♪ ♪ ♪ ♪ IF THE MINERAL PIRATE IS FOOLS GOLD ARE ARTIFICIAL SWEETENERS FOOLS SUGAR.

STAY WITH US AS GASTROENTEROLOGIST LORETTA JOPHLIN BREAKS DOWN ARTIFICIAL SWEETENERS NEXT ON "KENTUCKY HEALTH."

>> "KENTUCKY HEALTH" IS FUNDED IN PART BY A GRANT FOR A HEALTHY KENTUCKY.

IN A 2014 EDITION OF THE MAGAZINE BALTIMORE, AN ARTICLE ENTITLED WHY DO WE LIKE SWEETS?

BIOLOGICALLY COULD IT BE OUR NATURE.

AUTHOR JANE MARION QUOTES REGISTERED DIETICIAN AND LICENSED NUTRITIONIST DIANE SEGUSSI SAYS EATING SWEETS ACTIVATES THE SAME RECEPTORS IN THE BRAIN THAT MORPHINE AND HEROIN DO BUT EASIER TO GET YOUR HANDS ON CHOCOLATE.

TO THIS POINT, COMEDIAN GABRIEL IGESIAS WHO SELF- IDENTIFIES AS BEING FLUFFY, IN RESPONSE TO SOMEONE WHO ASKED, WHY HE DRANK DIET SODAS, RESPONDED, SO THAT I COULD EAT REAL CAKE.

I CAN'T SAY THAT I AGREE WITH THAT LINE OF REASONING.

BUT I DO UNDERSTAND.

TO DECREASE OUR DAILY CALORIC INTAKE, MANY OF US HAVE CHANGED THE FOODS THAT WE EAT, THE WAY WE PREPARE THEM AND THE AMOUNT THAT WE EAT .

TO FURTHER MINIMIZE SUGAR INTAKE AND SATISFY OUR BUILT IN SWEET TOOTH WE HAVE TURNED TO ADDING ARTIFICIAL SWEETENERS TO OUR DRINKS OR CHOOSING FOODS IN BEVERAGES WHERE THEY HAVE BEEN SUBSTITUTED FOR NATURAL SUGAR.

THERE IS AN ASSORTMENT OF SWEETENERS ON THE MARKET THAT ARE EITHER WHOLLY MANMADE, DERIVED FROM NATURALLY OCCURRING CHEMICALS IN OUR OWN BODIES OR DERIVATIVES OF PLANTS.

WHILE BENEFICIAL THESE PRODUCTS HAVE UNINTENDED CONSEQUENCES.

ALAS AS THE SAYING GOES, THERE IS NO FREE LUNCH WHEN REPLACING SUGAR WITH ARTIFICIAL SWEETENERS.

AS THE OLD MARGARINE COMMERCIAL USED TO SAY...

IT ISN'T NICE TO FOOL WITH MOTHER NATURE.

TO TAKE US THROUGH THE GOOD, BAD AND UGLY OF THE ARTIFICIAL SWEETENERS WE HAVE Dr. LORETTA JOPHLIN.

DR. JOPHLIN IS A GRADUATE OF THE UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE.

SHE DID A RESIDENCY IN INTERNAL MEDICINE AT THE ICON SCHOOL OF MEDICINE AT MOUNT SINAI AND MOUNT SINAI HOSPITAL AND THEN RETURNED TO THE UNIVERSITY OF SOUTH CAROLINA FOR FELLOWSHIP IN GASTROENTEROLOGY.

NOT TO BE OUTDONE, Dr. LORETTA JOPHLIN DID A HELP TOLLING AT THE MAYO CLINIC COLLEGE OF MEDICINE UP IN ROCHESTER, MINNESOTA.

SHE IS CURRENTLY IN PRACTICE WITH THE NORTON MEDICAL GROUP AS A GASTROENTEROLOGIST HERE IN LOUISVILLE.

THANK YOU FOR BEING WITH US.

>> THANK YOU VERY MUCH Dr. TUCKSON.

>> I DIDN'T MENTION BUT YOU ALSO HAVE A PH.D. >> I DO.

>> WHEN DID YOU HAVE TIME TO GET THAT.

>> I DID A COMBINED PROGRAM.

IT WAS EIGHT YEARS OF MEDICAL SCHOOL FOR FOUR, Ph.D. FOR 4, BUT I DID MY FIRST TWO YEARS IN MEDICAL SCHOOL FIRST AND Ph.D.

IN THE MIDDLE.

>> WHAT WAS THE Ph.D.

WORKING?

>> CELL BIOLOGY AND REGENERATIVE MEDICINE.

>> RIGHT NOW THERE IS A YOUNG LADY WHO IS SITTING THERE WHO IS EIGHT YEARS OLD AND SHE SAYS YOU KNOW,I WANT TO BE AS COOL AS THAT LADY I SEE ON THE SCREEN.

