Gary Taubes, “Good Calories, Bad Calories”

Gary Taubes, a correspondent for Science magazine, contributed to the Atkins Diet craze with his New York Times article several years ago, "What If It’s All Been a Big Fat Lie?." He then spent the past several years expanding on that article, and the result Good Calories, Bad Calories, a book of some 600 pages (nearly 70 of which are the bibliography).

Taubes has several overarching themes; he contends, for example, that eating refined carbohydrates is what makes you obese, and that refined carbohydrates contribute to many of what used to be called "diseases of civilization" (such as heart disease, which seems to have been less common in traditional cultures that ate less processed food, including Northern cultures that ate almost exclusively meat).  (These arguments are still controversial, although new evidence continues to support them.)

The most important theme, however, suffuses the entire book: bias in scientific inquiry

Most of the chapters are headed by bias-related quotations, such as this from a 1921 book on philosophy of science: "In reality, those who repudiate a theory that they had once proposed, or a theory that they had accepted enthusiastically and with which they had identified themselves, are very rare.  The great majority of them shut their ears so as not to hear the crying facts, and shut their eyes so as not to see the glaring facts, in order to remain faithful to their theories in spite of all and everything." Or this quotation from a 1950 Fields Medal winner: "The thing is, it’s very dangerous to have a fixed idea. A person with a fixed idea will always find some way of convincing himself in the end that he is right."

Why is Taubes so interested in bias?  For several decades, it has been the conventional wisdom that dietary fat (and especially saturated fat) contributes to obesity, heart disease, and cancer.  Judging from Taubes’ exhaustive research — indeed, I’d be surprised if any other book examined bias within a particular scientific field in such detail — the conventional wisdom was based on unreliable and slender evidence that, once established and institutionalized in government funding, set a pattern of confirmation bias by which further research was judged (or ignored).  To take several examples (the book is full of many more):

  • Researcher Ancel Keys is perhaps the most important figure behind the origins of the dietary fat hypothesis.  Two of his most famous studies found a strong correlation between diet and heart disease in a handful of countries, but he cherry-picked the countries to analyze, omitting countries that would have undermined or even eliminated the correlation entirely. (pp. 18, 31-33).
  • Dietary researchers tended to ignore — or refused to allow publication of — studies showing that diet, cholesterol, and heart disease were not even correlated (pp. 27, 35), or even that low cholesterol raises other risks of death (in several studies, people with low cholesterol and/or people who ate low-fat diets were more likely to die of cancer, see pp. 37, 54, 71, 81).  As for cholesterol-lowering diets (which may include lots of polyunsaturated fat, and hence are different from low-fat diets per se), dietary researchers tended to rely on one positive result from a Helsinki study, while ignoring a politically incorrect result from a clinical trial in Minnesota (in which 269 mental patients assigned to a cholesterol-lowering diet died, compared to 206 in the control group). The Minnesota result wasn’t even published for 16 years; Taubes asked the researcher why, and got the response: "We were just disappointed in the way it came out."  (pp. 37-38).

  • Similarly, in 1961, a conference of the Association of American Physicians included a presentation showing that in comparing heart disease patients in New Haven to a healthy population, the diseased patients were much more likely to have high triglycerides than high cholesterol, thus implicating high carbohydrate diets (which elevate triglycerides).  One of the researchers told Taubes, "It just about brought the house down.  People were so angry; they said they didn’t believe it."  Despite this result, later studies funded by the National Institutes of Health would completely ignore triglycerides, focusing only on cholesterol levels. (pp. 157-60). 

Taubes closes the book with these scathing words:

The institutionalized vigilance, “this unending exchange of critical judgment,” is nowhere to be found in the study of nutrition, chronic disease, and obesity, and it hasn’t been for decades.  For this reason, it is difficult to use the term “scientists” to describe those individuals who work in these disciplines, and, indeed, I have actively avoided doing so in this book.  It’s simply debatable, at best, whether what these individuals have practiced for the past fifty years, and whether the culture they have created, as a result, can reasonably be described as science.

Here are some informative interviews with Taubes:

PBS

MIT.

The Borzoi Reader.

The Telegraph. Notably, Taubes admits in this interview that he himself might be biased: “What are the chances of writing an article that says the entire medical establishment is wrong, and them going, ‘Good point, thank you, Gary. Can we give you an award?’ When people challenge the establishment, 99.9 per cent of the time they are wrong. If I was writing about me, I’d begin from the assumption that I am both wrong and a quack.”

GD Star Rating
a WordPress rating system
Tagged as:
Trackback URL:
  • http://hanson.gmu.edu Robin Hanson

    So can someone summarize the single strongest piece of evidence on this subject?

  • Benoit Essiambre

    It’s never enough for research to find that something has an effect. It needs to determine the magnitude of that effect. Confidence intervals are crucial. Scientists publish crap based on dumb null hypothesis testing methods (p-values) which only prove minuscule effects that are most likely due to systematic errors in their method. The reliance on p-values is what got us into this mess. Researchers should be required to proved that an effect is big enough to be practically useful, not just different from zero. IMO, with the irregularities and biases there are in research, a diet should increase lifespan by a large margin something like 2 to 5 years compared to a control group before it is promoted.

  • sophiesdad

    .Robert Adkins was a board-certified cardiologist who went against the teachings of his professors, his colleagues, and the American Heart Association. He further chose to aggrandize himself and his ideas, and he became wealthy doing so, at a time when any form of advertising was considered taboo for legitimate physicians. Consequently, his colleagues and the “official” organizations regarding diet information labeled him a “quack”. He was not a “researcher” by trade, any more than Albert Einstein was a scientist by trade while working in the patent office and thinking about relativity. Adkins great thought was that most of the bad things that come from any type of diet involve the excess stimulation of insulin. The Adkins Diet is not a “craze”; it is a recognition of human evolution. Refined carbohydrates are a recent human invention for which humans have not evolved to handle in a healthy way. They, especially high-fructose corn syrup, cause an over-active secretion of insulin that converts excess calories to fat, is associated with atherosclerosis, Type 2 diabetes, and has a not-yet-understood correlation with some cancers. The physiology was there for all to see, but its significance was presented by an unpopular messenger, and thus rejected. It is a perfect example of harmful bias.

  • http://jewishatheist.blogspot.com JewishAtheist

    So can someone summarize the single strongest piece of evidence on this subject?

    He does a pretty good job of summarizing his argument in this hour-long lecture at Berkeley.

    What struck me is not any piece of evidence outside my own experience (the weight just falls off with no hunger and I simultaneously feel great) but his analogy with growing children. He says, we don’t say children grow because they eat too much — we say they eat a lot because they are growing. Obesity works the same way when insulin gets messed up. People overeat (and under-exercise) because their bodies are begging them to. In the absence of carbs*, weight is more or less self-regulating just as most other systems in the body are. On a low-carb diet, one doesn’t have to consciously limit food. The body does it for you.

    *carbs means significant amounts of starches and/or refined carbs.

  • rosensmith

    I don’t know if I’m qualified to determine what would qualify as the single strongest piece of evidence on this subject is, but I can tell you what struck me most forcefully: In his Berkeley lecture, Taubes discusses the prevalence of obesity among poor, developing-nations women–fat women who bring their skinny children to clinics to be treated for malnutrition and starvation (he’s got statistics, of course). He says something along these lines: If obesity is due solely (or even mostly) to overeating, then these women must be literally taking food from their children’s mouths. We have no known model of mammalian maternity that shows even a minority of mothers doing such a thing, much less a majority. Either these women are monstrous freaks of nature, or something else is going on.

  • Tim Tyler

    The conventional wisdom is that the total number of calories is what is important – while the macronutrient ratio is not terribly important – provided it does not lead to malnutrition.

    Demonization of one macronutrient or another is a common trait of diet fads.

    History shows you can sell diet advice more easily if you claim that fats or carbs are the problem – while the (admittedly rather obvious) idea that calories are the problem seems to be something that few are prepared to pay for.

