Articles

Introduction:

The ability to correctly identify odors may prove to be a more functional approach to identifying people at risk for early stages of Alzheimer’s disease (AD). Currently, physicians have to rely on expensive medical imaging (CT, MRI, or PET scans) to look for changes in the brain that are characteristic of AD. However, one of the problems with brain imaging beyond their cost is that it simply like taking a picture of the brain. Although sometimes these pictures provide valuable information, they do not evaluate the actual function of the brain.

Research has suggested that simple smell tests evaluating a person’s ability to identify odors may prove to be a practical screening tool for AD and age-related mental decline. Now a new study from Columbia University researchers has shown that a simple, inexpensive scratch and sniff test was shown to be better than an MRI measurement in predicting the early stages of AD.

Background Data:

The new study utilized the University of Pennsylvania Smell Identification Test (UPSIT). This simple test is commercially available for smell identification. It has become the gold standard of smell identification tests and has now been administered to about 500,000 patients so far. Developed by Dr. Richard Doty, the test has also been used as screening test in identifying early stages of AD and has been found to be superior to other non-diagnostic clinical measures in predicting cognitive decline. The loss of odor identification is based on memory and is not the same as a loss of the sense of smell.

Several other studies have also identified altered sense of smell in cognitive decline. For example, in a very simple approach to screening for early stages of AD, University of Florida researchers asked participants to smell a spoonful of peanut butter at a short distance from their nose. The participants had a confirmed diagnosis of early stage AD, some had other forms of dementia, while others had no cognitive or neurological problems. The results showed that patients with early stage AD had trouble smelling the peanut butter. Interestingly, when these patients blocked their right nostril, they had even more difficulty smelling the peanut butter. They typically were able to smell the peanut butter from 4 inches farther away with their right nostril than their left. The researchers found that this difference in smell between left and right nostril was unique to early stage AD.

In a more sophisticated study at the Mayo Clinic, it was found that older subjects with an average age of 79 years old who had the worst test scores on a smell test were 2.2 times more likely to develop impaired cognition and memory over the three and a half year study. If at the beginning of the study a patient was already exhibiting memory problems and had a low smell test scores, they were more likely to progress to Alzheimer’s disease. The smell test used was more elaborate than the peanut butter test and included six food items and six non-food items.

New Data:

The University of Pennsylvania Smell Identification Test (UPSIT) used in the new study involves scratching a surface, sniffing the odor that’s released, and identifying it from a multiple-choice list. The test consists of 4 different 10 page booklets, with a total of 40 questions. On each page, there is a different “scratch and sniff” strip embedded with a microencapsulated odorant. There is also a four choice multiple choice question on each page. The scents are released using a pencil. After each scent is released, the patient smells the level and detects the odor from the four choices. There is an answer column on the back of the test booklet, and the test is scored out of 40 items. The test is scored from 0 (no correct answer) to 40 (all answers correct). A low score indicates a decreased ability to correctly identify odors.

Again, the loss of odor identification is based on memory and is not the same as a loss of the sense of smell. The study included 397 patients with an average age of 80 from Manhattan, New York, who had undergone MRI and UPSIT and had no dementia at baseline. Researchers then followed these participants for 4 years. Analysis found that UPSIT and MRI predicted transition to dementia, but UPSIT was better. UPSIT was also able to predict general cognitive decline while MRI did not. In addition, when subjects scored very well on the UPSIT (score of more than 35 out of 40), almost nobody went on to get AD even though their average age was 80 years old.

These results mean that odor identification appears to be a better predictor of who will get AD as well as suffer from loss of mental function and memory (mild cognitive impairment).

Reference:

Scratch-and-Sniff Test Beats Imaging in Predicting Cognitive Decline. Medscape. Aug 03, 2016.

