Britain's postwar sugar craze confirms harms of sweet diets in early life
science.org
science.org
And if sugar is so metabolically harmful, where are the RCTs showing this? All I've seen is that outside of a caloric surplus, it isn't especially metabolically harmful, and ironically, even outside of a surplus, saturated fat is much worse:
https://diabetesjournals.org/care/article/41/8/1732/36380/Sa...
https://link.springer.com/article/10.1007/s00394-015-1108-6
Meanwhile tribes of hunter-gatherers in Africa get 15-80% of their daily calories from honey during certain seasons; why aren't they obese and diabetic? https://www.sciencedirect.com/science/article/abs/pii/S00472...
> different approach to nutrition
The "different approach" HNers gravitate towards is eating bacon and butter (i.e., keto/low-carb) and denying all of the evidence linking these foods to CVD, probably because fat and sodium are so addictive, much more so than sugar: https://news.ycombinator.com/item?id=42028432
obesity did not decline
>And if sugar is so metabolically harmful, where are the RCTs showing this? All I've seen is that outside of a caloric surplus, it isn't especially metabolically harmful
https://en.wikipedia.org/wiki/Fructose#Potential_health_effe...
>Meanwhile tribes of hunter-gatherers in Africa get 15-80% of their daily calories from honey during certain seasons; why aren't they obese and diabetic?
if you are are physically active and don't overeat, you can eat whatever the fuck you want and never get obese. if you are not obese, you will (most likely) never develop T2D
I find this is the difficult part. I find it much easier to not eat hyper-palatable foods at all than to eat "just a little".
Sure, I probably won't eat two hamburgers in a sitting, but eating one greatly reduces the calories I can eat during the other meals of the day if I don't want to slowly gain weight.
Jogging almost certainly won't burn the calories from the second burger.
https://www.mcdonalds.com/us/en-us/product/cheeseburger.html
https://www.mcdonalds.com/ca/en-ca/product/cheeseburger.html
I don’t have the time for that level of activity as an adult. In season, it was about 20 hours a week.
It's not just sugar, but the amount of it, and how fast it is consumed, and how and when do we expend energy (walking after meals directly consume blood glucose b/c calve muscles don't have a glycogen store) impacts fat buildup and T2D. Check out books by Robert Lustig on the subject.
The best study done to date on hyperpalatable foods found that fat and sodium were the most common drivers of hyperpalatability:
https://onlinelibrary.wiley.com/doi/10.1002/oby.22639
> The HPF criteria identified 62% (4,795/7,757) of foods in the FNDDS that met criteria for at least one cluster. Most HPF items (70%; 3,351/4,795) met criteria for the FSOD cluster. Twenty-five percent of items (1,176/4,795) met criteria for the FS cluster, and 16% (747/4,795) met criteria for the CSOD cluster. The clusters were largely distinct from each other, and < 10% of all HPF items met criteria for more than one cluster.
(CSOD, carbohydrates and sodium; FS, fat and simple sugars; FSOD, fat and sodium; HPF, hyper-palatable foods.)
> Check out books by Robert Lustig on the subject
Lustig is a crackpot who relies on animal studies and mechanistic speculation, because the highest-quality RCTs (like the ones I cited) don't support his theory.
No, that was not the conclusion from this study and it's absolutely not true. The only goal of this study was to "..develop a quantitative definition of HPF".
I cited RCTs in other comments pertaining to macronutrient intake and metabolic health. Lustig instead relies on mouse models and mechanistic speculation to make his case, because the RCTs in humans haven't shown sugar to cause all the ills he claims, without associated weight gain. Meanwhile saturated fat (given the available literature) ironically seems to be able to do much of what Lustig claims (impair insulin sensitivity, increase visceral fat), even without weight gain.
Seems like you are cherry picking data and ignoring other data from the chart - sure the total sugars from 2000-2020 are down slightly while what’s being labeled as “corn sweeteners” or HFCS is up 3x.
Since you mention diabetes it’s probably worth noting from 1970-1985 “corn sweeteners” more than 3x and before 1985 T2D was called adult onset diabetes considered an adult disease and 1983 was the first case of pediatric nonalcoholic fatty liver disease.
