[HN Gopher] Microbiome-driven effects of non-nutritive sweetener...
       ___________________________________________________________________
        
       Microbiome-driven effects of non-nutritive sweeteners on human
       glucose tolerance
        
       Author : masonhipp
       Score  : 115 points
       Date   : 2022-08-20 12:45 UTC (10 hours ago)
        
 (HTM) web link (www.cell.com)
 (TXT) w3m dump (www.cell.com)
        
       | edwnj wrote:
       | no free lunch
        
       | clearwind wrote:
       | Anecdotally, as a type 1 diabetic it's very interesting to
       | observe different effects of sugars and sweeteners on my
       | continuous blood glucose sensor over time.
       | 
       | For example DASH is a zero-calorie but sweet drink I have tried a
       | couple of times and it makes my body chart a course for the moon.
       | 
       | Another drink called Gusto seems to have replaced sugars with
       | Agave syrup, which works well at first but after several days
       | builds up intolerance or something.
       | 
       | Modern regular orange juice is like a load of TNT with a 4 minute
       | fuse.
       | 
       | Recently white wine and sparkling white wine instantly start
       | making my sugar readings hop around erratically, moment by
       | moment. (Not something I saw before about 4 months ago - before
       | that it would be more like a steady incline.
       | 
       | The disruptors have made their way over to food and drink, it
       | seems.
        
         | inetsee wrote:
         | Somewhat unrelated to the article: I am a LADA diabetic (Latent
         | Autoimmune Diabetes in Adults, sometimes referred to as Type
         | 1.5). I am insulin dependent, but I didn't become symptomatic
         | until my early 40s.
         | 
         | Lately, I have been experimenting with the "grazing diet".
         | Instead of eating three meals a day one would eat a dozen or
         | more really small meals; basically snacks.
         | 
         | The motivation was that the glucose response profile of my
         | insulin was poorly matched with the glucose response profile of
         | the foods I eat. My insulin (Humalog), has a profile lasting
         | three to four hours, while most of my foods have a much shorter
         | profile, some with a profile of an hour or less. By spreading
         | my carbohydrate intake over more time I get a better match to
         | my insulin response. For example, I spend two or more hours
         | eating lunch. So far, it seems to be helping noticeably.
        
         | stjohnswarts wrote:
         | have you ever tested diet soda with the various artificial
         | sweeteners? I've tried it personally and never seen the
         | slightest notch above what would random noise whereas sugar is
         | "straight to the moon, lois" a half hour to hour later.
        
           | clearwind wrote:
           | I have a similar effect to you usually with diet soda, maybe
           | a slight rise. Only some of the newer ones caused my readings
           | to funk up.
        
