What journalists should know before writing about fructophobia

In his new book, Fat Chance, Dr. Robert Lustig argues that “sugar is more toxin than it ever was nutrient.” He writes that sugar is as addictive as cocaine, that it should be regulated like tobacco, and that children should be carded before having a soda. He compares the fructose component of sugar to ethanol. “Pick your poison,” he writes, arguing that fructose will “fry your liver and cause all the same diseases as does alcohol.” He also challenges energy balance (calories-in-calories-out) as the dominant paradigm of understanding obesity and and argues that sugar is harmful in ways beyond the calories it provides.

With statements as controversial as these, it’s no wonder that the media, who tend to crave sensationalism to obtain readers or viewers, eat them up like candy. And Dr. Lustig knows what he’s doing and just what to say to elicit attention. He’s no stranger to the spotlight, as Elizabeth Weil writes in her article featuring the pediatric endocrinologist. The showman-doctor also knows just how to tell a classic falling-prey-to-cruelty story. He’d have his readers believe just what they want to hear: that their weight gain is not their fault, that the great evil monster of the food industry is putting addictive “poison” in their food in the form of sugar, and that the government is standing “idly by” letting it all happen. After reading Dr. Lustig’s book, it’s easy to understand why readers are entertained and maybe even enraged enough to give up on sugary sodas, cheese cake, and apple pie. But are the arguments Dr. Lustig makes in the book right or wrong?

Sparked by my ire of journalists buying into the sensationalism without so much as offering a contrasting view, I previously wrote about how Dr. Lustig’s eyebrow-raising claims didn’t appear to hold water. For example, one need only check the evidence from systematic reviews of human intervention trials (not rodents) to find that: 1) fructose has no significant effects on body weight, blood pressure, or uric acid when compared to other carbohydrates contributing the same amount of calories in the diet; 2) fructose in high doses providing excess calories increases body weight as expected from its contribution of excess calories and not because of any unique property of fructose; 3) and fructose at the levels normally found in fruit, which equals to around 10 grams per meal, is shown to improve glycemic control long-term. Does that sound like an ingredient that is “toxic”? I didn’t think so and neither do most nutrition scientists who’ve reviewed the evidence. For these reasons, scientists lashed out against Dr. Lustig’s inflammatory rhetoric and overstatements in a symposium sponsored by the Corn Refiner’s Association at Experimental Biology last April. I wrote about the debate, which I dubbed the “Sugar Showdown“, and then followed up with an interview with Dr. John Sievenpiper, a lead author of several systematic reviews and meta-analyses evaluating fructose’s effects on health of the body, to bring more clarity to the subject.

Despite the push-back from his scientist-peers, however, it’s evident that Dr. Lustig is pressing on with his mission to demonize sugar and his published book has gained him plenty of new attention in articles and interviews. I’ve found it difficult to keep up with it all and have lagged behind, having been busy with other projects (like moving to a new house). Fortunately, exercise physiologist and sports dietitian David Driscoll took up the charge to set the record straight on fructose around the World Wide Web. I’m indebted to Driscoll for nicely summarizing my own thoughts, pushing my blog article, and bringing my attention to other articles. And I would encourage any journalist or blogger who is writing about sugar, fructose, or Dr. Lustig’s book first read Driscoll’s comment and follow each of the links. He told me over Twitter that he posted the following comment, or ones like it, on at least 50 different sites over five days:

While Dr Lustig’s theories and evidence may seem convincing to the general public and reporters, the real test is how well he performs with his fellow scientists!
He was certainly called out for overstating the evidence and poorly extrapolating rat research at a conference he spoke at earlier in the year – check out the Q and A video in the attached article by David Despain (as well as the other lectures)!
What research shows that it is fructose that causes addiction? At the Q and A at the Sugar Symposium, Dr Lustig was called out on this and one researcher showed that rats liked glucose based carbohydrates over sucrose, and another questioned the applicability of rat research to be extrapolated to humans!
Also a recent rat studied suggests that it might be the sweet taste and NOT the fructose (as they used an artificial sweetener) although the article title gets it wrong also!
The major issue with Dr Lustig’s theory is looking at US Sugar intake over history – levels were still high in the early 20th century – so saying it is sugar is either an oversimplification or there is a threshold value that we have recently crossed. Methinks that it is a perfect storm of more sugar and less burning it up with physical activity!
I hope you get a chance to review these before the interview – especially the video lectures linked to within the article by David Despain

