Michael Pollan says, 'don't listen to scientists'

[jt512]

I'm not arguing against the theoretical issue the two sugars should have the same impact once absorbed into the bloodstream. . .

The study results are mixed so far.

Study Shows More Insulin Resistance With Fructose-Sweetened Beverages

A sweet problem: Princeton researchers find that high-fructose corn syrup prompts considerably more weight gain

I get it that it appears that theoretically HFCS and sucrose given the same caloric concentration should act the same once digested and enters the blood stream. HOWEVER, it's is sometimes a good idea to test what we think seems obvious and not just assume a conclusion.

WHEN YOU ACTUALLY DO THE RESEARCH, you get mixed results. It is not clear why, but it is clear that there may indeed be a difference between the two sugars regardless that it is counterintuitive.

Neither of the two sources you've linked to support these contentions.

The paper that your first link refers to compares fructose with glucose, and thus, as the very second sentence in the article states, has "little relevance" to the debate about HFCS vs sucrose.

The paper that your second link refers to presents the results of two studies in rats.

In Study 1, 40 rats were randomized to one of four diet groups (n=10 per group) for 8 weeks: (1) round-the-clock (24-hr) access to HFCS, (2) 12-hr per day access to HFCS, (3) 12-hr per day access to sucrose, or (4) control (no HFCS or sucrose). HFCS was an 8% solution of HFCS-55 in water, and sucrose was a 10% solution in water. All four groups were permitted ad libitum access to rat chow (ie, they were allowed to eat as much chow as they wanted). The investigators report that "[a]nimals with 12-h 8% HFCS access gained significantly more weight in 8 weeks than animals with 12-h 10% sucrose access (F(2,25)=3.42; p<0.05)."

These results, at best, only moderately support the hypothesis. A p-value of 0.05 is the standard (though arbitrary) cutoff for "statistical significance." The investigators tested significance by using an F-test (with 2 and 25 degrees of freedom), and reported the resulting p-value as "p<0.05." In fact, the actual p-value is 0.049. This is barely significant, and, from a Bayesian point of view, implies only moderate support for the hypothesis. Additionally, the description of the statistical methods in the paper was so vague that it cannot be determined whether they properly adjusted the results of their statistical test for multiple comparisons.

In Study 2, male and female rats were subjected to different protocols. None of the males were fed sucrose, so no comparisons between HFCS and sucrose can be made; therefore, I won't discuss the male part of this study further. The females were randomized to one of four diet groups: (1) 24-hr access to HFCS + ad libitum chow, (2) 12-hr access to HFCS + 12-hr chow, (3) 12-hr access to sucrose + 12-hr chow, or ad libitum chow.

Study 2 found no significant difference in weight gain between female rats with 12-hr access to HFCS + 12-hr chow and those with 12-hr access to sucrose + 12-hr chow (the only comparison relevant to the present discussion).

In short, of the two studies reported in this paper, one found weak evidence for greater weight gain for HFCS- than sucrose-fed rats. The other found no evidence at all.

Jay

 

[quadraginta]

You are repeating what I already addressed without addressing what I said. In addition, I still don't see how you figure HFCS has a smaller percentage of fructose than sucrose does.

<snip>

"HFCS 42" has 42% fructose. It is the HFCS preparation most commonly used in prepared foods (as opposed to soft drinks).

Sucrose has 50% fructose.

42% < 50%. What part of this is confusing you?

You also asked for sources. I gave you one ... with footnotes citing even more.

How does this not address what you asked?

Umm, are you sure? My source says sucrose is about 50:50 glucose and fructose and HFCS is 45% glucose and 55% fructose.

I'm interested in accuracy so a source that says HFCS differs in different products would be important.

<snip>

 

[Skeptic Ginger]

OK, I missed the HFCS was 42 fructose rather than 42% glucose.

However, looking back over the data, I still conclude the studies are mixed. This short article summarizes my position on the rat studies nicely:

HFCS: Worse than Sugar?

Conclusion
“High-fructose corn syrup prompts considerably more weight gain, researchers find” Science Daily.
“A sweet problem: Princeton researchers find that high-fructose corn syrup prompts considerably more weight gain” Princeton Review.