> Meanwhile tribes of hunter-gatherers in Africa get 15-80% of their daily calories from honey during certain seasons;
The chart shows honey is a nominal source of sugar for Americans. There are other facts about honey, like its low glycemic index compared to other forms so it doesn’t raise blood sugar levels as dramatically as regular sugar and especially HFCS.
The fact is the US government just lumps all forms of sugar together and labels it all genetically as sugar…ignores there are different forms of sugar, each processed by our bodies differently and having different metabolic impacts and harms.
People will spend the next 100 if not 1000 years arguing if sugar is responsible for metabolic diseases like T2D and nonalcoholic fatty liver disease - yet it’s settled now that T2D & NAFLD are both 100% preventable diseases and in some cases T2D can be reversed by minimizing sugars/carbs and increasing fats so your mitochondria is primarily using ketones rather than glucose.
The idea being in the past the only linoleic acid we would be getting was from whatever seeds we consumed naturally. With the advent of industry it's now a 20B+ business. It was hard for humans to consume so much seed oil in the past.
Consider this statement elsewhere in the thread: > before 1985 T2D was called adult onset diabetes considered an adult disease and 1983 was the first case of pediatric nonalcoholic fatty liver disease.
We've eaten sugar and saturated fats for ages. Of course, not everyone ate the same amounts that people do today - but we'd expect someone to be feeding their kid enough bacon (which people ate huge amounts of even ~100 years ago relative today) to give them fatty liver disease, if e.g., its saturated fats, or feeding them enough sugar.
But what people didn't eat, almost at all, was seed oils. Canola oil was not consumed at all before the 1970s - canola is a CANadian scientist created version of rape Oil, with Low Acid - rape oil itself being too poisonous/bitter to eat. Soybean oil was practically unheard of. Cottonseed oil (aka Crisco) was just being invented as a wonderfood, here to solve our problems. Today these oils, particularly soybean and canola, are the second highest source of calories in the average American diet, and the single highest source of fats. We're suddenly beset by major metabolic problems, from heart disease, obesity, fatty liver, T2D, that did not exist or existed in much smaller proportions, even in historical populations where people were eating tons of bacon or sugar. Meanwhile, we have a food source that went from "negligible" to "one of our main sources of calories." It's not proof, there are almost certainly other factors involved as well, but it's really, really suspicious. Making matters worse, what you feed animals also impacts the fat composition of their meat, and we now feed cows and pigs canola and soy.
This statement is factually false, though: https://www.sciencedirect.com/science/article/pii/S258955592.... It may not have been explicitly called that, but it was clearly shown to exist. This is not some new phenomenon that first popped up after the introduction of seed oil.
Per the study you linked:
>The term non-alcoholic fatty liver disease entered the hepatology lexicon in 1986, introduced by Fenton Schaffner (American physician and pathologist).
As you acknowledge the disease didn’t even have a name until 1986, or 3 years after the first diagnosis in children.
There is nothing in the study you link suggesting kids were being diagnosed and treated for nonalcoholic fatty liver disease pre-1983 under a different name - they weren’t.
This is easy enough to confirm on google independently [1].
>This is not some new phenomenon
Yes it is, in the ~40 years since the first recorded medical diagnosis it’s become an epidemic effecting 5-10% of kids or ~10M kids in the US. There is no way this is not a new phenomenon and 5-10% of kids had nonalcholic fatty liver disease throughout history and we have no record of it.
[1] Title: Steatohepatitis in Obese Children: A Cause of Chronic Liver Dysfunction.
Isn't canola oil one of the oils with the fewest saturated fatty acids, typically 7-8g per 100g?
Olive oil has ~twice as much, sunflower oil as well. Palm oil has ~7x more. And coconut oil ~10x more.
Calories-wise, all these oils are pretty much the same, typically in the range of ~800kcal per 100ml. So, I am not sure I understand the arguments against it.
Canola oil is pretty much the best bet if you want to reduce your fatty acids intake.
