narush points out elsewhere that this isn't a controlled experiment, so take these numbers with a grain of salt. Also I am not a statistician, so take this with another grain of salt.
That being said, if I am interpreting Table 2 correctly, the study is saying that consuming a large amount of surgery beverages causes your risk of having low-testosterone related problems to rise by 2.29 times compared to not drinking many sugary beverages. This is after correcting for age, race, BMI, alcoholism, and physical activity levels.
The risk increase before correcting for these things is 2.78 times, so that would seem to indicate that sugary beverages do have a pretty large effect compared to the confounders they choose, though it is still possible sugary beverage consumption is acting as a proxy for something else.
Is it the sugar or BPA lined cans? Also do they mean "sugar" or high fructose corn syrup? Seems like men had higher test levels in the era of glass bottles and real sugar soda.
Agreed. I am not saying that full-sugar soda is healthy, but it seems in the past people ate a lot of sugar and seemed to have less endocrine problems than they do today.
That's unquestionably what the observational evidence shows. (Just look at pictures of soldiers and other men from WWII (wiry and rail-thin, but strong), Vietnam (still skinny, but getting heavier), and Iraq/Afghanistan (a surprising number of guts and much more flabbiness).
My guess is that there's more to both HFCS vs. sugar and the continuous exposure to endocrine disruptors in food, food packaging, etc. Think about it - how little of your life are you not in contact with plastics anymore? (If you're typing a reply, you're rubbing on those plasticizers again...)
In the era of glass bottles and real-sugar soda, we drank a hell of a lot less soda. The era of free refills on sodas not just existing but being expected, and 32-ounce "medium" size soft drinks is quite recent.
Also, I'm unconvinced a small difference in the balance between glucose and fructose is worth treating HFCS as different from beet or cane sugar. Its effect on the price of sugar is a different matter, however.
[EDIT] see the 1989 skate film Gleaming the Cube for an example from a few years before free refills started being advertised fairly frequently, and a solid decade before they became the overwhelming norm: there's a Pizza Hut in it with an advertisement posted on the side of the building for a special on pitchers... of soda, not of beer.
This is what I was thinking. Rate of consumption between then and now has to heavily skew towards now. I've worked with multiple people who would come to work with a 64oz of soda (diet, if that matters) in the morning, finish it by lunch time, and come back from lunch with it refilled. I assume these people are extreme cases, but even average soda consumption has to be on the high end.
It's really easy, even if you're not that big a soda fiend and wouldn't think of downing 128 ounces of soda at work (these people are less rare than one might hope, I think, though), to accidentally down 40+ ounces with a long meal, with a waiter coming by refilling your drink every few minutes. Things were different when you had to ask for a refill, and understood you'd be paying for two drinks to get it.
Then you get specials that make the unlimited soda effectively $0.30 or whatever. Ugh.
I do agree that this investigation seems warranted but they are specific about saying that it seems like "some component" in the beverages is responsible, not even saying glucose or fructose etc. etc.
For anyone wondering, this is not an experiment, it's an epidemiological study. I've commented about it on HN before [1], but nutritional epidemiology is in its own league of shady science. If you didn't know, 80% of things you eat give you cancer [2].
That being said, sugar is bad. Main-lining sugar by drinking it in huge concentrations seems even worse!
Edit: that being said, if you are doing nutritional epidemiology, or any data science for that matter, check out Mito [3]! It's what I do when I'm not shit-posting on sugar on HN :)
Sugar is not bad. Just like meat or bacon is not bad.
Why would sugar on its own be bad? Obviously it's the whole lifestyle and diet that is bad. There are cyclist that carb load by eatig raw sugar and have no metabolic issues like some of the overweight diabetics do when they drink their second gallon of sugary coca cola.
I think you can make a solid case that, for most people, fructose and therefore sucrose is bad in any significant quantity. Sure, fructose can help replenish liver energy stores if you're an athlete, but most people aren't.
This always confused me. Why does the WHO only have guidelines on "added sugar", why not all sugar?
Based on a naive reading of things, I removed fruit from my diet as well, but that's against WHO guidelines: I used to eat like 3 Fuji/Envy a day (haha).
I remember reading a news story that an international organization (in my memory it was the UN) wanted to issue a warning about all sugar, but the US government representatives lobbied hard for the wording to be changed, because of the US food industry.
Sadly I once tried to refind this story by googling but couldn't find it again, so I might as well be screaming, "the second coming is nigh!"
It's really well known that fiber interacts with the gut microbiome and the immune system. There's at least a decade of mainstream publications backing up that fiber helps inducing regulatory T cells. These are needed to avoid inflammation.
This is not true. The Robert Lustig scaremongering is a big lie. In his talk he mentions the healthy Japanese but he does not mention that they eat more calories from fructose (in percentage of their consumed calories) than USA citizens yet are healthier.
Similarly how people stand against epidemiology they should stand against demonizing single ingredients.
Apple, by Lustig's opinion, is the worst fruit there is but he will never, in a scientific study, demonstrate the ill-effects of consuming apples, while another group consumes the same equivalent amount of raw fructose extract.
>Another nutrition expert, Dr. Robert Lustig, a professor of pediatrics at the University of California, San Francisco, who has called sugar “toxic” at high doses and fructose the most “actionable” problem in our diet, is still a fan of fruit. “As far as I’m concerned, fiber is the reason to eat fruit,” since it promotes satiety and the slow release of sugar.
There are lots of examples that support your argument.
For example, there are hunter-gatherer tribes living today that consume a significant amount of sugar (up to 60% of their calories) and don't have the same problems with obesity, diabetes, etc.