HOW, WHAT DO YOU TELL THAT PERSON TO TELL THEM HOW TO GET TO WHERE YOU ARE NOW?

AND I DON'T MEAN SITTING HERE TALKING TO ME.

REALLY INVESTIGATE WHAT BRINGS THEM JOY AND PASSION IN THEIR LIVES.

EIGHT YEARS OLD IS A LITTLE EARLY BUT I WOULD SAY IF YOU ARE INTERESTED IN SCIENCE AND MEDICINE, YOU KNOW, COME ON TO A SHADOWING PROGRAM OR THINK ABOUT DOING SOME SCIENCE FOR SUMMER CAMP, REALLY LEAN INTO YOUR SCIENCE CLASSES AT SCHOOL.

MAKE SOME SLIME AT HOME.

>> ALWAYS BEGINS WITH THE SLIME, DOESN'T IT?

>> IT DOES.

>> ALL RIGHT.

HERE IS YOUR CHOICE.

SUGAR OR SUGAR SUBSTITUTE?

WHICH ONE AM I GOING TO TAKE?

>> I WOULD SAY IT DEPENDS ON WHAT YOUR HEALTH CONDITIONS ARE AT THE TIME.

IF YOU ARE IN EXCELLENT METABOLIC SHAPE, YOU ARE NOT OVERWEIGHT, YOU DON'T HAVE DIABETES, THEN WE CAN TOLERATE SOME REAL SUGAR.

BUT THESE ARTIFICIAL OR NON-NUTRATIVE HAVE COME INTO THE MARKET, THEY HAVE BEEN DEVELOPED SPECIFICALLY TARGETING FOLKS WHO HAVE METABOLIC CONDITIONS TO ALLOW FOR THEM TO HAVE SWEET THINGS, BUT NOT TO HAVE TO PAY THE CONSEQUENCES WITH THE CALORIES.

BUT WHAT WE ARE LEARNING ABOUT THEM THOUGH IS THAT THEY'RE NOT BIOLOGICALLY INERT.

THEY HAVE EFFECTS EVEN IF THEY DON'T HAVE CALORIES.

>> SO BEFORE WE PICK UP ON THAT, WHETHER WE TALK ABOUT SUGARS, WE SEE THINGS AS RAW SUGAR AND THEN THERE IS HONEY.

SOME PEOPLE SAY MOLASSES.

IS THERE ANY DIFFERENCE TO AS TO THE BENEFICIAL NATURE TO OUR BODIES ARE IS ANY SUGAR, SUGAR IS PROBABLY GOING TO BE BAD FOR US SOMEWHERE DOWN THE ROAD?

>> CALORIE WISE WE KNOW THAT A TABLESPOON OF SHUG SUGAR AND A TABLESPOON OF HONEY MAY HAVE VERY SIMILAR CALORIES.

BUT THE NUTRATIVE CONTENT OF HONEY AND MAPLE SYRUP MAY BE HIGHER THAN THAT OF WHITE TABLE SUGAR.

DEFINITELY BETTER THAN HIGH FRUCTOSE CORN SYRUP.

THERE MAY BE BENEFIT TO HONEY WITH LOCAL ALLERGENS, THE BEES THAT PRODUCE THEM MIGHT DECREASE ALLERGIES AND INFLAMMATION WHEREAS MAPLE SYRUP HAS HIGH LEVELS OF MAGNESIUM AND OTHER TRACE MINERALS THAT CAN BE BENEFICIAL FOR US.

THE SECOND WAY THAT THEY'RE DIFFERENT IS THE GLYCEMIC INDEX.

THE GLYCEMIC INDEX IS A MEASURE OF HOW QUICKLY THE SHUG BLOOD SUGAR SPIKES IN YOUR BODY WHEN YOU EAT SOMETHING THAT CONTAINS A SWEETENER IN IT.

THE GLYCEMIC INDEX OF TABLE SUGAR IS HIGHER THAN THAT OF MAPLE SYRUP, HIGHER THAN THAT OF AGAVE SYRUP AND HIGHER THAN THAT OF HONEY.

>> SO WHEN YOU TALK ABOUT THE GLYCEMIC INDEX, SO WHAT IF IT SPIKES UP HIGH?

IS IT GOING TO GO HIGH AND COME BACK DOWN AGAIN?

WHAT DAMAGE IS THAT TO OUR BODIES?

>> YEAH, THE GLYCEMIC INDEX IS HOW QUICKLY A FOOD RAISES YOUR BLOOD SUGAR AND THAT'S HOW QUICKLY INSULIN WILL BE RELEASED IN RESPONSE TO THAT.