  • Anonymous

    This article critiques Taubes’ original New York Times Magazine report, with a number of scientists claiming that Taubes had misrepresented their views:

    http://www.reason.com/news/show/28714.html

    Here is a blog posting (on a generally pro-Atkins-diet site) with a review of Taubes’ recent book by George Bray, one of the most respected figures in obesity research; and a rebuttal to Bray’s criticism, by Taubes.

  • sophiesdad

    TimTyler:The conventional wisdom is that the total number of calories is what is important – while the macronutrient ratio is not terribly important – provided it does not lead to malnutrition.

    The “conventional wisdom” is wrong; that’s what this is all about. There is a major difference between gaining weight and gaining fat. A local man who has been Mr. America, Mr. Universe, and Mr. Olympia stands five-feet, eight inches, and weighed 240 pounds at his competitive best. His body fat measured less than 5%. By every conventional index, he is obese. More calories than you need will indeed cause weight gain, but what kind of weight you gain is highly influenced by insulin. I was taught the conventional wisdom in medical school; to say again: it is wrong.

  • http://occludedsun.wordpress.com Caledonian

    The conventional wisdom is that the total number of calories is what is important

    It’s diet and exercise that conventional wisdom says are important. A given intake of calories may or may not lead to obesity, depending on the level of activity.

  • billswift

    “By every conventional index, he is obese.”

    Nonsense. The definition of obese is greater than 30% bodyfat. BMI and life insurance tables are just quick rules of thumb and explicitly warn that they are not useful for the extremely muscular.

  • http://www.orbsorter.com Ryan

    Agreed with Tim. Personally, I ended up simply monitoring my calories, cutting my intake from probably 2500-3000 to around 1500-1800 per day. I did not follow any particular diet, in fact I had lots of fast food and hardly exercised. Still, I lost all my excess weight easily this way. Once at a healthy weight I found myself motivated to exercise and improve my diet.

    My guess is a lot of people don’t realize how many calories they are consuming. So this allows people to carry on imagining things like, “I eat very little but still gain weight” or for a thin person, “I eat as much as I want and never gain weight”. And many are just unwilling to endure through any initial discomfort of being hungry when reducing consumption. Of course this is just a biased view based on my own experience.

  • sophiesdad

    billswift: “By every conventional index, he is obese.”

    Nonsense. The definition of obese is greater than 30% bodyfat. BMI and life insurance tables are just quick rules of thumb and explicitly warn that they are not useful for the extremely muscular.

    Billswift, your comment is nonsense. Clearly, you are not a medical professional, nor have you ever had to represent an overweight person to their insurance company or their potential employer, as I have. The medical definition of obesity is: Obesity-the state of being well above one’s normal weight. There is good reason for this: the increased weight puts a greater strain on the heart and the vascular system, regardless of its composition. See: Arnold Schwarzenegger’s cardiac history. Some advice from the medical profession for some of the commenters on this blog: in terms of medical reliablity, anecdotal experience is equivalent to lies.

  • Kuntsa

    Taubes’ hypothesis is that the hormones make you eat, or stop eating. The caloric explanation is pretty much like flogiston. It does explain everything but then it does not explain anything. Caloric explanation does not tell why a female has more fat than a male, why growing kids start eating more, or why expecting mothers suddenly become very hungry. Hormones, on the other hand, explain handily all those cases.

  • http://hanson.gmu.edu Robin Hanson

    The critique linked to above seems pretty damming. So the fact that Taube goes on about bias so much leaves a bad taste in my mouth. Perhaps it is a bad sign when people go on at length about bias against their views – do such people just tend to be wrong?

  • Tim Tyler

    Calories are the bottom line – e.g.:

    Study examines calorie restriction and glycemic load

    It isn’t difficult to understand why this might be:

    It’s the Calories, Stupid!

    Re: It’s diet and exercise that conventional wisdom says are important

    True, but it’s difficult to shift much body fat with exercise, since each gram of fat takes so much exercise to shift. Exercise has other benefits besides obesity-avoidance, though, it is true.

    Re: Caloric explanation does not tell why a female has more fat than a male

    Nor does it pretend to. It does explain why females weigh less than men. They eat fewer calories. Of course, this a proximate explanation. It’s the same with growing kids and pregnant mothers. Hormones are not the ultimate explanation for any of these things either – that lies with human evolutionary biology.

    Anyway, Taubes, seems to deny the basic thermodynamic perspective. Instead he promotes the Atkins diet – a dubious dietary strategy not based on scientific evidence, which seems to have been designed to sell diet books – by telling people that they can eat as much as they like of some foods and still go on a weight-loss diet.

    The basis of such diets is a severe restriction of carbohydrate calories – which simply causes a net reduction in total calories.

    It’s not the carbs, it’s the calories, Atkins plan analysis shows

    Testing to determine whether the resulting odd diet is even safe continues.

    IMHO, Taubes’s grounds for his position seem pretty flimsy – and he is likely to be misleading his readers.

  • sophiesdad

    Robin Hanson:The critique linked to above seems pretty damming.

    That article was written in March 2003. I suggest you search for recent articles that have vindicated the Atkin’s ideas about avoiding refined carbohydrates. Taubes may have written a biased book with inaccuracies, but that does not discount the underlying fact that humans have not yet evolved to handle refined carbohydrates in a healthy way. Atkins never said that you could eat as many calories as you want and lose weight, and yes it is true that people tend to feel satisfied with fewer calories when they produce less insulin. But the real point that readers such as Tim Tyler seem oblivious to is this: all the numbers are better and there is less atherosclerosis on a low-carb (refined carb) diet. Yes, Atkins was a showman; coincidentally, he was correct.

  • http://yudkowsky.net/ Eliezer Yudkowsky

    An interesting note: I read Robin’s comment saying the critique was damning, but am currently in the middle of writing another post, so did not divert to read it. I initially found Taubes’s view pretty plausible, but if Robin says there’s a damning critique out there, there probably is.

    So in my current state of mind, if someone asked me, “Do you believe in Taubes’s view?” I would have to say “No. It seems pretty plausible on the surface, sure. But a trustworthy friend said in a blog comment that there was a damning critique of it, although I haven’t read the critique yet.”

    It feels like a pretty unnatural state of mind and I have to work to maintain it, which may explain why there’s so much disagreement in the world.

  • http://jewishatheist.blogspot.com JewishAtheist

    The latest large study of low-carb vs. low-fat (and vs. Mediterranean, which also did well) revealed low-carb to work significantly better for weight-loss and cholesterol:

    Average weight loss for those in the low-carb group was 10.3 pounds after two years. Those in the Mediterranean diet lost 10 pounds, and those on the low-fat regimen dropped 6.5.

    More surprising were the measures of cholesterol. Critics have long acknowledged that an Atkins-style diet could help people lose weight but feared that over the long term, it may drive up cholesterol because it allows more fat.

    But the low-carb approach seemed to trigger the most improvement in several cholesterol measures, including the ratio of total cholesterol to HDL, the “good” cholesterol. For example, someone with total cholesterol of 200 and an HDL of 50 would have a ratio of 4 to 1. The optimum ratio is 3.5 to 1, according to the American Heart Association.

    Doctors see that ratio as a sign of a patient’s risk for hardening of the arteries. “You want that low,” Stampfer said.

    The ratio declined by 20 percent in people on the low-carb diet, compared to 16 percent in those on the Mediterranean and 12 percent in low-fat dieters.

  • Tim Tyler

    Re: Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet

    Is that relevant? The study was not isocaloric. Each group consumed a different level of calories. The calorie deltas after 6 months were: low carb -560 calories, Med diet, -254 calories, low-fat, -458 calories. The most obvious explanation for the varying levels of weight loss is that the participants consumed varying levels of calories.

    Re: all the numbers are better and there is less atherosclerosis on a low-carb (refined carb) diet

    As I understand it, this is not true. We still know relatively little about the effects of low carb diets – which is part of the reason why nutritionists rarely recommend them.

  • http://nutritionscienceanalyst.blogspot.com/ David Brown

    In any weight control discussion there are three considerations that rarely get mentioned, much less intelligently discussed. The first is biochemical individuality which amounts to genetically determined variations in the makeup of cells. The second is physiological variability that determines, to some extent, the absorption efficiency (most writers seem to believe that caloric absorption is 100% for everyone) of nutrients from the gut into the bloodstream. The third is unabsorbed calories. It’s estimated that, on average, only 80 % of calories are absorbed. The remainder pass out of the body without contributing to the body’s caloric energy needs.

