Artificial Sweeteners May Change Our Gut Bacteria in Dangerous Ways | Hacker News Reader

Artificial Sweeteners May Change Our Gut Bacteria in Dangerous Ways

scientificamerican.com

204 pointsdanielam153 comments

I'm currently trying to kick a Diet Coke habit (my equivalent of smoking), which I think is contributing to several health problems, not the least of which is carrying about 40 pounds more than I should around.

Part of it, which isn't covered by these studies, is how a reliance on diet soda affects your diet overall. It serves as a lubricant, for lack of a better word, for dense starchy carbs and salt. I can wolf down french fries with diet soda, but it's a lot harder with just water, which doesn't cut the salt or grease.

My real warning to cut back came from my mouth. I have an autoimmune problem that causes sores similar to cold sores. My salty, sour, spicy diet aggravates it, and the diet soda enables that diet (and is itself acidic). I'm tired of pain, so I'm cutting back.

Lost five pounds in an instant.

Well done for cutting something out and losing weight to try and improve your health, this is an admirable goal.

However, from your tone I would hazard a guess that the problem is not your diet coke so much as your desire to consume so much that you are choosing diet coke as an optimal lubricant to enable that.

You can't compare a habit like this to smoking imo, which is chemically addictive with a reasonably well understood chemical pathway and requires considerable willpower to stop due to physiological withdrawal symptoms as well as the psychological aspects of addiction.

Maybe you have some underlying problem which is causing your behaviour, because most people do not require very much willpower to not eat when it is uncomfortable to do so without 'lubricating it' optimally with some specific drink. Or maybe I am just misunderstanding and overreacting based on how shocking I find your comment...

Nah, I don't think it's a sign of bad health. I'm in reasonably good health (and if anything underweight), and drinking soda definitely makes eating a lot of greasy food like fries easier/more pleasant than drinking something like water. If I were in the habit of drinking soda regularly, my diet would probably get worse just for that reason.

i have never noticed this and i consider myself to be /disgustingly/ decadent.

reading these kinds of comments makes me feel like a saint

I believe it's the carbonated water that cuts the salt and grease. I used to drink a lot of soda and switched to carbonated water so I understand what you mean by lubricant.

My wife has a similar autoimmune problem. She also drinks 4-5 diet cokes a day. I wonder if there is a connection. There are flora in your mouth too.

I lost 30lbs switching from coke to diet coke and it's stayed off for 22 years so far. I changed nothing else about my diet or behavior. Just cut out sugary drinks of which coke was the 90% of.

I also have a bad Diet Coke habit. Drink cans and cans a day. I hear Elon Musk and Bill Gates also drink copious amounts. I wonder what it is about Diet Coke that's so addictive.

Caffeine and phenylalanine, in addition to the sweetness-without-actual-energy that is likely backfiring to create further sweet-cravings.

(I wouldn't be surprised if research eventually concludes regular Coke is safer than Diet Coke, even given the problems with HFCS. So, if trying to quite Diet Coke, you might 1st want to try substituting regular Coke... which you might find more satiating and thus consume less of, by volume.)

I'm not sure you can describe an essential amino acid as an addictive substance... sure there is a strong desire to consume it, but its closer to things like oxygen, water or any vital thing that keeps you alive.

Caffeine on the other hand has a well understood and documented mechanism of physical dependence, but its considered extremely mild compared to substances traditionally considered addictive (nicotine, alcohol)...

Do people crave phenylalanine beyond the essential levels needed? There's strong hints some do, via both diet sodas and sugar-free gums. And there's a plausible mechanism, given phenylalanine's relation to key neurotransmitters, and its use in treating depression and other neurologic disorders.

(I suppose we could raise the same question about food in general. Obviously food is necessary, but can it ever make sense to talk about a 'food addiction'? Or perhaps more accurately, an 'overeating addiction'? I think it can, in some cases. For someone wondering why they feel 'addicted' to diet soda, the high levels of mood-altering phenylalanine from the aspartame is highly likely to be a factor.)

we are still comparing apples and oranges even with your argument...

I don't have much of a sweet craving. I turn down dessert much of the time, don't like candy generally.

What Diet Coke makes me crave is starches - "crunchy salt" in my wife's parlance. Potato chips, popcorn, crackers, stuff like that.

Yep, there are a couple recent studies showing diet sodas have no weight loss benefit over regular soda.

Well it does, if all else is head steady. But the issue seems to be that nothing is held constant in reality and the missing sugars are made up for with snacks elsewhere.

I'm assuming you're talking about canker sores. I don't know how much help this will be to you, but here it is anyway:

You may have tried these, but I've found the best ways to dull the pain are swishing 50/50 Maalox/Benadryl and using a styptic pencil.

Also, I've found in my case that what helps most to prevent them is keeping my mouth as clean as possible. The two main causes I've identified are illness and physical trauma to the tissue. The worst offender is the crap plaque excrete; it eats away at tissue, and I've found more than a few new sores under a stray piece of lunch. Oh, and I've had far fewer sores since I switched to an SLS-free flavour of Sensodyne.

It's diagnosed as lichen planus... http://en.wikipedia.org/wiki/Lichen_planus

It's possible that the core trigger is actually a beta blocker I'm on for high blood pressure. If so, I'll deal with the lichen planus - seriously, I'd rather have a sore mouth than a stroke.

