Designed to show a False Result? - Research Project of Gary Taubes / NUSI
- POSTED ON: Aug 28, 2013

Any reader who has paid attention to my posts here at DietHobby knows that...

I highly respect the work of Journalist, Gary Taubes, who wrote "Good Calories Bad Calories"  and "Why We Get Fat".  In fact DietHobby's section; BOOKTALK  features "Why We Get Fat", together with summaries of what I personally found in every single chapter.

Since these books were published, I have conducted quite a few personal Experiments-of-One with Low-carb eating. In fact,  I'm involved in one at present.

However, my own experience and education leads me to believe that this not a one-size-fits-all-world, and that while Every Diet Works for Someone, No One Diet Works for Everyone.

As a lay person with no biochemistry education,  I'm interested in Gary Taubes' Low-carb Theories, and am open to the issues involved in his alternative hypothesis ..., although I will admit at this point I am not convinced that the hormone "insulin" is the sole and ultimate answer. 

Based on my own personal Experiments-of-One, and life experience of observing others, I am still convinced that Calories matter. While I can see that the body processes macronutrients differently, and that additional processing differences exist between individual bodies due to genetic and/or hormonal differences etc., no matter HOW nutrients are processed within the body, it seems obvious to me that ultimately, fat gain, loss, or maintenance, is a matter of Energy balance in and out. This is despite whether, or not, one makes the choice to label that Energy with a caloric number. While body processing differences can make it difficult for one to know precisely how much energy each molecule of food possesses, I cannot help but think that Discounting this Truth as  "CICO garbage", as many people in the the low-carb community tend to do, is a rather stupid way to throw out the baby with the bathwater.

I also respect the work of the obesity specialist, Dr. Yoni Freedhof, M.D. and find his take on Gary Taubes NuSi's potential Research very interesting, so I'm sharing two of his related articles about it here at DietHobby. The first article he posted today, and the bottom one is from a year ago. 

 Here's the current one:

I Predict Gary Taubes' NuSi's First Experiment Will Show Dramatic Low-Carb Benefits 
             by Dr. Yoni Freedhof, M.D. 8/28/13 www.

Because that's exactly what it appears it's designed to do.

Taubes lays out the experiment in his recent NuSi promoting Scientific American piece. He's going to take 16 individuals with overweight and obesity and house them in a research facility so as to ensure careful and total control over their dietary intake. Next he'll feed them a diet that's 50% carbs, 35% fat and 15% protein. He'll then tweak calorie intake until subjects are neither gaining or losing weight. Once weight stable he's going to pull the carbs out from under their feet and drop the 50% carbs in their diets down to 5% but will do so while keeping calories entirely stable.

And here's Taubes' description of the implications of his study design,

"In this case, if fat accumulation is primarily driven by an energy imbalance, these subjects should neither lose nor gain weight because they will be eating precisely as many calories as they are expending. Such a result would support the conventional wisdom—that a calorie is a calorie whether it comes from fat, carbohydrate or protein. If, on the other hand, the macronutrient composition affects fat accumulation, then these subjects should lose both weight and fat on the carbohydrate-restricted regime and their energy expenditure should increase, supporting the idea that a calorie of carbohydrate is more fattening than one from protein or fat, presumably because of the effect on insulin."

I'll get to why in just a second, but I predict they'll all lose between 6-20 pounds in the first 2 weeks of a diet consisting of 5% carbs following a step down from one that consisted of 50% despite the fact calories will remain constant. I also imagine that the experiment won't last much longer than the time it'll take for them to lose that weight as most folks don't have the time/luxury of spending months and months in a metabolic ward.

So why will they lose so much weight while calories are kept stable? Won't that indeed confirm Taubes' hypothesis is right on the money?

