[HN Gopher] For some Greenlanders, eating sugar is healthy
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       For some Greenlanders, eating sugar is healthy
        
       Author : tiahura
       Score  : 47 points
       Date   : 2021-12-27 16:04 UTC (6 hours ago)
        
 (HTM) web link (science.ku.dk)
 (TXT) w3m dump (science.ku.dk)
        
       | GlenTheMachine wrote:
       | My kid has an autoimmune (not genetic) version of this. It almost
       | killed him. He is 5' 10" and got down to 105 lbs, was severely
       | malnourished and dehydrated. Couldn't keep food down without
       | significant medical intervention. He spent a month in the
       | hospital and another month in an inpatient clinic to start to
       | address the resultant eating disorder.
       | 
       | Also, without insurance, the drug to treat it (sucrase) is
       | $4000/month and is available only in a liquid form that has to be
       | refrigerated... and you have to take it with meals. Which means
       | you have to carry a small cryo bottle with you wherever you go.
       | 
       | Don't wish for this to happen to you.
        
         | poizan42 wrote:
         | That's an absolutely insane price for something used in food
         | production. Have you looked into using food-grade sucrase
         | instead? There's an article about using BioInvert 200 as a
         | substitute for Sucraid here:
         | https://ejhp.bmj.com/content/24/Suppl_1/A226.2
        
         | teruakohatu wrote:
         | Sounds aweful. Have you managed to find a diet that avoids the
         | need for sucrase for every meal?
        
           | GlenTheMachine wrote:
           | Just about impossible in the US.
        
       | ajuc wrote:
       | If the mutation makes it so kids have diarrhea every time they
       | eat sugar - it might be possible that they learn not to eat sugar
       | and are healthier as a result. Some of the bad consequences of
       | sweet diet are very delayed.
       | 
       | I wonder how they controlled for that effect.
        
         | phonypc wrote:
         | That's addressed in the study. In fact, in their mouse model,
         | the benefits don't show up _unless_ they are fed sucrose.
        
       | beefman wrote:
       | The paper:
       | https://www.gastrojournal.org/article/S0016-5085(21)04065-8/...
        
       | betwixthewires wrote:
       | So much wrong with this article. First, it beats around the bush
       | about the point of the article for quite a while, and then
       | delivers a children's storybook version of the explanation after
       | a while. Which is common in articles these days.
       | 
       | > The reason for this widespread genetic variation among
       | Greenlanders is due to a diet that has stood out from that of the
       | rest of the world for millennia.
       | 
       | Greenlanders haven't existed for millennia. Greenlanders have
       | existed for just _under_ a millennium.
       | 
       | > "It is probably due to Greenlanders not having had very much
       | sugar in their diet"... He adds that this has made the genetic
       | variation frequent, as there has never been a need to absorb
       | sugar rapidly in the bloodstream.
       | 
       | That's not how evolution works. If this mutation gives a health
       | or fitness advantage it would be selected for. It's selection
       | probably ticked _up_ after the widespread availability of sugar.
       | 
       | But on the topic in it, I think such a mutation would be great to
       | have. I wonder if it exists off the island or how frequent it is.
        
         | wnevets wrote:
         | > If this mutation gives a health or fitness advantage it would
         | be selected for.
         | 
         | the more important question is if a mutation presents as a
         | disadvantage for reproduction.
        
           | podgaj wrote:
           | In this case, for the Inuit, the common allele (for
           | Caucasians) presents as a disadvantage.
           | 
           | They needed this polymorphism to survive on a diet with low
           | sucrose.
        
         | dahart wrote:
         | > If this mutation gives a health or fitness advantage it would
         | be selected for.
         | 
         | That's not always how evolution works, especially when you're
         | talking about characteristics that (as the writer pointed out)
         | were not present or used during evolutionary selection.
         | Adaptations that are selected for can and frequently do have
         | byproduct effects that are not selected for. There are words
         | for these effects, like "vestigial", "tag-along", "spandrel",
         | "byproduct", "non-adaptive trait", etc., etc.
        
