Calories In/Calories Out

Is it time to de-bunk this claim from nutrition and diet studies?

Anything that doesn't fit anywhere else below.

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Re: Calories In/Calories Out

#21  Postby Just A Theory » Mar 08, 2011 7:14 am

Apollonius wrote:Calories in/Calories out would add up those sugar calories and what is left to budget for the rest of the day, and for that moment say you either went over or you didn't. End of story. Each day is a simple equation where calories are the only variable. That is all there is to know. The sum total of each day's equations of in/out tells the complete story.


The problem is that people who drink 2x cup of ~800 calorie soft drink are also the same people who cannot limit their additional food intake to a mere 600 calories. High sugar foods do not feel like you are eating a lot, they do not activate the leptin signalling system that controls appetite and consequently, people will eat more even if they have just consumed a large number of calories. eg. Chocolate bars do not fill you up.

The critics are saying no. The problem here is the content of those calories. Sugar would be the worst choice of calories. An excess of sugar calories over time increases insulin in the body. As a side effect, your body changes.


This is factually incorrect. There have been numerous studies on the effect you are citing: insulin resistance. Here is one. There is next to no evidence that increased sugar intake promotes insulin resistance. That is not to say that increased intake of sugars does not promote release of insulin but, as fatty acids are released into the blood stream, insulin levels fall again - this is the sensation of coming off the sugar high.

By contrast, high fat intake can and does lead to elevated insulin resistance.

That change results in a new "normal" weight for the sugar consumer.


You have missed a step in your reasoning. High sugar intake leads to accumulation of adipose tissue by well known mechanisms and a higher concentration of fatty acids in the blood stream. As described above, this leads to insulin resistance and also to leptin resistance, both of which promote increased appetite and a tendency to accumulate still further adipose reserves.

However, the key point is that it all started by consuming excess calories which were converted to fat.

Continue consuming this worst choice of calories and the "normal" weight goes up.


Except it doesn't, unless you are consuming sufficient calories to force the body to accumulate fat reserves.

In Taubes summary of this, over time, you don't get fat from eating more, you eat more because you are getting fat. You are getting fat because you consumed the sugar over time that changed the insulin level to change what your "normal" weight would be to a higher number.


Complete and utter bullshit from Taubes, as per the articles I linked above. Glucose consumption does not alter resting insulin levels nor does it promote insulin resistance. However, getting fat does both. I'm sorry but Taubes isn't even wrong here.

So if it is correct, it would not be the sum total of each day's calorie calculation that matters. What matters is what those calories do to the body to re-set a "normal" weight.

This is what the sources in the OP are discussing.

I tried to summarize about a book's worth of Taubes "Why We Get Fat" in one paragraph and I know I didn't do it justice. If Taubes is right, calories in/calories out does not work over time, and chemistry matters. If he is wrong and calories in/calories out is right, it's just a matter of what the calculation is for each point in time (like X amount per day).

Just about all of the health and nutrition writing I can find take calories in/calories out to be a truth beyond question.


Very low calorie diets do promote extreme hunger as various hormonal feedback systems induce a desire to replace the missing nutrients. However, mild calorie deficiency induces mild hunger which can be ignored with determination and willpower.

It really is all about eating slightly less than what you burn. Doing that while simultaneously consuming quantities of high sugar foods which are rapidly converted to glycogen and fatty acids is next to impossible.
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Re: Calories In/Calories Out

#22  Postby NilsGLindgren » Mar 08, 2011 7:43 am

Apollonius wrote:If he is wrong and calories in/calories out is right, it's just a matter of what the calculation is for each point in time (like X amount per day).

That is oversimplifying it. As I pointed out in the previous thread (the "Does exercise make you thinner"), a period of strenuous exercise may be followed by a much longer period of raised metabolism, meaning, during that period you will burn more, despite being at comparative rest.
My point is that the "calories out" is not self-evident. It is difficult to measure the actual metabolism over an extended time (not impossible though, as the study I quote proves).

I would like to add to "Just a theory"'s excellent post that the persons who drink copious amounts of fructose soft drinks, eats large amounts of fatty snacks (potato chips e g), etc, are not very likely to be the ones who frequent a gym.
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Re: Calories In/Calories Out

#23  Postby Apollonius » Mar 08, 2011 1:49 pm

Just a Theory-

Thanks for the info. That is exactly what the OP was intended to seek-a criticism of Taubes that is worth investigating.

