Paper Credentials Vs. The Fitness Industry

2010 November 18
by Alan Aragon


Is the fitness industry unique?

The fitness industry appears to be unique in its ability to facilitate career success despite a lack of what I call paper credentials (letters after your name). Before I go on with this, it might be a good idea to set some operational definitions for fitness industry & career success. The latter term is highly subjective, so let’s just define it as the ability to make a decent living. I’m not necessarily talking about getting filthy-rich, but at least being able to comfortably cover your independent living expenses without needing a night-job where dollar bills are waved at you.  read more…

A Recent Career Milestone

2010 October 30
by Alan Aragon

One of the most defining moments in my career just happened.

Some of you might relate to the experience I’m about to describe. The reason I wanna share this is not to show off how cool I am, but to show you how I still run into inner struggles with a journey that I’ve intended to create for myself. I also think there’s a lesson or two to be learned, and I’d like to pass those on.

Last week I was given the opportunity to test my chops as the full-time nutritionist of the Los Angeles Kings. During a lengthy discussion with Jeff Solomon, the team’s director of operations, we came to an agreement that my distance-based model of working with clients didn’t line up with his vision of having a full-time staffer who traveled with the team. I could have decided to fulfill this more traditional position, but instead I chose to stick with my current trajectory.  read more…

Why Nutritional Dogma Dies Hard

2010 June 15
by Alan Aragon

Intro not really necessary

I’m fairly certain that most of you reading this are familiar with the veteran strength coach/author Mark Rippetoe, best known for Starting Strength and his collab with Lon Kilgore, Practical Programming for Strength Training. To say that these books are influential cult classics that get consistently glowing reviews would be an understatement. Given this, I had my expectations set pretty high regarding Mark’s general approach to the acquisition and dissemination of knowledge. But, it turns out I was wrong in my assumptions – at least about the nutritional aspect of his message board.

Pubmed, Schmubmed

Having recently registered at the Starting Strength Forums, I randomly engaged in discussion with a member who was worried about combining carbs and fat in the same meal. One of the members stepped in and attempted to justify the carb-fat separation tactic. In Socratic fashion, I helped him discover that there wasn’t anything about his claim that he could substantiate from a scientific standpoint. But that’s not the kicker. After some browsing, I ran into a rather unique forum rule. Here are some key sections from a stickied thread in the subforum of the resident nutrition coach John Sheaffer (who posts as “Johnny Pain” on Mark’s forums):

“…there are many other places (where many of you may already be members) for you guys to post studies and talk about medline, and Pubmed, and argue the validity of someone’s research…”

“I am largely not interested in that sort of thing. It takes too much time away from the important stuff, and the people who are doing the real science in the gym and at the table. I am not into arguing with people on the internet.”

“I will continue to answer questions that are relevant to the board. I have been legitimately enjoying this so far, and have met some great people. Do not however, bother posting threads or individual posts that include discussion of or links to studies. They will be deleted.”

Now, don’t get me wrong. I can appreciate simplistic/no-brainer/default-based approaches to helping out forum members. But in this particular realm, isn’t it kind of odd to literally forbid scientific research-related discussion? If John is not interested in getting into scientific debates, then that’s fine. But to prohibit this from occurring in his subforum even if he’s not involved is, well, an interesting way to run a community.

Prohibiting discussion that includes citing scientific research shifts the bias too far in the direction of anecdote/personal testimony. Heck, there are dozens of methods out there with a ton of testimony behind them and very little actual merit. Published research is not, cannot, and will never be the end-all judge. However, it’s an indispensable tool that helps separate the empty claims from the ones backed by objective evidence (however limited that evidence might be).

Nutritional mythology 101

And of course, you always have to laugh when scientific research is cited when it’s convenient, and dismissed when it doesn’t match up with someone’s personally held beliefs/anecdotes. Funny how that works. Now, let me give you a perfect example of why research should be discussed on training/nutrition forums. Have a look at this quote from John:

“Separate your carbs and fats. In each meal, you will have a portion of protein in addition to either carbs or fats, but not both. In the earlier half of the day, your meals should be Protein + Carb (P/C) in order to fill your muscle glycogen stores for your athletic activities. Later in the day (afternoon to evening, depending on your individual metabolism), when you are more sedentary, your meals should be Protein + Fat (P/F). Since carbs produce an insulin response, removing the carbs at this time will decrease the likelihood that you will store your excess calories as fat. Your final meal of the day should be *only* protein. Also, your PWO meal, regardless of what time of the day it is, must be a P/C meal.”

