Artificial Sweeteners And Health

Bonnie is a patient of mine who struggles with her weight. When she was younger she was slender, active, enjoyed exercise and enjoyed cooking. She is a nurse and has always been drawn to high-stress fields where she feels she can make a real difference for her patients. She married late and had two children and since then her weight has gotten out of hand.

At a recent appointment I asked whether she was ready to make some changes and tackle her weight. She has tried a number of weight loss programs without lasting success. At her last visit she brought a bottle of what turned out to be her favorite beverage with her: Diet Coke.

I asked her about it and she admitted she drinks almost nothing but diet Coke. She doesn’t like coffee so she relies on the caffeine in her soda to get her going in the morning. She justifies it by saying “at least it’s DIET Coke, there’s no sugar, so it’s OK.”

But is it? New research has come out suggesting that artificial sweeteners are not the weight loss magic they were designed to be.

Researchers in San Antonio, Texas, published a very thorough review of both animal and human research studies looking at the effects of artificial sweeteners on a number of health parameters. They found that animals fed a whole range of artificial sweeteners – including saccharin, sucralose, acesulfame potassium, aspartame, or the combination of erythritol+aspartame – had a number of adverse impacts on their health.

They tended to eat more. They gained weight. They developed higher percent body fat. They had worse metabolic markers including those for diabetes and for inflammation.

These changes were more pronounced in male animals and in those with a genetic predisposition to obesity. They were especially striking in those eating high-fat, high-sugar diets and diets meant to mimic our “Western” diet.

In the human studies those participants who reported daily (or more frequent) use of artificial sweeteners had more weight gain. They gained more weight around the abdomen, which is the most dangerous place to gain it. They were more likely to be overweight and obese.

I’ve always said there’s a difference between being fat and being unhealthy. You can be a fit overweight person. But those study participants who used artificial sweeteners tended to NOT be fit or healthy. Those who reported daily or more frequent intake of diet drinks (the most common source of artificial sweeteners) were more likely to have hypertension, metabolic syndrome, diabetes, depression, kidney dysfunction, heart attack, stroke, and even cardiovascular and total mortality.

Obesity studies tend to have a heavy participation of female subjects. Because the animal studies showed the impact of artificial sweeteners is more pronounced in male animals, the dangers of these additives may actually be more than what we are seeing (which is bad enough).

If you are currently drinking diet soda thinking it will help you lose weight, please stop. The science is clear that diet beverages promote weight gain and increase the risk of diabetes and other health problems. If you like fizzy drinks there are plenty of unsweetened seltzer drinks available to choose from. Even unflavored seltzer with a dash of fruit juice is a better option.

The good news is that diet soda consumption is on the decline. But people looking to lose weight are still susceptible to the lure of something for nothing. Remember, if it sounds too good to be true, it probably is.

QUESTION: Do you drink diet soda? Will this information cause you to rethink that?

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When Misleading Ads Harm People

My patient Brian is a gay man who has been taking the medication Truvada to protect him from HIV infection. Recently I saw him in the office and he said he saw an ad on Facebook suggesting this medication causes bone and kidney problems, so he stopped it.

When advertisers mislead people to make a buck, that’s one thing. When misleading ads lead to people being hurt or killed, that’s another.

Brian is at increased risk of HIV infection due to his lifestyle. He is a lovely, gentle man who is a talented musician. Whether you agree with his choices or not, he does NOT deserve to contract a deadly disease if it can be prevented. And Truvada reduces the risk of HIV infection by 99%.

The ads in question are being run by legal firms who, it seems, are attempting to organize class-action lawsuits against the company that makes Truvada. These misleading ads claim the medication is dangerous and imply taking it isn’t worth the risk. When patients without medical knowledge, like Brian, see these ads online they become concerned and sometimes choose to stop their medication.

