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Too much fructose can damage your liver, just like too much alcohol (ucsf.edu)
289 points by arikr on Oct 22, 2017 | hide | past | favorite | 156 comments


>Scientific evidence on fructose and the liver is relatively new

People have been force feeding animals to fatten them up (gavage) for about 5,000 years, but specifically feeding them sugars/grains for the purpose of fattening their liver.

Ever hear of the French delicacy Foie Gras(1)? It literally means fat liver, and after 5,000 years of perfecting fattening liver what do we force feed the animals? Corn! The same fructose we highly concentrate and load into foods and drinks and feed to kids...which goes hand in hand, per the article, with why kids weren’t diagnosed with fatty liver disease pre 1980’s and now 13% of US children have it.

(1) https://en.m.wikipedia.org/wiki/Foie_gras


High fructose corn syrup is made by processing regular corn syrup (mostly glucose) with enzymes to convert some of the glucose to fructose, making it sweeter. Corn is not naturally high in fructose.


Is there a term for scientific claims made in this way? I saw something similar on reddit the other day where a commenter was trying to prove that a certain chemical was not harmful. It went something like "The reason we think this chemical is harmful is because of this study from the 60s which was done in 17 countries. But one country was excluded from the study because of inconclusive results. Which one? The US! The country that we care the most about, and there weren't solid results here!"


It's basically a narrative, "an explanation", not science. In particular this is an easy to vary explanation. (Just cherry pick other data to fit your narrative.)

https://www.ted.com/talks/david_deutsch_a_new_way_to_explain...

Science is looking at a problem. Stating it. Analysing it. (Setting up hypotheses, gathering data, coming up with clever ways to test those hypotheses, desigining experiments, conducting them, evaluating their results, and then iterating on this. While being vigilant at every step. Trying to falsify every step. If you can't falsify it, great, you have a useful model.)


I don't know if it has a term of not, but it sounds like the pretty fuckin' opposite of science to me - adjusting the results to fit your wanted view instead of adjusting your view to fit the results.


Cherry-picking / confirmation bias.


Same with skim milk, which has always been used to fatten pigs. But some prefer it today thinking less fat and cholesterol is healthier and would make them lose weight over whole milk. If only the most complex system in the universe (the human body) was that simple! People and, unfortunately, scientists completely ignored the complexity of hormones, gene expressions, and many other factors when suggesting "healthier" alternatives!


False. Fructose != skim milk. Less fat and less calories in skim milk can cause weight loss.

The claim that skim milk was fed to pigs because it has some magical fattening properties is just another urban myth. Skim milk was fed to pigs because it was free/cheap and nutritional.

http://www.slate.com/articles/health_and_science/food/2014/0...

http://northernplanets.blogspot.com/2007/07/milk-folklore.ht...


When did I ever say that skim milk and fructose are the same thing?! Both whole and nonfat milk contain the same quantity of lactose and galactose. By the way, galactose is equally bad if not worse than fructose and lactose converts to galactose in your digestive tract, so, your misreading is partially correct. Unfortunately for me, galactose is present in yogurt as well.

Anyway, they fed pigs skim milk because no human wanted it, and when you take out the fat for cream and butter than junk was suitable only for the swine. Your articles are no scientific or historical proof. Without the fat in milk, the calcium in skim milk ends up in your arteries, not your bones. So, fattening or not, skim milk is not a healthier alternative from many aspects.

The funniest thing is that skim, and whole milk in America have the same price! So, the fat is removed to sell it separately and at a high price, and, yet, both types of milk are sold at the same price because there are stupid enough people to consider it "better."

I have organic raw grass-fed whole milk, and my kids have had it for over 5 years with no issues whatsoever. Kudos to Organic Pastures [0] to keep providing a high-quality product with consistency during this time!

[0]: https://www.organicpastures.com


Parent comment: > People have been force feeding animals <fructose> to fatten them up

Your comment: > Same with skim milk, which has always been used to fatten pigs.


This is know scientifically for ~10 years now (in a sense that there are some studies, and the biochemistry of mechanisms is know, but the statistical power of the studies might be low... can''t remember, left the biomedical field years ago), and anecdotally since like for ever (google "making fois gras").

Also, for cats and dogs, other sugar (xylitol if I member well) can destroy their livers pretty fast. Fortunately, we come from sugar-happy monkeys (that used to eat lots of rottenfruit), so we can safely enjoy our booze in moderation :)

And for extra self-destructive power, mix fructose and fats: your liver will be too overloaded processing the fructose (that btw, also gets transformed to extra fat and collesterol if its other metabolizing pathways get saturated) to be able to handle the fats correctly, so "bad collesterol" will accumulate in you blood, and then clog your arteries (yeah, it needs some extra help from inflamation).

But, oh, wait, there's a name for that: donuts! ...or virtually every other fatty sweet stuff. Oh, and for extra-extra-damage the fats should be fried (for reason I don't have time to detail). And there's a name for that too: KFC + dessert!

Now go enjoy your deserts! Or the fois gras you had before it ;)

EDIT+: video explaining some (older) science behind it, form UCTV: https://www.youtube.com/watch?v=dBnniua6-oM


Dr. Lustig's argumentation is questionable at best.

http://www.alanaragonblog.com/2010/01/29/the-bitter-truth-ab... https://blogs.scientificamerican.com/brainwaves/is-sugar-rea...

Eat less sugar? Sure! But don't do it because of Dr. Lustig's exaggerations and paranoia. Do it because sugar is calorie-heavy with no real benefit.


> calorie-heavy with no real benefit

Wtf does that even mean?! You mainly eat to get your calories... the calories are your main intended benefit, that's mainly why you eat, to get your fuel to burn. It's like the stupid phrase "empty calories". Also, the calories that you need to burn, will inevitably deal damage to your body in the process of being burn (free radicals -> aging, cancer etc.) and that's unavoidable.

