11 ms·

Sugar-sweetened beverage intake and serum testosterone levels in adult males (2018)

77 points by prostoalex 6y ago

ronnier 6y ago
> Conclusion: SSB consumption is significantly associated with low serum testosterone in men 20–39 years old in the United States.
- acbart 6y ago
  Do they give the effect size anywhere?
- genrez 6y ago
  narush points out elsewhere that this isn't a controlled experiment, so take these numbers with a grain of salt. Also I am not a statistician, so take this with another grain of salt. That being said, if I am interpreting Table 2 correctly, the study is saying that consuming a large amount of surgery beverages causes your risk of having low-testosterone related problems to rise by 2.29 times compared to not drinking many sugary beverages. This is after correcting for age, race, BMI, alcoholism, and physical activity levels. The risk increase before correcting for these things is 2.78 times, so that would seem to indicate that sugary beverages do have a pretty large effect compared to the confounders they choose, though it is still possible sugary beverage consumption is acting as a proxy for something else.
  - osdoorp 6y ago
    Small correction: the study is saying that consuming a large amount of sugary beverages *is associated" with lower-testosterone concentration — they didn't say anything about causation. It's also possible that lower-testosterone causes you having a "sweet tooth".
klipklop 6y ago
Is it the sugar or BPA lined cans? Also do they mean "sugar" or high fructose corn syrup? Seems like men had higher test levels in the era of glass bottles and real sugar soda.
- SketchySeaBeast 6y ago
  You'd think you can compare that by also looking at artificial sweeteners.
  - klipklop 6y ago
    Agreed. I am not saying that full-sugar soda is healthy, but it seems in the past people ate a lot of sugar and seemed to have less endocrine problems than they do today.
    - spoonjim 6y ago
      Even 50 years ago even white collar people did a lot more physical work then they do now.
    - dublin 6y ago
      That's unquestionably what the observational evidence shows. (Just look at pictures of soldiers and other men from WWII (wiry and rail-thin, but strong), Vietnam (still skinny, but getting heavier), and Iraq/Afghanistan (a surprising number of guts and much more flabbiness). My guess is that there's more to both HFCS vs. sugar and the continuous exposure to endocrine disruptors in food, food packaging, etc. Think about it - how little of your life are you not in contact with plastics anymore? (If you're typing a reply, you're rubbing on those plasticizers again...)
- intergalplan 6y ago
  In the era of glass bottles and real-sugar soda, we drank a hell of a lot less soda. The era of free refills on sodas not just existing but being expected, and 32-ounce "medium" size soft drinks is quite recent. Also, I'm unconvinced a small difference in the balance between glucose and fructose is worth treating HFCS as different from beet or cane sugar. Its effect on the price of sugar is a different matter, however. [EDIT] see the 1989 skate film Gleaming the Cube for an example from a few years before free refills started being advertised fairly frequently, and a solid decade before they became the overwhelming norm: there's a Pizza Hut in it with an advertisement posted on the side of the building for a special on pitchers... of soda, not of beer.
narush 6y ago
For anyone wondering, this is not an experiment, it's an epidemiological study. I've commented about it on HN before [1], but nutritional epidemiology is in its own league of shady science. If you didn't know, 80% of things you eat give you cancer [2]. That being said, sugar is bad. Main-lining sugar by drinking it in huge concentrations seems even worse! Edit: that being said, if you are doing nutritional epidemiology, or any data science for that matter, check out Mito [3]! It's what I do when I'm not shit-posting on sugar on HN :) [1] https://news.ycombinator.com/item?id=26764060 https://news.ycombinator.com/item?id=26764060 [2] https://pubmed.ncbi.nlm.nih.gov/23193004/ https://pubmed.ncbi.nlm.nih.gov/23193004/ [3] https://trymito.io/hn https://trymito.io/hn
- andi999 6y ago
  Which sugar is bad? Is fructose as bad as glucose?
  - deleted 6y ago
    [deleted]
  - arcticbull 6y ago
    Usually, glucose is regarded as the worst from an insulin resistance perspective - makes it way directly to your blood causing a large spike in blood sugar. Fructose isn’t as bad from that perspective because it has to be metabolized by the liver first. But with that in mind, consuming too much fructose can lead to nonalcoholic fatty liver disease which is basically cirrhosis but from other causes.
  - twobitshifter 6y ago
