Feeling Full
For all its 8,000 words, there were few actual data in the Taubes piece. It was rather like reading a treatise explaining how the Chicago Cubs may well be the best team in baseball history without being informed they haven't won a pennant since 1945. Instead readers were regaled with explanations of physiological mechanisms -- the basis for which, Taubes wrote, is "Endocrinology 101" -- that might explain how dieters shed pounds and inches. Endocrinology 101 is a term popularized by Dr. David Ludwig, who runs the pediatric obesity clinic at Children's Hospital Boston.
According to Taubes, Endocrinology 101 "requires an understanding of how carbohydrates affect insulin and blood sugar and in turn fat metabolism and appetite." In brief, it says there are aspects of a high- or low-carbohydrate diet that affect both how much we want to eat (referred to as "satiety") and how efficiently the body converts the various nutrients into body fat. And the theory says an Atkins-like diet is both more satiating and less efficient in converting calories to fat.
Yet the published literature that Taubes ignored says otherwise. The aforementioned review of over 200 studies in the Journal of the American Dietetic Association expressly nixed the idea that any type of food converts less efficiently to body fat. "None of the popular diet research we reviewed suggests a metabolic advantage with respect to weight loss," it declared.
Nor can Taubes fall back on his five studies, according to Seeley.
"Ultimately our data do not support any of the mechanisms" for why a low-carbohydrate diet might be especially effective in inducing weight loss "that Atkins and proponents of the diet have [suggested]," he told me. Indeed, each explanation that Taubes presents for how an Atkins diet might cause weight loss collapses under the weight of the published research he ignores.
Consider the matter of satiety. How, Taubes wondered, could a low-calorie regimen "suppress hunger, which Atkins insisted was the signature characteristic of the diet." One possibility, he said, was, yes, "Endocrinology 101: that fat and protein make you sated and, lacking carbohydrates and the ensuing swings of blood sugar and insulin, you stay sated."
But is there any empirical support for this? No, according to an April 2002 review of studies in the Journal of the American College of Nutrition that summarized "high and low fat treatments when subjects were allowed to eat ad libitum." It found "energy intake on the low-fat diets ranged from 16 percent to 24 percent less than those on high fat diets."
"We've done masses of studies on fat and satiety," says Barbara Rolls, professor of nutrition at Pennsylvania State University, where she has authored four books and written about 60 medical journal articles on human food intake. She's widely considered the nation's top authority on satiety. Some of her experiments involved ingestion; in others, "We directly infused pure fat and pure carbohydrates both directly into [human] veins and directly into stomachs." Says Rolls, "We found very little difference between fats and carbohydrates."
Rolls does say there is some evidence that high-protein diets may be more satiating, but Atkins isn't really high protein; it's just high fat. According to an analysis in the journal Circulation, Atkins starts off at 36 percent protein from calories and declines to 24 percent in the "maintenance" stage.
What really counts when it comes to satisfying hunger, Rolls says, is "foods that give big portions without a lot of calories. We call these low-energy-density foods." She adds, "The Atkins diet would not be a good way to reduce energy density at all, especially with the restrictions on fruits and vegetables that are really the keys to a low-energy diet." Further, because fat contains more than twice the energy per ounce as either carbohydrates or protein, "high-fat foods are so energy-dense that it's really easy to eat excessive portions."
Rolls says she sent a big pile of her material on satiety to Taubes, but he "just brushed it aside." She says he also interviewed her for over six hours, but every last sentence disappeared into a black hole. Likewise for the interviews Taubes conducted with James Hill and at least five other top obesity researchers from whom he apparently couldn't extract even a single useful line: Dr. F. Xavier Pi-Sunyer of St. Luke's-Roosevelt Hospital in New York; Marion Nestle, chairwoman of the Department of Nutrition and Food Studies at New York University; Dr. Arne Astrup of Denmark; and Dr. Jules Hirsch, whom Taubes interviewed in his office at Rockefeller University in New York. "I just kept telling him, it doesn't matter what kind of calories you eat," says Hirsch.
Taubes is "very selective in what he chooses to include because he's trying to sell a specific line," Rolls says. "He is a good writer; that's the thing that scares me. This is such a good example of how you can pick and choose your facts to present the story you want. But that's not how science should be done. You can't interview everybody and simply ignore the people you don't want to hear." She means that rhetorically, of course.
