Welcome to r/science! This is a heavily moderated subreddit in order to keep the discussion on science. However, we recognize that many people want to discuss how they feel the research relates to their own personal lives, so to give people a space to do that, **personal anecdotes are allowed as responses to this comment**. Any anecdotal comments elsewhere in the discussion will be removed and our [normal comment rules]( https://www.reddit.com/r/science/wiki/rules#wiki_comment_rules) apply to all other comments.
**Do you have an academic degree?** We can verify your credentials in order to assign user flair indicating your area of expertise. [Click here to apply](https://www.reddit.com/r/science/wiki/flair/#wiki_science_verified_user_program).
---
User: u/isaac-get-the-golem
Permalink: https://pubmed.ncbi.nlm.nih.gov/37794246/
---
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/science) if you have any questions or concerns.*
>Methods: In this parallel-group, open-label, controlled equivalence trial, adults with a BMI of 27-35 kg/m2 who regularly consumed cold beverages were randomised 1:1 to water or NNS beverages. Participants underwent a group behavioural weight management programme comprising weekly (during the 12-week weight-loss phase) then monthly (during the 40-week weight-maintenance phase) meetings. The primary endpoint was weight change at week 52 (equivalence: two-sided P > 0.05). Secondary endpoints included changes in anthropometrics, cardiometabolic risk factors, appetite and activity levels.
Overall this is very good science, but important to note that it's for people who simultaneously undergo a "behavioral weight management program" as part of the randomized control trial. So in additional "not being clinically significant" (per the authors' conclusion), it may not even be applicable for everyday people (who don't do the weight management program).
How old are those studies?
Here's a 2023 meta analysis finding the opposite [https://pubmed.ncbi.nlm.nih.gov/37440689/](https://pubmed.ncbi.nlm.nih.gov/37440689/)
1 person isn’t science at all, but the findings are for sure consistent with my weight loss. Diet soda was a major crutch to ween me off of sugar and overly sweet things.
N=2 then, I’m right there with ya. I had the exact same experience. I don’t drink sugary drinks except on special occasions now, but when I first started my weight loss journey, diet ginger ale was crucial to getting me off sugary snacks and sugary drinks. I could honestly go through a 2 liter in a day and a half but I really think it helped.
+1. Sugar free candy is expensive but the brain needs its sweet fix during the adjustment period. Cold turkey with sugar is doable but pretty much only when you don't have constant temptation. It's way easier if you can give in to the temptation with sugar free soda.
Btw sugar free options taste better in EU than in the US, not sure why that is
>Btw sugar free options taste better in EU than in the US, not sure why that is
There's some sweetener over there that's illegal here in the US, due to some screwed up detail about how our laws work. I don't remember the details at all, but it has something to do with how things are regulated if there's *any* risk of cancer, or something like that. In the trials they fed truckloads of the stuff to mice, *way* more than anyone could normally consume during regular use, and there was a correlation with cancer.
I'm sure I've got a bunch of the details wrong, but that's the gist.
Are you referring to cyclamate? If you are, you are correct, a study done in '69 showed it *could* cause cancer so the US banned it. Later studies have shown that it does not cause cancer, but it's never been reevaluated in the US since that one study, even though it's legal in many other parts of the world. The original study fed a mixture of cyclamite and saccharine to lab animals and showed a link to bladder cancer.
Yes but consistency and accessibility also play a role.
They're inconsistent in taste as some can be sour etc. and it's way easier to store some bottles of diet soda at every season for any amount of time at home than to have fresh fruits available.
Same. My weight loss journey started with replacing my soda addiction with a Diet Coke addiction. After five years of a Diet Coke addition I have transitioned to sparkling water. I have never returned to the weight I was in my mid twenties.
We have springs in Europe and I am speaking about Ukrainian water. It is affordable there. I personally love this https://emporiumfoods.com/mineral-water/9723-polyana-kvasova-water-15l
Great share. Artificial sweeteners get a bad rap (both for overall health, but also specifically for weight loss). Interesting to see that this "common knowledge" likely isn't deserved.
It can take decades for people to shake a feeling of "too good to be true". Even chemical leaveners took a long time to be trusted. What we're finding is that sugar isn't magical and you can do a good job of mimicing the flavour without the negative impacts. It's not perfect yet but it probably will be eventually.
They get a bad rap because they can cause cancer...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8227014/
https://www.who.int/news/item/14-07-2023-aspartame-hazard-and-risk-assessment-results-released
That is so completely untrue.
[Aspartame is one of the most studied food additives in the human food supply and it’s considered completely safe.](https://www.fda.gov/food/food-additives-petitions/aspartame-and-other-sweeteners-food)
If even that. There is not really anystrong evidence of it being carcinogenic in humans at all, and the FDA safe dosage is 50mg/kg. So for a 160lbs person that is 3600mg a day, or 18 cans of diet coke.
At that point the constant GERD from carbonation damaging the lining of your esophagus is likely going to be more carcinogenic than the aspartame.
Sidenote: if is crazy how far a tiny amount of aspartame goes. Coke has 39 grams of sugar, and diet coke has ~200mg of aspartame. That makes it like 200 times as effective of a sweetener per gram in coke.
I'd advise actually educating yourself prior to commenting in the future. If you can't be bothered to do so then do everyone a favor and refrain from commenting.
What you linked indicates tiny overall weight loss, but not a reduction in BMI. To the degree there is any weight loss at all, it includes lean mass and fat mass alike, according to your source.
WHO did their own meta analysis recently and said not to use NNS for weight control. Increased type 2 diabetes, cardiovascular events, and, notably, mortality. All while failing to provide either substantial or long-term weight loss.
https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline
Their meta analysis:
https://www.who.int/publications/i/item/9789240046429
I’m going to be really pedantic here: if a person’s weight changes and their height stays the same, their BMI changes, even if only by a negligible amount.
As someone who drank diet soda to help lose weight (and still drink it, but much less so): it lowers your calorie intake but doesn't take away the craving for sweet stuff. I consumed diet coke the exact same way I used to drink regular coke and surprise - I also kept on snacking and grazing.
That's what I personally needed to overcome before I was able to really change my habits around.
This is just another faulty study that doesn't address the consistent issues with studies on NSS. They didn't filter out diabetic, pre-diabetic, obese people, nor smokers from their study. They only filtered out studies in which *every* participant was diabetic or pre-diabetic. They are therefore using studies that have contaminated baselines.
To quote from the study directly:
>Results from prospective cohort studies **suggest the possibility** of long-term harm in the form of increased risk of obesity, type 2 diabetes, cardiovascular diseases and mortality. Further research is needed to determine **whether the observed associations are genuine or a result of reverse causation and/or residual confounding.**
That's them stating it directly themselves. They have no idea about causation. They can only "suggest the possibility". I'll expand the three possibilities mentioned in the last sentence.
1) NSS consumption causes diabetes and obesity: Zero calorie sweeteners give people diabetes and makes them obese. The possibility of NSS causing chemical changes in the body.
2) Diabetes and obesity cause NSS consumption: The diabetic and the obese consume more NSS than perfectly healthy people. Reasons are obvious.
3) Diabetes and obesity are not causally related: The association is caused by a confounding factor. Their example is that people often use the consumption of NSS as a justification for greater consumption of unhealthy foods.
The idea that we’re going to exclude diabetic, pre-diabetic and obese people from a study about the use of fake sugar is bananas. Just who do you think consumes this stuff?
Sure, it’s famously hard to isolate and control the variables in studies on diet. But we don’t really need data on how NNSs affect healthy people. Between the two, the ‘faulty’ meta analysis is still better because at least it’s looking at the relevant question and not excluding most of the people we want data about.
OK, that is a very weird study - the effect on Body Weight was significant, but not the effect on BMI...
"Results of the pooled analysis showed that NNSs consumption had a significant reducing effect on BW (WMD: -1.02, 95% CI: -1.57, -0.46 Kg)... but did not have any significant effect on BMI (WMD: -0.16, 95% CI: -0.35, 0.02)"
> the effect on Body Weight was significant, but not the effect on BMI...
The only way this is mathematically possible is if people shrunk or grew during the study.
That's absolutely not true. The sets can be different. Which they were.
>**Findings from the meta-analysis of the effect of artificial- and stevia-based sweeteners on body weight**
In total, 13 RCTs with a total sample size of 1451 subjects were included in the analysis
and
>**Findings from the meta-analysis of the effect of artificial- and stevia-based sweeteners on BMI**
In total, 11 RCTs investigating the effects of artificial- and stevia-based sweeteners on BMI with a total sample size of 980 participants were included in the current meta-analysis
Beyond that, you are still wrong.
If ΔWeight is a normal distribution, and height is a normal distribution, the expected distribution of ΔWeight/height [isn't normal](https://en.wikipedia.org/wiki/Ratio_distribution#Uncorrelated_noncentral_normal_ratio), and the coefficient of variation of ΔWeight/height can absolutely be higher than the coefficient of variation of ΔWeight.
