Scleroderma: Is Food the Cause?

An acquain­tance of mine has scle­ro­der­ma, and she asked me whether scle­ro­der­ma has any­thing to do with diet. The answer to that ques­tion seems to depend on whom you ask.

Peo­ple who haven’t both­ered to study the sci­en­tif­ic lit­er­a­ture on nutri­tion insist that food has noth­ing to do with scle­ro­der­ma. Such idiots deserve to be swat­ted on the snout with a rolled-up med­ical jour­nal, because they are spread­ing dan­ger­ous non­sense. On the oth­er hand, the sci­en­tists who have ded­i­cat­ed their sci­en­tif­ic careers to study­ing the rela­tion­ship between food and diet say that the autoim­mune dis­eases, includ­ing scle­ro­der­ma, are strong­ly relat­ed to diet.

The rules for avoid­ing autoim­mune dis­ease are sim­ple: don’t eat your rel­a­tives, don’t eat too much fat, and make sure you get plen­ty of vit­a­min D. If you get an autoim­mune dis­ease any­way, get test­ed for celi­ac dis­ease and ask a reg­is­tered dietit­ian to help you plan an exclu­sion diet to see if some­thing you are eat­ing is trig­ger­ing your prob­lem.

Like oth­er autoim­mune dis­eases, scle­ro­der­ma is com­mon in the same pop­u­la­tions that eat a lot of ani­mal-based foods, which means a lot of ani­mal pro­tein and a lot of fat. On the oth­er hand, autoim­mune dis­eases are rare in pop­u­la­tions that eat a low-fat, plant-based diet. Autoim­mune dis­eases are also less com­mon in sun­ny cli­mates, which sug­gests that vit­a­min D (the “sun­shine vit­a­min”) plays a role in pre­vent­ing them. A diet-relat­ed ill­ness called celi­ac dis­ease seems to increase the risk of oth­er autoim­mune dis­eases, prob­a­bly because it caus­es “leaky gut.”

Why do I say “don’t eat your rel­a­tives”? Why does eat­ing ani­mal pro­tein pose such a risk of autoim­mune dis­ease? It all has to do with a sim­ple fact about DNA. The more close­ly relat­ed two species are, the more alike their DNA is, and the more alike their pro­teins are. The more alike two pro­teins are, the more eas­i­ly they can be mis­tak­en for each oth­er by the immune sys­tem.

Let’s imag­ine that you eat some meat and some pota­toes. Ordi­nar­i­ly, the pro­teins from the meat and the pro­teins from the pota­toes would get bro­ken apart into indi­vid­ual amino acids in your diges­tive sys­tem, and from there the indi­vid­ual amino acids get absorbed into your blood­stream. But let’s imag­ine that you have a prob­lem with your intes­tine. It leaks a lit­tle, so some frag­ments of pro­tein from the meat and from the pota­toes make their way into your blood­stream before they are com­plete­ly bro­ken down. The immune sys­tem may mis­take these pro­teins for a for­eign invad­er and make anti­bod­ies against them. Unfor­tu­nate­ly, the pro­teins from the meat look a lot like your body’s own pro­teins, so the anti­bod­ies against them end up attack­ing some of your own tis­sue. The pro­teins from the pota­to have no “fam­i­ly resem­blance” to any­thing in your body, so any anti­bod­ies that you pro­duce against them will prob­a­bly not attack your own body. So don’t eat your rel­a­tives! Eat plants, instead. How­ev­er, you may have to be a lit­tle picky about which plants you eat.

In peo­ple with celi­ac dis­ease, a pro­tein from wheat (or from rye or bar­ley, both of which are close­ly relat­ed to wheat) trig­gers the immune sys­tem to attack the intes­tine. Celi­ac dis­ease can cause a wide range of prob­lems, rang­ing from mal­ab­sorp­tion to “leaky gut.” So you’d expect peo­ple with celi­ac dis­ease to be at par­tic­u­lar­ly high risk for an autoim­mune dis­ease like scle­ro­der­ma. As a mat­ter of fact, they are!

