11 ms·

And now, 13 years after Lustig's "Sugar: the Bitter Truth" totally convinced me it was sugar and not fat, and sugar consumption has decreased while obesity has

by Lucent 4y ago

And now, 13 years after Lustig's "Sugar: the Bitter Truth" totally convinced me it was sugar and not fat, and sugar consumption has decreased while obesity has increased, I'm unconvinced it's sugar either. It's some environmental contaminant. https://twitter.com/mold_time/status/1414242490404720648 https://twitter.com/mold_time/status/1414242490404720648

notshift 4y ago
Probably sugar consumption has gone down because people have replaced it with artificial sweeteners, which have similar metabolic effects in the body to what Lustig has attributed to sugar. It'd be nice to see a combined graph of sugar + artificial sweeteners.
- stjohnswarts 4y ago
  they do not have similar metabolic effects. Go look up studies on blood sugar levels of diet vs regular soda.
TEP_Kim_Il_Sung 4y ago
Starch. Sugar consumption may have decreased, but starch converts to sugar in our stomach acid, and with the Amylase in our saliva. Yup. The largest part of the food pyramid: Grains. Noodles, potatoes, porridge, bread... It's all sugar.
- notshift 4y ago
  Starch converts to glucose, which is processed VERY differently from table sugar, sucrose, or the type of sugar found in fruit, fructose. So, sugar is not all sugar. I believe Lustig has argued that the latter two are much worse than the former. I agree overeating of carbs is not good, but is the reason why America is so fat because we just magically eat more bread, noodles, and potatoes than comparable countries? Probably not.
- pengaru 4y ago
  You're conflating glucose and fructose. Fructose is the Lustig-argued toxic half of sugar that gets processed ~identically to ethanol by the liver.
- stjohnswarts 4y ago
  White bread literally has basically the same affect on blood sugar as an equal amount of sugar (by weight) as does processed (not whole wheat) pasta. It may be a bit delayed vs sugar's almost immediate absorption but the end result is quite on the same order.
joemelonyeah 4y ago
Processed foods, HFCS, fruit juices are also sugar
sydbarrett74 4y ago
Why can't it be both? Also, the consumption of sucrose in the developed world may or may not have appreciably decreased in the period since Lustig's lecture came out, but the pandemic and corresponding spike in inflation have forced many people to seek out cheaper sources of food. And what are those cheaper sources of food loaded with? Yep: sugar and salt.
300bps 4y ago
Now I’m just a person who has remained the same approximate weight for the past 3 decades so I don’t know anything about substantial weight loss or gain. But is it at all possible it’s just calories in calories out? I know it isn’t a sexy theory but it works like hell for me.
- tobiasSoftware 4y ago
  Calories in calories out (CICO) is the what, not the why. If you saw someone who spent $1000 on jewelry every month and didn't pay their electricity bills, would you tell them to learn to budget? Heck no, you'd tell them they need therapy to fix much deeper root causes. So why are we telling obese people they need to "budget" by saying that CICO is the one and only solution? CICO is great if you want to lose a few pounds, and if an obese person sticks to it, they will lose weight. But while CICO is a great tool, followers of CICO as the one and only way frustrate me, as they turn weight loss into a moral struggle solely about willpower. To them, the only reason someone is fat is because they are weak willed and any desire for an "easy way" out through anything other than CICO is viewed as laziness. Yet, while most of these "easy ways" out are indeed fake, we do know that in several specific cases there is a root cause separate from willpower, such as thyroid disorders and PCOS. In these cases, it is not simply a matter of the affected person having less willpower, but rather that they need greater willpower to use CICO to overcome their obesity than their non-obese counterparts. Note that in these cases CICO does still work, but once you shift the perspective from "these people have less willpower" to "something is requiring these people to have greater willpower to do the same thing" then a new question immediately arises: "what is that something?" Considering we know such root causes are possible, is it so unreasonable that rather than 1/3 of the population having bad willpower, that instead they have some sort of invisible disorder that is the root cause? Before 1982, gastritis and peptic ulcers had unknown causes and were attributed to stress. These days, we understand there is a bacteria H Pylori that is the root cause that we can give antibiotics for and "magically" cure. My personal belief is that within 100 years we will find some sort of similar root cause for obesity and if we are lucky, we may similarly be able to find a "magic cure" for it too. Meanwhile, as someone who is obese and is working on it, I absolutely do recommend CICO as the best tool we currently have. But it's strikingly similar to trying to get a homeless person to budget in that there are likely other things that need to be fixed first, we just don't know what they are.
