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Comment by marknutter | Hacker News Reader

I have become so wary of comments about lifestyle or diet changes that result in a bevy of subjective improvements. Like when people start running and they have all these wonderful side effects — more energy, better sleep, mood improvements, etc — where in my experience I really didn't experience any of it when I trained for a triathlon a couple years back. It just reminds me of infomercial testimonials. I need to see double-blind clinical trials that prove the effects outperform placebo at this point. It all sounds logical, because "sugar bad" but I have become far too skeptical these days.

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Double blind dietary study? It would be quite hard to fool someone into thinking they are eating cupcakes when they are really eating a bowl of unsweetened oatmeal.

Dietary studies are very hard. There is no conspiracy preventing rigorous studies, they are just really hard. You need a large enough sample, you need to control the subjects very tightly (people don't self-report accurately), and you need to do it for long enough to see if the effects are lasting or illusory.

If you want real science here, we need to change our expectations and think in terms of $10B not $10M. Probably still a good investment in health, comparable to cancer research.

Until that time, what are you using to make your dietary decisions, given there's not much real science behind any of it?

I completely agree that it would be very difficult to perform such studies, if not impossible, but that doesn't make me desire them any less. Instead I've become very skeptical of everything and – if you'll pardon the pun – follow my gut instincts.

I find maintaining a high level of skepticism tends to dissipate any longterm benefits of the placebo effect. So sometimes I'll try a fad, or a lifestyle change, but hold my judgement until months later and most of the time I'm left disappointed in the overall results.

Other than that, I follow the golden rule of health and nutrition: "everything in moderation".

Skepticism is fine. But that doesn't mean you can't take someone's advice and just try it. Sometimes it works out, some times it does not. But it's just optimizing what works for "you". This is something you'll never find in a clinical study no matter how good.

> Sometimes it works out, some times it does not

Actually, it almost always works out, at least initially. The problem is, the benefits go away; that's how placebo works. I'm just wary of getting my hopes up these days so I'm very careful about what drastic lifestyle changes I make now. Beyond that, I'm also tired of people guilt-tripping everyone else every time they make one of these lifestyle changes. Everyone rushes from one fad to the next and along the way we all feel a little worse about ourselves.

"Everything in moderation" is just a tautology. "Moderation" for kale is different from "moderation" for sugar is different from "moderation" for opiates. "Everything in moderation" means "the right amount of everything," which is just begging the question of what the right amount is in the first place.

Ah, thank you for articulating the problem I have with that statement that I could never quite put my finger on.

Also thank you for using "begging the question" correctly.

I would not agree it means "the right amount of everything". That would be "everything in the right amount". I take "everything in moderation" to mean not too much of anything, using your best judgement of what too much is. It's subjective and based on intuition, to be sure, but I think everyone has a decent understanding about when they are having too much of something. And I fully admit it's not a great tautology. But in lieu of better science, at least it's something.

"It would be quite hard to fool someone into thinking they are eating cupcakes when they are really eating a bowl of unsweetened oatmeal."

I would be willing to be fed slurry through a tube, if it provided good information.

This does assume the form factor and visual re-enforcements don't contribute to the effect. You can call this "placebo" if you want, but the perception is real and might not have a clear "alternative placebo".

I wouldn't count those chickens anytime soon.

But wouldn't you give the control and test groups the same looking / tasting slurry?

I would recommend trying it yourself. I always had problems with my knees, wrists and elbows to the point where pretty much any kind of exercise caused lot of pain. Then I spent a month at a yoga ashram where all food was made fresh without any sugar. After two weeks the joint pain was almost completely gone.

I am now on a low-sugar diet and my joints are still doing well. When I eat some sugar after half an hour my wrist and elbow start to hurt again.

I have tried this a few times and the effect is totally reproducible. This experience makes me wonder how many people who have arthritis and other inflammatory diseases could reduce their symptoms with a low/no sugar diet.

Keeping weight off is also much easier with low sugar.

My advice is: Keep it a try. Stay off sugar for a month and see if you notice any changes. There is nothing to lose (besides a few pounds).

