While You’re Waiting…

… For Part IV, here’s some food for thought: an excerpt from Gary Taube’s recent article on Slate (http://hive.slate.com/hive/time-to-trim/article/its-not-about-the-calories) entitled It’s Not About The Calories.

For readers not familiar with Gary Taubes, he’s the award-winning medical and science journalist at the New York Times, and has written two books on obesity, nutrition, diets, and bad science that I consider ‘must reads’. First is Good Calories, Bad Calories and second is his newest book, Why We Get Fat: And What To Do About It.

The article is part of Slate’s new series on how to combat childhood obesity, and as always Taubes cuts right to the chase. Here are a few paragraphs, but the article (with various links) is worth reading in its entirety.

It’s Not About the Calories: Why existing efforts to combat childhood obesity are bound to fail.

By Gary Taubes

The past few years have seen the launch of many admirable initiatives to solve the problem of childhood obesity in America, but I’d like to respectfully suggest that these programs are, quite simply, doomed to failure. This is not because the food industry will subvert their efforts. It’s not because the children and parents in this country lack the willpower to tackle this problem and certainly not because they lack the motivation. It’s because the advice these anti-obesity initiatives give isn’t going to help, and the science they’re based on is misguided.

Take Michelle Obama’s Let’s Move! campaign, one of the most high-profile examples of this mistaken approach to the problem. The principles of Let’s Move! sound good. Who would be against getting kids to be more physically active and eat more fruits and vegetables? But anyone who thinks that will reverse the obesity epidemic is sorely mistaken.

Beneath all the program’s talk of making healthier food choices and increasing physical activity, its fundamental tenet is that we get fat because of the “overconsumption of calories.” This is how the White House’s Task Force on Childhood Obesity phrased the problem in its May 2010 report. And so the way to induce our children to lose weight is to get them to consume fewer calories, which they’ll do supposedly by eating less-energy-dense foods, and, of course, expending more energy through exercise—hence the name, “Let’s Move!”

This approach is certainly convenient. As Michelle Obama has said, it doesn’t require the “demonization of any industry.” All foods are OK in moderation, and the more our kids exercise, the more they can consume without getting fat. Follow this simple prescription and all will be well.

Except it won’t be. For the last 60 years, physicians and public-health authorities have been giving that exact same advice to obese people—children and adults—with little or no success. When researchers have tested diets that restrict how many calories are consumed—counseling their subjects to eat, say, 500 or 1,000 fewer calories a day than they normally would—the results have been depressingly predictable. The subjects experience modest weight loss (maybe nine or 10 pounds in the first six months), and then they gain the weight right back. Weight loss doesn’t last.

A conspicuous example of how these kinds of diets fail is the Women’s Health Initiative, the largest and most expensive nutrition trial ever conducted. The researchers enrolled nearly 50,000 mostly overweight or obese women into the trial, chose roughly 20,000 of them at random, and instructed that group to eat a low-fat diet, rich in fruits, vegetables, and fiber. These women were given regular counseling to motivate them to stay on the diet. If we believe what these women said they were eating, they also cut their average energy intake by well more than 300 calories a day.

The result? After seven-plus years on the diet, these women lost an average of one pound each. And their average waist circumference—a measure of what the diet-book authors like to call “belly fat”—increased. This suggests that whatever weight these women lost was not fat but lean tissue—muscle. It also suggests that getting people to increase their consumption of fruits, vegetables, and whole grains is not the way to induce weight loss.

The truth is, the conventional wisdom about why we get fat is simply wrong. It’s not about energy balance; it’s not about “over-consumption of calories” or “taking in more calories than we burn.” It’s about something else entirely: how the human body regulates fat metabolism and the accumulation of fat in our adipose tissue. This seems so obvious that it should go without saying—getting fat is a disorder of accumulating too much fat, so of course we should pay attention to how our bodies regulate fat accumulation —but this idea never managed to spread to the clinicians dealing with obesity, obsessed as they were with the notion that their patients were simply eating too much and exercising too little. (The 120-page Childhood Obesity Task Force report, tellingly, does not mention anything about how fat accumulation is regulated in the human body.) The real question to ask is why we accumulate fat—or more specifically, why our fat cells store more calories as fat than they release into the circulation to be burned for fuel.

