18 ms·

Sugar Substitutes Surprise

459 points by hprotagonist 4y ago

jhassell 4y ago
Doesn't the risk of being overweight completely overwhelm the risk of a not-yet-understood gut flora change? We know that even being minimally overweight poses a risk; a Nurses’ Health Study reported that women with BMIs in the range of 24-24.9 had a 5-fold greater risk of diabetes when compared with women with BMIs of less than 22.
- hinkley 4y ago
  In geriatric patients, being slightly overweight has better prospects than being underweight. I’m not sure what the pathology is there, other than hitting starvation cycles if you get certain illnesses, and possibly bone density.
- yamtaddle 4y ago
  Gut flora probably affect calorie and nutrient absorption. It seems worth checking whether the gut flora changes increase calorie absorption or cause increased appetite (say, by causing nutrient deficiency) before deciding which path is better for weight loss.
  - docandrew 4y ago
    Any change in absorption is going to be minuscule in comparison to the difference in calories one gets from all the excess sugar. Anecdotally, switching from full-sugar soda to diet has been a hugely beneficial change to my own health. Would water be better? Maybe, but I’ll settle for harm reduction.
    - yamtaddle 4y ago
      > Any change in absorption is going to be minuscule in comparison to the difference in calories one gets from all the excess sugar. I think that depends on how much it takes to have this effect. If the equivalent of one diet soda every couple days (the doses in the article seemed pretty small to me?) is acting like a kind of pesticide, even in small doses, and killing a lot of calorie-eating gut flora, the harm might exceed the benefit. On the other hand if the artificial sweetener is replacing the sugar in 64+oz of soda per day rather than 16ish oz every couple days, sure, the benefits probably overwhelm any harm.
    - hinkley 4y ago
      I switched from soda to tea three or four times in my life before swearing off soda entirely. Lost 10 lbs every time. The problem with artificial sweeteners is that we have “taste buds” for sweet in our intestines, and there’s a theory that reacting to that increases absorption, so your body pulls more carbs from French fries you ate with your Diet Coke. This is likely a big part of why lecturing people about CICO is such a dick move. “Calories” in food are net calories, not gross calories. We didn’t calculate the calories in bread by burning it in a sensor chamber. We got it by isolating volunteers, measuring the energy in their food versus the energy in their poop, assuming the rest ends up in your body. But of course any heat generated by gut microbes might be shed, and the hydrogen bonds in your burps are also lost calories. I was a very gassy person when I was a young beanpole. Not so much anymore.
      - kenjackson 4y ago
        Anecdotally my wife changed her diet and basically tried to replace sugar with sucralose wherever she could. The end result was a significant weight loss. I should note she also did start exercising more at the same time, so definitely not a controlled study. But the delta in calories from sugar was far greater than the caloric expenditure from exercise.
        hinkley 4y ago
        I started long distance walking this year, and nearly every time I see the calorie count I am reminded of the aphorism about not being able to outrun a bad diet. I think that’s bullshit, with a proviso. The provision is that you can’t outrun a bad diet by exercising a half hour a day. That 30 minutes is a number doctors settled on not to scare sedentary people into not starting an exercise program. You really need an hour or more a day. I’m trying to get my walk route down to 90 minutes, in prep for a half marathon next year. If I stop for a matcha at the halfway point, I’ve still burned well over twice what I consumed. If I get the smoothie still come out ahead. The real “secret” there is that when I watch TV I nibble. Not getting food on books is the only reason I don’t nibble when reading. What I’ve done in a 90 minute walk is to forestall eating more than one single thing in that ninety minutes. And lowered my stress level. Cortisol is the other killer here. Even before that the nearest good coffee shop was a mile away and my net calories were ~100. If I avoided a certain cream based beverage. For some people, banning prepared foods does a similar thing. Preparing a snack takes fifteen minutes instead of fifteen seconds. You just don’t have as much time in the day to stuff your face once the convenience is gone. The other aphorism is that you lose weight at the grocery store, which I do believe. If you come home with fruit instead of pie and chips you’ve already fought half the battle.
  - matthewdgreen 4y ago
    The issue is not necessarily just nutrient absorption, but also the body's production of GLP-1: that influences appetite and blood sugar regulation. https://pubmed.ncbi.nlm.nih.gov/33820962/ https://pubmed.ncbi.nlm.nih.gov/33820962/
- cowmoo728 4y ago
  It is possible (likely?) that the observed gut flora changes interfere with normal metabolic function, causing long term weight gain. 2020 - "future studies should consider the metabolic pathways of different artificial sweeteners. Further (long-term) human research investigating the underlying physiological pathways of different artificial sweeteners on microbiota alterations and its related metabolic pathway is warranted to evaluate the potential impact of their use on body weight control and glucose homeostasis." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817779/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817779/
  - andrewmutz 4y ago
    Yes, there has been some fascinating research coming out suggesting that the gut flora composition can have a causal effect on obesity. For example, if you transplant feces from overweight humans and normal weight humans to mice, the mice will gain (or not gain) weight, depending on which person the feces came from: https://www.science.org/doi/10.1126/science.1241214 https://www.science.org/doi/10.1126/science.1241214
- colordrops 4y ago
  Many non overweight people eat these fake sweeteners too.
  - hinkley 4y ago
    You can be skinny and diabetic too. One of the American Ninja Warriors last season wore an insulin pump. While competing. I’ve since noticed pictures of a few competitive runners with them. Weight and metabolic function are correlated, not equivalent.
    - roxymusic1973 4y ago
      She was type 1 diabetic, so perhaps not relevant: https://www.diabetesselfmanagement.com/blog/an-american-ninja-warrior-with-type-1/ https://www.diabetesselfmanagement.com/blog/an-american-ninj...
    - colordrops 4y ago
      That's my point. We shouldn't only be concerned about overweight people.
- time_to_smile 4y ago
  You're making the implicit assumption that sugar substitutes do reduce the risk of being overweight. At least the first post I found on the topic suggest there is evidence of "a positive correlation between regular use of artificial sweetener and weight gain"[0] 0.https://www.publichealthpost.org/research/can-sugar-substitutes-reduce-risk-of-obesity/ https://www.publichealthpost.org/research/can-sugar-substitu...
  - tuatoru 4y ago
    This article suggests a mechanism for that positive correlation: impairment of glycaemic response by the most commonly used artificial sweeteners.
- awestroke 4y ago
  False dichonomy; you can choose to consume neither sugar nor sweeteners
  - Al-Khwarizmi 4y ago
    That, and it's also possible to consume (moderate amounts of) sugar and have a good BMI.
  - SoftTalker 4y ago
    Yep. I used to drink a lot of diet soda. I stopped that probably 10 years ago or so. I don't use artificial sweeteners in anything. I mostly drink water now. When I drink coffee or tea it's unsweetened. For an occasional treat such as a milkshake I will use sugar, sparingly. Incidentally, when I drink diet soft drinks now they taste like chemicals. Completely unnatural sweetness. I don't find them enjoyable at all. But when I used to drink them daily, I liked them, really almost craved them.
  - SamPatt 4y ago
    Other than natural sugars in fruit, my diet has effectively no sugar or sweeteners. It's not that hard after several years of changing your eating habits slowly. It helps that I've always preferred drinking water.
- deleted 4y ago
  [deleted]
- googlryas 4y ago
  Sure, if sugar sweetener is the only thing keeping you overweight. But it's probably harder for your body to deal with being both overweight and having a weird gut biome simultaneously.
- PuppyTailWags 4y ago
  It seems that despite increased risk of diabetes, being slightly overweight actually decreases all-cause mortality and being grade 1 obese doesn't affect all-cause mortality. I heard of this through a podcast and I'm not super educated, but it seems to me that the relationship of weight and health is more complicated, since I agree that increasing risk of heart disease, diabetes, etc. is bad. It just doesn't seem to bear out in actually killing a person. Maybe it decreases their quality of life drastically instead? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855514/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855514/
  - stnmtn 4y ago
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    - PuppyTailWags 4y ago
      The article explicitly compares overweight, grade 1 obesity, grade 2 & 3 obesity together, obesity generally, relative to normal weight. > Random-effects summary all-cause mortality HRs for overweight (BMI of 25–<30), obesity (BMI of ≥30), grade 1 obesity (BMI of 30–<35), and grades 2 and 3 obesity (BMI of ≥35) were calculated relative to normal weight (BMI of 18.5–<25).
      - stnmtn 4y ago
        Great point, I completely misread that. Edited my original comment!
- ZeroGravitas 4y ago
  It does feel a bit like "Big Sugar" at work, demonising its replacement with FUD. The way they lump them all together feels really odd to me. It would be like a report saying non-hydrocarbon vehicles are bad for reason X. Why would anyone but the sugar industry care about all the different substitutes for sugar in such an undifferentiated way?
  - rpdillon 4y ago
    Last paragraph: > They make sure to note that they’re not calling for consumption of sugar instead, because excess sugar is absolutely, positively linked to adverse health effects. I think they care about the substitutes because that's an area where the harm is often debated and much is still unknown. They don't seem to be suggesting that sugar is preferable in any way.
