Wednesday, November 12, 2014

The Nutrition Debate #261: Non-Caloric Artificial Sweeteners (NAS)

Bad science writing and poor thinking don’t have to go together, but when they do it’s insulting to the discerning reader, not to mention a waste of time. I read literally dozens of précis and abstracts every week to find good material suitable for my readership. Most don’t cut it – they’re either too arcane or just hum-drum repetition – and I simply pass them over. This one was so bad, on so many counts, that I was about to pass, and then I saw the comment by Richard K. Bernstein, MD

The title in Diabetes-in-Control was, “Non-Caloric Artificial Sweeteners May Induce Glucose Intolerance.” The subject is controversial, so I looked to see if this one had anything new to add to the discussion. The sub-head suggested it did: “Consumption of non-caloric artificial sweeteners seems to induce glucose intolerance in mice and human (sic) by altering gut microbiota.” The gut part – a trendy subject itself – was a new twist, so I decided to read on.

“Many studies has showed…” the third sentence began. Two errors: wrong number (singular) and wrong past particle in the progressive tense. Okay, nobody’s perfect. Maybe the anonymous writer of this particular newsletter piece for medical professionals is not a native English speaker, but don’t they have an editor? I do. Okay, I’m being picky, and a little smug.

How about a lack of clarity? In the second paragraph, try to make sense of these sentences: “Also to correlate findings in obese patients, mice were fed high fat diet while giving them NAS or pure sucrose as a control. This also showed that mice developed glucose intolerance that were on commercial saccharides.” I don’t know where to begin! 1) Correlate humans to mice? 2) Feed mice fat (rather than carbs) to make them fat? 3) “Pure” sucrose? Is there any other kind? 4) And check out the syntax of the second sentence: How about, “Mice that were on commercial saccharides developed glucose tolerance.”

I know. This is not a blog about English grammar, punctuation and syntax. It’s about how “gut microbiota may mediate NAS-induced glucose intolerance.” There’s one short paragraph devoted to that. I quote it here, verbatim, in its entirety:

“Gut microbiota may mediate NAS-induced glucose intolerance. Fecal transplantation was performed to test this theory, where transferring the microbiota configuration from mice on normal-chow diet drinking commercial saccharin or glucose as a control into normal-chow-consuming germ-free mice. Mice consuming commercial saccharin that received microbiota exhibited impaired glucose intolerance compared to mice consuming glucose after 6 days of fecal transplantation (P<0.03).”

Hmmm. “…commercial saccharin or glucose as a control…” This time it’s commercial saccharin or glucose. Last time “NAS or pure sucrose.” Sucrose, as my readers know, is only 50% glucose. The other 50% is fructose. And this time it’s “commercial saccharin” (a specific chemical compound) vs. “commercial saccharides” that was the sweetener tested. And how can “commercial saccharin or glucose” both be controls? And do I understand that the mice who received “commercial saccharin” exhibited IGT while the mice who consumed glucose did not? And do they mean “after 6 days of fecal transplantation” or do they mean “6 days after fecal transplantation.”?

The Diabetes-in-Control piece then goes on to describe two entirely different short and long term experiments of NAS in humans. It doesn’t say how long the long-term study is – only that it is ongoing and involves 381 non-diabetics. The short term study involved 7 people for 7 days. The summation drew an audible chuckle from this reader: “Overall, results from short and long-term human NAS consumer cohorts suggest that individual have personalized response to NAS depending on differences in their microbiota function.” Huh?!! There was no mention whatsoever of fecal implantation in the Diabetes-in-Control write-up of either human experiment.

The last sentence was the pièce de résistance: “NAS consumptions seems to increase in the obesity and glucose intolerance.” That is a verbatim quote. No typos (on my part). Just poor writing, poor editing and poor thinking.

Then I saw the comment by Bernstein, M.D., F.A.C.E., F.A.C.N, C.W.S., FCCWS, author of “Diabetes Solution.”

“They used brand name powdered sweeteners that were all 96% sugars but were labeled zero calories. At least 1 brand (Sweet and Low) used glucose. So they were testing sugars rather than artificial sweeteners.”

So, am I piling on? Maybe so. Do I bask in the reflected glory of the venerable Dr. Bernstein? Sure. We (those of us with impaired glucose tolerance) all venerate him. But would I have bothered to write this up if he had not commented on it. Probably not, because, without a subscription, I only had access to the ABSTRACT on which this précis was based. But I was shocked, shocked, to learn where this paper was published. You will be too: in Nature, a prominent scientific journal.

N.B.: The abstract in Nature is a good read. Its CONCLUSION: “Collectively, our results link NAS consumption, dysbiosis and metabolic abnormalities, thereby calling for a reassessment of massive NAS usage.” That sounds reasonable to me.
If you want to know how your BG reacts to a non-caloric sweetener, use your meter!

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