         | VLM wrote:
         | As the article points out, super high carb diets make them very
         | sick, but what about the effects of lower or normal (pre 1900)
         | carb diets when they're not feeling sick?
         | 
         | Given that its pretty well known that high levels of sugar in
         | the gut cause gut bacteria to go wild, a very reasonable
         | research hypothesis would be to figure out why their gut
         | microbiome is naturally deficient, such that turbocharging it
         | up with a dose of raw sugar beings their gut microbiome
         | activity up to normal healthy levels.
         | 
         | Sure dumping 2 liters of pepsi soda in their gut might cause
         | all kinds of IBS like symptoms when their guts explode. But in
         | the old days they just ate a couple berries once in a while, or
         | at least the article claimed that.
         | 
         | This could be something as trivial as lots of fat intake means
         | lots of bile production means some probiotic bacteria that's
         | sensitive to bile suffers, until they eat a tiny amount of
         | sugar that lets them grow to normal levels.
         | 
         | Could look at what gut bacteria do in stereotypical average
         | humans. Gut bacteria under normal conditions do churn out some
         | thiamine, folate, biotin, riboflavin, vit K, and probably stuff
         | I'm not able to find from a quick search at pubmed central.
         | 
         | I think a really good research paper would combine the article
         | results with a hypothesis that greenlanders as a group suffer
         | (or, archeologically suffered, or occasionally suffered, or
         | their kids suffered, etc) from deficiencies in folate, biotin,
         | vit K, etc, basically the list above, and turbo charging their
         | gut bacteria with a dose of raw sugar makes the bacteria more
         | active which brings their vit K level or whatever up to normal
         | human levels such that they're healthier on average and/or
         | their kids die less often etc.
         | 
         | I didn't google up much immediately for deficiencies in
         | Greenlanders. Maybe folate. Small amounts of sugar in small
         | intestine would superficially seem to help with that. Folate
         | deficiency really screws up pregnant women. As a hypothesis for
         | a future research paper, it all kinda adds up, almost too
         | neatly (conspiracy theory like). So their diet is not exactly
         | folate rich, their pregnant women get all messed up, someone
         | gets a mutation where their gut bacteria which produce folate
         | get turbocharged by a couple berries, thus producing more
         | folate in their gut, which optimistically is absorbed by their
         | pregnant women, so women with that mutation have like three
         | times as many living children as folate-deficient women without
         | the mutatuon, it all kinda adds up.
        
         | erk__ wrote:
         | The Thule people of which the Greenlanders seem to have been
         | somewhat separate for at least 4000 years, this likely focuses
         | on the Greenlanders because it is made by a Danish University.
         | I don't think you can say that the same is not the case for
         | other arctic populations, they just have no research showing
         | that yet.
        
         | throwawaycities wrote:
         | I only read the article (not the study) but I also take issue
         | with the following:
         | 
         | > Imagine being able to swap out broccoli for sweets, Ben &
         | Jerry's or some other sugary treat and achieve the same health
         | benefits.
         | 
         | The study finds the genetic variation/gut bacteria metabolizes
         | the sugar directly from the intestines as opposed to being
         | deposited in the blood-stream and triggering insulin to remove
         | it and begin either the metabolic process or storage.
         | 
         | That is a metabolic benefit for sure and as a result could
         | protect from metabolic and chronic diseases. But nothing about
         | that process improves the nutritional value/health benefits of
         | the sugar. Broccoli contains vitamins, minerals, and
         | potentially enzymes (depending on cooking method) which the
         | sugar doesn't gain.
        