Introduction:

Conventional wisdom is that we need to avoid sun exposure in order to avoid skin cancer. However, one of the issues with conventional wisdom is that it is born out of convenience and not critical thinking. With all of the new data emerging on the importance of vitamin D, which can be made in our body when sunlight hits the skin, researchers are finally starting to ask the right questions. The answers are surprisingly showing that avoiding sun exposure is a significant health risk. In fact, the authors of a new study published in the Journal of Internal Medicine concluded based upon their results that avoiding the sun “is a risk factor for death of a similar magnitude as smoking.” These results shatter conventional wisdom, but they are not new. Noted vitamin D researcher Michael Holick, MD, PhD, warned almost a decade ago that avoiding sun exposure to prevent skin cancer results in such a drop in vitamin D levels that for every life saved from skin cancer over 100 people will lose their lives to other forms of cancer most notably prostate, breast and colon cancer. This new study definitely proves his warning to be true.

Background Data:

A huge and growing amount of research has now shown that avoiding sun exposure has created an epidemic of vitamin D deficiency. Current estimates are that at least 50% of the general population and 80% in infants are deficient in vitamin D. Low levels of D3 are now known to play a major role in the development in many of the chronic degenerative diseases. In fact, vitamin D deficiency may be the most common medical condition in the world and vitamin D supplementation may be the most cost effective strategy in improving health, reducing disease, and living longer. Those deficient in vitamin D have twice the rate of death and a doubling of risk for many diseases, such as cancer, cardiovascular disease, diabetes, asthma and autoimmune diseases such as multiple sclerosis.

New Data:

According to a recent study published in the Journal of Internal Medicine, the life expectancy of people that avoided sun exposure was reduced by about 2 years compared to those who regularly sun bathed. In fact, nonsmokers who stayed out of the sun had a life expectancy similar to smokers who had the highest level of sun exposure.

Researchers looked at data from 29,518 Swedish women that were enrolled in a study that began in 1990. The women were 25-64 years of age at the start of the study. The study was originally designed to evaluate the rate of melanoma, a type of skin cancer, so sun exposure was one of the variables that was being examined.

The results showed that women that regularly sun bathed lived longer because they had a lower rate of death cardiovascular disease (CVD) and deaths that were not due to cancer or CVD as compared to those who avoided sun exposure. However, as a result of living longer, these women did have a higher rate of cancer death.

Because nonsmokers who avoided sun exposure had a life expectancy similar to smokers in the highest sun exposure group, the researchers concluded that avoidance of sun exposure is a risk factor for death of a similar magnitude as smoking.

Commentary:

It is time we advocate sensible sun exposure instead of complete avoidance. Sunscreens have their place, but we need some sun exposure for our health. And, we also need to regularly check vitamin D3 levels. For optimum health, most experts recommend blood levels of vitamin D3 (25(OH)D₃) between 50-80 ng/mL (125-200 nmol/L).

Reference:

Lindqvist PG, Epstein E, Nielsen K, et al. Avoidance of sun exposure as a risk factor for major causes of death: a competing risk analysis of the Melanoma in Southern Sweden cohort. J Intern Med. 2016 Mar 16. doi: 10.1111/joim.12496.

Introduction

One simple rule that would save a lot of suffering in the world is to “never take a drug that has more severe side effects than your symptoms.” A new study highlights this adage as it shows an extremely popular group of stomach acid-blocking drugs, the proton-pump inhibitors (PPIs), are now linked strongly to another serious side effect – this time dementia.

This risk is added to the other conditions these drugs produce including osteoporosis, heart attacks, strokes, intestinal infections, bacterial pneumonia, and multiple nutrient deficiencies. Here is the blaring fact that not enough doctors and patients know. It is conservatively estimated by noted experts in conventional medicine that up to 70% of all PPI prescriptions are likely inappropriate. In alternative medical circles that number is 100%.

Popular examples of PPIs include Nexium, Prilosec, Protonix, Prevacid, and Aciphex.

These drugs are dominant medical treatment of peptic ulcers, gastroesophageal reflux disease (GERD), and indigestion.