    For testosterone, they’re looking a sugar sweetened beverages which would either be sucrose or glucose-fructose (HFCS), so it cannot be answered Here’s a recent study that found that sucrose and fructose double liver fat production when compared to glucose. Both need more “processing” than glucose making them more expensive. My theory is that the body compensates for this by trying to increase fat stored. The study found that this happens even with moderate amounts of sugar. https://scitechdaily.com/even-moderate-amounts-of-added-sugar-doubles-bodys-fat-production/ https://scitechdaily.com/even-moderate-amounts-of-added-suga... >Ninety-four healthy young men took part in the study. Every day for a period of seven weeks, they consumed a drink sweetened with different types of sugar, while the control group did not. The drinks contained either fructose, glucose or sucrose (table sugar which is a combination of fructose and glucose). The researchers then used tracers (labeled substances that can be traced as they move through the body) to analyze the effect of sugary drinks on lipid metabolism. >Fructose and sucrose double fat production beyond food intake
knuthsat 6y ago
Too many confounding variables that can't be removed by a mathematical magic wand. What about obesity, what about body fat percentage? Yeah, fat men have lower testosterone levels. Yeah, non-smokers have lower testosterone levels. I drink a bunch of HFCS and sugar sweetened beverages. Don't feel like it affects my weightlifting, maybe teeth mostly.
- jack9 6y ago
  If you stick to fountain sodas, it won't wreck your teeth for decades. The acid in the can (and 2liters, small bottles, etc) is very hard on them.
  - stryan 6y ago
    Is there a study about that? I'd love to see more info on difference in health effects between fountain soda vs bottled/canned.
    - Jiocus 6y ago
      I think this is a misconception. It's not about the fountain vs canned or bottle soda. Carbon dioxide lowers the pH of a drink to 4.5, which is acidic. The acid pH level erodes teeth and one shouldn't brush their teeth too soon after drinking soda because the enamel can be damaged. (Edit: acid on your teeth is always bad, brushing or not.) Getting a soft drink from a fountain often means getting a straw for your cup as well. Using a straw to drink does help somewhat to bypass the soda from making contact with the teeth in the first place. Use a straw, save a tooth.
      - phonypc 6y ago
        The pH of soft drinks is more typically in the range 2-4, due to the addition of various acids. And the negative effect of soft drinks on dental health is primarily from the action of acid-producing bacteria metabolizing sugar. Diet drinks aren't nearly as bad for your teeth, carbonated water barely has any effect.
dublin 6y ago
Interesting. It would be even more interesting to see if the High Fructose Corn Syrup used in most sweetened drinks today has a different effect from the sugar used in previous generations. Given the changes in Men's morphology over the past 50 years, something is definitely making men fatter and softer (and of course, T is probably a large part of that...)
- blunte 6y ago
  There is much greater consumption of processed food today than 30 years ago. "Food science" wasn't so clever back then, so the boxed and premade foods were not especially tasty. Now they can be addictively tasty. And in these busy times with lots of things grabbing our attention, premade foods - even ones which would appear to be made up of all good ingredients - are the easy choice. To give processed foods a longer shelf life, they need more salt; but to compensate and make them palatable they then need more sugar. So even ignoring the less clear downsides of how processing might affect the chemistry, the simple observation is that foods have more added sugar or sweeteners now than ever before. In human history, that's a pretty rapid and significant change... much like the body shape changes that have occurred during the same 30 years.
- fghthidudhmbdi 6y ago
  HFCS varies between ~40 to ~55 percent fructose. Compare this with sucrose (table sugar) which is 50% fructose. If it were the case that HFCS had an outstanding effect on health, it would be in the non-sugar part of the HFCS. I think the simple explanation reflects reality the best: the diet in the US and now the rest of the world contains more foods which are rich in sugars and oils, which are highly processed and therefore easily digested, and which were designed to stimulate cravings to facilitate eating and sales. Rich foods are more calorie dense. Since satiety is partly related to volume of food consumed, rich foods can provide sufficient calories without diminishing hunger. Highly processed foods are effectively partially pre-digested. This increases the energy availability of the foods. For example, you will get more calories from white flour than from whole wheat flour than from wheat berries. Finally, products that have been successful are ones that sell more. For food marketers, the goal is to optimize the "bliss point", which is a balance between salt, sugar, and fat content. This is important because, in the past, when people's lives became more sedentary, they ate less in response. Targeting the bliss point has reversed that trend.
