
Obesity and Fitness Are Revolutionized By Reddit, Not Doctors - jc4p
http://greatist.com/health/dick-talens-reddit-healthcare-obesity/
======
beloch
The key obstacle to weight loss is the same as any form of self-improvement:
Motivation. Most people know what they need to do in order to lose weight.
They just don't do it because its hard to motivate ourselves to do things
we're not used to doing. i.e. It's hard to defy our habits. Healthy people
don't defy their habits any more than unhealthy people do. They just have
healthy habits. So when you're trying to become healthy the goal should not be
to "lose 5 pounds this week", but to form healthy habits and break unhealthy
ones. This kind of thinking is crucial. You might have enough willpower to
defy your habits long enough to achieve your weight-loss goal, but only
forming healthy habits will keep the weight from coming right back.

This is possibly why doctors aren't terribly useful. They can tell us when we
need to lose weight and perhaps even give us a general idea of what we need to
do, but they really aren't trained to focus on habits and motivation. Even if
they were, everyone responds differently to ideas and we each need to sift
through a lot of possible ideas to find ways of changing our habits that are
actually compatible with how we live and think. It's a matter of brute-force.
A doctor has maybe 10 minutes to set you on the right path, but you can spend
hours upon hours reading reddit looking for things that will work for you.

One point in the linked article that I absolutely disagree with is that cardio
is unimportant. To be fair, he only really said it's unimportant for weight-
loss. If all you want is to look pretty then perhaps it's not crucial, but it
absolutely is important for being healthy. Above I said that forming healthy
habits is a way to side-step the need to constantly motivate ourselves, but
the truth is that it also takes effort to change our habits! Having the
strongest possible motivation helps, and I've found that being healthy so I
can do things like play sports and hike is a better motivator than simply
looking good.

~~~
mberning
Couldn't disagree more. Motivation implies some sort of personal failing or
personal weakness, which leads me to believe that you buy into the"eat less,
exercise more" mantra.

I would just like to point out a few things.

You state that "most people know what they need to do in order to lose weight"
as if there is some cut and dry method to getting thin. Well, I suppose
starvation diets ARE that easy, but nobody sticks to them, so they are useless
in the long term. This brings me to my first point. If losing weight were as
simple as following a specific regimen and the pounds fell off there would be
no obesity problem. Nobody chooses to be fat. In fact fat people generally
hate it and try incessantly to lose weight. I think the advice that these
people get from their doctors, the government, the fitness gurus etc. is
almost universally wrong. I could write much more on this subject, but
consider that most people that want to lose weight try a variety of methods,
and conspicuously none of them work. If this were isolated to just a few
people I would say it is a personal defect, but since it is such a widespread
phenomena (and growing) I must say I don't think it can simply be explained
away as bad habits. People need good information on what to do, and by and
large they aren't getting good info.

The other thing that I would like to point out is that the focus on exercise
is a relatively recent development, and even though more people are exercising
than ever before, there has been absolutely no slow down in obesity rates. Go
to any gym and you will see an abundance of fat people trying to get fit. It
simply doesn't work. They stay fat.

~~~
beloch
Yes, I buy into the "eat less, move more" idea. But then, I'm a physicist and
I believe in the laws of thermodynamics.

I am in complete agreement with you that starvation diets, fad diets, and
other cook-book regimens are likely to result in failure. The point I was
trying to convey was that this failure comes from the fact that it takes
willpower to follow these, while you're much more likely to succeed if you try
to form habits that don't require willpower to follow. I was borderline obese
once myself, but I never followed any specific diets or regimens. I just
learned healthy habits.

Exercise is absolutely crucial for good health. Just being skinny doesn't
necessarily make you healthy. Perhaps there was less focus on exercise in the
past because people were, on average, much more active in their daily jobs.
Today, paper-pushers really need to exercise to be healthy.

~~~
mberning
Nobody is disputing the first law of thermodynamics. I do question your
interpretation though. Firstly because the human body is not a closed system,
and secondly, because there are different ways to interpret the laws as they
relate to nutrition.

Consider that x is the calories required to run your body at a given weight,
and y is a surplus amount of calories.

Traditional view:

If you eat x + y calories your body will store y as fat.

Non-traditional view:

If your body needs x calories to function, but it's trying to store y calories
as fat you need to eat x + y calories.

The non-traditional view is becoming more favorable amongst obesity
researchers. If you have an obligate weight gain caused by a biochemical
defect, then you better eat the calories to satisfy the needs of the body.

------
_delirium
What's missing in this article is mention of actual scientific evidence. I can
believe that traditional nutritional recommendations are on flimsy ground, but
replacing them with new cargo-cult ideas isn't necessarily better. Do these
newer recommendations have good science behind them? My lurker experiences in
/r/fitness are quite mixed; they seem like nice people, but the specific diet
plans are very heavy on anecdotal evidence, with people professing very high
confidence in recommendations relative to how much evidence there is (if
anything, it reminds me of alternative-medicine communities). They're also a
bit too focused for my interests on bodybuilding/image/etc. rather than
measurable health outcomes, e.g. reduction in heart-attack or diabetes risk
rather than muscle definition.

~~~
dicktalens
Far from alternative medicine. The beliefs touted by /r/fitness, such as
intermittent fasting, increased protein consumption (many times more than the
FDA recommendation), progressive load resistance training, and NOT focusing on
cardio for weight loss are highly researched. The leaders of the /r/fitness
community are incredibly well-versed in science and there are extremely
intelligent debates that take place on /r/ fitness. The problem is that these
concepts rarely make it to the mainstream on their own.

There's lot of links to the research, but this wasn't the appropriate article
to include them. :)

------
david_shaw
Disclaimer: this post is going to go into some of my personal experiences with
weight loss, fitness, and reddit.

In March 2012, not all that long ago, I was considered obese. Living a life
primarily behind the computer screen while leading an engineering team at a
rapidly growing startup (over 100% growth in the last year alone) left little
time for me to consider my fitness.

I'd eat trash -- burritos four or five times a week, pizza or fast food the
rest. I never cooked, because I "didn't have time." I didn't work out for the
same half-assed reason.

I realized in early April that I weighed more than I ever had before, that I
was not satisfied in my appearance, and that I was very likely introducing
unwanted health issues.

