What's with the "What's With Wheat" movie?

I was planning on doing a masterpost about grains and gluten for a while now.
Since there's a new movie on the subject about to launch, I figured I'd be remiss in my duties if I didn't get this together about now.

This movie "What's With Wheat" you may have heard of appears to have been inspired by the financial success of a similar fearmongering misinformation piece known as "That Sugar Film" and there appears to be some cross-promotion between the makers of that film and this one. The "experts" and funders of the movie are a veritable who's who of woo, featuring all manner of pseudoscience based health & diet authors in particular.

Not having or intending to watch this fictional piece I cannot offer a review myself but I will add links to reviews as they become available. As to the claims the film makes, I understand that they range from the "gluten is bad" to the "it's not the gluten it's the chemicals they spray on the crops" to the "the wheat is GMO which makes it bad" sort of nonsense that has been claimed and debunked repeatedly for at least as long as I've been in the fitness business.

Here's an entry from a blogger who was offered a cut to promote the film, but declined on ethical grounds: Nurse Loves Farmer - No, I Will Not Promote Your Anti-Wheat Documentary.

It's always ironic to me that these "alternative" health marketers constantly claim that we can't trust the scientists and the qualified health professionals as they have financial incentives to promote certain information... while they themselves run affiliate programs offering financial incentives to promote their own, non-evidence based misinformation. As a side note, remember that time they tried to pay ME off to promote lchf and paleo pseudoscience? I sure haven't forgotten it.

The following links alone will debunk many of the disingenuous claims of this marketing piece masquarading as a documentary:

• Wheat Has Not Changed.
• Wheat In The World.

In the next section you'll find links regarding the benefits of keeping cereal grains in your diet unless you have an actually diagnosed medical reason to avoid them.

As I've attempted to explain for years now... active people have a certain ENERGY requirement as well as other nutritional requirements to meet. They will best meet those requirements through a more inclusive diet, rather than a more restrictive one.

The Master Post On The Benefits Of Keeping Whole Grains In Your Diet Starts Here:

Latest Update: January 2019

• Blow to low carb diet as landmark study finds high fibre cuts heart disease risk.
• The lifesaving food 90% aren’t eating enough of. 
• Carbohydrate quality and human health: a series of systematic reviews and meta-analyses.

 

Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review.

http://www.bmj.com/content/353/bmj.i2716?etoc

What is already known on this topic

• A high intake of whole grains has been associated with a lower risk of type 2 diabetes, cardiovascular disease, and weight gain
• Recommendations for whole grain intake have often been unclear or inconsistent with regard to the amount and types of whole grain foods that should be consumed to reduce chronic disease and risk of mortality

What this study adds

• A high intake of whole grains was associated with reduced risk of coronary heart disease, cardiovascular disease, total cancer, and all cause mortality, as well as mortality from respiratory disease, infectious disease, diabetes, and all non-cardiovascular, non-cancer causes
• Reductions in risk were observed up to an intake of 210-225 g/day (seven to seven and a half servings/day) and for whole grain bread, whole grain breakfast cereals, and added bran
• The results strongly support dietary recommendations to increase intake of whole grain foods in the general population to reduce risk of chronic diseases and premature mortality

Consumption of whole grains and cereal fiber and total and cause-specific mortality.

http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-015-0294-7

• Consumption of whole grains were inversely associated with risk of all-cause mortality and death from cancer, cardiovascular disease (CVD), diabetes, respiratory disease, infections, and other causes.
• Our data suggest cereal fiber is one potentially protective component.

See also: http://www.livescience.com/50231-whole-grain-cereal-fiber-early-death.html

 Gluten free diet and nutrient deficiencies: A review.

http://www.ncbi.nlm.nih.gov/pubmed/27211234

• GF-diet was found to be poor in alimentary fiber due in particular to the necessary avoidance of several kinds of foods naturally rich in fiber.
• Micronutrients are also found to be poor, in particular Vit. D, Vit. B12 and folate, in addition to some minerals such as iron, zinc, magnesium and calcium.
• Moreover, an inadequate macronutrient intake was reported related above all to the focus on the avoidance of gluten.

Association Between Carbohydrate Nutrition and Successful Aging Over 10 Years

https://biomedgerontology.oxfordjournals.org/content/early/2016/05/23/gerona.glw091.full 

• Consumption of dietary fiber from breads/cereals and fruits independently influenced the likelihood of aging successfully over 10 years. These findings suggest that increasing intake of fiber-rich foods could be a successful strategy in reaching old age disease free and fully functional.

 

Whole-grain wheat consumption reduces inflammation in a randomized controlled trial.

http://ajcn.nutrition.org/content/early/2014/12/03/ajcn.114.088120.abstract

• Whole-grain wheat consumption reduces inflammation in a randomized controlled trial on overweight and obese subjects with unhealthy dietary and lifestyle behaviors.

