AMA #74: Sugar and sugar substitutes: weight control, metabolic effects, and health trade-offs

**Peter Attia** (0:10)
Hey, everyone, welcome to a sneak peek, Ask Me Anything, or AMA episode of the Drive podcast. I'm your host, Peter Attia. At the end of this short episode, I'll explain how you can access the AMA episodes in full, along with a ton of other membership benefits we've created. Or you can learn more now by going to peterattiamd.com/subscribe. So without further delay, here's today's sneak peek of the Ask Me Anything episode.
Welcome to Ask Me Anything AMA episode 74 In today's AMA, we're taking a closer look at one of the most common and misunderstood questions we receive. How to evaluate sugar and its substitutes in the context of health. To help answer these questions, we'll walk through a three part framework that reflects the most popular scenarios where sugar substitutes come into play. One, beverages, things like regular soda versus diet soda. Two, protein supplements, powders and bars, which often rely on sweeteners to make them even remotely palatable. And three, sweet treats, everything from candy to low calorie desserts, where the goal is simply to satisfy a sweet craving while minimizing the consumption of sugar and calories. We will discuss why humans are hardwired to crave sweetness and how that evolutionary advantage now collides with today's food environment. Whether or not sugar is uniquely fattening, the evidence on isochloric comparisons and sugar's rapid effects on hunger hormones, fructose versus glucose, drinks versus solids, and natural quote unquote versus refined sugars. Why the timing of your sugar intake matters, what the big three sweeteners, saccharin, aspartame, and sucralose do and don't deliver for weight loss, glycemic control, and the microbiome? What makes allulose a standout sweetener, and why it is challenging to use in all products? Sugar alcohols, erythritol, xylitol, and sorbitol. Their calorie savings, common GI pitfalls, and xylitol's unique dental benefits. And the long-term safety of common sweeteners. Do they raise cancer or heart disease risk? If you're a subscriber, and you want to watch the full video of this podcast, you can find it on the show notes page. If you're not a subscriber, you can watch the sneak peek of the video on our YouTube page. So without further delay, I hope you enjoy AMA number 74

**SPEAKER_1** (2:51)
Peter, welcome to another AMA, how are you doing?

**Peter Attia** (2:54)
Good, thank you for having me.

**SPEAKER_1** (2:56)
Yes, thank you for showing up. Anything interesting going on today? Anything recent going on?

**Peter Attia** (3:03)
Well, I was playing what I thought was the game of my life this morning in chess, and then I made a very tactical blunder and found myself on the receiving end of checkmate inside of two moves at the hands of my seven year old, which is becoming a constant theme these days. He's probably beating me six out of ten games, which is simultaneously enjoyable to watch and infuriating to experience.

**SPEAKER_1** (3:32)
I was going to say, for people who have listened a while, read the book, the assumption would be, you might not take losing to a seven year old in a mental game overtly positive. So what's the reaction like when you have a seven year old, not only he have his friends lecturing you on diet, so does which fits to this conversation today, and then they're beating you in chess. Yeah.

**Peter Attia** (3:58)
I hope that kid is listening. So I am actually not a competitive person. I think people are always surprised to hear that because they assume I am. I'm really not. I'm internally competitive. I'm not at all externally competitive. But chess is different. Chess is the only thing I do because you have to play against another person, where I get insanely upset when I lose. And so I'm trying to teach the boys sportsmanship. So every time I lose, I put my hand across the table and I say, good game, and we shake hands. And I have mostly done a good job of that. But a week ago when Harry beat me, I took my king. Well, he was going to beat me, so I was resigning. So I wanted to just tip my king over, which is to say I resign. Or maybe he had checkmated me and I put my king down. But anyway, I was so pissed, I smacked my king across the room. And my wife happened to be sitting there and see this. And she is like, amazing modeling there, Peter. Like what a great job of a 52-year-old modeling for his two boys how to be a sore loser. Good for you. Good for you.
Just, just. So now you have, you're pissed that you lost, the shame of the realization that your wife is right, plus you're pissed at her for calling you out. I mean, it was not a fun couple of hours after that.