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muzster

RIP: British Scientist John Yudkin - The man who tried to warn us about the perils of sugar..

Source(s) : http://www.telegraph.co.uk/lifestyle/wellbeing/diet/10634081...

https://en.wikipedia.org/wiki/John_Yudkin

Edit: Lest we not forget his arch-enemy Ancel Keys

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My mother (1973, Edinburgh) bought "Pure, White, and Deadly," and we all read it. I was ten or so. Yudkin attacked white flour, white (processed) fat, and above all white sugar. It made perfect sense to us all, and cutting back on sugar became a slow, yet consistent part of our lifestyle. We never ate that much anyhow. I stopped eating sugar entirely at 15. I still recall the book's cover.

Edit: it took me a lot longer to cut fruit juice from our diet. I was so convinced by that "natural" label. Until I realized my daughter, who'd drank a lot of juice growing up, was addicted to sugar. Then we cut it out. My other kids, not addicted. I was fooled for so long...

The sugar industry has a lot to answer for. It is IMO comparable to the tobacco industry's suppression of cancer studies. Yet worse, because the effects of high-sugar diets are doing more damage, to more people, and last generations.

Think of the hundreds of millions of children who have eaten high sugar diets since they were babies... lifelong damage to their health. A hundred years of damage, these executives and corrupt scientists caused.

Sugar does have some nutritional value, and is a hallmark of primate diet. Tobacco is an addictive insecticide that won't even get you high.

> Sugar does have some nutritional value, and is a hallmark of primate diet. Tobacco is an addictive insecticide that won't even get you high.

This statement reflects a glaring ignorance of both scale and science. First of all, sugar is a hallmark of a primate diet only in complex not in simple forms, which is not the kind being referred to here. By nutritional value do you mean has calories? So does Vodka. And what at all do the calories have to do with the scale of harm?

Does this not include sugar found in foods? Are those considered complex?

Is eating natural sugar found in fruits as bad as eating refined/processed sugar?

There are many different kinds of sugars. It's worth understanding. Fructose is what harms you. Glucose is harmless. Sucrose is fructose plus a glucose. Lactose is harmless as long as you can digest it. Maltose is harmless. Etc.

Fruits contain varying amounts of fructose. Wild berries, not so much. An apple or grape, rather a lot. Apple juice, considerably more.

> Fructose is what harms you

Can you provide more info on this?

This is Robert Lustig's well-known talk on the subject:

https://www.youtube.com/watch?v=dBnniua6-oM

It is very very hard to reach a harmful level of fructose when eating apples or other fruit.

If consuming juices or concentrates it is very easy.

Orange flesh is about 3% fibre. 97% juice. There is no significant difference between eating an orange and drinking a small glass of juice, except the work involved.

I don't think that changes "very easy" to "very very hard".

Even time to chew it all is a big difference. It takes several oranges to make a glass of orange juice, which I can down in about a minute. It takes me quite a while to eat an entire orange. Since it also takes time for people to realize they're full, this also helps not to eat so much.

Scooby's workshop, a very popular bodybuilding & fitness website covers this: https://www.youtube.com/watch?v=tAFdWifkt0E

i stopped drinking oj when I moved to San Francisco and saw one of those novelty juicing machines with the orange hopper and exposed internals. it was like 6 or 7 oranges in a single glass!

also made me realize why fresh oj is insanely expensive at restaurants.

Except, each orange only contains about 2 fl.oz of juice. What is significantly easier - drinking 16 fl. oz of juice or eating 8 oranges?

This is reductionist thinking, the same kind of thinking that led to the low-fat fad, which unfortunately lasted decades.

Fruits don't deliver just fructose, the also deliver nutrients, vitamins, antioxidants and fiber. As a consequence we digest fruits differently compared with processed sugar, as the absorption of fructose when eating fruits is slowed down.

And our taste buds love sugar because our bodies crave for fruits, to fuel our big brains. We would have never developed this trait if naturally occurring sugar would harm us.

Remember though that modern fruits have been bred to be sweeter.

>As a consequence we digest fruits differently compared with processed sugar, as the absorption of fructose when eating fruits is slowed down.

When sugar is introduced to the body the liver begins to store/process the sugar. So it doesn't matter whether the sugar is from say coke (high fructose corn syrup) or an Apple.

What happens when the liver can't store/process the amount of sugar you ingest is the body triggers insulin production, and while insulin production will be linked to obesity the insulin itself is the real harm to the body. Insulin triggers the bodies production of fat cells to store the sugars it can't process. Also, Insulin has the effect of enlarging the bodies cells (fat cells, cancer cells, etc...) this can lead to enlarged organs (liver disease, heart disease, etc...).

There is something to be said that an Apple has nutritional value that the soda is lacking (plus fiber), and this can account for some people drinking multiple sodas a day (maybe even a 2 litter) but very unlikely to be eating 12 Apples a day; nevertheless, the underlying sugar is harmful vis-a-vis insulin spikes. The real difference is the person eating the apple instead of drinking the coke is likely to stop their sugar intake at 1 Apple and is more likely to incorporate some form of exercise. Personally, I go by a rule of thumb I try not to consume anything with more than 10g of sugar (a whole apple is almost double).

>And our taste buds love sugar because our bodies crave for fruits, to fuel our big brains. We would have never developed this trait if naturally occurring sugar would harm us.

Humans develop traits and cravings for things that have detrimental side-effects quite regularly. It used to be that Type 2 diabetes was called adult onset diabetes, in fact in the UK kids weren't diagnosed with Type 2 until the 2000's. Despite hundreds of billions a year spent managing Type 2, in most cases it can be completely prevented and even controlled to the point people can stop taking any medication through proper diet.

+1. It's all about the insulin release. After a year or so on a zerocarb diet I'd allow myself an occasional feast of fresh fruit, but in the process my body has become so sensitive to insulin, a fresh spike of it would lead to an immediate loss of energy and sleepiness regardless of the time of day.

I've tracked my weight and did blood tests consistently, and most dramatic weight loss periods coincided with the minimal insulin presence.

Lol, our big brains developed long after we left our jungle environment, and are fueled above all by protein (meat, so hunting). Our taste buds love sugar because fructose is a drug that plants evolved to get our ancestors working as seed dispersal machines. And I believe if you eat grapes or oranges or apples, the juice (and fructose) is barely wrapped in fibre if at all. Chewing an orange, you have extracted the fructose almost entirely. Do you think the "nutrients, vitamins, antioxidants" slow down the digestion process?