No Effects of Gluten in Patients With Self-Reported Non-Celiac Gluten Sensitivity

http://www.gastrojournal.org/article/S0016-5085%2813%2900702-6/abstract

And a couple more I've shared already in an earlier entry, in case you missed it then:

• Myths Busted: The Whole Grains Council.
• Intake of whole grains is associated with lower risk of myocardial infarction. 

And here's a link to the Australian 2016 Grains For Health Report.

But what about Adrenal Fatigue though?

I'm glad you asked. For good measure here are some links discussing this condition, which is frequently invoked by fearmongers to convince you to adopt whatever form of restrictive diet they are selling.

Does such a condition even exist though? Spoiler: in the context they describe, nope.

• Fatigued by a Fake Disease.
• Adrenal Fatigue: Myth vs Reality.
• Adrenal Fatigue: A Fraud Perpetrated On Unsuspecting Patients.
• And while we're at it: Debunking The Myth Of Leaky Gut Syndrome.

Bottom line: there's money to be made in fearmongering, but there's a lot of harm to be done in promoting restrictive dieting via fear aka orthorexia. There are many benefits to including whole grains in a healthy & balanced diet.

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Read This Before You "Eat More To Lose Weight"

This might seem like something of an ironic post coming from me of all people. 

After all, I'm the guy who's been saying "we need to fuel people for best performance and condition, not try to starve weight off them" for the past few years, when no one else seemed to be.

The message finally appears to be catching on, and more people are beginning to realise that slashing calories ever lower is as damaging as it is unsustainable. But before we arbitrarily replace the blanket statement of "eat less (and less) move more (and more)" with it's polar opposite, let's assess the situation to ensure that this time, we're actually giving advice that is good and helpful.

First though, let's bust some myths. 

Myth: You need to eat clean. It is the quality of foods that matters, not the calories. You don't lose weight eating "junk food", and any of the "wrong" foods will make you gain weight.

Nope. 

• Twinkie diet helps nutrition professor lose 27 pounds.
• Teacher lost 56 pounds eating only McDonald's.

Of course we should all try to make sensible choices and include many healthy options, but your total energy intake is what influences your body weight.

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Myth: Low Carb & Keto Diets are the best / only option for weight loss.

Nope.

• Low Carbohydrate versus Isoenergetic Balanced Diets for Reducing Weight and Cardiovascular Risk.
• Comparison of Weight Loss Among Named Diet Programs in Overweight and Obese Adults. 
• Long-term effects of a low carbohydrate, low fat or high unsaturated fat diet compared to a no-intervention control.
• Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity.
• Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men.
• Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates.
• Similar weight loss with low- or high-carbohydrate diets.  
• Differences in Insulin Resistance Do Not Predict Weight Loss in Response to Hypocaloric Diets in Healthy Obese Women.
• Consuming energy primarily as carbohydrate or fat for 3 mo did not differentially influence visceral fat and metabolic syndrome in a low-processed, lower-glycemic dietary context.

Even more as of February 2018:

• Low-fat vs low-carb? Major study concludes: it doesn’t matter for weight loss - report on Examine.com. Amusingly, this is yet another study funded by Taubes' NuSI organisation.
• Does high-carbohydrate intake lead to increased risk of obesity? A systematic review and meta-analysis: On the basis of the current study, it cannot be concluded that a high-carbohydrate diet or increased percentage of total energy intake in the form of carbohydrates increases the odds of obesity. Amusingly,  the authors of this study thank Noakes for his assistance in the design.

More Still: April 2020

• Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis of randomised trials. 

This was probably redundant after the previous section anyway, but there's no benefit to low carb or keto dieting over balanced diets of the same energy provision. Some people sure do seem to like them, but personally I would see VLC & keto diets as disadvantageous for most people with an interest in long term adherence for sustainable results.

Again though, the facts are that if you go from an excessive regular energy intake and lack of physical activity to less excessive energy intake and more suitably active, you'll lose weight. Whether you cut back on carbs, on fats, or cut back across the board... from more excessive to less excessive energy intake, and especially from inactive to suitably active, you will lose weight.

Update: Upon demonstrating that Low Carb approaches are not required or preferable for weight loss, it is almost inevitable that a special pleading, goal post shifting argument will be made of the "but if they have Type 2 Diabetes..." variety. Let's knock that one on the head while we're about it, too.

• Low-carbohydrate, low-GI, Mediterranean, and high-protein diets are effective in improving various markers of cardiovascular risk in people with diabetes and should be considered in the overall strategy of diabetes management.

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Myth: When Weight Loss Stalls, Add More High Intensity Calorie Burning Cardio Workouts.

Nope.

• Constrained Total Energy Expenditure and Metabolic Adaptation to Physical Activity in Adult Humans.
• Physical activity did increase energy expenditure as expected, but only up to a point.  

As stated above, from inactive to suitably active is a very good idea indeed, but let's assume we're talking about people who are already quite active and participating in training. Adding more and more non-productive high intensity activity to burn calories is not only impractical, but the links above show that it will offer no benefit.

Take home point here: train productively, for enjoyment and for the specific benefits of the choice of activity. Not "to burn calories".

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  Myth: The 5:2 Diet, Intermittent Fasting, Meal Frequency & whatever else.

