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>The global health body said a systematic review of the available evidence had suggested that use of non-sugar sweeteners, or NSS, “does not confer any long-ter

>The global health body said a systematic review of the available evidence had suggested that use of non-sugar sweeteners, or NSS, “does not confer any long-term benefit in reducing body fat in adults or children.” As someone who used artificial sugars exclusively as part of a low carb diet to lose 40 pounds, this just seems like an insane statement to make no? Unless the WHO no longer believes calories consumed matters at all, replacing sugar with a 0 calorie substitute literally leads to less calories. Obviously if someone just eats more to compensate there's no net gain, but that's pretty much the same as someone who eats 20 apples a day just because they heard they're healthy. That obviously wouldn't mean apples are bad for you.

adamhearn 3y ago
It seems like the average consumer of diet sweeteners is already likely to be overweight, diabetic, or have other ailments. This article seems highly sensationalized. For the average person, the risk of sugar impacting blood glucose levels seems far riskier than any side effect of a NSS
- bombcar 3y ago
  As a former twitter entertainer once said, "I have never seen a thin person drinking Diet Coke." I suppose we could do a nation-wide experiment by insisting that the sugar water vendors use only NSS for a year; but that would probably result in the overthrow of the government.
  - dataflow 3y ago
    > As a former twitter entertainer once said, "I have never seen a thin person drinking Diet Coke." There's a lot he hasn't seen in this world. Doesn't mean those things don't happen.
    - xp84 3y ago
      Yeah, and also not even an insightful joke. I mean, isn't Taylor Swift, notable thin pretty human, a famous Diet Coke fan? That's just the first person who comes to mind. Also half the people I know, as well.
  - artifabrian 3y ago
    That tweet doesn't reflect my experience at all actually, in Europe at least. I know it's an anecdote but I know many fit people that drink frequently Diet Coke or Coke Zero. Is this a US thing?
    - bombcar 3y ago
      Coke Zero is much more common as an Everyman drink in Europe apparently, perhaps because of less sugar insensitivity. In the USA a large size combo meal with a diet coke coming in at 1500+ calories is a meme based in reality.
  - irthomasthomas 3y ago
    The fattest person I ever worked with used to drink 4-8 litres of diet coke a day. When I met him again two years later, his weight was normal. Asked how he did it, he just stopped drinking the diet coke. NNSs trigger the same insulin/fat storage mechanism as sugar, but they arent absorbed, and stay on the blood longer, leading to insulin resistance.
    - amanaplanacanal 3y ago
      Please point us to some science about this, because of that is true, it’s a pretty big deal.
      - bombcar 3y ago
        It's anecdata but I've seen similar - however, it could also be explained by "not taking weight loss seriously if all you do is switch to gallons of diet drink". And for lots of sodas, caffeine plays, too. It's hard to factor out the various issues that could also be present.
      - irthomasthomas 3y ago
        There's lots. Here's one that tested sugar+sweetener, note the decrease in insulin clearance when sweeteners are consumed, vs just sugar: sucralose ingestion caused 1) a greater incremental increase in peak plasma glucose concentrations (4.2 ± 0.2 vs. 4.8 ± 0.3 mmol/L; P = 0.03), 2) a 20 ± 8% greater incremental increase in insulin area under the curve (AUC) (P < 0.03), 3) a 22 ± 7% greater peak insulin secretion rate (P < 0.02), 4) a 7 ± 4% decrease in insulin clearance (P = 0.04), and 5) a 23 ± 20% decrease in SI (P = 0.01). https://diabetesjournals.org/care/article/36/9/2530/37872/Sucralose-Affects-Glycemic-and-Hormonal-Responses https://diabetesjournals.org/care/article/36/9/2530/37872/Su...
    - Tokkemon 3y ago
      Also interested to see if there's any proof of this. I know, anecdotally as an obese man, that whether I cut out diet soda or not doesn't seem to make a difference. Maybe I'm not doing it for long enough?
inglor_cz 3y ago
"Obviously if someone just eats more to compensate there's no net gain" Words like "obviously" and "just" are papering over a complicated system called metabolism. Nothing is really "just obvious" in human body, which is a result of a billion years of chaotic evolution. If artificial sugars mess with an average person's feelings of satiety or kill useful gut microbiome, you can't expect them to help an average person to lose weight. Things like hunger cravings matter for most people when it comes to weight regulation. You might be one of the few exceptions.
- hammock 3y ago
  Yes. To add, cravings regulated by hormones.. also related to set point.. also related to ozempic
xhrpost 3y ago
> Obviously if someone just eats more to compensate there's no net gain I remember a study that showed people who consumed NSS would end-up on their own accord, eating additionally the same amount of calories as they were "avoiding" in their beverages. Ie. 2 cans of soda roughly 350cal, 2 cans diet soda -> eat another 350cal that day without actually planning on it. I think the hypothesized reason is that many of these 0-cal sweeteners still cause a release of insulin which then drops your blood sugar, which then makes you crave carbs more. I personally try to consume sweetners with no insulin effect for this reason (eg. Stevia) whenever I do use one. FWIW I have a similar gut reaction to this headline. How can there be completely no benefit to not adding 30-60g of sugar to my bloodstream every day? If the sweetners are combined with a controlled diet, I would still think they have benefits. I don't feel my blood pressure rise or my mood shift when I have a little NSS, which is the opposite of consuming straight sugar for me, I can feel it.
