Meat and veg? Veg and meat! (No chocolate biscuit.)

May 12, 2010 2:37 AM

Atkins was right?! According to a meta-study of nearly 350,000 people, "there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of (heart disease) or (vascular disease)... However, replacement with a higher carbohydrate intake, particularly refined carbohydrate, can exacerbate ... insulin resistance and obesity that includes increased triglycerides, small LDL particles, and reduced HDL cholesterol. Dietary efforts to improve ... (cardiovascular disease) risk ... should primarily emphasize the limitation of refined carbohydrate intakes and (losing weight)."

So... eat lots of bacon, eggs, and butter?! Not so fast. "Fats and meats are the primary dietary source of advanced glycation end products which are linked to diseases and aging, particularly if cooked at high temperature (broiling, frying)". Meanwhile, raw food diets have been shown to reverse incurable diseases. So while we evolved as omnivores, clearly there's something to a diet that's lower in sugar and carbs, which emphasizes vegetables, fish, and the occasional serving of lean meat. Just because our ancestors foraged for food and hunted for meat, that doesn't mean they were eating all the time, or that meat was always easy to catch.

posted by markkraft (207 comments total)

It's not so much that Atkins was right as that all of the extremist American diet trends are wrong. Including Atkins.
posted by kaibutsu at 2:43 AM on May 12, 2010 [16 favorites]

All I know is that whenever I go on Atkins, I lose ridiculous amounts of weight quickly and easily.

That being said, a fistful of chicken is all of 100 calories.
posted by effugas at 2:49 AM on May 12, 2010

So, nutritionists of mefi - what's the verdict on whole grains, particularly my morning bowl of quaker oats?
posted by phrontist at 2:49 AM on May 12, 2010

*nods*

I was anti-Atkins for quite awhile, never did the diet, and still do not feel that the way most Atkins diet people eat is all that ideal or healthy... that said, he was more right than the government, and its lobbyist-friendly food pyramid.

Scientific American has also reported on this aspect of the recent study:

"Will the more recent thinking on fats and carbs be reflected in the 2010 federal Dietary Guidelines for Americans, updated once every five years?

It depends on the strength of the evidence, explains Robert C. Post, deputy director of the U.S. Department of Agriculture’s Center for Nutrition Policy and Promotion. Findings that “have less support are put on the list of things to do with regard to more research.”

Right now, Post explains, the agency’s main message to Americans is to limit overall calorie intake, irrespective of the source. “We’re finding that messages to consumers need to be short and simple and to the point,” he says.

Another issue facing regulatory agencies, notes Harvard’s Stampfer, is that “the sugared beverage industry is lobbying very hard and trying to cast doubt on all these studies.”
posted by markkraft at 2:50 AM on May 12, 2010 [7 favorites]

The study (second link) looks like good science.

The other links? Not so much.

And .... this is what dieticians - at least those without anything to sell - have been saying for a long time: whole grains are good, fat helps the body, refined sugar is bad, all that Pollan stuff.
posted by kanewai at 2:52 AM on May 12, 2010 [8 favorites]

Refined carbohydrates are bad. Stick to veggies, lean meats, fish, eggs (predominently whites).

It's that simple.
posted by tgrundke at 2:56 AM on May 12, 2010

Yeah, everything on the "heartscan blog" seems seriously crank-tastic.
posted by phrontist at 2:57 AM on May 12, 2010 [1 favorite]

It's probably wrong that this post makes me hungry for bacon.
posted by twoleftfeet at 2:58 AM on May 12, 2010 [3 favorites]

"So, nutritionists of mefi - what's the verdict on whole grains, particularly my morning bowl of quaker oats?"

I am not a nutritionist. That said, I research these sorts of matters voraciously. And frankly, I am amazed at just how informed cardiologist Dr. William Davis is over at the Heart Scan Blog. He has clearly learned a *LOT* from his practice, and from maticulously charting, testing, and advising his patients, to the point that he has very solid evidence of turning people's lives around and reversing coronary heart disease... something that non-cardiologists like Dr. Dean Ornish have never done.

What really has stunned me is how a whole slew of studies have come out after-the-fact which support exactly what he has advised in the past. Perhaps he's well-connected to the research community... or perhaps he's learned a lot through his exacting tests.

I'm not about to break down and get a heart scan quite yet, but when he says lay off the oatmeal, I would personally consider listening to him.
posted by markkraft at 3:03 AM on May 12, 2010 [2 favorites]

They came to me and asked me to give up bacon, and I said "what care I of bacon?" Then they came to me and asked me to give up cheesecake, and I said "what care I of cheesecake?" Finally they came for me and asked me to give up whole wheat, rice, and granola. And I said, "does this mean I can eat bacon again?"
posted by twoleftfeet at 3:10 AM on May 12, 2010 [53 favorites]

A lot of what he writes is very similar to what you'll find over at Mark's Daily Apple. Especially when it comes to carbs and their effects on the body.
posted by tgrundke at 3:14 AM on May 12, 2010 [1 favorite]

Another thing to take into consideration is what foods you combine. For example, it is recommended that you may want to combine anti-oxidant foods such as berries or orange juice when eating things like bacon.

Or, when eating oatmeal, try mixing in some protein powder or nuts, which can help slow the sugar spike.
posted by tgrundke at 3:16 AM on May 12, 2010 [1 favorite]

Stopped paying attention when I got to the "raw foods fixed my diabetes" YouTube link. Try again when you excise pseudoscience from your diet along with carbs.
posted by Punkey at 3:25 AM on May 12, 2010 [15 favorites]

I'm writing an inedia cookbook but I haven't found any good recipes.
posted by twoleftfeet at 3:26 AM on May 12, 2010

See also the French Paradox.

It seems intuitive that eating fat would make you fat, but this is wrong. There has never really been any evidence backing it up, either. It's the sugar, stupid.
posted by mek at 3:27 AM on May 12, 2010 [3 favorites]

Punkey -

I don't know that raw foods will necessarily "fix" diabetes, but there's a lot of evidence to demonstrate that curtailing your refined carbohydrate/sugar intake can go a looooong way toward managing blood sugar.
posted by tgrundke at 3:31 AM on May 12, 2010 [3 favorites]

mek is right. Sugar is just plain bad for our bodies and our American diet focused heavily on refined grains make it even worse. Toss in some good ole' fashioned high fructose corn syrup in just about anything and everything processed and you've got a recipe for disaster.
posted by tgrundke at 3:33 AM on May 12, 2010

"this is what dieticians - at least those without anything to sell - have been saying for a long time: whole grains are good"

Actually, I don't think it says that at all. Rather, it says that carbohydrate intake, particularly refined carbs, such as flour and sugar, are dangerous and should be avoided... and if you're giving a patient a diet to avoid heart disease, that diet should target carbs.

"everything on the "heartscan blog" seems seriously crank-tastic"

... except, of course, that he is a cardiologist who has specialized in prevention for his patients, for years and years, meticulously tracking their cases.

Not only did his work and testing led him to the conclusion that carbs were the problem, he also identified all of the risks mentioned from carbs -- insulin resistance, obesity, increased triglycerides, small LDL particles, reduced HDL cholesterol -- before the study ever came out!

Likewise, he also identified the potential risk cooking "fats and meats . . . at high temperature (broiling, frying)" before the recent study which pointed out that a "high-heat-treated diet induced significantly lower insulin sensitivity".

Before that study came out, Dr. Davis said "in humans, greater quantities of AGEs are present in diabetics, pre-diabetics and people with insulin resistance."

Now, there are probably other previous studies that led him towards that conclusion, which he could cite. But I find the idea of considering a doctor "crank-tastic" when he clearly pays meticulous attention not only to his patients but to the latest scientific research basically foolish.