Our brain runs on sugar mostly.

As the sibling poster stated, brains run almost exclusively on glucose outside starvation or ketogenic diets.

No difference between fructose in fruit and the fructose which the body splits from sucrose in refined sugar. Fruit sugar is fructose. It's reported that in some people a marked increase in blood pressure is associated with high fructose intake. That is certainly so in my case after eating more fruit than I should.

That constitutes more than you should for you?

Personally I stopped buying jumbo massive apples and now usually only eat the small ones they say are for kids. I usually only est fruit with other things like in a salad or in a bowl of yoghurt nuts and seeds (tahini too) and maybe with coconut oil. I think this combo slows digestion to smooth out the sugar absorption.

I think it would be difficult to eat too much sugar from fruit in the same as from, say, soda just because it would be hard to eat that much fruit, but still possible to over do it.

When I was studying nutrition one of my lecturers was fond of telling a story about one patient he saw who, when asked what he ate, just said "apples", lecturer asked "and?" and the guy says "oh no, just apples". The guy was eating like a bucket of apples a day and nothing else. That could cause some problems.

Sugar that occurs naturally in foods are often complex. Complex sugars are larger molecules that can be broken into simple sugars (lactose, fructose, glucose).

There is actually very little sugar in fruit, and they are full of vitamins and minerals which are good for you.

If you cut artificial (added sugar) foods from your diet you will likely find that other foods taste sweeter as your taste becomes more sensitive.

> There is actually very little sugar in fruit

that's incorrect. in fact drinking a glass of orange juice is similar to drinking a coke. just because its fructose does not mean it's any better for you.

https://www.youtube.com/watch?v=dBnniua6-oM

Yes, let me go and pick a glass of orange juice from my glass of orange juice tree.

I lol'd

http://thepaleodiet.com/fruits-and-sugars/

pretty far from little sugar.

That is largely because you need to squeeze more than one orange to get one glass of orange juice.

The word fructose comes from the word fruit, it literally means the sugar found in fruits. Most fruits have more fructose than other sugars. A banana has 14 grams of sugar, equivalent to 4 teaspoons of table sugar. If fructose is bad for you then fruits are bad for you, there's no way around it. You can argue that it's ok to eat fruit because it's balanced by the fiber and vitamins, but that's equivalent to saying that fructose is ok in moderation. Which seems to go against the current nutritional science understandings.

> If fructose is bad for you then fruits are bad for you, there's no way around it.

Actually fruits also have fiber which slows down the absorption of fructose. The way we digest fruits is different from the way we digest table sugar.

Beware reductionist thinking: https://en.wikipedia.org/wiki/Reductionism

Yes, and no. If you drink straight apple juice, yes, that's bad for you. If, however, you eat an apple, that's good for you. The Apple has plenty of fiber that keeps the body from absorbing the fructose too quickly. Straight apple juice kicks your pancreas into high gear.

Apple flesh is 2.6% fibre.

Where does this myth come from that fruit is high in fibre? It simply is not true. Some fruits are. Wild fruits certainly are. Domesticated table fruit is not. Google "fibre content of apple" if you don't believe me.

I didn't say "high in fibre", I said plenty of fibre. Difference.

Animals are comprised of a huge amount of water and some other stuff. I think even meat is something like 80-90% water. But people don't usually say "man I'm thirsty, someone bring me a ribeye!"

When cells are made up so primarily by water saying "oh but this fiber is a trivial percentage" is very misleading. If all sugar is in the water which is contained in cells which are bound up by fiber then the fiber could make it much more difficult for your body to just absorb all the sugar wholesale.

> I think even meat is something like 80-90% water.

For fresh (not processed like hams etc), ~50ish% is usually a safe bet.

> There is actually very little sugar in fruit

Whoever told you this did you a disservice, because it's completely untrue. I think coke is a pretty good posterchild for "a shocking amount of sugar", and an 8 oz bottle of coke has about the same sugar content as an apple or a navel orange (and the orange has half the calories, making the comparison even less favorable). The difference between the two is that the coke is (nutritionally speaking) nothing but carbonated, liquid sugar while a whole apple comes with a fair amount of fiber. The difference in speed of absorption is primarily what makes one healthy and the other terrible for you.

You are mostly right. The mostly part is this:

gram for gram Apples and coke are about the same, however an 8oz coke has over twice the sugar content of an apple.

Secondly, on the disservice, you are particularly correct. I have done myself a disservice by not correctly interpreting my own research. Two years back, when switching to become a vegetarian, I calculated macros for loads of foods. For sugar I used a calculation based on the food's glycemic index.

That's was what I was getting at in general: glycemic index is far more relevant than gross sugar content[1]. But my criticism still stands: It's good that that's what you yourself use GI (as do I), but it's misleading and inaccurate to phrase a low GI as "very little sugar". It's particularly confusing for those readers of your comment who might not be familiar with GI. Instead of falsely claiming that fruit has little sugar as a roundabout way of describing it's GI, instead one can say: "Fruit has plenty of sugar, but the attendant fiber content makes the absorption of said sugar better for you than mainlining it as liquid Coke".

As an aside, where are you getting your nutritional info? It's way off what I've found. I was using the nutritional info for a regular "medium apple", and in the sources I found it has 20g vs coke's 25g, and almost the exact same amount of calories. 80% of a coke's sugar, calorie-forcalorie and serving-for-serving, hardly qualifies ad "very little sugar".

I couldn't say this more. I had to cut everything[1] except raw food (meat, carrots, tomatos, salad) and it's true that within a few days you start to feel the sugar in these even in small forms. You also recognize how sugary processed food is, and how it affect your mind.

In all honesty since I was able to eat anything again, I surrendered to a junk food from time to time. I know how to keep it small; but I have to admit how hard is it when your body allows it.

[1] my brain / heart / veins reacted wrong to any fat, sugar, too much salt.. so I was highly driven into avoiding them. That made the need for will power irrelevant at the time. A bonus.

"Natural", in this context, is a weasel word that's whose key uses include making people feel more comfortable about buying junk food, so that junk food manufacturers can sell more junk food.