Fat in the diet can also be a prob­lem in autoim­mune dis­ease. Roy Swank was warn­ing peo­ple about this prob­lem this start­ing in the late 1940s, but he was large­ly ignored, even though he pub­lished his results the world’s most pres­ti­gious med­ical jour­nals. The role of a high-fat diet in caus­ing mul­ti­ple scle­ro­sis has recent­ly been “dis­cov­ered” again. Unfor­tu­nate­ly, no one can make a for­tune from this dis­cov­ery, so I’m afraid that it will fall back through the “mem­o­ry hole” yet again.

If you want to put out a fire, the first thing to do is to stop pour­ing gaso­line on it. Like­wise, when you get a diag­no­sis of a dis­ease that is known to be relat­ed to diet, stop eat­ing the foods that are known to pro­voke that dis­ease! In gen­er­al, a low-fat, plant-based diet has been asso­ci­at­ed with a low risk of autoim­mune dis­ease. How­ev­er, a few peo­ple may have trou­ble with wheat or some oth­er plant-based food. Con­se­quent­ly, they should con­sult a reg­is­tered dietit­ian for advice about an exclu­sion diet. Peo­ple with autoim­mune dis­ease should also ask their doc­tor, physi­cian assis­tant, or nurse prac­ti­tion­er to mon­i­tor their vit­a­min D lev­els and test them for celi­ac dis­ease.

High-Fat Diet Causes Alzheimer’s Disease

Even Late in Life, a Low-Fat Diet Helps

The more fat you eat, the more like­ly you are to lose your mar­bles in your old age. This graph came from an arti­cle that explains why it’s rea­son­able to con­clude that the fat in the diet is the cul­prit. It also explains that even late in life, a change to a bet­ter diet is ben­e­fi­cial.

The arti­cle men­tions that in Europe and North Amer­i­ca, high­er fish con­sump­tion seemed to pro­vide some reduc­tion in risk. That may be because the fish were sim­ply replac­ing foods that were even more dan­ger­ous. It doesn’t mean that a health-opti­miz­ing diet for a human being would include fish.

Humans and Gorillas Can Get Gout, But We Can Both Get By With Very Little Salt!

9212407896_d19f978822_gout
Gouty arthri­tis results from the buildup of crys­tals of uric acid in the joints.

Peo­ple who eat a lot of meat are at risk for gout—one of the most painful con­di­tions known to med­ical sci­ence. Gout results when crys­tals of a uric acid salt build up in the joints. These crys­tals can also build up in the uri­nary sys­tem, pro­duc­ing kid­ney stones—another of the most painful con­di­tions known to med­ical sci­ence. A recent the­o­ry sug­gests that our high risk for gout is a side effect of an adap­ta­tion that enabled human beings, goril­las, and the oth­er great apes to sur­vive a short­age of sodi­um.

Although eat­ing meat and seafood caus­es gout in peo­ple, it doesn’t cause gout in a nat­ur­al car­ni­vore like a cat. That’s because cats, like most mam­mals, pro­duce an enzyme called uri­c­ase, which breaks uric acid down into some­thing that dis­solves eas­i­ly in water and pass­es right out through the kid­neys. Human beings and the great apes are prac­ti­cal­ly the only mam­mals that can’t make uri­c­ase. This fact sug­gests that peo­ple, like goril­las, should prob­a­bly be eat­ing a high­ly plant-based diet.

In the wild, apes are free from gout because their plant-based diet is low in purines, which the body con­verts to uric acid. Fruit and veg­eta­bles are also mild­ly alka­lin­iz­ing, and the mild meta­bol­ic alka­lo­sis enables the blood to keep more uric acid dis­solved. So the great apes can live gout-free even though they can’t make uri­c­ase. Sim­i­lar­ly, human beings can avoid gout sim­ply by eat­ing a plant-based diet with a heavy empha­sis on fruit and veg­eta­bles.

