from Hacker News

Sugar alters hormones and metabolism, sets stage for obesity and diabetes

by inertial on 10/21/17, 2:07 PM with 205 comments

• by troydavis on 10/21/17, 3:01 PM

  The CDC says 34% of US adults have pre-diabetes, and of those, 88% are undiagnosed[1]. Yes, about 29% of US adults have un-diagnosed pre-diabetes, or about 74 million people.

  I think a significant cause is that testing blood glucose is thought of as something that only diabetics do, and as a result, most people have no idea how their bodies respond to meals they'd consider normal. The feedback loop is completely open. A typical Chipotle burrito has ~115 grams of carbs, often consumed in 20 minutes[2]. For some people, that's fine, and for others it's not, but the only way to know (other than waiting for problems) is to actually measure one's own blood glucose an hour later.

  Until blood glucose testing is either (a) thought of more as data collection without fear or stigma, like a bathroom scale, or (b) made blood-less and automatic, like is rumored about the Apple Watch[3], many people won't learn the answer to that question until a symptom of pre-diabetes appears.

  If you're reading this and haven't had your fasting blood glucose tested as part of a regular checkup, get that done. It's not nearly as informative as post-meal testing, but it's much better than nothing.

  Also, if you're a diabetic who created a side project/hack because you wanted it, and at scale, that project could mitigate the public health impact of diabetes, feel free to contact me. I'd consider helping make it mainstream[4]. My interest is improving societal health (this will be a massive problem in 20 years if nothing happens now), not personal or financial.

  [1]: CDC National Diabetes Statistics report, 2017: http://cdc.gov/diabetes/pdfs/data/statistics/national-diabet... (page 7)

  [2]: Chipotle nutrition calculator: https://www.chipotle.com/nutrition-calculator

  [3]: "Apple CEO Tim Cook test-drove a device that tracks his blood sugar": https://www.cnbc.com/2017/05/18/apple-ceo-tim-cook-test-drov...

  [4]: https://twitter.com/troyd/status/920747116703518720, https://twitter.com/troyd/status/921409373661884416

• by kichuku on 10/21/17, 4:11 PM

  I would like to share an anecdote. In March 2016, I was weighing 96 kilograms (211.64 pounds). I made just one change during that time which is to stop having anything with sugar. I continued to take other natural sweeteners like jaggery and honey. The rest of my diet remained the same and my activity level remained the same ( I work in IT as a network engineer in a desk job)

  In October 2016, I was weighing 72 kilos (158.73 pounds). I am still maintaining that same weight between 70 to 72 kilos since then. Incase if it is relevant, I am a 29 year old guy with a height of 172 cm (5 feet 7 inches).

  Along with that, I got several other benefits such as being more energetic, not feeling sleepy all the time, general improvement in mood etc.

  All this just with stopping of sugar and nothing else changed.

  I can share even more side benefits which I got, but it will seem more unbelievable because I have observed that the general population is still unaware of the extremely harmful effects of sugar.

  EDIT: I had typed October 2017 when I had intended to type October 2016. It was just 7 months.

• by jnordwick on 10/21/17, 4:22 PM

  The recent demonization of sugar substitutes hasn't helped either. The problem with studies that link them to weight gain is that they confuse correlation and caution then make some wild unsubstantiated stab at causation by guessing that maybe they cause insulin issues. I went looking for information on that, and found and excellent article by a diabetic site summarizing the evidence and treating each substitute as its own compound. The bulk is the data is that they have no correlation (there is some in vitro evidence for a couple of lesser used sweeteners but under very contrived circumstances). As long as we deny the existence of usable substitutes, we are making this harder on ourselves.

  https://www.marksdailyapple.com/artificial-sweeteners-insuli...

• by ruminasean on 10/21/17, 9:59 PM

  I've been on a ketogenic (very low carb, no sugar) diet for a little over a year. At the beginning of the diet, I started eating MORE than I used to, and tracking calories religiously, including weighing my food. I never miss a meal now and eat breakfast every day. The biggest thing I cut out was sugar.

  In that time, I lost 45 lbs, going from 210 to 165. I didn't exercise or do anything else. That weight came off in about 3 months.

