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Cutting Back Sugar Improves Obese Children's Health in Just 10 Days (well.blogs.nytimes.com)
546 points by imjk on Oct 27, 2015 | hide | past | web | favorite | 402 comments

Here is a link to the actual journal article on the study, since the NYTimes omitted it for some reason (currently free to access):




Lustig, R. H., Mulligan, K., Noworolski, S. M., Tai, V. W., Wen, M. J., Erkin-Cakmak, A., Gugliucci, A. and Schwarz, J.-M. (2015), Isocaloric fructose restriction and metabolic improvement in children with obesity and metabolic syndrome. Obesity. doi: 10.1002/oby.21371

As an aside, it's very strange that the article is not cited in the NYTimes post. A journalist should at least give the DOI at the bottom if there is not a link to the article in the body of the text.

Edit: I left this same comment on the NYTimes article and the text now links to the journal (though my comment was not approved). Seems like a win! NYTimes editorial staff: thank you!

Also, this very important piece of title is omitted: "...with obesity and metabolic syndrome". Sugar is getting too much bad press already (along with meat, white bread and computer games). Nothing is just black & white. </rant>

Title should be:

"Substitution of starch for added sugars improves health of children suffering from obesity, metabolic syndrome, and high habitual added sugar consumption."

But then it seems slightly less groundbreaking.

I think the result is still interesting. There's a whole lifestyle called "IIFYM" or If It Fits your Macros which suggests that the macronutrient breakdown (% carbs/fat/protein) is the main factor in growth/health, and that you can eat whatever IIFYM.

This study contradicts that by showing health improvement while maintaining macronutrient breakdown, albeit in obese kids. Is this replicable in adults and/or normal weight people? Who knows? Still a pretty interesting result IMO.

I agree completely. In my experience I'd say roughly 50% of patients we see in primary care have essentially no clue when it comes to nutrition, then maybe 40% or so have a decent understanding of the macros and percentages on US food labels, and the remaining 10% are actually well-versed on the subject.

This study should be an eye opener for that 40% who largely believe "all carbs are created equal".

But on the flip side, you have people that believe only "processed" carbs/sugars are bad. You wouldn't believe how many diabetics think they're doing themselves a huge favor by switching from Coke to apple juice, or from pasta to mashed potatoes.

I'm tempted to start a tangential rant here but I'll just say that I generally try to avoid fructose. Yes, fruits contain fructose in addition to other nutrients, but my personal opinion is that high-sugar foods (including certain fruits like cherries, grapes, and bananas as well as cookies and chocolate bars) should be considered a treat and used sparingly.

> This study should be an eye opener for that 40% who largely believe "all carbs are created equal".

All carbs pretty much are equal, it tends to be the amount of fiber that comes with the carb that changes things. This study was about fructose, not sugar in general, and we've known for a long time that fructose behaves differently from other carbs due to the way it is metabolized in the liver.

> All carbs pretty much are equal, it tends to be the amount of fiber that comes with the carb that changes things.

Anecdotally-empirically, a lot of Type 2's have found carbs, fiber or no fiber, are just bad news. For at least those with a specific variation of Type 2 (still as-yet not clearly understood, but there is growing consensus that there are many different "sub-types" of Type 1 and Type 2, each of which responding well to different treatment protocols), it doesn't matter how much fiber you eat with a scoop of carbs once the metabolic syndrome manifests itself with a high enough insulin resistance response.

With enough carbs (as few as 50g for some) the end result at that stage of the condition is still a highly-adverse event, a high blood sugar spike above 100 mg/dL. Even if the spike is controlled down within 1-2 hours, there is a lot of accumulating evidence that it isn't the duration or absolute value of high blood sugars, but the spikes (the occurrence of any delta in the first place) themselves that cause cellular damage.

In a few years, we will hopefully start accumulating a flood of highly-granular, anonymized biometric sampling data, ideally tagged with true/false flags of known and suspected genetic markers (but not enough DNA data to individually dox someone). Has someone solved the problem of publishing biometrics with tagged DNA data, and be able to update the DNA tags as our understanding of genetic markers improves over time, without risking doxxing an individual from the genetic marker tags?

I highly doubt that it's possible to publish such data anonymously. There are less than ten billion people, about 33 bits are enough to identify everyone individually. If you publish a couple dozen genetic markers you almost certainly have very few people who share the same pattern.

See http://33bits.org/2009/12/02/the-entropy-of-a-dna-profile/

Fascinating, thanks for a great link. Could publishing health research data in the opposite direction help?

Today we hand medical researchers large databases pre-filled with the data they seek.

As we move into a world of increasingly ubiquitous biometric monitoring, asymptotically trending towards real-time, could the data gathering be flipped around instead? Individuals become the only ones who own their detailed DNA profile (the profile with billions of base pairs stored), held on either a personal device with suitable encrypted backups (ideal) or held on their behalf by a trusted service (encrypted with a key only the individual holds). Researchers send out requests for specific data ("weekly blood pressure of males between 20-60, with these genetic markers, starting now/5-years-ago"). Individuals either manually approve matching requests or set up approval "subscriptions"/rules. Requests matched with data sources get anonymized data of course.

Researchers not only can get data this way, they get a continuous, crowd-sourced data feed. Longitudinal studies might get easier to set up through this kind of channel. There isn't a way to ID someone by their feed and the researchers' requested, limited matching genetic markers alone, unless an attacker systematically breaks into multiple research databases, and starts building a Palantir-like correlation amongst all the hacked databases; that dramatically raises the detection risk to the attacker. Another attack is an overly-broad set of genetic markers in a single request, and those requests can be auto-denied before even getting into the brokering system. Short-term, we can prohibit the collection of any part of the 13-base-pair CODIS markers, though long-term we have to assume that CODIS or its future successors will eventually expand to a larger set of markers (and in the far, far future, possibly the entire sequenced genome).

> With enough carbs (as few as 50g for some) the end result at that stage of the condition is still a highly-adverse event, a high blood sugar spike above 100 mg/dL. Even if the spike is controlled down within 1-2 hours, there is a lot of accumulating evidence that it isn't the duration or absolute value of high blood sugars, but the spikes (the occurrence of any delta in the first place) themselves that cause cellular damage.

The "normal" threshold for an oral glucose tolerance test (OGTT) at 2 hours post-load (75g glucose after fasting) is 140mg/dL. Where is this research indicating that a spike above 100mg/dL is "highly-adverse"? All the research I have seen, and the position of the ADA, is that it is normal to go well above that after a heavy carb load.

I have seen claims by Dr. Richard Bernstein and his adherents that the ADA is wrong and that "normal" is much lower and flatter than they claim. I have seen no supporting research on this, and even active criticism of that idea fro various medical researchers.

My bad, sorry, my post should read 140 mg/dL. I was thinking of some (minority) of the more aggressive patients sharing their experiences on diabetesdaily.com forums, and they are holding down to below 100 mg/dL post-prandial, to aim for as close to below 140 mg/dL OGTT as possible; I'm interested in reading their stories because that cohort is self-reporting far more success at stopping medication, and still respond "normally" to OGTT and A1c tests, so that they fall into the "insulin resistant but not cured" category.

> Anecdotally-empirically, a lot of Type 2's have found carbs, fiber or no fiber, are just bad news.

Sure, I wasn't talking about diabetic people.

> In a few years, we will hopefully start accumulating a flood of highly-granular, anonymized biometric sampling data, ideally tagged with true/false flags of known and suspected genetic markers (but not enough DNA data to individually dox someone). Has someone solved the problem of publishing biometrics with tagged DNA data, and be able to update the DNA tags as our understanding of genetic markers improves over time, without risking doxxing an individual from the genetic marker tags?

I also hope that this is the future. Unfortunately we're probably not going to do much better than HIPAA when this technology is widely available and being used. I'm not sure how to prevent the GATTACA side effects, but it feels like the health advances might be worth it.

> Even if the spike is controlled down within 1-2 hours, there is a lot of accumulating evidence that it isn't the duration or absolute value of high blood sugars, but the spikes (the occurrence of any delta in the first place) themselves that cause cellular damage.

Can you link to anything about that?

Batty GD, Kivimäki M, Smith GD, Marmot MG, Shipley MJ. Post-challenge blood glucose concentration and stroke mortality rates in non-diabetic men in London: 38-year follow-up of the original Whitehall prospective cohort study. Diabetologia. 2008 July;51(7):1123-6.

Polhill TS, Saad S, Poronnik S, Fulcher GR, Pollock CR. Short-term peaks in glucose promote renal fibrogenesis independently of total glucose exposure. Am J Physiol Renal Physiol. 2004 Aug;287(2):F268-73.


Thanks for the links.

I don't really think these studies show that acute blood sugar level elevation is causing the damage you are talking about. The first one talks about how TII diabetics tend to have lower β-cell count and higher apoptosis frequency, but that doesn't mean they go through waves of apoptosis more frequently (ie: during blood sugar spikes), it means that they have a lower life span. The study doesn't establish causality, so it's unclear whether diabetics have lower β-cell count because they are diabetic, or whether lower β-cell causes diabetes. It is a great study though, pretty well designed and building on kind of amazing resources from the Mayo Clinic.

