Dr. George Bray's model of obesity
Dr. George Bray's model of obesity

In July 2008 I posted on Dr. George Bray’s critique of Gary Taubes’ book Good Calories, Bad Calories that appeared in Obesity Reviews.  Included in my post was a copy of Gary’s response.  Now Dr. Bray is back with a rebuttal to Gary’s response to his (Bray’s) original critique.  In conversation, Gary told me he has elected to drop the issue because the discussion is going nowhere.  Gary makes substantive points; Bray obfuscates the issues and will continue to do so.  I, however, am not going to drop the case.  Maybe I’ll have the last word here.

I want to go over Dr. Bray’s response to Gary’s letter in some detail because it is emblematic of all that is wrong with obesity research today and clearly demonstrates why we will never get anywhere until the people of Bray’s generation fade away. I don’t know that I’ve ever seen so many instances of one writer missing the point as often as Dr. Bray does in this short reply.  The entirety of his response is an example of either shoddy thinking or intellectual dishonesty.  Or maybe both. It brings to mind Mary McCarthy’s famous quote about Lillian Hellman: “Every word she writes is a lie, including ‘and’ and ‘the’.

(You can read Dr. Bray’s original critique of Good Calories, Bad Calories along with Gary’s response in my July 2008 post.  The full-text of Dr. Bray’s letter of reply we’ll be discussing in today’s post can be found here.  You should pull it down in pdf and print it so you can follow along.)

Right off the bat, in the very first line, Bray leads off with his first porkie.

In his nearly 5000-word response to my book review, Mr. Taubes has raised a number of issues.

Gary’s response was slightly under 2000 words.  You might think this just simply a typo, and normally I would too, but the entire piece is filled with so many inaccuracies seemingly designed to denigrate Gary’s response that I don’t think so.  Why even put the number of words?  Why not simply say: In his response to my book review…?  By quantifying the number of words the way he does, Bray casts a pejorative shadow on Gary’s response from the get go.

If you read Gary’s letter, you will see that he methodically refutes Dr. Bray’s criticisms of GCBC and identifies those issues in which he feels Bray misses the point.  In his response, Bray says Gary’s critique of his (Bray’s) review of GCBC

opened the door for [him] to contrast [Taubes’] hypothesis for obesity with [his own].

It’s a kind of disingenuous way for Bray to get his own hypothesis of obesity into play in what amounts to a review of Gary’s book, but let’s take a look at what he has to say.  First, he completely simplifies and basically mischaracterizes Gary’s hypothesis of obesity.  Here is Gary’s hypothesis of obesity and his proposed treatment as interpreted by Dr. Bray:

taubes-model-of-obesity

As you can see, it appears pretty simplistic, which, I’m sure, was the intent.  Not shown are all the feedback loops and intricacies Gary has described at length in GCBC .

In referring to this diagram, Dr. Bray admits that it is based on “two sentences from the letter,” which doesn’t seem like a lot out of a 5,000-word letter (or even the 2,000-word letter that it was).  Then he goes on to use three sentences to establish the basis for the diagram.  (See what Mary McCarthy meant about even ‘and’ and ‘the’?)

After giving short shrift to Gary’s hypothesis of obesity, Dr. Bray then goes on to lay out in great detail his own theory of obesity as represented by the Rube Goldbergesque diagram at the top of this post.  Bray’s entire hypothesis, for which he recruits leptin, insulin, the brain, glucocorticoids, and God knows what else to help make his point, is based on a faulty premise.  But it’s a faulty premise he has accepted uncritically.

His hypothetical model of obesity, he authoritatively states

starts with the First Law of Thermodynamics, which states that the change of energy in a closed system is the difference between the heat added to the system and the work done by the system.

Dr. Bray then restates this hypothesis (and the First Law) in the form of this equation:

Δ E = Heat (q) – Work (w)

Readers of this blog know this as the energy balance equation, which looks like this in its more familiar form:

Δ Weight (the Δ means change) = Energy in (food) – Energy out (exercise plus metabolism)

The fatal flaw in Dr. Bray’s hypothesis (which is a flaw we’ve discussed often in these pages) is that he doesn’t understand that the components on the right side of the equal sign are not independent variables.  They are dependent variables.  If one eats less, the rate of metabolism falls to compensate.  If one exercises more, the appetite increases, and one eats more to compensate.

Were these components truly independent variables, life would be easier (but we may not have survived).  According to Dr. Bray, Anthony Colpo, and countless others, however, these components are independent variables.  Eat less, say they, and you’ll lose weight.  Which is true, to a point.  But once the energy-out component of the equation kicks in, weight loss stalls, even if you are eating less, a fact everyone who has ever dieted knows.  Exercise more, they pontificate, and you’ll lose weight.  Which, again, works (maybe) in the very short term.  But once appetite kicks in, you unconsciously eat enough more to compensate for your increase in exercise, as anyone knows who has tried to lose weight by walking or other exercise alone without consciously restraining eating.

Now don’t get me wrong, it is possible to lose weight by decreasing food intake and increasing exercise.  It worked well in the concentration camps in WWII and in Ancel Keys’ starvation studies in the 1940s.  But in those cases, people were under lock and key.  It doesn’t work for the long term for the majority of people unless they are coerced.

This fairly obvious observation that the energy in/energy out components are not independent variables seems to elude most (if not all) obesity researchers, including George Bray.  These people persist on basing the foundation of any obesity treatment on the admonition to eat less and exercise more, which is a total folly.  Yet Bray and his ilk continue to clothe this folly in the garments of academic respectability and work to pass it off as the latest fashion in scientific thinking.

Dr. Bray believes that the reason so many people are fat is twofold. First, he thinks  humans have a ‘hedonic’ drive that inexorably pushes them to increase their food intake.  And, second, he reckons that this ‘hedonic’ drive also overrides the “appropriate negative feedback signals to stop eating.”  What stimulates this ‘hedonic’ drive?  According to Dr. Bray

It is caused by the pleasurable effects of high-fat, high-sugar foods.

Well, at least he’s half right on that one.  No one binges on pure fat.  It’s impossible because of feedback inhibition to eat a lot of pure fat at a sitting.  Try sometime to sit down and eat some butter all by itself.  See how much you can choke down.  I can guarantee you it won’t be much.  Then add a little sugar to the mix and see what happens.  Suddenly the butter is converted to frosting, and you can put away a lot of it.  What’s the difference?  It’s the sugar.  Sugar – and carbohydrates in general – override the stop-eating center in the brain.  That’s why all binge eaters binge on a combination of fat and carbohydrate.  That’s also why you can go out to dinner, eat ‘til your stuffed, not be able to eat another bite of any kind of meat or other real food, yet perk up when the dessert tray comes around.  As the old saying goes: there’s always room for dessert.  Why? Because your brain knows the stop-eating center will be overridden by the sugar and carb in the dessert.

Dr. Bray would have been more accurate had he said that the stimulus for the ‘hedonic’ drive is carbohydrate.

But he doesn’t.  He is trapped in the fat-is-bad paradigm.

In experimental animals, highly palatable food or a high-fat diet is one of the easiest ways to disturb this homeostatic system [as defined by Dr. Bray], and this may apply to human beings as well.

Dr. Bray seems to believe that we live in a toxic world in food terms.  We are unable to help ourselves, and are therefore destined to be fat because of our ‘hedonic’ drive.  We are helpless.  There is no cure save eating less and exercising more, which even he more or less admits doesn’t work despite his entire model being based on the idea.  As I have discussed in another post, Dr. Bray is a major proponent of drug therapy to treat obesity.

In a way, I agree with him about the idea that we live in a toxic world, one with all kinds of the wrong kinds of food available to tempt us 24/7.  Problem is that Bray and his ilk are a major part of the reason we live in such a world.  But that’s a topic I’ll leave for a future post.

Dr. Bray makes a bizarre case for why he thinks the majority of dietary studies show better results in those subjects following low-carb diets than in those consuming low-fat regimens.  I’m going to use his own words, so you won’t think I’m making this up.

the principal studies that directly support this model [Taubes’ theory on low-carb dieting] included the word ‘Atkins’ in their clinical trial. When similar low-carbohydrate diets were tested without using this ‘name’, the low-carbohydrate diets had no more effect than those to which they were compared.

There you have it.  All you have to do to make a diet work is include the name ‘Atkins’ in the title.  I wish MD and I had known that when we wrote Protein Power.

What is truly ironic about this nonsense is that in this very same issue of Obesity Reviews containing Bray’s rebuttal is a long review article titled Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities.  This article takes an in depth look at studies comparing low-carb diets to low-fat diets.  Here is the conclusion as written in the abstract:

There was a higher attrition rate in the low-fat compared with the low-carbohydrate groups suggesting a patient preference for a low-carbohydrate/high-protein approach as opposed to the Public Health preference of a low-fat/high-carbohydrate diet. Evidence from this systematic review demonstrates that low-carbohydrate/high-protein diets are more effective at 6 months and are as effective, if not more, as low-fat diets in reducing weight and cardiovascular disease risk up to 1 year.

Dr. Bray lists five other issues about Gary’s letter to which he wishes to respond, but before he gets to the list, he makes one last flippant point.

I thus conclude that if any diet ‘cured’ obesity as their proponents often claim, there would be no obesity and thus no need for the next diet. Yet the past 150 years, since the publication of Banting’s first popular diet, have seen a continuing stream of new diet books.

The reason, of course, is that we dieting fish all swim in waters that have been polluted by Bray and his brethren, more about which in a later post.

Now to the list.

1.    Near the end of the letter, Mr Taubes suggests that my review of his book may be a ‘conflict of interest’. He says ‘I [Bray] may be defending what my scientific research has led me to believe’. If this is a conflict of interest, then all scientists have a conflict of interest.

