PODCAST: Do Artificial Sweeteners Really Have Zero Impact on Blood Sugar?

ZACH MOORE: Welcome to On Health with Houston Methodist. I’m Zach Moore, I’m a photographer and editor here and I’m also a longtime podcaster.

KATIE MCCALLUM: I’m Katie McCallum, former researcher turned health writer, mostly writing for our blogs.

ZACH: And Katie, do you use artificial sweeteners?

KATIE: I think it’s impossible not to these days. But not necessarily using them, they’re just in everything. I mean, do you think you don’t?

ZACH: That’s where they get me. I drink things where they’re already there ‘cause I’m like, “I don’t use these,” but I do.

KATIE: Yeah. I have a theory. And this is not based on any kind of evidence or fact or anything, it’s just something, like, as I have become more aware of where artificial sweeteners are, kind of, everywhere. I have this theory that if a processed food that’s like usually kind of sweet, is under a hundred calories per serving, they’re using artificial sweeteners. That’s, like, always my test. Like if I pick up a granola bar…

ZACH: Mm-hmm.

KATIE: Or a protein bar, and it’s only like 90 calories, I flip it over and I look and I’m like, “Yeah, it’s full of these sugar alcohols and other things.” If something is like deceptively low calorie, it pretty much is like guaranteed to have artificial sweeteners at this point.

ZACH: Yeah. Now see, I’m not a big coffee drinker, and when I think -- or like iced tea for example. I’m more of a sweet tea drinker and a fancy coffee drink drinker. So, like, I don’t drink the basic stuff, so that’s where the trap is for me where I’m like, “Well, I don’t use artificial sweeteners.”

KATIE: My first experience with artificial sweeteners, and this will, like, age me. Is like when you’re growing up and you would get an iced tea, and like, you know, all the packets in the center of the table. I would, like, I loved the pink packet. I love aspartame. Like, more than just getting, like, sweet tea. And then at some point realized like, “Oh, that’s healthier for me ‘cause it’s not real sugar.” Or is it?

ZACH:  You know, when you’re younger, and it’s time to grow up and start drinking iced tea instead of a soft drink, you take a drink of this iced tea and you’re like, “Man, that does not taste as sweet as soft drinks do.” So, you go to that center little thing on the table, and you pull out the blue packet or the pink packet, that’s the danger. You start pouring that in there, and then, “Oh yeah, it tastes great.” But then how much have you added in there? That’s not healthy for you.

KATIE: What? Is it not healthy?

ZACH: Well, that’s what we’re gonna talk about.

KATIE: Exactly. I mean, I first gut reaction would be, you know, two packets of aspartame is healthier than five scoops of granulated sugar, but I don’t know if that’s true. But that’s like where my perception goes.

ZACH: Right. Well, that’s what we’re gonna talk about today.

KATIE: Yes. Is artificial sweetener too good to be true? It tastes sweet, it’s sweet, it makes things delicious, but what is it doing to us? What’s it doing in our body?

ZACH: Mm-hmm. And who did we talk to about this, Katie?

KATIE: We talked to Mag Ayyad. He is an Exercise Dietitian at Houston Methodist. And for this particular episode, we’re getting in the angle of -- really more about how artificial sweeteners may or may not affect your blood sugar. So really, like, what’s happening when they hit your blood stream that’s different from regular sugar? Are there impacts that we need to be thinking about when we’re using ‘em? Is it bad to maybe put five or six packets of -- or blue packets in your iced tea? What’s it doing to your blood sugar? Is it spiking it? Are blood sugar spikes that bad anyways? And we also get into sort of the difference between what a healthy individual with no underlying health issues needs to know versus someone who has diabetes or another medical condition, what they need to know about artificial sweeteners.

[Sound effect plays to signal beginning of interview]

Hey Mag, how are you doing today?

MAG: I’m doing well. Thanks for having me. Always a good time on here.