Background Data:

PPIs will typically raise the gastric pH above the normal range of 3.5, effectively inhibiting the action of pepsin – an enzyme involved in protein digestion that can be irritating to the stomach. Although raising the pH can reduce symptoms, it also substantially blocks a normal body process – digestion! The manufacture and secretion of stomach acid is very important not only to the digestive process, but also because it is an important protective mechanism against infection. Stomach secretions can neutralize bacteria, viruses and molds before they can cause gastrointestinal infection.

As far as the digestive process, stomach acid is not only important in the initiation of protein digestion, it ionizes minerals and other nutrients for enhanced absorption; and without sufficient secretion of HCl in the stomach the pancreas does not get the signal to secrete its digestive enzymes.

PPIs drugs are associated with numerous side effects and here are just a small number of examples:

• Pneumonia – People using acid blockers were 4.5 times as likely to develop pneumonia as were people who never used the drugs. Apparently, without acid in the stomach, bacteria from the intestine can migrate upstream to reach the throat and then lungs to cause infection.
• Increased fractures – people taking high doses of acid-blocking drugs for longer than a year had a 260 percent increase in hip fracture rates compared to people not taking an acid blocker. Evidence suggests that these drugs may disrupt bone remodeling making bones weaker and more prone to fracture.
• Heart attacks – Stanford researchers found regular use of PPIs to have a two-fold increase in dying from heart disease compared to those not taking PPIs.
• Vitamin B₁₂ insufficiency – acid blocking drugs not only reduce the secretion of stomach acid, but also intrinsic factor (a compound that binds to and assists the absorption of vitamin B₁₂). Vitamin B₁₂ deficiency is among the most common nutritional inadequacy in older people. Studies indicate that 10 to 43 percent of the elderly are deficient in vitamin B₁₂ making them at risk for a number of health conditions including dementia. Many elderly put away in nursing homes for Alzheimer’s disease, may simply be suffering from vitamin B₁₂

New Data:

A new study from the German Center for Neurodegenerative Diseases published online February 15, 2016 in JAMA Neurology, has confirmed the suspected link between PPIs and dementia. The study used the largest mandatory public health insurer in Germany, which includes one third of the overall population and as much as 50% of the elderly population. Its database includes information on diagnoses and drug prescriptions.

The analysis included 73,679 subjects aged 75 years or older who initially did not have dementia at baseline. The results showed that the patients who were regularly using a PPI had a 44% greater risk for dementia compared with those not taking PPIs. It did not seem to matter what brand/form of PPI was used. The results were similar for all of them.

In addition to the link between PPIs and vitamin B₁₂ deficiency, there is evidence that PPIs may get into the brain and cause an increase in the beta-amyloid deposits characteristic of Alzheimer’s disease.

Having diabetes and being prescribed five or more drugs other than the PPI (defined as polypharmacy) were also associated with significantly elevated dementia risk, but the risk was about a 16% increase. That was much lower than the 44% increased risk due to regular PPI use.

These results of the study highlight the need for first eliminating inappropriate PPI prescribing and then looking to natural alternatives for peptic ulcers, GERD, and other conditions currently being treated with PPIs.

Reference:

Gomm W, von Holt K, Thomé F, et al. Association of Proton Pump Inhibitors With Risk of Dementia: A Pharmacoepidemiological Claims Data Analysis. JAMA Neurol. 2016 Feb 15. doi: 10.1001/jamaneurol.2015.4791. [Epub ahead of print]

Written by Dr. Mark Hyman, MD (drhyman.com)

IF YOU CAN’T CONVINCE THEM, CONFUSE THEM – Harry Truman

The current media debate about the benefits (or lack of harm) of high fructose corn syrup (HFCS) in our diet misses the obvious. The average American increased their consumption of HFCS (mostly from sugar sweetened drinks and processed food) from zero to over 60 pounds per person per year.

During that time period, obesity rates have more than tripled and diabetes incidence has increased more than seven fold. Not perhaps the only cause, but a fact that cannot be ignored.

