Monday, January 10, 2011

Book review: Gary Taubes' Why We Get Fat


It's rare that I've had the occasion to read a book whose premises I agree with (that we eat way too many carbs, that they in turn impact on our weights, and that weight-wise exercise isn't much to write home about), but whose arguments make me cringe. Gary Taubes' Why We Get Fat met that billing.

Let me start out by stating that I'm quite low-carb friendly and that I readily agree that science has proven that saturated fat has been wrongly demonized by the medical establishment for decades, including somewhat by me when I co-wrote my book in 2006/7 (a guy's allowed to learn, and it was in this spirit that I approached reading Taubes' book). Furthermore, I also agree that carbohydrates, more specifically the refined highly processed ones, contribute dramatically to both obesity and chronic disease and their reduction may well have a role to play in most folks' weight management efforts, and that a myopic view of dietary fat as causal to chronic disease and obesity has likely in and of itself, by means of a consequent dietary shift to carbohydrates, contributed dramatically to the rise in the societal prevalence of chronic disease and obesity.

All that said, I found Why We Get Fat to be an extremely difficult read. Not because the writing wasn't engaging. On the contrary, Taubes is an excellent writer. I found the book difficult to read because for reasons I can't understand, Taubes seems to have decided to abandon journalistic and scientific integrity in place of observational data, straw men and logical fallacy.

Taubes' manifesto is straight forward. Carbohydrates make us fat and they do so independently of the first law of thermodynamics. Forget about calories, you can eat as many or as few of those as you'd like, ultimately weight is purely about carbohydrates.

Why We Get Fat's observational data comes hard and heavy right out of the gates. Taubes posits that because there have been examples throughout history of impoverished peoples with high rates of obesity that the concept of a toxic environment (cheap calories and minimal exercise) being causal to our modern day weight woes must be false. Does Taubes really think that obesity has a singular cause? That there's only one pathway to weight gain? That because he can find obese impoverished people the environment's not involved? Apparently he does.

Straw men and logical fallacy? Try this one on for size. He tackles an observation made by Williams and Wood, researchers who'd studied exercise and weight. They found that even marathon runners tend to gain weight over time and suggested that in order to avoid that gain they'd have to run further each and every year. Taubes extrapolates to suggest that any middle aged runner wanting to stay lean will have to run half marathons five days a week to resist weight gain. Sounds ridiculous, right? He then concludes on that basis the calories-in/calories-out hypothesis couldn't possibly be true. But couldn't calories in and out still matter in these runners? Don't our lives change as we get older - less time, more disposable income, more responsibilities - all things that may cause increased reliance on both convenience and celebratory calories. And doesn't metabolism naturally slow as we age due to age-related sarcopenia - wouldn't that also lead a person to steadily gain weight even if all other things (intake and exercise based output) remained constant? Or couldn't the runners consistently be consuming more calories than they burn as a consequence of either exercise-induced hunger or overcompensated reward based intake, and that coupled with natural aging's effect on metabolism causes ever increasing weight gain in the absence of changing calories in or calories out?

Next Taubes' tackles the classic 20 calorie a day mismatch leading to 2 pounds of weight gain a year (roughly the average gain per year of North American adults) and then presents it literally which of course appears ludicrous and ridiculous. Are 3 extra chips a day causing you to gain weight? Of course not. Therefore according to Taubes' next straw man, calories in and calories out can't be causal for weight. Forget about the fact that calories can come in clumps. 3,500 calories in extra Christmas time treats doesn't sound to me to be too off the mark and those alone would take care of 175 of Taubes' 20 calorie days. Tack on a couple of birthday celebrations, a vacation and a visit or two to a Chinese buffet and we're more than done.

Next comes cows. Taubes shows us pictures of two cows. One an Aberdeen Angus - fatty and delicious looking. The other a Jersey milk cow - lean and chewy looking. He then goes on to state that it's not possible that breeders have simply manipulated genes to make the Aberdeen cow hungry and the Jersey cow active. Instead Taubes argues that genetic breeding has impacted on these cows partitioning of fat (one to flesh and one to milk production). While I don't disagree with him, his conclusion that their genes don't determine how many calories the animals consume, but rather what their bodies do with those calories doesn't in any way support or refute the notion of calories in or calories out. A quick Google image search had me staring at some pretty hefty Jersey cows and some Anguses with very visible rib cages, and I'm fairly confident that were female Angus cows given hormones and milked daily, they'd also have big full udders. Could it be that cows do in fact behave both according to the laws of thermodynamics and also according to their genetic makeups? That's where my money'd be in Vegas.

Taubes' own cognitive dissonance appears mid book and it led me to be briefly more hopeful. Taubes was going on about the first law of thermodynamics (TFLOT) (that energy can neither be created nor destroyed - the cornerstone of the calories in/out hypothesis of weight). He actually seemed to agree with TFLOT but then tried to suggest that talking about "overeating" is not the same thing as talking about "energy" and that the important question to ask is, "WHY",

"Why do we take in more energy than we expend? Why do we overeat? Why do we get fatter?"
I agree, those are tremendously important questions and moreover I agree that macronutrient distributions (one's daily dietary spread of carbs, fats and proteins) for many folks likely play a big role in those whys.

Sadly Taubes takes a strange road to walk in following up on those whys. Taubes rages against the calories-in/calorie-out hypothesis stating that one would be, "hard-pressed to find (a concept) more damaging". He states the calorie concept has done, "incalculable harm", that it has fueled the obesity as a function of sloth and lack of willpower that lays blame squarely on each obese person's ample shoulders.

I wholly disagree with him. It's not the concept that's done so much harm, it's the misuse of the concept, its oversimplification and its grossly unfair, individualized, blame-based application. The danger and the harm lies solely with the failure of society and medicine to ask why are people consuming so many more calories - a failure Taubes so rightly pointed out just a few pages prior.

Amazingly, despite his embrace of the concept that different bodies do different things with the calories presented to them (as evidenced by his discussion of the fat partitioning of cows), next he comes at the reader with this painful series of questions,
"It's the environment we live in that makes us fat, we're being told, not just our weakness of will. Then why don't lean people get fat in this toxic environment? Is the answer only willpower?
Could Taubes possibly be suggesting that genetic variation only impacts upon fat distribution and that it's silent in terms of dietary choices, inclination towards activity, non-exercise induced thermogenesis, the thermic effect of food, resting energy expenditures, etc? Does Taubes truly consider us all to represent a single genetic and metabolic lineage that should see us all uniformly responding the same way to a specific environment?

Taubes next talks of differences in fat distributions seen between men and women to support his assertion that the amount of fat is "exquisitely" regulated. To me all it suggests is that distribution is regulated. Then Taubes launches into a discussion of wild animals and points to the fact that hippos and whales don't get diabetes and "never get obese" as further proof for his theories. He states that no matter how abundant their food supply, wild animals will maintain a stable weight and never become obese. Really? Do we track the weights of wild animals? Is there an animal NHANES database on squirrels, frogs and crows, or is Taubes, a man who purports to be a "firm believer in science" really just relying on his own observational assessments of animals and at the same time extrapolating wild animals to be useful to this discussion as small little human models appropriate for comparisons? Even putting aside a lack of actual data to support his thesis, even were it to be true that animals never become obese, could it not also possibly be the case that wild animals, most of who don't have very good health care plans, don't have the luxury of living long enough or healthfully enough to maintain gains in weight and that disease and early death help keep their weights down?

And what of human "wild animals". Up until a hundred years or so ago, obesity was a rarity for free-living humans as well, and I don't think Taubes will dispute the fact that genes tend not to change dramatically in just 3 generations. Clearly something else is at play - but for Taubes it's not excess consumption of calories that make us fat. Instead he believes carbs make us fat independently of thermodynamics, and in turn our fat itself drives us to overeat.

To support his point Taubes continues to lean on anthropomorphizations and frighteningly non-scientific comparisons with other species. He talks of elephants and blue whales eating huge amounts because they're huge. He talks of mice that are bred to be obese who when starved to death, still have more adipose tissue at autopsy, but to me all that proves is the notion that the distribution of calories is regulated by the body, not that calories don't count. Then he suggests that marathon runners run not because they choose to, or that they want to embrace what they see as a healthy lifestyle, but rather because their muscle tissue is regulated to take up more calories and they're literally driven unconsciously to burn off those calories by, "a very powerful impulse to be physically active". Who cares that there's no evidence to suggest that's true - that sound awesome. The reason I'm not a marathon runner is that my actual body isn't forcing me to lace up my shoes. And here I thought it was because I don't have much free time. But wait a second, I'm pretty damn lean and my diet's in the neighbourhood of 45-50% carbs, how can that be if carbs make people fat independently of energy consumption? But forget about me, I'm a case study of one. Forget too about the thousands of folks in the National Weight Control Registry who manage to control their calories and maintain their weights on low-fat (and hence high carb) diets. Forget too about the multiple studies that have looked at isocaloric restriction and haven't found significant differences between different dietary macronutrient distributions. No, instead I think it'd be fair given Taubes' penchant for observational data for you to do a quick observational exercise of your own. Think for a moment about all your leanest friends and relations. Are they marathon runners, obsessive exercisers or hard-core low-carb dieters? Perhaps some are, but I'm willing to wager, the vast majority aren't. What's up with them? How do they (and I) fit into Taubes' hypothesis?

And then there are simple non-truths. At one point Taubes states,
"You don't get fat because your metabolism slows, your metabolism slows because you're getting fat."
But as anyone who measures resting energy expenditures knows, metabolism actually rises as one gains weight due to the very simple fact that the more of a person there is, the more calories that person burns, and that significant weight loss almost invariably results in significant decreases in resting energy expenditures. Perhaps Taubes is referring to the individual who stays the same weight but loses muscle in place of fat - but of course as a seasoned writer, he knows that's not how readers will interpret his statement.

So what's the cause of everything according to Taubes? Oh yeah, carbs. In fact he states that the reason any diet works isn't because of caloric restriction, but rather it's due to carb restriction, with the corollary also being true - weight gain's not a consequence of caloric intake, but rather carb intake. Tell that to Twinkie Diet guy Mark Haub who lost 34% of his body weight eating 1,800 controlled, processed carby, junk food calories a day purchased from convenience stores.

To hammer his point home Taubes ignores the fact that correlation doesn't prove causality and talks of how it was during the 60s and 70s that doctors stopped believing in the low-carb route to weight management and how this coincided with the obesity epidemic as a means to prove his thesis. Of course nothing else has changed since the 60s or 70s to promote weight gain has it? I mean the world's exactly the same as back then, isn't it? Same number of restaurants, same dollars spent outside the home on food, same time spent preparing home cooked meals, same number of food commercials, same fast paced electronically tethered existence, same portion sizes, same number of available foods in the grocery store, same cost per calorie of food, same everything, right? No? You think that some or all of those things and dozens more might impact on weight? Me too.

Next he launches into antique medical textbooks and their takes on low-carb diets as proof of his manifesto. Does the fact that antique medical texts through until the mid 19th century recommend phlebotomy to treat asthma, cancer and pneumonia mean that we should start practicing it again?

Taubes next argument centres around the suggestion that carbs were not evolutionarily a part of our natural diet and that consequently we did not adapt to high carbohydrate diets. While I don't disagree with the suggestion, unlike Taubes I can't make the stretch that the foods we became adapted to eating during the millennia that our life expectancies were in our 30s and 40s necessarily have a bearing on our health and long lifespans today. He points to indigenous peoples of the world and comments on how when they kill an animal they eat, "virtually all" of its fat as proof that's a wise way to live and that fat's healthy for us, and while there's no doubt that the data on fat suggest it's not particularly scary, the fact that hunger-gatherers try to make the most out of every meal they catch doesn't impress me much to prove anything other than hunting's tough. Further to his discussion of evolutionary dietary adaptations he notes of our modern refined sugars and carbohydrates,
"That a diet would be healthier without them seems manifestly obvious."
And here I thought scientists were supposed to rely on evidence, not what seems obvious to draw conclusions. Sadly what seems, "manifestly obvious" isn't always a good or true idea as was evidenced by our reliance on the logic of the obvious in recommending decades of hormone replacement therapy to postmenopausal women.

Next up is his discussion of the Maasai tribesmen who he reports don't have cancer, heart disease or obesity and traditionally were very-low carb eaters. Of course they were also nomads who wandered and hunted all day long with life expectancies of 42 years for men and 45 for women - hardly a lifestyle or lifespan we should aspire towards and certainly potential explanations in and of themselves for the Maasai's lack of heart disease and cancer - both diseases tightly associated with age and at least partially preventable by means of exercise.

So how does Taubes' explain the impact of carbs on weight? Amazingly he states,
"We know the laws of physics have nothing to do with it."
Ultimately he embraces the notion that carbs make you fat regardless of the calories in/out hypothesis, rather than discuss such possibilities as carbs making you fat by having a lesser impact on satiety. Mid book I had hoped this was where he was going, but sadly, for reasons that are backed up by observation, inference, logical fallacy and straw men, apparently he's decided that living creatures are magical beings that live independently of the laws of physics and thermodynamics.

Taubes doesn't just rely on non-scientific argument, he also appears to be comfortable in ascribing his beliefs to other people and to omitting facts when its convenient. In discussing the World Cancer Research Fund's Food, Nutrition, Physical Activity and Cancer Report that concluded obesity and cancer were tightly linked he calmly states,
"If the expert authors of the report had paid attention to the science of fat accumulation ... they would have concluded the obvious: that the same carbohydrates that make us fat are the ones that ultimately cause these cancers"
Yeah, I'm sure none of these folks know anything about the physiology of fat. On omission - there's no doubt that Taubes knows that between 5-10lbs of weight are lost on a low-carb diet due to the mobilization of the water stored with glycogen, yet when discussing the A TO Z Weight Loss study, he doesn't bother to mention that the 9lbs lost in the first 3 months of the study almost certainly included a significant percentage from the water lost due to the participants' adherence to ketogenic carb limitations and that some of their regain as they added carbs back in was also likely just water weight.

Finally Taubes talks of the individuals who have cut their carbs down to nothing and still can't lose weight. He quotes Wolfgang Lutz, an Austrian low-carb practitioner from the 50s as stating that those patients must have "reached a point of no return". Makes sense to Taubes because he doesn't believe that the laws of physics apply to people and therefore it wouldn't be consequential to him (or presumably Lutz) if perhaps those folks were simply consuming too many fat and protein based calories.

Why We Get Fat is certainly a book that will appeal to the masses as it pseudo-scientifically preaches that carbs are a magic food and that if you eat almost none of them - the diet he recommends includes 20 grams (less than an ounce) a day - you'll magically lose weight. Perhaps more appealingly, Taubes and Why We Get Fat also preach that you can eat as much fat and protein and you want and you'll never gain. Of course that's pretty much identical to the original Atkins' diet, and virtually all of the diets that Taubes himself references. You think that maybe, were it that easy the world would already be skinny? That low-carb would have continued its huge surge from the early 2000s (or the mid 1800s)? Why didn't it? Not because it doesn't work as for many folks it does - by means of folks on low-carb diets naturally eating, wait for it, smaller numbers of daily calories because they're not as hungry. No, ultimately I think that low-carb diets didn't continue to surge because most folks don't want to adhere to them as by their very definition they meet the classic definition of a "diet" - blind restriction and deprivation - things most folks don't want to live with for a lifetime.

At the end of the day Why We Get Fat's likely fate is to serve as the book for the next century's Taubes to point at, just as Taubes pointed at Banting's, in discussing how science has overlooked the horrors of carbs. Nothing new to see here, it's just another magic diet book.

The question that bothered me most throughout the book wasn't about carbs or thermodynamics, but rather why has Taubes chosen to argue his points like he's a Grade 9 student writing a high school science project rather than a well respected, scientific journalist? Some have suggested it's simply to sell books and have acerbically changed his name to Gary Taube$. I don't know, I think he was probably already doing pretty well for himself before this book was published. Perhaps the best explanation for why Taubes seems to have abandoned thoughtful journalism in place of this mess is his comment near the end of the book,
"One problem here is that when people, experts or not, decide to review the evidence on an issue dear to their hearts (me included), they tend to see what they want to see. This is human nature, but it doesn't lead to trustworthy conclusions."
Well said, and readers of this book, are best advised not to forget it.

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157 comments:

  1. Anonymous8:12 am

    Thank you for such a thorough review. I had thought about buying this book, but will now save my money.

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  2. Alexie8:15 am

    Thanks so much for this review. I've just finished reading the much weightier and more scientific Good Calories, Bad Calories by Taubes and it had begun to bother me. Although I believe in Occam's Razor, when an author begins to ascribe every ill known to mankind to one cause (in this case, carbs), it makes me intellectually uneasy. Without knowing the literature of obesity, I also wondered whether he was cherry picking evidence, especially in his references to the Japanese. He had to do some fast talking to explain why they are lean, despite their white rice regime.

