14 ms·

Health effects of the use of non-sugar sweeteners: a review and meta-analysis

159 points by ValentineC 4y ago

ThrowawayTestr 4y ago
"The results suggest that, in the short term, NSS use may lead to small reductions in adiposity without any significant impact on cardiometabolic risk. There is suggestion of negative health effects with long-term use, but the evidence is ultimately inconclusive." I won't be getting rid of my Coke Zero any time soon.
- BbzzbB 4y ago
  What a blessed day! I'll take those odds as well.. not that I haven't so far either way.
- adhesive_wombat 4y ago
  I just wish they'd also avoided the phosphoric acid in it! Might not be full of sugar, but it's still bad for teeth.
  - halfmatthalfcat 4y ago
    On the same topic, recently learned that erythritol (Swerve) does not contribute at all the plaque as normal sugar/other substitutes do.
  - lotsofpulp 4y ago
    Not nursing the drink forever and rinsing your mouth afterwards with water should return the pH to normal relatively quickly, according to my dentist.
    - dannyw 4y ago
      Also, chew some xylitol gum after, or just regularly. Straws also help. Get reusable metal ones.
  - xattt 4y ago
    The local Pepsi bottler has been distributing Crystal Pepsi (!) in our market the last few weeks. I thought I would have never seen the day. I would be drinking it more regularly to avoid caramel colour (possible link to microvascular damage that leads to increased likelihood for atherosclerosis, no citation at hand), but also to be ironic.
    - manholio 4y ago
      It's a limited revival, enjoy it while stocks lasts. Or, perhaps, build inventory. But do they have the Max sugar free version in Crystal?
      - xattt 4y ago
        Unfortunately not. I am wondering if the artificial sweetener scene was different in the 1990s versus now. I think we have sucralose and stevia now that we didn’t have before.
  - daneel_w 4y ago
    From what I've understood, the phosphoric acid is also a problem for the gut flora. With regular daily intake it will apparently kill certain bacterial cultures over time, and with that comes a set of new problems.
    - refurb 4y ago
      Unlikely. Phosphate is ubiquitous in the body. Your metabolism basically runs off phosphate ions. And your stomach is far more acidic than phosphoric acid.
      - feet 4y ago
        If phosphate ions are present in abnormally high concentrations, could that cause issues for some species of bacteria? AFAIK our phosphate is usually contained within our cells, and I'm definitely not an expert on the digestive process so I'm not sure how phosphate gets absorbed, at what rate, or if any enzymes would mess with it
        refurb 4y ago
        Phosphate is present in every cell of your body and in extracellular fluid. Your kidneys keep phosphate levels within a very narrow range.
        feet 4y ago
        Right, so what happens if the concentration is too high in the intestines? What is the absorption rate compared to the concentration in coke zero? Would it take slamming 6 coke zeros in a row on an empty stomach to hit concentrations that would be bad for the previously mentioned species?
        refurb 4y ago
        It won't be too high by the time it hits your intestines. It'll be absorbed and excreted in the urine.
- nathanaldensr 4y ago
  If my wife's caffeine withdrawal is any indication, you might want to be more concerned about your amount of caffeine intake rather than the sweeteners.
  - na85 4y ago
    I just go cold turkey every few months when my caffeine tolerance gets out of hand.
    - sundvor 4y ago
      Two decades ago in response to colleagues' worry that I was drinking too much caffeine I quit for a year. All sources of caffeine; espressos, energy drinks, diet cokes. I didn't suffer any withdrawals. However I greatly missed my coffee, so after the year I resumed (sans the energy drinks) and will be having my coffee until the day I die. Quit alcohol nearly two years ago; that's a habit that can stay gone. Definitely feeling the benefits of ditching even what was a relatively modest consumption. In a way, diet cokes (Coca Cola No Sugar) are my naughty drinks now - so I can see from this study I should probably limit it somewhat day in-out, and as long as I do it should be ok. I primarily drink filtered water and filtered Sodastream water for my fluids.
  - verall 4y ago
    Unless you're drinking like 6 a day it's nothing compared to regular coffee drinkers: 12oz coke zero: 34mg caffeine 12oz brewed coffee: 120-240mg depending on beans and strength Double shot espresso: 60-180mg I can easily do 2 12oz brewed or doubles in a day and friends drink much more.
    - thaumasiotes 4y ago
      OK, but that's like saying there's no reason to watch your alcohol intake unless it's on par with a raging alcoholic.
      - vkou 4y ago
- beached_whale 4y ago
  Lets add that some of these are really old food additives * 1965/1983 - Aspartame * 1976/1991 - Sucralose * 1879/1884ish - 1960s - Saccharin
  - mountain_peak 4y ago
    I've been reading some old (early 1900s) diabetic recipe books from archive.org and it was a bit of a surprise to see how many recipes used saccharin back then (and almond flour, bone broth, etc.). I remember seeing saccharin tablets everywhere as a youngster, then they all suddenly went away. As it turns out, researchers found a higher incidence of bladder cancer in rats fed a diet of saccharin (20x the expected human dose, I think), which caused the production of saccharin to drop off dramatically. Up until that point, it was cheap, relatively easy to produce and plentiful. Further research eventually proved that saccharin reacted with a compound in rat urine that caused crystals to form in the urine, which 'scraped' the bladder wall, causing injury, increased cell repair, and (therefore) an increased incidence of bladder cancer in rats. The researchers proved that this compound did not exist in human urine and crystals did not form, therefore the increased incidence of cancer should not exist in humans - and analysis of bladder cancer rates for lifelong saccharin users backed-up the new findings. Still, the damage to saccharin had been done and I think there's only one plant in Europe that still produces it. I'm not sure how large the artificial sweetener market is (it seems to be growing exponentially), but every decade an old sweetener appears to fall out of favour and is replaced by a new one (or is added in combination with others). I'm not sure we're much further ahead than we were in the early 1900s!
