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Sugar-sweetened drinks with protein rich meal affect metabolism (biomedcentral.com)
131 points by nreece on July 23, 2017 | hide | past | web | favorite | 168 comments

Often people are wary of new results about health, so it's worth pointing out that this paper is rigorous and the conclusion is very likely to be correct, as explained by this comment on Reddit's /r/science [1].

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

> The study was pre-registered (At ClinicalTrials.gov: NCT02211599), with a clear outline of the scope and methods (protocols) to be used. This avoids bias where only hypothesis-affirming data are reported and hypothesis-contradicting data are hidden or discarded.

This is good to see. I wonder if unregistered studies will ever be ignored like non-peer-reviewed studies are.


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

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

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

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

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

* a conflicting study used a different artificial sweetener

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

* also all the limitations mentioned in the study

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

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

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

  the possibility that gut microbial response ... might cause the differences
This will eventually be proven to be a significant factor, IMHO.

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

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

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

For 300,000 of human existence except the past couple of centuries, humans did not use vaccines.

It is always a good idea to hold off on vaccines.

Not saying drinking sugary drinks is good, but your justification is bad

For 300,000 year children were'nt getting type 2 diabetes or fatty liver disease.

For 4,500 year humans have been engaging in gavage or the forced feeding of animals to fatten them up, for example the popular French dish Foie Gras - french for fat liver - is liver of duck or goose force feed corn.

If for the first time in history you concentrate the sugar found in corn and put it in beverages and regularly feed them to kids and the kids beging developing the same fatty liver as the Foie Gras...is it then ok to question the sugar?

>Not saying drinking sugary drinks is good, but your justification is bad

Parent isn't rejecting the questioning of sugar.

He's pointing out how the reasoning used is spurious.

Isn't there some valid probability in stating humans should likely eat what they've adapted to over hundreds of thousands of years?

And humans have been using medicine for thousands of years, which have an intrinsic property of being good for us -- thus vaccines are just an extension of this.

I'm all for resisting fallacies but this hypertechnical idea that natural vs unnatural is completely irrelevant due to a few exceptions is counterproductive. It's practical and beneficial for the average person to view natural things as better.

This is not a good comparison. Your counter analogy is equally bad.

The parent is disagreeing with the reasoning, not the conclusion.

On the flip side, the idea of drinking mainly non-alcoholic water also emerged only in the past couple decades. Humans have been drinking beer/mead/wine since prehistory, which are basically sugar sweetened drinks left to ferment.

This wasn't predominant in rural areas; it became necessary in cities/towns where sewage wasn't kept out of drinking water sources. If your water is unsafe, beer or ale becomes your standard beverage (except when the water is boiled, e.g. for tea or coffee).

>the past couple decades.

Well, Islam has forbidden alcoholic drinks from the very beginning so that means you are off by at least 1400 years.

Children drinking alcohol?

Yes, absolutely. Not much, granted, but if you look into the history of beer production, you'll see commonly the production from a single mash two, or even three beers, ending with the "small beer", which was commonly served to all, including children. Because wort was boiled, it was a safer alternative to water, from a time before germ theory was understood.

Ok. But not even close to the way kids drink sugary drinks today.

Amen. People are very confused. Just because they think something is okay for then doesn't make it so.

In a short time we will pull our heads out of fats asses and realize that sugar is the nicotine of our era. It's not healthy. It has major health reprecussions. Etc.

Unfortunately, fat, literally, makes you stupid. So embracing the obvious might as chose as it should be.

How does fat make you stupid? I've only seen claims to the contrary, that keto diets are good for the brain.

Dietary fat and body fat are different things. Keto is associated with the former, but if anything it reduces the latter. I think his claim is that (excess) body fat is what makes you stupid.

I don't know what specifically this is supported by, but your objection is based on misunderstanding the claim.

Edit: I just Googled it and I think he probably means this CMU study: http://www.menshealth.com/weight-loss/how-being-fat-makes-yo...

Yes, body weigh fat, not fat. Your brain actually need fat. But obesity compromises the major organs. Organs the brain depends on. Less effective organs - e.g. heart and circulation - is going to compromise the brain.

https://duckduckgo.com/?ko=-1&q=obesity+effects+on+brain+fun... https://duckduckgo.com/?q=https://duckduckgo.com/?ko=-1&q=ob...

First, it's kinda obvious. That is obesity compromises the organs. That would include your brain. Furthermore, the brain outsources a lot: blood, oxygen, glucose, etc. Obesity compromises the foundation the brain stands on.

That said, here ya go...

https://duckduckgo.com/?ko=-1&q=obesity+effects+on+brain+fun... https://duckduckgo.com/?q=https://duckduckgo.com/?ko=-1&q=ob...

Fat makes you stupid?

I should have said being overweight or obesity. Not fat.

