15 ms·

Sugar alters hormones and metabolism, sets stage for obesity and diabetes

299 points by inertial 9y ago

troydavis 9y ago
The CDC says 34% of US adults have pre-diabetes, and of those, 88% are undiagnosed[1]. Yes, about 29% of US adults have un-diagnosed pre-diabetes, or about 74 million people. I think a significant cause is that testing blood glucose is thought of as something that only diabetics do, and as a result, most people have no idea how their bodies respond to meals they'd consider normal. The feedback loop is completely open. A typical Chipotle burrito has ~115 grams of carbs, often consumed in 20 minutes[2]. For some people, that's fine, and for others it's not, but the only way to know (other than waiting for problems) is to actually measure one's own blood glucose an hour later. Until blood glucose testing is either (a) thought of more as data collection without fear or stigma, like a bathroom scale, or (b) made blood-less and automatic, like is rumored about the Apple Watch[3], many people won't learn the answer to that question until a symptom of pre-diabetes appears. If you're reading this and haven't had your fasting blood glucose tested as part of a regular checkup, get that done. It's not nearly as informative as post-meal testing, but it's much better than nothing. Also, if you're a diabetic who created a side project/hack because you wanted it, and at scale, that project could mitigate the public health impact of diabetes, feel free to contact me. I'd consider helping make it mainstream[4]. My interest is improving societal health (this will be a massive problem in 20 years if nothing happens now), not personal or financial. [1]: CDC National Diabetes Statistics report, 2017: http://cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf http://cdc.gov/diabetes/pdfs/data/statistics/national-diabet... (page 7) [2]: Chipotle nutrition calculator: https://www.chipotle.com/nutrition-calculator https://www.chipotle.com/nutrition-calculator [3]: "Apple CEO Tim Cook test-drove a device that tracks his blood sugar": https://www.cnbc.com/2017/05/18/apple-ceo-tim-cook-test-drove-glucose-monitor.html https://www.cnbc.com/2017/05/18/apple-ceo-tim-cook-test-drov... [4]: https://twitter.com/troyd/status/920747116703518720 https://twitter.com/troyd/status/920747116703518720, https://twitter.com/troyd/status/921409373661884416 https://twitter.com/troyd/status/921409373661884416
- goodells 9y ago
  This sounds very interesting as another metric (like weight on a scale, as you put it) for someone trying to be conscious about their health. Is this something that a person could do cheaply at home with over-the-counter diabetic testing supplies? Could you be more specific or link to something about a protocol for e.g. measuring the effect of a meal on blood glucose and how to interpret those results?
  - troydavis 9y ago
    Disclaimer: This is not medical advice and I'm not very knowledgeable, I'm just a data and public health geek. If you believe you may have diabetes or pre-diabetes, contact a doctor. Yes, it's doable with over-the-counter products. You need a meter and lancet device, and then for each test, a single-use lancet insert (tiny needle) and test strip. These are usually bundled together in a pharmacy for $25-$75. However, if you look or ask the pharmacist, there's often a 100% money back refund right in the store. Additional test strips are $0.75-$1.75/strip in packs of 25, 50, or 100. While that sounds expensive (and for diabetics, is), for the purposes we're talking about, one could probably only test after high-carb meals and a few days of fasting readings. The included 25-50 test strips may yield enough data to act on, and if not, one more 25-50 pack probably would. https://www.diabetesselfmanagement.com/blog/what-is-a-normal-blood-sugar-level/ https://www.diabetesselfmanagement.com/blog/what-is-a-normal... has more about when to test (basically, 1 and 2 hours after the start of a meal) and what results to expect. Feel free to ask the pharmacist to show you how to use it and interpret the results. Important note: this feels nothing like a blood draw. It's barely noticeable at all and not anything I'd call painful. There's a depth adjustment on the lancet, so it's the tiniest imaginable prick on the side of a finger. It yields less than a drop of blood, then immediately closes, ie, no bandage or bleeding. I did this myself as an extension of quantified self in 2012 (https://twitter.com/troyd/status/281931325471068161 https://twitter.com/troyd/status/281931325471068161), just because I wanted to see the readings and the process. I did it again this year to see whether the testing process had improved (no) or my results had changed (no). Other than some puzzled pharmacists who aren't used to people buying a meter for cash, there's really nothing to it. It'll also give a tiny peek at a process that millions of people do all the time. It's fascinating to see how one's body responds, particularly to meals that aren't obviously unhealthy (and depending on the person, may not be). Some examples: sandwiches (especially on big hoagie/grinder-style refined bread), burritos (tortilla+rice+beans), any meals with 2 significant sources of carbs (sandwich with fries or potato, breakfast with toast and hash browns, etc), and pasta. These aren't inherently unhealthy, but they all significantly raise blood glucose, and the only way to see how much is to test. More on "glycemic load": https://www.google.com/search?q=glycemic+load https://www.google.com/search?q=glycemic+load
vixen99 9y ago
Short take: this is adapted from ‘The Case Against Sugar’ by Gary Taubes, a science writer who's been a long-standing campaigner against dietary carbohydratesa and sugar'.
- lokerfoi 9y ago
  Is he bashing vegetables and fruits? The average US citizen does not eat the recommended minimum amount for fiber. Is he bashing the 3500kcal diet of average US citizen or is he purposefully demonizing a single macronutrient group?
  - matt_wulfeck 9y ago
    Don’t you see the trend? “Recommended amounts” may be a large part of the issue. Doesn’t the US recommend 325 grams of sugar (carbohydrates) a day?
    - lokerfoi 9y ago
      Fiber has 0 calories, which implies people in the US in general barely eat fruit and vegetables. No one overdosed on fiber. It's quite silly to claim that 2000kcal of legume carbohydrate (more than 300 grams of carbs) will alter my hormones or metabolism in a negative way, so demonizing a macronutrient is bad science.
      - fmihaila 9y ago
        > Fiber has 0 calories, which implies people in the US in general barely eat fruit and vegetables This is true. The vast majority of Americans do not eat sufficient fruit and vegetables. This 2015 CDC study [1] concluded that only 13.1% of the population consumes enough fruit, and only 8.9% eat enough veggies. > It's quite silly to claim that 2000kcal of legume carbohydrate (more than 300 grams of carbs) will alter my hormones or metabolism in a negative way, so demonizing a macronutrient is bad science. Nobody claims that. You obviously haven't read the article. The excess of carbohydrates in today's diets doesn't come from fruit and vegetables (as [1] clearly shows), but from added sugar and refined grains. The article explains the critical role a chronically high level of insulin in the bloodstream plays in throwing the body's metabolic processes out of balance, leading to both obesity and type-2 diabetes. [1] https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6426a1.htm https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6426a1.htm
kichuku 9y ago
I would like to share an anecdote. In March 2016, I was weighing 96 kilograms (211.64 pounds). I made just one change during that time which is to stop having anything with sugar. I continued to take other natural sweeteners like jaggery and honey. The rest of my diet remained the same and my activity level remained the same ( I work in IT as a network engineer in a desk job) In October 2016, I was weighing 72 kilos (158.73 pounds). I am still maintaining that same weight between 70 to 72 kilos since then. Incase if it is relevant, I am a 29 year old guy with a height of 172 cm (5 feet 7 inches). Along with that, I got several other benefits such as being more energetic, not feeling sleepy all the time, general improvement in mood etc. All this just with stopping of sugar and nothing else changed. I can share even more side benefits which I got, but it will seem more unbelievable because I have observed that the general population is still unaware of the extremely harmful effects of sugar. EDIT: I had typed October 2017 when I had intended to type October 2016. It was just 7 months.
