Latest / Wellness, Actually with Emily Oster & Perry Wilson, MD / What's the deal with artificial sweeteners?

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What's the deal with artificial sweeteners? · Wellness, Actually with Emily Oster & Perry Wilson, MD

• 0:00
  Speaker 1: Hi, before we start the episode, just a quick announcement
• 0:02
  Speaker 1: that next week we'll be doing our first Wellness Actually
• 0:06
  Speaker 1: grab bag episode for all the ridiculous wellness fads that
• 0:10
  Speaker 1: don't merit a whole deep dive, but we still think
• 0:13
  Speaker 1: they'll be a lot of fun. We'd love your help.
• 0:15
  Speaker 1: Go to wellnessactually.fm and submit a question or comment about
• 0:19
  Speaker 1: a fad via text or voice memo. We'd also love
• 0:22
  Speaker 1: a social media post for us to watch. The deadline
• 0:24
  Speaker 1: is end of day on Saturday, September 19th, so don't dally.
• 0:28
  Speaker 1: And thanks so much. Now, here's today's episode. Emily, I'd
• 0:33
  Speaker 1: like you to put yourself in the mindset of an
• 0:36
  Speaker 1: environmental investigator. All right. Someone is leaking raw sewage into
• 0:42
  Speaker 1: the municipal water supply somewhere upstream, and you have to
• 0:47
  Speaker 1: figure out where it's coming from. Now, you can test
• 0:51
  Speaker 1: the water at various points and look for different substances.
• 0:55
  Speaker 1: So I'm wondering what kind of things you might look
• 1:00
  Speaker 1: for in the water to kind of trace back until
• 1:03
  Speaker 1: you see who is dumping the sewage into the local
• 1:07
  Speaker 1: pond or river. What do you think these environmental investigators
• 1:11
  Speaker 1: are looking for?
• 1:14
  Speaker 2: Chemical signatures, different strains of E. coli.
• 1:18
  Speaker 3: Nice.
• 1:19
  Speaker 2: Bacterial type.
• 1:20
  Speaker 1: Totally, yeah. So bacteria that are generally found in poop
• 1:27
  Speaker 1: and stool and stuff, definitely a big one. But not
• 1:30
  Speaker 1: all bacteria thrive. What you really want are some chemicals
• 1:34
  Speaker 1: that are excreted either in the urine or in the stool,
• 1:38
  Speaker 1: are really unchanged by the environment, and even better, something
• 1:41
  Speaker 1: that's not found in nature. So I'll give you one example,
• 1:44
  Speaker 1: which is gadolinium from MRIs. So when you get an
• 1:47
  Speaker 1: MRI with contrast, you get gadolinium injection. You pee it out,
• 1:52
  Speaker 1: it comes out in your urine, and it goes into
• 1:54
  Speaker 1: the sewage, and there just ain't no gadolinium in the
• 1:58
  Speaker 1: river water supply anywhere unless there's some sewage leaking into it.
• 2:02
  Speaker 1: So they could use gadolinium, but, you know, depends. Are
• 2:05
  Speaker 1: there MRIs going on around? One thing that they are
• 2:09
  Speaker 1: using more and more is sucralose, Splenda. Isn't that fascinating? Yeah,
• 2:16
  Speaker 1: because there isn't any Splenda anywhere. in freshwater supplies unless
• 2:21
  Speaker 1: it gets there by passing through someone's GI tract where
• 2:25
  Speaker 1: it is not absorbed. This is, of course, what we're
• 2:27
  Speaker 1: talking about today when we talk about non-nutritive sweeteners or
• 2:29
  Speaker 1: artificial sweeteners. Splenda is one that just goes right, passes
• 2:34
  Speaker 1: right through you. And increasingly, environmental investigators are using the
• 2:39
  Speaker 1: Splenda concentration gradient in freshwater to track down where the
• 2:46
  Speaker 1: leakage is coming from.
• 2:49
  Speaker 2: That's gross. Does it also work with like olein? Do
• 2:53
  Speaker 2: you remember that?
• 2:53
  Speaker 3: Oh, yeah.
• 2:54
  Speaker 2: Speaking of things, unnatural things that just went like right
• 2:56
  Speaker 2: through you?
• 2:57
  Speaker 1: Yeah. I don't think– yeah, maybe.
• 3:01
  Speaker 2: We don't have that anymore, sadly.
• 3:03
  Speaker 1: A University of Alberta study looked at a sweetener that's
• 3:06
  Speaker 1: excreted in the urine. It's a sulfame. It's excreted unchanged
• 3:11
  Speaker 1: in the urine. It's nicely absorbed and excreted unchanged in
• 3:13
  Speaker 1: the urine. And researchers at the University of Alberta tested
• 3:16
  Speaker 1: the level of this sweetener in public pools and hot
• 3:21
  Speaker 1: tubs as a proxy.
• 3:24
  Speaker 2: It's fine if people pee in the hot tub, okay?
• 3:27
  Speaker 2: It's natural.
• 3:29
  Speaker 1: It was detected everywhere. It was dramatically higher in the hot.
• 3:36
  Speaker 2: Tub, everyone. Than in the pool? Well, hot tub's small.
• 3:40
  Speaker 2: Hot dog small. Okay. Guys, you might think based on
• 3:43
  Speaker 2: this discussion that this is an episode about poop, but
• 3:45
  Speaker 2: that was two weeks ago. Today's episode is on artificial sweeteners.
• 3:50
  Speaker 2: So let's go. I'm Emily Oster. I'm an economist and
• 3:56
  Speaker 2: a data expert.
• 3:56
  Speaker 1: And I'm Perry Wilson. I'm a medical doctor.
• 3:59
  Speaker 2: It's Thursday, September 17th, 2026. And this is Wellness Actually.
• 4:04
  Speaker 1: Because you're getting a staggering amount of health and wellness
• 4:07
  Speaker 1: information nowadays from every source imaginable. And some of it
• 4:11
  Speaker 1: is awesome.
• 4:12
  Speaker 2: And some of it is, well, actually bullshit. Fortunately, we're
• 4:18
  Speaker 2: both people who know how to read studies, how to
• 4:20
  Speaker 2: parse the data, and can tell you what's worth thinking
• 4:23
  Speaker 2: about and what you can safely ignore.
• 4:25
  Speaker 1: But before we dig in, a note that this podcast
• 4:28
  Speaker 1: is for educational purposes and should not be construed as
• 4:30
  Speaker 1: medical advice. We don't know your unique situation. So talk
• 4:33
  Speaker 1: to your doctor for personal health decisions.
• 4:37
  Speaker 2: This week, we're asking what's the deal with artificial sweeteners?
• 4:40
  Speaker 2: Harry and I will give the official smasher pass and
• 4:43
  Speaker 2: we'll get to your question of the week. But first,
• 4:45
  Speaker 2: let's do the health news roundup after the break. And
• 4:59
  Speaker 2: now we're going to have the health news of the week. Perry,
• 5:02
  Speaker 2: there is an outbreak of Legionnaire's disease in New York City.
• 5:07
  Speaker 2: How concerned should we be?
• 5:09
  Speaker 1: Another outbreak of Legionnaire's disease. Outbreak number two. The first
• 5:14
  Speaker 1: was in Manhattan earlier this summer, resulting in 11 deaths
• 5:19
  Speaker 1: and 90 infections. This one's in the South Bronx. Looks
• 5:23
  Speaker 1: like just five infections so far. No, we're not going
• 5:27
  Speaker 1: to panic too much, but Legionnaires is an interesting and
• 5:31
  Speaker 1: difficult to deal with bacteria. So for those of you
• 5:34
  Speaker 1: who are not familiar, Legionnaires disease was originally discovered in
• 5:37
  Speaker 1: Philadelphia at a, there was a Legionnaires convention, I believe,
• 5:42
  Speaker 1: where a bunch of people got infected. It's a bacteria
• 5:45
  Speaker 1: that causes a pneumonia. So typical symptoms, fever, cough. But obviously,
• 5:51
  Speaker 1: it can be pretty severe, particularly in people who are
• 5:54
  Speaker 1: immunosuppressed or hospitalized patients. Death rates among hospitalized patients with
• 5:58
  Speaker 1: Legionnaires can get up to 30% or so, so we
• 6:00
  Speaker 1: worry about that. But what is really concerning and why
• 6:03
  Speaker 1: people talk about outbreaks is that Legionnaires likes to live
• 6:07
  Speaker 1: in warm water. It's actually not spread very efficiently at
• 6:11
  Speaker 1: all between people. It's almost always acquired from the environment.
• 6:16
  Speaker 1: Legionnaires can survive in hot water heaters, in the drip
• 6:19
  Speaker 1: pans of air conditioning units. It likes a temperature of
• 6:23
  Speaker 1: around 95 degrees and any fresh water that's warm could
• 6:28
  Speaker 1: potentially harbor Legionnaires. The problem is it forms a biofilm,
• 6:32
  Speaker 1: like the plaque that's on your teeth, and it can
• 6:35
  Speaker 1: be really, really hard once it takes root in a
• 6:38
  Speaker 1: system to get it out of the system. It can
• 6:41
  Speaker 1: form along pipes that are corroded. It gets kind of
• 6:43
  Speaker 1: into the corrosion and the gunk that's in pipes, and
• 6:46
  Speaker 1: it just can persist for quite some time And most
• 6:49
  Speaker 1: people end up getting infected. You know, they might be
• 6:51
  Speaker 1: taking a shower and it sort of aerosolizes that water.
• 6:54
  Speaker 1: They breathe it in. It gets into their lungs. So,
• 6:57
  Speaker 1: you know, this isn't something that you're going to be
• 6:59
  Speaker 1: like wearing a mask for or worrying about. But the,
• 7:03
  Speaker 1: you know, environmental protective services are going to be testing
• 7:05
  Speaker 1: a lot of water supplies in New York City. And
• 7:08
  Speaker 1: the remediation is not easy and can be quite costly
• 7:11
  Speaker 1: to get this stuff out once it's in.
• 7:14
  Speaker 2: Great. Great. Good.
• 7:16
  Speaker 1: Great. Thanks. Yep.
• 7:18
  Speaker 2: Okay.
