What Drives Obesity - Diets High in Fat? Carbohydrates? Actually, It's Everything - and Fructose Is at the Center

[redqueen]

A new study led by CU Anschutz researcher Richard Johnson, MD, unifies a number of hypotheses behind the dietary cause of obesity that once seemed incompatible
3 minute read

Written by Kelsea Pieters on October 17, 2023

Nutrition experts have recognized for many years that Western diets rich in fats and sugar may be behind the cause of obesity, but debate has reigned over the primary culprit - intake of too many calories? Specific foods such as carbohydrates or fat? This has led to some groups recommending reducing sugar, some reducing carb intake, while others believe the key is reducing high fat-foods.

A paper published today in the research journal Obesity suggests these theories are not incompatible with each other, and that they can all be brought together in one unified pathway that centers around one true driver: fructose.

According to Richard Johnson, MD, University of Colorado Anschutz Medical Campus researcher, and his colleagues, the primary problem in obesity is fructose, which is present in table sugar and high fructose corn syrup. Fructose can also be made in the body from carbohydrates (particularly glucose). When fructose is metabolized, it lowers the active energy in the body (known as ATP, or adenosine triphosphate) which causes hunger and food intake.

(More at link)

https://news.cuanschutz.edu/news-stories/what-drives-obesity-diets-high-in-fat-carbohydrates-actually-its-everything-and-fructose-is-at-the-center

[spooky3]

1. Interesting, thanks. Nt

[MOMFUDSKI]

2. Carbs IN ANY FORM are

what puts the weight on. Cut your carbs-weight falls off.

[Caliman73]

4. Not entirely true.

Carbohydrates are absolutely necessary for bodily functions. Glucose, a carbohydrate, is the only fuel source for brain cells.

They are also the most easily converted into fat for storage. Many people in other parts of the world, eat a diet higher in carbohydrates, in the form of rice or potatoes, and vegetables, and do not have the levels of obesity that we have in the United States. If carbohydrates were the primary cause, then we would be seeing the same pattern play out all over the world, especially in places where carbohydrates make up the majority of calories consumed.

The problem is that the food that we are sold for convenience, and the schedules we are conditioned to keep, and the layout and design of many of our living spaces (cities) are such that we overeat and are not active enough. Processed foods have a combination of fat, sugar, and salt that is for all intents and purposes, "addicting". For many people, the diet in the United States contains ingredients that actually work to shut down the Leptin cycle, which is the hormonal trigger for satiety. We don't feel "full" like other people, who eat a more natural diet or get more activity, would so we overeat and the cycle repeats.

The above is a very simplistic explanation of a complex process that involves what we eat, our psychology, and our levels of activity.

For many people, "cutting carbs" or cutting calories, simply doesn't work because the body's internal processes have been damaged.

[Happy Hoosier]

5. But your body can create glucose.

Most of us get PLENTY of glucose for the brain even on a very low carb diet. But even if we didn't, the body is capable of creating the glucose it needs using a process called neoglucogensis.

Folks on Ketogenic diets (as an example) do not normally suffer from a lack of glucose for the brain.

But yeah... fructose..... I remember when fructose was touted as the "sugar for diabetics"! Ho boy... what a terrible idea! Our body does not metabolize it well, and too much fructose probably causes fatty liver disease.

[Caliman73]

6. Agreed.

I was responding primarily to the statement that "CARBS in ANY form, are bad." You can eat a ton of most salad vegetables, which are primarily carbohydate foods, and be good.

Like you said, what you need to avoid is the fructose and sucrose laden foods like cake, white bread, etc... that are basically sugar with very little else nutritionally.

[redqueen]

12. Veggies have carbs but also fiber

Not all veggies are equally 'bad', carb wise. The starchy ones will spike blood glucose though which you want to try to avoid.

[mitch96]

59. Yup, Veggies have fiber that also make it "slow carbs" that don't spike your blood sugar. nt

[MOMFUDSKI]

26. All points well taken.

I am coming from being a diabetic for 27 years. Always amused me that “rice feeds the world” while rice is one of the worst things I can eat. I count carbs to determine how much insulin to take. EVERY diet book out there is basically low carb if you look at it. I am aware that I do need at least 1400 calories/day to run my brain. I don’t count calories. Enough is enough already. Food is a funny thing. The average person eats about 300 carbs per day. I average 120. Thanks for the info.