Maybe he's being *extremely* careful with his patient's health by cutting out the carbs so strictly... but given that most are seriously ill heart patients who are already at significant risk of an early death, it seems to me that he's justified. Before he starts taking risks by exposing them to a *little* risk by eating foods which simply did not exist when their ancestors were evolving, shouldn't he at least be sure to "do no harm", and ideally halt and reverse the progression of their disease?
posted by markkraft at 3:34 AM on May 12, 2010 [5 favorites]

I don't know any of this stuff, that is, whether this or that is right or wrong or good or not good. What I do know: look at pictures of people from the time, say, of WWII, random photos or men and women. They are nearly always thin. Why? Now look at random photos of people as they are now. Many are overweight. Why?
posted by Postroad at 3:49 AM on May 12, 2010

What I do know: look at pictures of people from the time, say, of WWII, random photos or men and women. They are nearly always thin. Why? Now look at random photos of people as they are now. Many are overweight. Why?

Rationing?
posted by biffa at 4:07 AM on May 12, 2010 [27 favorites]

I think that this is very interesting. I am looking forward to more discussion of the paper. I don't have access to the paper myself.

This previous metastudy found significant reduction in cardiac events when dietary fat is decreased. (But, interestingly, there was no apparent effect on total mortality.) It did so with randomized, controlled trials lasting greater than six months.

The AJCN abstract suggests that the fault with previous studies of the effects of fat on cardiovascular events ignored the effects of macronutrient replacement. I haven't checked, but this sounds pretty fishy to me. If you drop 200 calories off of a group's diet then chalk the effects up to decreased fat, you're going to get a lot of attention for being, basically, a liar. If you replace saturated fat with unsaturated fat, you can't claim to be a fat reduction. Again, I haven't checked this stuff out, it just sounds like there might be something wrong with their characterization of the previous work.

While the Cochrane study I linked to looked at randomized controlled studies, it sounds as if the AJCN study looked at survey data. The RCTs are great for establishing causality, but they can be criticized for being too short-- maybe you see decreased CV events for a year, and then a rebound effect, where increased CV events more than make up for it. It has to be recognized, though, that the AJCN metastudy can't show any causality. Again, don't have the article, just basing this on the sound of the Scientific American link markkraft was kind enough to provide. Most important is whether participants changed their diets, or just told researchers what they ate that day.

I would be really excited to read the actual study. Failing that, I would be excited to see some skeptical discussion of the article. I think it has the potential to be really interesting. Dietary fat, and how much of it to eat, has been a contentious issue. (It's going to continue to be so. From what I can see, this paper is not any kind of final nail in the coffin.)
posted by nathan v at 4:11 AM on May 12, 2010 [3 favorites]

I'm going to wait until we evolve so that refined sugars taste bad.
posted by Obscure Reference at 4:15 AM on May 12, 2010 [4 favorites]

EATING fat may not give you heart disease, but you know what? There's a lot of evidence that BEING fat does. And it's pretty easy to get fat by eating lots of it.*


*This is not to let refined carbs etc off the hook.
posted by smoke at 4:22 AM on May 12, 2010 [2 favorites]

People with access to lots of food tend to eat like pigs until they consciously slow down and think about what they're eating and start taking their weight (loss) seriously. Just about any diet will do if you stick to it and it includes calorie limits.

Here's a new fad diet for you to try. I'll call it the Bucket of Cocks diet. It will work for most people who give it a fair try and stick to it.

Label some plastic wieners (or anything else, but plastic wieners are good for a buck of cocks) with numbers (50 and 100?) so that you have enough calories to add up to the calories you can eat every day. These are your cocks. If you want to get extravagant, use little dildos. If you want to keep it cheap (and clean), maybe use ping pong balls that you pretend are cocks. It's your bucket of cocks. Just make sure they are all of a certain color, whatever color is easiest to get, maybe white (if you're using ping pong balls). If you're crafty, make your own cocks.

Also get some extra cocks (dildos, ping pong balls, whatever) of another color, maybe red, and also number them.

Now. Get three clear buckets, each of which is big enough to hold all of your calories for one day. Every time you consume calories, shift the approximately correct number of calorie cocks from bucket A to bucket B. Start with the white ones. That's your normal diet.

If you run out of white cocks, you have to start using red ones: transfer them from bucket C to bucket B. Those are your eating-like-a-damned-pig cock calories. If you use a lot of them, your bucket of cocks will runneth over and you're going to be fat.

To make it easier, find out approximately how many calories are in the things you commonly eat. If you eat the same items every day, you might even want to make some cocks that specifically represent them. Every can of Coke, for example, might be a certain color or kind of cock with the exact calorie count for a can of the kind of Coke you consume. (Ulrika-ka-ka-ka!) Or just use the empty cans rather than a representation of them, but remember to think of the empty cans as cocks in your bucket of cocks.

To make it portable (maybe for work), take a supply of mini-cocks in your right pocket. Every time you eat, shift some of your mini-cocks to your left pocket. A pocket of cocks. Then make sure you transfer the equivalent number of bucket-sized cocks when you get home.
posted by pracowity at 4:26 AM on May 12, 2010 [35 favorites]

Blame it on the burgers. It appears to be the combination of fat and refined carbs which is the worst of all.
posted by caddis at 4:31 AM on May 12, 2010

"Stopped paying attention when I got to the "raw foods fixed my diabetes" YouTube link. Try again when you excise pseudoscience from your diet along with carbs."

There's nothing pseudoscientific about it, Punkey. It's being used by doctors. It works wonders... if you stick with it. You can even see the documentary I mentioned, in which a patient with *type-1* diabetes who took insulin every day since he was young, damn near came off of insulin entirely... and probably would've had a good shot of doing so too, if he wasn't sneaking in booze during the experiment. Some of the type-2 patients came off of insulin entirely within days.

Indeed, before insulin in the 1920s, diabetes was a rare, fatal diesease, and "the only way to manage diabetes was through a diet low in carbohydrate and sugar, and high in fat and protein. Instead of dying shortly after diagnosis, this diet allowed diabetics to live but only for a few years".

Now, that's type-1 diabetes, not type-2... and not as strict a diet. So, really... is there anything particularly radical about suggesting that for many people, type-2 diabetes can be treated with the appropriate diet?
posted by markkraft at 4:32 AM on May 12, 2010 [1 favorite]

It's the sugar, stupid.

Or our nearly-sedentary lifestyle.

Many are overweight. Why?

Because the most movement they do in a day is a couple-dozen walks of about 20 ft. on average. And that's including the trip from your bed to the bathroom and back.

Most people drive to work, sit in chairs, all day, and when they get home they sit in more chairs and watch television, then they go to sleep. But when they were kids they walked to school, had gym class, shit-tons of walking throughout the day, enforced periods of recreational exercise (a.k.a. play–) time. That's what people are truly neglecting. They simply don't move around enough for the calories they ingest.
posted by Civil_Disobedient at 4:44 AM on May 12, 2010 [18 favorites]

markkraft, you are walking a fucking dangerous line here. Type 1 diabetes was a death sentence, and before the advent of pharmaceutical insulin, type 1 diabetics slowly starved themselves to death (because it was preferable to dying quickly). This grim fact has no applicability to an argument that Type 2 diabetes should be controlled with diet. In fact it pisses me off to see this getting bandied about in a thread about nutrition. The hell they suffered had nothing to do with nutrition and everything to do with having the bad luck to develop an auto immune disease that left them unable to tolerate carbohydrates. What this says about the rest of us and carbohydrates is nothing.

smoke, it is not necessarily easier to "get fat" by "eating fat." Fat is more naturally filling than carbohydrates -- try absentmindedly eating potato chips and see how long it takes to feel full. Then do the same with avocado. Fat may have more calories per gram of food, but there are more variables involved in how much food a person eats than merely the raw tonnage.

Anecdotally, I follow a paleo diet (no wheat or grains, no sugar, no starchy veg) and about 50% of my daily calories come from fat. I eat when I'm hungry and stop when I'm satisfied. I'm not fat (anymore).
posted by telegraph at 4:45 AM on May 12, 2010 [3 favorites]

Oops... here's the link to the full documentary. It's quite inspiring, actually.

