A Diet Manifesto: Drop the Apple and Walk Away

NY Times ^ | December 27, 2010 | ABIGAIL ZUGER, M.D.

[neverdem]

Another year ends, and still the war drags on. In the final salvo of 2010, the combatants are lobbing fruit.

Not literally, of course, though they might like to: The long war of the weight-loss diets has aroused passions just about as overheated as those of any military conflict.

How is a person best advised to lose extra weight and retreat from diabetes and heart disease? Count calories, cut fat and fill up on fruits and vegetables? Or turn instead to a high-protein, high-fat...

--snip--

In the opposite corner we have Gary Taubes, the science journalist who has thrown in his lot with the high-fat, high-protein crowd, arguing in his new book that the overweight should just put down their apples and walk away: “If we’re predisposed to put on fat, it’s a good bet that most fruit will make the problem worse, not better.”

But those who are curious about the science behind it all could do worse than to pick up Mr. Taubes’s book “Why We Get Fat: And What to Do About It.”

--snip--

And the only one of these hormones under even a smidgen of voluntary control is insulin. At this point Mr. Taubes merges onto the narrative highway traveled by all low-carb advocates: The body’s insulin levels are largely determined by ingested carbohydrates, and for some people the high-carb foods that stimulate insulin secretion and cravings for more high-carb foods are, in this worldview, just so much poison.

So that apple — a filling package of fiber and vitamins to the Weight Watchers folks — is just a serving of fructose to Mr. Taubes. Fructose is the problematic sugar our bodies turn to fat the most readily, and if you are programmed to be fat, an apple will make you that much fatter...

[dsc]

“reflects established scientific fact”

Yes, like global warming does.

If you want a fact, try this one: research into other causes of obesity is underway in many different places. And they’ve found some.

Perhaps what you say is true for you. There are millions for whom it is not.

I wouldn’t wish it on you, but if you were suddenly to discover that the amount of food and exercise that had been allowing you to maintain normal weight now caused you to gain weight, as did less food and more exercise, and even less food and more exercise, and still less food and more exercise than that...if that were to happen, then perhaps it would occur to you that there are differences among people, that what is true of you might not be true of everyone.

Unless and until something like that happens, just enjoy the smug.

[grey_whiskers]

Blood type A- here. Had no problems with Atkins. But "intermittent fasting" works better, faster, and healthier.

Late to the thread as usual, sorry.

What is this "intermittent fasting?" I've heard of a diet program where one does near-total-fast one day, and eats to satiety the next, (modified caloric restriction) and the pounds just drop off...

Is this something similar?

Cheers!

[grey_whiskers]

I’ve seen recipes for adding a habanero pepper to vodka for a little heat.

You might enjoy Cave Creek Chili Beer.

Cheers!

[A Navy Vet]

"Demonizing one macronutrient or another is a common trait of diet fads."

Point taken and that is why I'm so interested in what a professional nutrition doctorate has to say.

However, as "aruanan" posted and has been long proven there is a difference in how the body uses those macro-nutrients. There is a difference in carbs (simple vs complex); there is a difference in fats (healthy vs unhealthy - think olive oil compared to lard); smaller difference in protein (amino acids) unless they have a bad protein to fat ratio. Think lean meats.

I agree with him that lean protein is the best for our ancient metabolism and that processed carbs are not so good. "Clean" fats are good; bad fats contribute to our triclyceride counts.

C'mon, apples bad? Really? Twinkies good, really?

Let me end my input by stating the mediterranean and Alaskan Intuit diets produce the longest living people. Why? Because of fish diets that include pure protein and healthy fats (Omega 3 acids). If you want to argue that med peoples eat lots of pasta (carbs), remember they also drink lots of red wine, which has resveratrol that is now known to be one of the best anti-oxidants ever.

Thinking I will have another glass of red wine...haha! Or better yet, some vodka to thin my blood...and kill more brain cells so I will make even less since next time around - har! Best.

[Eagle Eye]

You were a self confessed beer swilling, pizza eating orca, right?

When you look at Raymond Burr, Alan Hale, Ed McMahon, Jackie Gleason, etc nowadays they don’t seem worthy of all the fat man jokes they endured back in that day.