rzazueta 4y ago
Agreed - all of the things said below, plus: depression; less activity due to cars, sitting at desks all day, and other non-active activities; the absolute contant confusion about what foods are healthy and aren't; the complete confusion over what "food" actually is (Michael Pollan has done some great writing there). It's a combination of all of these - and many other - variables, which have different influences on different people. For every morbidly obese person dealing with all of the health, societal, and metal affects, I can just as easily find at least one unhealthy "healthy" person who obsesses WAY too much over this stuff. Both have eating disorders for pretty much the same reasons, but with different results. And there are more than enough folks who continue to take advantage of all of this confusion to make money at both ends who see no reason to stop it and prefer to prolong it. Who is there left to trust here?
- glandium 4y ago
  You forgot another one: portion sizes. Seriously, just focusing on this would help a lot IMO.
pengaru 4y ago
Based on personal observations I find it very hard to believe sugar consumption has decreased across the US population in the last 13 years. There's a near constant line out every Starbucks drive-thru I pass. Whenever I go in one to work while caffeinated, those definitely aren't unsweetened beverages being prepared for the masses. Supposedly the whole reason Starbucks espresso is so bitter is so it works well with their sweetened beverages, straight espresso drinkers are in the extreme minority.
- noasaservice 4y ago
  I was thinking similar, but I think its plastic contaminants and byproducts.
  - pengaru 4y ago
    They're not mutually exclusive. How fructose is metabolized is so well understood at this point it's clearly a major factor in obesity and diabetes. It's the primary cause of non-alcoholic fatty liver disease AIUI. And it hasn't been removed from the US diet. That's very unlikely to occur until corn subsidies go away. Even once that occurs it'll take awhile for such a huge industry to evolve away from such a mature supply chain. It strikes me as a problem resembling pivoting from fossil fuels. It won't happen quickly, and we haven't even started yet w/fructose. Which is why I don't think the graph at that twitter link above is even plausibly true. Furthermore there's massive business interest in convincing the public sugar isn't the problem, so don't bother stopping consuming it. That's what all the sugar addicts certainly want to hear anyways.
    - stjohnswarts 4y ago
      sugar isn't that much more expensive than corn syrup, so I don't think cancelling subsidies on it would make much difference at all as sugar could replace it 1:1 with very little overall increase in prices of food products.
      - pengaru 4y ago
batter 4y ago
Sugar decreased? I can't eat any US bakery just because it has enormous amount of sugar and gluten. Unbearable. If this is decreased... what was before?
chubot 4y ago
It's processed food! Thinking it's sugar, fat, or some other macro/micronutrient is reductionist "nutritionism". Food processing and industrial cooking is the culprit. It took me about 20 years to understand this. Michael Pollan wrote lucidly about it starting ~15 years ago, and he wrote about the marketing patterns that the food industry uses (to this day) to cast blame. And this is being made rigorous, e.g. by the NIH. Great article with history and science: How ultra-processed food took over your shopping basket (includes recent Brazilian public health policy, and the NIH study) https://www.theguardian.com/food/2020/feb/13/how-ultra-processed-food-took-over-your-shopping-basket-brazil-carlos-monteiro https://www.theguardian.com/food/2020/feb/13/how-ultra-proce... Previously: https://news.ycombinator.com/item?id=21071809 https://news.ycombinator.com/item?id=21071809 You can eat ANYTHING except processed food: traditional Asian, Italian, Mexican, Indian, etc. with the ingredients and recipes they used. Really! The problem is that this is quite difficult to get in many areas, because so much food is processed and enhanced to sell. For a rough picture, processed food was probably 5% of the American diet in 1940, and when I grew up in the 80's and 90's it was maybe 50%. But now it's more like 80%.
- wyager 4y ago
  > It's processed food! This doesn't mean anything. It's a floating signifier.
  - chubot 4y ago
