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August 08, 2008

What Is Making Us Fat?

Michael Blowhard writes:

Dear Blowhards --

Stephan catches the NYTimes making some dumb mistakes in a health story. It isn't fat that is making us fat, it's ... But best to hand it over to Stephan:

Now that I've deconstructed the data, let's see what the three biggest changes in the American diet from 1970 to 2006 actually are:

  • We're eating far more grains, especially white wheat flour
  • We're eating more added sweeteners, especially high-fructose corn syrup
  • Animal fats from milk and meat have been replaced by processed vegetable oils

Wheat + sugar + processed vegetable oil = fat and unhealthy. Sounds familiar, doesn't it? This NYT article is just another example of how superficial journalism can really obscure the truth.

Fun to read the comments on Stephan's posting about his three-eggs-and-butter breakfast too.



posted by Michael at August 8, 2008


The fact that is usually omitted in stories like this is that calorie consumption is way up and calorie expenditure way down. You can eat all the vegetable oils, fructose sweetener, and white flour you want and, so long as you burn more calories than you consume, you won't get fat.

Posted by: Dennis Mangan on August 8, 2008 9:28 PM

It's not just that people are eating different types of foods today. We're also eating more food, period.

Posted by: Peter on August 8, 2008 10:03 PM

I've got to lose this gut!

I'm playing with kid bands these days (30s and 40s), and they're all skinny.

The Karaoke Queen and I joined a brand new yuppie gym in Jersey and I'm working out hard.

But, I love to eat. And the Karaoke Queen works both sides of the deal. She's a gym rat, but she's always cooking.

Dear Doctor: What do I do?

Posted by: Shouting Thomas on August 9, 2008 10:35 AM

I've been reading the 2B food postings only here and there, so please excuse me if I'm bringing up something that's already been discussed, but it seems to me that there are a really a number of controversies that are being discussed in the various 2B posts on diet and food (e.g., processed vs. unprocessed food; long-distance vs. local; etc.), and at least some of the controversies discussed (i.e., the high-fat vs. low-fat debate; the food pyramid; etc.) seem to me to be a result of, what I'll call for lack of a better expression, sloppy word usage.

For example just because a diet/program is anti-high fat, that doesn't mean that that it isn't also anti-SIMPLE carbohydrate (and pro-COMPLEX carbohydrate) -- and that it isn't also anti-processed / pro-whole food and pro-local, etc.).

And, even if one can successfully lose weight on a "high" fat diet and even if not all fats are the heart killers that they've been made out to be by some, that doesn't mean that a high-fat diet might not also be detrimental to overall longevity, health and vitality (e.g., contribute to diabetes, strokes, various cancers, etc.). (I'm not saying that high fat diets do indeed contribute to such problems, only that this is a different point of contention from whether they are good for loosing weight or whether they cause heart attacks.)

Also, I've been following the high fat vs. low fat debate since the late 1960s -- when the high fat (more or less) approach was considered to be basically OK (if one switched away from saturated fats) and was just beginning to be challenged by the low-fat people, and when the real nutritional "outsiders" (the "crazies" that were altenately ignored and "dissed" by the mainstream media) were the low-fat people, like Nathan Pritikin (of the Pritkin Program). It's interesting to look at the various arguments that were forwarded by Pritikin and the anti-low fat establishment in those days and to look at the arguments being forwarded by some of the anti-low-fat people now. Bascially, it seems to me that the new anti-low fat people are "talking" past the issues raised by the low-fat people and not really addresssing the same issues or studies. (That doesn't mean that the anti-low-fat people are necessarily wrong, only that they seem to be talking past the issues / arguments that were originally raised.)

For instance, Pritkin cites the good health and longevity of certain cultures having high COMPLEX carbohydrate, low-fat, unprocessed, locally grown diets. (I believe he mentions the traditional diets of the Japanese, Hawaiians and the Bantus) and how the health of people from these (genetic) groups is adversely affected when they move to cultures with high-fat, high simple-carbohydrate diets. Now there may be something wrong with these studies (e.g., maybe they were just anecdotal and not scientifically rigorous, etc.), but from the cursory readings that I've done (due to the 2B postings) of some of the anti-low-fat people, nobody seems to be addressing these studies to show how Pritikin, and others, may have been mislead (if they have been misled).

Also some of the anti-low-fat people seem to me to be making their own questionably scientific statements. (Offhand, for instance, it seems to me that writer linked to in the above post is making a scientifically questionable correlation between a rise in obesity and the championing of low-fat diets by the scientific establishment. That isn't to say that a valid link between low-fat diets and obesity might not eventually be made, only that the logic and evidence presented by the poster (at least from my admittedly cursory reading of his post) seems to me to be scientifically suspect.

