[jal278]

> High intake of sweetened beverages was associated with higher risk for most of the studied outcomes, for which positive linear associations were found. In contrast, a low intake of treats was associated with a higher risk of all the studied outcomes.

Not sure what to make of this -- some kind of other latent explanation (e.g. that many of those with the lowest intake of treats were on a diet due to bad health?).

From the discussion section:

> One aspect to take into consideration is however that there is a social tradition of “fika” in Sweden, where people get together with friends, relatives, or coworkers for coffee and pastries (41). Thus, one could hypothesize that the intake of treats is part of many people's everyday lives without necessarily being related with overall poor dietary or lifestyle patterns, and that it might be a marker of social life.

[lolinder]

Isn't a simple possible explanation that people who are at high risk of (or already diagnosed with) these diseases make up a disproportionate chunk of the lowest sweets consumption bracket, simply because they're the ones who are actively restricting intake on advice from doctors?

I'd naively expect most healthy people to fall in the second-to-lowest bracket—they're not actively restricting, but they don't have the pervasive bad habits of the highest consumers.

[kristjansson]

This is exactly what happened with the “red wine is good for you” claim

[ricardobeat]

That was my first thought as well, but the paper says that after excluding all people with a previous condition, that association remains unchanged. There might be something else, like particular diets, at play.

[lolinder]

That would rule out pre-existing conditions but not rule out people who already knew they were high risk for reasons other than a previous diagnosis (such as blood work, family history, etc.).

[dylan604]

Could it be that the type of sugar used in the soft drinks is different than the type of sugar used in baking and where the body processes them differently?

Yes, I'm questioning if high fructose corn syrup is worse for the body than table sugar. From everything I've ever seen, that tends to be the case.

Or could it be that the non-fructose corn syrup artificial sweeteners are having more of a negative impact as people do not limit their in-take of those beverages since there's "no sugars" or "0 calories"?

[analog31]

There might be a dietary difference, even though it seems superficially like there shouldn't be. This is my summary of the reaction from a chemist who did her master's degree in sugar chemistry: "Complex sugars (sucrose) and starches are broken up into glucose and fructose quite efficiently by enzymes in your digestive tract. Only glucose and fructose are absorbed into the bloodstream."

That chemist is my mom. So I'm biased. ;-)

The puzzle is whether table sugar and high fructose corn syrup have different dietary effects, and if they do, why. I don't think it's a settled matter.

[thatcat]

There is clearly a difference in the uptake of fructose and glucose as you can see here, no insulin is required to uptake fructose. https://phdmuscle.com/fructose-metabolism/

If there is a difference in fructose and high fructose corn syrup it would likely be the fact that it is corn based. Corn has been selected to be farmed with high glycophosate (round up ready), which metabolically different from other corns and produces some proteins not found in non GM corn. https://enveurope.springeropen.com/articles/10.1186/s12302-0...

[ltbarcly3]

No insulin is necessary? Please don't propogate nonsense.

[thatcat]

Its true, check the link and look at the metabolic pathway. insulin is a response to glycogen from the fructose 6 phosphate formed during glucose metabolism. since fructose converts to fructose 1 phosphate form no glycogen is released and so no insulin is required to uptake fructose.

Anyway, apparently HFCS contains about 50% glucose so it would require insulin, but less than pure glucose.

[ltbarcly3]

Fructose doesn't need insulin to be converted to glucose in the liver, but I don't think this is what you are thinking at all. Fructose isn't used by the body directly, it almost always has to be first converted to glucose first. Glucose does require insulin to be pulled into cells throughout the body. So fructose does require insulin to be used by the body for energy or to be stored into fat.

When you say insulin isn't needed for fructose it's a fundamental misunderstanding on a few different things.

[glial]

My layman understanding is that insulin is used to absorb blood glucose into muscle and fat cells, while fructose is processed by the liver into other things (which may include glucose), but that initial processing doesn't require insulin.

[ipaddr]

Glucose gets broken up in the liver but fructose doesn't. So those with slow liver processing like Gilbert's syndrome the differences between the two make a bigger difference.

High fructose corn syrup floods the system (body) and it can't process it quick enough.

[CrazyStat]

HFCS is high fructose compared to regular corn syrup. It's not necessarily high fructose compared to table sugar (sucrose). Table sugar is 50% fructose by weight; HFCS comes in 55% and 42% fructose varieties. The FDA says [1] the 42% variety, which has less fructose than table sugar, is used in most processed food other than soda. So fructose doesn't seem like a plausible mechanism for non-soda HFCS to be worse for you than table sugar.

