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:
> US sugar consumption declined from 2000-2020 to 1970s levels, while its T2D prevalence only increased
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.
> 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
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.
>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.
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.
That does not make sense statistically. A decrease in total HFCS consumption would lead to a decrease in new diabetes cases if it was the actual root cause.
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?
You perfectly framed why it’s my belief this debate will rage on for 100-1000 years.
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.
The study you linked to defines the "high fat diet" as 55 % fat/25 % saturated fat/27 % carbohydrate.
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.
> 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.
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.
> E.g. look at how "added sugar" is distinct from other carbohydrates but no "total sugar" metric on nutritional boxes on food products.
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?
Just for context, total sugar is the only thing shown on European food labels. Makes it somewhat annoying the other way around, it's hard to figure out if it's just the sugars the ingredients contained or if it's stuffed with extra. I prefer this worry over the other option though. In a perfect world we would have both.
If sugar is added, it’s in the ingredients list in the EU. They are sorted by decreasing amount, hence while you won’t be able to tell exactly how much was added, you can narrow it down. But sometimes they add different sugar types and it becomes really difficult to estimate the quantity of added sugar.
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.
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.
Do you mean oils that have turned rancid before they are consumed? I don’t really get the hate seed oils are getting. In studies they seem to have shown no ill effects. They do certainly use oils in studies that are not rancid, while your average supermarket oil might be (?).
The problem is linoleic acid and our overconsumption of it. It seems to cause way more oxidative stress during metabolism, to which the brain is more sensitive. Plus it also seems to adversely affect metabolism of other kinds of fats. And it plasticizes during cooking.
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.
Without a literature review, they'd certainly be a number one suspect.
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.
> before 1985 T2D was called adult onset diabetes considered an adult disease and 1983 was the first case of pediatric nonalcoholic fatty liver disease.
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.
>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.
"Seed oils" are a nonsensical category because the main example is canola oil which doesn't actually have the problems associated with them (bad omega-3:6 ratios).
I thought the problem with seed oils is that seeds don’t want you to eat them and their chemistry may reflect that. Fruit bodies such as olives on the other hand are “designed” to be eaten and so aren’t likely to have such defenses.
Olives are a pretty weird example of something that "wants" to be eaten by us, given the insane amount of processing it takes to make anything remotely palatable from them.
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.
It just has to be mammals in general. If e.g. a rape seed doesn’t want to be eaten by squirrels, to take a common seed eating mammal, there’s a decent chance that as mammals we share enough in common that whatever surface is being targeted in squirrels would affect us as well.
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?
> And if sugar is so metabolically harmful, where are the RCTs showing this?
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.
>US sugar consumption declined from 2000-2020 to 1970s levels, while its T2D prevalence only increased
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
>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
Just one cheeseburger is three miles of running. Not only is it very easy to shop and overeat, your body continually encourages it. The only way out is determination not to eat whatever you want.
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.
If you eat a normal burger with high quality meat and traditionally made roll and fresh vegetables on top the overeating thing isn’t as much of an issue. I have a hard time finishing a single one let alone eating more.
The jogging might not be necessary for the calorie burn, but humans evolved based on movement / activity. Our great great great great...n ancestors didn't have desk jobs starring at screens.
I find it way easier not to eat whenever I want. I'm doing 24h break from eating every 24h. Basically one day I'm eating just till 4PM and the next one only after 4PM. I've lost about 6kg (from being slightly overweight) in two months eating whatever I want. Just not whenever I want.
Nobody is implying it’s so simple that you can “eat whatever you want” and be at a healthy weight. This is true if you’re underweight as well. If you’re trying to gain weight, you need to eat more than you want.
> 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?
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.
> 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.
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.
Problem with sugar isn’t that is so bad chemically from my experience, it is super mega addicting, it is way more addicting than nicotine for me for example. I don’t crave some eggs and sausage but crave sugar like crazy. So I am very likely to over consume sugar compared to other things. This is what makes is very harmful to me at least
The depressing part is that there's a large subset of people that can't even begin to grasp just how extremely embarassing it is to attach accelerometers to tribesmen and then think it becomes a steam engine and can be modeled as such.
> 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.
Readers here probably aren't hunter gatherers in Africa though. If you live sedentary lifestyle with an abundance of food you may need to take a different approach to nutrition. Sure it would be ideal if we were all hyper athletes, but the reality is that probably isn't going to happen and I am not sure it's even better holistically.