       | wdwvt1 wrote:
       | Microbiome researcher here - I feel like this is the time I get
       | to shine in HN threads.
       | 
       | The Segal and Elinav labs are powerhouses in computational and
       | gnotobiotic microbiome study. They've published several highly
       | cited papers around interactions between diet, the microbiome,
       | and various host parameters. A couple highlights include this [1]
       | 2015 Cell paper predicting host glycemic response from microbial
       | and dietary information, and this [2] 2014 Nature paper
       | identifying artificial sweeteners as a source of glucose
       | intolerance (mediated through the microbiome).
       | 
       | In the current work, they show that two non-nutritive sweeteners
       | (NNS, saccharin and sucralose) impair glucose tolerance, and that
       | the microbiome of individuals most susceptible to NNS-induced
       | glucose-intolerance can transmit some of the phenotype to mice.
       | These data are generated with human cohorts of good size (n=20
       | per sweetener) over a reasonable time frame (2 weeks of daily NNS
       | administration). Importantly, the levels of NNS that are
       | administered are well below the acceptable daily intake (ADI).
       | For example, sucralose is given at 102 mg/day, about 34% of the
       | ADI of 5 mg/kg, and reasonably close to an estimate of 1.6 mg/kg
       | as average daily consumption in humans (reference in [3]). The
       | strongest data for the paper is with sucralose (and saccharin).
       | The researchers show that consumption of sucralose causes a shift
       | in glycemic response: participants consuming sucralose had higher
       | glucose excursion in a glucose tolerance test (GTT) than those
       | consuming either control diet (Fig 2A, E, F). In addition to GTT
       | changes, sucralose-consuming participants had altered level of 9
       | identified metabolites (Fig 4B-D).
       | 
       | After establishing these baseline results, the researchers search
       | for mechanism by stratifying the sucralose cohort in the top and
       | bottom responders. These are, respectively, the individuals who
       | show most change from baseline in GTT at the end of intervention
       | (2 weeks) and those that show the least. There are differences in
       | metabolites, as well as the biochemical pathways those
       | metabolites come from (TCA cycle) in these two groups (Fig 4E,
       | F). There are correlations between changes in the microbiome
       | (both specific taxa and functional gene categories) and the
       | changes in measured metabolite levels as well (Fig 5).
       | 
       | In figure 6, the researchers present their strongest data. The
       | researchers inoculate groups of germ-free mice with fecal samples
       | from the sucralose participants from either the baseline or end
       | of intervention. 4 groups of mice receive the feces of the top
       | 1-4 responders (most perturbed GTT), 3 groups receive feces from
       | the bottom 1-3 responders, and each of these is compared to a
       | group receiving baseline feces. The purpose of this test is to
       | see if the microbiome, altered by sucralose administration, can
       | cause impaired glucose tolerance in mice that have never been
       | exposed to sucralose. The researchers show that indeed there is
       | significant glucose-tolerance impairment in mice that receive
       | post-sucralose feeding feces, though interetingly they show that
       | both bottom- and top-responder feces causes this (Fig 6A, G).
       | They show that baseline samples from bottom- and top-responders
       | do not cause differences in glucose tolerance (Fig 8C), showing
       | that something about the sucralose treatment changes microbial
       | composition to promote glucose intolerance. The researchers
       | attempt to find a mechanistic explanation for the differences by
       | comparing groups of mice colonized with top- and bottom-responder
       | (grouped by baseline or end of intervention) feces.
       | 
       | Ultimately, this is an extremely impressive paper representing a
       | lot of work (and many storied I haven't recapped). Like many
       | microbiome papers, I think it oversells the mechanistic and
       | physiologically relevant aspects of the research.
       | 
       | 1. The data is presented in ways that maximize statistical
       | significance with very little reference to the scale of the
       | actual change. a. Fig 4 B-D and Fig 5 B, D, F show significant
       | metabolite differences but give no reference to actual changes in
       | blood concentration (also Fig 5 metabolites not significant after
       | FDR correction). Without isotope-dilution mass spectrometry
       | (which this is not), it's hard to tell how large the changes are
       | in the blood metabolites. The relationship between concentration
       | of a metabolite and measured area on a mass spec is a power
       | function (for different metabolites exponents can be less or
       | greater than 1), and so this data may represent a lot of change
       | in concentration or very little. In addition, the authors rely on
       | GTT differences to tell the story, but what is the scale of these
       | changes? It is not clear that there is physiological relevance to
       | this scale of change. b. Many of the metrics used are hard to
       | relate to physiologically relevant quantities and allow
       | researcher degrees of freedom. As an example Fig 3 ordinates the
       | participant samples using a principal components projection of
       | the microbial gene annotations. The loadings determining the
       | ordination - and selected for highlight are shown in Fig 3 G-J.
       | The researchers group several of these loadings into super
       | pathways (e.g. purine metabolism) but it's very hard to tell if
       | this kind of difference reflects a functional capacity change in
       | the microbiome (and certainly gives no data about the actual
       | transcription of these genes). Any of these groupings could be
       | highlighted, allowing a lot of flexibility in the storytelling
       | with no penalization for multiple hypotheses. c. Fig 8J "Spearman
       | correlation of sucrose degradation pathway fold change abundance
       | (day 21/baseline) with fold difference in GTT-AUC of each of the
       | conventionalized mouse groups." This is so far away from
       | physiology it's hard to say what it means.
       | 
       | 2. Both Eran Segal and Eran Elinav are co-founders of the company
       | DayTwo - a personalized microbiome company that helps diabetics
       | manage their symptoms with microbiome based analytics and
       | treatments. The paper feels like it explores the 'personalization
       | angle' and the expense of other mechanistic studies. For example,
       | the importance of osmolarity on the microbiome and how phenotypes
       | around osmostress might be contributing to the resulting host
       | phenotypes.
       | 
       | [1]
       | https://www.sciencedirect.com/science/article/pii/S009286741...
       | [2] https://www.nature.com/articles/nature13793?tdc_uid=921043
       | [3] https://foodinsight.org/everything-you-need-to-know-about-
       | su...
        
       | tejohnso wrote:
       | They indicate:
       | 
       | > Notably, all four tested NNS (saccharin, sucralose, aspartame,
       | and stevia) significantly and distinctly altered the human
       | intestinal and oral microbiome, as would be expected for these
       | chemically diverse compounds.
       | 
       | But also:
       | 
       | > Non-nutritive sweeteners (NNS) are commonly integrated into
       | human diet and presumed to be inert
       | 
       | So they are presumed to be inert, but also significantly alter
       | microbiome, _as would be expected_ since they are chemically
       | diverse compounds.
       | 
       | They indicate it should be obvious that they are not inert at the
       | same time as they are presumed to be inert? And if it's obvious
       | that they are not inert then why are there so many unanswered
       | questions while they're still allowed into our food system? Is it
       | unreasonable to expect that some newly popular food additive is
       | properly studied before it stats to gain massive adoption in
       | prepared foods?
        
