Very useful information about diet,but no mention of NIH study about milk thistle benefit to potentially reversing early stages of fibrosis.
It appears that both meat and refined fructose play a role in fatty liver disease (NAFLD).
https://www.ncbi.nlm.nih.gov/pubmed/17850914
2
Lets see....all those years of evolution and our livers have not become attuned to sodas and other sugary things...shocking.
3
If you find even any canned HERRING that doesn't taste like candy, please note brand here.
1
Or we could simply ban high fructose corn syrup.
9
That article is reasonably well written, and covers some of the nuances, strengths and limitations of the study (all clinical studies have both), and suggests the journalist is at least trying to avoid bias. The headline is typically exaggerated and encourages polarisation rather than consideration. The only thing missing from it would appear to be the exclamation!
2
It needs to be much much easier to buy food without added sugar. I have a PhD in public policy (so someone who has the education and time to to spend thinking a lot about food when many people do not) and I decided to go a month without eating any added sugar partly for health, but for health I could have just reduced sugar. I really wanted to know how hard it would be to not eat ANY added sugar at all for a month. In the end, it was very hard. I was unable to go out to eat because almost all restaurants cannot tell you what they add sugar to. They know about meats, dairy, gluten, but the wait staff does not know about sugar. You have to go bother the chef which is annoying for the chef and the wait staff will hate you. Once I ordered a roasted salmon on basic greens with a olive oil dressing (guess what they glazed the salmon in sugar first). Even at the salad chain Sweet Green to find out if something has added sugar in it, you have to google a very hard to find PDF document with ingredients. The info IS NOT posted in their health conscious restaurants. I also had to spend tons of time reading labels of things I never thought had sugar in them. So while I enjoyed how I felt, the month was isolating as it basically meant I needed to cook every meal at home from scratch which I enjoy, but its also nice to eat with other people! Sugar is clearly a very bad for health and we need help from the food industry to avoid it.
11
Sugar is the problem with the American diet. Everyone eats or drinks items loaded with sugar. At my work, everyone always brings in donuts. Everyone always drinks soda, regular and or diet. The biggest laugh about diet, is how zero calories are calculated. It is not the case that diet sodas do not have any calories. Those sodas do not have sugsrs that are digestivable into calories by the human body. After drinking diet sodas, the human body is still tricked into producing insulin. There are not healty sugary or diet drinks. There is a huge industry in selling legal and dangerous addictive substances to the entire population of children and adults.
After cutting out sugar, fruit and veggies start tasting alot better. Also broccoli, potatoes, carrots and rice are not expensive and easy to cook. Buying a similar amount of packaged food, candy and soda will cost a lot more.
6
The children in this study lost 3 pounds in 8 weeks, which is a lot of weight for a child to lose in that little time. (I do scientific work in this area, search for DOI: 10.1056/NEJM200012143432415) Typically, weight control in children focuses on maintaining weight, not losing weight.
The food was provided by the researchers. To get children to lose three pounds in eight weeks, the kids must have been, in effect, on a reduced calorie diet. Over time, hunger will probably cause them to eat more than they ate during this study. This may turn out to be just one of many, many studies where metabolic problems get better during the initial phases of a diet, only to return, worse than ever, later on.
Making it worse is that it seems these kids were encouraged to eat fruit. This NYT article says (correctly) that fructose causes fatty liver, then says (incorrectly) that fructose is not the type of sugar in fruit. Fructose is named for the word "fruit". About half the total calories in fruit sugar come from fructose.
If the children are told to snack on fruit, that may negate any benefits of this diet in the long run. Many veggies also get a lot of their calories from fructose.
People who have fatty liver disease are often blamed for having a bad diet. However, the advice given to these patients is often wrong. The old advice was to eat a low-fat diet. It now turns out that low-fat diets make fatty liver worse. This diet may turn out to be bad in the long run, too.
3
Correction: I meant "About half the total calories in *fruit* come from fructose." (The other half come from glucose, which is also a sugar. I am only considering sweet fruits here, not fatty ones such as avocados.)
1
@Judy Shapiro Yes, there's a HUGE amount of fructose in ripe fruit, and there's plenty of research showing that it ends up as fat in our livers.
Most soft drinks and, BTW, those "fruit cocktails" masquerading as "juice" in the school vending machines are sweetened nowadays with fructose made from corn (using GMO-derived enzymes), or tropical fruit paste.
Let's label sugar addiction as a serious health issue!
5
What’s shocking here is that parents are letting their children drink sodas which are just fizzy sugar water, rotting teeth and filled with useless calories. It’s a sad statement on us as parents in this privileged country.
7
How on Earth are we not regulating the food industry? It's not a secret anymore that highly processed food is causing untold damage to human health, at a social and economic cost that is hard to even calculate. Why is it even legal to produce foods that are so unnecessarily unhealthy?
10
@Juliet O . Simple answer to the last question, congressional bribes, er, contributions. Both parties.
1
Eat your fruit, don’t drink it.
Thirsty? Water is what your body needs.
Enjoy something sweet now and then, not everyday.
Prepare much of your food at home, pack your lunch, learn how to make bread, grow some tomatoes, visit the farmers market, let the children help in the kitchen, know where your food comes from. Eat your veggies.
Pass on healthy habits to your children.
12
The title of the article is misleading, and should be changed. The referenced study was aimed at combating existing fatty liver. To avoid fatty liver, avoid weight gain. At least 80% of NAFLD is the result of excess adiposity. So.....To Avoid Fatty Liver, Avoid Weight Gain.
The best way to avoid weight gain is to change the food environment, from one that features highly-palatable, energy-dense foods that are obtainable at too little cost. In other words, decrease the rate of return on investment.
Government policy could play a large role. For example, taxes or subsidies related to energy density, degree of processing, or some other relevant metric. Limit advertising of foods and beverages. Advertising does affect consumption, especially in children but even in adults. Conduct a public advertising campaign that show to how quickly prepare simple, nutritious foods. Begin to transition the built environment from a driving to a walking environment.
Individuals can reduce their food "net reward" value starting immediately. Eat before grocery shopping and buy only whole foods or foods that require cooking before eating; for example, oats, beans, rice, whole fruits, vegetables, unsalted nuts, meat, fish. Avoid restaurants, not just fast food. Very tasty food and variety are not our friends; food that is good enough, is. Trade as much walking and cycling for driving as possible. Driving makes foraging too easy, with a huge EROI (high calories, no effort in obtaining them).
2
@childofsol
Let's see, "highly palatable, energy dense foods obtainable at too little cost". What kinds of foods could those possibly be?
That's a lot of mental gymnastics to just say "sugar" without admitting that sugary foods are a root cause of the problem.
Glad that you're finally backing away from the refined seed oils and that you've finally added meat and fish to your list of nutritious whole foods. Did you reform your veganism? Or just get hungry for some real nutrition?
1
@The Pooch
The Pooch is a liar. The Pooch constantly remarks about my supposed veganism, despite being told many times that I am an omnivore, not a vegan. And not once advocating the elimination of any animal food from the diet. The Pooch continually remarks upon my love of "refined seed oils", despite reading and replying to my posts discussing the importance of consuming a whole-foods diet, and the problems with consuming highly-processed foods.
Which makes one wonder, Why? Perhaps someone with a balanced, moderate approach that takes into account ALL of the weight of the evidence is threatening to a certain belief system.