Eh...

• After one year, weight loss in the alternate-day fasting group (6.0 percent) was not significantly different from the daily calorie restriction group (5.3 percent), according to the results. 

Again; "energy provision vs energy requirement" is the rule that matters. Forcing yourself onto a different meal schedule may mean that you eat less, but it is still the change in amount of energy intake that influences body condition, and not the change in timing of energy intake.

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So far, all of this supports "eat more to lose weight". Should you really though?

Active people require a certain amount of energy and resources in order to be able to recover and adapt to training. If you're restricting to a low level of energy intake with the misguided "calorie deficit" approach, a lack of progress is likely to be due to falling well short of that amount. Introducing more "calorie burning" activity only squanders what resources you have made available in an unproductive manner.

• "Chronic starvation = increase in body fat percentage". Applies to male and female athletes.
• Three weeks of food restriction not only suppressed resting metabolism, but also decreased nonresting energy use by nearly half.

Bottom line here: being under fueled and over worked is not conducive to good results, even when weight loss is a significant aspect of your goal.

Is that what is actually happening though?

As the saying goes; the first principle is that you must not fool yourself, and you are the easiest person to fool. 

For inactive people who are not involved in sports or training, even a "normal" amount of food will be in excess of an amount that you are putting to use, which means weight gain. In this circumstance, "eat more to lose weight" would almost certainly result in rapid gain of an even greater amount.

Here's where it gets complicated and the issue becomes contentious.

Actually not a myth: Humans are extremely likely to under estimate food / energy intake and over estimate activity levels.

• Discrepancy between self-reported and actual caloric intake and exercise in obese subjects.
  
  Conclusions: The failure of some obese subjects to lose weight while eating a diet they report as low in calories is due to an energy intake substantially higher than reported and an overestimation of physical activity, not to an abnormality in thermogenesis. 

• Validity of U.S. nutritional surveillance:National Health and Nutrition Examination Survey caloric energy intake data, 1971-2010.
  
  Results: These results are indicative of significant under-reporting. The greatest mean disparity values were -716 kcal/day and -856 kcal/day for obese (i.e., ≥30 kg/m2) men and women, respectively.

• A comparison of the accuracy of self-reported intake with measured intake of a laboratory overeating episode in overweight and obese women with and without binge eating disorder.
  
  Conclusions: Findings confirm that those with BED consume significantly more than controls during a laboratory binge and controls tended to be more accurate in recalling their intake 24 h later.

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It is important to include these studies for two reasons, the first of which is that people who are fixated on the calorie deficit model are likely to show you them with the inference that they prove that "the problem is that they're eating a lot more than they think they are. If they were eating the amount that they think they are, they'd be in deficit and therefore they'd be losing weight".

Yes, but no.

It's important to notice that these studies are not of athletes or on people of less excessive weight who are participating in sports or training. In my years of experience as a coach, when active people come to me and report that they are working to restrictive and low targets without seeing progress, I tend to believe them and we consistently see much better results as we increase first towards an adequate and then closer towards a more optimal total energy and macronutritient provision... including when weight loss is a goal.

Regardless, we do know that a disparity between perceived and actual intake is very common, so unless we are actually working to a plan to hit our current targets, we can't assume that we are. Intuitive eating is awesome IF you're still making progress, but if your eating habits are erratic, unscheduled, unmeasured and inconsistent... we have no reason to consider the total energy provision to be anything other than an unknown and random amount.

On a related note...

• Irregular meal-pattern effects on energy expenditure, metabolism, and appetite regulation.

To my way of thinking just adding "more" to a random amount isn't much better than slashing below an unknown amount. Where you end up is anyone's guess.

Let's cut to the chase.

If you're overweight and inactive, first and foremost you need to become suitably active.
People who are already active, assess your consistency at training. If you're working to targets based on requirements for 5 sessions per week but you've only been making 2 lately, eating more is not likely to have the desired effect.

Now, if you're training consistently and especially if you're progressing from a beginners level to an intermediate level, from lower intermediate to upper intermediate and so on... your fueling requirements will increase as the demands on your body to perform, recover from, and adapt to training are greater.

If you have a set of intelligently determined targets for intake, but you've just been winging it as described above, you will need to start actually planning your daily intake in advance to ensure adherence to those targets, and then assess the results.

Good performance at training, good energy levels outside of training and improvements in condition might suggest that your targets are appropriate all along but you just weren't hitting them. If you had "beginner level" targets but you're not really a beginner anymore and you see no improvement in condition, that might be a good sign that you need to recalculate with your new level of consistency and proficiency in mind.  If you last 3 or 4 days and then find you are ravenous and eat everything in sight... are you thinking "start over again and this time be more disciplined" right now? Screw that. It's a sure sign that you need to recalculate and increase daily intake accordingly.

When you're training consistently and seeing good progress without paying much attention on the nutrition side, you can safely assume you're getting it right either through good intuition or because you've practiced the appropriate habits for long enough that your appetite is well tuned to your requirements and your body trusts you to listen when it tells you that it needs more. When you're not seeing progress, you need to go back and plan in advance to meet appropriate targets, and then assess the situation.