  I am now commuting 11mi by bicycle most days, I feel better than I ever have. I fit perfectly into a few things I owned in HS (I'm in my 40s and was a skinny kid).

  Sugar is the worst.

• by dlwdlw on 10/21/17, 6:35 PM

  Fad diets like keto offer something very important, a model of nutrition. Currently heuristic based eating like "natural" or "non-processed" work, but the knowledge doesn't compound and is brittle. In eastern cultures especially there is a huge body of heuristics for eating. In Chinese culture there is a concept of hot/cold foods and despite it not being accepted in the west, it still has predictive ability above chance.

  The end goal I would like to see is healthy off the shelf long lasting processed food that tastes great. It runs contrarian to "eat local and natural, big food is evil" but it solves a huge problem.

  Of course on the way imperfect models will yield bad results and heuristics are all we have. When doctors refused to wash their hands because they didn't know germ theory despite the massive heuristic evidence, people needlessly died.

• by mncharity on 10/21/17, 5:20 PM

  How Big Business Got Brazil Hooked on Junk Food[1]. "As their growth slows in the wealthiest countries, multinational food companies like Nestlé, PepsiCo and General Mills have been aggressively expanding their presence in developing nations, unleashing a marketing juggernaut that is upending traditional diets from Brazil to Ghana to India." "a growing number of people are both overweight and undernourished." "The diet is killing us." Nestlé: "We didn’t expect what the impact would be".

  [1] https://www.nytimes.com/interactive/2017/09/16/health/brazil... , about: https://www.nytimes.com/2017/09/17/insider/as-global-obesity...

• by sn9 on 10/21/17, 11:56 PM

  Sugar's role in diabetes seems likely to be true, but to say that CICO is false and a mutually exclusive explanation compared to the way in which insulin affects one's metabolism is empirically false [0].

  Taubes would be hard pressed to explain how you could lose weight on a diet of Twinkies or how those subsisting on high carb, low fat, low protein diets that fail to meet their caloric needs in famine-afflicted regions remain thin.

  The way insulin works and the way the body requires a caloric surplus to gain weight are not remotely mutually exclusive ideas and to suggest otherwise requires cherry-picking the literature in a way that's scientifically irresponsible.

  [0] https://examine.com/nutrition/what-should-i-eat-for-weight-l...

• by mrmr22 on 10/22/17, 5:01 AM

  Here's a study showing Metabolic and behavioral effects of a high-sucrose diet during weight loss: https://www.ncbi.nlm.nih.gov/pubmed/9094871 It shows when kcals are equated,there is no difference in fat loss in high vs low sugar intake. I find Layne Norton a good resource for science related information about nutrition. I will say he is an outspoken critic of Taubes. Here is one of Layne's articles on sugar with references: https://www.bodybuilding.com/content/the-science-of-sugar-an...

• by retreatguru on 10/21/17, 9:36 PM

  This about sums it up: "A far more parsimonious hypothesis is that the same thing that makes our fat cells fat makes us fat: ‘high blood glucose’ and concomitant elevated levels of insulin and the insulin resistance itself, both caused by the carbohydrate content of our diets. Insulin is secreted in response to rising blood sugar, and rising blood sugar is a response to a carbohydrate-rich meal. Sugar is implicated, in particular, because its chemical structure includes a large proportion of the carbohydrate fructose, and fructose is preferentially metabolised in the liver. As such, it is a prime suspect for the fat accumulation in liver cells that is hypothesised to be the trigger of insulin resistance itself."

• by vixen99 on 10/21/17, 3:46 PM

  Short take: this is adapted from ‘The Case Against Sugar’ by Gary Taubes, a science writer who's been a long-standing campaigner against dietary carbohydratesa and sugar'.

• by Nomentatus on 10/21/17, 8:07 PM

  The largest hormonal change we experience isn't puberty - it's night, under the aegis of the master hormone melatonin. Almost every hormone changes.

  I was overweight and had an appetite out of control a couple decades ago. For other health reasons, I adopted a natural night (real dark, can't see you hand in front of your face) and exactly the same lights on and lights off time. My extra weight vanished. My appetite didn't just lower, it changed away from salt fat and sugar (exactly what you want when starving) towards veggies and salads.