Not exactly. No doubt some of their losses may well be consequent to the fact that there are differences in what I'll broadly describe as the bioavailable calories of different foods and macronutrients - and so indeed, Taubes may well demonstrate that calories in and calories out is a far from perfect equation (though that's not exactly news), but the bulk of their losses will be consequent to the fact that during the low-carb phase these individuals will burn through their bodies' natural carb stores, their glycogen, and in so doing they'll liberate all the water stored with it.

Depending on your source and each body's level of training, by weight glycogen is responsible for 1-4% of muscle weight in an individual with fully stocked stores (as the study subjects' here will given their 50% carb loading diets). Every gram of glycogen in turn also carries with it near 3 grams of water and if you lose the glycogen, you'll lose the water too. Folks with obesity carry a great deal of muscle. According to friend and author Brad Pilon, in his work he'd found those with obesity to sometimes have a full standard deviation more lean mass than he'd have predicted and regularly carried with them 100lbs of muscle (especially taller men). That's consistent with my findings here in my office and also passes McMaster Professor Stuart Phillips' sniff test.

Consequently this study subjects' muscles' glycogen stores will weigh somewhere in the neighbourhood of 1-4lbs. Add in the water associated with those pounds and now we're talking 4-16lbs that will be rapidly mobilized when carbs are cut (and even more if the deck is super-stacked by only including men with class II or higher levels of obesity). They'll also have liver glycogen stores of between 50-150 grams which when lost along with associated water, will drop them an additional 0.5-1.25lbs. Couple those losses with the tiny bit extra you might expect consequent to the differing thermic effects of food and I'd bet, in total, losses will range between 6-20lbs despite the fact total calories won't have changed.

I'd bet too that there's a great chance this will be a crossover study (or one will soon follow) where Taubes will show us his subjects' massive and total regains when carbs are reintroduced (and glycogen and water reaccumulate) as that will certainly appear to support his hypothesis. Subjects may even gain back more as some papers suggest glycogen starved muscles are able to acutely store larger amounts of glycogen following a carb reintroduction.

I imagine glycogen will be mentioned in the study's discussion section, how could it not be, but what do you think the headlines are going to focus on when the findings that keeping calories constant in a metabolic ward setting but dropping carbs led to massive weight loss are published? Do you think the press will appreciate the result is entirely expected and hence perhaps not even newsworthy?

If simply cutting carbs was a sustainable, enjoyable, and consequently realistic, strategy for the masses, the world would already be slim as it's been down the low-carb road plenty of times before, and I'm unclear on how this particular study is going to do anything other than confirm something we already know to be true.

Lastly, I must as always point out, I'm not anti-low carb. I don't think low-carb is unsafe. I do think low-carb helps many with weight loss. And I do think society's increased reliance on heavily processed carbs has been a contributor to its growing weight. But I also think that low-carb diets have proven themselves to be difficult for many to sustain and consequently that low-carb diets are far from a realistically applicable global panacea for the problem at hand.

Taubes has rightly raged against the damage done by the oversimplified application of calories-in-calories-out, which is why I find it so confusing that he seems to be championing the equally oversimplified message of, to paraphrase, it's the carbs stupid.

[UPDATE: A source who wishes to remain anonymous has informed me the study's formal primary endpoint will be energy expenditure and the secondary endpoint changes in fat mass.]

  Here's the previous one:

Gary Taubes Launches Non-Profit to Prove His Low-Carb Hypothesis
             by Dr. Yoni Freedhof, M.D. 9/12/12 www.

Today marks the formal launch of Gary Taubes' new non-profit organization NuSI whose stated mission is to, "improve the quality of science in nutrition and obesity research", and whose implied mission is to prove Gary Taubes' carbohydrate hypothesis of obesity is as correct as he clearly believes it to be.

