

Meta-study says too much carbohydrate, not fat, leads to obesity - scribu
http://thatpaleoguy.com/2013/11/20/bmj-swedish-health-advisory-body-says-too-much-carbohydrate-not-fat-leads-to-obesity/

======
ghshephard
As someone who has closely followed the literature (I scraped and reviewed
pretty much all of ACJN) - I find it fascinating that nobody has gone to the
effort of doing a large-scale controlled study on this topic.

Seriously - how difficult would it be to just get a large population in a
controlled environment for period of time (12-18 months), separate them into
groups, and feed them pre-determined diets, and observe the results.

I'm sure there are lots of institutional opportunities where we have large
populations of people who would be happy to volunteer for this type of study.

~~~
RobLach
Doing some personal research a while back revealed to me that diet studies in
general have ridiculously low standards. The vast, vast majority of them are
volunteer, self-journaled data based that would be laughed out of any other
scientific context.

Controlled group studies are almost entirely non-existent and are typically
limited to very specific conditions and goals, such as diets for epileptics.

I hope at some point we'll sit down and do a proper broad study on different
diets where all meals are controlled for x amount of time and get a range of
data that you could further divide and conquer and figure such a crucial part
of our existence out.

------
fingerprinter
When people ask me about this, I like to start off by telling them that of the
three macronutrients, carbs, protein and fat, only carbs are non-essential. We
literally can't live without fat and protein, but we would do just fine with
out carbs.

Most people don't know that carbs are not required to live. We've been sold a
bill of goods on carbs and it's been hurting us for 2 decades.

And further, there are certain people who should be no where near carbs.

* Diabetics and pre-diabetics

* cancer patients

* the obese

* people who don't workout

Carbs aren't evil, they should just be used strategically. Namely, to gain
weight. Bodybuilders and powerlifters have known this forever. To gain weight,
eat everything but mostly carbs. To lose weight, keep protein high, fill the
rest of your calories with fat and limit the carbs.

~~~
ironchef
"we would do just fine with out carbs" \- Intuition leads me to want to
disagree with this. How would the body handle not having ANY fiber? I'm
curious. Fiber helps digestion, feeds the happy parts of your internal biome,
makes your colon happy, etc. I can't imagine that eliminating all carbs is
good for your body.

~~~
thebrokencube
Normally if you follow a low-carb diet, you get your fiber from greens. I
believe the statement was targeted more towards carbs like bread, pasta, rice,
etc.

~~~
fingerprinter
Indeed.

~~~
encoderer
Ok, but that's not what you said? You say something bold and provocative and
then start carving out exceptions buried downthread.

As I said elsewhere in this discussion: "I feel like all the simple answers in
nutrition are BS and the only short answer is 'it's complex.'"

~~~
fingerprinter
Ok, here it is. Technically, we don't need carbs. Whatever that means, it is
what it is. Carbs are a non-essiential macronutrient.

We need some vitamins, minerals and what not as well as protein and fat. We
don't need carbs. Some of those vitamins and minerals come from plants, which
have, as we say in the biz, trace carbs and fiber.

When I'm cutting down for a photoshoot I go keto. I might not have a veggie
for weeks. My bloods and panels all look fine. I mostly eat veggies b/c I feel
bad for not eating them.

I do take a multivit every day and I'm eating plenty of fat which helps the
colon move things along.

When I'm gaining muscle, I do eat carbs. Lots of carbs. But we don't _need_
carbs.

~~~
DanBC
> But we don't need carbs.

Do you have any science to back up this bold claim?

And what are you claiming carbohydrates are? Simplex and complex carbohydrates
- sugars and starches?

It seems like you're saying that we don't need carbs, but that eating a diet
with no carbs means we lose out on all those foods that have other useful
nutrients (ie green vegetables). So, we tend to eat diets that have carbs to
get the other benefits. Is that right?

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gx3
The Carbohydrate Hypothesis of Obesity: a Critical Examination:

[http://wholehealthsource.blogspot.com/2011/08/carbohydrate-h...](http://wholehealthsource.blogspot.com/2011/08/carbohydrate-
hypothesis-of-obesity.html)

Basically debunks the carbohydrate hypothesis:

"I hope you can see by now that the carbohydrate hypothesis of obesity is not
only incorrect on a number of levels, but it may even be backward. The reason
why obesity and metabolism researchers don't typically subscribe to this idea
is that it is contradicted by a large body of evidence from multiple fields. I
understand that people like ideas that "challenge conventional wisdom", but
the fact is that obesity is a complex state and it will not be shoehorned into
simplistic hypotheses."