         | podgaj wrote:
         | I agree with the first part of what you said.
         | 
         | (Note: I am an amateur Nutritional Geneticist)
         | 
         | They said:
         | 
         | "The results demonstrate that carriers of the genetic variation
         | have what is known as sucrase-isomaltase deficiency, meaning
         | that they have a peculiar way of metabolizing sugar in the
         | intestine. Simply put, they do not absorb ordinary sugar in the
         | bloodstream the way people without the genetic variation do.
         | Instead, sugar heads directly into their intestine."
         | 
         | Ha! What? SI, the gene that they studied, ONLY exists in the
         | intestine. The inability to break down sucrose leads to microbe
         | imbalance that concerts the sucrose to acetate. They are using
         | the word "sugar" to cover everything from sucrose to any other
         | oligosaccaride. They just do not understand the science enough.
         | If you read the study it is clear.
         | 
         | And in NO way doe sthis mean that eating sugar is healthy for
         | them as the title implies!!!! Look at what happens when you
         | have this deficiency!
         | 
         | https://medlineplus.gov/genetics/condition/congenital-sucras...
         | "After ingestion of sucrose or maltose, an affected child will
         | typically experience stomach cramps, bloating, excess gas
         | production, and diarrhea. These digestive problems can lead to
         | failure to gain weight and grow at the expected rate (failure
         | to thrive) and malnutrition. "
         | 
         | So this is NOT a great mutation. There is no such thing as a
         | universal "great" mutation. These genetic changes are just one
         | change in a probably network of changes in the Inuit. Others
         | would include genes like FADS1 and FADS2 and CPT1A.
         | 
         | (NOTE: I have Saami heritage, who are the Inuit of Finland.)
         | 
         | Next:
         | 
         | "'It is probably due to Greenlanders not having had very much
         | sugar in their diet. For the most part, they have eaten meat
         | and fat from fish, whales, seals and reindeer. A single
         | crowberry may have crept in here and there, but their diet has
         | had minimal sugar content,' "
         | 
         | Here the researchers are correct, this is not only a
         | Greenlander trait, but a common trait in all Inuit, and very
         | low sucrose is common in all Inuit diets.
         | https://pubmed.ncbi.nlm.nih.gov/25452324/
         | 
         | And this absolutely is a fitness example. For people with the
         | common allele, the lack of sucrose in the diet leads to lower
         | levels of acetate and these people would die off leaving the
         | survivors with the less common allele to flourish.
        
           | phonypc wrote:
           | > _And in NO way doe sthis mean that eating sugar is healthy
           | for them as the title implies!!!!_
           | 
           | That's actually exactly what the study concludes. They say
           | children do experience those symptoms, but adapt as adults
           | and are better off for it.
        
             | podgaj wrote:
             | The study does not conclude that at all. They only
             | concluded they might be able to trick some people to make
             | money off a a drug they will make.
             | 
             | Limitations: We hypothesize that the healthier metabolic
             | profile observed in homozygous c.273_274delAG carriers was
             | mediated by acetate produced by gut bacteria; however, we
             | lack data to firmly verify this hypothesis.
             | 
             | Impact: Our results suggest that sucrase-isomaltase
             | constitutes a promising drug target for improvement of
             | metabolic health, and in a broader perspective add to the
             | debate about the health effects of sugar consumption.
             | 
             | You know, it could be that these people are healthier
             | because they avoid sugar because sugar makes them feel like
             | crap when they get overloaded with aceatate.
             | 
             | There is no evidence that higher levels of acetate are
             | better for people. Because if that as so drinking would be
             | healthy for everyone.
             | 
             | https://academic.oup.com/alcalc/article-
             | abstract/23/2/123/96...
             | 
             | https://www.biorxiv.org/content/10.1101/2020.07.20.212597v1
             | ....
        
               | phonypc wrote:
               | > _You know, it could be that these people are healthier
               | because they avoid sugar because sugar makes them feel
               | like crap when they get overloaded with aceatate._
               | 
               | They address that hypothesis and dismiss it. It's beyond
               | my understanding to assess their methods, but don't
               | pretend they didn't even mention it.
        