Gorging on Theory
Stacking theory atop theory, Taubes roared on. Something called "hyperinsulinemia" could also favor the Atkins dieter, he insisted. When carbohydrates are ingested they are broken down in the intestine into glucose and other sugars. Glucose then stimulates cells in the pancreas to secrete insulin to remove that glucose and take it into tissues to be used as fuel or stored. Protein and fat consumption don't have nearly the same impact on insulin production because the whole point of insulin is to maintain the stability of the sugar level.
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|10.22.09 @ 3:57PM|#
Having read all three pieces in this debate, Fumento's critique of Taubes is so wholly inadequate I feel embarassed for him, and disappointed that Reason didn't vet Fumento seriously before publishing his original critique of Taubes. Taubes' position is increasingly permeating the research community and will likely be vindicated, leaving Fumento's piece as an embarassing example of Reason failing its mandate to provide critical analysis of contemporary debates. Reason's standards should be higher than merely being a forum for dissent -- you should have some standards for the dissent, and recognize dogmatic clinging to establishment thinking when you see it. The sooner the Lipid Hypothesis dies and refined carbs are recognized for their negative health effects the better the health of the world. We owe Taubes a serious debt of thanks for his integtrity and iconoclastic pursuit of reason. He shouldn't have had to offer this defense, likely only read by a fraction of those who read the original critique.
|7.10.10 @ 6:41PM|#
Taubes responds to this (google Taubes response to Fumento) and it's pretty devastating. I love Taubes, he's awesome. Read his Good Calories Bad Calories
TT, R.D.|3.24.11 @ 7:54PM|#
Ya, he has no education in nutrition or medicine, so let's put faith in his writing. Until you do, you have no idea how strenuous and rigorous the education truly is. For example, "his low carb diet will reduce headaches." Interesting. Since glucose is a necessity to the and astrocytes at the blood brain barrier are selective in allowing substances to pass into the cerebral cortex, I find that extremely hard to believe. Read a textbook one time, not a BS journalists made up science.
|5.6.11 @ 4:08AM|#
Did you read his book? I wonder, as a registered dietician (presumably that is what R.D. stands for in your handle) are you just a little worried that you might be responsible for promoting faulty dietary advice--we tend to defend practice which we become dependent upon for our livelihood. I'm just sayin'...
|5.11.11 @ 9:26PM|#
In other words, you have nothing with which to debunk the dietician, so you try to slander him instead? Nice. Not.
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|2.8.11 @ 3:04AM|#
Interesting how low carb "doesn't work" considering I lost over 120 lbs in 8 months after only being able to lose (at most) a handful of lbs on low fat. I've kept it off for nearly 7 years now. My cholesterol, blood pressure and A1c all dropped to textbook levels on it. And BTW, why would I care how "original" a diet is if it works to make me healthier?
|2.8.11 @ 11:27AM|#
Fumento quotes Seeley, "If you're only allowed to shop in two aisles of the grocery store, does it matter which two they are?" Wouldn't it matter to you which two you eat from exclusively?
Two aisles: "HBA" and "Paper Products."
Two aisles: "Candies" and "Pastries."
Two aisles: "Meats" and "Produce."
|5.6.11 @ 4:01AM|#
Amazing. The arguments against Taubes' conclusions are no more than continued repudiations based on the very faulty assumptions Taubes refutes in his book. Naysayers cite the seemingly sensible but scientifically weak arguments which have caused the spike in overweight, obesity, and disease. Remember Galileo? I hear he had this funny idea (not completely original) about the Sun. You see, it might look light it rises and sets, moving around the earth, but in truth we had it backward. Our observations were limited by our presumptions and assumptions. Hear it didn't go to well for ol' Galileo, but the rest of us have benefitted immeasurably because other scientists had the humility and curiosity to pursue study which had already resulted in exile and denunciation. Seems the more things change the more they stay the same.
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|8.31.11 @ 4:00PM|#
Having read the dodging and weaving of Taubes' "response" slander, and juxtaposing this against Guyenet's recent analysis of the moneybags cherry picker's conclusions, it's hard for me to read a comment calling Taubes "awesome" because of the tears of laughter in my eyes. What seems awesome to me is the amount of money Knopf paid for this hill of beans. Er, pork rinds.
Karl jones|9.28.11 @ 12:47PM|#
Shame I didn't read this tripe earlier I'd have saved myself the easiest time loosing 80 pounds, dropping my blood pressure, looking ten years younger, and a six pack to boot. Lets cut the crap, low carb is right.
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