A retrospective of the fructose alarmism debate.

2010 February 19
by Alan Aragon

Three hundred…

After 300 comments and counting, it’s safe to agree with Nigel Kinbrum that my recent critique of Dr. Robert Lustig’s fructose lecture “has caused a bit of a stir in the nutritional blogosphere.” The intense debate (& discussion) that ensued inspired me to re-cap some things I feel were most interesting. There was plenty of learning to be had on both sides of the fence. Here are the highlights as I see them:

  • Dr. Lustig showed up, to the excitement and anticipation of all, including me. He went 3 rounds with me, which was actually more than I expected.
  • In round one, he defended his position using  survey data that was contrary to the ERS/USDA data, which is well and good. I don’t disagree that survey data in general is pretty messy and equivocal, not to mention, incapable of establishing causal relationships. He then repeated his claim that the Japanese diet contains no fructose outside of fruit. Perhaps due to hasty error, he says, “That is what we are talking about here; added dietary sugars; not endogenous ones.” I’m going to assume he meant to say intrinsic sugars, not endogenous sugars.  In any case, this idea that the Japanese do not add sugar to their diets is completely false – regardless of which regional or traditional aspect of Japan you’re talking about (this actually was never specified). He also mentioned the revised recommendations of the American Heart Association (AHA), which David Gillespie follows up on towards the end of the discussion, where the full picture is omitted until I post it up (I’ll get to that).
  • In my rebuttal to Lustig’s initial comment, I first point out the limitations of epidemiological data, as well as Lustig’s neglect of the numerous factors that have contributed to a reduction in energy expenditure, such as, “an increase in sedentary occupations; an increase in two-income households and single-parent households; transportation and infrastructure changes that discourage physical activity; a decrease in PE classes and extracurricular sports programs in schools; an increase in sedentary forms of entertainment (i.e. TV/movie viewing, video games, internet, etc.); demographic changes (i.e. aging population, immigration, etc.); a decrease in food costs with increase in food availability and changes in food consumption patterns” (study here).  I  finish off by pointing out the error of the claim regarding the Japanese diet, and mention Lustig’s omission of giving concrete numbers in his lecture regarding the dose-dependent safety of fructose in the diet.
  • Lustig’s 2nd round defense was merely a cut/paste of the abstract of a 31 year-old epidemiological study showing that, “a high fat, high simple carbohydrate, low complex carbohydrate diet and/or reduced levels of physical activity increase risk of diabetes.” My rebuttal to this was simple. I pointed out how Lustig was not only using uncontrolled data to support his stance, but he was being selective about what the observational data showed. I used the study he posted plus two more recent studies to show the common thread among each of them: an increase in fat, an increase in sugar, and a decrease in physical activity was associated with adverse health effects. Clearly, it’s incorrect to selectively scapegoat the single factor of your personal choice.
  • In Lustig’s final defense, he first cites as study wherein roughly 150 grams of fructose (the equivalent of 6-7 cans of non-diet soda), increased visceral adiposity and reduced insulin sensitivity in overweight & obese subjects. Does this surprise anyone? The study he cited used a fructose dose that’s 3 times the average American intake. He then goes on to cite rodent research despite his acknowledgement of my demand for human interventions using non-stratospheric doses of fructose. All this, after my multiple citations of human research showing the contrary.  To top everything off, Lustig cited his Youtube popularity as a basis of accuracy and credibility. That was not a good move. My rebuttal to Lustig’s final comment is right here.
  • I emailed Lustig, thanking him for the discussion, and he responded by preaching to me more of his gospel. I politely asked that he take his argument back to the blog since the purpose of the whole discussion in the first place is to educate the public. He would have none of that, quipping that “real scientists” don’t go tit-for-tat on blogs, they go to journal clubs to discuss research with other “real scientists.”  If his case was as strong as he thinks it was, he wouldn’t have gotten embarrassed by the opposition.
  • As I mentioned in response to a straight-shooting article by Martin Berkhan, Lustig probably has more education and native intelligence than he knows what to do with. However, as he demonstrated, you can be the most brilliant guy in the world & still find yourself fumbling over groundless claims.
  • Comments by Ryan Zielonka (here), RG (here), DSD  (here), and Rob (here) illustrate the regional heterogeneity of the Japanese diet, and how it can’t be simply pegged as fructose-free aside from the fruit intake.
  • Fred Hahn brought his classic carbophobic flair (here), which was well-rebutted by Mike Howard (here) and Leigh Peele (here).
  • Ganine asked the question of whether or not HFCS has different metabolic effects than regular sugar (sucrose). James Krieger came in with a follow-up response stating that, “The only practical difference between sucrose and HFCS is in the bonding. The glucose & fructose in HFCS is mainly free and unbonded, while it is bonded in sucrose. However, this makes no *meaningful* difference in regards to metabolism in the body. The bonds in sucrose are quickly broken when sucrose hits the acid environment of the stomach. This means that once sucrose hits the stomach, it’s no different from HFCS. Once you get to the small intestine, metabolism is *exactly* the same. This *little bit of difference* does not lead to the problems Dr. Lustig talks about. The fact is, HFCS and sucrose are identical as far as your body is concerned. The difference in bonding wouldn’t make a shred of difference in regards to your health.”
  • Speaking of James Krieger, I’d like to direct anyone interested in fructose metabolism to this fine tutorial here.
  • In response to Mike K’s advocacy of food avoidance, I posted research indicating an association between inflexible, all-or-nothing eating habits and adverse conditions. To quote Stewart et al, “The study found that individuals who engage in rigid dieting strategies reported symptoms of an eating disorder, mood disturbances, and excessive concern with body size/shape. In contrast, flexible dieting strategies were not highly associated with BMI, eating disorder symptoms, mood disturbances, or concerns with body size.”
  • Here’s a quote from a similar study by Smith et al: “Subjects were administered questionnaires measuring dietary restraint, overeating, depression and anxiety. Measurements of height and weight were also obtained in order to calculate BMI. Canonical correlation was performed to evaluate the relationship of dietary restraint variables with overeating variables, body mass, depression and anxiety. The strongest canonical correlation (r=0.65) was the relationship between flexible dieting and the absence of overeating, lower body mass and lower levels of depression and anxiety.”
  • Indeed, correlation doesn’t automatically equal causation, but the two studies I cited above build a far better case than the baseless assumptions of folks who assert their dietary perfectionism onto the world around them.
  • Ardent sugarphobe David Gillespie presented some very engaging arguments. However, he ignored all other posters, as well as the evidence I presented. He correctly pointed out that John White’s HFCS article contained a citation of research that did not support the point he was making (good catch, David!). However, he went on to dismiss reams of data on the grounds of funding source. He also incorrectly accused a study of being funded by the Coca Cola company, when in fact, Coke funded the travel expenses after the study was already complete. As James pointed out, the study was funded by a scholarship, two fellowships, and a grant from the Canadian government. Beyond that, studies should not be judged solely on funding source; the weight of their scrutiny should rest on their quality of design.
  • David responded by citing the AHA’s recommendations, which I’ll quote him as saying, “Of particular note is their final recommendation that an adult male should consume no more than 144 calories (38 g) per day in added sugars (which would be 19g of fructose).” The problem with this is that it omits the range of doses the AHA listed for various populations, which went as high as 19 teaspoons of sugar per day for active males, which is double the figure that David emphasized. Of course, it’s convenient to leave out the higher end when you’re building a case that’s biased toward sugar avoidance. Go here to see my response to this, which includes a screen shot of the chart in the AHA paper.
  • In my final rebuttal to David, I explain what discretionary calories are, and how their intended use further supports the point I made in my original article. To quote my response, “The discretionary allotment for an active male is 512 kcal, and a sedentary one is 290 kcal. The average of this is 401 kcal. Technically, it wouldn’t violate the AHA’s recommendations if someone’s entire discretionary kcals came from sugar, which in the case of 401 kcals is about 100g, which equates to 50g fructose, which brings us right back to the exact number I listed as the upper safe limit in my original article.”
  • An honorable mention is deserved for the most epic comment, by Jamie Hale.

I want to give sincere thanks everyone who contributed to this discussion. To end off, I encourage anyone interested to check out the following scientific reviews for further information on the topic of fructose:

http://www.ncbi.nlm.nih.gov/pubmed/19592634

http://www.ncbi.nlm.nih.gov/pubmed/18996880

http://www.ncbi.nlm.nih.gov/pubmed/20047139

http://www.ncbi.nlm.nih.gov/pubmed/20086073

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991323/

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165 Responses leave one →
  1. February 19, 2010

    Errm, Google Alerts doesn’t work if you mis-spell my name. :-D

  2. February 19, 2010

    Oh crap, lemmie fix that :)

  3. Mike L. permalink
    February 19, 2010

    Great recap, Alan.

    Loved following this thread. Hope to see you address more controversial issues in the future.

    Best,
    Mike L.

  4. February 19, 2010

    Great summary Alan!

    I missed some of the initial thread and by the time I got back it was too extensive to read in entirety (without losing half of my day).

  5. February 19, 2010

    Great post, and another example of a group scientific, logical thinkers versus a group of nonscientific thinkers. Alan’s team- logical thinkers, and scientists- wins again.

    What is a Real Scientist?

    Although a person with a science degree might claim to be a scientist, the true test of the scientist is how one thinks. A good scientist:
    · Accepts nothing in science absolutely.
    · Is willing to change his opinions based on new data.
    · Does not rely on Authority.
    · Thinks critically.
    · Knows that extraordinary claims require extraordinary proof.
    · Has an open mind.
    · Relies on logic and reason.
    · Knows how to form hypotheses and test them.
    · Respects the scientific method.
    · Examines all the data, not just the data that support his or her view.
    · Builds on the work of others, giving them appropriate credit.
    · Documents his or her experiments so they can be duplicated by others.
    · Knows that if a claim is made, the claimant must provide the proof. (It is not up to others to disprove it.)
    · Is intellectually honest
    . And drops the ego and admits when their belief system has been refuted by scientific data. It’s not enough to consider the weight of data, but the quality and strength must also be considered.

    Of course, all of the points above are not directly applicable to the previous fructose discussion, but some are.

    If you lack the skills to evaluate the data it really makes no difference, scientific data is all the same. But if you decide to participate in a scientific debate it’s a good idea to be able to read what you are claiming to be evidence. As I said earlier, anyone interested in scientific data should at least take the time to study research methodology and at least have a basic understanding of the central themes of science and logic.

  6. Insight permalink
    February 19, 2010

    Alan is seriously like some kind of nutrition hero. It’s like his goal in life is to find things that people worry about and get them to realize that it’s all superstitious nonsense. And the remarkable thing is, 99% of the time – it really is superstitious nonsense.

    It really has been life-changing to read some of this stuff — from a completely non-scientific standpoint, I almost feel like there’s a deeper message at play here: intuitively we all know we shouldn’t have to be worrying about fructose, or the GI, or freaking out over meal times, or eating too much fat, and so on. And it’s quite liberating to realize – our intuition was dead on.

    What other areas in life are there in which our intuition is dead on? What other things in life are 50x easier than usually believed, but nobody knows this? Making money? Being a rock star? Becoming enlightened?

    Anyway, enough lame romantic-era type shit, but you all get the idea.

    And BTW Alan, I don’t know how to say this any other way — there may be no limit to the depths I will sink in order to get a vbulletin forum up on this site. forums.alanaragonblog.com FTW – will it ever happen?

  7. Insight permalink
    February 19, 2010

    I have just learned something: the principle that the most intuitively simple explanation is often the right one is actually the same thing as Occam’s Razor. Sweet!

    See that shit right there, brah? Raising my IQ up!

  8. Eric permalink
    February 20, 2010

    I recently got into a brief dialogue with a coworker about this topic and it all started when she started demonizing HCFS. I usually don’t butt in with my comments but I couldn’t help myself and I used some of the info I learned from here, the AARR, and one of Lyle’s posts. I even linked her to one of the articles. She did seem to kind of acknowledge the facts but was still worried about it.

    I told them that these guys, Alan, Lyle, Jamie, etc, really review the research and their ability to analyze data is superb.

    Wasn’t impressed at all, would rather listen to the guy actually conducting the research and how the media might distort it.

    People get too married to their beliefs of what they see on TV or in the general media (including magazines) and won’t relent no matter what because it maybe helps them justify something they are doing.

    I’m proud to say that I USED to be a bro but I have changed my beliefs after seeing the cold hard facts. Isn’t that what learning is all about?

  9. February 20, 2010

    More info on scientific thinking and logic:

    Scientific and Nonscientific Approaches to Knowledge
    http://www.maxcondition.com/page.php?126

    The Fitness Skeptic
    http://www.maxcondition.com/page.php?105

    Authorities are Fallible
    http://www.maxcondition.com/page.php?117

    How To Read A Scientific Paper
    http://www.biochem.arizona.edu/classes/bioc568/papers.htm

    Critical Thinking: What it is and why it counts
    http://www.gustrength.com/critcialthinking:facione1

    Top 20 logical fallacies
    http://www.theskepticsguide.org/resources/logicalfallacies.aspx

    Knowledge Summit
    http://www.knowledgesummit.net

  10. February 20, 2010

    I think it’s good to be cautious about too much sugar intake. But I think it’s more important to restrict omega-6 intake to reasonable levels.

    I read John Yudkin and T. L. Cleave and William Dufty three decades ago and restricted my sugar consumption accordingly thinking I was doing well. However, I got blind sided by omega-6. In 1993 I bumped my shin on a saw horse and was struggling with cellulitis and an ever-deepening sore (ulcer) a week later. Three months of trying various remedies to no avail, I took a few days off work to alternately soak my leg in Epsom salts and elevate. I had a book entitled “Vitamin E: Health Preserver” by Canadian physician and vitamin E researcher Wilfred Shute. Dr. Shute described how he used vitamin E to treat diabetic gangrene, phlebitis, congestive heart failure, and skin ulcers. I obtained some, took it orally, and applied it topically. Worked great. Was able to sleep at night without taking aspirin and the wound filled in with granulated tissue as described in the book.

    A little more research and I concluded that I was consuming too much polyunsaturated seed oil, mainly from mayonnaise and salad dressing. I cut those from my diet and my health improved – for a while. More recently I’ve been losing strength and flexibility in my legs to the point where running is impossible and getting up from a chair difficult. I tried stretching and experimented with supplements of various sorts with limited success. Stretching was painful and supplements expensive. Then I heard Dr. Bill Lands utter these words: “…there are some really interesting foods that have more omega-3 than omega-6; but not all. Did you know that peanuts have 4,000 milligrams per 28 gram, one ounce serving of peanuts? 4,000 milligrams of omega-6 and one milligram of omega-3. The United States is the land of peanut butter. Grow our kids. Make our kids healthy. Whoops.”

    Whoops indeed! When I learned how much omega-6 was in peanut butter I quit consuming it. That was about three months ago. Recently, I noticed an increase in muscle strength in my legs. In addition, the pain associated with stretching has subsided and I am able to run again and stand up from a chair without thinking about it.

    I used to believe that excessive sugar intake was the major cause of clogged arteries. But after listening to Dr. Lands I’m not sure sugar has that much to do with it. Here’s a link to the lecture: http://videocast.nih.gov/summary.asp?live=8108 You can drag the timer button slightly to the right to the 12 minute mark where Dr. Lands begins speaking. If you are unable to play the videocast on you computer you can read a transcript of the lecture at http://www.amazon.com/tag/health/forum/ref=cm_cd_tfp_ef_tft_tp?_encoding=UTF8&cdForum=Fx1EO24KZG65FCB&cdThread=Tx241KS54K89FO7&displayType=tagsDetail

  11. February 20, 2010

    David — While I agree that omega-3 FAs are generally underconsumed (esp. in terms of proportion with omega-6 FAs), I wouldn’t cut out foods I liked on those grounds. I’d just eat less of them, or I’d eat more omega-3 FA. There’s magic in peanut butter, you didn’t know this? I think people can go overboard in their zeal for omega-3 as well, taking a more-is-better approach & swinging the pendulum too far in the other direction. Throwing out peanuts on the sole basis of FA proportion may be a case of throwing the baby out with the bathwater. More reading for you:
    http://www.ncbi.nlm.nih.gov/pubmed/18716180
    http://www.ncbi.nlm.nih.gov/pubmed/17514537
    http://www.ncbi.nlm.nih.gov/pubmed/12672709
    http://www.ncbi.nlm.nih.gov/pubmed/18716179
    http://www.ncbi.nlm.nih.gov/pubmed/19396658

    Insight — I don’t think I’d have enough time to properly nurture a full-fledged forum community. I’ll leave that madness for Lyle :)

    All – Thanks very much for the feedback.

  12. Billy permalink
    February 21, 2010

    Alan,

    What do you think about this video featuring Gary Taubes author of “Good Calories Bad Calories”? http://www.dhslides.org/mgr/mgr060509f/f.htm

    It was recently posted on Bodybuilding.com. He claims to be a man of science and states that calories in vs. calories out does not explain obesity. Instead, insulin, glycerol-3 phosphate & carbohydrates are the culprits in making the body store fat regardless of calorie intake or expenditure.

    Of course he mentions fructose as being the worst offender.

    Perhaps he might be a good candidate for you to continue this debate. He seems like he make a better scientific argument for his case.

  13. February 21, 2010

    @Billy

    Alan already thoroughly addressed Taubes and his nonsense in one of his research reviews. Taubes should be forced, as a penance, to rewrite the book (for free) with accurate information and call it “Good Calories, Bad Gary.’

    Cheers,

    Michael

  14. February 22, 2010

    Billy — I once read an interview with Taubes on T-mag. I was amazed at the misinformation being spewed forth. I have not read GCBC, but from every snippet of it I’ve some across, it sounds to me like he cherry-picks the research that fits his Gripping Story, instead of considering the entirety of the research, then drawing conclusions from there. I am not at all interested in fictional reading at this point in my life. I really wish I had time for it, but then I’d read more of the good stuff in the sci-fi genre. In the meantime, give this a read:

    http://www.thebsdetective.com/2009/10/bullshitter-of-day-oct-7th-gary-taubes.html

  15. Patrick N. permalink
    February 22, 2010

    Alan, you should really read the book (GCBC). At worst, you would be able to rant against it even better. :) I really don’t understand how people can discredit a book (or the author) without even reading said book themselves.

    Patrick

  16. February 22, 2010

    Patrick — I should really read a lot of things…in the peer-reviewed literature. GCBC is low on the list. And like I said, that T-mag interview was more than enough to cast considerable doubt on Taubes’ objectivity. If you find anything in Krieger’s writeup you find to be false, then feel free to take it up with him & link me to your discussion.

  17. February 22, 2010

    I’m tempted to take Fred up on his “3500 calorie per day meat/egg/fat” diet. I have access to a DEXA scan and can be “overseen” by the head of the exercise physiology department at one of the local universities. When I come back fatter, he’ll still explain it away. Hell, I can present everything at next summer’s “Ancestral Health Symposium.” Interesting n=1 experiment.

