
Sugar-sweetened drinks with protein rich meal affect metabolism - nreece
https://blogs.biomedcentral.com/bmcseriesblog/2017/07/21/sugar-sweetened-drinks-and-your-metabolism/
======
ulber
Often people are wary of new results about health, so it's worth pointing out
that this paper is rigorous and the conclusion is very likely to be correct,
as explained by this comment on Reddit's /r/science [1].

[1]
[https://www.reddit.com/r/science/comments/6oufus/comment/dkk...](https://www.reddit.com/r/science/comments/6oufus/comment/dkkfh95)

~~~
joveian
However:

* the "multiply p value by ten" rule would exclude the main results (but not some well known findings)

* paper does not have much discussion of context or past results

* paper does not have any scatter plots or show individual data at all for the primary results; there are scatter plots under additional files for oxidation vs. lean body mass and vs. fat mass and 24 hour energy expenditure vs fat mass

* there is no discussion of the possibility that the small additional calories could have had the same effect even if not sugar

* there is no discussion of the possibility that gut microbial response to the non-sugar drink might cause the differences they see

* a conflicting study used a different artificial sweetener

* the study did not test if the same SSB vs NNSB given at non-meal times would have a similar or different effect

* also all the limitations mentioned in the study

* this is a basic research study, not something directly applicable to real life; if you aren't doing extensive research in the area then drawing any conclusions from this one paper is unlikely to be helpful

Of course, considering the study in connection with the rest of the literature
is likely to address some of these considerations and it may be a valuable
contribution. Saying "very likely to be correct" does not sound accurate to
me.

Since fructose is suspect, comparing trehalose vs. sucrose would be
interesting.

~~~
DrScump

      the possibility that gut microbial response ... might cause the differences
    

This will eventually be proven to be a significant factor, IMHO.

------
spodek
> _The next time you tuck into a protein rich dinner, it may be a good idea to
> hold off on the sugary drinks._

For 300,000 of human existence except the past few decades, humans drank no
sugar-sweetened drinks.

It is _always_ a good idea to hold off on sugary drinks.

~~~
gaius
Fruit juice? Does fructose vs sucrose make a difference?

~~~
mchannon
I predict in the coming years we'll start referring to fructose as "bad sugar"
and glucose/dextrose as "good sugar".

Sucrose, being a 50/50 compound of the two, thus inherits "bad sugar" from the
fructose produced during digestion.

HFCS actually ranges from 29-55% fructose vs. glucose/dextrose (the highest
being available in CocaCola freestyle soda machines), and can be better or
worse than sucrose, but is generally equivalently bad.

Since dextrose is basically incompatible with acidic beverages and solidified
candies, we're not likely to see fructose going away, either as a direct
ingredient or as a metabolite.

If natural concentrated sweetener is considered, attempts to replace sucrose
and fructose with dextrose-only sources like plain old corn syrup (POCS), rice
syrup, and honey, might achieve some fascinating health benefits. Is it
possible that we're fat only because we're eating the wrong kind of sugars?

~~~
resf
> Is it possible that we're fat only because we're eating the wrong kind of
> sugars?

Nope, we are fat because there are many cheap sources of calories,
particularly deep fried foods.

~~~
wutbrodo
The objections to this oversimplified reasoning usually point to the fact
that, among other things, there's a documented rise in obesity among animals
as well, across a variety of situations (feral rats, lab primates, domestic
pets). Lab primates aren't eating out more or getting less PE in schools,
which suggests the possibility of an environmental factor[1].

> particularly deep fried foods.

This is a very early-1990s understanding of nutrition. The low-fat
recommendations pushed by the USDA and followed to a large degree by American
consumers didn't do anything to halt the obesity rise, because excess dietary
fat isn't nearly as bad for you as excess processed carbs/sugar.

