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High carbohydrate intake, not fat, was associated with higher risk of mortality (2017) (www.thelancet.com) similar stories update story
85 points by jeremylevy | karma 4626 | avg karma 13.07 2022-01-29 11:00:47 | hide | past | favorite | 108 comments



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But what about the whole movement toward plant-based diets?

It probably depends on what you mean by “plant based”. If you mean a broad range of plants with plenty of fiber and nutrients, that is probably good. If you mean “eat all the rice, corn, and potatoes”, then your results may be wanting.

I don’t understand the hate for potatoes, they have tons of nutrients.

Potatoes have many nutrients including Potassium which most people are deficient in but they also spike insulin without an equal rise in glucagon. Many people are developing insulin resistance and steadily heading towards pre-diabetes so these days folks are watching out for things that spike insulin.

Potassium deficiency is very rare, and causes arrythmias and other electrical problems just like ingesting too much of it.

I think you mean magnesium, whose deficiency is widespread and it is though to be caused by depletion of it in the soil due to intensive agricultural practices.


> Potassium deficiency is very rare

Potassium-deficient diets are not rare. Using the U.S. as an example, only 3% of people in the U.S. consume adequate levels of potassium in their diet according to the most recent NHANES survey.[1] The U.S. Dietary Guidelines Advisory Committee has identified potassium as 1 of 4 "shortfall nutrients" (nutrients that are underconsumed by the U.S. population at large) that are of public health concern in 2015.[2] That is why the FDA has required food manufacturers to include potassium amounts in the "Nutrition Facts" label since 2016.[3]

[1] https://academic.oup.com/advances/article/4/3/368S/4591617

[2] https://nutritionj.biomedcentral.com/articles/10.1186/s12937...

[3] https://www.ift.org/news-and-publications/food-technology-ma...


Given that 68% of people in the US are deficient from the other electrolyte, magnesium, I maintain that potassium deficiency is rare(r), and certainly is scarier to supplement that Mg is.

https://www.lifeextension.com/magazine/2005/9/americans-magn...


What? 97% of U.S. people have potassium-deficient diets, which is greater than the 68% of U.S. people who have magnesium-deficient diets (according to your source). I agree that anyone who is taking potassium supplements should carefully monitor their potassium intake, but most foods have low enough levels of potassium that excessive potassium consumption is extremely uncommon. The FDA limits most potassium supplements in the U.S. to 99 mg per dose, an insignificant 2% of the Daily Value.*

* https://ods.od.nih.gov/factsheets/Potassium-HealthProfession...


No I mean Potassium. Very few people eat foods rich in Potassium and certainly very few people come close to the 4.7 grams RDA. Excess Potassium is excreted by the kidneys assuming one does not have stage 4 renal failure. Potassium is extremely hard to measure in the serum because the body always tries to keep the levels high enough but the cellular levels can be deficient even when serum levels appear fine. Chronic low potassium intake can lead to idiopathic hypertension. I learned this the hard way.

If a person is consuming the RDA and having arrhythmia I would suggest they see a doctor and require extended lab work and multiple EKG's done to find out what is going on. There could be a more serious issue that needs to be addressed sooner than later. One could even get their own consumer grade 6-lead EKG to get prolonged measurements that the doctors office will not have time for.


As I mentioned in a sibling comment, 68% of US people are Mg deficient, 3% are K deficient. And considering how many are hypertensive, K supplementation, which is already tricky, needs an even bigger caveat, as many hypertensive medications are potassium sparing, thus supplementation should _not_ be done without medical supervision. I agree that it's tricky to test, and the science around potassium metabolism with HTN medication is confusing and contradicting: you can find studies for the same medication that say it's potassium sparing and another that says that hypokalemia is a common side effect.

You can have vegetables containing potassium, sure, but it's a bit of a stretch to say that potassium deficiency is widespread, in general and supplementation of it is discouraged.


> 68% of US people are Mg deficient, 3% are K deficient

My comment said that "only 3% of people in the U.S. consume adequate levels of potassium in their diet according to the most recent NHANES survey", which means that 97% of U.S. people (100% - 3%) have diets that are deficient in potassium (K).

> And considering how many are hypertensive

Excess sodium and insufficient potassium in the diet contribute to hypertension, not the other way around.[1][2] In contrast to potassium, 89% of U.S. adults and 90% of U.S. children exceeded maximum recommended sodium intake levels in the 2009–2012 NHANES survey.[3] With almost everyone in the U.S. consuming too much sodium and too little potassium, the high prevalence of hypertension (29% of U.S. adults as of 2011–2012) is not surprising![3]

[1] http://cardiacos.net/wp-content/uploads/ArticulosMedicos/200... (PDF)

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4224208/

[3] https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6452a1.htm


Starchy carbohydrates, unfortunately, are one of the two ways to consume way too many calories way too quickly.

