I would love to see a video about the effect of artificial sweetners on gut bacteria! What is your takeaway regarding this topic, should we avoid artificial sweetners because of this?

How can you claim that you have no conflict of interest, if you are such a sweet boy

Type 1 diabetic here. Yes its possible for me to consume regular sugar sodas , but it makes things much more difficult - insulin technology just isn’t there yet. Diet sodas allow me to consume something sweet, which I enjoy, without having to worry about all that normally comes with it. Plus there’s no extra calories 👍 Artificial sweeteners make living with the burdens of diabetes just a little bit lighter and that’s a good thing 👍

I used to use Spenda in my coffee and tea. I now use NO sweetener in coffee and tea. I also drink unsweetened iced tea (with lemon) and limit myself to 2 - 4 small cans (7.5 oz.) of regular soda per month. I just wanted to lessen sugar/sweeteners in my drinks. Small steps and you can get there.

I enjoy how Dr Gil also throws in nuggets about critical thinking and the necessity of reflecting on new information to keep an informed opinion.

I hit a point in my 20’s where I slowly put on 80 pounds and was a junk food eater I eliminated sugar and swapped for diet soda (1-2 cans a day) and eventually lost the 80 pounds but living a healthy lifestyle Worked wonders for me and it’s 25 years later:)

Every video this channel pumps out is a gem. Thanks so much for all the hard work!

I replaced sugar with no sugar. Seems best.

I can't bear the taste of the artificial sweeteners I've tried, so for me it's best to avoid sodas altogether.

Thank you Dr. Can you do a video on monk fruit extract, allulose, and stevia specifically?

Was raised in the 1960s by a mother who kept sugary treats to a rare event. Soda pop was restricted to occasional summer picnics or parties. So glad to have had that upbringing. I drink water, and have reduced alcohol to less than 1 per month. Needless to say, I have normal weight and A1C.

I'm losing a bunch of weight these last months, I started drinking diet soda instead of normal one and changed many habits, but I can measure my health data before and after these changes and will see if they had or not positive effects in some months, for now it appears to work well compared to before

Could be psychosomatic, but i really notice that diet sodas increase my hunger compared to just water

It isn't easy to change a decades-long habit of consuming soda. I drank diet soda for about 4 decades, and gave it up about 7 years ago, when I realized that my aging body wasn't metabolizing aspartame well, anymore. I had evolved to not sweetening my hot drinks (coffee and tea), which I drank in the winter, but continuing to consume cold drinks (diet soda and iced tea) with aspartame in the summer. Turns out that in my 50s, aspartame was giving me brain fog and muscle aches (my mother had experienced short term memory loss with aspartame when it first came out in the '80s, and switched back to saccharine). It wasn't too hard to adjust to drinking iced tea without sweetener, but it was *really* hard to give up diet Coke, especially in certain situations (road trips). It was the combination of caffeine, flavor, and the bubbles (along with just the habit of drinking it) that made it difficult to give up. I liked my brain a lot more than I liked diet Coke, though, so I managed to do it. For me, it was never about trying to control my weight, it was just that I didn't like drinking that much sugar. Made me feel sick.

Do you have any thoughts on the study recent Cedars-Sinai did regarding the impact of artificial sweeteners on the gut microbiome published in the journal iScience?

Best nutrition channel in any platform!

The pepsi max has completely eliminated my tooth sensitivity from real sugar. I know it still has acids which wears down enamel but the change in pain is night and day

I am using a lot of sweetners for the last 30 years - when I stop sugar in food and drinks I lost 33kg and never gained it again- I am 61 and still and is so healthy as 20 year sportman

WE are lucky to have you!! Thankyou for your work

Great video. Glad to see someone balancing all the bad science out there. I'm 62 years old. 6'3" and 185 pounds. I've been drinking diet soda since 1981. I probably average about 1.5 per day. I grew up in a household, unfortunately, where we always had sweets - desserts after every meal, and so I have a sweet tooth to this day. I've done my best to cut out sugar as much as possible starting about 10 years ago. I use artificial sweeteners whenever I need to sweeten something. Currently Swerve is my go-to. Some of you would probably have a heart attack if you saw how much I put on my oatmeal for breakfast. I still struggle to avoid sweets - especially after a meal, but now it's usually a piece of sugar-free candy. My health is excellent. I'm on no medications - and I mean zero medications! There have been so many bad studies on artificial sweeteners and misrepresentation of the results. I have not seen anything that conclusively shows artificial sweeteners to be bad for you. I look at it as the lesser of two evils.

