Because of the widespread availability and use of artificial, non-caloric, sweeteners we must examine this subject from the standpoint of their impact—if any—on health.

At present there are six such sweeteners on the market, all cleared as being safe by the FDA. The following discussion centers on the three most prevalent, which are aspartame, saccarin, and sucralose .

First, let’s look in more detail about each of these substances:

Aspartame (EqualR ,NutrasweetR) is a combination of 2 amino acids, aspartic acid and phenylalanine. It is about 220 times sweeter than sugar and leaves little aftertaste when consumed. One rare exception to its excellent safety record is that people who have phenylketonuria (PKU) cannot eat aspartame. This is because their bodies cannot metabolize, phenylalanine, one of its amino acids. Fortunately PKU is a rare, genetically inherited condition that is routinely screened for in early infancy, and this regularly allows for those individuals to avoid such substances in their diets. Otherwise, aspartame is one of the most researched sugar substitutes available in the United States, with more than 200 studies establishing its safety, and no adverse health consequences have been identified. Although there has been a lot of misinformation about aspartame since it came onto the market in 1981, studies have concluded that it specifically does not cause headaches, seizures, Alzheimer’s disease, Parkinson’s disease, lupus or multiple sclerosis.

Saccharin (Sweet ‘N LowR and Sweet TwinR) is the oldest sugar substitute, first discovered in 1879. It is 200 to 700 times sweeter than sugar, depending on how it is used. Saccharin leaves an aftertaste some people can detect. Earlier, safety was of some concern, and it used to carry a warning label indicating that it was known to cause cancer in laboratory animals. After extensive research on the safety of saccharin, however, the United States government passed a bill in 2000 confirming its safety and removed the warning label from food and drinks made with saccharin.

Sucralose (SplendaR) is another no-calorie sugar substitute that tastes like sugar but is 600 times sweeter. It leaves no aftertaste when consumed. It was approved for use in the United States in 1998, and also has been subjected to many studies on its safety, all of which have indicated that it is safe for people to consume in customary amounts used for sweetening.

How effective are these products? Since we have recognized their excellent safety record, another important question centers on whether they are helpful:

Although substitution of artificial sweeteners in food and drinks offers promise of better weight control,  I note that leading medical organizations have weighed in on this issue[1]: According to the joint scientific statement from the American Heart Association and American Diabetes Association. “At this time, there are insufficient data to determine conclusively whether the use of such sweeteners to displace caloric sweeteners in beverages and foods reduces added sugars or carbohydrate intake, or benefits appetite, energy balance, body weight, or cardiometabolic risk factors.”

As suggested, research results are mixed about this issue, for some studies show that individuals consuming artificial sweeteners often compensate by consuming more high caloric foods in response to the non-caloric sweeteners, thus nullifying any efforts at weight control. Although this is a complicated issue, from personal experience I have found virtually nothing to suggest that those individuals consuming such products actually do lose weight. One counter argument, however, is to say that these same individuals—had they consumed sugary beverages—would have actually gained weight, but, unfortunately, they probably would have done so either way. Accumulating evidence[2] demonstrates that frequent consumers of sugar substitutes are also at increased risk of excessive weight gain. This may result because consuming sweet-tasting but non-caloric or reduced-calorie food and beverages interferes with learned responses that normally constrain sugar and energy consumption. As a result of this interference, frequent consumption of high-intensity sweeteners may have the counterintuitive effect of inducing metabolic or brain responses that actually induce the individual to eat more calories. Some experimental studies in animals have also supported this contention.

Not only has research failed to confirm the idea that artificial sweeteners are beneficial in reducing overall caloric sugar intake, there are some preliminary data suggesting that they may be actually harmful, increasing one’s propensity to develop cardiovascular disease, i.e., the same malady that we wish to prevent! These newer data show an association between daily consumption of dietary beverages and cardiovascular disease (CVD) outcomes (including mortality) in postmenopausal women. The findings were based on an analysis of dietary beverage intake and cardiovascular risk factors in 59,614 women who did not have cardiovascular disease at the time they enrolled in the study. Results were reported in March, 2014, at a large national medical meeting. At an average follow-up of 8.7 years, they found that women who drank at least two diet drinks on a daily basis had a higher risk of cardiovascular disease (CVD) events compared to the zero-to-three drinks per month group.