KATIE: Yeah, glad to have you back. Today, we are talking about artificial sweeteners. And I think this is something -- yeah, definitely a hot topic, I think. I think this is something that, you know, whether people have -- whether people mean to or not, we’ve probably all swapped sugar for an artificial sweetener in something. 

MAG:  Yeah.

KATIE: Whether we do it on purpose in, like, our iced coffee just to make it a little, like, quote, unquote “healthier,” or, you know, these sweeteners are in everything now, so even if you pick up a granola bar, chances are, you know, you’ve probably got some. And so, you know, the prevailing logic I think would that that’s a smart swap, right? Like, you’re getting rid of sugars, tons of calories, all that stuff. But it kind of brings up the point of like are artificial sweeteners too good to be true? And like, what might they be doing in our bodies that we’re not thinking about?

MAG:  Yeah. Well, they’re a lot sweeter than regular sugar.

KATIE: Yes. Sometimes very, like, obnoxiously sweet.

MAG: And then the more we use them, the more we stop realizing how much sweeter they are because we’re just adapting, our tastebuds are adapting, our body is adapting. So, in a sense, people are like, “Do artificial sweeteners, like, cause you to crave sugar?”

KATIE: Mm-hmm.

MAG: Like, naturally no. But it’s almost saying someone who smoked for 25 years, and you’re like, “Hey, try this vape instead of the cigarette.” And you just take a little taste of it, and then your body’s like, “Ooh.” So, it’s kinda similar. It’s like you’re not having the actual sugar, but then you’re having artificial sweeteners, and it’s playing that trick on your mind like, “Ooh, this is super sweet, I forgot how much I like this.” And like you said, it’s in everything. So innately, whether you’re trying to reach for it or avoid it. It’s becoming where it can be detrimental, especially if you’re trying to cut back on sweets, on desserts. But then flip side. Like, there’s people who are on weight loss journeys, people who are diabetics who can benefit from it by reducing a lot of their sugar intake so it’s almost a double-edged sword, but it’s in everything we have now.

KATIE: Yeah. And to the point you just mentioned about, you know, its impact on diabetes management potentially. I mean, I think the topic of blood sugar is coming up more and more, and, you know, there’s these continuous glucose monitors that even like, you know, healthy people that don’t have diabetes, they can put ‘em on their, you know, shoulders and start tracking their blood sugar when they eat. And again, you know, artificial sweetener, zero calories. So, I guess --

MAG: Not zero calories, though. We’ll talk about that.

KATIE: Okay, okay tease. We’re gonna talk about that. Well, so I think maybe if we could just level set for all of us, what is blood sugar? And what are blood sugar spikes? And are they good or are they bad? When are they bad? Can you set the playing field here?

MAG:  Yeah. So, any time we eat food, it breaks down into sugar into our body. Some foods break down faster, some foods break down slower, but it’s -- where does it go initially? It goes into your bloodstream. So, the sugar breaks down, it’s in your bloodstream. That’s where that “Spike,” quote, unquote. It’s not necessarily a spike, it’s just a rise in blood sugar. It’s normal for daily function. Our pancreas does what it’s supposed to do if we’re healthy individuals, releases that insulin, that key, and then that sugar starts going into your cells, it goes into your muscles, it goes into your organs. The spike starts to come back down, so. There is a healthy range of blood sugar for most of us. Between 70 to 180, we’re constantly flowing through that all day along. As we eat food, it rises, pancreas does its job. If pancreas isn’t functioning as well, if we’re on insulin, if we’re on other medications, it’s reducing that slowly. And we just merry go around throughout the day about that. For some reason, there has been recently these, whether it’s influencers or people marketing certain things, they put these fear tactics into people. Like, “You should never have a sugar spike. Sugar spikes are bad.”

KATIE: Yeah. No, I literally think of it as a bad thing.

MAG:  Yeah. And it’s not. It’s just…

KATIE: Okay.

MAG: It’s how our physiology works. If we consume food, it has to go somewhere. So, it breaks down, sugar goes up, and then it comes back down once we starting using it, so. It’s when those spikes stay up for long periods of time without going down where we start to have concern. Like, what is happening? Why are the functions not working as they should be?

