UCSF Endocrinologist debunks "Calories In / Calories Out" Model | Hacker News Reader

UCSF Endocrinologist debunks "Calories In / Calories Out" Model

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71 pointsahoyhere87 comments

I saw this literally after just finishing this video: http://video.google.com/videoplay?docid=4362041487661765149# Gary Taubes giving a presentation about his book Good Calories, Bad Calories.

If you've never seen someone actually make the case for this stuff, but only let other people diss it for you, I encourage you in the strongest terms to actually listen to the case directly and make up your own mind. These are not the rantings of people who think fire can't weaken steel or that insist immunizations cause autism; indeed, they make a very strong case that the people who insist on the "calories in/calories out" model should be lumped right in with those folks.

(Oh, guess I missed the party 18 days ago. Well, nobody linked that video that I saw. If you are interested in Good Calories, Bad Calories, but don't want to buy it, that video is a reasonable substitute for the scientific explanations in the book, which is very similar to the linked video. You don't get the huge sheaf of references in the back or the long exposition of history explaining how we got where we are, but if you're interested in that after the video I'm sure you can find the book.)

Here's a review of Taubes' book by George Bray: http://www.proteinpower.com/drmike/wp-content/uploads/2008/0... in case you do want someone dissing it for you.

Also I don't think we should "make up [our] own mind" the biology on this is way beyond the layman. Hacker News has a pervasive conceit that somehow as programmers we can see the obvious truth that people with decades of experience are apparently (or deliberately) unable to. In fact it's the reverse most subjects are substantially more complicated than they appear. You can't encompass the biology of obesity in a pop-sci best seller.

Also I don't think we should "make up [our] own mind"

Although it's true that don't-think-for-yourself-and-don't-question-authority is standard practice, it's not often one hears someone explicitly argue in favor of it.

I have three objections to what you're saying. The first is that it's ahistorical. You don't have to look back very far to see the insanity that human deference to experts can produce. ("Breast feeding is bad for babies", anyone?) Scientific consensus isn't nearly as stable or as true as you're implying; nor, for that matter, nearly as scientific. Which brings me to my second objection: it doesn't consider the economic and political interests that drive these things. There is a great deal of money being made from people being fat and sick. This has a huge influence on the research and regulatory systems surrounding this stuff. It follows that naive trust of consensus recommendations is foolish. Finally, everyone does make up their own mind whether they intend to or not. It's like Sartre said: not to choose is to choose not to choose. Everyone has a pool of their own judgment to allocate; if you like to invest yours completely in the expert consensus du jour, that's your perogative. I like to diversify mine, including putting a little into my "own mind", thanks. As far as I'm concerned, any discourse that penalizes people for asking simple questions is not to be trusted.

I have a simple metric for determining the validity of a scientific consensus: "Does it make true predictions?"

It does not take much research to discover that it is an objective truth that the nutrition dogma does not make true predictions. It says if you eat less (of the same thing) and exercise more, you will lose weight. The peer review verdict on this is rock solid: False. It treats fat cells as passive bags: False. After that the logic flows pretty simply. (Including the flat-out evil of people still talking as if calorie-reduction diet and exercise is some sort of scientifically proved therapy when in fact the exact utter opposite is true.)

People claiming that the dietary orthodoxy is false have plenty of fully credentialed experts on their side, and your implicit claim or belief that it's not supported by evidence or peer review is flat-out false. I commend to you the first few frames of the video linked in the topic, for instance. I can't beat PhD with years of actual field experience; can you? Because that PhD with years of field experience is not on the side of the orthodoxy.

By the way, I went and read the George Bray review that you posted. It seemed a little odd. For one thing, Bray places great emphasis on a first-law-of-thermodynamics argument which as far as I can tell is just a big red herring. (Obviously nobody is questioning the first law of thermodynamics; equally obviously, thermodynamics doesn't ipso facto explain obesity; so what's the point? It's not clear.)

So I dug around a bit and found Taubes' rebuttal, which strikes me as more or less devastating:

http://www.proteinpower.com/drmike/wp-content/uploads/2008/0...

I wanted to come back and thank you for the link to Taubes' lecture. I watched the whole thing (on an exercise machine, ironically) and it was definitely worth it. I'd never heard of Taubes, but he's an unusual and formidable character. Whoever heard of a science journalist thinking for himself!? I got a lot out of both his talk and Lustig's and am going to try out what they each say (they both agree and disagree).

I don't find it hard to believe that Taubes is the only person who ever bothered to go back and thoroughly read the last hundred years of literature on this subject. Most specialists already "know" what's true, so why would they bother. Besides, it takes a very long time; Taubes spent five years doing it, and that only because he got a huge advance for his book. It's interesting to me that it took someone outside the scientific establishment to do this.

Incidentally, there's a clip on youtube of Lustig asking Taubes a question at one of his lectures. Whoever posted it gave it the asinine title of "Lustig yells at Taubes about fructose". He doesn't in the least "yell", he simply asks a question politely (it's clear the two know each other). Kind of a fun crossing of streams.