I'm no expert but it seems that the human body doesn't handle bodyfat very well. Perhaps all of this negativity around sugar can be explained by the fact that sugar is calorie-dense and calorie-dense foods tend to make people fat. Especially in the hyper-palatable forms we have in America.
> Perhaps all of this negativity around sugar can be explained by the fact that sugar is calorie-dense and calorie-dense foods tend to make people fat.
Sugar is less calorie dense than fat, and this kind of naive reductionist CICO thinking would tend to support the war on fat that preceded recognition of the problems associated with sugar.
It’s true that humans are not well adapted to deal with persistent surplus, but sugary persistent surplus seems to be a particular problem.
CICO is how the body works. If you absorb more calories than you burn you will gain weight. It also doesn't matter the source of the calories. We have metabolic ward studies that tell us that.
> sugary persistent surplus seems to be a particular problem
I agree. In fact one of the prevailing theories of diabetes is that fat molecules enter the cell and get in the way of insulin absorption. In other words, insulin resistance.
Really, hunter-gatherer tribes eat 60% of their calories in refined sugars? Or are you conflating any form of sugar (specifically in fruit) and refined sugars such as in soft drinks?
No I'm talking about honey or plain white sugar depending on the tribe.
I forgot their names but there are 3 main tribes that I remember being studied. Two of them ate significant amounts of honey and a third traded for refined white sugar.
In that paper they also reference the Mbuti pygmies of the Congo. Specifically:
"The Mbuti of the Congo forests eat large amounts of honey. According to Ichikawa (1981), honey is their favorite food. At times, during the rainy season up to 80% of the calories in their diet come from honey."
I wonder, though, what happens if you investigate the important variables - "up to", "during the rainy season," - maybe the human body can tolerate this for short periods of time, but not 24/7; and pygmies makes me think lower growth hormone / IGF-1, so the impact of the sugar may not be near as bad
Yeah, this has been my general takeaway: calorie-counting and things like intermittent fasting are much more important than reading ingredient labels (for people who don’t have allergies and diet-related health issues like diabetes).
>> there are hunter-gatherer tribes living today that consume a significant amount of sugar (up to 60% of their calories) and don't have the same problems with obesity, diabetes,
The reason they don't have those issues is they are constantly burning calories and in constant motion. H/G is not an easy life and those tribes (both men and women) put in a ton of manual labor. In college I remember one film where a tribe in Papua New Guinea were shown climbing a 15ft tall palm tree. All three males they showed were totally shredded. Six pack, lean upper bodies, biceps and legs were all cut.
I would imagine the sugar gets burned up pretty quickly and it not only a source of calories but a primary source of energy - which is needed for how they live.
That supports my claim. If they burn off the calories then they wont get fat and therefore avoid metabolic issues.
My whole point is that the bodyfat is causing the issues. If sugar was the root cause then we should be seeing diabetes, etc. in these hunter-gatherer tribes.
> he will never, in a scientific study, demonstrate the ill-effects of consuming apples, while another group consumes the same equivalent amount of raw fructose extract.
I can imagine lots of reasons for not running this study. Maybe there's no funding or interest in it. Or maybe it falls short of proving what you're hoping it proves. Or maybe he's busy with a dozen other things. I have no idea. It's certainly an effort that needs to be justified. Just saying he isn't doing something isn't particularly enlightening. Much better would be if you could link to some other study on this and show the results didn't match what he claims.
> In his talk he mentions the healthy Japanese but he does not mention that they eat more calories from fructose (in percentage of their consumed calories) than USA citizens yet are healthier.
No comment on Lustig in general, but 3 comments on your criticism:
- He literally says in his talk that the Japanese diet "eliminates fructose". So it's not really that he doesn't mention what you're saying; he actually claims the opposite is true, so he addresses this head-on. Do you have a link or something (for those who don't know) that show's he's wrong about this you could share? You could try to shoot down down his argument if you show he's wrong on that basic fact. Make sure you get the details correct, though, like the time period (in case things have been changing).
- "Healthier" is too vague. They could be doing better on lots of metrics but not the particular one he's talking about, but come out "healthier" overall.
- Similarly, there could be a million and one other things that they do differently from Americans that could make up for whatever damage fructose is alleged to do. Just because the end result is that they're healthier and that they consumer more fructose doesn't mean fructose isn't having a negative effect on them.
You haven't really provided any more support for your argument than he has at all, so it's hard to take your word over his (regardless of whose might be right). If you have something to support your position that would be super helpful.
Yes exactly. Sugar should probably be placed in the same category as alcohol in terms of health consideration. It's fine to enjoy in moderation, but fundamentally toxic. Less acutely toxic than alcohol, but more strongly habit-forming.
Sugar is not fundamentally toxic. This is a very poor conclusion to draw, and even more so when, as someone else suggested, expanding this to all carbs.
Glucose is used in IV drips, and in emergency conditions, providing someone with glucose and electrolytes can prevent them from passing out.
When people say sugar they are generally referring to sucrose. When they say that sugar is toxic, it's not because it's broken down into glucose, it's because it is also broken down into fructose.
The metabolism of fructose is somewhat analogous to that of ethanol.
Of course not, because that study analyzes concentrates and not natural source of fructose. Eating the equivalent amount of fructose used in those studies in fruit will never get you similar effects to ethanol. These studies are interesting but vacuous.
Nice trolling, I hope, because it’s terrifying if you’re serious. Sugar basically doesn’t exist in nature without fiber. Animals have not evolved to consume significant quantities of it. Bacterial flora in your gut is different when you have sugar and not enough fiber.
Jokes aside, there are a few natural sugar sources without fiber, like sugar cane (it has fiber, but we just spit it). I think we can all agree that eating too much honey or sugar cane juice would be bad for our health.