• 7:18
  Speaker 1: In further good news, Emily, I enjoy a hot cup
• 7:24
  Speaker 1: of coffee every morning, but a new study has come
• 7:29
  Speaker 1: out that tells me, like everything else, that this is
• 7:32
  Speaker 1: going to kill me. Not because coffee, because we all
• 7:34
  Speaker 1: know that coffee is wonderful, but hot beverages now being
• 7:37
  Speaker 1: linked to esophageal cancer. What do you think about this one?
• 7:43
  Speaker 2: Yeah, so this is a new study. It's actually an
• 7:46
  Speaker 2: idea that has come up in other data before. And
• 7:51
  Speaker 2: this is a new study. It's a very large study
• 7:53
  Speaker 2: out of the UK, which compares people who drink a
• 7:56
  Speaker 2: lot of hot beverages to people who drink fewer hot
• 7:59
  Speaker 2: beverages and looks at their rates of esophageal cancer. And
• 8:03
  Speaker 2: they find an elevated risk in the very hot beverage drinkers.
• 8:08
  Speaker 2: So I complain a lot about observational data. and differences
• 8:13
  Speaker 2: across people and blah, blah, blah, blah, blah. And this
• 8:16
  Speaker 2: is a case where there's a bit of that, but
• 8:18
  Speaker 2: actually much less than in many other settings. So a
• 8:21
  Speaker 2: lot of times when we're looking at observational data, there's
• 8:24
  Speaker 2: like huge differences in weight and education and income and
• 8:28
  Speaker 2: other kinds of resources and how people eat and all
• 8:30
  Speaker 2: kinds of other stuff. Here, we don't see as much
• 8:33
  Speaker 2: of that. These groups look fairly comparable. And I think
• 8:36
  Speaker 2: that's partly because drinking hot beverages is actually something that
• 8:40
  Speaker 2: some people do and some people don't do, but isn't
• 8:42
  Speaker 2: as core as whether you ever consume a vegetable. So
• 8:46
  Speaker 2: the argument for causality, I think, is stronger here. There's
• 8:50
  Speaker 2: also a mechanistic reason why this might matter, because you
• 8:54
  Speaker 2: drink a very hot beverage, it potentially sloughs off your esophagus,
• 8:59
  Speaker 2: and that has to rebuild. And that rebuilding may put
• 9:02
  Speaker 2: you at greater risk for rebuilding in a way that
• 9:06
  Speaker 2: the cells are problematic. This is actually... I think the
• 9:10
  Speaker 2: same mechanism people have hypothesized for the possibility that endurance
• 9:14
  Speaker 2: runners are at higher risk for colon cancer, that you
• 9:17
  Speaker 2: slough off the inside of your large intestine more frequently. Yeah, gross.
• 9:23
  Speaker 1: My question about this one, though, is this is a
• 9:27
  Speaker 1: survey question, right? Like how hot do you drink your tea, coffee,
• 9:31
  Speaker 1: et cetera? And you could say like it's warm, it's
• 9:33
  Speaker 1: a little hot.
• 9:34
  Speaker 2: It's like how many very hot beverages do you drink
• 9:36
  Speaker 2: a day?
• 9:37
  Speaker 3: Okay.
• 9:37
  Speaker 2: Okay.
• 9:37
  Speaker 1: Is it possible that people with subclinical esophageal problems drinking
• 9:44
  Speaker 1: the same temperature tea would perceive it as hotter because
• 9:50
  Speaker 1: it's like, oh, I've gotten irritated esophagus already and it
• 9:52
  Speaker 1: kind of burns more as it goes down. So I'm
• 9:54
  Speaker 1: going to answer this survey and say it's hotter even
• 9:56
  Speaker 1: if it isn't. Am I reaching too much here? Maybe.
• 10:00
  Speaker 2: I think you're reaching a little bit. And this is
• 10:01
  Speaker 2: what we call a perspective study. So they have these
• 10:03
  Speaker 2: surveys and they follow people over time. So it's like
• 10:06
  Speaker 2: not quite as subject to that as you might think
• 10:08
  Speaker 2: if you like surveyed people in the moment and ask
• 10:11
  Speaker 2: them this question. I think the more important thing for
• 10:13
  Speaker 2: people to understand is this is a very, very rare cancer.
• 10:16
  Speaker 2: So this isn't, you know, this is a sort of
• 10:19
  Speaker 2: medium-size increase in the risk of cancer on a very
• 10:22
  Speaker 2: low base rate of this cancer. Esophageal cancer is just
• 10:25
  Speaker 2: not a very common cancer. So even if you did
• 10:29
  Speaker 2: change this behavior, and even if we thought these estimates
• 10:31
  Speaker 2: were causal, the sort of potential reduction in your cancer
• 10:35
  Speaker 2: risk is very, very small. So my guess is for
• 10:38
  Speaker 2: most people, this is sort of not decision-making. relevant, but
• 10:43
  Speaker 2: it's an interesting example for me of kind of an
• 10:45
  Speaker 2: observational study where I think there's more potential weight. But
• 10:50
  Speaker 2: something we'll never get a randomized data on because it's
• 10:53
  Speaker 2: too rare and the behavior is too ingrained.
• 10:56
  Speaker 1: But you know what? Iced coffee, delicious. Nothing wrong with that.
• 11:00
  Speaker 2: I hate iced coffee. Iced coffee is like a nightmare.
• 11:03
  Speaker 2: I think that's totally wrong. I think you're a hundred.
• 11:05
  Speaker 2: Like I couldn't, I couldn't disagree with you more.
• 11:07
  Speaker 1: That's a hot take listeners. Please tell us who's right
• 11:10
  Speaker 1: about iced coffee. Me or Emily. This is a slam
• 11:12
  Speaker 1: dunk for.
• 11:13
  Speaker 2: Hot coffee in the morning. It's like iced coffee is like,
• 11:16
  Speaker 2: what is this? Okay.
• 11:19
  Speaker 3: Yep.
• 11:20
  Speaker 2: Last question. There've been some new headlines about a new
• 11:25
  Speaker 2: designer drug showing up in a San Francisco autopsy. Is
• 11:31
  Speaker 2: it the next fentanyl?
• 11:32
  Speaker 1: This is really sad.
• 11:33
  Speaker 2: Yeah.
• 11:34
  Speaker 1: This is a drug called cyclorphine. And, you know, I
• 11:38
  Speaker 1: think the thing a lot of people that aren't in
• 11:40
  Speaker 1: this space don't realize is a lot of people, when
• 11:42
  Speaker 1: they hear about opiates, opioids, drugs that bind the opioid receptor,
• 11:47
  Speaker 1: things like morphine, heroin, et cetera, that cause, obviously, untold
• 11:51
  Speaker 1: suffering in the U.S. and around the world, most people
• 11:53
  Speaker 1: still think like, oh, yeah, but you need these poppy plantations, right,
• 11:57
  Speaker 1: you know, in Afghanistan or whatever to get the raw materials. And, like,
• 12:00
  Speaker 1: that's at least a rate-limiting step. That is not true.
• 12:02
  Speaker 3: Nope.
• 12:03
  Speaker 2: Nope.
• 12:04
  Speaker 1: So synthetic opioids like fentanyl are really coming to dominate
• 12:08
  Speaker 1: the market. These are things you can synthesize in just
• 12:11
  Speaker 1: kind of any lab, like any minimally equipped lab with
• 12:15
  Speaker 1: some relatively common raw materials. And cyclorphine is yet another
• 12:22
  Speaker 1: one of these. I think the thing that's scary about cyclorphine,
• 12:25
  Speaker 1: number one, is it's probably quite a bit more potent
• 12:28
  Speaker 1: than even fentanyl, which is, of course, like 100 times
• 12:31
  Speaker 1: more potent than heroin. So we don't have a precise
• 12:35
  Speaker 1: date on this because it's a relatively new drug. It
• 12:36
  Speaker 1: only showed up in Europe in 2025. And I think
• 12:38
  Speaker 1: this case in the US is the first death from
• 12:41
  Speaker 1: cyclorphine in the US. This was a teenager, by the way,
• 12:44
  Speaker 1: I think a 16-year-old kid, unfortunately. Cyclorphine might be about
• 12:47
  Speaker 1: 10 times more potent than fentanyl, which means like an
• 12:51
  Speaker 1: amount that would be very barely visible to see could
• 12:54
  Speaker 1: be a lethal dose. And of course, people aren't necessarily
• 12:58
  Speaker 1: taking it because they even think it's cyclorphine. They may
• 13:01
  Speaker 1: believe they're taking heroin. They may believe they're taking a
• 13:04
  Speaker 1: Percocet or something like that. And this stuff is added
• 13:07
  Speaker 1: to give the high, but because it's so potent, minor
• 13:12
  Speaker 1: miscalculations on dosage get you into a potentially fatal situation.
• 13:17
  Speaker 1: The other thing that some people are worried about is
• 13:20
  Speaker 1: that naloxone, which is the opioid reversal agent, many people,
• 13:24
  Speaker 1: including me, have doses of naloxone around just in case.
• 13:30
  Speaker 1: It's not a terrible idea, but it may require higher doses.
• 13:35
  Speaker 1: Because this is such a potent opioid, it may require
• 13:37
  Speaker 1: higher doses of naloxone to fully reverse if someone is overdosing.
• 13:42
  Speaker 1: So it's definitely scary and something that needs to be monitored.
• 13:49
  Speaker 2: Next week, I think that we should have only positive
• 13:51
  Speaker 2: things in our health news. And I think people should
• 13:55
  Speaker 2: also consider themselves lucky that I didn't make us discuss
• 13:58
  Speaker 2: the hydrox diarrhea incident in today's health news.
• 14:02
  Speaker 1: I'm so thankful for that.
• 14:03
  Speaker 2: You're welcome. That's it for the health news of the week.
• 14:07
  Speaker 2: And now, what is the deal with artificial sweeteners?
• 14:13
  Speaker 1: All right. A while back, Em, we got a question
• 14:17
  Speaker 1: from a listener who was like, I'm paraphrasing. I might
• 14:21
  Speaker 1: not get it correct. But it's basically like, I love
• 14:23
  Speaker 1: Diet Coke, but I am worried about these artificial sweeteners.
• 14:27
  Speaker 1: Is it healthier to drink a Coke than a Diet Coke?
