Taubes - His Golden Oldie

This article, published in 2003, was one of Taubes' first shots at the lipid hypothesis (cholesterol causes heart disease).  The topic is as controversial today as it was then, with a few exceptions, such as the USDA Dietary Guidelines indicating that, among saturated fats, stearic acid is benign.  This is as concise a summary of the issue as you'll find - note, the alternative hypothesis is also called the 'carbohydrate hypothesis':

The science behind the alternative hypothesis can be called Endocrinology 101, which is how it's referred to by David Ludwig, a researcher at Harvard Medical School who runs the pediatric obesity clinic at Children's Hospital Boston, and who prescribes his own version of a carbohydrate-restricted diet to his patients. Endocrinology 101 requires an understanding of how carbohydrates affect insulin and blood sugar and in turn fat metabolism and appetite. This is basic endocrinology, Ludwig says, which is the study of hormones, and it is still considered radical because the low-fat dietary wisdom emerged in the 1960's from researchers almost exclusively concerned with the effect of fat on cholesterol and heart disease. At the time, Endocrinology 101 was still underdeveloped, and so it was ignored. Now that this science is becoming clear, it has to fight a quarter century of anti-fat prejudice.

The alternative hypothesis also comes with an implication that is worth considering for a moment, because it's a whopper, and it may indeed be an obstacle to its acceptance. If the alternative hypothesis is right -- still a big ''if'' -- then it strongly suggests that the ongoing epidemic of obesity in America and elsewhere is not, as we are constantly told, due simply to a collective lack of will power and a failure to exercise. Rather it occurred, as Atkins has been saying (along with Barry Sears, author of ''The Zone''), because the public health authorities told us unwittingly, but with the best of intentions, to eat precisely those foods that would make us fat, and we did. We ate more fat-free carbohydrates, which, in turn, made us hungrier and then heavier. Put simply, if the alternative hypothesis is right, then a low-fat diet is not by definition a healthy diet. In practice, such a diet cannot help being high in carbohydrates, and that can lead to obesity, and perhaps even heart disease. ''For a large percentage of the population, perhaps 30 to 40 percent, low-fat diets are counterproductive,'' says Eleftheria Maratos-Flier, director of obesity research at Harvard's prestigious Joslin Diabetes Center. ''They have the paradoxical effect of making people gain weight.''

http://www.nytimes.com/2002/07/07/magazine/what-if-it-s-all-been-a-big-fat-lie.html?pagewanted=all&src=pm

For those would be leaders in field of nutrition, "people of consequence", who unwittingly told us to eat a diet that's (possibly) killing us - how much evidence will they need put in their faces to change their minds?  Perhaps more significantly, how many of them have the gumption to truly chase the truth in the carbohydrate hypothesis?  Will they invest their time and reputations in the types of expensive studies that will measure the hypothesis accurately? It would be much more comfortable to sit back and say "it's a toxic food environment and people are fat and sick because they eat too much and exercise too little."

A Star Speaks

My friend and co-worker and CrossFit client Star lost 12 pounds this summer.  She lost the weight not after ramping up her fitness training - she did that several months prior - but by changing a few pieces of her diet.

For example, she asked for help correcting the mid-morning crash, because after all it is bad form for the boss to fall asleep in a morning meeting.  Well, that was an easy fix - replace the banana, juice and yogurt breakfast (in other words, a 40 gram carb bomb) with a palatable amount of protein (in Star's case, eggs), some quality fat and only a bit of carbohydrate ... if you really enjoy it and want it.

Why does this work?  When you sleep, your body is able to perform some system maintenance.  Assuming you don't end the day on a high carb metabolism wrecker, you convert to a combination of ketogenic metabolism and fat burning through the night.  This is good, since you wake up with adequate glucose/ketones for your CNS to run well, and plenty of fat available for oxidation for the rest of your tissues.  In other words, you are fasted but adequately fueled.  While your body is purring along smartly on ketones and fat, it has been able to scavenge AGEed proteins in and beta amyloid proteins as well.  This formula is all good!

If you break your fast with protein and fat, many of the good processes continue and hunger will be manageable.  If you give yourself a sugar bomb, on the other hand, you'll interrupt all of your fasting maintenance functions, and set yourself up to be hungry before your mid day meal.

This all makes sense in light of the paleolithic model.  Your cromag ancestors would not have been able to grab a muffin first thing every morning, and were more healthy because of that.

Congrats Star!  You make a good example of how to make small, important changes which generate weight loss, hunger management, and health improvements all in one.

Review of the Basics of Glucose Metabolism

"The liver's capacity to store carbohydrates in the form of glycogen is very limited and can be easily depleted within ten to twelve hours. So the liver's glycogen reserves must be maintained on a continual basis. That's why we eat carbohydrates."The question no one has bothered to ask until now is this: what happens when you eat too much carbohydrate? Here's the answer: whether it's being stored in the liver or the muscles, the total storage capacity of the body for carbohydrate is really quite limited.

"If you're an average person, you can store about three hundred to four hundred grams of carbohydrate in your muscles, but you can't get at that carbohydrate. In the liver, where carbohydrates are accessible for glucose conversion, you can store only about sixty to ninety grams.

"This is equivalent to about two cups of cooked pasta or three typical candy bars, and it represents your total reserve capacity to keep the brain working properly.

"Once the glycogen levels are filled in both the liver and the muscles, excess carbohydrates have just one fate: to be converted into fat and stored in the adipose, that is, fatty, tissue.

"In a nutshell, even though carbohydrates themselves are fat-free, excess carbohydrates ends up as excess fat. That's not the worst of it. Any meal or snack high in carbohydrates will generate a rapid rise in blood glucose. To adjust for this rapid rise, the pancreas secretes the hormone insulin into the bloodstream. Insulin then lowers the levels of blood glucose.

"The problem is that insulin is essentially a storage hormone, evolved to put aside excess carbohydrate calories in the form of fat in case of future famine. So the insulin that's stimulated by excess carbohydrates aggressively promotes the accumulation of body fat.

"In other words, when we eat too much carbohydrate, we're essentially sending a hormonal message, via insulin, to the body (actually, to the adipose cells). The message: "Store fat."

"Hold on; it gets even worse. Not only do increased insulin levels tell the body to store carbohydrates as fat, they also tell it not to release any stored fat. This makes it impossible for you to use your own stored body fat for energy.