Of course, it's also controversial in some circles whether saturated fats are bad, but that's a separate discussion. There is more to a cooking oil than it's saturated/polyunsaturated/monounsaturated fat ratios.
A lot of things in plants are there to repel insects but we like it or they're nutritious for us. Caffeine, for example.
But the problem with seed oils is supposed to be that they're inflammatory and can oxidize (ie go rancid.)
If something was specifically targeting birds or reptiles then it may not affect humans, but are the seeds in question in environments without mammals? I don’t think so?
Contrast with, say, sesame or sunflower seeds which can be eaten straight from the plant raw, or pumpkin seeds which just need a simple roast and peel, I'm not sure that your categorical assertion really holds up, as intuitive as it may seem.
HFCS consumption is still higher than it was in 1970, but it has declined since 2000, and its decline has driven the overall decline in sugar consumption, yet obesity and diabetes incidence have only increased.
> some cases T2D can be reversed by minimizing sugars/carbs and increasing fats so your mitochondria is primarily using ketones rather than glucose.
"Reversed" means you can eat carbohydrates normally again. If anything, high-fat, low-carb diets seem to worsen actual insulin sensitivity, which carbohydrate restriction just masks (even then, not always, as many on keto find when they check their BG): https://pmc.ncbi.nlm.nih.gov/articles/PMC5291812/
Severely restricting carbohydrate enough to get an artificially low HbA1c or fasting BG and claiming you "reversed" diabetes is like claiming you "reversed" your lactose intolerance by never drinking milk. But actual weight-loss (however you achieve it) does improve real insulin sensitivity, but low-carb isn't magic when it comes to that either.
Because metabolic diseases are progressive chronic conditions. That’s why T2D & fatty liver were historically adult diseases, it’s not because throughout history people gradually increased sugar consumption as they got older and got the diseases, rather the metabolic damage progressed. In short when you are over consuming sugar for 20 years and see obesity, T2D and fatty liver disease increase you don’t necessarily expect to see it decrease even if sugar use slightly decreases…if you want to decrease or eliminate T2D/fatty liver disease then eliminate the sugar.
>"Reversed" means you can eat carbohydrates normally again.
That’s not what “reversing diabetes” means, it means getting off insulin because you manage your BG through diet and lifestyle.
>Severely restricting carbohydrate enough to get an artificially low HbA1c or fasting BG and claiming you "reversed" diabetes is like claiming you "reversed" your lactose intolerance by never drinking milk.
It’s just not a good metaphor because your definition of “reverse” is returning to eating carbs normally was wrong. Lactose intolerance is an acute reaction related to inability to produce an enzyme to breakdown and digest lactose - it’s managed not treated with medication, though some may take the enzyme lactase. Further, taking lactase because you’re lactose intolerant and want to eat some ice cream tonight is in no way comparable to having T2D and the need to take insulin.
Sugar is not the cause of diabetes.
That was a surprising statement to me, a layperson on the matter, so I ran to the Mayo clinic to check: https://www.mayoclinic.org/diseases-conditions/type-2-diabet...
As far as I can tell, we do not know why it happens, but monitoring sugar intake is a key strategy for managing the disease, which also has no known cure.
Assume type 2 diabetes is actually just a natural phenomenon associated with aging, that hits some people earlier, some later, and some little or not at all. Wouldn’t it stand to reason that careful moderation of sugar intake is still a good idea?
Regarding sugar consumption declining while T2D and NAFLD increase, could it be the case that metabolic effects could translate to genetic mutations that are expressed in later generations?
People irrationally get agitated and become sugar advocates when you explain the two truths:
1. 100% of T2D cases can be prevented through diet/lifestyle
2. Some T2D cases can be reversed (not a cure but getting off insulin) through diet/lifestyle
As you point out that the diet/lifestyle I am referring to consists of restricting carbs and sugars.
Unfortunately, that’s where people freak out and declare “sugar doesn’t cause diabetes” as if that’s well settled science - it’s not. Maybe sugar causes T2D or maybe it doesn’t, but it is immaterial to the point that it is established that sugar/carb restriction can prevent 100% of cases and is both practical and actionable for nearly everyone.
