This author doesn't read his own studies or check his numbers. Here's the most glaring example:
> 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].
Except the Japanese DON'T eat much fruit compared to Americans. It's in his own citation:
Japan fruit consumption: 41.5 kg per person per year
USA fruit consumption: 126.5 kg per person per year
Americans eat over 300% more fruit than Japanese. I don't know what a "significant staple" is, but from my time in Tokyo, Osaka, the rest of Kansai, and Hokkaido, Japanese have a heck of a lot less fructose than Americans do. It's mostly rice, meat, fish, and vegetables, and the main desserts are only semi-sweet like mochi and red bean.
The most powerful argument Lustig makes is one he barely makes any fuss about in the video, but can't just be waved aside: "I use this information to craft diets that consistently cause obese children to lose weight."
If you dig into actual dietary outcomes, "a person consistently loses weight on this diet" is a milestone hardly any diet reaches. Certainly not diets based on the idea that obesity is caused by eating too much and so the solution is to eat less; those have a terrible track record.
The way to cut through the scientific fog is not to argue about mechanisms and causation; the way is to look at who makes correct predictions, and consequently in the case of diets, what works and what doesn't. Fructose may not be evil, it may merely be strongly correlated with something else that is evil, but that's good enough for me, for today.
I also didn't think the problem was fruit, but rather things like HFCS-sweetened sodas. A banana or an apple has about 100 calories, but a 12 ounce can of soda has about 150. I know people (I was one) that will drink 32 ounces (about a liter) of soda just at lunch but won't have more than 2 pieces of fruit a day.
There's also the fact that the apple or banana have fiber and other nutrients the sodas are missing. The sodas (or often other HFCS-rich foods) don't have.
Yeah, at one point Lestig points out that generally fruit is ok because the amount of fructose in fruit is relatively low and accompanied by lots of fiber and micronutrients. Fruit also tends to be more expensive so you can't eat as much even if you wanted to.
A mango is a sweet and not particularly fibrous fruit, and it's only about 15% sugar. According to nutritiondata.com, A pound of mango pulp has about 65 grams of sugar. That would probably cost about $7.00 prepared (you can get them sliced fresh at Whole Foods). According to thedailyplate, a 20oz bottle of Pepsi, which feels expensive at $1.25 as you can get liter bottles for only slightly more, has 69 grams of sugar.
And like I said, mango is not a particularly low-sugar fruit. Pineapple is 8.5% sugar and the bromelain makes your mouth hurt if you eat too much. Apples 10.5%.
Sweetener control becomes a lot easier if you elect to add it yourself: For example, to keep my own cravings at a minimum I've moved towards a combination of fruits and individual sugar packets, or more often noncaloric sweeteners, for sweetening. The sugar packets are 5g each(as are sugar cubes), which means you would have to dump eight of them in your coffee to make it as sweet as a 12oz Coke(40g).
Nobody dumps in eight sugar packets into plain coffee - they buy a sweetened coffee beverage instead, which is about as sugary as the Coke and costs more to boot.
Candy bars and cookies are similarly difficult to portion control, because, again, they're overconcentrated.
Also, the author makes one of the most annoying forms of argument: "truth through averaging." "So, what’s the upper safe limit of fructose per day (all sources considered)? [Author than compares high and low estimates]... Figuring that both sides are biased, the middle figure between the two camps is roughly 50 grams for active adults."
Lessee -- scientists argue that the Earth formed ~6 billion years ago, creationists say ~6000 years ago. Figuring both sides are biased, the middle figure between the two camps is roughly 3 billion years ago. So the Earth is 3 billion years old. QED.
It completely depends on what probability distribution you assume for the range. If it's a normal distribution with a high confidence interval from 25g to 90g, taking the average is reasonable. For the age of the Earth example, clearly the distribution is a bit more binary.
Maybe we're getting "hung up on the trivial minutia of an exact gram amount", though.
Although I don't completely agree with the author, he accuses Lustig of a similar fallacy: using the popularity of his Youtube video to justify where the truth stands.
To be fair, that study has a few procedural gaps that make me want to wait for confirmation and expanded testing.
Even though I'm predisposed to agree with it's conclusions --or perhaps because I'm so predisposed to agree with it's conclusions-- I'd prefer to wait for better science before calling the race.
The resulting chemical structure, after digestion, is the same, but with different amounts of each chemical. Sucrose is a 50/50 mix of fructose to glucose. HFCS has a customized ratio, 55/45, 42/58, or 90/10.
A sucrose molecule is just a glucose and a fructose chemically bound as a compound (so it necessarily has a 50/50 composition). But the fructose is HFCS is free, not bound to glucose. This is an interesting hypothesis for why HFCS might have such an effect compared to sucrose.