So here is the answer: Fat accumulation in the human body is regulated fundamentally by the hormone insulin. If insulin levels increase, so does fat accumulation. If insulin levels decrease, fat is released from the fat cells and used for fuel. There’s nothing controversial about this fact. You can find it in most biochemistry and endocrinology textbooks, like this one that the Library of Medicine makes available online. It’s just considered irrelevant to the problem of obesity.

And here’s the catch: Insulin levels, for all intents and purposes, are controlled by the carbohydrates in the diet. The more refined and easily digestible those carbohydrates (the higher the glycemic index, as nutritionists would say), the more insulin will be secreted. And the sugars we consume—i.e., sucrose, the stuff we put in our coffee, as well as high-fructose corn syrup—will cause long-term increases in insulin production.

It’s been known for centuries that carbohydrates are fattening. The Frenchman Jean Anthelme Brillat-Savarin made this observation back in 1825 in The Physiology of Taste, one of the most famous books ever written about food. Restricting carbohydrates has been the theme of one wildly successful diet book after another ever since. Through the 1950s, the diets prescribed for obesity at medical school hospitals—at Harvard, Cornell and Stanford, for instance—restricted starches and sweets, allowing meat and eggs to be eaten freely. In 1963, a British Journal of Nutrition article by one of the two foremost dietitians in the United Kingdom began, “Every woman knows carbohydrate is fattening: this is a piece of common knowledge, which few nutritionists would dispute.”




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26 Responses to While You’re Waiting…

  1. LisaAPB says:

    I went to Slate and read the whole article, and a lot of the responses. Holy cow, (nonfat) people sure get fired up about the CICO argument!

    Taubes suggests that we warn our children that processed carbs are “fattening”. Heck, I think we should tell them they are poison.

  2. DogR4me says:

    That what I have being thinking the whole time…Its the sugar and refined carbs that has made us fat…Thanks to the government and companies that has made us addicted to these food. I’m currently on a modified Atkins Diet but with the foods that do well with my system…It doesn’t matter how many calories I consume, whether its 1000 or 2000..I’m still losing an average of .5 to 2lbs a day. I’m suppose to start the HCG next week…but at this rate…I’m not going to need it.

    Do you know what is the maximum amount that anyone should consume in carbs and sugar?

    • You must be a guy. Sometimes I think men can just cut out the one can of soda they drink a day and still lose 60 pounds in two months. It’s not fair. 🙂

      Daily maximum amount for sugar? Actual sugar in all its many forms, like HFCS, agave syrup, dextrose, maltodextrin, etc? ZERO!

      Don’t believe me? Go read Sugar Blues or Pure White and Deadly. While you’re waiting for the books to arrive, go click the link on the home/introduction page and watch Sugar: The Bitter Truth. You’ll never be even tempted to eat sugar in any form again except perhaps in small amounts (1/2 of “one serving” per day) of really good dark chocolate, like 85% Lindt.

      As for all other carbs, that seems like an easy question, but I assure you it’s very complex. This is precisely what I’ll discuss in Part IV, and if there’s room at the end I will provide a ratio into which you can plug your height, weight, etc. then match that up against the other important info about YOU that I’ll discuss. Please have patience, Part IV will be here soon—ish.

      • LisaAPB says:

        Think of it this way: our great grandparents probably ate about 25-30 lbs of sugar annually and nowadays the average for most of us is 5 times that!

        Please tell me that I will still be able to eat my apple! occasional grapefruit, berries or oranges?