Sorry to ask this personal question, do you know if there is a name for the autoimmune problem that causes scores?

Some such sores, if occasional, may just be canker sores:

http://www.healthline.com/health/canker-sores

I've noted a correlation with: stress or lack of sleep; candy binges; eating scratchy foods like say popcorn.

I've been suffering from these blasted things for 18 years, and have similarly noted the same sorts of correlations. My best efforts: cutting out gum; cutting out sharp foods; cutting out acidic foods; taking vitamins B-12 and C, L-lysine, and zinc; switching toothpastes and brushing techniques. I regret not recording my history of occurrences, but I perceive things are improving. At the very least, it's safe to say the cause of canker sores is multi-factorial.

Sorry, I'm rambling. No one in my life can relate, so I'll take any chance to talk about it.

You reminded me: I switched years ago to SLS-free toothpaste (Biotene), because that's supposed to help. And for many reasons, I now eat way less sugar and sugary drinks. Maybe because of those changes, or just age, I get canker sores much less frequently. When I was younger, it was maybe 2-3 times a year, and sometimes 2 at once. Now I go a year or two between single, smaller ulcers. Good luck!

I can relate. You're probably right about them being multi-factorial, but changing toothpaste has been the biggest help to me. I use baking soda most of the time and have avoided these sores for years.

I've noticed the same causes and correlation. Canker sores' formal name is aphthous stomatitis. But whether it is an autoimmune disease is debatable. As noted in [1]:

"Despite this preferred theory of immuno-dysregulation held by most researchers,[7] aphthous stomatitis behaves dissimilarly to autoimmune diseases in many regards. "

[1]: http://en.wikipedia.org/wiki/Aphthous_stomatitis

Sjogren's syndrome?

probably psoriasis

Or lichen planus.

http://en.wikipedia.org/wiki/Lichen_planus#Oral_lichen_planu...

It's lichen planus. Diagnosed years ago.

Does the same apply to Coke Zero also?

I was interested myself, and a Google search for "is coke zero diet coke" showed me:

> Coca‑Cola Zero delivers the great taste of Coca‑Cola, with zero sugar. While it has the same sweeteners as Diet Coke (a blend of aspartame and acesulfame-K), it has a different flavour base, though both are low calorie and zero sugar.

It's entirely possible that this is just sloppy science journalism, but the distinction the SA article mentions sounds a bit ridiculous.

"In the Israeli experiment, 10-week-old mice were fed a daily dose of aspartame, sucralose or saccharin. Another cluster of mice were given water laced with one of two natural sugars, glucose or sucrose.

After 11 weeks, the mice receiving sugar were doing fine, whereas the mice fed artificial sweeteners had abnormally high blood sugar (glucose) levels, an indication that their tissues were having difficulty absorbing glucose from the blood. "

So you feed group B sugar, and group A things that are not sugar, and then you put both groups through a glucose challenge, administering a calibrated amount of sugar, and group A's blood sugar spikes higher than group B's, which is not acclimated to metabolizing sugar. This is not surprising.

I suppose I'd need to read the journal article later when I have time, to be sure. There are a lot of things that look like interesting correlations in tests like this that actually aren't, when you control for all of the variables, and consider the short-term and long-term adaptations the body makes.

Researchers actually went much further than you assume and used microbe transplants to show that the gut microbiome from the sugar-fed mice rescued the artificial-sweetener-fed mice. And that similar transplants in the other direction resulted in the bad outcomes in the sugar-fed mice.

I don't think your speculation and armchair research is any more more helpful than the bad science journalism you complain about. If you don't know what you're talking about, maybe you could try keeping it to yourself.

Actually, the combination of your two comments was very enlightening.

It's always appropriate to try and understand the world, and then discuss what doesn't make sense to you. This is a great example.

> I don't think your speculation and armchair research is any more more helpful than the bad science journalism you complain about.

Anonymous people on the Internet can't be held to the same standards as a research paper. On the contrary, since this is largely a public opinion forum I believe that commenting without evidence is encouraged and it's up to the reader to make a determination about said opinion.

What a silly idea that we aren't allowed to publicize opinion.

There is Kind of a big difference between saying that a comment is not helpful and that you are not allowed to make a comment, you know.

Random unscientific speculation on scientific matters is a problem and should not be encouraged.

It looks like a good start to doing some more serious research, especially the human study. But as I mentioned in a comment, the healthy volunteer study appears to use max daily acceptable intake, which sounds reasonable at first. The amount, however, is the equivalent of 250 packets of sweet and low. That is the sloppy part of the article to me.

There was a documentary where identical twins did a health challenge or a month. One ate only carbs and the other only fat/protein. Guess which had blood sugar spikes at the end of the challenge... the one eating fat/protein.

But if you continue to eat low-carb, you don't end up with blood sugar spikes.

I know I'm much better off on a low-carb diet than I ever have been, and my blood glucose level is much more stable. My brain works better, and I've lost a lot of weight. But I can't pig out on sweets or I get a hangover. It's a tradeoff.

On the plus side, the sugar-loving bacteria in my gut have probably mostly died off, since I no longer get sugar cravings like I used to. So I don't feel like pigging out on sugar. Works for me.

