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Hard Science About Diet

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If you haven't read either of Taubes's books, please do. I highly recommend Why We Get Fat[1]. It's a spectacular piece of scientific journalism. If that's too much for you, try one of his talks on the same topic[2].

When I first encountered the idea that we do not get fat from eating too much and that calories weren't responsible, I thought it ludicrous—the body can't disobey the laws of physics! Thermodynamics! But after seriously thinking about the idea, I realized Taubes was providing a far more complete understanding of metabolism. The human body doesn't run on calories, it runs on food. Yes, we can easily learn the caloric content of food, but that's largely irrelevant. What's important is how food affects the body, not its raw energy content. I see this misconception time and time again, especially among smart people who like to reduce the human body to merely a physical machine, often ignoring the whole biology thing.

I think the hormone theory of obesity is correct and I think these studies will prove it. But even if they show otherwise, this type of research is long overdue and we all stand to benefit from the results.

[1]: http://www.amazon.com/Why-We-Get-Fat-About/dp/0307474259

[2]: http://youtu.be/ywRV3GH5io0

> I see this misconception time and time again, especially among smart people who like to reduce the human body to merely a physical machine, often ignoring the whole biology thing.

Like the people behind Soylent?

I'm going to wholeheartedly disagree with you.

I've posted here about this before - I got involved with weight watchers through my two roomates as moral support for them, and have personally seen and been involved with many hundreds of people losing many thousands of punds - and keeping it off (that was over 10 years ago).

I've always thought of weight-loss like everything else we learn and do in life - start out simple and make it achievable while getting "beginner" results, then work your way up making it more and more complicated.

When you're 6 and learning to count, you are not taught differentiation and complex numbers.

When you're learning to surf, nobody would through you in at the world's biggest wave.

When you learn a new language, you don't learn the most complicated conjugations first.

Losing weight starts simply by reducing the amount of energy you're eating (calories) to a level lower than your body is using on a daily basis. I don't care if you eat raw sugar or fat, as long as you eat slightly less calories than your body is using for a prolonged period of time. (yes, you'll likely feel like shit if you eat raw sugar or fat, so I don't recommend it). Like you said, the body must obey the laws of thermodynamics. The longer you keep that up, the more weight you will lose.

I genuinely believe anything else at the "beginner" stage is noise and over complication. The mere fact so many books exist on the topic, and so many "new" theories come out each year is proof that it's too complicated for beginners.

Once you have some good "beginner results" and are losing weight consistently you will and start to move from morbidly obese to just obese down to a somewhat healthy range. THEN you can start making it more complicated, and start focusing on WHAT you're eating, not simply how much.

It's an advanced topic that isn't required for the basics. (just like you don't need complex numbers to count the number of marbles in your bag, or almost all other functions required in a normal adult life.)

Do you know how difficult it is in comparison, to lose weight using a low carb approach? Even if it's more difficult for some, it'll be easier for others.

>Difficult

What do you mean difficult?

Just put less energy in your mouth than you're using. Want a Big Mac? Great! a beer here or there? no worries. Personally, I find it much more difficult to vet the "type" of food I'm eating.

On average, just eat less energy than you're using. For most obese and morbidly obese people that's still an enormous amount of energy, so much so, they can continue to eat some pretty bad shit for a long time.

Here's the thing. Your advice has been constantly given to people wanting to lose weight for half a century. During that period, despite the people receiving the advice wanting to lose weight, the population has become massively obese. Makes me wonder why you're so cock-sure of yourself.

Anyway, Taubes deals very effectively with the argument you're presenting. The gist is that the number of kilo joules consumed does not have a particularly good correlation with fat stored, because the fat storage mechanism is mediated by insulin, which is heavily influenced by the consumption of carbohydrates.

> Makes me wonder why you're so cock-sure of yourself.

Because I've seen it work for hundreds and hundreds of people, and I know for a fact Weight Watchers (which is 100% what I'm talking about) has worked for millions of people.

> The gist is that the number of kilo joules consumed does not have a particularly good correlation with fat stored, because the fat storage mechanism is mediated by insulin, which is heavily influenced by the consumption of carbohydrates.

You're going to honestly tell me if I only put 9 gallons in my tank every day, but I burn 10 every day that I won't "run out" and burn up my reserve tank?

You're wanting to make it so complicated you can't see the simplicity in front of you.

I think you might be exaggerating when you say Weight Watchers has worked for millions of people. Here's a nice article about their success rate: http://fatfu.wordpress.com/2008/01/24/weight-watchers/ It says it's extremely low, less than 1%.

You linked a fat activists blog to try to prove a point? As far as I'm concerned, anyone who thinks eating less than you burn in energy won't lose you weight is selling something.

If I was an inanimate heat engine, you would have me dead to rights. But I'm not, I'm a living creature with free will (or a good approximation thereof). If I start feeling hungry, I'm going to want to eat, and it's not much use telling me that I shouldn't, if my body is crying out for more food I'll listen to it more than you (whereby "I" I mean an average person - it just so happens that personally I'm capable of resisting the urge, but I know I'm in the minority on this one).

When you eat carbohydrates, your body produces insulin, which encourages your body to suck the glycogen out of circulation, and store it in triglycerides. Congratulations, you just got fatter, and worse still, because all of that glycogen has just been stored away, you're feeling hungry again.

That means that if you can find foods that help keep your body from sending the "hungry" signal (by e.g not triggering the insulin-response), then you will naturally eat less.

>If I start feeling hungry, I'm going to want to eat, and it's not much use telling me that I shouldn't

So you admit that eating less calories is a valid way to lose weight, but that it takes willpower to stick to the diet? Use that free will of yours to eat less calories, and not less yourself become an inanimate eating machine. Sounds like you're letting your body control you, not the other way around.

I've met a lot of people who say that calorie counting doesn't work, but I haven't met a single person who consistently and meticulously counted calories over a long period of time, eating at a caloric deficit, who failed to lose weight.

The argument is that you won't keep off the weight. See chapter 2 of Why We Get Fat by Gary Taubes. If you turn off the calorie restriction, you gain all the weight back, and more.

I believe you're confusing "simple to describe" with "simple to accomplish".

You were never obese, were you? Because if you were, you wouldn't trivialize this affliction to this degree.

> I don't care if you eat raw sugar or fat, as long as you eat slightly less calories than your body is using for a prolonged period of time.

Well, you might not care, but your body sure does. Your body responds very differently to sugar than it does to fat. And for some people—I would say anyone struggling to lose weight—this difference is the key to success.

Yes, some people can lose weight eating nothing but carbs. There's a lot we don't know, and proponents of this theory will admit this. But one of the primary prinicples of this theory is that genetics plays a large role in human fat metabolism. Some people can eat whatever they want and remain thin, while others eat whatever they want and become obese. There is no such thing as a one size fits all diet.

Yet somehow people weren't widely obese in the 60s. I have this fascination with random pictures: it's really interesting to look not at the focus but an the background. You see the stuff in houses, the items in shop windows, etc. The relevance here is look at pictures of the 60s and people's sizes. Skim eg these [1] and look at the older relatives in the wedding pictures. You'll see people who can stand to lose 25 pounds, but (I just got back from the midwest) you don't see people who could stand to lose 100+.

Undoubtedly food has changed wildly in 55 years, but so also has the quantity. Not to mention all the estrogens from plastics.

[1] http://www.buzzfeed.com/summeranne/adorable-real-vintage-wed...

My guess is the folks smoked more cigarettes.

Sure they did, but not everybody.

There have always been adamant non-smokers just as there have always been convinced smokers.

Consumption has increased substantially:

http://www.usda.gov/factbook/chapter2.pdf

That lists a 25% increase in calories consumed between 1970 and 2000.

And all of those calories have been carbohydrates. So the question remains open: is it the calories or the carbs. And that is what the research in TFA is trying to answer.

If the hormonal food-partitioning theory is correct, had we increased calories 25% using fat instead of carbs, we wouldn't have an diabesity epidemic today. Instead, people would have perhaps gained a little weight and burned off a lot more using non-exercise activity thermogenesis.

Did you look at the file?

It does include an annual increase in grain consumption of about 50 pounds and an increase of sugar consumption of about 45 pounds.

But it also includes an increase of meat consumption of about 50 pounds, an increase of fat consumption of about 30 pounds and an increase in fruit and vegetable consumption of more than 100 pounds.

There are reductions of about 15 pounds of eggs and 100 pounds of milk products (people drink less of it, much of that weight is water).

There is certainly an increase in carb consumption, but it's clear enough that "all" is an overstatement, people are consuming an additional 85 pounds a year of meat+fats.

People were also shorter then as well, and shorter still as you go further back. Old clothes, houses, beds, cars... all based around a smaller frame. I'm 198cm/6'6", and while some modern cars are uncomfortable, some old cars I physically cannot fit into the driver's seat.

Nobody is arguing that reducing calories to below the amount spent will not cause weight loss. Of course it will.

I know however that if I ate 1900 calories in sugar a day, let's say by drinking two 2-liter bottles of Coke, I would be constantly hungry. Eating 1900 calories in high-fat high-protein food however leaves me more than satiated.

I think by focusing on the arithmetic in isolation you're making dieting much more difficult than it need be.

I agree.

Would you lose more weight drinking two liters of coca-cola a day or eating the equivalent total calories in a high-fat protein rich food?

I would think your body would burn through the straight sugar calories much faster than the protein. But consuming all the sodium in the coca cola product might cause water retention.

Toss up. But most if not everyone's diet will never be that one-dimensional.

> I would think your body would burn through the straight sugar calories much faster than the protein. But consuming all the sodium in the coca cola product might cause water retention.

http://zestnzen.files.wordpress.com/2011/11/nutritionenergyh...

You completed omitted any impact that hormones will have on this equation.

The sugar you eat in Coke is going to send your blood sugar / insulin levels to sky rocket. High insulin levels cause fat storage. You could "lose" weight, but your body composition (or body fat percentage) certainly won't improve.

This isn't how homeostasis works at all.

Insulin levels cause fat storage in order to lower blood sugar levels. If all you did was chug two 2-liter bottles of Coke, you'd temporarily go through lipogenesis, then go back through lipolysis to pull the stored calories back out for use later in the day.

Insulin doesn't magically make you fatter if you're consuming the same number of calories. A high protein/fat diet is more satiating and you consume less calories, but insulin is not evil.

I think we're arguing semantics.

Most people when they say they want to lose "weight" meant they want to lose "fat" and improve body composition.

Focusing solely on calories in / calories out omits any effects hormones have on fat burning / storage.

In your scenario - yes - if someone drank 2000 calories of coke and that's it, they might not get "fatter", but that's not how real life works.

99/100 times, that person who drank 2000 calories of coke is going to be starving shortly afterwards and isn't going to simply "fast" and let lipolysis take place. Instead, because sugar causes ridiculous cravings - they're probably going to crack and down another 1,000 calories of another carb intensive, sugary food ('cause cravings) until their calorie intake exceeds their calories used and their hormone levels are thoroughly trashed.

I like hypothetical scenarios as much as the next guy, but focusing strictly on calories in / calories out and ignoring hormone imbalances, cravings and other real-life factors are typically symptoms of someone who reads lots of books, but hasn't has too many real life case studies to work with.

No, we aren't arguing semantics. You're arguing semantics now that you have a lot of qualifiers on the statement you made earlier.

Your initial assertion was that high insulin levels cause fat storage (really, insulin causes blood glucose to drop, either through glycogen uptake in muscle tissue or lipogenesis and glucagon causes it to rise via the opposite mechanisms) in response to the prompt:

> Would you lose more weight drinking two liters of coca-cola a day or eating the equivalent total calories in a high-fat protein rich food?

I'm sorry that my made-up scenario isn't the same as your made-up scenario, which now has a ton of conditions and it suddenly "real life".

Yes, in real life, someone who consumes 2000 liquid calories is going to be hungry. As is someone who consumes 2000 calories of bread. Or donuts. Or anything else which is digested rapidly (and this is exactly why I brought up satiation).

