Sugar: The Bitter Truth (UCSF lecture)

http://www.youtube.com/watch?v=dBnniua6-oM

by chipsy • 17 years ago

153 86 17 years ago

chipsy• 17 years ago

I was struck by the allusion Lustig makes to sugar being as poisonous as alcohol. It makes ours look like a world of drug fiends.

gregwebs9• 17 years ago

This is an interesting anecdote from someone who claims to have cured his alcohol abuse problems by going low carb. http://fathead-movie.com/index.php/2009/04/30/primal-body-pr...

shiny• 17 years ago

The paleo diet is awesome. I've lost a considerable amount of weight on it, and feel and look much better.

Also, a diet with staples like grass-fed beef, pastured butter (or any other healthy animal fat), avocado, and fish is my kind of diet. No more forcing down bitter grain or soy products in fruitless attempts to go "healthy". Plus, my meals are so substantial and high in fat that I only need to eat once or twice a day.

For anyone interested, there's a lot of good paleo sites out there, but I'd start with http://paleonu.com and http://freetheanimal.com

And if you can, pick up Nourishing Traditions by Sally Fallon.

gaius2• 17 years ago

If you have ever tried going low- or no- carb, it is exactly like withdrawal. You feel awful and then just a taste, just a little, won't affect the diet, and you feel OK again...

pg2• 17 years ago

I highly recommend watching this.

rarrrrrr3• 17 years ago

The natural health community has been screaming this for decades. Few take heed.

My family has spent many years studying human health. The well-researched conclusions are so far from mainstream American beliefs that the ignorant dismiss them as absurd.

I'll get down voted, but in the interest of countering groupthink, here are some examples anyway:

- Food basics: Avoid hydrogenated oils, sodium nitrite, MSG/yeast extract, artificial colors, high fructose corn syrup, all artificial sweeteners, all grains that aren't whole. Replace sugar with agave nectar or stevia. Know the smoke points for the cooking oils you use an don't exceed them.

- Any multivitamin which packages B12 solely as "cyanocobalamin" is cheaply manufactured. Quality vitamins package hydroxocobalamin. You'll probably have to look online or at health food stores to find good quality vitamins. Many of the options sold at pharmacies are little better than candy.

- As much as 60% of Americans are deficient in vitamin D. The body makes it in response to skin exposure to direct sunlight (not through glass.) Sufficient vitamin D reduces risk of nearly all cancers by around 70%. Why isn't the American Cancer Society screaming this message?

- A cup of blueberries a day is more effective at reducing cholesterol than current pharmaceuticals. Tastes better, too.

- Eating refined carbohydrates depletes the supply of B vitamins. For women, this contributes to the discomfort of menstruation.

- A number of plants have strong cancer prevention or anticancer properties. Examples: turmeric with black pepper, maca root, garlic.

...a few thousand more little details.

m_eiman5• 17 years ago

As much as 60% of Americans are deficient in vitamin D

Unlike many other vitamins, it's also very hard to overdose on D. Taking too much of some of the others is worse than not taking any at all, but with D that's not a problem.

pg2• 17 years ago

Actually none of those suggestions seem crazy, as far as I can tell.

hachiya7• 17 years ago

Mostly good points. I think some comments are necessary on a few though:

Agave nectar and stevia as sugar substitutes are also not without controversy. I find it easiest to get my sugar from whole, ripe, and fresh fruit. Once sufficient fruits are eaten on a regular basis, the desire for refined sugary products disappears.

Stevia: Potential problems, including cancer, reproductive issues, and interference with energy metabolishm: This article is a good start: http://www.cspinet.org/nah/4_00/stevia.html

Remmeber, stevia is an herb. Treating an herb as a food, i.e. the amount used in order to function as a replacement for sugar, is not necessarily a wise idea. Would you use ginkgo balboa or St. John's Wort as a food? Also, most people don't use actual stevia leaves, so it is still a refined product. Moving from refined sugar cane to refined herbs is not necessarily a good move. Developing a taste preference for whole fresh fruits over refined sugar products would serve our interests far better in the long run.

Agave nectar/syrup: this one certainly has a lot of hype behind it, but mostly it appears to be marketing tactics. Just think about the fact that excess fructose can raise general risk markers (triglycerides and VLDL) and has been linked to increased risk for insulin resistance, diabetes, and cardiovascular disease.

High fructose corn syrup is 55% fructose.

Agave syrup is 70-90% fructose.

