AMA Delegates Consider "Fat Tax" on Coke and Pepsi

Delegates to the American Medical Association will vote on a proposal to impose a tax on soft drinks containing high fructose corn syrup (Thoreau take notice). The physician lobby will also consider a recommendation that the amount of salt in fast-food hamburgers and fries be cut in half as well. (Not a problem for me since I will just pick up extra salt packages from the condiments counter to make up for the difference.)

According to the Daily Mail:

Doctors will this week declare war on America's soft drinks industry by calling for a 'fat tax' to combat the nation's obesity epidemic.

Delegates at the powerful American Medical Association's annual conference will demand a levy on the sweeteners put in sugary drinks to pay for a massive public health education campaign…

Delegates at its Chicago conference are gunning in particular for high fructose corn syrup, the sweetener which is added to everything from ketchup to cola.

One American politician labelled it the 'crack of sweeteners' because it is so widespread.

Whole article here.

Comments

[thoreau]

Why should I take notice? Corn syrup isn't my pet issue, it's just my favorite joke. There's a big difference.

Corn syrup, incidentally, is on the supply list for the July 1 H&R gathering in DC.

[jf]

Delegates at the powerful American Medical Association's annual conference will demand a levy on the sweeteners put in sugary drinks to pay for a massive public health education campaign...

Hey, it worked on cigarettes.

[Captain Holly]

One American politician labelled it the 'crack of sweeteners' because it is so widespread.

So, is the DEA going to cover Iowa with Paraquat now?

[David]

Delegates at the powerful American Medical Association's annual conference will demand a levy on the sweeteners put in sugary drinks to pay for a massive public health education campaign...

I wonder who'd benefit financially from such a campaign? 😛

[Dave W.]

The AMA has taxing authority.

Sounds like a very stupid proposal.

HFCS issues (if any) need to be settled by limbless litigants rather than by porkbarrel politicos.

I wonder what the response would be if the AMA had instead suggested getting rid of any and all gov't programs that tend to reduce the price of HFCS relative to other sweetner choices.

I would back that.

[Dave W.]

should be:

The AMA has taxing authority?!?!?!?

[Adam]

Dave W., it's the little-known Article I(B) of the Constitution.

It is secret and unwritten.

[Dave W.]

Besides obesity is the primarily responsibility of the obese person, unlike some other adverse physical conditions. Obesity comes on too slowly and obviously for the obese person to foist the blame on anybody else.

[Jennifer]

How about ending agricultural subsidies on corn? Nah.

[fyodor]

I wonder what the response would be if the AMA had instead suggested getting rid of any and all gov't programs that tend to reduce the price of HFCS relative to other sweetner choices.

Libertarians generally like getting rid of goverment programs, but if select programs were dropped with the specific and preordained goal of effecting a relative rise in HFCS price, many of us would have problems with that. Those many of us would prefer dropping government programs that interfere with or prejudice consumer choice across the board. Then, if the net result is a relative price increase in HFCS, why then fine and shpandy.

[Dave W.]

but if select programs were dropped with the specific and preordained goal of effecting a relative rise in HFCS price

Interesting objection. Noted.

[David]

How about ending agricultural subsidies on corn? Nah.

The AMA can't make any money by ending corn subsidies. Of course, if they really cared about this latest "epidemic", they'd just start the public health campaign without needing to tax those to be re-educated.

[D.A. Ridgely]

(Not a problem for me since I will just pick up extra salt packages from the condiments counter to make up for the difference.)

Sure, until under Phase Two salt becomes a controlled substance!

[Dave W.]

AMA should do its freaking job and determine the strength of correlations between various sweetners and diabetes.

So, you know, like, the consumers can choose their sweetner choices in light of accurate medical info.

AMA sounds as bad as the ABA.

[Dave W.]

AMA should do its freaking job and determine the strength of correlations between various sweetners and diabetes.

So, you know, like, the consumers can choose their sweetner choices in light of accurate medical info.

AMA sounds as bad as the ABA.

[the other Mark]

Can you catch fatness from standing too close to some waddling human marshmallow? No? Then it's not an epidemic.

[smacky]

Can you catch fatness from standing too close to some waddling human marshmallow? No? Then it's not an epidemic.

"Yes, hi, Boss, it's me. I can't come in to work to-day. I caught teh fat. Yeah. I think from some shirtless guy at the Indians game."

[Dave W.]

AMA should also do its freaking job and determine whether HFCS has secondary physiological effects that cause obesity (eg, effects on body's hunger mechanism, subtle metabolical differences).

However this means a lot more looking at human bodies and a lot less interjecting itself into the taxtaking process.

[Ayatollah Usoe]

Can you catch fatness? Here's an interesting news article on catching obesity.
http://www.theonion.com/content/node/30630/print/

[Dave W.]

Can you catch fatness from standing too close to some waddling human marshmallow? No? Then it's not an epidemic.

no, you catch it from ingredients in your food, just like Mad Cow or salmonella.

Obesity may be an epidemic, but because it is transmitted so slowly and visibly, it is an "epidemic" that needs to be fought with private responsibility rather than gov't resources.

[thoreau]

Dave, this thread is scaring me. I'm agreeing with you. Quick, call for a lawsuit so I can disagree with you!

🙂

[Warren]

Finally, after two hundred years, an invocation of the obscure Article 1, Section B clause:
The power to establish the proper diet to be eaten by the people, and to lay tax upon food stuffs for the purpose chastising the people for their own good, shall reside in a professional organization instituted by the healers, barbers and midwifes of the several states.

[MP]

Dave,

If the average person ate 1500 calories a day, exclusively composed of HFCS, they wouldn't gain an ounce. They may become diabetic and have other health related issues dealing with lack of protein and dietary fat intake, but they won't get fat.

[David]

"Yes, hi, Boss, it's me. I can't come in to work to-day. I caught teh fat. Yeah. I think from some shirtless guy at the Indians game."

That's plausible enough. Looking at the crowd at Yankees games, I think "teh fat" might be contagious.

[thoreau]

Having carefully studied thermodynamics, I agree with MP. There would be no weight gain if a person consumed fewer calories than he burned, no matter where those calories came from.

There could be lots of other problems, depending on what is eaten and what isn't eaten, but there would be no weight gain.

[Dave W.]

If the average person ate 1500 calories a day, exclusively composed of HFCS, they wouldn't gain an ounce. They may become diabetic and have other health related issues dealing with lack of protein and dietary fat intake, but they won't get fat.

That is a wonderful idea for an AMA study. Have they done it? Got a link?

Here's another good study idea:

put one group on a 1500 cal HFCS study; and another on a 1500 cal sucrose diet and see which group has a higher percentage of participants stick out the study to the end.

So many legit things for the AMA to do and all they can do in reality is try to legitimate a tax increase. Disgusting!

[thoreau]

Actually, Dave, that is a horrible idea for a study. The duration of the study would probably be too short to determine if chronic problems like diabetes ensued, but the deprivation of other vital nutrients aside from carbs would almost certainly cause a variety of health problems in the short term and therefore cause huge ethical issues.

[fyodor]

Dave W,

You may also notes calls for ending corn subsidies. While I understand and sympathize with your criticism of the AMA for getting involved in politics at all, I don't think I would actually mind if they merely observed that corn subsidies may be playing a role in facilitating eating habits that lead to obesity.

Domestic sugar protectionism is the other big HFCS enabler that I think most here would have little problem with ending, again, for its own sake rather than to effect a particular outcome.

[the other Mark]

you catch it from ingredients in your food, just like Mad Cow or salmonella.

I have to take issue with this comparison. You can't control (not much, anyway) if your burger is full of mad cow nasties. But you can constrain yourself from eating three of them every day.

To the extent that it's an "epidemic", it's an epidemic of people making poor choices. And the way to combat it is for everyone to relentlessly mock fat people.

[Dave W.]

Having carefully studied thermodynamics, I agree with MP. There would be no weight gain if a person consumed fewer calories than he burned, no matter where those calories came from.

I am just a lowly mechanical engineer, but I think this thermodynamic analysis fails to address some obvious laws-of-thermodynamics issues:

one possibility is that one sweetner will cause the body to expell calories by changing the nature or balance of the waste substances the body expels.

Another possibility is that one sweetner will cause the body to give off more heat than another (presumably because of a difference in the exothermic reactions or kinetic motions taking polace within the body.

another possibility is that different sweetners cause slight, but thermodynamically significant, differences in body temperature.

These are just a couple thermodynamic possibilities. There is also the idea that HFCS plays with the hunger mechanism in a bad way and therefore requires a lot more willpower than what might have been required in the times of our mothers and fathers.

[the other Mark]

Actually, I'm in favor of a law banning fat chicks from bars. Won't somebody think of the drunk horny dudes with poor judgement and worse impulse control?

[Dave W.]

T:

me and mp's suggested studies are meant to be more evocative and shorthand than a research grant would be.

The studies I was discussing with mp relate to relationship between HFCS and obesity because, as you can see from my previous response, I don't buy into the simple thermodymanic analysis.

The diabetes studies should be a separate thing and I probably consider them to be more important than the obesity studies because obesity can be countered by personal responsibility in a way that diabetes really can't.

[MP]

Dave,

Even if it were possible to "normalize" calories of different foods based on their varying effects on insulin levels and caloric absorbtion levels, thus showing that a calorie of HFCS was equal to 1.1 calories of Sucrose (numbers which I just made up), it still wouldn't account for the general population's tendancy to be heavy.

[thoreau]

Dave-

First, I agree, it is possible that one sweetener might be metabolized more efficiently than another, or absorbed from the digestive tract more efficiently than another. Still, I maintain that if the number of available calories consumed is less than the calories burned in physical activity then there is no way to gain weight.

I will also concede that impulse control may be more difficult with certain sweeteners and less difficult with others. However, people regularly manage to tame their cravings for alcohol, nicotine, and other known habit-forming substances. It would certainly be good to know if one sweetener is more habit-forming than another, but that wouldn't diminish the importance of personal responsibility.

As far as diabetes, I'm no expert, but a few years ago the doctors told my stepfather that he was "pre-diabetic", which apparently meant that if he didn't curtail his calorie intake he would develop diabetes soon. Well, he lost a lot of weight and remains healthy. Not every diabetic becomes diabetic due to food intake, but those who are at risk can certainly control themselves. I will grant that it would be good to know if it turned out that some foods carry greater risks than others, so that people at risk could eat accordingly.

[John]

A fat-tax on sodas would yield no revenue. There are zero grams of fat in soda.

And how about an "asshole tax" on meddling doctors?

[Dave W.]

I maintain that if the number of available calories consumed is less than the calories burned in physical activity then there is no way to gain weight.

Is this a practical possibility?

Does anybody do this (even top athletes)?

If anybody can maintain this kind of regimen, is it only top athletes (in other words does most weight loss we observe in real life depend in part (maybe large part) on the concept of expelled calories or body temp adjustments?)

If it is extremely difficult to maintain this kind of regimen, is this difficulty, at the margin of willpower, made tremendously more difficult by cornstarch derivatives? What I am trying to say is that doing a diet with a net calorie deficit may require a lot, lot, lot more willpower than a more modest diet that relies in part on thermodynamic artefacts and/or expulsion of calories in the form of chemical bonds.

I am not suggesting these things as assertions. unlike you, T., I am not a medical researcher. Maybe I should have been. I seem to have that curiosity and imagination that could be a boon in that job. On the other hand, I have a big mouth sometimes.

[Dave W.]

I maintain that if the number of available calories consumed is less than the calories burned in physical activity then there is no way to gain weight.

I think they woulda told me the same at the end of 2002 if I had gone in. Hope that Atkins didn't trash my kidneys too bad. the second 50 lbs don't come off as easy as the 1st.

[Dave W.]

Again, with correct quote:

a few years ago the doctors told my stepfather that he was "pre-diabetic", which apparently meant that if he didn't curtail his calorie intake he would develop diabetes soon.

I think they woulda told me the same at the end of 2002 if I had gone in. Hope that Atkins didn't trash my kidneys too bad. the second 50 lbs don't come off as easy as the 1st.

[MainstreamMan]

Shock and awe.
A group of citizens lobbying based on their views of an issue. We should have campaign reform to stop these people from spending their money on political speech ;~)

And jsut how does the AMA make money off of less fat people with less diabetes? Just asking since a profit motive was suggested.

(the tax is a dumb idea, btw).

[Dave W.]

The AMA and government have many interconnections. handing politicians a new tax (they wish!) would get them a lot of (inappropriate) quid pro quos. And we would never know what they are.

However, so there is some balance, check out the AMA being on good behavior:

"Another top priority of the AMA is to lobby for change to the federal tax codes to allow the current health insurance system (based on employment) to be purchased by individuals. Such changes could possibly allow millions of currently uninsured Americans to be able to afford insurance through a series of refundable tax credits based on income (ie: the lower your income, the greater your credit)."