Fruit juice? Does fructose vs sucrose make a difference?

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

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

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

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

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

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

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

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

> particularly deep fried foods.

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

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

Glucose tastes awful so I wouldn't call it a good sugar.

Sucrose is one part fructose and one part glucose. Our cells use glucose for energy directly, the liver metabolizes fructose. This similarity of fructose and alcohol is the basis of the whole sugar is a poison. Fruit is fructose, which is probably why we are to be able to metabolize it, but fruit is generally very high in fibre and around the size of a serving or 2. Serving sizes of juice and additive sugars are extremely oversized.

A bit off topic, but if anyone reading through could explain to me why adding fiber to fructose makes it "good" sugar I'd be really interested. I mean, I know that we need fruits and vegetables in our diets. I know that apples and carrots are good for me. I just don't understand why fructose without fiber is bad?

Right now... I just don't drink the soda or sugary drinks at all. But I don't really understand the science behind my decision.

Because I'm eating apples and carrots all the time ???

Slower intake rate. Much like your liver can metabolize an oz of alcohol per hour in perpetuity (well, until liver cancer sets in) and you won't even get drunk, but trying to drink 100 oz all at once every 100 hours will promptly kill you. So the theory is slapping your blood and insulin system with the equivalent of 20 apples in a single impulse will mess with your insulin levels and fat storage rates much more than slowly sipping it in, by having chunks of apple take hours if not an entire day to digest.

Sipping a glass of apple juice over the course of an entire day would probably be healthier than slamming it in one gulp, however your dentist probably wouldn't approve. Speaking of dentists, scrubbing the flat surfaces of my teeth by grinding carrots for awhile in my mouth should lead to fewer dental issues than soaking my teeth's plaque layer in completely liquid acid and sugar.

There's also the fairly obvious issue that given the choice of 100 grams of apple fructose or 50 grams of fructose plus 50 grams of inactive fiber, obviously the raw fruit will provide fewer calories for a given subjective level of fullness. I know I'm eating junk food when I juice, but sometimes its fun and it certainly is tasty, and it never fails to amaze me how it takes half a bag of produce to generate a cup of juice. Most of the calories in that bag are in my cup of juice. A normal snack for me is a couple carrots, but I can turn five pounds of carrot calories into a (very large) cup and slam it.

Possibly your body can survive having the liquid sugar of 25 apples slammed into it instantly, every day. Certainly we never evolved to eat that way, so if we can handle it without sickness, its just good luck as opposed to evolutionary pressure. Our ancestors digested a lot of citrus very slowly one piece at a time, there was strong evolutionary pressure to thrive eating a piece of fruit per meal.

What people really mean here is that when you consume real fruit, you get fiber, vitamins, other micro nutrients and, yes, fructose. But the quantity of fructose you get is relatively small. When people drink fruit juice, basically all they are getting is the fructose (with water). And you're getting many apples worth at one time. This overloads the liver which starts turning the fructose into fat.

So eating an apple or an orange is fine. Drinking fruit juice is not. Hope this helps

Besides just making it hard to overdose on sugars it also slows down digestion to soften the blow, can even reduce amount absorbed at all.

More info https://intensivedietarymanagement.com/fibre-reduces-insulin...

The fibre in fruit allows a signal to stop eating to be sent to the brain. The fibre doesn't make the sugar good, but you will stop eating when you're sated and so consume less sugar. No such signal is sent when drinking sugary drinks, so it's more likely you will consume more sugar.

It's less a matter of making fructose into a good sugar, and more a matter of reducing the bioavailability of it. When you eat a piece of fruit, your body has to break it down in order to get at the fructose, and that takes enough time that you're now competing with your gut bacteria for access to that fructose. When you drink it in a soda, it's much easier to process and you have a significantly higher chance of absorbing it at soon at it enters your small intestine.

While I don't have any hard facts or make any claims about what it does, the idea that fruit juice = fruit is likely inaccurate. Juicing seems to leave behind the fiber and concentrate the sugar. It seems at least plausible that there's a significant difference in the digestion and metabolism of each.

The fruit that they used to have probably didn't resemble what you can go out and buy these days either.

However, I don't think that looking at what humans ate millennia ago is a good indication of what we should do.

God forbid we discover our ancestors used to eat dirt.

Not just our ancestors. People still eat it today.


Well they obiously had a lot more dirt in their diet by proxy. Fruit and veggies weren't as vigoriously washed as they are now, which is the reason why so many people are B12 deficient.

Many animals do, especially clay compounds that absorb toxins.

Even parrots have been observed eating clay soils in the wild.

You are right. I cant remember the link but there was an article I read that drinking fruit juice is not the same as eating fruits with fiber.


Fructose loads your liver. Sucrose breaks down into glucose (which can be metabolized by many cells) and fructose (which is only metabolized by the liver). They're both bad when over consumed.