My favorite bit is when one of the participants goes to see her doctor after the thirty days, after dropping twenty-five pounds, and no longer taking insulin or high blood pressure medicine.

"So, how do I send all my patients off to Arizona?!"
posted by markkraft at 4:51 AM on May 12, 2010 [1 favorite]

The constant (and constantly changing) confusion over nutrition and health is exactly why I avoid food altogether.
posted by DU at 4:56 AM on May 12, 2010 [16 favorites]

I know, hah hah, eating the wrong stuff couldn't possibly make you sick and changing how you eat won't make you better. Of course, there's the ketogenic diet, which has helped many epileptics. Epilepsy. Think about that. That's far different than diabetes, isn't it? You could at least sketch out a crude relationship between foods with a high glycemic index and insulin and body fat. It makes sense at a handwavy level, enough to say, "We ought to look into that for a study."

And yet, diet can touch even epilepsy. So maybe hold off on the snickers. And the Snickers.
posted by adipocere at 4:57 AM on May 12, 2010 [2 favorites]

thirty days, after dropping twenty-five pounds

If true, this is unhealthy. A typical intake requirement is ~2000 calories/day. A pound of fat 3500 calories. Even if your metabolism remaining constant while dieting, you can't lose a pound of fat in under 1.75 days. Exercise could conceivably put that down to 1-1.25 days, but keep in mind that's without taking in ANY calories. For 30 days. This woman lost a lot of water weight and some fat. She is some combination of malnourished and dehydrated.

If you cut out 500 calories a day, you'll lose about a pound a week. Pretty slow and undetectably grim, right? Well, if you measure and track it (one tool), you can see it happening in near realtime. And because 500 calories is so small, it takes almost no willpower to maintain¹, which means you can last for the long haul it takes to add up. 50 lbs in a year, healthily and sustainably lost.

¹And if it does take too much willpower, do 400 calories. Or 100.
posted by DU at 5:04 AM on May 12, 2010

"What I do know: look at pictures of people from the time, say, of WWII, random photos or men and women. They are nearly always thin. Why? Now look at random photos of people as they are now. Many are overweight. Why?"

Part of it, certainly, is portion size... but that overlooks a lot of the changes in what people ate, and how processed and concentrated the calories are today.

From the Guardian UK:
Study shows wartime rations were better for children

1800 calories instead of 3000. "boiled cabbage, corned beef, beetroot and grated raw carrot". . . no snacking.

While the current school lunches contained the equivalent of 17 teaspoons of sugar and the entire salt allowance for the day, those served during wartime relied entirely on fresh organic vegetables being delivered daily to the schools along with a serving of meat or fish.
posted by markkraft at 5:09 AM on May 12, 2010 [1 favorite]

Markkraft, while it looks like raw food diets can improve glucose tolerance in animal models, you have zero evidence beyond the anecdotal that such diets *cure* anything. The scientific gravitas of your AJCN review does not extend to cover anecdotal quackery.
posted by The White Hat at 5:12 AM on May 12, 2010 [2 favorites]

I want to say that I still think we really do not understand metabolism at all well and I am still extremely skeptical of folks and studies who claim that we do, because honestly we don't.

We don't understand why at some times different kinds of diet regulation and exercise regulation work differently for different people.

We don't understand the famine studies that we conducted during world war ii with conscientious objectors.

We don't understand how the folks who survived (there were some folks who suicided or tried to during the study) ended up gorging after the study but tended to normalize at their starting weight before the famine diet within about a year.

We don't understand why some folks' metabolisms appear to follow set-point characteristics and some don't.

We don't understand why most folks' metabolisms don't follow a purely mechanistic understanding of calories in equals calories out.

We don't understand how to talk about weight, diet, weight loss and related issues while being polite, respectful and not loading strangers up with inappropriate expectations.

So, in essence, there's a lot we don't understand, and I think it's insulting or at the very least disrespectful to claim that we do.
posted by kalessin at 5:24 AM on May 12, 2010 [13 favorites]

What I do know: look at pictures of people from the time, say, of WWII, random photos or men and women. They are nearly always thin. Why? Now look at random photos of people as they are now. Many are overweight. Why?"

I wonder how much of this can be attributable to :
a) easy access
b) variety

Pre-war there were few fast food outlets and grocery stores. Now, we are completely surrounded by both advertisement and food repositories. Plus, our jaded palettes are constantly being tempted by new foods and new combinations: New Hamburger 'N Fries Flavored Doritos, Sweet 'N Salty Oreos with Pretzel Frosting, Super Premium M & Ms with 8 different chocolate layers.

When your choices are limited, you eat less, but when offered more choices, you tend to eat more. How often when you are full from dinner have you "found room" for dessert? Which is why snacking and all-you-can-eat buffets are so deadly.
posted by Secret Life of Gravy at 5:27 AM on May 12, 2010 [2 favorites]

Yeah, I'm pretty skeptical of that Heartscan blog. Just in the first three posts on the front page right now, there are two that raise some flags for me. The first is this one about AGEs. There are a lot of claims, but no citations. AGEs are a relatively obscure scientific topic, certainly not something talked about in common discourse. If one wants to be taken seriously one really needs to cite your broad, and perhaps contentious, statements.

The second one, which really confuses me, in part because of my own ignorance, is the one about carbs and LDL cholesterol. This may just be a housekeeping issue, but I can't figure out his units at all. He writes: "LDL particle number 2620 nmol/L (which I would equate to 262 mg/dl LDL cholesterol) " I searched around to try to make sense of this conversion just because I had never seen cholesterol listed in anything other than mg/dl. Ok, it turns out that SI standards suggest that it should be measured in mmol/L. But notice that Heartscan uses nmol/L. Alright, that's an easy conversion I guess. But the only conversion factor I can find, including on the JAMA website, is 0.0259. Math is not my strongest suit, and I may well be missing something, but I don't understand how 2620 nmol/L gets converted to 262 mg/dl. Maybe it doesn't matter as long as he uses the same units throughout? Can someone else help me out?
posted by OmieWise at 5:37 AM on May 12, 2010

I once picked up an Atkins book a friend had, I skimmed it a bit and read the intro. It said something to the effect of:

There are three things you should avoid discussing with someone else if you want to have a pleasant conversation with them; their religion, their politics, and their diet.

It seemed to me that this guy knew what he was talking about.
posted by P.o.B. at 5:44 AM on May 12, 2010 [7 favorites]

Is it just me, or does nutrition basically come down to the paleodiet? http://en.wikipedia.org/wiki/Paleolithic_diet

I've lost 60 pounds on simple calorie counting via LoseIt! on my iPhone. I find that if I can use nutrition as a "game" then it somehow works for me.

I don't follow the paleodiet per se, but I do notice that bang-for-buck calorie-to-fullness ratio goes up when I start eating meat, eggs, fruits, vegetables, and a little cheese. I also feel way more alert and sleep better when I eat well and exercise (and I get to take off those 500 calories/workout for my calorie game!).
posted by imneuromancer at 5:45 AM on May 12, 2010 [3 favorites]

Yeah, Atkins was right.

Our gene line evolved to eat fruit, leaves and flowers and whatever we could chase down: insects, birds, mammals and fish. With occasional root vegetables if we got really hungry, and dirt for vitamins. Millions of years of primate evolution.

Agriculture is only 14,000 years old, or approximately 700 generations. Grass-based starches are even more recently added to our diet. Industrial refined sugars just a couple hundred years.

We're not optimized for that shit. I'll say it again. We are not optimized for that shit.

The fact that we can eat commercial starch and industrial fast-food isn't proof that it is good for us. It is proof that, as omnivores, we can eat almost anything and survive just long enough to breed the next generation. That's all that is important. If we can eat it, and breed, we've demonstrated our survival capabilities in adverse conditions.

