More Heresy on Obesity

Obesity — its causes and consequences — is a frequent topic on this blog (and the podcast too). In the podcast, Eric Oliver argued that “the causal relationship between weight and maladies like heart disease, cancer, and even diabetes has not been firmly established.” That certainly strikes some as heresy. In a recent EconTalk podcast, noted heretic Gary Taubes lays out a well-argued position:  

Taubes argues that for decades, doctors, the medical establishment, and government agencies encouraged Americans to reduce fat in their diet and increase carbohydrates in order to reduce heart disease. Taubes argues that the evidence for the connection between fat in the diet and heart disease was weak yet the consensus in favor of low-fat diets remained strong. Casual evidence (such as low heart disease rates among populations with little fat in their diet) ignores the possibilities that other factors such as low sugar consumption may explain the relationship.

Anyone for the paleo diet? 

Leave A Comment

Comments are moderated and generally will be posted if they are on-topic and not abusive.

 

COMMENTS: 87

View All Comments »
  1. Cor Aquilonis says:

    I’m on a low-carb paleo right now, and just started strictly a couple weeks ago. Sure, I lost a little weight, but I really enjoy feeling full between meals and getting full, restful sleep. I plan to stick with it for the foreseeable future.

    I like life better without the sugar and grains.

    Well-loved. Like or Dislike: Thumb up 31 Thumb down 3
    • John B says:

      Hidden due to low comment rating. Click here to see.

      Disliked! Like or Dislike: Thumb up 12 Thumb down 17
      • Cor Aquilonis says:

        1) I don’t know.
        2a) Not my job.
        2b) While I’m sympathetic to the plight of the undernourished of the world, I neither have the resources nor the education nor the power to make any meaningful impact on their lives. I recognize this fact and accept it.
        3) You’ll notice every sentence I used in the above post had the subject of “I.” You’ll notice none of them had the subject “you” or “they.” That would be because I was talking about myself, not you or them.

        Conclusion: Brush up on your reading skills. I didn’t propose the paleo diet as the solution to all the world’s dietary ills. I just said that it agrees with me.

        Well-loved. Like or Dislike: Thumb up 38 Thumb down 24
      • Adam says:

        Way to be a jerk about it, geez. The sad thing is that you have a good point, but it gets lost in cheap shots like, “brush up on your reading skills.”

        Well-loved. Like or Dislike: Thumb up 25 Thumb down 2
      • Wout Mertens says:

        Taubes is quite anti-carbs but if you look around on the web you’ll find quite a few Paleo Dieters saying that safe carbs are fine up to your limit. For instance, see http://perfecthealthdiet.com/?p=5027 for the discussion with pointers to the science.

        Unfortunately, corn and wheat definitely aren’t safe starches so they would have to be replaced with other crops.

        Thumb up 1 Thumb down 1
      • Cor Aquilonis says:

        @ Adam (November 30, 2011 at 1:00 pm):

        You’re right, the “brush up on your reading skills” comment wasn’t appropriate.

        @ JohnB (November 29, 2011 at 1:13 pm):

        I apologize for attacking your reading comprehension skills. I didn’t read your comment with a charitable spirit, and misinterpreted it as a snide comment that implied that I didn’t care about the hungry. This was wrong of me. If I were able to redact that comment I would, and I encourage future readers to disregard it. Again, my apologies.

        Well-loved. Like or Dislike: Thumb up 13 Thumb down 0
  2. al says:

    It is very important to know that fat cannot be directly absorbed to the body unlike sugar, sugar therefore has a much faster absorption in the human body than anything else and is therefore more harmful to your metabolic system than anything else. Basic grade level 10 biology (in canada anyways). Eat more fatty food, eat little sugar.
    http://en.wikipedia.org/wiki/Fatty_acid_metabolism
    http://en.wikipedia.org/wiki/Citric_acid_cycle

    Well-loved. Like or Dislike: Thumb up 23 Thumb down 2
  3. M R says:

    Taubes speaks the truth, I’m living proof. Try low-carb/high fat for a month, you’ll see the difference too. Fat does not make a person fat, fat does not cause high cholesteral; carbs do.

    Well-loved. Like or Dislike: Thumb up 24 Thumb down 6
    • Mike B says:

      Hidden due to low comment rating. Click here to see.