The above quote is so packed with broscience, it’s enough to provide a strong case for more research-based discussion on John’s subforum. Regarding the “don’t mix carbs with fat” myth, I wrote an article debunking it here. As for warning against carbs at night, there’s nothing inherently fattening about night-time carbs unless they contribute to a chronic surplus of calories that isn’t used for building lean tissue. The ONLY reason cutting carbs out of the evening works for controlling fat gain in some folks is because it restricts total caloric intake for the day.

“No carbs at night” is nothing more than a calorie-cutting-for-dummies tactic. Can it work? Yes, it can. In the case of people who tend to overeat carbo-liscious foods at night, this can serve as a default solution, but it’s not a guideline that should be universally recommended. What works just as well is cutting back on an equivalent amount of calories earlier in the day. There are no night-time insulin fairies ready & waiting to store carbs in the fat tissue — at least not at any greater rate than they would do so during the day.

Is there research to back up the claim that shifting the majority of your carbs to the later part of the day won’t magically chub you up or make it tougher to lose fat? Yes there is – and this occurred despite exercise being in the earlier part of the day for both groups compared [1]. For those who put a lot of stock in case studies, the lack of fattening effect of pre-bed carbs has plenty of examples – particularly in Martin Berkhan’s clientele [2].

Come at me, bro

If I had a chance to discuss these issues with John or Mark on the Starting Strength Forums, I would have gladly done so. However, it’s clear that Mark is not interested in discussing it with me, as seen in this thread. John hasn’t said a word about it yet, and I sincerely encourage him to do so. I’m easy to reach, and willing to field any challenges to any of the claims I’ve made. I won’t hold my breath, though. To relay John’s own words stuck at the top of his subforum:

“I am not into arguing with people on the internet. I think it’s gay to do so. I think it makes you a pussy. If people have a problem with the way I handle my board, please go to another forum and talk trash on me. It’s ok. People do it all the time. Better yet, catch up with me at an event that I am attending and voice your concern to me in person. That’s how it should be anyway, right?”

To the above quote, I would counter that there’s no way it can’t be productive to calmly & intelligently discuss any topic by presenting scientific evidence to support your case, while being open to research that perhaps you were not aware of. But hey, learning and staying informed about the scientific side of things takes considerable effort. And apparently, some people have no interest in delving into anything beyond their pre-existent beliefs. I personally think that there’s ALWAYS room for learning from scientific research, especially if you include science to justify your methods of practice. Disagree? Then come at me, bro.

_________________________________________________________________________

References

  1. Keim NL, et al. Weight loss is greater with consumption of large morning meals and fat-free mass is preserved with large evening meals in women on a controlled weight reduction regimen. J Nutr. 1997 Jan;127(1):75-82. [Medline]
  2. Berkhan M. Client Updates. (note that in many cases there’s even some fat with the carbs in those large evening meals – shocking, I know) [Leangains]

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Fatherhood & Freedom

2010 May 31
by Alan Aragon

Reflecting upon the path

Memorial Day, the unofficial start of Summer, elicits a lot of reflection upon the path I’ve walked and the path I’m creating. Undoubtedly, it makes me thankful to those who made the freedom I enjoy possible. The picture above was taken yesterday after church; that’s my 3 year-old (going on 13) son. In reviewing the pics within the small format of the camera, I initially mistook him for my 6 year-old, since I normally think of him as the baby, but apparently, that perception is already disappearing.  Time seems to accelerate with each passing year. I’d like to quote Arnold Schwarzenegger recalling a particularly hectic time in his life (1975) right after he filmed Stay Hungry and was in the midst of filming Pumping Iron:

“What it came down to was this: You have 24 hours in a day, and you have so many years to reach your dreams. I utilized the 24 hours more than anyone I know. You snooze, you loose. So what are you gonna do?”

Our time is limited, but do we really get that?

Fatherhood has been one big wake-up call for me. Before the kids hit the deck, the passage of time was a slow-to-nonexistent grind. However, seeing my kids grow and change on almost a daily basis reminds me that time is whizzing by whether we like it or not, and squandering the time we’re given is downright criminal. You might recall from the career series that I’ve cut my in-person client days at the office down to 2 per week, and work from home the rest of the week.