    There is a group of scientists and policy makers making this rigorous. They are starting to use the label "ultra-processed food" which has a precise definition. https://pubmed.ncbi.nlm.nih.gov/30744710/ https://pubmed.ncbi.nlm.nih.gov/30744710/ Read this article for background on the Brazilian policy and the NIH studies: https://www.theguardian.com/food/2020/feb/13/how-ultra-processed-food-took-over-your-shopping-basket-brazil-carlos-monteiro https://www.theguardian.com/food/2020/feb/13/how-ultra-proce... And watch this video by Hall from the NIH, with a 2019 study: ILSI NA: Ultra-Processed Foods (Kevin Hall) https://www.youtube.com/watch?v=_im2zAuBmME https://www.youtube.com/watch?v=_im2zAuBmME (mentioned in the article) He is the one who is described as a physicist by training, and he thought a calorie is a calorie -- whether it's processed or not. That's the "reductionist hypothesis". He EASILY disproved it and changed his mind. The study controls for macro- and micro-nutrients and the only difference is PROCESSING. And his new question is to ask how can we make processed food HEALTHY ! Because it feeds a lot of people. So he's not the typical person who espouses a view against processing. Again read the guardian article for background. (Personally I will eat unprocessed foods until they answer that question.) Governments are finally paying attention because their population has been ravaged by processed food in the last ~70 years. Brazil and Mexico have big problems. It corresponds to when processed foods and industrial cooking took over. This is an extremely repeatable experiment -- again read Pollan. Historically, populations get the set of chronic conditions called "Western diet disease" (obesity, high blood pressure, cancer, etc.) when introduced to processed foods and industrial preparation/cooking.
raegis 4y ago
That graph is misleading. The 1980s level of sugar intake is already way, way higher than sugar intake of prior generations of humans. For example, if you eat 3 times as much sugar as prior generations, reducing the intake to only 2 times as much, which is still too high, means you still get diabetes and liver disease. I'm impressed that people are so easily fooled by this one.
lhl 4y ago
I'd agree that sugar isn't the only thing to blame - there's a lot more nuance, and increased sugar is only one of the many negative environmental/lifestyle changes affecting modern metabolic health (increased meal frequency, lower quality of sleep/circadian disruption, food processing and hyper-processing, and sure, hormone altering contaminants in the food and water supply all play a role. Also, speculatively an unprecedented increase in the consumption of PUFAs), but I think it's still worth noting some caveats to Guyunet's graph that you link to: * While sugar (sucrose from sugar beets and sugar cane) has decreased since 1980, this is largely because of a switch to non-sugar caloric sweeteners, initially HFCS, and a range of others (I've noticed agave being pretty popular in "health" foods for example - while it has a slightly lower GI, it's actually more calorically dense than sugar: https://www.sugar.org/wp-content/uploads/Sweeteners-in-Food_2.pdf https://www.sugar.org/wp-content/uploads/Sweeteners-in-Food_...). Note you can look at a graph of the intake data from the Sugar Association (a sugar industry site) that shows that total sweetener consumption remains quite high: https://www.sugar.org/diet/intake/ https://www.sugar.org/diet/intake/ (data is sourced from the USDA) * While these are aggregate/average numbers, and obesity in the US continues to grow https://www.cdc.gov/obesity/data/adult.html https://www.cdc.gov/obesity/data/adult.html (41.9% in 2017-2020 data) - a declining overall consumption may mask a divergence between a decrease in healthier and increase in unhealthier populations - it's hard to separate that out because the data isn't broken down between the USDA consumption vs NHANES health data populations. * A lot of the "sugar consumption is declining (or soda consumption is declining) so it can't be the problem" proclamations are also being masked by the aformentioned caloric sweetener replacement, and in the sugar sweetened beverage (SSB) replacement - less soda, but the same sugar consumption via sweetened teas or juices, sports drinks, etc. Here's the CCD data on SSB conumption, which remains grim: https://www.cdc.gov/nutrition/data-statistics/sugar-sweetened-beverages-intake.html https://www.cdc.gov/nutrition/data-statistics/sugar-sweetene... SSB consumption has quite robust evidence (including many RCTs) showing that they are particularly bad for metabolic health and consumption continues to increase globally (and has not decreased, but actually mildly increased in the US as well): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778490/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778490/ (Fig 1 and Fig 2) I don't track this space as closely now, but for anyone interested, a few interesting reads on some of the stuff I mentioned: Some recent RCTs: Hall, Kevin D., Alexis Ayuketah, Robert Brychta, Hongyi Cai, Thomas Cassimatis, Kong Y. Chen, Stephanie T. Chung, et al. “Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake.” Cell Metabolism 0, no. 0 (May 16, 2019). https://doi.org/10.1016/j.cmet.2019.05.008 https://doi.org/10.1016/j.cmet.2019.05.008. Schwarz, Jean-Marc, Susan M Noworolski, Ayca Erkin-Cakmak, Natalie J Korn, Michael J Wen, Viva W Tai, Grace M Jones, et al. “Effects of Dietary Fructose Restriction on Liver Fat, De Novo Lipogenesis, and Insulin Kinetics in Children with Obesity.” Gastroenterology 153, no. 3 (September 2017): 743–52. https://doi.org/10.1053/j.gastro.2017.05.043 https://doi.org/10.1053/j.gastro.2017.05.043. Donga, Esther, Marieke van