The researchers warned, however, that data on the link between diet beverages and CVD outcomes have been limited and emphasized that more research was needed to verify the findings. This type of research, although showing clear links between artificial sugar intake and CVD, does not conclusively establish a causal role for such beverages, because other, heretofore unrecognized factors may cast such a conclusion in doubt.

Regardless of the eventual resolution of this issue, however, simply substituting all sweetened/caloric beverages with simple unadulterated water is the best—and cheapest—solution to this problem. If you cannot tolerate plain old water, seltzer or unsweetened tea may be an acceptable alternative. In the absence of conclusive data, children and pregnant women are advised to avoid any of these products.





The idea of “detoxifying” or “purifying” the body of “harmful” substances has been around for centuries and returns periodically to haunt the modern world. The idea behind such “cleansing” schemes is to rid the body of some unknown substance(s)–usually vaguely specified, sometimes promising to rid the system of “toxins” absorbed from the environment and the less-than-healthy foods we eat.

The basic concept of “detoxifying” is blatantly flawed, because our natural processes, especially liver and kidney function, cleanse our bodies far better than any extrinsic activities or substances could possibly achieve. Some detox ideas center also on the intestines, but by attempting to flush out the “bad stuff” from our intestines, they are also threatening to flush out the good bacteria that keep the intestines healthy, which is becoming a hot topic these days (see post of 4/13/14).

The various plans can last anywhere from three days to about a month or more. In the process of flushing “poisons” from your body, they promise to eliminate pounds of excess fat, clear your complexion and bolster your immune system, while leaving you feeling more energized. While believers claim they feel more energetic, studies on starvation actually show the longer you fast, the more lethargic and less focused you become.

Very often these ideas are popularized by “experts” in alternative medicine, a.k.a, quacks. There are no hard numbers on how many people have tried the latest fashionable plans, much less stuck with them, but dozens of new do-it-yourself cleansing or fasting books are glutting bookstore shelves. Each of the programs has its own take on how to cleanse the body — one calls for spices and fruit juices, another for only vegetable purees — but most of them boil down to extremely low-calorie, primarily liquid diets.

Some plans restrict all solid foods and instruct dieters to survive on only low-calorie beverages for days at a time. The Joshi holistic diet involves an elaborate list of so-called “acid-forming foods” to avoid for three weeks, including healthy vegetables and grains.

Those plans that include lengthy or repeated fasts, or near-fasts, pose, in themselves, significant risks. Nutritional deficiencies and blood-sugar problems are serious drawbacks.  Some plans that restrict solid foods often call for laxatives, resulting in frequent liquid bowel movements. If a fast lasts for several weeks, it may lead to muscle breakdown and a shortage of many basic nutrients, depriving the body of the vitamins and minerals obtained from food. Thus, in contrast to the claimed benefits, a fast can actually weaken the body’s ability to fight infections and inflammation. Also, because most of these diets contain very little protein, it can be difficult to rebuild lost muscle tissue

Because many crash diets can upset blood sugar, potassium and sodium levels in the body, they should be strenuously avoided by anyone with diabetes, heart or kidney disease or by women who are pregnant or nursing. Children, teens, older adults or people with certain digestive conditions should also steer clear.

Unfortunately, many of these plans include various herbal products that are not carefully monitored by the FDA. These various components have recently been associated with an increasing rate of toxic effects, most notably liver injury (see posts 1/1/14 and 5/20/14).