The reason to do RCTs and establish causality isn't to generate excuses for a sugar diet, it's to head off bullshit alternatives that don't fix the problem but advertise like they do.
Almost no RCTs are done when it comes to diet. They are outrageously expensive to do for any length of time, and nobody will fund them. Don't expect to see definitive studies done within your lifetime.
What's your point? The article implied that sugar magically causes obesity and diabetes, all calories being equal, when the weight of the evidence supports neither assertion, and ironically implicates saturated fat as being worse, showing an ability to cause an increase in visceral fat and worsened insulin sensitivity (measured with oral glucose tolerance tests), even in weight-stable subjects.
> 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
> Early-life sugar could drive later-life disease in various ways, Gracner says. Exposure in the womb might affect fetal development in a way that predisposes someone to metabolic diseases. Infants eating a sugary diet might also develop a taste for sweet foods, causing them to eat more sugar as adults—an outcome for which her team has some preliminary evidence.
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.
If sugar is not part of the problem, why did the sugar companies pay to suppress studies and promote fat as harmful? No company is going to spend money to suppress results that would show their products in a positive light…
Also, just speculation on my part, but their daily caloric intake may be less than that consumed by a Westerner. Combined with their (presumably) greater expenditure of calories than Westerners, that sugar is not going to result in any significant health issues.
Try eating mostly honey and roots and see how much you can over consume. The problem in US is the variety of food and how engineered they are to be hyper palatable. Snacks are designed to pump sugar into the blood stream, with just enough salt, fat, or carbonation (in drinks) to mask just how much sugar is in everything. That's the reason why warm flat soda tastes disgustingly sweet.
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 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.
>The best study done to date on hyperpalatable foods found that fat and sodium were the most common drivers of hyperpalatability...
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".
Yes, there are more "types" of foods that are high in fat and sodium, but that does not mean that these foods are more popular or more hyper-palatable than the ones with sugar. We would need another, different study to resolve this.
Fizzino's HPF study, while not an RCT, is the most comprehensive study to date done on HPFs. She's also identified links between HPF proliferation and tobacco companies: https://onlinelibrary.wiley.com/doi/10.1111/add.16332
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.
> US sugar consumption declined from 2000-2020 to 1970s levels
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.
>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."
So what is your point, you think sugar is not such a big problem and we're not eating too much of it? Then what is according to you the major cause of diabetes and obesity?
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.
>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?
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.
I don't quite understand the details but diet plays a role in epigenetics. The effects a diet (in this case sugar) can imprint itself across multiple generations.
This article does us a great disservice by ignoring industrial sugar. The end of sugar rationing also meant that sugar could be added to industrially produced products, like bread. Visitors to America gag on the unbearable sweetness of standard sliced bread, which is commonly sweetened with high fructose corn syrup. Bread in the UK switched to the Chorleywood rapid process in the 60s, which allowed them to use low quality low protein flour. The result is a high glycemic index white bread which is rapidly digested to glucose.
That's only bread. Then consider breakfast cereals, baked products, baked beans, etc. Every staple suddenly has massive quantities of sugar.
Like environmental issues, this is a corporate problem being presented as an individual problem. It’s not going to be fixed by every single individual person monitoring every single thing they eat. It’s going to be fixed by removing the incentives for companies to do antisocial things.
It can be both. Nobody is holding a gun to anyone's head and forcing them to buy sugary cereal, highly processed white bread, peanut butter with sugar, jellies and jams and "maple" syrup that is all just basically corn syrup, sodas, kool aid, and on and on and on.
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.
People are holding a gun, the gun is human nature. If you could buy meth at your local supermarket we'd have a LOT more meth heads. The human mind and body is not built to address addictive substances on a societal scale. We require policy, as we have done with tobacco in the past.
India saw a similar thing with the sugar craze once the economy opened up in the 1990s— although the diabetes rate has only gone up 2% in three decades.
Similar in Eastern Europe after the fall of USSR when western snacks came on the market and we fell pray to advertising after decades of isolation: "Those sugary western snacks can't be bad for you since they come from the developed west and rich westerners eat them". Oh boy, if we only knew back then what we know today. Probably why a lot of millennials today don't look very healthy.
I'm from the region and to me it was always about "ooh, this is real chocolate, not Compound chocolate".
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.
I imagine it has more to do with the smoking and drinking rates than sugar. I very clearly remember an aunt of mine losing her mind in the 90s about me drinking coke, while smoking when she was pregnant.
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").