Dijk, J. Gert van Dijk, Nienke R. Biermasz, Gert-Jan Lammers, Klaas W. van Kralingen, Eleonara P. M. Corssmit, and Johannes A. Romijn. “A Single Night of Partial Sleep Deprivation Induces Insulin Resistance in Multiple Metabolic Pathways in Healthy Subjects.” The Journal of Clinical Endocrinology and Metabolism 95, no. 6 (June 2010): 2963–68. https://doi.org/10.1210/jc.2009-2430 https://doi.org/10.1210/jc.2009-2430. Some interesting mechanistics: Izumida, Yoshihiko, Naoya Yahagi, Yoshinori Takeuchi, Makiko Nishi, Akito Shikama, Ayako Takarada, Yukari Masuda, et al. “Glycogen Shortage during Fasting Triggers Liver–Brain–Adipose Neurocircuitry to Facilitate Fat Utilization.” Nature Communications 4 (August 13, 2013). https://doi.org/10.1038/ncomms3316 https://doi.org/10.1038/ncomms3316. Moorsel, Dirk van, Jan Hansen, Bas Havekes, Frank A. J. L. Scheer, Johanna A. Jörgensen, Joris Hoeks, Vera B. Schrauwen-Hinderling, et al. “Demonstration of a Day-Night Rhythm in Human Skeletal Muscle Oxidative Capacity.” Molecular Metabolism 5, no. 8 (August 1, 2016): 635–45. https://doi.org/10.1016/j.molmet.2016.06.012 https://doi.org/10.1016/j.molmet.2016.06.012. Mouse model, but this team at UCR has been doing a series of studies over the years that's also very interesting: Deol, Poonamjot, Jane R. Evans, Joseph Dhahbi, Karthikeyani Chellappa, Diana S. Han, Stephen Spindler, and Frances M. Sladek. “Soybean Oil Is More Obesogenic and Diabetogenic than Coconut Oil and Fructose in Mouse: Potential Role for the Liver.” PLOS ONE 10, no. 7 (July 22, 2015): e0132672. https://doi.org/10.1371/journal.pone.0132672 https://doi.org/10.1371/journal.pone.0132672.
safety1st 4y ago
Why do people always make this debate so complicated? The average American consumes 24% more calories than they did in 1961. [1] The average American is also 24 pounds heavier than they were in 1960. [2] Sure there may be other contributing factors, but this is the simplest explanation based on our most fundamental nutrition science. People have eaten more calories every decade, and have gotten fatter every decade as a result. [1] https://www.businessinsider.com/american-calorie-intake-last-52-years-diet-food-eating-increase-science-2017-6 https://www.businessinsider.com/american-calorie-intake-last... [2] https://www.usnews.com/news/blogs/data-mine/2014/09/04/study-americans-24-pounds-fatter-than-in-1960 https://www.usnews.com/news/blogs/data-mine/2014/09/04/study...
- pmarreck 4y ago
  And yet willpower has not decreased in that time. So something about the food must have become more addictive or hunger-inducing.
  - safety1st 4y ago
    It could just have gotten more calorically dense. Nearly half of our increased caloric intake since 1961 is in the form of vegetable oils which are very calorically dense, and you might not even notice when you're eating them. Portion sizes are probably a factor. Anecdotally they're a lot bigger than they used to be. Calories are cheaper to produce and restaurants put bigger plates in front of their patrons because it's a competitive advantage to serve bigger meals. If I had to guess the big culprits are the increases in portion size and availability of cheap calories (corn syrup, oils, flours, etc.). You don't have to infer any major changes in individual behavior - people still finish what's on their plates, and still gravitate toward brightly colored boxes of junk in the supermarket (which are a higher % of shelf space than they used to be).
    - pmarreck 4y ago
      vegetable oils are a fat, and no one who only eats fats, gains any weight; in fact they lose weight, which is the whole principle behind Atkins and keto. The idea that people gain weight from fats, is thus false. if all you did was eat fat calories, you would lose a ton of weight, because ketone bodies cannot be stored inside fat cells, only glucose fructose, etc. can. If all you did was eat protein calories, then yes, you could gain weight via gluconeogenesis (conversion of protein to glucose, again for fat storage and energy needs), although it would probably take more calories than carb calories to do so (since conversion likely results in molecular and energy losses); there is no such biochemistry available for ketones from fat
pmarreck 4y ago
It's high glycemic index carbohydrates, full stop. They do not satiate hunger, they result in more hunger, they are intrinsically addictive (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1931610/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1931610/ for example; animal studies conveniently dodge "human willpower" accusations and demonstrate this nicely), and at the end of the day they result in the average person using their average motivations (i.e. not strenuously avoiding calories) to steadily gain weight. Watch the entire 3-part series on youtube, "Nature Wants Us To Be Fat"; Dr. Richard Johnson seems to know his stuff, he's accredited, and he cites plenty of research: https://www.youtube.com/watch?v=gAjC_BWMElk https://www.youtube.com/watch?v=gAjC_BWMElk It's a little dry but fascinating- this seems to be the intellectual crowd that might be receptive to "dry but fascinating"