      Disliked! Like or Dislike: Thumb up 16 Thumb down 40
      • Wout Mertens says:

        The reasoning you’re following is not what the science seems to indicate. Read Taubes’ book for more information, but the gist of it is that you’re hungry because you’re getting fat, not the other way round.

        One of the interesting experiments described is that when you take a female mouse and remove its ovaries, it will eat a lot and get fat. If you however give it only the same amount of food as before, it will still get fat, but it will stop moving about, only eating and sleeping. This means that their body is storing the energy from food as fat instead of using it.

        Furthermore, if there is any artery-clogging fat it’s probably Omega-6 oils (which is in high abundance in vegetable oils) which are inflammatory.

        Thumb up 3 Thumb down 2
      • Mike B says:

        Funny how many people disagree with the idea that if you eats less, you lose weight. I guess that’s why we have such an obesity problem.

        Hot debate. What do you think? Thumb up 14 Thumb down 16
      • Rob says:

        The “fat clogs your arteries” belief is the worst dietary myth perpetuated upon the public by bad science, along with the “dietary cholesterol is harmful” myth. Taubes’s book Good Calories, Bad Calories is very similar to Freakonomics in that it attempts to dispel popular beliefs that are rooted in misconceptions. The “fat makes you fat” and “fat clogs your arteries” comes from flawed studies done by Ancel Keys in the mid 1900s. He omitted pertinent data that would disagree with his preconceived notions. And the US Government solidified his bad science in the minds of the public in the 70s by making his recommendations official policy. Out of this was born the lipid hypothesis, which Taubes demolishes in his book. From a logical point, why would fat “clog” our arteries? That is how we store excess calories! When you are running a calorie deficit, you are dining on a high fat diet: Your own.
        By making calories king in the war on obesity, officials create a vicious cycle of dieting and binging. Telling someone to eat 1500 calories a day and then to eat horrible processed “diet” food like soy and whole grains virtually ensures they will fail. This is where the concepts from Paleo come into play. If you eat high quality, minimally processed foods like meat, vegetables, fruit, properly prepared tubers raised/grown in natural conditions, the calorie issue should take care of itself (as long as you don’t have some underlying metabolic condition). As someone who was always overweight to some degree and believed in the low-fat/calorie counting method of losing weight, eating relatively low carb Paleo seemed like a miracle. The extra weight disappeared, my blood sugar moved out of the pre-diabetes range and my cholesterol count dropped to normal. All in 3 months. And without calorie counting and exercise, since my finger was broken and I couldn’t do my normal workout.

        Well-loved. Like or Dislike: Thumb up 12 Thumb down 2
      • John says:

        Obviously what we are looking at with the ‘obesity epidemic’ is more government induced unintended consequences. The parents saw all of the big banks being bailed out and figured that junior wasn’t all that sharp so if they fed him a little different… he’d be ‘too big to fail’!

        Thumb up 0 Thumb down 1
    • Independent Girl says:

      When I turned 38, I began to put on weight for no apparent reason. I buckled down on my diet and was scrupulous about weighing food and watching everything I ate, and continued to gain. On the advice of a nutritionist, I tried low-carb/high fat for three months. I was miserable. I lost a little weight for the first week and then continued to gain weight as I had done before. I was hungry all the time because low-carb/high fat foods are calorie dense, don’t have much fiber, and are not very bulky. I continued to keep carbs low and my weight skyrocketed. I finally went back to high fiber/high carbs and my weigh gain has stopped, although I haven’t been able to lose. At least I’m not starving all the time.

      I’ve been fighting this battle for 5 years now, and am so tired of hearing what a miracle low-carb diets are (did nothing for me!) and on the other side, how it is all calories in vs. calories out. The reality is that metabolism is extremely complicated and we are just beginning to figure it out. Reducing caloric intake and increasing exercise can actually slow your metabolism and change your calorie in vs. calorie out values. What works for one person is not guaranteed to work for anyone else.

      So, I’d say what we need are fewer people being autocratic and judgmental and telling everyone that they have the one dietary solution to fix everyone’s problems. Because I can guarantee, you don’t.

