I think sugar is the main problem (not fat) and I'm not convinced calory count is key. We did not evolved to eat processed sugar, which is not easily found naturally in the environment.
My 2 cents:
- eat as much vegetables as you want (learn to cook them, with a little bit of olive oil)
- eat as much fish as you want (no need to cook! Low temperature baking, 1h at 70-80°, the best cooking you'll ever have)
- eat meat in reasonable, "as-if-you-had-to-hunt-it-with-a-bow" quantities
- ban every processed food, sauce, appetizer.... If you would not eat a spoon of every single ingredient of some food, don't eat it.
- ban all added sugar, except (real) honey in reasonable proportions.
This implies to know/learn how to cook (not so hard but this is easier when the local/family culture allowed you to learn passively).
It looks like this is hard to do in the USA: you don't easily find, for example, yogurt without sugar added. (Or I didn't look at the right place, once again this is not judgemental).
Generally speaking, it is easy to find online high-level cooking courses, but hard to learn the basics of how to cook your onions or tomatoes in different ways in everyday life, or make an healthy meal with what's left in the fridge; this could be interesting to have.
--edited for typing errors
> You can find really good junk food everywhere, or pay a really high price to eat in high-level Italian restaurants for example, but it is very difficult to eat standard meat-with-vegetable-without-sugar-added, except in Asian restaurants
Restaurants are typically not where I go to eat healthy food anywhere in the world, although I do think you have a pointed that American restaurants are often relatively junk food oriented.
> ban every processed food, sauce, appetizer....
There is nothing inherently wrong with "processed" food; it is entirely possible to use industrial processes to make a perfectly healthy and wholesome food product. Take for example, (this is by no means an endorsement) Larabar . They make snack bars that typically contain 2-3 ingredients that are all just dried fruit. Should they be banned as "processed" food because of how they are made?
> If you would not eat a spoon of every single ingredient of some food, don't eat it
This is a ridiculous statement and is one of the main reasons why I'm commenting. I wouldn't eat a spoonful of yeast, should I not eat bread? I wouldn't eat a spoonful of salt, should I not eat... anything?
> It looks like this is hard to do in the USA: you don't easily find, for example, yogurt without sugar added.
I've never lived in an area in the United States where I've ever had any problem finding anything like this.
1. The number of ingredients in something does not directly indicate how (un)healthy it is. The fact that Larabar contains 2-3 ingredients says nothing about its nutritional value.
2. In fact, many people would not consider Larabar to be a "processed" food to begin with because it literally is just 2-3 fruits and nuts mashed together. You could make something very similar in your own kitchen. The way you're speaking makes it sound like "processed" food is anything that is cooked or combined in some way. That is not how people use the word IME.
3. Have you looked at the sugar content of Larabar? It's not low, nor would I consider it healthy or wholesome. They likely chose dates specifically because of their extremely high sugar content so that they could pretend they are healthy while actually including unhealthy amounts of sugar in their product under the guise of dates.
> ban all added sugar, except (real) honey in reasonable proportions.
As if there is something "magic" about honey that makes it OK as opposed to all other sugars. There is not.
There's a distinction between processed and ultra-processed (or highly processed). For example, canned fish is processed (added salt and oil), while a frozen TV dinner is ultra-processed (many ingredients added, some of which you probably don't have in your kitchen).
Processed food is fine assuming you're aware of what's in it, how it's processed, and make sure you're not overeating any of it.
Sure, but OP said ban all processed food. That's what I'm responding to, not "ban all ultra-processed food." That said, I do find your categorization to be troubling. Just because something is a frozen dinner doesn't necessarily mean that it's bad for you. Whether or not something is good or bad for you is based entirely on its chemical composition; it has absolutely nothing to do with how it has been put together or what form factor its being distributed in.
It may sound like I'm being pedantic, but I think these kinds of short cuts are actually genuinely harmful. I've known many people who have thought "cheeseburgers from McDonald's are unhealthy not because cheeseburgers are unhealthy but because they are processed" and then gone right ahead and made themselves cheeseburgers that have three to four times the calories, fat, and salt of the McDonald's counterpart.
Does that make McDonald's a healthy option? Absolutely not. But why is McDonald's unhealthy? It's because the food they serve is unhealthy. It's not that the food that is served at McDonald's is unhealthy because McDonald's is unhealthy.
> Processed food is fine assuming you're aware of what's in it, how it's processed, and make sure you're not overeating any of it.
If people want to eat healthier, they need to pay attention to the ingredients in the things they're eating. If we're going to regulate something, we need to regulate the ingredients that go into things people eat. Using buzz words like "processed" and "ultra-processed" with definitions that are, at best, not well understood by the general population just leads to people working around personal/social rules/regulations.
Just because your t-bone steak is local organic grass-fed whatever does not make it good for you. That food is just not healthy, even if it is the only ingredient. We did not evolve eating food like that with any kind of regularity. If you want to be healthy, you need to just not eat it.
A lot of non-technical people get hung up on the marketing terms than actually thinking through the fundamentals.
For e.g. "Handspun ice-cream! OMG!". Uhh..what difference does it make if it is hand-spun or machine-spun? It is not tool of spinning ice-cream, but what the process is. To majority of non-techy people, processed or machined or anything to do with automating a method is highly repulsive - thanks to the hipster marketing.
The general take away is - "Automated machines will never replace the touch of the hand"... oh really? then how come we can make insanely precise things called semiconductors in almost a completely automated fashion. Some fabs don't even have operators inside, just technicians or engineers. This is an extreme example just to make a point.
Just don't tell me that your Japanese knife when hand sharpened cannot be as good as something done by a robotic arm. Otherwise, I have some news - Japanese knife's edge sharpness(not durability) is no match for a surgical scalpel which is made by millions in quantities in fully automated fashion for less than $20. Or even a razor blade that costs $0.10. If scalpels were made from bluesteel (RH 62+), which is a horrible idea for a scalpel but just to make a point, then they would totally match a Japanese knife's durability too.
I could find countless examples where machines can have proper process control (SPC with control charts), high repeatability and can work well given all PMs are done and they're well maintained - totally out perform humans in many handcrafted jobs. Even things that we traditionally associate with artisan such as Guitars can be manufactured better and for cheaper by machines. "Only a master luthier can tell if the wood is good by knocking on it and feeling the resonance" - absolutely not. We can have ultra precision transducers and a whole bunch of DSP to figure that out and actually quantify that bullshit claim of artisanal value.
"But they have no human-like imperfections" - sure, just add random variation in the runtime code and imperfections can be automated.
What bothers me about this artisanal movement is not about craftsmanship, but about the marketing of it - just say it's handmade. Not because it is better but we want to preserve old ways of doing things. Don't say machines are not capable because I will show at your door and automate your job away.
And I seriously doubt that anyone will claim that a knife sharpened by a robot arm reproducing the exact movements of a human will produce an inferior product. The problem is that most automated sharpeners are some variant of a rotary grinding wheel run linearly along the blade and, unless you're sharpening a machete, there are all sorts of aspects of the blade geometry that are ignored by this process but can be accounted for by a skilled worker at a whetstone.
If you started hamming your scapal against a chopping board everyday, it would get blunt very quickly. Comparing two knives with completly different use cases makes no sense.
> "But they have no human-like imperfections"
Easier said than done. You would need some sorts of adversarial model that would quantify which random variations were pleasing and which were not. People. Often prefer inperfections, but that does not mean all or most inperfections are desired.
I think it is a bit meaningless to talk about the merits or demerits of particular ingredients (other than the obviously bad such as rancid fats, pollution by heavy metals, or high in toxins) Humans evolved to eat a varied diet and the more variety of nutrient dense food you have the better off you will be. The main issue with nutrition is how can we teach people to eat better while keeping the production costs down.
I recognize I'm bloody lucky to be able to afford the food I get to eat every week, but just thinking of the resources required to have everyone eat this way is very hard. How sustainable would it be for everyone to eat fresh seafood every weekend or constantly import oranges to northern latitudes? Part of the problem is that people choosing processed food leads to an increasing divide in costs between the processed and the freshly prepared, only due to economies of scale. And it will only keep getting worse. My parents' generation all had fresh milk delivered daily at their homes (relatively affordable even for the middle class), today how many people could afford something like that? It took only a little time when cheaper options appeared for it to become uneconomical and nowadays even if you wanted to pay a premium, how big would it be?
A big mistake is to only focus on macronutrients when micronutrients are as important. Even then, it is a relatively unexplored field, how many chemical species you think an apple has? We have explored relatively few classes and particular examples of vitamins and it would be misleading to just go by the RDA of a few classes of chemicals which were explored because of simplicity, technical development at the time? How many vitamin E analogues are in a kernel of wheat? When did we stop doing this basic research into food and nutrition? There are millions of different molecules in natural food, how much is destroyed by processing? Like the homogenization of milk, which is practically very vigorous stirring and yet it destroys lactoferrin.
Exactly. Approximations are good, because they allow you to start doing things now, rather than procrastinating because you need to do proper research first.
You don't need to research the best exercise in the world before you start exercising. Just start exercising, and don't hurt yourself.
You don't need to do the nutrition research. Eat lots of vegetables, cut down on sugar and salt.
...and of course, you can still do the research later, if you want to. But if the proper research will take you say 10 years, it is better to spend those 10 years already exercising and eating vegetables and avoiding sugar.
It sounds to me like this is the crux of your argument.
I think I'd agree and hopefully add some clarifying points.
Processing doesn't necessarily make things less healthy. It depends on the type of processing and what is being processed.
If you blend a steak, it isn't less good for you (although it is more susceptible to food poisoning). Adding heat to things like meat can actually make them more bio-available since they're easier to digest. Adding heat to vegetables can break down certain vitamins and make the result less healthy.