[1] [https://www.livescience.com/10277-obesity-rise-
animals.html](https://www.livescience.com/10277-obesity-rise-animals.html)

------
beagle3
Note that (at least the summary indicates) this experiment refutes "calories
in calories out" theory - food composition affects thermogenesis. (I am not
talking about the tautological and useless thermodynamic sense in which it
definitely is true; I am talking about the "measure your intake and exercise"
crowd)

~~~
astrange
Exercise is a bad way to increase calories out, because it's just too
efficient. The conversion is something like 1 mile run = 1 tbsp peanut butter.

~~~
bitexploder
Assuming you meant inefficient. It is exceedingly difficult for people to make
lifestyle change. Some shockingly small percentage of people lose 40 lbs and
keep it off.

I have an anecdotal idea that, basically, folks who are fit enough to exercise
off 1000-1500 calories every week and do so are the ones that never have to
lose the weight in many cases. Finally, although inefficient in the
thermodynamic sense, I think part of why this is true is because most people
gain weight over a course of years. That extra soda or beer every day. When
you have a simple balancing lever like an extra mile or two of vigorous
walking or something else it can all balance. When you are sedentary in the
same situation, you slowly get diabetes.

Also peanut butter is dense, but a good way to illustrate the problem to
someone a good way is to also ask someone if they are willing to walk for 30
minutes for one soda.

~~~
rebuilder
Moving the mass of a human body over a mile on one tablespoon of fuel is
highly efficient!

Edit: tablespoon, not tea-

~~~
cma
Trains do about 30 times better on a tablespoon of diesel, and that's only
including the weight of the freight and not the train itself.

~~~
meesterdude
i feel like a train isn't going to get anywhere on a tablespoon. That's enough
for a few engine strokes perhaps, but that's hardly 30 times better than a
mile by a human, no?

~~~
awodol
I'm not sure on the numbers but I know a human couldn't get freight moving
even with a whole jar of peanut butter.

~~~
meesterdude
> I know a human couldn't get freight moving even with a whole jar of peanut
> butter.

This is probably one of the best serious sentences I've ever read.

------
zython
Lately I've been having this feeling that the pseudo science of nutrition (not
talking about the researchers but the food and lifestyle artists on social
media) makes it very hard to find out what a good diet is and what isnt.

Meat ? Bad unless it isnt. Dairy and Eggs ? Even worse except when it isnt.
Vegan/vegetarian nutrition ? The worst except, you guessed it, when it isnt.

If you dont believe me just google any food and try to find out a general
consensus about it. A lot of these sites talk about facts without sources, use
terms like "toxins" without going into detail about what exactly they are
etc.pp.

Thoughts ?

~~~
tomxor
I know what you mean, and my answer probably wont be very satisfying to you:
Use common sense, eat what your grandma tells you (if you have a good
grandma), ignore all the crap on the internet which is 90% confusing rubbish
(with the exception of some scientific studies which can be insightful but not
necessarily anything to base a diet on).

Try to cook your own food at least half the time and have a balanced intake
(just the basics: meat + veg + fruit), if you stick to natural unprocessed
foods it's pretty hard to go wrong, avoid sugary treats and highly processed
food as much as possible, that's basically all you need to know (sounds pretty
obvious because it's common sense).

The fad diets and contradicting advice do not arise out of a failure of your
grandmas advice, they arise out of supermarket foods, high sugar, high carbs,
ready meals etc. Same with the obesity epidemic, it does not come from lack of
will power to not eat like most people think, it comes from the laziness and
temptation that we all get from supermarkets.

I try to cook at least half the time and keep an eye on my tendency to be
lured by what is becoming way over half of supermarket isles these days (sugar
and carb packed processed shit), go to the meat and veg isles out of habit
don't even walk down the others unless you want to treat yourself (sugar is a
treat not an everyday thing).

~~~
KitDuncan
My grandpa ate meat and dairy every day and died after his forth stroke at 70.
He had his first stroke at 50, but never even considered changing his diet. My
grandma is obese on a similar diet and probably won't make it much longer.

My mom ate the a same since an early age and had very high cholesterol and the
doctors warned her that she is on a similar course as my grandpa if she didn't
change her diet.

I've since convinced her of going on a plant based diet and I am planning her
meals. Her cholesterol has been decimated, she lost a ton of weight and feels
way better now.

Am I a qualified nutrionist? No. Am I feeding her the diet my grandma ate.
Fuck no. Where did I get my information? Plenty of peer-reviewed studies.
There is no denying that dietary cholesterol is a killer and cutting out meat
and dairy is probably the healthiest option for the majority of the
population.