Particularly noteworthy was the excerpt of how the government propagandized reduced fat and increased carb consumption starting in 1982, and the resulting behavior changes in the general population tracks so well with weight gain.

And yet some people still believe that a handful of Congressional staff lawyers and lobbyists (that's who really write the legislation) should be trusted to engineer the entire health care industry.

Works okay in other countries. And I know it's not because, say, Australian government folks are just less corrupt than American govt folks.

Here it is, all in one long (90 minute) video: http://www.youtube.com/watch?v=dBnniua6-oM

Reposted: http://news.ycombinator.com/item?id=1006980

But it's such a huge PSA I'm upvoting anyway.

I've struggled with weight my entire life. After trying every diet and exercise plan under the sun, just to watch the pounds come rolling back. At the end of November I said enough was enough and had bariatric surgery (an adjustable gastric band, or lap band to be more specific).

While it has only been 8 weeks, I'm already deeming it an overwhelming success. I can't tell you the feeling of utter relief when I feel completely satisfied after eating a single cup of food (8oz). It is almost euphoric. Living in my body before the op was almost like living in a prison, I was shackled to my ravenous hunger. It didn't matter how much I ate, I was never satisfied. I still have 80% more of my target weight loss to go, but I'm 100% confident I can make it there with this tool.

If you've struggled for a long time and feel hopeless, please at least take a look into bariatric surgery. Don't feel hopeless. Don't blame yourself, morbid obesity is not something that 98% of people can handle on their own, there are factors that are simply out of your control.

If you have any questions that you'd like to ask to a fellow hacker, please don't hesitate to contact me. I know what you're going through and would be more than happy to talk to you.

v o n a t n i t r i q d o t c o m

downvoted for signature

It isn't a signature. I put my email address on there so that if someone has a question about bariatric surgery, they could contact me. If HN had a way of private messaging people, I wouldn't have done it.

You can put contact info in the 'about' section of your user page.

A more elegant way for him to do it might be to put his e-mail address in his profile "about" section, and to reference that in his post. BUT, I appreciate viggity's candor in his post, and the success he's had with his surgery. Also, I think it perfectly appropriate that he offered his e-mail to people who might be depressed or otherwise unsure of what to do, who might be in a position to consider bariatric surgery.

Good on you, viggity, for being open to helping people with that.

Upvoted for sincere willingness to help others

(Even if I don't particularly subscribe to the point of view promoted.)

The title is horrible. This should be called "How a diet rich in fructose makes us fat, poisons us slowly, and wastes billions of dollars on health care for self-inflicted chronic diseases, and what you can do about it NOW.

Here's a brief summary of the salient points:

1) Consumption of fructose, sucrose (which is a glucose-fructose disaccharide), or alcohol (ethanol is metabolized by the same pathway as fructose) should be extremely limited. That includes HFCS and most fruit juices.

Why? Because the way your body metabolizes fructose, eating a lot of it results in insulin resistance (type II diabetes), hypertension (high blood pressure), high triglycerides, high LDL cholesterol (the bad kind), and weight gain due to inability to self-regulate hunger. The combination of these effects is known as Metabolic Syndrome.

There are two notable exception to this fructose prohibition: 1) it's ok to eat as long as it's in fruit because there's not much of it and it comes with lots of fiber, which makes it even more OK, and 2) if you're in the middle of (or have just completed) some seriously epic exercise and your are glycogen-depleted, fructose actually helps you restore glycogen much faster than regular carbs. See: Gatorade.

2) Do eat "food" as Michael Pollan would say. The closer to it coming out of the ground, the better. Google "paleolithic diet".

3) His research shows that you can begin reversing Type-2 Diabetes in a short number of weeks by eating an appropriate diet.

4) His research shows that the #1 factor causing most diets to fail is cheating on fructose consumption (even worse than cheating on exercise!).

4) Exercise is good for you, but not primarily due to calorie burning. It barely burns any calories relative to food intake. It's good for you because it reduces stress and helps your body maintain a "fast metabolism" on an ongoing basis.

5) Fructose is a major part of our food supply due to politics. It will take a while before the corruption that propagates the problem is broker. Thus, don't trust the government on this one.

The full video is an amazing presentation by a talented presenter. It is worth watching the full thing especially if you struggle with obesity or don't understand how the body metabolizes food.

The lecture is by a MD and/or PHD talking to a bunch of MDs and PHDs, so it's pretty high level. He covers a lot of biochemistry, but in a way that is pretty accessible.

http://www.youtube.com/watch?v=dBnniua6-oM

After watching this all, I think the take-home-message was that, for fairly complex biochemical reasons, fructose (which is also a component of sucrose) is a particularly bad sugar. For one thing, it doesn't cause satiety very well, and for another, it does some damage directly which glucose, nature's preferred sugar, does not.