This first short point of only three sentences tells you everything you need to know about Dr. Bray’s scientific credibility.  I have no problem with the first sentence.  The second sentence is purportedly a quote from Gary Taubes letter.  It isn’t.  It is a paraphrase…sort of, but put in quotation marks.  This is a real no no.  It was done so for a particularly egregious reason, which was for a set up for Bray’s final sentence.  But that sentence even further diminishes his credibility.  Scientists are supposed to constantly challenge their own hypotheses, not accept them as fact simply because they’ve spent their careers enraptured with them.   All true scientists don’t have this conflict of interest.

2.    The first paragraph of his letter dealt with lipoproteins that I said he had not covered. The issue was not the lipoproteins but their receptors, from which we have learned so much in the past 30 years.

This one is a real copout.  In Bray’s original critique he wrote:

As I read through Good Calories, Bad Calories, I found a number of errors of omission or commission that are important when relating diet to heart disease.  There is no mention in the Diet-Heart section of low-density lipoprotein-cholesterol (‘bad cholesterol’) or of high-density lipoprotein-cholesterol (‘good cholesterol’).

The issue may have been the receptors and not the lipoproteins, but as you can see from his direct quote above, that’s not how Bray characterized it.  Gary set him straight with a list of about two dozen pages and groups of pages where LDL and HDL were mentioned, yet Bray weasels instead of admitting his mistake.  When I read his first letter, it made me wonder if he had even read the book.

3.    In his letter he mentions doubly labelled water only to conclude that we knew this already from the 19th and early 20th century and he did not need to discuss it in his book. I would submit that we did not know that people under-report their intake by as much as they do and that overweight people under-report more than normal-weight people do.

Okay.  There’s a total non sequitur.  What does the second sentence have to do with the first?  Weird.  Was Bray on dope when he wrote this?

4.    Mr. Taubes say ‘the goal of science is to determine causality…’

(What Gary actually wrote was ‘The goal of science is to correctly determine causality,’ but who’s counting?)

Then Bray wades into this strange discourse about the theories of Karl Popper, whom he misnames as Hans Popper.  (Does this guy ever bother to look anything up?)

This is significantly different from the views of Hans Popper, the philosopher of science, whose search is for ‘reality’ rather than ‘causality’. Popper says ‘there is a reality behind the world as it appears to us, possibly a many-layered reality, of which the appearances are the outermost layers. What the great scientist does is boldly to guess, daringly to conjecture, what these inner realities are like. Popper also espouses the concept of ‘falsification’, which is at the heart of rationalist thought. To quote him again –’a false theory may be as great an achievement as a true one. And many false theories have been more helpful in our search for truth than some less interesting theories which are still accepted’.

If you can make sense of this gibberish, you’re a better man than I am.  All I know is that Bray misses Popper’s point about falsification in a major way.  (We discussed Popper and his theory of falsification in an earlier post.  And it ain’t anything like Bray makes it out to be. I seriously doubt he has even read Popper’s work.)

The last sentence of the above paragraph I find particularly interesting.  Writes Bray, apropos of nothing really:

And many theories have been more helpful in our search for truth than some less interesting theories which are still accepted.

I don’t know about the search for truth, but I can tell you that the inability of Bray and the rest of the academic obesity ‘experts’ to shake loose from their own ‘less interesting theories’ have led us into the obesity epidemic we’re in the throes of now.

Dr. Bray’s fifth comment, which I’m not going to reproduce in full, is a world-class case of totally missing the point.  After commending Gary for proposing an experiment to validate his hypothesis, he goes on to quote Gary’s rebuttal letter:

He says ‘the positive energy balance hypothesis of obesity asserts that the only way to lose excess fat is to eat less and/or exercise more – that without consciously inducing a negative energy balance we will not lose weight’. His hypothesis is ‘the carbohydrate/insulin hypothesis asserts that if we restrict carbohydrates in the diet/and or improve the quality of the carbohydrates consumed then insulin levels will be lowered, reducing the accumulation of fat in the fat tissue independent of the nutrition state of the subject’. I would take exception to his use of the word ‘consciously’ in his statement of the energy balance hypothesis. For example, the current level of oil prices may increase human energy expenditure through more walking as it decreases automobile use. This is not a ‘conscious’ choice in the sense used above but would have the same effect.

Say what?!?!?!

Let me get this straight.  Dr. Bray thinks if we walk more because we decrease automobile use as a consequence of the high price of gasoline that we’ll lose weight because we are unconsciously exercising instead of volitionally exercising?  As I say, he misses the point, which is that the two components on the right side of the energy balance equation are not independent variables, but are dependent variables.  It doesn’t matter if one walks as a part of exercise or because one can’t afford the gas, the body compensates by increasing food intake.

Dr. Bray ends his response by resorting to the old conservation of energy principle, which all the eat-less, exercise-more folks hew to.  They seem to believe that no one who advocates low-carb diets can understand the laws of thermodynamics when it is they themselves who don’t understand them as applied to diet.  There is nothing inconsistent with Gary’s theories of the cause and treatment of fat accumulation and the laws of thermodynamics.  It’s Bray and friends’ lack of understanding of these laws and/or their refusal to accept the dependent nature of the energy in/energy out components of the energy balance equation that are the heart of the problem.

This entire rebuttal of Dr. Bray’s reminds me of my own favorite lines from Good Calories, Bad Calories.  They are my favorite because I’ve seen first hand what they describe.

The institutionalized vigilance, “this unending exchange of critical judgment,” is nowhere to be found in the study of nutrition, chronic disease, and obesity, and it hasn’t been for decades.  For this reason, it is difficult to use the term “scientist” to describe those individuals who work in these disciplines, and, indeed, I have actively avoided doing so in this book.  It’s simply debatable, at best, whether what these individuals have practiced for the past fifty years, and whether the culture they have created, as a result, can reasonably be described as science, as most working scientist or philosophers of science would typically characterize it.  Individuals in these disciplines think of themselves as scientists; they use the terminology of science in their work, and they certainly borrow the authority of science to communicate their beliefs to the general public, but “the results of their enterprise,” as Thomas Kuhn, author of The Structure of Scientific Revolutions, might have put it, “do not add up to science as we know it.”

The result is an enormous enterprise dedicated in theory to determining the relationship between diet, obesity, and disease, while dedicated in practice to convincing everyone involved, and the lay public, most of all, that the answers are already known and always have been—an enterprise, in other words, that purports to be a science and yet functions like a religion.

Is it any wonder that Dr. Bray didn’t enjoy the book?

95 Comments

  1. Hey, Dr. Eades. I have a few questions.

    1.) Is there a responsible way to use exercise to speed weight loss in conjunction with a carbohydrate-restricted diet?

    and,

    2.) What does the delta in the weight loss equation stand for?

    Thanks,
    mc

  2. ….he’s obviously an old dosser(close to 80 ?) trying to shore up a belief around which he’s seemingly fashioned his whole career and thus identity.

    Calling Karl P Hans P (the lesser known waffle salesman from Baden Baden) is just plain sad.
    He’d make a good Pope however !

  3. As one of my last prerequisites for grad school (RD/MPH program), I’m taking a undergrad nutrition course. As I painfully work my way through a nutrition book full of inaccuracies, illogic, apparent ignorance of how the human body actually works and what looks like just plain biased thinking, it’s somehow reassuring to know it doesn’t get better further up the rungs of academia. The way I see it, refuting nonsense put forth by the “nutrition experts” will ensure my job security–as a “nutrition expert”–for a long time to come. What is truly ironic to me is the extent to which the textbook emphasizes how we should question the information we hear regarding nutriton. We should examine sources, read the primary research, be on the look out for bias, etc.–all of this stated ingenously, as if there is no bias to be found within the academic field of nutrition itself. The most infuriating thing about trying to argue something with folks like Bray is that their bias is so deeply rooted, it prevents them from even hearing counter-arguments accurately in the first place. (In his first response, Bray implies that GT thinks “Insulin secreted by carbohydrate is the problem in obesity.” Huh? His bias is so soundproof, he can’t even write.) To save my sanity, my nutrtion book is full of sticky notes referring me back to the real science that refutes the nonsense that I find. Thanks for a great post & safeguarding my sanity a bit as well.

  4. “…that purports to be a science and yet functions like a religion.”

    Reminds me of another hot button issue of the day, that global warming thing.

    1. i just love to see a paradigm fall. thanks all you guys. Bray’s crowd has been denying the cure for diabetes, which you guys will have for us soon. This is the most entertaining thread i’ve read in a long while. I actually laughed, but i know it’s not funny……..

  5. hi doc
    i love this blog. i have been checking almost on an hourly basis for a new post. it makes my day. since this post is about comments made on comments made on comments etc i feel i can add my two cents
    i have looked at the position of other diets that advocate some carbs, such as south beach, zone, dr oznor, lyle mcdonald, the cyclic ketogenic diet and the Testosterone advantage from mens health.the fact is you can lose weight on any diet. the problem is to lose fat but not muscle and vital tissues.
    the worst example of this was the recent fight between oscar de la hoya and manny pachaio. oscar looked horrible. he shed a lot of weight and looked like a dachau inmate. he even had the bent back of an old man. his punches had the old form but no speed or power. he lost badly. the preservation of lean tissue is where low carb and resistance training makes such a difference.
    my own experience is that even on little or no carbs i still feel hungry, but only late in the day. the cravings begin somewhere between 5 and 8 pm. if i stick with it though i lose weight, which i know is fat because my belt gets slack.
    what i am trying to work out is how much protein to eat and how much carbs, if any. i know that when you keep insulin low body fat is released to be used as fuel, but BOTH protein and carbohydrate raise insulin
    secondly, there is a need for glucose by the brain etc. this glucose can be made from amino acide by gluconeogenisis, but why not simply consume a prescribed amount of carbs to provide this glucose.
    i guess what i am really asking is how much protein, fat and cho is ideal for fat loss with an appropriate resistance training program
    i cannot thank you enough for this blog and the real service it provides to al of us who are trying to recover our true body

  6. A scientist I am not, but it seems that if one starts from a flawed premise, it is almost inevitable that one will arrive at a flawed conclusion. Perhaps one ought, when examining the work of someone considered an opponent, to suspend disbelief and examine the opposing evidence with enough openness to ask, can this is true? Can I be wrong?