Plot twist: the sugar loving bacteria in our gut secrete a chemical which cause the sugar cravings.

Actually, that's believed to be the case [1], which is why I said what I did.

[1] http://medicalxpress.com/news/2014-11-bacteria-gut-affect-cr...

> Guess which had blood sugar spikes at the end of the challenge... the one eating fat/protein.

I believe this is thoroughly discussed in The Four Hour Body, amongst other things. It's the reason you eat beans and other "slow carbs" on that diet, since breaking down fat without any carbs will spike your sugar.

I can't remember the source, but somebody was speaking recently on the US healthcare system.

He made the point that the proof our healthcare in this country is broken is that when you go to the doctor to complain about illness nobody has ever been asked "How have you been eating?". Unless you have specific medical restrictions, there is little time spent on how your diet affects your health. My dream of quantified-self is a disrupted healthcare system focused on gestalt care.

I think part of the reason for this is that generally speaking, people who eat poorly know they're eating poorly and would rather have their cake and eat it too. They know soda is bad for them and that apples are good for them. That sitting all day long doesn't expend a lot of energy and running the back hills for a half hour does.

So when someone asks an ill person who eats poorly "How have you been eating?" they know they're about to receive a long story about how they've tried and failed, or that lately they've been "cheating" or that they've been super busy at work and kids and life is hard and they have no time for such things. What's the doctor supposed to say after this? Nothing. Because people are only going to change themselves when they truly want to and not when someone tells them they should.

So instead they look for more efficient routes at attempting care. Drugs are pretty good at this for a while. Got high blood pressure? Here's some beta blockers. You got an aching back? Here's some pain medication for that. They make more money this way, their patients can reliably take the 3 seconds to swallow a pill everyday, and everyone seems to be pretty happy until they have a heart attack or need a wheelchair. It's a good thing that those things come with old age so their poor health condition can be blamed on yet again something other than their continued poor diet and lack of exercise.

It's funny how simple being healthy is. Sleep, diet and exercise.

> their patients can reliably take the 3 seconds to swallow a pill everyday

This isn't even close to being true. Compliance is one of the biggest issues in modern medical practice. And people who reliably take the three seconds to swallow a pill every day are much, much healthier than people who don't, no matter what's in the pill.

Meh, your both wrong. When appropriate, doctors do ask about diet, they do recommend changes to diet, it does make a difference, and being healthy is not necessarily simple.

You basically reinforced his point. People know what they're doing wrong, and when they want to change that part of their lifestyle, then they will and any doctor will be more than happy to help them. There's such a thing as a dietitian after all.

Meh, my point is diet is always appropriate. And it is.

Very early in the research, if I am to just go off the article. First, the article really only addresses saccharin. Second, the healthy volunteer study appears to use max daily acceptable intake, which sounds reasonable at first. The amount, however, is the equivalent of 250 packets of sweet and low:

http://www.fda.gov/Food/IngredientsPackagingLabeling/FoodAdd...

Aspartame (Nutrasweet) is pretty controversial in how it got approved by the FDA.

See: http://www.huffingtonpost.com/robbie-gennet/donald-rumsfeld-...

When I was 8 years old, I started having grand mal seizures and my parents noted a strong correlation between drinking a Diet Coke and having a seizure. When they eliminated it from my diet, my seizures declined. Fortunately I stopped having seizures around 12 years of age. But given my experience, I continue to avoid all artificial sweeteners.

I know sources like https://en.wikipedia.org/wiki/Aspartame#Safety_and_approval_... claim that it is safe... and I agree that for most people it is probably okay in moderation. But based on my experience and the history of how Aspartame (Nutrasweet) got approved, I have serious doubts about its safety.

That article has a lot of fear mongering about artificial sweeteners and then at the bottom an ad for "certifiedorganicevaporatedcanejuice.com". Maybe it's not the most objective source of information?

Rumsfeld was the CEO at Searle - the makers of Aspartame... And he used his political influence to replace the FDA commissioner so Aspartame could be legalized. That's a conflict of interest.

its legal in plenty of other places and the bulk of research (some very recent) seems to show that it is very safe within the constraints of those studies, with the well documented and understood exception of people with phenylketonuria.

this makes it very hard for me to believe in the corruption argument, no one individual has the power or money to do something on that scale. maybe its a coordinated effort, but such arguments strain credibility. even if we assume corruption, it is not relevant to the safety discussion if we have piles of evidence that something is only dangerous in well understood cases.

on the other hand, we will never really know for sure, and we don't even have a complete picture until enough people have been consuming it for long enough 'in the wild'... but the same is true about anything discovered recently.

and of course, the individual case you point out is shocking regardless as to the safety of aspartame.

But then apart from the FDA, Canada, the UK, Europe, Singapore, probably many more, have all OK'd it and it's still approved. Surely his political influence doesn't cover dozens of countries over nearly half a century.

Aspartame is 50 years old now. Any researcher that showed a clear damaging effect would instantly be set for life, no? I know that isn't strong evidence, but it's some evidence.

I don't know what it is about artificial sweeteners in general, but I think people hate the idea of getting something for free, that you can literally enjoy a sweet dessert without paying for it in calories.