Best results will always come when training is both consistent and strategic, and fueling is closer to optimal rather than further into deficit. At the very least, you must be working to exceed a minimum adequate requirement. A couple of times with more advanced athletes I have only set a minimum requirement with an official "no maximum limit", and the results were nothing short of amazing.

• Eating more and moving more appears to be better for fat loss than eating less and moving less.
• Homeostatic regulation of body weight is more effective when energy intake and expenditure are both high.

Here's a new one circa January 2020:

• Our results suggest that composition of weight loss may have functional importance for energy balance regulation, with greater losses of FFM potentially being associated with increased weight regain and appetite.

Bottom line: best long term results will come from consistent participation with a strategic and productive approach to training, and anticipation of increased fueling requirements as performance improves.

A little update:  if you're looking to get started with an introductory training program & fueling guidelines, see the weight loss tab on my blog right here.

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Artificial sweeteners are quite safe and helpful in weight loss: masterpost.

Another master post / link dump for you all, this time all about artificial sweeteners and aspartame in particular. It's ironic that many of the people who fear monger over natural sugars also insist that artificial sweeteners must also be avoided.

It's almost as if they just have a puritanical view on food and don't want you enjoying anything sweet at all, isn't it?

Newest Updates: 2018

• Scepticism is strong but research finds artificial sweeteners help ‘cut calories and control cravings’.
• These data do not support the view that aspartame is problematic for the management of glycemia, appetite, or body weight.
  

Pertinent Update: July 2017

• A new review of research finds a modest but inconsistent benefit from consuming artificial sweeteners over sugar. Their conclusion of a possible backfire effect, however, does not seem to be supported by the studies they review.
• Article Saying Diet Drinks Cause Stroke, Dementia Is Full Of Holes.
• Fast Take: What You Need to Know about a New Study Linking Beverages to Stroke or Dementia.

Let's start continue, with a video:

A couple of posts from some good friends of this blog:

• From Gabrielle Maston: Are Artificial Sweeteners Safe?
• And from Ground Up Strength: The Aspartame Myth-Information Campaign.

SuppVersity have a hell of a lot of articles on artificial sweeteners, here are some helpful ones:

• Artificially Sweetened Foods Promote, Not Hinder, Fat Loss
• Study Confirms Fake Sweetness Promotes Weight & Waist Loss, Decreases Hunger

More Information On The Safety Of Aspartame:

• Aspartame 'safe' at current levels, says European food regulator.
• Aspartame: a safety evaluation based on current use levels, regulations, and toxicological and epidemiological studies.
• Aspartame: review of safety.
• European Food Safety Authority: Report of the meeting on Aspartame with National Experts.
• EFSA Topic: Aspartame.
• Aspartame – what it is and why it’s used in our food.
• Artificial Sweeteners and Diabetes.
• Snopes: Aspartame - Sweet Poison?
• Science Based Medicine: Aspartame Truth vs Fiction.
• Aspartame is safe according to the scientific consensus
• Harvard hospital retracts statement about data on aspartame and cancer.
• Gut reaction: Zero-calorie sweeteners produce same response as water.
• Cancer Council: Artificial Sweeteners and Cancer.
• The Persistent Mythology Of Sweeteners.
• Examine.com: Is Diet Soda Bad For You?
• Effects of carbohydrate sugars and artificial sweeteners on appetite and the secretion of gastrointestinal satiety peptides.  
• Scientific Opinion on the re-evaluation of aspartame (E 951) as a food additive.
• Carcinogenicity of Aspartame in Rats Not Proven.
• The safety and regulatory process for low calorie sweeteners in the United States. 
• Consumption of aspartame-containing beverages and incidence of hematopoietic and brain malignancies. 
• Aspartame: a safety evaluation based on current use levels, regulations, and toxicological and epidemiological studies. 
• The effects of water and non-nutritive sweetened beverages on weight loss and weight maintenance: A randomized clinical trial. 

Latest Updates:

Great infographic and supporting article from Scott Baptie. I'm more of a Pepsi Max man myself, just for the record.

In the interests of balance:

To be fair there are some studies that do suggest a correlation between regular use of artificially sweetened beverages and obesity and/or health concerns.  This should not be confused as to suggest that it because of those beverages that the person's diet is inappropriate and unhealthy.

At best (or, at worst) we could interpret this data as evidence that "simply switching to artificially sweetened beverages from those that contain sugar may not be enough to ensure that your diet is appropriate over all, depending on what other choices of meals and snacks you make".

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The Most Epic Week In Review, Ever?

Selfie of the week is a little awkward but
at least my arms look huge.

I don't always do a week in review every week, because some weeks there's not all that much to talk about. This week though? Holy crap. This week was a legit game changer as far as I'm concerned. So much happened.

First of all though; Busted Scammer Of The Week is always a regular feature. And today we got some good news regarding perhaps one of the most disgusting and despicable scammers of all time.