    Great comments over at Free The Animal, BTW.

    Best,
    Skyler

  18. Patrick N. permalink
    February 22, 2010

    If you overfeed on “meat/egg/fat”, you will probably gain weight (a good deal as fat). In the Zero Carb forums that I read, people who overeat on ZC do gain weight. But some are also able to NEAT it away and do not gain. 3500 is not that much. If you want to make sure that you gain, try to intake 10000 kcal. I read posts from people saying they did not gain on 10000 kcal, but that is probably BS. :)

    Patrick

  19. Aaron permalink
    February 23, 2010

    Skyler,

    I think the counterargument the Taubes camp would make is that you would then return to your normal bodyweight once you resumed regular eating. This is the layer of details that gets hazy using the GCBC approach. Being on this blog, you’re probably athletically oriented, and I’m guessing may lift weights as well. That’s a helluva of a lot of specific prompting to get from your hormonal profile, in my estimation. I wouldn’t be surprised to learn that you did return to your normal bodyweight, but I would be surprised to learn that this was done completely unconsciously. You’d probably limit calories in some fashion, exercise, etc. The idea that I’m genetically programmed to seek my desk job in order to limit my caloric expenditure and that you in turn would be programmed to increase your conscious exercise to achieve a weight equilibrium just seems several steps too far for me. It’s a shame, because I think there are some good ideas that could have come out from that book, but were buried under mounds of hype. For instance, satiety is discussed a lot, and one person’s recommendation for low carb, meat focused dieting was that people would feel full on it BEFORE they consumed too many calories. Why not just present that? Why not just discuss saturated fat in a diet that matches caloric expenditure? He seemed to be trying to write specifically against the low-fat crowd that he just became a carb critic, and that seems to have lead things like the HFCS crusade.

    Aaron

  20. February 23, 2010

    Bray’s Review of Good Calories Bad Calories

    http://mindandmuscle.net/articles/jamie-hale/practical-scientist-7

    Taubes a man of science? Read my post above -What is a real scientist?

    jamie hale

  21. Patrick N. permalink
    February 23, 2010

    Jamie: “What is a real scientist?”

    Very good question !

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719747/

    “I regard consensus science as an extremely pernicious development that ought to be stopped cold in its tracks. Historically, the claim of consensus has been the first refuge of scoundrels; it is a way to avoid debate by claiming that the matter is already settled. Whenever you hear the consensus of scientists agrees on something or other, reach for your wallet, because you’re being had.”

    “Let’s be clear: the work of science has nothing whatever to do with consensus. Consensus is the business of politics. Science, on the contrary, requires only one investigator who happens to be right, which means that he or she has results that are verifiable by reference to the real world. In science consensus is irrelevant. What are relevant are reproducible results. The greatest scientists in history are great precisely because they broke with the consensus. There is no such thing as consensus science. If it’s consensus, it isn’t science. If it’s science, it isn’t consensus. Period.”

    ;-)

    Patrick

  22. February 23, 2010

    Skyler Tanner said…
    “I’m tempted to take Fred up on his “3500 calorie per day meat/egg/fat” diet. I have access to a DEXA scan and can be “overseen” by the head of the exercise physiology department at one of the local universities.” I’ve exchanged a few e-mails with Taubes re: I have a theory. He’s kinda busy right now and wants me to finish reading GCBC before he’ll engage in further debate. I mentioned some individuals that had gained weight on low-carb diets but Taubes said that a proper study was required. Fair enough, but that’s not going to happen any time soon.

    If you do do your experiment, will you do a crossover trial i.e. a low-carb bulk followed by a low-carb cut, a rest, then a high-carb bulk followed by a high-carb cut?

    Cheers, Nige.

  23. David Miklas - snorkelman permalink
    February 23, 2010

    Ahh, a cliff’s version. Perhaps this will encourage some additional bros to educate themselves. Then again, I posted about a 5 sentence response on bb.com and a bro asked me for cliffs :)

  24. February 23, 2010

    Nigel,

    I could do that but I’m really more concerned with the outrageous notion that one wouldn’t gain weight on such a diet. Add in an activity tracker like the Fitbit and a caloric expenditure tracker like the Body Bugg and you’ve got as close to a metabolic chamber as can be managed in free living conditions.

    Aaron,

    I know I’d return to a lower weight post force feeding because that’s what I do naturally. However, this wasn’t his contention. Like Greg Ellis before me I expect to gain fat, not magically recomp like a test-fueled 18 year old neophyte.

    best,
    Skyler

  25. February 23, 2010

    Patrick — While I appreciate Michael Crichton’s point of being wary of the concensus, I think Jamie’s punchlist of the scientific mindframe is quite a bit more compplete.

    David — That’s way too funny.

    All — I see a vision: skylerthescienceproject.com

  26. Patrick N. permalink
    February 24, 2010

    Yes I agree, Jamie’s links are very good.

    Patrick

  27. February 24, 2010

    Over the past decade, it has became increasingly easy for the lay person to access scientific research data. Assuming the layperson has read the data, shouldn’t this mean they are now better equipped to make rational decisions? Not necessarily.

    Quote from Randomised Controlled Trials: A user’s Guide (Jadad, 1998):

    “Even if RCTs were perfectly designed and readily available to users, they could not influence health care decisions and outcomes if users could not understand them.

    During the past 15 years, I have noticed that most people do not understand the concept of randomisation and its strengths, the different sources of bias in RCTs, and the role of RCTs in health care decision making. This could be explained, at least in part, by the fact that most efforts to promote a better understanding of RCTs (and research in general) have focused on researchers in training, particularly graduate students. Little has been done to promote an understanding of research among other users of research. Even though some training programmes for health professionals, policy makers, health planners, and managers include courses on research methodology, they often lack formal activities to promote a better understanding of RCTs. The situation for patients, their family members, and other lay members of the public is even worse. These groups, without whom most RCTs would not exist or would not be needed, have been left unaided to handle research information, let alone RCTs. Journalists who have a profound influence on the dissemination and impact of research information are in a similar situation.

    It would be reasonable to assume that those who understand research will be more likely to use it to their advantage than those who do not understand it. People who do not understand research are more likely to ignore it or misuse it. They also have a higher risk of becoming confused, anxious, and frustrated when trying to use research, which could result in worse health outcomes if irrelevant or biased information is used to guide their decisions. The potentially harmful effects of the lack of understanding of users is now compounded by the amount of information available. Until recently, only health care providers had to deal with information overload. Now, with the growth of the Internet, an increasing number of patients, family members, and other lay members of the public are gaining unprecedented access to information and experiencing the effects of information overload.

    Against this background, I feel confident in saying that the development and implementation of effective strategies to increase users’ understanding of research, and RCTs in particular, is a top priority. Part of the success of these strategies will depend on the way in which the results from research are presented to users (see above). Part also depends on our ability to recognize, understand, and overcome specific barriers to the adequate use of RCTs by different groups of decision makers. Success will also depend on how well these strategies target all groups of potential and actual users of research.

    Timing will be crucial. To date, efforts to promote a better understanding of RCTs and research have focused mainly on adults. Perhaps the effectiveness of such efforts could be enhanced if they were targeted to younger learners. For instance, the basic principles of decision making, research, and critical appraisal in health care could be incorporated in school curricula7,13 and taught using interactive video games and other innovative computer based methods. If children can understand these principles, they will not only be in a better position to participate in health care decisions, but will require little additional education and reinforcement once they become adults fulfilling the roles of health professionals, policy makers, planners, managers, journalists, patients, family members of patients, and other healthy adult members of society.

    Efforts to increase our understanding of RCTs should take into account the tendency of human beings to rely excessively on intuition and rules of thumb, to follow inadequately built theories, and to be strongly influenced by vivid experiences and anecdotes. Efforts also need to account for the fact that research information will be modulated, not only by other types of information, but also by the values and preferences of the decision makers and the unique circumstances in which most decisions are made. If trials are to be used efficiently, and if evidence based decision making is to reach its full potential, we will need to couple our efforts to increase the understanding of RCTs with efforts to promote a better understanding of the relationship between RCTs and other study designs, between research information of all kinds and other types of information, and between information available to decision makers, their values and preferences, and the circumstances in which they are making the decisions. We will need a better understanding of the interaction among different groups of decision makers (that is, nurses and physicians, physicians and hospital managers, nurses and patients) in terms of their own information, values, and preferences in different contexts. Gaining this understanding will require different research approaches, input from multiple disciplines, and an enormous commitment at all levels.”

    On a final note, the common quasi-experiment- which people often reference as evidence- lacks the strength of a scientifically controlled true or quasi experiment. An example of this type of common experiment would be one in which the trainer advises the trainee to supplement with supplement x. Once the trainee starts the supplement regimen, he/she begins to feel better, get stronger, etc. After 8 weeks the trainee has experienced significant gains, thus the supplement must work. In reality, the trainer and trainee have no idea why or what were the causative factors contributing to the gains. This is not real evidence, and in fact with uncontrolled quasi studies such as this, virtually any type of intervention can be shown to cause positive results.

  28. Patrick N. permalink
    February 24, 2010

    Truly good stuff Jamie !

    Thanks,

    Patrick

  29. February 25, 2010

    ^^^Yup, what Patrick said.

  30. Eric permalink
    February 25, 2010

    People who do not understand research are more likely to qualify ANYTHING they read as “research”. I think it happens in other fields besides fitness as well.

  31. sameer permalink
    February 27, 2010

    Alan bro,

    I just finished reading your Jan 08 Issue and got lost here “There are other agents of lipogenesis such as acylation stimulating protein (ASP), which can facilitate fat storage in the absence of insulin”. Does this mean there are other factors to consider besides the energy balance for limiting fat storage (i.e., Is it possible to gain fat while at calorie deficit)?

    Can you please give a brief explanation of what you meant?

    Thanks

  32. February 28, 2010

    Sameer — My point was there there are various acute (short-term) lipogenic agents aside from insulin, which is actually a multifactorial anticatabolic (& contextually dependent anabolic) agent. Nevertheless, in a net deficit of energy over a period of weeks (or more), these various lipogenic and/or antilipolytic agents ultimately bow to the power of the energy deficit, and fat amd/or weight loss occurs – regardless of the physiological flux of these agents. For more on insulin & fat loss, see the Oct 2008 issue of AARR.

  33. Patrick N. permalink
    February 28, 2010

    Personally, I think weight loss is easy. It’s preventing obesity that seems more difficult. Is it because it is too easy to eat too many calories nowadays (perhaps because carbs are too easy to binge on) ? Is our metabolism really deregulated ? Is there something in our current diet that effects our satiety ? Perhaps a mix of all this ?

    This is what I am really interested in. Weight loss is the easy part, maintaining is more difficult. It looks like _preventing_ obesity would be easier than trying to fix it. But is it just a matter of not eating too much ? Or can we help ourselves, to not eat too much, simply by choosing specific food to this effect ?

    In my research so far, I found that there are some food stuff that really helps with satiety. Should we teach our children simply to not overeat or teach them to choose proper food to this effect? Maybe both. :)

    Patrick

  34. Sameer permalink
    February 28, 2010

    Thx Alan

  35. February 28, 2010

    Patrick — We should teach people which foods should predominate the diet & which should comprise minority of the diet. Most people alrteady know what healthy choices and not-so-healthy choices are. The key is gathering up some balls and doing what needs to be done consistently enough, while allowing some flexibility in your plan. This is the nutshell version of how dieters succeed long-term.

  36. March 1, 2010

    Alan-

    What can you tell me about trans fat?

    It seems that it is Girl Scout Cookie season again and my eyes are immediately drawn to the ingredient list of the Thin Mints and Samoas which contain the words “partially hydrogenated palm kernel and/or cottonseed oil, soybean, and palm oil.”
    http://www.girlscoutcookies.org/images/nutrition_info_2009_2010.jpg

    What do you think would be a safe amount (in grams) of hydrogenated oils in an average diet?
    What about conjugated linoleic acid from grass-fed beef, dairy, etc.?

    I’ve always been a little unfamiliar with trans fat. Bros always tell me that if I eat a donut I am guaranteed to die the next day due to the trans fats…but we all know that is not true.

    I know you will enlighten me.

  37. Teddy permalink
    March 1, 2010

    “I once read an interview with Taubes on T-mag. I was amazed at the misinformation being spewed forth. I have not read GCBC, but from every snippet of it I’ve some across, it sounds to me like he cherry-picks the research that fits his Gripping Story, instead of considering the entirety of the research, then drawing conclusions from there. I am not at all interested in fictional reading at this point in my life. I really wish I had time for it, but then I’d read more of the good stuff in the sci-fi genre. In the meantime, give this a read”

    I feel disappointed when I read reviews like this. GCBC main purpose was to dismantle the lipid hypothesis and show how much more refined carbohydrates contribute to disease of civilization than anything else. That is basically it. Yes, there are flaws with the book. He doesn’t mention every enzyme – he skips over ASP and leptin and he implies that a metabolic advantage exists. He doesn’t mention any of the heat created toxins created when cooking meat. But, these are all minor themes of the book. I am perplexed that people will globally label him as a fraud and a liar because of these details. The work he did was outstanding, even with the flaws. He got way more right than wrong.

  38. Matt permalink
    March 1, 2010

    @Teddy: I don’t think anyone here’s concerned with the stuff he got right. But then again, that also depends on what you define as “right.” His carbohydrate theory is batshit crazy, but he hit the nail on the head when dismantling the lipid hypothesis. (I have read the book, by the way.)

  39. March 2, 2010

    Teddy — I’ve heard several people say that Taubes does a good job of sticking it to the lipid hypothesis. Great. However, I would ask how much of the book is dedicated to the lipid hypothesis, and how much of it is dedicated to the carb/insulin/obesity nonsense, along with the “exercise doesn’t work” nonsense. Why would I be motivated to read a super-long book (by a journalist, not a scientist) that I might end up giving a C-grade to, at best?

    DB — The degree of worry over trans fat intake would depend on how much you plan on going off on those GS cookies. It’s virtually impossible to determine an exact threshold of grams of trans fat beyond which your health is significantly at risk. That said, it’s been postulated that TFA from industrial sources *may* be more risky than TFA from ruminant (meat/dairy) sources. My general advice for you would be to eat those GS cookies & enjoy them — but just don’t make them a major part of your daily diet. 2-3 cookies = no big deal. 2-3 packages of cookies = big deal. As for CLA, the amounts contained in ruminant foods are no biggie as long as you keep your sources relatively lean (for the most part).

  40. March 3, 2010

    Thanks Alan! :)

  41. Rourke D. permalink
    March 3, 2010

    “This *little bit of difference* does not lead to the problems Dr. Lustig talks about. The fact is, HFCS and sucrose are identical as far as your body is concerned.”

    Again, not to defend Dr. Lustig, but the above statement is a strawman. At no point in his lecture does Dr. Lustig draw a distinction between sucrose and HFCS. Indeed, he goes to great pains to show that they are metabolically identical. When he says, “they’re not the same,” he is unambiguously differentiating between the metabolism of fructose and glucose.

    Whether or not you agree with Dr. Lustig’s allegations and conclusions, misrepresenting his positions only damages your own credibility.

  42. March 4, 2010

    Rourke — You miss the point that Lustig takes fructose out of context when discussing effects on hormones that influence appetite. Many of his points would stand if he was talking about isolated fructose in large doses, but alas, speaking of sucrose (or similar) does not support the point of his that I went through great lengths to counter. Misreading my interpretation only damages your credibility…oh wait, I just relayed your own irrelevant point back to you. My bad.

  43. Colby permalink
    March 5, 2010

    One of the worst things about this is Lustig’s arrogant comment that “real scientists” don’t discuss publicly on blogs. Researchers have to learn to accept that these new forms of media are changing how information is disseminated. This is a great example of how a community of critical thinkers is an improvement over the sheltered status quo that most scientists still live in.

    Hopefully Lustig won’t let himself become reinforced in his perspective by an encounter like this.

  44. March 6, 2010

    Nano,

    AA,

    In the newest promotional video for the “MuscleTech Hardcore Pro Series” line of supplements, Branch Warren and Jonnie Jackson are shown in the lab with MuscleTech’s top chemist, none other than Mr. Issac McNano.

    Can you provide any insight as to what they may be discussing? I can only assume (and hope)that they are combining Branch and Jonnie’s real world supplement knowledge with Issac’s book-smarts, so that we can be blessed with some new, ground breaking supplements from MuscleTech!

    Thanks,
    -BC

  45. March 6, 2010

    Branch — Thanks for stopping in. The problem is, you leave a trail of nano vapor in your wake that lingers like memories of war.

  46. March 9, 2010

    My nano vapors are cryo blasted.

  47. Patrick N. permalink
    March 10, 2010

    Yep.

    Bray GA.

    “SUMMARY: The present review concludes on the basis of the data assembled here that in the amounts currently consumed, fructose is hazardous to the cardiometabolic health of many children, adolescents and adults.”

    Patrick

  48. Matt permalink
    March 11, 2010

    “…that in the amounts currently consumed, fructose is hazardous to the cardiometabolic health of many children, adolescents and adults.”

    Duh.

  49. March 11, 2010

    So Bray did a bunch of investigation and concluded that America consumes too much sugary beverages? The man’s a revolutionary.

  50. March 14, 2010

    Well, it also tells you that you don’t have to eat abnormal levels (= rats fed with >50E%) of fructose to get a screwed-up metabolism.

  51. Alan Aragon permalink
    March 18, 2010

    Mikael — this depends on dose & context, not sure if I’ve stressed that enough yet… :)

  52. Blake permalink
    March 18, 2010

    Should we really be surprised that (a) people are more than willing to believe that a certain macronutrient (rather than how many calories they consume) is responsible for all of our public health ailments, and that (b) there are people of all walks (with credentials, without credentials, etc) willing to feed them the dogmatic swill they are so desperately ready to devour?

    Keep in mind, we are a nation of folks who amass infinite credit card debt to buy things we don’t need/can’t afford, then we blame the companies who lent it to us for ‘swindling’ us. We take out ridiculous mortgages that simple math shows we can’t pay, then blame mortgage lenders who had the audacity to lend us the money when we default. Our supposed ‘smartest’ financial gurus lost billions on, essentially, a simple pyramid scam/ponzi scheme (Madoff) that basic logic, ultimately, exposed… We obviously like to live above our means and when the bill comes due, we find someone to blame for our circumstance because it couldn’t possibly be us, right? So why would anyone expect our national approach to food consumption be any different?