In my own reading of Dr. Lustig’s book over the last few days, I’ve found that apart from the claims about sugar, the rest of the book is relatively tame. In fact, it reminds me of why I tend to hate popular diet books and find them boring. There is one chapter where Dr. Lustig calls out out insulin as “the bad guy,” as Gary Taubes does, and I’ve discussed why this is shortsighted in my post “Good insulin, bad insulin: Its role in obesity“. He also dismisses physical activity as having a participating role in weight management (although he does say it’s good for you for other reasons); as I’ve written before, exercise is critical because of the role of skeletal muscle in consuming energy and determining metabolic rate. Mainly, however, the book regurgitates a lot of the same arguments about what’s wrong with the food system, some controversial and some not.

Overall, many nutritionists would probably agree that Dr. Lustig’s recommendation are somewhat controversial. He summarizes them by shortening Michael Pollan’s “Eat food. Not too much. Mostly plants.” to just simply “Eat food.” He argues that if you cut out all processed foods and sugar, people are bound to lose weight. He calls for completely cutting out anything with a Nutrition Facts label, which denotes that it is a “processed food”. It’s a no-brainer that people who go to this extreme would likely lose weight from lack of contributing calories from those foods. But it’s not the only approach one can take to lose weight. To say that one can’t include processed foods (even those with fructose) in one’s diet and still be healthy is just a fallacy. There are many people who include processed foods in their diet in moderation and have no problems maintaining their weight. There are also several degrees of processing and several different types of processed foods that make Dr. Lustig’s sweeping statements misleading. In some cases, processed foods (e.g. meal replacements) can be helpful in promoting weight loss.

One might ask, why all the fuss about scientific accuracy? What’s the problem with the cause of getting people to limit intake of sugar if it leads to a common good of reducing obesity? My answer to people who ask me this is the same that other scientists have voiced, which is that singling out of any ingredient and to make it the scapegoat for the obesity epidemic is just distracting. It’s not helpful to call sugar or fructose alone as “toxic” and ultimately does nothing to change people’s habits, except maybe causing them to forgo buying any food with high-fructose corn syrup for a while. In the end, people will still continue to eat too much, exercise too little, and gain weight.

Update 5-13-13: San Diego State University professor Mark Kern, Ph.D., offers a much more thorough scientific review of Dr. Lustig’s book than I ever could. I’d encourage all to read it here (ht Colby Vorland) on the CRA’s “Sweetener Studies” website (no, I have no financial relationship with CRA). From Kern’s review, here are a couple of quotes that best sum up my own thinking:

  • “Dr. Lustig misinterprets the available scientific evidence by making sweeping conclusions based on studies that do not examine real-life consumption patterns.”
  • “The addition of the Nutrition Facts Panel to packaged food was a major step forward in public nutrition education and transparency on behalf of food manufacturers.”
  • “…inaccuracies suggest that the author is not well-versed in the sciences of foods and nutrition or is misleading readers in a way to promote their agreement with his views.”

Published by David Despain, MS, CFS

David is a science and health writer living on Long Island, New York. He's written for a variety of publications including Scientific American, Outside Online, the American Society for Nutrition's (ASN) Nutrition Notes Daily, and Institute of Food Technologists' (IFT) Food Technology magazine and Live! blog. He's also covered new findings reported at scientific meetings including Experimental Biology, AAAS, AOCS, CASW, Sigma Xi, IFT, and others on his personal blog "Evolving Health." David is also an active member of organizations including the National Association of Science Writers (NASW), the American Association for the Advancement of Science (AAAS), the American Society for Nutrition, the Institute of Food Technologists, and the National Audubon Society. David has a master's degree in human nutrition from the University of Bridgeport, and a bachelor's degree in English from University of Illinois at Springfield. He also earned his Certified Food Scientist credential from the Institute of Food Technologists.