But you can try to find the least damaging combination of source of calories (like at least don't mix high-fat with high-sugar in the same meal), and yeah, also so get your vitamins micronutrients, fibers etc. that you also need besides those calories.

And I agree with you too :) ...Lustig's paranoia is way over the top, especially when he gets to comparing fructose with alcohol (we're not cats and dogs - 'carnivores', we're 'rotten-and-occasionally-toxic-fruit eating monkeys', we can take our liquor and drugs as long as we don't overdo it :P), or calling it "toxic" or "poison".


When I say "calorie-heavy with no real benefit", I mean that you get glucose and fructose and that's it. No vitamins, no minerals, no fiber, just pure straight carbs. In other words just calories that your body can use or store, and unless you've been doing strenuous activity within a short time frame, those calories will be stored as fat.


The less confusing distinction would be between "slow (absorbed) calories" and "fast (absorbed) calories". That's what "glycemic index" and all that is all about. Most fibers are especially about this: they slow the absorbtion of sugars and other stuff, so they don't cause a spike in blood sugar concentration.

You can even have basically pure carbs that are absorbed slowly and have a good glycemic profile (they are glucose polymers that take longer to break up into the glucose monomers they are made of). One of these is the modified starch that you can also get "naturally" by reheating some types of pasta, others are pretty weird chemical inventions that are not proven safe yet I think...

You could eat just "pure slow carbs" and throw in some vitamin pills, essential fats, essential amino acids and antioxidants (they would all amount to like a small fist of pills a day I think) and be quite healthy I guess. Not sure why would anyone want to leave such a tasteless life though :)

EDIT+: actually, scratch that, your liver might actually fail long term if you don't pass something more akin to "real food" through your gut at least occasionally, for probably complex reasons that amount to "the liver is a damn complex chemical plant that is expected to actually run continuously on all pathways, not to be left abandoned" ...I'm really looking forward for 10+ years results for the people living on that soylent thing only btw.


"because sugar is calorie-heavy". That's it? What about all the studies that shows high consumption of sugar leads to diabetes, heart disease, mental health etc.?

Who knows what is true any more? May be big sugar companies are fighting back using fake studies and blogs to lessen the blame like they did with fat before.

Edit: I forgot to mention 2 real examples:

1. My father is not fat. We don't eat any junk foods, everything is cooked at home. He goes to office by cycle, it's long commute. But eats too much sweets and sugar, kind of addicted. He got diabetes, glucose reading 290 without food.

2. I started eating lots of sweets/sugar after I stayed at my parent's home for four months. When I sleep on my stomach, I started to feel my heart beat. It was not like this before. It was a bit scary. Then I read all those articles about sugar, and I figured that might be the reason. I stopped eating sugar completely. I no longer feel heart beat while sleeping on stomach. My heart beat per minute came down from 67 to 61. I only stopped sugar, everything else was constant.

Okay, these are only 2 cases, it proves nothing. I know. But, I don't care what anyone says about sugar now. I know what I experienced and I believe on that.


And what about the studies that attribute those same maladies to fat, excessive protein intake from red meat, aluminum and countless other factors?

I know people who are fit and well within normal weight, blood pressure, cholesterol and everything else, eat a very healthy diet and they still got diabetes.

One of them lives almost exclusively on home-grown and home-cooked meals (they run a small farm), he's very into working out and is one of the most fit people I know. Yet he has type-2 diabetes.

You're absolutely right that we should all eat less sugar, but there's no great mystery to it.


I'm not saying there are no other factors.

But, lots of studies have showed sugar is highly related to diabetes, heart disease, mental health etc.. And here you are saying avoid sugar only because of calorie. Like there can't be anything more to it. Where did you get that?


Those studies are starting to be shown as wrong.

I bet those people who eat "healthy" it a lot of carbs, which the body just changes into sugar. So they really aren't eating that healthy.


So what makes you so sure the studies demonizing sugar are not equally as flawed as the previous studies?


Just because your fathers main meals are home cooked doesn't necessarily mean they are healthy.


Plus, when you eat sugar your body produces insulin, which instructs your body to stop burning fat and store it straight into your fat cells.


That's not true at all... What would possibly make you think that?


First search shows: http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/panc...

> Insulin promotes synthesis of fatty acids in the liver

> Insulin inhibits breakdown of fat in adipose tissue

...but don't take that to mean "insulin is what gets you fat". It does not... or not as in it being a bad thing. It's more like "insulin just tells your body to process away that damn extra sugar"... and your body does whatever it can with it, like converting it into stored fat. It would be much worse if it didn't! You'd have diabetes then, and that sugar standing unprocessed in you blood would do tons of damage to your body! Making you a bit fatter is kind of the best thing your body can do with the extra sugar that got dumped into your blood...


I can't point to anything specific, however I was under this impression from listening to a few Keto diet enthusiasts.


Donuts and KFC are terrible. You should stick to Ben & Jerry's.


The main title in the article ("The Toxic Truth") is a tribute to UCSF's famous Dr. Lustig of the lecture "Sugar: The Bitter Truth" [1], which is a fascinating and well worthwhile lecture about the biochemistry of fructose as it relates to obesity. I thought I'd just watch a few minutes of it and ended up sitting through it and learning a whole lot.

He also wrote a book on the topic("Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease")[2].

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

[2] https://www.amazon.com/dp/B0095ZMPTU/


Lustig has always stuck me as a bit alarmist. Another red flag are his attempts to capitalize on his increase in popularity. That being said, he does seem sincere and not attempting to spread disinformation as such.

A somewhat old, but measured take on some of Lustig’s claims: https://blogs.scientificamerican.com/brainwaves/is-sugar-rea...


