
Treatment of obesity with calorically unrestricted diets (1953) [pdf] - DiabloD3
http://ajcn.nutrition.org/content/1/5/343.full.pdf
======
jrapdx3
Having quite a few years of experience treating obesity it's interesting how
often this topic comes up here. As several posters say, the "paleo" diet in
some form is not a recent idea. Despite paleo's apparent merit, the "standard"
high-CHO diet continues to predominate. But why?

I can only speculate. Much has been written about "carbohydrate addiction", an
idea that remains controversial, yet there's some evidence for it. We know
about the huge amounts of sugars in processed convenience foods, disrupting
the body's energy-handling mechanisms, shunting calories into fat deposition.

Industrialization plays a role, it's cheaper to produce and distribute
pleasing sugar-rich items vs. fresh farm-grown vegetables. Healthful food is
expensive and less available, especially for economically stressed
populations. For others, the problem is exacerbated by a demanding, tech-
driven lifestyle. Under pressure, taking time to consider what's truly
beneficial for health is less likely. Just grab the Starbucks and let's go.

While obesity is in part a behavioral issue, it's a fallacy to assume it's
_only_ a subset of the "mental health" domain. I assert obesity is the most
complex medical condition we face. All body systems, down to each and every
cell has a stake in the intake and distribution of energy, and plays some role
in these processes.

Metabolic illness is among the most prevalent and costly to our economy, and
also among the most intertwined with psychiatric, medical, cultural, and
political phenomena. As pointed out, Banting's fish diet of 1863 worked, but
also roundly criticized. The insight keeps reemerging, which seems to mean
it's a pointer to solutions, not itself a solution.

~~~
CuriouslyC
The real problem with diet and obesity research is that they are trying to
identify "universal truths". Unfortunately, an individual's response to
nutrient intake is highly specific, and depends on genetics, activity level,
adiposity and gut flora. This is why controlled studies don't show a
significant difference between low carb and high carb diets. Researchers tend
to view the intra-group differences are just random variation, when in
actuality different diets are better for different people.

------
omegaham
Keto's been around for a long, long time.

In my own experience with keto, the biggest reason why it works is that it's
very difficult to eat at a surplus. I can eat a pound of pasta in one sitting.
In contrast, eating that same amount of calories in meat and vegetables is
much more difficult. You can get fat very easily by eating pizza and drinking
beer. It is significantly harder to do so by drinking water and eating lentils
and chicken.

~~~
rhaps0dy
Don't lentils contain too many carbs for keto? One friend of mine started
doing it a few months ago, he has lost a lot of weight. He eats less than 25g
of carbs a day, and lentil servings usually surpass that.

~~~
david_shaw
Lentils are popular in the "slow carb" diets, as they are a _moderately_ low-
carb legume. People doing full-on keto would probably avoid them.

------
JesperRavn
I don't see how it makes sense to focus on a single study in 1953. Most of the
comments here imply that this study found the truth, which has been ignored or
forgotten since then. On the other hand, the mainstream claims to have come to
a different conclusion on diet based on a huge number of other studies [0][1].
If you're going to use this study as evidence for low carb diets, you have to
explain why this particular study is so important, why it was better designed
or otherwise more conclusive that studies that came before/after it, etc.
Otherwise this is just cherry picking.

[0] [https://en.wikipedia.org/wiki/Low-
carbohydrate_diet#Opinions...](https://en.wikipedia.org/wiki/Low-
carbohydrate_diet#Opinions_from_major_governmental_and_medical_organizations)

[1]
[https://en.wikipedia.org/wiki/Medical_research_related_to_lo...](https://en.wikipedia.org/wiki/Medical_research_related_to_low-
carbohydrate_diets)

------
et2o
It's fun reading papers from the 1950s because this would never be published
today.

I had an interesting thought reading this. It's well-known that caloric
restriction extends lifespan. People who are obese but lose weight have
metabolic changes similar to those induced by caloric restriction (lower BMR
among others). I wonder if those who were formerly obese but are able to keep
off weight have longer lifespans.

~~~
ggbjr
this is very well known in the scientific community (which is one of the
reasons it's unlikely to be published today). one of the key challenges in
diet science is that what works for individuals may not be an ideal public
health or clinical recommendation.

re your hypothesis, i don't know of any studies on your specific question
(there aren't many people who keep the weight off -- the national weight
control registry is following several thousand), but there are studies showing
that people who weight cycle minimally (1-4 times) have lower all-cause
mortality:
[http://aje.oxfordjournals.org/content/early/2012/02/01/aje.k...](http://aje.oxfordjournals.org/content/early/2012/02/01/aje.kwr378.full.pdf)

~~~
ThrustVectoring
My model of the obesity crisis is that it's fundamentally a mental-health
issue, not a nutritional one. Food and eating is connected to your
motivational and emotional centers on a deep and fundamental level. The actual
mechanics of losing weight is fairly straightforward, but turning an over-
eater into a healthy-eater isn't.