         | VLM wrote:
         | > Greenlanders haven't existed for millennia. Greenlanders have
         | existed for just under a millennium.
         | 
         | I got google-y for fun and every scientific paper title implies
         | its inuit greenlanders whom have the mutation, not the euro
         | greenlanders, and greenland is about 90% inuit. The picture of
         | the prof looks like he's a euro greenlander looks like Denmark
         | heritage to me but who knows (and it doesn't matter much
         | anyway).
         | 
         | wikipedia says the inuit greenlanders have been chillin on the
         | island for near 5000 years now.
         | 
         | I would imagine due to intermarriage, if the euro greenlanders
         | are outnumbered 10 to 1, that quite a few euro greenlanders
         | have the mutation, but the paper titles all seem to imply inuit
         | greenlanders only.
         | 
         | The wikipedia article implies the archeological inuit
         | greenlander diet was mostly carnivore. That's actually pretty
         | healthy as long as they eat enough organ meats but not too much
         | (particularly liver)
        
           | jeromegv wrote:
           | I don't know where you're looking on Wikipedia, but Inuit
           | Greenlanders arrived in 1200 AD
           | 
           | Source: https://en.wikipedia.org/wiki/Greenlandic_Inuit
           | 
           | It's also common knowledge, Inuit/Thule were pretty much the
           | last ones that migrated from Asia across Bering. They
           | displaced previous indigenous people that had been there for
           | few thousand years before (at least in Canada).
        
             | AlotOfReading wrote:
             | They arrived _in Greenland_ during the last millennium.
             | Paleo-Inuit peoples have been in the Americas for probably
             | around 5000 years. The previous indigenous people you 're
             | talking about were earlier branches of the same "family".
             | Moreover, this particular mutation is known to be common in
             | Arctic peoples as a whole, not just Greenlandic Inuit.
        
           | ijlx wrote:
           | Greenland may have been inhabited for 5000 years, but that
           | does not mean they share a genetic heritage back that long.
           | 
           | The Thule people, from whom modern indigenous Greenlanders
           | descend, originated around 1000 CE in Alaska.
        
             | dEnigma wrote:
             | I'm pretty sure the Inuit diets in Alaska and Greenland are
             | pretty similar though, at least in terms of macronutrients
             | (i.e. a lot of fat).
        
               | podgaj wrote:
               | The diets are the same and the Alaskan Inuit also carry
               | the SI deficiency alleles.
               | 
               | https://pubmed.ncbi.nlm.nih.gov/25452324/
        
         | teekert wrote:
         | And then that part about the gut biome "learning how to make
         | energy out of sugar", facepalm. How can you write this, it's
         | really bad indeed. Oh and swap broccoli for sweets oh
         | Greenlanders, like not being able to take up sugar efficiently
         | equates to not needing anything of nutritional value.
        
         | opportune wrote:
         | It doesn't have to do with Greenland specifically but the Inuit
         | lifestyle in general which is thousands of years old. Inuit
         | settlement in Greenland may be more recent but people have
         | practiced the Inuit lifestyle (and its almost 100% animal
         | content) for much longer.
        
         | arbitrage wrote:
         | > If this mutation gives a health or fitness advantage it would
         | be selected for.
         | 
         | This is not always the case. Be wary of assigning intent to a
         | stochastic process like evolution. It's about probability, not
         | certainty.
         | 
         | See: vagus nerve
        
         | phonypc wrote:
         | > _Greenlanders haven 't existed for millennia. Greenlanders
         | have existed for just under a millennium._
         | 
         | That sentence is saying the diet is millennia old. The diet and
         | genetic variation are also common to other Inuit populations.
        
         | phdelightful wrote:
         | Yeah it even starts with something not backed up by the study
         | it's reporting on:
         | 
         | "Imagine being able to swap out broccoli for sweets, Ben &
         | Jerry's or some other sugary treat and achieve the same health
         | benefits. This is fact not fantasy for about two to three
         | percent of the Greenlandic population"
         | 
         | The study does not say sweets confer the same health benefits
         | as broccoli!
        
           | phonypc wrote:
           | It kinda does, partially and indirectly. The study indicates
           | it's not a matter of them eating less sucrose, the benefits
           | actually don't show up in the absence of sucrose in the diet.
           | It essentially acts like soluble fibre.
           | 
           | Of course the micro-nutrients that would be in the broccoli
           | don't materialize out of nowhere.
        