         | Tagbert wrote:
         | The assertion of them being "inert" is probably in terms of
         | interaction with the human metabolism. That is likely what is
         | studied when deciding if a compound is safe for ingestion.
         | 
         | What you are calling out is the wider impact to our internal
         | ecology and that is s much more complex thing to measure and
         | something that we are only beginning to understand. There are
         | no regulatory frameworks that take that into account.
        
       | anjel wrote:
       | Just wondering why sugar alcohols like sorbitol and erythritol
       | were excluded from this study.
        
         | mirekrusin wrote:
         | ...or xylitol?
        
         | heisenbit wrote:
         | By messing with part of the fructose transport mechanisms sugar
         | alcohols are messing with the microbiome so likely would have
         | stood out. There is a reason at least here there are labels
         | warning of too much consumption.
        
           | anjel wrote:
           | Erythritol as a NNS is claimed/marketed not to effect the gut
           | biome, indeed to pass through the body unmetabolized.
        
             | ta988 wrote:
             | This is a bit more complicated, it is not really
             | metabolized but it does have a big impact because it is
             | absorbed by the gut and also change bacterial
             | populations... https://academic.oup.com/advances/article/10
             | /suppl_1/S31/530...
        
               | petra wrote:
               | According to the article in the link, erythritol doesn't
               | change bacterial populations.
        
             | dataangel wrote:
             | generally any alternative sugar that isn't metabolized by
             | you is metabolized by bacteria
        
       | vanilla-almond wrote:
       | I use stevia as a replacement for sugar. This research is
       | difficult to understand for a layperson like me (I'm too thick).
       | Is anyone able to answer the questions below?
       | 
       | ---
       | 
       |  _Extract_ : "non-nutritive sweeteners (NNS), such as saccharin,
       | sucralose, aspartame, acesulfame-K, and stevia, that do not
       | contain calories and are thereby presumed to be inert and not
       | elicit a postprandial glycemic response."
       | 
       |  _Question_ : Does this research confirm that stevia elicits a
       | postprandial glycemic response? (Does stevia stimulate insulin?).
       | 
       | ---
       | 
       |  _Extract_ : "Notably, all four tested NNS (saccharin, sucralose,
       | aspartame, and stevia) significantly and distinctly altered the
       | human intestinal and oral microbiome, as would be expected for
       | these chemically diverse compounds."
       | 
       |  _Extract_ : "Degradation of steviol glycosides by gut bacteria
       | is an established component of their metabolism although some
       | species may be more proficient than others in performing this
       | task and thus, pre-exposure microbiome heterogeneity may conduce
       | to differential responses to stevia."
       | 
       |  _Question_ : So stevia alters the human intestinal and oral
       | microbiome. Are these changes a negative outcome and thus a
       | concern for anyone using stevia?
        
         | clusterhacks wrote:
         | I just skimmed this study but other RCTs say no to your first
         | question:
         | 
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103435/#:~:tex...
         | .
         | 
         | You can go down a rabbit hole with the references in this paper
         | - I think a generally interested layperson is definitely
         | capable of understanding papers like this. My instinct is that
         | the hardest to understand papers are often actually so special-
         | area related that those papers don't contain useful information
         | except for researchers. So you can skip them.
         | 
         | Don't know about the second question and suspect no one else
         | does either.
         | 
         | As an aside - how did you manage that transition to stevia? I
         | _despise_ non-sugar sweeteners and can detect them in very
         | small amounts. For  "reasons" I don't eat meat and I supplement
         | protein intake with whey. If it wasn't for a small number of
         | high-quality unflavored (and thus lacking artificial
         | sweeteners) whey isolates I would probably re-introduce meat
         | into my diet.
        
           | vanilla-almond wrote:
           | Thank you for the answers. I didn't find it difficult to
           | transition to stevia. At first, it had a different taste from
           | sugar (not unpleasant, much sweeter) but I got used to the
           | taste. Some people find stevia has a bitter aftertaste. Lots
           | of stevia products are a mixture of stevia and erythritol
           | (like 'Truvia') to mask any bitter aftertaste. I use less
           | stevia than sugar (about half of the sugar amount).
        
             | mod wrote:
             | Are you using stevia in all places you would use sugar?
             | 
             | Are there any things/situations you can't use stevia for?
        
               | sillystuff wrote:
               | > Are there any things/situations you can't use stevia
               | for?
               | 
               | Unrefined ground dried stevia leaf can be quite bitter
               | depending on what it is mixed into. I find it works well
               | in baked goods like cinnamon rolls and corn bread, but
               | makes berry smoothies too bitter to drink.
               | 
               | The refined version is much less bitter-- e.g., it works
               | in berry smoothies (but, there is a very noticeable fake
               | sugar taste/after taste with smoothies).
               | 
               | In either case, mixing with a little regular sugar
               | (naturally occurring sugar content in e.g., berry
               | smoothies is sufficient), generally improves the favor.
               | 
               | And, stevia does not caramelize like sugar when cooked.
               | E.g., replacing most of the sugar in pancake/waffle
               | batter will result in pancakes/waffles that do not brown
               | when cooked.
        