by Lucent 4y ago

notshift 4y ago

Probably sugar consumption has gone down because people have replaced it with artificial sweeteners, which have similar metabolic effects in the body to what Lustig has attributed to sugar. It'd be nice to see a combined graph of sugar + artificial sweeteners.

stjohnswarts 4y ago
they do not have similar metabolic effects. Go look up studies on blood sugar levels of diet vs regular soda.

TEP_Kim_Il_Sung 4y ago

Starch. Sugar consumption may have decreased, but starch converts to sugar in our stomach acid, and with the Amylase in our saliva. Yup. The largest part of the food pyramid: Grains. Noodles, potatoes, porridge, bread... It's all sugar.

notshift 4y ago
Starch converts to glucose, which is processed VERY differently from table sugar, sucrose, or the type of sugar found in fruit, fructose. So, sugar is not all sugar. I believe Lustig has argued that the latter two are much worse than the former. I agree overeating of carbs is not good, but is the reason why America is so fat because we just magically eat more bread, noodles, and potatoes than comparable countries? Probably not.
pengaru 4y ago
You're conflating glucose and fructose. Fructose is the Lustig-argued toxic half of sugar that gets processed ~identically to ethanol by the liver.
stjohnswarts 4y ago
White bread literally has basically the same affect on blood sugar as an equal amount of sugar (by weight) as does processed (not whole wheat) pasta. It may be a bit delayed vs sugar's almost immediate absorption but the end result is quite on the same order.

joemelonyeah 4y ago

Processed foods, HFCS, fruit juices are also sugar

sydbarrett74 4y ago

Why can't it be both? Also, the consumption of sucrose in the developed world may or may not have appreciably decreased in the period since Lustig's lecture came out, but the pandemic and corresponding spike in inflation have forced many people to seek out cheaper sources of food. And what are those cheaper sources of food loaded with? Yep: sugar and salt.

300bps 4y ago

Now I’m just a person who has remained the same approximate weight for the past 3 decades so I don’t know anything about substantial weight loss or gain. But is it at all possible it’s just calories in calories out? I know it isn’t a sexy theory but it works like hell for me.

tobiasSoftware 4y ago
Calories in calories out (CICO) is the what, not the why. If you saw someone who spent $1000 on jewelry every month and didn't pay their electricity bills, would you tell them to learn to budget? Heck no, you'd tell them they need therapy to fix much deeper root causes. So why are we telling obese people they need to "budget" by saying that CICO is the one and only solution? CICO is great if you want to lose a few pounds, and if an obese person sticks to it, they will lose weight. But while CICO is a great tool, followers of CICO as the one and only way frustrate me, as they turn weight loss into a moral struggle solely about willpower. To them, the only reason someone is fat is because they are weak willed and any desire for an "easy way" out through anything other than CICO is viewed as laziness. Yet, while most of these "easy ways" out are indeed fake, we do know that in several specific cases there is a root cause separate from willpower, such as thyroid disorders and PCOS. In these cases, it is not simply a matter of the affected person having less willpower, but rather that they need greater willpower to use CICO to overcome their obesity than their non-obese counterparts. Note that in these cases CICO does still work, but once you shift the perspective from "these people have less willpower" to "something is requiring these people to have greater willpower to do the same thing" then a new question immediately arises: "what is that something?" Considering we know such root causes are possible, is it so unreasonable that rather than 1/3 of the population having bad willpower, that instead they have some sort of invisible disorder that is the root cause? Before 1982, gastritis and peptic ulcers had unknown causes and were attributed to stress. These days, we understand there is a bacteria H Pylori that is the root cause that we can give antibiotics for and "magically" cure. My personal belief is that within 100 years we will find some sort of similar root cause for obesity and if we are lucky, we may similarly be able to find a "magic cure" for it too. Meanwhile, as someone who is obese and is working on it, I absolutely do recommend CICO as the best tool we currently have. But it's strikingly similar to trying to get a homeless person to budget in that there are likely other things that need to be fixed first, we just don't know what they are.

rzazueta 4y ago

Agreed - all of the things said below, plus: depression; less activity due to cars, sitting at desks all day, and other non-active activities; the absolute contant confusion about what foods are healthy and aren't; the complete confusion over what "food" actually is (Michael Pollan has done some great writing there). It's a combination of all of these - and many other - variables, which have different influences on different people. For every morbidly obese person dealing with all of the health, societal, and metal affects, I can just as easily find at least one unhealthy "healthy" person who obsesses WAY too much over this stuff. Both have eating disorders for pretty much the same reasons, but with different results. And there are more than enough folks who continue to take advantage of all of this confusion to make money at both ends who see no reason to stop it and prefer to prolong it. Who is there left to trust here?