In SF, it's obnoxious, to the point of places not even carrying sucralose or aspartame, only <shudder>, Stevia. Or people saying, with a straight face, "Yep, our tea has real sugar, so it's far better for you."

While scummy, that doesn't necessarily mean that Aspartame is dangerous.

certified organic evaporated cane juice.com

For those who struggle to parse without spaces :)

Interestingly enough, a low carbohydrate (often including a switch to artificial sweeteners) is a well-established treatment for childhood epilepsy.

Really? Can you point to a source?

Many people with epilepsy and migraines have discovered different food triggers. In my case Aspartame was the leading trigger. Anyone who has seizures should seek out and eliminate potential triggers to see if it helps. I suppose a high carb diet could be a trigger for someone... I didn't have a high carb diet... but I know eliminating aspartame helped me.

I am still amazed how Donald Rumsfeld was able to influence its approval by the FDA.

They're likely referring to a ketogenic diet. They were quite common in the past before anticonvulsant meds were created, and are still used in intractable cases today, particularly in pediatric care. There's lots of information out there about their use in epilepsy.

Some to get you started:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898565/

http://www.epilepsy.com/learn/treating-seizures-and-epilepsy...

http://www.mayoclinic.org/medical-professionals/clinical-upd...

Interesting - thanks.

[Edit] - The ketogenic diet is interesting. And I can see how some would want to substitute sugar for an artificial sweetener to help achieve a low carb diet. But given Aspartame is a known trigger for many types of seizures, it should be introduced carefully.

Do you have a source re: aspartame and seizures? I did a cursory search and the only non-anecdotal thing I could find was a study[1] that showed there was no link in people who described themselves as sensitive.

[1] http://www.ncbi.nlm.nih.gov/pubmed/7614911

To add, most of the studies done on rats had "normal dosages" of aspartame for Humans not Rats. In other words the dosage was not relative to the rats mass it was relative to ours.

http://www.efsa.europa.eu/en/efsajournal/pub/2089.htm

Unfortunately I can't point to an official study - just many anecdotal claims from people like me. When you google, I am sure you will see many such claims - including the 'internet hoax'. (The internet hoax is unfortunate because it takes away credibility from the many anecdotal claims like mine that sincerely feel real. More carefully constructed studies should occur.)

That's tricky to evaluate, because you get the exact same narratives from people who claim sensitivity to glutamates, where we can be somewhat certain that there isn't a health connection.

It's easy to evaluate if you have seizures. You don't need to wait for it to be definitively proven to make use of the anecdotal evidence. If you learned that aspartame could trigger a seizure, wouldn't you be cautious and want to see if a change to your diet would reduce your seizures?

It is not at all hard to find people who believe MSG triggers seizures.

The key thing to search for is "keto" or "ketogenic," the name for the high-fat, low-carbohydrate diet that puts you in a fat-burning state called ketosis.

- http://en.wikipedia.org/wiki/Ketogenic_diet

- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898565/

- http://www.drperlmutter.com/study/dietary-treatment-adults-r...

https://www.reddit.com/r/ketoscience

The validity low carb diets is generally orthogonal to artificial sweeteners and probably should not be conflated.

Thus the phrase "often including..."

I wasn't attempting to disprove or contribute to his claims. Just to point out an interesting intersection of diet and seizures.

Can you give a source for aspartame/artificial sweeteners being often included with low carb diet for treating childhood epilepsy? It doesn't seem intuitive to me that a diet to treat such a disease would often include something like aspartame.

> It doesn't seem intuitive to me that a diet to treat such a disease would often include something like aspartame.

It's the avoiding carbs part that means they look to eat something sweet that isn't a carb. They don't prescribe aspartame; they just say don't leave ketosis.

Well a ketogenic diet is used to treat epilepsy, and artificial sweeteners don't generally conflict with ketosis. I didn't mean to imply artificial sweeteners are prescribed to epileptics. Maybe they're even specifically forbidden as well, I'm not sure.

You're definitely not alone. There's definitely a trend moving in this direction. We admittedly track the click data on our protein powder buyer's guide (https://blog.priceplow.com/guides/best-protein-powder) and far more people than you'd think have been choosing the natural sweetener path.

But interestingly, the number of products is still incredibly small in comparison. Hmmm...

Aspartame has been approved in many, many countries. It is unlikely that Rumsfeld influenced all of them.

forgive me for asking perhaps an obvious question , but did you reduce overall caffeine intake by switching from diet coke, or did you stick to something with similar caffeine levels and still experience the reduction in seizures?

I was 8 years old and my family rarely drank soda. I went from having a diet coke occasionally to occasionally having a regular coke, ginger ale, root beer, etc... So I don't recollect changing my periodic intake of caffeine.

I didn't do a thorough study of it... and I recognize that the logic that aspartame was a trigger could be wrong. But when you find something that appears to work and later hear of others who identified the same potential trigger and fix, then you start to believe it may be true. Personally I don't think there have been sufficient studies to show a connection or not. But people who have seizures shouldn't rule it out.

But people who have seizures shouldn't rule it out.

People that have any symptoms that correlate with consumption of foods shouldn't rule out anything a priori.

