Which sugar substitute do you choose when drinking coffee?

White. Pink. Blue. Yellow.

Walk into any restaurant and you can immediately know what's in it by the color of the sweetener package on the table.

Sugar. Saccharin. Aspartame. Sucralose.

Which one do you choose to pour into the coffee cup or teacup? Sometimes, it feels like playing roulette. Various claims about the safety or unsafety of sweeteners are confusing and contradictory.

Alyssa Kaplan Michaels (Alissa Kaplan Michaels), for example, never chose pink. She still thinks saccharin may cause cancer. In the 1970s, the Food and Drug Administration (The Food and Drug)

Administration) tried to ban saccharin because domestic mice developed bladder cancer after consuming large amounts of the chemical.

But the U.S. Congress decided to suspend the ban, so the pink package is Sweet'N.

Low) Sugar is still on the table in the restaurant. The Food and Drug Administration withdrew the ban in 1991, and in 2000, when studies showed that the mechanism of action of saccharin in domestic mice was different from that in humans, and there was no conclusive evidence of an increase in the incidence of cancer in the population, the warning sign about saccharin was also removed. Ms. Michaels, who works as a public relations consultant in New York, knows about it.

But she said, "the key is that domestic mice do get cancer. I can't put this behind me. "

Although many people have doubts about artificial sweeteners, they still use a lot of these chemicals to avoid sugar and calories-the annual market for artificial sweeteners is as high as $1.5 billion (9.2 billion yuan) worldwide.

The scientific community's conclusions are also divided. With any sweetener, you can easily find a study that promises to be safe, and another that details the potential hazards. In addition, the long-term effects of sweeteners on the human body are likely to become apparent after decades of use.

As a result, many people's choices of sweeteners are often dominated by bizarre talk, hearsay and whimsical.

For Ms Michaels, childhood impressions are much more useful than the FDA's decisions.

She even keeps her chosen sweetener in her bag-sucralose known as Splenda-in case sometimes the restaurant runs out of sucralose, and she has to choose between pink and blue. "I'm the kind of girl who prefers yellow," she said.

Tens of millions of people gobble down foods and drinks containing artificial sweeteners, and so far, no large-scale health disaster has fallen on these people.

The US Food and Drug Administration has put the three main artificial sweeteners currently on the market in the same category: "recognized safety". Manufacturers cite numerous health studies to support this claim.

"in accordance with conventional food safety standards, the scientific community believes that sweeteners have been adequately tested to rule out any potential toxicity," said New York Medical College (New)

Gary M. Williams, a professor of pathology at York Medical College.

Williams) the doctor said. He himself has been involved in safety assessments of several artificial sweeteners, some of which are funded by sweetener manufacturers. "I drink Diet Coke. I don't need calories. Fresca is my personal favorite, and to be honest, I don't know what's in it. "

Dr. Williams' confidence in safety stems in part from the fact that artificial sweeteners are much sweeter than sugar, so people eat very little. Most of the white substance in the package is actually a filler rather than a sweetener. The dose used in animal safety trials is hundreds of times higher.

But critics, particularly of aspartame, known as Equal or NutraSweet, say health problems such as headaches, neurological disorders and cancer do occur, but regulators are indifferent.

The Health Initiative Center for Science in the Public interest (Center for Science in the Public Interest) applauded the use of "avoid" labels on saccharin and aspartame packages, but said the new generation of sweeteners sucrose and neotame, which are chemically similar to aspartame but sweeter, are safe. The center also warned against another less common sweetener, acesulfame. Although it rarely appears in the form of small packaging used on the table, it is used in carbonated drinks and baked goods with other sweeteners to taste closer to white sugar. For example, Dr. Williams' favorite drink, Freska, uses acemide and aspartame. These two sweeteners are also used in Halls sugar-free throat lozenges.

For those who choose to use stevioside (stevia), a sweetener extracted from plants, the center gives advice to "use it with caution" because only one experimental animal has been selected for carcinogenicity studies on the sweetener. ("just because a substance is natural doesn't necessarily mean it's safe," the center's website warns.)

A Google search will immediately make many people wonder about a variety of sweeteners: will Newt Health Sugar cause brain cancer? Is it true that candy candies belong to the same chemical category as DDT? How to explain the research that artificial sweeteners can lead to weight gain even though they don't contain calories?

Walter, head of the Department of Nutrition at the Harvard School of Public Health (Harvard School of Public Health)

Willett) doctors point out that after a comprehensive assessment of risks and uncertainties, people can make rational choices. "the world is never black or white, and we rarely do it after we are absolutely sure of something," he said. "the most important thing is to avoid the big risks that have been identified, such as smoking, obesity and regular intake of high-energy carbonated drinks."

