Robert Lustig girds for war.
March 28, 2013 3:11 AM Subscribe
Everyone's favourite shit-disturbing pediatric endocrinologist recently became a published author of popular science. He's not doing it for money, and given the upturned noses of some of his brethren, probably not for love, either. The parade of overweight kids passing through his clinic at UCSF's Benioff Children's keeps getting longer, and the man is angry. So angry, he's going to law school to help quarterback the fight against the processed food industry himself. Previously.
Going to fight the food industry?
Is he also going to chase after the Corporations at the base of the food industry like ADM and Monsanto?
There are plenty of sinners up and down the food chain here. The lower hanging fruit for Mr. Lustig is to file the $400 (perhaps many sets of $400) and start the creation of some non-profits for the sugar issue and the arguments put forth in the book wheat-belly. Use the money gained to start collating studies that show issues in the food supply along with long-term studies - the kind of studies not being done because if there was a negative outcome it would go directly to the bottom line of very large firms.
posted by rough ashlar at 4:22 AM on March 28, 2013 [2 favorites]
Is he also going to chase after the Corporations at the base of the food industry like ADM and Monsanto?
There are plenty of sinners up and down the food chain here. The lower hanging fruit for Mr. Lustig is to file the $400 (perhaps many sets of $400) and start the creation of some non-profits for the sugar issue and the arguments put forth in the book wheat-belly. Use the money gained to start collating studies that show issues in the food supply along with long-term studies - the kind of studies not being done because if there was a negative outcome it would go directly to the bottom line of very large firms.
posted by rough ashlar at 4:22 AM on March 28, 2013 [2 favorites]
The sugar industry is an amazing optimisation of production, marketing and sales by the ag cartel.
Sugar is trivial to make from a variety of inexpensive feedstocks, and our instinctive consumption of it is programmed by millions of years of evolution.
It's a miracle product, it really is. It would be difficult to conceive of a better product. Even cocaine and heroin are worse -- though they are even more addictive, and cheaper to make per dose, overconsumption kills the customer. Eating too much sugar just makes you want more sugar. It's brilliant.
Brilliant.
posted by seanmpuckett at 4:32 AM on March 28, 2013 [11 favorites]
Sugar is trivial to make from a variety of inexpensive feedstocks, and our instinctive consumption of it is programmed by millions of years of evolution.
It's a miracle product, it really is. It would be difficult to conceive of a better product. Even cocaine and heroin are worse -- though they are even more addictive, and cheaper to make per dose, overconsumption kills the customer. Eating too much sugar just makes you want more sugar. It's brilliant.
Brilliant.
posted by seanmpuckett at 4:32 AM on March 28, 2013 [11 favorites]
So, Dr. Atkins is a nut for saying sugar is bad for you and you should stop eating it. But this guy is a hero for saying sugar is bad and suing the people who make it?
At least, that's what a smartass would say.
posted by gjc at 4:43 AM on March 28, 2013
At least, that's what a smartass would say.
posted by gjc at 4:43 AM on March 28, 2013
Yes, he is my favorite pediatric endocronologist.
The Bitter Truth video is brilliant.
Thanks for posting this.
posted by maggiemaggie at 4:48 AM on March 28, 2013
The Bitter Truth video is brilliant.
Thanks for posting this.
posted by maggiemaggie at 4:48 AM on March 28, 2013
So, Dr. Atkins is a nut...
Doc Atkins drew his diet from actual medical science - his book is a lot of fun to read. He half-asses the "self help guru" stuff and spends most of his energy explaining complex metabolic processes, and the formal studies that he used as a guide to develop his treatment. If he stripped out the dieting advice, it would have been a great science book aimed at laymen.
The diet also works for many people, so there's that as well.
posted by Slap*Happy at 5:10 AM on March 28, 2013 [2 favorites]
Doc Atkins drew his diet from actual medical science - his book is a lot of fun to read. He half-asses the "self help guru" stuff and spends most of his energy explaining complex metabolic processes, and the formal studies that he used as a guide to develop his treatment. If he stripped out the dieting advice, it would have been a great science book aimed at laymen.
The diet also works for many people, so there's that as well.
posted by Slap*Happy at 5:10 AM on March 28, 2013 [2 favorites]
I couldn't help but start humming a few bars of "The Impossible Dream."
Nonetheless, I hope he can take a few effective shots at this monster and that he doesn't completely burn himself out doing so. I was just thinking last night how much the obsession over fat and weight has messed up my life. Now, that doesn't affect everyone today, but I can easily say that without endlessly available crap food, gaining weight (and losing it) would not have been as much of a problem for me.
posted by Currer Belfry at 5:15 AM on March 28, 2013
Nonetheless, I hope he can take a few effective shots at this monster and that he doesn't completely burn himself out doing so. I was just thinking last night how much the obsession over fat and weight has messed up my life. Now, that doesn't affect everyone today, but I can easily say that without endlessly available crap food, gaining weight (and losing it) would not have been as much of a problem for me.
posted by Currer Belfry at 5:15 AM on March 28, 2013
"So, Dr. Atkins is a nut for saying sugar is bad for you and you should stop eating it. But this guy is a hero for saying sugar is bad and suing the people who make it?"
