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823 Why We Get Fat

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Doctors and dietitians have been recommending a prudent low-fat diet for decades. Now there's increasing evidence that a low-fat diet, which is necessarily a high-carb diet, may make weight control more difficult. Science writer Gary Taubes has sifted through the data and offers his views on why the usual calories in/calories out mantra is mistaken.

Guest: Gary Taubes is a science writer and author of Good Calories, Bad Calories (2007) and Why We Get Fat and What to Do About It (2011). He is a Robert Wood Johnson Foundation Investigator in Health Policy Research at the University of California, Berkeley School of Public Health. His website is www.garytaubes.com/

The podcast of this program will be available the Monday after the broadcast date. Podcasts can be downloaded for free for six weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99. For a special offer of Gary Taubes' book plus the CD at $7 off, click here.

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If Taubes' hypotheses are correct, then why are people from Asian, Latin American, and African countries, who all eat high-carb, low-fat diets, NOT obese? His ideas do not fit the science.

PEOPLE'S PHARMACY RESPONSE:

Please listen to the interview. Gary Taubes has an answer. Hint...think SUGAR!
The show airs at 07:00 Saturday morning August 6 on our host station, WUNC-FM. There is a streaming audio at:

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http://www.peoplespharmacy.com/2011/08/06/823-why-we-get-fat/

"...a low-fat diet, which is necessarily a high-carb diet..."

Er, no it isn't.

PEOPLE'S PHARMACY RESPONSE:

Please describe a low-fat diet that doesn't replace the missing calories with carbohydrates. Most researchers have found that when people cut back significantly on fat they add carbs.

One cannot just eat protein. Truly, we are very interested in your perspective. Not trying to be argumentative. Just curious.

So you read his hypotheses then? Obviously not or you'd already have your answer. He literally has researched over 100 years of data and you write him off because some of the people in Asia are skinny.

Why don't you try reading his books or articles instead of trying to say he is wrong based off a one paragraph summary.

Robert Atkins was saying this almost 40 years ago. It's about time the rest of the world accepted it.

I recently spent six weeks on two separate trips in China, Vietnam, and Cambodia on vacation. At all times our only dessert was watermelon. It was filling and refreshing. We ate a lot of meat/poultry/fish, green vegetables, lots of oil but none of it made me sick the way I get sick in North Carolina when I eat at country restaurants with all the fried food.

We didn't always have rice depending on where we were. I ate no snacks or sweets and I was never hungry. I returned home both times without a sweet tooth and determined to stay that way. It didn't take long to sink back into the old ways. All our social events revolve around food, and there's always a choice of sugary desserts and rarely plates of watermelon.

Molly,
Sometimes you have to listen to the smartest guy in the room. That person is Gary Taubes. He is a real scientist (degrees, education, etc.) who became a science writer, but is still a scientist. I have read both his books and they make perfect sense. He methodically shows how the "science" which told us to eat all the carbs we want and just cut fat was bad advice. The result of that advice is the diabetes epidemic in our country and the methobolic syndrome epidemic.

More importantly, he explains why a lo carb diet is safe and effective. And by the way, check out what happens to the Asians, Latin Americans and Africans when they come here and eat our "diet." Open your mind and listen to the podcast.

Note: If your weight is where you want it, your glucose and A1c is good and your triglycerides are low and your lipid profile is good, continue doing what you are doing, if not, listen particularly well.

Sometimes it is very hard to believe what is diametrically opposed to what you have been taught.

Yes that's true that a low fat diet is a high carbohydrate diet, and vice versa. Protein intake for the most part remains constant.

Went on a vegan diet prompted by a book called prevent and reverse heart disease. The fat content is 10 to 12 percent and the carbs of vegetables and fruits 70 percent and the rest protein. I admit I ate huge amounts of these foods but nothing that originated from an animal with a face - no meat, fish, chicken, or anything from a cow or any animal. I quickly lost 20 pounds and saw my cholesterol levels change for the better..

I am at the lowest weight ever during my adult life. I also do aerobic exercise regularly for at least 45 minutes with greater ease than before the diet.
So the message I am trying to leave is that a high carb diet without information on what carbs you are eating and what kind of fats you are consuming and how much exercise you get how often does not tell the whole story adequately.

PEOPLE'S PHARMACY RESPONSE: WELL SAID. THE QUALITY OF THE CARBS MAKES A BIG DIFFERENCE. IT SOUNDS LIKE YOUR DIET IS LOW GLYCEMIC LOAD, THUS AVOIDING THE PROBLEMS THAT GARY TAUBES WAS TALKING ABOUT.

I agree that sugar is a big bad-guy, as are fried foods, refined flours and the like. I also agree that low-carb diets can work for a lot of people. However, one point. When Asian, Latin American, and Africans come to America, they begin eating a high-fat, high-protein, high-sugar diet, which creates obesity, diabetes and heart disease. They are leaving behind their healthy diets of whole foods to come eat our over-processed junk food. This is what makes them sick, not carbohydrates.

I *do* agree that there are good calories and bad calories, and I'm not disputing all of Taubes' theories. What I am disputing is the constant message from the media and elsewhere that all carbs are bad and only high-protein diets are good. This is false and unhealthy. Diets rich in vegetables, fruits, whole grains, legumes and nuts are proven to be the healthiest thing we can put into our bodies. Why argue with REAL science?

The only problem with this show was that I wish it had been longer. I could hear the tone in Gary Taubs' voice all the weariness of bucking the establishment for so long. It's high time that this long known issue about high fat diets becomes finally known as accepted fact in the lay audience. I have just finished reading the book "White Coat, Black Hat" by Carl Elliot which details how much human health is dominated by corporate America. Obesity is certainly more profitable for the corporate world than proper weight. Thank you for all you do in your program.