> India ranks second after China in the global diabetes epidemic with 77 million people with diabetes (google)
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.
The culture around sweets in India is different than from the West. You're supposed to eat one little square piece of a sweet or a couple of gulab jamun balls and that's it. Indians don't sit with a big plate of Indian sweets like it's the "dessert" course of their meal.
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.
I didn't understand when I first moved to the UK. The dessert here is really sweet. I don't understand how people are able to eat that. How can things be tasty when it is that sweet. They are off putting.
Yeah, well modern diets also have a wildly imbalanced omega 3-6 ratio, which causes chronic inflammation which in turn is a central driver of diabetes. Funny how they just disregard it and try to pinpoint everything to a single variable.
You’re not wrong. Sugar isn’t the only thing that changed after rations were lifted. Caloric intake in general went way up. Environmental changes came about. Processed foods became mainstream. I just don’t know how you can pinpoint one thing and choose it as the chief villain.
I suggest you read the study in detail. I originally had a similar thought as you, but then seeing how the researchers were able to tease out specific effects based on minor differences in birth timing relative to the end of sugar rationing was strong evidence.
> 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.
Yes, but sugar having a substantial effect as observed does not rule out fat type also having some effect, perhaps as a modulator or synergistic process, such as sugar being the main driver but the body being less capable of coping with sugar when most of what it gets is dead food high in linoliec acid.
> sugar having a substantial effect as observed does not rule out fat type also having some effect
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.
this is a fair point, but still: sugar might just be a diabetes catalyst on the condition other large changes have occurred (low exercise, high processed food diets, more stress etc.), and we don't know if the effect would've been the same since no conditions exist where diet, lifestyle and other factors remained completely static for a number of decades.
Honestly, when I see the young generation in US, it seems it’s kind of a given than young males must bulk up, under penalty of not being instagrammable enough to find a girlfriend. That sentence may sound terribly superficial…
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.
It’s highly likely not one thing. We’ve moved to trash foods, more sugar, worse fats, etc, plus we’re more inactive than ever and being constantly bombarded by stress 24/7 from news and the internet and consumerist mentality.
That is irrefutable. Eat 4 eggs fried in butter and then measure blood sugar an hour later vs eating the same amount of sugar by weight on separate days, on an empty (12 hour fast).
Exercise temporarily raises your heart rate and systolic blood pressure, yet avid exercisers have lower RHRs and SBPs; how do you know it isn't the same with carbohydrates, provided fat (especially saturated) is restricted?
To avoid any doubt: there is no scientific basis for “imbalanced omega 3-6 ratio, which causes chronic inflammation which in turn is a central driver of diabetes”. There is no indication that omega-6 in human diet cause inflammation (we don’t eat that much of them, and they are readily metabolised). And as a matter of fact, diabetes is more strongly correlated with sugar than any kind of fat.
Actually, the only people I have seen claiming this are conspiracy theorists who jumped on a new boogeyman.
Good luck convincing anyone of that without being called a crackpot, a disinformation bot, or worse. At this point in my life, I keep such knowledge to myself and leave everyone else to the peril of their own incomplete understanding.
Rigorous scientific study in the nutrition field is extremely hard to do.
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.
> 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?
Actually, almost all of your body runs on glucose. Your muscles for example.
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.
I get what you’re saying about insulin and blood sugar, but I think it’s important to remember that sugar itself isn’t inherently “bad” for us. Our bodies are actually well-equipped to handle it, especially when consumed in reasonable amounts. Glucose is a primary energy source for the brain and muscles, and occasional treats or small amounts of sugar can be part of a healthy diet without causing harm.
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.
Yeah ok, but I think it is also clear at the same time that a lot of food that we eat today is much more sugary than the previous millions of years before that, and that we seem to be getting more and more problems with overweight and diabetes type 2.
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.
You are totally right. A honey crisp apple has a lot of fiber in it. 5,000 years ago outside of a few regions getting access to cane sugar would be difficult. Mango and pineapple somewhat easier but probably less sweet than today. This does concern me a lot. It’s sad when a restaurant sends you cut strawberry’s with sugar sprinkled on top. But sugar free chocolate just isn’t as good :)
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.
Aha, yeah, the keto hype is the pendulum swinging the extreme opposite way, and yeah there is a middle balance. I think keto is also an attempt to "cheat responsibly", because people have a hard time saying good bye to sweets, so all kinds of fancy keto sweeteners are promoted. But yeah I think it's eventually a bit futile, you're trying to fool yourself, and in the long run that doesn't work.
