You’re exactly right: This one incident did not shape the entire body of scientific research.
There is a common trick used in contrarian argumentation where a single flaw is used to “debunk” an entire side of the debate. The next step, often implied rather than explicit, is to push the reader into assuming that the opposite position must therefore be the correct one. They don’t want you to apply the same level of rigor and introspection to the opposite side, though.
In the sugar versus saturated fat debate, this incident is used as the lure to get people to blame sugar as the root cause. There is a push to make saturated fat viewed as not only neutral, but healthy and good for you. Yet if you apply the same standards of rigor and inspection of the evidence, excess sugar and excess saturated fat are both not good for you.
There is another fallacy in play where people pushing these debates want you to think that there is only one single cause of CVD or health issues: Either sugar, carbs, fat, or something else. The game they play is to point the finger at one thing and imply that it gets the other thing off the hook. Don’t fall for this game.
I think common sense here can be a guide though. You don't need sugar at all, excluding high levels of anaerobic exercise. Your liver can produce the glucose your body actually needs from other sources (gluconeogenesis) and a lot of your tissues that use glucose also can use fatty acids or ketones. Fructose isn't needed at all. ("low blood sugar" isn't a symptom of not consuming enough sugar, it's a symptom of a disregulated metabolism -- ie insulin resistance or other conditions)
Saturated fats have all sorts of uses biologically.
That has nothing to do with whether excesses of those nutrients cause cardiovascular disease, though. The general consensus is that the healthiest diet is one with 5-10% of total calories from saturated fat. For most people, it's necessary to restrict saturated fat to land in that range. We also need to distinguish between sugar and carbohydrates. Again, the general consensus is that intake of sugar and refined carbohydrates should be minimized, while 50-75% of total calories should come from sources of complex carbohydrates like vegetables, beans, and whole grains.
Carbohydrates are sugars (from the first sentence on wikipedia): "A carbohydrate (/ˌkɑːrboʊˈhaɪdreɪt/) is a sugar (saccharide) or a sugar derivative." Saying you need "50-75% of your energy from [sugar]" illustrates why that is a somewhat odd statement. Yes, glucose is much better than fructose, but eating a ton of glucose will still lead to high insulin spikes and inflammatory diseases. Complex carbohydrates are better in that they take longer to digest, not because they're magically different. Vegetables are good for nutrients not because you need their carbs.
GP was talking specifically about calories, not other nutrients. My impression is when a vegetable provides significant calorie content it tends to be in the form of carbohydrates.
You have to get your calories (ie raw energy) from somewhere. If you limit saturated fat to 10% then what's left for the other 90% is (roughly speaking) unsaturated fat, simple sugars, carbohydrates (ie complex sugars), and protein. In terms of long term habits converting protein to calories is probably not a great choice for your health. If you decide to go for complex carbohydrates over various oils then vegetables that provide those are a good option.
People are on ketogenic diets for years and even decades with no adverse affects. There's nothing wrong with getting energy from other sources, your body can manage it fine.
Ketogenic diets are high fat. I suggested that a diet where the bulk of your calories comes from protein (not lipids, carbohydrates, or simple sugars) was probably not great for your health.
Your body can certainly "manage" on a high protein low fat low carb diet but I don't understand it to be good for you.
Funny you should say that after today's FDA announcement. (Not taking any side here just interested in how we determine what is a consensus these days)
It's hard, because when an issue becomes politicized everyone has their own preferred "consensus". I would say it should come from the scientific community, not government agencies. Sometimes government agencies agree with the scientific consensus, but not always.
My go-to source for nutrition information is Understanding Nutrition by Whitney and Rolfes.
There is a third option: looking at the diets of your closest ancestors with the best longevity.
There may be a misconception that there is one single best diet for everyone, when in reality we people (over generations) evolve with our diets, and your best diet and my best diet may be completely different.
The problem with using science as a guide is that there are just too many variables and not enough time, data and money to isolate them all sufficiently.
However that is distinct from the idea that too much of something like refined sugar might be unhealthy for just about everyone. So science does have an important role to play, I just don't think it's advanced far enough to fully answer the question for everyone.
