Who Wants Seconds?

@ Bill and Laura:

Actually, many are making the case that high-fructose corn syrup and other similar refined carbohydrates are uniquely bad for the human body. Sure, the poison is always the dose. But if you take a look at population studie…s that account for when previously unexposed people start eating those things you find extraordinary increases in obesity, diabetes, heart disease, and cancer. There’s lots of epidemiological evidence for this. As for artificial sweeteners, there’s some evidence that mimicking a sweet taste does kick of some neurological mechanisms that cause the body to act like it just ate real sugar, but the evidence for this– and for other poor health effects– are much more scant.

I think, Bill, in this piece you really did not concentrate on the key point above regarding refined carbohydrates. Which is funny, because you just made a glancing blow on the subject and the corn lobbyists are already on you. But that is the story. It so happens that the obesity epidemic in America happened to coincide with the increased consumption of these items, at least partly because of the demonization of dietary saturated fat.

We are not, I think, getting fatter just because we are consuming too much food. We are getting fatter because we are consuming the wrong macronutrients. And it isn’t just calories. It is the metabolic effect of those calories.

If you haven’t already, Bill, I *highly* recommend Gary Taubes “Good Calories, Bad Calories” for coverage on this subject. The dude has convinced me, and I have my own weight-loss and health success story to back up the rhetoric. And Taubes is not a lightweight. He’s won the Science in Society Journalism Award of the National Association of Science Writers three times and was awarded an MIT Knight Science Journalism Fellowship for 1996-97.

Bill Coffin I hear you, Karl. And thanks for the awesome comment. The NYT Magazine did a piece on sugar – fructose, specifically – this last weekend, and I hear it’s a doozy. My food science knowledge is not the best, so I have tried to not get into th…e unique shortcomings of refined carbs, mainly because I don’t feel that I know what I’m talking about, so when I get into their role in the obesity epidemic – and it really is an epidemic – I tend to give them a pass for simplicity’s sake. I should stop that.

I’ve come across the theory that artificial sweeteners evoke a response from the body that expects sugar and actually makes you hungrier when there is no sugar to be had…not sure how strong the science behind it is, but anecdotally, I can tell you that my snacking goes up if I ingest any kind of artificial sweetener, which is why I must avoid them.

As for the effect of refined carbohydrates…we can’t really discuss obesity in this country without discussing them, as they’re a HUGE part of the problem. The point of my article wasn’t so much the science of obesity, but to hit my audience over the head with the fact that the obesity problem is, in fact, costing all of *them* money, so it’s in their best interest to do something about it. I will most likely follow this up with additional articles, and the science of refined carbs needs looking into. I am confident at least a few life and health insurance companies are investing either directly or indirectly in corn refining. If all I can do is to get the insurance industry to stop investing in enterprises whose products hurt policyholders, then I can say I got the insurance world to do something about it. Which, given the industry’s resistance to change, would be something. I’m a long, long, long way off from that, though.

When you’re telling a non-food industry to do something about obesity, it can come off as expecting an industry to pick up the tab for something it’s not really a part of. My readers are already seriously bothered by health care reform, so I can’t just say, “Hey, you guys. You’ve got a lot of money. Why not fix this problem where people eat too much, eat poorly and don’t exercise enough?” There is no call for that. But for an industry that is looking to find ways to cut its costs, it’s overlooking one so obvious it has escaped notice. And that is obesity.

Thanks for the recommendation on “Good Calories, Bad Calories.” I’ve heard good things about it. I’ll be sure to pick it up.

Karl U. Bucus That article on sugar is from the same guy who wrote “Good Calories, Bad Calories”, btw.

One question to ask your readers vis a vis personal responsibility: Do they say “Alcoholics just need to learn to drink a little bit.” The …metaphor here is a little broad and hamhanded, but once you buy into the refined carb argument you start going down that path: Lots of people eat HFCS, sugar, and refined white flour, and something metabolically kicks in that dramatically undermines their ability to respond any differently than eating more of it. I know this to be personally, anecdotally true. I don’t eat that stuff. But if I do go ahead and eat a bowl of breakfast cereal, it’s like potato chips to me. Can’t eat just one bowl. More likely to eat three.

Also, one needs to take into account the metabolic effects of fat. Some suggest (Taubes, for one. I know. I sound like a cult member.) that people consume more calories because of the metabolic demands of their fat. It’s not that they get fat because they eat too many calories. I know this sounds– weirdly– both circular and counterintuitive. What’s the difference, right? Well, the difference is changing one’s thinking to “Why does a fat person’s body metabolize certain nutrients to fat deposits,” as opposed to “Why don’t fat people just eat less?”

The answer just might be, in part, suggesting fat people cut out the sugar and other refined carbs from their diets. Basically, cut out the things your 200k year-old ancestors would not recognize as food. Those are the nutrients that are creating the weight gain, which then creates a hormonal feedback loop promoting further weight gain. There are *plenty* of diet studies, in fact, suggesting such a regime is just what the doctor ordered to promote weight loss. And those diets– despite the increased fat content– improve lipid profiles. Oh, and there is hardly any evidence that dietary saturated fat leads to increased mortality. And I say “hardly any” in the spirit of being generous to those who say it does.

