[HN Gopher] Sugar Substitutes Surprise
___________________________________________________________________
 
Sugar Substitutes Surprise
 
Author : hprotagonist
Score  : 350 points
Date   : 2022-11-03 15:58 UTC (7 hours ago)
 
web link (www.science.org)
w3m dump (www.science.org)
 
| CodeWriter23 wrote:
| > 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 wrote:
  | That sounds sarcastic to me.
 
  | falcor84 wrote:
  | 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
 
| keepquestioning wrote:
| Is sugar good or bad for you?
 
| jgerrish wrote:
| > 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 wrote:
  | bot?
 
    | jgerrish wrote:
    | ✓ botulism...
    | 
    | No, I'm not a bot. Hello.
 
      | jgerrish wrote:
      | 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.
 
| baxtr wrote:
| Could someone summarize the findings?
 
  | LesZedCB wrote:
  | artificial sweeteners aren't physiologically inert.
  | 
  | they increase/change intestinal microbiota. tbd what that
  | means.
 
  | dsr_ wrote:
  | Yes: that's the article, a summary of the findings.
 
| bradlys wrote:
| 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 wrote:
  | 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 wrote:
    | 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 wrote:
    | 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.
 
      | layer8 wrote:
      | Stevia has a bitter-ish side taste that is truly awful.
 
        | duderific wrote:
        | Totally agree, I can't drink anything with Stevia. I can
        | taste it immediately. My father in law thinks it's the
        | greatest thing ever, doesn't bother him at all. Go
        | figure.
 
        | layer8 wrote:
        | There are genetic differences in how one tastes
        | bitterness (e.g. the TAS2R38 gene), so that might be one
        | factor.
 
      | gilrain wrote:
      | To me, stevia tastes distinctly like the aroma of burnt
      | hair. It's intolerable.
 
      | kyriakos wrote:
      | Stevia when used on it's own as a sweetener leaves a bad
      | after taste of bitterness. It's better be used in
      | combination with another sweetener or sugar (just to
      | decrease the amount of regular sugar in a product). Most
      | products advertised containing stevia usually include an
      | additional sweetener if you pay attention at the
      | ingredients list.
 
      | purplerabbit wrote:
      | Fascinating. It's like your body gradually figured out that
      | you were trying to fool it, and revolted.
      | 
      | I'd bet there are digestion processes that "start up" in
      | response to taste. Maybe your body detected that stevia was
      | regularly "starting up" one of these processes and then
      | withholding the expected glucose spike, and got upset about
      | the pattern
 
        | jimmywetnips wrote:
        | I think that was some of the findings in the linked
        | research. Certain artificial sugars were changing insulin
        | response in subjects. I'm just a sample size of 1, and
        | they're a sample size of 100 but I think it's clear that
        | the beliefe that ALL the artificial sugars are inert and
        | pass right through us is false... sometimes.
 
  | LesZedCB wrote:
  | how could microbiome changes not have measurable impact on the
  | body? bodies are ridiculously complex systems.
  | 
  | and there are plenty of instancess where gut microbiome changes
  | _are_ known to be impactful. my partner got SIBO which caused
  | lots of problems for a few months and she was basically unable
  | to eat anything.
 
| j2kun wrote:
| Does this say anything significant or new about xylitol? This
| seems like the safest bet...
 
  | gavinmckenzie wrote:
  | Unless you own a dog, and then it can be a huge risk. It
  | doesn't take much xylitol to kill your dog, and I've watched a
  | friend lose their dog due to this. I've had a scare where my
  | dog ate a piece of a popsicle on a hot day that, unknown to me
  | in the moment, was sweetened with xylitol; thankfully not in a
  | fatal concentration but we still had to stay up all night to
  | keep an eye on our dog and were hours away from the nearest
  | animal hospital. Allulose won't kill your dog.
 
  | pmlamotte wrote:
  | 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.
 
  | curmudgeon22 wrote:
  | I recently read some interesting info on xylitol and benefits
  | for dental health:
  | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4232036/
 
  | Der_Einzige wrote:
  | 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 wrote:
    | 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.
 
| birdyrooster wrote:
| Am I the only one that prefers aspartame to sugar? Sugar has this
| aftertaste that tastes like something decaying.
 
  | duderific wrote:
  | 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.
 
| donatj wrote:
| > 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 wrote:
| 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 wrote:
| > _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?
 
  | m463 wrote:
  | I was confused by that too.
  | 
  | are saccharin and sucralose good (benign) sweeteners?
  | 
  | or is stevia a good (benign) sweetener?
 
    | VLM wrote:
    | "good (benign)"
    | 
    | More accurate word choice would be "less bad".
    | 
    | I don't believe dietary science knows of a benign sweetener
    | at this time.
    | 
    | Kind of like the situation with alcohol; there's some that
    | are worse than others, none that are beneficial, none that
    | are neutral.
 
  | chronogram wrote:
  | Hopefully this image helps, because I am still not sure:
  | https://ars.els-cdn.com/content/image/1-s2.0-S00928674220091...
 
    | pb7 wrote:
    | Thanks for the image but to me personally it only raises more
    | questions. If sucralose "impairs glycemic response", then why
    | does the line go up more aggressive on the "glycemic
    | response" chart? Is having a higher response bad? Do I want
    | my body's glycemic response to be as inert as possible?
 
