15 ms·

It’s the Sugar, Folks

175 points by joecurry 14y ago

3am 14y ago
They had better change the messaging. I'm in favor of common-sense regulation of mass-production food ingredients, and "sugar is toxic" even rubs me the wrong way.
- kansface 14y ago
  We need to tax sugar like we tax tobacco for the same reasons. It will decrease consumption. Those taxes will pay for the medical expenses of people with diabetes.
  - dangrossman 14y ago
    An apple a day is the doctor's pay?
  - TDL 14y ago
    So we should be taxing fruits then, right?
    - themgt 14y ago
      No, it would be worth your time to read/listen to Robert Lustig. He explains how and why consuming natural sources like fruit where fructose is encased in digestion-slowing cellulose is normally fine, while extracting the fructose and adding it to other products like soda (and huge amounts of American processed foods) leads to toxicity and liver and metabolic damage. You can make jokes, but cutting excess fructose from American diets would probably be the #1 easiest thing to do for millions of people to live longer, healthier lives. And Bittman is correct that the FDA should get involved. It's actually difficult to buy "Healthy, Good for You™!" yogurt in an American supermarket that doesn't contain toxic amounts of added fructose - that is just crazy.
      - TDL 14y ago
        Educate then, don't attempt to socially engineer. Smoking was reduced through education, not taxation. The more people understood the long term consequences of smoking the less people smoked. I share the views of those who are not fans of processed sugars or fructose, but I am entirely opposed to social engineering.
        gnaritas 14y ago
        > Educate then, don't attempt to socially engineer. Education is social engineering.
        TDL 14y ago
        Nonsense. Social engineering is using the force of the state to modify behaviors. You can say forced education is social engineering, but the act of educating or learning is not social engineering.
        gnaritas 14y ago
        > Social engineering is using the force of the state to modify behaviors. You may think that, but that isn't what it means. Look it up Wikipedia: Social engineering is a discipline in social science that refers to efforts to influence popular attitudes and social behaviors on a large scale, whether by governments or private groups. Google: The application of sociological principles to specific social problems. Dictionary.com: the application of the findings of social science to the solution of actual social problems. So whatever you're talking about, social engineering isn't the phrase you're looking for.
        TDL 14y ago
        In the political sense I am using the term appropriately. You want to get into semantic debate and I am not really interested.
        14y ago
    - roc 14y ago
      Is there a societal problem of people having massive fruit intake? It seems both logical and effective to just worry about the 'added' sugars in processed foods.
  - deelowe 14y ago
    When is this going to stop? Endless government regulation is not the solution to everything. Look, there's a huge health movement going on in the country right now. Just like there was an anti-smoking movement starting up before the government ever got involved with that. The people who fund this crap aren't looking to do good, they just want more tax revenue (or more grant dollars from those who want more tax revenue). That's what they've always wanted. Don't believe me? Restaurants are now voluntarily adding calorie numbers to menus, because the lower calorie stuff is higher margin and people buy it. Vitamin water, coke zero, pepsi one/0, izze, baked chips, etc... etc... etc.. take up much more room in the grocery stores than they used to. Trader joes and whole foods are massive businesses now and threatening the big boys like kroger. I'm not saying obesity isn't a problem, but I do think we'll see the trend start changing for the better soon. There's no need for regulation. The public will shift on it's own. All we need is better education. Almost everyone I know(in my age group and younger) eat much more healthily than their parents do/did simply because they are better informed. Contrary to popular belief, people do make rational decisions when it comes to eating (excluding socioeconomic factors).
    - __david__ 14y ago
      > Don't believe me? Restaurants are now voluntarily adding calorie numbers to menus, because the lower calorie stuff is higher margin and people buy it. Actually, if you are in California then it's more likely because of a 2009 law[1]: "Putting our heads in the gastronomic sand became a bit harder starting July 1, 2009, when a new law went into effect making California the first state to mandate that chain restaurants--those with 20 or more locations--provide a calorie count for everything on the menu." [1] http://www.examiner.com/article/calorie-count-california-restaurant-law-urges-restraint http://www.examiner.com/article/calorie-count-california-res...
      - breckinloggins 14y ago
        I moved from Texas to California and I can confirm that, while there does seem to be a trend toward more and more restaurants voluntarily including this information, you don't really SEE it until you cross the border into California. This is an example of a business regulation that has had a directly positive impact on my daily food choices... I find that I automatically choose lower calorie foods just because the calorie numbers guilt me into doing so. In fact, this one thing led to a general softening of my hard-core libertarian "no regulations ever let the market decide" stance of the past.
  - jlgreco 14y ago
    Would taxes on sugary things actually decrease consumption? I doubt you would actually be able to tax a 50 cent drink enough to make anyone reconsider purchasing it, particularly considering people will pay up to several dollars for that same beverage in other contexts. Nobody is going to be doing the "can I afford this, with the tax price included" calculus with things that cheap. (The fact that we seem to always display prices pre-tax only aggravates this)
    - anigbrowl 14y ago
      (The fact that we seem to always display prices pre-tax only aggravates this) I find this practice of American retailers incredibly pernicious. I really think displayed prices should be out-the-door on everything - you can still put the tax data on the receipt. When I moved to the US from Europe, I found it very difficult to manage my grocery bill for the first year or so until I got used to adding 8% to everything.
  - eli_gottlieb 14y ago
    No, we need to stop subsidizing sugar and flour production. I'm visiting the US after living elsewhere, and the #1 thing I notice about the meals is how carbo-loaded and sugar-loaded they are -- including most people's home cooking! Not to say I don't enjoy some of the sugar-loading, but the carbo-loading is just annoying. When I help friends make a vegetable stir-fry with noodles, I don't want a bowl that's 75% rice noodles. I don't want to feel hungry again 3 hours later despite eating a large meal, because the large meal had little in it other than kilocalories from simple carbohydrates. I want the kind of veg-and-protein filled meals I've gotten more used to, in which I can measure sugar levels by whether something tastes sweet and I feel full all day/evening because most of the meal's content was "thick" stuff like vegetables, legumes, eggs, meat, cheese, olive oil and/or fish rather than "thin" foods like milk or sauce, or "very thin" foods like bread, pasta, or rice.