               | vanilla-almond wrote:
               | Yes, I have replaced sugar completely with stevia. I have
               | tried different stevia brands and found them fairly
               | similar - they are a mixture of stevia blends with
               | erythritol.
               | 
               | I found one stevia brand with a 1:8 ratio (1g of stevia =
               | 8g of Sugar i.e. 1:8 ratio). Found that too sweet for me
               | and had a bitter aftertaste. I usually buy stevia with a
               | 1:2 ratio (i.e. 1g of stevia = 2g of Sugar).
               | 
               | I use stevia in tea and coffee. Have also used stevia
               | successfully to make cakes, cookies, and ice cream.
        
           | kekebo wrote:
           | Not OP but what did the trick for me was a combination of the
           | following sweeteners, listed from largest to least amount:
           | 
           | - erythritol (~0 calories, ~2/3s as sweet as sugar),
           | 
           | - xylitol (~60% of sugar calories, improves oral biome,
           | inhibits enamel demineralization),
           | 
           | - stevia or sucralose for added sweetness.
           | 
           | After experimenting with different ratios I now rarely crave
           | sugar at all anymore.
           | 
           | Another thing to consider is that the initial dopamine
           | response to sweeteners seems to generally be lower than with
           | sugar, but there are indications that this gap may lessen
           | with continued use over a matter of weeks (at least in mice
           | in a small number of studies). Andrew Huberman from Stanford
           | brought it up in a recent episode about nutrition:
           | https://hubermanlab.com/how-foods-and-nutrients-control-
           | our-...
        
             | temeritatis wrote:
             | I'd like to add monk fruit to that list. Usually you wanna
             | combine: (monk fruit OR stevia) + (erythritol OR xylitol)
             | to get a very nice flavor. Stevia or monk fruit on their
             | own are "flat" in sweetness but very strong. The xylitol or
             | erythritol gives some fullness, or body.
        
             | sillystuff wrote:
             | PSA: xylitol is extremely toxic for dogs.
             | 
             | https://pubmed.ncbi.nlm.nih.gov/20473849/
        
               | bigtex wrote:
               | Also it can give some people gastric problems. I don't
               | have an issue but know people who do.
        
               | bjelkeman-again wrote:
               | Gastric problems to me, in other words are, a problem for
               | my intestinal microbiome which my health depends on.
        
         | kekebo wrote:
         | [Disclaimer: Not a doctor or nutrition expert]
         | 
         | From what I've read about postprandial glucose levels, the
         | question seems less about _whether or not_ something elicits a
         | glycemic response, but by how much and how that compares to
         | glucose /fructose.
         | 
         | Another useful measure would be comparing satiation after
         | consumption of sugar vs non-caloric sweeteners, to determine if
         | the significant drop in calories leads to more food ingested
         | overall.
         | 
         | Stevia in particular seems to be one of the lesser studied
         | sweeteners, based on a handful of papers postprandial glucose
         | levels doesn't seem to differ a lot compared to sugar. But
         | there seem to be somewhat consistent findings that satiety
         | levels remain largely the same given the same mass of ingested
         | food ( e.g. [0][1]).
         | 
         | To your second question, from my view the understanding of the
         | human microbiome is still rather poor, especially in terms of
         | health implications on various physiological systems (including
         | neurological), optimal composition and applicable ways to
         | maintain it. Although the last time I checked was probably 1-2
         | years ago, if anyone is aware of useful new data here I would
         | welcome a link.
         | 
         | [0] https://sci-hub.ee/10.3390/nu11123036
         | 
         | [1] https://sci-
         | hub.ee/https://www.sciencedirect.com/science/art...
        
           | TheSpiceIsLife wrote:
           | I'd argue both those studies are insufficient to come to any
           | conclusions because people do not exist for only one day, and
           | they do not exist in only a healthy state.
           | 
           | A healthy subject, say in their mid twenties, should be able
           | to consume 60g glucose almost instantaneously and have little
           | to no affect on blood glucose. That same subject, if they
           | were to repeatedly do that, multiple times a day, for four
           | decades, is highly likely to have Type 2 diabetes and a heart
           | condition, also likely to have a kidney condition, peripheral
           | neuropathy, macular degeneration, etc take your pick.
           | 
           | The interesting question is what are the long term effects.
           | There are no positive outcomes for a long term high sugar
           | content diet, and _I argue_ that taking any one plant
           | derived, or synthetic chemical, concentrating it and
           | consuming it, is either nutritively, or medically,
           | beneficial, or, if not beneficial, will work, at least to
           | some extent, to tax the body by making healthy homeostatic
           | more difficult.
           | 
           | As an aside, and this isn't directed at you in particular,
           | but at the HN community, if such a thing can be said to
           | exist, more broadly: _frameworks_.
           | 
           | What frameworks exist within which do make sense of
           | nutritional / health information. How are we to live? What
           | are some (any?) of these frameworks, and where should we go
           | to read about them?
        
