

Calories, fat or carbohydrates? Why diets work (when they do) - kareemm
http://www.garytaubes.com/2010/12/calories-fat-or-carbohydrates/

======
wycats
What I find most frustrating about online comments on Taubes work is the
amount of people who assume that this is just another crank peddling nonsense.

Instead, Taubes has spent the better part of a decade reviewing the state of
research and putting forth a compelling, detailed argument in favor of his
position, that the high-carbohydrate diets associated with civilization are
also the cause of the cluster of diseases known as diseases of civilization.

His latest book lays out the argument in a more reader-friendly way than his
earlier tome (Good Calories, Bad Calories), but it's hardly junk science, and
Taubes is hardly a junk scientist. He has been a very good science journalist
for decades, and has won the the Science in Society Award of the National
Association of Science Writers three times. He does his homework.

Again, I recommend that those whose gut reaction is to be skeptical of Taubes'
thesis read at least his latest book, which addresses, very carefully,
virtually all of the common reactions people have in these kinds of online
fora. There are certainly areas still open to debate, as Taubes himself says
repeatedly in his writing, but they are not about the knee-jerk topics most
people think they will be about.

If you're curious, feel free to take a look at the wikipedia post summarizing
the results of low-carb diet trials at
[http://en.wikipedia.org/wiki/Medical_research_related_to_low...](http://en.wikipedia.org/wiki/Medical_research_related_to_low-
carbohydrate_diets). You'll find, at the very least, some cognitive
dissonance. And that's really what Taubes' writings (in book and blog form)
are about.

~~~
dkarl
_What I find most frustrating about online comments on Taubes work is the
amount of people who assume that this is just another crank peddling
nonsense._

I don't think he can complain about that. He takes his case straight to the
public, and he uses rhetoric that is likely to be effectively with the public.
That's what cranks peddling nonsense do, so by convergent evolution he sounds
exactly like them, which makes it much less likely that people will take his
ideas seriously enough to find out if he really is a crank.

~~~
wycats
To be fair, I was the one complaining about it, not him. That said, I don't
think it's fair to compare his research, rigorous report of that research, and
various academic lectures to be the equivalent of what the snake-oil-salesmen
do.

He presents a very strong hypothesis for a very important subject, and his
public statements are mostly focused on demonstrating that what most people
believe on the subject isn't exactly right. In my mind, the cognitive
dissonance that he creates with his blog isn't intended to be the argument.
Instead, it's designed to get people past their initial preconception so they
might be willing to read the more rigorous version(s) of his argument.

In general, I don't think it's fair to say that an article in the New Yorker,
followed by 5 years of literature review, followed by a (dense, by all
accounts) report represents the kind of quackery you are cavalierly comparing
his work to.

~~~
dkarl
I think it's fair to say he talks like a quack. Maybe not in the New Yorker
article -- I assume he had to be a bit more respectable there. Every time I've
seen him linked on Hacker News, however, he's been extremely derogatory of
other nutritional researchers. In this particular post, he compares some
researchers unfavorably to schoolchildren, calls others lazy, and adopts a
generally belittling tone. By speaking directly to the public and taking a
dismissive attitude toward what he calls the "authorities," he gives the
impression that he has given up on convincing other nutritional researchers of
the validity of his views. He then makes a case that his views are quite
obviously right if you look at the data a certain way. They're so obviously
true that lay people such as myself should be persuaded, yet the nutritional
"authorities" refuse to acknowledge them. That's his most glaring warning
signal. Personally, I think it's reasonable to assume that nutritional
researchers are mostly intelligent and honest people. When experts are
blinded, they're blinded by knowledge or by powerful ideas. Whether Taube is
right or not, if he is able to convince me but not able to convince other
nutritional researchers, it's because of something they know that I don't
know.

Maybe this is a paradigm shift in nutrition, and maybe lay folks like us _are_
better equipped to understand this breakthrough than people who have been
studying nutrition professionally for years, but that's unlikely. It isn't
just unlikely because such paradigm shifts are rare: his ideas just aren't
that inaccessible or revolutionary. So for me it's a red flag that he's so
derogatory toward nutrition researchers who disagree with him, instead of
treating them as an important audience for his ideas.

Or maybe -- and I think this is the most likely explanation if he's really a
reasonable fellow -- he's not so much an outsider as he pretends. Maybe his
ideas are part of a spectrum of respectable opinion in the nutritional
community and accorded some consideration by other researchers. Maybe his
defiance of the "authorities" is just a rock star act. If so, can you blame me
for believing it?