And, finally (and thanks for the rant-space. You are most hospitable and kind) please note: The obesity epidemic in America pretty much started when public health agencies started demonizing fat and dietary cholesterol, and instead promoted the consumption of various carbs in their place.

Bill Coffin And this, boys and girls, is why it pays to be Karl’s friend on Facebook. This guy does smart chatter like nobody else. You should see his political threads. Good stuff.

My major shortcoming in food science is that I have, for a long time, r…elied on my wife, who knows way more about all of this than I do. (You and Alli would have the most amazing food conversations, Karl.)

When it comes to HFCS, sugar and refined flour…I totally get where you’re going. I had the same exact problem, especially with cereal. It was only when I cut that stuff out of my diet did I realize I just did not want it like I used to. A few weeks ago, we got boxes of cereal (health food stuff) for the kids, and Alli was rightly worried I might tear into it at night. It was easy for me not to. I just did not want it any longer. I think there is a lot to the metabolic feedback look caused by refined carbs and the like. We are not biologically engineered for it, so it does wonky stuff to us. The insidious thing about it is how subtly it hijacks our sense of want. Breaking away from this kind of eating really is a bit like breaking other forms of addiction.

As for how my readers would respond to the notion of alcoholics practicing moderation (good one, BTW), one of my first editorials here openly wondered how many life and health CEOs are overweight or obese. None of them should be, but there are plenty who are. This is true of the rank and file in the industry, as well. To openly practice unwellness while selling insurance against death and illness is mind-boggling to me. I can’t wait to see what kind of response I get when I write the same kind of article about tobacco products. Or the investment portfolios of the L&H industry. I am convinced at least one company invests in products that directly hurt their own policyholders…and their bottom line. We’ll see if I’m right on that one.

Karl U. Bucus So kind, amigo. And back ‘atcha 100%.

Karl U. Bucus Oh, and I should share: The only insurance salesman I know well, personally, is GIGANTIC.

Laura That NYT article backed the same point I made: HFCS or sugar, it has the same effect on your body. Companies swapping HFCS for sugar in processed food will be just as bad. The article also talks about quantity being the problem — how much …sugar (or HFCS) *could* be dangerous for us. And just as the evidence is not quite in for the toxic danger of sugars (in various forms) — and I’ll say from the article, I’m willing to consider the hypothesis — what little has been done regarding artificial sweeteners has me just as wary. As the article pointed out very well, our lack of research on these theories does not necessarily excuse their plausibility.

Laura And taking Bill’s fine article and jumping into an entirely different line, the other factor that makes any of these studies so difficult is the variations in the human body’s ability to metabolize what we put into it. Nutritionists are rea…lly only just starting to recognize the different needs of different metabolisms. And whereas a crapload of sugar isn’t going to be good for everyone, what one body can handle safely and another cannot makes research very tricky. Whether those abilities are genetic or environmental (whether exterior environment or the result of conditioning to the “food” and “drink” (because let’s face it not much of what we put in there is really either) is a whole other facet that messes with our attempts at understanding. Then we throw in the anecdotal, which on personal levels is so hard to ignore. I cannot digest artificial sweeteners, thus I infer from my body’s rejection that there has to be something very wrong with it. People feel great after giving up — fill in the blank — and assign blame to that element. But the realities and the science can be so different. I think the only thing that we can say for sure goes back to the whole foods argument — eat almost everything in a form as close to its original state. And eat less of it, a lot less.See More

Laura Oh, and sorry Bill for totally hijacking your post with my diatribe.

Karl U. Bucus Compared to me, Laura, you were the soul of brevity.

And I love your concluding advice, and (for me) would just change it to “Eat almost everything that our evolutionary ancestors ate.” When most people do that their hunger levels plummet. D…o that and the quantity issue become much more manageable– for many taking care of itself without any intent at all– although for others there’s certainly a psychological element that still needs to be addressed, too.

My personal exception? Cheese and other dairy. Love it, and tolerate it well. But other people, not so much. There’s that individual variation, again.

Laura Sullivan And for me,the exception: In all this sugar talk, no one can ever convince me that a fine French pastry — preferably with some element of cream — is not a work of art to be devoured by the eyes, body and soul. But I also eat them rarely, if for no other reason than a fine French pastry — sadly, even in France — is hard to come by.

Bill Coffin It is no hijack when it raises the collective intelligence of the thread, Laura. :-)

Karl U. Bucus Don’t fear the cream. It’s health food. Much better for a person than the blue ultrahomogenized skim milk crap. Not even lipidophilic me, though, recommends it as a default beverage for hydration.

That’s the conversation so far. No telling how long it might go on for, but I thought you might get something out of it. Why, again, does this matter? Because the health insurance industry is currently paying out about $80 billion a year in extra costs linked to obesity. $80 billion a year. That’s $800 billion in a decade. At a time when the industry is talking about the need to attack health care cost drivers, obesity is right out in front as one that is largely preventable, yet the industry efforts to address it seem not to be making a dent. Obviously, the industry needs to do more if it expects to reduce the costs here.

Oh, and if you haven’t friended National Underwriter on Facebook, do! Shoot me a friend request while you’re at it, and I’m certain to accept. That goes for LinkedIn, too. Also, if yould like to follow my friend Karl on his adventures, check out his Twitter feed at karl_bucus. He’s with MS Health Communications. Social media is worth your time, trust me.