Here's another serious and level-headed look at Dr. Lustig's claims. He's an alarmist, and we don't need those.

http://www.alanaragonblog.com/2010/01/29/the-bitter-truth-ab...


>That excess fructose is broken down by the liver and transformed into fat globules (triglycerides)

I believe this is not "that" accurate. Generally the presence of excess carbohydrates cause the body to prioritize sucrose/fructose/glucose to glycogen conversion and storage & usage. Dietary Lipids that are ingested are stored rather than used for energy. While, De novo lipogenesis (turning carbs to lipids) does occur, it is inefficient enough that the body barely converts something around 1% of carbs to fat.

Since glycogen is stored in the liver and muscles, and insulin signals the muscles & liver to take up the glycogen in the blood, this is probably where diabetes starts when the liver and muscles are already filled with enough glycogen and there is no where for the glycogen in the bloodstream to go.

If the body could efficiently convert sugars to lipids, I don't think diabetes would be that much of an issue. People would just get obese with the diabetes.

AFAIK, the priorities for energy consumption of the body is:

1. sugars into glycogen into ATP

2. protein into glucose into glycogen (gluconeogenesis) into ATP (some limited amount)

3. lipids into ketone bodies into ATP

So as long as the body was sugars to use up, that is the priority of usage.

One of the most calorically intensive tasks the body does is growth and repair of new tissue. Excess sugars are generally used up by kids who are growing. However, once people reach adulthood, the growth rate slows so significantly that the excess caloric intake forces all the lipids ingested to be stored.


Something that has been popularized in certain countries is the notion that there is a huge difference between different kinds of sugars, and that especially fructose is harmful to people. I wonder if there is any truth to that.


What I understand is the core structure of glucose and fructose differ enough that the metabolic pathways are different. And also while fructose tastes sweet it isn't under homeostatic control like glucose is. So I think it's important health-wise to distinguish the two.

There are other sugars that either differ only slightly from glucose or are dimer, etc. AKA lactose is a disaccharide sugar composed of galactose and glucose. Compare with sucrose which is disaccharide composed of glucose and fructose.


> Excess sugars are generally used up by kids who are growing. However, once people reach adulthood, the growth rate slows so significantly that the excess caloric intake forces all the lipids ingested to be stored.

Huh? You mention that the SUGARS the kids are eating are used for growth. But then say it's the LIPIDS (dietary fats) that are stored in adults? What about the sugar...?

I've always been skinny, and even eating loads of sugar, and loads of fat, never seem to budge in weight. Best I could do was put on 15lbs of muscle in college when I started working out... That's the only time I've ever been able to gain weight. What gives?


Gaining weight or losing weight is all based on whether one is at a caloric surplus or deficit.

Point was that kids generally have a “higher metabolism” because they are in a growth stage. (Hence using up the sugars) The adolescent body is generating tons of human growth hormone and testosterone to build muscle, bone, cartilage, etc and that activity is calorically intensive.

When people get older, that activity subsides so much that eating at the same rates as an adult leads to weight gain. Plus, kids are generally more active having to walk from class to class while most adults (us office workers) are sitting all day.

The body also likes to stay at a homeostasis of sorts for weight. Listening to you body and only eating when you’re hungry and maintaing weight is a wonderful genetic trait most people have.

Body builders who have wanted to get larger but could not would actually force fed themselves the calories to the point of being mildly sick.

People usually have mentioned post-workout hunger the say of or the next day. Thats where the body lifting weights craves a lot of calories for growing.


Just wanna say that my wife has a PhD in nutrition and this isn't news to us.

We've "known" that unbound fructose is hard on the liver for years.


Yea, as uncertain as a lot of nutritional science can be, and as ill informed as even otherwise well informed people can be about it: "too much fructose can damage your liver" is not something I thought was remotely controversial or novel.


> Just wanna say that my wife has a PhD in nutrition and this isn't news to us.

Does she recommend low fat food alternatives to her patients? My nutritionist pushed them like the gospel. And she would tell us in the next sentence that most low fat foods had added sugar to increase the flavor.


what do you and your wife eat?


Everything except red meat and dairy, honestly.

But if you want to know what we believe to be true about which foods are healthy, there's probably no better starting point than Harvard's Healthy Eating Plate.

- https://www.hsph.harvard.edu/nutritionsource/healthy-eating-...


What do you mean by "unbound fructose"? I assume fruit juices etc? Harvard's Healthy Eating Plate says "eat plenty of fruits", which says contrary to the advice given by many commenters here.


It's very hard to ingest too much fructose by eating oranges. Drinking orange juice on the other hand...


I don't see eggs in there. Got an opinion on those?


Personally we eat eggs. Though increased consumption of animal protein (including eggs) is tied to increased cancer risk.


so, not paleo. Does your wife have comments on the paleo diet thesis?


My bumper-sticker answer is basically that paleo proposes some of the right things but for the wrong reasons.

Avoiding processed foods and refined sugar is good. Avoiding dairy is good. But there's no reason in general to avoid cereal grains, legumes or potatoes unless you're sensitive/allergic.

And higher-quality meat is an improvement over the status quo but a vegetarian diet is likely to be healthier.

But all that is me talking, not my wife. I suspect she would say similar things but honestly we don't spend a lot of time discussing the random fad diet book du-jour.


My guess would be nuts, vegetables, and meats (like fish). Some fruits are okay though, like low sugar ones (avocados). I personally have tested my diet for years and found this diet to be optimal for me, and in line with most current research on what the body needs—and what the body should stay away from.

Many people would consider a diet like this difficult, but if you approach it correctly (I end up cooking a lot of szechuan cuisine), it's quite easy—and delicious!


While insightful, you very strangely answered a personal question directed at another user. How could you know what they eat?


What is unbound fructose, and can you give some links about it?