It's hard to eat 2000 calories of steak in a sitting. It's almost impossible to eat 2000 calories of lettuce, broccoli, cabbage, etc. in a sitting.

It's really easy to consume 2000 calories of potatoes, wheat, or rice in a sitting.

The other easy way to consume way too many calories is to slather your food with butter or oil. A tablespoon of oil or butter isn't terrible and may even be healthy for you--a quarter cup, however, is approaching 1000 calories. That's not so good. And people tend to use whole sticks of butter in cooking (1 stick is 1/4 cup) per dish or easily put a quarter cup of salad dressing (mostly oil) on their vegetables.


An entire large potato is 300, 400 calories. Even "loaded" with fixings, I can't imagine eating 2000 calories in potato-centered food in one sitting.

> It's really easy to consume 2000 calories of potatoes, wheat, or rice in a sitting.

You would have to eat 1.5kg of cooked rice to eat 2000 kCal of rice. You would have to eat 1.9kg of potatoes. I don't know what you call "really easy" but about 180g of rice is a normal portion.

The same would require about 800g of steak, by the way.


Eating a small serving of potatoes is generally fine for most people who have a healthy metabolism (i.e. not insulin resistant). But they do have a high glycemic index.

https://www.va.gov/WHOLEHEALTHLIBRARY/tools/glycemic-index.a...


Potatoes are their own worst enemy in a way since they are delicious fried in high temperature oil which is not super healthy for a number of reasons. But yes I agree with you in general, I hear you can technically survive on potatoes and butter.

Yes, potatoes contain all the proteins necessary in the human diet. So in a pinch, just potatoes + a multivitamin will, uh, suffice for a while.

Oats and most legumes (soy, peas, lentils, etc.) are like this as well. And spinach. Many other plant foods, like wheat, do have all the proteins required by humans, but not in quantities sufficient to meet the minimum intake at normal calorie levels if you ate them near-exclusively.

This is conjecture, but I suspect this is the underlying reason for why so many vegetarian dishes are based on a pairing of wheat or rice with a legume. Peanut butter + crackers. Tahini + pitas. Curry + rice. Bean + wholegrain salad. All the same pattern.


Hah, you’re comment cracked me up remembering some dude who showed up in a food thread the other day saying that he’d been eating for like $0.30 cents per meal by eating nothing but potatoes. Built different.

A lot of the nutrients are in the skin, so the real trick is to buy organic (no pesticide), then eat the skin also... Reducing food waste is a bonus.

What about them? They're mostly low carbs

When people talk about food it seems they forget about nuance. Somebody catches wind that a high carb diet is bad and before long they're full carnivore and start proselytizing that eating a fruit will kill you.

I'm on carnivore, and although fruits are no-no (for me at least), in my own research they're better than grains and other vegetables. Unlike leafy vegetables, most fruits are evolved to be eaten by animals, and have the seeds pooped out or discarded in the ground. That's why they taste so fricking good. Though evolution didn't make them this big and full of sugar, we did. And then we juice them so you can consume 20 apples in one sip, and call that healthy.

In my eyes and personal opinion, the diet we are most genetically optimal for is high fat, mostly carnivore, with seasonal fruits and berries, and remembering that modern fruits are nothing like what we have been eating for hundreds of thousands of years. And ideally insects, though they weren't a huge part of our diet. We after all are big herbivore hunters and scavengers.


Wait, are you actually serious? You don't eat fruits or vegetables because you think they are unhealthy?

Fruits have a ton of sugar, which I both don't need and don't really like.

OTOH, you can pry my veg from my cold dead hands.


Pretty much every study ever has found a correlation of more fruits = healthier. That majority of studies just group fruits and vegetables together because they basically have the same effect as vegetables in terms of above correlation.

Fruit juices however, totally worthless, just as bad as sugar.


Healthier than what? "Healthy" doesn't exist in a vacuum.

Fat is healthy in a vacuum, fat with a carb heavy diet causes metabolic syndrome.

Fruit is healthy in a vacuum, but anything containing fructose, fibre or not, isn't great when you have metabolic syndrome, insulin issues or non-alcoholic fatty liver disease.

Plenty of nutritional studies are completely worthless for this reason. There is no double-blind, randomised and controlled dietary studies.