Dr. Atkins and Dr. Lustig were saying two fundamentally different things that only look similar if your understanding of carbohydrate metabolism goes only so deep as questions about what 'sugar' does. Dr. Atkins' case, at least the one that was original from him, was related to the effects of diets based on glucose - a sugar- as a primary source of calories that he saw as generally detrimental but was much more complex than just glucose is bad. Dr. Lustig is talking about the effects of both fructose and sucrose - also sugars - and the complex effects they have that are distinct from what glucose does.
posted by Blasdelb at 5:40 AM on March 28, 2013 [2 favorites]
Dr. Atkins and Dr. Lustig were saying two fundamentally different things that only look similar if your understanding of carbohydrate metabolism goes only so deep as questions about what 'sugar' does. Dr. Atkins' case, at least the one that was original from him, was related to the effects of diets based on glucose - a sugar- as a primary source of calories that he saw as generally detrimental but was much more complex than just glucose is bad. Dr. Lustig is talking about the effects of both fructose and sucrose - also sugars - and the complex effects they have that are distinct from what glucose does.
posted by Blasdelb at 5:40 AM on March 28, 2013 [2 favorites]
Ever since I first encountered this guy, my complaint has been the same - he has a thing for always picking the metabolic pathway for a given molecule that has the effect he wants and ignores all the other metabolic pathways that said molecule might go down, and redefining things to suit his case. His list of criterion by which "fructose is a poison" is a primo example since, by the exact same logic, hemoglobin is a poison. This makes him seem a lot more like a showman than a scientist to me.
As for Atkins' science, first sentence first paragraph after the introductory quote.
posted by Kid Charlemagne at 5:45 AM on March 28, 2013 [9 favorites]
As for Atkins' science, first sentence first paragraph after the introductory quote.
posted by Kid Charlemagne at 5:45 AM on March 28, 2013 [9 favorites]
As for Atkins' science, first sentence first paragraph after the introductory quote.
Yeah, but Atkins was saying there was a way to turn fat into glucose - it's what fat's there for, evolutionarily speaking - without making the patient feel starvation (as much) as they would with an across-the-board calorie restriction diet, which also turns fat into glucose.
posted by Slap*Happy at 5:58 AM on March 28, 2013 [3 favorites]
Yeah, but Atkins was saying there was a way to turn fat into glucose - it's what fat's there for, evolutionarily speaking - without making the patient feel starvation (as much) as they would with an across-the-board calorie restriction diet, which also turns fat into glucose.
posted by Slap*Happy at 5:58 AM on March 28, 2013 [3 favorites]
Over the past 6-7 years I have gone from being a die-hard believer in the hypothesis of Atkins/Gary Taubes/Robert Lustig, to a skeptic about all three. One thing which was helpful for me was the blog called The Carb-Sane Asylum (be advised that right now the author of that blog is being the target of really vile harassment, so most of her posts are about that issue).
While I agree that sugar consumption is probably a factor in obesity, the confounding evidence is that there are traditional diets which are relatively heavy in fructose and starches, but these diets don't seem to cause the same metabolic diseases in their native cultures. Yes, yes, I understand that the refinement of sugar, the absolute level and the percentage of consumption also matter--but there's another explanation that I think better accounts for these factors too.
Instead I'm more in agreement with Stephan Guyenet, who is building an intriguing argument that "junk food" causes a neurological response similar to drugs. This idea isn't new. What is different is that Guyenet argues that this brain response has a side-effect on the hypothalamus, impairing its ability to naturally regulate body weight and appetite. Normally, if you eat too much, your hypothalamus can influence your activity level, reduce your hunger later in the day, and generally keep things balanced around your "set point." The neurological effect of snack foods messes that up.
So in Guyenet's opinion, it's not the direct metabolic effect of sugars per se, instead sugar is only harmful to the extent that it triggers a "food reward" response in the brain, which over time damages the self-regulatory power of the hypothalamus.
posted by overeducated_alligator at 6:01 AM on March 28, 2013 [9 favorites]
While I agree that sugar consumption is probably a factor in obesity, the confounding evidence is that there are traditional diets which are relatively heavy in fructose and starches, but these diets don't seem to cause the same metabolic diseases in their native cultures. Yes, yes, I understand that the refinement of sugar, the absolute level and the percentage of consumption also matter--but there's another explanation that I think better accounts for these factors too.
Instead I'm more in agreement with Stephan Guyenet, who is building an intriguing argument that "junk food" causes a neurological response similar to drugs. This idea isn't new. What is different is that Guyenet argues that this brain response has a side-effect on the hypothalamus, impairing its ability to naturally regulate body weight and appetite. Normally, if you eat too much, your hypothalamus can influence your activity level, reduce your hunger later in the day, and generally keep things balanced around your "set point." The neurological effect of snack foods messes that up.
So in Guyenet's opinion, it's not the direct metabolic effect of sugars per se, instead sugar is only harmful to the extent that it triggers a "food reward" response in the brain, which over time damages the self-regulatory power of the hypothalamus.
posted by overeducated_alligator at 6:01 AM on March 28, 2013 [9 favorites]
Christ, what an asshole.
posted by edheil at 6:04 AM on March 28, 2013 [1 favorite]
posted by edheil at 6:04 AM on March 28, 2013 [1 favorite]
Dr. Lustig's lecture has many strong points. As a T1diabetic, I've monitored sugar levels in my blood for almost my entire life. I would not know about the difference between HFCS and other sugars, regarding satiety. It seems plausible. I avoid them all.
The assertion that avoiding ingested will starve your brain is often repeated, but simply false. About 50% of protein is converted to glucose.
http://www.ncbi.nlm.nih.gov/books/NBK22591/
From a diabetic perspective, there is plenty to criticize about the Atkins diet. Eliminating starchy foods is a good idea, IMO, as long as you never reintroduce them.
posted by steve jobless at 6:12 AM on March 28, 2013 [1 favorite]
The assertion that avoiding ingested will starve your brain is often repeated, but simply false. About 50% of protein is converted to glucose.
http://www.ncbi.nlm.nih.gov/books/NBK22591/
From a diabetic perspective, there is plenty to criticize about the Atkins diet. Eliminating starchy foods is a good idea, IMO, as long as you never reintroduce them.
posted by steve jobless at 6:12 AM on March 28, 2013 [1 favorite]
Lustig isn't wrong about a lot of things, but he has a tendency to sensationalize and disregard context, as other commenters are pointing out. Things tend to get even more twisted when Lustig's arguments are referred to by internet laymen, often with hilarious results. Alan Aragon's The Bitter Truth About Fructose Alarmism is a good, balanced take. Lustig chimed in in the comments, and Aragon summed up the discussion here.
