You’ll note that people on these diets, including the strictest low-fat high-carb diets, significantly reduce their total amount of carbohydrates (therefore reducing the amount of insulin they secrete). The reason, I believe, most of these diets have some efficacy – at least in the short-term – is that they all reduce sugar and highly refined carbohydrate intake, either explicitly or implicitly. Someone made a great point in response to my post on why fruits and vegetables are not actually necessary for good health. I know a lot of people who eat this way and, I’ve got to say, these folks do not eat a lot of sugar or a lot of highly refined carbohydrates.
While I do plan to write an entire post on this topic of what one can and cannot conclude from an experiment, I do want to at least make the point here: The biggest single problem with nutrition “science” is that cause and effect are rarely linked correctly.
I am, to be clear, not implying this is the case for this trial, but I want you to understand why it’s important to read papers fully. This trial, The Lifestyle Heart Trial, prospectively randomized a group of not-so-healthy patients into two treatment groups: the control group and the experimental group (or what we’d call the “treatment” or “intervention” group).
First off, and perhaps most importantly from the standpoint of drawing conclusions, compliance was reported to be excellent and the differences between the groups were statistically significant on every metric, except total average caloric intake. Take a moment to look over the rest of the table (or just skip reading it since I’m going to keep talking about it anyway). Though not shown in this table, the experimental group also reported less chest pain severity (though chest pain frequency and duration were not statistically different). Let’s take a leap of faith and hypothesize that the dietary intervention (rather than, say, the social support) had the greatest impact on the measured parameters in the subjects. It’s certainly the most likely factor in my mind. But what, exactly, can I conclude?
People don’t like to be hungry, and if they are reducing their caloric intake by reducing fat intake, they seldom find themselves satiated.
Semi-starvation reduces basal metabolic rate, so your body actually adjusts to the “new” norm and slows down its rate of mobilizing internal fat stores. I argue that reduction of fat intake has nothing to do with it and that the reduction of total calories has a transient effect. It’s *really* tough to study this stuff properly, especially compared to studying things blood pressure lowering pills, which are complex in their own right, but MUCH easier to control in a study. A nutrition department of a university accepts funds from a company that makes confectionery.
Do you think the Academy’s supporters want to hear that if you eliminate their products you will no longer need to rely on the products provided by the biggest supporters of the Diabetic Association? Pretty much solely because of their report, Suzuki was forced to eventually withdraw the Samurai from production in the US although they later won the lawsuit that was filed as a result of the forged report by showing videos from the actual testing of the car conducted by CR. Ironically, the fact that CR had to admit it was faked somehow wasn’t plastered all over their magazines and the front pages of a bunch of newspapers.
At that point, everything they publish became suspect and may as well line a birdcage somewhere.
Peter, I have a coworker who has recently lost 80lbs over the course of a year on weight watchers.
Looking forward to your next post, and of course people's comments for the current one! I will discuss all of this in great detail, hopefully in the coming month, when I do a post on PUFA (polyunsaturated fatty acids). Anyway, it’s nice to discover someone who takes the Taubes viewpoint on things, and also takes the time to actually post online about it with some frequency, so thanks!
Oh absolutely, I was mostly referring to the fact that most of the excess carbs we eat are converted to palmitic acid, which is a SFA. There was an (1) average protein, low fat group (65% CHO), (2) High protein, low fat group , (3) Average protein, high fat, and (4) high protein, high fat (35% CHO).
Thanks very much, Bob, both for the kind comments and for sharing the other data with folks. This section provides all sorts of references for you to use while you are beginning your journey on the low FODMAP diet. But there are SO many other helpful resources in this section for dietitians or individuals that want to learn more about the low FODMAP diet. Just hover over the FODMAP Basics tab to find great information that will help you navigate the low FODMAP diet.
Probiotic supplements WITH chicory root or inulin would be a potential issue not probiotics in general. Thanks Kate, So foods from the fruit group and sweeteners that are “safe” should be limited to 1 serving per meal or sitting? Fruits should be limited to one serving per sitting or meal OR spaced out at least 2-3 hours. Samantha, Yes soy lecithin should not be an issue on the low FODMAP diet to the best of my knowledge.
I also had a couple of strawberries today that upset my stomach but I think they were overripe. That said, many of the successes (at least weight-wise, though hopefully by now you realize there is much more to health than just body composition) of popular diets can be explained by a few simple observations.
You can argue that those who are overweight probably consume an even greater amount of carbohydrates.
