My personal, unsubstantiated opinion is that the food most people eat is now full of substances and chemicals that weren't there 50 years ago. A huge example is high fructose corn syrup. Almost everything is sweetened with that instead of cane sugar.
Food manufacturers IMO only care about making food cheap, making us crave it, and making it last a long time on the shelf. They aren't concerned about making sure it is healthy, as long as it doesn't immediately kill us.
Another example is artificial sweeteners. Studies have shown that sucralose (Splenda) reduces insulin resistance something like 17%. Is anyone making sure that everyone knows that? Hell no.
Not to blindly defend excessive food additives or anything, but putting questionable additives into food has been a thing for at least three times as long as you say; look up Dr. Harvey Washington Wiley[1] and swill milk[2].
Sure, but HFCS is also a bit of a red herring. Sucrose is half fructose, the difference from HFCS is minor - they're both problematic for humans to consume in excess.
There's a very big difference between HFCS and sucrose. HFCS is soluble monosaccarides. Sucrose is a disaccaride which requires enzymatic cleaving to produce free fructose and glucose. The kinetics of the fructose processing are very different as a result--with sucrose the release is much slower because it's rate-limited by the quantity and kinetics of the sucrase enzyme. It's not going to hit your liver with a high concentration of fructose instantaneously, it's going to be a slower release over an extended period.
Well, given that he references papers from the "corn refiner's association" immediately afterwards, I'll note that this may not be entirely unbiased. This entire industry in the US has immense political clout, and that may well extend to publishing questionable research that comes out in their favour to confuse wider debate and regulatory change.
There's plenty of evidence from the other point of view demonstrating that HFCS has rather different behaviour than sucrose. Quickly-found example: https://pubmed.ncbi.nlm.nih.gov/22152650/
> Well, given that he references papers from the "corn refiner's association" immediately afterwards, I'll note that this may not be entirely unbiased.
That's a fun conspiracy theory and all, but he's clearly not advocating for HFCS consumption. Watch the entire talk, he's obviously not pro-corn industry. Infact he does attack HFCS specifically but not for metabolically different reasons.
He's clearly concerned about people mistaking HFCS as the problem when fructose is the problem, and sugar is half fructose, so you're not avoiding it by replacing your HFCS with sucrose. Metabolically they're basically the same.
I run a health food company[1] and when going to trade shows to interact with reps from the big ingredient supplier companies it's all about touting that everything is 'Legally GRAS' or Generally Recognized as Safe and 'Clean Labeling' meaning that experimental ingredients can be put on the label under a more innocuous sounding name. Inquiring as to actual safety is met with blank stares.
However, glucose can be stored and metabolised throughout the body whilst fructose requires processing in the liver. Our bodies are not designed to have a large instantaneous "hit" of fructose. They can cope with slow release of natural fructose in fruits, but in processed food it's soluble and released very quickly. The kinetics of how it's processed are very different.
Humans didn't eat a lot of sugar until fairly recently, too. And even if you did, you'd have to be very, very rich to be eating it 3 meals a day.
Now you can get sugary cereal for breakfast, sandwich bread with HFCS for your lunchtime sammo, and a curry jam packed with palm oil and sugar for dinner. And that doesn't count the cookies or Pepsi you slam in between.
Raw sugar of HFCS -- don't matter none, it's that you're slamming em at each meal, all the time.
Fructose is an appetite stimulant, so eating a lot of it will change your eating habits. And we definitely eat more fructose than a few generations ago.
Huge chlorine (chlor-alkali) plants using mercury cells produce “mercury-grade” caustic soda, hydro- chloric acid and other chemicals which are, in turn, used to produce thousands of other products, in- cluding food ingredients such as citric acid, sodium benzoate and HFCS.2 The mercury in these plants can contaminate their chemical products, as well as the broader environment.
In HFCS production, caustic soda and hydrochloric acid are used to separate corn starch from the corn kernel, as well as to adjust the pH of the process. The HFCS industry, according to Vulcan Chemical Company, former operator of one of these plants, is a primary user of “mercury-grade” caustic soda and hydrochloric acid.2 The Environmental Health commentary provides data substantiating that mercury contaminating commercial HFCS is a problem.
In the fall of 2008, we looked for total mercury in 55 brand-name food and beverage products where HFCS was the leading or second highest ingredient. An independent laboratory found total mercury, above the limit of detection, in about one in three products, including: dairy beverages, soft drinks, salad dressings, barbecue sauces, flavored syrups and jams. In other words, we found total mercury across the range of foods and beverages in which HFCS is routinely used.
As if people 50 years ago had a life expectancy of 120. While healthcare is primary reason for its increase it is not scientifically rational to pray what was there 50 years ago. HFCS contributed to diseases so far less than cane sugar, with a lower volume dose as it is sweeter by far.