             | xorcist wrote:
             | It's a baffling thought that so much research is spent on
             | which _type_ of sugar water might cause the least amount of
             | bad long term effects.
             | 
             | It's not like there is any medical need for the body to
             | consume sugar water at all.
             | 
             | As recreation, sure, but doing something daily is routine,
             | not recreation. That last part is the strange bit. Consume
             | it every tenth meal and you can pick any type of sugar, an
             | otherwise healthy individual would suffer no long term
             | effects. Consume it every meal and you will.
             | 
             | As a though experiment, it would be interesting to think
             | about how much research would be made into finding out
             | which alcohol we could ingest 50 g of to every meal while
             | minimizing long term damage.
        
             | kekebo wrote:
             | It's good you point that out. Two studies should almost
             | never sufficient for a conclusive argument, especially not
             | in a field where physiological variability may be more
             | decisive than probability distributions derived from group
             | studies (On average peanuts don't kill people but that's
             | not a useful metric if you happen to be allergic).
             | 
             | In terms of informational frameworks regarding nutrition I
             | have to say the landscape is quite bleak. Understanding
             | broccoli or its effects on the human body make big pharma
             | no money, publications are only slowly picking up speed
             | with new (crowd-) funding options. Even worse, the lack of
             | funding and publishing set a rather low barrier for food
             | industry players to manipulate the field in their favor,
             | which makes for even less solid ground (e.g.
             | https://www.nytimes.com/2016/09/13/well/eat/how-the-sugar-
             | in... ).
             | 
             | But there are exceptions, Rhonda Patrick comes to mind,
             | she's mostly or fully crowdfunded, including her papers
             | iirc. She can go very deep but is usually aimed at non
             | specialists:
             | https://www.youtube.com/c/FoundMyFitness/videos
             | 
             | And Andrew Huberman who finances his podcast through
             | sponsors, quite dense but always trying to explain medical
             | terms and concepts he brings up:
             | https://www.youtube.com/c/AndrewHubermanLab
             | 
             | As for "how are we to live" I think a good starting point
             | nutritionally is to try and watch/feel the body reacting to
             | different foods and maybe reading up after something feels
             | really good or bad to maybe gain some theoretical insights.
             | There are no studies for your body in particular but you
             | have full production test access pretty much all of the
             | time (I would try to prevent restarts though).
        
           | vanilla-almond wrote:
           | Thank you for the links. I agree, it would be really useful
           | to see more research. Newer products likes monkfruit
           | sweetener and allulose have even less research.
        
         | 41b696ef1113 wrote:
         | While it does not address the root question, one benefit of
         | sugar substitutes is that they are many times sweeter than
         | sugar: stevia is 200-300x sweeter, resulting in less total mass
         | consumed. My hopelessly-naive-because-biology thought is that
         | each molecule would be metabolized a single time (by your own
         | liver or your microbiome), resulting in less total impact on
         | your body.
        
           | vanilla-almond wrote:
           | I also find using less stevia than the equivalent sugar
           | amount. I still have a sweet tooth but I don't buy sweet
           | foods (make my own sweet foods with stevia).
        
         | hedora wrote:
         | Not answering your questions directly, but it has been known
         | for decades that fake sugars (NNS in the abstract) cause weight
         | gain.
         | 
         | Since you asked about insulin response; (some?) artificial
         | sweeteners seem to be safe for diabetics. There is no other
         | group of people I can think of that should consider using these
         | products.
         | 
         | On a somewhat related note, the soft drink industry has
         | replaced some "diet" drinks with "light" versions that contain
         | sugar and NNS.
         | 
         | I've found that this causes (intentional?) confusion,
         | especially at restaurants, and multiple servers have
         | inadvertently tried to serve our kids that stuff when we
         | ordered things like "lemonade".
         | 
         | In addition to all the above, consuming NNS causes migraines
         | for some people, and they interact badly with some medications.
         | I disagree with the abstract's use of the term "presumed
         | inert", but I suppose they are trying to be diplomatic.
        
       | api wrote:
       | A glance suggests that Saccharine and Sucralose may be
       | problematic. The others may be "complicated" but the effect also
       | looks close to noise. They should have included some non-
       | sweetener molecules of a similar nature as controls.
       | 
       | Sucralose was an instant no to me when I saw the molecule. "Here
       | let's hang a chlorine off this here sugar." Nope. I recall seeing
       | similar sentiments in a thread over at Reddit where a biochemist
       | remarked that it looked like a pesticide.
       | 
       | The weird complicated molecules in Stevia and Monk Fruit seem
       | safe precisely because they look like something the body is going
       | to hack apart right away and look like all the other complicated
       | molecules found in plants that the body is used to dealing with.
       | Things like blueberries and onions are just loaded with random
       | baroque carbon sculptures like this.
        