    Our nation obviously doesn’t like to count, or take personal responsibility. Telling people to budget their finances or count their calories elicits yawns from most of them. They know that taking responsibility would work, most likely, but secretly yearn for (or, worse, believe there is) a back door that would allow them to eschew the ‘rules’. Self-purported gurus or profit-driven companies emerge to pray on these self-delusions, teasing them with the idea that they can somehow ‘beat the system’ and skip the responsibility that monitoring intake/output requires. This gets them ‘excited’… learning that they can find a loophole that absolves them of responsibility. Baseless and obviously flawed mantras emerge: ‘Screw calories, just don’t eat carbs and you won’t get fat’, or ‘ZERO percent interest on balance transfers, because we want to help you get out of debt’.

    Why? Because we want to believe we are faultless. We don’t make bad food judgments… some company has merely ‘coerced’ us into making bad choices. We’re not fatter because we eat more… some company has hidden terrible ingredients in our food to make us WANT to eat more. We’re not broke because we have a house /car/wardrobe/lifestyle we can’t afford… some creditor has hidden secret clauses in their lending agreement meant to ‘screw’ us. It’s practically our national philosophy: We are faultless in all things!

    Alan is certainly knowledgeable about nutrition, excercise, biochemistry, etc… to be honest, though, any pursuer of logic and reason can deduce from the myriad of scientific evidence available that carbs/fructose, ALONE, haven’t made us fat and sick – neither have fats, carbs, proteins or any other sole factor. But our public problems would indicate that, by and large, we are not a nation of ‘logical’ thinkers – we simply want what we want, when we want it… and, since our own desires and decisions cannot be at fault for our fate, those who give us what we want MUST be.

    Our nation’s refusal to acknowledge our own implicitness in our circumstance cartainly hasn’t helped us in addressing our national issues (all issues, not just the ‘nutritional’ ones). And until we assume responsibility for our choices, ‘logic’ will be hard-pressed to enter into our national discourse on any public matter (economy, health, foreign policy, etc). We will be doomed, instead, to replace ‘logic’ with ‘blame’ , and will, thus, continue to be inundated with swill from those who would demonize carbs, fructose, government, business, and (ultimately) all forms of common sense.

    Until then, I will continue to find my logic here (and sites like Lyle’s, Martin’s, etc)…

    Great site, Alan!

  53. March 19, 2010

    Blake — Thanks for the commentary. Where can I read more of your stuff?

  54. Blake permalink
    March 20, 2010

    Thank YOU for the blog, Alan. I don’t have one of my own yet… since my expertise is in political studies, about the only writing I usually do is ultra-boring academic-type stuff. I have written a thesis that might manage to put even the most ardent academics to sleep. Perhaps I could create a blog for narcoleptics… :-)

    Given my background, I am used to seeing irrational arguments come from folks with advanced degrees – the majority of our politicians are well educated folks, but the nature of their profession is to create consensus among voters so that they can get elected/employed. That means I am used to watching otherwise rational men make irrational arguments to play upon the fears/hopes/beliefs of voters…

    As far as my interest in the science of nutrition and fitness, I’m really just a recovering alarmist myself. I was a ‘meal timing’ alarmist who swallowed the supplement company dogma that missing a meal/pill/workout every now and then would lead to fat gain/muscle loss/failure/fitness oblivion/etc. Don’t get me wrong, the strategy ‘worked’ for years – but, for looking so great, I sure was miserable. Then, I started seeking alternative methods to achieve results/fitness happiness, found Lyle McDonald’s writings, which led me to Matrin Berkhan’s site, which led me to yours. And, finally, I realized that all of the crap I had been swallowing was drivel circulated by supplement companies to get me to buy their products. Even a supposedly ‘educated’ guy like me was capable of irrationality in the face of his own ignorance (in this case, my ignorance was a lack of knowledge about the actual science of human performance). My eyes were opened…

    So I have followed all of your sites regularly for some time and have never felt compelled to comment on any of them before – even in the face of the compelling debates that often go on. I usually just don’t feel I have NEAR enough knowledge to add much to the debate that isn’t already being contributed. But reading the discussion where you calmly and rationally responded to a supposed ‘scientist’ (as though people with advanced degrees aren’t capable of being poor logicians) while he basically refused to accept your references to ‘updated’ (i.e. more recent than 30 year old) data/studies, and, ultimately, reverted to the always popular argument that most parents use on their children (“because I said so”) reminded me of watching the recent political debates in our country… and made me angry. Watching a familiar scenario from my studied field play out on a site like yours that devotes itself to unbiased research review reminded me that NOTHING is exempt from the ‘political’ anymore… because human psychology applies to all modes of our understanding.

    I know how this works (in theory, at least) in the political arena – so I felt I might be able to illustrate an analogous point to remind your readers that this ‘scientist’s’ argument has plenty of precedent… our politicians do it every day, so we shouldn’t be surprised to see it from the ‘good doctor’. Further, we shouldn’t be surprised when it works (i.e. gets a ton of YouTube hits). After all, we are the country that made Brittany Spears a billionaire… so we obviously love to swallow the otherwise unpalatable :-)

    Again, thank you for sharing your knowledge, and providing a forum where reason still has merit. It is a welcome respite from that with which I deal everyday!

  55. March 23, 2010

    My aversion to HFCS is more of the practical sort and admittedly extremely unscientific. It tastes horrible, and it prevents proper gelling activity when boiling pectin-based fruits.

    Is there any explanation as to why drinks containing HFCS burn my throat while drinks with equivalent amounts of sucrose don’t?

  56. March 29, 2010

    Hi Alan,

    I asked:

    Alan,
    For me the issue is not about obesity or HFCS vs. Sugar and calories. What I found interesting in Dr. Lustig’s presentation was the metabolism of fructose by the liver and the by-products ( Triglycerides and vLDL ). As an adult onset type II diabetic, when my ability to control blood sugar was impared ( through lack of diet and exercise) my triglycerides and LDL numbers were high. Having gotten my A1C number down to about 5.1 my triglyceride and LDL numbers came into line ( dramatically so).
    Any thoughts on this portion of Dr. Lustig’s presentation?

    You said in response:

    Alex — This is yet another fairly grey area that seems to be solved by simple moderation. I’ll quote the section of a paper that touches upon this: Glycated hemoglobin (HbA1c) rises as a result of nonenzymatic modification of hemoglobin by glucose and is a strong risk factor for diabetic complications (especially retinopathy, peripheral vascular disease, and death) (20) and for CHD in nondiabetics (21). Several intervention studies in diabetics and nondiabetics show fructose to markedly lower HbA1c (22–27). Metaregression analysis confirms this as a fructose dose-dependent effect (10) (Fig. 1 A). Neither energy nor macronutrient intakes were confounding factors, but there is still need for studies on the progression of disease over very long durations. A fall in HbA1c caused by moderate to high fructose intake is not entirely expected. A rise in HbA1c would occur should insulin sensitivity be impaired. On the other hand, glycemic control more reflects a relative impairment of pancreatic function; meanwhile, fructose, which is low glycemic, makes little demand on the pancreas.” http://www.ncbi.nlm.nih.gov/pubmed/19386821

    We agree on:

    “The big picture solution is in managing total caloric balance with a predominance of minimally refined foods and sufficient physical activity.”

    But, I don’t think you answered my question. So, permit me to ask again…

    Let me start by saying I make ( and neither does Lustig ) *NO* distinction between the health value of table sugar vs. HFCS. I had to watch his presentation 3 times to understand that he was vilifying all sugar ( except that which comes naturally in raw fruits and vegetables ) and not just HFCS. Afterall, there is almost no difference in terms of glucose/fructose ratios between the two…

    As I understand it, the reason fructose doesn’t really impact HbA1C is precisely because it is metabolized entirely by the liver. To greatly simplify the situation: When too much fructose enters the liver, the liver can’t process it all fast enough for the body to use as sugar. Instead, it starts making fats from the fructose and sending them off into the bloodstream as triglycerides (& vLDLs).

    In my mind, this is potentially bad for at least three reasons:

    1) High blood triglycerides are a risk factor for heart disease.

    2) Fructose ends up circumventing the normal appetite signaling system, so appetite-regulating hormones aren’t triggered–and you’re left feeling unsatisfied. This is probably at least part of the reason why excess fructose consumption is associated with weight gain.

    3) There is some evidence that excess fructose (and I mean from sources like sugar(sucrose) & HFCS) consumption may facilitate insulin resistance, and eventually type 2 diabetes.

    Do I have this wrong? Does this clarify why I think we should pay a good deal of attention to what Dr. Lustig is saying?

  57. March 29, 2010

    Consider these charts:

    When reduced the amount of sugar in my diet, and increased my exercise levels, I saw dramatic change in my lipid profile ( in 30 days mind you ).

  58. Rod permalink
    March 29, 2010

    Alan

    Just discovered this site more or less by accident (in Australia) – spent some days at a medical conference last week where several sessions were about obesity.

    Yes, everyone always wants the “magic bullet” solution. I am fascinated by the obesity epidemic (Australia is just a little behind the USA). I remember in 1998 watching some archival TV footage on the 30th anniversary of RFK’s death – the “funeral” train’s passage was lined by thousands of people – and they were SO MUCH THINNER than Americans “today” (ie 1998) it was stunning.

  59. Hugo permalink
    March 30, 2010

    Both Dr. Lustig’s lecture and Alan’s review are educational, to be sure. However, I get the feeling that most people are getting caught up in minutia and fail to recognize what to me seems to be the real issue.

    The real problem driving excessive consumption seems to be food choice. For example, I assume that the higher consumption of juices goes in hand with lower consumption of fruits and vegetables.

    First, juices are more convenient (opening a carton instead of peeling and orange) and easier to consume (drinking instead of chewing and spitting out seeds). This may lead to higher caloric consumption of a fruit juice than the fruit itself.

    Second, fruits and veggies have a higher fiber content than their respective juices. Fiber is a satiating nutrient.

    Another example may be excessive consumption of highly caloric, sugar filled sauces.

    Therefore, I believe that good food choices are probably a natural prevention, so to speak, of excessive involuntary caloric intake. Eat more fibrous foods, drop the soda, etc., and caloric intake will surely drop.

    I had a friend that would have a 2 liter coke bottle next to bed in case he woke up thirsty! That plus all the soda he had throughout the day. He recently dropped the soda, and is now ~10-15lbs lighter.

    Add poor food choice with a sedentary lifestyle from a young age, and you have a plausible explanation for the increasing obesity and diabetes occurrences in both adults and youths.

    So, processed sugars probably do have negative effects on your health and should be kept to a minimum, but it is a volume issue as many have stated. And this volume problem seems to be driven by the greater issue at hand, which is food choices.

    To end this post I will admit that I can in no way back my conclusion. Perhaps someone else can. I base my assumptions on observed behaviors of people I know in addition to some common sense.

  60. Rod permalink
    March 31, 2010

    Last year when taking 3rd year medical students for tutes I asked each group to “solve the obesity crisis” in one week between tutes. I was hoping for a “George Dantzig” moment [http://www.snopes.com/college/homework/unsolvable.asp] but sadly, and I suppose unsurprisingly, they never managed it. I told them if they had I would have ackowledged them in the footnotes of my award-winning papers!

    Lustig and others may be on to something, but if it were that easy, it would also be easily solved, and the “solver” would be a multi-millionaire. Again I tell my students that if they had any program that delivered long-term weight loss in over 50% of people who signed up for it, then people would be coming from around the world to see them.

    With regard to high-fructose corn syrup, it is barely used here in Australia but we have nearly the same obesity problems as the USA. And yes, I know we eat more sucrose in Australia, but the “uniqueness” of the HFCS argument can’t hold here as the sole explanation of obesity.

    Last week I was at the World Congress of Internal Medicine in Melbourne, Australia and there were a few sessions on obesity. Japan is interesting – the BMI’s for men have gone up slowly over the last 30 years or so (but much less than other Western countries), while for women they have remained fairly stationary overall, and have actually FALLEN for women under 40 years of age. And of course people of Japanese descent in Hawaii and South America tend to have the BMI’s of the locals, not of their Japanese forebears.

  61. April 2, 2010

    Rod — Good points made, and I agree with much of them. However, the idea of “dropping” a particular food implies strict abstinence, and in many cases, this is not a realistic nor optimal solution. Decrease? Sure. Drop? Not necessarily. I’d refer you back to this post regarding flexible vs inflexible dieting: http://www.alanaragonblog.com/2010/01/29/the-bitter-truth-about-fructose-alarmism/#comment-1182

  62. April 2, 2010

    Alex,

    I’d direct you again to the importance of dose & context. But first off, there is no solid evidence that fructose avoidance will benefit diabetics. What we can solidly conclude is that a reduction in overall carbohydrate intake can benefit certain diabetic circumstances. Further, the detriment or neutrality of fructose (particularly with regards to TG production) would be largely dependent upon chronic energy balance. In a nutshell, if someone is chronically hypercaloric, then liver glycogen would tend to be topped off more often, and thus TG production would occur to a greater extent. In the event of a chronic energy deficit, fructose intake would have a tendency to be directed towards gluconeogenesis. Allow me to direct you to this review indicating that a TG-raising effect in those with type-2 diabetes occurs above a threshold of 60g fructose: http://www.ncbi.nlm.nih.gov/pubmed/19592634

    “A dose threshold for the effect of fructose on TG was observed in type 2 diabetes. Only at fructose doses greater than the CDA threshold of >60 g/day (>12% energy for a 2,000-kcal diet) (5) was a TG-raising effect observed in subgroup analyses. This threshold is consistent with the 100 g/day identified across different clinical states (7) and findings from hypercaloric feeding trials with fructose intakes at 25% excess energy in healthy humans, the only trials in which a TG-raising effect has been observed reliably (29,30,32–35). Although our threshold is lower than these estimates, it is higher than the estimated U.S. intake of total fructose of 9.1% energy (45.5 g/day for a 2,000-kcal diet) (8). The inability of low doses to stimulate a quantitatively meaningful DNL response may explain this threshold”

    Bottom line: I’d rather support scientific thought than alarmist whistle-blowing.

  63. Some Guy permalink
    April 3, 2010

    Mr. Aragon, thoughts on the following?

    http://www.ncbi.nlm.nih.gov/pubmed/20219526

    It’s just the abstract, but in release (below) they mentioned the “free-floating” nature of the fructose and glucose in HFCS rather than what is found in cane or beet sugar. Would you consider that to be an essential?

    http://www.princeton.edu/main/news/archive/S26/91/22K07/index.xml?section=topstories

    Enjoy your site.

  64. April 4, 2010

    Some Guy — Rodent response to fructose is vastly different than human response to fructose. I’m currently writing a paper on this very subject. The differences are, well, big.

  65. April 21, 2010

    James Krieger stated that, “The only practical difference between sucrose and HFCS is in the bonding. The glucose & fructose in HFCS is mainly free and unbonded, while it is bonded in sucrose. However, this makes no *meaningful* difference in regards to metabolism in the body. The bonds in sucrose are quickly broken when sucrose hits the acid environment of the stomach.”

    So, according to Krieger, the enzyme sucrase, which secreted by the tips of the villi of the epithelium in the small intestine, is not actually needed to catalyze the hydrolysis of sucrose to fructose and glucose. So what chemical action in the stomach gets the job done?

  66. April 21, 2010

    David,

    Acid can catalyze the hydrolysis of sucrose.

  67. April 21, 2010

    James,

    You say stomach acid catalyzes the cleavage of sucrose. This article [http://en.wikipedia.org/wiki/Fructose] says, “Free fructose is absorbed directly by the intestine; however, when fructose is consumed in the form of sucrose, digestion occurs entirely in the upper small intestine.” I’m interested in the truth. Is there research to support your assertion?

  68. April 21, 2010

    David,

    Research as far back as 1921 showed that sucrose hydrolysis does occur in the stomach.

    http://ajplegacy.physiology.org/cgi/pdf_extract/59/1/413

    Now, the extent of sucrose hydrolysis in the stomach is low. It is also dependent upon the amount of time that the sucrose is present in the stomach. The percent hydrolysis will be low when sucrose is consumed on an empty stomach, as the sucrose will not remain present in the stomach long enough for extensive hydrolysis to occur. The majority will be hydrolyzed by sucrase in the small intestine.

    With a mixed meal, sucrose will stay present in the stomach much longer, giving much more time for acid hydrolysis in the stomach.

    Even if most sucrose is hydrolyzed in the intestine, it makes no difference when compared to HFCS. It’s been shown that the rate of intestinal glucose and fructose absorption, when in free form, is identical to the rate of intestinal glucose and fructose absorption when ingested as sucrose:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC292710/pdf/jcinvest00261-0118.pdf

  69. SED permalink
    June 9, 2010

    Alan,

    Love, love, love this post and the thought-provoking comments. I am not an M.D., biochemist, or nutritionist — but as a layperson, I’d like to point out that anyone who wants to observe the effects of a diet very rich in unbound dietary fructose on primates, as opposed to rodents, can just visit their local zoo or turn on the Discovery Channel. The clinical trial period for unbound dietary fructose consumption among primates has been going on for several million years at least. (While the distinction between fresh fruit and refined sweeteners is obvious to most, as are dose and context, it seems not to be in much of the writing I’ve seen lately demonizing poor, defenseless monosaccharides.)

    Alan, thanks for the great blog and I can’t wait to read your forthcoming paper comparing rodent and human data.

  70. June 9, 2010

    SED — Thanks for the feedback, glad you liked the melee. As for my article comparing humans & rats, that was done a couple of issues ago in AARR.

  71. Leonardo permalink
    July 10, 2010

    This Addictive Commonly Used Food Feeds Cancer Cells, Triggers Weight Gain, and Promotes Premature Aging

    Death by sugar may not be an overstatement—evidence is mounting that sugar is THE MAJOR FACTOR causing obesity and chronic disease.

    Is sugar a sweet old friend that is secretly plotting your demise?

    There is a vast sea of research suggesting that it is. Science has now shown us, beyond any shadow of a doubt, that sugar in your food, in all its myriad of forms, is taking a devastating toll on your health.

    The single largest source of calories for Americans comes from sugar—specifically high fructose corn syrup. Just take a look at the sugar consumption trends of the past 300 years:[1]

    * In 1700, the average person consumed about 4 pounds of sugar per year.
    * In 1800, the average person consumed about 18 pounds of sugar per year.
    * In 1900, individual consumption had risen to 90 pounds of sugar per year.
    * In 2009, more than 50 percent of all Americans consume one-half pound of sugar PER DAY—translating to a whopping 180 pounds of sugar per year!

    Sugar is loaded into your soft drinks, fruit juices, sports drinks, and hidden in almost all processed foods—from bologna to pretzels to Worcestershire sauce to cheese spread. And now most infant formula has the sugar equivalent of one can of Coca-Cola, so babies are being metabolically poisoned from day one if taking formula.

    No wonder there is an obesity epidemic in this country.

    Today, 32 percent of Americans are obese and an additional one-third are overweight. Compare that to 1890, when a survey of white males in their fifties revealed an obesity rate of just 3.4 percent. In 1975, the obesity rate in America had reached 15 percent, and since then it has doubled.

    Carrying excess weight increases your risk for deadly conditions such as heart disease, kidney disease and diabetes.

