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The Obesity Epidemic — Is Medicine Scientific? 909

Posted by kdawson
from the paradigm-takeover dept.
An anonymous reader writes "An award-winning science author, Gary Taubes, has written a book that pans the medical community's treatment of the obesity epidemic. What is interesting is that it looks like the medical community is behaving in a very unscientific manner. Taubes points out that the current medical orthodoxy — that consuming fat makes you fat and exercise makes you thin — has no basis in research. In fact, all the available research points in quite another, and more traditional, direction. Here's the (excellent) podcast of an interview with Taubes on CBC's 'Quirks and Quarks.' So, has medicine become a non-science? Is it mostly a non-science? Somewhat?"
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The Obesity Epidemic — Is Medicine Scientific?

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  • Taubes is a quack. (Score:5, Informative)

    by morgan_greywolf (835522) on Tuesday November 20, 2007 @02:10PM (#21424397) Homepage Journal
    From personal, scientifically-measurable experience, I can tell you that gaining and losing weight isn't a matter of 'good calories' or 'bad calories'. It's a matter of calories. Burn more calories than you consume over a period of time, and you will lose weight. Burn fewer calories than you consume over a period of time, and you will gain weight. Yes, it's that simple. I suggest you all put down this claptrap, and read The Hacker's Diet [fourmilab.ch] by former AutoCAD developer and AutoDesk VP John Walker. It's done wonders for me.
  • Re:Ugh... (Score:3, Informative)

    by mocm (141920) on Tuesday November 20, 2007 @02:13PM (#21424449) Homepage
    But insulin makes you hungry and eating carbs especially sugar makes you release insulin.
  • by spaceyhackerlady (462530) on Tuesday November 20, 2007 @02:21PM (#21424617)

    Calories in greater than calories out => gain weight.
    Calories in less than calories out => lose weight.

    At least, that's how I thought it worked. I decided late last year, as a new years resolution, to start Operation Flab. My weight had crept up, ours is not a physically active field to begin with, and middle age (I'm 46) didn't help.

    I've made some healthier choices in my diet, cut back on portions, exercise vigorously 3 times a week, and have lost significant weight. I feel 100% better. There is no magic: I didn't gain it overnight, and I'm not going to lose it overnight either. Heroics never work, because too great a lifestyle/diet change will never last.

    I didn't bother with a health club membership or anything like that. My sole expense was an MP3 player.

    ...laura

  • Re:Ugh... (Score:5, Informative)

    by tgd (2822) on Tuesday November 20, 2007 @02:22PM (#21424629)
    This thread is ripe for turning into a flame-fest, but you may want to do at least some casual reading on what insulin is and the processes the body goes through to process fats, proteins and sugars. There's a thousand variables involved in how the body processes raw materials it takes in and what it does with the materials it creates from them. No combination of those will result in your blanket statement.
  • by ChronosWS (706209) on Tuesday November 20, 2007 @02:22PM (#21424633)
    I agree. From TFA:

    According to his research, eating fatty foods doesn't lead to heart disease, cholesterol levels aren't something to worry about, and exercise doesn't help you lose weight.

    This is stupid. If for no other reason, I think it would violate some thermodynamic laws to say exercise does not contribute to lowering your weight. For the same quantity of input energy (vis-a-vis food being digested) and a varying amount of output energy (exercise above and beyond the resting energy use of the body), you will have a net gain or loss of energy. We retain energy via various biochemical means, all of which involve putting it into cells and storing them somewhere. This results in more weight. If we utilize more energy than we take in, that energy has to come from somewhere, and that somewhere is those same cells, which are consumed. Thus we lose weight.

    The exact process may be more complicated, but I don't think the energy equations are.

  • by discontinuity (792010) on Tuesday November 20, 2007 @02:39PM (#21424969)

    Here's a link to an article by Taubes that originally ran in 2002, and sounds like it was the seed for this book.

    "What if It's All Been a Big Fat Lie?"
    http://query.nytimes.com/gst/fullpage.html?res=9F04E2D61F3EF934A35754C0A9649C8B63

    It's long for a NYTimes article, but it's an interesting read. I'm sure the book updates much of the data.