3
@childofsol this is the American “I hate vegetables” line of thinking on food. Go to other countries and healthy tasty fresh foods are available much more than they are here. Problem is our food production—meat with little flavor, seafood old, tasteless and often bitter vegetables, even fresh fruit with no taste (commercial strawberries).
2
Fatty liver should be treated with diet (reducing sugar, especially HFCS, processed flour and unhealthy fats) and liver supporting supplements like lecithin and milk thistle together, studies have proven that when lecithin's Phosphatidylcholine is taken with milk thistle, the liver healing effects of milk thistle is increased. Other liver healing supplements include CoQ10, Sam-e and medicinal mushrooms like reshi. Having treated my elderly cat for fatty liver disease with milk thistle, lecithin, sam-e, co-q10, medicinal mushrooms; I can attest to the efficacy of their ability to return liver enzyme levels to normal. The vet called my cat "the miracle cat" because she didn't expect her to pull through. While the causes of fatty liver are somewhat different in humans than in cats, the symptoms are the same and the above supplements are useful to both feline and human.
4
@Libby Did your cat have feline hepatic lipidosis? That is a completely different disease than fatty liver in humans. It often develops in cats within days and is treated largely by force-feeding the cat. However, I am interested in the supplements you mention, and will take a look.
It's gotten so bad lately that all I see at the grocery store is fat, salt and sugar when I look at products on the shelves. I am very conscious to it and the frustration sometimes has me walking away empty handed.
I grew up in a home (70's) that used canned and packaged products but I think the food then was more wholesome than the chemical laden and fake food stuff today.
6
Sugar is a drug pure and simple!
7
Study after study is showing that the major culprits in American's diets are sugar and its close cousin white flour. Sugar and white flour are in basically everything that is packaged in a typical grocery store. To stop eating sugar, stop buying packaged foods. That includes supposedly healthy foods like granola bars and fruit juice. The dietitian working for the fruit juice industry (note the city: lobbyist) below points to the problem; much of our economy is built on packaged foods. To fix the obesity / liver / heart disease / diabetes crisis, follow the money. Get rid of food industry lobbyists. Real food will start to take over the shelves if they're allowed to think for themselves. I get that poor areas are food deserts; maybe the lobbying money can be repurposed to open markets in poor areas.
5
As a registered dietitian working with the Juice Products Association, I would like to point out that this is preliminary research which requires more data before any conclusions can be drawn. Why? First, the study was conducted on a small population of Hispanic adolescent boys with a specific liver condition. t is not clear if you would get the same results in girls. Second, while the 8-week study did find positive results, it did not show levels in the normal range. Thus long-term studies need to be done to determine if a. this approach is cost-effective and b. it is beneficial. Finally, in this study a research team, planned, purchased and provided all foods for the family, which also means the study was not blind. This is not practical in a real-life setting. All of these factors make these results interesting, but not conclusive enough to make recommendations.
Please keep in mind that 100% juice does not contain added sugar – just the natural sugars found in the fruit it is squeezed from. Studies demonstrate that healthy people who drink 100% juice have higher quality diets, eat more whole fruit, and have either comparable or higher total dietary fiber in their diets as well as lower intakes of saturated fat, total fat, sodium and added sugar than non-juice drinkers. Therefore, there is no reason to eliminate appropriate servings of fruit juice from the diets of healthy children. Learn more at SipSmarter.org.
1
@Diane Welland
Come on now, Diane!
There is absolutely no reason to consume much of any amount of fruit juice. If you have a few oranges, fine, squeeze them. But probably the rule should be to eat them out of hand, taking in the fiber as well (as you mentioned). But fruit juice without added sugar is still just that: it is fructose. An 8 oz glass of apple juice is said to have the same as a half of a can of soda.
So yeah, giving up soda is a no brainer. But replacing soda consumption with juice drinking cannot be said to be a healthy choice.
If anything, drink more water.
26
@Diane Welland as a registered dietitian working in healthcare you're the reason our profession gets so much flack for industry corruption.
25
@Ashlie C Exactly right - Sipsmarter.org is run by the juice products assocation. Guess who they represent??
21
I stopped eating food with added sugar 4 months ago, and also eliminated white carbs, which are too easily converted into glucose by our bodies. I've never felt better. I don't seem to have any more inflammation and with it, the joint pain that had plagued me. It's just gone. I'm losing weight without hunger, feel alert and energetic, my blood sugar and cholesterol test results are now in the normal/acceptable range, all thanks to eliminating sugar and simple white carbs. I'm convinced that taking in too much sugar is akin to poisoning ourselves.
18
Sweet!!
2
The following from a previous post bear revisiting:
https://www.ucsf.edu/news/2018/12/412916/sugars-sick-secrets-how-industry-forces-have-manipulated-science-downplay-harm
https://academic.oup.com/jhmas/article/63/2/139/772615
https://foodtreemd.com
Incidentally, our tax dollars go a long way to sustaining the high consumption of (and addiction to) sugar. I like to say that we have an "alimentary industrial complex" (with a nod to General Eisenhower) and are the only country in the world with socialized diabetes.
14
Too bad the Trump administration rolled back the healthy school lunch program regulations initiated by the Obama administration.
https://www.nytimes.com/2018/12/08/us/trump-school-lunch-usda.html
13
The government should be subsidizing fruits and vegetables not wheat, corn and sugar.
24
Sugar is a scourge. But have a look at the nutrition panel on any food and you will see there is no recommended daily sugar intake by weight/ percentage per serve in the same way as there is for fat, protein or sodium, or carbohydrates collectively. This attests to the power of the sugar lobby at the expense of population health. It is a disgrace that shames legislators.
20
@Andrew
The FDA established 10% as the RDA for sugar a few years ago. I believe it will be reflected on the new labels. As well, to use your hyperbole, the fat lobby pressured them to eliminate the fat allowance. So, there won't be any RDA for fat, just for saturated and trans fats.
2
@Ron A
The restrictions on total fat were removed because the "lipid hypothesis" sank after crashing into iceberg after iceberg of scientific evidence.
After decades and hundreds of millions of dollars spent trying to validate the "low fat" dogma, it was never demonstrated to be useful, healthful, or protective in any way. And low(er) carb, high(er) fat diets were shown to have _benefits_ in clinical trial after clinical trial.
5
and hopefully Pepsi, Coke, "sports drinks" like Gatorade execs and marketers are, as we're speaking, now flinging themselves out of buildings; the jig is finally, finally, finally starting to be up. yes, they have been poisoning America and waving the flag. and no giving yourself type 2 diabetes is NOT an American aspiration. I've read Taubes for 10 yrs and he's been dead on the entire time. and no, Pepsi/Coke it ISNT about "making healthy choices" if it includes any of your products.
all these sugar-laden poison liquids, along with other sugary poison "foods" like ketchup (tomato-flavored slurry), most yogurts (check the label, you'll fall over), breads, donuts, cakes, candies (chocolate including your Hershey kisses) all and mean ALL cereals except 100% shredded wheat, most breakfast bars and even Gramps or diet "protein shakes". just read the label.
13
I was diagnosed with fatty liver about 15 years ago. It took me 10 years to find a solution that fixed the problem (as in cured).
For those that don't want to read, I simply had to remove grain from my diet (all grain).
I spent 6 months on drugs to supposedly control it, but they failed to work and their side affect was liver failure. I used annual blood tests (and at times quarterly) to see if changes to my routine had any affect. Along with drugs I tried exercise, diet changes (the basics: sugar, meat, fat). I tried doing nothing. I tried changing environments: I used to work long hours as a software engineer, and now I am a part time farmer and support a high school engineering shop as a volunteer (major stress reduction).
