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Swapping soda for diet soda
That analysis looked at markers of fat tissue, HbA1c, and other measures. For someone who drinks sugar-sweetened beverages, switching to an artificially sweetened one is a net positive, because the calories at stake are serious: five or six Cokes a day is a lot of energy.
Comments under posts about sweeteners keep turning up the same story: a reader cut out soda, drank diet soda instead, and lost 50 or 75 pounds, and one reported 100. Those are self-reports, but they point at how big the lever can be.
Whether a sweetened drink is healthier than water is unknown, and probably not. For someone who has lost that much excess fat tissue, a small alteration to the gut microbiome matters little next to the gut microbiome being much healthier overall.
How do sweeteners taste sweet without calories?
Sweeteners bind the same sweet taste receptor on the tongue, a pairing of proteins called T1R2 and T1R3, that sugar does. Many are either not metabolized or are used in tiny amounts because they are far sweeter than sugar. Sucralose is roughly 600 times sweeter than table sugar by weight. Aspartame is around 200 times sweeter.
Why would sweeteners affect the gut microbiome?
Some sweeteners, such as saccharin and sucralose, are poorly absorbed and reach the colon, where gut bacteria encounter them. A 2014 study in Nature from the Weizmann Institute reported that saccharin changed gut bacteria and caused glucose intolerance in mice. It also reported similar changes in a small group of human volunteers. Later human trials have found mixed results.
How does a network meta-analysis compare many trials?
It pools direct head-to-head trials with indirect comparisons made through a shared comparator, such as a placebo or water. This lets treatments that were never tested against each other be ranked in one analysis. Cochrane and other review groups use the method. Its reliability depends on the included trials being similar enough to compare.
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