- sebcat 9y ago
  I'm 17x cm and weigh 7x kg. I run (mostly 10K, completed a half-marathon recently) and lift weights semi-regularly. I have a relatively low sugar intake. I don't feel energetic at all. I get home from work and more or less lay down until I fall asleep. Gabriel Iglesias seems to be way more energetic than me. Jaggery seems to be 50% sucrose, and honey is mostly glucose and fructose. Shouldn't it have the same effect on blood sugar levels?
  - ohnoesjmr 9y ago
    Had the same, was diagnosed with sleep apnea.
- ThrowawayR2 9y ago
  > I continued to take other natural sweeteners like jaggery and honey. ...which are also 80+% sugar.
  - smilliken 9y ago
    Honey has a lower glycemic index/insulin response than sucrose.
jnordwick 9y ago
The recent demonization of sugar substitutes hasn't helped either. The problem with studies that link them to weight gain is that they confuse correlation and caution then make some wild unsubstantiated stab at causation by guessing that maybe they cause insulin issues. I went looking for information on that, and found and excellent article by a diabetic site summarizing the evidence and treating each substitute as its own compound. The bulk is the data is that they have no correlation (there is some in vitro evidence for a couple of lesser used sweeteners but under very contrived circumstances). As long as we deny the existence of usable substitutes, we are making this harder on ourselves. https://www.marksdailyapple.com/artificial-sweeteners-insulin/ https://www.marksdailyapple.com/artificial-sweeteners-insuli...
- QAPereo 9y ago
  With very few edits, you've identified the problem with science journalism: The problem with studies... is that they confuse correlation and caution [sic] then make some wild unsubstantiated stab at causation..."
- mike_o 9y ago
  "The Obesity Code" by Jason Fung goes into all the issues from the article in more detail. He references studies that seem to prove sugar substitutes cause weight gain rather than correlate with weight gain: Sucralose raises insulin by 20 percent, despite the fact that it contains no calories and no sugar. This insulin-raising effect has also been shown for other artificial sweeteners, including the “natural” sweetener stevia. Despite having a minimal effect on blood sugars, both aspartame and stevia raised insulin levels higher even than table sugar. Fung, Jason. The Obesity Code: Unlocking the Secrets of Weight Loss (p. 172).
- amriksohata 9y ago
  Dude you need to read up about sweetners
alexandercrohde 9y ago
Tl; dr: Author contrasts two explanations of the obesity and diabetes crises: A) that the root of the issue is caloric intake stemming from low-self-control or B) that the root of the issue is high blood-sugar and its subsequent effects. Author explores the long history of this debate and presents points for both sides. Author admits the thermodynamic validity of caloric math but cites that at a cellular glucose levels cause insulin levels to rise that cause the cell to take on fat. Author cites other research, such as increased appetite among obese animals, suggesting a systemic effect. Author cites ketogenic diets as evidence (which restrict sugars but not total calories). Author contrasts the moral interpretation of each theory. Proposes the caloric consumption model places blame on the individual, whereas the glucose explanation places blame on the FDA.
- rwnspace 9y ago
  And yet, behavioural biology tells us that the development of the pre-frontal cortex is heavily influenced by genetics, epigenetics, and early-years experiences. The PFC appears to influence things like rates of risk-taking behaviour, addiction, and ability to choose long-term rewards... Of course, we wouldn't want to pass the buck of choice back to societal influences. Not that I know anything, I've just watched and read Robert Sapolsky's material.
Siilwyn 9y ago
So I wonder... is the effect of sugar on your body permanent, building up over time? Or would stopping the intake of refined sugars restore your system?
- halotrope 9y ago
  The worst effects of excessive Insulin, non alcoholic fatty liver and insulin resistance (which becomes type 2 diabetes after some time) can be reversed pretty easily by cutting sugar, fasting or a diet with extremely low levels of carbohydrates (Ketogenic Diet). Check Dr. Jason Fung and Robert Lustig on youtube. They both have done a great deal of research about the topic and have published very interesting material. I have adopted a very high fat, low carb diet (LCHF) and avoid all sugar for a couple months now and it is absolutely incredible how it changes your body, makes you loose fat and increases overall energy. Gone are these cycles of high and crashing after meals etc. I am absolutely convinced, that we will have a wake up to the toxicity of sugar very similar to that of cigarettes. Especially cancer and sugar seem to have a very strong and under researched relationship.
  - BareNakedCoder 9y ago
    ++++Dr Jason Fung
  - Siilwyn 9y ago
    Thank you for your reply, definitely interested in this. Going on further investigation!
- iamt2 9y ago
  There is be a cliff, over which the damage is permanent. If you change habits soon enough, then we know many avoid it the permanent damage altogether. This is due to the beta cells in the pancreas; destroy to many, and go below a critical threshhold, then they don't seem to be repaired/regenerated enough forever more.
  - Siilwyn 9y ago
mncharity 9y ago
How Big Business Got Brazil Hooked on Junk Food[1]. "As their growth slows in the wealthiest countries, multinational food companies like Nestlé, PepsiCo and General Mills have been aggressively expanding their presence in developing nations, unleashing a marketing juggernaut that is upending traditional diets from Brazil to Ghana to India." "a growing number of people are both overweight and undernourished." "The diet is killing us." Nestlé: "We didn’t expect what the impact would be". [1] https://www.nytimes.com/interactive/2017/09/16/health/brazil-obesity-nestle.html https://www.nytimes.com/interactive/2017/09/16/health/brazil... , about: https://www.nytimes.com/2017/09/17/insider/as-global-obesity-rises-teasing-apart-its-causes-grows-harder.html https://www.nytimes.com/2017/09/17/insider/as-global-obesity...
- grecy 9y ago
  I have been through countless dirt-street towns from Guatemala to Mali where the local store has a few moldy potatoes, coke and Doritos. All the kids are eating the coke and Doritos as a meal, and of course there is nobody telling them not to, or that they should be brushing their teeth or anything like that. It's a massive, massive disaster.
PeterStuer 9y ago
Ever notice how since the 1980 the mantras changed from 'eat less, exercise more' to 'fad' diets whose one common theme was 'don't consume less, but eat different'. Subsequently obesity skyrocketed and the fat-lobby made sure that anyone who even pointed out the problem got demonized. Meanwhile 'food-scientists' silently made designer drugs out of daily consumables leading to a feeding frenzy and an obesity pandemic.
- keymone 9y ago
  > fat-lobby made sure that anyone who even pointed out the problem got demonized do provide sources. the one such episode i recall was demonization of John Yudkin in 60s when he tried to point out how bad sugar was.
- abecedarius 9y ago
  I remember 1980 and it's not clear to me that the popularity of "eat less, exercise more" as advice has increased or decreased; it seems comparable (but less justifiable since it's been so ineffective in the face of obesity taking off while exercise has increased). "Fad diets" were very much seen as such well before then. By contrast, I don't remember "fat acceptance" as a thing at all back then.
arikr 9y ago
Robert Lustig has written an excellent book on this topic: "The Hacking of the American Mind."
- jakeogh 9y ago
  Neat interview: https://overcast.fm/+FaTQX2SRE https://overcast.fm/+FaTQX2SRE
Tistron 9y ago
If you prefer audio the author appears in Sam Harris' podcast in a long interview abd speaks about this subject. #74 — What Should We Eat? Waking Up with Sam Harris Duration: 2:07:24 Published: Sat, 06 May 2017 20:30:08 +0000 URL: http://traffic.libsyn.com/wakingup/Waking_Up_74_Gary_Taubes.mp3?dest-id=480596 http://traffic.libsyn.com/wakingup/Waking_Up_74_Gary_Taubes.... In this episode of the Waking Up podcast, Sam Harris speaks with Gary Taubes about his career as a science journalist, the difficulty of studying nutrition and public health scientifically, the growing epidemics of obesity and diabetes, the role of hormones in weight gain, the controversies surrounding his work, and other topics.