Like many other things in my life (coding, managing, infosec, etc.) I took the
"dive deep" approach into health and fitness.

I experimented with several diet and fitness plans, until finally finding one
that seemed sustainable for me. I'm not trying to start a flame war about
diets -- I've seen far too many of them in the last few months -- but a very
low-carbohydrate, ketogenic diet (called "keto") works extremely well for me.

I found a reddit community (surprise!) called /r/keto that shares recipes,
support, and tips with each other. Especially in the beginning of my diet, it
was an invaluable resource.

I started my keto diet on April 18th, at about 255 lbs. Today I weigh 189.

I'm still not where I want to be (yet), but I can personally attest to the
extremely kind and supportive atmosphere that reddit provides when working
towards a goal like this. We rejoice in each others' victories and help each
other through the harder times.

That said, there _are_ downsides, too. I already mentioned the diet/exercise
flame wars that go on -- for example, Low-Carb/High-Fat (LCHF) diets vs. High-
Protein/Low Fat vs. Low-Fat Generalized, etc. I think that each of these diets
can work (science supports that), but different people need to figure out what
works for them.

The problem with these subreddits -- /r/fitness included -- is that they
develop a hive-mind towards their respective goal. /r/fitness almost makes a
joke of it ("join a gym, quit facebook, get girls"), and "starting strength"
is recommended all the time, in response to pretty much everything. Not that
these are bad recommendations at all, just something that I see a lot.

The communities are very welcoming, but when an individual strays from the
hive mind, they can also be very _dis_ couraging.

Hope this lends a little insight and personality to the article!

~~~
neutronicus
I have a pet hypothesis that one of (for instance) Keto's main benefits is
that it shakes up habitual eating patterns. Instead of trying to eat less of
foods you're used to eating a lot of, you're forced to develop new habits
around entirely new food.

I've also gone from 250-ish down to 170-ish (although over the course of 2
years, not 4 months, lol), but I haven't really bought into any specific diet.
I just don't eat out.

~~~
konstruktor
Expanding on the theme of unexpected benefits, I think that one of the things
that makes weightlifting helpful for weight loss is causing cognitive
dissonance when eating crap. Since the first increases in what you can lift
come from increased inter- and intramuscular coordination and are thus very
rapid and really astounding, you can quickly get a feeling of agency and the
belief that you are becoming a sporty person. Both will help you make better
food choices.

------
zone411
I'm sorry but the content on Reddit is very shallow compared to popular
fitness and nutrition forums that have been existing and going strong for many
years. There is nothing in this poor article that shows Reddit to be superior
in any way. It is very questionable that Reddit's weak voting system improves
the quality in any way (and reputation and other voting systems are available
on many forums anyway).

~~~
manaskarekar
It's not just the content alone that makes the difference. A few things:

\- It's the community that makes you feel like a part of something. Compared
to popular fitness boards, you don't go to reddit only when you're in the
'trying to lose weight actively' mode. You just go to reddit and then these
posts show up in your stream keeping you actively engaged. YMMV of course.

\- It serves as a gentle break-in to more detailed/technical information. Most
of the advice there is usually watered down from some technical sources, which
people/FAQs eventually link to in case someone needs more information.

The third and perhaps the most important point would be,

\- people see 'regular joes' like you and me losing xxx pounds and know by
their posting history that they're not a made up figment of the advertisers
imagination. This works on two levels, not only does it give confidence to the
average guy, it also ensures that he's not being fed some bullshit theory in
lieu of money.

The major fact that people get amazing results without throwing money at the
techniques seems to lower the barrier to 'hmm maybe I should try this.'

I'm a big time fan of keto and have had great results and I have but r/keto to
thank for this.

------
peterwwillis
Obesity and Fitness are not revolutionized by a forum full of people telling
you what worked for them. The revolution comes when people find what works for
themselves. So far, it's very far away.

News flash: Most people don't go on Reddit. _gasp_ Calm down. I'm sorry I
frightened you. But it turns out you don't get a revolution by a small number
of people who use a particular forum looking for fitness tips from their
formely fat peers.

In the future, you will be able to go online, fill out a questionnaire, and
for a small monthly fee receive one of several pre-programmed diet and
exercise programs, complete with local gyms that are part of the program and
can help you perform your exercise requirements. A local food store will also
be part of the program, with a special aisle of diet food for you to buy from.
The solution comes from tailored, marketed, cult-of-the-self products that
suck you in for long enough to make a dent.

The problem I see with the fitness portion is creating a fitness product
without real user engagement. You've seen it before plenty of times: CrossFit.
P90X. Tae Bo. Yoga. The Brazilian Butt Lift. They can all pretty much work to
get you in better shape, but there's nothing keeping a random person engaged
in it enough to continue for long. For someone starting out for the first
time, they have to have an enormous amount of motivation to continue once they
see how difficult it will be to begin.

To my mind, the easiest way to get people stuck on fitness is to Facebook it.
Make it addictive and interesting, and make them obsessed with how they are
doing. Give them micro stats. Gimmicks and social fluff to turn it into a
game. Anything to keep them hooked, to the point where the exercise is just a
small component to them. The diet becomes the same, giving lots of interesting
variables and an infinite number of simple user-friendly options to continue
getting healthy while being obsessed with a new toy.

If it's done right, they'll have gone weeks with the program, eating right,
and working hard, and suddenly find they've made some noticeable gains. The
rest takes care of itself. The revolution comes when people don't really
notice that they're being healthy.

~~~
BrandonM
This sounds like a pretty good approach. Why must it be "in the future"? Why
don't you work on it yourself? This _is_ Hacker News, after all.

~~~
jc4p
His description is exactly what the site founded by the author of the post
(and where I work) is :)

~~~
peterwwillis
Your marketing might need some work. All I know about Fitocracy is that it's a
forum, with some kind of "show people how many hours you've exercised"
thingie. I don't remember any kind of questionnaire thing, or being given any
kind of tailored workout program or dietary regimen.

------
abalone
Not surprising that this is an unscientific article.

What evidence is presented that "ignoring the fitness advice of doctors"
achieves "better results"?

Anecdotal evidence, that's what. 1 dude. The author even cites a "completely
unscientific, but accurate chart." That says it all.

~~~
davidtanner
How strong have you ever known anyone to get by following the advice of
doctors?