  • by Budenny (888916) on Tuesday November 20, 2007 @02:40PM (#21424977)
    Probably not whole grains. That whole grains are better for you is a myth. No cultures with a tradition of long lived good health eat wheat or rice bran - or any non soluble bran. They feed it to animals and eat the animals. Also, such cultures treat soy with great wariness and respect. This too they feed to animals, unless fermented and aged, and even then they eat it in very small quantities.

    The reason is partly phytates, and partly irritation of the bowels, and partly plant estrogens. Wheat bran is non soluble and so is an irritant to the bowel. But because of phytates, it prevents the absorption of minerals. The plant hormones in soy are just plain bad for you. Brown rice is lower in delivered nutrition than polished. It is not how much nutrients a product contains. Its how much it delivers to you when you eat it.

    We are embarked on a huge uncontrolled experiment in nutrition, and one undertaken without the slightest evidence in its favor. We started out with a diet which obtained about one third of its calories from saturated fats, about one third from protein, and one third from partly refined carbs, generally all eaten together with a variety of vegetables. Curiously enough, heart disease was rather low. I say partially refined - the bread before the invention of modern industrial baking was sourdough long fermented and slow risen, and was made from high extraction but not whole wheat flour. It was chewy, low GI and very digestible. These foods were eaten slowly in sociable meals. They were not wolfed down on the way from one place to another, or held in one hand while typing with the other.

    We moved from this to a diet which substituted refined and often hydrogenated vegetable oil, high in polyunsaturates, for the animal fat. We then added to this recently the most industrialized kind of processed food there is: soy 'milk' and meal of various kinds. This too raised the proportion of vegetable oil in the diet. We then had a campaign to lower total fat consumption, which led us to a high carbohydrate diet, but high in those same vegetable oils.

    Our last state was worse than our first. Nothing in our evolutionary history has prepared us for such a diet. Its consequences are continual hunger, over eating, endless snacks, obesity, and degenerative diseases.

    What do we need to do? Go back to the traditional comfortably off working family diets of about 1900. Meat and two vegetables, high extraction sourdough bread in liberal quantities, oatmeal, full fat milk, butter, cheese, fish in moderation. Minimal amounts of vegetable oil, minimal amounts of sweets. Pastry made, if one has to eat pastry, with suet. No snacks.

    Women are the especial victims of our current dietary mania and the diet industry. If we could do one thing to improve the health of society, it would be to abolish dieting, dieting books, and conversations about dieting and one's weight. Couple that with only eating at mealtimes, cooking only real food from scratch, using ingredients available in 1910, and we would all be infinitely better off.

    Read "Nourishing Traditions." It will change your life.
  • by benj_e (614605) <walt DOT eis AT gmail DOT com> on Tuesday November 20, 2007 @02:48PM (#21425139) Journal

    He's not alone in his conclusions that the diet being feed to us (pardon the pun) is wrong. There was an article in the NY Times in October stating this as well. http://www.nytimes.com/2007/10/09/science/09tier.html?ei=5124&en=67642ef2330f51af&ex=1349668800&partner=permalink&exprod=permalink&pagewanted=all [nytimes.com]

    I read Men's Health magazine and they have presented a number of articles on the topic

  • by tfoss (203340) on Tuesday November 20, 2007 @02:50PM (#21425183)
    There was a spat [reason.com] in Reason years ago about exactly this.

    -Ted
  • by Grym (725290) * on Tuesday November 20, 2007 @02:56PM (#21425301)

    Medicine as it is is normally taught and used as treatment has never been science. Doctors are not taught real rigorous scientific method, and many don't really understand what science is really about. Just because one may think they know about how something works doesn't mean that it is scientifically proven. It just makes me angry that some doctors spout that they are people of science when they are never really trained in the scientific method or really understand what that means.

    Speaking as someone who is currently in medical school, allow me to put forth the falsifiable claim that you don't know what you're talking about.

