These ideas that obesity is the result of eating too much or exercising too little or both is treated as a self-evident truth. People invoke the First Law of Thermodynamics and people who argue otherwise are marginalized as not understanding the First Law.

But what if it’s wrong? What if the causality is all mixed up? What if you eat more because your body is getting fat? What if you don’t feel like exercising because you are already obese? What if simple calorie restriction is not particularly effective in losing weight? It isn’t and yet it’s repeated over and over again, “You are overweight because you overeat,” and “If you just eat less, you will lose weight.”

In this lecture by Gary Taubes, he does a great job of showing the fallacy of the conventional wisdom:

It’s a longish video, about 70 minutes, but it’s a nice introduction to his ideas. If you find it all compelling I highly recommend his book, Good Calories, Bad Calories. It’s not a diet book, it’s a science book, and it sets out to demolish some of the conventional paradigms we have about diet, obesity and disease.

UPDATE: Changed the title because we don’t need a new paradigm really, we need an old one. If you watch the video, you will understand what I mean.

It remains to be seen whether the current Atkins school theory of ketosis—the process by which the body resorts to burning its own fat when starved of carbohydrates—will someday seem as quaintly quackish as Kellogg’s theory of colonic autointoxication. What is striking is just how little it takes to set off one of these applecart-toppling nutritional swings in America; a scientific study, a new government guideline, a lone crackpot with a medical degree can alter this nation’s diet overnight. One article in the New York Times Magazine in 2002 almost single-handedly set off the recent spasm of carbophobia in America.

I wonder if Pollan has read Taubes book. I’d be shocked if he hadn’t. To me there is much that they agree on. For instance, I bet they both would agree that we would be more healthy if we ate like our great grandparents did, and that traditional cuisines lead to healthier people than modern processed diets. They both see the large amount of processed carbohydrates like high fructose corn syrup as harmful to those that eat it. Furthermore, Taubes goes to great lengths to establish that cutting carbs to lose weight is not a late 20th century fad. It’s the accumulated wisdom of doctors and patients going back at least two centuries, precisely the kind of cultural wisdom that Pollan so admires in traditional cuisines.

Pollan goes on to dismiss orthodox attempts to study food and nutrition:

So every few decades some new scientific research comes along to challenge the prevailing nutritional orthodoxy; some nutrient that Americans have been happily chomping for decades is suddenly found to be lethal; another nutrient is elevated to the status of health food; the industry throws its weight behind it; and the American way of dietary life undergoes yet another revolution.

This is precisely what happened 30-40 years ago according to Taubes. It’s one of the sources of outrage in his book. Based on rather thin scientific evidence, the hypothesis that saturated fats were the great evil in the American diet became the orthodox, throwing aside the collective wisdom of decades of clinicians who would tell their patients exactly the opposite and see them lose weight.

I think Pollan’s quarrel with Taubes may have more to with personality and approach than substance. It also seems that I’m hardly the first person to see the harmony between Pollan and Taubes. Maybe even Pollan himself realized that he had more to agree with Taubes. After reading this blog post, I might need to read his new book too.

So I was delighted to find that Pollan and Taubes are on the same wave length. The person who exposed the whole fat paradigm as a historical disaster “is a science journalist named Gary Taubes, who for the last decade has been blowing the whistle on the science behind the low-fat campaign,” Pollan writes. “In a devastating series of articles and an important new book called Good Calories, Bad Calories, Taubes has all but demolished the whole lipid hypothesis, demonstrating just how little scientific backing it had from the very beginning.”

A month or two later, frustrated with my inability to lose weight on my own, I looked up Seth’s scientific paper online about what makes food fattening and tried his method. It worked! I started losing weight again.

After a few weeks of sipping sugar water and drinking olive oil, I spent a week in New York for the Del Close Marathon. I was explaining it to a friend and he responded, “Oh you mean the Shangri-la Diet.”

The next day I bought the book and found Seth’s website.

As the months went by and I lost more and more weight, my former prejudice against fats in the diet had been seriously challenged. I was losing weight not by restricting fats (like I had in my 20s), but by adding fats to my diet.

Then I read an interview of Gary Taubes on Seth’s blog. I started reading more about low carb diets.

Finally when I got my Kindle, I read Good Calories, Bad Calories by Taubes. After reading it, I switched to a low carb diet of mostly meat, cheese, eggs and green leafy vegetables, something I had already started to do gradually.

In a discussion on low carb diets on Seth’s website, I saw a reference to The Omnivore’s Dilemma, by Michale Pollan. I downloaded it to my Kindle. I haven’t finished it, but I’m sure it’s going to have a profound affect on how I eat in the future, along with Taubes book. (Pollan chides Taubes in his introduction without mentioning him by name over his 2002 article, “What If It’s All a Big Fat Lie?,” because of what is said about bread. However, their books could easily go hand and hand. For instance, high fructose corn syrup is one of the villains in both books.)

From there, I found eatwild.com, a website with a listing of grass fed beef farms across the United States. Next Saturday, I hope to visit a farm near Springfield. And in June, I’ll be heading to the local farmer’s market in Peoria.

I certainly would not have thought that a book on economics would have so radically changed my eating habits and be responsible for me losing over 50 lbs in little over a year, but in a way, it has. One thing leads to another to another to another.