Chimpanzees, for example do eat a lot of fruit. I believe it's their primary source of calories. But the wild fruits that chimps eat are a very different beast from how humans in wealthier countries consume fruit. The fruits they typically eat haven't had their sugar content dramatically increased through centuries and millennia of selective breeding. They haven't been turned into juice, which removes all the fiber and essentially renders them a nutritional equivalent of Coca-Cola. They haven't been dried, which concentrates the sugar and increases the glycemic load. They haven't had extra sugar added as a ("natural"!) preservative in order to maximize the shelf life. etc. etc.

All that aside, though, no, I'm pretty sure there hasn't been any compelling evidence to indicate that your body can somehow tell whether the sugar in your food was produced in situ or extracted from some other plant and then added to what you're eating. To it, C12H22O11 is C12H22O11. There is some stuff suggesting that processing affects how much sugar is extracted by your digestive system, though. It's not able to break down the food and get at its contents quite as efficiently when the food hasn't been mechanically ground up or macerated first, and your teeth are unlikely to grind it up quite so finely. In a nutshell, sugar that's inside a plant's cells is going to be less available (and, to that extent, "have fewer calories") than sugar that's on the outside of the cells.

> All that aside, though, no, I'm pretty sure there hasn't been any compelling evidence to indicate that your body can somehow tell whether the sugar in your food was produced in situ or extracted from some other plant and then added to what you're eating.

To clarify I wasn't saying that the difference was how the sucrose is produced, but the actual metabolic process it takes to obtain it. It takes significantly more time for the body to break down sugars which are bound with fibers, something like today's epidemic simply would not be possible solely with whole fruits.

> To [your body], C12H22O11 is C12H22O11.

Uh, careful. If you said "sucrose is sucrose" I would agree, but lactose and maltose also have that formula, and require different enzymes to digest.

> Tobacco is an addictive insecticide that won't even get you high.

Nicotine is an addictive substance which suppresses appetite and increases focus; as found in tobacco leaves, it has a pleasant smell and taste.

Loss of focus is a well known symptom of nicotine withdrawal. It goes away after a few days.

I'm confused, what is your point?

Often you get the opposite effect of a drug in withdrawal, e.g. caffeine reduces headache pain, causes headaches in withdrawal.

It's worth mentioning, since most people don't know, that nicotine on it's own is not as addictive as tobacco. AFAIK the MAOIs in tobacco smoke contribute more to its addictiveness than nicotine [1]

I've been chewing nicotine gum semi-regularly for a few months to improve my focus at work, and have not found it addictive so far. (I've never smoked).

(Still, I wouldn't recommend people in general do this without carefully considering the risks.)

[1] https://www.gwern.net/Nicotine

Companies that produce cigarettes also optimize the tobacco blend and chemical treatment to make it as addictive as possible, which is why vaping nicotine doesn't have the same addictive effect as smoking cigarettes.

It is true that many monkeys are tree dwellers and are heavy fruit eaters. Humans and other primates are neither. They will eat fruit as part of a mixed diet that is more omnivorous than anything. And wild fruit is not as rich in sugar as you imagine. It's mostly fibre. The stuff you buy in the supermarket is not a hallmark of a primate diet. Soft drinks are not a hallmark of a primate diet. Cakes and biscuits, they are not a hallmark of a primate diet. They are fake food.

Genuinely curious as to what you mean by "other primates". What else is there apart from humans and monkeys?

Primates are monkeys. A monkeys isn't necessarily primate.

You have that backwards.

Nope.

Doh! My mistake.

Apes are not monkeys (monkeys have tails). In general primate is a very large group that includes lemurs and tarsiers.

I just had to google this. Thanks! I guess I never really questioned (learnt?) it and thought monkey/ape was interchangeable.

Apes are also primates, but not monkeys. So for example, the rest of the great apes (orangutans, gorillas, chimps).

Fructose is a hallmark of primate diet. Refined fructose is not. The only refined fructose in the wild is honey and that is way too rare and too well defended to be the hallmark of anyone's diet (other than honeybees, of course).

Humans are perfectly capable of eating all the fructose they may ever want in its unrefined state as it appears in nature without any adverse effects. I.e. you can eat fruit until you are full, and nothing bad will happen. It is in fact quite healthy. But once you refine it into pure fructose, such as crystal sugar or molasses, then all hell breaks loose.

As a former smoker, you are absolutely wrong. Tobacco will give you a kick, as nicotine is a stimulant.

I'd describe it as being similar to caffeine, it makes you more alert. Of course there are downsides that everyone knows about.

well the lie has recently morphed into the laws slowing and prohibiting soda sales in schools and such all the while promoting juice which can be worse in many cases because people assume its healthy and you cannot over drink because of that

One time I was craving some juice or smoothie, so at the gas station I took one of those 'Naked' brands and glanced on the label, it had some ridiculous amount of carbs and sugar in it, more than 50g. Put it right back.

I was doing that for years on gas stations, just picked the blue ones. Now that I am more sugar aware, I look at the labels a lot. I was also shocked to see some ridiculous amount of sugar in that what used to be my favourite drink.

Not coincidentally Naked was sued in a class-action in 2012 for labeling issues ("misuse of health phrases") and of course they settled so there is no finding of liability on the claim.

Even the best juice possible (made fresh, raw, organic, and green-leafy vegetables) will be comparatively high in sugar. A 16oz juice requires somewhere in the amount of 4-6 lbs of vegetables and naturally no one would ever consume 4-6 lbs worth of vegetable sugars in one sitting much less 6x a day. With the store bought juices there are also likely fruits added which have even more sugar than green leafy veggies and they store bought juices likely aren't raw (i.e. pasteurized) killing many of the beneficial enzymes and nutrients.

>> lifelong damage to their health.

It's only lifelong damage if you don't change your diet and lifestyle. The world is filled with people who were morbidly obese and have made the changes necessary to reverse the damage and live far more healthy lives now.

The way you put it, it sounds like an irreversible course akin to a death sentence, which it most certainly is not.

Anyone who has been morbidly obese has permanent damage as a result. It is certainly better to right the ship, but some damage does not go away.

That is a myth. Every legitimate long term study of non surgical weight loss shows that it doesn't happen for the vast, vast majority of people.