Several years ago I read an article regarding grain and how modern grain has a number of things the body likely considers toxic. The author claimed all sorts of wonderful side affects when one removes grains from their diet. While I was skeptical (and still am) of much of the article, I figured it would be easy to try and see if it had any affect on my liver. Six months later I received the results of my first liver/blood test without grain in my diet, and the result was my first perfectly normal liver function. As a bonus I also had normal cholesterol levels! I have had three more tests since, all with perfectly normal levels. None of my previous tests showed any change in liver functions since my first roughly 15 years ago.
15
I was the care giver to my father who had fatty liver, and it ultimately gave him a bad quality of life in his final years, and likely shortened his life. All because of his lifelong addiction to sugar and soda. Doctors would plead with him to just drink water, and he refused.
Don’t let sugar control you or your life. Be in control of food, don’t let it control you. All the research in the world just reinforces common sense.
14
@Studioroom
Sugar is addicting and sugar withdrawal, while not like withdrawal from opioids, is still a hurdle to overcome.
10
@Studioroom
I strongly reco the book 'Sugar Blues'
An oldie but VERY goodie!
4
In the 1950's and 1960's great debate about which foods were most harming American's health, it was a battle between Saturated Fats and Sugars. Sugar won the political battle (political corruption perhaps) and Saturated Fats were ostracized for an entire generation.
It turns out that the politicians were wrong, saturated fat is good for you and sugar is causing all the health issues. I hope the next generation won't be duped like ours was.
11
@Ronny
This is not an issue. The problem is being overweight. One can eliminate this food or that but as long as they continue to be grossly overweight, they will have health problems.
5
@Ron A
Excess body fat and types of foods consumed are pretty closely related...
Naturally fatty foods satiate the appetite. Sugar stimulates more appetite. Now how might that affect consumption and body fat?
4
Some simple rules:
- avoid the interior isles of the grocery store - that's where the processed food typically lives
- buy and consume more foods that don't carry labels (veggies, grains, nuts, seeds, raw fruits, etc.)
- cut down / avoid dairy - as my primary doc reminded me many decades ago, cow's milk is great for calves, not so much for the rest of us
- generally lean towards a plant-based diet - the closer the better, for you and the environment
- get outside and move on a regular basis - find something you like and get after it - running marathons may not be right for everyone but time spent on the couch is time wasted
- sugar is generally a bad thing - this certainly isn't news unless you've been living in a cave for the last 100 years
- and remember to laugh, the more the better. No adverse side effects on that one.
None of this is news. But then you already knew that.
15
What's the difference between those of us who consume sugar in moderation and also exercise and those who don't?
2
Great information. Thank you for calling attention to this study.
3
Elevated fasting insulin is the precurser of fatty liver, metabolic syndrome and type II diabetes and should be the preferred test to prevent these problems before major systems take hold.
5
The article whose link appears below provides evidence that an underlying cause of fatty liver disease in lab animals is exposure to glyphosate, which is used on virtually all genetically engineered crops, and also as a ripening agent on wheat, and sugar. This suggests that an organic diet might be therapeutic.
https://www.gmwatch.org/en/news/archive/17402-roundup-causes-non-alcoholic-fatty-liver-disease-at-very-low-doses
6
You are right bill. Glyphosate is not used as a ripening agent on wheat. Glyphosate is used however as a drying agent on grain crops such as wheat, oats and other grain crops. It's sprayed just before harvest to dry the grain so there is more control over when the harvest can be brought in. Trace amounts of glyphosate is even found in some "organicly grown" grain crops such as oats.
7
@Peter Kraus
Thank you for this. I had never seen or heard of the association between Roundup use (whether on gmo crops or non-gmo crops) and damage to the liver before.
3
@bill high fructose corn syrup is in a lot of food.
I had fatty liver disease. I eliminated all processed food and limited sugar to only fruits and occasional honey. Within 6 months last year, I lost 30lbs and more importantly all the liver functions returned to normal. My advice is to catch this as early as possible (bloodwork), work gradually changing dietary habits and make it a lifestyle, not a diet. Also remember that alcohol should be limited, as well. It is reversible at this stage. When I do taste things with sugar now, it tastes too sweet! Go for your health! You'll feel so much better inside and out! Cheers!
36
Fat kills.
1
@R. R., please read the article. It says nothing of the sort.
8
@R. R.
Fatty liver can kill. But it didn't happen because of _dietary_ fat.
9
@R. R. I’m not a doctor so don’t hold me to this, but, my understanding is that your liver actually requires dietary fat to do its job.
5
Readers should know that this study is about overweight children who have fatty liver disease, and is about a specific diet recommendation for the treatment of fatty liver.
There is no claim and no evidence in this study that the consumption of sugar (added or not) causes fatty liver disease.
3
@Kip Hansen
It does though, particularly fructose, which the liver has to deal with.
9
It would help if we started with labeling 'high fructose corn syrup' as SUGAR. And making sure that everyone in the country knows that.
12
These are not new findings. John Yudkin did all the research in the 1950’s and published his findings only to be thwarted by the sugar lobby. This problem with sugar is no different than what the Big Tobacco Companies did to discredit the scientists who proved that tobacco was a major health issue. Robert Lustig, A pediatric endocrinologist from the University of California at San Francisco has studied this problem for 30 years and he has written the ultimate book entitled The Hacking of the American Mind, the SCIENCE Behind the CORPORATE TAKEOVER of Our Bodies and Brains. In spite of what corporate interests promote sugar is a poison to the human body especially high fructose corn syrup which is pervasive throughout our food supply. Type two diabetes will be the disease that destroys the American healthcare system and the tragedy is that it is preventable if people would wake up and realize that sugar is just as toxic as antifreeze and what they have in common is that they both taste good. Just because it tastes good and has an addictive effect on brain chemistry does not mean it is not toxic and poisonous to the human body.
27
I have recently lost two siblings to cirrhosis due to NASH. Hypertension, diabetes and a genetic predisposition to the disease led them to this illness. (Our father died of the disease 30 years ago). It is a painful and heart rending disease, with few to no treatments other than weight loss in the early stages.
This medical research is critical to the future of these obese children. We need more.
Thanks for this article educating the public.
Last, family physicians need to be on the outlook for this symptom and educate the families to prevent this deadly disease.
24
Milk is lactose, a sugar.
5
@Rich I'm not a scientist but lactose is naturally occurring in the milk, not an added sugar which seems to be the culprit here.
4
@rich
You are right, Rich. The lactose naturally occurring in milk is a part of a larger whole, and if naturally occurring fat (cream) is not removed, the two combine to make for an excellent nutrient dense food. Leaving the fat in slows down the digestive process, increasing satiety and avoiding spike in sugars from lactose. Skim milk is like drinking sugar water. You’ll find whole A2 milk in Publix grocery stores in your state. Milk does a body good if you’re not intolerant. A2 might help those that are.
Cutting sugary foods and drinks is good for your body? Wow, really?
The researchers should have allocated the funds they spent on this study toward researching medical issues that aren’t quite so glaringly obvious.
1
And yet state WIC programs give poor pregnant women and young children credits for sugary juice products and white bread and are very stingy with protein foods. Just because you are aware of something doesn't mean it doesn't have to be thoroughly documented.