~~~
js2
It's worth quoting the introduction to give context to that conclusion:

"I'd like to begin by emphasizing that carbohydrate restriction has helped
many people lose body fat and improve their metabolic health. Although it
doesn't work for everyone, there is no doubt that carbohydrate restriction
causes fat loss in many, perhaps even most obese people. For a subset of
people, the results can be very impressive. I consider that to be a fact at
this point, but that's not what I'll be discussing here.

What I want to discuss is a hypothesis. It's the idea, championed by Gary
Taubes, that carbohydrate (particularly refined carbohydrate) is the primary
cause of common obesity due to its ability to elevate insulin, thereby causing
increased fat storage in fat cells."

Aside: if I only had time to follow one blog on nutrition, it would be Whole
Health Source.

------
rayiner
This stuff gets a little conspiracy theorist. I think the most basic problem
is that carbs are cheap and it's easy to eat a lot of them because they're not
filling. Losing weight is about calories in versus calories out, but calories
in is about hunger management.

Where I get breakfast, they sell these pretzels. 300 calories for something
that'll leave you feeling hungry immediately. Meanwhile a small container of
2% Greek yogurt will fill you up till lunch for half the calories.

My favorite lunch is a salad at chipotle: lettuce, chicken guacamole, cheese.
At 450 calories, it's ridiculously filling and has about as many calories as a
small sandwich that'll leave you hungry by the afternoon. Or a twelve piece
nuggets at chick fil a. 400 calories for a tasty lunch that is so filling it's
even a bit hard to eat in a sitting.

But have a cup of coffee and a scone at Starbucks? Same number of calories as
the twelve piece nuggets, except people don't feel like fat asses having that
before going home for dinner.

If you have trouble losing weight because you can't stay on the wagon, at
least try a low carb diet. Realize that a bagel at 200 calories = 5-7 strips
of bacon and the latter will fill you up and the former won't. Also eat lots
of vegetables to add volume with low calories. If you have a sweet tooth, put
a teaspoon of sugar in some FAGE. It's only 15 extra calories.

~~~
rckrd
I would not advise anyone trying to lose weight to go on a 'low carb' diet.
While its true that most people need to consume less carbs, a good balance of
fats, proteins, and carbs are a part of most healthy diets.

Satiation has less to do with the absence of carbs as it does the glycemic
index of the carbs. Foods like oatmeal have a low glycemic index and thus
raise your blood sugar much slower than a candy bar which might cause a sudden
spike. So its advisable to eat slow burning low glycemic index carbs in the
morning to feel fuller during the day.

Also there are a lot of mixed views about dairy as well as the high sodium
content of chipotle in the weightlifting and weight loss world.

~~~
rayiner
Note I qualified my advice as being aimed at people who are having trouble
losing weight because they can't easily control their eating (which
encompasses many or even most people). For those people, I think trying to
have a "good balance of fats, proteins, and carbs" (whatever that means--most
nutrition advice is handwaving) is an additional constraint that makes it too
hard to stick to a diet that limits calorie intake. I think its actually
ultimately unhealthy to advise people to try and maintain a "balanced" diet
(again, whatever that means), because clearly people don't have the willpower
to to begin with (or else they wouldn't all be fat).