    The vast majority of medical school applicants come with degrees in scientific fields (usually Biology or Chemistry). To be considered for admission they must to do well on the MCAT, a difficult test which stresses scientific knowledge and reasoning abilities. Once in, they are drilled for the first two years with what's called "basic" sciences, where they are expected to gain an in-depth understanding of a wide breadth of information all directly based upon accepted scientific literature. Mastery of this information is tested via the USMLE Step 1--again, another very difficult test.

    So, please, enlighten us as to where you're getting this idea that modern medicine is taught unscientifically, because as far as I can tell your notion is not based in reality.

    The funny thing is, a common argument that I hear on a frequent basis is that because medical school is taught by PhDs and not MDs, it is focused too much on scientific details and not based on clinical reality. There is no point in training a family doctor to be able to draw out the TCA cycle or recite G-protein signaling transduction pathways as such information has no impact on treatment or diagnosis.

    -Grym

  • by UserChrisCanter4 (464072) * on Tuesday November 20, 2007 @02:58PM (#21425349)
    Medicine is a non-science? Wow. I whole heartedly invite anyone who believes that line to go take a gander at any clinical trial design for any drug, device, or procedure.

    As for the book, I haven't read it but I did read both the Amazon and boingboing summary and listen to the podcast. Taubes main points seem to be:

    1. Replacing fat with starch is a bad idea
    2. High fat diets don't have as much of an impact on cholesterol counts as we believe and that triglyceride levels are a better indicator of heart disease risks
    3. Exercise isn't as good an idea for weight loss as we might think. (Because people might consume more calories afterward than they expended)
    4. Atkins is a great diet plan.

    Look, you don't sell a diet book or any book titled, "Stop eating so much, jackass!" What does sell well are systems that help us accomplish that goal and books that tell us why what we're doing is wrong.

    Put simply, excess calories make you fat; it's basic thermodynamics and can be (and has been) proven with the simplest of experiments. It is easier to eat excess calories in a diet high in carbohydrates for a number of reasons. For many people, cutting those excess carbohydrates needs to happen because they aren't eating a proper diet. I've seen studies that indicate that the average American eats 3800 Calories in a day, and I'm sorry, but most of us aren't doing that with baked potatoes, whole-grain bread, or pasta - we're getting there with coke, chocolate, "coffee" drinks that might once have contained a coffee bean, and candy.

    If you need a book to tell you to remove carbs before you'll start watching how much you eat, then I hope you buy that book now. If you need to be on a partcular diet scheme to force you to check the caloric value on a box of pre-packaged food, then I hope you start that diet now. If you want to build a strawman based on decades old medical advice taken out of context of what has been the constant recommendation for a balanced diet with a quantity of food suited for your activity level, then please, write that book as long as it helps people lose weight.

    While there is some variance from person to person, a diet book that was two pages long could easily satisfy nearly everyone on earth. It would essentially say:
    1. Burn the amount of Calories that you take in.
    2. Guess what? You're probably eating way more Calories than you think you are.
    3. Don't believe us? Track what you eat everyday for a week. Yes, that includes snacks. Yes, that includes really measuring how much of a given food you ate.
    4. See, we told you you ate too much.
    5. Stop drinking your Calories, dammit! Coke doesn't fill you up at all, but it's an easy 10% of your daily intake per glass.
    6. If you sit around all day, non-stop, then you're going to need to cut back more. If you want to eat more, go get some exercise.
    7. Lather, rinse, and repeat.
    8. By the way, you'll probably start using fewer Calories as you get older. If you find this difficult to follow, start again at step one.
  • Re:Ugh... (Score:3, Informative)

    by vertinox (846076) on Tuesday November 20, 2007 @02:59PM (#21425359)
    Calories make you fat, regardless of whether they come from fat, sugars, or starches.

    It depends on your bodies reaction. If you have two men who have been without food for 4 weeks and you feed on 1000 calories of butter and the other 1000 calories of whole wheat bread, the one who ate butter will most likley die of glycemic shock.

    Although, we are talking about the opposite (of having too much food all the time) in which eating 1000 calories of butter will be processed completely different than eating 1000 calories of whole wheat bread and will process in a way that you might not get all the calories.