         | GekkePrutser wrote:
         | Hmm,"let's hang a chlorine of this here sodium" seems to work
         | out pretty well for us in moderation. I guess it's all about
         | the molecule's properties.
        
         | ta988 wrote:
         | you can't just read a molecule and say "oh it looks like
         | something safe". Digitalin and the cardiac glycosides [1a,1b]
         | may look like completely innocuous compounds (just have to
         | remove a group and they are inactive). Some hormones look like
         | cholesterol. Some steroisomers [2] (think of it as just
         | changing the order atoms are connected in space but not what
         | they are connected to) of molecules kill you while some other
         | forms are safe and that's even harder to grasp on a 2d
         | representation of the structure.
         | 
         | [1a] https://en.m.wikipedia.org/wiki/Cardiac_glycoside
         | 
         | [1b] https://en.m.wikipedia.org/wiki/Steroid
         | 
         | [2] https://en.m.wikipedia.org/wiki/Enantiopure_drug
        
         | matheusmoreira wrote:
         | The presence of chlorine does not necessarily imply toxicity.
         | Widely used medications like sertraline and loratadine have
         | chlorine atoms.
        
         | balderdash wrote:
         | As someone that is relying on a single high school chemistry
         | class as a base of knowledge, why would Cl here give you pause?
         | In other words why is the Cl here bad, but ok in say salt?
        
           | refurb wrote:
           | Alkyl halides (carbon chains with halogens off of them) can
           | be alkylating agents - basically they can bond to molecules
           | within your body and if it's things like DNA, can cause
           | mutations and other bad stuff.
           | 
           | Nitrogen mustards (highly reactive alkyl halides) are used in
           | chemotherapy. They basically damage DNA which is used to kill
           | off fast reproducing cancer cells (but they also kill off
           | normal cells).
           | 
           | I was a little surprised when I first saw the structure of
           | sucralose. Chlorides aren't that reactive (bromides and
           | iodides are much more reactive), but a person might consume
           | grams of sucralose so concentrations are high.
           | 
           | That said, many experiments have been done and sucralose
           | isn't reactive at all. Due to the shape of the molecule and
           | steric interactions, the chlorines are very difficult to
           | knock off.
           | 
           | I wouldn't be concerned with taking it.
        
           | hinoki wrote:
           | As another person with only high school chemistry, sucralose
           | does look a bit like DDT.
           | 
           | https://en.m.wikipedia.org/wiki/DDT
           | https://en.m.wikipedia.org/wiki/Sucralose
        
             | simias wrote:
             | Am I supposed to find that this https://upload.wikimedia.or
             | g/wikipedia/commons/e/e9/Sucralos... looks like this https:
             | //upload.wikimedia.org/wikipedia/commons/0/0b/P%2Cp%27... ?
             | 
             | Because I'm not seeing it.
        
             | photochemsyn wrote:
             | The fundamental difference is between the sugar ring
             | (flexible, which each carbon having tetrahedral geometry,
             | and localized electron density) and the aromatic benzene
             | ring (flat trigonal geometry, with electrons delocalized
             | over the ring).
             | 
             | If you attach chlorine to the latter, you end up with
             | something that's very hard to break down (very persistent)
             | and which will often (depending on exact structure) stick
             | tightly to many biological molecules. Thus they can cause
             | developmental disruption, odd forms of cancer, liver
             | damage, etc. For example, TCDD (dioxin, a side product of
             | many herbicide synthesis routes, a notorious component of
             | Agent Orange formulations in Vietnam, etc.):
             | 
             | https://en.wikipedia.org/wiki/2,3,7,8-Tetrachlorodibenzodio
             | x...
             | 
             | The chlorinated sugar ring is probably easier to break down
             | but if this produces an activated chlorine species during
             | metabolism, say in your liver, it might bind to who-knows-
             | what and cause problems. Or it might just get excreted as a
             | chlorine ion, no different from NaCl (table salt). I'd
             | avoid it myself.
             | 
             | Some organo-chlorines (and -bromines) also occur in small
             | amounts in many edible seaweeds, apparently often with the
             | halide attached to fatty acids and lipids. Hence consuming
             | large amounts of seaweed might not be the best idea either.
        
             | kortex wrote:
             | In the grand scheme of molecules, they look nothing alike.
             | 
             | DDT is what we call a "greasy brick", while sucralose is a
             | highly water soluble sugar.
        
             | FollowingTheDao wrote:
             | I saw someone who looked like my brother. But it was not my
             | brother.
        
