Previously: Mainstream Nutrition Science on Obesity, Atkins Redux, Did the US Government Give Us Absurd Advice About Sugar?

In this post, I'm going to deal with an issue that's central to Gary Taubes' critique of mainstream nutrition science: what causes obesity?

This is a post a post I found exceptionally difficult to write. You see, while his 2002 New York Times article portrays mainstream nutrition science as promoting a simplistic mirror-image of the Atkins diet, his books do manage to talk about the mainstream view that if you consume more calories than you burn you'll gain weight... sort of. As I looked closely at the relevant chapters of those books, it became less and less clear what view he's attributing to mainstream experts, or what his alternative is supposed to be.

Because this discussion may get confusing, I want to start by repeating what I said in my first post: the mainstream view is that people gain weight when they consume more calories than they burn, but both calorie intake and calorie expenditure are regulated by complicated mechanisms we don't fully understand yet.

Yet Taubes goes on at great length about how obesity has other causes beyond simple calorie math as if this were somehow a refutation of mainstream nutrition science. So I'm going to provide a series of quotes from relevant sources to show that the experts are perfectly aware of that fact. All of the following sources are ones Taubes cites as examples of how absurd the views of mainstream nutrition experts supposedly are:

The etiology of obesity is multifactorial and includes genetic, neurohormonal, endocrine, metabolic and life-style-associated factors. Generally, obesity is a result of excess energy resulting from disturbances in the energy intake/expenditure equilibrium.

Report From FDA's Sugars Task Force. 1986. p. S14.

The causes of obesity are incompletely understood, so that effective treatment is difficult. Obesity is the net result of an excess of energy consumption over expenditure. Factors that must be considered as contributing to causation are: (1) heredity, (2) primary overeating, (3) altered metabolism of adipose tissue, (4) defective or decreased thermogenesis (the process by which calories are converted into heat), (5) decreased physical activity without an appropriate reduction in food intake, and (6) certain prescribed medications. These potential causes can interact with one another. Of the six factors, individuals may have some control of overeating and underactivity.

The Surgeon General's Report on Nutrition and Health. 1988. p. 290.

Positive energy balance can result from increased energy intake, reduced energy expenditure, or both, and over the long term, can lead to obesity and its associated complications... Obesity is enhanced not only by this energy imbalance but also by a genetic predisposition to obesity and altered metabolic efficiency... The specific causes of obesity are not well known, although some obese people clearly consume more energy compared to people of normal weight, whereas others are very sedentary or may have increased metabolic efficiency.

1989 National Academy of Sciences Diet and Health report. 1989. p. 10.

Maintenance of a normal body weight requires a match of food intake to energy expenditure... Both nutrient intake and energy expenditure are regulated by a complex interaction between the periphery and the central nervous system. Although not all aspects of central-peripheral interactions involved in energy balance are understood, key factors have been identified. For example, leptin from the adipocyte, ghrelin from the stomach, peptide YY from the gut, and insulin from the pancreas are all involved in the central regulation of energy balance. In the brain, more than a dozen peptides have been implicated in appetite and satiety.

Article on obesity on Joslin's Diabetes Mellitus. p. 536.

There's also the Handbook of Obesity (whose first edition sadly does not appear to be easily accessible online), which I attempt won't quote from because it devotes dozens of chapters to the etiology of obesity, including chapters titled "The Genetics of Human Obesity," "Behavioral Neuroscience of Obesity," and "Endocrine Determinates of Obesity."

Now what exactly is Taubes' objection to the above statements? It's easy to find answers to this question in his books. It's less easy to reconcile all the different answers with each other. At times, he seems to suggest the above statements are self-contradictory, such as when he gives the following example of an "apparent contradiction" (in Good Calories, Bad Calories on p. 271):

It may be true that, “for the vast majority of individuals, overweight and obesity result from excess calorie consumption and/or inadequate physical activity,” as the Surgeon General’s Office says, but it also seems that the accumulation of fat on humans and animals is determined to a large extent by factors that have little to do with how much we eat or exercise, that it has a biologic component.

At times like this, Taubes reminds me of the biologists who Ernst Mayr chided in his paper "Cause and Effect in Biology" for failing to realize that biological phenomenon can be cause on multiple levels. Mayr quotes an example:

The earlier writers explained the growth of the legs in the tadpole of the frog or toad as a case of adaptation to life on land. We know through Gundernatsch that the growth of the legs can be produced at any time even in the youngest tadpole, which is unable to live on land, by feeding the animal with the thyroid gland.

Just as there's no contradiction between thinking leg growth in tadpoles is controlled by hormones, and thinking this mechanism is an evolutionary adaptation, there's no contradiction between thinking weight gain is the result of consuming more calories than you burn, and also thinking that there are a lot of different factors that influence calorie intake and expenditure.

But maybe Taubes doesn't mean to suggest there's a contradiction there. He goes to great lengths to assure his readers he isn't rejecting the laws of thermodynamics. Furthermore, he doesn't seem interested in claiming any loopholes in the basic calories-in, calories-out math along the lines of Atkins' ketones-in-the-urine hypothesis. Instead, the idea often seems to be that the calories-in, calories-out idea is true but trivial. Why We Get Fat (p. 74) offers this analogy:

Imagine that, instead of talking about why we get fat, we're talking about why a room gets crowded...

If you asked me this question and I said, Well, because more people entered the room than left it, you'd probably think I was being a wise guy or an idiot. Of course more people entered than left, you'd say. That's obvious. But why?

This is a poor analogy, because the fact the importance of calories in weight gain is far less obvious than the importance of people in a room's getting crowded. Imagine: what if it had turned out that it's the total mass of your food that matters? Or just the total grams of fat? Or just the total grams of carbs? Or the phlogiston content?

A poorly-chosen analogy, though, is a minor problem compared to the false implication that mainstream that obesity researchers have ignored the factors that influence calorie intake and expenditure. This is a claim that Taubes makes explicit in other cases, for example:

Good Calories, Bad Calories (p. 295):

What may be the single most incomprehensible aspect of the last half-century of obesity research is the failure of those involved to grasp the fact that both hunger and sedentary behavior can be driven by a metabolic-hormonal disposition to grow fat, just as a lack of hunger and the impulse to engage in physical activity can be driven by a metabolic-hormonal disposition to burn calories rather than store them.

Why We Get Fat (pp. 80-81):

Of all the dangerous ideas that health officials could have embraced while trying to understand why we get fat, they would have been hard-pressed to find one ultimately more damaging that calories-in/calories-out... it's misleading and misconceived on so many levels that it's hard to imagine how it survived unscathed and virtually unchallenged for the last fifty years...

There has to be a reason, of course, why anyone would eat more calories than he or she expends, particularly since the penalty for doing so is to suffer the physical and emotional cruelties of obesity. There must be a defect involved somewhere; the question is where.