KATIE: Mm-hmm. To that point, you know, artificial sweeteners, can they get broken down into blood sugar.

MAG: Yeah, so back to that point you know, like are they calorie free? Most are not. Most have a few calories, whether it’s five calories or – I think, I was actually like looking through this and aspartame, which is a common one in a lot of foods.

KATIE: The pink one, pink packet.

MAG: The pink packet. It has about 12 calories per teaspoon, per packet, right.

KATIE: Really?

MAG:  So, it’s not – yeah. Yeah.

KATIE: This is news  -- this is definitely news to me.

MAG: Yeah, so.

KATIE: Okay.

MAG: It’s not a ton of calories. It’s almost like saying I take a bite of an apple and it’s got ten calories in it.

KATIE: Interesting. Okay.

MAG: It’s gonna slightly raise your sugar. It’s not gonna make you spike. But people are like, “Oh, aspartame. Calorie-free. Splenda, sorbitol, let me use four packets in my morning coffee.” Coffee has no calories, but you’re adding a few calories in there. It’s gonna have some effect on your sugar levels. So, from that perspective, unfortunately, there’s not very many things on the market that are calorie-free even when it says zero calories. There is a threshold where, I think if you’re under five calories you can say it’s no calories.

KATIE: Okay. Got you.

MAG:  So, it’s impacting you even if you think, “Oh, I can add as many as I want. Nothing will happen.”

KATIE: When I think of artificial sweeteners, I do just naturally immediately compare it to, you know, granulated sugar. So, like, you know, the little white crystals versus what’s in the packet. I mean, would you say artificial sweeteners are always better than granulated sugar, or is that an oversimplification?

MAG: I would say oversimplification, because if you have no reason to use it, if you’re not, again, controlling weight or trying to manage a pre-diabetes or diabetes, then -- I think we’ve vilified sugar so much that we’re just trying to get away from it completely. But I mean we have natural sugars in dairy, we have natural sugars in fruit. And if we were to use a small bit of sugar in a coffee or a tea or a baked good and we’re able to control it, there’s nothing innately wrong with that sugar. And we’re not introducing an artificial sweetener. So, they’re almost equal if we’re healthy individuals and we’re not monitoring diet or diabetes.

KATIE: I guess my thought, and again, this is probably like you said, these fear tactics everyone’s put in our brains, I guess I thought like the more  you spike your blood sugar, the more likely you are to have diabetes. So, you’re trying not to spike your blood sugar a lot over time. Is that wrong?

MAG:  No, that’s a good thought process of it. It’s -- but again, it’s not necessarily that spike after a meal, it’s how long that spike stays and then how many spikes you’re having throughout the day, so.

KATIE: Hmm. Okay.

MAG: Usually, we’re -- most of us, maybe we are skipping a meal. But we’re having two to three meals a day and maybe a couple snacks in between. If we’re seeing constant spikes more than that, then something’s happening, right, or your sugar’s just not coming down.

KATIE: Okay.

MAG: But I should expect, when we review these, like you said, especially for diabetics who are wearing a continuous glucose monitor and we look at their graphs like, I want to see a spike and a dip, a spike and a dip, a spike and a dip. Especially when they eat food. Otherwise like, we would die.

KATIE: Okay. Yeah, that’s natural.

MAG: We would get such low blood sugar that we would pass out and not be able to function…

KATIE: Okay.

MAG: So, spikes are not bad. We're looking at the time you're staying up there and we're looking at if you're having random spikes where food is not part of the equation.

KATIE: Okay. You and I talked about this -- another piece of this once that I think would be interesting for our listeners to hear, because what you'd said to me was something I hadn't considered at the time, and that, you know, we have these sugar free foods and the way they make themselves sugar free is they just use an artificial sweetener. And those can still really impact your blood sugar you know, if you're eating too much. And I think it comes back to that point of other things. It's not just sugar that contributes to blood sugar.