    - TheDudeMan 4y ago
      This is so frustrating. Because you know this is the tip of the iceberg.
      - seventytwo 4y ago
        Nah… this stuff happens, unfortunately. There’s no need to blast off into conspiracy space.
- ralusek 4y ago
  Drink water
  - deleted 4y ago
    [deleted]
- ramraj07 4y ago
  If you drink a can every two days, great. If you get a personalized gallon sized mug with a straw filled with diet soda every day to work and are also already morbidly obese, maybe the drink won’t help. The second statement I’ve seen so many times in Texas :(
  - honkdaddy 4y ago
    Very true. But if they’re morbidly obese as it is, it’s pretty likely they have a brain chemistry which responds very positively to sugary drinks, so without the diet soda it’s possible their health would be even worse. I’ve never met an obese person who liked being obese, but I’ve met lots who have a really challenging relationship with food which slowly brought them to the point they’re at now. I’m an addict as well, it’s just not as visible.
    - PcChip 4y ago
      >they have a brain chemistry which responds very positively to sugary drinks I'm convinced this can be changed! I used to love sugary drinks, however after being on keto my brain adjusted and now if I even taste a real coke I'm disgusted by how sweet it is
      - bcrosby95 4y ago
        What works for you doesn't work everyone. My wife did keto and still loved her soda afterwards.
        ihateolives 4y ago
        That's not keto then.
        giaour 4y ago
        No true Scotsman could like soda after doing keto!
- 29athrowaway 4y ago
  If I may suggest... you should try to get into tea. There are teas for all tastes including fermented tea, and related beverages like yerba mate, guarana, etc.
  - hirvi74 4y ago
    Yerba mate puts me in the best mood. I have no idea why. Maybe the MOAIs?
- Gigachad 4y ago
  Also my conclusion. Aspartame and other sweeteners have been researched to death now and they still can’t tell me they have found anything. While other chemicals in regular use have real and concrete health issues.
  - mjevans 4y ago
    It is practically impossible to conduct a long term health study on something like an artificial sweetener. The only way I can think of to accurately remove environmental noise is to collect extensive records on a _large_ population, and then line up A / B sets where the only major difference between the sets (other exposures similar) are the sweeteners. With a lot of samples that fulfill that criteria a historic review might be able to identify statistical anomalies towards outcomes (positive or negative) that are common to the matched A and B sides of the set. I could see an AI administering such a data collection and comparison in an accurate and ethical way; but only the scifi grade strong / true AI.
    - Gigachad 4y ago
      It's also impossible to do this on almost every other substance we use. I'll focus my energy on avoiding things we know for sure are problematic like refined sugar and get to artificial sweeteners when everything else more important is solved.
      - Teever 4y ago
        Why not just avoid both?
        eropple 4y ago
        Because humans are not automatons and there is value in deriving pleasure from one's lived experiences? This isn't a difficult question.
        n_io 4y ago
- bhk 4y ago
  I don't think that's a balanced summary of the study. "Results from prospective cohort studies suggest the possibility of long-term harm in the form of increased risk of obesity, type 2 diabetes, cardiovascular diseases and mortality." And regarding the short-term weight loss, the confounding factor of reduction in sugar and overall energy intake seems to be the explanation. The "Concluding Remarks" section of the paper is a good, and very brief, encapsulation of the results.
- ipaddr 4y ago
  Your teeth will be affected. I spent a year drinking as much coke as I wanted. The teeth issues that resulted made me never drink the stuff again. If I could go back and tell my younger self one thing.. stay away from the coca cola.
- stjohnswarts 4y ago
  Yes I always figured if there is something, it's on the order of 10%-20% "bad outcome" vs being a sugar teetotalar. However since I avoid as much sugar as possible and have some splenda in my coffee and coke zero pretty much guilt free.
adhesive_wombat 4y ago
Large amounts of sugar are so bad for you that it would be pretty obvious statistically if sweeteners were anything like as bad and they'd be banned. Somewhat like how if cars were invented today they'd be deemed insanely dangerous.
- fredgrott 4y ago
  Not exactly true. If eat a whole orange, the fiber in the orange slows down sugar uptake whereas if I drink juice the sugar hits bloodstream much faster. And generally Phenylalanaline is better than some of the others. Why? Well because it's one step away from L-DOPA which is one step away from dopamine
  - adhesive_wombat 4y ago
    Right, but "large amounts" of sugar. 250ml of juice (and yes, I know the suggest serving size of orange juice is much less than that, but it's very easy to drink a normal glass of it) is quite a few oranges. Sugar is, like everything except plutonium, fine in moderation. But "in moderation" is not how sugar occurs in many modern diets.
    - sgerenser 4y ago
      Every orange juice I’ve seen here in the US lists a serving size of 8oz or 237ml, which I wouldn’t consider “much less” than 250ml.
      - adhesive_wombat 4y ago
        It's 150ml in the UK (6 servings per litre). Unsure if that's because they don't want to write 25g of sugar on the "traffic light" label (it's about 1g per 10ml), or they want people to think the packs are bigger in terms of servings.
  - polalavik 4y ago
    By what metric is it “one step”? D2O is one step away from water, but that doesn’t make it good for you.
TaupeRanger 4y ago