As with making food cheap, I doubt what diet will be if local farming is the only choice. Suddenly no oranges from Cali, beef from Chicago, nor fishes from sea. How is it possible to have seafood diet if someone lives in Utah then? Fish out of the dead salty swamp? The single catch-all phrase of "that was not a thing 50 years ago, and there are bad things happening last 50 years, gonna blame them all" I'd rather unhelpful.
this makes me so sad. I can't eat anything sweet and the one thing I found that I seem to tolerate well to a degree is sweetened with sucralose, sweet is addictive... I just ate 8 apples today when I lost control and I'm going to pay the price the next few days (food intolerance)
Seemingly intolerant to starches and sugar in general, leads to depression.
Weirdly enough green stuff seems to give me panic attacks and suicidal ideation.
Takes about 4 days to get into effect. Probably something to do with fermentation.
Next one will be the 3rd Therapist, this time she's also a general practicioner. There are all kinds of doctors on youtube talking about this, but haven't found one in Germany who could give me a diagnosis... I'm so frustrated
Not a doctor, but it could be auto-brewery syndrome [1]. In effect, your gut biome contains fermenting bacteria that ferment sugars and starches into alcohol. The alcohol might be causing depression, and switching to a diet that avoids fermentable stuff might cause anxiety due to alcohol withdrawal.
Again, not a doctor, not a diagnosis, but it might help give you a name that your doctor could look into.
Oh wow, that sounds incredibly frustrating. It seems wise to consider that it might be a fermentation problem, perhaps a serious imbalance of microbes or something.
Good luck. I dealt with GI issues that lead to both physical and psychological misery once (after repeated courses of antibiotics), and my advice is to hang in there — you could find something that works for you, even it takes a while.
yes, fermentation was my thought as well. Carnivore diet helps, but I am unable to stick to it some days and when stressed out I'll eat anything carb, even cookies that bugs won't touch. Probably toxic in other ways I don't know.
8 apples is nothing, they contain very few sugar, the question is more what else do you eat? isn't it the combination that's causing intolerance?
edit: I saw your other reply, there must be other problems, like constipation (fruits should be digested quite quickly and not too quickly too - diarrhea, it takes time to build the right microbiome), not enough mastication maybe too, and not enough fasting
Fermentation is actually something great (before eating), like naturally fermented onions or peppers (they get soft), or almost all non sugary vegetables, allows to skip cooking which destroys most valuable things in vegetable
Not chemicals. It’s the processed foods and food science.
And by processed foods, I mean foods that are designed to:
- Minimize required mastication and digestion time.
- Designed to subvert the satiation and cloying defense mechanisms, that tell our body to stop.
Who else has trouble interpreting these guidelines? What's 300g of fruit in practical terms? I ate a huge honeycrisp apple for breakfast. It probably weighed 400 or 500g. Is that a whole day of fruit? Or, does it not really count because of the water content? I also ate half a dozen dried apricots. Am I supposed to mentally rehydrate them to arrive at the serving size? And what about this use of the term "optimal"? The way they are using it is to mean "there is no risk associated with exposure beyond the optimal intake exposure level" which to me suggests a word like "sufficient" instead. Can you just eat as much fruit as you like?
I'm old and my eating habits aren't going to change but my children are both really interested in these topics and concerned about developing bad eating habits, even though I think I have given them healthy ones.
It is unusual that it's so careless in its consideration of its audience and precision of its language.
- In lab work, "dry mass" refers to what's left when the water is removed. However, "dried" in food science refers to a product's water activity. Since neither 300g of hydrated or dry mass would seem an excessive amount, specifying "fresh or dried apple" would have been more useful.
- Concentrations and amounts vary per unit and variety, and recommendations vary by the individual. If the overall message is "consume fewer calories, especially calories from these compounds, to lower risks of diabetes and live a longer and healthier life", start with those and list common products that contain them - and that don't.
- A great failure in the US is the erosion of food traditions by "convenience"... and sometimes the interference of laws. People do not generally have the background to interpret the creative vocabulary used on food product labels. Even the FDA has trouble with this[1]. Giving clear examples of meals and recommendations for how to buy and store ingredients is helpful to people who have never consumed anything that was not a manufactured food product.
Unless something drastic has changed in our understanding of diabetes, we don't know enough what causes T2DM to say that it's x% attributable to y amount excess/insufficient consumption of food z. Especially when a lot of the pathways are indirect (e.g. excess calories, visceral fat, fatty liver disease) and so the attribution to specific foods is shaky. Their risk factors literally read like the major calorie source for each region.
Best evidence right now says to maintain a healthy weight, that eating moderately of meats and fats is fine, that we should eat adequately of plant matter, etc. Limit highly processed foods, or foods comprised of large amounts of highly-processed ingredients. Probably because that tends to equate to large amounts of sugar and/or fat.
If your children are really interested and you think it's not going to lead to an obsession then a continuous glucose monitor can lead to fascinating insights about their individual response to specific foods, combinations thereof, the interaction with exercise, etc. If you really want to explore the rabbit hole there's a community of type 1 diabetic hackers; obviously the etiology and hazards are different but as far as collection and analysis of the data there's a lot of prior art there.