"So the excess carbohydrates in your diet not only make you fat, they make sure you stay fat. It's a double whammy, and it can be lethal.

"Insulin is released by the pancreas after you eat carbohydrates. This causes a rise in blood sugar. Insulin assures your cells receive some blood sugar necessary for life, and increases glycogen storage.

"However, it also drives your body to use more carbohydrate, and less fat, as fuel. And, insulin converts almost half of your dietary carbohydrate to fat for storage. If you want to use more fats for energy, the insulin response must be moderated.

"Diets high in refined sugars release more insulin thereby allowing less stored fat to be burned. High insulin levels also suppress two important hormones: glucagon and growth hormone. Glucagon promotes the burning of fat and sugar. Growth hormone is used for muscle development and building new muscle mass.

"Insulin also causes hunger. As blood sugar increases following a carbohydrate meal, insulin rises with the eventual result of lower blood sugar. This results in hunger, often only a couple of hours (or less) after the meal.

"Cravings, usually for sweets, are frequently part of this cycle, leading you to resort to snacking, often on more carbohydrates. Not eating makes you feel ravenous shaky, moody and ready to "crash." If the problem is chronic, you never get rid of that extra stored fat, and your energy is adversely affected."

http://www.mercola.com/article/carbohydrates/lower_your_grains.htm

So, what's a sugar fiend to do?  Eat meat, vegetables, nuts and seeds, some fruit, little starch and no sugar or wheat.  Train your body to run on fat, leaving the glucose to the parts of you that truly need it, the CNS and hemoglobin cells.  

"As a matter of fact, we evolved for hundreds of thousands of years from the so-called cave man's diet," which consisted solely of meat and vegetables. With the onset of modern civilization about 5,000 years ago, our physiology suddenly was asked to digest and metabolize larger amounts of sugar and starch especially refined sugars. But if we are unable to utilize the amount of carbohydrates we eat, certain symptoms will develop." 

Symptoms like metabolic syndrome, which leads to all the other diseases of the West.

Dr. Cordain on Nutrient Density

http://www.thepaleodiet.com/articles/JANA%20final.pdf

This is a fascinating link which calculates various vitamin and mineral counts based on the USDA's former dietary recommendations and the paleo diet.  Paleo dominates.  So the good doctor Cordain wants folks to try a diet which is mainly lean meats and vegetables, eating more fruit and veggies and virtually no processed food, grains, legumes or dairy.  It has more nutrient density than the establishment diet.  And the establishment freaks out about his radical diet.  "Go figure."

Pollan on Diet

If restated as "eat food, starting with protein and fat and adding some vegetables and fruit", I'd agree w Mr. Pollan 100%.  His other comment - that we spend more time worrying about and trying to understand food than anyone, for no discernible benefit (as a culture), could be attributed to the absolutely miserable science which our government has advocated.  We'd never know how this would have turned out if the Feds had recommended a paleo diet vice a grain diet in the 70s.

http://well.blogs.nytimes.com/2008/01/17/an-omnivore-defends-real-food/
As a health writer, I've read hundreds of nutrition studies and countless books on diet and eating. And none of these has contained such useful advice as the cover of Michael Pollan's latest book, "In Defense of Food."
Wrapped around a head of lettuce are seven words that tell you pretty much everything you need to know about healthful eating. "Eat food. Not too much. Mostly plants."

Author Michael Pollan (Alia Malley)This seemingly-simple message is surprisingly complex, because there is food, and then there are what Mr. Pollan describes as "edible food-like substances." Mr. Pollan, who writes for The New York Times Magazine, developed something of a cult following for his best-selling book "The Omnivore's Dilemma," which traced the food chain back to its original source. But while "Omnivore" left many scared to eat, "In Defense of Food" helps the reader bravely navigate the food landscape, explaining what food is, what it isn't and how to tell the difference.
Mr. Pollan agreed to take some time this week to answer a few questions from the Well blog.
In this book, you talk about "nutritionism," the tendency of scientists and nutrition experts to view food as just a sum of its nutrient parts. What's wrong with that thinking?

Two things go wrong with nutritionism. Whatever tentative scientific information is developed, it gets very quickly distorted by the food marketers and manufacturers. They will take partial information about antioxidants, and they are suddenly telling you if you eat almonds you are going to live forever. There is a distortion of what are hypotheses of science. We're guilty of this too. We take sketchy science, and we write headlines.
One of the things that surprised me is how poor the data is that is underlying many of these big dietary trials. If you try to fill out a food frequency questionnaire, you realize very quickly this is not good data. I was as honest as I could be and tried to remember what I'd eaten, and it claimed I was only eating 1,200 calories a day. Clearly, I was forgetting at least 1,000 calories. We know people underreport by about 30 percent. We don't know the first thing about nutrition, which is, "What are people actually eating?" It's hard to build good science on top of that.
Did you expect the phrase, "Eat food. Not too much. Mostly plants." to create such a stir?

I was kind of surprised. After the original article in The Times magazine used those words, I started hearing it then. I realized they had a certain power. That's why I encouraged the publisher to put them on the cover and give it all away there.
But it's not as simple as it sounds, is it?

It's not, because of all these edible food-like substances in the stores that are masquerading as food. It's simple advice as long as you know what food is, but I spend 14 pages trying to define what food is. It's gotten complicated because of food science and the kind of engineering that's gone into processing food.
Speaking of engineering, food from cloned animals appears headed for approval in Europe and the United States. Does cloned food qualify as real food?

I think the bigger concern with cloned animals is not personal health. It's what will it take to keep a herd of genetically identical chickens, horses or pigs alive? Sex and variation is what keeps us from getting wiped out by microbes. If everything is genetically identical, one disease can come along and wipe out the entire group. You will need so many antibiotics and so much sanitation to keep a herd of these creatures going. The bigger concern should be antibiotic resistance.
The nutrition community is fascinated by the French paradox - the fact that the French eat seemingly fattening food but don't get fat. In your book you describe an American paradox. What is it?

Americans are a people so obsessed with nutrition yet whose dietary health is so poor. That strikes me as a paradox. We worry more about nutritional health, and we see food in terms of health. Yet we're the world champs in terms of obesity, diabetes, heart disease and the cancers linked to diet. I think it's odd. It suggests that worrying about your dietary health is not necessarily good for your dietary health.
So how should we think about food and health?