It’s sur­pris­ing that human beings and the great apes can’t make uri­c­ase. We’re prac­ti­cal­ly the only mam­mals that don’t. The gene for uri­c­ase has sur­vived almost unchanged through hun­dreds of mil­lions of years of evo­lu­tion. That’s gen­er­al­ly a sign that the gene does some­thing impor­tant. Yet the lack of uri­c­ase might actu­al­ly be an advan­tage for wild apes. The extra uric acid in their blood might enable them to sur­vive on a diet that would oth­er­wise be dan­ger­ous­ly low in sodi­um.

As we’ve seen, goril­las eat a very low-sodi­um diet. Meat-eaters don’t run a risk of sodi­um defi­cien­cy, because meat and oth­er ani­mal-based foods are high in sodi­um.

Gout Hurts!

Gout is one of the most painful con­di­tions known to med­ical sci­ence. As you can see in this 1799 car­toon by James Gill­ray, a gout suf­fer­er, gout tends to strike the big toe. Back then, gout was a dis­ease of the rich, who could afford to eat lots of meat and drink lots of booze.

Another cartoon by gout sufferer James Gillray.
Anoth­er car­toon by gout suf­fer­er James Gill­ray.

Gout results from the buildup of crys­tals of uric acid in the joints. Some­times, this buildup can be very severe. If you want to see how bad it can get, click here.

The good news is that gout can be pre­vent­ed and treat­ed by prop­er diet. Sci­en­tists have known for cen­turies that gout results from eat­ing too much meat. Gout is com­mon in the Unit­ed States but is vir­tu­al­ly unknown in soci­eties where peo­ple eat a starchy, plant-based diet. The best way to pre­vent and con­trol gout is to cor­rect the diet. One word of cau­tion: rapid weight loss, even from a switch to a healthy diet, can trig­ger an attack of gout, because of the sud­den release of uric acid result­ing from the loss of body fat.

In an upcom­ing post, I’ll explain why peo­ple get gout, why goril­las could but don’t get gout, and why real car­ni­vores like dogs and cats and real omni­vores like rats can’t get it.

If the Guest Is Too Tall for the Guest Bed, Cut Off His Feet!

Accord­ing to ancient Greek mythol­o­gy, there was once a man named Pro­crustes who was the world’s worst host. He had an inn by the side of a road, and he offered hos­pi­tal­i­ty to pass­ing strangers. Unfor­tu­nate­ly, if you were too short to fit his iron guest bed, he would stretch you to make you fit. If you were too tall, he’d chop your feet off. Obvi­ous­ly, a bet­ter solu­tion would be to find a bed that fits the guest.

When­ev­er I hear about some­one get­ting their stom­ach sta­pled, I think of Pro­crustes. Are peo­ple obese because their stom­ach is too large? I doubt it. Maybe the solu­tion to obe­si­ty isn’t to sur­gi­cal­ly reduce the size of the stom­ach, but to reduce the calo­rie den­si­ty of the food. If peo­ple ate as much as they want of low-fat, high-fiber, plant-based foods, they can con­trol their weight nat­u­ral­ly with­out count­ing calo­ries or feel­ing hun­gry. In oth­er words, they could go ape, go wild, and eat plants instead of sub­mit­ting to expen­sive and dan­ger­ous surgery. Here are a bunch of peo­ple who have done just that!

Where Do Gorillas Get Their Vitamin B12?

Termites: The Other, Other White Meat

Vit­a­min B12 is one of the two nutri­ents that are essen­tial for human beings but aren’t avail­able from a pure­ly plant-based diet. The oth­er is vit­a­min D, which isn’t tru­ly a vit­a­min but is a hor­mone that your body can make for itself if you get some bright sun­shine on your skin. Goril­las live in Africa, where there’s no short­age of sun­shine. The inter­est­ing ques­tion is where do they get their vit­a­min B12? Evi­dent­ly, they get it from the insects and oth­er creepy crawlies that they eat. Their favorites are termites—the oth­er, oth­er white meat.

