Gary Fettke – Another Day, Another Fructophobe Who All of A Sudden DOESN’T Want To Discuss Evidence Part 3

Here is Part 3 of this ordeal (If you landed here, try Part 1 and Part 2 by clicking on them)

Here is Gary’s (non) response to my dismantling of his post! Weak and off topic in my opinion!

Gary Fettke ‘I will continue to share my positive experiences and my interpretation of the literature as I see fit. It is helping people and encouraging a healthy lifestyle. That is my priority and passion. I am committed to this topic and believe in what I put forward. Why else would I do it?
There will never be a definitive article on this topic. In the meantime I will not debate your articles unless there is that definitive article to discuss.’
If you want to keep pushing the sugar corporate industry barrow, then please do it on your own site. If you have something positive to contribute you are most welcome.
Happy to have a chat sometime over a beer (fructose free of course).
Gary Fettke

David Driscoll  “I will continue to share my positive experiences and my interpretation of the literature as I see fit. It is helping people and encouraging a healthy lifestyle. That is my priority and passion. I am committed to this topic and believe in what I put forward. Why else would I do it? “

I haven’t challenged any of those premises, I haven’t suggest that you are insincere or questioned why you are doing it – I just want to discuss the evidence with someone who is scientifically literate? With all due respect, where did this come from?

“There will never be a definitive article on this topic.”

Again, I haven’t suggested that there was. But two big (and well done) studies have challenged the premise that fructose is uniquely addictive and switches off appetite control in humans. I’m happy to see any evidence to the contrary, one, ten or twenty studies. I don’t doubt that you came to your conclusions honestly and based on facts – I’d just like to know what they are?

“In the meantime I will not debate your articles unless there is that definitive article to discuss.”

Is it not definitive that massive doses of fructose didn’t result in increased energy intake vs glucose? Is this an insignificant point in the case for or against fructose?

“If you want to keep pushing the sugar corporate industry barrow, then please do it on your own site.”

I’ve told you that I have no corporate ties, at what point did the discussion degenerate into this? It started talking about the evidence, then it went to questioning my motives, some misrepresentations (like Rosemary Stanton) and wanting to talk about the big picture and not the details?

“If you have something positive to contribute you are most welcome.”

I thought that I was welcomed here to discuss the evidence? Isn’t the search for it positive? Aren’t I on the same journey that you were on for 18 months?

“Happy to have a chat sometime over a beer (fructose free of course).”

Sorry, but now I am really confused. Why happy to chat in person but not in (virtual) public. If I had offended you (which was never my intention and if so I am sorry), but I figure that you wouldn’t make such an offer.

I understand that these types of discussions are time consuming, but you did spend 18 months trying to disprove David Gillespie (and said you couldn’t). As someone who is on the same journey, I am truly baffled at what has triggered this change of heart.

Thanks for you time

Disappointed David Driscoll.

Back to an equally vague, general and avoiding response from Gary Fettke

Gary Fettke Dear David M Driscoll. I have copied this across for you. Please refer to my previous response to you of April 7. I can copy and paste it if you wish to read it again.
There are many things we do in practice without waiting for absolute evidence. It has happened for all eternity and particularly in medicine. Most breakthroughs start with looking at the information available. You draw your own conclusions based on your own experience, the basic science as perceived , literature that is read with an open mind and then proceed with those conclusions. That is what I do. That is what most doctors do. There is conflicting literature on most aspects of medicine but it has not stopped progress. Remember when the Earth was flat.
Drs Barry Marshall and Robin Warren rewrote the textbooks with reference to what causes gastritis and gastric ulcers when they went against conventional thinking.
If a tsunami warning is given on a beach you have two options. You can go down to the beach and demand the seismographic proof and then see what happens. The other option is to move to the higher ground, play it safe for a while and see what happens. I believe a tsunami is rolling in when it comes to our health.
There is no cost and no side effects of what I am proposing. There is enough evidence for me to recommend it to my patients and those that adopt it are finding major benefits. I am playing it safe.
People are feeling better. What’s the problem with that?
On a practical note. Have you decreased your current intake of sugar in comparison to that of 5 years ago? Just a simple yes or no will suffice.

David Driscoll “There are many things we do in practice without waiting for absolute evidence.”

Once again, you seem to be responding to comments that I haven’t made, and I hoped for better than strawmen logical fallacies in this type of discussion. I haven’t suggested that things are absolute (although no fructose does sound pretty absolute)!

Just to recap, I initially asked for your evidence with regards to fructose being addictive and its effect on appetite. We agreed that sweetness is probably more likely to be an issue versus fructose. YOU quoted the JAMA study and I showed you how the results probably have been misinterpreted/misreported. I also showed how these (lack of) results were consistent with another highly refereneced study (Stanhope 2009) and then asked on what other evidence you based this position. (I think that these type of ‘clinical’ and practical tests of mechanisms and theories are strong indicators personally. Lots of great work on theories and mechanism have failed the ‘practical application’ test).

And then you step backed, went for the ad hominems and seem to talk around the issues. It all of a sudden became about me, about you, motivation, vested interests and everything but evidence. Why? I hoped to talk about the other evidence later (as I indicated via email), but you brought it up yesterday for some reason, before we got through the initial topic.