    Anyway, many thanks for this. It means I can continue to enjoy my whole grain toast in the morning, without worrying it's going to make me obese by re-organising my body.

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  3. Yoni,

    Thanks for the in-depth review of the book. I read it and have started using it in presentations ... as just another book/concept that adds to the confusion.

    Once he dismissed the "toxic food environment" and based much of his thinking on the 20 calorie a day concept, I knew I was in for a lot of misinformation.

    The carbs/fat debate is really a mis-direction. If people want to stay out of the "circle of disease", simply stated, I recommend:

    omit this:
    Fast Food
    Junk Food
    Candy
    Soda
    Highly Processed Food

    add this:
    Exercise

    If a little effort is made, it's not difficult to identify incredible foods that replace the above.

    Thanks again for the review.

    Gotto go, Atlanta has 6-inches of snow and it's time to enjoy the day off.

    Does 6-inches of snow shut down your neck-of-the-woods ... lol?

    Best,

    Ken Leebow
    http://www.HighSatiety.net

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  4. Paulette8:23 am

    Interesting review, and will certainly save me the money buying the book. While I agree with a diet that features less (simple) carbohydrate than is so readily available to us, demonizing one nutrient isn't an answer. What you say you consume ~45-60%, (if I am quoting correctly) carb seems a reasonable level & no doubt is sourced mainly from vegetable, fruit & some whole grain.
    I'm not a nutrition or medical specialist, but my understanding is that carbohydrate is the preferred source of energy for brain function. Perhaps following his own carb restricted diet for too long resulted in less thoughtful conclusions.

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  5. anonymous8:59 am

    I read this book yesterday, and wondered what you would think about (was even going to ask). Thanks so much!

    If you get a chance, I'd love to hear your opinion on the new weight watchers points plus plan.

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  6. Excellent review and comments. Looks like Taubes has entered the dogmatic phase of his career.

    Several years ago, in 2003, Jared Diamond wrote an excellent paper ("The double puzzle of diabetes" - (see http://bit.ly/9KVX36 or here to DL the pdf: http://bit.ly/hwj5Iw) - it's a lot about genetic susceptibilities to diabetes (and obesity), still as interesting and relevant today as it was 7 years ago (perhaps just need to update the prevalence figures...).

    You can look hard and long but in the various examples the biggest thing that correlates the best is... amount of food. Of course sugar & other carbs increase as well, but, of course.

    It's a pity, because a good, popular scientific analysis would be really useful, but would probably be too complex to be a best-seller (and apart from $ there are also ego & vanity as attractive alternative reasons)

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  7. Anonymous9:38 am

    "Does the fact that antique medical texts through until the mid 19th century recommend phlebotomy to treat asthma, cancer and pneumonia mean that we should start practicing it again?"

    Just because the old textbooks that Taubes refers to document approaches that are now considered bunk, does not mean that all the approaches to medical problems that were used at the time are bunk. I am certain there are many examples of good practices that are still used today.
    ********
    "'And what of human "wild animals'."

    Aboriginal people are not (and were never) the "wild animals" of the human world, and to refer to them as such, even in quotes, is insulting to say the least.

    *********
    "Why We Get Fat is certainly a book that will appeal to the masses as it pseudo-scientifically preaches that carbs are a magic food and that if you eat almost none of them - the diet he recommends is the 20grs a day - you'll magically lose weight."

    The 20 grs recommnedation is only for the first two weeks. Not for the whole diet.

    *******
    "Clearly something else is at play - but for Taubes it's not excess consumption of calories that make us fat. Instead he believes carbs make us fat independently of thermodynamics, and in turn our fat itself drives us to overeat."

    He does not think carbs make us fat, directly. He believes that carbs increase insulin levels, causing the body to store the energy from the carbs as fat. If your insulin levels remain elevated (because of your diet), the energy stays in storage. As you get fatter, more and more of the energy from the food you eat gets diverted to managing these fat stores, which is why a fat person often feels tired and doesn't have the energy to exercise. A fat person therefore expends less energy on exercise and other activities, because so much has been diverted to the management of these stores. So, he's not saying that thermodynamics don't apply, but rather that the energy gets stored instead of used, causing the person's body to slow down, while requiring ever more energy. It's a vicious circle.

    I think that if you really wanted to debunk Taubes' theory you would have to do a good diet study that included a group of people like the twinkie guy - they would have to eat nothing but sugar and refined carbs, and if a significant number them lost weight in spite of it, that would prove Taubes wrong.


    Jennifer D.

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    1. Anonymous7:51 pm

      That stil would not proof it wrong as you can loose weight but still do not loose fat.

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  8. Jennifer,

    I thought it was clear from the writing, but the human "wild animals" I was referring to was all the global us of us a few hundred years ago who didn't have the benefit of a toxic food environment to gain weight.

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  9. I am by no means a Taubes evangelist. I too have been troubled by the fact that he doesn't adequately account for high-carb cultures and that he pooh-poohs toxic environments as contributing to obesity. (Although re the former, apparently he is now talking with Robert Lustig and is saying that fructose may be the agent involved in creating hyperinsulinemia which dietary carbs then exacerbate).

    I'm also not a low-carb zealot. I've done ridiculously well losing weight on ketogenic diets, but because I treated them as such, I'd go back to standard American fare once the diet was over. And over time the weight would pile back on. Now I'm working more from a "go on the diet you can live with -- forever" approach.

    All of this said, I am glad that Taubes is out there because whatever one's understanding of the first law of thermodynamics -- I don't see how you cannot conclude that there is something at work wrt obesity besides calories in and out.

    I don't think he has it right either. But whether it is carbs, or fructose, or high omega-6 veggie oils, or something else, maybe other toxins like pesticides -- or how much DHA our mothers ate before we were born, there is something way more to the story than just "eat less, move more."

    If Taubes primary contribution will be to get more researchers looking at what's really going on, then perhaps he won't just be another Banting.

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  10. Anonymous11:49 am

    Hi Yoni,

    I actually really enjoyed your review of Taubes - but the "wild animals" reference was rather alarming.

    Good blog. I enjoy reading it.

    Jennifer D.

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  11. Mike S11:56 am

    I will start by saying I have a bias toward's Taubes point of view but I'd make a couple observations:

    1. The law of thermodynamics does hold but does not tell us how the body decides what to burn and what to store. Also, Taubes does not argue you can eat more calories than you burn and not gain weight (although there is some evidence that excretion plays a role) but rather that you can eat as many calories as you like meaning that you will stop naturally when your hormonal response (leptin/insulin) when you are satified. Again, several studies show that people will voluntarily eat less calories on a low carb diet without having to think about it.

    2. You mention humans a hundred years ago didn't have a obesity epidemic. Well is this because of the lack of toxic environment or because they ate the number of calories they needed to have energy but stay lean without thinking about the number of calories (ie. because of natural instinct). You can hypothesize that it is the toxicity with as much credibility as I can hypothesize that it was natural instinct.

    3. You talk about the water weight that was most likely lost on the low carb diet in the A to Z study but don't note that this number is not collected and therefore is your assumption, nor that by the end of the study the Atkins people had added back more carbs than advised by the diet and probably (I can assume too) gained back some of that water weight and still had lost more. Also, how much of the other diet's weight loss can be accounted for in water?

    While I admit to a bias towards Taubes point of view I do think he may have stretched his point a bit but you cannot deny the scientific evidence has piled up to show the effectiveness of carbohydrate restriction in weight loss and heart disease factors, can you? It seems obvious that even you don't believe it is ALL calories in/calories out. So the question is, how important is calories in/calories out as opposed to getting our bodies back to the state where we can trust that our hunger is the result of needing more energy or that it is the result of some reaction to blood sugar drops, or a result of energy being stored in fat and not available to burn?

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  12. Hi Mike,

    I'd invite you to reread the second paragraph of my post as to what I believe.

    Regarding thermodynamics - he explicitly states that the laws of physics don't apply. Why? I can't imagine. Like you, I think diets higher in protein and fat naturally lead folks to consume fewer calories and that the laws of thermodynamics apply.

    You are wrong by the way to suggest that Taubes doesn't state you can eat as much protein and fat as you'd like. Here's a quote from page 211 of the book, "But protein and fat don't make us fat - only the carbohydrates do - so there is no reason to curtail them in any way."

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    1. Taubes does not state that the 1st law of thermodynamics does not apply. He states that it does nothing to tell us the all important "why". He uses the crowded room analogy. There is a crowded room. Ok. Someone observes the crowded room and states, "that room is crowded because more people have entered it than left it". Obvious. All Taubes says it that the 1st Law of Thermodynamics is an obvious redundant statement when in fact, it is being purported as explaining "why". It does no such thing.

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    2. All I know is this,a year and a half ago I read his book. I went from 205 pounds down to 175 and have been able to keep it off. This book got me looking at nutrition in a whole new way. I did not eliminate carbs but I certainly reduced them and the sugars.You all can go on and on about the science and theories etc...i took his advice used it and it worked for me. I do not excercise, lift weights or run due to a sinus condition that limits my activity. I am 50 years old and I am proof his theories work....have a nice day.

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  13. Anonymous12:26 pm

    This was an excellent review. Starches are the cornerstone of all culture's eating habits - pasta for the Italians, rice for Asians, corn for South Americans, etc. Clearly there are many other factors that influence weight much more strongly than carb intake. This one-note author has run it's course. My favourite part of your review is near the end where you say low carb diets are the very definition of a diet involving deprivation and sacrifice. High fibre eating habits trumps low carb http://www.theglobeandmail.com/life/health/healthy-living/embrace-the-f-word-if-you-want-to-lose-weight/article1385126/

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    1. M. Singer10:33 am

      This is exactly Taubes' point! These cultures do NOT eat pounds of REFINED sugar and REFINED flour; they eat whole flours and starches that are UNPROCESSED. Please read Taubes' original book carefully, and don't rely exclusively on an unconvincing review of the "Reader's Digest" version.

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  14. Thanks for the reply!

    I don't really want to speak for Taubes, and he probably is over simplifying things here, but when he says 'there is no reason to curtail them in any way', I believe, is that he believes our natural instincts will stop us from eating more calories than we need when eating protein and fat. In my experience, it is very difficult to overeat these foods (depending on your definition of overeating).

    Also, I don't have time to find all his quotes about thermodynamics but he does say 'But that does not mean that the laws of thermodynamics have anything more to say about us getting fat by any other law of physics'. The law of thermodymanics being energy in a system = energy added to a system - energy removed from a system. Where does that say that the system cannot preferencially keep energy in the system rather than remove it from the system? It says nothing about cause and effect. Is the amount of energy taking out of the system influenced by the amount taken in and the amount stored? It is irrelevant therefore to use the law of thermodynamics just as it does me no good to say someone is broke and in debt because he spends more than he makes. So what, it doesn't mean anything unless I know why he is making so little and why he is spending so much. And I cannot do anything about it if the guy increases the amount of spending disproportionally to the amount of extra money I give him.

    Is it not possible that the body will store energy as fat preferentially and not release it for energy burning and instead cause cravings and the compulsion to eat through whatever hormonal mechanism? And if we do not overcome this hormonal mechanism some how, are we not doomed to gain the weight back or have to fight the compulsion to maintain the weight?

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  15. Absolutely Mike.

    A shame that Taubes' book seems to have spent less time hammering home the impact of diets high in protein and fat on satiety than it did on trying to refute the first law of thermodynamics.

    As I noted in the review, that's where I'd hoped Taubes was going and I was frankly surprised he didn't.

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  16. Lindsay12:38 pm

    Hi Dr. Freedhoff!

    You might be interested by a recent paper entitled 'Canaries in the coal mine: a cross-species analysis of the plurality of obesity epidemics' recently (Klimentidis et al., November 2010)published. The authors examine body weight in 24 populations of animals from laboratory rodents to wild animals.Very nice paper! Cheers!

    ReplyDelete
  17. Anonymous12:57 pm

    Fat is slow to digest, a diet high in fat and protein can leave you feeling sluggish and heavy, not to mention constipated!

    ReplyDelete
  18. Anonymous12:57 pm

    On the point made by Mike, commenter above, about hunger. I have tried dropping my carb intake to under 50 grams a day, and I must say, that the constant cravings for sweets and breads stopped after about three days, for the first time that I can remember. And when I was hungry, I knew that it was really hunger and not a craving. I don't intend to pursue a very low carb diet over the long term, but it's clear to me that whatever refined sugar and white flour do, it's not good! And I find that as I get older and fatter, the cravings have worsened. On the low-carb diet, I could not finish my evening meals - I was no longer hungry. I have never experienced that before, except when I was sick. Anyway, I live in Ottawa, and hope your BMI approach will help. I am impressed by your flexibility and open perspective. I'm sure I can find a happy medium that involves more than 45grams of carbs per day. At least I hope so.... Jennifer D.

    ReplyDelete
  19. Fair enough. I think from Taubes standpoint he feels the need to refute the simplistic 'eat less and exercise' advice as being unproductive. He seems to believe we need to understand why we overeat and don't exercise and that the character flaw argument does not cut it.

    I was overweight most of my life and believe me this argument is used to both demean the overweight and to dismiss them as being lazy and slothful (as I'm sure in your work you've seen). I appreciate Taubes pointing out that the traditional view of weight loss has been based on assumption, not science and when the science shows the traditional view is wrong, or at least deeply flawed, the media and many health professionals ignore it.

    It angers me every time I see a morning talk show trying to tell people to cut back fat and sugar. I don't believe removing fat is nearly as important as removing sugar and refined carbohydrates, and, for those most insulin resistant, many fruits and whole grains. I believe this because the science seems to be telling me so.

    Anyway thanks for the response. I really wrote because I think that the good information in Taubes book about the flawed assumptions behind the conventional wisdom and the science that shows it to be so. I think it's important for people and I also think he is doing far more good than harm in outlining that simply looking at calories in/calories out does not work. Maybe he takes it too far. Maybe not. I think even Taubes would agree that a well designed study is required to prove it one way or the other. Of course that's difficult because you have to control too many variable.

    ReplyDelete
  20. One quick question. Do you know of any other books that give such a careful review of the history of the science of nutritional research into obesity and weight loss?

    I would be very interested in reading more on the subject.

    ReplyDelete
  21. To Jennifer:

    Congratulations on your success. I won't presume to give you advice, just the observation that even the Atkins diet has people adding back carbs. The process you go through is to add back in a certain order (nuts, then berries, etc) until you find a threshold where you feel the hunger and cravings again or start to gain weight (I am oversimplifying). This threshold is the amount of carbs that is probably best for you.

    I like this approach because it is individually tailored. Some may be able to eat 100 g of carbs a day or more, some may have to stay at less than 50.

    ReplyDelete
  22. Mike, I'm looking forward to this one: http://amzn.to/fxa5se.

    ReplyDelete
  23. Anonymous3:38 pm

    Taubes recommends 20 g carbs per day, that means you could only have one serving of a grain, fruit, or dairy. How does this result in a nutritionally balanced diet?

