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Author: NailThatJello Big gold star, 5000 posts Ticker Guide Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 30785  
Subject: Diet soda causes diabetes? Date: 2/8/2013 9:11 PM
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I'm so used to misinformation about all things diet-related in the media, that I prefer to check with you guys first. You've debunked many a myth here in the past.

This study sounds like it comes from credible origins just judging from the important sounding journal title and author's home institutions. But who knows if he was funded by the sugar industry in its desperate attempt to continue to poison people, or what.

http://shine.yahoo.com/healthy-living/study-diet-soda-increa...
Drinking just one 12-ounce can of an artificially sweetened fizzy drink per week can increase your risk of Type 2 diabetes by 33 percent, French researchers found. The study will be published in the American Journal of Clinical Nutrition. It was conducted by France's National Institute of Health and Medical Research and covered 66,118 middle-aged women whose dietary habits and health were tracked from 1993 to 2007.

The results were unexpected. Though it's well-known that people who consume a lot of sugar are more likely to develop diabetes, the researchers found that participants who drank "light" or "diet" soft drinks had a higher risk of developing Type 2 diabetes than those who drank regular, sugar-filled sodas. Those who drank 100 percent natural squeezed fruit juices instead had no additional risk.

Women who choose artificially flavored soft drinks usually drink twice as many of them as women who choose regular soda or juice—2.8 glasses per week compared to 1.6 glasses. "Yet when an equal quantity is consumed, the risk of contracting diabetes is higher for 'light' or 'diet' drinks than for 'non-light' or 'non-diet' drinks," the researchers, epidemiologists Francoise Clavel-Chapelon and Guy Fagherazzi, said in a statement.

So how can artificially sweetened drinks be making the problem worse if they're fat- and calorie-free?

"The relationship with diabetes can be explained partially by a greater craving for sugar in general by female consumers of this type of soft drink," the researchers explained. "Furthermore, aspartame, one of the main artificial sweeteners used today, causes an increase in glycaemia and consequently a rise in the insulin level in comparison to that produced by sucrose."

Translation: Drinking artificially sweetened drinks makes you crave other sweet things (hello, chocolate!). And your body reacts to aspartame—also known as NutraSweet and Equal—much in the same way that it reacts to plain old sugar.


Sounds to me that if the diet soda drinkers also consumed more sugar, as implied above, the study confounds two important variables.

But the statement that aspartame causes insulin to spike more than sugar, if true sounds concerning. I've heard various mentions of this before but few solid scientific statements about it. Let alone for the other sweeteners.
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Author: JenBales Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 29971 of 30785
Subject: Re: Diet soda causes diabetes? Date: 2/9/2013 6:47 PM
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It sounds like an epidemiology study - following a population of people over time with occasional questionnaires or the like. Epidemiology studies are useful for spotting large effects (like smoking and lung cancer) but tend to be misleading for smaller effects. It is too hard to tease out what is cause and what is effect, even if the correlation is real and not noise.

Epidemiology studies told us that hormone replacement therapy was protective against heart disease. As soon as a double blind test was done, the reverse turned out to be the case. This is not at all unusual. THat os why things are good for you one week, bad the next, and back to good again. We are mistaking noise for signal.

Particularly be cautious when there isn't any logical mechanism for the proposed correlation. Why would diet soda cause diabetes? It seems really unlikely,

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Author: JenBales Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 29972 of 30785
Subject: Re: Diet soda causes diabetes? Date: 2/9/2013 6:52 PM
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And I am almost sure that this:

""Furthermore, aspartame, one of the main artificial sweeteners used today, causes an increase in glycaemia and consequently a rise in the insulin level in comparison to that produced by sucrose.""

is flat out wrong.

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Author: WarriorNurse Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 29973 of 30785
Subject: Re: Diet soda causes diabetes? Date: 2/10/2013 10:07 AM
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It sounds like an epidemiology study - following a population of people over time with occasional questionnaires or the like. Epidemiology studies are useful for spotting large effects (like smoking and lung cancer) but tend to be misleading for smaller effects. It is too hard to tease out what is cause and what is effect, even if the correlation is real and not noise.

Epidemiology studies told us that hormone replacement therapy was protective against heart disease. As soon as a double blind test was done, the reverse turned out to be the case. This is not at all unusual. THat os why things are good for you one week, bad the next, and back to good again. We are mistaking noise for signal.



Very well said.

I would add: specifically OBSERVATIONAL studies (whether the sample is a large population as used in epidemiological studies, or a smaller group). These are NOT clinical studies or experimental studies. Observational studies are based on self-report and human memory (I can't even remember what I had for lunch Wednesday, let alone how many diet sodas I drank, or how often, over the past 20 years). This is why we should NEVER make medical decisions and lifestyle changes based on Observational studies. It is a shame that the media thinks they need to report every observational study. Observational studies should always be further developed into higher level studies, such as a clinical trial, experimental study, or comparative study of some kind. The information from observational studies is best used by researchers, not media, general public or medical personnel.