[tinrobot]

21. Not exactly. The culprit is mostly simple carbs that get metabolized too quickly.

That causes insulin spikes, which cause the body to store the excess sugar as fat. Simple carbs would be things like (obviously) sugar, most breads and baked goods, and a lot of processed foods.

Carbs with fiber, such as veggies, legumes, true whole grains are less problematic.

Even then, you still can't overeat, need to get complete nutrition, and do some exercise.

[Cetacea]

22. Lost weight on Keto AND Complex Carb diets

I wish that Keto folk would distinguish which carbs they are referring to.

[Quixote1818]

51. Blue zones eat 60 to 65% complex carbs

Carolers in calories out is much more important. Sure you can cut carbs for while on a diet to help shed pounds a bit quicker but for longevity carbs are very important in pretty much any peer review study and what shows up in blue zone diets.



https://www.cnbc.com/2022/12/06/5-foods-the-communities-with-high-rates-of-living-to-100-eat-often.html#:~:text='The%20five%20pillars%20of%20a,potatoes%20and%20yams%20(complex%20carb)

https://www.businessinsider.in/science/health/news/the-longest-lived-people-run-on-a-high-carb-diet-and-its-a-big-part-of-their-secret-to-living-to-100/articleshow/103251584.cms

[Skittles]

62. nonsense

it's lack of movement that puts the weight on and keeps it there

[GumboYaYa]

3. This is long but right on point.

Bob Lustig has been flagging the fructose problem for a long time. You can boil all the information he throws at this to feed the gut and protect the liver.

https://robertlustig.com/fructose2/

[superpatriotman]

8. Readf the whole thing...Thanks!

Sugar is the culprit. Big food knows this. They are in the addiction business.

...pick it up, “Fat chance” which was written for the public, but really to be honest with you, I wrote it for doctors. My publisher says “You cannot write a book for doctors, we won’t publish it”, I said “Okay, fine. I’ll write it for the public.”

But I really wrote it for doctors because the whole medical profession has to change. And the problem is they bought the bill of goods that the industry was selling. And we got to fix it, because a calorie is not a calorie, it never was and never will be.

So, lastly we have started a non-profit, very specifically to provide medical nutritional and legal analysis and consultation to promote personal and public health against Big Food called the Institute for Responsible Nutrition...

[redqueen]

13. "They are in the addiction business."

Precisely so. Imo it needs to be addressed ASAP. Diabetes can be cured but some are making tons of money due to the backwards treatment offered, meanwhile healthcare costs are soaring.

[exboyfil]

17. No doubt

My wife is addicted to McDonalds. She will panic if she can't get her breakfast sandwich. I utterly detest eating at McDonald's but I have to twice a year (free breakfast Mother's and Father's Day). I can distinctly taste the sugar in their eggs, and their best meat source is sausage which doesn't taste very good at all. Why anyone would want that crap over making a tasty omelet with vegetables/mushrooms at home is beyond me. Not sure you save much time by driving there and waiting in line for your food.

[MOMFUDSKI]

28. I don't agree that diabetes can be cured.

Kinda like being a little bit pregnant. I’ve been thin my whole life but got the genetics from my dad’s side.

[redqueen]

31. Apologies, type 2 adult onset can be cured

The kind that's caused by a lifetime eating the SAD and being overweight

[TexLaProgressive]

33. As a person with type 2 diabetes mellitus for 33 years,

I respectfully disagree. It is possible for a person with T2DM to get good blood glucose management with diet and exercise - that is not a cure. If it was a cure then they could go back to old ways without issue. The majority of people do not have the same problem as those with T2DM.

I was obese at diagnosis. I was put on an oral med, Micronase, and began reducing carbohydrates and exercising. In 6 months the Micronase was stopped and I was in great control for 10 years. Then came progression.

I was started on Metformin, added Lantus and 30 months ago I began multidaily insulin injections (currently on a pump). In the 33 years I have been OCD about diet and exercise and have been thin.

Not everyone with T2DM will have it progress as far as me. Some, especially those diagnosed prediabetes can possibly continue with only diet and exercise. It is the chronic over secretion of insulin caused by cellular insulin resistance that eventually wears the Beta cells down. That is the cause of the progression.