    In 1893, there were fewer than three cases of diabetes per 100,000 people in the United States. Today, diabetes strikes almost 8,000 out of every 100,000 people.[1]

    You don’t have to be a physician or a scientist to notice America’s expanding waistline. All you have to do is stroll through a shopping mall or a schoolyard, or perhaps glance in the mirror.

    Sugars 101 — Basics of How to Avoid Confusion on this Important Topic

    Sucrose

    It is easy to become confused by the various sugars and sweeteners. So here is a basic overview:

    * Dextrose, fructose and glucose are all monosaccharides, known as simple sugars. The primary difference between them is how your body metabolizes them. Glucose and dextrose are essentially the same sugar. However, food manufacturers usually use the term “dextrose” in their ingredient list.
    * The simple sugars can combine to form more complex sugars, like the disaccharide sucrose (table sugar), which is half glucose and half fructose.
    * High fructose corn syrup (HFCS) is 55 percent fructose and 45 percent glucose.
    * Ethanol (drinking alcohol) is not a sugar, although beer and wine contain residual sugars and starches, in addition to alcohol.
    * Sugar alcohols like xylitol, glycerol, sorbitol, maltitol, mannitol, and erythritol are neither sugars nor alcohols but are becoming increasingly popular as sweeteners. They are incompletely absorbed from your small intestine, for the most part, so they provide fewer calories than sugar but often cause problems with bloating, diarrhea and flatulence.
    * Sucralose (Splenda) is NOT a sugar, despite its sugar-like name and deceptive marketing slogan, “made from sugar.” It’s a chlorinated artificial sweetener in line with aspartame and saccharin, with detrimental health effects to match.
    * Agave syrup, falsely advertised as “natural,” is typically HIGHLY processed and is usually 80 percent fructose. The end product does not even remotely resemble the original agave plant.
    * Honey is about 53 percent fructose[2], but is completely natural in its raw form and has many health benefits when used in moderation, including as many antioxidants as spinach.
    * Stevia is a highly sweet herb derived from the leaf of the South American stevia plant, which is completely safe (in its natural form). Lo han (or luohanguo) is another natural sweetener, but derived from a fruit.

    All Sugars are Not Equal

    Glucose is the form of energy you were designed to run on. Every cell in your body, every bacterium—and in fact, every living thing on the Earth—uses glucose for energy.

    But as a country, sucrose is no longer the sugar of choice. It’s now fructose.

    If your diet was like that of people a century ago, you’d consume about 15 grams per day—a far cry from the 73 grams per day the typical person gets from sweetened drinks. In vegetables and fruits, it’s mixed in with vitamins, minerals, enzymes, and beneficial phytonutrients, all which moderate the negative metabolic effects. Amazingly, 25 percent of people actually consume more than 130 grams of fructose per day.

    Making matters worse, all of the fiber has been removed from processed foods, so there is essentially no nutritive value at all. And the very products most people rely on to lose weight—the low-fat diet foods—are often the ones highest in fructose.

    It isn’t that fructose itself is bad—it is the MASSIVE DOSES you’re exposed to that make it dangerous.

    There are two overall reasons fructose is so damaging:

    1. Your body metabolizes fructose in a much different way than glucose. The entire burden of metabolizing fructose falls on your liver.
    2. People are consuming fructose in enormous quantities, which has made the negative effects much more profound.

    The explosion of soda consumption is the major cause of this.

    Today, 55 percent of sweeteners used in food and beverage manufacturing are made from corn, and the number one source of calories in America is soda, in the form of high fructose corn syrup.

    Food and beverage manufacturers began switching their sweeteners from sucrose to corn syrup in the 1970s when they discovered that HFCS was not only far cheaper to make, it’s about 20 percent sweeter than conventional table sugar that has sucrose.

    HFCS contains the same two sugars as sucrose but is more metabolically risky to you, due to its chemical form.

    The fructose and the glucose are not bound together in HFCS, as they are in table sugar, so your body doesn’t have to break it down. Therefore, the fructose is absorbed immediately, going straight to your liver.

    Too Much Fructose Creates a Metabolic Disaster in Your Body

    Dr. Robert Lustig, Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco, has been a pioneer in decoding sugar metabolism. His work has highlighted some major differences in how different sugars are broken down and used by the human body.

    I highly recommend watching Lustig’s lecture in its entirety if you want to learn how fructose is ruining your health biochemically.

    As I mentioned earlier, after eating fructose, most of the metabolic burden rests on your liver. This is NOT the case with glucose, of which your liver breaks down only 20 percent. Nearly every cell in your body utilizes glucose, so it’s normally “burned up” immediately after consumption.

    So where does all of this fructose go, once you consume it?

    Onto your thighs. It is turned into FAT (VLDL and triglycerides), which means more fat deposits throughout your body.

    Eating Fructose is Far Worse than Eating Fat

    However, the physiological problems of fructose metabolism extend well beyond a couple of pant sizes:

    * Fructose elevates uric acid, which decreases nitric oxide, raises angiotensin, and causes your smooth muscle cells to contract, thereby raising your blood pressure and potentially damaging your kidneys.[1]

    Increased uric acid also leads to chronic, low-level inflammation, which has far-reaching consequences for your health. For example, chronically inflamed blood vessels lead to heart attacks and strokes; also, a good deal of evidence exists that some cancers are caused by chronic inflammation. (See the next section for more about uric acid.)
    * Fructose tricks your body into gaining weight by fooling your metabolism—it turns off your body’s appetite-control system. Fructose does not appropriately stimulate insulin, which in turn does not suppress ghrelin (the “hunger hormone”) and doesn’t stimulate leptin (the “satiety hormone”), which together result in your eating more and developing insulin resistance.[3] [4]
    * Fructose rapidly leads to weight gain and abdominal obesity (“beer belly”), decreased HDL, increased LDL, elevated triglycerides, elevated blood sugar, and high blood pressure—i.e., classic metabolic syndrome.
    * Fructose metabolism is very similar to ethanol metabolism, which has a multitude of toxic effects, including NAFLD (non-alcoholic fatty liver disease). It’s alcohol without the buzz.

    These changes are not seen when humans or animals eat starch (or glucose), suggesting that fructose is a “bad carbohydrate” when consumed in excess of 25 grams per day. It is probably the one factor responsible for the partial success of many “low-carb” diets.

    One of the more recent findings that surprised researchers is that glucose actually accelerates fructose absorption, making the potential health risks from HFCS even more profound.[1]

    You can now see why fructose is the number one contributing factor to the current obesity epidemic.

    Is Uric Acid the New Cholesterol?

    By now you are probably aware of the childhood obesity epidemic in America—but did you know about childhood hypertension?

    Until recently, children were rarely diagnosed with high blood pressure, and when they were, it was usually due to a tumor or a vascular kidney disease.

    In 2004, a study showed hypertension among children is four times higher than predicted: 4.5 percent of American children have high blood pressure. Among overweight children, the rate is 10 percent. It is thought that obesity is to blame for about 50 percent of hypertension cases in adolescents today.[1]

    Even more startling is that 90 percent of adolescents who have high blood pressure have elevated uric acid levels.

    This has led researchers to ask, what does uric acid have to do with obesity and high blood pressure?

    In his book, The Sugar Fix: The High-Fructose Fallout That is Making You Fat and Sick, Dr. Robert J. Johnson makes a compelling argument for a previously unrecognized connection between excess sugar consumption and high uric acid levels. However, he promotes artificial sweeteners as an alternative to sugar and makes other recommendations that I don’t agree with.

    Dr. Johnson is a conventional physician who has not accepted large parts of natural medicine, however, he is one of the leading researchers defining the extent of fructose toxicity. He has spent many years of his life dedicating himself to uncover this mystery.

    There are more than 3,500 articles to date showing a strong relationship between uric acid and obesity, heart disease, hypertension, stroke, kidney disease, and other conditions. In fact, a number of studies have confirmed that people with elevated serum uric acid are at risk for high blood pressure, even if they otherwise appear to be perfectly healthy.

    Uric acid levels among Americans have risen significantly since the early half of the 20th Century. In the 1920s, average uric acid levels were about 3.5 ml/dl. By 1980, average uric acid levels had climbed into the range of 6.0 to 6.5 ml/dl and are probably much higher now.

    How Does Your Body Produce Uric Acid?

    It’s a byproduct of cellular breakdown. As cells die off, DNA and RNA degrade into chemicals called purines. Purines are further broken down into uric acid.

    Fructose increases uric acid through a complex process that causes cells to burn up their ATP rapidly, leading to “cell shock” and increased cell death. After eating excessive amounts of fructose, cells become starved of energy and enter a state of shock, just as if they have lost their blood supply. Massive cellular die-off leads to increased uric acid levels.

    And cells that are depleted of energy become inflamed and more susceptible to damage from oxidative stress. Fat cells actually become “sickly,” bloating up with excessive amounts of fat.

    There is a simple, inexpensive blood test for determining your uric acid level, which I recommend you have done as part of your routine health checkups. Your level should be between 3.0 and 5.5 mg/dl, optimally.

    There is little doubt in my mind that your uric acid level is a more potent predictor of cardiovascular and overall health than your total cholesterol level is. Yet virtually no one is screening for this.

    Now that you know the truth you don’t have to be left out in the cold, as this is a simple and relatively inexpensive test that you can get at any doctor’s office. Odds are very good your doctor is clueless about the significance of elevated uric acid levels, so it will not likely be productive to engage in a discussion with him unless he is truly an open-minded truth seeker.

    Merely get your uric acid level, and if it is over 5 then eliminate as much fructose as you can (also eliminate all beer), and retest your level in a few weeks.

    Sugar Sensitization Makes the Problem Even WORSE!

    There is yet another problem with sugar—a self-perpetuating one.

    According to Dr. Johnson1, sugar activates its own pathways in your body—those metabolic pathways become “upregulated.” In other words, the more sugar you eat, the more effective your body is in absorbing it; and the more you absorb, the more damage you’ll do.

    You become “sensitized” to sugar as time goes by, and more sensitive to its toxic effects as well.

    The flip side is, when people are given even a brief sugar holiday, sugar sensitization rapidly decreases and those metabolic pathways become “downregulated.” Research tells us that even two weeks without consuming sugar will cause your body to be less reactive to it.

    Try it for yourself! Take a two-week sugar sabbatical and see how different you feel.

    Are Fruits Good or Bad for You?

    Keep in mind that fruits also contain fructose, although an ameliorating factor is that whole fruits also contain vitamins and other antioxidants that reduce the hazardous effects of fructose.

    Juices, on the other hand, are nearly as detrimental as soda, because a glass of juice is loaded with fructose, and a lot of the antioxidants are lost.

    It is important to remember that fructose alone isn’t evil as fruits are certainly beneficial. But when you consume high levels of fructose it will absolutely devastate your biochemistry and physiology. Remember the AVERAGE fructose dose is 70 grams per day which exceeds the recommend limit by 300 percent.

    So please BE CAREFUL with your fruit consumption. You simply MUST understand that because HFCS is so darn cheap, it is added to virtually every processed food. Even if you consumed no soda or fruit, it is very easy to exceed 25 grams of hidden fructose in your diet.

    If you are a raw food advocate, have a pristine diet, and exercise very well, then you could be the exception that could exceed this limit and stay healthy.

    Dr. Johnson has a handy chart, included below, which you can use to estimate how much fructose you’re getting in your diet. Remember, you are also likely getting additional fructose if you consume any packaged foods at all, since it is hidden in nearly all of them.
    Fruit Serving Size Grams of Fructose
    Limes 1 medium 0
    Lemons 1 medium 0.6
    Cranberries 1 cup 0.7
    Passion fruit 1 medium 0.9
    Prune 1 medium 1.2
    Apricot 1 medium 1.3
    Guava 2 medium 2.2
    Date (Deglet Noor style) 1 medium 2.6
    Cantaloupe 1/8 of med. melon 2.8
    Raspberries 1 cup 3.0
    Clementine 1 medium 3.4
    Kiwifruit 1 medium 3.4
    Blackberries 1 cup 3.5
    Star fruit 1 medium 3.6
    Cherries, sweet 10 3.8
    Strawberries 1 cup 3.8
    Cherries, sour 1 cup 4.0
    Pineapple 1 slice
    (3.5″ x .75″) 4.0
    Grapefruit, pink or red 1/2 medium 4.3

    Fruit Serving Size Grams of Fructose
    Boysenberries 1 cup 4.6
    Tangerine/mandarin orange 1 medium 4.8
    Nectarine 1 medium 5.4
    Peach 1 medium 5.9
    Orange (navel) 1 medium 6.1
    Papaya 1/2 medium 6.3
    Honeydew 1/8 of med. melon 6.7
    Banana 1 medium 7.1
    Blueberries 1 cup 7.4
    Date (Medjool) 1 medium 7.7
    Apple (composite) 1 medium 9.5
    Persimmon 1 medium 10.6
    Watermelon 1/16 med. melon 11.3
    Pear 1 medium 11.8
    Raisins 1/4 cup 12.3
    Grapes, seedless (green or red) 1 cup 12.4
    Mango 1/2 medium 16.2
    Apricots, dried 1 cup 16.4
    Figs, dried 1 cup 23.0

    In addition to limiting your intake of fructose, you should eliminate all sweetened beverages and fruit juices (including all artificial sweeteners) and drink only pure water and raw milk.

    You can buy pure glucose (dextrose) as a sweetener for about $1 a pound. It is only 70% as sweet as sucrose, so you’ll end up using a bit more of it for the same amount of sweetness, making it slightly more expensive than sucrose—but still well worth it for your health as it has ZERO grams of fructose.

    Remember that glucose can be used directly by every cell in your body and as such is far safer than the metabolic poison fructose.

    Beer is also a good beverage to AVOID since it increases uric acid levels, just like fructose does, resulting in many of the same toxic effects.

    All alcoholic beverages cause you to produce excess uric acid (and block your kidneys from excreting it), but beer seems to have a more pronounced effect on uric acid levels because it’s a rich source of guanosine, the type of purine that is most readily absorbed by the body.1

    76 Additional Ways Sugar Can Ruin Your Health

    In addition to throwing off your body’s homeostasis and wreaking havoc on your metabolic processes, excess sugar has a number of other significant consequences.

    Nancy Appleton, PhD, author of the book Lick the Sugar Habit[5], contributed an extensive list of the many ways sugar can ruin your health from a vast number of medical journals and other scientific publications.

    1. Sugar can suppress your immune system and impair your defenses against infectious disease.[6] [7]
    2. Sugar upsets the mineral relationships in your body: causes chromium and copper deficiencies and interferes with absorption of calcium and magnesium.[8] [9] [10] [11]
    3. Sugar can cause a rapid rise of adrenaline, hyperactivity, anxiety, difficulty concentrating, and crankiness in children.[12] [13]
    4. Sugar can produce a significant rise in total cholesterol, triglycerides and bad cholesterol and a decrease in good cholesterol.[14] [15] [16] [17]
    5. Sugar causes a loss of tissue elasticity and function.[18]
    6. Sugar feeds cancer cells and has been connected with the development of cancer of the breast, ovaries, prostate, rectum, pancreas, biliary tract, lung, gallbladder and stomach.[19] [20] [21] [22] [23] [24] [25]
    7. Sugar can increase fasting levels of glucose and can cause reactive hypoglycemia.[26] [27]
    8. Sugar can weaken eyesight.[28] 1
    9. Sugar can cause many problems with the gastrointestinal tract including: an acidic digestive tract, indigestion, malabsorption in patients with functional bowel disease, increased risk of Crohn’s disease, and ulcerative colitis.[29] [30] [31] [32] [33]
    10. Sugar can cause premature aging.[34] In fact, the single most important factor that accelerates aging is insulin, which is triggered by sugar. 1
    11. Sugar can lead to alcoholism.[35]
    12. Sugar can cause your saliva to become acidic, tooth decay, and periodontal disease.[36] [37] [38]
    13. Sugar contributes to obesity. [39] 1
    14. Sugar can cause autoimmune diseases such as: arthritis, asthma, and multiple sclerosis.[40] [41] [42]
    15. Sugar greatly assists the uncontrolled growth of Candida Albicans (yeast infections) [43]
    16. Sugar can cause gallstones.[44]
    17. Sugar can cause appendicitis.[45]
    18. Sugar can cause hemorrhoids.[46]
    19. Sugar can cause varicose veins.[47]
    20. Sugar can elevate glucose and insulin responses in oral contraceptive users.[48]
    21. Sugar can contribute to osteoporosis.[49]
    22. Sugar can cause a decrease in your insulin sensitivity thereby causing an abnormally high insulin levels and eventually diabetes.[50] [51] [52]
    23. Sugar can lower your Vitamin E levels.[53]
    24. Sugar can increase your systolic blood pressure.[54]
    25. Sugar can cause drowsiness and decreased activity in children.[55]
    26. High sugar intake increases advanced glycation end products (AGEs),which are sugar molecules that attach to and damage proteins in your body. AGEs speed up the aging of cells, which may contribute to a variety of chronic and fatal diseases. [56] 1
    27. Sugar can interfere with your absorption of protein.[57]
    28. Sugar causes food allergies.[58]
    29. Sugar can cause toxemia during pregnancy.[59]
    30. Sugar can contribute to eczema in children.[60]
    31. Sugar can cause atherosclerosis and cardiovascular disease.[61] [62]
    32. Sugar can impair the structure of your DNA.[63]
    33. Sugar can change the structure of protein and cause a permanent alteration of the way the proteins act in your body.[64] [65]
    34. Sugar can make your skin age by changing the structure of collagen.[66]
    35. Sugar can cause cataracts and nearsightedness.[67] [68]
    36. Sugar can cause emphysema.[69]
    37. High sugar intake can impair the physiological homeostasis of many systems in your body.[70]
    38. Sugar lowers the ability of enzymes to function.[71]
    39. Sugar intake is higher in people with Parkinson’s disease.[72]
    40. Sugar can increase the size of your liver by making your liver cells divide, and it can increase the amount of fat in your liver, leading to fatty liver disease.[73] [74]
    41. Sugar can increase kidney size and produce pathological changes in the kidney such as the formation of kidney stones.[75] [76] Fructose is helping to drive up rates of kidney disease. 1
    42. Sugar can damage your pancreas.[77]
    43. Sugar can increase your body’s fluid retention.[78]
    44. Sugar is enemy #1 of your bowel movement.[79]
    45. Sugar can compromise the lining of your capillaries.[80]
    46. Sugar can make your tendons more brittle.[81]
    47. Sugar can cause headaches, including migraines.[82]
    48. Sugar can reduce the learning capacity, adversely affect your children’s grades and cause learning disorders.[83] [84]
    49. Sugar can cause an increase in delta, alpha, and theta brain waves, which can alter your ability to think clearly.[85]
    50. Sugar can cause depression.[86]
    51. Sugar can increase your risk of gout.[87]
    52. Sugar can increase your risk of Alzheimer’s disease.[88] MRI studies show that adults 60 and older who have high uric acid are four to five times more likely to have vascular dementia, the second most common form of dementia after Alzheimer’s.1
    53. Sugar can cause hormonal imbalances such as: increasing estrogen in men, exacerbating PMS, and decreasing growth hormone.[89] [90] [91] [92]
    54. Sugar can lead to dizziness.[93]
    55. Diets high in sugar will increase free radicals and oxidative stress.[94]
    56. A high sucrose diet of subjects with peripheral vascular disease significantly increases platelet adhesion.[95]
    57. High sugar consumption by pregnant adolescents can lead to a substantial decrease in gestation duration and is associated with a twofold-increased risk for delivering a small-for-gestational-age (SGA) infant.[96] [97]
    58. Sugar is an addictive substance.[98]
    59. Sugar can be intoxicating, similar to alcohol.[99]
    60. Sugar given to premature babies can affect the amount of carbon dioxide they produce.[100]
    61. Decrease in sugar intake can increase emotional stability.[101]
    62. Your body changes sugar into 2 to 5 times more fat in the bloodstream than it does starch.[102]
    63. The rapid absorption of sugar promotes excessive food intake in obese subjects.[103]
    64. Sugar can worsen the symptoms of children with attention deficit hyperactivity disorder (ADHD).[104]
    65. Sugar adversely affects urinary electrolyte composition.[105]
    66. Sugar can impair the function of your adrenal glands.[106]
    67. Sugar has the potential of inducing abnormal metabolic processes in normal, healthy individuals, thereby promoting chronic degenerative diseases.[107]
    68. Intravenous feedings (IVs) of sugar water can cut off oxygen to your brain.[108]
    69. Sugar increases your risk of polio.[109]
    70. High sugar intake can cause epileptic seizures.[110]
    71. Sugar causes high blood pressure in obese people.[111]
    72. In intensive care units, limiting sugar saves lives.[112]
    73. Sugar may induce cell death.[113]
    74. In juvenile rehabilitation centers, when children were put on low sugar diets, there was a 44 percent drop in antisocial behavior.[114]
    75. Sugar dehydrates newborns.[115]
    76. Sugar can cause gum disease.[116]

    It should now be crystal clear just how damaging sugar is. You simply cannot achieve your highest degree of health and vitality if you are consuming a significant amount of it.