47 thoughts on “What journalists should know before writing about fructophobia

  1. I have to say, I completely disagree. I've talked to Lustig and checked out a lot of scientific research on the topic. My own article on obesogens in Environmental Health Perspectives mostly focused on chemical obesogens (mostly EDCs) but in my interviews that didnt make it into the piece, I did research High-fructose corn syrup which is also an obesogen that can alter the epigenome of unborn children, according to some research. Here's a link to the PD of my article http://www.wendeeholtcamp.com/Obesogens-EHP.pdf

  2. Nicely done David!I have one question: Where is the academic press book on the topic? And all I have to say in answer to that is that he could not write one. Which to me is QED.Are there no fact checkers at UC Davis that might have stopped his juggernaut of misinformation … like, say at the UCDavis produced YouTube video level? For shame!

  3. My original critique at http://wp.me/p16vK0-6W described fructophobia as a threat and an opportunity. If people use the book to find out about metabolism it will have been an opportunity. For example, the metabolism of fructose has hardly anything in common with the metabolism of ethanol but if the question is used as a way of finding out about how they are really metabolized that will be a big step forward. If we ask the really interesting questions: Glucose and fructose are interchangeable and they come together at the level of the three carbon compounds, the triose-phosphates. in those cases where fructose has a unique effect, how does the cell know where the carbons come from, or does it?. If we can use the fructose case to expand our knowledge of metabolism, that will be a great thing. On the political end, if fructophobia can lead us into real use of carbohydrate restriction that will also be a benefit. I am concerned that when you give up on science, you never know where it will go so progress will probably be slow. The low-fat-cholesterol thing is dying a slow and agonizing death because of having given up on science early on.

  4. I removed my previous comment because it was off-list to David and slightly off-topic and duplicated some of the above. The question was about ethanol and fructose metabolism which is one of the great inaccuracies in Lustig's story. I mentioned that I had published an article showing the similarities and differences between the oxidation of ethanol as a food and oxidation in glycolysis in which both glucose and fructose participate. The paper suggested that ethanol metabolism was a good transition between organic and biochemistry.https://dl.dropbox.com/u/37202414/JCE-ADH.pdfBottom line, if you know a little biochemistry: ethanol is oxidized to acetaldehyde which is then oxidized to acetic acid and that, in turn, is converted to acetyl-CoA and goes into the TCA cycle. The oxidizing agent is NAD+ as in many redox reactions in metabolism. I have a blogpost that may make this clearer http://wp.me/P16vK0-eYThe key oxidation in glycolysis is the conversion of glyceraldehyde-3-P to 3-P-glyceric acid, analogous to (but more complicated than) the second step in ethanol oxidation. The difference is that in glycolysis it is done in two steps. Why? The idea is that you learn in sophomore organic that aldehydes are easily oxidized. So NAD+ + ethanol is energetically very favorable. Where does the energy go? There is no mechanism for capturing the energy and it is wasted as heat. For glycolysis, however, instead of letting the oxidation run straight through, the enzyme (Ga-3-P dehydrogenase) uses the energy of oxidation to make a high energy compound 1,3-bisphosphoglycerate. This compound can then be coupled (catalyzed by 3-P-glycerate kinase) to the synthesis of ATP. So the combination of the two steps allows some of the energy to be captured. Both fructose and glucose feed this reaction in glycolysis which is a different pathway from the ethanol reaction. Another important difference is that, at some point, the NAD pathway cannot keep up with high ethanol and it becomes a drug or toxin, if you like. There is a separate oxidative process, the P450 system, which might reasonably be called detoxification. No such system exists for fructose as far as I know. Calling fructose a toxin doesn't have an obvious correlate in metabolism.

  5. Thank you for this wonderful insight, Professor Feinman. If I get a chance, I'll write something up about it. FYI – For those of you who don't know him, Richard Feinman is professor of Cell Biology at SUNY.