[redqueen]

38. Did you try fasting?

It really is reversible. It might not be fully curable in all cases but I'm not a researcher. Those who manage patients are the ones saying it can be cured.

And no that doesn't mean you can go back to treating your liver like crap by eating lots of unnecessary carbs but it does mean you can stop taking the medicines that actually cause the progression and enable doctors to call it a chronic disease.

[TexLaProgressive]

49. Fasting helped a bit in the beginning

At the 10 year turning point there was no way to lower my blood glucose levels regardless of what I ate or didn’t eat or how much I increased exercise. At the time I had been 10 years maintaining normal or near normal BG levels with diet, fasting and exercise.

There are medications that stimulate the Beta cell to secrete more insulin. These can and probably do, increase the rat of Beta cell decline.
1.Incretin mimetics - Byetta, Bydureon, Victoza, Ozempic and Trulicity
2. Dipeptidyl-peptidase 4 inhibitors (DPP 4 Inhibitors) - Onglyza, Januvia and Tradjenta
3. Sulfonylureas - Maybe the worst class drugs to cause Beta cell death. - Micronase, Glucotrol and Amaryl I was only on Micronase for 3-4 months in the beginning.

The go to drug for newly diagnosed with T2DM is Metformin which does not stimulate insulin secretion. It slows digestion a bit, decreases stored glycogen from being converted to glucose and just a bit increases cellular response to insulin.

The SGLT 2 inhibitors, Farxiga and Jardiance do not stimulate the Beta cells, but decrease the glucose threshold in the kidneys to increase the excretion of glucose in urine. Benefits are heart and kidney protection, can make one prone to UTIs, yeast infections and euglycemic DKA.

Thiazolidinediones such as ACTOS actually increase cellular insulin sensitivity quite a bit. ACTOS is linked with bladder cancer.

Here’s a little primer on diabetes.
There ar 7 completely different diseases named diabetes. That word is an adjective describing the common symptoms of polydipsia (excessive thirst) and polyuria (excess urination. D. Insipidus is 4 diseases that interferes with the body’s ability to conserve water. Their urine is nearly pure water.

The 3 main types of D. Mellitus (L. mel - honey) all have issues with blood glucose (sugar) management. The rarest is pancreatogenic type 3c DM which is caused by diseases such as pancreatic cancer, acute and chronic pancreatitis, cystic fibrosis and a few others that damage the digest enzyme producing function of the pancreas and by collateral damage the very small islets of Langerhans that house the 4 cell types that regulate glucose levels. Depending upon how extensive the damage they may need to inject insulin and take digestive enzyme supplements with each meal.

Next group is autoimmune type 1 DM. This often occurs in children and teens, but can be contracted at any age. It requires a particular gene variant plus a trigger, which is often a viral infection that may or may not be symptomatic. This causes the immune system to mistakenly identify dify the insulin secreting Beta cells in the islets of Langerhans as foreign. The Beta cells are destroyed and the person will have to inject/infuse insulin throughout every day or die.

The most common by far, is insulin resistant type 2 DM. This is the result of some 30 to 70 genetic variants that cause cells in need of glucose to cause their insulin receptors to resist the attachment of insulin. This causes a rise in blood glucose levels which causes the Beta cells to secrete more and more insulin to lower BG levels and overcome some of the resistance. The other thing is that lots of insulin with lots of glucose floating around in the blood causes the liver to convert glucose into triglycerides a fat, to be stored in fat cells.

[redqueen]

50. This part

30 to 70 genetic variants that cause cells in need of glucose to cause their insulin receptors to resist the attachment of insulin

Doesn't sound right to me.

[TexLaProgressive]

57. Why?

There are loads of people who are skinny, obese, eat loads of carbs and are euglycemic (normal BG management) It's only around 8 or 9% that develop T2DM.

It's not only genetic but appears to be an evolutionary tactic to allow a portion to survive during times of famine.

If you have the time and inclination listen to this podcast a bit more than 2 hours.
https://peterattiamd.com/geraldshulman/

[redqueen]

58. Ok I get it now, I was misreading

I wish I was one of those euglycemic types

And thanks for the link!