  | pb7 wrote:
  | Glad someone else got stuck here. I couldn't figure out from
  | context whether this is good or bad and looking up "glycemic
  | response" still didn't clear up whether it's a desired trait or
  | not in terms of sweeteners, health outcomes, and diabetics for
  | example.
 
  | photochemsyn wrote:
  | Defintion: _The Glycemic Index (GI) is a measure of the extent
  | of the change in blood glucose content (glycemic response)
  | following consumption of digestible carbohydrate, relative to a
  | standard such as glucose._
  | 
  | Blood glucose is actively regulated by your body via relying on
  | glycogen storage and breakdown in the muscles and liver, in
  | healthy humans this system reacts quickly to maintain a
  | constant blood glucose level (required for say, active brain
  | function). See figure 1 in this review (pdf) of glycogen-
  | related inherited diseases for an overview of how it's supposed
  | to work (it's all tied into the cellular Krebs, aka
  | tricarboxylic acid, cycle):
  | 
  | https://www.researchgate.net/profile/Joseph-Wolfsdorf/public...
  | 
  | Practically speaking, flooding your bloodstream with sugar
  | (soft drinks, candy) seems to overwhelm the normal functioning
  | of that system, but when you eat more complex carbohydrates
  | which are slowly digested (potatoes, bread, pasta, etc.) this
  | results in a steady but slow input of sugars to the bloodstream
  | via the digestive system, which, depending on your resting
  | energy level, will be either stored as glycogen or fed into the
  | Krebs cycle for cellular energy conversion.
 
    | baby-yoda wrote:
    | one point of contention - potatoes and bread (specifically
    | white) are some of the highest GI foods available. i
    | specifically use these (white bread with peeled boiled
    | potatoes) for their quick conversion to available sugars
    | prior to exercise. some scales actually use white bread as
    | the index point (GI = 100) because of this.
 
      | Max-q wrote:
      | Potatoes have gotten an undeserved bad reputation. Boiled
      | potatoes can be as 58. Especially if you cool and reheat.
      | Mashed or fried is over 100.
 
    | [deleted]
 
    | renewiltord wrote:
    | So if glycemic response means
    | 
    | > _change in blood glucose content (glycemic response)_
    | 
    | then does that mean an impaired response is higher or does it
    | mean it's lower?
 
      | brnaftr361 wrote:
      | If you don't know, insulin signals a process for
      | sequestering sugars through glycogenesis.
      | 
      |  _Stevia_ and _Glucose_ groups both increased plasma
      | insulin. Contrasted with _Saccharine_ and _Sucralose_
      | which, the authors suggest, blunted insulin release and
      | thus increased blood sugar. They cite a paper indicating
      | that combined NNS and caloric sweeteners increase the
      | insulin response compared with a NNS itself.
      | 
      | So... both..? It's a disproportion. NNS should have
      | negligible impact on blood sugar to be called "inert",
      | either when paired or when not, regardless of whether
      | glucose is present or not. Addition is changing the whole
      | formula. They're saying it's fucking up the signal
      | interpretation. At least that's what I've put together.
 
        | renewiltord wrote:
        | Thank you. So let me see if I get it correct.
        | thing         effect on plasma insulin         gut result
        | glucose       baseline increase                standard
        | g+sucralose   increase less than baseline      altered
        | g+stevia      baseline increase                altered
        | g+aspartame   baseline increase                altered
        | 
        | So since there was lower than baseline increase in the
        | g+sucralose group, we can conclude that the sucralose is
        | blunting the response that the glucose would have caused.
        | 
        | So, in this context, that means we got increased blood
        | sugar because of the lower plasma insulin? Okay. I think
        | I understand now.
 
  | twawaaay wrote:
  | 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 wrote:
    | 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?
 
      | noodlenotes wrote:
      | I found another paper [1] that implies that "impaired
      | glycemic response" is measured by an "oral glucose
      | tolerance test" and that high levels of blood glucose in
      | the two hours after drinking a glucose solution are what
      | they mean by an impaired response. The graphical abstract
      | [2] from the paper discussed in the Science article has
      | "glycemic response" graphs, which I assume are from this
      | oral glucose tolerance test, although I wasn't able to
      | access the paper's PDF.
      | 
      | [1] https://www.researchgate.net/figure/Impaired-glycemic-
      | respon...
      | 
      | [2] https://www.cell.com/cell/fulltext/S0092-8674(22)00919-
      | 9?_re...
 
      | narag wrote:
      | They mixed glucose with the artificial sweeteners so sugar
      | level must raise. But it didn't go down, so it seems that
      | the sweeteners could be stopping the insulin response.
 
        | secabeen wrote:
        | Right, and that's a good thing, because lower
        | postprandial glycemia correlates with better health
        | outcomes: https://pubmed.ncbi.nlm.nih.gov/20234031/
 
        | smaddox wrote:
        | I'm not sure we can equate low glycemic index foods with
        | foods that suppress the insulin response. They might have
        | a small insulin response in common, but their effect on
        | blood sugar concentration is not at all the same.
 
        | narag wrote:
        | I have no insight on the studio but that it's only
        | logical "impairment" must mean the response was _even
        | less_ than the one expected if the same amount of glucose
        | and no sweetener was ingested.
        | 
        | Otherwise it's misleading and not surprising at all.
 
      | wrycoder wrote:
      | 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.
 
| hammock wrote:
| Explain (all of) the findings like I'm five?
 