- giantg2 4y ago
  "Doesn't the risk of being overweight completely overwhelm the risk of a not-yet-understood gut flora change?" Probably. However those outcomes can be achieved in ways that don't involve sugar substitutes (eg question implies a false dichotomy).
- deleted 4y ago
  [deleted]
- pessimizer 4y ago
  > Doesn't the risk of being overweight completely overwhelm the risk of a not-yet-understood gut flora change? It's possible that becoming overweight could cause a gut flora change, or a gut flora change could make you likely to become overweight. There's no benefit to ending research into diabetes after you find an association between overweight and diabetes, or in making an assumption that the condition of one's gut flora and being overweight are independent.
- narag 4y ago
  Doesn't the risk of being overweight completely overwhelm the risk of a not-yet-understood gut flora change? If you put me in that dilemma, I would choose the artificial sweeteners every single time. So yes. Diets are difficult enough. But... Although I distrust all the studies that seem to nudge me into stopping dieting, and the article mentions some of them that are now discredited or impossible to reproduce, I don't simply ignore them. Maybe it's "Big Sugar", as a fellow HNer called it, but maybe not. Flora disruption seems very real to me. I had to quit Coke years ago (don't ask) and now I've quit sodas alltogether. I don't like coffee, but fortunately caffeine is sold in pills, and much cheaper. I mention soda specifically because that's what kept me needing sweeteners. Now I drink only water, beer when out with friends, and tea, that unless I'm actively trying to lose weight, I have with one cube or nothing.
- maxk42 4y ago
  You're making the assumption that artificial sweeteners solve the problem of weight gain. The studies that have been conducted so far show only a minimal impact to body composition by switching from sugar to artificial sweeteners. There are more mechanisms at play than are presently understood.
- shkkmo 4y ago
  As far as we know, yes. As other commenter have noted, I wouldn't discount the potential role of gut flora changes on obesity risk. This is explicitly called out in the This study isn't saying that everyone should stop eating artificial-sweetners. It is saying that the previous understanding that artificial sweeteners are biologically inert and risk free. This study shows that we need to do further research to understand what the gut biome changes entail. It also suggests that we should be a more circumspect about replacing sugars in our diet without worrying about trying to reduce our overall desire for sweet foods / drinks.
- VLM 4y ago
  The local minima for diabetes is likely not the overall minima for death rate. I would be surprised if the minima for diabetes diagnosis was NOT slightly below the minima for overall death rate. The famous JAMA article from 2013 that everyone likes to cite, including in comments below, showed no significant increase in death rate for grade 1 obesity and the effects really kicked in strongly around grade 2 and 3 obesity. The more recent BMJ article from 2016 that no one wants to cite, showed minimum death rate in the 20-24 BMI range depending on smoking history. That paper reported the most reliable looking studies of 'non-smokers followed up for over 20 years' had a minimum total death rate at a BMI around 20-22, but that does not support the "Healthy at Every Size" narrative so its memoryholed. I try to keep up to date on diet and supplement journal articles; there's probably journal articles newer than 2016 thats not in my notes yet. Something EVERY study seems to agree on is the death-curve looks very U shaped kind of like computer chip hardware failure rates. The point being that studies disagree on the exact minima death rate vs BMI which is only relevant for large scale population goals, however they all agree that going from, perhaps, 22 to 23 will have an effect that although possibly measurable if across enough people, will tiny and be deep in the decimal places, whereas going from "twenties" to "forties" for BMI means the patient is unquestionably going to die very young, although EXACTLY how young may vary from study to study. The problem with BMI of course is it was originally a screening criteria to "find the worst quartile and counsel them" but as happens with all metrics over time eventually the rough and imprecise low resolution screening criteria turned into an "optimize for its own sake" metric and people getting very weird and hyperfocused about their personal metric calculated to five sig figs at least.
coldcode 4y ago
It's interesting, but still a small sample size in a single country with potentially similar gut microbiomes. It would be much more meaningful to do the same study across different parts of the world and with a larger number of people. I think in some parts of the world it might be difficult to find enough people who don't consume any artificial sweeteners. If you never consume any and now take the test amounts, is that different than consuming it for many years? Could the effect of the test in people not continuously exposed to the sweeteners be different than those who use it routinely?
- naasking 4y ago
  No, I think enough studies have been done to conclude there's an issue. For instance, some other recent ones: * Personalized microbiome-driven effects of non-nutritive sweeteners on human glucose tolerance, https://www.cell.com/cell/fulltext/S0092-8674(22)00919-9 https://www.cell.com/cell/fulltext/S0092-8674(22)00919-9 * Artificial Sweeteners Negatively Regulate Pathogenic Characteristics of Two Model Gut Bacteria, E. coli and E. faecalis, https://www.mdpi.com/1422-0067/22/10/5228 https://www.mdpi.com/1422-0067/22/10/5228 * Artificial sweeteners and risk of cardiovascular diseases: results from the prospective NutriNet-Santé cohort, https://www.bmj.com/content/378/bmj-2022-071204 https://www.bmj.com/content/378/bmj-2022-071204 These are all from different countries.
coliveira 4y ago
I believe any change in diet also causes a possible change in gut microbiomes. Is there any reason to be alarmed about this?
- xeromal 4y ago
  Science compounds so even if this doesn't tell you why the gut microbiome changed, it's useful to know that it did.
  - kekkidy 4y ago
- micromacrofoot 4y ago
  As with most science it's a "warrants further investigation" kind of issue
- phyzome 4y ago
  Not just "change in microbiome". It caused a change such that a gut flora transplant to mice caused the mice to have the same glucose reactions. So the artificial sweeteners change glucose metabolism, at least partly mediated by gut flora. (This has actually been known for at least 3 or 4 years.)
- stephen_g 4y ago
  Yeah, I really want to see a breakdown of the before and after species. I'm very interested in gut microbiome, but frustratingly what's available from the paper outside the paywall doesn't give any details on what the change was. Changes in gut microbiome composition can be very positive or very negative, or mildly positive or mildly negative... What was it in these cases? The thing about the GI changes in the mice in interesting but I really want more details on the bacteria changes!
SevenNation 4y ago
Bottom line: > Collectively, our study suggests that commonly consumed NNS [non-nutritive sweeteners] may not be physiologically inert in humans as previously contemplated, with some of their effects mediated indirectly through impacts exerted on distinct configurations of the human microbiome. In other words, these sweeteners can alter gut bacteria in humans, each person can have a different reaction, and the consequences of these changes are largely unknown.
- wrycoder 4y ago
  The conclusions were at the very end, and I’m not really sure what they were. Not a very good article.
  - jibe 4y ago
    Almost like they expect people to read the whole thing.
    - layer8 4y ago
      The article is still inconclusive.
      - thehappypm 4y ago
        Because the science is inconclusive, but these results are interesting anyway.
- hinkley 4y ago
  I strongly feel that it’s a good policy not to try to trick your body into thinking something is going on when it isn’t. Tricking it into thinking you are sugar has consequences. So does tricking your body into thinking you have an active lifestyle (eg, weight lifting for aesthetics vs cross training).
amadeuspagel 4y ago
I interpreted this headline as "sugar replaces surprise" - if people eat enough sugar they don't care to be surprised anymore, they loose their curiosity, they get their dopamine hits from the sugar rather then from learning surprising things.
- aliqot 4y ago
  This would be a good short story writing prompt. I wonder if it would be a net-gain, as a developer, to crank out a short story each morning as part of normal kata. Seems like it'd juice the creativity-piece of the brain.
bradlys 4y ago
Sounds like aspartame (my artificial sweetener of choice) seems to still be basically without side effect besides gut biome changes. Which doesn’t really mean anything currently because they don’t know if that has any measurable change in the body overall.
- jimmywetnips 4y ago
  Take this with a grain of aspartame, but I was also very gung ho on artificial sweetners and swept all the fear mongering in with gluten and msg. Aka bullshit. For years, I was drinking tons of diet soda. Maybe 2L per day of diet root beer. For whatever reason, 4 years ago, I became super sensitive to aspartame. It would make me hyperalert like a more subtle version of caffeine. I had insmonia for random days. It took me forever to isolate it to aspartame, since I've never had a problem, nor suspected there could even be a problem. I don't have pku but it is what it is. Sucralose, stevia, regular sugar still fine. Bodies are weird. I still believe in science but the older I get, the more I give credence that in some people things just work differently. I don't just jump to the conclusion that they're making something up just because official scienctific papers say it's 99.999% safe.
  - tuatoru 4y ago
    I don't know what artificial sweeteners are used in NZ, but they trigger my asthma. I mostly stick to soda water (only carbon dioxide, no flavorings) these days.
  - jansan 4y ago
    I drank a lot of Coca-Cola life (the one with stevia) and thought that I may have found a drink with a good-enough taste/sugar balance for me. Then, from one day to the other, I got absolutely disgusted by one part of the drink's taste, most probably the sweetener. I could not drink a single glass anymore and today when I even think about Coca-Cola life, it sends me a shiver down the spline. I can drink infinite quantities of drinks made with cheap sugar-free lemonade sirup, so other sweeteners seem to be fine for me, but not stevia.