This laid out pretty well in The Obesity Code by Jason Fung (a real doctor).

As I understand it, it's worse still. While glucose can be directly converted to energy, fructose must first be turned into fat, before it can be converted to glucose or ketones.

This fat will be stored in the liver.

The more fat you have in your intestines the more insuline resistance you'll have. Which in the end will screw with the entire body in various ways.

Fructose is mostly turned into glucose and metabolized that way. No need to turn it first to fat. https://en.m.wikipedia.org/wiki/Fructolysis

Fructose alone is even worse than sucrose. Fructose doesn't produce satiety and it's metabolized by the liver in a similar way to alcohol. The difference it makes with fruit is the fiber content which is what satiates and slows down fructose abortion.

Not really. Sucrose is basically one part glucose and one part fructose. I think what matters is the amount of sugars, not the type of sugars.

The way your body metabolizes different sugars is different and certainly important/relevant. The knowledge required to explain these differences is outside the scope of a comment here, but I encourage you to do some research on how different types of sugars are processed by the body.

In brief, current reasoning is that it does make a difference, and fructose is, if anything, worse for the body, metabolically speaking.

> Fruit juice

Coke is better. It has similar sugar levels but has caffeine which seems to be good for you.

Fruit juice with fibre is better, but like most loopholes really you are just fooling yourself. So at least with coke people seem to know it's bad so I'd stick with that.

Then there's coke zero that's better for you than water. (But not for your teeth)

For many consumers (including the USA), Coke has HFCS instead of sucrose.

Humans have been drinking fruit juices for a very long time...where do you think wine originated from?

I believe the glass of OJ for breakfast is a fairly modern habit.

Wine, hard ciders, etc. were popular for the very reason that the actual fruit juices weren't. The lack of refrigeration and with no knowledge of pasteurization fruit juices were likely only consumed a few days a year when the fruits were ripening. Cellar preserved fruits likely wouldn't produce good juice either.

So the juices were preserved by fermenting the glucose (and much of the fructose), or making preserves, etc.

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

What if you're not overweight and get a lot of exercise? My goal is to put on weight and not have meat sweats at night, so perhaps I should actually be taking more sugary drinks with my meals.

For those who follow the targeted ketogenic diet it can be beneficial to ingest some sugar prior to a high intensity workout.

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

"Calories in, calories out" is both true (in the thermodynamic sense) and accurate enough to be useful (in a practical sense). I've personally performed the experiment, using MyFitnessPal and a $14 digital scale, and it turns out that I can control my weight to within a few pounds.

There are a few caveats:

- Yes, your diet composition does have metabolic effects. Protein, sugar and fat all follow different metabolic pathways, and converting between them requires energy. Protein is supposedly easier to store as lean mass than as fat, for example. But unless you're already lean and training hard, these effects are relatively minor. If you want to lose 50 pounds of fat, calories are good approximation.

- Unless you're a hard-core distance athlete, the "calories out" side of the equation is mostly useless. Depending on your weight, walking a mile burns about 1 Oreo. Essentially, it takes a lot of energy to run your brain and your digestive system, but exercise is surprisingly energy efficient. So if you work at a desk job, and you don't run 5 miles a day, then use the "Sedentary" option when calculating your daily calories.

- If you want to be both lean and muscular, things get trickier, because you need to worry about your muscle:fat ratio. You can control this with resistance training. But weightlifting while losing fat can be pretty metabolically brutal. Conventional wisdom says that it helps to watch your protein:carbs:fat ratio, and to eat a nutrient-rich diet. (And my personal experience bears this out, especially once I've exhausted the easy gains in the weight room.)

- Most diets fail because most people stop dieting. If you revert to your old habits, you'll eventually revert to your old weight and body composition. As a general rule, few people stick with long-term lifestyle changes.

Losing weight and becoming muscular are both solved problems. The major challenge is sticking with the behaviors that produce the desired result.

An even blunter instrument that I’ve found very useful for weight and health is “mass in, mass out”.

That is, in a First Law sense, you can’t gain more than the mass of what you eat & drink, and you will always lose a certain amount of mass each day through breathing (metabolism, exercise) and excreting (waste, sweat).

So for example I lose 1–2 pounds a day with my metabolism, activity level, and diet, so I eat a bit more than that per day and try to make sure that those foods are healthy most of the time. For me, “healthy” means mostly plant-based, high in fiber, balanced in nutrients, and so on. I joke that my diet consists of vegan food and cheeseburgers, but it’s pretty close to the truth.

I think this should be the first step that most people take toward changing their dietary habits, because it’s dead simple: look at the weight on the package of the stuff you’re putting in your face, and get a cheap kitchen scale if you want to be particular about it. Then incorporate calories as you begin to get an intuitive sense of how caloric density affects the answer to “How much of this can I eat if I want to maintain/lose/gain weight?” and then incorporate other details like macronutrients.