    Even this varies from person to person... Someone who is very inactive but digestive system is inert may not extract calories from the butter where as an active person with a better metabolism will extract more calories and burn more but have a greater amount of calories left over than the sedentary person.

    At the same time this varies from person to person depending on your genetics and of course digestive capabilities. A person with lactose intolerance may not get many calories out of drinking milk or eating ice cream just because of the bodies reaction to it doesn't process or break down the calories within the milk products. Of course anyone with lactose intolerance isn't going to be eating lots of ice cream and cheese just because they aren't going to get fat from it due to the fact it leaves the system in a fairly unpleasant way.
  • Re:Ugh... (Score:2, Informative)

    by hedwards (940851) on Tuesday November 20, 2007 @02:59PM (#21425381)
    No, just no. There is no basis for that statement in fact.

    That has been completely obliterated as a valid result with years of research. People who eat a high protein and fat diet, may lose weight or stay the same weight, but it isn't because you get free calories. It's because the body can't keep muscles on without sufficient protein, and nearly all of the protein ends up being broken down to make up for the fuel that isn't being absorbed from carbohydrates.

    The net result is an individual that has substantially lower muscle mass and substantially larger fat deposits for their weight.

    Even when people do gain more weight as a result of a high carbohydrate diet, it isn't because carbs are dangerous or bad, its because the spiking of the blood glucose levels tends to make people feel hungrier when the subsequent drop occurs than they would otherwise be. The end result being that people on a high carb diet are eating more calories than individuals on a high protein and fat diet. Some don't, but they don't typically have an issue with putting on weight.

    Carbs also are frequently found with things like water and fiber, and if one gets those two components along with the carbs, the likelihood of seeing an increased hunger is much less likely than if one is eating sugar for food.

    And so no, just no, why don't you read up on the research before suggesting things as outdated as that. As everyone that has ever taken a psych class knows, correlation is not causation. And in this case, it isn't even a very good correlation.
  • by happyemoticon (543015) on Tuesday November 20, 2007 @03:01PM (#21425397) Homepage

    the countries that start to follow the "american way of life" (fast food, sedentary life, high-calory carb snacks) tend to follow american's fatness.

    The palate in America is very sweet. Granted, I only have a few weeks in Spain to base my opinion on, but it seemed quite conclusive and corroberates with what I've heard from some family members who've traveled more than I have.

    Take a churro. In America, it's a deep-fried dough stick rolled in sugar and cinnamon. In Spain, it's a deep-fried dough stick. It's savory by our standards. You get a cup of hot chocolate, and it tastes almost like coffee. You get ham, and it's not the artificially sweetened ham we're used to, it's just a big hunk of organically-fed pig that's been sitting in a barrel of salt for a few years. Even bread in America has high fructose corn syrup in it. Now, most of the food in Spain except for the ham, seafood and churros is bordering on objectively disgusting, but everyone I saw over there is very thin.

  • by eallison (105451) on Tuesday November 20, 2007 @03:10PM (#21425561)
    I'm reading the book right now. He's not denying thermodynamics, in fact he has a whole chapter dealing with calories and the conservation of energy. The research suggests that exercise increases appetite in proportion to the number of calories burned. The body likes to stay at equilibrium. Someone who is 300lbs and holding steady is at equilibrium - just a non-optimal equilibrium. Taubes may be wrong, but if you read what he writes, he's certainly not a quack. Science writers tend not to be quacks. In general the book is incredibly well-written. It's a review of basically all the pertinent diet research over the last 100 years, and is very careful to state what is hypothesis, what has been confirmed by facts, and what is correlation vice causation.
  • Re:Ugh... (Score:5, Informative)