I think health should be a byproduct of eating well, for reasons that have nothing to do with health, such as cooking meals, eating together and eating real food. You're going to be healthy, but that's not the goal. The goal should just be eating well for pleasure, for community, and all the other reasons people eat. What I'm trying to do is to bring a man-from-Mars view to the American way of thinking about food. This is so second nature to us - food is either advancing your health or ruining your health. That's a very limited way to think about food, and it's a very limited way to think about health. The health of our bodies is tied to the health of the community and the health of the earth. Health is indivisible. That's my covert message.
A reader commented recently that this sounded like a diet book. Is it?

There is no Michael Pollan diet. It's an algorithm to help you make decisions rather than telling you narrowly: "Eat butter. Don't eat margarine." Although you could probably deduce that from what I'm saying. I don't feel like it's our job to tell people what to eat. I think our job is to help people think about it. I'm trying to take down the cult of expert eating. The danger is that I then offer myself as an expert. I'm trying to channel the wisdom of culture about eating. My idea here is that science so far hasn't figured out nutrition well enough to be the arbiter of our food choices. When science has done that - take the public health campaign around fat, that has been the biggest test case - it didn't work out very well. If science can't guide us yet, who can? The answer is not me. The answer is culture, history and tradition. That's what my rules are all about. The book is trying to show why this nutritionism approach to food doesn't work very well, besides the fact that it ruins our pleasure in eating.
What do you eat?

I eat lots of food. What do you mean?
Does your food ever come out of a package?

Really seldom. If you look in my pantry, you won't find that much processed stuff. Maybe some canned soups and tuna fish. I don't have a lot of low-fat products. I much prefer to eat less of a full-fat product. You wont' find skim milk. We're lucky. I live in Berkeley with a farmers' market four blocks away, and it's open 50 weeks a year. I have the luxury of being able to buy very fresh, good food. I have a weakness for bread. A good white baguette - I have a weakness for that.
After reading your book, I want to plant and grow something. Do you get this a lot?

My first book was about gardening, and I like gardening. It's a really important part of the solution. In so many places, including urban areas, there is a yard, there is a lawn, a little patch of land where you could grow food. My garden is only 10 by 20 feet. It's a postage stamp. I grew so much food there last summer. What food is more local than the food you grow yourself, not to mention the fact that you get all this exercise while you're gardening.
How does one stop eating edible food-like substances and switch to eating real food? Isn't it difficult to change?

We have more choices now than we've ever had. There is organic food at Wal-Mart. The big challenge is that you do have to cook. A lot of us are intimidated by cooking today. We watch cooking shows on TV but we cook very little. We're turning cooking into a spectator sport. This process of outsourcing our food preparation to large corporations, which is what we've been doing the last 50 years, is a big part of our problem. We're seduced by convenience. You're going to have to put a little more time and effort into preparing your food. I'm trying to get across how pleasurable that can be. It needn't be a chore. It can be incredibly rewarding to move food closer to the center of your life.

Vitamins Are .... Good for You?

This is the first study I've seen which shows a health benefit from vitamin supplementation.  This is a complex subject, as it seems more and more obvious that many neolithic foods (grains and legumes for example) irritate the gut so much that the gut does not absorb what it should (nutrients), but allows things to enter the blood stream that activate the body's immune response - leading the systemic inflammation and in some cases, the autoimmune disorders.


I like Stephen's summary:


"This result, once again, kills the simplistic notion that body fat is determined exclusively by voluntary food consumption and exercise behaviors (sometimes called the "calories in, calories out" idea, or "gluttony and sloth"). In this case, a multivitamin was able to increase resting energy expenditure and cause fat loss without any voluntary changes in food intake or exercise, suggesting metabolic effects and a possible downward shift of the body fat "setpoint" due to improved nutrient status.
Practical Implications

Does this mean we should all take multivitamins to stay or become thin? No. There is no multivitamin that can match the completeness and balance of a nutrient-dense, whole food, omnivorous diet. Beef liver, leafy greens and sunlight are nature's vitamin pills. Avoiding refined foods instantly doubles the micronutrient content of the typical diet. Properly preparing whole grains by soaking and fermentation is equivalent to taking a multi-mineral along with conventionally prepared grains, as absorption of key minerals is increased by 50-300% (10). Or you can eat root vegetables instead of grains, and enjoy their naturally high mineral availability. Or both."
http://wholehealthsource.blogspot.com/2010/06/low-micronutrient-intake-may-contribute.html

Interesting from Harvard Health

BLUF:  Take no more than one multivitamin per day, and consider whether you need that one because there's virtually no evidence of a health benefit gained from taking vitamins - excepting vitamin D (virtually everyone needs to supplement).  "Experts agree" the best way to get nutrients is through food - in other words, the answer is not known, so we have to rely on expert opinion, which is always suspect.  Lastly - they list 'nutrient dense' foods but do not quantify how they would define the terms.  Their list is interesting but suspect.  Were I you, I would consult Dr. Loren Cordain's lists at www.paleodiet.com because he actually shows the relevant numbers - calories and nutrients.   

"Once we believed it was possible to compensate for dietary deficiencies by popping a multivitamin every day. But research suggests that multivitamins may not be all they're cracked up to be.

Moreover, many multivitamins contain some micronutrients in amounts greater than those recommended in the government's Dietary Guidelines for Americans. If you choose to take a multivitamin, take one daily; no more. It's an especially bad idea to take extra multivitamins in an effort to ramp up your intake of a single
micronutrient. Doing so means you're sure to get too much of other vitamins and/or minerals, which can be harmful.

Meanwhile, the benefits of multivitamins remain uncertain. The Women's Health Initiative study concluded that postmenopausal women who took multivitamins did not have a lower death rate than others and were just as likely to develop cardiovascular disease or cancers of the lung, colon and rectum, breast, and endometrium. These results are consistent with findings from other studies. And in 2006, the NIH said there wasn't enough evidence for a recommendation
about taking multivitamins.