Depending on the severity of the symptom and their desire to eat certain foods, they may want to experimentally narrow down the trigger. I guess I would not be inclined to eat artificial sweeteners in an attempt to see if they triggered a seizure.

https://en.wikipedia.org/wiki/Phenylketonuria

I got a job at a company that had free soda. I was happy with that. I started drinking 1 diet coke in the afternoon every day. until after a few weeks I realized I was also getting a headache in the afternoon everyday. Fixed by switching to Perrier over the Diet Coke.

Granted, one person is an anecdote not data but switching from coke to diet coke lost me 20 lbs in a year. 500-1000 calories less each day.

You must have been drinking around 2 litres of Coke for that many calories. Have you tried switching from Diet Coke to water? You'll need a few trips to Starbucks a day (an americano has 0 kcal, it's like caffeinated air!) until you can reduce your caffiene dependence.

Given the college or hacker environment, a six-pack or 2l over the course of 18 hours isn't a lot to drink. Healthy, no, but then neither is doing a 12" pizza solo and that was pretty commonplace as well. Coffee shops didn't exist, and even if they did, it's hard to beat a quarter a can. Hacking without caffeine? Gunna take a while...

Science reporting is really hard. This story comes off as if there was enough research to start to move away from the researched sweeteners. Especially the part in the end is laughable: "Segal, for one, is taking no chances: he says that he has switched from using artificial to natural sweetener in his morning coffee."

However the study done on humans had small sample size, the only studied sweetener was saccharin and the subjects were given the full ADI. These are very preliminary studies and are useful mostly for deciding future study targets. So not really studies to base your diet decisions on.

"He and his team analyzed a database of 381 men and women and found that those who used artificial sweeteners (...) were also more likely to have impaired glucose tolerance."

So those who are intolerant to glucose tend to avoid glucose? That hardly seems surprising.

> had 50 percent fewer Bacteroidetes bacteria and 50 percent more Firmicutes bacteria than normal mice did. When they transferred a sample of the Firmicutes bacterial population from the obese mice into normal-weight ones, the normal mice became fatter.

Woah. I assume someone is now doing research on introducing Bacteroidetes into the guts of obese people?

I know you can buy probiotics. Can you buy just Bacteroidetes ?

General Biotics [http://www.generalbiotics.com] has some more information available on that (and a product based on the research).

Meh. Let me know when useful long term test are actually done on humans and not mice models.

It is already happening with all those people drinking soda. And everyone knows it is not healthy.

Does anyone have any thoughts how Xylitol or Erythritol might fare under a study like this? They're currently my go to sweeteners. I'm not sure why they're not more popular.

Sugar alcohols can have some unpleasant side effects, which make them unpopular for general use. They can cause bloating, flatulence, and diarrhea if you consume too much of them. The pop-culture example of this is the review section on http://www.amazon.com/Haribo-Sugar-Free-Gummy-Bears/dp/B008J..., or in a less ridiculous form at en.wikipedia.org/wiki/Xylitol#Safety and http://en.wikipedia.org/wiki/Erythritol#Side_effects.

That's not at all to say they're bad or poison; I love sugar-free gum a lot, but the amount of sugar alcohol in each piece is very low. The problem is just that the side effects mean that if they're widely used, eventually someone is going to crap themselves and blame your product, and almost nobody wants that.

I actually used knowledge of their unpleasant side effects to help overcome my unhealthy diet.

While I was still addicted to sugar and craving the taste of sweets, I switched to the "sugar free" sugar alcohol versions of treats. The knowledge that anything more than a reasonable portion would lead to discomfort (at best) was wonderful motivation to keep my portions in check. I used the same method to wean myself off of potato chips and other greasy, salty snacks. I'd heard plenty of horror stories about Olean when I was a child, so I never dared eat more than 4 Fat Free Pringles at a time. The necessarily smaller portions made it easier to focus on enjoying the treats (and thus be satisfied with less), instead of getting lost in a binge.

I don't even bother to walk down the sweets or snacks isles at the grocery anymore. I highly recommend the method for anyone whose willpower needs just a wee bit of bolstering.

I put two tbsp of xylitol into my smoothies and I've never had a problem. It's also supposed to be good for your teeth.

I do wonder how something can be so dangerous for dogs and safe for humans. Aren't our cells almost identical?

Yeah, xylitol inhibits bacterial growth in the mouth. I like it in gum, it seems to help me. It seems like different people have different tolerances for xylitol to some extent; I know that my wife, who is much smaller than me, has a higher absolute tolerance than I do (i.e. if we eat the same amount without accounting for body weight, I will experience discomfort and she will not).

I'm not a vet but I'm waiting on some batch tests at work so I did some reading. According to http://veterinarymedicine.dvm360.com/new-findings-effects-xy..., dogs absorb Xylitol much more quickly than rats or humans do. Xylitol also provokes dogs to release insulin, but not people. The reasons behind that are not completely clear to me, but since they quickly and completely absorb Xylitol, they end up producing a ton of insulin very quickly which tanks their blood glucose levels. That's dangerous without any complicating factors.

Additionally, dogs metabolize xylitol differently, and it's thought that a side effect of the metabolization is to deplete adenosine triphosphate in the liver, which can cause liver necrosis (obviously very bad news).

Humans don't absorb xylitol well (it's only partially digestible and some of it acts as dietary fiber, sort of), and we don't metabolize what we do absorb very efficiently. The difference is likely in both the dose relative to body weight, and the intensity (since dogs metabolize it much faster and more completely).