    ReplyDelete
    Replies
    1. Anonymous3:42 pm

      Despite what one so often hears, it's actually not very difficult at all to get a nutritionally-balanced diet on 20 g of carb a day, as grain (and to a lesser extent fruit) is not particularly nutritious. Do note that in calculating carb intake, low-carb diets do use the somewhat sketchy "net carb" concept, subtracting fiber from the total carb content to reach the "net carb" value. Here is a nutrition report from such a diet:

      Turkey breast, meat only,roasted 575 g 776.2 Calories
      Nuts, walnuts, English 9 g 58.9 Calories
      Nuts, almonds 40 g 230.0 Calories
      Cabbage, chinese, raw 100 g 13.0 Calories
      Broccoli, raw 100 g 34.0 Calories
      Flax oil 2 tsp 80.1 Calories
      Tomatoes, red, ripe, raw, year round average 100 g 18.0 Calories
      Asparagus, steamed 100 g 22.0 Calories
      Kale, raw 50 g 25.0 Calories
      Milk, Hood Calorie Countdown, Fat Free or Skim 0.5 cup 17.5 Calories

      ===========================================
      Nutrition Summary for June 21, 2012
      Report generated by CRON-o-Meter v0.9.9
      ===========================================

      General (71%)
      ===========================================
      Energy | 1274.7 kcal 199%
      Protein | 195.0 g 406%
      Carbs | 33.7 g 11%
      Fiber | 13.3 g 44%
      Starch | 0.3 g
      Sugars | 10.1 g
      Fat | 40.4 g 184%

      Vitamins (90%)
      ===========================================
      Vitamin A | 14870.1 IU 496%
      Retinol | 74.7 µg
      Alpha-carotene | 127.0 µg
      Beta-carotene | 8709.5 µg
      Beta-cryptoxanthin | 1.0 µg
      Lycopene | 2603.0 µg
      Lutein+Zeaxanthin | 22113.2 µg
      Folate | 376.9 µg 75%
      B1 (Thiamine) | 0.8 mg 65%
      B2 (Riboflavin) | 1.8 mg 139%
      B3 (Niacin) | 48.0 mg 300%
      B5 (Pantothenic Acid)| 5.8 mg 115%
      B6 (Pyridoxine) | 4.0 mg 237%
      B12 (Cyanocobalamin) | 2.9 µg 119%
      Vitamin C | 215.7 mg 240%
      Vitamin D | 103.6 IU 26%
      Vitamin E | 15.6 mg 104%
      Vitamin K | 614.3 µg 512%
      Choline | 586.7 mg 107%

      Minerals (86%)
      ===========================================
      Calcium | 585.4 mg 59%
      Chromium | 0.0 µg 0%
      Copper | 1.4 mg 155%
      Iron | 14.1 mg 177%
      Magnesium | 383.6 mg 91%
      Manganese | 2.4 mg 104%
      Phosphorus | 1845.5 mg 264%
      Potassium | 3444.3 mg 73%
      Selenium | 199.4 µg 362%
      Sodium | 528.1 mg 41%
      Zinc | 13.6 mg 124%

      Lipids (100%)
      ===========================================
      Saturated | 4.5 g
      Monounsaturated | 15.8 g
      Polyunsaturated | 16.7 g
      Omega-3 | 6.0 g 149%
      Omega-6 | 10.4 g
      Trans-Fats | 0.0 g
      Cholesterol | 479.7 mg 160%
      Phytosterol | 7.0 mg

      Yes, it's a bit low on calcium. And yes, it uses special, low-carb milk. But it's significantly over five fruit and vegetable servings a day, and far more nutritious than most commercial diet plans, precisely because it loads up on veggies instead of grains.

      Delete
  24. It's always interesting to read about the "Diet Camps" people are in. It's like politics: You get in a camp and are not willing accept others.

    Interesting, a healthy diet can be eaten from vegan to paleo. It's what they all omit that makes the difference:

    Fast Food
    Sugar
    Candy
    Junk Food
    Processed Food

    Now it's back to Snowmageddan Atlanta.

    Ken Leebow
    http://www.HighSatiety.net

    ReplyDelete
  25. To Anonymous who said:

    Taubes recommends 20 g carbs per day, that means you could only have one serving of a grain, fruit, or dairy. How does this result in a nutritionally balanced diet?


    I think you would have to first determine what is a nutritionally balanced diet, wouldn't you? If you are an inuit, it involves no grain, fruit or dairy. I think the 'balanced' diet concept is kind of silly. Isn't the point to get the optimal diet given an individual's metabolism and health? In that case, maybe the obese can get far healthier with less than 20 grams of carbs (which would come from veggies not fruit or whole grains) than with what the common wisdom says is a 'balanced' diet.

    Before you say people should be eating a balanced diet, I think you should have some sort of evidence of the superiority of what you believe is balanced over what you believe to be unbalanced in terms of health benefits. And a rhetorical question like 'how is that balanced' does not suffice as proof.

    ReplyDelete
  26. Anonymous4:34 pm

    To Mike:
    Why choose a weight loss method that does not provide your body with all the essential nutrients it requires?

    You can read the Dietary Recommended Intake reports as to the function of the essential nutrients a 20 g carb diet is short in, including calcium, vitamin D, potassium, folate, and fibre. I'm assuming people following such a restricted diet take supplements but you can't duplicate all the nutrients and phytochemicals found in all the restricted foods.

    Some of the points in this article posted below have been argued in the literature but several still hold true
    http://205.238.201.105/LowCarb.html

    Additionally there is the argument that a diet high in meat is more harmful to the enviroment. As you say, different eating habits suit different people, but authors like Taubes don't give any other approach any credit at all.

    ReplyDelete
    Replies
    1. To anonymous:
      the reason you need micronutrients is to process macronutrients. Different macronutrient ratios need different micronutrient ratios. More carb requires more thiamine, for example; more protein, more B6; more fat, more B5. You tend to get the micronutrient you need with the macronutrients if the food is whole.
      This one reason why attempts to construct RDA tables have been so fraught with dissension; not everyone has the same needs.
      But you could always take a multivitamin, as I am sure many dieters do.

      Delete
  27. Heather4:50 pm

    The Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association states, “High-protein diets are not recommended because they restrict healthful foods that provide essential nutrients and do not provide the variety of foods needed to adequately meet nutritional needs. Individuals who follow these diets are therefore at risk for compromised vitamin and mineral intake, as well as potential cardiac, renal, bone, and liver abnormalities overall.”

    ReplyDelete
  28. Low carb diets are not high protein diets, they are high fat diets.

    ReplyDelete
  29. Excellent review, Yoni. Now I have someplace to point people who keep recommending this book. Yes, this does basically seem like Atkins 2011 -- do people really not remember that Atkins didn't work?

    I am curious about this:

    "Why We Get Fat is certainly a book that will appeal to the masses as it pseudo-scientifically preaches that carbs are a magic food and that if you eat almost none of them - the diet he recommends includes 20 grams (less than an ounce) a day - you'll magically lose weight."

    I'm not disagreeing with this -- I've certainly seen this phenomenon -- but I find it baffling. Why do so many people find it so much more interesting and appealing to cut out one kind of food -- carbs, fat, white food, whatever -- instead of just reducing their overall caloric intake? I personally find the "eat more or less whatever I want, as long as it stays in a caloric budget and makes me feel satisfied" plan to be easier and more pleasurable, with much more freedom and variety. Why do you think so many find this so difficult, and find the "don't eat any white food" plan or whatever so appealing?

    ReplyDelete
  30. "...our natural instincts will stop us from eating more calories than we need when eating protein and fat. In my experience, it is very difficult to overeat these foods (depending on your definition of overeating)."

    Mike, as someone who at one time could easily devour an entire jar of peanuts or an entire pint of Ben and Jerry's in one sitting, let me tell you that my own personal experience of that is radically different from yours. And so is the personal experience of a whole lot of people. I am very, very far from the only person for whom the "servings per container" on a pint of Ben and Jerry's was One.

    As to this:

    "You mention humans a hundred years ago didn't have a obesity epidemic. Well is this because of the lack of toxic environment or because they ate the number of calories they needed to have energy but stay lean without thinking about the number of calories (ie. because of natural instinct). You can hypothesize that it is the toxicity with as much credibility as I can hypothesize that it was natural instinct."

    This is begging the question. If a hundred years ago people ate the number of calories they needed to have energy but stay lean without thinking about the number of calories... why did they do that a hundred years ago, and not now? What has changed in the last hundred years? It can't possibly have been our "natural" appetites -- as Yoni pointed out in the original post, three generations is not enough time for that radical a change in our genes. It seems much more likely that what's changed is the food environment -- which, among other things, is being deliberately manipulated by Big Food to trigger our "natural" food instincts in a way that sells us more food and brings them big profits.

    ReplyDelete
  31. Hi Greta,

    I think people are attracted to magic food diets because they involve no thought. Follow a few simple rules and you're good to go.

    ReplyDelete
  32. Anonymous5:04 am

    Greta,
    I guess Gary's book only outlines the first two weeks of a low carb diet, where you can eat only 20grs of carbs if you want. But actually, when I tried it, I ate about 45grs, and I ate a lot more vegetables and nuts than I usually do. So it's not just one kind of food. I can't speak for others, but it really just removed all my cravings, which is a really useful experience. I hope to get help creating an eating plan that is fairly low carb, but just not THAT low - like maybe 100-150grs a day. But I respect people who follow this diet. It's not a fad, and it's not another "magic" diet like the grapefruit diet. It's actually the way most Indigenous cultures ate until they were colonized, and they survived for thousands of years that way.
    Jennifer D.

    ReplyDelete
  33. Really? Atkins didn't work? Do you have a study where you show it didn't help people lose weight and improve their heart disease risk? Or is this based on personal experience? I've heard people that say Atkins didn't work because otherwise we wouldn't have an obesity epidemic. Just thought I'd mention we had more medical and media support for the low-fat hypothesis for the last 30 years and that didn't go great guns either.

    Because I can quote at least 3 recent studies right off the top of my head where Atkins (or some other similar diet) not only worked, but worked better than those diets with more carbohydrates.

    And as for eating an entire tub of peanut butter (assuming no bread and that it was not processed peanut butter), peanuts are higher in carbohydrates than animal products and therefore are limited on a low carb diet (not eliminated but limted) so your example doesn't hold. Have you been able to sit down and eat a dozen italian sausages or a couple pounds of steak? Now that is the self-limiting advantage of low carb that I am talking about.

    Adherence is the problem with any diet and Atkins is no different. And I understand that the ability to adhere is more than hormonal. There are emotional reasons why someone may have difficulty with any diet. What Taubes is getting to is that a diet high in carbohydrate is physically harder to stick to because of the hormonal reaction to those carbohydrates. If a low fat diet or just a calorie restricted diet works for you, that's great. But really if you are going to argue with the premise of a book that is largely based on a review of the scientific evidence, you'll need more than empty rhetoric to make a good case.

    ReplyDelete
  34. And what has 'Big Food' done to manipulate our 'natural appetite'? Introduced more fat and protein into our diet? Nope. Introduced far more carbohydrates, especially refined carbs and sugars.

    ReplyDelete
  35. Dr. A. Green9:35 am

    This from a man who counsels people for profit about how to lose weight. Yeah, what if people were able to figure it out all on their own? Kinda like the wolf minding the hen house here. Taubes' thoroughly well-researched book Good Calories Bad Calories needs to be read first to understand the extent of the science. To criticize him for a lack of it in a book clearly meant to simply the original GCBC information is unfair. There are LEGIONS of examples of people reversing heart disease, diabetes, hypothyroid, and a host of autoimmunity issues with the Paleo diet just as there are LEGIONS of people who make their money and living from keeping the status quo in place. When the Diabetes Association in my community has a pizza sale to raise money it's hard not to laugh at the disconnect. All we can do is try it. I have lost 55lbs since March EFFORTLESSLY with NO HUNGER by eating proper fat and following the Paleo way of eating. Fat satiates. Carbs, even whole grain ones, make you hungry and cravy. (Not a word, I know, but it should be.) They cause leaky gut which is at the root of autoimmunity. There are also neurological studies that point to carbs acting in the brain on the same receptors and in the same way as heroin. There's a withdrawal when one stops carbs. How can this possibly be good for the body if the body suffers when it is discontinued? We were not, evolutionarily speaking, meant to consume carbs. I always say to people, try cutting them out for one month and see how you feel. After you get over the withdrawal of the first week the energy is amazing.Personally I don't give a rats bum about all the arguing and finger pointing in the science and medical community about what is and isn't the best way to be healthy. I have tried this and it feels amazing. My diet is probably 75% fat and my lipid profiles are in the higher end of the EXCELLENT range. Go by how you feel. People need to learn to LISTEN TO THEIR BODIES. Food is medicine not entertainment.

    There's also a new paper out this week that is referring to Alzheimer's as the "diabetes of the brain" and people with mild dementia (a precursor to Alzheimers) were placed on a very low carb and saw prodigious results and improvements in cognitive function.

    Taubes' educates about the importance of proper fat and balancing the omega 3 and 6. Also getting off the industrial (omega 6 laden) seed oils like canola and vegetable and corn oil. Olive oil, coconut oil and butter and ghee are the only ones we should eat. Some key points missed here in this slammy review. Taubes covers ALL of it in GCBC. By following the Paleo diet I have also tapered down 80% off of hypothyroid meds I was on. Am almost 50 and am nothing else. I am seeing similar results in family members as autoimmune disease is all through my family. (Lupus, celiac, type 1 diabetes). Can you imagine if the all the doctors, ESPECIALLY THE ONES WHO CANNOT BE TRULY OBJECTIVE BECAUSE THEY MAKE THEIR LIVING TREATING THE OBESE, actually worked on finding a solution instead of spending long hours pumping out dissertations aimed at criticizing those who actually do? We can dream.

    ReplyDelete
  36. Anonymous9:55 am

    Angry doctor guy.

    I guess Taubes' books are all non-profit?

    Funny thing too. Freedhoff made his book freely downloadable.

    He also states pretty damn clearly that low carb does work in helping people lose weight.

    He'd better go back to wolf school.

    ReplyDelete
  37. Dr. A. Green10:06 am

    Anonymous. Not angry. And not saying saying Taubes' isn't entitled to compensation. Didn't say also that Yoni didn't agree low carb assists in weight loss. Yoni is also entitled to charge people to tell them what should be readily available if people were not complicating the flow of information to an indiscernible slurry.

    As a friend pointed out to me, "the thing is, both guys are "right" to a certain extent. No one sells books, or services for that matter, though, by taking the moderate stance. For clients (or patients) who just want to know the truth of the matter -- and the truth is, that for every extreme that possesses a good percentage of truth, there exists a counter-argument that also possesses a good bit of truth. The real "truth" though, is found in the murky, messy middle. When proper diet is argued from a right/wrong, black/white prospective, everyone loses."

    ReplyDelete
  38. Anonymous10:11 am

    Not angry doctor guy,

    "When proper diet is argued from a right/wrong, black/white prospective, everyone loses."

    Perhaps you should mention that to Gary Taubes, as that is precisely what he's done with Why We Get Fat (and Good Calories, Bad Calories).

    ReplyDelete
  39. I think what the 'angry doctor' is objecting too is claiming that Taubes is financially motivated because he is saying something (calories in/out doesn't matter) but ignoring that the doctor reviewing the book also has a profit motive. The profit motive is the same 'straw man' argument that the doctor is objecting too.

    He also makes a good point that Taubes book is very educational in terms of a review of the science (even if you disagree with his conclusions) and to write a review this lopsided (misquoting, misrepresenting his arguments) and seeing people say 'good job, I saved money on buying the book' is distressing. There is SO much good information in this book that to dismiss it with empty statements like 'that's not balanced' and 'it's a magic diet' is sad.

    Taubes makes excellent points backed by science that genetics and hormones (insulin especially) do more to determine the behavior of overeating and the distribution of energy taken in to storage and burning (he ignores excretion which he probably shouldn't). This isn't conjecture like saying all you have to eat less and exercise (which I don't believe the good doctor that writes this blog is saying), it is based on science:

    For example, the A to Z studied showed that for similar calorie intake, the lower carb diet did better. The doctor blogger says that was most likely water weight but ignores the water weight in the other groups and also the lack of data to prove his point. Not to mention, as the low carbers added back carbs, they gained some weight back (probably mostly water by the doctor's logic).

    Now does this prove that calories in/out doesn't matter? Maybe not, but it definitely proves (or at least would seem to indicate) that diets in different macronutrient compositions with the same calorie count have different effects, and that removing the carbs had the greatest beneficial effect.

    I think the reviewer did more harm than good by dismissing the book and (maybe unintentionally?) discouraging people from reading it. I initially received this link from a friend who had not read the book and I got the impression that because of the review he was less likely to do so. Many of the comments said the same thing.

    That's what I find objectionable. There is great information in both Taubes books. They go beyond the empty rhetoric like 'fat makes you fat' and 'it's all just calories in and calories out' and 'eat a balanced diet and everything will be ok'. They examine what is actually happening biologically, using a review of the history of the science to back them up (in the case of GCBC, a very extensive review). Every other book or blog on weight loss seems to ignore this or takes the science for granted and just uses anecdotal evidence to prove their point (eg. one guy lost weight only eating 1800 calories a day in Twinkies). The reason anecdotal information such as this is compelling, is it seems logical but there is no control over the variables. What if he ate 2000 calories in steak and brocolli? Would he have lost more weight? Would he have had better improvement in heart disease risk?

    ReplyDelete
  40. Snowed in again in Atlanta. So, it's always amusing to read the missives of people defend their diet camp.

    I recommend watching Jon Stewart's monologue from last night. While it was about the Arizona shooting and politics, you can easily substitute "diet camp" for political sides.

    Here's to a some peace in the diet and health world ...

    http://www.thedailyshow.com/watch/mon-january-10-2011/arizona-shootings-reaction

    Ken Leebow
    http://www.highsatiety.net

    ReplyDelete
  41. So you want to compare a debate about the science of diets to the political debate in the US?

    Observing the debate and making pithy remarks characterizing it is not contributing anything towards making the debate more rational and less emotional.