• 14:32
  Speaker 2: Yes. And.
• 14:34
  Speaker 1: And are you saying yes, that we had that question
• 14:37
  Speaker 1: or yes.
• 14:37
  Speaker 2: That's the answer? Yes, we had that question. No, that's not, no.
• 14:40
  Speaker 2: I'm not answering it, but yes, we had that question.
• 14:42
  Speaker 3: Yeah.
• 14:42
  Speaker 1: I think that more than anything else exemplifies like why
• 14:47
  Speaker 1: we need to talk about the artificial sweeteners because there
• 14:49
  Speaker 1: is so much scary stuff out there that the whole
• 14:53
  Speaker 1: reason we have artificial sweeteners is because people are like, oh, well,
• 14:56
  Speaker 1: sugar is not good for you. Like sugar is bad.
• 14:58
  Speaker 1: And here's an alternative, you know, that doesn't have calories.
• 15:01
  Speaker 1: and is therefore better. And people are so nervous about
• 15:04
  Speaker 1: artificial sweeteners that they're actually like, well, for that whole
• 15:08
  Speaker 1: use case, I don't even care about because the dangers
• 15:10
  Speaker 1: are so high.
• 15:11
  Speaker 2: People also really love Diet Coke. So, you know, like
• 15:14
  Speaker 2: Gen Z calls Diet Coke a fridge cigarette, which I
• 15:18
  Speaker 2: think is so right. It's like you take it out
• 15:20
  Speaker 2: of the refrigerator in a can. It's like cold and
• 15:22
  Speaker 2: you open it and that first sip, it's like, it's sweet,
• 15:25
  Speaker 2: but it's not too sweet. And it's like fizzy. Like
• 15:27
  Speaker 2: Diet Coke, it's like, there's just nothing like that, you know?
• 15:32
  Speaker 1: Do you remember RC Cola? Are you old enough to
• 15:35
  Speaker 1: remember that?
• 15:36
  Speaker 2: I really, really am a devotee of Diet Coke. I
• 15:38
  Speaker 2: was on RC Cola.
• 15:40
  Speaker 3: All right.
• 15:40
  Speaker 1: Yeah. Hot take, RC Cola is the superior cola. Bring
• 15:43
  Speaker 1: it back.
• 15:44
  Speaker 2: What I'm saying here is that this is important to
• 15:46
  Speaker 2: people's lives. Yes, it is. This question is important. And
• 15:50
  Speaker 2: there are actually a lot of fears that people express,
• 15:53
  Speaker 2: but I think in some ways the most interesting one
• 15:57
  Speaker 2: is the question of whether Diet Coke makes you fat.
• 16:01
  Speaker 2: And whether artificial sweeteners are, in fact, also making you fat.
• 16:06
  Speaker 2: So why don't you just have, you know, regular sweetened
• 16:09
  Speaker 2: soda if they're both going to be linked? And a
• 16:12
  Speaker 2: super interesting feature is that in the observational data, that
• 16:15
  Speaker 2: is definitely true. So people who drink more artificially sweetened
• 16:19
  Speaker 2: beverages consistently, we see associations with higher obesity rates, higher
• 16:23
  Speaker 2: type 2 diabetes across large cohorts, millions of people. That
• 16:27
  Speaker 2: is very, very established as an association factor. in the data.
• 16:33
  Speaker 1: But people aren't coming to us for associations. They want
• 16:36
  Speaker 1: some causality.
• 16:37
  Speaker 2: They want some causality.
• 16:40
  Speaker 1: And we'll get into that. But before we talk about
• 16:44
  Speaker 1: the observational data and the problems with observational data here,
• 16:48
  Speaker 1: we should talk about plausibility even first, right? You can
• 16:52
  Speaker 1: observe data, but you want there to be some plausibility.
• 16:54
  Speaker 1: And I will say, as a lover of the laws
• 16:59
  Speaker 1: of thermodynamics, that I really do believe that fundamentally changes
• 17:05
  Speaker 1: in weight are driven by the difference between calories you
• 17:08
  Speaker 1: take in and calories you put out. Calories in, calories out. Now,
• 17:13
  Speaker 1: I know it's not that simple. That's like someone saying like, well,
• 17:16
  Speaker 1: you get rich by earning more money than you spend.
• 17:19
  Speaker 1: And like, well, that's technically true. Like it doesn't really
• 17:22
  Speaker 1: encapsulate everything. I know it's a bit pat, but when
• 17:26
  Speaker 1: it comes to sucralose, aspartame, we'll talk about all the
• 17:30
  Speaker 1: fun artificial sweeteners in this episode, these give you zero calories.
• 17:36
  Speaker 1: So if we're going to say that they cause an
• 17:39
  Speaker 1: increase in weight, they must do something to bring in
• 17:44
  Speaker 1: other calories in some other way, right? Because it can't
• 17:47
  Speaker 1: be them in and of itself or can it?
• 17:50
  Speaker 2: Right. No, it definitely can't. That's not how that works.
• 17:52
  Speaker 2: I think the two things that are sort of mucking
• 17:54
  Speaker 2: around in the background of some of the wellness discussion
• 17:57
  Speaker 2: here are one, the idea that that in some way
• 18:01
  Speaker 2: these chemicals change your microbiome in a way that is
• 18:04
  Speaker 2: going to then impact your absorption of calories in some way.
• 18:08
  Speaker 2: And there's a fair amount of hand-waving there. But because
• 18:10
  Speaker 2: we don't really know anything about the microbiome, we don't
• 18:13
  Speaker 2: understand it that well, I guess that could be true.
• 18:16
  Speaker 2: And then I think there's something else about kind of
• 18:18
  Speaker 2: sugar tolerance, like sort of sweetness tolerance that impacts things
• 18:21
  Speaker 2: in some other way. But fundamentally, it doesn't really make
• 18:25
  Speaker 2: any sense because the way that our body, for the
• 18:29
  Speaker 2: most part, gets calories is by consuming them. And if
• 18:32
  Speaker 2: you consume something that doesn't have any of them, you're
• 18:34
  Speaker 2: not consuming them. And so that doesn't really make any sense.
• 18:36
  Speaker 1: But I do believe that like, yeah, I think sugar
• 18:40
  Speaker 1: tolerance is a thing. Emily, you told me that I
• 18:43
  Speaker 1: should not be sweetening my coffee as much.
• 18:45
  Speaker 2: Sugar tolerance is a thing.
• 18:47
  Speaker 1: And, you know, I know my kids like sweet things.
• 18:51
  Speaker 1: And I do sort of wonder like, okay, if they
• 18:53
  Speaker 1: had less sweet things, maybe they would, you know, like
• 18:56
  Speaker 1: sweet things like fruit as opposed to sweet things like
• 18:58
  Speaker 1: Kit Kats.
• 18:59
  Speaker 2: Maybe. But I will say, I think in general, the,
• 19:03
  Speaker 2: the kind of claims about diet soda that people make
• 19:05
  Speaker 2: that are really difficult to track with the, just the
• 19:09
  Speaker 2: reality of the world is this idea that like, it's
• 19:11
  Speaker 2: just the same to have a Coke or a Diet Coke, right?
• 19:14
  Speaker 2: Like that those things are somehow equally contributing to, to weight.
• 19:18
  Speaker 2: And that's just very hard to imagine that that's true.
• 19:22
  Speaker 2: And yet we have these very persistent associations that, Which
• 19:26
  Speaker 2: brings me to why I think artificial sweeteners are like
• 19:30
  Speaker 2: an incredible example for statistics. Okay. Which is that this
• 19:34
  Speaker 2: is a place where we have very clearly the two
• 19:38
  Speaker 2: fundamental problems with learning causality from observational data. And I'm
• 19:43
  Speaker 2: going to tell you what they are. Okay, here we go.
• 19:46
  Speaker 1: I'm ready.
• 19:46
  Speaker 2: Tell me. Number one, reverse causality. So people begin to
• 19:54
  Speaker 2: consume diet sodas because they would like to lose weight. Okay.
• 19:59
  Speaker 2: This happens in many places, but it definitely happens here,
• 20:02
  Speaker 2: that people who are interested in losing weight because perhaps
• 20:07
  Speaker 2: they are struggling with obesity, will start consuming diet soda.
• 20:11
  Speaker 2: And so then you observe out in the world, you know,
• 20:13
  Speaker 2: the people who are struggling with obesity are more likely
• 20:17
  Speaker 2: to consume diet soda, but it's that the weight is
• 20:19
  Speaker 2: causing or the illness or whatever it is, is causing
• 20:22
  Speaker 2: the diet soda consumption rather than the.
• 20:24
  Speaker 1: Other way around.
• 20:25
  Speaker 2: So that is what's called reverse causality. You see this
• 20:29
  Speaker 2: like everywhere. So, you know, people who take baby aspirin
• 20:36
  Speaker 2: are more likely to have heart attacks even though baby
• 20:40
  Speaker 2: aspirin protects you against heart attacks because we tell people
• 20:43
  Speaker 2: to take baby aspirin when they have already had a
• 20:45
  Speaker 2: heart attack.
• 20:46
  Speaker 1: Yeah, yeah, yeah. The medical researchers often call this confounding
• 20:50
  Speaker 1: by indication, right? Like you have an indication to take
• 20:53
  Speaker 1: a baby aspirin and that's the confound there. But I
• 20:55
  Speaker 1: like reverse causality better because economists' terms are always easier
• 21:00
  Speaker 1: to understand.
• 21:00
  Speaker 2: We're winning there.
• 21:01
  Speaker 3: Yep.
• 21:01
  Speaker 2: The second problem, which you call residual confounding and we
• 21:05
  Speaker 2: call omitted variable bias, is that the people who are
• 21:08
  Speaker 2: consuming Diet Coke are ex-ante even before any of the
• 21:12
  Speaker 2: other behavioral confounding or just ex-ante different. So this is
• 21:16
  Speaker 2: a lifestyle marker. We tend to see consumption of artificial
• 21:22
  Speaker 2: sweeteners is associated with less education, with lower income. That's
• 21:26
  Speaker 2: just what you see. And that seems to be driving,
• 21:28
  Speaker 2: it's also associated with smoking and less physical activity and
• 21:32
  Speaker 2: all kinds of other variables which contribute to health. And
• 21:37
  Speaker 2: my sort of favorite set of facts here, and I
• 21:40
  Speaker 2: actually confirmed this by running the data myself yesterday in
• 21:43
  Speaker 2: preparation for this episode, is that this varies with different
• 21:48
  Speaker 2: kinds of sweeteners. So if you think about the space
• 21:51
  Speaker 2: of artificial sweeteners, and we're going to talk about the
• 21:53
  Speaker 2: different kinds of sweeteners, But we have like sucralose, aspartame,
• 21:58
  Speaker 2: which are kind of like the baseline, like the old
• 22:02
  Speaker 2: school regular sweeteners. Yeah. And then we have stevia, which
• 22:06
  Speaker 2: is like the Prada of artificial sweeteners.
