A political, emotional, even moral issue.
February 22, 2014 7:27 PM   Subscribe

Sugars and cardiometabolic health: A story lost in translation? (Video.)

On February 11, 2014, John Sievenpiper, MD, PhD, presented a talk at the University of Alabama at Birmingham, asking important questions about both the scientific research and the popular narratives concerning fructose intake and health.

Interesting points include ecological studies showing a "sugar intake paradox" in certain countries, the effect sizes of individual nutrient intakes compared to effect sizes from behaviours like smoking, and the importance of taking observational research in nutrition forward by conducting trials on overall dietary patterns, using hard endpoints.

Be sure to click the "Chapters" tab if you don't have a whole hour. The historical background of the great nutrition debate (sugar vs. fat) in Bookmark 4 is especially interesting.
posted by Ouisch (43 comments total) 8 users marked this as a favorite
"install Silverlight"?
posted by mr vino at 7:45 PM on February 22, 2014 [6 favorites]

"Those are my disclosures over the past 24 months: I'm not gonna go through them all, but I can send them to you if you like. I'll just simply state I think it's important that I be transparent; I have received unrestricted investigator-initiated funds from the Coca-Cola company, from Dr. Pepper, so there are some industry connections....so, I do have an iron in the fire, if you like."

Spend some time on that disclosure slide. I think that's about all I need to give this a pass; I can put this hour to better use.
posted by Miko at 7:56 PM on February 22, 2014 [11 favorites]

I think it's an interesting topic for debate and discussion, but I just cannot take this presenter seriously given his conflicts of interest. The points he raises are intriguing, but I don't feel comfortable accepting his interpretations, given the angle he's coming from. Are there any better sources for this argument?
posted by bookish at 8:29 PM on February 22, 2014

posted by srboisvert at 8:30 PM on February 22, 2014 [2 favorites]

It is too bad they decided to make it require silverlight since I am on my iPhone and have an hour to kill
posted by birdherder at 8:38 PM on February 22, 2014

No Silverlight here. Can anyone summarize?
posted by eye of newt at 9:02 PM on February 22, 2014

Damn it, this isn't what Lard-Cola's research dollars were supposed to pay for!
posted by Behemoth at 9:07 PM on February 22, 2014 [2 favorites]

On Linux, so no silverlight. Alternate source?
posted by [expletive deleted] at 9:08 PM on February 22, 2014 [1 favorite]

Can anyone summarize?

It basically presents a case that fructose, in moderation, cannot be singled out more than other carbs as being responsible for things like weight gain or diabetes (except gout), despite what animal studies might show (pigs, rats, sheep, etc). It emphasizes all calorie intake, the need for more exercise, and the need for real life human studies. Selected country paradoxes are also presented, where less sugar shows more weight gain.
posted by Brian B. at 9:12 PM on February 22, 2014 [2 favorites]

I think he may well be right. The problem with HFCS isn't necessarily that it's an evil demon substance, the problem is that it is in goddamn everything. And lots of it. Really, it's in virtually every product many people buy that isn't a fresh fruit, vegetable, or meat. And it's not fair to count the fresh fruit since that's got tons of fructose, it simply isn't HFCS.
posted by Justinian at 9:48 PM on February 22, 2014 [8 favorites]

posted by pracowity at 9:48 PM on February 22, 2014

I'm on Linux so I can't see the video or comment on it's usefulness but I note that one of the chapters is "The Australian Paradox".

Background Briefing two weeks ago on ABC Radio National did a pretty comprehensive job of demolishing the paper that posited the Australian Paradox. Here's some follow up on ABC news.
posted by coleboptera at 10:24 PM on February 22, 2014 [3 favorites]

Thanks for those links on the Australian paradox coleboptera. That was interesting. Even f the ordinal claim that Australians were consuming less sugary soft drinks. I was suspect that people are getting their sugar in other drinks like coffee drinks or juices.