Even before all this, the zeroth step is to document your habits by just writing them down. It might just be how my mind works, but if I want to fix something about what I’m doing—eating, sleeping, taking drugs—then it’s way easier to think about it in terms of adjusting a graph than all the details of the actual problem at hand.

Actually most diets fail because you stop dieting AND when you do, you now have decreased your metabolic rate and increased your production of hunger hormone. In summary you are way more likely to fail keeping a stable weight after dieting then you were before.

The failure rate is something like 98%

But that's the point. A diet is not something that you do a few months after which you get and keep a killer figure while returning to eating whatever you want. A diet should be the preliminary to a permanent shift in eating habits.

This is very true. We just need to avoid recommending unsustainable diets based on calories in/out thinking. Since they all ultimately fail. Also why settle for a decreased metabolic rate when you could actually increase it and enjoy the extra energy instead. No need to feel miserable the rest of your life.

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

I feel like it's one of those things that sits in the background and eventually has a decent effect over time (assuming you're not looking for unreasonably rapid weight loss). It's an extra tool not, not a replacement for restriction (as well as a safeguard against a crashing metabolism).

An easy run of three miles three times a week takes three half hours out of your week and can easily burn 1000 calories. If you're keeping an eye on calories in and don't go over to compensate, that's a pound every 3-4 weeks. That sounds glacially slow, but if you're doing CICO for six months it's an extra 8-9 lbs.

And this is being conservative: given the lengths of willpower people go to in the calories-in side, going for a half hour run every day isn't that unreasonable. That will lose you an extra 17 lbs in six months. If you're trying to lose even 50-100 lbs, 17 lbs over six months is not insignificant (let alone if you're trying to lose 20-30lbs).

I think the idea that it's not useful for weight loss comes from the fact that it's tough when you're starting, but then, so is calorie restriction.

All of this is ignoring weightlifting, which is even better at making weight loss easier.

Except swimming where a lot of calories are burned to maintain body temperature. The number of calories top swimmers have to eat per day dwarfs those of other sports I believe.

In fact I believe being cold in general is a good idea all else being equal if you want to lose weight but the advantage of water is that it's a better conductor of heat out of your body than air is.

Cold in general prompts the body to begin to hold fat. Heat makes breaking of bonds easier.

Yes but if the body is trying to maintain normal body temperature it is necessary to burn fat if you are not eating to excess.

Cold in general also makes your brown fat more prominent relative to the white fat. The brown fat is the good one, and its purpose is to dissipates heat. If you are never cold, it will get reduced to the minimum in a 'use it or loose' it sense.

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

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

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

Inefficient for weight loss, efficient in a fuel per work done sense.

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

Edit: tablespoon, not tea-

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

I knew I was asking for trouble, generalizing peanut butter into fuel...

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

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

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

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

My car will probably go (at its best) about 300m on a tablespoon of fuel. About a fifth of a mile. But it weighs about 20 times as much as I do, so I think that's pretty good going.

With a rolling start and flat ground it will pass this test at 30mph, and probably higher too. That's quite a lot faster than I can run, too...

Based it on the weight-miles per gallon (assuming something like a 200lb human).

And people almost always overestimate how much they've burnt, and often eat more to compensate.

My (entirely non-scientific) opinion is that most people exercise the wrong way.

After a bit of training, muscles can store carbon-hydrates for about 1.5 hours of exercise. When these carbs a burned, muscles take new carbs directly from the blood stream.

So if you exercise by burning mostly carbs and don't eat, you end up with low blood sugar levels and a very strong urge to eat.

The trick is to burn fat. But to burn fat in a straight forward way you first have deplete the carb store, and basically force muscles to burn fat. This requires exercise that lasts many hours in one go.

The additional benefit as far as I know is that if muscles are trained to burn fat, they will start burning more fat even when not in use. So the effect lasts a lot longer than just the actual amount of exercise.

So we have a culture where exercise means to go to the gym and do exciting things there. Which mainly burns carbs.

In the past when people did manual labor, they worked the same way for an entire day, burning mostly fat.

I'm a distance runner and personally find I enjoy a high fat diet for balancing weight, performance (how I feel more than time), and physique (entirely ego driven, but can't over look the real effect of thoughts/beliefs on health).

That said I have personally run on high fat (even in ketosis, and seperately eating animal products and vegan); high protein/more fairly a body builder bulking macro(including dairy protein: whey and casein); and high carb. And we all know we can find athletes of the highest level in every sport practicing various mixtures of those diets to great success. So I don't think it is fair to say people are doing it wrong by burning primarily glucose as opposed to fat.