      Well-loved. Like or Dislike: Thumb up 12 Thumb down 6
      • EP says:

        Go to your kitchen right now, throw out anything with high-fructose corn syrup or corn, soybean, sunflower, or safflower oil. Give it a month or so and you won’t have to equivocate to feel good about yourself.

        Hot debate. What do you think? Thumb up 13 Thumb down 10
      • Independent Girl says:

        Would that it were so easy. I don’t have any of those things in my house and they have never been a part of my diet. I don’t eat cookies or sweets and have never eaten them (no virtue here, I’m more a popcorn person). I don’t drink soda or diet soda. I cook with olive or peanut oil, carefully weighed so I don’t accidentally use too much. I eat home-cooked lean meat, 2-3 cups of fresh veggies a day, 1-2 pieces of fresh fruit a day, and whole grains from dried beans, brown rice, and dried chickpeas. All of which is home-made and none of which is processed. So none of your easy-solution assumptions apply to me.

        This is exactly what I mean when I’m talking about people thinking they are experts and have the miracle solution for everyone. Face it, you don’t.

        Well-loved. Like or Dislike: Thumb up 12 Thumb down 2
      • EP says:

        I left peanut oil off my list because I didn’t think anyone used it, but it’s about as bad as it gets. I’m a little frightened that you use enough oil that you have to weigh it. But I’d guess that if you have anything in a box or a can, you have those problem oils.
        Popcorn…corn oil…unless it comes from a bag, then there’s plenty more wrong with it.
        Also, cut the fruit in half…HFCS, etc.
        Beans and chickpeas are not grains.

        No matter what nonsense is being hypothesized on this board, weight maintenance depends on only two things, 1.5 of which you can control: caloric intake and caloric expenditure. The latter include basal metabolic rate, which you can’t do much about, but that means you have to deal with it and adjust your lifestyle accordingly.

        If eating less leaves you too hungry between meals, change your eating habits in terms of meal times, sizes, and numbers. Nutrition isn’t rocket science and we know a considerable amount about it. It can help you, too.

        Thumb up 6 Thumb down 7
      • Wout Mertens says:

        You seem to eat a lot of grains, legumes and Omega-6 oils. Those are probably bad for you and can influence your fat regulation.

        Have a look at http://perfecthealthdiet.com/?page_id=8 (my favorite) and see if that works for you. As you will find, it is a very well thought-out diet with lots of things you can tweak for you personally. The book explains it best.

        Anyway your situation sounds hormonal, is your thyroid ok?

        Well-loved. Like or Dislike: Thumb up 6 Thumb down 1
      • Independent Girl says:

        There is no reply button to your subsequent post below, or for Wout’s post. Sorry if this shows up in the wrong place.

        It seems that neither of you read my initial post very carefully. I did the low carb thing for three months, during which time I did not eat the grains or the beans. It did me no good. I did not lose weight on the low-carb diet but continued to gain. It did not help, so I went back to my whole grains. I do not use a lot of oil; I weigh b/c it is more accurate to measure out

        I am going to resist the temptation to respond to you point by point about the details, EP, because you are missing the point. I have been to three nutritionists, two personal trainers, and an endocrinologist. Despite them all tinkering with what they all say is

        Thumb up 1 Thumb down 1
      • Independent Girl says:

        Sorry for this, for some reason it posted before I was done. I was saying that it is more accurate to measure out 4 grams of oil than one teaspoon.

        Back to the nutritionists, et. al. Despite all their tinkering with what they say is a fundamentally healthy and portion controlled diet, they haven’t been able to help. My thyroid numbers are supposedly fine. The endocrinologist wasn’t too interested in my case, b/c from his perspective while my weight gain has been distressing to me, I’m still only slightly overweight with great cardio-vascular health and he deals with the obese and sick all day. However, he did say, and I quote, “What we don’t know about metabolism could fill a book. You may not be able to reverse your weight gain but keep working out and you’ll be healthy.”

        I’m already in tl/dr territory, so I’ll just go back to my main point and leave it at that. There is no magic solution that works for everyone if you think you have one you are deluding yourself.

        Well-loved. Like or Dislike: Thumb up 6 Thumb down 1
      • EP says:

        Yes, because thinking you are a nutritional special case that does not follow the laws of physics is not deluding yourself.
        Give paleo a try, and stop using legumes as grains.

