"Substitution of starch for added sugars improves health of children suffering from obesity, metabolic syndrome, and high habitual added sugar consumption."
But then it seems slightly less groundbreaking.
This study contradicts that by showing health improvement while maintaining macronutrient breakdown, albeit in obese kids. Is this replicable in adults and/or normal weight people? Who knows? Still a pretty interesting result IMO.
This study should be an eye opener for that 40% who largely believe "all carbs are created equal".
But on the flip side, you have people that believe only "processed" carbs/sugars are bad. You wouldn't believe how many diabetics think they're doing themselves a huge favor by switching from Coke to apple juice, or from pasta to mashed potatoes.
I'm tempted to start a tangential rant here but I'll just say that I generally try to avoid fructose. Yes, fruits contain fructose in addition to other nutrients, but my personal opinion is that high-sugar foods (including certain fruits like cherries, grapes, and bananas as well as cookies and chocolate bars) should be considered a treat and used sparingly.
All carbs pretty much are equal, it tends to be the amount of fiber that comes with the carb that changes things. This study was about fructose, not sugar in general, and we've known for a long time that fructose behaves differently from other carbs due to the way it is metabolized in the liver.
Anecdotally-empirically, a lot of Type 2's have found carbs, fiber or no fiber, are just bad news. For at least those with a specific variation of Type 2 (still as-yet not clearly understood, but there is growing consensus that there are many different "sub-types" of Type 1 and Type 2, each of which responding well to different treatment protocols), it doesn't matter how much fiber you eat with a scoop of carbs once the metabolic syndrome manifests itself with a high enough insulin resistance response.
With enough carbs (as few as 50g for some) the end result at that stage of the condition is still a highly-adverse event, a high blood sugar spike above 100 mg/dL. Even if the spike is controlled down within 1-2 hours, there is a lot of accumulating evidence that it isn't the duration or absolute value of high blood sugars, but the spikes (the occurrence of any delta in the first place) themselves that cause cellular damage.
In a few years, we will hopefully start accumulating a flood of highly-granular, anonymized biometric sampling data, ideally tagged with true/false flags of known and suspected genetic markers (but not enough DNA data to individually dox someone). Has someone solved the problem of publishing biometrics with tagged DNA data, and be able to update the DNA tags as our understanding of genetic markers improves over time, without risking doxxing an individual from the genetic marker tags?
See http://33bits.org/2009/12/02/the-entropy-of-a-dna-profile/
Today we hand medical researchers large databases pre-filled with the data they seek.
As we move into a world of increasingly ubiquitous biometric monitoring, asymptotically trending towards real-time, could the data gathering be flipped around instead? Individuals become the only ones who own their detailed DNA profile (the profile with billions of base pairs stored), held on either a personal device with suitable encrypted backups (ideal) or held on their behalf by a trusted service (encrypted with a key only the individual holds). Researchers send out requests for specific data ("weekly blood pressure of males between 20-60, with these genetic markers, starting now/5-years-ago"). Individuals either manually approve matching requests or set up approval "subscriptions"/rules. Requests matched with data sources get anonymized data of course.
Researchers not only can get data this way, they get a continuous, crowd-sourced data feed. Longitudinal studies might get easier to set up through this kind of channel. There isn't a way to ID someone by their feed and the researchers' requested, limited matching genetic markers alone, unless an attacker systematically breaks into multiple research databases, and starts building a Palantir-like correlation amongst all the hacked databases; that dramatically raises the detection risk to the attacker. Another attack is an overly-broad set of genetic markers in a single request, and those requests can be auto-denied before even getting into the brokering system. Short-term, we can prohibit the collection of any part of the 13-base-pair CODIS markers, though long-term we have to assume that CODIS or its future successors will eventually expand to a larger set of markers (and in the far, far future, possibly the entire sequenced genome).