I really don’t understand this over-reaction to the ‘vested interest’ position where people just seem to dismiss anything someone says who has a history (although it is popular). Sure it is a serious problem that must be considered, but I think the pendulum has swung a little too far! For me, this issue should just bring increased vigilance and not total dismissal. I don’t believe that you can totally dismiss someone for life who has had corporate sponsorship, especially when doing meta-analysis and review studies. Surely an appropriate response is to draw to people’s attention where the evidence is lacking, what was wrong with inclusion or exclusion criteria, evidence to the contra that wasn’t considered etc. Simple dismissal PURELY based on corporate associations isn’t something I would expect from someone with your level of training (It really is just a cheap lawyer/debating trick) and the David Despain bit was a low point! You seem to have put a lot of effort into finding something wrong with most people involved – and then skipped over the initial exchange. Again, why?

All I have asked for is the evidence that you have deemed compelling (or couldn’t fault), I’m not sure why you turned it into the facade that yesterday became (including the cheap shot responses).

“There is enough evidence for me to recommend it to my patients and those that adopt it are finding major benefits.”

Great, and all I am asking is that you share that evidence – something that you seemed to indicate that you would do when discussing on the Sweet Poison page.

“What’s the problem with that?”

Again, why do you think I have a problem with that? I’ve stated a number of times (and similar of David Gillespie and Sarah Wilson) – if this is just a gut feeling or something you have experienced great, but if it is based on evidence – all I am asking is to see that evidence.

“On a practical note. Have you decreased your current intake of sugar in comparison to that of 5 years ago? Just a simple yes or no will suffice.”

I don’t know. I know that wasn’t one of the options, but that is my answer. I hope it wasn’t an attempt to draw me into the debate on the Australian Paradox (or distract from the points that I am trying to raise), but irrespective I don’t think population wide trends do much to give us hard data. For me, correlations are starting points for actual scientific studies, not an end point so I don’t think it is relevant nor compelling. Lots of things get lost or exaggerated when averaged across a population.

I hope we can get back to discussing the evidence and leave the rest behind us. If you don’t wish to (it can be time consuming), I totally understand. I just hope that if you don’t, you can stop with the cheap shots and misrepresentations regarding myself.
————————————-

So there it is! I would have liked to gotten to the dismissal of studies and blog posts based on PURELY who has written them, but unfortunately it didn’t happen. Oh well, now we will return to our normal programming!

 

Gary Fettke – Another Day, Another Fructophobe Who All of A Sudden DOESN’T Want To Discuss Evidence Part 1

Apologies for the slight break in normal fact checking, but I needed to set the record straight, now that it has been erased along with my access to the No Fructose Facebook page, please forgive the self-indulgence (but you may recognise the ‘tactics’ about how to avoid an actual discussion of evidence).

In what at first seemed like it would be a civil exchange of evidence, surgeon and converted anti-fructose + seed oil campaigner Gary Fettke claims that he tried to debunk David Gillespie’s work and couldn’t and thus became an advocate.

The usual suspects thought that I wouldn’t dare confront a surgeon (why not, we’re not talking about surgery?) and at first the exchange was civil, fair and based purely on evidence. I initially sent an email about general evidence and then found the Facebook page and then responded to a Robert Lustig post (within an hour or so), which is where the following discussion is from.

The initial email read;

I was checking out your website and came across this curious quote “The science is bearing this out and I have spent the best part of 15 months researching it, trawling through the depths of some pretty esoteric journals and all I have done is found information that supports what I am writing about.”

All you have found? Here is the results of a pubmed search of review articles (from which as you know you can grab all of the sources) http://davidgillespiesbigfatlies.com/200/latest-fructose-research-part-1/

I was wondering what the source of your original search was if all I have found is information that supports what you are writing?

More than happy to discuss the science, can’t seem to find too many others who will do it honestly.

Thanks in advance.

Gary Fettke replied the following day – Hi David Replied to you on Facebook Gary Fettke No Fructose. Cheers

My response – Posted this before I found the Facebook page – this is a different question – will post once we get through the Lustig/addiction stuff if it is ok with you.

Anyway, back to the first Facebook exchange.

No Fructose Screenshot 300x203 Gary Fettke   Another Day, Another Fructophobe Who All of A Sudden DOESNT Want To Discuss Evidence Part 1

Via Facebook Gary (sort of) acknowledged that sweetness may be the real problem (vs fructose) and then listed a few references to support his position. But then things changed.

In what now seems a familiar ploy in this (any many other) arena(s), as soon as the science got a little too in depth (and wasn’t going the way of Gary), he pulled back, wanted to look at the big picture, wanted to revert to ad hominems attacks (which he did later apologise for, but didn’t correct his other errors), wanted to talk about motivation, personal experience, limitations of evidence and pretty much everything BUT the science. Broad sweeping generalisations about authors and entire fields of research simply dismissed and another separate topic was introduced in order to muddy the water (or distract from the losing battle that had ensued on Facebook)

Gary Fettke No Fructose   Sugar should be managed like Tobacco and Alcohol.

I have been a follower of Robert Lustig for some time. I completely agree with him that we require a bottom up approach to social reform on this issue.

In this lecture he covers recent epidemiological and scientific evidence about the problems of Fructose. The questions at the end are a bit detailed but interesting for nerds like me.

Thanks Colette for forwarding.

Robert Lustig, MD — Sugar: No Ordinary Commodity
www.youtube.com
Robert Lustig, M.D., presenting at the Ancestral Health Symposium 2012 (AHS12) Sugar: No Ordinary Commodity Abstract: Substances of abuse qualify for regulat…

David M Driscoll While Dr Lustig’s theories and evidence may seem convincing to the general public and reporters, the real test is how well he performs with his fellow scientists!