    Ok, does that mean we stop debates and go to our rooms? Or does it mean that both sides (mine included) and those undecided should look at the rationality of the arguments rather than the emotion (I've been trying not to put emotion into my posts, maybe I didn't succeed all the time) and decide where the weight of the evidence lies?

    I would sure love to see that in politics both down south and here (I'm Canadian). I doubt it will happen in politics but I do have more hope in the health and nutrition realm as it is supposedly full of people of science (doctors researchers etc.).

    ReplyDelete
  42. Dr. A. Green11:04 am

    "Anonymous said...Not angry doctor guy, "When proper diet is argued from a right/wrong, black/white prospective, everyone loses." Perhaps you should mention that to Gary Taubes, as that is precisely what he's done with Why We Get Fat (and Good Calories, Bad Calories)."

    It is my belief from a thorough review of the science that what Taubes has to say, and the way he says it, does not argue right/wrong black/white. He's not that dense. He just happens to be correct. The research proves this. In black and white. It's there for the reading. For all of us.

    Still not angry.

    ReplyDelete
  43. fredt4:33 pm

    Taubes has to sell books to live. What makes a good books may require something less than an ideal arguments. So be it. For me (N=1) low carb, controlled protein and controlled fat is the daily program I now live without hunger. My satiety sensors just do not work and never did, I don't know why. Taubes at least offers a partial explanation, something that the conventional medical establishment has not. Lustig and Harcombe offers more. Occasionally this blog does too. It is a matter of sorting off the chaff and using what applies to me in the battle with this complex disease. Grains make me hungry, I just keep eating them given any of them.

    For today I will give up sugars, grains, lubricants, and processed foods for today and see how I feel about it in the morning.

    Your book review has no place in my recovery. Good luck pushing your agenda. But what do I know. Down 55 Kgs.

    ReplyDelete
  44. Anonymous7:58 pm

    On Lance Armstrong:

    While I know that hard training and great discipline have contributed to Armstrong's success, Taubes does have a point about his biking as he does because of his body:

    Gleaned from various scientists/specialists:
    Armstrong clearly has some great genetic advantages. His oversized heart can beat over 200 times a minute and thus pump an extraordinarily large volume of blood oxygen to his legs.

    His VO2 max—the maximum amount of oxygen his lungs can take in, an important measurement for an endurance athlete—is extremely high.

    He produces one-third less lactic acid than do other top cyclists and delivers oxygen to his legs at a rate higher than all but maybe 100 of his fellow earthlings.

    Stacy Ingraham, Ph.D. lecturer in Kinesiology, says Armstrong's entire body is built for the bike.

    Jennifer D.

    ReplyDelete
  45. Anonymous8:44 pm

    @Dr. A Green

    You say of Taubes that

    "He just happens to be correct. The research proves this."

    See this blog for countless examples (and growing) of how Taubes misrepresents/misinterprets research: http://carbsanity.blogspot.com/search/label/GCBC%20Fact%20Check

    To all of the people claiming they followed Taubes' advice and it made them lose weight while feeling less hunger, corrected lipid values etc. there are alternative explanations than what Taubes offers. The biggest is that studies clearly demonstrate that an increase in protein intake (or reducing a protein deficiency) leads to spontaneous reductions in calorie intake. It has nothing to do with insulin.

    ReplyDelete
  46. Anonymous9:44 pm

    Interesting and *long* read. I always appreciate reading a opposing view.

    In your case your finish with a personal attack on him

    "why has Taubes chosen to argue his points like he's a Grade 9 student writing a high school science project rather than a well respected, scientific journalist?"

    was beneath you.

    Also, I was impressed with Taubes reliance on science, where is yours?

    After 20 years of selling ideas to people, I have learned this much as truth:

    Stick to your knitting. If you have a proof, use it liberally. Fighting on your opponents terms is like bringing a knife to a gun fight.

    Pity. I wish I could have learned something here. I did not and you passed up on the chance.

    (Why does all the vitriole come out over diet anyway???)

    ReplyDelete
  47. Good review. Different people just might need different ways of eating. BTW- I'm a family genealogist. My relatives 100 yrs ago lived LONGER than the generation born after WWII is living now. A Civil War vet applied for a pension in 1907- taking care of his 90-year-old father. Females averaged age 83 at death. Males 77. Now females in 70s and males in 60s. Something is very wrong.
    Mom is short and round. She loves the low carb life. It gives me bleeding constipation. I am tall, thin, and fidgety. I need (whole grain) carbs to fuel me through the day, or I get weepy and confused by the end. Eating a doughnut is like throwing gasoline on a bonfire- temporary energy that leaves me depleted and unaccountably angry. Steak or a big hunk of cheese leaves me in digestive agony for days.
    Taubes is an adherent of one viewpoint. Maybe one should read him and Ornish/Esselstyn/Campbell back to back, then cull out the commonalities (and the sound science) and go from there, modifying as we go for individual needs. Veggies, anyone?

    ReplyDelete
  48. Quite frankly, I found this review to be disappointing.

    This statement is heavily bothersome to me because it's an outright lie.

    "And then there are simple non-truths. At one point Taubes states,..."You don't get fat because your metabolism slows, your metabolism slows because you're getting fat."
    I totally don't agree that this is a non-truth, it is not the SOLE reason your metabolism slows down but it is a true statement. Taubes should've qualified it but you should have called it, as a half-truth, not a non-truth, basically calling Taubes a liar, in a nice way.

    Personally, I find this the most infuriating & disturbing statement of all..."In fact he states that the reason any diet works isn't because of caloric restriction, but rather it's due to carb restriction, with the corollary also being true - weight gain's not a consequence of caloric intake, but rather carb intake. Tell that to Twinkie Diet guy Mark Haub who lost 34% of his body weight eating 1,800 controlled, processed carby, junk food calories a day..." HELLO, you're a doctor...the KEYWORDS here are DIET WORKS. What kind of health & shape was Twinkie guy in? Probably the same shape as the guy in Super Size Me. Can he sustain the weight loss eating TWINKIES? The answer is NO & you very well know that. Can he be healthy eating Twinkies as a changed lifestyle of eating? The answer is no! Doctors like you are a hazard to their patients.

    After this point, I didn't bother reading further because you lost all your credibility as far as I was concerned.

    Anyone that said they wouldn't buy this book because of this review has already wasted their money, reading your blog. Yes, I am aware it is free, still my point. Since I am ABSOLUTELY SURE you won't post this comment...It would be nice to see you follow this review up with some clarifiers.

    ReplyDelete
  49. Anonymous5:06 am

    I guess ketones don't fuel brains as well as glucose.

    This was a book review.

    Not a Taubes review, not a low-carb review.

    Freedhoff actually makes it very clear he's a low carb supporter. He also doesn't attack Taubes personally. In fact he makes it clear he disagrees with a blogger who did.

    Book reviews review the writings of books.

    Freedhoff didn't like how this one was written. He thought it was very poorly argued and to back himself up he provided examples.

    That's called a book review.

    So everyone take a deep breath and enjoy yourselves some bacon.

    ReplyDelete
  50. I didn't read all of the comments, and only skimmed the review, but this point caught my attention:

    "Ultimately he embraces the notion that carbs make you fat regardless of the calories in/out hypothesis, rather than discuss such possibilities as carbs making you fat by having a lesser impact on satiety. Mid book I had hoped this was where he was going, but sadly, for reasons that are backed up by observation, inference, logical fallacy and straw men, apparently he's decided that living creatures are magical beings that live independently of the laws of physics and thermodynamics."

    If that's what you got from this book, then you may want to read again, more carefully. Taubes makes the point several times that this is precisely NOT what he is saying. Living organisms are bound by the laws of physics just as any physical system. The issue is that those laws don't tell you anything about WHY you got fat. Clearly in order to store extra fat you need to eat more energy than you expend. The relevant question is why you ate too much in the first place, since this indicates a breakdown in metabolic regulation.

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  51. Hmmmm ... Thanks (?) for linking to my blog.

    Well, more importantly thanks for a great review. I've linked to it for the benefit of my readers.

    Unless I get a library card (or GT sends me a free copy to review LOL) I won't be reading this installment so I much appreciate the detailed analysis.

    I'm curious if he addresses the whole carbs required to store calories at all this go round, this being what initiated my issues with Taubes. Or has glycerol phosphate done a total disappearing act?

    I've refrained from the Taube$ stuff to focus on the facts, but anyone who doesn't realize that the whole GCBC "franchise" is a huge part of his income stream, therefore needs to be protected, is kidding themselves.

    As someone posted, I have a GCBC Fact Check label over at my blog that includes several posts demonstrating where he has outright misrepresented the content of some of his references, ignored others he should be aware of, etc.

    I'm a low carber myself (eating a few more these days actually and losing a teeny bit if anything) but can't abide shoddy science and the presentation thereof all the while claiming to debunk the serious work of thousands toiling in relative anonymity.

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  52. Anonymous4:19 pm

    Your review demonstrates why Good Calories Bad Calories needed to be such a long and in depth read compared to the abbreviated set of arguments in Taubes' new book Why We Get Fat. Once you've read GCBC you cannot accept calories in/out anymore and thus most of low calorie / exercise dogma. Additionally, to assume from the outset that there isn't one common cause for a massive common disease such as obesity (a one commenter did) is fool hardy at best (Occam's razor). The introduction of steel rollers to refine flour and the massive increase in sugar consumption that we've seen in the last 100+ years seems to be the obvious cause. As a scientist, I find it much easier to accept that something in the western diet has changed (and clearly something has) than some sort of mass psychosis of gluttony and sloth.

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  53. Anonymous12:34 pm

    Anyone who still thinks that the reduction of calories is not at the heart of the low-carb argument should listen to this interview by Eric Westman, the Atkins spokesman:

    http://radio.theheart.org/bob-harrington-show/2010/12/10/31-atkins-diet-obesity-and-cardiovascular-disease-risk-with-dr-eric-westman?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+radiotheheartorg+(radio.theheart.org)

    I don't think you're going to find this recent interview cited on any of the low-carb boards or forums. I'd love to have a low-carb blogger explain it away!

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  54. Elenor5:49 pm

    "... why has Taubes chosen to argue his points like he's a Grade 9 student writing a high school science project."

    Gary Taubes wrote his second book at a 9th-grade level because his readers are intended to be the "mass public" -- who can't read at a 10th-grade level!! If you are one of the medical personnel or educated laypersons for whom he wrote "Good Calories, Bad Calories," then do the work and read that book. If you're not willing to do that, then stick with the 9th-grade book and figure out how the uneducated public will use what he wrote in his second book.

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  55. Anonymous11:52 am

    I have not read this book but did recently read "The End of Overeating"
    by Dr Kessler...he takes a whole different tact and has loads of science to fortify what he says. What does anyone else think of Kessler?

    ReplyDelete
  56. Anonymous7:57 pm

    plus...Kessler talks a lot about why we eat more than we need.....and he includes sodium along with fats and carbs.....I found it to be comprehensive.

    ReplyDelete
  57. Jerry M.3:13 am

    The failure of the laws of thermodynamics in diet is like the same failure in automobiles. Notice that I can put so many BTUs (use kilocalories if you like) of gasoline in your automobile and drive a certain distance on a level road that is flat and dry. Put the same no. of BTUs of maple syrup in the tank and the car will not work at all. Or if you prefer use the same number of BTUs of alcohol. Automobiles do not run well on pure alcohol, but will be able to move.
    Thermodynamics does not describe how well automobiles (or animal bodies) operate on various fuels. Thermodynamics is about heat from burning the fuel. Automobiles operate differently on different fuels even if the amounts of those fuels contain the same ability to heat water in laboratory conditions.
    Therefore Taubes is really saying that the old supposition that a Calorie of protein and a Calorie of sugar and a Calorie of fat will provide equal fuel for the body is not true. In fact, I challenge anyone to site a piece of research that shows they are equal.

    ReplyDelete
  58. Anonymous9:17 am

    Evidence?

    Uh, ok.

    http://www.ajcn.org/content/62/1/19.short

    http://www.ajcn.org/content/55/2/350.short

    http://www.nejm.org/doi/full/10.1056/NEJMoa0804748

    http://www.nejm.org/doi/full/10.1056/NEJMx090065

    ReplyDelete
  59. As for your evidence:

    Study #1 is about overfeeding, not about carbohydrate restriction. In the absense of high level of carbohydrates, you'd see different results.

    Study #2 has the line on page 2 'For inclusion in this analysis, each period of formula feeding had to be >= 2 wk and the subject had to remain weight stable'. If you only include people who did not lose weight, it doesn't prove that restricting one macronutrient will better affect weight regardless of calories because you are limiting people to those who prove your point.

    Study #3 - the most people got down to was 42.9% calories from carbohydrates which is NOT a low carbohydrate diet. At best it is a moderate carbohydrate diet. The difference

    Study #4 - Shows that the low carb and meditterranean did better than low fat for very similar calorie count. In fact the meditteranean diet dropped less calories and lost more weight than low fat. Mmmmm... maybe that was the macronutrients. The 'low carb' diet again didn't get lower than 40% calories from carbs and was therefore a moderate carb diet but still did better than low fat for only going 20 calories on average less than the low fat after 2 years and more calories than low fat at 6 months and 2 years. And weight loss at all times was greater in low carb.

    Might want to read the whole study before quoting it as 'proof' that macronutrient composition doesn't matter

    ReplyDelete
  60. Sorry, didn't finish my comment on Study #3.

    The 'low carb' group dropped their calorie count by less again and lost as much or more weight. Again showing that it is at least possible that the macronutrient composition of the diet can be a factor in the amount of weight loss and it is possible that all calories are not alike.

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  61. He states that no matter how abundant their food supply, wild animals will maintain a stable weight and never become obese. "Really? Do we track the weights of wild animals? Is there an animal NHANES database on squirrels, frogs and crows, or is Taubes, a man who purports to be a "firm believer in science" really just relying on his own observational assessments of animals and at the same time extrapolating wild animals to be useful to this discussion as small little human models appropriate for comparisons?"

    This science behind this is covered in detail in Good calories, Bad Calories. I assume he left it out of this book because of space constraints. It is very difficult to make animals obese if you supply them with their natural foodstuff.

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  62. Anonymous5:15 pm

    Oh really?

    http://rspb.royalsocietypublishing.org/content/early/2010/11/19/rspb.2010.1890.full.html

    ReplyDelete
  63. Your proof that there is an obesity epidemic amongst animals is a survey of animals that are raised either by humans (in research colonies or in their homes as pets) or are living around humans? Is that a 'natural' habitat or the wild?

    ReplyDelete
  64. Anon

    As i said "It is very difficult to make animals obese if you supply them with their natural foodstuff."

    The effect of providing "unnatural" versus "natural" foodstuffs to lab animals was covered in Good calories, Bad calories.

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  65. I would like the reviewer to comment on the most important aspect of Taubes's book: The section on how fat deposition is a hormonally controlled process. It seemed to me to be the most important part of the book and the most damning of the present diet industry.

    I don't think the general public really understand the importance of hormones in every process of the body. There are thousands of disorders that result because of hormone imbalances.

    ReplyDelete
  66. @Brian: I would suggest that if someone really wants to understand fat metabolism, they should look to scientists working in that arena, not science journalist's (erroneous) relating of it.


    http://journals.cambridge.org/download.php?file=/PNS/PNS60_03/S0029665101000416a.pdf&code=9f30142b9e1794805367dab8427fc72d
    Discussed in the following blog post: http://carbsanity.blogspot.com/2010/10/insulin-resistance-taubes-v-frayn.html

    http://journals.cambridge.org/download.php?file=/PNS/PNS56_02/S0029665197000232a.pdf&code=ba16d82ae3de042fe051a6bcc1b17fc3
    Discussed in the following blog post: http://carbsanity.blogspot.com/2010/12/asp-pathway-and-regulation-of.html

    ReplyDelete
  67. Anonymous11:24 am

    Dr. Freedhoff,

    Taubes doesn't dispute the First Law of Thermodynamics.

    The argument he makes is not about whether people who have gained weight consumed more calories than they used. (They have.) It is WHY they consumed more calories than they used.

    His explanation is that, depending on one's genetic susceptibility, an individual who eats large amounts of carbohydrates pushes his metabolism into feedback loop that increases his appetite (calories in) and decreases his tendency to be active (calories out).

    You may dispute the evidence he cites supporting a mechanism of insulin desensitization leading to differential fat storage of consumed calories.

    However, you are wrong to state that Taubes claims that the First Law of Thermodynamics isn't true. He just says it is not relevant to understanding what causes the behavior that leads to the imbalance.

    Please note: I've a background in biophysical chemistry and have read his book very carefully, noting all of his references to thermodynamics.

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  68. Anonymous3:59 pm

    So many people simply looking to verify their own way of thinking, inlcuding you, apparently, Yoni.