Even the Ornish diet, which is the most restrictive diet with respect to fat and most liberal with respect to carbohydrates, still reduces carbohydrate intake by about 40% from what people were likely eating pre-diet. No one on the Ornish Diet or Jenny Craig Diet is eating candy bars and potato chips, at least not if they are adhering to it. The point was, essentially, that telling people to eat 5-6 servings per day of fruits and vegetables can hopefully drive a beneficial substitution effect. I have no intention of engaging in a battle with proponents of plant-based eating or no-saturated-fat diets. Stated another way, it’s one thing to observe an outcome, but it’s quite another to conclude the actual cause of that outcome. In other words, for every intended difference between the groups a difference existed, except that on average they ate the same number of calories (though obviously from very different sources), which was not intended to be different as both groups were permitted to eat ad libitum – meaning as much as they wanted. Ornish’s study? I think the reduction in sugar and simple carbohydrates played the largest single role in the improvements experienced by the experimental group, but I can’t prove it from this study any more than one can prove a low-fat vegetarian diet is the “best” diet. We can only conclude that it’s better than eating Twinkies and potato chips which, admittedly, is a good thing to know. And, the majority of the benefit folks receive comes from the reduction of sugars and highly refined carbohydrates. Case in point…they recently reported that olive oil is not good for you because it does not contain omega 6. 3, has a good point about some plans (including WW) having the advantage of group support, which I think is a very major confounder. It is wonderful to watch these people glow once they have found some sort of solution to their weight problem.
One of my favorite things to say to people who are scared of saturated fat is that even on an entirely plant based diet, (ala Ornish Diet), if they are restricting their caloric intake, their bodies will be running on the saturated (animal) fat that they have stored on themselves.
For example the degree of unsaturated fatty acids in our membrane bilayer probably plays a role in our insulin sensitivity, just as one example. But most importantly, please work with a dietitian knowledgeable in the low FODMAP diet to ensure you are following it correctly and meeting your nutritional needs.
I want to make my own yogurt as its cheaper than buying the expensive low lactose probiotic yogurts and the packet stuff is gluten free too and still doesn’t have additives and gelatin and all the other crap yogurt seems to have added to it! But for the purpose of simplicity, let’s assume even the folks who go on these diets are consuming the national average of approximately 450 grams of carbohydrate per day (in compliance with governmental recommendations, as a percent of overall intake). If you tell someone who eats Twinkies, potato chips, and candy bars all day to eat more fruit (and they do), you’ve almost guaranteed an improvement in their health if they eat bananas and apples instead of the aforementioned junk food. I’m reasonably confident that the proponents of these diets are good people who really want to help others and have nothing but the best intentions. Ornish was the principle investigator on a trial published in the journal The Lancet in 1990. In other words, there were not enough subjects in the study to determine a difference in these “hard” outcomes, so we can’t make a conclusion about such events, only the changes in “soft” outcomes. Good science, bad interpretationGravity and insulin: the dynamic duoIf low carb eating is so effective, why are people still overweight?
His clinical interests are nutrition, lipidology, endocrinology, and a few other cool things.
Eg, the criticism of the Ornish Lifestyle Heart Trial is excellent (and I LOVED the kitten-stroking quip), and really could and should have stood alone. After short diologue with her on the particulars of her daily intake I quickly realized her consumption of carbohydrate was significantly reduced and eliminated almost all fructose. I have been following the FODMAP for about a month but we have a freezer full from our garden and was wondering if they were ok to eat? I only have a small amount of yogurt with my breakfast but its still a good source of morning protein, calcium needs and those wonderful probiotics that help our tummies too!
The outline is tailored to my recommended 1,200-1,399 calorie range, so if your calorie count is different, yours will look slightly different.Monday through Friday, I did two yellow containers at dinner (meal 5).
Popularity, of course, was determined by a number of factors, including compliance with current government recommendations (sorry Atkins), number of people who have tried the diet, and reported success on the diets.
That doesn’t mean bananas and apples are “good for you” – it just means they are less “bad for you.” Here’s the kicker, though. But that doesn’t mean we can or should overlook the errors being made in drawing their conclusions. I’m not discounting soft outcomes, only pointing out the distinction for folks not familiar with them. They never factor in that the chicken was breaded or that when someone ate steak or fish they had a large amount of bread of potatoes along with it.
The M stands for monosaccharide or the sugar, fructose, when present in foods in excess of the glucose content–found in some apples, pears, watermelon, honey and agave syrup! My green container was also a double for lunch.Click here to download an excel template for making your own meal plan. We’re led to believe that the reason such folks get leaner and more healthy is because they are eating more fruits or more vegetables or more grains or more [fill-in-the-blank], rather than because they eliminated the most egregious offenders from their diet. Ornish personally, and I can only assume that he is a profoundly caring physician who has dedicated his life to helping people live better lives.