But this isn't a "hormone imbalance." This is, in fact, absolutely typical and ideal action from hormones doing their job, unless your made-up-real-world scenario now also involves people with insulin resistance. Because 2000 calories is 2000 calories, and while studies show that the normal metabolic range is +/- 200kcal from calculated bmr, "hormones" are not some wild card. Men eat more (higher bmr, testosterone promotes liposysis and better nutrient partitioning), but a man or a woman doesn't go through massive hormonal changes on a regular basis, and consumption of an equivalent number of calories from different macronutrient groups can be expected to have about the same effects on composition (unless it's all protein, in which case you get to worry about dying).

If you want to discuss hypothetical scenarios (2000 calories of sugar vs equivalent total calories in a high-fat protein rich food), discuss them. But don't change your stance when someone questions you.

You are indeed both correct.

The problem with people who do things like drink 2 litres of coke, is that they become insulin resistant. Meaning they produce a lot more insulin than required, as thier bodies ability to gauge how much insulin is thrown out of wack (by the spikes in sugar).

Now when you have something that only requires 2units of insulin, your body outputs 4 (because of insulin resistance) and now fat cells are being created when they shouldn't be. (Because insulin is what regulates fat storage, i.e insulin takes the sugar out of your blood by shoving it in a fat cell).

Keep this up, and you eventually end up diabetic.

You are both saying the two different sides to the same coin.

EDIT: To be clear - If you have regulated insulin (by controlling carbs and suger) you will gain less fat (but lose it normally). If you starve your body of those sugars in the first place you will lose more than you gain (regardless of insulin). This is why WeightWatchers works, and why Excercising your arse off works, and also why Paleo/Atkins/Low-carb works.

I can't reply to your comment & don't want this to turn into a flamewar, but we're essentially saying the same thing.

Calories in > calories out can "work", but it's not an efficient way to address body composition - especially with people new to nutrition because of the hunger / craving factor that invariably comes up.

Also - continually drinking 2000 calories of coke is going to lead to chronically high blood sugar / insulin levels and will degrade their insulin sensitivity over time.

You have to eat zero fat on a sustained basis and absolutely gorge on sugar to make lipogenesis happen at all. The body can store pounds of sugar as glycogen. In humans lipogenesis is an extremely inefficient process that burns up nearly 30% of the calories in conversion.

Zero fat, high sugar diets have been a proven way to get lean for decades. If you put people on a very low fat diet with a good amount of protein (say 90 grams), you can allow them to eat sugar and starch ad libitum and they will get lean. No need to count calories.

https://www.drmcdougall.com/2013/12/31/walter-kempner-md-fou...

Are you seriously linking a study from the 40s from a blog post hawking a book? Please go read the last 80 years of nutritional research.

Humans are very inefficient at converting carbohydrate to fat; we don’t do it under normal conditions. (The cost for this conversion is 30 percent of the calories consumed.) Subjects overfed large amounts of simple sugars under experimental laboratory conditions, however, will convert a small amount of carbohydrate to fat. For example, both trim and obese women fed 50 percent more calories than they usually ate in a day, along with an extra 3 ½ ounces (135 grams) of refined sugar, produced less than 4 grams of fat daily (less than 1/8 ounce). That’s just 36 extra calories stored as fat per day. You’d have to overeat all of those extra calories and table sugar every day for nearly 4 months just to gain 1 pound of extra body fat.

6 . Hellerstein MK. De novo lipogenesis in humans: metabolic and regulatory aspects. Eur J Clin Nutr. 1999 Apr; 53 Suppl 1: S53-65. 7 . Acheson KJ, Schutz Y, Bessard T, et al. Glycogen storage capacity and de novo lipogenesis during massive carbohydrate overfeeding in man. Am J Clin Nutr. 1988 Aug; 48 (2): 240-47. 8 . Minehira K, Bettschart V, Vidal H, et al. Effect of carbohydrate overfeeding on whole body and adipose tissue metabolism in humans. Obes Res. 2003 Sep; 11 (9): 1096-1103. 9 . McDevitt RM, Bott SJ, Harding M, et al. De novo lipogenesis during controlled overfeeding with sucrose or glucose in lean and obese women. Am J Clin Nutr. 2001 Dec; 74 (6): 737-46. 10 . Dirlewanger M, di Vetta V, Guenat E, et al. Effects of short-term carbohydrate or fat overfeeding on energy expenditure and plasma leptin concentrations in healthy female subjects. Int J Obes Relat Metab Disord. 2000 Nov; 24 (11): 1413-18. 11 . McDevitt RM , Bott SJ, Harding M, et al. De novo lipogenesis during controlled overfeeding with sucrose or glucose in lean and obese women. Am J Clin Nutr. 2001 Dec; 74 (6): 737-46. 12 . Danforth E Jr. Diet and obesity. Am J Clin Nutr. 1985 May; 41 (5 Suppl): 1132-45. 13 . Hellerstein MK. No common energy currency: de novo lipogenesis as the road less traveled. Am J Clin Nutr. 2001 Dec; 74 (6): 707-8.

> Humans are very inefficient at converting carbohydrate to fat; we don’t do it under normal conditions.

You must have a strange view of "normal conditions." Fat is actually a more-efficient, longer lasting source of energy than carbohydrates.

From the first citation in the above comment:

>De novo lipogenesis in humans: metabolic and regulatory aspects. http://www.ncbi.nlm.nih.gov/pubmed/10365981

"Eucaloric replacement of dietary fat by CHO does not induce hepatic DNL to any substantial degree. Similarly, addition of CHO to a mixed diet does not increase hepatic DNL to quantitatively important levels, as long as CHO energy intake remains less than total energy expenditure (TEE)."

I agree with you, have you read this? It's from 1958 : http://www.ourcivilisation.com/fat/index.htm

Agreed :)

> High insulin levels cause fat storage.

You need to read more than your confirmation bias-laden sources if you believe these things. Stop reading Taubes and pick up Aragon and McDonald. The best way to actually learn the truth is to read something that runs counter to your viewpoint and analyze it.

> The best way to actually learn the truth is to read something that runs counter to your viewpoint and analyze it.

The best way to learn the truth is to experiment for yourself and see what actually happens.

I'm always willing to read counterpoints - but I've yet to see anything that counteracts the fact that high insulin levels prevent the fat burning process from taking place. Insulin isn't evil and if you time it right - it can actually be quite beneficial, but chronically elevated insulin levels are a problem for people trying to burn fat.

I'm happy to read any links you want to send my way. In the meantime, I suggest you take a look at John Kiefer's work at http://body.io to see how your hormone levels can have a bigger effect on your overall body composition than straight calories.

>body composition (or body fat percentage) certainly won't improve.

It most certainly would improve. He might have a better result with a more reasonable diet, but he would still see a significant reduction in his body fat percentage if he stayed on the diet long enough.

It is more complex then the situation you presented.

Sugar is literally a poison, it's the reason why unchecked type 1 diabetes leads to deterioration of various organs. The body knows this but also runs on the stuff, so it tries to keep it at a sane level that does the least amount of damage to the body while still providing enough energy to run.

When blood sugar spikes, the body starts storing in the liver, when that storage is used up, it starts converting the sugar into cholesterol(and fat). Insulin is the primary hormone involved in this mechanism. So the body starts storing the energy in alternative non-immediately usable forms not because it runs out of storage and an excess of sugar in the blood is extremely harmful.

Protein based or complex carbs which convert to sugar interaction with this bodily hysteresis differently. It does not cause the blood sugar spike and the associated insulin surge.

Using a completely different line of logic, it's trivial to say that energy in / energy used is the dominating factor in weight gain or loss, when you examine people that eat a lot and don't gain weight regardless of exercise/fitness related factors, vs those that eat moderate portions with moderate exercise but nevertheless do not lose weight.

In short, there are a lot of factors involved here.

Sugar is not literally a poison. Anything ingested to excess is bad for you, even water.

"a substance that is capable of causing the illness or death of a living organism when introduced or absorbed."

Water can be a poison if it wants to be too, however, sugar is orders of magnitude more poisonous than water.

Sugar is not a substance like water in which "hey if you drink enough water, more than most people can even if they were trying to, you can die." It's more like, the body is constantly struggling to keep blood sugar levels at a level that won't kill it, and there are great many metabolic disorders in which it fails to do this, and dies.

Also, there are diets which can simply overwhelm the body's ability to regulate blood sugar levels, some which lead to the body dying, see: type 2 diabetes.

If you count up the premature deaths(looking at human-life-years lost is probably most informative) associated with type 2 diabetes and heart disease related to sugar-induced metabolic disorders, one might be surprised that the poison we call sugar may have one of the highest kill counts of all known poisons. And to top it off, it happens to be a poison that we are, by an unfortunate evolutionary happenstance, generally addicted to. Oh yeah, it's also supported and pushed by multiple billion dollar industries with significant lobbying power.

I've never seen sugar implicated as a cause of type II diabetes. Is sugar bad for you once you get type II diabetes? Sure! But it didn't cause it.

>I've never seen sugar implicated as a cause of type II diabetes.

Sugar has been implicated as a cause of type II diabetes by many people [1]. Whether they are right or not is up for debate.

Even my great grandmother, born in 1915, used to warn that too much sugar would cause diabetes. According to her this was conventional wisdom when she was young.

[1] http://www.npr.org/blogs/thesalt/2013/02/28/173170149/sugars...

And my grandmother said dietary oil causes acne. Conventional wisdom isn't science. If it were, all science would ever do is confirm conventional wisdom.

I'm not arguing conventional wisdom is evidence that sugar causes diabetes.

The GP said he or she had never seen sugar implicated as a cause, like that was something he'd never heard of--when in fact it was and is a common belief. Whether that belief is true isn't something I'm arguing.

There is a new documentary called Fed Up, produced by Katie Couric, that I'm pretty sure will say that sugar is the most likely cause of the diabetes epidemic. I have it on preorder.... out Sept 9th.

http://fedupmovie.com/#/page/home

If I drink a litre of water in one sitting, I feel queasy and unwell. This is "the illness of a living organism". I've done it before on hot days - it's not like it's hard to drink a litre, most people can do it easily. I have been poisoned by water, using that definition, but most would say that using the term that way is needlessly pedantic.

Are you aware that just like the body regulates sugar, it also regulates water? The body tries to maintain the right level of water, and it's easy to show: drink a lot. In short order, you'll be pissing a lot, to get rid of the excess water. People that have their ability to regulate water inhibited also show a lot of illnesses as a result - in terms of demographics, this can be seen in cultures where women aren't allowed to go to the toilet during the day. Sugar doesn't get magical, unique treatment in biology - water even has its own organ system that is primarily devoted to managing water content. And if you want to get socio-political about it (unsure why this means it's a poison...), we're also addicted to water and nations go to war over fresh water supplies... something that is pretty rare for corn or cane fields.

The point is that labeling sugar as a poison is being simplistic, and the picture is far more complex than that when discussing diet.

Of course sugar is literally a poison. So is water. I think what you mean is in practice it doesn't really matter.

No, it really isn't. "Sugar" is not a poison. "A very large dose of sugar" is a poison. It's a very important distinction. Small or moderate amounts of sugar do not cause problems, and in fact give the organism more energy to work with. If you take the position that the substance is a poison simply because it's possible to hurt yourself if you take ridiculous amounts of it, then the term 'poison' becomes meaningless. Everything then becomes a poison, and it's then completely redundant to label something a poison.

Besides, sugar is the primary fuel for your brain; without sugar, we don't exist. It's a funny sort of poison that is necessary for our existence.

I'm not saying it's useful to call sugar a poison, and I don't generally refer to it as one. I'm saying it fits the definitions I've seen of poison, and that makes it literally a poison.

> Besides, sugar is the primary fuel for your brain; without sugar, we don't exist. It's a funny sort of poison that is necessary for our existence.

Arsenic, along with several other low-dose poisons, is also necessary for our existence[0]. Do you disagree it's a poison?

0 - http://www.chemicool.com/elements/arsenic.html

Let's stop being silly. No substance is or is not a poison. You have to talk about concentration and mass relative to everyday exposure when you claim something is poison.