There's also sugars like inulin (https://en.wikipedia.org/wiki/Inulin), which are actually classified as soluble fiber because we can't digest them, so the bacteria in our digestive system does it for us. Inulin is a prebiotic, so it's actually healthy to eat in moderation.
Inulins just aren't sugars. As you say, they're categorized as soluble fiber. Any definition of sugar that included inulins would include all soluble fibers.
Yeah nature does create sugar with little fiber, but it's not comparable to 1) the amount of high-fiber sources, and 2) the amount of refined industrial sugar.
I'm not trolling. There's a giant wave of misinformation all of a sudden scaremongering around another ingredient, sugar. And the individuals boast on how this was previously done for fat and how epidemiology makes everything cancerous.
Both approaches entirely missing the diet and lifestyle connection and just scare people into restrictive and orthorexic diets and behavior.
> Obviously it's the whole lifestyle and diet that is bad
Of course, we all recognize that eating small amounts of sugar is not the problem.
The reality is that most of us are consuming reasonable amounts of sugar in our normal diets before we even start introducing refined sugar products like sweetened beverages or candies. When people say "sugar is bad" it's over-simplified, yes, but they're not literally suggesting that glucose is inherently evil. The point is that sweets and treats where refined sugar is present in unreasonable quantities are not good for you, as is clearly the topic in this study about sweetened beverages.
> There are cyclist that carb load by eatig raw sugar
Not at all relevant for anyone except elite athletes preparing for an extreme exertion. That said, there are some concerns about ingesting a bolus of refined sugar outside of the context of a meal, which is a glycemic stimulus so intense that it's virtually impossible to achieve during ordinary diets. Even athletes prefer to pace their glucose ingestion and/or ingest carbohydrates as part of a meal with fiber and other mass that slows absorption. Chugging raw sugar is an edge case.
For every person who can control their sugar intake enough to use it as a tool there are like 10 who can't, so I think its normal to expect people to have trouble with it
I ate more sugar than anyone I knew, and in 2011 I was diagnosed with type II diabetes.
I had no family history of diabetes, I was never overweight, and was always athletic.
Admittedly, this is a sample set of 1, but I remain convinced that my voracious appetite for sugar played into my diagnosis. I no longer eat sugar (with the exception of fruit).
Usually, glucose is regarded as the worst from an insulin resistance perspective - makes it way directly to your blood causing a large spike in blood sugar.
Fructose isn’t as bad from that perspective because it has to be metabolized by the liver first. But with that in mind, consuming too much fructose can lead to nonalcoholic fatty liver disease which is basically cirrhosis but from other causes.
For testosterone, they’re looking a sugar sweetened beverages which would either be sucrose or glucose-fructose (HFCS), so it cannot be answered
Here’s a recent study that found that sucrose and fructose double liver fat production when compared to glucose. Both need more “processing” than glucose making them more expensive. My theory is that the body compensates for this by trying to increase fat stored. The study found that this happens even with moderate amounts of sugar.
>Ninety-four healthy young men took part in the study. Every day for a period of seven weeks, they consumed a drink sweetened with different types of sugar, while the control group did not. The drinks contained either fructose, glucose or sucrose (table sugar which is a combination of fructose and glucose). The researchers then used tracers (labeled substances that can be traced as they move through the body) to analyze the effect of sugary drinks on lipid metabolism.
>Fructose and sucrose double fat production beyond food intake
> sucrose and fructose double liver fat production when compared to glucose
Of course it does. Sucrose is 50/50 fructose/glucose and fructose uses the liver as the metabolic pathway but glucose does not.
Pretty clueless that the linked article tries to correlate these results with type 2 diabetes, when insulin resistance is caused by glucose intake. The only correlation there is that if you're consuming a lot of fructose, you're probably consuming a lot of glucose, too.
I second this. Nutritional epidemiology is a crime against science and is responsible for countless deaths and billions in lost productivity, unnecessary medical treatment. Fight against nutritional epidemiology for the good of society.
There are mountains of evidence. It gets overlooked because of the momentum of dogma and the entangling of politics, dogma and research grants/funding. And it’s spread out over many, many individual topics and issues. It doesn’t lend itself to a comment or a single literature review.
I will explain exactly how you can see for yourself. You only have to do one thing. Simply try to understand for yourself the biological underpinnings of human disease. Try to understand it for yourself. This will involve cracking open a biochemistry textbook. It’s not a trivial matter.
It started for me when I got to a certain age and said to myself, gee, I’m getting to the age where I should understand heart disease. So I googled heart disease. And I kept going down the rabbit hole. Luckily I already had a background in biology and chemistry. Believe it or not, that single decision ultimately unraveled into the opinion expressed in my original comment.
I am looking forward to what you find. Happy trails.
I agree there is an enormous amount of shady nutritional nonsense. I disagree with characterizing this study in that way.
This study appears credible for suggesting an association. The authors do not misrepresent this. They acknowledge it does not determine any causality or solutions.
Determining causality is expensive and time consuming. There is not enough research funding available to do that for every plausible hypothesis. We need retrospective studies such as this to determine where further funding should be applied.
I think this is a misconception. It's not about the fountain vs canned or bottle soda.
Carbon dioxide lowers the pH of a drink to 4.5, which is acidic. The acid pH level erodes teeth and one shouldn't brush their teeth too soon after drinking soda because the enamel can be damaged. (Edit: acid on your teeth is always bad, brushing or not.)
Getting a soft drink from a fountain often means getting a straw for your cup as well. Using a straw to drink does help somewhat to bypass the soda from making contact with the teeth in the first place.
The pH of soft drinks is more typically in the range 2-4, due to the addition of various acids.
