Myths About Fat and What to Do About It

[salvorhardin]

Harriet Hall reviews Gary Taubes' book Why We Get Fat: And What To Do About It and finds it lacking. It's somewhat lengthy so here's just the start:

Journalist Gary Taubes created a stir in 2007 with his impressive but daunting 640-page tome Good Calories, Bad Calories. Now he has written a shorter, more accessible book Why We Get Fat: And What to Do About It to take his message to a wider audience. His basic thesis is that:

* The calories-in/calories-out model is useless.
* Carbohydrates are the cause of obesity and are also important causes of heart disease, type 2 diabetes, cancer, Alzheimer’s, and most of the so-called diseases of civilization.
* A low-fat diet is not healthy.
* A low-carb diet is essential both for weight loss and for health.
* Dieters can satisfy their hunger pangs and eat as much as they want and still lose weight as long as they restrict carbohydrates.

Taubes supports his thesis with data from the scientific literature and with persuasive theoretical arguments about insulin, blood sugar levels, glycemic index, insulin resistance, fat storage, inflammation, the metabolic syndrome, and other details of metabolism. Many readers will come away convinced that all we need to do to eliminate obesity, heart disease and many other diseases is to get people to limit carbohydrates in their diet. I’m not convinced, because I can see some flaws in his reasoning. For example, Taubes says that restricting carbohydrates “leads to weight loss and particularly fat loss, independent of the calories we consume from dietary fat and protein. We know that the laws of physics have nothing to do with it.”

He acknowledges that the laws of physics are unavoidable, then contradicts himself by saying weight loss is independent of the calories consumed. He attacks the calories in/out principle with something of a straw man argument. He is really only saying that using that model hasn’t been very successful in producing weight loss. But no one has ever denied that. He says exercising and reducing total calorie intake do not work; then he goes too far and says they cannot work. Most of us would argue that they can and do; the problem is not with the principle, but with its implementation.
Full article: http://www.skeptic.com/eskeptic/11-05-04/#feature

[salvorhardin]

1. Unfortunately, I think Hall mischaracterizes a couple of Taubes' arguments

There's a lot of good information in Hall's review to contradict Taubes so it's unfortunate that on a couple of his key arguments she seems to be rebutting formulaic arguments by generic low-carb diet promoters and not Taubes' specific arguments. Here's my reply at eSkeptic:

Harriet Hall claims that Taubes attacks the calories-in/calories-out argument with a straw man. Unfortunately, Hall constructs her own straw man when she says, “He acknowledges that the laws of physics are unavoidable, then contradicts himself by saying weight loss is independent of the calories consumed. … He is really only saying that using that model hasn’t been very successful in producing weight loss.”

What Taubes is really saying is that calories-in/calories-out is a tautology that doesn’t explain how or why people become obese. Taubes argues that calories-in/calories-out turns obesity into a behavioral disorder when it is, in fact, a metabolic disorder. Taubes believes that high carbohydrate diets are really high fructose diets which causes insulin resistance which in turn causes the body to store more fat, and induce greater hunger in the individual.

There’s a whole lot to criticize in Taubes book. I’m almost through reading it and it has raised some serious questions with me (it has generally given me a lot to think about; especially the historical information). But let’s look at what Taubes is actually saying, and not debunk what we think he’s saying.

Hall also gets Taubes arguments about LDL cholesterol wrong. She says that, “Taubes admits that studies show that low-carb diets tend to raise the level of “bad” LDL cholesterol, but he thinks that this is more than compensated for by rises in “good” HDL cholesterol and by lower levels of triglycerides.”

Actually, Taubes argument is that LDL in general isn’t a problem but the type of LDL is important. LDL isn’t really cholesterol, but the molecule that transports cholesterol around our blood stream. The LDL molecules come in two sizes — small and large and that it’s the small LDL molecules that cause atherosclerosis. Taubes further argues that high carb diets increase the number of small LDL molecules and can actually increase artery plaques, while low carb diets do precisely the reverse.

While I’m no doctor, there does seem to be some science behind what Taubes claims. For instance, here’s a Men’s Health article from last February which says the same thing: http://goo.gl/mqaH Obviously, I’ll take Harriet Hall’s expertise over Men’s Health any day, but my problem isn’t with Hall’s expertise. My beef is that she just doesn’t seem to be reading Taubes very closely.