dlwdlw 9y ago
Fad diets like keto offer something very important, a model of nutrition. Currently heuristic based eating like "natural" or "non-processed" work, but the knowledge doesn't compound and is brittle. In eastern cultures especially there is a huge body of heuristics for eating. In Chinese culture there is a concept of hot/cold foods and despite it not being accepted in the west, it still has predictive ability above chance. The end goal I would like to see is healthy off the shelf long lasting processed food that tastes great. It runs contrarian to "eat local and natural, big food is evil" but it solves a huge problem. Of course on the way imperfect models will yield bad results and heuristics are all we have. When doctors refused to wash their hands because they didn't know germ theory despite the massive heuristic evidence, people needlessly died.
- aaron-lebo 9y ago
  I tried keto for a very short time, found it difficult to meet such dietary restrictions. Not gonna be shocked if we find out in 10 years that eating keto is actually horrible for your cholesterol or something, and then it's gonna be too late for the early adopters. As an anecdote, I noticed some people advocating that diet literally eat bacon and steak all the time and justify it. They're probably gonna have major health problems one day because it's not actually a good rule, it's just a rule that sounds good and tastes delicious. Most of our popular models of diet are basically unscientific quackery. Maybe they are bad models? You are right of course in simply having a set of rules to follow seems to help.
  - iamt2 9y ago
    What I see happening is many morbidly obese people who adhere to keto will initially drop weight, roughly until their BMI reaches around the upper normal range. Then CICO kicks in with a vengeance, and they have to be much more careful compared to before. Keto is a useful on-ramp for many to a fitness (or at least more-fit) lifestyle, but not a magic bullet, and I don't see anyone claiming you can skip counting calories while on keto, then still reach 12-15% body fat, and reveal abs. If you see someone writing that, then yes, they're quacks. My personal rough rule of thumb is once you reach the low 20s percentage body fat, you either keep increasing cardio (preferably HIIT), or dropping counted calories, until your moving average weekly weight keeps trending down. Fit keto around that or even drop it, and it won't matter (unless you're the same subtype diabetic like me, and then keto is an essential ingredient to avoiding medication). If you go in once a quarter for a VAP lipid panel (the most extensive lipid panel I could find), then as long as those numbers trend in the right direction, keep on doing whatever works for you. After being diagnosed with Type 2 and having to figure out myself how to beat the fucker into remission, I've concluded that medical science can give rough guidelines for describing metabolic processes, but it is up to each of us to hack our own bodies. Try one change, test the change with measurements, and repeat; commit the changes that work, fork away from the changes that don't, accept failures and setbacks as signals of what not to do, and move on.
carnismisfunny 9y ago
Gary Taubes is a well known meat and dairy industry propagandist who stands to gain everything through the sale of his carbophobic books and lectures. His villification of an oversimplified sugar Boogeyman just detracts from the animal fat and protein which has and continues to wreck the health of hundreds of millions of people.
thearn4 9y ago
I've been trying to cut sugar out of my diet recently. Eventually I'd like to at least feel comfortable treating it like alcohol: only for consumption in social settings and not too often.
Nomentatus 9y ago
The largest hormonal change we experience isn't puberty - it's night, under the aegis of the master hormone melatonin. Almost every hormone changes. I was overweight and had an appetite out of control a couple decades ago. For other health reasons, I adopted a natural night (real dark, can't see you hand in front of your face) and exactly the same lights on and lights off time. My extra weight vanished. My appetite didn't just lower, it changed away from salt fat and sugar (exactly what you want when starving) towards veggies and salads. (Ten hour nights recommended as your sleep will bifurcate.) Recommended. Nature ain't all wrong, it turns out.
- aaron-lebo 9y ago
  This sounds very wooey. Do you have anything to show this isn't the result of you wanting to change, changing habits, and your excitement at attempting change carrying through to produce some kind of placebo effect? I get similarly suspicious when people talk about how going on keto radically changed how they felt. Maybe it is true, but in an sea of anecdotes, it's really hard to figure out what is real. Do you notice how almost all of these turn into "this is how nature actually works"? That similar belief has led people to not get cancer treatments and then die horribly, so there's gotta be more than "this is how nature works". Congrats on your weight loss, regardless.
  - floatingatoll 9y ago
    There's no way to demonstrate that as one individual, full stop. The burden of proof you require to consider whether a valuable benefit could potentially be derived is unacquirable. A more interesting test is to measure the difficulty of trying a certain anecdote yourself. How easily can you 'black out' your bedroom and sit, lay, or sleep in it for a 10 hour window at night for 30 days in a row? If you can do such a test easily, and you are invested in seeing a certain change that you think may result from it, then it does you no material harm to try it. Worst case scenario, you lose sleep for a few days and abort the experiment. Best case scenario, it has a positive impact. The results could be anywhere between those two endpoints. So, that makes this a 'safe' test to apply to your own personal body system, which is not necessarily applicable to any others. Anecdotes that require you to alter what you ingest (food, water, supplements, medicines etc) are much riskier, yet people constantly try these out endlessly under the rubric of "diets" without a second thought for the potential of months of damage to their gut biome, muscle mass, hormone levels, and so on. It's been demonstrated by a vast array of people that it's relatively safe to cut out all the sugar from your diet, but you have to make sure you don't let your blood sugar levels fall too low in the process. Anecdotes that require you to alter your body (e.g. stomach stapling) are even riskier than those, as we have very little experience in this space compared to diets or other non-consumption non-modification approaches. You are absolutely correct to be suspicious, but consider also the level of suspicion appropriate for the context. "Try blackout curtains for a month at night and charge your phone face down" is a far lower bar to be 'worth a shot' than "Remove all carbs from your diet". And if you see others failing to take this into account, remind them of the inherent level of risk in what they're considering. It's not always about being right or wrong, but instead about e.g. "how much harm could come to me if I try keto diet?". EDIT: There's very much a personal overtone to these risk assessments as well. My personal mental stability hinges critically on getting enough sleep, so I am unusually wary of anything that messes with sleep, because I need mental stability far more than I need the benefits such an experiment may or may not produce for me. EDIT: Harness the placebo effect! Believe that what you're trying could help when you try it. If you're doubtful and pessimistic and cynical about something you're trying, be especially careful to focus every day on why you're trying it. Doing so makes it more likely that the placebo effect will enhance your results, and less likely that the nocebo effect will diminish them. This relates directly to a lot of "woo-woo" thinking, but apply my logic above. What's the level of risk of trying a placebo-welcoming approach? You could mislead yourself into thinking something helped when it didn't. Keeping a careful journal about your experiments is an effective treatment for that problem for many folks, and the placebo effect is really powerful. No point in setting aside a useful tool just because it's mind-body.
