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As with everything, there’s more to the artificial sweetener story than their effect on weight. To learn more about them, I spoke with Dr. David Ludwig, an obesity and weight-loss specialist at Harvard-affiliated Boston Children’s Hospital. He has a keen interest in products designed to help people lose weight at keep it off. And what he has learned about artificial sweeteners worries him.

All artificial sweeteners are not created equal

The FDA has approved five artificial sweeteners: saccharin, acesulfame, aspartame, neotame, and sucralose. It has also approved one natural low-calorie sweetener, stevia. How the human body and brain respond to these sweeteners is very complex.

One concern is that people who use artificial sweeteners may replace the lost calories through other sources, possibly offsetting weight loss or health benefits, says Dr. Ludwig. This can happen because we like to fool ourselves: “I’m drinking diet soda, so it’s okay to have cake.” The AHA and ADA also added this caveat to their recommendation.

It’s also possible that these products change the way we taste food. “Non-nutritive sweeteners are far more potent than table sugar and high-fructose corn syrup. A miniscule amount produces a sweet taste comparable to that of sugar, without comparable calories. Overstimulation of sugar receptors from frequent use of these hyper-intense sweeteners may limit tolerance for more complex tastes,” explains Dr. Ludwig. That means people who routinely use artificial sweeteners may start to find less intensely sweet foods, such as fruit, less appealing and unsweet foods, such as vegetables, downright unpalatable.

In other words, use of artificial sweeteners can make you shun healthy, filling, and highly nutritious foods while consuming more artificially flavored foods with less nutritional value.

Artificial sweeteners may play another trick, too. Research suggests that they may prevent us from associating sweetness with caloric intake. As a result, we may crave more sweets, tend to choose sweet food over nutritious food, and gain weight. Participants in the San Antonio Heart Study who drank more than 21 diet drinks per week were twice as likely to become overweight or obese as people who didn’t drink diet soda.

But you say you can give up diet drinks whenever you want? Don’t be so sure. Animal studies suggest that artificial sweeteners may be addictive. In studies of rats who were exposed to cocaine, then given a choice between intravenous cocaine or oral saccharine, most chose saccharin.

What’s your definition of safe?

Whether non-nutritive sweeteners are safe depends on your definition of safe. Studies leading to FDA approval have ruled out cancer risk, for the most part. However, those studies were done using far smaller amounts of diet soda than the 24 ounces a day consumed by many people who drink diet soda. We really don’t know what effect large amounts of these chemicals will have over many years.

And there are other health concerns beside cancer. In the Multiethnic Study of Atherosclerosis, daily consumption of diet drinks was associated with a 36% greater risk for metabolic syndrome and a 67% increased risk for type 2 diabetes. Aren’t these diseases that artificial sweeteners may help prevent in the first place?

Back to sugar?

Maybe sugar isn’t too bad after all. It’s all in how it’s packaged.

“Sugar-containing foods in their natural form, whole fruit, for example, tend to be highly nutritious—nutrient-dense, high in fiber, and low in glycemic load. On the other hand, refined, concentrated sugar consumed in large amounts rapidly increases blood glucose and insulin levels, increases triglycerides, inflammatory mediators and oxygen radicals, and with them, the risk for diabetes, cardiovascular disease and other chronic illnesses,” Dr. Ludwig explains.

I think I’ll have a glass of water and an apple.

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Originally posted by sjtill:
In the Multiethnic Study of Atherosclerosis, daily consumption of diet drinks was associated with a 36% greater risk for metabolic syndrome and a 67% increased risk for type 2 diabetes. Aren’t these diseases that artificial sweeteners may help prevent in the first place?

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Originally posted by MNSIG:

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Originally posted by sjtill:
In the Multiethnic Study of Atherosclerosis, daily consumption of diet drinks was associated with a 36% greater risk for metabolic syndrome and a 67% increased risk for type 2 diabetes. Aren’t these diseases that artificial sweeteners may help prevent in the first place?

