Keys to a Healthy Body Weight: Avoid Liquid Calories 

Love this comment, and philosophically I totally agree that we need to give up seeing certain foods or drinks as the enemy, or feeling ashamed if we crave them. Everything we eat or drink has some function, and I do think it's important to not only consider the physical effects. At the same time, I do think it's good to be informed and make an active choice, rather than having to face the consequences years later. Best wishes to you, Mario

Just to be clear: "The occasional wine" is very different from drinking regularly and particularly regular heavy drinking. I am having a drink or two every once in a while myself, and am not concerned about that at all. However, I do think that people underestimate the risks associated with regular drinking. Cheers Mario

Thanks, Steve! Best wishes, Mario

Hi Hans, Thank you for your kind words. I haven't seen specific studies looking at the impact of alcohol-free beer or wine on calorie intake, body weight, or liver fat. The only thing to consider is that these beverages could still be fairly high in sugar. For example, some alcohol-free beers list 19g of sugar per serving (8 oz, or 240 mL). That's about half as much as soda, and my best guess would therefore be that an alcohol-free beer would increase calorie intake a little bit, but less than regular beer or soda. Best, Mario

Should read ‘your recent questionnaire ‘.

"...So why do we have this fascination with sugar in the first place? Why does sugar make us want more? What’s the selective advantage? In chapter 4 we saw that insulin blocks leptin signaling to promote leptin resistance, in order to allow the weight gain associated with puberty and pregnancy to occur. In chapter 5 we saw that sugar stimulates brain dopamine and opiates to let us know what foods are safe. But why should sugar cause insulin resistance and hyperinsulinemia? Naturally occurring sugar in fruit is what makes fruit palatable. But for our ancestors, fruit was readily available for one month per year, called “harvest time.” Then came four months of winter, and no food at all. We needed to stock up-to increase our adiposity in preparation for four months of famine. In other words, in the doses that were available to our forebears, sugar was evolutionarily adaptive. Indeed, fruit binges among orangutans in Indonesia are responsible for their altered energy intake and changes in weight. For their normal diet, they consume 21 percent of their calories as fruit-as opposed to when fruit is plentiful during a binge, at which point that figure rises to 100 percent. This results in high insulin, driving energy storage and cyclic adiposity.14 But with our current global sugar glut, devoid of fiber and in high doses 24/7/365, our weight gain is not cyclic anymore, and this process has become maladaptive. Face it, we’ve been “frucked.” Still, while sugar is the biggest perpetrator of our current health crisis, it is by no means the only bad guy. There are “antidotes” to the fructose effect, but they have been removed from our environment as well. The rest of Part 4 will lay bare the rest of our “toxic environment...”

Go straight edge!

I am sorry to be the bearer of bad news, and I can relate that if this is something that is important to your lifestyle, that it's hard to change. Keep in mind though that it's isn't just the absolute amount of alcohol someone is drinking, but also the number of binge drinking-sessions. In essence, when someone gets drunk badly, their liver is just totally overwhelmed. If that happens once a year, it may not be a huge issue, but if it happens regularly, the effects will probably accumulate over time. Best, Mario

I had the same problem, but i reduced my drinking Routine from year to year. I started with 50 Drinking days per year. Every sip of Alkohol counts as a Drinking days. I Made a list of every time a Drink in my Phone, to track the remaining Times a could have a Drink... Feel Strange in the beginning but you start to value this days. Planning a head of the concerts and festivals. I got used to this habit over the years. I'm now down to 10 drinking days, since the last 2 year, It still works but i'm much often the Driver now 😜

Thank you for your kind support. Best, Mario

I find that adding olive oil (perhaps in a dressing) makes me feel fuller after eating a salad. As long as you dont overdo it, because fat is calorific, it can be a good way to bump up satiety. I also add a good lean protein to my salad. I think most people would still feel ravenous after eating a bunch of vegetation with no noticeable protein lol Obviously these things are different for everyone. Some people find that eating a lot of fibre in one go helps them get full but it might not be a good fit for others.

@@lily5952 I do add some dressing to my salads. I'll check to see which ones contain olive oil. Thanks for the tip.

Great point. And I also agree that it would have been good to explicitly mention that fruit juice is more similar to soda, and should similarly be minimized. Cheers Mario

No, unfortunately, you really cannot know your visceral and ectopic fat mass based on your total fat mass, as the fat distribution is totally different in each person. However, you could have visceral fat or liver fat measured directly (by MRI or CT scan), or use blood -based biomarkers to estimate where you stand. I talk about this in these two videos: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-cP57oM8lBaU.htmlsi=eplz6rbRBVMnS9Iz ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-Fg3n-vi2t3Y.htmlsi=FAQ91_ste75akZ4o Cheers Mario

Fruit juices and smoothies may be less bad than soda, but I am certainly not a fan of drinking these in larger quantities regularly. Cheers Mario

This is a video about reversing insulin resistance. Sorry if this was not clear. As I say in the video, a major cause of insulin resistance in many people is a fatty liver. Because drinking alcoholic and sugar-sweetened beverages are a major cause of fat accumulation in the liver, one of the most important steps someone can take to prevent or reverse insulin resistance is to not drink such beverages. Many more videos on the subject are coming. Of note, because there is not just one cause of insulin resistance, we need to tackle each of these.

