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.
I don't know. Maybe I'm not understanding Taubes' theories correctly, and if this worked for you, then it worked for you.
But I tried a low-carb diet once (Atkins), and it was an unmitigated disaster. I felt like hell, because I couldn't get enough fiber in my diet, and had to quit after about a week.
On the other hand, I'm just finishing up losing about 70 lbs under the (previous) Weight Watchers Momentum program, and it worked like a dream. Granted, WW doesn't espouse a strict calorie reduction (points are a combination of calories, fat grams, and fiber grams), but the program is basically one of eating less calories and fat, eating more fiber, and getting more exercise.
I have experienced the phenomenon of sugar consumption causing hunger, and my husband did see some improvement in his blood work under Atkins, but I'm not sure that a low-carb diet is for everyone.
Posted by: Karen LH | 03 February 2011 at 07:19 AM
Taubes doesn't recommend "the Atkins diet." In particular, the specific regime he recommends includes _unlimited_ quantities of leafy greens, which ought to get enough fiber into anyone's diet.
He strongly suggests that people who succeed on regimens other than "low-carb" -- for example, WW -- do so precisely because by following the regime they happen to reduce their carbohydrate load. It's tough to cut calories without cutting carbohydrates, and many measures that increase fiber intake -- such as switching from white to whole-grain bread -- also have the effect of cutting carbohydrates.
I'll write more about the dietary recommendations in another post.
Posted by: bearing | 03 February 2011 at 07:49 AM
I'm looking forward to the dietary recommendation post. My pendulum is finally swinging to a point where I'm ready to get serious (again) about eating correctly to lose weight and as a warm-up for Lent, and your posts always encourage me.
I have found that your rule about not eating after a certain time in the evening is one of the strongest factors in seeing a lower number on the scale the next morning, though I don't always follow that in practice.
Posted by: MrsDarwin | 03 February 2011 at 12:12 PM
Does he address caffeine? I've noticed that if I drink black coffee (in particular) on an empty stomach, I get a serious blood sugar crash. Adding half and half helps, but protein helps more. Since I've added more protein to my diet, it's helped with snack cravings.
I've lately gotten a little too comfortable in Akron (to use your analogy); I have to get off my tail and get moving to LA.
Posted by: Robin | 03 February 2011 at 12:13 PM
Caffeine might be treated in more detail in _Good Calories, Bad Calories._ I don't remember. In this book, the specific dietary recommendations -- which appear in an appendix that re-presents the instructional pamphlet from a successful clinical diet developed at Duke University -- include this advice:
"Some patients find that their caffeine intake interferes with their weight loss and blood sugar control. With this in mind, you may have up to 3 cups of coffee (black, or with artificial sweetener and/or cream), tea (unsweetened or artificially sweetened), or caffeinated diet soda per day."
Posted by: bearing | 03 February 2011 at 12:51 PM
I'm sorry; I can't hear the term "adiposity" without thinking of the Dr. Who episode with the Adipose diet pill that made the fat literally walk away from your body.
Posted by: Barbara C. | 04 February 2011 at 12:50 PM
I've been pondering weightloss as I've seen statments like "you CANNOT! CANNOT! get fat eating vast quantities of organic meat". I'm like... really? If you eat excess calories of good quality food, you won't get fat? Because in my anecdotal experience, I eat organic meats, lots of unprocessed stuff, good fats, oils... and I've been carrying 20 extra lbs around since my 3rd child. In the last six weeks, the only thing I've done is eat LESS of what I usually eat.. even keeping in things like chocolate, other high calories like EVOO etc, and I've lost 15 lbs, doing nothing but reduce calories. Have you seen the guy who lost 27 lbs on the Twinkie diet, as a test of the "calories in, calories out" theory? He was eating processed sugar crap, but restricted the calories, and lost weight. Now obviously I wouldn't recommend that diet, but it does seem to fly in the face of "it's not calories, it's WHAT you're eating", kwim"?
Posted by: KJ | 04 February 2011 at 08:24 PM
Whoops I should clarify, I haven't seen YOU make those statements, just others on teh interwebz. :-)
Posted by: KJ | 04 February 2011 at 08:25 PM
KJ, I think the common thread between the Twinkie diet and you with your "I already ate good stuff, I just ate less of it" and the Taubes work is this: If you, KJ, were already eating a diet with lots of good stuff and simply cut back on everything across the board, that means you ate fewer grams of carbohydrates, and that lowered your insulin levels enough to unlock the fat cells. The Twinkie guy might be eating ONLY carbohydrates now, and crappy ones at that, but maybe before he went on the diet -- before he restricted his diet to a certain amount of Twinkie calories -- he was eating a greater number of carbohydrate grams than he was when he went on the diet. (He didn't do the control experiment where he ate as many Twinkies as he wanted -- only the experiment where he ate a restricted amount of Twinkies).
Quality of carbohydrates does matter, as I read Taubes, because (for example) eating sugar as part of a meal with fiber, fat, and protein doesn't affect your blood sugar as much. But as I read it, the fundamental variable is something akin to glycemic load (not glycemic index) -- so cutting back on even the *best* kind of carbs can result in weight loss.
The other thing is that, as Taubes points out, the calorie balance equation still has to hold at all times. Losing weight must be accompanied by consuming fewer calories than you expend. I think it's kind of a two-part thing. You have to keep the glycemic load low enough to *allow* weight loss, and then weight loss must be accompanied by a calorie deficit (though it's unclear whether you have to consciously create the calorie deficit or not).
Posted by: bearing | 05 February 2011 at 08:14 AM
ok so Taubes isn't saying "you can eat unlimited non-carb foods and not gain weight"? Because that is what I'm encountering lately. And it just sets off my BS-meter.
Posted by: KJ | 06 February 2011 at 09:22 AM
No, he says that hunger and cravings will diminish on such a diet. Presumably it would be possible for some people to gain some weight by force feeding themselves..
Posted by: Bearing | 06 February 2011 at 04:28 PM
K.J. What you have to realize is that you have less control over your bodyweight OVER TIME than you think day-by-day. So overeating one week might result in less unconsious eating the next week as long as your insulin-response is healty and your carbs are limited. Ref. Taubes wild animal-examples that never are overweight without reason (i.e. 100K trim African Gnus can't be wrong etc.)
Posted by: Biggie Small | 11 February 2011 at 06:14 AM
Just wanted to mention that the NY Times has a piece written by Taubes in the Magazine for this week:
"Is Sugar Toxic?"
http://www.nytimes.com/2011/04/17/magazine/mag-17Sugar-t.html?_r=1&src=me&ref=general
I haven't finished it yet, but I'm really hoping he's wrong. ;)
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