Everyone I know who constantly harps on aspartame, sucralose, MSG, etc. also drinks an alcoholic beverage 5 or more times per week and never exercises beyond an occasional meandering neighborhood walk. The latter is astronomically more likely to harm them, but it's easier to think that they're being "healthy" simply by avoiding artificial sweeteners.
- deleted 4y ago
  [deleted]
- incone123 4y ago
  The real danger with people constantly harping on aspartame is that they bore others to death. All you can do is try to limit your exposure.
- bagacrap 4y ago
  what's the complaint with msg? have never heard anyone complain about that, although as a kid with all the "no msg" signs at Chinese restaurants and no other context I thought of it as something similar to MDMA or LSD.
  - jokowueu 4y ago
    There is nothing bad about it. The reason why it was attacked is another story https://youtu.be/E-POAKKH5IM https://youtu.be/E-POAKKH5IM
- Gordonjcp 4y ago
  All of those taste unbelievably vile, which is why I avoid them. I don't care about the health effects, I care about them making everything taste like antifreeze.
riku_iki 4y ago
Interesting, that from my reading it looks like using non-sugar sweeteners caused -570 calories daily intake reduction, but somehow just -0.71kg of body weight.. Edit: it is 570 kJ = 136 calories.
- laweijfmvo 4y ago
  You need -500 calories every day for a week in order to lose 1 pound.
  - riku_iki 4y ago
    I think it is -0.71kg of total body weight loss, not just per one week.
  - PuppyTailWags 4y ago
    * +/- up to 20% deviation (some people absorb more or less calories in their food) * until your metabolism adapts to consistent calorie deficit, which causes up to 50% decrease in weight loss Maintenance Phase had a fascinating episode about calories being significantly more complicated than we expected.
- dmix 4y ago
  This is the punchline of every keto book. The whole ‘you just need to eat less calories to lose weight’ thing that has been pushed since post-WW2 despite having almost no solid evidence supporting it for long term weight loss. The best one that destroys the woo-y history of calorie (and fat) obsessed health science (or lack of science) is the book “The Case for Keto” by the author who wrote “The Case Against Sugar” and “Good Calorie Bad Calorie”.
  - EMM_386 4y ago
    > The whole ‘you just need to eat less calories to lose weight’ thing CICO, or "calories in, calories out", is obviously real. If you don't eat food, you will lose weight and eventually starve to death.
andrew_ 4y ago
Glucose index effect can play a large role in weight gain and retention. A lot of the NSS products have a worse GI effect than straight cane sugar, especially the sugar alcohols.
- riku_iki 4y ago
  Can you support your claim by any evidence? Stevia for example has 0 GI, while sugar has 80 GI: https://www.va.gov/WHOLEHEALTHLIBRARY/docs/Understanding-Sweeteners-508.pdf https://www.va.gov/WHOLEHEALTHLIBRARY/docs/Understanding-Swe...
  - deleted 4y ago
    [deleted]
- tpush 4y ago
  I don't think there's any robust evidence for glycemic index/load mattering at all, unless you're diabetic of course.
  - icelancer 4y ago
    In fact most of the evidence actually supports the opposite hypothesis: It really doesn't matter.
    - gruez 4y ago
      source? I always vaguely thought that high GI foods were bad because it would stress out your pancreas and lead to pre-diabetes.
  - stjohnswarts 4y ago
    I think you better do some more reading if you think stressing your insulin mechanism daily with far more sugar than humans evolved to partake of is "ok". There's pretty good evidence for 30-35% of humans not handling it well at all...
- 4y ago
LAC-Tech 4y ago
Genuine question - how well regarded are these kinds of studies from the WHO? Are they generally considered pretty solid and reliable?
- greazy 4y ago
  In general, WHO reports are highly regarded and highly read and cited by the respective fields. This report would be no different.
henearkr 4y ago
They analyzed all studies about any of the different non-sugar sweeteners... I bet there are some that are bad and some that are good, I'm waiting for more precise results. In particular, it seems that stevia based sweeteners are rather innocuous or even good (e.g. lowering blood pressure).
- deleted 4y ago
  [deleted]
havblue 4y ago
I wonder if it's just that a single 20oz of diet/zero sugar soda doesn't make a big enough difference one way or another. Likely not so good for you but not as addictive and statistically significant as say, alcohol, nicotine or fatty and sugary foods.
neonsunset 4y ago
Consuming anything that has aspartame in it gives me a severe migraine.
supernova87a 4y ago
Have there been any solid findings on whether, even if there is no nutritional value (directly fattening/metabolic effects) in artificial sugar, it has effects on whether it triggers your hormones -- or that of your gut bacteria -- to contribute as if it were real sugar? In my mind that is the most interesting unanswered question to help decide whether it's an effective sugar substitute.
ineedasername 4y ago
You really can't get to a good understanding on this issue without an analysis of comparative harm. The issue is only partly about whether non-sugar sweeteners have negative effects. The more important question is whether regular & processed sugars produce an overall worse impact than substitutes consumed at comparable levels, with stratification by consumption level. E.g., non-sugar sweeteners may have a similar danger profile at both low and high levels of consumption while sugar's negative impacts may be more linear. Or so other balance. In a situation like that, the proper advice to individuals looking to become healthier may vary, especially given that immediate and rapid wholesale change if a person's behavior is not usually possible.
- whoisjuan 4y ago
  Sugar is not even in a comparable realm. By every measure, sugar is worst than any non-sugar sweetener. Modern medical consensus is that added sugar should be avoided as much as possible.
  - adrianN 4y ago
    I would be very surprised of there is consensus in nutrition science about anything as absolute as avoiding all added sugar.
    - spacemanmatt 4y ago
