
Is Fat Killing Us, or Is Sugar? - kmf
http://www.newyorker.com/magazine/2017/04/03/is-fat-killing-you-or-is-sugar
======
Aron
My intuition is that there is a small delta in impact between a 'reasonable'
diet and a 'perfect' diet, and so playing in that margin is pointless. But
I've always felt it notable that you can consume a whole day's worth of
calories in about 5 minutes with a super happy value meal, and then be hungry
again a few hours later. I'd say avoid doing that.

~~~
kough
Actually, it's pretty hard to eat a whole day's worth of calories in a single
meal. I know this because I've tried to, regularly, as part of a longer
attempt to gain weight. If you're ordering at McDonald's, your best
calorie/dollar ratio [edit: s/your best/my preferred] is the ~800 calorie
double quarter pounder with cheese for ~6 dollars. My daily caloric
requirements are estimated at 3000 calories based on my age and gender, which
means I'd have to eat a little under four of these. The best I've managed is
two, and that's even with smoking weed to increase my appetite.

~~~
sushisource
Yep. Anyone who has ever trained for a marathon or other endurance event
understands that eating 4000+ calories a day is a chore. On top of the fact
that you want these to be "good" calories... Let's just say I ate a _lot_ of
rice with veggies.

Which leads to the blunt advice I give most people seeking to lose weight.
Sure, you might be genetically predisposed to have a slow metabolism, but at
the end of the day "calories in / calories out" is as absolute a fact as it
gets (of course, all things in moderation). So I say "You have two options:
Eat less, work out more, pick the one you like."

~~~
Nav_Panel
I still think "eat less" is bad advice, because just "eating less"
chips/soda/garbage is pretty difficult. I've tried. It requires an extreme and
inhuman amount of willpower. Our natural drive is to vacuum up all the easy
energy in front of us.

"Eat better" is probably better/more useful vague advice. You can eat a whole
lot of salad/veggies and it wont end up being that many calories (so, in this
case, you're eating MORE, but consuming less energy/fewer calories). Same with
meat. It's hard not to lose weight if you're eating a lot of (leaner) meat,
because you feel extremely full after a couple hundred calories worth. If you
start modifying your diet, your cravings will change too. It's all about these
weird feedback loops.

~~~
solidr53
He never stated "eat less volume of food", so I take it he ment the general
term "calories of food".

How you do it doesn't matter. (eat more volumetric food or stop drinking soda,
doesn't matter)

~~~
TheCoelacanth
Except that it does matter how you do it. There is pretty much no human alive
who has the willpower to eat exactly their daily caloric requirement in chips
and soda and then stop every day.

------
ThrustVectoring
A lot of nutritional studies have a common flaw:

1\. Various health outcomes and indicators are caused by a food or combination
of foods that you regularly eat.

2\. A diet is studied where these foods get removed from your diet, to be
replaced with whatever the diet under study is.

3\. The participants in the diet study have poorer than average health
outcomes and indicators (otherwise, why would they try changing their diet?)

4\. Regression to the mean happens, and all sorts of dietary changes appear to
be good for your health.

Basically, if you're fatter than average, and it's caused by the foods you
eat, you can fix that by making a list of everything you eat and not eating
those foods. "Whatever you don't eat" is a more average diet than what you're
currently eating, so you'll get more average results.

(This idea shamelessly stolen from HN user jimrandomh. Hopefully I didn't
butcher the details too badly.)

~~~
coldtea
> _3\. The participants in the diet study have poorer than average health
> outcomes and indicators (otherwise, why would they try changing their
> diet?)_

Because they're asked to, as part of the experiment?

> _4\. Regression to the mean happens, and all sorts of dietary changes appear
> to be good for your health_

Why would the mean be better, since in (3) you mentioned that those people had
"poorer than average health outcomes and indicators" to begin with? For
regression to the mean, they should have started the diet after some extreme
readings. But who said those are what prompted them to the diet? People don't
start on a diet when they get extremely heavy, they start and stop diets all
the time, while being continuously obese.