    For a lay person such as myself, watching these nutrition debates from the sidelines, so to speak, I can’t enter the discussion in the same way you or Bray or Taubes can, so for me, the question becomes, whom do I choose to believe if my health is a concern for me? I tried it Bray’s way for most of my adult life and ended up weighing over 200 lbs, feeling like crap mentally and physically. My diet-crazy daughter introduced me to Atkins a few years ago (and now I know why it worked: the name “Atkins” is a potent magic abacadabra word that causes fat to burn away, according to Bray!). Later I read the PPLP, and it was the science there, followed by all the evidence since found in many blogs on the Internet, that has kept me committed to low-carb nutrition. But why do I trust the information from the low-carb community over the mainstream dietary advice? Because the low-carb claims have been backed up by my personal experience: weight lower, acid reflux gone, normal blood pressure, good lipid panel, depression gone, better energy, good dental health, in my fifties and disease and medication free, improved memory, freedom from constant hunger and cravings….

    Scientists can debate all sorts of things in theory, but in applied science, the consequences can be deadly if they get it wrong. I’m going to die somehow sometime, but I’m optimistic that, armed with the nutrition knowledge I have gained, I may dodge a few unpleasant ways of spending my old age, such as Alzheimer’s, heart disease, diabetes, etc., assuming Providence permits me to live to be old.

  7. Love it Doc! Given what we know today about human biochemistry and its idiosyncratic responses based on individual genetic variations makes thinking the body is a machine plainly ridiculous! I have come to the conclusion that you are right, until the ‘old guard’ dies we will be left with these illogical concepts about human health. Driven by bottom-line profits, corporations will eventually focus on how to optimize the health of the ill as they recover (if possible) and the obese as they lose wt to restore health — this will not happen overnight as there are many who will continue to worship the ‘old guard’s outdated nonsense’ for some time to come. With any luck, those with some intelligence in the NIH will begin to understand that much of what is understood to be healthy isn’t based on fact or what has come out of unbiased double-blind studies, then maybe the govt might start recommending really appropriate practices/behaviors. However, this is probably waaay too idealist a hope, so I won’t hold my breath waiting…lemming behavior beats intelligent thought almost every time *G*!

  8. Okay, having read a few of the comments that have come in, I can’t let let the one about Bray making a good Pope go unchallenged. The implication behind the fantastic leap of illogic asserting that because Bray got Popper’s first name wrong, he would make a good Pope is insulting and bigoted. Someone who believes that Popes are stupid men who can’t get facts straight is not educated enough about them to offer an intelligent opinion. His Holiness Benedict XVI is one of the most learned and intelligent men alive today, as was his predecessor of beloved memory John Paul II. And many in a long line of pontiffs before them have been men of formidable intellects and among the most pre-eminent scholars and philosophers of their day.

    Someone may be a smarty-pants in one scientific discipline, but expertise in a particular niche does not confer the automatic ability to comment knowledgeably about other scientific disciplines, history, metaphysics, theology, philosophy, or any other realm of knowledge outside one’s immediate area of experience.

    1. theology isn’t science. the butt of the guys joke wasn’t the pope, it was Bray. and the writer wasn’t commenting on other disciplines at all. it was a joke. if you’re thin skinned about religion, you won’t find much sympathy here. science and medicine keep advancing and religion repeats the same myths from century to century. Good luck with that.

  9. @Steve- a lot like global warming! We just had a record low this morning here in Oklahoma City, shattering the previous record by 5 degrees. If I were to mention this to a global warming proponent, he/she would say “well that’s just idiotic, you can’t point to one day as demonstration of a trend” and of course, they would be right. Or, if they were feeling frisky, they would run with the new argument, that as a result of global warming, the climate is becoming more extreme. So record lows are in accord that line of thinking. And of course, as quickly as they would call you an idiot for pointing out that you can’t use one day to demonstrate a trend, they would surely do that very thing in a safe crowd, or if they lost their temper (as a friend did with me the other day).

    The great thing about issues of nutrition is that you can be actual living, breathing proof of your results. Even so, people still will doubt that you can “keep it up”…my friend’s overweight father who had a heart attack two years ago saying the other day, as I refused the remaining sushi at the table after previously refusing doughnuts earlier in the day, “he’ll eat real food one day, when he ends up like me.”

    So even though global warming appears to be on the backburner (the “issue” Americans care about the least according to a recent poll: http://www.cnsnews.com/public/content/article.aspx?RsrcID=42474) the true believers will continue manipulating the topic and yank it out again when its necessary. Like Dr. Eades said, we’ll have to wait till these guys die. But in the meantime, although their skewed logic can be maddeningly frustrating, occasionally its fun to poke the bear, whether its with a 22 degree morning or a 32 inch waist 🙂

    1. There are such things as polar ice caps you know. They are probably a more sensitive measure of global temperatures than the weather in Oklahoma city. Is opposition to global warming theory really as parochial as that?
      There’s a lot of information about diet in these blogs, and you can test any theory for yourself in real time with your own body and the perople around you. There’s no information about meterology here and it’s not the case that any global climate theory can be easily tested at home (unless you live near the poles or a glacier).
      The two things should not even be compared.

  10. You must admit, it’s very generous of Bray to share his deep understanding of the laws of thermodynamics with Gary Taubes … who has a degree in physics. From Harvard.

  11. Ah, ‘Hedonics’- that explains everything…

    Next he’ll grandiosely announce it’s carbohydrates that controls the ‘Dr. George Bray Hedonics Module™’. Something a simpleton like Taubes couldn’t be expected to realize.

  12. Not responding to the response is a mistake. While it is certain that Bray will never recant, there is a critical group of people – those who are allergic to bad reasoning – that can be won over by constantly destroying the opposing argument in detail in a reasoned manner. This is especially so among scientists. Letting Bray have the last word would let a good opportunity go to waste.

    Therefore, if Gary is reading this, please take the time required to write up a detailed response. Loved your book by the way – one of the most important books around today, given our public health situation.

  13. “No one binges on pure fat. It’s impossible because of feedback inhibition to eat a lot of pure fat at a sitting. Try sometime to sit down and eat some butter all by itself. See how much you can choke down. I can guarantee you it won’t be much. ”

    The same thing could be said of sugar. Sit down with a cup of sugar and see how much you cna eat. I guarantee you it won’t be much. I could definitely eat more butter than sugar.

    1. carbs are easier to eat than fat. i’m surprised u don’t agree. fat feels more filling. it’s not just the taste to me. it’s the fullness. But I crave carbs desperately, especially if i’m not sticking to very low carb.

      1. But I do agree. That’s why most of us have such a problem…because carbs are easier to eat than fat. And usually much more appealing.

    2. What if the sugar is dissolved in coca-cola? A lot of people find it easy to overdose on syrup with no fat content in this way.

  14. “He says ‘the positive energy balance hypothesis of obesity asserts that the only way to lose excess fat is to eat less and/or exercise more – that without consciously inducing a negative energy balance we will not lose weight’. His hypothesis is ‘the carbohydrate/insulin hypothesis asserts that if we restrict carbohydrates in the diet/and or improve the quality of the carbohydrates consumed then insulin levels will be lowered, reducing the accumulation of fat in the fat tissue independent of the nutrition state of the subject’. I would take exception to his use of the word ‘consciously’ in his statement of the energy balance hypothesis. For example, the current level of oil prices may increase human energy expenditure through more walking as it decreases automobile use. This is not a ‘conscious’ choice in the sense used above but would have the same effect.”

    I think what Bray is saying in the above passage is that if you follow a low carb diet and loose weight without consciously trying, it shouldn’t count because it therefore isn’t fair 🙂

  15. Bray’s responses make it clear as day that Tabues was right in suggesting that Bray may be defending himself rather than his positions. He’s too invested in his answers. It’s like Dean Ornish, but much worse.

  16. The difference between the science behind low carbs and global warming, better called climate change, is what Dr. Eades has been teaching us about controlled studies and observational studies. We can observe the ice caps melting at both poles, but we cannot really prove that humans and cows are causing it. We cannot do a controlled test on the earth.

  17. Hey Mike,

    As you know I disagree with both sides of this fairly pointless dispute. Sure, more with Bray and his dishonest and largely incoherent ramblings, but I still think the elephant in the room from your and Gary’s (and just about any low carb author I have read) side is not considering the variables that are not included in the equation at all.

    Clearly there are a lot of other factors which influence food intake. I wonder again why some sort of reasonably in depth discussion of these does not appear in low carb weight loss books. Is it because these are deemed fall more in the realm of psychiatry and not in general medicine? Maybe these variables are seen as too hard to accurately assess in real world trials?

    Again as I’ve said before Gary’s exercise example flies in the face of personal experience for a lot of people. You say that this cannot work without coercion – well I’m sure many people act in the way they do from either self imposed or societal coercion (the former generally being initiated to satisfy the later) to exercise more and eat less, and while they do so weight loss and maintenance of that loss is achieved – or it is until the metabolic impact of doing this the high carb, low fat way has its almost inevitable effect on insulin resistance and, coercion or not, the price of the necessarily increasing sacrifice becomes too high to pay.

