Artificial Sweeteners: Are the Scary Claims Real?

I'm an avid user of StumbleUpon - I'm kind of a random fact sort-of-guy.  So, being able to hit a button and learn about random stuff is pretty cool.  Although "Health" is one of my interests on there, I rarely spend much time reading the pages that come up.  Why?  They're either not very informative, a picture of someone exercising, or a blog/website that is based on false information.  Sometimes a good one will pop up here or there... but it's not very common.  There's been a certain topic that always catches my eye, however, and that's the use of artificial sweeteners.  Many media outposts have claimed them as chemicals that can cause us to be fat, carcinogenic, toxic, and are just flat out bad for us.  Some websites even say they would prefer to eat foods that are laced with sugar than to eat any amount of artificial sweetener.  Is this really true?                            Let's take a look:



Artificial sweeteners fall into a category of "non nutritive sweeteners" - meaning, they don't provide any nutrition in the form of calories, vitamins, minerals, etc.  The only thing that they provide is sweetness.  The Food and Drug Administration has come up with an Acceptable Daily Intake (ADI) for each of the sweeteners, whose levels are set at 100 fold less than any known toxic levels.  In effect, consuming these sweeteners at the ADI you are no where near the known toxic levels and are safe from any potential harm.
Acesulfame-K - 15mg/kg
Aspartame - 50mg/kg
Saccharin - 5 mg/kg
Sucralose - 5 mg/kg

You may have noticed that these are units of measurement based on kg of your body mass.  Here's a simple calculator that will tell you how many cans of pop or packets of sweetener you can have in a day at the ADI.  That page doesn't really show you the whole picture since artificial sweeteners are being more commonly used beyond these two types of foods, but it puts it in perspective.  The UK's Food Standards Agency goes further about the discussion of ADI and states that it is not expected that everyone knows them and religiously calculates them and stays under their limit.  That's why they are set at 100 times less than the unsafe limit.

chemistryexplained.com

Non nutritive sweeteners are not all new:  a handful have been around for nearly four decades.  There are some new players to the field because companies are looking for sweeteners that provide better sweetening power that have fewer "off" tastes (like bitterness).  Essentially, the more palatable they can make a sweetener, the better the food tastes and the more product they will sell.

Now the baseline is set, let's get into the meat of the discussion:

In looking for sound research or good website articles, it should go without saying that there are some things that need to be considered:

1. Who is the publisher?  Do they have any conflicts of interest?
2. Is the article looking at the research as a whole, or picking and choosing research that supports a viewpoint? (You can truly find research to support any theory you want)
3. How old is the research?  Is it current? (I consider current anything that has been published within the last 10 years)
4. What could be other causes to the outcomes of the research?  Do they use good research methodology?

To me, this should be common sense, but it seems many bypass this understanding.  A couple of great, well-rounded, thoroughly researched meta-analysis, recently published articles by top-notch organizations (citations between the two are above 270):

Nonnutritive sweetener consumption in humans: effects on appetite and food intake and their putative mechanisms.  American Journal of Clinical Nutrition - Published 2008

Nonnutritive Sweeteners: Current Use and Health Perspective.  American Heart Association and American Diabetic Association - Published June 2012.

Should You Sour on Aspartame? Professional Report by Tufts University - Published 2007.

Here's the lowdown on what they say about sweeteners.  "At this time, there are insufficient data to determine conclusively whether the use of NNS to displace caloric sweeteners in beverages and foods reduces added sugars or carbohydrate intakes, or  benefits appetite, energy balance, body weight, or cardiometabolic risk factors." (AHA and ADA article)

"There is no clear evidence that NNS augment appetite by activating cephalic phase responses, altering osmotic balance, or enhancing food palatability. Indeed, there is emerging evidence that selected NNS may stimulate the release of satiety hormones, although the link between these hormones and energy intake in free-living individuals is also open to debate. With respect to energy intake, there is no substantive evidence that inherent liking for sweetness or NNS activation of reward systems is problematic." (AJCN Article).


The last article written by Tufts speaks specifically about the toxicity of aspartame, a concern when aspartame either breaks down in the body or when it is heated about 86 degrees Faranheit.  "Besides cancer concerns, you might be prompted to avoid aspartame because of the claims rocketing around the Internet that it causes everything from lupus to multiple sclerosis to Gulf War Syndrome. These “dangers” are little more than urban legends, according to the American Council on Science and Health: “The scientific evidence does not support any of these alleged associations.”"