And I agree with overeducated_alligator about the quality of Guyenet's writing; here's his post about sugar intake in non-industrial cultures.
posted by ludwig_van at 6:28 AM on March 28, 2013 [7 favorites]
And I agree with overeducated_alligator about the quality of Guyenet's writing; here's his post about sugar intake in non-industrial cultures.
posted by ludwig_van at 6:28 AM on March 28, 2013 [7 favorites]
While everyone debates the specific type of food to eliminate from your diet, I've lost 20 pounds over the last couple of years by eliminating nothing. I just consume fewer calories, and I walk at least a mile every day. Also, I limit going out to eat to maybe once a week and am careful about not consuming too many calories in restaurants (it's very easy to overeat in restaurants which is why I try to avoid them).
posted by jenh526 at 6:34 AM on March 28, 2013 [5 favorites]
posted by jenh526 at 6:34 AM on March 28, 2013 [5 favorites]
While everyone debates the specific type of food to eliminate from your diet, I've lost 20 pounds over the last couple of years by eliminating nothing. I just consume fewer calories, and I walk at least a mile every day. Also, I limit going out to eat to maybe once a week and am careful about not consuming too many calories in restaurants (it's very easy to overeat in restaurants which is why I try to avoid them).
Beware, sharing anecdotal accounts of successful weight loss by calorie counting is inviting an avalanche of special snowflakes.
posted by srboisvert at 7:00 AM on March 28, 2013 [11 favorites]
Beware, sharing anecdotal accounts of successful weight loss by calorie counting is inviting an avalanche of special snowflakes.
posted by srboisvert at 7:00 AM on March 28, 2013 [11 favorites]
"Yeah, but Atkins was saying there was a way to turn fat into glucose - it's what fat's there for, evolutionarily speaking - without making the patient feel starvation (as much) as they would with an across-the-board calorie restriction diet, which also turns fat into glucose."
Humans do not have a mechanism to turn fats or any lipids into glucose, and if Atkins at any point said so that would be something very much worth pointing out. It is simply not possible as a basic function of how our citric acid cycles only go one way and catabolize as they spin, which allows us to use fats to replace glucose in most cells but does not allow any of our cells to convert fats into glucose for the benefit of those of our cells that do not have the ability to use fats for energy. Your link discusses glycogen as a store for glucose, which is basically just polymerized glucose and analogous to starch in plants rather than fats. Kid Charlemagne is referencing how the human body does in fact obligately require at least some small amount of glucose in the diet to avoid one of the aspects of Rabbit starvation. While I also see Atkins' ideas has having many serious flaws, failing to address this isn't really one of them.
posted by Blasdelb at 7:03 AM on March 28, 2013
Humans do not have a mechanism to turn fats or any lipids into glucose, and if Atkins at any point said so that would be something very much worth pointing out. It is simply not possible as a basic function of how our citric acid cycles only go one way and catabolize as they spin, which allows us to use fats to replace glucose in most cells but does not allow any of our cells to convert fats into glucose for the benefit of those of our cells that do not have the ability to use fats for energy. Your link discusses glycogen as a store for glucose, which is basically just polymerized glucose and analogous to starch in plants rather than fats. Kid Charlemagne is referencing how the human body does in fact obligately require at least some small amount of glucose in the diet to avoid one of the aspects of Rabbit starvation. While I also see Atkins' ideas has having many serious flaws, failing to address this isn't really one of them.
posted by Blasdelb at 7:03 AM on March 28, 2013
On a more practical note, if you're wondering what you should you be limiting your added sugar consumption to, here's some reasonable advice:
The American Heart Association (AHA) recommends limiting the amount of added sugars you consume to no more than half of your daily discretionary calories allowance. For most American women, that’s no more than 100 calories per day, or about 6 teaspoons of sugar [26.6 grams]. For men, it’s 150 calories per day, or about 9 teaspoons [40 grams].posted by exhilaration at 7:20 AM on March 28, 2013
Source: http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyDietGoals/Sugars-and-Carbohydrates_UCM_303296_Article.jsp
I would recommend developing a simple carb calorie units label to identify every product.
posted by Brian B. at 7:28 AM on March 28, 2013
posted by Brian B. at 7:28 AM on March 28, 2013
Humans do not have a mechanism to turn fats or any lipids into glucose
I thought lipolysis released glycerol, which was turned into glucose via gluconeogenesis? (I'm not doubting you, I'm just curious.)
And yeah, the by-the-book Atkins Diet, even at its most restrictive, requires that you also eat your veggies and get in some exercise.
posted by Slap*Happy at 8:00 AM on March 28, 2013 [1 favorite]
I thought lipolysis released glycerol, which was turned into glucose via gluconeogenesis? (I'm not doubting you, I'm just curious.)
And yeah, the by-the-book Atkins Diet, even at its most restrictive, requires that you also eat your veggies and get in some exercise.
posted by Slap*Happy at 8:00 AM on March 28, 2013 [1 favorite]
I was also impressed by this guy.
http://www.youtube.com/watch?v=Ktmi-HCDosc
posted by steve jobless at 8:47 AM on March 28, 2013
http://www.youtube.com/watch?v=Ktmi-HCDosc
posted by steve jobless at 8:47 AM on March 28, 2013
How is Lustig still credible when the very first thing I read about his YouTube hit is that he says the Japanese diet doesn't have sugar in it?
Japanese food is stuffed with it - those dudes put sugar in their omelettes! Japan's leading brand of mayonnaise has a tablespoon of sugar in it! They also have a convenience junk food culture in the big cities which is, if anything, more bonkers than the US.
posted by colie at 8:50 AM on March 28, 2013 [1 favorite]
Japanese food is stuffed with it - those dudes put sugar in their omelettes! Japan's leading brand of mayonnaise has a tablespoon of sugar in it! They also have a convenience junk food culture in the big cities which is, if anything, more bonkers than the US.
posted by colie at 8:50 AM on March 28, 2013 [1 favorite]
How is Lustig still credible when the very first thing I read about his YouTube hit is that he says the Japanese diet doesn't have sugar in it?