  | lm28469 wrote:
  | Don't eat sugar, don't eat sugar substitutes
 
    | hammock wrote:
    | That's not what the study says. It makes distinctions between
    | different categories of substitutes
 
| coldcode wrote:
| 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 wrote:
  | 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
  | 
  | * 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
  | 
  | * Artificial sweeteners and risk of cardiovascular diseases:
  | results from the prospective NutriNet-Sante cohort,
  | https://www.bmj.com/content/378/bmj-2022-071204
  | 
  | These are all from different countries.
 
| polYate wrote:
| OMG!!!
 
| stephc_int13 wrote:
| 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 wrote:
  | > 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 wrote:
  | 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.
 
  | astro_robot wrote:
  | Would this analysis also extend to drinks like Kombucha which
  | add more gut bacteria to your body?
 
    | gunshai wrote:
    | Maybe this is lazy commenting, but do we actually have any
    | evidence that the bacteria in kombucha even makes it to your
    | gut biome?
 
      | benj111 wrote:
      | I've seen probiotic yogurts advertising the claim.
      | (Scientifically proven). So there must be some truth. I
      | haven't delved in further though.
 
  | atombender wrote:
  | > 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?
 
  | kloch wrote:
  | > As an example, we've often been told to eat more fibers to
  | increase "flow"
  | 
  | About 10 years ago I switched overnight from a very meat heavy
  | diet to mostly plant based (I still eat dairy products and one
  | or two servings of fish per week).
  | 
  | Within a week I was shocked at how well my digestive tract was
  | suddenly working. Before that I had no idea how broken it was.
  | 
  | All other factors aside, I could never go back to the slow,
  | uncomfortable digesting process of a typical USA meat heavy
  | diet.
 
    | orangepurple wrote:
    | You can run the same experiment with water fasting. We
    | overeat.
 
    | wintermutestwin wrote:
    | My annecdata is that I spent two years eating a healthy
    | vegetarian diet (to contrast with french fry vegetarians) and
    | my digestive tract never adapted. I switched back to eating
    | plenty of lean meat (mostly chicken and fish) and the
    | plumbing almost instantly began working properly.
    | 
    | The added benefit is that my diet is much higher in protein
    | and lower in carbs, which definitely has helped me build and
    | maintain muscle and reduce dad bod.
    | 
    | Again, just annecdata, but maybe individuals have differing
    | nutritional profiles that work best for them?
 
      | dendrite9 wrote:
      | Or maybe the masses inside those individuals have different
      | needs? Different bacteria levels responding differently to
      | various diets. I think that's what some of the microbiome
      | companies were working on, but I don't think it was ever
      | successful.
 
    | stephc_int13 wrote:
    | From my experience, the worst thing is eating the same thing
    | all the time, no matter what it is.
    | 
    | The goal is to keep your microbiota as far as possible to a
    | monoculture.
    | 
    | I am absolutely not an expert on this subject, but so far, my
    | understanding is that there are not really "healthy"
    | bacteria, there are only healthy mixes where different
    | species balances and keep the other from growing.
 
    | MacsHeadroom wrote:
    | As long as we're sharing anecdotes; about 10 years ago I quit
    | being vegan and transitioned into a carnivore diet.
    | 
    | I now eat mostly red meats and my gut has never worked
    | better.
    | 
    | When I was vegan I had constant GI issues to the point of
    | multiple hospitalizations.
    | 
    | Everyone is different.
 
      | valenaut wrote:
      | Just to finish off this Goldilocks story: I've been vegan
      | for four years, and previously ate a meat and dairy heavy
      | diet. I noticed basically no change to my gut health--it
      | has been pretty good, with occasional minor issues, for my
      | whole life.
 
  | boplicity wrote:
  | > 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.
  | 
  | This isn't an accurate portrayal of the benefits of fiber. The
  | laxative effects of fiber are just one of many benefits. For
  | example, Fiber can bind to saturated fats, disabling the
  | negative affects of them. Specifically, in terms of bacteria,
  | many bacteria digest fiber, which in turn creates short chain
  | fatty acids, which have many health benefits.
  | 
  | You're right about one thing, though: this is indeed a complex
  | subject.
 
    | dilap wrote:
    | I belive the viewpoint that many hold that constipation is
    | usually caused by a lack of fiber is often mistaken, and
    | indeed eating a no or low fiber diet can resolve
    | constipation.
    | 
    | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435786/
    | 
    | https://pubmed.ncbi.nlm.nih.gov/15654804/
 
  | hombre_fatal wrote:
  | If you're going to share something as fringe as 1) the benefit
  | of fiber is that it makes us poop (disregarding it's other
  | benefits) and 2) it does so because it's toxic, you're going to
  | have to at least share links.
 
  | Invictus0 wrote:
  | > 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.
  | 
  | Citation?
 
    | stephc_int13 wrote:
    | This is pretty well understood and documented.
    | 
    | https://www.nhs.uk/conditions/lactose-intolerance/causes/
    | 
    | "Bacteria in the colon break down the lactose, producing
    | fatty acids and gases like carbon dioxide, hydrogen and
    | methane.
    | 
    | The breakdown of the lactose in the colon, and the resulting
    | acids and gases that are produced, cause the symptoms of
    | lactose intolerance, such as flatulence and bloating."
 
      | stephc_int13 wrote:
      | The tricky part is that there are multiple species of
      | bacteria able to digest (ferment) lactose, and the
      | composition of your microbiota is highly variable at the
      | individual level and also over time.
      | 
      | In practice, your reaction to lactose is difficult to
      | predict, regardless of your production of lactase.
 