- xp84 3y ago
  > people who consumed NSS would end-up on their own accord, eating additionally (Note: this comment is not disagreeing with the parent) In my opinion, studies like these (and especially the pop "science" articles that package them into clickbait) are flawed because: 1. They summarize and basically take a mean across an entire population (see quote above for an example), which means a wide spectrum of behavior patterns are being reduced to "people do xxxxx" which is obviously not universally true. Some people will do something, and others won't. This study assumes you're not in control enough or smart enough to NOT do that unproductive behavior when trying to lose weight. I know it's a cliché that everyone assumes they're smarter than normal people, but, surely some are, right? 2. The "People will just xxxxxx" line -- that basically crosses right into psychology, which... some people would say is the least objective 'science.' I mean, people can go right ahead and convince themselves that switching to literal sugar will be a positive effect on the body. I'll just keep drinking diet soda, which has also eliminated tooth decay as a serious concern in my life since I switched.
- irthomasthomas 3y ago
  You already hit on it. Insulin is the fat storage hormone. It triggers your fat cells to expand by absorbing sugars from the blood. But NNSs aren't absorbed by fat cells, so they stay in your blood longer, keeping your liver working longer, pumping out insulin. This results in diminishing insulin response over time.
bombcar 3y ago
The report mentions one of the effects of NSS is lower caloric intake. What people may not realize is your body is quite "efficient" at running at various caloric amounts, and ±569 kJ/day (135 calories) may not do much. Especially if there are other side effects of consuming "sweetener" like wanting to eat a tiny bit more (the opposite of using mouthwash, for example, which makes you want to eat nothing more).
- qeternity 3y ago
  > What people may not realize is your body is quite "efficient" at running at various caloric amounts, and ±569 kJ/day (135 calories) may not do much. Source? I'm very much in the camp that diet has a huge impact on one's ability to control their eating, but I've never seen anything that suggests that calories in calories out doesn't apply (outside of extremes, like genuine starvation).
  - bombcar 3y ago
    Calories in = calories out, but 135 calories is not much (that's what, a 30 minute slow walk for an average American)? So if you drop your intake by 135 calories you may just not walk as much and not even really notice it. Or your body may slow down metabolism a tiny bit, etc.
    - lm28469 3y ago
      Yeah but then again the average american walks ~3000 step a day, which is about 30min.
  - nmarinov 3y ago
    To add on to what bombcar said: I don't think the implication is CICO doesn't apply. In my experience (and also studies) change in calorie intake is correlated with change in activity i.e.: when you eat more you naturally move more. Not just exercising and walking but also jittering and cleaning that little bit harder and moving that little bit faster. Or the opposite, saving a little bit of energy. Instead of moving your whole head to look at something - just a glance and so on. CICO is still valid but the body adjusts beyond what we can _easily_ measure. It's a lot more complicated but the above is one simple example how it adjusts.
wing-_-nuts 3y ago
Attia's book 'Longevity' had a great point on this. Studies have found that artificial sweetener wasn't associated with weight loss, higher a1c, etc. What they don't tell you is those people most likely to use a lot of artificial sweeteners are probably overweight and prediabetic, and have over-eating issues beyond just what they're using to sweeten their drinks.
irthomasthomas 3y ago
Caloric scale was invented in the 19th century to measure the energy of fuels in a furnace. Human body is not a furnace. Human body is a complex chain of cascading chemical reactions. When you eat sugar, an instruction is sent to the liver to produce Insulin in the blood. Insulin is the fat storage hormone, it signals to fat cells that they should absorb sugars from the blood stream. Mountains of research show that, just as sweeteners trigger a sugar-like chemical reaction in your mouth, they also trigger that same reaction in your liver.
twelve40 3y ago
> As someone who used artificial sugars exclusively as part of a low carb diet to lose 40 pounds, this just seems like an insane statement to make no? i don't mean to sound too negative but i'm no longer impressed by "dropped X pounds" statements having done that and more several times. The only success criteria that impresses me now is keeping it off for 5+ years. If the WHO says "systematic review of the available evidence" against "long-term use of sugar substitutes" it's probably worth paying attention to. Since you haven't even specified your timeline, we have no idea if it qualifies as long-term use or not.