      > The American Heart Association suggests a stricter limit for added sugars — no more than 100 calories from added sugar a day for most women and no more than 150 calories from added sugar a day for most men. That's about 6 teaspoons (24 grams) of sugar for women and 9 teaspoons (36 grams) of sugar for men. I think I just used 1/3 of my recommended limit in my tea.
    - zeristor 4y ago
      It is curious why the sugar risks were down played: “How the Sugar Industry Shifted Blame to Fat” (2016) https://www.nytimes.com/2016/09/13/well/eat/how-the-sugar-industry-shifted-blame-to-fat.html https://www.nytimes.com/2016/09/13/well/eat/how-the-sugar-in... The science seems to have been so muddied by PR, is there anyway to get a clear consensus independent if vested interests?
UIUC_06 4y ago
I'm being a killjoy here, sorry: Just drink water. Much healthier. Carbonated, if you like. With some lemon or lime juice, maybe.
- derefr 4y ago
  Who said anything about soft drinks? They're putting artificial sweeteners in "unsweetened" sauces and condiments these days. They're getting about as hard to escape as sugar was in the "fats bad" era.
  - UIUC_06 4y ago
    Good point. I say, have the regular stuff (w/sugar) but just go easy with it.
    - eslaught 4y ago
      The thing that's crazy is that even the "regular" items sometimes have artificial sweeteners now. You basically cannot assume any product category, with any labeling, with not have it. You have to check the ingredient list yourself (and make sure you're familiar with all the names these things go under). At this point my main strategy is to minimize number of ingredients (e.g., two ingredient peanut butter) because otherwise it's just too easy to miss something getting slipped in there. It's insane.
      - unclebucknasty 4y ago
        >You basically cannot assume any product category Picked up a loaf of bread on sale the other day and, because it wasn't the brand I normally get, I scanned the ingredients. Surprised to find that it contained sucralose. It wasn't listed as "lite" or similar. Just "regular" bread. With sucralose.
        pawsforthought 4y ago
        Does the place you shop not sell fresh bread? In European supermarkets that’s the norm. Anything branded (i.e. shelf stable and sold in a plastic bag) is to be treated with suspicion.
victorvosk 4y ago
The absurd amount of money and time that has been spent on studies around artificial sweeteners should tell you its probably safe. Everyone has been dying to find a smoking gun here for decades and it never happens.
- Gordonjcp 4y ago
  It doesn't matter if they're safe or not, because they taste absolutely revolting. I guess this is overall good for my health, because I can no longer drink soft drinks or eat most processed foods.
- spacemanmatt 4y ago
  The politicized approval process that got sucralose and aspartame on the market should give anyone reason for concern. Remember that the beneficiaries of those approvals are people who know the most about these chemicals and are motivated to avoid learning more or disclosing what they know.
  - Someone1234 4y ago
    Can you cite whatever it is you're referring to?
  - gruez 4y ago
    >The politicized approval process What do you mean by "politicized"? >Remember that the beneficiaries of those approvals are people who know the most about these chemicals and are motivated to avoid learning more or disclosing what they know. That's basically the status quo for how every new product gets approved.
- adrian_b 4y ago
  The conclusion of this study is that in the long term the sweeteners are not safe for adult people, because they increase the risk of diabetes and of various cardio-vascular problems, even if they do not cause any cancer risk. The same is true for added sugar, so the sweeteners are not better than sugar.
hypertele-Xii 4y ago
Why would you ever want to fool your body into thinking you're eating something you're not? If you want to taste sweet then eat sugary foods. If you don't want to eat sugary foods, why in the world are you eating artificial lab-created pretend-sugar? As much as you should aspire to be truthful in your life, you should also be truthful in your diet. Eat actual food. Artificial sweeteners are a scam.
- Gigachad 4y ago
  The foods are not fake sweet, they are actually sweet. Being sweet doesn’t mean being sugar.
  - hypertele-Xii 4y ago
    Sweetness is a taste we literally evolved over millenia to find sugar.
    - jokowueu 4y ago
      Whats your point ?
      - hypertele-Xii 4y ago
        Artificial sweeteners are by definition fake sweet. They are lab-discovered chemicals that short-circuit our sugar-detection mechanism, the taste of sweetness, which explicitly evolved to detect sugar, which artificial sweeteners are not.
        jokowueu 4y ago
        Can you explain how it short circuits our sugar detection mechanism ? Your body detects sugar by the beta cells of the pancreatic islets, causing them to increase the release of insulin into the blood . Non of the common sugar substitutes do this
FrozenVoid 4y ago
I'd play it safe and eat only natural sweeteners like inulin/stevia/xylitol. Gut microbes haven't evolved to expirience the whole array of artificial sweeteners.
Gordonjcp 4y ago
The increased use of non-sugar sweeteners in soft drinks means that I now drink a lot more beer, because I can no longer drink soft drinks. I don't know what sort of health effect that has.
2-718-281-828 4y ago
That study cannot be complete if it isn't covering Xylitol - period
exabrial 4y ago
If I'm not mistaken, essentially the conclusion is shit we already knew: Unless you change your eating habits (decrease volume of calories and increase quality of food), you're probably going to be stuck where you're at. Drinking 24x cans of diet soda every day isn't going to you there.
- __ryan__ 4y ago
  decrease volume of calories By, say, replacing 24 cans of “regular” soda (24 * ~100cal) with 24 cans of diet soda (24 * ~0cal). I calculate about 2400cal savings, and if CICO is legit, I think that would get them there.
  - exabrial 4y ago
    This misses the point. People are using Diet soda as an excuse to consume excessively (Hence Quality of food statement above). _anything_ in excess is bad for you

