343,000 reasons to be annoyed

The positive reaction to this new series has really encouraged me, and given that my dear readers tend to be smarties who like to know the logic behind how a thing works, it seems like a good time to lay down some basic information. (Sean, this one’s for you!) So that means this post is going to be somewhat dense.

In GCBC, Gary Taubes reviews the fat-cholesterol hypothesis of overweight, heart disease, etc. that’s been the default position among diet scientists for some decades now, and contrasts its explanatory power with that of the carbohydrate hypothesis. The basic story in making the case for the latter is that insulin and its close hormonal cousins are housekeepers, cleaning up and putting away for later any sugars that flood your bloodstream when you eat.

But there’s more. GCBC goes into exhaustive detail about related impacts of this activity on cholesterol itself, the lipoproteins that convey it, and their various types and subtypes. You may think you know about “good” and “bad” cholesterol and heart attack risk factors and such; I learned just how much was wrong about what I thought I knew. Here’s a tiny sample.

On a diet that [Ronald] Krauss calls the “average American diet,” with 35 percent of the calories from fat, one in three men will have the atherogenic pattern B profile. On a diet of 46 percent fat, this proportion drops: only one man in every five manifests the atherogenic profile. On a diet of only 10 percent fat, of the kind advocated by diet doctors Nathan Pritikin and Dean Ornish, two out of every three men will have small, dense LDL and, as a result, a predicted threefold higher risk of heart disease. …. Krauss and his colleagues even tested the effect of types of fat on these lipoproteins, and reported that, the more saturated fat in the diet, the larger and fluffier the LDL — a beneficial effect. [GCBC, Ch. 9, p. 173; emphasis in original; footnote elided]

Bizarrely, when it comes to scientific study results rather than public-health pronouncements and diet books, there isn’t much that’s particularly controversial about how all this works. (By the way, the cholesterol/lipoprotein discussions were the biggest of the reading “slogs” I mentioned in my first post, but if you really want to know, you’ll really want to read it.)

But fructose is one of those “good” sugars that’s okay to have in your diet, right? You know, ’cause it’s from fruit? Not so much.

As Peter Mayes has explained, our bodies will gradually adapt to long-term consumption of high-fructose diets, and so the “pattern of fructose metabolism” with change over time. This is why, the more fructose in the diet and the longer the period of consumption, the greater the secretion of triglycerides by the liver. [Ibid., Ch. 12, p. 200; footnote elided]

Seen one of those ads on American TV touting the wonderfulness and safety of high-fructose corn syrup? Yeesh.

Because sucrose and high-fructose corn syrup (HFCS-55) are both effectively half glucose and half fructose, they offer the worst of both sugars. The fructose will stimulate the liver to produce triglycerides, while the glucose will stimulate insulin secretion. [Ibid., Ch. 12, p. 201]

The really frustrating part is that these feedback mechanisms in our bodies can lead to a vicious circle of starvation in the land of plenty, so to speak.

[I]nsulin renders the fat deposits temporarily invisible to the rest of the body by shutting down the flow of fatty acids out of the fat cells, while signaling the cells to continue burning glucose instead. As long as insulin levels remain elevated and the fat cells remain sensitive to the insulin, the use of fat for fuel is suppressed. We store more calories in this fat reserve than we should, and we hold on to these calories even when they’re required to supply energy to the cells. We can’t use this fat to forestall the return of hunger. [Ibid., Ch. 24, p. 436]

Well. That’s encouraging, isn’t it?

Not to pick on anyone specifically, but in the first dozen (out of 343,054) diet books that happened to be listed on Amazon at the moment, I found a lot of reasons for frustration:

  • Advice on how to “think like a thin person”, from someone who believes that any calorie-controlled diet will work
  • Instructions on how to lose belly fat by eating things like English muffins (at least they’re whole-wheat ones)
  • How to swap items at your local fast-food place to choose lower-calorie ones
  • A book about getting a flat belly that insists low-carb foods make you fat
  • A popular and not entirely clueless diet that nonetheless lists low-fat (vs. high-fat) dairy as an inherently good thing
  • One book on “eating clean” that seems to have a clue about the actual science of metabolism

All of the above — the science and the largely contradictory diet advice — explains a lot, if you’re a long-time low-fat dieter: you’ve probably been doing it the hard way (and the unhealthy way), assuming it’s even been working for you at all.

While I acknowledge that different diet approaches really do seem to work for different people (another future post or three), increasing the knowledge and awareness of metabolism-science facts is a great Step 1.

Can we agree that a good Step 2 is starting to ignore stuff like this?

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9 Comments to “343,000 reasons to be annoyed”

  1. Rita 22 March 2009 at 2:10 pm #

    How about a big “DUH?” Early man ate meat almost exclusively and certainly dependably. The most sought after part of that meat was the high fat content areas…often given to the hunter who landed the prey.

    Now I am not saying these folks who lived much shorter lives were healthier, I am only saying we humans grew up as a species eating high fat meat and no processed foods with sugar and refined grains. Such is the nature of our digestive system; we crave and are at our best when we eat what we were bred to eat. It really is that simple.
    Okay, Eve, your turn.

  2. Eve 22 March 2009 at 3:17 pm #

    Well, I did promise ruminations in a “Duh” category. :-) But the problem is that if people are bombarded with a lot of hypotheses (let’s not dignify them with the word “theories”) that contradict each other, they’re less likely to choose any course of action at all, much less the actions that are likelier to lead to better health and less obesity.