From these articles, the acute effects of sweeteners seems to have been found OK, but long term studies are needed to determine further risks.  Keep in mind, however, that's not really a radical statement.  Also, the correlation between artificial sweetener consumption and weight gain may not be causation:  instead it may be caused by the mindset, "I had a diet pop today instead of sugared, so I can have desert tonight".  People over consume sugar as a reward for substituting in artificial sweeteners.  This claim needs more research, but interesting nonetheless. 


There is certainly much more to these research articles that talk about specific concerns with non nutritive sweeteners, so I encourage you to read them - at least the abstracts and conclusions.


As with anything, keep in mind the source of the information your reading.  There are LOTS of bad articles out there about nutrition and exercise.  Don't fall into the trap of websites like these (it's an "all-natural" website looking to sell their products, founded and funded by Joseph Mercola, a known alternative medicine physician that believes sunscreen, drugs, and vaccinations are bad for you).  Media outlets such as newspapers, TV shows (like the TLC article in the first paragraph), blogs (that's ironic, isn't it?) aren't always trustworthy, either.


Feel free to share any further concerns you may have!


Cheers to looking for for the real facts!

Corporate Wellness Participation is Less than Half: Study

Published in the Internation Journal of Behavioral Nutrition and Physical Activity, research found that participation in corporate wellness programs range from 10% to 64%, median being 33% and typical was below 50%.

Although participation levels were low, the research did find that several key factors were influential in participation rates: incentives, multi-component strategies, and a focus on multiple behaviors.

Take note, my friend.

Milken Institutes, "An Unhealthy America"

While writing some well-being emails for work, I ran across this interesting research done by Milken Institute.  I've never heard of Milken Institute, but some web searches show that it is a reputable, non-profit, non-partisan economic think tank.  The original founder looks a bit shady (Mike Milken, who pleaded guilty to six accounts of securities and tax evasion).  However, the reputation of the Institute seems to have outweighed the founder's woes as it seems to be highly regarded and the accomplishments it has made have been profound.

This research and summary not only looks at the current status of America's health, but looks at trends and projects what the health status will be beyond 2020.  Although not factual and will only be proven with time, it is interesting to see what it will be like if current trends continue.  Just a word of warning:  it's not good.

Here's an interesting tidbit that can whet your palate:
They researched 7 different diseases that accounted for an economic impact of $1.3 trillion annually.  Of this amount $1.1 trillion are due to lost productivity (workplace wellness, people!)

There are some really, really good graphs in there, as well:

This graph also shows the importance and the reason why so many workplace wellness initiatives are trying to find ways to calculate presenteeism.  This metric can make or break a business, and is surely one of greatest things impacted by a wellness movement.

Take a look at it... and let me know if there should be red flags about this institute (ethics, conductivity, etc.).

Just Beginning the Path to a Wellness Movement? Read This First!

There are good resources and then there are superb resources.  This just so happens to be a superb resource.  If you are building a wellness plan from the ground up, read this article by WELCOA's magazine, "Absolute Advantage".  It's an 88 page-long, detailed outline on how, where, and when to do certain tasks for starting a movement.  Stuck on how to do a needs assessment?  This article will tell you why you need to do it and how to design and implement one.  In most cases, the article will also point you further to other sources for additional help.  The article or "guide" is meant to be comprehensive and is based upon the statistics of more than 600 wellness programs.  I haven't gotten to the second part yet (an entirely separate article dedicated to the later stages of wellness implementation), but I am sure it will prove just as useful.  This article is definitely a must read.

Cheers to superb resources that provide top-of-the-line help!

Journal Rankings

Did you know in the category of "Sports Sciences" there are 92 periodic (presumably peer-reviewed) journals?  "Nutrition and Dietetics" rakes in 77.  Are all of them trustworthy?  If you know anything about some certain journals and their representing companies, you would know not to trust every journal, nor every article in all journals.  How can you tell which journals are better than others?  Take a look at these two websites:

Journal-Ranking.com

Eigenfactor.org

These two websites, in conjunction with each other, will provide you with a good amount of data on the trustworthiness of particular journals and their rankings among journals in the same field.  For Journal-Ranking, exercise related journals will be listed under "Sport Science" and nutrition will be under "Nutrition and Dietetics".  Once you find a journal of interest, head over to Eigenfactor to get a second viewpoint and to view the cost effectiveness of that journal.  Eigenfactor has some cool graphs, but it was pretty hard to get to the fields that I was interested in, but they were certainly eye popping and informative!