As you can see, the goril­las just dis­man­tle the tree where the ter­mites are. That’s prob­a­bly why they don’t both­er using tools to fish for ter­mites, as chim­panzees do:

Except for vit­a­min D and vit­a­min B12, plants pro­vide all the essen­tial nutri­ents that peo­ple need. Plants con­tain min­er­als, such as cal­ci­um and iron, which they have absorbed from the soil. Plants con­tain all of the oth­er vit­a­mins and essen­tial amino acids, which they have made for their own pur­pos­es. Plants are also the orig­i­nal source of the essen­tial fat­ty acids. How­ev­er, plants don’t make vit­a­min B12, and nei­ther do ani­mals. All of the vit­a­min B12 in nature comes from bac­te­ria.

Some plant-eaters get their sup­ply of vit­a­min B12 from the bac­te­ria in their own diges­tive sys­tem, as long as they are eat­ing some­thing that con­tains the ele­ment cobalt. (Vit­a­min B12 con­tains cobalt). Cat­tle and sheep are par­tic­u­lar­ly good at get­ting vit­a­min B12 from their own gut bac­te­ria. They have a lot of bac­te­r­i­al fer­men­ta­tion going on in their stom­achs, so the vit­a­min B12 is made before the food pass­es through the part of the intes­tine where the vit­a­min B12 gets absorbed. Such ani­mals are called “foregut fer­menters.”

Oth­er species, includ­ing rab­bits and goril­las and human beings, are “hindgut fer­menters.” Their gut bac­te­ria make vit­a­min B12, but only after the food has passed through the part of the intes­tine where the vit­a­min B12 can get absorbed. Rab­bits solve this prob­lem by eat­ing some of their own drop­pings. Wild moun­tain goril­las some­times do the same thing, usu­al­ly dur­ing peri­ods of bad weath­er. Cap­tive goril­las do it a lot more often, pos­si­bly because they are bored.

On the oth­er hand, goril­las and human beings can eat foods that already con­tain ready-made vit­a­min B12. For goril­las, that means tasty, tasty ter­mites, which get vit­a­min B12 from their own gut bac­te­ria. Mod­ern human beings who don’t want to eat ter­mites, or any oth­er ani­mal prod­ucts, can get their vit­a­min B12 from a nice, clean, and very cheap sup­ple­ment. As long as their gas­troin­testi­nal sys­tem is healthy, peo­ple can even take their vit­a­min B12 by mouth. Vit­a­min B12 shots are use­ful for peo­ple who have trou­ble absorb­ing vit­a­min B12 from their food, because of gas­troin­testi­nal dis­ease.

Stupid Nutrition Quiz From LiveScience!

I just saw this “nutri­tion quiz” from Live­Science:

http://www.livescience.com/php/trivia/?quiz=nutritionquiz

Most of the ques­tions are mis­lead­ing, and some of the answers are down­right dan­ger­ous!

A “good” type of fat is …

  1. Hydro­genat­ed oil
  2. Monoun­sat­u­rat­ed and polyun­sat­u­rat­ed fat
  3. Trans fat and sat­u­rat­ed fat

Their answer: Monoun­sat­u­rat­ed and polyun­sat­u­rat­ed fat

My response: This is a mis­lead­ing ques­tion, and a dan­ger­ous answer. Hydro­genat­ed oil con­tains trans fat and sat­u­rat­ed fat, so the first and third answer are real­ly the same. The only one left is “monoun­sat­u­rat­ed and polyun­sat­u­rat­ed fat,” which means that there is no “cor­rect” answer to this ques­tion.

A rea­son­able ques­tion to ask is which kinds of fat­ty acids are essen­tial in the human diet. The answer is omega-6 fat­ty acids (such as linole­ic acid) and omega-3 fat­ty acids (such as alpha linolenic acid). Both of them are polyun­sat­u­rat­ed. How­ev­er, you only need a tiny amount of either one in the diet. The opti­mal lev­el of omega-6 fat­ty acid in the diet is prob­a­bly about 2% to 4% of total calo­ries. The opti­mal lev­el of omega-3 fat­ty acid in the diet is sim­i­lar.

