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Tag: artificial sweeteners

  • Are Carboxymethylcellulose, Polysorbate 80, and Other Emulsifiers Safe?  | NutritionFacts.org

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    Emulsifiers are the most widely used food additives. What are they doing to our gut microbiome?

    When grocery shopping these days, unless you’re sticking to the produce aisle, “it is nearly impossible to avoid processed foods, particularly in the consumption of a typical Western diet,” which is characterized by insufficient plant foods, too much meat, dairy, and eggs, and a lot of processed junk, “along with increased exposure to additives due to their use in processed foods.”

    The artificial sweetener sucralose, for example, which is sold as Splenda, “irrefutably disrupts the gut microbiome at doses relevant to human use” and “induces glucose intolerance.” In other words, it can make our blood sugars worse instead of better. It’s relatively easy to avoid artificial sweeteners, but “it may be much more difficult to avoid ingestion of emulsifiers…because they are commonly added to a wide variety of foods within the modern Western diet.” In fact, “emulsifiers are the most widely used additives,” and “most processed foods contain one or more emulsifiers that allow such foods to maintain desired textures and avoid separation into distinct parts (e.g, oil and water layers).” We now consume emulsifiers by the megaton every year, thanks to a multibillion-dollar industry, as you can see below and at 1:03 in my video Are Emulsifiers Like Carboxymethylcellulose and Polysorbate 80 Safe?.

    Emulsifiers are commonly found in fatty dressings, breads and other baked goods, mayonnaise and other fatty spreads, candy, and beverages. “Like all authorized food additives, emulsifiers have been evaluated by risk assessors, who consider them safe. However, there are growing concerns among scientists about their possible harmful effects on our intestinal barriers and microbiota,” in terms of causing a leaky gut. As well, they could possibly “increase the absorption of several environmental toxins, including endocrine disruptors and carcinogens” present in the food.

    We know that the consumption of ultra-processed foods may contribute to weight gain. Healthier, longer-lived populations not only have low meat intake and high plant intake, but they also eat minimally processed foods and “have far less chronic diseases, obesity rates, and live longer disease-free.” Based on a number of preclinical studies, it may be that the emulsifiers found in processed foods are playing a role, but who cares if “emulsifiers make rats gain weight”? When we read that “emulsifiers can cause striking changes in the microbiota,” they aren’t talking about the microbiota of humans.

    Often, mice are used to study the impact on the microbiome, but “only a few percent of the bacterial genes are shared between mice and humans.” Even the gut flora of different strains of mice can be considerably different from each other, so if we can’t even extrapolate from one type of mouse to another, how are we supposed to translate results from mice to humans? “Remarkably, there has been little study of the potential harmful effects of ingested…emulsifiers in humans.”

    Take lecithin, for example, which is “perhaps best known as a key component of egg yolks.” Lecithin was found to be worse than polysorbate 80 in terms of allowing bacteria to leak through the gut wall into the bloodstream. However, it’s yet to be determined whether lecithin consumption in humans causes the same problem. “There is certainly a paucity in the data of human trials with the effects of emulsifiers in processed foods,” but we at least have data on human tissue, cells, and gut flora.

    A study was titled: “Dietary emulsifiers directly alter the human microbiota composition and gene expression ex vivo potentiating intestinal inflammation.” Ex vivo means outside the body. Researchers inoculated an artificial gut with fresh human feces until a stable culture was established, then added carboxymethylcellulose (CMC) or polysorbate 80 (P80), resulting in boosts in proinflammatory potential starting within one day with the carboxymethylcellulose and within the first week with polysorbate 80, as you can see below and at 3:39 in my video.

    “This approach revealed that both P80 and CMC acted directly upon human microbiota to increase its proinflammatory potential…” When researchers then tested the effect of these emulsifiers on the protective mucus layer in petri dish cultures of human gut lining cells, they found that they can partially disrupt the protective layer. As you can see below and at 4:00 in my video, the green staining is the mucus. Both emulsifiers cut down the levels.

    However, this study and the last both used emulsifier concentrations that were far in excess of what people might typically get day-to-day. 

    “Translocation of Crohn’s disease Escherichia coli across M-cells: contrasting effects of soluble plant fibres and emulsifiers” is probably the study that raised the greatest potential concern. The researchers surgically obtained cells, as well as actual intestinal wall tissue, and found that polysorbate 80 could double the invasion of E. coli through the intestinal lining tissue, as shown here and at 4:27 in my video.

    In contrast, adding fiber—in this case, fiber from plantains—could seal up the gut wall tissue twice as tightly, as seen below and at 4:33.

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    Michael Greger M.D. FACLM

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  • Does Chewing Gum Burn Calories? | NutritionFacts.org

    Does Chewing Gum Burn Calories? | NutritionFacts.org

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    What are the effects of chewing gum on hunger and appetite?  