159 points by ValentineC 4y ago

"The results suggest that, in the short term, NSS use may lead to small reductions in adiposity without any significant impact on cardiometabolic risk. There is suggestion of negative health effects with long-term use, but the evidence is ultimately inconclusive." I won't be getting rid of my Coke Zero any time soon.

BbzzbB 4y ago
What a blessed day! I'll take those odds as well.. not that I haven't so far either way.
adhesive_wombat 4y ago
I just wish they'd also avoided the phosphoric acid in it! Might not be full of sugar, but it's still bad for teeth.
- halfmatthalfcat 4y ago
  On the same topic, recently learned that erythritol (Swerve) does not contribute at all the plaque as normal sugar/other substitutes do.
- lotsofpulp 4y ago
  Not nursing the drink forever and rinsing your mouth afterwards with water should return the pH to normal relatively quickly, according to my dentist.
  - dannyw 4y ago
    Also, chew some xylitol gum after, or just regularly. Straws also help. Get reusable metal ones.
- xattt 4y ago
  The local Pepsi bottler has been distributing Crystal Pepsi (!) in our market the last few weeks. I thought I would have never seen the day. I would be drinking it more regularly to avoid caramel colour (possible link to microvascular damage that leads to increased likelihood for atherosclerosis, no citation at hand), but also to be ironic.
  - manholio 4y ago
    It's a limited revival, enjoy it while stocks lasts. Or, perhaps, build inventory. But do they have the Max sugar free version in Crystal?
    - xattt 4y ago
      Unfortunately not. I am wondering if the artificial sweetener scene was different in the 1990s versus now. I think we have sucralose and stevia now that we didn’t have before.
- daneel_w 4y ago
  From what I've understood, the phosphoric acid is also a problem for the gut flora. With regular daily intake it will apparently kill certain bacterial cultures over time, and with that comes a set of new problems.
  - refurb 4y ago
    Unlikely. Phosphate is ubiquitous in the body. Your metabolism basically runs off phosphate ions. And your stomach is far more acidic than phosphoric acid.
    - feet 4y ago
      If phosphate ions are present in abnormally high concentrations, could that cause issues for some species of bacteria? AFAIK our phosphate is usually contained within our cells, and I'm definitely not an expert on the digestive process so I'm not sure how phosphate gets absorbed, at what rate, or if any enzymes would mess with it
      - refurb 4y ago
        Phosphate is present in every cell of your body and in extracellular fluid. Your kidneys keep phosphate levels within a very narrow range.
        feet 4y ago
        Right, so what happens if the concentration is too high in the intestines? What is the absorption rate compared to the concentration in coke zero? Would it take slamming 6 coke zeros in a row on an empty stomach to hit concentrations that would be bad for the previously mentioned species?
        refurb 4y ago
        It won't be too high by the time it hits your intestines. It'll be absorbed and excreted in the urine.
nathanaldensr 4y ago
If my wife's caffeine withdrawal is any indication, you might want to be more concerned about your amount of caffeine intake rather than the sweeteners.
- na85 4y ago
  I just go cold turkey every few months when my caffeine tolerance gets out of hand.
  - sundvor 4y ago
    Two decades ago in response to colleagues' worry that I was drinking too much caffeine I quit for a year. All sources of caffeine; espressos, energy drinks, diet cokes. I didn't suffer any withdrawals. However I greatly missed my coffee, so after the year I resumed (sans the energy drinks) and will be having my coffee until the day I die. Quit alcohol nearly two years ago; that's a habit that can stay gone. Definitely feeling the benefits of ditching even what was a relatively modest consumption. In a way, diet cokes (Coca Cola No Sugar) are my naughty drinks now - so I can see from this study I should probably limit it somewhat day in-out, and as long as I do it should be ok. I primarily drink filtered water and filtered Sodastream water for my fluids.
- verall 4y ago
  Unless you're drinking like 6 a day it's nothing compared to regular coffee drinkers: 12oz coke zero: 34mg caffeine 12oz brewed coffee: 120-240mg depending on beans and strength Double shot espresso: 60-180mg I can easily do 2 12oz brewed or doubles in a day and friends drink much more.
  - thaumasiotes 4y ago
    OK, but that's like saying there's no reason to watch your alcohol intake unless it's on par with a raging alcoholic.
    - vkou 4y ago
beached_whale 4y ago
Lets add that some of these are really old food additives * 1965/1983 - Aspartame * 1976/1991 - Sucralose * 1879/1884ish - 1960s - Saccharin
- mountain_peak 4y ago
  I've been reading some old (early 1900s) diabetic recipe books from archive.org and it was a bit of a surprise to see how many recipes used saccharin back then (and almond flour, bone broth, etc.). I remember seeing saccharin tablets everywhere as a youngster, then they all suddenly went away. As it turns out, researchers found a higher incidence of bladder cancer in rats fed a diet of saccharin (20x the expected human dose, I think), which caused the production of saccharin to drop off dramatically. Up until that point, it was cheap, relatively easy to produce and plentiful. Further research eventually proved that saccharin reacted with a compound in rat urine that caused crystals to form in the urine, which 'scraped' the bladder wall, causing injury, increased cell repair, and (therefore) an increased incidence of bladder cancer in rats. The researchers proved that this compound did not exist in human urine and crystals did not form, therefore the increased incidence of cancer should not exist in humans - and analysis of bladder cancer rates for lifelong saccharin users backed-up the new findings. Still, the damage to saccharin had been done and I think there's only one plant in Europe that still produces it. I'm not sure how large the artificial sweetener market is (it seems to be growing exponentially), but every decade an old sweetener appears to fall out of favour and is replaced by a new one (or is added in combination with others). I'm not sure we're much further ahead than we were in the early 1900s!
  - TheDudeMan 4y ago
    This is so frustrating. Because you know this is the tip of the iceberg.
    - seventytwo 4y ago
      Nah… this stuff happens, unfortunately. There’s no need to blast off into conspiracy space.
ralusek 4y ago
Drink water
- deleted 4y ago
  [deleted]
ramraj07 4y ago
If you drink a can every two days, great. If you get a personalized gallon sized mug with a straw filled with diet soda every day to work and are also already morbidly obese, maybe the drink won’t help. The second statement I’ve seen so many times in Texas :(
- honkdaddy 4y ago
  Very true. But if they’re morbidly obese as it is, it’s pretty likely they have a brain chemistry which responds very positively to sugary drinks, so without the diet soda it’s possible their health would be even worse. I’ve never met an obese person who liked being obese, but I’ve met lots who have a really challenging relationship with food which slowly brought them to the point they’re at now. I’m an addict as well, it’s just not as visible.
  - PcChip 4y ago
    >they have a brain chemistry which responds very positively to sugary drinks I'm convinced this can be changed! I used to love sugary drinks, however after being on keto my brain adjusted and now if I even taste a real coke I'm disgusted by how sweet it is
    - bcrosby95 4y ago
      What works for you doesn't work everyone. My wife did keto and still loved her soda afterwards.
      - ihateolives 4y ago
        That's not keto then.
        giaour 4y ago
        No true Scotsman could like soda after doing keto!
29athrowaway 4y ago
If I may suggest... you should try to get into tea. There are teas for all tastes including fermented tea, and related beverages like yerba mate, guarana, etc.
- hirvi74 4y ago
  Yerba mate puts me in the best mood. I have no idea why. Maybe the MOAIs?
Gigachad 4y ago
Also my conclusion. Aspartame and other sweeteners have been researched to death now and they still can’t tell me they have found anything. While other chemicals in regular use have real and concrete health issues.
- mjevans 4y ago
  It is practically impossible to conduct a long term health study on something like an artificial sweetener. The only way I can think of to accurately remove environmental noise is to collect extensive records on a _large_ population, and then line up A / B sets where the only major difference between the sets (other exposures similar) are the sweeteners. With a lot of samples that fulfill that criteria a historic review might be able to identify statistical anomalies towards outcomes (positive or negative) that are common to the matched A and B sides of the set. I could see an AI administering such a data collection and comparison in an accurate and ethical way; but only the scifi grade strong / true AI.
  - Gigachad 4y ago
    It's also impossible to do this on almost every other substance we use. I'll focus my energy on avoiding things we know for sure are problematic like refined sugar and get to artificial sweeteners when everything else more important is solved.
    - Teever 4y ago
      Why not just avoid both?
      - eropple 4y ago
        Because humans are not automatons and there is value in deriving pleasure from one's lived experiences? This isn't a difficult question.
        n_io 4y ago
bhk 4y ago
I don't think that's a balanced summary of the study. "Results from prospective cohort studies suggest the possibility of long-term harm in the form of increased risk of obesity, type 2 diabetes, cardiovascular diseases and mortality." And regarding the short-term weight loss, the confounding factor of reduction in sugar and overall energy intake seems to be the explanation. The "Concluding Remarks" section of the paper is a good, and very brief, encapsulation of the results.
ipaddr 4y ago
Your teeth will be affected. I spent a year drinking as much coke as I wanted. The teeth issues that resulted made me never drink the stuff again. If I could go back and tell my younger self one thing.. stay away from the coca cola.
stjohnswarts 4y ago
Yes I always figured if there is something, it's on the order of 10%-20% "bad outcome" vs being a sugar teetotalar. However since I avoid as much sugar as possible and have some splenda in my coffee and coke zero pretty much guilt free.