AND INSULIN LEADS TO A DECREASE IN YOUR BLOOD SUGAR AND COULD YOU HAVE A SUGAR CRASH.

MAKES PEOPLE FEEL NOT VERY GOOD, MAKES PEOPLE WANT TO HAVE MORE SUGAR.

>> SO YOU GET THIS OUTPOURING OF INSULIN.

THE SUGAR GOES AWAY AND WE SAY GOD, I NEED MORE ALL OF A SUDDEN.

>> I NEED MORE, YEAH.

WHEN YOU HAVE A SLOW RISE, SOME OF THE GLYCEMIC INDICES ARE LOWER, BLOOD SUGAR RISES MORE SLOWLY.

INSULIN MAY BE MORE-- IT MAY BE ABLE TO TAKE CARE OF THE SUGAR LOAD AND YOU MAY HAVE MORE SATIETY.

>> MEANING YOU FELL FULL.

>> YOU FEEL FULL.

>> INTERESTING.

IS THERE A WAY THAT I CAN FIND THE GLYCEMIC INDEX OF A PARTICULAR PRODUCT OUT THERE?

>> YOU CAN GOOGLE.

>> GOT TO GO TO GOOGLE.

>> AND WILL YOU COME UP WITH ALL OF THESE CHARTS THAT HAVE VARIABLE GLYCEMIC INDICES.

SUGAR ON ONE CHART MIGHT BE 60, MIGHT BE 80 ON ANOTHER ONE.

SO THERE IS A LOT OF INFORMATION OUT THERE, I DON'T BELIEVE THAT WE HAVE NAILED DOWN THE GLYCEMIC INDEX FOR EVERY SINGLE FOOD OR FOOD GROUP.

BUT THE CHARTS ARE OUT THERE AND YOU WILL SEE RELATIVE INDICES.

SO THE CHARTS MAY VARY THOUGH.

>> IT'S NOT GOING TO BE ON A LABEL WHEN WE GO BUY OUR BOX OF CEREAL OR SOMETHING LIKE THAT?

>> NO, NO.

THIS IS SOMETHING THAT I BELIEVE ENDOCRINOLOGIST, AS GROW ENTEROLOGISTS INTERNAL MEDICINE FOLKS ARE THINKING ABOUT BUT IT HASN'T GONE MAINSTREAM.

WHEN I THINK ABOUT HAVING A GLASS OF ORANGE JUICE OR EATING AN ORANGE.

THE GLYCEMIC INDEX OF THE ORANGE MAY BE LOWER BECAUSE OF THE FIBER THAT IS IN THE ORANGE.

IT HELPS TO ABSORB AND SLOW THE RELEASE OF THE SUGAR AS IT GOES INTO OUR STOMACH AND OUR SMALL INTESTINES MUCH THAT'S WHY THE SUGAR-- THAT'S WHY THE ORANGE IS PROBABLY HEALTHIER FOR YOU.

>> IS THAT SOMETHING WE CAN TAKE IN GENERAL?

SAY IF YOU HAVE A CHOICE BETWEEN APPLE JUICE OR EATING THE APPLE, IF THEY BOTH PROVIDE THE SAME EQUIVALENT OF VITAMINS WE MIGHT DO BETTER BECAUSE OF THE GLYCEMIC INDEX?

IT'S LOWER ON THE APPLE?

>> THE FIBER THAT IS IN THE APPLE IS GOING TO CARRY SOME BENEFITS FOR YOU RATHER THAN JUST THE APPLE JUICE.

>> GREAT.

THAT'S A VICTORY FOR THE WHOLE FOODS GROUP.

I LIKE THAT.

ALWAYS HAPPY ABOUT THAT.

>> YES.

>> ARTIFICIAL SWEETENERS.

WHAT ARE THEY AND HOW DID WE GET TO THIS POINT?

>> ARTIFICIAL SWEETENERS, THAT'S WHAT WE USED TO CALL THEM.

I THINK WE ARE LEANING MORE TOWARDS CALLING THEM NON-NUTRATIVE SWEETENERS.

ARTIFICIAL HAS THE CONNOTATION THAT IT IS MADE IN THE LAB AND NOT ALL OF THESE ARE MANUFACTURED IN A LAB: SOME OF THEM ARE GENERATED FROM PLANTS SUCH AS STEVIA, WHICH, YOU KNOW, STEVIA IS MADE FROM THE LEAF BUT IT DOES HAVE TO GO THROUGH A FERMENTATION PROCESS.

SO IT'S NOT COMPLETELY NATURAL.

MONK FRUIT IS NATURAL.

APARTMENTS TAME, SACCHARIN, THESE ARE CHEMICALS.

SACCHARIN WAS MADE FROM THE DOLED TAR INDUSTRY.