 

MAG: Sure. Yeah. It's -- like we said the order of -- there's different things that impact it at a faster rate or at a higher rate. So, carbs are the devil apparently, but they're not. We have carbs that are simple sugars. We have starches. We have fiber foods. All of those are most likely to raise it faster or impact it more. But then we have protein foods, we have fatty foods where it still impacts it because it's still calories, it's still food that's gonna get broken down into energy and sugar into your body. But it is not a significant spike as the counterparts of carbohydrates. So go back to the cup of coffee. Maybe I'm putting a couple tablespoons of creamer in it and that creamer has fat in it. So now you've added additional calories. Or you're making a baked good and you're like, “You know what, I don't want to use sugar. I'm gonna use artificial sweeteners.” What else is in that baked good? Right. You're using some sort of fat, you're probably using some sort of flour. So, a lot of that is still adding calories. I would still expect to see an increase in your blood sugar if you consume it. Even if I'd used zero grams of sugar in it.

 

KATIE: Yeah. So you could -- if I ate a whole package of no sugar cookies…

MAG:  Yeah. Still a lot of calories

KATIE: Could spike my blood sugar like I could if I ate just the regular sugar cookies? If I ate enough.

MAG:  If you ate enough, I would say maybe it raises it more if you had the sugar cookies because they probably have more calories and more sugar versus the no sugar cookie. But it still has calories, it's still gonna raise it.

KATIE: Yeah. Maybe this question, I don't know, this could be not a great question, but when you're spiking your blood sugar that much, 'cause you're overeating, you know, is that a time where, okay, you're overeating anyways, you may as well just take the full sugar option. 'Cause you're already kind of doing it to yourself. Why not keep going?  I have a very,  like, as you can tell, I have an “all or nothing” sort of mentality to some of this. Or is it still better to say like, “Hey, I'm overeating, but at least this spike is a little lower?”

MAG: Depends on the person. If you're a healthy individual, if you're an all or nothing person, like maybe we should address the all or nothing mentality.

KATIE: Okay. Fair.

MAG: Like, the mindful eating and all of those. But if you're not battling with, you know, “I'm trying to reduce weight for a specific like cardiovascular risk. If I'm not diabetic.” Then yeah, all or nothing with either. But if you are battling with those things then I would rather you overdo it on the sugar-free substance, because it's likely to raise your blood sugar less, ‘cause we're addressing a specific concern, not necessarily, I'm healthy, I'm just overdoing it one day. Have whatever you want. It's likely not gonna impact you dramatically if you had the sugar counterpart.

[Music to signal a brief interjection in the interview]

ZACH: The FDA doesn't explicitly define a recommended limit for our natural sugar intake, the amount of sugar consumed while eating fruit for example. But it does for the sugar added to packaged foods and drinks. The FDA recommends that added sugar make up no more than 10% of total calories in your diet. You can find the amount of sugar added to a product on the nutrition label.

KATIE: Up after the break. We talk with Mag about what people with diabetes need to know about artificial sweeteners. And we ask him whether one type of artificial sweetener may reign supreme.

ANNOUNCER: From annual checkups to managing chronic conditions, your healthcare should be personalized to you. At Houston Methodist, our primary care doctors provide customized care for you and your family with more than 40 convenient locations across Greater Houston. We offer a variety of ways to get care, from in-person and virtual appointments to same-day visits when you're sick. Choose your doctor and schedule online at Houstonmethodist.org/stayhealthy. Houston Methodist, leading medicine.

 

[Sound effect signals return to the interview]

 

KATIE: Another very common thing, and you already alluded to this, but another common thing related to the artificial sweeteners that I've heard a lot is when you use an artificial sweetener every day, it makes you just crave sugar more. So, then you start eating more sugar, and it's like somehow worse for you and you gain even more weight. Is that -- I mean, you alluded to it. I mean, how true is that? You know, do we see that in evidence?