There is no decrease in HFCS it is up 3-4x since 1970.
Besides the fact that these figures add up to 107%, 27% of a 2000 kcal/d diet is 540 calories. At 4 calories per gram of carbohydrates, that works out to 135g of carbohydrates. Even if they were only eating 1200 kcal/d, that's still 81g of carbs.
Most ketogenic diets recommend no more than 20g of net carbohydrates per day (net carbs = total carbs - fiber - certain sugar alcohols).
This study may be valid, but I'd bet money there wasn't a single participant actually in a state of ketosis for this study, which makes it moot as a response to the parent comment you're refuting, which specifically mentions ketosis, not just a "high fat diet" that also contains 80g+ of carbs daily.
At the same time, these differences can be overstated. E.g. look at how "added sugar" is distinct from other carbohydrates but no "total sugar" metric on nutritional boxes on food products.
https://www.fda.gov/media/99331/download
It has had total sugars for as long as I've known the labels, and was changed in 2018 to break out added sugars. I'm not at all sure what OP is thinking.
Hence I would say it’s easy to know if sugar is added if you know the names it goes by. But it’s difficult to know how much.
I had to go check a few labels to be sure, but this is absolutely not true in the US—each nutrition label has a "total sugars" category that additionally breaks out the added sugars from the total sugar.
See the example on this page [0], and discussion of the sugars lines here [1]. Also see this PDF showing the differences in the 2018 nutrition facts label from the old one [2], which clearly shows total sugars have been there in at least the last two iterations.
Maybe you're thinking of the fact that there's no daily value listed?
[0] https://www.fda.gov/food/nutrition-education-resources-mater...
[1] https://www.fda.gov/food/nutrition-facts-label/added-sugars-...
If there's a significant lag between early-life exposure and disease outcomes, then it seems reasonable that the effects of the 2000-2020 drop won't be seen for some time.
https://www.penguinrandomhouse.ca/books/404271/epigenetics-b...
Look at the details of this study. The reason there are no RCTs is, at least for what this study looked at regarding very early childhood, they are impossible because they would be highly unethical. You can't take two groups of babies and randomly assign them to control group vs high-sugar group and test for the outcomes.
What this study is arguing is that the lifting of sugar rationing acted as a "best possible" form of a natural RCT as babies born relative to that lifting date had vastly different levels of sugar consumption in the first 1000 days. Note you see these types of "natural cohort" studies in a bunch of areas. E.g. it's not ethical to say group a is the "high levels of lead" group and group b is the control, but by looking at neighboring states that restricted leaded gasoline at different times you can try to tease out cause and effect.
I see tons of comments here arguing "how can they say it's just sugar!" I had a similar initial reaction, but I see very few comments that are arguing about the specifics of the study itself, and I'd argue the study is quite interesting and, at least from my layman's perspective, well done.
Maybe because it's "during certain seasons" and not the whole year around?
https://www.npr.org/sections/thetwo-way/2016/09/13/493739074...
I think this is added sugar only. It wouldn't surprise me if actual sugar consumption reduction were tempered compared to the linked graph. Hell, actual sugar consumption may have even increased. It's certainly far easier to get (fairly high-sugar) juice now than when I was a child.
What? Excuse me!?? This comment is just flooring me.
I am on my 40s, so I was born in the early 80s. Back in the 80s children were expected to drink juice, and LOTS of it. It was considered a health food for kids.
Juice came in frozen concentrate and WIC paid for it. Every family had juice, every younger (1-12 yr old) kid was expected to consume juice every single day. Grocery store freezer sections were PACKED with it, I remember being memorized by all the colors of the packaging.
I don't know anyone who feeds their children juice like I was fed it growing up. Even when people allow their kids juice now it's "eh, it's not healthy but at least it's better than soda."
I'd be willing to entertain a hypothesis that the demographic cohort of T2D Americans aren't getting most of their sugar in the form of organic, unprocessed honey taken directly from the hive.
To me it sounds logical that nutrition plays a major role in our health, and that sugar is a kind of food our bodies aren't made to process in such high quantities.