I am not an academic person or a scientist and have always been skeptical about the Adkins Diet. However, I have had a weight problem for most of my 60 plus years and found your radio show this morning convincing and most intersting. Thank you.

I recently went through a second round of open heart surgery. I had been eating a 'heart healthy' diet and exercising 5 days a week with an active lifestyle. My previous grafts were clogged and had to be replaced. I have switched to a plant-based diet. My cholesterol values prior to surgery were at levels my cardiologist had recommended. Now my HDL is too low, my LDL is slightly higher than where I would like it to be and my total cholesterol is hovering close to 105. After listening to this morning's program with Gary Taubes I feel that I should be eating more fat, but, understandably, this is worrisome.

This guest made me ill.

I hope TPP will soon offer the antidote to this disturbing interview. May I suggest one: http://goo.gl/jRze8

Taube will sell books because I reckon a lot of obese people will respond favorably to being told not to exercise, not to eat fruit, and consume all the bacon they want.

I have a master's degree in nutrition, have taught on the university level for years and more importantly have advised thousands of patients over the years on weight management.

In defense of Gary Taubes suggestions:

I have noticed that ovearall, people tend to eat less when they include protein and fat at each meal and snack. For example, even though a snack of peanut butter and crackers (whole wheat of course) has more calories than just the crackers, the higher protein and fat snacks appears to regulate blood sugar more effectively and the person is less likely to seek out another high carb snack in 30-45 minutes. So, the overall caloric intake is lower.

I'm buying the book!

Thanks again for a great show.

It feels good to hear people who talk sense and have the courage to question the obvious and go against 'the party line.' The remarkable thing about this author is his ability to use analogies (growing kids, restaurants) to get his point across, which he did to me (I fell for the old flux equation reasoning, like everyone else).

As a 68-year-old athlete with an abdominal aortic aneurysm stent graft (http://athletewithstent.com), who just completed an Ironman with the aid of this remarkable device, I sure wish Gary Taubes would tackle aging misperceptions.

Much appreciated.

-k @FitOldDog

The man talks sense. I have a high fat diet. Not fried carbs. I eat porridge and full fat yogurt for breakfast. I have oil dressed fresh salads / meat and fish / seeds, nuts, avocado for other meals. Bread made with whole grains, oats, rice, barley, spelt etc. Eat natural food, no processed manufactured junk. Which makes the big manufacturers rich, and helps big pharma rip the poplulatin off when we need medication all the food induced sickness.

High fat is not bad. Taubes is correct, the offical line is the cause of all the obesity and ill health in USA and the developed world. No need to buy his book. I am 65 woman with no deterioration in my bones, brain or muscle strength. I walk rather than take the car. Keep active, eat right which includes calorie dense natural fat in natural foods. AVOID white sugar, white bread, cakes and biscuits.

Your interview with Gary Taubes (#823) was so infuriating. I am a 63 year old male who received a triple bypass two years ago following a "mild" heart attack.

My research into avoiding a repeat episode led me to the work of Colin Campbell, and Caldwell Esselstyn Jr. By following Esselstyn's very low fat vegan program for the last six months I've lost 40 pounds without any hunger or ill effects. My Cholesterol is now 77! I have NEVER been healthier.

I lost 7 inches of my waist. Carbohydrates, especially fruits, are a main component of my diet (beans,greens,fruits and grains).

Taubes advocacy of a high fat diet is so misleading. Of course, people will improve their health by avoiding REFINED carbs, like corn syrup and the myriad packaged foods that contain it. But to suggest that people avoid fruit to improve their health borders on the criminal.

No wonder so many obese people are wandering in the wilderness with misinformation and half truths like Taubes presented. And what about all the phytochemicals and minerals that only carbs provide?

Aaaaagh! Maddening, I say!

Dear GG,
One size does not fit all. At 54 I had a triple bypass and I am now on a high fat low carb reasonalbe protein diet. My numbers are fabulous and my Cleveland Clinic doc (#1 for heart problems) encourages me to continue what I am doing.

I do eat carbs, mostly salad greens and non-starchy.
Today's fruits are higher in sugar than in the past and the sugars are higher in fructose.

You should be aware that cholesterol under 100 is associated with higher mortality in older people. Losing weight is unequivocally good and long as it doesn't yoyo, congrats. But at 77 total cholesterol, your HDLs may be an issue and with all the carbs and fruits, you may want to check your glucose and A1c.

One final note, carbs are not an essential nutrient. To say not eating fruit borders on criminal makes no sense. Whatever fruit supplies can be attained by other carbohydrates at much less calories and w/o fructose which remains suspect. Most importantly as Taubes points out, most people simply can't sustain the diet you are on. If it works for you and is healthy, great. But don't get too cocky after 2 years.

Hear, hear, GG! You've got it, right on. Campbell and Esselstyn are the right ones, they know the truth. Taubes is, as another poster said, "a lot of obese people will respond favorably to being told not to exercise, not to eat fruit, and consume all the bacon they want."

loved the show--has he read Sugar Busters? Published in 1995, says the same thing. I have lived Sugar Busters for most of my life and it works!

This so-called "scientific writer", Gary Taubes, is nothing more than a blatant opportunist who is cynically appealing (read, "Make a lot of money") to a new generation of overweight people (we never seem to run out of them) who aren't old enough to remember that the famous high-fat Atkin's Diet was forcefully discredited years ago as having fantastic short-term benefits with rather frightening long-term degenerative effects on virtually every organ system in the human body.

A strict vegan diet, on the other hand, properly balanced with proteins, vitamins, and minerals from - guess what - natural, whole-food carbohydrate and sugar sources such as grains, legumes, fruits, and vegetables will result in the same dramatic weight-loss outcomes that we desire. Gary, of course, fully knows that most people would be extremely reluctant to give up their favorite life-long "comfort foods" and the staple of most of present-day American diets - meat, eggs, and dairy products.

