Wednesday, September 12, 2012

Gary Taubes Launches Non-Profit to Prove His Low-Carb Hypothesis


Today marks the formal launch of Gary Taubes' new non-profit organization NuSI whose stated mission is to, "improve the quality of science in nutrition and obesity research", and whose implied mission is to prove Gary Taubes' carbohydrate hypothesis of obesity is as correct as he clearly believes it to be.

So let's for a moment presume that Gary Taubes is one hundred percent right. That what his NuSI backgrounder calls a "controversial" hypothesis,
"that the fundamental cause of overweight and obesity is the overconsumption of food in relationship to physical activity",
is truly dead wrong and that instead it's,
"the quantity and quality of the carbohydrates – plays the more critical role in both the accumulation of excess body fat and the chronic diseases that are associated with obesity"
So that means for the moment just ignore data like those from the Ewe tribe who were recorded as having an obesity rate of 0.8% despite diets that were 84% carb. Ignore the various studies that held calories constant while varying macronutrients that demonstrated weight stability. Ignore the results from Cuba's "natural experiment" in the 1990s.  Ignore the folks from the National Weight Control Registry who've lost and sustained their losses with widely divergent dietary strategies.  Ignore the fact that even the most low-carb positive studies demonstrate only minor differences in weight loss as compared with higher or middle of the road carb diets. Instead I want to ask you whether or not, assuming Mr. Taubes' shiny new researcher's bench is entirely, incontrovertibly, 100% right in placing blame squarely on carbohydrate consumption, would that bench-side proof actually have broadly applicable clinical utility for folks who struggle with their weight?

My bed-side says no.

That's certainly not to say that low-carb dieting doesn't help some manage their weights and health, it just means that no amount of bench-made "proof" will change the fact that low-carb dieting, for many, is far more of a restrictive diet than it is a livable, long-term lifestyle. Meaning that even if low-carb were the holy grail of diets on paper, that fact would be worthless in practice unless you happened to enjoy low-carb enough to stick with it, and judging from the folks I see regularly in my office, that's far from a given. In fact it's a very rare person that I meet who hasn't tried a low-carb diet at least once.  And all of those folks? No doubt when they undertook their low-carb diets they were true believers. As far as they were concerned low-carb was to be their salvation, and many report to me having had real success losing but that they just as rapidly regained everything when they couldn't stomach living low-carb anymore. It's that last bit that makes me think that regardless of the outcomes of Mr. Taubes' new non-profit's future studies, low-carb diets aren't going to be a panacea, just as they weren't in Banting's 1860s or Atkins' 1990s.

Mr. Taubes thinks that study design is the broken paradigm that's crippling weight management. He thinks that nutritional research hasn't asked the right questions or used the right methodologies and so that's why we're mired in this mess. And while it's easy to agree with him that there have been libraries filled with poorly designed studies, as far as clinical weight management utility goes, more effectively asking or studying whether low-carb diets have better outcomes than low-fat or other diets isn't likely to help much.

I think the paradigm that's crippling weight management are "diets" themselves.

Whether it's low-carb diets, low-fat diets, GI diets, middle-ground diets, vegan diets, and even bat-shit crazy diets, there are long term success stories and recurrent failures with each and every one, where the common ground to success is a person actually liking their life enough to sustain their new patterns of reduced dietary intake, and where the common ground to failure is suffering or restriction beyond an individual's capacity to enjoy their life.

And so while I don't share Mr. Taubes' view that there is one simple or predominant cause and treatment for obesity, and would in fact argue that anyone who thinks there's a singular cause for the society's weight struggles almost certainly doesn't work with actual living, breathing, human beings on their weights, I do agree that the research on what works and what doesn't work is inherently flawed. But it's a flaw that Mr. Taubes' is likely setting out to sustain and fund in that the flaw I see from my bedside is the arrogant belief that there's one right way to go and only one path to weight gain (or loss).

There's also the issue of spin.  Now I appreciate you've got to tell a good story when you're trying to raise money, but given Mr. Taubes has built his empire on the notion that science has misrepresented data on obesity for decades, you'd sure hope that he wouldn't simply do the same.

Without getting into it too deeply I want to present one graph that he includes in his non-profit's backgrounder that he uses to prove his point that it's the carbs, stupid.


The graphs are meant to be very clear. Carbohydrate intake has gone up since 1971 while fat and protein have gone down, and hey look, weight's gone up too. Must be the carbohydrates, right?

But yet a deconstruction of the first graph by Evelyn over at her Carb-Sane Asylum really gets right to the meat of things with this statement when considering the graph on the left,
"looking at this data, we have the men reducing fat % from 37 to 33% while carbs rose from 42 to 49% of intake. And the women? Fat went from 38% to 33% while carbs rose from 45% to 52%. Given all the studies done where the low carb diets were "hardly low carb" according to the militant keto wing of the movement, can we at least have a wee bit of intellectual honesty here and admit that the differences in macro proportions is largely insignificant?"
What she's saying is that from a macronutrient percentage perspective, the difference between the 1970s consumption of a diet containing 45% carbs (for women) and the 2000s diet of 52% (and for men the difference between 42% and 49%) is pretty insignificant and that 1970 diets were anything but low-carb and yet our weights were so much better.

But more disingenuous is the fact that Mr. Taubes left out his arch nemesis from the graph. Calories.

Here's a graph from Stephan Guyenet that superimposes increased American calorie consumption over that graph on the right hand side of Mr. Taubes' slide.


And would you look at that. As weight rose, so too did caloric intake.  Pretty much perfectly.

Sigh.

Why we're eating more is the question that needs to be answered, and while the increased consumption of highly refined carbohydrates may indeed be a player, there's zero doubt in this bed-side's mind, the game that's being played isn't one-on-one. There's no doubt it's not as simple as, "eat less, move more", and there's equally no doubt it's not as simple as just cut carbs.  If either were true, everyone who wanted to be would already be skinny.