Despite the promising press releases and sound bites, this article has too many big problems to be able to believe the results.
The first problem is the finding that in the short term, rats gain more weight with 12 hour HFCS access than 12 hour sugar access, but not with 24 hour HFCS access.
Then later on in the long term study, we do see that 24 hour HFCS access leads to more weight gain than 12 hour access, but this time there is no sugar group to compare with HFCS.
Karen Kaplan of the LA times got it right with her headline: “A not-so-convincing case that high fructose corn syrup is worse for you than sugar.”

Bottom line
Do I think high fructose corn syrup (HFCS) is good for you? Definitely not.
Do I avoid HFCS? Heck yes.
Does this study convince me that HFCS causes more weight gain than sugar? Nope, this study has too many problems both in design and in results to prove anything.

One reason for doing the studies is that perhaps we are drawing the wrong conclusion about etiology of the weight gain and/or appetite stimulation. It is possible the glucose and fructose ratios are the problem, not the total amounts. It is possible the glucose and fructose ratios are not the problem, but rather other byproducts in the HFCS are.

I found this PPT presentation looking at byproducts in HFCS. The concern was in feeding bees, I believe, but the idea that fructose and glucose are not the only things in HFCS is the point.

CHEMISTRY OF HIGH FRUCTOSE CORN SYRUP (HFCS)
USPHS Training Symposium; June 10, 2008
Blaise W. LeBlanc, PhD; LCDR MSC USNR; Research Chemist, USDA-ARS
Carl Hayden Bee Research Center; Tucson, AZ

• Impurities from manufacturing method
- Maltooligosaccharides
• Impurities formed from shipment / storage conditions
-Hydroxymethylfurfural (HMF)
-Hydrolysis products of HMF:
Levulinic acid, Formic Acid

These carbohydrate variations are only now beginning to be studied in relationship to appetite stimulation:

A behavioral analysis of the ingestion of glucose, maltose and maltooligosaccharide by rats.

Abstract
Glucose, maltose, and Polycose are stimuli that differ in their effectiveness in stimulating ingestion in the rat. To understand better how variation in glucose chain length affects the ingestion of these compounds, we compared the effect of six concentrations of glucose, maltose, and maltooligosaccharide (MOS) on the microstructure of the licking behavior of the rat. At the three lowest concentrations the order of effectiveness in stimulating ingestion was MOS > maltose > glucose. At the three highest concentrations, there were no differences among the three compounds in volume ingested. As measured by initial rate of licking, the orosensory stimulating effectiveness of the three compounds were ordered as MOS > maltose > glucose. The magnitude of the negative feedback signals were very similar for MOS and maltose and greater than glucose at all but the highest two concentrations of glucose, suggesting that glucose chain length, not caloric density, is responsible for the differences in the magnitude of negative feedback. With the three lowest concentrations, the ordering of the compounds in their ability to stimulate intake depended on orosensory stimulating ability.

I get it that equal amounts of calories, be they via HFCS or sucrose, should logically result in the same amount of weight gain when taken in excess. But my concern is with the effects on appetite, not with the physics of calories in and calories out. In addition to appetite, changes in resting metabolism, fat storage, utilization of stored fat vs stimulating the appetite and so on are all potentially having an effect on weight gain and weight loss. To think it is only about total calories in and out oversimplifies the problem of obesity. It's easy to adopt that oversimplified position as it seems logical to an evidence based thinker. But one must always consider there is something one is not seeing and that is the case with HFCs, IMO.

 

[jt512]

However, looking back over the data, I still conclude the studies are mixed. This short article summarizes my position on the rat studies nicely:

HFCS: Worse than Sugar?

That article is a critique of a single paper, the very same one you linked to earlier as an example of a study with a positive finding about HFCS causing obesity. As I did, the author of the critique found the paper to be seriously flawed. This article does not show that results of studies on HFCS and obesity, whether rat studies or otherwise, are "mixed." It just critiques one highly flawed study that tells us essentially nothing about the effects of HFCS on body weight.

I get it that equal amounts of calories, be they via HFCS or sucrose, should logically result in the same amount of weight gain when taken in excess. But my concern is with the effects on appetite, not with the physics of calories in and calories out. In addition to appetite, changes in resting metabolism, fat storage, utilization of stored fat vs stimulating the appetite and so on are all potentially having an effect on weight gain and weight loss. To think it is only about total calories in and out oversimplifies the problem of obesity.