The WHO, great band

Have you taken a course on communication, maybe copywriting? Your delivery is very easy to follow, not just logical. Those books in the background are also very interesting. I see ones on movies and art, also what looks like a history book. You seem like a very well-rounded person. Thank you for your videos!

Nice overall review, but you could have included/mentioned (at least passingly) some themes missing from this video. Namely - sweetener effects on gut microbiota - there is interesting scientific literature on the subject - effects on cancer risk - it is both ways depending on the type of cancer and the sweetener in question therefore an understandable omission - genotoxicity of sucralose-6-acetate - addressing the fear of hormonal metabolic effects still present in the public mind (insulin and ghrelin increase by tricking the mind - now mostly disproved) Maybe topics for an updated deep dive video on sweeteners? But as always, nice and to the point summation.

Blessed to hear this quality nuanced analysis here on KZfaq. Love the fact he's talking about the weight one study has vs the other one. Reminds me of Layne Norton 👍

I think with diet soda it isn’t the artificial sweeteners that are the problem otherwise half the population would have dropped dead from it by now. The problem is people use it as an excuse to consume more calories elsewhere. I worked in fast food in my younger days and we had obese people come in and order a double cheeseburger, large fries, chicken nuggets and dessert and then top it off with a large diet soda. One lady actually said to her friend that it was okay to eat all that because she got the diet soda. We also had thin people that would order a single cheeseburger, small fries and a small regular soda. So there’s some phycology going on there.

from what i understood, i thought there was a positive relationship between the amount of artificial sweeteners a person consumed and the amount of otherwise ultra processed foods they consumed. so rather than affecting your health directly, artificial sweeteners may affect your food choices. you may just get used to a certain level of sweetness that fruit can't provide for example, so you tend to eat sweeter things aka more sugar in turn!

Why not just get used to a non sweet taste ? I avoid sugar type products and artificial sweeteners. When I taste something sweet it tastes revoltingly sweet. You loose the taste.

Agreed. But I am cautious with NSS for two reasons. First, nature rarely lets us off the hook this easily. Just think about how the body starts to burn fewer calories when you reduce caloric intake. The body really seems to have a “there are no free lunches” principle. Even if the consequences aren’t morphological. Second, I worry most about elevating our baseline response to sweetness. If you have a friend from Asia, they can’t stand American treats because they are so sweet. If you have had Asian dessert, you know what I mean. If everything becomes sweet without consequence, we may come to expect this all the time.

From 6:20-6:29... You say the artificial sweeteners are beneficial compared to added sugars. Would a more "accurate" way of stating this be that artificial sweeteners are "less harmful" than added sugars? I struggle with accepting artificial sweeteners are "beneficial" overall

The Precautionary Principle is relevant here! Some US scientists and some governments across the pond think that it's best to avoid products whose long-term effects are unclear, unknown or disputed. In other words, it's smarter to be cautious rather than risk being overly casual. This makes a LOT of sense to me. If I don't *know* something is safe, I prefer to err on the side of caution. This can apply to food additives, pesticides and more.

Well, which sweeteners exactly? We have to test all of them, they are not the same :)

I don't drink regular soda, and I aldo don't drink diet soda either. Sometimes I put a sachet of artificial sweetener for my tea or coffee. So, this statement from WHO doesn't really impact me at all. But I agree with you that for someone who drink a lot of regular soda, small first step of getting healthier is to replace it with diet soda.

We do too much lumping when discussing anything health related. There really is no such a food as “artificial sweeteners”. Each of the sweeteners are their own unique molecule and have their own individual effect on your health. Same thing I think when I hear people say “processed foods”, it means nothing. What foods, processed how? Nearly everything is processed. These vagueries are poisoning our conversations about diet and nutrition.

Some artificial sweeteners act as laxatives or similar to fiber, which can also at least encourage weight loss.

Watching this while drinking my Coke Zero.