    The reason I find Taubes so refreshing is because he presents his data as what he believes. In one interview he even said, "I hope I'm right."

    Take a look at all the fat people and tell me we don't need a new way of thinking. You want science, read his first book. You want the short version, read this.

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  69. Excellent discussion. Thank you to all involved.
    I have to disagree with, correct, this:

    "It's actually the way most Indigenous cultures ate until they were colonized, and they survived for thousands of years that way."

    Indigenous cultures were always moving, following the food; food was scarce, people were hungry, and died young. They did not have many children because the diet couldn't sustain women having more than a couple. Food was primarily animal fat, true. You try surviving at 30 degree below zero when you have to be out in it most of the time, and chilled the rest, without needing huge stores of energy to burn.

    As for indigenous peoples who didn't live in Northern Canada, they had more than subsistence farming and gathering with preservation.

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  70. Anonymous5:25 pm

    Greta said:
    "I'm not disagreeing with this -- I've certainly seen this phenomenon -- but I find it baffling. Why do so many people find it so much more interesting and appealing to cut out one kind of food -- carbs, fat, white food, whatever -- instead of just reducing their overall caloric intake? I personally find the "eat more or less whatever I want, as long as it stays in a caloric budget and makes me feel satisfied" plan to be easier and more pleasurable, with much more freedom and variety. Why do you think so many find this so difficult, and find the "don't eat any white food" plan or whatever so appealing? "

    The main issue is that (at least for some people) restricting carbs while eating as much allowed foods as desired allows achieving an appropriate weight without counting calories and restricting them. It is easier to select the food types and let the caloric intake take care of itself than to select the caloric intake.

    Clearly a metabolically healthy human should regulate energy intake in order to match expenditure. In the natural state this should happen without much conscious effort.

    Obviously a system that requires defining what is a calorie, then measuring caloric content, then restricting intake based on this number is not how any creature's physiology works. The fact that we can do this relatively sophisticated analysis doesn't mean we should have to.

    (Of course this implies that we know what the offending substances are that cause overeating or other metabolic dysregulation, and that our metabolism hasn't been broken to such a degree that it's no longer responsive to the appropriate diet.)

    ReplyDelete
  71. I found the book readable enough - I read it cover to cover tonight. Much of what he had to say wasn't new to me, but it was nice to see it put together.

    Ultimately he embraces the notion that carbs make you fat regardless of the calories in/out hypothesis

    Actually I got the impression that he wasn't actually saying it was regardless of the calories you took in, rather he was attacking the causality of the relationship (you ate more/exercised less because you were storing more fat, not the other way around). The biggest problem I found was the oversimplification of it all. Single-factor explanations - be it fat or carbs - are almost never adequate in complex systems.

    That said, the thing that bothered me most was the one things I really understand. His defence of meat is predicated on the diets of hunter-gatherers who made it into the 20th century. That in itself is a major red flag, since hunter-gatherers who persisted after their neighbours adopted agriculture usually did so because they lived on marginal lands. If you ignore that, they fail to serve as useful analogs for our ancestors.

    I'm sure Taubes looked at the biochemistry with a more discerning eye. But the fact that he missed this important nuance on the issues I am familiar with makes me wonder if this problem might not run deeper.

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  72. Anonymous12:44 pm

    It is sort of sad that the first time the word insulin shows up is in the comments of others. Taubes book has one major theme and that is that carbs raise insulin and insulin is what makes us fat. Clearly other factors are at play (ie. hormones / genetics / environment) but I think the evidence against pure sugars and concentrated sugars is extremely damning. Other studies are linking insulin levels to hypertension and metabolic behavior. The whole book is about insulin control by eating less carbs/glucose. I don't think your review is completely fair.

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  73. Anonymous5:32 pm

    I suggest reading the post about thermodynamics on garytaubes.com or his interview on the fat head movie site. He is not arguing that the loaws of thermodynamics don't apply, and anyone who suggests otherwise is either being disingenuous or totally misreading him. The point is that saying we get fat because we take in more calories than we expend in no way answers why we do so, or what regulates how many calories our bodies decide they need, and how many they decide they need to expend. Saying we get fat because we expend less energy than we consume is, as he rightly points out, a tautology.

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  74. Anonymous1:01 am

    Whatever the rationale, low carb sure worked for me. Shortly after Hurricane Isabel, I agreed to "support" a coworker in "going back on Atkins." Having never been able to lose weight, I grudgingly agreed to 2 weeks. It was working for me, so I read the book (the endless testimonials were AWFUL) and followed "phase 2" for 8 months losing over 120 lbs. I no longer need medication for diabetes, cholesterol or hypertention. By coming off the diet according to instructions, I have kept it off for over 6 years. Sure has been nice being able to buy clothes in a department store too.

    ReplyDelete
  75. " Perhaps more appealingly, Taubes and Why We Get Fat also preach that you can eat as much fat and protein and you want and you'll never gain."

    This statement is a crock and you know it doc! You should be writing attack ads for politicians. No-one ever said you can eat "as much fat and protein as you want!"

    Common sense has to prevail on amount!

    Shame on you!!!

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  76. Anonymous6:09 pm

    You missed the point. He doesn't refute calories in/ calories out. He just says that's a crappy way of looking at it. Why are people eating more calories then they need?

    He uses the room analogy which I thought was well thought out. If we both observe a crowded room, you could say, "The room is crowded because more people have entered, then have left". That's technically accurate, and completely rubbish. A more useful explanation is to say "There's an awesome band in there that people want to see". That's a useful answer to that question.

    His point, in it's entirety, is that food that is high in carbs won't be as satisfying as food that is high in fat an protein. And he's right. A 20 oz T-Bone steak is around 1500 calories. And the majority of people couldn't finish it. Most people would consider half of that a large meal. I've eaten one one. I was full for th rest of the day. Alternatively, you could have a big mac meal, for the same number of calories assuming a large coke and fries. A big mac meal won't fill me, and i'll be hungry later.

    ReplyDelete
  77. The caloric bank account model of obesity is NOT valid. It is far too simplistic, has mountains of contradictory evidence against it, and explains fat too little.


    All of this is discussed at my blog.


    Science currently does NOT understand the chemical behvaior of fat cell receptors which is at the very heart of what we need to understand to cure obesity.

    Docotrs such as yourself, Dr. Yoni are NOT immune to ASSUMPTIONS about obesity.


    Obesity is a hellishly complex multi- factorial disease state , in which the genetic component is exactly the same as HEIGHT.

    Calories are only one factor among dozens, upon dozens upon dozens in the etiology of obesity.

    Science has found lack of sleep, gut microbiota, toxins, adenoviruses, medications, eating during sleeping hours and much more to be factors.

    Obesity research is full of VAST UNCERTAINTIES and UNKNOWNS. real scientists in the field, like Dr. Jeffrey Friedman- a TOP expert in the WORLD- ADMIT this.

    The VAST UNKNOWNS DWARF the knowns.


    The "laws of thermodynamics" do NOT, and CANNOT
    E X P L A I N the chemical behavior of fat cell receptors.


    Sorry, the certainty displayed by the diet industry CANNOT be defended by what science currently knows about obesity. We do NOT know nearly enough.

    I congratulate Gary Taubes for being the first journalist to point out the fact that the claoric bank acoount model of obesity is DOGMA- NOT scientific knowledge........

    ReplyDelete
  78. Nothing personal, but I found your review to be self serving and self reinforcing, based largely on your own paradigm rather than science. Most disappointing though is how many people took your comments to be good reason for them to not read Taubes' book. I doubt it was your intention, but you seem to have provided a lot of people the excuse they desired to remain intellectually lazy and ignore Taubes' excellent 2ndary research. Regardless of your point of view about the book, you would show more integrity if you reminded these people that they should read this unique view and make up their own minds rather than use your discouraging words as the excuse to simply read only that which reinforces their existing mental models.

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  79. Anonymous2:01 pm

    Who is this Tuabes guy? And why is everyone arguing?

    Can't we just go grab a Big Mac and Fries and all get along??

    ReplyDelete
  80. The number of people who said they were going to save their money by NOT buying Taubes book was alarming.

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  81. I would also like to extend my thanks for this review! Although I certainly agree with those who advocate eliminating refined, junk-food carbs from one's diet, personally I had a very bad experience with low-carb dieting a la Atkins the first time it came around (late 70s) -- causing me to yo-yo diet and end up gaining 20 pounds. (I gave up dieting and lost the weight, then joined the Army and took up running and got skinny.) I know that my body NEEDS healthy carbs to feel good -- and have maintained a healthy weight for 20+ years with plenty of complex carbs in my diet. Still, with all the hoopla surrounding this book I was wondering if I should be open-minded and give it a try. You confirmed my initial suspicions: not worth my money.

    ReplyDelete
  82. Anonymous8:19 pm

    When I read a commentary/review I am looking for evidence the person has some superior knowledge and wisdom. When I read " A quick Google image search had me staring at some pretty hefty Jersey cows and some Anguses with very visible rib cages, and I'm fairly confident that were female Angus cows given hormones and milked daily, they'd also have big full udders." This is a dead giveaway you don't know what you're talking about and are enamoured with the sound of your own pontification. Angus cattle are a beef breed, bred for a couple of years to grow fast and put on weight. Jersey cows are milk producers bred for a couple of hundred years to be lean of body and produce large quantities of butterfat rich milk. They are not given hormones to make them high producers so your grand gesture of milking daily can some how turn an Angus into a dairy cow is proof positive you don't know what you're talking about. Big udders indeed. Wake me up when you get to something you know about. Bovine agriculture you don't.

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  83. I think there's plenty of evidence that people on low-carb diets lose weight, just as there's plenty of evidence that people on low-fat diets lose weight. And until someone comes up with truly convincing evidence to the contrary, one can only conclude that both types of diets are achieving their results the same way: through caloric reduction.

    My main concern about promoting a diet high in saturated fats is that so many studies have shown strong correlations between high intake of saturated fat and risk for both heart disease and cancer.

    If you only care about losing weight, a high-fat/low carb diet should be fine, but if you care about reducing your long-term health risk I'd think twice.

    It's amusing that so many of Taubes's supporters assume the nutrition establishment is just blindly accepting the conventional wisdom and is unaware of all the counterarguments; it doesn't occur to these people that nutrition scientists might have looked at some of the counterarguments and rejected them on scientific grounds.

    I wouldn't be surprised if many of the examples touted by Taubes as supporting his theory boil down to polymorphisms. Just as humans don't all respond to exercise in the same way, it would surprise me if we all respond the same way to diet. Taubes points to specific populations as evidence to support his claims, but it's possible that those populations are literally different from the rest of us. I also suspect this could help explain the "French paradox," wherein French people tend to have lower incidence of obesity, heart disease, etc., despite diets that are relatively rich in saturated fats and certainly high in carbohydrates.

    ReplyDelete
  84. So many studies support the connection between saturated fat and heart disease? Name 3... That's the problem, the belief is that there are studies that show the link, but if there are any, they are epidemiological studies which are notoriously bad at showing any causal information.

    ReplyDelete
  85. @Low Carb Liberal: You're right, I was basing that on some older summaries of the state-of-knowledge from Harvard, which were very recently updated for the general public here:

    http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-full-story/index.html

    They are now citing only weak associations between saturated fat and cardiac risk, same for most cancers. The associations with trans fat are of course much stronger; there are associations between red meat consumption (especially processed meats) and cancer but those may not be due to saturated fat per se but rather other factors.

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  86. I completely agree on the trans fat as has Gary Taubes and most low carbers. I was in the process of finding studies that show no link between saturated fat and heart disease and found a couple (I'm sure I could find more):

    The Kraus meta study from last year:

    http://www.ajcn.org/content/early/2010/01/13/ajcn.2009.27725.abstract

    Another interesting study showing the association lies with carbs not fat:

    http://www.ajcn.org/content/80/5/1175.abstract?ijkey=133cef39301ff152b4a33418de7bb6fffcfb5421&keytype2=tf_ipsecsha

    I won't go on on that. However I'd also like to point out that every study that has pitted the low-fat calorie restricted diet against a low carb calorie unrestricted diet has shown the low carb diet is more effective in losing weight AND improving heart disease risk factors. In some cases it is questionable whether the low carbers were eating lower calories than the low fat groups voluntarily is debatable but it does seem to show that on low carb, whether through voluntary calorie restriction or metabolic advantage, dieters do better.

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  87. @Low Carb Liberal: What do you think of this study's findings?

    Sacks FM, Bray GA, Carey VJ, et al. Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates. N Engl J Med. 2009; 360:859-873.

    Summarized here:

    http://www.hsph.harvard.edu/nutritionsource/healthy-weight/best-weight-loss-diet/index.html

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  88. None of those diets is particularly low carb (Atkins induction is normally about 5% calories from carbs and 60-70% from fat). I don't know if the results were statistically significant but there is a 33% range between the lowest and a highest weight loss for similar assumed calorie deficit which shows some difference based on macronutrients, showing an advantage to higher protein.

    If you read the study (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763382/). Looking at heart disease risk markers, the lowest carb groups had better results in terms of HDL and triglycerides and not quite as much improvement in LDL (but still some improvment). And in looking at the results, the spread in the macronutrient ratios between the groups was quite small at 2 years: carbs from 42% to 53 %, fat from 26% to 35%. Not sure that really is showing what it thinks it's showing.

    A to Z study
    http://nccam.nih.gov/research/results/spotlight/030607.htm

    There's a great youtube video with the researcher:

    http://www.youtube.com/watch?v=eREuZEdMAVo

    The part at the end where he talks about the results with people with insulin resistance is VERY interesting. To my mind, that indicates that people with IR (and most obese people are insulin resistant) low carb is by FAR superior to low fat...

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  89. @Low Carb Liberal: Thanks, these studies are all interesting. I assume you're also familiar with the DIRECT study summarized here:

    http://www.hsph.harvard.edu/nutritionsource/healthy-weight/weight-loss-study/index.html

    I think I've been naturally skeptical of Gary Taubes and others who claim that the nutritional establishment has it all wrong, in part because it's so easy to cherry-pick studies that support a given view.

    But the fact that even Harvard Medical School is now changing its tune on dietary recommendations, acknowledging that "low fat" is not the right message to send, and acknowledging the benefits of low-carb diets makes me see that this is something to be taken seriously.

    In the meantime I'll just continue with my dietary approach, which follows the French philosphy of "un peu de tout, et rien de trop."

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  90. And yet, how can you not think it is possible that the medical establishment has it wrong when they keep changing their tune. As Gary Taubes wrote in both his books (hopefully you've read them), the advice used to be to avoid sugars and starches and that changed to eat low fat food and now that is changing again. Maybe the tide is shifting towards what is more correct but in the face of constantly changing contradictory advice, one can really only conclude that if they have it right now, they had it wrong 5-10 years ago. If they had it right then, they have it wrong now.

    The real problem seems to be that it is notoriously difficult to control variables in the studies. Ancel Key's seven countries study is a great example. He indicted saturated fat by ignoring countries that did not prove his point. He also ignored how sugar might play a role.

    Having said that, I agree. If what you are doing is working for you, great. However, your original comment noted that a low carb - high fat diet with saturated fat would compromise the dieters health in return for weight loss. That has not been shown to be true, in fact, the evidence seems to indicate that it is either equal to or better at improving things like heart disease risk factors.

    So like you, I will continue to do what works for me, and in fact I will continue to tweak my approach to see if small changes work better.

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  91. Yes, the medical establishment has had it wrong and are changing their tune again, but I don't think the message should be "don't listen to the medical establishment because they're always wrong," because that encourages people to listen to anyone who wants to grab their ear.

    Science isn't done by vote: one person who's right is worth 10,000 who are wrong. But when you're making policy decisions or decisions about your own personal health it makes sense to listen to what the majority is saying. It could turn out to be wrong, but unless you're qualified to judge for yourself it's hard to justify ignoring the recommendations of the majority of scientists in a given field. Most people aren't qualified to judge for themselves, and are confused by conflicting advice.

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  92. Actually, the original objection I had to your comment was that people doing the low carb diet are compromising their health. This has not been proven even though the establishment came to believe it and is now changing their tune.

    Also, I objected to your comment that 'so many studies' have proven that saturated fat is harmful, when that is not true, even thought the mainstream keeps pummeling that point as well.

    My point is that the mainstream media, the medical establishment have a history of getting things wrong, making assumptions about nutrition and holding onto them even when there is evidence that shows the assumptions are shaky if not invalid. So to assume they have it right this time is probably foolish.