He was certainly called out for overstating the evidence and poorly extrapolating rat research at a conference he spoke at earlier in the year – check out the Q and A video in the attached article by David Despain (as well as the other lectures)!

http://evolvinghealthscience.blogspot.com.au/2012/04/sugar-showdown-science-responds-to.html for a full review and links to all lectures – if not just watch the Q and A at http://www.youtube.com/watch?v=ypWe6npULUQ and http://www.youtube.com/watch?v=cnGhfX2yaU4

What research shows that it is fructose that causes addiction? At the Q and A at the Sugar Symposium, Dr Lustig was called out on this and one researcher showed that rats liked glucose based carbohydrates over sucrose, and another questioned the applicability of rat research to be extrapolated to humans!

Also a recent rat studied suggests that it might be the sweet taste and NOT the fructose (as they used an artificial sweetener) although the article title gets it wrong also!

http://www.health.msn.co.nz/healthnews/8582942/sugar-as-addictive-as-cocaine-nicotine

The major issue with Dr Lustig’s theory is looking at US Sugar intake over history – levels were still high in the early 20th century – so saying it is sugar is either an oversimplification or there is a threshold value that we have recently crossed. Methinks that it is a perfect storm of more sugar and less burning it up with physical activity!

http://davidgillespiesbigfatlies.com/wp-content/uploads/2012/09/sugar-intake-20th-century.jpg

Gary Fettke No Fructose Thanks David M Driscoll. It will remain a hot topic for some time yet and debate will be colourful. I recommend that people try the NoFructose concept for 6 to 8 weeks and make their own minds up. Most of all it generates an interest in looking at labels and getting an understanding of what you take in as fuel for each individual. The majority of this site is about trying to put a lot of complex material in to lay terms. Different individuals may interpret the scientific literature differently. This blog is my interpretation as a doctor, patient and observer. It works for me and many others. Welcome to the world of science and opinion.

David M Driscoll Thanks for the response. The fructose:addiction claims have always baffled me from an evidence-based point of view. While Lustig is on the fringe, he says that fructose is only weakly addictive. Is there any evidence that suggests that it is highly addictive? Is it purely anecdotal or based on the literature?

As the artificial sweetener trial I listed above suggests, isn’t it more likely the sweet taste and not specifically fructose that is the appealing element (thus questioning the wisdom of the high profile anti-fructose people selling recipes replacing fructose with glucose or other sweeteners)?

Reducing sugar has been the advice by health professionals for a long time. While I agree that there is no need to have fructose (unless an endurance athlete looking to carb load faster), I still can’t see an evidence based reason to eliminate it (especially in lieu of other simple carbs like glucose/dextrose). I would be interested in any research that you have on this. Thanks.

Gary Fettke No Fructose Hi David M Driscoll. We are addicted to sweetness. I think it is probably one of our most primitive survival instincts.
I enjoyed the Q&A videos. I completely disagree with the overview statements that Robert Lustig was being ‘called out by his colleagues’. There was caution expressed for adopting his ‘working models that generate a hypothesis’. – no problem with that. Couldn’t see much else wrong.
In my mind it is the ‘sweetness’ that is addictive – not just fructose. See my Behavioural page on http://www.nofructose.com/health-issues/mental-health/

Great statement from the audience from Professor John McNeill, PhD, Professor & Dean Emeritus, Faculty of Pharmaceutical Sciences, University of British Columbia who made comments in relation to rats having uricase and humans and primates not. This means the rats can break down uric acid whilst humans cannot. At an experimental level this probably means that fructose loads in humans may be a lot lower to generate damage in comparison with those in rats. Looking forward to chasing this down. Thanks for that.

Recent JAMA article supports the issue of fructose not having the satiety effect of glucose. This all fits within the modelling of appetite control.
Effects of fructose vs glucose on regional cerebral blood flow in brain regions involved with appetite and reward pathways. Page KA, Chan O, Arora J, Belfort-Deaguiar R, Dzuira J, Roehmholdt B, Cline GW, Naik S, Sinha R, Constable RT, Sherwin RS. JAMA. 2013 Jan 2;309(1):63-70. doi: 10.1001/jama.2012.116975.

David M Driscoll Numerous people called Dr Lustig out for extrapolating the rat research, including the researcher who said his rats favoured mannose (I think) over sucrose. Also the lecturer that stated that humans have executive function thus limiting the ability to extrapolate addiction data from rodent models.

Glad to see that you agree that sweetness may the real issue in this case, I know many professionals who fear that demonising fructose will just lead to the same issues as we had with fat. Manufactures will start saying things are fructose free, getting sweetness from elsewhere and not help anyone with their ‘threshold’ for sweet taste. I get the feeling (I probably should pose the question directly), that he wouldn’t endorse swapping fructose for glucose either.

I read the JAMA study and noted that on first examination there was no difference in satiety, hunger and fullness between the groups despite the massive doses (and ‘neurological’ changes). Only when re-examined with a more problematic statistical method, did two of the three measures reach statistical significance. Considering these factors (and that it was a proof if concept study with massive dosages, designed to get a result if one existed), I personally don’t think it does much to suggest that fructose is an issue, let alone needs to be eliminated, nor that it is HIGHLY addictive.

Similarly, the Stanhope study from 2009 (I think), that showed different fat deposits, also with massive fructose doses (vs glucose), showed no difference in energy intake (in supplementary materials) between the two groups. Theoretically the fructose group should have eaten a lot more if 25% of their energy intake (from memory) came from fructose. (For me more evidence that liquid calories do less for satiety, not fructose vs glucose).

The results mean even less clinically when considering that people almost always take fructose with glucose.