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.
The brain also runs well on ketones which are more energy dense and remove the oxygen bottleneck. It's easier to deliver a consistent level of ketones than glucose, avoiding spikes and crashes.
Ketones are a backup evolved to be used in short durations. How many people have you known who have stayed on a ketogenic diet for 10 or 20 years without ever coming out of ketosis?
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.
Are there any studies about the harm of a craze in non-sweet diets? While I would generally agree with this "confirmation" based on my understanding of diabetes, I wonder if it's actually sugar that is the problem here.
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)
plenty of studies on caffeine. Chocolate usually comes with loads of sugar unless you mean sugar alternatives? That wouldn't apply to just post war UK though. Also, it's hard to over consume non-sugar so that's not a lot of overlap. Remember carbs break down to sugar as well.
These things still don’t establish actual causation.
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.
> 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
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.
> Add the fact that we don’t know why some people are more tolerant and we cannot predict it
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, 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"?
I know this from the simple fact that I respond completely differently to sugar than almost everyone else I know, except gout sufferers.
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.
I'm not disputing that people respond differently to sugar. I'm asking how that explains the diabetes epidemic becoming more and more widespread as time goes on.
As more people consume a higher amount of sugar (regardless of form), the overall rate of societal diabetes increases. Other factors like reduced exercise, increased consumption of junk foods, exposure to more chemicals like endocrine disruptors, etc. also push the rate of diabetes up faster.
Because you have a blind spot over people responding differently, as indicated by your original question.
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.
To go back to what I said which you were responding to
> 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.
Because people eat different types of diets and consume, for example, different ratios of omega fatty acids - which in turn can cause chronic inflammation and diabetes
I'm not disputing that people respond differently to sugar. I'm asking how that explains the diabetes epidemic becoming more and more widespread as time goes on.
I see. Diabetes is downstream from chronic inflammation, so something is causing us to be inflammated at scale and that is why diabetes is becoming more commonplace. So differing response to sugar is one factor of N possible affecting variables
> These things still don’t establish actual causation.
Nope, it says there's a connection.
>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.
US sugar consumption declined from 2000-2020 to 1970s levels, while its T2D prevalence only increased: https://news.ycombinator.com/item?id=38094768
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...
> US sugar consumption declined from 2000-2020 to 1970s levels, while its T2D prevalence only increased
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.
> 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
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.
>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.
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.
That does not make sense statistically. A decrease in total HFCS consumption would lead to a decrease in new diabetes cases if it was the actual root cause.
Sugar is not the cause of diabetes.
> 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?
You perfectly framed why it’s my belief this debate will rage on for 100-1000 years.
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.
>A decrease in total HFCS consumption would lead to a decrease in new diabetes cases if it was the actual root cause
There is no decrease in HFCS it is up 3-4x since 1970.
The study you linked to defines the "high fat diet" as 55 % fat/25 % saturated fat/27 % carbohydrate.
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.
> 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.
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.
> E.g. look at how "added sugar" is distinct from other carbohydrates but no "total sugar" metric on nutritional boxes on food products.
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-...
[2] https://www.fda.gov/media/99331/download
Just for context, total sugar is the only thing shown on European food labels. Makes it somewhat annoying the other way around, it's hard to figure out if it's just the sugars the ingredients contained or if it's stuffed with extra. I prefer this worry over the other option though. In a perfect world we would have both.
If sugar is added, it’s in the ingredients list in the EU. They are sorted by decreasing amount, hence while you won’t be able to tell exactly how much was added, you can narrow it down. But sometimes they add different sugar types and it becomes really difficult to estimate the quantity of added sugar.
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.
The US does have both as of 2018:
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.
yup. seed oils also play a role
Do you mean oils that have turned rancid before they are consumed? I don’t really get the hate seed oils are getting. In studies they seem to have shown no ill effects. They do certainly use oils in studies that are not rancid, while your average supermarket oil might be (?).
The problem is linoleic acid and our overconsumption of it. It seems to cause way more oxidative stress during metabolism, to which the brain is more sensitive. Plus it also seems to adversely affect metabolism of other kinds of fats. And it plasticizes during cooking.
Those sound more like RFK Jr talking points than anything born from research on human health outcomes where all of this speculation goes to die.
Linoleic acid also blocks absorbsion of DHA.
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.
For the plasticizing bit check out this video for some n=1 evidence: https://youtu.be/Ra_tCL5-4c0
Without a literature review, they'd certainly be a number one suspect.
