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Is Sugar Toxic?


Dakki
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Okay, several people have mentioned this hypothesis is a version of the high carb/low carb debate. Can someone explain that? I don't keep up with dietary science stuff, since it all seems to be up in the air at the moment.

Oversimplification to follow....

The essence of it is that carbs cause insulin to rise. The higher the carb the higher the insulin. High insulin promotes fat deposition which increases resistance to insulin's effects. This causes the body to make more insulin as a compensation and a vicious cycle ensues. High carbs also promote high blood fats which promote atherosclerosis. So high carb causes weight gain and heart disease and stroke. There is a lot of research to back this up.

An ideal diet according to Atkins-type thinkers would be something like <50 g complex carb a day, lots of protein and some fat. The exact opposite of the USDA food pyramids which load up on carbs, perhaps to feed a nation during the depression (when they were first done). Low carb diets are tough to maintain. Who wants to minimize potatoes and pasta? They are expensive too since protein isn't cheap.

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Oversimplification to follow....

The essence of it is that carbs cause insulin to rise. The higher the carb the higher the insulin. High insulin promotes fat deposition which increases resistance to insulin's effects.

That is definitely oversimplification. Different sugar molecules have different effects because they take different metabolic pathways and are put to different uses by the body. Low-carb diets are hard to maintain because your body needs some carb; trying to burn only fat and protein has negative effects. The brain in particular is very fussy and wants a steady diet of pure glucose.

But the claims made by Lustig & co. are somewhat different from the Atkins claims. Lustig's claims center around the metabolism of fructose specifically, as it passes through the liver and produces triglycerides. One of the problems for Lustig is that the pathway and the linkages to the effects he claims has not been worked out with nearly as much certainty as he presents. In our industrialized food, a great deal of the fructose we consume comes from the HFCS in processed foods. It is of course also a component of sucrose, honey, maple syrup, etc. And is found naturally in fruit. In the past few decades, the average caloric consumption of Americans has been increasing substantially. It corresponds to the growth in fast food consumption, soda consumption, heavily processed snack foods, and the like. We are fatter and suffering the health effects of it. A lot of the excess calories come from sugar, and it's easy to make HFCS a particular target, though its health effects aren't very much different from other sugars. There's just so much more of it around. On the other hand, it is not that hard to avoid, because it is an industrial ingredient that only exists in industrial food. If you didn't consume anything with HFCS, you'd likely cut your sugar consumption significantly.

Edited by Moopheus (log)

"I think it's a matter of principle that one should always try to avoid eating one's friends."--Doctor Dolittle

blog: The Institute for Impure Science

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Lustig's claims center around the metabolism of fructose specifically, as it passes through the liver and produces triglycerides. One of the problems for Lustig is that the pathway and the linkages to the effects he claims has not been worked out with nearly as much certainty as he presents.

OK. So the basis of his theory is just a guess? Is there any agreement amongst scientists that the fructose => liver fat deposits => insulin resistant cells chain of causation really exists? Or is this just one guy's crazy out-of-context theory that gets him news coverage?

Seems the NYT has a reserve of "Will X kill you" stories built up, as they're also running one now asking Is Sitting a Lethal Activity?

Edited by cdh (log)

Christopher D. Holst aka "cdh"

Learn to brew beer with my eGCI course

Chris Holst, Attorney-at-Lunch

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The science is interesting but less clear than anyone admits. In lieu of hard unequivocal evidence, I'm sticking with Paracelsus' dictum: "All things are poison, and nothing is without poison; only the dose permits something not to be poisonous." As hard as I know only lead (and maybe some nasty radioactive beasties)hasn't been found to have a non-effects level (and I'm not positive of that.

Kevin

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What Moopheus said (thank you Moopheus!)

There is some real science behind "lo-carb" regimens, regardless of fashionable diets and the dumbing-down of the subject in the media and in the inevitable food-industry marketing accommodations (low-carb ice cream and all the rest). The insulin response is real; foods can be assessed via their effect on blood sugar; many individuals, even if not all, have successfully and safely shed fat by following regimens reflecting the real science.