Additionally, heating food in certain ways can make it less healthy because of the cooking process. Anything that chars the food or introduces partially combusted hydrocarbons (burned cooking oil, grilling/smoking, etc.) adds carcinogens to the food.
2. Macro-nutrient profile
Food satiety is relatively well understood: protein, water and fiber are all appetite suppressants. People need a certain amount of fat and probably desire at least a small amount of carbs (although the last part can be overcome in some people).
For a sedentary person, a diet high in carbs and fat is probably not good, as it will result in weight gain.
For someone with higher energy needs - say someone building a trail through the woods with a mattock - they may need to eat 6000 Calories per day just to maintain their body weight.
For a sedentary person, a diet high in protein will be distasteful and probably wasteful.
For professional athletes competing in strength sports, they may eat over 2g / kg of body mass of protein as part of a diet tailored to their goals.
Broadly speaking, in order to promote the health of a person, the macro-nutrient profile of their food should match their body and their activity levels.
Eating vegetables are good for you. The more raw the vegetables are, the better they are for you (probably). There is often a trade-off that needs to be struck between palatability and optimum health benefit.
There is also a wide array of micro-nutrients that can come from eating meat of various sorts.
There are many conflicting opinions here, without a broad consensus, so I'll leave it at that.
4. Weird stuff
Often times people will bring up ingredients in processed food that they don't know what it is, or even how to pronounce it.
I don't think people are bad to want to avoid stuff like that.
But for the most part, I have real doubts that this is the cause an health problems in even a small fraction of consumers.
Sure, as long as you use similar ingredients.
> I was under the impression that their food is loaded with sugar and strange additives.
It's not. The beef patty really is just beef. The bun is white bread, just like you can buy at the grocery store. And the condiments are self-evident. It's just that that they've nailed the production process so precisely that what you get tastes almost exactly the same, every time.
A lot of people have this warped, black and white view of "healthy" and "unhealthy", but the reality is that it's a spectrum, and you can get reasonably healthy food at McDonalds but eat like crap at home.
Their hamburger doesn't look any different than what I would make at home. I don't have any grocery store bought buns in front of me, but I assume it would have similar ingredients. The pickles are not the most natural, but once again, it's not much different than what I would buy in a grocery store.
The biggest difference for me personally is that I would usually make a salad or another vegetable along with homemade burgers and fries, but it wouldn't even cross my mind to order that at McDonald's. I suppose I bring that on myself.
Regular Bun: Enriched Flour (Wheat Flour, Malted Barley Flour, Niacin, Iron, Thiamine Mononitrate, Riboflavin, Folic Acid), Water, Sugar, Yeast, Soybean Oil, Contains 2% or Less: Salt, Wheat Gluten, Potato Flour, May Contain One or More Dough Conditioners (DATEM, Ascorbic Acid, Mono and Diglycerides, Enzymes), Vinegar.
100% Beef Patty: 100% Pure Usda Inspected Beef; No Fillers, No Extenders.
Prepared With Grill Seasoning (salt, Black Pepper).
Ketchup: Tomato Concentrate from Red Ripe Tomatoes, Distilled Vinegar, High Fructose Corn Syrup, Corn Syrup, Water, Salt, Natural Flavors.
Pickle Slices: Cucumbers, Water, Distilled Vinegar, Salt, Calcium Chloride, Alum, Potassium Sorbate (Preservative), Natural Flavors, Polysorbate 80, Extractives of Turmeric (Color).
Mustard: Distilled Vinegar, Water, Mustard Seed, Salt, Turmeric, Paprika, Spice Extractive.
The 'white bread' ingredient list looks nothing like real bread. Sugar? Oil? These are ingredients in muffins and cakes, not bread. The wheat they use has been processed to the point that a few key vitamins have to be added back just to make it legal again.
The ketchup and pickles are basically jam and sliced candy, there's so much sugar in them.
Not to mention the salt levels in everything.
If you eat low quality white bread and cheap condiments with every meal, you might as well have a candy bar and a bag of chips instead. But we've normalized it, we think we're eating home cooked food each time we reach for a plastic bottle or bag.
I also want to point out that "100% Pure USDA inspected beef with no fillers or extenders" doesn't mean what it sounds like. What this doesn't list are all the things that are allowed to be in your cheap, factory farmed beef and still be called 100% pure beef, like ammonia-treated lean highly textured beef (LFTB or 'pink slime': https://en.wikipedia.org/wiki/Pink_slime), HGH, antibiotics, etc.
By all means go out and enjoy some junk once in a while, but we've gotta stop normalizing ultra-processed foods in our homes.
> Regular Bun: Enriched Flour (Wheat Flour, Malted Barley Flour, Niacin, Iron, Thiamine Mononitrate, Riboflavin, Folic Acid), Water, Sugar, Yeast, Soybean Oil, Contains 2% or Less: Salt, Wheat Gluten, Potato Flour, May Contain One or More Dough Conditioners (DATEM, Ascorbic Acid, Mono and Diglycerides, Enzymes), Vinegar.
Each to their own!
> You can get reasonably healthy food at McDonald's
... Seriously? Do they even sell vegetables beyond the burger dressing?
Enriched flour (wheat flour, barley malt, niacin, reduced iron, thiamine mononitrate, riboflavin, folic acid), water, potato flakes, yeast, wheat gluten, sugar, 2% or less of: salt, soybean oil, soy flour, sodium stearoyl lactylate, corn flour, extratives of paprika and turmeric, calcium propionate, calcium sulfate, ammonium sulfate, sucralose, natural and artificial flavor, ascorbic acid, enzymes
So not much better than the McDonald’s buns, and maybe a little worse. I’m guessing that the above ingredients are all required for a hamburger bun that is both shelf stable and cheap.
I’m not sure what the takeaway of that is. Maybe I should get the more expensive and presumably more natural buns? Either way, the McDonald’s buns aren’t any worse than what most people are eating at home.
> fortified wheat flour (wheat flour, calcium carbonate, iron, niacin, thiamin), water, extra virgin olive oil (2%), fermented wheat flour, malted wheat flour, salt, yeast
They're not the cheapest of course, but hardly some absurd luxury at 33.8p each, they're a lot nicer than squidgy cheap rolls that are unlike anything you could reproduce at home or see a baker produce, and have pretty much the same ingredients list you'd use at home, if you used commercial yeast and bothered with three different flours.
And there's no selection bias or anything - I haven't looked at the ingredients list before, that's not why I buy them. I buy them because they're nice enough and so far I haven't bothered to bake rolls, mainly because my demand for them is more erratic than slice[able] bread.
Yeah, modern food is terrible.
This is why you want to have a high compliance, meaning that the sick person does what the doctor recommends. This is mostly caused due technical or behavioral complexity.
You can increase compliance by reducing complexity. At the same time, the accuracy decreases.
High Accuracy / High Complexity: "Do not eat frugugle, fergerio, flululu and fnyvoo." Why low compliance? Because the behavioral complexity is very high, especially for sick people:
1. Find the food ingredients list.
2. Loop over the ingredients list and compare the current item with the "do not eat"-list.
3. Make a decision for every ingredient, if this is in the list ("frugugle" is on the list, but one ingredient is "fruguglelase", what's my decision?)
Lower Accuracy / Lower Complexity: "Do not eat products with more than 3 ingredients." Why higher compliance? Because the behavioral complexity is lower:
1. Find the food ingredients list.
2. Count the amount of ingredients.
3. Make a decision after reading max. 3 ingredients.
IMHO it's easier to start with the second approach, because you make progress faster, and keep the momentum going.
And if I'm sick, and there are clinical details that are important to my treatment, then I'm absolutely not going to be satisfied with a low-accuracy simplification.
I don't know if I'd go as far as to say "wrong" but certainly the less processing a food has, the better, primarily because you get to retain more of the fiber content (and so the food is more filling).
Given how profit in the food industry and addiction is so closely tied together, I don't see how this is possible.
The flour you make French bread with is not found any more or less naturally in the environment than the sugar you get from cane or beet.
This whole thing about evolution and nutrition is entirely pseudoscientific woo.
If humans had to eat the same way as our ancestors (ie actual paleo, not some hipster fad diet) humanity would have died out long time ago.
The French thing makes this all the more ironic... I can’t imagine much more triumph in modern processing than the five mother sauces.
Clearly the American diet has a crazy oversupply of sugar... fructose, glucose, sucrose... at the amounts we’re talking about in the average American diet it doesn’t fucking matter (making the whole HFCS controversy always a joke).
I would not take paleo food as a reference, but rather look toward what our grandparents had for lunch when they were kids. I don't think they were doing so badly.
And I don't cook like Bocuse everyday, the five mother sauces are not intended to be eaten on a daily basis :-)
Anyway, honey has a higher concentration of fructose so it has a lower GI than table sugar, but this difference is quite moderate (a few percent) - it seems to get overstated a lot on the web. Honey is basically refined/processed fuel produced by bees - and on evolutionary time scales it has been in use by humans about the same as sugar. Don’t get me wrong, it has chemical and physical properties that make it a beneficial sugar alternative - probably most of which is earlier satiety and therefore less consumption. If consumed in similar quantities it’s still going to make you fat. TANSTAAFL.
My grandparents are probably older than average... but the life expectancy was a fair bit shorter just 100 years ago. Most didn’t even get the opportunity to live long enough to have gastric cancer (smoked meats) or a second MI.
This is baseless nostalgia, not something to base health advice on.
Wild varieties of wheat doesn't have nearly as much gluten, and the higher concentration results in a lot more children (myself being one of them) reacting to the protein with an immune disorder(celiac disease).
So you can't just say "sugar bad, flour good" as if it was a binary decision. Everything has consequences on different levels.