• Conwoman Belle Gibson faces $1m fines over cancer scam fundraising fraud.

What a piece of trash.

This following story is good news too, and if I'm not mistaken I believe the Blocked By Pete Evans page (which I was a founding admin of, but am no longer involved with) are owed credit for first exposing this dangerous and outrageous nonsense.

• Victorian Health Minister Jill Hennessy orders crack-down on 'rogue' chiropractors. 
• An excellent report on this issue at Science Based Medicine; The Crack Heard Round The World.

We're just getting started though. Now the big stuff.

The Biggest Loser Study was big news this week.

This one basically confirmed what I've been saying for years now. Too far into calorie deficit for too long at high activity levels (aka over worked and underfueled) is a myopic approach to weight loss and people WILL stop seeing further fat loss at a certain point, and slashing further into deficit or increasing activity even further will not fix it. This approach will backfire over the long term resulting in weight regain even if you do stick to the regime of restricting and burning of calories.

• The study: Persistent metabolic adaptation 6 years after “The Biggest Loser” competition.
• An earlier study also based on The Biggest Loser contestants: Metabolic adaptation following massive weight loss is related to the degree of energy imbalance and changes in circulating leptin.
• Does this mean there is no hope for obese people who'd like to lose weight? My take, on my facebook page. 
• Ironically I published this just a couple of days earlier, right here: Ending The Unhealthy Obsession With Calorie Deficit.
• Leigh Peele examines some of the limitations & implications of this study and offers practical advice for best results in long term successful weight loss and weight management, here.

Low carb & keto dieting as beneficial for weight loss, finally and thoroughly debunked.

I have saved the best for last and this really was epic. For years, advocates of low carb and ketogenic dieting have insisted that it is the only way to avoid weight gain, and the only way to lose weight. Obviously, that's not correct. All you have to do is ask around, "hey, you seem quite lean and not over weight. Are you doing low carb or keto?". You'll find there are no shortage of people who consume a moderate to high amount of carbohydrates within a total energy intake that is appropriate to them, who are quite normal sized, quite healthy, and even in quite athletic shape.

Real world observation and clinical evidence have shown for some time that it is total energy provision relative to total energy requirement that drives weight gain, and not the mere presence of carbs in the diet as per the alternative "carbs drive insulin, insulin drives fat storage" hypothesis.

Here's where it gets funny.

Proponents of this  alternate hypothesis such as Gary "Good Calories Bad Calories" Taubes who have rejected all of this evidence on the basis of "we don't know who funded it and if they might have had reason to fudge the numbers to protect big potato" (or something like that) decided they would fund and design their own study, contract respected, qualified, objective and impartial researchers to carry it out and find the conclusive evidence that carbs are to blame and LCHF &/or ketogenic dieting is what we should have been told to do all along.

Just one problem though... the research found the opposite.

Here's what we knew already:

• Low Carbohydrate versus Isoenergetic Balanced Diets for Reducing Weight and Cardiovascular Risk:
  
  Trials show weight loss in the short-term irrespective of whether the diet is low CHO or balanced in terms of its macronutrient composition. There is probably little or no difference in weight loss and changes in cardiovascular risk factors up to two years of follow-up when overweight and obese adults, with or without type 2 diabetes, are randomised to low CHO diets and isoenergetic balanced weight loss diets.
• Comparison of Weight Loss Among Named Diet Programs in Overweight and Obese Adults:
  
  Low-carbohydrate and low-fat dietary programs were associated with more weight loss than no dietary intervention over a 12-month period; behavioral support and exercise enhanced weight loss. The weight loss differences between indivdual named diets were small with likely little importance to those seeking weight loss. This supports the practice of recommending any diet that a patient will adhere to in order to lose weight.
   
• Long-term effects of a low carbohydrate, low fat or high unsaturated fat diet compared to a no-intervention control.
  
  Significant cardiometabolic risk factor reduction was observed equally with VLC, VLF and HUF diets after 15 months.

• Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity.
  
  Cutting carbohydrates increased net fat oxidation, but cutting fat by equal calories had no effect. Cutting fat resulted in more body fat loss as measured by metabolic balance.

Those are the sort of studies that the LCHF fanatics aren't terribly impressed by. Here's their own study, which one assumes they designed to be more stringent, rigorous and unbiased:

• Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men.
  
  Body fat loss slowed during the KD and coincided with increased protein utilization and loss of fat-free mass.
  
  The isocaloric KD was not accompanied by increased body fat loss but was associated with relatively small increases in EE that were near the limits of detection with the use of state-of-the-art technology. 

Even More: February 2018

It's funny because professional low carb conspiracy theorists like Taubes & Noakes keep trying to prove the superiority of a low carb approach, and keep failing spectacularly.

• Low-fat vs low-carb? Major study concludes: it doesn’t matter for weight loss.
• Does high-carbohydrate intake lead to increased risk of obesity? A systematic review and meta-analysis.

