Sugar Addiction and Prelude to a Review of The 21 Day Sugar Detox

With apologies in advance for some tangent going ons ...

As a popular paleo (for marketing purposes anyway) author released a paperback version of her 21 Day Sugar Detox this week -- yes, I'm talking about a $400-will-buy-you-a-certificate-that-says-so "holistic nutritionist" aka Certified Nutritional Consultant courtesy of 501c3 Bauman "college" -- I thought this journal article might be of enough interest to the inmates here to warrant a post.

The plausibility of sugar addiction and its role in obesity and eating disorders

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Why Fructose is NOT Like Alcohol

Where did this come from?

Beginning with his viral YouTube video (I won't link to it, every additional view is one view too many!), and continuing on, Dr. Robert Lustig has been making the claim that fructose is metabolized like alcohol by the liver.  You cannot make your misinformation more clear than to title a section in your book as Lustig did in Fat Chance --  Fructose versus Ethanol:  Pick Your Poison.

Before Lustig, I don't think I'd ever heard anyone equate sugar to alcohol on a metabolic level.  A few may have made an addiction analogy, but it was Lustig who "taught" us the "science" that the liver processes sugar just like alcohol.

It is shocking to me that his video was produced and distributed by an institution of higher learning as a "Mini Medical School for the Public" presentation.  This implies to me that the content has been somewhat vetted.  Apparently it has not been, and also, nobody within that establishment has ever seen fit to correct the record?  Again, apparently not, as there is that Skinny on Obesity series out there repeating many of the previous errors.

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De Novo Lipogenesis Again (and Science and Science Reporting)

In my last post, I just posted a graphic taken from an "FYI" inset by a scientist, Marc Hellerstein, whose work I've blogged on quite a bit here. (Anyone wanting to refresh can click on the image and enlarge.)  One good post to begin with if you are not familiar with that name is Where do Triglycerides Come From? I would say that between Marc Hellerstein's No common energy currency: de novo lipogenesis as the road less traveled and the works of Eric Jequier such as Nutrient effects: post-absorptive interactions, the case that hepatic DNL is quantitatively insignificant in human energy balance/fat accumulation is strong and has not been refuted by some newer scientific findings.    

I do hope to expand on the role of adipose DNL at some future point -- teaser: I have a paper showing that reducing WAT lipolysis upregulates adipose DNL and improves glucose homeostasis in the IGT irrespective of body weight  -- but adipose DNL had not been central to the arguments of folks from Taubes to Lustig to Eades to Naughton to a list far too long to go through here.  The claim has been that excess carbs are converted in the liver to fat and sent to the fat tissue for storage.  

Does this occur?  Yes.  Is it significant?   Only if you consider a couple grams fat synthesis per day significant at the metabolic cost "wasting" one gram carb for every four grams converted to fat ... and only if you consider a few grams of fat significant in the context of consuming 100, 200 or more grams of fat that is already fat.

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Scientific Review of Lustig's Fat Chance

Scientific Review of Lustig's Fat Chance

I don't often put blog posts up on someone else's works of this nature, but I'm going to make an exception because Mark Kern has done a thorough job of looking at some of the "science" Lustig puts forth in his book.  {I await the predictable dismissal ;-) }

Memes & Infographics

I don't know how many of my readers do the Facebook thing here.  So called infographics (perhaps should be better termed disinfo graphics in most cases) and memes are big in that social media venue.  These have, IMO, both good and bad aspects to them.  They are a reflection of just what a sound bite world we live in, which on balance I believe is a bad thing because two things happen with sound bites -- effective summarization of a larger theme or camouflaging misinformation.  On the good side, and to the former point, many people are reached at an intellectual level more by visuals and short phrases than by a sea of text.  

In any case, I thought I would share a couple of these here from time to time.  Many of these cannot be tracked back to an originator or are posted in "friends only" places so linking/attribution is difficult, so I won't be doing that here.  If anyone recognizes their work and would like attribution (or recognizes someone else's work and can provide a publicly accessible nod), pipe up in comments or pop me a note (carbsane at gmail dot com) .