Doubters still reading might be fucking shocked just how awesome their bodies feel after a couple of weeks just eating things we evolved to eat -- as opposed to the things we decided to eat. Mental clarity, reduction of joint pain, less fatigue, more energy, more stamina. No afternoon doldrums, waking up clear-headed and fresh.

Try it.
posted by seanmpuckett at 5:57 AM on May 12, 2010 [10 favorites]

I think that you are selling science way short, Kalessin.

In my opinion, it would be much more accurate to say that we don't have a perfect understanding of how things work. We do have a basic understanding of most of those things. We know the physical processes that are used to convert food into energy in the body. The calories in/calories out things is fairly incontrovertible from a physics standpoint. Calories aren't going to magically appear or disappear. They may be converted more or less efficiently.

It seems to me that the premise that consuming a lot of refined carbohydrates all at once is bad for you is evident in the physical processes of metabolism. The bloodstream can only hold so much sugar at any given time, and overloading that on a regular bases leads to all kinds of bad things. Other forms of calories are not subject to this restriction. Based on this, I would surmise that you can't generalize about the effects of sugar without knowing how the sugar is consumed. It might be far less harmful to eat a piece of chocolate every 30 minutes all day long than to guzzle down a liter of cola in 15 minutes. In both cases the amount of sugar that is consumed is the same, but only the cola would trigger the "over the limit penalty."
posted by jefeweiss at 5:57 AM on May 12, 2010

Is this the point where, after reading Good Calories, bad Calories I have a complete freak out that my morning bagel is giving me diabetes?
posted by The Whelk at 5:58 AM on May 12, 2010 [5 favorites]

(article) Robert Atkins had heart disease, myocardial infarction, hypertension, and congestive heart failure. During his last hospital stay, he weighed 258 pounds.

Also, his alternative health centers hired herbalists and acupuncturists. He tried to cure a woman's breast cancer with intravenous injections of ozone, and when she was injured he temporarily lost his medical license.
posted by Houstonian at 6:00 AM on May 12, 2010 [3 favorites]

That's worth expanding on briefly -- don't worry about the weight loss. Just understand that if you're in your 40s (like me), or older, and you've been eating crap -- and you switch to eating Paleo or low carb or whatever -- just get rid of the refined crap -- You will feel younger in your body and clearer in your mind. Weight loss and better blood chemistry is a fucking bonus if you ask me. I feel so alive.
posted by seanmpuckett at 6:03 AM on May 12, 2010 [1 favorite]

As a total non-expert on diet and health, I can't get rid of a nagging suspicion that it is the sedentary lifestyles that are hurting us, much more than the food choices. The food might make you fat, no question -- but the sedentary drive-sit-nap-sit lifestyle is extraordinarily far from how any of our ancestors ever lived until the last couple of generations.
posted by Forktine at 6:03 AM on May 12, 2010 [3 favorites]

Holy crap! That heartscan guy suggests taking T3 for weightloss. Yeah, no shit? You might as well just prescribe T3 for good at that point. Down-regulating your Thyroid into Hypothyroidism ain't no joke. I skimmed through a bit of his blog and I was fine with it until that point.
posted by P.o.B. at 6:08 AM on May 12, 2010 [2 favorites]

After I got diagnosed with type II diabetes I went vegan - immediately my blood sugar numbers got better. Even after taking up drinking again and gaining weight and doing everything wrong, my numbers are still good. Animal fat blocks insulin reception and utilization, increasing serum glucose levels and all the baggage that comes with that....
posted by pdxjmorris at 6:11 AM on May 12, 2010 [1 favorite]

Sweet 'N Salty Oreos with Pretzel Frosting...

I pressed the little plus sign on your comment, but for some reason it's not adding to my shopping cart.
posted by billyfleetwood at 6:15 AM on May 12, 2010 [48 favorites]

When someone makes sweeping, bizarro statements like "eliminate wheat", I start to assume they're more interested in notoriety than in actually accomplishing anything.
posted by gimonca at 6:19 AM on May 12, 2010 [5 favorites]

I think the low-carb crowd is more right than wrong. It's easy to mouth platitudes about calories in vs. calories out or how we are more sedentary in the past, but the case that refined carbs (and possibly even non-refined starches) is the primary trigger for fat gain and retention is much more solid than most people think.

Don't believe me? Let's bet. I'll bet that you can sit on your ass and eat more calories than you burn for a solid week and still lose a couple of pounds of fat (not just water) -- as long as you completely avoid carbs. See, the body cannot store fat without insulin. And it produces insulin in response to carbs. No carbs, very hard to store fat.

You will also, after a couple of days in which you might experience something like withdrawal, have much more energy and no post-meal slumps. No physical carb cravings. No blood sugar roller coaster.

Now IANAD and I can't guarantee that this is good for your heart or cancer prevention, etc. But I believe it is, especially once you add non-starchy vegetables back into your diet. Eat nothing but steak and salad every day and I suspect you'd be much healthier than if you replaced the steak with a lean meat paired with a starch.

Carbohydrate is the devil, people. Nobody's saying to stop eating your veggies -- the carb level is low and it's balanced by fiber and assorted micronutrients. But the sugar, the HFCS, even the bread and pasta and potatoes, they're what make you fat. Whole wheat is marginally less bad for you, but it really is marginal. Go compare the glycemic index values of white bread and whole wheat bread. There's some difference, but it's miniscule compared to the difference between carbs and protein or fat.

Also, dietary fat probably has a bad rap. The evidence against it is much less than you might think, given the rhetoric out there. I honestly believe that a steak slathered in butter (not necessarily margarine - everybody agrees that transfats are bad) might be better for you than a big bowl of pasta and veggies.

This is one of those things that they're going to look back on in 50-100 years and be like, WTF, science? Low fat, high carb diets?? Were you insane??
posted by callmejay at 6:26 AM on May 12, 2010 [6 favorites]

So, in essence, there's a lot we don't understand, and I think it's insulting or at the very least disrespectful to claim that we do.

We can't predict everyone's metabolic behavior 100 percent accurately, but it's not as if we can't make some solid general assumptions. Doctors are pretty good at knowing how people are built -- they don't open people up and discover the liver where the heart should be, for example -- and they are pretty good at knowing how all of those parts under the skin will behave when you give them certain stimuli. Pretending that diet is all an unfathomable mystery is a bit on the goofy side.

If you eat too much without working it off, you will get fat. There are variations in people and in how they will react to certain foods, but the basic truth for almost all people is that each calorie going into your body has to be burned up by a fairly predictable amount of work or some of the excess will take up residence in your body as fat. So fat people generally need to eat less (and exercise more, perhaps, but mainly eat less). If you can't lose your excess weight, you probably haven't reduced your calories enough (and perhaps you're sitting around too much when you should be up and active more, but mainly you probably just eat too much).
posted by pracowity at 6:26 AM on May 12, 2010

Robert Atkins had heart disease, myocardial infarction, hypertension, and congestive heart failure. During his last hospital stay, he weighed 258 pounds.

In that article, it sounds like at least 58 of those pounds were due to retention from fluids administered while in intensive care.
posted by pinky at 6:29 AM on May 12, 2010 [1 favorite]

I'm seeing a fair bit of the appeal to nature in this thread. Just because we ate something at an earlier stage of our development does not make it better for us, and just because we started eating something relatively recently in our species' history does not make it worse for us. Determining whether a given food is good or bad for us is the job of empirical scientific investigation, not of teleological misinterpretations of evolution.
posted by Pope Guilty at 6:29 AM on May 12, 2010 [31 favorites]

No secret that a diet of veggies and lean meat will suck you down in weight pretty quickly - my wife was a lightweight rower and to drop weight safely salad and chicken/beef/fish was the requisite course of action.

