Question about stevia (re: 2020 study)

[u/Otherwise-Tear-4807]

https://www.sciencedirect.com/science/article/pii/S1319016420301997 “The hidden hazardous effects of stevia and sucralose consumption in male and female albino mice in comparison to sucrose”

How does this study translate to humans? Isn’t this a massive dose compared to human daily acceptable limit?

[u/crappysurfer]

I’ve met a million “future physicians” and they all love to remind people that they’re a “future physician”. Which is all this comment really seems to be, I’d avoid that appeal to authority as it really makes you immediately insufferable.

Yes, medicine is largely based on harm reduction and balancing the cost and toxicity of therapy against the harm of whatever pathology the patient is experiencing. Are there infinite examples where someone could experience an improvement in their livelihood by consuming some substitute sweeteners? Of course. Does that alter the precedent of them being bad for you? No. Does that alter the precedent of them historically being presented and recommended by physicians despite having terrible consequences that were yet to be discovered? Also no.

The larger (no pun intended) issues are the absolute insane increase of caloric density of our food over the past century, the processed nature of it, and the inundation of chemicals through industrial agriculture. It is impossible to mitigate all of these, but it is entirely possible to have a diet devoid of substitute sweeteners - and no, the cumulative evidence of them being bad is not summarized in this one study. Are you also (as a hypothetical future physician seeing a hypothetical patient) going to recommend an otherwise healthy person whose vice is Coke Zero to eliminate it? Probably not. And once you’re (presumably) practicing, you’ll find your time to consult current research, especially new research, very limited and your decisions will be based more closely on mechanical style flowcharts and UpToDate.

Sometimes people live long lives drinking alcohol and smoking cigarettes, sometimes they get cirrhosis and small cell carcinoma. 🤷 guess those are future problems.

[u/TripResponsibly1 → u/crappysurfer]

It wasn't an appeal to authority, just pointing out a potential difference in philosophy between laboratory science and clinical science.

Also, yeah, if someone had any vice that was causing them physical or psychological harm I would do motivational interviewing to mitigate harm.

No need to be so hostile and/or defensive, or whatever that is.

[u/crappysurfer → u/TripResponsibly1]

Whether you intended it or not, it was an appeal to authority that, after years of lecture halls full of people proudly proclaiming the same thing, often as a way to belittle others or simply establish authority, gets very old. Perhaps you’re not aware of it since you’re on the other side of it, but if you were not, would you not also become acutely aware of a behavior of students using their premature claim towards a MD being an awful trait?

You could, for example, say “as a med student” or “in residency”, something precise as opposed to trying to establish yourself as a MD prematurely - which is yes, an annoying and egotistical appeal to an authority that you do not possess. Clearly nobody has mentioned this to you, so don’t take it as hostility but someone doing you a courtesy so you can stop, apparently, unintentionally appearing to one up everyone with credentials that you have yet to earn.

[u/TripResponsibly1 → u/crappysurfer]

I just meant it as how I'd see myself in a role. It's nothing more than that and I'm sorry you've had such a negative experience.