I've been suffering from hypoglycemia for a good part of my life, and recently the episodes have started to become a bit more frequent (a bad hypoglycemia episode is like an incredibly horrifying panic attack). Trying to figure out WTF is going on with me has been daunting, everyone tells me to eat more sugar or more complex carbs which just seems to repeat the cycle. No one wants to test me, or knows what to test me for, and right now I'm fighting to get a CGM so I can tie things with a food diary. Everything seems to revolve around food, but it's hard to figure out what's "bad food".
I occasionally get hypoglycemia. For me, it tends to be worse if I eat a lot of sugary foods the day prior and then go through a prolonged period of not eating. Like if I eat ice cream at night and then skip breakfast.
One trippy thing to try is to go on a keto diet. When your body is in ketosis, it stops using glucose as an energy source, so you shouldn't get hypoglycemia. It's actually a strange feeling. In my case, my energy level feels much more constant throughout the day.
This is what my wife did and it worked for her. She used to crash hard when eating a higher carb diet. She would hit in the 60s. After switching to keto it was more modulated and stays in the 80s.
You don't need a CGM, just get a GM. I had a case where I wanted to see the effect of foods, and the feeling of blood sugar levels that change during the day. I thought of going through one of the brands to get one but the per month price was decently high. The other issue with CGMs is they're for people with high blood sugar, so they're more tuned to high levels, not low levels you'd have from hypoglycemia, so I'm not sure how accurate those numbers would be. Besides, it's 15 minutes late and doesn't test the blood sugar directly (got this info when asked nutritionist friend who helps people with CGMs).
Getting the normal glucose meter was great. The poking of the needle barely causes an effect, and you can get pretty ingrained with numbers. The first couple weeks with the thing I went through tons of tests, before meals, various times after meals, and then if the sugar level was high, meaning over 130 for me, I'd go for a 10 minute walk and could see and feel that the numbers dropped to the low 100s so quickly. At this point I can tell decently well what level my number is.
The glucose monitor with poking stick is really great. Better, faster, cheaper, more trustworthy data than the current continuous monitors out there.
excluding cost (i recognize that’s a big con), is a traditional glucose meter really better? You have to plan/remember to take your readings. SUPER awkward if on the go with friends for example. I’m also not really seeing the big deal if it doesn’t measure the actual blood reading. Unless you’re trying to do a scientific study. A CGM is good at spotting large changes in blood sugar - that’s really all that matters for the average person that’s trying to learn what foods / activities bother them right? For example “i ate X and 15 min later my blood sugar spiked, maybe i should avoid X.”
It’s also harder to see how quickly your body responds to light exercise unless you carry your poking stick with you lol.
I found it was better. I didn't mention this in first comment, but nutritionalist friend got me a couple test CGMs after I'd been using normal GM with blood samples for a few weeks. I'd check them both at the same time, and many times the CGM was quite off, both on the super low and super high. There were points where I'd look at the CGM, see the number, feel that it was probably way off, and then test the blood and see that my feeling was correct.
Your example is definitely the thing I wanted both glucose monitors for. The CGM didn't seem that great at the giant spikes. With the GM, I'd test numbers right before eating, then 10 minutes into eating, 20, 30, etc. Sure it involved poking my finger, but those were much more informative. than the 15 minutes CGM time frames and the fact the those numbers weren't close to as correct as the blood GM.
True about the light exercise unless you have the poking stick with you. What I did was have an internal treadmill in my apartment building. Example would be test 20 minutes after food, see and feel a 140 reading from the GM, go down and walk for 10 minutes, come back up add see and feel the drop to 100. Learning the feels has been invaluable, and the CGM wouldn't have gotten me the same quick time information that I could trust compared with real time from the direct source.
I had a similar problem, and in my case it turned out to be reactive hypoglycaemia.
It means that my body is insulin resistant, and when I eat anything that raises my sugar levels, the body starts pumping out more and more insulin till it reaches a point where the sugar levels fall below normal. So the body is hit by bad effects of high sugar, and then with bad effects of low sugar.
In my case the solution was to avoid sugars and refined carbs in breakfast. As Indians our breakfast contains a lot of carbs.
If I have eggs for breakfast, I can pretty much anything the entire day and not feel it. On the other hand if I have pancakes with syrup, I know I am in for an episode of hypoglycaemia.
Also if I have sugar or refined carbs, having a fibre supplement (psyllium husk) with it helps.
Overall adding more salad and protein is what I would recommend if you also have this.
Perhaps I can share my personal experience. I have always felt tired/ crashed after having sugary foods. Sugary cakes & chocolate can leave me feeling pretty unpleasant. It might have been workable if eating more restored my mental state, but it didn't.
I figured this out in my twenties, stopped eating convenience food with sugar (cookies, sweet crackers, instant noodles, breakfast cereals), and instantly felt better.
I eat a high-protein breakfast of multigrain toast, avocado, cottage cheese, red onion and ham.
When you eat decent food with protein and vegetables you won't have cravings any more for sugary rubbish.
I snack on roast nuts (no peanuts), eat slightly more often and, for a pick-me-up in the afternoon, eat a small sandwich/ piece of sushi/ etc.