All kinds of fat: monoun­sat­u­rat­ed, polyun­sat­u­rat­ed, sat­u­rat­ed, and trans, can be incor­po­rat­ed into the plaque inside your arter­ies. Rather than eat­ing sup­pos­ed­ly “good” fats, peo­ple need to strict­ly lim­it their fat intake and to eat lots of leafy green veg­eta­bles. Trag­i­cal­ly, the Amer­i­can Heart Asso­ci­a­tion is using some stu­pid car­toon char­ac­ters to encour­age peo­ple to eat monoun­sat­u­rat­ed and polyun­sat­u­rat­ed fat instead of sat­u­rat­ed and trans fats, when they should be telling peo­ple to lim­it their fat intake to less than 10% of total calo­ries, or until their total cho­les­terol lev­el drops below 150 mg/dL.

Some ben­e­fits of a veg­e­tar­i­an diet that includes dairy prod­ucts are …

  1. An ample sup­ply of vit­a­min B12
  2. A low­er intake of sat­u­rat­ed fats
  3. A reduced risk for chron­ic dis­ease such as heart dis­ease

Their answer: A reduced risk for chron­ic dis­ease such as heart dis­ease.

My response: This is anoth­er stu­pid, mis­lead­ing ques­tion. Do they mean what would be the advan­tage of adding dairy prod­ucts to an oth­er­wise pure­ly plant-based diet? Then “an ample sup­ply of vit­a­min B12” might be rea­son­able, but they con­sid­er that answer to be “wrong.” Vit­a­min B12 and vit­a­min D are the only essen­tial nutri­ents that aren’t avail­able from a pure­ly plant-based diet. Unfor­tu­nate­ly, adding dairy prod­ucts to an oth­er­wise pure­ly plant-based diet rais­es the risk of seri­ous dis­ease, includ­ing heart dis­ease. Even if you add non­fat dairy prod­ucts, that means that you are adding extra dairy pro­tein, which rais­es the risk of dis­eases rang­ing from type 1 dia­betes to var­i­ous can­cers. If you want to reduce your risk of chron­ic dis­ease, such as heart dis­ease, you remove all ani­mal prod­ucts from the diet and take a vit­a­min B12 sup­ple­ment.

Which vit­a­min can only be obtained from sun­light and sup­ple­ments?

  1. E
  2. K
  3. D

Their answer is D, which is cor­rect. Score one for them!

Nuts are …

  1. Fat­ten­ing no mat­ter what
  2. High-calo­rie but good for you in small dos­es
  3. Most­ly full of trans fats

Their answer is: High-calo­rie but good for you in small dos­es.

My response: How small of a dose? An ounce? Nuts are a con­cen­trat­ed source of many nutri­ents, but they are ter­rif­i­cal­ly high in fat. They are one of the fat­ti­est foods on the plan­et. The excep­tion is chest­nuts, which some peo­ple call “the grain that grows on trees.”

Low-car­bo­hy­drate diets can put you at risk for …

  1. Insuf­fi­cient nutri­ents
  2. Gain­ing weight
  3. Osteo­poro­sis

Their answer is: Insuf­fi­cient nutri­ents.

My response: The cor­rect answer is osteo­poro­sis! The calo­ries in our diet come in the form of car­bo­hy­drates, fats, pro­tein, and alco­hol. When peo­ple talk about “low-car­bo­hy­drate” diets, they gen­er­al­ly mean diets that are high in pro­tein, as well as fat. The pro­tein and fat typ­i­cal­ly come from ani­mal sources. Unfor­tu­nate­ly, the heavy dos­es of ani­mal pro­tein cause a mild form of meta­bol­ic aci­do­sis, which is a major con­trib­u­tor to osteo­poro­sis. That’s why osteo­poro­sis is so com­mon in soci­eties where peo­ple eat lots of dairy prod­ucts but rare among peo­ple who eat a main­ly plant-based diet. Fruits and veg­eta­bles are rich in min­er­als and thus have a net alka­lin­iz­ing effect.