Hi Jean, Excellent questions. Re 1.) Yes, beer does usually contain some sugars, and has a higher GI. However, wine has a higher alcohol content, so I would have thought these two types of beverages should be similar. However, the few days we have (mostly observational studies) suggest that weight gain is more substantial with regular beer consumption compared to regular wine consumption. ("Beer belly" may be a thing, whereas I haven't heard anyone say that had a "wine belly"). Re. 2) I'll make a dedicated video about the various effects of the various non-caloric sweeteners. Sorry to deflect your question, but there is a lot of evidence available on these, and I haven't recently reviewed them all. Best wishes, Mario

I, too, would appreciate more scientifically backed evidence on this. The wellness sphere is rife with misinformation (and dare I say disinformation) about gluten.

Similar metabolic effects, probably, even though we don't have much trial data on dried fruit. Your teeth may have an opinion though, as I think that dried fruit is one of the worst foods for dental health (sticky sugary stuff). Cheers Mario

That is a great question, and I know that some people think this. I personally would not recommend this strategy. If you want to have a glass of wine with dinner because you like it and you don't gain weight doing that, it may be fine, but I wouldn't do it for the purpose of controlling my blood sugar response. The reason is that, yes, some alcoholic beverages may in some people reduce the postprandial blood sugar increase. As you say, that is largely because the liver secretes less glucose into the blood when it has to deal with alcohol. However, that doesn't make this a healthy long-term strategy in my book. Particularly if we have blood sugar issues already (which is when we would consider such a strategy) should we try to minimize factors (such as alcohol) that can contribute to weight gain and fat accumulation in the liver in the long term. Hope this makes sense. Cheers Mario

Really double zero beer. Null alc null carbs...

FYI; I have seen warnings against using agave on other sites.

My position is that any sweetener, be it household sugar or HFCS or honey or maple syrup or agave syrup, is fine as long as we use it in small quantities, either as an occasional treat or as a low-concentration component of a food. For example, if I have very tart Greek yogurt, I sometimes add about a teaspoon of maple syrup, not to make it insanely sweet, but to take the edge of the tartness. That kind of use is totally fine, IMO, and then it probably doesn't matter which sweetener is used. However, consuming a lot of sugar-sweetened beverages or baked goods and sweets, that's a different mater, and then any sugar is probably similarly harmful. Haven't seen any data on agave syrup specifically, but would certainly not consider it more healthy than other sugars or syrups. Cheers Mario

Postprandial insulin levels cover a very wide range. In our clinical studies, people who are insulin-sensitive often have 1-hour and 2-hour insulins of 10-40 uU/mL. Very insulin-resistant people have 1-hour and 2-hour insulins of 200-500 uU/mL, or even higher. Usually, 1-hour insulin levels are higher than 2-hour levels, but not always, and I personally would look more at the absolute levels than the time course. Also, please know that postprandial insulin levels are more reflective of systemic (whole-body) insulin sensitivity, and specifically muscle insulin sensitivity, whereas fasting insulin and HOMA-IR are more reflective of hepatic (liver) insulin sensitivity/resistance. For fasting levels, you want to consider glucose and insulin together, and calculate HOMA-IR. Watch the related video here: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-OZtxodqOBbw.htmlsi=mdgl5T7ip-EOfs2q Hope this helps. All the best, Mario

Excellent question. I'll actually write a paragraph about that in the blog post tomorrow and will link to that here. Cheers Mario