           | kortex wrote:
           | Chlorine-carbon (or halocarbons in general) bonds are
           | somewhat rare in nature. That is not to say they don't exist,
           | but they are a bit unusual. The problem with halocarbons
           | (aside from fluorine, which has its own issues) is they are
           | generally not very reactive, so they can bioaccumulate. But
           | when they do react with biological systems, it tends to be in
           | unwanted and toxic ways.
           | 
           | That said, as a former chemist, I consume sucralose, and I am
           | not worried by it. Unlike most halocarbons, It's very water
           | soluble, so it does not react in the ways the bad halocarbons
           | do.
        
           | adrian_b wrote:
           | In salts and in sea water, the chlorine is in the form of
           | free chloride ions, which is also the normal form of chlorine
           | in your body.
           | 
           | In sucralose, chlorine substitutes a hydroxy group and it is
           | covalently bonded to a carbon atom.
           | 
           | Most of the organic substances where hydroxy groups are
           | substituted with chlorine atoms are more or less toxic and
           | some are carcinogenic.
           | 
           | For example, substituting the hydroxy groups in carbonic acid
           | with chlorine yields the toxic phosgene, which has been used
           | as a chemical weapon in WWI.
        
             | naasking wrote:
             | > Most of the organic substances where hydroxy groups are
             | substituted with chlorine atoms are more or less toxic and
             | some are carcinogenic.
             | 
             | This kind of argument is so... "weird" to put it politely.
             | H2O also becomes toxic if you add an oxygen atom. The
             | safety of chemical compounds does not follow from a naive
             | classification of bonds.
        
               | dataangel wrote:
               | It's a heuristic. If you haven't done a randomized
               | placebo controlled double blind exhaustive study of the
               | compound and all you have to go on is the layout of the
               | molecule, is it a bad guess?
        
               | naasking wrote:
               | > If [...] all you have to go on is the layout of the
               | molecule, is it a bad guess?
               | 
               | Yes, almost certainly. Like I pointed out, one atom is
               | the difference between a toxin and water.
        
               | parineum wrote:
               | Guess all you want I suppose but there are fairly
               | exhaustive studies on artificial sweeteners.
        
         | naasking wrote:
         | > Sucralose was an instant no to me when I saw the molecule.
         | "Here let's hang a chlorine off this here sugar." Nope. I
         | recall seeing similar sentiments in a thread over at Reddit
         | where a biochemist remarked that it looked like a pesticide.
         | 
         | If you could infer the properties of a compound by making vague
         | analogies to other similar looking molecules, chemistry would
         | be easy. Changing a single atom can completely change the
         | safety properties of a compound, ie. H2O->H2O2, Hg2Cl2->HgCl2.
         | 
         | > The weird complicated molecules in Stevia and Monk Fruit seem
         | safe precisely because they look like something the body is
         | going to hack apart right away and look like all the other
         | complicated molecules found in plants that the body is used to
         | dealing with.
         | 
         | Yeah, like the atropa belladonna, the deadly nightshade? I'm
         | sure that's chock full of "baroque carbon sculptures". Maybe
         | biochemistry just isn't so easy.
        
         | seanhandley wrote:
         | Isn't bleach just a water molecule with an extra oxygen atom?
         | I'm not a chemist but I didn't think you could make assumptions
         | about the effect of a substance in the way you describe. Am I
         | missing something?
        
           | SAI_Peregrinus wrote:
           | Hydrogen peroxide is H2O2 (SMILES `OO`).
           | 
           | "Bleach" can refer to any chemical that makes things whiter.
           | Common laundry bleach is usually a chlorine bleach, most
           | often Sodium Hypochlorite (NaClO, SMILES `[Na+].[O-]Cl`).
           | 
           | There are a bunch of other bleaches[1].
           | 
           | [1] https://en.wikipedia.org/wiki/Bleach
        
         | FollowingTheDao wrote:
         | Everyone always with this "noise"! Of course there is noise!
         | They are looking at the "noise" and telling you what it is
         | from! Genetics!
         | 
         | If you average any trial out in a large population there will
         | be "noise", but these people who live with the "noise" are the
         | ones affected and suffering.
         | 
         | Does everyone have microbiome-driven effects of non-nutritive
         | sweeteners? Probably not, but what about the ones that do?
        
           | mlyle wrote:
           | > If you average any trial out in a large population there
           | will be "noise", but these people who live with the "noise"
           | are the ones affected and suffering.
           | 
           | If you do a trial in a large population of a drug, device, or
           | clinical practice that does _nothing_ - a perfect placebo-
           | you'll see a variety of effects: statistical noise.
           | 
           | If you do a trial in a large population of a drug, device, or
           | clinical practice that has an effect-- you'll measure that
           | effect, plus the statistical noise.
           | 
           | You can't generally tell for any individual whether the drug
           | helped or hurt. But you can tell that more people did well
           | (or badly) in group A than group B.
           | 
           | You can't even really know exactly how big the effect is
           | precisely: just a range of likely effect sizes.
           | 
           | The more things you try to measure to more precisely zero in
           | on an effect, the greater the chance that statistical noise
           | spuriously makes one of these look important (and the larger
           | the effect must be to be reliably measured).
           | https://xkcd.com/882/
        
             | FollowingTheDao wrote:
             | > You can't generally tell for any individual whether the
             | drug helped or hurt. But you can tell that more people did
             | well (or badly) in group A than group B.
             | 
             | That is what they found in this study, but the OP said it
             | was likely "noise" and had no scientific basis for saying
             | that. My point; saying something is "noise" is a way to
             | look cool on HN and dismiss any finding that does not fit
             | your world view.
        