> _Basically, if you 're fatter than average, and it's caused by the foods you
> eat, you can fix that by making a list of everything you eat and not eating
> those foods. "Whatever you don't eat" is a more average diet than what
> you're currently eating, so you'll get more average results._

Well, if you eat the same calories from your new "Whatever you don't eat",
then you'll get as fat.

~~~
ThrustVectoring
> _Because they 're asked to, as part of the experiment?_

Let me try another way to word the same concept: why would an actor in the
best shape of their life with a personal chef and nutritionist participate in
the experiment? Similar logic goes for less extreme examples on this end of
the curve.

> _For regression to the mean, they should have started the diet after some
> extreme readings._

They're obese, their diet _is_ an extreme reading from the space of possible
diets. They're choosing foods that only satisfies their various needs at a
caloric quantity that causes weight gain.

> _But who said those are what prompted them to the diet? People don 't start
> on a diet when they get extremely heavy, they start and stop diets all the
> time, while being continuously obese._

Caloric restriction diets and food choice diets aren't the same thing here.
People usually start and stop diets all the time because caloric restriction
diets have huge user experience issues. Specifically, the very common yoyo
dieting; you feel bad about being fat so you decide to do something about it,
then you do caloric restriction in a way that fails to meet many of your other
needs, then you abandon the diet because the stress of not meeting your needs
starts to outweigh the negative feelings from being fat.

> _Well, if you eat the same calories from your new "Whatever you don't eat",
> then you'll get as fat._

If your current diet meets your needs at an above-average number of calories,
you won't eat the same number of calories (unless you try to manually control
caloric intake through some variant of calorie counting).

------
bigbugbag
There's a BBC Horizon episodes with two identical twins, one goes for the low
fat diet and the other for low carb diet to test which one is worse.

[http://www.bbc.co.uk/programmes/b03t8r4h](http://www.bbc.co.uk/programmes/b03t8r4h)
[http://www.dailymotion.com/video/x1amh2t_bbc-horizon-
sugar-v...](http://www.dailymotion.com/video/x1amh2t_bbc-horizon-sugar-v-
fat-h264-1280x720-aac-rmac_lifestyle)

~~~
mkaziz
Do you have a quick synopsis of what happens?

~~~
praveenster
At time mark 57:20 in the DailyMotion video they say that it is neither of
them individually but the combination of fat and sugar that is the problem.

~~~
ThrustVectoring
How does that follow? If you have a below-average diet and replace foods from
it, you're likely to do better simply due to regression to the mean. You could
replace a shitty diet with one with different foods but the same macronutrient
distribution and likely end up improving things.

------
tchock23
The author lost me when it left out the mention of Ancel Keys cherry picking
data to support his hypothesis that fat is bad, and then noting off-hand that
he lived to be 100 (somehow validating his hypothesis?)

Poorly written article that felt more like a defensive hit piece (e.g.,
dedicating eight paragraphs to destroying the credibility of Sylvia Tara) than
something that sought to answer the question posed by its title.

~~~
emmanuel_1234
Totally. He comments on well documented pieces of work (at least Taubes', I'm
not familiar with the other one) and discard huge part of them without
bringing any evidence whatsoever (he even seems to admit that _his wife_ is
the expert on the topic of understanding statistics!).

I like Taubes work because he's thorough and refutable (notably in refuting a
lot of other studies). Doesn't mean he's always right, but I've yet to see
arguments against his work that are as sound as the one he brought to the
table.

------
mcorley28
I think that it's a deadly combination of both. We tend to consume way to much
sugar, and usually sugar without the associated natural fiber. The fats
typically consumed are cheap, low quality fats and oils.

Following a paleo-keto diet has been working wonders for me, I never felt or
looked better in my 30+ years. So I think fats, when they are high quality,
are the best source of fuel for the body.

~~~
snarf21
So true, the one thing that people leave out is the human factor. It doesn't
matter how "perfect" a diet is if the person can't follow it. Switching to
vegetables, lean proteins and good fats (olives, almonds) is not complicated,
just hard and hard to sustain for most people.

------
ellyagg
Neither by themselves, but when combined...

I read somewhere that when they want to fatten up lab mice they feed them a
mixture of 70% sugar and 30% fat or something similar. When you make something
much more delicious and available than what appears in nature, it screws with
an animal's energy balance signals.

~~~
Alex3917
The catch though is that you need fat to live. That is, without fat in your
diet you're not able to digest plants.

And if for whatever reason you're not eating enough fat, your body will crave
sugar.

So basically eat healthy fats. If you don't eat enough healthy fat (e.g. from
walnuts), your body will start craving unhealthy fats. And if you don't eat
either then your body will crazy sugar as a last resort.

As far as I can tell that's basically the secret to staying healthy, just make
sure to get enough walnuts and avocado or whatever, and once you have your RDI
of healthy fats then craving unhealthy fats or sugar won't be an issue.