But I knew when I heard Mr. Taubes say that people who want to lose weight should probably stay away from fruit (one of nature's most perfect foods), that this guy simply did not have a clue.

Question: How does a vegetarian adapt to the Atkins diet?

Yes, sugar is horrible. So is processed food. Taubes completely ignores research that has proven a plant-based diet reduces cholesterol and cancer growth. Meat and dairy are harmful. The Atkin's Diet is NOT a healthy diet. Vegetables and whole grains, which Taube ignores, should be the center of a healthy diet.

Marshall a strict vegan diet has problems of its own.

Keep in mind that whatever your diet is, whenever anyone starts fasting, or goes a long stretch between meals, your body is metabolizing fat and protein, which are your own fat stores and protein from your own muscles and organs.
The low carb diet (high fat) diet is what your body is meant to live on.

Fruit has been engineered to be much sweeter than it is in its natural state. If you're having problems losing weight you might be especially sensitive to carbohydrates and may see some benefit from cutting out the fruit and see what happens.

Minerals don't just come from carbs. I don't know where you got that idea.

Joe & Terry,

Thanks for the show, and bringing these comments to my attention.

Some people have not followed the science and feel like they have the answer for themselves and for everybody else, too.

For a great example of this, see the T. Colin Campbell review (and hundreds of ensuing comments) at the amazon.com site for The New Atkins for a New You.

Marshall W:
I would like to see the scientific evidence that the low carbohydrate lifestyle leads to (in your words) "frightening long-term degenerative effects on virtually every organ system in the human body."
-Eric Westman

One question...Those who think they know...Have you tried the low carb diet? Don't knock it if you haven't tried it. When I did it it was called the "Mayo clinic diet" and it was eggs and bacon every morning with grapefruit juice...Salad and vegetable (even potato with butter or sour cream) for lunch and a meat, salad, vegetable for supper, all you want to eat...and a half grapefruit or grapefruit juice with each meal. My high cholesterol returned to normal and I lost the pounds I wanted to lose with delicious meals...just no bread and sweets. Its nice to be able to control your weight so easily.

My brother also went on it in his 60's, a big guy with the same family cholesterol problem. Lost weight and returned cholesterol to normal...unfortunately died of lung cancer in his late 70's.

I worry about the one size fits all approach that seems to be approached. I agree that the predominance of highly processed foods and sugars does help people become obese. But for me low calorie consumption has always been the best way to take weight off.

I had to recently begin a diet due to an increase in blood pressure. I have a lot of weight to lose and so a low calorie diet seemed to be the best approach. I have been averaging 5 pounds of loss a week since beginning a low cal diet (42 pounds of loss in 7.5 weeks with less than 900 calories a day) with moderate exercise (two walks a day of one hour each).

I haven't had problems with diabetes or cholesterol even when fat but I have known thin people who had genetic tendencies to both. I also had to add a tomato to my diet since it was low calorie but high in potassium (a difficult mineral to get on low calorie diets). I think diets have to be optimized to an individual's genetic tendencies and there is no magic bullet, especially the Atkin's diet. Just my opinion.

- Kenneth B

Has any credible research been done on whether our food additives and preservatives could be the culprits in American obesity? A recent news story said that Europeans on vacation gained more weight in the USA than any other destination; obviously they did not completely change their eating habits for a week (ie. large portions, everyone eating at fast food restaurants, fried food et al).

I live in the South (the fattest part of the nation). I think it is at least as probable that additives, or some other 20th century event in the food industry, is the cause of obesity rather than overeating or carbohydrate eating (Italians are a slim society). I am now losing weight by shopping at our farmers' market. Any science to back up my suspicions about additives?

I am a personal trainer. Over the years, I have attempted to train persons on the Adkins diet to no avail. Each trainee had no energy to exercise and quit working out after only a few sessions. However, they each claimed that they had lost fantastic amounts of weight during their first few weeks of dieting. All of the trainees told me that after their first month of dieting, they drastically reduced their food intake because they could not stand to eat anymore meat and high fat foods.

Gary Taubes answers this question in his book. People in Asian countries typically have a low calorie diet without much sugar. Increase the amount of calories with the Asian diet and you get the same effects as you do from any carbohydrate based diet.

Not everyone responds to carbohydrates the same. About 1/3 of people have problems with insulin resistance. Eating a high fat, moderate protein and low carb diet increases insulin sensitivity.

I have lost 72 pounds by restricting carbohydrates. I have not been hungry. My health indicators have improved. I went from a Triglyceride level over 200 to 60. My LDL went down and my HDL went up. All that on a diet that is 70% fat.

Hi, In Biochemistry in college, we had to complete an experiment on alpha amylase, ptylin, that involved measuring its turnover number in forming glucose from starch. One person ran the experiment 3 times and got zero for his answer. His body is missing the gene for ptylin and he can eat and eat and eat and still remain skinny like the Chinese, maybe that's the answer why the Chinese remain skinny, maybe not.