               | mlyle wrote:
               | > That is what they found in this study, but the OP said
               | it was likely "noise" and had no scientific basis for
               | saying that.
               | 
               | It's a small finding in both effect size and statistical
               | significance, and prior probabilities count.
               | 
               | Barely statistically significant findings don't change my
               | beliefs much, because the base rate and prior knowledge
               | matter.
               | 
               | E.g. if you show me a p<0.05 finding that ESP exists, I'm
               | going to dismiss it as statistical noise-- even if the
               | study methodology is perfect it's only 10-20x more likely
               | that ESP works than before, and 20x my prior belief of
               | very near 0 is still very near 0.
               | 
               | If you show me a p<0.05 finding that green jelly beans
               | cause acne, after studying all colors-- I don't care at
               | all.
               | 
               | Here, the commenter you replied to-- api-- suggested that
               | the study clearly indicates that there's reason to be
               | concerned about saccharine and sucralose. It raises a
               | general level of concern about other NNS's, but the data
               | is ambiguous and weak. This is a reasonable reading of
               | the study.
        
           | simias wrote:
           | If you manage to model the "noise" and make it somewhat
           | deterministic then it's not noise any more. If genetic
           | variations really are the reason for these variations and
           | some people are indeed measurably harmed by these compounds
           | then it would be a very interesting and somewhat alarming
           | result, but that's not what the study says or what we can
           | conclude from it.
        
             | FollowingTheDao wrote:
             | > If you manage to model the "noise" and make it somewhat
             | deterministic then it's not noise any more.
             | 
             | Yes. That is called doing science.
             | 
             | > If genetic variations really are the reason for these
             | variations and some people are indeed measurably harmed by
             | these compounds then it would be a very interesting and
             | somewhat alarming result, but that's not what the study
             | says or what we can conclude from it.
             | 
             | What would make me not think that? Maybe we should
             | investigate it. That is also called science. Saying
             | anything is noise only disregards the response of that part
             | of the sample as useless. It is not useless.
             | 
             | It is why some of us are more sensitive to to certain
             | diets: https://www.chop.edu/conditions-
             | diseases/carbohydrate-malabs...
        
               | parineum wrote:
               | You know what isn't science? Not doing any of that and
               | just going off on a study that's led to more questions
               | (aka, science) in the comments of Hacker News.
               | 
               | Their study had a scope, they did the study and found
               | some results then drew some conclusions. They also found
               | the study wasn't large enough to draw all conclusions
               | because of noise, something they didn't know before the
               | study.
               | 
               | > Saying anything is noise only disregards...
               | 
               | Saying something is noise indicates that the data isn't
               | clear enough to draw a conclusion and more specific and
               | targeted studies are needed to draw said conclusion.
               | 
               | It certainly doesn't mean that they're ignoring the
               | plight of... you.
        
               | FollowingTheDao wrote:
               | I was commenting on how the original commenter was using
               | the term noise. Not how scientists use it.
               | 
               | Listen, the term noise is probably the worst term for
               | this data. Because we don't know if it's noise until we
               | examine to see if it is noise. So until we know it's
               | noise we can't call it noise. It's like you're walking
               | into a crowded room and you're trying to hear one thing
               | but there is too much "noise". This assumes we know what
               | we're looking for in the first place.
        
           | TaupeRanger wrote:
           | Yikes. When someone makes a comment about "noise" in this
           | context, they simply mean "we can't tell whether the effect
           | observed is due to the thing we're measuring". You'd need a
           | much larger study with totally different design to even begin
           | to approach the question of "do non-nutritive sweeteners make
           | peoples' lives worse or shorten their lives compared to
           | whatever else they might be ingesting". No need for the
           | confrontational angle.
        
             | FollowingTheDao wrote:
             | > You'd need a much larger study with totally different
             | design to even begin to approach the question
             | 
             | Yes, that is my point. As the OP remarked; "The others may
             | be "complicated" but the effect also looks close to noise.
             | " is disregarding that data.
             | 
             | When one thinks of the word "noise" one hears something
             | that bothers them, like "there is too much noise in here".
             | This is the problem with research. By getting rid of the
             | "noise" they will only zero in to the thing they wish to
             | hear clearly.
        
         | stjohnswarts wrote:
         | does hanging a chloride off of sodium scare you as well? sodium
         | alone scares me a lot more...
        
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