> In the 2 prospective cohorts with many repeated measurements of diet and up to 30 years of follow-up, we observed that a higher intake of fruit and vegetables was associated with a lower risk of total mortality and cause-specific mortality in a nonlinear manner. Our analysis in the NHS and the HPFS and in a meta-analysis of 26 prospective cohort studies documented that intake of ˜5 servings of fruits and vegetables daily was associated with the lowest mortality, and higher intake was not associated with additional risk reductions in mortality. The thresholds of risk reduction in mortality were 2 servings daily for fruit intake and 3 servings daily for vegetable intake. Higher intakes of most subgroups of fruit and vegetables were inversely associated with mortality, whereas intakes of starchy vegetables, fruit juices, and potatoes were not associated with mortality.

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.0...

A study doesn't need to be "double-blind, randomised and controlled" to have value. This study of 108,000+ people over 28-30 years is going to be more pertinent to the average person than, for example, an anecdote.


I eat some, but very little. 99% of my calories comes from animal foods.

I do not think they are _unhealthy_, but there are some benefits in restricting them in some cases. In mine, cures _my_ digestive and mood issues. One is caused by whacked intestinal flora, and once your gut is completely destroyed, nutrient malabsorption caused by phytates and other phytochemicals worsen into systemic issues, including mood disturbances and inflammation. In my case, the experiment has been an absolute success, but I often succumb to the temptation of a pizza and I'm 5 steps back.

Long term, I will reintroduce some as they are benign, but grains are actually bad for me. Gluten is even worse, again, for me.

There is more, but this is good enough for an internet comment. The science is a google search away.


What types of meat do you eat? How does a normal day of eating work like that?

3/4 of what I eat is organic, pasture-raised beef, pork and lamb from family owned farms, the rest is meat from supermarkets just because it's cheaper and sustainable meat is hard on the wallet. I hate cooking, I hate having to do it twice a day, so for me it's mostly grill/oven/pressure cook and eat 500g of meat twice a day with a little salt and spices. If I feel the need for more energy, butter or high quality organic ghee is added. Hunger is non existent, and I figure I'm naturally eating at a 20% deficit, because I have fat around me and my body knows it. Blood sugar perfectly stable at 5.5mmol/L, which feels incredible.

But vegs works great as a treat. Today I had a simple salad with my steak and it was lovely, though I'm a little gassier now.

If you use Reddit, look into /r/carnivore or /r/zerocarb.


Super interesting! Are you actually in a caloric deficit though?

I'd love to learn more about this type of diet btw, any recommendations before I jump into this rabbit hole?


I've updated my comment with reddit resources. Read on the science as well, learn about it.

It would be hard for me not to be in a caloric deficit. Meat and fat are incredibly filling, and once your body switches to ketone bodies and then fatty acid oxidation for fuel, it learns that, if you're overweight, you're carrying a ton of fuel ready for use. It's hard to explain if you haven't experienced it, but it actually feels _good_, as opposed to the regular carb and insulin dance.


> any recommendations before I jump into this rabbit hole?

Consult your physician.


Not the OP, but because this affects your health and thus whole life, be very conscious if the dietary advice you are getting comes from someone with a long term history of that diet!

In other words find people who are advanced in years and with the health results you hope to attain, and observe what they do. Preferably people with similar genetics to yourself!


You've got to be kidding. Most physicians know very little about nutrition. And that's not a criticism of physicians, it's just not really their field. Maybe try a registered dietician instead?

> The science is a google search away.

Google is not science. Google is not a particularly good way for many people to consume science, either, as unless one has a scientific background and a good deal of perspective, the average person just ends up confirming their biases by only looking at "science" that conforms to their bias.

I for one, was a heavy meat eater for much my life. Going pescatarian (kinda, I really just do fish oil and maybe fish as a dish once a month) recently lead a huge quality of life for myself. Really though, anecdotes are nearly completely worthless.

All other health issues with meat aside, a fully meat diet is going to load you with iron, and iron is a vigorous initiator of free radical oxidations, and high iron is associated with early dementia. Iron is also super hard to remove the body. If I ate an all meat I would watch my iron closely and perhaps donate blood as often as possible. And if you combine lots of meat with junk carbs, then that is most destructive diet possible.


Saying "google is not science" is like saying "spotify isn't music."

Yeah if you just go on there and do a mostly undirected mosey through whatever it suggests, you'll probably end up with low quality nonsense. The answer is to become better at using the tool.


The issue with talking nutrition with people is that they think one size fits all and that the body and its digestion is a simple machine we have fully understood.

Like you are preaching that meat gives too much iron and is bad, while in my experience decades of eating gluten have caused nutritional imbalances, one of which is called iron-deficiency anemia, and causes brain fog, tiredness, pallor and shortness of breathing. More meat and iron supplements (rarely) gives me an amount of energy I haven't felt in a decade. I've found this out for myself because even medical doctors keep repeating advice ("you should eat less red meat and more whole foods" is the MD's mantra) which doesn't respect one's own physiology and weren't able to track this down.