MAG:  We do. We see it in evidence. Not necessarily that, you know, if I have artificial sweetener it's gonna immediately make me consume more sugar right after, but it continues the lingering of that craving or like that sweetness ‘cause -- we were talking about this before we jumped on here, like, artificial sweeteners are so much sweeter. There's sometimes 500 to 1000 times sweeter than regular table sugar. So, if you're constantly having small doses of that, it makes it much more difficult to part ways with sugary foods, with those cravings versus saying, you know what, for 30 to 45 days we're gonna go cold turkey without artificial sweeteners, without sugar. That person who did that for 45 days is much less likely to crave those substances after that trial than someone who's routinely introducing artificial sweeteners into all of their foods. So, it's not that they're subconsciously making you say, “Oh I want sugar because I had this.” It's just -- it's a neurological effect. Like you're still getting some of that substance in even if it's not calorie dense or table sugar.

KATIE: Yeah. For our listeners, before we, you know, we turned the mics on, we were talking about how I've stopped using artificial sweeteners in my coffee and now -- or I had a chai latte recently and it was like overly sweet. Like to the point where like I could barely drink it 'cause I was just like, “Ah, this is so much.” 'Cause I -- and I think like that's my palate has really changed as far as coffee goes now. I still enjoy sweet stuff. But as far as coffee goes, it was like alarming to me how sweet it was.

MAG:  Yeah. And I mean take the sweets that you're saying, if you were to apply the same effect and you're like, “You know what, I'm gonna go 45 days without sweets or dessert.” The first time you have it after that you're probably gonna be like, “Wow, this is super sweet and I can't eat as much as I used to.” Or it might even offput you from it 'cause you're like, “This is a just a bomb of sugar that I'm eating, so.” And it's the same thing with people who reduce their sodium intake where I'm using a less salt overall and then the first time you eat a salty snack or a salty food, you're like, “Ooh, this is inedible. Like, too much salt.” So, palate definitely plays a role, and it's based on what we're feeding it constantly, so.  It's ever evolving, ever changing just based on what you're putting in day in, day out.

KATIE: Yeah. Another thing I want us to address, we don't need to get into details. Do these sweeteners, these artificial sweeteners, can they cause cancer?

MAG: No.

KATIE: Okay.

MAG: Not if we're moderately using them as we should be. Now most research comes out where if -- even if you're using like four to five packets of -- and name whatever artificial sweetener next to that, Splenda, aspartame, sorbitol, xylitol, it's not going to increase the risk of cancer, it's not growing cancer cells inside of us. So, the short answer is no, but also the dose like makes the poison. If we are having five to 10 diet sodas a day, and we're adding it to our baked goods, and we're adding it into our coffee, sure, maybe, because we're just overdoing it on a constant daily basis. But not on a regular moderate usage.

KATIE: Yeah. And probably hard to monitor that usage in a trial or something. Because I feel like I drink a lot of diet soda, but I do not drink five to ten a day, so.

MAG: And most of us don't.

KATIE: Yeah.

MAG: And that's why, like, we don't find much data where it's like, yeah, the only reason you got cancer was because you were using these artificial sweeteners. It’s just not -- it hasn't been shown evidence towards it.

KATIE: Yeah. And I think a lot of other very clear ways to help prevent cancer that we all wanna try to avoid and instead focus on, “Well it's those artificial sweeteners,” not those other glaring habits that we tend to have. So, I think we're all guilty of that one. We've mentioned that these sweeteners are now everywhere. Are there foods or even just situations where you'd say, “I kind of always prefer that people choose the artificial sweetener over regular sugar,” and vice versa? Like, just eat the regular sugar versus artificial sweetener. Anything else you'd add to that? I know we kind of touched on it.