adhesive_wombat 4y ago

Large amounts of sugar are so bad for you that it would be pretty obvious statistically if sweeteners were anything like as bad and they'd be banned. Somewhat like how if cars were invented today they'd be deemed insanely dangerous.

fredgrott 4y ago
Not exactly true. If eat a whole orange, the fiber in the orange slows down sugar uptake whereas if I drink juice the sugar hits bloodstream much faster. And generally Phenylalanaline is better than some of the others. Why? Well because it's one step away from L-DOPA which is one step away from dopamine
- adhesive_wombat 4y ago
  Right, but "large amounts" of sugar. 250ml of juice (and yes, I know the suggest serving size of orange juice is much less than that, but it's very easy to drink a normal glass of it) is quite a few oranges. Sugar is, like everything except plutonium, fine in moderation. But "in moderation" is not how sugar occurs in many modern diets.
  - sgerenser 4y ago
    Every orange juice I’ve seen here in the US lists a serving size of 8oz or 237ml, which I wouldn’t consider “much less” than 250ml.
    - adhesive_wombat 4y ago
      It's 150ml in the UK (6 servings per litre). Unsure if that's because they don't want to write 25g of sugar on the "traffic light" label (it's about 1g per 10ml), or they want people to think the packs are bigger in terms of servings.
- polalavik 4y ago
  By what metric is it “one step”? D2O is one step away from water, but that doesn’t make it good for you.