The "normal" threshold for an oral glucose tolerance test (OGTT) at 2 hours post-load (75g glucose after fasting) is 140mg/dL. Where is this research indicating that a spike above 100mg/dL is "highly-adverse"? All the research I have seen, and the position of the ADA, is that it is normal to go well above that after a heavy carb load.
I have seen claims by Dr. Richard Bernstein and his adherents that the ADA is wrong and that "normal" is much lower and flatter than they claim. I have seen no supporting research on this, and even active criticism of that idea fro various medical researchers.
Sure, I wasn't talking about diabetic people.
> In a few years, we will hopefully start accumulating a flood of highly-granular, anonymized biometric sampling data, ideally tagged with true/false flags of known and suspected genetic markers (but not enough DNA data to individually dox someone). Has someone solved the problem of publishing biometrics with tagged DNA data, and be able to update the DNA tags as our understanding of genetic markers improves over time, without risking doxxing an individual from the genetic marker tags?
I also hope that this is the future. Unfortunately we're probably not going to do much better than HIPAA when this technology is widely available and being used. I'm not sure how to prevent the GATTACA side effects, but it feels like the health advances might be worth it.
Can you link to anything about that?
Polhill TS, Saad S, Poronnik S, Fulcher GR, Pollock CR. Short-term peaks in glucose promote renal fibrogenesis independently of total glucose exposure. Am J Physiol Renal Physiol. 2004 Aug;287(2):F268-73.
I don't really think these studies show that acute blood sugar level elevation is causing the damage you are talking about. The first one talks about how TII diabetics tend to have lower β-cell count and higher apoptosis frequency, but that doesn't mean they go through waves of apoptosis more frequently (ie: during blood sugar spikes), it means that they have a lower life span. The study doesn't establish causality, so it's unclear whether diabetics have lower β-cell count because they are diabetic, or whether lower β-cell causes diabetes. It is a great study though, pretty well designed and building on kind of amazing resources from the Mayo Clinic.
The second study is interesting but extremely limited due to the fact that it was does in vitro. The problem is that it's talking about kidney fibrosis, or scarring of the kidney due to inability to regenerate. But when you remove much of the kidney and the surrounding body and then attack the kidney with glucose of course there is damage. That doesn't mean that in vivo the body can't deal with it. Kidneys do have a hard time regenerating, so it's an interesting foundational study, but I'd hardly call it "a lot of accumulating evidence."
I'll readily grant this can reasonably be construed as suggestive but not "a lot of accumulating evidence", my bad for phrasing it improperly. To me this line of research is raising interesting questions warranting further digging, in a "hm, I wasn't expecting that result going by the received wisdom" way.
Following the sporadic posts of Type 2 patients in online forums self-reporting success at getting off conventional treatment protocols, what appears to come up in common among them is what is currently considered (by the ADA and similar outfits in other nations) radically aggressive methodology to blood glucose control; <100 mg/dL post-prandial is not considered out of line in that crowd, and they avoid spikes as much as possible. A very small number have been at it for 20+ years and well into their 60-70's, and are reporting no long-term disabilities commonly associated with advanced stages of the metabolic disorder. They tend to be in very low (<50 mg/day) carb or even ultra-low (<20 mg/day) carb regimens, or constant ketosis, or varying fasting cycles, with varying amounts of exercise, or a combination of all of the above, with lot of nuances thrown in by each individual. A lot of what they practice directly goes against published large institutional guidelines, but it is really difficult to argue against the end results in their comprehensive blood panels and other bio-markers, so it is a fascinating case to me of the impact of an N=1 / DIY / Quantified Self ethos that increasingly more people are embracing with the aid of increasingly better technology. I find it really exciting that increasingly more laypeople are empirically "science'ing the shit out of this" (to paraphrase "The Martian") with a continuous hypothesis-test-adjust loop upon themselves. It is definitely not science by any conventional means, but as haphazard as it is, it is yielding in a startling number of cases exceptionally better results than the average and mean Type 2 patient experience.