Little or no evidence of protection

There's also been little or no evidence of protection against cardiovascular disease or cancers from a number of individual vitamin supplements, including vitamin E, vitamin C, beta carotene, and the B vitamin trio — B6, B12, and folic acid. Recent research suggests that potential harm has been added to the mix. In 2008, a Cochrane Collaboration review found that low-risk people in trials for a host of diseases who were given supplements of vitamin A, vitamin E, and beta carotene had a slightly higher death rate. And there's some evidence that excess folic acid (the synthetic version of folate, a vitamin found abundantly in vegetables, fruits, and grains) may be contributing to an uptick in colon polyps. Both observations warrant further study.

Experts agree that the best way to get the nutrients we need is through food (see list of nutrient-dense foods below). It is likely that what counts is the synergistic interactions of these nutrients; which might also help explain why trials of single nutrients often don't pan out.

However, it may be too soon to draw the line on all supplements.  Adequate calcium and vitamin D are essential in preserving bone density. Although you may be getting the recommended 1,200-mg calcium requirement in your diet, it may be almost impossible to get the recommended 1,000 iu of vitamin D, which is essential for calcium absorption, through food intake and sun exposure.

Nutrient-dense foods

Nutrient-dense foods have a lot of nutrients relative to the number of calories they contain. Some examples of foods that pack a nutritional punch are:
NOTE: This is a pretty good list - see my notes in parenthesis with an asterisk)
- Avocados
- Chard, collard greens, kale, mustard greens, spinach
- Bell peppers
- Brussels sprouts
- Mushrooms (crimini and shiitake)
- Baked potatoes (*Interesting - 150 kcal, not much nutrition)

- Sweet potatoes
- Cantaloupe, papaya, raspberries, strawberries
- Low-fat yogurt (*Low fat yogurt?  Ridiculous)
- Eggs
- Seeds (flax, pumpkin, sesame, and sunflower)
- Dried beans (garbanzo, kidney, navy, pinto)

(*Skip the beans - too many auto-immune reactors)
- Lentils, peas
- Almonds, cashews, peanuts (*Interesting here also - peanuts are legumes, vice nuts, and I don't recommend them)
- Barley, oats, quinoa, brown rice (*If you take these totally out of your diet you will notice you've lost exactly no essential nutrition)
- Salmon, halibut, cod, scallops, shrimp, tuna
- Lean beef, lamb, venison
- Chicken, turkey

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http://click.mail.health.harvard.edu/?qs=d9d6bbb10cf6b261d40fb9f4a9f8856323cf508d920a875aa3adf0b854e97371

Sun and D, 3

http://www.marksdailyapple.com/sun-vitamin-d/

 It’s the absolute dead of winter, and many of you are subsisting in ruthlessly frigid weather. The local meteorologist cheerfully announces that, since December, you now have 19 more minutes of daylight! Yippee. It’s 4:30, and the sun hasn’t completely sunk below the icy horizon. That’s all the news from Lake Tundra!

As tempting as it is to hibernate in the comfort of our warm living room, the fact remains that, while we’re well within our rights to curse the cold, we need the sunlight.

Yes, in summer, it’s simple. Just get off your duff and walk outside. In January, well, it’s The Christmas Story scene when Ralphie’s mom bundles up his little brother in preparation for the walk to school: “I can’t put my arms down!”

And, oh, we know what you’re thinking. The happy lights, while we love them and agree that they definitely help, aren’t as efficient as the real deal at inducing vitamin D3 production in the body. (Remember, I’m just the messenger.) Anyway, the dog needs his walk, and you could use the fresh air.

We at MDA talk quite a bit about sunlight starvation and the benefits of moderate sun exposure. Continuing research further bolsters proof that soaking up the rays (again, in moderation) is essential for good health. Recommended daily exposure times vary considerably, from 3-15 minutes for lighter skinned people to as much as an hour for darker skinned people. Opt for at least 15 minutes a day, depending on your skin tone and sun intensity.

Need more motivation? Let’s review.

Sunlight and Cancer

Research studies and analysis of global incidence data (GLOBOCAN) consistently find that sun exposure is a protective factor against the following cancers: lung, kidney, breast, endometrial, ovarian, prostate, colon and skin cancer. And the list keeps growing.

Whoa! Wait a minute – protective against skin cancer?? Yes, Watson, research out of Stanford University shows that moderate sun exposure causes dendritic cells (immune cells in the skin) to convert inactive vitamin D3 to the active form. The active vitamin D3 then allows the immune system’s soldier T-cells to transfer to the outer layers of the skin, where they do their otherwise usual duty of overthrowing damaged cells and fighting infections.

So, let’s go back, you say. Cancer-sunlight. How does this all work? Vitamin D, research shows, prevents cancerous cells from dividing as well as advances the death of cancer cells themselves. On top of it all, vitamin D enhances the activity of certain genes, including those that manage cell cycle. Is that a cool hat-trick or what?

Sunlight and Heart Health
Studies have also supported vitamin D’s role in promoting heart health. Vitamin D apparently enhances the heart’s pumping ability as well as the integrity of heart cell structure. It can also help lower blood pressure and inflammation and aids in reducing insulin resistance. And it keeps getting better….

Sunlight and Osteoporosis
The vitamin D sunlight produces in the body is essential to bone density. Yes, we know what Big Moo tells you. That milk moustache isn’t just overplayed; it’s an oversimplification. There are plenty of population groups around the world that consume little to no dairy, and their osteoporosis rates are miniscule compared to ours. In addition to well balanced nutrition and smart supplementation as well as regular weight bearing exercise, the vitamin D we get from sunlight is crucial to maintaining bone density. Need more still?

Sunlight and Mental Health

Research has found that vitamin D is essential for those suffering from SAD (Seasonal Affective Disorder). The vitamin has also been a successful therapy for many people suffering from depression. The trick: vitamin D boosts serotonin levels (a feel good chemical) in the brain, which is substantially lower in those suffering from depression-of the seasonal variety or not.

Feel good. Hmm. Not such a bad idea for run-of-the-mill winter crankiness either. We could probably all use that about now.


More from this author:  http://www.marksdailyapple.com/food-safety/

Sun and D, 2

More from Feasting on Fitness:  http://feastingonfitness.blogspot.com/2010/05/sunshine-of-your-love-part-1-safely.html

Christy does a thorough review - take a look.