For high-performance athletes, carbohydrates are still the main fuel. However, it is suggested these days that baseline diet should be high in natural, unprocessed foods like fruits, vegetables, lean meats etc. and that increases in high-output, high-glycogen-consuming activities be supplemented with a higher percentage of (good) carbohydrates like whole grain pastas, more fruits and the like.
posted by jimmythefish at 6:30 AM on May 12, 2010

Robert Atkins had heart disease, myocardial infarction, hypertension, and congestive heart failure. During his last hospital stay, he weighed 258 pounds.

There's no guarantee that Atkins practiced as he preached. He might've known was was right and not had the willpower to actually follow it.

To put it another way, there's no direct correlation between being a good hockey player and being a good coach. Scotty Bowman won 9 Stanley Cups and never actually played at the any professional level. Does that mean he doesn't know what it takes to be a good hockey player?
posted by Hiker at 6:34 AM on May 12, 2010 [1 favorite]

...I can't get rid of a nagging suspicion that it is the sedentary lifestyles that are hurting us, much more than the food choices.

It's probably a combination, the diet high in refined carbs plus a sedentary lifestyle.
posted by Brandon Blatcher at 6:35 AM on May 12, 2010 [2 favorites]

pracowity, I know plenty of folks personally who are on doctor recommended calorie restrictive diets that have worked for them as I have known plenty of other folks personally who are on doctor recommended calorie restrictive diets that haven't worked for them. Additionally I know the same numbers of folks who have or have not had exercise work for them. The variations? Mostly different doctors. I think some doctors may know things and be pretty good about it, but I also know that there are other doctors who don't.

Doctors in general know suff? Sure. Doctors in specific? People in specific? Not so much.

I do think that it's reasonable to think that at a very general level, combinations of calorie restriction and elevated exercise can lead to weight loss. But I also think that we don't understand, for instance, whether weight loss actually does good things for us.

Why do I think this? Because I have done medical and statistical research of the literature that indicates this may be true.

Additionally because some of that research indicates even that we don't know how to properly interpret statistical data and results and that in general we tend to take very non-indicative statistics as extremely significant if they support our preconceived notions of how things should be and in general we tend to discount indicative statistics if they complicate our understandings of things we think should be simple.

There's a very fascinating science of the psychology and methodology of our sciences that always gets completely ignored when we claim we know shit like this that we demonstrably do not "know" in a purely factual or theoretical sense.
posted by kalessin at 6:37 AM on May 12, 2010 [1 favorite]

You can even see the documentary I mentioned, in which a patient with *type-1* diabetes who took insulin every day since he was young, damn near came off of insulin entirely... and probably would've had a good shot of doing so too, if he wasn't sneaking in booze during the experiment.

This is ignorant bullshit. A type 1 diabetic who is eating an extremely low carb diet would of course be able to reduce insulin levels accordingly -- insulin intake for a type 1 is largely a function of how many grams of carbs the person is eating. And there's nothing necessarily wrong with that, if it works for the person. However, the notion that the person would have a "good shot" of coming off insulin "entirely" if he weren't "sneaking" bad food is based on ignorance, because a type 1 must always take a basal level of insulin to cover the constant low levels of glucose that the liver pumps out. A type 1's pancreas no longer works. After what's known as a "honeymoon period" following shortly after disease onset where the pancreas may still produce low and diminishing levels of insulin, it is an ex-pancreas. There is no cure for type 1 diabetes, no matter what your diet is like or how much exercise you get.

By contrast, type 2 diabetes in theory can be "reversed" - or what some might describe as cured. Those are loaded terms for various reasons, but I'll just say that, with some combination of luck, diet, exercise, and medication, it is generally possible for someone suffering from symptoms of type 2 diabetes to get to a point where they no longer need medication and have decent levels of blood glucose as a general matter. Without minimizing the various obstacles to achieving this, it is at least a reasonable goal for treating type 2 diabetics.

Just wanted to clarify.
posted by chinston at 6:51 AM on May 12, 2010 [7 favorites]

Or what telegraph said.
posted by chinston at 6:53 AM on May 12, 2010

Robert Atkins had heart disease, myocardial infarction, hypertension, and congestive heart failure. During his last hospital stay, he weighed 258 pounds.

Atkins slipped on some ice, had a massive brain hemorrhage, and swelled up to 258 pounds (fluid is heavy) before dying.

But, you know, if you want to get cheap points on someone else's death, you can do that.
posted by effugas at 6:57 AM on May 12, 2010 [15 favorites]

You should read the article. The weight is a cheap shot, but his heart stopped nine months before his fall, he had significant and developing arteriosclerosis according to his wife and his cardiologist, and the coroner's note listed congestive heart failure as well.
posted by OmieWise at 7:01 AM on May 12, 2010 [1 favorite]

By contrast, type 2 diabetes in theory can be "reversed" - or what some might describe as cured.

Once a Type II, always a Type II, there is no cure. It is possible for a person to get off meds with a combination of weight loss, diet and exercise, but they're still classified as a Type II.
posted by Brandon Blatcher at 7:06 AM on May 12, 2010

[...] his heart stopped nine months before his fall, he had significant and developing arteriosclerosis according to his wife and his cardiologist, and the coroner's note listed congestive heart failure as well.

That may or may not be, but one person's health (even if it's Atkins' health) does not prove or disprove the effectiveness of the Atkins diet. It's just anecdotal.

(I'm not defending the diet. I don't know or really care about it. I'm just pointing out that one guy's health is not a firm basis on which to judge a diet. There is no alternate universe Atkins who was not on that diet to whom you can compare the Atkins of this universe. But you can of course compare him to other people in this universe who were on his diet, and then I think you will see that they didn't all die of congestive heart failure, etc.)
posted by pracowity at 7:13 AM on May 12, 2010 [2 favorites]

Once again I have to recommend Gary Taubes' work of science journalism, Good Calories, Bad Calories. Diet and health are incredibly complex scientific topics with an overlay of emotion and politics. His book does a good job in looking at all that complexity to explain how we've gotten to our current understanding of diet. He ends up arguing that carbohydrates are a dietary problem, and I tend to believe it, but the process of getting there is as interesting as the conclusion.
posted by Nelson at 7:15 AM on May 12, 2010 [6 favorites]

There is a middle ground here between noshing on twinkies and eating only bacon. I think the paleolithic diet, that emphasis large amounts of vegetables, fruits, fish, and grass-fed ruminants (which definitely have less fat). I've been involved in butchering both wild and domestic animals. There is definitely no comparing something like a deer to a domestic pig...it's like an alien species, though a lot of hunters miss the best fat stores because they don't crack open the bones.

I've followed the paleo diet for about three years now. My body fat is low, my cholesterol is low, and my asthma, GERD, and IBS are gone. Eliminating wheat sounds extreme, but it was the only thing that worked for me, despite testing negative for celiac. I hate commenting on these kind of threat though because diet is so individual. I've had friends do well on vegan diets that are the opposite of mine, though they do have something in common: emphasis on whole fresh foods and elimination of junk food. Doing just that can make a huge difference.

While I respect Dr. Atkins for moving away from the high-carb approach, it doesn't mean we should throw the baby out with the bathwater. When I meet low-carbers eating mostly chicken, cheese, and bacon, I think they heading in the wrong direction. These foods are nothing like wild meat at all. Pigs and chickens are almost always fed grain anyway, so if you are what you eat...
posted by melissam at 7:15 AM on May 12, 2010 [2 favorites]

There's no guarantee that Atkins practiced as he preached. He might've known was was right and not had the willpower to actually follow it.

It is also possible that he was on an Atkins diet, and had he not been, he would have died even sooner.

From my own empirical studies done on a sample size of one--me--I have concluded that bread, potatoes, chips, crackers, etc., are poison. I came to this conclusion a roundabout way. I wanted to stop that food coma sensation I would get after eating lunch, even if it was a sandwich. That sensation was troubling to me. It can't possibly be the natural operation of the body to want to pass out after eating, that makes no sense.