  6. Thank you. Very timely discussion.Lustig's dismissal of exercise as important in weight control is counterintuitive and in conflict with population studies and everyday experience, but the calories burned during exercise are indeed fairly minimal. Can David or someone summarise the metabolic reasons why exercise is indeed important to prevent and treat weight gain? Lustig also does not believe that Calories consumed should balance Calories burned. This is contrary to both the laws of thermodynamics and nearly all known metabolic and nutritional knowledge, yet he offers little evidence to support his extraordinary but appealing view.I hope Australian journalists find your blogs before Lustig's book is released here.(I have no conflicts of interest to declare)

    1. The laws of thermodynamics do not apply in the same way to the human body at a high level as it does to a car engine. Please be mindful of this. We have to look at CICO on the cellular level, and with respect to what allows said calories to go “out”. If we do some reading on both sides of the coin to understand the metabolic processes that dance with thermodynamics at that cellular level we’ll see that it’s really just not as clear-cut as “burn the calories you eat.” The treadmill calorie counter does not what is going on in our cells/mitochondria, pancreas, bloodstream, liver, etc. Do the calorie math, and then experiment on yourself over the course of 5 years to see if you actually lose the weight you are “supposed” to based on thermodynamics. You’ll see that eating 200 calories more per day won’t turn you into a behemoth (I’m exaggerating ^_^), even if the math dictates so.,

      1. “kilocalories from foods can be different in the way they’re metabolized”

        This is exactly what I was referring to. Thank you David!

  7. I don’t like the approach that Lustig takes. It can discredit what is a legitimate argument. I’d like to see the systemic reviews you point out that exonerate fructose–what kind of studies were they? Observational? Clinical? Who funded them? Are the numbers pure (read: statin research’s manipulation of the “decreases your risk of heart disease by 54%” number)? I say this not as a challenge but out of complete curiosity. Not saying that this is what you’re implying, but we should be careful to not try to exonerate fructose to the point where people revert to thinking that corn syrup is “ok” again just because it’s fructose and it doesn’t impact the glycemic index. It’s also important to further research statements such as:

    “Regarding the potential dangers of sugar in the diet, it is important to keep in mind that fructose is converted more efficiently into glycerol phosphate than is glucose. This is another reason why fructose stimulates the liver so readily to convert it to triglycerides, and why fructose is considered the most lipogenic carbohydrate. Fructose, however, does not stimulate the pancreas to secrete insulin, so glucose is still needed for that purpose. This suggests that the combination of glucose and fructose— either the 50– 50 mixture of table sugar (sucrose) or the 55– 45 mixture of high-fructose corn syrup— stimulates fat synthesis and fixes fat in the fat tissues more than does glucose alone, which comes from the digestion of bread and starches.”

    Taubes, Gary (2007-09-25). Good Calories, Bad Calories (Kindle Locations 7986-7991).

    As you can see that was from Taubes. There’s a lot of insulin-bashing in the book but at the same time not once did I remember him implying it as a “bad guy” that further implies that we should be rid of it. Rather, the context in which it is used is to say that it is the oversecretion or undersecretion of it that is dangerous, and that it’s driven by carbohydrates. And several folks in this space, such as Jonathon Bailor, repeatedly emphasize that insulin–like all of our other hormones–is important, and that it’s not the devil, but that sugary substances can either play a role in influencing insulin (glucose) or the metabolization of triglycerides (fructose). True or not? Let’s research this further instead of attributing an out-of-context “bad guy” quote to an author like Taubes in an effort to lump him in with the more sensational, youTube-hungry Lustig.

    I appreciate this post as a whole though, not in that I wholeheartedly agree but in that we need all sides discussing the merits and demerits of the topic in a less-sensationalized way and–as Feinman notes above–push even further into this research, together, instead of drawing swords.

      1. I appreciate that as well. Again it’s why I think Lustig is not good for getting a clear message out there. He’s not collaborative. I don’t think fructose is the devil. I think, as with any other macronutrient or even micronutrient, it’s in the APPLICATION and QUALITY of it. I love blueberries. I’m in good health. Those blueberries aren’t killing me. But I won’t be consuming any amount of HFCS. I think if Lustig were to talk about dose, as Sievenpiper emphasizes, everyone would be in a better position.