Doubt and confusion are the currency of deception, and they sow the seeds of complacency. These are used skillfully through massive print and television advertising campaigns by the Corn Refiners Association’s attempt to dispel the “myth” that HFCS is harmful and assert through the opinion of “medical and nutrition experts” that it is no different than cane sugar. It is a “natural” product that is a healthy part of our diet when used in moderation.

Except for one problem. When used in moderation it is a major cause of heart disease, obesity, cancer, dementia, liver failure, tooth decay, and more.

Why is the corn industry spending millions on misinformation campaigns to convince consumers and health care professionals of the safety of their product? Could it be that the food industry comprises 17 percent of our economy?

The Lengths the Corn Industry Will Go To

The goal of the corn industry is to call into question any claim of harm from consuming high fructose corn syrup, and to confuse and deflect by calling their product natural “corn sugar”. That’s like calling tobacco in cigarettes natural herbal medicine.

In the ad, the father tells us:

“Like any parent I have questions about the food my daughter eats–-like high fructose corn syrup. So I started looking for answers from medical and nutrition experts, and what I discovered whether it is corn sugar or cane sugar your body can’t tell the difference. Sugar is sugar. Knowing that makes me feel better about what she eats and that’s one less thing to worry about.”

Physicians are also targeted directly. I received a 12-page color glossy monograph from the Corn Refiners Association reviewing the “science” that HFCS was safe and no different than cane sugar. I assume the other 700,000 physicians in America received the same propaganda at who knows what cost.

In addition to this, I received a special “personal” letter from the Corn Refiners Association outlining every mention of the problems with HFCS in our diet–whether in print, blogs, books, radio, or television. They warned me of the errors of my ways and put me on “notice”. For what I am not sure. To think they are tracking this (and me) that closely gives me an Orwellian chill.

New websites like www.sweetsurprise.com and www.cornsugar.com help “set us straight” about HFCS with quotes from professors of nutrition and medicine and thought leaders from Harvard and other stellar institutions.

Why is the corn industry spending millions on misinformation campaigns to convince consumers and health care professionals of the safety of their product? Could it be that the food industry comprises 17 percent of our economy?

But are these twisted sweet lies or a sweet surprise, as the Corn Refiners Association websites claim?

What the Science Says About HFCS

Let’s examine the science and insert some common sense into the conversation. These facts may indeed come as a sweet surprise. The ads suggest getting your nutrition advice from your doctor (who, unfortunately, probably knows less about nutrition than most grandmothers).

Having studied this for over a decade, and having read, interviewed, or personally talked with most of the “medical and nutrition experts” used to bolster the claim that “corn sugar” and cane sugar are essentially the same, quite a different picture emerges and the role of HFCS in promoting obesity, disease, and death across the globe becomes clear.

Last week over lunch with Dr. Bruce Ames, one of the foremost nutritional scientists in the world, and Dr. Jeffrey Bland, a nutritional biochemist, a student of Linus Pauling, and I reviewed the existing science, and Dr. Ames shared shocking new evidence from his research center on how HFCS can trigger body-wide inflammation and obesity.

Here are 5 reasons you should stay away from any product containing high fructose corn syrup and why it may kill you.  