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What's wrong with food in the Incestral Health Community

A little trifecta for you here of things are responsible for the evolution of the term "paleotard" through neolithic times and flourishing in the present.  Some examples of dietary dogma to chew on the next time you consider what foods are *OK*  to eat.

Mark Sisson

First up, the man himself, the guy with the advice column "Is it Primal?"  I've read these for years now and they seem to get evermore ridiculous.   I vividly recall reading my first installment before the IIP roundups became more the rage, a "Dear Mark" about buckwheat.  

At first glance, buckwheat certainly looks promising. Unlike grains, it’s not a grass, but rather a flowering pseudocereal. The triangular seed from the buckwheat plant, called a groat, is harvested and can be milled into flour or used whole in cereals. Seed? Seeds work, right? Not necessarily. While I love most seeds for their high fat content and protein, they do have to be low in carbs to pass the test. Buckwheat groats are decidedly starchier than, say, flax (another story altogether) or pumpkin seeds, so we must use caution. Buckwheat’s glycemic index is 54, which is still fairly high despite being lower than actual grains.

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LIRKO vs. TWICHOO X.0

from this study, image from this post

It occurred to me as I was thinking again about LIRKO, that this little mouse not only countered TWICHOO 1.0, but it pretty much puts the lid on TWICHOO X.0.  This profoundly hyperglycemic and hyperinsulinemic liver insulin-receptor knockout mouse, is not fat.  Though not statistically significant, the trend is to eat a tad less, be a tad smaller, and pack on fewer fat grams  than controls.  But let's just call it a wash.

For any newer readers, TWICHOO stands for Taubes Wrong Insulin-Carbohydrate Hypothesis Of Obesity.  Version 1.0 was that which was put forth in Good Calories Bad Calories.  In this version, Taubes put forth four ways by which the carbohydrate could promote obesity:

1.  Carbohydrates stimulate insulin which stimulates fat storage and/or traps fats in our fat cells so fat accumulates.

This was pretty much the "lead singer" of his Barbershop Quartet singing the TWICHOO jingle.  Carbs stimulating insulin basically led to chronically elevated insulin levels.  The other three are:

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If you drink OJ, might it just as well be Orange Crush?

I'm sure you've heard it many times -- fruit juices, even unsweetened ones, are still just glasses of sugar, and you might as well be drinking a soda or Tang (remember that?). According to nutritiondata.com, a cup of orange juice contains 21g sugars.  They don't "itemize" in the OJ entry, but if we look at the ratios oranges we can calculate that of those 21g, roughly 11 g are sucrose, 4.5 g are glucose and 5.5 g are fructose.  Thus for each cup (8 oz) of OJ, you get around 11g of the dastardly fructose poison.  This is roughly the same as you would get in the same amount (small can!) of orange soda.

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Gary Debunks Taubes II ~ It's the Frucose Stupid, revisited

Gary Taubes had a problem on his hands for his "Alternate Hypothesis" on the cause of obesity. While Why We Get Fat was in the writing stage, a couple of NIH biophysicists remained pesky thorns in Gary's side having challenged him on a lynch-pin of TWICHOO (Taubes Wrong Insulin-Carbohydrate Hypothesis Of Obesity).   Not to mention an equally pesky then-anonymous bunny-eared blogger who posted some pretty damning stuff on the subject, especially when she looked at his seminal reference on the subject from GCBC.  Downplay as he might, try to move on and have everyone forget, as he eventually relented and did, Taubes' original WWGF remains enshrined in the first journalistic effort on the topic: Good Calories Bad Calories.

It wasn't all that long ago that people were shouted down in forums and comment sections of the low carb persuasion for daring to suggest that people could gain weight on low carb.  Remember the meme?  At least you won't gain weight being a fat glutton?  Can't gain weight so long as there's no carb around?  It was all there in black and white in GCBC-- you need glucose to make alpha glycerol phosphate (aka glycerol-3-phosphate) to store fat.  