deleted 6y ago
[deleted]
bagacrap 6y ago
""" After adjusting for possible confounding variables, BMI was an independent risk factor for low testosterone level """ So after adjusting for BMI, sugary beverage consumption had nothing to do with T. But BMI is correlated with T which is (very) old news, and sugary drink consumption is presumably correlated with BMI. Yawn.
- genrez 6y ago
  My reading of the study is that both BMI itself and sugary drink consumption after adjusting for BMI among other factors are risk factors for low T.
nabla9 6y ago
The interesting point in this study and one they reference is that >... After adjusting for possible confounding variables, BMI was an independent risk factor for low testosterone level In other words, even adjusting for obesity, consuming sugar-sweetened beverages is a risk factor. There is other sugar -> low testosterone link, separate from sugar -> fat -> low testosterone with adjusted odds ratio 2.29.
- serverholic 6y ago
  It's also possible that sugar-sweetened beverages are a proxy for something else. You can't establish causation with studies like this.
papandada 6y ago
As a 41 year old man getting remarried, I'm personally interested in the subject of serum testosterone. I have noticed a sharp decline the past couple years and I'm sure aging plus computer job plus covid is a noxious blend. General advice out there includes lower stress, lose weight, keep active, get sleep, weightlifting is good, cardio is good but maybe not too much, IF may be good. Scientific studies are good but it takes a lot of work to even prove directionality it seems at times. So please, lay on me the personal anecdata of what you've seen give good results in a safe way. My own anecdote, years back I did martial arts training which seemed to send my sex drive and aggression through the roof. A large component of this was isometric stance training so I've tried incorporating that a few times a week and am seeing some striking changes in sexual function. Could that also be more sunshine, walking, fresh vegetables in diet? Could be, yes, but changes have been evident. Can anyone else report good results from their own experiences?
- lambdaba 6y ago
  More dietary cholesterol. Raw egg yolks (easier to consume raw) in as large a quantity as you can handle.
  - ypcx 6y ago
    Cholesterol/saturated fat will clog your penis arteries which is the leading cause of ED. (In fact ED is one of the first symptoms of heart disease, the No.1 killer.) Nutrition Facts has a page about testosterone, I'd suggest you start there: https://nutritionfacts.org/2017/05/16/foods-that-affect-testosterone-levels/ https://nutritionfacts.org/2017/05/16/foods-that-affect-test... edit: link to a video about ED vs diet: https://youtu.be/OVXzT_RBxFk https://youtu.be/OVXzT_RBxFk
    - mizzack 6y ago
      Dietary cholesterol has very little to no effect on serum cholesterol levels. Eat those yolks, folks.
- totony 6y ago
esdott 6y ago
As a type 1 diabetic for 20+ years, I feel like two large but underrated issues in the overall sugar conversation are (1) the functional aspect of fiber and (2) the rate of consumption and its effect on the body (e.g. drinking a SSB all at once). The body just has trouble dealing with a large amount of both insulin and sugar at the same time. When we reduce fiber intake the issue compounds. Simply spreading out your normal daily sugar consumption throughout the day (you know, chew your food slowly ;) would have huge benefits in terms of your body's ability to convert glucose efficiently (what's at the heart of the type 2 diabetes epidemic). Add fiber back into the equation would also help this immensely. I say all this to say that we shouldn't ignore the machine like qualities of the body in the discussion. Think about your intake rate along with the overall consumption.
rthomas6 6y ago
>Multivariate logistic regression revealed the odds of low testosterone was significantly greater with increasing SSB consumption (Q4 [≥442 kcal/day] vs. Q1 [≤137 kcal/day]) 442/4 = 110.5+ grams of sugar, per day, every day. Before even including food. Do people really not know living like this is bad? Is this result really surprising?