So many many months of experimentation led me to the conclusion that the starchy crap I listed earlier is death. Why is it I can eat a 12 oz steak and not experience food coma, but I get it after a bowl of cornflakes or a plate of spaghetti? Understanding only slightly the biochemical processes involved, I have to conclude that there is something intrinsically unnatural about the baking of bread and these other carb-heavy products that alters their chemistry in a way that wreaks havoc with my system. Maybe the density of carbs is far heavier than anything that exists naturally. Or maybe the heating of these foods creates other bizarre chemicals.

Bread, pasta, etc. and in particular anything that comes in a mylar bag are not food. They are processed foods. They are to grains and corn what Slim Jims are to meat. I've removed that stuff from my diet entirely and have not looked back. I still eat fruit, I only occasionally eat vegetables, but I eat a lot of poultry and some beef. No more food coma, no cholesterol problems, and I lost weight without having to go hungry.
posted by Pastabagel at 7:16 AM on May 12, 2010 [1 favorite]

This is one of those things that they're going to look back on in 50-100 years and be like, WTF, science? Low fat, high carb diets?? Were you insane??

Is this where I quote Woody Allen's Sleeper?
posted by device55 at 7:16 AM on May 12, 2010

kalessin: "But I also think that we don't understand, for instance, whether weight loss actually does good things for us[...] Why do I think this? Because I have done medical and statistical research of the literature that indicates this may be true."

Citations or it's fake. For instance, I just pulled three articles from pubmed which suggest that weight loss has real health benefits for certain subgroups. The last of these suggests that the middling conclusions are the result of confounding from muscle mass. Using abdominal girth measurements or body fat percentages may disentangle the effects of exercise and diet-based lifestyle modification regimines.
posted by The White Hat at 7:17 AM on May 12, 2010

Yes, you're absolutely right, Brandon Blatcher. I didn't mean to approve of the term's use myself.
posted by chinston at 7:27 AM on May 12, 2010

So...does this mean a KFC grilled Double Down is actually health food?
posted by anthom at 7:28 AM on May 12, 2010 [1 favorite]

When someone makes sweeping, bizarro statements like "eliminate wheat", I start to assume they're more interested in notoriety than in actually accomplishing anything.

Ok, but (anecdata):

My husband developed celiac disease, and has a serious intolerance to wheat in any form, so was forced to eliminate it from his diet. He still eats copious amounts of corn, rice, quinoa, beans (so he does get carbs), meats, fruits and veggies and whatever gluten-free stuff he can get his hands on that doesn't taste like complete ass. Some of which is processed/frozen and can include quite a bit of sugar. So calorically, he's still consuming quite a bit.

He has lost probably 100 pounds, and now weighs about what he did in high school. And it hasn't come back in a year.

Celiac disease and gluten intolerance, like many other allergies, also seems to be on the rise; there are more and more support groups/products/restaurants offering gluten-free menus.

I have seriously started to wonder if there isn't something about wheat--if, for example, there aren't a significant number of humans who may have a low-level undiagnosed gluten intolerance causing inflammation--what if a major factor of obesity is not as simple as calories or carbs, but in our bodies reacting badly to certain kinds of foods as though they were allergens? Isn't there a tie between inflammation and heart disease?

I'm not a scientist or a doctor, but watching my husband go through this transformation has definitely changed my ideas about what it means to "eat healthily". I am slowly reducing my own wheat intake and seriously thinking about giving it up altogether (though that's really a bitch, wheat gluten is in everything).
posted by emjaybee at 7:29 AM on May 12, 2010 [1 favorite]

So...does this mean a KFC grilled Double Down is actually health food?

In my opinion, yes, actually. As long as you didn't eat so many carbs that day that the insulin to convert that food into fat wasn't around.
posted by peacheater at 7:30 AM on May 12, 2010

So...does this mean a KFC grilled Double Down is actually health food?

Not for the chicken or the pig.

(Sounds like a scrum.)
posted by pracowity at 7:32 AM on May 12, 2010

On the KFC Double Down: In my opinion, yes, actually. As long as you didn't eat so many carbs that day that the insulin to convert that food into fat wasn't around.

Eh, it depends on whether the sandwich actually fills you up. Eating carbs that don't actually sate your hunger or sate it well is counter productive.
posted by Brandon Blatcher at 7:36 AM on May 12, 2010

I have seriously started to wonder if there isn't something about wheat

There may well be. It may be that most wheat people consume is in the form of a processed snack treat™ loaded with hydrogenated fats and corn syrup.

Celiac disease is a real thing that can be tested for. (Congrats to your husband by the way, that's fantastic) But, I think people's skepticism stems from the fact that every single 'naturopath' or health food nut will immediately jump on the 'cut out wheat' bandwagon without citing any particulars or, you know, performing an allergy test.
posted by device55 at 7:41 AM on May 12, 2010 [1 favorite]

So...does this mean a KFC grilled Double Down is actually health food?

Optimus Chyme argued in Metatalk that it's among the healthiest fast food meals available.
posted by Pope Guilty at 7:42 AM on May 12, 2010

Eating carbs that don't actually sate your hunger or sate it well is counter productive.

I wonder whether the right diet has to involve drugs? Maybe people with too much food need (safe) drugs that make us feel too full to eat the extra food. Not just make us feel not hungry, but give us that "Christ, I couldn't eat another damned bite!" full feeling people get after a Thanksgiving dinner.
posted by pracowity at 7:43 AM on May 12, 2010

I have seriously started to wonder if there isn't something about wheat--if, for example, there aren't a significant number of humans who may have a low-level undiagnosed gluten intolerance causing inflammation--what if a major factor of obesity is not as simple as calories or carbs, but in our bodies reacting badly to certain kinds of foods as though they were allergens? Isn't there a tie between inflammation and heart disease?
I have started to wonder about this too. I cannot tell you how differently I feel when I'm eating wheat and gluten and when I'm not. Yesterday I succumbed to the free ice cream they were giving out in the library and the rest of the day was a haze of sugar-induced cravings. Such a difference from days when I eat bacon and eggs or whole fat yogurt for breakfast, a chicken salad for lunch and maybe some broiled meat and asparagus for dinner. Truly like night and day.
Here's my considered opinion of how this whole low fat is great thing has come to be. There are some people who have naturally high metabolisms and are also tolerant of carbs. There was a recent study I remember seeing about a gene that protects against obesity that I should dig out. Anyway they tend to be the ones setting the rules about what we should eat and what we shouldn't because they're thin right? They know what they're doing. This ignores the fact that we're all built rather differently and I personally tend to do terribly on any sort of low fat diet. I ballooned up during my late teens in part because I decided I should diet -- which consisted of lots of plain pasta with fat free tomato sauce. So there's a vicious circle, those who most need to lose weight are fed exactly the wrong advice for their body type. It was a great day for me when I discovered Atkins by accident on some web forum. I was initially extremely skeptical, but decided to buy the book and read through the science portions. None of the science set off my bullshit meter (and I've taken lots of biochemistry classes). I was able to lose weight without any of the constant hunger cravings I had while doing low fat, because fat and protein are far more satiating than the equivalent in refined carbs.
You may disagree with specific details of his philosophy, but I predict that 50 years from now the evidence is going to come down firmly on his side. And I second the recommendation for Good Calories, Bad Calories, for a great explanation of the science by committee that led us up the low-fat garden path.
posted by peacheater at 7:44 AM on May 12, 2010

True incidence of food allergies (as opposed to food intolerance) much lower than people tend to believe, says report.
posted by blucevalo at 7:44 AM on May 12, 2010 [1 favorite]

Bread, pasta, etc. and in particular anything that comes in a mylar bag are not food. They are processed foods. They are to grains and corn what Slim Jims are to meat. I've removed that stuff from my diet entirely and have not looked back. I still eat fruit, I only occasionally eat vegetables, but I eat a lot of poultry and some beef. No more food coma, no cholesterol problems, and I lost weight without having to go hungry.
posted by Pastabagel at 10:16 AM on May 12 [+] [!]


