# Artificial Sweeteners and Sugar Alcohols **URL:** \ **Category:** In My Humble Opinion\ **Created:** [March 19, 2023, 10:48pm UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382 "2023-03-19T22:48:47Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![thelurkinghorror](https://avatars.discourse-cdn.com/v4/letter/t/7c8e57/32.png) [@thelurkinghorror](https://boards.straightdope.com/u/thelurkinghorror)\ **Post date:** [March 24, 2023, 10:40pm UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/21 "2023-03-24T22:40:56Z")
The only one I might seek out is xylitol in gum, because it’s supposed to be good for your teeth. Very bad for dogs though. Soda is usually Coke Zero which I think is ace K + aspartame. I do not miss when saccharin was in everything in the 80s. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [March 24, 2023, 11:00pm UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/22 "2023-03-24T23:00:56Z")
> [@Dr\_Paprika](#): > > 1. Which artificial sweeteners or sugar alcohols do you prefer, or avoid? > 2. What are your beliefs about these? > 3. What advice about these have you received? 1. I avoid all of them. Except i kinda like sorbitol. I can’t eat very much of it, because it gives me gas. But it has a unique “cool/sweet” flavor that i enjoy about once a year. 2. i believe that it’s unwise to fool your body. I also think it’s unwise to constantly consume sweet stuff. It sets you up to be unhappy if you don’t have sweets handy. If you are already in the habit of drinking sugar-sweetened beverages on a regular basis, nss beverages may very well be less unhealthy. But i only eat sweets as a treat, not as a routine. 3. i haven’t received much advice one way or the other. ---
**Author:** ![Dr\_Paprika](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr_paprika/32/3042_2.png) [@Dr\_Paprika](https://boards.straightdope.com/u/Dr_Paprika)\ **Post date:** [May 22, 2023, 8:45pm UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/23 "2023-05-22T20:45:13Z")
The WHO came out with some information about sweeteners. It’s a little misleading, even before being condensed by journalists. 1. In the short term, adults using sweeteners had lower weight 2. The quality of evidence is low 3. The conclusion does not apply to diabetics 4. Not gaining weight can be a victory, not included in “a failure to lose weight” 5. No one really knows how these products affect the microbiome, which we do not understand well 6. The quality of these studies is usually terrible, no one knows what they are last week 7. The people most likely to use these products do so for specific reasons 8. The bad reputation for sweeteners was a concerted effort to find something wrong with them, using unrealistic doses, whereas sugar was only considered at physiologic doses 9. The article says: _“Studies in rodents have also demonstrated that zero-calorie sweeteners don’t activate the brain’s reward centre, which regulates energy intake and appetite, the same way sugar does. When sweetness and calories are mismatched, the brain is tricked, leading to increased food consumption.”_ This is controversial. And people have been known to consume plenty of sugar in one sitting. I’m not against a reasonable analysis of these well used products. People should enjoy fewer sweetened foods. But will they? This is insufficient reason to badmouth a reasonable tool, and likely far better than consuming a lot of sugar. WHO should avoid making pronouncements when the evidence is marginal. > **[Non-sugar sweeteners aren’t effective for weight control and could be harmful...](https://www.theglobeandmail.com/life/health-and-fitness/article-weight-loss-artificial-sweeteners/)** > > A rundown of the WHO guideline, plus tips for reducing sweeteners in your diet ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [May 22, 2023, 9:55pm UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/24 "2023-05-22T21:55:08Z")
> [@Dr\_Paprika](#): > > _“Studies in rodents have also demonstrated that zero-calorie sweeteners don’t activate the brain’s reward centre, which regulates energy intake and appetite, the same way sugar does. When sweetness and calories are mismatched, the brain is tricked, leading to increased food consumption.”_ > > This is controversial. And people have been known to consume plenty of sugar in one sitting I read one of those studies as a young adult, and it may have had an outsized impact on my perception of artificial sweeteners. But the rats who drank saccharine water consumed the most calories. People have a lot more dietary choices than lab rats. I know people who switched from drinking sugar soda every day to drinking fake-sugar soda every day, and lost weight. It still feels unwise to me. Maybe not as unwise as consuming sugar soda routinely. I dunno. Meanwhile, I’m concerned that my daughter seems to have picked up a habit of drinking juice. ---