So huge props to Mr. Taubes for being such a passionate man and for truly wanting to see his theories proven - honestly, his bordering on pathological tenacity is genuinely laudable, though I wish he would hold his own spin and writing up to the same degree of scrutiny to which he holds others'. But ultimately, whereas Mr. Taubes now wants to trade in his pen for a bench and conduct research that presumably he himself won't instantaneously and churlishly deride as being useless, when it comes to clinical utility and weight management, the last thing the world needs is to believe that there's only one right way to go.

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85 comments:

  1. I just noticed when I clicked on Taubes's graphs that the scales on the two graphs are different, exaggerating the similarities between them. That can't be accidental.

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    1. Anonymous12:18 pm

      True, however that graph was provided by the CDC. There is a citation at the bottom left of the image.

      Delete
  2. Could not agree more. It is sad that Taubes and other proponents of low carb diets actually turn people off by their narrow-minded approach. Bigger picture (Big Food, TV, alcohol, sleep deprivation, stress, exhaustion, lack of exercise etc.) is almost never on their agenda. It is obvious that big picture is not serving their purpose.

    As you write, there is not too much difference in terms of weight loss between the different diets. Here is my take on the subject

    http://www.pronutritionistblog.com/long-term-weight-loss-and-low-carb-diets/

    In addition, people are getting fat not only in Northern America. In Europe, obesity has increased while consumption of carbs has declined, opposing Taubes' arguments. European stats from Finnish blogger Patrik Borg http://patrikborg.blogspot.fi/2012_06_01_archive.html

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  3. Anonymous10:18 am

    I have maintained a healthy body weight for over 25 years thanks to exercise and diet management. I actively read with great interest all kinds of diet books - low carb, cave man, vegan etc.. I consider my eating habits to be evolutionary in that I take little nuggets from all walks of dietary life that appeal to ME. I'm very interested in what this Gary dude finds out via his research. As for low carb, I've gotten some great ideas from this trend that have dramatically increased my veggie intake and balanced my protein intake but I'm keeping my hot cereals close by. I so totally agree with Yoni's take that the most successful path to healthy and sustainable eating has to be based on individual values. Keep up the great blog Yoni - this was a great post! Interesting and no doubt bound to creat some lievly debate and conversations! I cyber love you!

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  4. "I think the paradigm that's crippling weight management are "diets" themselves."

    YES.

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  5. Taubes has yet to focus attention on an important component of the modernized diet; industrial seed oils. Until he starts paying attention to the effects of excessive omega-6 consumption on appetite and fat storage, he won't have a complete picture from which to explain the trends. http://sciencenordic.com/vegetable-oils-promote-obesity

    Interestingly, global obesity expert Barry Popkin almost put his finger on it back in 2003. Note the comments about seed oils in this article: http://articles.orlandosentinel.com/2003-09-28/news/0309270148_1_overweight-or-obese-women-were-overweight-south-africa?pagewanted=all

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  6. Anonymous11:28 am

    Great post. One of my concerns with Taubes is that people who believe his theories who are unable to stick with the difficult low carb diet may blame themselves "if only I had the willpower to stick with low carb I would be losing weight". It's not realistic for most people, all diets fail people.

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  7. But getting sugar and acellular carbohydrates out of our diet will improve health and our weight.

    We human animals need to learn to live in our modern environment, that is changing incredible rapidly. We human animals must learn to adapt to that speed of change, even if adaptation means shunning the new, and returning to the old ways.

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  8. Shawn L12:25 pm

    My husband is proof of Gary Taubes' work. He's lost 60 lbs and kept it off, and now eschews most breads and wheats. His LDL and HDL are good and his triglycerides are excellent. I do agree that we all need a caloric max per day, and need to put in lots of veggies, low starch fruits, proteins, water, some carbs (less than 100g). I think very active non-obese people can stay slim, but I'd like to know what their triglycerides are, and how much visceral body fat they have. (The idea of normal weight obesity) Exercise for everyone is a must. 30 minutes fast walking a day, breaking a sweat a must. Not for weight loss, but for the health benefits and to reduce insulin resistance.

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    1. I'm proof of the opposite of what Taubes' believes in. I was diagnosed with type II diabetes in 2004
      weighed 323 lbs, was on medication for hypertension and acid reflux also had high cholesterol. I changed my diet to the dash diet which is a low sodium, low fat, low sugar, high fiber diet, started to exercise and lost 150 lbs in a year and a half and have maintained that weight loss, have not been on any medication and my diabetes is under control my A1C for the last 8 years has been 4.2. My carb intake is anywhere from 52% to 65% of my calories depending what I eat on a particular day. I eat a lot of fruits and vegetables, legumes,nuts and nut butters, whole grains including whole wheat products, small amounts of fat free dairy, eggs, meat and seafood. What I don't eat is any product made from refined white flour, white rice, fried foods, or products with a high added sugar content.
      My total cholesterol is low,ldl, hdl, and triglycerides are all excellent. It's great your husband lost weight and his health is better, I'm not advocating that my approach is the best way or the only way but only this is what works for me. As stated by Dr. Freedhoff that last thing we need to believe is that there is only one right way to go.

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    2. ejazz1 - Congratulations on your weight loss and your health accomplishments. Your carbohydrate percentages are high, but I'm betting that your absolute net carbohydrate consumption is down from 2004. I think that Taubes is overly dogmatic about percentages - my opinion is that absolute amounts and types of carbohydrates is more important than the percentages.

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    3. If you mean by net carbohydrate consumption, carbs minus fiber consumption, I'm not sure if it is less than what I ate before changing my diet. I never counted calories before losing weight and when I changed my diet I did count calories but never carbs. After the weight loss I don't count calories on a daily basis, only few times a month to give myself an idea of how many calories I'm eating. Even using a net carb total my carb consumption is roughly 310 grams per day, I usually eat 60 to 70 grams of fiber a day,a much higher amount than before I changed my diet. That is still considerably higher than what is considered low carb. I do agree the quality and types of carbs are important.