        And this may just be how stupid I am 🙂 but I don’t think Taubes simplifies. I have trouble following his data in GC,BC where I have to re-read pages again. I read his scientific analysis, line that up with the conventional wisdom I’ve grown up on, compare it with what the Heart Association and the Diabetes Association say, look at how low-fat diets affect people and their anecdotes, look at how low-sugar diets affect people and their anecdotes, and try to make sense of all of it. I think there’s merit to the idea that while fructose isn’t the devil, we should simply be aware of what it can do in unreasonable amounts, and then try to work together to find what the “reasonable” amount is. Lustig’s outbursts make it difficult for people to think rationally. (“Carbohydrates, fat. These two are never found together in nature.” Avocados, my man…)

  8. When you write about a physician by calling him “showman-doctor” and argue that he sensationalizes his message I have just one thought: Pot meet Kettle.

  9. hope for sanity was destroyed when most posters decided they knew what and how the human body metabolizes ANY nutrient, and I do mean any. the human physiology of digestion is this, it’s a chronological journey, birth-need mom’s milk, about 500 calories a day give or take 50-100, From age 1 to age 35,( I like to call these the hormone years) exploding growth of the human body from 5-6 lbs. to 6’2″ and a strapping 250 lb. linebacker the metaphysics of calories is feeding the furnace the fire of LIFE. Matters not the fuel being ingested (no disrespect intended, 7’4″ tribesmen do not eat broccoli) a calorie is a calorie is a calorie whence it’s pure beef lard or thirty eight pounds of aforementioned broccoli… when your body begins to slow down it knows we need less and less fuel to sustain our daily living, it becomes accustomed to hard physical labor or couch surfing. you’ll have a fat populace if they follow government guidelines. A calorie is a calorie is a calorie, if at 58 yours needs 650 a day to maintain your lifestyle and healthy body, then 300 extra will be 30 lbs overweight by age 65.

    1. Marshall, not all posters are equal, so it’s not clear who “most posters” refers to, but lumpint them all together is just wrong. Thinking of food as “fuel” that the body “burns” is a metaphor that is a good first approximation but hardly the whole story.Biochemistry is complex and if you want to simplifly for majority consumption you should realize that that is what you are doing. Sometimes a calorie is not a calorie. Read Austin’s remarks of April 26, 4 something pm.

    2. you’re right that a calorie is a calorie, but people don’t binge eat broccoli or gorge themselves on brown rice. Just saying

      1. That is because brown rice taste like paper covered dirt and while I enjoy broccoli, it does have a very strong taste and a most offensinsive odor that can linger in a house for days.

  10. As someone who has been ‘LARGE’ (aka morbidly obese, BBW, fatty, etc) since she was a little girl I’ve been put on or have gone on every diet I think known to man. What finally worked for me four years ago was a modified version of Atkins, a program that rigidly restricts all sugars and limits carbs. I lost 80 pounds and even though Ive reverted back to some of my bad carb habits I have kept the weight off.

    I believe there is a lot of truth in what Dr Lustig says. For some people. Thats the key. When I started Atkins I kept a food journal and could note how my body responded to my diet for the week. I found having just one cupcake would cause me to not lose for the week… and might cause me to gain. I also found I could eat three steaks and a basketful of strawberries with whip cream every day and lose 5 pounds that week.

    My big take away from my two years of journaling my diet and following the regimen was this: Not all calories are created equal, and everyone’s body chemistry is different and responds to food differently. Ever wonder why some people do really well on a low fat diet? And some dont lose at all? Or how some people lose weight through portion control while others dont seem to lose much if any? There is no one size fits all diet. The best thing anybody can do is to do a food journal or diary and figure out how food affects their body.

