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Monday’s medical myth: sugar is the main culprit in obesity

The debate about the health implications of sugar consumption began back in 1972 when Professor John Judkin, from the University of London, published Pure, White and Deadly, which linked sugar intake to…

Sugar doesn’t play a greater or lesser role in obesity than fat and other carbohydrates. Esther Gibbons

The debate about the health implications of sugar consumption began back in 1972 when Professor John Judkin, from the University of London, published Pure, White and Deadly, which linked sugar intake to heart disease and type 2 diabetes.

While more recent studies – such as the long-running Nurses' Health Study – have found no such link, there are other important factors at play in the sugar debate.

Since the 1970s, we’ve seen a vast increase in the consumption of sugar-laden soft drinks and a dramatic rise in obesity. Children and adolescents are getting a greater proportion of their energy intake (up to 25%) from sugars, especially from soft drinks.

In Judkin’s day, sugars in biscuits, cakes, desserts and other sweet treats came with some nutrients, vitamins, minerals or fibre. Soft drinks have no such redeeming features.

Overall, the increase in sugar from soft drinks has been accompanied by a decrease in sugar in other forms, so total sugar consumption has not increased.

Not all sugar is equal

Sugar is a sweet, simple carbohydrate that takes three natural forms:

  • Fructose is found in fruits and vegetables such as apples, pears and onions.

  • Sucrose is derived from cane and beet sugar. It’s known as a disaccharide (a molecule of glucose and fructose bonded together).

  • Glucose is the sugar our bodies use to power the brain, heart and muscles. The body needs to tightly regulate its glucose because excessive levels in the blood (diabetes) can damage cells.

Sugar and obesity

So has sugar played a larger role than fat, protein and other forms of carbohydrates in Australia’s obesity epidemic?

Probably not. There has been little change in the proportions of fat, carbohydrate and protein in our diet over the past 30 years. But total energy intake has increased – we’re gaining weight because we’re eating more of everything.

Overall, it seems that total sugar intake hasn’t played an undue role in the increase in obesity.

Domestic sugar consumption fell from 55kg per head in 1976 to 50kg per head in 1984 and it seems to have remained stable ever since (though data is only available to 1996). Sugar production hasn’t increased since 1996 and sugar-product imports are negligible, accounting for just 5% of confectionery and bakery goods.

Soft drinks are the exception and now account for a fifth of the average Australian’s sugar intake. Consumption of soft drinks doubled from 47 litres per head in 1969 to 113 litres per head in 1999.

Sugar and heart disease

There’s no doubt that sugar-sweetened beverages are associated with type 2 diabetes. Studies show women who consume more than one soft drink a day have a 40% to 80% increased risk of diabetes and a 28% to 32% greater risk of heart disease.

But sugar isn’t alone in increasing these risks. Eating large quantities of any carbohydrate with a high glycemic index (white bread, for instance) can double the risk of heart disease and diabetes.

Likewise, consuming large amounts of trans fat has been shown to increase the risk of heart disease by 33%. So sugar in soft drinks increases the risk of disease by a similar amount to trans fat and white bread.

Sugar and weight loss

A 2009 study of the effects of high liquid sugar intake found those who consumed a quarter of their daily energy intake as liquid sugar - either glucose or fructose – were more likely to have a greater appetite and gained around 3kg over the ten-week study period.

They will also notice other metabolic changes, such as increased blood fats and higher insulin levels, which increase their risk of heart disease.

Even when there’s no overall weight gain, excessive consumption of sucrose-based soft drink can raise liver fat. This makes insulin work less effectively, raises blood glucose and can also lead to long-term liver disease.

So will quitting sugar help you lose weight?

Swapping soft drinks for water or even diet drinks will undoubtedly help you lose weight. And cutting out other sugar-containing foods and drinks will help you reduce your total calorie intake because of the associated reduction in starch and fat intake. This will lead to longer-term weight loss.

But removing “natural” sugars – and therefore eliminating nutrient-rich fruits and milk – is not a sensible solution. Sugar, as a nutrient class, does not contribute any more to obesity than an excess of fat or carbohydrates.

Join the conversation

138 Comments sorted by

  1. 6minutes medical

    logged in via Twitter

    Your argument is based on sugar consumption figures that were discontinued in 1996 (why?) and "sugar production" figures. Surely there are more reliable and recent data for sugar consumption - for other western countries if not for Australia. What is the relationship between sugar consumption and obesity/diabetes etc in the US for example?

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    1. Michael James

      Research scientist

      In reply to 6minutes medical

      Rory Robertson has an explanation below in a comment.

      But I think everyone can see where much higher consumption of sugar has occurred--even if, regrettably and frankly completely unacceptably there are no reliable figures on this. Consumption of everything has gone up, especially many items that are youth-oriented and often consumed at fast food places. Namely, the portion size of sugary softdrinks, and the total amount kids drink these days.

      There are more and more snack items that are…

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  2. Clifford Chapman

    Retired English Teacher

    I truly fail to understand these so-called medical myths. They are almost always presented as 'fait accomplis', and there's virtually no feedback, responses, replies, discussions and debates to correspondents from the writers and authors of the original articles, This is not only rude and even offensive - in my view, it makes the academic world seem egotistical and elitist. Half the time they come across as 'straw man' arguments.

    This article, for example, focuses on sugar - God alone knows why…

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  3. Andrew Whitacre

    Communications Director

    Coincidentally, the U.S.'s main TV news magazine, 60 Minutes, carried a story on this last night: http://www.cbsnews.com/8301-18560_162-57407294/is-sugar-toxic/

    It basically backs up a lot of what you write, Peter, though puts a stronger emphasis on sugar's correlation with heart disease, diabetes, and even cancer (in the sense that it powers tumor growth that would otherwise be much slower).

    The years-long American narrative on sugar and health (and I guess Australian as well) is simply "sugar makes you fat, and fat leads to disease". But the 60 Minutes story suggested the opposite cause and effect: sugar leads to diseases, and those diseases makes you fat.

    There was also a great line from a researcher (and I don't know whether this is true or not) that, evolutionarily, human crave fructose so badly "because there is no food stuff on the planet that has fructose that is poisonous to you."

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    1. Denis M

      Satellite Specialist

      In reply to Andrew Whitacre

      That last sentence is very interesting considering that fructose itself could be considered poison. Our bodies cannot process it as they do other nutrients. Instead, it goes straight to the liver and causes similar dangers to alcohol.

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    2. Clifford Chapman

      Retired English Teacher

      In reply to Andrew Whitacre

      I'd like to continue this debate because your comment regarding 'sugar's correlation with heart disease, diabetes and even cancer (in the sense that it powers tumor growth that would otherwise be much slower)' is most revealing, and not just because of how it illustrates just what a crap programme it is, but in what it omits from the issues and questions it supposedly purports to be 'examining', an hyperbole if ever I heard one.

      It even virtually disregards completely from the equation any human…

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  4. philip salter

    Telecoms

    I struggle to see how this article is about a medical "myth" and obesity. In the article you clearly state: "...A 2009 study of the effects of high liquid sugar intake found those who consumed a quarter of their daily energy intake as liquid sugar – either glucose or fructose – were more likely to have a greater appetite and gained around 3kg over the ten-week study period...."
    Isn't the argument (or one of many) about sugar (fructose) in the diet, is that it inhibits one of the sated feedback mechanisms…

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    1. philip salter

      Telecoms

      In reply to philip salter

      It looks like the article was written to get the headline to link myth and sugar, then the body of the article argues against the heading. The heading should have been: "The myth about the myth that: sugar is to blame for our obesity epidemic "

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  5. David Gillespie

    logged in via Facebook

    The disclosure statement on this article says "Peter Clifton does not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article, and has no relevant affiliations."

    However in this study published in 2011 http://www.nutritionandmetabolism.com/content/pdf/1743-7075-8-87.pdf the following statement appears:

    "Flinders University was paid to do the secondary analysis of the Children’s Nutrition Survey by the Beverage Council of Australia and Peter Clifton was paid to write the manuscript by Coca Cola South Pacific."

    That study concludes (in part):

    "[This cross-sectional data set] provides little support to conclude that overweight in children is currently being driven by excessive [sugar sweetened beverage] consumption although it may be factor in some obese children."

    That payment appears to me to be something that should be included in the disclosure statement for this article.

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  6. David Gillespie

    logged in via Facebook

    oh ... and by the way, its John Yudkin not John Judkin.

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  7. Peter Ormonde

    Farmer

    As a recovering economist and former diabetic I'm a bit curious about this "myth".

    My interest has been pricked by the absence of any mention of the switch from cane sugar to High Fructose Corn Syrup in our soft drinks, cakes, tim tams and the like.

    This shift was made economically attractive by the US Department of Agriculture's floor price system which artificially inflates the price of sugar.