**Author:** ![Dr\_Paprika](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr_paprika/32/3042_2.png) [@Dr\_Paprika](https://boards.straightdope.com/u/Dr_Paprika)\ **Post date:** [May 22, 2023, 10:30pm UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/25 "2023-05-22T22:30:50Z")
Traditional diets were pretty low in sugar, and this is probably the best choice, though traditionally most people only lived three decades and so is only of some value. But the efforts to demonize sweeteners are well-known and long-standing. They have been studied extensively. The little found against them certainly has been well used. This does not mean there are no potential problems or that better studies shouldn’t be done. But the conclusion is based on low quality evidence and does not apply to diabetics. Does that include those at risk of developing this, a sizeable percentage of people? The evidence suggesting the contribution of sugar to diabetes and liver disease is also incomplete. But much stronger on some ways. One has to ask how realistic it is for all people to avoid the foods they have been conditioned to want the most, through physiology, upbringing and evolution. Kudos to those who do. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [May 23, 2023, 1:09am UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/26 "2023-05-23T01:09:33Z")
FWIW the WHO statement itself. > **[WHO advises not to use non-sugar sweeteners for weight control in newly...](https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline)** > > The World Health Organization (WHO) has released a new guideline on non-sugar sweeteners (NSS), which recommends against the use of NSS to control body weight or reduce the risk of noncommunicable diseases (NCDs). Recognized that the data is such as to qualify as a “conditional” recommendation. There is no debate I hope that part of the nature of modern society that leads to obesity is the early and constant exposure to hyper sweet foods, entraining that expectation, and leading to greater consumption of “hyperprocessed” food products. There is a harms reduction argument that can be made. Perhaps. ---
**Author:** ![Dr\_Paprika](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr_paprika/32/3042_2.png) [@Dr\_Paprika](https://boards.straightdope.com/u/Dr_Paprika)\ **Post date:** [May 23, 2023, 1:27am UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/27 "2023-05-23T01:27:13Z")
I didn’t see any headlines that referred to “conditional” or noted the limitations. Of course people should often eat fewer sweets and calories. I think the harms reduction argument is pretty strong based on what people do, who they are, and how marketing works. People should probably not get sixty percent plus of their calories from hyperprocessed foods either, but I have seen different definitions of what qualifies. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [May 23, 2023, 1:40am UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/28 "2023-05-23T01:40:52Z")
The recommendation certainly says “conditional”. > Because the link observed in the evidence between NSS and disease outcomes might be confounded by baseline characteristics of study participants and complicated patterns of NSS use, the recommendation has been assessed as conditional, following WHO processes for developing guidelines. This signals that policy decisions based on this recommendation may require substantive discussion in specific country contexts, linked for example to the extent of consumption in different age groups. > [@Dr\_Paprika](#): > > But the conclusion is based on low quality evidence and does not apply to diabetics. Does that include those at risk of developing this, a sizeable percentage of people? Insulin-dependant diabetics tell me that one problem with having an insulin pump talk to your blood sugar monitor is that there’s a significant lag, and a person with an intact pancreas starts making insulin when they eat. That’s got to be mediated by the sense of taste, and that would also explain why our saliva does a little of the breakdown of starch to sugar: as an early-warning system for the pancreas. So the theory is that artificial sweeteners might increase the risk of developing type 2 diabetes, by confusing the normal metabolic pathway, that includes the body pumping out insulin starting from when the tongue says, “sugar incoming”. Once you’ve developed diabetes, it’s too late, and you may as well enjoy sweetness without the sugar, though. And surely old people who have been eating artificial sweeteners for years have either run into problems or not, but may as well continue if they enjoy it. ---
**Author:** ![Dr\_Paprika](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr_paprika/32/3042_2.png) [@Dr\_Paprika](https://boards.straightdope.com/u/Dr_Paprika)\ **Post date:** [May 23, 2023, 1:54am UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/29 "2023-05-23T01:54:49Z")
But the first post includes a study that does not show insulin surges from many sweeteners, under a variety of conditions. Evidence is lacking. This has been studied in depth but remains a theory. Diabetics often report surprising results when they use continuous glucose monitoring rather than episodic testing. I don’t have a problem with reducing sugar or sweetener, or adopting a diet lower in processed foods. But this guideline is somewhat weak, and is guaranteed to be further mangled when widely reported. The body is sensitive to calorie intake and wants to maintain homeostasis. So maybe it is not surprising that taking in non-nutritive sweeteners does not in the long term reduce calorie intake or weight. Few diets result in long term weight loss. But if less sugar reduces (say) fatty liver, encourages more consumption of protein and healthy fats and sweeteners are a way to help do this in practice, they would seem to me to still have a role. They are not the best solution, but based on the current evidence seem a satisficing one. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [May 23, 2023, 2:00am UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/30 "2023-05-23T02:00:01Z")
