
Sugar and Health: Interview with UCSF professor Robert Lustig  - kqr2
http://www.kqed.org/a/forum/R201104211000
======
blakeweb
I just watched the mentioned video[1] the other day and made some notes, so
thought I'd share them since this hit the front page.

\- Fructose is metabolized similarly to ethanol. Both can only mostly be
metabolized in the liver, whereas glucose can be metabolized throughout the
body. Both result in a storage as fat of a significant portion of the
calories, possibly in the liver, where the fat causes long-term harm. Most of
glucose on the other hand is stored in the liver as glycogen, which is not
harmful long-term, and is the main source when you're eating a bunch of white
pasta (glucose) storing up for a big race.

\- If we just ate fructose from fruits we'd eat 10-20% as much as we do today.
Plus fiber is protective against many of the negative effects associated with
fructose. So fruit is probably on the balance still good for you or neutral in
terms of the negative effects from fructose mentioned here.

\- Fructose seems to suppress the post-eating dip in ghrelin levels, where
ghrelin is thought to be important in encouraging us to eat--the "hunger
hormone".

\- Fructose doesn't cause a spike in insulin and reduces leptin, which he
views as a negative, as it goes along with not discouraging further eating.

\- He gave no evidence that glucose is good or beneficial, or reasons why
glucose isn't a threat to increased risk of diabetes, etc. He's just chosen
his battle as against fructose, as it's more winnable than against all sugar.

That last bullet is my conclusion/wrapup of his perspective. I think his
points are valid, and his recommendations are good for an overweight person
(ie, your average American), but he oversimplifies things to make his case
simpler and stronger. If you're really trying to stay healthy, eating a ton of
glucose is not a good thing--an issue he mainly skirts to keep the focus on
fructose.

[1]<http://www.youtube.com/watch?v=dBnniua6-oM>

~~~
Egregore
>fiber is protective against many of the negative effects associated with
fructose.

Sorry for my ignorance in the subject, but isn't fiber the non digestible part
of food? I've read that it absorbs some toxins, but how it can have such a big
impact?

~~~
cmurphycode
It's probably not as simple as _just_ the fiber in fruits protecting against
fructose/glucose, but it does help. (EDIT: what I mean is, don't replace
fruits with a glass of metamucil and sugar :))

Soluble fiber is just that: soluble in water. In your stomach, it absorbs
water and turns into a sort of carb-trapping gel. While the carbs are still
eventually digested, the gel slows down the absorption. This is good, because
it helps to regulate your blood sugar (not as much of a big spike and drop).

Since blood sugar spikes == insulin response == hungry signals, this is quite
useful.

Insoluble fiber is also useful, but mostly just for waste processing.

------
symptic
Lustig makes a few great points, but it's important to keep in mind there are
some who argue he is a "fructose alarmist" and argue it's not as simple as
"blaming fructose alone." A good quote from Alan Aragon: "I would add that
fiber is only one of the numerous phytochemicals in fruit that impart health
benefits. Thus, it’s not quite as simple as saying that fructose is evil, but
once you take it with fiber, you’ve conquered the Dark Side."

Some links: [http://www.alanaragonblog.com/2010/02/19/a-retrospective-
of-...](http://www.alanaragonblog.com/2010/02/19/a-retrospective-of-the-
fructose-alarmism-debate/)

[http://www.alanaragonblog.com/2010/01/29/the-bitter-truth-
ab...](http://www.alanaragonblog.com/2010/01/29/the-bitter-truth-about-
fructose-alarmism/)

[http://www.bodyrecomposition.com/research-review/straight-
ta...](http://www.bodyrecomposition.com/research-review/straight-talk-about-
high-fructose-corn-syrup-what-it-is-and-what-it-aint-research-review.html)

I personally don't take sides with either. Like most things in the nutritional
field, a healthy balance is more effective for me than trending behaviors and
ideologies (i.e.: no-fat diet, "slow carb" diet, Atkins diet, etc.).

~~~
jerf
Did you listen to the linked MP3? If so, I'm not sure how you can listen to
that and conclude he's "blaming fructose alone". I'm up to at least three
times he's clearly explained why that's not the case. And I don't mean
"mouthing words about it then blaming it anyhow", I mean, explaining the ways
in which things work together to cause obesity, and how fructose is only the
most effective member of a group of 4 foods, and so on.

I really think people really ought to go primary sources and stop listening to
people summarizing summaries and then launching devastating assaults on
strawmen.