21
@SRB The study details exactly how the reduction in added sugar can help people with fatty liver disease. Moreover, it shows that the subjects in the reduced sugar group had only a small weight loss but still improved their liver function. So yeah, the study is important.
9
Added sugars are like crack to the body.
Addictive and harmful.
12
My 87-year-old father died from nonalcoholic fatty liver disease. It was something that he, with a lifetime of obesity, developed over many decades. It is a horrible disease, in part because it's fairly avoidable with the right dietary lifestyle. It's a very sad thing to see children with this condition.
9
I visited Japan and was delighted to see that it was possible to get even ‚fast food‘ that was low in sugar and calories! No wonder the Japanese are on the whole so thin and have a long life expectancy. What happened in the USA that food manufacturers came up with such sugary, high-calorie foods?
7
I recently added up grams of sugar in a preschooler's school-provided breakfast. Of course, I could not distinguish between naturally-occurring and added sugars, but this four-year-old's breakfast contained a whopping 74 grams of sugar. Chocolate milk, sweetened yogurt, graham "crackers," and apple juice.
18
One problem with added sugar is that it is not clearly labeled as such. One must be « savvy » when reading the list of ingredients and realize that any word ending in -ose (dextrose, fructose, and so on) is indeed sugar.
One simple way to cut down on sugar is, as stated in the article, to stick to water, natural teas and milk (if tolerated, but that is another issue) as beverages. No sodas, no fruit juices: fruit is best eaten in its natural form. Your taste buds eventually get used to the « less sugar » taste and start perceiving other foods differently.
Meals don’t need to involve time-consuming prep to be tasty — and most importantly, healthy! Lots of recipes on the Internet, you just need to look up « easy additive-free homemade recipes ». And between soups, salads, and some organisation, making the best use of your freezer and of your slow cooker if you have one, I am sure a better diet is not out of reach. Think of all the time (and money) you will save not having to plan visits to the doctor or the pharmacy!
14
Are there any studies correlating lack of gall bladder (removed for gall stones) with increase in fatty liver disease? Without a gall bladder, where are fats processed?
Just wondering. Almost all the women I know have had their gall bladders removed by age 50.
4
@Lexicron
ps: pubmed published some peer-reviewed articles in 2013 re fattt liver disease in kids (high prevalence noted). Also note articles on fatty liver as correlated with metabolic syndrome in people who have had their gall bladders removed-- but not thoae who have gall stones (no surgery). Removal of gall bladder is the most common gastro surgery. Was considered without serious effects. Ha.
2
So, to my knowledge (I say as not a physician), the gall bladder holds bile which is released into one’s intestine after eating (or triggering). This bike is mixed with other excretions and digested (you know, if you are lucky). Upon removal, that bile just leaks into the intestine once it’s made...this is why patients are advised small regular meals. I was told there was a correlation between gallbladder removal & colon cancer but I have not looked into it as I avoided the surgery.
I will say POTATO can be just as harsh as sugar & fat.
2
@Olly
Potato is starch, which releases slowly and is actually quite healthy if steamed or boiled. Some fats are very healthy, including saturated fat from coconut oil, palm oil and animal fat from pastured animals. Raw milk ( and the fat in it) if properly produced is very healthy with bacteria, enzymes, proteins, minerals and other nutrients. Again it should be grass fed dairy.
2
The obesity problem in this country is every bit as serious a health issue as the opiod crisis. Yet, mega-'food' companies are allowed to push their corn and sugar based poisons with impunity and profit enormously while straining the healthcare system when that so called 'food' makes us ill, which in turn charges the citizenry billions through Medicare and Medicaid. For a smart people who believe in 'evidence based best practice' we certainly have failed miserably when it comes to keeping our population healthy.
27
I keep remembering all the abuse Republicans heaped on Michelle Obama for urging families to get children to eat vegetables and to get some exercise.
70
@Kaleberg I believe Michelle Obama caved to the sugar industry and signed on to the "all calories are equal" argument that promotes exercise as the solution to obesity. It's a lobbyist's dream because the blame for obesity is now on the victim ("the sugar and carbs in your diet didn't make you fat, you're just lazy"). This study contributes to the cascade of evidence that shows sugar is toxic.
16
@Billybob
"I believe...." Youe should know something as a matter of fact before making accusations.
10
Michelle Obama did eventually partner with Disney and other advertisers to children as unlikely sponsors of her program. When she did that, she also changed her focus from vocally condemning targeted advertising of unhealthy and sugary "food" to children to a message more of personal responsibility; exercise as the way to lose weight, rather than stopping unhealthy advertising directly to children. A very simple Google search will reveal the details. It was a kind of caving on her part, in my opinion (and also that of others)
12
So, which will get us first, the fentanyl from China or the sugar from the U.S.?
17
Effects of Omega-3 Fatty Acid in Nonalcoholic Fatty Liver Disease: A Meta-Analysis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5019889/
5
@Sam: exercise is also beneficial in NAFLD, as it changes gene expression patterns in the liver in a way that reduces generation of more fat from protein and carbohydrate.
It’s a shame that families seek their nutrition advice from Drs. Registered dietitian nutritionists are nutrition experts unlike Drs (while Drs know some nutrition,) whose expertise is medicine.
Looking for sound nutrition advice? Seek out an RDN you can find one at eatright.org
10
@Christi
Maybe doctors know enough nutrition to tell their patients to avoid sugar.
12
@Christi
Most dietitians are genocidally ignorant about nutrition.
4
Wait! You mean, cutting sugar in one’s diet can be healthy for overweight people with fatty liver disease? Who’d a thunk? I wish research more dollars would be dedicated to fighting and curing cancer, which science can’t seem to crack, rather than on “mysteries” that have already been more or less proven.
7
@Jonathan Cohen
"...more or less proven" is not good enough for science.
4
@Jonathan Cohen "Curing cancer" is a poor alternative to preventing cancer. Should we spend money on curing smoking caused cancers or to prevent smoking? MORE dollars need to go to this kind of nutrition research, as obesity and poor food choices are increasing being identified as causess of cancers.
9
@Jonathan Cohen I’m with you on cancer if we get back to prevention. What ever happened to colon cancer and cured meats? ( or did Swift and Oscar Mayer lobby that away?)
I would love the specific list of what these families were eating. I was diagnosed with T2 Diabetes two years ago and have avoided any medications (and lost 50 pounds!) by drastically changing my diet. If there is something I’ve learned, it is that it is impossible to eat processed foods - a slice of bread, a bit of peanut butter or a jarred tomato sauce - that don’t have added sugar. When I do discover a version of something with very low sugar, it’s often cost-prohibitive...that no-added-sugar jarred spaghetti sauce is always $8 a jar while the conventional stuff is $3 a jar. It would be lovely to make everything from scratch, but I work full time and have two kids - I don’t have the time or energy to make my own salad dressing.
Please share the study’s specific choices!
17
@RM
Learning to cook is easy and more importantly the only way to eat healthy while saving money. Processing foods is how company's make profits and increase their products shelf life & sales by adding sugars and all the other junk.
11
@RM You tale a bottle of vinegar and a bottle of olive oil and mix to taste. Maybe add a little salt. Done.
27
@RM "I don't have time to make my own salad dressing."
Actually, you do. A little oil, a little vinegar, directly on your salad. Also see, salt and pepper. Of course, if you want to be fancy, put the oil and vinegar in a tiny plastic container, add a little Dijon mustard, and shake. I was a single mom with two kids practicing law full time and I don't think I ever used "bought" salad dressing.