I am occasional only with desserts, cakes and ice-cream; typically only after dinner. Quality makes a big difference; quality cakes for example are mainly eggs, butter, chocolate and a bit of sugar whereas cheap cakes are sugar sugar sugar, refined flour and artificial flavours. Protein and fat seem to help stabilize the effects of dietary sugar on my blood sugar levels and mood.
I know a guy who had that. Turned out these actually were panic attacks after all. Finger-prick blood sugar test told the story, and anxiety meds fixed it right up.
Hypoglycemia actually causes a panic attack, so symptoms are the same.
I don’t know if this helps at all but there’s some ways to get a GCM from the private industry without needing a prescription, such as Nutrisense. I paid about $150 a month for it though.
To me, that's a lot of money for a piece of plastic. I get that it's a medical device and needed lots of testing etc, but Nutrisense seems like too much "value add" to justify what they charge for it. Hopefully I can get a prescription and get this all covered by insurance.
> To me, that's a lot of money for a piece of plastic
It’s a medical device with wireless electronics, a mechanism to insert a sensor filament into your skin as painlessly as possible, and a lot of R&D went into making it. It’s not just a “piece of plastic”
The companies charge overhead to have a doctor write a prescription. You can try to find someone who will sell you one from India or another country, but by the time you pay international shipping you’re not saving much.
Regardless, don’t expect it to be all that informative for your condition. If you’re having episodes of hypoglycemia with symptoms, you don’t need a device to tell you that. CGMs are most useful for conditions without overt symptoms, where you need a device to expose the subtle changes. If you’re having episodes, just log that.
> Hopefully I can get a prescription and get this all covered by insurance.
There is a near zero chance that insurance will cover a CGM for curiosity or for diagnostic purposes. If it’s not indicated for a condition and there aren’t significantly powered studies readily available, it’s not something insurance would be interested in.
If you aren't diabetic you could pay for something like Nutrisense or Levels to get enough monitors to cover about 2-3 months of activity, learn what triggers spikes, and then cut it. What you see in those three months is pretty much what you are going to see going forward unless you were to make a significant lifestyle change and stick to it (going to/from carnivore/omnivore/vegetarian, cutting out alcohol, etc...)
I used Levels for about 3 months and I saw the same thing over and over again, it was obvious when I was being good about my eating, it was obvious when I went out for happy hour. I learned a couple things, mix a little fat or protein in if you are consuming carbs to blunt the spike, the alert to "take a walk to blunt the spike" is never long enough unless you go for an hour or more. Another year or two of wearing it wouldn't change any of that.
Unless your PC says for your condition of X we are going to try and get your glucose level to never go past Y and see if it fixes it, a CGM for non diabetic people is something you can timebox to 3-ish months, get the data, and get out for under a $1000 one time investment.
The "disposable" electronics in these are also extremely interesting. They're cost-reducing the hell out of these devices. Even in the last few months, one vendor replaced a cheap chip (TI RF430) with even cheaper custom silicon. They are not standing still!
According to Wikipedia, first CGM was approved in 1999. That may be recent for medical devices I guess, but it still seems like they're charging a lot for 20+ year old tech...
CGMs have improved a ton in the past 20 years, becoming less intrusive and easier to use.
We pay a lot more than $150 for all sorts of tech that is far more than 20 years old. But if you could make it for $20 or $30/month, that would be a serious innovation and perhaps you should try to start an advanced medical device company.
I've had it since I was a child. Am 40 now. I get hypoglycemic episodes (confirmed many times with a glucose prick test - symptoms are loss of mental focus, cold sweats, shaky hands, overall fatigue and lethargy, voracity to eat), solved easily by eating carbs / sugar. No doctor has been able to provide an explanation or even cared that I brought it up. it is not consistent either, I can be eating the same things in same schedules, some days I get it some days I don't. When I tend to get it though, it is in clusters. Like I get it frequently for a couple months, then nothing a couple months. Sometimes it goes away for a year. Then comes back. Most frequently I get it a couple hours after eating fruit on a semi / empty stomach.
I had nocturnal hypoglycemia. My blood sugar would drop precipitously while I slept and then I’d get a rush of adrenaline, which would bring my glucose up and wake me up. A doctor told me to drink apple juice before bed. Bad idea. Here’s how I fixed it: low-carb diet and exercise. My theory was that the problem wasn’t low blood sugar, but poor blood sugar regulation. Glucose regulation is a negative feedback system, and by eating large amounts of sugar or carbs, all I was doing was giving my system a temporary spike, which would lead to instability and a big drop later. So I cut out all carbs. That stabilized it a lot. Then I started exercising more. That really helped. And then strangely enough, meditating for twenty minutes before bed also seemed to have an impact.
Now, I’m in better shape and can eat some carbs, but only in relatively small amounts. If I eat fruit, I’ll usually go for a walk immediately, so I don’t get as much of a spike.
It’s also worth noting that I have PTSD, which is strongly linked with endocrine dysregulation, so maybe that’s some of the underlying cause.
The result of all this is that my glucose is now very steady and I’m not having the drops while I sleep. Of course, no doctor advised me to do any of this. This is all n=1 “nonsense” that “evidence based” medicine would ignore.
