Sugar: The Bitter Truth (UCSF lecture)
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I think it is important to differentiate between normal (hunter-gatherer) levels of fructose consumption (< 5% of total calories, normally closer to 1%, except perhaps in the summer when fruit is more abundant) and the amount we are eating today. That is, if fructose is harmful, the dangers only seem to manifest at the high levels of intake seen today.
Pragmatically, we may not need to be concerned about fructose at all, as eating refined sugar is obviously bad for health, so it should be eliminated anyways. (You need vitamins and minerals, and refined sugar doesn't have any!). Unrefined sources of sugar are not very good nutritional resources either.
Tragically, the damages of fructose may have been multiplied by the government recommendations to replace saturated fat intake with polyunsaturated fat. http://high-fat-nutrition.blogspot.com/2009/12/cirrhosis-and...
For GCBC, I think it is important to differentiate between demolishing the bad fat/cholesterol/salt, good fiber hypothesis, and proposing the new carbohydrate hypothesis. GCBC debunks these weak hypothesis. However, all it can do is propose a new hypothesis given (as admitted by the author) the small amount of research available that directly supports that hypothesis.
It is pretty apparent that he is not cherry-picking. First of all, the book wouldn't need to be as long! Seriously, this represents an absolutely enormous investment in time that as you point out just ends up turning off readers.
Normally a cherry-picker will stoop to low quality sources of information. When demolishing conventional wisdom, Taubes sticks to all (yes all, there aren't that many) of the high quality large-scale studies that actually matter (but goes through the history of lower quality information that lead to the available hypothesis). Again, he admits that the evidence is weaker for his carbohydrate hypothesis.
What about blackstrap molasses? https://secure.wikimedia.org/wikipedia/en/wiki/Blackstrap_mo...
I tend to stay away from these kinds of factory produced foods. You have to put trust in the manufacturer not to be adding chemicals, etc.
But maybe this could be a healthy part of the diet. The fructose is bad or sugar/refined carbohydrates is bad theories have not shown that the health problems could instead be caused by a lack of nutrients in the sugars we consume.
From my understanding (not a nutritionist), sugar has been taken away; nutrients have not been added, just concentrated by the extraction of sugar.
"I tend to stay away from these kinds of factory produced foods. You have to put trust in the manufacturer not to be adding chemicals, etc."
Because it's fairly nutritious as sweeteners go, it's available in organic form at many health food stores.
* Good Calorie, Bad Calorie;
* The Omnivore's Dilemma
* The End of Overeating.
In order: the science of fat and weight, as best as can be explained today; what's in your food, and what you should be eating; and how companies influence your eating decisions and how to take control of them.
In particular, the last book summarizes research showing that, for certain people, there is a reward conditioning feedback mechanism in the brain triggered by the intake of fat, sugar, and salt. see http://www.boingboing.net/2009/05/07/end-of-overeating-th.ht... for a longer review. In particular, if you have lots of willpower elsewhere in your life but struggle controlling your food intake, I can't recommend this book strongly enough.
In any case, I think everybody should read the above 3 books; you'll be a long way closer to being a well informed consumer of food and of it's effects on your body.
Anybody know of another source that describes the book's views on fat metabolism, blood sugar, etc. but is shorter and more to the point?
Not only for my own benefit to review, but I have a hard time recommending Good Calorie, Bad Calorie to friends who are only marginally interested in nutrition, but would still benefit from reading the book's core ideas in a distilled form.
The Omnivore's Dilemma, or at least the statements of its author, Michael Pollan to to eat low in the food chain are predicated on the idea that eating animal is bad for you, which thoroughly debunked (at least with respect to fat or saturated fat) by Taubes.
Taubes is also a fierce advocate that weight issues normally have little to do with willpower over overeating and everything to do with eating too many refined carbohydrates.
My family has spent many years studying human health. The well-researched conclusions are so far from mainstream American beliefs that the ignorant dismiss them as absurd.