~~~
beagle3
I would assume he has given up on convincing other researchers of the validity
of his views. And if you were actually familiar with how that system works (as
opposed to how you think it should ideally work, or some approximation
thereof), you would not appeal to the authority of those who practice
"nutrition science", because it is anything but.

The way science works, in general, is not the so-called "scientific method" -
most funding is controlled by people in the field who have a vested interest
(ego, monetary or otherwise) in maintaining the status-quo and beliefs. While
it's easy enough to practice "the scientific method" on new frontiers, it is a
quixotic endeavour to challenge a prevailing concept.

In many cases, it should be -- when the prevailing concept has actually been
rigorously studied and proved. This is NOT the case with nutrition (nor many
specific corners of medicine and health).

I don't know what faith you subscribe to, so this example might fall on deaf
ears, but PZ Myers and Richard Dawkins don't need to convince the pope of
anything -- they need to appeal to the masses. Much of nutrition
recommendations are based on faith (and politics) rather than evidence, and in
that sense, Taubes is not wrong in the attempt to appeal to the masses. And
while he might not be an established research scientist like Dawkins, he has a
better grasp of science and burden of proof than those he criticizes, and at
least "Good Calories, Bad Calories" is meticulously researched with hundreds
of references -- which is much more than you can say about your average (and
even "cream of the crop") nutritional science research.

Your argument is essentially an appeal to authority -- and to the wrong
authority at that.

------
dkarl
There's a difference between how people interested in public health read this
research and how people such as us who are interested in our own individual
health read it. People interested in public health wonder, "What happens when
you tell people to follow diet X?" That's what studies like this test.

People like us wonder, "What happens when an individual actually follows diet
X?" Questions like this are never studied at all, because it's difficult and
expensive. Almost everybody lies about their level of compliance, and when
people aren't actually lying, they're still underreporting because most people
remember eating less than they actually do.

Those facts about underreporting are not controversial. I don't know where the
misrepresentation happens, whether in the science itself or in the science
journalism, but the studies most people read about in the newspaper or on the
web are not about diet from an individual point of view. They don't study what
happens when somebody actually follows a certain diet. That would require
keeping people in an institutional setting and controlling or monitoring their
food intake around the clock. That's really expensive, and if you're
interested in improving public health, it isn't useful to know what the
results of following a particular diet are, because you don't have control
over what people eat. You only have influence over the public health message:
what people are _told_ they should eat.

So that's what is studied. The scientific debate over diet is not about what
you should eat to improve your health, but what we should tell the public to
eat to improve their health. If 50% of people on a low-fat diet stay up all
night eating low-fat cookies and big bowls of pasta with low-fat margarine,
then from a public health perspective, low-fat diets make you fat.

~~~
wycats
It's certainly true that dietary studies suffer from problems of
underreporting. So it is possible that the the results of most recent studies
(summarized well in
[http://en.wikipedia.org/wiki/Medical_research_related_to_low...](http://en.wikipedia.org/wiki/Medical_research_related_to_low-
carbohydrate_diets)) all suffer from a reporting bias that leads people
consuming low-fat diets to more significantly underreport their consumption
than those on low-carb diets.

However, that in itself would be a significant finding. If the level of
reporting compliance varies widely between different diets, it may also mean
that compliance with the diet itself varies. I'd personally be interested in
evidence on this point.

Also interestingly, studies using animal models of obesity tend to back up the
findings using the (admittedly flawed) studies using human reporting. Taubes'
most recent book goes into some detail about findings using rat obesity models
(such as experiments involving ovary removal and experiments involving Zucker
rats, which are genetically prone to obesity).

One very interesting result from those studies is that rats prone to obesity
(for whatever reason) will often die of starvation while retaining some
subcutaneous fat. Obese-prone rats also very clearly exhibit sedentary
behavior when the food supply is low, and more active behavior when the food
supply is high. They also have more fat when given identical amounts of food
as lean-prone rats.

In short, while we cannot be certain about the recent experimental results,
because of reporting bias, it's hard to believe that the experiments all have
no validity, and that animal models of obesity are flawed. Additionally, if
there was significant reporting bias, it would likely be the result of
compliance problems, which would be extremely relevant to the discussion at
hand.

It's one thing believe that the jury is still out on some of this; it's quite
another to stick to preexisting beliefs on the grounds that virtually all
recent studies have some flaw or other.