This is particularly true if you're a typical busy, stressed person who
doesn't have the time to prepare and plan his or her own meals. Restaurants
make it very difficult to eat limited calories while balancing fats, protein,
and carbs, because their dishes come with an overabundance of cheap carbs. To
use Applebee's as a reference for a typical American suburban restaurant, the
12 oz new york strip has 480 calories, while the seasonable vegetables adds
another 40-60. Almost all of the pasta dishes have 1100+ calories. If you're
trying to stay under 600 calories for dinner, you're going to have much more
success ordering the steak than you will ordering the pasta and willing
yourself to eat only half the portion.

Fun fact: the glycemic index of oatmeal isn't that low. See:
[http://www.amsa.org/healingthehealer/GlycemicIndex.pdf](http://www.amsa.org/healingthehealer/GlycemicIndex.pdf).
Oatmeal has a glycemic index of 61. Table sugar is 65. Whole milk is 27.
Peanuts are 14. Low fat yogurt is 33. Oatmeal is better than say white bread
or a bagel, but what isn't?

------
zdean
So I could eat 10,000 calories of fat per day and lose weight if I cut out the
carbs? I doubt it.

There seems to be a zero-sum mentality that will (maybe) never die off that if
one food group is good others must be bad. As for me, I'll listen to Michael
Pollan's advice:

Eat food. Not too much. Mostly plants.

~~~
jerf
"So I could eat 10,000 calories of fat per day..."

Try it. No carbs, just fat & protein, 10,000 calories.

Seriously, try it. Just one day. Won't hurt you.

It is possible to consume 10,000 calories of carbs in a day. Short of
physically stuffing it in, you will find it effectively impossible to eat
10,000 calories of fat and protein. You'll probably find it a challenge to go
beyond 3,000. (Though if you switch to a high-fat, high-protein diet you might
manage in the first couple of days before your body adjusts fully. And I'm
assuming you're average; a large man might get 4K, but again, that'll be a
challenge.)

Calories are not fungible. And once you accept _that_ , it's frankly hard to
look at the evidence, the biochemistry and how the hormones work, and not end
up fingering carbs as the source of the obesity epidemic, not fat.

You may find it interesting to note that carbs all come from plants. (But not
all plants, of course.)

~~~
mason55
The issue people take is that when people talk about this they frequently make
it sound like carbs are what make cause obesity (eg the title of this post).
However it's not that carbs cause obesity it's that carbs allow you to easily
consume lots of calories and excess calories cause obesity.

It's funny because most of the "carbs are bad" and "carbs are fine" people
agree that in reality it's calories that make you fat. For some reason when
they talk to each other that point gets lost and it turns into two people
talking past each other who agree in actuality.

~~~
fingerprinter
IMO, it would be better for the general public to think of them as "bad"
rather than "good" as we do now. Most people shouldn't be consuming carbs,
nearly at all. In general, the average person should be high fat, mod protein,
low carb (very low) and they would be in much better overall health.

I think the problem is that carbs, much more than either of the other 2
macros, have more complex mechanisms at play.

For instance, carbs in the morning or at night? Most people know that you are
burning fat when you wakeup from your overnight fast. But what most people
don't know is that the first time you eat carbs, the fat burning stops.

6 meals or 2? Smaller insulin spikes over time lead (it appears) to insulin
resistance moreso than one or two big spikes. The jury is a bit out on this,
but the data is leaning this way (last I looked).

The meal frequency doesn't really matter with protein and fat, just carbs it
seems.

Those are just some examples, but I think you get the idea. My mother (65)
recently asked me what she should do for her diet in old age. Simple, I told
her, eat lots of fish, meat, veggies, cream and some nuts. Avoid grains,
bread, over doing it on fruit etc. She's worried about living a long time,
heart health and cancer. No reason she should be anywhere near carbs.

~~~
a8da6b0c91d
> average person should be high fat

You probably want to be getting a substantial fraction of your calories from
sugars and starches, mixed with fat and protein. Ya know, like portions in
cuisine all around the world has favored for ages.