Re-read your comment and tell me it doesn't sound like an informercial testimonial. It worked for you. That's great. Placebo is a hell of a drug. Staying off sugar is a huge pain in the ass because it's in everything, it's delicious, and it makes me happy when I eat it. If I told you that I gave up tap water and strictly drank bottled water for a month, and my knees felt better and I had more energy and I was able to reproduce the effect, would you take it on faith and try drinking bottled water for a month?

Dude, why so much hate? What use would be an infomercial recommending to stop eating sugar?

In the abstract you're right, however in this case there are actually links between eating sugar and inflammation in the body. Sugar affecting arthritis is not a new concept; there's plenty of studies on the topic already out there and the relationship between sugar and cytokines in the body. I'd say that's fairly far from a placebo effect.

Let's say, for the sake of argument, this is just a placebo effect. Does it really matter? If it provides a noticeable, reproducible result that improves someones life, who cares? Is it guaranteed to work for you? No, but there's no guarantee with a double blind tested, well researched method either.

It's giving up sugar, not ingesting plutonium. Worst case scenario you don't get the 'infomercial results', but it most likely will still improve your overall health

I'd think about it carefully and see if it had some plausible scientific explanation. I'd look at the cost of trying it and the cost of not trying it. And then I'd try it for a month or not. It's a month! In a lifetime, it's not a long stretch of time. If there's a real benefit you win, if there's no benefit you learned something. (Keep in mind the above line on considering costs and whether I'd do it in the first place -- that's meant to put a bound on costs.)

There are probably places in the US where switching to bottled water would be a great idea, sadly. Northern Iowa, for instance, is struggling to remove nitrates from its drinking water (nitrates affect oxygen transport by blood), and in parts of Pennsylvania fracking has led to flaming tap water. If you live there, it might not be a bad idea to try your example of a silly experiment.

How can I tell somebody about my personal experiences without sounding like an infomercial? And why do you call it placebo? I have gone back and forth several times with the same results every time.

Maybe my body is different from anybody else's body and my results apply only to me. That's obviously a possibility.

That sugar is inflammatory sounds pretty likely, though. Actually, the Wikipedia article on sugar states that food with a high glycemic load cause inflammation.

Thank you for this. So many people online make diet and exercise seem like some silver bullet, and it's fascinating how much it has been accepted as a silver bullet, yet in my experience it was no big deal.

Though I've noticed that most of the silver bullet testimonials come from US citizens. Could be that the standard American diet is way, WAY crappier than most. Where I come from(somewhere in Africa), fast food and sugary foods are for the wealthy, while organic whole foods is for ordinary folk. So maybe I wasn't eating so badly before, that's why I didn't feel the 'magical' effects I read about from US citizens.

Yup it's a US centric problem. Before coming to the US I would never consider "maintaining a healthy weight" (I've lived in the UAE and India before). The sedentary lifestyle and abundance of cheap (I mean really cheap) sugary products is the root cause. One of the striking things to me when I moved to the US was the waistlines of people who were considered to be living below or around the poverty line. I was like "They seem to be well fed, in what sense are they poor?"

> Before coming to the US I would never consider "maintaining a healthy weight" (I've lived in the UAE and India before).

To be fair, the UAE has approximately the same obesity rate as the US.

Yes it is, amongst locals. Not expats. And sugary products in the UAE aren't as cheap as they are in the US.

so...not a "US centric problem" then

I am not saying this is the solution to all people who are overweight or anything like that.

I am only saying that for someone like me who was clearly addicted go suggar, the result is clearly here.

I tried to stop eating too much since I was ~17 years old and I was never able to do so until I cut added sugar.

I am only speaking for myself (and for my dad who needs to cut added sugar :))

Eating too much sugar and then bringing it down to "normal" levels is one thing, but cutting it out of your diet completely is another. I think eating too much of anything is going to have negative side-effects and bringing that consumption back to normal levels will have the reverse effect. It doesn't seem particularly compelling to me. Sugar is no more harmful to us than most of the other chemicals we consume when done in moderation, so I feel it's being unfairly singled out.