    by IllForgetMyNickSoonA (748496) on Tuesday November 20, 2007 @03:17PM (#21425677)
    You seem to forget a tiny inconvenient fact about predators: they don't get their fat from the local store. They have to RUN, sometimes all day, in order to get something to eat. Just buying some fat shit in Wall Mart, eating it in front of the TV, then turning in to a late-night slashdot session, for sure WON'T make you look like a Cheetah. Sure, you should train your body to get its energy from fat. However, the only way to do it is to EXERCISE, with the correct heart frequency and for a prolonged time periods (at least one hour per exercise, at least 3-4 times a week). I've been running for the past 8 months. I feel WAY better, my waist circumference has decreased significantly, my heart frequency is now around 60-65 (was: 75+), and my blood pressure went 10-15 points down. I don't go out of breath by going 2-3 floors by stairs any more. Actually, I even barely notice it. I really don't believe I'd have seen the same effect if I just started "eating like a predator" instead. I'm still over 100kg though, but I'm working on it.
  • Re:Ugh... (Score:2, Informative)

    by dirty (13560) <dirtymatt@@@gmail...com> on Tuesday November 20, 2007 @03:25PM (#21425779)
    A trans-fat is essentially an asymmetrical fat. These rarely occur in nature. They occur in processed food by partially hydrogenating unsaturated fats so that some of the carbon to carbon double bonds break into single bonds, then reform essentially rotated 180 degrees. A fully hydrogenated fat is not a trans-fat, it is a saturated fat (saturated with hydrogen). Food manufacturers love saturated fats because they're usually solid at room temperature, and extremely stable. Unsaturated fats can become saturated with other atoms like sulfur or oxygen which cause the fats to go rancid. Saturated fats have already been saturated with hydrogen so they keep for an extremely long time. I think a big push in using partially hydrogenated oils is that they are derived from plant sources and much cheaper than saturated fats from animal sources. Also, I think for a long time, "partially hydrogenated soy bean oil" sounded better than "lard". Even if the lard probably was better for you.
  • by flash4141 (849973) on Tuesday November 20, 2007 @03:27PM (#21425821) Homepage
    I have found that if I burn more calories than I eat, I lose weight (and vice versa!), no matter what kind of calories they are.

    There, fixed that for you. I believe that's what you really meant, based on the rest of your comment.
  • by happyemoticon (543015) on Tuesday November 20, 2007 @03:29PM (#21425857) Homepage

    Well, yeah. That's the basic message that the food lobby has been trying to suppress for decades because it would undermine their business. I forget the actual case, but some scientist was commissioned by the US Congress to study nutrition, and came up with "Eat less, eat less meat, and eat more vegetables." The food lobby put so much pressure on him that he had to change it to "Eat more vegetables." As a result, people started eating more, then they got more fat.

    Anyway, forgive me if this sounds like a personal attack, but if you think that the human body is that simple you're daft. Don't assume that just because you know something about physics and thermodynamics that the body is as simple as an engine or a gas lamp. Yes, people should eat less. No, all foods are not equal. I don't claim any expertise on the subject, but particularly, refined sugars cause people to be more hungry by increasing their insulin levels and making them sedentary, which makes makes it easier to overeat and makes your body store more energy. That knowledge is useful - just as useful as the knowledge that it's better to eat early in the day and avoid certain carcinogenic food dyes. It's not about the HFCS bandwagon, or the low-carb bandwagon, or fad diets, it's about understanding nutrition, which - believe it or not - is still a very murky area of science.

  • by Colin Smith (2679) on Tuesday November 20, 2007 @03:34PM (#21425931)
    I'm not splitting hairs at all. Left handed sugars for example are not metabolised, but otherwise carry identical amounts of energy as regular right handed sugars which are metabolised readily.

    That's because our bodies have specific nutritional requirements. You can push one chemical pathway by loading up with one set of energy carrying fuels and the body will respond in one way. You can push an entirely different set of pathways by using different fuels and attain a different response from the body.