In regards to salt, we are all halogen technology. Halogens, F, Cl, etc work by repelling water and also by an electron hopping mechanism. Their concentration is a graded one. It means too much is wrong and too little is wrong, but just right is good. Hydrocholoric acid, hydrogen chloride, does the same thing as sodium chloride, so it's not the sodium but it is the chloride concentration that's important. No one in medicine ran the HCl series and you have to do that to understand how it works. pg1246 o&o

The show is terrific; I love it, not because everything Gary said was correct, but the fact that he is opening up people's mind to ideas that might not be the most popular and 'scientifically' accepted. The research on obesity along with all the controversies are far from over. In fact, it is just starting, so I am not going to claim myself as an expert to tell you what is right and wrong. However, I do have a few words to say regarding the points expressed in the show:

1. Regarding the claim that Chinese (or Asians for that matter) eat a lot of rice and other carbs, but never gain weight, it is just a perception. The reality is that the Chinese ARE gaining a lot of weight now. In fact, obesity among the teenagers has been reported as one of the major problems facing Chinese students now. I have visited China every summer for the past 8 years and have seen Chinese getting bigger and bigger in their waist. I gain weight too in China. My take on this is as follows:
a. Chinese are eating more and more. Food is plenty in today's China as compared to 20-30 years ago (I was in China at that time). In those days, food was typically rationed since there was a shortage of food. When you are worrying where is the next meal coming from, you don't gain weight.
b. Chinese are not walking or moving as much as they used to. China has become the biggest automobile market in the world. Instead of walking, people are driving in their cars. Instead of bicycling, people are using public transportation which is amply provided in China.
c. people are not only eating more, but faster too. There is considerable medical literature to suggest that fast eaters tend to be fatter. The pace of life has accelerated due to the social changes and work pressures.

To sum up. based on my personal experience and observations, if you follow the following advise which is based on the above discussion, you will lose or be able to manage your weight. 1. control the PORTION of each meal and the total intake of food each day. 2. do not sit down after the meal, but move around after the meal (exercise lightly after the meal) and 3. take your time to eat, as my mother used to tell me "you work like a slave, but eat like a king". Try to enjoy your meal.

2. Regarding the role of the salt. Over the past 20 years, I have defended the consumption of salt, entering into countless arguments with people who insisted that salt contributes to high blood pressure. I don't believe it is a factor at all. In fact, I argue that lack of salt can contribute to obesity which can contribute to high blood pressure. I am a very heavy salt consumer, but my blood pressure has remained almost perfect according to my family doctor. In fact, it is so consistent that the nurse in my family doctor's office jokingly told me that she didn't need to take my blood pressure for each visit. My personal experience tells me that if I don't eat enough salt, I feel weak and tire easily.

I agree with LH. I lost 70 pounds on Atkins diet, kept it off for years, while gradually increasing the carbohydrates (have you been to the grocery store lately? 95% of food there is high carb/sugar). So the weight kept creeping back, despite intensive exercising.

This spring I restricted carbs again, and lost 25 pounds so far, still 20 to go to get to my lowest point from 10 years ago. I am a big supporter of this diet. Exercise is great and very important, but it is not the way to lose weight.

It is exhausting trying to explain to people that fat does not make you FAT. Telling them that not only is “fat” an essential macro molecule that our body requires to sustain itself in a healthy way; it is used in making cells, which are then stuffed with “sugar” which actually makes us FAT. The only reason a low fat diet might seem like its working at first is because restricting fat will cause the body to shift gears in how it stores the sugar, because it is running out of building block to make cells.

Now we have tons of sugar running around in our blood and the pancreas is going nuts with the insulin and the cells receptors are like: oh no you’re not shoving more “energy” in us, we’ll just shut down these receptors (so you feel tired after a meal because the cell is not letting the energy in) and now the body is like, well what am I supposed to do with all this sugar? I guess I’ll just store it in the fat-cells that I already have made, because I’m not letting it go, we may not have anything to eat for another month (because that’s how the body thinks). So yeah, it’s complicated and the average American person doesn’t seem to be able to handle complicated. They want something easy, like: oh, Fat = fat, well sorry, it’s just not that simple.

So people get hung up on the word “FAT”. I think in order for people to “get it” we need to change the words to something else. What those words would be… I have no idea; I’m not a word smith. But I can see that the confusion for the average American comes because the two words Fat and Fat are the same but they are not REALLY referring to the same thing. And no I don’t have any degrees in this stuff, I just listen and learn and comprehend what is actually going on, I don’t take things on blind faith and if something doesn’t work the way Dr. or the Preacher says it’s supposed to work I don’t accept it anyway, because they’re human just like me and we’re all capable of making mistakes.

What makes us smart is how we deal with those mistakes; by going out and making more observations, drawing new conclusions, and testing them. It is an ongoing process. So when I read a response like “Er, no it isn't.” or “This guest made me ill.” or “Question: How does a vegetarian adapt to the Atkins diet?”. I know that I’m still seeing the average American who doesn’t want to think for themselves and I feel exhausted.

PS: I really enjoyed this show.

With no risk factors and at a healthy weight, I was diagnosed with cancer five years ago. After treatment, I followed The Cancer Project's (PCRM) vegetarian diet. My protein sources changed to legumes and “healthy whole grains”, and my weight ballooned 60 pounds. One year ago I returned to a lower carb, higher meat protein diet as recommended by Gary Taubes and Dr. Westman, and have lost 45 of those pounds.

Recent studies indicate that it is important to keep insulin levels low for cancer prevention; difficult to achieve with those "healthy whole grains”. I have always eaten vegetables and low sugar berries, both good sources of phytochemicals and minerals. And I continue to enjoy them on a low carb, Paleo diet, while avoiding all added sugars and grains. The “all bacon argument” is getting old, that is not low carb.

The grains and legumes, not found in traditional diets, can contribute to increased insulin and are nutritionally empty compared to meat, fish and vegetables. The vegan diet recommended by the PCRM and Campbell may turn out to be what promotes cancer, not protect from it. Taubes’ recent article in the NYT, Is Sugar Toxic?, summarizes the concerns about the cancer and insulin (carbohydrate) connection. http://www.nytimes.com/2011/04/17/magazine/mag-17Sugar-t.html

Thank you for having Gary Taubes on the show, an excellent interview. Your listeners can learn much to improve their health from his book if it is read with an open mind.