David M Driscoll So getting back to my original question (sorry I’m always going off on tangents), what evidence leads you to believe that fructose is highly addictive (and maybe we can later get to ‘why we can’t have any)? I truly am interested in the key pieces of research that lead you to change your mind (and give you the confidence to go ‘against’ your peers – especially considering the levels of evidence that I would assume they need to ‘go all in’ . Thanks

David M Driscoll Sorry, finally on latop so now I can find and post links:

Stanhope 2009 – http://www.jci.org/articles/view/37385#sd
Supplementary data – http://www.jci.org/articles/view/37385/sd/1

Problems with performing comparisons against baseline within randomised groups are often used and can be highly misleading http://www.trialsjournal.com/content/12/1/264

Gary Fettke No Fructose David M Driscoll. I respond above.

Coming in Part 2 – how the tide turned!

 

Gary Fettke – Another Day, Another Fructophobe Who All of A Sudden DOESN’T Want To Discuss Evidence Part 2

Here’s where it got ugly (see Part 1 for the introduction to this story - Gary Fettke – Another Day, Another Fructophobe Who All of A Sudden DOESN’T Want To Discuss Evidence Part 1)

Here is the now unavailable response to the post numerous fructophobes have joyously been forwarding who regularly enjoy (and practise) playing the man and not the ball! I will add the original post below and the exchanges that occurred in subsequent posts. The sections in inverted commas and italicised are quotes from Gary Fettke’s post,

Gary Fettke Cat Out of Bag 300x275 Gary Fettke   Another Day, Another Fructophobe Who All of A Sudden DOESNT Want To Discuss Evidence Part 2

“David Driscoll is one of the most outspoken critics in Australia when it comes to the interest of Fructose and Polyunsaturated Fats and their relationship to Modern Disease.”

No, I am a critic of people extrapolating the data and polarising it to mean none, zero, poison, toxic etc. Did you see this part of the website?http://davidgillespiesbigfatlies.com/mission-statement/ . I haven’t made any statements as to what roles they play, merely critiqued those that I believe have oversimplified complex issues and suggested that these outcomes are based on science!

“He takes on David Gillespie of ‘Sweet Poison’, Sarah Wilson of ‘I Quit Sugar’ and Rosemary Stanton, (well known nutritionist) in the public domain, the internet and media. “

Takes on Rosemary Stanton? Where did you get this from? I agree with almost everything that Rosemary Stanton says and she shares similar opinions re fructose and polyunsaturated oils (and especially the extreme statements made about them) For example http://www.abc.net.au/local/stories/2013/03/06/3708514.htm

“You certainly go to a lot of trouble to question people who raise their heads up on the topic of ‘Sugar’. You are obviously passionate and informed on the topic and pop up all over the web with negative statements. I cannot find anything constructive that you say about raising people’s awareness of their dietary intake and particularly in relation to improving their lives.”

Again, why can’t we talk about the evidence? Sounds like the same kind of smear campaign I get from most others, very disappointing (I hope that I have just misinterpreted the intention of the statement)! Most of my consultations are done personally, which is why you may not be able to find what I do or recommend on the web?

I believe that trying to switch the argument over to a criticism of my beliefs, or anyone else critical of their ‘work’ (which David and Sarah do constantly) is merely an attempt to distract from the person making the claims (thus attracting the burden of proof). Again I hope that I have misinterpreted the intention of this statement.

“Do you have any commercial interest in taking up this very negative stance over and over?”

No, I’ll upload it to the “About Me” section of the website and post here for everyone’s benefit.

“I have worked for Sports Dietitians Australia and Gatorade is/was a sponsor (I think Powerade are now) and probably a few other supplement companies. I have done lectures for Sports Dietitians Australia which were sponsored by Gatorade, but have never worked for or been paid by them (Gatorade) directly.

I went to the Gatorade Sports Science Institute once and was bought lunch after getting a tour. I’ve also probably got a few drinks in a bag at a fitness expo or conference. Also I’m helping out friends with their internet marketing who own restaurants and a cake business (so I got some free cakes and probably a soft drink which contain sugar).

I worked for Sydney Kings in strength and conditioning and I think one of their sponsors was Coke. Probably got some free drinks and maybe a t-shirt too.

I would guess that the grand total for ALL of these ‘perks’ would be less than $2500 over the last 15 years. (When originally posting this I also challenged Sarah Wilson (and would extended the same question to David Gillespie) to answer the following question “Maybe you would like to disclose your earnings from your ‘vested interest’ so we can see where the real conflict of interests lie and who’s core business is being threatened in these exchanges? Purely in the spirit of full disclosure of course!)

I am or at times have been a member of Dietitians Association of Australia, Sports Dietitians Australia, Exercise and Sports Science Australia, National Strength and Conditioning Association (USA), Australian Strength and Conditioning Association, British Association for Sports and Exercise Science, American College of Sports Medicine, Sports Medicine Australia, International Society for Sports Nutrition, Australian Weightlifting Federation, USA Weightlifting and Australian Track and Field Coaches Association but I couldn’t tell you how many of their sponsors ‘relied on sugar or seed oils’. I hope I haven’t missed any.

“I ‘honestly’ believe that cutting down on our Sugar and specifically the Fructose component will have major health benefits.”

And as mentioned on the website “I would first like to dispel a myth that is often presented; that there is an anti-sugar group and a pro-sugar group. This false dichotomy ignores the fact that most health professionals, dietitians and the like have been encouraging people to reduce their sugar and processed food intake for decades. This logical fallacy suggests that because one doesn’t identify fructose as a sole/primary cause of modern disease, that they somehow are promoting sugar consumption.”