37
Someone really should mention the fact that we are the world's leader in the consumption of HFCS. Many of our health problems started with the introduction of HFCS inn the 70's
Then of course the corn is all GMO.
8
@Allan The fact that the corn is GMO has nothing to do with fatty liver disease, obesity, or anything else that science can measure. It is an atrocity that children suffer from fatty liver disease, but it is totally due to our overconsumption of sugary, fatty, garbage "food", and it would not matter if all that sugar and fat came from organic sources.
22
@Allan HFCS is 55% fructose. Sugar is 50% fructose.
1
@Kaleberg
There is a link to studies showing clearly that glyphosphate used on GMO plants does cause fatty liver disease at very low doses.
https://www.gmwatch.org/en/news/archive/17402-roundup-causes-non-alcoholic-fatty-liver-disease-at-very-low-doses
4
Additional important research once again showing the pernicious danger of added sugar. A problem is that many people, even knowing this, find it next to impossible to significantly reduce their sugar intake. Good news is that when you add heathy oils and fats, the desire for sugar drops away. Stacks of research -- and experience -- shows this. I recommend "Always Hungry" by David Ludwig to explain the mechanism for this.
20
@John
Oil is liquid fat without any nutritional benefits. At 4,000 calories a pound it packs on the pounds faster than sugar and it happens to be the most processed "food".
Id rather get my calories from potatoes, rice, corn or wheat which are all about 400 calories per pound.
3
@Dean O
Refined oils vs. starchy foods is a false dichotomy. There are many other foods or combinations of foods from which we could choose.
"Calorie density" sounds like a bad thing when dealing with refined oils and refined carbs/sugars. But when eating whole, nutrient dense foods, appetite adjusts perfectly well to the calorie density of meat, fish, and eggs.
7
@Dean O
Processed vegetable oils are poison. Coconut oil, palm oil, avocado oil and olive oil are especially healthy and well worth including in ones diet. Palm oil is rich in vitamin A as an example. Sugar is stored as fat by insulin. I agree with potatoes and rice, but exclude the corn ( gmo) and wheat ( gluten).
4
Somehow you managed to write a whole article about the connection between sugar and fatty liver disease without mentioning Dr. Robert Lustig (UCSF) who has been warning us about this for years.
This study confirms, very directly, all of his predictions, particularly with respect to fructose.
Of course, he's not the first to warn of the dangers of sugar--for those warnings, you would have to go back more than a century. But he's a pioneer in explaining how fructose affects the liver. For those interested, I would recommend his lectures (which can be found on youtube) on the subject.
31
@Justin
Dr. Lustig is fat...wonder why?
2
@Dean O
So... sugar is harmless, because Lustig himself is overweight? Got it.
6
@Dean O
Is this not pure fat-shaming? Dean-0, do you work for the sugar lobby?
Whether or not a scientist and researcher is fat, or balding, or wrinkled, or graying, has no impact on their studies. As you know.
3
"...doctors should advise patients and their families to check food labels for added sugars..."
There's no label on broccoli.
21
@Exiled in St. Louis
Funny...there's no Superbowl ads for it either.
11
@Exiled in St. Louis So your point is....?
2
@JP You avoid "added" anything (sugar or otherwise) if you avoid packaged food.
8
You have to cook your own food from basic
ingredients, then it's easy to avoid sugar! Saves
a lot of money, too. Once you get used to eating
real food you've cooked yourself, where you know
what all the ingredients are, you find that
processed foods (for example, bottled salad dressing)
taste just awful. If you have basic cooking skills there
there are lots of simple things you can make.
32
Pass on the cupcake and think you are being healthy? It boggles the mind how much hidden sugar is in the American diet. It can be difficult to find something as simple as soup or spaghetti sauce without it. Since when does soup need sugar? Most yogurt is a veritable sugar-mugging. Big Food needs to clean up its act as much if not more than individuals.
59
Time for a documentary on the obesity/junk food/sedentary lifestyle that is making America ill. It should be an unflinching look at the attitudes that enable, and the impact on both individuals and society as a whole. With graphic footage of the physical reality.
The fact that the obesity epidemic is now affecting the health of young children should be a huge wakeup call.
15
@Melissa
Check netflix...plenty of documentary's on the subject.
Forks over Knives, What the Health, Cowspiracy and Food inc. just to name a few to start.
5
@Melissa
Also Fed Up, The Magic Pill, The Perfect Human Diet.
2
I’m a practicing oncologist. I see patients with cancer every day and most patients have “fatty liver” on imaging studies. While it’s not cancer, this is a deadly condition, unequivocally worse than cancer mostly because it is ignored by the medical community. By the time it becomes cirrhosis, it’s too late and people die of liver failure. A patient with fatty liver ends up seeing a gastroenterologist who will charge for a liver biopsy and not address the underlying nutritional problem. Worse yet, family doctor tend to shrug their shoulders and say “it’s just fatty liver”. I will retire in a few years and have no doubt that this problem will lead to an already decreasing life expectancy for Americans. Let’s not forget that the president honors people by feeding them sugary, processed items that should not be labeled food.
180
@Daniel B Is there a blood test that can detect fatty liver? Or is only seen on imaging studies or with the biopsy that you mentioned?
5
@Martha Goff I'm not a doctor, so I would defer to anyone who is, but in my experience, they simply palpate (feel) the abdominal area.
Imaging may, of course, follow.
4
I’m currently at a research conference covering this very topic. There is no blood test for fatty liver disease per se but elevated liver enzymes (ALT and AST) levels is an indication, along with age, ethnicity, diabetes status, etc. The fat level can be determined by non-invasive imaging and pathology can be predicted by the level of hepatic portal pressure. The next step of fatty liver disease (non-alcoholic steatohepatitis (NASH)) can really only be determined by a liver biopsy to look for inflammation and the degree of fibrosis, but docs won’t order that unless there’s a strong suspicion of NASH.
12
The goverment's policies are just unconscionable. Soda, candy and fruit juice are clearly toxic for children and adults, maybe as toxic as cigarettes. But the government and industry-sponsored groups like the American Heart Association, the American Diabetes Association and the Center for Science in the Public Interest continue to have very little to say about sugar and fructose. Industry ties are too strong; sugar and corn producers are too powerful.
If the government would put half as much effort into reducing sugar consumption as it puts into trying to ban vape devices ...
73
@Tom
There are some people who won't be satisfied until the nutrition authorities proclaim that sugar is addictive as crack cocaine and as deadly as antifreeze. That is very unlikely to happen, because science does not support those beliefs. But the government and the groups you mentioned have all had plenty of negative things to say about sugar and processed foods. Sugar is a nutrient-free substance that promotes tooth decay and contributes to excess energy intake, and "they" have been advising the public to limit consumption for a very long time.
Anyone with an open mind who is interested in learning about nutrition can start by reading the USDA/FDA Dietary Guidelines for Americans 2015-2010
https://health.gov/dietaryguidelines/2015/guidelines/
@childofsol
USDA/FDA Dietary Guidelines for Americans 2015-2020
By the way, this article is a description of a study which looked at the effect of eliminating sugar on fatty liver disease in obese children. There is no implication here that sugar caused the fatty liver disease or the obesity in the first place. Obesity is the primary driver of this disease, accounting for at least 80% of cases. Obesity is a disease of over-nutrition - where highly-palatable, energy-dense foods create a food pattern of excess calories - within a context of high food availability and limited cultural constraints. Rather than reading the results of the scientific study, and seeing how they fit into other studies of diet and metabolism, it is tempting to skim the article and come away with what appears to confirm our beliefs.