We were advised to begin a "South Beach" type diet to combat insulin resistance in a family member in March. We all have lost weight and felt much healthier. There are entire aisles of the grocery store we don't even need to go down, because they contain processed and refined foods. I was initially skeptical about eating a higher fat diet, but we have all lost weight, particularly in our mid-sections. And, when we have gone out to eat and indulged in high MSG and/or fried foods, we quickly regret it because we don't feel well, which recalls one of Michael Pollan's food rules about remembering how you felt after you ate something.

This "Why We Get Fat" information IS entirely contrary to the American Heart Association's decades of advice, but you have to keep in mind the thin evidence that was based on, and in the meantime, the health of Americans has declined. Big Food with it's "value-added" products in all of those grocery aisles, is also part of the problem, and we are bombarded with their marketing.

Thank you for bringing out further scientific evidence supporting the health benefits of this lifestyle.

Tony T's link goes to what looks like a glorified Web site blog. don't be fooled by sites that pretend to be something they're not.

The low carb argument makes a lot of sense to me, but I have a sensitive stomach and fatty meats give me terrible heartburn. Any suggestions for folks like me who want to eat low carb, but who have a hard time with rich foods?

Thanks for this very informative program. I am a scientist who studies liver metabolism and can attest that Mr. Taubes is on firm scientific ground with his explanations of the role of carbs (especially fructose) on how the body responds. I have also adopted a mostly low carb diet and it resulted in substantial weight loss and correction of my plasma lipid profile.

One misrepresentation that has been repeated in several of the critical comments- these diets do NOT recommend dispensing with exercise. In fact, many if not most include a combination of resistance and cardiovascular exercise as part of the program.

At 61 on a mostly low carb diet I compete in distance running and bicycling events and maintain a body fat level of about 13% and am healthier than I have ever been.

One caveat, though. If you are an athlete you will likely need to incorporate more carbs in your diet. You need the calories. Just stay away from sugar.

I had every intention of getting up early Sat. to start my day but your interview with Gary Taubes had me glued to the radio. I have a couple of low carb cook books and the 2001 revision of Atkin's book, but have never been able to buy into the whole concept. Mr. Taubes sound reasoning and scientific explanations have got me interested to once again start this method of eating. I'm going to swing into it more easily this time by omitting all overt sugar and sweets.

My diet is pretty healthy already but I enjoy fruit and red wine and the thought of life without ever having another biscuit is pretty bad. The problem with this way of eating is that it seems so absolute, that there can be no modifications.
If I miss the show I download it to listen to at a later time and always enjoy your guests.

Marti V.

I can't get TPP live, so I just heard the podcast. I heard it after reading the comments and was surprised by the misstatements in the comments.

1. Never said don't exercise.
2. Never said eat all the bacon you want and never said could eat all the protein and fat you want.
3. Did say that certain studies did tell people they could eat as much as they wanted if limited carbs and these studies demonstrated better weight loss.
4. Suggested that if you are predisposed to gain weight, that fruits may not be a good food choice for you. Never said all people shouldn't eat fruit.
5. Suggested that the real culprit for metabolic syndrome may be sugar and fructose and explained that fructose is digested in liver which then gets fat deposits in the liver which may cause insulin resistance. Therefore, fruit may not be a good food source for anyone.

My comment: all the vegans who commented are basically agreeing with Taubes since they are eating no processed foods, little sugar and minimizing the effect of eating fruit by eating it with foods that slow digestion and therefore minimize the insulin rush.

I am appalled with Gary Taubes suggestion that fruits make people fat. I live in the mountains in Western Virginia. There are many fat people here. Many of them never have fresh fruit. One reason it's too expensive. So, they are not overweight because of too many fruit calories. I suspect if they ate fruit instead of other processed items they would be far lighter.

PEOPLE'S PHARMACY RESPONSE:

You might want to go back and listen to the part of the show that dealt with fruit.
Gary Taubes suggested that people with a weight problem might want to be cautious about fruit consumption. That is because of the sugar content of many fruits.

He did not say that fruit makes everyone fat. He repeatedly stated that the culprit is sugar and highly refined carbohydrates. Please do listen again so you can clarify this for yourself.

Warren - I applaud your being open to another solution. Yes, I too was worried about eating more fat. Remember - it's only worrisome because you and I have been brainwashed by the media, the medical establishment, and the drug companies for 50 years that fat is 'bad' for you. As Gary has more than demonstrated, nothing could be further from the truth. Good luck.

I have been studying nutrition as a hobby since the 1970's. Even Adelle Davis back then talked about the dangers of highly refined white flour, rice , pasta, etc.., however she died of cancer. My husband and I tried a low glycemic diet for years, and didn't lose a pound.

It wasn't until last year when I saw Dr. Neal Bernard on PBS that I started cutting down on the amount of animal protein we were eating, adding vegan protein such as beans, tofu and seitan to our diet. We also lowered the amount of fat we were eating. Instead of pouring on the olive oil we cut it down to a teaspoon on a salad, for example. We also started exercising more.

I had been a complete couch potato and now walk about 10-15 minutes per day. My husband with metabolic syndrome, ie high cholesterol, overweight with diabetes, who had always gone swimming for about an hour every day, began doing exercises at the gym in addition to swimming. We have both lost weight without feeling hungry.

However, my big concern about Dr. Taube's diet is that he doesn't talk about the quality of the food one eats, nor does he discuss eating for optimum health, which is the real goal for all of us. For example , I try to eat as much organic, local food as I can find and afford. I eat only grass fed beef, but we only eat it once or twice a month. We eat only free range chickens and their eggs. I don't want pesticides running through my veins. I now eat only whole grains, bread, rice, pasta, pearl barley, quinoa, millet, etc. I also try to eat as many fruits and vegetables as I can enjoy cooking and eating each day. I agree that low -glycemic is better, but by itself, it's not enough.

