Gary Taubes: What Really Makes Us Fat -- Calories Or Carbohydrates?
An essay by Gary Taubes from BMJ. A summary:
The history of obesity research is a history of two competing hypotheses. Gary Taubes argues that the wrong hypothesis won out and that it is this hypothesis, along with substandard science, that has exacerbated the obesity crisis and the related chronic diseases. If we are to make any progress, he says, we have to look again at what really makes us fat.
An excerpt:
Calories or carbohydratesAttempts to blame the obesity epidemics worldwide on increased availability of calories typically ignore the fact that these increases are largely carbohydrates and those carbohydrates are largely sugars--sucrose or high fructose corn syrup. And so these observations shed no light on whether it's total calories to blame or the carbohydrate calories. Nor do they shed light on the more fundamental question of whether people or populations get fat because they're eating more, or eat more because the macronutrient composition of their diets is promoting fat accumulation--increased lipogenesis or decreased lipolysis, in effect, driving an increase in appetite.
The same is true for bariatric surgery, which is now acknowledged to be a remarkably effective means of inducing long term weight loss. But does weight loss occur after surgery because of the rearrangement of the gastrointestinal tract resulting in hormonal effects that minimise appetite or directly minimise fat accumulation? Does it occur because the patient reduces total calories consumed after surgery or reduces carbohydrate calories and, specifically, refined grains and sugars? The observation that bariatric surgery works doesn't answer these questions.
As Erich Grafe noted about the lipophilia hypothesis 80 years ago, it "presupposes overnutrition." If a patient is getting heavier, they must be taking in more energy than they expend. With the energy balance hypothesis, overnutrition is causal; with lipophilia, it's compensatory, a response to the hormonally driven fat accumulation. Either way, it has to exist while an individual is gaining weight. And, by the same token, undernutrition or negative energy balance has to exist if an individual is losing weight.
Sugary beverages are another example of how these different hypotheses lead to different conclusions that are relevant to solving the obesity epidemics worldwide. The conventional wisdom has it that sugary beverages are merely empty calories that we consume in excess, although it is possible that the metabolism of fructose (a key carbohydrate component that makes these sugars sweet) in the liver somehow circumvents leptin signalling, leading us to consume these beverages and their calories even when we're not and shouldn't be hungry. The hormonal or regulatory hypothesis also focuses on the metabolism of fructose in the liver, but rather than leptin it uses evidence suggesting that fructose metabolism can induce insulin resistance, leading in turn to raised insulin levels and trapping fat in fat cells--increasing, in effect, lipophilia.
Taubes' excellent books are Good Calories, Bad Calories and Why We Get Fat. (The latter is an easier read for people who don't read tons of science.)
Thanks for posting about this subject. A short blog you posted in 2009 inspired me to learn more about low carb diets. You seemed to me to be a person who doesn't get behind something without pretty good rationale, and that credibility made me feel like it would be worth the effort to learn more.
So I read all I could find on the subject, including the Taubes and Eades books you recommended, stopped eating carbs, and lost 40 pounds over the next six months (from 235 to 195) My lipid profile, hgbA1c and blood pressure went from bad to good, and I gave up the four medications I was taking. I now weigh less than 185 and feel so much better than before.
Anyway, much appreciation from me to you for having the credibility to make your recommendations worth exploring.
Ken R at April 20, 2013 9:31 PM
Amy Alkon
https://www.advicegoddess.com/archives/2013/04/gary-taubes-wha.html#comment-3685363">comment from Ken RWow - thank you so, so much, and congratulations!
Amy Alkon
at April 21, 2013 12:16 AM
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