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9eB1 comments on Critiquing Gary Taubes, Final: The Truth About Diets and Weight Loss - Less Wrong
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I have been following this series with muted interest. While I am very interested in nutrition and have done much reading on the topic, I'm not a huge fan of Taubes', in spite of that fact that I think low-carb dieting actually is superior for most people and that many of the points he makes about the conventional wisdom are correct. I think this is the first article in the series that appeals to me at all, with its greater focus on the actual available state of our knowledge and a lesser focus on Taubes specifically.
One element which I think is somewhat misleading is the seeming equivalence you are drawing between low-carb and low-fat diets. While you note that low-carb diets have higher prevalence of side effects, they also show statistically significant benefits in areas other than weight loss, including relative improvements in blood pressure, triglycerides, HDL cholesterol, and insulin sensitivity. Notably, in 6 month and longer studies low-carb had better attrition rates, which is the key to the long-term weight loss conundrum if you are making decisions for yourself (source). I recognize that it is rude to say so, but I can't help but suspect that your moral position with regards to eating animal products likely affects the way that you have researched, thought about, and framed this evidence. In the same way that the world is allowed to throw us problems with no good solution, it's also allowed to make any particular "morally desirable" position the more costly, difficult, and unhealthy.
Questions of nutrition often touch on this weird gray area of human knowledge, where even though science has many answers, it still doesn't have the resources to give us ALL the answers with statistical significance. Losing weight is in part a psychological and cultural phenomenon, and I think there is an important aspect which is not captured in the studies which allows people to lose weight with low-carb diets more easily than with low-fat, and the only evidence I have is to tell you to read a few pages of posts at /r/keto and see if they feel extraordinary to you. Better yet, try a low-fat diet for 3 months and a low-carb diet for 3 months and see which feels more natural and which improves your health markers more. It's different when you are a member of a randomized, controlled trial vs. when you are actively going out and looking for the best weight-loss strategies.
Huh, yeeeeah, that's definitely not a self-selected sample at all.
Even a few days of not eating much pasta or bread or rice or potatoes or legumes or beer or fruits feels very unnatural to me; conversely I actually get tired of eating meat if I eat lots of it for a few days in a row. (YMMV.) And anyway, that's a false dichotomy.
Of course it's self-selected. That's part of my point. A gigantic number of people have been able to select themselves for losing truly massive amounts of weight. If you are making decisions for your own weight loss, that is highly relevant information. The studies that have been done show people losing on average 10-20 pounds. If you need to lose 200 pounds, it may just be that those studies don't capture every relevant fact. There never will be large randomized studies on the weight loss of people who need to lose this much weight.
Feeling tired after eating low-carb for only a couple days is an extremely well-known temporary side effect, so I'm surprised you weren't aware of it if you were actually intentionally going on a low-carb diet. It's not really a false dichotomy because the difference between those two modes of weight loss is precisely what I was making a point about, what Gary Taubes is talking about, and what all the researchers have studied. From a public health perspective, the diets that you prescribe can only be of limited complexity and time-cost. The intersection between people who can successfully count calories and explicitly track macronutrients for years and the people who are overweight is small. The intersection between people who are overweight and can successfully eat low-fat or low-carb diets is still apparently small (based on the studies), but larger than those who can track calories.
So, what's wrong with the National Weight Control Registry mentioned in the OP, which is self-selected for persistent weight loss but not for diet used to achieve it?
I can't see how prescribing a low-calorie diet is that much more complex than prescribing a low-fat one or a low-carb one. (And what's up with everybody treating “carbs” as if it was a terribly useful category? If we abolished that word so that people who actually mean to talk of both sugars and starches had to explicitly say “sugars and starches” and everyone else would have to decide which one they actually mean, the amount of nonsense in these discussions would probably be reduced by half an order of magnitude.)
There's nothing wrong with the National Weight Control Registry. I never said anything was wrong with it, so I'm not really sure what you'd like me to address about it or how it relates to my argument. Low-fat dieting and generic calorie restriction can definitely work to lose weight. According to their research, the percentage of people that have lost weight through low-carb dieting has increased from 5.9% in 1995 to 17.1% in 2003, which is ambiguous with respect to the question of whether low-carb dieters are actually more successful, and is only a measure of the increase in popularity of such diets.