It must be the case that very few people really understand this. I have been looking for what is or is not wrong with what Taubes is saying for about a week and so far nothing that specific to follow up on.

Of course it may also be true that I and the blogs mis-stated what he is saying. This is interesting stuff.
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Re: Calories In/Calories Out

#24  Postby NilsGLindgren » Mar 08, 2011 3:28 pm

Templeton wrote:
An example of this as was stated in the previous thread; True or False-Exercise Makes You Thinner?, the thyroid releases two fat burning hormones T3, and T4, but these must be activated in the liver. If the liver is overstressed then the liver will not activate these hormones. The liver is one of our most important organs and is primarily responsible for filtering toxins from our bloodstream. If the liver is not functioning properly this can affect every organ and system in our body.


However,
Overall, the majority of patients with liver disease are clinically euthyroid, and this can be confirmed with a normal high sensitivity TSH test and a normal free T4. The latter test is routinely performed and obviates the need to take into account the variation in thyroid‐binding globulin levels seen in patients with liver disease.

http://qjmed.oxfordjournals.org/content/95/9/559.full#sec-6

The liver has a very large overcapacity in everything it does, and, while liver steatosis may be a reality, it does not necessarily follow that the liver has a measurably decreased level of function.
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Re: Calories In/Calories Out

#25  Postby Dudely » Mar 08, 2011 6:47 pm

My wife got up above 30 stone (410+ lbs/ 186 kg) while she was pregnant, so I look at this with more than a little interest. Thanks to all for the good discussion and reference material. :cheers:



As an aside her weight gain had a very interesting psychological basis. Now that the problem is somewhat mitigated she has lost 80lbs in 6 months (close to 20% of her body weight)! It was so effortless on her part she had to be convinced by friends and family that she was losing weight. She thought the saggy skin meant she was gaining, and couldn't understand why her pants had gotten so big. . .
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Re: Calories In/Calories Out

#26  Postby Apollonius » Mar 09, 2011 12:44 am

Just A Theory wrote:..

This is factually incorrect. There have been numerous studies on the effect you are citing: insulin resistance. Here is one. There is next to no evidence that increased sugar intake promotes insulin resistance. That is not to say that increased intake of sugars does not promote release of insulin but, as fatty acids are released into the blood stream, insulin levels fall again - this is the sensation of coming off the sugar high.

...


This was a good post over all, but I read that link and I am not sold.

That was just a lot of people answering a survey. What I conclude from that is that a lot of people will answer a survey, but I don't know if they answered it honestly, or even what the questions were.

This says it isn't so, but they just quote a doctor and not a study...
The problem with sugar is that, simply, it spikes insulin. And when insulin levels are raised, people accumulate fat.

“At one point, your pancreas (which produces insulin) will start wearing out and then you’re looking at diabetes two,” says Ranveig Elvebakk, an Oakland-based doctor and nutrition expert who is a long-standing member of the American Society of Bariatric Physicians…

…”Ninety percent of the weight problem we have is caused by eating sugar, not fat,” she says. “If you want to lose, gain, or stay the same weight, then you need to understand the mechanics of weight loss. And when you raise your blood sugar, you raise your insulin and insulin stores fat…”

http://dietforhumans.com/2011/03/09/low ... -no-maybe/

Is everything that Elvebakk saying bullshit? (I checked her web site and she said "studies confirm this" but she didn't cite the studies)
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Re: Calories In/Calories Out

#27  Postby Elena » Mar 09, 2011 1:51 am

Just A Theory wrote: There is next to no evidence that increased sugar intake promotes insulin resistance.

This is incorrect. The evidence is rather strong. An experimental model of insulin resistance and hyperinsulinemia induced precisely by a (low-fat) high sugar diet can be found here: http://jap.physiology.org/content/84/4/1311.full

Just A Theory wrote: Glucose consumption does not alter resting insulin levels nor does it promote insulin resistance.

Incorrect, re: both the short and the long term. In the short term, dietary glucose raises blood glucose and immediately triggers insulin secretion. In fact, the concentration of insulin parallels that of glucose.

