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Monday, June 2, 2014

Confusion About Nutrition Confusion: More Answers and Questions

by Nina and Brad


Peaches by Edouard Manet
I guess we should have known that even a post about nutrition confusion would cause further confusion. After all, the question of what you eat can literally be a life or death one, as you’ll see below. A few days after the post Nutrition Confusion!, we received an email from a friend of ours who is a regular reader. This led to a little email conversation between Brad and our reader, which I thought would be worth sharing with you, in case you had some of the same concerns our reader did. —Nina

READER EMAIL:

Hummmmm...
Well this hits home with my husband and I. It's been 3 weeks since his near, fatal heart attack and almost 2 weeks since we have gone Vegan--cardiologist's orders. 

I forwarded you blog to my husband. Here are a couple more books that might add to the confusion, or clear it up. I can say this in taking out dairy and meat to date-- we both feel really great. Even my menopause symptoms have subsided. 

My husband’s question of who funded her research is one to look into. Did the dairy or meat industry fund her work? Have you guys watched or read, Forks over Knives? 

BRAD’S RESPONSE:

Yes, this is all very confusing. I don't think there is a field of scientific inquiry that's as screwed up and contradictory as the nutrition sciences, especially when it comes to recommendations for dealing with being overweight, or for people with “bad” blood chemistry (high cholesterol, etc.).

In regards to the author, one should always be suspicious about motives. I suspect it has nothing to do with her funding (if she has any) but rather with making her claims more sensational than is justified. You know, “sell more books and be on more talk shows.” Never underestimate self-promotion as an explanation. That said, I've been following the real data behind this story for some time, and there is scientific merit to it. The long held conventional wisdom of avoiding saturated fats and high-cholesterol foods combined with the multi-billion dollar (cholesterol lowering) statin drugs industry, is a big problem. More confusion than good data.

I just had a phone conversation with a colleague at Harvard who runs the Joslin Diabetes Center. They're looking into fructose as a serious driver of not only diabetes, but possible cardiovascular problems as well. It turns out not all sugars are the same in how they are metabolized and absorbed by the body (insulin production etc.) , and we should probably all severely limit our consumption of drinks (and other foods) containing added sugars, especially those high in fructose*. And there are a lot of them out there—and not just in soft drinks. A study just came a few days ago (Hochuli  et al., 2014. J Clin Endocrinol Metab) that showed that just one 12oz sugar-containing soft drink a day for one week led to negative changes in liver function in young healthy male volunteers. The researchers concluded that drinks supplemented with fructose, sucrose or glucose all showed signs of impaired beta-oxidation pathways (not a good thing), but fructose drinks showed the largest increase in fatty acid synthesis (an even worse thing for the liver).  I’ve only mention the liver here—this is what this particular study focused on—but there are well-documented effects on muscle tissues and the cardiovascular system a well. 

Also, fried foods, vegan or otherwise, should also be avoided. Too many inflammatory effects from oxidized fats. This has been known for some time.

Personally, I'm sticking to my diet = vegan + poultry/fish, with the (very) occasional eggs/cheese. However, I probably will try to further reduce my overall carbohydrate intake (bread, pasta, rice)—at least a little—and shift more to vegetables. I may still eat an occasional hamburger or steak, but probably not more than once a month.

A vegan diet for you guys sounds like a good idea, as I know you're eating lots of fresh/real foods. It will help make some choices much easier and more clearly defined. But I've seen some people who eat a vegan diet that made me cringe. Yes, no meat and dairy, but way too much carbohydrates and junk foods.

Sorry for the rambling email...

*One clarification: High-fructose corn syrup (HFCS, a mixture of fructose and glucose, typically higher in fructose) is made from corn versus fructose, the naturally occurring sugar found in fruits. Fructose, while chemically and metabolically different than the common table sugar sucrose (a disaccharide obtained from cane or beet sugar that is metabolized into equal parts fructose and glucose after ingestion), has some of the same problems as HFCS. But if it is consumed as whole fruit this is probably not an issue as most fruits don’t contain that much fructose  and their digestion and absorption is very different than that in drinks. But too much fruit juice or fruit-juice sweetened beverages that you often find in health stores could lead to some of the same problems—or possibly worse—than those seen with drinks containing high-fructose corn syrups. There is some very reasonable data on this, although still a highly contentious debate. 

READER EMAIL: 

Good, level headed comments.
This all makes such interesting conversation. I love it.

BRAD’S EMAIL:

With so much misinformation out there, false (or at least poorly supported) claims, hundreds of diet books with conflicting advice, and badly designed scientific studies, nutrition a topic that Nina, Baxter and I have been reluctant to go into in the blog. But it’s also one of the most important issues of healthy aging, and something that affects everybody—every day—in the choices we make. We'll see where we take all this....

But I too enjoyed our conversation.

Reference: “Sugar-Sweetened Beverages With Moderate Amounts of Fructose, but Not Sucrose, Induce Fatty Acid Synthesis in Healthy Young Men: A Randomized Crossover Study.” Michel Hochuli,* Isabelle Aeberli,* Adrienne Weiss, Martin Hersberger, Heinz Troxler, Philipp A. Gerber, Giatgen A. Spinas, and Kaspar Berneis. J Clin Endocrinol Metab, in press.

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