So if you think too much fructose is bad, you must think HFCS is better than agave syrup.

Lastly, the recommendation for cyanocobalamin to be shunned in favor of hydroxy seems a bit off. The known highest active form of B12 for humans is methylcobalamin. Hydroxy is more efficiently converted than cyano, but methyl has the general current consensus, in the medical research world, of being best. Fortunately, B12 supplements of the methyl form are easily obtainable (e.g. Jarrow is a brand with 1000 and 5000 mcg sublinguals cheaply available, and there are a number of other brands). I've never even heard of a hydroxycobalamin tablet - only that it is the standard form used for shots in some countries. It is important to realize that most US and European doctors are still behind the times and administer cyanocobalamin (in some European countries, hydroxy is used, but this is still not as preferable as methylcobalamin) for B12 shots when a patient is found to have a problem with B12 levels. However, shots are almost never needed anyway, as the diffusion process of sublingual tablets is so great that they are just as effective as shots.

JulianMorrison2• 17 years ago

You do realize that agave nectar is basically pure fructose, right?

Also, MSG has been unfairly accused. Wikipedia says "a statistical association has not been demonstrated under controlled conditions, even in studies with people who were convinced that they were sensitive to it".

azanar• 17 years ago

Awesome. Thanks for posting this.

But I do have a question regarding a couple of the items on your list:

===

1. Sodium Nitrite.

Through carelessness, it can result in the production of carcinogens; in large quantities this can cause cancer, but the AMA states that there have been no cases of food consumption induced cases of methemoglobinemia -- most of the cases have been due to contaminated water or accidental overusage in food. It has has been linked to migraines with those already showing a tendency. There is also a possible link between COPD and this substance, but the question is still largely unresolved. So there are risks, but only under particular circumstances. And, evidently, there are some things it treats effectively. It's worth being cautious about, perhaps, but not necessarily phobic of. Is there some other risk I am missing here? What is the additional cost involved of eliminating sodium nitrite? Is it worth it, considering that it prevents the growth of some really toxic bacteria?

2. Artificial colors (and some flavors, maybe?).

There is some suspicion that some of these colors might result in an increased instance of ADHD. Is the data reliable? What about the studies that suggest no correlation? Ask I asked in question 1, what are the additional costs of eliminating these? Since we may not color otherwise -- it is just aesthetic, after all -- what are the potential cost savings? Are they worth it? Any other risks I am missing? Same questions.

3. MSG.

Same concern as NaNO2 about migranes, and a possible link to obesity. Both of these appear inconclusive. Same questions as NaNO2.

===

There are a few other things I need to research more before I can asked good questions about them. And some of your advice I have no questions about; I'm already aware it is good advice. :-)

I'm not asking these just to be deliberately provocative; I think they are important questions to ask. A rambling train of thought on why I decided to ask them:

The people I know who really obsess about what is in their diet are, on average, the most unhappy, neurotic people I could imagine meeting. They spend much of their time avoiding disease and increasing longevity at the expense of enjoying life and not worrying so much.

Sure, they could just punt, and buy everything at the most natural store they can find, but that is really expensive.

To account for that added expense, they now have to find work that pays better, which for many people means compromising on a number of other intangible factors. These can play havoc on a person's frame of mind, and cause a variety of other health consequences.

I may not be speaking for many of the people here; I suspect the expense is something a lot of us -- including me -- could bare without a lot of trouble and without sacrificing much in quality-of-life.

But I don't think the average HNer is representative of the larger population.

Example: one friend of mine, neurotic about his diet, quoted me a grocery bill of over $600/month on average. You can probably imagine what sorts of items he buys regularly

This a remarkable sum of most peoples' take-home pay. If they bought food this way, the money they spend might increase their longevity; we've had threads on here in the past arguing that this budget is worth every penny. However, it might also severely hamper their quality-of-life; it might even start to hamper their ability to pay for what we consider necessities.

In the case of the friend, it was a significant chunk of his take-home pay. He constantly found himself strapped for cash and falling into deeper levels of depression as a result. I'm not sure if he was making the net positive trade-off. It sucks that he had to make that trade-off at all, but that is several political squabbles from getting solved.

I don't mean to discount any of your advice. In good circumstances, it is well thought out and well researched advice. I follow at least some if it myself, and probably should follow more. I'm making a note to add blueberries to the next shopping trip, even though my cholesterol was ok last time I had it checked -- they're tasty, that is reason enough anyway. :-)

But I think it's worth mentioning that this problem goes deeper than just individual people passively ignoring advice. As even Dr. Lustig pointed out, there is manipulation going on behind the scenes, and some people may not have the means to effectively fight against the manipulation and still feed themselves.