Your definition of poison includes literally everything and isn't very useful, or what anyone means when they use the word "poison".

"Calories count. Macros more so."

EDIT: I'm on the Keto(genic) diet (protein/fat primarily) and run 3x/week. I'm losing ~3lbs/week. Start weight: 178lbs; goal weight: 148lbs. Height: 5ft 6inches. I almost never feel hungry on the diet, and plan on continuing it after I meet my weight loss goals.

Depending on how carefully you want to track how you eat, I would recommend dropping the weight loss to ~1lb per week (~500 calories under TDEE). Any faster than that and you'll probably be sloughing off whatever muscle you already have, and you probably won't like the result of that.

I'm consuming ~140g/protein a day. Enough to build muscle while shedding the fat, but not enough to damage my kidneys during the process.

EDIT: Here comes the Pubmed!

http://www.ncbi.nlm.nih.gov/pubmed/23219108

http://www.ncbi.nlm.nih.gov/pubmed/17383270

TL;DR High protein diets increase kidney filtration rates; whether it causes kidney disease is inconclusive. Non-animal protein is preferable to animal-based proteins.

I eat about the same protein as you and am the same height, but my start and target weights are slightly lower (st: 160, target:132). I track my calories/macros religiously (my wife calls it an obsession that I weight and track all the food I eat)

I would still not advise you to go over 2 lbs a week of weight loss (which if you do everything right, will be about 80% fat, 10% muscle and 10% water, give or take). Just because you eat more protein (or lift weights) doesn't mean your body won't trigger muscle breakdown. It will mitigate the amount, sure, but won't just magically stop it because of high protein intake. What most likely will happen, is your body will use protein for energy.

It is quite hard (only found one study that corroborates this (and it was with really untrained obese males) where there was actual muscle increase while losing fat (something along the lines of 2 kgs muscle increase and 9 kg of body fat lost over a period of 6 months I think), but interestingly enough it was a medium carb, medium protein, low fat diet. I'll try to dig up the publication when I can.

Also, do note that keto/low carb (and do note, that fitness keto is different from actual ketogenic diet, the latter being more than 85% of calories from fat) diets tend to produce quick weight loss at the beginning due to water weight and I still recommend to regularly have an high carb-eat at maintenance day to restore hormone levels and fill up the muscles with glycogen (and this will make you go up the scale 2-3 pounds). (ps: high carb day = loads of fruit, some rice, bread, not icecream+cookies+chocolate)

Good luck with your progress.

I too have personally had the best luck with 1.5 lbs - 2 lbs per week. The proper caloric deficit to achieve those weight loss amounts per week, along with a 25% carbohydrate, 47% protein, and 28% fat diet has allowed me to lose mostly fat with very little muscle.

With my body at least, it seems that the difference between 2 lbs per week and 3-4 lbs per week is huge in terms of how much muscle is kept during the fat loss process.

If you're already hugely overweight than of course it doesn't matter and fast weight loss should be expected.

Thank you for all of the info! I'll ensure I keep a close eye on muscle breakdown and weight loss curve.

> I'm consuming ~140g/protein a day.

Care to share any suggestions how to accomplish this with a diet that actually tastes good and doesn't require too much preparation time? Most people seem to use yucky protein shakes or huge portions of ham or other bland food and I just can't force myself to eat such stuff.

I used to work with a guy who was a body-builder type, and all he would eat was chicken breast, breakfast, lunch and dinner. I guess you have to pick what's important to you.

I think that if your goal is just to be generally healthy, there's no need to eat that much protein.

http://www.pureprotein.com/products/35g-shake-rich-chocolate...

From Amazon, $22 per 12 pack. 3 cans per day.

Thanks for the suggestion - these are prohibitively expensive over here (about $15 per single can from amazon.de), but I found similar products at much better prices that I'll give a try.

Excellent! Best of luck! I also recommend /r/keto and /r/fitness on reddit.

I use Premier Protein shakes, 30g/shake. I'll say this: when I eat like crap, this much protein is really tough. I was a bad-air machine, bathroom trips all day long, to put it nicely. Once I went to the slow carb diet and basically cut out carbs/sugar, it was very doable to have 3-4 shakes per day.

Add a pint of milk to every meal. There's 30g of protein and 900 calories.

That plus eggs/omlette, bacon, sausage etc. for breakfast, sandwich for lunch and some kind of meat and veggies for dinner = 200g of protein easily.

With adequate exercise you won't lose muscle mass.

I work construction and went on a strict keto diet, I was losing ~1lb per weekday. I actually got stronger whilst on the diet, which I attribute to the increased testosterone that comes in after your body becomes adapted.

It's important to note that the Inuit used to live on an exclusive ketogenic diet, they also live in an environment that requires ~6,000 calories a day to simply maintain if living the traditional lifestyle.

What I found working outside whilst on keto and running into winter was that my body managed to maintain its heat extremely well and far better than previous years on a normal diet. I estimated my caloric use at between 4500-5000 a day by how much I ate and how much I lost.

As with any diet it's important to eat adequate protein and exercise. Protein is quite readily converted (very inefficiently) into sugar, and if you don't force it into ketosis you go into starvation and that's when you really risk muscle atrophy.

> I think by focusing on the arithmetic in isolation you're making dieting much more difficult than it need be.

On the contrary, I think by trying to teach a beginner all about the different kinds of food (complex numbers), and how much of each they need, you're make weight loss (learning to count) much harder than it need be.

How much easier than "eat less calories than you use" can it be?

>>How much easier than "eat less calories than you use" can it be?

Because we have no way to accurately measure how many calories your body actually uses. We only have very, very rough estimates and guidelines, and even then there are so many factors to take into account (some personal, some environmental) that it will simply overwhelm a beginner. For example, when you are at a caloric deficit, your metabolism slows down and therefore burns fewer calories too. Not only that, but your hormone balance changes too, and your body can re-prioritize which tissues to retain and which to get rid of. This is why people who lose weight don't lose just fat but also a lot of muscle, and become weaker as a result.

This is why an "eat this, not that" approach works a lot better than an "eat less calories than you use" approach. The former is very clear and tangible. The other uses a lot of rough measurements and guesswork and the side effects of its results are not always ideal.

> Because we have no way to accurately measure how many calories your body actually uses.

Of course we do!

Weigh yourself every week for months and months on end.

If you're gaining weight, you're eating more than you're using.

If you're more or less maintaining weight, you're in balance.

If you're losing weight, you're eating less than you're using.

And yes, absolutely your body will adjust and adapt and these values will change. That's why we re-adjust and re-evaluate constantly - in fact weekly!

The entire point is to lose weight, which by very definition will reduce your calorie requirements, which will then require you to again eat less calories, which again will make you lose weight, which.......

> This is why an "eat this, not that" approach works a lot better than an "eat less calories than you use" approach.

They're actually the same approach, one is just at a lower level of abstraction than the other. You're "eat this, not that" is basically just saying "avoid things that are very calorie dense, and as a result you will reduce your calorie intake". Of course, if I eat a lot of "this", I'm still going to put on weight, so your advice is too abstract to always work.

AND to include the "emotional" part, telling me I can't eat chocolate cake or have a beer sucks and it's too hard. I'm never going to sustain that for the rest of my life. Everyone slips up.

>>Of course we do! Weigh yourself every week for months and months on end.

Weight fluctuates a lot in the short term, which means that it is a very unreliable measure of one's progress. Furthermore...

>>The entire point is to lose weight

No, the entire point is to lose fat, and retain lean body mass. A simple scale will not show you these details, and even the fancy fat-measuring scales are grossly inaccurate.

>>Your "eat this, not that" is basically just saying "avoid things that are very calorie dense, and as a result you will reduce your calorie intake".

Nope. I don't have a problem with calorie-dense foods, because they keep me full for a longer period of time. What I do have a problem with is sugars, starches and simple processed foods. You know, things that spike insulin levels and increase both fat gain in the short term and risk of diabetes in the long term. The fact that these often times appear in calorie-dense foods does not mean that calorie-density itself is the problem. That's why an "eat this, not that approach" is useful: it can shed light on these types of discrepancies, as opposed to hiding them behind the calorie layer of abstraction. And ironically, keeping a simple list of foods to eat and foods to avoid is a lot easier than obsessively counting calories day in day out.

I have lost 35 lbs in the past six weeks or so. I could not have done it without my simple, digital scale. After using several methods of measuring progress, I realized that the scale is the only tool that isn't horribly prone to operator fluctuations in use. You can keep your calipers, your body tape, your impedance scale, I'll keep my scale, thank you very much.

> No, the entire point is to lose fat, and retain lean body mass.

This is a foolish thing to try to accomplish, as it's impossible to measure your progress and be sure that what you are doing is effective, unless you have your own underwater weighing device or DEXA pod or whatever.

You can effectively have one of two goals, gaining lean mass, or losing weight. It's pointless to gain lean mass unless you've lost enough weight that you'll be able to see the results of gaining mass. When you lose weight, you will also lose a certain amount of lean mass, which you can gain back easily, at least easier than it was to lose the weight.

My favored method for losing weight is to combine intermittent fasting, calorie restriction and carb restriction. I eat a small meal once a day. The other day I had a pub burger without fries and water, that was a rare meal where I had significant carbs. I also do light exercise consisting of a daily 2-3 mile walk. I've gone from 205 to 170 so far, and intend on continuing until I hit 160-155. I trick hunger with small spoonfuls of almond butter.

It sucks for energy and mood but it's fantastic for weight loss. I suspect the energy and mood part are largely mental. What I love about it is that I'm literally melting away years of neglect in the space of a few weeks. I didn't start out so strict, I used to eat a lot more calories in my one meal, around 1300-1500. Now it's closer to 5-900.

At some point I will stop starving myself and start lifting again. I used to try to do both, lose weight and gain lean mass, but without tools I could use to make sure I was on the right track I just gained muscle and kept the fat.

Your method does not 'accurately measure how many calories your body uses', it just tells you whether the goal of weight loss is being achieved.

It doesn't even tell you that very well. If you are losing muscle, you are likely becoming less healthy. The scale is an awful tool for measuring health.

I think you've lost track of the big picture here. Measuring against the goal of weight loss is the point. In absolute terms it's a terribly inaccurate way of finding calorie use, but in diet-management terms it's perfectly sufficient. Despite a multi-pound margin of error, given several weeks of data you'll have more accurate information on net calories than on income.

that guy is a troll. he's literally repeating the same useless thing over again. everyone knows how simple it is to lose weight, the problem is the difficulty with people who have a physiological and psychological problem of overeating. that's the thing he doesn't address at all and is the actual problem today.

He's not a troll, he simply correcting people's misunderstandings.

If you eat fewer calories than you burn will you loss weight? Yes, of course.

Do people have trouble sticking to calorie deficient diets? Yes, that's why so many people are fat.

Very few people even bother to track calories. Some people do have trouble sticking with it, but for most, the eureka moment happens sometime in the first week when they realize that they are consuming far more calories than they had believed. It's not a problem of perseverance when most people aren't even bothering to get started.

That's a fair point. A lot of people track calories and fail at doing it well enough to loss weight, while others never actually try.

Calorie logging is actually probably the best solution to the psychological problem. Your stomach is saying to your brain that it is hungry and that you must eat. Sometimes you might be so hungry that you feel you are actually hurting yourself. But if you have been logging your calories and macronutrients, your brain knows that you will be okay. You're not gonna die even if your stomach says that you will. It's a triumph of cognition over biology.

How about fixing the physiological problem that is telling you you are hungry? If you are feeling hungry all the time, it is because you are leptin resistant. People become leptin resistant in an insulin-flooded environment. Solution: restore leptin sensitivity by stopping the flow of insulin. You stop the flow of insulin by reducing carbs (and possibly protein). You maintain leptin sensitivity using intermittent fasting (if you have iron will-power, you could use this as a starting point, but that sounds miserable to me).

