An important missed angle is the effect of artificial sweeteners on gut microbiome. They cause intestinal inflammation which is relevant for IBD sufferers. My take is that I don't miss out on much by being conservative with food, as we still don't understand these complex interactions well enough. What's the harm in sticking to a balanced whole diet of ingredients that were available to our ancestors 200years or more ago.

▲ kibwen 4 hours ago | parent | next [-]

As the article mentions, this is a false dichotomy.

If you're an ordinary person driven to be healthy, drink water. Water is great. If you're already drinking water, you should absolutely not replace it with whatever bottled crap that Coke or Pepsi is peddling, be it "smart water" or otherwise.

But for people with sugar cravings bordering on addiction, which describes a depressingly enormous proportion of the population in the developed world, replacing sugary drinks with zero-calorie artificially-sweetened drinks can be a net health benefit. We know beyond a shadow of a doubt that obesity, diabetes, and heart disease are bad for your health, and consumption of sugar water is a significant driver of these. Yes, you could be even healthier by drinking water instead; see above. But sugar is an addictive chemical (sugar withdrawl is, in fact, a thing), and not everyone is going to quit cold turkey.

(And for the record, I fully agree that people should be more cognizant of their gut biome and how their diet affects it, including being skeptical of aspartame and other random synthetic ingredients.)

▲ malfist 3 hours ago | parent | next [-]

> sugar cravings bordering on addiction, which describes a depressingly enormous proportion of the population

It's almost like our bodies are designed to crave calories

▲ kakacik 3 hours ago | parent | prev | next [-]

Or... you know, there could be some little actual effort in shedding such addiction (sugar ain't that hard), build a bit of character and walk off better off in many regards. Winning against addiction won't kill you, break you or similar damage but makes you (much) stronger and healthier as a bonus. Why do people shy away from such things?

But no, lets do everything possible just to keep the comfortable crappy couch lifestyle, no sweat, no effort, miserable health, miserable life. Then there are articles how US population (which suffers the most these shit HFCS addictions and resulting obesity problems) is depressed... for many reasons of course, but this sort of helpless victim mindset is one of them.

	▲	acuozzo an hour ago \| parent \| next [-]
		> Why do people shy away from such things? Have you ever met someone with a true addiction to food? I'm not talking about someone with a habitual craving for sweets. I'm talking about someone who consumes food compulsively like a chain-smoker; someone who, in the absence of whatever their favorites are, will consume and consume with little regard for what the food is: an entire jar of pickles, multiple pounds of grapes, a whole rotisserie chicken, et al. I used to be one. I once ate six baked white onions¹ in one sitting before vomiting everywhere and rethinking my life. I broke through naturally, but I wish GLP-1s had been prevalent at the time. Want to know what made breaking it so challenging? `1. Unlike other addictions, you have to continue consuming this one or else you will die. 2. Nearly every social event in the USA is tied in some way to food which means that you have to exercise willpower __constantly__ if you have a social life. 3. People are more interested in shaming you than supporting you. Most want you to fail.` [1] https://www.youtube.com/watch?v=xV9spqCzSkQ
	▲	tptacek 3 hours ago \| parent \| prev [-]
		There's nothing wrong with HFCS either, at least not that isn't also wrong with sugar. This is all just naturalist fallacy stuff.

▲ cornholio 3 hours ago | parent | prev [-]

On the other hand, allowing people to feed their sweet addictions only re-enforces and desensitizates them further. So while you are probably safe drinking ungodly amounts of aspartame water, you won't find equivalent substitutes for sugar in other foods and you might suffer rebound consumption there, perhaps to a much higher total caloric intake versus just drinking sugary water in moderation.

Another thing to watch out for is caffeine input which is often associated with sweetened drinks. Caffeine is a diuretic and you will see yourself drinking can after can of diet coke while not quite quenching your thirst or properly hydrating yourself. This is documented to lead to intense muscle pain and unexplained migraines for people who do physical work and abuse these types of drinks, and can't be good for your kidneys long term, even under the assumption that sweeteners are 100% safe.

Overall, just drink plenty of water and use everything else in moderation seems like a solid advice.

▲ tptacek 3 hours ago | parent | prev | next [-]

How would that work? It's hydrolized into its constituents, which are present in higher quantities in apples and chicken and other foods, in the upper GI. Do you have a cite for this?

▲ perching_aix 4 hours ago | parent | prev | next [-]

Does aspartame cause intestinal inflammation, or do artificial sweeteners sans aspartame cause intestinal inflammation? Or which specific ones do?