    As I seem to be the only one trying to drum up interest in the unabsorbed calories phenomenon, just Google “David Brown unabsorbed calories” or “David Brown calorie excretion” for further discussion of this physiological phenomenon.

  • David Crookes

    Tim Tyler:Anyway, Taubes, seems to deny the basic thermodynamic perspective.

    No he doesn’t. Read the book. He’s very clear on this point. Anyone claiming he is deny the basic thermodynamic perspective are making a mistake.

    The hypothesis Taubes discusses as being open is that refined/starchy carbs encourage people to want to eat a calorific surplus.

    Tim Tyler:The most obvious explanation for the varying levels of weight loss is that the participants consumed varying levels of calories.

    Yes of course, but interestingly, from the method of that study, only low-carbers were allowed unrestricted calories, yet had a large deficit still. Taubes discusses this style of finding.

    My only criticism of the Taubes books is that it is so detailed that it can be dull and hard to complete. He painstakingly covers the history of these issues, the studies involved, the science involved.

  • michael vassar

    Let me aggravate Eliezer’s difficulties by disagreeing with Robin about the critique being damning, for a trio of reasons that I will not disclose at this time, and say that I assign significant probability mass to Taubes’ claims, but not as much as 25%, and that the probability mass that I assign to them is strongly correlated with that which I assign to other controversial medical claims, and more weakly correlated with that which I assign to some controversial non-medical scientific claims. I would also say that Taubes’ claims being correct correlates significantly and negatively with UFAI risk and positively with weakly and positively with risk from gradual civilizational collapse. In any event I express sympathy for Taubes’ being regularly and predictably misrepresented, and I believe, based on interviewing him, that he is actively trying to use the most sound epistemology he is capable of, while largely constrained by poor long-term memory.

    Thanks for chiming in David Brown.

  • http://occludedsun.wordpress.com Caledonian

    Foods high in specific kinds of carbohydrates are natural fuel sources for humans. We are not designed to be able to efficiently extract calories from non-carbohydrate sources. Meat makes us feel full, but doesn’t provide calories efficiently.

    Increasingly in human societies, vegetable and plant matter is expensive while starches and fats are cheap, and activity levels are far below what they once were. The obvious result is that people gorge themselves on nutrient-poor, calorie-rich foods and then don’t burn off the calories, so they become fat.

    High-protein, low-carbohydrate diets aren’t the solution. We know that they affect brain function and do not correspond with the vast majority of ancestral diets. Their only real benefit is that they let people lose weight while not having to restrain their urges, which most humans are incapable of to any real degree.

  • http://www.videogameworkout.com Glen Raphael

    The critique linked to above seems pretty damming.

    Robin, did you read the response from Taubes? If so, did you find it unconvincing? I thought it was pretty strong, especially the part about the USDA study.

    Having read some of the back-and-forth and watched the Berkeley video it seems to me Taubes and his critics (other than Fumento) are often in violent agreement with each other on the underlying facts; the areas of disagreement are speculative and have to do with which of those proven facts are thought to be more relevant to the questions at hand. Or with which facts we might expect to be proven in the future, if we did suitable studies. I like that Taubes is careful to call his thesis “an alternative hypothesis” and wants to do randomized controlled studies to test it.

  • bigfanofnonsenseramblingblogshere

    damning critique? have you bothered reading his response? oh i forgot, too busy writing new posts. way to contribute to the discussion. i’m horrified this nose snub ‘scientist’ gathering doesn’t understand thermodynamics basics. watch the berkeley video and from the explanation of energy equation you’ll understand why he is correct vs the scientist brethren working on fat grants all their lives. i didn’t see in that video fat gorging promotion. maybe atkins was a kook, don’t know didn’t try his diet and banning fruits sound like a dumb idea to me but the premise of what taubes talks about looks logically sound. not bayesian of course because only a few chosen ones can comprehend that. and they’re busy writing new posts and commenting bullshit on the side.

  • Tim Tyler

    Uh: A major reason for the obesity epidemic is the widespread assumption that “it is a simple question of how many calories you consume each day and how many you burn.”David Brown

    Re: Anyone claiming he is deny the basic thermodynamic perspective are making a mistake.

    Well, it’s an approximation. Taubes seems to think there is a metabolic advantage to low carb diets – at least he seems pretty critical of these comments – which present the conventional view that it is mostly calories that matter:

    “the results of several of the [low-carb] studies actually refute the contention that low-carbohydrate diets, in the absence of energy restriction, provide a metabolic advantage for weight loss.”

    If you must get the message that the bottom line is calorie intake out by writing a book entitled “Good Calories, Bad Calories” for goodness sake, let the good calories be the ones in nutrient-dense foods, and let the bad calories be the empty ones.

  • bigfanofnonsenseramblingblogshere

    OMG i just read bray’s ‘critique’. who are these people? are these the specialists that tell americans what to eat and what not? where do you find these geniuses? i wonder if he presented any papers with that logic. i might get on a deep fried chicken diet now just for spite.

  • http://jewishatheist.blogspot.com JewishAtheist

    Tim Tyler:

    Is that relevant? The study was not isocaloric. Each group consumed a different level of calories. The calorie deltas after 6 months were: low carb -560 calories, Med diet, -254 calories, low-fat, -458 calories. The most obvious explanation for the varying levels of weight loss is that the participants consumed varying levels of calories.

    The numbers are staring you right in the face! If the caloric hypothesis were true, we’d expect the low-carbers to do only slightly better than the low-fatters, with both being significantly better than the Med diet. That is not what happened.

    Re: all the numbers are better and there is less atherosclerosis on a low-carb (refined carb) diet

    As I understand it, this is not true. We still know relatively little about the effects of low carb diets – which is part of the reason why nutritionists rarely recommend them.

    Did you not read even the summary of the study I linked to above? Cholesterol ratios were improved the most under the low-carb diet.

    Caledonian:

    Their only real benefit is that they let people lose weight while not having to restrain their urges, which most humans are incapable of to any real degree.

    Even if that were the only real benefit, it’s an enormous one, and probably the single most important factor in long-term weight control. Almost anybody can lose weight once or twice. Keeping it off is a different story. People are too dismissive of those who can’t restrain their urges, as if it’s some sort of moral issue. Try holding your breath until you pass out sometime, resisting the urge to breathe, and you’ll maybe get an idea of what those urges are like for many of the obese and the price they’d have to pay to resist those urges.

    I mean, just think about it. Being obese sucks, so there’s a strong incentive not to be. Obviously, the urges are stronger still than that very strong incentive. Low-carb diets simply eliminate the physical, urgent urges, leaving only psychological ones, which are much easier (although still not easy) to control. You literally never have to be hungry to succeed on a low-carb diet, while restricting calories while eating carbs requires a constant struggle.

  • http://hanson.gmu.edu Robin Hanson

    To be very clear, I do not claim to have mastered this literature. It does seem clear that academic consensus is against Taubes, and a cursory look doesn’t tempt me to deny that consensus. Deviant prediction market estimates here would of course influence me much more.

  • Tim Tyler

    Re: The numbers are staring you right in the face!

    The study is totally hopeless at examining the role of calories in the results. Not only is the study not isocaloric – check out the error bars on the calories at six months:

    Low carb -560 +/-1568, Med diet, -254 +/-761 , Low-fat, -458 +/-1413

    Please wash your mouth out with soap before citing this irrelevant study back at me a third time.

  • http://jewishatheist.blogspot.com JewishAtheist

    TT:

    The error bars is a good point, but low-carbers were specifically told they could eat as much as they wanted, and they still lost the most weight. I think that’s a pretty important finding regardless of error bars.

  • http://stuartbuck.blogspot.com Stuart Buck

    A few points:

    1. The article by Michael Fumento — called “damning” above — wasn’t a review of the book; it was a response to the much shorter NY Times article that Taubes wrote back in 2003.