    Fortunately, your body has an amazing ability to heal itself when given the basic nutrition it needs, and your liver has an incredible ability to regenerate. If you start making changes today, your health WILL begin to improve, returning you to the state of vitality that nature intended.

    References:

    * [1] Johnson RJ and Gower T. (2009) The Sugar Fix: The High-Fructose Fallout That is Making You Sick and Fat, Pocket, 416 pp
    * [2] “What sweetener should you choose? Sugar? Honey? Agave nectar?” Fitnessspotlight
    * [3] Stanhope KL, Schwarz JM, Keim NL, Griffen SC, Bremer AA, Graham JL, Hatcher B, Cox CL, Dyachenko A, Zhang W, McGahan JP, Seibert A, Krauss RM, Chiu S, Schaefer EJ, Ai M, Otokozawa S, Nakajima K, Nakano T, Beysen C, Hellerstein MK, Berglund L and Havel PJ. “Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans,” J Clin Invest. 2009; 119(5):1322-1334
    * [4] Park A. “All sugars aren’t the same: Glucose is better, study says,” Time Magazine, April 21, 2009
    * [5] Appleton N. Lick the Sugar Habit (1996) Avery, 2nd Ed. 272 pp.
    * [6] Sanchez, A., et al. Role of Sugars in Human Neutrophilic Phagocytosis, American Journal of Clinical Nutrition. Nov 1973;261:1180_1184. Bernstein, J., al. Depression of Lymphocyte Transformation Following Oral Glucose Ingestion. American Journal of Clinical Nutrition.1997;30:613
    * [7] Ringsdorf, W., Cheraskin, E. and Ramsay R. Sucrose, Neutrophilic Phagocytosis and Resistance to Disease, Dental Survey. 1976;52(12):46_48
    * [8] Couzy, F., et al. “Nutritional Implications of the Interaction Minerals,” Progressive Food and Nutrition Science 17;1933:65-87
    * [9] Kozlovsky, A., et al. Effects of Diets High in Simple Sugars on Urinary Chromium Losses. Metabolism. June 1986;35:515_518
    * [10] Fields, M.., et al. Effect of Copper Deficiency on Metabolism and Mortality in Rats Fed Sucrose or Starch Diets, Journal of Clinical Nutrition. 1983;113:1335_1345
    * [11] Lemann, J. Evidence that Glucose Ingestion Inhibits Net Renal Tubular Reabsorption of Calcium and Magnesium. Journal of Clinical Nutrition. 1976 ;70:236_245
    * [12] Goldman, J., et al. Behavioral Effects of Sucrose on Preschool Children. Journal of Abnormal Child Psychology.1986;14(4):565_577
    * [13] Jones, T. W., et al. Enhanced Adrenomedullary Response and Increased Susceptibility to Neuroglygopenia: Mechanisms Underlying the Adverse Effect of Sugar Ingestion in Children. Journal of Pediatrics. Feb 1995;126:171-7
    * [14] Scanto, S. and Yudkin, J. The Effect of Dietary Sucrose on Blood Lipids, Serum Insulin, Platelet Adhesiveness and Body Weight in Human Volunteers, Postgraduate Medicine Journal. 1969;45:602_607
    * [15] Albrink, M. and Ullrich I. H. Interaction of Dietary Sucrose and Fiber on Serum Lipids in Healthy Young Men Fed High Carbohydrate Diets. American Journal of Clinical Nutrition. 1986;43:419­
    * [16] Reiser, S. Effects of Dietary Sugars on Metabolic Risk Factors Associated with Heart Disease. Nutritional Health. 1985;203_216
    * [17] Lewis, G. F. and Steiner, G. Acute Effects of Insulin in the Control of Vldl Production in Humans. Implications for The insulin-resistant State. Diabetes Care. 1996 Apr;19(4):390-3 R. Pamplona, M. .J., et al. Mechanisms of Glycation in Atherogenesis. Medical Hypotheses. 1990;40:174-181
    * [18] Cerami, A., Vlassara, H., and Brownlee, M. “Glucose and Aging.” Scientific American. May 1987:90. Lee, A. T. and Cerami, A. The Role of Glycation in Aging. Annals of the New York Academy of Science; 663:63-67
    * [19] Takahashi, E., Tohoku University School of Medicine, Wholistic Health Digest. October 1982:41:00
    * [20] Quillin, Patrick, Cancer’s Sweet Tooth, Nutrition Science News. Ap 2000 Rothkopf, M.. Nutrition. July/Aug 1990;6(4)
    * [21] Michaud, D. Dietary Sugar, Glycemic Load, and Pancreatic Cancer Risk in a Prospective Study. J Natl Cancer Inst. Sep 4, 2002 ;94(17):1293-300
    * [22] Moerman, C. J., et al. Dietary Sugar Intake in the Etiology of Biliary Tract Cancer. International Journal of Epidemiology. Ap 1993.2(2):207-214.
    * [23] The Edell Health Letter. Sept 1991;7:1
    * [24] De Stefani, E.”Dietary Sugar and Lung Cancer: a Case control Study in Uruguay.” Nutrition and Cancer. 1998;31(2):132_7
    * [25] Cornee, J., et al. A Case-control Study of Gastric Cancer and Nutritional Factors in Marseille, France. European Journal of Epidemiology 11 (1995):55-65
    * [26] Kelsay, J., et al. Diets High in Glucose or Sucrose and Young Women. American Journal of Clinical Nutrition. 1974;27:926_936. Thomas, B. J., et al. Relation of Habitual Diet to Fasting Plasma Insulin Concentration and the Insulin Response to Oral Glucose, Human Nutrition Clinical Nutrition. 1983; 36C(1):49_51
    * [27] Dufty, William. Sugar Blues. (New York:Warner Books, 1975)
    * [28] Acta Ophthalmologica Scandinavica. Mar 2002;48;25. Taub, H. Ed. Sugar Weakens Eyesight, VM NEWSLETTER;May 1986:06:00
    * [29] Dufty.
    * [30] Yudkin, J. Sweet and Dangerous.(New York:Bantam Books,1974) 129
    * [31] Cornee, J., et al. A Case-control Study of Gastric Cancer and Nutritional Factors in Marseille, France, European Journal of Epidemiology. 1995;11
    * [32] Persson P. G., Ahlbom, A., and Hellers, G. Epidemiology. 1992;3:47-52
    * [33] Jones, T. W., et al. Enhanced Adrenomedullary Response and Increased Susceptibility to Neuroglygopenia: Mechanisms Underlying the Adverse Effect of Sugar Ingestion in Children. Journal of Pediatrics. Feb 1995;126:171-7
    * [34] Lee, A. T.and Cerami A. The Role of Glycation in Aging. Annals of the New York Academy of Science.1992;663:63-70
    * [35] Abrahamson, E. and Peget, A. Body, Mind and Sugar. (New York: Avon, 1977)
    * [36] Glinsmann, W., Irausquin, H., and Youngmee, K. Evaluation of Health Aspects of Sugar Contained in Carbohydrate Sweeteners. F. D. A. Report of Sugars Task Force. 1986:39:00 Makinen K.K.,et al. A Descriptive Report of the Effects of a 16_month Xylitol Chewing_gum Programme Subsequent to a 40_month Sucrose Gum Programme. Caries Research. 1998; 32(2)107_12
    * [37] Glinsmann, W., Irausquin, H., and K. Youngmee. Evaluation of Health Aspects of Sugar Contained in Carbohydrate Sweeteners. F. D. A. Report of Sugars Task Force.1986;39:36_38
    * [38] Appleton, N. New York: Healthy Bones. Avery Penguin Putnam:1989
    * [39] Keen, H., et al. Nutrient Intake, Adiposity, and Diabetes. British Medical Journal. 1989; 1:00 655_658
    * [40] Darlington, L., Ramsey, N. W. and Mansfield, J. R. Placebo Controlled, Blind Study of Dietary Manipulation Therapy in Rheumatoid Arthritis, Lancet. Feb 1986;8475(1):236_238
    * [41] Powers, L. Sensitivity: You React to What You Eat. Los Angeles Times. (Feb. 12, 1985). Cheng, J., et al. Preliminary Clinical Study on the Correlation Between Allergic Rhinitis and Food Factors. Lin Chuang Er Bi Yan Hou Ke Za Zhi Aug 2002;16(8):393-396
    * [42] Erlander, S. The Cause and Cure of Multiple Sclerosis, The Disease to End Disease.” Mar 3, 1979;1(3):59_63
    * [43] Crook, W. J. The Yeast Connection. (TN:Professional Books, 1984)
    * [44] Heaton, K. The Sweet Road to Gallstones. British Medical Journal. Apr 14, 1984; 288:00:00 1103_1104. Misciagna, G., et al. American Journal of Clinical Nutrition. 1999;69:120-126
    * [45] Cleave, T. The Saccharine Disease. (New Canaan, CT: Keats Publishing, 1974)
    * [46] Ibid
    * [47] Cleave, T. and Campbell, G. (Bristol, England:Diabetes, Coronary Thrombosis and the Saccharine Disease: John Wright and Sons, 1960)
    * [48] Behall, K. Influ ence of Estrogen Content of Oral Contraceptives and Consumption of Sucrose on Blood Parameters. Disease Abstracts International. 1982;431437
    * [49] Tjäderhane, L. and Larmas, M. A High Sucrose Diet Decreases the Mechanical Strength of Bones in Growing Rats. Journal of Nutrition. 1998:128:1807_1810
    * [50] Beck, Nielsen H., Pedersen O., and Schwartz S. Effects of Diet on the Cellular Insulin Binding and the Insulin Sensitivity in Young Healthy Subjects. Diabetes. 1978;15:289_296
    * [51] Sucrose Induces Diabetes in Cat. Federal Protocol. 1974;6(97). diabetes
    * [52] Reiser, S., et al. Effects of Sugars on Indices on Glucose Tolerance in Humans. American Journal of Clinical Nutrition. 1986;43:151-159
    * [53] Journal of Clinical Endocrinology and Metabolism. Aug 2000
    * [54] Hodges, R., and Rebello, T. Carbohydrates and Blood Pressure. Annals of Internal Medicine. 1983:98:838_841
    * [55] Behar, D., et al. Sugar Challenge Testing with Children Considered Behaviorally Sugar Reactive. Nutritional Behavior. 1984;1:277_288
    * [56] Furth, A. and Harding, J. Why Sugar Is Bad For You. New Scientist. Sep 23, 1989;44
    * [57] Simmons, J. Is The Sand of Time Sugar? LONGEVITY. June 1990:00:00 49_53
    * [58] Appleton, N. New York: LICK THE SUGAR HABIT. Avery Penguin Putnam:1988. allergies
    * [59] Cleave, T. The Saccharine Disease: (New Canaan Ct: Keats Publishing, Inc., 1974).131
    * [60] Ibid. 132
    * [61] Pamplona, R., et al. Mechanisms of Glycation in Atherogenesis. Medical Hypotheses . 1990:00:00 174_181
    * [62] Vaccaro O., Ruth, K. J. and Stamler J. Relationship of Postload Plasma Glucose to Mortality with 19 yr Follow up. Diabetes Care. Oct 15,1992;10:328_334. Tominaga, M., et al, Impaired Glucose Tolerance Is a Risk Factor for Cardiovascular Disease, but Not Fasting Glucose. Diabetes Care. 1999:2(6):920-924
    * [63] Lee, A. T. and Cerami, A. Modifications of Proteins and Nucleic Acids by Reducing Sugars: Possible Role in Aging. Handbook of the Biology of Aging. (New York: Academic Press, 1990)
    * [64] Monnier, V. M. Nonenzymatic Glycosylation, the Maillard Reaction and the Aging Process. Journal of Gerontology 1990:45(4):105_110
    * [65] Cerami, A., Vlassara, H., and Brownlee, M. Glucose and Aging. Scientific American. May 1987:00:00 90
    * [66] Dyer, D. G., et al. Accumulation of Maillard Reaction Products in Skin Collagen in Diabetes and Aging. Journal of Clinical Investigation. 1993:93(6):421_22
    * [67] Veromann, S.et al.”Dietary Sugar and Salt Represent Real Risk Factors for Cataract Development.” Ophthalmologica. 2003 Jul-Aug;217(4):302-307
    * [68] Goulart, F. S. Are You Sugar Smart? American Fitness. March_April 1991:00:00 34_38. Milwakuee, WI
    * [69] Monnier, V. M. Nonenzymatic Glycosylation, the Maillard Reaction and the Aging Process. Journal of Gerontology. 1990:45(4):105_110
    * [70] Ceriello, A. Oxidative Stress and Glycemic Regulation. Metabolism. Feb 2000;49(2 Suppl 1):27­29
    * [71] Appleton, Nancy. New York; Lick the Sugar Habit. Avery Penguin Putnam, 1988 enzymes
    * [72] Hellenbrand, W. Diet and Parkinson’s Disease. A Possible Role for the Past Intake of Specific Nutrients. Results from a Self-administered Food-frequency Questionnaire in a Case-control Study. Neurology. Sep 1996;47(3):644-650
    * [73] Goulart, F. S. Are You Sugar Smart? American Fitness. March_April 1991:00:00 34_38
    * [74] Ibid.
    * [75] Yudkin, J., Kang, S. and Bruckdorfer, K. Effects of High Dietary Sugar. British Journal of Medicine. Nov 22, 1980;1396
    * [76] Blacklock, N. J., Sucrose and Idiopathic Renal Stone. Nutrition and Health. 1987;5(1-2):9­Curhan, G., et al. Beverage Use and Risk for Kidney Stones in Women. Annals of Internal Medicine. 1998:28:534-340
    * [77] Goulart, F. S. Are You Sugar Smart? American Fitness. March_April 1991:00:00 34_38. Milwakuee, WI
    * [78] Ibid. fluid retention
    * [79] Ibid. bowel movement
    * [80] Ibid. compromise the lining of the capillaries
    * [81] Nash, J. Health Contenders. Essence. Jan 1992; 23:00 79_81
    * [82] Grand, E. Food Allergies and Migraine.Lancet. 1979:1:955_959
    * [83] Schauss, A. Diet, Crime and Delinquency. (Berkley Ca; Parker House, 1981)
    * [84] Molteni, R, et al. A High-fat, Refined Sugar Diet Reduces Hippocampal Brain-derived Neurotrophic Factor, Neuronal Plasticity, and Learning. NeuroScience. 2002;112(4):803-814
    * [85] Christensen, L. The Role of Caffeine and Sugar in Depression. Nutrition Report. Mar 1991;9(3):17-24
    * [86] Ibid,44
    * [87] Yudkin, J. Sweet and Dangerous.(New York:Bantam Books,1974) 129
    * [88] Frey, J. Is There Sugar in the Alzheimer’s Disease? Annales De Biologie Clinique. 2001; 59 (3):253-257
    * [89] Yudkin, J. Metabolic Changes Induced by Sugar in Relation to Coronary Heart Disease and Diabetes. Nutrition and Health. 1987;5(1-2):5-8
    * [90] Yudkin, J and Eisa, O. Dietary Sucrose and Oestradiol Concentration in Young Men. Annals of Nutrition and Metabolism. 1988:32(2):53-55
    * [91] The Edell Health Letter. Sept 1991;7:1
    * [92] Gardner, L. and Reiser, S. Effects of Dietary Carbohydrate on Fasting Levels of Human Growth Hormone and Cortisol. Proceedings of the Society for Experimental Biology and Medicine. 1982;169:36_40
    * [93] Journal of Advanced Medicine. 1994;7(1):51-58
    * [94] Ceriello, A. Oxidative Stress and Glycemic Regulation. Metabolism. Feb 2000;49(2 Suppl 1):27­29
    * [95] Postgraduate Medicine.Sept 1969:45:602-07
    * [96] Lenders, C. M. Gestational Age and Infant Size at Birth Are Associated with Dietary Intake among Pregnant Adolescents. Journal of Nutrition. Jun 1997;1113-1117
    * [97] Ibid.
    * [98] Sugar, White Flour Withdrawal Produces Chemical Response. The Addiction Letter. Jul 1992:04:00 Colantuoni, C., et al. Evidence That Intermittent, Excessive Sugar Intake Causes Endogenous Opioid Dependence. Obes Res. Jun 2002 ;10(6):478-488. Annual Meeting of the American Psychological Society, Toronto, June 17, 2001 http://www.mercola.com/2001/jun/30/sugar.htm
    * [99] Ibid.
    * [100] Sunehag, A. L., et al. Gluconeogenesis in Very Low Birth Weight Infants Receiving Total Parenteral Nutrition Diabetes. 1999 ;48 7991_800
    * [101] Christensen L., et al. Impact of A Dietary Change on Emotional Distress. Journal of Abnormal Psychology.1985;94(4):565_79
    * [102] Nutrition Health Review. Fall 85 changes sugar into fat faster than fat
    * [103] Ludwig, D. S., et al. High Glycemic Index Foods, Overeating and Obesity. Pediatrics. March 1999;103(3):26-32
    * [104] Pediatrics Research. 1995;38(4):539-542. Berdonces, J. L. Attention Deficit and Infantile Hyperactivity. Rev Enferm. Jan 2001;4(1)11-4
    * [105] Blacklock, N. J. Sucrose and Idiopathic Renal Stone. Nutrition Health. 1987;5(1 & 2):9­
    * [106] Lechin, F., et al. Effects of an Oral Glucose Load on Plasma Neurotransmitters in Humans. Neurophychobiology. 1992;26(1-2):4-11
    * [107] Fields, M. Journal of the American College of Nutrition. Aug 1998;17(4):317_321
    * [108] Arieff, A. I. Veterans Administration Medical Center in San Francisco. San Jose Mercury; June 12/86. IVs of sugar water can cut off oxygen to the brain
    * [109] Sandler, Benjamin P. Diet Prevents Polio. Milwakuee, WI,:The Lee Foundation for for Nutritional Research, 1951
    * [110] Murphy, Patricia. The Role of Sugar in Epileptic Seizures. Townsend Letter for Doctors and Patients. May, 2001 Murphy Is Editor of Epilepsy Wellness Newsletter, 1462 West 5th Ave., Eugene, Oregon 97402
    * [111] Stern, N. & Tuck, M. Pathogenesis of Hypertension in Diabetes Mellitus. Diabetes Mellitus, a Fundamental and Clinical Test. 2nd Edition, (PhiladelphiA; A:Lippincott Williams & Wilkins, 2000)943-957
    * [112] Christansen, D. Critical Care: Sugar Limit Saves Lives. Science News. June 30, 2001; 159:404
    * [113] Donnini, D. et al. Glucose May Induce Cell Death through a Free Radical-mediated Mechanism.Biochem Biohhys Res Commun. Feb 15, 1996:219(2):412-417
    * [114] Schoenthaler, S. The Los Angeles Probation Department Diet-Behavior Program: Am Empirical Analysis of Six Institutional Settings. Int J Biosocial Res 5(2):88-89
    * [115] Gluconeogenesis in Very Low Birth Weight Infants Receiving Total Parenteral Nutrition. Diabetes. 1999 Apr;48(4):791-800
    * [116] Glinsmann, W., et al. Evaluation of Health Aspects of Sugar Contained in Carbohydrate Sweeteners.” FDA Report of Sugars Task Force -1986 39 123