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    4. It proves the DIET works for SOME people, at least temporarily.

      It does NOT prove Taubes's pet guess/ personal proposal (I can't even call it a scientific theory).

      Or are you telling us your husband's
      insulin was measured,
      and his G3P,
      and his ASP,
      and his exercise,
      and the effect of the diet on his brain's reward systems,
      and the contributions of each to fat storage / removal was measured somehow (using not yet invented techniques)

      all those measurements would be needed to prove Taubes's pet guess/proposal

      the diet he suggests was known to reduce fat mass in some people, at least temporarily, long ago- that is NOT in dispute

      It's Taubes's pet guess in explaining this effect that is in dispute.

      One more thing you would need to do: feed your husband 10,000 calories a day and see if he gains weight, because Taubes also claimed that with low carbohydrate one can NOT gain fat mass.

      You might need to make really good tasting ice cream using very high fat cream and artificial sweeteners. Basically the highest fat, lowest carb foods that he really likes. I could do this easily - when I was on Atkins I cold consume 2 of those yellow Nielson's whipping cream cardboard boxes per day. I LOVED that stuff, just LOVED it.

      Delete
    5. Anonymous4:55 pm

      Gary Taubes is much less dogmatic than most here are claiming.. he repeatedly says his hypothesis need to be rigorously tested throughout his books.

      In any case I think that the key (more so than carbs) is limiting or eliminating sugar, refined flour, white rice, etc (white carbs so to speak).

      ejazz... your accomplishment is impressive.. but I don't think you are a refutation of Taubes necessarily. Your diet, while high in carbs, eliminates most high glycemic foods

      Delete
    6. Anonymous10:07 pm

      ejazz1... hang on, you mean you cut out sugar, white flour, rice, etc (i.e. cut out refined carbohydrates!)?

      Isn't this EXACTLY what Taubes is on about, almost in every chapter in his book? I suggest that your experience would actually support Taubes hypothosis, that refined carbs are bad, and complex carbs, aren't bad. (metabolic sydrome aside).

      Delete
    7. Anonymous5:50 pm

      @Sanjeev - regarding the eating of 10K calories, check out this: http://www.huffingtonpost.co.uk/sam-feltham/my-5000-calorie-experiment_b_3350869.html

      While it's not 10K calories, and it's by no means a controlled experiment, based on the number of calories he should have gained a lot more weight. It's interesting and I'd love to see more research done in this area.

      Delete
  9. I feel like you wasted the time of everybody who just read this on a rant against Taubes. I'm not a huge fan of Taubes, but I wish you had gone into the NuSI thing a bit more. What do you think of their methods? What do you think of their notion that existing science is bad? If "diets" are the problem, then do macronutrient mixes not matter at all? For decades, low-fat was drilled into us by everybody from the government on down and I think they are at least as wrong about that as Taubes is about low carb.

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    1. Awesome- Taubes is at least trying to help and is doing the research for free? Who else in America is doing this?????? Andrew Wiel says Gary's work is sound and you can go to Garys website and watch the video of him and OZ along with Weil going at it. I think there must be something there if 3 brillant people are talking about it? I personally have done all the diets and eating a diet that holds insulin down works for me and I dont have to shoot insulin. Fish, deep green veggies, Grass fed food and Fat. I wonder why our fore fathers didn't suffer from diabetes? Hey I know they ate Whole food and desserts were a treat, They slept and went to bed at a decent hour, probably worked for a living and had better food not laced with all the crap we have at all the food stores today. We feed the livestock so poorly you would shake your head in disgust and we wonder if that has anything to do with all the new diseases that are popping up? Its a shame we in America have to buy Irish Butter if we want it to be real Grass fed and hormone free- Wisconsin get on the band wagon and make real Butter thats yellow oozing from the rich omegas that real butter has and taste so good. I remember when Wisconsin had real butter and they served it in the restaurants. Hey at one point Wisconsin had Real Cheese and Real Beer from Hopps and Barley,I guess time's are a changing and with it real food and health are slowly being taken from us.

      Delete
  10. It really depends on the person going on a diet. If he lacks the mind, the power and the will, he will definitely lose track of his fat to slim goal.

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  11. Not everyone who eats excess carbs will be fat but practically everyone who is fat eats excess carbs!

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  12. Hold on... Is the author of this blog a bariatric surgeon??

    Who gets paid for performing surgery on obese people...

    Conflict of interest anyone?

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    1. Sorry to disappoint Mat, not a surgeon. But I'm sure you'll find something else to be mad at me for.

      Delete
    2. I'm not mad.

      I just think we changed our dietary advice and obesity and diabetes have taken off.

      Delete
  13. @ Mat: practically everyone who is fat is excess carbs, protein and fat. Big surprise.

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  14. I disagree, I eat 2400 Kcal per day and have done for about 3 years:

    65% fat, 5% carb and 30% protein

    Lost 43lbs in 9 months and kept it off so far.

    Would you say 2400 Kcal is an excess?

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  15. I did the lowcarb thing for a long time. I gave it up. I'm now eat a vegetarian diet, for many reasons, including health. I have to say that for me, it's been easier to maintain a vegetarian way of eating than low carb. More variety, more possibilities. I have managed to lower bgs and weight on this way of life. I did also on the low carb diet, but as you point out in the article, once I could no longer stand it (I started to crave green beans!), the weight came right back on.

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    1. RawNut11:08 am

      Wendy Hanawalt, You could have had over two pounds of green beans and still remained under 50 grams of carbs for the day. http://cronometer.com/food.html?food=4691&grams=453.5923696&measure=366337

      I'm low carb and I usually eat up to two pounds of veggies on in addition to a huge salad with peppers, cukes, tomatoes, celery, ect. every day. It sounds to me like you may have been doing what's called "zero carb" or an all meat diet.