From the article:
"Second, as a result of the manufacturing process for high-fructose corn syrup, the fructose molecules in the sweetener are free and unbound, ready for absorption and utilization"
Interestingly, there's one difference between sucrose and a 50:50 glucose/fructose mix: the sucrose will have less sweetness per calorie, because it's only one molecule (a disaccharide) and can thus stimulate only half as many sweet receptors.
Given that the body attempts to measure current calorie intake by calibrating past calorie consumption versus past perceived sweetness, this means that the glucose/fructose mix will prime the body to crave sweets more intensely. This is pretty much the only biologically plausible argument against HFCS.
Compare: the studies showing that diet sodas actually lead to an increased risk of diabetes (doi:10.2337/dc08-1799).
I think he must not have been aware that article... pretty embarrassing for him after he does that long, snide blog post only to have a new study blow it out of the water.
I think the point was that the Atkins diet allows for far less fruit consumption than the Japanese have on average, so grouping the two diets together as "effectively fructose-free" is incorrect.
Very interesting article. I continue to be amazed at how primitive our nutrition science is but I guess that's what happens when you combine a tough problem with market distortions.
The tough problem: there are a million variables to control for, people's environment (work, health, happiness, etc.) confounds everything, accurate reporting is difficult, food quality varies (e.g., apple nutrients have changed over time), etc.
The market distortions: huge subsidies and entrenched interests for factory farming with a heavy emphasis on grains, cereals and legumes, particularly wheat, corn, and soybeans.
I've found that substituting lots of fat and protein for carbohydrates while emphasizing food quality (little processed foods) produces lots of satiety, and improvement in physical performance, a better lipid profile and loss of body fat. But YMMV.
The science of nutrition and biochemistry in general is anything but primitive. Unfortunately though, there is probably no single field that has a greater amount of psuedo-scientific nonsense published about it in the mainstream media (not to mention crackpot blogs, books etc). Anyone can publish a book or a blog and pretend to have expertise on the topic. For example, I remember seeing one that was proudly emblazoned with the author's name appended with "PhD". It was complete fluff. Turns out her PhD was in English literature.
Like all sensationalist issues, the fructose thing is more nuanced than the fruitcakes on either side would have you believe. But where's the fun in that?
I've been considering starting some sort of site for publishing the real truth on this stuff, but I'm not sure how interesting it would be to other people. The truth just isn't link-baity and sensationalist enough, y'know?
> The science of nutrition and biochemistry in general is anything but primitive.
Really? Given a particular food item/meal/diet, can we accurately predict all of the effects it will have on a particular person? As far as I can tell, our knowledge of nutrition (even the most “scientific” bits I’ve seen) are largely based on a few stabs in the dark, lots of hearsay/anecdote, and either exaggeration or lots of hedging.
Add in questions about which food items are most useful when eaten at the same time, what part of our daily schedule should have which foods, how nutrition intersects/interacts with sleep/exercise/mental activity, etc., and I’ve never read anything that leads me to believe we have even the beginnings of an “advanced” understanding.
We can make some broad suggestions: eat a varied diet; hold off on the sugar; try to get some aerobic exercise; sleep enough; get enough sunshine; etc. But human bodies seem to be pretty tolerant of many possible diets: which can we tolerate, and under which do we thrive?
Our daily diets – for example eggs and cereal for breakfast, sandwiches at midday, a piece of meat and some mixed vegetables or some pasta or whatever at night – are basically culturally specific, driven by historical accident: in different parts of the world, diets, work schedules, types of physical exercise, &c. vary substantially; which of these differences are because of legitimately different needs, and which are arbitrary?
In terms of fruitcakes, I was thinking more of the people that bring a political agenda or talk about "toxins" or what not.
Long story short: fructose is only problematic if you are consuming it without dietary fiber (e.g. as fruit) for glycemic control, as well as all the other modulating effects fiber has.
Fructose (and HFCS) sweetened foods are really just a sideshow to the the main issue: people making bad nutrition and lifestyle choices over the long term, e.g. drinking sodas every day. There's no easy, magic bullet that takes away one's responsibility for making good choices.
Magically eliminating fructose or HFCS from our diets won't reverse the obesity trend. It'll help a bit, of course, but ultimately humans will need to find a way to adapt to over-abundance of temping, high-calorie foods. Meanwhile, a modicum of education and self-discipline are the keys.
The Lestig talk offers some fairly convincing arguments that what you say is not the case. Fructose is inherently problematic. Fiber merely mitigates the effects, which are still there and wouldn't have happened at all had you eaten something without sugar at all.
Furthermore, while drinking sodas every day is perhaps a choice, what about the example of walking down the bread aisle and finding that something like 95% of the varieties listed HFCS as an ingredient? It's not just that sodas and juice drinks are ubiquitous, heavily-marketed, cheap, tasty, and designed to maximize consumption and therefore profit through use of diuretics and sodium and therefore people find themselves making the dietary choice to drink them with meals instead of water, but also the fact that HFCS is used in an enormous number of processed foods.