        • You’re right about the sugar your grandparents ate, and current sugar consumption. If trends continue, by 2020 one out of every three Americans will be diabetic. Here’s the first time I’m going to talk about the sugar-free goodies I hope to sell by the end of summer: I created them because I just couldn’t stand what sugar was doing to everyone, especially kids, anymore.

          And yes, you’ll still be able to eat your fruits. 🙂 The amount will depend on YOUR levels of metabolic resistance. And another factor that I’ll discuss in Part IV.

      • DogR4me says:

        Nope, ALL woman with two wonderful children…I even have one that is having weight issues too..mainly from her medicine…She has gained over 70lbs in a year’s time. I try to beat into her head not to eat that…and to eat this. I can’t control what goes in her month…but I can control what comes in the house, but hubby is not helping one bit.

  3. LisaAPB says:

    “Carbohydrates are fattening”

    Being plant based, and historically plants were primarily available for seasonal harvest Then there must be a biological, evolutionary function to the design of carbohydrates adding fat. The fittest would fatten up on the abundance of the harvest (carbs), hence weather the harsh winters better. A pretty good system for staying alive UNLESS the conditions of availability are grossly abundant year round. A slim down period was automatically build into the old system.

    Abundance has broken that system. We’re able to fatten up, stay fat, fatten some more and … getting sicker people. Most of us don’t have the build in slim down period to counteract the abundance of carbs going into our diets. Welcome to the future.

    I have a tom cat who fattens up ridiculously toward the beginning of winter. In the summer he becomes a long lean hunter. He goes through some kind of cycle naturally. Grandma & Gramps probably used to do that in the olden days. He gives me hope that a natural slimming mechanism is built into our animal nature.

    I don’t think all carbs are alike, so I’m willing to make an exception to some carbs. My rule is, would those grandparents in the olden days have been able to have it? If so, it’s probably OK in my diet.

    • Diane says:

      Bingo!!! Well Stated. My rule of thumb, with the exception of meat (I can’t think of eating that raw!) eating food as close to the way God made it is healthiest by far. If we ate a sugar cane stalk to consume the amount of sugar we take in, in a single serving of a modern day “treat”, we wouldn’t be able to eat the equivalent whole. We are meant to eat WHOLE foods. Fiber in foods helps eliminate excess intake of sugar. Drinking fruit juice instead of eating the whole food should even be reconsidered as an unhealthy idea. And plant enzymes are contained in the whole food, in the raw state, that contributes to proper digestion of that food. Ohhhh don’t get me started!

  4. Heather says:

    You have me on the edge of my seat! Such interesting research and I’m so thankful that you’ve put so much thought and time and energy into it!

  5. m says:

    I have done numerous rounds of HCG and lost 30 lbs. Dr. S’s assurance that the”hypo resets” has not occurred. My weight has NOT stabilized. I have eliminated all sugars and carbs from my diet (for 2 years), save for one daily apple. I have been told that I am hypothyroid, insulin-resistant, have high cortisol and Candida, am estrogen dominant, and have emotional issues. I’m on all sorts of supplements for liver, thyroid and adrenals…My naturopath wants me to do another round of HIS brand of HCG, thinking it will re-set me. I would love to get to the bottom of why I can’t stabilize my weight. I can’t wait to read the next installment…

    • Grandeuce, I’m sorry to have to say this, but it may be time to look for a new doctor. One who doesn’t have a monetary stake in selling you things. And one who has read (and remembered!) his Biology 101 textbook. Because if you are truly insulin-resistant (and if you are fat, you are), and if you have lost 30 pounds on the HCG diet as written, then you have mostly lost lean muscle mass rather than fat and are in the process of trashing your metabolism into the ground. Here’s why:

      1: Increased muscle mass means increased (healthy) metabolism. Muscle burns a lot of calories, so the food you eat goes to feed those muscles. Fat burns negligible calories, so when you have a lot of fat and little muscle to feed, the food you eat gets stored as fat. The more muscle you loss, the more fat you put on. Basic biology.