And the negative effect of soft drinks on dental health is primarily from the action of acid-producing bacteria metabolizing sugar. Diet drinks aren't nearly as bad for your teeth, carbonated water barely has any effect.
> Other demographic and clinical variables examined as potential confounders included age, sex, race/ethnicity, poverty/income ratio, BMI, serum cotinine, heavy drinker status, and physical activity MET score. BMI (weight/height2) was measured by trained technicians at the NHANES MEC physical examination [19]. Obesity was defined as a BMI ≥30 kg/m2 according to the World Health Organization criteria [20]. Heavy drinker status was defined as respondents who reported consuming alcoholic beverages ≥4 times/week in response to the question “In the past 12 months, how often did you drink any type of alcoholic beverage”? Physical activity was estimated by summing the time spent weekly engaged in activities as reported by participants, multiplied by the metabolic equivalent of task (MET) value for that activity, which yields a MET-h index. One MET is the energy expenditure of 1 kcal/kg body weight per hours [21]. MET-min/week ≥500 was considered physically active, and < 500 MET-min/week was considered non-active.
I haven't finished reading it, but they do seem to have considered these other variables (body fat by using BMI as a proxy).
I know that they are considering it but the variables are so noisy that the mathematics won't work. It never works when it comes to epidemiology. It works for physics.
Interesting. It would be even more interesting to see if the High Fructose Corn Syrup used in most sweetened drinks today has a different effect from the sugar used in previous generations. Given the changes in Men's morphology over the past 50 years, something is definitely making men fatter and softer (and of course, T is probably a large part of that...)
There is much greater consumption of processed food today than 30 years ago. "Food science" wasn't so clever back then, so the boxed and premade foods were not especially tasty.
Now they can be addictively tasty. And in these busy times with lots of things grabbing our attention, premade foods - even ones which would appear to be made up of all good ingredients - are the easy choice.
To give processed foods a longer shelf life, they need more salt; but to compensate and make them palatable they then need more sugar. So even ignoring the less clear downsides of how processing might affect the chemistry, the simple observation is that foods have more added sugar or sweeteners now than ever before.
In human history, that's a pretty rapid and significant change... much like the body shape changes that have occurred during the same 30 years.
HFCS varies between ~40 to ~55 percent fructose. Compare this with sucrose (table sugar) which is 50% fructose. If it were the case that HFCS had an outstanding effect on health, it would be in the non-sugar part of the HFCS.
I think the simple explanation reflects reality the best: the diet in the US and now the rest of the world contains more foods which are rich in sugars and oils, which are highly processed and therefore easily digested, and which were designed to stimulate cravings to facilitate eating and sales.
Rich foods are more calorie dense. Since satiety is partly related to volume of food consumed, rich foods can provide sufficient calories without diminishing hunger.
Highly processed foods are effectively partially pre-digested. This increases the energy availability of the foods. For example, you will get more calories from white flour than from whole wheat flour than from wheat berries.
Finally, products that have been successful are ones that sell more. For food marketers, the goal is to optimize the "bliss point", which is a balance between salt, sugar, and fat content. This is important because, in the past, when people's lives became more sedentary, they ate less in response. Targeting the bliss point has reversed that trend.
"""
After adjusting for possible confounding variables, BMI was an independent risk factor for low testosterone level
"""
So after adjusting for BMI, sugary beverage consumption had nothing to do with T. But BMI is correlated with T which is (very) old news, and sugary drink consumption is presumably correlated with BMI. Yawn.
The interesting point in this study and one they reference is that
>... After adjusting for possible confounding variables, BMI was an independent risk factor for low testosterone level
In other words, even adjusting for obesity, consuming sugar-sweetened beverages is a risk factor. There is other sugar -> low testosterone link, separate from sugar -> fat -> low testosterone with adjusted odds ratio 2.29.
As a 41 year old man getting remarried, I'm personally interested in the subject of serum testosterone. I have noticed a sharp decline the past couple years and I'm sure aging plus computer job plus covid is a noxious blend.
General advice out there includes lower stress, lose weight, keep active, get sleep, weightlifting is good, cardio is good but maybe not too much, IF may be good. Scientific studies are good but it takes a lot of work to even prove directionality it seems at times.
So please, lay on me the personal anecdata of what you've seen give good results in a safe way. My own anecdote, years back I did martial arts training which seemed to send my sex drive and aggression through the roof. A large component of this was isometric stance training so I've tried incorporating that a few times a week and am seeing some striking changes in sexual function. Could that also be more sunshine, walking, fresh vegetables in diet? Could be, yes, but changes have been evident.
Can anyone else report good results from their own experiences?
Cholesterol/saturated fat will clog your penis arteries which is the leading cause of ED. (In fact ED is one of the first symptoms of heart disease, the No.1 killer.)
I don't since I'm pretty young, but a few people I follow do talk about it. Check out Greg Doucette on Youtube qho talks about it a lot. (Although I think there are better sources online and you should ask your doctor)
Yeah, maybe I can help here as I faced the same stark realisation some years back.
Generally speaking, higher testosterone levels are correlated with higher protein and fat intakes, mainly because cholesterol is used by the Leydig cells in your balls to produce testosterone. I am not saying you should start adding butter to your coffee or whatever other dumb things the keto people are saying, but going very low-fat and/or low protein is not good for your test levels.
I greatly increased the amount of animal protein I eat to roughly 2g/kg (roughly 1g/lb, if that's easier). I ignored fat, just consuming it with my protein sources. To make room for the added protein, which is now the centre of my diet, I eliminated most starchy carbs (pasta, rice, etc) as they are low-value foods. I still eat bread because, well, freshly baked bread is delicious and I am not a low-carb zealot. My main carb sources are now vegetables, lentils and beans, the latter two of which have some protein as well. But the best sources are always animal-based and this will no doubt irritate many people who read this.