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The Sugar Twins step in it ... or almost. Part I: Lustig Eats Crap

The Rock'em Sock'em battle of the gurus in Carblandia continued last week as both Lustig and Taubes took to the media airwaves.  I'll now call them the sugar twins because ultimately both hinge their arguments on sugar/fructose.  Lustig says that because fructose is converted to fat in the liver, sucrose is the one food on the planet that is both fat and carb together and that makes it fattening.  That combo is particularly insulinogenic and insulin blinds your brain to leptin so you don't know when to stop eating cheesecake.  Taubes is making his last stand at TWICHOO Bunker Hill by saying that all the bad things he's been telling you for years about carbs -- fat cells going wild, spontaneous horizontal growth spurts, starving cells, etc. -- you may be spared of this forever and eternity so long as you never bathed your liver in fructose.  Fructose causes insulin resistance and sets the wheels in motion for fat accumulation.  Both (misguided) positions hinge on SUGAR = OBESITY.

So, first up to the plate, Lustig went on Alec Baldwin's radio show.  This excited Andreas Eenfeldt because low carb hacks see only the headline and have no interest in looking any further, so he alerted his readers to a "great interview" with Robert Lustig.  (Transcript HERE)

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The Men Who Made Us Fat

Here's the YouTube playlist for the whole thing:

The Men Who Made Us Fat   Jacques Peretti

A few questions/comments:

1.  Does bread today have more sugar in it (corn syrup), than breads of yesterday?  Talking hamburger buns.  How or why would adding corn syrup to rolls make them last longer as Peretti claims?

2.  Are soft drinks the largest single source of calories in the American diet?  How do we define "source"...

3.  If HFCS (55% fructose/45% glucose vs. 50-50 for sucrose) is sweeter than sugar, is it true what Lustig claims?  If sweeter they should use less in substitute.  Lustig claims they use more.  True?

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Contest! Why we get fat ...

... Nah, for a change it's not Gary Taubes or Robert Lustig or any of the other usual suspects hailing from the US making sheet up and mangling facts. No, this article comes from the UK ... if you thought the state of science journalism in the US was bad, wait till you get a load of this specimen of health journalism in the UK!  This one was brought to my attention courtesy of Chris Highcock of Conditioning Research blog.

Why our food is making us fat

We are, on average, 3st heavier than we were in the 60s. And not because we're eating more or exercising less – we just unwittingly became sugar addicts

I count at least 15 glaring inaccuracies, contradictions and/or exaggerations bordering on deceit.  Can you find them?  Winners get free Gin It Up & Tonic cocktails and Bologna Roll-ups  tonight at the Asylum Bar & Grill!  And, as always, I'm happy to substitute to meet your dietary needs :D

image linkimage link

Fructose, Fat & Obesity

The other day, Stephan Guyenet shared some of his own thoughts on David Despain's can't-say-enough-nice-things-about-it interview with Dr. John Sievenpiper.  In case you missed it, Stephan discusses his post looking at the links or lack thereof  between sugar consumption per se and obesity.  See:  Is Sugar Fattening?  At the end of the current post is the following footnote:

** If fructose is fattening due to its ability to become fat, then dietary fat should be even more fattening because it doesn't have to undergo an inefficient conversion process-- it's already fat.

Excellent point!  I might add that if saturated fat is such a healthy fat for your body, fat produced by de novo lipogenesis -- mostly palmitic acid in the liver -- would be an even better source of that fat as it would give you a "metabolic advantage"!   It takes almost no calories to digest and store dietary fat in body fat.  It is highly energy intensive to convert fructose to fat, so you get some free calories!

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Review & Critique: The Skinny on Obesity ~ Intro and Part I

Staying true to one of the founding missions of the Asylum, there's a YouTube series entitled The Skinny on Obesity, from University of California, that deserves critical attention.   If you're going to put forth science to explain obesity and associated disease, especially in the affirmative sense ("fact", "we know", "is" rather than "possibly", "probably", "evidence supports"), it should be correct to the best of current knowledge.   I've made it through five of the episodes to date, and sad to say, this series falls far short of that mark.  

