So, a little while ago, I saw an article appear in the New York Times regarding artificial sweeteners, and how they’re “better” for the average person than regular table sugar. My head hurts just thinking about this, but it’s important that we talk about this a little bit.
The entire article is worth a read, if for no other reason than to take a look at the studies listed regarding artificial sweeteners and their history. (Read this first, though.) But one part in particular stood out to me:
Epidemiologic studies have found that even after controlling for other factors, a population’s intake of added sugars is associated with the development of type 2 diabetes, with a 1.1 percent increase in prevalence for each can of sugar-sweetened soda consumed on average per day. A study following people for an average of more than 14 years published last year in JAMA Internal Medicine found that those in the highest quintile of added sugar consumption had more than twice the risk of dying from cardiovascular disease than those in the lowest quintile, even after controlling for many other factors.
The accompanying editorial noted that the increased risk of death began once a person consumed the equivalent of one 20-ounce Mountain Dew in a 2,000-calorie diet, and reached more than a fourfold increase if people consumed more than one-third of their diet in added sugars.
It should come as no surprise that the intake of added sugars is significantly associated with body weight. A systematic review and meta-analysis of randomized controlled trials, published in BMJ 2012, found that sugar intake increased both fat and overall weight. Another meta-analysis of randomized controlled trials, published in The American Journal of Clinical Nutrition in 2013, found that sugar-sweetened beverages alone cause body weight to go up in adults. In comparison, a meta-analysis of randomized controlled trials of artificial or low-calorie sweeteners published last year in the same journal found that their use led to lower body weight and less overall fat. [source]
So, very quickly, let’s talk about what a “meta-analysis” is.
A “meta-analysis” is when the data from various other studies covering a similar reaction and outcome with similar variables in place is all compiled to serve as data for a new pattern or relationship between particular variables. If there are 40 studies researching why black girls rock, and a different organization pulls together all of the data to compile and compare, only to find that black girls not only rock but they also roll, then the meta-analysis has taught us something new about the relationship between black girls and how they rock and roll. Make sense?
The problem with meta-analyses, however, is the fact that… well, I’ll let the National Institute of Health explain it:
Meta-analysis is a powerful tool to cumulate and summarize the knowledge in a research field, and to identify the overall measure of a treatment’s effect by combining several conclusions. However, it is a controversial tool, because even small violations of certain rules can lead to misleading conclusions. In fact, several decisions made when designing and performing a meta-analysis require personal judgment and expertise, thus creating personal biases or expectations that may influence the result. Meta-analysis’ conclusions should be interpreted in the light of various checks, discussed in this work, which can inform the readers of the likely reliability of the conclusions. Specifically, we explore the principal steps (from writing a prospective protocol of analysis to results’ interpretation) in order to minimize the risk of conducting a mediocre meta-analysis and to support researchers to accurately evaluate the published findings. [source]
Why am I splitting this seemingly unimportant hair? Simple.
When I think about the number of people who consume “zero-calorie drinks,” I think of people who are intentionally health-conscious. People who might willingly change the way they’re eating primarily because they’ve got a particular fitness or body goal they’re seeking to accomplish. A meta-analysis likely wont tell me anything about these people – their socioeconomic status, for a huge example – which makes it hard to truly understand a sentence like “In comparison, a meta-analysis of randomized controlled trials of artificial or low-calorie sweeteners published last year in the same journal found that their use led to lower body weight and less overall fat.”
If low-calorie sweeteners are the realm of the health-conscious, wouldn’t it also be possible that they have “lower body weight and less overall fat” because they’re also likely mindful of their consumption and their activity levels in other areas? A meta-analysis couldn’t tell me anything about that.
For that to be the primary thing this entire essay was built upon felt a little petty to me. That’s not enough to make me think artificial sweeteners – and all of the research covered by The New York Times staff, itself – are benign and worth ignoring.
That being said, let’s say we did completely remove all of the risks of consumption, all the arguments about “chemicals” – because, yes, everything is a chemical (even though I’m really growing annoyed with this phrase) – and all of the side-effects that people report after consuming artificial sweeteners.
As someone who works with people who are fighting through emotional eating issues and a general purpose addiction to “sweet”, I’ve got to tell you something: in the long run, an artificial sweetener is no different from an added sugar.
Most people consume far too much “sweet” to begin with – their breakfast cereals, their oatmeals, their non-dairy milks, their salad dressings, their coffee, their drinks, their condiments, their pastries, all of it. Every last bit contains sugar. Lots of it, in many cases. It’s not just the sodapop, even though a large portion of the sugar comes from there.
Consuming “sweet” – not just “sugar” – at every turn makes it easy to breed a connection to the good feelings associated with sugar, while simultaneously making it more difficult to actually be able to turn down a “sweet” when faced with the chance. The average person has a hard time saying “no,” and this is why – there’s so much sugar all over your daily diet, that it becomes a part of your expectations and you rarely even know it. You can become attached to it subconsciously, and the only signal you might have to what’s happening is a growing waistline.
Artificial sweeteners, in this instance, send the wrong message. When artificial sweeteners are marketed or discussed among health-conscious people, the focus is on the reduction of the penalty: they’re “zero calorie.” Talking about “low calorie” foods in certain circles means, ultimately, that it’s “okay” to have them as much as you want because they’re so low-calorie. Except, the goal shouldn’t be to simply consume nothing but artificially sweetened drinks – the goal should be to reduce consumption of and reliance on “sweets,” altogether.
This was the point of creating artificial low/no-calorie sweeteners – so that people wouldn’t have to reduce their consumption of their favorite sweets, and they wouldn’t have to stop spending money on their favorite brand of product. And, because many of these companies also own other brands that heavily rely on being “sweet” to ensure that they’re profitable, it also saves them from potentially losing you as a customer in other products, too, if you decide to cut back on sweet tastes altogether.
Artificial sweeteners make it increasingly difficult for many sugar addicts to begin the work of learning how to say “no.” They’re still saying “yes” to certain kinds of “sweet flavors,” creating loopholes to justify continued consumption instead of exploring the four other kinds of flavors (sour, bitter, salty, savory) as alternatives. This only makes it more difficult to break the cycle of craving sweet, acquiring sweet, consuming sweet, receiving the neurological benefits of consuming the sweet, feeling bad again because sweets don’t solve problems, repeat; but it also can result in people thinking that, because they’ve skipped the risks inherent in regularly-sweetened sodapop, it’s okay to overindulge somewhere else. This isn’t helpful, either – the “Can I get a number six, a number two, and an extra-large fry with a Coke Zero” syndrome is real.
The doctor in the article admits to giving his children four or five sugar-free sodapops a week, which struck me as shocking… but then I snapped out of it. Children, being the ones most likely to develop early relationships with sweets that are unhealthy and who also have very limited means of fighting issues like type 2 diabetes on their own, would potentially be susceptible to sugar addiction as they age.
Never mind the NYT’s own coverage of studies pointing out the problems with artificial sweeteners. Never mind the fact that one of the girls in your training class is constantly loading her black coffee us with Sweet-n-Wack. Never mind all of it – you have to look at yourself and determine where the sweet is coming from in your life, and do what you can to limit it. And, quite honestly, you’d be better off using regular sugar to get that done, too.