I had my T levels taken before and after and I saw a pretty big increase in free test. But to be honest, test levels vary a lot even over the course of a single day so the best thing is to simply go by the old standby: are you consistently getting wood in the morning? If yes, you are probably okay.
Another bonus to the high-protein life is increased muscle protein synthesis. When you are young, this is largely hormonally driven but as you get older, falling test levels make it more difficult to build and keep muscle. This leads to age-related muscle wasting, also called sarcopenia. You can delay this process simply by eating a lot more protein to drive an anabolic response.
That is very insightful information! Thank you greatly.
I must ask, do you know if there is a relationship between engaging in cuckoldry and developing low testosterone levels?
It was a pastime that I knew nothing about until I started working at a Ruby shop about three years ago. Some of my coworkers were active cuckolds and they encouraged me and my wife to give it a try. We did and it was quite the thrill seeing her experience things that I could never get her to experience even though I did not ever consider myself to be an inadequate lover.
But as time went on and I was denied all intimate contact with my wife, I found my body starting to change. My testes shrank until I could feel them no longer. My doctor did not seem concerned, though, but my T levels showed a decline.
When I got a new job and we moved to a different city we stopped that pastime. My testes have gotten bigger again but I do not think that they are as big as they were in times past.
> lower stress, lose weight, keep active, get sleep, weightlifting is good, cardio is good but maybe not too much, IF may be good
It's annoying that these things seem like hand-wavy common sense advice for improving general health and not just raising T, but they are interrelated and helpful when it comes to boosting T.
Lowering stress reduces cortisol, which is catabolic. Your note about too much cardio plays in here as well. It increases cortisol and is also catabolic in its own right.
Lowering cortisol helps you lose weight and get better sleep.
Losing weight and intermittent fasting both improve insulin sensitivity.
Insulin sensitivity makes for better weightlifting gains.
Weightlifting increases T in its own right.
I've had good results with lifting heavy (3x 5-8 reps, 85% 1RM) in a fasted state around 11AM, followed by lunch and early dinner, maintaining a roughly 18/6 IF window.
As a type 1 diabetic for 20+ years, I feel like two large but underrated issues in the overall sugar conversation are (1) the functional aspect of fiber and (2) the rate of consumption and its effect on the body (e.g. drinking a SSB all at once).
The body just has trouble dealing with a large amount of both insulin and sugar at the same time. When we reduce fiber intake the issue compounds.
Simply spreading out your normal daily sugar consumption throughout the day (you know, chew your food slowly ;) would have huge benefits in terms of your body's ability to convert glucose efficiently (what's at the heart of the type 2 diabetes epidemic). Add fiber back into the equation would also help this immensely.
I say all this to say that we shouldn't ignore the machine like qualities of the body in the discussion. Think about your intake rate along with the overall consumption.
>Multivariate logistic regression revealed the odds of low testosterone was significantly greater with increasing SSB consumption (Q4 [≥442 kcal/day] vs. Q1 [≤137 kcal/day])
442/4 = 110.5+ grams of sugar, per day, every day. Before even including food. Do people really not know living like this is bad? Is this result really surprising?
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[ 3.0 ms ] story [ 213 ms ] threadThat being said, if I am interpreting Table 2 correctly, the study is saying that consuming a large amount of surgery beverages causes your risk of having low-testosterone related problems to rise by 2.29 times compared to not drinking many sugary beverages. This is after correcting for age, race, BMI, alcoholism, and physical activity levels.
The risk increase before correcting for these things is 2.78 times, so that would seem to indicate that sugary beverages do have a pretty large effect compared to the confounders they choose, though it is still possible sugary beverage consumption is acting as a proxy for something else.
they didn't say anything about causation.
It's also possible that lower-testosterone causes you having a "sweet tooth".
My guess is that there's more to both HFCS vs. sugar and the continuous exposure to endocrine disruptors in food, food packaging, etc. Think about it - how little of your life are you not in contact with plastics anymore? (If you're typing a reply, you're rubbing on those plasticizers again...)
Also, I'm unconvinced a small difference in the balance between glucose and fructose is worth treating HFCS as different from beet or cane sugar. Its effect on the price of sugar is a different matter, however.
[EDIT] see the 1989 skate film Gleaming the Cube for an example from a few years before free refills started being advertised fairly frequently, and a solid decade before they became the overwhelming norm: there's a Pizza Hut in it with an advertisement posted on the side of the building for a special on pitchers... of soda, not of beer.
Then you get specials that make the unlimited soda effectively $0.30 or whatever. Ugh.
That being said, sugar is bad. Main-lining sugar by drinking it in huge concentrations seems even worse! Edit: that being said, if you are doing nutritional epidemiology, or any data science for that matter, check out Mito [3]! It's what I do when I'm not shit-posting on sugar on HN :)
[1] https://news.ycombinator.com/item?id=26764060 [2] https://pubmed.ncbi.nlm.nih.gov/23193004/ [3] https://trymito.io/hn
Why would sugar on its own be bad? Obviously it's the whole lifestyle and diet that is bad. There are cyclist that carb load by eatig raw sugar and have no metabolic issues like some of the overweight diabetics do when they drink their second gallon of sugary coca cola.
Based on a naive reading of things, I removed fruit from my diet as well, but that's against WHO guidelines: I used to eat like 3 Fuji/Envy a day (haha).
Sadly I once tried to refind this story by googling but couldn't find it again, so I might as well be screaming, "the second coming is nigh!"
* The lobbying thing
* That fiber gets you full so you don't eat as much fructose
* That fiber modifies the absorption process
Similarly how people stand against epidemiology they should stand against demonizing single ingredients.
