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Author Topic:   Good Calories, Bad Calories, by Gary Taubes
molbiogirl
Member (Idle past 198 days)
Posts: 1909
From: MO
Joined: 06-06-2007


Message 391 of 451 (630441)
08-25-2011 8:52 AM


Sorry about the delay in my response.

We had to put down our beloved Papillon and I am still out of sorts.

It'll probably be a few more days.


molbiogirl
Member (Idle past 198 days)
Posts: 1909
From: MO
Joined: 06-06-2007


Message 392 of 451 (630917)
08-29-2011 10:30 AM
Reply to: Message 390 by Percy
08-22-2011 8:26 PM


Re: Refined v. unrefined insulin response
Percy writes:

You can't disprove the claim that refined carbohydrates cause a larger insulin response than complex carbohydrates using a paper whose data does not distinguish between complex and refined carbohydrates.

I'm not trying to "disprove" the claim that refined carbs evoke a greater insulin response than unrefined carbs. I am arguing that refined and unrefined evoke a very similar insulin response.

First. You can't argue this:

Hoyt writes:

Similar ISs [insulin scores] were observed for white and brown pasta, white and brown rice, and white and whole-meal bread. All of these foods are relatively refined compared with their traditional counterparts.

And this:

Percy writes:

With the possible exception of white pasta none of these foods are thought to have any significant refined carbohydrate content.

Both white and brown pasta are on your lowest IS list. Either they are refined or unrefined. You can't have it both ways.

If you are going to argue that all food that has been processed in any way is "refined" (aka both white and brown pasta/white bread and whole grain bread) then there is nothing on the list that is "unrefined".

Refined and unrefined carbs evoke similar responses. Which is why the book is titled "Good Carbs Bad Carbs" not "Refined Carbs Unrefined Carbs".

From the discussion:

Despite containing similar amounts of carbohydrate, jellybeans induced twice as much insulin secretion as any of the four fruits.

Same carbs, twice the insulin response. Jellybeans = refined. Fruit = unrefined. Little hard to explain that given Taubes' assertion is that it is the carb content and the carb content alone that determines insulin response. (And the insulin response is to blame for weight gain.)

Despite containing more carbohydrate than porridge and muesli, All Bran produced the lowest GS.

Again. A hiccup that Taubes' hypothesis can't explain.

And the coup de grace:

Significant differences were found both within and among the food groups when the insulin AUC responses were examined as a function of the food's carbohydrate content. On average, protein-rich foods produced the highest insulin secretion per gram of carbohydrate.

These results reflect the insulinogenic effects of protein and fat.

Protein is insulinogenic. How does that fit in with Taubes' hypothesis?

Percy writes:

Grapes rate exceedingly high in fructose, one of the highest levels of all fruits, though I don't believe fructose has a significant influence on insulin levels.

Percy. Look at the data. First, as a group, fruit has an IS mean that is comparable to both carb rich foods and bakery products. Look at Figure 1. Look at the error bars. Second. You neglected to include the error bars when you made your lists.

Bananas 81 +/- 5 (aka 76-86)
Grapes 82 +/- 6 (aka 76-88)
French fries 79 +/- 12 (aka 62-91)
Popcorn 61 +/- 14 (aka 47-75)

How can grapes be on your list for high IS and popcorn on your list for low IS when the scores are so similar?

Where do you draw the line? Beef is 58 +/- 12. That's 46-70. That's awful close to grape territory. Grain bread is 56 +/- 6. That's 50-62. Smack dab in the middle of beef territory. How can you claim that refined carbs are do darn bad when beef is right there in the middle?

Remember, 240-calorie servings of cheese, beef and fish elicit greater insulin release than isocaloric servings of pasta and porridge.

Lots of foods are insulinogenic. As mentioned above, protein and fat evoke the highest insulin response per gram of carb. Milk is very insulinogenic. As is cocoa powder (no sugar, just the powder).

I have a write up of cocoa and milk at work. Irene knocked out the subways yesterday and they aren't back up and running yet ... so I'll have to post that info tomorrow.

Refined carbs and unrefined carbs evoke similar insulin responses. Protein and carbs evoke similar insulin responses. Fruit and carbs evoke similar insulin responses. Taubes' hypothesis doesn't take this into account and can't explain it.


This message is a reply to:
 Message 390 by Percy, posted 08-22-2011 8:26 PM Percy has responded

Replies to this message:
 Message 393 by Percy, posted 08-30-2011 7:02 AM molbiogirl has responded
 Message 394 by Percy, posted 08-31-2011 8:15 AM molbiogirl has responded

Percy
Member
Posts: 16022
From: New Hampshire
Joined: 12-23-2000
Member Rating: 3.1


Message 393 of 451 (631068)
08-30-2011 7:02 AM
Reply to: Message 392 by molbiogirl
08-29-2011 10:30 AM


Re: Refined v. unrefined insulin response
Hi Molbiogirl,

Just for reference, here's a link to the paper again:

An insulin index of foods: the insulin demand generated by 1000-kJ portions of common foods

molbiogirl writes:

I'm not trying to "disprove" the claim that refined carbs evoke a greater insulin response than unrefined carbs. I am arguing that refined and unrefined evoke a very similar insulin response.

I don't see a significant difference between these two positions, but okay, fine, you're arguing that refined and unrefined carbohydrates cause similar insulin responses. The same question remains. How are you going to do that with a paper whose data does not distinguish between complex and refined carbohydrates (except for sugar)?

The best that we can do with this paper is make our own inferences about which foods are high in refined carbohydrates and which are not, and I did that with my two tables. This table lists the foods from Table 4 with the greatest insulin scores, most of which are known for high levels of refined carbohydrates:

FoodInsulin score
Jellybeans
Mars Bar
Potatoes
Baked Beans
Yogurt
White bread
Whole-meal bread
Cookies
Ice cream
Grapes
160
122
121
120
115
100
96
92
89
82

And this table lists the foods from Table 4 with the lowest insulin scores, most of which are known for a low level of refined carbohydrates:

FoodInsulin score
Peanuts
Eggs
All Bran
White pasta
Brown pasta
Porridge
Cheese
Muesli
Beef
Popcorn
20
31
32
40
40
40
45
46
51
54

As I indicated before, I agree that white pasta is normally considered as having higher levels of refined carbohydrates than brown pasta, and possibly there is something wrong with their data because it is contradictory. If you look at Table 2 you'll see that their white pasta is higher in sugar and lower in fiber, but Table 4 shows that their brown pasta produced higher glucose levels and a higher glucose score, which is opposite to the known effects of fiber (increasing levels correlate with a lower glucose response) and sugar (increasing levels correlate with a higher glucose response).