    2. Taubes’ response to Fumento seems to me to have the better of the case, particularly as to the insinuation that Taubes had misquoted various researchers. http://www.reason.com/news/show/28721.html

    3. You can view Taubes’ book as having two overall themes: A) The conventional wisdom on fat vs. carbohydrates has arisen largely via slender-to-nonexistent evidence viewed through confirmation bias by people who routinely ignored counterevidence; B) The better view is that carbohydrates are largely responsible for obesity and many serious diseases, and here’s a thorough explanation of the biological mechanisms that might account for such a result. B is more speculative and contrarian, and people might differ as to whether Taubes makes the case convincingly. But to my mind, the book establishes A overwhelmingly.

  • sophiesdad

    From the comments, especially those of Tim Tyler, who seems mostly to enjoy seeing his name in print, most everyone seems to be overlooking or ignoring the fact that the “low-carb diet” is meant to be “low refined-carb diet”. No matter what Tim Tyler says, avoidance of refined carbohydrates leads to improvement in blood profiles and reduction of risk-factors for cardiovascular disease, with or without weight loss. While in other academic pursuits it may not hold true, most of my physician colleagues subscribe to the cliche in medicine that those who can, do; those who cannot, teach. Or as one Italian professor told me: “I nefer learn anything; I teach.”

  • michael vassar

    Robin: It seems clear to me that academic consensus is against Taubes… and that academic consensus is against consensus. Consensus among sociologists is that economists are right wing tools of the man. Among economists its that sociologist don’t know anything significant. To physicists there is Among medical researchers, its that medical interventions are highly useful, individually and collectively. Ditto among political scientists, but not among public health experts familiar with RAND and other data. Academic consensus is… great when there is a consensus and an associated track record of practical accomplishment.

  • Julian Morrison

    You can’t validly use the existence of a consensus to condemn a polemic whose stated thesis is that there IS a consensus, AND it is built on blind trust in some really old, really bad science. You aren’t making any claim that he disputes.

  • Thanatos Savehn

    Two things:

    1) many of those who posted above have obviously not watched the UC Berkeley webcast as the issues are addressed and plausibly answered – it’s far from an infomercial for the Atkins diet and anyone who says it is is trying to sell a competing point of view rather than critique the argument; and,

    2) I’m surprised that Robin and Eliezer rush to the defense of the frequentists almost reflexively – did I miss a recent change of hearts? Taubes refers to reproducible science re: genomics and metabolomics – since when is 21st century science automatically dismissed when 20th century frequentist “science” is to the contrary?

  • J Thomas

    Review the bidding.

    Taubes says that the conventional wisdom on this topic is based on inadequate research. Does anyone disagree?

    The claim that you will lose weight if you absorb fewer calories than you expend, and you will gain weight if you absorb more calories than you expend is clearly true. Further, it is more useful than the stock market advice to “buy low, sell high”. But it might not be useful enough. So for example David Brown is clearly right that we do not absorb all the calories we eat. It isn’t controversial that we don’t absorb all the fat, for example. You might eat more calories with one diet and still absorb fewer. And figuring out how people can get themselves to eat less might be a big deal. Telling people to eat less is better than telling them to buy low, but maybe not enough better.

    It’s obvious that not all foods provide the same health benefits. If you were to go on a vinegar diet, and you drank enough vinegar to gain weight on that diet…. Is it plausible that perhaps refined foods with a lot of carbohydrates might tend to be unhealthy, eaten to excess? Sure. How do we find out how much is excessive? Maybe the controlled studies that Taubes wants to do and which have not been done?

    There’s no particular reason to decide any known diet is right at this point. If refined carbohydrates are particularly bad for you, then an Atkins diet might be better even if it’s bad for you in some other ways. Something different might be better still. We won’t find out until we look.

    Have I said anything controversial? If not, what is the argument about?

  • Douglas Knight

    A common problem is that experts lie about consensus. I’m not talking about competing communities of academics, the way michael vassar is, but smaller groups that might be expected to have a consensus. Often equal sized groups claim consensus without acknowledging the other’s existence. They might do it to improve the credibility of their claims to outsiders, but they fail to acknowledge the other group even within the community, so it may be simple ignorance. Stuart Buck’s pair of claims represent two such communities, I believe.

  • http://occludedsun.wordpress.com Caledonian

    A common problem is that experts lie about consensus.

    An even commoner problem is that people pay attention to consensus when they shouldn’t. Without sufficient evidence to support the position in question, a consensus is just a majority making an error. Who cares what the experts say if they cannot back up what they say with reasoned argument?

  • Some Random Economist

    One thing that Taubes is right about is that a lot of research into diet is poorly done and the consensus is not always supported by science. Studies that support the consumption of whole grains compare eating whole grains to eating processed grains, without considering potential selection biases. The consensus in favor of numerous small meals each day seems unaffected by growing evidence (at least from experiments on animals) that eating as irregularly as every other day, even holding calories constant, can be beneficial.

  • http://www.nancybuttons.com Nancy Lebovitz\

    I suspect there’s a bias towards telling people to do things they don’t want to do. Part of it is that if there’s no drama in what you’re saying, who’s going to listen? And I suspect that cutting people off from their choices and pleasures is a status marker, and has its own satisfactions.

    If I’m right about any part of this, then there will be a bias towards recommending extreme dietary changes.

    And what if fatness isn’t a good measure of health or the lack of it?

    I remember the first time I read the theory that arteriosclerosis might be a matter of infection and inflammation. The idea that it might *not* be a moral issue about people living wrong was surprisingly hard for me to assimilate.

  • http://www.blogger.com/profile/25595105 Crush on Lyle

    The health effects of how much fat you eat and what kind may be an open question, but I’ve never seen convincing evidence that weight gain/loss isn’t in the end a matter of number of calories (in and out). Studies that suggest otherwise are usually based on subjects self-reporting their intake. I’d bet that, in terms of comparing low-carb vs. low-fat diets, the subjects on the low-fat diets would be more likely to underreport (quite possibly unawarely) because they’re hungrier than the people on the low-carb diets.

  • Katherine

    Hi Folks, This is the first time I’ve seen your website and it’s fascinating. I’ve read the Taubes book about five times (no kidding) and I am conducting an online discussion about the book with a bunch of friends: Professor heart patients, Diabetic scientists, High cholesterol engineers, obese librarians. Smart, well-educated people suffering from what Taubes calls the Diseases of Western Civilization. Having read the book so many times, having conducted so many discussions about the book and having my own experiences this is what I can tell you: 1) It’s an amazingly well-researched book: thorough, comprehensive, critical, relevant. A beautiful example of research. 2) Taubes anticipates and has an answer to every one of your comments about calories, nutrients, metabolism, body-type, will-power, hunger, genetics, environment, evolution, scientific rigor and credibility, the appropriateness of epidemiological studies, researcher bias, specialization within medicine, diet(s), conservation of energy, exercise, cell structure and energy, adipose tissue vs muscle tissue, inflammation, the “Moral” issue of “not living right,” homeostasis, scientists afraid to argue with consensus, government policy and funding. Really. All of that and more. 3) I’m frankly appalled at the number of people who are so fast to attack Taubes without having actually read the book. Skepticism is essential. But being dismissive without actually doing the reading? Well, that’s just . . . stupid. And a horrifying example of bias. You have questions about the book, about the quality of the research, about the argument, well, then READ IT. –Katherine

  • sophiesdad

    Katherine:

    If there were a God, I’d ask him (her) to bless you.

    • Julie

      There is a God…

  • http://profile.typekey.com/halfinney/ Hal Finney

    My problem is, why can’t I trust the people I pay to be experts on this topic? My taxes go towards all kinds of scientific research and grants that are used to fund researchers who spend their entire professional lives developing expertise in this area. Why should I have to second-guess them, to become an instant expert myself, to seek out and read scientific papers, review articles, discussions of people’s personal results?

    Why is it that I, or Gary Taubes, can read the literature and learn the truth, while a professional with far more experience and knowledge than either of us is unable to do so? This is the fundamental paradox I run into again and again on controversial topics.

    Two possible answers are, A, you can’t, so trust the experts; or B, the experts are committed to the conventional wisdom and institutional forces prevent them from acknowledging the truth, while you are free from such prejudices. All I can really say is, I’ll be really angry if B turns out to be true. Why should I have to do every damn thing for myself? Why can’t I live in a world where people have a reasonable level of competence, where experts actually have expertise? For now, I just hope that A is correct.