From the wiki, err, wikipedia.

[MP]

A group of citizens lobbying based on their views of an issue. We should have campaign reform to stop these people from spending their money on political speech ;~)

No. We should fund an opposing lobbying group which tells the AMA they are full of stupid ideas and to STFU.

And jsut how does the AMA make money off of less fat people with less diabetes? Just asking since a profit motive was suggested.

They profit when Medicaid/Medicare starts considering obesity as a disease, and thus starts funnelling even more government money into the hands of the AMA's members.

[Captain Holly]

I maintain that if the number of available calories consumed is less than the calories burned in physical activity then there is no way to gain weight.

Is this a practical possibility?

Does anybody do this (even top athletes)?

Yeah, it's called "dieting". Millions of Americans successfully do it every year, just like they successfully quit smoking, lay off the booze, or give up coke (the real thing, not the Real Thing (tm)).

In fact, humans can show a remarkable amount of self-restraint if they are fully exposed to the consequences of their actions. Even if they have a weakness for a highly-addictive substance (which HFCS most certainly is not).

Inanimate objects -- including dietary supplements -- aren't evil. It's how they are used that makes them good or bad.

[Dave W.]

Yeah, it's called "dieting"

do most diets run at a net calorie deficit where the calories expended by consciously-controlled physical activities outstrip calories consumed.

You say that people's weightloss diets work that way, but how do you know that?

T. was trying to say that diets had to work that way based on simple thermodynamics, but I think I may have talked him out of some of his confidence on that point by suggesting some alternative hypotheses for marginal weightloss.

[David]

And just how does the AMA make money off of less fat people with less diabetes? Just asking since a profit motive was suggested.

MSM,

They won't make money off fewer people having diabetes, they'll make money off the "massive public health education campaign" which will be funded by the fat tax on soda.

[Jennifer]

If we tax corn syrup, we can use the tax money to fund the corn subsidies. It would make a lovely vicious circle. (Or rather, considering the consistency of most corn syrups I've seen, a viscous circle.)

[Rich Ard]

[groan]

[Dave W.]

that was kind of corny.

[Jennifer]

Y'all're just jealous that I'm punnier than you are.

[D.A. Ridgely]

Considerations of actual basil metabolism and the catalytic properties of various caloric substances aside, it really does boil down to using up as much or more energy than you consume. Otherwise, it gets stored as fat. So if you want to lose weight you either eat fewer calories, exercise more or some combination of the two. As to whether 1500 is the magic number, who knows? Someone engaged in regular strenuous manual labor could probably consume far more calories and still lose weight even while adding muscle tissue because adipose tissue would decrease resulting in a better body mass index.

[Captain Holly]

do most diets run at a net calorie deficit where the calories expended by consciously-controlled physical activities outstrip calories consumed.

If they're real diets, yes. If they're silly fad diets, no.

You don't have to run marathons to lose weight, either. All you have to do put down the donuts and get up off the couch.

Methinks this is the reason the AMA is up in arms about HFCS: It's easier to blame a Heartless Corporation for obesity than it is to blame fat lazy people themselves.

You say that people's weightloss diets work that way, but how do you know that?

Personal experience. I used to be a long-distance runner (5 and 10Ks only, no marathons) and every summer when I ramped up my training schedule I would drop from about 190 to a very trim and consistent 167. When I would stop running in the fall, it would bounce back up to around 190. It wasn't intentional, but the principle was the same:

Start exercising, and you'll lose weight.

Or there's the current example of one of my neighbors. A few months ago he topped the scales at over 300 pounds, so he has started walking. He's pretty reliable, too; I see him every morning while I'm making breakfast. Since February he's lost about 50 pounds.

Dave, I know it pains you to hear this, but there's nothing special about HFCS. You can drink HFCS soda pop all day and still lose weight if you reduce your overall calorie intake or increase your calorie consumption.

It's like eating a diet high in saturated fats; yes, they contain more calories per gram but if you use all those calories up (like a Marine recruit in boot camp; once again, personal experience) you won't gain a pound.

[MP]

As to whether 1500 is the magic number, who knows?

Disclaimer: 1500 was somewhat of an arbitrary figure and it in no way represents my specific recommendation for a target for any particular individual. Caloric requirements for weight maintenance vary wildly from person to person.

[thoreau]

Dave-

You didn't talk me out of anything. I agree that if some people metabolize some substances more efficiently than others then you need to be careful about how you measure calories consumed.

The bottom line remains: If you take more calories into your body than you burn then you will gain weight. If you burn more calories than you consume you will lose weight.

I don't know the extent to which various people and foods differ regarding efficiency of burning and whatnot, but if you normalize for those differences (however small or large they may be) then the thermodynamic analysis still holds true.

If you can prove otherwise then you don't have to bother arguing with me on this forum. You can just go directly to Stockholm and collect your Nobel Prizes (notice the plural).

[Dave W.]

If you take more calories into your body than you burn then you will gain weight.

Untrue. For example, if you take in 100 calories and burn 10 of them in pushing the remaining 90 calories out your anus then you gain no weight.

I could come up with other counterexamples, but this one is enuf to destroy your statement. C'mon T. ur supposed to be a scientist.

If you burn more calories than you consume you will lose weight.

Provisionally true, but you do not know if this is the process that real people use when they lose weight. It is also misleading because the burning of calories is only partially under our conscious control and observations. Example:

A person eats special food with x calories. Person then burns off x calories off with an excercise seesion. However, the special food containing the x calories slows the person's heartbeat such that the heart requires x fewer calories to operate than it otherwise would because of the composition of the special food. Paractical result: the person gains weight despite the excercise because of the heart slowing effect.

You should be enuf of a scientist to understand and cognize these types of possibilities. I can understand when the non-scientists don't get this, but I should be speaking your language here, T.

[Happy Jack]

The AMA would make better use of their time if they could explain the French Paradox.

[thoreau]

Dave-

Look, I'll be the first to grant that you might not absorb all of the calories through the digestive tract, and so you could swallow food containing X calories by take Y

[kelley]

According to author Michael Pollan, we are people of the corn.

[thoreau]

Edit to first paragraph:

...so you could swallow food containing X calories but only take Y

[thoreau]

Oh, I see the problem: I used a "less than" sign.

...so you could swallow food containing X calories but only take Y < X calories into your bloodstream.

[Dave W.]

and I'm sure that people who study metabolism are aware of it.

ORLY. Because I haven't heard about any shit collecting studies. I think that part may have been, errr, fudged in the existing studies, which may be part of the reason that science is as clueless as it is about obesity. I am glad Einstein didn't assume that Newton accounted for the finite speed of light in modelling the world. Cause scientists don't assume things, not in the context of shit nor God. That is why they are agnostics.

I'm sure that they've worked it into their measures of calorie intake and consumption.

Even if so, there is still the sweat we expel, the urine, the breath and the air exchange through the skin and exterior mucous membranes.

That doesn't change my statement that if the amount of calories burned during the day (be it through rest, exercise, whatever) is less than the amount of calories that enter your bloodstream then you WILL gain weight. If the reverse is true then you WILL lose weight.

That still doesn't address my contention that this statement may have little to do with how real, actual people in the real world really lose weight. If a person flaps her arms hard enuf she wil fly and that's a fact. However, when people fly that is not how they do it.

[MainstreamMan]

"They profit when Medicaid/Medicare starts considering obesity as a disease, and thus starts funnelling even more government money into the hands of the AMA's members."

I call bullshit on that one. Obesity (not just overweight) is already treated as a disease. The AMA, gasp, might actually have public health motivations. You may not agree with their methods, but their motivation is public health, more than likely.

http://www.cdc.gov/nccdphp/dnpa/obesity/

[Dave W.]

Even if so, there is still the sweat we expel, the urine, the breath and the air exchange through the skin and exterior mucous membranes.

as well as exchanges of thermal energy through the skin.

[thoreau]

Dave-

What is it that you're worried about now?

[Jennifer]

Untrue. For example, if you take in 100 calories and burn 10 of them in pushing the remaining 90 calories out your anus then you gain no weight.

Dave, are you trying to make some point about how calories don't matter in regards to weight, or are you simply disagreeing with Thoreau because you enjoy disagreeing with him? Find an example of someone who gained weight despite burning and/or shitting out more calories than he consumed, and then maybe you'll have a point.

[Jennifer]

By the way, the reason I manage to stay so skinny is because I shit pure gold, which as we all know is extremely heavy, thus leaving little weight behind to stick to my own.

[rhywun]

For example, if you take in 100 calories and burn 10 of them in pushing the remaining 90 calories out your anus then you gain no weight.

And with that image freshly burned in my mind, it's time to move on to another thread.

[Dave W.]

I am worried about scientists who lack the imagination to grasp the true physics of weight loss and weight gain as real people experience it in the modern world.

I am worried that this lack of imagination is causing unimaginative physicists to say: "eat like a monk and excercise like Lance Armstrong to lose weight," instead of coming up with a realistic plan.

I am worried that large businesses prefer unimaginative scientists to imaginative ones in order to avoid rocking the income streams.

[Dave W.]

The kind of monks that don't eat much I mean.

[thoreau]

I am worried that this lack of imagination is causing unimaginative physicists to say: "eat like a monk and excercise like Lance Armstrong to lose weight," instead of coming up with a realistic plan.

I never said that. I, for one, have lost 13 pounds in 6 months by moderating my diet a bit and walking during breaks, plus walking more in the evening. It isn't dramatic weight loss but it is significant and part of a lifestyle that's easy to adhere to. It is also perfectly consistent with the thermodynamic analysis.

Really, what is your point about thermodynamics: Are you aware of people who lose weight while eating more calories than the body burns? Are you aware of people who gain weight while consuming fewer calories than the body burns?

[MP]

I call bullshit on that one. Obesity (not just overweight) is already treated as a disease. The AMA, gasp, might actually have public health motivations.

What the CDC says and what Medicaid/Medicare pay for are two entirely separate things.

And I never claimed the AMA was driven by a profit motive in this case. I'm only supplying the evidence that you requested as to why some people may perceive this as being either partially or completely motivated by $$$.

[Jennifer]

I am worried about scientists who lack the imagination to grasp the true physics of weight loss and weight gain as real people experience it in the modern world.

Which scientists, exactly, lack the imagination to grasp the concept "if you eat a lot* and don't do any physical activity you're likely to get fat?" That's what real people experience in the modern world, and coincidentally that's what the scientists are saying.

*For Dave's benefit I should mention that if you eat nothing but unbuttered corn on the cob you will probably not get very fat, since you'll shit out a lot of undigested corn. However, an all-corn diet might put you at risk of certain vitamin deficiencies, plus you'll bankrupt yourself buying dental floss.

[Timothy]

I am worried about scientists who lack the imagination to grasp the true physics of weight loss and weight gain as real people experience it in the modern world.

Ummmm....physics is physics, yo.

Last I checked the universe was bound by immutable laws of physics. And I don't know what your difficulty in understanding something so simple as fewer calories in + more calories out = weight loss is.

You don't need imagination to understand glycolysis. And, if you need to know more about fructose metabolism try the "Entry of non-Glucose carbons into Glycolysis" link from that page. The way in which different sugars are metabolized took me, oh, fourty seconds to find and is extremely well understood.

[MP]

I am worried that this lack of imagination is causing unimaginative physicists to say: "eat like a monk and excercise like Lance Armstrong to lose weight," instead of coming up with a realistic plan.

Dave,

Your typical dietician and/or physical trainer will almost always suggest a very reasonable/moderate way to balance your diet and maintain a healthy weight. It is no different than the average dentist telling you "well, if you'd only brush and floss twice a day, you'd be fine". Unfortunately, many people are completely unwillng to put in the effort.

I'll offer up this book as one of hundreds of examples of material that present a realistic and easy to follow way to get or stay healthy and fit.

[thoreau]

Dave's inability to grasp the thermodynamics of weight loss is very reminiscent of the guy in the Onion article that Ayatollah Usoe linked to:

http://www.theonion.com/content/node/30630/print/

The scientist laments his inability to find a cure for obesity, and says that he's been working so much and eating so little that he's lost 20 pounds. But he's determined to press on until he finds a cure for obesity.

[MainstreamMan]

"What the CDC says and what Medicaid/Medicare pay for are two entirely separate things."

True, however...

In 2004 Medicare covered about 8,000 weight-loss surgeries, mostly for disable people under the age of 65. The procedure can cost between $15,000 to $20,000. (http://www.therubins.com/aging/medicare.htm)

Details on Medicare coverage rules for obesity.
http://www.cms.hhs.gov/transmittals/downloads/R23NCD.pdf

(3/5/06)- Medicare officials announced new regulations that would expand coverage for severely obese beneficiaries. To be eligible, a beneficiary must have tried other treatments without success, have at least one health condition related to obesity and a body mass index of 35 or more.