    At risk of repeating myself further, your example of ‘feedback inhibition’ of a low carb diet is also one that is routinely overridden by those with disordered eating behaviour. Sure a low carb diet lessens the metabolic pressure to over consume – and your example of pure(ish) fat is probably right, but slightly less ‘pure’ food sources such as cheese (less than 1% carbs) or fatty meat (even less carbs) are things that derail the weight loss or maintenance phases of low carb for more than a few. It may not be your (or Gary’s) personal experience (that you can eat too much of these things) but I assure you I, and more than a few others, can.

    Let me stress that I don’t see any of these flaws as in any way detracting from the wonder of health and much easier weight management that a low carb lifestyle represents. Bray’s supporters (assuming he has any!) will get no comfort from me. But I think the low carb thesis would be enhanced if all issues were addressed rather than assuming complicated human behaviour can be reduced to an (over) simplistic equation … whichever way the arrows point!

    Oh yes, and while I am in soap box mode, I really hate to see people justify the abandonment of science in other areas, simply on the basis of one person tainting the concept of true scientific enquiry in the field of nutrition. As Gary suggests, Bray and a lot of other people in this field, don’t deserve to be called scientists. Whilst I am all for sceptical analysis of … anything! – those suggesting a giant conspiracy in other areas should probably reflect on how difficult this would be to achieve, especially as the big money is on the other side … but that is probably enough about that one!

  18. While we’re watching someone at the far end of his career hang on nonsensically to the theory he built his career on, I wonder:

    Do you, Dr. Eads, spend much time guarding yourself against that kind of thing? You are someone who has built an entire career on a particular theory. You and I think you are right and Bray is wrong, but what do you do to challenge your own hypotheses as you described above? Like, let’s say if Bray is wrong, but it turns out some yet to be discovered science means you are also wrong. Do you think you’d be able to see it?

  19. I say NAY to Dr Bray
    He will likely go to his grave with his ideas intact. His reccomendations for diet have had life and death implications (in both quality and term) for a great many of his fellow human beings. With blood on your hands like that, it becomes just about impossible to admit culpability.
    travis t

  20. Every time I read any “blurby” nutrition thing – like stuff the school sends home about keeping kids healthy, practically any magazine article, etc. – it’s always the same old exercise/eat less/lean meats/low fat falderole! It’s like living in a fun house. The good information is out there, but the usual suspects are holding up distortion mirrors. I’m thinking Wait? Haven’t you ever read…? Considered…? Am I the one losing my mind here or….maybe it’s the cotton candy.

    Thanks, Dr. Eades, for your “sane house”!

  21. I’m astonished he didn’t draw the flowchart for Taubes with a crayon. I mean, come on, could he have chosen a worse opponent to use the “my opponent is a stupid head” argument against?

  22. I like the bit about animals. Not sure what he’s been experimenting on, cattle (and other food animals) fatten quicker on grain than on nearly anything else. Well, silage is good, but you have to let it ferment a while to get at those sugars.

  23. To ethyl: I understand, appreciate, and applaud your passion in support of our Pope. I am also Catholic. Another way of looking at Nancy Boy Fellows’ argument is this: If nutrition is an enterprise that purports to be a science and yet functions like a religion (see quote of GT by Dr. Eades above), than Dr. Bray can accurately be described as holding a very large, very public, very influential role in that enterprise. I do not believe that anyone is comparing the direction that folks like Dr. Bray steer the nutrition enterprise with the Pope’s direction of Catholicism.

    To fasching: GT has no need now to “take the time required to write up a detailed response”. He need only link to this post. Dr. Eades has quite capably done it for him.

    I love this blog.

  24. “Sit down with a cup of sugar and see how much you can eat. I guarantee you it won’t be much. I could definitely eat more butter than sugar.”

    I don’t agree. I don’t think it feels good to do so (at least not later), but I’ve known people who have eaten bags of pure white sugar and brown sugar (in secret).

    Not saying the same isn’t done with sticks of plain butter or lard, but I’ve never known anyone to do it. Personally, I know that as much as I love butter and other natural fats (and use a lot in my cooking), I don’t ever crave or eat concentrated fats by them selves the way I used to be able to eat concentrated sugars alone, like cotton candy or sugar cubes (with a nice stomach ache later).

    Together, wow, fat and sugar is lethal.

  25. Is there a real live Dr Bray responsible for this drivel?

    Is there a real live corporate spin doctor engaged to write this drivel?

    There are some highly suspect organisations that would benefit from the
    nonsense dispensed by “Dr Bray”.

    The mistakes (Hans Popper?) the deliberate misquotes make me think of a mercenary
    wordsmith (PR/ghost/writer) hired to denigrate someone.

  26. >>1.) Is there a responsible way to use exercise to speed weight loss in conjunction with a carbohydrate-restricted diet?<<

    Nothing comes remotely close to a well-designed weight training program for the purposes of body recomposition & long term health.

    Some useful intro links:

    http://www.ultimate-exercise.com/

    http://www.youtube.com/profile?user=bodybyscience&view=videos

    http://baye.com/

    I’d also recommend checking out this book, which combines weight training & a low-carb diet:

    http://tinyurl.com/dzp4zr

    (Anything by Jeff Volek is well worth reading, IMHO)

  27. I wonder what Bray and his ilk think of the use of octreotide (inhibits insulin release) to treat obesity. It works quite well apparently, especially for the “insulin hypersecretors” and in hypothalmic obesity. The efficacy of blocking insulin release to treat obesity would seem to be strong support for Taubes’ thesis, and I don’t understand why these so-called obesity researchers ignore this sort of evidence. Willful ignorance? As you point out, his bungling of the facts argues more along the lines of stubborn arrogance.

    Thanks so much for your blog.

  28. I do think that eating flour and sugar is a bad idea. I don’t think that things are as simple as carbs drive insulin drives fat accumulation, or the Japanese would all be fat, when in fact they have a 2% obesity rate and very little diabetes on their ultra high carb diet.

  29. Thanks for this blog Dr Mike. It is sad to see someone who was a leader in the weight loss world so publicly inarticulate in his own defense. How old is he now? Very sad. I am sorry his diatribe was published.

    I do appreciate his simplistic diagram of the carbohydrate hypothesis as it does represent very clearly what all the low carb folk keep saying (with or without the feedback loops).

    We still have a lot to learn about the way food afects our bodies, we aren’t there yet, so I like to look at the research data that both supports and does not support the carbohydrate hypothesis, and try to apply it to my own situation as a troubled weight loser.

    I did lose 70 pounds following PP and am most grateful. I regained 20 “falling off the wagon” which I am trying to re-lose. Although I keep my carbs under 50 ECC (carbs minus fiber) and usually under 30 ECC a day, I am not losing any weight and have not lost any weight for the past 8 months but instead have gained weight. I simply eat too many high fat proteins in a day. So at this stage I must consider the second law of thermodynamics which calls for either a reduction of calories each day or an increase in exercise ,or both, without increasing my daily ECC.

    I don’t think we have all the answers yet. Low carb is a great start and I firmly believe it to be far superior to low fat, but we are all so very differet one from another that a one size fits all diet is not the complete answer. I firmly agree with Gary Taubes that we need more research on the subject. I would like to see the carbohydrate hypothesis tested, by itself, with different groups of subjects in terms of age, gender, daily calorie intake, daily exercise, BMI, lenght of time the subject has been obese etc etc. It’s important that we continue to compare the low fat hypothesis with the low carb hypothesis for a while yet in order to show the efficacy of low carb over low fat but we also need to plan ahead in our search to tweak our knowledge base.

    Thanks for giving us a link to the new article on low fat versus low carb.

  30. In reply to this:

    ““No one binges on pure fat. It’s impossible because of feedback inhibition to eat a lot of pure fat at a sitting. Try sometime to sit down and eat some butter all by itself. See how much you can choke down. I can guarantee you it won’t be much. ”

    Mike Dodge wrote:

    “The same thing could be said of sugar. Sit down with a cup of sugar and see how much you cna eat. I guarantee you it won’t be much. I could definitely eat more butter than sugar.”

    If the sugar is dissolved in water — i.e., if you make a soft drink from it — many people will drink huge amounts. Of course soft drinks contain additional ingredients but on a macronutrient basis, they are pure carbohydrate. I can’t think of any food which is pure fat on a macro nutrient basis that has the same effect on people.

    For example, a MacDonalds large coke (32 ounces) contains 86 grams of carbs (all of it sugar), zero grams of protein, and zero grams of fat. (Those are MacDonalds’s numbers.)

    That’s 310 calories of carbs. If what you say is true, there would be foods with 310 calories of fat, but no carbs and no protein, that people like to eat. Can you think of an example? I can’t.

  31. Doc:
    I agree with your thinking, appreciate the time that you take to educate and admire your passion when it comes to nutritional misinformation especially something as blatant as Dr. Bray’s nonsense.

    One question, however: DOES EXERCISE PLAY ANY ROLE IN WEIGHT LOSS OR CONTROL?

    Thanks, once again, for your insight.

  32. Always love seeing the Mary MacCarthy quote!

    Exercise: The experience of a lot of us gym rats is that adding lean body mass (muscle), even from 5 pound on up to 25 pounds and more helps tremendously with fat loss. Weight work with larger weights, and High Intensity Interval Training not only add muscle, but require a few hours ( three is usually enough) of exercise to maintain that muscle. It is likely that losing 20 pounds of fat and adding the same amount of muscle will do all sorts of good things for your looks and metabolism.

  33. As a native Londoner I was fascinated to see you use a piece of Cockney rhyming slang in this article. A “porky” is short for “pork pie”, which means “lie”.