Not hypoglycemia, but I have IBS. Doctors usually run some basic standard health panels, everything comes back pretty close to normal, they tell me I look super healthy, and that if a food bothers me, don't eat it. It took me two years of this to start to have an idea of which foods bother me, but no doctor has been helpful with figuring out what is going on with my body or why so many foods bother me.
For me it's seemingly food intolerance to starch and sugar. About 4 days after consumption I'll get depression and suicidal ideation. I'll ruminate over work and whatever stresses me will be amplified.
For example I walk with a friend in the forest and shortly aware that I don't know where I am will turn into "he'll kill me" freakout... assistance dog would notice if something was off, and he's happily sniffing around and enjoying himself.
I know very little about hypoglycemia (though I’m naturally prone to sugar lows rather than highs) and your problem is likely more complex than diet.
That said, wouldn’t it be better to be doing the opposite of what you’re being told, and cut down on carbs (both simple and complex) to eat more protein and fat which body can use to slow-release blood sugar for a longer duration? (For routine diet I mean - obviously at the onset of an attack you’ll want to consume sugar).
Have you looked into the glycemic index of what you eat?
The glycemic index (GI) relates to the effect food has on the glucose levels after consumption: high is more severe than low. Vegetables have a low index and sugary foods a high one. Surprisingly white bread and cornflakes also have a high index, and other foods we would not describe as sugary.
Maybe the 'bad food' turns out to have a high index.
Unless there's an easy solution most of us are just going to die from this. I can't battle the market that wants to feed me supersized everything because that's where they can hide the cost of wages and offer an illusion of value.
It needs to be tasty (enough), it needs to be cheap (at least enough to compete with the crap food that's already an option), and it needs to be an option everywhere.
Clearly, regulation is required to force the market to offer healthy options for consumers.
It’s pretty easy to stop eating processed crap. Heck, it’s easy to stop eating entirely for most of the day.
Skip breakfast and lunch. Have a single meal a day and use the time you saved from skipping the other meals to prepare something nutritious and delicious.
It’s so easy that people have been doing it for thousands of years. Except now it’s even easier because you don’t have to stalk a gazelle or wake up at dawn to weed a garden.
The skip is key in my experience - if you try to “eat something small” your body goes into “devour the entire McDonald’s” mode and it takes much more willpower.
Yes you can - stick to whole foods and cook reasonable portions. Mediterranean dishes are easy and healthy to cook. The rest of the world can do it, so can America!
People are jumping on you, but you’re right. As long as billions of dollars are being pumped into selling people bad food this isn’t going to get better.
And carry a bottle of mouthwash; if you take a small snack immediately wash your mouth out afterwards; it greatly decreases the desire to snack some more.
What about consumption of processed sugar? (e.g. ice cream, candy, cookies, brownies, and all the foods from the grocery stores in the United States with sugar discreetly sprinkled in).
Personally, I know if I consume too much of the above for several days, weeks, or months prior to a blood test, my A1C will be fucked up and bad. I am quite athletic, trim, and thin.
Discreetly? It’s on the nutrition label. I don’t think candies and ice cream today are particularly less healthy than they were 50 years ago - and there are clearly more options today. It’s easier to eat healthy today than it ever was - this is not why people are getting fat.
This is an unwinnable conflict between population medicine and policy and individual choice.
No - in general shrinkflation is a thing - and it tends that things peaked 20 to 30 years ago. Many junk food items are larger than when they hit the shelves but substantially smaller than their peak sizes.
An example since the pandemic, a "pint" of Hagen Dazs ice cream is no longer a pint (16oz). They are now 14oz. Same with most other brands that come in that size container. Halloween candy also got pretty microscopic. The "bite size" snickers, etc, are like 1/4 the size they used to be.
>Beginning in late January 2009, 16-ounce cartons shrunk to 14 ounces, and two months later the larger 32-ounce pots lost 4 ounces. The price for either carton, however, stayed the same.
> Compared to 50 years ago, portions are larger and, based on little more than my personal impression, stuff has gotten softer and easier to eat.
The person I was replying to was talking about supermarket sold mass produced confections, and my response was valid, not based on personal experience and can be easily verified. For most of those things shrinkflation is the predominant force. Ice cream packaging sizes and prepackaged cookies haven’t gotten larger. And if anybody is surprised that these products are loaded with refined sugar (then as now) that’s on the public education system. The fats used have may have changed.
Restaurant portion sizes and content have increased but that’s a different problem. Same as dispensed soft drinks.
> gotten softer and easier to eat.
What does this even mean?
Hostess foods famously went out of business a few years ago. When I think “soft” and calorie dense I can’t imagine any time more representative than the 50s and 60s.
I believe the implication is that packaged food is even more processed than before (less fibre, more multi-syllabic ingredients). The benefit is that our bodies can extract more calories from food (ground beef provides more calories than similar amount of steak). But the increase in type-2 diabetes suggests lack of calories is not a problem for these people.
The problem is the same as with cars; it's true that the "standard size" M&M packet may be smaller now (I've not checked, but let's grant it), but most checkouts are lined with KING SIZE or SHARE SIZE which are way bigger.