Dr. WAS A SCIENTIST AT HOPKINS WORKING ON THIS MADE HIS LUNCH AT HOME AND DIDN'T WASH HIS HANDS.

SAID WHAT IS THE SWEET TASTE IN WENT BACK TO THE LAB AND FOUND HE MADE A CHEMICAL THAT THEN BECAME THE FIRST ARTIFICIAL SWEETENERS AND TEDDY ROOSEVELT WITH HIS DIABETES REALLY LIKED IT.

>> INTERESTING.

>> SO WE OWE TEDDY ROOSEVELT FOR THE POPULARITY OF SACCHARIN.

>> SOMEWHAT.

>> OR SOME GUY'S DIRTY HANDS.

>> YES.

WASH YOUR HANDS, PLEASE.

>> SO WHAT IS THE DIFFERENCE THEN IN BEHAVIOR OF THESE NON-NUTRATIVE SWEETENERS?

OR DO THEY HAVE ANY DIFFERENCE OR IMPACT ON GLYCEMIC INDEX WHICH YOU WERE JUST TELLING ABOUT THE DIFFERENT SUGARS WE HAVE.

>> SOME OF THE SWEETENERS THAT ARE IN THE CLASSIFICATION OF SUGAR ALCOHOLS, THEY DO HAVE SOME CALORIES AND THEY DO HAVE GLYCEMIC INDEX THAT CAN BE REGISTERED.

WHEREAS SOME OF THE OTHER ONES, SUCH AS ASPARTAME, SACCHARIN, SURCULOSE, STEVIA, ZERO CALORIES AND GLYCEMIC INDEX THAT IS NEGLIGIBLE.

>> WHAT HAPPENS TO THE BRAIN THOUGH?

IT SAYS, THIS TASTES SWEET.

BUT IT'S NOT SWEET.

IS THE BODY GETTING GEARED UP TO PUT OUT ALL THIS INSULIN BECAUSE YOUR BODY SAYS HEY, SOMETHING SWEET IS HERE?

OR IT DOESN'T WORK THAT WAY?

>> I THINK THAT'S THE FEAR.

AND THAT'S DEFINITELY THE UNKNOWN.

IN THE LAST COUPLE OF DECADES, THERE IS OVER 2500 PAPERS, SOME SMALL RESEARCH STUDIES, SOME ARE LARGE OBSERVATIONAL STUDIES.

THE FEAR IS THAT WE WILL EAT SOMETHING SWEET AND THE BODY CANNOT DISCRIMINATE IF THIS IS REAL SUGAR THAT HAS CALORIES OR A FAKE SUGAR THAT HAS NO CALORIES.

AND THE INSULIN RESPONSE WILL BE THE SAME AND THE LEP TIN RESPONSE WILL BE THE SAME.

THIS IS KNOWN AS UNCOUPLING.

A COUPLED RESPONSE IS I HAVE A MUFFIN THAT HAS REAL SUGAR, REAL CALORIES.

I'M GOING TO EAT IT.

INSULIN IS GOING TO SPIKE.

BLOOD SUGAR IS GOING TO SPIKE.

AND THAT'S THE NORMAL RESPONSE.

IT'S COUPLED.

WHEREAS IF I HAVE A MUFFIN THAT HAS VERY LOW CALORIE AND HAS FAKE SUGAR, THE BODY SENSES THAT THAT SWEETNESS AND INSULIN IS STILL RELEASED BUT THERE IS NOT THE GLUCOSE THERE AND SO WHAT DOES THAT INSULIN DO?

WELL, IF IT IS RELEASED A NUMBER OF TIMES AND THERE IS NOT A GLUCOSE SIGNAL THERE FOR IT TO TAKE CARE OF, DOES THAT BREED INSULIN RESISTANCE?

DOES THAT MAKE DIABETES WORSE?

>> CAN WE BURN OUT OUR PANCREAS IF WE HAVE THESE FALSE STARTS OF PRODUCING INSULIN WHEN IT IS NOT REALLY REQUIRED?

>> I DON'T THINK WE HAVE ENOUGH RESEARCH TO SHOW THAT THAT IS HAPPENING.

I THINK WE CAN DEVELOP INSULIN RESISTANCE DEFINITELY BY EATING TOO MUCH REAL SUGAR.

WE KNOW THAT'S THE CASE.

THAT'S HOW DIABETES, OBESITY, METABOLIC SYNDROME IS AN EPIDEMIC.

I BELIEVE IT'S THE REAL SUGAR THAT WE EAT IN OUR DIET THAT IS THE CAUSE OF OUR PROBLEM RIGHT NOW; PARTICULARLY THE HIGH FRUCTOSE CORN SYRUP.