If you believe cutting down sugar is great, then I agree – it is just that with a website named ‘No fructose’ I could assume that your position was a little more extreme than that? Not an unreasonable assumption I hope?

The website also says “To be clear (and avoid the often stated ‘strawman’ logical fallacy), I am yet to see anyone say that unlimited sugar is warranted, people should increase their sugar intake (except sometimes for athletes with high energy requirements) or that don’t think most westerners each too much sugar or processed foods. The advice given by almost all experts is to reduce sugar intake, limit soft drinks and fruit juices (some suggest totally eliminate them) and eat more unprocessed foods, thus the point of contention is the ‘all or nothing’ nature of the debate (or less than 10g per day) as well as the fact that science supports these views. Further to this, no one is suggesting that people should reintroduce sugar who have eliminated it, nor discounting that their experience may have resulted in improved health and weight loss – the dispute is around the claims that one nutrient/compound can be blamed for the majority of the obesity epidemic and healthy problems the modern world faces.”

In my response to you re Dr Lustig I wrote “The major issue with Dr Lustig’s theory is looking at US Sugar intake over history – levels were still high in the early 20th century – so saying it is sugar is either an oversimplification or there is a threshold value that we have recently crossed. Methinks that it is a perfect storm of more sugar and less burning it up with physical activity!”

I hope that my position on fructose/sugar is now clear. Reduce from ridiculously high levels – yes. Eliminate – why? Replace with glucose – definitely not the right message!

“Reducing our polyunsaturated fat consumption should have added benefits. This blog and www.NoFructose.com is dedicated to it. That is my opinion that is out there and yes, I will back it with my name. The majority of www.NoFructose.com is about trying to put a lot of complex material in to lay terms. Each individual may interpret the scientific literature differently. It happens all the time in our own monthly Journal Club meeting. This Facebook site and my website are my interpretation as a doctor, patient and observer. It works for me and many others. “

And as stated on the website “If David Gillespie’s message was simply here is something I have tried, it worked for me – there wouldn’t be any contention nor reaction from health professionals. If the research presented was called preliminary but far from defining or the message reduce sugar intake, again there would be little disagreement. As stated above, it is the claim that these conclusions are based on research and science (the black and white, all or nothing conclusions) as well as the inference that disagreement is based on ignorance or dishonesty that are the points of disagreement.”

“Welcome to the world of science and opinion. It looks as though your opinion is different to mine. That’s fine. I am just recommending something that has No Cost, No Side Effects and is worth a trial period for many people. The whole concept that I discuss and give my ‘opinion’ on, help a lot of people and appears to be very sustainable. I cannot see why you have a problem with this concept of raising awareness.”

So to make it clear to me (and others), is this based on opinion, personal experience or on hard scientific evidence (or what ratio of the three)? I got the impression from the website that it was mostly research and evidence based. That’s all I’m trying to assess, is whether or not that is the case. You should know as well as anyone that anecdote is a poor substitute for science – otherwise literally everything would work, including homeopathy and witch doctors. If you are saying that this is based on your opinion, experience and some preliminary research, good luck to you. If you are suggesting that your position is science-based (as David Gillespie does), then you should be aware of what that implicates for people who disagree (and you probably weren’t aware of this), as often in this debate it has been implied, sometimes directly stated (i.e. opponents aren’t up to date on current literature or corrupted by financial interest). Again I’m not suggesting that you are saying that opponents are incompetent and/or corrupt – just hoping to make you aware that a cynical public can take the message this way.

Also bear in mind that David Gillespie in Big Fat Lies makes the following statement re his claims “The evidence for all of these statements is abundant and unequivocal” while quoting on average 2-3 studies to support his myopic views (and hardly ever review studies). I’m hoping that you will also agree that the issues (especially based on the research) aren’t black and white and almost certainly exist in a grey area.

“There is no definitive article out there that I am aware of that proves everything I say is true and there never will be. You are correct on that note. There are too many variables to conduct a proper long term study that would meet ethics approval. I know because we have been trying to organise one for 12 months.”

Then I would be more than happy to read a dozen articles that in total lead you to believe that we should have no fructose.

“You have asked me to comment on a several articles and the first is Stanhope’s 2009 article. What’s the problem? Both she and the editorial (which you did not attach) from the Journal of Clinical Investigation support the issue that Fructose loads have biochemical effects which can be detrimental. It supports work that she published a year earlier in the same journal. http://www.jci.org/articles/view/37385#sd

And my point here was that massive fructose loads didn’t increase energy intake vs glucose. If fructose affects appetite, surely the fructose groups in this and the JAMA studies would have taken in more energy vs glucose groups?

“You then post a link to an article on study design techniques which I presume was supposed to be relevant to the Stanhope article. Doing clinical dietary trials is a nightmare and as a result the definitive trial on these topics will never be done. We will continue to extrapolate human clinical data as well as we can.http://www.trialsjournal.com/content/12/1/264

No, it related to the JAMA study – here is their findings “There was no significant difference between glucose vs fructose ingestion on predrink-postdrink changes in hunger, fullness or satiety.”

When re-analysed with a less reliable method, the changes then appeared “Glucose ingestion resulted in a significant difference in predrink-postdrink changes in fullness and satiety, whereas fructose ingestion did not have a significant effect on predrink-postdrink changes in fullness or satiety (mean difference, 0.3) The article refers to this type of statistical (re)analysis.

