October 29, 2007

What Taubes Has Proven and What Remains to be Studied

Thinking over the Taubes book, Good Calories, Bad Calories, I've been struck by two things: What he has proven and what it is that he didn't discuss that is just as important as what he did.

What Taubes Proved



1. Taubes proves beyond a shadow of a doubt that the quality of nutritional research published in mainstream journals over the last 50 years is abysmal

2. Taubes proves beyond a shadow of a doubt that the Cult of Personality allowed politically powerful experts to impose their theories on the health community even when the research did not support their theories.

3. Taubes proves that the belief that eating saturated fat causes heart disease has never been well supported by the data and that cutting back on eating fat and replacing fats with carbohydrates has never been shown to reduce the incidence of heart disease.

4. Taubes proves very solidly that the belief that a low fat/high carb diet prevents cancer has never been supported by any well-conducted research and that, in fact, it is possible that lowering cholesterol may promote rather than prevent some cancers.

5. Taubes proves that most of what "everyone knows" about the causes and treatment of obesity is urban legend and that the findings of the better obesity researchers have been ignored because they do not support the dream that self-control and exercise are all it takes to solve a serious weight problem. In this he pretty much agrees with Gina Kolata's conclusions in her review of obesity research, Rethinking Thin and with what is documented in the even better review of Obesity Research, Fat: Fighting the Obesity Epidemic, by Robert Pool.

The better research seems to show that losing weight once it has packed on is extremely difficult verging on impossible and that Taubes is very right that we need to understand what disorders the metabolic controls that prevent weight gain, because once they are shot, very little helps.

6. Taubes points to some good research suggesting that the huge increase in fructose intake from sugar (sucrose) and high fructose corn syrup may contribute to weight gain and heart disease. Unfortunately, there isn't enough rock solid research to conclude this categorically.

7. Taubes points to some good research suggesting that high triglycerides caused by eating too much fructose may disturb the systems used to regulate metabolism and lead to the accumulation of unnecessary fat.

8. Bottom line: There is a great deal we just don't know about the relationship of diet and health and the best way to deal with obesity. That is because so much of the research done over the past 50 years is of very bad quality, and that this research then gets recycled in "meta studies" that are treated as if they could somehow surmount the serious flaws in data in the studies used to create the meta studies.

Real Progress Could Come From Admitting How Much We Don't Know



Taubes anoints a low carb diet as the solution, but those of us who have been deeply involved with low carb diets for many years and who have gone past the religious conversion stage of low carb dieting know that low carb diets do not solve most people's weight problems and that there are significant problems that keep people from sticking to them long term.

To blame long term low carb dieters for their failure to stick to the diet, blaming either weakness of will or the very suspect concept of "carb addiction" is to fall prey to the same blindered "I know it's true so I'll ignore anything that suggests there are problems" attitude that let the failed low fat diet rule for so long, even though it rarely worked.

My own experience over almost a decade of involvement with the online diet and health community is that Low Carb advocates are just as religious about their beliefs as are the low fat people. They, too, ignore data that does not fit the conclusions they'd like to believe are true.

Low carb diet advocates get angry and abusive if real issues are raised, for example, the slowing of the metabolism on a on long term low carb diet. I've been shunned in more than one online community for raising this issue, and the related issue of possible thyroid problems which is the main problem that got me to stop my very low carb diet after sticking to it for 3 years the first time and 2 the second time.

My take on it for now is that Low carb dieting is more effective than low fat dieting for many people with blood sugar abnormalities, but it does NOT solve all their problems, and maintaining weight loss over time can become very tough as is the case on ANY diet.

Eliminating sugar, fructose, and corn syrup, did not solve my weight problems years ago though I did it for 3 years. It is not a magic bullet. In fact, if 75 years of diet research has done anything, it should have been to teach us there are no magic bullets.

What Was Left Out May Be As Important As What Was Put In Taubes' Book


Some issues that Taubes did NOT discuss that haven't been researched enough and probably won't be, which have a huge impact on health and obesity are these:

1. The impact of the skyrocketing use of plastics to wrap and contain food over the past 25 years on obesity. We know that phthylates seem to have a negative impact on health, but very little research has been done on this huge issue which is one of the biggest changes that has occurred during the period in which obesity rates have leapt.

2. The impact of various chemical additives used in packaged foods and fast foods on obesity, cardiac health and cancer. The list of preservatives and mysterious sounding additives like "dough conditioner", "texturized protein,", "hydrolyzed plant protein", as well as the many other chemicals used in prepared foods and restaurant foods is much longer than it was 50 years ago.

Few of us know much about these chemicals. Even worse, we do not know anything about the chemicals that don't appear on the label but may be in our food since so many food additives are imported from China where they are polluted both intentionally and accidentally, especially with the industrial chemicals and pesticides in Chinese water.

3. The impact of pesticide residues in our foods on our health and the mechanisms our body uses to maintain weight homeostasis. Our foods are full of pesticide residues and there is for all practical purposes NO EPA oversight in this area anymore.

4. The impact of industrial chemicals which are found in our air and water and get into our foods as they grow.

5. The impact of hormones and hormone mimics in water supplies which have become significant enough to cause sexual changes in some fish and amphibians exposed to them.

6. The impact of changes in the amount of exposure to radiation including X-ray and microwave radiation.

7. The impact of adding soy and soy byproducts to almost all prepared foods, even things like bread. The dangers of soy are well described in The Whole Soy Story by Kaayla T. Daniel. This book is as well researched as Taubes' book and it should be MUST reading for anyone who cares about food and health. Daniel shows the same pattern of fatally flawed research was used to turn an industrial byproduct into a supposed "health food" and documents a long list of serious health problems caused by soy in our food.