MAG: I think even with like normal individuals, and we were talking about this again, like some people do have aversions to artificial sweeteners. Gut issues, digestive issues, it messes up with their bowel movements. And that has been shown in studies, like it does affect your gut microbiome, and it can affect it negatively. So, if that's the case, then yeah, maybe we are resorting a little bit more to using regular sugar, again, still in moderation. But that would be one instance where I promote using sugar-based foods or honey or agave over using all of these artificial sweeteners because then you're just -- if it's already affecting you, continuing to use 'em is probably making the matter worse. You're not gonna magically start adapting and being okay with them. So, that's probably an instance where aside from weight loss, aside from diabetes, I'd be like, “Hey, maybe we should do a test,” and stop using them. And whether you want to introduce sugar or not, that could be something that's negatively impacting your health.

KATIE: You mentioned diabetes and so I think we ob -- you know, we obviously need to talk about what people with diabetes specifically probably need to know about artificial sweeteners. 'Cause you know, before these sweeteners made it into sort of the wellness space, I would say where they're in the protein powders, they're in the yogurts, they're in all the stuff that, you know, we all just randomly pick up, they were mostly touted as being beneficial for people with diabetes and helping manage their blood sugar, right?

MAG: Mm-hmm .

KATIE: And so I, I guess I wanted to get your take on, is there anything you would, you know, off the top of this question, is there anything you would want people with diabetes to know about artificial sweeteners that’s kind of different than what you'd want just a regular sort of, you know, young adult who doesn't have diabetes to know?

MAG: Not necessarily like different to know, but this is where those fear tactics really impact our population, right? We get a lot of patients here and they’re like, “I'm not using any artificial sweeteners. Have you heard what they do to you?”

KATIE: Oh wow.

MAG: And it's like, “Yes, but have you researched into it? Have you seen what happens, or is this actually true?” Meanwhile, like, they're continuing to utilize sugar, their A1C is increasing, their spikes are staying longer, and it's like diabetes can take over and it can have a lot of drastic effects on your health versus using artificial sweeteners. And I'm not saying, “Hey, we're gonna use these for the rest of our lives.” But can we use it as a method to get better, to reduce your diabetes risk, knowing that a lot of these fear tactics, it's someone selling something, it's someone that's just trying to turn you off because they wanna sell you this supplement or they wanna -- for some reason have an agenda. So, this is where it gets really hard for people walking in the door and they have a lot of misinformation. And it's like, “No, like this is a helpful tool for you.” If you drink six Cokes a day and you switch to six Diet Cokes a day, and all of a sudden 50 points are knocked off your blood sugar daily, this is a -- that's a win.  So, when you're a normal individual, it's not impacting you as much. Even when you're like, “You know what, I'm not gonna use these artificial sweeteners,” 'cause there's nothing happening in the background.

KATIE: Right.

MAG: It's more difficult to see with diabetics, especially with those who are like, “you know what, I'm starting to not feel my toes and my eyesight's getting worse.” It's like your diabetes is getting worse. Let's introduce some of these things. And now it's like, “No, let's just get you on a GLP medication instead and let's go through weight loss.” And it's like, “Okay, but that's still not helping the cause of you having so much sugar,” and the more sugar we continue to have, it's such a hard cycle to get out of. So, that's probably where it's the most difficult when you find a lot of these things online and it's like, “No, these are helpful tools.” And we're not touting  them to be healthy. We're not telling you to pump your body with artificial sweeteners, but we can use them to help you help that reduction in your diabetes risk.

KATIE: Yeah. I think that's helpful. You mentioned, you know, swapping a full sugar soda for a diet soda. Any other kind of swaps you can think of where you have these sneaky, or people just drink or eat a lot of these high sugar foods that they could -- that you could say, “Hey, you know, this is a time to incorporate artificial sweeteners instead?”

MAG:  Yeah. I mean, we touched on baked goods. A lot of people do enjoy their pastries, their desserts. The positive thing on today is there's a ton of things on the market where they are using artificial sweeteners to make counterparts of desserts and muffins and Keto based products where -- you know, I will push them towards those things, because if we can't break the habit or the addiction of what you're consuming, maybe at least we can change the profile of what it is while still having that sweet factor.

KATIE: Mm-hmm.

