5 ms·

I agree completely. In my experience I'd say roughly 50% of patients we see in primary care have essentially no clue when it comes to nutrition, then maybe 40%

I agree completely. In my experience I'd say roughly 50% of patients we see in primary care have essentially no clue when it comes to nutrition, then maybe 40% or so have a decent understanding of the macros and percentages on US food labels, and the remaining 10% are actually well-versed on the subject. This study should be an eye opener for that 40% who largely believe "all carbs are created equal". But on the flip side, you have people that believe only "processed" carbs/sugars are bad. You wouldn't believe how many diabetics think they're doing themselves a huge favor by switching from Coke to apple juice, or from pasta to mashed potatoes. I'm tempted to start a tangential rant here but I'll just say that I generally try to avoid fructose. Yes, fruits contain fructose in addition to other nutrients, but my personal opinion is that high-sugar foods (including certain fruits like cherries, grapes, and bananas as well as cookies and chocolate bars) should be considered a treat and used sparingly.

wdewind 11y ago
> This study should be an eye opener for that 40% who largely believe "all carbs are created equal". All carbs pretty much are equal, it tends to be the amount of fiber that comes with the carb that changes things. This study was about fructose, not sugar in general, and we've known for a long time that fructose behaves differently from other carbs due to the way it is metabolized in the liver.
- alextgordon 11y ago
  OK but when people talk about "carbs" they aren't talking about chemicals, they're talking about foods. Nobody is ever going to know what the chemical composition of a potato is, it's just a potato. Fibre, water, protein content is "carbs" when it's in a potato.
  - TeMPOraL 11y ago
    Fixing notation would definitely help talking about nutrition. Scientific terms should be used precisely, or not used at all. Dear diet industry: invent your own words, or capture the generic ones. Start with 'magic'.
  - wdewind 11y ago
    I'm not really sure what you are saying, sorry.
    - rnovak 11y ago
      a carbohydrate refers to a molecule made up of a chain of carbon atoms bonded with hydrogen atoms (if I remember correctly from Organic Chemistry). There are plenty of different molecules, such as Sucrose, Glucose, etc, which are all forms of carbohydrate molecules. But when people refer to "carbs", they're not referring to the chemical molecule, but most likely processed carbohydrates such as bread. Hopefully that's more clear
      - Dylan16807 11y ago
        But a potato isn't processed, and people call it carbs.
        rnovak 11y ago
        I imagine the "carbs" label extends to both processed/unprocessed/simple/complex carbohydrates, which I think potato belongs to "simple" and "unprocessed" (according to this[1] website). [1] http://www.ehow.com/about_4613535_chemical-makeup-potato.html http://www.ehow.com/about_4613535_chemical-makeup-potato.htm...
        Dylan16807 11y ago
        Now I'm lost. Isn't that all categories of carbohydrate, meaning they're correct?
        wdewind 11y ago
        No, potatoes have some simple carbs but they are predominantly starches, which are complex carbs.
        rnovak 11y ago
        awesome, thanks for the correction, I appreciate it.
- agentPrefect 11y ago
  Just a quick note; but "sugar in general" contains fructose. Given that you're talking about simple sugars.
  - wdewind 11y ago
    Right...specifically fructose, not sugar in general...
    - sov 11y ago