  • sophiesdad

    Mr. Finney: There is also answer C: I am unable to understand the topic, so I must rely on the experts.

    I came to this blog relatively recently because of a referral from the Singularity Institute, where the opening page reads: “All it takes is one technology – Artificial Intelligence, brain-computer interfaces, or perhaps something unforeseen – that advances to the point of creating smarter-than-human minds. That one technological advance is the equivalent of the first self-replicating chemical that gave rise to life on Earth.”

    If this statement is accurate (under answer C, I am forced to accept it), and if the leading (and only) research fellow at the SI is busy participating in morality blogs and deciding whether participants are trolls, I certainly hope that this seemingly irrelevant activity will somehow lead to the solution of the most important dilemma to occur since chemical replicators. And I hope it does so rather expeditiously, since I’m almost 62. I’d do it myself, but I don’t know how.

  • J Thomas

    Crush, I believe that you are right that weight gain is a matter of calories in — calories out.

    But let me make a metaphor — stoichiometry in chemistry always works. Aftera chemical reaction you always have the same numbe of atoms, and you always have the same number of each kind of atom.

    It’s always true. But nobody thinks that’s the whole story.

    If you need 1200 calories to maintain your weight, you have to get them somehow or you’ll lose weight. If you aren’t losing weight, somebody who follows you around and records what you eat will find you’re eating at least that number of calories. But it makes a difference to your health what you eat. 1200 calories of salad dressing is different from 1200 calories of wheat, or 1200 calories of cabbage, or 1200 calories of cow muscle tissue. The number of calories is not the whole story.

  • JohnN

    Mr J Thomas asks:
    “Have I said anything controversial? If not, what is the argument about?”
    Perhaps it is about Incommensurability? Per Thomas Kuhn: the ovelapping of successive paradigms.
    It is my personal belief that we’re approaching such a shift in paradigm with the publication of GC/BC.

    “It isn’t controversial that we don’t absorb all the fat.” I’m not trying to pick on Mr Thomas but only use this to make a larger point:

    Perhaps it’s true for Olestra (an artificial fat) but people adapted to a high fat diet (the Inui, the Masai ot the Kaniewski’s Optimal Diet) have very efficient conversion rate for fat intake.

    Conversely,excess protein intake beyond what’s needed for cellular repair/rebuilding must be converted to glucose by the liver through a process called gluconeogenesis before the body can use as energy. This is an inefficient conversion process with significant amount of energy wasted as heat (thermogenesis). The reason behind eating protein promotes satiety?

    Additionally, a large portion of the carbohydrates we take in (especially “indigestible” fiber) is actually “processed” by the gut microbiota and converted to fat for storage and our later use – an extremely efficient energy conversion process.

    From PubMed:
    “The gut microbiota is an important environmental factor that affects energy harvest from the diet and energy storage in the host.”
    http://www.ncbi.nlm.nih.gov/pubmed/15505215?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=2&log$=relatedarticles&logdbfrom=pubmed

    In short, people who rely on the all-too-convenient and mis-applied Laws of Thermal Dynamics make some critical false assumptions about how the body (our body, as the host, and the trillions of microbes that colonize our intestines) process the food intake.

  • Katherine

    Experts are necessary because the world is simply too complicated for one person to understand everything that we need to know to be competent citizens. But that doesn’t mean that we stop thinking critically. If anything, it means that we must be really, really good at critical thinking. If I listen to a bunch of “experts” — let’s say nutritionists, dietitians, doctors, advertisements for billions of dollars worth of low-fat foods, newspaper and magazine reporters, government recommendations and policies — and they all say the same thing: fat is bad for you; meat is bad for you; high-fructose sugar is better for your blood sugar levels; yadda, yadda, yadda, then there appears to be a consensus. And consensus can be awfully compelling. But what if all that expert advice just doesn’t seem to working in the real world?

    This is what a good friend of mine eats: cold cereal with fat-free milk for breakfast. An “energy” bar and an apple (plus a banana if he’s really hungry) for lunch. A salad with some chicken or salmon for dinner. That diet is almost nothing but carbohydrates: Grains, fruits and vegetables. He plays softball every summer. He golfs and runs. He is not overweight. He had a heart attack at age fifty. Everyone I know drinks low-fat milk and eats low-fat yogurt. They’re all eating fiber. And they all have at least one symptom of Metabolic Syndrome: high blood pressure, diabetes, hyperinsulinemia, heart disease, obesity, high LDL levels, low HDL levels, inflammation. These are all good people who are trying their best.

    And, so I start my critical thinking engine: it can’t simply be a matter of will-power; these folks have plenty of will-power. It can’t be about eating fat and meat because they aren’t eating fat and meat. It can’t be about lack of exercise because they exercise. It can’t be about genetics because they had slender grandparents. Okay. I’m not an expert on this stuff, but it sure seems to me that the so-called experts aren’t either. Maybe there’s some other theory out there that I haven’t heard about? Maybe it would be worth my time and trouble to read what the fringe has to say. And, so, I pick up a copy of “Good Calories, Bad Calories” and my entire understanding of human metabolism changes. AND, I see Thomas Kuhn’s “The Structure of Scientific Revolution” at work. But I am, by nature, a skeptical person. I really did read Taube’s book five times. I really did do other reading on the same subject. I really did ask some very pointed questions of my doctor. I really did try to think of all the objections to Taubes’ argument and see how he dealt with those objections.

    I’m convinced that Taubes is right. But that conviction is based on critical thinking. The problem with a lot of experts that they don’t do enough critical thinking about the basis of their own expertise. Well, the problem with the human race is that we don’t do enough critical thinking.

    I think that experts are necessary: I don’t know how to build a computer, I don’t know how to feed the poor, I don’t know how to make solar energy economically viable. And I depend on experts to provide me with information. But that doesn’t mean I’m allowed to shut off my mind. Just the opposite, it means that I am obligated to think critically about that information, to make sure that it’s “good:” accurate, relevant, reliable, timely, unbiased. There’s no shortage of information, folks. It’s always been a question of quality rather than quantity.

    The thing is, I’m not saying anything original. Critical Thinking should be the goal of every single class, subject of inquiry, college course, book, scientific research project, blog, artistic endeavor, newspaper, website, human mind in existence. Everything else is just noise.

    Thanks, Sophie’s Dad, for the blessing. My particular brand of critical thinking has lead me to be an Atheist. But I think blessings come from people anyway.

    I realize that I’ve taken an awful lot of time and space for someone who’s just joined the discussion. I don’t get to discuss these matters very often, so I’m, Uh . . . enthusiastic.

    –Katherine

  • http://www.blogger.com/profile/25595105 Crush on Lyle

    J Thomas, I agree that what makes up those 1200 calories makes a difference, absolutely, for long-term health; I was just questioning the claim that people could eat more calories on a low-carb diet and still lose more weight. (Although, eating carbs does cause you to retain more water, so you can lose a little more “weight” on a high-protein diet, but it’s just water weight.)

    Katherine, in Okinawa the average diet is naturally low-calorie and low-fat, and Okinawans have some of the longest life spans on the globe. So I don’t think low-fat diets cause heart attacks. Michael Pollan has written interestingly on the matter of why our grandparents were slender and we are not.

    It hasn’t been proven with humans, but calorie restriction lengthens life span in every other species tested (provided adequate nutrition).

    I certainly hope it doesn’t turn out that saturated fat and high-protein diets are required for heart health, because I eat a vegetarian diet for environmental/sustainability reasons.

  • J Thomas

    Crush, I agree with you right down the line, I think. There is the side issue that the more you have to transform a food to absorb it and convert it into storage materials, the more energy you’ll use doing that. So to convert protein into glucose and then into fat takes more steps, plus you have to get rid of more toxic waste products. Less net calorie gain.

    To efficiently use fat you (often) first have to chew it well enough, then produce enough bile, then it must be broken down some before it can be transported, then rebuilt, etc. I don’t know how much metabolic cost that is, but it might make a measurable difference. Also when there is sufficient carbohydrate present the transport of fats might be somewhat inhibited. We tend to adapt to take the easiest nutrients first.