I did listen to this show, but did not hear anything new.

I have tried lots of so called DIETS, but have found for me just eating smaller portions and only eating when hungry, I lost 18 LBS.

It's my opinion, people today in this culture just eat way too much.

Low carb definitely works in conjunction with understanding the emotional reasons we eat.

I've been Type II diabetic for 25 years after a youth filled with Ding Dongs, Twinkies, Hostess Apple Pies and white bread. I was overweight when I was diagnosed at 21 then lost a bunch of weight working at a tough job. The weight would go up, then down 20 pounds or so several times over the next 10 years, with little time spent in the normal BMI range (I was mostly overweight) until I got serious about my food addiction, Atkins and physical activity.

I dropped 20 pounds in 2003 (after which my cholesterol, blood sugar and bp were amazing) and have had one 10 pound gain/loss since. I've been on the low side of normal BMI consistently for the longest time in my life now. I watch portion control (I eat small amounts multiple times a day) and glycemic load of foods including fruits and veggies, and occasionally have the small piece of cake at a celebration or splurge on bites of my favorite Gorgonzola pasta and bread at a lovely Italian restaurant.

I don't miss the carbs. I don't crave them.

>only high-protein diets are good.

No, it's actually high fat diets that are good. More protein, once you get "enough," doesn't add any value.

Where I live, the fat people aren't eating fruit. Follow them around the grocery store--it's all boxed carbs, with SKUs and bar codes. If the only carbs we ate came in items with PLU # instead, we wouldn't be as fat as we are, collectively.

>fatty meats give me terrible heartburn

Quit eating anything with gluten for a few days, then try high fat. Wheat is what drives my heartburn, and lots of Atkins eaters will tell you their heartburn goes away completely when they quit eating flour.

>Each trainee had no energy to exercise and quit working out after only a few sessions.

Workout stamina comes back in a bit longer than your clients are giving it. Suspect your clients quit working out because it was easier to quit than to defend a way of eating that promoted weight loss in the face of skepticism. There's a market for PTs who can figure out how to help low carb eaters work out, rather than trying to convince them that low cal, low fat is the answer.

>Taubes completely ignores research that has proven a plant-based diet reduces cholesterol and cancer growth. Meat and dairy are harmful. The Atkin's Diet is NOT a healthy diet. Vegetables and whole grains, which Taube ignores, should be the center of a healthy diet.

You can eat a ton of kale and leafy greens on Atkins. Whole grains aren't good for an awful lot of people who can't process gluten.

>a lot of obese people will respond favorably to being told not to exercise, not to eat fruit, and consume all the bacon they want."

As long as they abstain from all refined carbs, they'll probably be just fine, too. At the very least, they'll be in no worse shape than they are today.

Ever since Newton, we’ve understood the “clockwork” of planetary orbits; modern cosmologists make confident inferences about what happens billions of light years away. In contrast, scientists still can’t agree on what food is good for us. There is a real sense in which dietetics is harder than cosmology. (Sir Martin Rees)

I enjoyed and resonated with Gary Taubes's perspectives. Thank you for the engaging show. Gary Taubes made an offhand comment that some people have high cholesterol due to genetics.

Joe, had Mr Taubes made a similar offhand comment that some people have high cholesterol due to environmentals or allergies or sleep deprivation, would you have left the statement unchallenged? Whenever you interview a guest who attributes something to genetics, please do us the favor of asking, "Which gene?" If he or she can cite the gene, move ahead, but if he or she doesn't know but it must be genetic because it runs in families, that's not science.

That's like saying People's Pharmacy must be a great show because the theme music is written by B J Liederman.

PEOPLE'S PHARMACY RESPONSE:

Dear JGS,

Yikes...I am somewhat confused. "Familial Hypercholesterolemia" is a well known condition. I can't think of any physician or scientist who would challenge a statement that "some people have high cholesterol due to genetics."

Here is what the NIH has to say on the topic:

"Familial hypercholesterolemia is a disorder of high LDL ("bad") cholesterol that is passed down through families, which means it is inherited. The condition begins at birth and can cause heart attacks at an early age...Familial hypercholesterolemia is a genetic disorder caused by a defect on chromosome 19."

We assumed that this was such common knowledge that challenging Gary Taubes on this point was unnecessary. Identifying the specific gene that is responsible also seemed like more information than the average listener needed.

Please help us understand your discomfort with his statement a bit more clearly. We are missing something.

Joe

I enjoyed the broadcast; but I would challenge most of us to adopt a go-carb lifestyle versus a low-carb diet. A go-carb lifestyle encourages people to learn how to reduce the time allotted for carbohydrate storage in the body. My analogy is that carbohydrates are a close relative that you must see once in awhile, but only in spurts of short visits.

Once carbohydrates have over-extended their visit - bad things happen. The fact of the matter is carbohydrates aren't meant to be stored in our bodies for a very long time. We only have enough room in our bodies to store a few hundred grams of carbohydrates. The body wants to burn carbohydrates rather quickly. Exercise, especially anything that requires high intensity movement (sprinting, jumping, lifting weights, getting out of the way of danger...etc...) are the leaders in the eviction of carbohydrates. Again, carbs aren't meant to sit in our bodies. We are to consume them and use them, they become toxic when they are stored (obesity, diabetes & heart disease). It is as if carbohydrates are speaking to us through these diseases and we are choosing to ignore them.