The study, as well as the article and most of the comments, also illustrate what I consider to be a fundamental weakness of current nutrition research: most of the focus appears to be on various dietary and other interventions to treat metabolically sick individuals. It is an unfortunate fact that a large number of Americans fall within this classification; however, such an emphasis tends to obscure what a healthful lifestyle looks like for normal metabolic functioning. One result of this is that there are many foods - potatoes, bread, etc. - now deemed by many to be unhealthful simply because they create problems for sick people.
@childofsol
The questions of what caused the disease and what treats the already existing disease might have different answers, sure.
But you have such logical gymnastics to try and disconnect sugar and obesity! Let's see -- what might be an energy dense, highly palatable food that stimulates appetite and creates a food pattern of excess calories? Why, that just might be (wait for it) sugar! (usually in combination with refined carbs and refined seed oils).
One fact the authors fail to mention is that infant formula in the US contains as much added sugar as Coca Cola--and infants as young as six months are being diagnosed with fatty liver disease at an alarming rate.
75
@Comp This is not true. 8 oz of Similac Advance Formula contains 10.7 grams of carbohydrates, which is coming from the lactose. Lactose, milk sugar, is also present in breast-milk. 8 oz of Coco-Cola contains 25.6 grams of carbohydrates , all from high-fructose corn syrup.
27
@Comp
Breast milk is also quite high in sugar. The proportion and type of sugar in formula is very similar to what's in breast milk, as Sarah points out (and not similar to Coke.)
Sugar isn't the only nutritional factor associated with fatty liver. A lack of essential fatty acids in the diet is also associated. For example, patients fed intravenously long-term (total parenteral nutrition) eventually develop fatty liver because the feeding formula lacks essential fatty acids; the lipids in the formula come only from soybean oil. There may be a similar situation with many infant formulas.
11
@Sarah Coca-Cola contain 11g sugar per 100mL. Infant formula usually contains about 10.8g of carbohydrate per 100 calories (usually dissolved in ~150mL) so the concentration of carbohydrate is lower in formula due to the amount of fat and protein that federal regulations say it must contain. The brand name formulas like Similac or Enfamil will use lactose as the carbohydrate source to mimic milk. However, generic store brands that try to undercut the big names frequently use corn syrup because it's cheaper. Depending on the method of manufacture, corn syrup may contain no fructose at all or as much as 30% fructose.
1
O'Connor repeats the common error of claiming that "Added sugars are typically high in fructose,". The error stems from the name of "high fructose corn syrup", which is not particularly high in fructose when compared to table sugar.
What is truly high in fructose are fruit juices and the fruit they are made from. Fruit juices and fruit are healthy choices for most people.
This piece does not make it clear that the diet changes that are good for treating an existing condition (fatty liver) are not necessarily the same as good diet advice for preventing the condition.
2
@Kip Hansen
No, FRUIT is a healthy choice for most people. Fructose can only be metabolized in the liver; whole fruit is a healthy choice because it contains a realtively small amount of fructose (which is many times sweeter than sugar), conjugated with micronutrients and fiber.
You would have to eat a dozen oranges to get the amount of fructose you get in one small glass of orange juice.
46
@Comp false. we evolved to eat fruit seasonally. like a desert offered over a specific period. not daily. not 3x daily. fruit is candy.
9
@Comp here is the deal with oj and juice:
A portion of OJ (1/2 cup) contains 10.5 grams of sugar. It takes 1 1/2 oranges to make 1/2 cup of orange juice—so whether you eat the fruit or drink the juice, you'll get the same amount of sugar.
8
Adding the nutrient Choline, through diet or supplements, can benefit a fatty liver.
10
A Shock that so many young people already have a fatty liver. And that sugar really does seem to be the villain that some have warned about.
One easy to overlook message about how they got children to change what they eat, was that the focus was on helping the FAMILY change its eating habits. It takes a bit of work to get off sugar laden foods, and the only way children will get to - and maintain -a better way of eating is when their families commit to eating the same way. With enough "practice" it can become the norm.
47
About a year ago, I watched a documentary called "Sugar Coated." It was a real eye-opener. I found out that fruits contain fructose...fruit sugars. Fructose turns into fat in the liver. Whether it's high fructose corn syrup or a banana, fructose turns into fat in the liver. Honey, maple syrup, agave sweeteners and all sweet fruits contain fructose. We push fruits and honey on children as a substitute for sugar. This is what's causing fatty liver syndrome...too much fruit and honey. A hundred years ago, we ate fruit about 3 months a year, when they ripen in our local community. Today, we have fruit all year round, from all over the world. We used to get honey as a rare treat...now we eat it all year round, too. Fruits ripen in the fall. This gives us the fat we need to keep warm in the winter. That's it. Don't eat fruit the rest of the year! That's what I'm doing and it's amazing how my weight fluctuates from summer to winter just by eating fruit. I'm not talking about lots of fruit...just one persimmon or one apple a day from Nov, Dec, Jan and half of Feb. By then, it's time to quit and lose a bit of weight, get ready for spring planting. BTW, I eat no sugar or grains. Ketogenic and Paleo diet, all organic. At 75 yrs old, I have no doctors, take no pills, am healthy and energetic, milk goats, run cattle, garden.
30
@Denise Anderson: I eat fruit when I want to lose weight. Your experience is not universal, and in fact does not match what clinical studies show. People who eat more whole fruit live longer, have a more diverse set of gut microbes, and enjoy better health.
It’s funny how people can get upset about conversion of carbohydrates to fats in the liver, but then vigorously promote consumption of “healthy fats” (which go to the liver after consumption) as the alternative.
2
At age 50, my GP sent me to an endocrinologist for hypothyroidism (low thyroid). The endocrinologist told me that the low thyroid was the least of my problems as it could be treated with a daily pill. He was alarmed by my high blood sugar, weight, and abdominal fat. He warned me that I was close to developing pre-diabetes and recommended that I meet with his dietician. I did, and received instructions on how I should change to a low-carb (sugar) diet. It took some getting used to, but I lost 20 lbs in a few months from 175 lbs and have kept if off since then. I was encouraged to eat more fat and protein, full-fat plain yogurt, for example (read the labels). The low fat diet took some getting used to but it absolutely worked for me. I recommend any books written by Robert Ludwig M.D. and his videos online.
33
@mg
Wow, you got a dietician who recommended a low-carb diet. You lucked out my friend.
24
The dietician was a member of the endocrinologist’s practice which was largely devoted to obese patients. They worked as a team. Probably the best medical care and advice I ever received. Changed my life.
6
@Charlierf
Amen!
This research ignores the key role that abdominal visceral fats play. "Non-alcoholic fatty liver disease (NAFLD) is a hepatic manifestation of metabolic syndrome that includes central abdominal obesity along with other components. Up to 80% of patients with NAFLD are obese, defined as a body mass index (BMI) > 30 kg/m(2). However, the distribution of fat tissue plays a greater role in insulin resistance than the BMI. The large amount of visceral adipose tissue (VAT) in morbidly obese (BMI > 40 kg/m(2)) individuals contributes to a high prevalence of NAFLD. Free fatty acids derived from VAT tissue, as well as from dietary sources and de novo lipogenesis (fat making), are released to the portal venous system. Excess free fatty acids and chronic low-grade inflammation from VAT are considered to be two of the most important factors contributing to liver injury progression in NAFLD."
https://www.ncbi.nlm.nih.gov/pubmed/25071327
19
@Wind Surfer
This, once again, mistakes correlation for causation.