So I can't explain their white/brown pasta data, but it's just one data point. Overall their data is very consistent with the hypothesis that increasing levels of refined carbohydrates cause increasing insulin scores.

Despite containing similar amounts of carbohydrate, jellybeans induced twice as much insulin secretion as any of the four fruits.

Same carbs, twice the insulin response. Jellybeans = refined. Fruit = unrefined.

But they are not the same carbs. The carbohydrates in Jellybeans are sucrose (50% glucose, 50% fructose), while those in fruit are fructose. The glucose in jellybeans requires no conversion to glucose, which is not true of fruit which has no glucose. The glucose and insulin responses of glucose and fructose are not the same. Plus fruit has fiber, jellybeans have none. You can't compare apples to oranges, or in this case jellybeans to grapes.

Despite containing more carbohydrate than porridge and muesli, All Bran produced the lowest GS.

Again. A hiccup that Taubes' hypothesis can't explain.

You keep misstating Taubes' hypothesis, which is that increased intake of refined carbohydrates is responsible for the diseases of western civilization.

Someone somewhere might be arguing that total carbohydrate content is by itself a good indicator of glucose and insulin responses, but it isn't me and it isn't Taubes. If you're arguing that this hypothesis is wrong then I agree with you, and I'm sure Taubes would agree with you, too.

But if you're also arguing that that is Taubes' hypothesis then you are wrong. Taubes' hypothesis is that increased intake of refined carbohydrates is responsible for the diseases of western civilization.

And the coup de grace:

Significant differences were found both within and among the food groups when the insulin AUC responses were examined as a function of the food's carbohydrate content. On average, protein-rich foods produced the highest insulin secretion per gram of carbohydrate.

Of course protein-rich foods produce a high insulin response per gram of carbohydrate. That's because protein-rich foods contain very little carbohydrate. Protein produces its own insulin response, and when you divide that response by a small carbohydrate content you'll get large numbers. The insulin response of beef and fish per gram of carbohydrate is infinite, while that of cheese and eggs is merely astronomical. In other words, measuring insulin response per gram of carbohydrate for foods with little or no carbohydrate content is a meaningless exercise.

These results reflect the insulinogenic effects of protein and fat.

Protein is insulinogenic. How does that fit in with Taubes' hypothesis?

It is not Taubes' hypothesis that only carbohydrates cause an insulin response. The digestive system breaks food down into constituents that can be absorbed by the bloodstream, such as glucose. Insulin response is governed by many factors, but one significant factor is blood glucose levels.

How can grapes be on your list for high IS and popcorn on your list for low IS when the scores are so similar?

It isn't my list. It's just the data from Table 4 sorted into order by insulin score. I didn't make the mathematical rule that says that 54 (popcorn) is less than 82 (grapes).

How can you claim that refined carbs are do darn bad when beef is right there in the middle?

The hypothesis is that refined carbohydrates, because of their rapid digestion, cause glucose and insulin spikes and other health effects that are ultimately responsible for the increasing rates of obesity and and diabetes observed in western countries. Beef isn't rapidly digested, nor does it cause glucose and insulin spikes.

Refined carbs and unrefined carbs evoke similar insulin responses.

No they don't. In general, the more refined the carbohydrates the greater the insulin response, and this paper, to the extent possible given that it didn't measure levels of refined carbohydrates, fully supports this.

--Percy


This message is a reply to:
 Message 392 by molbiogirl, posted 08-29-2011 10:30 AM molbiogirl has responded

Replies to this message:
 Message 396 by molbiogirl, posted 09-02-2011 10:12 AM Percy has responded

  
Percy
Member
Posts: 16022
From: New Hampshire
Joined: 12-23-2000
Member Rating: 3.1


Message 394 of 451 (631261)
08-31-2011 8:15 AM
Reply to: Message 392 by molbiogirl
08-29-2011 10:30 AM


Re: Refined v. unrefined insulin response
Hi Molbiogirl,

Sorry for the second reply, but I'd like to get through the points where we disagree as quickly as possible. Here are what I believe are our primary areas of disagreement:

  1. You believe that Taubes' hypothesis is that all carbohydrates are bad, while I believe that Taubes hypothesis is that the greater the intake of refined carbohydrates the worse are the health effects regarding obesity and type II diabetes.

  2. You don't believe that increased intake of refined carbohydrates is associated with an increased incidence rate of obesity and type II diabetes, while I believe that it is.

  3. You don't believe that any particular food categories can be singled out as causing greater insulin responses than other foods, while I believe that in general the greater the refined carbohydrate content the greater the insulin response.

Regarding #1 concerning Taubes' hypothesis, he has clearly stated his hypothesis a number of times in articles, books and talks. Taubes believes that it is the increased intake of refined carbohydrates that is responsible for the diseases of western civilization. He was clear about this in the original article in the New York Times (What if It's All Been a Big Fat Lie?), he was very clear about this in his book (Good Calories, Bad Calories, of which you have a copy), and he's been clear about this in his talks.

Regarding #2 concerning the association of increased refined carbohydrate intake with obesity and type II diabetes, here is a study showing this effect with type II diabetes.

Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the United States: an ecologic assessment

From the conclusions:

Gross et al writes:

Conclusions: Increasing intakes of refined carbohydrate (corn syrup) concomitant with decreasing intakes of fiber paralleled the upward trend in the prevalence of type 2 diabetes observed in the United States during the 20th century.

Regarding #3 concerning some food categories causing greater insulin responses than others, the paper I just cited makes this statement:

Gross et al writes:

In several small-scale metabolic trials, refined grains have been shown to cause a significant increase in insulin secretion and the postprandial glucose response (50-54).

Very interestingly, one of the papers they cite in support of this statement about the effect of refined grains on insulin response is the same one you've been citing in support of the opposite view. Clearly this paper shares my interpretation that the paper you're citing disagrees with you.

