Added sugar intake and its associations with incidence of cardiovascular disease
Comments
Etheryte
ecmascript
As a swede myself I agree somewhat but also I don't think what you're saying is the case anymore, even if it used to be.
Today I think swedes in general consume a lot more sugar and much more in a super processed way that we used to. The culture of only eating candy on saturdays is probably alive and kicking among many children but I think isn't that strong anymore with grown ups. A lot of swedes, including myself, struggle with overweight and I think it is mostly how the food culture has changed to go from european to american inspired.
It's basically impossible to find a restaurant close to a highway that doesn't serve ultra processed food that is cooked in some other kitchen far away or simply fast food where it used to be common place to have basically home cooked meals everywhere you went. Now it's mostly low quality crap food just like the USA.
Also the pasteries to the fikas have changed to be more processed. Everything is made with vegetable oil instead of butter etc. Even things that are supposed to be healthy like yoghurt and similar things are filled up with thickener additives or unnecessary added sugars.
Unfortunately Sweden goes along to be more and more americanized (especially food-wise) and I think it sucks. I wish Sweden would be more like the rest of europe and keep it's food culture.
TL;DR: It used to be like the OP said, but it isn't anymore. It is hard to eat healthy because manufacturer keep pushing so much crap in their products and the availability of crappy food items is just insane.
jal278
> High intake of sweetened beverages was associated with higher risk for most of the studied outcomes, for which positive linear associations were found. In contrast, a low intake of treats was associated with a higher risk of all the studied outcomes.
Not sure what to make of this -- some kind of other latent explanation (e.g. that many of those with the lowest intake of treats were on a diet due to bad health?).
From the discussion section:
> One aspect to take into consideration is however that there is a social tradition of “fika” in Sweden, where people get together with friends, relatives, or coworkers for coffee and pastries (41). Thus, one could hypothesize that the intake of treats is part of many people's everyday lives without necessarily being related with overall poor dietary or lifestyle patterns, and that it might be a marker of social life.
lolinder
Isn't a simple possible explanation that people who are at high risk of (or already diagnosed with) these diseases make up a disproportionate chunk of the lowest sweets consumption bracket, simply because they're the ones who are actively restricting intake on advice from doctors?
I'd naively expect most healthy people to fall in the second-to-lowest bracket—they're not actively restricting, but they don't have the pervasive bad habits of the highest consumers.
kristjansson
This is exactly what happened with the “red wine is good for you” claim
ricardobeat
That was my first thought as well, but the paper says that after excluding all people with a previous condition, that association remains unchanged. There might be something else, like particular diets, at play.
lolinder
That would rule out pre-existing conditions but not rule out people who already knew they were high risk for reasons other than a previous diagnosis (such as blood work, family history, etc.).
dylan604
Could it be that the type of sugar used in the soft drinks is different than the type of sugar used in baking and where the body processes them differently?
Yes, I'm questioning if high fructose corn syrup is worse for the body than table sugar. From everything I've ever seen, that tends to be the case.
Or could it be that the non-fructose corn syrup artificial sweeteners are having more of a negative impact as people do not limit their in-take of those beverages since there's "no sugars" or "0 calories"?
analog31
There might be a dietary difference, even though it seems superficially like there shouldn't be. This is my summary of the reaction from a chemist who did her master's degree in sugar chemistry: "Complex sugars (sucrose) and starches are broken up into glucose and fructose quite efficiently by enzymes in your digestive tract. Only glucose and fructose are absorbed into the bloodstream."
That chemist is my mom. So I'm biased. ;-)
The puzzle is whether table sugar and high fructose corn syrup have different dietary effects, and if they do, why. I don't think it's a settled matter.
thatcat
There is clearly a difference in the uptake of fructose and glucose as you can see here, no insulin is required to uptake fructose. https://phdmuscle.com/fructose-metabolism/
If there is a difference in fructose and high fructose corn syrup it would likely be the fact that it is corn based. Corn has been selected to be farmed with high glycophosate (round up ready), which metabolically different from other corns and produces some proteins not found in non GM corn. https://enveurope.springeropen.com/articles/10.1186/s12302-0...
ltbarcly3
No insulin is necessary? Please don't propogate nonsense.
thatcat
Its true, check the link and look at the metabolic pathway. insulin is a response to glycogen from the fructose 6 phosphate formed during glucose metabolism. since fructose converts to fructose 1 phosphate form no glycogen is released and so no insulin is required to uptake fructose.
Anyway, apparently HFCS contains about 50% glucose so it would require insulin, but less than pure glucose.
ltbarcly3
Fructose doesn't need insulin to be converted to glucose in the liver, but I don't think this is what you are thinking at all. Fructose isn't used by the body directly, it almost always has to be first converted to glucose first. Glucose does require insulin to be pulled into cells throughout the body. So fructose does require insulin to be used by the body for energy or to be stored into fat.
When you say insulin isn't needed for fructose it's a fundamental misunderstanding on a few different things.
glial
My layman understanding is that insulin is used to absorb blood glucose into muscle and fat cells, while fructose is processed by the liver into other things (which may include glucose), but that initial processing doesn't require insulin.
ipaddr
Glucose gets broken up in the liver but fructose doesn't. So those with slow liver processing like Gilbert's syndrome the differences between the two make a bigger difference.
High fructose corn syrup floods the system (body) and it can't process it quick enough.
CrazyStat
HFCS is high fructose compared to regular corn syrup. It's not necessarily high fructose compared to table sugar (sucrose). Table sugar is 50% fructose by weight; HFCS comes in 55% and 42% fructose varieties. The FDA says [1] the 42% variety, which has less fructose than table sugar, is used in most processed food other than soda. So fructose doesn't seem like a plausible mechanism for non-soda HFCS to be worse for you than table sugar.
I don't like HFCS--I think it gives sodas a flavor I can best describe as "sharp," based on blind taste tests I've done comparing same-brand sugar and HCFS sodas--but I don't see solid evidence that it's worse than sucrose. I think it's mostly used as a scapegoat by people who don't want to conclude that sugar in general is bad for you.
[1] https://www.fda.gov/food/food-additives-petitions/high-fruct...
simmerup
Don’t you have that the wrong way around?
toast0
> The puzzle is whether table sugar and high fructose corn syrup have different dietary effects, and if they do, why. I don't think it's a settled matter.
I don't know how you would design a study around it, and this is an anecdote, but I find sugar sweetened soda to be much less palletable than HFCS sweetened soda.
That wouldn't necessarily show up in a study comparing equal intake, but could be a factor in reducing intake of sweetened beverages in places without HFCS compared to those places with.
djtango
I'll go one step further. A gram of sugar in an orange is not the same as a gram of sugar in a teaspoon.
Medium matters - that sugar in an orange is dissolved in the juice which is locked in the pulp.
Who knows what the bioavailability of the sugar is in that messy fibrous orange you partially chewed? I guarantee it'll be less than that pure refined sugar in the spoon.