HIGH FRUCTOSE CORN SYRUP HAS A HIGHER GLYCEMIC INDEX THAN TABLE SUGAR.

WHEN IT ENTERS THE BODY, IT GOES STRAIGHT TO THE LIVER AND THE LIVER HAS TO CONVERT IT INTO GLUCOSE THAT IS USED.

IT CAN BE HIGHLY INFLAMMATORY TO THE LIVER AND IF YOU HAVE TOO MUCH AT ONE TIME, THE LIVER IS GOING TO CONVERT IT TO FAT.

THAT'S HOW FATTY LIVER DEVELOPS.

FROM HIGH FRUCTOSE CORN SYRUP.

>> IS THAT RIGHT?

>> IT'S REALLY THE WORST.

>> ALL BECAUSE SOMEBODY WANTED TO MAKE A LITTLE EXTRA MONEY OFF OF THIS CORN THAT THEY HAVE AROUND.

>> POSSIBLY.

>> IT'S A FASCINATING STORY TO SEE HOW WE GOT TO USING HIGH FRUCTOSE CORN SYRUP.

YOU ARE IMMINENTLY QUALIFIED TO TELL ME BEING A Ph.D IN CELL BIOLOGY AND GASTROENTEROLOGIST, WHAT ARE THE NON-NEWT TRIF SWEETENERS DOING AS FAR AS OUR HOMOEOSTASIS IS CONCERNED.

>> IT GOES BACK TO UNCOUPLING.

THAT'S THE THEORY THAT IS BEING STUDIED BY A LOT OF THE GROUPS WHO WANT TO KNOW MORE ABOUT EFFECTS OF THE CHEMICALS.

THEY'RE NOT INERT IN OUR BODY.

ONE OF THE MOST PROVOCATIVE AREAS OF RESEARCH RIGHT NOW IS WHAT DO THESE DO TO OUR MICROBIOME?

OUR MICROBIOME-- >> FIRST OF ALL TELL US WHAT IT IS.

>> THE MICROBIOME IS-- YOUR MICROBIOME IS DIFFERENT FROM MY MICROBIOME.

BUT IT'S, IF WE FOCUS ON THE GUT MICROBIOME, IT'S THE POPULATIONS OF BACTERIA, WHICH THERE CAN BE VERY DIVERSE POPULATIONS OF BACTERIA THAT LIVE IN OUR GUT, AND THEY ARE BELIEVED TO HAVE METABOLIZE SOME OF THE FOODS, SOME OF THE CHEMICALS THAT COME INTO OUR BODY AND PRODUCE ITS OWN INDEPENDENT BIOLOGICAL EFFECTS ON US OUTSIDE OF OUR OWN CELLS.

AND SO WE ESSENTIALLY HAVE THIS BODY OF ORGANISMS LIVING INSIDE OF US THAT IS DICTATING PART OF OUR HEALTH AND WELLNESS, BEYOND OUR CONTROL.

>> AND THESE NON-NUTRATIVE SWEETENERS ARE IMPACTING THESE THINGS?

>> THERE HAVE BEEN STUDIES SHOWING THAT PARTICULARLY ONE STUDY, A VERY ROBUST ONE, 2020 IN THE JOURNAL CELL THAT SHOWED STEVIA, SURCULOSE, ASPARTAME, AND SACCHARIN ALL HAVE THEIR OWN UNIQUE EFFECTS ON THE HUMAN MICROBIOME.

WHEN THEY TOOK A GROUP OF 120 VOLUNTEERS WHO ARE OTHERWISE HEALTHY AND ASSIGNED THEM EACH TO RECEIVE THESE NON-NUTRATIVE SWEETENERS, AND THEN THEY HAD A CONTROL GROUP THAT HAD GLUCOSE ALONE AND THEN ANOTHER GROUP THAT HAD NOTHING.

THEY FOUND THAT THERE WAS MICROBIOME CHANGES, VERY SIMILAR IN THE GROUPS BUT EACH INDIVIDUAL HAD THEIR OWN VARIABILITY.

SOME PEOPLE IN THE SACCHARIN GROUP HAD CHANGESSED IN THERE THEIR MICROBIOME DIFFERENT FROM OTHERS BUT OVER ALL THERE WAS A TREND HOW THE MICROBIOME SHIFTED.

>> SO IN OTHER WORDS WE ARE SEEING DIFFERENT ORGANISMS THAT ARE BEING PRESENT.

SO WHERE THEY HAD ONE LEVEL PRIOR TO THE NON-NUTRATIVE SWEETENERS, AT THE END, THE DISTRIBUTION AND NUMBERS WAS TOTALLY DIFFERENT.

>> RIGHT.

THE SHIFT IN THE MICROBIOME AND THEY TOOK THAT STUDY ONE STEP FURTHER.