    - 4y ago
donatj 4y ago
> sucralose significantly impaired glycemic response What's the takeaway from that? Sucralose (Splenda) has long been my sweetener of choice. I prefer the taste over actual sugar in many things. Should I be avoiding it? Is that impaired glycemic response a bad thing I should be worried about?
UIUC_06 4y ago
How many fat people do you see drinking Diet Coke? It doesn't seem to be helping, does it? The answer: just indulge your sweet tooth, if you have one, but be real moderate about it. A quarter tsp of sugar in the coffee, just a couple cookies after dinner. And so forth. And quit drinking soda, period. Get carbonated water if you have to have those bubbles. Don't eat between meals. Next case.
AdamH12113 4y ago
> Exposure to saccharin and sucralose significantly impaired glycemic response, but this was not seen with the aspartame or stevia groups. None of the blood markers show real changes in any group except for insulin levels going up in the glucose and stevia groups (and since everyone was getting glucose as part of the dosing, that suggests a lowering of the glucose-driven insulin response overall). What does impairing glycemic response mean, exactly?
- twawaaay 4y ago
  It is your body's ability to regulate blood sugar level in presence of intakes of food or their absence. A healthy person should have no problem maintaining blood sugar level except for very extreme situations (like running a marathon). Impaired response suggests then some kind of underlying problem.
  - hcurtiss 4y ago
    I’m still confused. In the context of this paper, does “impaired glycemic response” mean blood sugar levels go up but do not come down because insulin production is impaired? Or that insulin levels increase and blood sugars still do not fall? Or that the glycemic response, that is the blood sugar concentrations, do not increase in the first instance?
    - wrycoder 4y ago
      Right, I had the same response to that sentence, see my comment infra. It seems to me that an "impaired" glycemic response is what is actually desired, but the word "impaired" has negative connotations. It might be typical usage in a journal article, but it is not for an article in Science.
      - andor 4y ago
        Impaired glycemic response, when bad enough, is a cause of diabetes. Insulin is not a bad thing, high blood glucose is. When there is no need to immediately use glucose as a fuel (like when exercising), insulin is secreted. It acts as a signal to the rest of the body to remove glucose from the bloodstream and store it (as glycogen or fat). Without insulin (and without exercise), blood glucose levels would be too high for a long time.
ajkjk 4y ago
I feel like this isn't a surprise at all, but I guess it's good to have empirical evidence of it. It's abundantly clear anecdotally that the people who drink tons of artificial-sweetened stuff are _not_ as healthy as those who consume neither tons of sugar OR artificial sweetener. Or put differently: everyone who chugs diet soda seems to be weirdly skinny or weirdly fat, so there is clearly some microbiome effect going on.
- bena 4y ago
  A variation of the "blue car" bias. You notice the weirdly skinny or fat, then notice what they drink.
  - ajkjk 4y ago
    The existence of a bias doesn't mean the observation is invalid, just that the bias has to be taken into account. Anyway, it's definitely not true in this case. I notice the very unusual instance of people drinking soda because it's so rare these days (among my extended social circle). In some cases I _hear_ about it before I meet the person ("my bf drinks like a liter of soda a day" or whatever) -- and then meet them and, unsurprisingly, they're weirdly skinny or fat.
    - bena 4y ago
      Yes, I'm sure you're a completely unbiased source of whether or not you're an unbiased source and you're not discounting all the times this didn't happen because you didn't bother to note the occurrence.
      - ajkjk 4y ago
        I don't think I'm unbiased? I just believe I'm taking the bias into consideration. Pointing out an obvious bias isn't a useful counterargument, it's just a way of saying "whatever you think you've noticed in your life, ignore it, you will always be wrong". Intellectually it's a complete non-starter, it's just a way to write off impressions you don't agree with (instead of, say, debating it, offering supporting or counter-evidence, etc). Obviously you are free to ignore the opinions of a random internet commenter, of course. But I like to mention what I've noticed in case it resonates (or anti-resonates) with any other casual readers.
aenis 4y ago
Anecdata. I did quite a few experiments on myself, as I practice alternate day fasting and keto diet for extended periods of time, and routinely maintain high blood ketone body levels (3-9mmol/l). Drinking beverages with artificial sweeteners (coke zero) did not change my ketone levels - or interrupted them going up. I think it may be overall beneficial since those beverages make low carb diets way easier.
- wrycoder 4y ago
  The article points out that different artificial sweeteners have different glycemic responses, so you could try some others.
  - aenis 4y ago
    Yup, it's an interesting research - even if it's poorly summarized. I will look for more info, since we use a lot of sweeteners. I have a sweet tooth and my wife bakes a lot of keto cakes and makes keto desserts with them. Surely some are better than others.
- pcorsaro 4y ago
  I don’t doubt your statement about the artificial sweeteners, but how in the hell are you getting to 9mmol/l of ketones? I’ve seen levels around 5 after several days of fasting. You’d have to be ingesting ketone esters or something to get to 9.
  - aenis 4y ago
    TLDR: Long fasted cardio. No exogenous ketones needed. My wife and I have the same dietary regime when we need to lose weight - but I exercise, and she does not. We do 0-calorie alternate day fasting + strict keto on the eating days. I do quite a bit of fasted cardio - I cycle to the office 3 days per week, on my fasting days, and thats 3x72km of cycling over hard terrain and usually in the wind. I am around 6-9 mmol/l on fasting days and 3-4 mmol/l on keto days, and she - same diet, but no exercise - is around 1.5-2 mmol/l on fasting days and 0.5-1mmol/l on keto days. All measured around 6pm when our ketone bodies are usually at their highest levels. We reach those levels at around 3-4 weeks of following the diet. (We use this diet every year in the autumn, to burn what we gained over the summer of beer, eating out and other indulgences). A few other differences: - fasted cardio means I get to maintain high ketone body concentrations through the night and in the morning. I routinely get 5-6mmol/l at 7am following the fasting+cycling days. - fasted cardio makes me very satiated the following day; I eat a very small keto breakfast and can't stand the sight of food till the evening. I maintain high ketosis through the day and have no problem with energy levels. Weird. - i have very low blood sugar, at around 2-3mmol/l on the fasting+cycling days. First few days are hard, then it's getting easier and easier. I did ADF and ADF+keto many times in my life, usually for 2-3 months, and it always works, but only when I added long, steady-state fasted cardio did I start to experience those very high levels of ketone body concentrations. It was very scary at first, but nothing bad happened. For comparison, while doing a multi-day fast - the longest I did was 82 hours - I am reaching something like 3mmol/l and feel very miserable throughout (not physically, but mentally). Short fasts (36hr) and keto are significantly easier. Weight drops very, very quickly.
hammock 4y ago
Explain (all of) the findings like I'm five?
- lm28469 4y ago
  Don't eat sugar, don't eat sugar substitutes
  - hammock 4y ago
    That’s not what the study says. It makes distinctions between different categories of substitutes
b800h 4y ago
Even more interesting because gut microbiome health is also associated with autoimmune disease and (apparently - not sure of the veracity) ASD. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337124/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337124/ https://pubmed.ncbi.nlm.nih.gov/30747427/ https://pubmed.ncbi.nlm.nih.gov/30747427/
Veliladon 4y ago
The holy grail of sugar substitution is ironically sugar. The left-handed isomer of glucose still hits our taste buds but doesn't get metabolized in the body. It just goes straight through. We've tried it before and it worked absolutely perfectly but to synthesize and then separate the isomers was prohibitively expensive. Whoever finds a way to make left-handed glucose economically is going to be fucking rich.
- kccqzy 4y ago
  I thought L-glucose and D-glucose would interconvert in water? They will reach an equilibrium with both present?
  - Vloeck 4y ago
    D-fructose and D-glucose interconvert in basic environment. You cannot convert L-glucose to D-glucose and vice-versa.
- smeagull 4y ago
  I never see much in replacing Sucrose with normal Glucose. Never understood why.
- tomp 4y ago
  Why not make both isomers and feed them to bacteria? Only left-handed remains.
  - actionfromafar 4y ago
    It's gotta be something more to than that, even 50-50% sugar would be a great product in its own right.
    - tablespoon 4y ago
      Maybe the problem is more with synthesizing sugar without biological help. After some cursory googling, it sounds like many artificial sweeteners are several orders of magnitude "sweeter" than table sugar, so you'd have to synthesize far more L-sucrose to get a similar effect.
lm28469 4y ago
> They make sure to note that they’re not calling for consumption of sugar instead, because excess sugar is absolutely, positively linked to adverse health effects. But attempting to replace it with artificial sweeteners may not be a good way to go, either Oh no, what will the food industry that got us addicted to sugar will do ?
baxtr 4y ago
Could someone summarize the findings?
- LesZedCB 4y ago
  artificial sweeteners aren't physiologically inert. they increase/change intestinal microbiota. tbd what that means.
- dsr_ 4y ago
  Yes: that's the article, a summary of the findings.
stephc_int13 4y ago