Our "datafication" of nutrition and stuff like calories has led to so much silly pseudoscience.
Calories are my biggest pet peeve of BS to take with a grain of salt. Why are we basing our nutrition and diet on the performance of the food in a bomb calorimeter?
ipaddr
Table sugar is 1/2 glucose and half fructose. An orange is 100% fructose. The medium of the pulp allows for slower absorption and the fiber does a number of things like simulating the intestinal walls.
Remnant44
> An orange is 100% fructose
It is not:
https://fdc.nal.usda.gov/food-details/746771/nutrients
In fact an orange is a mixture of glucose, fructose, and sucrose (which itself is glucose and fructose). An orange actually looks surprisingly like table sugar in terms of the sugar types, although you are correct that the pulp / fiber / etc do mean that the response of our body is likely different.
chithanh
It is known that people who consume sugary drinks are at higher risk of death from disgestive diseases, which is less so for people who consume artificially-sweetened drinks. So there may be a causal link.
scythe
There do appear to be some specific effects of sucrose, although there are no immediately obvious health implications:
https://www.sciencedirect.com/science/article/abs/pii/S00223... (unclear disaccharide effect of sucrose)
https://www.science.org/doi/abs/10.1126/science.493983 (unclear, but seemingly harmful, disaccharide effect of sucrose)
https://www.sciencedirect.com/science/article/abs/pii/S00223... (disaccharide effect of sucrose but not maltose)
https://link.springer.com/article/10.1007/s00394-011-0228-x (unclear, but seemingly beneficial, disaccharide effect of sucrose)
https://www.cambridge.org/core/journals/journal-of-developme... (unclear, but seemingly harmful, disaccharide effect of sucrose)
https://onlinelibrary.wiley.com/doi/abs/10.1002/hipo.22368 (very surprising beneficial disaccharide effect of sucrose that should require further confirmation)
https://journals.plos.org/plosmedicine/article?id=10.1371/jo... (John Ioannidis, Why Most Published Research Findings are False, cold shower to the preceding)
I think that at least it is not obvious that sucrose intake should be equivalent to invert sugar intake. In order for sucrose to be saccharified, the enzyme sucrase must be produced; in order for sucrase to be produced, some internal regulation must occur; if some internal regulation occurs, other effects are at least possible. But no such effect has been clearly demonstrated as far as I can tell.
normie3000
> Yes, I'm questioning if high fructose corn syrup is worse for the body than table sugar.
Study is from Sweden. I think high fructose corn syrup may be a North American thing.
Mistletoe
>Because of its low cost and long shelf-life, HFCS is used widely in manufacturing many food products, including candy, throughout the United States. However, due to strict EU regulations, HFCS is banned in much of Europe, including Sweden.
LargoLasskhyfv
> due to strict EU regulations, HFCS is banned in much of Europe, including Sweden.
May be the case for Sweden, but the 'strict EU regulations' ceased to exist in 2017.
I'd guess that applies to 'much of Europe' too, then.
That aside, we always had https://en.wikipedia.org/wiki/Inverted_sugar_syrup , which is frowned upon by many.
yieldcrv
Could HFCS become a Schedule I substance regulated by the DEA?
oblio
Under the new administration the DEA (and FDA, etc) risks going extinct.
rqtwteye
The DEA may grow because they may start the war on drugs back up. FDA and especially EPA are definitely at risk.
adastra22
Have a single source to back that up?
TJSomething
I think the evidence merely suggests that his DEA will be ineffective. His initial pick for head of the DEA, Florida sheriff Chad Chronister, went two days [0] from being announced to be being "pulled out" on account of his lack of experience with the border and his arrest of a megachurch pastor for COVID public gathering rule violation [1].
My assumption is that the GP expects that it will be gutted by the Department of Government Efficiency and/or be significantly laid off via Schedule F conversion [2]. However, rules made earlier this year by the OPM should limit that specific method of getting rid of civil servants [3].
[0] https://www.cnn.com/2024/12/03/politics/chad-chronister-trum...
[1] https://apnews.com/article/chad-chronister-trump-withdrawing...
[2] https://www.axios.com/2022/07/22/trump-presidency-schedule-f...
[3] https://www.govexec.com/workforce/2024/04/opm-issues-final-r...
jillesvangurp
> I think high fructose corn syrup may be a North American thing
It is. It's not a common ingredient here in Europe or most places in the world. Corn syrup is a weird side effect of subsidized corn farming in the US. This causes all sorts of health issues in the population.
Anyway, you'd struggle to find it in supermarkets or in food outside the US. Even coca cola doesn't use corn syrup in it's beverages outside the US. As far as I know, there is no major taste difference and I've never heard any US people complain about their coke tasting a bit off outside the US. But I don't drink cola that often myself.
LargoLasskhyfv
Have you ever heard of https://en.wikipedia.org/wiki/Inverted_sugar_syrup ?
( https://de.wikipedia.org/wiki/Invertzucker#Verwendung )
It is listed on so many labels as ingredient that it is really hard to avoid.
dylan604
> As far as I know, there is no major taste difference and I've never heard any US people complain about their coke tasting a bit off outside the US.
Apparently, you are not well informed about the happenings across the pond. It is well known that Coke made in Mexico uses sugar, and it is a known thing in the US to get Mexican Coke. There used to be a small plant in Dublin, Texas that made Dr. Pepper with sugar that was a well known for the different taste. Eventually Dr. Pepper won it's case against the Dublin plant and it is no longer available.
To claim that there's no taste difference between sugar vs HCFS just shows you're not well informed on the topic.
rileymat2
It is not straightforward, psychology plays a big part in perception. https://www.seriouseats.com/coke-vs-mexican-coke#toc-what-do...
> Regardless of what was actually in the serving containers, people stuck by their original choice. Those who preferred what really was the Mexican Coke the first time (we'll call these guys the Mexico Boosters) unanimously picked the Coke that I told them was the Mexican Coke the second time, whether it really was or was not. Even when the containers were completely removed from the test and the Coke was served in plastic cups, the Coke labeled as Mexican was picked by the Mexico Boosters every time.
sickofparadox
Dr. Pepper does make, in limited quantities, its own version[1] of the real sugar deal. It isn't stocked at major supermarkets - in fact, I've only ever bought it at a liquor store in Texas. It's fantastic!
[1] https://www.drpepper.com/s/products/dr-pepper-made-with-real...
jdougan
US people who have expressed opinions on the matter near me claim to like the taste of Coca Cola from other countries better. Specifically Mexican Coke, though I've heard similar sentiments with Canadian Coke.
bluGill
Corn syrup isn't about corn subsidies, it is about sugar. Sugar has large tariffs which makes core syrup cheaper in the US.
infecto
We are just making hypothesis here but I doubt its that. HFCS has been looked at a lot and while there are amounts of people that think it can make them sick, I don't believe in normal doses it does harm in the base case.