glandium 4y ago
You forgot another one: portion sizes. Seriously, just focusing on this would help a lot IMO.

pengaru 4y ago

Based on personal observations I find it very hard to believe sugar consumption has decreased across the US population in the last 13 years. There's a near constant line out every Starbucks drive-thru I pass. Whenever I go in one to work while caffeinated, those definitely aren't unsweetened beverages being prepared for the masses. Supposedly the whole reason Starbucks espresso is so bitter is so it works well with their sweetened beverages, straight espresso drinkers are in the extreme minority.

noasaservice 4y ago
I was thinking similar, but I think its plastic contaminants and byproducts.
- pengaru 4y ago
  They're not mutually exclusive. How fructose is metabolized is so well understood at this point it's clearly a major factor in obesity and diabetes. It's the primary cause of non-alcoholic fatty liver disease AIUI. And it hasn't been removed from the US diet. That's very unlikely to occur until corn subsidies go away. Even once that occurs it'll take awhile for such a huge industry to evolve away from such a mature supply chain. It strikes me as a problem resembling pivoting from fossil fuels. It won't happen quickly, and we haven't even started yet w/fructose. Which is why I don't think the graph at that twitter link above is even plausibly true. Furthermore there's massive business interest in convincing the public sugar isn't the problem, so don't bother stopping consuming it. That's what all the sugar addicts certainly want to hear anyways.
  - stjohnswarts 4y ago
    sugar isn't that much more expensive than corn syrup, so I don't think cancelling subsidies on it would make much difference at all as sugar could replace it 1:1 with very little overall increase in prices of food products.
    - pengaru 4y ago

batter 4y ago

Sugar decreased? I can't eat any US bakery just because it has enormous amount of sugar and gluten. Unbearable. If this is decreased... what was before?

chubot 4y ago

It's processed food! Thinking it's sugar, fat, or some other macro/micronutrient is reductionist "nutritionism". Food processing and industrial cooking is the culprit. It took me about 20 years to understand this. Michael Pollan wrote lucidly about it starting ~15 years ago, and he wrote about the marketing patterns that the food industry uses (to this day) to cast blame. And this is being made rigorous, e.g. by the NIH. Great article with history and science: How ultra-processed food took over your shopping basket (includes recent Brazilian public health policy, and the NIH study) https://www.theguardian.com/food/2020/feb/13/how-ultra-processed-food-took-over-your-shopping-basket-brazil-carlos-monteiro https://www.theguardian.com/food/2020/feb/13/how-ultra-proce... Previously: https://news.ycombinator.com/item?id=21071809 https://news.ycombinator.com/item?id=21071809 You can eat ANYTHING except processed food: traditional Asian, Italian, Mexican, Indian, etc. with the ingredients and recipes they used. Really! The problem is that this is quite difficult to get in many areas, because so much food is processed and enhanced to sell. For a rough picture, processed food was probably 5% of the American diet in 1940, and when I grew up in the 80's and 90's it was maybe 50%. But now it's more like 80%.

wyager 4y ago
> It's processed food! This doesn't mean anything. It's a floating signifier.
- chubot 4y ago
  There is a group of scientists and policy makers making this rigorous. They are starting to use the label "ultra-processed food" which has a precise definition. https://pubmed.ncbi.nlm.nih.gov/30744710/ https://pubmed.ncbi.nlm.nih.gov/30744710/ Read this article for background on the Brazilian policy and the NIH studies: https://www.theguardian.com/food/2020/feb/13/how-ultra-processed-food-took-over-your-shopping-basket-brazil-carlos-monteiro https://www.theguardian.com/food/2020/feb/13/how-ultra-proce... And watch this video by Hall from the NIH, with a 2019 study: ILSI NA: Ultra-Processed Foods (Kevin Hall) https://www.youtube.com/watch?v=_im2zAuBmME https://www.youtube.com/watch?v=_im2zAuBmME (mentioned in the article) He is the one who is described as a physicist by training, and he thought a calorie is a calorie -- whether it's processed or not. That's the "reductionist hypothesis". He EASILY disproved it and changed his mind. The study controls for macro- and micro-nutrients and the only difference is PROCESSING. And his new question is to ask how can we make processed food HEALTHY ! Because it feeds a lot of people. So he's not the typical person who espouses a view against processing. Again read the guardian article for background. (Personally I will eat unprocessed foods until they answer that question.) Governments are finally paying attention because their population has been ravaged by processed food in the last ~70 years. Brazil and Mexico have big problems. It corresponds to when processed foods and industrial cooking took over. This is an extremely repeatable experiment -- again read Pollan. Historically, populations get the set of chronic conditions called "Western diet disease" (obesity, high blood pressure, cancer, etc.) when introduced to processed foods and industrial preparation/cooking.