MP: the "bullshit" was not aimed at you but rather at the argument.

[Jennifer]

I love that article, Thoreau.

"we know that obesity tends to run in families," Kim said. "But we have yet to pinpoint exactly what it is that causes, say, the Smith family to splash about their backyard pool blissfully unaffected while, just over the fence, the Jones family languishes 30 percent overweight on their barbecue deck."

[carrick]

I am worried that this lack of imagination is causing unimaginative physicists to say: "eat like a monk and excercise like Lance Armstrong to lose weight," instead of coming up with a realistic plan.

And a realistic plan would be what? Ingesting manufactured chemicals to alter metabalism? Converting digestible sugars into non-digestibles sugars (converting food into non-food)?

You know Dave, you can go for extended streaks when you make sense, then you turn back into an asshole for reasons that are unfathomable.

Carrick

[Dave W.]

Really, what is your point about thermodynamics: Are you aware of people who lose weight while eating more calories than the body burns? Are you aware of people who gain weight while consuming fewer calories than the body burns?

I don't know and neither do you, even though you think you do.

You have been round this blog long enuf to hear me say my mantra of: "know and respect what you don't know." You are blowing on that. That wouldn't bother me if I was the popular one and u the freek, but it ain't that way and complacency is the majority position.

Sometimes I wish there was a board where people think like me instead of refusing to think at the margins, but there's not.

Happily the Harper's cover story is on Wal*Mart and antitrust. Most important thing I will read this year (halfway thru article). Finally someone who sees the world as I do. I hope Barry C. Lynn starts blogging whoever he is cause his article completely rawks. Recommended reading for all. A concise statement of how the world really works. July 2006 Harper's. On newstands now!

Among other things, the article talks about how Coke now decides what new product formulas to pursue. Hint: It ain't the FDA dictating the terms.

Final note (this response gets longer as the server keeps eating iterations): What untrue or misleading statement about thermodynamics have I made on this thread? My thermodynamics may be subject to factual uncertainties, but I stand behind any thermodynamic related things I have said here at least until someone can show me a thermodynamics mistake.

[thoreau]

Today's lesson: When you're popular, you have a duty to not trust the laws of thermodynamics.

Just because the body is known to burn fat reserves when food intake isn't adequate to calorie requirements, that doesn't mean that burning more calories than you consume will cause weight loss. It could all be a big coincidence.

Or something.

[Jennifer]

I don't know and neither do you

You don't know if people can gain weight by consuming more food energy than they use?

[Big Sugar]

I don't suppose these solons are aware that the City of Chicago ALREADY imposes a 12% tax (vs. 2% on other food items) not only on ALL carbonated soft drinks (regular and diet), but also on juice drinks containing less than 50% juice (even if these still provide significant amounts of vitamins). I don't remember the pretext used for justifying this tax, but I seriously doubt that the revenue generated by this tax is being used any more appropriately than the AMA's 1% would be. Nor do I think even a 12% tax has had any appreciable effect on consumption of these evil beverages.

[Phil Collins]

You don't know if people can gain weight by consuming more food energy than they use?

No, I argued that people don't know how much energy they use and don't know how much the composition of the food affects the energy they use.

Without knowing these things, your statement is pretty useless as a practical matter.

[Jennifer]

No, I argued that people don't know how much energy they use and don't know how much the composition of the food affects the energy they use.

Despite your deliberate and transparent attempts to confuse the issue, Dave, a person does not need to know exactly how many calories are burned each time they take a step to figure out a few broad dietary parameters, such as "If you eat a lot of high-calorie foods and the only exercise you get is pushing buttons on your remote, you'll get fat," or "if you eat a lot of high-calorie foods but also do a lot of heavy physical labor you'll probably be all right," or even "if you cut back on the amount you eat and simultaneously increase your physical activity you'll probably lose weight."

[bzial]

Dave,

While I applaud your desire for specificity in terms of understanding how the metabolic process works, I'm a bit confused on why you think Thoreau's thoughts somehow translate into "eating like a monk and exercising like Lance Armstrong."

I tend to pudge up every couple of years and lose weight through mild caloric exercise and very moderate exercise. It certainly isn't outrageous and/or impractical. Now I certainly know that caloric measurement is an extremely rough way to judge energy consumption and usage, but it does serve well as a rough guide.

Though I am curious, is there a preferred weight loss strategy that you have in mind or reflects better on what you feel the current state of known medical knowledge about weight loss?

As a practical matter, people do lose weight through caloric restriction and increasing energy consumption.

Yes, yes, I know correlation does not equal causation, but it isn't necessary for someone to have a detailed knowledge of hydrolysis of carbohyrdates to apply some general principles of this to weight loss. Just like the average body builder doesn't need a detailed knowledge of molecular biology as it applies to muscle tissue to build up their strength.

Though more to my original point. What are your thoughts on this issue (other than frowning at the use of rough calories in/calories out). I'm more of a lurker on this blog, so I have no stake in this particular argument. You have had some interesting insights in the past, so I'm curious more to where you think people should be focusing.

[Timothy]

I argued that people don't know how much energy they use and don't know how much the composition of the food affects the energy they use.

This is ridiculously easy to determine, but Jennifer is correct that you don't really need to know exactly.

[Dave W.]

Jennifer:

I don't deny that conscious excercise will tend to decrease your weight. I joined the local Y this week so I can excercise more. Ever since it got warm I have been walking several miles a night (cause I drive to work now).

But let's be realistic: excercise is hard and I have a limited time for it. If I could decrease my appetite by eating different foods (or the same foods with different ingredients), then I want that consumer info to be developed. If I could increase the amount of calories expelled with my feces or sweat or by increased thermal transfers through my skin, then I also want that consumer information to be developed.

The thing is, this info wouldn't just be helpful to me -- there are people out there with waists even bigger than 38". They need all the help they can get.

The rational thing would be for clinical researchers (like our T.!) to be developing this info. there should be an economic profit in developing this info. So why is this not happening?!?!?!?!?!?!?!?!?!

A big part of the answer is in the new Harper's article I recommended upthd.

The other part is complacency of individuals, most especially medical researchers.

I can't do much about the problems discussed in the Harper's, but I have been very happy to be slowly shaking T. out of his complacency the past year. Whether I am sending Ghosts after him, or just showing him what a sophisticated thermodynamical analysis looks like -- he is gonna get that pidgeon.

[Timothy]

So basically we should devote precious medical research dollars and time to this issue because most people are too lazy to go for a jog?

[carrick]

decrease my appetite by eating different foods

Google produced 384,000 hits. I'm sure at least of few of those would provide the information that you seek.

Carrick

[Dave W.]

So basically we should devote precious medical research dollars and time to this issue because most people are too lazy to go for a jog?

We should be finding any feasible ways so that people need to spend less time jogging, yes. The higher a person's billing rate, the greater the loss to the economy when they are out jogging for more extended periods.

I would think and hope the private sector is up to that challenge. My position is that they have not been doing a good job with that challenge. In view of the sucky attitudes about this prospect on this thd, perceptive readers will get sort of an emotional inkling about why I think this.

[Dave W.]

Google produced 384,000 hits. I'm sure at least of few of those would provide the information that you seek.

I don't even know whether sucrose affects my appetite differently than taste-equivalent amounts of HFCS, and I have been consuming those substances for years.

I don't think Google has the answer. I think the answer is locked in the results of a study that hasn't been done yet.

[Jennifer]

I don't even know whether sucrose affects my appetite differently than taste-equivalent amounts of HFCS, and I have been consuming those substances for years.

It doesn't matter. You don't need a multimillion-dollar scientific study to know whether or not your waistline has been getting bigger.

Here's a simple rule of thumb: if your waist is expanding, you've been eating too much. If it hasn't, you haven't.

We should be finding any feasible ways so that people need to spend less time jogging, yes. The higher a person's billing rate, the greater the loss to the economy when they are out jogging for more extended periods.

So now you're saying we need a weight-loss alternative to "eat less, exercise more" because if too many people do that the economy will suffer?

[thoreau]

I have been very happy to be slowly shaking T. out of his complacency the past year. Whether I am sending Ghosts after him, or just showing him what a sophisticated thermodynamical analysis looks like -- he is gonna get that pidgeon.

Ah, yes, it takes a patent lawyer to teach me thermodynamics.

And only a complacent person would be working on understanding blood vessel development while also developing techniques for imaging processes inside live cells. That's right, I do these things because I don't care about human health.

If I really cared then I would devote my efforts to measuring the efficiency with which calories from different foods are absorbed by the body. Never mind that my training and abilities aren't particularly suited to this task, and that I could do more good on other problems while somebody with a more appropriate skill set works on digestion experiments. The important thing is that I would be showing how much I care.

And that's what it's really all about, isn't it? There's this big evil world where people simply don't care. They tend to focus on things like "Well, if you eat less and exercise more then you'll lose weight." They simply don't care that Dave wants easier answers than that.

Forget about imaging processes inside cells. Forget about mechanisms of blood vessel growth. I should work on things that Dave cares about, to show that I also care!

[Rich Ard]

I would think and hope the private sector is up to that challenge. My position is that they have not been doing a good job with that challenge.

Then fund the damn study, Dave. 🙂 My guess is that if the studies you're looking for haven't been done because they're either:

a) silly, or
b) not been thought likely to produce useful results.

I'm pretty sure that it's not because

c) Coca-Cola has murdered every person who tried.

[Dave W.]

only a complacent person would be working on understanding blood vessel development

BTTT

The only difference between you and all the other complacent researchers is that I actually get to dialogue with u.

[thoreau]

The only difference between you and all the other complacent researchers is that I actually get to dialogue with u.

I feel so special!

[Dave W.]

So now you're saying we need a weight-loss alternative to "eat less, exercise more" because if too many people do that the economy will suffer?

I am saying that there is important research that lots and lots of people would want to pay for that isn't getting done because the people who control the research money don't give enuf of a damn about consumer preferences. The reason they don't give a damn about consumer prferences is explained fully and eloquently in the Harper's article I recommended you upthd.

While there is little we can about the larger market failure (unless a Feingold/Spitzer ticket materializes), we can at least show T. that his overly simplistic answers on obesity research woefully uncurious and underdeveloped, esp 4 a research scientist.

[Thomas Paine's Goiter]

Wait, so because Dave is a tub o lard, we have to hear the most bogus discourse on science and nutrition in known bloggery?

[thoreau]

While there is little we can about the larger market failure (unless a Feingold/Spitzer ticket materializes)

Yes, I'm sure their first priority would be to dig through fecal matter to see how much food was undigested.

we can at least show T. that his overly simplistic answers on obesity research woefully uncurious and underdeveloped, esp 4 a research scientist.

I know, it's so unscientific to invoke the accumulation of centuries of research in physics and medicine when an old question comes up, and devote my attention to open questions on the frontiers!

[Isaac Bartram]

Dave, this thread is scaring me. I'm agreeing with you.

Well, I knew it was too good to last. 🙂

[Timothy]

Man, it took me all of five seconds to find this study [PDF] about HFCS and feelings of fullness.

It sure is hard to find these things. That's from the Experimental Biology 2006 conference, the website for the whole thing can be found by truncating the URL for the .pdf linked above.

[Some South Jersey Guy]

I really can't believe that there are people who can't grasp that if the body uses more energy than it ingests it must lose weight.

Dammit, the energy has to come from somewhere.
There is a strong possibility that Dave W. is just pulling y'all's legs by acting like a dumbass.

We should be finding any feasible ways so that people need to spend less time jogging, yes. The higher a person's billing rate, the greater the loss to the economy when they are out jogging for more extended periods.

Quotes like this make me think his postings are mainly meant to mock libertarians. The second of the quoted sentences is so full of wrong-headed ideas that one would have to be particularly stupid to believe it.

[Dave W.]

I feel so special!

I just wish it was the AMA that I was dialoguing with on this. They are much more responsible for the lack of decently directed research than u r T.

I don't want the gov't to solve the obesity crisis. I want it solved in the private sector by people like the AMA and T.'s boss.

[Jennifer]

There is a strong possibility that Dave W. is just pulling y'all's legs by acting like a dumbass.

I sincerely hope so.

Incidentally, since I had a little free time and a few million dollars to spare, I just did a study on how various foods affect the appetite. Here is what I discovered:

If you eat a lot of something but still feel hungry, that means it does a poor job of satisfying your appetite. Conversely, if you only eat a little of something and then feel full, that means it does a good job of satisfying your appetite.

[Dave W.]

I don't even know whether sucrose affects my appetite differently than taste-equivalent amounts of HFCS, and I have been consuming those substances for years.

Man, it took me all of five seconds to find this study [PDF] about HFCS and feelings of fullness.

does the study compare fullness feelings resulting from taste equivalent amounts of sucrose and HFCS? Cause I don't really want to waste my time with a pdf that talks on for pages about fullness and HFCS without answering my question. That is usually what happens with these links.