    Yudkin, J. and Eisa, O. Dietary Sucrose and Oestradiol Concentration in Young Men. Annals of Nutrition and Metabolism. 1988;32(2):53-5

  72. July 10, 2010

    Leonardo — Thanks for that lengthy, yet utterly empty cut/pasted contribution to the discussion.

  73. July 25, 2010

    I’d say that Leonardo can’t spell irony and hasn’t bothered to read any of the actual debate. I would have moderated such an obvious blind dump but thats just me.

    OTH thanks for the initial post & this summary.

  74. July 26, 2010

    Thanks for the comment, Jason. I’ll leave Leonardo’s dump up there just for comic relief.

  75. Marlena permalink
    September 15, 2010

    Hello Alan,

    As you suggested, I read the link provided by you in JC’s blog. However, while the main bulk of your article may have taken a mere 15 minutes (or less) I haven’t had time to read all of the other links to references or articles listed therein. I do plan to plug away at it though.
    What has been made clear to me though is that our current society is going to HELL in a handbasket.
    I do respect your desire to objectively critique other’s scientific offerings, that’s what science is all about right?
    I am not a follower necessarily, or a fan of Dr. Lustig’s particularly. Nor am I a scientist. What I am, aside from a health care practitioner trying to lead by example, is a concerned mother trying to find a healthy balance and a way to keep my twin 12 y/o sons’ exponential growth fueled by something other than rice crispie squares and chocolate milk, that won’t have them accusing me of relishing in their suffering. I find it pretty much impossible to keep them fed and feeling satiated.
    I respect Dr. Lustig’s concern for the welfare and future of our children and I also respect other’s whose research would aid in that crusade. I would like to know if the need to discredit his theories is in pursuit of such a goal. It would appear as though you have a lot of focus and energy that could be used for good instead of evil (insert healthy sense of humour).
    I would love to hear any suggestions you may have, it is obvious from reading around that you have helped people and that you have the respect of many.
    I still disagree with JC’s article on clean eating though. Just because he took it to the extreme of deprivation and bingeing, does not invalidate it as a lifestyle. And afterall, it’s just a name.

  76. September 29, 2010

    “I Sir, raise the point that you, Sir, doth spake cobblers and I buttress said cobblerism with this salvo!
    “‘No, no, no Sir, I contend that you, Sir, doth speaketh out of thine asscrack and I rebutt thine ascertions with this pearly gem!!”

    This article and the response page makes me feel like break-dancing. Love it….That is all..

  77. chuck p permalink
    October 19, 2010

    If fructose is no better/worse than regular sugar (i.e. sucrose breaks down to fructose/glucose quickly in the stomach), then why is it said that fructose doesn’t raise blood sugar as fast or as high?

    Perhaps that’s a myth (I haven’t tested), but perhaps there is a reason why fructose is different and possibly more dangerous?

  78. snoop911 permalink
    October 19, 2010

    What about sugar substitutes that come from fruits (luo han guo), plant leaves (stevia herb), and sugar alcohols? These are several order of magnitude sweeter, and so only a small fraction is usually consumed.. nonetheless, what are your thoughts on these alternative, sugar substitutes?

    Also what effect does polyunsaturated fats (omega-6s, etc) have on sugar/fructose? If consuming pufas, would eating something with a high fructose:glucose ratio (ex. apple) be worse than a low ratio (ex. sweet potato), or it makes no difference?
    http://en.wikipedia.org/wiki/Fructose#Food_sources

  79. chuck p permalink
    October 20, 2010

    @snoop:

    Regarding polyunsaturated fats causing more inflammation with fructose:
    http://blog.cholesterol-and-health.com/2010/10/high-fructose-corn-syrup-is-sweet.html

  80. gary permalink
    October 21, 2010

    Fructose is different, did anyone look up the references in lustig’s video?

    http://www.sciencedaily.com/releases/2010/10/101018092152.htm

  81. October 23, 2010

    Awesome blog, thanks. Been trying to lose weight with the Cambridge diet these past few months and it’s going well. I will try and update to let you guys know how it’s going, so far I’ve lost 20 pounds in 5 months!

  82. enliteneer permalink
    October 26, 2010

    According to
    http://www.foodpolitics.com/2010/10/new-study-hfcs-sweetened-drinks-higher-in-fructose-than-expected/ ,

    “At most, HFCS is supposed to be 55% fructose, as compared to the 50% in table sugar. Most foods and drinks are supposed to be using HFCS that is 42% fructose. A percentage of 55 is not much different biologically than 50, which is why the assumption has been that there is no biologically meaningful difference between HFCS and table sugar. This study, if confirmed, means that this supposition may need some rethinking.

    The study names the beverages that contain 65% fructose: Coke, Pepsi, Sprite. It identifies Dr. Pepper, Gatorade, and Arizona Ice Tea as containing close to 60% fructose.”

  83. October 29, 2010

    Snoop911 — Zip of that refutes my argument.

  84. Scurb permalink
    November 3, 2010

    “In response to Mike K’s advocacy of food avoidance, I posted research indicating an association between inflexible, all-or-nothing eating habits and adverse conditions. To quote Stewart et al…”

    “Here’s a quote from a similar study by Smith et al…”

    “Indeed, correlation doesn’t automatically equal causation, but the two studies I cited above build a far better case than the baseless assumptions of folks who assert their dietary perfectionism onto the world around them.”

    This was taken from your argument at the very top. It appears to be supporting the idea that inflexible eating habits are causing the stated health problems. In other words, inflexible habits come first and the undesired heatlh symptoms follow as a result. However, using those two quotes, one could just as easily argue that it was the health problems that came first, and the inflexible eating habits that followed in attempt to do something about the problems. This sounds more realistic to me. People eat what they want without thinking, just like any animal, until they learn consequences. I doubt that all of those slim happy people with their flexible no-strategy eating will continue in such a carefree manner if they began suffereing undesirable changes to their body. Those two studies are a good example of biased conclusions. Your use of them doesn’t support anything. Questionnaires. Questionnaires. People preaching their dietary perfectionism based on personal experience and success have stronger evidence then that.

  85. November 4, 2010

    Scurb — You’re wrong on at least 2 counts: 1) Straw man regarding a claimed “no-strategy eating”. Flexiible doesn’t automatically mean devoid of strategy. 2) Observational research data in all of its flawed glory still holds more weight than your personal/anecdotal opinion.

  86. Scurb permalink
    November 4, 2010

    Take the “no-strategy” phrase out of the sentence then.

    Regarding the overall argument, cyanide or rat poison is safe if the dose is small enough. Why don’t we just throw them in there too. Lets just eat everything that there is an industry for, as soon as we determine the smallest dose that the body can withstand, of course.

    So 50 grams of fructose is a perfectly healthy limit. Such a nice even number. This must mean that anything more can start to creep into the unhealthy range. The only reason I can see to make such a defensive stand is if consuming 50 grams of fructose is healthier than consuming zero. Are you saying this? If so then where are the research studies supporting improved health markers and overall health from the supplementation of fructose. I don’t see them in this argument. If not then why care if people skip it entirely? What about the tobacco industry when the “official” advice became that nicotine is addicting and can cause cancer, were you out telling people to stop being irrational? Just one cig a day is acceptable. All this work just to keep the knowledge-is-power equations strong with one more variable.

  87. Scurb permalink
    November 4, 2010

    Yep. Reading the abstract, inflexibility could have easily started after the symptoms began. My observation still stands and debunks the notion that inflexible eaters get into trouble more. I call to have that supporting evidence stripped from the argument. Then I call for a removal of the argument and disassembly of the blog, followed by a resignation from any positions of influence, and finally a wandering of the streets to feed off of the fat chunks that people cut off their steaks and throw in the garbage. Won’t find much fructose in the garbage though. People are pretty good about not letting any of that go to waste.

  88. November 5, 2010

    Scurb — You just committed another fallacy, this time the false analogy. Whoa, that rhymes. It’sn’t that divine? Comparing a carbohydrate with cyanide tells me all I need to know regarding your tendency towards alarmism.

  89. February 4, 2011

    I just need to be clear on one thing — is anybody claiming that lots of sugar, regardless of its source, is just fine for the sedentary masses?

  90. Goinglite permalink
    February 4, 2011

    Hi Alan Aragon,

    I would be interested in a list of countries that have a high diabetes rate, but very low fructose consumption. If such a list exists, the data may be useful.

  91. February 5, 2011

    Eg — No.

    Goinglite — Not likely to find such data, since countries with high diabetes rates tend to eat an excess of a wide range of foods (both processed & nonprocessed). On a related tangent, here’s a quote from the CRA site, just an an FYI for anyone interested:

    “Obesity is a complex problem and its cause cannot be simply attributed to any one component of the food supply such as sweeteners.”11

    Further, the prevalence of obesity is increasing around the world, according to the International Obesity Task Force—even though use of high fructose corn syrup outside of the United States is limited or nonexistent.12 In fact, sugar accounts for about 92 percent of caloric sweeteners consumed worldwide.13″

  92. Laurent Buhler permalink
    March 3, 2011

    I’m afraid I might join after the battle but, anyway, I take my chances. I’m a French dietician and I have to say that in my country, France, I can see a fructose phobia raising, particularly among bodybuilders and *health enthusiasts*. Those fructophobics are afraid to get dyslipidemia, cancer, diabetes, NAFLD from the very first gram of fructose they might eat. Needless to say, they ban fruits from their diets because of their obscene fructose content. My concern as a dietician is to fight against this phobia and to make them understand the concept of “dose and context”. Therefore I want to say a big THANKS to Alan, James and all of the contributors to this discussion for giving me ammo on this topic (I’ve read the original post from Alan as well as the retrospective and all of the discussion following both).

    Through all I’ve read, I’ve seen a recurring concern which I could summarize this way : “is fructose beneficial to the human body in any way ?” I think it might be helpful to gave simple answers to this question (well, as far as “simple” is possible). For instance :
    – fructose might help to replenish liver glycogen faster than glucose after exercising.
    – in a hypocaloric or maintenance state, fructose won’t raise blood glucose as much as glucose.
    – more surprising, a study from the Linus Paulin Institute suggests that the antioxidant capacity of fruits comes from their fructose content:
    http://www.ncbi.nlm.nih.gov/pubmed/15203196

    Also, considering that our organism synthesizes enzymes to handle fructose, I don’t understand why fructose opponents say we’re not adapted to fructose. Of course, if fructose consumption overwhelms those enzymes capacity, our body can not handle excess fructose but we’re back to the notion of “dose and context” here.

    As I try to look to both sides of the data, I’d like to submit two recent studies that may raise concern about fructose consumption around exercise:

    “Fructose modifies the hormonal response and modulates lipid metabolism during aerobic exercise after glucose supplementation”
    http://www.ncbi.nlm.nih.gov/pubmed/18533896

    and

    “A dose of fructose induces oxidative stress during endurance and strength exercise.”
    http://www.ncbi.nlm.nih.gov/pubmed/19763999

    At the moment, I don’t have access to full-text for these studies therefore I don’t know if they’re flawed in any way (such as using unrealistic doses of fructose). Hope you’ll give us a hint about that.

  93. Laurent Buhler permalink
    March 9, 2011

    Another interesting study :

    “Fructose Addition to a Glucose Supplement Modifies Perceived Exertion During Strength and Endurance Exercise”
    http://www.ncbi.nlm.nih.gov/pubmed/21068682

  94. March 10, 2011

    Great post , cant believe I havent come across your blog before ;)

    cheers

  95. Art Vandelay permalink
    March 27, 2011

    Rats evolved eating cereals. Humans evolved eating fruit/meat and that’s what tastes the best to us. I don’t know if rats are the best animal to test fructose consumption on. I read a study on rat behavior that said they prefer the taste of cereals and eggs, and fruit is one of their least liked tastes along with raw vegetables.

  96. Laurent Buhler permalink
    April 8, 2011

    About the study I mentionned :
    “Fructose modifies the hormonal response and modulates lipid metabolism during aerobic exercise after glucose supplementation”
    http://www.ncbi.nlm.nih.gov/pubmed/18533896

    It appears that the glucose and glucose + fructose solutions compared in this study are not isocaloric. It seems to me a strong bias to begin with…

  97. Carl Los permalink
    April 13, 2011

    I begin with the caveat that while I read a lot of the post in the prior thread and many of the posts in this thread I did not read them all, so if I repeat something forgive me. I would like the perspective of Alan and of those who are of like-minded.

    1. From my understanding Taubes’ thesis is that calories in calories out is wrong in that conventional wisdom doesn’t address the effect of insulin on the body. He further states that insulin is the main fat storage hormone and without it fat cells cannot store triglycerides because fat cells need Glucose 3 phosphate ( I think? the byproduct of glucose metabolism in the fat cell) to link fatty acids to form triglycerides. Therefore, if you take away the insulin you take away the fixation of fatty acids in the fat cell.

    Is this correct? If not, how is it, wrong? Is there some other way fat cells store fat not elucidated by Taubes?

    2. In Re Lustig, I took away that fructose is metabolized differently than glucose and is only metabolized in the liver. He further stated that fructose is metabolized like alcohol in the liver and that glycogen is produced from DHAP and glyceraldehydes, which is produced from fructose. He further stated that excess fructose causes the production of triglycerides in the liver, which lowers insulin sensitivity.

    Is he wrong about that? If he is wrong what is wrong? Is there another metabolic pathway for fructose not discussed?

    Finally, I would like to know what your beef is with both of these guys. Is it because they are sensational in their presentation? (i.e. calories don’t matter, exercise won’t help) Or, is it their use of epidemiological [sic?] studies, which can often be suspect and by their nature are unscientific?

    I ask because upon reading the writings of these two guys I changed my life and lost 80 lbs of fat in a year by cutting out the carbs and limiting my fructose. I also did limit the calories. Is there something else I’m missing? I’m just not understanding the hostility over this topic. I mean sugar is bad we can agree on that right?

    Any answers would be most helpful, all the best.

  98. April 15, 2011

    http://www.washingtonpost.com/wp-dyn/content/article/2009/01/26/AR2009012601831.html

    HFCS contains mercury. Just another reason to avoid it.

  99. STG permalink
    April 25, 2011

    Alan,

    I appreciate your blog and the debate about fructose. When the science is fuzzy, a discussion is always warranted. I am going to assume that you are blessed with a good metabolism and probably can eat carbs to your heart content. You look like you are under 40 years? I am over 60 and am not blessed with a good metabolism so based on my own experience, I limit fructose and other carbs. I think people are unique including their nutritional needs. I am fortunate, however, I do backcountry skiing about 24 hours a week. I can cover many miles and I gain about 3000 feet everytime I go out. I live to ski, not ski to live. The dietary changes I have made have enhanced my ability to perform and enjoy my passion, backcountry skiing. It works for me, so I will keep doing it!

  100. Liam Gordon permalink
    May 8, 2011

    I’ve spent 20 years researching aspects of this area and I think that the balance of the evidence supports Lustig’s idea that increased consumption of simple sugars has had an adverse effect on the health of the ‘average’ person. Increased calorie consumption has certainly contributed but the independent research generally confirms Lustig’s hypothesis.

    Many misunderstandings seem to have arisen, just few of which I’d like to flag up: Lustig is fairly clear and consistent in blaming ‘added simple sugars’ and largely supportive of ‘endogenous simple sugars’ (evolution has allowed us process fruit without to much harm but evolution hasn’t had time to allow us to deal with the industrialized addition of sugars); Lustig is not favouring sucrose over HFCS–he repeatedly states that they are both bad; a quick glance at the Aragon referenced papers above indicates significant conflicts of interest or sugar industry influence (n.b. paying for travel is just another form of consulting fees–I know since I’ve collected them from big pharma for years!); Luc Tally’s independent research repeatedly flags up fructose and simple sugars as having problematic health effects–interesting that Aragon only picked one review and ignored the dozens of other relevant publications by the Swiss researcher.

    What we do not have is ‘guilt beyond a reasonable doubt’. Long term health studies in humans make that nearly impossible e.g. although the evidence is overwhelming smoking and lung cancer is still only a strong theory and not a proven ‘truth’. Once Aragon et al listen to all the Lustig talk, understand the biochemistry (hard science) and physiology ( hard science), and perhaps go off and get a PhD/MD in the field, perhaps work in research for a couple of decades to truly understand the research, then we can have a worthwhile debate.

