Are sugar substitutes healthier than the real thing?
economist.com
economist.com
The trouble is that they seem extremely expensive to make and sell, so they're not terribly viable as mass-market sugar replacements, and few people are even aware they exist.
There was a tagatose-based sweetener available called "tagatesse" which was unbelievably good, but it was withdrawn from the market about a decade ago. It resurfaced some time ago, but they changed the formula and it now contains a lot of sucralose...
Anyway, to the point, there's lots of evidence to suggest that tagatose and psicose are actively healthy. They inhibit alpha-glucosidase, stimulate the release of GLP-1, boost glycogen storage in the liver, and are highly fermentable by beneficial gut bacteria. Definitely healthier than sugar.
But it looks like, these days, others are on it. I just checked and both tagatose and psicose (allulose) are available quite cheaply on Amazon.com. This is something rather new...
Makes me want to make sure my body is donated to science as a data point to help settle this.
"The thing you thought was good is bad! The thing you thought was bad is good!". Articles are clicked on, and if you are lucky therein lies more nuance. Often not.
As long as we have the online ad economy, you are going to see articles like this.
"Sugar substitutes are a mixed sachet. They include synthetic concoctions (such as aspartame, saccharin and sucralose) and substances derived from plants, including a family of carbohydrates known as sugar alcohols (such as erythritol, maltitol, sorbitol and xylitol) and stevia."
So they're all completely different substances, with completely different effects on the human body. Surely the article will address that critical piece of info?
"a number of large, long-term observational studies have found the opposite: people with higher consumption of sugar substitutes—some of whom may be using these to replace sugar in their diets—end up putting on more weight than those who consume the least."
Nope. There's barely even an article there, and it just makes a giant sweeping generalization. They might as well have written an article about how food is bad for humans, because they studied several kinds of food (including poisonous mushrooms) and some people got sick.
> Nope. There's barely even an article there, and it just makes a giant sweeping generalization
The article mentions both RCTs that show the benefit, as well as long-term observational studies that show the disadvantages of sugar substitutes, and furthermore clarifies that "proving causality through such observational studies is difficult". That strikes me as fairly nuanced.
It's been shown over and over again that sugar consumption significantly increases obesity, metabolic syndrome, cancer, strokes, cardiovascular disease, chronic inflammation, high blood pressure, bad cholesterol, and probably more things that I'm forgetting. Natural sugar advocates absolutely love to ignore and forget this.
Anything talking about the harms of sugar substitutes needs to always be in relation to the harm definitively known to be caused by equivalent sugar intake. This article does not do that. It only pretends to in a very misleading way.
> In some randomised controlled trials (typically lasting 4-12 weeks) substituting other sweeteners for sugars did admittedly result in lower weight gain. But a number of large, long-term observational studies have found the opposite: people with higher consumption of sugar substitutes—some of whom may be using these to replace sugar in their diets—end up putting on more weight than those who consume the least.
These two statements are orthogonal to each other but they're misleadingly positioned to trick you into thinking otherwise.
Claim A: People who consume sugar substitutes instead of sugar gained less weight than the people who consumed equivalent sugar.
Claim B: People who consume more sugar substitutes in general, with zero relation to equivalent sugar replacement, had more problems than people who consumed less sugar substitutes. But this says absolutely nothing about what health problems would occur if those people had instead consumed sugar equivalent to the greater sugar substitute intake.
People who consume more sugar also experience more health problems than people who consume less sugar. The question is whether consuming sugar substitutes is worse than consuming the equivalent sugar, not whether consuming sugar substitutes is worse than consuming no sweetener at all.
Not to mention the problem of lumping all sugar substitutes together as though biochemistry is a function of flavor perception.
All ingredients should be regulated for public health and safety. That means sugar too, but where are all the articles titled "Are sugars healthier than the substitutes? We share some bitter truths"? Eh? Eh?
What it suggests is that you should avoid processed snacks and choose fruit instead, which seems like good advice, but is slightly tangential.
Then again if such an idea were so widespread, there would be no market for weight loss drugs. People would just fast to desired weight as their willpower would be ironclad.
> people need to realize instead that moderation is a better answer than continuing to be gluttanous over dubiously "better" alternatives.
The article:
> The prudent thing to do is eschew these products altogether.
I find it emptier than the calories you condemn. And of worse character than the people you so impugn upon.
Why? Why not make a more enjoyable world? Why insist in denial? It's so confusing to me that such bitterness and aggressive zeal, such negative energies, go so unchecked. And for what?
I hate to drag an innocent into my countrr-tirade, but Paul Ford writing about mounjaro/glp-1 was a great article for raising this issue that medicine has fixated upon a correction of disease, leaving it adrift at dealing with the questions of what happens if biotechnology can make us better. Not just correct the wrong, but give us that better living through chemistry (etc). It's so tiring that the progressive possibilities we encounter out there always spark such fierce negative clawing us backward condemnations. It's all a hill of supposition, a politics of fear & scaring. https://www.wired.com/story/new-drug-switched-off-appetite-m...