My real takeaway was this:

Everybody always treats science as if it's a sure thing. But you can have every statement you make be true, and still be wrong overall, because you missed something important.

Like the 7 Countries study, where the author didn't regress with fat-vs-sugar. Everything he said was true, but he was wrong in the end.

(Oh, yeah, and fructose is awful and mass food producers are poisoning us. But I knew that already.

Many restaurants, not just fast food restaurants, even put high-fructose corn syrup in meat.)

While making his case against fructose, Lustig makes a few offhand positive comments about glucose -- but it's not clear if he'd actually recommend ingesting it from nearly-pure sources, or using it as a sweetener instead of sucrose/HFCS. (Others with similar dietary recommendations often view pure glucose as bad as any other sugar.)

Sweettarts, Pixie Stix, Lik-m-Aid, and a few other brightly-colored super-sweet candies are almost entirely d-glucose, aka dextrose -- often with no other sugars listed as ingredients. I wonder if according to the Lustig analysis, these are relatively OK, or still have other problems (like triggering rollercoaster blood glucose/insulin levels) and so should be avoided.

I have been wondering the same thing since watching the video a week ago. Specifically, would it be good to use corn syrup (the old-fashioned glucose kind, not HFCS) as a replacement for fructose/sucrose?

I mentioned this video to my wife, who is a registered dietitian and a PhD in nutrition science (the RD / PhD combo is relatively rare). She said, "Yeah, I'm uncomfortable just saying 'calories in / calories out' because human metabolism is just way more complicated than that."

She's interested in watching the whole video herself; I'll post her thoughts if she does.

I'd prefer a written overview of the ideas rather than sitting through an hour lecture. The first ten minutes really didn't offer a lot of detail.

First, until there are comprehensive notes, it's worth watching the video. It really is excellent.

That being said, here are the notes I've taken so far. I started these back in December, but didn't have time to finish the video. If anyone wants to continue where I left off, please feel free to.

16:30 - Introducing HFCS.

17:20 -Why use fructose? It’s sweeter. (Also, cheaper.) Should be able to use less. But drink manufacturers use it more. (Shows chart with different types of sugars and their positions on a sweetness index.)

18:20 - Chemical composition of fructose versus glucose versus sucrose. Fructose and glucose are not the same. Fructose and sucrose are exactly the same from a body processing perspective. Both dangerous.

21:50 - Slide: Secular trend in fructose consumption: Natural - 15g / day WWII - ~20g / day 1977 - ~37g / day 1994 - ~55g / day Current adolescents - ~73g / day It’s not that we’re eating more (although we are). It’s that we’re eating more sugar.

23:30 - How did this happen? Why did this happen? The politics perspective: three political winds that swirled at the same time, creating the perfect storm. 1. In 1972, Nixon makes food prices a “non-issue.” 2. 1966, HFCS invented, introduced to the US in 1975. This makes sugar CHEAP. “High fructose corn syrup isn’t evil because it’s metabolically evil, but because it’s economically evil. Because it’s so cheap, it’s found its way into everything.” 3. In the late 70s, the USDA, the AMA, and the AHA all call for the reduction of fat in diets. Why? To stop heart disease. Did it work? No. So why’d they tell us to stop eating fat? In the 1970s we discovered LDL. In the mid-1970s, we learned that dietary fat raises LDL. In the late 1970s, we learned that high LDL correlates to cardiovascular disease. So, the conclusion was that if A leads to B, and B leads to C, then A leads to C. But the premise is incorrect. Why? It suggests that it’s transitive. That isn’t the case.

John Yudkin - Pure, White, and Deadly.

Keys - performed multivariate regression analysis (running data to filter out what really caused what) on cardiovascular disease. Showed calories from fat correlated highly with cardiovascular disease. But he didn’t run a complete regression analysis. He showed that sugar comes along with the fat, and that if you hold saturated fat constant but increase sugar, it doesn’t show results. But he didn’t go the other way, holding sugar constant and showing that fat still has an effect. (around 35:00) So his results aren’t actually reliable, but we’ve been basing 30 years of nutrition education and policy on this incomplete study.

36:30 - Two types of LDL. Large/buoyant, and ...

"In the mid-1970s, we learned that dietary fat raises LDL. In the late 1970s, we learned that high LDL correlates to cardiovascular disease. So, the conclusion was that if A leads to B, and B leads to C, then A leads to C. But the premise is incorrect. Why? It suggests that it’s transitive. That isn’t the case."

Specifically, there's no problem with transitivity, but (just based off you've written) a correlation/causation problem: A leads to B but B correlates with C. A conclusion that A leads to C would therefore be invalid. (Not sure if this is an error in the summary or the video, and in any case it doesn't undermine the larger point; I'm just being pedantic. :)

Actually, in the video he points out the following is invalid:

    1. A -> B
    2. B -> C
    3. A -> C
    4. ~A -> ~C

Step 3 is valid (skipping over the correlation issue); the problem is actually step 4. ~C -> ~A is valid, but ~A -> ~C is a fallacy. The correlation issue doesn't come up, possibly because it isn't even necessary; this logic fallacy dominates it.