I suspected this some time ago when I tried to learn more about all the potential problems related to gut bacteria. When you ingest something that you can't digest directly, there is a good chance that some bacteria in your guy can. And when they do, they multiply, this process is often faster than most people realize. The problem rarely are the bacteria themselves, but the byproducts of their own metabolism, that can be benign is trace quantities and harmful in larger quantities. The immune system also constantly monitors and reacts to those byproducts and bacteria population. What we usually call Lactose intolerance or Gluten sensitivity is in practice an indirect effect of some species of bacteria digesting those, and then the reaction of your immune system. Overall, the gut microbiome is a fascinating and complex subject, unfortunately often oversimplified or misunderstood. As an example, we've often been told to eat more fibers to increase "flow", the flow increase is because the fibers are digested by bacteria and the mild toxicity of the process forces the digestive system to flush everything. Same with Sorbitol (contained in dried prunes and often used as a soft laxative) but even more toxic.
- ephbit 4y ago
  > As an example, we've often been told to eat more fibers to increase "flow", the flow increase is because the fibers are digested by bacteria and the mild toxicity of the process forces the digestive system to flush everything. Very interesting. Can you maybe refer to some text(s) about this phenomenon of mild toxicity from digestion of fibers?
- wrycoder 4y ago
  The flow increases because the bulk increases with more fiber. Most fiber is cellulose, and your gut biome can't process that, as far as I know.
- atombender 4y ago
  > the mild toxicity of the process forces the digestive system to flush everything Do you have any more information on this "mild toxicity"? That does not sound like a healthy reaction to me. My understanding was health experts encourage insoluble fiber more than anything, precisely because it is essentially inert — not digestable or fermented by microflora — and therefore merely adds bulk to the waste, which helps move stuff through the gut. Are you talking about soluble fiber and prebiotics?
dr_kiszonka 4y ago
Good article! I spent one evening last week on reviewing the role of sugar substitutes in diabetes prevention. Sadly, it seems that most of them, except for perhaps Xylitol, mess with our insulin response. I decided to starting to cut down on my Coke Zero, but it is a struggle...
j2kun 4y ago
Does this say anything significant or new about xylitol? This seems like the safest bet...
- Der_Einzige 4y ago
  It tastes the best, it never gets implicated in these studies, and is used in many keto/no sugar products today. I love it, and insulin and allulose. Not sure why people are obsessed with the nasty shit like stevia, monk fruit, or blue agave...
  - mandmandam 4y ago
    Agreed. Xylitol is yummy, good for your teeth, inexpensive, time tested, and doesn't have a weird aftertaste. The only downsides are that it doesn't work quite the same as sugar in cooking, some are sensitive to it, and if you overdo it there can allegedly be some runny side-effects.
- pmlamotte 4y ago
  Doesn't look like anything new. AFAIK erythritol is the best of the sugar alcohols and potentially the safest of the sugar substitutes. Another option that needs to be studied a bit more but seems safe so far is allulose, which is nice for baking since it will actually brown and doesn't have the cooling effect erythritol has.
  - scottlamb 4y ago
    I subjectively like using allulose, but I don't know the research/theory well. Does it fit into the same "nonmetabolized carbohydrates" category as sucralose?
- curmudgeon22 4y ago
  I recently read some interesting info on xylitol and benefits for dental health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232036/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232036/
- 4y ago
Thrymr 4y ago
"who knows what artificial sweeteners we might have missed out on due to lack of sloppy lab technique?" is gem.
lisper 4y ago
TL;DR: sugar substitutes may be bad for you because of how bacteria in your gut metabolize them. Or maybe not. Either way, sugar is still worse. Not that much of a surprise actually.
8f2ab37a-ed6c 4y ago
So, are monkfruit or stevia bad for you? I'm a heavy user.
- technoooooost 4y ago
  Everything bad, eat what makes you happy, we get cancer one way or the other
- mandmandam 4y ago
  Stevia and Xylitol seem much less disruptive to your gut than sucralose or saccharin, but I'm not an expert. Even a world-class nutritionist can't tell you what their effect on you will be with certainty. The only way to be sure is to cut them out of your diet for 6 weeks or so and see what happens.
kome 4y ago
that's not a surprise at all...
- mandmandam 4y ago
  No, it's not. But sweetener maxis often say the gut bacteria effect is unproven, so every good study there helps.
birdyrooster 4y ago
Am I the only one that prefers aspartame to sugar? Sugar has this aftertaste that tastes like something decaying.
- duderific 4y ago
  I wouldn't say I prefer aspartame to sugar, but to me it's the least bad tasting sugar substitute. On the rare occasion when I get Diet Coke at a restaurant, it has a really nasty taste because they add saccharine in the fountain version. Compared to the canned version which uses only aspartame, the fountain version is almost undrinkable.
mabbo 4y ago
I don't save many comments on HN, but I saved this one and re-read it about once a year for a chuckle: https://news.ycombinator.com/item?id=9440566 https://news.ycombinator.com/item?id=9440566 > I have a slight fascination with sweeteners. About five years ago I imported a kilo of "Neotame" sweetener from a chem factory in Shanghai.
- smaddox 4y ago
  Fascinating. Now it's sold in much smaller quantities: https://www.amazon.com/EASTCHEM-Neotame-25g/dp/B07YYNZP68 https://www.amazon.com/EASTCHEM-Neotame-25g/dp/B07YYNZP68 And https://www.amazon.com/T-Miles-Neotame-Sweetener-Beverages-Pastries%EF%BC%8825g/dp/B09X5NHD4H/ref=mp_s_a_1_1_sspa?crid=JKNWVYJOTJLI&keywords=Neotame&qid=1667504811&qu=eyJxc2MiOiIyLjEyIiwicXNhIjoiMS43NSIsInFzcCI6IjEuNTAifQ%3D%3D&sprefix=neotame%2Caps%2C200&sr=8-1-spons&psc=1 https://www.amazon.com/T-Miles-Neotame-Sweetener-Beverages-P...
wintermutestwin 4y ago
Good luck finding certain foods without artificial sweeteners. 99% of whey protein powders have it. I have to buy pure whey and then I add sugar to it (of course I add a much lower amount because I am not addicted to insanely sweet foods). Also, nearly every product that is labeled as low sugar has them. I make my own fruit spritzers with 1 part fruit juice and 4 parts soda water. Plenty sweet for me...
- mandmandam 4y ago
  I don't know if you can get them where you are, but I'll plug Ireland's All Real protein bars here. They're fantastic. They use dates and honey for sweetness, with whey from happy grass-fed Irish cows. And they're not even much more expensive than the awful alternatives.
- jimmywetnips 4y ago
  it's a real shame. There are a few brands who do try natural stuff, including some pea protein vegan powders. But they kinda taste nasty if im being honest. There just isn't a market that's distinctly anti-artificial sugar yet, besides for the vegan crowd. But I hope the trend of companies like spindrift keeps increasing. low sugar, no articicial sweetners.
keepquestioning 4y ago
Is sugar good or bad for you?
polYate 4y ago
OMG!!!
CodeWriter23 4y ago
> since those are benevolent All Natural substances harvested under blue skies to a background of chirping birds and gentle breezes Researchers expressing bias like this (or the opposite as well) should be disqualified. Science is factual, not emotional nor invective.
- TehCorwiz 4y ago
  That sounds sarcastic to me.
- falcor84 4y ago
  I don't know, I for one really appreciated that touch. Not all scientific content has to be encyclopedic, and this specifically is a commentary blog[0], which I think serves a valuable purpose. [0] https://www.science.org/blogs/pipeline https://www.science.org/blogs/pipeline
jgerrish 4y ago
> since those are benevolent All Natural substances harvested under blue skies to a background of chirping birds and gentle breezes. No shit Science? This is reasoned discourse? One of the most critical components of our world-wide health system, sugar and diabetes. And this is the response. It makes it difficult to truly (no fucking pun intended) assess risk in life. This isn't about cheap rebellion. That's not the relationship you build for. One reason of hundreds.
- sam345 4y ago
  bot?
  - jgerrish 4y ago
    &check; botulism... No, I'm not a bot. Hello.
    - jgerrish 4y ago
      We all love Ooey Gooey Cookies, right? So, how can I make that without killing the crowd? That's the question of the day. Is stevia a decent substitute for sugar? Is sugar ok if consumed on weekends only? I know, silly questions. And then we get Jenny McCarthy provoking editorials, targeting the people who could use knowledgeable advice. And years later, we'll be lectured on bad decisions.
theshrike79 4y ago
Aspartame and asesulfame make my farts smell like literal death - have done so for over a decade, took me a long while to figure out the reason. _Something_ is going on with my gut bacteria and those two. I could also easily down 1.5 litres of sugar free Pepsi MAX in an afternoon. On the other hand a can of sugar coke is more ... satiating? Can't drink EU-Pepsi at all, because even the sugar version has the two horsemen of the fartocalypse in it =(
jjgreen 4y ago
Years ago I was a student nurse and spent a lot of time on the geriatric wards, I really liked the old farts but was somewhat disturbed by how they could spend hour after hour discussing their bowels with anyone who would listen, very strange. Reading this thread has sent me right back there.
SnowHill9902 4y ago
Weird question but can’t you not eat sweet at all? What’s wrong about just not using sugar or any sweeteners?
- Tokkemon 4y ago
  Yes, I, too, hate myself.
nkurz 4y ago
The full article is (currently) available here: https://www.weizmann.ac.il/immunology/elinav/sites/immunology.elinav/files/2022-08/Personalized%20microbiome-driven%20effects%20of%20nonnutritive%20sweeteners%20on%20human%20glucose%20tolerance.pdf https://www.weizmann.ac.il/immunology/elinav/sites/immunolog...
stevespang 4y ago
alexitorg 4y ago
I haven't seen him for a while. But I love the author's, Derek Lowe, work. His posts on Things I won't work with were some of the most entertaining science writing I have read. e.g. https://www.science.org/content/blog-post/things-i-won-t-work-dioxygen-difluoride https://www.science.org/content/blog-post/things-i-won-t-wor...

