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Comment by bmelton | Hacker News Reader

The flip side to the caveman diet is that 1) it wasn't particularly planned. They eat what they could, when they could, and 2) There was a pretty major exercise component that went along with it, in that if they didn't hunt / fish / forage, they died of starvation.

The main issue with obesity is that people can easily afford to be obese and not too significantly impact their lives (aside from all health and social malaise of being overweight).

Eating how a caveman ate isn't a particularly bad diet, but misses out on the major aspect of a day filled with exercise.

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Numerous studies (See the first chapter of "Why we get Fat, by Taubes) have shown that Obesity is a disease of poverty. The food that keeps you lean (protein/fats) is expensive. Carbs are cheap. Poor people eat carbs. Rich people eat steak, chicken, fish. There is no significant research that shows adding exercise to an overweight person's lifestyle will significantly reduce their weight - typically just increases their appetite.

If obesity is a disease of poverty, then how come truly poor people (e.g., the poor in India or China) are skinny?

Lack of money for food is not a cause of obesity. If your goal is to obtain 2500 calories (assuming that is what you need to maintain a healthy weight) for a little money as possible, you will consume 2500 calories of carbs. You will not become obese. If you instead consume 3500 calories and become obese, you are wasting money on 1000 extra calories. You are not constrained by cost. You could instead reduce consumption by 1000 calories, and spend the money on increasing the quality of the remaining 2500 calories.

There is no significant research that shows adding exercise to an overweight person's lifestyle will significantly reduce their weight - typically just increases their appetite.

Increasing exercise and holding consumption constant will reduce body fat. One of many studies:

http://www.duke.cardiologydomain.com/images/uploaded/dukeh/2...

Do a google scholar search. The only difficulty is that you'll find so many studies which measure additional benefits to exercise that some of the studies measuring only effect on body fat will be buried. (I.e., the majority of the articles have conclusions like "exercise reduces body fat AND increases muscle mass", "exercise reduces body fat AND breast cancer", etc).

I'm curious, did you hear this claim from Gary Taubes? The one time I read a blog post by him, I discovered him to be incredibly dishonest: http://crazybear.posterous.com/how-1-graph-reveals-what-3000...

> If obesity is a disease of poverty, then how come truly poor people (e.g., the poor in India or China) are skinny?

Because they're not eating extremely processed foods based on subsidized grains that make them cheaper than real food... yet.

If obesity is a disease of poverty, then how come truly poor people (e.g., the poor in India or China) are skinny?

Corn subsidy in the U.S.. Not much else to say.

Rice and wheat are subsidized in India too. And unlike US poor, the poor in India can't afford to supplement it with a Big Mac, Fried Chicken or a Premium Southwest Salad.

They are skinny because they eat less. They cannot afford 2500 calories, so they consume 2000 calories (mostly rice or wheat, depending on region) and suffer adverse health as a result. They also get exercise working physical jobs rather than sitting at home and watching TV.

Of course, even if corn subsidies were unique, poverty still don't explain why the US poor waste money on 500-1000 extra calories. If they were optimizing for cost, they would eat only 2500 calories of cheap corn.

Corn subsidies in the US since more than a decade are mostly for fuel; the net effect is to make corn use for food more expensive, not less.

"and holding consumption constant" is the trick, ain't it? Works great if you want to lose a little weight later more than you want to eat another 500 calories now. Most people don't want that (me included, by revealed preference -- I'm over 300 lbs).

When people say that obesity goes with poverty, they're noting that virtually everyone eats until they are sated, and if you eat until you are sated with high-quality, expensive food, you will be far less likely to be overweight than if you eat until you are sated with low-quality, inexpensive food.

Exactly. Obesity goes with poverty because both are a result of a high discount rate.

High discount rate reduces the propensity for work (most poor don't work much, if at all), particularly work with a career path. Why work hard now just to have a middle class life in the future?

Similarly, a high discount rate cuts against a healthy lifestyle - why suffer through a run in the park and hunger right now, just for future health?

(Also explains correlation between poverty and: drugs, alchohol, unprotected sex, probably other pathologies I can't think of.)

High discount rate is the cause, everything else is an effect.

Of course, a high discount rate has nothing to do with the cheapness of carbs, fat and sugar relative to meat or veggies. Money is not the limiting factor. Willpower/preferences are.