Thus far, there have been three contributors:  Dr. Robert Lustig, Elissa Epel, and Barbara Laraia.  Almost everyone is familiar with Lustig, the last two listed as affiliated with The Center for Obesity Assessment and Study at UC but we learn nothing about their backgrounds.   By far the major contributor to the science is Lustig and he gets some basic things so horribly wrong they must be called out.  Lustig became an instant star in LC circles with his viral fructophobic YouTube video.  YouTube fame is one thing, but this series, put out by University of California, and media appearances like on 60 Minutes (that I did not see) are evidence that this man IS mainstream, and his Nature article and recent public statements can leave no doubt he is highly agenda driven with draconian goals.  Therefore it is important to examine the evidence he puts forth before we have another Ancel Keys on our hands!

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Great Interview on Fructose ~ The "Other" Side

This one is too good just to tweet.  One of those gems I mentioned the other day is David Despain's Evolving Health blog.  He's been posting quite a bit of late on fructose.  His latest:   Fate of fructose: Interview with Dr. John Sievenpiper.

It's definitely worth reading the whole thing, but I'll excerpt a few things that address the problems with many of the fructose studies and problems with them, and some nice correcting of Lustig & Co.:

• The 50th percentile for intake in the United States is 49g per day, which is just a little less than 10 percent per day of energy from fructose. ... the 95 percentile for intake for NHANES for fructose consumes 87g of sugar or little less than 20 percent energy.

It seems to me that sugar consumption in the US is often inflated, and the inflation is done by those who seem to have an "crisis agenda" -- by that I mean looking to whip up a crisis for the purpose of enacting legislation or finding a new tax revenue stream. So related to the quote above, Sievenpiper takes issue with the "superphysiological doses" of fructose used in most studies.

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Is Low Fat & High Fructose Causing Metabolic Syndrome?

Via Twitter, Beth from Weight Maven blog asked me if I read That Paleo Guy and a recent paper he blogged on.  The answers would be no and no, but I have now ;-)    The title of the study is:  Is the metabolic syndrome caused by a high fructose, and relatively low fat, low cholesterol diet?

 
The following stuck out at me from the conclusion of the paper:

In conclusion, we would urge medical practitioners to encourage individuals exhibiting MetS to strongly limit the consumption of dietary fructose [75] and other high-glycemic-index carbohydrates, and to stop discouraging them from consuming foods rich in cholesterol [76].

Now I don't know what medical practitioners are out there pushing fructose on people, but the recommendations to consume fruit are a far far cry from endorsing the consumption of sugar sweetened beverages and lots of juice.   I do think it's a crime that fruit juices are considered the equivalent of a piece of fruit to many nutritionists, but that aside, it is darned near impossible to eat 50g of fructose per day eating just whole fruits, let alone the 100g and upwards amounts in liquid form often used in studies.  There have also been scant few isocaloric studies done with fructose. 

In any case, as I read the study, I couldn't help getting "flashbacks" of sorts of the "Cafeteria Rat" study I blogged about over a year ago.  There is so much to that study that, yes, was in rats, but so are a heckuvalot of studies on MetSyn.   I'll be bumping the three posts directly referencing the study, and in a few days I'll publish the rest of this post that is in the hopper.  Here are the links anyway:

http://carbsanity.blogspot.com/2011/02/why-we-get-fat-lessons-from-cafeteria.html 

http://carbsanity.blogspot.com/2011/03/why-we-get-fat-lessons-from-obese.html

http://carbsanity.blogspot.com/2011/03/why-we-get-sick-fat-lessons-from.html

The last one deals with the effects that were seen on the liver, fat tissue and pancreatic cells and is probably most pertinent to a discussion of the fructose/low cholesterol hypothesis. 