I want to be clear though: there is certainly evidence that very high blood sugar causes significant damage, sometimes permanent, I'm not contesting that. How high "very high" is varies, and as far as I know doesn't really happen in people who aren't diabetic. All I'm saying is I don't think blood sugar spikes are bad for non-diabetics, but they certainly are for diabetics.
Nobody is ever going to know what the chemical composition of a potato is, it's just a potato. Fibre, water, protein content is "carbs" when it's in a potato.
There are plenty of different molecules, such as Sucrose, Glucose, etc, which are all forms of carbohydrate molecules.
But when people refer to "carbs", they're not referring to the chemical molecule, but most likely processed carbohydrates such as bread.
Hopefully that's more clear
[1] http://www.ehow.com/about_4613535_chemical-makeup-potato.htm...
sucrose = glucose + fructose - water
lactose = glucose + galactose - water
maltose = glucose + glucose - water
Starch and glycogen are basically all glucose.Based on this study, I would guess that replacing all HFCS with an equivalent-sweetness amount of regular corn syrup (all glucose) would immediately result in significant improvements to the public health, even though the sweetened products would have more calories per serving.
You're right though, it probably would've been more helpful for me to say carbohydrates in general.
This study isn't a contradiction. It just says that micronutrients matter, which is pretty uncontroversial.
Most of the people I see practicing IIFYM believe exactly this.
They routinely top off with donuts and candy to hit the high carb count needed to gain weight. It's way easier than trying to choke down a pound of brown rice every day.
IIFYM is probably not a bad diet for a teenage boy or steroid user trying to pack on weight while doing a high volume of work. Everyone else will put on a lot of unwanted fat.
That would depend on both your total calorie count and your macro breakdown. IIFYM determines what percentage of your calories should come from each of carbs, fats and proteins. So if your calorie count is suitable for your height, weight and activity level, then your macro breakdown isn't going to cause you to gain weight. If your breakdown is out of whack, then you're going to end up feeling tired, hungry or otherwise malnourished, but it shouldn't cause you excessive weight gain outside of water retention. The calorie counting needs to be more accurate than the macro breakdown.
That sugar vs. starches makes a difference is hardly news either if you just take a look at glycemic index/insulin response.
And that the kind of fatty acids make a difference in fats is also an aspect going beyond macronutrient breakdown. So really, "fits your macros" has never been sufficient.
Making a distinction between glucose and fructose has been more controversial and it's good to see it studied more.
Well, how do you think the unhealthy people got that way in the first place? Yes, healthy people can deal with moderate or immoderate sugar intake better than people with metabolic syndrome. But at the margin you are probably degrading your health anyway.
Eat too little carbohydrates, and you'll die. Eat too much, and you'll die. Your claim that any increase must lead to the same marginal results is absurd.
ALSO, the general effects of sugar on aging and immune system are not so good either in general.
The problem is that the HN title is sensationalistic without merit.
In this case, I think that just giving these children the self-reported diet would yield massive effects on their health, sugar or no sugar. I am quite sure children with obesity problems don't know their real diet - not because they are dishonest, but because we (as people) are very efficient at hiding the uncomfortable truths from ourselves.
The actual reason links to studies are often left off articles (particularly in cases like this with sharp deadline pressure to publish fast before the competition) is that the software powering the editing and publishing workflow really badly needs improvement. An incredible amount of work and knowledge goes into a story like this.
Versioning rich text through many different software tools designed for writing/editing and publishing across many platforms is hard. Sometimes people copy/paste by hand and in doing so a link can go missing. The news industry needs more technologists to work on these problems. We're hiring for people to do that, by the way: http://developers.nytimes.com/careers/
(Also, the link to the study is now in.)
Now I don't want it to sound dismissive or personal in any way, but tell me - if say, few of great software devs now drop everything they do and come to NYT to help, sit down for months and develop the most awesome software package the world of press has ever seen, will it actually solve the quality issues articles have? And more importantly, if sold to other papers, will it suddenly solve their problems?