• 22:08
  Speaker 1: Fancy.
• 22:09
  Speaker 2: Fancy sweeteners. And it turns out if you look in
• 22:13
  Speaker 2: the data at like who consumes those sweeteners, About 53%
• 22:18
  Speaker 2: of Stevia consumers have a college degree versus about 30%
• 22:22
  Speaker 2: of consumers of other. So it's like Stevia is like
• 22:26
  Speaker 2: it's consumed by people who have a lot of other
• 22:29
  Speaker 2: positively selected features.
• 22:30
  Speaker 1: Every product category has a bougie component, apparently.
• 22:35
  Speaker 2: Stevia is the bougie artificial sweetener. And then it turns
• 22:38
  Speaker 2: out if you looked in the observational data. stevia is
• 22:42
  Speaker 2: not associated with an increase in weight, whereas the other
• 22:44
  Speaker 2: artificial sweeteners are. And I think that kind of closes
• 22:47
  Speaker 2: the book a little bit here on this kind of like,
• 22:49
  Speaker 2: like it's not the art of, none of these things
• 22:51
  Speaker 2: have any, like they're all sweet. None of them have
• 22:54
  Speaker 2: any particular, you know, calories in them. It's just who
• 22:59
  Speaker 2: is consuming them. And I think those combination of middle
• 23:01
  Speaker 2: variable bias and reverse causality are driving a huge share
• 23:04
  Speaker 2: of what we see in this.
• 23:06
  Speaker 1: I think it can certainly explain what we see in
• 23:08
  Speaker 1: the observational literature, which, again, is consistent associations between intake
• 23:12
  Speaker 1: of these things and a higher BMI and diabetes. But
• 23:16
  Speaker 1: what we like to do to actually prove one way
• 23:19
  Speaker 1: or another is to do a trial, right? Let's randomize
• 23:23
  Speaker 1: some people. And it goes without saying, you can't do
• 23:27
  Speaker 1: randomized trials of 10 million people to find tiny effects
• 23:31
  Speaker 1: and things like that. But we do have some data,
• 23:34
  Speaker 1: I think, that we can speak to that would at
• 23:37
  Speaker 1: least suggest whether the observational data is completely backwards or not. Emily,
• 23:46
  Speaker 1: so broadly, yeah, I agree. The observational data showing a
• 23:50
  Speaker 1: link between artificial sweetener consumption, BMI, diabetes could very easily
• 23:54
  Speaker 1: be explained by reverse causality and omitted variable bias. But
• 23:59
  Speaker 1: maybe it's also true, right? These things exist and they
• 24:02
  Speaker 1: push things in that direction. But nevertheless... Maybe there is
• 24:05
  Speaker 1: some effect here. And it seems to me like the
• 24:08
  Speaker 1: best way to settle this, as always, is to do
• 24:11
  Speaker 1: a randomized trial, right? Do we have data where we
• 24:15
  Speaker 1: take some people and give some of them artificial sweeteners
• 24:18
  Speaker 1: and some of them not artificial sweeteners? And broadly speaking,
• 24:21
  Speaker 1: what happens when you do that?
• 24:23
  Speaker 2: Yeah, what happens when you do that is people lose
• 24:25
  Speaker 2: a little bit of weight. And we have some trials
• 24:27
  Speaker 2: on that in adolescents, although largely they're just replacing sugar
• 24:32
  Speaker 2: sweetened beverages with like water. But when we generally replace
• 24:38
  Speaker 2: sweetened beverages with artificially sweetened beverages, people lose a little
• 24:40
  Speaker 2: bit of weight. These trials tend to be pretty short.
• 24:42
  Speaker 2: People lose a couple of pounds. It's not like an
• 24:44
  Speaker 2: earth-shattering change in everything, but it does seem consistent with
• 24:49
  Speaker 2: what you would expect, that removing 250 calories a day
• 24:53
  Speaker 2: from people's diet causes them to lose some weight, which
• 24:55
  Speaker 2: is pretty much what you would expect in the kind
• 24:57
  Speaker 2: of calories in, calories out story. I guess I think
• 25:01
  Speaker 2: this for me answers this core question people have at
• 25:05
  Speaker 2: the top and the question we started with, which was like,
• 25:08
  Speaker 2: should I substitute a regular Coke for my diet Coke? No.
• 25:11
  Speaker 2: Don't do that. You shouldn't do that.
• 25:14
  Speaker 1: Don't drink calories.
• 25:15
  Speaker 2: Yes. Don't drink your calories. Sometimes it's good to drink
• 25:18
  Speaker 2: your calories, but in general... don't drink your calories.
• 25:21
  Speaker 1: If you're worried about your weight, don't drink calories. How
• 25:23
  Speaker 1: about that?
• 25:23
  Speaker 2: If you're, otherwise it's fine.
• 25:26
  Speaker 1: Training for a run.
• 25:26
  Speaker 2: Yeah.
• 25:27
  Speaker 1: Yeah.
• 25:27
  Speaker 2: Great ultra, if you're on in the middle of an
• 25:29
  Speaker 2: ultra marathon, and I think another way to say it's like,
• 25:31
  Speaker 2: if people are in the middle of an ultra marathon,
• 25:33
  Speaker 2: like they drink Coke, they don't drink Diet Coke. And
• 25:36
  Speaker 2: that is because it doesn't have any sugar in it.
• 25:39
  Speaker 2: It doesn't give you the glucose that you need to
• 25:42
  Speaker 2: complete the rest of Western states. Having said that, that
• 25:46
  Speaker 2: is actually a fairly narrow version of this question. I
• 25:49
  Speaker 2: think there is a much broader version of the artificial
• 25:52
  Speaker 2: sweetener question, which gets into like, how does sweetness work?
• 25:58
  Speaker 2: And also, are there other concerns about this? And I
• 26:02
  Speaker 2: guess that's, you know, beyond the, is this going to
• 26:05
  Speaker 2: make me fat? I think there's a question of like,
• 26:06
  Speaker 2: is this going to give me cancer? Like, am I
• 26:08
  Speaker 2: just putting some random, you know, you told me at
• 26:10
  Speaker 2: the cold open that like, you know, these things are
• 26:14
  Speaker 2: so difficult to process that they're using them to track sewage.
• 26:18
  Speaker 2: It doesn't seem good. And so I think that's where
• 26:20
  Speaker 2: we should turn now.
• 26:22
  Speaker 1: Absolutely. And the story of how some of these substances
• 26:27
  Speaker 1: came about is another example of where a lack of
• 26:34
  Speaker 1: good regulatory oversight and honestly outright corruption is got into
• 26:38
  Speaker 1: the very DNA of this stuff and has persisted in
• 26:44
  Speaker 1: the form of conspiracy theories ever since. And we're going
• 26:47
  Speaker 1: to tell that story after the break. Okay, we are
• 26:56
  Speaker 1: back talking about artificial sweeteners, and it's time to do
• 27:01
  Speaker 1: a little bit of science and explain how this stuff
• 27:05
  Speaker 1: actually works. So Taste is really an amazing sense. And
• 27:12
  Speaker 1: you have a bunch of receptors on your tongue that
• 27:15
  Speaker 1: do certain jobs, and they communicate via nerves to the brain,
• 27:18
  Speaker 1: and your brain interprets those signals to give you a
• 27:20
  Speaker 1: sense of how things taste. And that's really all there
• 27:22
  Speaker 1: is to it. You have, for example, a sour receptor
• 27:25
  Speaker 1: that basically is just a hydrogen channel. So hydrogen is
• 27:30
  Speaker 1: what is present in acids, things that are sour. And
• 27:33
  Speaker 1: if you put a bunch of acid in your mouth,
• 27:35
  Speaker 1: the hydrogens go through that channel, stimulate a nerve. Your
• 27:38
  Speaker 1: brain says, ooh, acid. I'm going to interpret that as sour.
• 27:40
  Speaker 1: And that's sour. You have a salt receptor, saltiness, which
• 27:44
  Speaker 1: does the same thing, but with sodium. So if you
• 27:46
  Speaker 1: put a bunch of sodium in your mouth, your brain
• 27:47
  Speaker 1: says like, oh, that is salty. But sweet is a
• 27:51
  Speaker 1: bit more complicated. It's a protein-based receptor, actually. It's two
• 27:55
  Speaker 1: proteins that come together in a protein dimer. And when
• 27:59
  Speaker 1: something binds this protein, it opens a channel that allows
• 28:04
  Speaker 1: actually calcium to flow in. There's always calcium sitting around.
• 28:07
  Speaker 1: And that's the sweet signal. And that's what sugar does.
• 28:09
  Speaker 1: That's what sucrose does or fructose or anything. They all
• 28:12
  Speaker 1: bind this channel. That's all well and good. And then
• 28:16
  Speaker 1: You know, like any other receptor in your body, you
• 28:19
  Speaker 1: can design chemicals that bind that receptor in their own way, right?
• 28:24
  Speaker 1: And activate the receptor in their own way. But basically
• 28:28
  Speaker 1: none of the artificial sweeteners were designed. designed to do
• 28:33
  Speaker 1: this in any way. They were almost all discovered accidentally.
• 28:37
  Speaker 1: Can I just run through? Because I think it's hilarious.
• 28:41
  Speaker 1: The history of artificial sweeteners is the history of bad
• 28:43
  Speaker 1: lab hygiene. What not to do.
• 28:46
  Speaker 2: Or just bad work hygiene. Just bad hygiene.