Note that this physiological state (leptin resistance) is likely an evolutionary survival advantage as people would be insulin-flooded when eating fruit in the late summer and early fall, just as packing on weight for winter would be most advantageous. Since we never have the proverbial winter to lose the weight and restore leptin sensitivity, we are left starving and eating more all of the time.

People don't get fat because they are eating too many calories. People are eating too much because, physiologically, they are getting fat. Hormones drive the behavior.

Actually, the thinking is that if you eat right, you don't have to count calories. It's certainly easier to say "avoid food types A and B", rather than "take all the foods you eat, get the calories per gram, weigh them up, then count how much you're eating, make sure you stay below this limit, and just ignore that nagging feeling in you're brain that tells you you're hungry, you could avoid that feeling easily by eating right, but that's too complicated for you, just eat whatever and write down these numbers instead."

I don't know for sure what works, but arguing by "what's more simple" is stupidity.

"How much easier than "eat less calories than you use" can it be?"

Sending a rocket to space is easy. You just need enough fuel to get to space.

Weight loss is hardly as simple as learning to count, assuming we're talking about actually doing something and not just planning for it. You seem to assume very little capacity for learning basic nutritional facts and very high capacity for sticking to a diet (willpower). I would argue most people are in the opposite position.

this is like telling an alcoholic "recovering from alcoholism is simply reducing your level of alcohol intake to a level that isn't harmful." - yes, that's true. however it doesn't fix anything.

obese people are not normal. if "just eat less" was even remotely possible, they would have done it already. the above statement literally adds nothing of value to the situation. there are millions, soon to be billions, of obese people in this world - telling them all to "just eat less" isn't a solution. it's just not.

similarly, some people simply "drink too much" and can easily follow this advice. most alcoholics can't. here's the catch though - those who can just cut down, aren't alcoholics. do you see how this "just do less of X" logic is only descriptive, not prescriptive? there's a big difference.

keto is a specific diet designed to combat a specific kind of overeater, and it is extremely effective at that. it also happens to work for lots of others such as athletes who want to cut fat extremely quickly.

many overweight people are addicted to carbs and processed food, full stop period. because they eat too much carbs, they can not stop eating carbs, which pulls them into an insulin/fat storage/hunger spiral which is extremely, if not impossible, to pull out of. they have to just STOP, but the trick is replacing it with something else that will actually satisfy them.

keto helps with that. it helps direct your eating choices in a sustainable way while returning hormone levels to that of a normal person, preventing the death spiral of hunger and eating. it also satiates hunger and allows people to eat foods they like without feeling deprived, a critical component of long-term success. in short - keto allows you to eat less, or to eat like a normal person. combined with the judgment call that fat is not bad for you per se, it's an amazing way of approaching this problem.

don't forget the human element in dieting. pardon my language but "just eat less!" is worthless advice. utterly, devastatingly, uncompassionately worthless.

> if "just eat less" was even remotely possible, they would have done it already..... - telling them all to "just eat less" isn't a solution. it's just not.

In my experience, this is not true.

Of the hundreds and hundreds of people I watched over many years lose combined thousands of pounds, I estimate somewhere around 75-85% of them had no idea how "calorie dense" some foods are in relation to others. And when I said no idea, I mean not even an inkling of an idea.

I've seen hundreds of grown adults completely jaw-dropping shocked that an massive bowl of salad has the same amount of energy (points in WW speak) as a small piece of chocolate cake.

I've seen them dumbfounded by how much energy is in a "meal" at a fast food joint.

I've seen them argue and think the book is wrong that a piece of meat, or a glass of wine has so much energy in it, but a cucumber or multiple Apples has very little.

Weight loss is a problem of education and understanding.

>it also happens to work for lots of others such as athletes who want to cut fat extremely quickly.

It's interesting you would suggest that the technique you're advocating works well for athletes... you're a Math teacher saying we should teach 6 year-olds Complex Numbers because it works well for Engineering Students. Athletes and people attempting to take the first steps to losing weight and understanding their bodies are not even remotely the same, and it's preposterous they would use the same technique to reach their goals.

(Also note, your incorrect interpretation of what I said shows you yourself are not completely understanding what I'm saying or what you need to do about it. I never once said eat less. In fact, I've seen hundreds of people lose weight by vastly increasing the amount they eat by eating vast mountains of vegetables and some fruit, and eating many, many meals per day. They only need to decrease the amount of energy they're eating, not the raw amount.)

>>In my experience, this is not true.

Here's an interesting idea: maybe your experience is simply your own and doesn't apply to that many people.

That's why we have science, after all: so that we don't make important health decisions based on some person's "experience."

My experience is Weight Watcher's experience, which I'm going to bet has some of the biggest body of experience about weight loss in the modern world.

here's one for you.

http://www.cracked.com/blog/the-5-most-useless-pieces-advice...

> I've seen hundreds of grown adults completely jaw-dropping shocked that an massive bowl of salad has the same amount of energy (points in WW speak) as a small piece of chocolate cake.

I think this is the most important part. I'm an adult, I have a PhD in Computer Science (not boasting, just saying I felt like I should be on the more educated side of things), and I still massively underestimated the tomato to chocolate cake calorie ratio when challenged to do so.

I've lost 270 pounds over 2 years by simply eating less as determined by calorie counting, so I think it depends a lot on the person.

What about inflammation? What happens to my body when I eat 800 calories of pancakes, syrup and hash browns, and start to sweat, feel sick and get tired?

Sugar does not cause inflammation. Sugar lowers cortisol and adrenaline levels. These stress hormones suppress existing inflammation. So in people with elevated catecholamine levels sugar intake tends to unmask damage and initiate a healing process.

This is related to the reason people think low carb diets work. Low carb dieting sends stress hormones way up, because cortisol is necessary to break down proteins into needed sugars. People tend to feel pretty good at first in this state. The problem is it totally breaks down into bad endocrine and metabolic problems after two or three years. Nobody debates that ketogenic diets seem to work for weight loss in the short run; the issue is that in the long run they're a health disaster.

I do not believe that is true. I can eat greasy hamburgers minus the bun and feel completely fine. I thought the body would use fat and ketones to convert to energy and only convert a very small percentage of protein to glucose.

From the Harvard Medical School Family Health Guide:

"Don't be so refined. The bolus of blood sugar that accompanies a meal or snack of highly refined carbohydrates (white bread, white rice, French fries, sugar-laden soda, etc.) increases levels of inflammatory messengers called cytokines. Eating whole-grain bread, brown rice, and other whole grains smooths out the after-meal rise in blood sugar and insulin, and dampens cytokine production."

http://www.health.harvard.edu/fhg/updates/What-you-eat-can-f...

The cytokine release is exactly what I was describing. It only happens when there is damage and infection to heal. You do not see an inflammation response in a healthy person when they eat sugar/starch. The glycemic index stuff is pretty much nonsense. If you don't have type I diabetes your body is perfectly happy to sop up spikes of sugar and it does no harm at all.

Thanks. Can you recommend a book?

So the claim that on a ketogenic diet your brain only needs 5% of energy from protein (to make glucose) and the rest from fats and ketones is wrong?

I would recommend Ari Whitten's "Forever Fat Loss" as a book on fat loss nutrition.

I don't know all the detailed claims ketogenic diet advocates make, all I know is that sustained low carbohydrate diets are damaging and a very bad idea. They do in fact work for fat loss in the short run, which is why so many people are buying into it.

> The problem is it totally breaks down into bad endocrine and metabolic problems after two or three years

Citations please?

> Like you said, the body must obey the laws of thermodynamics.

Perhaps I'm reading more into it than you intend, but a pure thermodynamics view assumes if you eat an extra 1000 calories that it will be stored as fat, does it not?

I know from personal experience this is simply not true.

But maybe you're only referring to the weight loss end of the spectrum? In which case yes, there are certain laws that the body simply cannot defy - however, with very small variance in calories, evidence suggests the body can switch metabolism levels, so once again, it's not quite simple thermodynamics - conversion efficiency varies.

> but a pure thermodynamics view assumes if you eat an extra 1000 calories that it will be stored as fat, does it not?

Replace "will" by "might", and you're there. Thermodynamics just say the energy must go somewhere, but whether it's your fat cells or your excrements (or maybe some other channel I'm not aware of right now) is a matter of medicine.

body heat whole point of having high metabolism is your body simply gets rid of excess energy by heating up(100W on average?). Its burning calories while you sleep.

Avg is 100W net - 9 MJ (megajoules), or 2000 kcal (food calories).

http://en.wikipedia.org/wiki/Black-body_radiation#Human_body...

Thank you. May I take this one step further ?

The very first step is exercise. Walk. Do some yoga or martial arts. Resistance training (weights).

There is very little point in discussing or pursuing any of this in the absence of daily, vigorous exercise.

I've lost about 50 pounds over the last two years by reducing my food intake without any additional exercise.

In fact, I can't really do much in the way of exercise because of chronic knee problems, which is one reason why I wanted to lose weight in the first place.

Exercise is important for fitness, but it's really irrelevant for weight loss. For a male, running burns about 100 net calories per mile: http://www.runnersworld.com/weight-loss/how-many-calories-ar... (depending on weight). To achieve a weight loss of one pound per week, you have to run five miles a day every day. If you're out of shape, that'll take an hour a day, every day, time you almost certainly don't have.

Exercising your way to weight loss is an incredibly inefficient use of time. And telling people that they shouldn't even try to lose weight until they can fit in daily exercise into a schedule that's already full is needlessly setting them up for failure.

> time you almost certainly don't have.

As a runner for the past 23 years, you really, really do have a whole hour a day to dedicate to moving.

I assure you that your body will fall apart sooner than later if you dedicate no time to keeping it strong and limber.

I'd also say consumption is closer to 120 calories per mile. 3600 calories per lb. of fat so ~30 miles = 1 lb. I usually advise 5 times a week x 3 miles as a beginner program (after a moderate buildup of walk/run and less days per week). So every two weeks our subject would lose 1 lb. That's 26 lbs. in a year.

Assuming these are 12 minute miles (which is just a bit faster than a walk), 12 x 15 miles = 3 hours a week. That is really a bare minimum of activity. If people start doing this at age 25 or so instead of trying to start at 45 when they are 60 lbs heavier than they should be it's not too difficult.

Don't get me wrong. Exercise is good. But from personal experience and the advice of very smart people, diet is at least 80 percent of losing body fat.

Even in Taub's book "Why We Get Fat", he lays the blame squarely on eating highly-refined carbohydrates.

I disagree. Walking is good, but if you're really overweight then lose it by diet first, before really focusing on excercise. It will be so much easier when you're not carrying all that weight around. I lost 30 pounds this summer on a keto diet with almost no excercise. I now have a ton more energy, and I'm starting to get into shape.

Gary Taubes points out in Why We Get Fat that exercise builds muscle, but doesn't lose fat. He argues you do that best by cutting carbs.

I would have agreed with you completely before this summer. I had done weight watchers and lost weight, but as soon as I stopped tracking my diet (and restricting my calories), my weight drifted right back to where I started. Gary Taubes has a whole section in Why We Get Fat on how you can't keep weight off by temporarily restricting calories.

This summer I've been reading a lot of books [1] on a low carb, moderate protein, high fat diet. It is called a LCHF or Keto diet. I now think that insulin resistance has a lot more to do with weight than I realized. I've lost 30 pounds this summer without counting calories (or weight watchers points). I just keep my carbs below 20g a day, and try not to eat too much protein. I'm not hungry, it doesn't take time to track, I feel really good, and the weight has some off so much faster than with weight watchers.

[1] My summer reading, that has really changed my life:

Why We Get Fat, by Gary Taubes

http://www.amazon.com/Why-We-Get-Fat-About/dp/0307474259

The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet, by Nina Teicholz

http://www.amazon.com/Big-Fat-Surprise-Butter-Healthy/dp/145...

Death by Food Pyramid: How Shoddy Science, Sketchy Politics and Shady Special Interests Have Ruined Our Health, by Denise Minger

http://www.amazon.com/Death-Food-Pyramid-Politics-Interests/...

Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet, by Jimmy Moore, Eric Westman MD

http://www.amazon.com/Keto-Clarity-Definitive-Benefits-Low-C...