It's being "unfairly" singled out because it's being "unfairly" added to most processed foods. Why is it added? Because it's addicting, people will always want more, and are therefore willing to pay for it. Want your food product to sell more? Add sugar. It's nice that you think people should "just eat normal levels", but it's extremely hard in practice when the food landscape is heavily saturated in the stuff, especially the cheaper products. Healthy food, or "moderate" behavior, exists alongside a mountain of more appealing options in the moment, especially considering cost.

Go to the grocery (in the US), and look at many products attractive to children. Notice the heavy prevalence of added sugar. Unfairly singled out? lmfao

> Why is it added?

Because it's delicious.

Why do people eat too much sugar? Because they like delicious things and eating delicious things makes them happy. Maybe we should focus on why people use food to feel happy rather than why food is manufactured to make people feel happy.

> Maybe we should focus on why people use food to feel happy rather than why food is manufactured to make people feel happy.

That's not really fair. I agree with your general skepticism in this thread (there's a reason that most of these studies show small effects due to dietary modifications but most anecdotes of the same are "and now everything is amazing!"), but the human body is designed to crave things like fat and sugar and to feel good when they're acquired.

Some kind of ascetic lifestyle -- where we can remove the desire for the pleasure of eating -- may be possible, but the physical design of the body and our reward system indicates that enjoyment from eating food is built right in.

It would be like ignoring people perpetuating fraud and instead only trying to solve all the ways that the human brain is susceptible to it.

You responded to a rhetorical question and completely ignored my response to your ridiculous claim that sugar is being unfairly singled out. Why is that?

Because it's delicious

It's not though. It's only delicious for people who have high sugar intake. And besides, deliciousness is subjective and orthogonal to nutrition, while nutritional value is largely objective (we hope).

Smoking is bad for you, so it's illegal for minors to buy and it's illegal to even smoke with a minor in the car. High sugar intake is bad for you, so it's illegal to advertise sweets to children /s.

Maybe we should focus on why people use food to feel happy rather than why food is manufactured to make people feel happy.

You really think for us to have any hope of changing the prevalence of obesity is to get people to change their behavior, instead of minimizing the accessibility and prevalence of the environment which reinforces said behavior? It'd be great to do both, but realistically...? Get millions of people to change their behavior and opt for the more expensive / less flavorful foods? (And I mean less flavorful in a subjective sense, since they're used to very sweet, very salty things.)

You guys just love arguing about semantics.

We can't convince others with an aggressive tone. Like I'm doing. But we can definitely win over an audience.

> > Why is it added? > Because it's delicious.

You can't possibly be this ignorant of nutrition. Do you really think sugar is somehow objectively and universally delicious (excluding the trivial definition in which almost every taste is "delicious" in that it contributes to the overall palette of flavor)?

I didn't quite cut sugar out of my diet but around college I stopped eating as much, and I now found most of the desserts or candy one would find in the supermarket to be too sweet for my tastes, as well as most "normal" sweetened drinks (by contrast to e.g. many fruits). How does that mesh with your claim that sugar is added because it's simply "delicious", as opposed to other's model of a feedback loop between amt of sugar consumed and amt of sugar desired?

Sugar is addictive. It is therefore a drug. Like it or not.

Stop eating it for a few weeks and you will find food with a lot of added sugar disgusting (eg: coke).

> Sugar is addictive. It is therefore a drug. Like it or not.

Addictiveness has nothing to do with whether or not something is a drug. Like it or not.

I agree, most of the life changing experiences people describe sound a lot like they were depressed and now they're not.

I ran in excess of 32 miles a week for several years and the only side effect I had from it was blisters.

If the only change 32 miles a week had on your body was blisters then you must of been in rather great shape to begin with. No cardio improvement? No muscle gain? No weight loss? For the vast majority of Americans I have a feeling this would not be the case.

I transitioned to running in college when I got too old for most basketball leagues so I was in pretty good at the time.

I started running again a few years ago after a 5 year hiatus from any regular physical activity. I logged my Time, Avg/Max HR, and Calories burned for each run and there really wasn't much of a change in metrics over the 3 year period I tracked them. My heart rate was surprisingly stable and run times reduced gradually but only about a minute a year.