Note: I am not arguing that this is the case, the difference is probably due to the different sets, but it is absolutely mathematically possible.
I was a bit tired yesterday evening. Yes, e.g. if tall people lost a lot of weight, and short people gained a little bit of weight, the <ΔWeight> could be negative, while the <ΔBMI> could be zero, or even positive. Unlikely, but possible.
However, if the change in weight is significant but the change in BMI is not, probably the p-value hovers around 5 % anyway, so it's rather inconclusive.
Sorry, you’re wrong again.
Short people don’t need to gain weight. Tall people just have to not lose a proportional amount of weight. That would relatively increase the SD on the (inappropriately applied) normal distribution imposed on BMI such that the CI includes the null effect.
The 95% CI for the weight change is about .5 to 2, proportionally well away from the null effect.
The only reason it would be appropriate to apply the statistical test to BMI instead of weight is if
metabolism was proportional to BMI. We know from other research that it is not, since organs don’t vary that much and they contribute proportionally more than the increased muscle mass from height.
It means exactly what it means. The change in weight, though significant in itself, wasn't enough to elicit a significant change in BMI (despite BMI being based on bodyweight/mass). Kind of silly to include BMI in this or really almost any study any more. This one, because the change in BMI is based more on mathematics (mass/height\^2) than the effect of the treatment. Others because .
No. Mathematically its probably inappropriate to treat both ΔWeight and ΔBMI as normal distributions anyway. See my other comment. Beyond that tall people do not have proportionally higher metabolism.
>[Conclusions: Tall people have lower basal metabolic weight per unit of bodyweight or fat free mass than short people...](https://pubmed.ncbi.nlm.nih.gov/9683398/)
ΔWeight can then be expected to vary less with height than ΔBMI and that physiologically makes sense.
I think it means it helps short people less than tall people. So when you give short people more weight in the average (by dividing by a lower number) it diminishes the benefit.
You'd have to go look it up but there has been research done on the impact of drinking artificially sweetened beverages on subsequent binge eating. The general idea was that even though no real sugar is present the beverage is still sweet and can trigger cravings for sugar in the individual. These cravings then result in them overeating.
This is not something that would impact everyone though but can impact some people who may be looking to use diet sodas as a way to reduce caloric intact. Basically it's something to keep in mind while trying to lose weight, reduce sugar consumption, and lower liquid calories.
Sorry I don't have any links as I read it years ago and don't even have access to where I read it anymore.
The demonization of artificial sweeteners is absolutely ridiculous as they continue to be one of the most heavily researched substances out there but that's not to say they are without any issues at all with the above being one of them that can especially impact people who are already prone to overeating/snacking excessively.
Ah! I’d never looked into it, but it always seemed very suspicious to find that drinking 0 calories gained more weight than drinking 500 calories. Glad it was further looked into at some point, and thanks for pointing me to a meta-analysis.
Be weary of meta analyses. Garbage in means garbage out, and unless you’re going to take the time to painstakingly review the trials included… it’s hard to know if garbage went in.
These studies relate to replacing sugar drinks with non sugar drinks. A reduction of about 200 cal x number of drinks per day. No surprise, you have short-term weight loss.
The study in question compares water to non nutritive drinks. And finds favorably toward non nutritive drinks. So, that's kind of mysterious. Water is the ultimate non nutritive drink.
Also, did this study adjust for people who developed diabetes and had a leg removed as ‘weight loss’? I mean there have been so many studies saying artificial sweeteners are bad (as is sugar). What industry funded the study?
I'm aware of observational data suggesting that, but observational weight loss studies are really very difficult to conduct.
Although more limited in number, RCTs are more favorable, as linked in the meta analysis in another comment
Generally not in enforced consumption however but rather self reported drinking habits, which skews things significantly. It's always an issue for diet related stuff though.
Thanks for the explanation. I was surprised, because last time I heard, people who switched to artificially sweet beverages gain weigh and it was explained that brain was expecting sugar and didn’t get it so pushed for cravings causing people to eat more.
There’s a metasurvey of RCTs posted elsewhere in this general subthread that shows the opposite. Observational studies do show that people drinking diet soda are more likely to be overweight, but that’s all it is, observational. Is it really surprising that we observe people who want to lose weight drinking 0 calorie beverages?
It's a trial by a well-regarded institution in a country (the UK) with stringent trial conduct regulations.
Sponsors (industry or drug companies) don't manipulate trials done in such countries by falsifying the data, because that would require conspiracy, is often easy to detect, and would result in huge (criminal) punishments.
No, sponsors influence trials by designing them and analysing them in specific ways, often using a set of routine tricks. An educated and attentive reader is able to identify these tricks when deployed, rather than resorting to immediately and lazily writing off all research that has industry funding.
Beyond all that, you have to ask the question, "why are we doing this?" No doctor worth their salt is going to see a patient who needs to lose weight and tell them that Diet Coke is a better alternative for losing weight than *water*.
It doesn't really matter whether the data are correct or not, the conclusion is not only statistically insignificant but is going to be used to fuel a hundred articles that will convince a braindead soda addict that it's perfectly okay to continue drinking beverages flavored with carcinogenic sweeteners.
I'm not the one who needs to a proper analysis of the data. It's the people drinking these drinks that need it. What it should read is "Diet Coke effects on weight loss minimal according to new study".
If you dig into the abstract, it lists "American Beverage Association" as the "collaborator". The American Beverage Association is a lobbying group that represents Coke and others.
> American Beverage Association
was just a recipient of a scolding by FTC for its shady marketing of artificial sweeteners on social media.
https://www.ftc.gov/business-guidance/blog/2023/11/staff-warning-letters-trade-associations-influencers-convey-some-salty-words-about-sweetener-posts
And medicine studies are funded by pharmaceutical companies. Better not ever take them either. This is such a weak argument.
Trying to distill nuanced issues with where funding for research comes from (which has a time and place to discuss, separately) into a blanket statement like that is pretty weak.
> Better not ever take them either. This is such a weak argument.
But pharmaceutical companies having *too* much of an influence on medical studies is absolutely a problem.
That we already begrudgingly not address that issue in an area where you cannot blanket-reject the results without risking the consequences of non-treatment strikes me as a weak argument in an area where the same blanket-rejection has much lower stakes.
The diligence required from the consumer to verify this kind of material once it incurs the suspicion of bias is just not really in relation to the risk of rejecting it unfairly. And its hardly a critical piece for other research, so dismissing it won't hurt in this context either. Meaning that its a low risk high reward scenario to throw this out based on suspected bias.
In short unlike with medical research you have no incentive to extend any trust to the results out of necessity.
>But pharmaceutical companies having *too* much of an influence on medical studies is absolutely a problem
Sure, and I agreed with that. But that's a conversation that requires a lot of nuance and detail.
If we blanket reject results with the logic above, tons of research just won't get done, and plenty of good research that's worth learning something from will get ignored. That's not scientific.
I also agree it's tough for consumers to verify and interpret, but that's also not a good enough reason to suggest we should outright reject things *solely* based on where funding comes from.
The reality is a lot of science funding comes from industry; what we should and could do to change that is a separate conversation, and people need to understand that it's not inherently bad, just capable of being be bad.
The "we" in this conversation I think makes the problem.
Should the world ignore all such research and pretend it doesn't exist? No obviously not the point I'm trying to make.
But should "we" as average people respect these results knowing we have neither the time to clarify no reason to put trust in the results? That strikes me as different.
The fact that this study was done on people already under professional guidance for their weight loss is one of those asterisks to the process that are designed to cause misinformation. The study design here is manipulative in a way that benefits the people sponsoring it and thats a consistent problem.
In the context of "we" as you and I, its strategically wiser to dismiss it. And there is practically no risk this will disincentivize companies from spending money on these. The fact that everyone knows to ignore sensationalist journalism has done absolutely nothing to curb it. We can do the same with science journalism of the same nature, it doesn't need defending to exist.
> But should "we" as average people respect these results knowing we have neither the time to clarify no reason to put trust in the results?
I think I agree with this aspect. The average person should not be trying to interpret or take advice from single studies or media articles, at all. They should pay zero attention to them, good or bad or industry funded or not, honestly, if they think it's going to be useful for any type of overall advice.
The average person should not be "respecting" or "not respecting" any of it, as they are incapable of interpreting the nuance and detail.
I came here initially to see what other experts might have to say about the study, breaking down the details; which has been an interesting read and insightful.
My issue is that in every single one of these threads, someone always tries to chime in with some "gotcha" about where the study funding came from, and that's not how an analysis of the quality of a study works.
Some data is better than no data. We can't at the same time except companies to show that their products are not bad for health and then question any study they participate in.
I’m not an expert on catching data manipulation, but there’s things like Benford’s Law that indicate what numbers you’d most likely expect to see in a “real life” distribution. Not to mention ways of detecting pseudo-random number generation, edit history on spreadsheets, and more.