1. Sugar in any form causes obesity and disease when consumed in pharmacologic doses.  Cane sugar and high fructose corn syrup are indeed both harmful when consumed in pharmacologic doses of 140 pounds per person per year.  When one 20 ounce HFCS sweetened soda, sports drink, or tea has 17 teaspoons of sugar (and the average teenager often consumes two drinks a day) we are conducting a largely uncontrolled experiment on the human species.  Our hunter gatherer ancestors consumed the equivalent of 20 teaspoons per year, not per day. In this sense, I would agree with the corn industry that sugar is sugar. Quantity matters. But there are some important differences.
2. HFCS and cane sugar are NOT biochemically identical or processed the same way by the body. High fructose corn syrup is an industrial food product and far from “natural” or a naturally occurring substance. It is extracted from corn stalks through a process so secret that Archer Daniels Midland and Carghill would not allow the investigative journalist Michael Pollan to observe it for his book The Omnivore’s Dilemma. The sugars are extracted through a chemical enzymatic process resulting in a chemically and biologically novel compound called HFCS. Some basic biochemistry will help you understand this. Regular cane sugar (sucrose) is made of two-sugar molecules bound tightly together– glucose and fructose in equal amounts.  The enzymes in your digestive tract must break down the sucrose into glucose and fructose, which are then absorbed into the body. HFCS also consists of glucose and fructose, not in a 50-50 ratio, but a 55-45 fructose to glucose ratio in an unbound form. Fructose is sweeter than glucose. And HFCS is cheaper than sugar because of the government farm bill corn subsidies. Products with HFCS are sweeter and cheaper than products made with cane sugar. This allowed for the average soda size to balloon from 8 ounces to 20 ounces with little financial costs to manufacturers but great human costs of increased obesity, diabetes, and chronic disease.  Now back to biochemistry. Since there is there is no chemical bond between them, no digestion is required so they are more rapidly absorbed into your blood stream. Fructose goes right to the liver and triggers lipogenesis (the production of fats like triglycerides and cholesterol) this is why it is the major cause of liver damage in this country and causes a condition called “fatty liver” which affects 70 million people.  The rapidly absorbed glucose triggers big spikes in insulin–our body’s major fat storage hormone. Both these features of HFCS lead to increased metabolic disturbances that drive increases in appetite, weight gain, diabetes, heart disease, cancer, dementia, and more.  But there was one more thing I learned during lunch with Dr. Bruce Ames. Research done by his group at the Children’s Hospital Oakland Research Institute found that free fructose from HFCS requires more energy to be absorbed by the gut and soaks up two phosphorous molecules from ATP (our body’s energy source).

This depletes the energy fuel source, or ATP, in our gut required to maintain the integrity of our intestinal lining. Little “tight junctions” cement each intestinal cell together preventing food and bacteria from “leaking” across the intestinal membrane and triggering an immune reaction and body wide inflammation.

High doses of free fructose have been proven to literally punch holes in the intestinal lining allowing nasty byproducts of toxic gut bacteria and partially digested food proteins to enter your blood stream and trigger the inflammation that we know is at the root of obesity, diabetes, cancer, heart disease, dementia, and accelerated aging. Naturally occurring fructose in fruit is part of a complex of nutrients and fiber that doesn’t exhibit the same biological effects as the free high fructose doses found in “corn sugar”.

The takeaway: Cane sugar and the industrially produced, euphemistically named “corn sugar” are not biochemically or physiologically the same.