--Percy


This message is a reply to:
 Message 392 by molbiogirl, posted 08-29-2011 10:30 AM molbiogirl has responded

Replies to this message:
 Message 397 by molbiogirl, posted 09-02-2011 10:32 AM Percy has acknowledged this reply

  
Percy
Member
Posts: 16022
From: New Hampshire
Joined: 12-23-2000
Member Rating: 3.1


Message 395 of 451 (631481)
09-01-2011 7:42 AM


A Possible Evolutionary Connection
A group of scientists have proposed an evolutionary explanation for why people might become more sensitive to refined carbohydrates as they get older. In the August 6-12, 2011, issue of New Scientist, Michael R. Rose of the University of California, Irvine, suggests the possibility that human evolution over the 10,000 years since the emergence of agriculture has caused adaptations to a diet higher in "grass-derived foods," but that these adaptations work best when you are young, and less well when you are old. This is because, he argues, "the forces of natural selection decline with age." In other words, processes that emerge after you've already reproduced cannot be directly affected by natural selection. He goes on:

Michael R. Rose writes:

Given the declining forces of natural selection, we can expect to be well adapted to agricultural diet at early ages but less so at later ages. This has the effect of amplifying the decline in adaptedness that we experience as we get older.
...
So it may be beneficial to our health to switch to the diet and activity levels of hunter-gatherers.

I have been following such a diet - essentially avoiding grass-derived foods, such as grains, rice, corn and sugar cane, and anything made from milk - for two years and the results have been good.

New Scientist article: The end of ageing: Why life begins at 90

--Percy

PS - I am well aware of the amount of nonsense in New Scientist. I'm only throwing this out there as an interesting idea.


  
molbiogirl
Member (Idle past 198 days)
Posts: 1909
From: MO
Joined: 06-06-2007


Message 396 of 451 (631664)
09-02-2011 10:12 AM
Reply to: Message 393 by Percy
08-30-2011 7:02 AM


Re: Refined v. unrefined insulin response
And this table lists the foods from Table 4 with the lowest insulin scores, most of which are known for a low level of refined carbohydrates:

Your list is wrong. You can't ignore the error bars. Here's the list, from lowest to highest, with error bars included.

Peanuts 20 ± 5 25
All-Bran 32 ± 4 36
Eggs 31 ± 6 37
Porridge 40 ± 4 44
White Pasta 40 ± 5 45
Brown pasta 40 ± 5 45
Muesli 46 ± 5 51
Cheese 45 ± 13 58
Grain bread 56 ± 6 62
Apples 59 ± 4 63
Oranges 60 ± 3 63
Popcorn 54 ± 9 63
Beef 51 ± 16 67
Lentils 58 ± 12 70
Special K 66 ± 5 71
Honeysmacks 67 ± 6 73
Brown rice 62 ± 11 73
Potato chips 61 ± 14 75
Fish 59 ± 18 77
Sustain 71 ± 6 77
Cornflakes 75 ± 8 82
Doughnuts 74 ± 9 83
French fries 74 ± 12 86
Bananas 81 ± 5 86
Grapes 82 ± 6 88
White rice 79 ± 12 91
Croissants 79 ± 14 93
Cake 82 ± 12 94
Crackers 87 ± 12 99
White bread 100 ± 0 100
Ice cream 89 ± 13 102
Cookies 92 ± 15 107
Whole-meal bread 96 ± 12 108
Yoghurt 115 ± 13 128
Potatoes 121 ± 11 132
Mars Bars 122 ± 15 137
Baked beans 120 ± 19 139
Jellybeans 160 ± 16 176

So I can't explain their white/brown pasta data, but it's just one data point. Overall their data is very consistent with the hypothesis that increasing levels of refined carbohydrates cause increasing insulin scores.

From the wiki article on this paper:

+/- indicate uncertainty in the data ... In practice this means that if two foods have large uncertainty and have values close together then you don't really know which score is the higher.

The brown pasta/white pasta thing isn't the only problem. And it's not just "one data point".

I think you need to read the introduction and the discussion carefully.

Hoyt writes:

Our study was undertaken to test the hypothesis that the postprandial insulin response was not necessarily proportional to the blood glucose response and that nutrients other than carbohydrate influence the overall level of insulinemia.

(T)he macronutrient composition of foods has relatively limited power for predicting the extent of postprandial insulinemia.

In other words, you can’t predict the insulin response based on carbohydrate content.

Hoyt writes:

(E)qual-carbohydrate servings of foods do not necessarily stimulate insulin secretion to the same extent. For example, isoenergetic servings of pasta and potatoes both contained 50g carbohydrate, yet the IS for potatoes was three times greater than that for pasta. Similarly, porridge and yogurt, and whole-grain bread and baked beans, produced disparate ISs despite their similar carbohydrate contents.

These findings, like others, challenge the scientific basis of carbohydrate exchange tables, which assume that portions of different foods containing 10-15g carbohydrate will have equal physiologic effects and will require equal amounts of exogenous insulin to be metabolized.

These findings have been replicated and confirmed.

Twenty-three products (five breakfast cereals, six bakery products and crackers, and twelve biscuits) had their GI and II values determined, and were characterised by their fat, protein, starch and sugar contents, with the carbohydrate fraction further divided into total fructose, RAG, SAG and resistant starch.

Of the carbohydrate fractions investigated in the present study, RAG demonstrated the strongest correlation with II, but still only explained 32 % of the variance. (This) in agreement with previous findings ( (Kabadi, 1991; Trout, 1993; Brand-Miller 1995).

The effect of protein and fat should not be completely dismissed, and indeed their presence in the foods investigated is probably responsible for some of the variance observed in GI and especially II value.

Englyst, K at al. Glycaemic index of cereal products explained by their content of rapidly and slowly available glucose, British Journal of Nutrition (2003), 89, 329–33

In other words, the type of carb (rapidly absorbed glucose, slowly absorbed glucose, resistant starch, nonresistant starch) is no more predictive of the insulin response than the % carb content.

Plus fruit has fiber, jellybeans have none. You can't compare apples to oranges, or in this case jellybeans to grapes.

Percy, you're missing the point. First, look at the corrected list I posted above. Yogurt, potato, beans and candy have the highest IS. If you are arguing that refined carbs have the highest IS, why are beans, potatoes and yogurt 3 out of the top 5?

Second, the IS of a food is the IS of a food. If you're going to argue a difference between fructose and glucose, then you need to back that up. Oranges (fructose) and pasta (glucose) have identical IS.

If you're going to claim fiber or some other aspect affects the insulin response, you need to back that up. RAG and SAG evoke nearly identical IS.

Third, refined carb content is NOT predictive of insulin response. Carbs are all over the map. Grapes (unrefined) and cake (refined) are identical. Brown rice (unrefined) and potato chips (refined). Apples (unrefined) and bread (refined).