I would caution that just because your body can make something doesn't mean it will have optimal performance when doing so. People in ketosis do have worse peak performance in sports than those that eat more carbs/sugar.
This is true, but I don't think our understanding of nutrition is good enough to really pick and choose what we want to optimize for. Eg we still don't have a recommendation on whether we should costume external vitamin K2 or not. The same goes for many amino acids. Some of the non-essential ones can have interesting effects when taken alone, eg glutamine - seems to help the gut lining. (We also don't know whether that's perfectly safe due to cancer risks, because some cancers eat glutamine.)
Your mind and health are impacted by your physical body. If eating a certain way impacts your physical performance then it might also have effects on your health (and mind) in unexpected ways.
I'm not saying that ketosis has this kind of an effect, but rather that eating or not eating some other things might. Eg vitamin K2. The body is be able to make vitamin K2, but we might have stronger bones and teeth, and a healthier cardiovascular system, if we get extra K2 from an external source.
Looks like it's true that low-carb adapted athletes rely more on fat oxidation during exercise but performance suffers nonetheless because of increased oxygen demands that basically cannot be met.
Your entire argument here applies in the other direction as well. You do not need dietary saturated fats, and sugar has all sorts of uses biologically.
That is only partly true: you don't need dietary saturated fats, but you do need essential fats (omega-3 and omega-6), which are polyunsaturated. However, sugar does not have all sorts of uses biologically; it has only one: as one (but not the only one) source of energy.
That sugar however is produced by the body itself.
Technically speaking, dietary requirement for sugar is 0. This doesn't mean it isn't useful to have some, but it definitely shouldn't be the basis of the food pyramid.
> There is another fallacy in play where people pushing these debates want you to think that there is only one single cause of CVD or health issues: Either sugar, carbs, fat, or something else. The game they play is to point the finger at one thing and imply that it gets the other thing off the hook. Don’t fall for this game.
Okay but right now we're talking about science getting corrupted by money. Which did happen in this instance, so that companies could hide the damage that sugar does to people.
Sugar does damage and scientists were paid to downplay that fact. It is not the first time. This is concerning when we talk about principles and public trust.
Where I'd suggest you go too far is implying that saturated fat and sugar are similarly bad. Technically you do hedge the claim with "excess", which is effectively a tautology, so the claim isn't outright false. You also don't qualify whether you mean excess in absolute terms (i.e. caloric intake) or as a proportion of macronutrients.
In practical terms, I don't consider it useful guidance based on the available evidence. As far as I can tell, there's little to no evidence that saturated fat is unhealthy (but lots of bad studies that don't prove what they claim to prove). Meanwhile, the population-wide trial of reducing saturated fat consumption over the past half-century has empirically been an abject failure. Far from improving health outcomes, the McGovern committee may well have triggered the obesity epidemic.
I think the benefits of "low fat" may have been dulled by how literally people took that message, and what companies replaced the fat with.
Most available "low fat" products compensated by adding sugar. Lots of sugar. That way it still tastes nice, but its healthy right?
Just like fruit juice with "no added sugar" (concentration via evaporation doesn't count) is a healthy alternative to soda right?
In truth your body is perfectly happy converting sugar to weight, with the bonus that it messes up the insulin cycle.
At a fundamental level consuming more calories than you burn makes you gain weight. Reducing refined sugar is the simplest way to reduce calories (and solves other health issues.) Reducing carbohydrates is next (since carbs are just sugar, but take a bit longer to digest). The more unprocessed the carb the better.
Reducing fat (for some, by a lot) is next (although reduce not eliminate. )
Both sides want to blame the other. But the current pendulum is very much on the "too much sugar/ carbs" side of things.
Agreed, this is a big part of the problem. The average person doesn't have anything resembling a coherent mental model of nutrition, and vague conflicting nutritional advice only adds to the confusion. The average person doesn't even know what a carb is, much less understand the biochemistry of how their body processes one.