The second study is interesting but extremely limited due to the fact that it was does in vitro. The problem is that it's talking about kidney fibrosis, or scarring of the kidney due to inability to regenerate. But when you remove much of the kidney and the surrounding body and then attack the kidney with glucose of course there is damage. That doesn't mean that in vivo the body can't deal with it. Kidneys do have a hard time regenerating, so it's an interesting foundational study, but I'd hardly call it "a lot of accumulating evidence."

Fantastic synopses, thanks.

I'll readily grant this can reasonably be construed as suggestive but not "a lot of accumulating evidence", my bad for phrasing it improperly. To me this line of research is raising interesting questions warranting further digging, in a "hm, I wasn't expecting that result going by the received wisdom" way.

Following the sporadic posts of Type 2 patients in online forums self-reporting success at getting off conventional treatment protocols, what appears to come up in common among them is what is currently considered (by the ADA and similar outfits in other nations) radically aggressive methodology to blood glucose control; <100 mg/dL post-prandial is not considered out of line in that crowd, and they avoid spikes as much as possible. A very small number have been at it for 20+ years and well into their 60-70's, and are reporting no long-term disabilities commonly associated with advanced stages of the metabolic disorder. They tend to be in very low (<50 mg/day) carb or even ultra-low (<20 mg/day) carb regimens, or constant ketosis, or varying fasting cycles, with varying amounts of exercise, or a combination of all of the above, with lot of nuances thrown in by each individual. A lot of what they practice directly goes against published large institutional guidelines, but it is really difficult to argue against the end results in their comprehensive blood panels and other bio-markers, so it is a fascinating case to me of the impact of an N=1 / DIY / Quantified Self ethos that increasingly more people are embracing with the aid of increasingly better technology. I find it really exciting that increasingly more laypeople are empirically "science'ing the shit out of this" (to paraphrase "The Martian") with a continuous hypothesis-test-adjust loop upon themselves. It is definitely not science by any conventional means, but as haphazard as it is, it is yielding in a startling number of cases exceptionally better results than the average and mean Type 2 patient experience.

I agree with much of what you're saying, even though I don't think the science strongly supports it (yet). A lot of cool stuff going on right now.

I want to be clear though: there is certainly evidence that very high blood sugar causes significant damage, sometimes permanent, I'm not contesting that. How high "very high" is varies, and as far as I know doesn't really happen in people who aren't diabetic. All I'm saying is I don't think blood sugar spikes are bad for non-diabetics, but they certainly are for diabetics.

OK but when people talk about "carbs" they aren't talking about chemicals, they're talking about foods.

Nobody is ever going to know what the chemical composition of a potato is, it's just a potato. Fibre, water, protein content is "carbs" when it's in a potato.

Fixing notation would definitely help talking about nutrition. Scientific terms should be used precisely, or not used at all. Dear diet industry: invent your own words, or capture the generic ones. Start with 'magic'.

I'm not really sure what you are saying, sorry.

a carbohydrate refers to a molecule made up of a chain of carbon atoms bonded with hydrogen atoms (if I remember correctly from Organic Chemistry).

There are plenty of different molecules, such as Sucrose, Glucose, etc, which are all forms of carbohydrate molecules.

But when people refer to "carbs", they're not referring to the chemical molecule, but most likely processed carbohydrates such as bread.

Hopefully that's more clear

But a potato isn't processed, and people call it carbs.

I imagine the "carbs" label extends to both processed/unprocessed/simple/complex carbohydrates, which I think potato belongs to "simple" and "unprocessed" (according to this[1] website).

[1] http://www.ehow.com/about_4613535_chemical-makeup-potato.htm...

No, potatoes have some simple carbs but they are predominantly starches, which are complex carbs.

awesome, thanks for the correction, I appreciate it.

Now I'm lost. Isn't that all categories of carbohydrate, meaning they're correct?

Just a quick note; but "sugar in general" contains fructose. Given that you're talking about simple sugars.

Right...specifically fructose, not sugar in general...

  sucrose = glucose + fructose - water
  lactose = glucose + galactose - water
  maltose = glucose + glucose - water
Starch and glycogen are basically all glucose.

Based on this study, I would guess that replacing all HFCS with an equivalent-sweetness amount of regular corn syrup (all glucose) would immediately result in significant improvements to the public health, even though the sweetened products would have more calories per serving.

"Sugar" is composed of fructose and glucose. Do you mean carbohydrates in general?

I guess we are getting pretty semantic. I meant simple sugars, of which glucose and fructose are two, not sucrose, which is "table sugar," and is partially fructose and glucose.

You're right though, it probably would've been more helpful for me to say carbohydrates in general.

not just fiber, also how complex of a polymer it is.

Yes but I'm arguing that doesn't make a huge difference. Certainly there is a small one, but all things being equal the accompanying fiber is a lot more important.

IIFYM is a layer of complexity on top of Calorie Counting. If Calorie Counting is "Eat whatever you want as long as you eat below X Calories" IIFYM says, "Hit your calorie mark, but make sure you have enough Fats/Proteins/Carbs". It's not shocking that it would work since it is strictly better than Calorie Counting which also works, but its goal is primarily Body Composition, IE becoming leaner. There is plenty of room to improve on top of that by improving the quality of the nutrient sources and managing micronutrients.

This study isn't a contradiction. It just says that micronutrients matter, which is pretty uncontroversial.

Likewise, IIFY (Macros + sugar) would be another improvement.

AFAIK, IIFYM also notes that you need vitamins etc. They don't try to make it seem like you can eat sugar cubes, chicken breast and avocado and be healthy.

> They don't try to make it seem like you can eat sugar cubes, chicken breast and avocado and be healthy.

Most of the people I see practicing IIFYM believe exactly this.

They routinely top off with donuts and candy to hit the high carb count needed to gain weight. It's way easier than trying to choke down a pound of brown rice every day.

IIFYM is probably not a bad diet for a teenage boy or steroid user trying to pack on weight while doing a high volume of work. Everyone else will put on a lot of unwanted fat.

>IIFYM is probably not a bad diet for a teenage boy or steroid user trying to pack on weight while doing a high volume of work. Everyone else will put on a lot of unwanted fat.

That would depend on both your total calorie count and your macro breakdown. IIFYM determines what percentage of your calories should come from each of carbs, fats and proteins. So if your calorie count is suitable for your height, weight and activity level, then your macro breakdown isn't going to cause you to gain weight. If your breakdown is out of whack, then you're going to end up feeling tired, hungry or otherwise malnourished, but it shouldn't cause you excessive weight gain outside of water retention. The calorie counting needs to be more accurate than the macro breakdown.

Why are they trying to gain weight? They can't convert donut into muscle. Donuts for a sugar feed while working out, sure.

There are many body functions besides muscle growth and fat burning. These functions require vitamins.

Is it really news? Verbose food labels break down Carbs further into fiber/sugar/polysaccharides for a reason.

That sugar vs. starches makes a difference is hardly news either if you just take a look at glycemic index/insulin response.

And that the kind of fatty acids make a difference in fats is also an aspect going beyond macronutrient breakdown. So really, "fits your macros" has never been sufficient.

Making a distinction between glucose and fructose has been more controversial and it's good to see it studied more.

I like your line of thought, but this is no refutation of IIFYM or "eat less if you're fat" unless they performed this substitution isocalorically. Eating fast sugars instead of equivalent slow starches makes me crave more sooner, and eat more.

Someone else here (a medical doctor) has commented before along the lines of "It's OK for healthy people to eat sugar. It's when you're unhealthy (i.e. metabolic syndrome) that you should avoid it."

Well, how do you think the unhealthy people got that way in the first place? Yes, healthy people can deal with moderate or immoderate sugar intake better than people with metabolic syndrome. But at the margin you are probably degrading your health anyway.

People's bodies are not linear systems.

Eat too little carbohydrates, and you'll die. Eat too much, and you'll die. Your claim that any increase must lead to the same marginal results is absurd.

Actually it's disputed wether carbs are needed at all. It might be possible to function on fat alone (for energy) https://en.m.wikipedia.org/wiki/Ketosis

This is not really the point of the thread and I know what you are trying to say but your example is bad. You don't need to eat any carbohydrates at all. Your body can manufacture enough glucose for your brain on its own.

I have to contest the "eat too little and you'll die" statement. Human's can survive (and thrive) on zero carbohydrate diets. Gluconeogensis will provide any glucose the body requires.

The bad effects of sugar on teeth are almost invariable. So even for healthy people there are downsides.

ALSO, the general effects of sugar on aging and immune system are not so good either in general.

That completely changes the story. The HN title should be edited.

Exactly. Also: "...comparable percentages of protein, fat, and carbohydrate as their self-reported diet". Self-reported? That must be really reliable, let's just skip control group...

The problem is that the HN title is sensationalistic without merit.