Eponysterical!
posted by cereselle at 7:46 AM on May 12, 2010 [6 favorites]

Eh, it depends on whether the sandwich actually fills you up. Eating carbs that don't actually sate your hunger or sate it well is counter productive.

Sorry, I don't get this. The "sandwich" doesn't really have any carbs to speak of.
posted by peacheater at 7:47 AM on May 12, 2010 [1 favorite]

OmieWise: you're right, it does not make sense. The conversion factor for LDL cholesterol is, as you say, 1mmol/l ~ 39mg/dl. Starting with a concentration of 2.62mmol/l:

2.62 mmol/l * (39 mg/dl / (mmol/l)) = 102.18 mg/dl.

To have the cited 262mg/dl, LDL cholesterol would need to have an equivalent density of 1g/l (equiv. 100mg/dl).

Truthfully, I'm wary of this heartscan blog. I'm surprised Davis was able to get a medical degree given that he can't do stoichiometry (meaning he probably wasn't able to pass freshman Chem.)
posted by zonem at 7:47 AM on May 12, 2010

Carbs aren't evil, but they need to be balanced with activity. Gonna go out and run a marathon? Need carbs. Gonna sit on your ass all day? You should just eat foods that contain the necessary amino acids and vitamins to keep your body running for the day.

What we are learning is that calories aren't fungible.
posted by gjc at 7:47 AM on May 12, 2010 [2 favorites]

Eat food. Mostly carbs plants bacon. Until a study next week says otherwise.
posted by mccarty.tim at 7:51 AM on May 12, 2010 [1 favorite]

Sorry, I don't get this. The "sandwich" doesn't really have any carbs to speak of.

I think people are referring to following the 'sandwich' with a bucket of fries and mashed 'potatoes' with 'gravy'
posted by device55 at 7:53 AM on May 12, 2010

I think people are referring to following the 'sandwich' with a bucket of fries and mashed 'potatoes' with 'gravy'

Yes, but I thought I specifically said it was healthy as long as you didn't do that. Anyway, never mind, doesn't truly matter.
posted by peacheater at 7:56 AM on May 12, 2010

Meanwhile, raw food diets have been shown to reverse incurable diseases.

Can I just pop in and complain about the inclusion of that video in this post? A reality show is not a study. Whatever the end result, this does not support the conclusion that raw food diets reverse diabetes.
posted by lexicakes at 7:58 AM on May 12, 2010 [4 favorites]

I CANNOT BELIEVE I HAVE TO HAVE MY ILL-INFORMED OPINION ABOUT FOOD AND METABOLISM AND AMERICAN DIETARY HABITS BURIED WAY THE FUCK DOWN HERE. OUTRAGEOUS.

Anyway, if you aerate your wine properly, you can eat anything you want and live a long, slender, healthy life. It's the French Paradox!
posted by everichon at 8:07 AM on May 12, 2010 [6 favorites]

Optimus Chyme argued in Metatalk that it's among the healthiest fast food meals available.

Actually the large chili from Wendy's, without cheese is healthier. 330 calories, 10 g of fat, 32 gram of carbs, about the same in sodium though.
posted by Brandon Blatcher at 8:10 AM on May 12, 2010

Has anyone tried a reduction of carbs (not elimination but cutting way back), but without adding a lot of meat? I want to lose weight, but I don't really like meat that much and the thought of steak makes me want to hurl. Yet I need to change my eating habits to cut back on carbs.
posted by theredpen at 8:10 AM on May 12, 2010

Has anyone tried a reduction of carbs (not elimination but cutting way back), but without adding a lot of meat? I want to lose weight, but I don't really like meat that much and the thought of steak makes me want to hurl. Yet I need to change my eating habits to cut back on carbs.
Sure, my mother lost about 30 pounds on two years of eating vegetarian low carb (she just doesn't like the taste of meat). It's harder because there aren't as many choices and it's harder to feel full and not go over your carb allowance for the day. But if you could eat some meat, like chicken or tuna, it would be way easier and you really wouldn't need to add that much. You really don't need to eat steak if you don't want to. Eggs are your friend here.
posted by peacheater at 8:16 AM on May 12, 2010 [1 favorite]

Has anyone tried a reduction of carbs (not elimination but cutting way back), but without adding a lot of meat?

My own transition to lower carb hasn't involved adding much more meat. Mostly it means replacing potatoes with salads at restaurants and snacking on cheese, nuts, or sausage at home. I wouldn't particularly miss the sausage.

Speaking anecdotally, I find that I'm simply eating less on a lower carb diet. A handful of cashews or an ounce of cheese makes me feel full in a way that bread or chips never did. You know how Lay's used to advertise their potato-slurry chips "bet you can't eat just one"? It's sort of hideous. I'm perfectly content to eat just one piece of cheese.
posted by Nelson at 8:21 AM on May 12, 2010

Reading this thread, I see an awful lot of "A doctor treated his patients with X and found Y" and "I did A and B happened". That's not science. It doesn't tell anyone else what they should do. It's not generalizable.

You can't establish causal relationships unless you're looking at a large sample. Even studies of tens of thousands of patients have a hard time sussing out anything useful. A doctor or health guru doesn't see enough people in his/her practice to do anything statistically significant. A doctor isn't blinded, the patient isn't blinded, the patients are all receiving some form of treatment, the doctor is usually trying to prove a theory, etc. There's almost nothing you can learn from a doctor or dietician acting on their own without major support from real clinical researchers. Generally speaking, medicine knows a lot but you shouldn't blindly trust any one doctor or nutritionist.

These nutrition studies are looking for effects that are relatively small. Much smaller than the random variation you see from person to person, which is why your experience doesn't mean *anything* to me. I know a health nut cyclist who routinely rides 100 miles at a time, weighs about 130 lbs, and had a heart attack in his late 40's. Meanwhile, I know lots of fat folks who _haven't_ had any sort of cardiovascular event. Clearly there's way more going on here than simply obesity or diet or genetics or environmental factors.

The science of nutrition is ridiculously primitive. There's almost nothing that anyone can say for sure. Some studies find that small, frequent meals are the way to go. Others find that fasting is healthier. Some determine that saturated fat is bad. Some don't. Epidemiological studies often find that "diet x" (Mediterranean? Okinawan?) is great, but then a few years later it turns out that a clinical trial shows the diet has no significant effect either way. X is good for you, or maybe causes cancer. Something that helps type 1 diabetes might kill someone else.

I'm not sure what the real consensus is. Don't base your diet on white flour and sugar. Eat vegetables. Eat some fatty fish. Try to eat relatively lean grass-fed meat (our ancestors were not eating fatback, paleonuts). Don't eat too much. Don't get fat. Drink a little bit of alcohol.

Personally, I bet the single most effective "diet" is to simply cook your own food from scratch. I'd love to see a good study comparing people who cook their own food to people who eat out all the time. It's hard to load your own food up with even a third as much shit as you'd find in food prepared by a restaurant or factory. It encourages you to chill the hell out for an hour, which can't be bad for you.
posted by pjaust at 8:21 AM on May 12, 2010 [21 favorites]

True incidence of food allergies (as opposed to food intolerance) much lower than people tend to believe, says report.

I don't think the original poster was talking about allergies that cause an immediate response, as that article seems to be defining them (since that's the only way a challenge test could be done). I"m surprised that the writer says "only" 1 in 20 people have that sort of reaction - higher than I'd have guessed - but the argument was about allergies as a more constant relationship to food, so that eating it has a general and long term impact.

If we can work out what foods aren't best or most efficient for us, then perhaps our diets can be improved - and the idea behind allergies is that perhaps it's not identical for everyone, so there isn't so much a right answer to the question as a right diet for the individual.
posted by mdn at 8:22 AM on May 12, 2010

That's not science.

Science is when you have a lab coat and a clip-board, and at least one retort.
posted by everichon at 8:38 AM on May 12, 2010

How the meat was raised makes a big difference. Factory farm beef is terrible, grass-fed organic is wonderful. Same with chickens, fish etc..