School Food

"What I saw during my week in Berkeley's central school kitchen was a pair of seasoned, professional chefs who knew what the deal was with kids and vegetables. Being chefs on a budget, they take a clear-eyed, pragmatic approach to making school meals. They weren't just slapping peas on a tray to satisfy some standard dreamed up in Washington, D.C. With stoic determination, they were finding ways to incorporate vegatables that would actually be eaten in daily meals, often by making them much less obvious. They don't waste time or money on broccoli side dishes. They serve lots of beans, which satisfy government vegetable requirements cheaply and efficiently-just in case that Tuscan bean salad ends up being scraped into the compost bin.
Why serve kids local brussels sprouts if they just end up in the trash? That was exactly the message D.C. school officials sent legislators here when they tried to adopt new Institute of Medicine standards calling for bigger portions of vegetables: Please don't!
In the District of Columbia, canned green beans, steamed carrots and broccoli cooked to death appear on Styrofoam serving trays on a regular basis, only to be ignored by the children for whom they are intended and dropped into trash receptacles at the end of the meal. "They're nasty," is how my 10-year-old daughter and her classmates describe them. Isn't the defininition of insanity repeating the same behavior over and over, expecting a different result?"
http://www.theslowcook.com/2010/05/17/lessons-from-berkeley-can-we-handle-the-truth/

I can't even dream of how bad most school lunches are.  We ate a steady diet of bread, milk, and some protein back in "my" day.  The veggies were OK, if not great.  Now, I wonder if they can still provide meat based burgers?  Whole milk?  I bet you still get a dose of sugar for a dessert at every meal.  You could live on those meals, but I'll bet many, myself included, had a predictable blood sugar spike followed by a post-insulin crash, resulting in the post-lunch fog.  I didn't even know enough then to know the benefit of bringing my own food to school.  At least my kids won't suffer the same fate, nor need yours.

By the way - the best way to get kids to like veggies is to eat a bunch while the kid is in utero!

Red Meat Study - Some of the Issues

"The study was a meta-analysis, which combines the results of several studies looking at the same issue. Like others of its kind, the study "is limited in terms of scientific value," Dr. Eckel said. None of the studies in the analysis, for example, was a randomized controlled clinical trial, just one factor affecting the strength of the findings. The report is helpful in raising issues for further study, but "it doesn't answer any questions," he said.
http://online.wsj.com/article/SB10001424052748704314904575250570943835414.html
==These are great points and should be taken to heart as regards all study results.  If the study is not an intervention trial, it cannot be used to establish causality, but it may be useful to form or refine a conjecture/hypothesis for further study.

"The American Meat Institute Foundation took issue with the findings [regarding processed meat products], saying they conflict with national dietary guidelines. "The body of evidence clearly demonstrates that processed meat is a healthy part of a balanced diet," James H. Hodges, president, said in a statement. He said the study didn't "achieve the standard threshold that would generate concern" and that "it is no reason for dietary changes." "
==Mr. Hodges is correct in this case - this study is no reason for dietary change. 

Current U.S. dietary guidelines call for limiting saturated fats-the kind found in red meats and dairy products such as milk, cheese and butter-to less than 10% of calories consumed each day-while keeping overall fat consumption to under 30% of calories. A big reason is that saturated fats are associated with higher levels of cholesterol in the blood. Dr. Eckel said that "is still a reasonable recommendation."
==The thing to keep in mind when hearing this bit of drivel - that saturated fat intake raises cholesterol levels -  is that it's true but irrelevant, as Taubes covers in delicious detail in "Good Calories Bad Calories."  Saturated fat intake raises both HDL and LDL, and almost always improves the total cholesterol to HDL ratio that is a far more significant (if imperfect) predictor of CVD.  Saturated fat, as we've covered many times, has a significant health benefit, and virtually no negative health impact (except for a few folks who are sat fat sensitive).

"The report is the second meta-analysis in recent weeks to question just how much of a culprit saturated fats are when it comes to cardiovascular risk. In March, a meta-analysis (involving 21 different studies) by a team headed by Ronald Krauss at Children's Hospital Oakland Research Institute, Oakland, Calif., found that intake of saturated fat wasn't linked to a statistically-significant increased risk of heart disease, stroke or cardiovascular disease."
==More on that study here:  http://fireofthegodsfitness.blogspot.com/2010/02/meta-analysis-considering-impact-of-fat.html

"That's not necessarily a license to unleash your inner carnivore. Calorie control as well as a diet rich in fruits and vegetables, fish, whole grains and nuts remain the mainstay of heart-healthy eating, he said."
==They have to advocate something - but be advised they do not have anything like scientific certainty for much of what they advocate.  Eat fruit and vegetables if you like them, nuts are great, fish is great, but don't let them convince you they KNOW (I think they have their head in the sand if they think grains, whole or otherwise, are a significant part of a healthy diet).  They are making a guess.  You are perfectly capable of sorting through the issues and coming to your own conclusions, testing and experimenting with what works for you.  The recommended prescription remains the same - "Eat meat and vegetables, nuts and seeds, some fruit, little starch and no sugar." 

WHS - Seed Oil Hypothesis

Concise, important post about why we don't want to eat seed oils.  Fits the general model of not necessary for health, suspect due to their novelty in the human diet, and some data supporting the hypothesis that these oils have a high, negative impact.

The hard part is - they're everywhere and hard to avoid.
http://wholehealthsource.blogspot.com/2010/04/do-seed-oils-cause-multi-generational.html

As per the usual, with Whole Health Source, there's as much to chew on in the comments about the article as there is in the article itself - a benefit of a well established blog with very bright commenters.

Review of a Critique, Conclusion

(continued from yesterday) Mr. BS has good reason to at least attempt to be high handed with GCBC.  GCBC is an elemental attack on the quality of work of the entire field of nutrition for the last forty years.  If Taubes is right, a very large number of people in government and in the “leaders” of the nutrition field are being told, effectively, “you guys have wasted the last 40 years of your professional lives and have been upstaged by a journalist.”  In fact, that is what has happened, in my humble as ever opinion.  This is how Taubes describes it in his rebuttal to one such field leader (link below): 

“Finally, I would like to identify one potential conflict of interest on Bray's part that he neglected to mention. In the 1970s, as I discuss in GCBC, the hormonal/enzymatic regulation of fat tissue was deemed irrelevant to the cause, cure and prevention of human obesity. I identify Bray as one of two individuals most responsible for this dubious accomplishment, and 'for effectively removing the [century-old] concept of the fattening carbohydrate from the nutritional canon . . .' (GCBC, p. 417). Thus, Bray's critique of GCBC may be as much a defense of his own career as it is an unbiased assessment of the book.” 

