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Comment by tkyjonathan | Hacker News Reader

I still dont agree that sugar is the problem. Lustig himself seems to have not figured out what the secret is to health and weightloss as he is obese to morbidly obese.

Saturated fats still do cause heart disease, strokes, alzheimers.. anything where blood is blocked or doesnt reach the organ it needs to.

If anything, processed sugars like HFCS which is extracted from corn by a chemical enzyme process, could be the cause. But the problem to me is when people think chocolate bar, cake, pizza or milk shake.. these are food items with 75% calories from fat. So if you exclude high fat items and greatly reduce heavily processed sugar foods, you will not have the issues we are facing today.

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The irony of you starting your rebuttal with an ad hominem attack is pretty amusing.

Expecially in reponse to an article that talks at length about others in nutritional science using ad hominem attacks as a primary form of defence against dissident arguments.

It may seem like an attack, but you can also consider it fair comment as he is an expert tell us that sugar causes weight gain, when he himself is obese for many years now. How can you both be an expert on weightloss and obese at the same time?

I can think of plenty of reasons: he might not care (or care enough to change his life style to the degree necessary). He might have a disease that causes it. Or maybe he doesn't know how to get slim, but still knows that reducing fat is not the answer.

You're confusing knowledge and application of that knowledge in a personal situation.

A cosmologist may know all about the orbit of the planets but still say 'The sun rose this morning'.

against dissident arguments

Against alternative explanations, I prefer. Dissident carries a negative connotation that is unwarranted here.

> Saturated fats still do cause heart disease, strokes, alzheimers..

All the studies claiming to make these links have been comprehensively debunked. And it's worth remembering that the vast, vast bulk of fats and cholesterol in your body are not dietary, they were produced inside your body from other macro-nutrients. And they are essential. Without them you would die.

On a very basic level, blood flow gets blocked because inflammation in your arteries causes cholesterol manufactured by your liver to stick to the walls and build up. Consuming saturated fat does not cause this inflammation. Whereas there is evidence that consuming sugar does.

It is my understanding that your reply is the reasonable state of affairs. Do you have some "canonical", go-to link that makes your claim approachable to ordinary people? Say parents?

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/

http://www.nature.com/ejcn/journal/v67/n8/full/ejcn2013116a....

Ketogenic diets increase all-cause mortality

http://www.ncbi.nlm.nih.gov/pubmed/20820038

http://www.ncbi.nlm.nih.gov/pubmed/22850317

http://www.cell.com/cell-metabolism/fulltext/S1550-4131(15)0...

and make you gain weight http://www.nih.gov/news-events/news-releases/nih-study-finds...

not compared to a high carb/sugar based diet as we can plainly see in everyday life.

Re: 20820038 - Keto is low carb, moderate protein. it doesn't really matter where you get the protein from.

Re: 22850371 - Again, Ketogenic is not HIGH protein diet as eating too much protein is just turned into sugar which defeats the whole purpose of eating keto... so yes, if you eat a lot of fat, and a lot of sugar, you will die sooner.

re: Cell.com - it measured whether or not these people went into ketosis for 6 whole days, when it takes upwards of 3 months to become keto-adapted. It takes the average person (not the morbidly obese person) 3-5 days just to get into ketosis, let alone keto-adapted.

how could I calculate what is moderate compared to high protein? I agree with you, but don't know when I am in eating too much protein.

every one is different. I have found a good basic starting point (for me) would be .5g protein per pound of body weight and then lower it based on how you feel. So for a 240lb person who does not lift 'for gains', maybe goes to the gym twice a week, ballpark of 120g (+/- 20%) a day would be fine, it just depends on how you feel.

Keto macros are supposed to (generally) be:

80% calories from fat (I try to get 200g/day)

15% calories from protein (I try to keep mine around 120g/day)

5% calories from carbs (keep it under net 20g/day)

This is pretty difficult to do. I usually end up somewhere around 70-75% fat, 7%ish carbs, 20%ish protein. But at least I can eat bacon wrapped avocados without guilt... i'm constantly adjusting to get my macros. I just added MCT oil to the daily diet.

I was (am?) obese when I started this and I've dropped a considerable amount of weight (30+lbs), and my blood sugar has dropped and stabilized. I'm not keto-adapted yet, though.