Yes, people can thrive on a diet of Mars bars, but it's not that simple and doesn't work for everybody. And I'd be more worried about heavy metals on a pescatarian diet than any other diet, vegan or otherwise.


Between you and me, and I think a reasonable person would identify you as the one preaching. I mentioned iron once and that was me doing my best to interact with your extreme position as reasonable and productively as I could possibly manage. But since you brought it up again, I'll take this time to mention that the population with the longest lifespan AND health-span in the world, are anemic as a rule (Japanese women).

> The issue with talking nutrition with people is that they think one size fits all and that the body and its digestion is a simple machine we have fully understood.

Anecdotes are worthless. Conditions get worse or better, for a variety of reasons and a sample size of one is statistically and scientifically worthless. It's nearly impossible to perform something like a double blind study on one's self, and even if you could make to bake out the bias, you still have sample size of 1. You may have found a system that you can live with, but the fact that you have concluded that an nearly all meat diet is the healthiest for you means either that you either aren't human or disagree with the vast majority of dietary scientific knowledge.

For what it's worth, I was on a keto diet for a number years and my approach to keto was a nearly all meat with moderate amounts of low carb vegetables. I did good on the diet as a rule and dropped weight as rock, but study after study has found that more meat equates more higher mortality and shorter health-span. I cut out a lot of the meat but continued to abstain from simple carbs and processes foods and now have given myself the best chance known to science to be healthy in terms of diet.

> Yes, people can thrive on a diet of Mars bars, but it's not that simple and doesn't work for everybody.

Also, nobody can thrive off a diet of mars bars, so I fail to see how that adds anything to your point. Are somehow trying equate eating only mars bars with eating a diet with fruits and vegetables? Eating a diet of all mars bars has a lot more in common with eating a diet of nearly all meat than it does eating a varied diet that includes significant portions of fruits and vegetables, in a extremely unbalanced diet sense.

> And I'd be more worried about heavy metals on a pescatarian diet than any other diet, vegan or otherwise.

You are consuming more heavy metals than I am with your daily meat intake than I am with my monthly fish. And antibiotics, dioxins, copper, arsenic, and many other adulterants that end up concentrated in factory farmed meats. So if you are worried about heavy metals, I would be worried.


Excessive iron levels can be dangerous, but iron deficiency is also common among athletes.

https://www.teamusa.org/USA-Triathlon/News/Blogs/Multisport-...


I'm very sorry to hear about your digestive and health issues.

With diets we don't see the effects fully in the short term and from what you said I highly suggest you work out how to eat a range of vegetables in your diet, to support your nutritional long term needs.

If it's not just fruit but also vegetables that trigger your digestive issues, are you aware of the low Fodmap diet? It is based around understanding which vegetables don't cause the inflammation you mentioned, designed for people with digestive issues and reducing food irritation and inflammation.


Not the parent but going ti check this out. Feels that this could help bloating

It certainly did for me + IBS goes away after just a week on it. Gas is passed once a week, if at all. It's hard to argue that my gut is extremely happy when eating an extremely restricted diet. Digestion is a non event.

And no, you don't _need_ fibre. I'm right in the middle of the Bristol stool scale with zero fibre. Another thing that scientists are uncovering right now but "you need fibre, fibre is good" keeps being parroted by everybody because someone said so 5 decades ago. Such is dogma.


fwiw, my wife is going through a similar experience and has done roughly 1 bajillion hours of trying to sort out the various buzzword diets referenced across the internet.

"Fuck it i'm just going to eat chicken soup and unaged beef and ghee" is not nuanced, nor is it a great idea long term probably, but it did bring a pretty abrupt end to a lot of the symptoms she was having, including but not limited to: diarrhea, esophagitis, duodenitis, insomnia, random undirected anxiety, lethargy and ovarian cysts. We don't yet know what she was eating before that was causing issues, but it seems pretty clear that the issue was in her diet. She is planning on slowly reintroducing foods but her planned timeline is measured in years.

I say this as a vegan of many years. I hate it, but I can't argue with the results so far.


Thank you for bringing this up. It means that I am not crazy when I notice that I get really tired after eating certain foods.

Last November I started to have serious digestive upset, to the point where I missed most meals due to nausea, stomach cramps and diarrhea. Lost a tonne of weight and fell into anxiety and depression.

I was introduced to the idea of FODMAPs

https://en.m.wikipedia.org/wiki/FODMAP

A low FODMAP diet basically restricts stuff like gluten, a lot of fruit and vegetables, etc. I've found it has pretty much solved my digestive issues, and if I cave in and eat a bread sandwich... I'm suffering for the next 2 days.

I think the human digestive system is highly complex, and should be the focus of a lot of research. There's so much we still don't know about the effects of what we eat.