      Delete
    2. Anonymous4:57 pm

      Uh, you can certainly eat green beans on a low carb diet. Even Atkins induction allows green beans

      Almost all low carb diets allow green vegetables... in large amounts once you reach maintenance stage. Green vegetables have almost no net carbs since they are so high in fiber

      Delete
  16. Thoughtful post, Yoni. The most important phrase: "Why we're eating more is the question that needs to be answered." Yup.

    Something has "broken" a great many of us and this brokenness prompts us, possesses us, to eat and gain weight despite enormous social stigma. I'd put my money on one or more endocrine disruptions that cause hormonal impulses to eat. Hormones (effluent from birth control) in out drinking water? Growth hormones (designed to make our livestock grow fat) ingested via milk and meat? In my mind, these are the frontrunners, but there are dozens of possibilities -- viruses, bacteria, food preservatives and colorants. Once we are "broken," it's hard to fix us. We can lose weight, but then after a short honeymoon the hormonal impulses double down. Some of us can counter impulses with doses of exercise, macronutrient management and a keen attention to our OWN bodies, which often inform us contrary to the "diet du jour."

    Gary Taubes is simplistic and boorish. Sadly, in our current society that kind of communication gets attention. Keep talking, Yoni. You are so right that obesity is complex. I wish I knew how to make that message as attention-grabbing as Taubes's.

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    1. I wouldn't call a 600 page book that includes 100 pages of bibliography, all to explain one hypothesis, "simplistic and boorish". Now, a blog post, or even a comment on that blog post, maybe.

      If you'd read the book, then read a blog post saying "...would in fact argue that anyone who thinks there's a singular cause for the society's weight struggles..." (meaning "there's only one"), you'd immediately see that this is a gross misinterpretation of a lengthy and extremely detailed argument. Taubes never said carbs were the only cause. He said it was the primary cause. You and me, we're smart, yes? So we know the difference between "the only" and "the primary".

      Invoking the strawman fallacy is almost cliche. But that's what it looks like right here.

      Delete
    2. Holy appeal to authority, Batman! Taubes's claim that total calories consumed doesn't really matter in weight gain is indeed "simplistic and boorish", even if he got two books out of it.

      Delete
    3. > I wouldn't call a 600 page book

      I wouldn't call Gary Taubes's thing a book.

      It's 600 pages of picked cherries from ancient manuscripts that were already rotted and stinking to high heaven long before he found them.

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    4. @Sanjeev,

      If that's true, I'd like to see the refutations of those "rotted and stinking picked cherries" if you don't mind providing them to us here. I could look for them myself, but since you obviously know about them, it would be easier if you just gave us what you have. Also, this way, we'd all be discussing the same refutations you know about. Finally, it's also a way to make sure you're not just blowing hot air about the whole thing sorta kinda. There's tons of those picked cherries and it wouldn't be fun to read through all the refutations, so just provide one and we'll go from there.

      Thank you.

      Delete
    5. @PuffsPlus,

      Taubes' claim is not that calories consumed doesn't really matter, it's that the idea that calories consumed is actually an effect - not a cause - of weight gain. Now if you believed that calories consumed is a cause of weight gain, then heard Taubes contradict that saying it's not a cause it's an effect, I can see how you'd come up with the claim that "Taubes said calories consumed doesn't really matter". But it's still not what Taubes said. On the other hand, if you believe Taubes really said that, I'd like it if you gave a quote with full URL.

      Thank you.

      Delete
    6. I've been invited before, and based on that experience I can say: Debating people who think insulin can make time move backwards

      ... I CANNOT WAIT !!!! where do I sign up?

      In case you're one of the few whose request is not in bad faith, you can check out carbsanity.blogspot.com, Lyle McDonald, Anthony Colpo, Alan Aragon, James Krieger

      proven non-dogmatists: folks who are not pushing an agenda, and when they discover good research that proves their past stance wrong, they admit it.

      Delete
  17. Excellent post Yoni!

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  18. Wow the "fat acceptance" true believers nearly always dismiss or downplay obesity-related scientific studies by handwaving about a conspiracy by the diet industry to fund most research in that area. Now the low-carb true believers like Mat are pointing to a conspiracy by the eebil bariatric surgeons to suppress the twoof about carbohydrates!

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    1. Sorry to burst your bubble but I'm more about the N=1 where the 1 is me!

      I followed the 'base your meals on starchy foods' advice and got fat.. Changed my diet to 'just eating real food' and managing carbs and hey ho! The weight dropped off and I got my health back.

      The thing is though... These N=1 experiments seem to keep cropping up with people.

      Yes, I could lose weight by calorie restriction but guess what. I'd lose muscle and be hungry, If you want a good experiment to see what it is like to work against your body; hold your breath for as long as possible and carefully note the body's reaction. Please note I'm not comparing losing weight by calorie restriction. I'm just highlighting the effects of working against your body.

      I lost all 43 lbs eating a varied diet that never once left me hungry. In my opinion, starving yourself to lose weight and exercising yourself into the ground is pure madness!

      Delete
  19. "the common ground to success is a person actually liking their life enough to sustain their new patterns"

    That I think can sum up the issue with health... If you find a new way of living (re: new habits) that is healthy AND you can enjoy (or even just tolerate) it, then that is sustainable for life, and that is how you will live.

    Can someone "diet" their entire life? No, I don't think so. Can someone enjoy the food they eat, and get something enjoyable out of the way they move, for their entire life? Absolutely.

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  20. Anonymous11:19 am

    I think one major change in the American diet since the 1970s is the addition of snacking. Historically, snacking was not accepted within the three squares a day diet, and limited to rare occasions. In today's food climate, experts tell us we should eat every three hours as to not put our bodies into starvation mode. However, instead of avoiding starvation we are distancing ourselves from natural cues of hunger and satiate, as well as increasing our daily caloric intake.

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    1. Snacking is only a "symptom". The question is: WHY are Americans snacking?

