
Big Sugar’s Secret Ally? Nutritionists - hvo
https://www.nytimes.com/2017/01/13/opinion/sunday/big-sugars-secret-ally-nutritionists.html?action=click&pgtype=Homepage&clickSource=story-heading&module=opinion-c-col-right-region&region=opinion-c-col-right-region&WT.nav=opinion-c-col-right-region&_r=1
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jessaustin
Nutrition is like, the _worst_ field of medical research, and that's saying
something. All of the hallmarks of typical medical research (studies sponsored
by interested parties, non-repeatable results, tiny sample sizes,
contradictory health recommendations, lack of properly controlled
experimentation, etc.) are present in nutrition, but turned up to eleven.
Future generations will lump the nutrition advice with which we struggle to
survive, in with bloodletting and snake oil.

No, I don't see a way around any of this. Lots of money is spent on food, and
will be for the foreseeable future.

~~~
Xeoncross
Ridiculous. The future will not show that proper nutrition is a waste of time.
It is absurd to think our body responds to every input the same.

You are lumping every Doctor, Biochemist, Farmer, and John Doe who call
themselves a "Nutritionalist" together. They are really, really different
people and some of them are totally right and some are dead wrong.

~~~
bcassedy
jessaustin isn't saying proper nutrition is a waste of time, but rather that
nutritional research is of exceptionally poor quality due to the amount of
money on the line for the vested interests that fund the studies.

To your second point, the problem is that we don't know who is right and who
is wrong. The studies are conducted so poorly or with such bias that it's near
impossible to have concrete recommendations.

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snarf21
Also, don't forget that the food pyramid is defined by the Department of
Agriculture (whose job it is to sell food and maintain food surplus) and not
the Department of Health and Human Services (whose job it is to pay for all
the trillions in health issues resulting from the billions in subsidies).

The calorie is a calorie argument is old and dumb. It ignores insulin which is
a _BIG_ deal. It also ignores that high blood sugar can cause a temporary
endorphin rush. Ever hear anyone talk about a "protein high" or "fat high"?

~~~
QSIITurbo
Anecdotal evidence _for_ a calorie being a calorie: lost 5 kgs in three months
by cutting food intake evenly by just reducing the size of meals. Also
consumed slightly over 10% of daily intake in sugar (saccarose) which
surpasses the recommended level (10% absolute max). Otherwise stuck to
official recommendations. Sedentary lifestyle, moderate alcohol consumption.

The magic trick is being able to measure your weight for the first week or two
and then keep the same habits until the goal is reached. No fancy apps or
diets or nutritionists or whatever required. So a calorie is a calorie.

~~~
overgard
The problem with anecdotal evidence is there's no particular reason to think
that others metabolism is going to react the same as yours does, or that your
weight loss will continue indefinitely. For instance, a diabetic on insulin
would likely gain weight following the diet you follow while you lose weight,
because the insulin would signal to the body to store the calories as fat.

~~~
QSIITurbo
Since you're an expert in the field: How does the insulin for a diabetic
patient differ in its fat-storing capabilities from the normal insulin
secretion of a healthy person? I agree that there are metabolic differences in
people but rarely non-pathological and rarely not age or body mass related.
Pathological cases where the difference in metabolism is indicable, we already
know how to treat / be unable to treat them. Moreover: type I diabetics tend
to be lean / normal weight. So the question is: what is the metabolical
difference you are referring to?

~~~
overgard
I'm referring to insulin resistance. Chronic high levels of insulin will
result in cells not responding to the signal from insulin to store blood sugar
(because they've already saturated their glucose storage capacity), which will
result in the pancreas releasing more insulin to compensate. The more insulin
resistant you become, the more your pancreas ramps up its insulin levels (to
diminishing returns, unfortunately), until it reaches the point where your
pancreas can't make enough insulin to control blood sugar. (Type 2 diabetes).
Your body can't/won't burn fat when insulin levels are high, and the insulin
resistance results in insulin never dropping an appropriate amount, which
results in fat not being burned despite the meal not being particularly
egregious.

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KZeillmann
I wish they'd quit misusing the word "nutritionist". The word has no value
whatsoever. If you want to call yourself a nutritionist, go ahead. Nobody will
stop you.