Would love to see a video about known effects of fluorine in toothpaste

Nice overall review, but you could have passingly included/mentioned some themes missing from it, namely - sweetener effects on gut microbiota - there is interesting sci. Lit. On the subject - effects on cancer risk - it is both ways depending on the type of cancer and the sweetener in question therefore an understandable omission - genotoxicity of sucralose-6-acetate - addressing the fear of hormonal metabolic effects still present in the public mind (insulin and ghrelin increase by tricking the mind - now mostly disproved) Lumping all the many vastly different sweeteners together is also strange. Maybe topics for an updated deep dive video on sweeteners? But as always, nice and and concise summation.

Allulose seems like a more natural and beneficial sweetener than the others.

Great video! Thanks for sharing Dr Carvalho

This is exactly my through too and, based on the experiment I did on myself, the result I found concordant with what you said in the video. I can't speak for other as we all have different lifestyle, habit and health conditions. I am only mentioning what I discovered on myself. Best way to see / decide which sweetener/ sugar is best for you is to observe yourself and evaluate how different sweetener have different effect on your overall health.

Ive seldom seen a comments section miss the point this bad

Great video! Unrelated question: dietary antioxidants, like matcha and blueberries and red wine. Do they really do anything in vivo? What about supplements?

I love that your channel breaks down the nuances of these studies. Thank you for helping people learn how to think objectively and scientifically! 🙂

This is a great video! It would be nice to see tea versus artificial sweeteners, similar to what you suggested: the regular soda versus diet soda. Honestly, it would be nice to know a quantification of the benefit of tea over diet soda. It's a switch I made awhile back, several years after I switched from sugar soda to diet soda.

Is stevia considered an artificial sweetener? Maybe different sweeteners also have different risk profiles and we shouldn't lump them all together.

"If artificial sweeteners help you cut back" is the #1 point. I had an ex who was super addicted to Diet Coke. Switching to normal Pepsi initially limited her because her body definitely felt the difference. She went from 6+ cans a day to 1-2. If you can maintain that. And drink water instead. Then regular sugar would be better. But her caffeine and stress addiction just came back until she was drinking huge amounts of sugar soda. The sweetener was not the root problem. Stress and caffeine addiction was. The effects of sweeteners, if any, seem to be quite mild.

Artificial sweeteners keeps people addicted to very sweet food and makes it harder to move towards a whole food plant based diet, which is what truly improves health outcomes.

This has come up at work but the question is only ever about cancer. I think that’s what most people want to know. My argument has always been that the data are inconclusive but we do know that processed meats and charred meats are carcinogens, so unless your coming with that same energy for your turkey sandwich and steak, you’re going to have to miss me with this hyper fixation over artificial sweeteners.

Did you ever do a fact-check on Robert Lustig? Particularly: Sugar, the bitter truth. If not, then please do.

Wasn't there a trial that showed that people who eat artificial sweeteners with a meal would consume fewer calories during the meal, however they'd make up for those calories in their following meal... something about how the body assumes it needs more insulin because of the sweetness, and so it gets blood sugars very low, causing the hunger to kick in.... is that an incorrect memory I have?!?

Interesting topic, thanks!

But substitution isn't appropriate here. An analogy would be replacing smoking with vaping. Sure it is best to replace smoking with vaping but it is also best not to vape. So both recommendations are correct. I still enjoy a diet coke whilst my friends and colleagues are getting smashed!

I think everything in moderation for some of us will work. I lost 87lbs in 2020 subbing in diet drinks in place of full sugar...also eliminated processed junk foods. Have maintained my wgt & labs are all good. Zevia soda uses stevia.

I have to tell you a crazy story. Last year i went to Mexico with my parents. It's a rural small town. I stayed down there for 1 month. I lost 7 pounds in 1 month. I was eating about 8 big corn tortillas a day. I was adding brown sugar to my coffee in the morning. I was eating one whole wheat bread with the coffee every morning.. The tortillas don't have any preservetives so they go bad in about 2 days. They make them fresh every morning. The same for the whole wheat bread. It's freshly made every morning and it goes bad after 2 days. I don't eat that much bread or tortillas here in the US because i know they are loaded with preservetives..

That was really interesting. I'm a huge consumer of pure, powered monk fruit, I import it directly from China. I also consume a lot of 90% reb A Stevia and a lot of sucralose and I have done for well over a decade...with the exception of Monk Fruit, as it's not been available for that long. I'm plant based and at 60 I'm in good health and slightly under weight, so I'm hoping that bodes well for the future. My only health concern is Mgus...could that be linked to the sweeteners? My teeth are fine and that was originally my reason for quitting sugar, I'd heard of some terrible consequencies attributed to having rotten teeth. Thanks again, always love watching your videos and appreciate the time you must put into making them.

