Artificial Fear

A short story

As most of my readers know by now, much of my interest in health and nutrition stems from my past employment with General Nutrition Center. For roughly 8 years I worked in a retail store that promoted a healthy lifestyle through the aid of mostly questionable advice and supplemental products. In due time I came to realize just how dubious the claims of many of GNC's products were, and ultimately made the decision to get out of that industry completely (unfortunately, only to find myself in the evermore sleazy industry of corporate dentistry...but that story is for another time). Despite GNC's constant peddling of bogus claims and alternative medicine, there were still plenty of customers coming through the door everyday who could somehow always find a way to one-up the bullshit we were selling .

One encounter that I remember quite vividly was really rather short and benign, but it left a lasting impression on my mind about the food and nutrition 'truths' that many people believe without a second thought. As a sales associate my job was to sell, and one great way to get a product in to a customer's basket is to provide them a free sample. With that said,  I was expected to offer different samples to every customer that walked through the door, depending on what was the spotlight product at the time. Featured in this particular instance was a chewable calcium and vitamin D supplement that GNC was promoting as a part of their newest women's health line.

One of the few people who actually accepted one of my free samples was a young woman wearing medical scrubs and looking for a multivitamin. She commented that the chew was very good, and we continued to talk about her options for a multivitamin. At the register (where we kept the actual product) I made sure to mention that we had the chews she had just enjoyed on sale. She had another sample and said, "These things are too good to actually be good for you," then proceeded to pick up a bag and read the ingredient list. After a short review she smiled and said, "I knew it! You guys put sucralose in these." She then dropped the bag on the counter and began to lecture me about how she could not believe that a store dedicated to being healthy would put something as "dangerous" as sucralose - or any other artificial sweetener - in its products.

Now, working in retail you get used to this kind of self-righteous behavior from customers, but something about this incident in particular stuck in my head to this day. I had heard plenty of complaints and off-the-wall claims about artificial sweeteners before, but many of them have always been very weak, citing dismissed studies on rats or correlation studies, if they cite anything at all. This particular customer was bold enough to cite herself. "As a nurse", she claimed that she knew that sucralose causes dementia and stated should would not let anyone of her friends or family ever come near the stuff. Her argument from authority ensured there would be no need for further debate, and she completed her purchase and left.

As I said before, this incident was not out of the ordinary for my typical day working in the health and wellness field, but I am continually reminded of it anytime I come across some social media, health and fitness guru promoting any type of 'natural' alternatives for dieting. At the base of many anti-artificial sweetener claims is the idea that simply being 'unnatural' is enough to warrant absolute avoidance. I will get back to the fallacy of this argument later, but for now let's just go through a very brief review of the most common artificial sweeteners on the market today and the common claims against them.

Sucralose

Since my opening story revolved around sucralose, lets start there. Sucralose is one of the most commonly used artificial sweeteners available, found in thousands of products and sold as a stand-alone ingredient known as Splenda. Sucralose is derived from natural sugar, undergoing a process that ultimately makes it up to 700 times sweeter than sugar while simultaneously contributing no dietary calories. Due to the fact that it has less of a bitter aftertaste than some other artificial sweeteners, it is a common ingredient in diet sodas especially. Its prevalence in that market has made it an easy target for anti-artificial naysayers with claims that it has been linked to dementia and even shrinking of the brain.

What is true it that the consumption of diet soda in general has shown to have a correlative link to a heightened risk of the onset of dementia in some individuals. What is not true is that the consumption of diet soda or sucralose have been shown to cause this increase in risk. The studies suggesting such a link are a perfect example of how correlation does not necessarily mean causation. In fact, all attempts to establish a cause-and-effect relationship between sucralose and dementia have returned negative results. Similar claims regarding sucralose and increased cancer risk have been made, however with over 100 peer-reviewed, scientific studies demonstrating its safety, it seems that the FDA has got it right with approving sucralose for regular consumption.

Aspartame

Next on the list is another commonly vilified artificial sweetener - aspartame. Aspartame is about 200 times sweeter than table sugar, and does yield some dietary calories. However, because of the extremely low quantity needed to improve flavor, the calories consumed from aspartame are negligible. Since its inception aspartame has been the target of numerous negative claims, many of which originated from conspiracy theories promulgated by email messages claiming to link aspartame to everything from multiple sclerosis, to seizures and depression, and even death (for more on conspiratorial thinking in alternative medicine click here).

Despite such claims, aspartame - one of the most rigorously tested food ingredients in the United States - has not been linked to any major adverse events among those who consume it regularly, with one exception. Among those who have been diagnosed with phenylketonuria (PKU), aspartame can be potentially hazardous. Due to aspartame's higher levels of the essential amino acid phenylalanine, those with PKU have to be aware and cautious regarding their consumption of the ingredient. PKU affects the body's ability to properly metabolize phenylalanine and adverse reactions can occur if someone who is diagnosed ingests high levels of aspartame.