459 points by hprotagonist 4y ago

Doesn't the risk of being overweight completely overwhelm the risk of a not-yet-understood gut flora change? We know that even being minimally overweight poses a risk; a Nurses’ Health Study reported that women with BMIs in the range of 24-24.9 had a 5-fold greater risk of diabetes when compared with women with BMIs of less than 22.

hinkley 4y ago
In geriatric patients, being slightly overweight has better prospects than being underweight. I’m not sure what the pathology is there, other than hitting starvation cycles if you get certain illnesses, and possibly bone density.
yamtaddle 4y ago
Gut flora probably affect calorie and nutrient absorption. It seems worth checking whether the gut flora changes increase calorie absorption or cause increased appetite (say, by causing nutrient deficiency) before deciding which path is better for weight loss.
- docandrew 4y ago
  Any change in absorption is going to be minuscule in comparison to the difference in calories one gets from all the excess sugar. Anecdotally, switching from full-sugar soda to diet has been a hugely beneficial change to my own health. Would water be better? Maybe, but I’ll settle for harm reduction.
  - yamtaddle 4y ago
    > Any change in absorption is going to be minuscule in comparison to the difference in calories one gets from all the excess sugar. I think that depends on how much it takes to have this effect. If the equivalent of one diet soda every couple days (the doses in the article seemed pretty small to me?) is acting like a kind of pesticide, even in small doses, and killing a lot of calorie-eating gut flora, the harm might exceed the benefit. On the other hand if the artificial sweetener is replacing the sugar in 64+oz of soda per day rather than 16ish oz every couple days, sure, the benefits probably overwhelm any harm.
  - hinkley 4y ago
    I switched from soda to tea three or four times in my life before swearing off soda entirely. Lost 10 lbs every time. The problem with artificial sweeteners is that we have “taste buds” for sweet in our intestines, and there’s a theory that reacting to that increases absorption, so your body pulls more carbs from French fries you ate with your Diet Coke. This is likely a big part of why lecturing people about CICO is such a dick move. “Calories” in food are net calories, not gross calories. We didn’t calculate the calories in bread by burning it in a sensor chamber. We got it by isolating volunteers, measuring the energy in their food versus the energy in their poop, assuming the rest ends up in your body. But of course any heat generated by gut microbes might be shed, and the hydrogen bonds in your burps are also lost calories. I was a very gassy person when I was a young beanpole. Not so much anymore.
    - kenjackson 4y ago
      Anecdotally my wife changed her diet and basically tried to replace sugar with sucralose wherever she could. The end result was a significant weight loss. I should note she also did start exercising more at the same time, so definitely not a controlled study. But the delta in calories from sugar was far greater than the caloric expenditure from exercise.
      - hinkley 4y ago
        I started long distance walking this year, and nearly every time I see the calorie count I am reminded of the aphorism about not being able to outrun a bad diet. I think that’s bullshit, with a proviso. The provision is that you can’t outrun a bad diet by exercising a half hour a day. That 30 minutes is a number doctors settled on not to scare sedentary people into not starting an exercise program. You really need an hour or more a day. I’m trying to get my walk route down to 90 minutes, in prep for a half marathon next year. If I stop for a matcha at the halfway point, I’ve still burned well over twice what I consumed. If I get the smoothie still come out ahead. The real “secret” there is that when I watch TV I nibble. Not getting food on books is the only reason I don’t nibble when reading. What I’ve done in a 90 minute walk is to forestall eating more than one single thing in that ninety minutes. And lowered my stress level. Cortisol is the other killer here. Even before that the nearest good coffee shop was a mile away and my net calories were ~100. If I avoided a certain cream based beverage. For some people, banning prepared foods does a similar thing. Preparing a snack takes fifteen minutes instead of fifteen seconds. You just don’t have as much time in the day to stuff your face once the convenience is gone. The other aphorism is that you lose weight at the grocery store, which I do believe. If you come home with fruit instead of pie and chips you’ve already fought half the battle.
- matthewdgreen 4y ago
  The issue is not necessarily just nutrient absorption, but also the body's production of GLP-1: that influences appetite and blood sugar regulation. https://pubmed.ncbi.nlm.nih.gov/33820962/ https://pubmed.ncbi.nlm.nih.gov/33820962/
cowmoo728 4y ago
It is possible (likely?) that the observed gut flora changes interfere with normal metabolic function, causing long term weight gain. 2020 - "future studies should consider the metabolic pathways of different artificial sweeteners. Further (long-term) human research investigating the underlying physiological pathways of different artificial sweeteners on microbiota alterations and its related metabolic pathway is warranted to evaluate the potential impact of their use on body weight control and glucose homeostasis." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817779/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817779/
- andrewmutz 4y ago
  Yes, there has been some fascinating research coming out suggesting that the gut flora composition can have a causal effect on obesity. For example, if you transplant feces from overweight humans and normal weight humans to mice, the mice will gain (or not gain) weight, depending on which person the feces came from: https://www.science.org/doi/10.1126/science.1241214 https://www.science.org/doi/10.1126/science.1241214
colordrops 4y ago
Many non overweight people eat these fake sweeteners too.
- hinkley 4y ago
  You can be skinny and diabetic too. One of the American Ninja Warriors last season wore an insulin pump. While competing. I’ve since noticed pictures of a few competitive runners with them. Weight and metabolic function are correlated, not equivalent.
  - roxymusic1973 4y ago
    She was type 1 diabetic, so perhaps not relevant: https://www.diabetesselfmanagement.com/blog/an-american-ninja-warrior-with-type-1/ https://www.diabetesselfmanagement.com/blog/an-american-ninj...
  - colordrops 4y ago
    That's my point. We shouldn't only be concerned about overweight people.
time_to_smile 4y ago
You're making the implicit assumption that sugar substitutes do reduce the risk of being overweight. At least the first post I found on the topic suggest there is evidence of "a positive correlation between regular use of artificial sweetener and weight gain"[0] 0.https://www.publichealthpost.org/research/can-sugar-substitutes-reduce-risk-of-obesity/ https://www.publichealthpost.org/research/can-sugar-substitu...
- tuatoru 4y ago
  This article suggests a mechanism for that positive correlation: impairment of glycaemic response by the most commonly used artificial sweeteners.
awestroke 4y ago
False dichonomy; you can choose to consume neither sugar nor sweeteners
- Al-Khwarizmi 4y ago
  That, and it's also possible to consume (moderate amounts of) sugar and have a good BMI.
- SoftTalker 4y ago
  Yep. I used to drink a lot of diet soda. I stopped that probably 10 years ago or so. I don't use artificial sweeteners in anything. I mostly drink water now. When I drink coffee or tea it's unsweetened. For an occasional treat such as a milkshake I will use sugar, sparingly. Incidentally, when I drink diet soft drinks now they taste like chemicals. Completely unnatural sweetness. I don't find them enjoyable at all. But when I used to drink them daily, I liked them, really almost craved them.
- SamPatt 4y ago
  Other than natural sugars in fruit, my diet has effectively no sugar or sweeteners. It's not that hard after several years of changing your eating habits slowly. It helps that I've always preferred drinking water.
deleted 4y ago
[deleted]
googlryas 4y ago
Sure, if sugar sweetener is the only thing keeping you overweight. But it's probably harder for your body to deal with being both overweight and having a weird gut biome simultaneously.
PuppyTailWags 4y ago
It seems that despite increased risk of diabetes, being slightly overweight actually decreases all-cause mortality and being grade 1 obese doesn't affect all-cause mortality. I heard of this through a podcast and I'm not super educated, but it seems to me that the relationship of weight and health is more complicated, since I agree that increasing risk of heart disease, diabetes, etc. is bad. It just doesn't seem to bear out in actually killing a person. Maybe it decreases their quality of life drastically instead? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855514/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855514/
- stnmtn 4y ago
  ̶R̶e̶a̶d̶i̶n̶g̶ ̶t̶h̶i̶s̶ ̶s̶t̶u̶d̶y̶,̶ ̶I̶ ̶b̶e̶l̶i̶e̶v̶e̶ ̶y̶o̶u̶ ̶a̶r̶e̶ ̶m̶i̶s̶i̶n̶t̶e̶r̶p̶r̶e̶t̶i̶n̶g̶ ̶t̶h̶e̶ ̶r̶e̶s̶u̶l̶t̶s̶.̶ ̶I̶t̶ ̶s̶a̶y̶s̶ ̶n̶o̶t̶h̶i̶n̶g̶ ̶a̶b̶o̶u̶t̶ ̶i̶f̶ ̶b̶e̶i̶n̶g̶ ̶o̶v̶e̶r̶w̶e̶i̶g̶h̶t̶ ̶d̶e̶c̶r̶e̶a̶s̶e̶s̶ ̶a̶l̶l̶-̶c̶a̶u̶s̶e̶ ̶m̶o̶r̶t̶a̶l̶i̶t̶y̶ ̶r̶e̶l̶a̶t̶i̶v̶e̶ ̶t̶o̶ ̶n̶o̶r̶m̶a̶l̶ ̶w̶e̶i̶g̶h̶t̶.̶ ̶I̶t̶ ̶o̶n̶l̶y̶ ̶s̶a̶y̶s̶ ̶b̶e̶i̶n̶g̶ ̶o̶v̶e̶r̶w̶e̶i̶g̶h̶t̶ ̶d̶e̶c̶r̶e̶a̶s̶e̶s̶ ̶a̶l̶l̶-̶c̶a̶u̶s̶e̶ ̶m̶o̶r̶t̶a̶l̶i̶t̶y̶ ̶r̶e̶l̶a̶t̶i̶v̶e̶ ̶t̶o̶ ̶o̶b̶e̶s̶i̶t̶y̶.̶ ̶ ̶T̶h̶a̶t̶ ̶i̶s̶ ̶h̶o̶w̶ ̶I̶ ̶r̶e̶a̶d̶ ̶i̶t̶ ̶a̶t̶ ̶l̶e̶a̶s̶t̶,̶ ̶I̶ ̶c̶a̶n̶'̶t̶ ̶f̶i̶n̶d̶ ̶a̶ ̶b̶a̶s̶e̶l̶i̶n̶e̶ ̶f̶o̶r̶ ̶t̶h̶e̶ ̶H̶R̶ ̶o̶f̶ ̶a̶ ̶n̶o̶r̶m̶a̶l̶ ̶w̶e̶i̶g̶h̶t̶ ̶i̶n̶ ̶t̶h̶e̶ ̶s̶t̶u̶d̶y̶ ̶l̶i̶n̶k̶e̶d̶.̶ edit: this is wrong, see reply below
  - PuppyTailWags 4y ago
    The article explicitly compares overweight, grade 1 obesity, grade 2 & 3 obesity together, obesity generally, relative to normal weight. > Random-effects summary all-cause mortality HRs for overweight (BMI of 25–<30), obesity (BMI of ≥30), grade 1 obesity (BMI of 30–<35), and grades 2 and 3 obesity (BMI of ≥35) were calculated relative to normal weight (BMI of 18.5–<25).
    - stnmtn 4y ago
      Great point, I completely misread that. Edited my original comment!
ZeroGravitas 4y ago
It does feel a bit like "Big Sugar" at work, demonising its replacement with FUD. The way they lump them all together feels really odd to me. It would be like a report saying non-hydrocarbon vehicles are bad for reason X. Why would anyone but the sugar industry care about all the different substitutes for sugar in such an undifferentiated way?
- rpdillon 4y ago
  Last paragraph: > They make sure to note that they’re not calling for consumption of sugar instead, because excess sugar is absolutely, positively linked to adverse health effects. I think they care about the substitutes because that's an area where the harm is often debated and much is still unknown. They don't seem to be suggesting that sugar is preferable in any way.
giantg2 4y ago
"Doesn't the risk of being overweight completely overwhelm the risk of a not-yet-understood gut flora change?" Probably. However those outcomes can be achieved in ways that don't involve sugar substitutes (eg question implies a false dichotomy).
deleted 4y ago
[deleted]
pessimizer 4y ago
> Doesn't the risk of being overweight completely overwhelm the risk of a not-yet-understood gut flora change? It's possible that becoming overweight could cause a gut flora change, or a gut flora change could make you likely to become overweight. There's no benefit to ending research into diabetes after you find an association between overweight and diabetes, or in making an assumption that the condition of one's gut flora and being overweight are independent.
narag 4y ago
Doesn't the risk of being overweight completely overwhelm the risk of a not-yet-understood gut flora change? If you put me in that dilemma, I would choose the artificial sweeteners every single time. So yes. Diets are difficult enough. But... Although I distrust all the studies that seem to nudge me into stopping dieting, and the article mentions some of them that are now discredited or impossible to reproduce, I don't simply ignore them. Maybe it's "Big Sugar", as a fellow HNer called it, but maybe not. Flora disruption seems very real to me. I had to quit Coke years ago (don't ask) and now I've quit sodas alltogether. I don't like coffee, but fortunately caffeine is sold in pills, and much cheaper. I mention soda specifically because that's what kept me needing sweeteners. Now I drink only water, beer when out with friends, and tea, that unless I'm actively trying to lose weight, I have with one cube or nothing.
maxk42 4y ago
You're making the assumption that artificial sweeteners solve the problem of weight gain. The studies that have been conducted so far show only a minimal impact to body composition by switching from sugar to artificial sweeteners. There are more mechanisms at play than are presently understood.
shkkmo 4y ago
As far as we know, yes. As other commenter have noted, I wouldn't discount the potential role of gut flora changes on obesity risk. This is explicitly called out in the This study isn't saying that everyone should stop eating artificial-sweetners. It is saying that the previous understanding that artificial sweeteners are biologically inert and risk free. This study shows that we need to do further research to understand what the gut biome changes entail. It also suggests that we should be a more circumspect about replacing sugars in our diet without worrying about trying to reduce our overall desire for sweet foods / drinks.
VLM 4y ago
The local minima for diabetes is likely not the overall minima for death rate. I would be surprised if the minima for diabetes diagnosis was NOT slightly below the minima for overall death rate. The famous JAMA article from 2013 that everyone likes to cite, including in comments below, showed no significant increase in death rate for grade 1 obesity and the effects really kicked in strongly around grade 2 and 3 obesity. The more recent BMJ article from 2016 that no one wants to cite, showed minimum death rate in the 20-24 BMI range depending on smoking history. That paper reported the most reliable looking studies of 'non-smokers followed up for over 20 years' had a minimum total death rate at a BMI around 20-22, but that does not support the "Healthy at Every Size" narrative so its memoryholed. I try to keep up to date on diet and supplement journal articles; there's probably journal articles newer than 2016 thats not in my notes yet. Something EVERY study seems to agree on is the death-curve looks very U shaped kind of like computer chip hardware failure rates. The point being that studies disagree on the exact minima death rate vs BMI which is only relevant for large scale population goals, however they all agree that going from, perhaps, 22 to 23 will have an effect that although possibly measurable if across enough people, will tiny and be deep in the decimal places, whereas going from "twenties" to "forties" for BMI means the patient is unquestionably going to die very young, although EXACTLY how young may vary from study to study. The problem with BMI of course is it was originally a screening criteria to "find the worst quartile and counsel them" but as happens with all metrics over time eventually the rough and imprecise low resolution screening criteria turned into an "optimize for its own sake" metric and people getting very weird and hyperfocused about their personal metric calculated to five sig figs at least.