That's not what we're saying. It's not a question of equal energy, but of equal composition. Both sucrose and HFCS are about 50:50 mixtures of glucose and fructose, and if you understand the digestion of sucrose, it is pretty unlikely to matter in any physiologically meaningful way whether you consume fructose and glucose together as a mixture of monosaccharides or as the disaccharide sucrose. As one reviewer succinctly put it, "Sucrose [and] HFCS . . . deliver the same sugars in the same ratios to the same tissues within the same time frame to the same metabolic pathways."¹

[O]ne must always consider there is something one is not seeing and that is the case with HFCs, IMO.

Why? Hypotheses should have some reasonable basis? What's the reasonable basis for yours?

Jay

¹ White JS. Straight talk about high-fructose corn syrup: what it is and what it ain't. Am J Clin Nutr 2009;88(suppl):1716S–21S.

 

[Skeptic Ginger]

That article is a critique of a single paper, the very same one you linked to earlier as an example of a study with a positive finding about HFCS causing obesity.

D'uh. That's why I posted it. The article explained the complexity interpreting the research results. That's what mixed results means. Contrary to the confirmation bias you are trying to paint me with, I have not said the research supports the conclusion HFCS is bad.

That's not what we're saying. It's not a question of equal energy, but of equal composition. Both sucrose and HFCS are about 50:50 mixtures of glucose and fructose, and if you understand the digestion of sucrose, it is pretty unlikely to matter in any physiologically meaningful way whether you consume fructose and glucose together as a mixture of monosaccharides or as the disaccharide sucrose. As one reviewer succinctly put it, "Sucrose [and] HFCS . . . deliver the same sugars in the same ratios to the same tissues within the same time frame to the same metabolic pathways."¹

Try reading my post again. You seem to have missed something.

Why? Hypotheses should have some reasonable basis? What's the reasonable basis for yours?

The increase in obesity in the US is correlated to the increase in HFCS being added to our diets. I'm not willing to dismiss the potential relationship out of hand based on theorizing the glucose and fructose don't seem that different from the sucrose which consumption has dropped as the HFCS has replaced it. I think we should take a closer look and I personally choose to avoid the HFCS until the studies are more conclusive.


I thought I was clear, perhaps it was buried in my post: fructose and glucose are not the only things in HFCS.

One reason for doing the studies is that perhaps we are drawing the wrong conclusion about etiology of the weight gain and/or appetite stimulation. It is possible the glucose and fructose ratios are the problem, not the total amounts. It is possible the glucose and fructose ratios are not the problem, but rather other byproducts in the HFCS are.

¹ White JS. Straight talk about high-fructose corn syrup: what it is and what it ain't. Am J Clin Nutr 2009;88(suppl):1716S–21S.

JS White is the Corn Refiners' Association scientist. Yes, his stuff has been published in peer reviewed journals. But just as I consider research the drug manufacturers publish to not be sufficient by itself, so do I take anything White publishes. He's a paid spokesperson.

He also serves as an advisor to the commercial food industry front group, American Council on Science and Health

 

[tyr_13]

The increase in obesity in the US is correlated to the increase in HFCS being added to our diets. I'm not willing to dismiss the potential relationship out of hand based on theorizing the glucose and fructose don't seem that different from the sucrose which consumption has dropped as the HFCS has replaced it. I think we should take a closer look and I personally choose to avoid the HFCS until the studies are more conclusive.


I thought I was clear, perhaps it was buried in my post: fructose and glucose are not the only things in HFCS.

But there is already a much better explanation explaining why increased use of HFCS correlates to increased obesity. It has increased caloric intake in the same way sugar would have. They are also temporally connected with other factors such as decreased physical activities and such. Weight gain and dirty dishes are probably strongly correlated as well, but that doesn't mean we need to find a different reason than 'they are both caused by the same thing.'

One reason for doing the studies is that perhaps we are drawing the wrong conclusion about etiology of the weight gain and/or appetite stimulation. It is possible the glucose and fructose ratios are the problem, not the total amounts. It is possible the glucose and fructose ratios are not the problem, but rather other byproducts in the HFCS are.

In which case honey and apple juice would be even more problematic. Almost all HFCS is very close to the same ratio as sugar.

JS White is the Corn Refiners' Association scientist. Yes, his stuff has been published in peer reviewed journals. But just as I consider research the drug manufacturers publish to not be sufficient by itself, so do I take anything White publishes. He's a paid spokesperson.