      | Invictus0 wrote:
      | Right. I guess I had misunderstood the comment as implying
      | that lactose intolerance was not a result of insufficient
      | lactase production.
 
| b800h wrote:
| 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://pubmed.ncbi.nlm.nih.gov/30747427/
 
| mabbo wrote:
| 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
| 
| > 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 wrote:
  | Fascinating. Now it's sold in much smaller quantities:
  | https://www.amazon.com/EASTCHEM-Neotame-25g/dp/B07YYNZP68
  | 
  | And https://www.amazon.com/T-Miles-Neotame-Sweetener-
  | Beverages-P...
 
| kome wrote:
| that's not a surprise at all...
 
  | mandmandam wrote:
  | No, it's not.
  | 
  | But sweetener maxis often say the gut bacteria effect is
  | unproven, so every good study there helps.
 
| wintermutestwin wrote:
| 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 wrote:
  | 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 wrote:
  | 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.
 
| coliveira wrote:
| I believe any change in diet also causes a possible change in gut
| microbiomes. Is there any reason to be alarmed about this?
 
  | micromacrofoot wrote:
  | As with most science it's a "warrants further investigation"
  | kind of issue
 
  | xeromal wrote:
  | Science compounds so even if this doesn't tell you why the gut
  | microbiome changed, it's useful to know that it did.
 
    | kekkidy wrote:
 
  | phyzome wrote:
  | 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.)
 
| Thrymr wrote:
| "who knows what artificial sweeteners we might have missed out on
| due to lack of sloppy lab technique?" is gem.
 
| SevenNation wrote:
| 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.
 
  | hinkley wrote:
  | 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).
 
  | wrycoder wrote:
  | The conclusions were at the very end, and I'm not really sure
  | what they were. Not a very good article.
 
    | jibe wrote:
    | Almost like they expect people to read the whole thing.
 
      | layer8 wrote:
      | The article is still inconclusive.
 
        | thehappypm wrote:
        | Because the science is inconclusive, but these results
        | are interesting anyway.
 
| Veliladon wrote:
| 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.
 
  | Metacelsus wrote:
  | Too bad the theoretically cheapest way (mirror-image
  | microorganisms) is an enormous ecological risk.
 
    | canadianfella wrote:
 
    | kulahan wrote:
    | Can you please elaborate on this? I tried googling it and
    | just got a lot of seemingly unrelated stuff.
 
      | [deleted]
 
      | actually_a_dog wrote:
      | Mirror image microorganisms process and produce molecules
      | of opposite normal chirality as a result of their
      | metabolism. Since there's no _a priori_ reason why life
      | should prefer either left handed or right handed molecules,
      | the way we got here is the result of the first proto-
      | metabolic processes billions of years ago just _happening_
      | to choose what we use today. If we introduced mirror image
      | microorganisms into the ecosystem, the danger is they could
      | outcompete existing organisms while simultaneously
      | contaminating the environment with their mirror-image waste
      | products.
 
        | herrrk wrote:
        | Presumably they would be poisoned by the large amount of
        | right handed biochemistry thats everywhere already.. It
        | might be super hard to keep them alive in nature at all.
        | 
        | But if youre in the lab and thinking about it could ya
        | whip us up some C-F eating/mineralizing micros? Talk
        | about whats poisoning the biosphere..
 
        | grogenaut wrote:
        | in tl;dr scifi parlance, we could make it so that we'd
        | have bountiful food and starve because we turned earth
        | into an alien planet
 
        | brookst wrote:
        | Who you calling "we", l-grogenaut?
 
        | dooglius wrote:
        | Wouldn't they be at a strict disadvantage because they
        | cannot eat other typical-chirality-producers for
        | resources?
 
        | AlanSE wrote:
        | I think the idea is that we would keep them in a lab and
        | feed them whatever works.
 
        | kibwen wrote:
        | For anyone interested in this concept, without spoiling
        | too much, you should read the sci-fi book Starfish by
        | Peter Watts. He has the entire text of the book up for
        | free on his website, in glorious 1990s handcrafted HTML:
        | https://www.rifters.com/real/STARFISH.htm
 
      | vazma wrote:
      | I am also interested to know that!
 
    | ctoth wrote:
    | Curious, did you remove the green goo post because you found
    | something wrong with the reasoning or did you judge it to be
    | an infohazard?
 
  | antiterra wrote:
  | Do we know that it doesnt have an effect on gut-biome though?
 
    | Balgair wrote:
    | There would be none:
    | 
    | "..but cannot be used by living organisms as a source of
    | energy because it cannot be phosphorylated by hexokinase, the
    | first enzyme in the glycolysis pathway. "
    | 
    | https://en.wikipedia.org/wiki/L-Glucose
    | 
    | EDIT: Ok, yeah, sorry. I'm sure _some_ bacteria out there
    | could do something with it and make you have an upset
    | stomach. But it 's not very likely.
 
      | hgsgm wrote:
      | That means it has no nutrition, not no effect.
      | 
      | For example:
      | 
      | > l-Glucose was also found to be a laxative
 
      | herrrk wrote:
      | Nature laughs at "not very likely".. We gotta get used to
      | this as a species.
 
  | nope96 wrote:
  | Interesting! https://en.wikipedia.org/wiki/L-Glucose
 
    | giarc wrote:
    | "L-Glucose was also found to be a laxative," perhaps another
    | factor in it's adoption.
 