So let's for a moment presume that Gary Taubes is one hundred percent right. That what his NuSI backgrounder calls a "controversial" hypothesis,

"that the fundamental cause of overweight and obesity is the overconsumption of food in relationship to physical activity",

is truly dead wrong and that instead it's,

"the quantity and quality of the carbohydrates – plays the more critical role in both the accumulation of excess body fat and the chronic diseases that are associated with obesity"

So that means for the moment just ignore data like those from the Ewe tribe who were recorded as having an obesity rate of 0.8% despite diets that were 84% carb. Ignore the various studies that held calories constant while varying macronutrients that demonstrated weight stability. Ignore the results from Cuba's "natural experiment" in the 1990s. Ignore the folks from the National Weight Control Registry who've lost and sustained their losses with widely divergent dietary strategies. Ignore the fact that even the most low-carb positive studies demonstrate only minor differences in weight loss as compared with higher or middle of the road carb diets. Instead I want to ask you whether or not, assuming Mr. Taubes' shiny new researcher's bench is entirely, incontrovertibly, 100% right in placing blame squarely on carbohydrate consumption, would that bench-side proof actually have broadly applicable clinical utility for folks who struggle with their weight?

My bed-side says no.

That's certainly not to say that low-carb dieting doesn't help some manage their weights and health, it just means that no amount of bench-made "proof" will change the fact that low-carb dieting, for many, is far more of a restrictive diet than it is a livable, long-term lifestyle. Meaning that even if low-carb were the holy grail of diets on paper, that fact would be worthless in practice unless you happened to enjoy low-carb enough to stick with it, and judging from the folks I see regularly in my office, that's far from a given. In fact it's a very rare person that I meet who hasn't tried a low-carb diet at least once. And all of those folks? No doubt when they undertook their low-carb diets they were true believers. As far as they were concerned low-carb was to be their salvation, and many report to me having had real success losing but that they just as rapidly regained everything when they couldn't stomach living low-carb anymore. It's that last bit that makes me think that regardless of the outcomes of Mr. Taubes' new non-profit's future studies, low-carb diets aren't going to be a panacea, just as they weren't in Banting's 1860s or Atkins' 1990s.

Mr. Taubes thinks that study design is the broken paradigm that's crippling weight management. He thinks that nutritional research hasn't asked the right questions or used the right methodologies and so that's why we're mired in this mess. And while it's easy to agree with him that there have been libraries filled with poorly designed studies, as far as clinical weight management utility goes, more effectively asking or studying whether low-carb diets have better outcomes than low-fat or other diets isn't likely to help much.

I think the paradigm that's crippling weight management are "diets" themselves.

Whether it's low-carb diets, low-fat diets, GI diets, middle-ground diets, vegan diets, and even bat-shit crazy diets, there are long term success stories and recurrent failures with each and every one, where the common ground to success is a person actually liking their life enough to sustain their new patterns of reduced dietary intake, and where the common ground to failure is suffering or restriction beyond an individual's capacity to enjoy their life.

And so while I don't share Mr. Taubes' view that there is one simple or predominant cause and treatment for obesity, and would in fact argue that anyone who thinks there's a singular cause for the society's weight struggles almost certainly doesn't work with actual living, breathing, human beings on their weights, I do agree that the research on what works and what doesn't work is inherently flawed. But it's a flaw that Mr. Taubes' is likely setting out to sustain and fund in that the flaw I see from my bedside is the arrogant belief that there's one right way to go and only one path to weight gain (or loss).

There's also the issue of spin. Now I appreciate you've got to tell a good story when you're trying to raise money, but given Mr. Taubes has built his empire on the notion that science has misrepresented data on obesity for decades, you'd sure hope that he wouldn't simply do the same.

Without getting into it too deeply I want to present one graph that he includes in his non-profit's backgrounder that he uses to prove his point that it's the carbs, stupid.

The graphs are meant to be very clear. Carbohydrate intake has gone up since 1971 while fat and protein have gone down, and hey look, weight's gone up too. Must be the carbohydrates, right?

But yet a deconstruction of the first graph by Evelyn over at her Carb-Sane Asylum really gets right to the meat of things with this statement when considering the graph on the left.