  (Ten hour nights recommended as your sleep will bifurcate.)

  Recommended. Nature ain't all wrong, it turns out.

• by ha8o8le on 10/21/17, 9:52 PM

  This is the truth. There's a lot more to this - so much so that I decided to make a documentary about it. I don't mean to promote it (there is nothing to promote yet, for now it's just a website), but here it is if anyone is interested http://FoodLies.org

  I have one of these thought leader doctors on board. Would love any feedback or help from the community to get this made.

• by projektir on 10/21/17, 8:24 PM

  But why has obesity not been such a problem in the past, despite sugar being available?

  One point to make from the article, though: "They suggested that the physician-authors were trying to con the obese with the fraudulent argument that they could become lean without doing the hard work of curbing their perverted appetites."

  If you want to really confuse what's going on, turn to moralism. Desire to judge and to avoid being judged completely messes with incentives and people will line up to the "hard working" side while avoiding the "lazy" side, regardless of what is actually true.

• by thearn4 on 10/21/17, 7:48 PM

  I've been trying to cut sugar out of my diet recently. Eventually I'd like to at least feel comfortable treating it like alcohol: only for consumption in social settings and not too often.

• by arikr on 10/21/17, 5:47 PM

  Robert Lustig has written an excellent book on this topic: "The Hacking of the American Mind."

• by PeterStuer on 10/21/17, 5:29 PM

  Ever notice how since the 1980 the mantras changed from 'eat less, exercise more' to 'fad' diets whose one common theme was 'don't consume less, but eat different'. Subsequently obesity skyrocketed and the fat-lobby made sure that anyone who even pointed out the problem got demonized. Meanwhile 'food-scientists' silently made designer drugs out of daily consumables leading to a feeding frenzy and an obesity pandemic.

• by iopq on 10/21/17, 11:43 PM

  I'm lean and I eat a lot of sugar. Sugar is not a toxin. It's a source of energy. I'll eat some sugar and go to the gym. I'll come back and eat more sugar to replace the glycogen I drained.

  What happens to overweight people has NOTHING to do with lean people who exercise.

• by Tistron on 10/21/17, 6:08 PM

  If you prefer audio the author appears in Sam Harris' podcast in a long interview abd speaks about this subject.

  #74 — What Should We Eat? Waking Up with Sam Harris Duration: 2:07:24 Published: Sat, 06 May 2017 20:30:08 +0000 URL: http://traffic.libsyn.com/wakingup/Waking_Up_74_Gary_Taubes....

  In this episode of the Waking Up podcast, Sam Harris speaks with Gary Taubes about his career as a science journalist, the difficulty of studying nutrition and public health scientifically, the growing epidemics of obesity and diabetes, the role of hormones in weight gain, the controversies surrounding his work, and other topics.

• by Montezuma_II on 10/22/17, 12:03 AM

  Not meaning to be rude or ignorant, but was anyone actually doubting this? I thought that the link of sugar to diabetes and obesity was common knowledge.

• by Siilwyn on 10/21/17, 4:39 PM

  So I wonder... is the effect of sugar on your body permanent, building up over time? Or would stopping the intake of refined sugars restore your system?

• by milesward on 10/21/17, 9:00 PM

  I cut out carbs (<20g per day) and am down 50lb in <1 year. YMMV, but keto worked for me.

• by alexandercrohde on 10/21/17, 4:25 PM

  Tl; dr:

  Author contrasts two explanations of the obesity and diabetes crises: A) that the root of the issue is caloric intake stemming from low-self-control or B) that the root of the issue is high blood-sugar and its subsequent effects.

  Author explores the long history of this debate and presents points for both sides. Author admits the thermodynamic validity of caloric math but cites that at a cellular glucose levels cause insulin levels to rise that cause the cell to take on fat. Author cites other research, such as increased appetite among obese animals, suggesting a systemic effect. Author cites ketogenic diets as evidence (which restrict sugars but not total calories).

  Author contrasts the moral interpretation of each theory. Proposes the caloric consumption model places blame on the individual, whereas the glucose explanation places blame on the FDA.