    A couple of other examples: “barnet”, short for “barnet fair”, meaning “hair”, as in, “I’m going to ‘ave me barnet cut”. And, “trouble and strife” for “wife” as in, “‘Ow’s yer trouble?”.

    Google around for Cockney rhyming slang, it’s a fun subject.

  34. Like Peter Silverman above, i would sure like to understand the “japanese diet” thing. I work with an oriental lady, in her late 40’s, who lives practically on rice alone with a little bit of meat for flavouring, and she’s pencil-thin. And it’s WHITE rice. I have had people ask me this question, and i just don’t get it.

    the other thing us non-scinetists find hard to explain to friends and family is how eating MORE fat and cholesterol (and less carbs of course)results in lower blood cholesterol and triglycerides. I follow the logic in the books (like protein power) but boy, try explaining it to someone who still thinks that fat and cholesterol we eat clogs our arteries like rust in a pipe!

    Dan

  35. I can certainly see why Taubes would drop the subject. You can’t win a “carbohydrate hypothesis” argument with an obesity expert who holds a patent for low fat potato chips.

    “The reason, of course, is that we dieting fish all swim in waters that have been polluted by Bray and his brethren”

    That’s a good way of putting it.

  36. Responding to the person talking about the “high-carb” diet of the Japanese…most people think Asians eat tons of rice. Not true! My husband has worked in/traveled in China and reports that rice is part of a meal, but a very small part. He ate a lot of meat and also ate a wide variety of meat and vegetable dishes in one meal.

    Perhaps the Japanese eat more rice now but eating tons of it is not part of their traditional diet. I think I read somewhere that the health of Asians changed as brown rice was polished, and it also became a cheap staple for poor families. Similar to what happens here – cheap to load up on shelf-stable, cheaper processed carb foods. Changing to “Western-style” eating. We know how the body changes when that happens…

  37. @Peter —

    If the figures I’ve seen are correct, the Japanese actually consume fewer carbs per day than Americans do. Yes, they eat rice (but are now eating more meat and less rice than in previous decades, and also consuming more calories), but they don’t load up on Frosted Flakes, Krispy Kreme donuts, french fries, foot-long sub sandwiches, Big Gulps and Doritos, then top it off with a pint of Cherry Garcia while watching Dancing With The Stars.

    Same applies to the “vegetarians are skinny!” argument I hear so often. Since vegetarianism is touted as healthy, it appeals to a self-selected group that tends to shun sodas, candy, donuts, etc. They don’t necessarily consume the 500 carbs per day that is (from what I’ve read) typical in America today.

    The self-selection continues over time. Many of us who tried vegetarian diets experienced a growing insulin resistance that led to gaining weight and feeling lethargic. I was at my absolute fattest during a vegetarian phase, my film’s composer was 20 pounds heavier as a vegetarian, and a lean & lovely woman who did some consulting work on the film gave up being a vegetarian in her 30s because she started gaining a lot of weight. Consequently, we’re all ex-vegetarians who would’ve been fat vegetarians had we continued.

    But some people are, shall we say, resistant to becoming insulin resistant. They don’t have the problems I did, and so they remain vegetarians, Skinny Legs And All, as the Tom Robbins title says.

  38. hi Doc
    its me again. When I read the post at first i thought i would raise issues that affected me. reading it again and following the links you gave i think that although Bray criticizes taubs the material he presents actually supports taubs view.
    i tried to follow the diagrams but they are confusing to sayt he lest. now even in how i reason i am lo carb. i go straight to the meat of the matter. after all the verbiage and illustrations when you boil down bray’s stew here is what you get. people like fat and sugar and eat too much of it. any kid can tell you that. as you and several comments clearly point out we dont go for fat alone but the sugar is the bait. bray’s argumrent seems to lend further support to taubs since he points that over and above the effects on insulin we simply like sugar too much for our own good. so where is the beef?

  39. “If the sugar is dissolved in water — i.e., if you make a soft drink from it — many people will drink huge amounts. Of course soft drinks contain additional ingredients but on a macronutrient basis, they are pure carbohydrate. I can’t think of any food which is pure fat on a macro nutrient basis that has the same effect on people.”

    mix sugar in water, with no acidulants, no carbonation, no flavors or colors and see how much people will consume.

  40. I like the little box named “hedonistic drive” in between food intake and the brain.

    He might as well have wrote “human sin” or something there. Or “The devil”.

    MSG 4 DR BRAY: PLZ TO BE STOP DISGUISING IRRATIONAL RELIGIOUS-LIKE THINKING AS SCIENCE. THX.

    Question. If humans are genetically, biologically, evolutionarily designed to hedonistically overconsume, AND if this is intentional for the purpose of storing excess nutrition, how do we explain the fact that obesity is a recent, as in past 40 years thing? And, why are only a few humans vulnerable to TRUE medically severe obesity, with the rest never progressing past relatively normal degrees of fatness (overweight or “thickness” or whatnot).

    I like the model designed by Taubes. I understood it as less simplified and more condescending and hilarious. It’s almost as if he was passively showing Bray’s diagram was obfuscating nonsense without any real meaning … and all Bray was saying in that elaborate mess was “immorality causes weight gain”. So, Taubes responded with a diagram that completely skpped the “obfuscating nonsense” to the point where there was absolutely NO science at all and all that remained was the simple message “eat carbs, store fat, become fat”.

    DR Bray, <a href=”http://www.gembapantarei.com/supply%20chain%20kitteh.png”take a lesson from supply chain kitteh; fancy diagrams does not led credibility to your bible thumping finger-waving hypothesis of obesity. You wouldn’t take advice from a (cute) cat even with arcane statistics and flowcharts and numbers and logical relationships between them. You wouldn’t take advice from a “doctor” (why do people think being an MD equals knowing everything about anything remotely physiological) who lists a bunch of metabolic feedback loops and similar meaningless garbage …and replicates that chart with the exclusive change of inserting the word “hedonistic drive”.
    As if this were the sole and exclusive cause for obesity. Or if it even existed. Are you a hedonistic water drinker? Hedonistic air breather? Apparently I used to be a hedonistic eater. Nice.

    I mean, imagine the cajones… to say “hedonism” is the cause of obesity. In this day and age, with what we know. Holy crap. Where on earth do you even get the nerve to even open your mouth with the label of “expert”? Have you missed the past several decades outlining major physiological differences between obese people and thin ones? Have you missed the piles of research? Have you not heard any of the popular journal reports for laypeople? Go back to drowning witches. Thanks.

  41. Oh, I just realized I misinterpreted what you wrote, and that Bray was the one who designed that “chart” and ascribed it as descriptive of Taubes.

    At this point, it’s less hilarious (well, still slightly hilarious in that Bray thinks anyone could believe Taubes legitimately thinks this way, sorta how the national enquirer runs stories about britney spear’s secret diaries with entries like “Hearing voices again”)…

    Knowing this, it’s just frigging upsetting. This is not a person you can debate. They have no intention of debating. All debate has some emotion involved but when people are blatantly BSing and putting words in yer mouth it’s time to pack it up.

  42. It is possible to lose weight on a high-carb vegetarian diet: you just have to avoid colas and vegetable oils. I have lost about 10 pounds in the past year by following a diet of lentils with a lot of ghee plus white rice and also whole wheat.
    I do consume a lot of dairy though: about 40-50% of total calorie consumption as milk, yogurt (non-sweetened), buttermilk, butter, cheese.
    I had a medical test (for insurance purposes) in November and the fasting sugar came out to be 72 and total cholesterol as 125.

  43. Frank wrote:

    “mix sugar in water, with no acidulants, no carbonation, no flavors or colors and see how much people will consume.”

    This is not responsive to what I wrote. What I wrote was that Coke has a macronutrient composition of 100% carbs, 0% protein, and 0% fat. If fat is really more appealing than sugar, as somebody had written earlier, then we should be able to think of equally appealing foods with compositions of 0% carbs, 0% protein, and 100% fat. But I couldn’t think of any. I asked if anyone else can think of any.

    I take it that you can’t think of an example either.

    However since I wrote my earlier post I thought of an example, although I don’t know if it’s true. I’ve read that Cretans drink pure olive oil by the glass.

  44. Re: The Japanese Diet

    I would argue (as I have done on my blog) that the main factors in obesity across the world are the “gruesome twosome”: wheat and fructose (as in sugar, HFCS, etc.). Each of these foods has a way of comprimising the metabolism in detrimental ways. When it comes to fructose in particular, there is plenty research implicating its role in metabolic symdrome. I personally feel that the research in obesity should focus more on the effects of the *types* of carbohydrates and their unique qualities, as opposed to carbohydrate quantity in general.

    Gary Taubes cites John Yudkin in GCBC, who believed that sugar was the main player in modern degenerative disease. Taubes also recently admitted (on Jimmy Moore’s blog) that the fructose theory of disease — as explained by Dr. Richard Johnson — is something that seems plausible and merits more research.

    As for the Japanese diet, the main carbohydrate is a starch: white rice. Starch breaks down to glucose. In my opinion, Asian cultures that eat white rice as their main source of carbohydrate, as opposed to fructose/wheat-laden foods (as is common in the U.S.), are avoiding disease by keeping their diets free of these harmful foods. As wheat and fructose become more common in these countries, I predict that obesity and diabetes will, as well.

  45. I can eat coconut oil by the spoonful — actually I’ll crave it — if my activity level outstrips my calorie intake. If I mix the coconut oil with sugar it’s much less appealing to me. It’s true that there’s no way I could sit down and eat a little dish of coconut oil as if it were ice cream, though.