The War on High Fructose Corn Syrup

The war has gotten to the point where the Corn Refiners Association has made an attempt (and I should say that it has failed) to change the name of high fructose corn syrup to avoid further negative connotations this embattled energy source has endured.   Questions about this sugar and non-caloric sweeteners are the most common questions that people ask me in the area of nutrition.  People are worried that this sugar substance is going to cause poor health, and they have good reasons to believe so.  If you have listened to mass media and/or read diet magazines or websites, you have probably witnessed the articles accusing high fructose corn syrup for part of the obesity epidemic, diabetes, and other health concerns.

High fructose corn syrup is under a lot of scrutiny, scrutiny that I believe any food product should undergo.  I’m not a fan of taking specific ingredients out of your diet, or adding this vegetable because of it’s “cancer fighting” properties, rather, I praise well-rounded diets that include a variety of different foods yet still includes those triple chocolate brownies that you oh-so dearly admire (in moderation, of course!).   But, what exactly is there to fear about high fructose corn syrup?

First, what is high fructose corn syrup?

The plain old table sugar (sucrose) that we are used to contains an even amount of two “simple” sugars: glucose and fructose.  These are naturally occurring sugars – glucose is most commonly consumed from grains (in the form of very long chains), fruits, vegetables and dairy products.  Glucose is rarely consumed in it’s single molecular form, however, it is more commonly consumed in part of a chain such as found in breads and grains, or linked to another sugar molecule such as fructose.  Fructose is commonly found in fruits and vegetables, hence the name.

In the process of taking cornstarch and making it into high fructose corn syrup, manufacturers have the option to create different types of high fructose corn syrup: a 55% blend of fructose and 45% glucose (used in drinks because of physical properties) or a 42% fructose blend with 58% glucose (used in baked goods because, again, of it’s physical properties). 

In the 1960’s and 70’s, the use of high fructose corn syrup was nearly nonexistent.  As the refining process became more efficient, it started to be cheaper for manufacturers to substitute beet or cane sugar with high fructose corn syrup.  Thus, consumption increased, and incidentally, so did obesity and other comorbidities.  The million dollar question, the one that a lot of research efforts are focusing on, is whether this was a coincidence or if, in fact, high fructose corn syrup plays a role in weight gain and the incidence of other diseases and illnesses. 

Pointing towards charts and data that show high fructose corn syrup consumption has increased dramatically really doesn’t show you the whole picture.  This is the argument made by most people, that this increase in consumption can be blamed for many of the health issues of Americans.  However, as HFCS has increased (page 10), sucrose consumption has decreased, and in a very parallel fashion with HFCS.  In effect, Americans are not consuming more or less of fructose, rather, its consumption has stayed fairly constant over the last 3 decades (data was never accumulated before then).

Some people are skeptical of the manufacturing process of HFCS, that this in itself, causes unknown changes within the body that cause weight gain.  Physiologically, this isn’t possible.  No matter where the source of carbohydrate comes from, glucose is processed like glucose, fructose like fructose, lactose like lactose.  The body cannot decipher the source of the molecule.  On the flip side, research has shown that fructose is more readily available for processing (either for immediate energy needs or transforming it to fat) in high fructose corn syrup when compared to sucrose.  This is due to the fact that some fructose is “free” in HFCS, whereas in sucrose it is always bound to another glucose molecule. Keep in mind that the Princeton article was looking for psychological effects of fructose, and so they did not restrict consumption amounts.   This area is in need of more research to find out if the data can stay consistent and what exactly causes the changes within the body.  How’s that chemistry 101 treatin’ ya?

What should you make of all this?  Considering that many scientific articles looking at meta-analyses of HFCS research, at this time there is nothing to fear (Academy of Nutrition and Dietetics, Critical Reviews of Food Science and Nutrition, American Journal of Clinical Nutrition, Mayo Clinic, Center for Disease Control).  Eating a well-balanced diet that includes the limitation of added sugars will already significantly reduce any potential adverse health effects if HFCS was found to have a significant impact on obesity or other illnesses, giving you benefits that far outweigh any harm from HFCS.

When people ask me about HFCS, I tell them to avoid sugary drinks and other foods with added sugars.  If necessary, consume them in moderation.  It isn't a health recommendation solely based upon high fructose corn syrup, but a recommendation based on sugars as a whole.

Cheers to research and continued advancements in the area of nutritional science!

The Smoker's Dilemma

Wake up and grab your first cigarette.  11 minutes.  After breakfast, another cigarette.  11 more minutes.  By the time the day is over, the average smoker will have shorten their life by nearly 4 hours.  
Ready for an onslaught of statistics?