The logic of calories-in/calories-out allows only one acceptable answer to this question. The defect cannot lie in the body-perhaps, as the endocrinologist Edwin Astwood suggested half a century ago, in the "dozens of enzymes" and the "variety of hormones" that control how our bodies "turn what is eaten into fat"—because this would imply that something other than overeating was fundamentally responsible for making us fat. And that's not allowed. So the problem must lie in the brain. And, more precisely, in behavior, which makes it an issue of character.

To which I reply: no, those involved in obesity research did not fail to grasp the factors that drive hunger and sedentary behavior, and there was no unchallenged dogma the causes of obesity can't lie in our bodies. Read your own damn sources, Taubes.

I wish I could end this post there, but there's a complication: what about those statements I talked about in part 2, that it's "not a medical fact" that losing weight requires cutting down on excess calories, and that dietary fat has no effect on fat accumulation in the body? Well, there is an explanation for those statements. It's something Taubes goes on at great length about in Good Calories, Bad Calories, but is perhaps most succinctly expressed in Why We Get Fat (p. 99): "We don't get fat because we overeat; we overeat because we're getting fat."

The part of me that's still trying to figure out how to be charitable to Taubes urges that surely that sentence wasn't meant to be taken too literally. To use Taubes' own analogy of the room getting crowded: it's one thing to say "the room is getting crowded because more people are entering than leaving" is too obvious to mention. It's another thing to say that that claim is false, and on the contrary it's the room getting crowded that's causing people to enter. (There's a sense in which that could be true given the phenomenon of social proof, but then we're talking about a feedback loop, not one-way causation.)

So it's natural to assume Taubes is playing with meaning here a bit, using "getting fat" to refer not to the weight gain itself but a metabolic tendency to get fat, or something like that. Surely he still recognizes that how much we eat still has an effect on our weight, right? On the one hand it seems that he does: he talks about how calorie intake affects calorie expenditure, but he doesn't claim they march so closely in lockstep that it's literally impossible to lose weight by cutting calorie intake. His discussion of low-calorie diets plays up how unpleasant they are, but he does acknowledge people lose weight on them. 

On the other hand... Taubes seems really serious about this claim, portraying it as one of the fundamental mistakes of mainstream nutrition experts. From Good Calories, Bad Calories (p. 293):

The first law of thermodynamics dictates that weight gain—the increase in energy stored as fat and lean-tissue mass—wil be accompanied by or associated with positive energy balance, but it does not say that it is caused by a positive energy balance—by “a plethora of calories,” as Russel Cecil and Robert Loeb’s 1951 Textbook of Medicine put it. There is no arrow of causality in the equation. It is equally possible, without violating this fundamental truth, for a change in energy stores, the left side of the above equation, to be the driving force in cause and effect; some regulatory phenomenon could drive us to gain weight, which would in turn cause a positive energy balance—and thus overeating and/or sedentary behavior. Either way, the calories in wil equal the calories out, as they must, but what is cause in one case is effect in the other.

All those who have insisted (and still do) that overeating and/or sedentary behavior must be the cause of obesity have done so on the basis of this same fundamental error: they will observe correctly that positive caloric balance must be associated with weight gain, but then they will assume without justification that positive caloric balance is the cause of weight gain. This simple misconception has led to a century of misguided obesity research.

He even goes so far as to say (in Why We Get Fat, p. 76):

The experts who say that we get fat because we overeat or we get fat as a result of overeating—the vast majority—are making the kind of mistake that would (or at least should) earn a failing grade in a high-school science class.

So what's going on here? I think the answer lies Taubes' eagerness to portray mainstream nutrition experts as big meanies who blame fat people for being fat. I've already quoted him as saying that on the mainstream view, being overweight or obese must result from a defect of character. Just to drive the point home, in the same book he later says (p. 84):

Much of the last half-century of professional discourse on obesity can be perceived as attempts to circumvent what we could call the "head case" implications of calories-in/calories-out: how to blame obesity on eating too much without actually blaming the fat person for the human weaknesses of self-indulgence and/or ignorance.

So if you hear an advocate of the mainstream view claiming not to be a big meanie, don't believe them!

But this puts Taubes in a bind: now if he says how much we eat has an effect on our weight, he's a big meanie too. It doesn't work for him to say fat people can't help overeating because of something wrong with their metabolism, and this in turn causes them to gain weight, because he's committed himself to the principle that blaming behavior equals blaming a character defect. So instead, we get wild rhetoric about how stupid the experts are with no coherent view underneath it.

A more sensible approach would've been to emphasize that akrasia is an extremely common problem for humans, and that people who don't suffer from akrasia in regards to diet probably suffer from akrasia about something else. But that wouldn't have made for as an exciting of a book. Robin Hanson once commented that "few folks actually care much about the future except as a place to tell morality tales about who today is naughty vs. nice." I suspect this point generalizes. If you want to sell a book, flatter your audience and give them some villains to hate.

I have no plans of discussing Taubes claims about carbohydrates having a unique ability to mess up the systems that regulate weight. For one thing, I don't have anything to add to what others have already said. For another, one thing Taubes is definitely not claiming is, "while obesity researchers have spent a great deal of time studying the mechanisms that regulate weight, they've completely failed to realize how badly carbs screw up these mechanisms."

Instead, he accuses them of ignoring the relevant mechanisms entirely. This claim is so wildly untrue as to be grounds to doubt anything you think you learned from Taubes—indeed, to doubt any ideas you originally got from him even if you thought you later got confirmation for them elsewhere.

Closing thought: it's quite possible for a majority of the experts to be wrong. And I can even imagine finding a case somewhere where a non-expert rationally arrived at the correct answer when 95% of the experts are wrong—though I've been unable to actually find such a case. But when you see someone claiming that the vast majority of the experts have an obviously stupid view that should have earned them a failing grade in high school science, that is a very strong signal that you are dealing with a crackpot.

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To me it feels like this whole series is simply failing to find a smoking gun of Taubes saying something false, or Taubes implying that the mainstream view is X when it is actually Y, because a bunch of individual papers saying Y does not mean that the mainstream view is not X. On a recent visit to an endocrinologist she still earnestly advised me that I ought to reduce fat in my diet because fat has 9 calories per gram. Recently glancing at a state-government handbook for pregnant women it contained the original food pyramid with half your calories supposed to be for grains (along with a recommendation to get folic acid which didn't distinguish folic acid from folate, no mention of iodine supplementation, and no mention of choline supplementation). This is what Taubes is criticizing and the fact that many experimentalists have found that this is terrible and published papers accordingly is part of his criticism, not a refutation of it; he is, precisely, accusing mainstream dietary science of ignoring its own better knowledge, and continuing to have endocrinologists and government pamphlets earnestly advising people that eating fat makes you fat.

The CDC diet and nutrition website at this very moment says:

Diets high in saturated fat have been linked to chronic disease, specifically, coronary heart disease. The Dietary Guidelines for Americans 2010 recommend consuming less than 10% of daily calories as saturated fat.