OK, sorry it took me a few days, but here is the revised paragraph I where I wrote about this. Please see the website for all of the references: Quote from nourishedbyscience.com/liquid-calories/ "As an aside, there are a few studies that have directly compared beverages sweetened with 100% fructose vs. 100% glucose. Again, even though no one drinks such beverages sweetened with just fructose or just glucose, using these types of sweeteners in a research study can be useful to try to figure out which of the two sugars plays the primary role in increasing weight gain or the fat content in the liver. As I discussed earlier, fructose- and glucose-sweetened beverages do not differ in the degree to which they trigger an overconsumption of calories or weight gain. However, fructose-sweetened beverages do increase de novo lipogenesis, i.e., the amount of fat synthesized by the liver, while glucose-sweetened beverages do not. This difference in the handling of fructose and glucose led to massive differences in metabolic health in one landmark study: drinking four servings per day of a 100% fructose-sweetened beverage induced all features of the metabolic syndrome in as little as 10 weeks, while an identical dose of 100% glucose-sweetened beverages did not in spite of similar weight gain. Specifically, dietary fructose-, but not glucose-sweetened beverages induced an increase in hepatic de novo lipogenesis, visceral fat mass, insulin resistance, and dyslipidemia characterized by massively elevated diurnal plasma triglyceride levels. Fructose, as compared to starch (glucose) is also able to induce an increase in the fat content of the liver even under isocaloric, weight-stable conditions. Still, two small, short, randomized controlled trials comparing the impact of fructose- versus glucose-sweetened beverages have not been able to detect differences on liver fat content. It is possible that these studies were too small or too short to detect differences; it is also possible that the previously detected differences in the effect of fructose versus glucose on de novo lipogenesis do not necessarily translate to greater liver fat content on diets rich in fructose versus glucose. While some uncertainties remain as to whether fructose indeed has a greater impact on liver fat content than glucose, the cumulative evidence would suggest that the fructose content of common sugar-sweetened beverages plays a particular role in the increase in liver fat content simply because fructose is the sugar that preferentially ends up in the liver and there can be converted into fat while also inhibiting an important pathway through which the liver can get rid of fat, fat oxidation (see figure below)." Now practically, it isn't all that relevant whether 100% fructose-sweetened beverages are more potent at inducing fatty liver than 100% glucose-sweetened beverages, because sugar and HFCS are both mixtures of fructose and glucose. Best, Mario

David, Ah, you watched Gil's video about the study? We had an exchange about that on Twitter, and here is what I wrote: "The primary exposure here, the corrected insulin response (CIR) is a measure of the early insulin response, relative to the early increase in blood glucose. The early insulin response (first 30 minutes after glucose ingestion) is mostly related to the first-phase insulin response (pre-formed insulin that is secreted immediately upon ingesting glucose). Having a high CIR means that the person secretes a lot of insulin relative to the change in their blood glucose. The mean differences between the tertiles were very substantial, with the change in blood insulin level being about 3-fold greater in the third tertile compared to the first tertile, assuming identical blood glucose responses. That's a huge difference. This is relevant in several ways: many prominent proponents of low-carb diets or the carbohydrate-insulin model of obesity suggest that hyperinsulinemia is a key driver of weight gain and insulin resistance. If hyperinsulinemia were indeed a major determinant of either, we should see differential changes in body weight or insulin sensitivity over the following 4 years. The prospective data in this study show very clearly that this was not the case: baseline CIR did not predict changes in BMI or insulin resistance over the following 4 years. I agree with your assessment, Gil, that these data are not consistent with the idea that hyperinsulinemia is a key driver of weight gain and insulin resistance. The second interesting observation here is that having a high baseline CIR was associated with a massively reduced risk of developing prediabetes or type 2 diabetes in the following 4 years, even though participants with a high CIR were more insulin resistant at baseline. The way I interpret this is that many of those in the lowest CIR tertile probably exhibited inadequate insulin secretion relative to their blood glucose levels, which is probably indicative of an inadequate first-phase insulin response. And an inadequate first-phase insulin response is a hallmark sign of type 2 diabetes, and a major risk factor for type 2 diabetes in those who do not yet have diabetes. So in that way, these data are a nice confirmation of other studies in this field." This study is academically interesting, as it tells us a lot about the relationship between the ability of the pancreatic beta-cell to type 2 diabetes risk. And it certainly does not support the idea that hyperinsulinemia is the cause of weight gain or insulin resistance, as is so often claimed. But we need to be a bit careful in interpreting this in the context of differences in diet-induced hyperinsulinemia. If the same person, with a set ability to secrete insulin, eats either a low-carb or a high-carb highly insulinemic diet, that could still differentially affect outcomes in the long term. We should not mix up these two issues. Does that distinction make sense to you? In a way, what the study measures is how much insulin someone can produce in response to a standardized load of glucose, and how much that is is linked to their risk of T2DM. That is not a surprise. Better beta-cell function = lower T2DM risk. As to the insulinemic index of oatmeal and other foods, I consider the paper linked below one of the best sources on this, and oatmeal (porridge) has the expected insulinemic response. pubmed.ncbi.nlm.nih.gov/9356547/ Cheers Mario

Good question. However, HbA1c only measures glycation with glucose, which means that HbA1c underestimates the overall glycation-related risks in someone on a high-fructose diet. In general, because fructose levels are so low, they are not considered relevant. I think this may turn out to be a mistake. Given that fructose is more active in glycating proteins, a relatively higher blood fructose level could contribute to the overall glycation burden. The same applies to other sugars, such as galactose, a component of lactose. Cheers Mario