Fascinating as always thank you! Have you done a video on Ultra Processed food yet?

I'm curious about your medical view of erythritol, given the stud(ies?) this year that linked it to major cardiovascular events. As someone who replaced aspartame etc with erythritol, I'd love to know how sound the science is re cardiovascular events.

Something occurred to me this morning about my sugar consumption: I like to drink coffee with a shot of sweetened cream. Not a big deal right? BUT: the MANNER in which I drink it sparked a question. See, I like to slow sip throughout the day, rather than slug it down in one session. So I wonder if it’s worse to slowly sip on this low level of sugar all day long vs a quick dose all at once like when most people drink coffee? I’m thinking that I’m spiking my glucose for hours and not giving my system a rest, vs one glucose spike event…I wonder if it’s making it hard for me to lose weight?

To give up my Coke addiction, I first had to transition to non-caffeinated soda. Then I gradually went to flavored water. It's been 10 years or so but I still can't make the switch to plain water, but I'm still trying (drinking a LaCroix while watching).

“No conflicts of interest”, yet releases sweet videos. Come on, Gil! 😛

One of the ways to put the TL:DR - If you are someone can manage it, then maintain healthy weight and consume only water and whole foods; but if you are not someone who can do that, then zero-calorie sweeteners are probably less damaging to you than sugar is.

My negative health experience is an arthritis flare up (swelling, joint pain) in my feet (luckily one foot at a time) that started about ten years ago, if I consume aspartame (>one can diet soda), too much high fructose corn syrup or regular sugar. This past holiday season (duh!) caused a flare up that took two weeks to subside, the longest yet. I use Liquid Splenda (not powdered form) in my coffee because it contains no maltodextrin (that gives a dumb sugar like high). I drink sparkling water & seltzers to hydrate. My doctor's only advice "avoid the triggers". HTH.

Good points and my experience bears this theory out. I’m 6 months into keto with IF/PF and have lost 96lbs/43kg/6 stone 10lbs finding it really easy as I love the food I am eating and have no hunger cravings. I have been a strict practitioner with no carby foods BUT my one cheat is artificial sweeteners in drinks as it is the one dietary pleasure I need to keep me happy and motivated. I have heard it may spike insulin and reduce fat burn but, for me at least, when I measure my blood ketones they do not appear to be affected. I have another 60lbs to lose and, if my weight loss plateaus I may look at this again but I am confident I will be OK as my loss has been almost perfectly linear since day 1. As a bonus some major diabetes symptoms disappeared within just 2 weeks before the weight loss really kicked in. My diabetic HbA1c numbers have been reversed over the course of ther first 5 months too.

My study reached the endpoint after just one dose: Impressive hives! Never mind the longterm effects.

What are your thoughts about Stevia and Monk Fruit? In this case 0 GI natural sweetners, compared to artificial sweetners?

I don't think they are bad if it is consumed in controlled amounts. The bad thing about this type of sweeteners are that they are added in everything nowadays

Recently I’ve read about adverse health effects from artificial sweeteners.

From someone who had SIBO: Artificial sweeteners _can_ ef up your microbiome, especially if you're already compromised. Laying off artificial sweeteners was my first bout of relief in years. Granted, I had been consuming a _ton_ of 'em daily.

There is so much disagreement on this topic that it is very hard or impossible for the average person to perceive the real truth on the issue and to make life changes that they can feel confident will improve their health. With all of that, I can only assume that the topic of sugar and artificial sweeteners as they relate to human health isn't properly understood at this time.

I laughed so hard when you said “draaama”😂

I'd be curious to hear your take on the evidence of genotoxicity of sucralose-6-acetate. Specifically, the data collected using the repligut system.

Erythritol leaves a weird taste in my mouth that stays for hours

Maybe it's me, but after ditching all added sugar (I never used artificial sweeteners, as the name itself - "artificial" - scares me off), regular plain food tastes better and sweet enough. Even banana is too sweet. Or adding glycine suplement to the shake - makes it VERY sweet. But this zero demand for sweet taste became especially pronounced after I finnaly stop using remaining animal products - i.e. diary and eggs. During last few years while I was still using them, I saw clear correlation - the more animal fat I use - the more I crave for smth sweet. Not sure why.