Justian's comment about the OP's scientist being right does make sense too. HFCS by itself isn't the culprit, it is that it a everywhere and people consuming more. When I was a kid a large coke was 12oz. Now there is the super big gulp. Having a coke every once in a while won't make you obese but having a few cans a day will.

California is considering putting labels on sugary drinks which may make some people think again. The soft drink lobby hates it. If the label leads to lower consumption or smaller portion sizes it is a good thing

I hope to watch the video tomorrow when I'm in front of a computer (fun fact: I made a typo spelling tomorrow and iOS autocorrect made it to Oreos. Ok that wasn't fun but now I want a cookie )
posted by birdherder at 11:52 PM on February 22, 2014

The historical background of the great nutrition debate (sugar vs. fat) in Bookmark 4 is especially interesting.

There was a really interesting TV programme on a few weeks ago, in which twin doctors spend a month, one pigging out on sugar, the other pigging out on fat. Horizon maybe?

The most interesting thing in the show though, was the idea that consumption of either, alone, tends to be relatively self-limiting. However, when you mix the two together in roughly equal proportions, you have the perfect dietary weapon. Stuff like ice-cream, cheesecake, etc. we can (and do) eat until the cows come home with a sack full of sugar cane on their back.

And they had a man with rat studies to show rats quickly grow bored of either one alone, but will eat themselves to electric wheelchair in Disneyland proportions if you feed them cheesecake.

Mmmm, cheesecake...
posted by PeterMcDermott at 1:16 AM on February 23, 2014 [11 favorites]

For those with access to iPlayer, here's the link.

And a YouTube link for those who lack iPlayer access.
posted by PeterMcDermott at 1:18 AM on February 23, 2014 [1 favorite]

For those on linux or otherwise non-silverlite, VLC will play the direct video stream if you have the appropriate codecs installed
(Media > Open Network Stream > Paste in that URL)
posted by coleboptera at 1:28 AM on February 23, 2014 [1 favorite]

This looks like an interesting presentation. Besides the need to look sideways at this fellow and his research because of his industry connections, I am looking forward to listening.

That said, I don't know how any responsible MD talking in the context of diabetes (as the researcher is here), can really ever say that HCFS is an acceptable part of one's diet.

I was recently diagnosed with pretty severe high blood pressure. Although it's hard to know what is causing it, the condition is likely due to my obesity, inactivity, and work-related stress.

When I went to see the doctor I had dangerously high blood pressure - I am going to die within 5 years if I don't get it under control.

So the first thing I had to do was immediately eliminate any and all salt and sodium from my diet, and eat as much potassium-rich food as possible. While salt is likely not the cause of my high blood pressure, it makes it much worse.

By eliminating salt, I can no longer go to the convenience store to get a snack. I can no longer eat out at restaurants (unless I order green salad with no dressing). I can no longer eat store-bought bread. I can no longer eat any prepared foods outside of plain yogurt and tofu.

Everything else has salt in it. So my dietary choices are pretty limited.

This is a blessing, really, because anything store-bought is high in calories. Any prepared foods you buy at any grocery store, whether it be a health food store or Safeway is high calorie.

It's high-calorie because of all the added fats and sugars, and this includes HFCS.

So while the researcher may be correct in his hypothesis that there is no causal relationship between HFCS and obesity rates, at the same time he should be saying that basically, all prepared foods, from Coca Cola to taco mix are essentially poisonous.

Anyway, over the past 6 or 7 weeks I have lost about 40 pounds, and I have another 40 to go (goal is my weight and BMI when I was 19 and I am 40 now).

I now walk about 90 minutes a day. I love to walk.

Stopping eating out, stopping eating wheat and potatoes (still have 1 serving of sticky rice at lunch), stopping eating snacks, no drinks - the weight has come off so far pretty quickly. I don't think I could have done it without the death sentence, which still hangs over me.