- josefresco 14y ago
  Agreed. Using the same logic, they could wage the same campaign against water.
  - themgt 14y ago
    Because your chance of diabetes goes up 1.1% for every glass of water you drink?
    - mpyne 14y ago
      Consumption of dihydrogen monoxide correlates perfectly with onset of diabetes. In fact there is not one single person who has developed diabetes who hasn't ingested DHMO at some point in their life.
      - sophacles 14y ago
        Nope, its actually a correlation of 0. All the people who didn't get diabetes had the same DHMO consumption. If you want to be snarky, do try to at least make sense.
        mpyne 14y ago
        No, the R^2 is 1.0 between (dhmo-exposure,got-diabetes). You're talking about (dhmo-exposure,!got-diabetes) which turns out to also have a 1.0 correlation, which was kind of the point of my snark in the first place. Those who don't understand even the basics of correlation are doomed to be led astray by statistics. The authors of the paper in question seem to understand it just fine, it would be nice if we could expect even minimal statistic comprehension from those making follow-on claims using the paper as supporting evidence.
        gamblor956 14y ago
        No, your snark fails because you picked the wrong variables. Got Diabetes necessarily implies a population of Did Not Get Diabetes, so the r^2 would not be 1.0. On the other hand, the r^2 between Have Diabetes and Water Exposure would be 1.0.
- stretchwithme 14y ago
  Yes, its an indiscriminate expression. Sort of like saying metal can kill you when its actually bullets. Its isolating fructose from its natural packaging that is the problem. Metabolizing large amounts of it must be done by the liver and it has side effects. The other half of table sugar is glucose and it is handled by releasing insulin. Insulin releases leptin as a side effect, which makes you feel satisfied. Starches break down into glucose. And glucose can be used by every cell in the body. Lustig's video on this goes through all the biochemistry.
awolf 14y ago
>In other words, according to this study, obesity doesn’t cause diabetes: sugar does. Sigh. No, according to this study, there is a stronger correlation between sugar and diabetes than between obesity and diabetes. >Each 150 kilocalories/person/day increase in total calorie availability related to a 0.1 percent rise in diabetes prevalence (not significant), whereas a 150 kilocalories/person/day rise in sugar availability (one 12-ounce can of soft drink) was associated with a 1.1 percent rise in diabetes prevalence. Much better! Lead with that next time, medical research reporter. All in all, this seems like a pretty good study that controls for a lot of confounding variables that a lot of diet related studies completely neglect. I just wish the reporting here, and in general in all medical research reporting, wasn't so sloppy. The goal should be to spread awareness of new findings, not to spread misconceptions.
- JPKab 14y ago
  "The study controlled for poverty, urbanization, aging, obesity and physical activity. It controlled for other foods and total calories. In short, it controlled for everything controllable, and it satisfied the longstanding “Bradford Hill” criteria for what’s called medical inference of causation by linking dose (the more sugar that’s available, the more occurrences of diabetes); duration (if sugar is available longer, the prevalence of diabetes increases); directionality (not only does diabetes increase with more sugar, it decreases with less sugar); and precedence (diabetics don’t start consuming more sugar; people who consume more sugar are more likely to become diabetics)." As far as observational studies, (of which I am a huge skeptic), this one is pretty well controlled for. It's not like they studied 7 nations, or 11 nations. They studied 175 nations. That allows for a whole lot of controllability for various factors.
  - snowwrestler 14y ago
    Not on that list: family history/genetics. I believe that has already been identified as a significant risk factor for diabetes. So it's not just the sugar.
    - marcosdumay 14y ago
sukuriant 14y ago
I'm sitting here, dumbfounded, in a mix of response between "no shit" and "this isn't something that needs to be regulated".
deleted 14y ago
[deleted]
- deleted 14y ago
  [deleted]
- deleted 14y ago
  [deleted]
mbreese 14y ago
This is ridiculous. Sugars are fundamental bio-molecules and are essential for life. Yes, we know that over-eating causes diabetes and obesity. And this study says that foods high in sugar pose the greatest threat. But seriously, are we going to start to say that sugar is toxic in the same way that cigarettes are toxic? We can manage the dangers of sugar toxicity pretty easily by exercising. The damage done by smoking... not so much. This reminds me of a pet peeve that my grad advisor had. In our area it was common to see signs that said something to the effect of "No dumping of chemicals". He loved to point out that water was a chemical.
- sophacles 14y ago
  Actually yeah, just like a cigarette here and there is not the same in effect as smoking a pack a day, some fructose and other sugars here and there are probably not going to hurt you, but there are noticeable long term effects of constantly having too much sugar. Further comparison: sugars and nicotine both trigger dopamine cycles that can turn into mental dependence on higher doses, feeding the negative affects even more. Finally, I can't wait to see all the backpedalling from food companies about how the healthy staple foods they load up with sugar (e.g. whole wheat bread) are actually and 'obviously' just meant to be treats. 'the added sugar should be a give away, its right there in the small print on the back of the label, under the "this is super healthy" label'.
  - barney54 14y ago
    The backpedalling needs to come from the federal government. After all, they have been promoting the idea of the food pyramid and "a calorie is a calorie" for decades. The food companies are definitely influenced by what the federal government says is healthy and what they convince people is healthy.
- awolf 14y ago
  I agree with your general sentiment, but one thing you said bears correction: >We can manage the dangers of sugar toxicity pretty easily by exercising. No, not really. Our bodies run on glucose yet our diets are rife with fructose which must be converted by our livers into a usable form. The metabolic pathway responsible for this conversion is a bottleneck and has nothing to do with how much exercise we get.
Uhhrrr 14y ago
Two comments from the article that I liked: As the principal author of this study, I wanted to clarify some of its details for scientifically-minded readers, in order to avoid misinterpretations: http://epianalysis.wordpress.com/2013/02/27/sugardiabetes/ http://epianalysis.wordpress.com/2013/02/27/sugardiabetes/ ----- The opening line ("Sugar is indeed toxic.") is distorted and inane. Sugars are not toxic, as evidenced by our evolution of taste buds that respond so positively to them. Sugars are a dense source of energy, which is why our metabolic systems cherish them. Let's leave such excessive, unsubstantiated commentary to The Onion or Mad Magazine, and just apply common sense to our diets.