[Timothy]

It's just the abstract. It's a paragraph, it was done by researchers at the University of Washington. Read the abstract, note that "research support" was provided by some folks in industry, maybe find the whole paper yourself, and perhaps your questions will be answered. God dammit man, try independent learning sometime. It's good for you.

[Timothy]

In short: YES, YES IT DOES.

[Dave W.]

If you eat a lot of something but still feel hungry, that means it does a poor job of satisfying your appetite. Conversely, if you only eat a little of something and then feel full, that means it does a good job of satisfying your appetite.

Oh yeah, I saw that in the AMA Journal. that was the one that concluded that if you eat like a Gitmo prisoner and excercise like Lance Armstrong then you lose weight.

Pretty useless for me because I aspire to be neither Lance Armstrong, nor a Gitmo prisoner. I want the diet where I can eat enough to avoid hunger pangs, eat things that taste good and still lose weight simply by walking 3 miles a night. Ain't found that study yet.

[Dave W.]

Timothy, don't give me a link if you don't know what the study says. that just wastes everybody's time.

[science]

thoreau,

"developing techniques for imaging processes inside live cells."

That sounds like a great focus. Now if we could get to neuronal processes we'd really be getting somewhere. I am so used to working with the aggregate behavior of 10's of thousands of cells.

Do you have links to any publications on this stuff?

[Timothy]

I read the abstract, it basically answers your questions, that's why I provided the link.

[Timothy]

And, Just in case you don't feel like taking all that time to read the link, here's the abstract:

Hunger and satiety profiles and energy intakes following the ingestion of soft drinks sweetened with sucrose or high fructose corn syrup (HFCS)

Martine Marie Perrigue, Pablo Monsivais, Susan L Adams, Adam Drewnowski. Epidemiology, University of Washington, 305 Raitt Hall, University of Washington, Box 353410, Seattle, WA, 98195-3410

Reports that liquid sugar energy is not detected by the body have suggested a physiological link between soft drink consumption and excess weight
gain. One question is whether HFCS-sweetened beverages have a different satiety profile from sucrose-sweetened ones. This study examined the
relative impact of 16 oz. beverage preloads on motivational ratings and energy intakes at a test meal, using a within-subject design. Participants were 19 men and 18 women, aged 20-30 y. The iso-energetic (214 kcal) beverages were cola sweetened with either sucrose, HFCS 55 (55% fructose, 45% glucose); HFCS 42 (42% fructose; 58% glucose), or aspartame, and 1% milk. A no beverage control was also employed. Breakfast was consumed at 8:00 am and the beverages were consumed at 10:10 am. Subjective ratings of hunger, fullness, desire to eat, thirst, and nausea were collected at 20 min intervals until lunch was served 140 min later. Caloric beverages suppressed hunger ratings and increased satiety ratings relative to the no beverage control. However, there were no significant differences in satiety profiles among the sucrose- and HFCS-sweetened beverages, diet cola, and 1% milk. Energy intakes at lunch were lower for all 4 caloric beverages (mean 955 kcal) as compared to the aspartame and the no beverage conditions (mean 1009 kcal), suggesting that a degree of energy compensation did occur following the ingestion of liquid energy. No differences in hunger, fullness, thirst, or desire to eat were detected between sugar-sweetened soft drinks, milk, or aspartame-sweetened soft drinks, all of which were significantly different than the no-beverage control. Research support provided by the American Beverage Institute and the Corn Refiners Association.

[Captain Holly]

It could all be a big coincidence.

Or something.

C'mon, Thoreau. Be brave and say it out loud!

IT'S A CONSPIRACY!!

I'm pretty sure that it's not because

c) Coca-Cola has murdered every person who tried.

So certain are you, Rich.

The Truth is out there...

[Happy Jack]

satisfying your appetite

Jennifer, yes, which is what some of the non-existent research on the French Paradox suggests.

[thoreau]

science-

A lot of work has been done on live cell imaging. I will be vain and only link to my own small contribution:

Here it is, open access.

[Dave W.]

Timothy,

It is a devcent link and somewhat helpful, so I shouldn't have given you such a hard time for doing me the favor of providing it. Seems kinda relevant.

Nevertheless:

I said "taste equivalent amounts." Although the abstaract is not clear, it appears that they used calorie equivalent amounts, instead of taste equivalent amounts as the basis of the comparison.

[science]

Dave W.

Try eating more small meals rather than fewer large meals (same total caloric intake). Keep up the 3 miles a night. Try to eat as many different food types as you can (different colors is a good clue to the right diversity). More raw foods, less fried, eat then exercise. Drink water instead of soda. Avoid cakes, cookies and other foods high in refined flour and sugar...

There are sooooo maaaannnyyy studies on this topic, if you can't find them, you just ain't looking.

[science]

Thoreau,

I was actually referring to your work, so you're not being vain... just accomodating.

FYI
I get "Bad Request (Invalid Hostname)" from your link.

[thoreau]

Try this one, and then click on the link to the .pdf:

http://www.opticsexpress.org/abstract.cfm?id=89304

[Jennifer]

Pretty useless for me because I aspire to be neither Lance Armstrong, nor a Gitmo prisoner. I want the diet where I can eat enough to avoid hunger pangs, eat things that taste good and still lose weight simply by walking 3 miles a night.

And apparently you're either too lazy or too intellectually lacking to do things like actually pay attention to what you eat and whether or not you feel full afterwards.

What you want is for somebody to figure out a way you can lose weight without having to expend what you consider to be too much effort. And until that happens, you'll blame scientific ignorance for the fact that you're not as skinny as you want to be.

[smacky]

I'm sure their first priority would be to dig through fecal matter to see how much food was undigested.

I'm having enough difficulty digging through fecal matter on this thread to see if there is a sensible discussion going on.

[science]

Thoreau,

I get the same error again.

Hmm... I'll try it with explorer.
Nope... same thing.

[thoreau]

OK, here's the reference:

Optics Express
volume 14, issue 8 (April 2006), pg. 3193-3203

[science]

Thanks.

[Jennifer]

I'm having enough difficulty digging through fecal matter on this thread to see if there is a sensible discussion going on.

Here's the Cliff's Notes cheat-sheet version of the thread:

According to Dave W., the idea that you can lose weight by eating less and/or exercising more is scientifically controversial, or would be if not for a secret scientific conspiracy to hide the fact that scientists don't really know if that's a way to lose weight. Maybe it's possible to gain weight even if you don't eat much. Hell, maybe you can gain weight even if you don't eat at all! Maybe the underfed victims of concentration camps actually died not of starvations, but because they gained so much weight that their bones collapsed under the load! Anyway, anybody who tries to mention things like "thermodynamics" to explain why it's impossible to gain weight if you burn off more energy than you consume is a dumbass who forgets to consider the relative weight of shit in his weight-loss calculations.

[Phil Collins]

What you want is for somebody to figure out a way you can lose weight without having to expend what you consider to be too much effort.

I don't want inefficiencies when making my food-pleasure versus health tradeoffs anymore than I want inefficiencies to suck dollars out of my personal money budget.

I look to science to help me root out these inefficiencies as they can be hard to detect and track, and because I think most other people are in the same boat I am.

I know you like to help T., but giving him reasons to be complacent about simplistic solutions is not help to somebody in his Baconian line of work.

[Jennifer]

Also, we need to spend millions of dollars on alternate weight-loss theories because if people eat less and exercise more our economy is fucked.

[Phil Collins]

should have been:

--food-pleasure vs. health vs. excercise-pain tradeoffs--

[Jennifer]

I don't want inefficiencies when making my food-pleasure versus health tradeoffs anymore than I want inefficiencies to suck dollars out of my personal money budget. I look to science to help me root out these inefficiencies as they can be hard to detect and track, and because I think most other people are in the same boat I am.

You're not looking for science to root out inefficiencies; you're looking for science to make your decisions for you so you don't have to take responsibility for your own oversized body.

If you honestly think there's a huge controversy behind "eating less and exercising more is the way to lose weight," you don't need scientific help in the field of weight loss; you need science to figure out how to raise your IQ by about 50 points.

[Jennifer]

I know you like to help T., but giving him reasons to be complacent about simplistic solutions is not help to somebody in his Baconian line of work.

Your fat ass is not Thoreau's responsibility.

[Jennifer]

I know you like to help T., but giving him reasons to be complacent about simplistic solutions is not help to somebody in his Baconian line of work.

Your fat ass is not Thoreau's responsibility.

[thoreau]

Well, I have heard of efforts to develop weight loss drugs. But if anybody ever experienced any sort of bad side effects I'm sure that Dave would want the manufacturer sued. Then again, if they refrained from bringing it to market until every single possible side effect was eliminated then Dave would probably be upset that they aren't solving his problems fast enough.

Basically, if somebody doesn't immediately deliver a way for Dave to get around the time-tested solution of eating less and exercising more then he will insist that it's because everybody's priorities are in the wrong place.

I don't want inefficiencies when making my food-pleasure versus health tradeoffs

I think he's referring to the undigested corn kernels in the fecal matter. He wants to know if he can subtract the calories in those undigested kernels from his calorie count so he can get a more accurate count of how many calories he's actually consuming.

And so we come full circle to the subject of corn.

[thoreau]

Well, I have heard of efforts to develop weight loss drugs. But if anybody ever experienced any sort of bad side effects I'm sure that Dave would want the manufacturer sued. Then again, if they refrained from bringing it to market until every single possible side effect was eliminated then Dave would probably be upset that they aren't solving his problems fast enough.

Basically, if somebody doesn't immediately deliver a way for Dave to get around the time-tested solution of eating less and exercising more then he will insist that it's because everybody's priorities are in the wrong place.

I don't want inefficiencies when making my food-pleasure versus health tradeoffs

I think he's referring to the undigested corn kernels in the fecal matter. He wants to know if he can subtract the calories in those undigested kernels from his calorie count so he can get a more accurate count of how many calories he's actually consuming.

And so we come full circle to the subject of corn.

[smacky]

Here's the Cliff's Notes cheat-sheet version of the thread:

Oh noes! Another teacher who could tell I read Cliff's Notes. How do they know...

Anyway, anybody who tries to mention things like "thermodynamics" to explain why it's impossible to gain weight if you burn off more energy than you consume is a dumbass who forgets to consider the relative weight of shit in his weight-loss calculations.

I suppose someone would really have to be full of shit for that to be a serious consideration. 🙂

[David]

Dave W,

Why not just try cocaine(powder or crack). If I remember correctly from my pawnbroker days, cokeheads have the weight just melt right off. Junkies seemed to thin out pretty quickly too, so you have two minimal effort options right there.

[Phil Collins]

we need to spend millions of dollars on alternate weight-loss theories

vigorous research and development should be the norm in a free market economy, especially one facing an obvious problem like obesity. so, yeah, spending millions of dollars (in the private sector of course) is exactly what should be happening. It is weird u think this should not be happening. You don't get on Bailey when he plays his R&D shell game with his wonderdrugs of the future, do you?

when complacency and product stagnation become the norm, then we have a problem. It basically means that the market needs to be made more competitive and the researchers need a vigorous shake by the ears, intellectually speaking.

[thoreau]

Why not just try cocaine(powder or crack).

Medical recommendations like this, even when offered tongue-in-cheek, let me know that this is in fact a libertarian forum! 🙂

[jbk]

I usually just lurk here, but I think DW is getting a bad rap.

The point about thermodynamics is almost irrelevant to weight loss. Yes, it is certainly happening, but in order to use thermodynamics to demonstrate weight loss, it assumes that eating habits do not change metabolism, and that increased exercise also does not. In fact, it is possible to maintain weight at extremely low caloric consumption. And these processes are not well understood. In fact, it is quite possible that the "excercise more" part works mostly by converting adipose tissue into muscle, which leads to a slightly higher body temperature, which leads to increase in caloric consumption.

My only point is, DW is right in that the real mechanisms that cause these things to happen are not very well understood.

[anon2]

Dave W.,

If you're overweight and you snore, or you feel tired throughout the day even after "a good night's sleep", you may want to have a sleep study done. You may have Obstructive Sleep Apnea. If so, a device known as a CPAP (Continuous Positive Air Pressure) machine might help you sleep better.

People who go on CPAP frequently report losing weight even though they aren't consciously trying to increase their activity level or decrease their portions. Of course the actual weight loss is indeed due to burning more calories than they consume, but in some people it happens naturally when they get better sleep.

Sleep apnea can be dangerous, since in addition to it making people constantly tired, it also decreases the amount of oxygen in the blood stream, sometimes to levels low enough to be damaging to internal organs. It's also a nasty downward spiral, since tired people exercise less, which leads to weight gain, which makes the apnea worse, which makes one even more tired still.