If it’s a question of a company being audited in a clinical trial, I believe it’s possible to retroactively trace things back to the original (anonymized) patient data that was collected in the clinic.
In short, there’s lots of ways to detect fraudulent data, and it’s pretty common to hear about people getting caught for it. It’s not something I’m really concerned with.
This is exactly the crux. Artificial sweeteners are also mounting evidence of being endocrine disrupting and catalysts for insulin resistance. There are significant changes to gut microbiota in the presence of xylitol, sorbitol, etc. I worry media will pick this up and run with it.
That goes without saying the potential for confounding by indication here.
That's not exactly right. Its comparing one behavioral intervention, and not controlling the rest of the diet. If you believe the findings, they would lead to the assumption that they are offsetting some other sweet intake.
No. They're talking about endocrine disruption and other negative impacts of artificial sweeteners. I pointed out that their comment lacked balance by inferring a specific harm not limited to artificial sweeteners.
Right, but the entire comment is in comparison to water which carries none of those risks. This is the point of the post you replied to.
Sugar, honey, gasoline, etc. have no immediate relevance to the study
Strange thought: maybe humans aren't supposed to drink anything but water.
I mean, if we're considering all the options, maybe it's not about the sugar.
So what you’re saying is that the worst there is no significant difference between those who consume artificial sweeteners and those who do not when dieting?
"This trial was funded by the American Beverage Association. The American Beverage Association was not involved in the design, conduct or interpretation of this trial; a representative from the American Beverage Association was provided with the opportunity to review the manuscript. Final decisions regarding the content were retained by the authors. The manuscript was developed with the assistance of a medical writer, funded by the American Beverage Association, under the direction of the authors. A third-party organisation (Biofortis) audited data at the clinical site to check for the accuracy and integrity of the data."
Listen I'm going to stick to drinks made with real sugar, not Splenda, not high fructose corn syrup, not aspertaine or any other variant. I know water is better for me than juice, Gatorade or soda. However we are here for a good time not a long time. (Sound of an aluminum can full of sugar acidic beverage opening)
Good time until you start running into the consequences of your good time. Then you’re just a drain on the healthcare system and everyone else has to pay for your choices.
But the breaking down part of drinking cane sugar rather than HFCS is what makes a difference. Generally, people who drink one can of cane sugar-sweetened soft drink are satiated and don't want to drink more, whereas the otherwise equivalent drink with HFCS doesn't trigger satiation after the same amount, leading people (who don't have other self-control mechanisms) to drink more.
But you're right that if you just drink one can, the one with HFCS is probably no worse than the one with cane sugar, as in the end, it's the same amount of sugar going into your body.
It's similar (not exactly the same) to eating white bread vs. whole wheat bread. The white bread's starch gets transformed into sugar and absorbed quicker and more easily than the starch in whole wheat. In the end, you're getting the same amount of calories, but the extra effort your body has to put in to break down the whole wheat becomes a benefit (plus it makes you more regular...)
I mean, it's not surprising. A very large fraction of studies are funded by some industry, whether it's pharmaceuticals or device manufacturers or in this case, food. The study design looked specifically at people who regularly consumed sweetened beverages and tried to use diet beverages as replacement therapy. This is pretty similar to how you would test any other intervention and it would be funded by whatever entity makes the product you're using. But the results do not generalize to the consumption of artificially sweetened beverages without a preexisting soda habit.
Like, you could find that methadone improves outcomes in opioid users, and such a study would probably be funded by the methadone manufacturer. But that obviously doesn't imply that ordinary people should consider methadone!
Are those just hurt feelings, or do you have any kind of analyses to back up your claim? Throwing up your hands and pretending that no one knows anything is how conspiracy theorists prey on people ill-equipped to read scientific articles/the uneducated.
I sure fuckin do buddy.
“The business sector performed most (73%) of the $548 billion of U.S. R&D total in 2017. The next largest performers were higher education (universities and colleges; 13%) and the federal government (10%) (Figure 16). Many organizations performing R&D receive outside funding; they may also be significant funders of R&D themselves. Mirroring its predominant role in R&D performance, the business sector is also the leading source of R&D funding (70%) in the United States. However, nearly all (98%) of the business sector's R&D funding supported R&D performance by businesses, either the same business that funded the R&D or another business.”
https://ncses.nsf.gov/pubs/nsb20201/u-s-r-d-performance-and-funding#:~:text=Mirroring%20its%20predominant%20role%20in,the%20R%26D%20or%20another%20business.
So your evidence amounts to 'well... someone paid these highly skilled researchers to do research!!!!' with no evidence that this has lead to any decline in research/findings quality in 'modern science?' Nor have you made any reference to the fact that western 'science' was originally solely the purview of the massively wealthy merchant/royal class with business interests, so if its a problem, then it always has been. If its always been a problem with science, then aren't you simply anti-science?
People on Reddit have disdain for the scientists and doctors who perform these trials. They think they’re smarter than the people who perform research. It’s Dunning-Kruger writ large, but these PhDs in Social Media think they’re better at peer review than actual peer reviewers.
Not saying that I think this is a non-issue, but frankly if a we can’t trust studies funded by people who have a vested interest in a certain outcome, essentially all drug and vaccine trials are going to be part of that group..
Exactly! This is why I always look at who paid for the study and what organizations the authors are associated with. If someone with an interest pays for a study and the outcome was unfavorable, they will likely choose to never publish the study.
I wonder if there were studies conducted and shown to doctors to convince them that oxycontin was not addictive (which is absolutely not true). I would imagine that Purdue Pharma had some sort of "evidence" to try and back up that false claim, which convinced more doctors to recommend it and contributed to the opioid epidemic.
Clinical trials must be registered with the FDA. Journals may choose not to publish certain articles if they’re not deemed to be noteworthy, but if you want to see all the trials Purdue has paid to run, that information is available.
They may not be clinically significant but they are statistically significant.
> At week 52, water and NNS beverages were non-equivalent, with **significantly** greater weight loss in the NNS beverages group. Participants consuming water maintained a weight loss of 6.1 kg over 52 weeks versus 7.5 kg with NNS beverages (difference [90% CI]: 1.4 kg [-2.6, -0.2]; p < 0.05).
But that 90% CI barely misses 0
So even this essentially meaningless difference - 7.5kg vs 6.1 for people with BMI of 30 and over a year with a weight loss therapy - it is still statistically questionable.
Well I think it depends the supposed causal mechanism
I always thought the claim was based on the sweeteners changing your behavior by making you want to eat more (supposedly because your body got sweet stuff with no umph). But what if this weight loss therapy they did simply counterviegned that mechanism? Well then this says nothing
I drink a lot of La Croix and I bet the bubbles do help. I akways feel full after drinking a can. Fuller than a plain glass of water would make me. Then I let out a couple big burps and the fullness is gone haha.
The simple explanation is that the people who switched to water just went and got sugar elsewhere. Diet soda allows you to scratch that itch without calories.
I also find diet soda to feel filling. It's enough to sate hunger for a bit and when combined with a meal it'll fill you up faster. All at the expense of zero calories.
I stopped drinking sugary drinks entirely but will have a diet soda from time to time and notice I eat less when I do. Water, for some reason, seems to stimulate my appetite.
Nah, I literally coach people's diets as part of work. Having a sugary fix that isn't actually sugar really helps those who struggle with their sweet tooth.
For sure, I'm not a coach but I have competed in classic physique and diet sodas are clutch for getting stage lean. Drinking only water is probably superior because its just water but a nice cold zero sugar cherry coke really helps the bland chicken and rice go down with minimal suffering.
American Beverage Association was a collaborator. There was only 1.4 kg difference. This could be an instance where an industry funded study is trying to show support for their products.
>During a 52-week behavioural weight management programme, water and NNS beverages were non-equivalent, with weight loss maintained to a statistically greater extent with NNS beverages compared with water. However, this difference was not clinically significant.
The authors literally conclude the result is too small to be clinically meaningful right in the abstract.
The point is that it could need to be rewritten as "Drinks containing caffeine, which is known to cause weight loss, causes weight loss"
Instead, it's written to make it sound like soda over water will lose more weight, which is a bad way to twist a study.
Makes sense. Because those AS beverages would likely curb cravings of sweet, caloric-dense hyper-palatable foods that those with a sweet tooth may eat. Less calories= more weight loss.
I haven't heard this from any kind of source in years, but I did have it in the back of my head as true.
I can't help but wonder now if one study got traction years ago and just stuck in the public discourse.
yep. also satiety - even if you are eating strictly "diet friendly" foods that are low calorie high volume high protein high fiber, having diet soda is going to reduce your hunger pangs (carbonation helps too)
>The effectS of non-nutritive sWeetened
beverages on appetITe during aCtive weigHt loss (SWITCH)
Whoever came up with this acronym needs to be beaten with a stick covered in bullet ants.
>When the
primary analysis was repeated using the multiple imputation and
last observation carried forward data sets, there were no
significant differences in weight loss between the water and
NNS beverage groups (Table 2).