~~~
Xodarap
Given that every single Olympic athlete is advised by doctors I would say,
"pretty damn strong".

------
Professoroak
I firmly believe that for most things, fitness and health included, the
internet will always be lightyears ahead of what is published in peer-reviewed
journals. Now, new ideas get thrown on a blog for millions to (potentially)
see, the ideas are read and analyzed by a portion of the general population,
and then they're either rejected or expanded upon. It's the perfect
meritocracy of ideas, and the slow peer review process can't keep up.

~~~
jmduke
> _the internet will always be lightyears ahead of what is published in peer-
> reviewed journals_

The thing is, its not as if r/fitness or /fit/ invented the low-carb diet or
the paleo diet. They just spread it to people who'd otherwise never engage in
debate/discourse about nutrition (which is of course commendable.)

> _It's the perfect meritocracy of ideas, and the slow peer review process
> can't keep up._

I think Reddit and blogs have seen enough false witch hunts and outright lies
to know that the internet is very, _very_ rarely a meritocracy. Peer-reviewed
processes aren't meant to serve as a proxy for the general population, or to
spur rapid progress; in fact, their goal is serve as objective judges of
validity and accuracy.

This is somewhat akin to when people complain about the difficulty in passing
legislation in the U.S. Things like bicameral legislature and checks and
balances were instituted specifically to slow down the passage of legislature
and allow a more deliberate review process.

~~~
Nicole060
All the things you said are true but remember, not all doctors are up to date
with research and even if you can find a lot of false information on the
internet, you're more likely to also find the truth than you are with an
outdated physician.

The general practitioner that has followed me since I was born whenever I was
ill or hurt is someone who has nearly stopped reading anything about medicine
since he finished his study and got his job. On his own admission he doesn't
even use computers much and doesn't read the research you can find on places
like pubmed. He's nearing retirement and I'm going to change my physician (in
France you have to declare one to prevent people from hopping to one place
from the other whenever they're ill and "paranoid" and save costs to our
health care) once I get done with the paperwork, since I am very lazy when it
comes to anything that has to do with paperwork. Btw I know all this about him
because he's rather talkative and love to waste time once he's done with the
check up. One thing that enforced my laziness in looking for another one is
the fact that it can be good to have a physician who knows all your health
history from the start, even if he's somewhat incompetent.

When you end up with that kind of "doctor" the internet doesn't look so bad.

------
rickdale
This is the first time I have seen the reddit fitness stuff. I was big at the
beginning of the year. Wasn't even thinking of a diet. Then I read a comment
here on hn posted by Aramgutang, on the best books of 2011 thread, where they
recommended reading the four hour body. The community behind the four hour
body was a huge motivator for me to lose 40 lbs and really it does change the
way you think about things. I think reddit offers a similar backing to your
diet. You need support, sometimes it seems pointless, but when you are feeling
good, you will never feel better. Everywhere you look is temptation to
sabotage, a strong community behind you really helps. I always wanted to thank
Aramgutang so thank you.

PS Get a kettlebell.

~~~
Aramgutang
You're very welcome. Inspiring someone to become more healthy is probably the
most rewarding inspiration there is.

~~~
rickdale
Well, once again thank you. It's crazy how some tiny comment on the internet
can really change some random persons life. When I started to read 4HB, I was
like whoa, that comment on HN was/is my hirjaku moment. It was the door to the
other side. So once again thank you so much.

I looked up your email at one point to send a gratis note, but couldnt find
anything. Glad you spotted out my comment. Not sure how you found it :)

------
xiaoma
From reading the article I get the impression that the author isn't that
familiar with the scientific literature at all. The evidence he presents
against the usefulness of cardio for weight loss compares a group of
weightlifters against a group of runners who ran only 20km per week and they
still lost marginally more weight than the weightlifters! Cardio really should
be a minimum of an hour per day, at least 5 days a week if weight control is
the goal. Health benefits accrue much sooner, though.

Science certainly hasn't weighed in on favor of high protein diets or
abandoning cardio unless you cherry pick specific smaller studies to get what
you're looking for. On the other hand there are HUGE studies supporting
cardio, both for weight loss and for health.

I've written about this many times before on HN:

According to the 32,000 person study in the American Journal of Clinical
Nutrition (1999), "fit persons with any combination of smoking, elevated blood
pressure, or elevated cholesterol level had lower adjusted death rates than
low-fit persons with none of these characteristics". The same study found that
aerobic fitness had a far more important impact on longevity than obesity did.
Fantastic Voyage, Kurzweil and Grossman, Chapter 22.

Here's a report on a study that monitored over 100,000 people:

 _Paul Williams, Ph.D., author of the study, found that men who ran two or
more marathons per year were 41 percent less likely to suffer from high blood
pressure, 32 percent less likely to have high cholesterol, and 87 percent less
likely to be diabetic than non-marathoners. Those who ran only one marathon
every two to five years also had significantly lower risk for these conditions
than non-marathoners. The benefits of running marathons were largely
independent of total number of miles run per year by participants, indicating
that isolated distance running bouts in preparation for marathons may have
been effective in decreasing risk of disease. Even runners who didn't run
marathons - those who included longer runs as part of their usual exercise
routines - were less likely to have high blood pressure, diabetes, or high
cholesterol._ <http://www.medicalnewstoday.com/articles/140104.php>

Here's a different piece on how regular hour-long runs stimulate neurogenesis
and memory improvements in middle aged humans:

<http://www.dana.org/news/brainwork/detail.aspx?id=7374>

Distance running is one of the most beneficial things you can do for yourself.
Racing marathons can be reasonably low-risk with sufficient training, but it's
the training that gives benefits.

In terms of life expectancy, endurance athletes such as marathoners and cross-
country skiers live about 2 years longer than sprinters, 4 years longer than
power lifters and 6 years longer than the general populace. (warning- small
sample sized case study)
[http://www.mdconsult.com/das/citation/body/163630869-2/jorg=...](http://www.mdconsult.com/das/citation/body/163630869-2/jorg=..).

Recommended food for thought for those convinced that low-carb is the optimal
diet: Why is it that both Atkins and Taubes got so fat on very low carb diets
while Japanese people traditionally ate (and many still do eat) rice at every
single mean, lunch, breakfast and dinner? Maybe a bunch of high protein eating
redditors don't have all the answers.