Further & Related: 

• NutritionWonk asks: Is the Insulin Theory of Obesity Over?
• Carbsane asks why Taubes continued to promote his low carb / insulin myth while knowing that his organisation's own study has disproved it?
  
  It's beyond frustrating at this point, it's infuriating. Taubes' dishonesty is unparalleled in its audacity. Truly. The MDs -- Ludwig, Hyman, Lustig to name just three -- cashing in on TWICHOO are simply shameless at this point as well.
• Not directly related but while we're on the subject: High-carb meals better in curbing appetite amongst the obese. Thanks to Gabrielle Maston Dietitian & Exercise Physiologist for bringing this one to my attention.
• Further still, more related to sports nutrition: A problem with the reporting of effects of ketogenic diet.

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Sugar is not an addictive substance: masterpost

There's so much nonsense doing the rounds about how "sugar is addictive just like illegal drugs are addictive", usually coming from LCHF cultists. So here's a masterpost of all the information to put that myth to rest once and for all.

Also though; here's my collection of reviews of That Sugar Film, in case you missed it: That Sugar Film: Link Dump

Update: September 2018

Here's a great new article; Is Sugar Really Bad For You, by Jessica Brown via BBC Future. It's wonderful to see such good and factual content on a major platform for once.

• Overall, evidence that added sugar directly causes type 2 diabetes, heart disease, obesity or cancer is thin.

You'll find much of the supporting evidence for the facts laid out in this article, below.

Studies on sugar addition, food addiction and eating addiction:

The plausibility of sugar addiction and its role in obesity and eating disorders.

http://www.clinicalnutritionjournal.com/article/S0261-5614%2809%2900239-8/abstract

• The [above] predications have in common that on no occasion was the behaviour predicted by an animal model of sucrose addiction supported by human studies.
• There is no support from the human literature for the hypothesis that sucrose may be physically addictive or that addiction to sugar plays a role in eating disorders.

 

The mesolimbic system and eating addiction: what sugar does and does not do.

http://www.sciencedirect.com/science/article/pii/S2352154616300638 

• Sucrose is reinforcing and it promotes dopamine release independent of its taste.
• Drugs and sucrose have strong yet transient effects on the mesolimbic system.
• Addictive drugs severely disrupt brain plasticity after long-term exposure.
• No data currently suggest similar central adaptations following sucrose.

 

Eating is addictive but sugar and fat are not like drugs, study says.

http://www.eurekalert.org/pub_releases/2014-09/uoe-eia090914.php

• People can become addicted to eating for its own sake but not to consuming specific foods such as those high in sugar or fat, research suggests.
• An international team of scientists has found no strong evidence for people being addicted to the chemical substances in certain foods.
• The brain does not respond to nutrients in the same way as it does to addictive drugs such as heroin or cocaine, the researchers say. 

 

“Eating addiction”, rather than “food addiction”, better captures addictive-like eating behavior.

http://www.sciencedirect.com/science/article/pii/S0149763414002140

• “Eating addiction” describes a behavioral addiction.
• An “eating addiction” is not necessarily associated with obesity.
•  Consider “eating addiction” as a disorder in DSM-5 “Non-Substance-Related Disorders”.

Sugar addiction: the state of the science

http://link.springer.com/article/10.1007/s00394-016-1229-6

• Given the lack of evidence supporting it, we argue against a premature incorporation of sugar addiction into the scientific literature and public policy recommendations. 

Eating dependence and weight gain; no human evidence for a 'sugar-addiction' model of overweight.

https://www.ncbi.nlm.nih.gov/pubmed/28330706

• The current findings indicate that sugary foods contribute minimally to 'food dependence' and increased risk of weight gain. 

See also...

Sugars and Health Controversies: What Does the Science Say?

http://advances.nutrition.org/content/6/4/493S.abstract

We conclude that added sugars consumed in the normal forms in which humans consume them, at amounts typical of the human diet and for the time period studied in randomized controlled trials, do not result in adverse health consequences. Although more research trials are needed in many areas of sugar consumption and health, there is little scientific justification for recommending restricting sugar consumption below the reasonable upper limit recommended by the Dietary Guidelines for Americans, 2010 of no more than 25% of calories. 

 Bonus Content:

• Australian obesity increases despite lower sugar intake.
• Soft drink and added sugar consumption on the decline in Australia.
• Is sugar addictive? Probably not, say Cambridge neuroscientists.
• Chronic fructose substitution for glucose or sucrose in food or beverages has little effect on fasting blood glucose, insulin, or triglycerides: a systematic review and meta-analysis.
• Researchers say fructose does not impact emerging indicator for cardiovascular disease.
  “This is more evidence that fructose has adverse effects only insofar as it contributes to excess calories,” said Dr. Sievenpiper. 
• Adiposity among 132 479 UK Biobank participants; contribution of sugar intake vs other macronutrients.
  Fat is the largest contributor to overall energy. The proportion of energy from fat in the diet, but not sugar, is higher among overweight/obese individuals. Focusing public health messages on sugar may mislead on the need to reduce fat and overall energy consumption."
  An excellent commentary on this study can be found at Gibney On Food.
• Focus On Sugar Is Hampering UK Obesity Battle.
• Sugar Fixation Hampering Obesity Battle.
• Weightology: No, You're Not Addicted To Sugar.
• No, Sugar Isn’t The New Heroin.