I confess, I stopped drinking soda for over a decade and then started drinking a can of diet a day due to eating out a lot at work during one project

One issue of replacing diet soda with fruit is that fruits contain calories. Which is more satiating, an apple or a 2l diet coke? The coke has less calories also. Diet drinks are the closest thing we have to a diet hack. Something that tastes as good as the original, but has virtually no calories.

I don't recommend to anyone getting involved with this. There are no reasons for me to pick sweeteners OUTSIDE of Black Strap Molasses and Dates or date sugar (which is not really a sugar but just the date itself in modified form) No sweeteners in the world are nearly as healthy as the above, and those above are safe safe safe.

I used Splenda for a while...until I started getting painful sores on my tongue. Then I switched to Stevia, but it was mostly fillers. For the last 2-3 years, I have been splurging on Stevia without fillers. I sometimes add supplements that are a bit sweet: inositol, TMG, and Glycine.

In order to be prioritized, the RCTs should have the same time-frame as the observational. Who knows if sweeteners long-term lead to change in people's cravings, and the bad outcomes only happen much later?

Is there convincing evidence that aspartame is completely safe if consumed within the limits that ought to be safe?

Is there a long term effect of artificial sweetener on the liver?

I stopped using artificial sweeteners because of the potential for kidney damage. But for years it did help me control my weight. I missed diet soda for a while but I don’t even like the taste anymore.

Reverse causation that he mentions is so part of it to me.

great subject! as suggestion one subject that will great to be presented by your channel will be about the cookware we can use safe in every day, with statistics and real facts, for example one important subject is about the ceramic cookware that has a very contradictory info on the web, also the daily use of dishwashing soap and similar things, using plastic packages etc I think all these can add up every day and influence our health unfortunately, without even knowing

If someone has been eating bad food, not getting exercise, then really starts noticing how fat they've gotten, they then start artificial sweeteners. But the damage is possibly already done, so they show up later in the long-term stats with artificial sweetness being the link even when they did much damage earlier. Right or wrong? I sure don't know.

I get hungry from them, same as regular sugar. I kind of keep both as a treat, not a regular.

I’m learning so much from your channel. Thanks!

Thanks for the info!

Excellent review . Will help clinical practice. Many thanks

Not many people grow up consuming NNS over sugar by default. The default is sugar, and only people who perceive themselves as having a problem or potential problem push themselves into a direction where they get used to the taste of NNS. (One could argue that NNS is inferior in terms of taste, but a lot of people who get used to it may prefer it.). I think the default assumption is that there is at least some reverse causation here. It would be crazy to think that this isn't a self-selecting population.

The WHO has lost A LOT of respect in recent years. They don't seem to actually be on top of the latest science in some fields, and their "invested interests" issue really made them take a hit in terms of public trust and frankly the believability of theire ostensible objectivity.

I object to lumping all artificial sweetners together. Focus on one artificial sweetner at a time. The risks of aspartame vs. sucralose vs. saccharin are probably very different. I'm surprised you lump them. I wouldn't

I took sugar out of my coffee, tea, porridge etc. And I don't drink fizzy drinks as a rule. Think I'd be ok with stevia though.

Stevia can go along well with lemon juice Monk fruit can go along well with chocolate They have no carb nor sugar

Agree that the announcement was a bit dramatic and uncalled for. Knowing how the WHO functions, it felt like someone was trying to get or justify their funding by reviving an old scare... That said, there are concerns in the nutrition world about the effect of artificial sweeteners on microbiome health and diversity. Would love it if you could do a video on research in that direction, as they are starting to make their way everywhere into our foods (in the plethora of diet sodas and drinks; the ever-increasing number of "no sugar added" processed foods and products; and even in non-diet foods, where they are used to lower the total calorie amounts). I've stopped using artificial sweeteners and avoid any food containing them, and I've gone back to consumption of regular sugar and honey in small amounts (e.g. in my coffee/tea, a cookie or pastry once in a while). Sugar is supposed to be bad for the microbiome too, but most of it gets digested and goes into the bloodstream before hitting the gut, whereas artificial sweeteners pass through your digestive system straight to your microbiome 🤷‍♂️ Not sure whether my reasoning is correct but would love to see it tested in research.