77 points by prostoalex 6y ago

> Conclusion: SSB consumption is significantly associated with low serum testosterone in men 20–39 years old in the United States.

acbart 6y ago
Do they give the effect size anywhere?
genrez 6y ago
narush points out elsewhere that this isn't a controlled experiment, so take these numbers with a grain of salt. Also I am not a statistician, so take this with another grain of salt. That being said, if I am interpreting Table 2 correctly, the study is saying that consuming a large amount of surgery beverages causes your risk of having low-testosterone related problems to rise by 2.29 times compared to not drinking many sugary beverages. This is after correcting for age, race, BMI, alcoholism, and physical activity levels. The risk increase before correcting for these things is 2.78 times, so that would seem to indicate that sugary beverages do have a pretty large effect compared to the confounders they choose, though it is still possible sugary beverage consumption is acting as a proxy for something else.
- osdoorp 6y ago
  Small correction: the study is saying that consuming a large amount of sugary beverages *is associated" with lower-testosterone concentration — they didn't say anything about causation. It's also possible that lower-testosterone causes you having a "sweet tooth".

klipklop 6y ago

Is it the sugar or BPA lined cans? Also do they mean "sugar" or high fructose corn syrup? Seems like men had higher test levels in the era of glass bottles and real sugar soda.

SketchySeaBeast 6y ago
You'd think you can compare that by also looking at artificial sweeteners.
- klipklop 6y ago
  Agreed. I am not saying that full-sugar soda is healthy, but it seems in the past people ate a lot of sugar and seemed to have less endocrine problems than they do today.
  - spoonjim 6y ago
    Even 50 years ago even white collar people did a lot more physical work then they do now.
  - dublin 6y ago
    That's unquestionably what the observational evidence shows. (Just look at pictures of soldiers and other men from WWII (wiry and rail-thin, but strong), Vietnam (still skinny, but getting heavier), and Iraq/Afghanistan (a surprising number of guts and much more flabbiness). My guess is that there's more to both HFCS vs. sugar and the continuous exposure to endocrine disruptors in food, food packaging, etc. Think about it - how little of your life are you not in contact with plastics anymore? (If you're typing a reply, you're rubbing on those plasticizers again...)
intergalplan 6y ago
In the era of glass bottles and real-sugar soda, we drank a hell of a lot less soda. The era of free refills on sodas not just existing but being expected, and 32-ounce "medium" size soft drinks is quite recent. Also, I'm unconvinced a small difference in the balance between glucose and fructose is worth treating HFCS as different from beet or cane sugar. Its effect on the price of sugar is a different matter, however. [EDIT] see the 1989 skate film Gleaming the Cube for an example from a few years before free refills started being advertised fairly frequently, and a solid decade before they became the overwhelming norm: there's a Pizza Hut in it with an advertisement posted on the side of the building for a special on pitchers... of soda, not of beer.

narush 6y ago

For anyone wondering, this is not an experiment, it's an epidemiological study. I've commented about it on HN before [1], but nutritional epidemiology is in its own league of shady science. If you didn't know, 80% of things you eat give you cancer [2]. That being said, sugar is bad. Main-lining sugar by drinking it in huge concentrations seems even worse! Edit: that being said, if you are doing nutritional epidemiology, or any data science for that matter, check out Mito [3]! It's what I do when I'm not shit-posting on sugar on HN :) [1] https://news.ycombinator.com/item?id=26764060 https://news.ycombinator.com/item?id=26764060 [2] https://pubmed.ncbi.nlm.nih.gov/23193004/ https://pubmed.ncbi.nlm.nih.gov/23193004/ [3] https://trymito.io/hn https://trymito.io/hn