I used to buy this high fat idea before reading more broadly. Firstly, non-
saturated fats should be avoided to the extent possible, and that's hard to do
on a high fat diet. Secondly, high fat meals are clearly inflammatory. More
inflammatory than carbs. They cause endotoxin absorption and promote
dysbiosis. The hormone profile of being a "fat burner" is not so great either.
Cortisol goes up, because that drives fat metabolism. This is why people who
go atkins or go on a fast say they feel great. It's elevated cortisol, just
like a runner's high. That's fine in short doses, but sustained it leads to
breakdown and damage.

Relax and have some sugary chocolate milk. It's perfectly healthy. Almost a
balanced meal, in fact.

------
tgb
Turns out it's food that leads to obesity: [http://examine.com/faq/what-
should-i-eat-for-weight-loss.htm...](http://examine.com/faq/what-should-i-eat-
for-weight-loss.html)

~~~
revelation
That is why this topic keeps attracting the terrible pseudo-science and cults,
the overbearing media reporting.. we already know the simple principle by
which you can lose weight. Turns out people are terrible at making changes in
their routine.

Instead of discussing some paleo nonsense or how carbs are evil, we should
tell people to find a sport they enjoy and join a local club..

~~~
jamesaguilar
But that is also nonsense. The amount of time you have to spend exercising to
spend significant calories is enormous. Far beyond what most people can
allocate to the activity.

~~~
revelation
I think you are being overly dramatic on "enormous", but either way: it is not
a zero sum game. If someone adds some activity into their weekly plan while
simply maintaining their current eating habits, that is still an overall win.

It is certainly a win for their _health_ , because obviously eating "healthy
stuff" does not actually make you perfectly healthy.

------
xacto75
It's no coincidence that the modern Western diet is based on carbohydrates and
hydrogenated oils. While an individual can choose to eat a high fat, low
carbohydrate diet, our entire society cannot. This is a problem of scale.

Our politicians made a deal with the agri-business devil to ensure (most)
everyone is fed relatively cheaply. The toll for this deal is that some people
end up fat and sick. I'm convinced this is known and understood; nothing will
be done about it.

It's left to the individual to adjust their lifestyle to suit their biology.

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tmikaeld
There seems to be a misconception about LCHF, it means LOW CARB not NO CARB.
I've been on the diet since March and lost 10KG and is now stable on 67KG
weight and i'm 174cm long. I eat about 5% carbs each day, most from nutritious
sallads, vegetables and berries. And i have NEVER been healthier in my life,
even my doctor confirms this.

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ajcarpy2005
I have long suspected this to be the case. I have observed the association of
obesity with "impoverished" Americans. Think about the kinds of food poor
people buy. Macaroni, Ramen noodles, bread, soda, McDonald's (fries, bread),
candy, cereal, etc.

I also suspect that lower proportions of protein and nutrients play a role in
carbs not being handled well by the body.

------
smtddr
As someone who struggled to lose weight for about 1 year, but after that was
able to defeat the extra 35+ pounds gained after marriage, I concur that the
key thing I've almost completely removed from my diet was carbs & sugar. The
weight disappeared. I purposely seek out whole milk, cream on top, and eat a
bowl of Erewhon organic raisin bran[1] pretty much nightly. Simply avoid rice,
bread, pastas & sugar(especially corn syrup). Now I don't wanna get into a big
ol' argument about corn syrup vs. regular sugar, but I don't gain weight
anywhere near as fast if I have an occasional japanese snack[2], versus a
western candies such as the typical items at a 7-eleven[3]. Authentic Japanese
snacks never seem to contain corn syrup, afaik.

1\.
[http://www.wholeandnatural.com/catalog/Erewhon%20Organic%20R...](http://www.wholeandnatural.com/catalog/Erewhon%20Organic%20Raisin%20Bran.jpg)

2\.
[https://www.localresearch.com/site_media/media/uploads/img/2...](https://www.localresearch.com/site_media/media/uploads/img/2010/Aug/17/DSC_0812.JPG)

3\.
[http://www.theepochtimes.com/n2/images/stories/large/2011/02...](http://www.theepochtimes.com/n2/images/stories/large/2011/02/08/1133928.jpg)

------
jrwren
no shit. where the fuck have you been?

SUGAR - THE BITTER TRUTH

RTFM