Does "reduce fat consumption" mean a proportional reduction (i.e. increase carb/protein consumption) or an absolute reduction (i.e. decrease overall caloric intake)? In either case, what macros and level of caloric intake relative to TDEE are the assumed starting point? Who knows, but the net effect has been multiple generations hooked on absurd concentrations of sugar and UPFs.
> The next step, often implied rather than explicit, is to push the reader
This is the key part of this. It isn't even about the post or person that is being replied to, it's about the far wider audience who doesn't post but who who reads these interactions.
The big problem is that "truth tellers" very often leverage media platforms to sell their unscientific and unsupported or lightly supported opinions.
It's relatively simple to ultimately buy airtime to sell a product and have the one air host fawn over it as if what's been sold is the greatest truth of our lifetime. Some of the court documents against infowars placed the price for that sort of airtime at something like $20,000.
The problem comes in that the actual experts have very little want or desire to do the same. We're lucky if we see a few "science communicators" that step up to the plate, but they very rarely end up with the funds to sell the truth.
This a big part of how the "vaccines cause autism" garbage spread. Long before it caught on like it did, Wakefield was going around to conferences and selling his books and doing public speaking events on the dangers.
That pattern is pretty apparent if you look at major fad diets over the years. Selling that "you just have to eat meat" or "You just have to eat raw" or "You just have to eat liver" can make you some big money and may even land you on opera where you can further sell your magic green coffee beans.
Medical reality is generally a lot more boring. Like you point out, CVD is likely influenced by multiple factors. Diet, alcohol intake, exercise (or lack thereof) all contributing factors.
I disagree. Demand is the big problem, not supply.
The general public possesses domain-independent expertise on social pressures, institutional and financial incentives, and other non-epistemological factors that in some cases can support a rational rejection of scientific consensus.
Inadequate gatekeeping—premature or belated consensus or revision—is a failure of a given field of inquiry, not a failure of the general public.
> The next step, often implied rather than explicit, is to push the reader into assuming that the opposite position must therefore be the correct one.
See this in the constant "the MSM is imperfect, that's why I trust Joe Rogan or some random `citizen-journalist' on Twitter" nonsense. It's how everything has gotten very stupid very quickly. People note that medical science has changed course on something, therefore they should listen to some wellness influencer / grifter.
> excess sugar and excess saturated fat are both not good for you
The submitter of this entry is clearly a keto guy, and it's a bit weird because who is claiming sugar is good or even neutral for you? Like, we all know sugar is bad. It has rightly been a reasonably vilified food for decades. Positively no one is saying to replace saturated fats with sugar. In the 1980s there was a foolish period where the world went low fat, largely simply because fat is more calorically dense and people were getting fat, ergo less fat = less calories. Which of course is foolish logic and people just ate two boxes of snackwells or whatever instead, but sugar was still not considered ideal.
Someone elsewhere mentioned MAHA, and that's an interesting note because in vilifying HFCS, MAHA is strangely healthwashing sucrose among the "get my info from wellness influencers" crowd. Suddenly that softdrink is "healthy" because of the "all natural sugar".
The 80’s anti fat diet was mostly clogged arteries before we had all these anti cholesterol drugs and research showing how little impact dietary cholesterol has.
US obesity simply wasn’t as common (15% in 1985 vs 40% today) and at the time most research is on even healthier populations because it takes place even earlier. Further many people that recently became obese didn’t have enough time for the health impact to hit and the increase of 2% between 1965 and 1985 just didn’t seem that important. Thus calories alone were less vilified.
Put another way when 15% of the population is obese a large fraction of them recently became obese (last 10 years), where at 40% the obese population tends to be both heavier and have been obese for much longer. Heath impacts of obesity depend both on levels of obesity and how long people were obese.
The government and medical groups were advocating lower fat diets for CVD reasons, but among the mainstream it took hold overwhelmingly because it was seen as a mechanism for weight reduction or management. A gram of fat has twice the calories of a gram of protein or carbs, and this was widely repeated (yes, I was alive then). Similarly, if being fat was bad (and yes, it was viewed as very bad), then fat as a component of food must similarly be bad.