Several years ago (before the media chatter and respondent low-carb marketing campaigns) I had to loose some unnecessary weight and my excellent, widely respected physician prescribed a supervised diet based on reasonably limiting total carb intake weighted by glycemic index. He and colleagues had printed a list of the data for many foods. This was consistently successful, and it has affected my habits since (especially towards moderation in food). One friend even went from morbidly obese to quite fit by similar regimen (literally releasing the athlete inside that had been struggling to get out -- now regularly does extreme sports). But this was all somewhat deeper and more detailed than what I later saw in sound-bite reductive media explanations and online "debates." And for us food obsessives it CAN be a challenge to suddenly do without potatoes, risottos, apples, hearty pasta meals, &c.

To expand slightly on Moopheus's later remarks (echoes of Michael Pollan!) the natural sweetenings in plant foods (often essentially pure HFCS) are NOT consumed just with carbonated water, artificial colorings and flavorings as in synthetic soft drinks. Those sugars occur in balance with many other natural components -- vitamins, minerals, fiber, antioxidants that preserve the fruit itself, polyols (see recent WikiGullet Alcohol article, ahem), countless congener molecules (plants typically contain not just a single representative of a chemical class but rather a group of related ones that occur together) and this, not cola or Twinkies or Cheeze Wiz, is what we evolved to eat.

(ETA link)

Edited by MaxH (log)
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Oversimplification to follow....

The essence of it is that carbs cause insulin to rise. The higher the carb the higher the insulin. High insulin promotes fat deposition which increases resistance to insulin's effects.

That is definitely oversimplification. Different sugar molecules have different effects because they take different metabolic pathways and are put to different uses by the body. Low-carb diets are hard to maintain because your body needs some carb; trying to burn only fat and protein has negative effects. The brain in particular is very fussy and wants a steady diet of pure glucose.

But the claims made by Lustig & co. are somewhat different from the Atkins claims. Lustig's claims center around the metabolism of fructose specifically, as it passes through the liver and produces triglycerides. One of the problems for Lustig is that the pathway and the linkages to the effects he claims has not been worked out with nearly as much certainty as he presents. In our industrialized food, a great deal of the fructose we consume comes from the HFCS in processed foods. It is of course also a component of sucrose, honey, maple syrup, etc. And is found naturally in fruit. In the past few decades, the average caloric consumption of Americans has been increasing substantially. It corresponds to the growth in fast food consumption, soda consumption, heavily processed snack foods, and the like. We are fatter and suffering the health effects of it. A lot of the excess calories come from sugar, and it's easy to make HFCS a particular target, though its health effects aren't very much different from other sugars. There's just so much more of it around. On the other hand, it is not that hard to avoid, because it is an industrial ingredient that only exists in industrial food. If you didn't consume anything with HFCS, you'd likely cut your sugar consumption significantly.

Right. But I was responding to a question about lo vs high carb effects. I was not addressing Lustig's HFCS claims or anything in particular about specific sugars.

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"So am I still in danger if I cut out my 3-liter-a-day Coke habit but still put sugar in my coffee and eat the occasional slice of cake?"

Population statistics cannot be used to predict the fate of any individual. If we compared two large groups of people (say 1000 in each, matched for sex, age, body type, ethnic background, diet, exercise level, yada, yada, yada), the group drinking 3 L/day of HFCS sweetened soft drinks would be slightly less healthy. With only 1000 in each group, the difference between groups isn't likely to be statistically significant. If we looked at much larger populations (millions), we would find statistically significant numbers of things like type 2 (adult onset) diabetes; we would also see statistically significant higher rates in both groups for people with a familial history of diabetes, and if the numbers are large enough, the increase from each factor, and their interaction.

A good place to start reading is http://diabetes.niddk.nih.gov/dm/pubs/statistics/

One quote that struck me (and may have relevance to whether you want to decrease your sugar/HFCS Coke intake) is "In general, every percentage point drop in A1C blood test results, for example, from 8.0 to 7.0 percent, can reduce the risk of microvascular complications—eye, kidney, and nerve diseases—by 40 percent."

But only about 11 percent of people in the US over 20 have type 2 diabetes, rising to about 26% for those over 65. YMMV

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As I noted in my first post in this topic, too many of the deductions, based on these so-called studies that relate to any food in the diet of any group of people, accept as truth what can only be a conjecture.

A study based on a fallacy because the "researcher" accepts as fact something that is extremely difficult to prove is inherently false itself.