I hope one day I can reintroduce "normal" food again... Because frankly FODMAP restriction sucks. At least I'm not wasting away anymore.


Kill off the fermenting yeasts from your gut and replace them with beneficial microbes.

When you want to try bread again, look for sprouted grains. It may help.

Thanks

Funny how things are between people. I hugely cut down on meat and mainly eat fruit and veg, with some chicken and fish but rarely red meat. I too feel better than ever, lots of energy.

I will never understand how people can go around saying things like, "In my personal opinion, the diet we are genetically optimal for.."

You are not interpreting genetic information. You are speculating about human evolutionary history and what "paleo" means.


Are they? Plants aren't known for their fat or protein contents are they?

Nuts and seeds are known for their fat and protein content. Legumes are known for their protein content. Avocados are known for their fat.

and olive oil, palm, sunflower, canola oils...

the result of processing plants isn't the same thing as 'what plants are known for'.

all the things you're talking about involve pressing seeds.


Olive and palm oil do not involve pressing seeds, and have been around for thousands of years.

Oil is literally made by pressing seeds.

Most oils are made by pressing seeds. Some are not.

So what? Pressing seeds does not matter here. Nobody eats an orange or an avocado without peeling it first and nobody eats a nut without cracking it first. So some kind of processing is assumed.

Some of the most appreciated vegetable oils, like olive oil or avocado oils, are not even in the seed.


> the result of processing plants isn't the same thing as 'what plants are known for'

This claim does not have any sense. If there is a thing that most plants are known for, is as a source of valuable products after being processed.


What about it?

The movement toward plant-based diets is almost always made for ethical reasons. The health reasons are mostly due to healthy user bias. It's not surprising to me that maximizing some ethics and maximizing health would lead to different diets.

Yeah that’s not true and is mostly due to your bias.

The Harvard School of Public Health released some comments about this soon after: https://www.hsph.harvard.edu/nutritionsource/2017/09/08/pure...

Indeed. Probably the most pertinent quote is this: "The main messages for nutritional advice have not changed: follow a healthy dietary pattern that includes abundant amounts of vegetables, fruits, whole grains, legumes, and nuts; moderate amounts of reduced-fat dairy products and seafood; and lower amounts of processed and red meat, sugar-sweetened foods and beverages, and refined grains."

Metabolically, fruit is not very different from “sugar sweetened foods and beverages” (and imho gram for gram, fructose is worse than sucrose). The same goes for whole grains.

Fat is the most calorie dense nutrient. The human race has spent a majority of its time just trying to stay alive. Up until very recently, this meant eating substantial quantities of fat, and specifically animal fat.

Harvard Medical is part of the problem. People stop getting published if you’re contra-establishment, which means you stop getting juicy grants and donations.


From what I've read though, the sugar content in fruit isn't metabolised in the same way as say a bar of chocolate.

This is why I said it was worse. I’m being downvoted by people who don’t actually know the science.

Fructose must be metabolized by the liver, whereas glucose can be metabolized directly in skeletal muscles as glycogen.


People are disagreeing with you because you claimed, without evidence, that eating fruits and whole grains is similar to consuming sugar-sweetened foods and beverages.

Fructose in fruit is trapped in the fibrous flesh and takes longer to digest. As it progresses through your system, a good portion is consumed by the gut microbiota so it doesn't have the same impact on your body.

Processed food using high fructose corn syrup, is not going to be digested in the same way as an apple.


A good portion? How much? What impact on the body are you referring to? How is the digestion different?

I would love to engage, but I have nothing to engage with. Yes, fiber impacts digestion, which has nothing to do with metabolic pathways. But even such, high sugar fruits have similar GIs to HFCS...the digestive impact of fiber is relatively small (compared to fats and amino acids, especially non glucogenic).


The team, from the University of Hohenheim, Germany, analysed the microbiota composition of 12 healthy females following consecutively different high-fructose diets, first a fruit diet (100 g/day fructose from fruit and vegetables) and then, after a low-fructose phase, a high fructose syrup (HFS) diet (100 g/day fructose from syrup) and characterised the responses of bacterial communities after the different dietary interventions.

The report concludes that a high-intake of fructose syrup causes a reduction of beneficial butyrate producing bacteria and a gut microbiota profile that may affect unfavourably host lipid metabolism, whereas high consumption of fructose from fruit seems to modulate the composition of the gut microbiota in a beneficial way supporting digestive health and counteracting harmful effects of excessive fructose.

Besides a high fructose content, the authors note that the high fruit diet was characterised by a relatively high content of fiber. They therefore point out that observed alterations in gut microbiota may at least partially reflect changes driven by a higher intake of fiber rather than changes in response to the high-fructose consumption.