       | 1cvmask wrote:
       | I can't but help remember the Harvard study paid for by the sugar
       | industry to blame fat:
       | 
       | The documents show that a trade group called the Sugar Research
       | Foundation, known today as the Sugar Association, paid three
       | Harvard scientists the equivalent of about $50,000 in today's
       | dollars to publish a 1967 review of research on sugar, fat and
       | heart disease. The studies used in the review were handpicked by
       | the sugar group, and the article, which was published in the
       | prestigious New England Journal of Medicine, minimized the link
       | between sugar and heart health and cast aspersions on the role of
       | saturated fat.
       | 
       | https://www.nytimes.com/2016/09/13/well/eat/how-the-sugar-in...
        
         | waffle_maniac wrote:
         | Despite that it's unlikely to have had any effect on the
         | American diet as Americans do not base their diet on anything
         | other than their taste receptors.
        
         | vmception wrote:
         | out of curiosity, why is that particular study and publication
         | weighed more heavily than... perhaps any other topic.
         | 
         | to me, this is like finding any random "coffee is good/bad for
         | you" of which there are thousands that conflict, and saying
         | "Aha! This particular one shaped the course of humanity for the
         | last half a century due to a major conflict of interest and
         | prestigious publication!"
         | 
         | were there just so many fewer studies in the 1960s? was there
         | further collusion and influence with Congress and the FDA? did
         | the sugar trade group fly airplanes and drop food pyramid
         | pamphlets everywhere letting everyone know liberation was
         | coming?
         | 
         | From your article:
         | 
         | > After the review was published, the debate about sugar and
         | heart disease died down, while low-fat diets gained the
         | endorsement of many health authorities, Dr. Glantz said.
         | 
         | so everyone just went along with it?
         | 
         | well, I've seen bad studies get headlines on Buzzfeed and stick
         | in the collective conscious based on the headline alone, so
         | stranger things have happened
        
           | grover35 wrote:
           | I've been very confused in the last couple decades about who
           | the experts truly are. On one hand you have government
           | agencies that hire "experts", and on the other hand you have
           | the New York Times, Hacker News, Reddit, and CNN. There was a
           | time when we thought the government was best to listen to,
           | but now with the murder of George Floyd and the election of
           | QAnoner Donald Trump and neoliberal Joe Biden I'm not so sure
           | that they have our best interests in mind. Plus demonizing
           | the press is textbook fascism.
           | 
           | In my view the real experts are writing for the New York
           | Times, tirelessly searching for contradictions and ulterior
           | motives in science so that the public may know the truth.
           | Time and time again the press has shown that the real health
           | foods are bacon, pork, and butter, and that we must avoid
           | heart-disease causing foods such as rice, potatoes, fruit and
           | carrots.
        
             | vmception wrote:
             | Careful, with that level of cognitive dissonance you might
             | accidentally slip up and say "both sides"
        
               | grover35 wrote:
               | Continue eating your oats and berries, QAnoner. The
               | science speaks for itself.
        
               | vmception wrote:
               | Whoosh, so the joke was that the
               | centrists/independents/unaffiliated are perceiving things
               | accurately but are ostracized by a polarized populace in
               | every forum.
               | 
               | But its less beneficial for me to say that directly
               | because then others would rather debate how both sides
               | are different instead of acknowledging the overlapping
               | areas of concern where they are the same.
               | 
               | Good luck with your approach of random non-sequiturs and
               | false positives.
        
               | [deleted]
        
               | grover35 wrote:
               | Based
        
           | dahart wrote:
           | Doesn't the linked article explain the answer to your
           | questions? I'm not sure I understand the snarky skepticism.
           | Is it surprising that a scientific article with prestigious
           | names attached has greater plausibility and weight than your
           | example of "random" studies? Harvard backed studies as a rule
           | seem to enjoy more support and media mentions than, say,
           | University of Phoenix, no? There are examples of journal
           | papers that are weighed more heavily than most, especially
           | when the writing resonates with people emotionally. I can
           | think of well known papers people talk about here on HN all
           | the time as if they're true, but aren't.
           | 
           | Are you sure there thousands of primary-source coffee studies
           | that make conclusions and judgements about whether it's good
           | or bad for you? Are you perhaps conflating blog spam and
           | articles for scientific papers? There are lots and lots of
           | articles, but not as many primary sources.
        
