodas like coke and pepsi. They set the sweetness bar and then everything rose to it. People became desensitized to sweetness by drinking sodas and then everything needed to up sweet to even taste a little sweet in comparison. I stopped drinking these a while ago and my sweetness tolerance dropped. Now when I make recipes I will use sugar (or honey or whatever natural sweetener called for) by only use 2/3 or 1/2 what it calls for it. Otherwise everything just comes out way too sweet.

Using artificial sweeteners just makes it the desensitivity worse in my opinion. Better to use real sugar but far less of it. Bonus is that you'll be able to taste more of the other flavors in the food and drinks.

I've tried to crawl through the underlying article - it basically sounds like non-sugar sweeteners have similar outcomes to consuming sugar... which is crazy. I can't find anything in the article - is there any theory about the mechanism? How NSS could cause diabetes? The way sugar causes diabetes is well-understood, I can't imagine it applies to other sweeteners.

Correct me if I'm wrong, but aren't there other ways that diabetes is caused with bad diet, aside from eating a lot of sugar straight? I imagine artificial sweeteners could have an effect of not significantly changing one's diet enough or compensating in other ways.

I'm sure people who put the effort in other areas of their diet with NSS, will see results. But people who see NSS as a cheatcode to continue their habits might not see results.

Framing NSS as a way to not change habits and continue to enjoy various treats might obfuscate the mechanisms for losing weight and cause weight loss to not occur.

Quite a few pathways to diabetes other than eating sugar. https://www.niddk.nih.gov/health-information/diabetes/overvi...

To the bad diet issue, diabetes is triggered by excess of carbohydrates hence the Association was sugar but sugar is not the only form of carbohydrate that causes insulin spikes and subsequent insulin resistance. Basically any cereal (aka grain) can spike the blood sugar to the point of causing diabetes. White rice, white flour lead the pack but as I've discovered with my CGM, any starchy food causes unacceptably high glucose spikes which leaves me eating nothing but non-starchy vegetables and meat.

from what i vaguely recall, a body starts releasing insulin when it expects incoming sugar because if it waits until the sugar hits the bloodstream, it has to dump a bunch at once, which is a strain, so it uses environmental cues like the taste (or even smell?) of something sweet. if you keep tricking your body by tasting something sweet, have it start to release insulin, and then have that insulin go unused, it may start to ignore that signal.

This seems like it would be pretty easy to test, but I can’t find anybody who has actually done it.

1. NSS users are still addicted to sweets and probably other junk foods. Whatever lunch option you are pairing a diet coke with is probably still not great.

2. A lot of people who try to cut sugar end up getting blind sided by carbs and starches, which become sugar during digestion. See above.

3. There are a lot of common staple items that are still sugarfied despite being marketed differently. How many people out there still think breakfast cereal is good for them? That yogurt advertising its antibiotic and other vitamins? There's a reason you have to turn the package around to see the sugar content.

> Don’t use sugar substitutes if you are trying to lose weight, according to a new guideline from the World Health Organization.

Is weight loss the main reason for using artificial sweeteners? I thought avoiding blood sugar spikes and crashes was at least as important, and also that the by-products of fructose metabolism weren't great.

I keep seeing "very low to low certainty evidence" - what does this mean? I read it as "there is an indicator of this, but it is so low signal as to potentially be noise.

If that is the case, it seems "it slightly maybe helps but doesn't seem to do much at all".

Why is this on the front page of CNN? Super misleading.

Read this one as “the sugar lobby has bought control of the WHO”

The easiest way to find out is to follow the money and find out who (no pun intended) funded the study.

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