projektir 9y ago
But why has obesity not been such a problem in the past, despite sugar being available? One point to make from the article, though: "They suggested that the physician-authors were trying to con the obese with the fraudulent argument that they could become lean without doing the hard work of curbing their perverted appetites." If you want to really confuse what's going on, turn to moralism. Desire to judge and to avoid being judged completely messes with incentives and people will line up to the "hard working" side while avoiding the "lazy" side, regardless of what is actually true.
- justinator 9y ago
  > But why has obesity not been such a problem in the past, despite sugar being available? Sugar, usually in the form of HFCS is added to almost any processed food these days, to make it more delicious and to make the food more profitable. HFCS is very, very cheap to produce. You're eating more sugar without perhaps even knowing you are. Low fat foods, introduced in the late 70's have the same amount of calories, but sugar was added to make the food more palatable. Sugary items, like sodas, are also coming in larger portions, as well. Sugars from fruit are less of a problem, as the fruit also contains fiber, which slows down the absorption of the fructose, and helps to not overload your liver. Calories in the form of glucose are digested differently than fructose or HFCS - the latter two which are processed in your liver. You shouldn't worry about eating too much bread - you should be looking at if the bread contains added sugar. Good video to watch: https://www.youtube.com/watch?v=dBnniua6-oM https://www.youtube.com/watch?v=dBnniua6-oM
- electriclove 9y ago
  Sugar was not readily available until relatively recently.
  - Fnoord 9y ago
    > Sugar was not readily available until relatively recently. Fruit? I'd put my money on a relation between abundance of food plus obesity because too high calorie intake is the main culprit of obesity.
  - 9y ago
milesward 9y ago
I cut out carbs (<20g per day) and am down 50lb in <1 year. YMMV, but keto worked for me.
- deleted 9y ago
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retreatguru 9y ago
This about sums it up: "A far more parsimonious hypothesis is that the same thing that makes our fat cells fat makes us fat: ‘high blood glucose’ and concomitant elevated levels of insulin and the insulin resistance itself, both caused by the carbohydrate content of our diets. Insulin is secreted in response to rising blood sugar, and rising blood sugar is a response to a carbohydrate-rich meal. Sugar is implicated, in particular, because its chemical structure includes a large proportion of the carbohydrate fructose, and fructose is preferentially metabolised in the liver. As such, it is a prime suspect for the fat accumulation in liver cells that is hypothesised to be the trigger of insulin resistance itself."
ha8o8le 9y ago
This is the truth. There's a lot more to this - so much so that I decided to make a documentary about it. I don't mean to promote it (there is nothing to promote yet, for now it's just a website), but here it is if anyone is interested http://FoodLies.org http://FoodLies.org I have one of these thought leader doctors on board. Would love any feedback or help from the community to get this made.
- jonex 9y ago
  I don't know how the film will be, but based on the short quips on the homepage, it seems Alan Aragon's quote from 2016 won't be far off: https://www.facebook.com/alan.aragon.796/posts/10155484600984992 https://www.facebook.com/alan.aragon.796/posts/1015548460098... Well, in the best case I guess, seems you think the textbook is just a bunch of lies and there won't even be half of the pages left in there? Just hoping that you won't further the spread of the many myths about nutrition that are so popular today. There are for instance actually still people who don't think calories in vs calories out determines weight change. The relevant question of course is what determines calories in and out if you aren't counting it manually.
ruminasean 9y ago
I've been on a ketogenic (very low carb, no sugar) diet for a little over a year. At the beginning of the diet, I started eating MORE than I used to, and tracking calories religiously, including weighing my food. I never miss a meal now and eat breakfast every day. The biggest thing I cut out was sugar. In that time, I lost 45 lbs, going from 210 to 165. I didn't exercise or do anything else. That weight came off in about 3 months. I am now commuting 11mi by bicycle most days, I feel better than I ever have. I fit perfectly into a few things I owned in HS (I'm in my 40s and was a skinny kid). Sugar is the worst.
mrmr22 9y ago
Here's a study showing Metabolic and behavioral effects of a high-sucrose diet during weight loss: https://www.ncbi.nlm.nih.gov/pubmed/9094871 https://www.ncbi.nlm.nih.gov/pubmed/9094871 It shows when kcals are equated,there is no difference in fat loss in high vs low sugar intake. I find Layne Norton a good resource for science related information about nutrition. I will say he is an outspoken critic of Taubes. Here is one of Layne's articles on sugar with references: https://www.bodybuilding.com/content/the-science-of-sugar-and-fat-loss.html https://www.bodybuilding.com/content/the-science-of-sugar-an...
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iopq 9y ago
I'm lean and I eat a lot of sugar. Sugar is not a toxin. It's a source of energy. I'll eat some sugar and go to the gym. I'll come back and eat more sugar to replace the glycogen I drained. What happens to overweight people has NOTHING to do with lean people who exercise.
- jm2721 9y ago
  You know what would give you even MORE energy? COCAINE! Try it out!
- toephu2 9y ago
  Sugar is a drug that is addictive and releases dopamine when consumed which is why you feel good when you eat it and have cravings for it.
  - nradov 9y ago
    Sugar doesn't meet the medical criteria to be considered an addictive drug.
sn9 9y ago
Sugar's role in diabetes seems likely to be true, but to say that CICO is false and a mutually exclusive explanation compared to the way in which insulin affects one's metabolism is empirically false [0]. Taubes would be hard pressed to explain how you could lose weight on a diet of Twinkies or how those subsisting on high carb, low fat, low protein diets that fail to meet their caloric needs in famine-afflicted regions remain thin. The way insulin works and the way the body requires a caloric surplus to gain weight are not remotely mutually exclusive ideas and to suggest otherwise requires cherry-picking the literature in a way that's scientifically irresponsible. [0] https://examine.com/nutrition/what-should-i-eat-for-weight-loss/ https://examine.com/nutrition/what-should-i-eat-for-weight-l...
- jmull 9y ago
  The issue with CICO isn’t that it’s wrong. It’s that it isn’t helping us solve the epidemic of metabolic disorders. While true (it’s simply a restatement of a law of thermodynamics after all) It’s an unhelpful, apparently mostly irrelevant model.
  - sn9 9y ago
    How is it unhelpful? For the obese, it presents the simplest and most actionable advice that has the highest relevance to their most pressing health problem.
    - grzm 9y ago
      The CICO message has been part of diet advice for decades. If hearing this message in and of itself were helpful, one would expect that we wouldn't be observing the current levels of obesity in the US. The biology and human behavior are more complex than that.
      - sn9 9y ago
        There are simpler explanations. People have no idea how much they consume and frequently underestimate how much they eat. Inaccurate measurement and non-existent tracking systems sabbotage people's attempts at modifying their weight. This is frequently solved by getting people to buy a food scale and weigh everything they eat for a few weeks and calculating the actual caloric content of their food. Food scales are frequently all people need to make real and persistent changes to their weight. The biology isn't complex enough that ignoring CICO or telling people that it's wrong is useful or helpful and not harmful.
Montezuma_II 9y ago
Not meaning to be rude or ignorant, but was anyone actually doubting this? I thought that the link of sugar to diabetes and obesity was common knowledge.
- deleted 9y ago
  [deleted]
craptocurrency 9y ago
Wtf, tell something which we don’t know about.