coldcode 4y ago

It's interesting, but still a small sample size in a single country with potentially similar gut microbiomes. It would be much more meaningful to do the same study across different parts of the world and with a larger number of people. I think in some parts of the world it might be difficult to find enough people who don't consume any artificial sweeteners. If you never consume any and now take the test amounts, is that different than consuming it for many years? Could the effect of the test in people not continuously exposed to the sweeteners be different than those who use it routinely?

naasking 4y ago
No, I think enough studies have been done to conclude there's an issue. For instance, some other recent ones: * Personalized microbiome-driven effects of non-nutritive sweeteners on human glucose tolerance, https://www.cell.com/cell/fulltext/S0092-8674(22)00919-9 https://www.cell.com/cell/fulltext/S0092-8674(22)00919-9 * Artificial Sweeteners Negatively Regulate Pathogenic Characteristics of Two Model Gut Bacteria, E. coli and E. faecalis, https://www.mdpi.com/1422-0067/22/10/5228 https://www.mdpi.com/1422-0067/22/10/5228 * Artificial sweeteners and risk of cardiovascular diseases: results from the prospective NutriNet-Santé cohort, https://www.bmj.com/content/378/bmj-2022-071204 https://www.bmj.com/content/378/bmj-2022-071204 These are all from different countries.

coliveira 4y ago

I believe any change in diet also causes a possible change in gut microbiomes. Is there any reason to be alarmed about this?

xeromal 4y ago
Science compounds so even if this doesn't tell you why the gut microbiome changed, it's useful to know that it did.
- kekkidy 4y ago
micromacrofoot 4y ago
As with most science it's a "warrants further investigation" kind of issue
phyzome 4y ago
Not just "change in microbiome". It caused a change such that a gut flora transplant to mice caused the mice to have the same glucose reactions. So the artificial sweeteners change glucose metabolism, at least partly mediated by gut flora. (This has actually been known for at least 3 or 4 years.)
stephen_g 4y ago
Yeah, I really want to see a breakdown of the before and after species. I'm very interested in gut microbiome, but frustratingly what's available from the paper outside the paywall doesn't give any details on what the change was. Changes in gut microbiome composition can be very positive or very negative, or mildly positive or mildly negative... What was it in these cases? The thing about the GI changes in the mice in interesting but I really want more details on the bacteria changes!

SevenNation 4y ago

Bottom line: > Collectively, our study suggests that commonly consumed NNS [non-nutritive sweeteners] may not be physiologically inert in humans as previously contemplated, with some of their effects mediated indirectly through impacts exerted on distinct configurations of the human microbiome. In other words, these sweeteners can alter gut bacteria in humans, each person can have a different reaction, and the consequences of these changes are largely unknown.

wrycoder 4y ago
The conclusions were at the very end, and I’m not really sure what they were. Not a very good article.
- jibe 4y ago
  Almost like they expect people to read the whole thing.
  - layer8 4y ago
    The article is still inconclusive.
    - thehappypm 4y ago
      Because the science is inconclusive, but these results are interesting anyway.
hinkley 4y ago
I strongly feel that it’s a good policy not to try to trick your body into thinking something is going on when it isn’t. Tricking it into thinking you are sugar has consequences. So does tricking your body into thinking you have an active lifestyle (eg, weight lifting for aesthetics vs cross training).

amadeuspagel 4y ago

I interpreted this headline as "sugar replaces surprise" - if people eat enough sugar they don't care to be surprised anymore, they loose their curiosity, they get their dopamine hits from the sugar rather then from learning surprising things.

aliqot 4y ago
This would be a good short story writing prompt. I wonder if it would be a net-gain, as a developer, to crank out a short story each morning as part of normal kata. Seems like it'd juice the creativity-piece of the brain.

bradlys 4y ago

Sounds like aspartame (my artificial sweetener of choice) seems to still be basically without side effect besides gut biome changes. Which doesn’t really mean anything currently because they don’t know if that has any measurable change in the body overall.

jimmywetnips 4y ago
Take this with a grain of aspartame, but I was also very gung ho on artificial sweetners and swept all the fear mongering in with gluten and msg. Aka bullshit. For years, I was drinking tons of diet soda. Maybe 2L per day of diet root beer. For whatever reason, 4 years ago, I became super sensitive to aspartame. It would make me hyperalert like a more subtle version of caffeine. I had insmonia for random days. It took me forever to isolate it to aspartame, since I've never had a problem, nor suspected there could even be a problem. I don't have pku but it is what it is. Sucralose, stevia, regular sugar still fine. Bodies are weird. I still believe in science but the older I get, the more I give credence that in some people things just work differently. I don't just jump to the conclusion that they're making something up just because official scienctific papers say it's 99.999% safe.
- tuatoru 4y ago
  I don't know what artificial sweeteners are used in NZ, but they trigger my asthma. I mostly stick to soda water (only carbon dioxide, no flavorings) these days.
- jansan 4y ago
  I drank a lot of Coca-Cola life (the one with stevia) and thought that I may have found a drink with a good-enough taste/sugar balance for me. Then, from one day to the other, I got absolutely disgusted by one part of the drink's taste, most probably the sweetener. I could not drink a single glass anymore and today when I even think about Coca-Cola life, it sends me a shiver down the spline. I can drink infinite quantities of drinks made with cheap sugar-free lemonade sirup, so other sweeteners seem to be fine for me, but not stevia.
  - 4y ago

donatj 4y ago

> sucralose significantly impaired glycemic response What's the takeaway from that? Sucralose (Splenda) has long been my sweetener of choice. I prefer the taste over actual sugar in many things. Should I be avoiding it? Is that impaired glycemic response a bad thing I should be worried about?