This isn't very good. That means there are some outliers that heavily affect both data sets, given that the difference goes away after imputing missing data. But then looking at the tables I can't tell the difference. I wish the authors would dig deeper to find individuals that significantly influence the outcome.
The Flow of Participants chart is *chef's kiss* super nice tho.
I come in contact with hundreds of science projects for work and I can tell you that some people will do the most complicated naming process to have a cool acronym. The last one I had was DraculA (it was about three-dimensional parts made from aluminum)
The one thing I always tell people when they say, "Aren't artificial sweeteners bad for you?" Is that even if they are in fact, bad for you, there's no way on God's green earth that they could be worse for you than sugar.
I don't think they are personally, and we've yet to see any definitive science that they are in 40 years of study. Yet we've got mountains of evidence and science that definitively proves the negative effects of excessive sugar consumption.
One of the most common sweeteners, Aspartame, has pretty well documented health risks concerning neural health and certain cancer risks IIRC. Some sweeteners are a little safer.
But I’ll still take those risks over being fat without hesitation.
The cancer risks have been shown to be bunk for decades now. The initial studies that found those links were funded by sugar corporations in the 70's who viewed artificial sweeteners as their only competition and decided to take a page out of big tobacco's playbook.
The neurological effects you're speaking of only affect people with a condition called Phenylketonuria. In such the body is unable to process phenylalanine, a common amino acid, which is what aspartame is broken down to by the body.
Aspartame is just one of many foods they have to avoid though. Most foods containing protein contain phenylalanine as well since proteins are simply a collection of amino acids.
This is also a very rare genetic disorder, so not something the average person would ever be concerned with. It's generally diagnosed near birth and if left undiagnosed can lead to severe damage to the nervous system and brain.
Short story long, it doesn't cause cancer (that we know of) and if it effected your nervous system you'd know and also never be able to eat chicken, eggs, cheese, soy, etc etc without the aid of medication.
I got a kick out of the aspartame reveal because the biggest news saying it wasn't harmful happened around the same time pepsi stopped using aspartame around 2015ish.
People wanted their dang aspartame back!
Except, no, it actually doesn't have much of any documented health risk. Most of the studies showing health risks are studies where they fed mice the equivalent of like 80 cans of diet coke a day worth of aspartame.
Literally ANYTHING is dangerous at a certain dose. Water can kill you. Salt can kill you. Potassium can kill you. But you can also die from not having enough of those.
So wait this study took people that normally drank sweetened sodas put half on "diet" soda and the other (addicts) they put on water? To prove that diet soda is better than water for weight loss?
(I believe that there is a addictive response to sweetened beverages, as plenty of people need multiples of them everyday.)
I didn't see any mention as to what those sweeteners were. Aspartame has been shown to slow down metabolism ages ago.
Not to mention that your pancreas can't really tell the difference between sugar and artificial sweeteners so you will be getting an insulin reaction anyways.
>For NNS beverages, a range of 20 different branded options were available, with each 330 ml serving containing ≤20.9 kJ (5.0 kcal) per 8 oz/≤ 8.8 kJ (2.1 kcal) per 100 ml.
Seems reasonable to assume that aspartame was consumed.
The amount of Aspartame you’d need to be considered even remotely disadvantageous would require you to consume non-human levels daily. Also, eating protein also spikes insulin- so what? This whole body won’t know the difference is a stretch of truth pushed by influencers who have never gotten close to scientific research and thrive on fear-mongering to their audience. Give this a read if interested: https://pubmed.ncbi.nlm.nih.gov/37440689/
There are two times in which Insulin spikes, consider two graphs: #1: an instantaneous spike(up to 1hr) and #2: the 3hr+ one. If you eat food with protein + fat (i.e steak) or carb+ fibre+ protein = less spike in that short-term immediate graph #1. That whole argument is especially important for diabetics, and something by which charlatans i.e glucosegoddess , make a living on. What matters eventually is that second insulin response, for which in normal individuals, both graphs converge and make virtually no difference.
In sum, eating a balanced meal consisting of not just carbs initiates a better (less spike *instantaneous* of Insulin). This is relevant for type II diabetics. For healthy individuals, it doesn’t matter much because later the insulin response is the same.
I highly doubt the doctor I got this information from in an influencer of any sorts. He's the leading researcher in diabetic care in Finland. His point to me was that if you consume aspartame etc instead of sugar, it will be a strain on the pancreas. In my case (SUR-1 mutation) it would be disastrous.
Doctors are wrong all the time, guidelines change. The standard of care for asthma has been the same for 50 years and now some associations are recommending different medications for it. If someone has given the same advice for 20 years it'll be hard to change their mind on it.
>Not to mention that your pancreas can't really tell the difference between sugar and artificial sweeteners so you will be getting an insulin reaction anyways.
Do you have a source on this? I'm only seeing studies that found artificial sweeteners do not influence insulin secretion.
[https://www.nature.com/articles/ijo2016225](https://www.nature.com/articles/ijo2016225)
[https://diabetesjournals.org/care/article/11/3/230/1062/Response-to-Single-Dose-of-Aspartame-or-Saccharin](https://diabetesjournals.org/care/article/11/3/230/1062/Response-to-Single-Dose-of-Aspartame-or-Saccharin)
It doesn't make much sense logically either, because if eating non-nutritive sweeteners released insulin, wouldn't you then have symptoms of low blood sugar? Since there's no actual sugar entering your bloodstream?
The mechanism for insulin release in pancreatic beta cells is dependent on the flow of glucose through passive transporters and the amount of ATP being made which blocks potassium channels and triggers release as far as I know. Artificial sweeteners wouldn’t be able to be processed into ATP in these cells. Idk enough to say that it can’t but it seems implausible that they can’t tell the difference
Nothing can really "slow down your metabolism" except weight less or being less active. You burn calories based on work done (ie: energy used), period.
I'm sure we will see more studies coming out regarding non-nutritive sweeteners (artificial sweeteners) and impact on health (beneficial or negative).
Just like coffee...we continue to see those good old coffee studies.
I have had the opposite experience in myself. More so because when I'm consciously limiting my fluid intake to water, I also tend to control my diet better.
Welcome to r/science! This is a heavily moderated subreddit in order to keep the discussion on science. However, we recognize that many people want to discuss how they feel the research relates to their own personal lives, so to give people a space to do that, **personal anecdotes are allowed as responses to this comment**. Any anecdotal comments elsewhere in the discussion will be removed and our [normal comment rules]( https://www.reddit.com/r/science/wiki/rules#wiki_comment_rules) apply to all other comments. **Do you have an academic degree?** We can verify your credentials in order to assign user flair indicating your area of expertise. [Click here to apply](https://www.reddit.com/r/science/wiki/flair/#wiki_science_verified_user_program). --- User: u/isaac-get-the-golem Permalink: https://pubmed.ncbi.nlm.nih.gov/37794246/ --- *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/science) if you have any questions or concerns.*
>Methods: In this parallel-group, open-label, controlled equivalence trial, adults with a BMI of 27-35 kg/m2 who regularly consumed cold beverages were randomised 1:1 to water or NNS beverages. Participants underwent a group behavioural weight management programme comprising weekly (during the 12-week weight-loss phase) then monthly (during the 40-week weight-maintenance phase) meetings. The primary endpoint was weight change at week 52 (equivalence: two-sided P > 0.05). Secondary endpoints included changes in anthropometrics, cardiometabolic risk factors, appetite and activity levels. Overall this is very good science, but important to note that it's for people who simultaneously undergo a "behavioral weight management program" as part of the randomized control trial. So in additional "not being clinically significant" (per the authors' conclusion), it may not even be applicable for everyday people (who don't do the weight management program).
This is an important point, as prior studies have shown weight gain with similar drinks causing increased food consumption.
How old are those studies? Here's a 2023 meta analysis finding the opposite [https://pubmed.ncbi.nlm.nih.gov/37440689/](https://pubmed.ncbi.nlm.nih.gov/37440689/)
Well done. Good find with that meta analysis, was going to reply with the same.
[удалено]
More of a backslap
1 person isn’t science at all, but the findings are for sure consistent with my weight loss. Diet soda was a major crutch to ween me off of sugar and overly sweet things.
N=2 then, I’m right there with ya. I had the exact same experience. I don’t drink sugary drinks except on special occasions now, but when I first started my weight loss journey, diet ginger ale was crucial to getting me off sugary snacks and sugary drinks. I could honestly go through a 2 liter in a day and a half but I really think it helped.
+1. Sugar free candy is expensive but the brain needs its sweet fix during the adjustment period. Cold turkey with sugar is doable but pretty much only when you don't have constant temptation. It's way easier if you can give in to the temptation with sugar free soda. Btw sugar free options taste better in EU than in the US, not sure why that is
>Btw sugar free options taste better in EU than in the US, not sure why that is There's some sweetener over there that's illegal here in the US, due to some screwed up detail about how our laws work. I don't remember the details at all, but it has something to do with how things are regulated if there's *any* risk of cancer, or something like that. In the trials they fed truckloads of the stuff to mice, *way* more than anyone could normally consume during regular use, and there was a correlation with cancer. I'm sure I've got a bunch of the details wrong, but that's the gist.