The easier explanation is that most "treats" are low glycemic as they are paired with a fat. Where with a can of coke you are ingesting 40g of sugar mixed with some flavorings and water.
simmerup
There are some people that argue this actually. Dr Fungs book on type 2 diabetes goes into it.
Basically his take is that while glucose can be distributed in the bloodstream, fructose is broken down by the liver. With high intakes of fructose comes an overwhelming of the liver and higher incidence of fatty liver plus visceral fat. And those things are highly associated with bad health outcomes
Worth a read if you’re interested
Wolfenstein98k
There is not much evidence that it does any unique harm when you calorie-match it to regular sugar.
shlant
yea I think people concern themselves too much with glucose vs fructose vs sucrose etc.
chithanh
tl;dr It's the acid. Drink only water.
The issue is that soft drinks are generally bad for cardiovascular health, whether sugar sweetened or not.
https://doi.org/10.1001/jamainternmed.2019.2478
Plausible mechanism is that acidic drinks cause tooth enamel degradation, and poor dental health is a known risk factor for cardiovascular disease.
zug_zug
> that many of those with the lowest intake of treats were on a diet due to bad health
I haven't read this study, but any study that isn't complete garbage normally would examine the to groups across all variables (age, gender, weight, health, etc) and deliberately control for any systematic differences between groups.
tuukkah
You can never control for all variables when humans are involved. (You can only control for variables that your data contains.)
EDIT: From the article: "[There's a] need for future research to incorporate more accurate measures, such as urinary sodium excretion, to more precisely assess the impact of sodium intake as a potential confounding factor."
nerdjon
One of the best things I did for my diet was to try to rein in all of the places that sugar was snuck into my diet so when I want to get a candy bar or a soda I can not feel bad about it.
My best example of this is peanut butter. I love peanut butter but started making my own with just dry roasted unsalted peanuts and a small amount of salt.
Still enjoyed the things I wanted and fully sustainable. Didn’t actually eliminate anything and no “cheat” days.
Somewhat recently I had a PB craving so I got a jar. Was shocked at how sweet it was.
russell_h
Does peanut butter often have added sugar? I’ve got Kirkland and Adam’s in my closet and am 99% sure neither lists that on the container.
MR4D
You are correct - Kirkland’s has no added sugar. [0]
[0] - https://www.nutritionix.com/i/kirkland-signature/organic-pea...
pkaye
Despite the no added sugar, I always found it pretty sweet despite no added sugar. So I just looked it up and they use Valencia peanuts which apparently can taste sweeter.
adastra22
That’s the back door for an organic products. Source varieties that are naturally sweeter, then you don’t have to list the sugar as a separate ingredient.
ugh123
Lately i've been avoiding all peanuts (and Kirkland's in my house) because of the saturated fat content, but i'm never sure if its that necessary.
pmg101
Saturated fat is very good at making you feel full. I view peanutS/PB as a snack-displacement food: if I'm roaming around for nibbles, some sat fat will kill my cravings and reduce the likelihood of eating sugar. But ymmv
globular-toast
This is one reason working in an office can be a disaster if you're someone who would "roam around for nibbles". In every place I've worked there has been a vending machine or otherwise easily accessible junk/sugar dispenser. In my eyes these are no different from having a cigarette machine or a gambling machine or something, but not everyone sees it that way.
In my house there is no ready-to-eat food at all. I'm not just going to go to the kitchen and cook a potato when I feel a bit peckish.
But this seems difficult for many people. Personally I find hunger to be a normal part of every single day. I don't fear it or feel the need to squash it the moment it arises. I also don't feel any discomfort when I'm not surrounded by ready-to-eat food at all times. But many people do seem to feel a constant need to have food available and find it deeply uncomfortable if the next meal doesn't seem readily available.
r00fus
If you're good with handling hunger - that's great!
A lot of people get hypoglycemic (ie, irritable) when low on blood sugar, so for them, snacking is an acceptable evil (esp. if only healthier snacks are stocked).
For me, I find whipping up some dill/garlic/mayo dip + cut carrots, or celery + good PB a meaningful snack.
My guideline is to try to find a good carb/fiber ratio (pref: 5:1), and avoid added sugars.
globular-toast
People without diabetes don't get hypoglycaemia. I believe you can train yourself to expect food at certain times. I eat two meals a day and only get irritable (hangry) around those times.
But anyway, what you've written is basically my point. If you want/need to snack then unless you think ahead and make healthy snacks available then it's going to sugar/junk that you find in the socially acceptable junk machine.
pmg101
I have a BMI of 20 so I'm not trying to avoid calories. However I do try to avoid sugar, UPFs, and so on, because what benefit would there be in putting that crap in your body.
r00fus
Man, the evil that was done to diets by the sugar industry in the 80s is still paying dividends.
Saturated fats, like anything, are bad in excess. However, avoiding them completely is bonkers - and leads to people replacing (ok) fats with additional eating - mostly with sugary snacks.
inferiorhuman
Peanut butter and mayonnaise both often have added sugar in the United States. You can find brands without but they're less common.
seizethecheese
It depends on the grocery store. Fancier “natural foods” stores in Seattle have very little peanut butter with sugar added
inferiorhuman
Right, that's addressed by the second sentence.
seizethecheese
Is it? The point is that the availability depends on the retailer, not just that they “can” be found. In some places there’s one brand and others there are many.
inferiorhuman
Yes.
seizethecheese
I think you responded without reading the whole comment, or are purposefully trolling?
inferiorhuman
I'm responding to the question of "is it". Go be overly pedantic somewhere else.
r00fus
Any "shelf-stable" or "no-stir" peanut butter (aka Jif brand) will likely contain sweetener and also palm oil.
You don't have to make your own peanut butter but it tastes even better than a good peanut butter like Kirkland/Adams/etc. Some stores allow you to grind nuts on-site (almond/peanut) and charge you for the output.
PaulStatezny
Yes, at least in the USA it almost always has added sugar.
holler
Not true, you can find unsalted organic peanut butter w/o any other ingredients at WholeFoods and elsewhere.
tuukkah
Your statements are not contradictory: products at WholeFoods etc. are a minority in the big picture.
russell_h
At a glance I think you’re both right. Apparently I’ve been buying the good stuff by accident.
PaulStatezny
Totally!
And it's all upside (your body feels better afterward) no downside. (Ok, it's more expensive.) Especially when combined with other sweet ingredients, e.g. a banana – equally if not more delicious.
christophilus
I only buy 100% natural peanut butter with only peanuts and some salt. Every grocery store I’ve ever been to carries this— even the budget stores.
euroderf
It gets worse. PB from the UK can have cane sugar and also palm oil.
What I've read is that peanut oil is valuable as an industrial lubricant, so they siphon it off, replace it with palm oil, and then use sugar to obscure the flavor change.
UK PB is NFG.