Bread, pizza dough, tomato sauce, cookies, candy bars, chocolate, yogurt, sports drinks, salad dressing, BBQ sauce, chocolate milk... HFCS is everywhere because it's cheap, because it makes food taste better, and because it doesn't fill you up so people will consume (and therefore buy) more of it.
On the one hand, fats are more calorie-dense, but sugar doesn't fill you up (and in my experience salt has a similar effect but I work out and sweat a lot so that could be why). So the combination of sugar and fat is the killer combination.
Try this experiment: for a single day, try to eat 4,000 calories of nothing but a simple starchy food (like white rice) with some fat, like olive oil. This is a low fiber, high calorie diet. My guess is that you'll feel incredibly full after all the rice and oil. You may not even be able to reach 4,000 calories in 16 hours. You'll have to force yourself to eat by the end.
Then, a few days later after you've sent some fiber through your digestive system to clear out any blockage you caused eating so much rice, try the same thing with soda and cookies. Get a couple boxes of your favorite HFCS-sweetened cookies and a couple of 2-liter bottles of your favorite soda or better yet, juice drink. See how hard it is to reach 4,000 calories now. My guess is that you'll have no trouble, although you may feel a bit ill by the end of the day.
You have to applaud Coca Cola. Over a mere 70 years they have managed to teach the entire planet to consume a dessert multiple times a day; for some people multiple times in one meal. Imagine trying to convince the entire planet to eat ice cream or chocolate cake with every meal. That is an impressive manipulation of human behavior.
> 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 across the board, rather than an increase in carbohydrate in particular.
Ok, but the Calories in/out argument is a silly oversimplification. Pregnant women gain weight because they consume more calories than they expend, but this isn't the most interesting level of causation.
Let's say that one day I drink two cans of Coke in the morning, and measure how I feel for the next few hours. The next day I eat 320 calories worth of chicken breast. To say that an increase in caloric intake can be caused by a change in the kinds of foods consumed is not a contradiction.
The author of this rant either completely misses, or tries to skate around this obvious point, as many do.
I think the author's 'rant' contains an answer to your post:
"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 think the main point of his post is that fructose is being demonized. He points out that we're taking in more calories while spending less. If anything is to be taken from the article is that moderation is the way.
aking 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 across the board, rather than an increase in carbohydrate in particular.
Doesn't Lustig propose that a change in the proportion of fructose to other sugars in the diet causes a decrease in satiety, leading to more overall caloric intake?
Sort of tangentially to this (fairly good) article, I have noticed a number of people recently somehow conflating all fructose with high-fructose corn syrup and other refined variants. I am not sure if this is just symptomatic of ignorance or a concerted effort of some kind.
Could you be more specific? The two are not without similarities in how they are metabolized, so if we're to understand what you mean by "conflating" you should mention the way in which they should not be combined/confused. Since HFCS is a solution of fructose and glucose, there is overlap.
There is no HFCS "molecule"- high fructose corn syrup is a solution containing a certain percentage of fructose and glucose molecules, which are not attached to each other.
You may be confusing it with sucrose (table sugar) which does consist of a fructose and glucose molecule with a glycosidic linkage.
I've done my best to understand the data, but with my limited understanding of natural science, I trust the man with the M.D. and a focus in metabolism more than the one with an MS in nutrition.
Really? Can't we evaluate these claims properly? Both sides here are citing sources and starting a healthy debate. Why must we resort to choosing a side based solely on authority? I always assumed the HN audience would never fall back on that since we've seen success and intelligence where least expected.
On the contrary, I think it makes a lot of sense to accept the opinion of someone more educated on a topic than yourself. I'm a technologist, not a nutritionist. Likewise, if a doctor thought he knew more about software than me, he'd likely be mistaken.
If you know nothing about a topic, then yes, best to listen to someone that does. But both individuals here are at least knowledgeable enough to debate this without us automatically choosing a side. This isn't the case of a sales director arguing with a senior programmer. It's a junior programmer taking on a senior programmer.
> Likewise, if a doctor thought he knew more about software than me, he'd likely be mistaken.
Usually, but I would hope if a Con Kolivas offered an opinion on your code, you wouldn't brush him aside merely because he was a doctor :) Reminds me of this thread: http://news.ycombinator.com/item?id=930117
> 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].
Except the Japanese DON'T eat much fruit compared to Americans. It's in his own citation:
Japan fruit consumption: 41.5 kg per person per year
USA fruit consumption: 126.5 kg per person per year
http://www.ers.usda.gov/publications/wrs0406/wrs0406h.pdf
http://www.usda.gov/factbook/chapter2.pdf
Americans eat over 300% more fruit than Japanese. I don't know what a "significant staple" is, but from my time in Tokyo, Osaka, the rest of Kansai, and Hokkaido, Japanese have a heck of a lot less fructose than Americans do. It's mostly rice, meat, fish, and vegetables, and the main desserts are only semi-sweet like mochi and red bean.