"looking at this data, we have the men reducing fat % from 37 to 33% while carbs rose from 42 to 49% of intake. And the women? Fat went from 38% to 33% while carbs rose from 45% to 52%. Given all the studies done where the low carb diets were "hardly low carb" according to the militant keto wing of the movement, can we at least have a wee bit of intellectual honesty here and admit that the differences in macro proportions is largely insignificant?"

What she's saying is that from a macronutrient percentage perspective, the difference between the 1970s consumption of a diet containing 45% carbs (for women) and the 2000s diet of 52% (and for men the difference between 42% and 49%) is pretty insignificant and that 1970 diets were anything but low-carb and yet our weights were so much better.

But more disingenuous is the fact that Mr. Taubes left out his arch nemesis from the graph. Calories.

Here's a graph from Stephan Guyenet that superimposes increased American calorie consumption over that graph on the right hand side of Mr. Taubes' slide.

And would you look at that. As weight rose, so too did caloric intake. Pretty much perfectly.


Why we're eating more is the question that needs to be answered, and while the increased consumption of highly refined carbohydrates may indeed be a player, there's zero doubt in this bed-side's mind, the game that's being played isn't one-on-one. There's no doubt it's not as simple as, "eat less, move more", and there's equally no doubt it's not as simple as just cut carbs. If either were true, everyone who wanted to be would already be skinny.

So huge props to Mr. Taubes for being such a passionate man and for truly wanting to see his theories proven - honestly, his bordering on pathological tenacity is genuinely laudable, though I wish he would hold his own spin and writing up to the same degree of scrutiny to which he holds others'. But ultimately, whereas Mr. Taubes now wants to trade in his pen for a bench and conduct research that presumably he himself won't instantaneously and churlishly deride as being useless, when it comes to clinical utility and weight management, the last thing the world needs is to believe that there's only one right way to go.

   SO.... what does this all mean?

I'll be watching, paying attention to further developments.  
Meanwhile, .... I'll just keep on Running Down the Up Escalator.  

Secrets of the Sugar Industry
- POSTED ON: Nov 07, 2012

Gary Taubes has written a new article on how Big Sugar promotes and defends its produce, entitled: "Big Sugar and Sweet Little Lies".

Taubes is a top-notch science journalist, who has written for Discover, Science, and the New York Times Magazine, and is the author of the 2011 best-seller “Why We Get Fat” which is featured here on DietHobby in the section BOOKTALK. He is currently writing a book about sugar.

Gary Taubes also discusses the Sugar Industry’s Secrets in the video below.

Cutting Carbs? or Cutting Calories?
- POSTED ON: Sep 17, 2012

Which is better or most effective, cutting Carbs, or cutting Calories?

Everything I’ve seen and experienced personally, leads me to believe that calories matter even when one chooses to eat low-carb. There’s a possibility that one can eat a few more calories by reducing carbs, but … for most people … the amount of extra calories doesn't appear to be a very large number.

 It seems like there are an endless number of specific diets and rules for weight loss. One of the most popular of these rules is that cutting carbohydrates (carbs) is the best way to lose weight.

The Atkins diet, first popular in the the most famous low-carb diet. This diet recommends limiting foods high in carbs, such as bread, pasta, rice, and starchy vegetables such as corn and potatoes. Carbs are replaced with foods containing a higher percentage of proteins and fats (meat, poultry, fish, eggs and cheese) and other low-carb foods (mostly vegetables).

What does the evidence show us about whether low-carb diets really are better for weight loss and weight-maintenance than other diets?

Conventional wisdom says that a “calorie is a calorie” and it doesn't matter what types of food the calories come from, and therefore, all reduced-energy (calorie) diets should lead to equivalent weight loss.

However, some studies have reported that low-carb diets, in the short-term, lead to greater weight loss than other types of diets. What are some possible explanations for these results?