    “Horace Fletcher,” proclaimed one of his obituaries in 1919, “taught the world to chew.” Also known as the “Great Masticator,” Fletcher was a health reformer who popularized the idea of chewing each mouthful more than 32 times—“once for every tooth.” It wasn’t put to the test, though, until nearly a century later. In that study, participants were told to eat pasta until they felt “comfortably full” and were randomized to chew each mouthful either 10 times or 35 times before swallowing. The subjects were told the study was about the effects of chewing on mood, but that was just a ruse. The researchers really wanted to know whether prolonged chewing reduced food intake. And, as it turned out, those who chewed more felt full earlier than those who chewed less, such that they ended up eating about a third of a cup less pasta overall. 

    If chewing suppresses the appetite in some way, what about chewing gum as a weight-loss strategy? As I discuss in my video How Many Calories Do You Burn Chewing Gum?, an article entitled “Benefits of Chewing Gum” suggested as much by saying that it “may be a useful behavior modification tool in appetite control and weight management,” but it was co-written by the executive director of The Wrigley Science Institute and a senior manager at the Wm Wrigley Jr Company. Why don’t we see what the unbiased science says? 

    Big Gum likes to point to a letter published in 1999 in The New England Journal of Medicine. In it, Mayo Clinic researchers claimed that chewing gum could burn 11 calories an hour. Critics pointed to the fact that they didn’t really test “typical” gum chewing; they instead tested chewing the equivalent of four sticks of gum “at a very rapid cadence.” Specifically, the participants were told to chew at a frequency of exactly 100 Hertz (Hz) “with the aid of a metronome” for 12 minutes. That seemed to burn 2.2 calories, hence, potentially 11 calories an hour. 

    One might have had more confidence in the Mayo scientists’ conclusion had they not lacked a fundamental understanding of basic units. As defined by Merriam-Webster, hertz is a unit of frequency equal to one cycle per second, so 100 Hz would mean 100 chews per second. (That would be a very rapid cadence!) If it’s true that 11 calories may be burned an hour, though, that means you could burn more calories actively chewing gum while sitting in a chair than you would if you weren’t chewing gum while upright at a standing desk. 

    In fact, as you can see in the graph below and at 2:24 in my video, chewing one small piece of gum at your own pace may only burn about three calories an hour, which would approximate the calorie content of the sugar-free gum itself. However, chewing off the calories of a piece of sugar-sweetened gum might take all day. What about the purported appetite-suppressing effect of all that chewing, though? 

    The results from studies on the effects of chewing gum on hunger are all over the place. For example, as you can see in the graph below and at 2:50 in my video, one showed decreased appetite, another showed no effect, and yet another even showed significantly increased hunger in women after chewing gum. The more important question, though, is whether there are any changes in subsequent calorie intake. Again, the findings are mixed. 

    One study, as you can see in the graph below and at 3:12 in my video, even found that while chewing gum didn’t impact M&M consumption much, it did appear to decrease the consumption of healthy snacks. Interesting, but the researchers used mint gum, and the healthy snacks included mandarin orange slices. So, that may have just been an orange juice-after-tooth-brushing effect.  

    It can take an hour before the residual taste effect of mint toothpaste dissipates. This is bad if it cuts your fruit intake, but what about harnessing this power against Pringles? An international group of researchers had people eat Pringles potato chips for 12 minutes, interrupting them every 3 minutes to swish with a menthol mouthwash. As you can see in the graph below and at 3:50 in my video, compared to those in the control groups (swishing with water or nothing at all), the minty mouthwash group cut their consumption by 29 percent. The researchers concluded: “If a consumer finds themselves snacking on too many crisps [potato chips] during a given eating occasion, one potential strategy could be intervening by having a peppermint tea, menthol flavoured chewing gum, or brushing their teeth, to slow down or stop snacking.” 

    What we’re wondering about, though, is weight loss. Even if a little tweak like chewing gum can affect the consumption of a single snack, your body could just compensate by eating more later in the day. The only way to know for sure if chewing gum can be used as a weight-loss hack is to put it to the test, which I cover in my video Does Chewing Gum Help with Weight Loss? 

    For more information on calories and weight loss, check out related videos below. 

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    Michael Greger M.D. FACLM

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  • No One Has to Pretend Water Is Exciting

    No One Has to Pretend Water Is Exciting

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    Over the past few decades, what Americans want out of their beverages has swung wildly between two extremes. In the 1990s, sweet drinks were all the rage. Soda sales were on what seemed like a limitless upward trajectory. Quaker bought the then-ascendant Snapple brand for $1.7 billion in cash, a sum that made me actually snort when I read it in the harsh light of 2023. Gimmicky drinks such as Surge, Orbitz, and SoBe “elixirs” crowded grocery-store shelves. As a middle schooler in the late ’90s, my consumption patterns were practically a case study in the era’s marketing magic. I’m not sure a single drop of plain water ever touched my lips outside of soccer practice.

