These data suggest that low-calorie sweetener consumption may deleteriously affect visceral fat deposition, a strong risk factor for cardiovascular disease and mortality.
Mechanisms for the association between low-calorie sweetener use and progressively rising prevalence of abdominal obesity remain unknown. One potential explanation derives from the physiology of the brain food reward system.
Therefore, individuals who consume low-calorie sweeteners may compensate by over-eating in order to experience the expected satiety. Another possible mechanism may involve the gut microbiome.
Interesting, but unoriginal. I've known about both potential explanations for years, as well as the fact that switching to low calorie sweeteners does not seem to be a good way to lose weight.
Wouldn’t fatter people naturally try to switch over to low calorie sweetener in order to lose weight? whereas non fat people might just enjoy sugar instead?
The difference is that one choice of sweetener is inherently bad for those trying to lose weight, while the other choice of sweetener puts the burden of fault for weight gain on a lack of self control.
We're humans. Not wanting to eat bitter food all the time is natural and should not be faulted. Losing weight shouldn't have to be a strenuous ascetic chore, so choosing to consume something sweet isn't the mental failing; the mental failing is choosing to choose something calorically and macro-nutritionally incorrect for one's body recomposition goals.
When someone puts sugar in my tea or coffee it genuinely ruins it for me, but I eat sweet things faily rarely and so haven't developed the tolerance and/or addiction to that flavour.
Could it be that not eating sugar isn't so much of a strenuous ascetic chore, but rather it's the reduction in sugar intake which is particularly (albeit temporarily) awkward?
My comment wasn't against not eating / drinking sweet thing things. My comment was anti-anti-sweet things (which is not the same as pro-sweet things in certain systems of logic)
One doesn't need to have an addiction to sweet things to want to enjoy sweet things every once in a while, though I admit that "addictions" to sweet things exist (namely my father, whom I have a hard time breaking him away from that addiction).
The point was mainly that there is a certain brand of health and fitness that says one must suffer / become a stoic ascetic in order to make progress, and it's this brand of health and fitness that is counter productive. Yes, maybe it works for many people, but it doesn't work for everyone.
I'm perfectly happy living a rather Spartan life; my 70 year old father is not and it's very difficult to change his stubborn mind.
Another way of putting it is that if you say that the only way to health and fitness is to climb over this 50 ft. wall, then you're going to get far fewer people actually putting in the effort to do so. Artificial Sweeteners are the large hand holds on the climbing wall, before they're ready to switch over.
And yes, if your goal is body recomposition, then macronutrition and caloric intake is far more important than this "artificial sweeteners make you fatter" voodoo magic nonsense.
This seems incredibly weak because they haven't shown causation -- or, in particular, disproved reverse causation. (That people struggling with weight gain are more likely to use sugar substitutes.)
This is more of a "huh, someone should do additional research" paper than anything conclusive.
Came here to make exactly this point. It seems like the people already slim and petite are less likely to be drawn to such artificial additives, whereas many/most overweight people would at least be trying some "bare minimum" weight management through them.
Yes, this shows how hard science can be. Studies have shown both that people who consume artificial sweeteners tend to gain a little weight (like this study) and that people who lose a lot of weight tend to be above-average consumers of artificial sweeteners. Best hope is that chemistry can untangle the mess.
Not only that, but often people will justify a larger calorie consumption because the diet soda is free. I imagine that this sort of thing would need to be tightly controlled for and show a direct mechanism of action. Especially since low calorie sweeteners vary so much in possible delivery and in structure (aspertame being an amino acid, sucralose a sugar alcohol, and using the powdered forms come mixed with maltodextrin, which is real sugar, but the liquid forms not having it).
I remember seeing an article maybe a couple of months ago that turned up a possible cause / mechanism that operates via the liver, IIRC. If I read it correctly, this paper reports only a small average effect, just a small fraction of the difference between obesity and normal weight. But that is just an average effect, it might be that the artificial sweeteners have no effect on most but a large effect on a few.
What would be required to disprove reverse causality? They discuss it more than twice
> In other words, an outcome assessed at visit v was regressed on low-calorie sweetener history up to the visit prior to outcome assessment to rule out reverse causality. In Model 2, outcomes at visit v were regressed on low-calorie sweetener use history through visit v-1, hence minimizing reverse causality.