~~~
kenjackson
And Lustig, in this podcast, talks about how fiber and fructose tend to go
together in nature, which is why whole foods are good as they usually have
both. He gives two examples where they don't though... grapes and honey. But
he says that honey is protected by bees. But no answer for why grapes make it
easy to get fructose without fiber.

~~~
zach
Grapes have been domesticated for thousands of years, and at every step the
goal has been to maximize fructose and minimize fiber, most notably in making
the seedless varieties that comprise the vast majority of table grapes sold
today.

At this point, who knows what grapes were originally like? Of course, we know
they had real seeds and I'm guessing they weren't so plump and thin-skinned.
So maybe they had a much more commendable fiber-to-fructose ratio.

Today, table grapes are just glucose and fructose water balloons.

~~~
thaumaturgy
Wild grapes tend to have large bunches of really small fruit with a few seeds,
if I remember right. We had some in our backyard in Livermore years ago.

~~~
GeneralMaximus
Are you guys talking about the huge, swollen, purple grapes that are
incredibly sweet and juicy? In New Delhi, you only find those grapes at large
supermarkets. Most grapes sold here are exactly what you described: large
bunches of really small fruit. No seeds, though.

~~~
dangrossman
Yes, very large red/purple/green grapes without seeds are the common variety
in stores in the US.

------
staktrace
Here's a 1.5 hour lecture by him on the exact biochemical pathways that make
fructose a poison.

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

------
jyu
Cliff Notes: Drinking soda makes you fatter. Also orange juice, cookies, and
any other highly processed drinks/foods. Avoid these to lose weight.

~~~
daniel-cussen
Also fruit and some other unprocessed things.

~~~
hristov
That is not correct. If you listen to his talk Lustig said something to the
effect of "wherever god put the poison, he also put the anitdote." Thus,
anywhere in nature where fructose appears there is also fiber. And fiber if it
is processed at the same time and similar quantities as fructose allows the
liver to process fructose properly.

So there should not be anything in its natural state that is problematic. The
only exception to that may be honey.

~~~
Saavedro
If you personally have to brave FREAKING BEES to get to it then you'll
probably moderate your consumption enough ;]

------
bgentry
I'm going to reiterate this again on this thread:

Yes, this interview is long, as was the Youtube video from Lustig. But it is
worth every minute of listening time.

Watch the original video (linked in this thread) for a more in-depth technical
explanation of the cellular processes at work. It's truly fascinating
material.

------
tremendo
I felt let down by the interviewer interrupting and changing the topic at
least two times when I was eager to hear more. The first when Lustig tries to
address Alan Aragon's criticisms, he even insists that it is important to
follow on it, and the second when he begins talking about the externalities of
using public policy to counter the effects of increased consumption. In both
cases the interviewer abruptly changed the topic and the arguments were left
incomplete. The rest was not news if for anyone that has seen his youtube
video.

------
chipsy
I recommend this video as a sort of sequel to the points presented by Lustig:

[http://journal.crossfit.com/2010/04/insulin-body-weight-
and-...](http://journal.crossfit.com/2010/04/insulin-body-weight-and-energy-
production.tpl)

Dr. Connelly expresses broader and more extreme opinions(he doesn't care about
fiber, and essentially recommends you drown yourself in protein before
touching carbs), but also has a good technical overview of the biochemistry.

------
kenjackson
Thank you. I found this a lot more useful than the NYTimes article.

------
espeed
Last summer I did a 14-day juice fast (primarily organic vegetable juice).

After about 3 days of no carbs your body burns off most of the sugar in your
body (the liver's glycogen stores) and you go into ketosis
(<http://en.wikipedia.org/wiki/Ketosis>) where your body switches its fuel
source from sugar and starts burning body fat for fuel.

Some people who go on these types of fasts talk about the mental clarity they
receive after a few days into it. I can attest to it -- the best way I can
describe it is going from ADD to no ADD.

When this happens I have assumed it has something to do with the change in the
brain's fuel source. I don't know if this is related to sugar being toxic, but
I have suspected it might be.