In the long term, high sugar intake (determined as glycemic load) is independently associated with insulin resistance and hyperinsulinemia.

Just A Theory wrote: By contrast, high fat intake can and does lead to elevated insulin resistance.

Sorry, in the abstract you linked there is no support for your dismissal of the role of dietary sugar in insulin resistance. (And, it's a study on diabetics -not healthy people).
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Re: Calories In/Calories Out

#28  Postby Templeton » Mar 09, 2011 3:00 am

NilsGLindgren wrote:
Templeton wrote:
An example of this as was stated in the previous thread; True or False-Exercise Makes You Thinner?, the thyroid releases two fat burning hormones T3, and T4, but these must be activated in the liver. If the liver is overstressed then the liver will not activate these hormones. The liver is one of our most important organs and is primarily responsible for filtering toxins from our bloodstream. If the liver is not functioning properly this can affect every organ and system in our body.


However,
Overall, the majority of patients with liver disease are clinically euthyroid, and this can be confirmed with a normal high sensitivity TSH test and a normal free T4. The latter test is routinely performed and obviates the need to take into account the variation in thyroid‐binding globulin levels seen in patients with liver disease.

http://qjmed.oxfordjournals.org/content/95/9/559.full#sec-6

The liver has a very large overcapacity in everything it does, and, while liver steatosis may be a reality, it does not necessarily follow that the liver has a measurably decreased level of function.


Now now Nils, I'm just a humble country bumpkin with a 4th grade education, and here I'm having to run around looking up words like euthyroid and steatosis - I've always found it easier to communicate to the lowest common denominator. ;)

Clinically Euthyroid - in common parlance means "Normal"

Steatosis - In cellular pathology, steatosis (also called fatty change, fatty degeneration or adipose degeneration) is the process describing the abnormal retention of lipids within a cell. It reflects an impairment of the normal processes of synthesis and elimination of triglyceride fat. (http://en.wikipedia.org/wiki/Steatosis)

I may have erroneously implied that a liver would/could/always? malfunction if under undue stress, which was not my intention, although I would point out that proper liver health is vitally important to the overall health of the human body.

In reply to your link; unfortunately those tests are not always conclusive.

"Thyroid function tests in chronic liver disease: evidence for multiple abnormalities despite clinical euthyroidism."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1420033/
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Re: Calories In/Calories Out

#29  Postby Just A Theory » Mar 09, 2011 4:08 am

Elena wrote:This is incorrect. The evidence is rather strong. An experimental model of insulin resistance and hyperinsulinemia induced precisely by a (low-fat) high sugar diet can be found here: http://jap.physiology.org/content/84/4/1311.full


From that paper,
Barnard et al wrote:
This study was designed to examine the effects of a high-fat refined-sugar (HFS) or a low-fat complex-carbohydrate (LFCC) diet on insulin-stimulated skeletal muscle glucose transport, plasma insulin, blood pressure, plasma triglycerides, plasma glycerol, body weight, and body fat in female Fischer rats.


and, later on:

Barnard et al wrote:
The results of this study clearly indicate that insulin resistance/hyperinsulinemia precedes the other characteristics of the metabolic syndrome. Furthermore, the data demonstrate that obesity is not the cause of insulin resistance/hyperinsulinemia, rather an HFS diet is the true underlying factor. Recent studies by Barnard et al. (2-4) have documented that diet appears to be a major factor in the metabolic syndrome and have shown that the syndrome can be induced in rats by feeding an HFS diet similar to the typical US diet and can be controlled in humans by feeding an LFCC diet combined with aerobic exercise.


The high fat, high sugar diet was compared to a low fat, complex carbohydrate diet. Sugar may increase insulin resistance but the study you linked doesn't demonstrate it because there is no control for a high fat, low sugar diet.

Shulman et al propose a method to decrease fat-mediated insulin resistance in the linked paper.

I'm not current in the field, so I apologise if my research is out of date. I've only re-familiarised myself via a relatively quick skim of the literature that popped up articles like:

Overnight lowering of free fatty acids with Acipimox improves insulin resistance and glucose tolerance in obese diabetic and nondiabetic subjects - which seems to indicate that blood FFA composition is quite important in insulin resistance.