Self reported is unfortunately very common in nutritional studies, for obvious reasons. I don't think it makes sense to dismiss a single study for having the same flaws as most others, as opposed to the general recognition that nutritional science findings are baseline less robust.

I wouldn't cut them so much slack. The study is either reliable or it isn't. And it wouldn't take them much more effort to make the results significant in some way.

In this case, I think that just giving these children the self-reported diet would yield massive effects on their health, sugar or no sugar. I am quite sure children with obesity problems don't know their real diet - not because they are dishonest, but because we (as people) are very efficient at hiding the uncomfortable truths from ourselves.

Newspapers usually don't cite their sources because they don't want to drive traffic away or get their facts proven wrong. Subarine PR and native ads are where sources get cited.

It constantly frustrates me how news articles never cite research articles, they always just mention "a study" and the author, leaving me to fumble around for 10 minutes to find the actual study. Does anyone know why this is SOP?

Because journalism is a systematically dishonest profession populated largely by people who do not want their readers to be able to catch their mistakes and do not want to give credit to the researchers who made the discovery that earned the clicks for the news article. They care about entertaining, not informing; the truth or falsehood of what they are writing is irrelevant to them, except as a constraint that might impede the telling of a sensational story (all else being equal, a story is more sensational if it is true than if it is fiction). Like PageRank-hungry SEO scum, they will only name sources if they think some of that the source's credibility will rub off on their article, never vice versa.

It's really depressing how cynical that is. (Developer working at the NYTimes here).

The actual reason links to studies are often left off articles (particularly in cases like this with sharp deadline pressure to publish fast before the competition) is that the software powering the editing and publishing workflow really badly needs improvement. An incredible amount of work and knowledge goes into a story like this.

Versioning rich text through many different software tools designed for writing/editing and publishing across many platforms is hard. Sometimes people copy/paste by hand and in doing so a link can go missing. The news industry needs more technologists to work on these problems. We're hiring for people to do that, by the way: http://developers.nytimes.com/careers/

(Also, the link to the study is now in.)

It's cynical because that's what we, regular readers of news, have to deal with. NYT may be top of the line, but sadly it's not above the line.

Now I don't want it to sound dismissive or personal in any way, but tell me - if say, few of great software devs now drop everything they do and come to NYT to help, sit down for months and develop the most awesome software package the world of press has ever seen, will it actually solve the quality issues articles have? And more importantly, if sold to other papers, will it suddenly solve their problems?

Will it make journalism honest and trustworthy instead of lies and clickbait bullshit?

I'm not sure how much blame to put on broken publishing workflow, a lot of this seems really to be about broken incentives - "deadline pressure to publish fast before the competition" that leads to the "many articles, as sensationalist as possible, truth be damned" mentality, especially in the management layer.

But you did give me a pause here. Only recently I had a chance to peek at internals of a tiny part of manufacturing industry, and oh boy how much money they waste on badly designed software, which is badly designed because of deadline pressure and top management pressuring to iterate over a broken software package (and then messing with the process) instead of scrapping it altogether and doing it right. Maybe software is more to blame than I thought.

> Now I don't want it to sound dismissive or personal in any way, but tell me - if say, few of great software devs now drop everything they do and come to NYT to help, sit down for months and develop the most awesome software package the world of press has ever seen, will it actually solve the quality issues articles have?

This actually happened and that's how we got d3.js. It didn't fix journalism though.

Oh, didn't know the origin story; I only thought they just like it over there. D3 is absolutely awesome!

>Will it make journalism honest and trustworthy instead of lies and clickbait bullshit?

You get what you pay for, which online tends toward nothing.

It turns out that paying people to talk to you, although it can work, tends to get them to tell you what you want to hear. Often, this is "lies and clickbait bullshit." (Think of a stereotypical Soviet government report.) Markets work very well for lots of things, but they can't establish honesty and trustworthiness. Instead, they need honesty and trustworthiness to function.

Still, it's better than them getting paid to tell you what someone else wants you to hear.

I don't recall ever having a problem with any actual reporting.

My objection is with the editorials. I've all but stopped reading "the news" (NYT, WSJ, Economist, my local paper, etc) as a result.

This is the best sort of thing that happens at HN.

"I don't like [thing]" "I work at [thing], come help me fix it"

You miss that the subject changed from media in general to NY Times. It is like mixing apples and ... well, rotten pears.

(Not claiming that NY Times is perfect. Of course. There are other good sources, too. But NYTimes isn't like the media I grew up with. At 20 I realized that all their coverage of subjects which I knew beyond the surface was garbage, at best. My specific example is DN, the largest Swedish morning paper, but could be most of the media.)

I'd be happy to be corrected of course.

I'm glad to see that the link to the study is now in. Also, the current version of the article includes phrases like "the study’s lead author, Dr. Robert Lustig"; did it originally? I can't find the link to the version history of the post.

I'm skeptical of this "software" explanation. Software can of course make citation management much easier, but I see lots of articles that don't even bother to mention the lead author of a cited publication; and how did the software get that way in the first place? The software reflects the priorities of the corrupt organization that produced it.

Having a chance to peek at a tiny area in manufacturing process, I can sort of imagine software replacing a more manual process by something faster, but much more messy and generally worse. It starts with three layers of corporate management above a subcontractor hired to write the software. Of course all requirements go through the entire chain, in what resembles and adult version of the game of telephone (aka. "deaf phone" or "Chinese whispers", the latter being particularly appropriate since what I saw, I saw in China...).

Somebody could probably sit down with the journalists for few weeks and come up with a software package that would fit their needs perfectly - if the development consisted of direct communication between the developers and journalists/editorial staff, without any management middlemen in between. Alas, that's not how software is procured in large organizations.

But I'm also skeptical. It could explain NYT's problems, but it doesn't explain the even worse problems every other news outlet has.

The reason articles about studies leave out a link to the paper is that the software doesn't support it? Why not just put the URL in, or just cite it normally?

Yeah. I can imagine they have lots of problems with preventing tidbits of information from getting lost in an environment of multiple people chaning the same block of free-form text, but if the article is literally about some particular paper, then starting the file with:

NOTE: Study "Effects of X on Y given XYZ" by Researcher N. Here, http://address-to-paper.org

(not the placeholder, the actual data) should help. I don't see such a line getting lost, and even if they happen to publish it by accident instead of incorporating into the text (as sometimes happens, things slip through), it would still reach the same goal anyway.

Good luck in your work, but unfortunately it wasn't the tech stack that prevented NYT from publishing the warrantless wiretapping story in due time.

The NYT managed to put together an absolutely massive printing and diatribution operation. If editorial cared about putting a citation in a story, they would do it. Getting a journal citation right is no harder than spelling the scientist's name right. Tech talent is not the blocker.

> sharp deadline pressure to publish fast before the competition

Sounds like the problem lies here and not on the technical side of writing, editing and publishing text.

I wonder what part of this decadence is imputable to ad revenu. If I were very naive, I would say all of it.

What a refreshingly cynical argument!

Cynical, yes. Accurate, unfortunately so. I worked for a small weekly paper for a number of years. Weeklies are still very community oriented and immune to many of the diseases that afflict large city dailies or national news outlets. Still, if you aren't selling advertising, you aren't in business, and advertisers don't want to see their ad next to something that either offends sensibilities or bores the hell out of readers.

You can wish it weren't so, or call it cynical, but that IS the reason they don't add a link to the source in the article. God help us all if people clicked away from the site, learned more about the topic than the reporter, or had the piece go over their head.

(Edit: I misread your "unfortunately so" as "unfortunately no" and I was super confused.)

I find your comment disheartening because I was kind of hoping that I was guessing wrong. Can I still hope that things are not quite as bad at the NY Times as at local weeklies?

It's just a guess.

My local newspaper's website never links to outside pages, always to previous articles within the site. I assume it is to prevent readers to go wander off.

I was going to link to a piece Dave Winer wrote on scripting news some years ago:


Where he talks about encouraging outgoing traffic.

But one of the more interesting links in that post has gone "evil-dark" (expired, taken by squatters, endless unclosable javascript "your iOS app is inf1ected!!1one! Call us to fix it! Have your credit card ready!"

So by your newspaper linking only to itself, it could be that they actually hope to avoid this dead link behavior. (Although it would be better that it was a self link that went to a vetted link repository.)

I'm really not a web guy, so I'm surprised that this problem hasn't been solved for most content management systems.

Linkrot is a huge problem, and we need IPFS or a similar system to prevent it.

It makes it harder for the reader to find mistakes and harder for the paper to sensationalize. It diminishes the ability to use a study as either commercial or political propaganda (which is not to say the studies themselves aren't commercial or political propaganda in the first place).

Media outlets want viewership more than anything else and the way to get and keep viewership is to tell people what they want to hear. It's why media outlets always have a consistent "slant"; MSNBC people watch MSNBC because it aligns more directly with their worldview than Fox News, and vice-versa. There is minimal tolerance within the audience for a host or pundit that appears to disagree on important factors.