Cause reading the blogpost, it explicitly calls out that most other artificial sweeteners do not get broken down "at all", suggesting their in-body lifecycles are quite different. I'd expect this not to apply to aspartame as a result, and thus it not being a missed angle at all:

> Incidentally, this same logic does not apply to other artificial sweeteners which mostly aren’t broken down at all.

▲ ottah 2 hours ago | parent | prev | next [-]

I have had a long diagnosis of IBS before being diagnosed with crohns. You can drive yourself crazy chasing spurious diet/symptoms corolations. Alot of people drive themselves into disordered eating habits trying to control symptoms with diet. Ultimately your mental state has more to do with how you feel then any specific dietary input taken with moderation. Most people with autoimmune diseases also have high amounts of anxiety and stress. If you put more focus on the mental component, you'll likely find more symptom relief.

	▲	hawk_ 2 hours ago \| parent [-]
		Look up CDED (Crohn's disease exclusion diet) which is the first line of treatment for pediatric Crohn's and now it's increasingly being used for adults. So don't dismiss the diet link despite the facts and research.

▲ BirAdam 3 hours ago | parent | prev | next [-]

I get what you mean, but do remember that pretty much everything humans eat (fruits, vegetables, grains, meats) did not exist before humans cultivated them.

▲ ChrisRR 3 hours ago | parent | prev | next [-]

Most people don't suffer from IBD though. IBS is very common, IBD isn't

▲ AlexandrB 4 hours ago | parent | prev | next [-]

There's no harm to doing that if you can do it. But advice like "just eat healthy, natural food" is not really something most people can stick to long term. I know I can't!

When I find myself in a stressful situation the craving for sweets is very strong and artificial sweetners at least mean I have options that won't dump a bunch of calories/refined sugar into my body.

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BirAdam 3 hours ago | parent | next [-]

Also, what is a natural food? Wheat, maize, oranges, bananas, broccoli... those are human made.

	▲	malfist 3 hours ago \| parent [-]
		And there's plenty of unnatural, ultraprocessed food that's good for us. Try telling the body builder he can't have a protein shake.

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pizzafeelsright 3 hours ago | parent | prev | next [-]

I believe in you.

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Forgeties79 4 hours ago | parent | prev [-]

There’s also the cost element on top of the realities of sugar addiction

▲ llm_nerd 3 hours ago | parent | prev | next [-]

>An important missed angle is the effect of artificial sweeteners on gut microbiome.

Everything affects the gut microbiome. Every single type of food you eat alters it. Taking a walk alters it. Taking a flight alters it.

The whole "but it changes the microbiome" thing needs to be qualified by whether that change is meaningfully relevant in some direction, and evidence thus far, for most sweeteners, is unconvincing. 10.1016/j.cell.2022.07.016 is the only mildly legitimate research on this (a seemingly well executed RCT), but even it shows a rapidly fading effect, and no effect for aspartame given it's the subject of this submission.

But researchers who want a bit of attention (and a remarkable amount of research is plied not for useful results, but knowing that certain topics are easy mass media coverage) know it's gold to write a paper saying a sweetener changed the microbiome, because it plays into a fear people have (people are always susceptible to the "too good to be true" aha moment). Or worse still the garbage observational studies that conflate that people with metabolic issues are more likely to use sweeteners, so flip cause and effect and claim that sweeteners cause metabolic issues.

>What's the harm in sticking to a balanced whole diet of ingredients that were available to our ancestors 200years or more ago.

If people ate calorie-restricted, balanced diets, and limited simple carbs and sugars, most food problems fade away (presuming they aren't eating overtly poisonous things, which many of our ancestors did). But that isn't reality. In reality sugar is one of the greatest health crises of our times, and finding some mechanism of reducing that problem is beneficial. Better still people should tame the sweet tooth, but we live in reality.

And FWIW, you can do the reductionist thing that wellness grifters do with most any food. Loads of "balanced whole diets" are full of crazy, scary constituents, many of which are known carcinogens. Spices and herbs are full of deleterious ingredients. And so on.

▲ BiteCode_dev 3 hours ago | parent | prev [-]

n = 1 but I clearly feel the effect when I start drinking aspartam drinks a few times a week. So much so that I just stopped drinking them.

I didn't use to. But I stopped rafined sugar for a year and compensated with coca zero. After that, guts never been quite the same and it took some copious amount of probiotics with regular doctor checks to feel better.

Even then, it's still no back up to baseline, and now drinking aspartam more than once is upsetting.

	▲	tptacek 3 hours ago \| parent [-]
		People say this about MSG too, but when you blind-test them the effect vanishes, which is unsurprising because the constituents in MSG are, like aspartame, widely prevalent in traditional foodstuffs.