Is there an artificial sweetener left that doesn't cause issues? Splenda was associated with CVD so that's why I switched.
Hear me out.
I have never had such sweet bread as I had after being on Keto for a year. As in actual Ketosis, doctor verified.
When I started eating "normal" again, lots of things tasted way sweeter than I remembered. But like saltiness and other things you get used to it.
All in all, I decided pretty early on that eating stuff that tastes extremely sweet but does not cause the associated glucose spike is a weird way of fooling one's body, and it just doesn't seem like a great idea to me...
Reducing sugar/overly sweet stuff intake has this nice by-effect that everything else starts tasting much, much more intense. I'm very much into savory stuff nowadays, and when I sometimes let someone trick me into trying something sweet, I usually regret it - purely based on the disappointing taste.
The catch is that no one has found a way to synthesize it cheaply.
It seems everything that gratifies the tongue is bad in some way.
Without further study there is no way to say if there is an increased risk of thrombosis from this data alone. Just enough to say they should perform further studies to make a determination. In most cases with these studies, the increased risk of thrombosis would so low that you could offset it by taking a walk once a week.
I personally won't stop my consumption of erythritol on this data alone, but there ARE other sweeteners. I mostly use Stevia myself.
Layne Norton did a quick video explaining the shortcomings of the study.
https://www.youtube.com/watch?v=Ad8_scQtHFM
The problem with studies like this is the reporting on them. I'm fairly sure most people reporting on this study did not actually read it (and you can't read it without paying). And it just plays into the confirmation bias that any non-nutritive sweetener is bad, despite them all being wildly different chemical compounds that all get metabolised in very different ways.
Also, here is a thread from a week ago that also discussed allulose: https://news.ycombinator.com/item?id=34879059
Gave me hives all over my face for a few hours. Intensely itchy.
Now whenever I drink something new, I always look out for it.
Like this one.
> One chronic (78-weeks) study in rats with dietary levels of 0, 1, 3, or 10% erythritol (equal to > 0.46, 1.4 and 5 g/kg bw/day for males and 0, 0.54, 1.7 and 5.7 g/kg bw/day for females) (Til > and van Nesserooij, 1994) and another 2-year chronic toxicity/carcinogenicity study in rats > with dietary levels of erythritol of 0, 2, 5, or 10% (equal to 0, 0.9, 22, and 4.6 g/kg bw/day for > males and 0, 1.0, 2.6, and 5.4 g/kg bw/day) (Lina et al., 1994; 1996) demonstrated that > erythritol did not affect survival and had no carcinogenic effect.
https://ec.europa.eu/food/fs/sc/scf/out175_en.pdf
From this paper:
> In a population-based prospective cohort study with repeated dietary records, ingestion of multiple artificial sweeteners (for example, aspartame, acesulfame potassium and sucralose) was associated with CVD risk.
Ok, let's look at that reference.
> Results Total artificial sweetener intake was associated with increased risk of cardiovascular diseases (1502 events, hazard ratio 1.09, 95% confidence interval 1.01 to 1.18, P=0.03); absolute incidence rate in higher consumers (above the sex specific median) and non-consumers was 346 and 314 per 100 000 person years, respectively. Artificial sweeteners were more particularly associated with cerebrovascular disease risk (777 events, 1.18, 1.06 to 1.31, P=0.002; incidence rates 195 and 150 per 100 000 person years in higher and non-consumers, respectively). Aspartame intake was associated with increased risk of cerebrovascular events (1.17, 1.03 to 1.33, P=0.02; incidence rates 186 and 151 per 100 000 person years in higher and non-consumers, respectively), and acesulfame potassium and sucralose were associated with increased coronary heart disease risk (730 events; acesulfame potassium: 1.40, 1.06 to 1.84, P=0.02; incidence rates 167 and 164; sucralose: 1.31, 1.00 to 1.71, P=0.05; incidence rates 271 and 161).
This study shows the same thing with _all_ artificial sweeteners, and has way more people (n=103,388) than the present Nature study (n=1,157). And we know that erythritol is often used by type 2 diabetics due to its low effect on insulin levels. That population is predisposed to cardiac events to begin with.
When adjusting the US/EU cohorts for cardiovascular risk factors, the observed effect with erythritol are smaller and closer to this study of other artificial sweeteners.
> Consistent with the results observed within the discovery cohort (adjusted HR = 2.95 (1.70–5.12) P < 0.001; Fig. 1 and Supplementary Table 4), the association between erythritol levels (fourth quartile versus first quartile) and incident MACE risk remained significant in both US and European validation cohorts following adjustments for cardiovascular risk factors (adjusted HR (95% CI) = 1.80 (1.18–2.77) and 2.21 (1.20–4.07), P = 0.007 and P = 0.010, respectively
I'm not convinced of the validity of this study. They ignored the rat chronic toxicity data and proposed a mechanism for what they saw in a small cohort of humans, but it should be reproducible in mammals.
I've read 2022 studies on various non-sugar sweeteners, and statistically, sucralose seems to have a slight advantage over aspartame and acesulfame-k in regards to cancer risk correlation.[1] Whereas aspartame and stevia didn't significantly impair glycemic response / glucose tolerance over a 2-week trial, but sucralose and saccharin did.[2] So each sweetener probably has different downsides. In the end, I think they seem safe enough to have occasionally in place of sugar, though I wouldn't go wild with them.
(It's also interesting that this new study comes from Stanley Hazen's lab. He's also published research about the potential cardiovascular risk impact of choline through its metabolite TMAO.)
[1] [(Mar 2022) Artificial sweeteners and cancer risk: Results from the NutriNet-Santé population-based cohort study](https://journals.plos.org/plosmedicine/article?id=10.1371/jo...).
[2] 2022 Suez: https://www.cell.com/cell/fulltext/S0092-8674(22)00919-9 - from https://www.reddit.com/r/ScientificNutrition/comments/wt813r...
