生物与医学2025nature.com
含糖饮料导致的2型糖尿病与心血管疾病负担
Type 2 Diabetes and cardiovascular disease attributable to sugar beverages
入门 · 约 45 分钟读完前置知识：基础营养学概念、流行病学基础
导读
这篇 Nature Medicine 论文量化了 184 个国家中含糖饮料（SSBs）对 2 型糖尿病和心血管疾病负担的贡献。研究指出含糖饮料因液体形式快速消化，导致饱腹感低、热量摄入增加、内脏脂肪堆积及肝脏和肌肉胰岛素抵抗，并估计其“高剂量”约为每周 9 份（每 8 盎司含添加糖且超过 50 千卡的饮料）。
HN 关注点：含糖饮料的公共健康影响及是否应通过税收或限制销售来干预，讨论焦点集中在政策可行性、代谢机制和糖税效果。
HN 评论精选
这几条评论里：支持 1 质疑 1 补充 2
补充主张限制含糖饮料的规模化销售而非全面禁止，并认为相关利益方会阻挠全民医保
分析所用数据和代码均已公开。我们至今没有全民医保的原因之一是：一旦医保建立，那些明确有害健康的东西就会被禁止销售——这既有利于接受医疗的人，也有利于为医疗体系出资的人，因此销售这些东西的人会拼死阻止这种环境出现。不允许某样东西被大规模生产、营销和销售，与彻底禁令是两回事。我个人认为大规模销售的烟草和汽水不应被售卖，但人们自己手卷烟丝抽到进坟墓、在家自制汽水，那是他们的自由。
sitkack查看英文原文
> Burdens of type 2 diabetes and cardiovascular disease attributable to sugar-sweetened beverages in 184 countries https://www.nature.com/articles/s41591-024-03345-4.pdf The data and the code used for the analysis appears to be available. ---- One of the reasons that we don't have Universal Healthcare in the US is that things that are categorically unhealthy would be prohibited from being sold. Afterall, it would benefit not only the receivers of care but also the people funding the healthcare system. The sellers of those things will fight (to their death) to prevent that environment from existing. Not allowing something to be mass produced, marketed and sold is different than banning it outright. I personally think mass scale tobacco and soda should not be sold, at the same time I think people can hand roll and pack a pipe into the grave. Same for their at home bathtub soda.
补充指出论文核心是含糖饮料独特的代谢危害，并梳理了其剂量定义
有意思。评论区的朋友们可能没注意到，这篇论文的重点在于含糖饮料（SSBs）本身，其代谢效应与其他糖分来源不同：液体形式使其被快速摄入和消化，导致饱腹感更低、热量摄入更多和体重增加；大量快速消化的葡萄糖会激活胰岛素等调节通路，导致内脏脂肪、肝脏和骨骼肌胰岛素抵抗；大量果糖则直接激活肝脏脂肪合成，造成异位脂肪沉积和代谢功能障碍。遗憾的是论文没定义“高剂量”，但从其他表述看大约是每周 9 份“任何添加糖且每 8 盎司超过 50 千卡的饮料”，包括商业或自制饮料、软饮、能量饮料、果汁饮料、柠檬水等——一罐可乐是 12 盎司。
neom查看英文原文
Interesting. I think folks in the comments here maybe missed this paper is way more about the beverages part making it important. The research is around sugar sweetened beverages (SSBs). If I'm reading it right, the SSBs have a differentmetabolic effect. "Due to their liquid form, SSBs are rapidly consumed and digested, resulting in lower satiety, higher caloric intake and weight gain. High doses of rapidly digested glucose also activate insulin and other regulatory pathways, which can result in visceral fat production, hepatic and skeletal muscle insulin resistance and weight gain. High doses of rapidly digested fructose directly activate hepatic fat synthesis, leading to ectopic fat deposition and metabolic dysfunction in liver and muscle" Unfortunately I can't find where they define high dose, but if you look at what they say is high elsewhere, it seems to be around 9 servings a week of "any beverage with added sugars and >50 kcal per 8 oz serving, including commercial or homemade beverages, soft drinks, energy drinks, fruit drinks, punch, lemonade and aguas frescas." - A can of coke is 12oz I believe?
质疑认为结论早已是学界共识，新意有限
看到更多相关研究固然好，但这并不是新闻。研究人员早就知道存在一整类由饮食和生活方式引起的疾病（糖尿病、中风、某些癌症、脂肪肝、心脏病等），统称为代谢综合征。
tomcar288查看英文原文
It's good to see more studies come on this but it's not exactly news. Researchers have known for quite some time now that there's an entire constellation of diseases (diabetes, stroke, certain cancers, fatty liver disease, heart disease, etc, etc) known as metabolic syndrome that are all caused by diet and lifestyle.
支持主张对添加糖征收重税以遏制慢性病
我敢打赌，对超过 5 克的添加糖每克征收 1 美元的税，会立刻拉平慢性病曲线；如果针对儿童营销的产品，税率可以翻倍。除了糖/高果糖玉米糖浆之外还有很多问题，但它绝对排在问题清单的最前列。
siliconc0w查看英文原文
I'd bet a dollar per gram additive sugar tax in excess of 5g would immediately flatten the chronic disease curve. Maybe double that if it's marketed towards kids. There are a lot of problems besides sugar/HFCS but it's easily towards the top of the list.
相关资源
从这篇论文所有 HN 讨论帖的全部评论里整理出来的链接。
历次讨论
- 2025Hacker News 讨论帖432 分 · 384 评
同领域还值得读
CRISPR 在活体动物中消除 HIV-1 感染
CRISPR eliminates HIV-1 infection in live animals
报告利用 CRISPR/Cas9 基因编辑技术在活体动物中清除 HIV-1 感染：研究人员通过腺病毒载体递送特定的 Cas9 系统，从被感染细胞中切除嵌入的 HIV 病毒 DNA。
生物与医学2017 · 1,455 分 · 239 评入门 · 约 30 分钟编辑精选保护区飞行昆虫生物量27年下降75%
75% decline over 27 years in total flying insect biomass in protected areas
这篇发表于 PLOS ONE 的研究通过在德国保护区长达 27 年的昆虫生物量监测，发现飞行昆虫总量下降了约 75%。
生物与医学2017 · 901 分 · 432 评入门 · 约 45 分钟编辑精选为什么大多数已发表的研究发现是错的
Why Most Published Research Findings Are False (2005)
这篇 2005 年发表于 PLOS Medicine 的经典论文由 John Ioannidis 撰写，论证了在统计功效不足、研究偏倚和多重检验等因素下，大多数已发表的医学研究发…
生物与医学2022 · 388 分 · 351 评入门 · 约 60 分钟编辑精选人类免疫系统的物理接线图
A physical wiring diagram for the human immune system
这篇 Nature 论文系统绘制了人类免疫系统的“物理接线图”：通过大规模实验鉴定免疫细胞表面受体之间的相互作用（包括约 30 种此前未知的受体互作），并结合定量计算模型模拟免疫…
生物与医学2022 · 342 分 · 49 评专业 · 约 90 分钟编辑精选脂肪组织在减重后仍保留肥胖的表观遗传记忆
Adipose tissue retains an epigenetic memory of obesity after weight loss
这篇 Nature 论文研究了肥胖对脂肪组织的长期影响：即使减重成功，脂肪细胞仍保留着肥胖时期的表观遗传记忆，可能解释为什么减重后容易反弹。
生物与医学2025 · 263 分 · 327 评进阶 · 约 45 分钟编辑精选