Third, lots of papers have looked at the LACK of a relationship between carb content and IS.

In conclusion, the present results show that the GI of mixed meals calculated by table values does not predict the measured GI and furthermore that carbohydrates do not play the most important role for GI in mixed breakfast meals. Our prediction models show that the GI of mixed meals is more strongly correlated either with fat and protein content, or with energy content, than with carbohydrate content alone. Furthermore, GI was not correlated with II.

Flint A, et al. The use of glycaemic index tables to predict glycaemic index of composite breakfast meals, British Journal of Nutrition (2004), 91, 979–98.

In fact, GI scores have been reported for approximately 1300 foods, but data on insulin levels are limited. But what data there are indicate you can not predict insulin response based on macronutrient content.

For example, no one can explain the IS of milk.

The novel finding of this experiment was that skimmed milk elicited a disproportionately large insulinaemic response relative to its low glycaemic response in healthy normal subjects.

Certain amino acids (tryptophan, leucine, isoleucine and glutamine) are insulinogenic (Schmid et al. 1989). Hence, it has been hypothesized that elevated concentrations of these amino acids in milk may underlie its insulin-stimulating capabilities (Ostman et al. 2001).

(T)he the insulin scores for milk products have been reported to range from 89 to 115 (Holt et al. 1997; Ostman et al. 2001)

(A)ll dairy products (whole milk, skimmed milk, yoghurt, ice cream, cottage cheese and fermented milk products) have been shown to have potent insulinotropic properties.

Hoyt, G et al. Dissociation of the glycaemic and insulinaemic responses to whole and skimmed milk, British Journal of Nutrition (2005), 93, 175–17

Despite low glycemic indexes of 15–30, all of the milk products produced high insulinemic indexes of 90–98, which were not significantly different from the insulinemic index of the reference bread.

Milk products appear insulinotropic as judged from 3-fold to 6-fold higher insulinemic indexes than expected from the corresponding glycemic indexes.

Ostman, E et al. Inconsistency between glycemic and insulinemic responses to regular and fermented milk products, Am J Clin Nutr (2001) 74, 96 – 100.

Milk is unrefined. And yet it evokes a huge IS, six times what you would expect, way out of proportion to its carb content.

Cocoa is insulinogenic too.

Although the GI did not differ within each pair, the insulin index (II) of the chocolate product was always higher, by a mean of 28%, than the alternate flavored product.

Chocolate may not be unique in its insulinogenic capacity. We and others have noted that dairy products produce hyperinsulinemia despite a low GI (15–17).

Brand-Miller J, et al. Cocoa Powder Increases Postprandial Insulinemia in Lean Young Adults, The American Society for Nutritional Sciences J. Nutr. 133:3149-3152, October 2003.

There is a disconnect between the GI and the IS. The GI is not predictive of the IS. (In other words, this disconnect between the GI and the IS shows AGAIN that the carb content is not predictive of the insulin response.)

A food that has a low GI can have a high IS. This applies to dairy and to other fatty foods. Some foods (such as meat, fish, and eggs) that contain no carbohydrate, just protein and fat (and essentially have a GI value of zero), still stimulate significant rises in blood insulin.

Oku, T et al. Consideration of the validity of glycemic index using blood glucose and insulin levels and breath hydrogen excretion in healthy subjects, International Journal of Diabetes Mellitus Volume 2, Issue 2, August 2010, Pages 88-94

You can ignore the data on protein all you want, Percy, but the fact remains that both beef and fish stimulate a high insulin response. Right up there with Honeysmacks.

But if you're also arguing that that is Taubes' hypothesis then you are wrong. Taubes' hypothesis is that increased intake of refined carbohydrates is responsible for the diseases of western civilization.

No it isn't, Percy. Taubes spends over 600 pages trying to establish a link between carbs and insulin and then a link between insulin and weight gain.

But to again address your point that refined v. unrefined carbs have differing IS. There are 137 cites for the Holt paper. 27 support the findings that insulin scores/glycemic responses for refined and unrefined carbs are identical/very similar.

For example, these 4 papers showed that white and whole-meal breads showed similar glycemic responses both in healthy volunteers (Jenkins, 1981; Lilje, 1992) and in diabetics (Heinonen, 1985; Jenkins, 1983).

Jenkins DJA, et al. Lack of effect of refining on the glycemic response to cereals. Diabetes Care 1981;4:509–13.

Liljeberg H, et al. Metabolic responses to starch in bread containing intact kernels versus milled flour. Eur J Clin Nutr 1992;46:561–75.

Heinonen L, et al. The effect of different types of Finnish bread on postprandial glucose response in diabetic patients. Hum Nutr Appl Nutr 1985;39:108–13.

Jenkins DJA, Wolever TMS, Jenkins AL, Lee R, Wong GS, Josse RG. Glycemic response to wheat products: reduced response to pasta but no effect of fiber. Diabetes Care 1983;6:155–9.

You catch the last half of that last title? NO EFFECT OF FIBER.

It is not Taubes' hypothesis that only carbohydrates cause an insulin response.

C'mon, Percy. The title of chapter 22 is The Carbohydrate Hypothesis: Insulin.

The digestive system breaks food down into constituents that can be absorbed by the bloodstream, such as glucose. Insulin response is governed by many factors, but one significant factor is blood glucose levels.

That's called the GI. And, as I've shown above, there is a huge disconnect between the IS and the GI. The GI is not predictive of the IS.

The hypothesis is that refined carbohydrates, because of their rapid digestion, cause glucose and insulin spikes and other health effects that are ultimately responsible for the increasing rates of obesity and and diabetes observed in western countries. Beef isn't rapidly digested, nor does it cause glucose and insulin spikes.

Funny. Researchers disagree. No effect of fiber. RAG and SAG similar IS. Disconnect between GI and IS.

If you'd like, I can compile a list of the papers that show glucose load is not predictive of insulin levels. A list of the papers that show carb content is not predictive of IS. A list of the papers that show type of carb is not predictive of IS.

How about you show me the data that support your contention that type of carb is predictive of IS?

Edited by molbiogirl, : No reason given.