And it's also worth asking for clarification, even if one can make a change without an undue burden. Asking questions is always a good idea. :-)

voidpointer2• 17 years ago

Why on earth would you recommend Agave syrup as a sweetener when it has an even higher fructose/glucose ratio than the dreaded HFCS? There are sweeteners that are 100% glucose including plain old corn syrup but also other nice alternatives (maple syrup etc...) or even refined dextrose...

fauigerzigerk3• 17 years ago

"Sufficient vitamin D reduces risk of nearly all cancers by around 70%"

That sounds too good to be true.

GrandMasterBirt• 17 years ago

A simple but effective message.

If only this information was easy to come by. Most people don't have time to look into the nitty gritty details of the foods they eat.

In reality like comp programs before we optimize on details, let's solve the biggest problems we have then when those are solved we can focus on little details here and there.

Don't drink soda/juice, Eat blueberries and fruits instread of candy/cookies. Would that not significantly improve most people's health by itself?

rarrrrrr3• 17 years ago

Some quick answers to several of the questions posed in responses (I will try to spend more time in this thread later today):

The expense of good quality food -- agreed wholeheartedly. It's one of the many reasons for solving (as PG says) "the money problem." There are also policy changes we could make -- subsidizing fresh produce instead of corn and sugar would help.

Organic food is prohibitively expensive to many, and contributes to class divide. There's also some ethical argument regarding whether a class division across food should exist at all. Is it appropriate for the wealthy to create a separate variety of more healthful food which only they can afford? Having done so, what incentive do they have to improve the food supply generally? In the US, the demand for organic food has always exceeded supply.

Regarding the healthfulness of MSG, please see: http://en.wikipedia.org/wiki/Excitotoxicity

Regarding the suitableness of agave nectar as a sweetener: Yes, it's fructose, but not all fructose containing substances are the same. Agave has the useful quality of being very low glycemic -- lower than a peanut. This means it's absorbed slowly over hours instead of minutes like refined sugar. As a result, it avoids causing insulin spikes and blood glucose instability.

However, ideally health conscious people will become accustomed to less sweet foods over time. I think eventually tastes recalibrate. Personally, I now find broccoli and cashews to be very sweet, but I didn't years ago when I used to frequently eat sugar.

Regarding nitrites -- their safety is mostly argued by the meat packing industry (no surprise.) For (one of many) authoritative references, see the World Cancer Research Fund's report: "Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective" (2007). http://www.dietandcancerreport.org/

Artificial colors -- Take note of the history of colors approved by the FDA. We've spent decades approving substances and then later finding significant problems with them. I'm not ready to trust the current batch, and evidence against them is accumulating. Ironically, some of the safest color adding substances right now are made from ground insects! http://www.snopes.com/food/ingredient/bugjuice.asp

gregwebs9• 17 years ago

This guy is a great presenter. The hypothesis behind the damages of fructose actually gets worse than what is presented here, as fructose is implicated in the creation of toxic AGE. For a more in depth overview of the science behind fructose that is accessible, I would recommend Good Calorie, Bad Calorie by Gary Taubes. Aside from fructose, I would actually recommend that book to anyone concerned about their health.

I think it is important to differentiate between normal (hunter-gatherer) levels of fructose consumption (< 5% of total calories, normally closer to 1%, except perhaps in the summer when fruit is more abundant) and the amount we are eating today. That is, if fructose is harmful, the dangers only seem to manifest at the high levels of intake seen today.

Pragmatically, we may not need to be concerned about fructose at all, as eating refined sugar is obviously bad for health, so it should be eliminated anyways. (You need vitamins and minerals, and refined sugar doesn't have any!). Unrefined sources of sugar are not very good nutritional resources either.

Tragically, the damages of fructose may have been multiplied by the government recommendations to replace saturated fat intake with polyunsaturated fat. http://high-fat-nutrition.blogspot.com/2009/12/cirrhosis-and...

MikeCapone• 17 years ago

Thanks for the recommendation, I've requested it from the public library.

gregwebs9• 17 years ago

Actually, I shouldn't call it accessible since it is extremely detailed (and long). But now without purpose, as this is what is required to make a solid scientific case. It is easy to follow as long as you can maintain an interest in the subject at hand.

imd2• 17 years ago

"Unrefined sources of sugar are not very good nutritional resources either."