Incorrect, re: both the short and the long term. In the short term, dietary glucose raises blood glucose and immediately triggers insulin secretion. In fact, the concentration of insulin parallels that of glucose.


I didn't deny that at all, but was specifically referring to the proposition by Taubes that high sugar intake increases long-term basal levels of insulin.



The study you quote does not control for the intake of fats but is more aimed at the question of dietary fibre vs sugar intake. While that is worthwhile, it is important to mention that whole grain foods are generally low in fat too.

Sorry, in the abstract you linked there is no support for your dismissal of the role of dietary sugar in insulin resistance. (And, it's a study on diabetics -not healthy people).


How so?

From the article:


Furthermore, we have now increasing evidence that the adipose tissue not only produces free fatty acids that contribute to insulin resistance, but also acts as a relevant endocrine organ producing mediators (adipokines) that can modulate insulin signalling
Emphasis mine.

Most studies on insulin resistance (the mechanism referred to indirectly by Taubes) are carried out in diabetic or pre-diabetic patients. This is because insulin resistance is one of the major risk factors for that disease.
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Re: Calories In/Calories Out

#30  Postby irreligionist » Mar 09, 2011 6:07 am

bookmarking, owing to it being a very interesting discussion :popcorn:
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Re: Calories In/Calories Out

#31  Postby Apollonius » Mar 09, 2011 3:35 pm

So what if insulin resistance is something that just somehow exists with no proven explanation for it? Maybe it was always there.

Then what happens when those people got caught up in the low fat diet craze starting in the 1970s? Food companies piled on the sugar, and said, "eat up, no fat!"

The next diet craze after that was low carb. Why? Maybe the percentage of people that had insulin resistance and didn't know it were the hardest hit by the increased sugar, thanks to low fat.

They respond well to low carb, and become low carb true-believers.

Look at the diet guidelines that come from professional and government authorities and see if any one them even mention screening for insulin resistance before they start giving people advice.

I think the official low fat advice from the 70s neglected this and created a lot of problems for some people without them knowing it.

People are still arguing, and studies that don't take this into account may just be crap.
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Re: Calories In/Calories Out

#32  Postby NilsGLindgren » Mar 09, 2011 3:51 pm

Templeton wrote:Now now Nils, I'm just a humble country bumpkin with a 4th grade education, and here I'm having to run around looking up words like euthyroid and steatosis - I've always found it easier to communicate to the lowest common denominator. ;)

:oops: <- me (embarrassed)
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Re: Calories In/Calories Out

#33  Postby Just A Theory » Mar 10, 2011 1:16 am

Apollonius wrote:So what if insulin resistance is something that just somehow exists with no proven explanation for it? Maybe it was always there.


I'm not an expert, but insulin resistance as I understand it is primarily caused by a build up of free fatty acids (FFAs) in the bloodstream. There are two ways that this can happen. Either A) you eat a high fat diet or B) you eat a lot of everything else, get fat and experience elevated FFAs (or well, both A & B can be correct I guess). Increased sugar uptake is associated strongly with B but has not yet been demonstrated to directly cause insulin resistance at least in the case of the simpler sugars.

Insulin resistance also occurs from uptake of various chemicals and some disease conditions but as I am not a researcher in the area, I can't really comment on the baseline rate of insulin resistance.

Then what happens when those people got caught up in the low fat diet craze starting in the 1970s? Food companies piled on the sugar, and said, "eat up, no fat!"


Advertising companies have long known that a simple falsehood is more likely to sell well than a complicated truth. The truth is that the "no fat" 64oz Big Gulp you're drinking? Yeah, that one? That will make you fat. However, by putting "no fat" on the outside label, they can appeal to the millions of rationalisers who delude themselves into thinking that they can somehow consume whatever they want and not gain weight.

The next diet craze after that was low carb. Why? Maybe the percentage of people that had insulin resistance and didn't know it were the hardest hit by the increased sugar, thanks to low fat.


Actually the low carb diet has been around for well over a hundred years in one form or another. It keeps getting re-popularised and keeps getting shot down in flames. It's just snake oil for the modern era.

And I do not buy the theory that a significant percentage of the population had insulin resistance symptoms that were sub-clinical and that it only took an increase in sugar to make them manifest. I think it has more to do with lifestyle changes, increased expectation for employers to claim worker time, longer commutes, rise in dual income families and increased reliance on fast food in lieu of cooking.