UIUC_06 4y ago

How many fat people do you see drinking Diet Coke? It doesn't seem to be helping, does it? The answer: just indulge your sweet tooth, if you have one, but be real moderate about it. A quarter tsp of sugar in the coffee, just a couple cookies after dinner. And so forth. And quit drinking soda, period. Get carbonated water if you have to have those bubbles. Don't eat between meals. Next case.

AdamH12113 4y ago

> Exposure to saccharin and sucralose significantly impaired glycemic response, but this was not seen with the aspartame or stevia groups. None of the blood markers show real changes in any group except for insulin levels going up in the glucose and stevia groups (and since everyone was getting glucose as part of the dosing, that suggests a lowering of the glucose-driven insulin response overall). What does impairing glycemic response mean, exactly?

twawaaay 4y ago
It is your body's ability to regulate blood sugar level in presence of intakes of food or their absence. A healthy person should have no problem maintaining blood sugar level except for very extreme situations (like running a marathon). Impaired response suggests then some kind of underlying problem.
- hcurtiss 4y ago
  I’m still confused. In the context of this paper, does “impaired glycemic response” mean blood sugar levels go up but do not come down because insulin production is impaired? Or that insulin levels increase and blood sugars still do not fall? Or that the glycemic response, that is the blood sugar concentrations, do not increase in the first instance?
  - wrycoder 4y ago
    Right, I had the same response to that sentence, see my comment infra. It seems to me that an "impaired" glycemic response is what is actually desired, but the word "impaired" has negative connotations. It might be typical usage in a journal article, but it is not for an article in Science.
    - andor 4y ago
      Impaired glycemic response, when bad enough, is a cause of diabetes. Insulin is not a bad thing, high blood glucose is. When there is no need to immediately use glucose as a fuel (like when exercising), insulin is secreted. It acts as a signal to the rest of the body to remove glucose from the bloodstream and store it (as glycogen or fat). Without insulin (and without exercise), blood glucose levels would be too high for a long time.

ajkjk 4y ago

I feel like this isn't a surprise at all, but I guess it's good to have empirical evidence of it. It's abundantly clear anecdotally that the people who drink tons of artificial-sweetened stuff are _not_ as healthy as those who consume neither tons of sugar OR artificial sweetener. Or put differently: everyone who chugs diet soda seems to be weirdly skinny or weirdly fat, so there is clearly some microbiome effect going on.

bena 4y ago
A variation of the "blue car" bias. You notice the weirdly skinny or fat, then notice what they drink.
- ajkjk 4y ago
  The existence of a bias doesn't mean the observation is invalid, just that the bias has to be taken into account. Anyway, it's definitely not true in this case. I notice the very unusual instance of people drinking soda because it's so rare these days (among my extended social circle). In some cases I _hear_ about it before I meet the person ("my bf drinks like a liter of soda a day" or whatever) -- and then meet them and, unsurprisingly, they're weirdly skinny or fat.
  - bena 4y ago
    Yes, I'm sure you're a completely unbiased source of whether or not you're an unbiased source and you're not discounting all the times this didn't happen because you didn't bother to note the occurrence.
    - ajkjk 4y ago
      I don't think I'm unbiased? I just believe I'm taking the bias into consideration. Pointing out an obvious bias isn't a useful counterargument, it's just a way of saying "whatever you think you've noticed in your life, ignore it, you will always be wrong". Intellectually it's a complete non-starter, it's just a way to write off impressions you don't agree with (instead of, say, debating it, offering supporting or counter-evidence, etc). Obviously you are free to ignore the opinions of a random internet commenter, of course. But I like to mention what I've noticed in case it resonates (or anti-resonates) with any other casual readers.

aenis 4y ago

Anecdata. I did quite a few experiments on myself, as I practice alternate day fasting and keto diet for extended periods of time, and routinely maintain high blood ketone body levels (3-9mmol/l). Drinking beverages with artificial sweeteners (coke zero) did not change my ketone levels - or interrupted them going up. I think it may be overall beneficial since those beverages make low carb diets way easier.

wrycoder 4y ago
The article points out that different artificial sweeteners have different glycemic responses, so you could try some others.
- aenis 4y ago
  Yup, it's an interesting research - even if it's poorly summarized. I will look for more info, since we use a lot of sweeteners. I have a sweet tooth and my wife bakes a lot of keto cakes and makes keto desserts with them. Surely some are better than others.
pcorsaro 4y ago
I don’t doubt your statement about the artificial sweeteners, but how in the hell are you getting to 9mmol/l of ketones? I’ve seen levels around 5 after several days of fasting. You’d have to be ingesting ketone esters or something to get to 9.
- aenis 4y ago
  TLDR: Long fasted cardio. No exogenous ketones needed. My wife and I have the same dietary regime when we need to lose weight - but I exercise, and she does not. We do 0-calorie alternate day fasting + strict keto on the eating days. I do quite a bit of fasted cardio - I cycle to the office 3 days per week, on my fasting days, and thats 3x72km of cycling over hard terrain and usually in the wind. I am around 6-9 mmol/l on fasting days and 3-4 mmol/l on keto days, and she - same diet, but no exercise - is around 1.5-2 mmol/l on fasting days and 0.5-1mmol/l on keto days. All measured around 6pm when our ketone bodies are usually at their highest levels. We reach those levels at around 3-4 weeks of following the diet. (We use this diet every year in the autumn, to burn what we gained over the summer of beer, eating out and other indulgences). A few other differences: - fasted cardio means I get to maintain high ketone body concentrations through the night and in the morning. I routinely get 5-6mmol/l at 7am following the fasting+cycling days. - fasted cardio makes me very satiated the following day; I eat a very small keto breakfast and can't stand the sight of food till the evening. I maintain high ketosis through the day and have no problem with energy levels. Weird. - i have very low blood sugar, at around 2-3mmol/l on the fasting+cycling days. First few days are hard, then it's getting easier and easier. I did ADF and ADF+keto many times in my life, usually for 2-3 months, and it always works, but only when I added long, steady-state fasted cardio did I start to experience those very high levels of ketone body concentrations. It was very scary at first, but nothing bad happened. For comparison, while doing a multi-day fast - the longest I did was 82 hours - I am reaching something like 3mmol/l and feel very miserable throughout (not physically, but mentally). Short fasts (36hr) and keto are significantly easier. Weight drops very, very quickly.

hammock 4y ago

Explain (all of) the findings like I'm five?

lm28469 4y ago
Don't eat sugar, don't eat sugar substitutes
- hammock 4y ago
  That’s not what the study says. It makes distinctions between different categories of substitutes

b800h 4y ago

Even more interesting because gut microbiome health is also associated with autoimmune disease and (apparently - not sure of the veracity) ASD. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337124/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337124/ https://pubmed.ncbi.nlm.nih.gov/30747427/ https://pubmed.ncbi.nlm.nih.gov/30747427/

Veliladon 4y ago

The holy grail of sugar substitution is ironically sugar. The left-handed isomer of glucose still hits our taste buds but doesn't get metabolized in the body. It just goes straight through. We've tried it before and it worked absolutely perfectly but to synthesize and then separate the isomers was prohibitively expensive. Whoever finds a way to make left-handed glucose economically is going to be fucking rich.

kccqzy 4y ago
I thought L-glucose and D-glucose would interconvert in water? They will reach an equilibrium with both present?
- Vloeck 4y ago
  D-fructose and D-glucose interconvert in basic environment. You cannot convert L-glucose to D-glucose and vice-versa.
smeagull 4y ago
I never see much in replacing Sucrose with normal Glucose. Never understood why.
tomp 4y ago
Why not make both isomers and feed them to bacteria? Only left-handed remains.
- actionfromafar 4y ago
  It's gotta be something more to than that, even 50-50% sugar would be a great product in its own right.
  - tablespoon 4y ago
    Maybe the problem is more with synthesizing sugar without biological help. After some cursory googling, it sounds like many artificial sweeteners are several orders of magnitude "sweeter" than table sugar, so you'd have to synthesize far more L-sucrose to get a similar effect.

lm28469 4y ago

> They make sure to note that they’re not calling for consumption of sugar instead, because excess sugar is absolutely, positively linked to adverse health effects. But attempting to replace it with artificial sweeteners may not be a good way to go, either Oh no, what will the food industry that got us addicted to sugar will do ?

baxtr 4y ago

Could someone summarize the findings?