I was really surprised that most of what the medical establishment says about diet is so incredibly backwards.

"When Leibel had participants in one study drink formulas with the same number of calories but hugely different proportions of fat and carbohydrates, he saw no difference in the amount of energy they burned."

The study by Leibel mentioned in the article would seem to suggest that various sources of energy affect the body equally.

Saying that losing weight is about less calories in versus than calories out is like saying that flight is about developing more lift than your weight. Yes, that's the general principle, but it glosses over all the hard parts.

Right.

I didn't say this was easy, I said it was simple

Everything is simple if you get to redefine the problem to whatever you want it to be.

Calorie counting is more than balancing a budget of calories over the length of a day.

It creates an ability to discriminate about foods and portion types - how many calories in an apple, a slice of bread, a cup of milk-coffee or a beer? I know all of these because I have slowly learned them over the course of months. It does make a change when you go shopping and when you pick the size of your portion.

Also, it allows for intelligent management of cravings. For example, you have 500 calories left, and it's 16:00. You could eat a slice of pizza and that would be it. But you could also eat two slices of bread with cheese (250) and in the evening have a moderate snack of 250. You see, that's how you can play chess with your hunger. You can plan ahead, you can use your intelligence in a domain that was governed by blind impulse before.

You don't need to refrain from any type of food - you just have to couny it. Want french fries with steak while on a diet? Want some pizza? It's ok, but it's going to cost you. A beer (0.5l) is 180 calories - maybe some mineral water would be ok instead of the beer? But you can still have the beer, just have to eat less pizza. The fact that you can eat anything makes the regime more humane.

That's just something I deduced from my own experience.

TL;DR In time, better tracking and better planning become internalised and when you do stop counting, you're left with a bunch of good habits about eating that will protect you for the rest of your life.

What you deduce from your own experience does not generalize. Many genetic jackpot winners (eg the people who can eat anything the want, not exercise, and not gain anything) deduce from their experience weight control is a non-issue so fat people must be gluttonous.

I would argue the success you've had is more about altering the food types and less about counting the calories, and, if that's the case, why bother with the calories at all? That question is what TFA's studies are looking at.

> For example, you have 500 calories left, and it's 16:00. You could eat a slice of pizza and that would be it. But you could also eat two slices of bread with cheese (250) and in the evening have a moderate snack of 250.

"Intelligent management of cravings" naturally requires you to go beyond calorie counting to thinking about the impact of different kinds of food on your satiety. For example, instead of two slices of bread (160 calories), and a slice of cheese (90 calories), I'd instead do: 2 oz of lean roast beef or turkey (80-90 calories) wrapped around a slice or two of avocado (~50 calories) wrapped in a slice of cheese (90 calories) + half a cup of steamed veggies (= 25 calories). YMMV, but that would keep me from thinking about food a lot longer.

I strongly agree with part of this, and am reservedly skeptical about the rest. What I agree with is disputing "calories make us fat because thermodynamics". Yes, of course the laws of physics still apply, and energy in minus energy out has to equal stored energy... but there are all kinds of ways energy is entering and leaving the system.

I do think that calories eaten and expended are an important part of the equation - having seen some people lose weight through simply restricting portion size - but I am unconvinced that it is (or is not) typically the most important piece. I am convinced that "... because thermodynamics" is a poor argument for it being the only thing that matters.

If you eat less calories than you burn it is absolutely sure way to lose weight ... because thermodynamics.

It might not be a good way for a lots of people because they just can't stand being hungry.

This is the kind of inanity I'm talking about.

(Calories eaten, calories burned, calories stored in fat cells) is not a closed system, so thermodynamics doesn't have a lot to simplistically say about it. There's also chemical energy stored in other forms, there's calories excreted, there's thermal energy in and out. Yes, there is clearly an extreme at which thermodynamics will force fat to be burned, but thermodynamics alone does not tell us whether that is meaningful when the goal is promoting long-term health (of which losing weight is, for most people, a meaningful piece).

I get that calories leave body in various forms but they get inside just in one. And if you eat less calories than you loose then you are bound to loose weight. No matter what crap you eat. It might not be pleasent. It might not be healthy but I think that it's almost surely more healthy than gut surgery and by transitivity than staying obese.

"I get that calories leave body in various forms but they get inside just in one."

That's not strictly true, though it might be a good enough approximation. Calorie is a measure of energy. If you're heated, energy is entering the thermodynamic system. Of course, thermodynamics tells us that converting heat into chemical energy is harder than the other way 'round, so it's unlikely our body is doing a lot of that efficiently.

"And if you eat less calories than you loose then you are bound to loose weight. No matter what crap you eat. It might not be pleasent. It might not be healthy but I think that it's almost surely more healthy than gut surgery and by transitivity than staying obese."

You're bound to lose weight, but the following is perfectly consistent thermodynamically: "all your muscle wastes away before your fat, then you die, then you can't keep up burning more than you eat". I'm not saying this is the case! I'm saying we need things other than thermodynamics to get any reasonable conclusion here.

Are you absolutely sure that there is a chemical process to convert extrnal heat into mass that is not neglible in comparison to how much mass is saved by the body when it does not have to heat itself at that temperature?

Because for me it looks like mentioning air pressure when we are trying to solve the problem of how some colliding masses of lead will behave. Strictly speaking air pressure could influence outcome but you won't see that in result with the accurancy you can humanly achieve.

As for your second point, we have a lot of experience with people starving themselves, even to death. And we pretty much know that fat is one of the thing that goes first. You can also look at people after gut surgery. Nothing special changes for them. They just can no longer eat vastly more than they need. And they loose weight.

I'm sure there are better more pleasant ways to loose weight and they will be eventually discovered, but there are sure relatively safe ways now.

"Are you absolutely sure that there is a chemical process to convert extrnal heat into mass that is not neglible in comparison to how much mass is saved by the body when it does not have to heat itself at that temperature?"

I'm not absolutely sure of much of anything, and that's my point. And I said it "might be a good enough approximation" to ignore it.

"As for your second point, we have a lot of experience with people starving themselves, even to death. And we pretty much know that fat is one of the thing that goes first. You can also look at people after gut surgery. Nothing special changes for them. They just can no longer eat vastly more than they need. And they loose weight."

And for the fifth fucking time I agree that there is evidence that eating fewer calories helps one lose weight - but to draw conclusions you need that evidence, not "simple thermodynamics", which is my entire point.

I still fail to get your point. It's exactly because of thermodynamics.

People who trip, fall, because gravity.

People who eat less than they burn loose weight, because thermodynamics.

Both processes are more complex but laws of physics draw the boundaries of how that complexity might influence outcome.

If you seriously still fail to get my point, I think I'm done with you here.

Yup. I feel that you also miss mine. Let's just silently think about each others points for some extended period of time.

Nope, I understand your point, you're just still wrong for a pile of reasons that either I've been unable to express sufficiently clearly, you've been ignoring, or some combination thereof.

No one is suggesting that there's no thermodynamics involved. The objection is to using "thermodynamics, duh" as an argument. I generally encounter this in the stronger form of "the only thing that matters for weight loss is consuming fewer calories than you burn, because thermodynamics." That's obviously puerile. However, I think even in your more constrained (and better supported) usage here ("if you burn more energy than you eat, you will lose weight") it is still the case that you need to know other things about human biology; further, you need to know many more things to determine whether losing weight that way is advisable (even before incorporating the many physiological or psychological things that might mediate difficulty), which is the bit that actually matters.

These "many more things", we do have quite a bit of evidence regarding. But that evidence needs to be incorporated into the arguments to make the arguments meaningful.

Ok. I think I get your point now. I just don't agree.

> it is still the case that you need to know other things about human biology; further, you need to know many more things to determine whether losing weight that way is advisable

I believe that there are times when you need to be pragmatic and act before you know more. You might not be sure that losing weight (or that most obvious way to loose weight) is best for any given person but it's still an adivce they should take if they are overweight.

Just like it's a still good advice to excercise even if you are not perfectly sure that excersising won't kill you. You can take position of "I'm not sure. I better stay on my couch till the data comes in, indicating that it's healthy for me to run a bit." but that's not wise. You can't put yourself into stasis before you are sure if it's a good thing to eat less than you burn. Your life goes on and you need to act on incomplete knowledge you have so far.

TL;DR

I just don't agree that acting on "Do what physics tell you, ought to lower your weight." is worse than acting on "We need to learn more about our biology before we can do anything successful about our weight."

We knew plenty more than "thermodynamics" about losing weight before we knew about thermodynamics. I'm not saying "we need more study before anyone should make any changes to eating habits" - of course we need to operate off the best understanding we have (we certainly can't refrain from eating until we know everything :-P). My point is that reducing things to "thermodynamics, duh" is not doing that.

> The human body doesn't run on calories, it runs on food.

This and other "the human body is immune from the effects of thermodynamics" arguments are... well, wrong. Otherwise there is a breakthrough in physics waiting to be found and potential unlimited energy.

> This and other "the human body is immune from the effects of thermodynamics" arguments are... well, wrong. Otherwise there is a breakthrough in physics waiting to be found and potential unlimited energy.

I think you misunderstood me. I was simply saying that food is more than the sum of its caloric content. I am not implying that the human body is magically immune from the laws of physics.

Anyone who reads Taubes should also consider Stephan Guyenet's critique of his arguments:

http://wholehealthsource.blogspot.com/2011/08/carbohydrate-h...

http://wholehealthsource.blogspot.com/2011/11/brief-response...

I used to believe in the refined-carb/insulin hypothesis of Taubes, and I even lost weight on it, but I've ditched that model in favor of Stephan's more complete food reward hypothesis - the idea that more rewarding and palatable foods lead to increased calories ingested in certain individuals and hence lead to fat gain.

One approach to weight loss then is to lower the reward value of the diet. One way to do that is low carb, another way is low fat, another way is vegetarian, another way to use gentler cooking methods and less seasoning, the list goes on. But many successful diets that people have used are very well explained by food reward.

edit> I also believe calorie counting and intermittent fasting are very powerful tools used in conjunction with a reduced reward diet. Eating less calories with minimal hunger and losing fat is the holy grail, and these tools are helping me do that in a very effective way.

Personally, I find Guyenet's reward hypothesis to be nothing more than a rebranding of typical fat-shaming ("just control what you eat, fatso; and why don't you exercise some more?"). However, that doesn't mean I don't think there is a psychological component to obesity; I just think that psychological component is mediated more by the gut biome than by anything else.

The biggest problem in nutrition research is that almost all the research is useless for drawing conclusions.

The second biggest problem is researchers wrap their identities around their pet theories, so they are immediately blinded to any competing hypotheses (note: I consider Guyenet in this category, but I also put Taubes in this category, and I think Taubes has done more to progress nutrition in the past 50 years than just about anybody else because he is loud and he doesn't tolerate crappy science).

The third biggest problem is people want to believe there is only one cause and therefore one solution. There is no question in my mind that the catastrophic insulin-flooded hormonal environment caused by "6-11 servings of grains a day in 5-6 small meals spread throughout the day" is a large percentage of the cause of the obesity epidemic, but it's not all of it. Literal addiction to sugar is a piece of it. Ignorance is part of it. Deceptive marketing and inappropriate marketing to kids is a part of it. The list goes on.

I like David Katz' analogy[1]:

What we're all up against—in our efforts to find health—may be likened to a flood. A vast, obesigenic flood. A flood of highly processed, energy-dense, nutrient-dilute, hyper-palatable, glow-in-the-dark, betcha'-can't-eat-just-one kind of foods; a flood of marketing dollars encouraging us to eat ever more of the very foods that propel us toward obesity and chronic disease; a flood of gadgets and gizmos that do all of the things muscles used to do; a flood of agricultural policies that subsidize corn to fatten cows rather than vegetables and fruits to vitalize people; a flood of obligations that leave no time for attention to health.

There are only two ways of dealing with this: build a levee to contain the flood and turn the tide, or captain a ship (or arc) across the floodwaters. One is all about us; the other is all about you.