6private_messaging10y
To provide the context for those unfamiliar with Taubes' views on the polyunsaturated and saturated fats: (Since most dietary fats are a mix of saturated and polyunsaturated fats, the layman accessible advice would be to cut down on fats, and on the other side, Taubes has to proclaim both to be ok).
0Eliezer Yudkowsky10y
Keeping in mind that 'saturated fat' is not fat with extra fat, it is the fat which doesn't have chemically unstable double-carbon bonds. I wonder how much of this idiocy is just because of 'saturated fat' sounding like fat with extra fat in it, and 'polyunsaturated fat' not being called 'poly-unstable reactive fat'.
8ChrisHallquist10y
That you would say this tells me your picture of how mainstream science works is even more distorted than I realized. Studies have linked saturated fat to cholesterol levels and through cholesterol levels to heart disease. You said in the other thread that your nutritionist recommended you eat less saturated fat as a weight loss thing, which is wrong, because the real issue is cholesterol. But you shouldn't be dismissing worries about saturated fat as "idiocy." Now, recently there have also been studies finding no link between saturated fat and heart disease. I haven't looked into the issue closely enough to tell what's going on, but it's possible nutrition science is in the process of realizing they made a mistake about saturated fat. Or maybe the experts have reasons I don't know about for discounting those studies, I'm not sure, which is why I've left the issue alone.
4brazil8410y
Yes, I agree that one needs to draw a distinction between nutritionism for weight loss and nutritionism for other health-related objectives. As far as I know, there is good scientific evidence backing up the latter. That's why I asked Eliezer before what his doctor was hoping to accomplish by advising him to cut down on saturated fat. According to Eliezer, the doctor was indeed aiming for weight loss. Apparently the doctor in question is an endocrinologist. I would be curious to know what an obesity specialist would say.
-2Randy_M10y
The diet--heart attack link is debated as well, of course: http://en.wikipedia.org/wiki/The_International_Network_of_Cholesterol_Skeptics
2brazil8410y
Of course -- I am not surprised at all. But I still stand by my claim that there is good scientific evidence backing up nutritionism for health-related objectives other than weight loss.
-2Randy_M10y
Can you cite the one or two most convincing studies that saturated fat is a principle cause of heart disease? I have seen a lot from the other side and would like to get a fuller picture.
2brazil8410y
No, I can't -- not without researching it. My claim is that there is good scientific evidence backing up nutritionism for health-related objectives other than weight loss. If you represent to me that you are seriously skeptical of this claim I will try to find some supporting evidence.
0Randy_M10y
My skepticism at the moment is only about (quoting Chris from above) "Studies have linked saturated fat to cholesterol levels and through cholesterol levels to heart disease." (Well, and a bit with regards to cancer) I have seen such studies analyzed with alternative explanation convincingly by, for example, Uwe Ravnskov, Malcom Kendrick, Chris Masterjohn or Denise Minger, and wonder if there is more convincing evidence they atre excluding. Nutrionism (meaning mainstream health science?) and health are of course much more broadly defined and not doubt contain many factual statements, for example on how to prevent scurvy, that don't necessarily protect the entire field from the possibility of error.
2brazil8410y
Nutritionism is basically the idea that specific components of food potentially make them healthy or unhealthy. So assuming for the sake of argument that saturated fat is unhealthy, nutritionism would hold that it's a good idea to substitute canola oil for corn oil. That's an interesting question, but not one I've ever given much specific thought to.
0EHeller10y
The fact that people with genetic hypercholesterolemia tend to ( as the cholesterol link would indicate) die of heart attacks fairly young is at least one strike against this view.
0Randy_M10y
This is usually an acknowledged exception; whether the rationale for it to be an exception rather than counter evidence holds, I don't recall.
2Jack10y
That you would say this tells me that your picture of how mainstream science works and the merits of Taubes' critique is even more distorted than I realized. That was fun, but seriously. I posted it precisely because the nonsense about sat fat causing heart disease is one of Taubes biggest cudgels against nutrition science and it's something many experts are now admitting the medical establishment has been wrong about for decades. I'm confused how you came to a conclusion about Taubes without looking into it. It's probably what he deserves the most credit for. E.g. Stephan Guyenet, whose arguments against Taubes account of carbs and insulin causing weight gain you posted earlier, thinks that no unbiased person who is familiar with the literature can believe there is a causal link between sat fat and cholesterol and heart disease.
1ChrisHallquist10y
It's possible Taubes is right about saturated fat, but he's sufficiently unreliable on other issues that I wouldn't trust a word he says about saturated fat. And yes, this matters, because prior to this series Taubes was who everyone was citing for the "look how horribly wrong mainstream nutrition science is" claim.
0Jack10y
FYI, I'm going to keep citing him.
1waveman5y
Two issues here 1. Correlation is not transitive as you seem to assume (the claim is a) sat fats corr cholesterol, and b) cholesterol corr to heart disease, therefore c) sat fats corr heart disease, therefore d) sat fats cause heart disease) . A correlated to B and B correlated to C does not even mean A is correlated to C, let alone that A causes C. 2. When you go looking for solid evidence for saturated fats causing heart disease - as I have - it just isn't there. What seems to have happened is that the field was for many years dominated by one man Ancel Keys who had a hunch that saturated fat was the culprit. He then fell prey to the usual cognitive biases, e.g. confirmation bias, and failed to update his views based on evidence. Unfortunately the mania against saturated fats has let to a large uptake in intake of carbs in particular sugars (which Keys said was better than SF at least on one occasion), and Omega 6 fats contained in industrial seed oils ("vegetable oils"), trans fats and various other abominations that have been replacing trans fats. Read this and note how weak and old the evidence cited here is (president of the AHA). Circulation. 2017;136:e1–e23. DOI: 10.1161/CIR.0000000000000510 Per your comment about realizing there is a mistake I get the feeling that the tide is turning and they are slowly walking it back. Contrast the article above with this talk on the issue. https://www.youtube.com/watch?v=NUY_SDhxf4k&list=LLsRhdFOqQxl9zxUew3GgU8g&index=4&t=0s
-1private_messaging10y
One can also cut on fats to lose weight, if one doesn't proceed to eat more carbs and over-compensate in the end. Normally, when someone is having trouble losing weight, they don't realise how many calories they consume, and errors with fat are the largest in terms of calories. When volition or judgement are impaired, that's when things get very messy and cutting down on fat may or may not result in eating more.
-1Eugine_Nier10y
Correlation is not transitive, i.e., X being linked to Y and Y being linked to Z does not necessarily imply X linked to Z. Unfortunately, biologists and health scientists make this kind of mistake all the time. Weren't you trying to argue that mainstream science doesn't make mistakes?
1waveman5y
No Eugine
7ChrisHallquist10y
This is true. I wish we had surveys of the views of academic nutrition researchers on some of these questions, but as far as I can tell we don't. That said, this isn't a random bunch of papers I'm citing. Rather, I'm citing the very same sources Taubes uses to show how absurd the views of people in mainstream nutrition science are supposed to be. Taubes is at the very least guilty of misrepresenting what his own sources say. Furthermore, his choices of sources for the views of mainstream experts at least seem reasonable on the surface: FDA, NAS, Surgeon General, etc. Though I can't vouch for his description of them, Taubes describes the Handbook of Obesity as "edited by three of the most prominent authorities in the field”, and Joslin's as a "highly respected textbook." Whether this is good advice will depend partly on what you replace the fatty foods you cut back on with, and how much fat you're currently consuming. And it's not entirely clear to me what level of fat consumption is ideal. That said, it sounds like she understands that calorie intake is ultimately more important than fat intake, and was not claiming eating less fat by itself was a sufficient condition for losing weight. What are you complaining about?
2brazil8410y
FWIW, research from the National Weight Loss Control Registry apparently indicates that the rare people who lose the weight and keep it off generally eat low fat diets. Cite: http://www.nwcr.ws/Research/ My personal theory is that fat is not inherently unhealthy; it's just that if you eat a healthy diet you will naturally end up eating a diet which is low in fat compared to your typical American. In other words, I think fat is a somewhat useful proxy. But if you just focus on reducing fat intake, you will end up eating a lot of low fat potato chips and ice cream and drinking a lot of soda. Not good.
6brazil8410y
Didn't you say in the other thread that the advice was to reduce saturated fat? Is this the same doctor visit?