That's all secondhand info though, I don't have a JSTOR or equivalent account so I couldn't read any interesting primary papers. If we coincidentally have a vet wandering through I'd love to learn more about this.

You can adapt to xylitol in your diet. It is best to introduce it slowly into your diet. Chewing gum is a great way to use it daily and increase your intake over time. Dental recommendations are 6-10 grams per day, but most people would experience discomfort starting off at that amount.

> I do wonder how something can be so dangerous for dogs and safe for humans. Aren't our cells almost identical?

There's lots of differences in the enzymes that are made though. For example humans are one of the few species that can not make vitamin C.

Usually if you check the reason a food is dangerous for some animal it's that they lack an enzyme needed to degrade it, so it builds up.

The LD-50 for theobromine (found in chocolate) is 300 mg/kg for dogs, and 1000 mg/kg for humans. Additionally, dogs metabolize it more slowly than humans.

As a result, a dog who eats 1 oz milk chocolate or 0.25 oz dark chocolate per pound of its own body weight could die. A 192-lb human who eats 12 pounds of milk chocolate is unlikely to die... from theobromine poisoning.

Cats have an ever lower LD-50 for theobromine, but they are less likely to eat a lethal dose of chocolate, because they don't taste sweetness, while dogs can. Birds are not affected by capsaicin, but are absolutely repulsed by methyl anthranilate (artificial grape flavoring).

Xylitol is probably the best sugar alternative you can use. Dr. Ellie Phillips promotes it in her book Kiss Your Dentist Goodbye because the reseach has demonstrated that harmful bacteria are unable to utilize it for energy. I would assume since this is why it is beneficial to use in oral products, it would also provide the same benefits for stomach bacteria. It seems that erythritol is also unable to be used for energy. This is not true for all sugar alcohols; after exposure to sorbitol over a short period, bacteria can adapt to use it as an energy source. It also can contribute to reflux.

Add to that sorbitol. I like gum and and many brands like Orbit use it. Biggest side effect is it is actually a laxative in larger doses and some people have abdominal pain probably due to that (http://www.medscape.com/viewarticle/568700).

Erythritol seems like the best sweetner though with minimal side effects under 50mg per day.

Xylitol is not more popular because a tiny dose will kill a dog. I use it as well, but am very careful with it. I treat it essentially like poison.

Both of those are sugar alcohols, and as such have laxative effects, among other things.

But no idea how they'd fare under this sort of study.

Purely anecdotal: what I remember from the time the Doc was trying to determine what was making me sick while eating was the list of items totally off my diet. Besides the obvious, no dairy, no carbonated, no caffeine, and limit on other items like fats and salts, was no artificial sweeteners.

I didn't question it at the time as I was desperately in need of getting the situation fixed. Turned out the Ciphro I had taken; as last resort type medicine; had killed all the good bacteria and such in my intestinal tract letting something else move in. Another series of drugs later and that was cleared up but he still left me with a list of items to curtail for the next six months until all tests came clean and one was artificial sweeteners.

Stevia was not included, so for now I'll assume it is safe. It does have some positive effects such as increasing insulin sensitivity.

I only had diet soft drinks very occasionally, but I think I'll eliminate entirely and stick to water or juice.

I'm not sure that stevia is an "artificial" sweetener.

Your body doesn't care whether something was made by humans or whether it was made by nature. It only cares about the particularities of the molecules involved.

Yeah, it appears that stevia would likely have similar effects, as it has been suggested that tasting sweetness causes an spike in insulin without a corresponding bump in blood glucose levels, leading to an excess of insulin[1].

What causes the difference in effect between glucose and artificial sweeteners appears to be the taste of sweetness without the carbohydrates that would go along with natural sources of sweet taste.

[1] Sucralose Affects Glycemic and Hormonal Responses to an Oral Glucose Load -http://care.diabetesjournals.org/content/early/2013/04/30/dc...

Right, the issue is not the thing, but the tests and reviews on said thing being made by humans.

But for 99% of human history everything put into human bodies was made by nature.

Technically I don't think its artificial. However, I notice that most Stevia products also contain dextrose. I don't think dextrose is considered artificial either but still, it begs the question why Stevia alone isn't enough and/or if dextrose is low or zero calorie then why not just use that?

Dextrose is a filler starch. Raw concentrated sweetener would be more than you could handle, so the dextrose is added to allow you to use the artificial sweetener like you would use table sugar, e.g. spooning it or baking with it.

If you buy liquids then you don't get filler starch like dextrose.

Hmm. I bought a small container of pure stevia powder from Whole Foods, and it has a little tiny spoon I'd say about 1/20th a teaspoon. Put even that small amount in a cup of tea and it is as sweet as a whole packet of sugar.

Thanks for clarifying that! That's been bugging me forever. :)

Friendly correction, "begs the question" doesn't mean what you say in your post.

http://en.wikipedia.org/wiki/Begging_the_question

It's too late, that ship has sailed.

I've seen the incorrect usage in very fancy printed reference books.

This is just one of those ways where language changes.

agree. it's a moot point ;)

Tragically, too many people are disinterested in the actual meaning of words and phrases.

