Gary TaubesTag Archives

Challenging the current diet advice paradigm

I am currently rereading “Why We Get Fat and What To Do About It” by Gary Taubes. I saw Gary Taube’s lecture online in Dr. Mercola’s article, “These Vilified Foods Help Build Hormones and Tame Your Appetite,” and wanted to review his book. Gary reported on how the low-fat advice for heart health became a government recommendation. Back in 1984, the National Heart, Lung, and Blood Institute launched a massive health campaign. “At the time, the NHLBI experts lacked confidence in the fat/heart-disease connection, for good reason: the institute had spent $115 million on a huge, decade-long clinical trial to test the idea that eating less saturated fat would curb heart disease, but not a single heart attack had been prevented. This could have been taken as reason to abandon the idea entirely, but the institute had also spent $150 million testing the benefits of a cholesterol-lowering drug, and this second trial had succeeded. So the institute’s administrators took a leap of faith, as one of them, Basil Rifkind, later described it: They had spent twenty years and an inordinate amount of money trying to demonstrate that cholesterol-lowering, low-fat diets would prevent heart disease, Rifkind explained, and they had, up until then, failed. Trying again would be too expensive and would take at least another decade, even if the institute could afford it. But once they had compelling evidence that lowering cholesterol with a drug would save lives, it seemed like a good bet that a low-fat, cholesterol-lowering diet would as well. ‘It’s an imperfect world,’ Rifkind had said. ‘The data that would be definitive are ungettable, so you do your best with what is available.’” They declared the diet study to be flawed and went ahead with their health campaign.

But here’s the thing: the effect of a drug is not limited to the purpose it was developed for. When the cholesterol lowering drug trial succeeded, it was assumed that the cause of the success was the lowering of the cholesterol, but that may not actually be the case. In 2003, the American Heart Association reported this: “Statins Promote Potent Systemic Antioxidant Effects Through Specific Inflammatory Pathways.” In the conclusion, they state, “Statins promote potent systemic antioxidant effects through suppression of distinct oxidation pathways. The major pathways inhibited include formation of myeloperoxidase-derived and nitric oxide–derived oxidants, species implicated in atherogenesis. The present results suggest potential mechanisms that may contribute to the beneficial actions of statins.” So now we have a major health organization reporting a cause of benefit for statins other than its cholesterol lowering effects. Given that multiple studies have not shown a heart health benefit for following a cholesterol-lowering low-fat diet, perhaps the original NHLBI study on low-fat diets was not flawed after all. In other words, following a low-fat diet may not actually be heart-healthy as we’ve been led to believe for the past nearly 30 years.

A closer look at the effects of a low-fat diet reveal that the opposite may be the case. A low-fat high-carbohydrate diet will:

  • decrease HDL cholesterol
  • increase triglycerides
  • increase the harmful small dense LDL cholesterol while decreasing the large fluffy healthy LDL cholesterol
  • increase insulin in the blood, thereby increasing the risk of insulin insensitivity and metabolic syndrome

The A TO Z Weight Loss Study published in The Journal of the American Medical Association in 2007, gives an indication of what may actually be the best diet for losing weight and improving heart health. The winner in the study surprised even the researchers. This study compared four diets: the Atkins diet, a traditional low-fat diet, the Ornish diet, and the Zone diet. Those on the Atkins diet lost the most weight, and they had the best results for heart disease risk factors. Keep in mind that the Atkins dieters did this while eating as much food as they wanted while those on the other diets were restricting their calories. “The point man on this trial was Christopher Gardner, director of Nutrition Studies at the Stanford Prevention Research Center. Gardner presented the results of the trial in a lecture that’s now viewable on YouTube—“The Battle of Weight Loss Diets: Is Anyone Winning (at Losing)?” He begins the lecture by acknowledging that he’s been a vegetarian for twenty-five years. He did the study, he explains, because he was concerned that a diet like the Atkins diet, rich in meat and saturated fat, could be dangerous. When he described the triumph of the very low-carbohydrate, meat-rich Atkins diet, he called it ‘a bitter pill to swallow.’”