In the end, I think it's good to know how much raw stuff go into making any ingredients. It takes a lot of sugarcane to get a soda's worth of sugar.
At least I grew up on the east coast and my parents cooked. Anecdotally, I'm shocked by what my acquaintances from the midwest eat, and the consequences really start to show up when people reach their 30's (although there are signs earlier)
I read Michael Pollan's books (Omnivore's Dilemma, etc.) 10-15 years ago and they opened my eyes to how broken this country is in terms of food.
It's funny he is considered "liberal" here but it's just common sense in the rest of the world. The thesis is actually "conservative": eat things that your grandmother would consider food. If your grandmother wouldn't recognize it, don't eat it. Did your grandmother (or great grandmother) cook with high-fructose corn syrup? Or processed oils / margarine?
Who knows what additives were in our grandparents' foods.
The change in American diet was not subtle; it was huge. It was due to what's cheaper / more profitable for a huge industry to produce.
It's similar to what's going on right now with the software industry -- cloud services with mobile clients is great economically and great for collecting data, but not necessarily in the short-term or long-term interests of the users.
If you believe in capitalism, you would have to explain how optimizing for cheap and superficially appealing food would NOT happen.
There's a reason every country has an equivalent to the FDA that has to approve food additives. These agencies were not formed in advance - they were formed as a reaction to dangerous unregulated food additives, supplements, medicines, and so on. The FDA was formed in 1906. Michael Pollan saying that our grandparents only ate real food is an example of the golden age fallacy.
The average American woman weighs 166.2 pounds, according to the Centers for Disease Control and Prevention. As reddit recently pointed out, that's almost exactly as much as the average American man weighed in the early 1960s.
Men, you're not looking too hot in this scenario either. Over the same time period you gained nearly 30 pounds, from 166.3 in the 60s to 195.5 today. Doing the same comparison as above, today's American man weighs almost as much as 1.5 American women from the 1960s.
This is NOT a subtle change! And it has severe consequences.
I think it's clearly due to diet and the "hidden" choices in the food supply, but if anyone has contrary information I'm interested. It's a tremendous change that needs an explanation.
That very much depends on your location. High tourism locations will often have lots of junk food places. If you can move larger distances (i.e. rent a car and the like) you'll find wonderful and cheap restaurants pretty much anywhere. Even in otherwise expensive places like SF or NY.
Here's the problem though: portion sizes are _enormous_ . It took quite a bit of time to adapt, and adapt I did, if my measurements are any indication. If you want healthy portions, you'll either waste food, or you'll have to ask for a take out box. Essentially, a lot of places will serve you portions that are enough for two meals.
Ingredient availability varies a lot. In larger centers you can find almost anything you could possibility want. Even farmer's markets if you are lucky, which will often have locally sourced produce at lower prices compared to big supermarket chains (and sometimes even lower if you get there near closing hour ;) )
After doing a trip in America, I interpret "eat normally" for a French as not eating in the restaurants, but the food available in the supermarket that you cook at home.
Finding vegetables, fruits is hard, if not impossible. You don't find it in every supermarket.
Eating normally, for me, is buying the vegetables, meat, etc, and cooking it myself.
Yesterday I made a ratatouille:
Eggplant, courgette, poivron, tomatoes.
I remember finding these in USA was really hard.
And the only fruits we found was already cuts pineapply/mango/apples/etc...
Neighborhood bodegas, which can look like small shops selling food, are a very different type of establishment, and sound like what you’re describing. Perhaps you are ending up in those? (They’re rife in tourist areas!)
I live in the US currently, and can't think of a single supermarket that doesn't have a large fresh fruits and vegetables section, and all of the vegetables you mention are commonly available.
I suspect you were in a big city and going to the equivalent of corner stores (as someone else mentioned, what they call bodegas in NYC at least.
I think you fell into the common traveler's trap of thinking that your lifetime of knowledge of your home country would easily translate to a different country. When you don't know what's available or what to look for, it can indeed be difficult to find things.
I'm pretty sure this is the opposite of the actual situation. Cities attract both tourists and high-income residents, and the latter combined with high population density drive the development of much more diverse eating options within a reasonable range than a person in a more rural area has available to them.
Anecdotally, the organic grocery stores and vegan eateries I see in SF just don't exist where my parents live.
This I don't agree, I was in a backwhole and all I got was a supermarket and fast food. Sure I could take the raw veg, but it was cheaper to get the TV dinners.
Maybe you know your area better to find them but are they known by all, known enough to be advertised to tourists/visitors ?
> Here's the problem though: portion sizes are _enormous_
This is a result.. Not really a cause, I fully agree with you the portions are alien for me, but they didn't decide on those portions from nowhere.
> Ingredient availability varies a lot
> Even farmer's markets
This is both true and the problem. The fact you need to say that sometimes Farmers markets can handle you meats, and depending on what supermarket you go to you can get good veggie.. It's strange from an EU POV.
We have EU standards on all food trades, the UK is leaving the EU based on a few lies about the standards. But it actually is standing to prove that hey : 'Don't eat shit'.
• Restaurants don't sell food, they sell satiation, taste, brand, ambiance, customer experience.
• You rarely can ask for an ingredient list, you often can't see who made your food, it is a black box in a black box.
• All we really care about are omissions: the list of chemicals, macronutrients, hormones, and ingredients that are excluded from our menu items.
Not only does this disconnect us from the ingredients in our food... I think this is a huge problem that compounds toward multiple health crises such as obesity and diabetes. Chefs are seen as food experts, yet the nutrition aspect of restaurant food is entirely ignored. We expect individuals themselves to be their own nutrition experts (curating meals and ingredients for their own health).
I don't know what the solution is. But at the very least I think every restaurant owes its customers the macros and ingredients for every product they serve, in accessible formats. It should be easier to get that information onto your phone than a tweet. Food receipts should list macro and calorie breakdowns. Tools for nutrition analysis should be free, standard, integrated, and widespread. etc
I will have to disagree. Maybe this is a cultural thing (I'm from Brazil) but on business days I mostly refuse to have lunch in restaurants that don't offer nutritional food options, and I'm not alone in this matter, the majority of my team mates also care about their diet. Those who don't care about it and eat junk food at work every day are the exception.
Hence, restaurants have the incentive to serve healthier food in order to attract customers like me and my team mates.
That's not to say that I don't like junky food. I love to grab a beer and a burger, but I grant myself that treat at most once a week, not more than that.
Anyway, here in the EU we have strict rules on when/how foods may be labeled as "no added sugar". I think we should take those rules and turn them around and require "with added sugar" labels on basically everything that is not candy or patisserie, where you would clearly expect sugar as a main ingredient.
I do agree that the quantities of sugar in everything are _way_ too excessive though.
I travel all around the US a lot for work (or did, pre-covid) and all the way down to your fast food restaurants all the way up to fancy $500/plate places, I've never once found it difficult to eat a "standard meat-with-vegetable-without-sugar-added". I would say that 80% of my meals are exactly that. I've never once been to a single non-fast-food restaurant where they didn't have multiple different kinds of vegetables on the menu.
There's certainly an issue with portion size at most US restaurants, but I've never found it difficult to get a plate of plain roasted vegetables with lightly seasoned fish, for example.
>It looks like this is hard to do in the USA: you don't easily find, for example, yogurt without sugar added.
Yogurt in particular is not really popular in the US, so you will not find it in many restaurants. You can, however, find packaged sugarfree yogurt in most convenience stores and certainly every grocery store if that's your thing. Other than yogurt, there are plenty of sugarfree snacks widely available. Starbucks is on every corner and sells plain vegetables, plain fruit, plain eggs, etc, for example.
I suspect your complaints are mostly rooted in simply not being aware of certain brand names or which stores are known for what type of food, because all of the things you mentioned definitely are available as long as you aren't going to McDonald's or Five Guys for every meal.
> "You can, however, find packaged sugarfree yogurt"
That stuff is a miracle of modern chemistry. It has, however, only a passing resemblance to actual yoghurt. Nobody who grew up in Europe really wants sugar-free. It's "no sugar added" that matters. Nobody wants fat-free, either. And there are quite a few studies making the point that these "healthy" food actually contribute to weight gain.
"Starbucks is on every corner and sells plain vegetables, plain fruit, plain eggs"... if you're lucky. Usually, it's sold out fairly quickly.
In general, yes, getting healthy food in the US is much harder than it is in Europe. The vast majority of food here is processed to within an inch of its life, and the remainder is incredibly expensive, because it's treated as a luxury good.
I've spent a few decades in Europe, as well as a few in the US. I'm fairly confident I know which food I can get where in either place - and the US is severely broken. Trust me, I wish it weren't. But healthy food is difficult, and becomes extra-hard as you leave bigger cities with specialty stores behind.
>"Starbucks is on every corner and sells plain vegetables, plain fruit, plain eggs"... if you're lucky. Usually, it's sold out fairly quickly.
I've been throughout the US, both urban and rural, and never noticed a particular issue with it being sold out. And Starbucks was just one example; there are plenty of convenience stores that sell the same. I can't remember the last time I was in a gas station or 7-Eleven that didn't have plain fruit or plain nuts available.
I've been abroad as well (mostly in Asia, though some months in Europe) and I really do not at all have the same experience as you. Eating healthily is trivial in the US. I will acknowledge that it is not actively shoved in your face (sometimes you have to specifically ask that a dish be made without sauce, for example) but I have never, ever had a problem with the availability of healthy food.
If anything, I found that eating healthily in Asia was actually more difficult because in many situations it actually is not possible to get a dish that isn't based on some type of high-sodium/sugar sauce, white rice, or noodles. (The nice thing about Asia though is that even if their dishes are full of sugar and sodium, the portion sizes are relatively small, so it isn't as big of a deal.)