[Jennifer]

so, yeah, spending millions of dollars (in the private sector of course) is exactly what should be happening. It is weird u think this should not be happening.

Why should the private sector spend millions of dollars studying the fact that the way to lose weight is to eat less and exercise more? Or determining that a slice of chocolate cake is more likely than a raw apple to make you fat? On the next thread you'll be bitching about how nobody's spending money to determine whether the earth is round or flat.

[Timothy]

Dave W. / The Less Talented Ex-Genesis Drummer: You do know that corn syrup tastes sweeter than table sugar, right? So you'd need fewer units of HFCS to achieve the same sweetness level than you would units of sucrose. I am going to guess, then, that on a calorie-equivalent basis the HFCS drinks would taste sweeter than the sucrose ones, although I'd have to do a little digging into calories/gram of each to be certain (and as I'm unaware of any objective international unit of sweet taste, it'd still be tricky to back out).

[Peter Gabriel]

You suck, Collins!

[Phileleutherus Lipsiensis]

There is a lot of money spent on food research and in particular in the area of diet foods, etc.; in fact, you can even get a "food technology" degree at some universities.

[Dave W.]

we need to spend millions of dollars on alternate weight-loss theories

vigorous research and development should be the norm in a free market economy,
especially one facing an obvious problem like obesity. so, yeah, spending
millions of dollars (in the private sector of course) is exactly what should
be happening. It is weird u think this should not be happening. You don't
get on Bailey when he plays his R&D shell game with his wonderdrugs of the
future, do you?

when complacency and product stagnation become the norm, then we have a problem. It basically means that the market needs to be made more competitive
and the researchers need a vigorous shake by the ears, intellectually speaking.

Side note to the cocaine guy: what makes you think I haven't spent more than my share of nights staying up, hitting the ATM hard, digging out ashtrays with bits of discarded cardbord and sucking down rock after rock of pink, delicious, temporarily-satisfying crack. Cause I never said either way on that.
never said that.

[Dave W.]

as far as the feces go, T.'s example of undigested corn is one example. It is not the weight of the feces, but rather the energy required to form the chemical bonds in the constituent molecules of the feces.

as a more sophisticated example, lets say that there are dead white blood cells in the feces. You didn't get these from eating white blood cells. Rather, your body made them. The bonds in the white blood cells represent chemical energy. The more white blood cells in the fecal matter, the more calories you expel from your anus and don't have to jog away.

Now this is just a pedagogical example to show the concept. I doubt that HFCS slows down the white blood cell production/death/expulsion cycle, but if it did then that would be a form of weight gain. For all we know that form of weight gain might require marathons of jogging to counteract.

T. dismisses this kind of thing with a wave of his hand, but I think he needs to get his hands a bit more dirty.

[Phileleutherus Lipsiensis]

I wonder if T. wears a bunch of gold around his neck.

[Timothy]

PhilL: I damn well hope so.

[Some South Jersey Guy]

Dave is obviously having us on.

as a more sophisticated example, lets say that there are dead white blood cells in the feces. You didn't get these from eating white blood cells. Rather, your body made them. The bonds in the white blood cells represent chemical energy. The more white blood cells in the fecal matter, the more calories you expel from your anus and don't have to jog away.

The choice of white blood cells, is a dead giveaway. It's not as if those white blood cells are doing anything useful. If he had selected the obvious thing one wants to get rid of - fat - I might consider the possibility that he is simply a crank but the selection of a white blood cells convinces me that his tirades are some weird sort of joke.

[Dave W.]

I was just using an example based on one constituent I happened to remember was in feces. Chances are that white bloods cells represent a tiny, tiny fraction of the caloric energy that your body cycles.

Like I said "pedagogical example."

I am sure there are hundreds, if not thousands, of compounds in there for the properly motivated researcher to isolate and thermodynamically analyze. the ones with the high energy bonds will be the likely jogging-time-reducers.

although Jennifer is making this about my weight, really I am not that unhappy with my weight. I was using myself as a sort of humorous proxy for the many that really do have weight problems. a lot of people do you know. esp in nations that eat more HFCS than sucrose.

[Happy Jack]

At this point in time, I just want to see Cavanaugh use the phrase, "Thoreau, Dr. of Poopology".

[thoreau]

Happy Jack-

There is no such thing as "Poopology." I suggest you read Advanced Principles of Human Gastroenterology by Krapper, John, and Fecius before you embarrass yourself any further.

[Phileleutherus Lipsiensis]

Happy Jack,

I pity the fool! 🙂

[Chad]

It is pretty simple, folks. Calories in, calories out. All else is voodoo. Eat less, exercise more, or get fat. Take your pick.

[smacky]

There is no such thing as "Poopology."

Oh yes there is! Tell that to the poopsmith.

[Phil Collins]

Here is one of my hypothetical stories to help show the principles involved here:

I magine that they discover a new process for refining crude oil into gasoline. This process has some pros, cons and neutral aspects.

Let's start with the pro: the pro is that the new process costs the oil refining companies half as much to provide a gallon of gas. It costs half as much because they can use less valuable crude as the starting material, but also because the process of going from crude to finished gas is cheaper. So, like I said, te bottom line is that pretaxed gas costs half as much.

The oil refining companies sensibly meet in Dick Cheney's office (so that the meeting is secret) and decide to all switch to the new process at the same time. They decide to do this because they want to make sure that everybody switches and there is not a market inefficiency where some people sell gas the oldstyle gas and some sell newstyle gas. Substantially all the gas will be newstyle, and that is good because it will save consumers money.

The companies decide to pass 10% of the savings along to the consumers, to give them needed relief at the pump, and the oil refining companies will split the other 90% of the cost savings with the gas station operators. The 10% cost savings passed on to consumers mean that they save 5% at the pump after the taxes are added.

Okay, that is the happy part of the story, now let's hit the sad part. It turns out that this new process requires the vehicle operator to install a cheap filter in the car and to clean the filter weekly. The filters are so cheap that they will be given away free at the service stations and do not affect the costs perceptibly. The filters are also easy to install or uninstall in any vehicle. (assume it is some kind of magic filter you just stick in the filling hole in the vehicle) So far, not so bad. The bad part is that the filter must be cleaned by hand for one hour a week. The clening process is called "jogging" because it involves jostling and jogging the filter gently by hand. Only real human hands can do this operation, but it takes only an hour. You can even do it while watching tv or lissening to the Walkman. ony the actual hands of the vehicle's operator can do the process -- you can't delegate your jogging to a shiftless teenager or an illegal.

So the "sacrifice" for the gas cost savings is that vehicle operators now spend an extra hour a week doing this jogging process.

Finally the neutral aspect: none of this new refining / filling / jogging method has any net environmental impact. the only affects are the cost savings explained above and the time spent jogging by all the vehicle users.

Okay, any of you who have read this far, but especially Jennifer, how would you feel about this new deal on the gas? Happy or sad? Do you like your current deal on gas better or this new process? If you don't like the new process, what have you got against jogging? Its free and it is good for your hand muscles!

[Phil Collins]

addendum to previous hypothetical:

after the newstyle gas has been in use for 5 years it seems that 3X as many people are coming down with repetitive strees injuries in the hand.

However, it is difficult to tell whether any of this increase is coming from jogging the filters because people use their hands for other things besides jogging filters.

Should people with the repetitive stress injury have a tort claim against the oil companies? How could they ever prove that the filter jogging caused the injury, especially if the person uses a computer keyboard (computer keyboards are a known source of retetitive stress injuries after all!

[thoreau]

So, um, we need to figure out whether we can sue oil companies over carpal tunnel syndrome from cleaning a filter so we can determine whether undigested corn kernels in your shit have some impact on weight gain from eating too much corn syrup.

It all makes sense now!

[thoreau]

No more complacency for me! From now on, I will devote all of my scientific expertise to anything that Dave W. might worry about.

[Dave W.]

Sounds like u learned the correct lesson (as usual), T.

Just to explain, the jogging is akin to the extra jogging which the switch from sucrose to HFCS may (or may not) require. If you really engage with the first part of the hypothetical, then you may want to think about how citizens and their representatives could fight against the "jogging" without violating libertarian principles too badly. For those of you who think: "I would just start my own oil co. like John Galt would.": NO CREDIT; EXAM FAILED.

The carpal tunnel addendum to the hypothetical is akin to the diabetes part of the HFCS equation. I actually think there should be a tort claim for injured people on this part of the hypothetical and that hypothatical courts should figure out commonsense ways so that the oil companies would pay for the carpal tunnel they caused, but not for the proportion of the problem they didn't cause. Whether HFCS, in fact, causes diabetes a lot more than sucrose remains to be seen.

[David]

And here you thought your field would be optics. Selfish slacker. 🙂

[thoreau]

It's a cold, cruel world in which people might have to exercise to lose weight.

I will devote all of my scientific expertise to solving that problem once and for all.

[Jonas Salk]

No, t. You have fallen on your pamperback from you.

What we the public want from you the private medical research company is answers to the following questions (Pay Close Attention):

1. Do HFCS foods cause obesity more than sucrose sweetened foods on a per calorie basis?

2. Do HFCS foods cause obesity more than sucrose sweetened foods when people tend to consume the respective foods in accordance with their natural appetites for sweet foods?

3. Do HFCS foods cause diabetes more than sucrose sweetened foods on a per calorie basis?

4. Do HFCS foods cause diabetes more than sucrose sweetened foods when people tend to consume the respective foods in accordance with their natural appetites for sweet foods?

One pece of advice as you start your new, more-important work: wear gloves! You may want a mask, too.

[Dave W.]

"from you" should be --again--

[David]

Hey Dave,

If HFCS is a big concern for you, why not just buy and eat foods that are made only with natural cane sugar? Surely you can get those at Trader Joe's or Whole Foods or an organic store.

[Dave W.]

If HFCS is a big concern for you, why not just buy and eat foods that are made only with natural cane sugar? Surely you can get those at Trader Joe's or Whole Foods or an organic store.

why do you assume I haven't done these things. I have. I started a couple years ago. I just think that healthy capitalism should deliver these products without me doing a lot of extra driving around and waiting in extra lines.

Look at it this way:

I like obscure music. I don't mind so much visiting record store after record store looking for Captain Beefheart's "Lick My Decals Off" album or Prefab Sprout's "Swoon," or "The Mathematical Genius Of Pep Lester." I get it that not many people want these records and that a consumer will need to do a lot of extra legging to satify these kinds of oddball preferences.

When it comes to something like food, it is a far different story. I am not looking to for poached fricasse of owl or gila monster legs or cave grown rhubard. I want a freaking bottle of cola without cornstarch. So do lots of other people. Not only do we want these products, they may be the best enjoyment versus health tradeoff for lots of people (not the very fat or very skinny, but everybody in between). The fact that I have historically had problems getting these products tells me the market is out of whack. the fact that it is myth and lore (as opposed to hard knowledge) as to whether HFCS is inferior or not tells me the market is way, way out of whack.

I could sit here and say that I want sucrose off the market, but I am not saying that. All I am saying is that I want a sweetner that tastes as good and is no less healthy than what I enjoyed as a kid in 1975. I don't think it should be too much for the consuming market to expect that level of "progress" from the free market.

[Dave W.]

watching my older relatives have joints replaced and limbs surguried off because they have been too stupid to understand what is going with their soda these last 20 years is no picnic either. they watched their parents drink soda and assumed they could do the same. they are admirably brave about their operations. Why not? Their health insurance premiums are locked in politically.

[Dave W.]

The saddest was when my infant neice (child of a second cousin) was diagnosed diabetic last year. Maybe she would have been born diabetic in 1975. Given the way the stats look, tho, that is pretty cold comfort.

[thoreau]

I just think that healthy capitalism should deliver these products without me doing a lot of extra driving around and waiting in extra lines.

Yes, the inconvenience of Trader Joe's. Where the lines are shorter than Safeway. Right.

I want a freaking bottle of cola without cornstarch

I think you mean corn syrup.

The fact that it's so hard to get soda made with cane has nothing to do with market failures and everything to do with politics: Sugar tarriffs, corn subsidies, etc. Corn syrup is so much cheaper that products made with it trounce the competition in the not-so-free market that our legislators have created.

the fact that it is myth and lore (as opposed to hard knowledge) as to whether HFCS is inferior or not tells me the market is way, way out of whack.

Right. Because if there's something we don't know it must be market failure rather than the pace of scientific knowledge. See, I have no clue if HFCS is in fact more dangerous than sucrose, but there is good reason to suspect that any extra danger (if it's real) still pales in comparison with the risks of eating too much (of anything) and exercising too little. Small effects are always hard to measure, and that limits the pace of scientific progress sometimes. If one thing is less healthy than another, but both are consumed in an environment where much larger risks dominate, then it's hard to get good data to discern the smaller differences.

[thoreau]

BTW, if you really cared about your health you'd stop consuming regular soda and switch to diet soda or good old fasioned water.