> [@Dr\_Paprika](#): > > But if less sugar reduces (say) fatty liver, encourages more consumption of protein and healthy fats and sweeteners are a way to help do this in practice, they would seem to me to still have a role. Is there any of this “if” hypothetical that has a basis in reality? My observation is that NNS additives instead result in greater consumption of food that is overall harmful, highly processed, instead of real food that contains protein, real food fiber, and healthy fats. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [May 23, 2023, 2:29am UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/31 "2023-05-23T02:29:19Z")
> [@Dr\_Paprika](#): > > The body is sensitive to calorie intake I also want to respond to this. The _brain_’s centers, for satiety and pleasure value aka hedonic value, are in charge more than calories per se. That’s why we overeat the products of the food industrial complex. Real food more simply processed with _limited_ added sweeteners and with lots of fiber, protein, and healthy fats, tend to hit the hedonic center moderately, while hitting the satiety center firmly. NNS are part of early training to expect supranormal stimuli. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [May 23, 2023, 2:40am UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/32 "2023-05-23T02:40:34Z")
> [@Dr\_Paprika](#): > > But the first post includes a study that does not show insulin surges from many sweeteners, under a variety of conditions. Evidence is lacking. This has been studied in depth but remains a theory. But it references two meta-studies that show some evidence of a link between consuming sweet beverages and developing type 2 diabetes over the next ten years. The results are strongest for consuming sugar-sweetened beverages, but both artificially sweetened beverages and fruit juice look dicey. There’s a lot of smoke. I do think the age of the person matters. @DSeid argues that drinking sweet stuff trains people to expect sweetness. I’m sure this is true. I’m also willing to bet that it’s a more serious problem for children, who are learning “how the world works” than it is for old people. ---
**Author:** ![Dr\_Paprika](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr_paprika/32/3042_2.png) [@Dr\_Paprika](https://boards.straightdope.com/u/Dr_Paprika)\ **Post date:** [May 23, 2023, 3:07am UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/33 "2023-05-23T03:07:43Z")
I agree with your last points. I would not want my children to become to accustomed to too much sweet food, and to learn the value of fresh food and how to prepare it. When I was in medical school, not all that long ago, most of the textbooks used a “typical adult male who weighs 70kg (154 pounds) in sample cases. I occasionally wonder if these have been updated to the modern value of 200 lbs. We did spend a lot of time on biochemical metabolic pathways. We learned a fair bit about diet. We learned fairly little about sleep, shiftwork, exercise and some other pretty important topics. It always seemed to me that what doctors know about nutrition remains fairly incomplete. Trans fats are bad, but the industry trend to minimize all fats and increase sugar (Bakewells!) had some support from quasi-medical organizations and seems to have missed the mark pretty widely. Is the average patient ready to make a realistic commitment to greatly cut down on sugar? I did. It was and is difficult in practice. Sweeteners did make it much easier for me to do this. Many people are already trained. Anecdotes are not evidence. But I suspect this is true for others. If sweeteners in physiologic doses are harmful, this is important news. If the studies are so poor they cannot tease out the effect from the sweetener from the pathophysiology of the people most likely to consume them, they should wait for better quality evidence and fund studies to show it. Why are we still relying on weak evidence with regards to nutrition when we could do much better? ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [May 23, 2023, 3:27am UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/34 "2023-05-23T03:27:03Z")
> [@Dr\_Paprika](#): > > Is the average patient ready to make a realistic commitment to greatly cut down on sugar? I did. It was and is difficult in practice. Sweeteners did make it much easier for me to do this. Many people are already trained. That’s a fair point. I tend to read “artificial sweeteners are harmless” as license to consume unlimited sweet drinks. And that seems like a really bad message. But if you are really arguing that people who already drink unlimited sweet drinks might do better to switch from sugar soda to diet soda, well that’s probably true. There’s tons of evidence that consuming lots of sugar is bad for you. And I certainly know lots of people who find it hard to drink plain water. (I can’t comprehend that, but i believe people who say it’s true for them.) ---