I think he means fructose that is not bound to glucose ..


I think that might be incorrect since it's an easy first step for the body to snap the glucose of the fructose.


What I've read everywhere is that enzymes in your stomach make short work of disaccharides.


What isn't hard on your liver these days? Most drugs undergo metabolism and activation through the CYP450 system. Meaning that those drugs which clear hepatically are most likely hard on your liver in the long run.


Just because a CYP is involved, doesn't mean the target substance is hard on your liver in any way. Liver toxicity is highly non-linear with dosage, and damage typically starts abruptly when substrates are depleted. The classic example is paracetamol, which is quite safe at reasonable dosages (and without alcohol) where the liver is well within its limits, but causes damage rapidly at higher dosages when you run out of glutathione.


This nuanced explanation is sadly lacking in many places I encounter the phrase "liver damage". I have frequently read articles which would lead one to believe that things are bad for your liver linearly and are "unsafe at any speed". It's irritating.


Moderation is the important thing here. It's easier to avoid consuming drugs every day compared to eating a high fructose diet.


Your wife is one of the few pedigreed nutrionists who “knows” that! Sadly most nutritionists are overweight themselves and continue to advocate people consume whole grains, low-fat dairy, and fruit to lose weight/be healthier. Kudos to your wife for ignoring the massive amount of BS most doctors and nutritionists are inculcated with!


There's nothing wrong with whole grains or fruit. The book "Wheat Belly" is terrible science.

Also, my wife is a registered dietitian with a PhD, not a "nutritionist".


You misinterpreted what the parent said. Whole grains and fruits are not unbound fructose.


What is wrong with whole grains or fruit? I have never heard of that before.


Nothing, I think the parent is wrong or misspoke. The advice is usually "substitute bad processed sugar with fruit", which is what Dr Lustig has advocated for the last decade. Of course too much fruit is itself bad, since the fiber can only do so much.


Why would too much fruit be bad? This is sadly a myth that gets formed when “sugar is bad” is oversimplified.


A balanced diet is important. Fruit only covers certain parts. And yes it also has a bit much sugar. Replace 80% of your fruit with veggies and you will be better off.


I agree, but most people should start by replacing most of their food with fruits. All their carbs and sugars should come from fruits first, and once they master that, they can try replacing some of it with veggies.


Not sure this is a good way to diet, do you have any peer reviewed literature that says a diet of mostly fruit is a good way to lose weight?


Sorry, didn't mean mostly fruit. I meant to say that it's best to start by replacing all your sugars and most of your carbs by whole fruits instead of veggies. And I say that only because it'll be easier to achieve, and still better then the alternative processed foods.

You should also have fish/meat, nuts and seeds for proteins and fat. And if you can, do have veggies instead of sugar rich whole fruits. But its hard enough eating healthy, I've found that the first thing to do is focus on eating better and not the healthiest. So fruits are the best deserts, and are better then most snacky thing people eat between meals. Yet they're easier to adopt in your diet because most people find them tastier.

For example, I see some people who when hungry and looking to snack down a whole bag of chips, or a whole box of oreos without thinking. But who'd mentally find it excessive to down a whole container of strawberries. Changing that attitude is a good place to start, and eating a whole strawberry container instead of a box of oreo is a pretty easy and simple change. Easier then just not snacking at all, or then eating coliflower instead.


Mostly too many calories. Fruit isn't 'bad' as much as 'it's really hard to consume so many calories with all that fiber in the way'.

But if you process fruit by removing that fiber, as say fruit juice, you're easily consuming tons of calories.


Too much of anything is bad, even exercise.


The quibble could also be with the "low-fat" portion of the advice. Grouping all fats into a single category is about as useful as grouping fruits and vegetables together. There's nuance to which fats to eat, but they're mostly an important part of a healthy diet, despite being demonized for decades now. Low-fat and non-fat dairy products are little better than another source of sugar (lactose) since much of the healthy portion of dairy doesn't get absorbed without the fat.

Avoiding omega-6-rich oils is probably a good thing for most people, since most don't get enough omega-3 to balance out, but beyond that and crap like trans-fats, fats are something to embrace not shy away from. And, what's more, getting off the beaten track of traditional oils can add a lot of interesting flavor to foods. Beyond olive oil, which is pretty common, coconut, avocado, walnut and macadamia nut oil have all become favorites of mine and I find the tastes of the food I cook/prepare so much more interesting than when I used to use corn/soybean/canola oils or tried to avoid fats all together.


Agreed! Also lard, tallow, and grass-fed butter. Nature doesn’t make bad fats, factories do.


Whole grains are one of the biggest sources of dietary inflammation. There isn’t something inherently wrong with grains, it’s that they’re not even close to the grains we evolved to eat anymore (at least, not in the U.S. — grains in mainland Europe are generally fine, unless you have an issue with gluten/grains such as celiacs, Crohns, or IBS).

Source: Tons but the book Wheat Belly is one of the most succinct. Also, every trainer who is even half-way decent at transforming clients tells them to avoid grains, don’t discount what people are ACTUALLY doing to get results, even if a definitive study hasn’t been done on it (although many studies have been done, see Wheat Belly).

Fruit falls under the category of “healthy, if you’re healthy.” If you’re overweight and inactive, and you want to lose weight, then you should not be eating fruit, or any high-sugar, high-carb food for that matter. Once you’re lean and physically active, it’s fine.


Dr. John McDougall refutes the arguments that whole grains are unhealthy and cause disease in his critique of Wheat Belly.

https://www.drmcdougall.com/misc/2014nl/jan/smoke.htm


> every trainer who is even half-way decent at transforming clients tells them to avoid grains, don’t discount what people are ACTUALLY doing to get results

Isn't it more likely that trainers tell people to avoid wheat and corn because they tend to be high-calorie, low-satiety foods? I've lost 70+ lbs over the past year on IIFYM-style caloric restriction. I still enjoy corn and wheat products, but somewhat sparingly because I'd rather have an extra half pound of chicken than a piece of bread.