• 28:50
  Speaker 1: Terrible. So we'll start with saccharin, which was invented in
• 28:53
  Speaker 1: 1879 by a guy, Constantine Falberg. He was working on
• 28:57
  Speaker 1: coal tar derivatives, I guess, back in 1879. That's the
• 29:01
  Speaker 1: kind of thing you did. And he was at dinner
• 29:03
  Speaker 1: and his hands tasted sweet as he was like licking
• 29:05
  Speaker 1: his fingers. And he was like, oh, that's odd.
• 29:07
  Speaker 2: Boom.
• 29:08
  Speaker 1: They had discovered.
• 29:09
  Speaker 2: Wash your hands, people. Wash your hands. But if you don't,
• 29:12
  Speaker 2: you could discover a very important chemical. Yeah, right. Aspartame, 1965.
• 29:21
  Speaker 1: James Schlattler was trying to synthesize an anti-ulcer drug, and
• 29:27
  Speaker 1: he licked his finger to pick up a piece of paper.
• 29:29
  Speaker 1: He did that guy like, oh, and he was like, oh,
• 29:31
  Speaker 1: that's very sweet. And that gave us aspartame. Sucralose, 1976.
• 29:36
  Speaker 1: Shashikant Fadnes says, Queen Elizabeth College in London was working
• 29:43
  Speaker 1: with some colleagues and they had created a chlorinated sugar.
• 29:46
  Speaker 1: And apparently his colleagues asked him, can you test this?
• 29:50
  Speaker 1: He heard, can you taste this? And he tasted it.
• 29:56
  Speaker 1: It was very sweet. I just think This is hilarious.
• 30:00
  Speaker 1: But people... How did they.
• 30:02
  Speaker 2: Know that we're sick? Like sick. This is what I
• 30:04
  Speaker 2: don't understand. Like, do you just like you tasted some
• 30:07
  Speaker 2: sweet stuff on your hands at dinner? And then the
• 30:09
  Speaker 2: next day we were like, oh, I'm not dead. I
• 30:11
  Speaker 2: guess probably I should market that. Put it in a drink.
• 30:14
  Speaker 1: I mean, yeah.
• 30:15
  Speaker 3: No. Yeah.
• 30:16
  Speaker 1: They do animal testing. They do stuff. They do studies. Well,
• 30:20
  Speaker 1: with the aspartame, we got to get to the aspartame story.
• 30:23
  Speaker 1: But just one last thing because it's so fun. Have
• 30:26
  Speaker 1: you ever tried miracle fruit pills?
• 30:29
  Speaker 2: Absolutely. My kids once made me try this.
• 30:31
  Speaker 1: Oh my God. We did it with my kids.
• 30:32
  Speaker 2: Kids love this thing.
• 30:33
  Speaker 1: So do you want to explain like how it works?
• 30:37
  Speaker 2: I don't. This was a long time ago.
• 30:39
  Speaker 1: Well, not the chemistry. I'll do the chemistry, but just
• 30:41
  Speaker 1: the experience, right? So you get these pills in the
• 30:43
  Speaker 1: mail and you sort of like dissolve them in your mouth.
• 30:46
  Speaker 2: And then after, yes, you dissolve them in your mouth.
• 30:49
  Speaker 2: And then for some, like what I recall being quite
• 30:52
  Speaker 2: a lengthy period.
• 30:52
  Speaker 1: Like an hour.
• 30:53
  Speaker 2: Not like two minutes, but like a sizable amount of time,
• 30:56
  Speaker 2: you could just like eat a lemon and it was delicious. Yeah. Yeah, yeah.
• 30:59
  Speaker 2: And any kind of bitter, I mean, it's like any
• 31:01
  Speaker 2: kind of sour, sour thing would sort of taste sweet.
• 31:04
  Speaker 1: Totally. It's really cool. And people have these like miraculous,
• 31:08
  Speaker 1: it's called miraculous parties where they just have, yeah, they
• 31:11
  Speaker 1: have like pickle juice and lemon juice and all these
• 31:15
  Speaker 1: kind of things. And they just taste amazing. Or like
• 31:17
  Speaker 1: a Guinness tastes like a milkshake, basically. But the chemistry
• 31:20
  Speaker 1: is so cool. So the way miraculin works is it
• 31:23
  Speaker 1: binds that sweet receptor on your tongue, but it doesn't
• 31:26
  Speaker 1: activate it. So it doesn't actually taste sweet itself when
• 31:28
  Speaker 1: you dissolve in your mouth. It just sits there. And
• 31:30
  Speaker 1: it binds pretty strongly, which is why it lasts for
• 31:33
  Speaker 1: like an hour. And then if the pH in your
• 31:36
  Speaker 1: mouth goes down, like you put an acid in your mouth,
• 31:38
  Speaker 1: the chemical, the miraculin changes its shape on the receptor
• 31:42
  Speaker 1: and opens the receptor. So by putting an acid in
• 31:46
  Speaker 1: your mouth, all of a sudden your sweet receptors are like, ooh,
• 31:48
  Speaker 1: that's sweet. And your brain, like your brain doesn't know, right?
• 31:51
  Speaker 1: It's like, oh, that's sweet. Now the sour receptors still work.
• 31:54
  Speaker 1: Like Miraculin doesn't bind that at all. So for instance,
• 31:57
  Speaker 1: when you're drinking lemon juice on this stuff, you still
• 32:00
  Speaker 1: get the sour signal, but you also get sweet signal.
• 32:04
  Speaker 1: So it kind of tastes like lemonade. It's not just
• 32:05
  Speaker 1: like pure sugar. It's really fascinating. But actually people have
• 32:09
  Speaker 1: like hurt themselves by putting so much acid in their mouth,
• 32:12
  Speaker 1: like drinking vinegar and stuff like that, it all tastes
• 32:15
  Speaker 1: sweet that they can get little mouth ulcers and things.
• 32:18
  Speaker 1: So don't go crazy, but it is kind of fun.
• 32:20
  Speaker 2: That is, it is very fun. It's something your kids
• 32:22
  Speaker 2: will really like. Yeah.
• 32:25
  Speaker 1: All right. Aspartame is, because you were talking about how
• 32:30
  Speaker 1: we get from accidentally licking my fingers instead of washing
• 32:33
  Speaker 1: my hands to a world where we're concerned about, are
• 32:39
  Speaker 1: these things causing cancer or like, any other horrible scenario.
• 32:43
  Speaker 1: And the truth is the aspartame regulatory process was bad.
• 32:50
  Speaker 2: Bad.
• 32:50
  Speaker 1: It was bad. And this is bigger in Europe. I
• 32:54
  Speaker 1: feel like in the US, you don't hear people talking
• 32:57
  Speaker 1: too much about aspartame. It's like, oh, we got to
• 33:00
  Speaker 1: get aspartame out of the system. It's huge in France,
• 33:02
  Speaker 1: for example. It's a very big sort of issue, the
• 33:05
  Speaker 1: aspartame thing overseas. But I think this is why. So Em,
• 33:10
  Speaker 1: do you want to Walk us through the crazy stuff
• 33:15
  Speaker 1: that happened to get aspartame approved by the FDA.
• 33:21
  Speaker 2: Okay. In 1974, aspartame is discovered by Searle and it
• 33:28
  Speaker 2: is quickly approved by the FDA. Like very, very, quite quickly.
• 33:34
  Speaker 1: Yep. Thumbs up. Sounds good. Thumbs up.
• 33:36
  Speaker 2: It's great. And then... There is a freezing of the
• 33:39
  Speaker 2: approval because people are concerned, consumer attorneys are concerned, about
• 33:43
  Speaker 2: some related compounds causing brain tumors in mice. So this
• 33:46
  Speaker 2: idea that these are cancer-causing things kind of comes up.
• 33:50
  Speaker 2: And then the FDA starts investigating. And actually, it turns
• 33:55
  Speaker 2: out the animal testing was quite poor. And they actually
• 33:59
  Speaker 2: start requesting a criminal investigation of the company, suggesting that
• 34:03
  Speaker 2: they may have submitted false test results. So they may
• 34:05
  Speaker 2: have actually done the testing and then sent, or maybe
• 34:08
  Speaker 2: they didn't do the testing and they just made things up.
• 34:09
  Speaker 1: Yeah, this is a big, this does not happen. I mean,
• 34:13
  Speaker 1: criminal investigations of pharmaceutical companies are very unusual in this country.
• 34:19
  Speaker 1: And so, you know, this seems pretty bad, right?
• 34:24
  Speaker 2: What happens next is even worse.
• 34:26
  Speaker 1: Okay, keep going.
• 34:28
  Speaker 2: So then the U.S. attorney who is investigating this quits
• 34:32
  Speaker 2: the government and he moves on to a different job.
• 34:36
  Speaker 2: Where is that job?
• 34:37
  Speaker 1: Where did he decide to take a job?
• 34:39
  Speaker 2: He took a job with Searle. Yeah.
• 34:41
  Speaker 1: Weird.
• 34:42
  Speaker 2: The investigation kind of stalls out. They get to the
• 34:45
  Speaker 2: statute of limitations. And this sort of just for that
• 34:50
  Speaker 2: period goes nowhere. Then what happens?
• 34:53
  Speaker 1: Yeah. The FDA did... You know, there was some pushback
• 34:58
  Speaker 1: here for obvious reasons, right? You had the lead prosecutor
• 35:01
  Speaker 1: leaving the government, working for the people he was prosecuting.
• 35:03
  Speaker 1: The case had died. So the FDA, to sort of
• 35:06
  Speaker 1: mollify the public, put together an independent panel to review
• 35:10
  Speaker 1: the aspartame data. And they basically said, look, we're going
• 35:14
  Speaker 1: to recommend against approval of aspartame until there's more brain
• 35:17
  Speaker 1: tumor data. Now, to be clear, everyone up front, there
• 35:21
  Speaker 1: will be no more brain tumor data. Like, It doesn't
• 35:24
  Speaker 1: cause brain tumors. That data eventually comes out and has
• 35:27
  Speaker 1: been replicated ad infinitum in multiple other studies. But at
• 35:30
  Speaker 1: the time, in 1980, that wasn't clear. So this was
• 35:34
  Speaker 1: a reasonable thing, but I don't want to say just
• 35:36
  Speaker 1: because people were worried and asked for more data means
• 35:38
  Speaker 1: that it's true. It's not. But OK, so the FDA
• 35:42
  Speaker 1: panel says no. A year later, Ronald Reagan appoints Arthur
• 35:46
  Speaker 1: Hayes as the FDA commissioner, and he takes that FDA
• 35:51
  Speaker 1: panel recommendation against aspartame. and overrules it. Just, you know,
• 35:56
  Speaker 1: the FDA commissioner can do that, says, thank you for
• 35:58
  Speaker 1: your work panel, but nope, aspartame gets approved. He would
• 36:02
  Speaker 1: later leave the FDA to join a public relations company.