      | Filligree wrote:
      | In what quantities? Often these tests use implausibly large
      | amounts.
 
        | AuryGlenz wrote:
        | I'd imagine it works like lactose, and if that's the case
        | a "regular" dose will do plenty.
 
        | malfist wrote:
        | This is the source they used: https://www.giejournal.org/
        | article/S0016-5107(03)01304-X/ful...
        | 
        | Does was 24 grams. For reference, a 12 ounce can of coke
        | has 39 grams of sugar.
        | 
        | However, this was not a double blind study, so mileage my
        | vary.
 
        | shagie wrote:
        | It is the same/similar mechanism as the infamous sugar
        | free gummy bears.
        | 
        | https://www.healthline.com/health/food-nutrition/sugar-
        | free-...
 
        | orangepurple wrote:
        | If you are looking for high speed mass discharge a
        | heaping teaspoon of xylitol or maltitol (what is in sugar
        | free gummy bears) plus coffee will do the trick within 15
        | minutes.
 
        | semi-extrinsic wrote:
        | Be warned that you risk serious dehydration and/or
        | electrolyte imbalance if you try this.
        | 
        | What's used medically for this purpose (e.g. before a
        | colonoscopy) is an osmotically balanced solution of
        | polyethylene glycol, typically referred to as Macrogol.
        | 
        | Takes a couple of hours of continuous sipping, close to 1
        | liter total for an adult to get everything flushed, then
        | you'll be discharging almost clear fluid by the end.
 
      | r00fus wrote:
      | So wait, is this another Olestra? Guess it depends on what
      | kind of response you get in the gut.
 
      | MadcapJake wrote:
      | Actually that likely means there is a microbiome component,
      | unfortunately
 
        | phyzome wrote:
        | Or just an osmotic effect.
 
  | smeagull wrote:
  | I never see much in replacing Sucrose with normal Glucose.
  | Never understood why.
 
  | throwawaymaths wrote:
  | L-arabinose is a thing and it's natural. Only really available
  | in Japan though. Might give you some gas because some bacteria
  | can break it down, but probably not as bad as xylitol,
  | erythritol, etc.
 
    | petra wrote:
    | Another alternative is duox-matok's technology, that
    | increases the surface area of sugar or something similar, and
    | this allows to use 30%-50% less sugar for the same sweetness
    | effect.
 
    | cassianoleal wrote:
    | It's available in the UK but it's quite expensive. Sold as a
    | pre-meal supplement from what I can tell.
 
    | Melatonic wrote:
    | Any good sources you know of? Unless we are talking crazy
    | expensive I feel like it could be pretty useful for a lot of
    | home recipes. I don't make that much sugary stuff anyway.
    | Does it caramelize like normal sugar when heated?
 
      | throwawaymaths wrote:
      | I would be surprised if it didn't caramelize. I don't know
      | of any good sources, sorry.
 
      | adgjlsfhk1 wrote:
      | it does. it behaves identically to regular sugar except in
      | how it interacts with other organic compounds.
 
    | dvirsky wrote:
    | Doesn't allulose work pretty much the same way?
 
      | throwawaymaths wrote:
      | Ooh, I should try that sometime
 
        | dvirsky wrote:
        | It's pretty awesome in terms of taste - it's just a bit
        | less sweet but tastes just like sugar. I didn't find too
        | much info on impact but it seems pretty safe. And you can
        | really use it as a sugar, it even caramelizes. I use it
        | to make home made sugar free ice cream with real sugary
        | consistency. But for me personally, having too much of it
        | makes my stomach rebel.
 
        | Melatonic wrote:
        | Do you use an ice cream maker?
 
        | dvirsky wrote:
        | Yeah. I can't say that I've gotten to professional
        | quality but I'm a bit lazy with the recipes.
 
        | throwawaymaths wrote:
        | Yeah I think arabinose is likely to have less of a GI
        | effect (I have eaten some from the lab on a whim) but I
        | can't find any references on this.
 
        | semi-extrinsic wrote:
        | The GI effect should be just directly correlated with how
        | well large intestine microbiome can ferment these, IIUC?
        | And I guess also with how much you need to have
        | equivalent taste of 1 g sugar.
        | 
        | As in, if it tastes sweet but is not absorbed in the
        | small intestine, so has "no calories", it will inevitably
        | all pass on to the large intestine where it can be
        | fermented.
        | 
        | As someone who absolutely hates the synthetic taste of
        | aspartame etc. but has to stay on a low-FODMAP diet, I've
        | just resigned to eating stuff with ordinary sugar and
        | using sufficient moderation.
 
        | throwawaymaths wrote:
        | According to the big W, part of it is due to inhibiting
        | digestion of normal sugar, which tracks my understanding
        | of chemistry. So there's a lot of factors.
 
      | hebrox wrote:
      | It's not legal yet in Europe, but can't wait to try it out!
 
  | teeray wrote:
  | Is there any way to do this (safely) in small batch?
 
  | kccqzy wrote:
  | I thought L-glucose and D-glucose would interconvert in water?
  | They will reach an equilibrium with both present?
 
    | Vloeck wrote:
    | D-fructose and D-glucose interconvert in basic environment.
    | You cannot convert L-glucose to D-glucose and vice-versa.
 
  | tomp wrote:
  | Why not make both isomers and feed them to bacteria? Only left-
  | handed remains.
 