He also serves as an advisor to the commercial food industry front group, American Council on Science and Health

It's a red flag, but if the science is sound, the science is sound. To find flaws in his research, you would actually have to find flaws in his research.

 

[jt512]

D'uh. That's why I posted it. The article explained the complexity interpreting the research results. That's what mixed results means.

No, the article did not explain the complexity of interpreting the results. The article explained, as I did, that the study was deeply flawed. And "mixed results" does not mean that an individual study is difficult to interpret. It specifically means that a number of studies on a subject have been done, and have come up with "mixed" (ie, discrepant) results.

Try reading my post again. You seem to have missed something.

I read it again, and I missed nothing. You (unintentionally, I think) were making a straw man argument. You said that you understood that it was not a question of HFCS and sucrose having equal energy. However, none of us who have been arguing for the essentially physiologic equivalency of HFCS and sucrose have been basing our argument on their containing equal energy. Hence your argument was against a straw man. We are basing our argument, largely, on a stronger claim than just equal energy: substantially equal composition.

Hypotheses should have some reasonable basis? What's the reasonable basis for yours?

The increase in obesity in the US is correlated to the increase in HFCS being added to our diets. I'm not willing to dismiss the potential relationship out of hand based on theorizing the glucose and fructose don't seem that different from the sucrose which consumption has dropped as the HFCS has replaced it.

So, you're concerned about a correlation between the secular trend in HFCS consumption and obesity in spite of the lack of a plausible mechanism for causation. Yeah, I know, you've come up with several desperate hypotheses—eg, maybe it's the "byproducts." It's a process known as grasping at straws.

Jay

 

[Skeptic Ginger]

I'm not convinced the research supports the conclusion there is no difference between HFCS and sucrose. You all can argue all you want. I've looked at the data. I'm a health care professional with a master's degree and 35+ years of experience including 20 years in private practice as an ARNP. I know how to read and interpret research. I'm not an uneducated fool. And I am very much an evidence based medicine practitioner.

To boil all this down to a glucose and fructose calorie is a calorie is the oversimplified skeptic's position that is easy to fall into. I don't feel the need to post a literature search of citations showing the jury is still out. It takes too much time. I've been there and done that in other threads.

THE JURY IS STILL OUT. Period, end of story. If you are convinced the jury is in, that's fine. I understand why you've reached that conclusion. Try to understand why I have not.

 

[mikeyx]

Why am I not surprised to hear yet ANOTHER anti-religion diatribe from you jj?

Science is not infallible. In fact, "experts" of all types turn out to be wrong much more often than most people realize.

I'd recommend the book "Wrong: Why Experts Keep Failing Us And How to Know When Not to Trust Them." (by David H Freedman) VERY enlightening, but don't read it unless you're prepared to have your world-view shifted.

http://www.amazon.com/Wrong-us-Scientists-relationship-consultants/dp/0316023787

Yes Experts Just like (chuckle), Dr. Jeffery Meldrum, sold his soul to television for a buck. Credibility inside of science or footery, none.

 

[mikeyx]

Not as much as you'd think.

Get a copy of and read the book I linked to.



Which has exactly what to do with the point that we pay too much credence to scientists?

Your reasoning is flawed. You are parroting the things you read kind like a "Magazine or Bookclub Expert".....

Too much to "Scientists? Like Dr (If that is his real name) Meldrum?

 

[tyr_13]

I'm not convinced the research supports the conclusion there is no difference between HFCS and sucrose. You all can argue all you want. I've looked at the data. I'm a health care professional with a master's degree and 35+ years of experience including 20 years in private practice as an ARNP. I know how to read and interpret research. I'm not an uneducated fool. And I am very much an evidence based medicine practitioner.

To boil all this down to a glucose and fructose calorie is a calorie is the oversimplified skeptic's position that is easy to fall into. I don't feel the need to post a literature search of citations showing the jury is still out. It takes too much time. I've been there and done that in other threads.

THE JURY IS STILL OUT. Period, end of story. If you are convinced the jury is in, that's fine. I understand why you've reached that conclusion. Try to understand why I have not.

Apart from your appeal to authority (your own), 'the jury is still out', which I take to mean, 'so far research is insufficient to draw a conclusion', is different from, 'the results are mixed'. You've shown no mixed results.