I'm not going to dump the American Heart Association's (AHA) recommendations because our modern lifestyle makes the quick and efficient use of carbohydrates obsolete. When the AHA recommendation was issued to Americans to reduce fast-food fat intake; easy-access-processed carbs became the "food of choice" for most of us. Take a look in most American cupboards and you will see sugar filled snacks and high glycemic fruits and vegetables such as bananas and carrots. Even our "healthy" food has to be easily accessed and easily consumed.

It seems as if our problem is time. We want food, and we want it fast. We eat fast, and we want inactivity fast. It's interesting that we haven't pursued "speed" when it come to exercise or activity. Fast (or high intensity) exercise or activity will demolish carbohydrate stores.

I always tell me clients that a high-intensity workout is the best low-carbohydrate diet you can be on. In most cases, walking jogging, swimming, cycling and group fitness are so low in intensity that participants only put a dent in their carbohydrate stores. Getting on treadmill for an hour or two at a low-intensity doesn't help much in terms of reducing the body's carbohydrate stores.

Unfortunately, nature has wired us so our view of eating and exercise are tainted. We view eating as a prerequisite to live, and exercise as an option to expending limited energy reservoirs.

The Perspective of a Personal Trainer

Thanks, Joe, for the correction on familial hypercholesterolemia (about 0.2% of the population). I jumped to the conclusion that Mr Taubes was attributing a broader responsibility to genes.

To clarify what I'm asking, I sometimes wonder if medical commentators attribute causality to genetics when they know that symptoms run in families, but they don't know the actual mechanics. Families share as many traditions and environmentals and allergies and habits as they do genes. When there are data implicating genes, I would be interested to hear some (not a lot of) specifics and, when it only appears to run in families, I'd rather hear the medical professional admit that he or she doesn't exactly know why.

So, just a quick challenge: Q: Which gene? A: Chromosome 19. If there's time, maybe even, "They aren't implicated in 99.8% of the population." It would make a great show just a little greater.

Hi,

I listened to most of the Gary Taubes show, but could not finish because I found it too depressing. I happen to know that I have insulin resistance and a strong genetic family history of diabetes. Why am I not on the Atkins diet? When I give my reasons I am not implying that everyone has my preferences or my circumstances. I do know people who have done well on the Atkins, Eade and Eade and other high protein diets. I think that as a population we may differ both in terms of dietary preferences and in terms of how we feel on particular diets.

IF I have any point of strong disagreement with Mr. Taube it is with the implication that we all do well on the same diet. Ok. Enough talking around the issues. Here are my very personal problems with high protein diets.

1. Palatability and the ability to stick to the diet long term. I personally dislike the taste and texture of meat, and I adore fruits and vegetables, so I am at the leading edge of the people who have difficulty with this type of diet. However, I have read that many people have a great deal of difficulty sticking to a diet that eliminates fruits and vegetables on a long-term basis. I actually tried to follow this type of diet twice-- once in an attempt to lose weight (I did lose a bit-- mainly because I disliked everything I was allowed to eat, causing me to cut back on quantity, but lost more on a balanced diet once I failed on Atkins). I suspect that although this type of diet is harder for me than most, that many people fall off the wagon after a relatively short time. Many of these people go back to whatever they were eating before and gaining back any weight lost.

The second time I tried the diet I was urged to do so "for life" by a support group for people with insulin resistance. I could not tolerate it then, either, although that time in addition to losing pleasure in eating, I became depressed thinking that I would have to eat food I did not enjoy for the rest of my life. For people whose greatest pleasure is a big plate of steak with no veggies, this may not be an issue, so I am not claiming that everyone feels the same on this issue.

2. Energy. Although some people report that they feel energized and healthy on high protein diets, just as many report feeling weak, low-energy or even having muscle cramps. This happened to me. Although I kept exercising (I am normally a very active person) I found exercise harder and harder the longer I stayed on Atkins because of fatigue and muscle cramps. Potassium supplements helped somewhat with the latter, but the exercise intolerance alone made me reluctant to stay on Atkins long-term.

3. Environmental concerns. Meat production takes many more resources per calorie produced and causes more environmental destruction than does the production of vegetarian food sources, Furthermore switching to a higher meat lower vegetable diet encourages the expansion of factory farming, with concomitant poor treatment of animals.

4. Kidney issues. There is some evidence that people who adhere long-term to high protein diets have a higher incidence of kidney disease than people who eat a more "balanced" diet. I have read only secondary sources on this issue so I am not 100% convinced, but am convinced enough to worry. Apparently the people most likely to get kidney damage while on high protein diets are the very people Gary Taubes is trying to help-- i.e. people with either insulin resistance, pre-diabetes or diabetes.

5. Inconclusive evidence. There are two very divergent ways of thinking on this issue, with credible and well educated people lining up on both sides. I would recommend that Peoples Pharmacy interview someone like Terry Shintani or John Barnard to give the other side of hte issue. Although I believe that vegan diets are also difficult to adhere to (especially the extreme low-fat vegan diet recommended by John Barnard) vegans are the group in the U.S. population who are least likely to become obese, and who have the lowest incidence of diabetes, as well.

In addition, I just heard a report on National Public Radio that the Harvard School of Public Health released a very large scale epidemiological study indicating that red meat consumption was statistically linked with diabetes, regardless of weight or lifestyle (and yes, thin people do get type II diabetes if their genetic predisposition is strong enough, and this group includes several of my relatives.) They claimed that people who ate large amounts of red meat could reduce their probability of getting diabetes by replacing the red meat with whole grains and other vegetarian sources of protein. High fat meats such as bacon seemed to be particularly problematic.

Why am I stressing diabetes when most of the population will never get it? Because Gary Taubes' arguments seem to center around insulin release and insulin resistance-- all of which are magnified once people actually get diabetes. Again I have not yet had a chance to read this study. I merely want to indicate that the evidence is not all on one side.