[http://www.thedailybeast.com/newsweek/2008/07/15/the-
never-e...](http://www.thedailybeast.com/newsweek/2008/07/15/the-never-ending-
diet-wars.html)

[http://www.paleopharm.com/what-if-gary-taubes-is-a-big-
fat-l...](http://www.paleopharm.com/what-if-gary-taubes-is-a-big-fat-liar/)

[http://opinionator.blogs.nytimes.com/2012/03/16/no-
surprise-...](http://opinionator.blogs.nytimes.com/2012/03/16/no-surprise-
meat-is-bad-for-you/)

My own personal experiences are largely irrelevant, but FWIW the leanest and
fittest I ever was, I was getting nearly 80% of my calories from carbs. And
the time in my life I gained the most, I was only getting closer to 20% of my
calories from carbs. I can respect someone who encourages testing, a la Seth
Roberts' "n=1 studies". I can't respect someone who puts up a few blog posts
and claims to know more than the entire medical establishment. Americans are
more into protein and more into weightlifting than any other nation I've ever
seen. And while there are a number of muscled-bound guys strutting around,
there are a whole lot more fat people buying into the same pop weight-loss
ideologies.

~~~
dicktalens
This is a joke right? I almost stopped at the first sentence.

There are many studies detailing the inefficacy of cardio for weight loss for
various reasons -- from Friedenreich (2010) which actually compares cardio vs.
non-cardio groups... to Willbond et. al (2010) which talks about the
overestimation of caloric expenditure.

Not to mention the meta-analysis from last year:
<http://www.ncbi.nlm.nih.gov/pubmed/21787904>

But I guess you prefer observational, correlational studies instead. Of course
people who run marathons are likely more fit. Derp.

Guess what, those who drink diet sodas are more likely to be overweight. I
guess diet sodas make you fat?

~~~
xiaoma
It is not a joke.

Firstly, meta-analysis are generally amongst the worst things to go off (study
selection makes it very difficult to control for a researcher's expectations).
The link you provided doesn't even say how much cardio the subjects were
doing.

Secondly, the studies I cited were _massive_ and far better controlled than
most. Feel free to offer a link to a larger and better controlled on if you
can.

Thirdly your link, despite its problems, supports my argument. Participants
reduced their waist circumferences by 2cm in 6 months!

Interestingly the first search result for "Friedenreich (2010)" is your own
tweet, but looking further I found that he recommends exercise for cancer
prevention. In fact, this presentation I found in the first page of results
recommended more cario than any other type of exercise:
[http://wellspring.ca/Wellspring/media/common/documents/wells...](http://wellspring.ca/Wellspring/media/common/documents/wellspring-
cancer-exercise-lay-presDSantaMina.pdf)

~~~
dicktalens
Friedenreich found that the test group lost more weight than the control group
as well via. cardio. Yet I posted it in support of my argument anyway. Why?

It took an average of 35 hours of cardio to lose 1 lb of fat.

I'm not saying that it does not cause weight loss. I am saying that it's
ineffective. Of course cardio will cause some weight loss vs. doing absolutely
nothing. Of course it's good for your health. No one is arguing that.

Then again if you're saying that someone should run 1 hour/day for 5 days a
week... which is unrealistic for 99% of the population, and unnecessarily
complicates weight loss (not to mention makes it unsustainable)... then you
probably don't have a problem with 35 hours to lose a pound.

~~~
dennisgorelik
Running 20 minutes/day 7 days a week is very realistic for 90% of the
population. That's enough to keep the body in a good shape.

~~~
btilly
You don't have kids, do you? Become a full time parent, then see how much time
you have left.

And note that in this thread the standard for what you should do is an hour a
day 5 days a week rather than 20 minutes a day for 7 days a week.

~~~
hnriot
I do, and I don't have a problem finding 20 minutes to run every day. Become
better at time management before posting nonsense like that.

~~~
btilly
Let me guess, your spouse isn't in a medical residency?

Before I had kids, I never had trouble finding time to exercise and had little
sympathy for people who did. Since I've had kids my ability to exercise has
varied with life circumstances. At the moment it is very hard for me because
my wife _is_ in a medical residency, so most of the time I'm an only parent to
small kids.

In particular in periods when I exercised, I've found that between my personal
rhythms and outside climate, morning is the only time that it makes sense for
me to do so. (Perhaps you are happy running in 100+ degree heat, but I am
not.) But when I'm on my own trying to get 2 kids up, ready, and out the door,
before I start doing other stuff, I don't have 20 min where I can safely
disappear on them.

~~~
wisty
Not many people's spouses are in medical residency, and have children who are
too young to be left unsupervised for 20 minutes.

Even if you broaden it a bit (single parents, spouse in the military on
deployment, etc) you are not looking at 90+% of the population. And most
people looking after small children are pretty active anyway (due to all the
lifting, running around, and so on).

~~~
btilly
<http://singleparents.about.com/od/legalissues/p/portrait.htm> estimates over
13 million single parents in the USA. Granted, not all of their children are
small, but a lot are.

Also in every family with small kids, if one parent wants a piece of freedom,
it puts pressure on the other parent. So even if it is theoretically possible,
if half of those parents get the freedom to exercise in the morning, the other
half do not.

Does it amount to 10% with a legitimate difficulty in scheduling exercise? I'm
not sure. But it is more than I would have guessed before I had kids.

~~~
dennisgorelik
Staying as a single adult in the house is a long-term choice. You can: marry,
invite your friend to live together, invite your parents, rent our a room or
two in your house and ask for occasional babysitting help from them.

You can move into somebody else's house too.

------
vitno
I don't go on reddit much anymore, but the /r/paleo community is almost
directly responsible for my 75+ pound weight loss. They easily supplied the
basic knowledge & a sense of community.

------
mmaunder
"When it comes to weight loss, creating a caloric deficit is the most
important thing that matters; eating less, not moving more, is the most
realistic way to do so."

What? Please read Gary Taubes "Good Calories, Bad Calories" or "Why we get
fat". He is one of the leading thinkers in nutrition and is worshipped by
other gurus like Tim Noakes (who wrote the runners bible Lore of Running).
Taubes spends the first third of "Why we get fat" rebuking this "first law of
thermodynamics" approach to dieting.