I used standard Aristotelian logic notation here; it really ought to be fuzzy logic, but step 4 isn't valid there either, so it would just muck things up, and I don't know the numbers for the fuzzy logic anyhow. Doesn't matter.

You should use probabilities, actually. And while step 4 is not a logical consequence, it may have substantial probability, per Bayes' theorem:

  P(C | A) = P(A | C) * P(C) / P(A)

I do too, but this is one of the few hour-long videos that's worth watching. And I HATE long videos.

To steal a line, dietary science is younger than it looks. Don't be surprised if decade spanning long held beliefs start collapsing.

Another good video. Stanford nutritionist and self-described vegetarian admits benefits of low carb diets: http://www.youtube.com/watch?v=eREuZEdMAVo

I think this is a bit of a misleading title. At one point in grad school, I had broke 225 @ 6'3 with little muscle mass and I've changed that to 188 with much more muscle mass. My understanding is that fat is used for storing food energy and that each pound of fat stores ~3500 calories. So, something like dFat/dt = (f(calories in) - caloriesBurned())/3500 = amount of fat gained for some period of time. f might include something about the structure of the calories coming in, but it makes sense and my experience supports it.

I'm guessing you didn't watch the video. Sure, the lower your net caloric intake, the less weight you will gain. However, the types of food you eat have different effects on how much you want to eat. Therefore, if you eat different foods, you'll be more likely to lose weight.

It's a bit long, I read one of the supposedly accurate summaries... I'm OK with that idea, my main comment was on the title - doesn't exactly debunk the model, just some supplement regarding a "fullness factor" nothing new there imho.

Ah. Agreed.

plus I always WANT to eat. NOM NOM NOM NOM

A paper he wrote covering the same material:

http://www.nature.com/nrendo/journal/v2/n8/full/ncpendmet022...

To be credible, you should not try to dispute the simple truth that derives from conservation of mass and conservation of energy. Cal in = cal out; however, I do agree that our bodies are wired in such a way that particular substances trigger 'calories in' without a concomitant immediate increase in 'calories out', thus leading to increased weight and a new homeostatic baseline. This is not merely a pedantic point: it is the difference between making a credible statement about human nutrition and looking like someone who rejects chemistry.

It's worth noting again that this should reflect on the credibility of the submitter who chose the headline, not on the original presentation - which makes a different point entirely.

Yes, I do not have a problem with the content of the video at all. In med school, we are already being taught the evils of fructose, so this well-done presentation is actually in line with what we are taught now.

It might be just me, but watching this felt like watching 'The Inconvenient Truth of the food industry'.

So all we need now is a meeting of the leaders of the world in Copenhagen to ignore this huge problem with the processed food everybody buys and consumes for at least another 20 years. (potential problem, if you're not convinced something is wrong with the massive amounts of sugar in our processed food)

Summary at 6:30 of section 9 of 9: http://www.youtube.com/watch?v=_tyaRnfGRV0

The guy seems pretty sensible in his explanations earlier in the video series, but his style is inflammatory. If he left out the bitterness toward the industry players that he's arguing with, he'd be more convincing.

He thinks he's uncovered a major medical emergency that affects maybe a third of American citizens, to the profit of giant corporations, with government agencies in collusion. I would doubt him more if (given his claims) he didn't feel strongly about it.

If he's right, it does seem to be a major medical emergency, and so forth, as you describe. But it's not a sudden catastrophe, like an earthquake. He's surely held these same beliefs for at least a few months, right?

Maybe I should be more specific. Calling sugar a poison is a good example. It may be true, in a sense, but it's definitely not true in the conventional usage. For example, if you call Poison Control and say you have eaten some sugar, they would not help you. That's what I'd call inflammatory.

On the other hand, maybe it's just me. It's possible that I find dispassionate argument more convincing than most people.

Slides from related presentation of his

http://www.niehs.nih.gov/news/events/pastmtg/2007/cehr/docs/...

Anecdotes are great, and they're fun to read. Just keep a slight lean towards actual data, please.

video also here http://www.ucsd.tv/search-details.aspx?showID=16717

You will lose weight on calorie restriction as long as you go low enough. Though I've been fat my entire life, after college, I was 150 pounds overweight. I lost the extra weight by eating 900 calories a day for a year and a half or so.

At my normal healthy weight, I was starving. And weak as a kitten. I took up running, and stopped watching my diet. I literally could not keep up the willpower necessary to continue a 3000 calorie diet, even though 900 had been doable for so long. Despite running for an hour a day, I immediately started gaining 10-15 pounds a month.