Posted by: Benjamin Hemric on August 9, 2008 1:19 PM

ST: Try the Shangri-La diet + low-glycemic/low-carb. Got me down from 205 to 175 over 4 months with nary a hunger pang. 6 months later (having cut back on the Shangri La program) I'm at 172. After the summer I will try to steel myself to another daily oil-drinking regime and see if I can get down to 160.

Posted by: Intellectual Pariah on August 9, 2008 1:30 PM

Here's what you do. When your meal arrives, you cut it in half, and eat half. You will find that it's always enough. Soon, you will learn that you don't need to feel stuffed to the point of bursting to feel satisfied. And that way, no foods are forbidden.

It works for me, anyway.

Posted by: Sister Wolf on August 9, 2008 2:54 PM

My diet plan: stuff self, sleep it off.

Going out dancing 3 or 4 nights a week helps too.

Posted by: agnostic on August 9, 2008 5:36 PM

It works for me, anyway.

Why, yes it does, my dear Wolf. It does indeed.

Posted by: Your Gentleman Stalker on August 9, 2008 5:42 PM

Now there may be something wrong with these studies (e.g., maybe they were just anecdotal and not scientifically rigorous, etc.), but from the cursory readings that I've done (due to the 2B postings) of some of the anti-low-fat people, nobody seems to be addressing these studies to show how Pritikin, and others, may have been mislead (if they have been misled).

Benjamin Henric: Many of these studies have quite a few confounding variables. Are they adjusted for calorific intake and exercise? For instance moving to a high calorie, high fat western diet also entails moving to a society with less daily energy expenditure. Does energy expenditure influence life expectancy? It would appear so. People who are more active generally live longer and have better health than the sedentary crowd. The calorie restricting crowd seem to have some good evidence that calorie restriction alone prolongs life.

What is making us fat? I reckon the answer lays in culture, urban planning, and mechanisation. Food a distant fourth; it's a many headed hydra.

The amount of fat deposited=food intake-energy expenditure.

It's not about composition, it's about thermodynamics.

Posted by: slumlord on August 9, 2008 6:50 PM

Dennis and Peter,

You're correct that we're eating more calories, but our average energy expenditure has actually increased, contrary to popular belief. I just put up a post discussing the increase in calories and how I believe it fits into the obesity picture.

Posted by: Stephan on August 9, 2008 8:39 PM

Yes, moving from one culture (modern day Japan) to another (to modern day Hawaii or to modern day U.S. mainland) might have involved significant lifestyle changes (other than diet) for the participants involved -- but then again maybe it didn't. (And I believe, but am not sure, that the study involved more than just weight gain). And, yes, there are likely many variables to consider and sort out. But all of that is what's to be rigorously discussed in the low-fat vs. low-carb "debate." My point is that so far (in an admittedly cursory reading of the anti-(COMPLEX)-carb literature, I haven't even seen a mention of the same studies (these and quite a few others) that have been cited in the low-fat literature -- let alone a detailed counter analysis of them.

P.S. -- Although I can't get into details right now, between my first post and this one, I read what I assume are the best known of the Taub and Pollan articles and re-read parts of a 1974 book by Pritikin.

The Taub article especially seemed to me to make some very questionable assertions. For instance, he said one supposedly anti-carb doctor recommended a certain anti-carb diet to his diabetic patients. But the diet that Taub described in the article (to the extent that he described it) was the same as the Pritkin (very) low-fat, high complex carbohydrate one!

Plus Taub claims that cultures in Africa and the Carribean that have high carbohydrate diets were found to be obese -- without citing the studies he was referring to and the cultures they were supposedly studying. OK, it's only an article and not a book, but I still think he should at least give us SOME information about who did the study, when they did it, WHOM they were studying and what the methodology was. (Which could be about four sentences, or so.)

By the way, two of the studies that Pritikin cited in his 1974 book were indeed those of the Japanese and the Bantus (which I mentioned previously). But rather than Hawaiians (who were actually part of the Japanese study), the other study I was thinking of was actually that of the Papau (sp?) people of New Guinea.

Again, there may -- or may not -- be something wrong with these studies (and the others also mentioned in the book). My point is that these studies aren't being addressed (at least from what I've seen so far) in a scientific manner by the anti-carb "opposition."

With regard to Pollan: Rather than being anti-carb and pro-fat, he strikes me as being mostly a "contrarian" who nevertheless, to a large degree, is saying most (but admittedly not all) of same things (e.g., pro-leafy vegetables, anti-processed food) that the anti-fat people like Pritikin have been saying all along (at least since 1974). (For instance there's a line in his article that seems to concede that eating lots of meat is likely to cause cancer, and he seems to recommend the same leafy green vegetables and complex carbs that Pritikin does.)