 Even More: Do people need to "quit sugar" to lose weight?

• Weight loss in overweight subjects following low-sucrose or sucrose-containing diets.
  Conclusion: These results provide no justification for the exclusion of added sucrose in weight-reducing diets.
• Metabolic and behavioral effects of a high-sucrose diet during weight loss.
  Results showed that a high sucrose content in a hypoenergetic, low-fat diet did not adversely affect weight loss, metabolism, plasma lipids, or emotional affect.
• Reduced glycemic index and glycemic load diets do not increase the effects of energy restriction on weight loss and insulin sensitivity in obese men and women.
• Randomized controlled trial of changes in dietary carbohydrate/fat ratio and simple vs complex carbohydrates on body weight and blood lipids.

Bonus Content: Studies on the effects of restricting food choices. 

 

Selective carbohydrate or protein restriction: effects on subsequent food intake and cravings.

http://www.ncbi.nlm.nih.gov/pubmed/16844265

• The results indicated that selective food restriction resulted in selective behavioural consequences.
• Specifically, carbohydrate-restricted participants consumed more of a high-carbohydrate food than did controls or protein-restrictors, in addition to reporting more cravings for high-carbohydrate foods over the restriction period.
• Overall, selective food restriction is demonstrated to have negative psychological and behavioural consequences. 

Even more:

• Flexible vs. rigid dieting strategies: relationship with adverse behavioral outcomes. 
• Rigid vs. flexible dieting: association with eating disorder symptoms in nonobese women.
• How does thinking in Black and White terms relate to eating behavior and weight regain?

Also:
Restricting Your Children's Chocolate Could Do More Harm Than Good.

"In terms of parenting practice, the results indicate that in the short term, restricting 'bad' foods is an effective means to promote healthier eating habits. But by restricting access you may encourage a preoccupation with unhealthy foods which in the long term could encourage the very behaviour you are trying to prevent," explains Professor Ogden.

 And finally:

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Reviews of That Sugar Film: link dump

By no means whatsoever could this be considered
"too much sugar". Don't let silly people spoil your enjoyment
of nutritious & delicious foods.

What we know about sugar is that you really don't want to have too much of it terribly often.

What does "too much" mean, though? Well, according the World Health Organisation we should limit to no more than 6 teaspoons of added sugar on a daily basis. Key word here is "added", as the naturally occurring sugars within nutritious foods are absolutely fine within the context of a balanced diet of appropriate total energy provision.

Another word for those naturally occurring sugars is "intrinsic". We're talking about the fructose in fruits and vegetables, the lactose in dairy products, and so on. Various unsavory characters out there are making a lot of money via fear mongering over carbs in general, sugars in particular, and in some cases fructose specifically. Rarely are they actually people with a medical or dietetic background. More often they are simply marketers (at best) or outright charlatans and con men (and women).

Again, to reiterate: intrinsic sugars within an appropriate total intake are of no concern whatsoever. Added sugars in less nutritious & more indulgent choices should be limited. No country as best I am aware has healthy eating guidelines to the contrary, all recommend that added sugars be limited. The suggestion you'll often read from Low Carb High Fat trolls enthusiasts that the official guidelines support massive consumption of sugars is ridiculous and disingenuous. In other words they are lying through their teeth.

However it is possible that people might be unaware of the amount of sugar in some choices of foods and condiments that wouldn't seem obvious. This may be a valid concern which That Sugar Film addresses, however, none of the other claims it makes about sugar should be seen as even vaguely accurate.

A few quick side notes:

1. It seems apparent that anti-sugar quackitivists also similarly fear monger over artificial sweeteners and in some cases other plant based sweeteners such as stevia. There is ample and on going research to support the safety of non-nutritive sweeteners such as aspartame. 
2. Sugar is not addictive "like drugs are addictive".
3. Be aware of how much "still sugar, but not regular cane sugar" is often in expensive "sugar free" products. In some cases more so than in the conventional brands they would claim to be "healthier" than.

Reviews of That Sugar Film:

Do Not Believe The Shoddy Science in That Stupid Sugar Film.

This one might be my favourite.

Gameau’s panel of experts includes a supergroup of charlatans and cranks, [such as] the floppy-haired nutrition guru David Wolfe. A self-described “Health, Eco, Nutrition and Natural Beauty Expert” and “one of the world’s top authorities” on “chocolate and organic superfoods,” Wolfe spends his days touting the spiritual and health benefits of such things as deer antler spray (a “levitational,” “androgenic force”), baby-reflexology, and “earthing” (in which people plug themselves into the ground wire of an electrical outlet so as to “naturally discharge electrical stress from our bodies”).
Seen outside the context of That Sugar Film, the man appears to be a lunatic.

Sugar, sugar everywhere, but not a grain to be seen.