The fact you even have to ask this question is telling. Specifically you're talking about Hadza tribe that spends pretty much all of their waking hours outdoors hunting and tracking pray, day in and day out.
They quite literally track honeyguide birds, climb tall baobab trees, get stung repeatedly and then they eat freshest highest quality honeycombs whole, including larva, and not just extracted, industrially processed honey.
Westeners that show up to film hadza can barely keep up to them because just how fast, long and exhausting their hunts are.
This is akin to asking why do long-distance cyclists who spend 10-16hrs a day on bike on long cross country rides can drink liters of cola every day and be skinny like a fig.
I'm getting second hand embarrassment from just reading the question.
Look up Pontzer's Constrained Total Energy Expenditure Model. His doubly-labeled water experiments show that Hadza and other hunter-gathers have--contrary to his (and your) initial expectations--roughly comparable TDEEs to sedentary western counterparts (controlling for lean body mass) due to metabolic compensation (i.e., the more they exercise, the more their bodies compensate by expending less energy elsewhere, on things like inflammation and thyroid/sex hormones): : https://pmc.ncbi.nlm.nih.gov/articles/PMC4803033/
Regardless, they're in energy balance, meaning they aren't gaining or losing weight, and despite their high-sugar diets, they aren't presenting any of the metabolic maladies that Lustig ascribes to sugar specifically, and not to weight gain--maladies that saturated fat seems to cause with no weight gain.
> This is akin to asking why do long-distance cyclists who spend 10-16hrs a day on bike on long cross country rides can drink liters of cola every day and be skinny like a fig.
Sugar has 4 calories per gram. Fat has 9. Are you arguing that sugar calories are more fattening than fat calories?
> I'm getting second hand embarrassment from just reading the question.
It's remarkable that I've had less derogatory and flippant comments than yours downvoted and even flagged in this thread: https://news.ycombinator.com/user?id=462436347
> Sugar has 4 calories per gram. Fat has 9. Are you arguing that sugar calories are more fattening than fat calories?
Show me a molecule called "calory". Make a blood test - or any other measurement involving actual human body and show me exactly where this "calory" is. Obviously that is a rhetorical question, as human body does not operate on "calories", in fact, they are nowhere to be found in the human body.
Human body however does recognize glucose - C6H12O6 - and when your glycogen stores are depleted (such as by running in the jungle whole day, climbing a tall baobab tree or doing long distance cycling sessions) - the monosaccharides you consume will first go directly to replenish glycogen stores in muscles and liver and other organs.
If however, you're big fat couch potato with minimal lean muscle mass and a low basal metabolic rate, your glycogen stores are maxed out easily and continued consumption of sugar will directly lead to insulin spikes that will directly trigger lipogenesis (fat storage) as the fat cells will convert excess blood glucose into triglycerides. Eventually you develop insulin insensitity and eventually diabetes. Which is a very natural progression.
Consuming fat however does not notably spike insulin and does not trigger lipogenesis in the same fasion, quite the opposite - breaking down stored body fat can only happen if you stop constantly spiking insulin and enter a catabolic state. And thus - yes - even though fat is more energy dense on paper, it is way less fattening that sugar. And most important of all - consuming fat and proteins increases satiety via peptide hormones such as cholecystokinin which is released when the gut has to digest proteins and fat.
Embarassment really is the only polite way to express myself when confronted with people that compare hunter-gatherers that eat everything that moves, animals, their guts and organs whole, beas, larva, beawax and honeycombs in their entirity - to sedentary cookie muncher diets and claim that not only are those diets comparable (both being "high sugar" diets allegedly), but have similar daily energy expendiatures.
I suppose - to reach parity - couch potatoes expand all their energy producing... sex hormones? This is some truly fascinating stuff.
That's only bread. Then consider breakfast cereals, baked products, baked beans, etc. Every staple suddenly has massive quantities of sugar.
If people won't vote with their wallet, what makes you think they'll vote for someone who'll instate the necessary regulations? Both of those decisions stem from the same requirement to be educated and conscientious on the matter of diet.