I'll get down voted, but in the interest of countering groupthink, here are some examples anyway:
- Food basics: Avoid hydrogenated oils, sodium nitrite, MSG/yeast extract, artificial colors, high fructose corn syrup, all artificial sweeteners, all grains that aren't whole. Replace sugar with agave nectar or stevia. Know the smoke points for the cooking oils you use an don't exceed them.
- Any multivitamin which packages B12 solely as "cyanocobalamin" is cheaply manufactured. Quality vitamins package hydroxocobalamin. You'll probably have to look online or at health food stores to find good quality vitamins. Many of the options sold at pharmacies are little better than candy.
- As much as 60% of Americans are deficient in vitamin D. The body makes it in response to skin exposure to direct sunlight (not through glass.) Sufficient vitamin D reduces risk of nearly all cancers by around 70%. Why isn't the American Cancer Society screaming this message?
- A cup of blueberries a day is more effective at reducing cholesterol than current pharmaceuticals. Tastes better, too.
- Eating refined carbohydrates depletes the supply of B vitamins. For women, this contributes to the discomfort of menstruation.
- A number of plants have strong cancer prevention or anticancer properties. Examples: turmeric with black pepper, maca root, garlic.
...a few thousand more little details.
Unlike many other vitamins, it's also very hard to overdose on D. Taking too much of some of the others is worse than not taking any at all, but with D that's not a problem.
Interestingly, although it is now evident that Vitamin D insufficiency and deficiency is higher in the general population than previously realized, it is often worse in those with higher levels of fat in the body.
"CONCLUSIONS: Obesity-associated vitamin D insufficiency is likely due to the decreased bioavailability of vitamin D(3) from cutaneous and dietary sources because of its deposition in body fat compartments."Vitamin D toxemia can occur. One of the more common symptoms is nausea, and if the toxemia persists, calcification of soft tissue and formation of kidney stones can result. Vitamin D is needed for proper intestinal absorption of calcium, so excess Vitamin D can throw off proper mineral balances in the body.
Likelihood of toxemia is rare for Vitamin D, however.
Consider that a healthy individual can obtain 10,000 IU or more of Vitamin D produced by their own skin from being exposed to the sun for 20 to 30 minutes. The amount of Vitamin D in a standard multivitamin supplement is rarely more than the current US RDA, which is only 400 IU. So even people taking higher dose Vitamin D supplements of, say 5000 IU, are not really mega-dosing/"going Linus Pauling" with their Vit. D.
Also, that current RDA of 400 IU is now considered by many scientists and health professionals to be too low. It may simply be the minimum amount needed to prevent rickets (known in adults as osteomalacia). Now it is known that it is needed for more than just bone development and maintenance, as Vitamin D receptors have been found throughout the body; some reports say virtually everywhere.
Reading through the information at http://vitamindcouncil.org , it appears that to achieve what is now considered an optimal Vitamin D level in the body, people generally need more sun and/or supplementation.
In the news within the last year or so, a study reported that even 50% of Hawaiians were low in Vitamin D. In modern society, I guess that walking from the car to the office daily just doesn't cut it for sun exposure ;)
It seems like that 10,000IU/.5hr dose would be surface-area dependent. Are the face, hands, and maybe forearms sufficient? Or does that number depend on, erm... _all_ of the skin being exposed?
It's probably easier (and certainly more common) to overdose on water.
Agave nectar and stevia as sugar substitutes are also not without controversy. I find it easiest to get my sugar from whole, ripe, and fresh fruit. Once sufficient fruits are eaten on a regular basis, the desire for refined sugary products disappears.
Stevia: Potential problems, including cancer, reproductive issues, and interference with energy metabolishm: This article is a good start: http://www.cspinet.org/nah/4_00/stevia.html
Remmeber, stevia is an herb. Treating an herb as a food, i.e. the amount used in order to function as a replacement for sugar, is not necessarily a wise idea. Would you use ginkgo balboa or St. John's Wort as a food? Also, most people don't use actual stevia leaves, so it is still a refined product. Moving from refined sugar cane to refined herbs is not necessarily a good move. Developing a taste preference for whole fresh fruits over refined sugar products would serve our interests far better in the long run.