What about blackstrap molasses? https://secure.wikimedia.org/wikipedia/en/wiki/Blackstrap_mo...

gregwebs9• 17 years ago

Thanks for the link, that is pretty cool, and seems potentially like one of the best sweeteners. I guess I have never really looked at molasses because nobody eats it anymore. If my understanding is correct it is more concentrated in minerals because it has the minerals that have been removed from the table sugar. So it is also a type of refined sugar, but nutrients have actually been added instead of taken away.

I tend to stay away from these kinds of factory produced foods. You have to put trust in the manufacturer not to be adding chemicals, etc.

But maybe this could be a healthy part of the diet. The fructose is bad or sugar/refined carbohydrates is bad theories have not shown that the health problems could instead be caused by a lack of nutrients in the sugars we consume.

earl• 17 years ago

I have to second this recommendation. Everybody concerned about nutrition should read

* Good Calorie, Bad Calorie;

* The Omnivore's Dilemma

* The End of Overeating.

In order: the science of fat and weight, as best as can be explained today; what's in your food, and what you should be eating; and how companies influence your eating decisions and how to take control of them.

In particular, the last book summarizes research showing that, for certain people, there is a reward conditioning feedback mechanism in the brain triggered by the intake of fat, sugar, and salt. see http://www.boingboing.net/2009/05/07/end-of-overeating-th.ht... for a longer review. In particular, if you have lots of willpower elsewhere in your life but struggle controlling your food intake, I can't recommend this book strongly enough.

In any case, I think everybody should read the above 3 books; you'll be a long way closer to being a well informed consumer of food and of it's effects on your body.

stephen2• 17 years ago

Good Calorie, Bad Calorie was great, except that 90% of it was a history lesson where he explains, in a very detailed manner, how other nutrition theories of the last 100+ years were wrong.

Anybody know of another source that describes the book's views on fat metabolism, blood sugar, etc. but is shorter and more to the point?

Not only for my own benefit to review, but I have a hard time recommending Good Calorie, Bad Calorie to friends who are only marginally interested in nutrition, but would still benefit from reading the book's core ideas in a distilled form.

gregwebs9• 17 years ago

I don't think these books are in harmony with each other at all, what was your take on combining the knowledge?

The Omnivore's Dilemma, or at least the statements of its author, Michael Pollan to to eat low in the food chain are predicated on the idea that eating animal is bad for you, which thoroughly debunked (at least with respect to fat or saturated fat) by Taubes.

Taubes is also a fierce advocate that weight issues normally have little to do with willpower over overeating and everything to do with eating too many refined carbohydrates.

nearestneighbor4• 17 years ago

Someone will have to answer for sapping and impurifying our precious bodily fluids!

rdouble• 17 years ago

Jack LaLanne tried to warn us about this 50 years ago:

http://www.youtube.com/watch?v=LJVEPB_l8FU

dustineichler2• 17 years ago

If you want the jist of this lecture, around 1:15:00 is a good place to start, he rants about Gatorade and McD's. Otherwise, it's O-Chem(?) up to that point. Very interesting stuff. Less Fructose, more Fiber. Less Frankenburgers, more Fruits.

dustineichler2• 17 years ago

He also mentions the paleolithic diet as a cure of type 2 diabetes. Link here: http://en.wikipedia.org/wiki/Paleolithic_diet

CamperBob2• 17 years ago

Ah, yes. To live longer, eat like people who were lucky to see the far side of 30.

dcurtis2• 17 years ago

I suggest you do not skip the chemistry. It's fascinating and provides solid evidence to back the stuff he talks about later.

nearestneighbor4• 17 years ago

Exactly how does fiber work as an antidote to fructose? I didn't catch that. Did he even explain that?

nearestneighbor4• 17 years ago

I watched the whole video. I thought he was going to explain why they put salt in coke, but it seems he never did. Was he just implying that they are trying to get people to drink more?

onoj• 17 years ago

salt is hygroscopic - it sucks water from your body making you thirsty / sets off a mechanism which makes you feel thirsty. This is why beer and coke etc have salt in them (also explains free peanuts and pretzels in bars)

m_eiman5• 17 years ago

Salt also tastes good, which is why people want to eat/drink it (and there's probably an evolutionary reason for this - the body needs it). Try peanuts without salt, it's not quite the same.

jeremyw2• 17 years ago

So this is another odd failure case for science, where researchers from many areas selectively ignored (since the 1970s, let's say) a roughly-worked-out biochemistry. Add political chilling effects and mix.