I also like Yoni Freedhoff's comment about it, that people like to point to a sandbag (such as limiting marketing) and say "that won't solve the problem". It takes a lot of sandbags to hold back a flood[2].

Having spent 30 years obese before learning enough about biochemistry to be able to correct my metabolic disorder, one thing I know: we don't need any more fat shaming. It is deplorable and counter-productive. I'll just leave you with one woman's feelings about Guyenet and the realities of dealing with hormonally-induced eating[3]. She is one of the most knowledgable people I've read on-line, with a breadth of knowledge that I find humbling.

1. http://health.usnews.com/health-news/blogs/eat-run/2012/09/1...

2. https://www.youtube.com/watch?v=BuLAgnWCIDs&list=UUu_u-P3cBF...

3. http://itsthewooo.blogspot.com/2014/08/food-reward-hypothesi...

I never thought of food reward as typical fat shaming, but I suppose some of the "food reward friday" posts come across that way.

I'm reading through some posts and comments by "itsthewoo", and I'm trying to make sense of her experience. Thanks for pointing her out - food reward has worked really well for me and seems to explain a lot of data out there, but I suppose testing it with a large sample of humans (as opposed to rats) would help us see how universal its suggested interventions are.

>Personally, I find Guyenet's reward hypothesis to be nothing more than a rebranding of typical fat-shaming ("just control what you eat, fatso; and why don't you exercise some more?")

So a particular claim about the state of the world, e.g. "obesity is caused by a psychological propensity to overconsume, which can be controlled", simply cannot be true, because it might cause some people to justify a dismissive and callous attitude towards people with obesity?

That is what the logic of your statement sounds like to me.

More like, "it's a theory that has significant gaps yet is able to bypass deep scrutiny because it panders to the common societal belief that fat people are all fat because they can't control themselves."

Food reward is a tributary in the flood (and a tributary will flood some houses), but Guyenet makes it out as "all the waters", and my belief is that people accept it uncritically because it resonates with society's view of fat people as gluttonous sloths with no self control.

With regards to fat shaming and "gluttonous sloths", Stephan did say: "I do not consider it a "moral failure" to eat unhealthy food that is under your nose, socially accepted and in some cases even considered healthy. I think one of the main problems is simply a lack of accurate information."

http://wholehealthsource.blogspot.com/2011/05/food-reward-do...

But you are still equating "people are all fat because they can't control themselves" with "fat people as gluttonous sloths with no self control".

I'm not saying that a desire to look down on and judge other people doesn't bias people's views on obesity. But the main reason people believe that "people are all fat because they can't control themselves" is that there are so many individual stories of people losing weight by following a diet.

Losing weight is easy. I would hazard to say every obese person has lost weight, often times far more than they actually weigh. Maintaining weight loss is a completely different game, and one that is nearly impossible to do unless you address underlying hormonal disorders. The more unhealthy the starting point, the harder that is to do. And the standard reply of "just eat less and move more" is so useless as to be laughable.

As someone who has tracked their calories every single day for over two years. Every meal. Every piece of food that enters my mouth. How does my body not run on calories? I meticulously calculated, tracked, and adjusted my macros to a point where I have a hard number at which I know what % of fat I'll lose, over a specific period of time.

If you do the research yourself, you will quickly realize how the citation works when people are trying to sell you something. Scientific research is cited when it supports their statements, and is ignored when it counters their beliefs.

It's almost too easy to cite weak scientific studies to prove almost any belief you hold these days, in weight loss business.

Taubes is as good as Atkins - people and media love to hear and write about something different. I am sure the HN crowd already is aware of that. Despite the hate Stephan Guyenet has been receiving by Taubes fans, he does a great job at explaining why what Taubes is promoting isn't scientifically sound or absolute: http://wholehealthsource.blogspot.com/2011/08/carbohydrate-h...

For everyone who enjoy making references to Insulin without context, considering it an absolute storage hormone, here's a gem: http://weightology.net/weightologyweekly/?page_id=711

For me the answer is simple. If I eat 2500 calories a day of vegetables, nuts, meat, eggs and fruit I have trouble finishing it all. If I eat 2500 calories with grains and sugar included I'm starving at the end of the day and it takes every ounce of will power not to eat 3000 calories. It might well be calories in, calories out but what I eat makes it dramatically harder or easier to regulate the calories in.

This is true to an extent for me as well, but nuts are extremely calorie dense. I think I could easily eat more than 3k calories of nuts in a day if just ate as many as I wanted.

Holy crap, talk about burying the lede.

There's a table at the bottom of the article that contains the tl;dr about the scientific studies referenced. All are still underway, there are no published results yet.

More of a bait and switch. I had to read like 5 paragraphs before I realized I better start skimming to see when they got back to that study.

How is that buried? The whole article is about the process behind generating the hypotheses for the studies, the trouble in getting them funded, and how eventually a billionaire bankrolled them himself. It's not about their results, and in fact never even gives any preliminary results from any of them.

Fascinating that the core study the article focuses on is using strictly male subjects. I thought this had been a controversial approach[1] for quite some time now - yet they still claim the study's main goal is "doing it right."

[1]: http://well.blogs.nytimes.com/2010/06/30/phys-ed-what-exerci...

It is controlling for variables. They are trying to determine the role of macronutrients on food partitioning and, ultimately, weight. One can argue they should have used all women instead, but I think the challenge there is women have a more varied hormonal environment due to menstruation[1], which, again, adds a variable. As I understand it, fat partitioning appears capable of change during menstruation.

Of course, then we run into a problem that the results may not apply to women. Nutrition science sucks.

1. http://itsthewooo.blogspot.com/2014/08/food-reward-hypothesi...

After 150 comments have been made, maybe 6 people will stop to read this. But I feel compelled to contribute a bit of what I've learned about obesity.

I was the medical director of an obesity treatment clinic for 10 years, working with thousands of obese patients.

The most important lesson is that obesity is a disease, and each obese person has a different disease. Each case requires a unique treatment approach. "Cookie-cutter" methods won't cut it.

I'm convinced that obesity is the most complex disease the art and science of medicine has ever faced. I can't even begin to describe the mind-boggling complexity of the situation.

A minimalist outline: factor in participation of the endocrine system (insulin resistance, role of cortisol, thyroid, reproductive hormones), the immune system products promoting obesity, as well as adverse inflammatory effects of adiposity contributing to metabolic disarray, and the brain's functional role in metabolism involving highly intertwined connections of neuronal circuits regulating metabolism and sleep/circadian rhythms. And so I could go on for gigabytes on these subjects, even before citing the enormous list of references.

Short answer: all of these body systems (neural, endocrine, immune) are interactive. Think many:many relationship with "many"==trillions. Therein are the solutions to obesity. Small needles, huge haystack.

A few years ago it was mentioned at a conference that at the time over 250 human genes (and their peptide products) had been identified to play a role in obesity. Considering the multitude of known and potential gene/environment interactions, what simple "cause and effect" paradigm could we glean?

So yes, many obese patients respond favorably to low CHO, high N diets. Altering PUFA intake to approximate a 1:1 intake of N3 and N6 EFA in adequate amounts is warranted. Elimination of physiologically incompatible trans-fatty acids in the diet is absolutely necessary. Mono-unsaturated or saturated fats within calorie constraints are not usually an issue. Behavioral approaches are always indicated.

Just remember, each of us is different, our systems are inherently quirky, and tremendous variation is common. The above general rules are fine to start with, but be prepared, understand the "reality paradox": exceptions are the rule and not the exception.

Interesting and quite dense post - I had some trouble with the terminology so, for the other five people reading this.. CHO = carbon hydrogen oxygen (ie carbohydrates), N = nitrogen (ie proteins & purines)? This was hard to figure out from google alone but seems to make sense..

Also, PUFA = Polyunsaturated Faty Acids, EFA = Essential Fatty Acids. n3/n6 are more commonly (less precisely?) known as omega 3/omega 6 fatty acids.

From my personal, anecdotal experience the first intervention has been effective (and this seems to accord with the received recommendations wrt better health outcomes for those eating more vegetables and fish). But how clear are we on the outcomes of these simple and broadly applicable interventions have been made clear and concrete so far? The first goal for the science should surely be to end the debate on the proliferation "diseases of civilisation" which, to my understanding, we should be able to do by proving a difference in outcomes for these interventions and correlating them to the dietary shifts of the last 30 years

Sorry, should have been more explicit, but you've correctly deciphered all the obscure abbreviations.

I think your questions point to the gist of the matter: obesity is not a simple problem to understand or to solve.

There certainly is evidence that obesity is a "disease of civilisation". Over the last 5 or 6 decades the real prevalence of obesity, diabetes, depression, autoimmune disorders have sharply risen in concert in the industrialized world, but far less so in third world nations.

While many hypotheses have been put forward, the reasons remain a mystery. It seems possible, even likely, the issues surrounding obesity will not be settled in my lifetime.

It seems to me that you're forgetting a very important cause to obesity. The marketing campaigns led by big corporations such as Mac Donald's, Coca Cola and so on...

No doubt many researchers would agree: the food industry has contributed to the problem. Evidence points to manufacturers adding large quantities of sugars (in many forms) to convenience and fast foods as a major culprit.

Physiological effects of this intake result in greater synthesis of fatty acids which are easily stored in fat depots. Over time in vulnerable individuals the cumulative result is excessive adiposity and obesity.

There has been a push to reduce the sugar content of foods and educate the public about the risks. Consumers should learn to read nutrition labels and avoid products with high sugar content.

I read some time ago that there are only three dietary advices for general population backed by science:

  1. Eat food.
  2. Not too much.
  3. Mostly plants.

I wonder if anything changed since then.

Also what about non processed food ? I react very differently to raw vegies from anything with additional stuff (even simple sauce). It turns the food into a pleasure instead of a need and the additives sugarcoat-trick my brain into eating more.

The above is from Michael Pollan. The "Eat Food" refers to eat real food that is identifiable as such. Basically if it has over 4 ingredients listed on the label, its probably not "real food".

We need new rigorously controlled experimental studies to tease out the causation patterns suggested by correlations observed in observational studies of human diet. The way to test a causal hypothesis is always, at bottom, to do a controlled experiment.[1] So we will tease out the effects of diet on different people by finding experimental volunteers and subjecting the volunteers to controlled diets, such as those planned for some of the experiments described in this interesting article.

This is very difficult to do, as almost all human beings eat when they feel like eating WHAT they feel like eating. Earlier human experiments on effects of diet in the 1970s actually required the experiment subjects to live in the laboratory long-term, and to have every gram of everything they ate during the experiment measured exactly by experiment team assistants. Even at that, those experiments came up with few clear conclusions, perhaps because the experiments weren't lengthy enough or didn't include enough subjects for strong inferences. Now the experimenting begins again. Whether the currently hotly debated hypotheses about human diet win or lose, it's important to put the hypotheses to the test of a rigorous experimental study to advance human knowledge.

[1] http://escholarship.org/uc/item/6hb3k0nz

The body likely has ways of losing weight that are faster than simply eating itself (burning fat)

Not all weight is fat

Metabolic efficiency varies, including by calorie type

Much of the chemical energy output in the body is involved in actually repairing or replacing, not only in expanding the volume of fat reserves or even muscle.

It's all a thermodynamically-limited bunch of processes but thermodynamics is a limit rather than a driver of energy transformations.

Calorie REDUCTIONS don't guarantee weight loss because obviously the body can choose to expend less energy. And if the term CALORIE DEFICIT is used, it is not justifiably used because science currently can't determine the necessary level of granularity since energy, weight, and measurable metabolic output/activity all change in response to factors other than the ones which are thermodynamically relevant, and this makes thermodynamic equations/measurement of human dieing problematic. Essentially the system is kind of a 'black box' and some of the relevant inputs and outputs in the thermodynamic equation are 'inside' that mathematical 'black-box.'

Edits for spelling

Oh and a slightly less vague explanation can be expounded onto the concept of energy transformation to explain why it wouldn't always correlate with a weight change...combining or dividing molecules.