THEY TOOK THE MICROBIOME OR STOOL SAMPLES FROM THE INDIVIDUALS IN THE STUDIES AND THEY PUT THEM INTO MICE THAT HAD NO MICROBIOME AND THEY SHOWED THE METABOLIC CONSEQUENCES OF EATING THESE NON-NUTRATIVE SWEETENERS WAS CONVEYED TO THE MICE AS WELL.

SO THE SWEETENERS DID CAUSE SOME GLUCOSE INTOLERANCE IN PEOPLE AND SUBSEQUENTLY THE MICE HAVE GLUCOSE INTOLERANCE IN THE SAME WAY THAT THE PEOPLE DID.

>> WOW.

AS SERIOUS A PROBLEM AS THAT IS, THERE ARE SOME OTHER CONDITIONS THAT PEOPLE SEEM TO HAVE WHEN USING NON-NUTRATIVE SWEETENERS, WHICH IS RIGHT UP THE GASTROENT ENTEROLOGY PIPELINE.

TELL ME ABOUT THAT.

>> SURCULOSE, WHICH IS A CHEMICAL DERIVATIVE OF SUCROSE HAS BEEN MODIFIED THAT IT IS NOT ABSORBED AND TASTES SWEET AND THE SUGAR ALCOHOLS THEY GO THROUGH THE BODY RELATIVELY UNPROCESSED AND THEY CAN CREATE SOME GASTROINTESTINAL ISSUES SUCH AS FLAT LENS, BLOATING, DIARRHEA, AND FLAT LENS.

THE INDIVIDUAL VARIABILITY WITH THE TOLERANCE OF THESE, THAT MIGHT BE CONVEYED BY THE MICROBIOME.

>> WHEN YOU TALK ABOUT SUGAR ALCOHOLS, WHAT IS THE PRODUCT RHYME THAT I'M LOOKING FOR ON THE LABEL, THE NON-NUTRATIVE SUGAR ALCOHOLS.

>> SOMETHING THAT SAYS ALL AT THE END.

ERITHROTOL, XYLITOL, XYLITOL IS VERY SOMEONE IN MOUTH WASH AND IN TOOTH PASTE, SOMETHING THAT ENDS IN TOL.

SORBITOL ANDY RITH TOLL, YOU SEE THOSE IN SUGAR FREE BEVERAGES.

AND THINGS LIKE SALAD DRESSING.

IF YOU HAVE GASTROINTESTINAL DISTRESS AFTER EATING ANYTHING WITH THESE SWEETENERS IN IT, MAYBE YOU ARE SENSITIVE TO IT.

>> I'M ONE OF THESE PEOPLE THAT ARE SENSITIVE BECAUSE IF I HAVE A PIECE OF CHEWING GUM WITH ONE OF THOSE TOLS IN THERE, YOU DON'T WANT TO BE AROUND ME.

>> I HAVE THE EXACT SAME ISSUE.

I GOT MYSELF A PACK OF GUM AND I POPPED IT AND THEN I JUST LOOKED AT THE LABEL AND I SAID THE FIRST INGREDIENT IS MALITOL.

THIS IS GOING TO BE A GOOD AFTERNOON.

>> A LOT OF DIETETIC CANDIES, WHICH IS TERRIBLE.

YOU TRY TO CUT DOWN ON SUGAR, BUT NO, WHAT IS THE IDEA.

NOW I'M GOING TO HAVE DIARRHEA.

AND A BUNCH OF OTHER STUFF.

THAT'S A GREAT DINNER CONVERSATION.

SO WHAT ABOUT THE DIABETIC PATIENT?

SHOULD THEY BE USING THESE SUGAR SUBSTITUTES OR SHOULD THEY HAVE -- OR SHOULD THEY STAY AWAY FROM THEM ALSO?

>> WOULD I SAY THAT PAYING ATTENTION TO WHAT YOU EAT, TRYING TO EAT HEALTHIER, WHOLE FOODS, FRESH VEGETABLES, FRUITS AND GRAINS, THAT'S WHAT YOU WANT TO DO TO BEGIN WITH.

IF YOU CAN'T DO THAT, IF YOU ARE ALREADY HAVING DIET SUGAR SOFT DRINKS, DIET SOFT DRINKS, WOINT CHANGE-- I WOULDN'T GO BACK TO A FULL SUGAR SOFT DRINK.

I JUST WOULDN'T DO THAT.

SUGAR IS NOT GOOD.

WE KNOW THAT.

HIGH FRUCTOSE CORN SYRUP IS NOT GOOD.

SO IF YOU ARE ALREADY EATING THESE NON-NUTRATIVE SWEETENERS, I WOULDN'T TAKE A STEP BACK.