The Latin term: Post hoc ergo propter hoc, illustrates this; "after this, therefore because of this."

Just because something happens after one event does not mean that the preceding event (or meal or lifelong diet) caused the following event.

When they pounce on one factor and don't consider the entire series of events, they aren't presenting the entire picture.

To illustrate this:

I am sure you have all heard about older women "falling and breaking a hip" as it seems very common. What I bet you didn't know was that most of these are spiral fractures of the neck of the femur and a fall does not produce this type of fracture. What happens is that force from pivoting on the leg will cause the fracture in older women (and men) with osteoporosis. The fracture occurs THEN the fall.

Because the person was found on the floor or the ground the immediate idea was the fall caused the fracture. Post hoc ergo propter hoc in action.

Take everything with a grain of salt - what may appear to be true in one decade may be proven to be dead wrong in the next.

"There are, it has been said, two types of people in the world. There are those who say: this glass is half full. And then there are those who say: this glass is half empty. The world belongs, however, to those who can look at the glass and say: What's up with this glass? Excuse me? Excuse me? This is my glass? I don't think so. My glass was full! And it was a bigger glass!" Terry Pratchett

 

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Take everything with a grain of salt

No, don't do that; it'll raise your blood pressure! :wink:

Well, that is true with too much salt, but there is also the fact that we do need some salt and too great a restriction can also be a problem.

The first doctor for whom I worked was an internist and wrote a paper for the New England Journal of Medicine that illustrated problems that could happen with restricting salt intake too rigorously.

The peer review notes showed that was an "A-Ha" moment for several reviewers.

"There are, it has been said, two types of people in the world. There are those who say: this glass is half full. And then there are those who say: this glass is half empty. The world belongs, however, to those who can look at the glass and say: What's up with this glass? Excuse me? Excuse me? This is my glass? I don't think so. My glass was full! And it was a bigger glass!" Terry Pratchett

 

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Why all this hysteria about fructose and glucose (don't forget about galactose! my favorite monosaccharide name) when there's the growing crisis of (dum dum DUUUUM!) DIHYDROGENOXIDE!

Recent studies have found amazingly high levels of dihydrogenoxide in our diets - even in both bottled AND tap water around the world. Even the most remote mountain streams and deep glaciers show detectible levels today! While an estimated 90 ml/kg will kill you outright, where scientists have bothered to look for it (what are they trying to cover up by not doing more research!?!) 100% of cancer deaths had links with dihydrogenoxide!!!

The CIA won't confirm it publicly, but there are indicators that point to al Qaeda stockpiling dihydrogenoxide in their secret camps and safehouses around the world! (Then again, Rumsfeld, Bush and Cheney appear to have ordered the use dihydrogenoxide in attempts to extract information from captured members of al Queda.) And druggies appear to be experimenting with it, even though it is known to be fatal. Street names include "liquid crystal" and "W":

http://www.psychoactive.com/h2o.html

Oy vey...

For anyone interested in this overall problem of faux-science and bad policy, the English writer Ben Goldacre does a lot of great work in uncovering this stuff and explaining the foolishness. Along the lines of this discussion of "toxic sugar", he addresses some other nutrition malarkey. He examines a lot of the nutrition pseudo-science that's common in popular media, and purveyors like Gillian McKeith "PhD" whom you may have seen on TV divining medical information through a visual examination of someone's poop. (Her "PhD" is from an unaccredited "correspondence school".) An example of the malarkey she spouts is her promotion of chlorophyll-rich nutritional supplements with the implication that it will increase oxygen in the body. The problem, of course, is that chlorophyll needs light to work, and it's pretty dark in our intensities... (Guess what? You can conveniently buy those supplements on her website!)

Usually, it's just these "lifestyle" issues like us rich first-worlders worrying about eating too much sugar or throwing money away on "remedies" of wildly diluted bottles of nothing but water. But sometimes this bad science kills lots of people. He gives a talk where he delves into how "vitamins are the answer to everything" mumbojumbo gets marketed to politicians in Africa, where HIV/AIDS is killing many, many people. In several cases, government policies have been swayed to ineffective approaches that resulted in many unnecessary deaths.