This message is a reply to:
 Message 393 by Percy, posted 08-30-2011 7:02 AM Percy has responded

Replies to this message:
 Message 398 by Percy, posted 09-02-2011 9:05 PM molbiogirl has responded
 Message 414 by Percy, posted 09-03-2011 2:59 PM molbiogirl has not yet responded

molbiogirl
Member (Idle past 198 days)
Posts: 1909
From: MO
Joined: 06-06-2007


Message 397 of 451 (631670)
09-02-2011 10:32 AM
Reply to: Message 394 by Percy
08-31-2011 8:15 AM


Re: Refined v. unrefined insulin response
Regarding #2 concerning the association of increased refined carbohydrate intake with obesity and type II diabetes, here is a study showing this effect with type II diabetes.

Percy, I took a look at that paper. That is one sad little excuse for a paper. Intheir discussion, they fall all over themselves to excuse their crappy analysis.

The results of this ecologic study need to be interpreted in the context of the study’s strengths and weaknesses. Ecologic studies, such as observational studies of individual persons, are susceptible to confounding.

Although food disappearance data are an indirect measure of individual consumption, these data have been calculated annually for more than a century, making them the only consistent data available for identifying secular trends (22).

Changes in diagnostic criteria and screening practices for type 2 diabetes may limit the ability to determine the extent of effect due solely to dietary changes.

The issue of confounding with obesity, physical activity, or both is challenging. Unfortunately, there is no uniform source of consistent information about physical activity in the United States for the period studied.

Use of such scant data to control for obesity would lack sufficient power to be meaningful.

And when the authors get around to discussing type of carb and its relation to insulin response, they cite papers that don't support their argument!

In several small-scale metabolic trials, refined grains have been shown to cause a significant increase in insulin secretion and the postprandial glucose response (50-54).

From 50:

Correlation with the in vivo data was imperfect. Oat-based meals evoked smaller glucose and insulin responses than wheat- or maize-based meals.

Particle size influences the digestion rate and consequent metabolic effects of wheat and maize but not oats.

Not real convincing, Percy.

51 didn't address insulin levels.
52 is the Hoyt paper.
53 deals with fat intake, not carb intake.
54 deals with overeating, not type of carb intake.

I think you need to find something that supports your argument. This undermines it.


This message is a reply to:
 Message 394 by Percy, posted 08-31-2011 8:15 AM Percy has acknowledged this reply

Percy
Member
Posts: 16022
From: New Hampshire
Joined: 12-23-2000
Member Rating: 3.1


Message 398 of 451 (631755)
09-02-2011 9:05 PM
Reply to: Message 396 by molbiogirl
09-02-2011 10:12 AM


Re: Refined v. unrefined insulin response
Hi Molbiogirl,

I don't understand how you keep doing this, but at least you're remarkably consistent. You have again presented information that disagrees with you.

molbiogirl writes:

Your list is wrong. You can't ignore the error bars. Here's the list, from lowest to highest, with error bars included.

Here's your table, this time with labels:

FoodInsulin ScoreInsulin Score + maxerror
Peanuts20 ± 525
All-Bran32 ± 436
Eggs31 ± 637
Porridge40 ± 444
White Pasta40 ± 545
Brown pasta40 ± 545
Muesli46 ± 551
Cheese45 ± 1358
Grain bread56 ± 662
Apples59 ± 463
Oranges60 ± 363
Popcorn54 ± 953
Beef51 ± 1667
Lentils58 ± 1270
Special K66 ± 571
Honeysmacks67 ± 673
Brown rice62 ± 1173
Potato chips61 ± 1475
Fish59 ± 1877
Sustain71 ± 677
Cornflakes75 ± 882
Doughnuts74 ± 983
French fries74 ± 1286
Bananas81 ± 586
Grapes82 ± 688
White rice79 ± 1291
Croissants79 ± 1493
Cake82 ± 1294
Crackers87 ± 1299
White bread100 ± 0100
Ice cream89 ± 13102
Cookies92 ± 15107
Whole-meal bread96 ± 12108
Yoghurt115 ± 13128
Potatoes121 ± 11132
Mars Bars122 ± 15137
Baked beans120 ± 19139
Jellybeans160 ± 16176

I have no idea why you think sorting the table by "Insulin Score + maxerror" instead of just by "Insulin Score" is an improvement, but as anyone can plainly see the relationship I described before still holds true. As you scan down the table the Insulin Scores increase and the foods are generally higher and higher in refined carbohydrate content. My tables showed it, and your more complete table shows it.

Also, the relationship between grapes and popcorn that you expressed concern about doesn't change. Popcorn, a relatively more complex carbohydrate, has a lower insulin score than grapes, which contain a great deal of sugar in the form of fructose which is a relatively simple carbohydrate.

Englyst, K at al. Glycaemic index of cereal products explained by their content of rapidly and slowly available glucose, British Journal of Nutrition (2003), 89, 329–33

In other words, the type of carb (rapidly absorbed glucose, slowly absorbed glucose, resistant starch, nonresistant starch) is no more predictive of the insulin response than the % carb content.

You have again cited a paper that disagrees with you (Glycaemic index of cereal products explained by their content of rapidly and slowly available glucose). The conclusion is right there at the end of the abstract on page one of the paper:

Englyst et al writes:

In conclusion, the GI and II values of the cereal products investigated can be explained by the RAG and SAG contents. A high SAG content identifies low-GI foods that are rich in slowly released carbohydrates for which health benefits have been proposed.

GI is Glycemic Index and II is Insulinemic Index. The conclusion is stating that SAG (Slowly Available Glucose) is associated with lower a glycemic index, and RAG (Rapidly Available Glucose) is associated with a higher glycemic index.

You actually quoted part of the paper that raises questions about whether you understand what you're reading, particularly the math portions, for you quoted this, and I maintain the portion you highlighted in red:

Of the carbohydrate fractions investigated in the present study, RAG demonstrated the strongest correlation with II, but still only explained 32 % of the variance. (This) in agreement with previous findings ( (Kabadi, 1991; Trout, 1993; Brand-Miller 1995).

This is stating in no uncertain terms what I've been telling you, that in general the higher the content of refined carbohydrates the higher the glycemic index and the higher the insulin index. No one is saying there aren't other factors, which is all the part in red is saying. You're not telling anyone anything they didn't know already. You're not rebutting a claim that anyone has made.

It might be worth noting that in contrast to the other paper, this was a study of a narrow food group (cereal products only), and it was done in vitro, not in vivo, in other words, in the laboratory rather than with actual people.

Because you're exhibiting the same pattern as a couple years ago of citing papers that disagree with you I'm not going to look at the other papers you cited because I think I'll just find more of the same.