• 36:07
  Speaker 1: Do you want to guess what pharmaceutical company was on
• 36:09
  Speaker 1: that company's client list?
• 36:10
  Speaker 2: Let me guess, it was Searle. It was Searle, wasn't it?
• 36:13
  Speaker 1: It was Searle. So, This is all gross. This is
• 36:19
  Speaker 1: like classic government corruption, you know, revolving door nonsense at
• 36:24
  Speaker 1: the agencies. All that being said, like... it's actually not
• 36:29
  Speaker 1: aspartame's fault that these humans are gross and corrupt. Don't
• 36:34
  Speaker 1: blame the molecule. Blame the horrible people. And again, there's
• 36:40
  Speaker 1: potentially nothing more deeply studied in the nutrition literature than
• 36:45
  Speaker 1: the potential toxicology of aspartame since this time. It really
• 36:49
  Speaker 1: has gone through the ringer. It does not appear to
• 36:51
  Speaker 1: cause cancer or anything like that. But Because of how
• 36:54
  Speaker 1: it got started, there's this narrative. And I will say
• 36:58
  Speaker 1: that one thing that really set the narrative on fire
• 37:01
  Speaker 1: actually didn't happen until 1998. So long after all this,
• 37:04
  Speaker 1: aspartame has been approved for a while. We actually had
• 37:06
  Speaker 1: the follow-up studies that the FDA had originally requested, looking
• 37:09
  Speaker 1: for brain tumors, not finding any, and so on and
• 37:11
  Speaker 1: so forth. It appears to be safe. And then we
• 37:14
  Speaker 1: get a chain email, which is like, this is 1998,
• 37:18
  Speaker 1: before the days of social media, called the Nancy Markle email.
• 37:23
  Speaker 1: And according to the email, and I'll tell you what
• 37:28
  Speaker 1: it says, but I want people to think through how
• 37:31
  Speaker 1: much this stuff echoes what we see now on Instagram
• 37:34
  Speaker 1: and TikTok and stuff from influencers, because it's like the
• 37:36
  Speaker 1: exact same beats. Okay. So the email says that this
• 37:41
  Speaker 1: was taken from her talk, Nancy Markle's talk at the
• 37:43
  Speaker 1: World Environmental Conference. The email claims that aspartame causes multiple sclerosis, lupus,
• 37:49
  Speaker 1: chronic fatigue syndrome, seizures, brain tumors, Alzheimer's disease, blindness, birth defects,
• 37:54
  Speaker 1: and deaths. Some versions of the chain email were modified
• 37:57
  Speaker 1: to add Gulf War Syndrome, which is like, okay. It
• 38:00
  Speaker 1: has a lot of scientific jargon.
• 38:03
  Speaker 2: It reads like an Instagram post. Oh, 100%. It's like,
• 38:08
  Speaker 2: did you study show, you know, da-da-da-da-da, like, you know,
• 38:12
  Speaker 2: there's music over it in my head.
• 38:15
  Speaker 1: Yeah, 100%. Um, the letter says that while she was
• 38:18
  Speaker 1: giving this talk, people were standing up and saying like,
• 38:21
  Speaker 1: that's me. Like, like I've been affected by aspartame at this,
• 38:25
  Speaker 1: at this major scientific conference, which is the sort of
• 38:27
  Speaker 1: old and day equivalent of like, and then everybody clapped.
• 38:30
  Speaker 2: Right. Um, it had so many likes, so many people
• 38:34
  Speaker 2: like likes and comments.
• 38:37
  Speaker 1: Now, Nancy Markle does not exist. Neither does the conference
• 38:41
  Speaker 1: that's never been found. Um, The reporters have suggested the
• 38:45
  Speaker 1: email was written by an activist named Betty Martini. She
• 38:48
  Speaker 1: refers to herself as Dr. Betty Martini, but just a
• 38:51
  Speaker 1: note here that it's an honorary doctorate in humanities from
• 38:54
  Speaker 1: an unaccredited religious institution. Another wellness trope, referring to yourself
• 38:59
  Speaker 1: as doctor, when maybe not exactly. So anyway, that's a
• 39:07
  Speaker 1: bit of the aspartame thing. saga, which I think just,
• 39:11
  Speaker 1: it reminds me a little bit when we talked about
• 39:12
  Speaker 1: Lyme disease and how there are a lot of conspiracy
• 39:15
  Speaker 1: theories about Lyme disease now, and a lot of them
• 39:17
  Speaker 1: are traced back to the sort of bad way that
• 39:22
  Speaker 1: doctors treated the early patients before they understood what Lyme
• 39:25
  Speaker 1: disease was. And it's like somehow the origin of these
• 39:28
  Speaker 1: substances or these diseases like stay with us for decades
• 39:33
  Speaker 1: and lead to where we are.
• 39:35
  Speaker 2: I think the other sort of trope that works here
• 39:38
  Speaker 2: that echoes a lot of other wellness stuff is the
• 39:41
  Speaker 2: kind of discussion of chemicals and the scariness of chemical interactions.
• 39:47
  Speaker 2: So people will tell you something which is true, which
• 39:51
  Speaker 2: is that aspartame is a dipeptide and it's held together
• 39:55
  Speaker 2: by a methyl ester. And if you break it down,
• 39:57
  Speaker 2: you get aspirate, you get phenylalanine, you get methanol. And
• 40:00
  Speaker 2: that's toxic and it converts to formaldehyde. And oh my God,
• 40:04
  Speaker 2: this is basically just like drinking a can of formaldehyde.
• 40:06
  Speaker 2: And that's, you sort of work through that. That's true.
• 40:11
  Speaker 2: But of course it's like in tiny amounts that are
• 40:14
  Speaker 2: very similar to the amount of methanol you get from
• 40:18
  Speaker 2: a diet soda. Is it quite similar to what you
• 40:20
  Speaker 2: get from like a, you know, fruit juice? Like you
• 40:25
  Speaker 2: can process that.
• 40:26
  Speaker 1: Some formaldehyde. No, totally. So methanol, if you've ever brewed
• 40:32
  Speaker 1: at your own alcohol, brewed beer- And who hasn't?
• 40:37
  Speaker 2: I have.
• 40:38
  Speaker 1: Definitely. When you distill alcohol, the yeast don't only make ethanol,
• 40:44
  Speaker 1: they make methanol too, which is why fruit juice has
• 40:47
  Speaker 1: a little bit of methanol and a little bit of
• 40:48
  Speaker 1: alcohol in it. When you're actually distilling that out, you
• 40:51
  Speaker 1: have to be careful not to include, you have to
• 40:54
  Speaker 1: get rid of the methanol. That's part of what an
• 40:56
  Speaker 1: actual distillery does is get rid of the methanol and
• 40:59
  Speaker 1: only keep the ethanol. But yeah, all fruit juice has
• 41:03
  Speaker 1: a little bit of methanol in it. Just to put
• 41:04
  Speaker 1: some numbers on it, if you were to break down
• 41:07
  Speaker 1: all of the aspartame in 12 ounces of diet soda,
• 41:10
  Speaker 1: that would lead to about a 20 milligram methanol intake.
• 41:14
  Speaker 1: A typical alcoholic drink has about 35 milligrams of methanol.
• 41:17
  Speaker 1: Fruit juice, fresh squeezed before yeast have a chance to
• 41:20
  Speaker 1: do anything, has about 15 milligrams of methanol. If you
• 41:24
  Speaker 1: let it sit for a few hours, you have about
• 41:25
  Speaker 1: 30 milligrams of methanol. So yeah, the dose makes the poison.
• 41:30
  Speaker 1: We say this all the time. Your body has ways to...
• 41:32
  Speaker 1: Things in very high doses can be toxic that in
• 41:36
  Speaker 1: low doses just aren't because that's the natural world. We
• 41:39
  Speaker 1: evolved to process some methanol because we eat fruit and
• 41:44
  Speaker 1: other things that ferment.
• 41:46
  Speaker 2: To pull this together, despite these initial concerns, despite the...
• 41:53
  Speaker 2: corrupt nature of the aspartame approval. There is no evidence
• 41:58
  Speaker 2: that artificial sweeteners cause cancer in people. There's like in rats,
• 42:06
  Speaker 2: there are a few studies which have suggested that if
• 42:10
  Speaker 2: you exclusively feed rodents artificial sweeteners, Maybe there could be
• 42:16
  Speaker 2: some problems, although even those studies, I think, have some
• 42:19
  Speaker 2: pretty significant limitations. And again, when we get to the
• 42:23
  Speaker 2: sort of dosing issues, like we are talking about doses
• 42:26
  Speaker 2: that are vastly, vastly, vastly, vastly higher than people could
• 42:30
  Speaker 2: ever consider, even people who really, really like Diet Coke.
• 42:34
  Speaker 3: Yeah.
• 42:34
  Speaker 1: Some people listening might know that saccharin got a warning
• 42:38
  Speaker 1: label in 1977 about bladder cancer. It was subsequently removed
• 42:43
  Speaker 1: in the year 2000. But it's interesting if you look
• 42:46
  Speaker 1: at where that came from. So they had given mice
• 42:48
  Speaker 1: just Herculean doses of saccharin. And male rats formed saccharin
• 42:55
  Speaker 1: crystals in their bladder that irritated the lining of the
• 42:58
  Speaker 1: bladder that kind of damaged the epithelium of the bladder,
• 43:01
  Speaker 1: which increased the risk of bladder cancer. It's actually only
• 43:03
  Speaker 1: seen in Male mice, it was not seen in the
• 43:06
  Speaker 1: female mice. It was actually species specific to, like it
• 43:08
  Speaker 1: didn't happen in other mice. It's very unique to like
• 43:11
  Speaker 1: the kidney and urinary system of this particular mouse that
• 43:15
  Speaker 1: it just forms saccharin crystals. This doesn't happen in people,
• 43:18
  Speaker 1: which is why the label was removed because it's just,
• 43:21
  Speaker 1: it's not a human risk. But if you have this
• 43:24
  Speaker 1: particular species of mouse, please don't feed it exclusively saccharin water,
• 43:29
  Speaker 1: which I think is what was done with this study.