    In the end, we do what works for us. I tried what the mainstream is pushing to lose weight. I ended up not losing anything and being frustrated and hungry. When I eliminate grains and sugars and limit fruits, I am satiated and lose weight without hunger or having to consciously restrict my calories. For me that works. Am I saying that it would work for everyone? No, but I get frustrated when I hear comments like 'compromise your health' and 'so many studies' when these are demonstrably untry.

    This is also my main objection to the review of Taubes work causing people to choose not to read it. He has done a herculean job of researching the science and, agree or not, people should be exposed to the scientific evidence supporting the low carb option.

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  93. I still think there's quite a bit of evidence that high meat consumption increases cancer risk, it's just not necessarily due to saturated fat. There's the NIH-AARP Diet and Health Study from 2009 that showed men who ate the most red meat had a 31% higher death rate than those who ate the least, even after controlling for other health habits and risk factors. There are other studies showing associations between red meat consumption and colon cancer, confirmed by meta-analyses, a 2009 Australian study showing that heavy red-meat eaters (10 or more times/week) are 50% more likely to develop age-related macular degeneration than people who consume 5 or fewer portions/week, three studies showing links between red meat consumption and incidence of prostate cancer, and links between heavy red-meat consumption and poor sperm quality.

    It's possible that every one of these studies is simply showing associations and not causation, and there may be something about people who like to eat a lot of meat that predisposes them to these conditions. But given the uncertainties I would say it's risky to assume that a diet high in red meat and low in legumes, vegetables, and fruit is going to be "healthy."

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  94. Again, no measure of sugar consumption. A very large confounding variable. A plausible interpretation might be, those eating a more Mediterranean lifestyle are possibly more likely to be reducing sugar consumption. Depending on what you are trying to prove, it's very easy to look for the numbers to prove it. That goes true for myself with low carb as well.

    I would like to point out that Ketogenic (ie. very low carb diets) are being studied in terms of cancer treatment (http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=7790697&dopt=AbstractPlus&holding=f1000%2Cf1000m%2Cisrctn).

    I haven't read many of the studies of meat and cancer, but I understand they rarely separate out processed meats and when they do, these appear to be the culprit.

    Personally, paleo people have it right. We evolved eating meat and veggies, not grains and sugar. Evolution is probably the best clue as to what is healthiest for us.

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  95. I'll just add that an interesting analysis of the study you site is here:

    http://www.marksdailyapple.com/red-meat-study/

    Granted, that site is biased towards the paleo approach but I would argue the people interpreting the study are equally biased towards the conventional wisdom.

    Here's another study disputing the meat/cancer hypothesis:

    http://www.ajcn.org/content/early/2009/03/04/ajcn.2008.26838.abstract

    Another study comparing mortality in vegetarians vs. non vegetarians finding little or no difference:

    http://www.ajcn.org/content/early/2009/03/18/ajcn.2009.26736L.abstract

    And one linking sugar consumption to cancer:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1418069/pdf/bmjcred00475-0027.pdf


    And yes, we can go back and forth ad nauseum quoting contradictory study after study.

    I suspect the best advice is from the second last paragraph of the mark's daily apple post:

    The real take home message from this study is this: Don’t be obese, do exercise, don’t smoke, eat plenty of vegetables and fruit, take supplements, avoid processed meats, avoid overcooked meats, eat from a variety of animal foods. (And when you eat red meat or any other meat, try to eat the cleanest form possible because it would appear that the hormone-laced, antibiotic-tainted, grain-fed CAFO meat may slightly increase your risk of CHD and cancer – or not.) Red meat itself, at the end of the day, appears to be little more than a red herring.

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  96. @Low Carb Liberal:

    Re: I would like to point out that Ketogenic (ie. very low carb diets) are being studied in terms of cancer treatment

    Why would ketogenic diets work for cancer? They might starve the cancer cells faster than others thus killing them off. How does chemotherapy work? It kills the cancer cells faster than others.

    So there appears to be short term bennies to periods of ketosis, but how about the long term? We do as little chemo as possible to achieve a reasonable probability of killing off the cancer. Chemo is not good for us, it is detrimental to all cell health. Ketones aren't detrimental, but there's no evidence that we should be running on them all the time.

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  97. My point with the ketogenic diets and cancer is that it is hard to argue that low carb diets raise the risk of cancer on one hand and on the other hand, they may be used to treat cancer.

    I know Brad's original comment was related to meat but we still come to the possibility that it is sugar and refined carbohydrates causing the issue not the meat. It's so hard to keep the variables isolated and figure out what is really going on.

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  98. That's not necessarily true. Radiation both causes and is used to treat cancer.

    So my point was that the benefits of such diets may be short term. In the long term is the ketotic state preferable? Is a constant state of stress on the liver desirable? Also, in the long term, exposure to toxins associated with fats and cooking them may well be cancer inducing.

    As cancer goes, it is hard to distinguish increased incidence vs. increased detection. Prostate cancer, for example, in the majority of cases is slow growing and "contracted" later in life. Men died for millenia from other causes with prostate cancer but not from prostate cancer. See, for example: http://www.ncbi.nlm.nih.gov/pubmed/10691826

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  99. The radiation cancer argument is interesting but irrelevant. Radiation therapy is a specific and very targeted therapy (targeted at the cancer cells) and the radiation that causes cancer would be much more the result of more general exposure. I doubt that one exposed to radiation that gets cancer would be advised by the doctor to just do the same thing to cure it.

    It stretches the imagination that I could eat a ketogenic diet and get cancer and continue to eat exactly the same diet and treat it.

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  100. One could equally argue that it makes sense to look at the "blue zones" where an unusually high percentage of the population lives to be 100 years or older, and try to follow their diets and lifestyles -- at least in those cases we'd be following the diets of people who have a long life expectancy (I know there are arguments that preindustrial people who made it past their 40s lived as long as we do, but my understanding based on the literature I've seen is that this is based on small sample sizes in a limited number of geographic areas, which of course is also true for Blue Zones). My hunch is that we may see genetic influences at play in the blue zones, but longetivty in those areas could ultimately boil down to a combination of genetics and lifestyle/diet.

    In any case, I think it's clear that a wide variety of diets work for humans -- thousands of people have lost weight and kept it off on low-fat diets (i'm one; I lived with a low-fat cookbook author for a couple of years and lost 20 pounds, kept it off for more than a decade, and have never been very overweight...I'm 6'4" and the heaviest I've been is 190; i'm currently around 180 and still fit comfortably into the suit I bought in 1992). And thousands have lost weight and kept it off on low-carb diets.

    I agree that there's a lot of evidence to support avoiding simple carbs; with regard to meat I think there's enough evidence for the benefits of fish and chicken that if you're concerned about potential risks of red meat you can get plenty of animal protein without it. I love a good steak, but I've never gotten into the habit of eating it, so we have red meat maybe six or seven times a year; I've eaten this way since I was in my early 20s (I'm in my early 50s now).

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  101. Anonymous9:44 am

    Wow, the reviewer points out how the author mishandled information, and then proceeds to do the same thing in his review. Having just finished listening to the book, I can only say that the author is presenting a statisticians case, not a scientists study, and ultimately leaves the reader to make up his own mind. He leaves a vast amount of variance to genetics and is primarily interested presenting the most basic idea of what carbs do to an average body. As individuals he leaves it up to us to put this idea into action that works for us. The evidence is compelling, and yes it is one sided just as as every argument, including the reviewers, is. In the end the variables are too great for anything to be conclusive in this matter for every individual so I suggest that if you struggle with weight you give his ideas a try and see if it works for you. At least you will only have to fight what you eat and not how much. I myself, though lean and easily able to lose weight when I choose, plan to give it a shot mostly out of curiosity to see how this individual reacts to this generality.

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  102. Anonymous5:45 pm

    Do your own science. I do & have for years.

    0. I tried diet pills. I wasn’t hungry but they kept me awake. & then continued old eating patterns.
    1. I eat carbs, I gain weight & become lethargic. (see 4) (40 lbs in 4 months.)
    2. I eat meat & fat, I lose weight fast. (5 or more lbs a week after initial water loss.)
    3. I eat meat, fat & green & coloured veg, no grains, root crops & other high carb plants. I have my cheat Friday with some fun food & maintain weight. I can modify it enough to lose a few pounds when I wish to. (see 5)
    4. I go on Dr Ornish's <10% fat diet, with only one skinless chicken breast or same sized cod for supper. No other protein. The rest of diet is then vegan made up of high quality carbs from all good groups. All portions small. I ate 3 meals a day & 1 - 2 half fruit snacks. Took 12-18 thousand steps a day (good pedometer) & did at least an half hour aerobic exercise daily. Gained 40 lbs in four months (Ornish claims you might gain some weight but then it will start coming off- I was persistent. My cholesterol went from 3.4 to 7.2 & my triglycerides form 2 to 2.7; both increases were well past danger lines. My Dr handed me a prescription & said I would be on them for the rest of my life. I chuck prescription.
    5. I do a modified Atkins as per 3 with conscious effort to not have “heavy” carbs & three years later my cholesterol is near my usual, 3.7 (though not the3.4 it had always been before the Ornish nightmare) & my triglycerides are amazingly down to 1.17 (eventually 1.14- amazingly low) where they had previously always measured out at 2 (boarderline) prior to Ornish regime.
    6. I try HCG- did lose weight but at 900? calories, who wouldn’t lose weight, but it is not a lifestyle, only a stop gap.
    7. I try weight watchers back when you chose the diet, & doing a modified Atkins it was slowish but worked.
    8. I experiment giving up individual foods on Ornish. Still gained.
    9 I experiment adding an individual carb food to an Atkins styled diet to see how they affect my mood & or weight. Wheat, corn & other heavy starch stop lose immediately; other vegs slow it down.
    10. I fast for 40 days (not for any religious reason) & lose a lot of weight & keep it off after a 10 lb gain. (high 80s lbs in 40 days.)
    11. Meditation. Did help with portion size & I use this method still.
    12. Acupuncture & hypnoses. Short term affect.
    13. I try Eat Right 4 Your Type, Peter D’Adamo “O” diet & lose weight as it parallels Atkins. I begin to lose my arthritic hip pain within six weeks off wheat. I do lose weight similar to a modified Atkins.

    From other experiments I learned more about my body & its response to food, physical & mental exercises.

    Learn your own needs & how your body works. Taubes’ ideas work well for me. I also find that P A’damo’s “Eat Right 4 Your Type” diet for “O” bloods addresses a lot of issues for me. I lost my arthritic hip pain & there has been some positive revitalisation of the bone according to my Dr & his tests after giving up all wheat products. (It took 7 or so months to finally shed all the layers of pain.) (I was told by Dr in # 4 that I would need a complete hip replacement in 5 years. (13 years late still have hip & no pain but deformed hip bone.)

    I can have very few carbs all of which I get from vegetables nixing root crops & corn if I want to keep in shape.

    I know vegans who eat copious amounts of carbs & they are thin. I know others who are fat.

    All this is fortunate for the human race. In times of stress, some bodies are going to survive to continue the species. Celebrate it. Learn your needs & follow them. Find the time to do so. No one is going to do this for you.

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  103. Wait, is this a joke? It's quite obvious that the author of this review simply didn't well enough understand Taubes' argument. He needs to read the book another time. I'd be interested to see what he would have to say if he fully understood Taubes.

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    Replies
    1. Anonymous7:48 pm

      Exactly.

      Delete
  104. Hi Yoni

    I have read Taubes' books.

    I don't think your review was entirely dispassionate/accurate. And I see now that some commenting on Taubes' latest piece (Is Sugar Toxic? - NY Times) don't accurately represent what Taubes has actually said either.

    For example (although this was in the comments not your review), you say that Taubes spends a lot of time trying to debunk the law(s) of thermodynamics. I think this is incorrect. Rather he says that LOT is not helpful in trying to understand obesity.

    Your review seems to infer that Taubes might be largely motivated by money. That didn't help your argument or credibility.

    As a veterinarian, I was interested in your comments about Taubes' take on energy partition in Angus vs Jersey cattle. I think Taubes'argumentation was somewhat more cogent that your's. Sorry.

    Of course people have to make their own decisions regarding their time and money, but I suggest they should read Taubes' for themselves rather than making a judgement merely based on your review.

    SL

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  105. John Bailey5:34 pm

    As a doctor, who does seem to admit that high crab intake is a driver of obesity, why are you writing this? I read the book, then reduced my carbs, lost 14 lbs. in 8 weeks wihtout going hungry or losing energy.And did so with no exercise.None. How would you explain that ?
    And it has not taken "blind deprivation" at all. I feel angry when I see how consumers - espeically Moms - have been mislead to focus only on fat and calories to guide their food choices. What a scam! And look at the results, and the impacts on the cost of health care.
    By the way, do you really have convincing proof that exercise (partially) prevents cancer? What does partially prevents mean anyways?Besdies, Taubes says many times there are other good reasons to exercise, lead by making one feel good. He simply shows that noone has ever been able to prove that more execise has ever helped reduce fat or obesity. Many concur that exercise can maybe reduce weight an extra 10-20%. But the world continues to go out there excercising with the belief that it will make them lose weight. And lots of other people are taking money from them based on that lie. What a scam.
    Also, your Twinkie guy had a protein shake and a solid serving of vegetables everday ; and the snacks he piled into had lots of fat. You should tell all the facts.

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  106. Anonymous4:16 pm

    greetings.

    hopefully, this "in-depth" review never finds its way into the mind and heart of the anyone.

    it is pure conjecture.

    providing a series of vague open-ended questions (which you do repeatedly) is not arguing; it is crap writing...and it misleads people to the grave.

    by the end of your blog, logic degrades itself into pure name-calling: the lowest of the low.

    why so emotional, doctor?

    unfortunately, this tactic does seem to work on most...sad.

    i thought a "medical family doctor" would be capable of so much more than this.

    guess not.

    "why we get fat" is an abridged version of a much, much LONGER and scientifically-based book which Taubes wrote in 2007.

    it is written for the pleb., as an intro. to a much larger set of ideas and well-founded data.

    while you accuse taubes of being sneaky and manipulative...it is actually YOU yourself being this way: preserving your own self-interest (and selling your stuff, and your medical services) with abysmal name-calling and a whole lot of logical fallacy.

    how much "science" is in YOUR review?

    taubes has a 500-page book stuffed full of facts.

    i guess underneath it all comes down to this: why would any medical doctor (like yourself) WANT people to get well?

    YOU would lose your job.

    YOU wouldn't sell books.

    YOU wouldn't have a fancy car and a nice house...and high-end social status.

    sigh.

    whether you are aware of it or not, how many people have YOU hurt and are hurting for your OWN self-interest?

    i guess LOTS.

    but who cares: keep making money, keep killing people, and continue to live in denial of actualy evidence that has been around for decades and decades.

    most common medical doctors do.

    after all, you have to say these things...you have to keep people sick...you tow the line for a series of powerful medical and big pharma organizations that require and/or "encourage" you to...to keep profits rising...especially in Canada and the U.S..

    bottom line: medical doctors are trained NOT to heal--otherwise, they couldn't keep the money rolling in from all the sickness (that obesity causes, of course) and they might not be able to afford that mid-winter equatorial vacation extravaganza every year.

    ;)

    you probably won't post this; if you do, maybe there is hope for your patients and the people whom you influence.

    if you don't, you need to ask yourself seriously:

    doesn't this just prove my point?

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  107. He then goes on to state that it's not possible that breeders have simply manipulated genes to make the Aberdeen cow hungry and the Jersey cow active.

    Well, he clearly doesn't know squat about cattle, ranching, or selective breeding in general.

    Actually, yes, Dr. Taube: Beef cattle have been intensively bred for generations to be as bulky as possible, and they are fed to encourage fat-marbling in their meat. There's even a breed called a Beefmaster, and they're enormous.

    Milk cows don't need to be big and beefy because most people don't eat them. They're not bred for it and they're not fed to fatten them up.

    Sheesh.

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  108. Anonymous3:00 pm

    But see this:

    "A calorie is a calorie" violates the second law of thermodynamics,

    Richard D Feinman and Eugene J Fine
    Nutr J. 2004; 3: 9.
    Published online 2004 July 28.

    Conclusion begins: A review of simple thermodynamic principles shows that weight change on isocaloric diets is not expected to be independent of path (metabolism of macronutrients) and indeed such a general principle would be a violation of the second law. Homeostatic mechanisms are able to insure that, a good deal of the time, weight does not fluctuate much with changes in diet – this might be said to be the true "miraculous metabolic effect" – but it is subject to many exceptions. The idea that this is theoretically required in all cases is mistakenly based on equilibrium, reversible conditions that do not hold for living organisms and an insufficient appreciation of the second law. The second law of thermodynamics says that variation of efficiency for different metabolic pathways is to be expected. Thus, ironically the dictum that a "calorie is a calorie" violates the second law of thermodynamics, as a matter of principle.