Peas and beans are good plant sources of …

  1. Pro­tein
  2. Monoun­sat­u­rat­ed fat
  3. Cho­les­terol

Their answer is: Pro­tein

My response: Yes, peas and beans are rich in pro­tein, but vir­tu­al­ly all plant-based foods, except for some fruits, pro­vide more than enough pro­tein. Human pro­tein needs are actu­al­ly so mod­est that they are eas­i­ly met by vir­tu­al­ly any plant-based diet. It’s dif­fi­cult even to design a diet that would pro­vide enough calo­ries but not enough pro­tein. You’d have to eat noth­ing but apples or oth­er low-pro­tein fruit, but hard­ly any­one even thinks of doing that.

A pri­ma­ry risk fac­tor for dia­betes is …

  1. A high-sug­ar diet
  2. A low-car­bo­hy­drate diet
  3. A high-calo­rie diet

Their answer: A high-calo­rie diet.

My response: What kind of dia­betes? The dev­as­tat­ing type 1 dia­betes that results from pan­cre­at­ic fail­ure and has to be treat­ed with insulin replace­ment? The evi­dence is now over­whelm­ing that it results from an autoim­mune response trig­gered by a par­tic­u­lar pro­tein in cow’s milk. (No, I don’t think that goat’s milk is a safe alter­na­tive.) Or do they mean the most com­mon form of dia­betes, the milder form that occurs in fat peo­ple and goes away by itself if they eat bet­ter and exer­cise more? That has been linked to a high-fat diet, in par­tic­u­lar. High-fat diets pro­mote insulin resis­tance, and starchy diets pro­mote insulin sen­si­tiv­i­ty. Switch­ing to a starchy, high-fiber diet essen­tial­ly cures type 2 dia­betes, even if peo­ple eat until they are sat­is­fied and make no effort to lim­it their por­tions.

Eggs with brown eggshells are …

  1. Health­i­er than eggs with white eggshells
  2. Made by a dif­fer­ent breed of hens than eggs with white eggshells
  3. Bet­ter for bak­ing than eggs with white eggshells

Their answer is: Made by a dif­fer­ent breed of hens than eggs with white eggshells

My response: Eggs are chock-full of fat and cho­les­terol and have way too much pro­tein. You’d be bet­ter off with­out them in your diet. Besides, the con­di­tions under which the chick­ens are kept nowa­days are fright­ful­ly unsan­i­tary and inhu­mane.

The USDA rec­om­mends at least how many dai­ly ounces of whole-grain bread, rice and the like?

  1. 3
  2. 5
  3. 10

Their answer is: 3.

My response: Who cares what the USDA rec­om­mends? The pur­pose of the USDA is to pro­mote agri­cul­ture, not to pro­mote health. There­fore, the Nation­al Insti­tutes of Health, not the USDA, should be mak­ing the dietary rec­om­men­da­tions.

Skip­ping break­fast is a good way to …

  1. Gain weight
  2. Curb your appetite lat­er in the day
  3. Lose weight

Their answer is: Gain weight

My response: Peo­ple who eat fre­quent­ly can lose weight faster, but only if they’re eat­ing the right kinds of food. Why wor­ry about when peo­ple eat when the prob­lem is what they are eat­ing?

This Just In: Extra Calories Make People Gain Weight!

Eating More Fructose Than Nature Intended Is Also Probably a Bad Idea

I recent­ly read an arti­cle about a study that sup­pos­ed­ly found that high-fruc­tose corn syrup had a dif­fer­ent effect on the body than did “reg­u­lar sug­ar.” This made lit­tle sense, because high-fruc­tose corn syrup is only slight­ly high­er in fruc­tose than table sug­ar is. In fact, the study said exact­ly noth­ing about any dif­fer­ence between table sug­ar and high-fruc­tose corn syrup. On the oth­er hand, it did say that drink­ing a lot of sug­ar water can make you gain weight real­ly fast.