Apple, by Lustig's opinion, is the worst fruit there is but he will never, in a scientific study, demonstrate the ill-effects of consuming apples, while another group consumes the same equivalent amount of raw fructose extract.
https://well.blogs.nytimes.com/2013/07/31/making-the-case-fo...
>Another nutrition expert, Dr. Robert Lustig, a professor of pediatrics at the University of California, San Francisco, who has called sugar “toxic” at high doses and fructose the most “actionable” problem in our diet, is still a fan of fruit. “As far as I’m concerned, fiber is the reason to eat fruit,” since it promotes satiety and the slow release of sugar.
For example, there are hunter-gatherer tribes living today that consume a significant amount of sugar (up to 60% of their calories) and don't have the same problems with obesity, diabetes, etc.
I'm no expert but it seems that the human body doesn't handle bodyfat very well. Perhaps all of this negativity around sugar can be explained by the fact that sugar is calorie-dense and calorie-dense foods tend to make people fat. Especially in the hyper-palatable forms we have in America.
Sugar is less calorie dense than fat, and this kind of naive reductionist CICO thinking would tend to support the war on fat that preceded recognition of the problems associated with sugar.
It’s true that humans are not well adapted to deal with persistent surplus, but sugary persistent surplus seems to be a particular problem.
Yes. I never said that it wasn't.
> naive reductionist CICO thinking
CICO is how the body works. If you absorb more calories than you burn you will gain weight. It also doesn't matter the source of the calories. We have metabolic ward studies that tell us that.
> sugary persistent surplus seems to be a particular problem
I agree. In fact one of the prevailing theories of diabetes is that fat molecules enter the cell and get in the way of insulin absorption. In other words, insulin resistance.
I forgot their names but there are 3 main tribes that I remember being studied. Two of them ate significant amounts of honey and a third traded for refined white sugar.
>Honey represents a substantial portion of the Hadza diet (~10-20% of calories)
There is another tribe that will eat up to 60% of their calories from honey depending on the availability of food.
Another tribe trades with first-world countries for white sugar.
In that paper they also reference the Mbuti pygmies of the Congo. Specifically: "The Mbuti of the Congo forests eat large amounts of honey. According to Ichikawa (1981), honey is their favorite food. At times, during the rainy season up to 80% of the calories in their diet come from honey."
The reason they don't have those issues is they are constantly burning calories and in constant motion. H/G is not an easy life and those tribes (both men and women) put in a ton of manual labor. In college I remember one film where a tribe in Papua New Guinea were shown climbing a 15ft tall palm tree. All three males they showed were totally shredded. Six pack, lean upper bodies, biceps and legs were all cut.
I would imagine the sugar gets burned up pretty quickly and it not only a source of calories but a primary source of energy - which is needed for how they live.
My whole point is that the bodyfat is causing the issues. If sugar was the root cause then we should be seeing diabetes, etc. in these hunter-gatherer tribes.
I can imagine lots of reasons for not running this study. Maybe there's no funding or interest in it. Or maybe it falls short of proving what you're hoping it proves. Or maybe he's busy with a dozen other things. I have no idea. It's certainly an effort that needs to be justified. Just saying he isn't doing something isn't particularly enlightening. Much better would be if you could link to some other study on this and show the results didn't match what he claims.
> In his talk he mentions the healthy Japanese but he does not mention that they eat more calories from fructose (in percentage of their consumed calories) than USA citizens yet are healthier.
No comment on Lustig in general, but 3 comments on your criticism:
- He literally says in his talk that the Japanese diet "eliminates fructose". So it's not really that he doesn't mention what you're saying; he actually claims the opposite is true, so he addresses this head-on. Do you have a link or something (for those who don't know) that show's he's wrong about this you could share? You could try to shoot down down his argument if you show he's wrong on that basic fact. Make sure you get the details correct, though, like the time period (in case things have been changing).
- "Healthier" is too vague. They could be doing better on lots of metrics but not the particular one he's talking about, but come out "healthier" overall.
- Similarly, there could be a million and one other things that they do differently from Americans that could make up for whatever damage fructose is alleged to do. Just because the end result is that they're healthier and that they consumer more fructose doesn't mean fructose isn't having a negative effect on them.
You haven't really provided any more support for your argument than he has at all, so it's hard to take your word over his (regardless of whose might be right). If you have something to support your position that would be super helpful.
There is no healthy sugar by comparison.
Glucose is used in IV drips, and in emergency conditions, providing someone with glucose and electrolytes can prevent them from passing out.
The metabolism of fructose is somewhat analogous to that of ethanol.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3649103/
Does that mean it's toxic?
Honey?
Jokes aside, there are a few natural sugar sources without fiber, like sugar cane (it has fiber, but we just spit it). I think we can all agree that eating too much honey or sugar cane juice would be bad for our health.
There's also sugars like inulin (https://en.wikipedia.org/wiki/Inulin), which are actually classified as soluble fiber because we can't digest them, so the bacteria in our digestive system does it for us. Inulin is a prebiotic, so it's actually healthy to eat in moderation.
https://en.wikipedia.org/wiki/Hadza_people#Subsistence
Both approaches entirely missing the diet and lifestyle connection and just scare people into restrictive and orthorexic diets and behavior.
Of course, we all recognize that eating small amounts of sugar is not the problem.
The reality is that most of us are consuming reasonable amounts of sugar in our normal diets before we even start introducing refined sugar products like sweetened beverages or candies. When people say "sugar is bad" it's over-simplified, yes, but they're not literally suggesting that glucose is inherently evil. The point is that sweets and treats where refined sugar is present in unreasonable quantities are not good for you, as is clearly the topic in this study about sweetened beverages.