    Toward the end of that decade, the first evidence of the coming reversal was already visible. Skepticism (most of it warranted, though some of it not) toward sugar and artificial sweeteners steadily grew. The soda giants, reading the room, began marketing their own bottled-water brands to compete with the more fashionable likes of Evian and Perrier. Dasani and Aquafina came right on time: As soda sales faltered, bottled-water sales took off. In 2016, the Beverage Marketing Corporation estimated that, for the first time, Americans consumed more bottled water—almost 40 gallons per capita on average—than carbonated beverages. Tap water, too, has found a new home in an ever-increasing number of reusable water bottles. New Stanley cup, anyone?

    Americans, in short, got sold on hydration. As my colleague Katherine J. Wu recently wrote, how much water any particular person needs to drink to maintain a healthy baseline is still the subject of significant disagreement among experts. But in the absence of clear guidance—and with plenty of encouragement from the health-and-wellness industry—many people seem to have simply decided that more is more, and they shoot for as much as a gallon a day.

    That isn’t to say that everyone likes drinking all this water. As the nation has disciplined itself to refill its glasses, Americans have been forced to confront the inconvenient reality that drinking plain water day in and day out can be kind of a chore. To choke it all down, they’ve returned to powders and concentrated syrups designed to make water more palatable, more healthful, or both. Sweet drinks are back again, albeit in a different form. Enter the water enhancer.

    Today, products meant to gussy up your water are everywhere at grocery and convenience stores. They come in little brightly colored squeeze bottles or single-serving packets. The sales pitch is pretty simple: Throw one in your purse or laptop bag, and instead of buying a packaged beverage, you squirt a couple of drops of syrup or mix a tablespoon or two of powder into regular water. Voilà. Now water is better. This is not exactly a new type of product: Powdered mixes from Crystal Light and Gatorade were around in the 1980s. But unlike the water enhancers of yore, today’s mixes are mostly portioned for single servings instead of big batches.

    According to Phil Lempert, a grocery-industry expert and the founder of the website Supermarket Guru, water enhancers split into roughly two categories: low-calorie flavorings, such as Kraft Heinz’s highly concentrated MiO drops, and hydrating sports (or hangover) drinks, such as powdered electrolyte packets from Liquid I.V. Both MiO and Liquid I.V. debuted in the early 2010s. Within a few years, competitors including LMNT, Cure, and Buoy entered the market, along with the new entrants from old brands, Crystal Light and Gatorade among them. Most of these brands boast about their products’ low sugar content; even some of the enhancers flavored to taste like Skittles, Starburst, or other candy rely on artificial or alternative sweeteners and have few calories. Other ingredients have been incorporated into new products: Companies such as Cure now make caffeinated concentrates. Liquid I.V. has a powder that includes melatonin for sleep. Lots of other products now contain additional vitamins, minerals, or electrolytes. Many water enhancers have become, in essence, drinkable supplements.

    Water enhancers’ rise can easily be charted in sales numbers. Darren Seifer, the food-and-beverage-industry analyst at the consumer-data firm Circana, told me that although the products are still a small part of the overall beverage market, they’ve seen consistent growth. In 2022, sales volume of sports-drinks mixes—the category in which the firm places most water enhancers—was up 15 percent over the previous year. According to Seifer, the growth has been much larger for some brands. A spokesperson for Liquid I.V., which was bought by Unilever in 2020, told me that the brand’s sales have nearly doubled in each of the past four years.

    Like so many cultural phenomena, water enhancers also have become the subject of a viral trend. WaterTok, a subset of TikTok where users mix and match different powders and syrups into recipes inside giant insulated water bottles, flooded the internet earlier this year with tips on how to make tap water taste like, among other things, birthday cake. (Like most TikTok trends, it’s a little extreme, and it doesn’t seem to be especially indicative of how regular people end up using the products. TikTok Franken-water sounds sort of terrifying, and some health experts have expressed concern over its potential misuse as a weight-loss aid.)

    The whole concept of water enhancement can be pretty easy to mock: Why, exactly, can some people not find it within themselves to drink regular water? Why do they need it to taste like Skittles? Why do some people think a random wellness company might actually be able to improve on water, of all things? Once you’ve got the water in your glass, just stop there! Drink that! And yes, drinking Jolly Rancher aspartame water does strike me as more ludicrous than just having a Diet Coke. But if you let go of your immediate revulsion at the occasional licensed candy branding and consider water enhancers as a concept on its merits, you’ll find that even the worst of the bunch isn’t functionally much different than a sugar-free sports drink or low-calorie lemonade. In most cases, they’re arguably better if your goal is to stay hydrated, have a little treat, and have some say in how much sugar or sweetener you consume in the process.