I'd also argue that nutrition today is evolving from an anecdotal approach to
what works e.g. Dr Atkins discovering that if he eats meat-only he gets thin,
to a science based approach where we are beginning to understand the profound
effect insulin has on fat storage and why dietary fat does not make you fat.

Reddit is a great resource for new data, but not a source. It does however
have some amazing pointers. Another case in point is the cult of Mark Rippetoe
fans on Reddit and the AMA that Rip did on Reddit a while ago which was
awesome. [Rippetoe is pretty much God in strength training circles and his
book "Starting Strength" is the strength training bible.]

~~~
tomjen3
I have read Christians "refuting" evolution too.

I give a guy who doesn't thermodynamics (one does not refute that in a popsci
book) the same credit.

If he had really discovered something important, he would not be worshipped.
He would present evidence to other researchers, who would confirm his
experiments, etc.

~~~
glenra
Taubes _has_ been presenting evidence to other researchers. But the medical
establishment takes a loooooong time to change its collective mind on stuff
like this.

Here's a relevant video:

<http://video.google.com/videoplay?docid=4362041487661765149>

In that video, I think Taubes actually refutes the "law of thermodynamics"
approach to losing weight in a single _picture_ , with an existence proof.
There exist people who are emaciated in half their body (say, the top half)
and obese in the other half (say, the bottom). According to the "law of
thermodynamics" approach, such a person should simultaneously "eat less, move
more" (to cure their bottom half) and "eat more, move less" (to cure their
top).

This is clearly impossible advice to follow. These people need some _other_
form of advice. Once we figure out what that advice should be, it's probably
going to be of benefit to people who are fat or emaciated over their _entire_
body rather than a selected part.

As for your analogy: I'm an atheist, but if any Christian that others saw as
"refuting" evolution had as much social proof as Taubes - had huge communities
of my peers recommending his work - I'd kind of be inclined to check it out
and see what he had to say.

------
Tichy
"Reddit’s voting system provides a reliably transparent soundboard for fitness
knowledge."

Any studies showing that? I find such online discussions interesting, and
certainly sometimes they might reveal better information than just going to
your doctors office. But these are just people hanging out online - just
because they vote something up doesn't mean it is proven, it just means they
like to believe it. In fact, for any theory you can probably find an online
community that believes in it and votes up things supporting that belief.

The latest studies I read about seem to indicate that low carb and so on are
irrelevant, calorie reduction is all that counts. But if you want to believe
in low carb, you can probably find lots of anecdotes proving its
effectiveness. Possibly because the low carbers accidentally also reduced
calorie intake. (Although my own criticism of those studies is that it remains
unclear how differing diets allow you to keep calories low. One snickers bar
might have enough calories for a day, but it would be difficult to just eat
one snickers bar every day, contrary to eat lots of whole grains).

~~~
sixbrx
> because the low carbers accidentally also reduced calorie intake

Accidentally is a loaded word there, because if low carb diets tend to make
people eat less, then that is an enormous, critical advantage over competing
diets.

~~~
Tichy
Totally agree - as I said, it would be difficult to sustain a low calories
diet on chocolate, simply because of the craving it induces.

------
snarfy
> Here’s a discouraging fact: A 220 lb. man walking up 27 flights of stairs
> burns the caloric equivalent of half an Oreo

I always hate these statements because they are misleading. It is true the
amount of energy required to lift 220 lbs 27 flights of stairs is about half
an Oreo, but you burn a lot more than that. To put things in perspective, you
burn 35 calories smoking a cigarette.

------
dhughes
Reddit's /r/fitness is like the 4chan of fitness I stopped reading it due to
the bickering and posturing, I'd say a wee bit of roid-rage is leaking
through.

~~~
jacques_chester
This is a lazy, spiteful stereotype.

~~~
dhughes
No, it isn't. Read the posts for a while and you'll see a pattern of certain
groups who have an absolute view of what they perceive is right and aren't shy
to say it. Maybe the mods are better now but I gave up reading anything there
after a few months.

Another bad one is r/coffee lots of bickering there too, it must be the
caffeine or lack of it.

~~~
jacques_chester
People with strongly-held opinions share those opinions with others? Shocking.

I was referring to your "roid rage" slur, by the way.

~~~
dhughes
It's not a slur it's pretty obvious going by some comments in r/fitness, but
like I said I gave up reading r/fitness.

------
WalterSear
As a developer I bristle at the idea that 'if it's not in the curriculum, what
can you do?' The doctors are at fault here for not reaearching and advocating
for the research needed.

~~~
vacri
You don't seem to have any idea about how complex medicine is. You wouldn't
say the same thing about a specialist in IT ("This DBA doesn't know enough
Java!").

~~~
alex_c
For specialists, sure. But for a GP shouldn't it be essential to be
knowledgeable and effective about basic fitness and nutrition?

My (relatively uninformed) impression is that studies of fitness and nutrition
are surprisingly unsophisticated relative to research for curing specific
diseases.

This is basically the debate of preventive care vs. palliative care (and, I
guess, the argument that one allows for much higher profits than the other).

~~~
vacri
Western medicine has historically never been focused on preventative medicine;
their role has traditionally been to _make_ you healthy, not _keep_ you
healthy. It's not the conspiracy some might suggest, it's just that
historically you called a doctor when you were ill, not for lifestyle advice.
When it comes to fitness, you still don't - unless you're talking to a sports
doctor, you're not going to get a useful training programme tailored for your
needs.

Regarding GPs in particular - they aren't really about keeping you trim and
terrific. They're about dealing with niggling issues while flagging serious
ones for referral to specialists. They do know about basic fitness and diet,
but they're not specialists in the area - see sports doctors and dieticians.

Also consider that diet is a rapidly moving target at the moment - there's a
lot of contradictory opinion and new info coming out all the time. It's not a
GP's role to stay at the bleeding edge of medicine. That's what specialists
do, and as the specialists settle on the right thing, it filters down to the
non-specialists. You can of course find GPs who take special interests in
certain areas, and may get lucky and find one that loves fitness and diet.

Also, 'palliative' doesn't mean 'after injury', it means 'relieve symtoms
without attempting a cure', and most doctors would rather cure a problem than
use the patient as a cash cow (there's enough work out there, even before you
get to the ethical issues). Perhaps a better pair of terms would be
preventative/proactive vs reactive care.