1. Changes in body composition

Energy is stored in the body as protein, fat, and glycogen, which is a form of carbohydrate. If there is an imbalance between how many of these nutrients are ingested (through the food that is eaten) and how many are used by the body for every day functions, body composition will change.

In turn, this will affect body weight because of the different impact that the relative amounts of stored protein, fat and carbohydrates have on body weight.

However, the vast majority of studies in which they’ve measured calorie intake very accurately (that is, they’ve locked people in a room and measured exactly what they’ve eaten for several days), show absolutely no difference in weight loss based on the composition of the diet. High-protein diets and high-carb diets resulted in the same weight loss.

2.  Changes in metabolic rate

The body’s metabolic rate (the amount of energy expended by the body in a given time) is dependent on the composition of the diet. Consumption of protein, for example, is known to result in a larger increase in energy expenditure for several hours after a meal compared with the consumption of fat or carbs.

But the overall effect of diet composition on total energy expenditure is relatively small. As a result, the assumption that a “calorie is a calorie” is probably a reasonable estimation as far as energy expenditure is concerned.

3.  Changes in hunger levels and satiety

Some diets can lead to reduced hunger, improved satiety (feeling full), and can be easier to stick to than others. There is an enormous amount of research on this.

The problem is that it’s extremely difficult to accurately measure what people are eating over extended time periods. In general, people rarely stick to their diets for more than just a few weeks, making it almost impossible to adequately compare the effects of different diets.

And so, is cutting carbs the best way to lose weight?  Maybe.

However, all diets with similar calorie content appear to have a similar effect on weight loss in the long-term. This is probably because the body adapts rapidly to changes in relative protein, fat and carbohydrate intake levels.

The truth is that losing weight and keeping it off in the long-term is difficult. It requires permanent changes to the number of calories you eat each day. My own maintenance struggle has involved experimenting with many different diets, or ways of eating.

  I believe the best diet for a person, is whatever diet that person is able to live with comfortably long-term. My own maintenance involves a continual process of looking for a way of eating that satisfies that criteria for me, personally.  As a part of that process, I’ve made Dieting into a rather enjoyable Hobby for myself, which is why this website is named DietHobby.

Sugar Binges
- POSTED ON: Apr 21, 2011

 I recently heard someone say:

"I  plan on making the most out of tomorrow’s holiday.
Even if that means I'll be shoveling plain sugar into my mouth
and eating until I vomit."  

The above-quote is a good description of binge behavior.
Some people are only joking when they say
 that they are going to eat sugar until they vomit or feel like it. 
This may only mean they will actually have a few pieces of candy 
and/or cookies which will seem like a lot to them. 

But, some literally do Binge on a regular basis,
and this means they  actually do eat a large amount, 
such as one or more family size bags of candy/and or cookies
and these people...despite a great deal and time and effort....
are not able to overcome this "addiction-like behavior".

People are mentally and physically different.

I think there can be no doubt that Taubes, author of  Why We Get Fat
is correct when he says that sugar is a special kind of food,  
because i
t seems to "hijack" the brain.

Sugar seems to be an issue with almost everyone,
ever the definition of "bingeing" seems to differ between individuals.
For some, "bingeing" means "giving in" to a piece or two of cake
and for others it means eating the entire cake."
Most people equate "bingeing" with "Emotional Eating", 
but perhaps Taubes is correct when he says 
that this isn't merely a mental or behavioral issue. 

Maybe there's actually a large physiological issue...
our respective bodies are different in more ways than size.

Some of us seem to be more sensitive to carbohydrates than others.
There are some people for whom even "healthy" complex carbohydrates...
such as baked potatoes and whole kernal corn... can trigger binge behavior.


Experimenting with Diets
- POSTED ON: Apr 13, 2011

I enjoy trying out different Diets,
and my personal style is to "carve out my own path".
Therefore,  I'm usually involved in some type of dieting Experiment-of-One.