~~~
dkarl
Compliance levels in studies aren't relevant to our individual choice of diet,
though, because we can observe our own compliance for ourselves by recording
our intake. Observing our own bodies' response to a diet takes a much bigger
commitment, so it's nice to have some generalizations from science. For the
public health debate, there's no reason to separate the two, but from an
individual perspective it is unnatural not to.

 _It's one thing believe that the jury is still out on some of this; it's
quite another to stick to preexisting beliefs on the grounds that virtually
all recent studies have some flaw or other._

Interesting that you assume I have some particular opinion :-) I don't
necessarily disagree with Taube, though I don't think it signifies much that
he can persuasively make a point and disparage those who disagree with him
when he's talking to lay people. I'm just tired of seeing studies discussed as
if the results reflect what happens when people actually follow some
particular diet, when that's not what researchers are really interested in.
(I.e., researchers take compliance as part of the phenomenon being studied,
but journalists and lay people reading and discussing the results assume that
compliance is uniformly good or has been factored out somehow.)

Edit/PS: If you interpret studies as showing what happens when people actually
eat a certain diet, then compliance _is_ a flaw -- a really big one! We don't
know what people are actually eating, only that on average it's significantly
more than they report. And there's no questions researchers would _like_ to
know how actual intake relates to weight gain or loss. It's just rather
inconvenient and expensive to find out, and it's arguably less important than
the public health question of how instruction/exhortation relates to weight
gain or loss.

~~~
wycats
Compliance problems in studies may be relevant to our individual choice of
diet, since they are likely to predict our own personal compliance. In general
(as Taubes points out), most people can lose significant weight by reducing
their daily caloric intake to starvation levels. However, compliance is so
poor that it's not a viable solution. And it wouldn't be correct to say that
this problem is irrelevant to those who are looking to start a new diet.

I personally find the combination of the (potentially flawed) human studies
and the (more scientifically rigorous) animal studies to be fairly persuasive.
You can find fault with either of the two, but in sum, the two pieces of
evidence seem quite solid.

"If you interpret studies as showing what happens when people actually eat a
certain diet, then compliance _is_ a flaw -- a really big one!"

To me, the studies likely skew in that direction, while also providing
stronger evidence when interpreted as showing what happens when people _try_
to eat a certain diet.

"I don't necessarily disagree with Taube, though I don't think it signifies
much that he can persuasively make a point and disparage those who disagree
with him when he's talking to lay people."

Sure. On the other hand, he's a researcher who's been investigating this issue
for around a decade, and has published a very rigorous (by most accounts) book
on the subject. Given the stakes, I suspect that most people would eventually
take to the streets in an attempt to improve the situation.

Overall, I think we likely agree here :)

~~~
dkarl
I think we do mostly agree, but I think compliance is a very different factor
for each individual. Looking back through different fads and various swings in
nutritional orthodoxy, many people have succeeded in building strong, lean
bodies whether they believed in eggs, tofu, wheat grass, or protein shakes.
That's a fact that simply disappears and is forgotten when we focus on
aggregate results from mostly non-compliant subjects. I am pleased and
heartened by the conclusion of the study Taube criticizes: "It appears that
substantial differences in proportions of dietary macronutrients play only a
modest role in weight loss success, and that success is possible on any of
these diets provided there is adequate adherence. Getting individuals to
adhere to whatever diet they choose to follow deserves more emphasis." That is
excellent common sense.

------
johnwatson11218
I am about finished with "Why We Get Fat" by Gary Taubes. The main idea of the
book is that carbs are what makes us fat and causes heart disease - not meat
and fat as the medical establishment tells us. I know this same message is all
over the place right now, one thing that makes the book unique is that he goes
into the history of how the medical establishment came to the current
viewpoint. According to Gary Taubes the European medical establishment was
figuring out the carb/obesity link back in the 30s. WWII disrupted all that
and when the Americans picked the question back up in the late 50s it was fat
that was made the villain.

