How? It all starts with looking at nutrition from a much different angle than you’re probably used to hearing about.
There are several layers to this and, frankly, there are some things we can’t fully explain – I’ll always acknowledge this. Take a look again at the figure below, which shows you how many calories folks are consuming on each diet and, more importantly, where those calories come from. 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.
The New Year has arrived and you are more motivated then ever to start your new diet and exercise plan!
While many new dieters have good intentions, the truth is that most diet plans just don’t work. The reason these diets, and many others don’t work is because most, if not all, restrict certain foods or food groups or they require following a strict set of diet rules that cannot and should not be followed for very long. Diets can also cause participants to regain their lost weight and sometimes end up at a heavier weight then where they started. If you are frustrated with dieting or you eventually become discouraged with the diet you are currently on, remember that 90-95% of dieters regain their lost weight and that you are not alone (1). About the authorSarah RokuskiSarah graduated from Madonna University (Livonia, MI) in 2011 with a Bachelor’s of Science in Dietetics, where she had the privilege of playing 4 years of collegiate soccer. 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. You waited until the first of the year so you could eat all of your favorite holiday foods with no remorse.
Think for a moment just how many diet plans or programs that are on the market that promise weight loss and improved health.
Some may require that you eat prepackaged foods or meal replacements, which we all know cannot be done for a lifetime.
This is because our body adapts to being underfed and our metabolism naturally slows down to conserve the limited amount of energy we are consuming. My approach to counseling clients for weight loss is the concept that “all foods fit.” Foods from all food groups (including sweets and fried foods) can fit into a weight loss plan.
After finishing her degree, she completed her dietetic internship at Michigan State University in 2012 and passed the test to become a Registered Dietitian shortly after.
With that in mind there are certain diets that work better at keeping the weight off than others. 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. No more sweets or fried foods, limit carbohydrates, cut dairy, eat more fruits and veggies and of coarse…exercise every day! Now think for a moment of the people you know (or even yourself!) who have stuck to these plans for a significant amount of time and who have kept the weight they have lost off. Others advise that you limit your exercise due to the dangerously low amount of calories allowed per day.
And since muscle burns calories, if and when our muscles start depleting our metabolism will slow down even more to prevent starvation. The key to losing weight on this approach is being mindful of how you feel before, during, and after eating. Many diets focus on drugs and a lack of calories which can’t be sustained over the long haul. 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. Eating mindfully means recognizing the feeling of hunger and recognizing the feeling of satiety. We’re after pure fat loss, something that can only be done if we raise our RMR (resting metabolic rate) long enough throughout each and every day. This is done through proper exercise as we’ve already discovered, and through proper eating. 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. Eating when you’re hungry, stopping when you’re satisfied (not stuffed). This doesn’t mean you can eat doughnuts and French fries at every meal until you are satisfied!
It cannot be done, however, when following 99% of the popular fad or crash diet plans out there. 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. 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.
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. The Herbalife Diet: The Herbalife Diet is an easy but costly diet mainly consisting of supplements and one well balanced meal a day. 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%). It is a diet whose goal is profit but people can achieve fairly good results on it, except that it may come at an expense to their health.
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?). Some of the Herbalife supplements contain sida cordifolia, which is part of the ephedrine alkaloids family. 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.
Diets like these have one thing in common: they are high in proteins and fats and low in carbohydrates. The Zone Diet: While most of the research conducted on the zone diet has shown positive results in the first 6 months, more research needs to be conducted after that initial 6-month period. Comparing the zone diet with a balanced diet of high protein, high fibre, lots of fruit and vegetables and exercise I believe the latter is the more healthy route.
The Medifast Diet: The medifast diet is a low fat, low calorie mixture of balanced foods and appetite suppressors which are in special easy to eat shakes, bars, puddings, chilis, oatmeals and hot cocoa from the Medifast Diet Company.
The appetite suppressor used is ‘Super Citrimax’ which comes from a native Southeast Asian plant, “Garcinia Cambogia”. Thus far it has been shown to be a safe appetite suppressor; but most of the studies have been performed with rats.
The diet should only be followed by the direct supervision of a medical doctor to monitor your weight loss and diet.
6.The Sonoma diet is one which attempts to control portion sizes, limit caloric intake and encourage a fondness for cooking and an appreciation of food. It is not an innovative approach to weight loss but there are some good principles and recommended foods involved. It is not for those who do not enjoy spending time in the kitchen or at the grocery stores. The Best Life Diet The Best of Life Diet was created by an exercise physiologist, Bob Greene, and has been made famous by Oprah. Oprah has definitely pulled out all the stops to make Bob a celebrity by showing ‘before’ photographs of overweight people, listening to their testimonials and then unveiling the ‘new’ them with their slimmer bodies. At first glance, the Best Life Diet seems very logical: finding out what your own personal barriers are to keeping up with an exercise and nutritional program and overcoming them.
Mediterranean Diet We’ve all heard the saying “When in Rome, do as the Romans do.” New studies reveal that we shouldn’t just do as they do, we should eat as they do too!
Following a Mediterranean-type diet—a blend of traditional cuisines of the countries that border the Mediterranean Sea—has been found to provide many health benefits, such as reducing the risk for heart disease and cancer.
The Dash Diet The DASH Diet stands for Dietary Approaches to Stop Hypertension and it calls for a reduction in the amount of sodium consumed in a daily diet.
Recent studies have shown that this diet can lower the blood pressure of individuals and since this diet is backed by the National Institutes of Health it would suggest that these claims are valid. Abs Diet The Abs Diet is a diet which focuses on their slogan : ABS DIET POWER which stands for almonds, beans, spinach, dairy, instant oatmeal, eggs, turkey, peanut butter, olive oil, whole grains, extra protein powder and raspberries. The diet is actually a great one as it is more of a lifestyle change rather than a 2-3 month focus on changing caloric intake. Focusing on the 6 rules to nutrition is the only way to keep the weight off and maintain a low percentage of bodyfat. Key Things to Remember with Dieting Every meal should contain vegetables, a source of protein and fibre. Rod is successful author and one of the lead developers of the MyFit Fitness App which made it up to number three on the Apple app store.
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