I do think there are amazing human characteristics of restraint & measure, that have to be developed. But I don't necessarily know that projecting that onto our food or how we manage our weight is particularly an important load bearing piece of that human character. I don't think anyone knows that. And it seems like we're back at this constantly repeating juncture: we can improve how enjoyable life is for many, and, "this has made a lot of people very angry and been widely regarded as a bad move." -DA
At that point, forget the glp-1. Eat as much as you want, of whatever you want, and simply purge, like the elite in the Hunger Games. People have to realize these things aren't miracle workers. What are they doing in practice? Making you less hungry. So you might forget to eat breakfast. Or feel full before you finish your plate and stop eating. But again, think about what this is actually doing. Nothing you can't do yourself. Merely trading conscious willpower for unconscious convenience. A hand slapping at yours going for the cookie jar without you needing to realize there is hand there at all and feeling cheated or glum about it.
I just don't understand the cognitive dissonance required to realize this, accept it for what it is as you use the drug, but also not see it for what is and that one can merely do the same things off the drug if they decided to put forth the effort. The hand feeds the mouth. The brain controls the hand. All the levers are in your possession, should you really feel motivated. Taking these drugs, to me, amounts to a sort of tacit acceptance that one lacks any free will entirely. And where does that line in the sand stop? Do we accept this, lean into hedonism to satisfy dopamine cravings, or do we try and have some agency over some of our actions in our waking life? I think we all put a line somewhere in the sand. Just some of us draw that line at a point where weight is more in control. And there is no reason why one couldn't redraw a line for themselves.
I'm here because I just don't see what the problem is, and I think people should be allowed to make choices that work for and help them, and I feel like if we are going to start trying to controls people's lives or make character judgements against them there better be real harms real dangers, real reason.
> can merely do the same things off the drug if they decided to put forth the effort
Except their body is responding totally different, sending them totally different messages. Very unpleasant awful messages, for some people! Some people feel hunger very differently, and their challenge is very different than maybe you or I's.
> Taking these drugs, to me, amounts to a sort of tacit acceptance that one lacks any free will entirely.
I see it as taking control and making a decision. That is freedom to me.
(I see what you are doing as shattering free will and respect, as needlessly forming and broadcasting harmful dangerous rude control over other people.)
> And where does that line in the sand stop? Do we accept this, lean into hedonism to satisfy dopamine cravings, or do we try and have some agency over some of our actions in our waking life?
I'm all for control. But I think this is a ridiculous viewpoint to hold against people, to begrudge them this as the sliding scale, as some core thing which must hold, which you must do by yourself without help or aid. It doesn't add up to me. There's a lot of dangers with lack of agency, we are in strong agreement on that! But to let your fears and uncertainties grip you into making arbitrary lines that have to apply to everyone, making this broad judgement calls, that demonize and that deny people their will? Yeah, count me out.
FUD must always be wielded with caution, most of all with what judgements we let form within ourselves.
We are a couple years into a brand new capability opening up, to our options before us being bigger and wider than they were. To having more control and options than ever. It's just so wild to me how people can look at this, and go, oh no! Bad! Options! Yes, there will be some downsides! That usually seems inevitable. But my opinion is that conservatism usually makes things far worse with their aversions and judgementalisms, with the politics of fear, that takes root and propogates fear, makes it arise out of endless nothingburgers.
This is so so young a possibility, and we should at least have a couple decades of maybe, possibly, let's see, before we descend into harshly judging what is still at this point such a strong unknown. Especially for an unknown that has helped so many take back control over their lives.
You probably heard of aspartame but there are worse things. A chemical byproduct of sucralose known as sucralose-6-acetate has been identified as highly genotoxic, meaning it breaks down DNA and may increase cancer risks. Found in common sucralose-based sweeteners, it causes a "leaky gut" by damaging intestinal walls and poses serious health risks, even at low, allowed consumption levels.
https://www.medicalnewstoday.com/articles/a-chemical-found-i...
Heart Attacks (Erythritol): The sweetener erythritol, common in "keto-friendly" drinks, has been linked to increased blood clotting, potentially doubling the risk of heart attack or stroke.
https://www.aarp.org/health/conditions-treatments/are-artifi...
However, high levels of fructose have been engineered in many formerly natural foods, which is also dangerous (though far less so).
https://www.reddit.com/r/todayilearned/comments/13ecikd/til_...
Sugar-free drinks are increasingly linked to serious health risks, with studies suggesting they are not harmless alternatives. Key concerns include a 20% higher risk of AFib (irregular heartbeat), increased stroke and cardiovascular disease risks, and potential links to type 2 diabetes. They may also trigger digestive issues, gut microbiome disruption, and tooth decay.
The artificial sweeteners may not even do the very thing people choose them for. Contrary to their purpose, some studies show artificial sweeteners may raise type 2 diabetes risk by up to 38%. Other Potential Dangers: Research has linked consumption to metabolic syndrome, kidney disease, nonalcoholic fatty liver disease, and potential gut bacteria disruption. Dental Damage: Acidic components can cause enamel erosion despite the absence of sugar.