I think the most successful diets (no matter the macro nutrient philosophy) have the following in common:

1. Hydration/absorption: obviously no matter what cells must be properly hydrated and absorb micro/macro nutrients.

2. Anti-inflammatory foods: inflammation is linked to every chronic disease there is and even at the highest levels of performance do you want your cells combating inflammation or involved in the krebs cycle.

3. Anti-toxin: toxins can be eliminated from the body through the pores or excretion. Not all toxins can be sweated out and not all will naturally be excreated but certain foods can bind to toxins. So foods promoting removal of toxins from the body are important, but outside diet, exercise is important, abstaining from toxins like cigarettes is important, and probably because of the level of toxins on the modern western diet practices like juice cleanses and fastings could be important tools toward anti toxin cellular health.

4. Anti oxidants: as cells oxidize free radical can spread around the body, it's important to eliminate or isolate free radicals which can be potential causes of diseases like cancer.

5. Micro/macro nutrient: someone else mentioned maximizing micro nutrient intake to calorie ratio, that's probably a good way to put it. As I mentioned I'm starting to see macros as a personal choice based on the individual, that said I have very strong opinions to support my high fat preference (not keto though) and think so long as a person has achieved cellular health through 1-4 they too can experiment with their macros to suite their personal desire and needs.

6. Microbiome: I don't even pretend to understand what's going on here, but often hear this refered to as the second brain. While a neat phrase I'll just point to a study in equatorial Africa on twins, where it's not uncommon to have identical twins on the same diet 1 malnurished and the other not with the only difference to be found in their microbiome.

This whole toxins thing is a load of crap.

That's what I was always using bluntly in arguments with the 'detox crowd' until I learned about chelation therapy [1]. So it's not as simple as 'no way administering any substance will get rid of toxins'. Now, that doesn't mean there is any truth whatsoever in typical detox claims (think 'drink this tea for five days and you'll get rid of toxins stored in your body') but it does mean, to me, that I won't be using overly general claims like 'this whole detox is a bunch of crap' but instead opt for more prudent statements. Which is imo what the one you're replying to did: it wasn't about the standard detox stuff, but about avoiding toxins in the first place and about toxins binding to certain food. Which I'd love to read more about.. Sources anyone?

[1] https://en.wikipedia.org/wiki/Chelation_therapy

Thank you for giving me a fair reading in the understandably controversial topic of diet.

I don't use "anti-toxin" as a magical detox, and never thought that's how people would interpret what I wrote but I believe you are correct and that's what's occurring. I mean it as consuming foods that maximize detoxification processes of the body (healthy pores, health liver function, healthy kidney function) and minimizing the introduction of toxins, but also minimizing foods that clog the processes. I even acknowledge toxins don't all come from diet, and promote not smoking and exercise (sweating to release toxins), I'm not exactly selling anti toxin snake oil.

Truthfully I don't put a great amount of stock in juicing and fasting in otherwise healthy diets, which can be fairly read into my OP - though I'm open minded and understand the latest science to suggest fasting promotes cellular health and longevity - so while nothing of magic I do believe they are tools for people whose systems are regularly over overwhelmed.

There was just a great article on HN about how far away we are from immortality and to date the greatest tools we have are diet and exercise, it was just an interview but if you can find it, you would be able to find the research group and their studies, I never went further but I felt like I had finally found another person discussing diet/nutrition in terms of cellular health. Also I find pharmacists and doctors know a lot about the Krebs cycle. Separately, I would recommend talking to athletes about their diets, it's my personal Favorite way of learning, from body builders to endurance athletes, I like to think they are the real diet hackers and has what lead me to the philosophy I outline above. Personally I could talk about every food I eat and why. Lastly, there are a ton of food industry/diet documentaries on Netflix, they are a mixed bag and I will go so far as to say selling snake oil or industry propaganda, that said if this stuff interests you watch them, one of my favorites is a "juicing" one called fat sick and dying (or something) and while it's a bit of a sales pitch it inspired me to begin consuming (juicing/eating) a wide variety of green veggies and the impact is so great on my health and running that the reality is greater than the snake oil they sell.

The liver is an organ that functions to detoxify the body, read into my comment how you would like but at minimum it's not very controversial that you can abstain from the introduction of certain toxins to the body and you can consume foods that at minimum promote the healthy function of the liver so the liver is properly processing toxins into less harmful substances for removal from the body.

Even if you don't believe the science showing that certain food can bind with toxins allowing them to be brought to the liver, kidneys or excreted, It's not controverisial to belihumans can avoid adding unncecessary toxins to their body thru diet if not avoiding smoking. But honestly toxins in the body and the function of the liver are not controverial and it's not controversial that diet can either promote liver health and function or Overwhelm the liver leading to short term issues like alcohol posioning or long term issues including fatty liver disease.

It's much better people not have fatty liver, their livers otherwise process sugar/toxins properly, but to maximize cellular health mimizing the need for the liver spend energy detoxifying the body/processing sugar.