1) ["In controlled settings, participants who remain in weight loss programs usually lose approximately 10% of their weight. However, one third to two thirds of the weight is regained within 1 year, and almost all is regained within 5 years. "](http://www.ncbi.nlm.nih.gov/pubmed/1580453)

2) Giant meta study of long term weight loss: ["Five years after completing structured weight-loss programs, the average individual maintained a weight loss of >3% of initial body weight."](http://ajcn.nutrition.org/content/74/5/579.full)

3) Less Scientific: [Weight Watcher's Failure - "about two out of a thousand Weight Watchers participants who reached goal weight stayed there for more than five years."](https://fatfu.wordpress.com/2008/01/24/weight-watchers/)

4) [The reason why it's impossible seems to be that although calories in < calories out works, the body of a fat person makes it extremely difficult psychologically to eat less.](http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-...) This is borne out by the above data.

5) [The only thing that does seem to work in the long term is gastric surgery.](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421028/)

Moreover, you won't find any reputable study on the web where the average person lost 10%+ of their body weight and kept it off for five years. Not even one.

I lost 20% 10 years ago and haven't gained it back (295->225 lbs.). On the other hand I am still overweight and would like to lose more.

I did it by just exercising an insane amount every day. (Like 6 hours of cardio+strength training every day) Most people just aren't going to do that.

No diet I ever tried had any similar effect.

It did do a complete reset of my metabolism to the new weight though. I kind of think it has to be something drastic to have the effect people want.

The only problem is that it's really easy to injure yourself being drastic (that and you have have the right confluence of factors to have the free time to pull it off).

How do you get that much exercise? How did it reset you?

I was on a remote job site where all living expenses were paid (but not entertainment) and there was just NOTHING in the town. The hotel had a nice gym. I was the only person working from my company for quite a period, so I had nothing to do with my free time (the hotel did not have internet access at the time).

So with nothing better to do I thought, time to lose weight. So that's what I did when I wasn't working.

I did not keep the exercise up after the period, but I just wasn't that hungry and the weight stayed off.

You could say my stomach shrank, or metabolism changed, or whatever theory, I just say it as a "reset" to be generic, since I really don't know.

It's really hard for me to imagine spending that much time doing cardio+strength training every day.

I went to music school and I used to practice around 6-7 hours a day, every day. And even after switching to software I still practiced 3-4 hours every day for a long time. It was just part of my routine and I enjoyed it, but even despite those things I had to reduce my daily practice time just because I didn't have time to do my job, sleep, cook/eat, drive to work, handle regular stuff that comes up in life, and then practice for 6+ hours a day. I managed to keep 3-4 hours for awhile, but then it gradually kept getting lower and lower just because I was kind of getting worn out. These days I finally stopped and don't practice daily anymore at all. I still do practice every week, but definitely not daily.

> No diet I ever tried had any similar effect.

Have you tried eating 20% less every day with no effect? I have real trouble believing that.

A diet isn't just a change in what you eat, it's also a change in the amount.

Read point 4

It's quite a bit more psychologically difficult for a heroin addict to stop doing heroin, but we don't consider that a valid excuse to continue doing heroin.

I cut out refined carbohydrates and lost 50 pounds, and have kept it off for the last four years. I eat all I, I just make sure it is reasonably healthy.

The funny thing about all your links is this:

That most people who lost weight most often times gained it back - yet you somehow think gastric surgery is the cure all when you have to make lifelong changes to your diet and lifestyles and be even more diligent in doing so?

The weight loss for gastric patients levels off after 18-24 months, far shorter than the 5 year mark you use to measure success. I'm not sure how you rate one a success in half the time, and total failure for others since they don't meet your magical 5 year mark.

The problem is, you can't legislate freewill - you have to make a choice to be healthy. Is it easy? Nope, but it can be done.

My grandmother was overweight, had high blood pressure and other ailments. She was able to reverse her Type 2 diabetes through diet and staying active by walking 5 miles a day, hiking and other low impact activities. I had a hockey buddy who was on several different medications for high blood pressure, pre-diabetes and other ailments. Within two and half years, he was off the meds and back on the ice through a combination of intense cardio workouts (P90x, Insanity, etc), weight training, and Brazillian Ju Jitsu - which he had always been into. My best friend was depressed and put on a ton of weight, and became borderline suicidal. He was put on meds and continued to put on weight. Over the course of three years he made various (permanent) changes to his diet and to his life. He started with power lifting, then went to mountain biking, then cycling, then adventure racing, then to mountain climbing. Last year I saw him and he was pushing 40; he was still ripped and finally loving life.

You can't make a switch in 6 months and hope for a five year guaranteed return. Shit doesn't happen like that - it just doesn't. You can't go on a diet for two months and hope that 15 pounds you lost will stay off for five years unless you make permanent changes which is really hard for a lot of people. Finding time and energy to start something new is not how humans function. We constantly look for the shortcut. The shortcut to happiness, the shortcut to getting rich, the shortcut to learning some new programming language. Nobody wants to put in the time to get their shit straight, they just want it to be fixed in some nonsensical time frame.

Everybody I know that went through some serious health problems and got straighten out did not do so in any short amount of time - it took years of dedication, getting up at the crack of dawn, struggling and putting the hard work to get there. No diet can do that for you. The payoff is you get 8-10 years back of your life. You can breathe after you walk up a flight of stairs, you can reduce your cholesterol levels and have a healthy heart and lungs. You can get off your medications, or reduce them from what you're taking now. The upside to being healthy so vastly outweighs the downside and here you are saying - there is no hope, you should give up. How does that even sound to someone who's facing an uphill battle?

Unreal.

Surgery works with a 5 year timeline too, for the average person. The average person does not succeed any other way. It's not impossible - 5% of people in these studies succeed - which is why you see anecdotes like yours.

I didn't think this was true, but apparently it is:

"This study of isolated gastric bypass with a 5.5-year follow-up rate of 88.6% revealed a success rate of 93% in obese or morbidly obese patients and 57% in super-obese patients. " (note that this is a specific type of gastric bypass) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421028/

Yep

My father decided to lose his potbelly in the early 1980s at the recommendation of his doctor, who sent him to a nutritionist. The nutritionist advised him and gave him a diet plan.

6 months later, he returned to the nutritionist having lost the pot, and the nutritionist was shocked, as nobody had ever followed her diet plan before. He maintained the weight loss for the next 30 years. At one point he was even able to squeeze into his WW2 uniform.

He said it was a constant struggle. But it clearly is possible.

> He said it was a constant struggle. But it clearly is possible.

That is just confirmation of point 4 of the parent post.

It's a struggle in the same way not biting that nail is still a struggle 15 years after one quits biting their nails. Eating poorly and being sedentary are habits like any other.