Kenji
[dead]
didibus
These are such interesting results. The plot only thickens.
- Sweetened beverage were linked to cardiovascular disease
- Table sugar, honey, jams, and marmalades were a little linked
- Pastries, ice cream, chocolate, and sweets were negatively correlated
vineyardmike
I wonder if this is more correlation with the “transport” medium.
Pastries, ice cream, etc are high in fats, and thick, so they may break down and get absorbed by the body slower while soda is just sugar water so it may flood the body faster.
Alternatively, maybe it’s a time-of-day thing? A dessert you eat after a meal means you’re consuming it on a full stomach while a snack is consumed empty.
resoluteteeth
> Pastries, ice cream, etc are high in fats, and thick, so they may break down and get absorbed by the body slower while soda is just sugar water so it may flood the body faster.
It's definitely not impossible this is the reason. Fat massively affects how fast sugar gets absorbed and this is something that seems to not have gotten much attention in terms of nutrition in general despite things like gi index (which just looks at individual foods in their own).
If the thing that makes sugar bad is spiking blood sugar too much, it could be that how/when people consume it isn't being considered enough because of the assumption that it's always bad and needs to be eliminated as much as possible in general and so there's no point in trying to identify situations where it's not as harmful.
But it could also just be some sort of issue with this study.
forgotoldacc
As a person who loves pastries and ice cream but drinks no sweetened beverages, while I have doubts whenever I see studies that say "XYZ food proven to be healthy", I'm going to hope this is true.
seizethecheese
Ice cream is actually a low glycemic index food. Chocolate is surprisingly low, too.
adastra22
Last time I made ice cream myself it required an insane amount of table sugar. I tried less sugar and it didn’t have the right consistency. Sugar is needed to keep ice crystals from forming.
If you want GOOD ice cream, you need sugar. Or maybe antifreeze. But I’d rather have the sugar.
seizethecheese
Yes. It has a massive amount of sugar but the “cream” in ice cream is fat. The fat slows the absorption of sugars enough to make it actually lie glycemic index
tonyedgecombe
On the other hand it makes the food very palatable so we are prone to eating a lot of it.
adastra22
Interesting. Thanks.
buu700
I use inulin fiber sweetened with stevia and monk fruit [1], which measures 1:1 for sugar with equivalent sweetness, and the results are excellent.
I know what you mean, though. Years ago I used to just use liquid stevia, and texture was never quite the same.
More to the parent comment's point, there's a big difference between ice cream and something like hard candy or soda. Calories being equal, ice cream (even with full sugar) is going to be much better for you due to the proportionally higher fat and lower sugar content. A friend of mine once lost a lot of weight by going on an "ice cream diet", which wasn't quite keto but I imagine likely a bit closer to it than a standard American diet.
1: https://www.lowcarbfoods.com/low-carb-white-sugar-sweetener-...
tuukkah
Thanks! This nicely sums up an issue with these food-frequency questionaires:
> admitting to eating ice cream might correlate with metabolic health
That is, ice cream might well be bad for you but if you experience the bad effects, you might stop admitting that you eat ice cream and thus add an opposite data point in the study.
8f2ab37a-ed6c
> Negative linear associations were found between treats intake (pastries, ice cream, chocolate, and sweets) and all outcomes, and between toppings intake (table sugar, honey, jams, and marmalades) and heart failure and aortic stenosis.
Is all I wanted to know, study confirms my beliefs. Back to the pastry shop for me.
vouaobrasil
I still believe in reducing added sugar intake as much as possible, simply because cardiovascular disease is not the only metric that we should be judging sugar. Eating it less for instance has made my energy levels much more stable. And of course, reduces dental problems.
Wolfenstein98k
1) I always read this publication's name as "Frontier Sin".
2) "Added sugar intake was positively associated with ischemic stroke and abdominal aortic aneurysm, although the highest risks of most outcomes were found in the lowest intake category."
????
devmor
Does not surprise me at all - just because too much of something is bad for you does not mean that some amount of it isn’t essential for bodily function.
lolinder
I wouldn't jump to this conclusion too quickly, because there are a lot of possible confounding factors and possible reverse causality at play here.
For example, it's entirely plausible that being at high risk of any of these diseases would cause people to cut back on their sweetener intake into the lowest consumption bracket, leading to unhealthy individuals showing a bimodal distribution (those who cut back dramatically on advice from doctors and those who have very very bad habits) while healthy people have a more typical curve.
ertgbnm
This is a common phenomenon for most things because the people in the lowest intake category of a thing are normally there for a very specific reason.
For example, people who don't drink any alcohol are more likely to die than people who drink a little bit. Why? Because people who don't drink at all tend to be those with liver damage or former alcoholics who have already done permanent damage.
I suspect a similar explanation here. People who avoid added sugar probably have other health complications going on that force them into the lowest intake category.
1209412comb
>highest risks of most outcomes were found in the lowest intake category
If I am reading this right, it means small amount is even worse than a lot of it.
mrcode007
You’re reading it wrong. Our body requires no added sugar consumption to function properly. Period.
I know, it may come as a shocker to many (most?) people.
https://www.heart.org/en/healthy-living/healthy-eating/eat-s...
shlant
> I know, it may come as a shocker to many (most?) people.
Who argues that added sugar is required by the body? I think you might be conflating people who argue that the body requires glucose to function.
mrcode007
Indirectly saying lower sugar intake had higher risks and so on but we know you can live just fine without any added sugar consumed without any risks. Some comments above asked if that is the correct reading and the science provided us the answers to this question a long time ago and the answer is no; eating no added sugar is healthy and you will be fine.
You don’t have to take my word for it; you can take one of UCSF professor Lustig.
https://robertlustig.com/metabolical/
Edit: yes of course, glucose is the energy of life but you don’t need to consume it. I think all(?) carbohydrates break down into glucose; ergo you can get it from broccoli. Simple test is blood glucose finger prick test after eating.
But I did mean that there are people that argue that you need added sugar for proper nutrition. These people exist.
shlant
> You don’t have to take my word for it; you can take one of UCSF professor Lustig.
the guy who claims fructose is poison? I won't be taking that source at face value. You are revealing your bias very plainly (which was already pretty obvious with your initial smug comment)
> These people exist.
If they do, they are such a small group they are not worth mentioning let alone claiming "it may come as a shocker to many (most?) people."
mrcode007
To start: https://www.aatbio.com/resources/toxicity-lethality-median-d...
To finish: there are already numerous studies documenting that fructose is not that good for you; it is, after all part of high fructose corn syrup…
shlant
you reference "numerous studies" while sharing none of them and instead post the LD50 of fructose? you can't be serious. With that logic, everything is poison and you aren't making any point at all.
mrcode007
Is this good enough for you mister smarty pants?