This is not accurate. He says that the Japanese diet is heavy in sucrose, as opposed to fructose in the American diet.
posted by steve jobless at 9:07 AM on March 28, 2013
This is not accurate. He says that the Japanese diet is heavy in sucrose, as opposed to fructose in the American diet.
posted by steve jobless at 9:07 AM on March 28, 2013
Japanese food is stuffed with it - those dudes put sugar in their omelettes! Japan's leading brand of mayonnaise has a tablespoon of sugar in it! They also have a convenience junk food culture in the big cities which is, if anything, more bonkers than the US.
Agreed. OTOH I've found that cakes/pastries/etc. in east Asia do tend to be less sweet than U.S. versions.
posted by gyc at 9:08 AM on March 28, 2013 [1 favorite]
Agreed. OTOH I've found that cakes/pastries/etc. in east Asia do tend to be less sweet than U.S. versions.
posted by gyc at 9:08 AM on March 28, 2013 [1 favorite]
Yeah I'm going to have to chime in that a diet completely free of carbohydrates does not result in rapid brain death. You can prove empirically that by noting that it takes weeks or months to die if you stop eating completely, if you're getting enough water. Your brain doesn't just fall off when you stop eating sugars and starches. Or by noting the diets of those based in the Arctic who subsist on meat and fat for months at a time. The body makes glucose for the brain out of whatever is handy; sucrose/fructose would be easy, protein less easy, and fats not so easily.
posted by seanmpuckett at 9:14 AM on March 28, 2013 [1 favorite]
posted by seanmpuckett at 9:14 AM on March 28, 2013 [1 favorite]
He says that the Japanese diet is heavy in sucrose, as opposed to fructose in the American diet.
Sucrose is table sugar, and is composed of half fructose and half glucose. High fructose corn syrup is also made of fructose and glucose, with a slightly greater proportion of fructose (hence the name), but is metabolized virtually identically to sucrose.
posted by ludwig_van at 9:16 AM on March 28, 2013 [4 favorites]
Sucrose is table sugar, and is composed of half fructose and half glucose. High fructose corn syrup is also made of fructose and glucose, with a slightly greater proportion of fructose (hence the name), but is metabolized virtually identically to sucrose.
posted by ludwig_van at 9:16 AM on March 28, 2013 [4 favorites]
So he is wrong. That was easy.
posted by colie at 9:32 AM on March 28, 2013 [1 favorite]
posted by colie at 9:32 AM on March 28, 2013 [1 favorite]
"I thought lipolysis released glycerol, which was turned into glucose via gluconeogenesis? (I'm not doubting you, I'm just curious.)"
It does, and this is an awesome question. For those following along, fats are generally stored in fat deposits as triglycerides, which are a combination of three fatty acids each attached to a glycogen carbohydrate (sugar) backbone to create a larger four component molecule. Thus, when triglycerides that have been stored are broken down, this glycogen is indeed liberated and could theoretically be converted to glucose before being transported to starving cells that cannot power themselves any other way.
In practice however, this is not really functional as a response to carbohydrate starvation as the amount of glycogen that is liberated per gram of deposit is not really significant enough to address the problem, even if ridiculously toxic amounts of triglycerides are burned through over a short time frame. Indeed the fatty acids that are attached to those glycogens have to go somewhere and if both the catabolic and anabolic pathways fill up with them then the fatty acid degradation system must shut down. Part of the problem here is just how good fatty acids are at storing energy, where very little indeed goes a very long way.
posted by Blasdelb at 9:51 AM on March 28, 2013 [1 favorite]
It does, and this is an awesome question. For those following along, fats are generally stored in fat deposits as triglycerides, which are a combination of three fatty acids each attached to a glycogen carbohydrate (sugar) backbone to create a larger four component molecule. Thus, when triglycerides that have been stored are broken down, this glycogen is indeed liberated and could theoretically be converted to glucose before being transported to starving cells that cannot power themselves any other way.
In practice however, this is not really functional as a response to carbohydrate starvation as the amount of glycogen that is liberated per gram of deposit is not really significant enough to address the problem, even if ridiculously toxic amounts of triglycerides are burned through over a short time frame. Indeed the fatty acids that are attached to those glycogens have to go somewhere and if both the catabolic and anabolic pathways fill up with them then the fatty acid degradation system must shut down. Part of the problem here is just how good fatty acids are at storing energy, where very little indeed goes a very long way.
posted by Blasdelb at 9:51 AM on March 28, 2013 [1 favorite]
(Obligatory anecdotal snowflake: I've lost almost 80 doing the "Gary Taubes ketogenic thing" as Afroblanco put it.)
I'm not sure that Lustig is right about everything, but somebody needs to fight the food industry. Good on 'im -- I will be cheering.
As for Atkins' science, first sentence first paragraph after the introductory quote.
Why do people who have no idea what Atkins et al actually advocate(d) feel the need to make ridiculous straw men arguments?
posted by callmejay at 10:40 AM on March 28, 2013
I'm not sure that Lustig is right about everything, but somebody needs to fight the food industry. Good on 'im -- I will be cheering.
As for Atkins' science, first sentence first paragraph after the introductory quote.
Why do people who have no idea what Atkins et al actually advocate(d) feel the need to make ridiculous straw men arguments?
posted by callmejay at 10:40 AM on March 28, 2013
Sucrose is table sugar, and is composed of half fructose and half glucose. High fructose corn syrup is also made of fructose and glucose, with a slightly greater proportion of fructose (hence the name), but is metabolized virtually identically to sucrose.