Fibre is an important component of the human diet and has known health benefits including lowering cholesterol and improving blood glucose responses. Dietary fibre as a prebiotic has specific effects on the microbial populations and its function as individual taxa have been shown to selectively metabolise discrete fibre structures.

To me, although I don't really know a lot, it seems quite logical that fruit is generally good for you and quite hard to overeat. We've been consuming fruits for thousands of years and although agriculture may have increased availability and nutritional value, comparing 10g of fructose found in an apple to 10g of fructose found in candy is nonsensical.


> Metabolically, fruit is not very different from “sugar sweetened foods and beverages” (and imho gram for gram, fructose is worse than sucrose). The same goes for whole grains.

Most fruits* and whole grains have higher fiber content, higher nutrient density, and lower glycemic indexes than sodas and junk foods that are high in added sugar. There is strong evidence that high added sugar (including added fructose) consumption contributes to health issues like obesity and type 2 diabetes, but no evidence that fruits and whole grains in general are unhealthy for most people.

* Excluding fruit juices


That's true to an extent, but everything in moderation. If you consume a large quantity of fruit in a short period of time then your body will turn the excess fructose into fat.

https://peterattiamd.com/rickjohnson/

https://www.scientificamerican.com/article/ancient-mutation-...


An extent? Was anything claimed not actually true?

If you consume an excess of calories no matter what the food you'll gain weight, so that seems like pointless pedantry.


Please go back and read my comment, and the linked pages, more carefully. Obviously a positive energy balance will result in weight gain. The issue is that excess fructose will specifically cause fat gain as opposed to gains in other types of tissue. Other nutrients don't activate the same metabolic pathway. This is a crucial distinction and not pedantry.

I read your comment and one of the linked pages was a summary (and I'm not listening to the 2 hour discussion) and the other behind a paywall. Are you claiming that a large excess of calories due to consumption of which other nutrients than fructose does not cause adipose tissue increase? Because that would be pretty astounding. Can you copy a verbatim quote from the scientific american article (or timestamp from the video) that supports this?

Also to add: the chances of most people binging on fresh fruit are pretty low.

(Processed fruit like raisins and fruit juices are another story.)


> Most fruits* and whole grains have higher fiber content

True

> higher nutrient density

False (this is the problem with processed foods - they are dense and people eat too much)

> and lower glycemic indexes

True, but ignores a whole host of other considerations such as metabolic pathways.

> There is strong evidence that high added sugar (including added fructose) consumption contributes to health issues like obesity and type 2 diabetes, but no evidence that fruits and whole grains in general are unhealthy for most people.

False. There is evidence that people eat far too much, full stop. And much of that excess comes from cheap refined carbs. This is a socioeconomic observation and not a metabolic one. You are confusing correlation and causation. It’s comments like these that are the reason we have such horrible nutritional advice.

My comment was about how sources of carbohydrates (and all food for that matter) are more similar than dissimilar: drinking a soda and taking a multivitamin is metabolically not much different from eating fruit. That doesn’t mean people should drink soda instead of fruit, but it does mean people should consume less of both. You are better off having some vegetables, nuts or animal fats/proteins. Fruit isn’t healthy just because it’s natural.


Nutrient density is not a measure of calories per mass or volume (energy density). This is what nutrient density means in the context of nutritional science:[1]

> The nutrient density standard, as defined by the FDA, is the ratio of the amount of beneficial nutrients relative to the food’s energy content per reference amount customarily consumed. The more nutrient-dense foods are those that contribute more beneficial nutrients than calories to the overall diet.

Fruits and vegetables generally have higher nutrient density than most other food categories:[2]

> As expected, we found that fruits and vegetables were nutrient-dense in relation to their energy content.

> However, the data unambiguously showed that fruits and vegetables were nutrient-rich in relation to the little energy that they provide. Although fruits and vegetables suffer when assessed on the calories/price ratio, they represent extremely good value when assessed using the nutrient density score and the nutrient to price ratio.

Sugar-sweetened beverages (SSBs), the most common source of added sugars, contributes to obesity and type 2 diabetes (T2D):[3]

> Consumption of SSBs has increased markedly across the globe in recent decades, tracking closely with the growing burdens of obesity. These beverages are currently the largest source of added sugar intake and the top source of daily energy in the US diet. The cumulative evidence from observational studies and experimental trials is sufficient to conclude that regular consumption of SSBs causes excess weight gain and these beverages are unique dietary contributors to obesity and T2D. Compelling evidence indicates that reducing SSBs will have significant impact on the prevalence of obesity and its related diseases, especially T2D.

