Kurt G. Harris MD

PāNu means paleonutrition. The "paleo" here signifies "old" and not necessarily paleolithic. The PāNu approach to nutrition is grounded on clinical medicine and basic sciences disciplined by knowledge of evolutionary biology and paleoanthropology. The best evidence from multiple disciplines supports eating a pastoral (animal-based) diet rather than a grain-based agricultural one, while avoiding what I call the neolithic agents of disease - wheat, excess fructose and excess linoleic acid.

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What About Diet Soda?

Some of you may be aware of the observational study reported a few years ago - it reported that consumption of diet soda seems to independently correlate with the risk of metabolic syndrome (high blood sugar and insulin levels).

Now, there are a few ways this could occur;

1) Although they "control" for other factors like sugar consumption and calories, in any observational study, factoring out other variables is always mathematically supported guesswork. There may always be covariance with unknown risk factors that are inadequately accounted for or measured.

2) Artificial sweeteners, I believe, condition you to crave sweets. I have only personal and anecdotal clinical experience to support this, but it seems reasonable. I notice if during a long fast I drink diet soda, I get hungry about 15 minutes later every time.

3) There is some evidence there may be a physiologically significant insulin response with artificial sweeteners just due to the sweet taste- even if small, the corresponding drop in blood glucose may be exagerrated by the fact no glucose is consumed - when blood glucose drops, other hormones rise in response, stimulating your appetite. Of course insulin itself drives fat storage and decreases insulin sensitivity, so there may be direct unhealthy effects as well.

4) When it comes to artificial substances like aspartame, that we have even less experience consuming than the cereal grains I am leery of, the precautionary principle would dictate avoiding these substances.

As important as sucrose and HFCS avoidance? Probably not, but I don't recommend any artificial sweeteners. Once you are deconditioned to sugar, they will just "taste funny" anyway.

Reader Comments (5)

Hi Kurt -

Just discovered your blog, looks great! I've been following the paleo diet myself for a couple of years now, tweaking and refining it (and learning what I can and cannot eat - label-reading is practically a sport for me these days!).

Anyway, the reason I'm commenting on this specific entry of yours is because I wanted to pass on this little anecdote. Eight years ago (before I went paleo), I had normal blood sugars, etc. I became concerned about my weight (who isn't, these days?) and switched my intake of caffeinated cola beverages from regular to diet. Within two years I was borderline diabetic, and I blame that largely on the aspartame in the soft drinks. Since then I've gone paleo and managed to keep everything under control through the diet, but I still warn people whenever I can about the dangers of aspartame as I've experienced them firsthand.

June 30, 2009 | Unregistered Commentergcb

Very interesting anecdote

Most of the stuff I read on pubmed (aspartame * insulin) claims aspartame has no effect on insuliin levels - but then much of the nutrition literature claims sucrose is just fine for diabetics! I am suspicious that long term aspartame might somehow affect insulin resistance - I'll keep looking into this.

June 30, 2009 | Registered CommenterKurt G. Harris MD

Hi Kurt,

I'm new to your blog, having read your comments on Stephan's blog, and find your posts interesting and enjoyable. I follow the circuit of low carb and some paleo blogs and find it interesting that so many paleo adherents don't seem to address alcohol. I'm glad to see you have an entry on the subject and also address the role of gluten, as the information is not readily available.

It was IR that got me here and I have learned that inflammation is also an issue for me. I've been experimenting with giving up my daily wine as alcohol seems to be a major contributor to inflammation and it absolutely sends me into hypo territory if I drink on an empty stomach.

July 23, 2009 | Unregistered CommenterNick

I do have a sweet tooth, and I like stevia. I did a pubmed search and found one article: a South American study using stevia to put abdominal fat on chickens.
I am having a terrible time decreasing the stevia, but also have lost no weight. I guess it's time to bite the bullet.
Great blog. Jean

September 5, 2009 | Unregistered Commenterjean

Hello Doc Harris,
I think it depends from person to person. I´m doing fine with Stevia since years but can´t handle sugarfree chewinggum. I´m since 1 year in full ketosis, living almost on meat, ghee, red palm oil and coconut oil. I do miss NOTHING. But I earned a great improvement in asthma, hashimoto and mental condition. Great work you do, wish I ´ve had find earlier.
Greetings from Munich/Germany.

October 14, 2009 | Unregistered CommenterByron
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