It was shown over 10 years ago that sweet taste receptors are also expressed in the membranes of fat cells, and that artificial sweeteners activate these receptors in cell culture and drive up lipid storage.
Still doesn't mean anything until you prove it is significant in the end result (sweetener causing weight gain).
I've lost 60 pounds this year drinking huge amounts of diet soda. I've made more progress than when I tried cutting out sweeteners entirely.
There's a whole lot more going on with these issues than cell cultures and it's really counterproductive to pull random science out of a hat and say it proves your point. It only drives distrust in the whole concept of scientific reasoning.
To be fair this is the toxic way scientists gets funded. You are forced to publish or die. So if you just sit and do research and not publish (even though your research is not finished)you are done for. The institution you are in will force you to publish or force you out if you don't abide by these shitty rules.
Unless you can show that low calories sweeteners are directly responsible for weight gain; i.e. somehow the sweeteners affect how food is metabolized, fat is stored, etc., then these studies don't really say much other than people who are unable to control their appetites are unable to control their appetites.
Low calorie sweeteners are still a better option than sucrose with respect to flavoring.
In terms of annecdata, I've been trying to control my father's eating habits for years now (due to his numerous heart attacks and double bypass), and while I've not been completely successful, everything about my father's health has improved since he switched to diet pepsi from regular pepsi and since I got him to stop buying sugar for his coffee, convincing him to go with Stevia instead.
He still sneaks junk food, but that's not something that has changed. His blood sugar has decreased and his joint pains have improved.
To a certain extent, studies like this that make recommendations against recommendations seem irresponsible.
Yes. The failure to even mention, much less account for the selection bias that may come in to play here means the correlation may be used to recommend precisely the opposite of the healthy choice.
I see this as, "What we thought was true actually is, and we still have no real idea why."
The fact that this is a longitudinal study lets us say that not only is heavier use of low calorie sweeteners tied to being fat, it is correlated with getting fatter faster. That's an important point that only longitudinal studies can verify.
However without being able to control people's diet, we don't know which way causation goes. Do low calorie sweeteners cause people to gain weight faster? Or does having a tendency towards gaining weight cause people to use low calorie sweeteners? And if it is a cause, why that would be.
> However without being able to control people's diet, we don't know which way causation goes. Do low calorie sweeteners cause people to gain weight faster? Or does having a tendency towards gaining weight cause people to use low calorie sweeteners? And if it is a cause, why that would be.
It seems overwhelmingly likely that the causality goes the other way, though.
Totally unscientific theory: sweeteners are to sugar what methadone is to heroin. If you're using them, you're still craving/addicted to sugar and your palate remains out of whack, so you're probably also drawn to sugary foods that don't use sweeteners (eg. most commercial pasta sauce, ketchup, fruit juice, many breads).
But artificial sweeteners do not increase blood glucose levels, which are also linked to increased appetite. For me personally, avoiding sugar is a surefire way to decrease my appetite overall. It's so effective it almost seems like magic.
I grew up eating “normal” foods and drinking non-diet soda.
I am an average-sized guy. I fell in love with a sweetheart of a woman that was around 300lbs. I married her. She’s now less than half that.
I eat what she eats. Diet, sugar-free everything. After a few years of tolerating it, I prefer it. Normal soda tastes like cough syrup, to me. Cake and donuts make me nauseated. I don’t crave sugar, at all.
Also, ketchup has a shit ton of sugar in it, for the record. (I know this, because we use sugar-free ketchup.)
Do with this anecdotal informaton what you will; but as someone who has fully transitioned to artificial sweeteners - I can’t say that my lived experience lines up with your claims.
I use stevia and monk fruit a lot and would be curious too. I've never felt bad after using it though, unlike stuff like aspartame which seems to make me feel a bit funny.
This is an important note. Thank you for pointing this out. It seems like a lot of people here are arguing that this study reaffirms prior studies, when in reality I think they were thinking of this study as the one being re-affirmed without realizing it.