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.
> before 1985 T2D was called adult onset diabetes considered an adult disease and 1983 was the first case of pediatric nonalcoholic fatty liver disease.
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.
>that statement is factually false
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.
"Seed oils" are a nonsensical category because the main example is canola oil which doesn't actually have the problems associated with them (bad omega-3:6 ratios).
I thought the problem with seed oils is that seeds don’t want you to eat them and their chemistry may reflect that. Fruit bodies such as olives on the other hand are “designed” to be eaten and so aren’t likely to have such defenses.
Olives are a pretty weird example of something that "wants" to be eaten by us, given the insane amount of processing it takes to make anything remotely palatable from them.
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.
Depends on who's not supposed to be eating them.
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.)
It just has to be mammals in general. If e.g. a rape seed doesn’t want to be eaten by squirrels, to take a common seed eating mammal, there’s a decent chance that as mammals we share enough in common that whatever surface is being targeted in squirrels would affect us as well.
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?
What media do you consume to believe nonsense like this?
paul saladino
> And if sugar is so metabolically harmful, where are the RCTs showing this?
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.
>US sugar consumption declined from 2000-2020 to 1970s levels, while its T2D prevalence only increased
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
Physically very active. I used to gain 10 kg when my sport (American football) was not in season, although I did some training year-round.
I don’t have the time for that level of activity as an adult. In season, it was about 20 hours a week.
Just one cheeseburger is three miles of running. Not only is it very easy to shop and overeat, your body continually encourages it. The only way out is determination not to eat whatever you want.
Resting metabolism uses a -lot- of calories. You can have that hamburger, just don’t have two, no jogging necessary.
> just don’t have two
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.
If you eat a normal burger with high quality meat and traditionally made roll and fresh vegetables on top the overeating thing isn’t as much of an issue. I have a hard time finishing a single one let alone eating more.
"Hyper-palatable foods" was a new expression to me, but I like it. Much more reasonable than "processed".
The jogging might not be necessary for the calorie burn, but humans evolved based on movement / activity. Our great great great great...n ancestors didn't have desk jobs starring at screens.
Having two buggers and jogging is much healthier than eating one and be sedentary
[Citation Needed]
Jogging almost certainly won't burn the calories from the second burger.
I run 3 miles a few times a week and it’s something near 500-600 calories. I’d say maybe 4 miles depending on the type of burger we’re discussing
McDonalds cheeseburger is 300cals in USA (and 290 in Canada):
https://www.mcdonalds.com/us/en-us/product/cheeseburger.html
https://www.mcdonalds.com/ca/en-ca/product/cheeseburger.html
I find it way easier not to eat whenever I want. I'm doing 24h break from eating every 24h. Basically one day I'm eating just till 4PM and the next one only after 4PM. I've lost about 6kg (from being slightly overweight) in two months eating whatever I want. Just not whenever I want.
It's not so simple... I eat whatever I want and struggle to get my weight over 80 kg, which would be a healthy weight for my height.
Nobody is implying it’s so simple that you can “eat whatever you want” and be at a healthy weight. This is true if you’re underweight as well. If you’re trying to gain weight, you need to eat more than you want.
> 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?
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.
> 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.
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
Problem with sugar isn’t that is so bad chemically from my experience, it is super mega addicting, it is way more addicting than nicotine for me for example. I don’t crave some eggs and sausage but crave sugar like crazy. So I am very likely to over consume sugar compared to other things. This is what makes is very harmful to me at least
The depressing part is that there's a large subset of people that can't even begin to grasp just how extremely embarassing it is to attach accelerometers to tribesmen and then think it becomes a steam engine and can be modeled as such.
> 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.
Readers here probably aren't hunter gatherers in Africa though. If you live sedentary lifestyle with an abundance of food you may need to take a different approach to nutrition. Sure it would be ideal if we were all hyper athletes, but the reality is that probably isn't going to happen and I am not sure it's even better holistically.
The reason to do RCTs and establish causality isn't to generate excuses for a sugar diet, it's to head off bullshit alternatives that don't fix the problem but advertise like they do.
Almost no RCTs are done when it comes to diet. They are outrageously expensive to do for any length of time, and nobody will fund them. Don't expect to see definitive studies done within your lifetime.
What's your point? The article implied that sugar magically causes obesity and diabetes, all calories being equal, when the weight of the evidence supports neither assertion, and ironically implicates saturated fat as being worse, showing an ability to cause an increase in visceral fat and worsened insulin sensitivity (measured with oral glucose tolerance tests), even in weight-stable subjects.