--Percy

Edited by Percy, : Improve table presentation.


This message is a reply to:
 Message 396 by molbiogirl, posted 09-02-2011 10:12 AM molbiogirl has responded

Replies to this message:
 Message 399 by purpledawn, posted 09-03-2011 5:29 AM Percy has responded
 Message 417 by molbiogirl, posted 09-08-2011 12:05 PM Percy has acknowledged this reply
 Message 418 by molbiogirl, posted 09-08-2011 1:51 PM Percy has acknowledged this reply
 Message 420 by molbiogirl, posted 09-08-2011 3:38 PM Percy has responded

  
purpledawn
Member (Idle past 1014 days)
Posts: 4453
From: Indiana
Joined: 04-25-2004


Message 399 of 451 (631778)
09-03-2011 5:29 AM
Reply to: Message 398 by Percy
09-02-2011 9:05 PM


Interpreting Studies
quote:
Because you're exhibiting the same pattern as a couple years ago of citing papers that disagree with you I'm not going to look at the other papers you cited because I think I'll just find more of the same.
It seems reading studies is like reading statistics (or the Bible ). One can seem to make a case either way.

When it comes to health studies, I wish I could see more details concerning the subjects. Unlike cars we aren't exact duplicates off an assembly line. There is something different in those of us who store fat than those who don't. Whether it is a malfunction or a survival function, I don't think they really know yet. IMO, Taubes is trying to point out that scientists need to look deeper into what that difference is rather than blaming calories-in-calories-out or lack of willpower.

I feel he has shown that the studies used to support the edict to eat low fat, low cholesterol, etc.

So the public is still left in the cold because the majority of people do not have access to studies and simply go by what someone has written. Same with doctors. They aren't really looking at the studies, nor do they have time.

The internet makes it easier, but then we have to deal with individual understanding.

Bottom line, the individual has to do what works for them and most of us who have had to deal with storing fat, have tried many things over the years that didn't work or weren't sustainable.

For me, staying away from sugars and refined carbs as a norm works and is sustainable. I'm not afraid to eat a piece of cake at a birthday party and gain 5 pounds. (That was so annoying) I haven't seen a down side to staying away from starch and sugar.

Taubes alludes to the idea that storing fat may be an endocrine malfunction. Since reading his book I've read a book by Dr. Broda Barnes on Hypothyroidism. I know we would like to be able to point to one thing that actually causes the problem, but I still see the body as a very complicated machine and we are still trying to figure out how parts interact with other parts. Since the thyroid deals with metabolism, a malfunctioning thyroid may be what contributes to our reaction to refined carbs.

Just another piece in my puzzle at least. I am very glad you brought Taubes' book to my attention. It has helped my family a lot. Thanks


This message is a reply to:
 Message 398 by Percy, posted 09-02-2011 9:05 PM Percy has responded

Replies to this message:
 Message 400 by Percy, posted 09-03-2011 6:13 AM purpledawn has responded

Percy
Member
Posts: 16022
From: New Hampshire
Joined: 12-23-2000
Member Rating: 3.1


Message 400 of 451 (631779)
09-03-2011 6:13 AM
Reply to: Message 399 by purpledawn
09-03-2011 5:29 AM


Re: Interpreting Studies
purpledawn writes:

Bottom line, the individual has to do what works for them...

I know we would like to be able to point to one thing that actually causes the problem, but I still see the body as a very complicated machine and we are still trying to figure out how parts interact with other parts.

Yes, that's the problem. Human metabolic processes are very complicated, and we're all complicated in different ways, which only adds to the problem of figuring things out.

As you alluded, Taubes makes clear that the post WWII research (especially the country studies) indicting fat for the diseases of western civilization were highly flawed. He argues that increased intake of refined carbohydrates is responsible. He is aware that existing research is merely suggestive and not conclusive, and in his writings and talks he always calls for more research.

My own personal experience regarding obesity is that fat by itself is not bad, that refined carbohydrates in the form of refined grass-derived products and sugar are bad, and that refined carbohydrates combined with fat are very bad. I've been following a low carb diet for over a couple years now, and my recent annual blood tests yield better results for HDL/LDL and triglycerides than I have ever had in my life.

Taubes' original book GCBC gave no dietary advice, but what that advice would be had he given it is pretty clear, and it seems pretty much the same as Michael Pollan's advice to return to a diet somewhat similar to that of our great or great great grandparents. I have Taubes' new book, Why We Get Fat, but I'm having trouble getting through it because of boredom - the early chapters are just shorter and simplified versions of the same information in GCBC.

If you've never seen the movie Food, Inc. I think it is well worth watching. As the title suggests, it's about the food industry and not the diabetes and obesity epidemics, but it explains how the food we get in our stores that is so high in refined carbohydrates is a strong function of the nature of that industry.

But more relevant to this topic is a segment about a Latino family of four in poor financial shape struggling to get by where the father is a type II diabetic whose medicine is a significant expense for them. Because they have little money they are forced to consume the cheapest calories available, and those calories are high in refined carbohydrates. One scene shows them in a supermarket looking at healthy foods and their prices and showing how much more expensive it would be for them to create healthy meals instead of just going to McDonald's, whose fast food is the worst stuff for a diabetic. The entire family is overweight.

--Percy


This message is a reply to:
 Message 399 by purpledawn, posted 09-03-2011 5:29 AM purpledawn has responded

Replies to this message:
 Message 401 by purpledawn, posted 09-03-2011 7:57 AM Percy has responded

  
purpledawn
Member (Idle past 1014 days)
Posts: 4453
From: Indiana
Joined: 04-25-2004


Message 401 of 451 (631786)
09-03-2011 7:57 AM
Reply to: Message 400 by Percy
09-03-2011 6:13 AM


Re: Interpreting Studies
quote:
My own personal experience regarding obesity is that fat by itself is not bad, that refined carbohydrates in the form of refined grass-derived products and sugar are bad, and that refined carbohydrates combined with fat are very bad. I've been following a low carb diet for over a couple years now, and my recent annual blood tests yield better results for HDL/LDL and triglycerides than I have ever had in my life.
My husband and I have been doing basically low carb since 2003. We had come to the conclusion on our own after years of low fat eating, but still gaining weight. Our starting point was getting rid of things with preservatives, hidden sugar, and HFC. It has been a process.

Oddly enough when my weight went down, my cholesterol went up. Fix one thing and another breaks.