    Now I've read some rather disturbing stuff on the internet about how these HFCS products are metabolised. But I understand that just cos it's on-line doesn't mean it's true, particularly when it comes to the narcissistic obsession with what yanks eat.

    I'd greatly appreciate some informed information about the role of HFCS in our diet and the manner in which it is metabolised. Anyone got a clue?

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  8. Denis M

    Satellite Specialist

    The right medicine to cure a myth are facts. And this article could do with a few more. Quoting results from correlation studies does not help either, as they do not prove anything.

    The argument that sugar does not cause obesity seems to be backed up only by sugar production numbers. However, it does not appear to take into account other high calorie sweeteners, such as high fructose corn syrup (HFCS). Furthermore, we may not import a lot of plain sugar, but we do import processed foods that…

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    1. Katie W

      Dietitian

      In reply to Denis M

      Denis - there only very weak/no evidence to suggest that insulin has any response to artificial sweeteners, see:

      Renwick AG & Molinary SM (2010) Sweet-tast receptors, low-energy sweeteners, glucose absorption and insulin release. British Journal of Nutrition, 104: 1415-1420

      Steinert RE, Frey F, Topfer A et al (2011). Effects of carbohydrate sugars and artificial sweeteners onappetite and the secretion of gastrointestinal satiety peptides. British Journal of nutrition, 105: 1320-1328.

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  9. Paul Rogers

    logged in via Twitter

    Peter Clifton's central premise is correct. Over-eating and under-exercising that results in energy excess causes fatness and obesity. Sugar (and it's fructose) is but one element.

    Drinking too many soft drinks is clearly not healthy in many respects, but a diet that meets optimal energy and nutrient needs can include modest proportions of refined carbohydrates with few health consequences, especially when a robust exercise program is incorporated.

    Fructose is not a poison per se. Primates evolved with fructose in fruit as a primary nutrient. The dose makes the poison -- of everything. There are few more potent poisons in food than vitamin A for example. (Ask a polar explorer about dog and bear liver.)

    Reducing the debate on obesity to one element like sugar or fructose will inevitably miss the mark, especially when half-truths are spread to a naive public.

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    1. Peter Ormonde

      Farmer

      In reply to Paul Rogers

      Yes it's all about inputs and outputs Paul.

      It's horrifying when one reads my old CWA cookbooks ... lashings of lard, goosefat (makes the best chips), dripping... would make a cardiologist weep.

      Yet they were the lean languid Chips Rafferty types the characters who consumed this stuff. They burned it off.

      Not any more they don't.

      I live in cattle country. No one rides a horse. Walking is for people who haven't got a 4WD or a quaddie. But the diet is still rooted in the active past…

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    2. Paul Rogers

      logged in via Twitter

      In reply to Peter Ormonde

      Too true Peter. In earlier days it was called "hard work" and now the scientists call it 'non-exercise activity thermogenesis' or NEAT. It's hard to imagine, for most of us, the daily energy expended in cane cutting (oops, sugar) or clearing land by hand.

      I watched a TV program last week about how a small country town was trying to re-invent itself because of hard times.

      Hard times! I could not believe how many of those country folk were clearly overweight.

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    3. Miki Shapiro

      logged in via Facebook

      In reply to Paul Rogers

      Paul

      Depends on what problem you're trying to solve.

      If all you're trying to do is /understand and describe/ the problem, then yes, you need to go to all the required discourse to give ample attention to every facet of the problem.

      That may be what you're trying to do.

      Some people define the problem differently - they want to fix it. And to do that you need to start picking off the causes and doing something about them.

      Fructose is one of the obvious low-hanging fruit in that respect, due to its relationship with our built-in satiety mechanisms.

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    4. Clifford Chapman

      Retired English Teacher

      In reply to Paul Rogers

      This is also spot on the money.

      Are we so besotted with ourselves, that we have little or no real responsibility for what we do or become?

      The issues that are raised, for example, in the deaths of individuals like Whitney Houston recently, and others who have died in similar circumstances, always seem to focus on the tragedy, never on a person's responsibility for what they do or have done to themselves.

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  10. Donncha Redmond

    Software Developer

    The problem with increased sugar intake is its effects on insulin levels and how insulin affects what your body does with the food you eat.

    Why are people "eating too much"? I don't know anyone who sets out to get fat, so why are people habitually eating more fuel than they need?

    I find it odd that our body is quite good at regulating other processes that are essential to keeping us alive, but in the last 40 years has somehow lost the ability to regulate food intake. Could it be that the foods we are eating are interfering with our body's regulation processes?

    High sugar = high insulin = your body favours storage of food rather than using food, ergo you feel hungrier sooner, eat more and eventually end up fat.

    Makes sense to me.

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  11. Peter Ormonde

    Farmer

    This disputed entry from Wikipedia sums up my confusion regarding the rapid onset of diabetes and obesity and the apparent correlation with the widespread application of HFCS.

    http://en.wikipedia.org/wiki/Health_effects_of_high-fructose_corn_syrup

    Don't know the answer myself so I'd appreciate any sagacious advice from someone who actually knows about this stuff.

    On a purely anecdotal level, I have a pretty simple rule of thumb myself - I try not to eat anything I don't grow myself. This involves a lot of fruit. The diet and the physical work seems to have crunched the blood sugar down into manageable normal levels. But mine was not so much an obesity linked diabetes... but I was pumping sugar syrup (38) when they picked it up. This came from a nasty little anti-anxiety med called Zyprexa (keep your eye on that one docs).

    No longer anxious, no longer diabetic but just confused. Seems this goes with the territory. I thought science was supposed to answer questions!

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    1. Paul Rogers

      logged in via Twitter

      In reply to Peter Ormonde

      Not too much difference between HFCS and sugar and I would not expect any significant distinction as far as health impacts are concerned.

      The idea that sucrase splitting of sugar (sucrose) to glucose and fructose takes a little more energy is neither here nor there that I can see.

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  12. Rob Crowther

    Architectural Draftsman

    So will quitting sugar help you lose weight?

    In my personal instance it absolutely will.

    I note the average intake is 50Kg per head. That’s 137 grams per day. Given the recommended intake is about 80 then I would surmise whoever wrote the heading to the article is not paying attention.

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  13. rory robertson
    rory robertson is a Friend of The Conversation.

    former fattie

    Dr Clifton claims" "sugar-product imports are neglible". Yet Coca-Cola Amatil Ltd imports the “concentrates and beverage base for Coca-Cola trademarked products” (note 32 and footnote 3 and 4 on page 84 of 96 in http://ccamatil.com/InvestorRelations/Documents/CCA%202010%20annual%20report.pdf ).

    The ABS stopped counting "apparent consumption" of sugar after 1998-99 (not 1996). In particular, the ABS struggled to know how much sugar was contained in rapidly growing imports of things like bakery…

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  14. Geoff Russell

    Computer Programmer, Author

    Finally, a sensible article on sugar! Thank you Peter.

    There is per capita consumption on sugar from FAO through to 2007. I've plotted it
    with other foods for Australia, Cuba and Italy at the bottom of the following article:

    http://animalliberation.org.au/blog/123-who-owns-diet-guidelines.html

    Italy has an obesity problem, we have one and Cuba is just beginning to have
    one after having done really well until the last decade.
    The Italians eat very little sugar compared to the Cubans who have always
    eaten rather a lot! The obesity epidemic in the US is pretty simple ... too many Calories, too many Calories and too many Calories there has been a surge in corn syrup calories, but it wouldn't have
    mattered what they were, if you sit in front of a computer or TV all day while chomping
    through 4000 Calories of organic fruit, vegetables, whole grains and legumes, you will still get fat.

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  15. Gary Cassidy

    How does this article support the title?

    The second last paragraph actually (without evidence) disputes the title:

    "Swapping soft drinks for water or even diet drinks will undoubtedly help you lose weight. And cutting out other sugar-containing foods and drinks will help you reduce your total calorie intake because of the associated reduction in starch and fat intake. This will lead to longer-term weight loss."

    Various other statements indicate to negative effects of sugar consumption (although not related to the title).

    This article has left a very bad taste in my mouth!

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  16. rory robertson
    rory robertson is a Friend of The Conversation.

    former fattie

    Sorry, Geoff Russell, the FAO data are invalid, no good, unreliable after 1998-99 if not well before; the problem with the FAO data is that the ABS stopped counting because it couldn't find a way to reliably count sugar imports (see my previous comment).

    Before 1998-99, the ABS had originated the "apparent consumption" data while the FAO mostly just collated and distributed that ABS data. (The FAO downloads had to come from somewhere local: the United Nations has better things to do than to count…

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    1. Geoff Russell

      Computer Programmer, Author

      In reply to rory robertson

      Much appreciated. I knew FAO had spent most of 2011 trying to decide what to do about FBS data because of the immense difficulty of compilation, but haven't heard what has been decided if anything.

