Dispelling nutrition myths, ranting, and occasionally, raving

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Non-nutritive sweeteners and blood sugar


I’m starting to think that the sharing of research results is like the telephone game. Researchers publish their articles in journals, slightly (or more so) misleading press releases are issued, news articles are published, these are then shared via social media. Frequently, by the time the information has filtered through these channels, you’re left with a much different message than the original study provided.

I recently read this article that stated “artificial sweeteners affect metabolism and insulin levels”. Now, if you go back to the original journal article, you’ll see that this is quite misleading. The authors found that sucralose (not all non-nutritive or “artificial” sweeteners) had an impact on blood sugar levels and blood insulin levels following a glucose challenge.

Seventeen participants who were not regular consumers of non-nutritive beverages, did not have diabetes, and were classified as obese were given a glucose tolerance test following the consumption of water on one occasion and sucralose sweetened water on another. Increased levels of blood sugar and insulin were observed following the glucose challenge given after the sucralose consumption. However, the blood glucose levels were not all that different (4.2 + 0.2 and 4.8 + 0.3 mmol/L). The insulin levels were about 20% higher following the ingestion of sucralose. 

Other things that I would like to note about this study: there were only 17 participants. This is quite a small sample size (although slightly better than the ones Dr Oz was basing his recommendation to consume vinegar to prevent diabetes) which means that we can’t be certain that the results seen were all that meaningful. There is power in numbers and to be sure that a treatment is truly having the effect you’re observing you need lots of participants. In addition, these participants were not regular consumers of sucralose. Perhaps a different result would have been obtained had they tested individuals who regularly consume sucralose sweetened products. Finally, the study only included obese individuals (the average BMI was 42.3). Would the results be the same for healthy or overweight individuals? What would the results be had tests been done on participants who had type 2 diabetes?

Yes, it’s interesting that sucralose may have an effect on blood sugar but this study is not definitive and it’s definitely not reasonable to extrapolate the results to include all non-nutritive sweeteners.

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Do artificial sweeteners cause type 2 diabetes?

An article published in the latest issue of the American Society for Nutrition stated that women who consumed more than 359 ml of artificially sweetened beverages (e.g. diet pop) were at an increased risk of developing type 2 diabetes. This was in comparison to women who consumed no soda (sugar or artificially sweetened). Women who consumed traditional sugar sweetened beverages were also at increased risk of developing type 2 diabetes (no news here).

The researchers did point out that this was a correlational relationship. This means that with no certainty can we say that consumption of artificially sweetened beverages causes diabetes. However, they also said that: “randomized trials are required to prove a causal link between ASB consumption and T2D”. This, to me, suggests that they believe that artificially sweetened beverages can cause type 2 diabetes.

Personally, I would be quite surprised if it was the artificially sweetened pop causing type 2 diabetes, rather than a combination of genetic and lifestyle factors. I also think that this sort of research (and probably most of us) is looking at the problem from the wrong direction. Rather than looking for a single cause of “lifestyle” illnesses such as type 2 diabetes, we should be looking for the “causes” of health.

Consider this: One in every three American children will develop type 2 diabetes in their lifetime and similar rates are anticipated for Canadian children (1). Type 2 diabetes is just one of many chronic diseases affecting Canadians. I think that we need to shift our focus from seeking a likely non-existent single cause of such diseases and start looking at what we can do to retain our health for as long as possible. It’s the difference between a preventative model of health care rather than our current model which treats only those who are already ill. There is much truth in the adage that “an ounce of prevention is worth a pound of cure.”

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Is your food killing you?

Sound the alarms! The Food Industry is Waging War on Your Cells With These 10 Toxic Ingredients. Talk about sensationalist headlines. Allegedly these ten common food additives are smothering your cells which leads to “cell mutation and the perfect breeding ground for cancer”. Oh dear, sounds horrific. But how much truth is there in this article? Let’s look at this top ten list of deadly food additives…

1. Sodium Benzoate. This is a type of salt frequently used to preserve packaged foods. In a few mice studies it lead to lower growth rates and weights but there was no evidence of carcinogenicity 1. Is it safe in large amounts? More than likely not. Is it safe in the amounts in which it’s present in foods? Probably. Before deciding if a food preservative is safe Health Canada has to weigh the risks and benefits. Would more people die from consuming foods with microbial contamination than would die from consuming sodium benzoate? Probably. If you’re really concerned about the presence of sodium benzoate in your food then you should be eating fewer pre-packaged foods. Verdict: not ideal but not a carcinogen. Recommendation: prepare more meals at home using fresh ingredients.

2. Canola oil. This is not identical to rapeseed oil (although it comes from the same plant) and does not have the same health risks as rapeseed oil. In fact, canola oil actually has a pretty decent mono- and polyunsaturated fatty acid profile 2. If genetic modification is a concern for you (I know that it is to me) organic varieties are available at most grocery stores. Verdict: not a carcinogen and not necessarily bad for you – of course it’s a fat so it’s high in calories. Recommendation: choose healthy oils and fats based on your cooking needs.