"Of the 11 dietary factors considered, three had an outsized contribution to the rising global incidence of type 2 diabetes: Insufficient intake of whole grains, excesses of refined rice and wheat, and the overconsumption of processed meat. Factors such as drinking too much fruit juice and not eating enough non-starchy vegetables, nuts, or seeds, had less of an impact on new cases of the disease.
“Our study suggests poor carbohydrate quality is a leading driver of diet-attributable type 2 diabetes globally, and with important variation by nation and over time,” says senior author Dariush Mozaffarian, Jean Mayer Professor of Nutrition and dean for policy at the Friedman School. “These new findings reveal critical areas for national and global focus to improve nutrition and reduce devastating burdens of diabetes.”
Type 2 diabetes is characterized by the resistance of the body’s cells to insulin. Of the 184 countries included in the Nature Medicine study, all saw an increase in type 2 diabetes cases between 1990 and 2018, representing a growing burden on individuals, families, and healthcare systems.
The research team based their model on information from the Global Dietary Database, along with population demographics from multiple sources, global type 2 diabetes incidence estimates, and data on how food choices impact people living with obesity and type 2 diabetes from multiple published papers.
The analysis revealed that poor diet is causing a larger proportion of total type 2 diabetes incidence in men versus women, in younger versus older adults, and in urban versus rural residents at the global level.
Regionally, Central and Eastern Europe and Central Asia —particularly in Poland and Russia, where diets tend to be rich in red meat, processed meat, and potatoes —had the greatest number of type 2 diabetes cases linked to diet. Incidence was also high in Latin America and the Caribbean, especially in Colombia and Mexico, which was credited to high consumption of sugary drinks, processed meat, and low intake of whole grains."
Correlation does not equal causation. Diets high in red meat and fat have been the norm for most of human history, yet diabetes has only become an epidemic in recent decades. The real culprits are the processed foods and sedentary lifestyles of modern life, not traditional diets.
Red meat consumption in the US may be down compared to the 70s, but I'm pretty sure it's up compared to the human average 100, 500, 1000, 5000, 10000 and 50000 years ago.
Overall meat consumption (per capita per year) in the US has increased continuously and quite significantly from around 90kg in 1960 to around 120kg in 2000 and stable since then.
I would guess that processed grains and starches (i.e., stuff made of flour - even flour made from "whole grains", Veggie Straws, stuff like that) is still a bigger problem for most people. My understanding is that they get digested so quickly and efficiently that, from a nutritional perspective, they're equivalent to sugar.
imo, the biggest contributor is soda. soda is roughly half as many grams of sugar as ice cream, but eating half a soda bottle of ice cream would make most people puke
39g/355ml[1] is almost exactly half (54%) of 84g/414ml.
So Coke is indeed half the volumetric sugar content of ice cream. However, I think I probably could fairly handily eat half a Coke-can's worth of ice cream! Half a 2L-bottle's worth of ice cream (1L) would not end well, whereas 2L of Coke is a lot but definitely possible.
[1] Had never realised US cans were slightly larger than what we have (330ml).
Really confused as to how processed meats lead to an insulin resistance disease. Also, I thought refined carbs have similar glucose index as their non-refined counter parts, so how would adding more insulin inducing foods be beneficial? And how come the grand daddy of insulin spikes, sugar, isn't a factor?
The non-refined versions may release as much glucose, but they don't do it all at once. Also the fiber that they contain is good for you.
Processed meats contain a LOT of salt. Salt doesn't cause diabetes, but it does cause water retention and high blood pressure, so is bad for people with diabetes.
As for sugar, they are on the list of foods they examined. What they found is that we're eating more French fries, so that turns out to be a bigger factor in practice.
> Processed meats contain a LOT of salt. Salt doesn't cause diabetes, but it does cause water retention and high blood pressure, so is bad for people with diabetes.
Why is salt / bad influence for people with diabetes relevant in this context? Weren’t we interested in meat in relation to the rising global incidence of diabetes? Cottage cheese, shrimp, canned tuna and more also are high in sodium.
Even beef jerky has ridiculous amounts of sugar, it's hard to find a brand that doesn't have more sugar calories than protein calories. I tend to cook nearly all my own food anyway, but it would be nice to be able to pay somebody to make ready to eat foods that didn't include ridiculously needless additions.
I make sugar free jerky, and it is better or about the same as store bought jerky. It's about 20 minutes of total work for roughly two pounds, spread out over 8-12 hours of marinating and drying.
So the question is why it's hard to get even moderately low amounts of sugar, say <20% of calories from added sugar.
Not a doctor but it's because when you are diabetic the angiotensin system gets out of whack. Angiotensin is what is part of what regulates sodium and potassium in your kidneys which is what controls blood pressure.
It’s complicated too because nitrites found in fresh vegetables are strongly correlated with health improvements. This could mean that nitrites aren’t the problem, nitrites in the presence of animal proteins is the problem, or in the presence of fat, salt, etc. It doesn’t appear very clear to me.
