User:Lee.ji/sandbox

Cancer[edit]

See also: hazard ratio

A 2015 review of literature found that there was no clear evidence for a link between the use of artificial sweeteners and an increased risk of cancer.[40]

A 2017 review of literature found that although there are reports of a couple of studies signifying increased risks of cancer through the use of sugar substitutes (ie. colorectal cancer), a vast majority of studies yielded similar results to that of 2015. An extensive array of studies (ie. case-control, primary, and observational studies), studying varying cancer types such as lymphomas, hematological malignancies, urinary tract, bladder, pancreatic, biliary tract, and breast cancer displayed no significant association between this disease and artificial sweeteners.

**Add small section to intro

A sugar substitute is a food additive that provides a sweet taste like that of sugar while containing either no or significantly less food energy. Due to their lacking health benefits, sugar substitutes are also known as Non-Nutritive Sweeteners (NNS's). Some sugar substitutes are produced by nature, and others produced synthetically. Those that are not produced by nature are, in general, called artificial sweeteners. In 2017, sucralose was the most common sugar substitute used in manufacturing of foods and beverages, having 30% of the global market projected to become $2.8 billion in collective value by 2021.[1]

The three sugar substitutes commonly used in the United States are saccharin (e.g., Sweet'N Low), aspartame (e.g., Equal, NutraSweet) and sucralose (e.g., Splenda, Altern). In other countries, xylitol, cyclamate, ace-K, Neotame, and stevia are used.

When sweeteners are provided for restaurant customers to add to beverages such as tea and coffee, they are often available in paper packets that can be torn and emptied. In North America, the colors are typically white for sucrose, blue for aspartame, pink for saccharin, yellow for sucralose (United States) or cyclamate (Canada), tan for turbinado, orange for monk fruit extract, and green for stevia.

Use[edit]

Sugar substitutes are used instead of sugar for a number of reasons, including:

Dental care[edit]

• Dental care – Carbohydrates and sugars usually adhere to the tooth enamel, where bacteria feed upon them and quickly multiply. The bacteria convert the sugar to acids that decay the teeth. Sugar substitutes, unlike sugar, do not erode teeth as they are not fermented by the microflora of the dental plaque. A sweetener that may benefit dental health is xylitol, which tends to prevent bacteria from adhering to the tooth surface, thus preventing plaque formation and eventually decay. A Cochrane review, however, found only low-quality evidence that xylitol in a variety of dental products actually has any benefit in preventing tooth decays in adults and children.

Glucose metabolism[edit]

• Diabetes mellitus – People with diabetes have difficulty regulating their blood sugar levels, and need to limit their sugar intake. Many artificial sweeteners allow sweet tasting food without increasing blood glucose. Others do release energy but are metabolized more slowly, preventing spikes in blood glucose. A concern, however, is that overconsumption of foods and beverages made more appealing with sugar substitutes may increase risk of developing diabetes. [6] A 2014 systematic review showed that a 330ml/day (an amount little less than the standard U.S can size) consumption of artificially sweetened beverages lead to increased risks of type 2 diabetes. A 2015 meta-analysis of numerous clinical studies showed that habitual consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice increased the risk of developing diabetes, although with inconsistent results and generally low quality of evidence. [6] A 2016 review also showed positive correlations between artificially sweetened beverages and diabetes, although again, reported as biased.

• Reactive hypoglycemia – Individuals with reactive hypoglycemia will produce an excess of insulin after quickly absorbing glucose into the bloodstream. This causes their blood glucose levels to fall below the amount needed for proper body and brain function. As a result, like diabetics, they must avoid intake of high-glycemic foods like white bread, and often use artificial sweeteners for sweetness without blood glucose.

Cost[edit]

• Cost and shelf life – Many sugar substitutes are cheaper than sugar in the final food formulation. Sugar substitutes are often lower in total cost because of their long shelf-life and high sweetening intensity. This allows sugar substitutes to be used in products that will not perish after a short period of time.

Health effects[edit]

section from: Sugar substitute

Weight gain[edit]

Numerous reviews have concluded that outcomes from weight gain and on Non Nutritive Sweetener (NNS) usage, remain inconsistent and therefore, inconclusive.