The book is dense, bringing together a huge number of scientific studies that date back to the beginning of the the 20th century. His goal seems to be to overwhelm the reader with evidence that many of the assumptions about diet, obesity and disease are wrong. He isn’t content to give you one or two examples of studies that suggest that carbohydrates are the primary factor behind obesity, diabetes, heart disease, cancer and a range of other modern illnesses that were rare before the 20th century. He piles it on, determined to make sure that someone can’t read his book and dismiss it as “some fad diet book.” If you say he is wrong, you better bring your citations with you.

I’ve enjoyed the ride, but I wonder how many readers get bogged down and don’t finish it, or don’t care so much about the reams of evidence that Taubes has compiled and want to skip to his conclusions. One passage near the end that jumped out at me as something that people need to know:

By the mid-1960s, four facts had been established beyond reasonable doubt: (1) carbohydrates are singularly responsible for prompting insulin secretion; (2) insulin is singularly responsible for inducing fat accumulation; (3) dietary carbohydrates are required for excess fat accumulation; and (4) both Type 2 diabetics and the obese have abnormally elevated levels of circulating insulin and a “greatly exaggerated” insulin response to carbohydrates in the diet

He has done a good job. His book is why I’m trying a low carb diet. I’m taking a gamble, even going directly against my doctor’s orders to lower my already low cholesterol, hoping that would help my ailing gallbladder (after all, my first three gallbladder attacks all came after large restaurant meals full of carbs).

I’m going to give it a try. I’ll see how I feel in a month. Will I feel better? Will I lose the 20 pounds I have left to lose? Will I have another gallbladder attack? I’ll let you know.

UPDATE: I blogged too soon. I’m now in the epilogue and he has 7 main points he was trying to communicate in the book. I’ll add them here later.

I am probably too easily swayed by these kinds of books, ones which set out to prove that conventional wisdom is dead wrong. Years ago, before the Oliver Stone movie, I read way too many books about the Kennedy assassination and was convinced that elements of the CIA were involved (something I still find credible). Later I read a book about how the primary hypothesis about AIDS may well be wrong, and was, for a time, convinced. So I know that I need to temper my enthusiasm for this book.

In the last few years, I’ve had a couple of warning signs about my health. Minor problems, but they were the canaries in the coal mine, warning me that if I didn’t get my act together I’m heading towards obesity, heart disease maybe even diabetes. The first warning sign was my sleep apnea, which was diagnosed in 2003 and seemed to coincide with a gain in weight the year before. Then last year, it was my gallbladder. In my video journal, I talked about “food poisoning” in Scottsdale. After a few big restaurant meals, I experienced some rather nasty abdominal pains and nausea.

Finally after a particularly bad episode over Thanksgiving, I went to see the doctor. After an ultrasound, it was confirmed. My gallbladder was full of sludge which it was having trouble expelling into my digestive tract. Although I had no stones, I might eventually. This was not good. It could require surgery. However, he suggested we try another route. He gave me some medicine and told me to cut back on saturated fats and to exercise. We would meet back in a few months and see how I’m doing.

So that brings me to Taubes book. One of Taubes major points in his book is that fats (even saturated fats) are unlikely to be the kind of poison that we are led to believe. That maybe we don’t all need to be obsessed with cholesterol. And that the scientific evidence points towards refined carbohydrates like sugars, white flour and white rice as the main dietary factor in everything from heart disease to appendicitis. He has made a great argument so far that sugar and other refined carbohydrates are unambiguously bad for us. I’m not so convinced by his ambivalence towards saturated fat though.

I have been doing my own research, trying to find scientific studies published online that contain support for these ideas. Today I found this, a study from 90s which tried to identify risks for gallstones. This study did confirm that sugar likely plays a part in gallbladder problems:

A positive association between intake of refined sugars and risk of gallstone formation has been reported consistently. However, a diet rich in refined sugars is usually poor in complex carbohydrates and fiber; therefore, whether refined sugars and fiber have independent effects on gallstone risk remains to be fully clarified. Our findings suggest that refined sugars and fiber from cellulose may have independent effects.

Well what about fats?

The potential etiologic role of other fats has not been investigated thoroughly. Our study found no evidence of a link between polyunsaturated fats and risk of gallstone formation. The limited available evidence on the relation between these fats and gallstone formation is conflicting. The link between monounsaturated fats and risk of gallstone formation has not been investigated. Monounsaturated fats, as all fats, have been shown to have a powerful effect on the rate of gallbladder emptying. However, the effect is different from that of saturated fats because monounsaturated fats increase the ratio of HDL to LDL cholesterol and therefore may have important protective effects against gallstone formation.

Still the news was not so good for saturated fats, especially for men and saturated fats:

Of potential importance was the observed significant interaction in our study between sex and saturated fat intakes with regard to gallstone formation, indicating that the association between saturated fat intake and gallstone formation may be weaker in women than in men and that men in the highest quartile of saturated fat intake may be at greater risk than women.

You can see in this chart that the associated risk of saturated fat is much more significant for men.

The last week, I’ve shifted my diet towards an Atkins style diet. I’m no longer eating the ‘fat free’ versions of foods like yogurt and cottage cheese. I’m eating more meat (fish, turkey and chicken) and I even had a steak the other night. The main thing I’m restricting is sugar and other carbs. My doctor would not be pleased, but it has broken through my weight plateau. I am losing again. Now, I’ve got to pull it back. I don’t want to aggravate my gallbladder again. It has been getting better the last couple of months, and I can’t afford to be sick right now.