Necessary roughness

Some of you may have also noticed that I’ve had to resort to putting prospective clients on a 2-month waiting list to work with me. This is great in the sense that my expertise is in demand, but at the same time, I can’t help but feel bad for those who I’ve had to put on hold. But alas, managing my time is an ongoing learning process, and an art that might take me forever to master. During my lifetime, I want to be able to look back and be satisfied with the amount (& quality) of time I put into being the best dad I could. This, among other things, involves being physically & mentally present when hanging out with the kids. And yes, it also involves putting the brakes on how much work I think I’m able to do each day without disrupting the balance in my work & family life. Controlling the quantity of my work will also inevitably improve the quality of it. And that’s really what matters.

For those of you who aren’t parents

I know that for me, my kids are really the ‘hourglass’ that lights the fire under my feet to wring the most out of my time on this planet. For those of you who do not have kids (or don’t plan to), let me suggest you find your own metaphoric hourglass that reminds you that the clock is ticking away relentlessly. This is also the perfect time to remember that our forefathers have shed much blood, sweat, and tears to allow us the freedom to be the architects of our own lives and accomplish great things. So, let me encourage you all to get out there and do more stuff that matters and less stuff that doesn’t.

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JP Fitness Summit 2010: A Highly Biased Review

2010 May 22
by Alan Aragon

Another Year Elapsed…

…And I’m left to ponder it through. The JP Fitness Summit helps me contemplate my personal universe. It’s also a barometer for where I’m at in this whole fitness industry thing. Are folks benefitting from the information I dish out? Apparently so. Am I enjoying the hell out of it? Yes.  Therefore, everybody wins. The best parts of the Summit are the new & old friendships that get cultivated, and of course the memories that linger like sweet perfume (well, most of them).

The Attendees & Organizers

Let me just clear the air for a second and give credit to the beating heart of the JP Fitness Summit:  The vets & the admin. The Summit simply wouldn’t exist – much less run smoothly – without Nick Bromberg & the crew being on top of all the operations. Jean-Paul Francoer (founder of the JP Fitness Forums) gets credit for starting the whole thing. A unique aspect about the JP Fitness Summit is the Mahlership (named after veteran member John Mahler), where charitable individuals pitch in to build a fund that facilitates attendance for those who wouldn’t have had the means to make it there. This past Summit, enough funds were raised to sponsor 6 attendees. What other conference has this sort of selfless outreach? None that I know of.  

The Speakers

First up was Lou Schuler, whose trademark is a really sharp sense of humor and wit. He has a way of tying fitness and non-fitness concepts together that’s very unique and engaging. This time around, he drew parallels between the journey of a fitness professional and the  monomyth (also called the hero’s journey) as described by writer Joseph Campbell. I’ll admit straight away that I’m a hopeless fan of Lou’s talks, so I was captivated the whole way through, despite a deficiency of caffeine in me at that early point in the morning.

I was up after Lou, who quite eloquently introduced me in this clip. I discussed a variety of nutritional topics which included marconutrients, the placebo effect (demo on Lou with a parody of a strength test, depicted above). I ended off with a case study of a talented natural bodybuilder named Kelechi Opara, who I recently prepped for a contest without succumbing to any of the typical bodybuilding bro-dogma. As usual, I got a real rush out of presenting, and I had a blast interacting with the audience.

After me, in arguably the toughest spot (right before lunch) was my long-time friend Ryan Zielonka. He discussed his personal story and the lessons learned while going from extremely overweight, to maintaining a healthy/fit body composition – and most importantly, a healthy perspective. You could hear a pin drop while Ryan spoke; his narrative style was poised and polished. Although most of the crowd was ravenous (well, at least I was), no one shifted an inch in their seats as they listened intently the whole way through & asked lots of questions afterward.

Bret Contreras hit the fitness conference stage for the first time in his career, and did quite well considering this fact. I sensed some freshman jitters at the beginning of his talk, but I feel like he held it together and finished strong. He presented some great concepts, sound justifications, and innovative progressions for glute work. I got a chance to talk to Bret for about 2 hours straight at the airport while we waited for our flights to arrive. I must say that this guy has a truckload of knowledge in a wide range of training aspects for various sports. Bret is a true student of the game, and I see nothing but good things happening for him. He’s got a knock-out sense of humor, too.  

Nick Tumminello simply wowed the audience with his highly informative and eye-opening presentation on myofascial release. Nick’s extensive speaking experience really shined through in his flawless delivery. People were just in awe, eating up his information & insight. I’ve seen endless amounts of presenters at various conferences, and Nick ranks up there among the very top. It was really a treat to have him in the lineup this year. Nick and his lovely girlfriend Alli are a very classy couple that hit it off instantly with the JP Fitness crowd.