    | actionfromafar wrote:
    | It's gotta be something more to than that, even 50-50% sugar
    | would be a great product in its own right.
 
      | morepork wrote:
      | Fructose is about 50% sweeter than sugar (sucrose), so you
      | can save calories by substituting 2/3 of the quantity of
      | sucrose with fructose
 
      | tablespoon wrote:
      | 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.
 
        | canadianfella wrote:
 
        | actionfromafar wrote:
        | True, you'd need tablespoons of it. :-/
 
        | PaulHoule wrote:
        | It seems with all the bacteria out there it seems like
        | there would be one that does something obnoxious with
        | L-sucrose.
 
    | foxhill wrote:
    | if we could make racemic glucose (i.e. a 50:50 split of
    | D/L-glucose), the battle would be done.
    | 
    | you'd expect to see this if we had a purely synthetic process
    | for the creation of glucose in the lab. but, as far as i
    | know, we only have other biological processes that produce
    | glucose, and as such, only produce the one isomer.
 
      | throwawaymaths wrote:
      | It is 100% possible to make glucose synthetically,
      | racemically or otherwise. I believe it was done in the 60s
      | and iirc sharpless used sugar synthesis to demonstrate the
      | power of asymmetric epoxidation (which he won the Nobel
      | for).
      | 
      | It is however very _not_ economical to do so
 
        | monkeywork wrote:
        | I've seen the economics talked about a few times in this
        | thread but having no experience at all with the industry
        | - what is the difference between economical and not in
        | actual dollar values?
        | 
        | If you were to produce a KG of this vs say our common
        | art-sweetners what is the cost multipler
 
        | throwawaymaths wrote:
        | Well keep in mind that stuff like sucralose may be more
        | expensive to make but it's also selected because it's way
        | more potent, so there's a lot of filler (usually
        | cyclodextrin?) To fill out a packet and make a
        | cooking/flavoring equivalent.
        | 
        | Though I'm not 100% sure maybe sucralose is made by
        | enzymatically installing those halogens? I could be very
        | wrong.
 
        | twobitshifter wrote:
        | Speaking of filler, it seems the experiment in question
        | didn't control for that? Since there's so little
        | artificial sweetener is it possible the gut flora are
        | reacting to the filler?
 
        | bribroder wrote:
        | The experiment in the article explicitly does control for
        | this
        | 
        | > The participants (20 per group) were given sweetener
        | packets of aspartame, sucralose, saccharin, or stevia,
        | each bulked out with glucose to an equivalent size, with
        | another group that got just glucose and another group
        | that took no sweeteners at all.
        | 
        | In this experiment, the artificial sweeteners used
        | glucose as the filler. They also account for the effects
        | of the glucose filler on the insulin response in all
        | groups by measuring the difference in the response.
 
        | lazide wrote:
        | My guess is a minimum of 5-10x more expensive at scale.
        | 
        | Sugar is _really_ cheap, especially if you don't mind
        | which particular local source you use (sugar cane, corn
        | syrup, etc).
 
    | Veliladon wrote:
    | Because we have effectively infinite amounts of d-glucose in
    | the biosphere and that's incredibly hard to compete with on
    | cost.
 
      | throwawaymaths wrote:
      | Also there's more than one stereocenter in "generalized
      | glucose"
 
    | gowld wrote:
    | > Why not make both isomers and feed them to bacteria? Only
    | left-handed remains.
    | 
    | The hard part is synthesis, not separation.
 
      | adwn wrote:
      | Just a heads up: you seem to be shadow-banned, all your
      | posts are flagged.
 
        | Traubenfuchs wrote:
        | His post looks normal to me...
        | 
        | Apparently he got unshadowbanned recently.
 
        | adwn wrote:
        | I vouched for a couple of them; the others are still
        | dead.
 
        | eternalban wrote:
        | What posts? It shows empty for me.
 
    | Haga wrote:
 
| theshrike79 wrote:
| 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 =(
 
| jhassell wrote:
| 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.
 
  | PuppyTailWags wrote:
  | 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/
 
    | stnmtn wrote:
    | Reading this study, I believe you are misinterpreting the
    | results. It says nothing about if being overweight decreases
    | all-cause mortality relative to normal weight. It only says
    | being overweight decreases all-cause mortality relative to
    | obesity.  That is how I read it at least, I can't find a
    | baseline for the HR of a normal weight in the study linked.
    | 
    | edit: this is wrong, see reply below
 
      | PuppyTailWags wrote:
      | 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 wrote:
        | Great point, I completely misread that. Edited my
        | original comment!
 
        | PuppyTailWags wrote:
        | Yeah I had to read this a few times too! I was totally
        | baffled by having 3 categories for obesity, but one of
        | the categories is grade 2 & 3 categories together, and
        | one of the categories is grade 1, 2, & 3 together.
 