    There’s little reason to believe that the people who use water enhancers are doing so at the expense of the plain water that they’d be drinking otherwise. Americans’ consumption of plain water remains, by all indications, robust. It’s mostly sales of soda and juice that are generally sluggish, which at least hints that, for a lot of the people who like those types of drinks, the trade-off that’s actually being made is between water enhancers and some kind of heavily sweetened beverage. In a lot of cases, that trade-off seems positive, on balance, especially because the enhancers allow people to control how much sweetness actually goes into a drink. This does not guarantee that people consume lower concentrations of flavorings, but it at least allows them to do so if they want.

    To fully understand why people are suddenly so enthusiastic about water enhancers, you also have to look outside of the beverage market and to the kinds of vessels that are so often used to consume them: reusable water bottles and high-capacity insulated cups. According to Circana’s data, the Hydro Flasks and Yetis and Stanleys of the world are still selling like hotcakes, and they present a significant shift in the physical reality of how a lot of Americans get their daily fluids—and, potentially, how much of those fluids they intend to be drinking. If you’ve already got 30 or 40 ounces of water on your desk at work, buying a Gatorade or coconut water or other premixed beverage to lug around with it makes less sense than it otherwise would, and having a couple of packets of sweetened electrolyte powder in your laptop bag is comparatively easy.

    At the core of all of this is a fundamental anxiety. Americans want to do what they can for their health, but for so many people, the most meaningful changes—easier, more affordable access to nutritious foods; taking time for exercise; less stress—are difficult to achieve or outside of their control. Swapping out sugary drinks for plausibly healthier options might not be life-altering, but at least it feels like something. “It’s a low-hanging fruit, in terms of healthy behaviors,” Caleb Bryant, a food-and-beverage analyst at the consumer-data firm Mintel, told me. The same anxiety exists for people who buy bottled water regularly, which Circana’s Seifer points out is still a huge group whose numbers have not yet shown any decline. If you’re selling water enhancers, you don’t need to convert bottled-water drinkers away from a product they already like, as you would with a bottled drink—you just have to convince them that they might occasionally like adding something to it.

    The enhancers have their limits. The freedom they confer can easily mislead consumers about how much better self-mixed drinks actually are: The experts I spoke with all agreed that at least some people seem to assume that no matter how much or what kind of water enhancer they use, their beverage will end up inherently healthier than something prepackaged, just because they get to see the water first before they add anything to it. In that way, the brands behind water enhancers are still very much profiting off of the confusing hydration hype that’s been separating people from their money in dubiously healthful ways for years.

    On balance, though, water enhancers do seem to offer something desirable to people who want their water to be a little bit more palatable and the companies who want to sell to them. They are, on some level, a rare win-win: Water enhancers’ smaller, lighter proportions have significant upsides for the companies marketing them, according to Supermarket Guru’s Lempert. The beverage business as a whole is already a more profitable, less cost-intensive category in which to operate than many other sectors of the grocery industry, he told me, which likely helps account for all the upstarts flocking to the water-enhancer category—they’re inexpensive to produce and don’t spoil quickly. When you take away the necessity of buying plastic bottles and packing, shipping, and stocking heavy liquids, the beverage math gets even better. Consumers find some advantages in those differences too: They create less plastic waste (as long as you’re not always buying bottled water to use with them), take up less room in the pantry, and are sometimes less expensive per serving than a bottled alternative.

    Ultimately, the biggest driver behind water enhancers’ popularity is probably just the nature of water itself. It’s great, but drinking a ton of it every day can become drudgery. These additive products play to a tendency to tinker with water in pursuit of health, stimulation, or pleasure that humans have had for thousands of years. Teas, coffee, beer, wine, and sweetened, fruity drinks such as aguas frescas were all developed because, on some level, water—humble and utilitarian as it is—just wasn’t satisfying all of the needs and desires that our forebears had. Now that lots of people believe they need to be downing liters of water every day for their health, they’ve rediscovered an age-old problem. Yes, water is great. But maybe it could be better, or at least more fun?

    You do need to drink water; any downsides of erring on the side of overhydration don’t really kick in until the volume gets extreme. But forgoing a little fun or flavor in pursuit of perfect physical health is something that humans have never been particularly good at doing. One medieval religious text even cited drinking nothing but plain water as a just punishment for swearing against God. With that in mind, it might have been foolish to expect that in the 21st century, with so many alternatives available, copious amounts of plain water would be the widespread drink of choice for long.

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    Amanda Mull

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