- base698 14y ago
  Dr. Lustig does indeed claim sugar is toxic in the same since that alcohol is toxic. He goes through the complete cycle of metabolizing 1 molecule of sucrose (1 half glucose linked to 1 half fructose). The fructose metabolism is the problematic part, which was hard to follow for me, and I have an undergrad degree in Biochemistry and graduated with a 4.0. Here is the original talk: http://www.youtube.com/watch?v=dBnniua6-oM http://www.youtube.com/watch?v=dBnniua6-oM JPKab below has a good high level overview.
- ceejayoz 14y ago
  As with sugar, most toxins are only toxic at a certain level of intake.
  - sliverstorm 14y ago
    If you are talking about toxicity, this is a useless observation. Everything is toxic at certain levels. Did you know that there is an LD50 for water?
- Nathanael47 14y ago
  It's a problem of translation between the chemistry definition of toxic (it will kill you in short order) and the common definition (poisonous, noxious). Bittman was using the latter, with an understanding that the dose makes the poison.
tptacek 14y ago
Wouldn't it be better for us to link directly to the study, rather than to Bittman's editorial about it? I find the study harmonizes nicely with my view of the world, and I'm even ok with Bittman, but he's not a subject matter expert at all. He's the NYT's former food writer who recently decided to write more about food policy.
tocomment 14y ago
Is there something special about sugar compared to other carbs? If I had to choose between eating bread or cake for the same calories will cake hurt me more?
- ashmud 14y ago
  If the bread is a typical "pedestrian" loaf, there's probably little difference. There is a bigger difference if it's something like Ezekial sprouted grain bread.
- frankus 14y ago
  The difference is that table sugar and high fructose corn syrup are about 50% fructose (the rest glucose). While glucose (which is what bread is mostly metabolized into) can be used by every cell in the body, fructose must be broken down by the liver using a metabolic pathway similar to that used by alcohol. There is a hypothesis that once a person's metabolism has been damaged by enough fructose, that any carbohydrate is likely to cause obesity. Basically, that insulin resistance seems to affect fat cell last and once it sets it glucose will be preferentially absorbed by fat cells. So people with a well-functioning insulin response should be able to eat relatively large amounts of (non-fructose-containing) carbohydrates without issue, but those in whom the insulin response is damaged (probably a majority of Americans over age 25) might need to cut back on all carbohydrates to stay lean. But again, this is very much an untested hypothesis.
tocomment 14y ago
What do they mean by sugar "availability" in the study? How is that measured, by the price in a given country, imports?
- scottjad 14y ago
  I wondered the same thing. For the most important variable in their study they sure don't explain it very well. I looked all over FAOSTAT but couldn't find an explanation. http://faostat3.fao.org/home/index.html#METADATA http://faostat3.fao.org/home/index.html#METADATA
- mamoswined 14y ago
  I was going to publish a comment on the study about that- my background is in agricultural economics so I'm very familiar with the database they used. I am curious to know which FAOstat data they used. Was it Sugar, Raw Equivalent or Sugar, Refined Equivalent? Either way, the FAO data is calculated based on production + imports - exports. They admit in the paper itself that this is not a perfect proxy ("It is thought that much of the FAO data on foods and nutrients in the food supply have limits to their reliability") for consumption so it is alarming, but predictable to see this being termed as such by the media. I don't know if it's the best series of data to use for this. I would have used a much longer series if possible because to be honest the past ten years have not seen a dramatic change in sugar consumption, but I guess their diabetes prevalence dataset only spanned that long. But that brings up the question of the lag for developing diabetes itself, it's not like 50 extra calories. I also couldn't find if they threw out countries with weird or obviously low quality data. Israel's data, for example, is a bit strange. It goes from around 500 kcal/capita/day sugar to 230. I find it hard to believe that consumption habits changed so drastically there. They also do not discuss much about why they, as non-economists, chose to use econometric rather than epidemiology or biostat methods. I also hate that their final graph is totally unlabeled and there is no option to download a format that would allow one to see which dots correspond to which country. It would be wise for some of the alarmists on this thread to read the paper and this sentence in particular " Hence, any of the findings we observe here are meant to be exploratory in nature, helping us to detect broad population patterns that deserve further testing through prospective longitudinal cohort studies in international settings, which are only now coming underway."
iaskwhy 14y ago
Is aspartame a good alternative?
- vixen99 14y ago
  No it isn't. If you're going to use it or products containing it, I strongly suggest you research this subject for yourself since this is not the place to argue the toss. When you do so, as ever, look to the money.
  - jff 14y ago
    Big Sweetener.
  - mynameishere 14y ago
    look to the money What is that supposed to mean? Coke (et al) probably make more money per volume on the diet drinks. So now that we've looked at the money, so what? As for health, you've got conspiracy nuts on one side, and a clear link with obesity, diabetes, and tooth decay on the other.
    - marcosdumay 14y ago
      > What is that supposed to mean? It means that, when you read a study, also read the name of the entity financing it.
      - mynameishere 14y ago
        What study are you referring to? http://en.wikipedia.org/wiki/Aspartame_controversy http://en.wikipedia.org/wiki/Aspartame_controversy Aspartame has been deemed safe for human consumption by over 100 regulatory agencies in their respective countries ...are they all financed (corrupted) by your unidentified bogeyman?
- derleth 14y ago
  Yes, it is. http://web.archive.org/web/20070102024642/http://www.fda.gov/fdac/features/1999/699_sugar.html http://web.archive.org/web/20070102024642/http://www.fda.gov... > FDA calls aspartame, sold under trade names such as NutraSweet and Equal, one of the most thoroughly tested and studied food additives the agency has ever approved. The agency says the more than 100 toxicological and clinical studies it has reviewed confirm that aspartame is safe for the general population.
Semaphor 14y ago
Every time I see an article related to Medicine on HN it seems a high amount of people comment without reading or at least comprehending the article. It's pretty and remind me of the negative parts of Reddit.
bcoates 14y ago
There's an interesting idea in this article: ... and ideally removing fructose (the “sweet” molecule in sugar that causes the damage) from the “generally recognized as safe” list, because that’s what gives the industry license to contaminate our food supply. Ignoring the loaded language, does anyone know what the consequences of removing fructose from the GRAS list would be?