I don't see plain nuts as often as I'd like in stores, but they are super easy to find online: https://www.amazon.com/s?k=raw+almonds
But Trader Joe's usually has them too. Safeway sometimes does.
It's not that it's impossible, it's just that they don't have the same "staples" status they have in Europe. Usually, you find raw nuts in the cooking/baking ingredients area, while salted & roasted are considered "party food". And they're more likely to not have the party food variety than the raw variety.
Trader Joe's has decent nuts, but their prices are not competitive when you buy in bulk.
Walnuts, in my opinion at least, don't vary in flavor that much (compared to almonds for example). So... walnuts are walnuts: always buy the cheapest! :)
Actually, I find that a simply prepared, decent (not excellent, cut of meat) steak has now become a rare thing and is ferociously expensive.
I suspect that there is too much wastage of better meat cuts and that restaurant margins are so thin that every owner immediately cuts back the expensive stuff right away.
Anything other than turkey, chicken, salmon, or shrimp is now problematic to find as a protein. And, with the possible exception of certain kinds of salmon, all those flavors are bland enough that they almost always need something in the dish to help them out (cream, butter, sugar, etc.).
The Rise and Fall of American Growth by Robert J. Gordon makes the exact same point but gets there via analysis of where Americans are spending money for food. Since the 70s we've more than doubled the fraction of our income we spend eating outside of the home. This tracks with the rise in adult obesity in America and is a divergence from trends in other developed countries like France.
 Chapter 10
I have a difficult time finding these, as well. The culture here (spoken as an American) is to avoid fats, which is why most products advertise "no fat" (yoghurt with no fat seems like a strange contradiction to me).
> in Asian restaurants (and even there, food is often sweetened)
This is also true from my experiences. Chinese restaurants add sugar due to believing that's part of the American palette. (For Chinese foods, there's also a distinction between "typical" and "authentic" styles, and most Americans are unaware of the latter.)
So if you go for industrial-level food production, you end up with a higher proportion of sugar than what would be considered healthy. Sugar per se ist not bad at all (try to have an apple without it ;)). But our economy demands cheap, somewhat tasty, calories. Hence we end up with a lot of sugar or carbohydrates in general.
Any diet that rules out carbs works well because of that, not because of some intrinsic property of carbs.
As a French person you would probably never consider giving up on a good croissant or baguette, but in France these things are expensive. I doubt anyone gives their kids fresh croissant before school every day.
Bake at home ones are half that.
Cheapest "fresh" at Carrefour are 20 euro-cents.
Are village bakeries still a thing in France?
Very much so. You find bakeries in every village / town, usually less than 15 min walking in any city. I don't know many people in France who buy supermarket croissant (except when you buy very large quantities for groups for example).
And it's very common for people to go to their local bakery (small, 2 or 3 employee) to buy bread every two days.
Croissants or baguettes are not a daily thing if my assumption is correct. My experience is buying them when walking home from work and if I'm in the mood because bread isn't generally healthy for people compared to something else that happens to be better.
edit: okay, I now understand the comment is about apples having natural sugar.
Natural sugar is magnitudes times better than processed/added sugar.
Fructose consumed through fruits has never had a similar metabolic effect as high-fructose corn syrup.
Some points are valid though. Honestly, as an American, we've got some awful vegetables and tasteless food just about everywhere unless fat/sugar is added to them. Probably due to the way mass production and transportation of food goes in to the US. It wasn't like that. There is nothing wrong with our soil. I spent some time in India, Thailand, Vietnam, Japan and Korea and the veggies are almost like they grow in your home garden. Go to a store and pick out a tomato and it is impossibly good. America has farmers markets in every city, even in some of the most impoverished cities. But that's not where the majority of the middle class goes to shop for their vegetables.
Try growing veggies in your own garden on American soil and its gonna taste amazing.
Don't worry, Asian population wants malls, walmarts, and giant grocery stores with similar tasteless food. It is happening at a massive unprecedented scale.
I also think that our obsession with work hurts us. We don't have time to slow down and cook.
In the dietary world, you'll find anti-sugar camps, anti-fat camps, Atkins diet, ketogenic diet, fitness buffs. This article is an example. It's a deep dive full of science. The conclusions, however, are mostly nonsense.
I'll eat like you suggest. But I'll entertain with the reading. :)
I like your characterization of Americans: extremely angry about minuscule modalities. :)
Most of the research is that it's both. (Tt's the worst when fat and sugar are together) Specifically food is more rewarding, denser, cheaper, and easier to find than it used to be, so we overeat it. Same thing happens with almost any animal that's given ad libitum access to the american diet.
It seems there are two societal solutions, extremely heavy handed government interventions to ban tasty food or we invent a weight loss pill.
> Junk food is only cheaper than healthy food because our society has made that choice, and it can just as easily choose to change that.
Junk food is cheaper because it's easier to make junk food. If you want to make food more palatable cheaply, make it denser, fattier, and sweeter. i.e. turn it into junk food.
You could check
https://en.m.wikipedia.org/wiki/Sugary_drink_tax as a starting point. From a skim it doesn't look to me like a small tax is some kind of miracle cure for anything in this regard. Though I don't think anyone claimed that it would be the one factor that fixes everything. There is no one factor, and having the tax as part of a toolbox seems reasonable.
I don't this is really true? Candy is expensive. Chicken thighs, certain cuts of pork are affordable. Along with rice and filling sides like beans. You can eat well and cheap.
It might only be cheap if you're talking about time too?
There was a study that determined that the reason for the sugar+fat combo was that sugar "scratched" arteries and made them easier for fat to stick to.
Just plain fat is OK, because it doesn't stick to healthy arteries. But combine (highly processed) sugar and fat, then you get an insulin spike AND the fat clogs your arteries more easily.
I travel quite a bit for work (at least, when there's no pandemic) and even though my per diem would cover restaurants, I have almost completely switched over to hotel BBQs and eat better for way less money.
This youtube video goes into more detail about the US problem compared to japan: "Why is it so Easy to be Thin in Japan?" https://www.youtube.com/watch?v=lr4MmmWQtZM
"Standard" in the countries I've lived in would include a starch. Part of your reaction may just be to cultural differences in what's considered a standard meal.
Your "2 cents" is nothing more than an expression of the food culture you grew up with. There are many other amazing food cultures around the world - even in parts of the US, although you don't find them in the chain stores and chain supermarkets.
Yes. What do you do with it?
But no, not typical. Most Americans buy all their food at the Dollar Store, and its everything you say.
Buts Dollar stores are growing fast. That won't be true for long.
I wonder at the "make their own meals". Maybe from packets or reheating frozen stuff. But the meat counter sure isn't the largest section in the grocery store, not by a large margin.
At all of the American grocery stores I've been to, the unfrozen meat section is as large as the entire refrigerated section, which are all very typical grocery stores.
I think its maybe a 'first world' view, that every body goes to Dollar Stores for the same things the upper class go there for. One source noted there are many times more Dollar Stores in Texas alone, than WalMarts across the entire USA. Gotta be a reason, and it isn't batteries.
The 'unfrozen meat section' is a prestige-item display case with really a trivial amount of product on display compared to the square footage dedicated to it. Vs every other section of the grocery, with racks 5-10 shelves high crowded with products. I honestly buy meat at the butcher counter maybe once a month, for a special occasion. Not a lot to do with 'what I usually eat'. Maybe its different for others.
We had Dollar G stores open near me. I do get groceries there as my most common item there, but it is in the form of 'grab some sour cream and a block of cheese' just before dinner is done. Dollar G is ~2 minutes down the road from my house, vs. Kroger or Wally World which are ~20 minute drives.
If I am going to go get groceries, I'm going to go to Kroger by default, Walmart if it's a particularly big run, Publix if I'm feeling like burning money, and Dollar G as a last resort, since the latter combines the expensive prices of Publix with the saddest store brand version of a product you can find, if they even have it in stock.
Avoiding food because "we didn't evolve to eat" is not sound science, either.
My diet habit shifted 180deg in 48h, it's a weird realization:
1) eating raw vegetables tickles your brain differently (raw veggies make you feel full faster)
2) most probably because there's no fat nor sugar added (which makes you want to eat more I guess)
3) even dressing is bad, so raw is best to have a natural negative feedback system
4) even the most mundane raw veggies have a lot of flavour.. I eat carrots like M&M's nowadays, it's sweet. Same for lettuce or tomato. I really think modern western culture is hurtful there.
The proliferation of junk foods, boxed refined products, seems higher in North America. As you say dining out tends to comprise the Standard American Diet of high fat and carbs, low fiber.
As a Dutch person living in Amsterdam, I completely agree. I noticed when I visited SF a few times (and California in general) that:
- Vegetables are more expensive
- Bread is sweetened (there goes my breakdfast)
- Bread sucks (yep, I said it, basic bread should be thrown into the thrash can)
- Basic cheese in the US is a new species, and I am afraid of it
I went around these 2 issues by buying the highest quality French bread and imported cheese (how I missed actual France with their actual French bread... :'( ). While it was expensive, I could at least make a breakfast that I eat in Amsterdam (bread with cheese with butter, unsweetened).
The butter was normal. I have to give the US that.
Though, I do like what you guys can do with oatmeal. It taught me that the normal Dutch breakfast is uninspiring as hell, haha. So all in all, it was reall a positive experience, but it's so much nicer when you meet American people showing how they eat breakfast rather than traveling around in the country and simply guessing how to eat normal (normal being unsweetened / healthy -- I find that normal...).
Also, I found the US amazing with certain dinner options (e.g. sushi burito's).
Of course there's the cost difference, but then again that goes both ways - I can find avocados, strawberries, etc. here of a quality and at a price you'd be hard pressed to find in France. Tbh, I'd argue that as far as meat/seafood/etc. is concerned, you can get better quality in SF than you can in 90% of France, where your main option will be an Intermarché or a Carrefour.