Agave nectar/syrup: this one certainly has a lot of hype behind it, but mostly it appears to be marketing tactics. Just think about the fact that excess fructose can raise general risk markers (triglycerides and VLDL) and has been linked to increased risk for insulin resistance, diabetes, and cardiovascular disease.
High fructose corn syrup is 55% fructose.
Agave syrup is 70-90% fructose.
So if you think too much fructose is bad, you must think HFCS is better than agave syrup.
Lastly, the recommendation for cyanocobalamin to be shunned in favor of hydroxy seems a bit off. The known highest active form of B12 for humans is methylcobalamin. Hydroxy is more efficiently converted than cyano, but methyl has the general current consensus, in the medical research world, of being best. Fortunately, B12 supplements of the methyl form are easily obtainable (e.g. Jarrow is a brand with 1000 and 5000 mcg sublinguals cheaply available, and there are a number of other brands). I've never even heard of a hydroxycobalamin tablet - only that it is the standard form used for shots in some countries. It is important to realize that most US and European doctors are still behind the times and administer cyanocobalamin (in some European countries, hydroxy is used, but this is still not as preferable as methylcobalamin) for B12 shots when a patient is found to have a problem with B12 levels. However, shots are almost never needed anyway, as the diffusion process of sublingual tablets is so great that they are just as effective as shots.
Also, MSG has been unfairly accused. Wikipedia says "a statistical association has not been demonstrated under controlled conditions, even in studies with people who were convinced that they were sensitive to it".
Interestingly, some canned beans, e.g. Eden Organic (unsalted), come with kombu in the can.
All the debate over things like artificial/alternatives sweeteners and MSG seem like a severe case of not seeing the forest for the trees. The issue of which sweetener to use is not so big as how much of any of the sweeteners. And for those who eat a diet of only whole foods, the answer is even easier: none.
The controversy over issues like these has the general public all worried about things they don't need to worry about so much, instead of being concerned about things they really should be, e.g. what foods make up the diet and their nutrient density. Worrying about MSG in my junk food, organic vs. conventional pizza, or HFCS vs. cane sugar soda, is not likely to have much benefit if these items make a regular appearance in my diet.
But I do have a question regarding a couple of the items on your list:
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1. Sodium Nitrite.
Through carelessness, it can result in the production of carcinogens; in large quantities this can cause cancer, but the AMA states that there have been no cases of food consumption induced cases of methemoglobinemia -- most of the cases have been due to contaminated water or accidental overusage in food. It has has been linked to migraines with those already showing a tendency. There is also a possible link between COPD and this substance, but the question is still largely unresolved. So there are risks, but only under particular circumstances. And, evidently, there are some things it treats effectively. It's worth being cautious about, perhaps, but not necessarily phobic of. Is there some other risk I am missing here? What is the additional cost involved of eliminating sodium nitrite? Is it worth it, considering that it prevents the growth of some really toxic bacteria?
2. Artificial colors (and some flavors, maybe?).
There is some suspicion that some of these colors might result in an increased instance of ADHD. Is the data reliable? What about the studies that suggest no correlation? Ask I asked in question 1, what are the additional costs of eliminating these? Since we may not color otherwise -- it is just aesthetic, after all -- what are the potential cost savings? Are they worth it? Any other risks I am missing? Same questions.
3. MSG.
Same concern as NaNO2 about migranes, and a possible link to obesity. Both of these appear inconclusive. Same questions as NaNO2.
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There are a few other things I need to research more before I can asked good questions about them. And some of your advice I have no questions about; I'm already aware it is good advice. :-)
I'm not asking these just to be deliberately provocative; I think they are important questions to ask. A rambling train of thought on why I decided to ask them:
The people I know who really obsess about what is in their diet are, on average, the most unhappy, neurotic people I could imagine meeting. They spend much of their time avoiding disease and increasing longevity at the expense of enjoying life and not worrying so much.
Sure, they could just punt, and buy everything at the most natural store they can find, but that is really expensive.
To account for that added expense, they now have to find work that pays better, which for many people means compromising on a number of other intangible factors. These can play havoc on a person's frame of mind, and cause a variety of other health consequences.