andi999 6y ago
Which sugar is bad? Is fructose as bad as glucose?
- deleted 6y ago
  [deleted]
- arcticbull 6y ago
  Usually, glucose is regarded as the worst from an insulin resistance perspective - makes it way directly to your blood causing a large spike in blood sugar. Fructose isn’t as bad from that perspective because it has to be metabolized by the liver first. But with that in mind, consuming too much fructose can lead to nonalcoholic fatty liver disease which is basically cirrhosis but from other causes.
- twobitshifter 6y ago
  For testosterone, they’re looking a sugar sweetened beverages which would either be sucrose or glucose-fructose (HFCS), so it cannot be answered Here’s a recent study that found that sucrose and fructose double liver fat production when compared to glucose. Both need more “processing” than glucose making them more expensive. My theory is that the body compensates for this by trying to increase fat stored. The study found that this happens even with moderate amounts of sugar. https://scitechdaily.com/even-moderate-amounts-of-added-sugar-doubles-bodys-fat-production/ https://scitechdaily.com/even-moderate-amounts-of-added-suga... >Ninety-four healthy young men took part in the study. Every day for a period of seven weeks, they consumed a drink sweetened with different types of sugar, while the control group did not. The drinks contained either fructose, glucose or sucrose (table sugar which is a combination of fructose and glucose). The researchers then used tracers (labeled substances that can be traced as they move through the body) to analyze the effect of sugary drinks on lipid metabolism. >Fructose and sucrose double fat production beyond food intake

knuthsat 6y ago

Too many confounding variables that can't be removed by a mathematical magic wand. What about obesity, what about body fat percentage? Yeah, fat men have lower testosterone levels. Yeah, non-smokers have lower testosterone levels. I drink a bunch of HFCS and sugar sweetened beverages. Don't feel like it affects my weightlifting, maybe teeth mostly.

jack9 6y ago
If you stick to fountain sodas, it won't wreck your teeth for decades. The acid in the can (and 2liters, small bottles, etc) is very hard on them.
- stryan 6y ago
  Is there a study about that? I'd love to see more info on difference in health effects between fountain soda vs bottled/canned.
  - Jiocus 6y ago
    I think this is a misconception. It's not about the fountain vs canned or bottle soda. Carbon dioxide lowers the pH of a drink to 4.5, which is acidic. The acid pH level erodes teeth and one shouldn't brush their teeth too soon after drinking soda because the enamel can be damaged. (Edit: acid on your teeth is always bad, brushing or not.) Getting a soft drink from a fountain often means getting a straw for your cup as well. Using a straw to drink does help somewhat to bypass the soda from making contact with the teeth in the first place. Use a straw, save a tooth.
    - phonypc 6y ago
      The pH of soft drinks is more typically in the range 2-4, due to the addition of various acids. And the negative effect of soft drinks on dental health is primarily from the action of acid-producing bacteria metabolizing sugar. Diet drinks aren't nearly as bad for your teeth, carbonated water barely has any effect.

dublin 6y ago

Interesting. It would be even more interesting to see if the High Fructose Corn Syrup used in most sweetened drinks today has a different effect from the sugar used in previous generations. Given the changes in Men's morphology over the past 50 years, something is definitely making men fatter and softer (and of course, T is probably a large part of that...)

blunte 6y ago
There is much greater consumption of processed food today than 30 years ago. "Food science" wasn't so clever back then, so the boxed and premade foods were not especially tasty. Now they can be addictively tasty. And in these busy times with lots of things grabbing our attention, premade foods - even ones which would appear to be made up of all good ingredients - are the easy choice. To give processed foods a longer shelf life, they need more salt; but to compensate and make them palatable they then need more sugar. So even ignoring the less clear downsides of how processing might affect the chemistry, the simple observation is that foods have more added sugar or sweeteners now than ever before. In human history, that's a pretty rapid and significant change... much like the body shape changes that have occurred during the same 30 years.
fghthidudhmbdi 6y ago
HFCS varies between ~40 to ~55 percent fructose. Compare this with sucrose (table sugar) which is 50% fructose. If it were the case that HFCS had an outstanding effect on health, it would be in the non-sugar part of the HFCS. I think the simple explanation reflects reality the best: the diet in the US and now the rest of the world contains more foods which are rich in sugars and oils, which are highly processed and therefore easily digested, and which were designed to stimulate cravings to facilitate eating and sales. Rich foods are more calorie dense. Since satiety is partly related to volume of food consumed, rich foods can provide sufficient calories without diminishing hunger. Highly processed foods are effectively partially pre-digested. This increases the energy availability of the foods. For example, you will get more calories from white flour than from whole wheat flour than from wheat berries. Finally, products that have been successful are ones that sell more. For food marketers, the goal is to optimize the "bliss point", which is a balance between salt, sugar, and fat content. This is important because, in the past, when people's lives became more sedentary, they ate less in response. Targeting the bliss point has reversed that trend.