So, I’ve liked this series (and upvoted it), but I’ve had mixed feelings about the most recent post. It feels like this is verging dangerously close to “someone is wrong on the internet” (1) territory.

In particular, something that seems to me like a major failing is that I’m now 4 posts into a series on nutrition and I don’t know the right answer. I don’t even know your best guess as to the right answer. Without an executive summary on “the right answer to nutrition” this series has no actionable take away points. Its clear to me that a lot of research was done to write this series. The series would be more valuable if you shared the fruits of that research.

Actionability aside, not stating a view on what someone ought to conclude makes it hard to see just how wrong Taubes is or isn’t. Will following his advice kill me? (Taubes is a dangerous madman). Will following his advice cause me to gain weight or fail to lose weight? (Someone is wrong on the internet). Is Taubes directionally correct such that following his advice will cause me to lose weight but he overstates his case while taking rhetorical cheap shots at strawmen? (Someone is technically incorrect on the internet).

1: http://xkcd.com/386/

One other point I should make: this isn't just about "someone" being wrong. It's about an author frequently cited by people in the LessWrong community on an important issue being wrong.

Indeed, I'm not sure I'd know about Taubes at all if not for the LessWrong community.

I've already mentioned Eliezer's "Correct Contrarian Cluster" as an example in another thread, but perhaps it would be helpful to mention other examples:

  • In a thread where someone asked what the evidence in favor of paleo was, Taubes was the main concrete source that came up. Specifically, Luke mentioned Taubes as the person he's "usually" referred to on this question, without taking a stand himself and saying he didn't have time to evaluate the evidence personally.
  • Sarah Constantin (commenter at Yvain's blog, author of reply to Yvain's non-libertarian FAQ, and I just learned a MetaMed VP) has cited Taubes a couple times partly to make a libertarian point.
  • Jack bringing up Taubes in offline conversation
  • Yvain's old blog had a review of Taubes which doesn't seem to be public right now, but which I remember as partly criticizing Taubes but also lauding him for things that now I don't thin
... (read more)

Taubes is now involved in an initiative with the Arnold Foundation doing randomized nutrition trials. It would be interesting to make predictions about some of those.

If they do stop citing Taubes, I predict they start recommending the Perfect Health Diet. I think the correct response would be to suggest they write a summary, not write a series of articles rebuking the diet, so that we can question them and not the other way around. Make the people with novel advice do most of the work.

8Douglas_Knight10y
Really? Most of the negative reactions have been explicitly about finding the posts unconvincing. I doubt those people will stop citing Taubes.
2ChrisHallquist10y
It started out that way, but over time it seemed like over time the response morphed into, "okay, Taubes is wrong about thee things but so what?" Jack even made the argument that Taubes isn't a rationalist so it's unfair to hold him to that standard.
3Jack10y
Not "unfair" just not relevant to whether or not he is essentially right.
6FiftyTwo10y
I think people would react to your posts better if they included some of this at the top. You need to remind people why they should care
1waveman5y
I don't buy this at all. The OP has attacked Taubes on a peripheral issue and used that to make it look like Taubes got it wrong on his central theses. And I don't think he did. Even on this peripheral issue, I think Taubes is actually basically right. I have read 3 of his books and watched a few of his talks so I know his views on the topic. Overwhelmingly the advice to consumers has been eat less move more. As if that was a solution to the problem of weight gain. My own doctors have said this to me. Not a word about more sophisticated approaches to regulating appetite and hunger. The scientific rationale for the 2015-2020 guidelines has barely a thing to say about this. They have some ideas about eating less sugar and less takeaway food but evcen there the main argument is the hoary old chestnut about calorie density (fat = 9 calories / gram versus healthy carbs at 4). Of course you can find some quotes suggesting that regulation of weight is complex. But overwhelmingly the message is calories in calories out. Ancel Keys - who dominated the field, and was funded in part by packaged food companies - gave this message repeatedly in his works. Dietary policy in the US (and therefore in most of the world) has been a monumental failure with skyrocketing rates of obesity and diabetes. The fall in smoking rates and better treatments have masked the impact of this on heart disease. There is a long and sad history of the recommendations not being evidenced based and being skewed by the packaged food industry and by vegetarian/vegan zealots (particularly more recently).The AHA's original big funding splash came from Proctor and Gamble, who marketed the wonder food, Crisco, full of "healthy" trans vegetable fats. Read the reports over time and look at the evidence that wasn't there and the evidence that was ignored.
1waveman5y
As an example here is copypasta from the latest dietary guidelines: Straight wall to wall calories in calories out.
1timtyler10y
Not experts on the topic of diet. I associated with members of the Calorie Restriction Society some time ago. Many of them were experts on diet. IIRC, Taubes was generally treated as a low-grade crackpot by those folk: barely better than Atkins.

In particular, something that seems to me like a major failing is that I’m now 4 posts into a series on nutrition and I don’t know the right answer.

There seems to be pretty strong reason to think the right answer is "we don't know the right answer yet."

Actionability aside, not stating a view on what someone ought to conclude makes it hard to see just how wrong Taubes is or isn’t.

If you check out Guyenet's post (linked here, ChrisHallquist has linked it twice), he leads off with (paraphrased) "carb-free diets have worked for a lot of people, and that's great, but Taubes is wrong about the carbohydrate-insulin-hypothesis."

This article series began because the heuristic of "trust the expert consensus" was called into question, and Taubes came up as an opponent of the nutritional consensus, but it turns out that Taubes is mischaracterizing the expert consensus, even if he's not mischaracterizing the layman consensus (which, as you'd expect for laymen, is pretty bad). So that Taubes gets the expert consensus wrong is relevant to the meta-point of "trust the expert consensus."

4Emile10y
That's something that should take less than 4 posts to spell out :)

I concur with your criticism.

I wish people went to greater lengths in explaining themselves whenever they give contrarian advice here, maybe write a post of their own if the issue is important enough. That would make these kinds of posts obsolete.