They respond well to low carb, and become low carb true-believers.


Then they will develop ketosis, be unable to continue with the diet, binge on carbohydrates and become fat.

Look at the diet guidelines that come from professional and government authorities and see if any one them even mention screening for insulin resistance before they start giving people advice.


They don't because there is no need for it. Don't over eat, don't over eat fats and sugars and eat a balanced diet apply equally well regardless of insulin resistance.

I think the official low fat advice from the 70s neglected this and created a lot of problems for some people without them knowing it.

People are still arguing, and studies that don't take this into account may just be crap.


If you're referring to Taubes, his pet hypothesis is crap - as has been pointed out.
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Re: Calories In/Calories Out

#34  Postby Ironclad » Mar 10, 2011 2:45 am

Following a ketogenic diet I managed to shed down from 28% body fat (BF) to 17% BF. All this in around 4 month & not in a calorie deficit.
It also fixed my IBS, oddly.
I have ebooks on this method, including Lyle McDonalds, shoot me your email addy if you'd like a copy.
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Re: Calories In/Calories Out

#35  Postby CdesignProponentsist » Mar 10, 2011 2:54 am

Scot Dutchy wrote:Exercise does not lose weight. It can even make you heavier but well leaner. Muscle is three times as heavy as fat so turning fat into muscle can increase your weight.
Calorie counting helps me. To me it is logical if you burn more calories than you eat you must lose weight.


That depends on the type of exercise. Cardio generally burns without producing much new muscle tissue, whereas weight training does produce more muscle tissue. Runners are usually pretty lean and light, weight lifters tend to be heavy and high in muscle mass.
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Re: Calories In/Calories Out

#36  Postby NilsGLindgren » Mar 10, 2011 6:12 am

Just a Theory wrote:Don't over eat, don't over eat fats and sugars and eat a balanced diet apply equally well regardless of insulin resistance.
... and a certain amount of physical exercise (aerobic) :cheers:
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Re: Calories In/Calories Out

#37  Postby Matt_B » Mar 10, 2011 8:14 am

Just a thought, but if insulin resistance was that big a factor, drugs that affect it such as Metformin would be wonder weight-loss formulas. They do work to a certain extent, but they're far from magic bullets, which I'd think rather underlines that there's still no substitute for calorie-controlled diet and exercise.
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Re: Calories In/Calories Out

#38  Postby Apollonius » Mar 10, 2011 1:19 pm

Just A Theory wrote:..

If you're referring to Taubes, his pet hypothesis is crap - as has been pointed out.


I would not be so positive about that. Since we can agree that neither one of us is an expert or professional researcher in this area, we are both at a disadvantage. All we can do it look at research and use logic and clues to help get at the real story.

In the following blog entry, Taubes and Dr Oz are on Larry King live in 2007. Dr Weil basically affirms exactly what Taubes said with his first book, and explains that the assumptions medical folks are working off of are false. They go on to discuss the insulin resistance issue in terms of how some people are affected, and some are not.

Many of the assumptions that are held by the conventional medical community simply rest on nothing. There is no scientific evidence for it… I don’t agree that the way to process this is to eat a diet that is mostly meat and no carbohydrate. I think it is very important for people to understand how carbohydrates affect them, and the differences in carbohydrate food…

Not everybody is in this spectrum. There are some people who are not sensitive to carbohydrates and won’t get fat no matter how much they eat. His (Taubes) basic ideas are very important. A lot of the ways that we try to prevent and treat obesity are based on assumptions that have no scientific evidence.


http://dietforhumans.com/2011/03/10/test/

This guy Dr Oz is no dummy. Taubes ideas are a threat to him. Was just told (2007 clip) on a national broadcast that he was full of shit. He better come up with some evidence.

Just recently, Oz had Taubes on his show, and Taubes just told him point blank that what he learned in med school was false, about what he heard in 2007. Oz has had 3 years to counter this, and he can't do it. When challenged over the good calories/bad calories, he changes the subject. (see the longer vid clip on the blog above). In a later part, which is on Oz's website, he and Taubes go at it again over exercise. Again, Oz can't counter and changes the subject to the "other benefits" of exercise.