Thanks to Prof. Tim Crowe at Thinking Nutrition.

Damon claimed that his weight gain happened despite eating the same amount of food than before his high-sugar experiment. Yet only a very superficial attempt was made to estimate how much food was being eaten over the 60 days, making such a claim unreliable at best.

So, is there something insidious about sugar calories that can lead to greater weight gain? Not really. Sugar, including fructose, is not inherently fattening relative to other foods. Its effect on body weight is from the extra energy it adds to our diets, that’s all.

Those Sugar Films, How Do They Stack Up?

A great write up of this and a couple of other films about sugar, from The Nutrition Press.

Taking a closer look at the show’s talent, we find a lack of relevant expertise. The show’s chief sugar adviser, David Gillespe, is a former lawyer and founder of a software company. He has no scientific or nutrition qualifications and his book Sweet Poison, which supposedly reveals the true health effects of dietary fructose, has no scientific basis. It is certainly true that Australians are consuming too much sugar but Gillespe’s claim of 40 teaspoons as the average Australian’s daily sugar intake is an over-estimate by about 10 teaspoons. He also says that the average family of four consumes the equivalent of 6 x 1kg bags of sugar each week. Doing the math, based on his own figure of 40 teaspoons, a family of four would consume 4.48kg. Based on 30 teaspoons, this figure is 3.36kg.

D-discussion on ‘That Sugar Film’: Diabetes Counseling Online.

Some of these processed foods that are referred to in the film are baked beans, containing the equiv of 1 tsp of sugar per serve. Using baked beans as an example, the beans themselves are highly nutritious and 1 tsp sugar is in the sauce, which also contains nutrients such as lycopene that we need to obtain from cooked tomatoes.  That 1 teaspoon of sugar is not enough to spike your BGLs and baked beans do have a low glycemic index, so they’re a good option for us when we need a meal in a hurry.

There are also other processed foods such as tinned and frozen vegetables, some breakfast cereals, some grainy breads and dairy products that as a dietitian I regularly encourage people to use.  If these products weren’t being recommended, then chances are that people might inadvertently choose something less nutritious in an effort to have a little less sugar. Learning to label read is so important here. Some of the healthier, lower GI breakfast cereals are really convenient options in our busy lives, as well as containing important nutrients that we need for wellbeing, despite containing some added sugars.

Food Watch Reviews That Sugar Film.

Damon consumes lots of liquids which have been shown to be easier to over-consume than whole foods e.g. apples vs apple juice. I’m guessing his intake DID exceed what he was eating before and these sweetened liquids were responsible for the fat gain in the abdominal region as well as the decline in liver function.

Who ever said flavoured milk or iced tea drinks are ‘healthy’? They may be healthier choices than sweetened soft drinks but they are not on any 'Must Eat Lists' or Pyramids.

 

That Sugar Film review: Powerful propaganda proves little.

What limits the film is that its central method of argument is unscientific by definition, despite the facts and figures provided by a slew of presumed experts. Simply put, Gameau's one-man experiment is not rigorous enough to prove anything at all, however striking his results seem.

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Masterpost: All detoxes are a scam.

I decided a "master post" is where I dump EVERY link I can find addressing a particular source of nonsense, quackery, pseudoscience or scammery. In this case, "detoxing".

Here it comes, hold on to your hats.

First though, you may well ask "if all these things are scams, how do they get away with selling them?" well you may be sorry that you asked. Here's a great video that explains it.

You want more links explaining why "detox" is junk science? You got it.

• Detox Diet Deliberations.
• Detoxes: An Undefined Scam.
• The ultimate detox: your kidneys.
• Quackwatch.org  detox overview
• The Crap That Is Colon Cleansing
• Elitefitnessmentoring: A bit of common sense shows us that this is total BS.
• Detox programs amount to a large quantity of excrement, both literally and figuratively.
• You Can't Detox Your Body. So How DO You Get Healthy?
• What the marketers of detox products have done is made the term “detox” meaningless – actually the term now is nothing but a red flag for snake oil.
• The idea that we need to follow a special diet to help our body eliminate toxins is not supported by medical science.
• There are multiple case reports and case series that describe the adverse effects of colonic cleansing. 
• Sciencebasedmedicine.org Fashionable Toxins
• Alternative medicine’s ideas of detoxification and cleansing have no basis in reality. 
• it might be gentler to think of it as a voluntary, self-administered tax on scientific illiteracy and decadence.
• Detox diets myths vs reality
• There’s no such thing as ‘detoxing’. In medical terms, it’s a nonsense. Diet and exercise is the only way to get healthy.

A few updates, as if we didn't know these products were bad enough already:

• Proceed with caution: The tea that’s making women pregnant.
• Unexpected Pregnancies Caused By Popular Tea Detox That Can Stop The Pill From Working
• Women having surprise pregnancies 'can be traced back to tea detox'
• Why Detox Diets and Cleanses Always Fail
• Fancy Juice Doesn’t Cleanse the Body of Toxins 
• Products that promise “detox” are a sham. Yes, all of them. 

And another video for good measure.

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