MAG: So, a lot of those. And those are the biggest culprits we see with diabetic patients. Sodas, sugar in coffees and teas. “Oh, what is your snack?” “Oh, I have usually a blueberry muffin in the middle of the day.” What if we can use artificial sweetener in our coffee? Switch to diet soda? Switch to a Keto based or a artificially sweetened muffin? It's three wins right there and we didn't really change anything in their diet. I wasn't like, “Hey, we need to switch the five sodas with water only.” That's a much harder thing to get to.

KATIE: Right. I don't think you would get compliance.

MAG: No. And we don't, we don't get compliance, so. And a lot of the times we struggle with that because as dieticians we're meeting the patient where they're at, right. If you -- if we can reduce one soda, if we can switch to artificial, like that's a win for us and we take it one step at a time versus vilifying something. It's just basically applauding their progress, applauding what they're willing to do, and they're more likely to continue with it if they see progress, if they feel better. Like people, we want to feel better. Nobody wants to have diabetes.  Nobody wants to get an amputated leg or wake up in the middle of the night with completely low blood sugar. So, as they start feeling better, it gets easier.

KATIE: Yeah. Yeah. That makes a lot of sense. Anything people should know about the various options when it comes to artificial sweeteners? There are a lot. Any big kind of no-nos on the list? Any pros and cons to go through? Any clear winner on the artificial sweetener list?

MAG: That's a good question. You'll hear stevia and monkfruit often as like the big winners because they're plant-based derived and they're more natural sources. And they're not wrong about that, but it doesn't necessarily make them any better than using a Splenda or an aspartame. But back to that calorie conversation, I think aspertame is the highest calorie artificial sweetener. So, if you are considering it for weight loss, for diabetes control, maybe that's not your best option. Maybe you're resorting for others. If we go back to like our gut issues, usually xylitol, sorbitol are ones that will impact you more than Splenda or using something else. So, it kind of depends on what your symptoms are, what your goals are. If you're a healthy individual, I would say there's not one better than the other. But if you have a target, have a goal that you're trying to reach, yeah,  I would look more into how many calories are in these artificial sweeteners. And start, like, testing yourself. Like you mentioned, you cut out your Splenda in your coffee and it helped a little bit. So, you started making that connection. Is there Splenda in anything else that I eat? Because it's hidden, like you said.

KATIE: Oh, my gosh. So hidden.

MAG:  Yeah. You read the ingredient label and it's not sugar free, it's not artificial sweetened, but at the very bottom there's this sorbitol word and it's like, “Well maybe that's what's hurting my gut.” So, start making those connections, start reading nutrition labels, start identifying what's causing these issues for you, especially if you are battling a disease that you're trying to recover or to get better from.

KATIE: Yeah. I think that's great. This has been super helpful to get your take on all of this. 'Cause I have to say, this is probably one of the most confusing dietary topics in my opinion. Like, I've talked to you about this before. You know, I learn something new every time. So, thank you for coming and kind of clearing the air on some of this. Before we go, anything else you wanna add or leave our listeners with today?

MAG: Prioritize the important things.

KATIE: Hmm. Yeah.

MAG: Move more. Let's become more active. Let's get our fruits and vegetables in. Watch your nutrition, watch your portion sizes. Try to work on your stress. Get proper sleep. Once you have all of those in order, then start worrying about like how much artificial sweeteners, which one is best for me. And again, most of these are for healthy individuals. Sure, we prioritize like the usage of them if we have a disease state we're treating. But I think we've gone away so much from the basics and we focus on this, and probably not a fault of our own. It's what's put in front of us on social media, on the news. So, at the end of the day, exercise, nutrition, stress management will always trump all of these things. So, put a focus on those. Meet your dietician, meet an exercise specialist, go to your doctor, get your annual lab work. Those are the things that will continue having longevity over, “oh artificial sweeteners are killing me or causing cancer” or all of those, so. Once we have those ducks in order, then we can address the smaller things.

KATIE: Gotcha. I love it. That's kind of the perfect message to end on. So, thank you. It was to have you back on the podcast again. Thanks so much.

MAG:  Thanks for having me.