      But your description of the data relationships probably explains why I'm having so much trouble reconciling ABS meat data with FAO FBS meat data. However, I'm not sure that it invalidates my basic point which is that there are high sugar-low obesity countries and low sugar-high obesity countries which implies that it isn't something magical about sugar that is the problem.

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  17. rory robertson
    rory robertson is a Friend of The Conversation.

    former fattie

    Here's an interesting perspective for those claiming there's no clear link between sugar/fructose and obesity/diabetes:

    US scientists have produced diabetes in Rhesus monkeys within 6-12 months simply by letting them drink 75grams of fructose at their leisure each day via a 15% mix of standard Kool Aid in 500ml of water (http://www.kraftbrands.com/koolaid/ ; http://onlinelibrary.wiley.com/doi/10.1111/j.1752-8062.2011.00298.x/abstract ).

    Actually, I shelled out my US$35 to confirm that that…

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    1. Paul Rogers

      Manager

      In reply to rory robertson

      If you lock rhesus monkeys up so they can't move, and overfeed them with sugary drinks (about 30 teaspoons sugar, fructose equivalent), it's not surprising that they get fat and metabolically screwed up, considering their wild state and genome.

      Not much there to convince anyone of anything -- other than overeating and under-exercising makes us fat and sick.

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    2. Michael James

      Research scientist

      In reply to Paul Rogers

      The research that the article reports was primarily to establish that the Rhesus monkey primate was a suitable model to substitute for humans instead of the more common rodent models. They are. Fed on the fructose diet they gain all the problems humans get including diabetes at 6-12 months.

      So it is a first step (the publication was 2011--I know it is ridiculous that only now is this being put to serious scientific testing). Research with primates is extremely expensive so it is going to be quite some time before there is enough research done to be definitive on this complex issue. But note that the animals were over-fed sugar only. I am not willing to pay up $35 for the full paper so I am only reading the abstract:

      "...produces insulin resistance and many features of the metabolic syndrome, including central obesity, dyslipidemia, and inflammation within a short period of time; moreover, a subset of monkeys developed type 2 diabetes"

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    3. Clifford Chapman

      Retired English Teacher

      In reply to Paul Rogers

      Well said, Paul, and my argument exactly.

      These experiments have little or no significance or relevance to us because they cannot be related to an individual consciousness and being. The belief that such primates are suitable models for human beings rests entirely on the anatomical and seems to me a bit like a smoker blaming tobacco for causing his/her contracting cancer, rather than his/her own cretinous decision to smoke.

      Any attempts to suggest such findings on monkeys can be applied to people ignores human responsibility.

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    4. Gary Cassidy

      In reply to Clifford Chapman

      However, when headlines (such as the title of this article) are giving me the message that sugar doesn't make me fat, or sugar is just another constituent of a healthy diet, is that not telling me that I can be a responsible human (in regard to my health) and eat sugar sugar sugar.

      I can only be responsible for decisions I make with the knowledge I possess. I clearly know that smoking is a health hazard, I choose not to smoke for this reason. However, I have always received the message that sugar is just another constituent of a healthy diet, and until Tuesday I believed that message. Now I believe that excess sugar "might" be harmful. "might" is enough for me to take the decision to cut it from my diet.

      Considering the prevalence of sugar in our diet, "might" should be enough motivation for rigorous scientific studies (which would probably involve other animal species). The superficial energy in / energy out argument just doesn't cut it as scientific evidence.

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    5. Clifford Chapman

      Retired English Teacher

      In reply to Gary Cassidy

      I do understand what you mean here but the real issue is not when you say: 'The superficial energy in / energy out argument just doesn't cut it as scientific evidence', but people being responsible for themselves. That is why I think a much more accurate medical myth title for this thread would be something like: People Are Not Responsible For Their Own Obesity.

      Much of the debate here on sugar consumption, focuses on the product and not the person making a choice to consume that product.

      And for how long can the 'I didn't know' be used as a reason and not an excuse?

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    6. Gary Cassidy

      In reply to Clifford Chapman

      I too used to think of the problem as one of the individual (I actually thought I was pretty good since I maintained a healthy weight while society was getting fatter!)

      However I now believe the problem lies in our society as a whole. Yes, for an individual if "energy in" > "energy out" that individual will get heavier. Yes, an individual has the ability to balance energy in / energy out. But as a collection of individuals (a society) we are not balancing energy in / energy out. Why?

      Science…

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    7. Peter Ormonde

      Farmer

      In reply to Gary Cassidy

      Gary,

      I don't think it's so much that the input/output equation is wrong or flawed. More that we are lazy and clever. Not quite clever enough.

      We are smart enough to have worked out how to avoid work (or NEAT if you must) by pinching energy from the deep past... coal and oil.

      Sadly we are not smart enough to realise we shouldn't.

      It is also that we have developed a very clever social and economic system that allows excessive benefits (such as nutrition, income and wealth) to flow to certain classes of people while impoverishing and strip mining the rest. We pinch it and have done for centuries.

      But at the core of it is some sort of genetic attraction to laziness ...some sort of misplaced dysfunctional adaptation about the avoidance of sweat ... the lure of the soft option and the free ride.

      I reckon it's a fatal adaption myself.

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    8. Clifford Chapman

      Retired English Teacher

      In reply to Gary Cassidy

      Yes, these are fair questions to ask in some respects, and I'm well aware that companies will exploit people left, right and centre if allowed - just look at the morally bankrupt tobacco industry and its African and Asian marketing - but once education, research and knowledge of things that can or do impact seriously but negatively on our lives, becomes clear and in the public arena, as it were, like smoking and drink-driving, for example, the individual just has to take and bear responsibility.

      Often, it seems to me, the word 'society' is used as a kind of security blanket that allows us to avoid facing what we as individuals are responsible for.

      Why, for example, car insurance is rightly higher for young male drivers, as a rule, but people who smoke or are overweight are not subjected to similar penalties on account of their behavioural choices, beats me.

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    9. Clifford Chapman

      Retired English Teacher

      In reply to Peter Ormonde

      This is well said, Peter, and I can only imagine the negative you've received is from someone employed in something like the tobacco industry.

      The past did not have the benefits and knowledge that we now have in terms of medicine and hygiene - as their lower mortality rates well show - but I would hazard a guess that their core fitness was generally much higher than ours is today.

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    10. Miki Shapiro

      logged in via Facebook

      In reply to Clifford Chapman

      Clifford

      And herein lies the crux. Carbs, or some carbs, are an addictive substance (that happen to power us too).

      When we're addicted, our ability to make the rational choice is compromized. We make the wrong choice, and in the case of food, end up as guilty oversized humans. The mechanics to say "no" undergo a gradual attrition to an eventual state where saying "no" becomes outside the technical capability of the brain.

      There's another moral issue here. We can point at a heroin addict…

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    11. Clifford Chapman

      Retired English Teacher

      In reply to Miki Shapiro

      Miki, I do agree here with much of what you say - I know it's not an either/or thing - and obviously, since people's powers to move and make changes in life generally are not equal, a greater responsibility is also to be laid at the doors of some more than others.

      In society, if we acknowledge that the greatest powers lie in governments and politicians, then clearly that is where the real responsibility, when push comes to shove, must lie, even given public knowledge and an individual's understanding…

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    12. Paul Rogers

      Manager

      In reply to Miki Shapiro

      There is no more evidence that 'carbohydrates' are addictive than there is that 'fat' is addictive (Rolls and others). The use of the term 'addiction' as it relates to food is controversial, and is tied up with elements of hunger, appetite and satiety and the innate drive to eat in a world in which social constructs around food and physical activity are rapidly changing.

      Even so, in the scheme of things, fat is the least satiating macronutrient, and protein and low-GI, high-fiber carbohydrates probably the most. And boiled potatoes show up as being high on the satiety scale in several studies, despite their relatively high glycemic index.

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    13. Clifford Chapman

      Retired English Teacher

      In reply to Clifford Chapman

      Hello, I've just been awarded a negative. Maybe there is something in that study with monkeys after all.

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    14. Sue Ieraci

      Public hospital clinician

      In reply to rory robertson

      Mr Robertson, here is the point of the paper you cite: "Given the rapidity with which the metabolic changes occur, and the ability to control for many factors that cannot be controlled for in humans, fructose feeding in rhesus monkeys represents a practical and efficient model system in which to investigate the pathogenesis, prevention, and treatment of diet-induced insulin resistance and its related comorbidities."

      The aim of this research was to see whether they could create an animal model for diet-induced insulin resistence, which might help resaerch into the same condition in humans.

      This was not a controlled study to look at whether fructose had more effect than other carbohydrates, or a mixed same-caloric diet - that was not the aim of the study. If they wanted to see whether fructose ahd a greater impact on insulin resistence than other sugars or other carbohydrates, the study would have been contructed quite differently.