[MorbidButterflyTat]

54. OMG

That sounds so insidious. Not a doubt in my mind.

I fast regularly and recommend it. I feel so much better when I do, but other than being a bit loco, I don't have a chronic illness - that I know of.

Thanks for this info.

[redqueen]

55. The most I've done is a 5-day fast

I wish more people understood how good fasting is for the body.

I try to do at least a 36-hour fast every few months.

[exboyfil]

44. In my case early stage was I think cured

through Keto, intermittent fasting, and lots of exercise. A1C from 9.1 to 4.9. Insulin from 37 to 8.7. Homa IR from 11.2 to 2.3.

[redqueen]

48. Outstanding!

I didn't know about all this when I was first diagnosed as prediabetic, wish I had known at the time.

[exboyfil]

18. I love my Keto doctor

I did a presentation at a Keto group/support session on my journey. In his presentation he showed how much money he is saving the insurance companies by getting folks off diabetes medicine and insulin. I wish my wife would take it up as well - she has gotten better though and is getting in short walks everyday with me and the dog.

[MOMFUDSKI]

29. I could probably call my diabetes cured

if I ate no more than 60 carbs/day. Try that sometime.

[mitch96]

60. "They are in the addiction business.", yup. High fructos corn syrup, salt and fat is their combo...Want lo fat?

Last edited Sat Oct 21, 2023, 03:23 PM - Edit history (1)

Sure, just jack up the sugar and salt.
Want lo salt? jack up the fat and sugar etc. Anything to addict the population.
Like cigarettes. Legal addiction. The problem is you can stop smoking but you can't stop eating...but eat what?
I tend to eat a whole food plant based diet and it works for me..
Eat real food, mostly plants, and not too much as the saying goes...
My problem is the "not too much" part. I like to cook and I like to eat!!!
m

[Tree Lady]

19. He is great

Usually every year in January he is part of the Sugar Free video week they have with experts from all walks of nutrition and health talking about what Sugar does to you. I have heard him talk a few times and he is trying to make a difference, actually fighting the food industry to change.

[lindysalsagal]

7. I know from years of personal experience, that eliminating wheat and sugar leaves me happier

With fewer cravings. So, convenience foods are the problem. Greens, greens, greens, and low fat clean protein.

[redqueen]

14. Yep, once your body burns through the carbs

it wants more, even if you have plenty of fat stored, it will ignore that and demand more carbs.

I was on keto for years, no cravings. Now I'm low carb and I have to fight the cravings again.

[Celerity]

15. A profound lack of exercise by far too Americans is endemic as well. I was gobsmacked at utter disdain for simply walking a bit more that was present in many places.

Plus the enormous size of the portions of food, everyday, in far too many places, not mention so much unhealthy food, combined with a disdain for healthy food choices but so so many people.

One does do not have to be a scientist to easily see why there are so so many overweight and/or obese Americans.

[Tree Lady]

20. Very true when you visit overseas

Even though the food has plenty of carbs at least in Ireland where I spent summer in 2019, I didn't gain a pound even with eating out, drinking, bread with meals, dessert. It's all the miles and miles of walking every day.

[spinbaby]

56. True that

I travel to Japan with some regularity—the diet there is quite high in carbs, but almost no one is fat. Three things they have in their favor are a diet high in vegetables, an environment that encourages walking, and probably good genetics. I say good genetics because my Russian peasant genes have me gaining weight in Japan in spite of all the vegetables and walking—just can’t take all the rice and noodles.

[exboyfil]

16. I do Keto

Keto has worked for me. Down 153 pounds (most weight lost in about a 16 month period - now have been in a plateau around 200# for the last four months and bounced up 8 pounds from my low).

I combine with intermittent fasting. The September from Hell impacted my weight and exercise (two birthdays, a wedding, and my mom died).

In my prior attempts to lose weight I did the low fat approach eating lots of beans and brown rice. I found that I was crazy hungry all the time. With Keto this is not the case. I think you can get away with either a low fat or a low carb diet, but I find for me the low carb version works much better. In both cases you should be consuming a wide variety of low glycemic index vegetables. I also think a higher than recommended percentage of protein is very important especially if you are older and are doing resistance training to maintain muscle mass.