 

[meg]

Interesting discussion. I think some of you are taking his comments to mean things he isn't saying, though. I really don't think the guy is "anti-science".

In my opinion, after reading a couple of his books and a few of his articles, I think his general message (which is one I agree with) is: "Advertisements for processed foods touting scientific research as a reason why you should buy their product should be treated with skepticism. Most of these foods are not as "good for you" as their advertisers would lead you to believe. And most of these foods are not nearly as "good for you" as something you could make at home from scratch."


I don't think his beef is with the science as much as it is with how marketers and popular media use science to basically trick people into eating crap and thinking it's good for them.

 

[!Kaggen]

Interesting discussion. I think some of you are taking his comments to mean things he isn't saying, though. I really don't think the guy is "anti-science".

In my opinion, after reading a couple of his books and a few of his articles, I think his general message (which is one I agree with) is: "Advertisements for processed foods touting scientific research as a reason why you should buy their product should be treated with skepticism. Most of these foods are not as "good for you" as their advertisers would lead you to believe. And most of these foods are not nearly as "good for you" as something you could make at home from scratch."


I don't think his beef is with the science as much as it is with how marketers and popular media use science to basically trick people into eating crap and thinking it's good for them.

Yes it is rather obvious isn't it.
Pity the skeptical community does not tackle this as much as homeopathy and truthers.
It certainly does more harm imo.

 

[jt512]

And I am very much an evidence based medicine practitioner.

I think HFCS is a case where evidence-based medicine (EBM), as opposed to science-based medicine (SBM), can lead us astray. The difference between the two is that, strictly speaking, EBM uses only empirical tests to evaluate medical hypotheses, whereas SBM assesses the evidence from empirical tests in light of the plausibility of the hypothesis based on knowledge of the underlying basic science and physiology. From a strict EBM perspective, for example, many "alternative" medical treatments are worth testing, whereas SBM rules them out as implausible a priori.

One disadvantage of EBM is its tendency to rely on frequentist statistics, which, strictly speaking, can never provide evidence in favor of the null hypothesis. Thus, it is not surprising that you view the evidence as "mixed" and think that the "jury is still out." SBM, which favors Bayesian reasoning over frequentist, has no problem accepting the null hypothesis when warranted. A Bayesian approach to whether HFCS is more obesogenic than sucrose would go something like this:

Sucrose and HFCS have about the same proportion of glucose and fructose, the primary difference being that in the former they are covalently bonded as a disaccharide. In principle this could make a difference. However, when sucrose hits the duodenum it is readily hydrolyzed to glucose and fructose, which are absorbed via the exact same mechanisms as when they are ingested from HFCS—at which point point HFCS and sucrose are essentially indistinguishable to the body. Thus it doesn't seem likely from a physiologic perspective that HFCS would be more obesogenic than sucrose. Indeed, the only reason that HFCS was hypothesized to cause obesity was that an increase in its usage in the US coincided with an increase in the prevalence of obesity. However, as an ecologic correlation, this parallel trend is very weak evidence of causality; we can't even say if the people who are getting fatter are the ones who are eating more HFCS (eg, maybe they're eating more fat). Thus, based on physiology and epidemiology, our prior probability that HFCS is more obesogenic than sucrose is fairly low.

So what does the empirical testing over the last decade or more show? Not much. The evidence, as you say, is at best "mixed." So if HFCS is so obesogenic, we ask, then why has it been so hard to establish this fact? I mean a smart high-school senior ought to be able to design a double-blind trial of HFCS vs sucrose; it's not rocket science. If HFCS is more obesogenic by a non-negligible amount than sucrose, it ought to be easy to demonstrate; in fact, given all the furor over the hypothesis and all the testing that has been done, it should have already been conclusively demonstrated. But it hasn't been. Solid evidence that should be there, if the HFCS hypothesis were true, hasn't materialized. Therefore, we see no reason to change our opinion that the probability is low that HFCS is more obesogenic than sucrose. In fact, since clear evidence that should have emerged, were the HFCS hypothesis true, has not, we are inclined to think that the hypothesis is even less plausible after the testing than before.

THE JURY IS STILL OUT. Period, end of story.

Except that if you rely strictly on EBM and frequentist statistics, the jury can never reach a verdict if the null hypothesis is true. At best, you're stuck with a hung jury forever.