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  109. Amanda10:54 pm

    In my opinion Gary Taubes has nailed it and it's a shame people have been turned off the book by reading your review. Anecdotally, I can see considerable evidence amongst family and friends that supports Taubes conclusions. Perhaps it is far too simple for us to accept such logic. Entire University Courses would have to be re-written and drug companies who feed off the current obesity epidemic and its associated ills would go broke overnight. The reality is when you mention physical exercise and calorie reduction in the one sentence you you have already lost touch with the general populous.

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  110. I found this review quite troubling. I have read "Good Calories, Bad Calories" GCBC and have recently finished "Why We Get Fat"

    I must say I followed Taubes arguments in both books and found them quite illuminating. AT the time I read GCBC I was in the middle of loosing weight following an Atkins style of diet. So I read Taubes' book as I was nearing my target weight. I checked eveything he said in my own results. I lost 80 pounds in 8 months! You can not call that "water". The lower my carbohydrate intake and the faster I lost weight.

    I checked all of his claims as I was taking Altace, Atenolol, Lipitor and was being treated for sleep apnea. Now I am drug free and require no CPAP machine.

    The one issue I would discuss with him is exercise. I started out at 229 pounds and finished up at 145 in an 8 month period. As my weight loss progressed it began to slow down. To keep the weight loss constant I increased my exercise. Exercise does help if you keep your carb count low (the lower the better with 20 grams as good starting point).

    Why did I understake such a change? For my health obviously! I had become type 2 diabetic and was angry about it so I researched a lot of different things and settled on an extremely low carb diet and exercise. I don't take any diabetic meds either.

    We get fat because we are out of homeostasis!

    Taubes message was really quite simple but he belabored the point and folks still do not get it.

    We are on a genetic continum, some of us would probably never get fat and some of us would probably almost aways get fat, but for almost all of us, if we were living under the conditions in which we evolved, would not get fat either.

    Our species has been around for at least 200,000 years. During that time we adapted to eat a certain range of food stuffs. According to paleoanthropologists during that period we were actually more healthy than after we invented agriculture. Also, we had short life spans due to accidents. We had the capability to live 80 plus years during that period.

    So we invented agriculture and injected many new foods into our diet. This actually worked against us.

    For all of that, there has been some adaptation, but you can check the debilitating aspect of the european diet on Native Americans and Austrailian Aborigines. The Aborigines are 3.4 times more likely to become diabetic than those of European descent.

    I believe the carbohydrate fat storage mechanism that Taubes desccribes is an adaptation to assist in storing extra calories during the growing season when carbohydrate food stuffs would be more plentiful.

    Taubes did indeed say that thermodynamics applied but indirectly. If you really bothered to read the description of how fat storage works, and really understand it, the mechanisms that cause fat to be stored may leave us calorie deficient with respect to usable calories at which point we would either try to compensate by eating more conserving.I see you list yourself as a doctor but it would appear that you really need a background in endocrinology actually get his point.

    Too bad.

    If folks have any questions of me I can be reached by way of:
    jhh at envirobat dot org

    John Hayes

    I believe you have chosen to pick out key items, take them out of context and marginalize them.

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  111. As a country boy, I have to say that it looks to me like all you folks missed that both Gary  and Yoni apparently cant tell the difference between a cow and a bull. Both of them refer to 'two cows'. Sorry but that Angus is a bull - note the wedding tackle plainly dangling down  in the photo in Taube's book. The Jersey is a cow. Note the udder. By the way it is not 'swollen' Gary. That cow is either pretty dry or has been recently milked and from her generally bonniness calved many months before the picture was taken and has, as we say down on the farm, had all the fat milked off her. Even the vet didn't comment on it or didn't think it relevant. But Gary and Yoni are both pretty clearly suffering from urban provincialism.  One piece of advice to all you city folks. If you encounter one of those 'cows' with dangly bits down below in a pasture it would behoove thee to get thyself over the nearest fence. Bulls are notoriously unimpressed by ideological arguments. 

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  112. Anonymous6:26 pm

    Igude said: "Even the vet didn't comment on it or didn't think it relevant".

    The vet decided it was a distraction from the main points.

    An Angus, whether a bull, steer or cow, seems to partition energy differently from their dairy breed counterparts.

    Steve (the vet)

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  113. Read it again dude. You very much do not understand the material. Case in point: you think Taubes is having a physics argument.

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  114. I for one don't buy your concept either. You probably feel that Dr. Ornish is better than Taubes? I followed the Ornish diet and became very sick because all of the carbs and no fat. My insulin went straight thorough the roof.
    I gave up on Ornish and continued to watch my diet making sure everything was low fat and only ate whole grains only to become sicker over the years.
    I got to the point that I could not walk my arteries were so clogged. The docs wanted to put me on a whole bunch of drugs and ream me out. I was really afraid I was dying.
    I found a doctor who believed in Taubes and his work. I went on a diet based on Protein Power by Dr. Eads. In 3 months of being off all grains my arteries have cleared significantly and my cardiologist asked me what I was doing to clear them up so well. I told him I was following Protein Power's diet. He said to keep it up as it was working fantastically.
    My cholesterol dropped from 300 to 148 I can't tell you right off hand what my HDL and LDL numbers are the the good ones are suppose to be extremely good. I'm also on Dialysis (This started while on the Ornish diet which is full of carbs and no fat mind you.) My kidney function has improved slightly it went up from 2% to 19% my Nephrologist is impressed.
    So you can talk crap about Taubes diet all you want but it works for me and quite a few of my doctors other patients.
    I don't know why Doctors and the establisment don't open their eyes to people like Taubes... What, are you afraid he'll make everyone feel better and healthier so that would put you guy's out of business.
    Your review is not in the interest of real facts.
    BTW, my family comes from a long line of farmers and believe me you can and never get a Jersey to be as muscled like an Angus or any other beef breed. That's why they call them "Beef" breeds like Angus, Herefords etc. or "Dairy" breeds like Jerseys and Holsteins etc. The dairy breeds are bigger boned but not and will never have the muscle structure of a beef breed. You need to talk to a farmer and stop relying on the internet for your information.

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  115. "But wait a second, I'm pretty damn lean and my diet's in the neighbourhood of 45-50% carbs, how can that be if carbs make people fat independently of energy consumption?"

    I have a similar story. I'm well into my 50's now, spent 32 of my 35 (working) years behind a desk and have followed, for the most part, a diet of at least 60% calories from carbohydrates. Today it is even higher (about 80%). I'm 5' 11.5" and weigh 176 lbs with a 32" waist. According to Taubes I should be overweight if not obese.

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  116. @Robert: The problem with that logic is that it proves nothing. There are far fewer smokers that get lung cancer than do get lung cancer. You wouldn't say that smoking doesn't cause lung cancer would you?

    If you have been lean all your life, that says very little about the cause of obesity.

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  117. @Low Carb Liberal

    After I got married I managed to put on 20lbs due to my wife's cooking. My waist was 36". Lots of calories, lots of fat and very little exercise! After a few years I "cleaned up" my diet and started running. I went from 196 down to 174. Blood pressure dropped from 140/90 to 120/70. I don't remember the exact numbers for cholesterol but there was a vast improvement. So the combination of exercise and reduced calories and saturated fat resulted in all of these improvements.

    My "cleaned up" diet was fairly low in fat, very low in saturated fat and high in carbs. My diet today is around 80% plant-based and I eat mostly fish and legumes for protein. Starchy foods like potatoes (both regular and sweet) plus grains (rice, oatmeal, pasta) are included in my diet.

    What does my personal experience prove? It proves that the "carbs makes you fat" dogma doesn't apply to everyone. There are plenty of non-western cultures that consume traditional, high-carb, starchy diets that don't get fat. In fact, high-carb is associated with being slender in this case.

    Where populations get into trouble is when they depart from their traditional diet and adopt a more westernized way of eating. So, looking at the world's population, the number of people that actually get fat from eating a high carb diet is miniscule. My best advice: don't eat like a westerner!

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  118. Actually, your experience proves that for you, what you did helped you lose 20 pounds. And I do congratulate you for that. You also don't know that you wouldn't have lost that weight by instead eating less carbs and more fat. Or that the reduction in sugar (I'm assuming you avoided sugar given the diet you listed) caused the weight loss. I'm also curious what your absolute intake of carbohydrates and fibre (the undigestible carb) was before and after.

    I am absolutely not suggesting you should have done something different and do congratulate you on losing the weight but when I talk about obesity, I'm talking about people who need to lose ALOT of weight. Who eat until stuffed and are still hungry. Who try low fat high carb diets like you went on and only feel hungry all the time and are constantly having to fight that hunger. In my own n=1 experience (used to be close to 300 pounds and now I'm just below 220), the only thing that works is removing the carbohydrates (not vegetables but sugar, potato and rice definitely). If I don't do that, I cannot control my intake except through extreme willpower. If I do remove them, I lose weight without feeling invasive thoughts of food.

    True this is just my own experience but I read stories like this on blogs all the time. I truly believe that many if not most (notice I did NOT say all) people who are in the situation where they are truly obese, can be helped by the 'carbs make you fat' dogma. Perhaps the better phrase is 'certain carbs made you fat and most carbs are keeping you fat'?

    My guess is those who eat a traditional diet of high carbohydrates are fine because their metabolism is not messed up by the sugar, processed carbs and industrial fats like trans fats. If you took one of them, fed them the western diet containing these things for 10 years and watched them get fat, that it would not be easy for them to go back to the traditional diet of carbohydrates. Once the body is messed up, even these carbohydrates may keep them fat.

    One question asked on another blog that I found very interesting was 'is there a population that does not eat a diet of a significant amount of carbohydrates and not get fat?'.

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  119. @Low Carb Liberal,

    "You also don't know that you wouldn't have lost that weight by instead eating less carbs and more fat."

    I did experiment with low carb several years ago but didn't feel comfortable with it. By that I mean a lack of energy. I assume I'd still lose weight in this scenario but my experience is when I increase my intake of saturated fat my cholesterol increases.

    Yes I did keep the sugar intake quite low. I did eat modest amounts of fruit (1-3 servings per day).

    "In my own n=1 experience (used to be close to 300 pounds and now I'm just below 220),"

    Congratulations, that's fantastic!

    "Perhaps the better phrase is 'certain carbs made you fat and most carbs are keeping you fat'?"

    Personally its inactivity coupled with failure to adjust my intake accordingly. I think we both agree that refined flour and sugar is not a good thing. Asians however eat so much white (refined) rice. Some populations eat a bowl of it with every meal. I used to think they had some genetic advantage that allowed them to do this without getting fat but when Asians move to the US and adopt the SAD diet, they do get fat.

    I know many Asians here in Canada and they say that our food tastes sweet to them as if sugar has been added to just about everything. If I could only make one dietary recommendation to anyone it would be to cut out the sugar.

    "My guess is those who eat a traditional diet of high carbohydrates are fine because their metabolism is not messed up by the sugar, processed carbs and industrial fats like trans fats."

    Absolutely agree!

    "If you took one of them, fed them the western diet containing these things for 10 years and watched them get fat, that it would not be easy for them to go back to the traditional diet of carbohydrates. Once the body is messed up, even these carbohydrates may keep them fat."

    We hear about such people who then return to their country and lose the weight they gained. I think more than a few Chinese exchange students could relate.

    "One question asked on another blog that I found very interesting was 'is there a population that does not eat a diet of a significant amount of carbohydrates and not get fat?"

    Good question. There are a lot more populations that consumed high carb diets. I would think that the German diet (without the beer) could be considered a medium carb diet but I'm no expert on their diet.

    How about the Icelandic diet? They are apparently one of the healthier, longer-lived European populations. I'd have to look into their diet to see what they consume. They do eat a lot of fatty fish and I'd imagine their Omega-3/Omega-6 ratio is pretty good but again, I'm talking about their traditional diet. Something to check out I guess.

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  120. I agree with most everything you said with a couple points:

    1. I suspect Asians do not eat a lot of sugar so as a population, they don't get the insulin resistance that comes with that. However, keep in mind Sumo wrestlers do not eat fat to get fat, they eat meals of high levels of carbs. Is it because carbs make them fat? Sort of. I suspect it's because it is very hard to overeat fat except in the presence of carbs. Carbs on the otherhand are very easy to overeat.

    2. I don't know how long you stayed low carb but from what I've experienced and read about elsewhere there is an understandable period of adjustment where your body switches from burning carbs to burning fat so lethargy often comes with that. Not that I am saying that you went about things the wrong way, just a possible explanation for your experience with it.

    Bottom line, we should do what works for us as individuals

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  121. @Low Carb LIberal,

    1. The Sumo example would refute the "calories don't count" theory. Asians consume a lot of carbs in their diet. The difference between your typical Asian citizen and a Sumo wrestler is the amount of food eaten. They could eat (seemingly) endless amounts of white rice due to the low fibre content.

    2. Any idea how long this adjustment period is for switching over to fat burning on an LC diet?
    It is possible that I didn't stay with it long enough.

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  122. Great review, but your critique tends to focus on Taubes' argument against low-calorie. The bigger theme, however, is his refute of the low-fat fad, not low-calorie dieting. The enormous wealth of evidence he cites is to prove that fat is not bad in and of itself, but only when consumed with large amounts of carbs. He refutes low-calorie logic only as a baseless byproduct resulting from the primary assumption that FAT is the root of all obesity. He makes this point by referencing the countless societies which ate high fat diets and only began trending toward obesity and disease after the introduction of flour and sugar into their diets, while fat consumption remained relatively the same.

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  123. @Robert

    1. I don't know if you've read the book but Taubes doesn't really argue that calories don't count (the review was misleading in that regard) what he is essentially arguing is that the body has natural appetite regulation that goes out of whack when it becomes insulin resistant. He is saying that removing the carbs (especially the sugar and refined carbs) from the diet allows those natural mechanisms to automatically set the intake that one brings in. The problems with the calories-in-calories-out theory is that a) you cannot really know how many calories you are taking in or expending and 2) the body has a way of adjusting the amount you take in and expend via hormonal signals. If you simply restrict calories, the body can signal hunger or lethargy to compensate.

    Ask yourself, it if is all just calories-in and calories-out, and the obese have a huge store of energy in their fat, why, when calories are reduced, do the obese not still have abundant energy to pull from their stores? The reason, Taubes would argue, is that insulin chokes off the supply of fat from the stores so that the obese cannot really access them.

    The sumo example is really illustrative of the fact that overeating carbs is VERY easy. Overeating fat and protein is not. For example, a pound of steak is roughly 80 calories. There are not many people who can eat a pound of steak and honestly say they could keep going (eating JUST the steak, no sides except perhaps veggies). However, if you eat poutine, its' roughly the same number of calories but the end result is different. If you are obese, chances are you feel full but somehow still want to have some more or some desert. And by 'want to have' I don't just mean intellectually you want to have, your body is actually craving it. This is what the lean don't experience as far as I can tell. That drive to eat more even when you have eaten enough in terms of calories. Really, if you've experienced this and then experienced the change on low carb where you can eat the steak and veggies and be truly satiated and feel no biological drive for that dessert, it seems like a miracle. You may still have a desire for the dessert but it is not a compulsion

    In your case, you had 20 pounds to lose so I don't know that you were insulin resistant at all. Your extra weight may have been simply the result of overeating your wife's cooking. If your wife shunned carbs in her cooking, I'm guessing the weight might not have come on. Or if your wife cooked the way you eat now, it might not have come one. You are probably lucky in that you do not feel that drive to eat that comes with insulin resistance.

    It's not that calories don't count. It's that being out of energy balance is not always the direct cause of obesity. It can be a symptom of an underlying problem that can be treated and once treated, the intake and expenditure of calories naturally get back into balance.

    One more point in this long winded answer. Notice that animals in the wild do not generally get obese. I know hippos and elephants look obese but they are actually at their natural weight (and get so eating carbs BTW). The reason they aren't obese is that they have metabolisms that regulate how they eat. If they have an abundance of food, they eat until satisfied and then move on. If they don't have enough food, they slow down their activity levels until they do. Only once they are starving do they become skinny. All this without using a calorie chart.

    I really do suggest you read the book. There are some very interesting examples of experiments on mice that illustrate the power of hormones. There are also some shocking examples of how bad nutritional science has led to some completely unfounded conclusions.

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  124. @ Robert: To answer your other question:

    2) In terms of adjustment to low carb, the low energy can last for anywhere from 3 days to a couple weeks I think (not an authority on that). It's called the induction flu by some. It's important on a low carb diet to try not to do low calorie as well. That defeats the purpose. Eat until satisfied. Also, hydration is important because you do lose water as your glycogen stores empty, the water goes with it.