There is also no substitute to also being active. I walk 20-25K steps a day and attempt to resistance train 2-3 times/week along with some rowing. How much of the weight loss/maintenance is diet and how much is exercise? I don't know, but I know I need both.

Keto isn't just a lot of ribeyes. I find I seek out low fat options for much of my protein but supplement by cooking with Extra Virgin Olive Oil and butter. I also try to eat avocadoes frequently with my salads. I also try to eat smaller fish at least two times a week (usually in my omelets - I eat about 6 eggs/week). I eat a lot of vegetables including an entire heart of romaine lettuce in one sitting.

I bought McDonald's frequently for my mom, and I had absolutely no desire to eat the fries or burgers that I brought to her (she was terminal COPD so she ate what she wanted). I pull the skin off fried chicken. I will sometimes buy T-bones but I don't eat the strip of fat around them (my favorite steaks are sirloin on strip). I am finding that I prefer to order salads with steak in them instead of just the steak when in restaurants. I eat Jimmy John unwichs (lunch meat, cheese, all the veges and wrapped in lettuce) as my fast food option or Subway protein bowls. My pizza options are crustless pizzas from either Papa Johns or Marcos.

[redqueen]

24. So sorry for your loss

I do miss not having cravings. Maybe I should switch back to keto.

[Deep State Witch]

30. Try Avocado Oil

I'm been keto or some form of low carb since January of 2020. Lost 100 pounds, but have gained some of it back due to long COVID. One of my go-to fats is Chosen Avocado Oil. It's one of the few pure avo oils on the market. It has a higher flame point than olive oil, and less gastrointestinal issues.

I'm a big fan of Dr. Ken Berry. But, avoid someone named "Dr. Boz" (Annette Bosworth). She's a good keto doctor, but a RWNJ. Plus, she reminds me of a mean girl. Or Anya from "Buffy."

[exboyfil]

39. I will give Avocado oil a try

I just used up the rest of my Macademia oil (it came as free with my order of nuts).

Thanks

[Deep State Witch]

40. No Problem

Remember - get Chosen. Don't get Primal Kitchen. It's adulterated with seed oils. Chosen is 100% avo oil.

[Happy Hoosier]

53. I like that oil....

for some high-temp cooking.

I usually use Coconut oil though, because it's cheaper.

[Happy Hoosier]

35. Keto worked for me too...

Last edited Fri Oct 20, 2023, 11:30 AM - Edit history (1)

As I backed off hard-core Keto (I am back to traveling for work, and it's hard to stick to keto while traveling) I have put a little weight back on, though I have been holding steady for about 8 months.

I do love a good Ribeye, and it is nice to have it without feeling guilty about my health. I use Olive Oil, butter, and Coconut oil as my primary fats. I avoid vegetable oils when I can. I am not a fanatic about that, but I prefer the better fat composition of my primaries, and I prefer the taste... seed oils taste kinda "off" to me now.

I still avoid breads and grains, but do occasionally indulge in an actual slice of pizza. I rarely eat anything with added sugar. When I do, it's very clearly a "treat." I have starting eating a few more carby veggies, like peas and other beans. Not a ton. But I do enjoy a little variety with my non-carby veggies.

My A1C is holding steading in the 5's, and triglycerides remain low. I'm feeling pretty good, too!

[Deep State Witch]

41. You're Lucky You Can Have a Slice

Man, do I miss pizza. Keto Crust pizza at Blaze just doesn't cut it. But, I think that my system has been off of grains for so long that if I did, I'd get the runs.

[Happy Hoosier]

46. When I had been on Keto for a while...

My first moderate-carb meal resulted in some discomfort. I have decided to "carb-cycle" going forward. My body seems to be able to handle a moderate amount of carbs now, so I mainly eat VLC, but every 6 weeks or so, I do 2-3 weeks of moderate carbs. I can enjoy some of my old favorites and maintain some metabolic flexibility without making my average blood glucose go nuts. It seems sustainable. And it's especially useful when I visit my M-I-L who, despite many briefings has no idea of how to accommodate a Keto diet!

[Deep State Witch]

61. I may try that

I may try carb cycling. I'm disgusted with myself. I lost almost 100 pounds, then got COVID in May of 2022 - on a Low-Carb Cruise! Half of the conference came down with it, including me and my husband. We've both put back on about half of what we lost since then, even with continuing to maintain a low-carb lifestyle. I'm getting sick and tired of eating like this and the scale going the wrong way. We're both following the long COVID studies and have low cortisol levels, so that may be the culprit.