    All calories are NOT equal.
  • Here's the rebuttal (Score:3, Informative)

    by rrohbeck (944847) on Tuesday November 20, 2007 @03:43PM (#21426117)
    Several scientists are furious about the way Taubes mis-quoted them and there's a lot of science that says he's simply wrong:
    http://www.reason.com/news/show/28714.html [reason.com]

    My hypothesis: He simply sold out. Book contracts, maybe consulting with Atkins & co...
  • by tom_gram (861041) on Tuesday November 20, 2007 @03:47PM (#21426179)
    I suppose the visceral reactions of many of the posts reflect emotional content of the subject, since many posters have not read the book. - I am currently through about 40 percent of the book, and have to say that the authors approach is a rather methodical examination, starting with the research history of heart disease and leading to the roles of insulin and diet. As a scientist myself, I appreciate his gradual, pedagogic style. The book documents conclusions made about diet that have been wrong and yet were widely and forcefully proclaimed correct, and which retained influence both in public opinion and in availability of research funds. The author is not a scientist per se, but is a correspondent for science, and wrote about science, examining the Cold Fusion fiasco.

    While it may be some time before we learn if his position is correct, the book is an interesting read, even just from its reviews of prior conclusions. It is certainly not a book written in the style of "buy my diet book so I can get rich".

    A review of his position can be found in a an article written in 2002: "What if It's All Been a Big Fat Lie?" http://www.frontpagemag.com/Articles/Read.aspx?GUID=%7B367127E3-4395-4DB8-90E0-AC52B2D86AF4%7D [frontpagemag.com], though it written in a firebrand style, which the book is not.

  • by Raffaello (230287) on Tuesday November 20, 2007 @03:48PM (#21426205)
    Taubes is extremely biased in his presentation of available evidence. For a scathing critique of his abuse of science see this article [reason.com].
  • by rickb928 (945187) on Tuesday November 20, 2007 @03:51PM (#21426239) Homepage Journal
    1. Muscle must be fed. Fat doesn't. Strength training builds muscle, which if nothing else consumes calories all the time, just much less at rest.

    2. What goes in must either be used or go out. If I eat 6 pounds of food a week, and manage to consume 3 pounds of that as energy, eliminating 3 pounds as indegestible waste (you know what I mean), I neither gain or lose. If I work harder, or replace fat with muscle, I need more energy. It comes from somewhere.

    3. If I eat less, I will eventually lose weight. The key word is 'eventually'.

    4. If I work more, and don't change my diet, I will eventually lose weight.

    5. The equation is, eat less, work more, and be patient. My body may well try to hoard resources in response to the apparent famine or starvation of not so much food.

    6. Keep a balanced diet. Not feeding your body nutrients, especially calcium and trace elements, is very bad.

    7. Portion control. Just do it.

    8. Keep at it. Patience.

    9. Drink plenty of water.

    10. Read items 1-9 regularly and heed.
  • by DCheesi (150068) on Tuesday November 20, 2007 @03:51PM (#21426249) Homepage

    The core of his thesis is that a cellular-level metabolic disorder caused over time by consumption of concentrated and rapidly available carbohydrates, and the insulin spikes they provoke, is the cause not only of obesity but also of type II diabetes.
    This first part is pretty well accepted these days...

    Briefly, fat cells become too good at extracting glucose from the blood and storing it. This results in cellular-level semi-starvation in other body tissues, expressed at the organismic level by eating more and exercising less.

    But Type II Diabetes occurs because the fat cells become worse at removing and storing blood glucose, leading to a rise in overall blood glucose levels. So that whole explanation is backwards.

  • Re:Ugh... (Score:5, Informative)

    by PCM2 (4486) on Tuesday November 20, 2007 @03:57PM (#21426365) Homepage

    The law of conservation of energy is sufficient to result in that blanket statement.

    Sure... provided you have no real understanding of the processes involved.

    The common, simplistic explanation of nutrition is that you consume food, which your body then breaks down, releasing the energy of chemical bonds, which your body then uses as fuel. We measure the energy released in a unit called calories.

    This description is fine, and it suffices for most day-to-day discussions of food, with one caveat: It's fiction, almost from top to bottom.

    Just for starters, when nutritionists talk about calories, they're not really talking about calories like a physicist would. They're really talking about "food calories," which I believe are equivalent to kilocalories. This may be a minor point, but it serves to illustrate that if you think nutrition science maps directly onto physics, you are wrong.