deleted 6y ago

[deleted]

bagacrap 6y ago

""" After adjusting for possible confounding variables, BMI was an independent risk factor for low testosterone level """ So after adjusting for BMI, sugary beverage consumption had nothing to do with T. But BMI is correlated with T which is (very) old news, and sugary drink consumption is presumably correlated with BMI. Yawn.

genrez 6y ago
My reading of the study is that both BMI itself and sugary drink consumption after adjusting for BMI among other factors are risk factors for low T.

nabla9 6y ago

The interesting point in this study and one they reference is that >... After adjusting for possible confounding variables, BMI was an independent risk factor for low testosterone level In other words, even adjusting for obesity, consuming sugar-sweetened beverages is a risk factor. There is other sugar -> low testosterone link, separate from sugar -> fat -> low testosterone with adjusted odds ratio 2.29.

serverholic 6y ago
It's also possible that sugar-sweetened beverages are a proxy for something else. You can't establish causation with studies like this.

papandada 6y ago

As a 41 year old man getting remarried, I'm personally interested in the subject of serum testosterone. I have noticed a sharp decline the past couple years and I'm sure aging plus computer job plus covid is a noxious blend. General advice out there includes lower stress, lose weight, keep active, get sleep, weightlifting is good, cardio is good but maybe not too much, IF may be good. Scientific studies are good but it takes a lot of work to even prove directionality it seems at times. So please, lay on me the personal anecdata of what you've seen give good results in a safe way. My own anecdote, years back I did martial arts training which seemed to send my sex drive and aggression through the roof. A large component of this was isometric stance training so I've tried incorporating that a few times a week and am seeing some striking changes in sexual function. Could that also be more sunshine, walking, fresh vegetables in diet? Could be, yes, but changes have been evident. Can anyone else report good results from their own experiences?

lambdaba 6y ago
More dietary cholesterol. Raw egg yolks (easier to consume raw) in as large a quantity as you can handle.
- ypcx 6y ago
  Cholesterol/saturated fat will clog your penis arteries which is the leading cause of ED. (In fact ED is one of the first symptoms of heart disease, the No.1 killer.) Nutrition Facts has a page about testosterone, I'd suggest you start there: https://nutritionfacts.org/2017/05/16/foods-that-affect-testosterone-levels/ https://nutritionfacts.org/2017/05/16/foods-that-affect-test... edit: link to a video about ED vs diet: https://youtu.be/OVXzT_RBxFk https://youtu.be/OVXzT_RBxFk
  - mizzack 6y ago
    Dietary cholesterol has very little to no effect on serum cholesterol levels. Eat those yolks, folks.
totony 6y ago

esdott 6y ago

As a type 1 diabetic for 20+ years, I feel like two large but underrated issues in the overall sugar conversation are (1) the functional aspect of fiber and (2) the rate of consumption and its effect on the body (e.g. drinking a SSB all at once). The body just has trouble dealing with a large amount of both insulin and sugar at the same time. When we reduce fiber intake the issue compounds. Simply spreading out your normal daily sugar consumption throughout the day (you know, chew your food slowly ;) would have huge benefits in terms of your body's ability to convert glucose efficiently (what's at the heart of the type 2 diabetes epidemic). Add fiber back into the equation would also help this immensely. I say all this to say that we shouldn't ignore the machine like qualities of the body in the discussion. Think about your intake rate along with the overall consumption.

rthomas6 6y ago

>Multivariate logistic regression revealed the odds of low testosterone was significantly greater with increasing SSB consumption (Q4 [≥442 kcal/day] vs. Q1 [≤137 kcal/day]) 442/4 = 110.5+ grams of sugar, per day, every day. Before even including food. Do people really not know living like this is bad? Is this result really surprising?