Is that correlation or causation? I’d imagine overweight and diabetic individuals are significantly over represented among diet drink consumers.

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Originally posted by ridgerat:
Caffeine-free Coke Zero.

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Originally posted by ugeesta:
My vote is for Fresca as well. I don’t drink a lot of diet soda but find it a refreshing change. It’s really good with a shot or two of Absolut Citron mixed in too

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Originally posted by Ryanp225:
We drink Zevia brand in our house. It doest have any artificial sweeteners and tastes pretty darned good when compared to most diet sodas.

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Abstract
OBJECTIVE

We determined associations between diet soda consumption and risk of incident metabolic syndrome, its components, and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis.

RESEARCH DESIGN AND METHODS

Diet soda consumption was assessed by food frequency questionnaire at baseline (2000–2002). Incident type 2 diabetes was identified at three follow-up examinations (2002–2003, 2004–2005, and 2005–2007) as fasting glucose >126 mg/dl, self-reported type 2 diabetes, or use of diabetes medication. Metabolic syndrome (and components) was defined by National Cholesterol Education Program Adult Treatment Panel III criteria. Hazard ratios (HRs) with 95% CI for type 2 diabetes, metabolic syndrome, and metabolic syndrome components were estimated, adjusting for demographic, lifestyle, and dietary confounders.

RESULTS

At least daily consumption of diet soda was associated with a 36% greater relative risk of incident metabolic syndrome and a 67% greater relative risk of incident type 2 diabetes compared with nonconsumption (HR 1.36 [95% CI 1.11–1.66] for metabolic syndrome and 1.67 [1.27–2.20] for type 2 diabetes). Of metabolic syndrome components, only high waist circumference (men ≥102 cm and women ≥88 cm) and high fasting glucose (≥100 mg/dl) were prospectively associated with diet soda consumption. Associations between diet soda consumption and type 2 diabetes were independent of baseline measures of adiposity or changes in these measures, whereas associations between diet soda and metabolic syndrome were not independent of these factors.

CONCLUSIONS

Although these observational data cannot establish causality, consumption of diet soda at least daily was associated with significantly greater risks of select incident metabolic syndrome components and type 2 diabetes.

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Originally posted by MNSIG:

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Originally posted by SW_Sig: Even more troubling, these sugar stand-ins have been shown to have the same effect on your body as sugar. "Artificial sweeteners trigger insulin, which sends your body into fat storage mode and leads to weight gain," Alpert says.

I'd really like someone to prove that claim. It's often repeated, but defies science. The aspartame molecule bears no structural resemblance to glucose. It's like saying you walked past a 57 Chevy and your 2019 Ford key fob unlocked the door.

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Originally posted by KMitch200:

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Originally posted by MNSIG:

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Originally posted by SW_Sig: Even more troubling, these sugar stand-ins have been shown to have the same effect on your body as sugar. "Artificial sweeteners trigger insulin, which sends your body into fat storage mode and leads to weight gain," Alpert says.

I'd really like someone to prove that claim. It's often repeated, but defies science. The aspartame molecule bears no structural resemblance to glucose. It's like saying you walked past a 57 Chevy and your 2019 Ford key fob unlocked the door.

Yeah, I call bullshit on this too. They are not even remotely the same chemicals.

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Originally posted by flashguy:I thought Aspartame was simply a physical mixture of 2 amino acids--it wouldn't have a specific molecule. Am I wrong?

flashguy

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Originally posted by flashguy:
<snip>
I think the choice of Diet Vernors is a good one. I grew up with the original Vernor's in Detroit (at one time it was only available in that area).

flashguy

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Originally posted by PowerSurge:

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Originally posted by flesheatingvirus:
Diet Dr. Pepper is my go-to.

Yes. Diet Dr. Pepper tastes the closest to the original than any diet drinks I’ve had.