Post-Workshop Nutrition

One of the unique aspects of the JP Fitness Summit is that the attendees and the presenters are all on the same playing field. The speakers don’t huddle up together in their own corner the whole time while the audience keeps their respectful distance. It’s quite the opposite. Everyone has a blast hanging out & having fun throughout the entire weekend. Aside from the lecture & workshop, it’s really one big party.  This is an annual thing, so start saving your pennies for next year’s event, which I’ll be speaking at again. More than the opportunity to present educational material, it’s the fellowship and camaraderie with the attendees that keep me returning to the Summit each year. I hope to see more of you at the next one so I can put some faces to the names I’ve known online for so long now.

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What the fulk?

2010 April 2
by Alan Aragon

That was then (left), this is now (right)

The above pics are of a client and friend of mine named Phillip. For the sake of illustrating a point, I’ll let you guess his weight in both pics (hint: they are not the same). One thing that is almost universally agreeable is that he looks better in the right pic. Some of you might disagree, but most of you won’t. Another thing that’s hard to dispute is that he’s probably healthier in the right pic, as far as blood chemistry might show.

Bring on the pounds

To achieve the look of the left pic, Phillip fulked. That’s a word I made up that means he fat-bulked. Prior to my supervision, he perused the bodybuilding message boards and adapted a plan whose objective was to gain lots of size & strength quickly. His daily consumption was a pretty standard maintenance diet, but with an entire gallon of whole milk on top of that. Lots of strength was gained, and yes, a lot of weight was gained as well.

After the gain…

After the fulking stint, Phillip lost a bunch of weight due to an extended hiatus from the gym. This is when he sought my help. I put him through a progression that kept him within 10-15 lbs of his post-fulk deflation, but looking worlds better. I’d like to emphasize that Phillip is not genetically blessed in the muscle gain or fat loss department. He’s only had his monstrous work ethic to rely upon for results. I know I said I’d have you guess the weight difference between pics, but surprise, I’ll give it away right here: Phillip was 216 lbs in the left photo, and 176 lbs in the right one. That’s 40 fricking pounds!  Does he really look 40 lbs lighter? I’ll let you be the judge. What’s more easily apparent is five inches less waist girth, and a magic chest lift.

Men: afraid to lose?

Everyone’s familiar with the common scenario where female trainees can gain a few pounds and start panicking, regardless of positive changes in body composition. Well, a lot of men have the opposite but equally irrational fear that weight loss automatically equates to unsightly results. This makes them seek out the fulking route, finding comfort in seeing pounds rapidly pile up on the scale. This can be a good or bad thing — depending on how you look at it, and of course, depending on the individual situation.

Keep in mind that I am not blanketly condemning rapid weight gain.  What I’m trying to convey is that more isn’t always better when it comes to racking up pounds.

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Starting to look back a lot more.

2010 March 22
by Alan Aragon

hay bale pyramid

The fact of the matter is, I wasn’t always a model student. My original objective for getting a degree in nutrition was pretty frivolous – to have a unique credential among personal trainers. Amazingly enough, I intended to make a life of personal training – which didn’t end up panning out. Based on the evidence, I was destined to be glued to the computer rather than hands-on client work at the gym. Anyway, the point is, my underlying goal for the nutrition degree was to just get it over-with, so I could be more marketable than most personal trainers. In contrast to my lackadaisical waltz (& mediocre performance) through the undergrad, I got straight-A’s through my master’s degree in nutrition because I was actually interested in the topics. Timing is important; interest can’t be forced.

The class that shaped my future

The most profound change in my educational enthusiasm occurred during my graduate work in nutrition, in a research methods class. I had a professor in the late 1990’s named Brian Koziol, who had a brief stint as a part-time professor at CSUN. At the time, he was employed at Amgen, and as far as I know, he still is.

Brian Koziol’s passion was research — more specifically, dissecting it. What makes a good study? What makes a not-so-good one? What constitutes a true butcher-job of a study in terms of external and/or internal validity? Koziol actually tried to get the class interested in picking apart the strengths and weaknesses of studies. I’d say he succeeded with a handful of the class, but the majority were sort of lost on the point. In my opinion, he forgot to get across to the class why this exercise was important in the first place.

If I were to teach his class, I’d begin with the philosophy of science, and then move into the continuum of evidence. Heck, I’d even burden the class with the philosophy of evidence. I’d sincerely ask the class if they believed that science as an underlying philosophy is important, and why. I’d also belabor the elements of scientific thought, and why this is important in the battle against the bullshit products and protocols that pervade the health & fitness industry.