Low-calorie diets are complex because you can eat any food, but you have to track the calories of every item you eat to ensure that you don't go over your daily calorie budget. Low-fat and low-carb diets tend to simply disallow the dieter from eating categories of food, which requires no record-keeping and no-math. The most damaging foods for a dieter are those that are hyper-palatable, generally consisting of high levels of both fat and carbohydrates (think cookies, french fries, doughnuts). Because they are so rewarding to consume, it's very easy to eat an excess of calories. Both low-carb and low-fat diets restrict these foods, one because of the fat content and one because of the carbohydrate content.
When I say carbs I mean both sugars and starches, all carbohydrates. All of the research trials I've read on low-carb diets specifically state the total number of grams or Calories from carbohydrates in the diet. If someone is using low-carb to refer to low-sugar diets they are probably confused themselves, and spreading it to everyone else.
Has there been a comparrison done of the relative micro-nutrient levels of low carb vs low fat diets? I think its very plausible that nutrient deficiency could manifest as hunger, generating weight gain as the body compels oneself to eat enough to fulfill nutrient requirements despite the excess of calories.
Interestingly, I saw on article on the topic of micronutrients and hunger just a few days ago here. He cites two studies on multivitamins that show in one case no impact on appetite, and in another case an increase in fasting desire to eat but no impact on hunger, fullness, or prospective food consumption. With respect to the relative micronutrient levels of low-carb vs. low-fat diets it depends critically on the composition of such diets, and all of the studies that I've seen comparing them have a complete profile, as far as I can remember.
That makes sense. I mean, whether you cut fat or carbs you still have access to a variety of meat and vegetables, and people would want to study one variable at a time.
I don't know if it's been studied, but I don't find it plausible at all. Under the micronutrient theory, you could arguably control your weight by eating micro-nutrient fortified doughnuts for breakfast. Or eat a hamburger, french fries, and a micro-nutrient pill for lunch. If it were that easy, surely word would have spread around by now.
Or there's multiple needs that play on the same mechanism, making it harder to tangle out specific causes, rather than simpler. You need calories and nutrients from food to function properly, why should hunger only arise from one?
And also, you are assuming we have identified every micronutrient are are capable of adequately fortifying a donut with them.
Well there are a lot of possibilities, but if there are multiple micronutrients in play, then doughnuts could be fortified with all of them.
Not necessarily. If excessive eating results from a deficiency of 10 micronutrients, it's reasonable to expect that supplementing 5 of them would have a marked impact. Besides, it's also reasonable assume that these micronutrients are around in varying amounts in different kinds of foods. If the micronutrient hypothesis were correct, surely someone would have noticed by now that if you eat a serving of miracle foods X and Y every day, then the rest of the day you can eat whatever you want in the amounts you want and get and stay thin. Especially since people have been searching for foods like this for years with little success.
There was a wave of spam some years back for a type of bread that supposedly drastically reduced hunger. So if the spam is to be believed... which of course it isn't. But I'm curious to know if anyone has tried it.
If rather than keeping track of how many grams of fats (or carbs) you're eating you can just abstain from foods with lots of fats (or carbs), can't you do the same with calories too?
In principle, yes, of course. That's the "avoid junk food" diet.
Unfortunately, trying to restrict total calories this way without counting gives you a relatively narrow margin of error, and most of us aren't very well-calibrated. A normal calorie deficit for weight loss means eating ~20% below your maintenance level, so if you overshoot by 25% (quite easy to do when you're not measuring portion sizes), you're making zero progress and don't even know there's a problem.
It is comparatively difficult to accidentally eat bread at every meal without noticing.
Then again, if one day you overshoot by 25% and another day you undershoot by 25%, the (first-order) effects cancel out (there are second-order effects, but they are, well, second-order). Unless there's a systematic error, in which case you will notice in a couple of weeks, because you will gain/lose weight at a rate different than you want to gain/lose weight at.
No? once you know that beef has no carbs in it you no longer need to track anything about it. You can just eat it. But tracking calories involves knowing how many calories are in every food item you may want to eat and knowing how much and which you've eaten throughout the day.
And once you know that water has no calories in it you no longer need to track anything about it. You can just drink it. What's the difference?
Are you dense or just trolling? You can't live on just water. So you have to eat some food. this food will have varying amounts of calories. If you want to keep your calories below a certain amount, you need to track calories.
Can you live on just beef? (Possibly, but is it healthy to live on just beef? Is it fun to live on just beef? Is it cheap to live on just beef? Is it convenient to live on just beef?)
What do you mean by “track calories”? Did pre-WW2 Okinawans track calories?
I wasn't; I spent a few weeks in a country whose diet includes much more meat and less grains than mine. And I meant tired as in tired (i.e. bored) of always eating meat, not physically tired.