However, a few conclusions based on reviews of NNS's and weight gain studies are listed below:

Conclusions based on reviews of NNS & weight gain studies

Conclusion	Concluded by
Due to the nutrient lacking factor of NNS’s, the ingestion of Sucralose (the NNS used) did not release the same feeling of satiety to the hypothalamus, as opposed to that after the ingestion of glucose (the natural sweetener used).	Qing Yang of Yale University (through the Yale Journal of Biology & Medicine)
1) Because there becomes no “actual” glucose to feed the cells, the addition of NNS’s made insulin useless and potentially even an advocator for fat. The release of insulin, triggered by the "sweet taste". essentially becomes unnecessary. 2) Gut response changes to alter glucose metabolism and even make people glucose intolerant-which could in turn lead to obesity. To replicate the same sweet taste, only small amounts of NNS’s are needed. 3) Satisfaction from “real” sweet foods, such as fruits, start to diminish as the body’s ability to recognize sweet taste becomes blunt.	Kristin Kirkpatrick, MS, RD,  LD, Manager of Wellness Nutrition Services at Cleveland Clinic’s Wellness Institute
The body becomes unable to puzzle together the amount of calories in the food with the sweetness of the food it has ingested and therefore, tends to overeat. The texture, viscosity, and other characteristics of taste that people get from food are impaired. Through NNS’s, people un-condition their taste mechanism of engaging ideas such as ‘more viscous foods have more calories than less viscous foods’ (ie: whole milk vs. skimmed milk).	Professors Terry Davidson and associate professor Susan Swithers of Purdue University’s Psychology department

Reviews have yielded the above conclusions biased, yet still up for question. A 2010 review of epidemiological studies concluded there is a possible association between consumption of artificially sweetened beverages and weight gain in children, but the quality of the studies was weak and no clear cause and effect relationship could be determined. A 2014 review reported findings of weight loss with the consumption of artificial sweeteners, while a 2014 meta-analysis found a correlation between increased BMI and NNS consumption. A 2016 review reported findings with no significant links between body weight and Non-Nutritive Sweeteners (NNS's) consumption, while a 2017 review did not find evidence supporting the use of NNS's for weight loss, with a possible association of routine consumption with weight gain and risk of heart disease. The biased analyses, limited scopes of studies (including duration and population types), inconsistent and controversial results, leave the unanswered question of whether there is a correlation between weight gain and sugar substitute consumption, unanswered and still up for further research.

***After trying to post on main Wikepedia page and getting my section deleted due to the fact that I have used primary sources (the studies), I have revised the section that I have added below and deleted the studies (that were considered primary sources).

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Health effects[edit]

section from: Sugar substitute

Weight gain[edit]

A 2017 review did not find evidence supporting the use of non-nutritive sweeteners for weight loss, with a possible association of routine consumption with weight gain and risk of heart disease. A 2010 review of epidemiological studies concluded there is a possible association between consumption of artificially sweetened beverages and weight gain in children, but the quality of the studies was weak and no clear cause and effect relationship could be determined.

Although, no direct relationship has been established between NNS's and weight gain, the possible correlation between the two has prompted numerous researchers to hypothesize potential implications for this being.

NNS & Weight Gain

Study/ Research/ Experiment	Hypothesis	Hypothesizer
In a double blind study involving 55 overweight children, the children showed weight loss when fed a NNS-rich, but calorie restricted diet. Interestingly enough, when the experimented subjects became aware of the diet that they were being fed, they compensated, and in most cases “over-compensated” for the amount of calories, they believed that they had not consumed.	Due to the nutrient lacking factor of NNS’s, the ingestion of Sucralose (the NNS used) did not release the same feeling of satiety to the hypothalamus, as opposed to that after the ingestion of glucose (the natural sweetener used).	Qing Yang of Yale University (through the Yale Journal of Biology & Medicine)
One study documented by the Canadian Medical Association Journal  (July 17, 2017) was conducted over a span of 10 years with 405,907 participants. Although during a short period of 6 months, no noticeable trends of obesity through the use of NNS’s were signified, following the 10 year period, an increase in BMI, weight, waist circumference, and other factors leading to obesity were noted.	1) Because there becomes no “actual” glucose to feed the cells, the addition of NNS’s made insulin useless and potentially even an advocator for fat. The release of insulin, triggered by the "sweet taste". essentially becomes unnecessary. 2) Gut response changes to alter glucose metabolism and even make people glucose intolerant-which could in turn lead to obesity. To replicate the same sweet taste, only small amounts of NNS’s are needed. 3) Satisfaction from “real” sweet foods, such as fruits, start to diminish as the body’s ability to recognize sweet taste becomes blunt.	Kristin Kirkpatrick, MS, RD,  LD, Manager of Wellness Nutrition Services at Cleveland Clinic’s Wellness Institute
Over a course of 10 days, the two professors conducted a research on two groups of rats. While one group of rats were given two sweet-flavored liquids sweetened with natural, high caloric sweeteners, the other group of rats were given one sample sweetened with natural, high caloric sweeteners, along with another sample sweetened with NNS’s. The results showed that when given a high-caloric piece of chocolate, the rats exposed to the NNS’s ate significantly more of the chocolate.	The body becomes unable to puzzle together the amount of calories in the food with the sweetness of the food it has ingested and therefore, tends to overeat. The texture, viscosity, and other characteristics of taste that people get from food are impaired. Through NNS’s, people un-condition their taste mechanism of engaging ideas such as ‘more viscous foods have more calories than less viscous foods’ (ie: whole milk vs. skimmed milk).	Professors Terry Davidson and associate professor Susan Swithers of Purdue University’s Psychology department