Bit more than that. Physiological changes also.

A smoker who hadn't lit up in 20 years told me he still wanted a cigarette every day and struggled with it.

This is just defeatism, and falls down here "after completing structured weight-loss programs". The problem here is thinking of weight-loss in the short term.

If you are 200kg, and drink 5L of soda every day, you don't stop drinking soda for 12 months, lose weight and then go back to drinking 5L soda a day and except to keep the weight off.

You change your diet, and keep it that way. For ever. Thats how weight loss happens.

Most people don't succesfully change diet over the long term.

I changed my diet a lot after I got married, and I think it worked mainly because I was embarrassed to buy pie and ice cream all the time. If it's not in the house, I won't eat it casually every day ("if I don't finish this pie soon, it will get all dried out and go to waste!").

Maybe the key is to make diet changes along with other life changes. But I think people do the opposite: "I just started a new job... I'll settle in first before I go on that diet".

Naturally, it would make sense that changing habits would happen all at once. When else in history have we been able to say "I just moved someplace new... Now, where is the nearest KFC?". No, you move, and everything would change, including diet.

A kfc chicken breast and thigh together comes to 580 calories, which doesn't seem bad.

Probably not the best example, but the point is that we don't change our habits because we are never forced to, even when we make fairly big changes like moving 1000 miles away.

And when we can continue with the rest of our habits, it's hard to change individual ones like diet.

Most people do successfully change their diet over the long term - they just change it too eating too much stuff thats bad for them.

Many of my extended family got sick and some died from adult-onset diabetes brought on by eating too much sugar. My father and grandfather suffered and died from low-fat diets (where sugar was never a concern because doctors were obsessed with eliminating dietary fat, period). Even if the outcome isn't obviously fatal, the accumulated damage does not go away and it carries real health risks until death.

And please don't use that weasel word "lifestyle" which the sugar industry wielded as a weapon against their victims. Oh, fatty, go and exercise some more! It's your lifestyle that's wrong, not the rubbish we've put on your table.

And we still see supermarkets with rows and rows of sugar-based junk foods. It's going to take decades to undo the cultural and educational damage let along the health damage.

>adult-onset diabetes brought on by eating too much sugar

Genetics is a much bigger component of T2 than sugar intake.

That may be true, but diabetes rates have spiked in the US (and in every country that adopted a Western diet) during the 20th century even though our genetics haven't changed.

That points to the proximate cause being the change in diet, which means we should figure out 1) what changed in our diet and 2) which change led to obesity.

If you where fat as a child, you'll have more fat cells than normal. Those cells stay with you basically forever. So while eating less food makes you lose weight, those extra fat cells will keep messing with your hormones.

https://www.ncbi.nlm.nih.gov/pubmed/18454136?otool=karolib&t...

The number of fat cells is set in childhood and stays constant throughout adulthood, according to research conveniently titled "Fat cell number is set in childhood and stays constant in adulthood" http://scienceblogs.com/notrocketscience/2008/05/04/fat-cell...

The size of those fat cells can be changed through diet and lifestyle, but since the number of fat cells cannot be lowered naturally, sticking to a healthier lifestyle is extremely hard for a [formerly] obese person, as there's just one thing the fat cells are programmed to do, and that is to grow in size.

I tried arguing the dangers of concentrated fruit sweeteners not so long ago.

There was some debate about whether candy prices were too low.. But the truth is folks get much more sugar from supposedly "healthy" items in the form of fruit juice and concentrates. It is in the bread most folks eat (and sometimes whole grain bread is higher to make it more palletable), they put it in savory foods, and fruit juices and people put it in their coffee and tea. Granola bars and yogurts and a myriad of other supposedly healthy things? High sugar. It would be one thing if the sugar was simply what was contained in the fruit, but often it is above that.

It is much better to eat the piece of fruit than drink some juice - and I think if folks started drinking non-sweetened drinks and quit adding it to so much food (expecially commercially prepared food) it would help quite a bit. Personally, I lost weight after doing the adjustment. My only normal, daily beverages are black coffee or water and have been for years.

The thing is that you do somewhat miss the sugar at first, but I didn't find it any worse than missing some foods after moving countries. Over time, your tastes adjust and it isn't a bad thing.

I've been suspecting that another problem is modern roller mills break up the carbohydrate granules in wheat. It means making 'whole wheat flour' by adding back the bran after milling doesn't give you the same thing as more traditional course ground wheat flour.

The difference is when the carbohydrate granules are intact it takes much longer for the carbohydrates to hydrolyze and be absorbed in the gut. Rolled four because the granules are broken up hydrolyses and is absorbed quickly and results in spikes of blood sugar and insulin which is bad news.

[serious] Is there a reasonable way to eat actual whole grain bread? Every kind I've tried is the worst thing imaginable to attempt to eat...it's a real nightmare. I choke down a half a slice and then have to cleanse my pallet with an entire pizza.

1) You get used to it. Eventually you can come to prefer cheap whole grain bread vs cheap white bread.

2) Try non-wheat breads like dark rye. Dense dark ryes like a good seeded deli rye or even a cheap pumpernickel remain moist and chewy without the added sugar, which is why wheat breads tend to have HFCS or honey added. Note that lots of mass market rye breads contain wheat flour, so be careful about making assumptions and generalizing based on a few samples here or there. With wheat flour it will become stale quicker, and there'll be a less complex flavor profile.

3) Try higher quality breads. Note that higher cost does not necessarily imply higher quality, though that's more often true than not at supermarkets. Basically, the point is to get more flavor with minimal cost in carbs and calories. So a sprouted wheat or bread with nuts might help.

4) Maybe you're just a picky eater, which is a real thing. If all you like are, e.g., pizza and french fries and similar foods from childhood, and especially if things like the _texture_ of other common foods are offensive, it might be a psychological thing. Most people have psychological barriers to eating and enjoying different foods. It took me years to learn to tolerate Japanese cuisine--I could eat sashimi, no problem, but the flavors of sushi and Japanese cuisine in general were off-putting, much more so than other cuisines, even ones that weren't to my tastes. With _effort_ I learned to enjoy some of it. A simpler example is ginger--I hated ginger until I didn't. But some people are at the extreme end of the scale and it's much more difficult to learn to enjoy something even with effort. In retrospect, I've probably known several legitimately picky eaters. It's not uncommon AFAIU and it's fair to dial back expectations if that's the case. Indeed, foods with more complex flavors and textures as I recommended above might be overstimulating for picky eaters.