  46. Dr. Eades,
    Somewhere in a reply to a comment, you referred to a study by Stephen Phinney about physical performance. I can’t seem to locate the specific blog it was connected to, but in the paper he makes the exception to high intensity activity (weight lifting or bicycle sprinting) and the ketogenic diet. Can you comment?
    On this same topic, might there be a singular need for an insulin response after a high intensity strength training workout, not unlike Fred Hahn’s Slow Burn program? Would their be an optimum insulin response to encourage cellular uptake right after the exercise, but still not be a problem for the growth hormones? I’m imagining a protein shake with the right amount of carbs mixed in too.
    Thanks for all the info in this blogsite, it is so informative.

    I think this is the link you’re looking for.

  47. I guess they don’t really get the part of limiting calories, hunger and what it can do to you. Just yesterday, as I waited for a meeting, I picked up a copy of Competitor TX magazine. There was an interview with Parvati Shallow. She won an episode of Survior?

    Anyway, she had the following quote in the article….

    “When you get home from Survivor, a lot of us are crazy. Because we didn’t have any food for so long, you find yourself stashing food in your pockets, in your purse and in your car.”

    Sounds a little crazy to me. Couldn’t find this anywhere in the hedonic model. There are some others too, like how pretty jury looks when the bring them back after they’ve gained weight.

    Pretty interesting. The article is here: http://www.competitortx.com/features/from-survivor-to-wildflower.html

  48. Hi Mike. It is always a pleasure to read your blog. You do a terrific job.
    I have been reading Bart Hoebel’s work at Princeton which is delineating how sugar is truly addictive. When I hear an irrational defense of a high-carb diet, I sometimes wonder whether it’s because we are talking about their drug. At last year’s Obesity conference, one morning I happened to sit near Bray during breakfast. The man loves his carbs!

    Hey Jay–

    Good to hear from you. Thanks for the kind words about the blog. I, too, have noticed that Bray loves his carbs. I’ve been to several events where he was in attendance and watched him scarf them down.

    Best–

    M

  49. “the change of energy in a closed system is the difference between the heat added to the system and the work done by the system.”

    Still not done with the reading, but ended up stuck here. He *really* thinks human body is a closed system? The physicist in me wants to weep now.

  50. It had to take some Canadians to show what we already knew eh? Here’s an article on a study just published by some scientists at the University of British Columbia that centers around claims made for you guessed it – statins, no less. Bet this this study will never see the light of day in the US media.

    Conscientious medication takers can skew research: Study
    “A healthy adherer effect that is unaccounted for in the design or analysis of a study will make null effects appear protective, exaggerate protective effects, and attenuate harmful effects or even make them appear protective,” the authors state

    http://www.canada.com/Health/Conscientious+medication+takers+skew+research+Study/1479211/story.html

    Thanks. Nice article. I hadn’t seen the Circulation piece.

  51. ARGH!

    The whole “1st law of thermo” crap makes me angry!

    My dad is a Mechanical Engineer who has tought Thermo my entire adult life. I went to school for M. Eng.

    Bray shoots himslef in the foot right from the get-go by failing to note the “IN A CLOSED SYSTEM” bit. Duh, the system is NOT a closed one which makes the law inapplicable.

  52. I have an off topic question:

    I have PCOS with insulin resistance and have been on a low carb (less than 40 carbs a day) diet for the last 6 years. I am 28 years old and spend at least 6 hours a week in high intensity exercise. I have gained about 15 pounds of fat over the last 4 years due to the PCOS and my blood sugar being high.
    Is there a natural way to treat the insulin resistance that I might not be aware of? I am under the care of a naturopath and we are running out of treatments.

  53. I would like say that for those of you that get this stuff, if you see someone spouting idiotic “first law of thermodynamics, calories in, calories out!” BS on a public forum, please, speak up.

    I issued my first smackdown the other day, and it was kind of fun. People don’t seem to know what to do when they obnoxiously parrot “eat less” and you respond with a mini-essay talking about stuff like hormone-sensitive lipase, fatty acid synthase, futile cycling, and metabolic changes in response to energy input. Especially when it has multiple direct inline citations to definitions and studies backing up what you’re schooling them on.

    The deafening silence that follows is absolutely hilarious.

    BWAHAHAHAHAHAHAHAAAAAAAA

    I like being evil for a good cause. 🙂
    I probably wouldn’t be going into a biochem major right now if I hadn’t read PP ten years ago, either.

    This is significantly different from the views of Hans Popper, the philosopher of science, whose search is for ‘reality’ rather than ‘causality’. Popper says ‘there is a reality behind the world as it appears to us, possibly a many-layered reality, of which the appearances are the outermost layers. What the great scientist does is boldly to guess, daringly to conjecture, what these inner realities are like. Popper also espouses the concept of ‘falsification’, which is at the heart of rationalist thought. To quote him again –’a false theory may be as great an achievement as a true one. And many false theories have been more helpful in our search for truth than some less interesting theories which are still accepted’.

    As far as I can tell, what Bray’s doing here is seriously romanticizing the notion of science and scientific inquiry. The “reality” comments really are nothing but romanticizing. It’s basically a rephrasing of “appearances are not what they seem,” and claiming that scientists get to the “truth” behind the superficial appearance. Anyone with two brain cells to rub together knows that even the best, well tested hypothesis, generally accepted as “truth,” might one day well relegated to the rubbish bin. Then, one day, we might realize there was an inkling of a good idea in the hypothesis we scrapped, so we’ll bring it back and modify it. Science is done by humans, and thus as fallible as the humans that put it into practice. It gets emotional, it gets political, and it gets stupid. But, over time, it gets more correct, and that’s a good thing. If you go looking for truth, you’re only going to find stone-headed dogma.

    …I don’t have much to say about the falsification thing. Is he really so far gone as to think that “falsification” means that “false” or “proven” wrong ideas help contribute to the greater body of knowledge? Seriously, I’m so flabbergasted I can’t think of anything else to say except BLACK SWAN. Sheesh.

    People actually pay attention to this man’s WHARRGARBL? For why?

  54. Re the lady who eats a diet of white rice and a little meat – I have no trouble believing, that she is pencil-thin. A: she may be one of those people who tolerate carbohydrates well, B: you can ALWAYS lose weight on what more or less constitutes a single-food-diet. The questions that remain are: will that make you healthy? (I’d love to see some bloodwork of the white-rice-and-meat-lady) and can you stick to it? I know I could not. I have no trouble sticking to a low-carb diet.

    Designing an all-fat food that creates the same addictive behaviour as the soft drinks? The very idea…Fat is an essential nutrient (as opposed to sugar). Nature has made sure, that essential nutrients are not addictive.

  55. That article by Dr. Stephen Phinney on ketogenic diets and physical performance that you linked to earlier was really fascinating because it had a lot of useful information on what should constitute an ideal ketogenic diet that would preserve physical performance, especially with its recommendation that protein intake be constrained to 15-25% of daily energy expenditure or 90 to 120 g/day and the rest of the calories made up by fat. Also very useful was the recommendation of daily intakes for sodium at 3–5 g/d and total potassium at 2–3 g/d in order to maintain circulatory reserve and effective nitrogen balance with functional tissue preservation. Thanks!

  56. Just a quick note to tell you about this video:

    Paleo in a Nutshell Part 1: Food

    In five minutes it covers:

    – Why grains/dairy are bad
    – The usual counter arguments
    – Why doctors don’t know
    – Why scientists don’t tell us
    – The pharmaceutical / agricultural lobbies

    Hope you enjoy!

    Great video! Thanks for sending. Hope it becomes viral.

  57. Stacia,

    Have you considered intermittant fasting?

    If you are testing your insulin levels you will learn more about how it is affecting you. There are a number of variations of IF. I would say it can’t hurt to try them, find one you are comfortable with and see what happens.

    I was not testing my insulin levels, nor, at the time my BG. But the results I had with Fast-5 are certainly indicative of improvement in insulin resistance.

    I am assuming you are having no grains. But you might also try no dairy if you aren’t doing that .

  58. HELLO DR. EADES, AND FRIENDS: Happy Easter Holidays !! And thanks for the other great article you had about about critical-thinking and independence of thought which is real liberty. And i think that, this is not only happening in USA alone, but in many other capitalist, neoliberal, oligarchical, corporate states such as Mexico, UK, Peru, India, Colombia, Israel, Germany, Canada, Italy, etc, etc. where the “right” arguments and truths are the truths of the bourgeoise-classes, which owns the corporate-mainstream media, the medical sector, the private sector which in turns controls the state. One only needs to read the book by David Korten “When Corporations rule the world”. And this is the core of corporate-fascism, corporate-power. It is when states don’t regulate and control corporations, but when corporations have grown to be so powerful that they control every thing, the states and even science. I think that another cause of why many americans who have indeed access to internet, knowledge, books, and easily available electricity all the time, satellite TV, computers, etc. but at the same time even with all the information and knowledge that US citizens could benefit from are so closed-minded, and so dumbed-down, it is because of the extreme pragmatism and egocentric-individualist, relativism, and perspectivism of this society. which means that their truth is their right truth even if it’s very wrong.

    So it is real hard to get around people in this country, to teach, to spread truth, philosophy, knowledge an information to US citizens. Because like i said most US citizens think that their own ideas about how the world works, are right 100% (no questions asked, no bias no bull) even if those ideas are very wrong.

    For example, it’s real hard to convice many people in this country, that both political-parties are evil and don’t benefit american citizens, and that a diet high in carbohydrates increases insulin-levels which leads to fat-storage and there is literally no way to lose weight with a diet high in carbohydrates, specially high in starchy-carbohydrates (and we all know that most american citizens eat a diet very HIGH in starchy-carbohydrates such as bread, rice, pasta, potatoes, cookies, etc.)

    Thanx for your article again !!