“Interesting that infer that that this a ‘damning’ YouTube video yet it has only been viewed 636 times. You wrote on the link in your own words ‘Numerous people called Dr Lustig out’ and in a somewhat biased statement described Dr Robert Lustig as the ‘author of the upcoming book Fat Chance and man behind the infamous viral Sugar: The Bitter Truth Youtube clip’. I only found 1 question from the discussion that could be considered argumentative.”

The video I put on youtube via this site -http://www.visiond.com/ASN_2012/Sun_Sym_Fructose/QandA.html so you can’t really tell how many views it has had total, just via my personal links.

Here’s what I consider the opposition to Lustig was.

1. Adams – We need to wait for the trials in humans and lower dosages that represent normal doses
2. Adams – Lustig’s are just working models, don’t take them as fact – Need to understand the dose and exposure vs working models.
3. Rippe – addiction, humans have a pre-frontal cortex unlike rats, not a good model! People disagree with Lustig re addiction.
4. McNeill – Rats are not people (I thought the uricase example referred to rats being a poor model since if you inhibit and enzyme that rats have and humans don’t, it is hard to apply to humans – could be wrong one this as you suggested)
5. Sclafani – rats prefer maltose over sucrose and glucose vs fructose.
6. Black – addiction – pre-frontal cortex lights up with cocaine and sugar doesn’t mean same thing!
7. Breast milk is sweet (cheap shot but worth it  whole crowd got into this one!
8. Sievenpiper – move away from observation and animal data. Human stats for de novo lipogenesis not applicable to humans more like 3%!
9. Sievenpiper – Glycemia is benefit with fructose isocalorically
10. Sievenpiper – Energy not substrate driving signal in hypercaloric trials
11. Sievenpiper – Fructose performed not differently to other carbs
12. Sievenpiper – outcomes may be different in mixed meal long term studies
13. Rippe again on humans and de novo lipogenesis poor vs animal models

“I don’t know if you have ever attended the discussion section of a scientific meeting. They are generally amiable and this one was just that. You must be picking up on body language and commentary different to me. One member of the audience is not ‘numerous’. You may be the one overdramatising the event.”

I have been to many scientific meetings. I disagree that there was one question as noted above!

“You have put on your blog http://davidgillespiesbigfatlies.com/200/latest-fructose-research-part-1/a list of review articles that you allege make the whole Fructose issue questionable.”

Can we get onto the ‘new’ questions re research and seed oils later? I fear that the current questions have already been lost in this long exchange?

So to recap:
What evidence leads you to suggest that fructose is highly addictive (especially when an outlier like Lustig says that it is weakly addictive).
How do you explain the lack of appetite stimulation in the feeding trials using massive fructose vs glucose dosages?

Because if fructose isn’t addictive uniquely (which you seem to have already relented on somewhat and suggest that it is sweetness we chase) and it doesn’t have a considerable effect of appetite, a major part of the case (and reason for zero tolerance) has been dismantled.

I hope that we can continue to keep this dialogue about the evidence.

—————————————————–

Here is the original post if you have the stamina icon wink Gary Fettke   Another Day, Another Fructophobe Who All of A Sudden DOESNT Want To Discuss Evidence Part 2 !

The ‘Cat is Out of the Bag’

David Driscoll is one of the most outspoken critics in Australia when it comes to the interest of Fructose and Polyunsaturated Fats and their relationship to Modern Disease. It took him only a few days to challenge me via the websitewww.NoFructose.com and here on Facebook.

He takes on David Gillespie of ‘Sweet Poison’, Sarah Wilson of ‘I Quit Sugar’ and Rosemary Stanton, (well known nutritionist) in the public domain, the internet and media.

I have reposted the blog which has his comments and questions below. In his email he asks for an ‘honest’ discussion. Here is my reply.

For some it will be too long. For those interested it may be quite enlightening to see the background information and particularly in relationship to funding of literature from the ‘big’ international food industry. I am concerned that they might be misleading him and by inference you.

I think it is too late David Driscoll. The ‘Cat is Out of the Bag’

Dear David Driscoll

I took some time off yesterday to smell the roses and spend time with my family. I also wanted to clarify a few things.

I am concerned that you have been misled by the bias of the undisclosed interests, and by inference your own interpretation of the material you have sent on to me to comment on.

You certainly go to a lot of trouble to question people who raise their heads up on the topic of ‘Sugar’. You are obviously passionate and informed on the topic and pop up all over the web with negative statements. I cannot find anything constructive that you say about raising people’s awareness of their dietary intake and particularly in relation to improving their lives. Do you have any commercial interest in taking up this very negative stance over and over?

My Financial Disclosure is as stated on http://www.nofructose.com/gary-fettke/
‘Individuals who take on the concept of NoFructose and lose weight are encouraged to donate $10 per kg lost to a charity of their choice.’

You have asked for an ‘honest’ discussion via your email and attached this link to your dedicated web site http://davidgillespiesbigfatlies.com/200/latest-fructose-research-part-1/ and I will respond accordingly further along.

I ‘honestly’ believe that cutting down on our Sugar and specifically the Fructose component will have major health benefits. Reducing our polyunsaturated fat consumption should have added benefits. This blog and www.NoFructose.com is dedicated to it. That is my opinion that is out there and yes, I will back it with my name.

The majority of www.NoFructose.com is about trying to put a lot of complex material in to lay terms. Each individual may interpret the scientific literature differently. It happens all the time in our own monthly Journal Club meeting. This Facebook site and my website are my interpretation as a doctor, patient and observer. It works for me and many others.