~~~
e40
When I started doing intermittent fasting I also started eating lots of
walnuts, and I can say my craving for sugar went way, way down. I haven't had
sugar once since I started IF (> 30 days).

~~~
finid
_I haven 't had sugar once since I started IF_

Does that mean you haven't included sugar in your foods yourself, or you've
managed to avoid eating any prepared food since you started?

Practically all prepared foods contain sugar, though they might not call it
that in the ingredients list. When next you go boy chicken or turkey, read the
list of ingredients. I'm talking about the raw forms, not the already cooked
ones. It's shocking.

~~~
e40
I eat mostly food prepared by my SO. You're right, a lot of packaged foods
contain sugar. When I eat those, I look at the label and usually avoid them.

For me, the big change was desserts. I was a fiend for those. I've tried a lot
of things to ween myself from eating and binging on sugary treats. I wasn't
expecting IF to be the thing that worked. That was totally unexpected.

------
upofadown
At this point I am quite cynical about any claim that you can get healthier
with a specific diet. I can guarantee you that my cyanide and toxic metal diet
will make you less healthy but knowing that one thing is true does not
automatically mean that you know that another thing is true.

Exercise will make most people healthier in general, particularly stuff
associated with your cardiovascular system. We know that. That doesn't mean
exercise will make you anything else associated with good health. It might not
make you thinner, it might not change any sort of index based on medical tests
normally done on inactive people. It might not even make you better looking or
hotter in any way. We don't actually know any of that other stuff for sure.

This all simplifies things a lot. The advice should be: "get some exercise
every once in a while. Don't worry so much about stuff that we don't actually
know."

~~~
loco5niner
As a single guy that checks out girls a lot, I can verify that exercise makes
you hotter, if not better looking.

Yes, it may be true that healthier people are more likely to exercise exactly
because they are already healthy, but I would imagine that is true in less
that 1% of the population.

~~~
neilk
I don't know, man. If you're trying to make a serious point about health, do
you have to cite your expertise as an ogler of women? It sounds like you're
trying to allude to something we're all supposed to know, that people past a
certain percentage of body fat are all inactive and lazy.

Maybe what you meant was that, all things being equal, someone who is strong
and healthy is more attractive. That's probably true.

But as upofadown pointed out, there are lots of people who are very healthy
and strong, and exercise a lot, but their body shape or fat percentage doesn't
conform to the desires of the average voyeur.

~~~
loco5niner
> If you're trying to make a serious point about health

Not trying to make a serious point about health.

> do you have to cite your expertise as an ogler of women

You are misappropriating my comment.

------
abraves10001
I think I am misunderstanding the 30% claim. Is it over time or is it just
that 4.4 is ~30% greater than 3.4? I think the latter makes sense without "the
complex statistical way that the study’s results were projected over time" but
then again I haven't read the actual study.

------
finid
_It’s one of many cautionary tales about assessing dietary data. Everyone
wants to be healthy, and most of us like eating, so we’re easily swayed by any
new finding, no matter how dubious._

That's why I ignore the headlines and read the paper of any study that I'm
interested in.

------
mjevans
Yes.

For me, probably most is the highly sedentary office lifestyle.

Compounding this problem, I more or less live alone and thus 'community food'
(eating out) is my best access to non-frozen pre-prepared meals. I refuse to
do leftovers (this is not negotiable).

The main problem with eating out is the portion size. Everything is insanely
large.

~~~
UnoriginalGuy
It is "insanely large" because leftovers are built into the meal. You're meant
to take some home and have it for lunch.

I don't really know what your post is about. It starts with the word "Yes"
(???) and then gives a ton of incoherent excuses for something which isn't
specified.

~~~
antisthenes
Of course it's specified. It's an excuse for being fat.

------
shirro
It is neither and both. The problem is overconsumption. People eat too much
and the food they eat has far too much energy for their daily demands. People
just need to eat smaller portions, less energy dense refined foods and eat
less often.

------
justboxing
DUPE of
[https://news.ycombinator.com/item?id=13980272](https://news.ycombinator.com/item?id=13980272)

------
jimjimjim
all things in moderation.

not too much sugar.

not too much fat.

not too much food.

eat more green veges.

not too much carbon/charcoal.

avoid processed stuff.

but most important: don't tell anyone else. If everybody does it then the food
industry will insidiously alter itself to pull people back in while finding a
way to make good things bad.

~~~
omgwtfutoo
This is such vague, banal advice that it is useless. Suggest looking at peer
reviewed papers when deciding what to eat. See
[http://nutritionfacts.org](http://nutritionfacts.org)

------
jameslk
I see a lot of suggestions for diets in the comments here, but not a lot of
citations. It's good that others have recommendations to share, but at least
back it up from something.