           | arbitrage wrote:
           | Mid- to late-century capitalists used it as a foundational
           | argument in their advertising. The impact of that one study
           | was amplified many times over.
           | 
           | People tend to chose what they want to believe first, then
           | build a framework around that to support the decisions they
           | wanted to do anyway.
        
       | klipt wrote:
       | > "Younger carriers of the variation experience negative
       | consequences due to their different type of sugar absorption. For
       | them, consuming sugar causes diarrhea, abdominal pain and
       | bloating. Our guess is that as they age, their gut bacteria
       | gradually get used to sugar and learn how to convert it into
       | energy"
       | 
       | Sounds basically like lactose intolerance, but to sucrose instead
       | of lactose.
       | 
       | Which raises the question, if gut bacteria can solve the
       | symptoms, why don't we have probiotics to solve lactose
       | intolerance too?
        
         | grardb wrote:
         | I don't have an answer to that question, but it's worth noting
         | that lactose intolerance isn't a problem that needs solving,
         | but rather the natural state of things for most humans on the
         | planet and most (if not all) other mammals. There's no need for
         | us to consume lactose after we've finished breastfeeding.
        
           | fartcannon wrote:
           | Milk is in a lot of delicious things.
        
           | vorpalhex wrote:
           | You've clearly never had a good goat cheese and thyme ice
           | cream!
           | 
           | I kid but lactose intolerance does really hurt a lot of the
           | food selection people are used to. Sure you can live off
           | soylent or whatever but most people enjoy a wide variety of
           | food including dairy.
        
         | foob wrote:
         | Lactase is the main way that people digest lactose and it's
         | produced by human intestinal epithelial cells rather than
         | bacteria. It seems plausible that a bacteria to digest lactose
         | could serve a similar role, but I don't think that's how people
         | typically digest it.
        
         | johnnyApplePRNG wrote:
         | Fecal transplants should work.
        
         | godot wrote:
         | This is super anecdotal and personal, but that quote sounds
         | exactly like me. I'm Asian and didn't come from Greenland.
         | Consuming sugar usually causes me those things, especially in
         | high dose (like eating a slice of cake). Fortunately I don't
         | like cake or most sweet things in general, but if I do eat
         | them, I can only very eat very little or I would feel all of
         | those (diarrhea, abdominal pain, bloating). I'm also in my late
         | 30s and borderline underweight (5'8" and 125 lbs). I have not
         | grown out of this sucrose intolerance over the years.
        
         | podgaj wrote:
         | "Our guess is that as they age"
         | 
         | They are guessing and they are wrong. Higher levels of acetate
         | are just as bad as lower levels of acetate. You know what also
         | raises acetate levels? The metabolism of Alcohol.
         | 
         | The Inuit need a different diet. They do not "get used to"
         | these sugars.
         | 
         | And why should someone who is lactose intolerant eat lactose?
         | We have been getting around this for years by making yogurt and
         | cheese.
        
         | phonypc wrote:
         | That explanation doesn't really make sense, and a different
         | one[1] appears in the paper itself. People who lack the enzymes
         | to digest a sugar experience gastrointestinal distress
         | _because_ bacteria in the lower GI tract eat the sugar that
         | wouldn 't otherwise make it to them, producing gas in the
         | process.
         | 
         | [1]> _This discrepancy between adults and children, may be due
         | to the maturation and growth of the small intestine, increasing
         | the capacity to absorb luminal fluid with increasing age, and
         | to dietary adaptation caused by symptoms in childhood._
        
         | vorpalhex wrote:
         | We don't have probiotics but you can buy the lactase enzyme in
         | pills and take it with lactose containing foods and avoid
         | symptoms (as long as you dose right and eat quickly). My wife
         | who is very lactose intolerant can still enjoy ice cream and
         | queso.
         | 
         | I do have a friend who had a severe gastrointestinal issue and
         | basically went through having his bacteria "reset" for a lack
         | of a better term. It was pretty terrible and he was unable to
         | eat most things before and during, but now is back to a pretty
         | normal diet with some modifications. He was on very aggressive
         | antibiotics followed by months long probiotic treatments.
        
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