Video: Gary Taubes—Why We Get Fat and What To Do About It

Video: Christopher Gardner—The Battle of Weight Loss Diets: Is Anyone Winning (at Losing)?

Rethinking dietary advice

What if popular dietary advice was just plain wrong? Mainstream dietary thinking tells us that the number of calories in must balance the number of calories out. They tell us that the best way to make sure that the number of calories in is less than or equal to the number of calories out is to decrease our fat intake. They tell us that we should balance our diet with a certain amount of complex carbohydrates. They tell us that exercise can also alter the equation of calories in versus calories out. So what if all that was just plain wrong? What if the real cause of overweight was metabolic disturbance caused by an imbalance of hormones?

I am currently reading Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health by Gary Taubes which proposes exactly that theory. I am further inclined to believe that metabolic disturbance theory given my own anecdotal experiences. Firstly, I have been diagnosed with bipolar disorder and have consequently been prescribed various medications to treat that. Fortunately, these medications have been effective in controlling the bipolar disorder, but they have also led to side effects, most notably with some of the medications, weight gain. The worst of these medications for me was Depakote, an anti-seizure medication. I gained crazy amounts of weight on this medication without corresponding dietary alteration, so much so that I told my doctor to change the medication or he would have a noncompliance problem on his hands.

More recently, our dog was diagnosed with epilepsy, and Phenobarbital was prescribed to her. Before her seizure episodes and consequent prescription, we were able to feed her as much food as she wanted without her gaining weight. After she started her medication, she started gaining weight on much less food. At first, we cut back on her food to the level prescribed on the back of the bag. When she continued to gain weight, we consulted her vet and decided upon an amount of food that was even less than is typical for an active dog like her at her weight. We have since been able to control her weight at this lower consumption. Given that she is still an active dog and yet must eat less than her peers, we must assume that her medication causes some sort of metabolic disturbance.

In the book, Good Calories, Bad Calories, Gary Taubes puts forward the theory that overweight is caused by excess insulin. Excess insulin, in turn, is caused by excess carbohydrate in the diet. When carbohydrate is restricted, weight loss occurs even when calories are not restricted. The author cites studies in which carbohydrate restricted diets exceeded 3,000 calories a day and yet weight loss still occurred. Actually, they had difficulty getting their subjects to eat this amount of non-carbohydrate food, not due to boredom as has been postulated, but because the subjects had no appetite for higher consumption. Modern dietary advice tells us that all calories are created equal. Gary Taubes puts forward that this is not the case. Carbohydrates are uniquely fattening because they increase the secretion of insulin. Insulin drives the blood sugar into adipose tissue, often depriving the muscle tissue of that energy. This leads to increased food cravings, which are often satisfied with additional carbohydrates. This leads to a vicious cycle in which carbohydrates are consumed to offset an energy deficit that is redirected to the fat instead.

So let’s go back to my medications, particularly the Depakote. So why did Depakote cause such weight gain even though my dietary intake had not increased, and in fact, I was trying desperately to control my weight? As it turns out, Depakote is associated with hyperinsulinemia, which is an overproduction of insulin. Phenobarbital is likewise associated with changes in glucose metabolism. Given these effects, it is not surprising that both I and the dog would gain weight when prescribed these medications.

Recently, Woman’s World published an article promoting the use of coconut or MCT oil for weight loss. I did a little research to look into this further and found out that MCT oil is most effective for weight loss when associated with a ketogenic diet. This is a diet severely restricted in carbohydrates and high in fat. I did a little bit more research and found out that a ketogenic diet is often prescribed to epileptics. I found this particularly interesting because anti-seizure medications are often prescribed to bipolar patients. I wondered if maybe the ketogenic diet had been found effective in treating bipolar disorder. Particularly, I wanted to know if there was any contra-indication advising against a bipolar patient following a ketogenic diet. I found out that the ketogenic diet had been effective in animal studies of bipolar disorder, but that human studies have not been done. Stanford University wanted to conduct a study of the ketogenic diet for bipolar patients, but was unable to find participants for its study. Given what I have read and given my experience, I am ready to be a guinea pig for such a study.