All medications have risks. Doctors talk with patients and weigh these risks against the proven benefits of the medications. Often doctors run periodic tests to monitor for problems stemming from use of medications. Other medications can cause kidney problems (like blood pressure medications and NSAIDs like Advil) or bone problems (like some contraceptives and steroids used for severe arthritis) but we still use them.

Stopping blood pressure medication because some lots of generic medication have been found contaminated is one thing. High blood pressure is rarely dangerous over the short term – once it’s confirmed your pills aren’t from one of the affected lots you can restart them. However, stopping medication to prevent infection from HIV can be deadly over a short period of time, if one is exposed during that unprotected window.

Almost 40,000 new cases of HIV infection happen every year. Over 1 million Americans are living with HIV, and approximately 15% of these people don’t know they are infected. Gay and bisexual men, sex workers and IV drug users are at highest risk and most likely to benefit from treatment with Truvada.

If you are taking a medication, ANY medication, and you see something reported on TV or radio that concerns you, talk to your doctor before stopping your medication. Your physician should be able to address your concerns and, if not, you can decide together on a course of treatment that makes you comfortable and continues to meet your health goals.

It’s been said before, but bears repeating. Don’t believe everything you see or hear online.

QUESTION: How do you judge when you see concerning information online? How do you know what to believe?

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Meaningful Work And Joyful Play

“What do you do for fun?”

That may sound like a weird question for your doctor to ask you, but what can I say, I’m weird 😉 I’ve been doing some training on how to coach for nutrition and lifestyle change, and one thing I read this week really struck me.

Stress depends largely on a balance between meaningful work and joyful play.

So lately I’ve been asking my patients what they like to do for fun. If I’m seeing a patient for depression, chances are good they can’t tell me one single thing they do that they enjoy. One patient went so far as to tell me (tearfully) that she is not getting any fun out of life at all.

We’ll talk about Part Two in a minute, but I want to start by talking about meaningful work. Many of my patients, especially if they struggle with depression, have trouble with seeing their work as meaningful. They feel like they’re punching a clock, going through the motions.

I read once (probably connected with some small-business training or other) that all business boils down to making someone’s life better. Think about that. Why do you open your wallet and spend money? Because you believe that transaction will make your life better. Subscribing to Disney+, buying a new pair of shoes, sending your kids to private school, saving for retirement instead of taking an extra trip this year. Even paying taxes makes your life better (by averting the likelihood of prison for tax evasion)

There was a talk not long ago I attended about improving quality at a big hospital system. The speaker was talking about a time he visited an aircraft carrier. One of the airmen’s job was to clean up the deck. The speaker asked what his job was. He could have said “I’m the janitor,” or “I keep the deck clean.” But that’s not what he said.

When asked what his job was, the speaker said the airman stood up straight, looked him in the eye and said “Sir, I help planes take off and land safely to protect our pilots and further the mission of the United States Navy. Sir.” Wow! That’s a man with a clear idea of how his job makes people’s lives better!

When you go to work every day, your job will feel much more meaningful if you focus on how you are making someone’s life better. I challenge you in the comments to give me a job that DOESN’T make someone’s life better.

On the other side of the coin, no matter how meaningful your work is, you still need to make time for R&R, otherwise you’re courting burnout. My work is extremely meaningful, all of it, from doctoring to my Shaklee business to writing this blog. But if I don’t take time to play, I start to get irritable. I even have found myself feeling cynical.

For me, “play” means lots of things. I hang out with my kids and play video games sometimes. I practice martial arts with my family. I have a number of fiber crafts I love: spinning, crochet, knitting. I read novels. I practice my faith. I sing along with the radio and my music selection on my phone (not always well but with great enthusiasm, LOL). I do all these things to balance my incredibly meaningful but at times extremely stressful work.

In chasing the elusive “work-life balance,” it helps to focus on incorporating both meaningful work and joyful play in every day.

QUESTIONS: Two today! How do you play joyfully every day? And can you think of a job that would NOT make someone’s life better? Don’t pick politicians – that’s too easy 😉

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