And then, the higher level study should be repeated several times......


Jen
(and.......any study, even clinical trials and experimental studies, can be manipulated to show anything the researcher wants it to show...)

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Author: NailThatJello Big gold star, 5000 posts Ticker Guide Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 29974 of 30785
Subject: Re: Diet soda causes diabetes? Date: 2/10/2013 12:21 PM
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And I am almost sure that this:

""Furthermore, aspartame, one of the main artificial sweeteners used today, causes an increase in glycaemia and consequently a rise in the insulin level in comparison to that produced by sucrose.""

is flat out wrong.


It seems easy enough to test: take blood sample, drink aspartame in water, take blood sample again... Then test the two blood samples for insulin level.

Has this really never been done, for all the different sweeteners? By now this should be a case-closed nonissue instead of a decades-running urban myth.

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Author: oceanbluela Big red star, 1000 posts Old School Fool Ticker Guide SC1 Red Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 29975 of 30785
Subject: Re: Diet soda causes diabetes? Date: 2/10/2013 12:48 PM
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The Mayo Clinic concludes:

Artificial sweeteners don't affect your blood sugar level. In fact, most artificial sweeteners are considered "free foods" because they don't count as a carbohydrate, a fat or any other diabetes exchange. Remember, however, other ingredients in foods containing artificial sweeteners can still affect your blood sugar level.

Also, be cautious with sugar alcohols — including mannitol, sorbitol and xylitol. Sugar alcohols can increase your blood sugar level. And for some people, sugar alcohols cause diarrhea.


Since further refining my many years of low carb living by going Paleo (for general health and metabolism reasons), I now plan my food using organic whole foods including vegetables & fruits, grass fed or organic proteins, no grains or sugar, and healthy fats like olive and coconut oils. That means though, that I have also cut out all artificial sweeteners. I will have an occasional bar of dark chocolate, but sweet stuff is now a rare treat. Except for fruit, and only then, one serving a day. I miss my diet cocoa in the winter, but not the long list of chemicals in the ingredient list. I have never felt better in my life. Lots of energy! Low carb is the most healthy diet going. And for me, going Paleo was the added focus I needed. I take a day a month to eat off plan if I want. But I am pretty content keeping to my plan.

As for the glucose spikes caused by artificial sweeteners, I think we can all accept the Mayo Clinic's verdict... no spike.

Best,

Vivienne

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Author: WarriorNurse Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 29976 of 30785
Subject: Re: Diet soda causes diabetes? Date: 2/10/2013 1:20 PM
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I feel really good when I am truly low-carbing (50 grams or less per day on most days). I have been reading a lot about the Paleo diet and understand it philosophically. I would love to truly be Paleo----but I am having trouble implementing it!!! My husband does most of the cooking (well over 90%), and although he also believes in the Paleo philosophy, we aren't there (yet). I was very good at Low Carb when I was single....not so good now.



Jen

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Author: NailThatJello Big gold star, 5000 posts Ticker Guide Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 29977 of 30785
Subject: Re: Diet soda causes diabetes? Date: 2/10/2013 2:17 PM
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I think we can all accept the Mayo Clinic's verdict... no spike.

Good. Do you have a link for that?

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Author: oceanbluela Big red star, 1000 posts Old School Fool Ticker Guide SC1 Red Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 29978 of 30785
Subject: Re: Diet soda causes diabetes? Date: 2/10/2013 8:26 PM
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I hear you, Jen. Going Paleo is a process. to be sure. At least it was for me. I jumped in and out for a year but for almost two years now, I have been pretty strict about compliance. Except when I was in Italy and Paris. :-) The good news is there's no emergency to try it if you decide that's what you want to do. It's hard when your partner is the cook and not Paleo. I am the main cook in my house, so I make sure I eat clean. But I always cook non-Paleo things for my partner. To each, his own. Like you, I also eat very low carb. It makes the most sense to me, and I like feeling good.

Vivienne

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Author: oceanbluela Big red star, 1000 posts Old School Fool Ticker Guide SC1 Red Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 29979 of 30785
Subject: Re: Diet soda causes diabetes? Date: 2/10/2013 8:29 PM
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Good. Do you have a link for that? NailThatJello

Sure thing. Third paragraph: http://www.mayoclinic.com/health/artificial-sweeteners/AN003...

Vivienne

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Author: NailThatJello Big gold star, 5000 posts Ticker Guide Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 29980 of 30785
Subject: Re: Diet soda causes diabetes? Date: 2/11/2013 8:59 PM
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Artificial sweeteners don't affect your blood sugar level.