        Thumb up 5 Thumb down 5
      • Wout Mertens says:

        @Independent Girl, I seem to have answered outside of your thread. Please find my answer at http://www.freakonomics.com/2011/11/29/more-heresy-on-obesity/comment-page-2/#comment-275528 to “I.G.”

        Thumb up 0 Thumb down 0
      • Dan says:

        This is the problem. Your so called independent, have never tried paleo, go to nutritionists who have no clue about paleo, and then come to a post here and try and convince others your a special case. Well you are special, you think your a different animal to the rest of us, your not.

        Simply put, go away, try a proper paleo diet (look up Robb Wolf) for 1 month and come back here and tell us how terrible your doing, until then, enjoy your health issues.

        Keep a food log. Many people “think” they are paleo, there is always something to get rid off when starting off.

        Thumb up 3 Thumb down 2
      • MattieShoes says:

        Calories in and calories out is the answer, barring temporary issues like water retention or maybe some medical issues. Can starving yourself affect calories out by altering your metabolism? Of course it can, and so can other things not directly in your control (such as aging). But it’s STILL calories in and calories out. Consume less calories than you expend and you’ll lose weight. Consume more than you expend and you’ll gain weight.

        Hot debate. What do you think? Thumb up 12 Thumb down 16
      • Joe Dokes says:

        I use to believe it was a simple matter of calories in vs. calories out. Then I read an article in the NY Times by Gary Taubes.

        http://www.nytimes.com/2002/07/07/magazine/what-if-it-s-all-been-a-big-fat-lie.html?pagewanted=all&src=pm

        I then went on to read Good Calories Bad Calories. I then cut out a lot of carbs from my diet. I then lost 35 pounds in less than a year without ever being hungry.

        Calories in versus calories out is simple straight forward and wrong.

        Regar

        Well-loved. Like or Dislike: Thumb up 13 Thumb down 2
      • al says:

        Do you know what calories are? its just how much energy the food gives off when burnt in pure oxygen (This is high school chemistry in Canada), this method assumes the body processes food exactly the same way as a fire would. The real question is how does the body process different types of food? http://en.wikipedia.org/wiki/Calorimetry

        Well-loved. Like or Dislike: Thumb up 7 Thumb down 1
      • EP says:

        Hidden due to low comment rating. Click here to see.

        Disliked! Like or Dislike: Thumb up 2 Thumb down 8
      • Morten says:

        “EP says:
        December 1, 2011 at 12:14 am

        Do you know what calories are? It is the energy your body derives from the metabolism of a food. Fire has nothing to do with it. This is biochemistry everywhere in the world.”

        Wrong.
        The kcal given on your food packaging and in tables is the complete oxidation of a quantity of the average macronutrient. So it ignores the calories needed to digest and transport the macronutrients. Sugars and starches require almost no energy to digest and glucose requires no energy to transport so the energy of complete oxidation is the same energy provided to your body. Fats require approximate 7-10% of the energy contained to process and for protein it’s 15-25%. This is one of the reasons that you lose more weight on a calorie counting low-carb diet than you do on a calorie counting low-fat diet. This is irrelevant when it comes to Paleo since that’s an ad libitum diet. It is also where the flawed notion that many small meals stokes the metabolic fire. Post-meal metabolic increases are directly proportional to the amount of macronutrients ingested. So if you eat two Snickers or eat a Snicker, wait two hours and one more your ass will become equally fat.

        Well-loved. Like or Dislike: Thumb up 5 Thumb down 0
      • EP says:

        Hidden due to low comment rating. Click here to see.

        Disliked! Like or Dislike: Thumb up 0 Thumb down 5
      • Cassandra says:

        Female, 38, battling weight gain for 5 years after being otherwise ‘normal’? Please go and get your thyroid checked out. You sound like you are in the early stages of hypothyroidism. Even if your numbers are almost “normal” ask for trial thyroid hormone replacement. And don’t settle for just synthetic T4 either, ask for dessicated porcine thyroid.