    | eternityforest wrote:
    | Why is this such a hard question? You would think a question
    | as ubiquitous as "What should I eat?" would have more
    | consensus.
    | 
    | Some studies show extra mortality in normal to underweight
    | people, including from common causes relevant to average
    | people, but there's also a ton of work on calorie
    | restriction?
    | 
    | Is low BMI dangerous, or does it just commonly go along with
    | a lifestyle that might lead to injuries and rhabdomyolysis
    | and a case of diarrhoea in a place without hospitals?
    | 
    | It would be interesting to see adventurousness treated as a
    | separate category for controls.
    | 
    | In the past there was no fridge, people stored their own
    | energy, and there was no pepper spray and cops and forklifts,
    | exercise programs had the extra constraint of physical
    | activity being directly needed to survive.
    | 
    | What amount and type of activity should a modern person who
    | has reason to believe they'll probably never be in a serious
    | fair fight with no weapons or need to walk 3 days to get help
    | do?
    | 
    | How much should someone eat when they do not ever plan to
    | drink untreated water or go somewhere away from medical help
    | if they catch some parasite that causes rapid weight loss?
    | 
    | Is the ideal profile of nutrition changed for someone who
    | will not be exposed to woodsmoke, bacterial illness, etc?
    | 
    | And then furthermore, if higher BMI isn't helpful by itself,
    | what should people who ARE in poverty or otherwise exposed to
    | more stresses do?
    | 
    | Is there a subgroup that needs a metabolic reserve? Should
    | those people eat less to save money and be able to DoorDash
    | if needed and have external reserves like people without
    | poverty or adventurousness?
    | 
    | Or is there a real independent benefit to some level of fat?
 
    | adrianN wrote:
    | I wonder whether that is true for all age groups. In very old
    | patients, being somewhat overweight can act as an important
    | energy reserve that allows the patient to survive an illness
    | or a hospital visit. Younger patients generally are more
    | robust, I assume they benefit less from a couple of extra
    | kilos of fat.
 
      | PuppyTailWags wrote:
      | The study accounts for age and shows the phenomenon is
      | consistent across multiple age ranges.
 
    | DontchaKnowit wrote:
    | Yes THANK YOU. This is why it is infuriating to me that
    | elementary/middle school students are still being graded on
    | their BMI in gym class and taught to maintain a "good" BMI.
    | With my body composition, I would be absolutely emaciated if
    | I was on the lower end of the "healthy" BMI range. As it is I
    | am bordering on obese, which if you saw me in person would be
    | completely preposterous. The BMI itself is a pretty useless
    | metric of body fat, and body fat is a pretty useless metric
    | for health.
 
  | cowmoo728 wrote:
  | 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/
 
    | andrewmutz wrote:
    | 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
 
  | ZeroGravitas wrote:
  | 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 wrote:
    | 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 wrote:
  | "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).
 
  | shkkmo wrote:
  | 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.
 
  | colordrops wrote:
  | Many non overweight people eat these fake sweeteners too.
 
    | hinkley wrote:
    | 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 wrote:
      | She was type 1 diabetic, so perhaps not relevant:
      | https://www.diabetesselfmanagement.com/blog/an-american-
      | ninj...
 
      | colordrops wrote:
      | That's my point. We shouldn't only be concerned about
      | overweight people.
 
  | maxk42 wrote:
  | 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.
 
  | time_to_smile wrote:
  | 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-
  | substitu...
 
    | tuatoru wrote:
    | This article suggests a mechanism for that positive
    | correlation: impairment of glycaemic response by the most
    | commonly used artificial sweeteners.
 
  | [deleted]
 
  | pessimizer wrote:
  | > 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.
 
  | awestroke wrote:
  | False dichonomy; you can choose to consume neither sugar nor
  | sweeteners
 
    | SoftTalker wrote:
    | 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.
 
    | Al-Khwarizmi wrote:
    | That, and it's also possible to consume (moderate amounts of)
    | sugar and have a good BMI.
 
  | VLM wrote:
  | 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.
 
  | [deleted]
 
  | hinkley wrote:
  | 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.
 
  | googlryas wrote:
  | 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.
 
  | narag wrote:
  | _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.
 
  | yamtaddle wrote:
  | 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 wrote:
    | 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.
 
      | hinkley wrote:
      | 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.
 
        | [deleted]
 
        | layer8 wrote:
        | > there's a theory that reacting to that increases
        | absorption, so your body pulls more carbs
        | 
        | There doesn't seem to be any good studies about that.
        | Anecdotally, as someone who has been drinking 2-3 liters
        | of Diet Coke or Coke Zero daily for over two decades, I
        | haven't experienced such an effect.
 
        | hinkley wrote:
        | George Burns smoked cigars into his nineties. He was
        | famous for smoking them while performing.
        | 
        | Anecdotes don't mean shit for public policy.
        | 
        | And is this even an anecdote? Were you overweight before
        | you started drinking diet and now you're not, with no
        | other lifestyle changes? Food? Mood? Exercise?
 
        | layer8 wrote:
        | > Anecdotes don't mean shit for public policy.
        | 
        | Right, and so yours doesn't either.
        | 
        | My point is, the theory that artificial sweeteners
        | somehow cause more "net" calorie intake doesn't have much
        | grounded evidence. Presenting it as a likely truth is
        | fallacious.
 
        | [deleted]
 
        | kenjackson wrote:
        | 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 wrote:
        | 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.
 
        | watwut wrote:
        | Regular moderate exercise improves your health results
        | _whether you loose weight or not_. It is one of the few
        | interventions that actually have statistical results. It
        | also affects your life positively by making you stronger
        | or faster or just able to walk longer depending on how
        | exactly you exercise.
        | 
        | If you dont care about health or improvment in things
        | like strength stamina, then the "dont exercise it is
        | waste" knee jerk response makes some sense. If you care
        | about health, it does not at all.
 