  101. RayCinLA permalink
    May 10, 2011

    @ Liam Gordon:

    Nobody cares if you spent 20 years researching. If you don’t possess a basic sense of logic, then all of that was for naught. You sound a little disgruntled that Alan wiped the floor with Lustig, with little effort on his part. Lustig got served hot, and you’re mad about it. Cry him a river, go ahead. In the mean time, keep ignoring Lustig’s failure to present anything objectively in either his presentation or his horrible showing here.

    *SMH*

  102. JLB permalink
    May 10, 2011

    Liam,

    You’re just as alarmist as Lustig. Do you keep the sugar jar near your bed to scare away evil spirits while you sleep? It might work, you know. Sugar indeed is that powerful and evil.

    Perhaps you should deliver an anti-fructose scare-mongering lecture of your own so we can watch Alan utterly destroy you like he did Lustig. That would be great edutainment.

    No matter how much you extremists try to downplay Lustig’s failure and Alan’s win by championing sanity and moderation, you just make yourselves look like whistle-blowing toddlers. Grow up, or continue to get your butts kicked by the voice of reason (not that it isn’t fun to watch).

  103. Christine permalink
    May 10, 2011

    Mr. Gordon:

    Alan’s career consists of improving people’s lives by getting them more fit, better educated, and freeing them from irrational views of food, sort of like what you have. Go back to your lab and do some research on how you can possibly free yourself of your mortal fear of sugar. You are no better than David Gillespie and the rest of the tabloid sugarphobes. And, it’s not Alan’s fault that Dr. Lustig can’t reason clearly… At all.

    Alan, I’m a huge fan of your writings, keep up the good work. I’m happy to see you ruffling the feathers of the neurotic types.

  104. Dustin permalink
    July 23, 2011

    I highly highly recommend reading GCBC before coming to conclusions… Taubes even says that he has some ideas or theories but ultimately there needs to be more true, non biased, scientific research on the matter to either prove or disprove it. I was absolutely amazed at the amount of data and research he managed to compile. The book is huge… And he never comes out with his opinion until the very end and it’s all of a few pages and like I said above he says there needs to be more scientific research. Most of the book he is pointing out the weak scientific method that has been used over the years in various studies and shows the reader to not believe what we have been told is truth due to bad science and the rampant belief that correlation equals causation. It’s a great book… And at the end there are things I agree with and things I don’t but ultimately the information in that book is phenomenal. Alan, find the time to read it and THEN give us an educated opinion of the data within… I’d be interested to read your book report, but only if you read it with an open mind and not a preconceived notion that it’s all fiction… Like I said, there’s very little opinion in it, he mainly asks questions and points out weakness in the scientific method that has been used in the field of nutrition. In his tv interviews he mainly discusses his opinions and conclusions but the book doesn’t…it’s 99% historical study reevaluation and analysis. Read it!

  105. Triynko permalink
    August 29, 2011

    You know, he goes over the biochemical pathways, and the negative affects of fructose are clear. You’ve managed to insult his choice of data sources, and no shit the Japanese have some fructose in their diet, it’s no more relevant to the discussion that if he had claimed the moon was made of cheese… still wrong, still irrelevant. Also, he’s talking about “chronic exposure” to fructose, so even though 6-7 cans a soda a day is excessive, such a dose in the short term may have the same effect as a smaller dose in the long term. I think you’re completely missing the point that he’s basically correct in that we’re getting too much fructose, not enough fiber, and are not active enough.

  106. darkseeker permalink
    September 3, 2011

    Triynko, Lustig could have had every intention of delivering that message, but it came out more like “Fructose is an evil poison! Run for your lives!” You’re completely missing the point that dosage and context make all the difference, and we’re not all 2 year-olds who can only think in binary terms.

  107. Daniel Han permalink
    October 30, 2011

    Alan,

    I think you’re getting too mired in the small details and forgetting the big picture of nutrition/the human body. Instead of saying, oh fructose may not be SO bad, why not consider that cutting down fructose (and tons of whole grains/gluten/omega-sixes) will only do good for our obese/diabetic nation? We need people to change their lives and being overly conservative back in the direction of conventional wisdom helps no one. fit ppl stay fit, fat ppl stay fat.

    Also, as a personal q, have you ever been obese? Because I have and I know every bit how it feels and how my body responds to food, what with experimenting with countless diets/macro ratios/exercise regimens (I even became an amateur boxing champion)/counting calories. 99% of it didn’t work, i found a diet that works for me. Certain foods like HFCS and grains just dont sit well with my health and weight, as do many other people who struggle with obesity and eating disorders (for ex, bulimic ppl are often just obese ppl in physiology who purge their weight down). As an honest opinion from a former obese person, I caution you from getting too mired in the small numbers/studies. The body is vastly complex (and beautiful) and analyzing a few studies will not make sense of all of it. After all, modern medicine has some of the brightest and yet its failed Americans with something as “simple as food”. I immediately distrust ANYONE who believes in calories In n’ Out because it ignores endocrinology. Our bodyweight, if we’re healthy, is regulated well by satiety signals, namely leptin function in the hypothalamus. When they go awry (due to the diet, nothing wrong with me inherently), weight dysregulation occurs, including both obesity and anorexia. Fructose is one that specifically induces leptin resistance. Also, animals and man since the dawn of time never counted calories. Alan, before you knew about dumbbells and calories, did YOU become severely obese or severely underweight because u didn’t know about calories?? No i think not, your functioning system took care of your health. But you’ll say you can consciously control intake. Think of it like air, you can somatically choose to breathe or autonomically let your respiratory center take over. Same with food. But in those with a damaged respiratory center, they need an iron lung or they “forget” to breathe. In the obese, they need a dietary overhaul. It’s the type of fuel, not how much. My view of always-fit ppl teaching obese ppl is akin to a rich guy inheriting his wealth and teaching the avg joe how to get rich. They can help but it is only after empathy with their clients and not self-righteousness and ego. They also have to carefully examine the science behind the “other side”, whichever side you may be on.

    As for your arguments with Lustig, imo Lustig isn’t even superbly well-informed on nutrition. But he has a point, if your child grows up to become overweight (which in today’s environment is not hard), are you going to make him/her count calories or scold them for being morally lazy? It’s clearly something wrong with the diet. However, I commend Lustig for being in the right direction for most MD’s could care less about nutrition. I also tend to credit clinicians and clinical nutritionists who work with thousands of patients since they see real results, not theory and numbers. I am actually entering allopathic medicine next year, but unlike most, I do believe in the power of specific nutritional therapy/holistic medicine, not a generalized one-size-fits-all approach to diet.

    Dan

  108. Daniel Han permalink
    October 30, 2011

    As an add-on note, when I first watched Lustig’s video on youtube (and I have corresponded with him via email), I already felt he was being conservative. Many MD’s and clinical nutritionists who take a focus on nutrition are way way past simple HFCS. We now care about things such as saturated fat, eliminating grain products/hexane refined veggie SEED oils and how to optimize nutrition through epigenetics and vapcholtesting (VAP). Lustig’s shit is mad old, but yet the world NEEDS to hear it as a starting point. Also realize Lustig and many of these clinicians see tens of thousands of real diabetic/obese patients in their life-time. Results in the clinic > citing a few worthless NIH studies. cmon I worked at NIH for years, publishing a paper isn’t hard and often misses so many variables. this is why i caution you trying to go on your own and analyze raw studies. You have little lense, this is why review books are great for making sense of it all. A great book I’d highly recommend you read is Mastering Leptin by Byron Richards (clinical nutritionist who has arguably the most experience with leptin, which is a very new hormone in medicine). This is a must-read for anyone who gives a damn about weight, eating disorders and obesity. Applies to you too Alan, for your better health.

    I am not against healthy skepticism but Alan, please don’t take a smug approach towards “defeating” Lustig. The guy is chief of endocrinology at UCSF hosp, top 5 clinical center in the country. He is TOP of the food chain in terms of academic prestige, trying to do a smear campaign on him only makes people in the fitness industry look silly. Be professional about it

  109. Hauss permalink
    October 31, 2011

    Daniel,

    Do you realize that all you did was tell Alan to disregard current research, dig into a dusty textbook, and avoid being critical about someone’s needless scaremongering? Are you sure you’re not Lustig’s alias trying to save face after getting trampled? Wow, it’s time to stop posting. I know you’re about to go into medicine, but you’re sounding like a real scrub. And, do you REALLY think that Alan would ever claim that the endocrine system does not influence the energy balance equation? I think you’re the guy who needs to do more reading and learning instead of pitching in your pennies of half-hatched wisdom. You’ve written a novel over the course of your posts, but have said essentially zilch.

  110. Jason Steele permalink
    October 31, 2011

    LOL @ Lustig’s email buddies trying to come to his rescue. The guy got his butt whooped, get over it, people. It happens, learn from it and move on.

  111. Daniel Han permalink
    October 31, 2011

    Hauss:

    How did I say anything to the effect of disregard current research? The MOST current research is into nutrition’s impact of epigenetics, using VAP testing to analyze serum lipids and doing leptin research in clinical translation, NOT fucking counting calories.

    My pennies? Alan (and Lyle’s, Martin Berkhan’s, all these broscience 2.0 guys who go on rants about how educated they are when they think they know it all with a Masters degree) and his generalist approach is pretty much what the USDA/conventional nutritionists blabber about. guess what, we have 100M obese ppl. In fact I DID Lyle’s fat loss strategies and they failed me, thats why I eventually had to find my own method of Paleo Dieting (which is NOT what Lustig advocates, so don’t try to group me).

    Hauss in fact I bet YOU’RE one of Alan’s goonies here to defend your troll master. This is why I’m going into medicine, so I can avoid having my patients listen to a couple of weightlifters turned brains. One axis of broscience guys in general: Alan, Lyle, Krieger and Martin. Anyone can get a degree in nutrition pal, I have a Masters in Physiology and it only teaches you textbook bs 30yrs old. Everything I’m speaking about is not from any possible education. In fact, I DON’T believe Alan has a practical understanding of endocrinology outside of steroids producing small balls (and neither do you) because he clearly never even mentions effects of fructose that are common medical knowledge such as steatohepatitis, fructose’s ability to generate sdLDL, even a brief mention of metabolic syndrome or anything about leptin resistance at ALL. frankly its pathetic and this is why you fitness bros don’t catch on. the only guys who believed Lustig got “whooped” are gym dudes and ppl at LG.

  112. Hauss permalink
    October 31, 2011

    Daniel,

    The fact that you admitted to being a Paleotard tells all we need to know about your confused state of mental affairs. You’re either a troll, an idiot, or a trolling idiot. Plus, you call Alan, Martin, James, and Lyle “broscientists” because apparently you’re mad at them for being successful and popular for having solid, evidence-based writing. You, on the other hand, are a student-nobody/embittered ex-fatty who relies on the “What would Fred Flintstone do” approach. Good luck with your medical career in the Land of Oz.

    Alan,

    I doubt you have the time to read all your comments, but keep up the good work. The latest AARR issue is awesome, as always. Trust me, there is intelligent life out there that really appreciates what you, Lyle, Martin, and James do for the industry, and the public in general. Don’t ever let a few irrational dimwits make you doubt your service to the professionals and the public.

  113. W33DZ permalink
    October 31, 2011

    Dan is a Paleotard/Taubestard. It’s confirmed, look at his favorite books (Paleo Solution & GCBC):

    http://www.facebook.com/danhantheman

    Dan is a fan of Robb Wolf. Robb Wolf is a fan of AA’s work. Yet, Dan chooses to bash AA… Derp.

  114. Hauss permalink
    October 31, 2011

    OMG, LOL!

    Really, Dan? Hahahaha. Get outa here, man. Better yet, keep studying, you’ll need several more years of it to undo all that misinformation you have crammed in your skull. You’re not worth anyone’s time, and you’re certainly in no position to take shots at Alan with your intellectual squirt gun.

  115. Christine permalink
    October 31, 2011

    Daniel:

    Why all the bitterness, jealousy, and name-calling? Do you really expect Alan or anyone to take you seriously after calling him, Martin, James, and Lyle broscientists? You’re coming off like a typical hater in the bleechers who hasn’t accomplished anything worthwhile, so the best you can do is tout your physiology degree and your plans to become a doctor. Pretty pathetic, but most trolls are. And don’t blame Lyle that you’re still overweight. You should probably stop thinking about endocrinology a moment and take a look at how many kcals you’re consuming. Just because you avoid fructose doesn’t mean you can’t be overweight, and based on your pics, I think you’re proving that just fine.

  116. Daniel Han permalink
    October 31, 2011

    I’m a paleotard? so if something allows me to LOSE close to damn near 100lbs instead of Lyle’s bullshit advice keeping me fat, I shouldn’t adopt it? I should be giving paleo a fkin medal.

    W33DZ thats just sad and weird checking up on people (so who’s secretly losing their cool too?), this is exactly the type of smear bullshit the 4 guys I mention are doing. Even you guys can admit Lyle is a depressed asshole who tears his readers a new one whenever they disagree, and Alan likes to associate himself with better known ppl then attack their work. At Hauss, your stupid laughing at people while counting your calories explains why the fitness industry is a fail and people never get anywhere, weight loss or health wise. No one opens their eyes because of 1 thing: ego.

    Christine, I am currently lean, something I haven’t been since age 8. I know my science and my results with my own eyes. and learn to read, I clearly said my Physiology degree (fine in its own right) means zilch when it comes to nutrition, and I’m self-taught. I was alluding to the fact that these trainers think they know it all because of their certifications. counting calories is only ignorant spiel by self-righteous thin ppl who never GOT thin. they have no idea what an obese person feels like, which is exactly why I’m in the perfect position through experience and education to impact obesity. and believe me, that ignorant judging of fat people never helps.

    Honestly I think most of you are just pissed I probably mentioned I’m becoming an MD. you mad, bro? you mad I’m going to be making 500k/yr doing orthopedics while you’re hoaxing fat ppl in the gym for dollars and call it personal training? That’s too bad because unlike guys writing sorry blogs attacking the lifelong work of others, some of us have actually been contributing to the real world, I am currently doing AmeriCorps. You don’t become an MD thru being a smug asshole. What have you done lately? I admit I have a short fuse, but it will help me sift through the bullshit fitness industry that failed me for a decade when I take care of my own patients. Christine, those pics aren’t even bad, during my teens i was almost 275lbs, oh i’m sure thats just calories. when you have kids go tell them to fucking count calories and lower their self-esteem.

    I can suffer at the hands of biased health industry people, but tomorrow’s obese patients cannot afford to listen to you guys. and that’s right, you ARE broscience 2.0. You’re one step ahead of your predecessors but far from actually understanding the human body. Like any of you have even the basics of medical physiology, anatomy and endocrinology down. the human body is complex and none of us can expect to smugly give answers without a life-time of research and understanding. at least Lustig is in that position, Alan Aragon is NOT.

    I’m done with this blog, my first “novel” was done in peace and honestly to encourage Alan to to be mired in numbers and lose sight of the big pic. but this post is just for you guys and your smug remarks. hail broscience

  117. Christine permalink
    October 31, 2011

    Daniel:

    Well, well, your true colors are showing brightly aren’t they. You insult Alan and his colleagues instead of directing any specific questions toward him, and then you go on a whiny rant about your failed weight loss, and then you cap it all off by boasting about how much more cash you’ll make one day than us personal trainers. I can guarantee you that you will never ever earn the type of respect Alan has. Why? Because it comes with integrity and self-control. Two things you have not shown one bit of. Good luck with your career, it sounds like your motivations are all in the right place$$$.

  118. S. Harding permalink
    October 31, 2011

    Daniel,

    Allow me to quote you in case others missed it:

    “One axis of broscience guys in general: Alan, Lyle, Krieger and Martin.”

    You blew all of your credibility with that one statement. You instantly defined yourself as an ignorant troll. I’m not trying to insult you, I’m just speaking as a spectator. Between the four of those guys, you have easily some of the best information available in the fitness industry for trainers, clients, nutritionists, amd more. Surely, you didn’t think you were going to get coddled after barging into Alan’s house and hurling disparaging remarks in such a brash way. And you have the nerve to question the professionalism of others? My advice to you: take a look in the mirror before you start projecting. It could get you roughed up, as it did here in this discussion. And this is WITHOUT Alan coming in here and roughing you up, which I have no doubt he could do, very harshly if he so chose.

  119. RayCinLA permalink
    October 31, 2011

    Dan is a Paleotard/Taubestard. It’s confirmed, look at his favorite books (Paleo Solution & GCBC):

    http://www.facebook.com/danhantheman

    Dan is a fan of Robb Wolf. Robb Wolf is a fan of AA’s work. Yet, Dan chooses to bash AA… Derp.

    Haha, WOW. LMFAO!

    @ Dan:

    Robb Wolf is a fan of Alan’s writing. I guess he has bad judgement? As far as I know, Alan and Wolf have a mutual respect for each other. You appear to be a biased blowhard with a chip on his shoulder. By the way, 500K a year isn’t guaranteed to fix your anger and self esteem issues.

  120. W33DZ permalink
    October 31, 2011

    Why should anyone listen to Alan, Martin, Lyle, or James when we have The Almighty Daniel Han, Future Orthopedist to the Stars, MD, 500K/yr:

    ...

  121. darkseeker permalink
    November 1, 2011

    Hey Dan Han, are you related to Fred Hahn? You both share the same struggle with piecing together logical arguments.

  122. November 1, 2011

    Daniel — I’m at a juncture where I can’t dedicate a lot of time to responding to blog comments. This will lighten up in due time, but that time isn’t now. I wanted to step in here because one of my colleagues alerted me to the fiasco of recent comments. Let me be clear that I don’t like discussions to get beyond facts & into the realm of emotions. If you feel anything I said in this post was incorrect, please quote it, and be ready to provide links to research evidence that’s it’s incorrect. I am open to being wrong, and I’m happy to learn new things. I don’t mind correcting my stance based on contrary data I was unaware of. In fact, I welcome that – since it can only happen so often. However, I would rather discuss/debate that way rather than childishly wrestle over who’s a “broscientist.” It’s not motivating at all to engage someone who appears to have malicious/trollish/self-aggrandizing motives.

  123. W33DZ permalink
    November 2, 2011

    Dan, according to your FB, one of your favorite books is the Paleo Solution by Robb Wolf. Did you know that he is a fan of Alan Aragon’s work?

    Please respond to this screen shot:

    ...

  124. JLB permalink
    November 2, 2011

    Dan, please respond to Alan. We want to hear more appeals to the authority of the authors you like.