You'll never see Bill 'O Reilly and Rachel Maddow on the same network, because that network would not have any viewers; conservatives want their conservative beliefs reinforced, liberals want their liberal beliefs reinforced, and both will only consume media that performs that function. Most people are not open to having their beliefs challenged even slightly.

All that said, I do find such articles often do state the university and/or the professors that were involved in the study or studies. Some of it may just be convention established before hyperlinks existed, though in many cases, the actual study is not publicly accessible.

Joe Scarborough has a 95% lifetime rating from the American conservative Union, and he's on msnbc. Your statements are a lot more universal than the evidence supports and there are plenty of people who don't run for the hills if their network of choice has a diversity of viewpoints.

Personal POV doesn't have to align with what you spend your day spouting on TV.

"Morning Joe" is a different type of program than the primetime "rage pundits" and Scarborough is one of MSNBC's more moderate hosts, but he still spends his day pandering to MSNBC's core audience. Bias goes much deeper than the words that do or don't come out of a host's mouth; the networks sets the agenda, frames the debate, and procures the guests that will cater to their primary viewership target, and Scarborough passively rides the gravy train. Anchors are performers more than anything, putting on the show that the network has paid them to put on.

What politician is going to turn down the opportunity to have his face in front of tens of thousands of viewers for 2 hours every day, even if it means he has to play nice with the other side?

If there were plenty of people who wanted a "diversity of viewpoints", you'd see this in the marketplace. Could you point out one place where this is actually true? Even NPR, which has a much smaller profit motive and thus should be less concerned with viewership and more concerned with integrity, panders constantly to its audience and refrains from creating a "diversity of viewpoints".

How often do you hear a fair story on NPR about what the conservatives perceive as problems with abortion or same-sex marriage (meaning, a story that doesn't reduce these, either the beliefs and or the believers, to a gross caricature)? Never, because it would make NPR's listener base really mad, because they don't agree that there are problems with those things.

Very few, if any, news outlets are neutral. They pander to their audience's beliefs and they set the dialogue by choosing the stories to give airtime and feed to the base.

Even the "neutral stories" are framed to push a specific viewpoint. They usually go like this: open up with a brief, slanted statement of events. Call someone who supports your POV and ask for their comment. Spend 2 minutes making their argument and bringing it in. About 75% through, put on a 1 or 2 sentence clip from the other side that basically amounts to "we disagree because bad reason x" (bad reason provided either by editing the clip or selecting a bad rep of opposite viewpoint), and then follow it up with another comment from the first person, the person whose argument and authority you spent the first 74% of the story establishing, that says "Well, bad reason x is just ridiculous". Then sign off.

I guarantee you 90% of TV and radio news stories that discuss a news event in a supposedly "neutral" way approximate that pattern. They do it because they're trying to reinforce the beliefs that they believe will make them more money.

Because news organizations are still operating under a newsprint paradigm where citations are considered a waste of ink. Like I'm not saying they actually still think about column inches, but that's how this became standard and people are still just following the standard. This is actually a good litmus test to see if a news organization has moved to the online-first mindset or not.

It might be correlated to journals that charge $70.00 per paper. If the NYT publishes a story citing a journal, the journal may go back, see that the NYT never actually bought the paper and a journalist just got a copy from somewhere, and then try to sue the NYT. The 'study' may be a weasel word that is used to avoid this outcome. And yes, over one article this is frivolous, but if the journal waits a few years and amasses 100 instances where this happened, then the NYT may actually go to court.

That's definitely not the case... Journals provide news outlets with complimentary copies of papers specifically so that they can be written about. Often, but not always, they're even provided in advance of official publication.

Ahhh, so it is laziness then. I should have known, never assume conspiracy when idiocy will do.

How so?

Borrowing material from the library is a "thing" as far as I know.

I don't think you have to own a copy of something to write about it. That would be insane.

Because they are now competing with blogs for readership.

In my experience blogs are usually much better about citing studies than newspapers.

Most readers are not on university networks and so would not be able to read the study anyway, except in rare cases of open access journals.

So what? Whether or not you give someone credit for their work or provide evidence for a claim you make is not contingent on your audience's having immediate access to the fulltext of your source. If the source exists, you cite it, and link to it -- period.

It's not about the audience not having access.

It's that the reporter is getting access without having ever paid for it. (Pirating, reading from another article, etc)

Nobody could ever prove how the author accessed it. It just isn't even an issue, legally or otherwise.

Setting aside the fact that it is a non-issue, in any case many news agencies have various DB subscriptions, most public libraries have DB access, most universities have 'reader' accounts which grant access to these DBs for like $100 a year, etc.

Any reporter who wants to access an article legitimately can easily do so. Else, they really do not belong in the profession of journalism, which relies on practitioners being resourceful and researching things in order to convey accurate information to others.

Shoot. I could have sworn this thread was nested under Balgair's comment about journals that charge $70 per paper. I must have misread something.

I almost think that's a good thing. It would be a talking point for gathering support for widespread open access policy.

So only cite open access articles (like this one). It'd certainly be a win for the public.

The New York Times is especially guilty of this, the more so in its health and science reporting. I noted and specifically called out, IIRC, the LA Times for specifically referencing and linking a source.

The Times needs to get with the times.

I noticed nobody in the thread seems to be pointing this out, so I'll do it:

Scientific research articles are very often behind a paywall. So citing them wouldn't really give the reader much more information.

Because most news organizations are not rigorous and care more about clicks than journalism.

I completely removed added sugar from my diet for the past 6 months. It is hard to describe how my life changed.

I am much better at swimming, less tired, I eat a lot less. I lost weight the first 3 months and now my weight is very stable.

Cutting added sugar is not very hard but it requires some willingness.

The food producers put sugar everywhere: bread, red beans, smoked salmon, yogurt, etc. You just need to read the ingredients to avoid it. You will quickly learn which type of product is ok and which type is not.

Today I am more attracted to a fruit than a cup cake or an ice cream, and it feels good :)

I have become so wary of comments about lifestyle or diet changes that result in a bevy of subjective improvements. Like when people start running and they have all these wonderful side effects — more energy, better sleep, mood improvements, etc — where in my experience I really didn't experience any of it when I trained for a triathlon a couple years back. It just reminds me of infomercial testimonials. I need to see double-blind clinical trials that prove the effects outperform placebo at this point. It all sounds logical, because "sugar bad" but I have become far too skeptical these days.

Double blind dietary study? It would be quite hard to fool someone into thinking they are eating cupcakes when they are really eating a bowl of unsweetened oatmeal.

Dietary studies are very hard. There is no conspiracy preventing rigorous studies, they are just really hard. You need a large enough sample, you need to control the subjects very tightly (people don't self-report accurately), and you need to do it for long enough to see if the effects are lasting or illusory.

If you want real science here, we need to change our expectations and think in terms of $10B not $10M. Probably still a good investment in health, comparable to cancer research.

Until that time, what are you using to make your dietary decisions, given there's not much real science behind any of it?

I completely agree that it would be very difficult to perform such studies, if not impossible, but that doesn't make me desire them any less. Instead I've become very skeptical of everything and – if you'll pardon the pun – follow my gut instincts.

I find maintaining a high level of skepticism tends to dissipate any longterm benefits of the placebo effect. So sometimes I'll try a fad, or a lifestyle change, but hold my judgement until months later and most of the time I'm left disappointed in the overall results.

Other than that, I follow the golden rule of health and nutrition: "everything in moderation".

"Everything in moderation" is just a tautology. "Moderation" for kale is different from "moderation" for sugar is different from "moderation" for opiates. "Everything in moderation" means "the right amount of everything," which is just begging the question of what the right amount is in the first place.

Ah, thank you for articulating the problem I have with that statement that I could never quite put my finger on.

I would not agree it means "the right amount of everything". That would be "everything in the right amount". I take "everything in moderation" to mean not too much of anything, using your best judgement of what too much is. It's subjective and based on intuition, to be sure, but I think everyone has a decent understanding about when they are having too much of something. And I fully admit it's not a great tautology. But in lieu of better science, at least it's something.

Also thank you for using "begging the question" correctly.

Skepticism is fine. But that doesn't mean you can't take someone's advice and just try it. Sometimes it works out, some times it does not. But it's just optimizing what works for "you". This is something you'll never find in a clinical study no matter how good.

> Sometimes it works out, some times it does not

Actually, it almost always works out, at least initially. The problem is, the benefits go away; that's how placebo works. I'm just wary of getting my hopes up these days so I'm very careful about what drastic lifestyle changes I make now. Beyond that, I'm also tired of people guilt-tripping everyone else every time they make one of these lifestyle changes. Everyone rushes from one fad to the next and along the way we all feel a little worse about ourselves.

"It would be quite hard to fool someone into thinking they are eating cupcakes when they are really eating a bowl of unsweetened oatmeal."

I would be willing to be fed slurry through a tube, if it provided good information.

This does assume the form factor and visual re-enforcements don't contribute to the effect. You can call this "placebo" if you want, but the perception is real and might not have a clear "alternative placebo".