Published: 04 December 2024
Dietary fructose enhances tumour growth indirectly via interorgan lipid transfer
https://www.nature.com/articles/s41586-024-08258-3
Edit: for what it’s worth if you’re curious you can google most of these things yourself unless you don’t know how to but it is neither my responsibility nor my job to find these things for you or convince you. It is your job to convince yourself. If you pay me enough, I can work trying to convince you. In general I was trying to raise awareness of a fact as a form of „public service”. You are welcome to believe what you want and don’t have to agree with anything I say. But you’re are not welcome to be lazy and expect me to find things online for you.
shlant
> Is this good enough for you mister smarty pants?
lol a study on rats? for someone who sees themselves as doing a "public service" and telling everyone to "do their own research", you sure don't add much to the conversation. It's ok, I knew that to be the case from the get go. Good luck on your crusade.
mrcode007
It’s not a crusade :) but you do start sounding like a sugar industry shill. You can’t possibly justify, in good faith, giving humans cancer as a precondition for a study that the main thing to check is if sugar accelerates it?
If you want human studies here’s one:
The negative and detrimental effects of high fructose on the liver, with special reference to metabolic disorders:
https://pmc.ncbi.nlm.nih.gov/articles/PMC6549781/
As I said earlier, learn to google yourself.
devmor
Carbohydrates are sugars, and are required to live.
hollerith
People dont need to eat carbs to stay alive: most tissues can run on fatty acids and ketones, and the body can make glucose (slowly) from protein.
Dietary fiber is technically carbs (that the human body cannot digest and burn) and if a person eats no fiber, his gut microbiota withers, which is pretty bad, but won't kill him any time soon.
devmor
Sorry, let me rephrase - sugars are necessary for a pleasant and significantly healthy life.
hollerith
Did you mean to write sugars specifically as opposed to carbs that can be used to supply energy to the human body?
I.e., wouldn't enough rice and potatoes suffice?
AuryGlenz
I mean, they have charts showing exactly what they say, so they’re definitely not reading it wrong. Who knows what that’ll cause is though.
donatj
About ten years ago I gave up sugary sodas "for my health" at the behest of my doctor. Almost immediately, I gained a pretty significant amount of weight, rather than losing any. The opposite of what I was told would happen.
I am near certain that the rest of my diet didn't shift in any significant fashion, certainly not enough to replace the caloric intake of 2 to 3 sodas per day and the soda itself was largely replaced with black coffee.
Anyway I don't know what to take from this. I have not gone back to drinking soda, and I never really lost that weight. I suspect that our diets might be more complex than we realize though. I am not a doctor, your mileage may vary.
CharlieDigital
I didn't buy this at all.
Weight is a function of calories in and calories out.
If you removed the calories from sugary drinks from your diet and kept the same level of activity, you will lose weight. Conversely, if you replaced those calories or reduced your activity, you will maintain weight.
More than likely you unconsciously compensated for the loss of calories elsewhere in your diet.
Pooge
Experts like Dr Giles Yeo would disagree with you on the subject.
Processed food contributes more to weight-gain than would the same amount (in terms of calories) of a non-processed one.
Increasing physical activity has NOT shown that it's a good way to lose weight. Being mindful of what you eat, on the other hand...
A friend told me he wouldn't eat nuts because they are too caloric... ????
CharlieDigital
> Processed food contributes more to weight-gain than would the same amount (in terms of calories) of a non-processed one
The type of food and additives (ultra processed vs raw) can affect factors like satiation, water retention (not body mass), energy levels (and thus affect expenditure), etc. But for your body to gain cellular mass ("gain weight"), you necessarily have to have an excess of calories (calories consumed > calories expended).
Pooge
> It's all calories.
Except that it is not. X calories of refined food would contribute more to weight-gain than would X calories of almonds.
Taking directly from Dr Giles Yeo's book:
I’m not asking anyone to count calories at all, because the number of calories, simply taken in isolation, and out of context from whence they came, is not a particularly useful piece of information. Don’t get me wrong, calorie information does of course have its place. For one thing, calories are useful in quantifying portion sizes, so a 200-calorie portion of French fries will have twice the energy as a 100-calorie portion of fries.
[...]
[We] now know that the Atwater factors, both general and specific, are inaccurate, because they don’t take into account diet-induced thermogenesis (DIT), which is the energy, given off as heat, that is required for the metabolism of food. Fat has a DIT value between 0 and 3 per cent, meaning that for every 100 metabolisable calories of fat, it will cost between 0 and 3 calories to process. The DIT value for carbohydrates is between 5 and 10 per cent, meaning that for every 100 metabolisable calories of carbs, it will cost between 5 and 10 calories to process. While protein has the highest DIT value at 15 and 30 per cent, meaning that for every 100 metabolisable calories of protein, it will cost between 15 and 30 calories to process.
CharlieDigital
You're completely reading this wrong.
Yeo and most nutritionist would agree that certain foods provide "higher quality" calories and certain foods provide "lower quality" calories that affect things like your perceived satiation and energy levels.
But at a chemical level, the fat, protein, and carbohydrates function exactly the same way because at the cellular level, there are only so many chemical pathways to produce energy.
So yeah, eating the equivalent caloric amount of almonds vs fries leaves you feeling different levels of energy and satiation. Your body may even absorb the calories at different rates. It'll receive more proteins and fats from the almonds and more carbohydrates from the fries. But if your body expended more calories than you absorbed, the net effect is a loss of mass.
Pooge
> But if your body expended more calories than you absorbed, the net effect is a loss of mass.
Yes, I agree with this. This is called Net Metabolisable Energy[1] and is something mentioned in the book.
I think I said it badly, because I still think calories matter. Just that it matters more what kind of food you're eating rather than just reading the food label.
ltbarcly3
You are incorrect and there is an almost endless amount of evidence that you are incorrect.
In one study they fed rats 90% of their calories from HFCS and they had no health consequences so long as the total calories were controlled to be the same as thr non HFCS group.
The "type of calorie" theory is generally proposed by popular psuedo science articles that appeal primarily to overweight people who are looking for easy answers that don't require them to do something challenging. Meanwhile people on ozempic lose weight while eating junk. Your body doesn't care where the calories come from, all that matters is that you don't eat too much.
Pooge
> The "type of calorie" theory is generally proposed by popular psuedo science articles that appeal primarily to overweight people who are looking for easy answers that don't require them to do something challenging.
"Pseudo science" like a guy who got an OBE for his research? That's a first one.
By "something challenging", are you referring to physical activity? Physical activity is good and must be done whether or not you need to lose weight. The point is that physical activity alone is not enough.
dgfitz
> By "something challenging", are you referring to physical activity?
I believe they are referring to self-control about the foods consumed. Were you being willfully obtuse about this, given this entire sub-thread is about calories and you're deflecting to exercise?
Pooge
> I believe they are referring to self-control about the foods consumed.