Often I see some superficially weird off topic statement with upvotes indicating many people agree, although no actual discussion has taken place here regarding the issue, and I have no idea why I should believe it. Engaging those comments is rarely fruitful, but that could be my bad, and of course I probably make weird statements too, since I have little in common with a typical lesswrongian.

3ialdabaoth10y
I only regret that I have but one upvote to give for this comment.

Given this, you might like my next (and final) post about weight loss more.

8ephion10y
I completely agree with this post. A big issue that I have with it is that Taubes's (and Atkins) advice really does work for a lot of people. Evidently, Atkins and Taubes discovered something that worked, and tried to justify it with cherry picked science. They are salesmen, not scientists, so it isn't really surprising that their claims aren't rigorous. (EDIT: This summary of meta analyses on low carb diets backs up the efficacy of their diets) I'd like for ChrisHallquist to have investigated why low carb diets work so well for so many people, despite the fact that the evidence isn't all there. As for your questions, I'd say that following Taubes' advice won't kill you, will very likely result in weight loss, and that his methodology is more-or-less correct but his justification is lacking. I do plan on writing a series of posts on nutrition, exercise, and general health that are actionable with good recommendations.

This is such a weird, non-LW-type response compared to what I've become accustomed to.

It seems irrelevant whether or not Atkins "works" if the reason it works has nothing (or little) to do with the reasons being given.

In my experience, the fitness community is full of noise -- people who are sure their fitness plans "work" because "look at the great results!" But their justification is so bad that the advice is essentially meaningless.

Or people will swear that X supplement changed their life because they started taking it and presto! 90 days later they had lost 30 pounds, increased muscle tone, and doubled their energy level! Oh...and by the way, they had also concurrently started eating a clean diet, working out 5 times a week, meditating and sleeping more consistently during that 90 days.

As you said, it is important to figure out why the Atkins diet works (when it does). But simply concluding that it is good to follow Taubes advice since it can't kill you and it seems to work for some people is akin to saying you should give horoscopes a try because they are kinda fun and strangely accurate (when they are). You haven't gotten any closer to an accurate map.

9falenas10810y
That's a question of instrumental vs. epistemological help. It works -> instrumental. Here's why it works ->epistemological. Both are useful, and both are important for LW.
9FeepingCreature10y
I don't think that's what he's saying, I think he's saying "there really appears to be some sort of effect there, so I'd really appreciate if somebody would try to support it with proper research."
4ephion10y
I agree. falenas108 is completely correct that this is an instrumental vs epistemological rationality thing. Taubes and Atkins are both epistemologically suspect because they're salesmen, not scientists. Going too far into the specifics on why their arguments are bad seems like a waste of time to me, given that you wouldn't expect truth seeking out of salesmen in the first place.
5Brillyant10y
This is fascinating to me. I think the issue with bad epistemology in regard to nutrition is, for one, the potential for long term harm. Any principle that is epistemologically sound would account for that. Bad nutrition advice does not need to. Giving people a pass because they are not scientists is fine to the extent you don't then apply their ideas to your nutrition and your body. Taubes, or many other pieces of bad nutrition advice might not kill you... at least not right away. Now, I don't think Atkins or anything Taubes says is that detrimental to long term health. But I think there are plenty of cases where salesmen and scientists end up promoting bad nutrition ideas that do have negative long-term effects. Anyway, it is just interesting to me that anyone from LW takes Atkins seriously at all. From my wiki-research, the 1st phase is two weeks and involves eating up to 1680 calories per day. From my recall, this is about 1000 less than the average American male's intake. That is a 14,000 calorie deficit over the course of two weeks, which is a ~4lb loss. Add to that the following considerations: 1. 1680 calories is the target, with only 20 grams coming from carbs. 100 grams comes from fat; 150 grams comes from protein. It can be very challenging to find ways to consume 150 grams of daily protein consistently given the other types of food restrictions that Atkins has. I suspect most people don't do it, so, as long as they keep to the 20 grams of carbs and 100 grams of fat, consume even fewer that 1680 cals per day. 2. Many people (as evidenced by the fact the gym will be packed tomorrow) begin an exercise regiment concurrently with their diet. Of course, given these data, you are gonna see some results! Atkins seems to make it so many people will eat substantially less. And many of those people will start to exercise more, just 'cuz they are trying to be more active along with their diet. And that is great! What I'm hearing in the discussions on thi
0A1987dM10y
Postcyincism FTW!
0ChristianKl10y
That's a strange sentiment. There are people who care about losing weight. It might be surprising but those people do exist. If you give them a working solution they are happy, even if your theoretical underpinnings are off.
-3Brillyant10y
There are people who care about going to heaven. It might be surprising but those people do exist. If you give them a "working" solution they are happy, even if your theoretical underpinnings are off.
4ChristianKl10y
We assume that something like losing weight exists in the real world. If we would assume the same thing for going to heaven, I would want to follow heuristics that bring me to heaven. I don't really care whether given my a beggar a dollar brings me nearer to heaven because it's me showing compassion or because it's a sign that I'm not greedy. The core question is whether giving the person the dollar works as a strategy for raising my chances of going to heaven. Different churches might have huge disagreements about finding the real reason, but I don't care that much about those reasons. If you say that you don't care about whether something is working, that's declaring faith in the church of mainstream science, where adherence to virtues is more important than utility or consequences of actions. Is that really your position?
-1Brillyant10y
I care about whether or not something is working. I've got this idea for a workout plan to increase your muscle mass: Buy these Magic Muscle Beans from me AND workout with weights 4 times per week for 6 months. You will experience tremendous results! My point is that the Atkins Diet and every other Diet! basically combine common sense, well-established, mainstream health heuristics with magic. Magic Beans and Heaven and The Perfect Diet! might exist, but my guess is they are superfluous, and used only to line the pockets of those who cite them as real.
3ChristianKl10y
Then don't say that it's irrelevant. It's very valuable to distinguish between whether something works and whether the theoretical underpinning is correct. Usually there are years between the one and the other. Einstein formulated the theory of special relativity decades before it had strong empirical evidence. That's having theory before empirical confirmation. Washing hands before operating a person is the other case. Even before you know about bacteria and viruses you should start washing your hands if you see that having clean hands generally reduce the number of complications in operations. The people who advocate washing hands might tell you some magical theory about how washing hands means that you smell better and that your patients are less likely to develop complications because you smell better. It's a lot harder to find out that bacteria cause illnesses than to find out that surgeons who wash their hands achieve better results. On the same token it's easy to observe that many people who adopt a low carb diet, do lose weight on the diet. Whether it's due to changes in insulin production, ketones-in-the-urine or some other factor is a harder question. It's certainly nice is someone is right about the reasons why the diet he advocates works but the person who's suffering about overweight cares primarily about whether the diet works. A person who's in the advice business is generally forgiven if his advice works but his theory is off.
0A1987dM10y
ITYM general relativity -- the Michelson–Morley experiment had been performed 15 years earlier. (OTOH IIRC Einstein said he didn't remember whether he was aware of it in 1905.)
0ChristianKl10y
As far from what I remember from school Michelson-Morley did show that not all was well with the prevailing physical model. I don't think it provided enough evidence to validate that Einstein was completely right.
0Calvin10y
I think that for many people, getting fit (even if they arrived at fitness with incorrect justification) is far more important than spending time analyzing the theoretical underpinnings of fitness. Same thing with going to haven, choosing right cryo-preservation technique, learning to cook or any realm of human activity where we don't learn theory FOR THE SAKE OF BEING RIGHT, but we learn it FOR THE SAKE OF ACHIEVING X GOALS. I mean, I concur that having vastly incorrect map can result in problems (injuries during workout, ineffecting training routine, ending up in hell) but after you update a map a bit you hit the point of dimnishing returns, and it is probably better to focus on practical part than to theorize (especially in the realm of physical pursuits).
2Brillyant10y
Um, yep. And that has been position all along on this series of posts. I've said why I think Atkins works and why I don't think it has anything to do with why the Atkins diet is said to work. Eat Less, Exercise More for weight loss. Lift More for strength training. Of course there are lots of exceptions, and plenty of nuance within these heuristics. But you said it best: The diminishing returns happen quickly for most people and most advice. My point was only that if someone wants to sell you Magic Muscle Beans and a workout plan that says Lift More, don't buy the beans.
7passive_fist10y
The main problem with Taubes, I think, is that he fails to cleanly separate the two issues in question: * Why people have been getting more obese. * How to lose weight. These are very different problems. Why have people been gaining weight, on average? The reasons are complicated and Taubes gives important insights (even though, as OP said, his criticism of mainsteam nutrition is unfair). How to lose weight, though, is a different matter. Every source I consult seems to agree that the reason the Atkins diet works is mainly because it makes it easier to eat less, by severely restricting the types of foods you can eat and also possibly reducing hunger pangs. I have yet to see any study consistent with the idea that a Atkins-type diet inherently makes you lose more weight than a conventional diet from mainstream nutritionists (if you match the number of consumed calories). I'd love to be proven wrong, but it seems that if Atkins works for you, other types of caloric restriction diets will also work, long-term.
4hyporational10y
Don't expect it to generate any less controversy. I think it was Dennett who said that everyone thinks they're experts on consciousness because it's such a constant part of their lives, which makes it difficult for them to respect an expert philosopher on the topic. Well, everyone's an expert on moving their bodies and stuffing food in their mouth and gaining or losing weight too. Giving them advice is a violation of their expertise, unless they're looking for advice.
0private_messaging10y
Gravity is also a part of everyone's lives. Yet people respect Newton. Very special conditions have to exist for conversion of time spent into greater correctness. These conditions do exist for physics or physiology, but they do not seem to exist for philosophy of consciousness.
2hyporational10y
I think respect was a poor choice of words to begin with. Perhaps people here don't like Dennett, I don't care much about him either. If physicists tell laypeople something that contradicts their experience of gravity, like gravity affecting passage of time, some of them will have hard time accepting it. For laypeople, nutrition isn't about physiology, and if their experience of weight loss for example contradicts expert advice, again they will have difficulty accepting it. Change philosophy of consciousness to study of consciousness, and people would probably dismiss philosophers as well as neuroscientists if their findings didn't fit their experience. I think many philosophers of consciousness cite neuroscientists, so their conditions are pretty special too.
6private_messaging10y
Following his advice can result in chronic ketosis, read the article yourself to draw your conclusions. Furthermore, there's a wealth of contradictory data which he fails to report or distorts. For instance, Japanese eat high-carb low-fat diet (calories coming largely from white rice) and have very, very low prevalence of obesity, colon cancer, etc. Even more relevantly for Caucasians, obesity rates in Europe used to be very low fairly recently (and are still significantly lower than in the US), without being particularly low in carbohydrates - and the changes are very easily observable (fast food, soft drinks). As for whenever his diets are effective for losing weight, that is a very complicated issue, largely psychological in nature. Perhaps some people can be more motivated when they follow unusual / non-mainstream advice, where success proves them right and their boring doctor (who recommends cutting fats) wrong. edit: and as for whenever his advice would kill you... cancer risks associated with red meat are of interest.