One of the latest “detoxifying” vogues is that of “Detox Tea”, which purports to rid the body of unspecified “toxins”, whatever that means. One promoter of these teas states that “In the modern world, we’re exposed to many pollutants like caffeine, smoke and food toxins. These pollutants accumulate in the body and cause our overall health to decline. Drinking detox tea helps to remove these toxins from the body. It does this by supporting the internal cleansing process by adjusting the fire and air energies.” How vague can this be? The same source also clarifies that “detox tea is made from with a combination of herbs and spices, which have been used for centuries in India. The actual ingredients are cinnamon, liquorice, ginger, dandelion, fennel, anise, juniper berries, burdock root, coriander, cardamom, parsley, sage, cloves, turmeric root and black pepper. Also, detox tea is caffeine free and contains a laxative.” I suppose that all it lacks is a partridge in a pear tree!

The same “detox tea” company then goes on to issue a mild disclaimer: “Claims that drinking detox tea is good for the liver, lungs and kidneys are difficult to verify. These claims have not been verified by the Food and Drug Administration, and because of this, no one should rely on detox tea to treat or prevent disease. Also, despite the fact that detox tea is advertised as a health food, drinking it will not help you lose weight.” This is clearly a defensive statement, designed to keep the “feds” off of their tails! Similar statements are issued on virtually all bogus products that have not been supported by acceptable scientific proof.

In conclusion, I would simply advise our readers to steer clear of this entire concept of “detoxification”. The idea is simply presented to take your money while providing no scientific proof of benefit. But even more distressing, as noted above, there is no good way to find out whether any of these products poses a danger to health!



Whole grains are healthy because they seem to lower risk of major chronic diseases such as type 2 diabetes mellitus and cardiovascular disease (CVD). Until now, however, uncertainty surrounded whether whole grains’ could actually reduce mortality rates. Now this question has been answered in the wake of two very large population studies in both men and women.  In a sixteen year follow-up study of 43 744 men and 74 341 women, researchers showed that progressively increasing whole grain consumption brought about a stepwise reduction of mortality resulting from cardiovascular diseases, but not from cancer. They estimated that every serving of 28 gm/day (approximately 1 oz) of whole grain or bran resulted in a 5% lower total morality or a 9% lower CVD mortality, whereas the same intake level was not significantly associated with lower cancer mortality.

So how do we obtain this healthy food source? Here are a few guidelines:

What is a Whole Grain?

A whole grain is the entire grain—which includes the bran, germ and endosperm (starchy part). Wheat is a good source, and, to make 100% whole wheat flour, the entire wheat grain is ground up. “Refined” flours like white and enriched wheat flour include only part of the grain – the starchy part, and are not whole grain. They are missing many of the nutrients found in whole wheat flour.

Examples of whole grain wheat products include 100% whole wheat bread, pasta, tortillas, and crackers. Other whole grains to consider are the following:

  • Bulgur (cracked wheat)
  • Whole wheat flour
  • Whole oats/oatmeal
  • Whole grain corn/corn meal
  • Popcorn
  • Brown rice
  • Whole rye
  • Whole grain barley
  • Whole farro
  • Wild rice
  • Buckwheat
  • Buckwheat flour
  • Triticale
  • Millet
  • Quinoa
  • Sorghum

         Here are a few additional suggestions:

1) Substitute a whole-grain product for a refined product – such as eating whole-wheat bread instead of white bread.

2) Use whole grains in mixed dishes, such as barley in vegetable soup or stews and bulgur wheat in casserole or stir-fries.

3) Create a whole grain pilaf with a mixture of barley, wild rice, brown rice, broth and spices. For a special touch, stir in toasted nuts or chopped dried fruit.

4) For breakfast, use whole grain cereals such as toasted oat cereal, and these can also be used for snacks.

5) Try 100% whole-grain snack crackers, and popcorn, a whole grain, can be a healthy snack if made with little or no added salt and butter.

6) Regarding labels, use the Nutrition Facts label and choose whole grain products with a higher % Daily Value (% DV) for fiber. Foods labeled with the words “multi-grain,” “stone-ground,” “100% wheat,” “cracked wheat,” “seven-grain,” or “bran” are usually not whole-grain products.











© Hongyu W; Flint AJ, Qibin Q et al,  JAMA Intern Med. Published online January 05, 2015