" But the truth is folks get much more sugar from supposedly "healthy" items in the form of fruit juice and concentrates. "

Or, if you are here in Asia/Singapore, where T2 diabetes is starting to become a big issue- the 3-5 servings of white rice people eat each day is a front page issue on the newspapers.

What is an alternative? I eat a fair bit of rice as well.

Whole rice is not as much a problem as polished white rice. You could eat unpolished rice, like brown rice, red rice, etc., depending on what's available locally, that have all the fiber and other nutrients intact. This will also help fill your stomach with lesser quantity than polished white rice because of the fiber that's in them. If you have access to other grains, like quinoa, millets, amaranth, you could use them since they're somewhat close to rice in how you can use them (tangentially, this not a great idea for regular consumption if these items are imported from distant countries, since they'd have environmental and social impacts as well).

Rice, in general, has a pretty high glycemic index. From: http://www.health.harvard.edu/diseases-and-conditions/glycem...

Glycemic index of Brown Rice is 68, White Rice is 73, Coca Cola, in comparison, is only 63.

But, what makes white rice so really horrible, is not just the glycemic index, but the glycemic load - the net-impact on blood sugar. It's off the charts huge for a typical 150 gram serving of white rice at 43, (compared to just 16 for a coca cola).

Kind of mind blowing, that if you are worried about blood sugar, you are better off drinking 2 cans of 250 ml coke, instead of one 150 gram bowl of white rice.

That's because the Coke is 55% fructose. And most of that 500ml is water, with less than 50 grams of sugar in each can. In other words, there's less than 45 grams of glucose in two cans of Coke.

Fructose won't spike your blood sugar, but it's bad for other reasons, and so I wouldn't necessarily say that two cans of Coke is better than a cup rice.

Oh, definitely not suggesting Coke is better than rice, but if you are primarily concerned about an insulin reaction from glucose loading in the bloodstream, I am still amazed to discover that eating a bowl of rice will spike more glucose into your blood than drinking two cans of coca cola. It's so counterintuitive that I almost don't believe it.

I think eating a few bowls of rice per day (usually combined with a lot of veggies and some meat) is something that has been done in Asia for a long time, why would it be related to a recent increase in diabetes?

There is more than one kind of rice and some are more healthy than others. White rice used to be reserved for the rich, now it's mainstream all-day food for all, but it is rather poor in nutrients.

Also Asia (i assume you mean ready Asia) does know other foods than rice, think various noodles, soups, etc.

As opposed to what other kinds of rice? As far as I know, brown rice is not any worse or better for you, despite popular belief. It's like the difference between HFCS and table sugar. There's a technical difference (e.g. a little more hull with brown rice, or 5% more fructose with HFCS) but it's not really significant in the context of a normal diet.

If you mean different types of wild rice, okay, maybe. But I don't think wild rice was ever a staple in Asia. At least, not in the past few millennia.

Diabetes is likely rising for the same reason it's rising in every other wealthy region.

Asia, like most of humanity, was on the verge of starvation until recently.

I tend to be somewhat suspicious of any 'traditional' basic food getting too much bad press. Rice, bread, pasta. White rice tends to get some bad press here as well, along with white bread. Rice itself probably isn't a big deal. It is probably on par with the bread/pasta eaten in the states and Europe as far as health is concerned. There is healthier rice (brown and unpolished) and healthier bread, but we tend to eat the opposite.

But it tends to be a bigger problem if folks are also overweight - and folks aren't doing it by eating rice or bread alone. Large portions and simply eating too much and so on, adding in fast food and convenience food and all of the snacks. And it is a huge problem if you develop T2 diabetes because of the blood sugar spike.

A lot of people say that the real issue is blood sugar spike, how fast it happens, and what the glycemic index of the food you are eating is.

I always wonder about the whole glycemic index theory. Lot of counterintuitive data here: http://www.health.harvard.edu/diseases-and-conditions/glycem...

For example, where Glucose=100, Banana cake, made with sugar=47, but Banana cake, made without sugar=55, and Brown rice, average=68.

Or, Chickpeas=10, but Chickpeas canned in Brine=42.

White rice, of course, is the worst of all of these at 73. Worse than Apple Juice (41), Orange Juice (50), and even Coca Cola (63)

I agree. I survived a few years of war when food shortage was a real thing. And all we had to eat was white pasta and rice. Occasionally we would get meat/fish cans and similar and a bit of vegetable oil. Sugar was non-existent, you could have bought it on the local market for what is equivalent of $40. So it was there for special occasions only and not your daily poison. And guess what, we were all healthy, people with up to moderate blood sugar issues had no problems at all, back to their healthy selves. I was fit and healthy and feeling great. After that, the food came in and I gained 60 pounds in time span of few years. :)

I wonder if the tolerance, and then the love, of highly sweet things is acquired. And mostly probably, it is acquired when one is a child.

I have met and worked with many East Asians and Europeans who came to American in their 20's or older. Almost everyone of them thought American pastry and deserts are unbearably sweet. Most of them shun from soda drinks and other "food" containing high amounts of sugar. If they drink soda, they choose low- or zero-sugar kinds.

Related or not, a big percentage of American look overweight when compared to Europeans and East Asians.

When we bake from American recipes we often reduce the sugar by 1/2, sometimes even to 1/3.

I am of European descent, and while I had a sweet tooth in my teens, American pastries and desserts were barely edible.

Now that I'm older (and lost my desire for sweets somewhat), I wouldn't touch any of them with a 10 foot stick. They are disgustingly unfathomable to eat and whenever I tried, it upset my stomach greatly.

So are most of your soft drinks, by the way. I cut sweet teas and juices with water to 50/50 ratio and then drink it.

Same here. I love sweets (though I don't eat that much lately because you know, health reasons, I'm not 18 anymore - but from time to time I indulge) but it is not easy to find good ones in US (I wasn't born in the US). Practically all mass-produces ones are unbearable once you have shed the sugar addiction and the built tolerance (which I did, see above). Custom-produced are also hit or miss - many of them are terribly over-sugared to my taste. Finding a good dessert is not easy for me now, though in some places they still know how to do it tastefully. Hopefully as more people become aware of how careful one has to be with sugar, the situation improves.