~~~
alex_c
Great comment, and I agree with you on all counts. I believe western medicine
_should_ put more emphasis on preventive care and GPs, as most people's first
and sometimes only point of contact for health-related matters, _should_ be
much more informed and proactive about their patients' fitness and nutrition.

Regarding diet being a rapidly moving target, that is exactly my point. It
seems to me, as an uninformed layman, incredible how much we've learned about
diseases like cancer and yet how relatively little we seem to know about diet,
fitness, and the behavioural research related to them. Not because these
topics are in any way more simple than understanding a specific disease, but
because they affect everybody.

------
Xodarap
It's remarkable to me that hackers are against every form of alternative
medicine, except regarding nutrition.

If I told you that the American Cancer Society said wearing pendants to
protect from electromagnetic radiation was hokum, it would be case closed. But
when the ADA says [low carb diets are
nonsense]([http://www.eatright.org/Public/content.aspx?id=10645#.UCemyU...](http://www.eatright.org/Public/content.aspx?id=10645#.UCemyUgyC9U))
it's contentious.

I wonder why?

~~~
glenra
Hackers are in favor of following methods that are testable and that _work_.
When it comes to fighting obesity, the medical establishment is obviously
clueless - they don't have any advice to give that has a track record of long-
term success. It's not clear _why_ their advice doesn't work, but it's clear
that it doesn't. Which leaves room for alternative theories that at least
_might_ work.

I also think you're overestimating how much hackers approve of mainstream
medicine generally. There is quite a lot of bad science in the medical field
generally. If we were legally _allowed_ to build our own medical devices and
mix our own drugs and practice medicine ourselves, I suspect a lot of us would
be inclined to do that. The government hasn't yet made it _illegal_ to give
advice on diet and nutrition, so you see more people giving advice on diet and
nutrition than you see people giving advice on, say, dealing with cancer.

~~~
kanzure
> There is quite a lot of bad science in the medical field generally. If we
> were legally allowed to build our own medical devices and mix our own drugs
> and practice medicine ourselves, I suspect a lot of us would be inclined to
> do that.

Well, and if you're not allowed to, some people just do it anyway.

<http://groups.google.com/group/diybio>

<http://diyhpl.us/wiki/diybio/faq>

------
orangethirty
I've lost a ton of weight (no pun intended) by being an active member of
r/loseit. Nothing else. That community helped me achieve my goals. It is just
an amazing place.

~~~
illuminate
"Nothing else."

I find this doubtful.

~~~
orangethirty
What is it that you found doubtful? Or did you not understand the message
behind the sentence? It meant that I did not use any gimmicks or pills or
surgery. I relied (still do) on the community as a tool to achieve my fitness
goals. Of course, I still run about 20 miles _per week_ , and bicycle an equal
amount. I control what I eat by counting calories and I also calculate how
much to eat in order to keep a deficit of 3500 calories per month (one pound
of fat per month basically).

~~~
illuminate
You made the statement as if to bolster the subreddit as "revolutionary". It's
effective, but there's nothing medically or socially revolutionary about
fitness support groups. You followed healthy patterns and share your successes
with others.

~~~
orangethirty
You don't get it. :)

Where reason is king all the flowers are black and white.

Good luck.

------
kmfrk
I think the main appeal of communities like this is that there is a central
place to cheer on people who are trying to get into improving their health.
You see something similar going on at Pinterest, which, for all its
scientifically debunked advice, tries to encourage and inspire people to work
out.

It doesn't matter how good your workout and diet regimen looks on paper, if
you have to multiply that result with an enthusiasm of zero.

~~~
petercooper
I was thinking this. That is, even if a lot of the advice is bunk, as long as
it's not harmful, anything that gets people actually thinking "Yeah, I can do
this!" and _giving it a go_ has to be valuable.

For example, if my prime goal in life were to get as many people coding as
possible, I'd rather have an eager but bad VBScript developer I could train up
than someone who doesn't really care about programming either way. Ditto for
fitness, perhaps.

~~~
kmfrk
Since fitness people usually start from a very, very bad level of exercise and
dieting, you'd have to do some seriously stupid stuff for the net effect of
your regimen not to be a big improvement regardless. Compared to programming
or anything else, it's not that important to use the perfect way to improve
most of the time. Especially when all the research happens at the cost of
actually doing what you set out to.

So what if you can't burn fat from targeted areas on your body, when your
overall weight decreases and will eventually shed that tummy fat you've been
bothered by.

This is one of the reasons I like Hacker News as a community a lot. I think it
sometimes makes starting a company sound way too easy (and buzzwordy), but
there are a lot of people here who would never have started their companies,
if they hadn't found a community here to cheer them on.

------
moistgorilla
r/fitness is good for an average person but I would not say it's as good as
you make it out to be. Other bodybuilding and fitness websites are much
better. Also, most of the advice on r/fitness comes from /fit/.

~~~
oacgnol
Sure, the depth of the content is not as good as other forums, but a
peripheral point I think the article was trying to make was that the
accessibility of such resources is what makes it so revolutionary. I'm an avid
reader of r/fitness and one of the things that makes it so appealing it me is
how much of the advice relates to me, an average guy who spends much of his
time on the internet.

------
EternalFury
People always end up believing what they want to believe, even if it's
illogical or totally insane.

But, no one has ever put on weight on a calorie deficit. NEVER.

This being said, you can get overweight or even obese if you eat too much, be
it green beans or lard.

Similarly, you can lose weight eating "bad" foods, if you maintain a calorie
deficit.

Obviously, for long term results, it's best to eat good food, exercise
regularly and do both with moderation.

That is it. This is all there is to know on that topic.

PS: Anyone above 500 pounds can lose 100 pounds fairly quickly. Using such an
achievement to prove that this or that miracle diet is best...is disingenuous.

~~~
glenra
> But, no one has ever put on weight on a calorie deficit. NEVER.

The vast majority of people who lose a substantial amount of weight through
calorie restriction gain it all back and then some within a few years. Though
they do lose in the short run (say, 6 months), they're worse off three years
later than if they had never dieted at all. This simple fact - that dieting
doesn't work in the long run - suggests that telling people to lose weight
simply by dieting is BAD ADVICE.