      2: There is only one way to ‘liberate’ stored adipose fat, and that is by having your insulin so low, lipolysis (fat burning) can take place. Lipolysis can only take place in the absence of insulin. Lipolysis is stopped by the presence of insulin. Insulin-Resistance means a high presence of insulin. Hence, no lipolysis. Which means that if you are losing ‘weight’ you are in fact losing muscle, not fat, and you are ensuring that you will never keep the ‘weight’ off. Once you stop starving yourself, your now lower metabolism (less muscle to burn calories) will simply take all the food you’re eating and convert it to fact. Basic biology.

      Note I did not mention HCG. That’s because it is lipolysis that burns fat, not HCG. HCG is, if you read all of my articles on this blog, an adipogenic. That is, one of HCG’s main purposes in life is to tell proto fat cells to become full-fledged fat cells (a spare storage tank for adipose fat) in pregnant women so even if there’s scarce food later in the pregnancy, there’s extra fat to draw on for the fetus without having to sacrifice the mother’s muscle. A GREAT evolutionary adaptation if there ever was one.

      But if you’re not pregnant, and you create new fat cells (which then have the ability to create new fat cells of their own), you will have them forever, and you will have lots more room to store lots more fat as you continue to burn muscle and make fat.

      We are starting an experiment on the blog to prove beyond all doubt that it is NOT hcg that helps ‘liberate’ fat, but lipolysis. And Simeons was right about this: IF fat is liberated, it can make you feel full on fewer calories without hunger. That’s not in dispute. But if I’m right, and it is the lipolysis that liberates that fat (which process is, remember, insulin dependent), not HCG, then taking HCG will only make you fatter, literally, in the long run. I hope you’ll subscribe to the blog so you can follow the experiment!

      • Diane says:

        Ohhhh, that’s not very encouraging …I’m in the middle of a second round of HCG! Not finding success in eliminating belly fat which is what this was supposed to be all about. So how do we accomplish lipolysis???? Waiting with bated breath….

        • Diane, I hear you. Let out that bated breath and take a deep one. I am half-way through Part IV, and hope to finish it over the weekend. If you are a subscriber to the blog, you’ll get an email the second it’s posted.

          The bad news: if you are on HCG, and are losing weight (but not belly fat) you are losing muscle. Have you read Parts I – III in this series? You may find some helpful info there.

          Help is on the way…

      • m says:

        Ok, then here is my conundrum. I had a body scan performed two years ago, prior to hearing about HCG. I weighed 157 lbs, sum of body fat 56.9 lbs. My lean body mass was 100.1 lbs. After my last round of HCG, I found the old body scan report, and had another performed. Two years later, I weighed 128.8 lbs, sum of body fat 28.7 lbs. My lean body mass was again 100.1 lbs. My BMI went from 26.9 to 22.1, percentage of body fat went from 36.2% to 22.3%. Today I weigh 132-134, am eating only high fat/high protein (lost the daily apple last week!) but am above where I ended the last round of HCG by 6-8 lbs. How can I not be in lipolysis if I am not eating anything that even looks like a carb or sugar?

        • First, congratulations on losing all that weight, and fat, and especially for keeping most of it off for so long!

          But there are a few things to consider here. First, while body scans are good, they only tell part of the story. As you have now discovered for yourself. You are eating virtually no carbs/sugar, yet you weigh more than where you ended the last ’round’ of dieting. This is for several reasons. First, the only way to truly know what is going on with any one person’s metabolism is to look at it. And the only way to do that is through blood tests. It’s the only way to discover not only how many metabolic disorders (resistances) you have, like leptin, insulin and/or thyroid hormone resistance, but what “flavor” you might have and at what stage/s. Without these diagnoses, it’s impossible to to understand exactly why your brain is making the only decision about the food you eat that matters: Burn or Store.