Perhaps not too surprisingly for those who’ve followed my work, Koziol’s research methods class was my single greatest career influence. There were other catalysts (such as the work of Lyle McDonald) that led to the materialization of my research review, but Koziol’s class – which I took more than a decade ago – was the foundation for that.

Notes for the students

Back to my presentation at the career symposium… Each year it forces me to introspect upon what makes me tick, and what makes my career something I happen to be very happy with. Here’s a relay of some of the important bits of advice I threw at the students:

  • Come to grips with what it is you’re absolutely nuts about (not just vaguely interested in). This is what you should be doing as a career.  Try to recall the last time you did an exceptional job at something you couldn’t give half a crap about, and my point becomes clear.
  • It’s ideal to match your interests with your talents, but skill can always be developed; whereas the desire for a particular job cannot always be developed. Do not pursue a career merely because you think it’s a prudent or safe choice. This naive capitulation has been the kiss of death for many.
  • There’s a market for EVERYTHING, but just be aware of how large or small that market is, in order to estimate your earning potential.
  • Experience builds confidence. Don’t expect to be polished right off the bat. Get in the trenches, get dirty, but try to learn as much as you can from the mistakes of your predecessors. The career series I wrote to kick off this blog should give anyone contemplating a fitness career ample food for thought.
  • Your perception of success will change over time.  Your interests & goals will evolve over time. It’s crucially important to be aware of this metamorphosis and act upon it regularly. We get so caught up in the mind-numbing routine of our work week, that it’s easy to lose touch with where we are, versus the direction we need to be moving. The solution? Do a “blank sheet day” at least once a year. This is an idea I got from a highly successful friend of mine, Daryl Wizelman. What you do is block out an entire day once a year to be by yourself. The whole day – with no one around you. I know that this is a horrifying concept, but bear with me.  Get a paper notebook (not something with internet access), and get yourself out into a secluded area  (a park, abandoned wherehouse, etc – whatever it takes to be alone), and VERY SPECIFICALLY write out your dream lifestyle. I’m not talking about compromising here, I’m talking about having the balls to actually fantasize for a moment about what type of life would make you truly happy. This obviously is gonna vary, but in all cases, be honest with yourself about what it is. Answer questions like: Where do you want to live? What do you want to spend your day doing? How many days a week do you want to work? What kind of life & career have you always dreamed about having, and what SPECIFIC steps can you take to get there if you’re not there yet? What sacrifices do you need to make? How do you want to give back charitably once you get the means to do so? How do you want to be remembered? Then, review your plan regularly through the year. I’ve been doing this “blank sheet day” exercise annually for the last 3 years now, and suffice it to say that I can’t even begin to tell you how much it has helped me personally. I’m also consistently entertained by how much my goals & general perspective changes.
  • If you are enjoying the process of pursuing your goals and crafting your career, you can consider yourself successful. This principle is hammered so very eloquently by Robert Hastings in his essay called The Station. As cliche as it sounds, the destination is far less important – and certainly far less real – than the journey. Life is merely a succession of days. What you do with each day determines the kind of life you’ll create, and ultimately the kind of life you’ll look back on.

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It’s okay to disagree.

2010 March 13
by Alan Aragon

Disagreement leads to investigation, investigation leads to learning.

The photo above was taken by a friend of mine with a great sense of humor (note this post here). He knows full-well that I’m not a proponent of supplemental BCAA on top of a preexistent high-protein diet typical of the fitness population, so this pic is an inside joke for those who are new to my writings.

One of the things that people miss is that most professionals in a given field tend to agree on the majority of fundamental principles. For example, I may disagree with some folks on the amount of fructose that can safely be incorporated into a diet, but that probably represents 10% of the whole picture, 90% of which I’d probably be preaching to the choir.

Another example is supplemental BCAA. There are some highly intelligent, well-educated folks that disagree with me on the lack of justification of its use under the aforementioned conditions. Guess what? That’s okay. Disagreement occurs throughout the lowest to the highest levels of research & practice. If there was no dissent, there would be little motivation to push forward with investigations that can yield more definitive answers to the grey areas of knowledge.

While I might disagree with some folks about the use of supplemental BCAAs amidst abundant high-quality dietary protein, I probably agree with them on the majority of all other topics. In any case, I took an in-depth look at the applications & limitations of BCAA supplementation in the latest issue of AARR.