You missed or ignored my point.

No one is saying that poor people couldn't eat healthy if they wanted to more than they wanted to feel satisfied. They're saying that given two people with the same metabolic genes, exercise level, and discount rate, if one of these two people spends ten times as much on food as the other, they will be likely to be thinner. This is because being sated with more expensive food results in eating fewer calories and better nutritionally than being sated with less expensive food, and this point has everything to do with the cheapness of carbs, fat, and sugar (which taste good no matter how prepared, essentially) relative to well-prepared meat and veggies.

Are you (aside from your main point) saying that the calories in meat and vegetables come from elsewhere than carbohydrates and fats? There is lots of protein in lean meat, but protein is poisonous -- you can't depend on it alone for energy.

No, I'm not saying that. I only repeated it to tie it to what yummyfajitas had said to me, because that was the part I was responding to.

What you say is perfectly logical, but subtly flawed when it comes to the USA.

If you're poor, odds are that you're eating fast food. The primary cost of fast food is not the cost of the raw ingredients, it is the time and effort to make the fast food. Furthermore many of the customers there see large portions as a value. Therefore fast food places have found it worth their while to offer large portions at a low price, and to inflate those portions with the cheapest foods that they can - french fries and soft drinks.

As long as fast food places do that, there is no real cost difference between 2500 calories and 3500 calories. Given how addictive most people find food that is high in sugar, fat and salt (which describes soft drink + fries), people tend to finish the portions that they are given. That will make you obese fairly fast, even if you don't "supersize" your portions.

Food banks often offer similar foods to fast food places because it is cheap and what their clientele is used to. This causes similar consequences. So in the USA even if you have no money at all, it is easy to get fat.

If there were cheap, convenient places to eat that made you pay according to calories and were willing to give realistic but smaller portions for significantly lower prices, then your reasoning would be absolutely correct in the USA.

Now you can argue that the underlying cause that makes this possible is that the country is rich enough that we can afford to be wasteful even on poor people. This is absolutely correct. But for practical purposes that detail doesn't matter. If you personally have little money and live in the USA, it is really easy to become fat.

An incidental note on exercise. Exercise burns calories. Obviously. However it takes very little extra food to offset the calorie expenditure from moderate amounts of additional exercise. Luckily exercise also affects appetite for many people, and muscle mass increases your basal metabolism. Therefore exercise is a win, but for moderate amounts of exercise not mainly because it directly burns off calories.

A Big Mac has 540 calories, fries are 380. The cost difference between 2500 calories and 3420 calories is the cost of a Big Mac and fries. McD's portions are big, but they aren't 3500 calories big. This isn't about finishing your portions. It's about not ordering and eating an extra meal.

You might be right if the only meals available had 1750 calories. In that case, your only choices are 1 meal (underfed) or 2 meals (overfed). But that simply isn't the case.

It is easy to become fat in the US, rich or poor. The poor are more likely to take advantage of this, it is true. But it doesn't save them money.

Your argument is sound, but overlooks that most people don't consume their entire daily caloric intake in a single meal. If I have a Big Mac, Fries and a medium soda, I'm almost certainly overfeeding myself for that meal.

Here is a 3 meal/day McDiet with a beverage at every meal.

Breakfast: Egg McMuffin (300 cals), Hash Browns (150 cals) and Coffee (0 cals).

Lunch: McChicken (360 cals), Fries (380 cals) and Coca Cola (210).

Dinner: Big Mac (540), Premium Southwest Salad with Chicken (320 cals), and Coca Cola (210).

2470 cals/day.

To become obese, you need to add this:

Afternoon Tea: Sweet Tea (150 cals) and McRib Sandwich (500 cals).

Desert: Hot Fudge Sundae (330 cals).

Now you are up to 3450 cals/day.

There is nothing about being poor which compels you to spend money on the McRib Sandwich, sweet tea and the Hot Fudge Sundae.

http://www.mcdonalds.com/us/en/food.html

Of course you can stop eating, but a poor person is more likely to get the 50 nuggets for $10, instead. Twice, for a total of 4750 calories, minus the ones they don't get to in each meal before they get cold. ;)

">>There is no significant research that shows adding exercise to an overweight person's lifestyle will significantly reduce their weight - typically just increases their appetite.

>Increasing exercise and holding consumption constant will reduce body fat."