    And have a nice day 🙂

    .

  59. Wonder if you have seen this article by Donald Layman in Nutrition & Metabolism?:Dietary Guidelines should reflect new understandings about adult protein needs

    http://www.nutritionandmetabolism.com/content/6/1/12

    “The new research establishes health benefits and provides molecular evidence of numerous metabolic outcomes associated with protein intake or amino acid metabolism that are not reflected in the traditional measure of nitrogen balance. These outcomes include cell signaling via leucine [7,8], satiety [9,10], thermogenesis [11], and glycemic control [12,13]. The dietary protein necessary to optimize each of these metabolic outcomes is not reflected in measures of nitrogen balance and is not represented within the current concept of the minimum RDA.”

    Found it via this blog post: http://lowcarb4u.blogspot.com/2009/04/its-whats-for-breakfast-lunch-and.html

    I have seen the article. Thanks for posting it for others.

      1. Abstract
        The mechanism of the immunosuppressive effects of glycine and its pathophysiological applications are discussed in this review. Glycine has been well characterized in spinal cord as an inhibitory neurotransmitter which activates a glycine-gated chloride channel (GlyR) expressed in postsynaptic membranes. Activation of the channel allows the influx of chloride, preventing depolarization of the plasma membrane and the potentiation of excitatory signals along the axon. Glycine has recently been shown to have similar inhibitory effects on several white blood cells, including hepatic and alveolar macrophages, neutrophils, and lymphocytes. Pharmacological analysis using a GlyR antagonist strychnine, chloride-free buffer, and radiolabeled chloride has provided convincing evidence to support the hypothesis that many white blood cells contain a glycine-gated chloride channel with properties similar to the spinal cord GlyR. Molecular analysis using reverse transcription-polymerase chain reaction and Western blotting has identified the mRNA and protein for the β subunit of the GlyR in total RNA and purified membrane protein from rat Kupffer cells. Dietary glycine is protective in rat models against endotoxemia, liver ischemia-reperfusion, and liver transplantation, most likely by inactivating the Kupffer cell via this newly identified glycine-gated chloride channel. Glycine also prevents the growth of B16 melanomas cell in vivo. Moreover, dietary glycine is protective in the kidney against cyclosporin A toxicity and ischemia-reperfusion injury. Glycine may be useful clinically for the treatment of sepsis, adult respiratory distress syndrome, arthritis, and other diseases with an inflammatory component.

  60. Dr Eades,

    I am a 6 months reader of your blog. I appreciate three features of your approach, viz:

    1. Step 1 – Increased individual healthcare knowledge (achievement) – As a statistician by original training (many years ago!), I appreciate the rigour with which persons such as Taubes and yourself argue your case. I find myself arguing with some friends that there is a rational position on self-health care, which is evidence based, which supports the low carb end of the spectrum. However, I also see that some in your camp are as religious and irrational as those in the opposing camp(s).

    2. Step 2 – Increased health IQ, or ability to make reasoned judgements – This is the process of making judgements regarding the weight of evidence about the causality of many modern diseases and the appropriate preventive or treatment regimes. Your discourses on how to weigh the strength of various studies, are a good tutorial on the process of thought in science. Consequently we might disagree sometimes!

    3. Step 3 – Increased healthcare emotional intelligence – You have made some early attempts to assist your audience to put all of these judgements about the evidence within a broader framework as to how they might make decisions regarding their individual lifestyle, including “treatment” regimes.

    Much of the debate is still (appropriately) on the first step. Nevertheless, for a revolution to take place the second and third points will probably need to be addressed. They certainly will if one wishes to follow in John Gants footsteps and focus on the individual!

    It is in the context of thinking about the third issue that I stumbled across a recent radio show in Australia. On a government owned, Australian Broadcasting Commission (ABC), radio station there is a credible show called “The Health Report”, which tries to adopt an evidence based approach to reporting on health issues.

    Recently the show interviewed Professor Victor Montori from the Mayo Clinic, regarding work he has been doing on developing processes for patients to become involved in patient health care decision-making. Whilst I can pick holes (see above Step1) in the causality and outcomes information he has presented to patients in proper double blind clinical trials, I was fascinated by the algorithms he is attempting to develop about patient choices in an evidence based medical delivery system.

    Hear the show at: http://www.abc.net.au/rn/healthreport/stories/2009/2532951.htm .

    I am not an expert on the issue of “patient healthcare choices systems”, but can see an analogy with other areas of consumer skilling. Increasingly, the emphasis in such systems, leveraging off increased levels of education, is upon inculcating in the consumer a generalised algorithm that is aimed at promoting rational thinking, given their individual situation, where this situation includes not only rational evaluation of disease diagnosis and treatment options, but also all sorts of variables such as budgets, convenience, assessment of side effects etc.

    One can sense the possibilities if an evidence based choices system, aided by physicians, might be presented to patients during consutlations.

    Will the low carb folks obtain their proper market share for such systems?

    I hope so. My only problem with the evidence-based medicine that is worshiped so highly by so many is that often the evidence used to base medical decisions is flawed or meaningless. For instance, many hundreds of thousands of statin prescriptions are written using evidence-based medicine, when the evidence is a handful of observational studies that mean nothing. Yet those writing the prescriptions think they are adhering to the highest standards. It’s really pitiful.

  61. Dr Eades,

    Would you be able to comment on the article from Nutrition and Metabolism that MAC posted? In a comment in an older post, you mentioned that 60 grams/day of protein was the minimum for a woman. I’m 67, 5’2″ tall and weigh about 120 pounds, so I’ve been trying to maintain that level of protein intake/day. The article indicates that to prevent muscle loss, elderly people should eat 30 g/protein at a single meal at least twice a day. The problem for me would be that as a T2, 30 g at a sitting would probably raise my bg to an unacceptable level. However, if it would prevent sarcopenia and osteoporosis, I’d be willing to sacrifice my stellar A1C or look into metformin or insulin in order to be able to increase my protein intake.

    Not asking for specific advice, here, just would like your take on whether 60 g of protein a day is sufficient to prevent muscle and bone density loss in the elderly.

    Thanks.

    Maggie

    I would think it was a little low, especially for one on a low-carb diet. A lot of the dietary protein is used to make glucose if carb intake is low.

  62. Interestingly, the Mayo “health choices” program to which I refer, whilst being conventional in it’s reporting of Statin benefits to patients, appears to:

    1. Specifically note the variance of the benefits according to sex, age, other co-morbid conditions such as Type 2 diabetes etc.
    2. Note the variance of side effects and lifestyle impacts for each of the the same groups of people.

    The Mayo professor specifically notes that when patients are presented with such evidence tailored to their circumstances, via some form of simple “expert system”, patients appear to act rationally, viz:

    1. Those in low risk groups avoid the therapy in droves, as the supposed benefit is very small compared with the cost, side effects and/or lifestyle inconvenience – that is they react rationally
    2. Those in higher risk groups also in many cases avoid the therapy, as they do not see that their increased risk outweighs the disadvantages and they often seek alternative therapies such as lifestyle, diet and/or exercise changes – for many this may be rational
    3. Those who undertake the therapy do so knowing that their probability of preventing disease is quite low, but still consciously decide to accept this plus the risks
    4. More generally, the positive outcome is more targeted therapy, that avoids issues such as “Statins for all middle aged men”

    All in all, I was quite impressed, even if the initial data input may not be as good as we would like. The key appears to be to tell the patient the truth (even if independent of the physician) about the statistical likelihood of a therapy either preventing or remedying a condition, plus side effects, for a specific target group. This allows them to weigh such a therapy up against all sorts of other factors.

  63. just an awful article in Canada’s largest and most influential newspaper the Toronto Star about a large scale study proving “once and for all” that low fat so-called “mediterainian diet” is the best…

    http://www.healthzone.ca/health/article/617976

    i can already see the support this will garner. i just never understood where people got the idea that southern italians and greeks eat a “mediterainian diet” of whole grains, olive oil and wine… spend a short amount of time at an italian or greek bakery and youll see white bread with olive oil, stewed meats with pasta sauces and pastry treats for every special occassion.

    youll also see the most obese of european immigrants around in southern italians. half my family is obese eating this so-called traditional southern italian diet. a quick look at northern greeks (macedonians) and northern italians shows the meat heavy diet results in slimmer people period. this is cultural ignorance at its best. i honestly cant believe enough north americans think southern italians and greeks sit around eating whole grains, olive oil and some feta as a meal and thats why they are healthy….. go to a southern italian wedding, stuff yourself on the carb rich diet, enjoy the view of the majority obese people there and wonder where in gods name did anyone come up with this mythic dietary notion.

    1. As a Canadian I can attest that the Toronto Star is possibly the largest but hopefully not the most influential new source in the country! It’s a tabloid….

  64. I can understand the resistance of guys like Bray as well as the mainstream to Taubes and the arena of low-carb dogma.

    For one, it is overly simplistic. To say that carbs cause a release of insulin, and that insulin causes one to store fat and become resistant to insulin over time is completely wrong. Examples of people who eat massive quantities of carbohydrates without running into obesity, type II diabetes, and early death from related complications is endless. Look no further than Tabues’ beloved Saccarine Disease by T.L. Cleave for evidence of that, where Cleave noted a lack of obesity, type II diabetes, and health problems amongst rural Zulus eating a diet consisting of 90% of calories as carbohydrates.

    Or Kitavans…

    Or the Japanese…

    For an even better example, go straight to Taubes’ reliance on the Pima Indians to prove the ‘carbs make you fat’ theory. Pima Indians living in Mexico off of traditional carbohydrate staples – corn and potatoes (high GI BTW), have no such health problems like their Northerly Pepsi-slugging American Pima brethren.