Not considering the number of 300 pounders in high schools.

And fwiw, only inferior humans find me smug or arrogant or condescending.

It truly is my humility that keeps me so great!

[SunkenCiv]

Thanks neverdem.

[Darnright]

>you can choose to believe Taubes if you'd like. But Taubes is a fraud who learned how to sell books a long time ago. Taubes is a proponent of the Atkins diet – a dubious dietary strategy not based on scientific evidence<

If what you wrote above is absolute fact, how do you explain the following? Notice that this 3rd edition is dated 1864

Letter on Corpulence by William Banting

My grandfather was a doctor. We had some of his papers and one of them was a diet for diabetics, which stressed avoiding sugar, bread, noodles and other starchy foods, while eating meat and lots of green vegetables. That, in a nutshell, is the Atkins, or low carb diet. So, the information is not new at all.

Gary Taubes' book is one of the most well researched books I've read. He has page after page of references. He is absolutely no fraud and I defy you to prove he is. Prove it, not just bleat that "he follows Atkins".

[grey_whiskers]

One could argue that an additional energy-intensive process, fat synthesis, or an increase in this process, would, for the same amount of excess energy intake, result in decreased fat deposition due to the higher energy costs in maintaining the synthesis.

Hast hit it, friend wiggle.

Next couple o'questions...

1) Is it possible that the body keeps track of its amount of brown vs. white fat, exercise levels, and both TOTAL caloric intake and % of protein / carbs / fat, and then decides how much food to absorb, or to process for energy once absorbed, instead of excreting it unused? I.e. is the number of calories your body "sees" when deciding to become overweight, necessarily the number of kcal which would be released by oxidizing the food in a bomb calorimeter?

2) How well quantified are the various metabolic energy pathways? Can the body "deliberately" change to more or less efficient was of burning up your food depending on the amount of white / brown fat and your diet? Can one reset these markers over the short or long term by tweaking the *composition* of the diet rather than total calories?

Cheers!

[grey_whiskers]

I am definitely going to read “Good Calories, Bad Calories,” and soon.

Worth a read -- I read it about 12 months ago.

The thing is, in keeping with your earlier post about "the sumg is choking me" -- this book is definitely a refutation of the smarmy public service "The More You Know" ads. Acquiring the knowledge in the book does not give you the willpower to put it into practice.

My personal take is that the book is a good step forward but is not yet an accurate portrayal of weight gain -- I think there are still a number of what Rumsfeld called "unknown unknowns" lurking about.

Your mileage may vary.

Cheers!

[aruanan]

1) Is it possible that the body keeps track of its amount of brown vs. white fat, exercise levels, and both TOTAL caloric intake and % of protein / carbs / fat, and then decides how much food to absorb, or to process for energy once absorbed, instead of excreting it unused? I.e. is the number of calories your body "sees" when deciding to become overweight, necessarily the number of kcal which would be released by oxidizing the food in a bomb calorimeter?

The amount of brown fat in adults is very small. It serves a purpose in infants and small mammals by allowing a futile cycle in which heat versus ATP (etc.) is generated in order to keep the small body warm. It does this by uncoupling the mitochondrial electron chain from oxidative phosphorylation. The reason the fat is brown is because of a high number of mitochondria. The body does count calories and there is a lot of spontaneous adjustment between intake and expenditure in younger adults. The older you get, the less robust this coordination. In one study younger men who were either overfed or underfed for a relatively long period of time spontaneously adjusted their intake to gain or to lose weight to get back to their original long term weight. Elderly men either stayed underweight or overweight after the period of under or overfeeding. Once you ingest something, you're stuck with over 98% of its nutritive value unless you increase your energy expenditure or decrease your subsequent food intake. You can't excrete absorbed macronutrients you "don't need."

2) How well quantified are the various metabolic energy pathways? Can the body "deliberately" change to more or less efficient was of burning up your food depending on the amount of white / brown fat and your diet? Can one reset these markers over the short or long term by tweaking the *composition* of the diet rather than total calories?