Eh. Depends - glucose and fructose are metabolized differently. Whether the extra fructose is harmful is the question.
On the other hand, there is more in sugar and HFCS than glucose and fructose. In HFCS, you can pick up some fun impurities, like mercury, as part of the manufacturing process. It is a very involved industrial process, and it uses some nasty stuff to get to the end result. (The mercury was introduced by way of a caustic soda - mmm, all natural goodness in mercury-cell derived caustic soda, yessir...)
Even if it were as harmless as sugar, it's subsidized cheapness means it's everywhere. You can find HFCS in stuff like hamburger buns, canned soup and snack crackers - even when you're avoiding sweets, you're probably still consuming a sweetener of some description if you're eating any kind of processed food.
posted by Slap*Happy at 10:49 AM on March 28, 2013
Eh. Depends - glucose and fructose are metabolized differently. Whether the extra fructose is harmful is the question.
On the other hand, there is more in sugar and HFCS than glucose and fructose. In HFCS, you can pick up some fun impurities, like mercury, as part of the manufacturing process. It is a very involved industrial process, and it uses some nasty stuff to get to the end result. (The mercury was introduced by way of a caustic soda - mmm, all natural goodness in mercury-cell derived caustic soda, yessir...)
Even if it were as harmless as sugar, it's subsidized cheapness means it's everywhere. You can find HFCS in stuff like hamburger buns, canned soup and snack crackers - even when you're avoiding sweets, you're probably still consuming a sweetener of some description if you're eating any kind of processed food.
posted by Slap*Happy at 10:49 AM on March 28, 2013
I believe two things very strongly:
1. When using science to guide public policy, it's crucial that the science be understood correctly. Action should only be taken based on rock-solid evidence.
2. Whether or not the evidence against fructose is in fact rock-solid, somehow magically passing US legislation to effectively limit added sugar levels in food would have a major, positive effect on the obesity epidemic, saving billions and billions of dollars annually and improving the lives of millions of Americans.
There's a whole lot of tension in me between those two beliefs. Sometimes I lean toward #1, sometimes toward #2. The only sure thing is that, as we continue to do nothing, things will continue to get worse. We ought to be pouring money into this kind of science on a war-fighting scale.
posted by gurple at 11:02 AM on March 28, 2013
1. When using science to guide public policy, it's crucial that the science be understood correctly. Action should only be taken based on rock-solid evidence.
2. Whether or not the evidence against fructose is in fact rock-solid, somehow magically passing US legislation to effectively limit added sugar levels in food would have a major, positive effect on the obesity epidemic, saving billions and billions of dollars annually and improving the lives of millions of Americans.
There's a whole lot of tension in me between those two beliefs. Sometimes I lean toward #1, sometimes toward #2. The only sure thing is that, as we continue to do nothing, things will continue to get worse. We ought to be pouring money into this kind of science on a war-fighting scale.
posted by gurple at 11:02 AM on March 28, 2013
glucose and fructose are metabolized differently
Someone else says metabolized 'virtually identically'.
Surely the 'Japanese diet' mistake in Lustig is just an update on Weston A. Price-style 'myth of the healthy savage' stuff? He thought we'd all be living in Eden if it wasn't for white sugar and white bread and white flour.
posted by colie at 11:15 AM on March 28, 2013 [1 favorite]
Someone else says metabolized 'virtually identically'.
Surely the 'Japanese diet' mistake in Lustig is just an update on Weston A. Price-style 'myth of the healthy savage' stuff? He thought we'd all be living in Eden if it wasn't for white sugar and white bread and white flour.
posted by colie at 11:15 AM on March 28, 2013 [1 favorite]
Someone else says metabolized 'virtually identically'.
To be clear, I didn't say glucose and fructose are metabolized virtually identically; I said sugar (sucrose) and HFCS, both of which are made of glucose and fructose. The examine.com link I posted above has a number of citations supporting the conclusion that HFCS is no more inherently harmful than sugar. That isn't to say that HFCS can't be harmful if overconsumed, but simply replacing HFCS with sugar wouldn't make a difference.
posted by ludwig_van at 11:21 AM on March 28, 2013
To be clear, I didn't say glucose and fructose are metabolized virtually identically; I said sugar (sucrose) and HFCS, both of which are made of glucose and fructose. The examine.com link I posted above has a number of citations supporting the conclusion that HFCS is no more inherently harmful than sugar. That isn't to say that HFCS can't be harmful if overconsumed, but simply replacing HFCS with sugar wouldn't make a difference.
posted by ludwig_van at 11:21 AM on March 28, 2013
This is not a statement as to whether his ideas are right or wrong, but when the final link discusses his clinical practice, I found myself cringing. “This kid is a disaster—an unmitigated disaster." Sure, he's talking to a reporter and not the patient, but if this is the way he feels about his patients, no wonder they lie to him about their consumption habits. “You were doing so fantastically! You were so stable! What happened?” But who cares about the contributions of stress and stigma and feelings of failure and the associated reduction in health care seeking behaviors among the young unmitigated disasters he treats?
Although he clearly states that obesity should not be seen as a failure of personal responsibility, he himself appears incapable of separating from that thought in his clinical practice. Of course, clinical care is centered on the individual and not the population as a whole, but what is the value of asking an obese kid why their diet failed if you think systemic factors contribute the most to that obesity? You know why he couldn't do it, so skip the forced confession and maybe that kid will skip fewer appointments.
posted by palindromic at 11:37 AM on March 28, 2013 [3 favorites]
Although he clearly states that obesity should not be seen as a failure of personal responsibility, he himself appears incapable of separating from that thought in his clinical practice. Of course, clinical care is centered on the individual and not the population as a whole, but what is the value of asking an obese kid why their diet failed if you think systemic factors contribute the most to that obesity? You know why he couldn't do it, so skip the forced confession and maybe that kid will skip fewer appointments.
posted by palindromic at 11:37 AM on March 28, 2013 [3 favorites]
palindromic: “This kid is a disaster—an unmitigated disaster." Sure, he's talking to a reporter and not the patient, but if this is the way he feels about his patients, no wonder they lie to him about their consumption habits.By analogy, would you feel better or worse if an oncologist described a patient with a large tumor who was resisting medical treatment as "an unmitigated disaster"? I suspect the two doctor's POVs are very similar; they simply aren't mincing words when describing someone unwilling to move towards better health.
posted by IAmBroom at 11:44 AM on March 28, 2013
"How is Lustig still credible when the very first thing I read about his YouTube hit is that he says the Japanese diet doesn't have sugar in it?"