I like it, occasionally, but wouldn't recommend the consumption of larger amounts regularly. Still lots of glucose in liquid form, and while it may be better than soda or fruit juice, it's still liquid sugars. Cheers Mario

Sorry, that's not my area of expertise. If you do become insulin resistant, try to minimize other risk factors for insulin resistance, as explained in the video linked below. And discuss with a physician or dietitian whether a lower glycemic diet may be indicated (low-carb). ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-HYtnlRCq83s.htmlsi=MN1AbvRxXy97Q3XO Best, Mario

Good question. In my interpretation of the literature, there is no one 'best" diet. Instead, many diets can be very good, including keto or low-carb, but also a normal mixed diet. I personally believe it's a mistake to focus so much on macronutrient composition (i.e., whether we eat mostly carbs or fats or protein). There is a lot to be said about this, but if I had to summarize this in one sentence, I'd say this: minimize sugar-sweetened and alcoholic beverages as well as ultra-processed foods and refined grains and sweets, and otherwise eat whole, largely unprocessed foods that you enjoy. If that's mostly unprocessed meat, eggs, dairy, fish, and nuts, with lots of non-starchy vegetables (i.e., a low-carb diet), great. If it's largely vegetables, fruit, berries, legumes, and whole grains (i.e., a low-fat diet), also great. Same for a mixed diet containing all of these. There is obviously a lot more to be said about this, but the scientific evidence generally suggests that if you follow these simple rules in a way that you can happily maintain long-term, you are probably 80% there. For more detail, check out some of the earliest videos on the channel, and make sure you are subscribed, as I will talk about this in a lot more detail in future videos. Cheers Mario

@@nourishedbyscience thank you really much. So sweetener which are not sugar like Stavia are also healthy? Because I have they are worse than sugar but I don't know. And of course I am subscribed. Watched today your first video. They are helping a lot thank you!

What exactly would you like that video to entail? A comparison of different kinds of grain products, or a discussion of their effects on body weight, liver fat, and insulin sensitivity? Cheers Mario

I would be very interested to learn more about the different grain products and their impact on liver fat and insulin resistance. On social media you hear so many different opinions…. Should consumption be avoided or kept to the minimum… is there really a difference between white and whole grain bread or paste, etc… and is their a difference between grain types.. Thanks a lot for question and all you are doing on RU-vid, well done!!!

He did talk about the effects of alcohol itself, i.e. ethanol, on the liver, so I don't think there's a difference between alcohol from distilled vs undistilled drinks.

Agree with @TasteOfButterflies. We have few actual data on hard liquor or mixed beverages, and no randomized trials at all, but my best guess would be that regular higher-dose consumption would be similar to beer or wine. Cheers Mario

Not aware of any. Cheers Mario

For one, we don't know. There is actually one study in rats in which they were fed a diet with a slight caloric deficit, but with 40% of calories from fructose, and they did develeop a fatty liver. The more important point though is, IMO, that it would be difficult to maintain a stable body weight on a poor diet. Poor-quality foods have many qualities that make them less satiating and more likely to induce overeating (such as sugar-sweetened beverages, or ultra-processed foods). It's not like anyone wants to overconsume calories on a diet rich in fast food, ultra-processed foods, and alcoholic and sugar-sweetened beverages; it just happens spontaneously because of the intrinsic properties of these foods and their impact on our energy homeostatic system. Lastly, I am also a big proponent of eating a micronutrient-rich diet, and believe that is often underappreciated because the effects of marginally low intakes of key nutrients become aparent only in the long term. So, yes, calorie intake and energy balance matter a lot, but I do think that diet quality matters even more because it affects energy balance and ensures adequate intake of essential nutrients. Cheers Mario

Don't know these brands too well, but in general, I am not in favor of ultra-processed foods at all. I understand all the pros, such as cost and convenience, but overall my view is that there are likely risks associated with these types of industrial concoctions that we may not fully appreciate yet. Cheers Mario

If you want to prevent weight gain, fatty liver, and insulin resistance: yes! (Sorry ...) Best, Mario

Haha, Herr Worm, ich will Ihnen natürlich nicht ein Gläschen Wein madig machen! Und da Sie ja ziemlich sicher zumeist wenig 'Junk' essen schadet es Ihnen wohl auch nicht. Ob Alkohol aber wirklich nennenswert die Insulinsensitivität verbessert bezweifele ich ein wenig. Einen akuten Effekt auf den Blutzucker gibt es wohl, ohne Zweifel, und gegen eine vernünftige Menge ist wohl auch nichts einzuwenden. Das Problem ist dass die meisten Leute eher eine falsche Vorstellung davon haben, was eine vernünftige Menge Alkohol ist. LG Mario