      Some answers:

      1) High sugar/HFCS in foods increases insulin secretion, which in turn causes our bodies to store fat instead of using the fat for energy, which in turn causes us to want more food

      2) Low-fat diets decrease the fats we need for various parts of our body, causing us to crave more food to try to get what our body needs

      Snacking is an effect of a poor diet, not a cause.

      It's not often someone would eat fried eggs & sausage for breakfast, then want to snack an hour or two later.

      Delete
  21. So whats not to enjoy about eating Healthily Ryan. I eat low carb like Mat, but I also enjoy what I eat! Been eating this way now for three years. Love the food. Slim, trim, fit and 68years old!

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    1. Trish, maybe you misunderstood... My comment's aim was that a lifestyle is sustainable, a "diet" is not.

      I guess maybe the confusion is that the word "diet" has several contexts, especially in pop culture. In pop culture, and I would say the majority of Western people's minds, a diet is a restrictive, challenging, hard-working regimen that requires adherence to avoid "cheating"... Most people that I know diet to lose weight, not diet to eat healthy.

      Quite literally every person I've ever met that was "on a diet" to lose weight (including myself), never succeeded long term.

      So yes, of course, eating healthily (i.e. a "healthy diet") can be quite enjoyable, and sustainable.

      However, I think it gets confusing when people use the word "diet", as it can have many meanings to many people, and most pop culture has made it a 4 letter wordl

      Delete
    2. Karolina5:17 pm

      The main problem here, however, is the definition of "healthy". To put it bluntly - Taubes says low-carb is healthy, most people here say it is low calorie (or something to that extent) that is healthy. So go figure...

      Delete
  22. Yoni - For me and my patients the work of Dr Atkins and Gary Taubes has been a breath of fresh air and enlightening. At this point it might be fair to consider everything opinion based on current evidence (or lack of it). The purpose of NuSI is unbiased, starting with the question, are all macro nutrients created equal? The null hypothesis will either reject or not reject this alternative hypothesis. Heck, some of the investigators hired by NuSI do not even support the carb-inulin pathway. How can this be a bad thing? - Jeff Gerber, MD - http://denversdietdoctor.com

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  23. Anonymous6:38 pm

    Mat, while you lost 43lbs you are still overweight even though you eat virtually no carbs. How does that tally with Taubes' theories? Mind you, at least you lost some weight, half the people on Zoe's forum struggle to lose any weight at all yet still talk about the diet as though it's the holy grail of weight loss and, hahaha, let's all laugh at the ignorant masses who believe in CICO, not like us special chosen few who know the truth!!

    Do me a favour. Find anybody you know who has a truly impressive physique. Or find a fitness forum populated by people who have good physiques, or who have transformed their bodies in a truly impressive way. Then do a poll to find how many achieved their bodies with

    A) A calorie controlled diet + regular resistance and CV exercise

    or

    B) A low carb, high fat diet + "natural" exercise such as gardening (PMSL!)

    Then have a hard think about whether the Harcombe cult really has a right to be so smug.

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    1. kaiparapete2:14 am

      I'm on the Harcombe Diet and would thoroughly recommend it. Losing weight at an impressive weight and never hungry.

      You could add C) to the above vitriolic post as in C) pops steroids every day

      You are confusing a good physique with good health and parroting the simplistic Calorie In Calorie Out idiocy.

      No one is smug about THD and it certainly isn't a "cult". Many people have succeeded on this way of eating and I intend to be one of them.

      Delete
  24. Anonymous11:01 pm

    Wait, what's the problem again? NuSI has scientists on board who DON'T agree with Attia and Taubes. That's why they're going to be running studies - to see what's correct and what isn't.

    This is a great time to be launching such a scientific endeavor. As long as the science is sound it seems like an excellent opportunity to improve our understanding of nutrition and exactly what role it plays in our overall health. I don't expect that there will be black-and-white results in this since everyone's physiology is different, but good data is always a great place to start....

    I've been on a very strict ketogenic/intermittent fast type diet for the last two months. After the initial loss of water weight I've been able to easily keep my calories under control without feeling hungry, and I'm now losing about two pounds per week, even with the occasional "cheat" day. It's not magic, it's just dedication and patience. It works for me - and I don't pretend that it'll work for everyone.

    Certainly, not everyone can eat this way. Just look at what's available out there - 80% of manufactured foodstuffs have added fructose in the form of either sugar or HFCS. And that trend started in the late 70s when the dietary recommendations changed to emphasize low fat diets - the same time frame as the beginning of the obesity epidemic. I understand that correlation isn't causation, but all things considered I think it draws a big red flag.

    Robert Lustig's work on sugar metabolism shows that we're hammering our bodies with so much fructose that it throws off our insulin and leptin regulation. So maybe carbs alone aren't the problem but modern industrial diet itself. It really needs to be looked at from a fresh angle.

    Considering how out of control the obesity epidemic is in this country, I have to think that all the research that's been done so far hasn't done much to change the way we eat or the way we're getting fatter and fatter every year. Maybe it's time for some solid new research on the subject.

    ReplyDelete
  25. RawNut11:51 pm

    Anonymous,

    You'll find a ton more fit and active people at Marks Daily Apple than you will at McDougall forums. That's for sure!

    ReplyDelete
  26. Ah - A comedian. and a cowardly one at that.

    ReplyDelete
  27. Anonymous6:35 am

    Yeah, that's right everyone with a good physique takes steroids, it makes life easier to deal with to assume that I guess. Well, steroids are necessary to get extremely muscular, I'm simply talking about people who get lean (and healthy!) and fit. Like Mark Sisson, who I hate to tell you probably didn't get his physique from walking and gardening!

    The best you get from your diet is either no weight loss (like poor Laura, feel really sorry for her, hope she sees the light one day) or some weight loss which then grinds to a halt. And the only advice on offer is 'I think you need to eat more fat!'. Great. That's like saying to someone who's bankrupt to 'Maybe try spending more money?'