BUT IF YOU HAVE THE CHOICE TO NOT DO SO, I WOULD TRY TO WEAN YOURSELF OFF THE SWEETNESS.

THE SUGAR HIGH, WHETHER IT COMES FROM REAL SUGAR OR AN ARTIFICIAL SWEETENERS, IT IS A REACTION IN THE BRAIN, JUST LIKE YOU SAID IN THE OPENING.

CHOCOLATE IS EASIER TO OBTAIN THAN OTHER ILLICIT SUBSTANCES.

BUT IT DOES CREATE THAT FEEL GOOD FEELING.

AND WE ARE WIRED TO WANT SUGAR.

IT'S GOOD FOR US.

MAKES US FEEL GOOD.

>> IT DOES MAKE US FEEL GOOD.

SO TELL ME A LITTLE BIT MORE ABOUT THE PLANT-BASED ONES LIKE STEVIA AND THINGS LIKE THAT.

DO THEY CARRY SOME OF THE SAME PROBLEMS AS SOME OF THE MORE MANUFACTURED NON-NUTRATIVE SWEETENERS?

>> I THINK THAT MORE RESEARCH NEEDS TO BE DONE, BUT THERE ARE SOME EARLY SIGNALS THAT STEVIA DOES CAUSE SOME IMPACTS ON SATIETY, THAT IT DECREASES LEPTIN LEVEL AND LEPTIN IS THE I FEEL FULL HORMONE, SO THIS IS REALLY EARLY WORK AND IT DID AFFECT THE MICROBIOME IN THAT 2024 CELL PAPER-- IN THAT 2022 CELL PAPER.

MONK FRUIT, THERE HAS NOT BEEN MUCH RESEARCH DONE.

THE QUALITY OF THE RESEARCH STUDIES, IT'S VERY HETEROGENEOUS.

SOME ARE GOOD STUDIES, SOME ARE BAD STUDIES.

SOME STUDIES I DON'T THINK WE CAN REALLY TAKE A ROBUST CONCLUSION FROM.

AND SO WE ARE KIND OF IN A GREAT HUMAN EXPERIMENT RIGHT NOW.

>> BUT NONE OF LESS,-- BUT NONETHELESS, WHO IS REGULATING THIS MATERIAL?

AND IS THIS SOMETHING THAT, DISCUSS A CONSENSUS PANEL SAY, HARUMPH WE WILL LOOKED AT THE STUDIES YAY OR NAY OR SELF REGULATED BY INDUSTRY?

>> SO THAT IS A REALLY INTERESTING QUESTION.

I WISH COULD I GIVE YOU A STRAIGHT ANSWER BECAUSE I'VE LOOKED INTO THIS AND THERE IS ABOUT 3,000 CHEMICAL FOOD ADDITIVES THAT ARE ON THE FDA'S GENERALLY RECOGNIZED AS SAFE LIST.

AND SO IT IS EASIER TO GET ON THE LIST THAN TO COME OFF THE LIST.

SO SOMETHING HAS TO BE PROVEN AS HARMFUL.

THE FDA HAS TO LOOK AT IT AND IT CAN TAKE MANY YEARS.

IT CAN TAKE A DECADE TO GET SOMETHING OUT OF THE FOOD SUPPLY.

>> YOU KNOW, I WAS READING A BOOK, PROCESSED NATION.

AND THE AUTHOR MADE THE POINT OF SAYING THAT A LOT OF TIMES IF THEY-- JUST AS IT LOOKS LIKE CHEMICAL IS COMING UP FOR EVALUATION, IF YOU MAKE ONE SLIGHT CHANGE, IT STARTS THE CLOCK UP ALL OVER AGAIN.

IT'S RATHER FASCINATING PROCESS ABOUT ALL THIS?

>> AND IF YOU GET ONE PUNITIVELY HARMFUL SUBSTANCE OUT OF THE FOOD SUPPLY, THERE ARE DOZENS MORE THAT COULD BE SWAPPED IN FOR THAT SO IT'S A WHACK A MOLE.

>> YOUR PATIENT COMES IN TO YOU AND SAYS ALL RIGHT, YOU TOLD ME ALL THESE WONDERFUL THINGS.

YOU DON'T WANT ME TO HAVE SUGAR.

YOU DON'T WANT ME TO USE NON-NUTRATIVE THINGS.

WHAT AM I SUPPOSED TO DO?

WHAT DO YOU TELL THEM I WANT SWEETNESS IN MY CAKE.

WHAT DO YOU TELL PEOPLE?

>> I WOULD SAY IT REALLY DEPENDS ON WHAT YOUR OVERALL HEALTH STATUS IS AND WHAT YOUR GOALS ARE.

BUT MODERATION IS KEY.