1. HFCS contains contaminants including mercury that are not regulated or measured by the FDA. An FDA researcher asked corn producers to ship a barrel of high fructose corn syrup in order to test for contaminants. Her repeated requests were refused until she claimed she represented a newly created soft drink company. She was then promptly shipped a big vat of HFCS that was used as part of the study that showed that HFCS often contains toxic levels of mercury because of chlor-alkali products used in its manufacturing. (i)  Poisoned sugar is certainly not “natural”.  When HFCS is run through a chemical analyzer or a chromatograph, strange chemical peaks show up that are not glucose or fructose. What are they? Who knows? This certainly calls into question the purity of this processed form of super sugar. The exact nature, effects, and toxicity of these funny compounds have not been fully explained, but shouldn’t we be protected from the presence of untested chemical compounds in our food supply, especially when the contaminated food product comprises up to 15-20 percent of the average American’s daily calorie intake?  
2. Independent medical and nutrition experts DO NOT support the use of HFCS in our diet, despite the assertions of the corn industry. The corn industry’s happy looking websites www.cornsugar.com and www.sweetsurprise.com bolster their position that cane sugar and corn sugar are the same by quoting experts, or should we say misquoting … Barry M. Popkin, Ph.D., Professor, Department of Nutrition, University of North Carolina at Chapel Hill, has published widely on the dangers of sugar-sweetened drinks and their contribution to the obesity epidemic. In a review of HFCS in the American Journal of Clinical Nutrition,(ii)he explains the mechanism by which the free fructose may contribute to obesity.  He states that: “The digestion, absorption, and metabolism of fructose differ from those of glucose. Hepatic metabolism of fructose favors de novo lipogenesis (production of fat in the liver). In addition, unlike glucose, fructose does not stimulate insulin secretion or enhance leptin production. Because insulin and leptin act as key afferent signals in the regulation of food intake and body weight (to control appetite), this suggests that dietary fructose may contribute to increased energy intake and weight gain. Furthermore, calorically sweetened beverages may enhance caloric over-consumption.”  He states that HFCS is absorbed more rapidly than regular sugar and that it doesn’t stimulate insulin or leptin production. This prevents you from triggering the body’s signals for being full and may lead to over-consumption of total calories. He concludes by saying that:“… the increase in consumption of HFCS has a temporal relation to the epidemic of obesity, and the overconsumption of HFCS in calorically sweetened beverages may play a role in the epidemic of obesity.”  The corn industry takes his comments out of context to support their position. “All sugar you eat is the same.”

True pharmacologic doses of any kind of sugar are harmful, but the biochemistry of different kinds of sugar and their respective effects on absorption, appetite, and metabolism are different, and Dr. Popkin knows that.

David S. Ludwig, M.D., Ph.D., Associate Professor of Pediatrics, Harvard Medical School, and a personal friend, has published extensively on the dangers and the obesogenic properties of sugar-sweetened beverages.

He was quoted as saying that “high fructose corn syrup is one of the most misunderstood products in the food industry.” When I asked him why he supported the corn industry, he told me he didn’t and that his comments were taken totally out of context.

Misrepresenting science is one thing, misrepresenting scientists who have been at the forefront of the fight against obesity and high fructose sugar sweetened beverages is quite another.

1. HFCS is almost always a marker of poor-quality, nutrient-poor disease-creating industrial food products or “food-like substances”. The last reason to avoid products that contain HFCS is that they are a marker for poor-quality, nutritionally-depleted, processed industrial food full of empty calories and artificial ingredients. If you find “high fructose corn syrup” on the label you can be sure it is not a whole, real, fresh food full of fiber, vitamins, minerals, phytonutrients, and antioxidants. Stay away if you want to stay healthy. We still must reduce our overall consumption of sugar, but with this one simple dietary change you can radically reduce your health risks and improve your health.  While debate may rage about the biochemistry and physiology of cane sugar versus corn sugar, this is in fact beside the point (despite the finer points of my scientific analysis above). The conversation has been diverted to a simple assertion that cane sugar and corn sugar are not different.

The real issues are only two.

• We are consuming HFCS and sugar in pharmacologic quantities never before experienced in human history–140 pounds a year versus 20 teaspoons a year 10,000 years ago.
• High fructose corn syrup is always found in very poor-quality foods that are nutritionally vacuous and filled with all sorts of other disease promoting compounds, fats, salt, chemicals, and even mercury.

These critical ideas should be the heart of the national conversation, not the meaningless confusing ads and statements by the corn industry in the media and online that attempt to assure the public that the biochemistry of real sugar and industrially produced sugar from corn are the same.

(i) Dufault, R., LeBlanc, B., Schnoll, R. et al. 2009. Mercury from chlor-alkali plants: Measured concentrations in food product sugar. Environ Health. 26(8):2.

(ii) Bray, G.A., Nielsen, S.J., and B.M. Popkin. 2004. Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. Am J Clin Nutr. 79(4):537-43. Review.

“I know you’re not big on sugar and frequently tell people to cut down on it,” writes this week’s House Call. “But what about artificial sweeteners? Can I use those instead?”