As to your infant niece, I don't know her circumstances but I wonder how much HFCS an infant can consume anyway. I'm sorry to hear about her situation, but I'm going to go out on a limb and guess that HFCS has little or nothing to do with it.

[Timothy]

I just think that healthy capitalism should deliver these products without me doing a lot of extra driving around and waiting in extra lines.

And there's the rub. There is virtually no demand for these products because most people don't care or know better than Dave's paranoid, incoherent ramblings...so it must be a market failure! Capitalism has not delivered a naked and randy Salma Hayek unto me in a timely and efficient manner (at a reasonable price), MARKET FAILURE! I do not have a magical teleporter, MARKET FAILURE!

[Dave W.]

people don't care or know

It is that they don't know. That is why T.'s line of work is so important. If they would know, they would care. They got used to the old style US system where the medical research community actually tried to develop info mass consumers would care about. Now that has all become a cynical game.

As to your infant niece, I don't know her circumstances but I wonder how much HFCS an infant can consume anyway.

as much as her mother could for 9 crucial months. Duh!

Is here the meagre info your peeps have seen fit to give me about gestational diabetes incidence:

"The age- and ethnicity-adjusted yearly cumulative incidence of GDM increased steadily from 5.1% in 1991 to 7.4% in 1997 and leveled off through 2000 (6.9%) [2000 was the last year the study looked at."

Like I said, maybe she would have born with diabetes in 1975, but you can probably see why I smell a rat, especially when other types of diabetes seem to be aon a parallel, tho somewhat better documented, rise.

Trader Joe's, Whole Foods, etc.

no Trader Joes in Toronto yet. My wife says they are coming. There are Whole Foods, but not as conveniently located as when I lived in San Diego. A conservative estimate is that going to Whole Foods would add 45 minutes of driving over and above what I do already to get to one of the 2 nearest locations. One would involve 45 minutes extra of freeway driving, the other 45 extra minutes of urban. I very seldom pass either of the locations in my other errands. I'd rather spend an hour twirling my gas cap every week!

Not to mention the fact that my wife does the grocery shopping and she doesn't drive. No, it is not impossible for me to get to Whole Foods, just highly impractical. What I do in reality when I want a sucrose drink is have my wife make me lemonade. At restaurants I drink diet soda even though I think it sux. Thing is, I never though my taste for decent cola would be treated by the "free" market as something akin to my taste for Beefheart records (which are actually easy to get now over the Internet, ironically).

[Jesus u r acting dumb 2day, T.]

I want a freaking bottle of cola without cornstarch

I think you mean corn syrup.

"Like ordinary corn syrup, the high fructose variety is made from corn starch using enzymes."

from the wikipedia

[David]

Dave,

Try Boylan sodas, All their flavors are made with cane sugar. The cola and birch beer are very good.

[Dave W.]

The other funny thing, and here is where you really see the oligopoly at work, is that my wife has no problem walking to get fine quality fruits, vegetables, produce and meats. Sometimes she shops at the No Frills Supermarket and gets regular quality product, but more usually she gets our meats at the butcher shop and he has Mononite Chickens and all breast meat ground poultry and fine sausages and the like. same dealy with the vegetables -- there are organic, premium vegetables at small shops within walking distance of our apartment.

The thing I can't get is the thing it is easiest to make: pre-mixed sugar water with decent sweetner. Given the gigantic market for sweetened drinks, you have to wonder why this, of all the foods, is the thing we can't get easily.

It is not, like Timothy says, that people don't want it. More than one person here at HnR has expressed a preference for sucrose drinks. The mexican preference for this sweetner is well-known in California, too. No, it is not the fact that people don't prefer sucrose water. the problem is that three firms run the sugar water market and they have decided that this consumer preference will be marginalized. Good for their shareholders, but bad capitalism.

[Dave W.]

Try Boylan sodas, All their flavors are made with cane sugar. The cola and birch beer are very good.

Drop themn by my apartment anytime and I will pay you what they cost u to buy plus a 10% profit margin. We'll go cash so its taxless.

[Timothy]

http://www.sodapopstop.com

You can have them delivered to your bloody house.

[Jennifer]

Okay, any of you who have read this far, but especially Jennifer, how would you feel about this new deal on the gas? Happy or sad? Do you like your current deal on gas better or this new process?

This analogy only works if you can somehow invent a reason why high gas prices are Thoreau's fault, or some other example of a failure of the scientific community.

[Timothy]

Given the gigantic market for sweetened drinks, you have to wonder why this, of all the foods, is the thing we can't get easily.

1) Most people don't really care what their soda is sweetened with so long as it tastes okay.

2) Corn subsidies and/or sugar import quotas.

[Jennifer]

Dave, I don't remember how the whole you vs. Thoreau thing got started, but when exactly did you decide that your problems, wants and desires and his responsibility? Seriously--your whole rant here boils down to something along the lines of "I want to eat lots of tasty stuff without the risk of getting fat, and since I can't this means Thoreau is slacking."

[Dave W.]

Some interesting things about the site u recommended:

1. Most of the colas there have high fructose corn syrup.

2. The "normal" colas are mostly "out of stock." There are three or four such out of stock "normal" colas. By normal colas, I mean colas without extraneous flavors added (eg, green tea, cherry) and without smart drink ingredients (eg, kava kava)

3. Happily, this Internet soda store does have one brand of "normal" sucrose only cola in stock:

GIVE RED ROCK PREMIUM COLA A TRY TODAY!
INGREDIENTS: Carbonated Water, 100% Pure Cane Sugar, Caramel Color, Phosphoric Acid, Natural Flavor And Caffeine.

4. Sadly it would not let me order my 24 bottles because I am in Canada.

There is an ungodly amount of shelf space devoted to soft drinks within a mile of my apartment and probably even more within a mile of my work. I can't get a goshdarned "RED ROCK PREMIUM!"

[Jennifer]

This is why I don't have children: because I wouldn't want any kids of mine to have to live in the kind of world where Dave W. can't get exactly the type of soda he wants.

[thoreau]

Dave-

Um, if you're concerned about health and food, I would observe that the market has already delivered a solution and you are using it. Specifically, you said that your wife walks to the grocery store rather than driving. I'll bet that that regular exercise cancels out whatever disadvantages HFCS has over sucrose, assuming moderate consumption of sweeteners.

As to why the market isn't delivering sucrose: Sucrose is (by law) artificially expensive in the US. I don't know the situation in Canada.

And I still haven't figured out how this is all the result of me having the wrong attitude about something.

[Dave W.]

Jennifer, I wrote the whole gas cap hypothetical for u mostly. To show u that there are larger issues at stake than my personal waistline or the amount of shit T. has to go thru at work. It took me a long time to think of a good hypothetical and write it down.

After I rote the story down this morning and left for work I thought of one more tweak that would make the story better tailored for u personally. Imagine the above hypothetical, except that different cars require different amounts of "jogging." It is not your make and model of car, it is just a random characteristic on a vehicle-by-vehicle basis. Like a genetic lottery except carts don't have genes. You have no control over which your car is. Most people need to do an hour of "jogging" a week, but some unlucky car owners must do 5 hours a week. Others, more lucky, only need to do an hour every 6 months.

Now let's say the lucky owners tried to tell the normal and unlucky owners that they should just shut up and do their "jogging." No need to fight city hall on this. No need to try to change the prevailing system. Just do the duty and enjoy the gas discount. How would that make the normal owners feel about the lucky ones?

[thoreau]

Dave, it sucks that some people have to exercise more than others and eat less than others. It sucks.

It also sucks that I don't have any talent for law and you obviously don't have any talent for science. And neither one of us can analyze philosophical issues as well as Julian Sanchez.

What would you like me to do about that?

[Dave W.]

And I still haven't figured out how this is all the result of me having the wrong attitude about something.

Because your profession used to have the integrity to work on society's real problems, but it is no longer interested in that.

It is no longer interested in that because large company's want to (or are indifferent to) health concerns, beyond increasing the amount everybody spends on medicine where possible. instead of working on diabetes, for instance, researchers are busy working on drugs to counteract diabetes related blindness (to choose an example from this week's glowing headlines).

You are probably at pawn level in this game right now and you don't seem to realize it is even going on (I am pretty sure Bailey knows). the mission here is to improve your attitude so that when you rise to a position of real power you can call bullshit on bullshit research and instead have your peeps commence the research into shit.

It would have been pretty sad if Jonas Salk had said: ya know if those kids didn't want polio then they shouldn't have played in puddles. Health problems are what they are and to abandon the real needs of real people to chase pie in the sky dreemz of a rich upper crust is not the correct attitude.

However, before you can combat these bad research choice biases in your profession, you need to recognize that bad research choices are made under the current system. If/when it becomes established fact that HFCS is significantly worse than sucrose then these words will come back into your thoughts and correct your attitudes like a wayward spectre. I wonder if my neice will still be alive then.

And don't worry: I will get to Sanchez. It has taken me a year to get Bailey to stop shooting fish in barrels and start finding absurdities where they shouldn't exist: like AMA policy. Good for us! Other than an occasional spelling correction Weigel doesn't seem to need much guidance at all, although I don't get much of a sense of him as a pperson from his entries yet.

[Dave W.]

"It is no longer interested in that because large company's want to (or are indifferent to) health concerns"

should be:

--It is no longer interested because large companies actively profit from, or are at least indifferent to, most health problems--

[Timothy]

Because your profession used to have the integrity to work on society's real problems, but it is no longer interested in that

Patent Attorneys: Solving social ills one free-energy device at a time.

[Dave W.]

"The "normal" colas are mostly "out of stock." "

should be:

--The "normal" colas having sucrose sweetner only are mostly "out of stock." --

[Timothy]

It would have been pretty sad if Jonas Salk had said: ya know if those kids didn't want polio then they shouldn't have played in puddles.

Because being a lazy fat ass is exactly the same as contracting a terrible communicable disease!

[Dave W.]

Patent Attorneys: Solving social ills one free-energy device at a time.

Without the patents there is no incentive to invest in research.

Patents have become downright counterproductive in the drug sector, but that could be solved by wiping away the patent laws that apply to drug patents only. In other words, if the same law applied to drug patents that applies to all the other non-drug utility patents, then drug patents would stop being a problem. I am aware of this problem and not ashamed to acknowledge and fight it.

[Jennifer]

I have changed my mind and fully agree with Dave, and would like to add the following:

Fuck you, Ron Cheerleader Bailey, for being all "la de da ain't science grand" when science has done exactly JACK SHIT to change the fact that I'm short and if I want to get stuff off the top shelf of my cabinet I have to spend TIME and MONEY buying and using a STEPSTOOL. And I risk BREAKING MY NECK if I fall off. Is this justice? Is this equality? I have to risk PERMANENT LIFELONG PARALYSIS just to use my goddamned GRAVY BOAT while my boyfriend is all "tra la la I'm just going to grab the gravy boat with no problem because I'm tall." And science looks at this and does nothing.

And fuck you, Thoreau, for being all "oooh look at me I'm a big impressive optic scientist helping humanity" when you have done BUPKUS about the fact that my eyesight is not 20/20, and I have to spend TIME AND MONEY buying eyeglasses while other people get to just ditty-bop through life without spending a DIME on their vision. And if I want perfect vision I'd have to spend thousands of dollars on Lasik surgery. Is that fair? Is that just? I should say not. Why should I have to spend time and money on something that others get for free?

My whole life has been one gigantic market failure and you bastards ignore it and talk about how wonderful it is that I can buy glasses and high heels and stepstools when I need them. Well, I shouldn't have to.

[Dave W.]

Because being a lazy fat ass is exactly the same as contracting a terrible communicable disease!

My diabetic neice was not a lazy fatass. She is barely a toddler.

My diabetic older relatives: one skinny (very) and one fat.

[Timothy]

Is it of any consolation that chicks with glasses are hot?

[thoreau]

Dave-

What makes you think that there is no research being done on HFCS and diabetes? I seem to recall you sending me a paper on it once. I found the analysis somewhat suggestive but not really useful in drawing any conclusions. I seem to recall that this was merely one of many papers out there on the subject.

You think that if every single researcher isn't working on the problem that interests you most at the moment then nobody is working on it and nobody cares. I'm all in favor of the notion that an ounce of prevention is worth a pound of cure, and there are a lot of people working on trying to understand the causes of all sorts of conditions. And then there are people like me, who are trying to do basic research that can apply to prevention and cure, health and disease. If you don't see the value in it, well, I don't give a crap.

Some of the questions that you're posing can best be examined by epidemiologists. Well, I'm not an epidemiologist. I'm sure I could learn enough statistics to do a competent job of it, but I can do a much better job as a biophysicist. The world doesn't need one more mediocre epidemiologist.

And epidemiologists would be useless if there were no other scientists to see if there are plausible mechanisms for the relationships that they find in large data sets. So you need lots of researchers in lots of fields, both laboratory and clinical.