Then I don't understand how "overweight people avoiding something challenging" would use the excuse of the "type of calorie". It's a much harder concept to understand that fat, proteins and carbohydrates are absorbed differently. And you would also need to calculate it manually as packages don't take into account the difference of the composition of the food.
> Were you being willfully obtuse about this, given this entire sub-thread is about calories and you're deflecting to exercise?
Excuse me, but I am not the one who originally mentioned physical activity. In fact, I cited 2 paragraphs of a book I read talking only about calories absorption, and only 1 sentence of my comments was related to physical activity. Is that insufficient for you?
ltbarcly3
By "something challenging" I was, very obviously, referring to restricting calories to create a deficit.
dgfitz
You can die on this hill, you're just wrong. Doesn't bother me, my weight is fantastic.
Pooge
> You can die on this hill, you're just wrong
I think you replied to the wrong comment because I didn't make any point in the one you responded to. It's whatever, because I'm not alone on this hill and many nutrition experts agree on this. And I've chosen to give them credit and believe them as I'm not an obesity researcher.
> Doesn't bother me, my weight is fantastic.
No one asked.
ltbarcly3
> No on asked.
I think he was just expressing frustration that the people who seem to have the most 'knowledge' about weight loss also seem to be the people who are not able to manage their own weight. This is despite the fact that controlling your weight is incredibly simple to do, it's literally "do the most obvious thing". The truth is that this is very hard to do, and in the face of an inability to control their own behavior they instead convince themselves that there's something very complicated going on.
Pooge
I agree a lot with what you say. I will take another sentence from the book because I agree with it and have noticed it first hand after changing my diet:
> If you focus on health, your weight will take care of itself
There are some mornings when weighing on the scale where I notice that I lost more than 1kg (compared to 24 hours before). More often than not, I didn't even have a so-called "cheat meal". I eat healthily 95% of the time, so even if I eat junk food and gain 800g in a day I know I'm going to lose them by just sticking to my usual healthy habits.
I guess this was just a really long way of saying: fluctuations in body weight don't matter day-to-day if you stick to a healthy diet.
Taking into account my body weight (I'm lean, with muscles, and shorter than average for a man), I eat way more than I should be. My rice portion, which is a side, is sometimes as much as 250g. And this is about half my plate. Then I eat fruits, nuts during the day. All this after having eaten oatmeal for breakfast (about 100g). Dinner is a bit smaller than lunch but I eat at least twice what my parents would eat (granted, they are older).
dgfitz
I responded to the right comment. Take care!
r00fus
If you re-read what you wrote, then the point of calorie counting is simply usesless - because satiation and energy levels contribute to the other side of your calorie equation (you likely expend more energy).
Calorie counting is like counting MIPS or Mhz in a CISC architecture - when the IPC varies based instruction types processed - it's an incomplete (and IMHO useless) view.
CharlieDigital
> If you re-read what you wrote, then the point of calorie counting is simply usesless - because satiation and energy levels contribute to the other side of your calorie equation (you likely expend more energy).
In other words, you can lose weight even without exercise (increase in expenditure) as long as you decrease your consumption below your baseline caloric needs.
polishdude20
To add on to this, what about absorption? Like, calories in is important but are there foods that have a certain number of calories when measured in the lab but we actually don't extract all those calories in real life? Does gut microbiome have an effect? What about gut permeability ?
dbspin
I see this repeated all the time on Hackernews and this is absolutely not the case. Aging, gut microbiome changes and an enormous variety of medications can directly induce weight gain - while diet and exercise remain the same.
CharlieDigital
> ...aging
There can be no other way for the body to gain mass if not for caloric intake. Zero. You cannot gain any meaningful mass from water and air. Body mass is a conversion of ingested proteins, fats, and carbohydrates (along with other micronutrients); remove excess sources of protein, fats, and carbohydrates and the body has no mechanism to store excess energy.
dbspin
Right - we're in agreement. There are numerous factors which influence metabolic activity, all of them can influence weight gain or loss independently diet and exercise.
CharlieDigital
It's still calories in vs calories out.
You age and the calories out decreases; therefore, to maintain a stable body mass, your calories in must decrease as well. If you do not decrease calories in, then the result is gain in mass due to storage of excess calories.
Calories in, calories out.
dbspin
That's reductive to the point out outright inaccuracy.
The calories you consume affect your weight differently depending on your level of metabolic activity. So the key mediator here is how your body processes the calories you consume.
But talking about calories is wrong in any case. All calories are not the same. For example increasing glycemic index by consuming sugars and carbohydrates will lead to greater and more prolonged weight gain than consuming the same calorific load in protein - https://pubmed.ncbi.nlm.nih.gov/12081852/
It's simple misinformation to focus on calories rather than carbohydrate levels, physical activity, healthy gut bacteria etc.
ltbarcly3
Sorry but you are not correct. If you find the number of calories you burn daily with your current diet, and you eat 500 calories below that, I will bet you $1000 that you can't find any combination of foods, whether its pure corn syrup or pure hog fat or anything else that cause you to gain weight as long as you keep the calories below that threshold. I'll bet another $1000 that there are no foods you can find where you don't gain weight eating 500 above that threshold.
Show me the study that says otherwise. The "complex interaction" theory is just an excuse used by people for failing to cut calories enough to lose weight. Notice that people taking GLP1 drugs don't have to adjust for all these complexities at all.
marsovo
So certain are you? How are we measuring the calories for this bet, by what's on the package?
How does that number on the package get measured?
When I eat nuts, cashews, etc., did 100% of the food get digested and absorbed? A day later or so, there seems to be counterevidence of that plainly visible in the bathroom.
ltbarcly3
You are mixing up 2 issues here. We're not debating what % of food gets digested, so it's off topic.
We are talking about the theory that if you eat fructose, or if you eat 'highly processed foods' there is some complex hormone response that causes those calories to be preferentially stored as fat or to slow the metabolism down so they aren't burned.
For sure you are correct when you say that the calories on the label of a food is just an estimate, and not a very good one.
Pooge
> You are mixing up 2 issues here.
When people talk about "restricting your caloric intake", they are very obviously talking about what's written on the package and not after making calculations based on whether it's fat, protein or carbohydrates. So I think both issues are very tightly related.
ltbarcly3
I was hoping I gave myself plenty of buffer by making it 500 calories of deficit (which is pretty large), but maybe you can teach me something new.
What's the diet you would eat every day to get into a calorie surplus even though you are in >500 calorie deficit according to the labels?
Pooge
Unfortunately I never look at the calories on the label as I only look out for salt and proteins.
However, you can make the calculations based on the numbers I gave in my other comment - which are taken from Why Calories Don't Count from Dr Giles Yeo.
ltbarcly3
I think you still can't overcome 500 calories of deficit. If you ate pure protein you will still be in 150 calories of deficit using the most conservative numbers (30% overhead to process protein).
But this is assuming you calculate your daily calorie burn with one diet that is pure protein and then convert to one that has 100% calorie availability, you still can't overcome 500 calories of deficit on paper!