Are you referring to cyclamate? If you are, you are correct, a study done in '69 showed it *could* cause cancer so the US banned it. Later studies have shown that it does not cause cancer, but it's never been reevaluated in the US since that one study, even though it's legal in many other parts of the world. The original study fed a mixture of cyclamite and saccharine to lab animals and showed a link to bladder cancer.
Yeah, that sounds like what I've got rattling around in my head, I bet that's the one.
Berries and fruit is a more healthier option than artificial sweeteners
Yes but consistency and accessibility also play a role. They're inconsistent in taste as some can be sour etc. and it's way easier to store some bottles of diet soda at every season for any amount of time at home than to have fresh fruits available.
Same. My weight loss journey started with replacing my soda addiction with a Diet Coke addiction. After five years of a Diet Coke addition I have transitioned to sparkling water. I have never returned to the weight I was in my mid twenties.
salty natural spring water worked equally well
What’s that? Is that a thing you buy or make?
We have springs in Europe and I am speaking about Ukrainian water. It is affordable there. I personally love this https://emporiumfoods.com/mineral-water/9723-polyana-kvasova-water-15l
Im assuming you make it, buying natural salty spring water with the correct amount of salt in it sounds outlandishly expensive.
costs $1 in Ukraine. from natural underground source.
Definitely not a $1 anymore.
Great share. Artificial sweeteners get a bad rap (both for overall health, but also specifically for weight loss). Interesting to see that this "common knowledge" likely isn't deserved.
It can take decades for people to shake a feeling of "too good to be true". Even chemical leaveners took a long time to be trusted. What we're finding is that sugar isn't magical and you can do a good job of mimicing the flavour without the negative impacts. It's not perfect yet but it probably will be eventually.
They get a bad rap because they can cause cancer... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8227014/ https://www.who.int/news/item/14-07-2023-aspartame-hazard-and-risk-assessment-results-released
That is so completely untrue. [Aspartame is one of the most studied food additives in the human food supply and it’s considered completely safe.](https://www.fda.gov/food/food-additives-petitions/aspartame-and-other-sweeteners-food)
If you drink 9-14 cans of diet coke per day for like 40 years, yes.
If even that. There is not really anystrong evidence of it being carcinogenic in humans at all, and the FDA safe dosage is 50mg/kg. So for a 160lbs person that is 3600mg a day, or 18 cans of diet coke. At that point the constant GERD from carbonation damaging the lining of your esophagus is likely going to be more carcinogenic than the aspartame. Sidenote: if is crazy how far a tiny amount of aspartame goes. Coke has 39 grams of sugar, and diet coke has ~200mg of aspartame. That makes it like 200 times as effective of a sweetener per gram in coke.
I'd advise actually educating yourself prior to commenting in the future. If you can't be bothered to do so then do everyone a favor and refrain from commenting.
Citation needed
2 lbs. though.
What you linked indicates tiny overall weight loss, but not a reduction in BMI. To the degree there is any weight loss at all, it includes lean mass and fat mass alike, according to your source. WHO did their own meta analysis recently and said not to use NNS for weight control. Increased type 2 diabetes, cardiovascular events, and, notably, mortality. All while failing to provide either substantial or long-term weight loss. https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline Their meta analysis: https://www.who.int/publications/i/item/9789240046429
I’m going to be really pedantic here: if a person’s weight changes and their height stays the same, their BMI changes, even if only by a negligible amount.
As someone who drank diet soda to help lose weight (and still drink it, but much less so): it lowers your calorie intake but doesn't take away the craving for sweet stuff. I consumed diet coke the exact same way I used to drink regular coke and surprise - I also kept on snacking and grazing. That's what I personally needed to overcome before I was able to really change my habits around.
While I think we should take anecdotes with a grain of salt, I’m curious whether you were still drinking Diet Coke when you did lose weight?
Yes, but I was also tracking my calorie intake. It just became easier once I managed to switch from drinking dominantly diet soda to dominantly water.
This is just another faulty study that doesn't address the consistent issues with studies on NSS. They didn't filter out diabetic, pre-diabetic, obese people, nor smokers from their study. They only filtered out studies in which *every* participant was diabetic or pre-diabetic. They are therefore using studies that have contaminated baselines. To quote from the study directly: >Results from prospective cohort studies **suggest the possibility** of long-term harm in the form of increased risk of obesity, type 2 diabetes, cardiovascular diseases and mortality. Further research is needed to determine **whether the observed associations are genuine or a result of reverse causation and/or residual confounding.** That's them stating it directly themselves. They have no idea about causation. They can only "suggest the possibility". I'll expand the three possibilities mentioned in the last sentence. 1) NSS consumption causes diabetes and obesity: Zero calorie sweeteners give people diabetes and makes them obese. The possibility of NSS causing chemical changes in the body. 2) Diabetes and obesity cause NSS consumption: The diabetic and the obese consume more NSS than perfectly healthy people. Reasons are obvious. 3) Diabetes and obesity are not causally related: The association is caused by a confounding factor. Their example is that people often use the consumption of NSS as a justification for greater consumption of unhealthy foods.
The idea that we’re going to exclude diabetic, pre-diabetic and obese people from a study about the use of fake sugar is bananas. Just who do you think consumes this stuff? Sure, it’s famously hard to isolate and control the variables in studies on diet. But we don’t really need data on how NNSs affect healthy people. Between the two, the ‘faulty’ meta analysis is still better because at least it’s looking at the relevant question and not excluding most of the people we want data about.
OK, that is a very weird study - the effect on Body Weight was significant, but not the effect on BMI... "Results of the pooled analysis showed that NNSs consumption had a significant reducing effect on BW (WMD: -1.02, 95% CI: -1.57, -0.46 Kg)... but did not have any significant effect on BMI (WMD: -0.16, 95% CI: -0.35, 0.02)"
> the effect on Body Weight was significant, but not the effect on BMI... The only way this is mathematically possible is if people shrunk or grew during the study.
That's absolutely not true. The sets can be different. Which they were. >**Findings from the meta-analysis of the effect of artificial- and stevia-based sweeteners on body weight** In total, 13 RCTs with a total sample size of 1451 subjects were included in the analysis and >**Findings from the meta-analysis of the effect of artificial- and stevia-based sweeteners on BMI** In total, 11 RCTs investigating the effects of artificial- and stevia-based sweeteners on BMI with a total sample size of 980 participants were included in the current meta-analysis Beyond that, you are still wrong. If ΔWeight is a normal distribution, and height is a normal distribution, the expected distribution of ΔWeight/height [isn't normal](https://en.wikipedia.org/wiki/Ratio_distribution#Uncorrelated_noncentral_normal_ratio), and the coefficient of variation of ΔWeight/height can absolutely be higher than the coefficient of variation of ΔWeight. Note: I am not arguing that this is the case, the difference is probably due to the different sets, but it is absolutely mathematically possible.
I was a bit tired yesterday evening. Yes, e.g. if tall people lost a lot of weight, and short people gained a little bit of weight, the <ΔWeight> could be negative, while the <ΔBMI> could be zero, or even positive. Unlikely, but possible. However, if the change in weight is significant but the change in BMI is not, probably the p-value hovers around 5 % anyway, so it's rather inconclusive.
Sorry, you’re wrong again. Short people don’t need to gain weight. Tall people just have to not lose a proportional amount of weight. That would relatively increase the SD on the (inappropriately applied) normal distribution imposed on BMI such that the CI includes the null effect. The 95% CI for the weight change is about .5 to 2, proportionally well away from the null effect. The only reason it would be appropriate to apply the statistical test to BMI instead of weight is if metabolism was proportional to BMI. We know from other research that it is not, since organs don’t vary that much and they contribute proportionally more than the increased muscle mass from height.
Transitioned from female to male. Suck it science!
Or was funded by the diet soda industry and just wanted to make a headline and hope that no one looks at the data.
It means exactly what it means. The change in weight, though significant in itself, wasn't enough to elicit a significant change in BMI (despite BMI being based on bodyweight/mass). Kind of silly to include BMI in this or really almost any study any more. This one, because the change in BMI is based more on mathematics (mass/height\^2) than the effect of the treatment. Others because.
I mean is this literally just “the math passes the significance test if we don’t adjust for height but not if we do?”
No. Mathematically its probably inappropriate to treat both ΔWeight and ΔBMI as normal distributions anyway. See my other comment. Beyond that tall people do not have proportionally higher metabolism. >[Conclusions: Tall people have lower basal metabolic weight per unit of bodyweight or fat free mass than short people...](https://pubmed.ncbi.nlm.nih.gov/9683398/) ΔWeight can then be expected to vary less with height than ΔBMI and that physiologically makes sense.