        | hinkley wrote:
        | I've only lost a few pounds but inches off my waist. To
        | the point I'm wondering if I'm going to have to
        | repurchase running shorts next year. Muscle is heavy.
        | 
        | To your point on mood: there's definitely a feedback loop
        | or three there. Once you say "fuck it" a lot of things
        | unravel and everything spirals. Better mood means more
        | chores get done, which is both more exercise and improves
        | self image and mood. Being happier about the mirror does
        | the same thing.
        | 
        | Before the pandemic I wanted to walk a 10k. Now that's
        | practically my baseline, and new goals I wouldn't allow
        | myself are popping up. You can get a lot of places in 10k
        | round trip, especially if you aren't a sweaty mess on the
        | other end. That's 75% of the way to downtown for me.
 
      | yamtaddle wrote:
      | > 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.
 
    | matthewdgreen wrote:
    | 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/
 
| amadeuspagel wrote:
| 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 wrote:
  | 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.
 
| ajkjk wrote:
| 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 wrote:
  | A variation of the "blue car" bias.
  | 
  | You notice the weirdly skinny or fat, then notice what they
  | drink.
 
    | ajkjk wrote:
    | 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 wrote:
      | 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 wrote:
        | 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.
 
        | bena wrote:
        | What you are calling evidence is useless. You may believe
        | you are taking the bias into consideration, but you can't
        | actually know if you are or aren't. Your whole bit is the
        | non-starter.
        | 
        | But my "counter-evidence" would simply be me saying
        | "Well, I don't see that". To which you would respond that
        | it was actually _I_ who wasn 't being observant. When
        | there is no real way to determine that. And that
        | discussion itself is intellectually bankrupt.
        | 
        | My pointing out that your recollection of casual
        | observations and your self-assessment of how well you
        | "took the bias into consideration" is debate. I'm
        | questioning the source of your statistics.
        | 
        | Because even in this study, it's from 120 people. Total.
        | Who self-reported they had never had artificial
        | sweeteners.
        | 
        | And the other obvious thing is that you are also free to
        | ignore my opinions. I like to mention when someone is
        | offering biased anecdotes in place of substantive
        | discussion. In case it resonates.
 
      | layer8 wrote:
      | Anecdotally, I drink a lot of Diet Coke and am neither
      | skinny nor fat.
 
      | Spivak wrote:
      | You know your own life best but you might be missing the
      | underlying causes.
      | 
      | Overweight person A drinks diet soda because they struggle
      | with losing weight and use it to avoid drinking calories.
      | 
      | Underweight person B drinks diet soda because they have
      | body image issues and/or a mild-to-severe ED and are afraid
      | to gain weight.
 
        | ajkjk wrote:
        | Yeah, all valid. I guess the reason it seems obvious to
        | me that the diet soda is directly affecting weight is
        | that so many of the people with weight problems don't
        | seem to think the soda can have anything to do with it.
        | "But it's diet!" says, for instance, my mom.
 
        | sosborn wrote:
        | What is your mom's average daily calorie count?
 
  | beardyw wrote:
  | Me too. I thought the surprise was going to be that they are
  | good for you!
 
  | pwinnski wrote:
  | Correlation/causation question there. It is very plausible that
  | people already in categories you consider weird are choosing
  | diet soda because they agree with you and are trying to avoid
  | making the issue more severe.
 
    | ajkjk wrote:
    | true. My intuition is that that's not the case though. I
    | should add, I don't know _any_ non-diet soda drinkers, and
    | the diet soda drinkers are the ones with weight issues.
 
      | pwinnski wrote:
      | I drank non-diet soda semi-regularly before deciding that I
      | had put on too much weight, so I started a very austere
      | diet. The _only_ reason I 've been able to stick to the
      | diet as long as I have is the sweetness of Pepsi Zero Sugar
      | Mango. So that soda, in particular, has helped me lose 23
      | pounds and counting. Without it, I think I would have
      | series trouble staying on a diet so strict.
      | 
      | So yeah, I have a weight issue, and I'm diet soda drinker,
      | but for me, at least, you had the cause and effect
      | reversed.
 
        | ajkjk wrote:
        | Fair enough. I guess the root cause is the need to have
        | sweetness in your diet, though? Which, yeah, might be
        | mostly unchangeable now that you're already in that state
        | (presumably from a long diet of soda).
        | 
        | incidentally as a person who did not grow up drinking
        | soda, it's sickeningly sweet to me. It bothers me a lot,
        | also, that it is actually much sweeter than it tastes due
        | to the carbonation -- if you drink a flat soda you get a
        | better impression of what you're "really" drinking, which
        | is basically just watered-down syrup.
 
      | [deleted]
 
| dr_kiszonka wrote:
| 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...
 
| lisper wrote:
| 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 wrote:
| So, are monkfruit or stevia bad for you? I'm a heavy user.
 
  | technoooooost wrote:
  | Everything bad, eat what makes you happy, we get cancer one way
  | or the other
 
  | mandmandam wrote:
  | 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.
 
| aenis wrote:
| 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.
 
  | pcorsaro wrote:
  | 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 wrote:
    | 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.
 
      | smaddox wrote:
      | Very interesting. Thanks for sharing!
 
      | herrrk wrote:
      | Thats freaking fascinating. Thanks!
 
  | dawnerd wrote:
  | Same, I do keto about half of the year and diet sodas have zero
  | effect at all on ketone and glucose levels.
 
  | wrycoder wrote:
  | The article points out that different artificial sweeteners
  | have different glycemic responses, so you could try some
  | others.
 
    | aenis wrote:
    | 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.
 
| lm28469 wrote:
| > 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 ?
 
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