Lustig at no point says that Japan's diet is completely lacking in sugar and if you play around with the food balance sheets here creatively for a little bit it will show you using clear data that what he does say is in fact correct. Whether or not Japanese omelettes or maynonaise contain sugar is really totally irrelevant to the relative rates of total sugar consumption over time that he is actually addressing.
The FAOSTAT is awesome.
posted by Blasdelb at 11:52 AM on March 28, 2013 [3 favorites]
Lustig at no point says that Japan's diet is completely lacking in sugar and if you play around with the food balance sheets here creatively for a little bit it will show you using clear data that what he does say is in fact correct. Whether or not Japanese omelettes or maynonaise contain sugar is really totally irrelevant to the relative rates of total sugar consumption over time that he is actually addressing.
The FAOSTAT is awesome.
posted by Blasdelb at 11:52 AM on March 28, 2013 [3 favorites]
"Surely the 'Japanese diet' mistake in Lustig is just an update on Weston A. Price-style 'myth of the healthy savage' stuff? He thought we'd all be living in Eden if it wasn't for white sugar and white bread and white flour."
Oh for fucks sake
posted by Blasdelb at 11:53 AM on March 28, 2013 [1 favorite]
Oh for fucks sake
posted by Blasdelb at 11:53 AM on March 28, 2013 [1 favorite]
Lustig at no point says that Japan's diet is completely lacking in sugar
He says straight off that Japan's diet 'eliminates the sugar fructose', and a commenter above tells us that table sugar (prevalent in traditional and contemporary Japanese diet) is half fructose.
?
posted by colie at 11:59 AM on March 28, 2013
He says straight off that Japan's diet 'eliminates the sugar fructose', and a commenter above tells us that table sugar (prevalent in traditional and contemporary Japanese diet) is half fructose.
?
posted by colie at 11:59 AM on March 28, 2013
Someone else says metabolized 'virtually identically'.
Here's an overview of the difference between fructolysis and glycolysis.
I'm not convinced HFCS is behind the obesity epidemic, but the amount of spin and misinformation the HFCS industry and its lobby is shoveling our way does not look good. A month or so back, there was someone on NPR going on and on about how sugar and HFCS was identical "chemically" - which is oversimplification to the point of laughable falsehood.
(Not that sugar is off the hook, either - I'd like more research done on bleached food.)
posted by Slap*Happy at 11:59 AM on March 28, 2013
Here's an overview of the difference between fructolysis and glycolysis.
I'm not convinced HFCS is behind the obesity epidemic, but the amount of spin and misinformation the HFCS industry and its lobby is shoveling our way does not look good. A month or so back, there was someone on NPR going on and on about how sugar and HFCS was identical "chemically" - which is oversimplification to the point of laughable falsehood.
(Not that sugar is off the hook, either - I'd like more research done on bleached food.)
posted by Slap*Happy at 11:59 AM on March 28, 2013
Cancers and chronic diseases like insulin resistance are very different, and require different clinical approaches. A cancer patient resisting treatment will likely have a short disease course, marked by early death. Likewise, cancer treatments are often constrained in their frequency and duration (leaving aside the unpleasantness of said treatments). Becoming diagnosed with cancer is not stigmatized as representing the bad decisions you've made. These factors are markedly different from dealing with adolescents with chronic disorders - you are literally trying to change the patterns they have established over the course of their lives. You cannot just treat diabetes over a few months, and then come back once a year or whatever for scans. If you're treating your teenage diabetic patients like they have cancer, regardless of the eventual threat to life and well-being such diseases represent, no, I don't think that's appropriate.
Especially given that there's evidence that obese people tend to access health care services less often than their normal-weight counterparts because of factors such as physician condescension and stigma, a physician who treats obese patients for chronic lifelong conditions needs to take more of a long view and be a partner to his/her patients, and not be a ennui-filled, frustrated drill sergeant. People who have diabetes should feel empowered to see their physicians and not afraid of their judgment. If judgment and stark declarations about how your fatness is going to kill you (a la the oncologist with the non-compliant patient) were enough, America wouldn't have an obesity problem.
posted by palindromic at 12:02 PM on March 28, 2013 [4 favorites]
Especially given that there's evidence that obese people tend to access health care services less often than their normal-weight counterparts because of factors such as physician condescension and stigma, a physician who treats obese patients for chronic lifelong conditions needs to take more of a long view and be a partner to his/her patients, and not be a ennui-filled, frustrated drill sergeant. People who have diabetes should feel empowered to see their physicians and not afraid of their judgment. If judgment and stark declarations about how your fatness is going to kill you (a la the oncologist with the non-compliant patient) were enough, America wouldn't have an obesity problem.
posted by palindromic at 12:02 PM on March 28, 2013 [4 favorites]
“This kid is a disaster—an unmitigated disaster." ... if this is the way he feels about his patients, no wonder they lie to him about their consumption habits.
Indeed. Do doctors talk about anorexics like this?
posted by colie at 12:08 PM on March 28, 2013 [2 favorites]
Indeed. Do doctors talk about anorexics like this?
posted by colie at 12:08 PM on March 28, 2013 [2 favorites]
A month or so back, there was someone on NPR going on and on about how sugar and HFCS was identical "chemically" - which is oversimplification to the point of laughable falsehood.