Executive ruling: Series not appropriate for Main.

The main reason is what I feel is low argument quality; secondary reason, repeatedly not upvoted. I suspect that the reason your series is not being upvoted is that the readers agree with me that you've failed to find a smoking gun, and you're writing as if you'd already found a smoking gun. Taking this many posts to get to the main point, when making a point of this overall magnitude/importance/significance even if true, is also not acceptable for Main.

0A1987dM10y
Part 1 seems to still be in Main.

This is a poor analogy, because the fact the importance of calories in weight gain is far less obvious than the importance of people in a room's getting crowded

I agree with this. There is an idea out there that there are people who eat little but become and/or stay fat; and that there are people who eat a lot but stay thin. This is vaguely asserted to be related to peoples' "metabolism." For the most part, this is not so. When such people are scientifically tested, it almost invariably turns out that their perceptions of how much they eat are simply wrong.

By contrast, nobody seriously believes that some rooms are crowded because people appear from out of nowhere.

As with a lot of debates, the actual debate stems in large part from ambiguity over what exactly is being debated.

those involved in obesity research did not fail to grasp the factors that drive hunger and sedentary behavior,

Well that seems to be the crux of the dispute, to the extent that there is a dispute. According to you, there is no mainstream consensus position on what causes some peoples' natural drives to consume too much food. According to Taubes, it's carbohydrates which causes such drives.

it became less and less what view he's attributing to mainstream experts, or what his alternative is supposed to be.

less and less -> less and less clear?

I have no plans of discussing is Taubes claims

discussing is Taubes -> discussing Taubes?

4ChrisHallquist10y
D'oh. Fixed.
2RolfAndreassen10y
Also, is not as of a good grammatical structure as it could be. I suggest rephrasing.
2Vaniver10y
Also: Drop the attempt. cause -> caused

A more sensible approach would've been to emphasize that akrasia is an extremely common problem for humans, and that people who don't suffer from akrasia in regards to diet probably suffer from akrasia about something else. [...]

I have no plans of discussing Taubes claims about carbohydrates having a unique ability to mess up the systems that regulate weight.

Really? Basically you are arguing that you don't want to discuss Taubes central claim and instead argue that it would be helpful to speak about akrasia based on no evidence that doing so is useful?

I... (read more)

Could Taubes be using a nonstandard concept of causality? One that excludes the notion of proximal cause?

5private_messaging10y
Or multiple causes that work additively and multiplicatively... i.e. why is x*(a+b)+c+d+f(g(i)) ... too big? Is it because of x? a? b? c? is it f or g which are bad? The question should not be "which is the singular cause", the question should be "changing which variables is the best?".