Even as recently as a decade ago local producers would be using vegetable oils and less sugar so as to keep costs down. I remember being surprised how much sugar there was in plain cookies in Italy. British sweets I cannot touch to this day because they're commonly packed with salt as well as sugar. Same goes for American products - Reese's cupcakes are my holiday season guilty pleasure which inevitably gets me sick every time. They're violently flavourful.
On the flip side when I visited Ukraine in 2006 I noted that the local pralines had barely any sugar.
The Swiss and Germans seem to understand sweets on a deeper level than the rest. Notable exception is Lindt, which roasts the cocoa beans to seven hells for consistency, achieving a consistently sour-bitter aftertaste in its products.
Maybe it went up by 2% only, but it depends what were the actual numbers to start with. I've spent 6 months backpacking all over that country and although food is top notch, the sweets are ridiculously bad, often just distilled sugar with some (rather good) flavoring like safron.
I guess when you scorch all your taste buds since early age with all those chillies (its quite common to just eat raw chillies as a side dish to already crazy spicy foods on levels that most westerners going to their local indian restaurants will never experience), then to get any sensation from sweets they have to go over board.
That's why Western sweets are less sweet. You don't just eat a single one-inch cube of cheesecake, you eat a whole plate-sized portion of it which is like ten such cubes. Naturally it can't be as sweet as an Indian sweet.
Even growing up my parents said you're supposed to eat 1 Skittle and put the packet away (no joke). The fact that people in the West snack on a whole packet of Skittles was a culture shock.
In the 1990s, an overweight (not even obese) person was a rare sight. People were actually be surprised to see a non skinny person.
Nowadays, overweight and even obese people are everywhere you look. And type 2 diabetes is strongly correlated with being overweight.
1) Gravitas: Researchers identify gene variant that makes Indians susceptible to diabetes - https://www.youtube.com/watch?v=MBe8E0bqZZw
2) Diabetes Hits Hardest in Poor Countries That Aren't Overweight. Why? - https://www.youtube.com/watch?v=aGuED1JczbI (this includes generational studies done in India and highlights the insidiousness of "skinny fat").
TLDR, it was a gradual process, rationing of sugar ended in September 1953, rationing of meat almost a year latter.
[1] https://en.wikipedia.org/wiki/Rationing_in_the_United_Kingdo...
but it’s a reality for a lot of young men.
Long story short, bulking up is at odds with ecology, and we ask youngsters to do both.
How so? I would think that better nutrition and more physical activity is not at odds with being environmentally conscious, quite the contrary.
> Environmental changes came about. Processed foods became mainstream.
Those are definitely true, but those happened over time. The lifting of the sugar restrictions happened immediately at one date, and what is interesting is that you see such vastly, statistically significant differences in later diabetes and hypertension rates in babies that were born so close together (within a couple years), the main difference being their amount of sugar intake in very early childhood.
It's not like they just looked at "pre-war" vs. "post-war" babies.
Nobody is arguing that it isn't or couldn't. The study does a pretty good job, IMO, of pinpointing sugar intake as an infant as having substantial, significant impact on diabetes and hypertension rates in adulthood. It is not saying that it is the only possible causal factor.
Edit: it doesn't need much to be smarter than you, waihtis
Most studies rely on self-reported data, and people aren't very reliable in confessing what they ate and in what quantity. We are also a long-lived species and many effects take decades to manifest. Differences in environment (e.g. water impurities), genetics and gut microbiome confound the issue further.
Actually, the only people I have seen claiming this are conspiracy theorists who jumped on a new boogeyman.
> Using an event study design with UK Biobank data comparing adults conceived just before or after rationing ended, we found that early-life rationing reduced diabetes and hypertension risk by about 35% and 20%, respectively, and delayed disease onset by 4 and 2 years. Protection was evident with in-utero exposure and increased with postnatal sugar restriction, especially after six months when solid foods likely began.
Which part of the title isn't supported by the paper?
Before modernity, maintaining long-term ketosis (eg decade+ length) would have been extremely difficult. Some anti-sugar advocates portray sugar as inherently evil, suggesting that any consumption will lead to significant harm.