What if your body doesn't have enough energy to go through the processes of burning a fuel source (or the necessarily mistake or vitamins, or other nutrients...)

I think modern food marketing should get more scrutiny here. Aside from the 24/7 food ads with Photoshopped hamburgers, there are the new, more caloric, more addictive products. Starbucks, for example, has replaced the traditional American coffee and donut with a latte and pastry combo that has twice as many calories or more. You can't sell low-calorie coffee with creamer and sugar (~50 cals) for as much as you can sell a latte (~200 cals).

I have a hard time believing the new theories that fat is not that bad and sugar is the evil. I used to have a diet with plenty of beef and pork meat. Then I went to live for a couple of months in Singapore, and there I ate noodles. LOADS of them, because I loved them. The result was that I lost a lot of weight.

In my experience what gets me fat is meat, and what makes me lose weight is eating less meat and more pasta and rice. But I suppose it varies per person.

It isn't glucose or lactose that make you fat, it is the presence of fructose or sucrose in the absence of water soluble fibre that fuck up your insulin levels because you don't have the lipids to resist the shock.

Beef is incredibly energy dense, and yes it can lead to weight gain, but most people have their beef with sugary tomato paste / ketchup and a side of Coca Cola.

Noodles are actually very simple to make: Flour, touch of salt, and an egg. No fructose or sucrose. So of course you weren't getting fat because your insulin levels were still in check and you weren't craving too many calories per day. Also, I don't know about Singapore, but in North America sugar is added all over the place. Even something simple like BBQ sauce has more sugar per serving than something like an apple or a banana. And again, no water soluble fibre.

In my case I never ate much coke or ketchup, neither after nor before going to Singapore. I'm from Spain and the most typical way to have beef is together with homemade fries.

I suppose the kind of carbohydrates is everything: noodles and cereal good, sucrose bad... so that makes me wonder if the studies mentioned in the article might be too US-centric. Probably many Americans could lose weight by replacing the sugary coke and ketchup with more fat, so "high fat, low carb" may be a good advice for them. But in Spain where coke and ketchup aren't so widespread (some people have them, of course, but probably not even 10% as much as in the US) most people would do better to replace their fatty beef with carbs in noodle, pasta or rice form...

I don't believe its necessary for all the experiments to last that long. Its possible to have shorter more controlled experiments to gain insight to health benefits of particular diets.

For example...

A British group of volunteers were locked in a zoo and were allowed to eat up to 5 kilos of raw fruit and vegetables per day - but only raw fruit and vegetables.

"Nine volunteers, aged 36 to 49, took on the 12-day Evo Diet, consuming up to five kilos of raw fruit and veg a day."

"The prescribed menu was:

- safe to eat raw; - met adult human daily nutritional requirements; and - provided 2,300 calories - between the 2,000 recommended for women and 2,500 for men,"

"Overall, the cholesterol levels dropped 23%, an amount usually achieved only through anti-cholesterol drugs statins.

The group's average blood pressure fell from a level of 140/83 - almost hypertensive - to 122/76. Though it was not intended to be a weight loss diet, they dropped 4.4kg (9.7lbs), on average."

https://www.youtube.com/watch?v=JXZ1dH7tJWw http://news.bbc.co.uk/2/hi/uk_news/magazine/6248975.stm

Reading the comments so far, it's interesting how much people's ire gets raised on this topic.

Also, have a look at this, originally written/published, it seems, in 1958: http://www.ourcivilisation.com/fat/index.htm

Makes for a fascinating read, and it amazes me how close it gets to what's currently being put forward now (high fat low carb == good).

Two striking things about dieting. Firstly its a matter of calories in vs calories burnt. Stop eating and you'll lose weight so it's mostly down to your controls, conscious or unconscious. Secondly everyone starts at about 8 lbs at age 0 and ends up about 140lbs at age 18 give or take 50% and that's not down to conscious planning - the unconscious bits of the brain make kids hungry if they need food and to not eat and run around if they have too much. And the mechanisms are powerful - no kids remain at 20 lbs because they choose to. When adults get obese its seldom because they choose too but because the unconscious bit goes wonky. I think the US mostly due to sugary food and not much exercise. It's interesting if you look at the book 'French Women Don't Get Fat' that it's mostly a recipe book but her actual story was she went from France to the US for a year or so, hit the sugary snacks and piled on the pounds and then on her return her dad was horrified so she dropped the snacks and the weight went. So a mix of factors there.

Hypothesis: "Stop eating and you'll lose weight"

How do you scientifically prove this?

First, you must isolate a human being in such a way you can account for every single calorie incoming and outgoing. Incoming calories are relatively easy to measure, but for outgoing you have to at least measure:

- How much heat is produced by the body (how much energy is expended keeping the room at the same temperature) - How many calories did the body use to warm sweat and pee: collect every single drop of sweat and pee, measure its volume and temperature as soon as it leaves the body, compare to temperature of water ingested. - Collect every single particle of stool leaving the body, measure temperature, weight and calorie content.

Only after you have a human being isolated in a way all calories in = calories out, then you can test the "Stop eating and you'll lose weight" hypothesis. Before then, anybody with such a claim is just blurting out junk science.

You know there are ways to measure metabolic rate right? I don't have the study in front of me but there was an interesting paper that shows upon caloric restriction metabolism can drop 20-30% as the body attempts to hold onto calories.

I'm not sure why calories in = calories out is such a heretical statement on HN. It's a well establish fact. Of course the calories out can adapt to reduced calories in, but the fact remains, if you eat fewer calories than you burn, you will lose weight.

I have no problem with the "calories in = calories out" statement. Thermodynamics says it must be true.

If calories in <> calories out it doesn't mean the law of thermodynamics is wrong, it means you have a leak somewhere in the lab you must plug before you can test hypothesis such as "eat less and you will lose weight".

> if you eat fewer calories than you burn, you will lose weight

The laws of thermodynamics are a established fact, but somehow concluding that ingesting less energy will somehow cause you to lose weight is the same kind of logic fallacy that would lead you to fill your car with only half a tank of gas expecting to get twice the mileage.

You changed what I said. I did not say "ingesting less calories will cause you to lose weight", I said "ingesting less calories than you burn will cause you to lose weight".

"Gardner's study stems from his previous research, which suggests a diet's effectiveness may be due to how insulin-resistant the dieter is at the outset."

What if it also depends on the subject's microbiota, which would be impacted by a number of things including the (unwanted) consumption of residual antibiotics in meats.

Seems like the more we find out, the more questions there are.

The article mentions that they are collecting stool samples to monitor / control for this.

I'm actually a participant in the Gardner study -- they're testing for a ton of other factors, including microbiota.

What about calorie counting? I think the best way to lose some fat is to add up the sum of the calories of what you're eating, as the day goes by. In time, this will create an ability to know which foods are too rich and which are ok. Also, they allow management of appetite/hunger by allocating the rest of the calories for the rest of time. I personally found it much easier to eat on a budget of 1200 or 1400 calories a day than following a regime that forbids some kinds of foods or aims to make food less palatable. I lost 30 pounds that way and was able to keep my new weight in the following 5 years. I used an iPhone App for actual counting and calorie database lookups. Also, physical activities can be tracked and added up to the daily budget. If I walk for 2 hours, then I can have an extra meal, if I want to take it.

TL;DR Calorie counting makes for mindful eating and changes habits, without suffering.

If you were only 30 pounds overweight then you probably didn't have the types of problems that most Americans have: metabolic disorder / obesity / diabetes. To fix this problem requires not just a reduction in calories, but a repair of the insulin levels and an increase in water soluble fibre for lipid production.

Am I missing something? Is there any actual information in this article beyond

* Science in general and nutritional science specifically may or may not be sketchy (And this is news?),

* There are at least three ongoing, very interesting, apparently well-designed studies exploring the topic, with an emphasis on ongoing, and

* These three studies are the children of a researcher who lost weight when he changed his diet, an Enron billionaire, and Gary Taubes, a science journalist with a history of being very, very partisan. (No, really, go read Bad Science and then track down Polywater by Felix Franks---different scientific episodes, but with roughly similar hoo-ha involved; I'm talking about the style of the two discussions.

I firmly believe in the saying, "You get sick because of what's eating you and not being of what you are eating".

>NuSI's starting assumption, in other words, is that bad science got us into the state of confusion and ignorance we're in. Now Taubes and Attia want to see if good science can get us out.

NuSI's approach to test long-standing food science assumptions.

This seems intellectually interesting to me but it's frustrating because I feel it takes what is a relatively simple issue and makes it needlessly complex. Yes, maybe there is some amount of optimization you can do with your diet, but the simple fact is that there is a not a single study in the history of science which has been able to demonstrate eating at a caloric deficit and gaining weight. Show me an obese person not eating significantly too much.

From the practical standpoint of actually trying to lose weight/get people to lose weight, the challenges in nutrition are almost entirely around compliance (how to ensure someone sticks with the program) rather than substance (what people put in their bodies). Most people know, within reasonable terms, how to eat healthily. It may not be the most optimal way possible (perhaps keto or some other diet is), but if we spent more time studying how to teach compliance I think we'd be making a lot more progress towards stopping obesity.

"Show me an obese person not eating significantly too much."

http://en.wikipedia.org/wiki/Cohen_syndrome http://en.wikipedia.org/wiki/Bardet-Biedl_syndrome http://en.wikipedia.org/wiki/Ayazi_syndrome

There. That was easy.

I don't think genetic disorders should be considered as they're exceptions to the rules.

I stand by the statement "Show me an obese person (with no genetic conditions) that eats less energy than they use".

It doesn't exist, because it's not physically possible

I just showed you specific genetic conditions that lead to excess body fat without over-eating. You have to reckon that. Science doesn't work that way. You can't just ignore evidence that counters your hypothesis, waving your hands and saying "pah, these exceptions to the rules." On a similar note, do you think most females develop breasts because they consume more calories than they expend (v.s. males)? By your line of reasoning, you should believe that.

"Like many other medical conditions, obesity is the result of an interplay between genetic and environmental factors. Polymorphisms in various genes controlling appetite and metabolism predispose to obesity when sufficient food energy is present."

http://en.wikipedia.org/wiki/Genetics_of_obesity

Over-eating is required.

None of your links actually support the idea that you can become obese without eating excess calories. They are all genetic diseases where obesity is a symptom of the disease. Maybe because they eat too much?

When talking about "the obesity problem" in America these people are a statistically insignificant population. Less than .1% of people have those 3 diseases combined, whereas something like 30% of American adults are obese.

Taubes touches on it in this article a bit: http://garytaubes.com/2011/11/catching-up-on-lost-time-%E2%8...

It's not a scientific study, but it addresses the obese people not eating significantly too much.

> This seems intellectually interesting to me but it's frustrating because I feel it takes what is a relatively simple issue and makes it needlessly complex. Yes, maybe there is some amount of optimization you can do with your diet, but the simple fact is that there is a not a single study in the history of science which has been able to demonstrate eating at a caloric deficit and gaining weight. Show me an obese person not eating significantly too much.

Taubes would say that an obese person eats too much precisely because he is fat, not the reverse. The arrow of causality has been flipped. His body is demanding increased caloric intake (via insulin, leptin, and ghrelin) to maintain fat stores. Those fat stores can't be liberated when insulin levels remain high. If this hypothetical obese person keeps eating carbs and has become insulin resistant, those fat stores aren't going anywhere without a fight. A calorie restricted diet will help some, as less food produces less insulin, but it's far easier to restrict insulinogenic foods. This allows the fat stores to be utilized, and weight loss is the natural result.

It sounds counterintuitive at first, but this theory states that the human body knows how to maintain caloric intake. That's what hunger is for. But it can only do this if we allow the endocrine system to function normally.

Before dismissing the idea, listen to Taubes's talk: http://youtu.be/ywRV3GH5io0

That "arrow" of causality is more of a messy tangle. Everything (appetite, eating habits, body fat, environment, mental state, exercise/lifestyle habits) affects pretty much everything else.

In particular the environment can have a rather strong effect on eating habits. So be unreasonable, and adapt the world to support your goals.