adamhearn 3y ago

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

bombcar 3y ago
As a former twitter entertainer once said, "I have never seen a thin person drinking Diet Coke." I suppose we could do a nation-wide experiment by insisting that the sugar water vendors use only NSS for a year; but that would probably result in the overthrow of the government.
- dataflow 3y ago
  > As a former twitter entertainer once said, "I have never seen a thin person drinking Diet Coke." There's a lot he hasn't seen in this world. Doesn't mean those things don't happen.
  - xp84 3y ago
    Yeah, and also not even an insightful joke. I mean, isn't Taylor Swift, notable thin pretty human, a famous Diet Coke fan? That's just the first person who comes to mind. Also half the people I know, as well.
- artifabrian 3y ago
  That tweet doesn't reflect my experience at all actually, in Europe at least. I know it's an anecdote but I know many fit people that drink frequently Diet Coke or Coke Zero. Is this a US thing?
  - bombcar 3y ago
    Coke Zero is much more common as an Everyman drink in Europe apparently, perhaps because of less sugar insensitivity. In the USA a large size combo meal with a diet coke coming in at 1500+ calories is a meme based in reality.
- irthomasthomas 3y ago
  The fattest person I ever worked with used to drink 4-8 litres of diet coke a day. When I met him again two years later, his weight was normal. Asked how he did it, he just stopped drinking the diet coke. NNSs trigger the same insulin/fat storage mechanism as sugar, but they arent absorbed, and stay on the blood longer, leading to insulin resistance.
  - amanaplanacanal 3y ago
    Please point us to some science about this, because of that is true, it’s a pretty big deal.
    - bombcar 3y ago
      It's anecdata but I've seen similar - however, it could also be explained by "not taking weight loss seriously if all you do is switch to gallons of diet drink". And for lots of sodas, caffeine plays, too. It's hard to factor out the various issues that could also be present.
    - irthomasthomas 3y ago
      There's lots. Here's one that tested sugar+sweetener, note the decrease in insulin clearance when sweeteners are consumed, vs just sugar: sucralose ingestion caused 1) a greater incremental increase in peak plasma glucose concentrations (4.2 ± 0.2 vs. 4.8 ± 0.3 mmol/L; P = 0.03), 2) a 20 ± 8% greater incremental increase in insulin area under the curve (AUC) (P < 0.03), 3) a 22 ± 7% greater peak insulin secretion rate (P < 0.02), 4) a 7 ± 4% decrease in insulin clearance (P = 0.04), and 5) a 23 ± 20% decrease in SI (P = 0.01). https://diabetesjournals.org/care/article/36/9/2530/37872/Sucralose-Affects-Glycemic-and-Hormonal-Responses https://diabetesjournals.org/care/article/36/9/2530/37872/Su...
  - Tokkemon 3y ago
    Also interested to see if there's any proof of this. I know, anecdotally as an obese man, that whether I cut out diet soda or not doesn't seem to make a difference. Maybe I'm not doing it for long enough?

inglor_cz 3y ago

"Obviously if someone just eats more to compensate there's no net gain" Words like "obviously" and "just" are papering over a complicated system called metabolism. Nothing is really "just obvious" in human body, which is a result of a billion years of chaotic evolution. If artificial sugars mess with an average person's feelings of satiety or kill useful gut microbiome, you can't expect them to help an average person to lose weight. Things like hunger cravings matter for most people when it comes to weight regulation. You might be one of the few exceptions.