So I was convinced that it was all about calories. I was fat because I ate too much. Why my body was so hellbent on eating 4000-5000 calories a day, I didn't know. I seemed to have a lot more willpower than anyone else I knew. It was sort of confusing. Then about a year ago, I read Taubes' book.

What if the human body is actually sort of complicated? What if hormonal regulation controls fat? What if the "trash bin" theory of body fat is actually a humongous oversimplification or just wrong? What if, after getting to a "healthy" weight by starving fat, muscle, and vital tissue, I wasn't healthy at all? What if it had also made me malnourished (hence the amazing hunger at my "healthy" weight)?

Anyway, I cut the carbohydrates out of my diet last December. I made zero effort at calorie restriction. In fact, I ate a lot. I made very little effort to exercise more. After a year of this, I'm almost 100 pounds under my max weight. I recently started running again, for fun, not weight loss, and am up to 2-3 miles a day.

And I am stronger than I've ever been in my life. Eating steak every day is probably more expensive than building the same muscle mass with steroids, but I'm pretty happy. I wasn't expecting it. It's good being a carnivore.

Just out of interest, have you had any tiredness from cutting carbs from your diet? Many people on who restrict carbs, such as on the Atkins diet, experience this from what I've read.

No tiredness for me. There's the "induction flu" that people on Atkins get, and I felt that for the first few weeks. Apparently it's caused by sodium depletion (carbohydrates cause you to retain a lot of water/salt). Drinking non-sodium-reduced beef broth every day for that month will cure you. Wish I had known. I just toughed it out.

As far as my energy levels nowadays...pretty much boundless. I'm ravenously hungry when I don't eat. But I'm told that's how it's supposed to work. When I was fat, I was hungry around the clock, even after eating.

Can you recommend any sources for more details about this 'beef broth' fix for induction discomfort? (Would other sodium replenishment options be just as good?)

Personally, I found I actually have more energy -- which I think is from more stable blood sugar levels.

There's a tiredness and "brain fade" associated with these sort of diets. I'm not so sure it's the carb cutting so much as it is the extreme calorie restriction. I used a protein sparing modified fast (which Atkins is a form of) that advocated supplementing sodium and potassium along with essential fatty acids using fish oil (it was a low fat and low carb diet). I've tried Atkins before and experienced the tiredness/brain fade. The PSMF I was on though caused me none of these symptoms. In fact, I felt precisely the opposite. During the diet, I experienced a form of mild euphoria.

I tried a regulated vegetarian diet before and a diet like the Atkins diet before and experienced the following:

Veggies)

Bad:

-I typically felt kinda "blah", like I was on the verge of getting a cold

-generally low on energy

-injuries took forever to heal

-my joints ached after being on the diet for about 6 months

-I felt hungry almost immediately after eating

-I lost much less weight than on Atkins

Good:

-It's hard to describe, but I felt "clean" all the time. Like I had just taken a shower.

-I also tended to feel light, like moving about took less energy, but I felt like I had less energy overall

Atkins)

Bad:

-I felt kinda "gross" all the time, like oil was oozing from my pores and follicles.

-Expensive

-Most of the foods I wanted to eat were not on the approved list, and I got tired of eating on the diet after about 6 months

-I felt hungry all the time

-Hair and nails grew really fast...like freakishly so. I was cutting my finger nails like every 2 days at one point.

-I felt "heavy"

Good:

-I had super, non-stop, bottomless energy

-no midday loss of energy

-I could exercise for hours

-I lost tons more weight than on the veggie diet (about 3x as much in the same amount of time)

-Injuries healed super fast, maybe twice as fast as normal, and I got injured far less often than on the veggie diet, maybe 1:3 ratio

-I felt stronger, so even if I felt heavier, it was less effort to move about

-I packed on muscle, my bench press (without actually doing any weight lifting as a form of exercise) went from 140 to 210 in 6 months.

You should be very careful on carb restriction. It can cause acid levels to build up in your blood which can be exceedingly dangerous. One side effect: the acids can crystalize in your bloodstream and collect at your joints. In short, you get gout/pseudogout/other gout-like conditions (depending on the exact composition of the crystals).

I know someone who did this; she was bedridden for a month and couldn't turn her head for 2 months.

I've actually never heard of hyperuricemia being caused by carbohydrate restriction. Nobody seems to list it in the standard "drink your Coke, low-carb kills" list of warnings, either.

Anyway, here's Taubes on Gout: http://www.fourhourworkweek.com/blog/2009/10/05/gout/

There is a very important book you should read called _Life Without Bread_. It was that book that showed how excessive carbohydrates causes gout, and how that led my husband (who has gout at 30 b.c. of an immuneoresponsive issue) to cure his gout with low-carbohydrate diet.

Now -- anybody who does "no carb" is making a big mistake. Vegetables, and legumes, etc., are a very critical part of the diet. They provide so much more than carbohydrates, such as fiber and necessary acids.