But if a fat person simply eats less, no matter the macronutrient content, he or she will lose weight. This is well documented, and even Taubes doesn't disagree with that. There may be ways to lose weight more quickly, but my point is that the challenge here is how to make people who are on terrible diets consistently stick to any decent diet with a caloric defecit, not the optimal diet. If someone can't comply with a low carb diet it quite frankly doesn't matter if it's more optimal that a high carb (though I disagree with Taubes generally and think his analysis misses the forest for the trees).

> But if a fat person simply eats less, no matter the macronutrient content, he or she will lose weight. This is well documented, and even Taubes doesn't disagree with that.

A low-carb diet doesn't have to be intentionally low calorie. That's the point. Eating very low carb allows the body to adjust hunger levels to match existing fat stores. If you're fat and you allow your body to do its job, you won't be as hungry because you have plenty of energy stored up and the body is eager to use it. In other words, we've evolved to survive times of plenty and times of famine, and our modern diet with extremely high carb intake throws this system out of whack.

Low calorie is just forced starvation and although you will always lose weight this way, it's an uphill battle because you're fighting the body's fat regulation mechanism. You might be eating high-carb but low calorie, causing insulin spikes, extreme hunger, and protein wasting. It's not an easy diet to follow and it might even be counterproductive.

This is the theory anyway. This queston has been posted to Taubes many times over though, and he himself can explain it a lot better than I can. If you're interested in the topic, this is definitely worth a read: http://garytaubes.com/2012/11/what-would-happen-if-thoughts-...

> Low calorie is just forced starvation and although you will always lose weight this way, it's an uphill battle because you're fighting the body's fat regulation mechanism. You might be eating high-carb but low calorie, causing insulin spikes, extreme hunger, and protein wasting. It's not an easy diet to follow and it might even be counterproductive.

This is based on a false dichotomy of dieting sustainably low carb or unsustainably starving yourself.

Let's say we have someone who is 6' and 260lbs. To get to that state you need to consistently eat a diet of around 4000 calories. If that person eats 2000 calories of ANYTHING for the rest of their life, which should be completely sustainable, they will not only lose the weight (down to about 180 lbs), they will keep it off.

On the other hand, if that person continues to eat 4000 calories but they change their diet entirely to a ketogenic diet, guess what: they will still be fat.

The point is that when we are dealing with the 30% of Americans who are now obese, the low hanging fruit is in simply eating less. There may or may not be a suboptimization in macronutrient composition, I'm not saying that's definitely wrong. I'm just saying there's more low hanging fruit than that.

Most obese people have not been obese their entire lives, so obesity can't be a root cause of their obesity. At most, Taubes' writings might help explain why some obese people have trouble managing their over-eating.

The argument is that "compliance" is significantly influenced by hormonal regulation, which is influenced by amount of carbohydrates consumed.

" there is a not a single study in the history of science which has been able to demonstrate eating at a caloric deficit and gaining weight."

That's absolutely right.

"takes what is a relatively simple issue and makes it needlessly complex."

Human metabolism and psychology is complex. Basically, it's the most complex system that we know of.

You can't just throw out psychology and metabolism, and say it doesn't matter, because as long as you eat less calories than you consume you're alright.

People have know "calories in vs. calories out" for decades. People are still getting fatter. Maybe if you shout it a bit louder, it will start working? Sorry about the sarcasm, but that's how I feel about the issue.

I feel it's a bit like telling a depressed person to just "stop it". Snap out of it! Why are you thinking these bad thoughts? It's bad for you! Stop it!

https://www.youtube.com/watch?v=Ow0lr63y4Mw

You do touch on this though "(how to ensure someone sticks with the program)", but then seem to gloss over it. You start out saying it's "not complex". If it's not complicated, why is it not solved yet?

What you eat, is certainly not everything, but sugar drives behaviour very strongly. More so than other nutrients is my impression. It affects motivation which again affects how well you stick with a program. It's not everything, but it's part of the puzzle. Other things that affect compliance could be, mental health, friends, advertisement, culture, economical situation.. How is this not complicated?

I think we totally agree. My entire point is that this is enormously complicated, but mostly in the psychology department, and not so much in the eating department. Eating a caloric defect works for everyone, so the difficult part is figuring out how to get them to do that, which seems to be a psychological issue entirely.

Again, we agree that it is enormously complex, I am lamenting the fact that we don't put more resources into the psychological aspect of it.

Of course eating at a calorie deficit will work for everyone if your only goal is 'lose weight'. If you actually want to be healthy it's more complicated than that.

Maybe, but there is a massive amount of low hanging fruit in terms of making people healthy by simply making them less fat.

Have you considered that what you eat might make a difference to your psychology?

Of course, what I'd like is more studying of that and less studying of whether or not different macronutrient compositions cause you to lose more weight through something other than calorie deficit.

I think the point is that the macronutrient compositions is the driver in how food affects your behavior.

That is, what you are asking for is a study that would show why large populations of people can't just "eat less." Why are they stuck in a rut of eating more than they need? Worse, why are many of them not even happy about it, but still can't get out?

This hypothesis is basically that that behavior is fueled by a feedback cycle that has, in large part, the actual foods that people eat caught in it somewhere.

Now, I think I see what you are getting at. Could you fix this at other parts of the feedback cycle? Perhaps. And I certainly agree that should get research, too. I just don't think this research is unrelated.

> I think the point is that the macronutrient compositions is the driver in how food affects your behavior.

That is absolutely not the point of Taubes's research. Reread the article.

Sorry, my point is more that the study would be basically the same anyway.

That is, if this singles out some food as more likely to cause overeating/fat gain, that will still be an incomplete explanation. Which is where the psychology aspect would step up.

Right?

> Sorry, my point is more that the study would be basically the same anyway.

I disagree, the study would be completely different. This study is studying the acute effects of diet on the body, specifically trying to determine if macronutrient composition has an effect on weight loss, given equal calories.

The study I'm talking about would deal with long term behavioral aspects of dieting, and would look for people who had long term success with dieting and see what they are eating. Or maybe there would be some other study design, but it certainly wouldn't be like the one they are doing now, which completely controls diet thus eliminating the compliance aspect.

The reason I think this distinction is so important is because of the amount of energy being consumed by the scientific community around debating the question of whether or not macronutrient composition has a direct effect on weight loss. Even if the people who feel like macronutrient composition has a direct impact on weight loss are right, the effect is not very dramatic.

It would be much more fruitful to study the psychological impact of specific diets, and whether or not they are likely to impact over eating, which is the one and only cause of obesity, as you mentioned.

You don't think they'll be keeping behavioral notes on the subjects? They are keeping them under observation for the full study, right? Seems logical to record behavior, as well.

Though, I do have to cede the point that a proper study of this sort would be different.

If it were that easy, we wouldn't have an obesity epidemic. I get that the solutions for individuals seem straightforward, but something is affecting most of our population, and it's problematic.

Let's say that they're not be looking for "the perfect personal weight-loss diet," to sell, but working toward larger systemic changes that will reverse or halt the trend in the greater population (like mandating vaccines, but I doubt the answer here is a "fat vaccine").

> From the practical standpoint of actually trying to lose weight/get people to lose weight, the challenges in nutrition are almost entirely around compliance (how to ensure someone sticks with the program) rather than substance (what people put in their bodies).

Compliance and substance, using your definitions, are not orthogonal. "How you ensure someone sticks with the program" is not independent of what the things they eat are.

I get it why techies -- myself included -- would like the world to have nice, neat, orthogonal levers where you push this input and you get this simple output, and you don't have to manipulate a bunch of inputs to get a simple output (and, don't get a bunch of complex changes in output when you change a simple input.)

Unfortunately, many interesting domains -- especially those involving the human body and particularly the interaction between body and behavior -- don't work that way, and preferring that it works more simply isn't going to change that.

> if we spent more time studying how to teach compliance I think we'd be making a lot more progress towards stopping obesity.

The thing is, there's considerable evidence that "compliance" problems are neither one-size-fits-all nor simply a matter of teaching. Much current effort is on compliance, but it often involves how to manipulate metabolic signals to help people be better able to comply (there's definitely education as a component of that, but its not alone.)

And we understand where there are positive feedback loops involved, and breaking those is part of that (that's a major reason for the various forms and relatives of gastric bypass surgery -- it enables radically breaking some of the feedback loops that make it difficult to acheive compliance.)

> "How you ensure someone sticks with the program" is not independent of what the things they eat are.

We have not put nearly enough scientific resources into figuring that out to say that so confidently.

> Much current effort is on compliance, but it often involves how to manipulate metabolic signals to help people be better able to comply (there's definitely education as a component of that, but its not alone.)

I don't agree that much of the effort is on compliance, there is a massive imbalance towards substance from what I can tell, but who knows maybe you're right.

If anyone can find a sentence from the article that would make a more descriptive title, we can change it. This is one case where subtitles and the opening paragraph both fail us.

How about the URL: "What makes us fat"

The URL does sometimes supply a good title. But in this case I fear it is too vague and baity. The distinctive thing in this article is the new efforts to test what makes us fat.

Edit: I suppose "New efforts to test what makes us fat" would be a reasonable title, but I hate to do that. It's nearly always possible to find a suitable title in the article itself.

"FINALLY: HARD SCIENCE ABOUT DIET"

That doesn't seem to be a sentence from the article. The idea here is to use the article's own words.

This is the heading above the table describing the studies they are running.

You're quite right. My apologies.

I changed the title to that, but I fear the term "hard science" here is provocative enough to spark a tedious flamewar, as if the topic weren't enough already. So if anyone can find a more neutral description in the article, we might change it again.

"Finally, Good Science to Study Diet"

I think it's important to note that every individual is different. I'm surprised that gene therapy has not made any inroads into weight loss management and diabetes/hypertension prevention. In an ideal world, diet and exercise should be tailored to your genetic makeup, instead of the "one size fits all" brute force approach.

Those of us in the Keto community (who have our heads screwed on straight at least) willingly admit this.

I have seen people try high fat ultra low carb diets and fail badly despite following all best practices. I have also seen the exact same diet completely turn lives around restore hope to people.

There is a lot we do not know about nutrition yet. Why some people respond to certain diets and not others is one of those large unknowns.

what were the details of the failures?

i'm doing keto right now and steadily losing weight.

> what were the details of the failures?

I had a friend who, after 3 weeks, never got over the keto flu. He didn't lose any weight, was constantly sick and ill, and just had no luck on Keto at all. It was his second time trying it, he had the same experience on his previous try as well.

His Macros were spot on, and he was doing everything right, he just felt awful.

I've read anecdotal reports of other people having similar problems, though since they aren't first hand I cannot personally speak as to the accuracy of their experiences.

This seems to be one of the few failing points in keto: failing in keto-adaptation rather than getting through keto-adaptation and then failing to derive benefits medium or long-term. It would be great to have more data points on why people fail to keto-adapt (gall bladder dysfunction? other metabolic disorders?)

You are not a unique and beautiful snowflake. You are an ugly bag of mostly water, with mostly the same DNA as everyone else.

Diet and exercise should be tailored to what actually works (as should everything else; feedback loops are awesome). You don't find out what works uniquely for you by having some expert guess based on what your DNA makes very slightly more likely, you find out by trying and seeing if and how your results differ from what's typical or what you expected.

I agree that there is some consensus on what works for exercise, but livestock breeders readily breed strains of animal to enhance he efficiency at which they convert food to weight on the hoof.

If pigs or cows can vary as to how much weight they put on for the same input of food, surely humans can too?

Why can't we use gene therapy and proven methodologies? For example if one diet works 5% better for people with condition X use that as opposed to another diet. It's not all or nothing.

Why would an expert have to "guess" when they have piles and piles of data? I think it's 100 years too early for you to reply to me.

> You are an ugly bag of mostly water, with mostly the same DNA as everyone else.

And yet, BMI is highly heritable (http://scholar.google.com/scholar?q=weight+OR+BMI+heritabili...) so the 'mostly' is a pretty key qualifier.

The question is are you inheriting genes or memes?

Or bacteria?

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