Dur­ing diges­tion, table sug­ar is rapid­ly bro­ken down to a 50:50 mix­ture of two sim­ple sug­ars: glu­cose and fruc­tose. High-fruc­tose corn syrup is a 45:55 mix­ture of glu­cose and fruc­tose. Not much dif­fer­ence. How­ev­er, the study wasn’t a com­par­i­son of high-fruc­tose corn syrup ver­sus what an ordi­nary per­son would think of as “reg­u­lar sug­ar,” it com­pared huge dos­es of pure fruc­tose to huge dos­es of pure glucose—a major dif­fer­ence.

In real­i­ty, the study showed three things. First, peo­ple can gain weight real­ly fast if they drink a huge amount of watery syrup, which pro­vides a lot of calo­ries while doing very lit­tle to sat­is­fy the appetite. Sec­ond, a calo­rie is a calo­rie. Peo­ple gain weight just as effec­tive­ly if they get extra calo­ries from fruc­tose or glu­cose. Third, fruc­tose has dif­fer­ent effects on the body’s metab­o­lism than glu­cose has, but we already knew that. None of these results were sur­pris­ing, so none of the find­ings of this study were actu­al­ly news­wor­thy to the gen­er­al pub­lic. The jour­nal­ists who wrote about this sto­ry made it sound news­wor­thy by mis­in­ter­pret­ing it.

Thanks to the mag­ic of the Inter­net and the Nation­al Library of Med­i­cine, I was able to find the actu­al arti­cle for myself. The sub­jects in the study first spent two weeks in a clin­i­cal research cen­ter, eat­ing “an ener­gy-bal­anced, high–complex car­bo­hy­drate (55%) diet.” Of course, 55% of calo­ries from com­plex car­bo­hy­drates isn’t “high” in com­plex car­bo­hy­drates by my stan­dards, but so what?

After spend­ing two weeks eat­ing the con­trolled diet, the sub­jects were sent home for an eight-week out­pa­tient study, in which they were allowed to eat what­ev­er they want­ed, as long as they drank enough of a sweet­ened bev­er­age to give them 25% of their calo­rie require­ments. Some of the sub­jects were giv­en a bev­er­age sweet­ened with pure fruc­tose (not high-fruc­tose corn syrup), the oth­ers were giv­en a bev­er­age sweet­ened with glu­cose.

As a result of guz­zling all that sug­ar water, the peo­ple in both groups took in more calo­ries than they need­ed. In fact, peo­ple in both groups took in rough­ly the same num­ber of extra calo­ries and gained rough­ly the same amount of extra weight as a result. That wasn’t sur­pris­ing, although it was inter­est­ing that the extra fat tend­ed to get deposit­ed in dif­fer­ent places, depend­ing on which kind of sug­ar was con­sumed. Nor was it sur­pris­ing that the fruc­tose bev­er­ages caused spikes in the amount of fat (triglyc­erides) in the blood after meals. Sci­en­tists already knew that fruc­tose does that. They’ve also known for decades that high lev­els of fat in the blood con­tribute to insulin resis­tance, which in fact occurred among the peo­ple who drank all that extra fruc­tose.

Although the study does sug­gest that eat­ing too much fruc­tose can be bad for you, it didn’t say any­thing about whether high-fruc­tose corn syrup was sig­nif­i­cant­ly worse than table sug­ar. In fact, a com­men­tary that accom­pa­nied the arti­cle said, “It is not known whether the adverse effects of sucrose and HFCS con­sump­tion are ‘dilut­ed’ by their low­er fruc­tose con­tent rel­a­tive to pure fruc­tose.” The com­men­tary does make it clear that if you are eat­ing too much fruc­tose, you prob­a­bly aren’t get­ting it from eat­ing too much fruit. “One would have to eat vast quan­ti­ties of fruits every day in order to ingest meta­bol­i­cal­ly adverse amounts of dietary fruc­tose.”

The take-home mes­sage for con­sumers wasn’t clear from the news accounts, but it’s very sim­ple. It’s hard to over­dose on fruc­tose from eat­ing fruit, but drink­ing syrup-water isn’t good for you.