And sometimes shit just freaks out. Like me, I have "steroid psychosis" type responses to very low levels of non-oral steroids. Sometimes you just have to accept that you're a freaky outlier. Plural of anecodate is not data, sadly, either way.

What little I've read on obesity research seems to require that both excess sugar and fat are consumed to overcome homeostasis.

Sugars can ignore homeostatic regulation for hedonistic reasons and fats don't have the same day to day correction that carbohydrates do.

So the part that might be working in your diet might be the no-sugar part of no-carb.

Overall it's quite amazing that many people can consume something like a million calories per a year and end up within 0.5kg (3500 calories) of their starting point.

Would you say more specifically what you cut from your diet, and what you retained? You don't only eat steak, do you?

Last time I lost significant (for me) weight (220 down to 180) I did it by cutting carbs. I did not eat only meat, but I did cut out all bread, other starchy food, sweet fruits, and sugars. So I ate meat, eggs, cheese, nuts, and green vegetables like broccoli, spinach, and legumes. I missed bread, because I love good home-baked bread, but you can have enough variety with other foods to keep a low-carb diet from getting boring. Atkins says to cut coffee and diet soda but I didn't do that. I did not exercise beyond normal daily activities.

How about beans (like kidney beans)? Or are they too starchy?

Going from 4K-5K calories per day to 900 is an extreme swing. These type of diets are shown not to work. There is also some evidence they convince your body it is living in feast/famine time which triggers a fat accumulation response. I do not believe that it is healthy to remove carbohydrates from your body. The body is a complex machine indeed, but we have a pretty good understanding of how it works regarding nutrition. Most structures run on glucose, muscles are made of protein, fiber helps digestion and micronutrients are used all over the place. The bottom line is that fat is used for storing extra glucose. The function of protein in nutrition is very interesting. If you don't get enough, then your body will cannibalize muscles to get it. Proteins can be broken down to provide glucose, but it's inefficient and generates toxins. Carbohydrates break down to glucose much better. I would suggest you try a conventional approach : Checkout nutritiondata.com or one of the numerous calculators and for your weight and height calculate your daily needs. Pay particular attention to the grams of fiber needed and setup a plan that leads to 1-2lbs of fat loss per week - a deficit of only 500-1000 calories per day. Changing habits faster than that is generally not practical, it certainly never was for me. Make sure you are getting enough protein without overwhelming calories, supplementing with a protein shake if necessary. Try that out for half a year or a year with daily measurements and diet recalculation every 10 lbs lost. Never, ever deviate from the selected diet (you accomplish this by leaving wiggle room in your estimates), weigh yourself daily and keep careful records. I really don't think carb free living is either sustainable or healthy.

It did work. I lost the weight.

Pay attention to fiber? The research in support of that suggestion is execrable (pun intended).

I did try the 500-1000 calorie deficit for a number of months. My weight loss was on the order of 5-10 pounds, and I was hungry the entire time. And then I gained the weight back and more when I wasn't able to carry through. People simply do not lose large amounts of weight on small deficits. It's bizarre. According to the trash bin theory of body fat it should work. It doesn't. Almost like the trash bin theory is wrong...

The carb free living is sustainable and healthy. If you aren't going to read Taubes, then at least read Victor Steffansson. He's a bit more fun.

The research in support of that suggestion is execrable (pun intended).

It's not really a pun. "Execrate" and "excrete" aren't related. (Sorry for the distraction; I find these things interesting.)

It is a homophonic pun.

The associated Wikipedia article is pretty fascinating: http://en.wikipedia.org/wiki/Pun

Execrate and excrete are not homophones. But yes, that is a good Wikipedia article.

the point of paying attention to fiber is that if you get your daily needs in fiber, you'll have eaten so many vegetables that your tastes regarding carbs will change. Your belly will also be full, which cuts down on the feeling of hunger.

People do lose large amounts of weight on small deficits, get serious!! It just takes a while. I personally dropped nearly 40 lbs this way and large people can also certainly do this - go ask a nutritionist. Of course you were hungry all the time, your body was down regulating. You are sitting here attacking a theory immediately after admitting that you could not maintain the 500-1000 calorie deficit? That has nothing to do with the theory! You chose to eat more, you gained weight again - if you had maintained your discipline, you would not have gained the weight back.

I've researched the carb-free diet in detail and my conclusion is carbohydrates play an important role in human nutrition and it is very unwise to cut them out. We evolved to run off a particular type of fuel, continue with this diet for a couple more years and then consequences will become apparent. There is a wide variety of material from credible mainstream nutrition researchers on this. The healthy thing to do is to make sure your nutrients are handled in a balanced way and then slowly burn off fat and actually maintain discipline for years. This book has a lot of good info : http://www.amazon.com/Eating-Well-Optimum-Health-Essential/d...