- lnanek2 14y ago
  Industry would find the next cheapest alternative to making the food sweet.
- derleth 14y ago
  If fructose is removed from the GRAS list, that would imply fruits are no longer considered safe to eat.
  - bcoates 14y ago
    Does not being GRAS imply a duty to test edible plants for containing something? That seems difficult. Of course, it wouldn't be the first crazy regulation...
Pkeod 14y ago
There is no mention of it in this thread so far, so here: http://reddit.com/r/keto http://reddit.com/r/keto Check the sidebar out. See the transformations which happen to people when they (mostly) give up consuming sugars: http://www.reddit.com/r/keto/search?q=progress&sort=top&restrict_sr=on http://www.reddit.com/r/keto/search?q=progress&sort=top&...
- drivers99 14y ago
  Keto cuts out carbs including those that are converted to just glucose, not just sugar (which is 50% fructose). It's not the same thing at all.
  - Pkeod 14y ago
    Uh, sorry, what exactly did I say? I said mostly giving up sugars, which is why I mentioned keto.
pdeuchler 14y ago
A NYT Editor's Pick Comment: """ I'm glad the smoking gun has been found. High fructose corn syrup is in virtually everything people buy to eat. It needs to go. Enough people's lives have been ruined. The design and engineering of prepared foods people commonly buy is toxic and addictive. Now we need to re-educate people and make sure long-held views are erased. People have long blamed gluttony for obesity and obesity for diabetes. We now know it isn't true and that the super-sugars we are being force-fed are the culprit. We must all, together, demand that processed sugars such as high-fructose corn syrup be banned or, at the very least, severely restricted. I don't use the words force-fed lightly. Those among us who are on food stamps or a limited income have no choice but to buy the cheapest foods. Those are the ones that most commonly have the highest amount of sugars added. Anyone with a busy lifestyle eats out a lot. Fast foods, including the ones that claim to be "better," are laced with sugars, sodium, and fat. We must demand policies that protect us from harm and the greed-driven irresponsible practices of Big Food. Thank you, Mr. Bittman, for keeping us informed. """ So is "Big Food" the new scapegoat? I guess the next article we'll see a comment proclaiming how "Big Grocery" prices unhealthy foods too low, so now it's their fault. This is a great study, and it's results are extremely interesting, but this article, and the inferences people are getting from it border on witch trials. The article does a great job of doing everything but coming out and saying what the commenter does "They're force feeding us toxins!". There is such a clear departure from responsibility in today's culture it's almost astonishing. The blame lies 100% with nobody, but the individual has just as much a part to play as those producing the food. Edit: Does anyone notice the language used in the comment? "Force-fed", "re-educate", "We must all, together", "Enough people's lives have been ruined". It sounds almost like something from 1984. Also, look how easily the commenter provides inclusion to victimhood... anyone "with a busy lifestyle", or those who "are on food stamps or a limited income". Limited income is pretty broad. It's interesting also, how they "have no choice but to buy the cheapest foods".
- Strang 14y ago
  > next article we'll see a comment proclaiming how "Big Grocery" prices unhealthy foods too low, so now it's their fault. And here it comes: http://www.washingtonpost.com/wp-dyn/content/article/2011/01/20/AR2011012001581.html http://www.washingtonpost.com/wp-dyn/content/article/2011/01... This is a backhanded attack on "Big Grocery." Wal-Mart is being "responsible" with an initiative "to offer more healthful foods and push its suppliers to do the same." Of course, Wal-Mart's competitors can't afford to manhandle their suppliers at the same scale.
deleted 14y ago
[deleted]
- deleted 14y ago
  [deleted]
ImprovedSilence 14y ago
>>> The next steps are obvious, logical, clear and up to the Food and Drug Administration. To fulfill its mission, the agency must respond to this information by re-evaluating the toxicity of sugar, arriving at a daily value — how much added sugar is safe? — and ideally removing fructose (the “sweet” molecule in sugar that causes the damage) from the “generally recognized as safe” list, because that’s what gives the industry license to contaminate our food supply." Oh fer cryin out loud, just try to educate people a little better on how to MODERATE intake of everything, don't go overboard here and try to get a ban on sugar.... What is this world coming to when everybody expects some bigger force to make all the decisions for them and keep them safe. Learn how to think for yourselves and take some vested interest in you actions and decisions. Gotta strike a balance between natural selection and idiotracy I suppose...
- anigbrowl 14y ago
  I don't want a bigger force to make the decisions for me, but I am quite happy to delegate some of my authority to the government and have it act on my behalf by requiring more accurate labeling and so forth. I eat a very healthy diet, but I don't have the time or inclination to keep up with every last additive and food manufacturing process out there. In fact, I'm happy to pay some of my taxes so other people can study that as their full-time job.
  - thatswrong0 14y ago
    There's a huge difference between banning sugar and regulating labeling. Even Libertarian candidate Gary Johnson supports food labeling (though purists might be opposed to that).
    - anigbrowl 14y ago
      Nobody's proposing a ban on sugar.
Nux 14y ago
I think many people know by know sugar is "toxic" and is responsible for pandemic obesity, type 2 diabetes and 99% of the dental mafia, erm... industry; at least I for one preach against sugar every time there's a discussion on diets and food. This might have just reached a level where authorities need to get their shit together and do something about it... And this is the sad and hard part as many of our politicians may be "subsidised" by the food industry.
degenerate 14y ago
A very related, and VERY WELL PRESENTED and scientific video explanation of why sugar is poison, presented to residents at the University of California: http://www.youtube.com/watch?v=dBnniua6-oM http://www.youtube.com/watch?v=dBnniua6-oM If you like TED talks, this will just blow your mind. It gets highly medical at one point of the talk, but HN should be able to follow along. I recommend watching this when you have an hour of absolute free time and want to learn.
ChuckMcM 14y ago
With luck, this will encourage people to cook their own food. It isn't that hard to do, doesn't really take that much time, and the benefit of knowing what you are eating really helps inform your diet choices.
zmmmmm 14y ago
I'm uncomfortable with how this article keeps repeating that because it's "not possible" to do a better study, that the result must be conclusive. That simply does not follow. The fact that you can't do a better study doesn't mean we should believe the result of the best study we have uncritically - and it certainly doesn't mean by itself that the "smoking gun" has been found. So many health myths have been conclusively believed in the past that we should know better than this by now.