ONE FULL SUGAR SOFT DRINK A WEEK IS THEIR STREET, I THINK-- IS THERE-- ONE SOFT DRINK AS A TREAT A WEEK IS OKAY BUT I WOULDN'T HAVE ONE EVERY DAY.

>> YOUR PEOPLE LOOK AT YOU AND SAY WHAT PLANET IS SHE FROM?

I'M GOING TO HAVE MY MOON PIE AND MY DIE RC COMPANY LA.

AND YOU ARE GOING TO TELL ME WHY.

>> IT'S HARD.

IT'S HARD TO MAKE A BIG LIFESTYLE CHANGE TO CHANGE THE WAY THAT WE EAT WHEN WE ARE SO WIRED TO, WE HAVE FAST FOOD READILY AVAILABLE.

WE HAVE SO MANY PROCESSED FOODS.

EVERYTHING TASTES SO GOOD.

AND IT'S REALLY, REALLY HARD TO SWITCH OVER TO A WHOLE FOODS DIET WITH LESS CHEMICALS AND LESS SWEETS.

>> I WANT YOU TO GIVE ME THREE TAKE HOME POINTS WE SHOULD KEEP FROM THIS.

AND YOU GOT A LITTLE OVER A MINUTE OR SO TO GO HERE.

WHAT WOULD BE THE THREE THINGS YOU WANT TO MAKE SURE WE ALL TAKE HOME AFTER THIS DISCUSSION?

>> I WOULD SAY THE FIRST POINT IS LOOK AT HOW MUCH SWEET STUFF YOU HAVE IN YOUR DAILY LIFE.

AND THINK ABOUT HOW CAN I REDUCE THIS?

WHETHER IT IS SWEET OR NON-SUGAR OR ARTIFICIAL SWEETENERS OR TRUE SUGAR, I DON'T BELIEVE THAT EITHER CLASS IS GOOD FOR US.

AND SO HOW CAN YOU MAYBE SWAP OUT SOMETHING THAT IS A JUICE FOR THE FRESH FRUIT VARIETY.

OR IF YOU WANT TO HAVE A DESSERT THAT IS HIGHLY PROCESSED, HOW CAN I GET SOMETHING THAT IS LESS PROCESSED AND MORE NATURAL.

NOT COMPLETELY DEPRIVING YOURSELF BUT MAKING SMARTER CHOICES.

>> OKAY.

WHEN YOU ARE HUNGRY AND YOU WANT SOMETHING SWEET, ARE YOU TAKING A PIECE OF FRUIT?

>> WHEN I'M HUNGRY AND I WANT SOMETHING SWEET, I HAVE A LIST OF THINGS THAT THEY ARE MY GO TO AND I TRY TO KEEP WITH ME IN MY BAG AND SOMETIMES IF I WANT SOMETHING SWEET AND I HAVE AN ALMOND THAT IS NOT SO SWEET, IT'S ENOUGH TO SATISFY.

SOMETIMES I'M JUST HUNGRY BUT THE FIRST THING I THINK I WANT IS SOMETHING SWEET.

>> BUT AT SOME POINT WE ARE GOING HAVE YOU COME BACK AND TAKE A LOOK AT WHAT IS INSIDE OF YOUR BAG.

THANK YOU VERY MUCH Dr. LORETTA JOPHLIN.

THANK YOU FOR COMING HERE AND TELL TELLING US ABOUT THESE NON-NUTRATIVE SWEETENERS.

>> THANK YOU.

>> THANK YOU FOR BEING WITH US TODAY.

I HOPE THAT YOU HAVE A BETTER UNDERSTANDING ABOUT THE DIFFERENCES BETWEEN THE TYPES OF ARTIFICIAL NON-NUTRATIVE SWEETENERS AND THE PROS AND CONS OF EACH.

WHEN YOU DECIDE TO USE ONE OF THE THESE PRODUCTS CONSULT WITH YOUR HEALTHCARE PROVIDER.

IF YOU WANT TO WATCH THIS SHOW OR ARCHIVED VERSION OF PAST SHOWS GO TO ket.org/HEALTH.

IF YOU HAVE A QUESTION OR COMMENT ABOUT THIS OR OTHER SHOWS WE CAN BE REACHED AT KYHEALTH@ket.org.

I LOOK FORWARD TO SEEING YOU IN THE OAKS "KENTUCKY HEALTH" AND PLEASE JUST DON'T ADD SO MUCH SUGAR AND YOU CAN AVOID THE ARTIFICIAL SWEETENERS.

FOOD ACTUALLY TASTES GOOD.

LOOK FORWARD TO SEEING YOU AGAIN NEXT WEEK.

THANK YOU.

>> "KENTUCKY HEALTH" IS FUNDED IN PART BY A GRANT FROM THE FOUNDATION FOR A HEALTHY KENTUCKY.