> 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
> Early-life sugar could drive later-life disease in various ways, Gracner says. Exposure in the womb might affect fetal development in a way that predisposes someone to metabolic diseases. Infants eating a sugary diet might also develop a taste for sweet foods, causing them to eat more sugar as adults—an outcome for which her team has some preliminary evidence.
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.
I'm reading "Epigenetics" by Richard C Francis and he mentions the influence of diet during pre-birth as well during early development.
https://www.penguinrandomhouse.ca/books/404271/epigenetics-b...
If sugar is not part of the problem, why did the sugar companies pay to suppress studies and promote fat as harmful? No company is going to spend money to suppress results that would show their products in a positive light…
https://www.npr.org/sections/thetwo-way/2016/09/13/493739074...
Good thing the beef and diary industries aren't spending any money to convince you that saturated fat is harmless.
>15-80% of their daily calories from honey during certain seasons; why aren't they obese and diabetic?
Maybe because it's "during certain seasons" and not the whole year around?
Also, just speculation on my part, but their daily caloric intake may be less than that consumed by a Westerner. Combined with their (presumably) greater expenditure of calories than Westerners, that sugar is not going to result in any significant health issues.
Try eating mostly honey and roots and see how much you can over consume. The problem in US is the variety of food and how engineered they are to be hyper palatable. Snacks are designed to pump sugar into the blood stream, with just enough salt, fat, or carbonation (in drinks) to mask just how much sugar is in everything. That's the reason why warm flat soda tastes disgustingly sweet.
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 problem in US is the variety of food and how engineered they are to be hyper palatable
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.
>The best study done to date on hyperpalatable foods found that fat and sodium were the most common drivers of hyperpalatability...
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".
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Yes, there are more "types" of foods that are high in fat and sodium, but that does not mean that these foods are more popular or more hyper-palatable than the ones with sugar. We would need another, different study to resolve this.
Ummm, that's not an RCT. Unless you are talking about one you cited in a different comment?
Fizzino's HPF study, while not an RCT, is the most comprehensive study to date done on HPFs. She's also identified links between HPF proliferation and tobacco companies: https://onlinelibrary.wiley.com/doi/10.1111/add.16332
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.
> US sugar consumption declined from 2000-2020 to 1970s levels
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.
>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."
So what is your point, you think sugar is not such a big problem and we're not eating too much of it? Then what is according to you the major cause of diabetes and obesity?
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.
>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?
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.
I don't quite understand the details but diet plays a role in epigenetics. The effects a diet (in this case sugar) can imprint itself across multiple generations.
This article does us a great disservice by ignoring industrial sugar. The end of sugar rationing also meant that sugar could be added to industrially produced products, like bread. Visitors to America gag on the unbearable sweetness of standard sliced bread, which is commonly sweetened with high fructose corn syrup. Bread in the UK switched to the Chorleywood rapid process in the 60s, which allowed them to use low quality low protein flour. The result is a high glycemic index white bread which is rapidly digested to glucose.
That's only bread. Then consider breakfast cereals, baked products, baked beans, etc. Every staple suddenly has massive quantities of sugar.
Like environmental issues, this is a corporate problem being presented as an individual problem. It’s not going to be fixed by every single individual person monitoring every single thing they eat. It’s going to be fixed by removing the incentives for companies to do antisocial things.
It can be both. Nobody is holding a gun to anyone's head and forcing them to buy sugary cereal, highly processed white bread, peanut butter with sugar, jellies and jams and "maple" syrup that is all just basically corn syrup, sodas, kool aid, and on and on and on.
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.
People are holding a gun, the gun is human nature. If you could buy meth at your local supermarket we'd have a LOT more meth heads. The human mind and body is not built to address addictive substances on a societal scale. We require policy, as we have done with tobacco in the past.
India saw a similar thing with the sugar craze once the economy opened up in the 1990s— although the diabetes rate has only gone up 2% in three decades.
Similar in Eastern Europe after the fall of USSR when western snacks came on the market and we fell pray to advertising after decades of isolation: "Those sugary western snacks can't be bad for you since they come from the developed west and rich westerners eat them". Oh boy, if we only knew back then what we know today. Probably why a lot of millennials today don't look very healthy.
I'm from the region and to me it was always about "ooh, this is real chocolate, not Compound chocolate".
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.