    Clearly, the carbohydrate does not, in and of itself, cause obesity. If we found it to cause obesity in the United States for example, that still wouldn’t answer why carbohydrate-based diets around the world in Asia and in numerous primitive rural cultures don’t cause obesity there.

    If a person is deemed “carbohydrate sensitive” or has a metabolic problem (insulin resistance) that is apparently exacerbated by carbohydrate ingestion, then avoiding them is certainly one route to take. However, that still doesn’t ‘cure’ the problem, it just avoids it, like someone with allergies wearing a gas mask for life, or someone with a broken leg lying in bed for the rest of their lives. I think there is a much greater goal that can be achieved in the world of health, and that is overcoming insulin resistance and carbohydrate intolerance – instead of avoidance. That would be healing. True healing, instead of admonishing oneself to poor health and carb abstinence forever and ever, amen.

    Dr. Bray is at least acknowledging that carbohydrate consumption does not cause insulin resistance, but that there are other underlying conditions that cause it. Hypercortisolemia is certainly one of them, which also causes leptin resistance and many other health problems. A low metabolism is yet another.

    All in all, both Taubes and Bray, even though both have made some key contributions, are blind. Carbohydrate consumption, meat consumption, fat/natural sugar consumption in combination, fat consumption – you name it – they all predate the obesity/hyperinsulinemia epidemic.

    Uh, did you actually read the Cleave’s The Saccharine Disease? I have my copy in front of me, and I looked up every reference to the Zulu in the index. Nowhere does it say that the Zulu eat a diet that is 90 percent carbohydrate, unrefined or otherwise. Such a diet would be unsustainable. Even such anti-fat zealots as Ornish, McDougal and others don’t recommend a 90 percent carb diet.

    Taubes’ book has a reference for virtually each and every statement he makes. I would love to see your references about the Pima Indians of Mexico consuming a ‘traditional’ diet high in corn and potatoes and suffering no obesity. I would take issue with you that the Japanese and/or the Kitavans consume diets composed of 90 percent carbohydrates as your comment implied. If you have published data on that, I would love to see it.

    I would also be very much interested to see the published data showing that hypercortisolemia and/or a low metabolism cause insulin resistance as you averred.

    Provide the papers, and I’ll put them up for all to see.

    1. You’re overlooking the elephant in the room; the micronutrients and protein in the western high-carb diets are inadequate to build and supply the insulin receptors etc. to deal with the carbs.
      A healthy traditional diet that is reasonably high in carbs from whole plants is unlikely to be vitamin and mineral deficient, and the person eating it also gets more sunlight exposure.
      It is this “empty calory” nutritional paradigm that starts the insulin resistance problem. The low-carb diet is the best way out; just supplementing the micronutrients while still locked into the carb addiction is not as effective; you need to give insulin a rest as well.
      Also, in a low carb diet, calories need to come from somewhere – and they come from amino acids and fats, nutrients which can actually help to rebuild or protect the body.
      Where is the sugar that has the health profile of glycine or DHA?

  65. I am still baffled at the “Asians are slim and eat a lot of carbohydrates” argument. They do?

    I have no conclusive research to say they don’t but so far all my observations failed to show that they do.

    Most of my East-asian friends cook regularly and they do NOT consume a lot of rice, it’s a side dish to accompany all the sauces, soups and meat/fish dishes they prepare.

    This is the same story as Italians and pasta, Italians use pasta as a side dish and in small amounts. The french and their pastry, tiny portions after a meal.

    I spent a week in Japan eating with locals and yes rice and noodles are on the menu but so are heavy sauces, fish and meat. And no, these are not fancy restaurants, these are fill to the brim with locals, 5€-a-meal places.

    Thailand is the same story, it was 2 weeks of mostly meat and fish stews next to rice, the rice portion was small. And again this was local non-touristy restaurants and at the home of a Thai family.

    I think what happens is when Asians go to the west, money is not exactly flowing, so they focus more on the cheaper part of the meal: rice and noodles.

  66. You are SO right with that quote from Taubes book about the “nonscience” regarding
    obesity etc etc. It encapsulates some 50 years of garbage passed off as medical research
    by people with no understanding of scientific method.

    “You can “prove” anything with statistics.” That was a comment from my father when I was about twelve. He then added “Just dont believe it.”

    There are even US university departments that (jokingly?) suggest that they will “prove”
    anything you want (if you have enough money).

  67. p. 65
    “In that table it was shown that although 90 per cent of the calorific intake in the rural Zulu is provided by carbohydrates (which are generally regarded as the fattening foods), as against only 81 per cent of the intake in the urban Zulu, the crucial point is that, in the case of the rural Zulu, of the 90 per cent figure 89 is derived from unrefined carbohydrates, whereas, in the case of the urban Zulu, of the 81 per cent figure 71 is derived from refined carbohydrates. An explanation, therefore, based on the argument advanced in this work, fits the facts as a glove to its hand.”

    -Excerpt from…

    Cleave, T.L. and G.D. Campbell. Diabetes, Coronary Thrombosis, and the Saccharine
    Disease. John Wright & Sons LTD.: Bristol, UK, 1969.

    This is in reference to lack of obesity amongst rural Zulu’s on a diet of 90% carbohydrates.

    And “uh” yes, I’ve read all of Cleave’s work, who was a proponent of a diet high in natural, unrefined carbohydrates for the prevention of every known modern illness.

    I’ve also read your book, and literally hundreds of others – enough to know that “protein’s power” is the remarkable ability to slow down the human metabolism when eaten in excess, making it easier to gain weight on smaller amounts of calories than a diet rich in fat.

    This is why Atkins stated on page 313 of Dr. Atkins New Diet Revolution that his diet “tends to shut down the thyroid,” which is the exact pitfall of a low-carbohydrate diet that contains more than 20% of calories from protein – a common mistake in the fat-phobic world.

    Why not eat in a manner that improves the metabolism instead of catering to its insufficiencies?

    Ah, a different book than the one I have. Sorry. But, irrespective of whether it actually says what you claim or not, I don’t believe it. Had he written that 90 percent of the foods eaten by the Zulu were of plant origin, I could maybe buy it, but not the idea that 90 percent are carbohydrate. That’s not a sustainable diet.

    If you think that protein slows down metabolism, I would suggest a serious reading of the medical literature, not a cherry picking of those few papers that confirm your bias.

    1. You’ve read a hundred books, but you’ve obviously never eaten protein “to excess” if you believe it slows metabolism.
      A little experience is worth a (misread) library in this case.
      Look at the animals that eat the most protein (and fat) – they are the fast, lithe, muscular types, and they have the shortest digestive tracts.
      I live in New Zealand, in large parts still an unspoiled aboriginal subtropical paradise. I have tried living off the land, eating only the foods available to a hunter-gatherer in this country, using all the available books on edible plants.
      Carbohydrate deficiency is the first thing I noticed. There are few edible carbohydrate plants (so few that pre-european Maori spent hours preparing bracken roots, which have carcinogenic properties if not prepared properly, and still suffered liver cancer as a significant cause of death). If it were not for seafood and birds, one could perhaps have lived in this country, but no people would have flourished.
      It did not surprise me that the Maori (who came to New Zealand from Polynesia some time during the past millenium) drove the Moa (a large flightless bird) to extinction, then resorted to cannibalism.
      Maori today suffer from extremely high rates of diabetes and heart disease – and they are being told to eat less fat and more whole grains. This to a people who had never even seen a grain until 200 years ago, and who cannot possibly have adapted to gluten in that time.
      There is a point, when you give this high-carb low-calory advice to native peoples with their own dietary histories, at which medical folly crosses the fine line between misadventure and genocide.

  68. Dr. Eades

    For the guy several comments above me:

    I watch travel shows alot. Many Asian nations are featured. Asians eat a lot of organ meats, bugs, insects,(Thailnad) seafood like Octopus(China) etc. and fish in Japan. And in the case of Vietnam- snake ,snake, snake, snake and more snake- even the blood. There are a lot of American myths about the Asian diet that are made up by low fat advocates.

    They definitely consume a lot of animal / and or insect based protein too, very similar to a true paleo diet- like what Bear Grylles or Les Stroud eat on their shows.

    1. Atkins “tends to shut down the thyroid”
      The recent high-fat diet trials had lowered T3 as one of the anti-inflammatory end-points. A 10% drop in T3 accompanied better lipids, C-reactive protein, etc. But isn’t more T3 good for you?
      Perhaps when people over-eat carbs they need to make extra T3 to cope, and this can be bad for the thyroid; an anti-inflammatory diet has less need for thyroid stimulation (after all, heat is already being produced by futile cycles) and the thyroid can ease off a bit.
      Atkin’s comment is consistent with the most recent research and another example of how he knew what he was talking about long before anyone else did.

  69. Hello all: I would like to know if american cheese is allowed in the low-carbohydrate keto diet. Because i am trying to do a high-fat, moderate in protein low carb diet and i do eat american, mozzarella, monterrey, or swiss cheese and most hard cheeses only have about 1 gram of carbohydrate or less than 1 gram of carbohydrate for every 100 calories. But i read in a forum that cheese has a chemical which blocks weight loss. So i would like to know if its ok to snack on cheese on low carb diets.

    .

    1. Low-carber,

      IMO, American cheese is a modern “industrial” cheese food product, and not real cheese, no matter what the carb count. It’s highly processed and bears little resemblance to the great cheeses of the world.

  70. People overeat because they feel HUNGRY all the time. Stop the hunger feeling = loose weight. The only time I have never felt hungry was right after getting a Hepatitis B vaccine. I assume that the circulating liver enzymes as a result of the vaccine was the cause. A few days later, the appetite returned. Is it possible to take a liver enzyme tablet to cut off the appetite?

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