Jay

 

[Almo]

I read The Omnivore's Dilemma, and I found it an excellent book. I didn't find it preachy, or starry-eyed about "natural" foods. Honestly, having read the book and hearing him make these remarks makes me wonder if they are the same person.

 

[Skeptic Ginger]

....

It's a red flag, but if the science is sound, the science is sound. To find flaws in his research, you would actually have to find flaws in his research.

Hard to find fraud. What needs to happen is someone needs to repeat the research and come up with similar results just as is the case for ALL research results.

 

[Skeptic Ginger]

....

Except that if you rely strictly on EBM and frequentist statistics, the jury can never reach a verdict if the null hypothesis is true. At best, you're stuck with a hung jury forever.

Jay

No, I am looking at studies that assess the effect of HFCS on appetite stimulation and satiation. The others in this thread arguing that a calorie is a calorie are ignoring this entire avenue of research because it does not fit in with their confirmation bias.

What I am saying is that despite the fact a calorie is a calorie, 'calories in and calories out' is tempting but it is an oversimplified view of obesity.

 

[jt512]

Except that if you rely strictly on EBM and frequentist statistics, the jury can never reach a verdict if the null hypothesis is true. At best, you're stuck with a hung jury forever.

No, I am looking at studies that assess the effect of HFCS on appetite stimulation and satiation. The others in this thread arguing that a calorie is a calorie are ignoring this entire avenue of research because it does not fit in with their confirmation bias.

What I am saying is that despite the fact a calorie is a calorie, 'calories in and calories out' is tempting but it is an oversimplified view of obesity.

That is completely orthogonal to the point I was making in my post, including the part of it that you chose, apparently by some random process, to quote.

Jay

 

[jt512]

No, I am looking at studies that assess the effect of HFCS on appetite stimulation and satiation.

And is that what you think the jury is out on? Because, coincidentally, I happen to be looking at the same thing. Specifically, I'm looking at Table 1 from the 2008 review article "High-fructose corn syrup, energy intake, and appetite regulation" by Melanson et al.¹ You can view a copy of it here.

I've highlighted the six studies in which HFCS was compared with sucrose or a sucrose-like control. Among these studies, there is not a single significant difference in ad libitum energy intake, or any subjective or objective indicator of hunger or satiety. Not a single one. If the jury is still out, then they must have fallen asleep in the jury room.

Jay

¹ Melanson KJ, et al. High-fructose corn syrup, energy intake, and appetite regulation. Am J Clin Nutr. 2008 Dec;88(6):1738S–1744S.

 

[Skeptic Ginger]

That is completely orthogonal to the point I was making in my post, including the part of it that you chose, apparently by some random process, to quote.

Jay

I see it wasn't obvious that I didn't find your "evidence-based medicine (EBM), as opposed to science-based medicine (SBM)" relevant to my position. Allow me to point that out now.

Medicine is my profession. I know how to read and interpret medical research. I must say I'm aware I'm not perfect at it. Linda (fls) had a knowledge of medical research well above mine. But your imagination that I was somehow not looking at valid medical research was an incorrect assumption.


There are a dozen or so studies that have found no difference in their outcome measures comparing HFCS and sucrose. There are studies that have looked at fructose vs sucrose. There are some that have looked at short term calorie intake of HFCS vs sucrose.

What one needs to consider when evaluating these studies are the particulars:

• the time frame
• what specifically was compared
• the sample groups and the sample size

But the most important thing to look at is the

• outcome measure

Not every study supports the conclusions the researchers claim the results support. If you look at the difference between glucose and fructose you aren't looking at the other components in HFCS. If you look at HFCS but don't compare its use in the products that consumption occurs in you may be missing something. If you measure short term caloric consumption you could be missing long term or outside of the study framework effects.

Maybe the problem is in the motivation to market HFCS, maybe the actual substance is not the issue.

The evidence we do have that is undeniable is the rate of HFCS consumption has gone up. The rate of sucrose has gone down as HFCS replaces it. And the rates of obesity have gone up. If HFCS was merely added to sucrose consumption, you would easily see more calories consumed and more weight gained. But that is not what we see. We see HFCS replacing sucrose and obesity increasing.

Until the mechanism underlying the change in obesity increase is clearly understood, I am not willing to rule out HFCS despite the early research that has failed to detect the problem.