But as always, I STRONGLY encourage folks with access (or folks who are willing to purchase it) to read the paper in its entirety.
For people who don’t want to read the study completely, or who may not have much experience reading clinical papers, I want to devote some time to digging into this paper.
The end conclusion is the whole thing must be bad and therefore needs to be reduced or outright expunged from the diet. I recall hearing Gary talking about his discussion with a participant from the Biggest loser on Larry King and the rapant weight gain after the show. You might notice that for some food groups, I have less foods listed than the number of portion cups allowed for the day.
It’s hard to tell if this change was statistically significant by inspection, so you glance at the p-value which tells you it was not. That is one big difference I’ve noticed between studies cited by writers who want to condemn the entire diet consumed by Americans vs those who look at it with a more in depth eye and realize that certain components are the problem not the whole diet across the board. Why did the people in the China Study who ate more plants do better than those who ate more animals (assuming they did)? Well, for starters, reading abstracts, hearing CNN headlines, or reading about studies in the NY Times doesn’t actually give you enough information to really understand if the results are applicable to you.
It really is the best way to stay on track with your diet (and ultimately, spend less money too!)For the 21 Day Fix diet, you should be eating mostly whole foods.
Parenthetically, if you actually want the answer to this question, beyond my peripheral address, below, please read Denise Minger’s categorically brilliant analysis of the study.
Beyond this reason, and let me be uncharacteristically blunt, just because a study is published in a medical journal it does not imply that is worth the paper it is printed on. This means the majority of your grocery shopping will be done around the outer perimeter of the grocery store, which is always where all the good stuff is hidden.I used this grocery list for the 21 Day Fix by printing it out and making a note in the margins of how many servings of each container I needed for the week. Steve Rosenberg, once told me that a great number of published studies are never again cited (I forget the exact number, but it was staggering, over 50%). Translation: whatever they published was of such little value that no one ever made reference to it again. The thing is, it is possible to eliminate wheat and still eat way too many carbs (can we say ice cream?). Studies show that starting your day off with a nutritious breakfast is one of the biggest factors of success not only in your diet, but in your life in general.It also makes filling a red container super easy. I’m now happily in ketosis, and the best part is, I know the WHY of weight loss now, how totally liberating and hope giving.
It is about being healthy on the inside AND outside.481 Comments Kelly July 5, 2014 Reply Can you substitute Shakeology with just normal protein powder?
In the comment, it seemed as though the person felt like if they drank a shake they would get amazing results, so I replied “Whole foods are always going to be best. I like to describe Shakeology as the missing link that fills in nutrtional gaps, but it is never going to make up for a poor diet”.
A lot of people think shakes or pills can make or break results, I don’t feel this way, in the post I say that the shake is not a requirement. I never say anywhere that the shake is the best option, I said whole foods are the best investment. It is hard for me to have a highly varied diet, I have to meal prep most of my foods, I’m just to busy and I wind up eating a lot of the same foods. I would not spend money on a shake that contained these ingredients no matter the price or would I recommend others to.
Bethany Naomi February 14, 2015 Hi Bethany, I am in the same boat as Kelly in which I can not afford the shakes AND the fix .
And if you aren’t able to purchase the shakes, just make sure to fill its place with a healthy lean protein.
Bethany Jamie April 1, 2015 Reply Actually I believe Shakeology is the best out there and nothing else can compare to it. Thanks Carol Bethany Lyn March 2, 2015 Reply Hi Carol, Unfortunately, you really need fresh or frozen fruit. Canned fruit has nearly no nurtitional value as the canning process destroys most of the nutrients. Bethany Mary March 24, 2015 Reply Carol, I just wanted to add that anything you do is better than doing nothing. They might have a city program like Good Food Box Program that offers delivery of fruits & vegetables, weekly, bi-weekly or monthly.
The people I see that get the best results are those who follow the diet as is and push themselves in the workouts. Bethany Lelayna August 22, 2015 Reply Hi Carol, I just wanted to let you know that stores like Shop Rite and Stop & Stop offer delivery programs for people who cannot get out to the grocery store.
You would also count any other foods that you add with their corresponding colored containers.
Also will using lactose free products (yogurt(sadly there is not a lactose free greek yogurt. I know there is a coconut greek style and it is NOT good at all) and milk) make a difference?
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