    There’s some reason to think that details beyond the number of calories that go into your mouth may make some difference. The questions are testable and I’m not familiar enough with the literature to know how well they’ve been tested. Ideally we’d want long-term studies that see how quickly and how thoroughly people adapt to a change of diet, since we’re interested in maintenance diets more than initial-effect diets.

    I agree that the Atkins claim that you can eat more calories than you would on a high-carb diet and still lose weight appear to be uninformed. I can do some handwaving to say they might be true, but I certainly wouldn’t claim they are true.

    The Atkins claim that many people feel satiated when eating fewer calories on a low-carb diet also might be true, and it might be truer for some people than for others.

  • Sociology Graduate Student

    Katherine, your writing is compelling. Care to reveal your identity?

  • http://zbooks.blogspot.com Zubon

    Given this site, the meta-issues are probably more on-topic than actually disputing the content (although we always support correcting false information). I hereby commend the following comments and award seven points to each:

    When people challenge the establishment, 99.9 per cent of the time they are wrong. If I was writing about me, I’d begin from the assumption that I am both wrong and a quack. – Gary Taubes, via James Ord, original post

    No he doesn’t. Read the book. – David Crookes, and You have questions about the book, about the quality of the research, about the argument, well, then READ IT. – Katherine

    My problem is, why can’t I trust the people I pay to be experts on this topic? (and following comments – Hal Finney

    The meta-meta-discussion is also good, from Robin Hanson, Eliezer Yudkowsky, and Stuart Buck.

    I note these, instead of jumping into the debate, because more important (here) than which theory is right is how we would figure out which we should believe is right. An example of error or bias is like a story problem: working out the specifics is good and interesting, but the generalizable concept is what really matter. Just so we don’t get lost in the weeds.

    (And in those weeds, I think the best points are: (1) calorie intake/burn is the biggest thing; (2) smaller things may also be important; (3) certain diets may ease changes in calorie intake, such as appetite suppression cited by Atkins or Seth Roberts; (4) I like Tim Tyler’s citation of error bars.)

  • Katherine

    Hi Crush on Lyle,

    Actually, Taubes covers these issues very thoroughly. The relationships amongst the number of calories, the content of those calories, hunger and weight loss are addressed in the final third of the book. He also spends some time analyzing the studies of the Okinawan diet and explains how high-carb / low calorie diets work. There’s a chapter on calorie restriction and extended life span studies. He provides extensive evidence of the differences between the diets that our grandparents ate and that we eat. He covers the relationship between the high carb diet and heart disease. He explains exactly what cholesterol is (I loved the information about “big fluffy” cholestrol. I turns out we all want our cholesterol to look like children’s bedroom slippers). It’s not about how much fat one eats; it’s about how LITTLE refined carbs one eats. Honestly, folks, you have yet to come up with a question, issue, objection, concern that Taubes doesn’t address. Read the book.

    –Katherine

  • Katherine

    Hi Soc Grad Student. Thanks for the complement on my writing. I have a PhD in English Lit and I read a lot, but I’m not associated with any academic or research institutions. I like to spend time thinking about the many ways the human mind messes with itself and I’m amazed to find an entire website devoted to just that. –Katherine

  • Crush on Lyle

    I was never specifically attacking or responding to Taubes, just comments within this thread. So why the imperative to read the book? Apparently some of Taubes’ fans are misrepresenting his claims.

  • Tim Tyler

    Re: I’m frankly appalled at the number of people who are so fast to attack Taubes without having actually read the book. Skepticism is essential. But being dismissive without actually doing the reading? Well, that’s just . . . stupid. And a horrifying example of bias.

    I haven’t read Taubes’ book. But I have read other things by Taubes and about his work – and they do not inspire confidence in him anywhere near enough to actually do so. IMHO, such a perspective is neither stupid, nor horrifying – it’s a simple example of the use of a filter.

    Similarly, I’ve never read “Shadows of the Mind” – but I am confident that it’s a pile of crap.

  • michael vassar

    Thanks Zubon. Important points. I’d like it if you were to put together a post on this point, or at least a comment near the top of an open thread.

    Katherine: It’s great to see you here. Hopefully you will comment more elsewhere.

  • B.H.

    I am hoping that Taubes devotes his next book to anthropogenic global warming. I expect the result would be just the same: billions of dollars of federal money and a closed minded establishment with an ideological ax to grind generating massive amounts of confirmation bias. I hope the death count is not the same.

  • maurile

    Robin Hanson is biased in favor of Reason Magazine (as am I), so he is unduly inclined to trust the Fumento critique. He shouldn’t — for all the reasons stated in Taubes’s response.

    The fans of evolutionary biology here should be receptive to the idea that humans are well adapted to eating foods found in their ancestral environments (e.g., red meat), and not well adapted to eating founds not found in their ancestral environments (e.g., refined carbs).

    The fans of empiricism here should read Taubes’s book.

  • sophiesdad

    re :Maurile

    The most parsimonious and ultimately correct post on this topic. Generation X, as a gross generality, has developed the blog mentality that knowledge is gained by the process of commenting on comments. One must only skip from blog to blog, and topic to topic, to see that we have a nation of experts on everything, including books that they have not read.

  • http://www.majesstix.com/ebook/index.php Michael Danielson

    I was just questioning the claim that people could eat more calories on a low-carb diet and still lose more weight. (Although, eating carbs does cause you to retain more water, so you can lose a little more “weight” on a high-protein diet, but it’s just water weight.)

    It’s absolutely true. When your body is using carbohydrate metabolism for it’s fuel, it burns any carbohydrates in your blood stream for energy — and any left over go first to restore the glycogen balance in your liver (for stresstime bursts of energy), and then go through fatty-acid synthesis and get stored as fat.

    When your body is using fatty-acid metabolism for it’s feul, any fatty acids in your blood stream get burned for energy — but leftovers aren’t kept around for later unless your body is already so low on stored fat that your body deems it necessary. If you have fat stored, your body excretes those extra fatty acids as ketones in your urine, eliminating those extra calories from your body.

    As such, you can eat more calories and still lose weight – because your body isn’t hoarding all of the calories you eat.

    Testimonial: my wife has lost more than 60 pounds over the last year by eating a low-carb diet at the behest of her nutritionist — and she’s overcome asthma, infertility, sleeping disorders, PMS, and her pet allergies at the same time, just because of the change in her diet. She literally hasn’t changed anything else about her lifestyle (except to get pregnant and start taking prenatal vitamins — but that came after all of the other positive changes she experienced).

    Since I started seeing the changes in my wife, I’ve gotten together when her nutritionist and offered my services as a writer. We were both so thrilled to read Good Calories, Bad Calories, because it reinforced everything that she learned in her nutritionist’s certification classes. We’re hoping to take advantage of the “break” in the wall of Common Knowledge (TM) to get the truth out there.

  • Tim Tyler

    Re: you can eat more calories and still lose weight

    Most of the empirical evidence we have on the subject suggests otherwise – e.g.: Study examines calorie restriction and glycemic load

    Macronutrient ratios are mostly irrelevant – provided they do not lead to malnutrition. Calories are the bottom line.

  • J Thomas

    Tim, that study doesn’t do what you want.

    They carefully arranged that all participants had the same reduction in calories, enough to ensure weight loss, and they found that they then got about the same weight loss. They threw out of the sample people who showed evidence they got extra calories. This is entirely predictable — if you don’t get enough calories to maintain your weight, you will lose weight.

    This does not test the idea that some diets might result in weight loss even when the total number of calories is higher — that on some diets some calories are wasted. That could be true or false independent of this.

    And it does not test the idea that some diets might encourage people to stop eating sooner. They claim they figured out how to get that effect with all the diets they tried. That last part is what I found interesting about the study. If they actually got a variety of prepackaged foods that left people feeling satiated with considerably fewer calories, they’re in a great position to market those packages. When will their company go public?

  • Tim Tyler

    The most important type of study for investigating whether factors other than calories influence weight change are isocaloric ones. Eliminating the main dependent variable helps illuminate any other factors.