The protected professional designation is "dietitian". When the NYT calls out
"nutritionists", I have no idea who they're talking about.

~~~
cptskippy
I personally don't hold dietician in any higher regard than nutritionists.

My mom had a dietician as a next door neighbor. This lady was never seen
without a 1 liter big gulp filled with diet soda. We had her family over for
Thanksgiving one year; Mom puts on a big show with white table cloths, fine
china, crystal, etc. They all showed up with big gulps and even went home to
get some diet soda when they ran low because we only had regular.

The kicker was this lady didn't eat vegetables. Only bread, meat and diet
soda.

~~~
criddell
Even though she doesn't eat well, it doesn't mean she doesn't know a lot about
nutrition.

~~~
logfromblammo
Who wants to take advice from a hypocrite?

It would be like a dental hygienist that didn't floss, or a personal trainer
that never did squats, or an arms control advocate with armed bodyguards, or
an envronmentalist that never separates recyclables from the garbage.

~~~
criddell
Is a fat dietitian more of a hypocrite than, say, an out of shape football
coach?

~~~
logfromblammo
Neither is necessarily a hypocrite. You can't really tell until they open
their mouths and speak. It is likely that the coach was not out of shape at a
time when they participated in competitive team sports. But a football coach
that had never suffered a severe sports injury commanding players to "hit
harder"? That's some hypocrisy right there.

The fat dietitian might be self-experimenting to support they hypothesis that
their fat-loss diet plan works (at n=1), or becoming familiar with the effects
of various unhealthy eating habits.

But we weren't talking about a _fat_ dietitian. It was a dietitian that
apparently _does not eat vegetables_.

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grecy
Completely anecdotal - I've decided to give up refined sugar for 2017,
especially coke (I was drinking a can every two days or so in late 2016).

So I lasted until today, Jan 18th, when I had a small bottle of Sprite. (In my
defense, I was at a restaurant using the wi-fi and had to order _something_ ).

Within five minutes my heart rate was through the roof, I had the shakes and
felt really, really lightheaded. It lasted at least three hours.

Wow. Three weeks without sugar and then ONE drink did that to me. Now I'm ten
times more motivated to never have one again.

~~~
joecool1029
If you were actually in a state of ketosis for 3 weeks your body would have
mostly adapted to it. It takes a couple days of carb refeeding for insulin
sensitivity to return to normal.

[http://high-fat-nutrition.blogspot.com/2007/10/physiological...](http://high-
fat-nutrition.blogspot.com/2007/10/physiological-insulin-resistance.html) <
blog on the topic (sorry to link this blog again, he really has some good
posts on topics like this with research linked in)

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mtw
Look at the mirror. Big Sugar' best ally is not the nutritionist but the
average American consumer.

Between a fruit or a chocolate bar at identical prices, the vast majority of
Americans will choose the chocolate bar. Most people will scoff at eating only
veggies, whole grains, legumes, fruits (aka Mediterranean style diet). They
will cheat and get their sweets, sugar and refined bakery products, even
knowing the evidence.

Sugar (or bad food) is an addiction. It's not about nutritionists or
scientific evidence, it's about having enough mental strength to stay away
from bad foods.

~~~
joecool1029
> Sugar (or bad food) is an addiction. It's not about nutritionists or
> scientific evidence, it's about having enough mental strength to stay away
> from bad foods.

You're close. Attempting to do so while not having any understanding of why
things happen is a recipe for disaster.

It must be reasoned that obesity is a disorder caused by something more then
just 'poor eating habits'. There are physiotypes that will simply resist
obesity on the worst of diets. I don't need to link a paper for this, this
should be common sense from anyone's experience around enough people.

So, if you reason that obesity is a disorder or sickness... you would then try
to treat the cause, not the symptom. In the same sense that a person with a
peanut allergy would simply avoid peanuts, a person with obesity may have this
state caused by disturbed leptin/insulin signaling. A diet must then be
designed to compensate for that disorder. (we know that once surplus white
adipose tissue is grown, there's no going back, a modified diet must be
adapted for life or those buckets just start filling again)

~~~
everial
> we know that once surplus white adipose tissue is grown, there's no going
> back, a modified diet must be adapted for life or those buckets just start
> filling again