He goes into a lot of the biochemistry as well. As I was reading the book I
kept coming back to this notion that carbs are pushed down our throats and the
main reason why is that they are cheap. Not only cheap but they are easy to
transport and store. It made me wonder if the common people of ancient Rome
developed some of the health problems that modern people face. After all, they
were kept on a state sponsored diet of grain and bread.

~~~
Create
Sugar: The Bitter Truth

<http://www.uctv.tv/search-details.aspx?showID=16717>

------
KirinDave
So the crux of the argument is:

1\. In this one particular study, caloric restriction diets were explicitly
calorically restricted.

2\. In this one particular study, low-carbohydrate diets were not explicitly
calorically restricted.

3\. Weight loss was similar for both groups, but we assume that the Atkins
fatties were gorging themselves on meat while the other people were not.

But, the data from this study was self-reported. To me, this is an immediate
red-flag. It's two large waving red-flags for the inference the author is
trying to engage in. He's basing a huge article on an assumption which _is
absent from data._ This is anomaly hunting, plain and simple. The author
obviously has a preconceived desire to support carb-limiting as the Deep
Secret of weight loss, and so any anomaly is cast into evidence for this
desire.

This is not to say the author is wrong, I'm simply saying his logic doesn't
hold and analysis falls apart as a result. It's at least as basic a concept to
science as the notion of control that the article leads with: "You cannot draw
strong conclusions in an absence of data."

P.S., I'm not inclined to believe this good-calories-bad-calories stuff. I
lost 100lbs over the course of 13 months, and I didn't do it by carb cutting.

~~~
ryanwaggoner
Data from almost all diet studies is self-reported (see comment by dkarl) and
inherently unreliable, but it's the best we have. And his argument in this
article isn't that carb cutting is the source of the weight loss, just that
because we don't isolate the variables, we can't know for sure what the source
is.

How did you lose that much weight over 13 months?

~~~
KirinDave
> his argument ... we can't know for sure what the source is

This author's tone and content, in addition to other articles posted, leads me
to believe he has a preconceived notion. The text is litered with example of
this, like: _“And if they’re trying to cut calories, they’ll be removing some
number of total carbohydrates as well. And if these people lose fat on these
diets, this is a very likely reason why.”_

> How did you lose that much weight over 13 months?

Aggressively cut my calories and started going to the gym 5-7 nights a week.
My exercise regimen focuses heavily on cardio, but I've gradually been
increasing my resistance training. The bulk of the weight was lost in 6
months, about 40 lbs between Feb and July. The rest was a gradually lost
before and after.

~~~
ryanwaggoner
How many calories of fat, protein, and carbs did you eat before and during
your weight loss program?

~~~
KirinDave
I don't know. The only notable carb-cutting effort I took was removing most
forms of soda from my diet. But obviously, this is not an isolated action as
I've replaced it with water, tea, and coffee. All of those have substantially
less calories.

~~~
jancona
They also have substantially fewer carbs--which is Taubes' point. By reducing
your caloric intake you also reduced your carbohydrate intake, and so you
don't know which was responsible for your weight loss.

~~~
KirinDave
That logic works both ways, though. If you cut soda to kill carbs, couldn't
someone say, "Ahh, but you also cut calories! So it could have been that and
not the carbs that did it!"

This is is what we call a non-argument. There is insufficient data to make a
call either way. The author mentions this, but as I pointed out in other
comments on this thread his agenda was clearly to push one hypothesis.

I still don't think that's the case. Ditching soda was one of the first things
I did, and I only saw a bit of weight loss. It didn't really start until I
started exercising. Which is far more plausible than some sort of miracle
diet.

~~~
slashclee
> There is insufficient data to make a call either way. The author mentions
> this, but as I pointed out in other comments on this thread his agenda was
> clearly to push one hypothesis.

I think that's actually Taube's main point - the data is insufficient, and the
variables aren't being properly controlled. His suggestion that it was in fact
the carb-cutting that was the most effective seemed secondary to me.

For the record, I lost 37 pounds in the span of roughly two months by cutting
carbs. I ate more than 2000 calories per day (a fairly constant diet of bacon,
eggs, cheese, steak, chicken, and broccoli), but kept my carb consumption
under 40g of daily carbs for the entire two-month period, and still managed to
lose what I consider to be a shocking amount of weight.