    Also, even if you buy the carbohydrate hypothesis, there are different ideas — that is, it’s not “settled science” yet as far as I can tell — about how much plant-eating is appropriate or desirable in the context of meat-eating. Though I haven’t read Michael Pollan yet (thanks are due to Simon Phipps for suggestions about that), I suspect there are some interesting deltas between his and Nina Planck’s approaches on the one side, and the approaches suggested by Taubes’s evidence on the other.

    I definitely plan to discuss all of the above at some point. But at my once-a-week pace, you may have to wait a while…

  3. David Brown 22 March 2009 at 6:32 pm #

    Good observation about contradictory hypotheses, Eve. Nutritional controversies are extremely difficult to resolve once wrongheaded ideas become enshrined in textbooks and embalmed in the minds of professors and their students. Add to the mix commercial interests having a stake in perpetuating fallacy and you have the recipe for a public health disaster of global proportions.

    A really helpful way of looking at nutrition involves recognition that, ideally, food choices should be both appropriate and adequate. Confusion arises when researchers fail to recognize there exists a wide range of metabolic responses to food intake. Suggest you read Biochemical Individuality by Roger J. Williams, PhD for further insight into this matter.

    The problem of obtaining adequate nourishment involves both the biological potency of the food consumed and the balance of nutrient materials required for energy needs and tissue repair. Meet these criteria and sound health is yours. Hard to do these days given the way food is produced and processed. Meat, dairy, and poultry products are not what they once were. Read “Food for Nought” by Ross Hume Hall, PhD.

  4. Eve 22 March 2009 at 8:43 pm #

    David, thanks for your thoughts and additional reading suggestions.

    To your caution about commercial interests, I’d add that the interests of the medical establishment (whether they involve commercial, political, or not-invented-here motivations) also sometimes run contrary to quality science.

    Taubes starts his book with a tale of the first popular diet book ever, written by William Banting in 1863, and how it was slammed by the medical critics even though many of them agreed with its recommendations (low-carb, by the way). It’s a nasty business when The Lancet says “We advise Mr. Banting, and everyone of his kind, not to meddle with medical literature again, but be content to mind his own business.” Ouch. Touched a nerve there, did he?

  5. The Corfu 22 March 2009 at 8:53 pm #

    I don’t know which science is correct but I will relate my experience. I’m 6″ and weighed about 230 lbs. I am of average build, I feel I should be at 185-190. I tried doing low/non fat because that was “healthy”. I just ended up gaining weight, feeling hungry (ravenous) all the time, and at my physical, my blood work (cholesterol, BP, triglycerides, etc.) was very bad.

    I am not the smartest guy in the world but still I figured I needed a different approach. For me, if something doesn’t work, then do a 180. To me that meant protein and fat. Hmmm, what did humans eat 10,000 years ago? Meat, fish, vegetables, fruit, some dairy (or some goaty) and nuts. No Cocoa Puffs, Pop Tarts, or Tostitos.

    I did read Atkins and did follow the strict first 2 week plan. After that, I just stayed away from the carbs and sugar. With no real intent to do so, I began to eat more vegetables and did eat a lot of meat, eggs, and seafood.

    After 3 months, I had lost 25 lbs. What I noticed was that I did not get sleepy after lunch. I stopped snoring (wheat allergy?). I felt much better, much more lively. Up until then, I was getting a pretty good headache once a week. I’d end up taking 600-800 mg of motrin for that. Not good, because you’ll end up burning a hole in your digestive tract. For fun, read the detailed explanation that comes with prescription motrin. The question isn’t if it is bad, it is how much motrin for how long and how big a hole do you want. The headaches went away too. Even so, I felt like I was doing “bad” things because I was eating a lot of protein and fat.

    Time came for my physical for life insurance. I was really worried because I had been eating a lot of (i.e. living on) steak and shrimp. From borderline “we need to hospitalize you” my blood work improved greatly. My cholesterol dropped a lot and the HDL to LDL ratio was more than 5:1. My blood pressure was really low and my triglycerides were now so low that they were right at the line between healthy and too low. In a bizzare twist, I qualified for the ultra healthy insurance rate because the blood stuff was so good. Mind you, this happened in 3 months.

    I know everyone is different but I was flabbergasted that I could eat like that and get blood results like that. I was shocked I tell you, shocked.

    It is hard to do it all the time; I’d slit your throat for a pepperoni pizza but it seems, at least for me, to be much better for me than any other approach.

    I also found that I was never as ravenous as I was before. From what I have read, I’d say that was due to the eveness of my blood sugar when compared to the more carb heavy diet where the blood sugar levels fluctuate lot.

    I’m not writing a book but for a white, English, Scottish, German, Native American male, cutting processed carbs and sugar really seemed to help me.

  6. Eve 22 March 2009 at 9:27 pm #

    Thanks so much for sharing your experience! Mine was much the same (I’ll share details in a future post).

    When you get desperate for pizza, order up and then just eat the toppings. ;-) What’s really wild is that you get full way faster when you leave the crusts behind than when you consume them.

  7. The Corfu 23 March 2009 at 4:37 pm #

    Thanks, a good idea. I figured out that thin crust might be a little better for me (I said I wasn’t smart :–))

  8. rich 2 April 2009 at 8:00 pm #

    Interesting thread. I’ve just started the Atkins thing and am going to be blogging about it (the whole experience), at http://richonatkins.blogspot.com/

  9. Eve 3 April 2009 at 7:38 am #

    Hey Rich, I’m so excited for you! Will be following your progress. If you need any tips, try me – I got a million of ’em. :)