The article represents conventional wisdom among dietitians and scientists and so forth. It is true that overconsumption of processed meats and red meats and poor carbohydrate quality does lead to an increase in weight being overweight etc, especially weight over the stomach.. if you have a fat stomach you have insulin resistance and it decreases output from the pancreas.. this causes high blood sugar..
Now however, once you get fat and specially fat over the stomach then even high quality carbohydrates can cause high blood sugar which is the definition of diabetes.. so what happens is that low quality carbs plus processed meat leads to being overweight and having a fat stomach, which causes insulin resistance and decreased output from the pancreas.. once you get in this condition however adding whole grains does not help at that point, in fact it adds to your high blood sugar and in fact eating high quality grains at that point, once you have a fat stomach, leads to high blood sugar which is the definition of diabetes
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In other words, once you have fat over the stomach in great quantities, if you eat whole grains, fruits and beans and so forth at that point, that will cause diabetes, diabetes being high blood sugar.. you want to eat the high quality carbs, fruit, and beans before you get fat.. if you eat it after you get fat you will develop diabetes because high quality carbs, fruit, beans etc will give you high blood sugar if you have fat over the stomach
I'm also confused as to how "insufficient whole grain intake" has such a high correlation. "Whole wheat flour" hasn't been the norm in the US since the late 1800s and yet we only seem to have a Type-2 Diabetes problem recently.
Any study like this needs to have an explanation for the recentness of obesity and diabetes epidemics.
I believe the theory is that processed meat leads to visceral fat accumulation in the pancreas. Of course you can mitigate the risk if you exercise and eat meat in moderation.
I am but an n of 1. I have been monitoring my blood sugar, cholesterol, lipids and some other metabolic markers for 2 years. I struggled keeping my blood sugar under 100. My cholesterol was kind of high at 220 total.
Switched to a keto two months ago and everything has improved. Blood sugar always 90 or less, cholesterol 180, LDL down about 30%.
The kidneys turn salt into fructose as far as I know. When u're diabetic and you consume salt it's much better to have it in liquid form. I don't think the reasons are known, but it doesn't raise the serum sodium as much.
Dr. Johnson doesn't mention what organ in the body performs the conversion, but he does mention that high serum sodium activates an enzyme which converts glucose to fructose.
Fructose, in high amounts, causes high uric acid, leading to inflammation, insulin resistance, and causes the body to switch from fat-burning to fat storage (bears and migrating birds will increase their fructose consumption before hibernating/migrating).
According to Dr. Johnson, if you eat some food and feel thirsty, that indicates that your body has already started converting glucose to fructose internally. Drinking enough liquid to keep the serum sodium from increasing will prevent this conversion.
Then I found this article, https://www.hindawi.com/journals/ijn/2011/392708/, which states that "The increase in dietary fructose intake stimulates salt absorption in the small intestine and kidney proximal tubule through coordinated activation of PAT1, NHE3, and Glut5. We propose that reducing dietary intake of fructose and salt, as well as maneuvers aimed at inhibiting fructose absorption in the intestine and kidney tubules, could have profound beneficial effect on controlling blood pressure in patients with metabolic syndrome."
When I first came to Silicon Valley, the free soda really hurt me. I gained 30 lbs because I was drinking over 6 cokes a day. I didn’t realize the damage it would do and now I have type 2 diabetes.
This seems to be saying fast food hamburgers are a much bigger cause of type 2 diabetes than the soda. Not what I assumed, though does reflect those I know with type 2 diabetes now that I think about it.
The journal article breaks it down semi geographically, and call Western Europe and North America "high income countries." Probably a better term than "Western countries," but looks out of place between "Central/Eastern Europe and Central Asia" and "Latin America and the Caribbean."
And several weeks ago there was an article here on HN about some research showing that ice cream wasn’t unhealthy (for something, I forget, heart disease?). Seems safer to just eat less processed foods.
Even something like "ice cream" can be a very basic milk/cream/salt or something with sugar or something whose list of ingredients would make a petroleum engineer blush and run.
I've read a lot about avoiding whole grains lately as many of them contain lectins, a protein that disrupts the intestinal lining which causes leaky gut/inflammation. This inflammation can be disruptive for chronic diseases such as Diabetes. Curious what the ideal balance of grains would be.
Apart from this study, the disease isn’t linked to diets directly, but the result of diets if that makes sense. Obesity is a major factor. Being sedentary is another. Once you become pre diabetic it seems diet becomes a larger factor for more obvious reasons, but the path to get there in the first place doesn’t seem to require a specific diet. You could become obese eating anything and still wind up having very high risk for developing type 2 diabetes.
I think this is a source of confusion because people develop it even though they became overweight on relatively healthy food. Or, at the very least, what they consider to be healthy food.
As for this study it seems to indicate to me that certain foods are much easier to get obese with, so they’re linked to the disease.
When you consider carbohydrate quality, a major difference between high and low quality sources is that the higher quality ones are harder to eat more of. That by default is a great protection from obesity. Foods which are harder to eat are almost always better for us if we struggle with portioning.