But it's really all about caloric intake. As a society, we eat too many calories, and they are the wrong kind of calories.
posted by KokuRyu at 1:57 AM on February 23, 2014 [17 favorites]

I've got fairly severe Type II diabetes and I've actually been quite surprised to discover after the most recent round of medication and dietary permutations how much larger the effect on my average blood glucose levels of cutting out most of the non-sugar carbs, and swapping in a smaller number of fat and protein calories, was compared to previously cutting out most calories from sugar carbs (and not replacing them).

I was really convinced that it had to be sugar itself which was doing me the most harm, but not so; bread and rice and potatoes were the stone around my neck, apparently.

It also seems like I've probably worried far too much about dietary fat for most of my life; I've been eating more fat calories per week as a proportion of total calories in the last year or so than at any time earlier in my life, but been losing weight constantly long-term, which I've never done before, with fairly minimal exercise. Results may vary, a'course, and crossing my fingers that all these good numbers aren't a statistical anomaly.

(I have no idea if this is similar to what it says in the video as I'm also on Linux and only just noticed coleboptera's advice. Thanks!)
posted by XMLicious at 3:38 AM on February 23, 2014 [3 favorites]

No link handy atm for the guide I used to install, but if you're on Linux there's this thing called Pipelight that works really well. I haven't tried it on Netflix yet because my subscription's on hiatus while I'm mostly watching stuff that's already on Amazon, but Amazon's video works, and so does this.
posted by Sequence at 4:03 AM on February 23, 2014

More topically: I think most medical practitioners will say that HFCS can be a part of a healthy diet, as long as it's a small one. (I'm still just getting started with the video, since it is rather long.) I dunno why it is that there's always got to be one demon substance that we're supposed to avoid, in popular thought. Why does Pollan's "eat food, not too much, mostly plants" not have the same traction? What you have to do to correct things like obesity or high blood sugar after the fact can require being more stringent, but as a baseline, at some point, it boils down to "Coca Cola is a sometimes food".
posted by Sequence at 4:18 AM on February 23, 2014

Thank you, beverage/corn syrup industry, for setting my mind at ease.

I had my last Coke at least a year ago. I do my best to avoid your products. I shall continue to do so. The evil consequences of fructose corn syrup are readily apparent.

Ten or twenty years from now, sooner or later, "Coca Cola" will be about the same as "Marlboro" in stature.
posted by spitbull at 5:13 AM on February 23, 2014 [2 favorites]

I might add that, long before I understood I had health issues, we refrained from giving our kids fruit juices (let alone Coke). Fruit juice is understood to be a treat; Coke and other soft drinks are reserved for truly special occasions, maybe once or twice a year.

The sugar in fruit juice (not drink) obviously makes kids fat, and it's bad for their teeth.

I guess HFCS could be consumed in a moderate way, but it just doesn't seem like there is the education out there about what "moderate consumption" looks like.

This researcher is no help. The genius "science writers" for AP etc would probably spin this lecture as "researcher proves HFCS does not cause obesity."
posted by KokuRyu at 6:03 AM on February 23, 2014

So while the researcher may be correct in his hypothesis that there is no causal relationship between HFCS and obesity rates, at the same time he should be saying that basically, all prepared foods, from Coca Cola to taco mix are essentially poisonous.

There has been some really interesting writing (that probably made it here as previous FPPs, I imagine) about the ways in which food scientists engineer foods with perfect "mouth feel" and with combinations of salt, sugar (or HFCS), and fat that trigger greatly increased eating. It's not just Doritos and junk food at 7-11; the same companies apply the same techniques to developing and selling foods that people aren't thinking of as junk food at all (e.g. canned soup or pasta sauce, say) that are staples of ordinary, sit-down meals in most households.

It's clearly not about one bad ingredient, but rather that as a society we have a really problematic food system, from production through to disparities in who can afford good food. I don't know if moving away from demonizing HFCS is helpful or not; the problem is clearly broader but at the same time HFCS is emblematic of what is wrong.
posted by Dip Flash at 6:17 AM on February 23, 2014 [3 favorites]

I am potentially threadjacking, but here are better presentations from UCTV:

Sugar: The Bitter Truth -- Current Controversies in Nutrition -- Robert H. Lustig, MD, UCSF Professor of Pediatrics in the Division of Endocrinology, explores the damage caused by sugary foods. He argues that fructose (too much) and fiber (not enough) appear to be cornerstones of the obesity epidemic through their effects on insulin.