**Author:** ![Dr\_Paprika](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr_paprika/32/3042_2.png) [@Dr\_Paprika](https://boards.straightdope.com/u/Dr_Paprika)\ **Post date:** [May 23, 2023, 3:39am UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/35 "2023-05-23T03:39:53Z")
I don’t think sweeteners are harmless. I think that in people who do consume too much sweet food, they remain a useful tool - even if it is true that they do not lead to weight loss. However, I do not consider that conclusion really strong at this point. It is not the only factor with comparison to sugar. Metabolic health is more important than weight. ---
**Author:** ![LSLGuy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lslguy/32/5813_2.png) [@LSLGuy](https://boards.straightdope.com/u/LSLGuy)\ **Post date:** [May 23, 2023, 1:45pm UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/36 "2023-05-23T13:45:32Z")
Overall to diabetic me this sounds a lot like the smoking versus vaping debate. Should we encourage smokers to switch to vaping? Probably. As a matter of harm reduction that at least some people are willing to do. Should we encourage (or permit industry to encourage) non-users to start vaping or smoking? No and unequivocally **NO**. Vaping as a halfway house of harm reduction down from smoking? Sure. As a desirable end state for all to aspire to? Heck no. IMO childhood habituation to hyper-sweetness is, like a nicotine addiction developed as a tween / teen, notoriously difficult to fully clear later in an adult. The same bad habit developed at age e.g. 40 has a lot more likelihood to be reversible by an ordinary person with ordinary motivation. > [@Dr\_Paprika](#): > > If the studies are so poor they cannot tease out the effect from the sweetener from the pathophysiology of the people most likely to consume them, they should wait for better quality evidence and fund studies to show it. Why are we still relying on weak evidence with regards to nutrition when we could do much better? At the risk of stating the obvious … Profit dear boy; profit. The upside to food manufacturers from creating and maintaining a nation of addicts is obvious. The forces arrayed in the opposite direction are puny, ill-organized, and face an inherently harder problem of science as well as of politics and of money. ---
**Author:** ![Jasmine](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jasmine/32/2964_2.png) [@Jasmine](https://boards.straightdope.com/u/Jasmine)\ **Post date:** [May 23, 2023, 2:02pm UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/37 "2023-05-23T14:02:37Z")
There will always be debate, but one mind set that I personally think should be avoided is, “Oh, no sugar, just sweetener. I’m fine!” I think it’s better than sugar, but it’s still carbs and has a carb effect on one’s metabolism. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [May 23, 2023, 2:31pm UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/38 "2023-05-23T14:31:46Z")
Most artificial sweeteners aren’t carbs, fwiw. But i doubt they are actually neutral. ---
**Author:** ![Jasmine](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jasmine/32/2964_2.png) [@Jasmine](https://boards.straightdope.com/u/Jasmine)\ **Post date:** [May 23, 2023, 3:02pm UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/39 "2023-05-23T15:02:39Z")
> [@puzzlegal](#): > > Most artificial sweeteners aren’t carbs, It appears you’re right: > Artificial sweeteners, or non-nutritive sweeteners offer the sweet taste of sugar, but have **no carbohydrates** or calories. Artificial sweeteners do not raise blood sugar levels. Sorry, but it has been hard wired into my brain over time that, “Sweet means carbs.” Okay, no carbs, but they must be killing us in some other way, right? Well, no to that, too: > Health agencies have clarified that sugar substitutes do not cause serious health problems. > > Sugar substitutes also are not linked to a higher risk of cancer in people. Studies dating back to the 1970s linked the artificial sweetener saccharin to bladder cancer in rats. Since then, research has shown that those findings don’t apply to people. So, what the hell are they, anyway? [**Chemistry Explained: Artificial Sweeteners**](http://www.chemistryexplained.com/Ar-Bo/Artificial-Sweeteners.html) Um … what they said. 😳 ---
**Author:** ![Dr\_Paprika](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr_paprika/32/3042_2.png) [@Dr\_Paprika](https://boards.straightdope.com/u/Dr_Paprika)\ **Post date:** [May 23, 2023, 9:52pm UTC](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382/40 "2023-05-23T21:52:38Z")
I also considered the analogy of vaping and smoking. I decided it was a poor comparison. Vaping has more known harms, such as asthma, lung pathology and nicotinic effects. Eating some sugar is not really optional, given it’s inclusion in so many foods. Nor is it always bad - not all sugars are equal and timing matters. But reasonable people may disagree. You are completely right about profit motives. [Previous page](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382.md?page=1) [Next page](https://boards.straightdope.com/t/artificial-sweeteners-and-sugar-alcohols/981382.md?page=3)