    Then the Taubesian rationalisations have to come in about how maybe you're at your natural weight etc. What BS. Give me anyone on your forum and I'll get them losing weight. For example, you Mat. Keep eating what you're eating but eat 500cals less per day. Report back. I know you won't do this but I'm just planting a seed anyway.

    And remember the fact I'm anonymous doesn't mean you can't respond to my comments, that's another easy out. Or maybe just assume I work for Kelloggs or something then you can do your usual 'Conflict of interest, anyone?!!' which, again, gives you a free pass to not have to engage with the arguments.

    ReplyDelete
    Replies
    1. It's also extremely unfair to name individuals.

      Delete
    2. I think most are aware maximum secretion of satiety hormones, PYY, CCK and GLP-1 which regulate our feelings of hunger & sense of fullness & which activate the ileal brake to consumption, depends on FAT sensed simultaneously at duodenal,jejunal and ileal sites.
      Remove or reduce fat consumption and you are as well able to limit food consumption as you would be able to regulate car speed if brake fluid was removed from braking system.
      See how well you get on regulating car speed without being activate the braking mechanism but relying only on will-power and self-control.
      Other readers may be interested in the article A Carefully Scheduled High-Fat Diet Resets Metabolism and Prevents Obesity

      Delete
    3. > Other readers may be interested in the article

      A single rat study proves results for humans huh?

      > See how well you get on regulating car speed without being activate the braking mechanism

      See how well your health fares basing all your dietary an medical information on short term rodent studies.

      Good luck widdat.

      > most are aware maximum secretion of satiety hormones, PYY, CCK and GLP-1 which regulate our feelings of hunger & sense of fullness &

      reductionism, cherry picking, mistaking parts for the whole

      http://en.wikipedia.org/wiki/Fallacy_of_composition

      Delete
  28. @Anon;

    It is pretty small-minded to judge the effectiveness of something by basing your view on a 'support-forum'

    You seem to be pretty angry!

    Is it because you are hungry? ;)

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    Replies
    1. RawNut8:59 am

      Anon,

      You should use randomized, controlled studies instead of support forums. You don't because those studies show that low carb beats every other diet for weight loss and health markers hands down - especially long term. The studies show the exact opposite of your "observations."

      Have you heard of the A-Z study? http://jama.jamanetwork.com/article.aspx?articleid=205916

      The lead author is Christopher Gardner, PhD, a long time vegetarian. So you cannot claim "conflict of interests."

      He goes over the study in this video: http://youtu.be/eREuZEdMAVo

      More randomized controlled studies can be found here: http://www.dietdoctor.com/science

      Delete
    2. Anonymous12:08 pm

      Cherry picking at it's finest! Of course he doesn't list any of the studies which show no difference between low-carb and low-fat.

      But the real killer is that all the studies which show greater weight loss on low carb are free-living studies. That is all estimates of calries in are based on people's self reported food intakes which are known to be completely unreliable.

      Now find me a study showing the superiority of low carb where calories in were tightly controlled i.e.a metabolic ward study. You won't be able to, because these consistently show no advantage to low carb and that it comes down to calories in, calories out.

      Maybe try taking a look at the arguments of people who are not married to the low carb movement. If you always choose to get your information from low carb authors and bloggers you're just immersing yourself in one-sided groupthink. Take a look at what the other side are saying then you actually get a chance to engage with the debate.

      Delete
    3. RawNut11:32 pm

      Anon,

      Feel free to list any studies that contradict what I've listed. It's not up to me to further back up the studies that you can't refute anyway.

      Delete
  29. Anonymous7:52 am

    No, it's because I find it frustrating to see people being misled by bad information. And what else would I base it's effectiveness on if not a forum of people actually doing it? Science says that a diet that pays no regard to calorie intake probably will not work for most people and this appears to be borne out by the experience of many on the forum. The basic idea of 'Eat real food' is good. Making people think that calories don't count is not good. Don't believe me? Here is the great man himself admitting that no calorie deficit = no weight loss

    http://www.youtube.com/watch?v=XR3FVvEJ-Nk

    From 20 secs:

    "If we want to get lighter we have to expend more calories than we take in, absolutely no doubt about it.......It's the laws of thermodynamics, that's the way the universe has to work, there's no getting around it"

    Obviously he goes on to promote low-carb eating but there is Taubes himself acknowledging that you have to have a calorie deficit to lose weight.

    ReplyDelete
    Replies
    1. RawNut11:46 pm

      Anon,

      You don't seem to understand how low carb works. It makes you satiated so you eat less. Nobody is saying that calories don't count. They do indeed.

      I've been a low fat vegan before and was never more miserable,tired, hungry, bloated and heavy-feeling in my entire life. And no, I didn't eat sugar or refined grains.

      Low carb gives me energy without having to eat every hour or risk passing out. I feel light now because my stomach is not constantly full. I've lost weight even though I didn't have that much to lose. My experience is not unique.

      Delete
    2. Anonymous5:46 am

      Then we agree. I agree that low carb works (when it does) by making people spontaneously eat less.

      But you're wrong to say that no-one is saying calories don't count. I see it a lot on low carb forums and this is exactly what Zoe Harcombe says. And when people on her forum post to say they don;t understand why they are not losing the most common advice is eat more fat, or try to cut a few grams of carbs out. No-one pays any regard to calories.

      Fred Hahn thinks you could drink 5000 cals of olive oil and not gain weight. Taubes thinks you have to go low carb to lose weight as carbs make you fat as they release insulin.

      In fact I don't recall any low-carb guru who has a diet to sell ever admit this is how low carb works. It's always about keeping the insulin low or the metabolic advantage (Dr.Eades) or some other magical BS.

      Delete
    3. Yes, Taubes said those words. But he did not say that the calorie deficit is the cause, though it's easy to conclude that because it's intuitive.