Yeah, because toxins do not exist, right ? And you can't ingest them or be exposed to them chronically. It only makes sense that we all live in perfectly clean environment and eat perfectly nutritious food 24x7 ...


Your liver removes toxins as one of its normal functions. There is no evidence that any sort of 'detox' diet is able to assist with this any more than a normal diet (with sufficient vitamins etc.).

You acknowledge vitamins are required for healthy detox functions of the liver...those vitamins come from food/diet and the toxins themselves come from foods also.

So to promote optimal health foods that promote healthy detox functions should be consumed and those that uncessisarily introduce toxins or disturb proper detox functions of the body should be avoided...if you call that a "normal diet" fine, at this point you are debating semantics.

Just to put things in perspective with "normal", 10% of US kids have non alcoholic fatty liver disease, just like childhood diabetes...these diseases didn't exist in kids 30 years ago and they are all dietary, so let's drop words like "normal" and talk specifics.


Yeah, because liver has unlimited resources and efficiency just if u give it anything, such as dirt, and you can overload it with any type of toxin without a problem and it will do just fine. I am sure that is what is going on.

If your liver is overloaded (e.g. tylenol overdose) you would already be dead, you wouldn't just be mystically unhealthy somehow.

That's not how it works by any means...use alcohol as a single example, a normal, healthy liver processes alcohol at a given rate (approximately 1oz of alcohol/hour), your liver is "overwhelmed" when you consume more alcohol than it can keep pace with, that leads to alcohol in the blood and intoxication...that is a far cry from a liver being overwhelmed to the extent their is a lethal amount of alcohol in the blood and death.

Where do you think the disease fatty liver comes from? You do understand a fatty liver isn't going to be functioning normally and more easily overwhelmed by toxins in the future right?

Why do you think children for the first time in history have non-alcoholic fatty liver disease? Their livers are being overworked, not to the extent death by toxicity occurred, but to the extent they develop chronic conditions in childhood that it used to take a lifetime to acquire.

No one is talking about mystical healing, rational people are discussing eating foods that promote healthy liver/kidney function, in turn promote overall cellular health, and to the extent possible avoiding unnecessary toxins like smoking or excessive drinking.

You're right, but it depends. This is certainly true for aerobic exercise but things like weightlifting for mass will long term increase your BMR.

Weight Change = CI - CO

Where CO has a CI input.

This has been known for while. Protein has a thermic effect which can change your CO.

But the equation still works.

On the useless tautological sense. If you can't measure CO to within 20%, can hardly measure CI to within that range - then for all practical purposes, the equation does not work.

You may want to read about (lack of) precision in Atwater factors, to the tune of 50%, if you believe CI is easy to compute.

The two are the exact same thing. Not sure how the article refutes.

It says that different composition of X calorie in induces different calorie out spent on metabolism. That means short of living in a sealed chamber that measures everything, "calorie out" precision is so low that makes it a much less useful measure if you are trying to gain or lose weight.

No it doesn't. If you're not losing weight, it just means eat less. Every single fitness board ever knows that its impossible to know exactly how much you're consuming or exerting. Which is why you're supposed to just drop another 250 calories a day until you start losing weight again.

... which means the CI - CO is a useless equation because CO cannot be measured reliably in a standard setting.

You know that obviously, and so do I, but there are a lot of people (including here on HN) who argue that eating an Apple daily and otherwise not changing anything is guaranteed to make you gain weight, and that's just not true.

You say "cut 250" but the article just gave an example that 120 cals of different composition were netting amounts different by 40. That's a 30 percent difference based on composition.

I'd say it adds a logic circuit to the input, factoring in absorption.

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

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

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

Thoughts ?

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

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

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

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

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

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

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

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

I feel like you're omitting some key points here. You say they ate meat and dairy every day. Practically everybody eats meat and dairy every day, but not everybody has high cholesterol or an increased risk of heart disease (note that those are separate concerns, as CVD happens in people with low cholesterol as well). If I have a glass of milk with cereal in the morning, and a ham and cheese sandwich for lunch on white bread, I've already had two servings of dairy and a serving of meat. But I've also had one or two servings of a sugary breakfast cereal and two slices of white bread (both of which are about as nutritionally void as candy). Those are the really harmful factors here.

I believe you when you say they lost weight on an all plant diet. But I think you're probably attributing their success to the wrong thing. Correlation != causation. People on a diet would never dream of having refined carbohydrates or too much sugar, because those are universally understood to be bad for you (even if it's just the 'empty calories' argument). They just so happened to also stop eating any animal products. So I don't think you can target the meat and dairy and just claim that removing them is "probably the healthiest option for the majority of the population". Rotten thinking like this is what got us into this catastrophic obesity epidemic in the first place.