Pollan does seem less concerned with health and longevity, and more "que sera sera," than Pritikin (who was also concerned about general quality of life in old age as opposed to just heart disease and obesity). And Pollan (30 plus years later) is more sophisticated in his anti-processed food and pro locally grown thinking (which was just getting started in 1974). Also, while Pritikin seemed to think that organic and / or locally grown was probably a good idea in general, he seemed more concerned about whether people were also eating locally produced foie gras or "ruining" their locally grown produce with locally produced butter, etc.

Posted by: Benjamin Hemric on August 9, 2008 10:44 PM

Don't the people of New Guinea just eat each other? Or is that Borneo?

Posted by: Sister Wolf on August 10, 2008 6:52 PM

I have a strong hunch that there are 2 factors which vastly outweigh other contributors.

Anybody have access to figures for food cost / average income? I bet the US has the lowest ratio in the world.

And I'd also bet that fat hardly matters compared to exercise (or calories expended). They eat tons of fat here in China---great gobbets of fat alone are considered a special dish. But the average Zhou here climbs at least 20 flights of stairs and walks 3-4 miles just doing ordinary daily stuff. None of this door-to-car-to-restaurant living. AND as my city has gotten richer over the last 6 years, I've observed more and more fat men and children. More food, cars, elevators, escalators, etc.

Posted by: Sam_S on August 10, 2008 10:55 PM

Although, I've been trying to avoid this topic (because I really should be spending time on other things), it's just been too tempting! So over the weekend, I looked further into this subject and learned a lot of interesting new info.

For instance, some people who are, roughly speaking, in the low-carb camp (although maybe not Taubes and Pollan) have indeed been discussing the same studies mentioned by Pritikin. And not only that, some of them have had some VERY well-informed and extremely interesting things to say -- although I still think, however, that these low-carb advocates are, ultimately speaking, somewhat misguided and missing the point of the low-fat (and high COMPLEX carbohydrate) writings of Pritikin and Ornish.

One of the interesting discussions, with both sides having intelligent and informed things to say, is about the Massai (with a diet high in fat) and is on the "Conditioning Research" website (search Google along with Masai -- it's from June 10, 2008) that MB has linked to. It is in the comments section and is a dialogue between a "Randy" (low-fat advocate) and Stephan (low carb advocate, who I believe has contributed to this current thread).

The other is an extremely well-informed, FASCINATING essay about the Massai and Bantu (“Out of Africa . . . ”) by two, roughly speaking, low-carb advocates, Sally Fallon and Mary Enig on a website that I think MB would greatly enjoy exploring, if he hasn't found it already: the Weston A. Price Foundation website. (I think, but am not sure, that they are also pro-raw milk.)

Two things:

1) I say that some of these people are "roughly speaking" low-carb because when you actually read their recommendations they are "mostly" anti-REFINED carbs -- but, then again, low-fat advocates like Pritikin and Ornish are also vigorously anti-refined carbs too. And when you look at the concrete dietary recommendations being offered up by these supposedly low-carb advocates, they really don't seem all THAT different from what Pritikin and Ornish have recommended! (Yes, there are real differences, but still they are not all THAT different.)

For instance:

THE HEALTHIEST TRIBE THAT [WESTON A.] PRICE STUDIED was the Dinkas, a Sudanese tribe on the western bank of the Nile. They were not as tall as the cattle-herding Neurs groups but they were physically better proportioned and had greater strength. THEIR DIET CONSISTED MAINLY OF FISH AND CEREAL GRAINS. This is perhaps the greatest lesson of Price's African research —- that a diet of whole foods, one that AVOIDS THE EXTREMES OF THE CARNIVOROUS MASAI and the largely vegetarian Bantu, but INCORPORATES BOTH NUTRIENT DENSE GRAINS AND SEAFOOD, ensures optimum physical development. (Emphasis is mine -- BH.)

2) Generally speaking, however, I think they have missed the overall points being made by the Pritikin and Ornish programs:

a) Which "traditional" diet (e.g., the low-fat Bantu diet [with some meat or fish, but without the insects!] or the high-fat Massai diet) is the best fit for modern day peoples; i) who don't NECESSARILY engage in the high levels of physical activity of tribes like the Massai; ii) when it comes to OVERALL HEALTH and LONGEVITY (especially for people who are, generally speaking, living longer lives because of modern medicine, etc.); and iii) when it comes to safely REVERSING the damage of heart disease.

So, yes, one can eat either high fat or low fat (w COMPLEX carbs) and not get heart disease (if one exercises enough) -- but, as far as I know, only a low-fat diet will actually reverse heart disease (and protect against other degenerative diseases of "old" age, too).

Posted by: Benjamin Hemric on August 11, 2008 1:09 PM

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