• 43:32
  Speaker 2: Great, great point.
• 43:33
  Speaker 3: All right.
• 43:34
  Speaker 2: So that is all of the like regular artificial sweeteners
• 43:38
  Speaker 2: that we talk about. And one of the features of
• 43:41
  Speaker 2: almost all of these is that the doses are really,
• 43:43
  Speaker 2: really small. That we're basically giving people teeny tiny doses
• 43:46
  Speaker 2: because these things are very sweet. They really, like these chemicals,
• 43:50
  Speaker 2: you know, you touch something at your lab, you lick
• 43:52
  Speaker 2: your fingers, they're really, really sweet. Way sweeter than sugar.
• 43:56
  Speaker 1: Oh, yeah. Hundreds of times sweeter in some cases.
• 43:58
  Speaker 3: Yeah.
• 43:58
  Speaker 2: And so the third thing that I think we want
• 44:01
  Speaker 2: to touch on here is actually there are artificial sweeteners
• 44:07
  Speaker 2: or sugar alcohols that actually you do have to consume
• 44:12
  Speaker 2: quite a lot of to get the same effects. And
• 44:15
  Speaker 2: this is a place where I think there maybe are
• 44:19
  Speaker 2: maybe some reasons to be a little concerned.
• 44:22
  Speaker 1: I think that's right. And I think we should bring
• 44:26
  Speaker 1: it back to dose. I want to talk about dose
• 44:29
  Speaker 1: for a second and why, in principle, I get more
• 44:32
  Speaker 1: nervous when we're talking about relatively higher doses of any
• 44:36
  Speaker 1: substance versus relatively low doses of a substance. So all right,
• 44:40
  Speaker 1: no one is eating 30 grams of aspartame, right? 200
• 44:43
  Speaker 1: milligrams of aspartame in a Diet Coke. So getting 30 grams,
• 44:48
  Speaker 1: you're I can't do that math. 100 cans of Coke
• 44:51
  Speaker 1: or something like that. 100 cans of Diet Coke. But
• 44:53
  Speaker 1: a single serving of keto ice cream can get you
• 44:55
  Speaker 1: 30 grams of erythritol. No problem.
• 44:59
  Speaker 2: Okay.
• 44:59
  Speaker 1: So we're talking. And the reason you need so much
• 45:02
  Speaker 1: sugar alcohols, things like, by the way, xylitol, erythritol is
• 45:05
  Speaker 1: probably the most common one that you'll see. Maltitol, lactitol,
• 45:09
  Speaker 1: they all end in that at all. they're just not
• 45:11
  Speaker 1: that sweet. They're actually a bit less sweet than sugar,
• 45:14
  Speaker 1: about 70% the sweetness. And so you really need to
• 45:17
  Speaker 1: put a lot in. Whereas with things like aspartame or sucralose,
• 45:22
  Speaker 1: you put a tiny pinch in. And the reason this matters.
• 45:25
  Speaker 2: And why are people using the, like, why not sweeten
• 45:28
  Speaker 2: your non-sweetened? These are like commonly used in like keto
• 45:31
  Speaker 2: ice cream. Why not just stick in some Stevia and
• 45:35
  Speaker 2: that shit?
• 45:37
  Speaker 1: Some of the- non-nutritive sweeteners, the high potency non-nutritive sweeteners
• 45:41
  Speaker 1: aren't heat stable. I know that. I think sucralose is
• 45:45
  Speaker 1: actually though, but maybe sucralose is expensive. I mean, it
• 45:49
  Speaker 1: oftentimes comes down to cost.
• 45:50
  Speaker 2: I have to wonder if some of this is, by
• 45:51
  Speaker 2: the way, people are like, oh, I don't want to
• 45:53
  Speaker 2: have sucralose because I love this other thing, which seems fancier. Yeah.
• 45:58
  Speaker 1: And I mean, some of this stuff they can label
• 45:59
  Speaker 1: as like natural because they get it from plants or things.
• 46:04
  Speaker 1: But the reason I worry more about eating 30 grams
• 46:07
  Speaker 1: of something than 200 milligrams of something is, especially when
• 46:13
  Speaker 1: it comes to this, the, these molecules, the high potency
• 46:17
  Speaker 1: ones are designed to bind that receptor on your tongue.
• 46:21
  Speaker 1: They do that, that's their job and they do it
• 46:22
  Speaker 1: extraordinarily well. Because you're getting such a tiny dose, the
• 46:27
  Speaker 1: chance of them also binding something else and like doing
• 46:31
  Speaker 1: something else, what we call off target effects is just
• 46:34
  Speaker 1: slightly lower, not zero. But they're designed with high potency
• 46:38
  Speaker 1: towards one receptor. It makes it slightly less likely that
• 46:41
  Speaker 1: they're going to muck around with other things. When you're
• 46:43
  Speaker 1: taking 100 times the dose, 200 times the dose of
• 46:47
  Speaker 1: a sugar alcohol to bind that same receptor, well, the
• 46:50
  Speaker 1: chances that it can also do other things because there's
• 46:53
  Speaker 1: so much of it around just is higher. So I
• 46:56
  Speaker 1: do just out the gate worry a little bit more
• 46:59
  Speaker 1: about the effects of the sugar alcohols in principle. But
• 47:04
  Speaker 1: before we go to the real biology, the clear effects
• 47:10
  Speaker 1: are the gastrointestinal.
• 47:12
  Speaker 3: Okay.
• 47:12
  Speaker 2: I'm going to interrupt you here because there is someone
• 47:16
  Speaker 2: who worked for me for a while who we got
• 47:21
  Speaker 2: to talking because, you know, work on health and so on.
• 47:24
  Speaker 2: And it's talking about constipation. She was like, this is
• 47:29
  Speaker 2: not something you have to worry about. All you need
• 47:32
  Speaker 2: are these sugar-free supplements. gummy peach slices. You have a
• 47:36
  Speaker 2: bag of those. And like, if you are ever constipated,
• 47:39
  Speaker 2: just keep a bag of those and you're all set.
• 47:43
  Speaker 2: And that's true. That's really true.
• 47:46
  Speaker 1: It is true. So the sugar, the sugar alcohols are
• 47:51
  Speaker 1: broadly not absorbed. So they go into your intestinal tract
• 47:56
  Speaker 1: and they don't get absorbed by it. Some of them
• 47:59
  Speaker 1: do a bit, but because there's so much of them,
• 48:02
  Speaker 1: like the number of grams you're taking is high and
• 48:04
  Speaker 1: There's enough in there to suck water into the intestinal lumen.
• 48:11
  Speaker 1: We say they're osmotically active, right? So they suck water in.
• 48:17
  Speaker 1: It's like those packets that they put those drying packets in,
• 48:20
  Speaker 1: like pill bottles and stuff like that, right?
• 48:22
  Speaker 2: Yeah.
• 48:22
  Speaker 1: So they suck water in and that passes through you.
• 48:26
  Speaker 1: And I found some quotes on the Amazon reviews for
• 48:31
  Speaker 1: the Haribo sugar-free gummy bears. I think these are maltitol
• 48:35
  Speaker 1: containing for what it's worth. Can you pick one or
• 48:38
  Speaker 1: two of these? Because I was dying reading these.
• 48:43
  Speaker 2: These should come with a hazmat suit and a formal
• 48:46
  Speaker 2: apology to your plumber. Yeah. I ate the whole bag.
• 48:51
  Speaker 2: I am now typing this from the bathroom. My life
• 48:53
  Speaker 2: has changed. I am a different person than I was
• 48:55
  Speaker 2: 20 minutes ago.
• 48:59
  Speaker 1: A gummy bear shaped vessel for pure, unadulterated intestinal warfare.
• 49:07
  Speaker 2: So be careful is what we're saying. It's like fiber,
• 49:11
  Speaker 2: but very fast.
• 49:14
  Speaker 1: Yeah, absolutely. Okay, again, this is coming from the fact
• 49:18
  Speaker 1: that you have to eat more of them to get
• 49:19
  Speaker 1: that same sweetness. There is some concern about erythritol and
• 49:25
  Speaker 1: I'll be honest, these are small early studies, but just
• 49:29
  Speaker 1: to say it out loud, there's some concern that erythritol
• 49:32
  Speaker 1: levels are either associated with or potentially causative of a
• 49:38
  Speaker 1: higher risk of blood clots. There's a nature medicine study
• 49:41
  Speaker 1: in 2023 of 20 healthy volunteers. So this is a
• 49:46
  Speaker 1: crossover study where they were randomized to glucose intake, just
• 49:51
  Speaker 1: regular sugar intake versus erythritol. And they measured thrombosis potential,
• 49:55
  Speaker 1: like how quickly the blood would clot given a stimulus
• 49:58
  Speaker 1: to clot and platelet reactivity, which is how quickly platelets
• 50:02
  Speaker 1: clumped together, giving a stimulus to clump together. And in
• 50:05
  Speaker 1: both cases, they found that erythritol exposure increased the propensity
• 50:09
  Speaker 1: for those blood clots, which is, yeah, small study, but.
• 50:13
  Speaker 2: Yeah. I mean, you always have to be careful when
• 50:15
  Speaker 2: there are 20 volunteers because, and when there's a surrogate endpoint,
• 50:20
  Speaker 2: which means, you know, we're looking at platelet activity, we're
• 50:22
  Speaker 2: not looking at actual health outcomes. There's like a lot,
• 50:25
  Speaker 2: there's many steps between that and sort of genuine concern.
• 50:29
  Speaker 2: I think, you know, The more practical nature of like
• 50:33
  Speaker 2: some of these things really will affect you right now
• 50:36
  Speaker 2: is probably worth knowing. Yes.