If obesity is caused by gluttony and sloth rather than poisoning from plastic soda bottles, soy in our foods, pesticide residues, and industrial chemicals people can feel safe.

But if obesity and metabolic diseases are increasing at a frightening rate because of the emergence in the mid 20th century of plastics, pesticides, and toxic clouds of industrial chemicals which saturate the air and soil, no one is safe--though industry is not going to want to pay the price for making the changes needed to end the "epidemic" and industry has so corrupted our politicians that you won't ever see this issue getting any press. Which is one reason why any theory that blames people who are experiencing metabolic failure on those people's moral failings is going to continue being attractive to the people running industry and government

Meanwhile, the mainstream response to Taubes' book seems to be mostly petty debates about his interpretation of this or that cited study rather than an acknowledgment that his main finding is very true: most of our nutritional and health research has been sloppy crap and WE DON'T KNOW SQUAT ABOUT THE STUFF THAT MATTERS.

11 comments:

mscriver said...

Don't forget about our feedlot cattle that are deliberately fed and injected in a way that will force them to be fat -- substances that are eventually eaten by us ourselves.

Ideally, I think we should not eat cattle we don't personally know, which is easier in rural Montana.

Prairie Mary

Andrea said...

Jenny,

Thank you for slogging through Taubes' book to give us these highlights.

Jenny said...

Andrea,

Thanks! These are the points I took from the book, but I would hope that anyone with an interest in the subject of nutrition would read it themselves because they may find a lot of other points that are significant to them, though perhaps were things I already knew about and hence didn't find all that interesting.

Prairie Mary,

My other half grew up on a Dairy farm and reports that he did not like eating cattle he personally knew, especially the calfs he'd helped raise. Different strokes. . .

paul said...

Could you say more about the low-carb and thyroid connection? Do you mean low-carb can precipitate such problems, or that it can exacerbate them? (I haven't seen this link being made anywhere else...),
Thanks,
Paul.

Jenny said...

Paul,

Lyle Macdonald first mentioned thyroid slowing in his book, The Ketogenic Diet.

Michael Eades had this to say on Fran McCullough's Site: "As to your question about thyroid activity: reduced carbohydrate diets (and reduced calorie diets) sometimes decrease the activity of the enzyme that converts T4 (the inactive form of thyroid hormone that is released from your thyroid gland) to T3, the active form. We sometimes give our own patients small amounts of T3 during the weight loss phase of the program."

He also said this on his own web site, but then deleted it, and when queried a year ago, denied ever saying it. Clearly, though, he did.

Anonymous said...

I strongly suspect that the body's need for thyroid hormone declines when carbohydrate consumption is reduced, even in the absence of weight loss. I have a dead thyroid, and the levothyroxine dosage required to keep my TSH in the range where I feel well went from 125 mcg/d to 112 when I reduced my carbohydrate intake to control blood sugar. (Prior substantial weight loss had already lowered it from 137 to 125.) Studies of caloric restriction and intermittent fasting also suggest a reduced requirement for thyroid hormone when fat replaces glucose as the primary fuel for bodily functions. In other words, it's physiologic, not pathologic.

Jen

Jenny said...

Jen,

That would not explain why I and other people whom I have heard from report exhaustion and debility after 2-3 years of low carbing which resolves upon raising carb intake.

Also, it doesn't explain why Bernstein reports that he often needs to threat sudden thyroid disease in his long term LC patients. He claims is it because of the sudden development of autoimmune Thyroid disease, but I don't buy that explanation. I don't have autoimmune diabetes but I have experienced the exhaustion problem.

Until this problem is better understood, there will always be a subset of people who "fail" on LC. By ignoring it, or blaming people who suffer it, we do not advance the cause of improving health!

paul said...

The thyroid and exhaustion-after-a-few-years issues seems to fly in the face of the paleolithic diet argument - that low-carb is the diet we evolved to eat, and therefore the best possible diet for humans. Also didn't Stefansson's eskimos have notable physical resilience. It is surely the case, though, that most western low-carbers started life with a typical high-carb diet, and conceivably it is people who switch to low-carb, rather than lifelong low-carbers, who are suspectible to the problems.

paul said...

p.s. i meant susceptible! maybe one year of low-carb has made me dyslexic :)

Unknown said...

One of the big ommissions in both lists is the chronic shortage of omega-3 and overabundance of omega-6 in typical western diets. Because grain is almost all omega-6, the rusult is that meat, dairy and eggs are high omega-6, low-omega-3.

Omega-3 helps reduce inflamation, is a critical part of the glucose/insulin metabolism, increases insulin sensitivity, and improves brain function.

I wonder if this lack of omega-3 plays a major role in starting the spiral of insulin resistance that leads to gaining weight and an ongoing higher rate of damage with age.

v/vmary said...

1.) I do not understand the insulin hypothesis of obesity put forth by taubes. is he saying that high production of insulin is causing fat gain? then why can people with insulin insufficiency still gain weight easily? if they produced normal amounts of insulin, they would be even fatter??

2.) also, do you personally do anything to mitigate chemical exposure? I have recently started buying sardines in bpa free tins, and I don't eat a lot of canned stuff anyway. I used to buy black olives in cans, but not I buy the green ones in glass. I don't have a water filter or anything, though.

3.) maybe higher consumption of wild caught seafood would lessen exposure to chemicals to some extent since, although the ocean is not pristine, sea life living in it (not farmed sea life) will have not have the toxic load of animals injected with hormones and fed with chemical-laden feed.

4.) have you heard of reliable ways to test your water and soil quality? you could have your own garden at least in the summer, but if your soil is filled with toxins, you have not really helped yourself as much as you think.