If you disagree with anything I write, that’s fine with me. What’s the worst that can come from debating a topic? One or both sides acquire new knowledge…that’s a good thing.

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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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The bitter truth about fructose alarmism.

2010 January 29
by Alan Aragon

 

lustig-the-bitter-truth

Dr. Robert Lustig, professor of pediatrics at the University of California at San Francisco, is the star of the video above. While he presents some material that’s scientifically sound, he also makes enough errors to warrant a healthy dose of criticism. There’s a ton of material he goes over, so instead of writing a multi-chapter opus, I’ll discuss the aspects that I feel are the most relevant and interesting.

Bravo, Doc

Lustig’s delivery is clear, confident, charismatic, and engaging overall. I’m sure many would think that his style is annoyingly smug and preachy, but I find it entertaining. This is a good thing, since the video is about 90 minutes long. Amidst the  folly that prompted this post, he offers a few good observations.

First off, he makes a valid point that the public health movement against dietary fat that started in the early 1980’s was a grandiose failure. The climb in obesity to epidemic proportions over the last 30 years is plenty of evidence for this. It was also accurate of him to cite the significant increase in overall caloric consumption over this same time period. Furthermore, he shows an interesting progression of Coca-Cola’s 6.5 oz bottle in 1915 to the  20 oz bottle of the modern day.

Lustig acknowledges the First Law of Thermodynamics as it applies to changes in bodyweight. He attacks the vague expression that “a calorie is a calorie” by pointing out that different nutrients impart different physiological effects and have different roles within the body. His concluding recommendations included kicking out liquid calories except milk, which is generally a good strategy for children. Okay, so far so good. But what does he say that’s so misleading? Let’s take a look.

Boooo, Doc

While Lustig correctly points out that the nation’s overall caloric consumption has increased, he proceeds to blame carbohydrates as being the primary constituent. The thing is, he uses data spanning from 1989-1995 on children aged 2-17. Survey data is far from the gold standard of evidence, but if you’re gonna cite it, you might as well go with something more recent that includes adults.

Here’s the latest from the USDA Economic Research Service (ERS), which tracked the percent of total daily calories of the range of food groups from 1970-2007. The actual spreadsheet of the following figures can be downloaded here, click on the “Percents” tab at the bottom (note that these figures are updated regularly by the ERS, so the version you download may be different from what’s reported here) [1]:

  • Meats, eggs, and nut kcals decreased 4%.
  • Dairy kcals decreased 3%.
  • Percentage of fruit kcals stayed the same.
  • Percentage of vegetable kcals stayed the same.
  • Flour and cereal product kcals increased 3%.
  • Added fat kcals are up 7%,
  • Added sugars kcals decreased 1%
  • Total energy intake in 1970 averaged 2172 kcal. By 2007 this hiked up to 2775 kcal, a 603 kcal increase.

Taking a hard look at the data above, it appears that the rise in obesity is due in large part to an increase in caloric intake in general, rather than an increase in added sugars in particular.

Lustig insufficiently addresses the ‘energy out’ side of the equation. According to the research, it’s possible that over the last couple of decades, we’ve become more sedentary. King and colleagues recently compared the physical activity data in the National Health & Nutrition Examination Survey (NHANES) from 1988-1994 with the NHANES data from 2001-2006, and found a 10% decrease [2]. From a personal observation standpoint, that figure seems conservative (internet surfing for hours after your desk job shift, anyone?). It’s safe to say that all 603 extra daily calories have been landing in the nation’s collective adipose depot.

It’s also safe to say that all this finger-pointing at carbohydrate is just as silly as the finger-pointing toward fat in the ’80’s. Lustig takes the scapegoating of carbohydrate up a notch by singling out fructose. Perhaps the most passionate point he makes throughout the lecture is that fructose is a poison. Well, that’s just what we need in this day and age – obsessive alarmism over a single macronutrient subtype rather than an aerial view of the bigger picture.

Fructose is evil, context be damned

So, is fructose really the poison it’s painted to be? The answer is not an absolute yes or no; the evilness of fructose depends completely on dosage and context. A recurrent error in Lustig’s lecture is his omission of specifying the dosage and context of his claims. A point he hammers throughout his talk is that unlike glucose, fructose does not elicit an insulin (& leptin) response, and thus does not blunt appetite. This is why fructose supposedly leads to overeating and obesity.