You quotes from mainstream sources certainly indicate that the nutrition science community is familiar with the diverse factors that can lead to obesity-- but that's not surprising and wouldn't be surprising to Taubes. The issue has never been that the mainstream refuses to recognize that heredity, medications, hormones and altered metabolism can contribute to individuals being overweight. The issue is that these facts contribute almost nothing to the medical and nutrition authorities response to individuals trying to lose weight or to the world's growing... (read more)

I now suspect that a significant number of people are having a 'WTF is this and why is it on LW?!' response to these posts because the posts do not immediately seem to be related to LW rationality and do not seem to offer obvious benefits (contrast with Jonah Sinick's post offering tutoring help which got positive comments from people who could immediately benefit). This perhaps motivates William_Quixote's comment on this post (and the upvotes it received); in the absence of an obvious purpose for the posts, it might seem like Someone Is Wrong on The Inter... (read more)

Downvoted.

How metabolism works, and how to lose weight in a healthy fashion is a matter of general interest. Whether Gary Taubes mischaracterizes "mainstream diet experts", not so much.

Why is this post in Main while the other three are in Discussion?

2ChrisHallquist10y
Hyporational is correct. See here and also here.
2hyporational10y
There's apparently disagreement over where they're supposed to be. The previous posts were moved to discussion by Eliezer.

this whole post hinges on how one defines mainstream. I've heard "Eat Less Exercise More" hundreds of times from tons of people. All the time. Taubes is attacking "nutrition experts" and the people who make the food pyramid, not elite obesity researchers.

Once you start veering off into a shitty tangent about meanies maybe you need to reconsider just how much you want to attack Taubes vs how much you want to be useful or informative. This series of articles sucks and you should be ashamed. You're spending your time attributing extrapola... (read more)

I've heard "Eat Less Exercise More" hundreds of times from tons of people. All the time.

As I'll discuss in the next post, it's good advice. And contrary to what Taubes wants you to think, perfectly compatible with recognizing that the causes of obesity are complicated.

Taubes is attacking "nutrition experts" and the people who make the food pyramid, not elite obesity researchers.

The views Taubes attributes to "nutrition experts" are not only not the views of elite obesity researchers, they're not the views of the FDA, Surgeon General, or anyone else he attributes them to.

I get that you don't like his popsci "I'm a rebel" style...

It's not his style I don't like. It's the substantive and wildly false claims he's making.

...but that should've taken at most 1 post to say.

Some people take Taubes very seriously as a source of scientific information about nutrition, and unless it were a very long post, those people wouldn't have been satisfied.

As I'll discuss in the next post, it's good advice.

No, it really isn't (for me, at least). When I was limiting my calories and exercising more I was gaining weight, feeling like crap, and was miserable and hungry much of the time.

Now that I stopped trying to keep calories down and eat as much fat as I can handle (about 4/5 of my calories come from fat), I lost 30 lbs from my maximum, feel much better (in addition to having more favorable biomarkers), have significantly improved cognition, and almost never feel miserable because I'm hungry. This is precisely the opposite of the advice I received from virtually all the diet authorities I had encountered like my high school health textbook and doctors.

Now that I stopped trying to keep calories down and eat as much fat as I can handle (about 4/5 of my calories come from fat), I lost 30 lbs from my maximum, feel much better (in addition to having more favorable biomarkers), have significantly improved cognition, and almost never feel miserable because I'm hungry. This is precisely the opposite of the advice I received from virtually all the diet authorities I had encountered like my high school health textbook and doctors.

At what point do we start considering the hypothesis that different people have different things that work for them, and that a diet that is healthy for one person may be terrible or even life-threatening for another person?

So much focus is given on "Dietary advice X is good!" / "Dietary Advice Y is bad!", instead of asking how dietary behavior X interacts with metabolism Y?

I wonder if there's a market for a company that uses blood samples to examine various metabolic markers and meal logs to examine dietary behavior, and then correlate them over time with health markers and use that to craft a personal diet plan?

2ChristianKl10y
Keeping meal logs is itself a fairly significant intervention into someone's diet. It relatively hard to keep one that's accurate if you don't standardize your diet.
0brazil8410y
Will you agree to update your report in a year or so?
3Jayson_Virissimo10y
You mean at the 3 year mark? It has already been 2 years.
-2brazil8410y
Yes, although my erroneous impression from reading your post was that you hadn't been on the high-fat strategy for all that long. Thanks for cooperating!
0Brillyant10y
Can you explain how this happens? Is a variation of the Atkins diet? Eating Less + More Exercise = Gained Weight Eating More ("as much fat as you can handle") + Less Exercise = Lose 30 Pounds. Can you give more specifics? Time frame? Average calorie levels? Workout regiment? In the first scenario, did your low mood and hunger cause you to break the diet often and binge calories? Congrats, by the way. 30lbs is a lot of weight, and it sounds like you have improved your life all around.
0NancyLebovitz10y
What kinds of fat have you been eating?
5Jayson_Virissimo10y
In addition to the fat in my food (which tends to be fairly fatty like eggs, salmon, lamb, etc...), I usually add large amounts of butter, coconut oil, MCT oil, or olive oil. Also, I take way over the recommended dosage in cod liver oil supplements.
6EHeller10y
A word of warning here- long term use of large quantities cod liver oil can result in vitamin A toxicity.
4EHeller10y
Why was I downvoted on this?
0Jayson_Virissimo10y
Thanks. I'll look into that.
0James_Miller10y
Do you take Bulletproof coffee? (Coffee+butter+MCT)
0Jayson_Virissimo10y
Yes.
6hairyfigment10y
I think I detect some disconnect between the experts you refer to, and the medical professionals people actually talk to. (Scene 1 seems most directly relevant, but please read 5-7 as well.) Taubes didn't just invent this.
3brazil8410y
As I understand it, Taubes claims to be going against the experts. Assuming that's correct, then if there is a disconnect between the experts and medical professionals, it's a separate issue. That said, if you want to assess the position of medical professionals, I would be wary of going by uncorroborated self-serving doctor stories told by fat activists. Also, the story you cite to is basically of the "I restricted my calories but didn't lose weight" genre. When such claims are investigated they have turned out to be false. Fat people who record their eating tend to wildly under-report caloric intake.
4brazil8410y
Well I hope that you will define ELEM very carefully in assessing it. For example, does the Hacker's Diet by John Walker qualify as "Eat Less Exercise More"? Arguably it does since Walker advocates carefully counting your calories and being careful to eat less than your daily metabolic requirements. But at the same time, the Hacker's Diet is a lot more specific than simply Eat Less Exercise More. As a practical matter, the simple advice to "Eat Less Exercise More" is too vague to be of much value. And what about diets which achieve (or are claimed to achieve) ELEM indirectly? For example, the Shangri La diet. Do those count as "Eat Less Exercise More."? If you read ELEM broadly enough, you could simply take it to mean "Avoid diet strategies which entail regular consumption of excess calories." Which is surely good advice but if that's what you mean you need to spell it out.
4jimrandomh10y
This is the crux of the matter, and quite a few people disagree with it very strongly. In fact, it's downright offensive. Those people aren't here. All of the ad hominems against Gary Taubes are wasted on this audience.
3VAuroch10y
Have you not be reading the comments for the last four posts here? They are.
0ChristianKl10y
Those people don't care about the length of the attack. To quote Eliezers assessment: "this whole series is simply failing to find a smoking gun of Taubes saying something false". Quantity doesn't help as a substitute for quality.
1ChristianKl10y
Taubes doesn't advocate "recognizing that the causes of obesity are complicated". He advocates that cutting carbohydrates because of their effect on insulin is the main mechanism. Saying "causes of obesity are complicated" also doesn't help people with their day to day nutrition choices.
8hyporational10y
You seem angry. Why?
-1drethelin10y
I don't like being condescended at.
0hyporational10y
If you happen to refer to me too: curiosity, not condescension. You made an unusually aggressive comment, which commonly is a sign of anger. This topic doesn't make me angry, so that got me interested. There are some topics that could make me angry, but this isn't one of them.
0[anonymous]10y
Curiosity, not condescension. You made an overly aggressive comment, which usually is an indication of anger. This topic doesn't make me angry and can't imagine why it would so that got me interested. I admit there are topics than could make me angry too, but this isn't one of them.