Cutting out grains is a quick and easy way to help people hack their caloric intake more than anything else, IMO.


Congrats!

Yes that’s also true. But cutting grains also fixes your sense of satiety. Ever had a piece of bread and then next thing you knew the whole bread basket was gone? Many people feel like they can’t control themselves when eating bread. No one does that with steak. And even other high-carb foods like potatoes present less of a problem for people (in terms of whether they feel full and stop eating vs continuing to eat past the point of satiety).

IIFYM is very effective at fat loss BUT (and I know I’m going to get shit for saying this) it requires a very specific personality type that can be very mechanical about eating. Most people don’t have the time or interest to count their macros, and even if they did they still have difficulty overcoming the urges that come with consuming junk food such as modern grains in the U.S.


I don't think it's grains in particular that mess with satiety - it's carbohydrate-heavy diets (particularly simple carbohydrates) vs protein/fats. Protein in particular is known to be highly satisfying, and it tends to be less calorie-dense than carb-heavy foods. Carb-heavy foods are everywhere, because they prepare easily and keep for a very long time, and provide a lot of calories in a small package. Sugar + fat together make our brains super happy and trigger the "put all of that in my face now" response. In the right form, even starchy carbohydrates can be really easy to put down - consider a big bowl of mashed potatoes or white rice for example!

I actually agree with you about IIFYM needing the right personality type. http://physiqonomics.com/fat-loss/ is probably my favorite "how to be not fat" page in existence and it outlines that issue quite well - if you can be disciplined to stop eating, then IIFYM works great. If you can't, then full abstinence is pretty necessary. I find that I'm much more successful on an IIFYM diet than an abstinence diet, because on the latter I find myself craving the "forbidden fruit" and it eats at me until I crack, then I feel guilty, and it spirals from there. On IIFYM, I can let myself have whatever I'm craving, knowing that I just have to make up for it with the rest of my intake that day. The actual mechanical part of counting macros is pretty trivial once you've learned how to do it (MyFitnessPal learns your dietary habits quickly, and trivializes the process).

Not every approach works for everyone, but I have a lot of frustration around a lot of the diet fads that are constantly looking for the "magic bullet" - no fat! no sugar! only specific carbs! lots of carbs! 3 gallons of coconut oil daily! Only eat every 6 days! - when, IMO, the only magic bullet is self-discipline to find out how to keep yourself from overeating, and my experience has been that that can be different for each person based on their psychological tendencies.


Great article, just book marked it. Definitely appeals to people “like me” who align philosophically with HN types.

My biggest issue with it, and all diet advice that wants to “give it to you straight, it’s all about calories” is this — YES in order to lose weight you HAVE to burn more calories than you consume, there is no question about it, it’s tautological. But it’s kind of like saying, “in order to stay sober every night, you have to drink alcohol slower than your liver can process.” It’s true...but it doesn’t really answer the question you should be asking, which is “why are you an alcoholic?” The answer to that question is more complicated, but it’s the only question that matters.

Back to diet, when it comes to being lean — why were the vast majority of Americans lean in the 1950s back when almost no one did any formal exercise, especially women, and hardly anyone was counting macros, calorie counting, etc? They just naturally ate about as many calories as their body burned off. Their bodies had a mechanism to tell them to stop eating when they were full. So what’s the difference between people and food 60 years ago and people and food today? No other mammal on earth has gotten so obese as a percentage of the population as humans have. The answer to that question, I’d argue, is the only one that matters!

I think this is why the Paleo diet has taken off so well, because frankly we shouldn’t have to count calories, macros, etc to stay lean — yes, those methods work, but we should be able to simply rely on the signals our bodies are sending us, every other lesser mammal does this, and humans did it just fine 60 years ago.

TL;DR Yes, it’s all about eating fewer calories, BUT how you eat fewer calories has a big effect on whether you can sustain it long term and feel satiated.


I didn't know whether to laugh or cry reading "Wheat Belly". Honestly, how does a person who writes such garbage even call himself a doctor. It should be a case study for a textbook on what bad science is, and how we are very ill-served by celebrity-doctor types who try to make a lot of money off their brand.


What's the difference between mainland European and American (north American?) grains?


Citations for this crap?


Hm, did you read my comment?

I said source: Wheat Belly (book by Dr William Davis), but also my experience working with clients and with trainers who are experts at transforming clients from fat to fit.


Citations, not a diet books and anecdotes.

Edit: hate my tone all you like, but keep in mind if this weren’t fringe bullshit I’d be met with more than downvotes and attitude.


Wheat Belly is not a diet book, it’s a summary of the science out there on grains with 100s of scientific citations. Yes it has diet recommendations at the end of it.


The Wikipedia article only cites this article http://www.mdpi.com/2072-6643/8/2/84 . Do you have a link to another paper that also supports this conclusion?


The aversion to new facts is palpable. This is the top google hit to “wheat dietary inflammation”: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705319/

But really, your problem is not that the GP did not cite their facts, you just don’t like the sound of their claims, so you’ll respond in a toxic way. I hardly expect the actual scientific literature to change your views.


Did you even read the study? They only say that it might be possible that there could be an effect on inflammation, but also stating that there haven't been good studies done on that subject. The problem is that nutritional studies are often very narrow, only for specific cases and the same applies for the results. However, those studies are often broadly generalized by ill-informed people. I'm no expert either, so I can't say if grains would be good or bad, it's just clear to be that neither can all the other people who claim to know so.