Additional Studies

-A research was conducted with 1454 participants from the Baltimore Longitudinal Study of Aging (BLSA)- approximately half being NNS users and half being non-NNS users. Through a 28 year longitudinal study (1984-2012) larger waist circumferences, increased visceral fat, and higher average BMIs were measured. A 6-9 year follow up period maintained by over 8000 person-visits, also noted that although an increase in NNS usage throughout the years led to an increase in waist circumference, an increase in BMI was not. Furthermore, the results indicated a greater incidence with abdominal obesity.

- A research was devised and conducted a study with 12 healthy individuals to assess changes in plasma insulin, plasma ghrelin, blood glucose, and appetite levels after the injection of glucose (natural sweetener), fructose (natural sweetener), sucralose (NNS), aspartame (NNS), or acesulfame K (NNS). Results showed that although the injection of both glucose and fructose increased both plasma insulin and blood glucose levels, and lowered plasma ghrelin levels, the injection of all NNS’s, seemed to have no effect on these levels. Additionally, the appetite satiety that the participants felt after the injection of NNS’s was lower compared to the satiety they felt after the injection of the natural sweeteners, glucose and fructose.

- Elinav of the Weizman Institue of Science in Rehovot, Israel conducted a research with seven healthy individuals that have been on a rather NNS- free diet. Four individuals became glucose intolerant with a weakened gut micro-biome prone to metabolic diseases, the other three were unaffected.

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Article: Sugar substitute

This article could use a lot more information in the "weight gain" portion. There is only one sentence in regards to how sugar substitutes can weaken the brain's ability to process artificially sweetened sweet foods as having calories.

-add in additional hypotheses suggested on weight gain

Although, no direct relationship has been established between NNS's and weight gain, the correlation between the two has remained strong and numerous implications have been suggested from this.

-create something like a chart to organize research findings and studies conducted pertaining to the different hypotheses hypothesized

-Study/Research/Experiment (left column of chart); Results (middle column 1) Implication Approach (middle column 2); Implication (right column)

-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Critique on Wikipedia Article: "Fan Death"

This article did a very good job in staying unbiased. The author's opinions regarding the topic were unincorporated and instead, a neutral viewpoint was used to discuss the topic of matter- the author simply stated the facts. Additionally, for every side of a statement that the author mentions, the author makes sure to mention the other side of that idea as well (by using transition words such as "however"). Some noteworthy qualities of this Wikipedia article were the citations, links of certain key words (to other Wikipedia articles), and the referral to different a concept of "Fan Death"- the electro band- which gives readers interested in that topic a better place to search for their information needed. Overall, it is evident that the author of this article did a lot of research on the topic of "Fan Death", as there are numerous (around 14) credible sources ranging from newspaper articles all the way to scientific guidebooks. The author also covers a wide range of topics pertaining to the subject of matter ('origins, proposed causes, and media coverage'). Some of the issues with this Wikipedia article as stated in the Wiki-talk page revolved around the fact that the author had some mis-allocated, missing, and "un"- credible citations/sources. While there was one comment, commenting on the fact that this article did not keep a neutral viewpoint due to the fact that "Fan Death" is not 100% true, I would have to disagree with this opinion- as the author had mentioned that this concept is merely a superstition. So overall, this Wikipedia article did a well rounded job of giving a good introduction to the given topic of "Fan death".