And they need tools. They need optical tools, among other things. And they need methods for making their experiments more quantitative so that they can learn more from each experiment that they do. Those two issues are what I work on.

If you don't see the value in it, well, that's fine. Just stick to patent law and let the scientists do science.

And for God's sake, exercise more and don't drink soda, and then you won't have to worry about whether HFCS is worse than cane sugar. Is that so fricking hard?

[Jennifer]

And for God's sake, exercise more and don't drink soda, and then you won't have to worry about whether HFCS is worse than cane sugar. Is that so fricking hard?

GODDAMMIT HE SHOULD NOT HAVE TO DO THAT.

[Dave W.]

What makes you think that there is no research being done on HFCS and diabetes? I seem to recall you sending me a paper on it once. I found the analysis somewhat suggestive but not really useful in drawing any conclusions.

BTTT

and Timothy's corn foundation sponsored research upthd looked kinda favorable, but ya know it is hard not to notice who the sponsor was.

Cue long lecture about how science has so much integrity this kind of thing don't matter.

And for God's sake, exercise more and don't drink soda, and then you won't have to worry about whether HFCS is worse than cane sugar. Is that so fricking hard?

Tell it to my neice.

[Timothy]

But, Doc T, the on-line soda store based in LA won't deliver cane sodas to Dave's door because he is a Chanuckian! This is obviously a conspiracy, I'll bet the Free Masons are involved!

[Jennifer]

When my brother was six months old he had to have surgery for a hernia. If science and the free market are so great why haven't they fixed things so that little bitty babies don't need surgery, huh?

[Timothy]

Timothy's corn foundation sponsored research upthd looked kinda favorable, but ya know it is hard not to notice who the sponsor was.

Dave: I bloody well told you that it was sponsored by the industry. HOWEVER, feel free to, you know, call up the researchers and maybe get the paper and look at their citations. I'm pretty sure you're more than capable of digging through these things.

As for your neice...there are these things called genes, and they can sometimes mean that the pancreas doesn't work right...oh never mind, Pepsico is to blame.

[Dave W.]

When my brother was six months old he had to have surgery for a hernia. If science and the free market are so great why haven't they fixed things so that little bitty babies don't need surgery, huh?

If infant hernias were rising, I would hope science would look for a cause in the increase there, too.

Are infant hernias on the rise, cause I hadn't heard that.

I didn't say "no soda," I just said "soda no more harmful than what I was raised with." Seems reasonable.

[thoreau]

Dave, I have no idea why your niece has diabetes. For all I know, maybe HFCS is indeed to blame.

Not every question is easy to answer. There are people studying the problem, but sometimes it's simply not possible to get a fast or easy answer. You could say that every single scientist should drop everything and study diabetes, but then who will dig through fecal matter to measure the calorie content of undigested food?

[Dave W.]

When my brother was six months old he had to have surgery for a hernia. If science and the free market are so great why haven't they fixed things so that little bitty babies don't need surgery, huh?

weird how the incidence rates rose 1991-2000 (and may have risen b4 '91 and may still be rising since)

still it is all genetics so this observed rise must be an artefact of random chance. Zat the reasoning, Timothy?

[Jennifer]

If infant hernias were rising, I would hope science would look for a cause in the increase there, too.

You'd also yell at Thoreau for not doing a damned thing about it, and insist that if we don't know the answer RIGHT NOW it is proof of a market failure as well as evidence that scientists don't give a rat's ass about humanity.

[thoreau]

You know, it's great that Einstein laid the foundations of so much of modern biology, chemistry, materials science, and physics by figuring out diffusion, lasers (he didn't build them but he worked out the theory), and the basic properties of the light and electrons used in all of modern technology. (He helped lay down the foundations of quantum mechanics.)

But if he had really been a humanitarian he would have devoted his time to figuring out which foods and consumer products are safe and which ones are dangerous.

[David]

Dave,

Do you suppose it's possible that type 1 diabetes is on the rise because it is a manageable condition, and those who suffer from it can survive and pass their genes on to the next generation?

[Timothy]

There are different kinds of diabetes, I'm guessing that in an infant it's likely genetic (your niece's doctors could, you know, probably tell you).

And, yes, it's entirely possible that incidence rise of youth diabetes (well, the Type I, anyway, Type II is simply from fatness...which, well, you and I will apparently never agree on the causes of) is entirely a statistical artifact. In the same way you can flip a fair coin and get more heads than tails (and sometimes you'll get an overwhelming number if you look at a large enough data-set) things can have trends that aren't easily explainable and, even, are seemingly uncaused.

[Dave W.]

You'd also yell at Thoreau for not doing a damned thing about it, and insist that if we don't know the answer RIGHT NOW it is proof of a market failure as well as evidence that scientists don't give a rat's ass about humanity.

the switch to HFCS was made about 1980. There has been time for the medical community to suss this out better and avoid getting a foot in their ass from the public. they effed up.

[Jennifer]

the switch to HFCS was made about 1980. There has been time for the medical community to suss this out better and avoid getting a foot in their ass from the public. they effed up.

I see--the "medical community" does not consist of thousands of individuals working on thousands of different things, but is a single monolithic entity that can only do one thing at a time, and since that one thing isn't what you, Dave, think it should be, this proves that the medical community is slacking off on its responsibilities.

[thoreau]

I'm sure that questions about HFCS, as well as anything else that Dave is worried about, will be much easier to answer if basic researchers like myself stop trying to develop new tools and methodologies and understand basic mechanisms in biology.

[Happy Jack]

GRAVY BOAT

I hope you're not using white flour when you make gravy. Something about alloxan and diabetes.

Maybe Dr. T can spare some time in his day to get to the bottom of this.

[Dave W.]

develop new tools and methodologies and understand basic mechanisms in biology

blah blah tools blah medicines blahddy blahddy blah future blah blah blah progress blah blah blah.

[David]

Dave,

You could think of this as proof of evolution. Through series of random events, people who can better digest HFCS have a better chance at surviving in a post-corn syrup world than those who don't.

[Timothy]

It's too bad those guys who invented the CAT scan, DNA mapping, and the MRI didn't take all their time looking at food safety instead!

[thoreau]

Timothy-

Yeah, it sucks that they spent their time on that stuff. But what we need now is to find some guy whose tumor got worse after undergoing an MRI, and then we can allege that MRI causes cancer and lambast any scientist who doesn't drop everything to evaluate the safety of MRI.

[thoreau]

I just made that up about MRI and cancer, btw. But, you know, since I'm not aware of any studies on the subject I have to assume that no studies have been done. And I have to assume that this is part of some willful conspiracy of silence by the radiology-industrial complex.

T. needs to be shaken out of his complacency and start evaluating MRI.

[Jennifer]

I hope you're not using white flour when you make gravy. Something about alloxan and diabetes.

I use white flour for everything, and Thoreau needs to get off his lazy ass and fix things so that white flour is every bit as healthful as the whole-wheat stuff.

[Dave W.]

I use white flour for everything

I feel that if white flour was good enough for my my mother and grandmother, then it is good enuf for me. Feel the same way about cane sugar -- they always warned me to enjoy in moderation lest I get diabetes (seriously).

I only think something has gone awry when a major new food constituent is introduced and it appears to be significantly more dangerous than the ingredient it replaces. the market should be "smart" enuf to guard against that kind of nonsense.

By the way, the Harper's article (which you 3 really should read as a courtesy to me) is quite coy about the exact way in which WAL*MART had COKE reformulate its new product. I wonder whether WAL*MART ordered more corn starch derivative or less or whether it something else entirely. As usual, it is hard to know what is going on once the consumer relinquishes control of the market.

[thoreau]

Dave, why don't you care about people who may or may not be getting cancer from MRI machines?

[MainstreamMan]

Dave W.

I tried to post a list of studies addressing all of your questions on this issue. It was rejected (probably too many links since there is soooo much research being done in this area)...The server promised to post it later after review.

The summary. There are differences in the way your body absorbs fructose vs. sucrose. These have a small impact on your insulin levels. There is lots of research on the topic. The effect is so small compared to the impact of increased exercise and decreased calorie intake that the current best scientific advice is to eat less sugar (of any kind) and exercise more. Monitor your caloric intake, particularly if diabetes runs in your family. If you have a child, monitor this for them.

Try google scholar. It'll get you all the science you want on the topic. Nobody is bothering to measure shit since the better technique is to look at the impact on blood sugar. Believe it or not, the scientist know what they are doing and are asking the right questions, and studying the very topic that concerns you. Indeed, it probably only concerns you because you misread some science article or other.

[Jennifer]

I feel that if white flour was good enough for my my mother and grandmother, then it is good enuf for me. Feel the same way about cane sugar -- they always warned me to enjoy in moderation lest I get diabetes (seriously).

And yet, Dave, despite what you seem to believe, what you "feel" is not the be-all and end-all of science and health.

[Dave W.]

These have a small impact on your insulin levels.

I didn't ask about insulin levels, I asked about diabetes.

Last year I spent an afternoon searching GOOGLE for answers on the diabetes questions. The closest study (or two or 3) I can't remember, I emailed to T., because he kindly promised to review and did. His conclusion was that the best article I could find did not answer my questions.

I wouldn't be so sure that the answer is not out there except for the fact that I looked for it already.

[Dave W.]

And yet, Dave, despite what you seem to believe, what you "feel" is not the be-all and end-all of science and health.

Jennifer, when doctors become doctors they gotta promise to first do no harm (except to later term fetuses). This is sort of like that do no harm thing.

[thoreau]

Dave W.-

There's a difference between the best study out there and what you think is the best study out there.

[thoreau]

Monitor your caloric intake, particularly if diabetes runs in your family. If you have a child, monitor this for them.

Yes, but yesterday Dave was wanting to know if you might be getting fewer calories than you thought because some of the food was undigested. He won't rest easy until I dig through fecal matter to measure the calorie content of undigested food.

[thoreau]

Monitor your caloric intake, particularly if diabetes runs in your family. If you have a child, monitor this for them.

Yes, but yesterday Dave was wanting to know if you might be getting fewer calories than you thought because some of the food was undigested. He won't rest easy until I dig through fecal matter to measure the calorie content of undigested food.

Until then, he'll say that it's impossible to monitor your caloric intake.

[Dave W.]

getting cancer from MRI machines

because rich people get enuf medical attention for their niche problems already.

Note to T. on the "best article": That remains to be seen. You thinking of volunteering on GOOGLEduty this year?

[Jennifer]

Jennifer, when doctors become doctors they gotta promise to first do no harm (except to later term fetuses). This is sort of like that do no harm thing.

Refusing to rearrange their life according to your priorities is "like that do no harm thing?" Wrong.

Dave, there's something you need to realize: you are, by definition, at the center of your own personal universe, but you're barely on the fringes of everybody else's. The sooner you realize this, the better the chances that you'll overcome your solipsistic belief that if a person doesn't have the exact same priorities as you, that means the person is neglecting his duties to humanity as represented by the fabulous Dave W.

[Dave W.]

Until then, he'll say that it's impossible to monitor your caloric intake.

The people in my family who got diabetes are not particularly sophisticated. And they shouldn't have to be. they should not have to worry that food is more dangerous than it was when they were kids and learned their eating habits.

This is a lot more about them than it is about me.

[MainstreamMan]

"I didn't ask about insulin levels, I asked about diabetes."

You realize that diabetes and insulin are related right?

Try this link. It has a review that uses the word diabetes for you...

http://www.mendosa.com/diabetes_update_28.htm

The review
http://care.diabetesjournals.org/cgi/content/full/25/1/202

[MainstreamMan]

An important sentence from the review:

"Studies in controlled settings and studies in free-living subjects produced similar results. Therefore, the total amount of carbohydrate in meals and snacks will be more important than the source or the type."

[MainstreamMan]

"The people in my family who got diabetes are not particularly sophisticated."

So the good news is they don't need to be. The advice is simple. Eat less sugar, exercise. See your doctor regularly. These are all advice that your grandmother would have given.

[MainstreamMan]

Just cuz you'll point it out. I said "sugar" when the review said carbohydrate...

"carbohydrate: n : an essential structural component of living cells and source of energy for animals; includes simple sugars with small molecules as well as macromolecular substances; are classified according to the number of monosaccharide groups they contain [syn: saccharide, sugar]"

[Dave W.]

Not quite clear. Am I to infer that HFCS is worse, diabetes-wise, than sucrose from this part, MSM:

"Sweeteners.
The available evidence from clinical studies demonstrates that dietary sucrose does not increase glycemia more than isocaloric amounts of starch. Thus, intake of sucrose and sucrose-containing foods by people with diabetes does not need to be restricted because of concern about aggravating hyperglycemia. Sucrose should be substituted for other carbohydrate sources in the food/meal plan or, if added to the food/meal plan, adequately covered with insulin or other glucose-lowering medication. Additionally, intake of other nutrients ingested with sucrose, such as fat, need to be taken into account.