~~~
martythemaniak
This is the same type of idiotic quackary (semi-truths and lies mixed with
anecdotes and bullshit) that makes people turn to homeopathy, turn against
vaccines etc.

Let's see what's in that juice you drank for 2 weeks:
[http://caloriecount.about.com/calories-bolthouse-farms-
vedge...](http://caloriecount.about.com/calories-bolthouse-farms-vedge-
vegetable-juice-i127236)

Serving Size 8 fl oz (240.0 g) Amount Per Serving Calories 60 Sodium 450mg
Total Carbohydrates 12.0g Sugars 9.0g Protein 3.0g

Carb-restricted diets usually mean ingesting less than 30g of sugars/day.
Assuming you ingested at least 1800cal/day, you were ingesting 270grams of
PURE SUGAR a moderate amount of protein and 6 times the recommended intake of
salt.

None of what you're saying makes an ounce of sense and while you may have lost
weight due to caloric restriction, there is absolutely no way your body would
have gone into ketosis, and you have absolutely zero credibility talking about
anything nutrition-related.

~~~
espeed
You sure make a bunch of assumptions for being so emphatic. I didn't drink
much of it and bought ketone strips (<http://www.walmart.com/ip/Reli-On-
Ketone-Test-Strip/13037592>) to check it periodically -- I was definitely in
ketosis throughout the day.

"The ketogenic diet mimics a starvation or fasting state by denying the body
the carbohydrate it requires to function normally, and forcing it to
metabolize fat. As the fat is metabolized ketone bodies are produced. It is
the production of the ketone bodies which appears to play a central role in
the success of the ketogenic diet. When the body begins producing ketone
bodies it is referred to as the body being in ketosis. It usually takes 3 – 5
days for the body to go into ketosis after starting the diet. Ketosis is
readily recognized, because the ketones can be detected in the urine, and can
be recognized by a characteristic smell of the individual’s breath. The
prophylactic properties of the ketogenic diet build up with time and it may
take several weeks before the full effect of ketogenic diet is achieved" (UNM
School of Medicine,
<http://hsc.unm.edu/som/coc/clinics/Ketodiet_eng_10Dec09.pdf>).

~~~
martythemaniak
I just finished a type of low-carb (though non-ketogenic) diet, so I know my
terms, thanks.

Again, nothing you're saying makes sense. You said you drank nothing but low-
calorie/high-carb veg juice for 2 weeks, but now you say that you didn't drink
much of it? So where did your calories come from? Or did you just plain starve
yourself with 300 calories worth of veg juice a day?

If you're gonna play the nutritionist and offer people advice, expect to get
called out on things that don't make sense.

~~~
espeed
It was a juice _fast_ (as opposed to a pure water fast), not a juice diet --
calories are restricted, and energy comes, in part, from the ketone bodies
(<http://en.wikipedia.org/wiki/Ketone_bodies>).

And I am not trying to "play the nutritionist" -- I am simply drawing
attention to a possible relationship between Lustig's research on "sugar
toxicity", the research relating to the effects sugar has on ADHD, and the
effects the fast had on my ADD, after my glycogen stores had been depleted.

------
sklivvz1971
Fact check here: in short - the claim is debunked.
<http://skeptics.stackexchange.com/q/370/96>

~~~
1053r
In short - Wrong. Your link claims exactly the opposite if you dig deeper.

The top stack exchange answer links to an article which states that fructose
is in fact a chronic toxin in quantity, but that high fructose corn syrup is
no worse than sugar or honey or maple syrup or many other common sweeteners.
This is consistent with Lustig's claims. Read it for yourself.
<http://www.sciencebasedmedicine.org/?p=6501>

Lustig claims that consuming a glucose only sweetener, such as maltose or
dextrose or glucose should be lead to better health and weight loss when
compared to a fructose glucose mix, such as sugar or high fructose corn syrup.

Speaking from my personal experience, I lost 3 inches off my waist while
exercising less over a period of 2 months after switching all fructose sources
EXCEPT whole fresh fruit out for dextrose.