I am frustrated by the dismissal of this study in the comments. I think the burden of proof clearly lays on the claim that using artificial sweeteners is a healthier alternative to sugar. It seems fairly certain that is not the case.
That's not what this study is about. There are already plenty of studies showing weight loss or reduced weight gain when consuming low calorie sweeteners vs sugar. And there are no ill health effects such as causing cancer, which a lot of people still believe.
https://www.hsph.harvard.edu/nutritionsource/healthy-drinks/...
If sweet-tasting things stimulated a significant insulin response without providing the actual sugar to justify it, we'd die from insulin shock. Not hyperbole. This is the mechanism behind Xylitol toxicity in dogs, for example.
Not all artificial sweeteners are the same though. Xylitol, stevia, and monk fruit for example all taste super sweet and do not have a significant insulin response.
Fat people should probably try lactulose - a zero-calory (indigestible) sweet syrup (somewhat similar to maple syrup) with prebiotic and laxative properties. Besides being tasty it can actually make their guts healthier so their ghrelin (hunger hormone) secretion can decrease and their leptin (fullness hormone) secretion can increase.
Laxative artificial sweeteners have the problem that people don't dose food as carefully as medicine. I'm reminded of the famous Haribo maltitol gummy bears, which when eaten more than about 20 at a time would cause a...powerful laxative effect.
Worth (and fun) mentioning but as for me I don't feel like it's a problem as long as there is a toilet nearby. Lactulose laxative effect is faster to act but not nearly as powerful as e.g. that of bisacodyl. According to my experience (needless to say it may differ in others so be careful) it will hardly cause any serious inconvenience or discomfort any soon after you defecate (a couple of times in a row perhaps) or make you need a toilet really often, especially after you get used to it and your colon adapts and gets generally cleaner and healthier. What I find the most valuable property of lactulose is its prebiotic effect (somewhat similar to that of inulin[1]), it really feels and seems like it makes an amazing difference in the gut ecology.
Can anyone tell which low calorie sweeteners the study is talking about? Certain artificial sweeteners elicit a large insulin response even if they are "low-calorie". Did they use any of the sweeteners listed in https://www.hsph.harvard.edu/nutritionsource/healthy-drinks/...?
I was looking for Erythritol in the study, as it seems to be the safest sugar replacement so far (I'm using it all the time, still trying not to overuse it of course). It's strange that the study didn't take it into account.
“Using artificial sweeteners” vs “not using artificial sweeteners” doesn’t really tell you much. I mean it makes sense that people who use artificial sweeteners would have more excess mass since people who are dealing with that would seek artificial sweeteners in the first place. If you’re feeling fine about your weight you won’t bother with artificial sweeteners.
What would be interesting is if people who replaced the calories they ate that came from sugar with artificial sweeteners that are effectively no calorie and still had a greater increase in stored mass.
That said; the chance of a properly controlled food study is astronomical as you’d have to control people’s diets in near totality, for a large enough sample size, across years, which no one would agree to unless you planned to cover or subsidize their food costs over that time.
52 comments
[ 2.7 ms ] story [ 92.2 ms ] threadThese data suggest that low-calorie sweetener consumption may deleteriously affect visceral fat deposition, a strong risk factor for cardiovascular disease and mortality.
Mechanisms for the association between low-calorie sweetener use and progressively rising prevalence of abdominal obesity remain unknown. One potential explanation derives from the physiology of the brain food reward system.
Therefore, individuals who consume low-calorie sweeteners may compensate by over-eating in order to experience the expected satiety. Another possible mechanism may involve the gut microbiome.
There has been data like this out there for ages.
The fatalist claim being: well, one would've just eaten that much anyway, so what's the difference?
We're humans. Not wanting to eat bitter food all the time is natural and should not be faulted. Losing weight shouldn't have to be a strenuous ascetic chore, so choosing to consume something sweet isn't the mental failing; the mental failing is choosing to choose something calorically and macro-nutritionally incorrect for one's body recomposition goals.
Could it be that not eating sugar isn't so much of a strenuous ascetic chore, but rather it's the reduction in sugar intake which is particularly (albeit temporarily) awkward?