    You do not then need additional studies to show that adding calories to a given diet results in an average increase in weight – we already know that – from diet 101.

    Re: it does not test the idea that some diets might encourage people to stop eating sooner

    Indeed – but I quoted the point I was addressing.

  • J Thomas

    The most important type of study for investigating whether factors other than calories influence weight change are isocaloric ones. Eliminating the main dependent variable helps illuminate any other factors.

    Sure, but if you set the calories low enough that anybody who sticks to any of the diets is guaranteed to lose weight, then it isn’t a surprise that the people who stick it out and stay in the study lose weight.

  • ielerol

    I wish I’d gotten here in time to refer people Junkfood Science. It has a lot of interesting information on [http://junkfoodscience.blogspot.com/2008/07/round-eleventy-seven-in-diet-wars.html|that low-carb vs. low-fat vs. mediterreanan diet study,] the importance of [http://junkfoodscience.blogspot.com/2008/08/were-not-eating-so-badly.html|exercise to weight loss,] and the entire non-existent [http://junkfoodscience.blogspot.com/2008/08/jfs-special-report-obesity.html|obesity epidemic.]

    Genetics cause obesity. Genetics, and a few medications and endocrine disorders. Period. The difference between weighing 140 and 160 pounds? Probably partly environmental, possibly within your control. The difference between weighing 140 and 240 pounds, maintained over a period of years? Almost certainly genetic. Everybody loses weight on diets, and then, everybody gains it back.

  • ielerol

    …and doing most of your internet communicating in a specialized community with a unique linking style causes stupid mistakes when you post in other places. That and allowing nearly everything that is both conventional and unconventional wisdom about the relationships between eating, weight, and health, get your blood pressure up.

    The links: diet study
    I could like you to fifty other posts with the same point: nobody maintains weight, they only get significant results because the study ends before the regain has plateaued. Here’s one that looked at exercise.

    And then, of course, the epidemic that isn’t

  • http://stuartbuck.blogspot.com Stuart Buck

    Everybody loses weight on diets, and then, everybody gains it back.

    Not if they stick to eating healthily, they don’t. There’s no property of biology that would make you lose weight for a while, and then regain it all back, if you’ve been eating the same healthy diet the entire time.

    The difference between weighing 140 and 240 pounds, maintained over a period of years? Almost certainly genetic.

    What’s the genetic change that has rapidly occurred in America over the past few decades? I thought evolution couldn’t work quite that quickly.

  • http://www.videogameworkout.com Glen Raphael

    Robin asked:
    So can someone summarize the single strongest piece of evidence on this subject?

    I’m only partway through GCBC, but this bit fairly leapt out at me: The “Multiple Risk Factor Intervention Trial” (MRFIT). Researchers chose twelve thousand men whose cholesterol was so high they could be considered at imminent risk for a heart attack. These were randomly divided into a control group and a treatment group. The controls were told to live, eat and address their health problems however they liked; the treatment group was advised to quit smoking, take medicine to lower their blood pressure, and eat a low-fat, low-cholesterol diet (drink skim milk, use margarine instead of butter, eat only one or two eggs a week, and avoid red meat, cakes, puddings and pastries).

    In 1982 results were announced: there were slightly *more* deaths in the treatment group than the control. Taubes adds in a footnote “In 1997, the MRFIT investigators also reported that the men in the treatment group subsequently had more lung cancer than the controls. This was despite the fact that 21 percent of the men had quit smoking in the treatment group, compared with 6 percent in the treatment group.”

    One way to put a positive spin on that result is to note that “risk factors” declined in the test group and that that group had fewer deaths specifically attributed to heart disease (as opposed to, say, cancer). Another way to spin it is to carefully cherrypick – find an excuse to exclude subgroups that died a lot so you can claim the unexcluded remainder of the test group eventually did better due to late-acting benefits of intervention. (All of those tricks can be seen here) The fact remains that this is exactly the sort of study that should have been able to powerfully show the strength of (aspects of) the conventional wisdom on diet…were that view correct. And it didn’t. Yet the consensus remains.

  • Tim Tyler

    “Conclusions: After 6-8 years of followup, risk factor levels declined in both groups but slightly more in the special intervention group. Mortality from coronary heart disease and from all causes was not significantly different among the two groups.” – MRFIT description.

    Being encouraged to cease cigarette smoking, taking drugs, and being advised to follow a diet with 30 percent to 35 percent of calories from fat apparently had little effect on CHD or mortality in those high-risk patients over 6-8 years.

  • http://www.jeffevans.us/ Jeff

    Crush, you said, “I’ve never seen convincing evidence that weight gain/loss isn’t in the end a matter of number of calories.” Well did you read the book? The strongest and most comprehensive evidence I’ve seen against this is right there in the book.

    A few main ideas which are covered in detail First, different types of macronutrients require different metabolic pathways to metabolize and thus result in different net energy for the body. Second, different types of macronutrients affect hormonal and digestive processes governing appetite and fat accumulation among many other effects. Third, the number of calories “burned” or consumed by the body is not independent of the number of calories consumed – to the contrary, the output is an increasing function of the input. Fourth, there is a dearth of experimental and clinical evidence to support the “calories in, calories out” hypothesis and many well controlled trials have demonstrated weight loss in subjects consuming more total calories with different macronutrient ratios.

    Really, it’s all there in fascinating detail. Once you go through it come back with your objections and it will become a very interesting discussion indeed, because I’ve yet to see any valid rebuttals to his arguments in the book.

  • Tim Tyler

    many well controlled trials have demonstrated weight loss in subjects consuming more total calories with different macronutrient ratios.

    References? Preferably for diets that do not involve malnourishment.

    There is evidence that carb macronutrient ratios are mostly fluff from the CALERIE trial.

  • Mary

    Thank-you Gary!

    God bless, you! You’ve finally cleared up for me much of the confusing diet info I’ve encountered in my 60 years of living. Two years ago, I lost weight on Cheryle Hart’s “The Insulin Resistance Diet” (which limited me to 30 grams of carb per meal), dropping from 201 lbs to 145. It was relatively easy, and I lost the extreme craving for sweet carbs that had previouly driven my eating. But during this period I discovered at a screening that I was diabetic and, having no medical insurance and refusing to take meds anyway, I tried to bring my blood sugar down with healthy living. But my numbers stubbornly remained in too high, despite a diet with limited whole grains and beans and lots of exercise (my blood glucose would fall precipitously after exercise but would be back up the next day). I was so discouraged! Then I read your book and decided to try the protein and vegetables diet I’d been so warned against by the “experts” thirty years ago.

    Wow! I’m losing weight again (I should weigh about 130 lbs) and my morning glucose readings are in the normal range. Thank-you, Gary, for giving an old woman with no money to toss at expensive doctors a second chance at health — or at least, at avoiding some of the terrible complications that come with diabetes Type II.

    I think you should get a Noble Prize for wading through all that medical literature and drawing the logical conclusions that experts in their own field couldn’t or wouldn’t see. How sad! It’s like all those law enforcement agencies that miss terrorists and criminals right under their noses because they won’t cooperate with one another!

  • http://drchip.wordpress.com/ retired urologist

    Kudos, Mary.

  • Colleen

    As just a humble citizen trying to Think Critically, as Katherine urges, I find this discussion fascinating. I’m only halfway through the Taubes book (which I picked up after hearing an interview with him on NPR) and already I can see in these posts many examples of the conventional-wisdom bloc putting up a stiff resistance, as well as many thoughtful arguments from persons with much more formal education than me.

    You can argue that there’s no evidence that restricting highly-processed carbs improves health, but there sure isn’t any evidence that they’re good for you, so my family’s dietary journey is going to be veering in the direction of reducing said carbs. We have a good head start since we eat a lot of vegies and have always eschewed soft drinks and fast food, but it’ll be interesting to see what happens when I switch away from fat-free yogurt and salad dressing and (gasp) actually add beef, bacon, and butter (instead of I Can’t Believe It’s Not Butter Light) to our diet.

    I would like to mention that the little documentary “King Corn” might have something to add to this discussion, especially in showing how market forces reinforce the status quo.