The Skinny on Obesity -- Is sugar a toxin that's fueling the global obesity epidemic? That's the argument UCSF's Dr. Robert Lustig made in "Sugar: The Bitter Truth," a 2009 UCTV video that's since gone viral and sparked a national dialogue. In "The Skinny on Obesity," a 7-part series from UCTV Prime, Dr. Lustig and two of his UCSF colleagues tease out the science behind this alarming claim and the dire threat it poses to global public health.

Fat Chance: Fructose 2.0 -- Dr. Robert Lustig, UCSF Division of Pediatric Endocrinology, updates his very popular video "Sugar: The Bitter Truth." He argues that sugar and processed foods are driving the obesity epidemic, which in turn affects our endocrine system. (#25641)

I was planning a large FPP on UCTV but this seems a good place. I highly recommend watching presentations from the medical school.
posted by jadepearl at 7:30 AM on February 23, 2014 [8 favorites]

Yep, if this guys is sponsored by the junk food industry (and even admits to having an "iron in the fire" up front) I'm not going to bother with it. I get angry enough that my professional organization, the Academy of Nutrition and Dietetics, offers continuing education credit produced by junk food companies, has junk food companies as its most prominent sponsors, and their annual conference expo is basically a giant junk food vendor fest. And this organization is supposed to be representing dietitians who work in clinical settings. To the embarrassment of dietitians working in clinical settings. So anyway, I'm familiar with the food industries tactics, and their (hand-picked) research, and their practice of co-opting of medical professionals to health-wash their products. I don't need to watch an hour more of it.

Btw, if you're a dietitian, or if you want to help us get junk food sponsors out of our organization, please feel welcome to visit Dietitians for Professional Integrity to see how you can help, they're doing great work.

If HFCS cause particular harm it would be because the production process leaves you with a lot of monosaccharides, rather than disaccharides, so your body needs to expend less energy breaking bonds and can more quickly absorb the sugars present. But I'm not sure how great that effect is. The bigger issue is that kcal consumed in liquid form does not trigger your satiety mechanism the way solid food does. So if you give the same person a sugary drink or water, they will consume an equal number of kcal at a subsequent meal before feeling full. It's the extra kcal in the drink beyond what your natural hunger/satiety signals would make you consume that leads to weight gain from sweet beverages (soda, juice, whatever, equally). And it's also the reason why juicing is not healthy (unless your a juice appliance manufacturer, in which case it's healthy for your bottom line).

And congratulations, KokuRyu, and everyone else who is succeeding with lifestyle changes -- I know exactly how challenging they are. I hope it helps to know that it gets easier. Patients who've kept it up for over a year find that they no longer desire the foods they ate before. Exercise also gets easier. The more you do, the more you crave. You might try weight lifting, muscle is great for burning kcal and for boosting your immunity, and the feeling of increasing power and ease with which you can do things is addictive. If you are losing fast (and KokuRyu, you are losing, maybe, too fast.. but I don't want to discourage you because what you are doing is clearly working), plan a few months of practicing maintaining your current weight before going back into weight loss mode. Six months loss, six months maintenance, then repeat, tends to work, but you can experiment with other schedules. This helps avoid the dreaded plateau and rebound that usually occurs at the 6 month to 1 year mark in folks who are losing fast.
posted by antinomia at 8:12 AM on February 23, 2014 [6 favorites]