Realistically you would change diets, then find your baseline based on the new diet, and then calculate a calorie deficit from there. In that case you would be very close to a 500 calorie deficit, and you would unavoidably lose about 1lb of fat per week. A 500 calorie deficit sucks but you will adapt to it in a few months if you stick to it. I've managed to lose over 50lbs in the last year, probably close to 75lbs of fat mass. (I did use a GLP1, dieting is hard)
Pooge
It's worth noting that our metabolisms slow down when we start losing weight so it gets harder and harder to lose fat.
ltbarcly3
Our metabolism slows down primarily because it takes more energy to keep a fat person alive than it does to keep a healthy person alive. After you lose 20% or more of your body weight you might start to notice this, it isn't a real concern. The effect is negligible and again notice that people taking drugs thet let them comply with a calorie deficit diet don't have to resort to excuses like this to explain a failure to lose weight.
The cause of a failure to lose weight with moderate calorie restriction is always a failure to maintain the calorie restriction aka cheating on the diet (because it is incredibly hard to do when you aren't used to it).
Pooge
I think you know more than me on the subject. I have never cared about calories in my life and never really cared about my weight.
I lived abroad for a year and, when coming back home, started eating healthily (i.e. more greens and less reds, avoiding added salt). In about 3 months, I managed to reduce my weight by 10% - about 6kg. Although I have to admit, if anything, I wanted to keep those kilograms because it was helping me for weight-training lol. My objective was never to lose weight.
sabbaticaldev
> I'll bet another $1000 that there are no foods you can find where you don't gain weight eating 500 above that threshold
oh well, you lost money then. It is not even difficult to understand, some types of food/digestion/absorption will hold more or less water weight to the body so it’s possible to lose total weight even eating above the daily needs, for example a nocarb diet
Kirby64
It's not reasonable to account for water weight gains in talking about weight loss. Water weight is transient in that it will reach some maximal state, and often times it is only at the onset of a diet change (i.e., the first day or two) and then it comes right back off. Weight in general flucuates a LOT more than people think. My weight can flucuate by as much as 1-2 lbs per day, even while eating the same exact meals. The only appropriate way to look at weight gain/loss is on a weekly sliding average... and at a 500cal deficit per day, you almost certainly would see that weekly average change downwards.
sabbaticaldev
I don’t disagree with you just replied that by logic it is indeed possible to gain or lose weight depending on the type of calories you ingest
Kirby64
But it’s not when we’re talking about this in the context of weight loss/gain. When people colloquially say “gain weight” or “lose weight” they almost always mean gain/lose fat and/or muscle. Water weight is neither of those, and is generally bounded (unlike fat loss/gain).
Whether you gain or lose weight through water weight has little to do with calories at all. If you take creatine, for example, it’s pretty normal to gain a few pounds of water weight until your creatine levels equalize in your body. That doesn’t mean that your body’s “metabolism” changes or something based on the calories you ingest. You’ve just got another pathway to gain/lose apparent weight, albeit temporarily.
ltbarcly3
I'm going to guess people find you overly pedantic?
JeremyNT
It's a tiresome bit of pedantry.
Try this: when people on hn claim "ah but it's not calorie intake versus calorie expenditure!" you can assume in good faith that what they REALLY mean is "you are correct that it IS calorie intake versus calorie expenditure, AND there are subtle factors which impact both how efficient your body is at extracting energy from food and how efficient it is at performing work"
It's unlikely for the poor grandparent poster that they unlocked some latent ability to extract calories more effectively by reducing their sugar intake, and of course Occam's razor SUGGESTS that they simply started consuming more or exercising less to compensate, but there ARE reasons we study things like this.
dbspin
Strongly disagree - I've seen and had this argument multiple times on HN. There absolutely are a large cohort of people who do not accept that there are any factors other than 'calorie in, calorie out' that affect weight.
Side note - this is remarkably similar to the 'when we say abolish the police, we mean abolish the police' conversation from a couple of years ago. In other words a classic motte and bailey.
If we're going to have sensible conversations about diet and weight gain. Which socially in the West we are long past the necessity for, we need to start addressing these issues holistically. The pedantry here is the repetition of silly mantras like 'calorie in calorie out' or 'just exercise'. The nuance required is understanding - and indeed researching how the composition of diet, the pricing and availability of nutritious food, our perniciously sedentary workplaces etc all contribute to obesity. And more importantly what can be done about these things on an individual and societal level.
Personally - I've found intermittent fasting to be the only way to control my weight. The research consensus seems to be that it's impact is simply through reduced calorific intake. However - this misses the fact that say one meal a day will actually change your gut microflora enough, and relatively rapidly, to reduce the cognitive load of healthier diet choices. You literally get less hungry and want highly processed, sweetened food less. And yes of course there's a complex interaction of motivation, behaviour patterns and so on at work also. This is why systemic approaches are always necessary to behaviour modification.
And just to add - these aren't subtle effects. Age related weight gain, while keeping diet and exercise consistent is something all of us experience. Similarly, most women will experience menopausal related differences in metabolism, usually leading to weight gain. Eliding the reality of how weight gain and maintenance work isn't useful.
infecto
I would have a hard time understanding how other factors would make up a heavier weighting than calories in vs calories out. I am certain there are other factors but I am not certain that those factor have make up the majority.
dbspin
Sure, happy to explain. Here's one example. "The mechanism of antipsychotics-induced weight gain (AIWG) is generally hypothesized by the alteration of glucose metabolism and increasing cholesterol and triglyceride levels." https://pmc.ncbi.nlm.nih.gov/articles/PMC9170991/#:~:text=Th....
The problem seems to be that people confuse psychical activity with metabolic activity. The body isn't some kind of linear internal combustion engine. Numerous disease processes, medications etc will alter metabolic activity. A classic example is weight loss due to hypothyroidism.
infecto
I am not disagreeing that there are other factors and in some tail cases, like people who take antipsychotics, it may have larger weightings but fundamentally we are talking about caloric intake. I think we largely saying the same thing but with different views.
CharlieDigital
> ...psychical activity with metabolic activity
ses1984
Evidence?
dbspin
See my responses to other replies. Metabolic activity != physical activity.
Theres a moralistic inclination on HN to view complex descriptions of weight gain as defences of sedentary lifestyles and bad diets. Inarguably both are bad, obesity is bad etc. That's a separate issue from understanding why weight has increased globally - independently of dietary changes - including in both wild and lab animal populations - https://www.vox.com/2015/8/24/9194579/obesity-animals
badlibrarian
Matter cannot be created or destroyed. Unless it's in a Hacker News thread containing the phrase "gut flora."
themaninthedark
Could it be possible that the sugar in the soda was being process by the gut microbes and their byproducts were blocking the absorption of the excess calories? By ceasing the sugar consumption, the byproducts were no longer present and the calories were then consumed by the body?