Maybe if I was incredibly unhealthy but I generally eat well and at my worst I've only been 20-30lbs over weight. I know that sounds like a lot but I'm 6'5" and my "ideal" body weight is 190lbs which is kind of ridiculous.

Sounds like it worked great for you.

Some folks would argue that if you're in reasonably good physical condition, you're not going to see big results from any exercise program. The contention is that diet controls much of your body composition and all those other effects people are talking about. I don't know if I agree, but it's an interesting idea; the remaining hunter-gatherers in east Africa don't expend more calories than us even though they do a lot more physical activity every day. My own experience is that once I got used to biking 50 miles a week it had no effect on my body shape or composition.

However, once I stopped eating a few things that continually gave me sinus problems I didn't even realize I had, I did feel less depressed :)

What were you eating that gave you sinus problems?

I'm also curious about foods that may be related to sinus problems.

Surprisingly, wheaty foods. I was not a very nice person in the mornings for decades, because my face hurt. I thought that is what being tired felt like. My old roommate still mentions that I'm a grumpy morning person because that is all she ever knew.

Then I stopped eating wheat and I stopped feeling like someone punched me in the front side of the head. It was truly bizarre. I had no idea.

  Like when people start running and they have all these wonderful side effects 
  — more energy, better sleep, mood improvements

I can definitely vouch for that but I would not generalize it by saying everyone will feel the same way. The changes in me are remarkably stark when I do exercise/jog as compared to when I don't at all. I would like to counter the possible argument that I go for an exercise when I'm in better mood or feeling high energy by stating that I've had the mis/fortune of trying it out during various states of my being.

I think there may be an evolutionary aspect to it as we started of as nomads and the lifestyle that we live currently is the result of the industrial revolution and hence quite recent.

Well, I pretty much did the same thing and lost 35 lbs. I know my electronic scale can't be influenced by the placebo effect.

That said, I'm not trying to say sugar is 100% bad for you. I'm sure removing 100% of the sugar from the human body will cause it to fail. Just saying that if you're one of those knocking down 2 bottles of mountain dew and a candy bar everyday, you should probably stop.

>I'm sure removing 100% of the sugar from the human body will cause it to fail.

Why? You can get the needed carbs in other forms. Is sugar required to be eaten? I don't think so.

I don't know... it would be pretty difficult to argue "sugar good" as a lifestyle/diet change. BTW, there are plenty of studies that prove this.

EDIT: Don't want to say 'prove' but would mostly purport the argument that "sugar bad".

I challenge you to live without sugar of any kind. Sugar is not only undeniably good for us, it's completely necessary for survival. What we're debating here is the amount one should consume and that's where things start to get fuzzy.

I'm sorry, but how is sugar "completely necessary for survival"? Can you point to any studies that back that up?

I'm not a nutritionist, but from my layman understanding, carbohydrates break down to glucose during digestion, so any "good" carb source (oatmeal, beans, peas, etc.) will affect blood sugar levels.

But even those carbs aren't necessary for survival. After a period of time, the body (and yes, the brain as well) will adapt to use other sources of energy, such as ketones, which are a fats/lipids by-product. Even then, with no carb intake, glucose can be generated from non-carbs via gluconeogenesis, if needed.

Low-carb high-fat diets have been a life-saver for diabetics, helping reduce or eliminate their reliance on insulin, and that's pretty much proof the human body doesn't need sugar for survival.

Did you, in addition to training for the triathlon change your diet? I tried it both ways (not for a triathlon, but general fitness) 1) Not changing my diet 2) Changing my diet (less meat, minimal processed food, no coffee, etc.).

There was a massive positive difference with 2). IMO, a person's diet is way, way more important than his/her exercise regime.

I think it really depends on your natural baseline though, doesn't it? Someone that is not used to any kind of physical activity will enjoy greater benefits after a few weeks of regular exercise and his experience of the whole thing would be completely different I reckon.

Skepticism can be nullified from the big-picture point-of-view. Look at any one subject in isolation and it will get confusing fast. Look at everything as a highly-connected orchestra or puzzle and things may come into focus.

I try to orient my skepticism towards "things that don't make sense".

What does it mean for something to "make sense" exactly?

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