Even worse, if Taubes is right, the folks who were doing what they thought was best for the people of this nation, actually have done incalculable harm in recommending consumption of high carbohydrate and low fat over the last 30 to 40 years.  At the very least, it is clear that those recommendations were not based on good science, and at the worst, they’ve killed and damaged as many or more people as the cigarette industry, and used the United States Government to do so. 

The prestigious nutrition journals that Mr. BS is so proud to have been published in, and his entire profession, is diminished in significance if Taubes is right.  They’ve been advocating, for as long as I’ve been aware, a diet loaded in carbohydrate, including such nonsense as ‘healthy whole grains’, low fat dairy, bananas, oatmeal, breakfast cereals, and potatoes while avoiding saturated fat.  They have confidently stated, without scientific proof, that the way towards better health is by eating more high density carbohydrates as a way of avoiding fat.  We’ve been told by this “profession” that high protein will damage our kidneys, but they’ve made this pronouncement with no scientific evidence to back it up.  If they got anything right, it was to avoid transfats (which ironically only came into vogue after the saturated fat witch hunts began).  How eager do you think Mr. BS and his profession will be to embrace it if the proof is forthcoming of just how badly they’ve missed the mark? 

Taubes puts it like this (GCBC page 450) commenting on the “no assumptions” nature of two researchers Taubes admires:

“This is how functioning science works.  Outstanding questions are identified or hypotheses proposed; experimental tests are then established either to answer the question to refute the hypotheses, regardless of how obviously true they might appear to be.  If assertions are made without the empirical evidence to defend them, they are vigorously rebuked.  In science, as Merton noted, progress is made only by first establishing whether one’s predecessors have erred or “Have stopped before tracking down the implications of their result or have passed over in their work what is there to be seen by the fresh eye of another.”  Each new claim to knowledge therefore, has to be picked apart and appraised.  Its shortcomings have to be established unequivocally before we can know what questions remain to be asked, and so what answers to seek – what we know is really so and what we don’t.  “This unending exchange of critical judgment,” Merton wrote, “of praise and punishment, is developed in science to a degree that makes the monitoring of children’s behavior by their parents seem little more than child’s play.” 

The institutionalized vigilance, “this unending exchange of critical judgment,” is nowhere to be found 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 scientists 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 The Structure of Scientific Revolutions, might have put it, “do not add up to science as we know it.” 

 

We live in interesting times.  Information that would not have been available to the vast majority of us is but a few keyboard clicks away.  Unburdened by professional indoctrination, we have the benefit of wanting to believe what is true about diet and health, regardless of who the truth may embarrass, and we have the chance to test it out for ourselves, on ourselves.  How to do that?  Eat meat and vegetables, nuts and seeds, some fruit, little starch, no sugar and no wheat.  Supplement with fish oil and gel cap vitamin D.  Get your lipids tested, insulin levels too if you can, and note that your TG to HDL ratio will be less than 3.5.  Then consider yourself a victor in the diet wars, and live long and well.

Another critique of GCBC may be found here: http://www.proteinpower.com/drmike/wp-content/uploads/2008/07/bray-review-of-gcbc.pdf

Dr. Mike Eades’ and Gary Taubes’ Response to Dr. Brey: http://www.proteinpower.com/drmike/wp-content/uploads/2008/07/taubes-response-to-bray-ob-reviews.pdf

Dr. Mike Eades’ additional response: http://www.proteinpower.com/drmike/weight-loss/more-braying-from-bray/

Review of a Critique, Part 4

Mr. BS then moves on to another topic – Taubes’ hypothesis that, as Mr. BS writes it – well, he writes it about three different ways, and finally he comes pretty close:  “(Taubes’) claim is that positive energy balance is a result of accumulating excess fat, not the other way around.”  He again does the “predictions resulting from this hypothesis” routine, but his understanding of Taubes’ points is insufficient, so again his test predictions are not valid.  Mr. BS is fully wedded to the “body fat accumulation results from eating too much” model, and he cannot think through the implications of Taubes’ hypotheses, the most relevant two of which are as follows:

5. Obesity is a disorder of excess fat accumulation, not overeating, and not sedentary behavior.

6. Consuming excess calories does not cause us to grow fatter, any more than it causes a child to grow taller. Expending more energy than we consume does not lead to long-term weight loss; it leads to hunger.

In other words, as previously mentioned, Taubes’ focus is on causality.  The energy balance equation does not say anything about causality (but tons of folks have assumed that it does).  What they assume is “fat people get fat because they eat too much and work/exercise too little.”  This of course has never been proved, as most who believe it to be never thought to question it.  Note that this belief is rooted in a moral conviction that obesity results from human frailty.  Stated another way, the belief that obesity is a simple matter of people being too gluttonous and too lazy is a moral judgment – and thus serves the bias of any who wish to feel virtuous because they are not fat.  The question for those of us who would rather understand than judge the growing phenomenon of deteriorating health associated with increasing obesity is:  what has caused a larger and growing percentage of our fellow citizens to grow obese in the last 30 to 40 years?  It strikes me as unlikely on its face that the answer is “people are getting more lazy and more gluttonous”, particularly when viewed alongside the statistically significant increase in the number of people who are working out for the sole purpose of being leaner and more healthy.

How could it be true that fat accumulation causes hunger and thus more eating (increased intake of food energy), as well as a lower activity level (decreased expenditure of energy)?  The key is the work of insulin.  If carbohydrate intake is excessive, which means (by definition) it drives blood glucose towards a toxic glucose concentration level, resulting in an insulin secretion (the body’s natural defense for toxic glucose levels), blood glucose levels are reduced.  Muscles and organs can absorb some glucose at the cellular level, but most of the excess glucose will be converted to triglycerides and stored as fat.  Further, the consistent excess intake of carbohydrates will result in an increased baseline level of insulin – whatever that is for each individual.  High insulin levels prevent the body from liberating fat to make it available for use.  In effect the body fueled with excess carbohydrate is starving within a couple of hours of eating.  That is to say, just as in a starving body cannot get energy to its cells, so it is with the body we’ve described above.  There is energy in the body as stored fat – but at the cellular level, it may as well be in the next county. 