1
@Charlierf
You are argueing with academic researchers that use scientific data. Explain to me with scientific data.
2
@bill: You are wrong on both counts. Abdominal fat can be treated by (a) exercise and (b) a small degree of weight loss. By exercise, because it changes how the liver processes energy substrates like protein and carbohydrate, and by weight loss because fat on internal organs is lost first.
It is not a case of confusing correlation with causation, precisely because the mechanisms are known. Central fat is hormonally active and releases inflammatory signals (TNF alpha), which directly contribute to insulin resistance, a major element of metabolic syndrome.
1
Once again, this science is WRONG....FATS make you fat. EXcessive sugar can convert to fat but it takes sooo much energy....First fats make fat. The reason why the sugary donuts make you fat is because it is laden with saturated fats........sugary drinks will cause other ills and increase desire for fatty foods.
1
Calories contribute to obesity. Fat does pack more calories per gram than sugar it’s true, but empty calories of sugar add not only to obesity but to inflammation of body tissues. I recommend The Case Against Sugar by Gary Taubes as a START to the understanding of how sugar has contributed to today’s health woes; Diabetes, CAD, and now fatty liver. Check the research before condemn g this article. And check your sugar habits that you may be defending against the article’s findings.
41
@lola4md Why are you defending sugar? Of course sugar makes you fat--just look at people who drink a lot of sodas. Fats are necessary in the diet--sugar is not, and is harmful. Do some research.
44
@lola4md
Any other headlines from the 1960s you'd like to share? The idea that dietary fat drives obesity or chronic disease has been as thoroughly refuted as anything can be in nutritional science.
BTW, that donut is sugar and primarily _unsaturated_ fats from soybean oil.
36
How would one diagnose a non-alcoholic fatty liver disease? I mean - you actually found an American who isn't an alcoholic?
4
@Mike
I'm an American and have almost zero interest in alcohol - I go through a six-pack every 15 years or so (although I'm thinking of cutting back!), maybe a couple of glasses of wine a year. Just don't like the stuff much - I guess I'm lucky. Chocolate is another story but I try to limit it because of the sugar. I guess everybody's got a demon or two . . .
22
@Mike
I have NASH. I am 62 yo woman with a sugar addiction. I know this. My NASH was found after a liver biopsy recommended bcause my yearly blood work kept showing bad AST and another liver enzyme being too high. I am actively working on my diet and staying away from sugar.
15
@Mike The study and article referred to children, so I'm fairly certain their fatty livers were not from alcohol
14
Perhaps when reporting on new scientific findings, you guys could include a link to the primary literature (or at least the PubMed page?) to make it easier to see the actual findings for ourselves? It's not true in this case, but when corresponding authors have common names and that plus a huge journal is all there is to go on, it can get really hard to find the actual article.
52
@Polly
Yes, Polly. Frankly, in 2019 this is unforgiveable.
5
@Polly, @NYT editors
YES! Please include information allowing readers to easily locate original research reports. Agreed that, as a default, a PubMed/NLM link would be a good start. And, as Polly notes, if the lead researcher has a common last name, this can be arduous without a link.
These brief articles by NYT reporters who have no significant, formal training in medicine or science should only be seen as a flag to call the interested reader's attention to the underlying research. Framing them this way would greatly increase their utility.
2
@Polly There is a link at the beginning of the article. "rigorous new study"
3
Important article and subject! Liver disease is a much underestimated contributor to overall sickness (morbidity) and overall cause of death (mortality). The UK, which is really not that different from us over here, has some scary numbers and projections. Based on the findings from a very large number of patients (national health system),liver-related illnesses are set to become the number one cause of death for adults by next year! See https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00680-7/fulltext
High time for our health care officials to get a move on. A key contributor to these numbers is the rising alcohol use and abuse, something that is also going on Stateside.
9
While NYT correctly notes that most of the sample was Hispanic, they neglect to mention that the *entire* sample was boys--girls were excluded completely from the experiment. Ignoring women and girls in medical research is a sadly common phenomenon, which in many cases has led to substandard care. This is something that would have been worth mentioning.
193
@Polly
You make an excellent point. The NYT article ought to have made this clear. The reason, however, that the study looked exclusively at Hispanic boys was because, in the words of the study authors:
'Pediatric NAFLD is more common in boys than girls, and in Hispanic children compared with other races and ethnicities.'
3
@Colenso I should have written 'almost exclusively'. Two boys out of the forty were not Hispanic.
3
Gary Taubes is a hero. He certainly changed my life with his book "Why We Get Fat". As a result of reading it I lost over 50 pounds 4 years ago, and have pretty much kept it off. He is doing even more by supporting studies like these. He has made such a difference to so many people. Well done, Gary!
66
@Leslie
I also followed Taubes' recommendations for 4 years - even keto for 2 years - and felt terrible and gained 2 lbs per year (yes, low calorie as well as 20 g of carbs per day). Once I quit low carb and added fruit juice and fruit, I felt better and my A1C and cholesterol went down. My doctor shakes her head. I have thyroid issues that are probably the reason low carb doesn't work for me.
Bottom line: it's complicated. Don't assume everyone is the same. I'm glad it worked for you, but it doesn't work for me.
25
@pazza4sno
I had a similar response to a keto diet. My HGA1C went up. It wasn't disastrous, just interesting. For some reason when I eat carbs responsibly my HGA1C is lower. Although I did lose weight.
Metabolism is indeed complicated.
10
@Leslie Also want to add a compliment to Taubes. What seemed particularly interesting about this study is the assertion that it focussed only on sugars, but allowed carbs and did not restrict calories. This surprised me since Taube's other work shows that eating carbs contributes substantially to weight gain. Is this a reasonable take home from this study that fatty liver is more dependent on sugars alone?
5
This article spells out the clear distinction between fructose in fruits (good) and the fructose in fruit juices (bad). Still, one wonders how the juicing process transforms those very same fructose molecules from good to bad.
Could it be that the universal admonition to eat fruits and veggies was worse than wrong and no one wants to admit it?
2
@Charlierf
Answer: Juicers remove the fruit; the fiber. Not everything significant has a calorie.
17
@Charlierf In a fruit, the sugar is surrounded by the plant cell, and our bodies are slow to digest away the cell walls, so we get the sugar slowly. This means our insulin rises more slowly, or body can adjust to the sugar more slowly etc. Also, fruits often have less sugar than juices.
29
@Susan
Mike and Susan, slower digestion of glucose from some carbs, like fruit, is a minor virtue, modifying hammer blows to the pancreas and making the risk of causing diabetes less bad.
But this discussion is about fruit’s fructose, which is pretty much a poison to the liver, triggering de novo lipogenesis and causing fatty liver, atherosclerosis and asthma. Here, the question is not how fast the fructose is digested, but the quantity of fructose eaten.
7
I'm not convinced that eating fructose in fruit is OK regarding health. I love bananas, apples, and oranges but those videos on YouTube scare me re how they increase blood sugar.
4
@ring0, I believe fructose is safe in fruits because the fiber helps slow down the breakdown of those sugars.
23
@C Measure your blood sugar before, and then 20 minutes after, eating a banana. What was the result?