[Sound effect plays to signal end of the interview]

ZACH: So, something I learned, Katie was not all artificial sweeteners are calorie free, even if they may appear to be.

KATIE: Yeah, that was pretty mind blowing. I'm not really sure what to make of it, 'cause it kind of like is counterintuitive in your brain. I guess since, like to your point earlier when we were talking, if you put five of the blue packets in your drink, like that could be, you know, 20 calories or something. But if you're just using one packet, it's probably like negligible amount of calories. So, I guess it really just depends how much artificial sweeteners you're using there. But yeah, very surprising.

ZACH: Well, there's always -- there's always a price pay. There's always a tradeoff, right? ‘Cause you think, “Oh, well I'm doing this so I could do as much as I want because it's quote, unquote healthier than the other thing.” Well, that adds up, right?

KATIE: Yeah. Yeah. No, definitely.

ZACH: Something else really interesting that y'all talked about was the fear that people have that artificial sweeteners could lead to cancer.

KATIE: Yeah. I feel like when they first came out, or when they first became popular, it was like, “Oh my gosh, these are like miracle tools people can use whether they have diabetes or not, to just lower their calorie intake.” And then all of a sudden, that's shifted and now it's like, we need to be terrified of these things. And to your point, if you're having five packets in an iced tea, like should you be worried? And I mean, it’s interesting that we took something that might be a really helpful tool for people, and we made everyone afraid of it.

ZACH: That's what we do as a society, right? It's like when cell phones came out. They're like, “They're gonna cause a brain tumor.” I'm like, “Well we all would've died by now.”

KATIE: Or like, make you infertile if you keep it in your pocket kind of thing. I think he looped it back around to what it means and where the message is coming from in the sense of someone's villainizing artificial sweeteners and then you find out, well, it's because they're selling a supplement perhaps to lower your blood sugar. So, of course they don't want you using this really important tool for people with diabetes. They want you to take their supplement.

ZACH: Exactly.

KATIE: But then that message trickles down into people who don't even have diabetes and are just a healthy person who eats a granola bar or some yogurt and it's impossible not to find them in there.

ZACH: Yeah. Yeah.

KATIE: So, I think it's interesting how we do that. but I was glad to hear that they are safe to consume as far as cancer goes.

ZACH: Right. Well, as someone who's always struggling with soft drink consumption, and we've talked about in this podcast before, it made me feel a little better to say, “Well, you know, some people are out there drinking five, ten a day.” I'm like, “Well, I'm not doing that.” So, I'm more in that -- I'm more average than I thought maybe when it comes to that sort of thing. But no, if you are drinking five or ten soft drinks a day, then yeah, you should be concerned about that. Which leads to kind of the final point you guys were talking about, or one of the final points was, you know, we have a lot of health issues as a society, but don't blame everything on artificial sweeteners. There are other factors involved.

KATIE: Yeah. I love the way he ended it because it's also, even if you don't have health issues, I think it applies to everyone. Because it's just like we so quickly wanna forget the basics like he said. Like, are you sleeping well? Are you eating well? Are you exercising enough? If you're doing all those things, you probably don't need to worry about artificial sweeteners.

ZACH: Yeah. It's like, I'm sleeping four hours a night. It must be those blue packets I'm putting in my drinks that are causing the problem.

KATIE: Like, I'm basically not gonna sleep, but I'm gonna drink 90 Diet Cokes a day. And it's like, no, it's probably the four hours of sleep you’re getting. I do think it was that reminder of there is such a thing as overthinking some of this. Now, a healthy diet is very important and artificial sweeteners are, like we said, an effective tool for people who do need to be more worried about their blood sugar than others. But the rest of us probably don't need to fixate on some of this, like negativity we see about them in the news.

ZACH: Yeah, absolutely. Well, that's gonna do it for this episode of On Health with Houston Methodist. Be sure to share, like, and subscribe wherever you get your podcasts. We drop new episodes Tuesday mornings. So, until then, stay tuned and stay healthy.