I'd also argue that the pastries you find at Tartine/Four Barrel/etc. (they typically source from a variety of bakeries from around the bay) are way beyond, in quality, what you'd find in 90% of French bakeries (the glory days of master bakers are long gone, and a lot of it is frozen crap these days, although it's been getting better in the last few years). I suspect that by this point there are more world class bakers by square kilometer in the Bay Area than there are in France, perhaps with the exception of Paris/Lyon (quite a few that I've met went to France to study baking though, so our national pride isn't completely destroyed). I bake my own bread and can buy freshly milled flour from the The Mill, which would also be hard to find in France unless you had personal connections.
But of course, I haven't gotten to the main part - which is the insane diversity of food stores and restaurants here. No matter what kind of south american, african, middle eastern, asian cuisine you want to make/eat, you'll be able to find it. That is not the case at all in France.
This was all very different from the more "corn on the cob & chicken nuggets eaten in front of the TV" USA I had known until then.
I spent some months working in Houston a while back, and this drove me crazy! I mean, why on earth would you sweeten bread?!
Another thing that struck me was how many ingredients everything seemed to have - you could pick up just about any item in a grocery store, and it was pretty much guaranteed to contain 10-30 ingredients. Even the bread.
> Basic cheese in the US
This too - most cheese was of the horrible processed variety, with little flavour and an odd texture. And of course, dozens of ingredients. And of course, there was sugar in it.
Another thing - corn syrup. Not content with putting sugar in everything, corn syrup was added too.
In the last few years, I've started making my own sourdough bread (salt, water, flour, homegrown sourdough yeast) with no chemicals and I'm loving it. I can't remember the last time I've bought bread. (Dutch-oven method)
>most cheese was of the horrible processed variety
I had this experience as well, but in the last few years, things have massively improved IMHO. Don't go the deli section (where they cut cheese), go to the area where there's brie/english-chedder etc. However Wisconsin has really stepped up to the plate and now creates very reasonable European styles cheeses (of course, more expensive). It's worth trying it again if you've not done recently.
The only exception is hot-cross-buns during Easter. :)
I am defending "bad" bread because no one ever does, and it's really not comparable to "real" bread because the uses are different. It's cheaper, last much longer, and is better suited for sandwiches and toast because of the square shape.
It doesn't have to be that bad, it doesn't have to have lot's of sugar and corn syrup in it, and it doesn't have to have 20+ ingredients.
This is my experience as well.
Nonsense. There is nothing wrong with machine kneading, many European countries (but not all!) manage to produce quality loaves at an industrial scale. Can a good baker produce even better bread in small batches? Almost certainly yes. But even there I'm not convinced that it's the kneading specifically, as opposed to general attention to the whole process.
Presumably that's made without human involvement in each loaf.
Low-end: LIDL, VOMAR
Lower-middle: Dirk van der Broek
Middle: Albert Heijn, Jumbo
Middle—high: EkoPlaza, Landmarkt
I buy my bread from Vlaamsch Broodhuys—an upscale bakery chain—as there’s one by my home.
Diverse good breads are easily accessible in the Netherlands, I find. Back in the US, getting good bread is requires research and a drive. In my college town, both of the only two good artisanal bakeries were started by Europeans who were too fed up with American bread culture!
And a handy side effect for producers is that satiety is short lived, leading to repeated demand in the short term when included in a product.
This really needs so much attention and focus given the ungodly delicious amount of butter French people cook with.
I'm convinced that the quality of European food is, on average, vastly superior to what's available in America.
As biologist with a background in Agriculture and Culinary: they exist, most farm to table restaurants in the US just have a small footprint in overall ecosystem. I spent most of my culinary career within them, ranging from Vegan to vegetation to seasonal based omnivore option. I also worked and ran kitchens in Agrotourisms in Europe and I'm familiar benefits with the Mediterranean diet, Spain having now surpassing Japan in Life expectancy, and diet is a significant contributor to it.
> I think sugar is the main problem (not fat) and I'm not convinced calory count is key. We did not evolved to eat processed sugar, which is not easily found naturally in the environment.
Agreed, and even that is not always so cut and clear as having extra CNV of the amalayse gene (like I do) can be super beneficial, which leans to the need of the Biohacker space (of which I'm a part of and is comprised mainly of many dissatisfied Health Scientists) to play with diet and the epigenetic effects of it, as that has been woefuly neglected for decades in Medicine and Scientific journals but a mainstay in the Biohacker community that has become mainstream due to influencers.
As a kid I never understood the allure of sweets/desserts because of the CNV in my saliva is already breaking down the sugars in my mouth and makes super sweet things always taste a bit like the after taste of bitter chocolate or coffee--none of which I like. I always liked eating fruit, especially tart or sour ones more as a desert and only found out later in Life why that was. the study of how a palette is formed is a very interesting and entirely negated study in my opinion.
> This implies to know/learn how to cook (not so hard but this is easier when the local/family culture allowed you to learn passively).
Agreed! The best thing to do is to learn to cook with local, fresh organic products and help solidify a local food supply chain and relationship with your local farmers! This has a compound effect throughout the entire community and many communities are open vacant lots to community garden spaces.
> It looks like this is hard to do in the USA: you don't easily find, for example, yogurt without sugar added. (Or I didn't look at the right place, once again this is not judgemental).
It's there, its just found at higher end stores and outlets, ironically it costs more to deliver a product with less sugar and additives; but even Walmart has been a big player in the Organic produce Market. There is one next to my gym and I often went in to buy a pre-workout snack or a kombucha and there was always something I could eat without spiking my glucose levels.
> Generally speaking, it is easy to find online high-level cooking courses, but hard to learn the basics of how to cook your onions or tomatoes in different ways in everyday life, or make an healthy meal with what's left in the fridge; this could be interesting to have.
Agreed. Its an undervalued art and craft, in Boulder (one of the most concentrated 'foodie' places in the entire US) there are classes offered via a business that offers Learning Kitchen experiences where professional chefs from the surrounding area are commissioned on a topic/recipe/menu and teach paying members of the community on how to do things via interactive cooking.
Its a very cool model that I think should be expanded on. I'd love to be able to work with some of my old team members in the Industry especially if it could help offset my expenses and help me fund other projects in my Life; online learning could be a bridge or a primer, but cooking is ultimately a craft you learn by repeated instruction and correcting hand positioning (re-enforced with lots of cuts, burns, scrapes) that makes it more like going to the gym than watching a lecture on a subject.
You can learn online, I know I did watching Michelin Star chefs on Saturday Kitchen on the BBC before making the return into culinary in Europe, having only ever worked in catering while I was attending University as it inspired me to experiment with different techniques. I'm now retired from Kitchens but want I want to create a food docu-series, as I feel now is a critical time in Restaurants after having been so impacted due to COVID, that many may not make it.
> ban every processed food, sauce, appetizer.... If you would not eat a spoon of every single ingredient of some food, don't eat it. - ban all added sugar, except (real) honey in reasonable proportions.
I'm not for banning anything, just using it in moderation and having people have a solid understanding on what it does to you metabolically and its impacts on health. Japanese and Italian cuisine are the two pillars my culinary repertoire and sugar is a vital component of Japanese recipes that simply cannot be substituted. I've tried stevia and honey but it just doesn't work, a proper tare is sweetned with sugar not just for taste and lush sheen and gloss when used to grill, but also as the precursors for the bacteria to ferment that takes place over years to give it a unique and umami loaded taste that defines Japanese cuisine.
And pasta and bread, carbohydrates, are just processed long-linked sugars and I can never give those up despite seeing and personally experienced the benefits of keto and carnivore diets in my friends.
I'd throw including intermittent fasting and meditation/yoga in that equation as well and you have a solid foundation for how to be healthier and more productive in Life that I found via Biohacking methods, cooking and farming professionally.
I also have the genetics for longevity on both sides of my family: my grandparents all made it to their late 90s, and my grandmother on my maternal side hit 99.7 before passing due to non health related issues, so I'm hoping that with this information guiding my behaviour I can make it to 150 years of age.
I'll second that, I've only been once for a few weeks on a work related trip, and I never paid attention to what I was eating but by the second week I felt run down, lathargic and really 'not great' - Hard to describe properly but I wasn't myself at all. With work I was connected with a doctor that I met because I just didn't feel 'right'.
I wasked asked the usual questions but after talking a bit more about my diet usually (even before mentioning what I was eating in the US) she knew exactly what was going on. My body wasn't used to breaking down the amounts of processed sugars that are more commonly found in everyday foods in the US.
I took a more concious approach to what was coming into my body and over a week I was able to feel normal again.
I come from Ireland, we have a diverse mix of foods available, you pick a country, I can tell you a street to find their food authentically and I love trying them. I also cook heavy with bad cholesterol, lots of butter thanks to French friends, lots of salt in other dishes from others, lots of cheese, cured meats, smoked cheeses and meats, snacks etc. - My diet was never interestingly good.
After my US trip I realised that there is a small poisoning in a sense being taken over the consumption.
> My 2 cents: - eat as much vegetables as you want (learn to cook them, with a little bit of olive oil)
I'm not stereotyping here, my exposure to the collegues from the local area never cooked. This is fine, but when you replace good food for fast food, you start to go into that chain. They didn't know a good way how to peel an avocado, which I found out on a drunken night with them in my apartment. 10+ and none of them knew how to prep an avocado. But that is not their fault at all..
> It looks like this is hard to do in the USA
Spot on. I cannot stress this point enough.
You have to go out of your way to eat even moderately health conscious. This is a real shame. We will all take the easier path : 'Ah tonight I'll just get take-away, I'll just grab something on the way home.'