299 points by inertial 9y ago

The CDC says 34% of US adults have pre-diabetes, and of those, 88% are undiagnosed[1]. Yes, about 29% of US adults have un-diagnosed pre-diabetes, or about 74 million people. I think a significant cause is that testing blood glucose is thought of as something that only diabetics do, and as a result, most people have no idea how their bodies respond to meals they'd consider normal. The feedback loop is completely open. A typical Chipotle burrito has ~115 grams of carbs, often consumed in 20 minutes[2]. For some people, that's fine, and for others it's not, but the only way to know (other than waiting for problems) is to actually measure one's own blood glucose an hour later. Until blood glucose testing is either (a) thought of more as data collection without fear or stigma, like a bathroom scale, or (b) made blood-less and automatic, like is rumored about the Apple Watch[3], many people won't learn the answer to that question until a symptom of pre-diabetes appears. If you're reading this and haven't had your fasting blood glucose tested as part of a regular checkup, get that done. It's not nearly as informative as post-meal testing, but it's much better than nothing. Also, if you're a diabetic who created a side project/hack because you wanted it, and at scale, that project could mitigate the public health impact of diabetes, feel free to contact me. I'd consider helping make it mainstream[4]. My interest is improving societal health (this will be a massive problem in 20 years if nothing happens now), not personal or financial. [1]: CDC National Diabetes Statistics report, 2017: http://cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf http://cdc.gov/diabetes/pdfs/data/statistics/national-diabet... (page 7) [2]: Chipotle nutrition calculator: https://www.chipotle.com/nutrition-calculator https://www.chipotle.com/nutrition-calculator [3]: "Apple CEO Tim Cook test-drove a device that tracks his blood sugar": https://www.cnbc.com/2017/05/18/apple-ceo-tim-cook-test-drove-glucose-monitor.html https://www.cnbc.com/2017/05/18/apple-ceo-tim-cook-test-drov... [4]: https://twitter.com/troyd/status/920747116703518720 https://twitter.com/troyd/status/920747116703518720, https://twitter.com/troyd/status/921409373661884416 https://twitter.com/troyd/status/921409373661884416

goodells 9y ago
This sounds very interesting as another metric (like weight on a scale, as you put it) for someone trying to be conscious about their health. Is this something that a person could do cheaply at home with over-the-counter diabetic testing supplies? Could you be more specific or link to something about a protocol for e.g. measuring the effect of a meal on blood glucose and how to interpret those results?
- troydavis 9y ago
  Disclaimer: This is not medical advice and I'm not very knowledgeable, I'm just a data and public health geek. If you believe you may have diabetes or pre-diabetes, contact a doctor. Yes, it's doable with over-the-counter products. You need a meter and lancet device, and then for each test, a single-use lancet insert (tiny needle) and test strip. These are usually bundled together in a pharmacy for $25-$75. However, if you look or ask the pharmacist, there's often a 100% money back refund right in the store. Additional test strips are $0.75-$1.75/strip in packs of 25, 50, or 100. While that sounds expensive (and for diabetics, is), for the purposes we're talking about, one could probably only test after high-carb meals and a few days of fasting readings. The included 25-50 test strips may yield enough data to act on, and if not, one more 25-50 pack probably would. https://www.diabetesselfmanagement.com/blog/what-is-a-normal-blood-sugar-level/ https://www.diabetesselfmanagement.com/blog/what-is-a-normal... has more about when to test (basically, 1 and 2 hours after the start of a meal) and what results to expect. Feel free to ask the pharmacist to show you how to use it and interpret the results. Important note: this feels nothing like a blood draw. It's barely noticeable at all and not anything I'd call painful. There's a depth adjustment on the lancet, so it's the tiniest imaginable prick on the side of a finger. It yields less than a drop of blood, then immediately closes, ie, no bandage or bleeding. I did this myself as an extension of quantified self in 2012 (https://twitter.com/troyd/status/281931325471068161 https://twitter.com/troyd/status/281931325471068161), just because I wanted to see the readings and the process. I did it again this year to see whether the testing process had improved (no) or my results had changed (no). Other than some puzzled pharmacists who aren't used to people buying a meter for cash, there's really nothing to it. It'll also give a tiny peek at a process that millions of people do all the time. It's fascinating to see how one's body responds, particularly to meals that aren't obviously unhealthy (and depending on the person, may not be). Some examples: sandwiches (especially on big hoagie/grinder-style refined bread), burritos (tortilla+rice+beans), any meals with 2 significant sources of carbs (sandwich with fries or potato, breakfast with toast and hash browns, etc), and pasta. These aren't inherently unhealthy, but they all significantly raise blood glucose, and the only way to see how much is to test. More on "glycemic load": https://www.google.com/search?q=glycemic+load https://www.google.com/search?q=glycemic+load

vixen99 9y ago

Short take: this is adapted from ‘The Case Against Sugar’ by Gary Taubes, a science writer who's been a long-standing campaigner against dietary carbohydratesa and sugar'.

lokerfoi 9y ago
Is he bashing vegetables and fruits? The average US citizen does not eat the recommended minimum amount for fiber. Is he bashing the 3500kcal diet of average US citizen or is he purposefully demonizing a single macronutrient group?
- matt_wulfeck 9y ago
  Don’t you see the trend? “Recommended amounts” may be a large part of the issue. Doesn’t the US recommend 325 grams of sugar (carbohydrates) a day?
  - lokerfoi 9y ago
    Fiber has 0 calories, which implies people in the US in general barely eat fruit and vegetables. No one overdosed on fiber. It's quite silly to claim that 2000kcal of legume carbohydrate (more than 300 grams of carbs) will alter my hormones or metabolism in a negative way, so demonizing a macronutrient is bad science.
    - fmihaila 9y ago
      > Fiber has 0 calories, which implies people in the US in general barely eat fruit and vegetables This is true. The vast majority of Americans do not eat sufficient fruit and vegetables. This 2015 CDC study [1] concluded that only 13.1% of the population consumes enough fruit, and only 8.9% eat enough veggies. > It's quite silly to claim that 2000kcal of legume carbohydrate (more than 300 grams of carbs) will alter my hormones or metabolism in a negative way, so demonizing a macronutrient is bad science. Nobody claims that. You obviously haven't read the article. The excess of carbohydrates in today's diets doesn't come from fruit and vegetables (as [1] clearly shows), but from added sugar and refined grains. The article explains the critical role a chronically high level of insulin in the bloodstream plays in throwing the body's metabolic processes out of balance, leading to both obesity and type-2 diabetes. [1] https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6426a1.htm https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6426a1.htm

kichuku 9y ago

I would like to share an anecdote. In March 2016, I was weighing 96 kilograms (211.64 pounds). I made just one change during that time which is to stop having anything with sugar. I continued to take other natural sweeteners like jaggery and honey. The rest of my diet remained the same and my activity level remained the same ( I work in IT as a network engineer in a desk job) In October 2016, I was weighing 72 kilos (158.73 pounds). I am still maintaining that same weight between 70 to 72 kilos since then. Incase if it is relevant, I am a 29 year old guy with a height of 172 cm (5 feet 7 inches). Along with that, I got several other benefits such as being more energetic, not feeling sleepy all the time, general improvement in mood etc. All this just with stopping of sugar and nothing else changed. I can share even more side benefits which I got, but it will seem more unbelievable because I have observed that the general population is still unaware of the extremely harmful effects of sugar. EDIT: I had typed October 2017 when I had intended to type October 2016. It was just 7 months.