They are currently reworking how to present health information and food labels to the public. I wouldn't bet that they get this right with the current debates going on, but from a public policy viewpoint, they might want to revisit the thermal effect of food, during digestion, which seems to never be accounted for in food labeling (often referred to as negative calories). So 100 calories of white bread compared to 100 calories of wheat bread are processed by the body differently, and more quickly for the former, but only their carb readings would be different on the label. They could obviously use a point system for relative danger, perhaps a ratio, where 2:5 would indicate that 2 is relatively low risk for one serving, but it rises to 5 if the serving amount is doubled. That way an indication would be presented on the known danger of eating more of something, which is a message everyone needs.
posted by Brian B. at 8:17 AM on February 23, 2014

It has gotten pretty ridiculous how nutrition information has become a merry go round of superfoods and supervillans sprinkled liberally with anecdotes of miraculous personal health transformations from following the latest moralistic restriction fads.

It is as though nutrition information is mirroring processed food itself by being full of all kinds of easily digested crap that accumulates as intellectual flab. People even seem to have gotten to the point of snakeoil brand loyalty.
posted by srboisvert at 8:27 AM on February 23, 2014 [8 favorites]

srboisvert, it's because most of the "nutrition" information that the public hears comes from food manufacturers rather than scientists and public health organizations. (And when the media reports on nutrition they take one study at a time, which is not the way to consider the science, and blow the implications out of proportion to boost page views/ratings.) Food manufacturers can easily increase sales by adding some bogus "superfood" ingredient to their product, and the public equates these advertising message with actual health messages. Unfortunately food companies have budgets that are orders of magnitude greater than public health organizations, so the situation isn't going to change.

If you talk to a registered dietitian you will definitely not get superfoods/supervillians or moralistic restriction diets as part of the advice. We know all too well the harm that viewing food in this way can cause. Ie., what you're describing is not the message of mainstream practitioners, it's the message of food companies combined with the overreactions of the less-informed.
posted by antinomia at 9:22 AM on February 23, 2014 [2 favorites]

It's incredibly depressing to realize that literally every aspect of healthcare in the US is tainted by corporate money, whether it's drug companies messing with the doctors or agribusiness messing with the dieticians and nutrition researchers or me having to worry about whether my doctor is recommending that I get a mammogram partly because it would be done at their in-house Breast Imaging Unit and the hospital makes money off of mammograms. I honestly have no idea what to do about it. Is research coming out of other countries less tainted? This researcher is from Canada, so it seems maybe not.
posted by ArbitraryAndCapricious at 9:29 AM on February 23, 2014 [3 favorites]

I've learned an awful lot about fructose in the past several months -- my 7 year old daughter was diagnosed with fructose malabsorption disorder in August, after a lifetime of poor weight gain, poor appetite, abdominal pain, and miserable constipation. One of the things that was a big blow was realizing that we needed not just to avoid fructose as a monosaccharide, or even just as a disaccharide in sucrose, but in higher order saccharides as well, aka fructo-oligosaccharides and fructans. One of the most common sources of fructans? Wheat starch. (Also onions, garlic, asparagus, and artichokes, as well as a depressingly large set of vegetables and legumes. And inulin, chicory root extract, and other "pre-biotics" that are often promoted as being helpful for digestion.) I frequently wonder if some of the people who feel so much better after they give up wheat are having problems not with the gluten, but with the fructans in the starch.

For those who are looking to avoid excess dietary fructose, you should be aware that honey has exactly the same fructose/glucose balance as HFCS --55%/45%, fructose in excess -- and agave syrup is even worse, being about 80% fructose. Apple juice is about 2/3 fructose, and sucrose is of course an even 50/50 split. The most commonly available low-fructose sweetener is plain corn syrup, which is almost entirely glucose.
posted by KathrynT at 9:51 AM on February 23, 2014 [3 favorites]

KathrynT, you may be right about the wheat/gluten issue -- there's a study that shows no effect of gluten on those previously diagnosed with gluten sensitivity (not celiac, that's different) after and during being on the FODMAP diet, which is similar to what your daughter is on. The FODMAP diet is often suggested for those with irritable and inflammatory bowel disease because often these folks are sensitive to the stuff in our diet that feeds our gut flora, leading to overgrowth, which leads to a lot of gas and loose stools. But on the other hand, these are the very flora that promote the health of our colon by producing colon cancer-fighting short chain fatty acids, so finding alternative sources of fiber is important. Best of luck with it, and if you haven't already, ask for a referral to an RD who can help you find workable solutions to what is, yep, a challenging diet.
posted by antinomia at 10:15 AM on February 23, 2014 [1 favorite]

srboisvert, it's because most of the "nutrition" information that the public hears comes from food manufacturers rather than scientists and public health organizations.