Hold on a second…Lustig is forgetting that most fructose in both the commercial and natural domain has an equal amount of glucose attached to it. You’d have to go out of your way to obtain fructose without the accompanying glucose. Sucrose is half fructose and half glucose. High-fructose corn syrup (HFCS) is nearly identical to sucrose in structure and function. Here’s the point I’m getting at: contrary to Lustig’s contentions, both of these compounds have substantial research showing not just their ability to elicit an insulin response, but also their suppressive effect on appetite [3-6].

But wait, there’s more. In studies directly comparing the effect of fructose and glucose preloads on subsequent food intake, one showed no difference [7], while the majority have shown the fructose preload resulting in lesser food intake than the glucose preload [8-10]. A recent review of the literature on fructose’s effect on satiety found no compelling case for the idea that fructose is less satiating than glucose, or that HFCS is less satiating than sucrose [11]. So much for Lustig’s repeated assertion that fructose and fructose-containing sugars increase subsequent food intake. I suppose it’s easier to sensationalize claims based on rodent data.

In the single human study I’m aware of that linked fructose to a greater next-day appetite in a subset of the subjects, 30% of total daily energy intake was in the form of free fructose [12]. This amounts to 135 grams, which is the equivalent of 6-7 nondiet soft drinks. Is it really that groundbreaking to think that polishing off a half-dozen soft drinks per day is not a good idea? Demonizing fructose without mentioning the dose-dependent nature of its effects is intellectually dishonest. Like anything else, fructose consumed in gross chronic excess can lead to problems, while moderate amounts are neutral, and in some cases beneficial [13-15].

I’m obviously not in favor of replacing anyone’s daily fluid intake with soft drinks, but I can already see a number of straw man arguments headed my way. This is because people have a tendency to think in either-or terms that strictly involve extremes. I’ll quote an elegant review by independent researcher John White that echoes my thoughts [16]:

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

Atkins, Japan, & alcohol – oh my!

One of Lustig’s opening assertions is that The Atkins diet and the Japanese diet share one thing in common: the absence of fructose. This is flat-out false because it implies that the Japanese don’t eat fruit. On the contrary, bananas, grapefruits, Mandarin oranges, apples, grapes, watermelons, pears, persimmons, peaches, and strawberries are significant staples of the Japanese diet [17]. Lustig’s claim also implies that the Japanese do not consume desserts or sauces that contain added sucrose. This is false as well.

Another oversimplification Lustig makes is that fructose is “ethanol without the buzz,” and that fructose is toxic to the liver. This once again helps me illustrate my point that even in the case of alcoholic beverages, their risk or benefit to health is dose-dependent. Just like his extremist  treatment of fructose, Lustig bases his case on the effect of chronic isolated ethanol consumption in large doses. It’s easy to examine ethanol out of its normal context within beverages such as wine, because then you can conveniently ignore the evidence indicating its potential health benefits when consumed in moderation [18].

Partial redemption

Towards the end of Lustig’s lecture, he mentions that fructose within fruit is okay because its effect is neutralized by the fiber content. To a degree, this is a valid claim. However, in building this stance, he uses sugarcane to illustrate just how fiber-dominant natural sources of fructose are, and this is the exception rather than the rule. He claimed that, “Wherever there’s fructose in nature, there’s way more fiber.” That statement is far from universally true. Drawing a few common examples from the major fruits consumed in Japan, a midsize banana contains roughly 27 total grams of carbohydrate, 7 grams of fructose and 3 grams of fiber. A midsize apple contains 25 total grams of carbohydrate, 12 grams of fructose and 4 grams of fiber. Two cups of strawberries contains 24 total grams of carbohydrate, 4 grams of fructose, and 6 grams of fiber.

I would add that fiber is only one of the numerous phytochemicals in fruit that impart health benefits. Thus, it’s not quite as simple as saying that fructose is evil, but once you take it with fiber, you’ve conquered the Dark Side.

Summing up

I have a great deal of respect for Lustig’s professional accomplishments, and I share his concern for the nation’s penchant for sitting around and overconsuming food and beverages of all sorts. However, I disagree (as does the bulk of the research) with his myopic, militant focus on fructose avoidance. He’s missing the forest while barking up a single tree.

So, what’s the upper safe limit of fructose per day (all sources considered)? Again, this depends on a number of variables, not the least of which are an individual’s physical activity level and lean body mass. Currently in the literature is a liberal camp reporting that fructose intakes up to 90 grams per day have a beneficial effect on HbA(1c), and  no significant effects are seen for fasting triacylglycerol or body weight with intakes up to 100 grams per day in adults [15]. The conservative camp suggests that the safe range is much less than this; roughly 25-40 grams per day [19].  Figuring that both sides are biased, the middle figure between the two camps is roughly 50 grams for adults (I’m talking about the general population, athletes with high energy demands can safely consume more).