Consuming at least 2 servings of fruit and 3 servings of vegetables per day (excepting fruit juices, starchy vegetables, and potatoes) is associated with lower mortality:[4]

> In the 2 prospective cohorts with many repeated measurements of diet and up to 30 years of follow-up, we observed that a higher intake of fruit and vegetables was associated with a lower risk of total mortality and cause-specific mortality in a nonlinear manner. Our analysis in the NHS and the HPFS and in a meta-analysis of 26 prospective cohort studies documented that intake of ˜5 servings of fruits and vegetables daily was associated with the lowest mortality, and higher intake was not associated with additional risk reductions in mortality. The thresholds of risk reduction in mortality were 2 servings daily for fruit intake and 3 servings daily for vegetable intake. Higher intakes of most subgroups of fruit and vegetables were inversely associated with mortality, whereas intakes of starchy vegetables, fruit juices, and potatoes were not associated with mortality.

And again, there is no evidence that fruits and whole grains in general are unhealthy in a balanced diet for most people.

Eating fruits is not equivalent to combining sodas with multivitamins. Fruits have fiber, antioxidants,[5] and other compounds that are absent from multivitamins.

[1] https://academic.oup.com/ajcn/article/82/4/721/4607427

[2] https://www.researchgate.net/publication/7446672_A_Nutrient_...

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325726/

[4] https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.0...

[5] https://en.wikipedia.org/wiki/List_of_antioxidants_in_food


You really, really do not understand correlation vs causation. And you're so convinced you're right, you're hawking terrible science. Every claim you make is hedged: "...in a balanced diet". Yeah of course, in a balanced diet, nothing is unhealthy because by definition the unhealthy bits are balanced out somewhere else. What are you actually trying to prove here? Your grasp on these topics is tenuous at best. Antioxidants? Do you only get your nutritional advice from Whole Foods? Do you know how weak the science around dietary antioxidants is and our understsanding of free radicals in general? Fine, don't like my soda analogy...mix some psyllium husk in with your soda. Now you have fiber...this doesn't change the metabolic pathway in any material way. You don't understand what I'm talking about.

Honestly, these kinds of views are why the American diet is so poor. You so desperately want to prove a narrative, irrespective of what the science actually says. You're focused on nutrient density, as opposed to the real issue: calorie density. We don't need to run around inventing new standards for "nutrient density"...we need to get people to eat less. And most people are over eating due to chronically elevated insulin levels and reduced insulin sensitivity on the back of carbohydrate based diets. People aren't dying prematurely from specific vitamin, mineral, or EFA/EAA deficiency. They are dying because they are obese. Even a horrible diet is going to provide most nutrients in sufficient quantities. Outside of a select few nutrients, the human body can synthesize and up/down regulate processes to accommodate varying levels of "nutrients"...this is not what people in the developed world grapple with. But sure, let's all eat wheat cereal with oat milk and fruit and honey for every meal. So healthy.


I used the words "balanced diet" to rule out, for example, someone eating only fruits and nothing else. I hedge my words carefully because I don't want to make overly broad claims that are not backed by evidence, as you are doing. I do understand what you are talking about, and I have been pointing out that some of your claims are contradicted by or not supported by evidence.

You're accusing me of all kinds of things without providing a single piece of evidence to back up your claims. You're also putting words in my mouth that I never said, and claiming I take positions that I don't support. For example, I never recommended oat milk (which is not a whole grain product), honey (which is classified by the FDA as added sugar when not sold as a single ingredient), or breakfast cereals (which are often sold sweetened with added sugar and usually not whole grain). That is a straw man.

I agree that people who are consuming too many calories in their diet should reduce the amount of calories that they consume. However, that has nothing to do with the fact that fruits can be part of a healthy diet, which is backed by evidence from a wide body of research and not contradicted by any evidence that fruits are unhealthy for most people. If fruits are unhealthy for most people as you claim, you should have no problem finding peer-reviewed research of similar or higher quality that backs up your assertion.

Here's yet another review that confirms that fruit consumption has stronger anti-obesity than pro-obesity effects in most cases, which also explains why supplements and soda are not equivalent to fruits:

> Previous studies of the effects of fruit on obesity have shown that their anti-obesity effects are greater than their pro-obesity effects in most cases, as demonstrated in this review. Moreover, the final outcomes of these anti-obesity studies support the inclusion of higher amounts of fruit in our daily food intake to reduce weight, as well as promote a healthy life style by increasing physical activity and reducing the intake of sugar and fat. However, most types of fruit contain large amounts of simple sugars, which are well-known contributory factors to obesity and obesity-related diseases. Therefore, the high level intake of particular forms of fruit such as fruit juice is not advisable in certain age groups, especially children. In addition, it has been suggested that plant fiber and phytochemicals may be responsible for the anti-obesity effects of fruit, but cereals are also rich in phytochemicals and fiber yet they have no remarkable anti-obesity effects. Therefore, more human trials are required to address these two mechanisms. In addition to the possible anti-obesity mechanisms discussed above, we consider that various other important unknown components present in fruit may be responsible for preventing obesity. Furthermore, the anti-obesity properties of known fruit components need to be verified. Thus, future research should be focusing on identifying anti-obesity components in fruit as an urgent and important task in order to understand the scientific mechanism of obesity but also to develop a method for controlling obesity by increasing fruit consumption.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5084020/


And is this "healthy dietary pattern" based on good science?