I'm not sure you read the sentence you're responding to: "typically just increases their appetite."

Yes, if you lock a person in a room with the exact same meals every day, exercise will reduce their weight. A real world person who exercises though typically eats to compensate.

I'm not sure what your problem with Taubes is; your discovery of his 'incredible dishonesty' doesn't pass the smell test -- surely someone eating 7.5 extra strips of bacon per day would notice? There's a shot at his thesis being 'buy my book'; why is it more unreasonable to buy his cheap Kindle book than e.g. Tyler Cowen's to get the full scientific background? It's not like he's hawking some diet empire.

I'm not sure you read the sentence you're responding to: "typically just increases their appetite."

If you add exercise to a person's lifestyle without adding calories, they will lose weight. It's that simple. There is research to show this. I cited some of it.

your discovery of his 'incredible dishonesty' doesn't pass the smell test -- surely someone eating 7.5 extra strips of bacon per day would notice?

Go read Gary Taube's blog post. He spends thousands of words discussing that, according to the traditional calorie counting theory (which he is attempting to refute), the difference between a fat person and a thin person is "only" 20 calories above their respective maintenance levels. He then argues this must be absurd and incorrect, because how can "only a cube of sugar in your coffee" make you fat. This is an attempt at reducto ad absurdum.

He never, in his entire blog post, mentions the fact that the fat person is also eating 7 extra strips of bacon each day. If you read his article without being extremely careful, you will come away with the impression that the only thing the fat person eats that the thin person doesn't is an extra morsel of food each day.

"If you add exercise to a person's lifestyle without adding calories, they will lose weight. It's that simple. There is research to show this. I cited some of it."

That's great. There is also research that shows that acceleration due to gravity at sea level is 9.8 m/s^2, but that has little to do with what the OP said, which is that "exercise tends to increase people's appetites." You're refuting something he never claimed.

"He never, in his entire blog post, mentions the fact that the fat person is also eating 7 extra strips of bacon each day."

I'm guessing because that's not the case? You're begging the question by showing that his claims don't work out according to the calories in/calories out model.

You're refuting something he never claimed.

From the original post: "There is no significant research that shows adding exercise to an overweight person's lifestyle will significantly reduce their weight - typically just increases their appetite."

I'm guessing because that's not the case?

If you take as given the cals in/cals out model (as Taubes does, in an attempt to refute it via reducto ad absurdum), they do.

You're completely discounting the effect different foods have on insulin response as a factor in obesity. 2500 calories from carbs has a different effect on metabolism than 2500 calories from protein and fat.

The poor in India and China don't eat enough to become obese, let alone gain significant weight.

I think that the term "poverty" relates specifically to developed countries where fast food is the cheapest way for the poor to feed themselves off the dollar menu.

Very true, in my mother's generation overweight people in China were seen as 'freaks', as in circus freaks. This was even when there was enough food to feed everybody, most people remained in shape because

1. The food was whole. 2. People were very active, particularly where my mother grew up(Shanghai), mothers usually got up at 5am to get the fresh produce from markets everyday, people walked around a lot, bicycles were a luxury item.

Poor people eat carbs.

Poor people eat fast food. Good food is cheaper than McDonald's, but you have to be able to cook.

Fast food and carbs are equivalent: Potatoes, white flour, and sugar. The meat/vegetable content is negligible.

According to USDA, the recommended (carb, fat, protein) calorie distribution is (53%, 29%, 18%). Looking at McDonald's nutrition facts, the hamburger follows this distribution pretty closely; the other sandwiches appear to skew towards fat. Even fries still only get half their calories from carbs (and almost half from fat, well above the recommended 29%). When eating out, fat is cheap.

Again, good meat and produce (raw materials for cooking) are also accessible for less than it costs to eat out.

Where do you buy your affordable meat and produce? Every time I buy raw ingredients for a meal I end up spending like $25 (plus $100 worth of my time) for one or two servings that I could've got for $15 from Applebee's.

Where do you buy your affordable meat and produce?

The grocery store (and I don't mean some specialty place like Whole Foods -- if we're talking about eating on a tight budget, something like Wal-Mart will be much more helpful).

Actually, people cannot afford to be obese. They are massively subsidized by others in terms of health care expenses. Healthy people and other taxpayers are footing the bill.

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