Although the tendency is to get hung up on the trivial minutia of an exact gram amount, it’s not possible to issue a universal number because individual circumstances vary widely (this is a concept that baffles anti-fructose absolutists). The big picture solution is in managing total caloric balance with a predominance of minimally refined foods and sufficient physical activity. Pointing the finger at fructose while dismissing dosage and context is like saying that exercise should be avoided because it makes you fat and injured by spiking your appetite and hurting your joints.

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Note: for those with little tolerance for reading through over 400 comments, there’s a summary of the discussion here .

 

 

 

 

 

References

  1. Economic Research Service, USDA. Loss-Adjusted Food Availability Data. Updated Feb 27, 2009. [ERS/USDA]
  2. King DE, et al. Adherence to healthy lifestyle habits in US adults, 1988-2006. Am J Med. 2009 Ju; 122(6):528-34. [Medline]
  3. Melanson KJ, et al. High-fructose corn syrup, energy intake, and appetite regulation. Am J Clin Nutr. 2008 Dec;88(6):1738S-1744S. [Medline]
  4. Soenen S, Westerterp-Plantenga MS. No differences in satiety or energy intake after high-fructose corn syrup, sucrose, or milk preloads. Am J Clin Nutr. 2007 Dec;86(6):1586-94. [Medline]
  5. Monsivais P, Perrigue MM, Drewnowski A. Sugars and satiety: does the type of sweetener make a difference? Am J Clin Nutr. 2007 Jul;86(1):116-23. [Medline]
  6. Akhavan T, Anderson GH. Effects of glucose-to-fructose ratios in solutions on subjective satiety, food intake, and satiety hormones in young men. Am J Clin Nutr. 2007 Nov;86(5):1354-63. [Medline]
  7. Spitzer L, Rodin J. Effects of fructose and glucose preloads on subsequent food intake. Appetite. 1987 Apr;8(2):135-45. [Medline]
  8. Rodin J, Reed D, Jamner L. Metabolic effects of fructose and glucose: implications for food intake. Am J Clin Nutr. 1988 Apr;47(4):683–9.
  9. Rodin J. Comparative effects of fructose, aspartame, glucose and water preloads on calorie and macronutrient intake. Am J Clin Nutr 1990;51:428–35. [Medline]
  10. Rodin J. Effects of pure sugar versus mixed starch fructose loads on food intake. Appetite 1991;17:213–9.[Medline]
  11. Moran TH. Fructose and satiety. J Nutr. 2009 Jun;139(6):1253S-1256S. Epub 2009 Apr 29. [Medline]
  12. Teff KL, et al. Dietary fructose reduces circulating insulin and leptin, attenuates postprandial suppression of ghrelin, and increases triglycerides in women. J Clin Endocrinol Metab. 2004 Jun;89(6):2963-72. [Medline]
  13. Livesy G. Fructose ingestion: dose-dependent responses in health research. J Nutr. 2009 Jun;139(6):1246S-1252S. Epub 2009 Apr 22. [Medline]
  14. Dolan LC, et al. Evidence-based review on the effect of normal dietary consumption of fructose on development of hyperlipidemia and obesity in healthy, normal weight individuals. Crit Rev Food Sci Nutr. 2010 Jan;50(1):53-84. [Medline]
  15. Livesey G, Taylor R. Fructose consumption and consequences for glycation, plasma triacylglycerol, and body weight: meta-analyses and meta-regression models of intervention studies. Am J Clin Nutr. 2008 Nov;88(5):1419-37. [Medline]
  16. White JS. Straight Talk About High-Fructose Corn Syrup: What it is and What it Ain’t. Am J Clin Nutr. 2008 Dec;88(6):1716S-1721S. [Medline]
  17. Dyck JH, Ito K. Japan’s fruit and vegetable market. Global Trade Patterns in Fruits and Vegetables. [ERS/USDA]
  18. Saremi A, Arora R. The cardiovascular implications of alcohol and red wine. Am J Ther. 2008 May-Jun;15(3):265-77. [Medline]
  19. Sánchez-Lozada LG, et al. How safe is fructose for persons with or without diabetes? Am J Clin Nutr. 2008 Nov;88(5):1189-90. [Medline]

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