175 points by joecurry 14y ago

3am 14y ago

They had better change the messaging. I'm in favor of common-sense regulation of mass-production food ingredients, and "sugar is toxic" even rubs me the wrong way.

kansface 14y ago
We need to tax sugar like we tax tobacco for the same reasons. It will decrease consumption. Those taxes will pay for the medical expenses of people with diabetes.
- dangrossman 14y ago
  An apple a day is the doctor's pay?
- TDL 14y ago
  So we should be taxing fruits then, right?
  - themgt 14y ago
    No, it would be worth your time to read/listen to Robert Lustig. He explains how and why consuming natural sources like fruit where fructose is encased in digestion-slowing cellulose is normally fine, while extracting the fructose and adding it to other products like soda (and huge amounts of American processed foods) leads to toxicity and liver and metabolic damage. You can make jokes, but cutting excess fructose from American diets would probably be the #1 easiest thing to do for millions of people to live longer, healthier lives. And Bittman is correct that the FDA should get involved. It's actually difficult to buy "Healthy, Good for You™!" yogurt in an American supermarket that doesn't contain toxic amounts of added fructose - that is just crazy.
    - TDL 14y ago
      Educate then, don't attempt to socially engineer. Smoking was reduced through education, not taxation. The more people understood the long term consequences of smoking the less people smoked. I share the views of those who are not fans of processed sugars or fructose, but I am entirely opposed to social engineering.
      - gnaritas 14y ago
        > Educate then, don't attempt to socially engineer. Education is social engineering.
        TDL 14y ago
        Nonsense. Social engineering is using the force of the state to modify behaviors. You can say forced education is social engineering, but the act of educating or learning is not social engineering.
        gnaritas 14y ago
        > Social engineering is using the force of the state to modify behaviors. You may think that, but that isn't what it means. Look it up Wikipedia: Social engineering is a discipline in social science that refers to efforts to influence popular attitudes and social behaviors on a large scale, whether by governments or private groups. Google: The application of sociological principles to specific social problems. Dictionary.com: the application of the findings of social science to the solution of actual social problems. So whatever you're talking about, social engineering isn't the phrase you're looking for.
        TDL 14y ago
        In the political sense I am using the term appropriately. You want to get into semantic debate and I am not really interested.
        14y ago
  - roc 14y ago
    Is there a societal problem of people having massive fruit intake? It seems both logical and effective to just worry about the 'added' sugars in processed foods.
- deelowe 14y ago
  When is this going to stop? Endless government regulation is not the solution to everything. Look, there's a huge health movement going on in the country right now. Just like there was an anti-smoking movement starting up before the government ever got involved with that. The people who fund this crap aren't looking to do good, they just want more tax revenue (or more grant dollars from those who want more tax revenue). That's what they've always wanted. Don't believe me? Restaurants are now voluntarily adding calorie numbers to menus, because the lower calorie stuff is higher margin and people buy it. Vitamin water, coke zero, pepsi one/0, izze, baked chips, etc... etc... etc.. take up much more room in the grocery stores than they used to. Trader joes and whole foods are massive businesses now and threatening the big boys like kroger. I'm not saying obesity isn't a problem, but I do think we'll see the trend start changing for the better soon. There's no need for regulation. The public will shift on it's own. All we need is better education. Almost everyone I know(in my age group and younger) eat much more healthily than their parents do/did simply because they are better informed. Contrary to popular belief, people do make rational decisions when it comes to eating (excluding socioeconomic factors).
  - __david__ 14y ago
    > Don't believe me? Restaurants are now voluntarily adding calorie numbers to menus, because the lower calorie stuff is higher margin and people buy it. Actually, if you are in California then it's more likely because of a 2009 law[1]: "Putting our heads in the gastronomic sand became a bit harder starting July 1, 2009, when a new law went into effect making California the first state to mandate that chain restaurants--those with 20 or more locations--provide a calorie count for everything on the menu." [1] http://www.examiner.com/article/calorie-count-california-restaurant-law-urges-restraint http://www.examiner.com/article/calorie-count-california-res...
    - breckinloggins 14y ago
      I moved from Texas to California and I can confirm that, while there does seem to be a trend toward more and more restaurants voluntarily including this information, you don't really SEE it until you cross the border into California. This is an example of a business regulation that has had a directly positive impact on my daily food choices... I find that I automatically choose lower calorie foods just because the calorie numbers guilt me into doing so. In fact, this one thing led to a general softening of my hard-core libertarian "no regulations ever let the market decide" stance of the past.
- jlgreco 14y ago
  Would taxes on sugary things actually decrease consumption? I doubt you would actually be able to tax a 50 cent drink enough to make anyone reconsider purchasing it, particularly considering people will pay up to several dollars for that same beverage in other contexts. Nobody is going to be doing the "can I afford this, with the tax price included" calculus with things that cheap. (The fact that we seem to always display prices pre-tax only aggravates this)
  - anigbrowl 14y ago
    (The fact that we seem to always display prices pre-tax only aggravates this) I find this practice of American retailers incredibly pernicious. I really think displayed prices should be out-the-door on everything - you can still put the tax data on the receipt. When I moved to the US from Europe, I found it very difficult to manage my grocery bill for the first year or so until I got used to adding 8% to everything.
- eli_gottlieb 14y ago
  No, we need to stop subsidizing sugar and flour production. I'm visiting the US after living elsewhere, and the #1 thing I notice about the meals is how carbo-loaded and sugar-loaded they are -- including most people's home cooking! Not to say I don't enjoy some of the sugar-loading, but the carbo-loading is just annoying. When I help friends make a vegetable stir-fry with noodles, I don't want a bowl that's 75% rice noodles. I don't want to feel hungry again 3 hours later despite eating a large meal, because the large meal had little in it other than kilocalories from simple carbohydrates. I want the kind of veg-and-protein filled meals I've gotten more used to, in which I can measure sugar levels by whether something tastes sweet and I feel full all day/evening because most of the meal's content was "thick" stuff like vegetables, legumes, eggs, meat, cheese, olive oil and/or fish rather than "thin" foods like milk or sauce, or "very thin" foods like bread, pasta, or rice.
josefresco 14y ago
Agreed. Using the same logic, they could wage the same campaign against water.
- themgt 14y ago
  Because your chance of diabetes goes up 1.1% for every glass of water you drink?
  - mpyne 14y ago
    Consumption of dihydrogen monoxide correlates perfectly with onset of diabetes. In fact there is not one single person who has developed diabetes who hasn't ingested DHMO at some point in their life.
    - sophacles 14y ago
      Nope, its actually a correlation of 0. All the people who didn't get diabetes had the same DHMO consumption. If you want to be snarky, do try to at least make sense.
      - mpyne 14y ago
        No, the R^2 is 1.0 between (dhmo-exposure,got-diabetes). You're talking about (dhmo-exposure,!got-diabetes) which turns out to also have a 1.0 correlation, which was kind of the point of my snark in the first place. Those who don't understand even the basics of correlation are doomed to be led astray by statistics. The authors of the paper in question seem to understand it just fine, it would be nice if we could expect even minimal statistic comprehension from those making follow-on claims using the paper as supporting evidence.
        gamblor956 14y ago
        No, your snark fails because you picked the wrong variables. Got Diabetes necessarily implies a population of Did Not Get Diabetes, so the r^2 would not be 1.0. On the other hand, the r^2 between Have Diabetes and Water Exposure would be 1.0.
stretchwithme 14y ago
Yes, its an indiscriminate expression. Sort of like saying metal can kill you when its actually bullets. Its isolating fructose from its natural packaging that is the problem. Metabolizing large amounts of it must be done by the liver and it has side effects. The other half of table sugar is glucose and it is handled by releasing insulin. Insulin releases leptin as a side effect, which makes you feel satisfied. Starches break down into glucose. And glucose can be used by every cell in the body. Lustig's video on this goes through all the biochemistry.