How so?
posted by ludwig_van at 12:11 PM on March 28, 2013
How so?
posted by ludwig_van at 12:11 PM on March 28, 2013
How so?
Because... they're not?
OK. If you're talking about the chemicals sucrose and HFCS, they're different. There's an extra atom binding the sucrose and fructose together, it's a disaccharide. HFCS is a solution of two monosaccharides in water. You can't even measure their sweetness using ºbrix - sucrose in solution has a different refraction than HFCS! So, already, we're deep into "pretty much a lie" - their point is that there's no difference between digestion, which separates sucrose into glucose and fructose, and enzymatic processing, which turns some of the glucose in pure industrial corn syrup into fructose, to make it a more palatable sweetener. Maybe, arguable, but not definitive, and absolutely not the same chemically.
If you're talking about the ingredients sugar and industrial grade HFCS, well. As mentioned up-thread, there are other chemicals along for the ride apart from stuff that tastes sweet... mercury in some HFCS, chlorine oxides in some sugar, for example, both added by industrial scale processing. Nowhere near the same "chemically" - you can taste the difference, they're still selling "Pepsi Throwback" at the supermarket if you care to try for yourself.
posted by Slap*Happy at 12:40 PM on March 28, 2013
Because... they're not?
OK. If you're talking about the chemicals sucrose and HFCS, they're different. There's an extra atom binding the sucrose and fructose together, it's a disaccharide. HFCS is a solution of two monosaccharides in water. You can't even measure their sweetness using ºbrix - sucrose in solution has a different refraction than HFCS! So, already, we're deep into "pretty much a lie" - their point is that there's no difference between digestion, which separates sucrose into glucose and fructose, and enzymatic processing, which turns some of the glucose in pure industrial corn syrup into fructose, to make it a more palatable sweetener. Maybe, arguable, but not definitive, and absolutely not the same chemically.
If you're talking about the ingredients sugar and industrial grade HFCS, well. As mentioned up-thread, there are other chemicals along for the ride apart from stuff that tastes sweet... mercury in some HFCS, chlorine oxides in some sugar, for example, both added by industrial scale processing. Nowhere near the same "chemically" - you can taste the difference, they're still selling "Pepsi Throwback" at the supermarket if you care to try for yourself.
posted by Slap*Happy at 12:40 PM on March 28, 2013
Ok, right, they're not identical compounds, but in terms of their effects on the body when ingested, there don't seem to be any appreciable differences, which fact gets ignored when HFCS is demonized as being uniquely obesity-causing.
posted by ludwig_van at 12:56 PM on March 28, 2013
posted by ludwig_van at 12:56 PM on March 28, 2013
but somebody needs to fight the food industry.
But *WHAT* is the fight to have?
(added points for figuring out the case law on this issue)
posted by rough ashlar at 2:10 PM on March 28, 2013
But *WHAT* is the fight to have?
(added points for figuring out the case law on this issue)
posted by rough ashlar at 2:10 PM on March 28, 2013
High fructose corn syrup is also made of fructose and glucose, with a slightly greater proportion of fructose (hence the name), but is metabolized virtually identically to sucrose.
.....
Ok, right, they're not identical compounds,
Yes - different names indicate different nature.
but in terms of their effects on the body when ingested, there don't seem to be any appreciable differences
Digestion is one thing. Hormones is another.
The metabolism of carbohydrates is regulated by a variety of hormones and other molecules. Care to chart the hormones involved?
posted by rough ashlar at 2:22 PM on March 28, 2013
.....
Ok, right, they're not identical compounds,
Yes - different names indicate different nature.
but in terms of their effects on the body when ingested, there don't seem to be any appreciable differences
Digestion is one thing. Hormones is another.
The metabolism of carbohydrates is regulated by a variety of hormones and other molecules. Care to chart the hormones involved?
posted by rough ashlar at 2:22 PM on March 28, 2013
The metabolism of carbohydrates is regulated by a variety of hormones and other molecules. Care to chart the hormones involved?
Why don't you just tell me what hormones differ after ingestion of HFCS vs. sucrose? According to the multiple studies cited in the link I've posted twice above, there is no difference in insulin, glucose, GLP-1, or ghrelin, and no difference in statiety.
posted by ludwig_van at 2:49 PM on March 28, 2013 [2 favorites]
Why don't you just tell me what hormones differ after ingestion of HFCS vs. sucrose? According to the multiple studies cited in the link I've posted twice above, there is no difference in insulin, glucose, GLP-1, or ghrelin, and no difference in statiety.
posted by ludwig_van at 2:49 PM on March 28, 2013 [2 favorites]
http://www.princeton.edu/main/news/archive/S26/91/22K07/
As is often the case with nutrition, you can find studies pointing in both directions.
There are plenty of sweet deserts in Japan, and high levels of rice consumption. There are overweight and obese people, but at US levels.
Almost everything Americans eat contains HFCS. It is one of the main ingredients in baby formula, and PediaSure, for example. I think it's not too far of a stretch to conclude that this causes obesity in those of us that are genetically predisposed to it.
If we replaced the fructose with glucose would it make a difference? I don't know, but that's somewhat beside the point.
posted by steve jobless at 3:37 PM on March 28, 2013
As is often the case with nutrition, you can find studies pointing in both directions.
There are plenty of sweet deserts in Japan, and high levels of rice consumption. There are overweight and obese people, but at US levels.
Almost everything Americans eat contains HFCS. It is one of the main ingredients in baby formula, and PediaSure, for example. I think it's not too far of a stretch to conclude that this causes obesity in those of us that are genetically predisposed to it.
If we replaced the fructose with glucose would it make a difference? I don't know, but that's somewhat beside the point.
posted by steve jobless at 3:37 PM on March 28, 2013
Almost everything Americans eat contains HFCS. It is one of the main ingredients in baby formula, and PediaSure, for example. I think it's not too far of a stretch to conclude that this causes obesity in those of us that are genetically predisposed to it.