While watching fireworks for the first time with my 11 month-old son, the two ladies in front of us seemed to be oblivious to the above numbers.  In the two hour span that we watched the outhouse races and the fireworks show, the ladies each reduced their life expectancy by 44 minutes.  This, combined the cost of a pack of cigarettes (in Nebraska, it's somewhere in the $5 range, New York is near $11), the additional costs of the increase in disease burden, and the added health risks that are imposed on the surrounding people the numbers are completely staggering.
Smoking, by far, is the #1 preventable cause of death, with 443,000 people dying prematurely due to this habit (this accounts to 18% of all deaths in the U.S.).  The diseases and illnesses caused by smoking costs the U.S. $96 billion in healthcare costs.  Taking this number and dividing it by the national population, it costs you, the individual, $303 per year.  Have a family of five?  No one smokes?  You're still paying roughly $1500 to help pay for the healthcare of those that smoke (these numbers include the cost of stop smoking campaigns).  
In a weird twist of statistics, some estimate that healthcare costs would actually rise.  According to this study, costs would rise 7% for men and 4% for women.  Why?  People would live longer and contract other illnesses that would put a greater weight on healthcare spending.  But, this isn't a story about cost vs. savings, it's a story about the impact that this habit has on your health and the health of those around you.  
If you are a wellness coordinator/coach/educator, this could be your number one fight.  Depending on the demographics, smoking could be costing your company big money.  If this is the case, smoking cessation initiatives are a must - look into what your employer offers, their health insurance company may have a program, or even local groups and classes.  Also, look into being a smoke free campus (or tobacco free) - no smoking in or near the workplace, including the parking lot.  It may be a long process to become smoke free, but it is definitely worth it.
I don't ask people to stop smoking, I plea with them.  It is unimaginable the amount of mental toughness that is required to quit such an addiction, but to me, there is no question as to whether it should happen.

Cheers to those who are empowered to quit their tobacco addiction!

The Physiology and Importance of Motion at the Workplace

An article published by Wellness and Prevention, Inc. outlines an interesting approach to connect employee wellness to their engagement at the work place.  Using documented research done in sport psychology, they studied the effectiveness of having "breaks" at the workplace.  These "breaks" consist of 1-2 minute bouts of vigorous exercise every 30 minutes that an employee stays seated.  They tested this theory at a New Balance firm and reported marked results:  Employees felt increased energy levels along with an enhanced ability to focus.  As a result, 82% of participating employees made changes that they would likely continue.  Because of employee feedback their increased productivity, New Balance is lengthening the study by 90 days and including an extra 350 employees.  


This article does lack some evidence beyond the self-reporting of employees (which is very subjective), but I have heard of this new theory put into practice at other worksites with some impressive results.  If you have a sedentary workforce, take a look at putting this theory into practice.  If your workforce is fairly active (like mine), utilizing this strategy during meetings could improve the effectiveness of that meeting.  Just another snippet of proof that workplace wellness increases employee productivity, engagement and effectiveness!

The Power of Prevention

The Center for Disease Control's publication on the Power of Prevention is, well... powerful.  With the U.S. healthcare's pricetag now over $2.1 trillion dollars and an estimated 90% of those costs are preventable, it becomes even more important for health educators to direct effective messages and programs towards helping people live longer lives with less diseases and illnesses.  

Here are some numbers (although some are a bit outdated)drawn from the publication:

The Chronic Disease Price Tag— 

Estimated Annual Direct Medical Expenditures 

Cardiovascular disease and stroke...... $313.8 billion in 2009

Cancer.....  $89.0 billion in 2007

Smoking.....  $96 billion in 2004 

Diabetes.....  $116 billion in 2007

Arthritis.....  $80.8 billion in 2003

Obesity.....  $61 billion in 2000*

*According to one research paper, the cost of obesity in 2008 is now $113.9 billion.  In that same paper, the per person medical cost of obesity in that year was $1723.  

When people ask me what the government should do to bolster the economy, I point to these numbers and tell them that the stimulus package starts with what you eat and your physical activity.

The Weight of Nations

I thought this article was interesting enough to highlight it from the "Articles" page.  It talks about the average weight of certain populations and uses that country's population numbers to calculate the % weight of the entire world.  The article highlights two countries:

Source: NASA

Asia has 61% of the world's population, but their average weight is low so it takes up only 13% of the world's total biomass.

North America however, has 6% of the world's population, but takes up 34% of the total biomass.  This is due to an  18.7 kg increase in average mass for this continent over the average 62kg of the world.







Source

U.S. Exercising More Despite Warmer Weather

Some interesting data here:
Gallup-Healthways research shows that, on average, people are exercising more at this time of the year than compared to 2011.

This is good news, especially as obesity continues to be a health epidemic across the U.S.  Keep it up America!