sebcat 9y ago
I'm 17x cm and weigh 7x kg. I run (mostly 10K, completed a half-marathon recently) and lift weights semi-regularly. I have a relatively low sugar intake. I don't feel energetic at all. I get home from work and more or less lay down until I fall asleep. Gabriel Iglesias seems to be way more energetic than me. Jaggery seems to be 50% sucrose, and honey is mostly glucose and fructose. Shouldn't it have the same effect on blood sugar levels?
- ohnoesjmr 9y ago
  Had the same, was diagnosed with sleep apnea.
ThrowawayR2 9y ago
> I continued to take other natural sweeteners like jaggery and honey. ...which are also 80+% sugar.
- smilliken 9y ago
  Honey has a lower glycemic index/insulin response than sucrose.

jnordwick 9y ago

The recent demonization of sugar substitutes hasn't helped either. The problem with studies that link them to weight gain is that they confuse correlation and caution then make some wild unsubstantiated stab at causation by guessing that maybe they cause insulin issues. I went looking for information on that, and found and excellent article by a diabetic site summarizing the evidence and treating each substitute as its own compound. The bulk is the data is that they have no correlation (there is some in vitro evidence for a couple of lesser used sweeteners but under very contrived circumstances). As long as we deny the existence of usable substitutes, we are making this harder on ourselves. https://www.marksdailyapple.com/artificial-sweeteners-insulin/ https://www.marksdailyapple.com/artificial-sweeteners-insuli...

QAPereo 9y ago
With very few edits, you've identified the problem with science journalism: The problem with studies... is that they confuse correlation and caution [sic] then make some wild unsubstantiated stab at causation..."
mike_o 9y ago
"The Obesity Code" by Jason Fung goes into all the issues from the article in more detail. He references studies that seem to prove sugar substitutes cause weight gain rather than correlate with weight gain: Sucralose raises insulin by 20 percent, despite the fact that it contains no calories and no sugar. This insulin-raising effect has also been shown for other artificial sweeteners, including the “natural” sweetener stevia. Despite having a minimal effect on blood sugars, both aspartame and stevia raised insulin levels higher even than table sugar. Fung, Jason. The Obesity Code: Unlocking the Secrets of Weight Loss (p. 172).
amriksohata 9y ago
Dude you need to read up about sweetners

alexandercrohde 9y ago

Tl; dr: Author contrasts two explanations of the obesity and diabetes crises: A) that the root of the issue is caloric intake stemming from low-self-control or B) that the root of the issue is high blood-sugar and its subsequent effects. Author explores the long history of this debate and presents points for both sides. Author admits the thermodynamic validity of caloric math but cites that at a cellular glucose levels cause insulin levels to rise that cause the cell to take on fat. Author cites other research, such as increased appetite among obese animals, suggesting a systemic effect. Author cites ketogenic diets as evidence (which restrict sugars but not total calories). Author contrasts the moral interpretation of each theory. Proposes the caloric consumption model places blame on the individual, whereas the glucose explanation places blame on the FDA.

rwnspace 9y ago
And yet, behavioural biology tells us that the development of the pre-frontal cortex is heavily influenced by genetics, epigenetics, and early-years experiences. The PFC appears to influence things like rates of risk-taking behaviour, addiction, and ability to choose long-term rewards... Of course, we wouldn't want to pass the buck of choice back to societal influences. Not that I know anything, I've just watched and read Robert Sapolsky's material.

Siilwyn 9y ago

So I wonder... is the effect of sugar on your body permanent, building up over time? Or would stopping the intake of refined sugars restore your system?

halotrope 9y ago
The worst effects of excessive Insulin, non alcoholic fatty liver and insulin resistance (which becomes type 2 diabetes after some time) can be reversed pretty easily by cutting sugar, fasting or a diet with extremely low levels of carbohydrates (Ketogenic Diet). Check Dr. Jason Fung and Robert Lustig on youtube. They both have done a great deal of research about the topic and have published very interesting material. I have adopted a very high fat, low carb diet (LCHF) and avoid all sugar for a couple months now and it is absolutely incredible how it changes your body, makes you loose fat and increases overall energy. Gone are these cycles of high and crashing after meals etc. I am absolutely convinced, that we will have a wake up to the toxicity of sugar very similar to that of cigarettes. Especially cancer and sugar seem to have a very strong and under researched relationship.
- BareNakedCoder 9y ago
  ++++Dr Jason Fung
- Siilwyn 9y ago
  Thank you for your reply, definitely interested in this. Going on further investigation!
iamt2 9y ago
There is be a cliff, over which the damage is permanent. If you change habits soon enough, then we know many avoid it the permanent damage altogether. This is due to the beta cells in the pancreas; destroy to many, and go below a critical threshhold, then they don't seem to be repaired/regenerated enough forever more.
- Siilwyn 9y ago

mncharity 9y ago

How Big Business Got Brazil Hooked on Junk Food[1]. "As their growth slows in the wealthiest countries, multinational food companies like Nestlé, PepsiCo and General Mills have been aggressively expanding their presence in developing nations, unleashing a marketing juggernaut that is upending traditional diets from Brazil to Ghana to India." "a growing number of people are both overweight and undernourished." "The diet is killing us." Nestlé: "We didn’t expect what the impact would be". [1] https://www.nytimes.com/interactive/2017/09/16/health/brazil-obesity-nestle.html https://www.nytimes.com/interactive/2017/09/16/health/brazil... , about: https://www.nytimes.com/2017/09/17/insider/as-global-obesity-rises-teasing-apart-its-causes-grows-harder.html https://www.nytimes.com/2017/09/17/insider/as-global-obesity...

grecy 9y ago
I have been through countless dirt-street towns from Guatemala to Mali where the local store has a few moldy potatoes, coke and Doritos. All the kids are eating the coke and Doritos as a meal, and of course there is nobody telling them not to, or that they should be brushing their teeth or anything like that. It's a massive, massive disaster.

PeterStuer 9y ago

Ever notice how since the 1980 the mantras changed from 'eat less, exercise more' to 'fad' diets whose one common theme was 'don't consume less, but eat different'. Subsequently obesity skyrocketed and the fat-lobby made sure that anyone who even pointed out the problem got demonized. Meanwhile 'food-scientists' silently made designer drugs out of daily consumables leading to a feeding frenzy and an obesity pandemic.

keymone 9y ago
> fat-lobby made sure that anyone who even pointed out the problem got demonized do provide sources. the one such episode i recall was demonization of John Yudkin in 60s when he tried to point out how bad sugar was.
abecedarius 9y ago
I remember 1980 and it's not clear to me that the popularity of "eat less, exercise more" as advice has increased or decreased; it seems comparable (but less justifiable since it's been so ineffective in the face of obesity taking off while exercise has increased). "Fad diets" were very much seen as such well before then. By contrast, I don't remember "fat acceptance" as a thing at all back then.

arikr 9y ago

Robert Lustig has written an excellent book on this topic: "The Hacking of the American Mind."

jakeogh 9y ago
Neat interview: https://overcast.fm/+FaTQX2SRE https://overcast.fm/+FaTQX2SRE