But wouldn't you give the control and test groups the same looking / tasting slurry?

I wouldn't count those chickens anytime soon.

I would recommend trying it yourself. I always had problems with my knees, wrists and elbows to the point where pretty much any kind of exercise caused lot of pain. Then I spent a month at a yoga ashram where all food was made fresh without any sugar. After two weeks the joint pain was almost completely gone.

I am now on a low-sugar diet and my joints are still doing well. When I eat some sugar after half an hour my wrist and elbow start to hurt again.

I have tried this a few times and the effect is totally reproducible. This experience makes me wonder how many people who have arthritis and other inflammatory diseases could reduce their symptoms with a low/no sugar diet.

Keeping weight off is also much easier with low sugar.

My advice is: Keep it a try. Stay off sugar for a month and see if you notice any changes. There is nothing to lose (besides a few pounds).

Re-read your comment and tell me it doesn't sound like an informercial testimonial. It worked for you. That's great. Placebo is a hell of a drug. Staying off sugar is a huge pain in the ass because it's in everything, it's delicious, and it makes me happy when I eat it. If I told you that I gave up tap water and strictly drank bottled water for a month, and my knees felt better and I had more energy and I was able to reproduce the effect, would you take it on faith and try drinking bottled water for a month?

Let's say, for the sake of argument, this is just a placebo effect. Does it really matter? If it provides a noticeable, reproducible result that improves someones life, who cares? Is it guaranteed to work for you? No, but there's no guarantee with a double blind tested, well researched method either.

It's giving up sugar, not ingesting plutonium. Worst case scenario you don't get the 'infomercial results', but it most likely will still improve your overall health

How can I tell somebody about my personal experiences without sounding like an infomercial? And why do you call it placebo? I have gone back and forth several times with the same results every time.

Maybe my body is different from anybody else's body and my results apply only to me. That's obviously a possibility.

Dude, why so much hate? What use would be an infomercial recommending to stop eating sugar?

In the abstract you're right, however in this case there are actually links between eating sugar and inflammation in the body. Sugar affecting arthritis is not a new concept; there's plenty of studies on the topic already out there and the relationship between sugar and cytokines in the body. I'd say that's fairly far from a placebo effect.

I'd think about it carefully and see if it had some plausible scientific explanation. I'd look at the cost of trying it and the cost of not trying it. And then I'd try it for a month or not. It's a month! In a lifetime, it's not a long stretch of time. If there's a real benefit you win, if there's no benefit you learned something. (Keep in mind the above line on considering costs and whether I'd do it in the first place -- that's meant to put a bound on costs.)

There are probably places in the US where switching to bottled water would be a great idea, sadly. Northern Iowa, for instance, is struggling to remove nitrates from its drinking water (nitrates affect oxygen transport by blood), and in parts of Pennsylvania fracking has led to flaming tap water. If you live there, it might not be a bad idea to try your example of a silly experiment.

That sugar is inflammatory sounds pretty likely, though. Actually, the Wikipedia article on sugar states that food with a high glycemic load cause inflammation.

Thank you for this. So many people online make diet and exercise seem like some silver bullet, and it's fascinating how much it has been accepted as a silver bullet, yet in my experience it was no big deal.

Though I've noticed that most of the silver bullet testimonials come from US citizens. Could be that the standard American diet is way, WAY crappier than most. Where I come from(somewhere in Africa), fast food and sugary foods are for the wealthy, while organic whole foods is for ordinary folk. So maybe I wasn't eating so badly before, that's why I didn't feel the 'magical' effects I read about from US citizens.

Yup it's a US centric problem. Before coming to the US I would never consider "maintaining a healthy weight" (I've lived in the UAE and India before). The sedentary lifestyle and abundance of cheap (I mean really cheap) sugary products is the root cause. One of the striking things to me when I moved to the US was the waistlines of people who were considered to be living below or around the poverty line. I was like "They seem to be well fed, in what sense are they poor?"

> Before coming to the US I would never consider "maintaining a healthy weight" (I've lived in the UAE and India before).

To be fair, the UAE has approximately the same obesity rate as the US.

Yes it is, amongst locals. Not expats. And sugary products in the UAE aren't as cheap as they are in the US.

so...not a "US centric problem" then

I am not saying this is the solution to all people who are overweight or anything like that.

I am only saying that for someone like me who was clearly addicted go suggar, the result is clearly here.

I tried to stop eating too much since I was ~17 years old and I was never able to do so until I cut added sugar.

I am only speaking for myself (and for my dad who needs to cut added sugar :))

Eating too much sugar and then bringing it down to "normal" levels is one thing, but cutting it out of your diet completely is another. I think eating too much of anything is going to have negative side-effects and bringing that consumption back to normal levels will have the reverse effect. It doesn't seem particularly compelling to me. Sugar is no more harmful to us than most of the other chemicals we consume when done in moderation, so I feel it's being unfairly singled out.

It's being "unfairly" singled out because it's being "unfairly" added to most processed foods. Why is it added? Because it's addicting, people will always want more, and are therefore willing to pay for it. Want your food product to sell more? Add sugar. It's nice that you think people should "just eat normal levels", but it's extremely hard in practice when the food landscape is heavily saturated in the stuff, especially the cheaper products. Healthy food, or "moderate" behavior, exists alongside a mountain of more appealing options in the moment, especially considering cost.

Go to the grocery (in the US), and look at many products attractive to children. Notice the heavy prevalence of added sugar. Unfairly singled out? lmfao

> Why is it added?

Because it's delicious.

Why do people eat too much sugar? Because they like delicious things and eating delicious things makes them happy. Maybe we should focus on why people use food to feel happy rather than why food is manufactured to make people feel happy.

> Maybe we should focus on why people use food to feel happy rather than why food is manufactured to make people feel happy.

That's not really fair. I agree with your general skepticism in this thread (there's a reason that most of these studies show small effects due to dietary modifications but most anecdotes of the same are "and now everything is amazing!"), but the human body is designed to crave things like fat and sugar and to feel good when they're acquired.

Some kind of ascetic lifestyle -- where we can remove the desire for the pleasure of eating -- may be possible, but the physical design of the body and our reward system indicates that enjoyment from eating food is built right in.

It would be like ignoring people perpetuating fraud and instead only trying to solve all the ways that the human brain is susceptible to it.

You responded to a rhetorical question and completely ignored my response to your ridiculous claim that sugar is being unfairly singled out. Why is that?

Because it's delicious

It's not though. It's only delicious for people who have high sugar intake. And besides, deliciousness is subjective and orthogonal to nutrition, while nutritional value is largely objective (we hope).

Smoking is bad for you, so it's illegal for minors to buy and it's illegal to even smoke with a minor in the car. High sugar intake is bad for you, so it's illegal to advertise sweets to children /s.

Maybe we should focus on why people use food to feel happy rather than why food is manufactured to make people feel happy.

You really think for us to have any hope of changing the prevalence of obesity is to get people to change their behavior, instead of minimizing the accessibility and prevalence of the environment which reinforces said behavior? It'd be great to do both, but realistically...? Get millions of people to change their behavior and opt for the more expensive / less flavorful foods? (And I mean less flavorful in a subjective sense, since they're used to very sweet, very salty things.)

You guys just love arguing about semantics.

We can't convince others with an aggressive tone. Like I'm doing. But we can definitely win over an audience.

> > Why is it added? > Because it's delicious.

You can't possibly be this ignorant of nutrition. Do you really think sugar is somehow objectively and universally delicious (excluding the trivial definition in which almost every taste is "delicious" in that it contributes to the overall palette of flavor)?

I didn't quite cut sugar out of my diet but around college I stopped eating as much, and I now found most of the desserts or candy one would find in the supermarket to be too sweet for my tastes, as well as most "normal" sweetened drinks (by contrast to e.g. many fruits). How does that mesh with your claim that sugar is added because it's simply "delicious", as opposed to other's model of a feedback loop between amt of sugar consumed and amt of sugar desired?

Sugar is addictive. It is therefore a drug. Like it or not.

Stop eating it for a few weeks and you will find food with a lot of added sugar disgusting (eg: coke).

> Sugar is addictive. It is therefore a drug. Like it or not.

Addictiveness has nothing to do with whether or not something is a drug. Like it or not.

I agree, most of the life changing experiences people describe sound a lot like they were depressed and now they're not.

I ran in excess of 32 miles a week for several years and the only side effect I had from it was blisters.

If the only change 32 miles a week had on your body was blisters then you must of been in rather great shape to begin with. No cardio improvement? No muscle gain? No weight loss? For the vast majority of Americans I have a feeling this would not be the case.

I transitioned to running in college when I got too old for most basketball leagues so I was in pretty good at the time.

I started running again a few years ago after a 5 year hiatus from any regular physical activity. I logged my Time, Avg/Max HR, and Calories burned for each run and there really wasn't much of a change in metrics over the 3 year period I tracked them. My heart rate was surprisingly stable and run times reduced gradually but only about a minute a year.