~~~
tomjakubowski
> Plenty of peer-reviewed studies. There is no denying that dietary
> cholesterol is a killer and cutting out meat and dairy is probably the
> healthiest option for the majority of the population.

Yeah, except that the pendulum is swinging the other way now.
[http://www.health.harvard.edu/blog/panel-suggests-stop-
warni...](http://www.health.harvard.edu/blog/panel-suggests-stop-warning-
about-cholesterol-in-food-201502127713)

"There’s a growing consensus among nutrition scientists that cholesterol in
food has little effect on the amount of cholesterol in the bloodstream. And
that’s the cholesterol that matters."

which is exactly the phenomenon GGP commenter zython was describing.

edit: "dietary cholesterol != blood cholesterol" was even in the popular
culture ca. 1995, see "Homer the Great"
[https://www.youtube.com/watch?v=4OZkCXbbEJw](https://www.youtube.com/watch?v=4OZkCXbbEJw)

~~~
fredsir
It doesn't has as high an effect as saturated fat, no, but it still has a
negative effect, and fact of the matter is that we need to consume zero
dietary cholesterol, so every time we do, that is a negative action towards
the goal of health.

Another thing to note is that often the case is that food that is high in
cholesterol is also high in saturated fat, both things that affect ldl
cholesterol levels in a negative way.

------
maga
I wonder how it affects muscle building.

I have low carb diet and try to avoid "fast" carbs completely except when
taking proteins/BCAA right after workout--I was under impression that taking
protein without carbs might result in burning proteins for fuel instead of
using them to restore/build muscle.

------
bitL
There go protein bars... Does anyone know if artificial sweeteners hack the
body to switch to "fat storage" mode as well? Like metabolism after Coke Zero
with no sugar still causing excessive fat storage? Our bodies seem to use some
silly heuristics all the time, like the one hacked by drinking plain water but
with scent of a fruit in front of a nose, forcing brain thinking we drink
juice...

~~~
ulber
The control group in this study was drinking an artificially sweetened drink
in place of the sugary one. Otherwise, this answer [1] refers to recent
studies having shown insulin rising from artificial sweeteners, but says the
research on links to actual weight gain is still ongoing (I have no idea if
that answer is current).

[1] [http://www.health.harvard.edu/diabetes/ask-the-doctor-do-
art...](http://www.health.harvard.edu/diabetes/ask-the-doctor-do-artificial-
sweeteners-cause-insulin-resistance)

~~~
burger_moon
Do you have a subscription to that? I was only able to read the first
paragraph but it mentioned resistance to insulin which I thought is different
than temporarily causing your insulin levels to rise from consuming a sugary
drink or eating a high carb food like rice. I'm really interested to know if
drinking something with sugar alcohol,aspartame, or sucralose causes insulin
level spikes like sugar does.

~~~
heymijo
In the event GP doesn't respond, I probably have the same unsatisfactory
answer that the Q&A from the link does: we don't yet know.

I too, have the same interest regarding insulin spikes from artificial
sweeteners and spent considerable time researching. Caveat, this was about
five years ago so there could be new findings.

While the research is inconclusive, I personally try to cut down on artificial
sweeteners. I suspect they can cause an insulin response. This is based on my
understanding of the literature and my n=1 experiments.

------
phicoh
So it seems that for most of our past, this would actually have been
beneficial.

The article says: "We found that drinking a sugar-sweetened drink with a meal
significantly decreases fat use and diet-induced thermogenesis (heat
production)."

So if food is relatively scarce then this is a good thing.

Feels a bit weird to optimize diets for couch potatoes. The article doesn't
say how exercise was done, so I assume it was none.