Given that doctors are giving people bad advice, there's still plenty of room
for people to try to come up with BETTER advice.

~~~
EternalFury
You need to re-read my post.

~~~
glenra
You wrote: "This is all there is to know on that topic."

That seems pretty obviously false - there's more we know now and there's much
much more we _could_ know, even if we don't know it yet.

Before that, you wrote:

> _Obviously, for long term results, it's best to eat good food, exercise
> regularly and do both with moderation._

What exactly constitutes "good food" is one of the things under discussion and
is something else "there is to know on this topic". Whether it's "best" to do
both "with moderation" depends on how the terms are defined and what your
goals are. For instance, it might well be better to exercise irregularly than
regularly.

------
b3b0p
After reading almost every single comment in this story, I have come to 1
conclusion:

Geeks on Hacker News should not be giving out diet, nutrition, and fitness
advice.

(No one should be taking the advice anyway.)

Diet, exercise, and nutrition stories on Hacker News always seem to be messy.
They do end up being entertaining seeing all the back and forth controversy
though some times.

------
caycep
there are 2 different purposes here. the high saturated fat diets - yeah that
will drop weight. No one really knows what the long term effect on
cardivascular disease (i.e. damage to arteries) will be, since they haven't
been practiced for the several decades it takes to find that out.

------
m0nty
Ooooh! Delayed interstitial. Out of there.

------
zerostar07
... and as of now, also by hacker news.

------
creamyhorror
What's very inspiring are the body transformations posted by members of
forums. Just check out the ridiculous before-and-after shots on the following
thread from the SomethingAwful Forums' fitness subforum:

[http://forums.somethingawful.com/showthread.php?threadid=333...](http://forums.somethingawful.com/showthread.php?threadid=3334499)

Threads like these are what inspire people to radically change their
lifestyle, start lifting weights, and stay motivated. They go on to keep
fitness logs to keep themselves publicly accountable, and also join Fitocracy
and weight/diet-tracker sites. There're also a lot of helpful resource threads
on such forums, informing newbies on diet, exercises, supplements, etc.

On the scientific side of things, I've spent the last few weeks reading a
range of PubMed(Central) articles and various blogs and forums on fitness and
diet. There are many schools of thought, but many are mostly supported by
anecdotal evidence and not studies.

What I've found most helpful are scientific studies/articles, e.g.

\- Evidence-based resistance training recommendations <http://baye.com/wp-
content/uploads/2011/09/ebrtr-Fisher1.pdf>

\- ISSN recommendations for supplementation
[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2853497/?tool=pu...](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2853497/?tool=pubmed)

\- Protein per day for muscle-building: 1.6 g/kg of bodyweight (not the 1+g/lb
that many sites tout) <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2129150/>

\- Reduce saturated fat intake and replace with polyunsaturated fats, not
carbs or monounsaturated fats <http://www.ncbi.nlm.nih.gov/pubmed/19211817>

Scientific bloggers are also good to read, if they assess studies critically -
people like Bill Shrapnel, DH Kiefer, Bryan Chung, Stephan Guyenet, Alan
Aragon. Check their blogs out if you aren't already following them.

My current understanding of various controversial topics, based (mostly) on
studies:

 _Calories in, calories out_ \- absolute calories matters, but is mediated by
the effect of composition of diet. Consuming more protein tends to result in
an increased lean-mass-to-fat ratio (whether due to satiety, hormonal effects,
or a combination of the two).

 _Carbs/sugars/starches_ \- high glycaemic-index carbs are riskier than
saturated fats for heart disease. They are also associated with weight gain.
The endless intake of rice in Asian countries (like mine) makes many of us fat
and at risk of heart disease.

 _Dietary cholesterol_ \- probably not as bad as previously assumed, but
having >6 eggs a _week_ actually increases your risk of heart disease/events.

 _Intermittent fasting_ \- I haven't seen the scientific evidence for this,
though a friend assures me it's out there. All I see is Berkhan's
leangains.com and I'm not sure I'm convinced. I searched PubMed for a bit but
didn't come across anything.

 _Diet vs exercise for weight loss_ \- diet is the key to weight loss. Neither
cardio (whether HIIT or low-intensity) nor resistance training _alone_ is
particularly effective at causing weight loss (claims of raised metabolism
notwithstanding); you need a calorie deficit as well.

 _Training to muscular failure_ \- training to failure actually provides more
efficient strength gains.

 _Genetics and muscle_ \- genes play a major, possibly the largest, role in
determining how much muscle mass individuals can gain and how easily they do
it. "...it appears that those who are naturally lean and muscular to start
with, can gain strength and size to a much greater degree than naturally
‘skinny’ individuals." i.e. ectomorphs won't be exploding with muscle in short
order, despite their best efforts.

~~~
beagle3
> Dietary cholesterol - probably not as bad as previously assumed, but having
> >6 eggs a week actually increases your risk of heart disease/events.

Do you have a reference? I've been unable to find one (or for that matter,
anyone who's actually seen one). I have found examples to the contrary: e.g.
[http://www.sherdog.net/forums/f15/88-year-old-man-
eats-25-eg...](http://www.sherdog.net/forums/f15/88-year-old-man-eats-25-eggs-
per-day-733901/) (anecdote aside, it has other references as well)

~~~
creamyhorror
I went back and read the source paper carefully, and realised this was a
mistake on my part. The relevant study:

<http://www.ncbi.nlm.nih.gov/pubmed/10217054>

\----

After adjustment for age, smoking, and other potential CHD risk factors, we
found no evidence of an overall significant association between egg
consumption and risk of CHD or stroke in either men or women. The relative
risks (RRs) of CHD across categories of intake were less than 1 per week
(1.0), 1 per week (1.06), 2 to 4 per week (1.12), 5 to 6 per week (0.90), and
_> or =1 per day (1.08)_ (P for trend = .75) for men; and less than 1 per week
(1.0), 1 per week (0.82), 2 to 4 per week (0.99), 5 to 6 per week (0.95), and
> or =1 per day (0.82) (P for trend = .95) for women.