My problem seems to be that there is some significant overlap between the groups, “people who use HN” and “people who are the target audience for self help books.” Worse, are people who can’t cite and instead throw articles into the mix, while being condescending and pseudo-psychic.

Just bury me in good citations and we can both be happy.


On the other hand, it might just be that this particular topic is unusually divisive. The science of gluten sensitivity is young, its study fraught with placebos and confounding variables, and adherents of the anti-gluten movement are often nearly religious in fervor. Asking for citations might just be asking for trouble.


True, but there are few better demonstrations of the weakness of an argument than asking for someone to prove it, instead to be met with anger and verbiage.


FWIW, this could be because nutritionist : dietitian :: toothitian : dentist.


For anyone interested in this subject - and how sugars and carbs can _potentially_ harm your overall emotional and physical well-being and lead to obesity - I'd recommend "Why we get fat" by Gary Taubes.

It has a surprisingly healthy dose of scientific studies condensed for the layman, and some historical context as well.


> sugars and carbs

I feel like carbs are unfairly vilified by a lot of people, to the point of resembling fad diets. Anecdote: I eat very carb-heavy. I also lost 35 lbs in the last couple of months. I didn't do it by cutting carbs.

Sugar I buy into vilifying a bit more... Since it's particularly evil how much sugar gets added to everyday items these days, in the "high fructose corn syrup" era which is probably responsible for a lot of the current obesity problems. But I've come to see even a "no sugar" backlash as a little unfair. My daughter loves sweet desserts, as kids do, and we often cave and give her what she wants. But I've been finding on my current weight loss kick that I can eat a lot of it with her and still lose weight every week.

For me, being mindful of portion sizes and thinking about calories holistically has done a lot better than demonizing certain foods.


It is really, really surprising that this is discovered so lately. We should be knowing this for 30 or so years. I have a strong guess that this article is overpresenting how new this is. Otherwise something really weird is going on.


> It is really, really surprising that this is discovered so lately. We should be knowing this for 30 or so years. I have a strong guess that this article is overpresenting how new this is. Otherwise something really weird is going on.

1) You're right, it's not that new. I'm pretty sure I've read it at least once before on _HN_ itself.

2) Nutritional science is a mess not because something weird is going on but because it's really, really hard. It's difficult enough to study the short and long term effects of substances on the body when you're taking about a drug but when you're trying to do it for something like food. Food is intimately tied to culture, habit, social settings, and mood, which makes it hard to fully regiment what your test subjects are taking. Nutrients also both appear and are metabolized in extremely complex arrangements that we still don't fully understand (even something as basic as calorie counts use a pretty ridiculous, roundabout measurement technique), which makes it hard to accurately track. It also is something that everyone has to do all the time, so (unlike drugs), we have to go with "best current understanding" recommendations, which create their own political and reputational effects on scientific study when they're contradicted.

We just this year upended decades of public health consensus on the effects of low sodium on blood pressure. This isn't "something weird" going on, it's par for the course for the field.


Okay, thinking about your arguments I have to agree. This is not about nutritional advise but about nutritional science. In the pure science department having a good enough result to statistically trust it is rare and may happen even two or three generations until it is common believe already. It is actually good that they ignore common believe in favor of reliable data. Someone must.


It was either this or having a large part of humanity living without western comforts. Fructose is cheap to get and produce.

In addition a fat liver sounds more curable in a thirld-world-country then diabetes. So the worser of two it is.


Given the US uses HFCS a lot, whereas many other countries use other sugar, it would be interesting to compare liver disease rates since the 1980s in the US vs non-HFCS countries.


HFCS has roughly the same fructose:glucose ratio as table sugar, honey and other sugars that are claimed to be less unhealthy.

HFCS alarmism is just that: Alarmism.

The problem is not the composition of HFCS, it's that we in the western world are adding a hell of a lot more sugar to everything compared to 40-50 years ago.


But some claim that during the conversion of corn glucose to HFCS, a lot of contaminants end up in it, and explain some of its ill-effects to that.


Oddly enough, they don't seem able to actually back up those claims.


Then keep on consuming HFCS. I quickly googled for the lazy you and it's not too hard to find stuff on the subject like [0]. I am personally staying away from all sugars except those naturally found in fruits and honey.

[0]: http://www.washingtonpost.com/wp-dyn/content/article/2009/01...


That's production faults, not inherent to HFCS.

I try to stay away from added sugars too, but there is no reason to demonize HFCS specifically.


I didn't say contamination is specific to HFCS, but any large-scale low-cost process is prone to contamination. There was another point that the fructose part in HFCS is less stable than in table sugar, and affects the gut worse in some ways.


Fructose has always been known to be metabolized just like alcohol, so, here's the news? The only type of fructose that's tolerable, in my view, is in moderate consumption of whole fruits (not juice or other processed versions), and unadulterated honey - still in moderation. When I see people eating huge amounts of fruits, I start feeling sorry about their pancreas and liver!


Why "unadulterated honey"?


Supermarket-quality honey is pasteurized and has added sugar, i.e., it has almost no benefits, but gives you all the negatives of glucose and fructose.


Is it possible to buy processed foods that have no fructose. Certainly, fructose is sweeter and that's why it's used so much. But would be great to avoid it altogether. I know you can bake with dextrose.

I wish I'd taken chemistry. I see a lot of conflicting statements about isomers of glucose.


There are – or should be - many foods that may meet the definition of "processed food" and contain no fructose. I can't name or confirm specific brands, but unsweetened bran flakes would be one such example. Some varieties of crackers would (or should) also contain no fructose.

There are of course many more processed foods that don't contain added sugars, and therefore would contain no added fructose. At least some of these could be considered relatively harmless in moderation.