The different metabolic pathways are about as well characterized as anything in science. As I said before, outside of mice, voles, shrews, and infants, there isn't a whole lot of brown fat activity going on. It may be that those folks who can eat anything without gaining weight have a higher percentage of brown fat. But it would be a really, really bad thing to be able to increase people's quantity of brown fat. It sounds good, but what it really means is that it would take a much larger food budget to do exactly the same thing. The rest of the food is getting burned up in a futile cycle to produce heat. Increase everyone's energy expenditure by 20% and you've essentially increased the world's population by 20 percent. Can the world's farms take such a hit? The point of shifting substrate oxidation appears to be an automatic way the body has of dealing with greater or lesser relative amounts of macronutrients in such a way as to protect the body's health. Sure, increasing obesity may be a bad thing, but it's not as bad over the same length of time as glycosylated proteins from too high a blood serum glucose level.

[decimon]

BTW, I should have used a plate of pasta as a contrast with saltine crackers for differences in glycemic index.

FWIW, here's the story I got for cooking pasta 'al dente.' It's for workers. To make the food last.

The idea is that the fully cooked exterior of the pasta burns off quickly while the less cooked interior must first absorb water in the stomach. That helps to make you feel physically full for longer and effectively time-releases the carbs to be burned for energy.

[decimon]

Thanks. Nice fructin’ brawl going’ on in this thread.

[dsc]

“You were a self confessed beer swilling, pizza eating orca, right?”

When I weighed 155—165 lbs, yes. When my metabolism changed, possibly if not probably due to the onset of insulin resistance, those habits had to change.

You just can’t face the possibility that anything besides a person’s own wrongitude could be the cause of his fattitude, can you? It’t not a reasoned position with you; it’s a cult.

[dsc]

“And fwiw, only inferior humans find me smug or arrogant or condescending.”

Not so. And *that* is settled science.

[dsc]

“I think there are still a number of what Rumsfeld called “unknown unknowns” lurking about. Your mileage may vary.”

No, that’s my opinion too.

[neverdem]

Demonizing one macronutrient or another is a common trait of diet fads.

I never studied the Adkins diet in any detail. From what I've read, it's big on meat. I'm supposed to recommend initially the DASH diet and exercise for folks with high blood pressure.

If you enter Volek JS, Feinman RD into PubMed's query box, then you'll do an authors' search on two writers who have written at least 10 articles in the professional literature showing the benefit of carbohydrate restriction, especially for type 2 diabetics and those with metabolic syndrome, aka syndrome X.

I'd love to see a double-blinded, isocaloric diet, testing soft drinks sweetened with sucrose versus high fructose corn syrup. I don't recommend artificial sweeteners either: Artificial sweetener tied to weight gain

[Wonder Warthog]

"What is this "intermittent fasting?" I've heard of a diet program where one does near-total-fast one day, and eats to satiety the next, (modified caloric restriction) and the pounds just drop off..."

That's the one. It's a bit more flexible than that, but that is the gist of it. It goes by a lot of slightly different approaches, but fast/eat is the gist of it. My current regime is to fast/eat 20/4 (eating window from 4-8pm) on MWF, and "just eat normally" during the 4-8 window and TThSS.

I've dropped from 237 to 221 in the last three months, and find it to be FAR easier than any other approach. Best single site I've found is www.leangains.com, but searching on "intermittent fasting" gets lots of info.

The biggest shocker for me is just flat not being all that hungry, having higher energy, and better mental clarity on the fast days, effects I simply just did NOT expect. I have a tendency towards hypoglycemia (reactive, not chronic), and no problems with blood sugar, either.

[Eagle Eye]

Dare I say that you are proof?

Darn, now you need a hug I’ll bet.

[mickie]

I bet it was Topomax.
I changed doctors and the new one took me off nuerotin and put me on topomax and I quickly lost 30lbs.
I then joined WW and lost another 20lbs and now am 10lbs from goal.
Great way to start the New Year.

[dsc]

“Dare I say that you are proof?”

As Sir Arthur Conan Doyle wrote, “Mediocrity knows nothing better than itself;” so, sure, you don’t have any better sense than to say something like that. The mediocre never do.