      Taubes often used the example of a growing child. A child grows because of growth hormone, and then eats more to compensate. We could retard this growth by caloric restriction, however it would not stop growth hormone itself. The growth will still be driven by GH, we'd only restrict the materials needed for this growth to be realized. In a similar fashion, we could reduce obesity by caloric restriction, but it wouldn't stop the cause of obesity, we'd simply restrict the materials needed to sustain obesity. On the other hand, if we stopped the cause of obesity directly, the materials needed to sustain obesity would not be needed anymore, and caloric reduction would spontaneously occur. It's understood this is only a hypothesis, which I expect NuSI's upcoming research to test in one of its mechanism-of-action studies.

      Delete
    4. > though it's easy to conclude that because it's intuitive.
      __________
      Conservation laws only seem intuitive because they are today widely accepted results of scientific progress.

      They are NOT intuitive.

      Historically they were not fully accepted until fairly recently.

      http://en.wikipedia.org/wiki/Conservation_of_energy
      http://en.wikipedia.org/wiki/Conservation_of_mass

      Delete
    5. You misunderstand. What is intuitive is not the First Law of Thermodynamics, but the assumption that the arrow of causality always points in only one direction. With the example of the growing child, it's obvious that the arrow of causality can point in both directions. The growing child example is the most valid and relevant here because it's true, and it's with humans. However, there are other equally valid examples.

      The small guy vs the big guy. And the end of the day, the small guy eats less than the big guy because he's smaller. But if the small guy lugs around a big bag of stuff all day, he's gonna eat more too to compensate. Next day if he drops his bag, he's a small guy again, and eats like a small guy again. The cause here is not that he eats more or less, it's that he's bigger or smaller. This example can be done with cars and trucks instead but it's the same principle and the First Law of Thermodynamics applies.

      Now if we look at obesity, it's equally plausible that obesity is the cause, and overeating is the effect. Consequently, it's equally plausible that losing weight is the cause, and spontaneous reduction of food intake is the effect.

      Delete
    6. > if we look at obesity, it's equally plausible

      To support Taubes's position the small guy would have to gain weight BECAUSE he burns more calories. That would be a reversal of what we usually think of as cause and effect. What you present is a grade 9 science class lesson, completely consistent with regular cause and effect, but you somehow manage to twist it beyond logic-defying belief - a typical Taubes tactic.

      Congratulations - only one thoroughly cowed and gulled could convince themselves they pulled it off.

      Delete
  30. Anonymous12:51 pm

    Does anyone know if this Nusi org and Feinman's Nutrion & Metabolism Society are related? The stated objectives seem pretty much the same.

    ReplyDelete
  31. The Manhattan Project of Nutrition Short video Peter Attia talking to Dr Eenfeldt about this project.

    ReplyDelete
  32. I find it interesting how few of those who comment on diet blogs grasp the distention between prevention and treatment or cure.

    Going on a low carb diet after a lifetime of high carb eating may not help an obese person lose weight, just as quitting smoking after a lifetime of smoking a pack or two a day will probably not cure you of lung cancer. Once you're broken, you're broken.

    All types of birth control provide effective prevention against pregnancy - they have no effect after the fact. So eating low carb after you're obese, and quitting smoking after you have lung caner, just might not work for you.

    But, if you never eat a high carb diet and never smoke a cigarette the chances of you becoming obese and contracting lung cancer are probably slim to none.

    It just may be possible the "bench" discoveries that NuSI comes up with will lead to the prevention of obesity, and not necessarily the best treatment or cure.

    Cheers

    ReplyDelete
    Replies
    1. That would be "distinction" not "distention". LOL

      However, distention, is the state of my abdomen after consuming most FODMAPS.

      Delete
    2. That's very true. There's a condition called insulin-induced lipohypertrophy. It's where fat tissue grows bigger over time due to the action of insulin, more specifically chronic hyperinsulinemia. This extra fat tissue doesn't go away just by cutting carbs. It's there to stay. The condition is common among diabetics type 1 who inject insulin in the same spot for years. It's well known and the standard treatment is local liposuction. Though in the near future that might be replaced with a drug currently being tested that is capable of reducing fat tissue physically and permanently just like liposuction, though only proven in monkeys at this time.

      The point is that insulin, whether it's injected or secreted, has the same effect on human tissue. It wouldn't work to treat diabetes type 1 otherwise. And so if insulin can do this when we inject it in the same spot for years at doses most likely much higher than what our pancreas would secrete normally, then it follows that if our pancreas does secrete insulin in such high doses that it results in systemic chronic hyperinsulinemia, then it should do the same to all fat tissue everywhere in the body that is subjected to this insulin. And this could partly explain why long-time obese people have such a hard time to lose the weight at first, and maintain the loss later on, or why we hit the proverbial plateau with some stubborn fat we can't seem to get rid of no matter what we do.

      Delete
    3. I like to base how far I can run based on how far a person could run with multiple femur fractures, and multiple leg bones sticking out of their skin

      Delete
    4. Yes, I hear that argument all the time. It goes, diabetes type 1 is a pathology, therefore doesn't apply to obesity. Maybe it's true, but it doesn't change the fact that the insulin diabetics type 1 inject is the same as the insulin our pancreas secrete, therefore the effects of the insulin injected by diabetics type 1 can tell us a great deal about the effects of the insulin secreted by our pancreas.

      If you have evidence to the contrary, I'm all ears.

      Delete
    5. Martin, look up a little hormone called Amylin and you will see that a diabetic injecting insulin does not relate to a normal person secreting insulin.

      Delete
    6. And the reason people can't maintain weight loss is because of leptin, the set point hormone that when in a weight reduced state increases hunger in order to replete fat storage.

      The reason for the plateau is that people hit an equilibrium where their calorie intake is equal to their calorie expenditure so weight loss stalls. In calorie restriction this occurs because people can't accurately count calories or their estimates for expenditure are wrong. In low carb this occurs because of leptin causing additional hunger and whatever other mechanisms in play that caused overeating and the original obesity. Dieting just treats the symptoms of some underlying condition that causes excess hunger and food consumption, but what we do know is that insulin is unlikely to be the main contributor.