It's natural, but there are doubts about its safety. In many countries it is still banned. And in countries like the USA it has only been available for a short period of time (after lots of lobbying).

There aren't doubts about its safety, and reading about it a lot, I am not convinced there ever were that were based on data - seems they all had to do with scare tactics.

In the USA it was available until 1991 with not a single medical case against it - and again since 1994 (simultaneously considered "safe" on its own but "not enough data to classify as safe" as an additive).

Not to mention, it has more than a thousand year of use. See wikipedia[0] about history and also the part of "controversy".

Unlike the egg/cholesterol and salt intake recommendations, which appear to be grounded in scientific incompetence, any concerns about stevia seem to be strategically managed by a competitor.

[0] http://en.wikipedia.org/wiki/Stevia#History

The doubts about its safety are mine. I am skeptic about the safety of all artificial sweeteners - especially ones new to the market - given my personal experiences with Aspartame. From most American's points of view, Stevia is new and it is being promoted by big industry. It may have been around for a thousand years, but I seriously doubt any of my ancestors in the last 1000 years consumed much of it. I am fine with it being on the market... but until more people consume it routinely for a sufficient period of time, I am not going to rush out and incorporate it into my diet.

> Stevia is new and it is being promoted by big industry...

Stevia, the plant, is not new. Menacing industry in that equation is artificial sweetener interests that used government(s) to ban importation and ban the option to label stevia as a sweetener in the United States and elsewhere. It was still widely sold, bought, and consumed. Strains vary. Some have a bitter aftertaste. Some are bred to be mostly sweet with minimal aftertaste. Whether it's consumed as dried plant matter, ground, or as newer extracts, a wide sampling sifts out tasty, palatable strains.

> I am fine with it being on the market...

I'm fine with lettuce being on the market. It's smart to be skeptical about everything, especially on an individual level, and more so given your experience. I avoid artificial sweeteners, also. Not enjoying the taste helps.

>>I am skeptic about the safety of all artificial sweeteners - especially ones new to the market

Stevia is not artificial and has been used in Japan for decades. It is recognised as a mainstream sweetener. It's also used in Canada, for example, though not so widespread yet.

You're right its not artificial... my mistake. It is however rather new to the market in the USA and Canada. It has been around for a long time, but in small markets.

Also: https://news.ycombinator.com/item?id=8331474

So sugar is good again?

> Methadone is really harmful.

> So heroin is back in?

Evidently, both are bad and it doesn't seem to be immediately clear whether real sugar or artificial is more harmful. But we do know for a fact that excess carbohydrate intake causes numerous serious health problems (heart problems, obesity, diabetes, Alzheimer's, etc).

OT: Heroin can actually be safer, due to the long onset and long lasting effects of methadone. Methadone can take several hours to kick in, leading patients to think they might not have taken enough, and take some more. It also lasts much longer than Heroin.

3x10mg methadone pills may be enough to cause an overdose in a naive patient. Given the long times involved, this isn't an unrealistic scenario. Whereas with Heroin, a: oral bioavailability is rather low, and b: action happens faster, thus an OD is less likely. (Not true for IV usage, but hopefully such patients exercise more caution in the first place, reality excepted.)

And both aren't really "bad" for you, as far as long-term medicines go. The side effect profile is positively tame compared to other commonly accepted medicines such as anti-depressants or mood stabilizers.

Which is depressing because carbohydrates are so tasty. It's all I can do to resist them.

Same here though I've heard that with carbs and sugar, after a week or two without you find you don't crave them anymore. "I've heard" because I've not yet been able to attempt that particular experiment. :)

I've been doing low-carb (to varying degrees) for about 4 years now and love it.

I used to be all about potatoes, bread, pasta, milk, etc. Never big on sweets, but the complex carbs... oh yes. Once I almost hit 200lb at 17-ish I decided to cut carbs (/r/keto) and it worked wonders. I was down to about 150 (a healthy weight for my size) in about a year, but the weight loss is asymptotic. I lost like 10 pounds in my first two weeks, but it took me another 8-9 months to lose the other 40.

The first week or two are somewhat hellish for some people because you're essentially going through a withdrawal. It's nearly identical in mechanism and symptoms of a drug withdrawal. If anything, that should underline how detrimental regular excess carb intake can be. What's even worse than the normal "withdrawals," though, is when you cheat.

When I first went to college I ate an absurd amount of carbs for a rush event (aka fun/eating challenge) and literally fell asleep at the table. Then I felt like shit for the next 3 days. That was my last time cheating :)

You're absolutely right, though, after the first 1-3 weeks, your cravings stop, headaches stop, brain fog clears, you sleep amazingly, feel energized, and don't even notice the dessert menu. It's fascinating and I highly recommend it. You may hate it, you may love it. It has benefitted me in a lot of ways, and it continues to even as I somewhat elevate my carb intake in order to work out effectively.

Try going low carb for a month. There are amazing low carb foods too.

Like steak.

And bacon.

And cheese.

>But we do know for a fact that excess carbohydrate intake causes numerous serious health problems [...] Alzheimer's,

Do we know that for a fact? Definitely?

Of course not. But there are varying degrees of evidence supporting the idea that consuming excess carbohydrates (and more specifically, "simple" carbohydrates) contributes to a wide array of health issues.