~~~
MrTortoise
The problem is do you consider the minds reactions to hormones mental or
nutritional? You can have plenty of 'willpower' but if your chemistry craves
balance then you have blurred boundaries into saying its both, neither and
that they are broken abstractions.

~~~
ThrustVectoring
"Willpower" isn't the answer, either. Like, long-term expenditure of willpower
isn't a good solution to any problem. I hope I didn't imply that that was my
proposed solution.

Like, what I'm saying is that if you replaced the decision-making process for
eating with an algorithm designed to bring someone to a specific body weight,
that would basically solve the obesity problem.

To answer your question more directly, there may be nutritional solutions to
the mental problems that lead to over-eating.

------
QuercusMax
Seems like the discovered the effects of low-carb diets sixty years ago?

How did you find this paper, out of curiosity? Makes you wonder how many other
discoveries were made and ignored.

~~~
abecedarius
Not just 60.
[https://en.wikipedia.org/wiki/William_Banting](https://en.wikipedia.org/wiki/William_Banting)

Actually this made me wonder how far back you could go, and a little searching
turned up a vaguely-decent match from antiquity: "Obese people and those
desiring to lose weight should perform hard work before food . . . Their meals
should be of a fatty nature as people get thus satiated with little food. They
should, moreover, eat only once a day and take no baths and sleep on a hard
bed and walk naked as long as possible. —Hippocrates (Hippocrates on Diet and
Hygiene, Zeno, London, 1952)" at
[http://forum.lowcarber.org/archive/index.php/t-464645.html](http://forum.lowcarber.org/archive/index.php/t-464645.html)
which was ironically hard to find among all the hits for a vegetarian
Hippocrates Diet.

~~~
serf
>sleep on a hard bed and walk naked as long as possible

That's the problem , huh. I'll have to let my co-workers know that they're in
for a few weeks of naked walking around the office.

~~~
abecedarius
I wonder if the walking naked "as long as possible" is about the seasons? That
is, subjecting yourself to colder temperatures -- which is also a modern
recommendation (cold showers) in some of the same circles as recommend a high-
fat diet with intermittent fasting ("eat only once a day", "hard work before
food").

If so, the hard bed's the only part that been dropped.

~~~
CuriouslyC
Almost definitely not. Vitamin D deficiency is fairly common today, even with
good food sources like fortified dairy products and eggs. The ancient Greeks
didn't have fortified dairy and the chicken hadn't been domesticated yet, so
the only readily available food source of vitamin D was liver. Luckily, the
body can produce vitamin D; half an hour of naked sun exposure is more than
sufficient to meet your daily requirements.

~~~
abecedarius
That sounds like a better idea. I've seen a couple claims that higher
vitamin-D levels go with lower weight, e.g.
[https://www.fredhutch.org/en/news/releases/2014/04/vitamin-d...](https://www.fredhutch.org/en/news/releases/2014/04/vitamin-
d-effect-on-weight-loss.html)

------
Frozenlock
Here are some videos that convinced me to try low-carbs a few years ago:

[https://www.youtube.com/watch?v=dBnniua6-oM](https://www.youtube.com/watch?v=dBnniua6-oM)
Sugar: The Bitter Truth

1h29 - One of the best information (as in biology) video around about sugar.

\----

[https://www.youtube.com/watch?v=lDneyrETR2o](https://www.youtube.com/watch?v=lDneyrETR2o)
Why We Get Fat

1h10 - A little less technical (IIRC), but still a great insight on what's
going on.

\----

[https://www.youtube.com/watch?v=_vfK5U9qKaI](https://www.youtube.com/watch?v=_vfK5U9qKaI)
TWiT Live Specials 124: The Sugar Hill

55min - Steve Gibson on his discovery of low-carbs, how and why it works.

\----

[https://www.youtube.com/watch?v=dSLf4bzAyOM](https://www.youtube.com/watch?v=dSLf4bzAyOM)
\- Dr Eric Westman - Duke University New Atkins Ketogenic Diet for Weight Loss
and Health

38min - Dr Eric Westman guide patients through what they can eat and what will
be transition 'symptoms'.

------
rasengan0
Eat what you can shows the ancestors
[https://youtu.be/BMOjVYgYaG8](https://youtu.be/BMOjVYgYaG8)