Mind providing more references/reliable pointers on this?

~~~
joecool1029
Apologies, I can't find the precise paper covering what I mean. You will find
that there's a suspicious lack of studies on formerly obese people.

Paper to get you thinking on how WAT acts on signaling:
[http://www.cambridge.org.secure.sci-
hub.bz/core/journals/pro...](http://www.cambridge.org.secure.sci-
hub.bz/core/journals/proceedings-of-the-nutrition-society/article/div-
classtitlephysiological-role-of-adipose-tissue-white-adipose-tissue-as-an-
endocrine-and-secretory-organdiv/6F914782A23DBDEC3E582833F6A16717)

Paper on WAT quantity and its effects on metabolic syndrome.
[http://onlinelibrary.wiley.com/doi/10.1111/eci.12519/pdf](http://onlinelibrary.wiley.com/doi/10.1111/eci.12519/pdf)
. Where this one gets me thinking is that for some people, growing WAT may
actually be an _adaptation_ to prevent metabolic disorder from a poor diet.

What we know is WAT can hold about 4x its size in fat before it divides into
more. What we don't really know for humans is whether long term weight loss
allows us to lose some of these, or whether they just deflate.... some rat
studies show there can be a reduction, but for humans it would require
repeated biopsy......

~~~
everial
Thanks for the paper links.

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teolemon
Give this game a try :-) [http://howmuchsugar.in](http://howmuchsugar.in)

Also if you want to increase transparency for nutrition, consider contributing
to Open Food Facts (we need Perl, Android, iOS volunteers and barcode scanners
to help) [https://world.openfoodfacts.org](https://world.openfoodfacts.org)
[https://github.com/openfoodfacts](https://github.com/openfoodfacts)

~~~
Pxtl
ima go ahead and assume that has nothing to do with India.

~~~
teolemon
we have an Indian version and we need more contributions :-)
[https://in.openfoodfacts.org](https://in.openfoodfacts.org)

And we're translating it to Hindi :)

~~~
freehunter
I think he means "even though it uses the .in TLD, it's not directly related
to India".

~~~
teolemon
I was being obtuse ;-) It is actually a play on words so that you can have
nice urls like [http://howmuchsugar.in/broccoli-cauliflower-florets-
asda](http://howmuchsugar.in/broccoli-cauliflower-florets-asda)

More seriously, Open Food Facts is a mobile crowdsourcing effort, and we have
volunteers from all the planet :-)

------
projektfu
It's bizarre to me that he goes out of his way to say it's just okay for the
sugar magnates to promote sugar with junk science but it was really nefarious
for some researchers to promote a nuanced view, especially when they were
often relying on published studies promoted or financed by the sugar industry.
This is a weird form of muckraking, exonerating the sartorial and lambasting
the professional.

Are we really to think that the American diet is so unhealthy because of the
opinions of unknown dietitians and researchers? Was Fred Stare ever a
household name? (Maybe Fred Astaire). Or is it more likely that the
manipulation of the diet to use more salt, more sugar, more oils and thus more
food, is really the problem. Authorities have been saying for plenty of time
to avoid sugar, overeating, processed foods and sedentary lifestyles.[1] This
isn't a new thing. Taubes and similar authors act like they discovered a
conspiracy among scientists and thought leaders to make Americans sick, but it
just doesn't add up. The obvious culprit has been food processors' desire for
growth the whole time, and that was visible at least 40 years ago.

1\. _Healthy People: The Surgeon General’s Report on Health Promotion and
Disease Prevention_ , 1979.
[https://profiles.nlm.nih.gov/ps/access/NNBBGK.pdf](https://profiles.nlm.nih.gov/ps/access/NNBBGK.pdf)

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majkinetor
It is totally strange that anybody can think cal. is a cal. We proved
otherwise so many times.

People can eat the same amount of cals that are diffrently processed for
various reasons:

\- Insulin resistence

\- Specific cancers

\- Thyroid disfunction

\- Level of amylaze expression (how good we absorb complex carbs)

\- Microbiota status

\- Even viruses ([https://www.wired.com/2016/12/mysterious-virus-cause-
obesity...](https://www.wired.com/2016/12/mysterious-virus-cause-obesity/))

In all casses people/animals did eat the same amount of food and got different
amounts of fat.

Since anybody is in a differerent biochemical spot here the default should
actually be that cal. is NOT a cal, depending on your (meta/epi)genetics.

Any proffessional claiming otherwise should find another job IMO. I use this
claim as a marker for incompetence.

~~~
ThrustVectoring
"A calorie is a calorie" is wrong, sure, but so is Newtonian physics. It leads
to a lot of better-than-random-guessing predictions about what you should do
in order to achieve certain goals. Want to gain weight? A gallon of milk is
roughly 2k calories, so if you add that to your daily diet you ought to put on
weight. Want to lose weight? You should probably "eat less", and calories are
a good approximation of how much "less" eating less is.

~~~
majkinetor
Except it doesn't work that way. Nobody eats when not hungry. Obesity is a
disease or disfunction.

Imagine saying to someone that has bad vision to focus on the object.