LesZedCB 4y ago
artificial sweeteners aren't physiologically inert. they increase/change intestinal microbiota. tbd what that means.
dsr_ 4y ago
Yes: that's the article, a summary of the findings.

stephc_int13 4y ago

I suspected this some time ago when I tried to learn more about all the potential problems related to gut bacteria. When you ingest something that you can't digest directly, there is a good chance that some bacteria in your guy can. And when they do, they multiply, this process is often faster than most people realize. The problem rarely are the bacteria themselves, but the byproducts of their own metabolism, that can be benign is trace quantities and harmful in larger quantities. The immune system also constantly monitors and reacts to those byproducts and bacteria population. What we usually call Lactose intolerance or Gluten sensitivity is in practice an indirect effect of some species of bacteria digesting those, and then the reaction of your immune system. Overall, the gut microbiome is a fascinating and complex subject, unfortunately often oversimplified or misunderstood. As an example, we've often been told to eat more fibers to increase "flow", the flow increase is because the fibers are digested by bacteria and the mild toxicity of the process forces the digestive system to flush everything. Same with Sorbitol (contained in dried prunes and often used as a soft laxative) but even more toxic.

ephbit 4y ago
> As an example, we've often been told to eat more fibers to increase "flow", the flow increase is because the fibers are digested by bacteria and the mild toxicity of the process forces the digestive system to flush everything. Very interesting. Can you maybe refer to some text(s) about this phenomenon of mild toxicity from digestion of fibers?
wrycoder 4y ago
The flow increases because the bulk increases with more fiber. Most fiber is cellulose, and your gut biome can't process that, as far as I know.
atombender 4y ago
> the mild toxicity of the process forces the digestive system to flush everything Do you have any more information on this "mild toxicity"? That does not sound like a healthy reaction to me. My understanding was health experts encourage insoluble fiber more than anything, precisely because it is essentially inert — not digestable or fermented by microflora — and therefore merely adds bulk to the waste, which helps move stuff through the gut. Are you talking about soluble fiber and prebiotics?

dr_kiszonka 4y ago

Good article! I spent one evening last week on reviewing the role of sugar substitutes in diabetes prevention. Sadly, it seems that most of them, except for perhaps Xylitol, mess with our insulin response. I decided to starting to cut down on my Coke Zero, but it is a struggle...

j2kun 4y ago

Does this say anything significant or new about xylitol? This seems like the safest bet...

Der_Einzige 4y ago
It tastes the best, it never gets implicated in these studies, and is used in many keto/no sugar products today. I love it, and insulin and allulose. Not sure why people are obsessed with the nasty shit like stevia, monk fruit, or blue agave...
- mandmandam 4y ago
  Agreed. Xylitol is yummy, good for your teeth, inexpensive, time tested, and doesn't have a weird aftertaste. The only downsides are that it doesn't work quite the same as sugar in cooking, some are sensitive to it, and if you overdo it there can allegedly be some runny side-effects.
pmlamotte 4y ago
Doesn't look like anything new. AFAIK erythritol is the best of the sugar alcohols and potentially the safest of the sugar substitutes. Another option that needs to be studied a bit more but seems safe so far is allulose, which is nice for baking since it will actually brown and doesn't have the cooling effect erythritol has.
- scottlamb 4y ago
  I subjectively like using allulose, but I don't know the research/theory well. Does it fit into the same "nonmetabolized carbohydrates" category as sucralose?
curmudgeon22 4y ago
I recently read some interesting info on xylitol and benefits for dental health: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232036/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232036/
4y ago

Thrymr 4y ago

"who knows what artificial sweeteners we might have missed out on due to lack of sloppy lab technique?" is gem.

lisper 4y ago

TL;DR: sugar substitutes may be bad for you because of how bacteria in your gut metabolize them. Or maybe not. Either way, sugar is still worse. Not that much of a surprise actually.

8f2ab37a-ed6c 4y ago

So, are monkfruit or stevia bad for you? I'm a heavy user.

technoooooost 4y ago
Everything bad, eat what makes you happy, we get cancer one way or the other
mandmandam 4y ago
Stevia and Xylitol seem much less disruptive to your gut than sucralose or saccharin, but I'm not an expert. Even a world-class nutritionist can't tell you what their effect on you will be with certainty. The only way to be sure is to cut them out of your diet for 6 weeks or so and see what happens.

kome 4y ago

that's not a surprise at all...

mandmandam 4y ago
No, it's not. But sweetener maxis often say the gut bacteria effect is unproven, so every good study there helps.

birdyrooster 4y ago

Am I the only one that prefers aspartame to sugar? Sugar has this aftertaste that tastes like something decaying.

duderific 4y ago
I wouldn't say I prefer aspartame to sugar, but to me it's the least bad tasting sugar substitute. On the rare occasion when I get Diet Coke at a restaurant, it has a really nasty taste because they add saccharine in the fountain version. Compared to the canned version which uses only aspartame, the fountain version is almost undrinkable.

mabbo 4y ago

I don't save many comments on HN, but I saved this one and re-read it about once a year for a chuckle: https://news.ycombinator.com/item?id=9440566 https://news.ycombinator.com/item?id=9440566 > I have a slight fascination with sweeteners. About five years ago I imported a kilo of "Neotame" sweetener from a chem factory in Shanghai.

smaddox 4y ago
Fascinating. Now it's sold in much smaller quantities: https://www.amazon.com/EASTCHEM-Neotame-25g/dp/B07YYNZP68 https://www.amazon.com/EASTCHEM-Neotame-25g/dp/B07YYNZP68 And https://www.amazon.com/T-Miles-Neotame-Sweetener-Beverages-Pastries%EF%BC%8825g/dp/B09X5NHD4H/ref=mp_s_a_1_1_sspa?crid=JKNWVYJOTJLI&keywords=Neotame&qid=1667504811&qu=eyJxc2MiOiIyLjEyIiwicXNhIjoiMS43NSIsInFzcCI6IjEuNTAifQ%3D%3D&sprefix=neotame%2Caps%2C200&sr=8-1-spons&psc=1 https://www.amazon.com/T-Miles-Neotame-Sweetener-Beverages-P...

wintermutestwin 4y ago

Good luck finding certain foods without artificial sweeteners. 99% of whey protein powders have it. I have to buy pure whey and then I add sugar to it (of course I add a much lower amount because I am not addicted to insanely sweet foods). Also, nearly every product that is labeled as low sugar has them. I make my own fruit spritzers with 1 part fruit juice and 4 parts soda water. Plenty sweet for me...

mandmandam 4y ago
I don't know if you can get them where you are, but I'll plug Ireland's All Real protein bars here. They're fantastic. They use dates and honey for sweetness, with whey from happy grass-fed Irish cows. And they're not even much more expensive than the awful alternatives.
jimmywetnips 4y ago
it's a real shame. There are a few brands who do try natural stuff, including some pea protein vegan powders. But they kinda taste nasty if im being honest. There just isn't a market that's distinctly anti-artificial sugar yet, besides for the vegan crowd. But I hope the trend of companies like spindrift keeps increasing. low sugar, no articicial sweetners.

keepquestioning 4y ago

Is sugar good or bad for you?

polYate 4y ago

OMG!!!

CodeWriter23 4y ago

> since those are benevolent All Natural substances harvested under blue skies to a background of chirping birds and gentle breezes Researchers expressing bias like this (or the opposite as well) should be disqualified. Science is factual, not emotional nor invective.

TehCorwiz 4y ago
That sounds sarcastic to me.
falcor84 4y ago
I don't know, I for one really appreciated that touch. Not all scientific content has to be encyclopedic, and this specifically is a commentary blog[0], which I think serves a valuable purpose. [0] https://www.science.org/blogs/pipeline https://www.science.org/blogs/pipeline

jgerrish 4y ago

> since those are benevolent All Natural substances harvested under blue skies to a background of chirping birds and gentle breezes. No shit Science? This is reasoned discourse? One of the most critical components of our world-wide health system, sugar and diabetes. And this is the response. It makes it difficult to truly (no fucking pun intended) assess risk in life. This isn't about cheap rebellion. That's not the relationship you build for. One reason of hundreds.

sam345 4y ago
bot?
- jgerrish 4y ago
  &check; botulism... No, I'm not a bot. Hello.
  - jgerrish 4y ago
    We all love Ooey Gooey Cookies, right? So, how can I make that without killing the crowd? That's the question of the day. Is stevia a decent substitute for sugar? Is sugar ok if consumed on weekends only? I know, silly questions. And then we get Jenny McCarthy provoking editorials, targeting the people who could use knowledgeable advice. And years later, we'll be lectured on bad decisions.

theshrike79 4y ago

Aspartame and asesulfame make my farts smell like literal death - have done so for over a decade, took me a long while to figure out the reason. _Something_ is going on with my gut bacteria and those two. I could also easily down 1.5 litres of sugar free Pepsi MAX in an afternoon. On the other hand a can of sugar coke is more ... satiating? Can't drink EU-Pepsi at all, because even the sugar version has the two horsemen of the fartocalypse in it =(

jjgreen 4y ago

Years ago I was a student nurse and spent a lot of time on the geriatric wards, I really liked the old farts but was somewhat disturbed by how they could spend hour after hour discussing their bowels with anyone who would listen, very strange. Reading this thread has sent me right back there.

SnowHill9902 4y ago

Weird question but can’t you not eat sweet at all? What’s wrong about just not using sugar or any sweeteners?

Tokkemon 4y ago
Yes, I, too, hate myself.

nkurz 4y ago

The full article is (currently) available here: https://www.weizmann.ac.il/immunology/elinav/sites/immunology.elinav/files/2022-08/Personalized%20microbiome-driven%20effects%20of%20nonnutritive%20sweeteners%20on%20human%20glucose%20tolerance.pdf https://www.weizmann.ac.il/immunology/elinav/sites/immunolog...

stevespang 4y ago

alexitorg 4y ago

I haven't seen him for a while. But I love the author's, Derek Lowe, work. His posts on Things I won't work with were some of the most entertaining science writing I have read. e.g. https://www.science.org/content/blog-post/things-i-won-t-work-dioxygen-difluoride https://www.science.org/content/blog-post/things-i-won-t-wor...