There’s a common set of reactions in a starving body.  The core temp will decrease as the body starts looking for ways to conserve.  Starving people move around less. They feel, generally, more hungry.  So the notional body we’ve described above will result in human that will eat what’s available but will likely otherwise be conserving energy in ways that are not conscious. 

In summary, the driver for the accumulation of more fat for this person is the de facto deprivation of energy by the natural cycle that results from excess carbohydrate intake. 

This is not to say that no one on the planet is a gluttonous, lazy slob.  What I believe, and what Taubes’ work points to, is that gluttony and laziness are not likely drivers of population wide changes in body fat percentage.  It also seems unlikely that kids started to develop type II diabetes all of sudden, at the exact same time that the ‘authorities’ began to obsess over fat consumption (resulting in parents and governments feeding their kids a higher carbohydrate diet), because they became gluttonous and lazy.  If anyone chooses to believe that fat people are morally deficient, that’s their choice of course.  The only thing that leaves is the question of which meds to treat them with because, as the last 30 years have proved, the “eat less workout more” advice is not working (and for obvious reasons once the CH is understood).  My experiment in high carbohydrate land made me significantly fatter despite acute attention to my intake and while working out six days a week, sometimes twice per day, doing resistance training, cardio and martial arts.

In the end, Mr. BS’s piece includes an admission that he’s all wrong, but doesn’t realize it.  I quote: “There is strong evidence that diets high in refined carbohydrate, and the ingestion of sweet and palatable foods, cause disruptions in appetite regulation.  This then leads to overeating.” 

Then we are treated to Mr. BS’s closing shot: “Those of you who think Taubes is without bias, keep in mind that he has built a career around the CH.”  First off, anyone who thinks anyone is without bias is either immature or ignorant or both.  That’s why humanity benefits from the scientific method, the guiding principle of which is do not trust humans (especially other scientists).  But secondarily, Mr. Taubes was a highly regarded science journalist long before he started publishing the material that was eventually encapsulated in GCBC.  If anything, his work of late has put him into great conflict with a majority of the scientists and many doctors who care about this topic.  And that brings me to a reasonable segue to the close of this review, which I hope you'll join me for tomorrow.

Review of a Critique, Part 3

(continued) Mr. BS’s fourth test prediction – “Fat overfeeding, without additional carbohydrate, should not result in weight gain since insulin secretion is not increased” - is also invalid.  If one is consuming too much carbohydrate, and is also “fat overfeeding”, the CH would predict additional weight gain.  This is because, as previously discussed, excessive carbohydrate intake results in high levels of insulin secretion, and insulin signals storage of both blood sugar as fat, and of fatty acids in the blood as stored fat.  Insulin also shuts off the body’s ability to liberate stored fat (acts as a master hormone, limiting the effect of the 7 or so hormones that can release stored fat).  In other words, the results Mr. BS reports are consistent with the CH.  Further, synthesis of body fat requires glucose.  With low levels of glucose due to carbohydrate restriction (100g/day maximum), fat synthesis is impeded.  A more accurate test prediction derived from the CH would be as follows:  “Fat overfeeding in the absence of excessive carbohydrate intake will result in a lesser increase in body fat than an isocaloric combination of fat overfeeding and excessive carbohydrate intake.”  Higher levels of fatty acids in the blood from high fat intake, absent high insulin levels, do not require that the fatty acids be converted to stored body fat.  Should there be a need, there’s nothing to prevent fat liberation for oxidation.  GCBC cites studies which indicate that fatty acids are moving in and out of adipose tissue more or less constantly in a normal human.  If, however, carbohydrate intake is excessive, both glucose and fatty acids will be trapped in storage – in other words, in additional adipose tissue.

After his simulated but invalid duel with the CH through his initial four test predictions, Mr. BS posits additional objections he has to the CH.  First, he states that insulin has a hunger reducing effect on the brain, and uses this fact as a refutation that high insulin levels could result in hunger. In other words, he’s suggesting that this one influence – insulin’s appetite suppressive quality – is the main or most significant factor on human hunger.  This is a stunning over-simplification of human hunger, which depends on any number of factors, not all of which are clearly understood.  But as regards insulin, first and foremost, the function of insulin is to protect the brain and nervous system from toxic levels of glucose.  The appetite suppressive effect of insulin may be real, if all other things are equal, but I doubt there’s a one of us that has not noticed being hungry 2-3 hours after a high sugar and/or high carbohydrate meal.  This post-eating hunger cycle is generated after high glucose levels force an insulin response, which results in conversion of glucose to storage, resulting in low glucose levels.  What the insulin levels are at which points in the cycle is not known to me to any level of precision, but I believe that insulin is “consumed” as it does its job of getting glucose out of the blood and into the tissues.  The post eating hunger cycle - “excessive carbohydrate consumption drives high glucose drives insulin response resulting in low glucose and increased hunger” - is characteristic of folks who eat high carbohydrate diets, and most recognize the cycle when they hear it described. 

Mr. BS’s next criticism of the CH is:  “Another thing the carbohydrate hypothesis cannot explain is why there are many lean people who eat moderate to high carbohydrate diets (even people who do not have high daily expenditures).”  First off, the CH as described in GCBC does not assert that all individuals will fatten if they eat a high carbohydrate diet.  Therefore, in no way does it have to explain the phenomenon of the “high carbohydrate skinny dude” to be valid.   That said, even a rudimentary understanding of the topic would lead one to believe that in sensitivity to food intake, or carbohydrate intake, a human population will demonstrate a bell shaped distribution.  That is, some will be able to eat big piles of nearly anything and seemingly never fatten (in shape, these people are often what has been described as ectomorphs – tall, thin, shoulders often smaller than hips, and with ‘stringy’ muscles vice dense or puffy muscles).  Ectomorphs could be said to often be less insulin sensitive than average.  Others, the ones at the other end of the bell shaped curve for insulin sensitivity, are frequently endomorphs; large in the pelvis, soft in appearance as they tend to have more subcutaneous fat, and frequently, they seem to fatten on food that others would starve on.  To invalidate the CH, one would need to show that a test population failed to fatten when on a diet consisting of excess carbohydrate when compared to an isocaloric, low carbohydrate diet.  In other words, there is a very simple explanation for the skinny people we all know who can eat a ton but never get fat – they are relatively insensitive to insulin (not to be confused with pathological insulin resistance). 