Sadly, the answer is emphatically no. Human, animal, experimental, and other studies show artificial sweeteners can be just as bad and maybe even worse than regular sugar.

Artificial sweeteners have long been positioned as “guilt-free,” innocuous, safe alternatives, so why would I argue they are actually worse than sugar?

Manufacturers love to position zero-calorie sweetened foods and drinks as better because they create a “halo effect” and they know you’re more likely to buy them.

We’re surrounded by low-calorie or calorie-free foods and diet soft drinks that contain artificial sweeteners touted as healthy or consequence-free. As a result, the number of Americans who consume products that contain sugar-free sweeteners grew from 70 million in 1987 to 160 million in 2000.

At the same time, the incidence of obesity in the United States has doubled from 15 percent to 30 percent across all age groups, ethnic groups, and social strata. And the number of overweight Americans has increased from about 30 percent to over 65 percent of the population. The fastest growing obese population is children.

High sugar intake deservedly takes the blame here, but we frequently overlook artificial sweeteners as a potential culprit. The evidence is catching up. Recent studies have not been kind to artificial sweeteners, claiming among other problems they adversely affect gut health and glucose tolerance.

You’re probably wondering, though, how a calorie-free sweetener could make you fat. If you’ve read my blogs, you know that while calories count, other factors like hormonal imbalances contribute far more to weight gain.

Let’s briefly look at three reasons artificial sweeteners create adverse consequences to your waistline and health.

1. Artificial sweeteners increase your risk for diabesity. Studies show sugar substitutes potentially can increase your risk for weight gain, metabolic syndrome, type 2 diabetes, and cardiovascular disease. One study of rats that were fed artificially sweetened food found that their metabolism slowed down and they were triggered to consume more calories and gain more weight than rats fed sugar-sweetened food. In another animal study, rats that consumed artificial sweeteners ate more food, their metabolic fire or thermogenesis slowed down, and they put on 14 percent more body fat in just two weeks even if they ate fewer total calories than the rats that ate regular sugar-sweetened food.
2. Artificial sweeteners rewire your brain chemistry and metabolism. How could aspartame and other fake sweeteners make you gain weight even though they’re calorie-free? Because they stimulate your taste buds and trick them to think you’re eating real sugar. Artificial sweeteners can be 1000 times sweeter than sugar, so your body becomes confused and revs up production of insulin, your fat-storage hormone. Your metabolism slows down, you become hungry more quickly, you’re prone to eat way more food (especially carbs), and increased belly fat is the inevitable result. Because they confuse and slow down your metabolism, you burn fewer calories every day. Artificial sweeteners make you hungrier and cause you to crave even more sugar and starchy carbs, such as bread and pasta.
3. Artificial sweeteners are highly addictive. I regularly see patients who complain they can’t kick their diet-soda habit. “I have one in the morning and I can’t stop,” they say. It isn’t just their imagination: Artificial sweeteners can quickly become addictive. In an alarming study, rats offered the choice of cocaine or artificial sweeteners always picked the artificial sweetener, even if the rats were previously programmed to be cocaine addicts. The author of the study said that, “The absolute preference for taste sweetness may lead to a re-ordering in the hierarchy of potentially addictive stimuli, with sweetened diets… taking precedence over cocaine and possibly other drugs of abuse.”

Let’s consider that last point a little more closely, particularly with diet sodas, which account for a fair amount of the artificial sweeteners we consume.

One of the biggest struggles I see with patients – ironically, usually overweight or obese patients – is surrendering their diet sodas. Like artificial sweeteners, we’ve been misled to think they’re guilt-free alternatives to regular soda.

Hardly. Diet soda and diet drinks make you fat and cause type 2 diabetes.

Wait… diet soda makes people fat? Really? How does that happen?

If losing weight were all about the calories, then consuming diet drinks would seem like a good idea. That’s certainly what big-name cola companies want us to believe, judging by the ad campaigns highlighting their efforts to fight obesity. (And the other food giants making diet drinks push the same propaganda.)