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llimllib
Can somebody explain to me why Taubes gets so much credit on this forum? He
says himself that he's arguing without evidence.

~~~
hondo77
Exactly. He puts forth an interesting hypothesis. Now he needs to prove it.
You don't just get to say something _should_ be a certain way, you need data
to back it up.

~~~
defen
I don't think he has to prove anything. Personally, I'm long past the point of
feeling the need to argue about nutrition on the internet. No one is going to
change his/her mind due to "rational debate" because _all_ of the evidence is
shit. So...I will not eat sugar, but feel free to eat as much sugar as you
like. I genuinely don't care; if you develop obesity or diabetes or heart
disease, you can rest easy in your epistemic conviction that sugar consumption
didn't _cause_ it. Likewise, if I develop any of those conditions, I can be
absolutely sure it wasn't due to excessive sugar consumption.

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Hermel
One often overlooked factor of obesity is how fast you eat. The feeling of
having eaten enough comes with a delay. So the faster you eat (in calories per
second), the more likely you are overeating. And calories per second are
typically much higher with sugary food than with say vegetables.

~~~
majkinetor
Actually, there is evidence to contrary.

\- Faster eating will stretch your stomach muscles more which is trigger for
satiety

\- Faster eating will produce lower blood sugar as salivary amilaze doesn't
break complex carbs into simple sugars.

There are papers on that, but CBB to find them now.

------
sebleon
No surprises here. Sad truth is that science isn't driven by the search for
objective truth. Rather, research funding determines which way the scientific
literature will sway.

------
fennecfoxen
Big Sugar's biggest allies in the US were, historically, the United States
senators from Hawaii. To buy them off, Congress long ago applied nasty import
duties on the substance, tripling the price of sugar in the US and giving rise
to the substitute we all know and love to hate, high fructose corn syrup. (Not
that sugar is actually healthier for you at all, mind you.)

It looks like they might actually be getting out of the business, though. Good
luck on replacing the corn syrup now that the Midwestern corn states are their
own lobby...

~~~
vonmoltke
Hawaii's cane production has never been higher than Florida or Louisiana. Why
would anything to do with sugar be aimed at Hawaii?

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chx
[https://en.wikipedia.org/wiki/Nutritionist#Regulation_of_the...](https://en.wikipedia.org/wiki/Nutritionist#Regulation_of_the_title_.22nutritionist.22)

A demonstration of the ease in which it is possible to become an accredited
nutritionist can be seen in Dr Ben Goldacre's successful application to have
his dead cat Hettie accredited as a certified professional member of the
American Association of Nutritional Consultants.

~~~
majkinetor
Meh...

This is not specific to nutritionism. See "Get Me Off Your Fucking Mailing
List" is an actual science paper accepted by a journal

[http://www.vox.com/2014/11/21/7259207/scientific-paper-
scam](http://www.vox.com/2014/11/21/7259207/scientific-paper-scam)

------
CodeWriter23
Yep. Most all of the "low fat" and "reduced fat" foods pushed by nutritionists
contain more added sugar than their fat-laden counterparts.

~~~
logfromblammo
Every time I see candy marketed as "a fat-free food", I die a little inside.

Better put that crap on your packaging now, confectioners. I see mandatory
warnings like "consumption of this product increases your risk of developing
type 2 diabetes" in your future.

~~~
CodeWriter23
Compare the labels for the "Sugars" row on any regular vs. low fat food.
Deleting fat removes flavor so they add sugar. At the moment, the clearest
example that comes to mind is salad dressing.

------
ThrustVectoring
>Another way to say this is that what we eat doesn’t matter; it’s only how
much

The big, glaring, obvious problem with this is "how much you eat is the only
thing that determines weight gain/loss" doesn't imply that what you eat
doesn't matter. What you eat can easily change how much you eat; it's much
easier to consume a giant pile of calories if it's a cake than if it's
spinach.

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kmicklas
Does it really matter that much if one calorie is not exactly equal to one
calorie? What seems immediately obvious is that sugar is less filling per
calorie than almost anything else, and thus if you eat sugary foods you'll end
up eating more calories.

The only way to prevent this is to count precisely with an app or something,
which is obviously a big challenge for most people.

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alphabettsy
It's a food industry problem, not just a sugar problem. I'm supposed to
believe a company like ConAgra is being manipulated by the sugar lobby?

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georgewsinger
Nutritionfacts.org for evidence-based nutrition advice.

------
georgewsinger
nutritionfacts.org for evidence-based nutrition advice.