Maybe if I was incredibly unhealthy but I generally eat well and at my worst I've only been 20-30lbs over weight. I know that sounds like a lot but I'm 6'5" and my "ideal" body weight is 190lbs which is kind of ridiculous.

Sounds like it worked great for you.

Some folks would argue that if you're in reasonably good physical condition, you're not going to see big results from any exercise program. The contention is that diet controls much of your body composition and all those other effects people are talking about. I don't know if I agree, but it's an interesting idea; the remaining hunter-gatherers in east Africa don't expend more calories than us even though they do a lot more physical activity every day. My own experience is that once I got used to biking 50 miles a week it had no effect on my body shape or composition.

However, once I stopped eating a few things that continually gave me sinus problems I didn't even realize I had, I did feel less depressed :)

What were you eating that gave you sinus problems?

Surprisingly, wheaty foods. I was not a very nice person in the mornings for decades, because my face hurt. I thought that is what being tired felt like. My old roommate still mentions that I'm a grumpy morning person because that is all she ever knew.

Then I stopped eating wheat and I stopped feeling like someone punched me in the front side of the head. It was truly bizarre. I had no idea.

I'm also curious about foods that may be related to sinus problems.

  Like when people start running and they have all these wonderful side effects 
  — more energy, better sleep, mood improvements
I can definitely vouch for that but I would not generalize it by saying everyone will feel the same way. The changes in me are remarkably stark when I do exercise/jog as compared to when I don't at all. I would like to counter the possible argument that I go for an exercise when I'm in better mood or feeling high energy by stating that I've had the mis/fortune of trying it out during various states of my being.

I think there may be an evolutionary aspect to it as we started of as nomads and the lifestyle that we live currently is the result of the industrial revolution and hence quite recent.

Well, I pretty much did the same thing and lost 35 lbs. I know my electronic scale can't be influenced by the placebo effect.

That said, I'm not trying to say sugar is 100% bad for you. I'm sure removing 100% of the sugar from the human body will cause it to fail. Just saying that if you're one of those knocking down 2 bottles of mountain dew and a candy bar everyday, you should probably stop.

>I'm sure removing 100% of the sugar from the human body will cause it to fail.

Why? You can get the needed carbs in other forms. Is sugar required to be eaten? I don't think so.

I don't know... it would be pretty difficult to argue "sugar good" as a lifestyle/diet change. BTW, there are plenty of studies that prove this.

EDIT: Don't want to say 'prove' but would mostly purport the argument that "sugar bad".

I challenge you to live without sugar of any kind. Sugar is not only undeniably good for us, it's completely necessary for survival. What we're debating here is the amount one should consume and that's where things start to get fuzzy.

I'm sorry, but how is sugar "completely necessary for survival"? Can you point to any studies that back that up?

I'm not a nutritionist, but from my layman understanding, carbohydrates break down to glucose during digestion, so any "good" carb source (oatmeal, beans, peas, etc.) will affect blood sugar levels.

But even those carbs aren't necessary for survival. After a period of time, the body (and yes, the brain as well) will adapt to use other sources of energy, such as ketones, which are a fats/lipids by-product. Even then, with no carb intake, glucose can be generated from non-carbs via gluconeogenesis, if needed.

Low-carb high-fat diets have been a life-saver for diabetics, helping reduce or eliminate their reliance on insulin, and that's pretty much proof the human body doesn't need sugar for survival.

Did you, in addition to training for the triathlon change your diet? I tried it both ways (not for a triathlon, but general fitness) 1) Not changing my diet 2) Changing my diet (less meat, minimal processed food, no coffee, etc.).

There was a massive positive difference with 2). IMO, a person's diet is way, way more important than his/her exercise regime.

I think it really depends on your natural baseline though, doesn't it? Someone that is not used to any kind of physical activity will enjoy greater benefits after a few weeks of regular exercise and his experience of the whole thing would be completely different I reckon.

Skepticism can be nullified from the big-picture point-of-view. Look at any one subject in isolation and it will get confusing fast. Look at everything as a highly-connected orchestra or puzzle and things may come into focus.

I try to orient my skepticism towards "things that don't make sense".

What does it mean for something to "make sense" exactly?

> It is hard to describe how my life changed

I've sought out these types of experiences but never see the dramatic changes that other people do.

For a time, I cut sugar out of my diet. I didn't notice any changes other than my desire to eat sweet foods went away. I did experience the flu like symptoms for a few days, but that passed. Now, if I really binge on sugar, I get a headache, but consuming it moderation doesn't make me feel any different than when I had cut it out completely.

I've also experimented with cutting out caffeine, eating vegetarian, different sleep patterns, and different exercise routines. Only messing with my sleep had much effect (I need it, duh).

Being a minor pedant - the sugar in Smoked Salmon isn't really 'the food producers putting sugar everywhere', it's part of how the Salmon is cured before it's smoked. Rubs and cures are fairly typically a mix of salt and sugar along with herbs and spices - the sugar is a pretty integral part of the process rather than being an additional ingredient.

Not to mention its a very small amount of sugar. I noticed in the study they replaced added sugars with simple carbs (bagels/chips). Makes me wonder if the best strategy is just reducing all sugar/simple carbs across the board and replacing with low GI or high fat foods.

This works for me, I lost 65 lbs over a year. Now that I hit my goals I eat very low carb (< 20 net grams) for breakfast/lunch and low/moderate carb for supper (30-60 net grams).

It's more about the quantity of sugar than the fact the salmon has sugar. When people say cut added sugar out of your diet, they're talking about removing a single food item that might have 20-45 grams of sugar.

Why? Binding factors? Aesthetics? Is there any alternative (perhaps more expensive)?

I smoke my own salmon. After cutting the salmon, you let it sit in a mixture of salt and sugar overnight. From my understanding, the salt pulls moisture out of the fish - it's impressive how much moisture is pulled out. The fish starts out sitting in a bowl of salt and sugar, and in the morning the bowl is filled with liquid. You rinse all the salt and sugar off, dry the fish on racks, and then put it in a smoker.

I've been told the sugar is used to keep the fish from becoming overly salty, but I imagine it serves other purposes as well. I'd love to know what that is. We've started experimenting with using less sugar, but it seems the fish would get really salty if you cut too much sugar out.

Here's a picture of the fish drying: https://www.facebook.com/photo.php?fbid=10151063519684708&l=...

and after it comes out of the smoker: https://www.facebook.com/photo.php?fbid=10151064652569708&l=...

Hey man: That's some sexy looking salmon. Nice!

That's a lot of fish. 'Your own salmon' hopefully doesn't refer to your own consumption ;-)

Are you crazy!?! That looks like a few days worth of salmon for me (if I could afford it) :-)

I hear eating that much cured meats gives you cancer (back on topic, sorta, I guess)

Meh, cured meats will have to get to the back of the line. I drink too much and smoke like Thomas the Tank Engine :)

I live in southeast Alaska, so this is a day's catch once in a while. We try to keep a steady stock of smoked fish in the freezer and in the fridge.

But we pay through the nose for crappy fruit and vegetables!

Sugar is a preservative; it directly combats spoilage through osmotic effects, and does it indirectly in a couple different ways.

More importantly, since it was historically used to cure meats, it's become an important part of the flavor profile of those products. It's the same with nitrates and ham and bacon; without them, it just doesn't taste like bacon, which is why "uncured bacon" is usually a pretty deceptive product.

See dekhn's comment:

> Sugar is added to cured salmon because it helps prevent the growth of microorganisms. When this process was originally developed, food spoilage was a huge problem (it meant the difference between survival and death) while metabolic disorders were rare.

Adding sugar reduces the water activity, which inhibits microbial growth.

Sugar is added to cured salmon because it helps prevent the growth of microorganisms. When this process was originally developed, food spoilage was a huge problem (it meant the difference between survival and death) while metabolic disorders were rare.

One more thing: I did that because I wanted to eat all the time. When I learned than sugar is addictive, I stopped.

I would like to back that up. I used to be the guy that ordered miltiple additional portions of fries all the time. I thought I really liked fries.

Eventually I figured out it was the sugar filled ketchup that was doing it to me. Now I eat fries without ketchup and do not usually order additional portions (unless I am really hungry). Best of all, I do not feel like I am starving myself. When I do not have ketchup, I do not get the desire to eat more.

I can eat fries without ketchup just fine. My issue is with the salt. Give me more of that wonderful NaCl.

Fortunately no issue with NaCl. It has been demonized but turns out, humans with their salty blood are exquisitely tuned to regulate salt. Most of us have absolutely no problem with any amount of salt.

any amount of salt

Less Salt water than you might think can kill you. Lower levels can also prove deadly when your body is stressed.

However, long term effects do seem limited.

There's that lady that deliberately lived for months on a raft in the ocean, drinking only salt water. I'm doubting that salt water is terribly harmful.

Very similar stories on my side... I used to need a lot of food to feel "satisfied" or "full". Now, a regular meal, like my wife who has always eat small portion and healthy food, and I am good until the next meal.