Welcome to the world of science and opinion. It looks as though your opinion is different to mine. That’s fine. I am just recommending something that has No Cost, No Side Effects and is worth a trial period for many people. The whole concept that I discuss and give my ‘opinion’ on, help a lot of people and appears to be very sustainable. I cannot see why you have a problem with this concept of raising awareness.

The problem for the corporate food industry (and I will come to your citation list later) is that it means people will be buying less food filled with the cheap preservative Sugar and prepared with cheaper to produce Polyunsaturated oils. They are all still out there buying Real Food but it is not the Food Product which has made a lot of money for the big companies over the last few decades. It means people are moving back to ‘local’.

Twenty years ago I refused to do major elective Orthopaedic Surgery on smokers.

I was accused of being confrontational and making bold claims without justification. Sounds familiar again now. For some years I gave a paper called ‘Where There is Smoke There is Fire’. It looked at the early research of the effects of smoking on the health of patients and their healing potential.

Twenty years down the track it is very acceptable to continue to refuse to do major and minor surgery on individuals who elect to continue to smoke against advice.

I am at the same point now with the issues related to Fructose and Polyunsaturated Oils.

When I present my interpretation of the science to gatherings of doctors , I say, ‘Don’t believe me- go out and look for yourself. That’s exactly what I did.’

There is no definitive article out there that I am aware of that proves everything I say is true and there never will be. You are correct on that note. There are too many variables to conduct a proper long term study that would meet ethics approval. I know because we have been trying to organise one for 12 months.

If you look again at my website you will see that I have a section on virtually every page related to ‘IDEAS’. These make sense to me and remain my opinion. I have ideas for a 100 research projects but do not have the time (in this lifetime) or finances to do everything. If anyone wants to run with these ideas then go for it.

Over the last 18 months I have been piecing together parts of articles, both laboratory and clinical, and combining that with talking to my colleagues and patients. I have presented this to my peers on several occasions. Either I am onto something or I might be another ‘fast talking’ character as you have inferred that Robert Lustig is from your attached material. My talks remain well received and I am still standing.

You have asked me to comment on a several articles and the first is Stanhopes 2009 article. What’s the problem? Both she and the editorial (which you did not attach) from the Journal of Clinical Investigation support the issue that Fructose loads have biochemical effects which can be detrimental. It supports work that she published a year earlier in the same journal.
http://www.jci.org/articles/view/37385#sd

You then post a link to an article on study design techniques which I presume was supposed to be relevant to the Stanhope article. Doing clinical dietary trials is a nightmare and as a result the definitive trial on these topics will never be done. We will continue to extrapolate human clinical data as well as we can.
http://www.trialsjournal.com/content/12/1/264

You also asked me to view 2 videos related to a Q &A component of the Experimental Biology Conference 2012. The Corn Refiners Association sponsored the symposium and 2 other speakers on the podium, Mr White and Dr Rippe receive support from industry. One would have considered that Dr Robert Lustig was in the ‘pit of lions’ as a guest speaker.

Interesting that infer that that this a ‘damning’ YouTube video yet it has only been viewed 636 times. You wrote on the link in your own words ‘Numerous people called Dr Lustig out’ and in a somewhat biased statement described Dr Robert Lustig as the ‘author of the upcoming book Fat Chance and man behind the infamous viral Sugar: The Bitter Truth Youtube clip’.I only found 1 question from the discussion that could be considered argumentative.

I don’t know if you have ever attended the discussion section of a scientific meeting. They are generally amiable and this one was just that. You must be picking up on body language and commentary different to me. One member of the audience is not ‘numerous’. You may be the one overdramatising the event.

You have put on your blog http://davidgillespiesbigfatlies.com/200/latest-fructose-research-part-1/ a list of review articles that you allege make the whole Fructose issue questionable.

In your blog you state how to do a search and exactly what you did. I presume you are being ‘honest’ about that. I presume you are not ‘cherry picking’ articles.

I took the liberty of doing the same Pubmed search that you did for the same ‘Fructose review’ articles.

I seem to have come up with a different list, but presume that it might have been a lot different on January 13, 2013. I ‘only’ went back 1000 review articles to 1995.

I found only 8 of the citations you refer to below out of the 11 you have supplied and published.
Three seem to have slipped in to your list and interestingly, the authors of those three articles and 4 others, of the 11 in total, are sponsored by the food industry including Coca Cola, Pepsi, Cadbury, Nestle, Danone, the Canola Council and the Canola and Flax Council. A couple of them have replies that follow that dispute their findings. You seem to have missed posting these replies.

It ‘honestly’ beats me as to how the private sector gets to write the articles reviewing the issue anyway.

Here are the 4 non industry funded articles and they effectively put forward the case that Fructose is a health issue. The only question is how much of a health issue.

1.You did put in Luc Tappy’s article about the metabolism and damage process. No problems with that one. I recommend that to people anyway.
Metabolic Effects of Fructose and the Worldwide Increase in Obesity, Tappy http://physrev.physiology.org/content/90/1/23.long

2.Tappy, as a scientist, later tries to stay out of the politics of sugar. Not quite certain why you call that putting the whole issue into question and made it a ‘review’ article.
Fructose toxicity: is the science ready for public health actions http://www.ncbi.nlm.nih.gov/pubmed/22617566

3.Next is Stanhopes article that you posted above. Not really a review. Just states that you probably get Metabolic Syndrome from Fructose but unable to call obesity yet.
Role of fructose-containing sugars in the epidemics of obesity and metabolic syndrome http://www.ncbi.nlm.nih.gov/pubmed/22034869

4.Next is one stating that Non Alcoholic Fatty Liver Disease is related to Fructose consumption. That’s what I am trying to tell people. Thank you for finding me another supporting article.
Review article: fructose in non-alcoholic fatty liver disease http://www.ncbi.nlm.nih.gov/pubmed/22469071

Now we come to the next seven industry funded reviews and some of them are disputed in the replies to the editor. They are also NOT in the highest profile journals. In fact, the first 5 here come from the one author, John Sievenpiper from Toronto and his unit seem to get a lot of corporate sponsorship, not always cited in the original article though. Popular fellow when it comes to funding.