awolf 14y ago

>In other words, according to this study, obesity doesn’t cause diabetes: sugar does. Sigh. No, according to this study, there is a stronger correlation between sugar and diabetes than between obesity and diabetes. >Each 150 kilocalories/person/day increase in total calorie availability related to a 0.1 percent rise in diabetes prevalence (not significant), whereas a 150 kilocalories/person/day rise in sugar availability (one 12-ounce can of soft drink) was associated with a 1.1 percent rise in diabetes prevalence. Much better! Lead with that next time, medical research reporter. All in all, this seems like a pretty good study that controls for a lot of confounding variables that a lot of diet related studies completely neglect. I just wish the reporting here, and in general in all medical research reporting, wasn't so sloppy. The goal should be to spread awareness of new findings, not to spread misconceptions.

JPKab 14y ago
"The study controlled for poverty, urbanization, aging, obesity and physical activity. It controlled for other foods and total calories. In short, it controlled for everything controllable, and it satisfied the longstanding “Bradford Hill” criteria for what’s called medical inference of causation by linking dose (the more sugar that’s available, the more occurrences of diabetes); duration (if sugar is available longer, the prevalence of diabetes increases); directionality (not only does diabetes increase with more sugar, it decreases with less sugar); and precedence (diabetics don’t start consuming more sugar; people who consume more sugar are more likely to become diabetics)." As far as observational studies, (of which I am a huge skeptic), this one is pretty well controlled for. It's not like they studied 7 nations, or 11 nations. They studied 175 nations. That allows for a whole lot of controllability for various factors.
- snowwrestler 14y ago
  Not on that list: family history/genetics. I believe that has already been identified as a significant risk factor for diabetes. So it's not just the sugar.
  - marcosdumay 14y ago

sukuriant 14y ago

I'm sitting here, dumbfounded, in a mix of response between "no shit" and "this isn't something that needs to be regulated".

deleted 14y ago

[deleted]

deleted 14y ago
[deleted]
deleted 14y ago
[deleted]

mbreese 14y ago

This is ridiculous. Sugars are fundamental bio-molecules and are essential for life. Yes, we know that over-eating causes diabetes and obesity. And this study says that foods high in sugar pose the greatest threat. But seriously, are we going to start to say that sugar is toxic in the same way that cigarettes are toxic? We can manage the dangers of sugar toxicity pretty easily by exercising. The damage done by smoking... not so much. This reminds me of a pet peeve that my grad advisor had. In our area it was common to see signs that said something to the effect of "No dumping of chemicals". He loved to point out that water was a chemical.

sophacles 14y ago
Actually yeah, just like a cigarette here and there is not the same in effect as smoking a pack a day, some fructose and other sugars here and there are probably not going to hurt you, but there are noticeable long term effects of constantly having too much sugar. Further comparison: sugars and nicotine both trigger dopamine cycles that can turn into mental dependence on higher doses, feeding the negative affects even more. Finally, I can't wait to see all the backpedalling from food companies about how the healthy staple foods they load up with sugar (e.g. whole wheat bread) are actually and 'obviously' just meant to be treats. 'the added sugar should be a give away, its right there in the small print on the back of the label, under the "this is super healthy" label'.
- barney54 14y ago
  The backpedalling needs to come from the federal government. After all, they have been promoting the idea of the food pyramid and "a calorie is a calorie" for decades. The food companies are definitely influenced by what the federal government says is healthy and what they convince people is healthy.
awolf 14y ago
I agree with your general sentiment, but one thing you said bears correction: >We can manage the dangers of sugar toxicity pretty easily by exercising. No, not really. Our bodies run on glucose yet our diets are rife with fructose which must be converted by our livers into a usable form. The metabolic pathway responsible for this conversion is a bottleneck and has nothing to do with how much exercise we get.