------
IronBacon
I wonder if this means ending a meal with a dessert it's considered a "no no".

~~~
dgudkov
I would suspect it strongly depends on the dessert size. In North America
desserts are huge and that's a problem. A small two-bite dessert won't hurt
and would give the same satisfaction as a big one. Also a small (and I mean
really small) shot of fortified sweet wine (e.g. port or madeira) is a
traditional way to finish a meal in some parts of Europe, which I suspect is
healthier than a typical North American dessert.

------
0xbear
Does someone know of any serious "weight loss" books that are _rigorously
evidence based_, without layman explanations, bad/outdated research, and
bovine manure like confusing correlation with causation or relying on small,
unrandomized population studies to confirm the author's preconceived notions
for how things should be? I mean real, hard ass summary of today's best, most
rigorous studies + some recommendations.

~~~
Lionga
Eat less calories then you burn == weight loss

~~~
0xbear
I'm more interested in sustained weight loss over the rest of person's life.
Best I can tell, that is predicated on reducing insulin resistance while not
restricting calories too much. People don't stick with reduced calorie diets,
and human body can (and does) reduce its metabolic rate to compensate for
reduced calorie intake, thus defeating it.

------
mrfusion
This study seems like common sense to me. You're going to store more fat when
you add the calories and sugar from the soda.

Can someone explain what I'm missing?

------
gaius
This is very interesting - like most influenced by GI theory, I had assumed
that rate of absorption/avoiding an insulin spike meant that if you wanted
something sweet, it would be OK or at least least-bad, if it were mixed with
slow-digesting items such as protein. Guess not :-(

~~~
CuriousSkeptic
GI isn't the whole story. Some proteins trigger insuline response way more
than blood sugar.

This site has a lot of interesting material on the subject.
[https://intensivedietarymanagement.com/insulin-
index/](https://intensivedietarymanagement.com/insulin-index/)

Couldn't find the particular text I was loooing for but apparently there was
this study where they mixed pasta with milk or water and added glucose to
achieve equal mixes of glucose, lactose and such. The mix with the milk had
something like three times higher insulin response.

------
honorable
"Having a sugar-sweetened drink with a high-protein meal may negatively affect
energy balance, alter food preferences and cause the body to store more fat."

Damn that's a lot of negatives. I'm glad I haven't regularly drank soda in 5
years.

------
nthcolumn
Keeping people confined for long periods affect metabolism?

------
Pica_soO
So O-Juices and Eggs are a sin, to the holy church of body now? Well sorry, if
i sin on like a old heathen, while you drive up your blood pressure in your
schisms, popes and anti-popes.

Seriously, fruit was a base part of our food source - since we walked out of
the djungle. And we have cravings for it, wherever we go- to get some honey,
some overripe mango. If somebody wants to declare that unhealthy, he is free
to experiment on himself.

And yes, those monkeys did binge mango eating. Binge Banana, we did alot of
binge, and alot of starving, when the source of food was gone and the hunt was
on again. To try to fight these instincts, with self-moderation is kind of
funny.

~~~
KitDuncan
There is a difference between whole fruits and juices. Juices basically don't
have any fiber in them anymore and the sugar is much more concentrated. Nobody
will take eating fruit or even drinking smoothies away from you. (well maybe
the Keto folks will)

~~~
Pica_soO
I just wish there was- i dont know, some time-wise distance between research
and application. Time for the propaganda to die and the science to survive by
having repeatable results. This all is - too fast moving, to hasty, to many
zealots ready to jump on any band wagon promising a longer live.

Its just a guts feeling, but we had several times over by now, whole
category's declared bad and then re-instated. I will keep to what i can know
for certain, and that is the diet our hunter-gatherer ancestors ate. I shall
keep away from processed, enriched foods as much as possible. And thats it.

Everything not close or similar to the nutrition approach- no matter how
demonized or declared healthy will have to ripe for ten years, before i
evaluate it. Im sorry for the serious scientists, but in a field so ravaged by
Replacement-Religious fanatics and Cooperate Propaganda, time is the only
thing that will tell.