I'm not a doctor, a dietician, nor am I a nutritionist, so take the following with the largest grain of salt you wish, but a diet entirely devoid of fructose doesn't seem like it would be particularly useful compared to a diet with moderate fructose intake, in the general case. On the other hand, I'm unsure whether avoiding it entirely would be particularly harmful, if you were so inclined (but again, I'll point out that I'm not a doctor and this is not to be taken as medical advice.)


It frustrates me when I look at things so far from "dessert" like a can of chili, and find corn syrup or even sugar in the ingredients. Most great homemade recipes don't use that sugar, so why should the store bought stuff?


The simple answer is that sugar is a flavor enhancer, as is salt, which is why the level of both is generally very high in processed foods and pre-packaged meals.

Take chicken, for instance. A lot of chicken you buy is pumped full of sugar/salt-heavy brine, because water is cheaper than chicken. The salt helps the chicken bind the water, and the sugar balances out the taste. The end result is overpriced and compromised taste-wise.

Personally, I try to avoid added sugar wherever I can, and I have started thinking of sugar as a spice to be used very sparingly, if at all. The only exception is when I bake a cake, because cakes that aren't made full-butter, full-sugar full-everything are just sad. Make good cakes, just eat smaller portions of them, less often.


Because you (as a generic customer) will come back to buy more. Customers by now should be aware of significant deviations to the expected ingredients of common, well-known recipes.


Based on how much conflicting studies, stories, evidence, research and anecdotes out there, it seems nutrition is the one thing that really just boils down to self-experimentation, moderation, and common sense.


Without saying how much is too much :)

I wanted to know because it is probably really hard to reach without processing the sugar. IIRC dates are most fructose dense food we can find in nature. How many dates would be enough to damage my liver?

It would probably be hard to hurt your liver with alsohol as well, if you limit yourself to unprocessed alcohol (i.e.: by eating off fruits).


> Without saying how much is too much

Body weight, metabolism and exercise have to be big variables.

The scary part is how much sugar sneaks into your daily diet without noticing - I kept count of the sugar grams per day for a workday and I had about 98 gms of sugar & that's where it got labelled (unlike a tomato sauce pasta).

Anyway, all it taught me is that even if exercised like a madman, I won't lose the "moved to US" weight gain without minor diet changes - but what surprised me was that my diet was a good one in the meals, it is just the middle-of-meals grabbing of things that pushed that number up (like a yogurt).

> How many dates would be enough to damage my liver?

I was told that there's two ways to drink twelve glasses of alcohol a month - one's to hit six for two weekends and the other is to drink a glass on Fri, Sat and Sun.

And then said "it's like three pats on the back a week or two punches a month".

Bodies heal and repair damage - and at a varying rate as you age.


I've read Lustig's book, and my recollection is that he says that more than 10% of your daily calories from (all, both added sugar and naturally included sugar, if I remember correctly) sugar is too much. So if you're eating 2000 calories/day, then 200 calories from sugar, which means 200/4 = 50 grams total (including added sugar).

Separately, on the sugar science website they say:

> our scientific team recommends keeping all added sugars below the recommended limits of 6 teaspoons/day (25g) for women and 9 teaspoons (38g) for men.

http://sugarscience.ucsf.edu/sugar-faq.html


So one orange, a large apple and a banana per day will hurt my liver (totaling 63 grams of sugar[1])?

Where is the scientific evidence supporting this?

[1] http://www.sugarstacks.com/fruits.htm


I just watched a documentary where Lustig said sugar in fruit is fine because the fibre in the fruit means you absorb the sugar over a period of time, meaning the liver doesn't get one big hit.


No citation available, but I see far more people drinking fruit juice than I do eating fruit with the skin/fibre still intact.


Roughly 25 years ago when I was a kid, I remember drinking orange juice out of small 4" glasses with oranges on the side at diners and in homes. These glasses hold about 6 oz of juice, which is about 85 calories.

These glasses have been replaced by much larger ones. These days a 'small' juice is 12-16 oz, or 150-200 calories, which is just as bad as pop.

Portion sizes are growing with the collective waistline of America.


Fruit juice is no better than soda pop.


At least fruit juice has some nutritional value. You're right though that it still isn't a "healthy" choice.


The recommendation is about added sugars, which means sugars that are processed to remove all the fiber and everything else. Fruit is not added sugar.


I thought the fiber was good because it made you feel fuller and you don't eat as much, not that you somehow interacted with sugar to "disable" it. What's the connection?


I suspect there's no good answer to that question. People vary widely. Some people drink lots of alcohol for years with relatively unscathed livers and others get cirrhosis pretty quickly.

But your instinct is right that fructose that's bound up in real fruit isn't typically the problem. It's unbound fructose like you find in agave nectar or HFCS.


Why is real fruit not a problem but HFCS is? Dates sugar content is mostly sucrose which is broken down in the small intestine very rapidly into 50/50 glucose/fructose while HFCS is typically 45/55 glucose/fructose.

Once one sucrose is metabolized by sucrase it hits the bloodstream as glucose and fructose no different than HFSC.

Doesn't only matter in the end how much fructose you consume regardless of whether enters your body bound as sucrose or not as HFCS?

Can you point to some more information are the differences?


Industrial sugar contains no fiber vs. the fiber in many fruits complementing the fructose and ameliorating potentially harmful effects meanwhile slowing digestion [1]. My guess is this leads to a more sustained energy boost and relatively mild to nonexistent crash depending on how well your body reacts to carbohydrates.

One may need to be somewhat more moderate with dates as they contain little fiber to sugar content - hinting at the importance of varying your fruit diet.

[1] https://nutritionfacts.org/video/if-fructose-is-bad-what-abo...


So based on that it looks like nothing to do with sucrose vs HFSC, only that the berries have some other properties like binding the sugar up in fiber that slow down metabolism.

It would seem if you bound HFSC up with fiber it would have the same effect.


That's why I said "unbound" fructose.