Will it make journalism honest and trustworthy instead of lies and clickbait bullshit?
I'm not sure how much blame to put on broken publishing workflow, a lot of this seems really to be about broken incentives - "deadline pressure to publish fast before the competition" that leads to the "many articles, as sensationalist as possible, truth be damned" mentality, especially in the management layer.
But you did give me a pause here. Only recently I had a chance to peek at internals of a tiny part of manufacturing industry, and oh boy how much money they waste on badly designed software, which is badly designed because of deadline pressure and top management pressuring to iterate over a broken software package (and then messing with the process) instead of scrapping it altogether and doing it right. Maybe software is more to blame than I thought.
This actually happened and that's how we got d3.js. It didn't fix journalism though.
You get what you pay for, which online tends toward nothing.
Still, it's better than them getting paid to tell you what someone else wants you to hear.
My objection is with the editorials. I've all but stopped reading "the news" (NYT, WSJ, Economist, my local paper, etc) as a result.
"I don't like [thing]" "I work at [thing], come help me fix it"
(Not claiming that NY Times is perfect. Of course. There are other good sources, too. But NYTimes isn't like the media I grew up with. At 20 I realized that all their coverage of subjects which I knew beyond the surface was garbage, at best. My specific example is DN, the largest Swedish morning paper, but could be most of the media.)
I'd be happy to be corrected of course.
I'm skeptical of this "software" explanation. Software can of course make citation management much easier, but I see lots of articles that don't even bother to mention the lead author of a cited publication; and how did the software get that way in the first place? The software reflects the priorities of the corrupt organization that produced it.
Somebody could probably sit down with the journalists for few weeks and come up with a software package that would fit their needs perfectly - if the development consisted of direct communication between the developers and journalists/editorial staff, without any management middlemen in between. Alas, that's not how software is procured in large organizations.
But I'm also skeptical. It could explain NYT's problems, but it doesn't explain the even worse problems every other news outlet has.
NOTE: Study "Effects of X on Y given XYZ" by Researcher N. Here, http://address-to-paper.org
(not the placeholder, the actual data) should help. I don't see such a line getting lost, and even if they happen to publish it by accident instead of incorporating into the text (as sometimes happens, things slip through), it would still reach the same goal anyway.
Sounds like the problem lies here and not on the technical side of writing, editing and publishing text.
I wonder what part of this decadence is imputable to ad revenu. If I were very naive, I would say all of it.
You can wish it weren't so, or call it cynical, but that IS the reason they don't add a link to the source in the article. God help us all if people clicked away from the site, learned more about the topic than the reporter, or had the piece go over their head.
I find your comment disheartening because I was kind of hoping that I was guessing wrong. Can I still hope that things are not quite as bad at the NY Times as at local weeklies?
http://www.scripting.com/2005/12/12.html#howToMakeMoneyOnThe...
Where he talks about encouraging outgoing traffic.
But one of the more interesting links in that post has gone "evil-dark" (expired, taken by squatters, endless unclosable javascript "your iOS app is inf1ected!!1one! Call us to fix it! Have your credit card ready!"
So by your newspaper linking only to itself, it could be that they actually hope to avoid this dead link behavior. (Although it would be better that it was a self link that went to a vetted link repository.)
I'm really not a web guy, so I'm surprised that this problem hasn't been solved for most content management systems.
Media outlets want viewership more than anything else and the way to get and keep viewership is to tell people what they want to hear. It's why media outlets always have a consistent "slant"; MSNBC people watch MSNBC because it aligns more directly with their worldview than Fox News, and vice-versa. There is minimal tolerance within the audience for a host or pundit that appears to disagree on important factors.
You'll never see Bill 'O Reilly and Rachel Maddow on the same network, because that network would not have any viewers; conservatives want their conservative beliefs reinforced, liberals want their liberal beliefs reinforced, and both will only consume media that performs that function. Most people are not open to having their beliefs challenged even slightly.