Live Blogging from the Paleo Summit I: Mark Sisson

Link:  Mark Sisson

Ratings:

☼ ☼ ☼ ☼ ☼  Entertainment Value

☼ ☼ ☼ ☼ ☼  Content

☼ ☼ ☼ ☼ ☼  Informational Accuracy

☼ ☼ ☼ ☼ ☼  Overall

Summary:

It is fair to say that of all the paleo/LC folks with whom I have disagreements with on the substance of their message, Mark Sisson is probably the most enjoyable personality to listen to.  If you know nothing about paleo/primal, this is a good overview of the basics.  If you're familiar with Primal Blueprint at all, there's nothing new here.  The interview is more notable for what it is missing -- any major emphasis on excessive carbohydrate consumption (no carbohydrate curve), minimal mentions of insulin and no mention of fat being locked away.  Not too many overt factual errors or misrepresentations of the science.  Most of all this interview and other recent ones demonstrate Mark's ability to adjust his marketing pitch to the tune of what's going on out there.   His transition has been so smooth as to be almost unnoticeable.  The hot thing these days is the "fat burning metabolism", and Mark's a master at capitalizing on that.

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Some thoughts on fructose studies

I've been poking about the literature lately ever since the insulinogenic (in terms of circulating insulin levels but not necessarily secretion of insulin) properties of jelly beans were made known to me a while back.  I've been looking into studies comparing sucrose to glucose or fructose separately, or that measure insulin secretion and/or clearance per se.  It's a rough go.  Much of the research that turns up with fructose in the search phrase involves HFCS not fructose per se.  When you get isolated fructose studied, however, there are still other complications. 

For starters, it is impossible to isolate the effect of just fructose with whole foods.  Just about every source of fructose, like fruits, also contains sucrose and even considerable amounts of isolated glucose in many cases.   It is also virtually impossible to attain the levels of fructose generally required to elicit a measurable metabolic response.  For reference, a medium apple contains roughly 10g fructose (most of which is free).  A "bolus dose" for 50g would be difficult to achieve and would come with ~5g glucose per apple.  So ... sweetened beverages it is as the major dietary vehicle by which fructose is incorporated into dietary interventions.

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Salvaging the Hypothesis

You can't salvage a CIH with fructose and "refined carbohydrates" that has insulin as a mediator because there is no such theory that makes physiologic sense, and this would be obvious the moment such a theory is articulated         ~ Kurt G. Harris MD, 11/18/11

If 2011 will be remembered in low carb circles for anything, it will be for both the lack of anticipated rise and precipitous fall of what I call here at the Asylum TWICHOO.  With the December 2010 publication of Why We Get Fat, no doubt many low carbers began 2011 with a feeling of supreme optimism.   What with all the "Gary you're my hero" comments on his blog, and lots of exposure of the lay friendly book, even in the mainstream media, surely 2011 would be the year when "they" would finally get it.  The momentum of 2010 would be carried forward and by the end of the year low carbers envisioned an even more energized following with an expanding sphere of influence.  Oprah would finally get thin and stay that way going on Gary Taubes' diet and all would be right with the world.  Insulin had finally been implicated as the evil hormone everyone knew it was all along, and our grandmas would be vindicated for knowing all along that carbs were fattening.   The "late great" Robert Atkins' name would finally be cleared and his diet vindicated.  In Berkley, CA, a carving of the Mt. Fatless monument would begin:  Bauer, Yalow, Atkins & Taubes.

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Sweeteners

If you're not sitting down reading this, you might just want to, or grab onto something for support, because I'm going to start this post out doing something I don't all that often: praise Mark Sisson.   The sample menu page on his blog reads:

A typical breakfast for me is a cup of coffee with cream and sugar and an omelet

This page has been around for a good long time and he hasn't changed it, so presumably Sisson hasn't jumped headlong on the stevia wagon.  In the summer, as a kid, we would suck on honeysuckle blossoms for the faint sweetness.  Needless to say, we did this more for the novelty of "hey, this is sweet" than scavenging for every blossom we could find for a sweet kick ... they just weren't that sweet.   If one googles chewing and sugarcane or stevia leaves you will find references to both.    If you are ever in New England in late winter/early spring, you'll see the maple syrup taps on trees.  The dried syrup that may ooze from the tap, etc., also tastes sweet.  We humans tend to like sweet stuff, and when found in nature, we'll chew/suck or otherwise extract the sweet leaving the rest behind.  But the only foods that are truly sweet eaten whole (or at least most) are fruits and honey.  I suppose we could add in the faintly sweet root veggies as well.  

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