      "Sugar" is composed of fructose and glucose. Do you mean carbohydrates in general?
      - wdewind 11y ago
        I guess we are getting pretty semantic. I meant simple sugars, of which glucose and fructose are two, not sucrose, which is "table sugar," and is partially fructose and glucose. You're right though, it probably would've been more helpful for me to say carbohydrates in general.
    - logfromblammo 11y ago
      sucrose = glucose + fructose - water lactose = glucose + galactose - water maltose = glucose + glucose - water Starch and glycogen are basically all glucose. Based on this study, I would guess that replacing all HFCS with an equivalent-sweetness amount of regular corn syrup (all glucose) would immediately result in significant improvements to the public health, even though the sweetened products would have more calories per serving.
- luketych 11y ago
  not just fiber, also how complex of a polymer it is.
  - wdewind 11y ago
    Yes but I'm arguing that doesn't make a huge difference. Certainly there is a small one, but all things being equal the accompanying fiber is a lot more important.
- yourapostasy 11y ago
  > All carbs pretty much are equal, it tends to be the amount of fiber that comes with the carb that changes things. Anecdotally-empirically, a lot of Type 2's have found carbs, fiber or no fiber, are just bad news. For at least those with a specific variation of Type 2 (still as-yet not clearly understood, but there is growing consensus that there are many different "sub-types" of Type 1 and Type 2, each of which responding well to different treatment protocols), it doesn't matter how much fiber you eat with a scoop of carbs once the metabolic syndrome manifests itself with a high enough insulin resistance response. With enough carbs (as few as 50g for some) the end result at that stage of the condition is still a highly-adverse event, a high blood sugar spike above 100 mg/dL. Even if the spike is controlled down within 1-2 hours, there is a lot of accumulating evidence that it isn't the duration or absolute value of high blood sugars, but the spikes (the occurrence of any delta in the first place) themselves that cause cellular damage. In a few years, we will hopefully start accumulating a flood of highly-granular, anonymized biometric sampling data, ideally tagged with true/false flags of known and suspected genetic markers (but not enough DNA data to individually dox someone). Has someone solved the problem of publishing biometrics with tagged DNA data, and be able to update the DNA tags as our understanding of genetic markers improves over time, without risking doxxing an individual from the genetic marker tags?
  - wdewind 11y ago
    > Anecdotally-empirically, a lot of Type 2's have found carbs, fiber or no fiber, are just bad news. Sure, I wasn't talking about diabetic people. > In a few years, we will hopefully start accumulating a flood of highly-granular, anonymized biometric sampling data, ideally tagged with true/false flags of known and suspected genetic markers (but not enough DNA data to individually dox someone). Has someone solved the problem of publishing biometrics with tagged DNA data, and be able to update the DNA tags as our understanding of genetic markers improves over time, without risking doxxing an individual from the genetic marker tags? I also hope that this is the future. Unfortunately we're probably not going to do much better than HIPAA when this technology is widely available and being used. I'm not sure how to prevent the GATTACA side effects, but it feels like the health advances might be worth it.
  - vonmoltke 11y ago