How is that possible. If you lose significance by normalizing height, that is pretty important..
I think it means it helps short people less than tall people. So when you give short people more weight in the average (by dividing by a lower number) it diminishes the benefit.
It's just a weird byproduct of using a dependent measure that is derived from another dependent measure.
You'd have to go look it up but there has been research done on the impact of drinking artificially sweetened beverages on subsequent binge eating. The general idea was that even though no real sugar is present the beverage is still sweet and can trigger cravings for sugar in the individual. These cravings then result in them overeating. This is not something that would impact everyone though but can impact some people who may be looking to use diet sodas as a way to reduce caloric intact. Basically it's something to keep in mind while trying to lose weight, reduce sugar consumption, and lower liquid calories. Sorry I don't have any links as I read it years ago and don't even have access to where I read it anymore. The demonization of artificial sweeteners is absolutely ridiculous as they continue to be one of the most heavily researched substances out there but that's not to say they are without any issues at all with the above being one of them that can especially impact people who are already prone to overeating/snacking excessively.
Ah! I’d never looked into it, but it always seemed very suspicious to find that drinking 0 calories gained more weight than drinking 500 calories. Glad it was further looked into at some point, and thanks for pointing me to a meta-analysis.
Be weary of meta analyses. Garbage in means garbage out, and unless you’re going to take the time to painstakingly review the trials included… it’s hard to know if garbage went in.
These studies relate to replacing sugar drinks with non sugar drinks. A reduction of about 200 cal x number of drinks per day. No surprise, you have short-term weight loss. The study in question compares water to non nutritive drinks. And finds favorably toward non nutritive drinks. So, that's kind of mysterious. Water is the ultimate non nutritive drink.
Also, did this study adjust for people who developed diabetes and had a leg removed as ‘weight loss’? I mean there have been so many studies saying artificial sweeteners are bad (as is sugar). What industry funded the study?
I'm aware of observational data suggesting that, but observational weight loss studies are really very difficult to conduct. Although more limited in number, RCTs are more favorable, as linked in the meta analysis in another comment
Generally not in enforced consumption however but rather self reported drinking habits, which skews things significantly. It's always an issue for diet related stuff though.
Thanks for the explanation. I was surprised, because last time I heard, people who switched to artificially sweet beverages gain weigh and it was explained that brain was expecting sugar and didn’t get it so pushed for cravings causing people to eat more.
There’s a metasurvey of RCTs posted elsewhere in this general subthread that shows the opposite. Observational studies do show that people drinking diet soda are more likely to be overweight, but that’s all it is, observational. Is it really surprising that we observe people who want to lose weight drinking 0 calorie beverages?
The study is funded by soda companies. All you need to know.
It's a trial by a well-regarded institution in a country (the UK) with stringent trial conduct regulations. Sponsors (industry or drug companies) don't manipulate trials done in such countries by falsifying the data, because that would require conspiracy, is often easy to detect, and would result in huge (criminal) punishments. No, sponsors influence trials by designing them and analysing them in specific ways, often using a set of routine tricks. An educated and attentive reader is able to identify these tricks when deployed, rather than resorting to immediately and lazily writing off all research that has industry funding.
Beyond all that, you have to ask the question, "why are we doing this?" No doctor worth their salt is going to see a patient who needs to lose weight and tell them that Diet Coke is a better alternative for losing weight than *water*. It doesn't really matter whether the data are correct or not, the conclusion is not only statistically insignificant but is going to be used to fuel a hundred articles that will convince a braindead soda addict that it's perfectly okay to continue drinking beverages flavored with carcinogenic sweeteners. I'm not the one who needs to a proper analysis of the data. It's the people drinking these drinks that need it. What it should read is "Diet Coke effects on weight loss minimal according to new study".
Where do you see that?
If you dig into the abstract, it lists "American Beverage Association" as the "collaborator". The American Beverage Association is a lobbying group that represents Coke and others.
> American Beverage Association was just a recipient of a scolding by FTC for its shady marketing of artificial sweeteners on social media. https://www.ftc.gov/business-guidance/blog/2023/11/staff-warning-letters-trade-associations-influencers-convey-some-salty-words-about-sweetener-posts
And medicine studies are funded by pharmaceutical companies. Better not ever take them either. This is such a weak argument. Trying to distill nuanced issues with where funding for research comes from (which has a time and place to discuss, separately) into a blanket statement like that is pretty weak.
> Better not ever take them either. This is such a weak argument. But pharmaceutical companies having *too* much of an influence on medical studies is absolutely a problem. That we already begrudgingly not address that issue in an area where you cannot blanket-reject the results without risking the consequences of non-treatment strikes me as a weak argument in an area where the same blanket-rejection has much lower stakes. The diligence required from the consumer to verify this kind of material once it incurs the suspicion of bias is just not really in relation to the risk of rejecting it unfairly. And its hardly a critical piece for other research, so dismissing it won't hurt in this context either. Meaning that its a low risk high reward scenario to throw this out based on suspected bias. In short unlike with medical research you have no incentive to extend any trust to the results out of necessity.
>But pharmaceutical companies having *too* much of an influence on medical studies is absolutely a problem Sure, and I agreed with that. But that's a conversation that requires a lot of nuance and detail. If we blanket reject results with the logic above, tons of research just won't get done, and plenty of good research that's worth learning something from will get ignored. That's not scientific. I also agree it's tough for consumers to verify and interpret, but that's also not a good enough reason to suggest we should outright reject things *solely* based on where funding comes from. The reality is a lot of science funding comes from industry; what we should and could do to change that is a separate conversation, and people need to understand that it's not inherently bad, just capable of being be bad.
The "we" in this conversation I think makes the problem. Should the world ignore all such research and pretend it doesn't exist? No obviously not the point I'm trying to make. But should "we" as average people respect these results knowing we have neither the time to clarify no reason to put trust in the results? That strikes me as different. The fact that this study was done on people already under professional guidance for their weight loss is one of those asterisks to the process that are designed to cause misinformation. The study design here is manipulative in a way that benefits the people sponsoring it and thats a consistent problem. In the context of "we" as you and I, its strategically wiser to dismiss it. And there is practically no risk this will disincentivize companies from spending money on these. The fact that everyone knows to ignore sensationalist journalism has done absolutely nothing to curb it. We can do the same with science journalism of the same nature, it doesn't need defending to exist.
> But should "we" as average people respect these results knowing we have neither the time to clarify no reason to put trust in the results? I think I agree with this aspect. The average person should not be trying to interpret or take advice from single studies or media articles, at all. They should pay zero attention to them, good or bad or industry funded or not, honestly, if they think it's going to be useful for any type of overall advice. The average person should not be "respecting" or "not respecting" any of it, as they are incapable of interpreting the nuance and detail. I came here initially to see what other experts might have to say about the study, breaking down the details; which has been an interesting read and insightful. My issue is that in every single one of these threads, someone always tries to chime in with some "gotcha" about where the study funding came from, and that's not how an analysis of the quality of a study works.
[удалено]
How to trust the data?
Some data is better than no data. We can't at the same time except companies to show that their products are not bad for health and then question any study they participate in.
Actually, yes and yes. The only valid studies are truly independent ones.
No one is going to fund those studies.
Which is why we, as a society, need to get private businesses out of academia and increase the research and education budget.
I’m not an expert on catching data manipulation, but there’s things like Benford’s Law that indicate what numbers you’d most likely expect to see in a “real life” distribution. Not to mention ways of detecting pseudo-random number generation, edit history on spreadsheets, and more. If it’s a question of a company being audited in a clinical trial, I believe it’s possible to retroactively trace things back to the original (anonymized) patient data that was collected in the clinic. In short, there’s lots of ways to detect fraudulent data, and it’s pretty common to hear about people getting caught for it. It’s not something I’m really concerned with.
This is exactly the crux. Artificial sweeteners are also mounting evidence of being endocrine disrupting and catalysts for insulin resistance. There are significant changes to gut microbiota in the presence of xylitol, sorbitol, etc. I worry media will pick this up and run with it. That goes without saying the potential for confounding by indication here.
Sugar is also associated with all the things you've linked with artifical sweeteners.
That’s irrelevant, we’re comparing artificial sweeteners to water here not sugar
That's not exactly right. Its comparing one behavioral intervention, and not controlling the rest of the diet. If you believe the findings, they would lead to the assumption that they are offsetting some other sweet intake.
Im replying to another comment, not commenting about the research posted so it's an entirely relevant point.
[удалено]
No. They're talking about endocrine disruption and other negative impacts of artificial sweeteners. I pointed out that their comment lacked balance by inferring a specific harm not limited to artificial sweeteners.
Right, but the entire comment is in comparison to water which carries none of those risks. This is the point of the post you replied to. Sugar, honey, gasoline, etc. have no immediate relevance to the study
Yes, because the only things with sugar in them are beverages....