Tomorrow we'll hit the last points of Mr. BS's critique.

Review of a Critique, Part 2

(Continued)
Mr. BS proposes four predictions he derives from his understanding of the CH.  Naturally, if a prediction follows from a hypothesis, and that prediction can be falsified by known data, the hypothesis may be considered falsified.  For example, if I hypothesize that the sun comes up because I wake up, I could predict that if I did not wake up, the sun would not rise.  I can then falsify my hypothesis by noting that the sun has risen many times when I slept.  However, this kind of science is only as good as the participant’s understanding of the hypothesis in question.  Since Mr. BS appears not to understand the CH, then it should come as no surprise that his suggested test predictions are inadequate tests of the CH (a more objective test of a hypothesis is of course an intervention study, and such is proposed for the CH in some detail in GCBC on page 466 of the paperback version).

Having established these straw man predictions, based on an incomplete or incorrect understanding of the CH, Mr. BS proceeds to knock down all four.  The question is whether his test predictions are valid – do they really test the CH?   

Mr. BS’s first test prediction: if the CH is true, then the following should be observed:  “An inverse relationship between carbohydrate intake and body fat loss during food restriction, independent of energy intake.”

His first test prediction would be more accurately stated as follows: 

“Carbohydrate intake resulting in chronically high blood sugars and insulin levels should result in increased body fat accumulation when compared with an isocaloric diet composed of a macronutrient skew which does not generate chronically high blood sugars and insulin levels.”  Interestingly, Taubes suggests in one article that he thinks 100g/day or less is a ballpark number for a safe amount of daily carbohydrate consumption.  The uncited study (or studies) that Mr. BS says he refers to in his prediction falsification effort supports Taubes:  “I only observed an independent effect of carbohydrate intake at very low (italics mine) carbohydrate levels (<100g/day).”

Nutritionists on the whole seem to think that the minimum carbohydrate intake per day should be a level that I would consider "high" - 200 grams or more in order to ensure the brain gets enough glucose from ingested carbs, and to ensure that adequate calories can be ingested without overconsumption of protein (typical conjecture is that “too much is bad for the kidneys”) or fat (in line with the now conventional wisdom that “too much causes obesity and CVD”).  Those who use carbohydrate restriction with clients, however, would not call 100g/day a “very low intake level.”  Folks like the Drs. Eades or Dr. Atkins target 50-100g/day as normal carbohydrate intake.  In short, Mr. BS’s bias as a traditionally trained nutritionist is on display in his analysis.

Test prediction number 2 is, if the CH is true, then one should observe:

“A positive association between insulin levels and body weight gain.”

Mr. BS’s second test prediction is close to a Taubes hypothesis:  “8. Insulin is the primary regulator of fat storage. When insulin levels are elevated - either chronically or after a meal – we accumulate fat in our fat tissue. When insulin levels fall, we release fat from our fat tissue and use it for fuel.”  Mr. BS’s prediction refutation is invalid because he does not cite studies, and without being able to examine the studies he uses to refute the hypotheses prediction, we cannot know if they say what he interprets them to say.  Testing this hypothesis will take a carefully designed study.  If such a study has been done, I wish Mr. BS had cited it so I could examine it.

Mr. BS’s third prediction is, if the CH is true, then it should be true that “Fructose, a carbohydrate that generates very little change in blood sugar and very little insulin secretion, should result in less fat gain than glucose."  Mr. BS does not clarify what he means by fructose, nor does he cite the studies he claims falsify his (invalid) prediction.  Most likely he means high fructose corn syrup.  More importantly, Mr. BS’s third test prediction (as shown above) isn’t valid.  A valid prediction based on the CH would be:  “Fructose accelerates the fat storage signaling of excessive carbohydrate intake by increasing insulin resistance, which reduces the ability of non-adipose tissue to respond to insulin signals, therefore requiring that adipose tissue take up a greater portion of excess blood sugars.”  This prediction is validated to at least some degree by the non-cited study result Mr. BS refers to.

Tomorrow, we'll look at the fourth test prediction, and a few additional items covered in Mr. BS's post.

Grain, the Double Edged Sword

"Consumption of high levels of whole grain cereal products impairs bone metabolism not only by limiting calcium intake, but by indirectly altering vitamin D metabolism. In animal studies it has been long recognized that excessive consumption of cereal grains can induce vitamin D deficiencies in a wide variety of animals [81–83] including primates [84]. Epidemiological studies of populations consuming high levels of unleavened whole grain breads show vitamin D deficiency to be widespread [85–87]. A study of radiolabelled 25-hydroxyvitamin D3 (25(OH)D3) in humans consuming 60 g of wheat bran daily for 30 days clearly demonstrated an enhanced elimination of 25(OH)D3 in the intestinal lumen [88]. The mechanism by which cereal grain consumption influences vitamin D is unclear. Some investigators have suggested that cereal grains may interfere with the enterohepatic circulation of vitamin D or its metabolites [84, 88], whereas others have shown that calcium deficiency in- creases the rate of inactivation of vitamin D in the liver [89]. This effect is mediated by 1,25-dihydroxyvitamin D (1,25(OH)2D) produced in response to secondary hyperparathyroidism, which promotes hepatic conversion of vitamin D to polar inactivation products which are excreted in bile [89]. Consequently, the low Ca/P ratio of cereal grains has the ability to elevate PTH which in turn stimulates increased production of 1,25(OH)2D which causes an acceler- ated loss of 25-hydroxyvitamin D."

http://www.direct-ms.org/pdf/EvolutionPaleolithic/Cereal%20Sword.pdf

So, in case you needed another reason not to eat bread (whole grain or otherwise):

- besides the fact that it has a high calorie to nutrient ratio, and

- rapidly digests into simple sugar and thus drives blood sugars to unhealthy levels resulting in the insulin cascade, and 

- the fact that it has many 'anti-nutrient qualities', and 

- the fact that most bread doesn't taste good enough to eat by itself (how much sugar and/or butter do you slather on your bread to make it desirable?);

Here's another thing we don't need - it interferes with vitamin D utilization.