Aside from the risks to phenylketonurics, aspartame has been shown time and time again to be safe for regular consumption by the general population. As with other artificial sweeteners, much of the claims against aspartame are either backed with a small number of questionable studies, or not at all, with anti-aspartame advocates often falling back on the 'everybody knows it's bad for you', argumentum ad populum.

Saccharin

Though not quite as prevalent as sucralose or aspartame, saccharin has been another common enemy of the anti-artificial crowd. Saccharin's popularity was a product of war-time rationing during the first and second world wars. However, in the 1970s the FDA actually considered banning the substance outright after a single study surfaced linking it to bladder cancer in rats. For some time, saccharin-containing products actually even carried a warning label stating that the product may be hazardous to one's health, and that it had been shown to cause cancer in laboratory animals.

Further research, however, has proven that saccharin is generally safe for human consumption on a regular basis, and epidemiological studies show no link or associations with cancer in humans. As for the rats, it was discovered that male rats actually have a particular pH factor that contributes to a predisposition to developing bladder cancer. Despite this later discovery, the rat study is still often cited by those attempting to demonize saccharin, as well as other artificial sweeteners in general.

Where does the fear come from?

While the initial attacks on aspartame in particular demonstrate the influence that conspiracy theories can have over the way people think about health, there is a more prominent and recurring theme among nearly all of the criticisms of artificial sweeteners: It's simply not natural. This type of argument is known in the skeptic community as the 'appeal to nature' fallacy, and it is a favorite tactic of many of the health and fitness gurus mentioned above. Common buzzwords employed by these personalities include 'organic' and 'all natural', and their rhetoric tends to disparage anything man-made as not being 'real food', while offering little to nothing in the way of a coherent and useful definition of such terms.

Even if we decide to ignore the particulars and accept the most general, common sense definitions of what is natural and what is artificial, the premise of the appeal to nature argument is fallacious in itself. Just because a substance occurs in nature does not make it unquestionably safe to eat. In contrast, just because something is man-made does not automatically render it harmful for ingestion. Regarding health and toxicity specifically, Dr. Bruce Ames of UC Berkeley has conducted research finding that "...in high-dose tests, a high proportion of both natural and synthetic chemicals are carcinogens, mutagens, teratogens, and clastogens". Furthermore, Dr. Ames writes, "Several chemicals that have been shown to be carcinogens at high doses in rodents have also been shown to be anticarcinogens in other animal models at lower doses [emphasis added]". Dr. Ames, and countless other scientists, have regularly pointed out that all chemicals - natural and synthetic - can be toxic. It is not the substance that is toxic, but the 'dose makes the poison'.

Final thoughts

Artificial sweeteners have their place in the average person's diet, especially with the rising rates of obesity, diabetes, and other illness related to the over-consumption of sugar. Still, opting for a Diet Coke so you can still enjoy and extra piece of cake can easily be counterproductive. This may be why there is little research positively linking diet soda consumption with weight loss. Nevertheless, if one is content on keeping their sugar intake low, they should not be inundated with fear-mongering and food-shaming because they opt to use an artificial alternative.

Finally, as with any other food, there can and will always be the possibility of adverse reactions associated with some individuals. Everyone's biochemistry and DNA are a little different, and for some, that extra packet of Sweet'N Low might bring on unwanted side effects (headaches, nausea, etc.) However, when discussing the general safety of artificial sweeteners as a whole and for the general population, there is no strong evidence to support any of the common claims purported by the dogmatic, anti-artificial tribe.

More Added Sugar Confusion

The last post I made here back in 2016 (just before my 2 year hiatus to finish grad school) was titled "Added Sugar, or Added Confusion?", and was an argument against the FDA's newly imposed changes to the 'Nutrition Facts' labels on foods in the United States.  The two major changes that have been made include increasing the overall size of the calories per serving, and the inclusion of a new line item disclosing the amount of 'added sugars' underneath the 'total sugars' listing.  As stated in the aforementioned post, there's nothing inherently bad about providing more information.  My concerns stemmed from the politics of the decision and the ambiguity of terms such as "added sugar".

Little to my surprise, those concerns have surfaced in my news feed in the form of an article over at The New Food Economy entitled, "The FDA's Great Maple Syrup Fiasco".  According to the article, the FDA recently made a decision to require that maple syrup products contain the 'added sugar' label, despite the fact that adding sugar to maple syrup is actually prohibited by federal law.  Clearly, this would not merely be confusing for consumers, but would actually be misleading (or not - depending on how you look at it - read the full article, and decide for yourself).