          A healthy metabolism should be able to handle an apple or a slice of bread. And if it cannot it is, by definition, broken. A healthy metabolism not only should, but will maintain a healthy weight from year to year. One of my definitions of a healthy metabolism is this: despite eating a variety of foods throughout a year, including the occasional indulgence or overeating adipose fat-inducing foods, that person should be able to get on a scale on January 1, 2011 and weigh precisely the same (give or take an ounce or two) on January 1, 2012. This is how our bodies are designed to work. As Gary Taubes noted in his new book, How We Get Fat: And What To Do About It — the body has the capacity to fine-tune the metabolic system down to as few as 10 additional calories a day.

          The other issue is that our metabolisms are not static or stable over time unless we remain metabolically healthy. You may have been more insulin sensitive a year ago, when it appears you did lose fat (though I’ve got to say, after losing all that weight your lean muscle mass remained identical, down to the .1, as it had when you had much more fat strikes me as odd), which did mean you were in lipolysis for at least some of that time. In my first reply I said “if” you were insulin resistant, and should have added “and to the extent to which you may be insulin resistant” — but without those tests done two years ago, and then again when you did the body scan, there’s no way of knowing.

          For the tests you’d need, and how to get them without prescription if you don’t have insurance or your doctor won’t order them for you, see:

          A few final notes, and then I’m going to try to hold off answering any more individual metabolic questions until Part IV is done (because it will speak to a lot of these issues, including the two below):

          1: Eating excess protein can in and by itself cause adipose fat accumulation because roughly 50% of it gets converted to glucose by the body via gluconeogenesis.
          2: Eating very low carb over an extended period can, like eating very low calories over an extended period, cause the type of hypothyroidism known as thyroid hormone resistance. It’s a bad idea, and ultimately self-defeating.
          3: Please go back and re-read the information I gave about the adipogenic nature of hcg. After two rounds of it, you now have more permanent fat cells than you did when you began using the drug. Even if they’re not filled with fat (right now) they may have some fat in each, or they may be holding some “place-holder water.” This alone could explain the difference between where you ended the first ’round’ in terms of weight, and where you are now.

  6. DaffyDills says:

    Wow! I’m devouring your posts! I did an initial 35 day P2 to drop 18.5 pounds, followed by 3 short rounds (-10 lbs each, all homeopathic). My last VLCD ended a year ago. I’ve gained about 6 pounds, which seems small, but I have I’ve never gotten out of no sugar/starch phase 3. Some days it’s easy and other days it’s a struggle to get that weight to stay put. EVERY day I record my weight and foods, and carefully calculate my calories.

    I’m not on meds, but I do use natural supplements and a bladder friendly food list (minus starches/sugar) to help control inflammation and symptoms of Interstitial Cystitis. I’ve spent the past year ordering lab tests and screenings (no ins/doc) to see if I can find a key: hormone, cortisol, thyroid, ferritin, urinalysis, CBD with differential/platelet, general health screen, and life line risk assessment screening.

    I subscribed to your site and can’t wait to read the next segment, learn more about your experiment, and move forward with fresh ideas and HOPE! I am with a group of women who have been searching for answers and we are all watching your blog! 🙂

    Thank you so much for sharing your findings!

    • Hi, Daffydills! Thank you for your kind words, and for letting me know about your group. Please say hello to me for them. 🙂

      As for your not being able to get out of phase 3 to eat normal, good starches (I don’t think anyone should consume more processed sugar in a day than is in a few squares of 85% Lindt chocolate), please see my reply to “m – grandeuce.” You say you’ve had blood tests this past year. Did they include all the tests listed in Metabolic Blood Tests without a Prescription thread? If not, those are the tests you need to diagnose what metabolic disorder/s you might have, and in what stages. Then you can start to do something about it!

      Hope this helps…

      • DaffyDills says:

        Thoughts of eating normal good starches?
        Banned until further notice!

        I’m checking temps 3x daily through Sunday. My blood work in the Fall of 2010 did not include Reverse T3 or Leptin. Is there more info we need from your next post before ordering the metabolic blood tests?