Sucrose is glucose and fructose with a chemical bond between. HFCS is a slurry; there's no chemical bond connecting the two.

"Broken down in the small intestine very rapidly into 50/50..." ignores the fact that it takes a while to make it down as far as the small intestine.

I can't speak more to the differences personally because I'm not the one with the PhD and I'm not going to interrupt my wife from grading papers just to correct some rando on the Internet. :)


Both sucrose and HFSC must make it to the small intestine to be metabolized, the only difference is the chemical bond is broken by sucrase in the intestinal wall. Both are metabolized quickly and into the same components in the bloodstream.

I am still not seeing the difference?

edit

Perhaps I misunderstood what you meant by "unbound" I thought you where referring to the chemical bond in sucrose, vs being bound up physically with fiber in fruit.


> Why is real fruit not a problem but HFCS

Two things, people just don't eat that much fruit, usually. And whole fruits/vegetables when eaten release glucose and fructose slowly as the digestive enzymes slowly break it down. I think the idea is not to force your body to deal with a big slug of glucose and fructose all at once.


> Why is real fruit not a problem but HFCS is?

Fruit has loads of fiber, although less than what our ancestors gathered, and in less quantity. Fiber is what produces satiety. For the same reason fruit juice is not good for you.


Again seems like that has nothing to do with HFSC or sucrose, only whats its mixed with.


I hear as bananas ripen, the sucrose breaks down and more fructose is available. That's why they get sweeter. So healthier not to wait too long.


It's been a long time I did biology in high school, but a quick fact checking on WP suggests I'm not too far off: This is true for most/all(?) fruit and yet untrue for humans because sucrose is broken down into glucose and fructose by the body anyway.


going to bed with left over sugar is bad for you. but for regular exercise sugar is good too (slower carbs are better)

It's all about balance, possibly everyone should have a blood glucose meter and burn off that excess glucose every night.


[flagged]


Honey has micronutrients HFCS doesn't have. But by far the biggest difference is price. You won't overeat honey simply because you won't want to pay 21 times more. And for a taste that is not a direct replacement of sugar and may not combine well with everything.


The amount of micronutrients in honey is inconsequential, it is measured in single digit milligrams per hundred grams. It consists primarily of sugars and water, and the main component is fructose.


Why would anyone want to eat as much honey as they currently eat sugar? Why would anyone think that would be any less egregious?


Yes, and rape seed oil has the about the same combination of fatty acids as olive oil; which is healthy; but it's still poisonous gmo crap. Same goes for HFCS. The amount of genetic manipulation, processing and refining matters.


[Citations needed]

Very much so, in fact. Otherwise your post is simply unfounded paranoia.

Specifically, prove your assertion that rapeseed oil is "poisonous GMO crap".


Google not working for you? I picked this at random, you'll have to use your own brain if you want to know more:

https://draxe.com/canola-oil-gm/

"Canola oil is a Canadian invention that’s backed by Canada’s government, cheap to manufacture, and many packaged or processed foods contain it. Canola oil was first created in the early 1970s as a natural oil, but in 1995, Monsanto created a genetically modified version of canola oil. As of 2005, 87 percent of canola grown in the U.S. was genetically modified, and by 2009, 90 percent of the Canadian crop was genetically engineered."


"Just Google it" is very much not acceptable as a source.

So your primary source is a blog run by a "doctor of natural medicine" (or possibly a chiropractor), aka a fraud?

It may very well be that a lot of canola is genetically modified, but what is your proof that this has any negative health effects at all? Aside from baseless paranoia, of course.

Here's some info for you:

https://badscidebunked.wordpress.com/2015/12/08/axe-idental-...

https://rationalwiki.org/wiki/Joshua_Lee_Axe


Go kill yourself (?) for someone else's (?) profit then, you can lead a horse to water but not make it drink.


You're not being very constructive. Please provide some reliable and trustworthy sources.


Rapeseed grown in the EU is not GMO.


Doesn't too much of anything damage your body?


Too much of everything is always bad.


>Too much of everything is always bad.

That's folk-wisdom, which is sort of a good heuristic but is not useful when we can actually test and demonstrate. Some things are bad even in small quantities, say poison. Somethings we can't get enough of, say fresh air.

I've mostly cut out fructose (and most other forms of sugar) altogether from my diet and it's probably the single-most impactful change that I've made in my lifestyle on my well being.


> Somethings we can't get enough of, say fresh air.

Well, if you get too much air, the pressure will probably kill you, so... ¯\_(ツ)_/¯


I would have gone with hyperventilation, though there's a cutoff there


Even at ~atmospheric pressure, it depends on where you put it.


So you don't eat fruit?


That's a truism. Which makes it thoroughly uninteresting. What is interesting is: How much is too much? And, How much are you currently consuming?


The problem is when too much of something enters the food chain because manufacturers find it cheap (see for example, high fructose corn syrup).


Why is it that I can eat tons of sugar, including HFCS soda, and not gain any fat?


I don't know the answer to your question about you in specific, but I have a genetic disorder that predisposes people to being super thin. One element of it is that fats are misprocessed.

I have made some headway on dealing with it. But, I mean, I wouldn't know where to begin to explain it and I have no idea how it relates to your experience. So, I mean, I don't know what pieces to even talk about. If I know someone has, for example, diabetes, I can come up with pertinent things to say, even though that isn't my condition.

There is a lot of info out there these days. You may be able to eventually hack this and find a means to put on weight.


Depends on your age, metabolism, and lifestyle. By the way, just because you cannot see it, it doesn't mean that irreversible damage isn't being done on your pancreas beta cells. There's a diabetes epidemic among thin Asians.


It's almost as if too much of any one thing is bad for you.

It's interesting that science is just figuring this out. And I say this as someone who has doctor parents.




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