"Good Calories Bad Calories", by Gary Taubes, published in 2007.
is an excellent book, however, it is about 500 pages long
with more than 100 reference pages,
and was written primarily for medical professionals.

I’ve read it at least 5 times, and I still haven’t absorbed it all
because it is really hard. I have a doctorate in law,
with an extensive history in legal research,
but I still found it to be difficult reading.

The new book by Taubes,
"Why we get fat and what to do about it", (2011)
was written geared to people like me…those who are not medical professionals.
It is 250 pages and is a far easier to read.
Although it isn't what I would call a quick read.
This is the book that DietHobby is now featuring in BOOKTALK

This year, I am experimenting with Low-Carb
because I have not yet found a Way of Eating to maintain my weight-loss
that I enjoy enough to continuing doing for the rest of my life.

Low Carb is one of the few ways of eating
that I have very little personal experience with.
My body desperately wants to regain its lost weight,
and maintenance takes constant vigilance.
I’m hoping that low-carb will help eliminate some of my food cravings,
as well as some of my hunger.

I’ve also spent a lot of time experimenting with Intermittent Fasting,
and some of that was by using the 24 hr fasting method
suggested by Brad Pilon. in his e-book, "Eat Stop Eat".
I own that book as well; have read it thoroughly several times;
and think it is probably the best book around that addresses Intermittent Fasting

I will probably do more experimentation of Intermittent Fasting in the future.
Neither Calorie Counting, Low-Carb or Intermittent Fasting are mutually-exclusive.
A 24 hr fast is one way to further reduce insulin,
and many low-carb people use it for that purpose.

My primary purpose for Intermittent Fasting has been to reduce my calories
for up to one to three days a week, in order to drop my calorie averages.
For me, the primary difficulty with Eat Stop Eat, or any Intermittent Fast,
is not keeping my calories low on a fast day. I can do that.
On Fast days my practice is to eat dinner only, around 350 to 400 calories,
with no snacks after dinner.

However, on “normal” days, the days before and after an intermittent fast,
I have great difficulty eating only normal amounts,
and not compensating by eating more food than my normal calorie allotment,
and sometimes those fasts will trigger binge behavior for me.
This might not be the case IF I were eating low-carb,
since it is the sugars --refined carbs, and starches—complex carbs
that allegedly trigger those cravings and binges.

Low-carb eating is different for everyone, and
on pages 204 and 205 of his new book, WWGF,
Taubes clarifies his position on this matter.

“The fewer carbohydrates we consume, the leaner we will be.
This is clear. But there’s no guarantee that the leanest we can be
will ever be as lean as we’d like. This is a reality to be faced.

As I discussed, there are genetic variations in fatness and leanness
that are independent of diet. Multiple hormones and enzymes affect
our fat accumulation, and insulin happens to be the one hormone
that we can consciously control through our dietary choices.
Minimizing the carbohydrates we consume and eliminating the sugars
will lower our insulin levels as low as is safe,
but it won’t necessarily undo the effects of other hormones….

This means that there’s no one-size-fits-all prescription
for the quantity of carbohydrates we can eat and still lose fat or remain lean.

For some, staying lean or getting back to being lean might be a matter
of merely avoiding sugars and eating the other carbohydrates in the diet,
even the fattening ones, in moderation; pasta dinners once a week,
say, instead of every other day.

For others, moderation in carbohydrate consumption might not be sufficient,
and far stricter adherence is necessary. And for some, weight will be lost
only on a diet of virtually zero carbohydrates, and even this may not be
sufficient to eliminate all our accumulated fat, or even most of it.

Whichever group you fall into, though, if you’re not actively losing fat
and yet want to be leaner still, the only viable option… to eat still fewer carbohydrates, identify and avoid other foods
that might stimulate significant insulin secretion…and have more patience.
(Anecdotal evidence suggests that occasional or intermittent fasting
for eighteen or twenty-four hours might work to break through
these plateaus of weight loss, but this, too, has not been adequately tested) “

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