I also used to drink a lot of soda in my 20s, but once I stopped and my taste recovered, I can't drink the stuff anymore - too sweet.

Americans saying that foods are too sweet is quickly becoming the new "I don't have a TV." It's a humblebrag to show off status.

I am East Asian and came to America in my 20's. I love pastries and deserts, always looking for local pastries to try whenever I travel, to the point to book hotels that are close to famous pastry shops.

Sorry for any misunderstanding my early comment causes.

Good? I'm not sure it's a humble-brag unless you parade around about it, but if people associate a healthier lifestyle with status, then it's bound to propagate.

Even if that's true, what's your point?

I think you got it the wrong way around.

Imitation of habits with percieved high prestige value is one of the most strongest causes of cultural shifts.

Cultural shifts are accompanied by lot of things - including bragging about ones new lifestyle - which then drives the shift in braggees network (social proof if he/she is an average member of the network, imitation of an idol figure if her status is high).

When I first came to US, I found it to be the case for chocolates as well (being a vegetarian, I stay away from pastries and cakes).

I specifically remember trying out KitKat out of craving and it was way sweeter than what I get in India. Tried switching stores before concluding the recipes are tweaked.

I don't think it's strictly a childhood thing. I moved to Australia several years ago and they cut down on the sizes of soft drinks especially compared to standard American sizing. It took some months to adjust, but now when I go back to the US on a visit the entire thing just seems to be way too much sugar. Same with alot of the pastries, although donuts and cakes are about the same level of sweetness. Maybe with less frosting and more other flavors in the Australian versions. And they're not as stingy as their neighbors down here when it comes to sweets.

My family is originally from China but have lived in the west for 30 years. We eat the sweets in the US just fine. My wife and her parents recently came to the US from China...the sweets in the US are too sweet for them and they just eat a little bit.

> And mostly probably, it is acquired when one is a child.

Most likely acquired when one is a suckling. Milk is kinda sweet and the first thing a mammalian baby tastes. All further taste preferences are then largely acculturation.

When you say you don't eat sugar, what does that mean? Do you eat fruit? Bread? Things that metabolize to sugar -- potatoes, squash, tomatoes, grapes, watermelon, barbecue sauce etc. Do you ever indulge in chocolate cake? What about wine or beer?

I just find the term "sugar" to be extremely vague when 50% of foods metabolize to sugar...

That's because you are being extremely vague about the word "metabolize".

Perhaps you want to explore how that word unpacks into many different routes and rates of absorption of the various nutrients involved. How is this altered by the different states of starch before they become glucose? How does the presence or absence of fiber impact this? Which microorganisms are active in the gut in this process?

People used to ask me this all the time when I'd given up sugar. Everyone has their own idea what it means, but no food that has been sweetened to make it taste sweet is a good start. Personally I'll eat fruit that comes as fruit, but bread is a treat-only food.

The basic principle is to avoid refined carbohydrates. If a food is unrefined, then it is ok, with the exception of potatoes, which have way too much carbohydrate.

A good book on this is The Instinct Diet by Susan Roberts, who is a well-known nutrition researcher.

The paleos say we should eat the same diet as our foraging ancestors. The problem with that is different foraging tribes had very different diets. However, one thing they all had in common is they didn't eat any refined carbohyrates. That leads to the possibility our bodies are not well adapted for them, and there is a great deal of research that is n fact the case.

Not OP, but have been ketogenic over 3 years. No bread, no fruit, no potatoes, squash, tomatoes, grapes etc.

The fact that it all ends up as "sugar" is less important than how long it takes to fully metabolize, how much energy and other resources it takes to do so, and what other byproducts the food provides. In the quantities used in many processed foods, the "sugar" that you see on the food label and that is used as an sweetener is generally undesirable for those characteristics.

The issue is fructose and sucrose, people end up getting confused with glucose, which is not the problem.

Clarification: sucrose is a molecule that quickly breaks down into one glucose and one fructose molecule, so it's basically 50/50 glucose/fructose. Fruit juice, honey, and HFCS are also about 50/50 glucose/fructose.

Almost all other carbohydrates break down into glucose and no fructose at all.

So one theory is that the fructose is especially bad. It is processed in a different pathway and might be a lot worse than the glucose pathway.

"The sugar industry has a lot to answer for."

I don't get this argument. What do you expect the sugar industry to do, argue for consuming less sugar?

It is not the industry's obligation to care for your nutritional well-being. It is the obligation of parents and teachers to be informed and teach kids what good food is. That starts with stopping to watch commercials. Avoiding processed foods in the grocery store and cheap restaurants. Not buying products that have more than 5 ingredients, and above all contain high fructose corn syrup.

Buying vegetables and fruit at farmer's markets. Learning again that there are seasons, and that there is no need to buy apples in spring or summer (when they have to be kept in coolers for half a year, or imported from the other hemisphere). Learning again that good products can often be recognized through the nose rather than the eye. Spending time on small-scale farms. Reducing meat intake to 1-2 a week. Consuming fresh water rather than salt water fish (which are harvested beyond sustainability and have led a multitude of fisheries to go extinct already). Preparing food by hand, even if it is "unhealthy" food like french fries (made from potatoes, e.g. in an oven with a bit of olive oil), pancakes (milk, egg, flour - no need to buy this as a product) or cakes (made just with flour, yeast, milk, eggs, and sugar).

Just switch off television to get back common sense.

Most people take in the information given without a second thought. If their information about sugar is biased by the sugar industry, by paying scientists to lie about their product... then yes they have so much to answer for. But, alas the entire food industry does as well. A lie is a lie, no matter which side you are on.

  "Just switch off television to get back common sense."

I'm pretty sure myths and old wives tales existed long before television. At worst television allows myths and untruths to travel faster and more pervasively. But I think generally we're better off with television, especially in a society that values not just individual responsibility but shared responsibility wherein media outlets and commercial interests don't have complete liberty to spout non-sense, like they did 100 years ago. Compared to most under-developed countries the U.S. values more of the latter than you would think. And so major media outlets generally, and television outlets in particular, are much more reliable and truthful than in many other places.

For that reason the internet is probably a net regression in advanced societies. Perhaps people need to watch more television.

Another good discussion of Yudkin's work and how it was received: https://www.theguardian.com/society/2016/apr/07/the-sugar-co...