  125. Daniel Han permalink
    November 3, 2011

    Great you’re here, Alan. Read my first two posts. also realize that I NEVER said I wanted you to advocate paleo etc in that post. I admit it went a bit downhill after that lol because your goonies went ahead and started attacking ME and going to my fb to see that I believe in Paleo. fuck. off. don’t expect me to just act mellow if you’re gonna do that. so-what if Robb wolf is a fan of Alan’s work? Maybe Alan has good stuff on other topics too. This isn’t black & white, for or against all of a person’s works. only about learning more. just thinking that way shows you’re a fanatic.

    Anyways, aside from Lustig’s presentation on the health benefits/dangers of fructose, there’s a point that even he’s starting to miss. As Krieger (and even Chris Masterjohn, one of the biggest paleo community researchers) pointed out, insulin is NO longer the culprit for obesity. The shift is now onto leptin, an adipose hormone, and leptin resistance at its receptor site, namely in the brain. That is, the hypothalamus is not correctly perceiving the high levels of leptin in an obese individual, and physiologically interprets the fat cells as starving, leading to overeating/fatigue/under-exercising/cravings etc. Our long-term energy regulation is via our fat cell status, not what’s in our gut. Hence ppl realize they can boost leptin levels through certain macronutrients in a refeed. The caveat is a leptin-boosting dose of high carbs triggers satiety for a leptin SENSITIVE person (like a MB or Robb Wolf), NOT a leptin resistant individual. akin to insulin administration to Type 2 diabetics who are insulin resistant already. Again, read my first posts. I caution you to go off on your own reading ONLY pubmed studies of leptin, because it is a new hormone and very misunderstood. A great review book on leptin is Mastering Leptin by Byron Richards. He’s a long-time clinical nutritionist who’s probably “the leptin guy” right now as he’s reviewed roughly 15,000 leptin primary sources. He puts things in better perspective especially as no one else knows 2 cents about leptin. There are now MD’s/researchers who are putting his work into clinical translation and see excellent results on a patient level. One whose blog I actually follow on a daily basis is Jack Kruse, a neurosurgeon in Nashville who applied these leptin principles along with a paleo diet, and lost 135lbs in his 40’s. Of course his results are not why I follow him but his science:

    His shorter explanation and review of leptin is 3 parts + a leptin Rx (advice on what to do). Part 1:
    http://jackkruse.com/chapter-one-on-leptin/
    I’m sure you can contact him or reply as he blogs often online and frequently answers q’s. He started his own company simply to optimize people’s nutrition, not to buy into any philosophy.

    As for PALEO blogs, the best ones out there imo are Chris Masterjohn’s (who is completely unbiased as I mentioned before, he doesn’t specifically blame carbs for obesity) and J Stanton at Gnolls.org. They cite their works in their articles too, extensively.

    Pertaining back to Lustig and the big pic, I understand fructose as directly triggering leptin resistance (there are many studies for this). The EXACT mechanism is not 100% clear but it seems to be the ability of fructose to be metabolized uncontrollably quickly in the liver into TriG’s, and inducing inflammation (desensitization/noise at leptin receptor site as one of the consequences). I did a thesis on fructose and know that the liver does not hold onto fructose in storage (like glycogen) and will metabolize it into glucose or TriG’s as fast as it can, leading to a rapid rise in postprandial TriG’s. That is why Lustig hints that fructose may be toxic, since the liver is acting on it like it does for alcohol/other toxins it does not want circulating. It is also fact that fructose contributes to AGE’s much more so than glucose (7x more i believe), which is why the older policy of advising diabetics (who already age fast due to high glycation from high blood glucose) to consume fructose was retarded by the ADA. I get that you’re saying moderation won’t kill you, of course, I have some fruit here and there too. But pampering HFCS in the eyes of confused and junk-food craved fat ppl (understand this is physiological NOT psychological, once you read about Jack Kruse’s blog and esp Mastering Leptin) only leads to them rationalizing to eat more of it.

    This is recapping what my sources would advise, but in summary I believe if one moderates fructose consumption, avoids chronic high consumption of refined carbs/grains/PUFA’s (oxidized veggie oils), high stress or anything else leading to systemic inflammation, one can rid obesity. It just so happens paleo lifestyle CAN fit this primer and it must be tailored to your needs individually (not one-size fits-all). It is not because this Grok character is more fundamentally sound than the food pyramid that I follow Paleo personally. I feel even Paleo-ers don’t realize the benefits were hindsight after research was done confirming why this anthropological approach may work, esp for obese.

    I don’t know if this satisfies your requirements or not, and I don’t know how to go about writing a defense since I’m not an author. Thats why my initial posts had little to do with actual policy but just advising you to be open-minded and study carefully your opponent’s basis, i.e. Paleo or w/e. Remember you are not acting out of belief (this is not religion or political cause) but only about what actually works. My entire family and I were obese. Believe me, we counted calories and exercised our heads off on countless diets. Yet we never blamed the FTO gene etc.. Obesity takes a toll on your life, personally, professionally and physically. Then seeing an ignorant trainer online or in real life belittle my efforts is infuriating, telling me to count my kcals. In fact I was so desperate that I took up amateur boxing while studying at Penn to train at the historic Joe Frazier’s boxing gym. I became a local amateur boxing champion during the 2006 Philadelphia Golden Gloves. It broke my own stereotypes about myself as an Asian American. Yet after I quit, I ballooned in weight once I stopped training like an animal, showing that even high level athletic nutrition wasn’t good enough for everyone. This is not something about discipline or willpower. Becoming an amateur boxing champion and studying my balls off to get into Penn (and medical school) already demonstrated that. This is my heaviest at 290lbs, mind u my boxing weight division was 165lbs:
    http://a4.sphotos.ak.fbcdn.net/photos-ak-snc1/v3854/38/29/624140224/n624140224_3072208_5746307.jpg

    This is me about a year ago at 175lbs (I don’t have a current fb pic), I am about 8lbs leaner right now:
    http://a2.sphotos.ak.fbcdn.net/hphotos-ak-snc4/36638_725863651267_618317_40972665_5922284_n.jpg

    It was the first time in my life that I can actually eat to satiety, not exercise more than half an hr a day, and keep/lose weight effortlessly. The term effortlessly is foreign to obese ppl like my family. THAT is how I know leptin principles + paleo works. Anyone who forces their clients/patients to suck it up and lose weight the hard way doesn’t know what he’s talking about. Realize that ANYONE can lose weight itself, but keeping it off and preventing relapse hints at a deeper physiology than calories. Until you can consistently get morbidly obese ppl (who are simply motivated, not suicidal) to lose weight effortlessly and keep it off, you have not perfected your knowledge yet. and that’s fine, it’s how we learn.

    As for my entering medicine, forget I even brought it up. It means jack shit by itself. However, I unfortunately (or fortunately?) believe that as an MD, ppl will automatically listen to me, whether I’m right or not. Most MD’s have forgotten how to think for themselves, and is why we’re even in this mess. It is the medical profession’s fault FIRST and FOREMOST for the sad state of obesity and all other modern diseases in the US, everyone else second. They sit there at the top unwilling to give any other research against their food pyramid a fair shake, then listen with all ears about what they agree about. It’s called hubris. This fallacy applies to anyone, including low-carbers. It’s why it started out as Atkins (eat all the chinese PUFA buffets you want as long as you don’t touch rice) but had to evolve to a tailored Paleo diet ranging from low carb whole sources of meat all the way to a Kitavan-style of 70% carbs based on tubers/vegs.

    As for disparaging fitness trainers, I’m wrong. Many fitness trainers ARE clueless but some are a testament to the industry. One in particular is Sean Croxton of Underground Wellness. He reads other people’s works in nutrition in addition to analyzing raw studies. It was his constant evolution of his nutritional approach based on science and willingness to examine his mistakes that inspired me and changed my thinking about food. It was his attitude, unwillingness to belittle/write off his clients and innovative thinking that got me interested in nutrition to begin with. That led to nutritional therapy, holistic medicine and then western medicine. I didn’t start out premed, I wanted to be a banker and was well on my way until the end of college. My attitude doesn’t involve treading softly, I know I will have to incite alot of people in my career esp in the orthodox medical world. Just look at our current US Surgeon General, she’s obese but its obv out of lack of knowledge, not her willpower. While how to exercise isn’t even a secret anymore if you really look for it, nutrition still has ways to go. Take an enthusiastic look at what I listed to you Alan. I know it’s alot of links and a book, but realize you’re doing it solely for your own career and client’s benefit, NOT to prove me right/wrong. u don’t even know me. But think about this, what do i have to gain from this? self-aggrandizing? I’m a kid man, why would I care, I’m 23 and overworked, 120k in debt. fitness information isn’t my job. If i didn’t believe this cause was important for myself and family, I’d rather be chasing girls and making money than learning about leptin and writing at alanaragonblog.com. Arguing with trainers isn’t my hobby

    Given this information may influence/change how you work with overweight clients, I think its a good investment of some time. You are in a position to change people’s lives now whereas I won’t be for another good decade. Best of luck and props for thinking independently to begin with. that is the rarest thing today, the ability to think for your own. most ppl just latch onto another’s ideas, hold on for dear life and call that conviction. it’s not conviction, it’s stupidity and its the 99%. I don’t expect a specific reply from you, after all it was more for your consideration in the long-run anyways (esp my first post). Should have been a PM. To everyone else, dont’care wont read. you’re just followers.

  126. November 4, 2011

    @ Daniel Han,

    Your last post was actually very decent. Try to hold on to the thought that intelligent arguments must be fairly void of emotional baggage. Stick to facts, research and so forth – and most of all, it’s important to accept new information as it is provided, and if coupled with enough science to back it up, to be able to change your current views – no matter how much you love them.

    I don’t doubt that your Paleo approach worked for you and that’s great. Alan isn’t against Paleo per se, if that’s the way you like to eat and it gets you results.

    However I believe that Alan and many others are extremely skeptical about the claims that it was your Paleo approach and some magical removal of grains or Fructose that brought forth your weight loss. Most likely is that fact that your understanding of the human body is not sufficiently deep enough to understand the full complexities that took place when you changed your diet.

    I can cut carbs from my menu and drink a bit less water. I’ll lose inches off my waist, pounds of weight and look way better in just a few days. However I’m not goint to say that carbs somehow made me magically lose fat weight and get lean. Yet this is what 99% of people think when they start Keto for instance.

    You appear to be smarter than that, so I truly do hope that you aren’t giving praise to Paleo or cutting of Fructose just because it was the first thing that truly made a difference in your weight.

    But you seem like an intelligent man, so try to condense your entire post into a more compressed line of thought and try to add some studies or direct links to some articles in the interest of keeping this discussion going. :)

    I understand that you have a lot to get off your chest, but this topic is too wide to simply tell everyone to “Check Out” a dozen different authors, trainers and books and whatnot. Try to keep it more compressed.

    Give us a few direct studies, or articles by authors you appreciate and maybe we will all become smarter because of that. No-one here is above changing their opinion completely, if new evidence arises. :)

  127. RayCinLA permalink
    November 6, 2011

    @ Daniel:

    Did you purposely write a preachy monologue and avoid refuting Alan’s specific quotations with research? Do you really think that Alan will read your opinion and say, gee, my last 2 decades in this industry can be catapulted into greatness by avoiding those evil grains? Good luck on getting a response to that.

  128. OhNoSaveMeFromTheFruit permalink
    November 28, 2011

    Alan… Thank you.
    I could just leave it at that but to expound a bit, I thought I fell into the bizarro vortex upon watching Lustig’s “sugar caused the holocaust and grapefruits killed my daddy” lecture just yesterday. (yeah, i’m late to the party) To quote myself on another forum, “I had to stop at the 13 minute mark after the dozenth insultingly incorrect and/or brazenly intellectually dishonest statement.” But like Pandora and the box I had to go back. It didn’t get better. Luckily I discovered your blog and the day was saved! So again, thank you.

  129. Ruth permalink
    February 5, 2012

    I am very disappointed in Dr. Lustig, as he was complaining about statistical inaccuracies in other studies during his lecture and now I find out, he used data that had not been scrutinized by the proper use of statistical tools. Shame on him!
    And thank you for this blog and the information contained therein.

  130. Kris permalink
    February 16, 2012

    On the off chance that Alan spots this:

    I have an auto-immune form of arthritis. Any idea what the mechanism might be that causes stuff that contains HFCS to trigger significantly worse levels of joint pain than similarly sweet items which rely on sucrose? (For example: Can of Coke sweetened with HFCS = PAIN, can of Coke sweetened with sugar = not great for my diet, but not crippling.)

    Just trying to figure out what’s going on. (Someone suggested the issue may be to do with the source of HFCS, meaning grain intolerance, which is, I suppose, one possibility but also seems like another pretty popular scapegoat at the moment, so I take it with a grain of salt.)

    Obviously, this is anecdotal since it’s my own personal observations and I haven’t done careful testing, but I will mention that I noticed the HFCS=pain correlation in myself *before* everyone started demonizing it in the popular press.

  131. February 16, 2012

    Kris — I have no clue what it could be. Perhaps it’s time to just bite the bullet & cut back on your soda intake.

    All — Thank you for your comments.

  132. Kris permalink
    February 17, 2012

    Alan – yeah, that’s my practical solution to the problem. Delving deeper is just intellectual curiosity, trying to figure out what the heck is going on. Thanks for the response, I honestly wasn’t expecting you’d still bother with comments on this. :)

    (Though side bonus of all the crazy about HFCS=EVIL for me: It’s turning up less and less as a Stealth Ingredient in all kinds of other things. Granted, most of the things that have any kind of sweetener added are not necessarily something you want to eat all the time, but it’s nice to be able to have the odd treat without it being accompanied by crippling joint pain.)

    Anyway, thanks again. I appreciate that you take the time to write articles and review research and make some of it available outside of the subscription research review. (Which yes, I am pondering subscribing to. :) )

  133. Margaret permalink
    March 13, 2012

    Most article i read, they said that fructose is not good. Fructose is a major contributor to insulin resistance, obesity, elevated blood pressure, elevated triglycerides and elevated LDL, depletion of vitamins and minerals, cardiovascular disease, liver disease, cancer, arthritis and even gout. you can read it here – http://articles.mercola.com/sites/articles/archive/2010/01/02/highfructose-corn-syrup-alters-human-metabolism.aspx

  134. asmcriminal permalink
    April 15, 2012

    Here’s food for thought, if you’re not in the lab doing the studies, you’re a quack.

  135. George Henderson permalink
    May 15, 2012

    Maybe Lustig’s point was, that scientists like him, with jobs to go to, only have a limited amount of time and energy to spend following hundreds of comments on dozens of blogs for the rest of eternity.
    It would be nice for us, but draining for him.

    Lustig does not distinguish between HFCS and sugar.

    You say
    “He then goes on to cite rodent research despite his acknowledgement of my demand for human interventions using non-stratospheric doses of fructose.”

    As humans already use stratospheric and non-stratospheric doses of fructose, the first experiment should be, to find such humans with health problems, quantify their sugar consumption, then stop all sugar intake in a randomly chosen cohort.
    Later refinements could involve a few different low sugar doses, and replacing sugar calories differentially with starch or fat.

  136. George Henderson permalink
    May 15, 2012

    Hyperlipid has a very good post on this issue
    http://high-fat-nutrition.blogspot.co.nz/2012/05/on-glut5.html

    He gets seriously pedantic with another of Lustig’s claims (fructose and the liver), yet turns up a mechanism for fructose PLUS glucose (not fructose per se) affecting insulin sensitivity.

    Anthropologically, it looks as if fructose mainly entered our diet through tubers and roots, and honey, rather than fruit. Tubers and roots, and honey, are favoured over sweet fruits (a relatively poor calory source) by all modern hunter-gatherers, so far as I know.

  137. May 24, 2012

    Hi Alan, thanks so much for your thoughtful critique of Dr. Lustig’s video, of which I was (perhaps still am, jury is still out until I have a chance to sort through the argument) a big fan. Great however to get some opposing points of view, and, as you said, bring this debate, with integrity and sincerity, to the public consciousness. I have a question about which I have emailed Dr. Lustig at least 3 times, plus called his office, and have never heard back. Perhaps you or someone on the forum here could help. I am wondering if the active enzymes, or other nutrients, present in fresh juice (from a cold-running, low RPM masticating juicer) will change the metabolism of the fructose or other dietary sugars, meaning there would be a difference (in favor of the juice) between drinking fresh juice or soda, or even fresh juice and shelf-stable, pasteurized juice. Juicing is so associated with health and fitness, especially in the alternative medicine and lifestyle communities, that it is hard to imagine it could be harmful. In my own experience it proves noticeably energizing and detoxifying, having all sorts of physiological effects (dry, itchy skin and eyes, which I assume is related to liver detox; markedly increased diuresis; changes in mood; etc.). I cannot ignore however that it may have a high sugar content, especially with fruit juices, and that that may prove unhealthy, at least in excess. As a follow up: assuming the sugar in fresh juice is problematic, is there enough sugar in greens (kale, wheatgrass, etc.) to be of concern as well, or is it only with fruits?

    Thanks,
    -Abe

  138. Nick permalink
    June 8, 2012

    Mr Aragon, who are you exactly and what are your expert credentials ?? I am already familiar with Professor Lustig’s expertise, experience and credentials.

    Many Thanks, Nick

  139. Nick permalink
    June 8, 2012

    I am just interested to know who you are and a bit about your background.

  140. Jack permalink
    June 22, 2012

    I think the best thing is to stand behind the star spangled banner, and to declare that the american diet and waist size is the envy of the world. Who can argue with that?

  141. August 1, 2013

    i should write a lot too but i’ll try to keep it simple. too bad dr Lustig is not open for touch ups on his good intentions. i’ll leave all the science for now, you guys kinda covered it.
    people get fat because of lacking movement. food is not the same. now the real food is called organic not just food. there are too many chemicals added. and flavors that trick your brain into eating more. and especially GMO which is the main problem in HFCS not the “sugar” it self.

    that would be my short view.
    i wish you health and whatever brings peace for the soul

    cheers! :D

    ps- i’m just an artist

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  145. Emily permalink
    January 1, 2014

    What both Lustig and Aragon ignore in the case of the Japanese’ extremely low incidence of diseases is that this is down to their dietary intake of iodine. Sugar intake becomes irrelevant when iodine/iodide intake is in the order of 15mg per day. The traditional Japanese diet includes this amount in seaweed ingestion.

  146. January 20, 2014

    If your preferred fruit isn’t in season, use a package of
    frozen fruit with its syrup. But rather than scold them into eating their fruits and vegetables, I find that being creative works much nicer.

    1 ripe banana 1 tablespoon of honey (not for children
    under 1).

  147. Bill permalink
    February 1, 2014

    Not sure if anyone follows this thread anymore but here’s a new meta analysis on HFCS beverages and obesity. http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001578

    Financial Conflicts of Interest and Reporting Bias Regarding the Association between Sugar-Sweetened Beverages and Weight Gain: A Systematic Review of Systematic Reviews

    Beverage industry supported studies show no effect on obesity. Independent studies show a statistically significant impact on obesity. Not surprising.

    Thanks

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