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  18. rory robertson
    rory robertson is a Friend of The Conversation.

    former fattie

    Fair enough Geoff. But all should be clear that Australia is NOT an exception - we're a high-sugar, high-obesity country.

    The big question on this topic is: when will the high-profile Sydney Uni scientists correct the public record on their shonky sugar study?

    In Saturday's paper (http://www.smh.com.au/national/health/research-causes-stir-over-sugars-role-in-obesity-20120330-1w3e5.html ), Professor Brand Miller reportedly argued that I do not know what I am talking about because I am "not…

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    1. Geoff Russell

      Computer Programmer, Author

      In reply to rory robertson

      The fundamental issue is whether a person, not a rat, expending say 2500 kCal/day will
      get fatter eating 2500 kCal/day depending on the sugar ratio. Obviously if the sugar ratio is too high, then all kinds of nutritional deficiencies can occur and all bets are off and there will be plenty of metabolic problems. But at common ranges?

      If you accept the FAO data up till the mid 1990s, then there was a substantial sugar fall since the 1960s. I'm 57. When I was a child in the 1960s we put bucket loads of sugar on stuff. It wasn't added during manufacture. We piled it on afterwards ... wheat bix with tablespoons of sugar, porridge with bucket loads of sugar. I'm not recommending this, it buggers your teeth, and if you aren't burning it off, you get fat, but I don't buy it as a magical cause of obesity beyond its obvious caloric contribution. The fall in sugar shown by that FAO data accords with my experience which is why I find it believable and haven't bothered to dig too deeply.

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    2. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Geoff Russell

      hi again geoff...so here's that half-century chart of "available sugar" in oz, before adding plenty of sugary imports: http://sweetpoison.com.au/wordpress/wp-content/uploads/2010/11/percapita.jpg Notice that the post-1980 trend is UP not down, even before rising imports are added.

      by the way, here's what US scientists now are saying on american prime-time TV re sugar, obesity, diabetes and cancer.

      Part 1: http://www.cbsnews.com/video/watch/?id=7403942n&tag=contentMain;contentAux

      Part 2 (Web only): http://www.cbsnews.com/video/watch/?id=7403956n&tag=segementExtraScroller;housing

      rgds,
      rory

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    3. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Geoff Russell

      Sorry, Geoff, I missed it first time around....it's NOT a rat study...it's RHESUS MONKEY study...might be same colour as rats but their genomes are a 93% match with human genomes. so US scientists have produced diabetes in Rhesus monkeys within 6-12 months simply by letting them drink 75grams of fructose at their leisure each day via a 15% mix of standard Kool Aid in 500ml of water (http://www.kraftbrands.com/koolaid/ ; http://onlinelibrary.wiley.com/doi/10.1111/j.1752-8062.2011.00298.x/abstract ).

      rgds,
      rory

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    4. Geoff Russell

      Computer Programmer, Author

      In reply to rory robertson

      75 grams of fructose in a 6-7 kilo rhesus monkey is about 750 grams in a 60-70 kg person ... Even my mate Harley can't eat that much fructose and his record is 70 bananas a day with 30 being common:

      http://www.30bananasaday.com/

      Anybody getting that much fructose is way off the scale of what I figure is reasonable and metabolic problems shouldn't be surprising. Wikipedia has US intake of HFCS at 49 grams per day.

      P.S. Harley wins 24 hour bicycle races.

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    5. Paul Rogers

      Manager

      In reply to rory robertson

      Rory, why don't you publish your paper online, or, try to publish it as a letter in the journal? Then we can all see if you've got something. I doubt you have.

      Even if you show that sugar consumption has increased, have you considered confounding factors? For example, for sugar or fructose to be the culprit in the obesity epidemic, you would also have to show:

      1. That consumption of other macronutrients (protein, fat, starches) have not increased at the same time.
      2. That physical activity (exercise, NEAT) has not decreased in the same period.

      Without considering those factors, you can make few conclusions.

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    6. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Geoff Russell

      again geoff...these are monkeys NOT rats...study records them as "male
      rhesus monkeys, age 12–20 years (body weight 16.3 ± 0.4 kg)"...so monkeys are nearly 3 times as large as the chunky rats you have in mind.

      on US consumption, i recall including HFCS it's circa 70kg sucrose equivalent per person per annum (circa 190g per day), or 3-4 times your 49grams per day....(roughly half of that sucrose equivalent is fructose)...

      so yes, geoff, the monkeys did suck down heaps of fructose, and some…

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    7. Paul Rogers

      Manager

      In reply to rory robertson

      US prime-time TV, eh? Should we be impressed? You're quoting 60 Minutes as a reliable source?

      And that's not new, Lustig again . . .

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    8. Paul Rogers

      Manager

      In reply to rory robertson

      Okay, I'll try again. Consider this:

      A frugivore primate (eg, orangutan), or fruitarian human eats . . . let's guess at a 50%-60% fructose diet by energy. The rest is protein, glucose, a little fat. What happens to that fructose? Yes, fibre slows down digestion and fructose release, and yes it it has a different metabolic pathway compared to glucose, being more inclined to de novo lipogenesis or fat production in the liver because it can't be stored in liver and muscle like glucose.

      (BTW, fructose…

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    9. Geoff Russell

      Computer Programmer, Author

      In reply to Geoff Russell

      Thanks Rory. I didn't shell out for the study but got my weights from Wikipedia

      http://en.wikipedia.org/wiki/Rhesus_macaque

      and also the HFCS figure

      http://en.wikipedia.org/wiki/Fructose

      See also Paul Rogers statement about how the monkeys were kept. That should be in the study, but I'm not not convinced enough to pay for it ... yet!

      Nobody is suggesting that supersized cokes with gallons of sucrose or fructose is a good idea. They are a waste of nutritional space. But the technical issue is whether there is some magic diabetes trigger in sucrose or fructose or glucose or any combination. The technical issue matters because it will influence strategy if you seriously want to lobby for a change and get dietitians on side. Do perhaps people eating big buckets of deep fried chicken but not coke merely get fat and not diabetic? That would be a useful check. Anyway, I emailed you for your critique and I'll have a read.

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    10. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Paul Rogers

      hi paul...i'm happy to send you both my 20pager and punchy letter to "Nutrients" journal (and also to anyone else interested)...as well, i'm happy for someone to "publish" it on a preferred website....my email address is strathburnstation@gmail.com

      on the monkeys, note they are 12-20 years of age...i assume they had been locked in cages for years before being fed fructose as described. only after that did they get diabetes and take a big step towards obesity.

      paul you are full of beans…

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    11. Miki Shapiro

      logged in via Facebook

      In reply to Paul Rogers

      You said "but the fact remains that fructose at these high concentrations has no adverse effects".

      That is actually a lie.

      Based on your post, the fact seems to be
      "but the fact remains that fructose at these high concentrations SOMETIMES, namely when coupled with fibre intake has no adverse effects".

      The main concern people are voicing is their use in soft drinks.

      How many grams of fiber does a can of coke have?
      How many of the soft drinks in your local corner food-serving place have fiber? How much fiber will you find in fast food?

      In nature, it's a poison conveniently packaged with its own antidote.
      In a supermarket, we've separated them and pay diet professionals like Peter Clifton to say "since they're harmless in an apple, they're harmless in a coke". Which is, as you yourself pointed out, wrong.

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    12. Paul Rogers

      Manager

      In reply to Miki Shapiro

      Miki, you're nearly there. You seem to have accepted the idea that in a balanced diet, fructose at high levels has no adverse effects -- which was my point.

      Nutrient density and recommended intakes, and energy equilibrium, as Geoff Russell and I have pointed out in other posts, are key factors.

      Let's do some numbers. Let's say a fruitarian human or primate eats about 50% of energy needs as fructose. In an average 2000 kcalorie/day diet, that's 1000 kcals or (/4) 250 grams of fructose - about…

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    13. Miki Shapiro

      logged in via Facebook

      In reply to Paul Rogers

      Paul

      I was always there.
      If you hide a computer feature in Windows but don't enable it by default in a vanilla install on a computer, 99% of the people will not end up using it.

      Sure, people /can/ balance a sizeable doze of fructose from soft drinks with an excellent diet, much like they /can/ go through some technical wizardry to get that feature to work on windows.

      But what you seem to be ignoring is that in this place we call the non-lala-land real world, they *don't*. Here is the take…

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    14. Clifford Chapman

      Retired English Teacher

      In reply to Miki Shapiro

      Miki, I'd like to intrude here with something which I think is relevant to this debate.

      When I was 21, the then voting age, an idealistic youth in England in 1964, I voted for the first time,and for Labour to sweep the loathed Tories out of office, which they did.