Uhhrrr 14y ago

Two comments from the article that I liked: As the principal author of this study, I wanted to clarify some of its details for scientifically-minded readers, in order to avoid misinterpretations: http://epianalysis.wordpress.com/2013/02/27/sugardiabetes/ http://epianalysis.wordpress.com/2013/02/27/sugardiabetes/ ----- The opening line ("Sugar is indeed toxic.") is distorted and inane. Sugars are not toxic, as evidenced by our evolution of taste buds that respond so positively to them. Sugars are a dense source of energy, which is why our metabolic systems cherish them. Let's leave such excessive, unsubstantiated commentary to The Onion or Mad Magazine, and just apply common sense to our diets.

base698 14y ago
Dr. Lustig does indeed claim sugar is toxic in the same since that alcohol is toxic. He goes through the complete cycle of metabolizing 1 molecule of sucrose (1 half glucose linked to 1 half fructose). The fructose metabolism is the problematic part, which was hard to follow for me, and I have an undergrad degree in Biochemistry and graduated with a 4.0. Here is the original talk: http://www.youtube.com/watch?v=dBnniua6-oM http://www.youtube.com/watch?v=dBnniua6-oM JPKab below has a good high level overview.
ceejayoz 14y ago
As with sugar, most toxins are only toxic at a certain level of intake.
- sliverstorm 14y ago
  If you are talking about toxicity, this is a useless observation. Everything is toxic at certain levels. Did you know that there is an LD50 for water?
Nathanael47 14y ago
It's a problem of translation between the chemistry definition of toxic (it will kill you in short order) and the common definition (poisonous, noxious). Bittman was using the latter, with an understanding that the dose makes the poison.

tptacek 14y ago

Wouldn't it be better for us to link directly to the study, rather than to Bittman's editorial about it? I find the study harmonizes nicely with my view of the world, and I'm even ok with Bittman, but he's not a subject matter expert at all. He's the NYT's former food writer who recently decided to write more about food policy.

tocomment 14y ago

Is there something special about sugar compared to other carbs? If I had to choose between eating bread or cake for the same calories will cake hurt me more?

ashmud 14y ago
If the bread is a typical "pedestrian" loaf, there's probably little difference. There is a bigger difference if it's something like Ezekial sprouted grain bread.
frankus 14y ago
The difference is that table sugar and high fructose corn syrup are about 50% fructose (the rest glucose). While glucose (which is what bread is mostly metabolized into) can be used by every cell in the body, fructose must be broken down by the liver using a metabolic pathway similar to that used by alcohol. There is a hypothesis that once a person's metabolism has been damaged by enough fructose, that any carbohydrate is likely to cause obesity. Basically, that insulin resistance seems to affect fat cell last and once it sets it glucose will be preferentially absorbed by fat cells. So people with a well-functioning insulin response should be able to eat relatively large amounts of (non-fructose-containing) carbohydrates without issue, but those in whom the insulin response is damaged (probably a majority of Americans over age 25) might need to cut back on all carbohydrates to stay lean. But again, this is very much an untested hypothesis.

tocomment 14y ago

What do they mean by sugar "availability" in the study? How is that measured, by the price in a given country, imports?

scottjad 14y ago
I wondered the same thing. For the most important variable in their study they sure don't explain it very well. I looked all over FAOSTAT but couldn't find an explanation. http://faostat3.fao.org/home/index.html#METADATA http://faostat3.fao.org/home/index.html#METADATA
mamoswined 14y ago
I was going to publish a comment on the study about that- my background is in agricultural economics so I'm very familiar with the database they used. I am curious to know which FAOstat data they used. Was it Sugar, Raw Equivalent or Sugar, Refined Equivalent? Either way, the FAO data is calculated based on production + imports - exports. They admit in the paper itself that this is not a perfect proxy ("It is thought that much of the FAO data on foods and nutrients in the food supply have limits to their reliability") for consumption so it is alarming, but predictable to see this being termed as such by the media. I don't know if it's the best series of data to use for this. I would have used a much longer series if possible because to be honest the past ten years have not seen a dramatic change in sugar consumption, but I guess their diabetes prevalence dataset only spanned that long. But that brings up the question of the lag for developing diabetes itself, it's not like 50 extra calories. I also couldn't find if they threw out countries with weird or obviously low quality data. Israel's data, for example, is a bit strange. It goes from around 500 kcal/capita/day sugar to 230. I find it hard to believe that consumption habits changed so drastically there. They also do not discuss much about why they, as non-economists, chose to use econometric rather than epidemiology or biostat methods. I also hate that their final graph is totally unlabeled and there is no option to download a format that would allow one to see which dots correspond to which country. It would be wise for some of the alarmists on this thread to read the paper and this sentence in particular " Hence, any of the findings we observe here are meant to be exploratory in nature, helping us to detect broad population patterns that deserve further testing through prospective longitudinal cohort studies in international settings, which are only now coming underway."

iaskwhy 14y ago

Is aspartame a good alternative?

vixen99 14y ago
No it isn't. If you're going to use it or products containing it, I strongly suggest you research this subject for yourself since this is not the place to argue the toss. When you do so, as ever, look to the money.
- jff 14y ago
  Big Sweetener.
- mynameishere 14y ago
  look to the money What is that supposed to mean? Coke (et al) probably make more money per volume on the diet drinks. So now that we've looked at the money, so what? As for health, you've got conspiracy nuts on one side, and a clear link with obesity, diabetes, and tooth decay on the other.
  - marcosdumay 14y ago
    > What is that supposed to mean? It means that, when you read a study, also read the name of the entity financing it.
    - mynameishere 14y ago
      What study are you referring to? http://en.wikipedia.org/wiki/Aspartame_controversy http://en.wikipedia.org/wiki/Aspartame_controversy Aspartame has been deemed safe for human consumption by over 100 regulatory agencies in their respective countries ...are they all financed (corrupted) by your unidentified bogeyman?
derleth 14y ago
Yes, it is. http://web.archive.org/web/20070102024642/http://www.fda.gov/fdac/features/1999/699_sugar.html http://web.archive.org/web/20070102024642/http://www.fda.gov... > FDA calls aspartame, sold under trade names such as NutraSweet and Equal, one of the most thoroughly tested and studied food additives the agency has ever approved. The agency says the more than 100 toxicological and clinical studies it has reviewed confirm that aspartame is safe for the general population.

Semaphor 14y ago

Every time I see an article related to Medicine on HN it seems a high amount of people comment without reading or at least comprehending the article. It's pretty and remind me of the negative parts of Reddit.

bcoates 14y ago

There's an interesting idea in this article: ... and ideally removing fructose (the “sweet” molecule in sugar that causes the damage) from the “generally recognized as safe” list, because that’s what gives the industry license to contaminate our food supply. Ignoring the loaded language, does anyone know what the consequences of removing fructose from the GRAS list would be?

lnanek2 14y ago
Industry would find the next cheapest alternative to making the food sweet.
derleth 14y ago
If fructose is removed from the GRAS list, that would imply fruits are no longer considered safe to eat.
- bcoates 14y ago
  Does not being GRAS imply a duty to test edible plants for containing something? That seems difficult. Of course, it wouldn't be the first crazy regulation...