    I found out that portion control is absolutely the worst thing I could do. My body quickly goes into starvation mode and holds onto each bit of fat it cant. Obviously if one cupcake can make my body hold a couple extra pounds for the week, sugar is my nemesis. But unlike a male friend of mine who was also on the same diet regimen, I could eat potatoes and not have any problems. He gained weight and his blood sugar went way up with one spoonful of them.

    So my cupcake calorie is definitely not the same as someone elses. I think counting calories is outmoded. Counting the specific type of calories and knowing which ones affect your body and how is the key.

    Refined Sugar for me is toxic. I feel I have a stronger addiction to it than a heroin addict. My body constantly craves it… but it makes me gain weight, shoots up my blood sugar, makes me lethargic, sometimes depressed. I crash hard with it. Its a drug. My body cant handle it.

    What my body can handle is eating like a cave man. If it was available to them then I can eat it. Which leaves me to believe that my body chemistry is a more ancient type that is programmed to hold onto fat tightly if portions arent enough (starvation mode), and can effectively process meats, fish, nuts, berries, leafy veggies, fruits but has a lot of difficulty burning breads, processed foods, processed sugar.

    I didnt get the lucky newer genes that allow some people to gorge themselves on sugar (of course this lot probably are the ones that have difficulty with fats).

    Just my take on it from my solid experience and journaling. Bottom line.. the Dr is right… for SOME people.

    1. I will verify this woman’s account as I too, had to find out the hard way that refined carbs and sugar are like heroin to me. I actually knew this but got careless and forgot quickly this thing can take over and how perfectly legal and acceptable it is to be seen eating it. I stopped the madness and pounds melted with no real additional exercise. Now of course when I lost weight, I wanted to play golf more. I think we need to stop playing with this thing and tell the truth. I just read where we Americans basically gained our independence because the Crown was so busy fighting for their sugar colonies in Nevis. Tell it like it is before it get like it aint!

  11. Presentations at a “corn refiners convention.” In other words, paid studies by the interest group most likely to benefit from increased high-fructose corn syrup. The empty calories of such products are well known and the cause for much of our obesity. The corn refiners can pretend all they want, like the tobacco industry used to do, but their greed motivated hypocrisy is laid bare for all to see.

  12. The issue with HFCS is not that it is a fructose. The issue is a socio-economic issue that bears on the public health. HFCS is cheaper than sugar. Food manufacturers can therefore play an endless game of pumping more sweetener into their products, at nominal cost, to fulfill the public’s endless drive for more immediate gratification. Hence, we have an endless spiral toward higher sugar content in our products, and in our daily diets. Fructose, in itself, is not chemically evil. But HFCS, as a food additive, is very evil, nonetheless. It is one link in the chain of our public obesity epidemic.

  13. PROCESSED FOODS ACT LIKE ADDICTIVE DRUGS. Recent studies have shown that adulterated foods rich in fat and sugar act on the brain in the same way as cocaine and heroin. Rats allowed to gorge themselves on “bacon, sausage, cheesecake, pound cake, frosting and chocolate” developed compulsive eating and downregulation of dopamine receptors in the brain. (Johnson & Kenny, 2010, pg. 642) That means that people who are obese feel hungrier than people who are normal weight. In addition, they feel less full than normal weight individuals when they eat a full meal. This does not occur with normal food. Rats with an unlimited supply of normal chow do not show an altered brain chemistry and do not overeat or become obese. Similarly, rats who are given restricted amounts of junk food do not develop an altered brain chemistry, do not overeat, and do not become obese. The obese rats eat junk food with a frenzied insatiability that is not seen with normal eating. Even when administered SHOCKS, obese rats will not stop eating junk food while normal rats will (Kenny, 2011). It is the changes in brain chemistry due to food addiction that cause this behavior. “Similar changes in reward homeostasis induced by cocaine or heroin are considered to be crucial in triggering the transition from casual to compulsive drug-taking” (Johnson & Kenny, 2010, pg. 635). Knowledge about human brain chemistry and the changes due to addiction match those in the rat model: “interactions between brain reward function and metabolic state are conserved and thus are likely to occur in humans as well” (Johnson & Kenny, 2010, pg. 639).