    For someone in the position you were in, just 20 pounds to lose. If asked, I would advise a Primal diet (Mark Sisson's approach). Which essentially removes the grains and sugar and otherwise just eats foods in as natural a state as possible. For someone with a significant amount to lose, I'm not convinced that's enough to compensate for the damaged metabolism.

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  125. @Low Carb Liberal,

    "The sumo example is really illustrative of the fact that overeating carbs is VERY easy."

    Yes if they lack fibre, which is why I mentioned the white rice. I think Sumos load up on rice and vegetables.

    Natural whole foods are not that easy to overeat, i.e. your 1lbs steak or try overeating on apples or sweet potatoes.

    "In your case, you had 20 pounds to lose so I don't know that you were insulin resistant at all. Your extra weight may have been simply the result of overeating your wife's cooking."

    My wife likes to take credit for that weight gain. ;o) That was 20 years ago, since then my weight stays within a few pound of 175.

    According to my blood test results I'm pretty sure I'm not insulin resistant. I eat carbs but they are carbs like fruit, vegetables and tubers.

    "Notice that animals in the wild do not generally get obese."

    The exception being those animals that intentionally fatten up for the winter, but that's a special case. Yes, animals fed their natural diets don't get fat.

    In the US the gorillas in the zoo there were overweight and suffering from heart attacks. These gorillas were fed the standard gorilla feed that most every zoo feeds them. They stopped feeding their gorillas this processed gorilla feed and gave them natural foods, a wide variety of greens and vegetables. The gorillas lost weight eating more food.

    "However, if you eat poutine"

    Es-tu québécois? ;o)

    BTW, I have ordered his book from Amazon.

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  126. @Robert

    Glad to hear you ordered the book! That's very interesting about the Gorillas although not surprising.

    Overeating apples and sweet potatoes is not easy, you are right, but I do find that eating these can cause cravings later due to blood sugar rise and fall (I'm assuming that is the cause) so I have to be conscious of how frequently I eat those things and conscious of how it is affecting me.

    Great discussion, thanks! I am interested in how you react to the book.

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  127. @Low Carb Liberal,

    Here's a link to the gorilla story:

    http://www.sciencedaily.com/releases/2011/02/110217091130.htm

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  128. Anonymous9:04 pm

    http://www.fathead-movie.com/index.php/2010/11/16/the-twinkie-diet/

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  129. Anonymous9:15 pm

    I am a female in my mid-50s. I read GCBC by Taubes (as did my husband). We started eating the Taubes/Atkins way. Hubby lost 25 lbs in 4 mos, I lost 18 (from 168 to 150 which I've maintained for over a year - hubbie's kept his weight off too). Without exercise. My TGs went from 105 to 48. My HDL from 52 to 67. Great Apo B score so I don't worry about LDL. Hugely increased energy. I'm considering Paul Jaminet's experience with very low carb, wherein he says says he found it best (due to dry issue re eyes and mucosa) to not do VERY low carb, but instead add more glucose (200-400 calories daily) and additional Vit. C. His blog mentions Jan Kwasniewski, M.D.'s "Optimal Diet" orgs president and v.p. I think who both succumbed to stomach cancer and duodenal cancer respectively (originally Hyperlipid posted on this). While H.Pylori is generally the culprit in these cancers, H.Pylori also thins stomach mucosa, so where comes the cancer? The H.Pylori or what it does to the stomach mucosa? At any rate, Jaminet is a believer in keeping the glucose UP a bit more than Taubes/Atkins.

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  130. Anonymous9:16 am

    Do you know what the term straw man means? Because the way you use it suggests you don't. If Taubes is invoking a straw man then he is misrepresenting someone's argument and arguing against that misrepresentation rather than the actual argument. Look at your following passage:

    "Straw men and logical fallacy? Try this one on for size. He tackles an observation made by Williams and Wood, researchers who'd studied exercise and weight. They found that even marathon runners tend to gain weight over time and suggested that in order to avoid that gain they'd have to run further each and every year. Taubes extrapolates to suggest that any middle aged runner wanting to stay lean will have to run half marathons five days a week to resist weight gain. Sounds ridiculous, right? He then concludes on that basis the calories-in/calories-out hypothesis couldn't possibly be true. But couldn't calories in and out still matter in these runners? Don't our lives change as we get older - less time, more disposable income, more responsibilities - all things that may cause increased reliance on both convenience and celebratory calories. And doesn't metabolism naturally slow as we age due to age-related sarcopenia - wouldn't that also lead a person to steadily gain weight even if all other things (intake and exercise based output) remained constant? Or couldn't the runners consistently be consuming more calories than they burn as a consequence of either exercise-induced hunger or overcompensated reward based intake, and that coupled with natural aging's effect on metabolism causes ever increasing weight gain in the absence of changing calories in or calories out?"

    Where is the straw man? In what way is he misrepresenting someone else's argument and then attacking that misrepresentation?

    Your own writing provides a much better example of a straw man fallacy:

    "So how does Taubes' explain the impact of carbs on weight? Amazingly he states,
    "We know the laws of physics have nothing to do with it."
    Ultimately he embraces the notion that carbs make you fat regardless of the calories in/out hypothesis, rather than discuss such possibilities as carbs making you fat by having a lesser impact on satiety. Mid book I had hoped this was where he was going, but sadly, for reasons that are backed up by observation, inference, logical fallacy and straw men, apparently he's decided that living creatures are magical beings that live independently of the laws of physics and thermodynamics."

    He does not say that living creatures are independent of the laws of physics and thermodynamics. He says that physics and thermodynamics is not a sufficient explanation because "obesity is not a disorder of energy balance" and so a simple thermodynamical analysis of obesity is misguided. It's fine if you think that's wrong, but it's disingenuous and shameful to represent him as advocating some sort of anti-scientific view.

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  131. Taubes could not have been clearer about the role of the first law of thermodynamics. It describes what is happening, but doesn't explain what is happening. Taking in more calories than you burn is a precondition of weight gain but not the reason it happens.

    That was the whole point of the metaphor of the crowded room. If you ask, "Why is this room so crowded?" And someone answers "Because more people have entered than have left." That is true but not helpful.

    The point isn't that calories don't matter. It's that calories in/ calories out doesn't help us understand why we are getting fatter.

    It's as useful as saying you get wet when you get water on you.

    There are also a number of thought experiments he offers to help develop a new way of thinking about energy balance and weight regulation.

    After being told to eat less and exercise more for so long - to little success, the idea that the point of dieting is to restore your body's system of weight regulation to a healthy homeostasis, it's useful think into terms of some simple models.

    Example: If you restrict calories for a squirrel as winter approaches the squirrel still fattens up for hibernation. It just slows down its metabolism and moves less.

    Taubes does not deny that the semi-starvation diets will result in temporary weight loss.

    Thus it would come as no surprise that someone would lose weight on an 1800 calorie "twinkie" diet. But it also shows that you don't understand what Taubes is saying at all. Haub cut his calories from 2600 a day to 1800 a day. Thats 800 calories. But that also meant that he cut (I did the math once and if I remember right) 500 calories of carbohydrate. He also ate 6 meals a day with one 500 calorie protein shake. So his other meals were around 260 each. Cutting that many carbs and eating such small meals is going to have a real impact on insulin levels. Was the weight loss caused by cutting calories or by getting his insulin under control? The "experiment" was not design well enough to test one hypothesis against the other.

    The idea that animals, humans included normally maintain a healthy weight without consciously attempting to balance caloric intake with caloric expenditure should hardly cause so much confusion.

    What Taubes is saying boiled down to its essentials is "Take care of the quality of the calories and the quantity will take care of itself."

    Most nutritionists say some version of that and the opposite, that it's calories that count. It just depends on which part of the lecture you're listening to.

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  132. Anonymous1:19 pm

    Would just like to say that I have read Why We Get Fat twice now and am in the middle of reading Good Calories, Bad Calories.

    These are NOT diet books. Don't read these books if you are looking for meal plans and calorie counting methods or motivational speeches; these books are not about that.

    These books ARE an extremely thorough review of the science (and politics) behind what we currently believe (or have been lead to believe) about weight loss and health. They both include lengthy discussions (Taubes is very wordy) about the Calorie, and macro-nutrient theories and the science behind them. He is critical of the science and suggests that the subject has not been adequately studied and has been completed in a very biased way.

    Both books are fascinating reads regardless of what you believe. He does not discuss the political or ethical reasons for not eating meat and accurately states that they have no place in this discussion and only cloud the issue.

    If you are looking for a deep discussion about these issues, read The Vegetarian Myth by Lierre Keith. Don't be put off by the title, she is not trying to make fun of the vegetarians, but it is a good discussion about the political, ethical and nutritional logic behind vegetarianism.

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  133. Anonymous9:07 pm

    We all want the same thing - healthy weight management. Taubes WWGF made a very convincing argument against carbs and for protein and fat. However, I am concerned about the Omega 3: Omega 6 fatty acid issue as it relates to inflammation and disease. So, as much as I appreciate Taubes' work, I'm concerned about his apparent lack of concern re the fatty acid balance issue. Witness WWGF page 221 where he says "Olive oil and peanut oil are especially healthy oils..." According to a number of reliable sources, peanuts are high in Omega 6 and virtually devoid of Omega 3. The Paleo Diet (2011 edition) by Loren Cordain has this issue factored-in, and, despite Gary Taubes' great meta-research, comes across as being more "holistically complete." Any other thoughts out there on this dimension?

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  134. Patrick6:14 am

    "As a doctor, who does seem to admit that high crab intake is a driver of obesity, why are you writing this? I read the book, then reduced my carbs, lost 14 lbs. in 8 weeks wihtout going hungry or losing energy.And did so with no exercise.None. How would you explain that ?"

    Correlation does not equal (or even imply) causation.

    Great you lowered your carb intake. Did you replace the lost calories from that reduction with an equal number from another source?

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  135. Anonymous3:10 am

    Well I guess when you said you were cynical you weren't joking. Needless to say the scientists and doctors are starting to follow Taubes. I lost 44lbs after reading this book, eating as much fat as I could stomach and it was an immensely liberating experience. If you take issue with Taubes you should at least read the studies he sites such as the JAMA A to Z Weight Loss Study.

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  136. Anonymous8:04 am

    I've read through quite a bit of this thread and have to say this review and some of the comments have not put me off buying the book and forming my own views.I have already cut down on sugary starchy carbohydrate and increased my veg and salad intake along with more good fats and proteins.I shall be interested to read what Gary Taubes has to say.

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  137. Anonymous12:37 pm

    Must say i had to giggle with this review.Ignorance can be cured but stupidity is forever.

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  138. Anonymous9:08 pm

    By not cutting calories anymore (after hearing Gary Taube's lecture version of this book) I was able to finally sick to a diet. I still counted calories, however, to make sure the theory was true. I ate somewhere between 3000-4000 calories a day (tons of meat and cheese). I kept my carbs at 100g a day. After 4 and a half months of effortlessly dieting, I lost 50 pounds.

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  139. After 20 years of being a personal trainer with a love of learning from quantum physics to psycho cybernetics and Loren Cordain, Robb Wolf, Mark Sissons on Primal and Paleo i have to say i wholeheartedly agree with Gary Taubes - i am a huge fan of self experimentation and i have no fixed paridigm :)

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  140. The world turns upside down for the better IN 10 years If all added sugar was removed from the system.

    Period!!!

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  141. Anonymous11:13 pm

    I can't believe nobody has posted this in comments yet but the Law of Thermodynamics actually does NOT apply. You see the First Law of Thermodynamics only applies to closed systems as anyone who actually knows anything about the Law of Thermodynamics could tell you. Obviously human beings, and any other living organism for that matter, are not closed systems. A closed system requires that no mass may be transferred in our out of the system boundaries, I don't think I have to explain to you how absurd that is if you try and apply that to living organisms. Freedhoff is intellectually dishonest at best in bringing up Laws of Thermodynamics which he himself apparently has no clue about.

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  142. Anonymous6:45 am

    For weight, yeah, I can say calories in/out. Sure. But what about factors such as inflammation? I have had auto-immune conditions since the age of 13 or so - arthritis/psoriasis/sjorgens. For the most parts meds have been a big part of my life. I started reacting to them and started an alternative lifestyle. Going low carb got me off meds, my skin cleared, my energy levels are amazing, I have no pain (there is some inflammation in my fingers still but very minimal). I have always kept my weight down with a high vegetable/low fat/higher carb diet and these diseases came, persisted and started to get worse. As soon as I modified my diet (and I still get freaked out at how much fat I consume) has helped me so much that I feel like I got a life back. I have always worked out (except for a year where arthritis was just too much to take) and started up again when the diet change kicked in. I can't believe how quickly my strength came back. BTW, my calorie intake a day is probably over 2000 and I am pretty lean - much higher muscle mass/fat ratio than in my twenties while working out.

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  143. Anonymous7:53 pm

    Dr.,

    The book you reviewed was Taubes' purposeful condensation and populariazation of the arguments made in "Good Calories Bad Calories." GCBC is five hundred or so pages in length and has two hundred pages of notes. It covers all major studies (and most lesser) of obesiety from the nineteenth century forward.

    You are doing Taubes a disservice. Everyone should read GCBC, slowly, about three times.

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  144. Anonymous3:44 pm

    Hi Dr. Freedhoff,

    Your review is very useful. I do wish, however, that you had reviewed "Good Calories, Bad Calories" instead of "Why We Get Fat:" it's heavier on science, lower on polemic and simplifying shorthand, and handles the laws of thermodynamics more carefully. Please consider a review in future.

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  145. Anonymous7:42 am

    What do you think of George deJohn 21 day body makeover, how it's environmental toxins that need to be flushed out of the body for the adipose cells to shrink.

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    Replies
    1. I think someone's trying to sell books and needs to learn a bit more about our remarkable livers.

      Delete
  146. Anonymous5:20 pm

    I'm sure the poster who said your review is very useful meant to use the word "not" at some point. You should be ashamed and embarrassed, Doctor.

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  147. Anonymous1:57 pm

    I found this review to be absurd. The reviewer mis-characterized everything in the book, which I have read. Then he says things that are impossible to evaluate even if they were true, like a low-carb diet's first 9 lbs are water-weight (so? what's the water loss from other diets? How much of this 'water loss' is just the lower mass of food in your alimentary canal? Who knows?).

    I read the review as calling Taubes making straw-men arguments ....by making straw-men arguments himself.

    And if the 2 cows' different physiognomies aren't genetic, well what else explains this?

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  148. Anonymous9:41 pm

    I gave up meats and added sugar about 10 years ago. I was a pescetarian with an almost paleo approach (and an abysmal social life, in every new restaurant it took me 20 mins of interrogation to place an order).
    In my brain, most of the supermarket isles did not even register as food (the packaged stuff). During this time I stayed away from bread (almost completely), had minimal amounts of rice and just a bit of potatoes.
    About 4 years ago I was exercising in excess of 2 hours a day (riding a bike to work, working out at lunch-time and various types of training after work). I was averaging 150BPMs during the exercise (recorded with a polar heart rate monitor). I was exercising this much at the peak of my sports obsession and during the 10 years of pescetarianism I went through the whole continuum from couch potato to triathlon nut and back.
    I was eating remarkable amounts of fruits and fish and mostly clean food. Alcohol - maybe 1-2 beers/week and never more than 4 in an evening. I estimate that probably 50-60% of my food intake was "good carbs".
    My weight was relatively stable but I never lost my belly. I always had a bit of a belly, ever since I have known myself.
    5 weeks ago I stumbled upon the keto diet concept and decided to give it a try.
    Although I considered myself relatively lean, I already lost 4cm off my waist and the belly I have ALWAYS had. I feel fantastic, my cycling has improved compaired to 2 months ago and I have so much energy I don't know what to do with. I can actually run without hating it and tend to sprint everywhere if it's withiin 200m distance. I definitely do NOT restrict food intake, just try to keep fat at 60-70% by weight. I love eating and since I am so happy to have meat again, I eat until I get almost sick.
    So for me, this lifestyle is fantastic, whatever your review.
    And btw, as an engineer and physics lover, please don't even talk about calories in/calories out UNLESS you consider the calories IN STOOL/URINE! Thermodynamics work ONLY if you count ALL the in-out calories, not only the ones you want to count.
    Cheers and be happy!

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  149. Anonymous11:27 am

    Why We Get Fat is an execllent book. The reviewer seems to have some sort of axe to grind regarding Mr Taubes. As for many of the commenters: rather than say "well..I don't have to read the book now that I've read this review.." is very close-minded. It's an easy book to read in one sitting, at the book store or library. Personally, I lost 25 pounds after reading the book (and trying many other methods). It made me think about weight and food in a different way.

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