3. Monosodium Glutamate. Can I just skip this one? Evidence is inconsistent. Some people have reported adverse, allergy-like, reactions to consuming MSG but studies continue to show that it is safe for consumption 3. The purpose of MSG is to enhance the flavour of food. To me, that seems completely unnecessary. Verdict: Not necessary to avoid MSG if you are not sensitive to it. Recommendation: As it is an unnecessary ingredient do what you will with this information.

4. Sodium Nitrates. Okay, this one really is bad for you. I’ve written about it before… Verdict: Carcinogen. Recommendation: Avoid consumption whenever possible.

5. Margarine. Most margarines these days no longer contain trans-fat. This means that they’re not nearly as bad as they used to be. Personally, I prefer butter over margarine any day. Try to buy butter from grass-fed cows for the healthiest choice. Verdict: If you’re consuming a hard margarine with trans-fat then it’s a deadly choice (although not carcinogenic, just more likely to increase your risk of heart disease 4). If you’re consuming a soft-tub margarine without trans-fat then it’s not so bad. Recommendation: Go with your preference (non-hydrogenated margarine or butter) but remember that a little goes a long way.

6. Anti-foaming Agents (e.g. Dimethylpolysiloxalane). To be honest, I didn’t know anything about this one until I started reading this article. It’s a type of silicone which, according to the World Health Organization, is safe for consumption 5. What’s it used for? To prevent foaming when cooking foods like chicken nuggets in oil. I can’t find anything that says it’s bad for you but it really doesn’t sound all that fabulous. Verdict: Allegedly safe for consumption. Recommendation: Don’t eat chicken nuggets anyway! If you want chicken nuggets try making your own, baked in the oven without added dimethylpolysiloxalane.

7. Anti-caking Agents. These are used to help prevent powdered substances from clumping together. This is another one that I don’t know all that much about. According to the FDA, sodium aluminosilicate (one of these anti-caking agents) was approved as there was no reason to believe it would be any less safe than similar compounds which had been tested in mice 6. Looking into all this stuff is making me realise all the weird things that actually go into our food and how sketchy the approval system for these additives actually is. Verdict: I can’t find anything to say it’s a carcinogen but… Recommendation: Be cognizant of what’s in your food. Ask questions. Be a skeptic. Make most of your meals at home using fresh ingredients.

8. Artificial Colourings. Another contentious one. They may be safe, they may not be 7. They are being reviewed for their effect on behaviour problems in children. Verdict: The jury’s still out. Recommendation: Limit your consumption, especially limit consumption by your children.

9. Emulsifiers. These are used to stabilize foods, particularly fluids so fat will remain in suspension in say milk rather than separating out. Some of these may be okay, some of them may not. I’m not sure that any of them are actually carcinogenic though and to be perfectly honest, this post has taken up far more time than I had anticipated and I can’t be bothered to look all of them up. I did find an interesting article on carrageenan that presents both sides of the story. Verdict: Probably not carcinogenic but not necessarily great for you either. Recommendation: Look into additives you’re seeing on your labels. If you’re not confident in their safety try to choose another product that does not contain them.

10.  Artificial Sweeteners. Oh good, I’ve written about this one before too. Verdict: So far so good but I’m not 100% confident in their safety. Recommendation: You need to decide what’s most important to you: calorie reduction or flavour or confidence in safety. If calorie reduction is your goal try to forego sweeteners altogether.


Are artificial sweeteners even better than the real thing?

Myth 31: Artificial sweeteners have too many chemicals to be healthy.
What Dietitians of Canada says:
“Artificial sweeteners can be part of healthy eating. Health Canada approves all sweeteners for safety before they can be sold in Canada. health Canada also develops strict guidelines for how food producers can use a sweetener, as well as advice on how much is safe to eat each day. Artificial sweeteners add a sweet taste while limiting calories and can be enjoyed in moderation, as part of a healthy diet.”
What I say:
Oh boy, this is a contentious one. I wasn’t sure if I wanted to address it or not. Putting aside the obvious fact that everything is composed of chemical compounds, yep, you and all the food you eat… I know that, to-date, studies have shown that these artificial sweeteners are safe to consume. However, I’m still inclined to suggest having a little bit of a natural sweetener rather than a manufactured sweetener. We are the guinea pigs in the long-term study of the effects of non-nutritive artificial sweeteners. I also think that use of these artificial sweeteners may lead to over consumption. Just like when we took fat out of snack foods and then found out that people ended up actually eating more calories from sugar. But I’m just one of those people who thinks “better the devil you know than the devil you don’t know”. I used to eat foods sweetened with these non-nutritive sweeteners but I found that I became sensitized to the taste. Now, I find that I can’t enjoy yoghurt and cereals that contain them. Instead, I have plain yoghurt mixed with thawed frozen berries (fresh local berries in the summer) and cereal with no added sugar. That’s my personal preference. If you enjoy artificially sweetened foods I can’t give you a legitimate scientific reason not to continue to do so. However, I personally feel that you are better to have a small amount of real caloric sweetener (e.g. maple syrup, honey, or sugar) to satisfy your sweet tooth and try to choose more foods that don’t contain any form of sweetener.