Lindt is bottom of the barrel slop with fancy branding attached to it. It's the McDoanlds/Starbucks of chocolate.
I imagine it has more to do with the smoking and drinking rates than sugar. I very clearly remember an aunt of mine losing her mind in the 90s about me drinking coke, while smoking when she was pregnant.
Just looking around in India, I don’t believe the 2% figure. Maybe it’s not officially diagnosed, or the source for the figures is not accurate.
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.
No, it is much more than 2% because a lot of it is undiagnosed and a ticking time bomb in India. A couple of must-watch videos;
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").
> India ranks second after China in the global diabetes epidemic with 77 million people with diabetes (google)
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.
The culture around sweets in India is different than from the West. You're supposed to eat one little square piece of a sweet or a couple of gulab jamun balls and that's it. Indians don't sit with a big plate of Indian sweets like it's the "dessert" course of their meal.
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.
I didn't understand when I first moved to the UK. The dessert here is really sweet. I don't understand how people are able to eat that. How can things be tasty when it is that sweet. They are off putting.
Discussion (39 points | 1 day ago | 64 comments) https://news.ycombinator.com/item?id=42019398
complimentary link to the book that's got a not so PC title also irate members of the Oxford comma brigade, still worth a read.
https://en.wikipedia.org/wiki/Pure,_White_and_Deadly
Mind boggling the mental gymnastics people are doing in this thread to deny to themselves the obvious fact that refined sugars are bad for you.
Roald Dahl saw that coming: https://en.wikipedia.org/wiki/Charlie_and_the_Chocolate_Fact...
A timeline of the winding down of post WWII rationing in UK [1]
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...
Yeah, well modern diets also have a wildly imbalanced omega 3-6 ratio, which causes chronic inflammation which in turn is a central driver of diabetes. Funny how they just disregard it and try to pinpoint everything to a single variable.
You’re not wrong. Sugar isn’t the only thing that changed after rations were lifted. Caloric intake in general went way up. Environmental changes came about. Processed foods became mainstream. I just don’t know how you can pinpoint one thing and choose it as the chief villain.
I suggest you read the study in detail. I originally had a similar thought as you, but then seeing how the researchers were able to tease out specific effects based on minor differences in birth timing relative to the end of sugar rationing was strong evidence.
I don’t see how those are mutually exclusive, they said sugar isn’t the only thing, not that it doesn’t have a significant effect.
Because look at their argument:
> 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.
Yes, but sugar having a substantial effect as observed does not rule out fat type also having some effect, perhaps as a modulator or synergistic process, such as sugar being the main driver but the body being less capable of coping with sugar when most of what it gets is dead food high in linoliec acid.
> sugar having a substantial effect as observed does not rule out fat type also having some effect
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.
this is a fair point, but still: sugar might just be a diabetes catalyst on the condition other large changes have occurred (low exercise, high processed food diets, more stress etc.), and we don't know if the effect would've been the same since no conditions exist where diet, lifestyle and other factors remained completely static for a number of decades.
Indeed. Its the same idiocy as was/is with cholesterole
Honestly, when I see the young generation in US, it seems it’s kind of a given than young males must bulk up, under penalty of not being instagrammable enough to find a girlfriend. That sentence may sound terribly superficial…
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.
The kids these days are beanpoles and lack muscle mass. Far cry from the 80s.
> 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.
It’s highly likely not one thing. We’ve moved to trash foods, more sugar, worse fats, etc, plus we’re more inactive than ever and being constantly bombarded by stress 24/7 from news and the internet and consumerist mentality.
thank you for reading & comprehending the point, and not somehow concluding I'm claiming sugar doesn't raise blood sugar
Sugar raising blood sugar seems like a quite obvious effect but some people argue against it.
Edit: it doesn't need much to be smarter than you, waihtis
That is irrefutable. Eat 4 eggs fried in butter and then measure blood sugar an hour later vs eating the same amount of sugar by weight on separate days, on an empty (12 hour fast).
Exercise temporarily raises your heart rate and systolic blood pressure, yet avid exercisers have lower RHRs and SBPs; how do you know it isn't the same with carbohydrates, provided fat (especially saturated) is restricted?
Ask an endocrinologist. Robert Lustig has written extensively on the subject. This stuff has already been figured out. Here's one of his famous talks on sugar: https://www.youtube.com/watch?v=gmC4Rm5cpOI&pp=ygUNcm9iZXJ0I...