    Second, and more importantly, any good college chemistry instructor will tell you that the body does not "release energy" from the chemical bonds in food. Chemicals form bonds because the bonded compounds are the lowest-energy state for those particles. In other words, it takes energy to break a chemical bond, not the other way around. Digestion allows us to extract energy from food because we break down certain chemical bonds and cause those chemicals to form other, different bonds -- bonds with an even lower energy state than the original form. Our bodies can then take advantage of the surplus (and exactly how is still another story).

    If you understand this, it should be obvious that digestion can be a fairly complex process, not all food is equal, and you can't measure the "calories" in a food as if you had a gas gauge.

  • The model, from BFFM (Score:3, Informative)

    by steveha (103154) on Tuesday November 20, 2007 @04:35PM (#21426987) Homepage
    Here is a model of how the human body works with respect to fat gain and fat loss. This is my summary of my understanding of the material in a book called Burn the Fat, Feed the Muscle [burnthefat.com] by a pro bodybuilder named Tom Venuto.

    Your body is designed to keep you alive, even in hard times when it's difficult to get enough food. Thus, if you simply cut your calories back (say, to 1200 kCal per day) your body will store fat at every chance it gets. If you are really only eating 1200 kCal per day, yet burning more than that, you must burn fat (and perhaps some good stuff like muscle) so you will lose weight. However, your body will store fat any chance it can, so if you eat extra you can gain fat, and once you stop the 1200 kCal per day regimen you are almost certain to gain fat. Worse, it is likely you lost muscle during the 1200 kCal per day regimen.

    So, the goal is for you to lose fat, without your keep-you-alive tricks kicking in and making your body stubbornly try to store fat. BFFM recommends multiple, smaller meals each day, rather than a few big ones. If you are eating every 3 hours, how can you be starving to death? Everything must be okay, so your body will let go of the fat. Also you need to get enough sleep, and try to avoid stress in general; stress is a signal that you are in hard times.

    Muscle is your friend for fat loss. Muscle burns calories 24/7, so having more muscle means your daily base calorie burn goes up. This paragraph is important, so feel free to read it again.

    The primary way to lose fat is through "cardio" exercise, aka aerobic exercise: running, bicycling, swimming, various gym machines like the elliptical or the stair climber, etc.

    Another good thing is to eat a diet that fires up your metabolism. Imagine for a second that you had an entire mouthful of glucose, and you swallowed it all. That will pass straight out of your stomach and go straight into your blood as blood sugar, so it's just about 100% efficient as a food. For fat loss, this is a bad thing. How about a mouth full of vegetable oil? Pretty darn easy to digest, and it will be easily stored as fat since it's fat to start out. Imagine instead you have a mouthful of lean protein (skinless chicken breast, if you eat meat; non-fat cottage cheese if you are vegetarian, say). First of all you will expend some effort chewing, and then your digestive system has to work very hard to tear apart the proteins and turn them into something that can pass into the blood stream. If I recall correctly, you can burn about 30% of the calories in a serving of lean protein, just in the effort it takes to digest it. So the bottom line rule here is: complex carbs, high fiber, and lean protein are much better than simple carbs, low fiber, and high fat foods. Corollary: if you want seconds of anything, let it be lean protein.

    So, BFFM tells you how to calculate a good portion size, so you don't eat too much. (If my instincts were good and I naturally took a good portion size, I'd probably not need a book like BFFM.) BFFM encourages multiple, smaller meals, with a high proportion of lean protein, and as much natural whole foods as possible (eat apples, not apple pie). BFFM encourages working out to increase lean muscle mass, plus cardio exercise to actively burn fat. If you do everything in the book, you will lose fat, unless you are one of the fraction-of-a-percent people who have a medical condition that keeps them fat all the time. (And if you are, you have probably figured that out by now.)

    Tom Venuto has nothing good to say about BMI. He points out that bodybuilders with less than six percent body fat might still have a high BMI, because muscle is heavy. Body fat percentage is the best indicator, and it's not that hard to get a useful measurement.