• 50:40
  Speaker 1: And they will certainly affect your GI tract. About erythritol,
• 50:45
  Speaker 1: I was looking through my closet, my food, my pantry,
• 50:50
  Speaker 1: and I found that we had monk fruit sweetener, like
• 50:54
  Speaker 1: artificial monk fruit sweetener. And I was like, oh, okay.
• 50:57
  Speaker 1: Monk fruit is a high-potency sweetener. It's called mograside. It's
• 51:03
  Speaker 1: about 150 to 250 times the potency of sugar. So
• 51:07
  Speaker 1: it's like the others, harder to find, and I imagine
• 51:11
  Speaker 1: fairly expensive. But I looked at my monk fruit sweetener,
• 51:14
  Speaker 1: and the number one ingredient was erythritol. So like the
• 51:18
  Speaker 1: thing said monk fruit and the number two ingredient was
• 51:20
  Speaker 1: like monk fruit extract. And I think, I guess you
• 51:23
  Speaker 1: can just say that it's monk fruit sweetener because there's
• 51:25
  Speaker 1: like some monk fruit in it, but actually it was
• 51:28
  Speaker 1: just erythritol. So I was getting like the sugar alcohol
• 51:32
  Speaker 1: when I wanted some, you know, funky, bougie, high potency sweetener.
• 51:36
  Speaker 2: It's perhaps a good point to make that these fancy sweeteners, stevia,
• 51:42
  Speaker 2: monk fruit, which I think people view as like natural and...
• 51:47
  Speaker 2: bougie are also very highly processed. It's not like a
• 51:50
  Speaker 2: stevia is just like, it is true. That's a plant
• 51:53
  Speaker 2: with like a, it's like a slightly sweet, like you
• 51:55
  Speaker 2: can actually eat a piece of the stevia plant and
• 51:57
  Speaker 2: it's like slightly sweet, but to get from that to
• 52:00
  Speaker 2: the like stuff that you, you know, put in your
• 52:03
  Speaker 2: coffee is like quite an extensive processing procedure. Uh, so
• 52:08
  Speaker 2: I don't know. I think people should just be a
• 52:10
  Speaker 2: little less fancy. Yeah.
• 52:12
  Speaker 1: I mean, you're just, you're, you're, you're throwing your money
• 52:14
  Speaker 1: away on some fancy marketing.
• 52:17
  Speaker 2: Just get some sweet and low, my friend.
• 52:18
  Speaker 1: It works fine. Saccharin has a little bit of an
• 52:24
  Speaker 1: off-target binding to the bitter receptor. So in high doses,
• 52:28
  Speaker 1: that's why saccharin gives you a, just like, has that
• 52:30
  Speaker 1: kind of funky aftertaste, which something like sucralose doesn't have.
• 52:34
  Speaker 1: I use Splenda in my coffee, as you know, Emily,
• 52:36
  Speaker 1: because you've chastised me about having sweetness in my coffee.
• 52:39
  Speaker 1: But you don't like iced coffee either, so I don't
• 52:40
  Speaker 1: think your coffee opinions are valid in my worldview.
• 52:47
  Speaker 2: Yeah, that's fair. I don't like the taste of artificial
• 52:51
  Speaker 2: sweeteners very much, except for Diet Coke.
• 52:55
  Speaker 1: I think if anything comes out on top, it's Diet
• 52:57
  Speaker 1: Coke in this episode.
• 52:59
  Speaker 2: Not an ad, everyone. This episode should be titled, like,
• 53:01
  Speaker 2: what's the deal with Diet Coke and why is it
• 53:03
  Speaker 2: the most delicious?
• 53:06
  Speaker 1: All right, Em, I think it's time. Smash or pass
• 53:11
  Speaker 1: artificial sweeteners?
• 53:13
  Speaker 2: I'm a smash. I mean, I think that, you know,
• 53:16
  Speaker 2: it's not a health food, but it certainly isn't something
• 53:20
  Speaker 2: people should be afraid of.
• 53:23
  Speaker 1: Yeah, I'm a smash. I think I'm going to stand
• 53:27
  Speaker 1: by if you're worried about weight, drinking calories is just
• 53:30
  Speaker 1: too easy of a way to get too many calories
• 53:32
  Speaker 1: into you. But maybe we should be aware of like
• 53:36
  Speaker 1: sweetness overload and train yourself to like some things that
• 53:39
  Speaker 1: aren't so tasty and sweet.
• 53:42
  Speaker 2: All right, that's it for artificial sweeteners. Your mailbag question
• 53:45
  Speaker 2: of the week after the break.
• 53:50
  Speaker 3: Hi, Emily and Perry. This is Ezekiel Hinze from Des Moines, Iowa.
• 53:56
  Speaker 3: I've heard that sitting all day will like kill you.
• 54:00
  Speaker 3: So does that mean that standing won't? Is a standing
• 54:03
  Speaker 3: desk worth the investment? Thanks a lot.
• 54:06
  Speaker 2: Love the show. So I will tell you, I did
• 54:09
  Speaker 2: have a standing desk at my last meeting.
• 54:11
  Speaker 1: Office.
• 54:13
  Speaker 2: And I, it was really hard to get because it
• 54:16
  Speaker 2: was in a university. And when you want to get
• 54:17
  Speaker 2: a desk that's like different from the other desks that
• 54:20
  Speaker 2: one gets, it's like 4,000 bureaucratic layers. And I finally
• 54:24
  Speaker 2: got this standing desk. And then my husband would come
• 54:27
  Speaker 2: in every day and be like, why isn't your desk
• 54:28
  Speaker 2: in the standing mode? Why is it? And I think
• 54:30
  Speaker 2: I stood up like one time in my entire, like,
• 54:33
  Speaker 2: I just, I just like couldn't, you know, he had
• 54:35
  Speaker 2: to put it up, whatever. It was like, I feel stupid.
• 54:37
  Speaker 2: Do you have a standing desk?
• 54:39
  Speaker 1: I don't. What I have, which is I think the equivalent,
• 54:42
  Speaker 1: is I have a stationary bike that has like a
• 54:47
  Speaker 1: platform on it where you can put your laptop or papers.
• 54:51
  Speaker 1: And I was like, this is how I will stay fit.
• 54:53
  Speaker 1: And what I'm looking right now, I have- Is there
• 54:57
  Speaker 1: like clothing all over it? I have a jacket. I
• 55:01
  Speaker 1: have my white coat, my Dr. White coat sitting there.
• 55:03
  Speaker 1: I don't, yeah, it does not get used. I mean,
• 55:06
  Speaker 1: the data actually does suggest that use of standing desks
• 55:10
  Speaker 1: decrease sedentary time. And we do know that more sedentary
• 55:14
  Speaker 1: time is linked to worse health outcomes. And I think
• 55:17
  Speaker 1: there's some causality there, honestly. Your heart rate's up, your
• 55:21
  Speaker 1: muscles are tensing a little bit more when you're standing,
• 55:23
  Speaker 1: but it's not a replacement for real exercise and it
• 55:27
  Speaker 1: does require you to actually use the damn thing.
• 55:30
  Speaker 2: Yeah. I think this is a good example of a
• 55:32
  Speaker 2: place where the kinds of people who are adopting and
• 55:35
  Speaker 2: using standing desks are already like 95% of the way
• 55:38
  Speaker 2: towards doing enough exercise and so on. And so it's
• 55:43
  Speaker 2: sort of a different question than like if someone were
• 55:46
  Speaker 2: literally sitting all day, would they benefit from doing some
• 55:49
  Speaker 2: standing or some walking? Like, absolutely. If you are like
• 55:52
  Speaker 2: not getting any physical movement, getting some, any amount more
• 55:55
  Speaker 2: physical movement is really good for you. And if that
• 55:57
  Speaker 2: involves just sitting and standing from your chair, so you
• 56:00
  Speaker 2: stand up to the desk, like that's great. The idiots
• 56:03
  Speaker 2: who are purchasing standing desks like me or are purchasing like,
• 56:06
  Speaker 2: I don't know, sitting cycle work things like you are
• 56:10
  Speaker 2: like already kind of doing some exercise and basically everything
• 56:13
  Speaker 2: is fine.
• 56:15
  Speaker 1: And you're the last person who needs a standing desk.
• 56:17
  Speaker 2: I don't need a standing desk. I don't need a
• 56:18
  Speaker 2: standing desk. My daughter asked me the other day about
• 56:20
  Speaker 2: those like walking pads. you know, where it's like under
• 56:24
  Speaker 2: your desk and you're walking? Like, is that better than
• 56:27
  Speaker 2: a standing desk? I was like, I don't know.
• 56:30
  Speaker 1: Stay tuned for the next question of the week.
• 56:31
  Speaker 2: All right.
• 56:32
  Speaker 1: That's it for us today. Stick with us next week.
• 56:34
  Speaker 1: We're doing our first ever grab bag of wellness nonsense.
• 56:38
  Speaker 1: I'm so excited. It's going to be fun.
• 56:40
  Speaker 2: Can't wait. Wellness Actually is produced in association with iHeartMedia.
• 56:48
  Speaker 2: Our senior producer is Tamar Abishai. Our executive producer at
• 56:52
  Speaker 2: iHeart is Jennifer Bassett. Our theme music is by Eric Deutsch.
• 56:56
  Speaker 2: And our content is for educational purposes only.
• 56:59
  Speaker 1: If you like the show, help other people find us.
• 57:01
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• 57:04
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• 57:07
  Speaker 1: the show. You can follow us on Instagram at wellnessactuallypod.
• 57:11
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• 57:14
  Speaker 1: over to wellnessactually.fm and leave us a question for our
• 57:17
  Speaker 1: mailbag or suggest a topic for a future show.
• 57:20
  Speaker 2: We'll let the influencers have the last word.
• 57:23
  Speaker 1: Lydia, oh, Lydia, say.
• 57:25
  Speaker 3: Have you met Lydia?
• 57:25
  Speaker 2: Lydia, the tattooed lady. How are you feeling? Kind of
• 57:32
  Speaker 2: under the weather? Like you've got the flu?
• 57:37
  Speaker 3: That would be the ricin I gave you. I slipped
• 57:41
  Speaker 3: it into that stevia.
• 57:42
  Speaker 2: Crap that you're always putting in your tea.
• 57:44
  Speaker 3: Oh, my God.
• 57:47
  Speaker 2: Well, goodbye, Lydia. Thank you.