We know consuming excess carbohydrates is bad for you the same way we know that climate change is happening. The same way we know that a sedentary lifestyle is detrimental to your health. The same way we know that smoking causes lung cancer and a cornucopia of other health concerns.

Science rarely affords us the ability to make absolute statements.

I fully agree that sugar is harmful.

Parent post said "we know for a fact" that excess carbs cause alzheimers, and it is this specific strong claim that I'm challenging. I'm not even asking for "know for a fact". "Most researchers agree" will do.

Sugar causes overweight; but people who are overweight might be less likely to get alzheimers than people who are thin.

Today: http://www.bbc.co.uk/news/health-32233571

> Being overweight cuts the risk of dementia, according to the largest and most precise investigation into the relationship.

(Researchers who found this are cautious, saying this is just one study and that it conflicts with other research). But in 2011: http://www.bbc.co.uk/news/health-13213755

> Middle aged people who are overweight but not obese, are 71% more likely to develop dementia than those with a normal weight, according to research.

And confusingly in 2009 we thought that rapid weight loss might be an early sign of dementia: http://news.bbc.co.uk/1/hi/health/8055030.stm

> Researchers have produced more evidence that rapid weight loss in old age may be a early warning sign of dementia.

Well, it depends on your definition of fact. So far it's a fairly well supported and entirely non-refuted hypothesis.

http://www.ncbi.nlm.nih.gov/pubmed/15082091

Given that "sweetness" is provided by sugar?

Personally I've completely eliminated added salt and everything is now tasty as it was when I added salt - my taste has recovered from the over-stimulation. I can't imagine that added salt (or sweetener) is any different.

No, sugar is bad. It's just that other sweeteners are also bad.

Solution: Stop sweetening everything.

If you read the article, there's no such claim. Just that artificial sweeteners appear to change gut bacteria in a way that sugar doesn't.

Fake sugar tastes bad and is unnecessary. Let's get rid of it already. Eat whole foods!

It's funny how extracting and concentrating sucrose from certain hemi- and cellulose fibers (like their sponsor does) isn't very different from extracting and concentrating xylitol from other hemi- and cellulose fibers, but to some, it's worlds apart.

No Fucking Shit

Shocker.

Glad I stick with drinking tea, milk and water.

Soda is bad news.

I really don't understand the need for "diet" soft drinks.

I mean, soft drinks are ok, to drink sometimes. But if someone is drinking enough soft drink to worry about the amount of sugar intake, then he is drinking too much sodas. Soft drinks are like "light" cigarettes.

What is the problem about drinking water?

Flavored soft drinks taste better to some people than water. That's why people drink them more.

I once made fun of a friend for drinking a "diet" soft drink. Turns out he was diabetic and couldn't drink regular ones. I stopped making fun of people drinking diet soft drinks after that.

I agree though that water is the best :-)

I was not making fun about people drinking soft drinks. My point is that sweet drinks are unhealthy, no matter witch kind of sweetener they use. For me, the fact that there's people that ONLY drink soft-drinks (including fruit juices) is quite shocking. But anyway, seeing the amount of downvotes I got, I guess I touched some kind if american social tabu.

The need is for the caffeine--the easiest way to get off the diet soda train is green tea, and to ease off the caffeine from there. Others just don't find water satisfying for other reasons, which I can relate to. I tend to drink a 60/40% mix of seltzer and fruit juice, which after a week or so adapting tastes surprisingly sweet. In any case, there are options beyond water that aren't all bad.

Plenty of popular sodas are not caffeinated, so that's probably not the reason.

I think one of the most important things to keep in mind when reading articles like this is the old mantra that "correlation does not equal causation". I'm always a bit skeptical when studies show partially successful statistics.

I've done a lot of research on the subject at hand, and I still believe that consuming real sugar is orders of magnitudes worse than using sweeteners.

> "correlation does not equal causation"

I hate this phrase so much because it's so often used to imply that "because there is correlation it means there can't be causation"

> Tufte suggests that the shortest true statement that can be made about causality and correlation is one of the following:

> "Empirically observed covariation is a necessary but not sufficient condition for causality."

> "Correlation is not causation but it sure is a hint."

So often used to imply what? I've seen a lot of people ignoring correlation when they really shouldn't, I have never in my life seen them using the implication backwards. How often do you see that?

I might be misunderstanding what you're saying, but I see exactly what I mentioned in the parent comment, which is why I wrote my comment.

I don't see it like that. Large claims require large proof, that's all I see in the comment. Shocking numbers need more investigation, and need a big grain of salt, but that is still taking the result as weak support of causality, not a counter to it.

I think you're reading "skepticism" as "the opposite is likely" and I'm reading it as "assign low weight".

Sample size of one here, but no amount of additional exercise or any other dietary change has ever helped my weight or overall energy level as switching from Coke to Diet Coke many years ago. The effect was nearly instant, dramatic, and permanent. Probably like many things, there are just too many variables to say A is good and B is bad.

> I've done a lot of research on the subject at hand, and I still believe that consuming real sugar is orders of magnitudes worse than using sweeteners.

For the gut, or in general? If for the gut, please expand.

> I've done a lot of research on the subject at hand

It would be quite informative for the subject at hand for you to show your research results, if those results contradict OP findings

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