      I'm only quoting second-hand now, so this may not be factual, though it is sure believable, but apparently released Cabinet Papers 50 years' later from that same 'Socialist' Government, reveals that in then Cabinet discussions about…

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  19. Alexi Miller

    Admin

    Obesity is complex..saying that theres one thing to blame - sugar.. is simply unwise. Its nonsense! People are working longer hours, sleeping less, eating more, sitting at a desk all day. Yes you'll lose weight if you cut out soft drinks and beer and instead drink water. Yes you'll lose weight if you eat real foods instead of a trip to maccas. Exercise a little bit each day etc etc. Why do people want to hear that they just have to cut out sugar and that it will solve all their dietary problems?? Humans love sugar so we shouldnt simply deprive ourselves of it - just think moderation - and there is plenty of science to back that up.

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  20. Peter Ormonde

    Farmer

    Incidentally folks,

    While we're over here slugging it out about about the causes of the obesity epidemic, just a few column inches away there is a piece by a self-styled "fat activist and health educator" from Massey University in NZ denouncing such concerns as "healthism".

    According to Ms Cat Pause (I kid you not) the medical concern with obesity and exercise is all designed to make the self indulgent feel oppressed. She brings a liberating message that obesity is a state worth celebrating…

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  21. Peter Clifton

    Professor of Nutrition at University of South Australia

    A very vigorous discussion! Coca Cola uses only Australian cane sugar and not HFCS-not that there is a fundamental difference between the two. Liquid calories as soft drink whatever sugar source is used are associated with weight gain, type 2 diabetes and heart disease as the article notes. Australians are slowly changing their habits and from 2002-2007 sugar-sweetened soft drink consumption fell and diet soft drink consumption went up quite a bit. in the 2007 Childrens Nutrition Survey soft drink…

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    1. Paul Rogers

      Manager

      In reply to Peter Clifton

      Yes, and not just dietary fat (especially saturated fat), but overeating in general, including glucose, buggers up fructose metabolism in the second hit. It seems to me that fructose only becomes a problem in dietary excess and nutrient and antioxidant deficiency. That's why soft drinks in excess are not good, and why the biggest natural fructose consumers on the planet, frugivorous primates, don't have a problem.

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  22. Miki Shapiro

    logged in via Facebook

    I see what you've done there. Nice.
    You lionize the realy really bad stuff - fructose - that stuff that we don't soak up and that doesn't trigger our hunger response - summing it up to the layman as something that basically comes from fruit and veggies (creating an impression of healthy stuff without outright saying it).

    You demonize the better sugar - good because it does get used by the body and only a fifth of it or so hits the liver (as opposed to all of it in fructose) - and doesn't cause…

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    1. Miki Shapiro

      logged in via Facebook

      In reply to Miki Shapiro

      Alas, my point remaining valid, but my numbers are crooked even for back of the envelope math.

      Correcting:
      Pre-70's we were using sucrose for everything, half of which is still fructose, and half of it is glucose.

      So redoing the back of the envelope math again, an extreme case of someone whose sugar intake is 100% HFCS *today* gets has 100% of those 50 odd kilos hit his liver (bad. creates all the chronic problems ethanol does)

      That same someone living in the 60's and eating what's sold at the milkbar on a sweetness-similar diet would be consuming his 55kg of sugar intake from stuff sweetened with sucrose, half of which is good sugar and half of which is bad.

      So... half of 55kg plus 20% of the other half, amounting to 60% of 55kg, 33kg, hits the liver and cause illness.

      My point stands - my liver prefers to be hit by 33kg of toxin rather than by 50kg of it. That is a big increase.

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    2. Paul Rogers

      Manager

      In reply to Miki Shapiro

      So fructose is a "toxin" is it?

      How about I make a case for iron being a "toxin" as well. Or vitamin A or D or selenium? Too much vitamin A (retinol) will kill you stone dead and severely damage your unborn child. Excess iron in haemochromatosis will make you an invalid, and vitamin D in one form has been used as a commercial rat poison.

      It's worth debating the over-consumption of soft drinks and other sugary liquid drinks, including juice, but this nonsense has got out of hand -- and as usual, egged on by a media with the science reporting skills of a slow bear.

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    3. Miki Shapiro

      logged in via Facebook

      In reply to Paul Rogers

      Robert Lustig makes a very good argument for fructose being a toxin in the video I posted above. For your convenience, here it is again:

      http://www.youtube.com/watch?v=dBnniua6-oM&feature=youtu.be

      Yes, you'll need a bit of time and a pair of headphones. For what it's worth, I can assure you it will be a good spend of your time.

      He actually puts facts, figures and lots of substance behind his argument.
      If you're confident in its insignificance as a toxin and it being comparable to a lot of other nutrients we eat, I challenge you to formulate a counter-argument.

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    4. Paul Rogers

      Manager

      In reply to Miki Shapiro

      Time and a pair of headphones? Where do you think I live . . . in deep space?

      You think I haven't read and heard Robert Lustig's opinion? He started this and he needs to go back to toxicology school, starting with Paracelsus.

      There, that's my counter-argument . . . and it's all I need!

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    5. Miki Shapiro

      logged in via Facebook

      In reply to Paul Rogers

      Paul

      Pointing out that "you" (whoever you are, I have no clue what background you come from) are convinced is not helpful any more that it would be for Lustig to come waving his own credentials and smartness as a basis for an argument.

      The conversation is about sugar metabolism, not about us.

      As it stands, he seems to be able to connect modern diet with a broad gamut of adverse effects due to the way fructose is metabolized (that and the absence of fiber in that diet).

      Yes, eating a…

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    6. Geoff Russell

      Computer Programmer, Author

      In reply to Miki Shapiro

      Lustig needs to explain the increase in diabetes in places which eat very little sugar/sweets ... eg Japan, Italy Where is their increase coming from? You need evidence at many levels to make a causal case and if Lustig has it, he left it out of his Nature paper.

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    7. Miki Shapiro

      logged in via Facebook

      In reply to Miki Shapiro

      Allow me to sharpen the point
      Fructose in apple - good. Comes with fiber and in sane quantity.
      Fructose in a botttle of apple juice - bad. Sans fiber, concentrated and more likely than not with a healthy dose of HFCS.

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    8. Gary Cassidy

      In reply to Paul Rogers

      Is tobacco smoke considered toxic? I think it is. Although I can consume it for many years without dying, and I may never die from consuming it. Even if I don't die from it, I will very likely still have negative health effects from it.

      Could it be that excessive fructose is similar? I don't know? I would like to see some conclusive proof either way.

      This article, nor any comment, have conclusively supported the title.

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    9. Miki Shapiro

      logged in via Facebook

      In reply to Geoff Russell

      He did.

      These places are bombarded with soft drinks in every place that serves food same as everywhere else in the world. We all drink the same stuff.

      He makes the case that the drinks alone are sufficient, and the tight correlation between the substitution of ever-higher concentrated fructose for every other type of sweetener in drinks (and everywhere else)

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    10. Miki Shapiro

      logged in via Facebook

      In reply to Gary Cassidy

      Yes, it is considered toxic.
      So is the ethanol in your beer. It's why we (as a global society) regulate it, tax it, control its distribution, limit what you can do after its consumption etc.

      Lustig actually points out that the ethanol carbohydrate and the sucrose carbohydrate share virtually the same list of badness. The main difference is that ethanol is also metabolized by the brain and causes acute effects - drunkedness - whereas fructose doesn't. In a liver sense, giving your kid a bottle of coca-cola (Apologies to the writer of the article, who, as someone already referenced and pointed out in the comments above, is paid by them) - giving your kid a coke is liverwise the same as giving the kid a stubby.

      Refer lustig video I linked before.

      Do with that what you will.

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    11. Geoff Russell

      Computer Programmer, Author

      In reply to Miki Shapiro

      You've obviously never eaten in Japan. Anecdotes aside. The FAO data don't support this, Japanese sugar and sweeteners intake has been flat or slightly declining since 1970 ... ditto Italy. Rory did a good job convincing me that FAO data on Australian sugar is suspect. Fine. But everywhere else? Japanese tastebuds are differently "tuned" ... they think natto tastes good!

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    12. Miki Shapiro

      logged in via Facebook

      In reply to Geoff Russell

      Here's the question nobody is asking.

      WHICH sugar? Saying how much sugar was consumed means nothing. Tell us how much of it was fructose, how much of it was glucose or lactose. Back then and now.
      They are metabolized in a radically different way, fructose incurring high adverse affects at far lower quantities than glucose, galactose etc.

      The amount of sugar in a bottle of soft drink may have stayed the same for quite some time, as well as the number of bottles sold.

      This is what coca-cola hides behind - the aggregate.

      There was a (very well established, I believe) move to highly-concentrated fructose syrup, so while bottles and sugar/bottle remained constant (what coke claims is the evidence that exonerates them), unabsorbed-calories-hitting-liver/bottle grew dramatically because they swapped to a sugar our body can't metabolize.