- Mayo Clinic

What about insulin though? Maybe it goes up even if blood sugar doesn't - since you haven't consumed sugar?

Insulin has additional negative effects on the body besides fat storage.

Here are a few bits from googling around. As usual, they are confusing/contradictory:

In theory, fake sugar would seem like a great way to beat the system. After all, artificial sweeteners don't raise blood sugar, so they do help those with diabetes. But Mother Nature isn't fooled. "The problem with non-nutritive, noncaloric sweeteners is that the body senses them through the same mechanisms used to sense sugar," said Tim Osborne, professor of diabetes and obesity research at Sanford-Burnham Medical Research Institute in Lake Nona. When these sweet receptors get tripped, studies suggest, they turn on a mechanism that causes the body to absorb more dietary sugar and potentially convert more of that energy to fat, Osborne said.
http://articles.orlandosentinel.com/2012-08-29/health/os-art...

Artificial sweeteners are not all created equally. An article published in the journal "Hormone and Metabolic Research" in 1987 reported that the artificial sweetener acesulfame-K increases the release of insulin. One of the earliest artificial sweeteners, aspartame, was shown early on to have a positive affect on insulin secretion, according to an article published in 1986 in the "Diabetes Research and Clinical Practice" journal. Sucralose moves undigested through your digestive system without affecting insulin or blood sugar, according to a student paper on Vanderbilt University's Health Psychology site. Stevia does not cause a spike in insulin and may also improve glucose tolerance, a 1986 article in "Brazilian Journal of Medical and Biological Research" reported. Stevia might also improve insulin resistance, according to an animal study published in "Planta Medica" in February 2005.
http://www.livestrong.com/article/522973-does-artificial-swe...

Injection of Acesulfame K (150 mg/kg body weight) increased the plasma insulin concentration at 5 min from 27.3 +/- 3.0 microU/ml to 58.6 +/- 4.2 microU/ml without any significant change in the blood glucose. Infusion of Acesulfame K (20 mg/kg body weight/min) for one hour maintained the insulin concentration at a high level (about 85-100 microU/ml) during this period, and at the same time blood glucose was gradually reduced from 103.0 +/- 7.3 to 72.0 +/- 7.2 mg/dl. When using different amounts of Acesulfame K, the insulin secretion was stimulated in a dose-dependent fashion. The effect of Acesulfame K on insulin secretion was similar to that observed by injecting or infusing the same doses of glucose (150 mg/kg) body weight for injection and 20 mg/kg body weight/min for infusion), except that no hyperglycemia was observed with Acesulfame K.
http://www.ncbi.nlm.nih.gov/pubmed/2887500

Animal studies have indicated that a sweet taste induces an insulin response in rats. However, the extension of animal model findings to humans is unclear, as human studies of intragastric infusion of sucralose have shown no insulin response from analogous taste receptors. The release of insulin causes blood sugar to be stored in tissues (including fat). In the case of a response to artificial sweeteners, because blood sugar does not increase there can be increased hypoglycemia or hyperinsulinemia and increased food intake the next time there is a meal. Rats given sweeteners have steadily increased calorie intake, increased body weight, and increased adiposity (fatness). Furthermore, the natural responses to eating sugary foods (eating less at the next meal and using some of the extra calories to warm the body after the sugary meal) are gradually lost. A 2005 study by the University of Texas Health Science Center at San Antonio showed that increased weight gain and obesity were associated with increased use of diet soda in a population-based study.
http://en.wikipedia.org/wiki/Sugar_substitute#Weight_gain_an...

The notion that artificial sweeteners (and sweet tastes in general) might produce an insulin response is one of those murky memes that winds itself around the blogs, but it’s never stated one way or the other with any sort of confidence. Do artificial sweeteners induce insulin secretion (perhaps via cephalic phase insulin release, which is sort of the body’s preemptive strike against foods that will require insulin to deal with)?

One of the reasons a definitive answer is rarely given is that artificial sweeteners are not a monolithic entity. There are multiple types of sweeteners, all of them chemically distinct from each other. Here I break them out:

Overall, the evidence seems to suggest little, if any, effect on insulin secretion as a result of tasting or consuming aspartame.

We haven’t seen people orally taking acesulfame K in a fasted state and having an insulin response. Yet.

The evidence for saccharin’s effect on insulin is mixed, but either way, it doesn’t appear to have too big of an impact in real world terms.

There’s not much if any evidence that sucralose has an independent in vivo effect on insulin.

So far as I can tell, according to the literature there isn’t an appreciable insulin effect from most sweeteners.

http://www.marksdailyapple.com/artificial-sweeteners-insulin...

I like this last guy's the most, because he cited research.

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