Xylitol and Stevia may be exceptions, but they are also more naturally occurring. People sometimes try to use xylitol gum to stave off caries bacteria, but frankly, a diet rich in animal fats (butter etc) can do a lot more for teeth and bones.
Ah, a "seed oil" guy. This is the indication to everyone what level of discourse and scientific fact you're bringing to the table.
In fact, I'll just cite one single bit in your claim-
>Contrary to their purpose, some studies show artificial sweeteners may raise type 2 diabetes risk by up to 38%
This suffers from the same "aha!" nonsense as the garbage submission (and it is garbage). The "study" you are citing was an observational, epidemiological study. And wow, crazy and hard to believe, but it turns out that people with weight problems (and all that comes with that) are more likely to have partaken of "at least one" sugar substitute drink. This is similar to studying people who chew nicotine gum and for obvious reasons finding a higher rate of lung cancer, so then declare that nicotine gum causes lung cancer. It is so staggeringly stupid it belies belief, but it makes for a headline to fool some rubes.
2025: https://www.sciencedirect.com/science/article/pii/S126236362...
2023: https://pmc.ncbi.nlm.nih.gov/articles/PMC10465821/
To address your point: Potential for reverse causality cannot be eliminated; however, many sensitivity analyses were computed to limit this and other potential biases
2023: Clinical review https://pmc.ncbi.nlm.nih.gov/articles/PMC10822749/
multiple studies have shown various side effects associated with the use of these sweeteners. These side effects include gastrointestinal symptoms [9], neurologic [10] and taste perception changes [11], allergic reactions [12], insulin and metabolic effects [13], and cardiovascular effects [14]. In addition, ASs have been shown to affect the gut microbiota that may mediate certain side effects [15]. Most importantly, many researchers have assessed the potential effect of ASs on the cancer risk of people who consume these products [16,17].
and
Human studies performed by Suez et al. evaluated the impact of ASs on the human microbiome. A total of 381 individuals without diabetes who self-reported regular consumption of ASs, as determined by a food frequency questionnaire, were included. The study demonstrated a significant association between the consumption of ASs and the development of central obesity, elevated fasting blood glucose levels, increased hemoglobin A1c levels, impaired glucose tolerance, and elevated alanine aminotransferase levels. In addition, a subgroup analysis was conducted to compare those who consumed higher amounts of ASs with those who did not consume any ASs. The results of this analysis revealed a statistically significant elevation in hemoglobin A1c levels, even after controlling for body mass index.
They outright state this. The first directly says that their higher sugar substitute group had a higher BMI, lower activity, less fibre, and so on.
"To address your point: Potential for reverse causality cannot be eliminated; however, many sensitivity analyses were computed to limit this and other potential biases"
I've actually read the study (given that certain sorts cite it constantly), and do you know what "limited" that bias? Nothing. Literally nothing.
It is a correlation study. People with weight problems are more likely to utilize sugar substitutes. Reversing the causation is the root of an enormous amount of idiot science, though.
And just to be clear, researcher who post this bunk know exactly what they're doing, and usually it is to yield a "more research should be done" conclusion. It's when laymen start building their little notepad.exe listing of everything that supports their nonsense that it becomes a problem.
If you are going to be drinking 6 cans of soda a day, then diet soda is going to be better for you based on all available evidence today. By a large margin.
Drinking zero cans of soda is quite obviously better than either of those options.
Those who tend to indulge in large amounts of these substances typically have other unhealthy eating (and other) habits so good luck figuring out causation here.
I lost 100lbs coming from close to morbid obesity. Diet soda is the single vice I refuse to give up for mental health reasons. Of all the vices (eating, drinking, substances, etc.) I had before, this seems like the least concerning. Some people don't need that mental blowoff valve, but if I'm going to maintain the rest of my healthy habits I've found I require such a thing.
So really, get off the soda. It isn't even a great mental reward. Have a piece of chocolate instead. There are gut health benefits with chocolate.
It’s the thing I prefer. Don’t like chocolate or really other sweet things in general. Even full sugar soda is far too sugary for me, outside of some niche drinks out of Europe.
The available scientific evidence on fake sugars tends to skew towards “fairly safe, but not entirely so” until you get into observational studies as mentioned in the article. The few everyone loves to continually cite that show otherwise are using mouse or rat models with some absurd 10x safe daily ingestion rates to show what amounts to rather mild impacts.
There really is nothing like an ice cold Diet Coke for me after working hard in the back yard in the summer heat. Or something to sip on during horrible corporate meetings.
I’ve also wore a glucose monitor for fun, and it in no way impacts blood sugar levels - one of the leading bro science hot takes. I definitely can see how it can be involved in habits though and trigger mental signals to overindulge in other substances during and after consumption. Having one certainly begets the impulse to have another I need to watch out for.
I did pick up a (black) coffee habit to reduce consumption a bit, but I’m not convinced that’s any healthier.
Dealing with boredom with a shot of anything probably isn't a healthy coping mechanism if we are being honest. Better to train to have the resolve to steel over this sort of thing than to form some Pavlovian dependency.