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To avoid any doubt: there is no scientific basis for “imbalanced omega 3-6 ratio, which causes chronic inflammation which in turn is a central driver of diabetes”. There is no indication that omega-6 in human diet cause inflammation (we don’t eat that much of them, and they are readily metabolised). And as a matter of fact, diabetes is more strongly correlated with sugar than any kind of fat.
Actually, the only people I have seen claiming this are conspiracy theorists who jumped on a new boogeyman.
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Good luck convincing anyone of that without being called a crackpot, a disinformation bot, or worse. At this point in my life, I keep such knowledge to myself and leave everyone else to the peril of their own incomplete understanding.
Rigorous scientific study is more effective than luck.
Rigorous scientific study in the nutrition field is extremely hard to do.
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.
This isn't what the paper actually says, of course. Science by press release again.
Here's a quote from the abstract of the paper:
> 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?
Brain needs glucose.
Actually, almost all of your body runs on glucose. Your muscles for example.
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.
I get what you’re saying about insulin and blood sugar, but I think it’s important to remember that sugar itself isn’t inherently “bad” for us. Our bodies are actually well-equipped to handle it, especially when consumed in reasonable amounts. Glucose is a primary energy source for the brain and muscles, and occasional treats or small amounts of sugar can be part of a healthy diet without causing harm.
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.
Yeah ok, but I think it is also clear at the same time that a lot of food that we eat today is much more sugary than the previous millions of years before that, and that we seem to be getting more and more problems with overweight and diabetes type 2.
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.
You are totally right. A honey crisp apple has a lot of fiber in it. 5,000 years ago outside of a few regions getting access to cane sugar would be difficult. Mango and pineapple somewhat easier but probably less sweet than today. This does concern me a lot. It’s sad when a restaurant sends you cut strawberry’s with sugar sprinkled on top. But sugar free chocolate just isn’t as good :)
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.
Aha, yeah, the keto hype is the pendulum swinging the extreme opposite way, and yeah there is a middle balance. I think keto is also an attempt to "cheat responsibly", because people have a hard time saying good bye to sweets, so all kinds of fancy keto sweeteners are promoted. But yeah I think it's eventually a bit futile, you're trying to fool yourself, and in the long run that doesn't work.
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.
The brain also runs well on ketones which are more energy dense and remove the oxygen bottleneck. It's easier to deliver a consistent level of ketones than glucose, avoiding spikes and crashes.
Ketones are a backup evolved to be used in short durations. How many people have you known who have stayed on a ketogenic diet for 10 or 20 years without ever coming out of ketosis?
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
Are there any studies about the harm of a craze in non-sweet diets? While I would generally agree with this "confirmation" based on my understanding of diabetes, I wonder if it's actually sugar that is the problem here.
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)
Caffeine is not in so much products that it would be such an obvious smoking gun
plenty of studies on caffeine. Chocolate usually comes with loads of sugar unless you mean sugar alternatives? That wouldn't apply to just post war UK though. Also, it's hard to over consume non-sugar so that's not a lot of overlap. Remember carbs break down to sugar as well.
These things still don’t establish actual causation.
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.
> 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
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.
> Add the fact that we don’t know why some people are more tolerant and we cannot predict it
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.
> Now this is what should be being researched.
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, 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"?
I know this from the simple fact that I respond completely differently to sugar than almost everyone else I know, except gout sufferers.
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.
I'm not disputing that people respond differently to sugar. I'm asking how that explains the diabetes epidemic becoming more and more widespread as time goes on.
As more people consume a higher amount of sugar (regardless of form), the overall rate of societal diabetes increases. Other factors like reduced exercise, increased consumption of junk foods, exposure to more chemicals like endocrine disruptors, etc. also push the rate of diabetes up faster.
Because you have a blind spot over people responding differently, as indicated by your original question.
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.
Sorry for being dense (or having a "blind spot" I guess), but I still don't comprehend how this answers my question.
To go back to what I said which you were responding to
> 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.
So this is what I'm hung up on:
> 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.
Because people eat different types of diets and consume, for example, different ratios of omega fatty acids - which in turn can cause chronic inflammation and diabetes
I'm not disputing that people respond differently to sugar. I'm asking how that explains the diabetes epidemic becoming more and more widespread as time goes on.
I see. Diabetes is downstream from chronic inflammation, so something is causing us to be inflammated at scale and that is why diabetes is becoming more commonplace. So differing response to sugar is one factor of N possible affecting variables
> These things still don’t establish actual causation. Nope, it says there's a connection.
>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.