I may not be speaking for many of the people here; I suspect the expense is something a lot of us -- including me -- could bare without a lot of trouble and without sacrificing much in quality-of-life.
But I don't think the average HNer is representative of the larger population.
Example: one friend of mine, neurotic about his diet, quoted me a grocery bill of over $600/month on average. You can probably imagine what sorts of items he buys regularly
This a remarkable sum of most peoples' take-home pay. If they bought food this way, the money they spend might increase their longevity; we've had threads on here in the past arguing that this budget is worth every penny. However, it might also severely hamper their quality-of-life; it might even start to hamper their ability to pay for what we consider necessities.
In the case of the friend, it was a significant chunk of his take-home pay. He constantly found himself strapped for cash and falling into deeper levels of depression as a result. I'm not sure if he was making the net positive trade-off. It sucks that he had to make that trade-off at all, but that is several political squabbles from getting solved.
I don't mean to discount any of your advice. In good circumstances, it is well thought out and well researched advice. I follow at least some if it myself, and probably should follow more. I'm making a note to add blueberries to the next shopping trip, even though my cholesterol was ok last time I had it checked -- they're tasty, that is reason enough anyway. :-)
But I think it's worth mentioning that this problem goes deeper than just individual people passively ignoring advice. As even Dr. Lustig pointed out, there is manipulation going on behind the scenes, and some people may not have the means to effectively fight against the manipulation and still feed themselves.
And it's also worth asking for clarification, even if one can make a change without an undue burden. Asking questions is always a good idea. :-)
That sounds too good to be true.
If only this information was easy to come by. Most people don't have time to look into the nitty gritty details of the foods they eat.
In reality like comp programs before we optimize on details, let's solve the biggest problems we have then when those are solved we can focus on little details here and there.
Don't drink soda/juice, Eat blueberries and fruits instread of candy/cookies. Would that not significantly improve most people's health by itself?
Juice in what form though? Whenever I buy fruit juices I avoid the ones that add sugar/HFCS in addition to the fruit juice. Does drinking orange juice with lots of pulp give you the added fiber to counter-act the fructose?
I always wonder when people mention 'juice' because the vast majority of the juices that you find in a supermarket are loaded with sugar on top of the juice itself (which may be 'from concentrate'). I always avoid these like the plague.
Doing a quick lookup in the dietary app on my phone says that 8oz of orange juice (from concentrate, with pulp) has 28g of sugar and 0g of fiber. Meanwhile a cup of raw orange (peeled) has 17g of sugar and 4g of fiber.
Based on the presenter's description of the ratio of fiber to fructose in raw fruit, I'm starting to wonder if ANY commercial juice could provide enough fiber to counter-act the fructose. I guess you could add a fiber mix or something to the juice to match the fiber/sugar ratio of the raw fruit. I personally hate the taste/flavor/texture of mixin fiber and would rather just eat the fruit.
PS. Just saw kingkongreveng_'s comment about modern fruit being bred to contain more fructose than in the past (http://news.ycombinator.com/item?id=1008261). In that case the juice is even worse than my comparison makes it look because the sugar content of modern fruit would skew the baseline upwards.
Also, I would think that the pulp contributes fiber, no? That's why I added 'with pulp' (in addition to the fact that I like my orange juice heavy on the pulp).
I don't think so - didn't he say orange juice is filled with sucrose? Sucrose is 50-50 glucose-fructose, unless I misinterpreted that part of the video. HFCS, as I recall, is 55-45.
The expense of good quality food -- agreed wholeheartedly. It's one of the many reasons for solving (as PG says) "the money problem." There are also policy changes we could make -- subsidizing fresh produce instead of corn and sugar would help.
Organic food is prohibitively expensive to many, and contributes to class divide. There's also some ethical argument regarding whether a class division across food should exist at all. Is it appropriate for the wealthy to create a separate variety of more healthful food which only they can afford? Having done so, what incentive do they have to improve the food supply generally? In the US, the demand for organic food has always exceeded supply.