1.Effect of fructose on body weight in controlled feeding trials: a systematic review and meta-analysis. J Sievenpiper et al (Funded by Corporate sponsors)
http://www.ncbi.nlm.nih.gov/pubmed/22351714

2.The Effects of Fructose Intake on Serum Uric Acid Vary among Controlled Dietary Trials. J Sievenpiper et al (Funded by Corporate sponsors) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3327749/pdf/nut14200916.pdf

3. Effect of fructose on blood pressure: a systematic review and meta-analysis of controlled feeding trials. J Sievenpiper et al (Funded by Corporate sponsors)
http://www.ncbi.nlm.nih.gov/pubmed/22331380

4. ‘Catalytic’ doses of fructose may benefit glycaemic control without harming cardiometabolic risk factors: a small meta-analysis of randomised controlled feeding trials. J Sievenpiper et al (Funded by Corporate sponsors)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3411192/pdf/S000711451200013Xa.pdf

5. Effect of fructose on glycemic control in diabetes: a systematic review and meta-analysis of controlled feeding trials. J Sievenpiper et al (Funded by Corporate sponsors)
http://www.ncbi.nlm.nih.gov/pubmed/22723585

6.The next author’s other research is funded by Nestle France and Danone but fails to mention it in the review article. I had to look up other work from this author.
Health implications of fructose consumption: A review of recent data. SW Rizkallahttp://www.nutritionandmetabolism.com/content/pdf/1743-7075-7-82.pdf

7.The next is an article by an industry funded commercial food investigative company, The Burdock Group.
Evidence-based review on the effect of normal dietary consumption of fructose on blood lipids and body weight of overweight and obese individuals. Dolan et al
http://www.ncbi.nlm.nih.gov/pubmed/21108071

I find it difficult to draw conclusions, as you have seemingly done, when literature is published in lesser known journals by authors who have commercial interests. I am concerned that you were unaware of this.

I also looked at the blog spot you recommended and particularly David Despain’s commentary. evolvinghealthscience.blogspot.com

David Despain does not have a lot of good to say about going off Fructose and sugar. He claims he writes independently but is also a full time employee of a company that produces and markets ‘nutritional supplement meals’ that use Fructose rather than sugar in them. That’s what they advertise. He also works for the Institute of Food Technologists that receive sponsorship from Pepsi.

Isn’t the Internet a wonderful tool for investigation?

Following on from my ‘honest’ exploration of your arguments, I will not enter in to a blow by blow breakdown of every paper written on this very broad topic. I try and stay current on it for obvious reasons.

Four recent January 2013 articles, including an Editorial piece, in the highly respected British Medical Journal point to the turning tide of opinion on Fructose and Polyunsaturated Oils.

1.How science is going sour on sugar. Trevor Jackson deputy editor, BMJ.
BMJ 2013;346:f307 (Published 16 January 2013)

2.Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. Lisa Te Morenga, Simonette Mallard and Jim Mann.New Zealand Study
BMJ 2013;346:e7492 (Published 15 January 2013)

3.Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis. Christopher E Ramsden et al
BMJ 2013;346:e8707 (Published 5 February 2013)

4.Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies. Ying Rong et al
BMJ 2013;346:e8539 (Published 7 January 2013)

Hope these are current enough for you.

We are fortunate to live in a society that allows free speech and debate. Honesty and openness are paramount. I hate being conned or misled. Articles that are funded by ‘Big Sugar’ interests may put a ‘spin’ on health issues and should be openly and honestly declared. It seems that all of your negative bias comes from these potentially flawed papers.

There will never be a definitive article on this topic. In the meantime, I will not debate your articles unless there is that definitive article to discuss.

I will continue to share my positive experiences and my interpretation of the literature as I see fit. It is helping people and encouraging a healthy lifestyle. That is my priority and passion. I am committed to this topic and believe in what I put forward. Why else would I do it?

It is making my ‘day job’ easier and the benefits I am seeing on a daily basis far outweigh any negativity I am faced with.

If www.NoFructose.com and Gary Fettke No Fructose are helping people, that is all that matters. I accept that your opinion may differ from mine. It makes the world an interesting place.

Welcome to the Critique of David Gillespie’s Big Fat Lies

Thanks for visiting, we hope you find this page insightful and educational!

I would first like to dispel a myth that is often presented; that there is an anti-sugar group and a pro-sugar group. This false dichotomy ignores the fact that most health professionals, dietitians and the like have been encouraging people to reduce their sugar and processed food intake for decades. This logical fallacy suggests that because one doesn’t identify fructose as a sole/primary cause of modern disease, that they somehow are promoting sugar consumption.

Posts have been divided into a number of sections, based around the core claims of David Gillespie via both “Big Fat Lies” and related media appearances!

Fructose Facts

Exercise Evidence

Lipid Legitimacy

Common Arguments / Logical Fallacies

Media Muddles

 

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David Driscoll