TaupeRanger 4y ago

Everyone I know who constantly harps on aspartame, sucralose, MSG, etc. also drinks an alcoholic beverage 5 or more times per week and never exercises beyond an occasional meandering neighborhood walk. The latter is astronomically more likely to harm them, but it's easier to think that they're being "healthy" simply by avoiding artificial sweeteners.

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incone123 4y ago
The real danger with people constantly harping on aspartame is that they bore others to death. All you can do is try to limit your exposure.
bagacrap 4y ago
what's the complaint with msg? have never heard anyone complain about that, although as a kid with all the "no msg" signs at Chinese restaurants and no other context I thought of it as something similar to MDMA or LSD.
- jokowueu 4y ago
  There is nothing bad about it. The reason why it was attacked is another story https://youtu.be/E-POAKKH5IM https://youtu.be/E-POAKKH5IM
Gordonjcp 4y ago
All of those taste unbelievably vile, which is why I avoid them. I don't care about the health effects, I care about them making everything taste like antifreeze.

riku_iki 4y ago

Interesting, that from my reading it looks like using non-sugar sweeteners caused -570 calories daily intake reduction, but somehow just -0.71kg of body weight.. Edit: it is 570 kJ = 136 calories.

laweijfmvo 4y ago
You need -500 calories every day for a week in order to lose 1 pound.
- riku_iki 4y ago
  I think it is -0.71kg of total body weight loss, not just per one week.
- PuppyTailWags 4y ago
  * +/- up to 20% deviation (some people absorb more or less calories in their food) * until your metabolism adapts to consistent calorie deficit, which causes up to 50% decrease in weight loss Maintenance Phase had a fascinating episode about calories being significantly more complicated than we expected.
dmix 4y ago
This is the punchline of every keto book. The whole ‘you just need to eat less calories to lose weight’ thing that has been pushed since post-WW2 despite having almost no solid evidence supporting it for long term weight loss. The best one that destroys the woo-y history of calorie (and fat) obsessed health science (or lack of science) is the book “The Case for Keto” by the author who wrote “The Case Against Sugar” and “Good Calorie Bad Calorie”.
- EMM_386 4y ago
  > The whole ‘you just need to eat less calories to lose weight’ thing CICO, or "calories in, calories out", is obviously real. If you don't eat food, you will lose weight and eventually starve to death.

andrew_ 4y ago

Glucose index effect can play a large role in weight gain and retention. A lot of the NSS products have a worse GI effect than straight cane sugar, especially the sugar alcohols.

riku_iki 4y ago
Can you support your claim by any evidence? Stevia for example has 0 GI, while sugar has 80 GI: https://www.va.gov/WHOLEHEALTHLIBRARY/docs/Understanding-Sweeteners-508.pdf https://www.va.gov/WHOLEHEALTHLIBRARY/docs/Understanding-Swe...
- deleted 4y ago
  [deleted]
tpush 4y ago
I don't think there's any robust evidence for glycemic index/load mattering at all, unless you're diabetic of course.
- icelancer 4y ago
  In fact most of the evidence actually supports the opposite hypothesis: It really doesn't matter.
  - gruez 4y ago
    source? I always vaguely thought that high GI foods were bad because it would stress out your pancreas and lead to pre-diabetes.
- stjohnswarts 4y ago
  I think you better do some more reading if you think stressing your insulin mechanism daily with far more sugar than humans evolved to partake of is "ok". There's pretty good evidence for 30-35% of humans not handling it well at all...
4y ago

LAC-Tech 4y ago

Genuine question - how well regarded are these kinds of studies from the WHO? Are they generally considered pretty solid and reliable?

greazy 4y ago
In general, WHO reports are highly regarded and highly read and cited by the respective fields. This report would be no different.

henearkr 4y ago

They analyzed all studies about any of the different non-sugar sweeteners... I bet there are some that are bad and some that are good, I'm waiting for more precise results. In particular, it seems that stevia based sweeteners are rather innocuous or even good (e.g. lowering blood pressure).

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havblue 4y ago

I wonder if it's just that a single 20oz of diet/zero sugar soda doesn't make a big enough difference one way or another. Likely not so good for you but not as addictive and statistically significant as say, alcohol, nicotine or fatty and sugary foods.

neonsunset 4y ago

Consuming anything that has aspartame in it gives me a severe migraine.

supernova87a 4y ago

Have there been any solid findings on whether, even if there is no nutritional value (directly fattening/metabolic effects) in artificial sugar, it has effects on whether it triggers your hormones -- or that of your gut bacteria -- to contribute as if it were real sugar? In my mind that is the most interesting unanswered question to help decide whether it's an effective sugar substitute.

ineedasername 4y ago

You really can't get to a good understanding on this issue without an analysis of comparative harm. The issue is only partly about whether non-sugar sweeteners have negative effects. The more important question is whether regular & processed sugars produce an overall worse impact than substitutes consumed at comparable levels, with stratification by consumption level. E.g., non-sugar sweeteners may have a similar danger profile at both low and high levels of consumption while sugar's negative impacts may be more linear. Or so other balance. In a situation like that, the proper advice to individuals looking to become healthier may vary, especially given that immediate and rapid wholesale change if a person's behavior is not usually possible.

whoisjuan 4y ago
Sugar is not even in a comparable realm. By every measure, sugar is worst than any non-sugar sweetener. Modern medical consensus is that added sugar should be avoided as much as possible.
- adrianN 4y ago
  I would be very surprised of there is consensus in nutrition science about anything as absolute as avoiding all added sugar.
  - spacemanmatt 4y ago
    > The American Heart Association suggests a stricter limit for added sugars — no more than 100 calories from added sugar a day for most women and no more than 150 calories from added sugar a day for most men. That's about 6 teaspoons (24 grams) of sugar for women and 9 teaspoons (36 grams) of sugar for men. I think I just used 1/3 of my recommended limit in my tea.
  - zeristor 4y ago
    It is curious why the sugar risks were down played: “How the Sugar Industry Shifted Blame to Fat” (2016) https://www.nytimes.com/2016/09/13/well/eat/how-the-sugar-industry-shifted-blame-to-fat.html https://www.nytimes.com/2016/09/13/well/eat/how-the-sugar-in... The science seems to have been so muddied by PR, is there anyway to get a clear consensus independent if vested interests?