Regarding the healthfulness of MSG, please see: http://en.wikipedia.org/wiki/Excitotoxicity
Regarding the suitableness of agave nectar as a sweetener: Yes, it's fructose, but not all fructose containing substances are the same. Agave has the useful quality of being very low glycemic -- lower than a peanut. This means it's absorbed slowly over hours instead of minutes like refined sugar. As a result, it avoids causing insulin spikes and blood glucose instability.
However, ideally health conscious people will become accustomed to less sweet foods over time. I think eventually tastes recalibrate. Personally, I now find broccoli and cashews to be very sweet, but I didn't years ago when I used to frequently eat sugar.
Regarding nitrites -- their safety is mostly argued by the meat packing industry (no surprise.) For (one of many) authoritative references, see the World Cancer Research Fund's report: "Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective" (2007). http://www.dietandcancerreport.org/
Artificial colors -- Take note of the history of colors approved by the FDA. We've spent decades approving substances and then later finding significant problems with them. I'm not ready to trust the current batch, and evidence against them is accumulating. Ironically, some of the safest color adding substances right now are made from ground insects! http://www.snopes.com/food/ingredient/bugjuice.asp
Also, a diet with staples like grass-fed beef, pastured butter (or any other healthy animal fat), avocado, and fish is my kind of diet. No more forcing down bitter grain or soy products in fruitless attempts to go "healthy". Plus, my meals are so substantial and high in fat that I only need to eat once or twice a day.
For anyone interested, there's a lot of good paleo sites out there, but I'd start with http://paleonu.com and http://freetheanimal.com
And if you can, pick up Nourishing Traditions by Sally Fallon.
Human digestive tracts are made for high-quality (bio-available energy/mass) nutrition-dense foods, unlike ruminants, or large apes like the gorilla.
And most people get plants confused with seeds. No other animal eats seeds in the quantities we do, especially as Omega-6 rich seed-oils.
Pollan has become a touchstone for many, but imho he's fairly wrong.
very good video, learned a lot
It's also perfectly healthy to eat predominantly meat, organs, and dairy if the animals are properly pastured. So the "mostly plants" claim makes little sense without a lot of qualification.
Why not?
Maybe you can achieve similar effect with some other precise diet but eating mostly plants is the easiest way to improving your health and lower you calories intake.
"Dietary and lifestyle determinants of mortality among German vegetarians" found that "A longer duration of vegetarianism (> or = 20 years) was associated with a lower risk, pointing to a real protective effect of this lifestyle"
"Vegetables, fruit, and cancer prevention: a review" states that "the evidence for a protective effect of greater vegetable and fruit consumption is consistent for cancers of the stomach, esophagus, lung, oral cavity and pharynx, endometrium, pancreas, and colon. The types of vegetables or fruit that most often appear to be protective against cancer are raw vegetables, followed by allium vegetables, carrots, green vegetables, cruciferous vegetables, and tomatoes"
"Nutrients and food groups and large bowel cancer in Europe" found that "most vegetables, including pulses, were inversely associated with cancer of the colon and rectum."
Okay, the corn syrup is just fructose, and as I understood from the lecture it's equivalent to poison so we should avoid it.
But then sugar from plants and fruit also contains fructose! For every gram of natural sugar there is half a gram of fructose. If we eat natural sugar it seems equivalently bad? I don't get it.
So what does the lecture tell? Does it say we shouldn't be consuming sugar at all? Or should we only be consuming glucose part of sugar? Or what?
Can anyone explain?
Thanks!
I think the main message is to avoid fructose in all forms. The rest is basically ABC analysis. Identify where most of your fructose intake originates from and cut down on that source.
The fact that HFCS is made from normal corn syrup (almost 100% glucose), which is processed into fructose seems almost ironic.
Eating lots of fiber with fructose should theoretically counteract this cycle to some extent, by regulating the hormones and preventing overeating.
Almost everywhere fructose is found naturally, it is coupled with huge amounts of fiber. Because of this, humans haven't really been harmed by the negative effects of fructose until very recently. The speaker in the video suggests that you can kind of mitigate the negative effects of fructose by eating lots and lots of fiber, but I don't think this has been scientifically studied yet. It makes sense theoretically, though.