I eat them with mayo. I wonder if that has sugar? Anyway, still crave them, eat as many as I find on my plate (and half of what's on my wife's plate).

This. 100 times.

I've had the same experience (and a few relapses, but I do know better).

I've cut it out for the most part as well, and I (as anecdotal as it is of course) completely agree.

I've also lost 35 lbs since the beginning of summer as well, with few other specific changes than learning to pass up sweet stuff.

Naturally, it's calories in vs. calories out for weight loss, but there seems to be a dangerous feedback loop when it comes to me and sugar. Easiest way to exercise will power for me is to just say no altogether.

I agree with you on the benefits, but I did find it quite hard to get rid of added sugars from my diet. As you said it's basically in 90% of products you find at the grocery store, so the only way is to buy raw foods only and do a lot of cooking. I work remotely from home, so I have time to choose what to buy and time to cook everyday, but otherwise I don't think I could do it easily.

I have seen a bunch of friends trying with the same feedback.

I think the key is to do it very strictly for a few weeks. Otherwise, you have a hard time understanding some of your feelings. When you completely stop, you can clearly see the difference.

Sometimes, I think I am too strict so I take a peace of cake, and I usually regrets eat because I have this weird feeling an hour later.

Also, I want to insist on the fact that I had a lot of junk food while I was younger, and I think the effect on my body was big.

My observation is that people who grew up eating healthy don't have the same problems.

>> Today I am more attracted to a fruit than a cup cake or an ice cream, and it feels good :)

I had a buddy who has convinced me to do this as well and says everything tastes better when you re-align your taste buds so to speak. He says all his fruit tastes sweeter, vegetables and other foods have more flavor when he stopped eating processed sugar.

Clearly, you've had the same experience.

Exactly, that is why I say it is hard to describe, there is too many things changes.

Give me a plain yogurt and a fruit and I am as happy as I was with an Häagen-Dazs® ice cream :)

What do you mean by "added sugar"?

What about carbohydrates, which have "added sugar" (because they ARE sugar by default?)

What about high-sugar fruits like bananas, citrus, and red apples, which often have as much sugar as processed snacks?

Or do you mean that you eat low glycemic index foods?

Seems like you're aware of the relationship between gluclose and fiber, since you built up to glycemic index as your final question, but for those that don't know:

Fiber content in foods affect how the human body absorbs glucose. High-sugar fruits generally have decent quantities of fiber which mitigates the rate at which ingested glucose enters the bloodstream. At least this is my understanding of it from my nutritional scientist, sister, but I'm no medical professional. For more details, fiber:

"Attracts water and forms a viscous gel during digestion, slowing the emptying of the stomach and intestinal transit, shielding carbohydrates from enzymes, and delaying absorption of glucose,[62] which lowers variance in blood sugar levels"


Also, compare an orange vs orange juice:

Orange Glycemic Index = 40

Orange Juice Glycemic Index = 50


Carbohydrates are not "added sugar".

High-sugar fruits are not "added sugar".

Added sugar = sugar which is added to a product, and shows up on the ingredient list.

The only fruits you would worry about is fruit juice, because good luck eating 10-12 apples in one session, but you can drink 10-12 apples worth of juice without any problems.

I can eat 8-9 bananas in one session. I prefer smoothies because it is harder to get the necessary calories from fruit in whole form.

I have had this discussion so many times. I am pretty sure he means "refined" fructose. I.e. fructose that is removed from it's natural state and put into concentrated form. This is basically crystaline sugar and high fructose corn syrup.

Fructose that appears naturally is not bad for you. The reason is that naturally appearing fructose usually appears with fiber, and it is usually locked in plant cells. The body is perfectly capable of processing this type of sugar. There was a Japanese study where they had people eating large quantities of apples, and their blood tests did not show any of the negative effects associated with large intakes of sugar.

The only naturally occurring sugar one should be weary of is honey.

Also carbohydrates are not sugar by default. Sugar is a type of carbohydrate, but there are other types that are not sugar and should not be confused with it. There are also other sugars (other than fructose) that are perfectly fine. Glucose for example, is not bad for you in any form.

There has been a lot of confusing science done by assuming that all carbohydrates are the same. And while they do have similar molecular structures the way they are processed by the body is very different so they should not be mixed up.

I recommend you take a couple of university courses in biochemistry and energy metabolism and then reread what you just wrote. It's full of inaccuracies that you probably notice right away after you've learned the basics.

I've only learned what I know on the topic from readings here and there, as well as a bit of research when I'm particularly motivated. I personally didn't notice an overwhelming amount of incorrect information in his post, so I'd like to take the opportunity to ask you to expand on this comment.

I don't think anybody is going to take some university courses in order to find the factual inaccuracies in a comment they wrote, so to be more helpful in dispelling these inaccuracies, could you possibly list a few of them and some relevant terms/concepts that could act as stepping stones to finding the correct information?

I am genuinely curious on the topic, but don't always know where to start and what data is bought and paid for by biased parties. I have been curious since first asked strong proponents of "natural" foods to explain to me why fruit full of sugar was supposedly better for you than anything else full of the same amount of sugar and received answers that were quite unsatisfactory.

Ok then what are some of the inaccuracies? I am just curious so I know I will get my monies' worth when I take those biochemistry courses.

> The only naturally occurring sugar one should be weary of is honey.

Can you give some background on that? Is it because it's already been processed once (by bees), and therefore is less suitable for human consumption?

I think it has more to do with the fact that it is just sugar by itself. From what I've read, it seems that the context of the sugar is what makes it "good" or "bad", and that's because the effects are measured by how the food affects your blood sugar after eating it. This is tracked in the metric known as the glycemic index of the food. In fruits it is with fiber and plant material that results in your body taking longer to process the sugars and doesn't give a spike in blood sugar like eating the same amount of refined sugar would. Honey is just lacking the context that most natural sugars is and is thus more similar to refined sugar.

I suspect, based on the lines previous to that one, that the statement is related to the fact that honey is basically a high-sugar syrup. About 80% sugar, 17% water, and 3% "other". For comparison, simple syrup is 50% sugar and maple syrup is 60% sugar.



> carbohydrates [...] ARE sugar

Sucrose (table sugar) breaks down into fructose and glucose (as does corn syrup). On the other hand starch breaks down, after a couple of steps, into just glucose. Glucose is your basic fuel that is used by the muscles, etc, directly. Fructose has to be metabolized by the liver first, with some bad side effects if you have too much. The study that the (currently) top post links to is specifically about "fructose restriction". So we're not talking about carbohydrates in general.

Bananas and apples do have fructose, but it's not "added" sugar. However, if you take apple juice (or as I see on labels a lot, pear juice) and use it as an ingredient, that would be added sugar.

A lot of breads in North America have a lot of added sugars. You have to actually go out of your way to find breads that aren't sweetened significantly.

> A lot of breads in North America have a lot of added sugars.

The sugar feeds the yeast to make the bread rise. No sugar == solid lump of rock-hard bread-rock.

Sugar is one of the key ingredients in Western-style fluffy loaves, particularly wholegrain flours which need an accelerated fermentation process so that they rise before being 'set' by cooking. Which is nicely ironic since we've been conditioned that wholegrain is the healthy choice!

Sugar also helps to prevent staling, which is critical in home-baked breads which barely last 12 hours even with that assistance.

I'm not saying we should have NO sugar in our bread. But it's to the point where if you google "Why is American bread so sweet?" you'll find countless examples of Europeans comparing American bread to cake.

This is well beyond the scope of "feeding the yeast".

The amount is tiny though. I make my own bread, and you can use just half a teaspoon in a loaf, it's just to get the yeast going, and they probably metabolise most of it. I've also experimented with using part milk so they use the lactose instead, and this also gives a nice consistency to the bread (still working on further improving this though!)

This is incorrect. It's perfectly possible to make light fluffy bread without adding sugar. Sugar might be added to accelerate the process for economic reasons, but that's something else.

There are breads that DON'T have sugar in them?! Where do I find these mysterious breads?

ADDED sugar. As in "let's dump a bunch of refined white sugar or high fructose corn syrup in this dough to make it sell better to our sugar-addicted customers."

When I lived in the UK, I started making my own bread (I'm from Germany, we have a bit of a reputation for our bread). I have a rye sourdough from which I bake a rye and wheat mixed loaf. It's quite heavy -- slightly over 1kg for a large loaf tin (IKEA DRÖMMAR, to be precise) -- but stores well and I really enjoy the taste. The sourdough is my fridge pet (so to say), but since it lives in the fridge, it needs to be fed only once every two to three weeks, or whenever you bake it. I've had it for 1½ years now.

Picking a very standard "squashy" British loaf, the ingredients are [1]:

Wheat Flour (with added Calcium, Iron, Niacin, Thiamin), Water, Yeast, Salt, Soya Flour, Fermented Wheat Flour, Emulsifiers: E472e, E481, Vegetable Fat (Rapeseed, Palm), Flour Treatment Agent: Ascorbic Acid

This seems typical of all of them. The only ones with sugar are a couple of wholegrain ("brown bread") ones.