raegis 4y ago

That graph is misleading. The 1980s level of sugar intake is already way, way higher than sugar intake of prior generations of humans. For example, if you eat 3 times as much sugar as prior generations, reducing the intake to only 2 times as much, which is still too high, means you still get diabetes and liver disease. I'm impressed that people are so easily fooled by this one.

lhl 4y ago

I'd agree that sugar isn't the only thing to blame - there's a lot more nuance, and increased sugar is only one of the many negative environmental/lifestyle changes affecting modern metabolic health (increased meal frequency, lower quality of sleep/circadian disruption, food processing and hyper-processing, and sure, hormone altering contaminants in the food and water supply all play a role. Also, speculatively an unprecedented increase in the consumption of PUFAs), but I think it's still worth noting some caveats to Guyunet's graph that you link to: * While sugar (sucrose from sugar beets and sugar cane) has decreased since 1980, this is largely because of a switch to non-sugar caloric sweeteners, initially HFCS, and a range of others (I've noticed agave being pretty popular in "health" foods for example - while it has a slightly lower GI, it's actually more calorically dense than sugar: https://www.sugar.org/wp-content/uploads/Sweeteners-in-Food_2.pdf https://www.sugar.org/wp-content/uploads/Sweeteners-in-Food_...). Note you can look at a graph of the intake data from the Sugar Association (a sugar industry site) that shows that total sweetener consumption remains quite high: https://www.sugar.org/diet/intake/ https://www.sugar.org/diet/intake/ (data is sourced from the USDA) * While these are aggregate/average numbers, and obesity in the US continues to grow https://www.cdc.gov/obesity/data/adult.html https://www.cdc.gov/obesity/data/adult.html (41.9% in 2017-2020 data) - a declining overall consumption may mask a divergence between a decrease in healthier and increase in unhealthier populations - it's hard to separate that out because the data isn't broken down between the USDA consumption vs NHANES health data populations. * A lot of the "sugar consumption is declining (or soda consumption is declining) so it can't be the problem" proclamations are also being masked by the aformentioned caloric sweetener replacement, and in the sugar sweetened beverage (SSB) replacement - less soda, but the same sugar consumption via sweetened teas or juices, sports drinks, etc. Here's the CCD data on SSB conumption, which remains grim: https://www.cdc.gov/nutrition/data-statistics/sugar-sweetened-beverages-intake.html https://www.cdc.gov/nutrition/data-statistics/sugar-sweetene... SSB consumption has quite robust evidence (including many RCTs) showing that they are particularly bad for metabolic health and consumption continues to increase globally (and has not decreased, but actually mildly increased in the US as well): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778490/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778490/ (Fig 1 and Fig 2) I don't track this space as closely now, but for anyone interested, a few interesting reads on some of the stuff I mentioned: Some recent RCTs: Hall, Kevin D., Alexis Ayuketah, Robert Brychta, Hongyi Cai, Thomas Cassimatis, Kong Y. Chen, Stephanie T. Chung, et al. “Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake.” Cell Metabolism 0, no. 0 (May 16, 2019). https://doi.org/10.1016/j.cmet.2019.05.008 https://doi.org/10.1016/j.cmet.2019.05.008. Schwarz, Jean-Marc, Susan M Noworolski, Ayca Erkin-Cakmak, Natalie J Korn, Michael J Wen, Viva W Tai, Grace M Jones, et al. “Effects of Dietary Fructose Restriction on Liver Fat, De Novo Lipogenesis, and Insulin Kinetics in Children with Obesity.” Gastroenterology 153, no. 3 (September 2017): 743–52. https://doi.org/10.1053/j.gastro.2017.05.043 https://doi.org/10.1053/j.gastro.2017.05.043. Donga, Esther, Marieke van Dijk, J. Gert van Dijk, Nienke R. Biermasz, Gert-Jan Lammers, Klaas W. van Kralingen, Eleonara P. M. Corssmit, and Johannes A. Romijn. “A Single Night of Partial Sleep Deprivation Induces Insulin Resistance in Multiple Metabolic Pathways in Healthy Subjects.” The Journal of Clinical Endocrinology and Metabolism 95, no. 6 (June 2010): 2963–68. https://doi.org/10.1210/jc.2009-2430 https://doi.org/10.1210/jc.2009-2430. Some interesting mechanistics: Izumida, Yoshihiko, Naoya Yahagi, Yoshinori Takeuchi, Makiko Nishi, Akito Shikama, Ayako Takarada, Yukari Masuda, et al. “Glycogen Shortage during Fasting Triggers Liver–Brain–Adipose Neurocircuitry to Facilitate Fat Utilization.” Nature Communications 4 (August 13, 2013). https://doi.org/10.1038/ncomms3316 https://doi.org/10.1038/ncomms3316. Moorsel, Dirk van, Jan Hansen, Bas Havekes, Frank A. J. L. Scheer, Johanna A. Jörgensen, Joris Hoeks, Vera B. Schrauwen-Hinderling, et al. “Demonstration of a Day-Night Rhythm in Human Skeletal Muscle Oxidative Capacity.” Molecular Metabolism 5, no. 8 (August 1, 2016): 635–45. https://doi.org/10.1016/j.molmet.2016.06.012 https://doi.org/10.1016/j.molmet.2016.06.012. Mouse model, but this team at UCR has been doing a series of studies over the years that's also very interesting: Deol, Poonamjot, Jane R. Evans, Joseph Dhahbi, Karthikeyani Chellappa, Diana S. Han, Stephen Spindler, and Frances M. Sladek. “Soybean Oil Is More Obesogenic and Diabetogenic than Coconut Oil and Fructose in Mouse: Potential Role for the Liver.” PLOS ONE 10, no. 7 (July 22, 2015): e0132672. https://doi.org/10.1371/journal.pone.0132672 https://doi.org/10.1371/journal.pone.0132672.