Sorry, I don't wear that particular tinfoil hat.
posted by srboisvert at 10:30 AM on February 23, 2014

The tinfoil hat that I wear is that these waves of nutritional faddishness are driven by the laziness of the news cycle.
posted by wotsac at 10:41 AM on February 23, 2014

Yeah, we're working with an RD from Seattle Children's. Right now she's on a very aggressive elimination diet to allow her gut to heal from years of aggravation -- it boils down to "no plants, no sweets" as a rule of thumb, although reality isn't anywhere near that strict -- but we have a plan to re-introduce foods after four to six months of well-managed symptoms. She is never going to get back to the low-starch high-vegetable diet that I always presumed was de facto healthy for everybody, but I have hopes that we should eventually be able to get some whole grains, legumes, and vegetables back into her diet. And yeah, it's pretty challenging, but the change in my daughter is so worth it!
posted by KathrynT at 10:47 AM on February 23, 2014

See also: Scientific Review of Robert Lustig's Fat Chance by Mark Kern, PHD, RD, CSSD, Professor of Exercise and Nutritional Sciences at San Diego State University, and The Bitter Truth About Fructose Alarmism from Alan Aragon.
posted by ludwig_van at 10:55 AM on February 23, 2014

Sorry, I don't wear that particular tinfoil hat.

It's not a tinfoil hat issue. It comes from working in a public hospital where the vast majority of people there are in due to a complication of metabolic syndrome, and my job specifically being to educate those people on proper diet and physical activity levels, and personally hearing the misconceptions which are often right off of a food label or from some internet fad diet that's being passed around Facebook. It comes from hearing it so much I've stopped being surprised by it.
posted by antinomia at 11:01 AM on February 23, 2014 [10 favorites]

I was just diagnosed with Type II diabetes a month ago after a very stressful year where I was eating a lot of junk and drinking way more sugary caffeinated beverages that any one person should drink. The diagnosis was a huge wake up call. I've eliminated most sugars and simple carbohydrates from my diet, limited my fruit intake to 1 or 2 servings of fresh lower sugar fruit a day (apple or berries) and upped the veggies and lean proteins I'm consuming. I'm really working on exercising more--it is slow going because I've not been in the habit for a long time.

However, I have found my acid re-flux is gone, I'm sleeping better, my mood is better and I've lost over 10 pounds. As KokuRyu said above, I'm preparing most of my own food after having depended on restaurants and fast food.

Initially I was ashamed about my diagnosis, I know I brought this situation on myself. I didn't want to tell anyone except my close family. But I know that shame is a destructive emotion and the only way to make it constructive it to be "out" about the shameful thing. So I started telling a few folks at work who I knew are managing their diabetes well--their support and encouragement has been incredible. I now have two work buddies with whom I'm eating healthy lunches (one of the women has even been preparing food for all of us and bringing it for lunch a couple of days a week) we are doing gentle exercises together and encourage each other to get up from our desks during the day and move around (one of them is teaching me the "wobble" and "electric slide" I am a very poor student, but it is fun!).

