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Awesome. Thanks for posting this.

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. :-)

Mostly good points. I think some comments are necessary on a few though:

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.

You do realize that agave nectar is basically pure fructose, right?

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".

A natural form of MSG is found in one popular variety of edible seaweed: kombu.

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.

Glutamates are in Kombu, soy sauce, Parmesan, Marmite, peas...

http://en.wikipedia.org/wiki/Glutamic_acid_(flavor)#Sources

Please see my reply below.

Why on earth would you recommend Agave syrup as a sweetener when it has an even higher fructose/glucose ratio than the dreaded HFCS? There are sweeteners that are 100% glucose including plain old corn syrup but also other nice alternatives (maple syrup etc...) or even refined dextrose...

As much as 60% of Americans are deficient in vitamin D

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.

IIRC, it's the same with Vitamin C since it's water soluble (i.e. excess escapes through your urine). Just note that -- like everything -- it is possible to overdose, so don't down a whole bottle of Vitamin C/D pills in a single go. It's just in these cases your body can readily deal with excess (as long as it's not too much excess).

Vitamin D is a fat soluble vitamin, like Vitamins A, E, and K. It does accumulate in the fat tissue. An excess of Vitamin D is not simply disposed of in the urine, like Vitamin C or the B-complex.

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."

above from Am J Clin Nutr. 2000 Sep;72(3):690-3. Decreased bioavailability of vitamin D in obesity.

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 ;)

> ...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.

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?

I read somewhere that 15 minutes direct sun exposure per day in a t-shirt between 11 AM and 3 PM is sufficient. Obviously that has to depend on the latitude of your location so I'm not sure how accurate or meaningful it is. And it does depend on the color of your skin. The darker your skin the more sun you need to get the same amount of vitamin D.

It'd take more than just a bottle of vitamin C pills, I think--it's one of the least toxic substances known. The LD50 on vitamin C is probably about two pounds of pure vitamin for an average adult.

It's probably easier (and certainly more common) to overdose on water.

Some quick answers to several of the questions posed in responses (I will try to spend more time in this thread later today):

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

Actually none of those suggestions seem crazy, as far as I can tell.

"Sufficient vitamin D reduces risk of nearly all cancers by around 70%"

That sounds too good to be true.

A simple but effective message.

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?

> Don't drink soda/juice

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.

In the presentation (45:00) he walks through the metabolism of 120 calories of glucose (from white bread), alcohol (a shot), and fructose (orange juice). Not pretty.

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.

So would the occasional glass of orange juice actually be worse than the occasional can of soda? If the orange juice is mostly fructose, wouldn't the soda with 50/50 glucose-fructose be better (seeing as it at least has glucose in it)?

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).

>So would the occasional glass of orange juice actually be worse than the occasional can of soda?

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.