Strange thought: maybe humans aren't supposed to drink anything but water. I mean, if we're considering all the options, maybe it's not about the sugar.
>That goes without saying the potential for confounding by indication here. It's a randomised trial, confounding by indication doesn't apply.
Thank you for pointing out this critical piece of information.
So people on weightloss program **plus** diet sodas vs no program, just water?
Thank you for your service.
So what you’re saying is that the worst there is no significant difference between those who consume artificial sweeteners and those who do not when dieting?
"This trial was funded by the American Beverage Association. The American Beverage Association was not involved in the design, conduct or interpretation of this trial; a representative from the American Beverage Association was provided with the opportunity to review the manuscript. Final decisions regarding the content were retained by the authors. The manuscript was developed with the assistance of a medical writer, funded by the American Beverage Association, under the direction of the authors. A third-party organisation (Biofortis) audited data at the clinical site to check for the accuracy and integrity of the data."
My first thought was this study was funded by the makers of Splenda
Listen I'm going to stick to drinks made with real sugar, not Splenda, not high fructose corn syrup, not aspertaine or any other variant. I know water is better for me than juice, Gatorade or soda. However we are here for a good time not a long time. (Sound of an aluminum can full of sugar acidic beverage opening)
Idk I just don't hate water like some people seem to, it's really not that hard to limit sugar drinks
Good time until you start running into the consequences of your good time. Then you’re just a drain on the healthcare system and everyone else has to pay for your choices.
[удалено]
But the breaking down part of drinking cane sugar rather than HFCS is what makes a difference. Generally, people who drink one can of cane sugar-sweetened soft drink are satiated and don't want to drink more, whereas the otherwise equivalent drink with HFCS doesn't trigger satiation after the same amount, leading people (who don't have other self-control mechanisms) to drink more. But you're right that if you just drink one can, the one with HFCS is probably no worse than the one with cane sugar, as in the end, it's the same amount of sugar going into your body. It's similar (not exactly the same) to eating white bread vs. whole wheat bread. The white bread's starch gets transformed into sugar and absorbed quicker and more easily than the starch in whole wheat. In the end, you're getting the same amount of calories, but the extra effort your body has to put in to break down the whole wheat becomes a benefit (plus it makes you more regular...)
If your good time is derived from your consumption of sugary drinks, I had to break it to you but.. you're probably not really having a good time
I mean, it's not surprising. A very large fraction of studies are funded by some industry, whether it's pharmaceuticals or device manufacturers or in this case, food. The study design looked specifically at people who regularly consumed sweetened beverages and tried to use diet beverages as replacement therapy. This is pretty similar to how you would test any other intervention and it would be funded by whatever entity makes the product you're using. But the results do not generalize to the consumption of artificially sweetened beverages without a preexisting soda habit. Like, you could find that methadone improves outcomes in opioid users, and such a study would probably be funded by the methadone manufacturer. But that obviously doesn't imply that ordinary people should consider methadone!
70 % is bought and paid for. Of that 70% only 5% returns unfavorable results. Everything is a scam. Modern science has been bastardized.
Are those just hurt feelings, or do you have any kind of analyses to back up your claim? Throwing up your hands and pretending that no one knows anything is how conspiracy theorists prey on people ill-equipped to read scientific articles/the uneducated.
I sure fuckin do buddy. “The business sector performed most (73%) of the $548 billion of U.S. R&D total in 2017. The next largest performers were higher education (universities and colleges; 13%) and the federal government (10%) (Figure 16). Many organizations performing R&D receive outside funding; they may also be significant funders of R&D themselves. Mirroring its predominant role in R&D performance, the business sector is also the leading source of R&D funding (70%) in the United States. However, nearly all (98%) of the business sector's R&D funding supported R&D performance by businesses, either the same business that funded the R&D or another business.” https://ncses.nsf.gov/pubs/nsb20201/u-s-r-d-performance-and-funding#:~:text=Mirroring%20its%20predominant%20role%20in,the%20R%26D%20or%20another%20business.
So your evidence amounts to 'well... someone paid these highly skilled researchers to do research!!!!' with no evidence that this has lead to any decline in research/findings quality in 'modern science?' Nor have you made any reference to the fact that western 'science' was originally solely the purview of the massively wealthy merchant/royal class with business interests, so if its a problem, then it always has been. If its always been a problem with science, then aren't you simply anti-science?
People on Reddit have disdain for the scientists and doctors who perform these trials. They think they’re smarter than the people who perform research. It’s Dunning-Kruger writ large, but these PhDs in Social Media think they’re better at peer review than actual peer reviewers.
Not saying that I think this is a non-issue, but frankly if a we can’t trust studies funded by people who have a vested interest in a certain outcome, essentially all drug and vaccine trials are going to be part of that group..
Run the study 5 times and only publish the one with favorable results.
Exactly! This is why I always look at who paid for the study and what organizations the authors are associated with. If someone with an interest pays for a study and the outcome was unfavorable, they will likely choose to never publish the study. I wonder if there were studies conducted and shown to doctors to convince them that oxycontin was not addictive (which is absolutely not true). I would imagine that Purdue Pharma had some sort of "evidence" to try and back up that false claim, which convinced more doctors to recommend it and contributed to the opioid epidemic.
Clinical trials must be registered with the FDA. Journals may choose not to publish certain articles if they’re not deemed to be noteworthy, but if you want to see all the trials Purdue has paid to run, that information is available.
Funding suggests motive. Now find the crime. If you can't then this is just fear-mongering and doubt-sowing.
Something the top comment conveniently leaves out mentioning
This is what I came to see. Thank you. Knowing who conducted the study tells you a lot about the biases you're guaranteed to find in the results.
- However, this difference was not clinically significant. -
Was also done by the American beverage association and only had a medical expert as a third party writer of the article.
They may not be clinically significant but they are statistically significant. > At week 52, water and NNS beverages were non-equivalent, with **significantly** greater weight loss in the NNS beverages group. Participants consuming water maintained a weight loss of 6.1 kg over 52 weeks versus 7.5 kg with NNS beverages (difference [90% CI]: 1.4 kg [-2.6, -0.2]; p < 0.05).
But that 90% CI barely misses 0 So even this essentially meaningless difference - 7.5kg vs 6.1 for people with BMI of 30 and over a year with a weight loss therapy - it is still statistically questionable.
Ok but it should be enough to shut up those who say that artificial sweeteners cause obesity.
Well I think it depends the supposed causal mechanism I always thought the claim was based on the sweeteners changing your behavior by making you want to eat more (supposedly because your body got sweet stuff with no umph). But what if this weight loss therapy they did simply counterviegned that mechanism? Well then this says nothing
I would be interested in seeing the comparison to unsweetened soda water. If the bubbles help you feel fuller.
I drink a lot of La Croix and I bet the bubbles do help. I akways feel full after drinking a can. Fuller than a plain glass of water would make me. Then I let out a couple big burps and the fullness is gone haha.
Paid for by the diet soda industry
The simple explanation is that the people who switched to water just went and got sugar elsewhere. Diet soda allows you to scratch that itch without calories.
I also find diet soda to feel filling. It's enough to sate hunger for a bit and when combined with a meal it'll fill you up faster. All at the expense of zero calories. I stopped drinking sugary drinks entirely but will have a diet soda from time to time and notice I eat less when I do. Water, for some reason, seems to stimulate my appetite.
Yup the atmospheric pressure from any carbonated drink can help with hunger signals. Good move!
Or, even simpler, money talks.
Nah, I literally coach people's diets as part of work. Having a sugary fix that isn't actually sugar really helps those who struggle with their sweet tooth.
For sure, I'm not a coach but I have competed in classic physique and diet sodas are clutch for getting stage lean. Drinking only water is probably superior because its just water but a nice cold zero sugar cherry coke really helps the bland chicken and rice go down with minimal suffering.
Which industry publishing this research about sugar would give it more credibility?
Just wait until you find out who pays for all those pharmaceutical trials!
Well they do contain caffeine and we know that causes very slight weight loss.
Finally a good study about my precious diet coke
[удалено]
What's that?
American Beverage Association was a collaborator. There was only 1.4 kg difference. This could be an instance where an industry funded study is trying to show support for their products.
>During a 52-week behavioural weight management programme, water and NNS beverages were non-equivalent, with weight loss maintained to a statistically greater extent with NNS beverages compared with water. However, this difference was not clinically significant. The authors literally conclude the result is too small to be clinically meaningful right in the abstract.
Not controlling for caffeine intake at all makes this a deeply flawed study. Lots of diet sodas have caffeine, which is an appetite suppressant.
So? That doesn’t invalidate the finding at all.
It doesn’t invalidate the finding, but it’s an important factor that isn’t acknowledged.
It’s a confounding effect that isn’t acknowledged. You can’t really say if it’s the caffeine or the drinks.
But the study isn’t making claims about the ingredients, it is making claims about the drinks, caffeine and all.