> There are cyclist that carb load by eatig raw sugar
Not at all relevant for anyone except elite athletes preparing for an extreme exertion. That said, there are some concerns about ingesting a bolus of refined sugar outside of the context of a meal, which is a glycemic stimulus so intense that it's virtually impossible to achieve during ordinary diets. Even athletes prefer to pace their glucose ingestion and/or ingest carbohydrates as part of a meal with fiber and other mass that slows absorption. Chugging raw sugar is an edge case.
I had no family history of diabetes, I was never overweight, and was always athletic.
Admittedly, this is a sample set of 1, but I remain convinced that my voracious appetite for sugar played into my diagnosis. I no longer eat sugar (with the exception of fruit).
I was only diagnosed pre-diabetic (fasting glucose > 100) the last year before I blossomed into a full-blown diabetic.
My parents were pretty strict about sweets, but once I was on my own my diet quickly spiraled into an orgy of chocolate & sugar.
Please go and read all of Gary Taubes books to see the politics and bad science behind this propaganda.
Fructose isn’t as bad from that perspective because it has to be metabolized by the liver first. But with that in mind, consuming too much fructose can lead to nonalcoholic fatty liver disease which is basically cirrhosis but from other causes.
Here’s a recent study that found that sucrose and fructose double liver fat production when compared to glucose. Both need more “processing” than glucose making them more expensive. My theory is that the body compensates for this by trying to increase fat stored. The study found that this happens even with moderate amounts of sugar.
https://scitechdaily.com/even-moderate-amounts-of-added-suga...
>Ninety-four healthy young men took part in the study. Every day for a period of seven weeks, they consumed a drink sweetened with different types of sugar, while the control group did not. The drinks contained either fructose, glucose or sucrose (table sugar which is a combination of fructose and glucose). The researchers then used tracers (labeled substances that can be traced as they move through the body) to analyze the effect of sugary drinks on lipid metabolism.
>Fructose and sucrose double fat production beyond food intake
Of course it does. Sucrose is 50/50 fructose/glucose and fructose uses the liver as the metabolic pathway but glucose does not.
Pretty clueless that the linked article tries to correlate these results with type 2 diabetes, when insulin resistance is caused by glucose intake. The only correlation there is that if you're consuming a lot of fructose, you're probably consuming a lot of glucose, too.
Wow. Links to supporting documents?
I will explain exactly how you can see for yourself. You only have to do one thing. Simply try to understand for yourself the biological underpinnings of human disease. Try to understand it for yourself. This will involve cracking open a biochemistry textbook. It’s not a trivial matter.
It started for me when I got to a certain age and said to myself, gee, I’m getting to the age where I should understand heart disease. So I googled heart disease. And I kept going down the rabbit hole. Luckily I already had a background in biology and chemistry. Believe it or not, that single decision ultimately unraveled into the opinion expressed in my original comment.
I am looking forward to what you find. Happy trails.
"nutritional epidemiology is shady science, but if you are doing it try my side project mito" can't argue with that.
This study appears credible for suggesting an association. The authors do not misrepresent this. They acknowledge it does not determine any causality or solutions.
Determining causality is expensive and time consuming. There is not enough research funding available to do that for every plausible hypothesis. We need retrospective studies such as this to determine where further funding should be applied.
Yeah, fat men have lower testosterone levels. Yeah, non-smokers have lower testosterone levels.
I drink a bunch of HFCS and sugar sweetened beverages. Don't feel like it affects my weightlifting, maybe teeth mostly.
Carbon dioxide lowers the pH of a drink to 4.5, which is acidic. The acid pH level erodes teeth and one shouldn't brush their teeth too soon after drinking soda because the enamel can be damaged. (Edit: acid on your teeth is always bad, brushing or not.)
Getting a soft drink from a fountain often means getting a straw for your cup as well. Using a straw to drink does help somewhat to bypass the soda from making contact with the teeth in the first place.
Use a straw, save a tooth.
And the negative effect of soft drinks on dental health is primarily from the action of acid-producing bacteria metabolizing sugar. Diet drinks aren't nearly as bad for your teeth, carbonated water barely has any effect.
Using a straw is helpful in all these cases.
Fountain soda ph6.5 to ph8.5 and is a suspension
The differences are stark.
Wait, is this true? Non-smokers have lower testosterone levels. That's weird.
> Other demographic and clinical variables examined as potential confounders included age, sex, race/ethnicity, poverty/income ratio, BMI, serum cotinine, heavy drinker status, and physical activity MET score. BMI (weight/height2) was measured by trained technicians at the NHANES MEC physical examination [19]. Obesity was defined as a BMI ≥30 kg/m2 according to the World Health Organization criteria [20]. Heavy drinker status was defined as respondents who reported consuming alcoholic beverages ≥4 times/week in response to the question “In the past 12 months, how often did you drink any type of alcoholic beverage”? Physical activity was estimated by summing the time spent weekly engaged in activities as reported by participants, multiplied by the metabolic equivalent of task (MET) value for that activity, which yields a MET-h index. One MET is the energy expenditure of 1 kcal/kg body weight per hours [21]. MET-min/week ≥500 was considered physically active, and < 500 MET-min/week was considered non-active.
I haven't finished reading it, but they do seem to have considered these other variables (body fat by using BMI as a proxy).
Now they can be addictively tasty. And in these busy times with lots of things grabbing our attention, premade foods - even ones which would appear to be made up of all good ingredients - are the easy choice.
To give processed foods a longer shelf life, they need more salt; but to compensate and make them palatable they then need more sugar. So even ignoring the less clear downsides of how processing might affect the chemistry, the simple observation is that foods have more added sugar or sweeteners now than ever before.