Obesity was obviously far less common, but concern about weight -- and note that weight standards were much, much tighter (see the women in virtually any 1980s movie, which today would be consider anorexic) -- was endemic culturally. Snackwells weren't being sold to middle age men, they were being sold overwhelmingly to younger office women paranoid about their weight, and it wasn't because they were concerned about their arteries. Low fat products overwhelmingly targeted weight loss, including such ad campaigns as the "special k pinch".
"Thus calories alone were less vilified."
I'm sorry, but this is simply ahistorical. Calories were *EVERYTHING* among a large portion of the population. What is your knowledge on the 1980s from, because it certainly isn't based upon observable reality.
In the 1980s, being slightly overweight made you the joke (like literally the joke, as seen from Chunk in the Goonies, and many parallels in other programs). As calories became cheaper and people's waists started bulging, it was an easy paranoia to exploit.
Sure, that’s a reasonable take, but satiety research was also far less developed.
The general understanding at the time was basically a full stomach tells people they have eaten enough. We didn’t understand the multiple systems the body uses to adjust the hunger drive and how much a high carb low fat diet messes with them.
> I'm sorry, but this is simply nonsensical. Calories were EVERYTHING among a large portion of the population. What is your knowledge on the 1980s from, because it certainly isn't based upon observable reality.
Less vilified is on a relative scale, I was alive back then and there was plenty of nonsensical low calorie diets being promoted. However you also saw crap like the Fruitarian Diet where unlimited fruit meant people could actually gain weight on a diet that also gave them multiple nutritional deficiencies.
Low fat dieting is in part from that same mindset as fruitarian diet where it’s not the calories that are the issue but the types of food you were eating. Digging just a little deeper these ideas made more sense before global supply chains and highly processed foods showed up. Culture can be a lot slower to adapt than technology or economics, diet advice from your grandparents could be wildly out of date. Cutting X means something very different when you have 20 available foods vs 20,000.
The US FDA requires that schools not serve whole milk or any products containing normal and natural saturated fats, and instead serve “low fat” versions which literally remove the fats and replace them with sugar.
You say nobody is doing this, but all the subsidized meals for my kids do this.
Taking the cream out is (by some diet theories) bad. The fat in whole milk slows down the absorption of lactose, leading to a slower rise in blood glucose compared to skim milk. Whole milk is more satiating as well, because of the fat.
If you are trying to have some reasonable balance of fat, protein, and carbs in your diet, pushing kids from whole to skim milk is going to move the diet towards consuming more sugar/carbs, even if you have a seperate rule trying to tighten sugar consumption.
When you take a high satiety, high fat item, and replace it with a non-fat, low satiety item, you are in effect replacing fat with sugar, because you will eat/drink more of it to get same number of calories, and same amount of fullness.
Drink a glass of whole milk, then drink a cup of skim milk and tell me there is no difference. Try the same with full fat yogurt and non-fat yogurt. Big difference in satiety, but more importantly blood sugar response. Roughly the same amount of fat in a glass of whole milk as 1/4 pound burger.
>Big difference in satiety, but more importantly blood sugar response.
There is a negligible difference in glycemic index / glycemic load between the variations of M.F. milk products. Some analysis has skim milk as having a lower GI.
Unflavoured Milk is not relevant to the GI conversation.
I don't think anyone ( at least around me ) is drinking milk based drink twice as much just because they feel like they get less energy per drink from skimmed milk.
You are making an argument that people do so, do you have any evidence for this ?
Skim milk is not "low fat". It is fat free. In the US milk labeled as low fat is 1% or 2% milk fat (usually 2%). Whole milk is around 4%. Skim milk rounds to 0%.
Is it added deliberately or just concentrated as a side-effect? Say fat comprised, let me guess, 5% of whole milk volume. If you take away this 5% v/v component, now everything else in one liter of skim milk is 5% concentrated by comparison, unless they add water.
It's saying it's you give all your change away and then replace it with new money then you increase your bill value.
The meal does not get smaller. The meal has a calorie target, and the milkfat gets replaced with new food. And almost never will that new food be a chunk of lard, so it will increase the carb ratio.
>which literally remove the fats and replace them with sugar.