Soda companies proudly promote the fact that it has 180 low- or no-calorie drinks and that it has cut sales of sugared drinks in schools by 90 percent. Is that a good thing? I don’t think so. In fact, it may be worse to drink diet soda than a regular soda.

A 14-year study of 66,118 women published in the American Journal of Clinical Nutrition (and supported by many previous and subsequent studies) discovered some frightening facts that should make us all swear off diet drinks and products:

Diet sodas raised the risk of diabetes more than sugar-sweetened sodas.

Women who drank one 12-ounce diet soda a week had a 33 percent increased risk of type 2 diabetes, and women who drank one 20-ounce soda a week had a 66 percent increased risk.

Women who drank diet sodas drank twice as much as those who drank sugar-sweetened sodas because artificial sweeteners are more addictive than regular sugar.  The average diet soda drinker consumes three diet drinks a day.

The bottom line is you can’t outsmart Mother Nature. Fooling your brain into thinking you are getting something sweet plays dirty tricks on your metabolism. Artificial sweeteners disrupt the normal hormonal and neurological signals that control hunger and satiety (feeling full).

The use of artificial sweeteners, as well as “food porn,” the sexy experience of sweet, fat, and salt in your mouth, alters your food preferences. Your palate shifts from being able to enjoy fruits and vegetables and whole foods to liking only the sexy stuff.

Sugar or Artificial Sweeteners: What’s the Answer?

Let’s be clear here that I am not letting sugar off the hook. Of the more than 600,000 food products – note I said food products, not foods – 80 percent have added sugar. That’s where the trouble begins.

We went from eating about 10 pounds of sugar per person, per year in 1800 to 152 pounds of sugar (and 146 pounds of flour) per person, per year today. Think about it: On average we eat about one pound of sugar every day!

Those sugar-laden foods literally become drugs: Pharmacological doses that hijack our metabolism and make us fat and sick.

Adding a teaspoon of sugar to your coffee or having an occasional dessert doesn’t make you fat and sick. Added sugars in even so-called healthy foods or non-sweet tasting foods creates the real, cumulative damage.

I realize this can all become confusing. Here are five ways I recommend making sense about sweeteners:

1. Have a little. If you like sugar and want a little bit, fine, but eat real food and then have sweet things. Consider sugar a recreational drug that you can partake of in moderation like red wine or tequila. Put a little sugar in your coffee because at least you’re aware about how much you’re getting. Likewise, you’re not going to overeat cake, because you know it’s bad for you. One caveat: If you know a little sugar will become a slippery slope for overeating, stay away from the sweet stuff period.
2. Become aware of hidden sugars even in so-called healthy foods. Read ingredients and realize sugar lurks even in foods that don’t taste sweet or that are positioned as healthy.
3. Learn to appreciate natural sweetness. Fruit, nuts, and other real foods contain natural sweetness without processed foods’ sugar overload or the detrimental effects of artificial sweeteners.
4. Stop confusing your body. If you have a desire for something sweet have a little sugar, but stay away from “fake” foods. Eating a whole-foods diet that has a low-glycemic load and is rich in phytonutrients and indulging in a few real sweet treats once in a while is a better alternative than tricking your body with artificial sweeteners, which leads to wide scale metabolic rebellion and obesity.
5. Judiciously use this one sweetener. Among sweeteners, I make one exception with stevia. A little bit in your coffee or tea should be fine, but be judicious. Besides, overdoing stevia creates a bitter effect, so you’re more likely not to get carried away. If you partake, make sure you’re buying 100 percent pure organic stevia, not the stuff that contains bulking agents like maltodextrin (corn) and nebulous natural flavors.

Whatever you do, stay away from artificial sweeteners. I recommend giving up aspartame, sucralose, sugar alcohols such as xylitol and maltitol, and all of the other heavily used and marketed sweeteners unless you want to slow down your metabolism, gain weight, and become an addict. Use a little stevia if you must, but skip out on the others.