3
@ring0: “Blood sugar” is specifically blood glucose. So the fact that fructose increases your blood glucose (i.e. has a glycemic index) shows that the scare story about the liver turning all fructose into fat is a lie. Mostly, fructose is cut in half in the liver, rearranged/rejoined into glucose and put out into the bloodstream to fuel other tissues. Only a very small fraction becomes fat, and that too is exported to other tissues, the same as dietary fat.
NAFLD relates largely to excess calories and a sedentary lifestyle.
1
Yrs ago, when I put my two dogs on a diet, I was suprised to come home one day and find that they had eaten the entire contents of a large bottle of Advil. I rushed them to the vet where they stayed several days. Fortunately, they were large dogs and they survived the ordeal.
I asked the vet why they would do that. The pills had been in the medicine cabinet for years, and they had never climbed atop the counter, turned 90 degrees, opened the cabinet, and pulled out the bottle. Knowing that I had recently placed the dogs on a diet, the vet explained that the pills' coating contains sugar. Hungry, the dogs had smelled the sugar and found it irresistable.
I guess "sugar-coated" medicine has been with us for a long time, but why Advil? We don't chew it. It doesn't have a bitter taste. Just a pill that we hold in our mouths a few seconds before washing it down with water.
The ubiquity of sugar.
72
@maqroll Advil does have a bitter taste if it's not sugar coated. I once let one melt in my mouth as a kid, thinking it was like an M&M. When the sugar coating melted off, the pill revealed itself to be extremely, intensely bitter. I'll never forget that moment. It was extremely difficult to swallow.
Not that I'm excusing sugar being added to medicine. The coating can easily be changed to neutral tasting and sugar free, but people love sweetness. And if you want to sell products, you give people what they want, not what they need.
5
Children with fatty liver. Let that sink in for a moment.
128
@Someone
They're finding six-month old infants with NAFLD. Infant formula has as much sugar per serving as Coke.
14
Yes. Humans are metabolically incapable of handling the amount of fructose that is in a modern diet full of refined sucrose and HFCS. We can process the small amount that arrives naturally in fruits, but throwing in artificial sugars is far beyond the capacity of our bodies.
14
For those who talk about choice, for some products, there is no or almost no choice. It so frustrating that so many non-sweet foods contain added sugar, often without the percentage, so we can't CHOOSE the least bad one. In the (high-end, presumably health-conscious) supermarket I use the most when in the USA, there must be 50 bread products, but only ONE of them, the Italian baguette that come in unreliably or sells out fast, has no added sugar. I so wish the choice were the opposite - one or two breads with sugar and the rest without. It would make my choices easier. My search for commercial mayonnaise without sugar ultimately failed at three supermarkets - ALL of them contained sugar. I'm from France - mayonnaise with sugar??? (to be fair our industrial mayo probably has sugar now, too) So I made it myself. I would have liked the CHOICE that day to buy some for the myriad sandwiches I had to prepare for a large family picnic.
106
@Margaret
Primal Kitchen Mayo is becoming easier to find (I’ve seen it at Whole Foods, local grocery stores and maybe Costco). It contains no sugar.
https://thrivemarket.com/p/primal-kitchen-avocado-oil-mayo
I have no affiliation with Thrive Market or Primal Kitchen. But I do like a number of Primal Kitchen priducts precisely because they do not contain added sugar.
19
@Margaret
We bake our own whole wheat bread and use a small amount of glucose--not table sugar--to start the yeast. No fructose at all. You'd be surprised how easy it is to bake bread and make it routine. Also none of the other junk in commercial breads.
7
@Margaret
1. While not completely sugar free, Kraft Light Mayo has less than 1 gram of sugar per serving (tablespoon).
2. For ketchup my favorite market stocks "G Hughes Original Recipe Sugar Free Ketchup".
3
Yes sugar!
I refused to “touch” added sugar again after I read and article on on the potential damage it can do to our bodies.
That was 30 years ago,and my mother wasn’t so impressed (at the time) meanwhile I’ve remained the same weight/waist measure as I was when I was 20.
65
@Peter
The problem is, you have to carefully vet every item in the supermarket. Sugar is hidden everywhere: salad dressings, crackers, pasta sauces, breads, places you'd never think to look. That's why eating extra sugar is so insidious-it comes on top of the ghastly amount we already unconsciously consume.
27
@Scott Cole
True. But it kind of scares me that people don't already do that. Reading labels isn't that hard.
What is more important than the things you put inside your body?
7
@Peter-----"That was 30 years ago,and my mother wasn’t so impressed (at the time) meanwhile I’ve remained the same weight/waist measure as I was when I was 20."
This is a correlation. Does not mean that your refusal to touch added sugar actually resulted in same weight/waist measurement.
I am 60 years old, and weigh the exact same as when I entered the military at age 18 (5'10", 135 lbs) and I do not eschew sugar. My weight has been stable for my entire life (and within normal guidelines), with no dietary restrictions.
There are a number of factors involved in maintaining weight, and it is probably never done by limiting one item from a diet.
10
Here's another JAMA article that's quite relevant to the topic: "State Preemption to Prevent Local Taxation of Sugar-Sweetened Beverages." Shockingly, Big Sugar, just like Big Tobacco did with cigarettes, is pushing state-level legislation that prevents local governments from taxing sugary soda. Apparently, there's no downside (like increased medical costs, born by the taxpayer) to Big Sugar for increasing sugary soda consumption.
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I wonder if these results would translate to the general population of adults. The severe restriction of added sugars had a remarkable effect. I was a little surprised that fatty liver apparently has nothing to do with eating fatty food although it does seem to be related to being fat.
In case people are wondering if they're part of that huge estimate of Americans that have fatty liver disease they can have a blood test. Ask your doctor to add it on your next check up. I did this two years ago to set my mind at ease.
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@Ron A
blood tests for liver show only liver enzymes . You need an ultrasound to really know for sure. And eating fat doesn't make you fat.
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@Ron A Unlike carbohydrates, dietary fat is not directly metabolized by the liver but instead by the intestinal lining and adipose tissues. Dietary fat literally goes straight to your hips!
The obesity problem cannot be solved by another fine research project calling for more research or by doctors telling patients to read food labels for added sugars. A ton of research already exists pointing to the culprits in this crisis, but the results have not been translated into public health policies at any level of government. More research and general advise to eat a healthy diet are not the answers. Confronting the lobbying and marketing power of the food industry, however difficult, comes closer to the target. This will happen only after an aroused public pressures government agencies to work in the interest of public health, not in the interest of food and beverage lobbyists.
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@William
It is liberal’s idea to push public health policies. People have choices to be ignorant regardless of a tons of research. They hate fake news even though they don’t know which one is fake. I am almost certain that certain group of people will reject anything from NY Times. It is sad but being ignorant is their choices.
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@William
The public has been aroused more on "factory farming" and animal welfare than topics like this. We are also seeing more documentaries about GMOs and processed meats other than themes like added sugars and refined carbohydrates. You're right, what will end this is a public outcry, which will pressure lobbyist and Congress to act.
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@William
I hope people never become like this and ask the govt to decide what we should eat by curtailing existing companies and taxing undesirable foods. I don't buy the notion it's for our own good. Too many things fall under that umbrella and we're asking for years of legislation that limit our freedom.
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Thank you. Liver problems effect so many parts of the body. It is an unsung hero of health. Thanks for the guidance.
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The liver does a ton of tasks! It's like an independent machine of it's own.
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