Pkeod 14y ago

There is no mention of it in this thread so far, so here: http://reddit.com/r/keto http://reddit.com/r/keto Check the sidebar out. See the transformations which happen to people when they (mostly) give up consuming sugars: http://www.reddit.com/r/keto/search?q=progress&sort=top&restrict_sr=on http://www.reddit.com/r/keto/search?q=progress&sort=top&...

drivers99 14y ago
Keto cuts out carbs including those that are converted to just glucose, not just sugar (which is 50% fructose). It's not the same thing at all.
- Pkeod 14y ago
  Uh, sorry, what exactly did I say? I said mostly giving up sugars, which is why I mentioned keto.

pdeuchler 14y ago

A NYT Editor's Pick Comment: """ I'm glad the smoking gun has been found. High fructose corn syrup is in virtually everything people buy to eat. It needs to go. Enough people's lives have been ruined. The design and engineering of prepared foods people commonly buy is toxic and addictive. Now we need to re-educate people and make sure long-held views are erased. People have long blamed gluttony for obesity and obesity for diabetes. We now know it isn't true and that the super-sugars we are being force-fed are the culprit. We must all, together, demand that processed sugars such as high-fructose corn syrup be banned or, at the very least, severely restricted. I don't use the words force-fed lightly. Those among us who are on food stamps or a limited income have no choice but to buy the cheapest foods. Those are the ones that most commonly have the highest amount of sugars added. Anyone with a busy lifestyle eats out a lot. Fast foods, including the ones that claim to be "better," are laced with sugars, sodium, and fat. We must demand policies that protect us from harm and the greed-driven irresponsible practices of Big Food. Thank you, Mr. Bittman, for keeping us informed. """ So is "Big Food" the new scapegoat? I guess the next article we'll see a comment proclaiming how "Big Grocery" prices unhealthy foods too low, so now it's their fault. This is a great study, and it's results are extremely interesting, but this article, and the inferences people are getting from it border on witch trials. The article does a great job of doing everything but coming out and saying what the commenter does "They're force feeding us toxins!". There is such a clear departure from responsibility in today's culture it's almost astonishing. The blame lies 100% with nobody, but the individual has just as much a part to play as those producing the food. Edit: Does anyone notice the language used in the comment? "Force-fed", "re-educate", "We must all, together", "Enough people's lives have been ruined". It sounds almost like something from 1984. Also, look how easily the commenter provides inclusion to victimhood... anyone "with a busy lifestyle", or those who "are on food stamps or a limited income". Limited income is pretty broad. It's interesting also, how they "have no choice but to buy the cheapest foods".

Strang 14y ago
> next article we'll see a comment proclaiming how "Big Grocery" prices unhealthy foods too low, so now it's their fault. And here it comes: http://www.washingtonpost.com/wp-dyn/content/article/2011/01/20/AR2011012001581.html http://www.washingtonpost.com/wp-dyn/content/article/2011/01... This is a backhanded attack on "Big Grocery." Wal-Mart is being "responsible" with an initiative "to offer more healthful foods and push its suppliers to do the same." Of course, Wal-Mart's competitors can't afford to manhandle their suppliers at the same scale.

deleted 14y ago

[deleted]

deleted 14y ago
[deleted]

ImprovedSilence 14y ago

>>> The next steps are obvious, logical, clear and up to the Food and Drug Administration. To fulfill its mission, the agency must respond to this information by re-evaluating the toxicity of sugar, arriving at a daily value — how much added sugar is safe? — and ideally removing fructose (the “sweet” molecule in sugar that causes the damage) from the “generally recognized as safe” list, because that’s what gives the industry license to contaminate our food supply." Oh fer cryin out loud, just try to educate people a little better on how to MODERATE intake of everything, don't go overboard here and try to get a ban on sugar.... What is this world coming to when everybody expects some bigger force to make all the decisions for them and keep them safe. Learn how to think for yourselves and take some vested interest in you actions and decisions. Gotta strike a balance between natural selection and idiotracy I suppose...

anigbrowl 14y ago
I don't want a bigger force to make the decisions for me, but I am quite happy to delegate some of my authority to the government and have it act on my behalf by requiring more accurate labeling and so forth. I eat a very healthy diet, but I don't have the time or inclination to keep up with every last additive and food manufacturing process out there. In fact, I'm happy to pay some of my taxes so other people can study that as their full-time job.
- thatswrong0 14y ago
  There's a huge difference between banning sugar and regulating labeling. Even Libertarian candidate Gary Johnson supports food labeling (though purists might be opposed to that).
  - anigbrowl 14y ago
    Nobody's proposing a ban on sugar.

Nux 14y ago

I think many people know by know sugar is "toxic" and is responsible for pandemic obesity, type 2 diabetes and 99% of the dental mafia, erm... industry; at least I for one preach against sugar every time there's a discussion on diets and food. This might have just reached a level where authorities need to get their shit together and do something about it... And this is the sad and hard part as many of our politicians may be "subsidised" by the food industry.

degenerate 14y ago

A very related, and VERY WELL PRESENTED and scientific video explanation of why sugar is poison, presented to residents at the University of California: http://www.youtube.com/watch?v=dBnniua6-oM http://www.youtube.com/watch?v=dBnniua6-oM If you like TED talks, this will just blow your mind. It gets highly medical at one point of the talk, but HN should be able to follow along. I recommend watching this when you have an hour of absolute free time and want to learn.

ChuckMcM 14y ago

With luck, this will encourage people to cook their own food. It isn't that hard to do, doesn't really take that much time, and the benefit of knowing what you are eating really helps inform your diet choices.

zmmmmm 14y ago

I'm uncomfortable with how this article keeps repeating that because it's "not possible" to do a better study, that the result must be conclusive. That simply does not follow. The fact that you can't do a better study doesn't mean we should believe the result of the best study we have uncritically - and it certainly doesn't mean by itself that the "smoking gun" has been found. So many health myths have been conclusively believed in the past that we should know better than this by now.