His website http://www.badscience.net/ contains lots of his newspaper columns. Here's a great video of a talk he gives that touches on a lot of these issues:

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"So am I still in danger if I cut out my 3-liter-a-day Coke habit but still put sugar in my coffee and eat the occasional slice of cake?"

Population statistics cannot be used to predict the fate of any individual. If we compared two large groups of people (say 1000 in each, matched for sex, age, body type, ethnic background, diet, exercise level, yada, yada, yada), the group drinking 3 L/day of HFCS sweetened soft drinks would be slightly less healthy.

Given that 3 liters of coke has about 400 grams of sugar, I'd be kind of surprised if daily consumption on that level weren't having a noticeable effect.

"I think it's a matter of principle that one should always try to avoid eating one's friends."--Doctor Dolittle

blog: The Institute for Impure Science

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Given that 3 liters of coke has about 400 grams of sugar, I'd be kind of surprised if daily consumption on that level weren't having a noticeable effect.

On a simplistic level one has to think that a person drinking 3 liters of sugared coke a day is also not eating 5 servings of vegetables, getting adequate protein and fiber etc. How do the researchers tease out the other factors, and really- come on- people lie in these studies (the participants)

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I don't have too much to add to the scientific end of things, but I think it is far too easy to take a complex problem like obesity and diabetes and reduce it down to a far to simple answer. It is a comfortable place to point at something and "go that is culprit" when the issue requires more in the way of research. I think they are just trying to sell more low carb garbage, personally. People want to hear "just cut the sugar and all your problems will go away" instead of hearing, "eat in moderation and be active".

The American Diabetic Association has come out in recent years to say that sugar does not cause diabetes. Over eating overall causes type II diabetes. Every time we eat it sparks an insulin response in the system. So in less you are on a very low carb diet, you eat, you get a response. And chronic over eating means chronic over responses. Eventually, it breaks down.

That is just want I heard, don't hold me to how factual it actually is, I am not a doctor.

"I eat fat back, because bacon is too lean"

-overheard from a 105 year old man

"The only time to eat diet food is while waiting for the steak to cook" - Julia Child

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People want to hear "just cut the sugar and all your problems will go away" instead of hearing, "eat in moderation and be active".

When I was an editor, I wanted to submit a proposal for a diet book that had on page 1 a) eat reasonable amounts of real food b) don't eat too much junk food and c) get off your ass and get some exercise you slug, and then 159 blank pages. But I never did it.

"I think it's a matter of principle that one should always try to avoid eating one's friends."--Doctor Dolittle

blog: The Institute for Impure Science

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FYI, nutshell forthright mainstream US medical view of DM2 ("adult-onset" diabetes mellitus) risks as summarized in the professional Merck Manual (a physicians' reference), 18th edition, ISBN 0911910182, 2006:

Risk factors for type 2 DM include age over 45; obesity; sedentary lifestyle... Type 2 DM usually can be prevented with lifestyle modification. Weight loss of as little as 7% of baseline body weight, combined with moderate-intensity physical activity (e.g., walking 30 min/day), may reduce the incidence of DM in high-risk individuals by > 50%.

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Keep in mind I haven't read the recent article, but it's a technical subject (not the only such) with an epic record of fashionable misinformation (especially online) and scarcity of a few background facts (see below) that put, especially, HFCS into completely different light. What I mostly object to is frequent myopic focus on HFCS or fructose (without questioning the now-common gross consumption of other sugars). More about why, below.

Dr Lustig at UCSF isn't news; one friend was taken with his fructose-is-poison pitch a year or two back until shown some of its unstated context. Other friends are heavyweight experts in relevant science (more so possibly than Lustig) and have helped to fill out the picture. Lustig's pitch has reported information selectively, omitted essential context, completely misstated some facts (Japanese diet DOES include fresh produce and desserts, therefore significant fructose, also sucrose), and compared liver damage from gross chronic alcohol excess to liver damage from gross chronic fructose excess to conclude glibly that fructose acted like "alcohol without the buzz." That constitutes pop-culture science (something I run into periodically). Frankly I cringe to see someone using their respectable-looking title to lend legitimacy to what's more dispassionately characterizable as an opinionated and emotional crusade.