I just read the book (Why We Get Fat), and yes, he meant what he said when he said that people overeat because they are getting fat.

He explains this pretty clearly, though. He says its true in the same sense that its true that growing children eat more because they are growing. Since their bodies are growing they need more food to supply that, and the kids get hungrier.

In the same way, according to his theory, because a person's body is taking calories and storing them in fat, instead of using them for other tissues and for energy, the person will be hung... (read more)

0Lumifer6y
So why does this positive feedback cycle start in some people, but not others? That's pretty clearly not true.
0entirelyuseless6y
This is his description: * You think about eating a meal containing carbohydrates. * You begin secreting insulin. * The insulin signals the fat cells to shut down the release of fatty acids (by inhibiting HSL) and take up more fatty acids (via LPL) from the circulation. * You start to get hungry, or hungrier. * You begin eating. * You secrete more insulin. * The carbohydrates are digested and enter the circulation as glucose, causing blood sugar levels to rise. * You secrete still more insulin. * Fat from the diet is stored as triglycerides in the fat cells, as are some of the carbohydrates that are converted into fat in the liver. * The fat cells get fatter, and so do you. * The fat stays in the fat cells until the insulin level drops. But it gets worse because over time your cells start being resistant to insulin, so in order to overcome that, you emit even more insulin, and so you get even fatter. According to him this is why people tend to get heavier as they age. And if a time comes when you can't emit enough insulin to overcome the resistance, then you get diabetes. Two arguments he tries to make from common sense: 1. No one expects a boy or girl to have their growth stunted from too much exercise. Instead, they will feel hungrier and eat more. In the same way when the insulin makes you get fatter, you will not stunt the fat growth by exercising. Instead, you will feel hungrier and eat more. 2. Both eating less and exercising more make you hungrier, which makes you eat more, which makes you heavier. So the methods that people tell you to use to lose weight, cannot work. And this corresponds with how fasting diets normally work in the real world: people lose some weight, but they feel hungry all the time, so they stop, and they get the weight back. His theoretical explanation is that carbohydrates are relatively new to humanity's diet, at least in significant quantities. So people are not as well adapted to them as to fat and protein. If you
0Lumifer6y
The idea that insulin drives obesity was popular for a while (did Gary Taubes start it?) but I thought it didn't fare too well when tested against reality (see e.g. this and this) That's not common sense, that's analogies which might be useful rhetorically but which don't do anything to show that his view is correct. I don't know about that. Carbs are a significant part of the human diet since the farming revolution which happened sufficiently long time ago for the body to somewhat adapt (e.g. see the lactose tolerance mutation which is more recent). Besides, let's consider what was the situation, say, 200 years ago. Were carbs a major part of diet? Sure they were. Was there an "obesity epidemic"? Nope, not at all. If you want to blame carbs (not even refined carbs like sugar, but carbs in general) for obesity, you need to have an explanation why their evil magic didn't work before the XX century. No, I'm not. For any animal, humans included, there is non-zero intake of food which will force it to lose weight. "Starve" seems to mean exactly the same thing as "lose weight by calorie restriction", but with negative connotations. And I don't know about modified rats, but starving humans are not fat. Feel free to peruse pictures of starving people.
0entirelyuseless6y
I can't comment on those in detail without reading them more carefully than I care to, but that author agrees with Taubes that low carb diets help most people lose weight, and he seems to be assuming a particular model (e.g. he contrasts the brain being responsible with insulin being responsible, while it is obvious that these are not necessarily opposed.) They don't show that his view is correct. They DO show that it is not absurd. Lactose intolerance is also more harmful to people. Gaining weight usually just means you lose a few years of life. Taubes also admits that some people are well adapted to them. Those would be the people that normal people would describe by saying "they can eat as much as they like without getting fat." He blames carbs in general, but he also says that sweeter or more easily digestible ones are worse, so he is blaming refined carbs more, and saying the effects are worse. Sure, but they might be getting fat at the same time. They could be gaining fat and losing even more of other tissue, and this is what Taubes says happened with some of the rats. No. I meant that your body is being damaged by calorie restriction, not just losing weight. He gives some partial counterexamples to this in the book.
0Elo6y
Please fix the formatting. Edit: thanks
0Elo6y
it may not have a specific single cause. it may have many causes. But once it starts, it keeps going. (not endorsing, just proposing a model of how)

Comparing this map and this map makes me a bit sceptic about Taubes's claims. (I'm looking for a similar map for grain consumption per capita but I'm only finding ones about which grains countries consume.)

EDIT: Oh. Never mind.

EDIT again: No, looks like that map also counts grains fed to livestock.

the mainstream view is that people gain weight when they consume more calories than they burn, but both calorie intake and calorie expenditure are regulated by complicated mechanisms we don't fully understand yet.

How does this square with starches occupying the bottom of the pyramid?

Yet Taubes goes on at great length about how obesity has other causes beyond simple calorie math as if this were somehow a refutation of mainstream nutrition science. So I'm going to provide a series of quotes from relevant sources to show that the experts are perfectly a

... (read more)
6Randy_M10y
Food pyramid wasn't intended to be about obesity; ironically, obesity wasn't a national concern when the advice was formulated.
3Nornagest10y
The short version, if I recall correctly, is that starchy foods were seen as the least bad option: fats are more calorie-dense than carbohydrates, and meat and eggs were being discouraged for other reasons. I'm not sure why starchy foods were being recommended over fruits and vegetables, which are strictly better by the same standards, but the simplest answer is probably that they were already dietary staples and the people designing the guide wanted to rock the boat as little as possible. It's also worth mentioning that the food pyramid, and other nutritional advice contemporary with it, wasn't exclusively aimed at obesity (which at the time was rising, but wasn't anywhere close to the public health issue it is now). Managing cholesterol was hugely trendy in the Eighties, for example. Not to get too apologetic for the advice of that era, which I view as ineffective at best. But it wasn't that inconsistent.
-5Eugine_Nier10y
0EHeller10y
How does it not? You've said almost this exact sentence elsewhere, could you spell out your point by more than implication.