Matter is neither being created nor destroyed, you are dealing with a bio reactor that has inputs and outputs and the bio reactor doesn't process everything with 100% efficiency.
ses1984
How much biology do you know?
The sugar in soda is already pretty simple, so what would gut flora actually do to it? What possible byproducts could there be from microbes processing fructose? If the sugars were entirely processed by the gut flora then that would generate a ton of heat and gas in the gut that would be uncomfortable at best or most likely just kill you.
Does gut flora influence how nutrients get absorbed? Almost certainly. Is there a behavioral and/or metabolic component to weight loss? Again, almost certainly.
But if you measure how many calories you were eating at maintenance and then eat 500 less per day, you will 100% lose weight. Will you lose a pound a week, the amount predicted by the simple caloric model of weight? You might lose a little less, but you will lose weight for sure.
badlibrarian
Evidence?
scythe
>the soda itself was largely replaced with black coffee.
As unreliable as Internet medical advice always is, am I to interpret that you're drinking coffee at all hours of the day? Sleep disturbances can lead to all sorts of new problems. Coffee has much more caffeine than soda or any common tea. Switch to something else after noon and see if it doesn't help.
AuryGlenz
I drink a can of pop every day as I e found it helps significantly with my IBS. Theoretically it should do the opposite, but apparently my gut micro biome calms down with it.
Perhaps it was something along those lines for you.
soramimo
My kid goes to school in LA. While in theory it's great that they get free food (breakfast, lunches etc), however, I'm absolutely shocked by how much sugar is in everything they offer to kids, in particular for breakfast.
hombre_fatal
I wonder how many HNers accept this evidence but reject the converging lines of evidence across very different study designs (mendelian randomization, prospective cohort, RCTs) that cholesterol (more specifically, apoB) causes heart disease: https://pmc.ncbi.nlm.nih.gov/articles/PMC5837225/
AnthonBerg
Thanks for the paper!
For other readers: To expand on this, the paper in the parent comment is “Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel” (2017) – https://pmc.ncbi.nlm.nih.gov/articles/PMC5837225/
It refers to a second then-upcoming publication, which I believe is this one:
”Low-density lipoproteins cause atherosclerotic cardiovascular disease: pathophysiological, genetic, and therapeutic insights: a consensus statement from the European Atherosclerosis Society Consensus Panel” (2020) – https://academic.oup.com/eurheartj/article/41/24/2313/573522...
The difference between the titles: The 2017 paper discusses genetic, epidemiologic, and clinical studies and the 2020 one looks at pathophysiological, genetic, and therapeutic insights.
(Personally, I’m in the pathophysiology-and-molecular-biology-or-GTFO camp. And these papers are good to have.)
Thanks again! Just thought I’d share this second paper as I’d gone to look for it anyway.
shlant
also pay attention to how most of the big names who discount the causality of LDL regularly criticize questionnaire-based studies (or Nutritional Epidemiology as a whole), but only when it goes against their personal beliefs.
hombre_fatal
True, it's a common theme. But even someone who dies on the hill of FFQs has to contend with mendelian randomization and controlled trials.
erie
Is it the type of added sugar that matters more, because I think they use the cheapest sugars to maximize their profits. But it is not that simple. 'Naturally occurring sugars in fruits and vegetables come with fiber, vitamins, and minerals, which can mitigate some of the negative effects3 Added sugars, whether from table sugar or other sources, provide empty calories without nutritional benefits Sweeteners like fruit juice, honey, molasses and maple syrup contain natural sugar and have some nutritional benefits. Fruit has fiber, vitamins and antioxidants. Even raw honey and maple syrup can contain antioxidants and minerals like iron, zinc, calcium and potassium. https://www.hopkinsmedicine.org/health/wellness-and-preventi...
maerF0x0
Study is loaded with confounding factors, and problems relating it as general advice vs cohort: here's a bunch quickly of the top of head, simply for discussion's sake -- not as a direct criticism of the authors / study.
> Questionnaire-based diet and lifestyle assessments were administered in 1997 and 2009
These kinds of studies are not good because of a number of factors -- Morality of foods (people often answer questionaires with ideals or what they "ought" rather than fact), People are very bad at estimating their intakes, the data is ~15 yrs ago meaning lots of things can change in the interim
> One aspect to take into consideration is however that there is a social tradition of “fika” in Sweden, where people get together with friends, relatives, or coworkers for coffee and pastries (41). Thus, one could hypothesize that the intake of treats is part of many people's everyday lives without necessarily being related with overall poor dietary or lifestyle patterns, and that it might be a marker of social life. Consumption of sweetened beverages, one the other hand, has been linked to lower overall dietary quality (42).
Note that the positive associations were correlated with a _social_ form of eating. We already know folks with strong social connections, and distracting ways to slow life and eating, have better health outcomes. Also consider the zero sum form of eating whereby 100 calories of sugary beverage crowds out 100 calories of nutrient dense food (eg: broccoli). My own personal bias is that this is why vegetarians enjoy some health benefits -- they're simply eating a lot more vegetables (and not because meats are themselves deleterious).
> No mention of adiposity (body fat percentage)
A person with low and stable fat% is likely to have a very different response to sugars than someone with a high fat% (insulin resistance) and instability (yoyo-ing seems to matter albeit unclear how)
> Cohort
Unless you're a Swede of the average genetic profile ~97-09 then there's a gradient of issues related to your differences.
fud101
I believe it. What if you take sugar around and during exercise for performance reasons? Is that still bad or not? I have 30g sugar powder (gatorade).
0_____0
I have this question as well. I drink hi-carb beverages during exercise (had 200g of carb on the bike yesterday). I replace calories at or below parity.
I suspect the benefits of cardio outweigh the issues introduced by sugar, but I don't have the knowledge base to do anything more than speculate.
I've spent some time living in Sweden and I think there's a number of important details here that are not sufficiently highlighted that can radically change how to interpret the results. Swedes have a tradition of eating candy once a week on Saturdays. It's incredibly common for them to not have candy all week, then go buy an assortment bag on Saturday, eat it all, and then not have any again for a week. We don't know how this affects health outcomes compared to say, having a bit of candy every day, the glycemic load profiles will be widely different and we don't know if that matters or not.
Fika, a coffee break with pastries, is a very strong cultural phenomenon. The pastries Swedes have are generally of very high quality and many of them also contain a considerable amount of fat, which as we know, helps buffer glycemic load. While it's mentioned in the study in passing, I think it should instead be one of the core focus points, it's hard to assess the effect of this as opposed to plain added sugar.
And lastly, Swedes are very outdoorsy people. On any day of the week, you can see people strolling on nature trails, of which there are plenty, and spending a lot of time active in general. I would not be surprised if a large part of the health outcomes we see in statistics can be attributed to variance in this.
So to summarize, while these results are interesting, I think there are too many hidden influences here that are not controlled for to really generalize these results in any way.