Slow and steady works. Rapid and fast works also. Different tactics are needed for the different strategies. Your hunch that carbohydrates are important is indeed correct. The protein sparing modified fast that I was on, as outlined over at http://bodyrecomposition.com suggests strategic re-feeds incorporating starchy carbs once you get do more reasonable body fat percentages (e.g., under 30% for males). Lyle McDonald, the author of the site, is one of my favourite experts in physiology because he takes a hacker-like approach by researching studies, skeptically reviewing them, and then testing strategies that he thinks will work. If you peruse his forums you'll find all sorts of people, from athletes and bodybuilders to morbidly obese who have successfully adopted strategies that he has advocated (not necessarily devised).

In fact, Lyle starts off his book on Rapid Fat Loss (his PSMF) by specifically stating that if you can go the slow and steady route, then do so. It's certainly healthier and carries fewer risks. But some people can't or won't, for whatever reason, go slow and steady at losing weight. For them, it's much better to have lost the weight rapidly than carry it around having never lost it. For people like this, he suggests his form of PSMF.

I'm not necessarily against doing it quickly, but I see that as orthogonal to the protein/carbohydrate mix in the diet. As I see it, Person A currently has an average calorie intake of C, burns C' calories a day and requires P grams of protein and F grams of fiber. I would contend that it if you construct a diet plan with D<C' calories, then you will receive more favorable results with a proper diet that covers protein and intakes proper amounts of fiber and carbs and micronutrients. For me, this is a very vegetable heavy diet with daily protein supplements (I prefer brown rice protein + orange juice, to which you may add active culture yogurt)

They do work. Thras looks like he was on a form of Protein Sparing Modified Fast. They work really well. I've done the same thing. The tough part about these diets is transitioning out of the diet, but if you follow the "maintenance" modes that most of these diets advocate, you'll be absolutely fine. The promoters of these diets do not advocate these as long term solutions. For people that are > 30% body fat, the longest recommended time to stay on this diet is about 12 weeks before moving to maintenance. For someone whose body fat percentage is less than 30 but greater than 20, the longest recommended time to stay on the diet is 2 to 6 weeks before, again, moving to maintenance. After two weeks on maintenance but not yet reaching the target weight, the person may choose to proceed with the diet or opt for a more moderate one.

Checkout http://bodyrecomposition.com which promotes a form of Protein Sparing Modified Fast that the author has dubbed "Rapid Fat Loss". He is not an advocate of protein shakes on this diet but rather obtaining macronutrients from actual food, because protein shakes are metabolized so quickly that the body feels hungry soon afterward.

No no. I just eat a lot of meat, eggs, and cheese. I average 2-3 pounds of rib-eye per day, 6-9 eggs, and 3-6 ounces of cheese.

Googling for calorie information...good god, that's 2900-4500 calories a day. And I'm only 5'10". No modified fast for me. Lost 65 pounds in the last year. Not an amazing result. On the other hand, an amazing result -- on a 3000-4000 calorie diet.

Ahh I misread your first post. So you went on a 900 calorie diet that wasn't necessarily a protein modified sparing fast. Now, at a macronutrient level you just eat higher protein and fat whilst avoiding carbs.

Are you certain that you didn't have pre-diabetes or some form of insulin resistance before starting your diet? It might be the reason why you feel like crap when having carbs. At a healthy weight, reasonable levels of carbs shouldn't cause you to feel like crap unless you have some underlying condition that's affected by them.

UPDATE: Another thing that can be going on here is that when you lose weight, you don't necessarily get a reduction in fat cells. Normally, fat cells contain 90% triglycerides. When you lose weight, some fat cells release their triglycerides. But they can fill up with water instead (e.g., perhaps the body's adaptation to famine conditions... where there's no food there's likely no water). Your carb intake may have simply been causing you to bloat with water, and some of your fat cells may have been storing this water too. How long did this 10-20 lbs weight gain last? It's not abnormal to gain 10-20 lbs after losing such a substantial amount of weight because some of that weight lost will have been water-weight.

The weight gain lasted from when I was 170 pounds until I was 305. I had to stop running when I hit 240 or so.

At 305, I was still 30 pounds under my max...but something tells me it wasn't water weight.

no it wasn't water weight, it was the net result of eating approximately 470,000 calories beyond what you burned

Uh, yeah. That's somewhat obvious. How else would I have gained the weight? Magic?

Now comes the million dollar question: Why was I so hungry that I ate 470,000 extra calories? Could carbohydrate driving insulin driving fat explain it?

Homeostasis in the human body doesn't just fail without a reason.