I don't like HFCS--I think it gives sodas a flavor I can best describe as "sharp," based on blind taste tests I've done comparing same-brand sugar and HCFS sodas--but I don't see solid evidence that it's worse than sucrose. I think it's mostly used as a scapegoat by people who don't want to conclude that sugar in general is bad for you.

[1] https://www.fda.gov/food/food-additives-petitions/high-fruct...

[simmerup]

Don’t you have that the wrong way around?

[toast0]

> The puzzle is whether table sugar and high fructose corn syrup have different dietary effects, and if they do, why. I don't think it's a settled matter.

I don't know how you would design a study around it, and this is an anecdote, but I find sugar sweetened soda to be much less palletable than HFCS sweetened soda.

That wouldn't necessarily show up in a study comparing equal intake, but could be a factor in reducing intake of sweetened beverages in places without HFCS compared to those places with.

[djtango]

I'll go one step further. A gram of sugar in an orange is not the same as a gram of sugar in a teaspoon.

Medium matters - that sugar in an orange is dissolved in the juice which is locked in the pulp.

Who knows what the bioavailability of the sugar is in that messy fibrous orange you partially chewed? I guarantee it'll be less than that pure refined sugar in the spoon.

Our "datafication" of nutrition and stuff like calories has led to so much silly pseudoscience.

Calories are my biggest pet peeve of BS to take with a grain of salt. Why are we basing our nutrition and diet on the performance of the food in a bomb calorimeter?

[ipaddr]

Table sugar is 1/2 glucose and half fructose. An orange is 100% fructose. The medium of the pulp allows for slower absorption and the fiber does a number of things like simulating the intestinal walls.

[Remnant44]

> An orange is 100% fructose

It is not:

https://fdc.nal.usda.gov/food-details/746771/nutrients

In fact an orange is a mixture of glucose, fructose, and sucrose (which itself is glucose and fructose). An orange actually looks surprisingly like table sugar in terms of the sugar types, although you are correct that the pulp / fiber / etc do mean that the response of our body is likely different.

[chithanh]

It is known that people who consume sugary drinks are at higher risk of death from disgestive diseases, which is less so for people who consume artificially-sweetened drinks. So there may be a causal link.

https://doi.org/10.1001/jamainternmed.2019.2478

[scythe]

There do appear to be some specific effects of sucrose, although there are no immediately obvious health implications:

https://www.sciencedirect.com/science/article/abs/pii/S00223... (unclear disaccharide effect of sucrose)

https://www.science.org/doi/abs/10.1126/science.493983 (unclear, but seemingly harmful, disaccharide effect of sucrose)

https://www.sciencedirect.com/science/article/abs/pii/S00223... (disaccharide effect of sucrose but not maltose)

https://link.springer.com/article/10.1007/s00394-011-0228-x (unclear, but seemingly beneficial, disaccharide effect of sucrose)

https://www.cambridge.org/core/journals/journal-of-developme... (unclear, but seemingly harmful, disaccharide effect of sucrose)

https://onlinelibrary.wiley.com/doi/abs/10.1002/hipo.22368 (very surprising beneficial disaccharide effect of sucrose that should require further confirmation)

https://journals.plos.org/plosmedicine/article?id=10.1371/jo... (John Ioannidis, Why Most Published Research Findings are False, cold shower to the preceding)

I think that at least it is not obvious that sucrose intake should be equivalent to invert sugar intake. In order for sucrose to be saccharified, the enzyme sucrase must be produced; in order for sucrase to be produced, some internal regulation must occur; if some internal regulation occurs, other effects are at least possible. But no such effect has been clearly demonstrated as far as I can tell.

[normie3000]

> Yes, I'm questioning if high fructose corn syrup is worse for the body than table sugar.

Study is from Sweden. I think high fructose corn syrup may be a North American thing.

[Mistletoe]

>Because of its low cost and long shelf-life, HFCS is used widely in manufacturing many food products, including candy, throughout the United States. However, due to strict EU regulations, HFCS is banned in much of Europe, including Sweden.

[LargoLasskhyfv]

> due to strict EU regulations, HFCS is banned in much of Europe, including Sweden.

May be the case for Sweden, but the 'strict EU regulations' ceased to exist in 2017.

I'd guess that applies to 'much of Europe' too, then.

That aside, we always had https://en.wikipedia.org/wiki/Inverted_sugar_syrup , which is frowned upon by many.

[yieldcrv]

Could HFCS become a Schedule I substance regulated by the DEA?

[oblio]

Under the new administration the DEA (and FDA, etc) risks going extinct.