In human history, that's a pretty rapid and significant change... much like the body shape changes that have occurred during the same 30 years.
I think the simple explanation reflects reality the best: the diet in the US and now the rest of the world contains more foods which are rich in sugars and oils, which are highly processed and therefore easily digested, and which were designed to stimulate cravings to facilitate eating and sales.
Rich foods are more calorie dense. Since satiety is partly related to volume of food consumed, rich foods can provide sufficient calories without diminishing hunger.
Highly processed foods are effectively partially pre-digested. This increases the energy availability of the foods. For example, you will get more calories from white flour than from whole wheat flour than from wheat berries.
Finally, products that have been successful are ones that sell more. For food marketers, the goal is to optimize the "bliss point", which is a balance between salt, sugar, and fat content. This is important because, in the past, when people's lives became more sedentary, they ate less in response. Targeting the bliss point has reversed that trend.
So after adjusting for BMI, sugary beverage consumption had nothing to do with T. But BMI is correlated with T which is (very) old news, and sugary drink consumption is presumably correlated with BMI. Yawn.
>... After adjusting for possible confounding variables, BMI was an independent risk factor for low testosterone level
In other words, even adjusting for obesity, consuming sugar-sweetened beverages is a risk factor. There is other sugar -> low testosterone link, separate from sugar -> fat -> low testosterone with adjusted odds ratio 2.29.
General advice out there includes lower stress, lose weight, keep active, get sleep, weightlifting is good, cardio is good but maybe not too much, IF may be good. Scientific studies are good but it takes a lot of work to even prove directionality it seems at times.
So please, lay on me the personal anecdata of what you've seen give good results in a safe way. My own anecdote, years back I did martial arts training which seemed to send my sex drive and aggression through the roof. A large component of this was isometric stance training so I've tried incorporating that a few times a week and am seeing some striking changes in sexual function. Could that also be more sunshine, walking, fresh vegetables in diet? Could be, yes, but changes have been evident.
Can anyone else report good results from their own experiences?
Nutrition Facts has a page about testosterone, I'd suggest you start there: https://nutritionfacts.org/2017/05/16/foods-that-affect-test...
edit: link to a video about ED vs diet: https://youtu.be/OVXzT_RBxFk
Eat those yolks, folks.
So be sure you're asking the right doctor.
Generally speaking, higher testosterone levels are correlated with higher protein and fat intakes, mainly because cholesterol is used by the Leydig cells in your balls to produce testosterone. I am not saying you should start adding butter to your coffee or whatever other dumb things the keto people are saying, but going very low-fat and/or low protein is not good for your test levels.
I greatly increased the amount of animal protein I eat to roughly 2g/kg (roughly 1g/lb, if that's easier). I ignored fat, just consuming it with my protein sources. To make room for the added protein, which is now the centre of my diet, I eliminated most starchy carbs (pasta, rice, etc) as they are low-value foods. I still eat bread because, well, freshly baked bread is delicious and I am not a low-carb zealot. My main carb sources are now vegetables, lentils and beans, the latter two of which have some protein as well. But the best sources are always animal-based and this will no doubt irritate many people who read this.
I had my T levels taken before and after and I saw a pretty big increase in free test. But to be honest, test levels vary a lot even over the course of a single day so the best thing is to simply go by the old standby: are you consistently getting wood in the morning? If yes, you are probably okay.
Another bonus to the high-protein life is increased muscle protein synthesis. When you are young, this is largely hormonally driven but as you get older, falling test levels make it more difficult to build and keep muscle. This leads to age-related muscle wasting, also called sarcopenia. You can delay this process simply by eating a lot more protein to drive an anabolic response.
I must ask, do you know if there is a relationship between engaging in cuckoldry and developing low testosterone levels?
It was a pastime that I knew nothing about until I started working at a Ruby shop about three years ago. Some of my coworkers were active cuckolds and they encouraged me and my wife to give it a try. We did and it was quite the thrill seeing her experience things that I could never get her to experience even though I did not ever consider myself to be an inadequate lover.
But as time went on and I was denied all intimate contact with my wife, I found my body starting to change. My testes shrank until I could feel them no longer. My doctor did not seem concerned, though, but my T levels showed a decline.
When I got a new job and we moved to a different city we stopped that pastime. My testes have gotten bigger again but I do not think that they are as big as they were in times past.
Do you have any insights?
It's annoying that these things seem like hand-wavy common sense advice for improving general health and not just raising T, but they are interrelated and helpful when it comes to boosting T.
Lowering stress reduces cortisol, which is catabolic. Your note about too much cardio plays in here as well. It increases cortisol and is also catabolic in its own right. Lowering cortisol helps you lose weight and get better sleep. Losing weight and intermittent fasting both improve insulin sensitivity. Insulin sensitivity makes for better weightlifting gains. Weightlifting increases T in its own right.
I've had good results with lifting heavy (3x 5-8 reps, 85% 1RM) in a fasted state around 11AM, followed by lunch and early dinner, maintaining a roughly 18/6 IF window.
The body just has trouble dealing with a large amount of both insulin and sugar at the same time. When we reduce fiber intake the issue compounds.
Simply spreading out your normal daily sugar consumption throughout the day (you know, chew your food slowly ;) would have huge benefits in terms of your body's ability to convert glucose efficiently (what's at the heart of the type 2 diabetes epidemic). Add fiber back into the equation would also help this immensely.
I say all this to say that we shouldn't ignore the machine like qualities of the body in the discussion. Think about your intake rate along with the overall consumption.
442/4 = 110.5+ grams of sugar, per day, every day. Before even including food. Do people really not know living like this is bad? Is this result really surprising?