      Due to this, the aggregate sugar figure is meaningless.

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    13. Gary Cassidy

      In reply to Miki Shapiro

      Hi Miki, I think the term "sugar" is used colloquially to refer to sucrose which is 50% glucose, 50% fructose. HFCS has a similar proportion of glucose and fructose so it cannot be considered better or worse than sucrose. It is equivalent. HFCS is used more as an additive in USA (I think, due to government subsidies) and sucrose is used more as an additive in Australia.

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    14. Miki Shapiro

      logged in via Facebook

      In reply to Gary Cassidy

      ... and woe and behold, not many 250kg humans in Australia.

      Gary.. given the amount of money funneled into lobby groups, I would not be surprised if it got interpreted quite liberally (in a way that serves certain interests better) wherever they'd be able to make it fly.

      Here's the thing. That may be the situation today, but answer me this:
      Are the soft drink (and food, and yoghurt, etc etc) companies gradually cranking up the fructose concentration in Aussie drinks (even if to a lesser extent…

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    15. Paul Rogers

      Manager

      In reply to Miki Shapiro

      I can see you've either not been reading my posts, or don't understand them. Here is a summary.

      1. Fructose is metabolised to glucose and fat in the liver. Excess glucose is also converted to fat in the liver. Excess dietary fat also hits the liver (Kuk et al, 2008). Some fat from all three sources can be stored in the liver, possibly causing non-alcoholic fatty liver disease (NAFLD). This is primarily from overeating everything, not just fructose (the dose makes the poison). Some fat will be…

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    16. Miki Shapiro

      logged in via Facebook

      In reply to Paul Rogers

      Paul

      Thanks for taking the time to clarify.
      Yes, eat less move more is generally sound advice. And yes, obesity is a multi-faceted problem. But not all factors feeding into it are created equally, and in addressing it as with anything else, it makes sense to start with the high impact ones.

      The question is not about personal diet advice. Those who take it already know how to stay healthy. It's about oversight of the food ecosystem made available in the supermarket, before we wake up one day…

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    17. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Paul Rogers

      Afternoon Paul, how are you going in your critique of that shonky "Australian paradox" paper out of Sydney Uni? Again, check out Figure 5A: a 30% uptrend in sales of sugary soft-drink proving - you guessed it - a "substantial" decline in sugar consumption over the "past 30 years". The study was "peer reviewed" too, by independent experts you understand.

      In this sugar debate, I’m biased, because last May I stopped eating added fructose and over the next eight months lost 10kg – without extra…

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    18. Gary Cassidy

      In reply to rory robertson

      Hi Rory, did you have any adverse withdrawal effects when you gave up sugar? I've had an ongoing headache, kind of like I haven't had any caffeine for a day. I might check out David Gillespie's books.

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    19. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Gary Cassidy

      No need to buy the book Gary, just eat nothing sweet, beyond a piece of fruit or two per day (or less if you can). If in doubt, check the "sugar per 100g" on label (typically, 50% of that in processed food is fructose). Withdrawal? Yeah, but not headaches. I was just really hungry so I ate heaps of anything without sugar...drank lots of my instant coffee and diet coke. And then it all passed and I moved into a brave new world where I didn't think about my next snack every five minutes, all day every day. It sounds wankish, but removing added sugar really did "change my life". Now I'm amazed how simple it was, and how great it feels to tuck in my shirt (after a decade) on a Saturday night!

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    20. Peter Ormonde

      Farmer

      In reply to Paul Rogers

      Excellent Paul - many thanks.

      I reckon with all the fruit I eat I'm obviously getting in contact with my inner orangutang... not quite as cute but a lot less endangered.

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    21. Paul Rogers

      Manager

      In reply to rory robertson

      Sugar and appetite control? Like in this randomized, double-blind crossover study you mean:

      Int J Obes (Lond). 2007 Nov;31(11):1696-703.
      Appetite hormones and energy intake in obese men after consumption of fructose, glucose and whey protein beverages.
      Bowen J, Noakes M, Clifton PM.

      "CONCLUSION: In obese men, fructose- and glucose-based beverages had similar effects on appetite and associated regulatory hormones, independent of the differing glycaemic and insulinaemic responses. The contrasting…

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    22. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Paul Rogers

      Paul, the bit you are missing is that by simply avoiding fructose, I ate less of everything. i ate less of everything because i avoided fructose. no it's not rocket science, but it is not widely understood among scientists, let alone the average joes who are trying to do the right thing, slogging it out at the gym, and getting nowhere. the breakthrough has come for thousands of people in recent years simply by removing modern doses of fructose from their diets. you apparently know all that and…

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    23. Paul Rogers

      Manager

      In reply to Peter Ormonde

      Peter, orangutans eat a lot of durians. If you've ever tasted a durian, you'll probably wonder if the 'taste test' is a good guide in that case!

      Cheers.

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    24. Paul Rogers

      Manager

      In reply to rory robertson

      Rory, you're not fooling anyone, mate. You should peddle your diet books elsewhere.

      And for others reading this who want to lose weight, please don't use a "diet" book or one that masquerades as breakthrough science. I've literally read them all, and they are full of half-truths, selective use of the scientific literature, and downright lies.

      Get advice from an experienced dietitian.

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    25. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Sue Ieraci

      If (a) and (b) are what you require, Sue, then David Gillespie is your man. In any case, congratulations on being wise in the ways of science.  So please explain why, for thousands of overweight people in Australia in recent years, reversing our long-running trends towards obesity has indeed been as simple as cutting sugar/fructose from our diets.  That was all it took to spark my profound life change, and there are thousands of other stories out there along the same lines.  (Sorry, I have no book…

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    26. Sue Ieraci

      Public hospital clinician

      In reply to rory robertson

      "If (a) and (b) are what you require, Sue, then David Gillespie is your man."

      Truly? So everyone who has spent years of study on physiology, endocrinology, pathology, metabolic pathways, acid-base balance, kidney function - that was all wasted?

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    27. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Sue Ieraci

      I know that DG has done years of study on these and related topics; moreover, he seems to be able to "cut through" to the important things. In particular, ridding diets of added sugar was an obvious low-hanging fruit in the fight against obesity and diabetes that most highly trained professionals either didn't notice or didn't bother to mention to the masses. So DG made that "his thing", and thousand love him for it because it literally changed their lives profoundly for the better. On whether…

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    28. In reply to Sue Ieraci

      Comment removed by moderator.

    29. Sue Ieraci

      Public hospital clinician

      In reply to rory robertson

      "DG has done years of study on these and related topics;" What, precisely, do you mean by "years of study" What did he study?

      Professionals didn't notice anything about sugar and obesity or diabetes? Are you serious? Until newer research refined the approach, management of diabetes was all about avoiding sugar.

      Mr Robertson, your rant against education and training smacks of anti-intellectualism. To be an effective professional, having good judgement is not enough. You need not only deep knowledge of the entirety of your profession's knowledge base, but also practical experience of applying the principles and being responsible for the outcomes. We don't want bridges built by lay zealots who have read a lot. We don't want people who have only done self-directed reading to perform surgery.

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    30. Tom Hennessy

      Retired

      In reply to Sue Ieraci

      Excuse me ? You , I will that word , you , as an analogy of the medical profession. The medical profession believes , "the human female is the only female of a species which is universally iron deficient".
      THAT belief is precisely WHY the government , prodded by you and your ilk , adds the metal iron to all our foods.
      I have to drive for miles to find a loaf of bread that doesn't have iron added to it . THAT is BECAUSE of you and your ilk adding iron to all my bread.
      A hepatitis C patient , seeing he is likely to be homebound , can't even DREAM of getting a loaf of iron deficient bread while he attempts to save his life by adhering to his doctors orders of the low-iron treatment for his hepatitis C. THAT is because of you and your ilk.
      A starving mother in Africa , forced to feed iron fortified flour in her malaria stricken child ? Kills him.
      BECAUSE of you and your ilks sheer and utter stupidity.

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    31. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Sue Ieraci

      Good morning Sue. Recall that famous old cigarette ad "Doctors Prefer Camels" (http://www.youtube.com/watch?v=gCMzjJjuxQI ). Now that added sugar has replaced added smoke as the key health danger, attention should focus on the quality of the arguments not on the old pieces of paper gained many moons ago. On anti-intellectualism, Sue, an example might be someone - you? - denying an important body of knowledge accumulated by someone else - DG? - simply on the basis that he lacks a formal degree…

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    32. Sue Ieraci

      Public hospital clinician

      In reply to rory robertson

      "Now that added sugar has replaced added smoke as the key health danger, attention should focus on the quality of the arguments not on the old pieces of paper gained many moons ago."

      Mr Robertson, your first assertion is a straw man, the second is a fallacy.

      Active clinicians and researchers cannot relay on "old pieces of paper" but are required by law to pursue continuing education. That is how medical science moves forward.