        • Best to check daytime temps as follows:

          1: 3 Hours after waking up for the day.
          2: 3 Hours after that.
          3: 3 Hours after that. Then average. Extend the 3 hours by 30 minutes if the 3-hour mark falls at a meal.

          Is there more info we need from your next post before ordering the metabolic blood tests?

          No, but please make sure to be off any thyroid meds and/or hcg for 5 days before taking the tests, otherwise the results might be skewed. And the RT3 must be on the same draw as the FREE T3 and the FREE T4. So if you had those two before, you cannot use them. You’ll need to have all three done at the same time. Let us know how it goes.

  7. DaffyDills says:

    In rereading a few posts I’m curious about something you said to m-grandeuce:
    “One of my definitions of a healthy metabolism is … that person should be able to get on a scale on January 1, 2011 and weigh precisely the same (give or take an ounce or two) on January 1, 2012.” You followed that with this, from Gary Taubes: “the body has the capacity to fine-tune the metabolic system down to as few as 10 additional calories a day.”

    Those statements together seem juxtaposed, not supportive. As few as 10 additional calories a day would likely not change a weight. When you have time, would you mind clarifying? I would like to understand your textual intent.

    Thanks! (and keep writing so we can read the next segment!!) 🙂

    • Gary Taubes talked about the “extra ten calories” (a single m&m or a potato chip) like this: only 10 additional calories consumed over and above a person’s normal calorie consumption based on the rate calculated by height, activity, bmi, etc. (the usual suspects in CICO) = 3650 surplus calories per year. That should equal a gain of a pound of weight a year, or ten pounds gained over a decade. But in a person with a healthy metabolism — it doesn’t. Why? Because without leptin resistance, the brain sees that person for who they really are: slim and healthy. So it sends all the correct signals to all the other metabolic functions (like the liver’s T4 to T3 conversion) to burn, not store those excess calories. In someone with leptin resistance, say, those signals are never sent and the calories are stored, not burned. Taubes uses the example to show how ridiculous it is to talk about calories in, calories out, when the body clearly has the capacity to fine-tune down to the level of a single m&m — in whichever direction it wants.

  8. DaffyDills says:

    Thank you for filling in the blanks! As ridiculous as it seems, here I am, tracking CICO–apparently sent in the wrong direction–until I get my broken parts fixed.

    Here’s to Hope!

  9. NativeTexan says:

    Love your blog. Just finished reading Taube’s book and my eyes popped from amazement. Are you going to give ideas on how to turn insulin resistance around? I clearly have that and don’t want it (like I don’t want my turkey chin either). Also, why do you keep your identity a secret? Thanks.

    • Thank you for your kind words! Which book did you read: GCBC or Why We Get Fat? Either way, I can understand the amazement. I threw GCBC across the room in anger when I first read it, furious at how the medical establishment and our government had not just lied to us, but willfully so. And yes, I will be talking about how to turn all the metabolic resistances around, because if you don’t do that, no food in the world will do for you what you want it to. Believe me, I’m the Poster Child for Been There, Done That and one of the reasons I started this blog was to share what I’ve learned through trial and error. Lots of error.

      Another reason is to try and get folks off their intellectually lazy couches so they can start to think for themselves. If I hear one more person say they don’t know the results of their last lab tests “cause the Doc said I’m fine” I may tear my hair out. That’s why I don’t talk about myself much, though some detail will emerge in my writing. It’s not that I’m in hiding, rather that I want my work to stand on its own. Either it’s crap, in which case my having won a Nobel Prize in something or other won’t make it better, just … gilded over. Or my work is good, in which case it shouldn’t matter if I’m a street sweeper (with no offense to street sweepers). We’ve all come to rely so much on “authority” to tell us not how to think, but what to think, that I sometimes worry we’re losing our ability to do much solid thinking at all anymore. And as you’ve seen by what I’ve already written, “authority” is often an ignorant ass who don’t know ‘nuthin.

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