However, moderation is often more practical:
1. Many marathon runners use glucose gels and still enjoy long, healthy lives, typically living about 7 years longer than non-athletes.
2. Most researchers at the National Institute on Aging do not recommend avoiding all sugar or focusing solely on ketogenic diets. In fact, studies show that intermittent fasting often leads to longer lifespans than ketogenic diets.
3. New data is showing that long term ketogenic diets lead to the death of healthy cells, increased adipose tissue, increased triglycerides https://www.science.org/doi/10.1126/sciadv.ado1463
But that glucose is made by your body from the food that you eat, at a steady pace.
But if you eat sugary food, it will increase your blood sugar level too fast. Causing your body to produce lots of insulin. The insulin's job is to get the sugar out of your blood to restore safe sugar levels. The two ways in which insulin does this is:
- Using the sugar for muscle cells that are active and need fuel.
- If there are no muscle cells needing fuel, then it gets stored as glycogen in fat cells for later use, when blood sugar levels are too low.
So even though almost all of your body needs glucose, it's not the best if you eat that directly. Unless you would consume the glucose in a constant way keeping your blood sugar level constant. That could be done with an IV, but our bodies have this mechanism that they can take high- protein/fat & low- sugar/carb contents food and use that as a constant source for several hours. Then you only need to refill the stomach once in a while instead of being connected to an IV all day.
Edit: BTW, when the blood sugar level spikes from sugary food, insulin will spike thereafter, causing the sugar level to drop very fast, eventually making you feel tired and hungry, craving for a quick (sugary) snack, and the cycle starts again.
An example of this is Oral Rehydration Solution (ORS). Many people around the world suffer from dehydration, and electrolyte solutions are more effective when combined with glucose in a liquid form. Interestingly, the study often cited to argue that non-glucose-based versions are equally effective is misleading. In that study, participants consumed orange juice and cereal bars one hour before the test, which influenced the results. https://www.frontiersin.org/journals/sports-and-active-livin...
The liver and muscles act as natural buffers, storing excess glucose as glycogen and releasing it as needed, so a small sugar spike here and there—like a few pieces of candy—won’t typically lead to insulin resistance or other long-term problems. Issues like insulin resistance are more of a concern with constant, high sugar intake over time, particularly if the overall diet lacks fiber and nutrients and particularly for people who are inactive.
So, while excessive sugar intake isn’t great, enjoying sugar in moderation doesn’t overwhelm the body’s ability to regulate blood sugar. Our metabolic systems are designed to manage occasional spikes, and a balanced approach is key.
Every 10 years, the dietician community tends to demonize one type of macronutrient. When a theory claims that a single factor explains a complex phenomenon, it’s usually a red flag that the theory is flawed.
So yeah in moderation everything is ok of course, but I do have the feeling that on average, we might be overdoing it a little bit with the sugar.
I’m very interested to see ubiquitous continuous glucose monitors in action and the data we will get from that.
The high degree to which GLP-1 medicines work aide in your argument RE insulin quite a bit. I am just very suspect of all the keto claims (not made by you - just in general). If keto was a panacea then in the last 40 years we would have seen a bigger dent in obesity.
I think it is actually largely a psychological story. Food is like an addiction, a way of distracting yourself from the struggles of life. And addictive food (candy, snacks, fast food) is just the kind of drug that is easiest available to most people, and it's not illegal or necessarily looked down upon, even promoted in many ways (birthday cake). So that is why it's one of the bigger problems in society.
And the solution for addictions is not taking away the drug, because the desire is still there, and will eventually sip through in some other way. The way to deal with it is to look into the root cause of what is lacking in the life of the user causing it to try to fill up this hole in it's life with this drug. And then have a proper way of treating that, while also learning more about nutrition, because people have also just forgotten what healthy food is and how to make it.
For example, what about the massive amount of caffeine in soda, chocolate, and other "sweet diet" food? Or, what about just general over-consumption of food in postwar regardless of what it is (which is much more a societal issue than anything else)
For example, someone susceptible to later developing diabetes may consume unusually high quantities of sugar when available as a means to deal with some other insufficiency. (Guess where that idea comes from). The problem is not the sugar per se, but the fact that different people respond to the same consumed items completely differently, something that is very inconvenient for those that want to treat everyone the same way.