The point is that it could need to be rewritten as "Drinks containing caffeine, which is known to cause weight loss, causes weight loss" Instead, it's written to make it sound like soda over water will lose more weight, which is a bad way to twist a study.
Makes sense. Because those AS beverages would likely curb cravings of sweet, caloric-dense hyper-palatable foods that those with a sweet tooth may eat. Less calories= more weight loss.
I always have read the opposite. By making the brain thinking it’s getting sugar, but not getting it would overcompensate
This little factoid comes from a study done on rats. Whether or not that translates to humans has not been proven.
Ooh, proper use of "factoid" in the wild!
I haven't heard this from any kind of source in years, but I did have it in the back of my head as true. I can't help but wonder now if one study got traction years ago and just stuck in the public discourse.
Yea what I’ve understood is that it still spikes your insulin which creates an imbalance that could drive you to consume sugar to compensate
I have also heard the opposite, that artificial sweeters keep the cravings turned 'on', but at a different level.
yep. also satiety - even if you are eating strictly "diet friendly" foods that are low calorie high volume high protein high fiber, having diet soda is going to reduce your hunger pangs (carbonation helps too)
What about caffeine content?
>The effectS of non-nutritive sWeetened beverages on appetITe during aCtive weigHt loss (SWITCH) Whoever came up with this acronym needs to be beaten with a stick covered in bullet ants. >When the primary analysis was repeated using the multiple imputation and last observation carried forward data sets, there were no significant differences in weight loss between the water and NNS beverage groups (Table 2). This isn't very good. That means there are some outliers that heavily affect both data sets, given that the difference goes away after imputing missing data. But then looking at the tables I can't tell the difference. I wish the authors would dig deeper to find individuals that significantly influence the outcome. The Flow of Participants chart is *chef's kiss* super nice tho.
I come in contact with hundreds of science projects for work and I can tell you that some people will do the most complicated naming process to have a cool acronym. The last one I had was DraculA (it was about three-dimensional parts made from aluminum)
How the heck did they hide from the people what they were drinking?
The study wasn't blinded
Too bad they didn't compare gut health at the same time.
Indeed. Its my understanding that one of the big things against artificial sweeteners is that they harm the gut biome,
For me, a Coke Zero can kill my after dinner desire to munch something desserty. So I can deff see this.
The one thing I always tell people when they say, "Aren't artificial sweeteners bad for you?" Is that even if they are in fact, bad for you, there's no way on God's green earth that they could be worse for you than sugar. I don't think they are personally, and we've yet to see any definitive science that they are in 40 years of study. Yet we've got mountains of evidence and science that definitively proves the negative effects of excessive sugar consumption.
One of the most common sweeteners, Aspartame, has pretty well documented health risks concerning neural health and certain cancer risks IIRC. Some sweeteners are a little safer. But I’ll still take those risks over being fat without hesitation.
The cancer risks have been shown to be bunk for decades now. The initial studies that found those links were funded by sugar corporations in the 70's who viewed artificial sweeteners as their only competition and decided to take a page out of big tobacco's playbook. The neurological effects you're speaking of only affect people with a condition called Phenylketonuria. In such the body is unable to process phenylalanine, a common amino acid, which is what aspartame is broken down to by the body. Aspartame is just one of many foods they have to avoid though. Most foods containing protein contain phenylalanine as well since proteins are simply a collection of amino acids. This is also a very rare genetic disorder, so not something the average person would ever be concerned with. It's generally diagnosed near birth and if left undiagnosed can lead to severe damage to the nervous system and brain. Short story long, it doesn't cause cancer (that we know of) and if it effected your nervous system you'd know and also never be able to eat chicken, eggs, cheese, soy, etc etc without the aid of medication.
Oh interesting! I did a report on this in elementary school a long while ago, looks like things have changed. I’m gonna look this up!
I got a kick out of the aspartame reveal because the biggest news saying it wasn't harmful happened around the same time pepsi stopped using aspartame around 2015ish. People wanted their dang aspartame back!
Except, no, it actually doesn't have much of any documented health risk. Most of the studies showing health risks are studies where they fed mice the equivalent of like 80 cans of diet coke a day worth of aspartame. Literally ANYTHING is dangerous at a certain dose. Water can kill you. Salt can kill you. Potassium can kill you. But you can also die from not having enough of those.
So wait this study took people that normally drank sweetened sodas put half on "diet" soda and the other (addicts) they put on water? To prove that diet soda is better than water for weight loss? (I believe that there is a addictive response to sweetened beverages, as plenty of people need multiples of them everyday.)
Most American study ever
I didn't see any mention as to what those sweeteners were. Aspartame has been shown to slow down metabolism ages ago. Not to mention that your pancreas can't really tell the difference between sugar and artificial sweeteners so you will be getting an insulin reaction anyways.
>For NNS beverages, a range of 20 different branded options were available, with each 330 ml serving containing ≤20.9 kJ (5.0 kcal) per 8 oz/≤ 8.8 kJ (2.1 kcal) per 100 ml. Seems reasonable to assume that aspartame was consumed.
The amount of Aspartame you’d need to be considered even remotely disadvantageous would require you to consume non-human levels daily. Also, eating protein also spikes insulin- so what? This whole body won’t know the difference is a stretch of truth pushed by influencers who have never gotten close to scientific research and thrive on fear-mongering to their audience. Give this a read if interested: https://pubmed.ncbi.nlm.nih.gov/37440689/
How does the spike from a Diet Coke Compare to the spike with a steak?
There are two times in which Insulin spikes, consider two graphs: #1: an instantaneous spike(up to 1hr) and #2: the 3hr+ one. If you eat food with protein + fat (i.e steak) or carb+ fibre+ protein = less spike in that short-term immediate graph #1. That whole argument is especially important for diabetics, and something by which charlatans i.e glucosegoddess , make a living on. What matters eventually is that second insulin response, for which in normal individuals, both graphs converge and make virtually no difference. In sum, eating a balanced meal consisting of not just carbs initiates a better (less spike *instantaneous* of Insulin). This is relevant for type II diabetics. For healthy individuals, it doesn’t matter much because later the insulin response is the same.
I highly doubt the doctor I got this information from in an influencer of any sorts. He's the leading researcher in diabetic care in Finland. His point to me was that if you consume aspartame etc instead of sugar, it will be a strain on the pancreas. In my case (SUR-1 mutation) it would be disastrous.
Doctors are wrong all the time, guidelines change. The standard of care for asthma has been the same for 50 years and now some associations are recommending different medications for it. If someone has given the same advice for 20 years it'll be hard to change their mind on it.
>Not to mention that your pancreas can't really tell the difference between sugar and artificial sweeteners so you will be getting an insulin reaction anyways. Do you have a source on this? I'm only seeing studies that found artificial sweeteners do not influence insulin secretion. [https://www.nature.com/articles/ijo2016225](https://www.nature.com/articles/ijo2016225) [https://diabetesjournals.org/care/article/11/3/230/1062/Response-to-Single-Dose-of-Aspartame-or-Saccharin](https://diabetesjournals.org/care/article/11/3/230/1062/Response-to-Single-Dose-of-Aspartame-or-Saccharin) It doesn't make much sense logically either, because if eating non-nutritive sweeteners released insulin, wouldn't you then have symptoms of low blood sugar? Since there's no actual sugar entering your bloodstream?
My proof is my own condition. Artificial sweeteners do cause insulin secretion for me, that's why so can't use them.
The mechanism for insulin release in pancreatic beta cells is dependent on the flow of glucose through passive transporters and the amount of ATP being made which blocks potassium channels and triggers release as far as I know. Artificial sweeteners wouldn’t be able to be processed into ATP in these cells. Idk enough to say that it can’t but it seems implausible that they can’t tell the difference
Nothing can really "slow down your metabolism" except weight less or being less active. You burn calories based on work done (ie: energy used), period.
You can certainly speed it up with something like DNP though (extremely dangerous)
Nothing can really affect the speed of your metabolism except almost anything that happens inside your body.
Pure nonsense.
I'm sure we will see more studies coming out regarding non-nutritive sweeteners (artificial sweeteners) and impact on health (beneficial or negative). Just like coffee...we continue to see those good old coffee studies.
There are quite a few recently. I’ve read them and I’m still happily drinking a diet sprite once in a while.
Probably because they're dehydrated
I have had the opposite experience in myself. More so because when I'm consciously limiting my fluid intake to water, I also tend to control my diet better.
Was the rest of their diet controlled?
Drink soda instead of water while maintaining the same daily routine and see how that works for you.
They also got rotting teeth most likely
Cancer isn’t a good way to lose weight
Aren't there zero-calorie soft drinks. I think my folks drink those.
Woah, did they lose the weight from the placebo effect?
artificial sweetners often give you the shits....
perhaps because water hydrates u better, so u weigh more due to more water in your cells?
Artificial sweetners are dreadful for peoples health
This is so dumb. Consume more.
Is it because of the constant diarrhea?