Two years ago I wrote a longish review of Gary Taubes' tome, Good Calories, Bad Calories. Today I'm going to attack his new book, a sleeker, more-accessible version of the same information, containing dietary recommendations as well. The new book: Why We Get Fat and What to Do About It.
(You might go back and read my review of the first book, because I'm going to try not to repeat myself.)
I picked up a copy of Why We Get Fat two days ago in the mall, while I was shopping for pants. I always try to do my pants-shopping while I am visiting my in-laws, because my mother-in-law is a lightning-fast seamstress and if I say "pretty please" she will hem them for me, and I always need them hemmed. I bought the pants in a petites store and I still had to have two inches taken off the hem. That is just how short I am. But except for being short, pants-buying is just not the traumatic experience it used to be, and maybe that is why I remembered to stop by the bookstore and pick up the Taubes book. (I did it for you, just so I could write this review!)
I finished the book in an afternoon. That isn't in itself proof that the book is a quick read: I was already familiar with most of Taubes' arguments, because I've churned through Good Calories, Bad Calories twice. I probably skipped stuff. But then I showed it to my father-in-law. He wandered off with it, came back a few hours later having finshed it, and wondered aloud if maybe the reason his triglycerides had been shooting up the past year or so was because he'd consciously switched from bacon-and-egg breakfasts to cereal with dried apricots four days a week. So. This is a nice book to have in your library.
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In the first part of the book, Taubes marshals the arguments against the "calories in-calories out" hypothesis, the idea that obesity is caused by eating more calories than one burns. It's obviously true that obesity, and eating excess calories, go together; but Taubes shows rather convincingly that rather than one causing the other, they're both caused by the same main culprit: high levels of insulin in the blood. (Other hormones play roles, notably estrogen and cortisol, but insulin is the most important). As Taubes puts it, "obesity is a disorder of excess fat accumulation," and it just happens that adding extra pounds -- whether you are a growing child, a burgeoning pregnant woman, or a slowly-fattening adult -- drives you to eat more. Hormones cause growth, and growth causes eating.
The evidence for this is abundant, and most of what is presented here was already described in Good Calories, Bad Calories. For instance, identical twins often have identical body sizes, and some disorders cause people to accumulate enormous localized fat deposits while remaining underweight elsewhere (do they both undereat and overeat?). An anecdote that was new to me was a report of poverty-stricken families in Sao Paulo, Brazil: overweight mothers bringing "thin, stunted" undernourished children to the clinic. The author of that report implied that the mothers needed counseling for their overeating at the same time as their children were starving (and can you imagine being the mother, under such a judgmental eye?); Taubes points out that this assumption goes against everything we know about maternal care.
Remove the ovaries from a rat, and it gets fat, even if you starve it. Certain genetically-fat rodents, deprived of food, die of starvation without getting thinner first. To lose fat, you don't just have to eat less; you have to move the fat out of your fat cells so that it can be burned, and that can only happen if your insulin levels allow it.
Taubes lays these all out very concisely, mostly uncluttered by footnotes and references; no worries, if that's what you are after you can find them in the first book. It's still a damning debunking of the conventional wisdom regarding obesity.
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In the second part of the book, Taubes turns from showing that many nutritionists are wrong, to promoting his alternative model of obesity (or "adiposity," a term that means the same thing but carries less judgmental weight). In this model, a regulatory defect (high insulin levels) causes obesity, and in most of us who have it, the defect is caused by poor diet -- not by overeating, but wrong-headed eating: more refined sugar, flour, grains, and starches than our bodies can handle.
Sugar and flour and rice eaters don't always get fat; and most cigarette smokers don't get lung cancer. But that doesn't stop us from saying cigarettes cause cancer, and so we should be willing to say that sugar and flour and rice are fattening.
Here's one difference between the books: Taubes wrote with some reservations when he was penning Good Calories, Bad Calories four years ago, advocating only that the matter be studied more thoroughly in order to establish whether the alternative model is correct. These reservations seem to be gone now:
The bottom line is something that's been known (and mostly ignored) for over forty years. The one thing we absolutely have to do if we want to get leaner--if we want to get fat out of our fat tissue and burn it--is to lower our insulin levels and to secrete less insulin to begin with....
If we can get our insulin levels to drop sufficiently low (the negative stimulus of insulin deficiency), we can burn our fat. If we can't, we won't. When we secrete insulin, or if the level of insulin in our blood is abnormally elevated, we'll accumulate fat in the fat tissue. That's what the science tells us.
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I have to stop here, but I'll post this for now and write the rest of the review later, including my thoughts on Taubes' specific dietary recommendations, and why I don't think gluttony is entirely off the hook. Stay tuned.