      In the days of ancient Greece, the philosophers were also the…

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    33. Sue Ieraci

      Public hospital clinician

      In reply to Tom Hennessy

      Wow - I am personally responsible for poisoning the community food supply and killing children with malaria in Africa? I do hold a sense of responsibility, but I had no idea that these various harms were personally attributable to my behaviour.

      Mr Hennessy, please stop posting personal abuse. It doesn't make your statements any more credible. On the contrary.

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    34. Tom Hennessy

      Retired

      In reply to Sue Ieraci

      I got personal , did I ? As I said , the medical profession ,IE: YOU , prods the government to add the metal iron to all our foods , due to their utter stupidity. You pull the "higher education" card regularly BUT when someone points out that in fact you DID seem to "waste" that higher education , you say it is "personal abuse". IF you think you haven't wasted your time and effort getting that higher education , you shouldn't play the card , or someone just might call you on it.

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    35. Sue Ieraci

      Public hospital clinician

      In reply to Tom Hennessy

      Mr Hennessy, I have never claimed to represent my entire profession, and nor have I ever prodded any government, local, state or federal, to add metal iron to anything.

      As your posts get more hyperbolic, their credibility diminishes even further.

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    36. Tom Hennessy

      Retired

      In reply to Sue Ieraci

      You seem to have a problem understanding , when it is convenient. I have said , twice , when I speak to YOU , I use the word YOU to represent the WHOLE medical profession. I explained that TWICE and you BOTH times fail to understand the analogy and seem to PREFER that it is BELIEVED to be a PERSONAL attack upon YOU , personally. As evidenced by the removal of the first post I made in this series , which you obviously complained about. I have been in these discussions before , with others , and one of their tactics is being employed here by you , 'personal attacks' which do not exist. When you cannot stand upon your own two feet , you cry , personal abuse !!
      I've seen it before , and I cannot say I expected better from you , because as I've said before , you are caustic and egotistical .

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    37. Sue Ieraci

      Public hospital clinician

      In reply to Tom Hennessy

      Mr Hennessy - when you say "you are caustic and egotistical " - do you mean "YOU" (the WHOLE medical profession) or "YOU" (a PERSONAL attack upon YOU )?

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    38. Tom Hennessy

      Retired

      In reply to Sue Ieraci

      Quote: personal attack
      Answer: again with the personal attack . It is , and has been pointed out before by others , you are caustic , look it up , and you are egotistical , look it up. If you think telling the truth is personal abuse , you should maybe actually take some advice , look into WHY people DO think you are caustic and egotistical and NOW it seems being abusive. Take it elsewhere or say something about sugar or iron.

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    39. Tom Hennessy

      Retired

      In reply to Tom Hennessy

      "We show that iron modulates insulin action in healthy individuals and in patients with type 2 diabetes. The extent of this influence should be tested in large-scale clinical trials, searching for the usefulness and cost-effectiveness of therapeutic measures that decrease iron toxicity. Of paramount importance will be the definition of "normal body iron stores" and the establishment of early therapeutical interventions. Simple and inexpensive therapies, such as blood letting and iron chelators, are emerging as alternative and effective treatments for insulin resistance."

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    40. Tom Hennessy

      Retired

      In reply to Tom Hennessy

      These two articles show clearly , the meat eating by the inhabitants predicted the diabetes development years later.
      The two studies were done seperately from each other.
      The two studies were done by two different research groups during different years.
      The first study completed had found the highest highest iron stores in people in Unmmannaq and the second study years later found highest diabetes in Unmmannaq.
      The studies SHOW ..
      “Meat Eating Predicts Diabetes”
      The researchers had ALREADY…

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    41. Tom Hennessy

      Retired

      In reply to Sue Ieraci

      Actually I explained the studies very well. The fact a self appointed 'genius of medical study decipherment' fails to understand the relevance as explained , either points to the fact you are NOT what you say you are , or you again are attempting to be abusive. Which is it.

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    42. Sue Ieraci

      Public hospital clinician

      In reply to Tom Hennessy

      Mr Hennessy - I am a practising clinician - I have never appointed myself as any type of genius, but it is part of my job and my continuing education to understand critical appraisal of medical research.

      Paradoxically, it is you who is self-appointed as a "Health Research Analyst" (you said that yourself on another thread here - about coffee enemas).

      "Actually I explained the studies very well" No, actually you just quoted extracts from them. As I said above, the Greenland study looked at iron intake and body iron stores - they did not mention anything about diabetes.

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    43. Tom Hennessy

      Retired

      In reply to Sue Ieraci

      Let me dumb it right down for you , specifically you . The first researchers in 1993 found in Greenland one group had HIGH iron levels. They just measured iron , they were not diabetes researchers.
      Coincidentally , seven years later , diabetes researchers went to the same district , and measured diabetes levels. They found those people that had the highest diabetes ALSO coincidentally ALSO were the SAME people who had the highest iron levels from seven years BEFORE. So , no they didn't mention diabetes , because ? they weren't measuring diabetes , they were measuring iron. THAT is WHY diabetes wasn't mentioned in the first study , because they weren't measuring diabetes they were measuring iron . You see how that works , do ya ?
      Highest iron equals highest diabetes.
      How did the previous researchers SAY these people GOT their high iron levels ?
      Eating meat , heme iron.
      Therefore eating meat , eating heme iron , predicted the diabetes years later.
      High iron equals high diabetes.

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    44. Sue Ieraci

      Public hospital clinician

      In reply to Tom Hennessy

      Mr Hennessy - it appears that you have dumbed down the analysis - but not for my sake.

      Let's look at the actual papers you cite. Eur J Haematol. 2001 Feb;66(2):115-25.Iron status markers in 224 indigenous Greenlanders: influence of age, residence and traditional foods.

      This is a paper about iron DEFICIENCY - not iron overload. They found that the Greenlanders who ate the most traditional foods in their diet had the best iron stores, and those who did not follow traditional diets were more likely…

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    45. Tom Hennessy

      Retired

      In reply to Sue Ieraci

      Unmmannaq had highest iron.
      "Iron load highest in Uummannaq"
      Unmmannaq had highest diabetes.
      "Diabetes in Unmmannaq was higher"

      Try to misunderstand those two very short sentences.
      Highest iron = highest diabetes.

      “Prevalence of iron load highest in Uummannaq (men, 32.1%; women, 21.1%). "
      “Body iron stores can be explained by differences in the dietary intake of haem iron”.

      “Diabetes in Unmmannaq was higher than that in the towns of Nuuk and Qasigiannguit”

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    46. Sue Ieraci

      Public hospital clinician

      In reply to Tom Hennessy

      From the study itself:
      "Significant risk factors for diabetes were family history of diabetes, age, BMI, and high alcohol consumption, whereas frequent intake of fresh fruit and seal meat were inversely associated with diabetic status. Age, BMI, family history of diabetes, sedentary lifestyle, and place of residence were significant predictors of IGT."

      So now you are disagreeing with the researchers' findings?

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    47. Tom Hennessy

      Retired

      In reply to Sue Ieraci

      I don't really care , in this case , what the researchers found. I was researching , iron. I found the two studies and put them together. High iron equals high diabetes in Uummannaq.

      "Iron load highest in Uummannaq"
      "Diabetes in Unmmannaq was higher"

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    48. Sue Ieraci

      Public hospital clinician

      In reply to Tom Hennessy

      " I found the two studies and put them together." (incorrectly)

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    49. Tom Hennessy

      Retired

      In reply to Sue Ieraci

      (incorrectly)
      "Iron load highest in Uummannaq"
      "Diabetes in Unmmannaq was higher"

      The above is correct and your inability to admit it , is plain for everyone to see.

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    50. Sue Ieraci

      Public hospital clinician

      In reply to Tom Hennessy

      (Mr Hennessy, I don't think anyone else is looking)

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  23. Gary Cassidy

    Funny thing, yesterday morning I had long held a belief consistent with the articles title. After reading the article I was very disappointed that my long held belief of the title was not proven by the article - it actually created doubt. I've since spent a few hours poking around (the internet) trying to learn more. I'm still not convinced either way but I now have some doubt in the title.

    As of today I will be actively trying to limit my sugar intake (although not from natural whole foods - i.e. fruit and veg).

    Worst case outcome: I don't eat some foods that I enjoy.
    Best case outcome: I live a longer and healthier life.

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  24. Tom Hennessy

    Retired

    The rise in obesity rates could be due to the fact the government , in their ignorance , adds the metal iron to all our foods. They have shown iron and sugar 'interact.
    http://www.medscape.com/viewarticle/439591
    "Cross-Talk Between Iron Metabolism and Diabetes"
    "Iron Overload and Type 2 Diabetes: Emerging scientific evidence has disclosed unsuspected influences between iron metabolism and type 2 diabetes."

