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Yes, replacement can work to adjust weight trends in a controlled setting. But all empirical observations so far show that artificial sweeteners in people's di

Yes, replacement can work to adjust weight trends in a controlled setting. But all empirical observations so far show that artificial sweeteners in people's diets do not have the desired effect when people's food and beverage intake is uncontrolled. In fact results from animal studies are that you can even substitute part of the feed with just the artificial sweetener to achieve the same body mass gain. And this is known since 1960s with Cyclamate and rats: https://doi.org/10.1038/221091b0 https://doi.org/10.1038/221091b0 More studies in the meantime varied a bit on the size of the effect, and some were inconclusive, but generally the results held up. So no, artificial sweeteners do not help to manage weight. What the studies actually show is that controlling people's intake does.

KempyKolibri 1y ago
Let me get this straight: your epistemic framework is such that when presented with RCTs in humans showing positive effects, observational studies in humans showing null findings (likely because of poor adjustment models) and negative associations in rats, we should conclude “artificially sweetened is every bit as bad as sugar sweetened”?
- chithanh 1y ago
  No. What I say is if we introduce a public health policy, then we need to take human behavior and adherence rates into account. Example: Abstinence is 100% effective against STDs and teenage pregnancy in any controlled setting. That does not make it a good public health policy to tell teenagers to abstain from having sex. In fact despite condoms having lower efficacy than abstinence, teaching people the proper use of condoms is overall more effective. If we want to solve obesity then randomly adding/substituting artificial sweeteners to human food will not work. Instead we need to reduce access to hyperpalatable foods, which can be done through economic means (e.g. taxes).
  - KempyKolibri 1y ago
    Ok, so if I understand correctly, your argument is: in order for you to support a public health intervention we need to see evidence that such an intervention results in positive outcomes in a free living population with ad libitum consumption, regardless of the evidence in controlled settings. So what’s the evidence that banning artificial sweeteners leads to positive outcomes in a free living population, considering you said: “I'm in favor of banning artificial sweeteners”?
    - chithanh 1y ago
      > So what’s the evidence that banning artificial sweeteners leads to positive outcomes in a free living population, considering you said: “I'm in favor of banning artificial sweeteners”? It depends on the context. In the context of school lunches (which is discussed here) they absolutely need to be banned, same as added sugars. Giving children (sugar or artificially) sweetened meals trains children's palates and shapes lifelong preferences for sweet foods.
      - KempyKolibri 1y ago
        Ok, so we already have your standard: in order for you to support a public health intervention we need to see evidence that such an intervention results in positive outcomes in a free living population with ad libitum consumption, regardless of the evidence in controlled settings. We have your proposed intervention: “In the context of school lunches (which is discussed here) [NNS] absolutely need to be banned, same as added sugars.” So now we need evidence supporting this intervention sufficient to meet your own goalposts. Do you have it?
        chithanh 1y ago
        > Ok, so we already have your standard Who is "we"? I don't know what you are going on about. Empirical evidence is one thing, mechanism is another source of knowledge by which we can shape public health policy. While empirical evidence is valid only for the situation in which it was obtained, mechanism is universal. For example, we mandate wearing seatbelts in cars in the name of public health. It is however not necessary to do seatbelt on/off RCTs with actual people. How we know that this is beneficial: Because physics, verification through crash tests (with dummies), and because we know that seatbelt mandates increase the frequency of people wearing them. Going back to the original question, it was clearly shown in observational studies that giving children sweetened food is bad: Childhood dietary habits shape lifelong food preferences, and preference for sweet food leads to worse outcomes regarding chronic diseases later in life. This has been shown in lots of research, both in humans and in animal models: https://doi.org/10.1126/science.adn5421 https://doi.org/10.1126/science.adn5421 https://doi.org/10.3390/nu16030428 https://doi.org/10.3390/nu16030428 https://doi.org/10.1093/chemse/bjr050 https://doi.org/10.1093/chemse/bjr050 With randomly adding or substituting sugar with artificial sweeteners there is however no empirical evidence nor known mechanism which supports a public health benefit. In fact the mechanisms we know from animal farming suggest a detrimental effect.

KempyKolibri 1y ago

Let me get this straight: your epistemic framework is such that when presented with RCTs in humans showing positive effects, observational studies in humans showing null findings (likely because of poor adjustment models) and negative associations in rats, we should conclude “artificially sweetened is every bit as bad as sugar sweetened”?

chithanh 1y ago
No. What I say is if we introduce a public health policy, then we need to take human behavior and adherence rates into account. Example: Abstinence is 100% effective against STDs and teenage pregnancy in any controlled setting. That does not make it a good public health policy to tell teenagers to abstain from having sex. In fact despite condoms having lower efficacy than abstinence, teaching people the proper use of condoms is overall more effective. If we want to solve obesity then randomly adding/substituting artificial sweeteners to human food will not work. Instead we need to reduce access to hyperpalatable foods, which can be done through economic means (e.g. taxes).
- KempyKolibri 1y ago
  Ok, so if I understand correctly, your argument is: in order for you to support a public health intervention we need to see evidence that such an intervention results in positive outcomes in a free living population with ad libitum consumption, regardless of the evidence in controlled settings. So what’s the evidence that banning artificial sweeteners leads to positive outcomes in a free living population, considering you said: “I'm in favor of banning artificial sweeteners”?
  - chithanh 1y ago
    > So what’s the evidence that banning artificial sweeteners leads to positive outcomes in a free living population, considering you said: “I'm in favor of banning artificial sweeteners”? It depends on the context. In the context of school lunches (which is discussed here) they absolutely need to be banned, same as added sugars. Giving children (sugar or artificially) sweetened meals trains children's palates and shapes lifelong preferences for sweet foods.
    - KempyKolibri 1y ago
      Ok, so we already have your standard: in order for you to support a public health intervention we need to see evidence that such an intervention results in positive outcomes in a free living population with ad libitum consumption, regardless of the evidence in controlled settings. We have your proposed intervention: “In the context of school lunches (which is discussed here) [NNS] absolutely need to be banned, same as added sugars.” So now we need evidence supporting this intervention sufficient to meet your own goalposts. Do you have it?
      - chithanh 1y ago
        > Ok, so we already have your standard Who is "we"? I don't know what you are going on about. Empirical evidence is one thing, mechanism is another source of knowledge by which we can shape public health policy. While empirical evidence is valid only for the situation in which it was obtained, mechanism is universal. For example, we mandate wearing seatbelts in cars in the name of public health. It is however not necessary to do seatbelt on/off RCTs with actual people. How we know that this is beneficial: Because physics, verification through crash tests (with dummies), and because we know that seatbelt mandates increase the frequency of people wearing them. Going back to the original question, it was clearly shown in observational studies that giving children sweetened food is bad: Childhood dietary habits shape lifelong food preferences, and preference for sweet food leads to worse outcomes regarding chronic diseases later in life. This has been shown in lots of research, both in humans and in animal models: https://doi.org/10.1126/science.adn5421 https://doi.org/10.1126/science.adn5421 https://doi.org/10.3390/nu16030428 https://doi.org/10.3390/nu16030428 https://doi.org/10.1093/chemse/bjr050 https://doi.org/10.1093/chemse/bjr050 With randomly adding or substituting sugar with artificial sweeteners there is however no empirical evidence nor known mechanism which supports a public health benefit. In fact the mechanisms we know from animal farming suggest a detrimental effect.