Link: http://www.skeptic.com/eskeptic/11-05-04/#comment-3355

[truedelphi]

4. Ya know -- your review reminds me of this:

Whenever I go to a church social with a healthy salad topped with few slices of carrots, and I try to get someone there that I know who has diabetes to fill up on said salad, they look the salad over, and proclaim, "I have diabetes and my doctor has told me that carrots are bad for me cuz they're too high in sugar, so thanks very much, but I will pass."

Ten minutes later I usually spy that same person chowing down on a big chunk of cake, or a huge plate or bowl of ice cream (often topped with a strawberry, cuz who in this day and age doesn't want some fiber?)

My remark is not really pertinent of anything, but I do wish doctors would quit proclaiming that carrots are somehow the enemy.

[Dorian Gray]

5. My

mother in law goes to that doctor!

[HuckleB]

2. A good review.

I probably trust Hall more than Taubes, though I am generally ok with his work. Still, conclusion seems wise:

"Has Taubes destroyed the old low fat myth only to create his own new low carb myth? Rather than jumping on the low-carb bandwagon before his ideas are properly tested, the precautionary principle suggests that it might be more reasonable to follow a moderate diet like the Mediterranean diet (or to follow Michael Pollan’s stunningly simple advice to “Eat food. Not too much. Mostly plants.”), to limit “empty calories” from simple carbohydrates like sugar, to eat a variety of vegetables and fruits, to choose low calorie density foods that are more filling, to limit meat intake, to limit salt, and to keep looking for behavioral and environmental ways to change our calories in/calories-out balance."

[salvorhardin]

3. I agree

Like I said in the bold text in my comment, Harriet Hall's expertise is golden in my book. I just think she was a bit formulaic at a couple of points in her rebuttal of Taubes and could have stood to argue against Taubes' specific claims.

[Dorian Gray]

6. Yes

I follow this advice 80=90% of the time. (I have my indulgences!) It's worked well for my family.

[bemildred]

7. Fats are not the boogeyman. Carbs are not the boogeyman. There is no boogeyman.

It is ludicrous to say you can eat as much as you like and lose weight. It is ludicrous to say the calories-in vs calories-out model is useless.

[hedgehog]

8. But the assumption in what you say is that all fat people eat more than all thin people while

exercising less. Yes, there are overweight people who do load up their plates, but I have also seen people who don't eat large amounts of food but who gain weight.

[bemildred]

10. No, the assumption is that if you eat too little you will get skinny and die.

And if you eat way more calories than you burn, then you will tend to add weight as you go along. And that a healthy diet involves a balanced mix of fats, carbs, proteins, and all those other nutrients that we need or can use. Those are facts, and they do not in any way contradict the idea that we are all different and need to make appropriate adjustments in our diet and lifestyle, according to what we wish to bring about.

[Warpy]

9. True, but it's not the whole story, either.

Obesity is a much more complex problem than "eat too much, move too little." There is no cure for obesity since 90%+ of people who manage to starve down to their ideal weight will gain it back plus more within five years. Don't try to tell me that people who have the will power to starve themselves down to an ideal weight suddenly lose all that will power once that weight is achieved. That's just not the truth.

If only it were that simple. Trust me, no one wants to be fat. It's the last acceptable bigotry since too many people think of it as a moral failure instead of a health problem.

[bemildred]

11. I'm not saying it's simple, far from it.

If anything the guy in the OP is the one that's saying it's simple, he's got his simple little theory, all black and white, good nutrients and bad nutrients, simple, comforting, and wrong.

[bemildred]

12. For example:

* The calories-in/calories-out model is useless.

-- Bullshit

* Carbohydrates are the cause of obesity and are also important causes of heart disease, type 2 diabetes, cancer, Alzheimer’s, and most of the so-called diseases of civilization.

-- Carbs are part of a balanced diet.

* A low-fat diet is not healthy.

-- Quite true

* A low-carb diet is essential both for weight loss and for health.

-- All carbs is not good, I'll go that far

* Dieters can satisfy their hunger pangs and eat as much as they want and still lose weight as long as they restrict carbohydrates.

-- It is ridiculous to say you can eat as much as you want and still lose weight, and exercise is essential too good health, regardless of diet.