I consume around a kilo of xylitol in a month, and honestly it's correlated with a dramatic improvement in my health in the last 2 years. Though primarily helped with no more other refined sugars, and larger veg intake + no more chocolate bars. Xylitol has helped in stabilising of gums alongside fresh lemon with water. I add xylitol to matcha powder and soy milk. Maybe coincidental beneficial health effects. When I stop xylitol however, I notice reduced quality of health (gums and digestion) but maybe that's due to nocebo effect. The evidence of xylitol however is positive.

Can you do a video on the benefits of Xylitol. There are claims that it protects teeth from decay. Is this true?

Replacing sugar with artificial sweeteners makes sense, but if there is the option to drink water ws. artificial sweetener I prefer plain water. Why ingesting a chemical that does nothing to my body - at best -, but there is the potential to create havok - not yet discovered causation to cancer, killing microbiota and alzheimer or other diseases.

The World Health Organization (WHO) recently issued guidelines discouraging the use of artificial sweeteners, suggesting they may raise the risk of outcomes like obesity, diabetes, and death. However, Dr. Gil Carvalho argues that based on the current scientific evidence, the WHO's stance is likely incorrect. There are two main ways to study the health effects of foods/products - randomized controlled trials (RCTs) and observational studies. RCTs split people randomly into groups, give some the product being studied, follow them over time, and compare outcomes. These tend to be short-term, just months or a few years. Observational studies follow people long-term, see how much of the product they consume normally, and correlate that to health outcomes. These can track people for decades. In general, RCTs on artificial sweeteners point to their safety and benefits. People randomized to increase artificial sweetener intake tend to lose more weight compared to controls (Phetprathorn et al., 2021). Some trials even compare artificial sweeteners to water and find no statistically significant difference in parameters like weight loss, suggesting artificial sweeteners are equally good options (Phetprathorn et al., 2021). However, longer-term observational studies often find higher disease risk - more obesity, heart disease, and death - among those who consume more artificial sweeteners (WHO, 2023). This presents a contradiction between the short-term randomized vs. long-term observational data. The WHO sided with the observational evidence, mainly due to the shorter durations of RCTs. But there are limitations to these default observational analyses. People who consume more artificial sweeteners often do so because they are heavier/less healthy, in an effort to lose weight and improve health. So we may just be seeing reverse causation - the higher disease risk existed before they began using artificial sweeteners. The WHO report mentions this possibility but still favors the observational data over RCTs (WHO, 2023). However, there are more robust ways to analyze observational data, like substitution analyses - comparing specific alternatives head-to-head. The most sensible comparison is between artificially-sweetened products vs. regular sugar-sweetened versions. When analyzed this way - comparing diet soda to regular soda, for example - the results change dramatically. Those who consume artificially-sweetened options show lower risk of obesity, heart disease, and death compared to consumers of sugary versions (Miller & Perez, 2014). So Dr. Carvalho believes artificial sweeteners are likely beneficial, at least compared to added sugars. If future evidence continues supporting this view, the WHO may change its guidelines. A major new RCT did come out as this video was being made. Over 500 overweight people were placed on a weight loss regimen and randomized to either replace soda with water or artificially-sweetened drinks. Both groups lost weight, but the artificial sweetener group lost slightly more - 7.5 kg vs 6 kg over one year (Phetprathorn et al., 2021). This aligns with the previous evidence suggesting benefits. The WHO does make good points - that things like fruit and unsweetened drinks can also reduce sugar, and that just replacing sugary soda with diet soda does not greatly improve overall diet quality. But for public health implementation, if diet soda helps people cut back on regular soda, the evidence suggests that's still a net positive health move. While overall diet quality is crucial, getting an unhealthy population to move in a healthier direction is challenging. If diet soda assists with that transition, it may be advantageous despite not being the perfect solution. In summary, Dr. Carvalho believes based on the current randomized trial and substitution analysis observational evidence that artificial sweeteners are likely safe and beneficial alternatives to added sugar, at least helping support sugar and soda reduction efforts. If future evidence contradicts this view, opinions may shift. But for now, the weight of current scientifically rigorous data seems to support artificial sweeteners as helpful options. Of course, things like water and unsweetened drinks remain viable alternatives as well in supporting public health.

I remember some study relating artificial sweetners with poorer gut microbiome. Is this true? Should it be a concern for someone who is trying to improve gut health?

Life without sweetener is too bitter.