  • Julia

    “Everybody loses weight on diets, and then, everybody gains it back.

    Not if they stick to eating healthily, they don’t. There’s no property of biology that would make you lose weight for a while, and then regain it all back, if you’ve been eating the same healthy diet the entire time.”

    I only have to look at Oprah to see that weight is not a psychological/socioeconomic/willpower issue. She is in front of millions of people every day – therefore she has the motivation to lose weight. She has a personal chef who cooks lowfat meals for her. She has a personal trainer/nutritionist (Bob Greene) who touts the conventional low-fat, complex carbs, low meat diet. She runs, or otherwise exercises 6 days a week for an hour a day (she’s said on her show). She has access to some of the top thinkers/psychologists/religious people in the world to help her with her “issues” and “emotional baggage” that so many “experts” say cause us to overeat. And yet she cannot control her weight. That right there tells me that there is something more at work in the weight debate – something other than the morally simplistic and self-righteous lack of willpower, the lack of access to so-called “healthy foods”, the lack of time to exercise and cook a “healthy” meal.

    The thing I don’t understand is why people will not even accept the possibility that there could be a biological cause for being overweight? Why people are so invested in it being a moral/lack of willpower issue? What the hell is “willpower” anyway? Is it related to this “positive thinking” movement that has infected our culture that apparently allows people to overcome cancer and other diseases through the right mindset – so that we can therefore blame the victim, yet again – i.e. the cancer patients for dying because they weren’t positive enough and didn’t “will” themselves to heal? Mind over matter?

    I think asking questions and getting a dialogue going without all this dogma and self-righteousness (I’m better than you are because I’m thin and therefore smart, hardworking and entitled, and you? You deserve to be fat because you’re dumb and lazy – and you’re not allowed an opinion!) – is a good thing.

  • Conall Boyle

    I loved this discussion. Like Katherine I have read GCBC 3 times (over here in the UK it is titled The Diet Delusion – no idea why it had to change!) I have been waiting for this book for years. My son used to work on the website of The Lancet; I asked time after time to encourage the Editor of Lancet to do what we must now call a ‘taubes’. No luck there.

    As I see it only 2 scientific critiques of Taubes’ work have appeared: one by Bray the other by Latifumo (I may have mis-remembered the name, but it was a nasty ad hominem piece of work.) Both critiques have been, in my opinion, comprehensively shot to ribbons by Taubes. (and both were about his 2003 article, not the book). So where is the rebuttal? Why doesn’t the scientific establishment choose to defend their wisdom?

    For me it is the Sherlock Holmesian deduction of the ‘dog that didn’t bark’. The deafening silence of the medical science experts means that IT’S ALL TRUE! (sorry for the caps, but I’m experiencing an amazing awakening similar to that which I experienced after reading Ivan Illitch). What Gary Taubes says is true, valid, correct. Thank you GT for spending 5 years delving through the literature. Thanks you Englishman Berners-Lee for inventing the internet, without which GT’s research could never have been carried out.

    And yes, maybe GT should examine global warming – cause, effect and response.

  • Troy

    eat a balanced diet of carbs, proteins and fats (and not excessive amounts of any of them). excercise often. use common sense.

    and you too can be fit and healthy.

    amazing.

  • http://retiredurologist.com retired urologist

    @Troy: eat a balanced diet of carbs, proteins and fats…

    Nope. That’s the establishment talking, not Taubes.

  • FatThinFatThin

    I’ve experimented with food intake and exercise. Stopped daily exercise and watching what, how much, and when I ate. Didn’t change what I ate, though. I tended to eat a bit more I guess. Had another serving here and there. The portions may have become 1.2-1.5x. Did this for 6 months. Good news: I got visibly fat, as I suspected. Gained about 25 pounds. Returned to the regimen. Got thin, but it took me 8 months.

  • http://rhollerith.com/blog Richard Hollerith

    Englishman Berners-Lee invented the web, not the internet. The internet was already an important vehicle for free speech when Berners-Lee started asking for volunteers to run his web-server and web-client software. For the internet, thank the U.S. Department of Defense for the funding and the managerial vision and eight or so computer scientists and grad students for insights and decisions that caused it to turn out so well.

  • Karl

    Yes, low calorie diets work – but few can stay on them because you will be constantly hungry. The low carb diets – particularly avoiding any high glycemic foods – allows one to not be hungry all the time which helps people actually stick to the diet.

    I tried low-fat and low-carb and was hungry to the point that I purposely went to bed hungry because it was easier to tolerate while asleep. I still failed to lose any weight.

    After reading Taubes book (and noticing the finger-prints of the carbohydrate lobby on defunding key research) I started a low-carb diet and lost and now maintain a healthy weight (with ease). I don’t feel chronically hungry, fatigued and grouchy like I did on a low-cal diet. A low-carb diet has much more vegetables in it than the typical US diet.

    Early man did not eat high glycemic food on a regular basis – he ate lots of meat as the size and type of his bones show.

    If you haven’t actually read Taube’s book, please refrain from making statements about what is in the book as many of the above posts are dis-informative and misleading.

  • Lisa in SRQ

    I haven’t read Taubes’ book yet. I found this site from googling to view various reviews before purchasing the book.

    Reading these differing comments has made the book a must-read for me now, so thanks one and all for that!

    I didn’t see the metabolic advantage of very low-carb diets mentioned in relation to the amount of calories consumed across the 3 groups: low carb/low calorie, low fat/Mediterranean. Very low carb forces the body to burn fat for fuel. If I’m not mistaken, in order to burn fat while the intake of carbs is high, you would have to first deplete the 13-hour glycogen store in the liver before your body would begin burning fat. With low carb, the body is primarily burning fat for fuel all the time — even when sleeping. The limited amount of carbs fuels certain portions of the brain, but the rest of the body does quite well making the switch from burning carbs to burning fat, both dietary and stored in fat cells. Atkins isn’t a high protein diet. It’s a high fat diet.

  • Mason

    “the Okinawan diet is naturally lowfat”

    Not true. Free of the longtime Buddhist influence on the Japanese “mainland” (Honshu etc.), the Okinawan islands have a diet much like that of the Phillipines, i.e. plenty of animal protein in the form of pig and goat (and they famously use EVERY part of the animal as well). That said, they also consume plenty of seafood and claim that the bitter melon is an important part of longevity.

    So given that Okinawans eat more animal meat and bitter melon than the average Japanese, maybe that’s what Americans should be eating too. ;-)

    Oh wait. The second longest average lifespans (by nationality) belong to the Swiss, who famously eat a lot of cheese and chocolate. Or we can look at isolated communities in the Caucasus and Bulgaria, where the centenarians swear by the benefits of fresh yogurt.

    It’s all so confusing!! Well, one thing we know for sure — a diet high in saturated fat (percentage-wise) is not necessarily associated with early vascular issues, unless of course you refer to the chemically-laced, factory-farm-derived products that we find in the average supermarket here in the US.

  • Don

    I have been twenty pounds or so overweight for 10+ years. I consumed large amounts of carbohydrates in the form of sugars and processed grains. Five weeks ago I removed all processed carbs from my diet and total carbs now make up about 20% of my daily caloric intake. I have lost 21 pounds in this short time, never feel hungry and have more energy than I’ve had in years. You guys can continue arguing but I’m living proof of Taube’s arguments. I will never go back to eating carbohydrates.

  • RobertS

    I’m obviously a bit late to this discussion. I just finished reading GCBC, and IMHO it is the best investigative journalism I have ever read. After reading some of the comments dismissing essentially the highlights of the blog’s review, and possibly some of the interviews, I am wondering if some of those that did not actually read the book have taken the time to do so. I find it particularly interesting that the same dismissive attitude evident in some of the above comments is the exact same reason current nutritional guidelines have evolved as they have.
    Katherine thanks for your comments. You really hit the nail on the head:-)

  • eg

    The “a calorie is a calorie is a calorie” theory would be all fine and good were I a bunsen-burner, calorimeter or other such device. As I am not, the theory is insufficient.

    Furthermore, given a choice between the nutrition-experts and the biochemists, I’ll take the latter, thanks.

  • Pingback: The Shrubbloggers » Whole30x2: Day 20