Fiber also does a whole lot of other great things for you, too, and he discusses some of them in the video.
Given that there aren't particularly impervious ties in either political party to sugar/carbs (activists being health advocates on the left and anti-subsidy advocates on the right) I hope this set of research pathologies gets a kick in the pants when sugar support detonates.
The fact that we like it so much, as with sweets, suggests that it was hard to find - a significant mental reward was required to make us make the effort to find it.
Our bodies run on sugar; sources of sugar, such as fruits and starches were not hard to find.
Availability and use of fruit in our diet long ago is hardly anything new. It certainly was not hard to find.
http://www.health101.org/art_diet2.htm
Research Yields Surprises about Early Human Diets
Teeth Show Fruit Was the Staple
By Boyce Rensberger
May 15, 1979 issue of the New York TimesAssuming that nothing in how the body works happens for no good reason:
The fact that we enjoy it means that our body rewards us for eating it, something that most likely means that it's something the body wants us to do. If it was abundant, though, that'd make us eat too much of it (which is what's happening today) unless there was something to stop us. With salt it's possible to eat too much: that makes us feel bad. That suggests that salt was abundant, otherwise we wouldn't need the counter system. The lack of a counter system for sweets suggests that it wasn't abundant, at least not to the degree that we could eat enough of it to prevent us from reproducing.
Our bodies run on sugar; sources of sugar, such as fruits and starches were not hard to find.
Eveything we digest is converted to sugar, be it fruits, bread or meat.
Regarding the link:
That some of our ancestors two million years ago might have, or might not have, eaten mostly fruits doesn't say much of anything about how Homo Sapiens work. In the article they say that even the Homo Erectus were omnivores, and that was 1.5M years ago. Things have happened since then...
> The fact that we like it so much, as with sweets,
> suggests that it was hard to find.
> With salt it's possible to eat too much: that makes us
> feel bad. That suggests that salt was abundant,
> otherwise we wouldn't need the counter system.
Your speculation on sweet being difficult to find is also nothing more than (poor) speculation. The link I provided above is just one example showing that fruit WAS abundant, as regardless of what those creatures were, fruit was easily accessible.
It amazes me how much people use "evolutionary theories" to speculate about just about anything to reach just about any conclusion.
I revised it to abundant, but not as abundant as say air or water.
Your speculation on sweet being difficult to find is also nothing more than (poor) speculation.
Of course it is. However, you also need to take into account that (most) natural fruit is far from the sweetness of the cultivated fruits we can buy in the stores today. Compare wild apples to shop apples, for example.
The link I provided above is just one example showing that fruit WAS abundant
It might have been abundant 2M years ago, where those ancestors lived. That says nothing about what happened the next 2M years, which is a significant period of time in evolutionary terms (at least 100k generations). If something changed, e.g. there was less fruit, the ancestors might have started eating other things - maybe become omnivores (like the next step in the chain towards Sapiens, the Erectus). Sounds like something that fits pretty well with what's known about our ancestry.
Going back to an arbitrary point in our history and saying that that's when Things Were Right(tm) and ignoring what's happened since then is no better than my speculations. At least choose at time nearer to now if you're going to do that, maybe 10k years ago when the latest major change in our diet occurred? Even that is 500 or so generations ago, so we should have had at least some chance to adapt to a farmer's diet. And by the way, the farmer's diet is what's allowed us to get where we are today in terms of civilization.
It amazes me how much people use "evolutionary theories" to speculate about just about anything to reach just about any conclusion.
It's fun! Doesn't actually say a whole lot without actual research though.
> The lack of a counter system for sweets suggests that it
> wasn't abundant, at least not to the degree that we could
> eat enough of it to prevent us from reproducing.
Try to overeat on fruit - it's imposssible. You'll feel full and be tired of "sweet" long before you could ever overeat on it. Fiber and sufficient blood sugar have a way of telling one when they have been satiated.
We need sodium. We don't need rock salt.
CRON-O-Meter (Linux/Win/Mac) and similar software/sites (e.g. fitday.com) will demonstrate this for anyone who wants to see how the numbers fall into place for any of the nutrients.