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

Yeah, except that the pendulum is swinging the other way now. http://www.health.harvard.edu/blog/panel-suggests-stop-warni...

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

which is exactly the phenomenon GGP commenter zython was describing.

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

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

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

Personal experience: I lost some weight using a low carb diet, and now I'm slowly switching back. Basically I've cut back on everything processed, because frankly most of it is garbage.

Cooking using good quality foods (veg + fresh fish and/or meat) does a lot + I feel much better. If I do go for a sugary treats, then it's some good quality artisanal chocolate instead of mass produced crap.

One downside: I noticed my bi-weekly shopping bills to have definitely gone up. Probably spend double or even triple now what I spent before. But hey, you only live once.

> I noticed my bi-weekly shopping bills to have definitely gone up.

On the flip side, that might be a very cheap investment for your health vs future medical bills, lost productivity due to illness / lethargy etc, etc.

> One downside: I noticed my bi-weekly shopping bills to have definitely gone up.

Mine has gone down after switching to eggs as default go-to food.

Low carb or not, I can't believe eating 40+ eggs a week is healthy. Balance it out, yo! Plus, while I like eggs (a lot), they do get boring after a while. There are only so many different ways to prepare them.

Beyond boredom, many people will develop bad body odor from the choline in eggs:


My partner eats boiled eggs daily for breakfast and at one point I tried to switch to having 2 eggs for breakfast every couple of days. I rapidly developed an unpleasant body odor that went away when I stopped having eggs so frequently. So daily eggs is not be a viable solution for everyone.

Thanks for that link. There's not enough literature showing the adverse effects of eggs and meat that are not linked to fat and cholesterol.

> I can't believe eating 40+ eggs a week is healthy.

I've started precisely after reading the studies that find no correlation between consumed cholesterol and its levels in blood. Also when I found out that the vast majority of cholesterol in blood is made in the body to match the levels it needs. Also when I found out the link between heart disease and LDL levels couldn't be proven.

Of course, I eat them alone, without bread or fries like I used to do.

> they do get boring after a while

Luckily for me they don't

No correlation sounds wrong. Which study is that?

As far as I know, the consensus is that dietary cholesterol doesn't affect ldl cholesterol as much as saturated fat, but it doesn't have "zero effect" either.

Eggs also have a lot of saturated fat. That's already two things affecting your ldl cholesterol levels in a bad way.

> Which study is that?

One of the ones linked in this article, I don't remember which. https://lifeforbusypeople.com/2016/08/24/why-anti-fat-is-com...

40 eggs/week seems excessive, regardless of the cholesterol or lack of. Is the rest of your diet still balanced and diverse?

Indeed; imo anything that is consumed excessively can't be healthy. Whether that is eggs, meat, fish, veggies, etc. I'm not saying it's harmful -- just saying you need to find a balance. I personally eat about 4 to 8 eggs a week, so still a decent amount, in combination with plenty of other things.

Not sure where that number came from. I eat about 25/week. And of course it has other things. Veggies, meat, ...

Ah it's from the other poster. Yeah 25/week isn't as worrisome.

Harvard School of Public Health [0] provides advices backed by research and the main points did not change already for a long time. Meat is only recommended in small portions as well as diary [1].

[0] https://www.hsph.harvard.edu/nutritionsource/

[1] https://www.hsph.harvard.edu/nutritionsource/healthy-eating-...

Thank you for these links

Thoughts ?

It doesn't matter - the underlying mechanism of all these diets is simply that ANY amount of thinking about what you eat is better than the default choice of just eating whatever's in front of you.

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

What's good for me might not be what's good for you.

Lifestyle, genetics, gut biome can all make a huge difference in the way your body reacts to different foods

Eat stuff, exercise, measure results, adjust.

This stuff is extremely individual, unless we're talking extremes. Just do whatever makes your favorite KPI trend in the direction you want. Experiment. The rest is bullshit.

We don't have many biomarkers that can be measured cheaply and say something about your expected remaining healthspan.

Don't weight and bodyfat% have high correlation to lifespan? You can get a good enough scale for both for pretty cheap.

Fitbits and such also measure resting heart rate for cheap. As far as I've heard, that correlates well to lifespan as well.

You can control your weight and bodyfat reasonably well on a diet that consists solely of Twinkies, so only measuring those won't tell you much about the quality of your diet.

Exactly, find what suits you. I'm having great results with a low carb diet (been even keto for a period) but I'm not 100% sure it works for all.

Worked great for me too, though I didn't have to lose a massive amount of weight (8kg). Just cutting back on sugar itself already does a ton -- nothing more than an addiction. :(

I agree that there is a ton of misinformation floating around on the internet. Even legitimate nutritional research is notoriously difficult to conduct well. As you say, almost every diet has its benefits and supporting evidence. You will have people who claim that mostly vegetarian diets are best, and cite the Okinawans. Then you'll have the paleo crowd, who claims that you don't need fruits/vegetables at all and cite the Maasai. I think this comment pretty much sums it up: https://news.ycombinator.com/item?id=14813840.