I was stating the conclusion of the theorem I read you as criticizing. If you set a diet plan at say 3000-3300 calories per day, you can just choose not to deviate from it? There's all manner of things I would like to do that I just choose not to do. You just set out that amount of food, say to yourself OK this has all the nutrients I need and no matter how hungry I get, it's not going to kill me... and then you just don't deviate. The real question is why did you feel your hunger was so severe you could not suppress it? How about a lifetime of bad habits caused a psychological reversion to previous bad habits and it was nothing but eating hundreds of calories extra per day? It is possible that for some people, some kind of a strange mechanism is at work, but occam's razor tells me that it is more likely just a series of small bad choices and that the standard model for human nutrition applies. I don't know you, maybe you are the corner case where the model breaks down because hunger signals are amped up or something? In my experiences of my own life, negative results are much more likely to be a result of a series of my small bad choices than on account of me being a corner case. I just have studied human nutrition, I believe the macronutrient model (fiber+protein+carbs) + micronutrient model works and that proteins and fats are both broken down to glucose at particular rates, with particular byproducts. I believe carbs breakdown to glucose "better" than protein or fats with less side effects due to the structure of the molecules (particularly noting the ammonia [I think it is] byproduct of chemical reactions breaking down protein into glucose. I think fat is just about having excess glucose in the blood and carbs just offer efficient means of getting sugar. Look, I completely believe the average diet is hugely overcarbed - once I started watching nutrition most of my intake is veg.

Without steak (protein and extra calories), steroids don't work - so yeah, you're doing the cheapest way to build muscle ;)

I'm about halfway through Taubes' book (Good Calories, Bad Calories), and I also recommend it. So far, he has made a very strong case, and the theory that he supports seems to have better predictive power than the mainstream theory.

seriously, what's with you guys? I lost 75 pounds in 6 months. I couldn't have made my blog post about that more Hacker News bait than it already was. I know a lot of you saw it. and still the ratio of people talking about it to people doing it is like 10,000 to 1. and you'd still rather debate some tangentially relevant research.

google "Dr Joel Fuhrman." I lost 100 points of cholesterol in three months. 75 pounds in six months. all you do is you eat vegetables. there's a little more to it, but not much. it's easy. the guy has reams of case studies and science backing him up. my 100-point cholestrol dip barely even blipped on his radar personally - didn't even raise his eyebrows - because he sees it all the time, but just for comparison, my dad and my uncle both got 100-point drops in their cholesterol too, over the course of ten years, and their cardiologists were happy, because normal nutrition is so bad that ten years is an acceptable time frame for that. so: ten years' progress in two months' time.

seriously, this is a solved problem. this is like, "let's figure out how to get a computer into every home and office in America." they're already there! why are you trying to answer a solved problem?

you could spend your whole life debunking invalid theories, or you could just find the theory that works and run with it. which sounds like a more effective use of time?

I think it's pretty clear from your rant that you did not watch the presentation. The submitter did a great disservice to the speaker by framing this presentation as a debunking of the calories in/out model, because that is not, at all, the central point of this lecture.

(I have watched it through twice now, and it is a phenomenal presentation; I recommend it highly.)

In no way does the speaker attempt to turn thermodynamics on its head. Rather, he suggests that the storage of fat be perceived as the primary driver, and caloric intake & expenditure taking a back seat. He re-frames it this way because the real central thesis is about how fructose is a driver of obesity, which in turn leads to increased consumption.

The caloric in/out slide only serves as motivation for why we should be wary of the fact that fructose is a chronic toxin (in particular, the effects thereof), and how HFCS is an economic evil as much as a metabolic one.

It's ok to rail against the headline, though. The submitter took too much out of one slide, in my opinion.

Medical reporting is by far the worst type of reporting in the modern media. Anything health related that a journalist sensationalizes today will be contracted by something they sensationalize two years later. 16 years of agonizing about weight, and still I have no clue what might work and what might not work.

I don't have time to spend a lovely Saturday morning watching a 90-minute video just to criticize it, but how can one "debunk" the calories-in calories-out model? Surely this is just plain old thermodynamics?

If you're that busy you should skip commenting too.

The answer is that humans are not simple furnaces; different foods are metabolized in different ways, and affect appetite differently.

Heck, you're right, I should!

While that's true, the prime mover in weight gain is still calories. The type of calories is a secondary effect.

Discussing diet is hard because everyone reasons from personal experience. E.g., in my experience, almost all my fluid intake is Dr. Pepper and I consume large quantities of the "worst" food, as a proportion of my diet, but I don't eat that much and I work out, so I'm strong and fit with low cholesterol.

Surely this is just plain old thermodynamics?

Normally I'd be irritated at this obvious glib objection, but we have to make a physicist allowance in this case :)

The other one you hear all the time is, "But how can fructose be bad? It's in fruit." Gee, do you think he might have thought of that?

The submitter's sensational headline has very little to do with the lecture. You shouldn't watch it to criticize it. You should watch it because it is a very good presentation.

He doesn't debunk it. He asks the question why the normal regulation of the body, that tells you to stop eating, isn't working.

His answer is complex, but it all has to do with the introduction of fructose as a macronutrient after the 1970s.

And he brings up that point, and solidly refutes it.

Since you're short on time-- the human body processes a calorie of fructose differently than glucose-- it's actually more like ethanol (Maker's Mark in his case).

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