Along with Robert Atkins. https://en.wikipedia.org/wiki/Robert_Atkins_(nutritionist)

If you ask people to this day, they'll say Atkins died of his own diet. That was actually a total lie run by Harpers magazine. They corrected the mistake in the following edition, but the damage had been done.

Although there is little evidence to support it, the running conspiracy theory is that PR people in various arms of the food industry paid for that article.

Edit: Adkins died because he slipped on a piece of ice during a snow storm and cracked his skull.

To be completely fair, he slipped on the ice likely as a complication from heart disease. His doctors swear that his arteries and heart were the healthiest they'd seen for someone that age except for the infected portion.

I don't get it: heart disease causes people to slip on ice?

No, his body was fighting the heart disease but with the slip on the ice his body was not able to recover from both at the same time. In other words, he was an old man and with the new injury his body was not able to recover.

Compromised health tends to make effective responses to hazardous environmental conditions more difficult.

Heart disease can affect strength, balance, coordination, mental function, and any number of other responses, much as a cold or flu or pnemonia can. You might care to review the recent video footage of a notable candidate visibly collapsing whilst being aided into a waiting van for transport, as a consequence of pnemonia. A condition more generally understood to affect the lungs than major skeletal muscles, but here clearly a contributing factor.

Think systemically, please. Especially if you're in tech.

> Think systemically, please. Especially if you're in tech.

Which is why I would follow Occam's Razor in this scenario instead of using a convoluted theory to explain why someone slipped on ice.

"Simple is better than complex." [1]

[1]: https://www.python.org/dev/peps/pep-0020/

I'm not claiming either that:

1. The direct cause of Robert Atkins' fallin on ice was heart disease.

2. That his falling on ice is proof of heart disease.

Rather, I'm explaining how, as one of several precipitating factors, heart disease might be a factor in the question posed: "I don't get it: heart disease causes people to slip on ice?"

I'm suggesting that a multifactor risk analysis be considered.

It's the same multi-factor logic you might follow in answering questions of other disasters. Say: What caused the disaster of the RMS Titanic? What caused the Hindenberg disaster? What cause the Fukushima or Chernobyl disasters? What lead to the Bhopal disaster.

Looking only at the precipitating or triggering cause misses many other opportunities for mitigation or avoidance. The Titanic would have been better served with more lifeboats, 24/7 manned radios, regular lifeboat drills, the originally-scheduled first officer not having (inadvertently) pocketed the key to the bridge's binoculars case, heeding ice warnings, less hubris on the part of passengers, owners, and regulatory boards.

Old, sick people are more likely to slip and fall, and the hazards of such falls can be greater than for young, fit, healthy people.

To amend to your Zen of Python list: make things as simple as possible, but no simpler.

I see what you're saying now, but to be frank you could have saved some time with a shorter explanation.

Post short comment: be misread.

Post longer clarification: dismissed as too wordy.

Tough crowd.

If he had heart disease, it would make him more prone to slipping on ice. But because he slipped on ice (which perfectly healthy people do all the fucking time), does not mean he had heart disease, or was even in any other of the hundreds of conditions (some of which might speak to his health, others which might not such as being distracted by something) that might have made him more prone to slipping on ice.

So basically you've wandered into an "intro to critical thinking" level fallacy, which is especially ironic considering your last two sentences.

I'm not arguing the fall is proof of heart disease. That's a misreading of my comment.

Atkins is reported to have suffered cardiomyopathy -- a virally-induced form of heart disease -- by Dr. Stuart Trager, chairman of the Atkins Physicians Council:

http://www.nytimes.com/2004/02/11/nyregion/just-what-killed-...

I'm somewhat familar with the particulars of the story and debate over Atkins' perceived or claimed health or disease, and the disagreements over both arguments. I'm not taking a particular side.

But (as I've just commented to another response to my parent remarks above): yes, sick, frail, diseased, elderly people are more prone to falls than those who are well, strong, healthly, and young. And those falls can be fatal.

Hence: heart disease can be a contributing factor to slipping on ice (or the resultant injuries and outcome).

> Think systemically, please

systemically, or systematically?

Yes.

Why are you spreading this myth?

>Atkins' widow and Dr. Stuart Trager, the spokesperson for Atkins Physicians Council, both contend Robert Atkins weighed less than 200 pounds at the time of his accident, claiming "During his coma, as he deteriorated and his major organs failed, fluid retention and bloating dramatically distorted his body and left him at 258 pounds at the time of his death, a documented weight gain of over 60 pounds."

> Thanks to his death certificate, we know Atkins was 258 pounds at the time of his death. Yet according to a copy of his medical records, as turned over to USA Today by the diet guru's widow, Atkins weighed 195 pounds upon admission to the hospital 8 April 2003 following his fall. He died on 17 April 2003 after having been in a coma for more than a week.

Source: http://www.snopes.com/medical/doctor/atkins.asp

The dude was 72 years old. 72 year old people die of things like slipping on ice and cracking their heads. When he was admitted to the hospital, he was totally healthy, except for the head injury. There was no sign of any heart problems, except for some controversial leaked reports.

The tragedy is that Atkins really wanted people to be healthy and his diet was/is very healthy. It's very similar to Keto and many other low-carb diets. It's myths that keep countries like American in a downward spiral of obesity.

> When he was admitted to the hospital, he was totally healthy, except for the head injury. There was no sign of any heart problems, except for some controversial leaked reports.

He did have cardiomyopathy for a few years before that, and a cardiac arrest the year before he died.

He didn't die of a heart attack, but it's an overcorrection to say that there was 'no sign of any heart problems'.

More likely its a complication of the fact that ice is slippery.

I had no idea - I had dismissed the Atkins diet for years because I had heard that Atkins himself was morbidly obese and died from a heart attack (neither is true according to his Wikipedia article).

Chalk one up for the idea that it's usually not worth basing decisions on vaguely-heard rumors (especially in the age of Google).

A story every scientist should now. For its own sake.

Ancel Keys was certainly wrong when it came to sugars vs fats. However, he did live to be 100... so there's got to be at least some merit to his ideas, such as the Mediterranean diet, etc.

No, there doesn't

Isn't the merit of the Mediterranean mainly about increasing the amount of omega-3 fatty acids through increased consumption of high-fat low-carb foods such as fish, green leafy vegetables, olives, cheeses and olive oils?

Which is the complete opposite of low-fat high-carb diet recommended by Keys?

There are also heavy smokers and drinkers who live to 100 and more.

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