Well there is hardly any "good science" in human nutrition. It's mostly just observational studies with results distorted by the healthy subject effect and other uncontrolled confounding variables.


None of these studies are done with proper control, because there are restrictions to human experimentation. Even if it was studied for entire lifespans of a billion people, there would still not be enough data to conclude that any particular factor is definitely causative.

So, it is incredibly dishonest to present this (or any nutrition "science" study for that matter) as science. It's no better than guessing or astrology.


What? Science isn’t science because humans can’t be properly controlled for a study? Are you implying a study over a billion people over their lifespan wouldn’t be worth pursuing because it can’t be controlled? That’s ridiculous if you are. The study doesn’t even say it’s causative, but associated.

> Science isn’t science because humans can’t be properly controlled for a study?

No, non-science isn't science just because someone wants it to be.

> Are you implying a study over a billion people over their lifespan wouldn’t be worth pursuing because it can’t be controlled?

It should be pursued, and correlations explored and studied but the findings should be presented as what they are.


If you believe a peer reviewed paper on the Lancet is no better than guessing, you may have misconceptions and misunderstandings about what science is and how it works.

OR if you believe studiying self-reported data from 130k people gives us definite causative link between a single nutrient and lifespan/mortality, you should do yourself and the world a favor and get out of profession where any intellect may be required.

The paper in The Lancet is most definitely science. What is not science is leaping to any conclusions based on the findings documented in a single paper. Science is slow, unfortunately. Given sufficient time, science will, with a high degree of confidence positively correlated with the time we wait, enrich our understanding of the natural world.

Now we need two decades before all the studies of the past 10 years are common knowledge and I can buy full fat yogurt in my corner store, but right now it's only stocking reduced fat ones with added sugar, because some pillock in the 50s construed the idea that saturated fat is going to kill us. Sorry, but the obesity epidemic isn't because everybody is eating butter.

/r/ketoscience has plenty interesting studies about high fat low carb if you're interested in doing your own research. And I'm a big fan of the "Low Carb Down Under" Youtube Channel for latest research talks.

https://youtube.com/c/lowcarbdownunder


I love non-fat greek yogurt, extremely high in protein %, but yeah don't understand the non-fat & added sugar stuff.

Yogurt is VERY easy to make. And you can make it with whole fat milk.

Nutritional literature is notoriously contradictory.

Here's an article that says higher intake of dairy fat is associated with higher risk of cardiovascular disease. https://www.clinicalnutritionjournal.com/article/S0261-5614(...

And here's one that says the exact opposite of that. https://journals.plos.org/plosmedicine/article?id=10.1371/jo...


The vast majority of nutritional studies are based on epidemiology and pretty much useless. Since diet is so hard to control for, it looks at aspects of the diet of a group of people and tries to determine which variable are correlated with specific outcomes.

Most nutritional science is a whole load of crap. Which is why I invite anyone to learn and experiment with their body. The stakes are low, the benefits potentially great and it's easy to tell what feels good and what doesn't. It's not science, but again, most of nutrition isn't either.


“doing your own research.”

The battle cry of the scientific illiterate.


Let me get this straight, so doing experiments is "not science", while trusting Authority is real science?

I don't know what to say.


Unfortunately, the general populace does not understand that finding evidence in support of a conclusion is not equivalent to doing scientific research. Never mind evaluation of the science within publications. Never mind that often people find secondary sources (oneliners extracted from summaries from news post from press releases from groups writing the actual paper).

In practice, "doing your own research" is never that, at least from what I have seen. This pandamic had a special effect on my opinion I should add...


Bad science is still science.

"Trust the Authority" is not science at all.

Bad science >> no science.


Unnuanced statements are never correct or useful.

> and I can buy full fat yogurt in my corner store

Won't happen. Fat is (relatively) expensive and causes satiety fast.

Carbs are very cheap and very addictive and cause compulsive overeating.

Unless there's strong legislation or very severe social stigma (like for smoking), food will always trend towards low-fat high-sugar.


So I've never not been able to buy full fat, plain yogurt in Germany.

Just saying that low-fat high-carbs is the natural optimum for food industry profits. Everything else is niche and will come with a higher markup.

Full (and half) fat plain yogurt is also the cheapest in Germany.

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