I have a place where I can get my own blood tests done without going through a doctor, so I did my own experiment. I went without any manmade sugar whatsoever of any kind, not even artificial, for three months. When I tested again, the cholesterol was lower. Another three months and it was under 200. Then I allowed items with sugar once in a while for the next three months. The cholesterol started to go back up. I haven't worried about cholesterol and refuse to go on statins. Right now I'm on T3 for the thyroid and that makes my cholesterol go down. The odd thing is that on paper, my thyroid looks fine. So a new battle begins because I don't think T3 is a sustainable solution. Another piece to the puzzle.

I just wish the puzzle had come with a manual and wasn't so hard to put together.

quote:
But more relevant to this topic is a segment about a Latino family of four in poor financial shape struggling to get by where the father is a type II diabetic whose medicine is a significant expense for them. Because they have little money they are forced to consume the cheapest calories available, and those calories are high in refined carbohydrates. One scene shows them in a supermarket looking at healthy foods and their prices and showing how much more expensive it would be for them to create healthy meals instead of just going to McDonald's, whose fast food is the worst stuff for a diabetic. The entire family is overweight.
My husband and I had discussed that observation one day. If we look at the early pioneers, the "rich" were the ones who could afford the refined flours, sugars, etc. The farmers had the grass fed beef, brown flour, etc. Today it is the "wealthy" who are able to buy the "healthy food".

What used to be a sign of wealth is now bad for our health. We noticed the difference in our grocery bill when we changed the way we ate. At least we are able to buy a whole beef, which is cheaper than buying it by the piece in the store. I guess either the grocery bill goes up or the doctor bills go up. It's messed up.

We are at the mercy of the people who "make" our food. Everyone can't have a little hobby farm to grow their own food. It takes a lot of time and effort to do that. When both adults work, it is difficult.

Whenever my mother wants to cut expenses she wants to cut back on the healthy food. I told her to cut back on the useless crap she buys, not the food. She's diabetic. As long as she stays away from starch and sugar her numbers stay good and she stays off the meds.

If they mess up our food, we're in trouble. Evolution takes it course. Only those who can survive on the carbs with make it through. As Granny Magda says: Mutate and survive.


This message is a reply to:
 Message 400 by Percy, posted 09-03-2011 6:13 AM Percy has responded

Replies to this message:
 Message 402 by Percy, posted 09-03-2011 8:28 AM purpledawn has responded

Percy
Member
Posts: 16022
From: New Hampshire
Joined: 12-23-2000
Member Rating: 3.1


Message 402 of 451 (631789)
09-03-2011 8:28 AM
Reply to: Message 401 by purpledawn
09-03-2011 7:57 AM


Re: Interpreting Studies
purpledawn writes:

Oddly enough when my weight went down, my cholesterol went up. Fix one thing and another breaks.

Do you mean your overall cholesterol level actaully went up? Or that your HDL/LDL ratio worsened? If the latter then that *is* odd. If the former then it doesn't seem much worth worrying over.

Right now I'm on T3 for the thyroid and that makes my cholesterol go down. The odd thing is that on paper, my thyroid looks fine.

When you say your thyroid looks fine on paper, do you mean that blood tests for TSH and T4/Free come out normal? If so, then why are you on T3? And are you really on T3, or is it really T4 of which some percentage the body transforms into T3?

Also, for you is the T3 supposed to help with things like blood levels and long term health, or does it have an impact on the way you feel, things like energy level, endurance and alertness?

If they mess up our food, we're in trouble. Evolution takes it course. Only those who can survive on the carbs with make it through. As Granny Magda says: Mutate and survive.

Yes, exactly. A few messages back I described the view of some researchers that we have become better adapted to carbs over the past 10,000 years since the advent of agriculture.

--Percy


This message is a reply to:
 Message 401 by purpledawn, posted 09-03-2011 7:57 AM purpledawn has responded

Replies to this message:
 Message 403 by purpledawn, posted 09-03-2011 10:11 AM Percy has responded

  
purpledawn
Member (Idle past 1014 days)
Posts: 4453
From: Indiana
Joined: 04-25-2004


Message 403 of 451 (631793)
09-03-2011 10:11 AM
Reply to: Message 402 by Percy
09-03-2011 8:28 AM


Re: Interpreting Studies
quote:
Do you mean your overall cholesterol level actaully went up? Or that your HDL/LDL ratio worsened? If the latter then that *is* odd. If the former then it doesn't seem much worth worrying over.
Everything went up except the HDL. Of course at first I concentrated more on preservatives and HFC, not so much on reducing regular sugar or sugar alcohols. I was still eating candy. I love Treasures. The Doctors wanted to blame the eggs, but my egg intake had not increased from the last blood test. That's when I did the sugar experiment. It was the one thing I hadn't dealt with. Hey, I figured if I was losing weight and could still eat my candy, I was happy.

When staying off the sugar the Tri's dropped and my HDL went up, but even when my total was below 200 the LDL was still in the high range although not as high as it was. I thought that was odd, but at least the Tri's and the HDL were much better.

Now when I eat sugar the Tri's go up, but my HDL has remained in good shape. On my last one this year (I cut out sugar again), my total is 300, but my Triglycerides were 80 and the HDL was 54. The calculated LDL remains high. My LDL has remained in the high zone (although sometimes higher than others) since 99 when I started keeping my records.

My next cholesterol test is going to be the VAP that measures actual LDL and the sizes.

quote:
When you say your thyroid looks fine on paper, do you mean that blood tests for TSH and T4/Free come out normal? If so, then why are you on T3? And are you really on T3, or is it really T4 of which some percentage the body transforms into T3?

Also, for you is the T3 supposed to help with things like blood levels and long term health, or does it have an impact on the way you feel, things like energy level, endurance and alertness?


Yes, my blood test numbers for TSH and T4 fall into the normal range. I am on actual T3 (slow release, not synthetic) because my Free T3 is low. Bottom of the normal range. Most people go because of fatigue, but I don't notice fatigue in me.

The biggest reason is that I have symptoms of Hypothyroidism even though the numbers are normal. The two biggies are high cholesterol and Myxedema on the arms. There's also the low basal temperature. I don't notice fatigue in me. So I'm trying to deal with the symptoms I can measure more so than feeling more energetic. (I guess if I jump on a treadmill and want to exercise, my husband will know the "root is kicking in".)(Sorry movie reference)

The studies done by Dr. Broda Barnes showed that removal of the thyroid from rabbits caused them to develop hardening of the arteries. Giving them thyroid hormone replacement (T4 and T3) caused the hardening of the arteries to stop. I don't remember if it reversed or not. Don't have the book in front of me right now.