    Johnson, P., & Kenny, P. (2010). Dopamine D2 receptors in addiction-like reward dysfunction and compulsive eating in obese rats: Corrigendum. Nature Neuroscience, 13(5)

    Kenny, P. (2011). Reward mechanisms in obesity: New insights and future directions. Neuron, 69(4), 664-679. Retrieved from http://www.sciencedirect.com/science/article/pii/S0896627311001140

  14. The primary cause of obesity is addiction to energy-dense foods. While some have argued that sedentary lifestyle is a contributing factor, recent studies have shown that the total energy expenditure of a typical western lifestyle is no different than the lifestyles of hunter gatherers, or populations in developing or industrialized nations. The WHO’s response to obesity has focused on sedentary lifestyle and poor diet, when obesity is caused by diet alone. “Total Energy Expenditure (TEE)…did not differ significantly between developing and industrialized countries, which calls into question the role of energy expenditure in the cause of obesity at the population level” (Dugas, Harders, Merrill, Ebersole, Shoham, Rush, Assah, Forrester, Durazo, & Luke, 2011, pg. 427). The typical physical activity level found in modern cultures does not vary enough to cause a change in TEE. This is also true when comparing a western culture to a hunter gatherer culture. Such a study was recently completed on the Hadza in Tanzania. “Physical activity level, PAL, was greater among Hadza foragers than among Westerners. Nonetheless, average daily energy expenditure of traditional Hadza foragers was no different than that of Westerners… The similarity in metabolic rates across a broad range of cultures challenges current models of obesity suggesting that Western lifestyles lead to decreased energy expenditure” (Pontzer, Raichlen, Wood, Mabulla, Racette, & Marlowe, 2012, pg. 1). This means that the obesity epidemic is due to diet, not activity level. “Variation in adiposity both within and between populations was not correlated with PAL” (Pontzer, et al., 2012, pg. 1).

    Dugas, L., Harders, R., Merrill, S., Ebersole, K., Shoham, D., Rush, E., Assah, F., Forrester, T., Durazo, R., & Luke, A. (2011). Energy expenditure in adults living in developing compared with industrialized countries: a meta-analysis of doubly labeled water studies. The American Journal Of Clinical Nutrition, 93(2), 427-441. doi:10.3945/ajcn.110.007278

    Pontzer, H., Raichlen, D., Wood, B., Mabulla, A., Racette, S., & Marlowe, F. (2012). Hunter-gatherer energetics and human obesity. Plos ONE, 7(7), 1-8. doi:10.1371/journal.pone.0040503

  15. You keep saying fructose instead of glucose. They are different even though they have the same chemical formula C6H12O6 Simple example fructose has a melting point of 103°C and for glucose, α-D-glucose melts at 146°C, while β-D-glucose melts at 150°C.

  16. David, i am a type 2 diabetic and i can speak from experience that after having cut out anything with high fructose corn syrup in it, not only has it helped in controlling my weight but my asthma is no longer as bad, my blood pressure has dropped, my immune system has improved, my allergies have improved and those are just a few of the benefits of getting that out of my life. and there have been many studies done showing that high fructose corn syrup IS bad for you and what i have been thru agrees. are you working for the high fructose manufacturing industry? sure sounds like it. i have never heard of this doctor you speak of but based on my own experience, it sounds to me like he knows what he is talking about. if you are truly unbiased, next time you might consider doing better research before you go spouting off about something you obviously know nothing about.

  17. I have gone for one year and four months without eating sugar. I was addicted to it. I know that I can’t go back. I love fruit and eat at least 3-4 pieces per day. I am not addicted to fruit and am able to easily control how much I consume. I’m not sure exactly what causes the addiction but I don’t eat honey, maple syrup or sugar and I’ve lost 30 pounds and cannot begin to describe the difference between sugar and non-sugar. All I can say is researchers can do all the studies they want and read all the articles pertaining to this subject but I can tell you from first hand experience that I have an addiction. By the way…I still eat some processed foods and foods high in fat content (chips and nuts). I seem to be okay with an occasional gram or two of sugar although I try to avoid food like that. Fat does not seem to change how I feel.