I grew up as a kid in Italy until I was 12, probably the only thing that I too away from it as a positive was that preparing, cooking and eating food is really not for sustenance.
Sustenance is the result, what matters is the social time, the prep is almost like a meditation, and the collaborative effort is like a social movement.
Food is really not just for sustenance. And I implore anyone reading this to try just cook a meal with friends, family or loved ones. It has a nice impact on way more than your sustenance intake.
Sugar is good, avocadoes have a lot of them, even the bad ones, but I would much prefer to enjoy my food than inhale it, in the US, it was seen as a time consumer.
'You are what you eat' - This expression didn't come from nowhere.
PS: 5 a day and the Pyramid might be wrong, there is no 1 scale for everyone. But there sure as shit isn't a cereal loaded with sugar for anyone.
What really annoyed me though, was the cost of it. To eat more natural, is more expensive than processing food. Odd.
Not really. Try a ketogenic diet. You can eat tons food (including tons of fat) and still loose weight.
Every diet that doesn't involve directly counting calories tricks you into restricting them in some way, putting you in a caloric deficit. Period. This is how every diet works.
This does not happen with fat, so it is harder to get fat by eating fat.
If you want to get fat, like a sumo ringer, simple carbs are the way to go.
I summarized some articles that dispel insulin voodoo here, if you're interested: https://www.reddit.com/r/Fitness/comments/j853z/insulin_an_u...
Insulin, being necessary for healthy human life, is certainly not "bad". However, a shortage (e.g. Type 1 diabetes) or excess (e.g. Type 2 diabetes) is certainly a problem. Given the current epidemic of Type 2 diabetes, metabolic syndrome, and NAFLD, triggering excess insulin production is certainly something to be wary of.
Also of concern is impinging on the glucagon cycle, and in the linked-to post there is no mention of the important function of glucagon, which is typically considered as having effects opposite to insulin. Maintaining the insulin/glucagon cycle is important in maintenance of a healthy metabolism.
The article makes a point about how "Insulin is not needed for fat storage", but omits the fact that in reality, practically all fat storage is mediated by insulin and its effects on glucose. Insulin mediates glucose transport and promotes absorption of blood glucose into the liver, fat and muscle cells. Once the liver has filled its compliment of glycogen, it will indeed produce fat locally. Non-Alcoholic Fatty Liver Disease (NAFLD) currently afflicts about 25% of the entire human population, and the linked-to author would have the reader believe that excess insulin production isn't an issue? Very strange.
All in all, this article paints a false picture of human metabolism. People eating a typical Western diet should be concerned or at least aware of the facts of that process, and be wary of having an excess or deficit of insulin; and should know that the excess case is the more common condition. A reasonable scientifically-accurate depiction of the process can be found, for example, in Jason Fung's books, "The Diabetes Code" and "The Obesity Code".
I don't see how this is a strawman. Click through to the source article, that bullet point in particular is refuting the common belief that carbs alone are what spike insulin. Most insulin-centric discussion on fitness forums (which is where this was posted) tends to mention insulin spikes in the context of high-GI carbs.
> Also of concern is impinging on the glucagon cycle, and in the linked-to post there is no mention of the important function of glucagon, which is typically considered as having effects opposite to insulin.
Read the linked "part 1". It specifically mentions that newer research shows that glucagon does not counteract insulin as previously thought, and links some studies.
> The article makes a point about how "Insulin is not needed for fat storage", but omits the fact that in reality, practically all fat storage is mediated by insulin and its effects on glucose.
That isn't really relevant to the core point, which is debunking the idea that insulin is what makes us fat.
I just want to restate the fact that the above reddit post is a summary of articles, which themselves are a summary of studies. It is targeted at fitness people who are discussing insulin only in the context of weight loss. There is of course an oversimplification here due to omitting details the target audience might not need as well as being 2 steps removed from the source material.
Likewise for his comments on glucagon, it does not "cancel" the effects of insulin, it rather has the opposite effect at the same time. Also, in a natural system (i.e. without intervention), secretion of insulin typically suppresses secretion of glucagon, with some rare exceptions. He's stating a supposed myth and then taking it down with another one.
The two papers cited for his interpretation of the role of glucagon are quite old, from 2001. There have been dozens of studies since then, confirming the role of glucagon in lipid metabolism, from many different perspectives.
Here is one published last year
"Collectively, emerging data support an essential role of glucagon for lipid metabolism."
There are dozens of others -- you can get a start on this reading by seeing who has cited the two papers he referred to.
I didn't understand that the main point was "debunking the idea that insulin is what makes us fat", since I don't know anyone who believes that. Chronic poor nutrition can make you fat, sure, and rising basal insulin levels tend to occur as a result of that, but saying "insulin is what makes us fat" sounds a lot like "yellow fingertips cause lung cancer". Nobody I know believes that is true. I have to keep up on these things for my work, in drug development.
Regarding "being 2 steps removed", yes, it seems like some "broken telephone" is going on.
Insane amount of people believes and promotes that. As in INSANE. Just check any sports/diet related magazine :)
> Maintaining the insulin/glucagon cycle is important in maintenance of a healthy metabolism.
No point in focusing on hormones so much. I somehow don't see people fretting over their ACTH or progesterone.
> Insulin mediates glucose transport and promotes absorption of blood glucose into the liver, fat and muscle cells.
If you look at data from humans - insulin IS NOT needed for glucose absorption. Studies on diabetic people clearly show that glucose gradient into the cell is higher, not lower, despite them being incredibly insulin resistant. 1st role of insulin in humans that's critical is shutting down liver glucogenesis and gluconeogenesis.
The problem with insulin/glucose narration is omitting the role of FFA. Intracellular FFA levels drive down the glucose absorption gradient. If the glucose absorption gradient is low and we still have glucose - that will stimulate more insulin release to drive that glucose level to normal.
Problem is that as more insulin is present cells eventually start being resistant to insulin requiring more insulin for the same job. Which makes for a problem because if insulin is there to shut down liver glucogenesis and cells are now more resistant to insulin - bad news, we need more insulin to get blood glucose to same levels with a meal that used to be no problem.
Adipose tissue is simply the number #1 a-hole here because it's usually the least resistant to insulin and the least resistant to nutrient storage since it's its primary role. It will just pack more in.
P.S. Isn't Fung a quack? E.g. https://www.myoleanfitness.com/evidence-caloric-restriction/
I respectfully disagree. When I go to USA or Mexico in particular, the frequency of obesity is astonishing. Perhaps with more understanding of the mechanisms around the phenomenon, there would be more success in dealing with the problem. As I mentioned earlier, around 25% of the entire human population has NAFLD, which is also an astonishing figure.
I'm not saying that every person must study these metabolic pathways in detail, but rather that the quick and simple rules and choices people make in daily life should take advantage of what is known, hopefully for a better outcome than what is currently observed.
> insulin IS NOT needed for glucose absorption
I'm not aware of anyone claiming insulin is needed for glucose absorption. The brain, liver, and red blood cells, for example, cannot function properly if they are sensitive to blood insulin levels; this may be because the RBC and brain rely on a steady supply of glucose, and the liver must be able to take up or release glucose on its own schedule.
On the other hand, muscle and adipose tissue DO have insulin-sensitive GLUT4 transporters. The GLUT family of transporters are passive, so glucose flows down its concentration gradient, unlike the sodium-linked transporters of the gut and kidney, which actively transport glucose against a gradient.
So in the case of adipose tissue, it does require glucose in order to store fat. The glycerol backbone for intracellular triglyceride synthesis is provided by glucose. In a person without diabetes, insulin is released from the vesicles when the body detects the amino acids leucine and arginine, or the sugars glucose and mannose. So typically, insulin will also be present, and having its usual effect on the GLUT4 transporters.
This is all covered, to some degree, in the appendices to Fung's book on obesity, by the way.
> Adipose tissue is [...] usually the least resistant to insulin and the least resistant to nutrient storage since it's its primary role. It will just pack more in.
Yes that is my point as well.
> P.S. Isn't Fung a quack? E.g. https://www.myoleanfitness.com/evidence-caloric-restriction/
No, Fung is not a quack.
It doesn't seem fair to even compare Fung's work with the claims of Myolean, because Fung is a trained scientist and knows how to read, interpret, and communicate scientific information in the traditional manner that others can understand. Even if Fung's arguments were wrong, at a superficial level he would be more persuasive because he knows how to use the language and standards of science.
However, examining the discussion in some details will reveal that Fung is correct in all the major points covering this topic, as best as is known at present. (Of course there are major unknowns when it comes to human metabolism, but there is also a lot that is known).
From the link you provided, it seems quite apparent that Myolean does not understand what a non-linear feedback system is (e.g. human metabolism), and doesn't understand the role of motivation and willpower (for compliance) involved in maintaining a calorie-deficient or calorie-neutral diet.
At no point does Fung say the laws of thermodynamics don't apply, but rather that they aren't very relevant when you incorporate the variability of basal metabolism, and motivation/willpower, into the model. One of Fung's major points is that in reality, when people try to follow restrictive diets, doing it in a way that leaves you constantly hungry, with low willpower, and continuously high insulin production leads to failure of achieving desired results.
Here is Fung discussing FFA .
Lastly, it would be easier to take Myoleanfitness more seriously if I didn't get the feeling they are trying to sexually manipulate me with a hit of dopamine and testosterone with their ads such as  and .
The point is, the substance of the Myoleanfitness argument is not even wrong, its just irrelevant. But the form in this case matches the content. Distracting and irrelevant.
I agree. I'm simply pointing out the fact that with the picture as complex as we know it is I have a knee jerk reaction to people going from "how to have normal BF%" to "ok, let's talk about insulin". It's the same thing with people talking about brain, attention span and productivity. 10 seconds into the discussions it's "dopamine, dopamine ... DOPAMINE"
> So in the case of adipose tissue, it does require glucose in order to store fat. The glycerol backbone for intracellular triglyceride synthesis is provided by glucose.