        Thumb up 1 Thumb down 0
  4. Gary says:

    A great topic. Of course the real question is why governments continue to go down a low fat route, including taxing fatty foods, given the lack of evidence. An evidence based approach would rather tax sugar and sweeteners (especially sweeteners!), and wheat.
    Could the vested interests of the farming community, food producers/processors and cholesterol-reducing drug companies and their lobbying powers have a little something to do with it?

    Ultimately the lesson is not to trust anything anyone tells you until you know who their paymaster is.

    Well-loved. Like or Dislike: Thumb up 27 Thumb down 0
  5. Iljitsch van Beijnum says:

    Hidden due to low comment rating. Click here to see.

    Disliked! Like or Dislike: Thumb up 10 Thumb down 42
    • Cor Aquilonis says:

      Ummm. I’m pretty sure the thermodynamics you are referring to occur in a closed system. The human body isn’t a closed system. Of course, I’m not a physicist, but I also doubt you are.

      Well-loved. Like or Dislike: Thumb up 19 Thumb down 7
      • James says:

        No, the thermodynamics doesn’t require a closed system. It’s simply that if you take in more energy, in the form of food calories, than you expend, then that energy has to go somewhere. We know from observation that much of it is stored in the body, as fat.

        And BTW, I do have a physics degree.

        Hot debate. What do you think? Thumb up 10 Thumb down 12
      • Cor Aquilonis says:

        Congratulations on your physics degree, I’ll have to take your word for that.

        Color me skeptical that the Laws of Thermodynamics map so perfectly to the human biological system that Calories In Must Equal Calories Out And Much of The Difference Shall Be Fat. While I don’t doubt that the overall system follows the Laws of Thermodynamics, I doubt that it applies a simplistically as I frequently hear it applied. I suspect that there’s more going on then that, but then, I don’t have a pile of weighty scientific evidence for you in my back pocket.

        Let’s just say I have to see more compelling evidence supporting your thesis before I move beyond being a dietary agnositc who has found low-carb paleo useful for her own diet.

        Well-loved. Like or Dislike: Thumb up 16 Thumb down 8
      • Neil (SM) says:

        @Cor Aquilonis: Perhaps the calories-in-calories-out idea describes a perfect system in which every ounce of food one eats is metabolized and creates a fixed amount of calories. The reality is much more complex, where every person has a unique metabolism, and some foods are metabolized differently than others. And also it seems for many people fats are not absorbed nearly as well as carbs.

        @Iljitsch van Beijnum: the article is certainly not claiming high-carb will make one lose weight. What seems more important to the discussion is the claim that weight may very well not be connected to health.

        Thumb up 5 Thumb down 1
      • Clancy says:

        This is an unbelievably naive simplification. Yes it’s true that Energy in – Energy out = Energy stored, but there are many complicated processes, hormones, and other factors that determine where the energy is stored and in what form (white fat, yellow fat, glycogen, muscle tissue, etc.) Energy out is determined by metabolic rate which is determined by how much and what food you eat, insulin and a zillion other hormones, exercise, sleep, etc. And, unless you obsessively weigh everything you eat and have the Iron Will to overcome all your biological urges, your metabolism, hormones, body chemistry, etc. has a lot to say about Energy In as well.
        All three terms of the equation are influenced by the types of food you eat, when you eat them, and how much, in addition to a zillion other factors.

        Well-loved. Like or Dislike: Thumb up 21 Thumb down 1
      • Cor Aquilonis says:

        Bingo! That’s what I was trying (rather incompetently) to drive towards, but you put it so well!

        Thumb up 2 Thumb down 1
      • James says:

        Simplification, perhaps, but neither naive nor absurd, since it works pretty well as a model of reality. Just for an example which leaves out the human element and all that “Iron Will” stuff, take my two dogs. One was an overweight couch potato when I got her, the other a scrawny half-starved pup. After a couple of years of exercise and a reasonable diet, the chubby one lost 20% of her body weight, the scrawny one gained about 10%, and both are active enough to enjoy hiking & biking with me.

        So if this all works in dogs (and horses), as I see it does from my own experience, and in other animals, why would it not work in humans?