In subjects with diabetes, fructose produces a lower postprandial response when it replaces sucrose or starch in the diet; however, this benefit is tempered by concern that fructose may adversely effect plasma lipids. Therefore, the use of added fructose as a sweetening agent is not recommended; however, there is no reason to recommend that people with diabetes avoid naturally occurring fructose in fruits, vegetables, and other foods."

[Timothy]

The people in my family who got diabetes are not particularly sophisticated. And they shouldn't have to be.

Translation: My family are all lazy, ignorant hicks and they should be shielded by the government and medical community from anything even remotely potentially dangerous to them because they can't grasp simple concepts like "eat less, exercise more". Further, I'm unwilling to understand basic arithmetic, sugar metabolism, even the slightest bit of chemistry, and when confronted with evidence that is counter to my paranoia about HFCS will move the goal posts. They should not have to put effort into maintaining their health, and neither should I, neener neener.

Dave W: If HFCS is 1.3 times as sweet as sucrose, that means that the 39g of sugar in Coke from HFCS will be replaced by 50.7g of sucrose to achieve a taste-equivalent level of sweetness. So, of those 50.7g of sugar, 25.35 of them would be fructose. Thusly, not only would your total sugar intake increase by 30%, but your intake of fructose would increase by 18%. If fructose is worse for you, it is hard to see how this might be an improvement. And don't start with the "different kinds of fructose" nonsense again, jeebus. The site linked above lists it as a 120-160 on the sweetness scale (where sucrose is 100), so 1.2 to 1.6 times as much sucrose to replace it on a taste-equivalent basis. I've seen the 1.3 in a couple of places around the net, so that's what I went with. YMMV, all rights reserved.

As an aside, if the industry claim of 1:1 substitution is correct, then fructose per 12oz serving of coke would fall 10% to 19.5g from 21.45g. Which isn't a lot, really.

[MainstreamMan]

Dave W's Question: "the strength of correlations between various sweetners and diabetes."

In case he missed it, the answer--

"Studies in controlled settings and studies in free-living subjects produced similar results. Therefore, the total amount of carbohydrate in meals and snacks will be more important than the source or the type."

[Dave W.]

So the good news is they don't need to be. The advice is simple. Eat less sugar, exercise. See your doctor regularly. These are all advice that your grandmother would have given.

If the new sweetner causes diabetes more than the old sweetner, then you better bet it changes the message. My grandmother showed my mother every day in so many ways what was meant by "less sugar, excercise." If "less sugar, excercise" now means eat like a GITMO prisoner and excercise like Lance Armstrong, I can assure you that is not what it meant when my mother was growing up in the 40s.

That is the problem. A new sweetner should not require this -- or at least if it does, it should be clearly be marked that way. People develop expectations over decades. To suddenly change the whole equation and not tell anybody (if that is what has happened) is dastardly.

[MainstreamMan]

"The importance of prevention of diabetes in high-risk individuals is highlighted by the substantial and worldwide increase in the prevalence of diabetes in recent years. Genetic susceptibility appears to play a powerful role in the occurrence of type 2 diabetes in certain populations. However, given that population gene pools shift quite slowly, the current epidemic likely reflects marked changes in lifestyle. Lifestyle changes that are characterized by decreased physical activity and increased energy consumption have together promoted obesity, which is a strong risk factor for diabetes that itself is influenced by both genes and behavior. Despite the difficulty in maintaining a reduced body weight long-term, several studies have demonstrated the potential for moderate sustained weight loss to substantially reduce the risk for type 2 diabetes. Clinical trial data from both the U.S. and Finland now strongly support the potential for moderate weight loss to reduce the risk for diabetes (6,7). An active lifestyle also has been demonstrated in a number of prospective studies to prevent or delay the development of type 2 diabetes. Both moderate and vigorous exercise decrease risk of impaired glucose tolerance and type 2 diabetes.

Reduced intake of total fat, particularly saturated fat, may reduce risk for diabetes. Increased diabetes incidence is reported with increased intake of dietary fat, independent of total calories, although this effect is not demonstrated in all studies. It appears that all types of dietary fat (except n-3 fatty acids) may have an adverse effect on insulin sensitivity. Saturated fat may have the greatest effect. Increased intake of polyunsaturated fat, in the context of appropriate total energy intake for weight management, may reduce the risk for type 2 diabetes.

Recent studies have provided evidence for reduced risk of diabetes with increased intake of whole grains and dietary fiber. Although selected micronutrients may affect glucose and insulin metabolism, data to document their role in the development of diabetes are scarce or inconsistent. Moderate alcohol intake has been related to improved insulin sensitivity and reduced risk for diabetes. However, insufficient data exist to support a specific recommendation for moderate alcohol intake for prevention of type 2 diabetes.

No nutritional recommendations can be made for prevention of type 1 diabetes. Breastfeeding may be beneficial. Although increasing obesity in youth may be related to an increase in the prevalence of type 2 diabetes, particularly in minority adolescents, there is insufficient data at present to warrant any specific recommendations for prevention of type 2 diabetes in youth. Increased physical activity, reduced energy and fat intake, and resultant weight management may prove to be beneficial."

[MainstreamMan]

So Dave W.
I hope you see that you now have enough data to answer your basic question. The best evidence, based on lots of research, is that you are barking up the wrong tree.

While High Fructose is not the best source of energy for those at risk for diabetes, the difference is small compared to the larger lifestyle changes. It is quite likely that your family has a genetic trait that increases chances of diabetes, so they should look at simple lifestyle changes to prevent or manage that risk. Worrying about whether your soda has fructose or sugar as a sweetener is a distraction. The worry should be whether you should have soda or unsweetened tea, or a V8, or water, or milk, or juice, or any number of other options. Your choice should be between an orange and brownie, not between a sugar sweetened brownie and one with fructose.

The review I linked will have the references for all the original studies. Follow up the references in each of those, and by the next time you need to argue about this topic, you should be informed.

[thoreau]

Your choice should be between an orange and brownie, not between a sugar sweetened brownie and one with fructose.

Exactly. It's like the people who agonize over the dangers of flying after driving through Long Beach to get to the 405 and then take the 405 during rush hour to reach LAX.

[thoreau]

BTW, I'm sure Dave will say that driving through Long Beach would be safer if everybody had a permit to carry a concealed tort lawyer.

[MainstreamMan]

Just cuz you said it

"If "less sugar, excercise" now means eat like a GITMO prisoner and excercise like Lance Armstrong, I can assure you that is not what it meant when my mother was growing up in the 40s."

I can assure you that is not what it means today.

[Phileleutherus Lipsiensis]

🙂

[MainstreamMan]

Oh and Nature is sooo topical...

http://www.nature.com/news/2006/060612/full/060612-1.html

Trans-fat, Dave W., Trans-fat--GO!

[Dave W.]

None of those studies compare the diabetes risk of sucrose from that of HFCS. Some say there is a difference. others say there is a difference. None give a simple direct answer about what the realtive probablities are or attempt to quantify them.

It is all about whether you take it on faith that the diabetes spike comes from "lifestyle changes." Medical researchers are furiously trying to plant this seed and have been successfully apparently.

I don't mind it so much out of Timothy or Jennifer -- they remind me of my family members in some ways.

Out of a medical researcher, that kind of attitude is inexcusable. One day the difference will be quantified. If HFCS doubles (or more) the diabetes risk, y'all owe me a bigtime sucrose sweetned Coke.

I understand that you can always have avoided diabetes by living more like Lance Armstrong than your parents or grandparents or great grandparents did. However, this should not be required and it certainly should not be required without some kind of warning.

[thoreau]

I know, it's so irresponsible for medical researchers to say that eating moderately and exercising moderately are good strategies to follow.

They should confiscate my pocket protector!

[Dave W.]

I know, it's so irresponsible for medical researchers to say that eating moderately and exercising moderately are good strategies to follow.

Misdirection by platitude is bad, yes.

[thoreau]

Dave, if we're going to talk about misdirection, you keep referring to somebody who eats like a prisoner and exercises like a world-class athlete. You know darn well that nobody needs that lifestyle to lose weight.

How much exercise do you need? How much should you curtail your calorie intake? Sadly, there are no answers. It depends on the person and the goals. It would be nice if this knowledge were systematized to the point where you put some data into a computer, including the person's height, weight, calories burned during normal activities, maybe some metabolic and even genetic data, and whatever else, and an answer was spit out prescribing a calorie and exercise regimen.

I'm pretty sure that people already have things like that, and for all I know the answers may even be more or less right much of the time. But I'm sure you want perfection here, and I am skeptical of anybody who claims to have exact answers.

So long as we live in a world that isn't perfectly convenient for you, we'll have to resign ourselves to this awful, awful advice: Start by cutting back modestly and exercising modestly. If you fail to lose weight, or fail to lose as much as you'd like, cut back more.

Isn't it absolutely awful that scientists don't yet have exact answers so that you, Dave W., can live a life of absolute certainty? The humanity of it!

[Timothy]

Or stop focusing on weight and start focusing on fitness because muscle is more dense than fat and being Tom Cruise is a lot different than being George Costanza.

[thoreau]

For those who want to continue the fun when this drops off the main page:

http://grylliade.org/modules.php?name=Forums&file=viewtopic&t=991

[MainstreamMan]

Dave W.
I think you aren't digging hard enough. You haven't followed the links to the basic science studies. It take some time.

Here is a meta-analysis of the impact of our suggestions that lifestyle changes are the important information... Notice that we are talking about a 50% risk reduction here. It is really doubtful that you are going to top that with a change in sweetener.

Diabetes Care 28:2780-2786, 2005

Efficacy of Lifestyle Education to Prevent Type 2 Diabetes
A meta-analysis of randomized controlled trials
Kazue Yamaoka, PHD and Toshiro Tango, PHD

Department of Technology Assessment and Biostatistics, National Institute of Public Health, Wako, Saitama, Japan

Address correspondence and reprint requests to Kazue Yamaoka, PhD, Department of Technology Assessment and Biostatistics, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama 351-0197, Japan. E-mail: [e-mail]

ABSTRACT

OBJECTIVE?To evaluate the efficacy of lifestyle education for preventing type 2 diabetes in individuals at high risk by meta-analysis of randomized controlled trials, as assessed by incidence and a reduced level of plasma glucose 2 h after a 75-g oral glucose load (2-h plasma glucose).

RESEARCH DESIGN AND METHODS?Through an electronic search, 123 studies were identified. A literature search identified eight studies that met strict inclusion criterion of meta-analysis for 2-h plasma glucose and five studies for the incidence of diabetes. All were randomized controlled trials of ?6 months with lifestyle education that included a dietary intervention. Subjects were adults diagnosed as being at high risk for type 2 diabetes. The difference in mean reduction of 2-h plasma glucose from baseline to the 1-year follow-up and relative risk (RR) of the incidence of diabetes in the lifestyle education group versus the control group were assessed. Overall estimates were calculated using a random-effects model. Those estimates were confirmed by several models, and the possibility of selection bias was examined using a funnel plot.

RESULTS?Lifestyle education intervention reduced 2-h plasma glucose by 0.84 mmol/l (95% CI 0.39?1.29) compared with the control group. The 1-year incidence of diabetes was reduced by ~50% (RR 0.55, 95% CI 0.44?0.69) compared with the control group. Results were stable and little changed if data were analyzed by subgroups or other statistical models. Funnel plots revealed no selection bias.

CONCLUSIONS?Lifestyle education was effective for reducing both 2-h plasma glucose and RR in high-risk individuals and may be a useful tool in preventing diabetes.

Abbreviations: DPPRG, Diabetes Prevention Program Research Group ? IFG, impaired fasting glucose ? IGT, impaired glucose tolerance

[MainstreamMan]

So jump on the TransFat bandwagon. It has more legs.

Here's why, in case you missed it. Most of the research/common sense suggests that Fructose, with its lower glycemic index, is the BETTER choice, but the impact "is tempered by concern that fructose may adversely effect plasma lipids" so in the end it is a wash.

However there is good quantitative epidemiologic evidence (see above) that lifestyle changes make a difference. If the epidemiologists ignore the fructose questions you are asking, it is because they do not have consequences large enough to make an epidemiological difference.

[MainstreamMan]

And Dave W.

I want you to notice that we are talking about aggregated data from 123 Randomized Controlled Trials. This is about as strong as evidence gets.

What else would you like the doctors to base their "platitudes" on?

[MainstreamMan]

Correction:
Change "aggregated" to "aggregatible" if that's a word.

[Frank_A]

MSM,

I salute you!
A very fine bit of investigational work you have done, unfortunately though I think Dave W. will still think that he can as the immortal Dire Straits said, "Get you money for nothing and your chicks for free."
Cheers!