Cycling Wed Healthy Living

CW: The AHA and ADA drop the ball on Artificial Sweeteners

To be fair, most of the health messages coming from the American Heart Association and American Diabetes Association are spot on.

Yet, nobody is perfect.

The statement came from a “writing committee” of the AHA and ADA—two of the world’s leading health organizations. The writers hailed from places like Harvard, Stanford, Purdue and Northwestern. These are societies of experts charged with caring for two diseases—diabetes and heart disease–that mostly stem from humans making chronically bad choices about how they live in this world. It’s really that simple. Type II diabetes and typical heart disease (from hardening of the arteries) occur because people eat too much, move too little and do not get enough sleep.

I know that’s not news. Here’s what is—and what’s got me riled up.

The AHA and ADA released a statement giving a cautious endorsement of artificial sweeteners. (You can read more of the details on and Cardiobrief.)

After thousands of words and an exhaustive review of the less-than-clear science on artificial sweeteners, here’s what the position statement concluded:

The evidence reviewed suggests that when used judiciously, NNS (artificial sweeteners) could facilitate reductions in added sugars intake, thereby resulting in decreased total energy and weight loss/weight control, and promoting beneficial effects on related metabolic parameters. However, these potential benefits will not be fully realized if there is a compensatory increase in energy intake from other sources.

The press release begins…

Substituting non-nutritive sweeteners for added sugars in beverages and other foods has the potential to help people reach and maintain a healthy body weight and help people with diabetes with glucose control….

I understand their position. I respectfully disagree with it.

The premise holds that excessive sugar intake is bad for us. There is no debate here. I’d even add emphasis to the sugar-is-toxic idea. I truly believe that the number one nutritional problem in Western society is the excessive intake of insulin-spiking simple carbohydrates. One could write thousands of words describing the bad things that happen to the body when exposed to excess sugar. I’ll spare you that. Let’s get back to the AHA/ADA endorsement.

Since ingesting too much sugar is a problem, it stands to reason that zero-calorie artificial sweeteners would be beneficial. You get sweetness and pleasure, but avoid any adverse consequences. It’s like a free lunch. Not surprisingly, people have vigorously embraced these “diet” or “zero-calorie” products.

After reading the extensively researched position paper, it’s clear that the science on artificial sweeteners is weak. Convincing studies, or even strong trends, that either demonstrate clear benefit or overt harm of artificial sweeteners do not exist. Like so many nutritional studies in humans, confounding factors muddy the conclusions. In other words, it’s impossible to sort out the specific effects of artificial sweeteners.

But you already know the real problem with artificial sweeteners, don’t you?

A free lunch?

Free lunches fall in the same category as:

If it’s too good to be true…

Of course the smart use of artificial sweeteners might help selected people control calorie intake. But that’s not the spin of the press release or the headlines. The take-home message to the American patient will be that artificial sweeteners are good.

That’s not the message I want to hear from leading medical societies.

We are losing the battle of excess. Our health leaders shouldn’t settle; they should stay on message, even if it’s not well received or painfully basic. Even a cautious, call it small, endorsement from a leading health society will have a big effect on public perception.

In account, Harvard public health expert, Dr Walter Willett likened artificial sweeteners to the nicotine patch, basically saying that they aren’t that great, but they are better than the alternative–sugar. That’s awful. I’ve never once in my career written a prescription for a nicotine patch. I try to avoid substituting lousy treatments when simple avoidance is what’s needed. I don’t recommend substituting diet drinks for sugary drinks; I recommend not drinking sugary drinks.

Leaving out the cynical thoughts that such endorsements might be affected by financial relationships, ie…big red hearts on Diet Coke cans, let’s just say:

Doctors need to keep touting the basics. We must not be side tracked by the mirage of diet pills, calorie-free food or polypills. Of all people, we should know the dangers of free-lunch thinking.

Good sleep, better food and keep moving. I recommend this every day. So should our leading health societies.


One reply on “CW: The AHA and ADA drop the ball on Artificial Sweeteners”

Well John, I look at it this way.

Most soft drinks, and especially diet, are nothing but chemicals in a can. Who knows what that stuff does to you long term.

Aspartame comes with a warning on the label that it is really bad for “some people”. That tells me right there it’s no good for anyone. The times I used to ingest it, I would get head-achy and feel a bit off, and the aftertaste was terrible. No more . . . .

I’m on the fence about Splenda, but take a more balanced approach to the natural based things like Stevia. I wonder how they stack up in the order of things?

Disclaimer: I DO occasionally enjoy a good, and I mean good, ginger ale with real sugar and few artificial ingredients. They can be found. I drink a real Coke about once a month or so.

I do like some of the Splenda sweetened ice creams, but amazingly, I’ve found they contain almost as many calories as their regularly sweetened cousins. Where are the calories coming from, even with the reduced fat content? There is one brand that tastes good and is very low in calories – 70 per serving – and uses Splenda. I get the yogurt cups that don’t use aspartame, but they are hard to find.

Cutting out the ice cream is next on my agenda. I’m not quite there yet.

I agree with you. My opinion on artificial sweeteners has now shifted to the same one I have about some medications. The “better living through chemistry” approach is a panacea at best.

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