Although I am strongly on the side of eating vegetables and even (gasp!) fruit in my personal life, having failed miserably on a high protein diet, I am not necessarily recommending that people who have successfully lost weight on high protein diets and who are feeling great give them up. I would merely recommend that they try as much as they can afford to source their meat from responsible sources, and that, perhaps they have their kidney function monitored occasionally. This can be, and often is, part of a regular medical check up, along with other blood work such as a cholesterol check. What I am recommending, however, is that people look carefully at both sides before making long-term lifestyle choices, and that they not beat themselves up if they fail at Atkins or other high protein diets. It has by no means been proven that these are the healthiest diets for everyone.

Eating a fat free cookie, even a "healthy" one MAKES ME SICK! So does your attack on TPP! People got fatter by the day when fat free foods were pushed by the industry because there was corn syrup and sugar added 10-20% and more salt to put flavor in the products. Even Cheerios have so much salt in them, my mouth stood open I ate them like cookies without milk.

My partner was cut to 70 carbs/day, his insulin improved, BP went way down and so did his weight. He even cut his simvastatin in half!!!

I hope you have a long life, maybe you'll even be healthy YOUR WAY! Good luck. JOE AND TERRY are giving a lot of their time and effort to this site to educate all who want to learn!!!!

JGS has a good point about "inherited" conditions -- sometimes the data is merely a statistical correlation, and sometimes the data is from genetic analysis. Those are two different things, but they're often lumped together under the "inherited" or "familial" labels. That's OK when you're just making an observation, but not OK when you're talking cause and effect. "Statistics or genetics?" is a good question to ask in an interview.

You may have inherited a dose of grandma's genes, but you may also have inherited her recipe for fried chicken and biscuits. Either one, or both, could result in your family having a "tendency" toward high BMI, cholesterol, or what-have-you. This cuts both ways: my mom never deep-fried anything, I never learned how to do it, and I don't do it today -- and unless she develops a taste for KFC, my daughter is likely to "inherit" a familial absence of fried food from her diet.

The diet isn't a high protein diet. It's a high fat diet.

If you didn't adhere to the fat part, it makes a great difference how your body would accept it. Minus the taste and texture issue. I understand completely for not wanting to eat meat based on that. I personally have issues with most cheese based off of taste and texture. If I had to eat cheese for the rest of my life I'd be bummed too. It's no fun eating something that doesn't give you pleasure out of it.

I agree with you on the source of our meat. I believe if what the animal eats is rich in nutrients, will translate to good health for it, which will translate to a healthy source of food for us. Factory farming doesn't do that.

I would emphasize incorporating as much of the whole animal as possible into eating. The organs (especially the liver), the bones (great for the broths Taubes mentioned in the interview), the fattiest parts (tongue, brains, tail, belly - for example). Mind you, that the animal is from a good source.

I wonder how whole grain carbs fit in?

For Ann: As above--formal Atkins is high fat, not high protein. All you need is enough protein. I understand, if you don't like the mouth feel of meat, there's not much high fat food that will serve any better. My experience with "vegetables" is that the good ones have low enough calories that they don't change the overall ratio of my way of eating. Nobody gets fat on kale and collards.

When Harvard studies "red meat," it is unlikely that they are able to distinguish between grass-fed and corn-fed beef. Corn fed beef is, chemically, a very different food than grass fed. Bacon, IMO, is a condiment, rather than a meat. It's far too processed, at least in the form sold in most supermarkets, to be considered a real food.

Michael Pollan has a lot to say about the actual validity of most long term dietary studies that rely on self-reporting to gauge what people actually ate.

I would recommend the book Holy S***, available from Amazon (took me three tries to get my review published there because I quoted the title in the review, which is why I'm not spelling it out here) as a discussion of the possible value of meat production to food crops. If the price of gas continues to rise, corn farmers will have to add livestock in order to produce affordable fertilizer to the land. Even now, some meat producers get a higher value from poop than from meat.

Fascinating interview, however I wish there had been some discussion of the "Mediterranean" diet which has maintained many adherents throughout the modern discussion of diet pro's and cons. Mr. Taubes touched upon "good" (complex?) carbs vs. "bad" (low glycemic, less processed) carbs - but made no mention of good vs. bad fats.

I try to follow a diet with limited consumption of "good" carbs balanced with consumption of what I understand to be "good" fats from sources such as nuts, olive oil, salmon, and avocados. I'd love to know what Mr. Taubes (and/or you folks at People's Pharmacy) would say about this approach.

PEOPLE'S PHARMACY RESPONSE: WE'VE LONG ADVOCATED THE MEDITERRANEAN DIET AS ONE HEALTHFUL APPROACH.

There is no sugar in Asia dishes, sauces, or any other meal. Sugar only in food that labeled sweet only and Asian eats very little sweet stuff. In US, hidden sugar appears in everything, even in drug.

The first few weeks of eating low-carb is not a good time to begin an exercise program; your body is shifting from running on carbs to running on fat. I don't remember if I read this in Atkins or Gary's books, but it matches my experience.

After a few weeks of low-carb, I found my energy levels to be much more constant, muscle strength is good, and I never have "the munchies;" hunger might be assuaged with some nuts, an egg, salad, or a bit of cheese. Maybe it's okay to rethink what is a normal amount of food?

Five + stars.....

I have practiced this diet effectively for the last 20 years. You can feel great, enjoy great food, and not have to count calories for the rest of your life while staying fit.

The science does support this diet. With regard to other cultures' diets which may also work, well, there's not necessarily only one diet solution which is effective. For one, note that the Mediterranean diet is also low in sugar.

Keep on keepin' on Mr. Taubes....would love it if you would contact Coast to Coast AM to interview with them also as they present several "diet" guests as well.

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