Yes. And? Glucose to some extent is always present in the blood. Drop the glucose low enough and brain will die. One could say that adipose tissue will always figure out how to store fat.
As we go on you reference Fung (and defend him) a fair bit. I'd like to take this opportunity to state the obvious. Jason Fung is a trained and certified nephrologist, book author, popular doctor and so on. He does not hold (to my knowledge) a PhD nor has he published any peer-reviewed studies.
Thus calling him a quack on my part was bad (I was pulling your leg a bit) but he cannot be considered a scientist either. He's an expert in his field but his books can't be considered textbooks on human endocrinolongy. He's allowed to have his own opinion but asking anybody to agree or disagree with his views without in-depth study of them is asking too much and he haven't (to my knowledge) presented them in the form of some kind of scientific paper it's not worth arguing whether he's right or not.
That being said - the link you provided on FFA is about cholesterol. I fail to see how that's relevant to discussion about FFA impact on insulin resistance?
Alas, to make my point. Obesity is certainly a multifaceted problem. Thermodynamics certainly matter, human psyche, inflammation, hormones - essentially all of that has its place. Looking from a systems point of view there's no reason (and probably there isn't one) to look for single causative agent though some certainly play a grater role.
In my experience both time-restricted feeding, caloric restriction and macro restriction work and have their place depending on the individual. Generally as a rule IF and low-carb are certainly good ideas, I'm not a fan of keto for everything.
I defend Jason Fung because he's one of the few in this area of science and medicine who has gone to the trouble of writing books that ordinary people can understand, and yet still have some scientific rigor. I could cite innumerable scientific papers that very few have the training to read, or the one author who took the time to write something anyone literate can at least follow along with.
There are hundreds if not thousands of researchers and practitioners in this area, so it is convenient to point to someone that anybody literate can read and rely on. His books (several of them overlap greatly) cite hundreds of papers, so that work mostly a compilation of other's work (as it should be).
> He does not hold (to my knowledge) a PhD nor has he published any peer-reviewed studies.
From his books there are some references to his published scientific work on fasting, diabetes, CKD, and so on. See also
https://scholar.google.com/scholar?q=jason+fung+intermittent... , https://scholar.google.com/scholar?q=jason+fung+diabetes ,
and https://scholar.google.com/scholar?q=jason+fung+pcos for examples.
I'm not sure what a PhD has to do with anything, most of my scientific work was published before I got mine, or even started it, as is common in industry and applied sciences.
> That being said - the link you provided on FFA is about cholesterol. I fail to see how that's relevant to discussion about FFA impact on insulin resistance?
I'm sorry you don't see the connection regarding FFA, perhaps you can re-read what he wrote and click through to the underlying reference to get a better idea (the title is "Fat Oxidation, Body Composition and Insulin Sensitivity in Diabetic and Normoglycaemic Obese Adults 5 Years After Weight Loss"). I couldn't find the text of Fung's book online, but the other paper he references in this connection is "The role of fatty acids in insulin resistance" (2015) which I did find online, here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4587882/ .
> Alas, to make my point. Obesity is certainly a multifaceted problem. Thermodynamics certainly matter, human psyche, inflammation, hormones - essentially all of that has its place. Looking from a systems point of view there's no reason (and probably there isn't one) to look for single causative agent though some certainly play a grater role. In my experience both time-restricted feeding, caloric restriction and macro restriction work and have their place depending on the individual. Generally as a rule IF and low-carb are certainly good ideas, I'm not a fan of keto for everything.
I agree in general. I think IF is fine, I'm favor of balanced diets not very low or high in anything in general, and I believe without regular blood work and expert supervision, keto is downright dangerous for most. Thermodynamics are present, true, but this is in practice perhaps not the most helpful perspective, since things like willpower, hunger, and sustainably maintaining a healthy diet matter more; the thermodynamic perspective fails to model the feedback control system that regulates the human behavior component. Nonetheless, I agree with the overall thrust of your comment.
Best regards, and thank you for the conversation!
> Insulin is not required for fat storage.
Insulin provokes fat storage, regardless of any other pathways that may exist. Spiking your insulin with refined carbs is going to provoke fat storage more than the equivalent caloric amount of fat.
> Insulin spikes do not create energy out of nowhere and don't suddenly make the same number of input calories multiply.
Unfortunately, this "law of thermodynamics" view of things is too simple.
> Also, insulin spikes are nearly unpredictable anyway. Carbs aren't necessarily the trigger, protein and fat can be too.
Fat has minimal impact on insulin levels. Refined carbohydrates can raise blood sugar very high, requiring a double dose of insulin to get back to baseline. Meals high in protein or more complex carbs will be somewhere in the middle.
> I summarized some articles that dispel insulin voodoo here
If there's anything that's being dispelled there, it's not something that I actually said. Seems like this is a pet peeve of yours and you're seeing someone else in me.
The two measures I take everyday are:
1. Body weight; and,
2. Waist size.
I use the following routine for weight loss (I've lost about 50kg, and have kept it off for several years):
1. You must have a diet to weigh less;
2. You must have a distinct diet to lose weight;
3. You must do low impact cardio — I walk 3-5 miles a day; and,
4. You must do resistance training.
Those four things have the following purpose:
1. Keep you at a stable weight;
2. Take off weight;
3. Increase background caloric burn from "super sedentary"; and,
4. Encourage fat loss over lean body mass loss.
All of this is requires routine. You must develop a routine for the rest of your life, and not vary from it. It also requires honesty: you need to be honest with yourself about what you're eating, when; what exercise you're really doing; when. And, finally, if you're overweight you're at the mercy of millions of years of evolution, but you're the victim of our modern diet. It's not your fault, but there is something you can do about it.
I play and follow golf and the big injury issue with Tiger that made him multiple surgeries, and also had to reshape his golf swing from the pain running caused. Here's an article about that from Running Magazine. There's more to the story on this, like his background and mentality on Navy Seal training, with his body type and high impact running it caused huge problems he's still dealing with.
As for funning form types, check out the video of Cliff Young and his running style for the Sydney to Melbourne race at 61 but shuffling.
What I'm saying, and what I'm glad you included, is the importance of cardio being low impacts, and to also not feel bad if you're not a running. Biking, and especially swimming are great alternatives and so much better on your body long term.
I still drink way too much so losing weight is an issue, but I do feel healthier at least.
Personally, I just do weighted squats & heavy deadlift, but if your knees are bad, that's a bad idea. You can chat with a PT for 50–80$ and they can tell you exactly what's wrong & how to fix it in less than an hour.
I did recently have two radiofrequency ablations done, which burned the nerves that were giving me considerable pain. So far it's been successful and my biking/walking/lightweight lifting routine has probably helped too.
That's a complete lie. Most PTs don't know anything about anything and will try to milk you for "motivating" you in your workout and keeping a notebook for you on a regular basis. Usually for at least $300-500 a month, even at horrible gyms. By no means will they be able to tell you remotely, let alone, exactly "what's wrong".
"Personally, I just do weighted squats & heavy deadlift, but if your knees are bad, that's a bad idea."
Yea, and guess what? There is no easy solution for this, let alone one provided by a random PT. It's a cascading effect - you have one injury, you can't address the muscle imbalances causing it.
As far as posterior chain weakness, there is also the issue of lordosis, which results in horrible squat form. Deadlifts do help, but again, there is the risk of hyper-extension.
In short, solutions to this are far, far more complicated than your post implies.
With IF, I lost about ~5 lbs doing nothing besides being more mindful. Once I added in daily runs / walks of ~4-5 miles, I lost another ~10 lbs easily.
I think the biggest challenge for people looking to lose weight is mindless eating / snacking. Initially I kept a diet journal and wrote down everything I ate or drank, and realized I would get more snacks throughout the day than I thought. I also drank a lot less water than I thought.
The other thing is portions. When I was at my largest, the portions I would set for myself were larger, and I would more often get a second round. All without really thinking about it, of course. Now I deliberately think about how big of a portion is appropriate and I never go for seconds except on some cheat days.
One other thing I realised post-lockdown is just how much I relied on exercise to keep my back/posture in check. I used to climb regularly, though I slacked off on the cardio. Since quarantining, I've done a lot less resistance exercise and it really shows. One day of poor posture - e.g. hunching over a workbench, or working from a non-optimal place like bed or the couch - is enough to cause quite a lot of backache and it only really goes away after doing some exercise (far more effective in my experience than icing/heating/NSAIDs). My plan is to get back into bodyweight/calisthenics ASAP.
(Very interesting article by the way, the subway map would make a great poster)
For me, the key to staying hydrated is large containers.
When there is a glass of water on my desk in front of me, I sip it as I get thirsty. When it runs dry, I don't interrupt my current task to refill it, so it might sit empty for hours, and I won't drink enough later to make up for it. So, the fewer times I have to refill, the more water I drink.
In college, when I moved between many locations, I used a 1-quart canning jar in a knitted sleeve (classier and a little fall protection -- just remember you still have to wash it). These days, it's a 1-liter jug (err, may technically be a vase) that sits on my desk. I refill it in the morning (or night before) and once in the middle of the day, after it runs out.
Whereas if you workout daily even in a minimal form, suddenly you have a much easier budget.
For me, snacking was fixed by not buying snacks that I would consider too unhealthy. Generally the only snack foods I have in my house now are biscuits to dip in my tea in the evening (British..). Also I've never really liked fizzy drinks and pretty much drink water and black coffee (soya milk once a day for the B12 and protein).