Tistron 9y ago

If you prefer audio the author appears in Sam Harris' podcast in a long interview abd speaks about this subject. #74 — What Should We Eat? Waking Up with Sam Harris Duration: 2:07:24 Published: Sat, 06 May 2017 20:30:08 +0000 URL: http://traffic.libsyn.com/wakingup/Waking_Up_74_Gary_Taubes.mp3?dest-id=480596 http://traffic.libsyn.com/wakingup/Waking_Up_74_Gary_Taubes.... In this episode of the Waking Up podcast, Sam Harris speaks with Gary Taubes about his career as a science journalist, the difficulty of studying nutrition and public health scientifically, the growing epidemics of obesity and diabetes, the role of hormones in weight gain, the controversies surrounding his work, and other topics.

dlwdlw 9y ago

Fad diets like keto offer something very important, a model of nutrition. Currently heuristic based eating like "natural" or "non-processed" work, but the knowledge doesn't compound and is brittle. In eastern cultures especially there is a huge body of heuristics for eating. In Chinese culture there is a concept of hot/cold foods and despite it not being accepted in the west, it still has predictive ability above chance. The end goal I would like to see is healthy off the shelf long lasting processed food that tastes great. It runs contrarian to "eat local and natural, big food is evil" but it solves a huge problem. Of course on the way imperfect models will yield bad results and heuristics are all we have. When doctors refused to wash their hands because they didn't know germ theory despite the massive heuristic evidence, people needlessly died.

aaron-lebo 9y ago
I tried keto for a very short time, found it difficult to meet such dietary restrictions. Not gonna be shocked if we find out in 10 years that eating keto is actually horrible for your cholesterol or something, and then it's gonna be too late for the early adopters. As an anecdote, I noticed some people advocating that diet literally eat bacon and steak all the time and justify it. They're probably gonna have major health problems one day because it's not actually a good rule, it's just a rule that sounds good and tastes delicious. Most of our popular models of diet are basically unscientific quackery. Maybe they are bad models? You are right of course in simply having a set of rules to follow seems to help.
- iamt2 9y ago
  What I see happening is many morbidly obese people who adhere to keto will initially drop weight, roughly until their BMI reaches around the upper normal range. Then CICO kicks in with a vengeance, and they have to be much more careful compared to before. Keto is a useful on-ramp for many to a fitness (or at least more-fit) lifestyle, but not a magic bullet, and I don't see anyone claiming you can skip counting calories while on keto, then still reach 12-15% body fat, and reveal abs. If you see someone writing that, then yes, they're quacks. My personal rough rule of thumb is once you reach the low 20s percentage body fat, you either keep increasing cardio (preferably HIIT), or dropping counted calories, until your moving average weekly weight keeps trending down. Fit keto around that or even drop it, and it won't matter (unless you're the same subtype diabetic like me, and then keto is an essential ingredient to avoiding medication). If you go in once a quarter for a VAP lipid panel (the most extensive lipid panel I could find), then as long as those numbers trend in the right direction, keep on doing whatever works for you. After being diagnosed with Type 2 and having to figure out myself how to beat the fucker into remission, I've concluded that medical science can give rough guidelines for describing metabolic processes, but it is up to each of us to hack our own bodies. Try one change, test the change with measurements, and repeat; commit the changes that work, fork away from the changes that don't, accept failures and setbacks as signals of what not to do, and move on.

carnismisfunny 9y ago

Gary Taubes is a well known meat and dairy industry propagandist who stands to gain everything through the sale of his carbophobic books and lectures. His villification of an oversimplified sugar Boogeyman just detracts from the animal fat and protein which has and continues to wreck the health of hundreds of millions of people.

thearn4 9y ago

I've been trying to cut sugar out of my diet recently. Eventually I'd like to at least feel comfortable treating it like alcohol: only for consumption in social settings and not too often.

Nomentatus 9y ago

The largest hormonal change we experience isn't puberty - it's night, under the aegis of the master hormone melatonin. Almost every hormone changes. I was overweight and had an appetite out of control a couple decades ago. For other health reasons, I adopted a natural night (real dark, can't see you hand in front of your face) and exactly the same lights on and lights off time. My extra weight vanished. My appetite didn't just lower, it changed away from salt fat and sugar (exactly what you want when starving) towards veggies and salads. (Ten hour nights recommended as your sleep will bifurcate.) Recommended. Nature ain't all wrong, it turns out.

aaron-lebo 9y ago
This sounds very wooey. Do you have anything to show this isn't the result of you wanting to change, changing habits, and your excitement at attempting change carrying through to produce some kind of placebo effect? I get similarly suspicious when people talk about how going on keto radically changed how they felt. Maybe it is true, but in an sea of anecdotes, it's really hard to figure out what is real. Do you notice how almost all of these turn into "this is how nature actually works"? That similar belief has led people to not get cancer treatments and then die horribly, so there's gotta be more than "this is how nature works". Congrats on your weight loss, regardless.
- floatingatoll 9y ago
  There's no way to demonstrate that as one individual, full stop. The burden of proof you require to consider whether a valuable benefit could potentially be derived is unacquirable. A more interesting test is to measure the difficulty of trying a certain anecdote yourself. How easily can you 'black out' your bedroom and sit, lay, or sleep in it for a 10 hour window at night for 30 days in a row? If you can do such a test easily, and you are invested in seeing a certain change that you think may result from it, then it does you no material harm to try it. Worst case scenario, you lose sleep for a few days and abort the experiment. Best case scenario, it has a positive impact. The results could be anywhere between those two endpoints. So, that makes this a 'safe' test to apply to your own personal body system, which is not necessarily applicable to any others. Anecdotes that require you to alter what you ingest (food, water, supplements, medicines etc) are much riskier, yet people constantly try these out endlessly under the rubric of "diets" without a second thought for the potential of months of damage to their gut biome, muscle mass, hormone levels, and so on. It's been demonstrated by a vast array of people that it's relatively safe to cut out all the sugar from your diet, but you have to make sure you don't let your blood sugar levels fall too low in the process. Anecdotes that require you to alter your body (e.g. stomach stapling) are even riskier than those, as we have very little experience in this space compared to diets or other non-consumption non-modification approaches. You are absolutely correct to be suspicious, but consider also the level of suspicion appropriate for the context. "Try blackout curtains for a month at night and charge your phone face down" is a far lower bar to be 'worth a shot' than "Remove all carbs from your diet". And if you see others failing to take this into account, remind them of the inherent level of risk in what they're considering. It's not always about being right or wrong, but instead about e.g. "how much harm could come to me if I try keto diet?". EDIT: There's very much a personal overtone to these risk assessments as well. My personal mental stability hinges critically on getting enough sleep, so I am unusually wary of anything that messes with sleep, because I need mental stability far more than I need the benefits such an experiment may or may not produce for me. EDIT: Harness the placebo effect! Believe that what you're trying could help when you try it. If you're doubtful and pessimistic and cynical about something you're trying, be especially careful to focus every day on why you're trying it. Doing so makes it more likely that the placebo effect will enhance your results, and less likely that the nocebo effect will diminish them. This relates directly to a lot of "woo-woo" thinking, but apply my logic above. What's the level of risk of trying a placebo-welcoming approach? You could mislead yourself into thinking something helped when it didn't. Keeping a careful journal about your experiments is an effective treatment for that problem for many folks, and the placebo effect is really powerful. No point in setting aside a useful tool just because it's mind-body.