Chemical hidden worries

Saccharin, aspartame, sucralose and acesulfame are all chemical molecules that cleverly bind to specific proteins on the surface of the tongue. They stimulate neurons to send signals and shout to the brain, "how sweet!"

The question is, what happens when these chemical sweeteners are eaten?

In the case of aspartame, it is actually made up of two amino acids and a molecular fragment called methyl ester. Some people-about one in 25,000 in the United States-suffer from a genetic disease that cannot metabolize one of the amino acids, phenylalanine, and are advised to stay away from aspartame.

These two amino acids are abundant in many foods. "they are not completely specific ingredients," Dr. Willett pointed out. "this is not to conclude that they are completely harmless, but at least there are unlikely to be surprising conclusions waiting for us."

Others see toxins in aspartame. They point out that although these two amino acids are an essential part of the human diet, they can cause problems in the event of an imbalance.

The third ingredient that makes up aspartame, methyl ester, can be converted into toxic methanol. However, fruit juices also contain high concentrations of methanol. University of Arizona (University of

Woodrow C. Monte, professor emeritus of Arizona, believes that a range of diseases, including multiple sclerosis, are associated with low-dose methanol poisoning.

Some of the relevant scientific literatures are vigilant and some are reassuring. A large study conducted by a cancer institute in Italy found that domestic mice taking aspartame were more likely to develop leukemia and lymphoma. However, the National Cancer Institute (The) in Maryland

National Cancer Institute) reviewed the health data of 500000 retirees and found no link between consumption of aspartame-containing drinks and cancer.

At the same time, just as McNeil Nutrition Co., Ltd. (McNeil), the maker of delicious sugar.

Nutritionals) pointed out in the advertisement that sucralose is converted from sugar. The chemical reaction removes part of the sugar molecule and replaces it with chlorine atoms. This effective makeover allows most sugar molecules to be excreted directly out of the body without digestion. Therefore, the calorie is zero. But some people worry that once the chlorine in the sucrose molecule is absorbed by the human body, it may cause problems. Michael F. Jacobson (Michael, Executive Director of the Center for Science in the Public interest)

F. Jacobson) said that the results of animal experiments on sucralose were enough to rank it as "safe".

But the stability of sucralose molecules raises new doubts. The presence of sucrose in tap water has been detected, raising concerns about the consequences of ingestion of the chemical by many animals.

Measure risk

Since there are so many problems with artificial sweeteners, some people may ask: how bad is sugar?

The sweet taste of white sugar is the purest. It's natural. But its negative effect on health is also the most certain: it makes you fat.

A study published last year, which analyzed the comprehensive health data of more than 100000 American nurses over the 1/4 century, showed a positive correlation between weight gain and consumption of sugary drinks and desserts. People who drank sugar-free drinks containing artificial sweeteners did not gain weight.

Obesity causes a large number of health problems-diabetes, heart disease and even cancer. Sugary carbonated drinks (fruit juices are no exception) can lead to weight gain in particular. Usually, when the diet changes, the hunger signal of the food will be adjusted accordingly to ensure adequate nutrition intake. But the human digestive system seems to be too light on liquid calories. People who ate 140 calories from 12 ounces (340 grams) of tinned Coca-Cola did not subconsciously save those 140 calories from elsewhere.

"liquid calories seem to work differently, which is why they are particularly problematic," Dr. Willett pointed out. "many foods can lead to weight gain, but so far, sugary drinks seem to be the most serious problem." (because of this, New York Mayor Michael R. Michael

R. Bloomberg) proposed to ban the sale of large bottles of sugary carbonated drinks in the city, but allowed extra-large bottles of sugar-free carbonated drinks.)

Dr. Willett says the long-term safety of artificial sweeteners has yet to be proven. "keep in mind the interesting fact that if you smoke, the risk of lung cancer won't increase until 30 years later," he said. "but tobacco is a strong carcinogen. Many things will not be known until decades later. "

He also pointed out that trans fats, which have been in use since 1900, did not attract medical attention until the 1990s. "it took us nearly 90 years to realize that trans fats were a big problem," Dr. Willett said. "thinking about the long process is enough to wake people up."

On the relatively dangerous question-known risks of sugar and weight gain versus unknown risks of artificial sweeteners, Dr. Willett said: "artificial sweetener drinks are not that bad compared to drinks sweetened entirely with sugar." However, sugar-free carbonated drinks are far from the best choice. "in my opinion, they are similar to nicotine smoking cessation patches," he said.

The best solution to protect your health is to drink less drinks and eat less sweets.