    They have shown heme-iron / meat iron is absorbed at a higher rate than non-heme iron…

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  25. Peter Clifton

    Professor of Nutrition at University of South Australia

    Mr Gillespie feels I should have reported being funded by Coca Cola to write up the results of the 2007 Children's Nutriiton Survey. However an article that states that there is a clear association between soft drink consumption and type 2 diabetes and heart disease is certainly not one that provides any benefit to a soft drink company and raises no issues of conflicts of interest.

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    1. philip salter

      Telecoms

      In reply to Peter Clifton

      The attribution is significant when we see the contrast between the Shouted Headline and the content of the article.
      As stated before, the headline makes no sense other than as a talking point grabber when it is compared to the contents of the article where it states "....A 2009 study of the effects of high liquid sugar intake found those who consumed a quarter of their daily energy intake as liquid sugar – either glucose or fructose – were more likely to have a greater appetite and gained around 3kg over the ten-week study period...."
      The article down plays the effect of the high liquid sugar by stating that it is a myth that sugar is a cause of obesity.in the headline !! And it makes less sense when compared to the 2007 Children's Nutrition Survey as well.
      It makes more sense when the readers know that a high liquid sugar manufacturer had some hand in the article.

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    2. David Gillespie

      logged in via Facebook

      In reply to Peter Clifton

      Peter, I reckon if I owned a soft drink company I'd be pretty pleased with an article written by the 'Laboratory Head, Nutritional Interventions at Baker IDI Heart & Diabetes Institute' with a headline that read: "Monday’s medical myth: sugar is to blame for our obesity epidemic."

      I'd be even more pleased that the article went on to say "... it seems that total sugar intake hasn’t played an undue role in the increase in obesity ..." (in the context of rising soft drink consumption).

      Conflict of interest is such a tricky subject but I think its always worth erring on the side of caution and letting your audience judge (whilst in possession of all the facts).

      So in that spirit, I have written books that tell people they should avoid sugar. Some people buy those books and when they do, some of that money makes its way to me. I don't otherwise make money from people not eating sugar (and indeed they have been known to not eat sugar without giving me a cent).

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  26. Sue Ieraci

    Public hospital clinician

    So long as we keep looking for one simple answer for complex health issues, we will always miss the mark. The factors causing obesity and type 2 diabetes, and the associated pathophysiology, are complex.

    Of course it's tempting to read a book by a lawyer who has lost weight, and who sells books by promoting a simple solution. The problem is, it's just not simple, no matter how much we would like it to be.

    I would prefer to hear people with knowledge and clinical practice such as dieticians and endocrinologists analyse the research for us than have random people give their personal opinions.

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    1. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Sue Ieraci

      Actually Sue, it was as simple at that - removing sugar - for me. So I’m biased, because last May I stopped eating added fructose and over the next eight months lost 10kg – without extra exercise - from a peak weight of 97kg. For me, simply avoiding fructose - everything sweet – turned out to be an effective "silver bullet" for weight-loss and improved health.

      What was profound for me was that within a week or two, my long-lost self-discipline returned. In life after sugar, constant food…

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    2. Sue Ieraci

      Public hospital clinician

      In reply to rory robertson

      Actually Rory, I don't judge good advice by how many books one has sold, but whether the person (a) understands human physiology and (b) whether they have direct experience in managing people with diertary or obseity problems.

      "I did "x" and it worked for me, and then I wrote a book about it" just doesn't cut it for me. Human physiology is much more complex than most commenters here realise. Yes, you can cut out one whole class of foods and therfore ingest less overall energy. So that is the key answer to obesity for everyone? If only that were true, the world would be much simpler.

      My reading of research findings does not rely on faith. It relies on having some knowledge of human physiology as well as research methods.

      It took the wisdom of Socrates to know that you need to know what you don't know.

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    3. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Sue Ieraci

      So Sue, please explain why, for thousand of overweight people in Australia in recent years, reversing long-running trends towards obesity has indeed been as simple as removing sugar/fructose from our diets. The key is appeitite control. SUGAR/FRUCTOSE DOES SOMETHING BAD TO APPETITE CONTROL. In our lives post-sugar, many of us found - suddenly - that appetite control came easily, allowing us to eat less of everything and lose weight without much real effort. (Sorry, I have no book to sell). So…

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    4. Sue Ieraci

      Public hospital clinician

      In reply to rory robertson

      "So Sue, please explain why, for thousand of overweight people in Australia in recent years, reversing long-running trends towards obesity has indeed been as simple as removing sugar/fructose from our diets."

      There is lots of mainstream research about the factors effective in weight loss. Here is just one paper: http://ukpmc.ac.uk/abstract/MED/11673773/reload=0;jsessionid=Has9pKa3gNK77t6B2kA7.6
      Here is another: http://www.nejm.org/doi/full/10.1056/NEJMoa0708681

      I cannot "explain" your personal…

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    5. rory robertson
      rory robertson is a Friend of The Conversation.

      former fattie

      In reply to Sue Ieraci

      My guess is that within a decade or two fructose will be linked to obesity and diabetes in the same way that today the sun is linked to sun cancer, and tobacco is linked to lung cancer. So here's a smaller literature survey: “recent data suggest that fructose consumption in human[sic] results in increased visceral adiposity, lipid dysregulation, and decreased insulin sensitivity, all of which have been associated with increased risk for cardiovascular disease and type 2 diabetes. A proposed model…

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    6. Paul Rogers

      Manager

      In reply to rory robertson

      It seems that Rory subscribes to the scientific school that says if your ideas are debunked once or more, then all you do is keep repeating them and someone will listen. This is the strategy of 'anthropogenic climate change' sceptics, 'cholesterol doesn't cause heart disease' sceptics, and sundry complementary medicine protagonists like homeopaths.

      The relevance of the rhesus monkey study was addressed earlier here. If you feed caged primates excess liquid calories way in excess of energy balance, and you don't let them move naturally, then I'm afraid your work has little relevance to free-living primates, including humans.

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    7. Sue Ieraci

      Public hospital clinician

      In reply to rory robertson

      Mr Robertson, you say "I shelled out my US$35 to confirm that that the Rhesus monkeys did indeed become chunky and (some) diabetic. Yep confirmed." Did you also shell out any money to learn critical appraisal of research literature? Were you able to assess the validity of the findings of that paper you quote?

      The paper you link to above is a review. Have you read the full primate paper? Can you analyse the methodology for us? What was the research question? How many subjects were there? What were the inclusion and exclusion criteria? How does primate physiology and carbohydrate metabolism compare with human? What measurements did they make? Were the results in a normal distribution? How were the results analysed? How wide were the confidence intervals? OVerall, how did the findings justify their conclusions?

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  27. Gary Cassidy

    Two weeks into my switch to a low sugar intake (inspired by this article) and I'm quite happy and even surprised by the results. Clearly it's not a blind trial and I have a whopping sample size of 1, but here is a summary:
    * First few days I was hungry. Probably due mostly to the decrease in calories and my adjustment to no sugar foods. I've had to adjust my diet to pick up the shortfall in calories.
    * Now being hungry is a lot more pleasant. Before when I was hungry I would start feeling grumpy…

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  28. Sue Ieraci

    Public hospital clinician

    Did all the fructophobes who have posted here also cut out beer?

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  29. rory robertson
    rory robertson is a Friend of The Conversation.

    former fattie

    Readers, it has become increasingly clear in the past decade that modern rates of consumption of added and concentrated sugar - sucrose and fructose, especially in sugary drinks - are a major driver of global trends to obesity and diabetes, the greatest public-health challenge of our times. Yet National Diabetes Week (14-20 July 2013) has just been and gone again without much happening: http://www.australianparadox.com/pdf/Sugary-Drinks-Ban.pdf

    In an effort to counter the disturbing Australian…

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  30. Alfred Nassim

    logged in via LinkedIn

    This article is factually incorrect. Australian sugar consumption has been rising for many years. Consecutive governments have been doing their best to make it difficult for researchers to determine what Australian people are actually eating. I wonder why?

    Personally, I am 63 and have had a BMI under 22 for over 40 years. I eat no sugar. My kids (8, 12 and 22) and wife are the same. We do our own cooking to keep out the sugar that is hidden in everything from bread to ham. We use old-fashioned…

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  31. rory robertson
    rory robertson is a Friend of The Conversation.

    former fattie

    Hi Professor Clifton,

    I hope you are well. I'm keen on a fact-check, please, if you have the time. Yesterday, on the ABC's The World Today programme, the University of Sydney's resident expert on sugar was interviewed:

    "Professor Brand-Miller labels that as misguided.

    JENNIE BRAND-MILLER: It irritates me, frankly, to see that soft drinks are getting special mention yet again. Soft drinks are clearly a problem in US. American children drink about 10 times as much soft drink as our children…

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