projektir 9y ago

But why has obesity not been such a problem in the past, despite sugar being available? One point to make from the article, though: "They suggested that the physician-authors were trying to con the obese with the fraudulent argument that they could become lean without doing the hard work of curbing their perverted appetites." If you want to really confuse what's going on, turn to moralism. Desire to judge and to avoid being judged completely messes with incentives and people will line up to the "hard working" side while avoiding the "lazy" side, regardless of what is actually true.

justinator 9y ago
> But why has obesity not been such a problem in the past, despite sugar being available? Sugar, usually in the form of HFCS is added to almost any processed food these days, to make it more delicious and to make the food more profitable. HFCS is very, very cheap to produce. You're eating more sugar without perhaps even knowing you are. Low fat foods, introduced in the late 70's have the same amount of calories, but sugar was added to make the food more palatable. Sugary items, like sodas, are also coming in larger portions, as well. Sugars from fruit are less of a problem, as the fruit also contains fiber, which slows down the absorption of the fructose, and helps to not overload your liver. Calories in the form of glucose are digested differently than fructose or HFCS - the latter two which are processed in your liver. You shouldn't worry about eating too much bread - you should be looking at if the bread contains added sugar. Good video to watch: https://www.youtube.com/watch?v=dBnniua6-oM https://www.youtube.com/watch?v=dBnniua6-oM
electriclove 9y ago
Sugar was not readily available until relatively recently.
- Fnoord 9y ago
  > Sugar was not readily available until relatively recently. Fruit? I'd put my money on a relation between abundance of food plus obesity because too high calorie intake is the main culprit of obesity.
- 9y ago

milesward 9y ago

I cut out carbs (<20g per day) and am down 50lb in <1 year. YMMV, but keto worked for me.

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retreatguru 9y ago

This about sums it up: "A far more parsimonious hypothesis is that the same thing that makes our fat cells fat makes us fat: ‘high blood glucose’ and concomitant elevated levels of insulin and the insulin resistance itself, both caused by the carbohydrate content of our diets. Insulin is secreted in response to rising blood sugar, and rising blood sugar is a response to a carbohydrate-rich meal. Sugar is implicated, in particular, because its chemical structure includes a large proportion of the carbohydrate fructose, and fructose is preferentially metabolised in the liver. As such, it is a prime suspect for the fat accumulation in liver cells that is hypothesised to be the trigger of insulin resistance itself."

ha8o8le 9y ago

This is the truth. There's a lot more to this - so much so that I decided to make a documentary about it. I don't mean to promote it (there is nothing to promote yet, for now it's just a website), but here it is if anyone is interested http://FoodLies.org http://FoodLies.org I have one of these thought leader doctors on board. Would love any feedback or help from the community to get this made.

jonex 9y ago
I don't know how the film will be, but based on the short quips on the homepage, it seems Alan Aragon's quote from 2016 won't be far off: https://www.facebook.com/alan.aragon.796/posts/10155484600984992 https://www.facebook.com/alan.aragon.796/posts/1015548460098... Well, in the best case I guess, seems you think the textbook is just a bunch of lies and there won't even be half of the pages left in there? Just hoping that you won't further the spread of the many myths about nutrition that are so popular today. There are for instance actually still people who don't think calories in vs calories out determines weight change. The relevant question of course is what determines calories in and out if you aren't counting it manually.

ruminasean 9y ago

I've been on a ketogenic (very low carb, no sugar) diet for a little over a year. At the beginning of the diet, I started eating MORE than I used to, and tracking calories religiously, including weighing my food. I never miss a meal now and eat breakfast every day. The biggest thing I cut out was sugar. In that time, I lost 45 lbs, going from 210 to 165. I didn't exercise or do anything else. That weight came off in about 3 months. I am now commuting 11mi by bicycle most days, I feel better than I ever have. I fit perfectly into a few things I owned in HS (I'm in my 40s and was a skinny kid). Sugar is the worst.

mrmr22 9y ago

Here's a study showing Metabolic and behavioral effects of a high-sucrose diet during weight loss: https://www.ncbi.nlm.nih.gov/pubmed/9094871 https://www.ncbi.nlm.nih.gov/pubmed/9094871 It shows when kcals are equated,there is no difference in fat loss in high vs low sugar intake. I find Layne Norton a good resource for science related information about nutrition. I will say he is an outspoken critic of Taubes. Here is one of Layne's articles on sugar with references: https://www.bodybuilding.com/content/the-science-of-sugar-and-fat-loss.html https://www.bodybuilding.com/content/the-science-of-sugar-an...

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iopq 9y ago

I'm lean and I eat a lot of sugar. Sugar is not a toxin. It's a source of energy. I'll eat some sugar and go to the gym. I'll come back and eat more sugar to replace the glycogen I drained. What happens to overweight people has NOTHING to do with lean people who exercise.

jm2721 9y ago
You know what would give you even MORE energy? COCAINE! Try it out!
toephu2 9y ago
Sugar is a drug that is addictive and releases dopamine when consumed which is why you feel good when you eat it and have cravings for it.
- nradov 9y ago
  Sugar doesn't meet the medical criteria to be considered an addictive drug.

sn9 9y ago

Sugar's role in diabetes seems likely to be true, but to say that CICO is false and a mutually exclusive explanation compared to the way in which insulin affects one's metabolism is empirically false [0]. Taubes would be hard pressed to explain how you could lose weight on a diet of Twinkies or how those subsisting on high carb, low fat, low protein diets that fail to meet their caloric needs in famine-afflicted regions remain thin. The way insulin works and the way the body requires a caloric surplus to gain weight are not remotely mutually exclusive ideas and to suggest otherwise requires cherry-picking the literature in a way that's scientifically irresponsible. [0] https://examine.com/nutrition/what-should-i-eat-for-weight-loss/ https://examine.com/nutrition/what-should-i-eat-for-weight-l...

jmull 9y ago
The issue with CICO isn’t that it’s wrong. It’s that it isn’t helping us solve the epidemic of metabolic disorders. While true (it’s simply a restatement of a law of thermodynamics after all) It’s an unhelpful, apparently mostly irrelevant model.
- sn9 9y ago
  How is it unhelpful? For the obese, it presents the simplest and most actionable advice that has the highest relevance to their most pressing health problem.
  - grzm 9y ago
    The CICO message has been part of diet advice for decades. If hearing this message in and of itself were helpful, one would expect that we wouldn't be observing the current levels of obesity in the US. The biology and human behavior are more complex than that.
    - sn9 9y ago
      There are simpler explanations. People have no idea how much they consume and frequently underestimate how much they eat. Inaccurate measurement and non-existent tracking systems sabbotage people's attempts at modifying their weight. This is frequently solved by getting people to buy a food scale and weigh everything they eat for a few weeks and calculating the actual caloric content of their food. Food scales are frequently all people need to make real and persistent changes to their weight. The biology isn't complex enough that ignoring CICO or telling people that it's wrong is useful or helpful and not harmful.

Montezuma_II 9y ago

Not meaning to be rude or ignorant, but was anyone actually doubting this? I thought that the link of sugar to diabetes and obesity was common knowledge.

deleted 9y ago
[deleted]

craptocurrency 9y ago

Wtf, tell something which we don’t know about.