The confusion around how to properly label maple syrup stems from the FDA's lack of a clear definition of what exactly constitutes 'added sugar'.  From the article:

"Basically, FDA is trying to define added sugar as both sugar that has been added to your food and sugar that you might add to your food later—though at the moment you buy it, it hasn’t been added. When you look at a package of Rice Krispies Treats and read on the nutritional facts panel that a bar has 8 grams of total sugar including 8 grams of added sugar, you will conclude that 8 grams of sugar has been added to the product, and you will be correct. When you read that your maple syrup has 54 grams of sugar per 60 milliliters of syrup, including 54 grams of added sugar, you might reasonably conclude that 54 grams of sugar has been added to the syrup. And, of course, you’d be wrong."

The article goes on to explain that what the FDA's original intent appears to be was to help consumer identify "sneaky sugars", and in turn make smart decisions that prevent over-consumption.  Unfortunately, it is too subjective to define and label "sneaky sugars" and so the FDA was forced to work with what it had - namely, 'added sugars'.  To further illustrate the absurdities contained within the FDA's arbitrary definition of 'added sugars', the goes on to explain that:

"The federal standards of identity for jelly include added sugar. You can’t call a product jelly if it doesn’t have added sugar. So the sugar added to jelly doesn’t count as added sugar. Savor that for a moment: Jelly has to have added sugar, so it doesn’t have to declare any added sugar; maple syrup isn’t allowed to have added sugar, so it has to declare its entire content as added sugar."

So what's the takeaway here?  Simply put, the FDA's attempt to inform the public of what foods contain sneaky, excessive, added sugars is falling flat on its face.  It seems that money and time might have been better spent on actually educating the public on how to make informed decisions on their overall sugar consumption, rather than targeting a boogeyman buzzword.

Added sugar, or added confusion?

Everywhere I turn these days people are discussing food labels.  The FDA recently toyed with the ideas of defining what foods should or shouldn't be labeled as "natural", numerous organizations are still pushing for mandatory GMO labeling, and one poll even showed that 80% of Americans believe that foods containing DNA should be labeled.  In the midst of all of this debate about such arbitrary labels, one labeling change has been made official, and will be hitting our shelves soon.  The change I am writing about here is the revamped nutrition information label required on all food sold in the US.

Overall, the new design is nothing too alarming.  The two major changes are that the 'calories per serving' number will be noticeably larger and bolded, and beneath the 'sugar' line there will be a new line listing the total number of 'added sugars'.  At first glance the second change noted above seems like nothing more than a friendly reminder to keep track of your sugar intake.  However, when viewed in the context of the aforementioned labeling debates, it seems to be more of a win for the fear-mongering 'natural' and 'organic' marketers than a win for the American public.

My two biggest concerns regarding the 'added sugars' line come from the lack of knowledge most people have about sugar, and the misguided demonization of sugar by food-bloggers such as the "Food Babe", Vani Hari.  What's worse is that misinformation is rather abundant online, and more and more people are resorting to the internet to confirm what they already believe (right or wrong) about health and nutrition.

'Added sugar' has become a buzzword for the all-natural crowd.  Arguments against added sugar hinge on the premise that added sugar is somehow absorbed differently by the body, and this difference in absorption is directly related to increased incidences of obesity and type II diabetes.  Though no evidence has been found directly tying added sugar specifically to either one of these diseases, an overall increase of sugar consumption in general is widely understood as a contributing factor to both (this link is abundantly clear in the case of type II diabetes, and although sugar may not be the only contributing factor to obesity, it certainly is a component).

Too much sugar - either naturally occurring or added by a manufacturer - is not good, and the CDC has recommended that Americans keep their percentage of calories from sugar at or below 10%.  Unfortunately, the problem I've run in to numerous times online is that this 10% limit is often cited as pertaining only to added sugars, leaving the limit for sugar in general up to interpretation by readers.  By singling out added sugars on nutrition labels, shoppers may be inclined to ignore the total sugar content of any given product, and over-consume foods loaded with still unhealthy amounts of natural sugar, all because they feel good about the fact that at least they're not taking in those evil 'added sugars'.

This problem could easily be exacerbated when manufacturers look for loopholes, such as simply replacing added sugars with other ingredients high in naturally occurring sugars, and thus are able to continue producing sweet tasting foods with little change to the overall sugar and calorie content.  By making virtually no change to the end product, manufacturers will still find a way to slap a "no added sugars" label on their package and entice consumers to choose their seemingly 'healthier' option over their competitors.

But the biggest problem here is that by including the 'added sugars' on the nutrition information label, you are implying to consumers that the added sugar is somehow different than the naturally occurring sugars.  This is right in line with the arguments for labeling foods containing GMOs, where there is no real difference to the consumer, but the labeling acts as a way to stigmatize certain products.  Yet, in the end, sugar is sugar.  One gram of sugar (or any carb) is four calories, regardless of its source.  All sugars are processed in the body much quicker than other complex carbs, and excess consumption coupled with lack of exercise can lead to weight gain and diabetes.  But sugar is also a necessary nutrient for healthy brain and nervous system funtion.  It would be much more beneficial to stick to the original labels, and focus efforts on better nutrition education in general to combat the plethora of misinformation available through popular media.