I know all the sugar I was consuming was killing me and now when faced with something sugary I just think, "poison" and can turn it down. I hope I can sustain this new way of eating for a long, long time.
posted by agatha_magatha at 11:04 AM on February 23, 2014 [5 favorites]

Another potential factor: pills. When I was on depressed brain meds, my weight went up by twenty. When I came off (and with exercise & probably diet changes), the weight came off.
posted by five fresh fish at 4:17 PM on February 23, 2014 [1 favorite]

I've eliminated most sugars and simple carbohydrates from my diet, limited my fruit intake to 1 or 2 servings of fresh lower sugar fruit a day (apple or berries)

The craziest thing for me now is to catch myself saying to myself "Wait a minute, should I be eating that banana/apple - that's a lot of sugar" and then switching to cantaloup or something else with less sugar.

This is after regularly eating all sorts of crap as a snack for years.
posted by KokuRyu at 6:48 PM on February 23, 2014

I have little doubt that anti-sugar hysteria will fade away in a few more years. Then there will be some other pseudoscientific jihad against something else. Eventually some jihad or other might get it right, but if forced to bet, I'd bet that the relevant problems won't be the effects of one single demon ingredient.

A smart statistician friend of mine got sucked into the soda wars when he couldn't get an academic job out of grad school. He was astonished as he discovered--as he reported to me over the course of several years--how terrible the average study alleging that sugary drinks were uniquely bad was. As in: he at first simply could not believe how terrible the studies were. They often turned crucially on simple and obvious errors that, according to him, no even minimally competent statistician could possibly make. Some were bad enough that they left me speechless, and I'm no statistician. My friend began reporting his findings. The response by the anti-soda jihadis was to attack him personally and blackball him where possible. The incompetence was bad enough...but the dishonesty, vitriol, and atmosphere of warfare and personal destruction drove him out of that field as soon as he could find something else. He considers himself lucky to have escaped with his reputation intact, and will never work on that topic again.

He and I both used to make fun of our parents for scoffing at the output of "nutrition science"... "Oh, they're always saying something is bad for you," our folks would say. "It'll change next year, so why bother paying attention to it?"

My friend's experience didn't quite turn us into our parents...but let's say it rather moved us in that direction...
posted by Fists O'Fury at 7:24 PM on February 23, 2014 [1 favorite]

I think age can sometimes dictate how seriously you or "a smart statistician friend" takes the issue of the evil, diabolical HFCS. Up until the age of 35 for men, "metabolic syndrome" and accompanying disorders like high blood pressure, diabetes, kidney disease, and heart disease are pretty abstract. And even after the age of 35 you're thinking... "Hey, I'm still young, I can do something to turn the ship around."

But after 40, when health problems appear to suddenly manifest themselves in the manner that a complex system will, after withstanding multiple smaller issues, implode, all of these studies do turn you into your parents.
posted by KokuRyu at 8:01 PM on February 23, 2014 [4 favorites]

I guess that it kind of makes intuitive sense to me that drinking sugary beverages isn't great for you, for the reason that antinomia laid out above: you don't experience the satiety cues that tell you that you've consumed a lot of calories and don't need to consume any more. I rely on hunger and satiety cues to tell me when to stop eating, so if I'm drinking something with a lot of calories that doesn't fill me up, then my whole sense of what I need to eat is going to be off. I wouldn't describe myself as an "anti-soda jihadi," and I think people need to make their own decisions about what to eat and drink, but it sort of makes sense to me that drinking a lot of Coke wouldn't be a great idea.
posted by ArbitraryAndCapricious at 9:05 PM on February 23, 2014

I have little doubt that anti-sugar hysteria will fade away in a few more years. Then there will be some other pseudoscientific jihad against something else. Eventually some jihad or other might get it right, but if forced to bet, I'd bet that the relevant problems won't be the effects of one single demon ingredient.

The next big breakthrough will come when studies can be done by aggregating the unobtrusive measurements of nanomachines reporting on specific chemical reactions and the state of individual cells realtime. Studies will find some overarching nutritional truths, but they will find that even moreso the best approach to nutrition varies widely from person to person. A person's ideosyncratic mix of gut flora will go a long way towards predicting the how their body reacts to different ratios of nutrients.
posted by Hubajube at 5:22 AM on February 24, 2014 [1 favorite]

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