\----

At face value this seems to imply increased relative risk (1.08) of >=1 egg
per day, and that's what I concluded. But reading the results section of the
paper, I came across this:

\----

Because of the relatively strong correlation between consumption of eggs and
bacon, we further adjusted for bacon intake. The adjusted RRs across
categories of egg consumption are less than 1 per week (1.0), 1 per week
(1.00), 2 to 4 per week (1.04), 5 to 6 per week (0.78), and _1 or more per day
(0.93)_ (P for trend=.36) for men; and less than 1 per week (1.0), 1 per week
(0.81), 2 to 4 per week (0.96), 5 to 6 per week (0.91), and 1 or more per day
(0.78) (P for trend=.73) for women. Additional adjustment for other foods
including whole milk, fish, beef as main dish, chicken, or cereal had little
impact on the results.

\----

So it looks like 5-6 eggs/week actually resulted in the lowest relative risk
of heart disease, at least when the effect of bacon is accounted for. >=1
egg/day resulted in lowered risk as well. It's quite telling that bacon raises
the relative risk significantly while meats, milk, and cereals did not.

So, sorry I posted misinformation, and thanks for pointing this out. I hope
this post helps elucidate the current state of research for anyone reading.
I'm actually happy, because I've been eating 5 eggs/day on-and-off lately and
was reluctantly considering reducing my intake. Now I get to continue eating
dem eggs! (At least, one or two a day...)

~~~
beagle3
Thanks.

It's amazing how many things we believe (and when I say "we", I mean society,
including e.g. doctors whose job it is to know better) that have never been
scientifically looked at properly -- or worse, were looked at and shown to be
wrong.

My current list:

\- dietary cholesterol is bad for you (truth: essentially irrelevant)

\- serum cholesterol is bad for you (truth: it's a marker, not a cause.
apparently, the body makes more of it in an attempt to solve _other_ problems,
which will manifest faster if you use statins to reduce cholesterol)

\- dietary sodium is bad for you (truth: blood pressure is tightly regulated,
and dietary sodium has very little to do with serum sodium and blood pressure,
unless it is in ridiculous excess. Too little sodium is also harmful)

\- butter is bad for you. (truth: some is bad, some is good. butter is so ill-
defined to make general statements useless. grass-fed organic european style
butter is good for you)

\- you should avoid introducing allergens such as nuts to young kids, lest
they develop allergies. (truth: not clear, but observational evidence show
inverse correlation between how early you introduce nuts and the prevalence of
nut allergies)

\- weight change is equal to c*(calories in - calories out). (truth: only in
the tautologically useless sense. generally wrong the way 99% of the people
apply it. nutrition science is anything but)

I'm looking for a rigorous study that shows toothpasts are helpful (indeed,
that brushing is helpful). Some studies by Weston Price (and his successors)
imply that cavities correlate with grain and sugar consumption, and that
brushing is not helpful against cavities if the diet is bad.

~~~
creamyhorror
> \- serum cholesterol is bad for you (truth: it's a marker, not a cause.
> apparently, the body makes more of it in an attempt to solve other problems,
> which will manifest faster if you use statins to reduce cholesterol)

That's an interesting (and good) point - if it's (mostly) a marker, actively
reducing it without addressing the root cause makes no sense as a strategy.
But the probability remains that a high reading indicates underlying problems.
The uncertainty lies in whether it's only HDL or LDL that's a negative
indicator, or the ratio of HDL to LDL, or a particular subtype, etc. My
previous reading of bloggers on this topic only left me more confused.

> \- butter is bad for you. (truth: some is bad, some is good. butter is so
> ill-defined to make general statements useless. grass-fed organic european
> style butter is good for you)

I guess it would be easier if it was specified that "high sat-fat butter" is
bad for you, or the like. I don't know about the composition or nutritional
analysis of grass-fed organic euro-style butter, but I do think it still makes
sense to regard saturated fats with suspicion, at least under current studies.
Do you have any studies to share on this?

> \- weight change is equal to c*(calories in - calories out). (truth: only in
> the tautologically useless sense. generally wrong the way 99% of the people
> apply it. nutrition science is anything but)

I've been wondering if the composition of macronutrients affects the metabolic
rate significantly, resulting in increased calories-out. Or if macronutrients
are somehow wasted as excess heat, or excreted only half-used. That would
clarify the apparent conflict, in my mind.

> I'm looking for a rigorous study that shows toothpasts are helpful (indeed,
> that brushing is helpful). Some studies by Weston Price (and his successors)
> imply that cavities correlate with grain and sugar consumption, and that
> brushing is not helpful against cavities if the diet is bad.

Not heard anything about this, but such studies would be interesting to read.
I've heard doubts and disparagement expressed about the advice given on the
Weston Price foundation's website (not about the views of the man himself),
though.

~~~
beagle3
> I guess it would be easier if it was specified that "high sat-fat butter" is
> bad for you, or the like. I don't know about the composition or nutritional
> analysis of grass-fed organic euro-style butter, but I do think it still
> makes sense to regard saturated fats with suspicion, at least under current
> studies. Do you have any studies to share on this?

Apparently, grass fed vs. grain fed does NOT culminate in "high sat-fat" or
"low sat fat". There's a lot more, to the point that no one seems to have a
better characterization than "healthy cows, grass fed, organic, european style
(ver high fat content)".

refs: don't have any peer reviewed off hand, but Seth Roberts and Dave Asprey
have quite a bit (nothing as high caliber as NEJM or BMJ or nature -- but
convincing data nevertheless)

> I've been wondering if the composition of macronutrients affects the
> metabolic rate significantly, resulting in increased calories-out.

There are well known thermo-generating nutrients, I'd be surprised if that
wasn't the case. But there's also a lot to be said about the biome composition
(recently shown to control type 2 diabetes in rats, as in cause and cure by
replacing gut cultures).

> Or if macronutrients are somehow wasted as excess heat, or excreted only
> half-used

Oxidation is the dominant energy conversion mode, but it by no means the only
one. Glycolysis is about 20-50 times less efficient, and is used under some
circumstances (most notably, but thankfully not commonly, cancer); So
assumptions about energy availability are kind of flaky.

Not to mention, paper (cellulose) is a carbohydrate - if you assume 4kc/1gr of
carbs, you should be able to live well on paper.

> I've heard doubts and disparagement expressed about the advice given on the
> Weston Price foundation's website (not about the views of the man himself),
> though.

I've heard them too - but when they had any specifics, and I tried to verify
them, it seemed those doubts were FUD rather than genuine scientific inquiry.

