In this short health talk, Dr. David Perlmutter challenges the common recommendation to replace sugar‑sweetened drinks with diet beverages. He reviews two major epidemiological studies: a 2008 Obesity journal analysis of 3,682 adults over eight years that found a dose‑response relationship between the number of artificially sweetened beverages consumed and long‑term weight gain, and a French cohort of over 66,000 women followed for 14 years that showed a higher risk of type‑2 diabetes among artificial‑sweetener drinkers compared to sugar‑drink consumers. Perlmutter then presents a mechanistic hypothesis from Israeli researchers suggesting that non‑caloric sweeteners alter the gut microbiome, potentially driving the obesity and diabetes epidemics they were meant to combat. He concludes with a vintage “Chiffon” margarine commercial that warns, “It’s not nice to fool Mother Nature,” using it as a metaphor for the unintended consequences of artificial sweeteners. The talk blends data presentation, mechanistic speculation, and a cautionary narrative.
Chapters
Hello, I'm Dr. David Perlmutter. You know, with all this talk about sugar and carbs and avoiding sugars being so important for health, you know, you might think that, well, then maybe this is a call for all of us to be jumping on the artificial sweetener bandwagon. And I'm just going to tell you that that's not what you want to do. There is no free ride. We're seeing a lot of literature that challenges the wisdom of this notion that we should be using artificial sweeteners. Let's take a look. So, of course, this is what we're told to do if you don't want to drink a sugar-sweetened beverage. You're told to reach for diet this and diet that, but it looks as if new literature is really challenging the wisdom of whether we should be doing that or not. This is a report. entitled Fueling the Obesity Epidemic: Artificially Sweetened Beverage Use and Long-Term Weight Gain. Think about that— artificially sweetened beverages being associated with weight gain. This was published in the journal Obesity back in 2008. And what the researchers did was they looked at 3,682 adults, followed them for 8 years, and looked at their consumption of artificially sweetened beverages. And at the same time, looked at how many of these individuals became either overweight or frankly obese, and did so by looking at what is called their body mass index. And what they found was truly remarkable. I think this is a very powerful slide looking at how much was consumed, how many artificially sweetened beverages were consumed per week at the baseline of the study, and then over time, what was the change in the body mass index? And you'll see Moving from left to right, those individuals on the left who did not consume artificially sweetened beverages, their change in their body mass index, in fact, didn't really change, 0.9. So, as you get more and more consumption of drinks throughout the week, up to 22 or more, you see a dramatic increase in the body mass index, which basically correlates to how big is the belly. And these researchers indicated that, and I quote, we observed a classic positive dose-response relationship, and I'll explain that, between artificially sweetened beverages and long-term weight gain. Meaning that it's just like a drug. The more you do, the more you get the response. That's called a dose-response relationship. It's like, for example, if you took a blood thinner, the more you took, the thinner your blood would be. In this case, the more artificially sweetened beverages you consumed, The bigger would be your belly. Well, French researchers have also looked at the wisdom of consuming these artificially sweetened beverages. And they did a very large study looking at close to 66,000, just over 66,000 women and followed them for a long time, 14 years, looking at their consumption of sugar-sweetened beverages, and in comparison to those who drank artificially sweetened beverages and wanted to determine, was there a relationship between the consumption of these beverages and development of type 2 diabetes? Now, you'd think that the people who use the sugar-sweetened beverages would obviously have a higher risk of becoming diabetic. And here's what they found. Look at these curves. On the bottom, we're looking at how many cc's, how many milliliters of beverage was consumed as an average each week, and then measuring that against the risk during the study of developing type 2 diabetes. And what you see, which seems really counterintuitive, is that those individuals consuming the artificially sweetened beverages had a dramatically higher risk for developing type 2 diabetes in comparison to those who drank the sugar-sweetened beverages. You wouldn't have expected that. That's why I felt it was important. This is actually a graphic from the blog that I created when the— when I reviewed this information. So, next we look at why it might be happening. And, you know, we've puzzled over this for quite some time. Why is it if you're not using sugar, why would you have a high risk of becoming obese? Why would you have a high risk of becoming diabetic? And these Israeli searchers— researchers, rather, searchers, I guess they were searching for answers— had a very interesting quote. And it's towards the end of their study. Let me just amplify this forward. Together with other major shifts that occurred in human nutrition, this increase in non-caloric Artificial sweetener consumption coincides with the dramatic increase in the obesity and diabetic epidemics. Our findings suggest that non-caloric artificial sweeteners may have directly contributed to enhancing the exact epidemic that they themselves were intended to fight. What these researchers discovered is that the likely mechanism that relates artificial sweeteners to increased risk of obesity And to type 2 diabetes is the changes that these artificial sweeteners induce in the microbiome. That's what these researchers described in this incredible research. Well, you know, it's, it's not nice to try to fool Mother Nature. And it reminds me of back in the early 1970s, there was a chiffon, like a butter chiffon, it was some kind of margarine. commercial that talked about how it was not nice to fool Mother Nature. Let's watch.
Mother Nature, I didn't know you were so fine on the vine.
Well, there's a lot you don't know.
I'll bet you don't know about this.
Oh, come on. That's a stick of my sweet creamy butter.
That's Chiffon Stick margarine.
Chiffon Stick margarine?
Right. Chiffon fooled you.
It's not nice to fool Mother Nature. If you think it's butter, but it's
not, it's chiffon. Well, I hope you enjoyed that as much as I did. I think it really, it really tells a great story. Hope you enjoyed it. I'm Dr. David Perlmutter. Bye-bye.