        Thumb up 5 Thumb down 7
      • aepxc says:

        >>It’s simply that if you take in more energy, in the form of food calories, than you expend, then that energy has to go somewhere.<<

        The question being debated is whether the form that the energy comes in affects the desire to take in more energy, the portion of that energy that is absorbed (with the rest going to a white porcelain contraption in the bathroom), and the amount of energy expended through a varying metabolic rate. We eat food, not calories, and even then the system is much more complex than "calories eaten = exercise + fat".

        As far as I know, we have not played around enough with experimentally controlled radical diet variation to have a formal systematisation of knowledge about which combination of foods lead to what specific effects. Hence the prevalence of fads, folksy wisdom, angry debates, and rapidly evolving scientific consensus in the field.

        Well-loved. Like or Dislike: Thumb up 7 Thumb down 0
      • mikeh says:

        James – No one is arguing the human body is not obeying the laws of thermodynamics. What people are arguing is that there is an assumption hidden in the calories in / calories out hypothesis that is almost certainly flawed. That assumption is that calories in and calories out are independent variables. This is demonstrably untrue in a plethora of animal studies so the fact that it is assumed undeniably true in humans is quite possibly the biggest barrier to opening up to the idea that weight loss is not just about consuming less and exercising more. It is uncontroversially true that differing compositions of carbs / protein / fat causes differing amount of weight gain in controlled animal studies, so why would we assume it cannot be the same for humans ?! It is uncontroversially true that hormones affect hunger and energy levels and weight, and it absolutely true that food composition affects hormones.

        ~mike h

        Thumb up 3 Thumb down 0
    • Liz M says:

      Calories in – calories out = calories stored. This is obviously true. Your fallacy is assuming that the left-hand-side is causal and the right-hand-side is dependent. In reality, it most likely works the other way – something in your body is driving you to gain weight, so to compensate for that, you eat more and feel sleepy.

      This is obviously the case for growing children; they are getting taller and therefore they have big appetites. Why must this not be the case for people who get fat?

      Thumb up 6 Thumb down 5
    • Travis says:

      Portion control and health options are completely unrelated problems to solving obesity issues.

      The problem of “substituting” grains for meat is a serious one, particularly when combined with a modest amount of grains you need very little fat / meat to sustain ones self.

      However, overconsumption does not necessarily follow the finding that things like Sugar intake has more impact on obesity and other health problems.

      Also, just because the “high energy” from the fat has to go “somewhere” doesn’t mean it gets stored as fat. It can also end up in the toilet. Where it goes is quite important. Also, doesn’t sugar have more calories per unit volume than fat, or close, in addition to being more readily absorbed by the body.

      Thumb up 2 Thumb down 1
  6. John S. says:

    Prepare for a cascade of replies all the people who are eating less, feeling healthier, sleeping better and even having better sex on a diet that excludes (or includes) component X. I don’t doubt their sincerity, but don’t they realize that anecdotal evidence is worthless? Alternatively, if they want me to put faith in their testimonial, then they should explain to me why I should ignore the testimonials of other equally sincere individuals who achieve the same results on other diets. Patients of Dr. Ornish, for example.

    Well-loved. Like or Dislike: Thumb up 21 Thumb down 3
    • Cor Aquilonis says:

      Why, yes, I realize anecdotal data isn’t proof of anything. So, please don’t assume I’m ignorant of the (low) value of sharing my directly relevant experience on a comment thread. I’m not trying to convince you of anything, nor am I asking for your faith. I’m just sharing my experience.

      Thumb up 8 Thumb down 4
    • Enter your name... says:

      Yes, and have you ever noticed that not one of them will admit that what works best for one person is not necessarily what works best for every single human on the planet? It’s like they’re allergic to complexity.

      Thumb up 4 Thumb down 4
  7. Donald says:

    Dr. Lustig provides a causal relationship between sugar (more specifically fructose) in his lecture “Sugar: The Bitter Truth”. Well worth watching – http://www.uctv.tv/search-details.aspx?showID=16717

    Well-loved. Like or Dislike: Thumb up 8 Thumb down 0
  8. Brian Utterback says:

    While Gary Taubes complaints about the “establishment” wisdom has a lot of validity, his own attempts at producing a narrative that can be understood likewise falls short. See http://www.sciencebasedmedicine.org/index.php/why-we-get-fat/ at the “Science Based Medicine” website for more details.

    Thumb up 2 Thumb down 2