Pointless assertion.
posted by colie at 3:44 PM on March 28, 2013 [2 favorites]
Pointless assertion.
posted by colie at 3:44 PM on March 28, 2013 [2 favorites]
There was an FPP recently about the effort that snack food companies put into customer psychology, to make them want to consume lots of junk food. I wonder if this effort on the part of snack companies commenced around the time that HFCS started to be used, so even though HFCS has no effect, its introduction coincided with the use of much more effective advertising and culinary techniques to increase the whole "once you pop you can't stop" effect in their products.
posted by Elementary Penguin at 4:51 PM on March 28, 2013
posted by Elementary Penguin at 4:51 PM on March 28, 2013
As is often the case with nutrition, you can find studies pointing in both directions.
In this case I think this xkcd might be appropos.
The actual data from the Princeton study (which was performed on rodents and wasn't calorie-controlled) seem rather equivocal.
posted by ludwig_van at 7:12 PM on March 28, 2013 [1 favorite]
In this case I think this xkcd might be appropos.
The actual data from the Princeton study (which was performed on rodents and wasn't calorie-controlled) seem rather equivocal.
posted by ludwig_van at 7:12 PM on March 28, 2013 [1 favorite]
OK. If you're talking about the chemicals sucrose and HFCS, they're different. There's an extra atom binding the sucrose and fructose together, it's a disaccharide. HFCS is a solution of two monosaccharides in water. You can't even measure their sweetness using ºbrix - sucrose in solution has a different refraction than HFCS! So, already, we're deep into "pretty much a lie" - their point is that there's no difference between digestion, which separates sucrose into glucose and fructose, and enzymatic processing, which turns some of the glucose in pure industrial corn syrup into fructose, to make it a more palatable sweetener. Maybe, arguable, but not definitive, and absolutely not the same chemically.
If you're talking about the ingredients sugar and industrial grade HFCS, well. As mentioned up-thread, there are other chemicals along for the ride apart from stuff that tastes sweet... mercury in some HFCS, chlorine oxides in some sugar, for example, both added by industrial scale processing. Nowhere near the same "chemically" - you can taste the difference, they're still selling "Pepsi Throwback" at the supermarket if you care to try for yourself.
There aren't many foods that contain pure glucose, though, are there?
But you are right, the glucose and the fructose are already separated in HFCS, where in sugar they are chemically bonded. The body has to expend time and energy breaking that bond, which slows down digestion. Which is generally a good thing unless you are in an insulin coma. I guess the difference is how much energy and time it actually takes, and how insulin reactive and resistant the individual is.
posted by gjc at 7:48 PM on March 28, 2013 [1 favorite]
If you're talking about the ingredients sugar and industrial grade HFCS, well. As mentioned up-thread, there are other chemicals along for the ride apart from stuff that tastes sweet... mercury in some HFCS, chlorine oxides in some sugar, for example, both added by industrial scale processing. Nowhere near the same "chemically" - you can taste the difference, they're still selling "Pepsi Throwback" at the supermarket if you care to try for yourself.
There aren't many foods that contain pure glucose, though, are there?
But you are right, the glucose and the fructose are already separated in HFCS, where in sugar they are chemically bonded. The body has to expend time and energy breaking that bond, which slows down digestion. Which is generally a good thing unless you are in an insulin coma. I guess the difference is how much energy and time it actually takes, and how insulin reactive and resistant the individual is.
posted by gjc at 7:48 PM on March 28, 2013 [1 favorite]
But couldn't he go after:
1. those that encourage ridiculous portions? Nearly every American restaurant portion is for 2 people or more.
2. employers because most of us work through lunch.
3. schools because honestly, back in grammar school we did NOT have recess because the school said we were bad. Don't forget cutting gym programs, etc. A friend of ours said her school had to give back the gym mat because it is shared between 4 schools. Pathetic.
Process food is a huge culpret but obesity/diabetes a bigger wheel than just one spoke.
posted by stormpooper at 6:29 AM on March 29, 2013
1. those that encourage ridiculous portions? Nearly every American restaurant portion is for 2 people or more.
2. employers because most of us work through lunch.
3. schools because honestly, back in grammar school we did NOT have recess because the school said we were bad. Don't forget cutting gym programs, etc. A friend of ours said her school had to give back the gym mat because it is shared between 4 schools. Pathetic.
Process food is a huge culpret but obesity/diabetes a bigger wheel than just one spoke.
posted by stormpooper at 6:29 AM on March 29, 2013
Almost everything Americans eat contains HFCS. It is one of the main ingredients in baby formula, and PediaSure, for example. I think it's not too far of a stretch to conclude that this causes obesity in those of us that are genetically predisposed to it.
Pointless assertion.
I don't think this assertion is so pointless, considering our rates of obesity in children and toddlers.
posted by steve jobless at 7:08 AM on March 29, 2013
Pointless assertion.
I don't think this assertion is so pointless, considering our rates of obesity in children and toddlers.
posted by steve jobless at 7:08 AM on March 29, 2013
steve jobless: Almost everything Americans eat contains HFCS. It is one of the main ingredients in baby formula, and PediaSure, for example. I think it's not too far of a stretch to conclude that this causes obesity in those of us that are genetically predisposed to it.You are correct. Your assertion is not pointless. It's groundless. Concluding that HFCS causes obesity because Americans eat it and Americans are often obese is a helluva jump in correlation.
Pointless assertion.
I don't think this assertion is so pointless, considering our rates of obesity in children and toddlers.
Produce some data showing that those who don't eat it are much less likely to be obese, and/or that obesity levels correlate well with HFCS intake, and you'll have something.
As you stated it, you're just guessing with confidence.
posted by IAmBroom at 8:39 PM on March 31, 2013 [1 favorite]
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posted by Blasdelb at 4:07 AM on March 28, 2013 [3 favorites]