This is getting a bit off topic from the OP, but it is interesting and relevant I think.

Weil again in the 2007 clip-

A lot of us have genes that predispose us to have obesity if we are exposed to the kinds of foods that trigger these hormonal problems. Our diet is now flooded with those. It’s all of those sweetened drinks, high fructose corn syrup, things made from flour or starch. All things things that kids are eating in huge quantities are reacting with their genetics to produce this disorder.


This is relevant to the discussion just above, in the previous posts. Taubes is not the only one saying it.

It seems to me that it may just be true that this insulin resistance is not a yes/no switch. Everyone fits into the spectrum somewhere in between. The people on one end eat all they want, including cake and cookies, and weight doesn't change.

The people on the other end don't handle carbs well, insulin goes up, and hormonal changes affect weight more than anything else. These are the people Taubes is talking about, not everyone. He makes that clear in the first clip. Tell these people to exercise more, or "just count calories" and it doesn't help. The issue is what the carbs are doing to their metabolism. This is not a small group of people.

I would suggest this may very well account for a lot of difference of opinion in the low fat/low carb wars. People are not paying attention to the spectrum, and assuming that everyone's chemistry is the same as everyone else's.
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Re: Calories In/Calories Out

#39  Postby Eduard » Mar 10, 2011 1:41 pm

:coffee:

Nice topic. From what I know that if you aim to lose fat: reduce calories. If you want to build muscle, don't increase calories (or consume copious amounts of either one of the 3 macronutrient groups) just do a lot of resistance training that gets progressively more difficult. If you want to expedite the fat loss part then calories in - calories out is a pretty nice heuristic, but don't let it dominate your life.

I hate the health, fitness and diet industries sooooo much! Sooo much! :yuk:
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Re: Calories In/Calories Out

#40  Postby Apollonius » Mar 10, 2011 4:40 pm

Eduard wrote::coffee:

Nice topic. From what I know that if you aim to lose fat: reduce calories. If you want to build muscle, don't increase calories (or consume copious amounts of either one of the 3 macronutrient groups) just do a lot of resistance training that gets progressively more difficult. If you want to expedite the fat loss part then calories in - calories out is a pretty nice heuristic, but don't let it dominate your life.

I hate the health, fitness and diet industries sooooo much! Sooo much! :yuk:


Me too. There is so much bullshit that it is overwhelming.

The medical studies are just as bad. Just a Theory posted some good leads in the other thread on Biological Sciences, and I looked at those and took it from there. I found a lot of abstracts to read, and lot of work done that adds up to about nothing!

As we said back in chem lab: garbage in, garbage out.

I found a lot of studies that really miss the point, in regards to the discussion above. A lot of work has been done on low fat vs low carb, but I haven't seen one yet that screened people beforehand for this difference in insulin resistance among the population. The ones that try to investigate insulin resistance are treating it as a disease, and waiting until it becomes a problem.

If you spend some time reading the peer reviewed medical studies, you get a shit load of "neutral language" weak conclusions that one can interpret in many ways.

Taubes work is intriguing because he spent 10 years investigating the investigators. I think it would be giving him too much credit to say he is right on every point, but he is changing the debate and "getting warmer."

I am in similar discussions on other sites. Every one of them has people that chime in with a short story about how low carb worked for them and nothing else ever did. Then others say it's bullshit. Then someone always says "just cut calories, that is SO obvious."

It is very clear to me that a significant percentage of people have not done well on the " cut calories and exercise" standard soundbite, and plenty of people who have. I'm not including obvious exceptions like eating disorders. I'm talking about the people Taubes is writing for, the ones who really do their best with the most common advice and it simply is not helping, they walk past a cookie and their hormones change. (exaggerating, of course)

The people who do well on cut calories and exercise are quite often skinny anyway. They read the same stuff everyone else does, and attribute their thinness to how well they are following the standard advice. Good for them, but they can piss me off too. The attitude is often "look at me. It works for me. If you can't be like me, then you are not following instructions and something is wrong with you, not the advice."

When I was huge (I'm normal weight now due to low carb), I used to say, "who do you want to believe? Someone who is thin anyway and thinks that their thinness makes them an expert? Or do you believe someone who was big and had to figure out how to get back to normal?"
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