All that said, I do find such articles often do state the university and/or the professors that were involved in the study or studies. Some of it may just be convention established before hyperlinks existed, though in many cases, the actual study is not publicly accessible.
"Morning Joe" is a different type of program than the primetime "rage pundits" and Scarborough is one of MSNBC's more moderate hosts, but he still spends his day pandering to MSNBC's core audience. Bias goes much deeper than the words that do or don't come out of a host's mouth; the networks sets the agenda, frames the debate, and procures the guests that will cater to their primary viewership target, and Scarborough passively rides the gravy train. Anchors are performers more than anything, putting on the show that the network has paid them to put on.
What politician is going to turn down the opportunity to have his face in front of tens of thousands of viewers for 2 hours every day, even if it means he has to play nice with the other side?
If there were plenty of people who wanted a "diversity of viewpoints", you'd see this in the marketplace. Could you point out one place where this is actually true? Even NPR, which has a much smaller profit motive and thus should be less concerned with viewership and more concerned with integrity, panders constantly to its audience and refrains from creating a "diversity of viewpoints".
How often do you hear a fair story on NPR about what the conservatives perceive as problems with abortion or same-sex marriage (meaning, a story that doesn't reduce these, either the beliefs and or the believers, to a gross caricature)? Never, because it would make NPR's listener base really mad, because they don't agree that there are problems with those things.
Very few, if any, news outlets are neutral. They pander to their audience's beliefs and they set the dialogue by choosing the stories to give airtime and feed to the base.
Even the "neutral stories" are framed to push a specific viewpoint. They usually go like this: open up with a brief, slanted statement of events. Call someone who supports your POV and ask for their comment. Spend 2 minutes making their argument and bringing it in. About 75% through, put on a 1 or 2 sentence clip from the other side that basically amounts to "we disagree because bad reason x" (bad reason provided either by editing the clip or selecting a bad rep of opposite viewpoint), and then follow it up with another comment from the first person, the person whose argument and authority you spent the first 74% of the story establishing, that says "Well, bad reason x is just ridiculous". Then sign off.
I guarantee you 90% of TV and radio news stories that discuss a news event in a supposedly "neutral" way approximate that pattern. They do it because they're trying to reinforce the beliefs that they believe will make them more money.
Borrowing material from the library is a "thing" as far as I know.
I don't think you have to own a copy of something to write about it. That would be insane.
It's that the reporter is getting access without having ever paid for it. (Pirating, reading from another article, etc)
Setting aside the fact that it is a non-issue, in any case many news agencies have various DB subscriptions, most public libraries have DB access, most universities have 'reader' accounts which grant access to these DBs for like $100 a year, etc.
Any reporter who wants to access an article legitimately can easily do so. Else, they really do not belong in the profession of journalism, which relies on practitioners being resourceful and researching things in order to convey accurate information to others.
The Times needs to get with the times.
Scientific research articles are very often behind a paywall. So citing them wouldn't really give the reader much more information.
http://onlinelibrary.wiley.com/doi/10.1002/oby.21371/abstrac...
PDF:
http://onlinelibrary.wiley.com/doi/10.1002/oby.21371/pdf
Lustig, R. H., Mulligan, K., Noworolski, S. M., Tai, V. W., Wen, M. J., Erkin-Cakmak, A., Gugliucci, A. and Schwarz, J.-M. (2015), Isocaloric fructose restriction and metabolic improvement in children with obesity and metabolic syndrome. Obesity. doi: 10.1002/oby.21371
As an aside, it's very strange that the article is not cited in the NYTimes post. A journalist should at least give the DOI at the bottom if there is not a link to the article in the body of the text.
Edit: I left this same comment on the NYTimes article and the text now links to the journal (though my comment was not approved). Seems like a win! NYTimes editorial staff: thank you!