safety1st 4y ago

Why do people always make this debate so complicated? The average American consumes 24% more calories than they did in 1961. [1] The average American is also 24 pounds heavier than they were in 1960. [2] Sure there may be other contributing factors, but this is the simplest explanation based on our most fundamental nutrition science. People have eaten more calories every decade, and have gotten fatter every decade as a result. [1] https://www.businessinsider.com/american-calorie-intake-last-52-years-diet-food-eating-increase-science-2017-6 https://www.businessinsider.com/american-calorie-intake-last... [2] https://www.usnews.com/news/blogs/data-mine/2014/09/04/study-americans-24-pounds-fatter-than-in-1960 https://www.usnews.com/news/blogs/data-mine/2014/09/04/study...

pmarreck 4y ago
And yet willpower has not decreased in that time. So something about the food must have become more addictive or hunger-inducing.
- safety1st 4y ago
  It could just have gotten more calorically dense. Nearly half of our increased caloric intake since 1961 is in the form of vegetable oils which are very calorically dense, and you might not even notice when you're eating them. Portion sizes are probably a factor. Anecdotally they're a lot bigger than they used to be. Calories are cheaper to produce and restaurants put bigger plates in front of their patrons because it's a competitive advantage to serve bigger meals. If I had to guess the big culprits are the increases in portion size and availability of cheap calories (corn syrup, oils, flours, etc.). You don't have to infer any major changes in individual behavior - people still finish what's on their plates, and still gravitate toward brightly colored boxes of junk in the supermarket (which are a higher % of shelf space than they used to be).
  - pmarreck 4y ago
    vegetable oils are a fat, and no one who only eats fats, gains any weight; in fact they lose weight, which is the whole principle behind Atkins and keto. The idea that people gain weight from fats, is thus false. if all you did was eat fat calories, you would lose a ton of weight, because ketone bodies cannot be stored inside fat cells, only glucose fructose, etc. can. If all you did was eat protein calories, then yes, you could gain weight via gluconeogenesis (conversion of protein to glucose, again for fat storage and energy needs), although it would probably take more calories than carb calories to do so (since conversion likely results in molecular and energy losses); there is no such biochemistry available for ketones from fat

pmarreck 4y ago

It's high glycemic index carbohydrates, full stop. They do not satiate hunger, they result in more hunger, they are intrinsically addictive (see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1931610/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1931610/ for example; animal studies conveniently dodge "human willpower" accusations and demonstrate this nicely), and at the end of the day they result in the average person using their average motivations (i.e. not strenuously avoiding calories) to steadily gain weight. Watch the entire 3-part series on youtube, "Nature Wants Us To Be Fat"; Dr. Richard Johnson seems to know his stuff, he's accredited, and he cites plenty of research: https://www.youtube.com/watch?v=gAjC_BWMElk https://www.youtube.com/watch?v=gAjC_BWMElk It's a little dry but fascinating- this seems to be the intellectual crowd that might be receptive to "dry but fascinating"