I do have a thyroid thread if you want to get into this more, but looking at my family history (grandmother and mother) and the path they followed, I'm choosing to use thyroid hormones to deal with the symptoms and not the numbers.

Some of what Dr. Barnes addresses is the same thing we are dealing with here. How one interprets the studies. A study done to show how accurate the TSH readings were had some problems in Dr. Barnes' opinion. Apparently the "normal" group had some of the same hypothyroid symptoms as those whose numbers were outside the normal. So they supposedly excluded all the similar symptoms, if I"m wording that right, so the TSH seemed accurate.

My maternal grandmother, mother, and sister all took the T4 only and their TSH numbers were border line outside normal. They all continued the symptoms of hypo. My grandmother has since passed. She went from high cholesterol (after change), statins, stints, blood pressure meds for heart, diabetes, double bypass, and demtia. This is over a period of 20 or so years. My mother is following that same path. She just had double by pass this last Feb and is going towards dementia. (Had her tested for the demtia) I'm working to have her doctors (See Desiccated Thyroid vs Synthetic T4 Treatments) add T3 to her synthetic T4.

The thyroid seems to impact a lot of things and it is hard to paint a good picture in a post.

This is how I understand it. The thyroid affects our bodies in many different ways and when it isn't working as our individual bodies need, it sends out cries for help. Unfortunately those messages manifest themselves in many different ways and we've created meds to stifle those messages.

IMO, it would be better to treat the thyroid optimally and see what messages it answers.

The wonderful Framingham study that Taubes mentions. Barnes also uses that study to predict many of his patients should have had heart attacks over x number of years. (Still working off the top of my head.) I think per the Framingham study 72 of his patients should have had heart attacks and only 4 actually did. His theory is that the thyroid is what causes the hardening of the arteries. IOW, if an individuals body isn't getting the amount of thyroid hormone that they need, there is damage to the body.

I say individual, because I truly believe that we aren't all exactly the same and what my body needs for optimum health may not be the same as any other woman's.

So I am curious if the T3 will lower my cholesterol. Although I don't consider T3 only to be a long term treatment. Yes, I'm having an argument with my doctor over that too. I think desiccated is the way to go.

Hypothyroidsim Type 2: The Epidemic by Mark Starr, M.D. and Hypothyroidism: The Unsuspected Illness by Broda O. Barnes, M.D. are good books to read.

My choices are based on looking at patterns in my info and my families. I did find a app on the ipad that enabled me to put in my test scores and see a graph. Before I started taking the T3 it showed my TSH going higher and my T4 lower. This all happened about the time menstrual cycle ended. The "change" is usually when women start feeling the affects of screaming thyroid.

Some interesting points that both doctors make is that there are symptoms of hypothyroid long before the numbers show it. Even in children. After reading a bit you start to feel like everything is caused by the thyroid, but the doctors do stress that there can be other causes for some symptoms. But what if treating the thyroid should be the first line of preventative care instead of the last? (my question, not theirs)

What if that is part of our difference? Like I said, another piece to the puzzle.

Native Americans and other minorities tend to have more thyroid issues. I have Native American in my ancestry.

With all the mixed genetics, how can we tell how things are supposed to behave in any one person.

quote:
Yes, exactly. A few messages back I described the view of some researchers that we have become better adapted to carbs over the past 10,000 years since the advent of agriculture.
So we didn't mutate enough. I do notice my daughter doesn't have as much problem with carbs I do. But she hasn't come to the change yet!!!!!

Apparently thyroid problems are passed through the mother. My daughter does have depression and did as a child, which could be because of thyroid. Needless to say there are many things in our family history that lead me to my decision and they probably fall into the TMI category.

I think you would find the books interesting. Maybe your library will have them. They aren't expensive books. I found a used one for the Barnes book. $4. I have no problem with a preread book. The Starr book is available on Nook I believe. $9.99. Mines a hard copy though. If you read them, let me know what you think.

Is it too late to mutate?????


This message is a reply to:
 Message 402 by Percy, posted 09-03-2011 8:28 AM Percy has responded

Replies to this message:
 Message 404 by Percy, posted 09-03-2011 10:33 AM purpledawn has acknowledged this reply

Percy
Member
Posts: 16022
From: New Hampshire
Joined: 12-23-2000
Member Rating: 3.1


Message 404 of 451 (631797)
09-03-2011 10:33 AM
Reply to: Message 403 by purpledawn
09-03-2011 10:11 AM


Re: Interpreting Studies
Hi PD, thanks for all the information. I just looked down the list of symptoms for hypothyroidism and it looks like I don't really have any them. If I wanted to be picky I suppose I could say I have fatigue and weight gain, but that would be stretching it.

I have another appointment with my doctor coming up this week when we'll look at the results of the latest blood tests and see if anything interesting shows up. He included pituitary tests in addition to the thyroid tests this time.

--Percy


This message is a reply to:
 Message 403 by purpledawn, posted 09-03-2011 10:11 AM purpledawn has acknowledged this reply

  
Bolder-dash
Member (Idle past 1187 days)
Posts: 983
From: China
Joined: 11-14-2009


Message 405 of 451 (631804)
09-03-2011 10:59 AM


Just for your information- As a professional athlete, and someone who knows a fair bit about exercise and nutrition, I can tell you that one of the worst things you can give your body is a big glass of grape or apple juice.

People often give this to children, thinking it is a healthy alternative to the bad sugared soft drinks, but in fact the sugar levels of these juices is so high, that it wreaks havoc with your blood as much or more as the sugared soft drinks (all of which are bad of course-I haven't had even one in twenty some odd years) , as well as disturbing mineral levels and your calcium-phosphorus balance. The human body is not well adapted for taking in that much simple sugar so rapidly. Unfortunately, even so called exotic fruit juice drinks which advertise no added sugar, are generally just loaded with these two high glycemic load juices, with just a pinch of more slowly digested juices.

The choices for the average consumer in America are not very good unfortunately. I believe this to be the single biggest cause of obesity in your country.


Replies to this message:
 Message 406 by Percy, posted 09-03-2011 11:16 AM Bolder-dash has responded
 Message 407 by purpledawn, posted 09-03-2011 11:34 AM Bolder-dash has responded

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