[exboyfil]

42. Me too

The drop in A1C and triglycerides has been great for me. My insulin resistance is also down dramatically. My GP did whine a little bit about my slightly elevated LDL, but from everything I read and what my Keto doctor told me it shouldn't be a concern. Also another big one was the drop in my liver numbers - this is very important for avoiding fatty liver disease and fructose is one of the chief culprits of that.

I strip the cheese, sauce, and toppings off slices of pizza when a crustless option is not available. I actually find I have little or no desire to consume bread or other baked products. Same for most grains. I have found an adequate substitute for potatoes in soups and crock pots in turnips and radishes. I cook up a big medley of mushrooms and vegetables (peppers, onions, zucchini, celery, and olives) with my steaks and chicken. My go to dessert is full fat Greek yogurt with blackberries/raspberries and flax seed. I probably eat more cheese than I should though.

[Happy Hoosier]

47. Yep... I get the same thing about LDL from my GP.

But I am not concerned in the least. My TG/HDL ratio is less than 3, which is FAR more predictive of CHD than LDL alone.

Likewise, my liver numbers improved. I did not officially have FLD, but I was getting close. My liver numbers are now completely normal.

Like you, I eat more cheese than I should. It's just so deleicious. I also have to be wary of nuts. WAY too easy to eat too many of those.

[JanMichael]

23. Toss in sitting too farking much and voila!

The London Study of tram v bus drivers and the followup of mail clerks v mail deliverers shows huge increase for cardiovascular type death for the sitters v the walkers. Now? People sit even more.

[redqueen]

25. Lots of requests for standing desks at my office.

Sitting is the new smoking, or so I've been told.

[JanMichael]

32. It's funny you should mention that

In both London studies the people were pretty much the same demographic. They all ate the same food they all smoked they were all men or at least mostly. The only difference was sitting versus standing.

[Happy Hoosier]

36. I've heard that too, but....

.... studies are bit all over the place. The problem is that it's fairly hard to isolate physical activity from other health risk factors. So we have a lot of associative factors, but we're still figuring out casual relationships. Turns out human biology is complicated! Who'd 'ave thunk it!

[Skittles]

63. it kills me how many people claim they have "no time" to exercise

but they'll spend endless hours watching TV, surfing the internet, etc

[brewens]

27. I worked for a beverage distributor in the 80s and questioned fructose. It was in New York Seltzer that

was being promoted as all natural. I tried a couple and thought it tasted like any other sugar and asked what it was? If it's not some diet sweetener and isn't lower in calories, what's the difference? The beverage rep didn't have an answer and my boss thought I was being an ass.

That NY Seltzer maybe used more natural flavoring, but the only difference between that and other sodas was they didn't use food coloring. Once sales picked up, they came out with diet NY Seltzer that had artificial sweeteners. I laughed my ass of over being so freakin' right! LOL

[Windicator]

37. HFCS is the sputum of the industrial GMO & glyphosate corporate cornholing of the planet

[TexLaProgressive]

34. I reserve judgement since I cannot read and study the study

I am more than a little cynical about so called science journalism. They tend to hype parts and ignore other parts of studies. It is shoddy science reporting that is one of the causes of widespread distrust of science.

Think about coffee - it is bad, it is good, it will kill you, it will increase your life (rinse, repeat, rinse, repeat infinitum. So people say, I don’t know what to believe. They are all wrong.

It is my opinion that the overloading oof concentrated sources of fructose from excessive use of both sucrose and high fructose corn syrup is decreasing the health of people. I had a history of high triglycerides. Years ago I read a study on a drug being tested to lower triglycerides. They used Wistar fatty rats and gave them a 10% solution of fructose for their water to cause them to have high triglycerides.

Hello, does high consumption of fructose cause elevated triglycerides in some people?

[Marthe48]

43. Read the labels

The best change I made for myself was cutting out processed food. Avoiding those, I cut out a lot of high fat, carbs and fructose.

[exboyfil]

45. Yes

Stay on the outer perimeter of the grocery store as much as possible.