(I don't blame you for baking your own. I made good use of the German bakery when I lived in London, and I'm not German.)

[1] http://www.tesco.com/groceries/product/details/?id=256174499

American bread and European breads (including British) are a bit different -- Americans like a sweeter loaf. A traditional American sandwich bread often has milk and/or sugar. The milk increases sweetness.

King Arthur flour recipe: http://www.kingarthurflour.com/recipes/classic-sandwich-brea...

random blog: http://chefinyou.com/2012/08/27/white-bread/

Wonder bread etc just use high fructose corn syrup and honey. Cheaper than milk, can say lactose-free.

I didn't do it because of sugars, but I'm glad that none are added -- after a couple of months or so, I had enough of supermarket bread ;) There are easier ways to make your own bread though, soda bread is particularly quick and easy (although you'd typically use a bit of sugar for the yeast). It's literally 1h (ok, maybe 1h10m) from stepping into the kitchen to taking the loaf out of the oven.

Your local non-industrial bakery.

Basically, when it is written "sugar" in the ingredients, I don't eat it.

I eat fruits but not dry fruits or fruit juice / smoothie etc. I eat bread and pasta. I don't eat snack bar.

I try to eat food with a low glycimic index but I know bread has a high one.

    > What do you mean by "added sugar"?
People used to ask me this all the time too; for me it was anything that was sweet to the taste, and hadn't come like that way naturally. Bananas were ok, food that had been sweetened using bananas (like a smoothie) were not ok.

I tried this for about 9 months, and then a year later, for about a month and a half.

I can massively agree with this:

    > It is hard to describe how my life changed.
I lost a load of weight, and felt much better. However:

    > Cutting added sugar is not very hard but it requires
    > some willingness.
Your mileage may vary. Having had strong to mild nicotine, alcohol, and benzodiazepine dependencies in the past, kicking sugar was much much more difficult than any of the others.

At least part of the problem was that it's virtually impossible to get away from sugar; you'll eat something you thought wouldn't be sweet, but it is, and suddenly you have chocolate smeared around your mouth sitting in a field of candy wrappers...

Watching my wife try and give up sugar was also an education. Wild mood swings, bargaining, secret consumption ... it was quite something. We're both pretty athletically shaped and very active, but giving up sugar was comfortably ... impossible.

I have had excellent results recently eating 90% of my meals from a paleo food delivery service. I don't think I can get behind any of the "science" the paleo community puts forward, but eating balanced and very high quality meals had made many parts of my body much happier.

I take issue with this because was it really the sugar or were you reducing and eliminating other bad elements from your diet? Cup cakes and ice cream, for example -- it's not the sugar -- it's the high fat combined with sugar causing you problems.

Good point. My feeling is that this rule of cutting added sugar is a good rule to actually eat mostly healthy food. There is counter example to that of course. I am not doing a scientific study, I am just tired to gain weight if I don't run 3 times a week.

There's nothing wrong with high fat on its own. Sugar on its own is not good (might as well eat anything else, you'll save your teeth). But put the two together and you get heart disease.

One way to improve your diet is just to pay attention to it. And you're paying a lot of attention to your diet. Unfortunately your anecdote isn't very helpful to learn specifically about sugar.

Fruit has a lot of sugar in it, too. Do you avoid fruit as well?

1. Fruit is not healthy in large quantities. (Everything in moderation?)

2. If you eat fruit in its natural form (with the fiber etc), it has a much lower glycemic index than processed. Also consider the glycemic index and load of an apple is much lower than a potato.

Its worth noting that in the form of something like a smoothy, a person can consume more fruit than would be possible eating actual fruit. Imagine a counter top of fruit turning into a single large smoothy...

Fruit is perfectly healthy in large quantities if it is raw with nothing added. The human body is very capable of processing the sugars in fruit.

It's when those sugars get extracted and concentrated we run into trouble. Juices and smoothies are more dangerous because they concentrate the sugars while removing fiber. This decreases the liver's ability to process the sugar. But actual refined sugar is most dangerous.

Do you have any evidence to back this up? Glucose is glucose and fructose is fructose as far as I know. There are no fundamental chemical changes.

You should check out Dr. Lustig's youtube videos and his papers. He cites plenty of evidence. He also explains the mechanism by which fructose is processed by the liver, and why the fructose in fruits does not cause problems.

Ah, Lustig. Many of his fellow doctors are not on board with his conclusions: http://www.huffingtonpost.com/david-katz-md/sugar-health-evi...

In its natural form sugar is not singled out and thus other molecules from the fruit influence its absorption. For example, vitamin C in its oxidized form is transported by the same receptors as glucose (GLUT4) and quercetin is very good inhibitor of glucose transport.

I still doubt tho, that high quantities of fruit are good for you. One of the reasons is that current forms of fruit we eat are selected toward sweater taste.

I've read a few papers that suggest our bodies absorb sugars differently in the presence of other chemicals that are present in the fruits themselves, but not in the processed versions? I think this is one of those papers?


This is all on a continuum, I would concur that large quantities of raw fruit is far better for you than the same payload in say Coca Cola.

But is stands that it is possible to become insulin resistant from eating raw fruit, and this is simply not possible from eating eggs for example.

In regards to insulin resistance there is an upper bounds of healthy fruit consumption, just there is with almost any food (although for some foods the consideration may bot be blood sugar, but rather be total calories or omega-6 poly-fat, etc)

Most days I get 80% of my calories from fruit. Actually, eggs increase the risk of diabetes.


That is very unlikely, show me some real science (not the one flawed study from a few years ago). Type II diabetes is severe insulin resistance. A food like eggs don't have sugar, your body doesn't produce insulin when you eat them, therefore its not possible through any known mechanism for them to contribute to type II diabetes.



A food doesn't need sugar to produce insulin. A steak produces as much insulin as pure sugar.

>A food doesn't need sugar to produce insulin.

This is true. But non carbs have a much lower insulin response.

>A steak produces as much insulin as pure sugar.

Are you saying grams of protein to grams of sugar? A steak has a smaller insulin response than a piece of bread, not only that, the shape of the spike is drastically different.

If eggs do anything they decrease risk of diabetes. They may, or may not, be bad if you already have type 2.


"Recent research has shown that moderate egg consumption—up to one a day—does not increase heart disease risk in healthy individuals (1, 2) and can be part of a healthy diet."

How would smoothies remove the fiber. You're just grinding up the fruit, not taking anything out. All the fiber should still be there.

In what way does a smoothie remove fiber from fruit?

Dried fruit is also incredibly deceptive.

Actually, most fruit is fine even in pretty darn large quantities, due to the fact that the sugar is absorbed slowly, and it is paired with phytonutrients that have anti-oxidant and anti-inflammatory properties.

Bananas and dates are the main exceptions to this.

I eat fruit but I don't drink fruit juice. Today I prefer to eat a whole orange than drinking an orange juice.

Let's all give ourselves a pat on the back for eating fruit.

Fruit does not have added sugar and the fiber in fruit helps slow the digestion of the fructose greatly dampening the negative effects of the sugar. Plus fruit is loaded with naturally occurring vitamins essential to the human body.

Sugar in fruits is not added sugar.

It actually is. Except it's not added between growing and fruit and consuming it, but before growing the fruit. Fruit have been bred and genetically engineered for high sugar content for millennia.

... none of this is to bash fruit - they are definitely a much better alternative to sugary drinks and even fruit juices, due to their low glycemic load. But still, it's important to remember that fruit, especially some fruit, are far from being sugar free.

Added sugars refers to sugar carbohydrates added to food and beverages during their production.(artificially)


That statement seems to draw a narrow definition of "fruit". Olives have no sugar. Tomatoes and cucumbers have very little. All three are fruits and good staples in any diet.

Using the botanical definition in a culinary context doesn't make any sense.

Alright, let's just go with olives alone, then.

Do you drink coffee?

I do! Why?

Without sugar or you add something other like cinnamon?

Coffee without anything. Has been like that even before I cut added sugar.

I've always drank black coffee. Occasionally I will add a little skim milk, but that's more to cool it down if I'm in a hurry. Have never added sugar.

A lot of people (like myself) enjoy coffee black. If you prefer a cream you can add unsweetened coconut or almond milk.

This is almost surely placebo effect

Given the amount of time wasted on diet/nutrition fads I'm starting to thing the US government should actually do some science on these issues.

You mean like the article you're commenting on?

ya, the one where placebo (sugar pill) is documented to work in many times in lieu of actual narcotics.

"Tom Sanders, professor emeritus of nutrition and dietetics at King’s College London, said the study needed to be viewed “with some scepticism” because it was uncontrolled. It did not compare the children with a similar group who continued to eat a high-sugar diet. The comparison instead was made with their weight and health before the study while on their usual diet. “But it is well known that obese children underestimate and under-report food intake, particularly of soft drinks and snack foods,” said Sanders.

“This is a fundamental flaw in the study. It is likely that the changes in metabolic outcomes observed can be explained by the experimental diet providing fewer calories than the children’s usual intake.”

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