    He also has nothing good to say about Atkins. Carbs aren't your enemy; you need some. And the idea that you can eat as much fat as you want is just insane. You don't need to go into ketosis to lose fat, and it's not all t
  • Re:Ugh... (Score:1, Informative)

    by Anonymous Coward on Tuesday November 20, 2007 @04:44PM (#21427125)
    They are both handwaving. Talking about the first law of thermodynamics is a gross simplification. What you are handwaiving away are all of the messy details of how this stuff actually works, all the various metabolic pathways, how the endocrine system is influenced, psychology, and so on. Your body is really not just a simple furnace, and your fat stores are really not just a storage room off to the side. It's possible, in some situations, to treat them as such and make moderately accurate predictions, but this does not validate the model.
  • by shadroth (935602) on Tuesday November 20, 2007 @04:46PM (#21427163)
    yes, lets start eating lots of low GI food.

    Your weight is based on how you respond to your appetite, not on how much you exercise. Fat and protein are low GI. So are most whole grains and basmati rice. It's the white flour and sugar (the primary non naturally occuring foods in our diet) that have the highest GI. Fructose (fruit sugar) is the only low GI sugar.

    and for those who don't know, high GI foods increase your appetite by causing a spike in insulin levels which makes you hungry after the food you eat has been broken down.
  • by Valdrax (32670) on Wednesday November 21, 2007 @12:34AM (#21431661)
    Once I had a physical and my doctor told me I had twice the amount of calcium I should in my blood. I really didn't care or listen to him.

    You probably should listen to him. Drinking lots of milk doesn't result in significant spikes in calcium above healthy levels, especially if you're only going through a gallon a week (which is about what the FDA recommends, by the way). Maybe if you were going through more than a gallon per day and eating antacids.

    You could very well have a parathyroid problem. Regulation of calcium in the bloodstream is essential to nerve & brain function. Your parathyroid should not be allowing your blood calcium levels to get that high. Cancer is also a common cause of elevated calcium levels as is kidney failure. You should take your doctor seriously and have this rechecked.

    (Oh yeah, and ditto on the hyperbole. Normal blood calcium range is about 10 mg/dL. 16 mg/dL would put you in a coma.)
  • Re:Ugh... (Score:4, Informative)

    by DuckDodgers (541817) <keeper_of_the_wolf@@@yahoo...com> on Wednesday November 21, 2007 @09:57AM (#21434711)
    What you're saying makes sense, but I think you miss the major items in the article. Three major points:
    1. Easily digestible carbohydrates stoke your appetite. Fats and proteins suppress your appetite. For example, pick a day and eat as many cookies as you want. Pick another day and eat as much cheese or beef as you want. You'll eat less than half as many calories on the meat or cheese day.
    2. For some people, strenuous exercise tends to stoke the appetite. It does no good to burn 500 calories on the treadmill or do squats, pulldowns, and shoulder press until your arms and legs can't move if you go home hungry enough to eat two cheese steaks. When I was lifting weights 6 hours a week, a typical lunch was two cheese steaks with a salad and a dessert. I didn't get any fatter - but I didn't get any thinner either. (I also didn't get much stronger - I seem to get much better strength gains from strength training from just two or three 45 minute workouts per week.) Exercise is extremely helpful and important, but if strenuous exertion stokes your appetite, take that into consideration and only exercise moderately. Thin + mild exercise is better than Obese + strenuous exercise.
    3. (Most important) Cutting fat in your diet has not been linked to reducing your risk of heart disease. When some guy who lives on McDonalds Super Size meals has a heart attack, we've been taught it's because of the fat, period. But in fact, he's had tons of sugars in his soda, burger buns, and condiments, tons of starch in the fries, trans-saturated (i.e. not naturally occurring) fats used to cook the food, and tons of salt on the fries and in the sandwiches. (Ground beef and chicken have relatively little salt naturally, but fast food burgers and chicken are almost all positively loaded with it.) The beef in his burger probably had nothing to do with his problems.

    My bet is that the mother in the previous post might find her appetite reduces further if she put more fats and protein in her diet, and if she did moderate exercise (but not so strenuous as to send her appetite through the roof), it would help even more.

    More proteins and fat, and less simple sugars = a lower appetite. That makes it easier to Eat Less And Exercise More.

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