This is not accurate.
No they didn't "replace" the fats with sugar. There is a chocolate milk option, just as there was before, but all options need to be 1% or low M.F., which nutrition and medical science overwhelmingly supports.
Is chocolate milk not ideal? Of course. We all know that. They shouldn't serve it either.
Starch is the preferred carbohydrate, since digestion depolymerizes it to pure glucose which can be used directly by cells.
Cane sugar, a disaccharide, is split by digestion into its constituent glucose and fructose molecules, and the latter must be further processed by the liver. It is 50% fructose.
High fructose corn syrup is 55% fructose.
A variety of other sugars, such as maltose and lactose occur naturally in a variety of foods. However, they are in low enough concentrations to not be a health problem.
HFCS is from 42% - 55% fructose (the glucose obviously filling the remainder). Many uses are on the lower end.
A lot of people think the "high fructose" part of the name is relative to sucrose's 50:50. In reality it's relative to corn syrup which is almost entirely glucose, but some of the glucose can be processed to fructose to more closely match the sucrose that people are accustomed to. They go a little higher on the fructose because it is perceived as sweeter, so with a 55% ratio they can use less for the same sweetness.
While what you say is true, starch is still nutritionally unnecessary. And wheat in particular has a lot of unhealthy or even outright toxic substances in it, especially if you are talking about the whole wheat.
But there is also the fallacy where some people want you to believe basically everything will cause CVD and there is no single thing you could do to change it, so therefore just keep doing whatever you’re doing.
I call this the "Everything in Moderation" fallacy. From what I've heard people who say it, they emphasize the everything part of it. In other words almost everything is bad for you so just eat a little bit of everything and you won't get too much of the bad stuff. It's maddening.
The way I understand it (and my understanding is certainly poor, so I welcome well-supported pushback on it), is that few, if any, components in the food that we in developed countries eat today are actively harmful in themselves (with the caveat outlined below)
The main issue is overconsumption leading to overweight and obesity. Food that’s high in refined sugars and/or saturated fats tend to contribute to this, because it’s palatable and calorie-dense
So in that sense, yes - I believe that as long as your diet is varied enough that you get sufficient intake of all, or at least most, of the essential nutrients, and you don’t eat too much (i.e. in moderation), the ratio of macronutrients doesn’t make a big difference to your health outcome
The crux is that moderation is hard when the food is jam-packed with calories, and it’s so delicious you just want to keep stuffing your face
By volume most of the food in modern western grocery stores is unnaturally sugary or otherwise calorie dense.
You have to restrict yourself to produce and a few scant other options to escape with balanced nutritional products.
They even advertise cereals as a "part of a healthy breakfast". Which is a lie under any circumstances, because it's never a healthy part if you eat it long term. (Yes it could keep you from starving to death in a famine, still not 'healthy'.) Imagine if they could only say "it will keep you from starving, and may significantly contribute to diabetes"
I don’t think “Everything in Moderation” means you won’t get too much of the bad stuff. The philosophy alludes to the fact that in the modern world, trying to have the ideal diet is exhausting and near impossible. Lack of choice, money, time, education, self control etc. all contribute to you intentionally or unintentionally eating stuff that’s going to do irreparable harm to you. You could be eating salads and somehow poisoning yourself with pesticides and high sugar/fat/sodium salad dressings. Which is why this philosophy focuses on, do everything in moderation and you’ll maybe avoid CVD and other diseases for longer. It is meant for people who cannot meet the idealistic standards of what you are supposed to do.
Is it really that exhausting though? I've been on a zero-carb diet for two months (other than thanksgiving or christmas), and it really hasn't been hard at all. If I eat at a restaurant there's some things I can't avoid (seed oils), but otherwise it's not too hard to look at a menu and see things I can eat. The only hard part is to be optimally healthy I need to cook for myself, but that's always been true.
In a lot of ways, it's actually been easier. Because my blood sugar isn't crashing every few hours, I can easily skip a meal and feel perfectly fine. Fasting is very easy for me now, which it wasn't at all on an unhealthy diet.