UIUC_06 4y ago

I'm being a killjoy here, sorry: Just drink water. Much healthier. Carbonated, if you like. With some lemon or lime juice, maybe.

derefr 4y ago
Who said anything about soft drinks? They're putting artificial sweeteners in "unsweetened" sauces and condiments these days. They're getting about as hard to escape as sugar was in the "fats bad" era.
- UIUC_06 4y ago
  Good point. I say, have the regular stuff (w/sugar) but just go easy with it.
  - eslaught 4y ago
    The thing that's crazy is that even the "regular" items sometimes have artificial sweeteners now. You basically cannot assume any product category, with any labeling, with not have it. You have to check the ingredient list yourself (and make sure you're familiar with all the names these things go under). At this point my main strategy is to minimize number of ingredients (e.g., two ingredient peanut butter) because otherwise it's just too easy to miss something getting slipped in there. It's insane.
    - unclebucknasty 4y ago
      >You basically cannot assume any product category Picked up a loaf of bread on sale the other day and, because it wasn't the brand I normally get, I scanned the ingredients. Surprised to find that it contained sucralose. It wasn't listed as "lite" or similar. Just "regular" bread. With sucralose.
      - pawsforthought 4y ago
        Does the place you shop not sell fresh bread? In European supermarkets that’s the norm. Anything branded (i.e. shelf stable and sold in a plastic bag) is to be treated with suspicion.

victorvosk 4y ago

The absurd amount of money and time that has been spent on studies around artificial sweeteners should tell you its probably safe. Everyone has been dying to find a smoking gun here for decades and it never happens.

Gordonjcp 4y ago
It doesn't matter if they're safe or not, because they taste absolutely revolting. I guess this is overall good for my health, because I can no longer drink soft drinks or eat most processed foods.
spacemanmatt 4y ago
The politicized approval process that got sucralose and aspartame on the market should give anyone reason for concern. Remember that the beneficiaries of those approvals are people who know the most about these chemicals and are motivated to avoid learning more or disclosing what they know.
- Someone1234 4y ago
  Can you cite whatever it is you're referring to?
- gruez 4y ago
  >The politicized approval process What do you mean by "politicized"? >Remember that the beneficiaries of those approvals are people who know the most about these chemicals and are motivated to avoid learning more or disclosing what they know. That's basically the status quo for how every new product gets approved.
adrian_b 4y ago
The conclusion of this study is that in the long term the sweeteners are not safe for adult people, because they increase the risk of diabetes and of various cardio-vascular problems, even if they do not cause any cancer risk. The same is true for added sugar, so the sweeteners are not better than sugar.

hypertele-Xii 4y ago

Why would you ever want to fool your body into thinking you're eating something you're not? If you want to taste sweet then eat sugary foods. If you don't want to eat sugary foods, why in the world are you eating artificial lab-created pretend-sugar? As much as you should aspire to be truthful in your life, you should also be truthful in your diet. Eat actual food. Artificial sweeteners are a scam.

Gigachad 4y ago
The foods are not fake sweet, they are actually sweet. Being sweet doesn’t mean being sugar.
- hypertele-Xii 4y ago
  Sweetness is a taste we literally evolved over millenia to find sugar.
  - jokowueu 4y ago
    Whats your point ?
    - hypertele-Xii 4y ago
      Artificial sweeteners are by definition fake sweet. They are lab-discovered chemicals that short-circuit our sugar-detection mechanism, the taste of sweetness, which explicitly evolved to detect sugar, which artificial sweeteners are not.
      - jokowueu 4y ago
        Can you explain how it short circuits our sugar detection mechanism ? Your body detects sugar by the beta cells of the pancreatic islets, causing them to increase the release of insulin into the blood . Non of the common sugar substitutes do this

FrozenVoid 4y ago

I'd play it safe and eat only natural sweeteners like inulin/stevia/xylitol. Gut microbes haven't evolved to expirience the whole array of artificial sweeteners.

Gordonjcp 4y ago

The increased use of non-sugar sweeteners in soft drinks means that I now drink a lot more beer, because I can no longer drink soft drinks. I don't know what sort of health effect that has.

2-718-281-828 4y ago

That study cannot be complete if it isn't covering Xylitol - period

exabrial 4y ago

If I'm not mistaken, essentially the conclusion is shit we already knew: Unless you change your eating habits (decrease volume of calories and increase quality of food), you're probably going to be stuck where you're at. Drinking 24x cans of diet soda every day isn't going to you there.

__ryan__ 4y ago
decrease volume of calories By, say, replacing 24 cans of “regular” soda (24 * ~100cal) with 24 cans of diet soda (24 * ~0cal). I calculate about 2400cal savings, and if CICO is legit, I think that would get them there.
- exabrial 4y ago
  This misses the point. People are using Diet soda as an excuse to consume excessively (Hence Quality of food statement above). _anything_ in excess is bad for you