wdewind 11y ago

> This study should be an eye opener for that 40% who largely believe "all carbs are created equal". All carbs pretty much are equal, it tends to be the amount of fiber that comes with the carb that changes things. This study was about fructose, not sugar in general, and we've known for a long time that fructose behaves differently from other carbs due to the way it is metabolized in the liver.

alextgordon 11y ago
OK but when people talk about "carbs" they aren't talking about chemicals, they're talking about foods. Nobody is ever going to know what the chemical composition of a potato is, it's just a potato. Fibre, water, protein content is "carbs" when it's in a potato.
- TeMPOraL 11y ago
  Fixing notation would definitely help talking about nutrition. Scientific terms should be used precisely, or not used at all. Dear diet industry: invent your own words, or capture the generic ones. Start with 'magic'.
- wdewind 11y ago
  I'm not really sure what you are saying, sorry.
  - rnovak 11y ago
    a carbohydrate refers to a molecule made up of a chain of carbon atoms bonded with hydrogen atoms (if I remember correctly from Organic Chemistry). There are plenty of different molecules, such as Sucrose, Glucose, etc, which are all forms of carbohydrate molecules. But when people refer to "carbs", they're not referring to the chemical molecule, but most likely processed carbohydrates such as bread. Hopefully that's more clear
    - Dylan16807 11y ago
      But a potato isn't processed, and people call it carbs.
      - rnovak 11y ago
        I imagine the "carbs" label extends to both processed/unprocessed/simple/complex carbohydrates, which I think potato belongs to "simple" and "unprocessed" (according to this[1] website). [1] http://www.ehow.com/about_4613535_chemical-makeup-potato.html http://www.ehow.com/about_4613535_chemical-makeup-potato.htm...
        Dylan16807 11y ago
        Now I'm lost. Isn't that all categories of carbohydrate, meaning they're correct?
        wdewind 11y ago
        No, potatoes have some simple carbs but they are predominantly starches, which are complex carbs.
        rnovak 11y ago
        awesome, thanks for the correction, I appreciate it.
agentPrefect 11y ago
Just a quick note; but "sugar in general" contains fructose. Given that you're talking about simple sugars.
- wdewind 11y ago
  Right...specifically fructose, not sugar in general...
  - sov 11y ago
    "Sugar" is composed of fructose and glucose. Do you mean carbohydrates in general?
    - wdewind 11y ago
      I guess we are getting pretty semantic. I meant simple sugars, of which glucose and fructose are two, not sucrose, which is "table sugar," and is partially fructose and glucose. You're right though, it probably would've been more helpful for me to say carbohydrates in general.
  - logfromblammo 11y ago
    sucrose = glucose + fructose - water lactose = glucose + galactose - water maltose = glucose + glucose - water Starch and glycogen are basically all glucose. Based on this study, I would guess that replacing all HFCS with an equivalent-sweetness amount of regular corn syrup (all glucose) would immediately result in significant improvements to the public health, even though the sweetened products would have more calories per serving.
luketych 11y ago
not just fiber, also how complex of a polymer it is.
- wdewind 11y ago
  Yes but I'm arguing that doesn't make a huge difference. Certainly there is a small one, but all things being equal the accompanying fiber is a lot more important.
yourapostasy 11y ago
> All carbs pretty much are equal, it tends to be the amount of fiber that comes with the carb that changes things. Anecdotally-empirically, a lot of Type 2's have found carbs, fiber or no fiber, are just bad news. For at least those with a specific variation of Type 2 (still as-yet not clearly understood, but there is growing consensus that there are many different "sub-types" of Type 1 and Type 2, each of which responding well to different treatment protocols), it doesn't matter how much fiber you eat with a scoop of carbs once the metabolic syndrome manifests itself with a high enough insulin resistance response. With enough carbs (as few as 50g for some) the end result at that stage of the condition is still a highly-adverse event, a high blood sugar spike above 100 mg/dL. Even if the spike is controlled down within 1-2 hours, there is a lot of accumulating evidence that it isn't the duration or absolute value of high blood sugars, but the spikes (the occurrence of any delta in the first place) themselves that cause cellular damage. In a few years, we will hopefully start accumulating a flood of highly-granular, anonymized biometric sampling data, ideally tagged with true/false flags of known and suspected genetic markers (but not enough DNA data to individually dox someone). Has someone solved the problem of publishing biometrics with tagged DNA data, and be able to update the DNA tags as our understanding of genetic markers improves over time, without risking doxxing an individual from the genetic marker tags?
- wdewind 11y ago
  > Anecdotally-empirically, a lot of Type 2's have found carbs, fiber or no fiber, are just bad news. Sure, I wasn't talking about diabetic people. > In a few years, we will hopefully start accumulating a flood of highly-granular, anonymized biometric sampling data, ideally tagged with true/false flags of known and suspected genetic markers (but not enough DNA data to individually dox someone). Has someone solved the problem of publishing biometrics with tagged DNA data, and be able to update the DNA tags as our understanding of genetic markers improves over time, without risking doxxing an individual from the genetic marker tags? I also hope that this is the future. Unfortunately we're probably not going to do much better than HIPAA when this technology is widely available and being used. I'm not sure how to prevent the GATTACA side effects, but it feels like the health advances might be worth it.
- vonmoltke 11y ago