One doesn't need to have an addiction to sweet things to want to enjoy sweet things every once in a while, though I admit that "addictions" to sweet things exist (namely my father, whom I have a hard time breaking him away from that addiction).
The point was mainly that there is a certain brand of health and fitness that says one must suffer / become a stoic ascetic in order to make progress, and it's this brand of health and fitness that is counter productive. Yes, maybe it works for many people, but it doesn't work for everyone.
I'm perfectly happy living a rather Spartan life; my 70 year old father is not and it's very difficult to change his stubborn mind.
Another way of putting it is that if you say that the only way to health and fitness is to climb over this 50 ft. wall, then you're going to get far fewer people actually putting in the effort to do so. Artificial Sweeteners are the large hand holds on the climbing wall, before they're ready to switch over.
And yes, if your goal is body recomposition, then macronutrition and caloric intake is far more important than this "artificial sweeteners make you fatter" voodoo magic nonsense.
This is more of a "huh, someone should do additional research" paper than anything conclusive.
> In other words, an outcome assessed at visit v was regressed on low-calorie sweetener history up to the visit prior to outcome assessment to rule out reverse causality. In Model 2, outcomes at visit v were regressed on low-calorie sweetener use history through visit v-1, hence minimizing reverse causality.
I've lost 60 pounds this year drinking huge amounts of diet soda. I've made more progress than when I tried cutting out sweeteners entirely.
There's a whole lot more going on with these issues than cell cultures and it's really counterproductive to pull random science out of a hat and say it proves your point. It only drives distrust in the whole concept of scientific reasoning.
Low calorie sweeteners are still a better option than sucrose with respect to flavoring.
In terms of annecdata, I've been trying to control my father's eating habits for years now (due to his numerous heart attacks and double bypass), and while I've not been completely successful, everything about my father's health has improved since he switched to diet pepsi from regular pepsi and since I got him to stop buying sugar for his coffee, convincing him to go with Stevia instead.
He still sneaks junk food, but that's not something that has changed. His blood sugar has decreased and his joint pains have improved.
To a certain extent, studies like this that make recommendations against recommendations seem irresponsible.
The fact that this is a longitudinal study lets us say that not only is heavier use of low calorie sweeteners tied to being fat, it is correlated with getting fatter faster. That's an important point that only longitudinal studies can verify.
However without being able to control people's diet, we don't know which way causation goes. Do low calorie sweeteners cause people to gain weight faster? Or does having a tendency towards gaining weight cause people to use low calorie sweeteners? And if it is a cause, why that would be.
It seems overwhelmingly likely that the causality goes the other way, though.
But artificial sweeteners do not increase blood glucose levels, which are also linked to increased appetite. For me personally, avoiding sugar is a surefire way to decrease my appetite overall. It's so effective it almost seems like magic.
> ...users consumed lower amounts of fructose and higher amounts of caffeine than non-users, but had similar diet quality.
I grew up eating “normal” foods and drinking non-diet soda.
I am an average-sized guy. I fell in love with a sweetheart of a woman that was around 300lbs. I married her. She’s now less than half that.
I eat what she eats. Diet, sugar-free everything. After a few years of tolerating it, I prefer it. Normal soda tastes like cough syrup, to me. Cake and donuts make me nauseated. I don’t crave sugar, at all.
Also, ketchup has a shit ton of sugar in it, for the record. (I know this, because we use sugar-free ketchup.)
Do with this anecdotal informaton what you will; but as someone who has fully transitioned to artificial sweeteners - I can’t say that my lived experience lines up with your claims.
> The health effects of LCS are inconclusive, with research showing mixed findings.
https://vcahospitals.com/know-your-pet/xylitol-toxicity-in-d...
It doesn't take much of a response to accumulate significant fat over the years, when you're constantly consuming the stuff.
[1] https://www.startpage.com/do/dsearch?query=lactulose+inulin+...
What would be interesting is if people who replaced the calories they ate that came from sugar with artificial sweeteners that are effectively no calorie and still had a greater increase in stored mass.
That said; the chance of a properly controlled food study is astronomical as you’d have to control people’s diets in near totality, for a large enough sample size, across years, which no one would agree to unless you planned to cover or subsidize their food costs over that time.