Take raw carrots for example. You would struggle to become obese by eating raw carrots. On the other hand, you can casually drink like 4 carrots worth of calories in a few minutes via soda. And not feel full at all.
Type two diabetes is caused by hormonal imbalances. If you eat sugar or refined carbs, they get absorbed into the blood stream quickly and spike your blood sugar levels. Your body does a panic reaction where it releases insulin to force the excess glucose into your fat cells. Afterwards you might end up with low blood sugar and feel hungry again. Repeat this often enough and you can get type two diabetes at any body weight as your body becomes less and less responsive to the insulin.
yea unfortunately all these diseases have a lot do with cellular dysfunction from ageing. I ate mcdonalds and soda for 4 yrs in college everday but never had any diabetes.
I don't see one comment criticizing the study, below is the study design and below this section is much more information about how they generate the quotable number. It looks like at its core there are separate data sources which de-link the person with T2D to their specific diet features (I might be way off base here so please correct if I'm wrong). Instead they are doing quite some complicated fitting to deduce these numbers. I'm not an expert in this field, and even the field I am this type of statistical work would too much for me to easily understand, but I will say this: there is a lot of lost information and to me its difficult to know whether I should base dietary decisions on this. Anyway I do not need to be told processed meat is bad for me, it destroys my gut every time I eat it and still I go back for more.
---snip---
Study design
A comparative risk assessment model55 estimated the numbers, proportions and uncertainty of global T2D cases attributable to suboptimal intake of key dietary factors (Extended Data Fig. 1). Comparative risk assessment does not use ecologic correlations to estimate risk but incorporates independently derived inputs and parameters on demographics, risk factors, their etiologic effects and disease incidence to model attributable burdens55. For this investigation, we leveraged input data and corresponding uncertainty in 184 countries on (1) population dietary intake distributions based on individual-level survey data from the GDD (http://www.globaldietarydatabase.org/)56; (2) population overweight (BMI ≥ 25 kg m−2) and underweight (BMI < 18.5 kg m−2) distributions from the NCD-RisC57; (3) total T2D-incidence distributions from the Global Burden of Disease study58,59; (4) linear, BMI-stratified effects of dietary factors on weight gain or loss60; age-adjusted direct etiologic effects of these factors on T2D, adjusted for BMI, and of weight gain on T2D from previous meta-analyses and pooled analyses of prospective cohorts23,61,62; (5) optimal dietary intake levels from previous analyses12; and (6) population demographic data from the United Nations Population Division63,64 and the Baro and Lee 2013 dataset on educational attainment65 (Supplementary Table 6).
The linked 'scientific' paper is just embarrassing. From the study design "A comparative risk assessment model estimated the numbers, proportions and uncertainty of global T2D cases attributable to suboptimal intake of key dietary factors."
That's it, that's the whole paper, reporting what the risk assessment model estimated.
Adiponectin is a hormone and an adipokine protein that affects several metabolic processes and is mainly known for its insulin-sensitizing and anti-inflammatory effects. Your adipose tissue (body fat) is mainly responsible for producing adiponectin, though other tissues in your body produce it as well.
Does that mean subbing out my rice for brown rice or subbing out my white sourdough for whole grain sourdough reduced risk?? Or if I still eat way too much whole wheat pasta it’ll still contribute to t2d down the line?
I mean I'm 41 and mostly ate whole wheat and brown rice when I cooked and still got T2D, but on the other hand I have an incredible weakness for breakfast cereal -- not the sugary ones, just carb-loading on cheerios.
Sure it might be better to avoid milled grains, but if you do, (the vast vast majority of people don't avoid them) they should be whole or brown.
What's more, if you're talking ancestral diet, it should certainly includes grains like wild rice, whole barley, rough milled wheat, farro, and quinoa.
Lots of studies out there which are correlational and thus meaningless, or worse, studies which intentionally produce false results due to being bought-and-paid-for. I don't have time to look at each link that page cites, but for example the American Heart Association is a terrible entity with worse than worthless recommendations which are completely not backed up by science.
Most of human evolutionary history was hunter-gatherer times, and they were not eating wheat. Farming is a relatively recent invention.
Even if that were true for all human populations and not just a select few, 100,000 years is still very short compared to 2 million estimated years of hunter-gathering.
A study by the Friedman School of Nutrition Science and Policy at Tufts University found a correlation between poor diet and 14 million cases of type 2 diabetes worldwide in 2018. Insufficient intake of whole grains, excess refined rice and wheat, and overconsumption of processed meat were identified as significant dietary factors. The research revealed that poor diet has a larger impact on men, younger adults, and urban residents. Central and Eastern Europe, Central Asia, Latin America, and the Caribbean saw the highest number of cases linked to diet. The study suggests that addressing dietary issues can help tackle the global type 2 diabetes epidemic.
Food manufacturers IMO only care about making food cheap, making us crave it, and making it last a long time on the shelf. They aren't concerned about making sure it is healthy, as long as it doesn't immediately kill us.
Another example is artificial sweeteners. Studies have shown that sucralose (Splenda) reduces insulin resistance something like 17%. Is anyone making sure that everyone knows that? Hell no.