------
powera
Another diet article that's very, very long, low on facts, and repetitive on
the few facts they have. Are these showing up just because people have New
Year's Resolutions?

~~~
jerf
Another diet _blog post_. If you want facts, buy the Good Calories, Bad
Calories book, or presumably his recent book which I can't recommend either
way as I have not read it. If Gary Taubes does not have enough facts,
regardless of how you like his interpretation of them, you may give up all
hope of ever understanding diet issues yourself now.

So as to avoid a redundant post, I make this point to KirinDave as well. This
is not Taubes' argument, it's one particular small point, a marketing teaser.
If you really want to dismiss him you're going to have to do a lot better that
poking apart one blog post, you've got a book (or two, though I don't know
what the overlap is) to dismantle.

~~~
yummyfajitas
Why bother reading the book when the blog is either flawed (as this post is)
or dishonest (as the one from yesterday is)?

If the blog is junk science, it's unlikely that the book is better.

~~~
jerf
Neither are junk science. People's junk science detectors and the competition
to be the first to declare that something is "fatally flawed" are going off
excessively quickly. (See also the rush to be the first that some show or
something has 'jumped the shark'.) If there's junk science afoot it's
unfortunately in the "mainstream".

------
rfugger
Cached copy: [http://www.garytaubes.com.nyud.net/2010/12/calories-fat-
or-c...](http://www.garytaubes.com.nyud.net/2010/12/calories-fat-or-
carbohydrates/)

------
latch
Eat better and exercise more.

~~~
josephgrossberg
Yes, but what is "better"? And what is the best way to make both life changes
enduring? (E.g. if someone is constantly hungry, their change in diet is
probably not sustainable.)

~~~
latch
I'm a layman, but I'm highly skeptical at the amount and complexity of
information in this field with respect to your average person (which is not
the same as scientific and medical research into the subject of nutrition,
chemistry, etc.)

What's better? 5 servings of fruits and vegetable. Unrefined, whole foods.
Water. Legumes and grains. Fish.

Combine such a "diet" with 1 hour of light exercise (for example walking) a
day and I bet most people would be considerably healthier (all the better if
they can do aerobic exercise a couple times a week, say on the weekend). Most
impressive this is also normally a cheaper way to eat and doesn't have to
taste bad.

~~~
mike_organon
We should be skeptical. Taubes' books show most of the conventional nutrition
information is based on flawed studies that eventually became dogma. GCBC was
aimed at medical professionals, and his new book tries to present it for
average people, but he still has to present enough to counter 50 years of bad
advice.

"What's better? 5 servings of fruits and vegetable. Unrefined, whole foods.
Water. Legumes and grains. Fish."

Cut out legumes and grains - those are not whole foods, but they are modern
(in evolutionary terms) and processed, and detract from nutritional advantages
of of real food: fish, meat, eggs, and vegetables.

~~~
latch
Legumes are the dried fruit of a certain type of plant. I'm not sure how
that's modern or processed.

------
skunkworks
Gary Taubes is so incredibly wrong that it makes me sad.

If you want to read some intelligent analysis of dieting/nutrition, I suggest
reading Lyle McDonald (<http://www.bodyrecomposition.com>) and Alan Aragon
(<http://www.alanaragonblog.com>).

~~~
noarchy
Taubes may be wrong, but he has a very devoted following that apparently
includes HN. It's popular to sell magic bullet ideas, like carb-cutting, and
the anti-carb brigades have made an entire industry around this. It is far
less popular to tell people that they need to get off their rears, and get
active, since they'd rather stay on their rears and find a magic bullet that
will let them remain sedentary, and still lose weight.

~~~
aantix
The body is constantly fighting you to maintain current weight. That's why you
get really hungry after a hard workout or want to go to sleep after severely
cutting your caloric intake. Your body will respond.

You're giving exercise way too much credit.

[http://www.time.com/time/health/article/0,8599,1914857,00.ht...](http://www.time.com/time/health/article/0,8599,1914857,00.html)

~~~
noarchy
You're giving sedentary lifestyles way too much credit. If you want teenagers
with the fitness levels of elderly smokers, you've already got it happening
out there.

Quit driving to work, and start biking to work, and you'll see results. It
really has to be about lifestyle, and spending too much time on one's behind,
combined with eating badly, is slowly killing millions.