If I were you, I'd steer clear of any sites that talk about 'toxins', 'detox', 'cleanses', or anything else like that as it's likely to be junk science. Juice cleanses can be particularly hazardous (I am honestly baffled that anybody would think drinking a ton of sugary juice is healthy). I was going to say look for articles that cite their sources, but even the medical literature can be cherry picked to support any hypothesis.

We still have a long way to go before we have nutritional advice that 1. Is actually correct, meaning it's heavily supported by scientific research and has been shown to work and 2. Is accepted mainstream. Until then, I think everyone can at least agree on a few things:

1. Don't eat sugar. Yes, natural alternatives like honey or agave are also sugar.

2. Don't eat refined, processed carbohydrates.

3. Don't eat trans fats.

I think correcting those will eliminate the majority of most peoples diet-related health issues. Everything else pales in comparison.

It seems the best thing is to be reasonable. For example, eat a variety of foods from different food groups. Try to expand your pallette. Eat a fair amount of fruit and veg. Ideally, whatever you eat will fit in your lifestyle.

For me, I found a few things (and I've actually lost weight and kept it off for years):

Mostly vegetarian works for me - I eat fish a couple times a month. I had gall bladder problems, though, and have had it taken out. This works well for my body and I like the food. I cook at home 95% of the time. I skip breakfast (I'm not hungry!). I use butter and cream. I also walk often.

A very big problem has been the misunderstanding of fat that people still have to this date, leading to glaring contradictions. This video (and the other videos of the channel) explains very well the topic https://www.youtube.com/watch?v=5S6-v37nOtY (text version and sources in the description)

I appreciate the work that Daria Rose (Kevin's wife) has done with her book The Foodist and blog summer tomato. She had the same problem, but she is a Ph D and was looking for a project.

I wonder how it affects muscle building.

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

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

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

[1] http://www.health.harvard.edu/diabetes/ask-the-doctor-do-art...

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

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

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

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

Protein bars are heinous for any purpose other than getting in some calories and enjoying the taste. Anyone who thinks they are a good way to get protein for a diet are fooling themselves. Protein bars are candy bars + whey protein powder. Why not skip the candy bar part of the equation and just supplement protein directly if that is what you are after?

Because shakes are a lot less convenient. I wonder what the difficulties are in engineering a zero carbohydrate protein bar (with artificial sweetener if necessary); there are plenty of "low carb" bars on the market which of course still have a ton of sugar.

I'm not sold on the artificial sweeteners, so I try to minimize. For me I just bring 2 scoops of whey pro in a blender bottle and add water after the workout. It's pretty easy. Doesn't taste great but it is manageable.

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

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

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

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

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

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

Desserts and sodas should always be considered a big nono, if you're concerned about your health.

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

"better than steroids" by Dr Warren Wiley. Although it might be more focused for athletes than what you are after. And yes, the title is sensationalized, in the first few pages the author admits it.

I am an "athlete". Not a competitive one, but I do lift pretty heavy. Thanks for the recommendation.

its actually aimed at lifting. athlete was probably the wrong word. What i meant was, its for people who need to lose weight and build muscle to meet weight classes / physique competitions etc. Its not for people who need a diet but don't want to exercise. Lifting is perfect.

There's a good (old) talk where Stanford's Christopher Gardner researched different diet books with 311 women.

The Battle of the Diets: Is Anyone Winning (At Losing?) https://www.youtube.com/watch?v=eREuZEdMAVo

The study was announced at


Not sure but these might fit your requirements:


The CSIRO is an Australian government funded research organisation that has a very good reputation.

The initial book has been followed up by a number of others that expand on the recipes and complementary exercises.

I don't know of any books, but my favorite online resource is examine.com. They do an excellent job of presenting real research in an understandable but cited way.

Eat less calories then you burn == weight loss

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

Do you understand that you're commenting this on an article that literally disproves what you're saying?

I'm not aware of anything like that existing.

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

Can someone explain what I'm missing?

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

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

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

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

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

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


We've banned this account for continuing to violate the guidelines after we've asked you to stop.

We detached this subthread from https://news.ycombinator.com/item?id=14832471 and marked it off-topic.

He is correct though. OP used an appeal to nature fallacy. The conclusion is correct, the argument is stupid.

In this case an appeal to nature is not fallacious, although it lacked the appropriate justification.

No, it's still a fallacy.

By providing "appropriate justification," it'd no longer be a fallacy.

Isn't a fallacy a false (baseless) justification? I'm not sure how providing justification changes a fallacy.

Keeping people confined for long periods affect metabolism?

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

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

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

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

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

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

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

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