Yet you are unavoidably eating micro-plastics too, which have been linked to adverse CV events.
Also:
- If you are eating more fish (as opposed to eating meat), you are likely consuming more mercury.
- If you are eating more fresh veggies you are probably ingesting more pesticides.
- If you are easting dark chocolate for its health benefits, you are also ingesting cadmium and other heavy metals.
So all the above should be done in moderation. Even things that seem like unalloyed good can be dangerous. A burst of exercise beyond your conditioning can lead to a CV event. Too much water can be poisonous. Some people get constipation for too much veggies in their diet.
For example, instead to sticking to a narrow faddish supposedly healthy diet, you can enjoy a wide range of foods, which will make it more likely you are getting all the nutrients that will do you good (of course clearly unhealthy food should be avoided).
The body is more complex than we can ever know. There are some general principles for good health (including CV health) that should be followed, but to me it is clear that good health does not arise from a slavish devotion to very detailed set of rules.
Funnily I've heard that one reason why obesity is prevalent is that we have too many variations of food. Seems like our hunger controller suspends satiety when we eat a food too much, but when we eat few of lots of different foods, it's broken.
It'd be funny if lots of fad diets actually works because people are forced to eat a single type of food and that's entirely enough for it.
Your post sounds like "bad things can happen so why bother". Having a good diet isn't "slavish devotion", it's more like "don't eat something obviously terrible"
People who don’t make money, have to take care of childcare while working 2-3 jobs, probably aren’t able to cook themselves. Nor are the people who live in food deserts that only have limited options able to optimize around a specific diet that’s not restricted by availability.
I cook my own food and optimize around eating healthy. I wouldn’t be able to do it if I made less money or had a more demanding job or didn’t have great grocery stores in a 10 mile radius or had to spend time in childcare or any of the other completely valid reasons people have.
Besides, you yourself just described “do things in moderation” yourself: holidays, Christmas, restaurants etc. That’s really what the philosophy is.
What is moderation? The volume (or mass) of a single apple of alcohol is going to make you very drunk (most alcohol is mixed with water: an apple's worth of beer is very little, that much Everclear is a problem).
That is what I hate about the everything in moderation. We need to do better since some things should be in much larger amounts than others.
I think we all would agree that any amount of rat poison is a bad thing, thought perhaps this is too much of a strawman.
the greatest travesty of modern science is that fraud is not illegal.
in every other industry that i can imagine, purposely committing fraud has been made illegal. this is not the case in modern science, and in my opinion the primary driver of things like the replication crisis and the root of all the other problems plaguing academia at the moment.
It's hard to prove when it isn't investigated. How many of the debunked psychology professors took federal funding? How many have been criminally investigated?
my own institution launched an internal investigation into a professor who i know for a fact committed fraud and was "unable to prove intentional wrongdoing". academic institutions have taken the "this never happens because we are morally pure" approach which we all know is a load of baloney, they are perversely incentivized to never admit fraud.
the witness and reportee who i am friends with was directly instructed by this professor to falsify data in a more positive light in order to impress grant funders. multiple people were in attendance in this meeting but even that was not enough to see any disciplinary action.
duke also has a notorious reputation for being a fraud mill.
Note both those guys were found guilty for taking government money under false pretenses (to do with fake science, not for doing fake science, which is more supporting evidence that fake science is legal.
There is a common trick used in contrarian argumentation where a single flaw is used to “debunk” an entire side of the debate. The next step, often implied rather than explicit, is to push the reader into assuming that the opposite position must therefore be the correct one. They don’t want you to apply the same level of rigor and introspection to the opposite side, though.
In the sugar versus saturated fat debate, this incident is used as the lure to get people to blame sugar as the root cause. There is a push to make saturated fat viewed as not only neutral, but healthy and good for you. Yet if you apply the same standards of rigor and inspection of the evidence, excess sugar and excess saturated fat are both not good for you.
There is another fallacy in play where people pushing these debates want you to think that there is only one single cause of CVD or health issues: Either sugar, carbs, fat, or something else. The game they play is to point the finger at one thing and imply that it gets the other thing off the hook. Don’t fall for this game.