Inflammation and plaque on your artery walls are two different things. Also, sources of saturated fats such as meat and dairy cause inflammation.

http://ajcn.nutrition.org/content/early/2010/01/13/ajcn.2009...

The problem with that study is that it is observational and was set up to fail. Metabolic ward and interventional studies still show that if you eat more saturated fats, your cholesterol increases. For example, if you add 30g of butter to your diet every day, your cholesterol will go up. Sorry for breaking it to you.

I never said it wouldn't "go up" - but that butter may do more good than harm.

http://www.ncbi.nlm.nih.gov/pubmed/12716665

http://www.ncbi.nlm.nih.gov/pubmed/2619783

http://www.ncbi.nlm.nih.gov/pubmed/20071648

"CONCLUSIONS: A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD. More data are needed to elucidate whether CVD risks are likely to be influenced by the specific nutrients used to replace saturated fat."

>> If anything, processed sugars like HFCS which is extracted from corn by a chemical enzyme process, could be the cause.

Fructose, which Lustig (and other scientists) suspect as the prime cause is present in both HFCS and granulated sugar (cane or beet). It’s my understanding that the difference in fructose quantity between HFCS (55% Fructose, 45% glucose) and granulated sugar (50-50) is not a significant factor.

Turns out though depending on the source sometimes they are using 70/30 HFCS.

Difference between sugar and HFCS in the US is generally people add sugar themselves. And HFCS is added by the producer. Compare you putting a teaspoon of sugar in your coffee with the 10 teaspoons of HFCS in a can of coke. If you buy your coke at the quik mart it may also be HFCS 70/30 to boot.

> Lustig himself seems to have not figured out what the secret is to health and weightloss as he is obese to morbidly obese.

I just googled images and videos of him, in case your statement had some validity. The Lustig I saw looked like an ordinary man. Not detectably obese and certainly not morbidly obese.

"obesity" is an objective label. It's difficult to look at a photo of people who are overweight (and he's clearly overweight in the photos I've seen) and call them obese or not obese. Especially for men who tend to have visceral fat.

> But the problem to me is when people think chocolate bar, cake, pizza or milk shake.. these are food items with 75% calories from fat

I don't believe this statement is true. Calories in pizzas are generally around 1:1 from carbs:fat[1]. Likewise with a typical (i.e. low cocoa solids) chocolate bar[2], milk[3], or cake[4].

Calories in a milkshake are likely to be from 2:1 carbs:fat, at best (milkshake generally equals milk, plus sugar, fruit and flavourings).

[1] http://corporate.dominos.co.uk/Media/Default/CSR/Nutritional... [2] http://www.tesco.com/groceries/product/details/?id=273968548 [3] http://www.tesco.com/groceries/product/details/?id=254656543 [4] http://www.tesco.com/groceries/product/details/?id=257617038

>But the problem to me is when people think chocolate bar, cake, pizza or milk shake.. these are food items with 75% calories from fat.

Those are all junk food. Use sparingly. Try eating a piece of fruit instead.

I mean, FFS, I really like chocolate, but of course it's unhealthy. Salads and fish are healthy. Everyone knows that.

Modern fruit is junk food. It has a much larger sugar content than wild varieties of the same plant, and was purposely cultured that way because people like large sweet fruits.

Eat sparingly.

I eat a lot of fruit. Sometimes I eat over 600 grams of carbohydrate a day.

Look, I'm pretty sure that if I want something sweet, fruit is better than cake. I'm also pretty sure that if I want to never, ever "sin" regarding diet, I will probably die, because some jerk is going to find something wrong with boiled greens and then I won't even be able to eat those anymore.

Balance.

nothing is inherently unhealthy or bad for you.

let's have an example, lets say you eat a balanced diet, plenty of fibre, micronutrients, protein, fats, and you have 300 calories left for the day before you go over your maintenance intake. you decide to eat a mars bar. unhealthy? not at all.

another example, you don't eat enough fibre, because all you eat is pizza pockets. you drink coke instead of water, you go over your maintenance intake by 500 calories and decide to have a mars bar. unhealthy? yes. but it wasn't the specific food that was unhealthy.

unfortunately things aren't as simplistic as you want them to be, you have to look at things in the context of the diet.

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