I do agree with the biggest thing for me being portion size, I'm one of those people that if there's food on the table I will finish it, and I'll finish my wife's food as well if she doesn't want it. My wife also doesn't help as if I mention I'm hungry to her, she'll assume that I want more than usual and have to try and remind her that the usual amount will be more than enough :)
I want a scale without a screen and a measuring tape without numbers. Track often but only see the trend when you ask for it.
In my experience, the trick with body weight is that you actually do have almost perfect control over the day to day.
Assuming you take it in the morning before breakfast and after the bathroom, it's almost a pure function of your weight yesterday and the caloric balance from the day prior. If you control your caloric balance with diet and exercise, you can predict your 1-2lb swings (aka constant swings) pretty accurately.
The featured article tried and failed to do exactly this. As in, not just the magnitude but even the direction of the swing was often estimated incorrectly. My guess is that you would need to be very careful about accounting for water.
Traditional Japanese meals follow a standard format : a bowl of rice, several small sides (which can change by the day), and an optional cup of miso soup. Sticking to this format every day can be boring, but it keeps my diet reasonably balanced without the need for conscious efforts like counting calories (which I'm too lazy to continue long-term).
I think in modern cities we have too much freedom with regard to what we eat, which is great of course but the downside is that we’ve lost a great deal of local culinary tradition, and along with it intuitive understandings of what is and what isn’t healthy eating.
I don't think we've lost anything; it's just that, in an era of cheap economies of scale from mass-production, artisanal anything (including artisanal cooking) is going to cost more—possibly enough to put most "authentic" / "traditional" cuisine out of reach of the working class, unless they're willing to make it themselves. (And who has the time for that?)
If you live in a city, look through restaurant reviews for a couple minutes and you'll probably be able to find a dozen local places in your own neighbourhood that have been open for 80 years or more, keeping up the tradition of serving the same food, the same way, that they always have. The only thing that such places have changed between then and now, are their prices.
> Despite its long history in Japan rice was, for a long time, a food reserved for the warriors and the nobility. It was consumed by the majority of the population only from the seventeenth century onwards, not becoming the basis of Japanese food until the early twentieth century
> A disproportionate share of the rice crop was therefore consumed in the cities and by the political and economic elite, while the diet of much of the rural population continued to depend on the availability of a range of other grains – wheat, millet, barley, etc. – together with vegetables, fruit, pulses and occasional fish or game, grown at home or collected in the locality.
As far as I'm aware, all the current medical literature states to avoid simple carbs (like white rice) to prevent insulin spikes, and to eat things like whole grain breads instead. But, we noticed that this seems to only be true for people of European descent - my Asian co-workers were able to process white rice just fine. Which kind of makes sense - East Asian people eat a ton of rice, and yet they're thin.
This is all purely anecdotal of course, and I'm not a doctor, but we do know that different ethnicities process food differently (e.g. lactose), and it's not so hard to imagine that our current dietary recommendations might be a bit skewed, because the people in the datasets are mostly of European ancestry.
But it's supposedly healthier (there's a famous story about how eating too much white rice crippled the Japanese navy ), and personally I think it tastes better too.
I've had great success losing weight and keeping it off with food logging (shout out to Cronometer, the best food logging app I've used), trying to adhere to a keto diet, and time-restricted feeding (18 hours fasted, 6 eating). If I tried to do an ancestral diet instead, I'd fail primarily from ignorance of just what that might be. (Also, I'm from the southern US, so it's not like that ancestral diet is necessarily good for me anyway.)
For example, cooking rice is simply a matter of putting rice and water into the cooker and pressing a button . In the past we needed to first rinse the rice by hand.
I appreciate this honesty
For example, I've been losing weight and doing body-weight training the last month-and-a-half and a picture of my body now vs. then shows a fairly drastic change. But I can' say that I feel like I weigh less or feel that I'm stronger. Though, the scale and reps of exercise that I can do say otherwise. Every day starts a "new normal."
This has been my biggest struggle with health. I've always had troubles with autobiographical memory and without it, I can't stay motivated because I quickly forget how good exercise felt or how junk food made me feel a few hours later. I started going to the gym to dogfood when I joined a fitness company and within a few months I was looking a lot better but not feeling it. It wasn't until I started to really push my limit with rowing workouts that I felt the "runner's high" athletes talk about. From that point on, it was felt like I was discovering a new muscle group every few weeks and correlating how far I rowed in a 60 minute rowing session with my diet and lifestyle. Junk food that I would scarf down because unappetizing. Drinking alcohol went from a no-brainer to "how will I feel tomorrow?" Morning stretches and exercise became mandatory just to feel "normal."
Even now, with the gyms closed for months, I can feel that newly acquired skill slipping and predictably, my self discipline slides too. I've almost forgotten how good it feels after a nice workout.
For me developing this skill was a necessity after I encountered frequent headaches from eating and drinking the "wrong" things. I was basically forced to take my awareness of general overall wellbeing up a notch to really figure out what was causing them. Noticing small signs became important to prevent being sidelined from life with a nasty headache.
I have it down pretty well now and there are certain very small, but distinct, signals and feelings that tell me when headaches are coming so I can work to prevent them.
Anecdotal, but I've talked to lots of acquaintances about this and no one seems to understand what I'm talking about. I've also been meditating for 4+ years perhaps that adds to the heightened awareness.
I don't want to say that people are "unconscious" but is sad that many are missing out on a more nuanced experience of life.
Right? I've noticed my own mental health is slipping and I'm certain I can track it to things closing, me working from home more often, and my eating worse.
The unknown and anxiety around the start of the lockdowns and pandemic made me gravitate towards the 'comfort' foods and it's been a slow decline in mood and physical health since. Thankfully I've started to recognize this and remember how I felt before the start of all this so now I'm slowly working towards that point again.
> Your comment seems to imply that it didn't help.
Not that, so much. More that it'd be disingenuous for me to say that I noticed that exercise had a direct impact on my mental health. Cutting down on my consumption of alcohol (a lot) has probably had the most direct link to increased mental health, for what it's worth.
> Would you recommend picking lifting/running up?
Yes, indeed. It's undeniably good for your body. Just... don't go in with the expectation that it's gonna be an immediate mood-booster, though. If that does happen, great! But expect the actual (and measurable) rewards to be increased strength and endurance. Be happy with that. :)
I've been prescribed medication, but never got it filled (didn't like that prescribing meds was the default "fix"). Been close to going to therapy, but haven't (I'm skeptical of certain therapist's qualifications and I don't think I can really afford it long-term). So far, I've been able to live with my malady's. Just...REALLY uncomfortably on occasion. But if you can afford it and have the time, then you should definitely make use of those resources!
When I stop training, I quickly feel sluggish, with brain fog, muscle knots, difficulty sleeping, etc.
This is mostly a reminder to myself that my body wants movement and good nutrition, and that lapses are not worth it.
While I agree that there is way more to "being healthy" than just not being overweight/underweight, I think it isn't a bad idea to approach this in the priority order. Solving the issue of being overweight is much simpler and much more impactful to the overall public health than trying to go after more rare and difficult problems.
If your goal is to minimize the total number of health problems in your country, it would make sense to throw more efforts at a problem that affects 47 times more people, given that everything else about the problems is about equal. We are not comparing cancer to heart disease here. We are comparing two problems that are two sides of the same coin.
Everyone tries to compress a workout into a single time interval in the day, where you do n sets of each exercise and then go home. To do three sets in three minutes, you're going to have to pick a very conservative goal. Doing 5 sets spread out over the entire day, I could lift more and saw results pretty much right away, and really for the first time. I'd exercise while waiting for things like the drier to ding or toast to pop up, a file to download, a commercial break or a cut scene to finish. But, I had to have exercises I could do at home, which takes some creativity (or a lot of money).
Your body is conserving resources. The whole point of 'exercise' is to trick your body into thinking that you are an active person who needs to spend the extra resources to build and maintain large muscles, cardiac or lung capacity, or all three. If you are actually active you don't have to 'work out'. Your life is work, and your body adapts.
Once I got past that initial roadblock, I got results even from the gym, but I was able to be more consistent doing it at home.
The trouble with putting on a lot of bulk though, is if you stop. Exercise burns a lot of calories. Persistent exercise therefore changes your notion of what a 'normal' amount of food is. If you stop, it probably due to some major life event, and adjusting your notion of 'normal eating' might get lost in the mix. Which is probably why a lot of pro athletes chunk up when they retire (or get retired). Going from 3-4000 calories a day to under 2500 is quite a lifestyle change.
For anyone interested in learning more about this, it's called "greasing the groove". There are plenty of web articles about it, and it's also covered pretty thoroughly in the book _Overcoming Gravity_ by Steven Low.
Pullups are the trickiest. At the time there was a staircase with open treads near my apartment.
edit: Caution: don't start on squats without coaching.
It took 2 months of rereading the squat chapter, filming myself, correcting myself, etc, before I finally got that one down. Now that I understand it, I can spot faults in others, but it took a while for it to click. Rereading the dbook helps, though a couple of Rippetoe's coaching cues set me on the wrong path. A starting strength specific coach can straighten you out in just a couple of sessions. DON'T think any other certification, personal trainer, or coach is a substitute, they are NOT.
Don't do starting strength for a year. (If it takes you that long to do the novice linear progression, you are definitely doing something wrong.) Rippetoe's advice for intermediates is pretty marginal IMO and you can't possibly stay a novice for a year doing the program.
Switch to Barbell Medicine's "the bridge" instead of resetting the weights a second time.
That said, I recommend against people teaching themselves deadlift, because it's not nearly as intuitive, has more potential for injury, etc.
Another funfact is that you can literally go to bed for a few weeks, let muscle atrophy kick in, and lose more weight than any diet+exercise regime. Won't make you healthier, but you'll lose the weight. Yay metrics!