One repeated error of pundits has been to pull results of extreme-diet metabolic studies -- these studies occur for many nutrients and reasons -- and confidently infer conclusions from them about normal diets under conditions rendering the study irrelevant. Presence of other nutrients changes everything. For example, fructose indeed doesn't elicit the insulin-leptin response and can theoretically cause food cravings. But glucose has the exact opposite effect, completely changing the response if taken with fructose. There seems to be plenty of literature also demonstrating that moderate fructose intakes in diets induce no actual weight gain or serum triglyceride rise, contrary to one of Lustig's rhetorical points. Summary from an independent researcher (John White) who reviewed the biomedical literature:

"Although examples of pure fructose causing metabolic upset at high concentrations abound, especially when fed as the sole carbohydrate source, there is no evidence that the common fructose-glucose sweeteners do the same. Thus, studies using extreme carbohydrate diets may be useful for probing biochemical pathways, but they have no relevance to the human diet or to current consumption."

If fructose is "poison," we're all zombies; here's why, in a nutshell (you can readily verify this basic, non-controversial background if interested.)

1. Fructose and glucose are common or dominant natural sugars in our ancestral diet. Many natural foods (apples, bananas, grapes, pears, peppers, onions, etc.) contain 5-15% natural fructose-glucose mix -- more, sometimes, than percentages in soft drinks containing HFCS. Honey is almost completely fructose and glucose, a natural HFCS. Any concern over these sugars would logically consider their many natural sources and our long history of consuming them.

2. If you eat table sugar (sucrose), then before anything else happens to it, your body converts it to a fructose-glucose mix (sucrose itself is not directly usable). Sucrose's hydrolysis to fructose and glucose starts in your mouth, with salivary enzymes.

This means your body cannot actually tell whether you ate table sugar or HFCS; and you get HFCS anyway in natural foods extensively demonstrated as healthy.

I have found some people so convinced of simplistic evil associations of HFCS or fructose that they won't even try to think through the implications of this basic biochemistry. And, of course, many people are unwilling to examine shallow opinions when Google much more easily furnishes thousands of references that will seem to rationalize them.

I agree but what are your qualifications?

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I agree but what are your qualifications?

Lacking further cues I can't tell if that's an ironic quip in good humor or a serious question. But if serious -- ooh, wrong question!

One observation Mary-Claire van Leunen made in her great reference book on scholarly writing (I mention this because it's so contrary to pop-media culture) is that among serious scholars it's the writing that validates the credentials, never vice versa.

In this case (far from serious scholarship!) I reported personal experiences, upshots of some public criticism of Lusting's pitch, and basic biochemical and botanical background information that's readily available, including online. Anyone interested can and should confirm, and read more about, the latter points for themselves.

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Oooooh. Minefield here. Scientific issues are complex and interpreting them relies on a big foundation of knowledge that can't be gotten by a google search. Google doesn't tell you what you don't know to ask it. If one doesn't know what they don't know (paraphrase Rumsfeld)then there is a big chance for error.

I know that it is most undemocratic to say this, and I mean no offense, but training matters.

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I agree emphatically in general, gfweb. (Misunderstood, out-of-context online upshots have even replaced fat wallets full of clippings to yank out and "prove" things in barroom discussions. One of Paul Fussell's figurations in the 1980s.)

However in specific, Google does reveal serious critiques of Lustig's road show, and no specialized background is necessary to interpret the sugar compositions in fresh produce, or what becomes of sucrose after you eat it. Those two points then raise basic logical challenges that I never see examined by "fructose is poison" advocates.

(Because issues of similar complexity have been discussed publicly on the Internet since long before eGullet existed, I learned to at least try to post upshots that others can check independently if they are interested.)

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I know that it is most undemocratic to say this, and I mean no offense, but training matters.

Similarly, it's equally silly to suggest that if you are not an "expert" you can't comprehend or discuss an issue meaningfully.

"I think it's a matter of principle that one should always try to avoid eating one's friends."--Doctor Dolittle

blog: The Institute for Impure Science

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I know that it is most undemocratic to say this, and I mean no offense, but training matters.

Similarly, it's equally silly to suggest that if you are not an "expert" you can't comprehend or discuss an issue meaningfully.

I didn't say that. If that were true then this website might as well not exist. That was the minefield to which I referred. Lets not argue.

Edited by gfweb (log)
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