[rqtwteye]

The DEA may grow because they may start the war on drugs back up. FDA and especially EPA are definitely at risk.

[adastra22]

Have a single source to back that up?

[jillesvangurp]

> I think high fructose corn syrup may be a North American thing

It is. It's not a common ingredient here in Europe or most places in the world. Corn syrup is a weird side effect of subsidized corn farming in the US. This causes all sorts of health issues in the population.

Anyway, you'd struggle to find it in supermarkets or in food outside the US. Even coca cola doesn't use corn syrup in it's beverages outside the US. As far as I know, there is no major taste difference and I've never heard any US people complain about their coke tasting a bit off outside the US. But I don't drink cola that often myself.

[LargoLasskhyfv]

Have you ever heard of https://en.wikipedia.org/wiki/Inverted_sugar_syrup ?

( https://de.wikipedia.org/wiki/Invertzucker#Verwendung )

It is listed on so many labels as ingredient that it is really hard to avoid.

[dylan604]

> As far as I know, there is no major taste difference and I've never heard any US people complain about their coke tasting a bit off outside the US.

Apparently, you are not well informed about the happenings across the pond. It is well known that Coke made in Mexico uses sugar, and it is a known thing in the US to get Mexican Coke. There used to be a small plant in Dublin, Texas that made Dr. Pepper with sugar that was a well known for the different taste. Eventually Dr. Pepper won it's case against the Dublin plant and it is no longer available.

To claim that there's no taste difference between sugar vs HCFS just shows you're not well informed on the topic.

[rileymat2]

It is not straightforward, psychology plays a big part in perception. https://www.seriouseats.com/coke-vs-mexican-coke#toc-what-do...

> Regardless of what was actually in the serving containers, people stuck by their original choice. Those who preferred what really was the Mexican Coke the first time (we'll call these guys the Mexico Boosters) unanimously picked the Coke that I told them was the Mexican Coke the second time, whether it really was or was not. Even when the containers were completely removed from the test and the Coke was served in plastic cups, the Coke labeled as Mexican was picked by the Mexico Boosters every time.

[sickofparadox]

Dr. Pepper does make, in limited quantities, its own version[1] of the real sugar deal. It isn't stocked at major supermarkets - in fact, I've only ever bought it at a liquor store in Texas. It's fantastic!

[1] https://www.drpepper.com/s/products/dr-pepper-made-with-real...

[jdougan]

US people who have expressed opinions on the matter near me claim to like the taste of Coca Cola from other countries better. Specifically Mexican Coke, though I've heard similar sentiments with Canadian Coke.

https://en.wikipedia.org/wiki/Mexican_Coke

[bluGill]

Corn syrup isn't about corn subsidies, it is about sugar. Sugar has large tariffs which makes core syrup cheaper in the US.

[infecto]

We are just making hypothesis here but I doubt its that. HFCS has been looked at a lot and while there are amounts of people that think it can make them sick, I don't believe in normal doses it does harm in the base case.

The easier explanation is that most "treats" are low glycemic as they are paired with a fat. Where with a can of coke you are ingesting 40g of sugar mixed with some flavorings and water.

[simmerup]

There are some people that argue this actually. Dr Fungs book on type 2 diabetes goes into it.

Basically his take is that while glucose can be distributed in the bloodstream, fructose is broken down by the liver. With high intakes of fructose comes an overwhelming of the liver and higher incidence of fatty liver plus visceral fat. And those things are highly associated with bad health outcomes

Worth a read if you’re interested

[Wolfenstein98k]

There is not much evidence that it does any unique harm when you calorie-match it to regular sugar.

[shlant]

yea I think people concern themselves too much with glucose vs fructose vs sucrose etc.

[chithanh]

tl;dr It's the acid. Drink only water.

The issue is that soft drinks are generally bad for cardiovascular health, whether sugar sweetened or not.

https://doi.org/10.1001/jamainternmed.2019.2478

Plausible mechanism is that acidic drinks cause tooth enamel degradation, and poor dental health is a known risk factor for cardiovascular disease.

https://doi.org/10.1093/eurheartj/ehy836

[zug_zug]

> that many of those with the lowest intake of treats were on a diet due to bad health

I haven't read this study, but any study that isn't complete garbage normally would examine the to groups across all variables (age, gender, weight, health, etc) and deliberately control for any systematic differences between groups.

[tuukkah]

You can never control for all variables when humans are involved. (You can only control for variables that your data contains.)

EDIT: From the article: "[There's a] need for future research to incorporate more accurate measures, such as urinary sodium excretion, to more precisely assess the impact of sodium intake as a potential confounding factor."