------
parenthephobia
Previous discussion:
[https://news.ycombinator.com/item?id=13980272](https://news.ycombinator.com/item?id=13980272)

------
omgwtfutoo
It's both. Eat whole plant foods, I.e. a vegan unprocessed diet, and you'll be
fine. Just like your ancestors did and were.

------
mvpu
Bah, why do people write such painfully long posts without an executive
summary at the top?

~~~
munificent
The entire gist of the article is that nutrition cannot be executive-
summarized and that it is likely the confluence of many many factors that
determine how our diet affects our health.

~~~
antisthenes
But that's provably wrong, so the article is incorrect in its entirety then?

Here's the executive summary:

1\. Do not eat more calories than you need. 2\. Exercise 3 times a week (or
more if you have time and enjoy it), with moderate intensity 3\. Ensure that
most of your meals follow a good macro nutrient profile (but if you have to
cut something, do it in carbs --> fat --> protein order)

Not sure why people have such difficulty grasping those concepts and will come
up with statistically irrelevant anecdotes in futile attempts to prove the
main concepts wrong.

------
dibujante
Obesity is killing you.

------
necessity
None of the above.

------
tf2manu994
Neither. Calories.

------
sqeaky
Why not both? Why not neither?

------
nether
Welp

~~~
alpha_squared
You can be at a healthy weight and still develop diabetes. I think the whole
health discussion is about more than just weight.

~~~
pnw_hazor
Yes. Weight is a symptom, not a cause.

Eat too many carbs/sugars -> more insulin which yields more body fat.

------
X86BSD
Sugar. Hands down. Dr. Atkins is right.

------
Memebook
After years reading about what is right or not for me. I just gave up and
began eating what felt good to me.

After awhile, I begin to notice that my body's constantly telling me what
feels good or not. Sometimes good health is nothing more than a bit of
awareness and experimentation.

~~~
cheald
The problem is that your body is highly adapted for survival, and it frickin'
_loves_ calories, and we have a food industry that has perfected the process
of putting as many calories into as small a package as possible, with a
composition that sends your brain hormones into overdrive and tells you to
shove as much of it into your face as you can.

Obesity is epidemic in our society because the food available to us presses
all the "this feels good" buttons. _Most_ people eat what feels good to them;
the healthiest are the ones who intentionally restrict themselves from eating
what their brains tell them they should be eating.

~~~
Memebook
Perhaps. That's one story.

Another possible angle, we're so out of touch with our bodies, our emotions,
our very selves. That we've essentially numbed ourselves to the signals that
our body's constantly sending us.

Sitting children down in neat little rows for 16 years, while hammering them
into preconceived form; no play, no socialization, no getting to know self,
this seems to have a deleterious effect on their awareness.

Funny thing is that I subscribed to that often-repeated theory, and it may not
be wrong, after all, that story does make sense. However, when I started to be
mindful, I began to notice that sugar doesn't feel that great and it's kinda
gross same goes when I ate too much meat. Just the simple act of noticing has
led me to a healthier diet. The hardest part was relearning how to be present
and aware, the rest is gravy.

Makes me wonder how much bullshit we've been fed over the years about
ourselves.

------
jlebrech
Fat is for survival, if you're don't spend the night outdoors you wont burn
it.

Sugar is for energy to use immediately, if you don't use it it's turns into
fat, 30% of it is wasted in that process though.

Overeating carbs is better than overeating fat.

~~~
pnw_hazor
Not really. Excess fats do not convert to body fat. They just pass through.

Excess glucose (from sugar and carbs) triggers insulin production which causes
glucose to be converted to body fat and your muscles to stop consuming fat.
(Which also causes your muscles to be nutrient depleted leading to being
hungry soon after...)

The insulin flood caused by sugar and bad carbs is your body trying not to die
of glucose poisoning.

~~~
jlebrech
excess fat causes insulin resistance which causes sugar to stay in the blood
stream.

------
Shanbo
Kind of crazy that you guys don't understand this yet. I may not know how to
hack, but I know how the body operates. Most people would do well to read
Volek & Phinney, both 'the art and science of low carbohydrate living' and
'the art and science of low carbohydrate performance'

~~~
molloy
In turn, I recommend you read How Not to Die by Dr. Michael Greger.
[http://nutritionfacts.org/book/](http://nutritionfacts.org/book/)

~~~
cies
This is the single best advice in this whole thread. I read it: it covers so
much ground. You need to be a bit of a nerd (the text is loaded with refs to
papers) and makes use of jargon where no simple alternative exists -- but it
is by no means a hard read.

Srsly this book can add 15 healthy years to your life!