  18. Funny. In your “science” article, you didn’t really talk much about science. I’m in tune with Dr. Lustig’s comments regarding the biochemistry of sugar (Physics and Chemistry), But I AM interested in a debate on this issue. You haven’t provided one however. In particular, you don’t address Dr. Lustig’s point that fructose and glucose are treated differently by the body. In particular, that fructose goes directly to the liver where it is converted directly into triglycerides, and has a greater impact on insulin resistance as well as leptin resistance.

    This isn’t just Dr. Lusting saying this, here is a Pubmed article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2584858/
    and here is and artilcle from Cell Press (2009, March 9). Missing Link Between Fructose, Insulin Resistance Found.

  19. Kudos to Dr Lustig for calling out the status quo.. and look at them clammer and pile on. … Dr Lustig is RIGHT. sugar is something that I will never eat again.. all the scientific studies in the world. DO NOT compare to personal experience.. and with sooooo much status quo pressure…. you have to find out for yourself….. even TRYING to stop eating sugar is hard.. so is ANY addiction.. but the benefits are evident within a week.. I can think CLEARLY …. my emotions are STABLE…. I can work and focus ON DEMAND… no more sugar for me… I don’t need a BUNCH of so called experts.. to argue about what I can find out for myself

  20. This situation reminds me of the American Psychological Association stating that sexual molestation of little kids really isn’t a bog deal and might actually do the child good. LOL! extreme nonsense is being used with sugar being a villain. In the situation of pedophilia this is okay but sugar is some kind of “poison” used by big business to kill us or addict us? Honestly, these “wise” people have less and less credibility with MOST consumers. We tune them OUT. They can call conferences and write all the articles they want but rational consumers and parents pay little attention to them.

  21. I am amazed that anybody who has researched the topic would NOT believe that sugar is toxic to the body. Particularly processed sugar. Poison, period. Fruits are sugar yes, however they are not empty calories — they do have nutritional value ( blueberries!).

  22. Somebody needs to remove this mans Pencil from his possesion before he harms people. His personal opinion should be left to himself. There is nothing wrong with sugar. But if he doesn’t want to ingest it – thats fine by me, just keep his filthy hands and his psychotic OCD against sweets away from me.

    Was he bottle fed?

  23. There is a difference between refined sugars, which are mainly your processed white sugars found in most candy and desserts, and fructose which is a naturally occurring sugar in fruits and dairy products. It appears Dr. Ludwig is talking about one, and you are talking about the other. You mention fructose several times, but I do not see anything about refined sugars in your article. So maybe you should get your facts straight before condemning this doctor.

  24. This is all well and good, but when one says effectively “look to the dearth of human studies, not all those rat studies showing that fructose leads to diabetes and obesity” I smell special pleading; we don’t know how yet but rest assured, human metabolism is different in some unknown way than in all those diabetic obese rats. As long as the jury is still out – the meta-analyses (the weakest kind) find conflicting or contradictory data in the literature and what human evidence there is is correlation not causation (admittedly hard to do a well controlled study on humans that eliminates confounding lifestyle factors), go ahead, don’t worry, eat fructose.


    I suppose I don’t know. Any particular study could be mistaken, in fact, most probably are. But when I look at the waistlines and health problems of people who drink a Big Gulp for breakfast, compared to the person who has a cup of coffee and a bowl of oatmeal, my anecdata suggests that refined sugars might be a problem for some people.

  25. All I know is that I dieted for years with little success. But when I followed the same basic food plan without any sugar or flour, I lost 60+ lbs in 10 months, and have kept it off.

  26. Hmmm … Lustig’s findings are a big threat to Big Food. Freelance journalist who does a lot of work for the Institute of Food Technologists (IFT) publicity machine writes blog about Lustig’s findings. IFT stinks of Big Food (check out an unbalanced defence of processed food in the 2012 IFT presentation paper “Can Processed Foods Be Healthy?”). It follows that Lustig takes a pasting on this blog. This comment is bound to be deleted by the blogwriter.

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