Haven't diabetes rates been steadily rising until today though? How does one explain that away as "people respond differently to sugar"?
The question is why people are guzzling so much sugar in the first place. The answer is they are malnourished. Post war britain was a particularly bad case they deliberately paper over, but my parents grew up with rationing and never snapped out of it, like many others, which led to many of my generation also being subjected to that diet. It simply fills you up but provides people with my metabolism with no energy at all.
If you look at the history of celiac disease the cause wasn’t recognized until a hospital of people were reduced to eating sawdust/dried up tulips, only to find a group of patients actually improved when this happened since they were no longer being actively poisoned. You are not alone in your blind spot, but it is amazing the enthusiasm with which it is promoted by those that should have worked this out years ago.
> the fact that different people respond to the same consumed items completely differently
You are making this more specific than it is to be just about sugar and diabetes.
My, non radical, assertion is that different metabolisms lead people to process the same things in fundamentally different ways. Some of these clearly lead to diabetes (and gout etc).
The underlying problem is consuming x or y in isolation could be ok for everyone but in some people x and y are dangerous. Given the mix of what we consume this rapidly becomes a combinatorial headache (especially if factoring in gut bacteria) so there is some sympathy for researchers in this area, but the tendency to confuse cause and effect is way too common.
> The problem is not the sugar per se, but the fact that different people respond to the same consumed items completely
You stated as a fact that sugar itself is not the problem, and you point to other causes (earlier, differing metabolic responses among people; now, a different substance being a confounding factor) as the explanation. But these just seem to be hand-waving conjectures about how something else could be the problem, not anything factually indicating that sugar itself isn't.
Furthermore, the fact that some people respond differently to sugar would not itself imply that sugar itself is not the problem, which is what's been throwing me off about your discussions. There are plenty of illnesses that some people are resistant or even immune to. There are also plenty of cases where some people initially tolerate a substance but then eventually -- even after many years -- suddenly start showing severe reactions to it, simply as a result of excess consumption. The fact that people don't have the same uniform responses to the same substances doesn't necessarily mean the substances aren't the problem.
This is why I'm saying I can't follow your logic. Your conclusion that sugar itself isn't the problem might still be correct; I don't know. I'm just saying I don't see how your explanations imply that conclusion.
First, the fact that people react differently does not mean that it is not a public health issue. Some people can drink absurd amounts of alcohol and still be functional afterwards. It’s still not a good idea to drink more than a small dose of alcohol regularly.
Then, there are dangerous and lethal thresholds for all substances, even for seemingly-tolerant people. The fact that most symptoms take decades to develop does not help.
Add the fact that we don’t know why some people are more tolerant and we cannot predict it. Sugar is a problem, at the individual level and even more so because of the burden on society because of public health issues. I am happy to give a gold star to sugar-tolerant people who remain fit and live a long life despite eating tons of the stuff. I am very happy for you. But you are not a proof that sugar is not bad.
Now this is what should be being researched.
The public health problem with that is you might come to a conclusion where it is harder to blame the patient. The “sugar is bad mmmkay” serves a convenient purpose when providing people with something to moralize about.
Indeed. Not only that, but it as well. And believe me, it is being researched.
> The public health problem with that is you might come to a conclusion where it is harder to blame the patient.
How is that a problem? Public health is not about blaming anyone, it’s about improving individuals’ health and diminishing the burden of illnesses on society overall.
> The “sugar is bad mmmkay” serves a convenient purpose when providing people with something to moralize about.
A lot of things are bad. Sugar, like most things, is benign in small quantities but at this point its downsides are quite well documented. It is also quite addictive. There is nothing moral or immoral about this. I don’t really blame people who consume too much of it, but at the society’s level we should do something about it. And other things, we have more than one problem.
>The problem is not the sugar per se, but the fact that different people respond to the same consumed items completely differently That's true, but most people respond to sugar the same way. When talking about a population, the people that don't respond to over consumption of sugar with diabetes is a rounding error.