Given that there aren't particularly impervious ties in either political party to sugar/carbs (activists being health advocates on the left and anti-subsidy advocates on the right) I hope this set of research pathologies gets a kick in the pants when sugar support detonates.

camccann2• 17 years ago

The sugar lobby is the corn lobby, because that's where most refined sugar comes from. In other words, Midwest farmers, particularly in Iowa. See the problem now?

jeremyw2• 17 years ago

Understood -- I'm saying there are growing factions in both parties that will make these old allegiances obsolete.

pkrumins• 17 years ago

I watched it a while ago but I did not understand what was the key idea that he wanted to say.

Okay, the corn syrup is just fructose, and as I understood from the lecture it's equivalent to poison so we should avoid it.

But then sugar from plants and fruit also contains fructose! For every gram of natural sugar there is half a gram of fructose. If we eat natural sugar it seems equivalently bad? I don't get it.

So what does the lecture tell? Does it say we shouldn't be consuming sugar at all? Or should we only be consuming glucose part of sugar? Or what?

Can anyone explain?

Thanks!

gaius2• 17 years ago

IIRC T-nation had an article on this. Fructose in an apple is OK because the fibre etc means it is absorbed more slowly. The body isn't designed to have a huge amount of fast-digesting carbs dumped into it in one go - even if the total calories are the same.

fauigerzigerk3• 17 years ago

I think what he means is that the amount of fructose you get from eating fruit is much less as a proportion of beneficial nutrients than if you were drinking fruit juice or stuff with high fructose corn syrup added.

I think the main message is to avoid fructose in all forms. The rest is basically ABC analysis. Identify where most of your fructose intake originates from and cut down on that source.

voidpointer2• 17 years ago

This was really very interesting. I for one was mostly ignorant to the big difference there was between glucose and fructose. Also the bit on ethanol was quite interesting in itself.

The fact that HFCS is made from normal corn syrup (almost 100% glucose), which is processed into fructose seems almost ironic.

scotty794• 17 years ago

Eat food. No too much. Mostly plants.

nunb• 17 years ago

As the professor points out in that lecture, plants have their own problems (fiber).

Human digestive tracts are made for high-quality (bio-available energy/mass) nutrition-dense foods, unlike ruminants, or large apes like the gorilla.

And most people get plants confused with seeds. No other animal eats seeds in the quantities we do, especially as Omega-6 rich seed-oils.

Pollan has become a touchstone for many, but imho he's fairly wrong.

ivan_ah• 17 years ago

if i understood correctly, fiber the good part of fruits (fructose being the bad part) ref: ... packaged the poison with the antidote...

very good video, learned a lot

kingkongreveng_4• 17 years ago

The whole video is about how fructose is toxic. Many, many plants are rich in fructose. It's not as simple as "eat plants." A modern variety apple or orange is a blast of fructose.

It's also perfectly healthy to eat predominantly meat, organs, and dairy if the animals are properly pastured. So the "mostly plants" claim makes little sense without a lot of qualification.

ericd• 17 years ago

He says that fiber mitigates the fructose in fruit. It's when it's separated from the fiber as juice that it becomes a problem.

scotty794• 17 years ago

'Mostly plants' refers to the only piece of diet world that has been proven by science. If you eat more plants you have lower risk of many severe diseases. That's all we know about diet for sure. The rest is guesswork and wishful thinking.

Freebytes• 17 years ago

Wow. I just read a lot about sugar last night. I wanted to know if glucose was truly the only sugar the brain needed. I found that processed sugars are used almost immediately by the body; whereas, the sugars from natural sources are released at a later time in smaller quantities. I read an article that stated that these large doses of sugar cause a sudden, large increase in insulin which can actually starve the brain from getting all of the sugar it needs as the body tries to dispose of excess sugar. It was a very interesting series of articles that I might hunt down again and post on HN at some point.

johnl• 17 years ago

If you are going to see grandparents this holiday, a good discussion might be to ask them about their sugar consumption, prevalent health problems now and then, and compare those to your own. Bet there is a big difference.

CamperBob2• 17 years ago

If they're honest, what they'll report is that their own grandparents died about 20 years younger than they are now.

Sugar: The Bitter Truth (UCSF lecture)

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