hammock 3y ago
Yes. To add, cravings regulated by hormones.. also related to set point.. also related to ozempic

xhrpost 3y ago

> Obviously if someone just eats more to compensate there's no net gain I remember a study that showed people who consumed NSS would end-up on their own accord, eating additionally the same amount of calories as they were "avoiding" in their beverages. Ie. 2 cans of soda roughly 350cal, 2 cans diet soda -> eat another 350cal that day without actually planning on it. I think the hypothesized reason is that many of these 0-cal sweeteners still cause a release of insulin which then drops your blood sugar, which then makes you crave carbs more. I personally try to consume sweetners with no insulin effect for this reason (eg. Stevia) whenever I do use one. FWIW I have a similar gut reaction to this headline. How can there be completely no benefit to not adding 30-60g of sugar to my bloodstream every day? If the sweetners are combined with a controlled diet, I would still think they have benefits. I don't feel my blood pressure rise or my mood shift when I have a little NSS, which is the opposite of consuming straight sugar for me, I can feel it.

xp84 3y ago
> people who consumed NSS would end-up on their own accord, eating additionally (Note: this comment is not disagreeing with the parent) In my opinion, studies like these (and especially the pop "science" articles that package them into clickbait) are flawed because: 1. They summarize and basically take a mean across an entire population (see quote above for an example), which means a wide spectrum of behavior patterns are being reduced to "people do xxxxx" which is obviously not universally true. Some people will do something, and others won't. This study assumes you're not in control enough or smart enough to NOT do that unproductive behavior when trying to lose weight. I know it's a cliché that everyone assumes they're smarter than normal people, but, surely some are, right? 2. The "People will just xxxxxx" line -- that basically crosses right into psychology, which... some people would say is the least objective 'science.' I mean, people can go right ahead and convince themselves that switching to literal sugar will be a positive effect on the body. I'll just keep drinking diet soda, which has also eliminated tooth decay as a serious concern in my life since I switched.
irthomasthomas 3y ago
You already hit on it. Insulin is the fat storage hormone. It triggers your fat cells to expand by absorbing sugars from the blood. But NNSs aren't absorbed by fat cells, so they stay in your blood longer, keeping your liver working longer, pumping out insulin. This results in diminishing insulin response over time.

bombcar 3y ago

The report mentions one of the effects of NSS is lower caloric intake. What people may not realize is your body is quite "efficient" at running at various caloric amounts, and ±569 kJ/day (135 calories) may not do much. Especially if there are other side effects of consuming "sweetener" like wanting to eat a tiny bit more (the opposite of using mouthwash, for example, which makes you want to eat nothing more).

qeternity 3y ago
> What people may not realize is your body is quite "efficient" at running at various caloric amounts, and ±569 kJ/day (135 calories) may not do much. Source? I'm very much in the camp that diet has a huge impact on one's ability to control their eating, but I've never seen anything that suggests that calories in calories out doesn't apply (outside of extremes, like genuine starvation).
- bombcar 3y ago
  Calories in = calories out, but 135 calories is not much (that's what, a 30 minute slow walk for an average American)? So if you drop your intake by 135 calories you may just not walk as much and not even really notice it. Or your body may slow down metabolism a tiny bit, etc.
  - lm28469 3y ago
    Yeah but then again the average american walks ~3000 step a day, which is about 30min.
- nmarinov 3y ago
  To add on to what bombcar said: I don't think the implication is CICO doesn't apply. In my experience (and also studies) change in calorie intake is correlated with change in activity i.e.: when you eat more you naturally move more. Not just exercising and walking but also jittering and cleaning that little bit harder and moving that little bit faster. Or the opposite, saving a little bit of energy. Instead of moving your whole head to look at something - just a glance and so on. CICO is still valid but the body adjusts beyond what we can _easily_ measure. It's a lot more complicated but the above is one simple example how it adjusts.

wing-_-nuts 3y ago

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

irthomasthomas 3y ago

Caloric scale was invented in the 19th century to measure the energy of fuels in a furnace. Human body is not a furnace. Human body is a complex chain of cascading chemical reactions. When you eat sugar, an instruction is sent to the liver to produce Insulin in the blood. Insulin is the fat storage hormone, it signals to fat cells that they should absorb sugars from the blood stream. Mountains of research show that, just as sweeteners trigger a sugar-like chemical reaction in your mouth, they also trigger that same reaction in your liver.

twelve40 3y ago

> As someone who used artificial sugars exclusively as part of a low carb diet to lose 40 pounds, this just seems like an insane statement to make no? i don't mean to sound too negative but i'm no longer impressed by "dropped X pounds" statements having done that and more several times. The only success criteria that impresses me now is keeping it off for 5+ years. If the WHO says "systematic review of the available evidence" against "long-term use of sugar substitutes" it's probably worth paying attention to. Since you haven't even specified your timeline, we have no idea if it qualifies as long-term use or not.