      Delete
  33. This comment has been removed by the author.

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  34. (clearer than the original)

    > I'm all ears.

    Pull the other one, it's got bells on.

    Keep repeating it though: someday even you might believe it.

    ReplyDelete
  35. To those who cite Taubes' example about obesity being similar to a child growing, consider this. Nobody can control their height by calorie intake, yet people can control their level of fatness by calorie intake. This is evidenced by the personal trainer who went from ripped to obese in 6 months and back to ripped in another 6 months (http://www.fit2fat2fit.com). Do you see somebody going from 5' tall to 6' and then back to 5' by manipulating their dietary habits, NO!

    Insulin doesn't affect energy expenditure as shown by metabolic ward studies, but instead the reason obesity occurs is because of over-eating, not because of insulin partitioning calories into fat. The only valid question that needs to be answered is WHY DO PEOPLE OVEREAT? And so far insulin does not explain it.

    ReplyDelete
    Replies
    1. Dave, as you well know, well documented facts and cogent arguments will change a lot of minds among the Taubes cult ... yeah, right

      like everything Taubes wrote on obesity, it's complete, unadulterated, unvarnished BS

      scientific american

      or another

      > regions of extreme poverty or prolonged warfare, environmental
      > factors like chronic malnutrition during childhood or adolescence
      > may account for delayed growth and/or (in severe cases) marked
      > reductions in adult stature

      Dave:
      > Nobody can control their height by calorie intake,

      malnutrition CAN make it so one does not grow to one's potential height.

      it's common to see taller-than-6-foot kids in the US whose Asian immigrant parents who had lived through periods of malnourishment before coming to the US are very short

      Delete
  36. Anonymous2:09 am

    Surprised that people didn't really understand Taubes's research - did anyone actually read his books that are commenting here on this forum? He's only stating what the science has proven so far. That eating carbs produce fat in our body. 'Why we overeat' is a different study, and he does begin to address that by mentioning addictive behavior. He has integrity and is not judging anyone. He is presenting the facts and it's up to us to apply the discipline it takes to stop eating unhealthy foods or not. Time to grow up America!

    ReplyDelete
  37. I think people are not reading and just misinterpreting a lot of the information. I understand a lot of the United States' citizens have reading difficulties, I just never realized it until now after reading these comments and articles such as this one.

    If anyone needs help with research look up, preferably on google, William Banting's works and also works done by Stefansson. What I have read so far Taubes and others are stating that high insulin over long periods of time results in fat storage.

    Low carb is different for everyone. Not all will have to eat below 50 grams of carbs etc. In type 2 diabetics, insulin levels are dangerous for people who continually feed on carbs (grains) and sugars (sucrose, fructose). You'd think that less consumption or eliminating it altogether would lead to a reversal or even curing this condition. (?)

    ReplyDelete
    Replies
    1. By the time Type 2 diabetes is diagnosed, most people have lost 40% of the insulin producing cells in their pancreas. That will not change with diet or weight loss. The best you can hope for is to minimize the drugs and side effects same that you have to take to control it.
      http://www.phlaunt.com/diabetes/14046739.php

      Delete
  38. Anonymous4:36 am

    I know. It'd be great if we could reverse or cure diabetes with low carb diets. Some of the foodie documentaries seem to suggest that a vegan diet can cure the condition.
    A friend who has diabetes eats the exact same diet outlined by Taubes. He was eating this way long before Taubes's book was published. So it's hard to believe that a low carb diet can't be maintained. My friend has no choice, when you are diabetic, you don't just eat what you want, when you want to.

    It's been many years of a semi-vegetarian diet for me, and I have to finally concede that my body does better wtih animal protein. I'm glad that Taubes wrote "Why We Get Fat" and that it makes sense. The other book is a bit harder to get through.

    ReplyDelete
  39. "The graphs are meant to be very clear. Carbohydrate intake has gone up since 1971 while fat and protein have gone down, and hey look, weight's gone up too. Must be the carbohydrates, right?"

    Except that's not what the graph says or purports to show. The label, clearly visible on the image you show says "Despite following dietary recommendations- for example, reducing fat intake- Americans are getting more and more obese" which the graph certain does so (and is true). So seems perfectly intellectually honest.

    "low-carb dieting, for many, is far more of a restrictive diet than it is a livable, long-term lifestyle"

    Really? I just cut out the nutrient-sparse starches that make up most calories in a typical meal and eat mostly meat and vegetables. Seems simple enough to me and nothing like a diet. It's certainly better, in practice, than the standard advice which is just i) eat less than the amount that currently satisfies you and sometimes ii) eat less tasty foods which don't make you want to eat so much.

    ReplyDelete
  40. Bob Gardinger10:56 am

    ...the fact that low-carb dieting, for many, is far more of a restrictive diet than it is a livable, long-term lifestyle"

    Taubes doesn't advocate a low-carb diet as much he's arguing for a shift in thinking. I read his books and now I see breads and sugars as the thing that made me fat. The only thing I find difficult is that the fast food world is built on carbs. I don't care how many nuts and raisinsand bran you put in muffins and scones; you're eating cake. That bread that hold your sandwich together is unnecessary. Sugar is in everything you find at a traditional grocery store. Stop glorifying the carb!

    ReplyDelete
  41. Why are people eating more calories? Could it have anything to do with that fact that we've replaced nutritionally dense fats and proteins with nutritionally empty carbohydrate calories? Look at the calorie count of the government's recommended percentage of added sugar we can eat. The carbohydrates make us hungrier. Is it a coincidence that I could eat a big steak, large potato and small dinner salad and not feel satisfied, but when I dropped the potato, I had to wrap up half the steak for tomorrow because I was full?

    ReplyDelete