What your parents and grandparents ate makes a difference in your health today. And the health of your children and grandchildren will depend on what you eat today. Epigenetics is one of the most interesting lines of nutrition research.

Veggies are carbohydrates .. naturally fortified with vitamins. Instead of a small plate of veggies and side of potatoes, just double the veggies and skip the starch. It's about nutrient density.

Eating fat can make you fat. Fat is just storage of excess energy, in whatever form it arrives. OTOH, fat sedate's hunger and so you don't want to eat - a spoon of olive oil when your hungry can replace a meal. It's about calorie amounts.
posted by stbalbach at 8:39 AM on May 12, 2010

mdn--you are correct, I was not saying everyone has a testable food allergy, but that many of us might have an undiagnosed sensitivity. What I was trying to get at is wondering if allergic reactions/inflammation/immune system responses aren't playing a hidden role in obesity.

And among people who suffer with allergies, there is a high percentage who test "negative" but end up self-treating by eliminating the allergen anyway, because they're so miserable and it works to eliminate their symptoms. Online boards are filled with unhappy people suffering hives and other symptoms whose doctors have thrown up their hands in confusion.

Which actually is my husband's situation. He eliminated wheat when he suspected he had celiac, and it had immediate effects. He has never been "officially" diagnosed, because to do so would require eating wheat for a week or so and then getting tested. And he's simply not willing to put his body through that, after so many years of misery. His doctor is ok with this, and his health is better than it's been in years. It's anecdata, but judging by the way both obesity and food allergies seem to becoming a bigger problem, it would be interesting if any research were taking place on a connection between the two.
posted by emjaybee at 8:39 AM on May 12, 2010

The White Hat, let me go meta on you a little and call your citations into question with the very reasonable BMJ discussion from 2007 that calls into question our ability to call our findings significant. BMJ's discussion seems to indicate that we can only really "know" that our statistics are indicative of anything if we are looking at a 2000% relative risk (i.e. 20 times the risk of the control population) between control and findings/conclusions.

For citations, unfortunately I don't have a lot of time to devote to this rediscovery process. I found a summary article in JunkFoodScience (which I realize many folks have problems with editorially), and checking bmj.com unfortunately the free area on methodology and reporting really only goes back to 2008.

I do want to say that unless you have citations that show a RR of higher than 20, I'm not really interested in discussing the relative merits of diet change, weight loss, cholesterol control, heart disease control therapies, pharmacologies, etc. I just don't think findings that have a lower RR than 20 are really worth talking about, especially in a general and largely theoretical discussion like this. They're not epidemiologically sound and from my perspective are not worth considering. They're more like tilting at windmills or lashing out against the dark, and are little better than faith healing.
posted by kalessin at 8:42 AM on May 12, 2010 [1 favorite]

No. Not rationing...during WWII, at home, there were ration cards but that did not deprive people of food but rather of certain items such as amount of sugar, meat, and a few other items. But I am referring to pictures of people prior to WWII and well after that time, say in the 1950s...random photos when food was plentiful and there was no rationing still show mostly unfat people.

Look at photos or actual people from China, Japan etc till very recently: not overweight...then, creeping in to Japan, Am diets with our occupation etc and fast food joints...now they are gaining weight...China is opening One New Kentucky Fried Chicen franchise EVERY DAY...outdoing even McDonalds. So watch for photos in near future.
posted by Postroad at 8:44 AM on May 12, 2010

Have you tried cutting wheat out of your diet?
posted by domographer at 8:48 AM on May 12, 2010 [4 favorites]

P.S. Looked at your citations, White Hat, and of the three citations only one talks about (int he Abstracts, which is all I could see) RRs, which are sub-1.0 RRs, so yeah, not really worth talking about.
posted by kalessin at 8:49 AM on May 12, 2010

but the sedentary drive-sit-nap-sit lifestyle is extraordinarily far from how any of our ancestors ever lived until the last couple of generations

I'd put the blame squarely on the automobile.
posted by Civil_Disobedient at 9:07 AM on May 12, 2010 [6 favorites]

...and at least one retort.

Same to you, buddy!
posted by zamboni at 9:10 AM on May 12, 2010 [2 favorites]

Reading this thread, I see an awful lot of "A doctor treated his patients with X and found Y" and "I did A and B happened". That's not science. It doesn't tell anyone else what they should do. It's not generalizable.

It does seem possible that nutrition (along with psychology, and possibly a number of other medical areas...) is not an entirely generalizable area of study. That is, maybe different bodies simply have different ideal diets. If this is the case, the 'anecdata' shouldn't be dismissed entirely. What matters is that each of us can find dietary habits which serve us best. Since we eat everyday, experimenting is easy, and so long as the diets are not extreme, not too risky. Hearing what worked for others provides ideas of what we might try, recognizing we may not have the same outcome.

What science can do is be more personalized in its studies - perhaps there are people with certain genetic tendencies, certain lifestyles, who knows, certain kinds of livers, for whom certain diets are more likely to be successful. If we understood these relationships better, the advice could be more nuanced than "60% of our general study reacted well". Perhaps there are reasons for whether I'm in the 60 or 40% side of that divide. If science is going to stick to the overgeneral claims (success when a slim majority* respond well) we can't be surprised when people look for their own answers. 40% of the study that proves something works have scientific proof that it did not work for them.

*or slim increase over the placebo effect
posted by mdn at 9:10 AM on May 12, 2010

I think one problem is that people sometimes tend to focus on things that have tiny impacts, because it's a nice displacement activity from more important stuff.

Why not start like this.

Are you getting any exercise?
No -> Worry about doing some exercise, forget everything else for now
Yes ->

Are you fat?
Yes -> Worry about losing weight, forget everything else for now
No ->

Are you eating some fruits and vegetables?
No -> Worry about eating some fruit and veg, forget everything else for now
Yes ->

Are you getting enough protein and vitamins?
No -> Worry about getting enough of these, forget everything else for now
Yes ->

Do you have anything better to do than worry about your diet?
Yes -> Have fun and stop worrying, you're pretty healthy by most people's standards by now.
No -> Start worrying about the balances of the different fats, the effects of different kinds of carbs, the different forms of cholesterol...
posted by TheophileEscargot at 9:16 AM on May 12, 2010 [3 favorites]

How about instead starting with:

Are you feeling any discomfort?
No -> Cool
Yes -> Go see a doctor about that

Under a doctor's care, is your doctor seeing any disorders in your health that are not related to simply being fat?
No -> Cool
Yes -> Treat that specific symptom

Are you getting regular exercise?
.
.
.
posted by kalessin at 9:21 AM on May 12, 2010

The thing about atkins is that it makes eating boring. Of course you lose weight. You can hardly stand the thought of yet another chicken salad or whatever. Cutting wheat out of your diet would probably do the same thing, or other common ingredients.

--

I personally lost a ton of weight just by exercising and counting calories. I didn't pay any attention to what I ate, just wrote down what I ate in a spread sheet and that was it, making sure to limit my calories and go to the gym several times a week.

Later on, after I had gained a little weight back I started doing an elliptical at home every day, counting calories, etc. I lost weight again, without needing to worry about what I ate.

But I suppose as people get older and start to get paranoid about their health, it makes sense that you would have to look at more then just calories. People's bodies naturally do a worse job of regulating blood sugar as they age, regardless of what they eat.
posted by delmoi at 9:29 AM on May 12, 2010

They don't call sugar and flour the white devils for nothing.
posted by iconomy at 9:31 AM on May 12, 2010 [1 favorite]

My diet book has a typo and I've spent a month trying to eliminate crabs from my diet.

And it hasn't done a damn thing.
posted by umberto at 9:44 AM on May 12, 2010 [13 favorites]

The thing about atkins is that it makes eating boring.

Actually, the thing about Atkins is that its so freaking expensive.

I'm one of those people for whom nothing works. (yeah, I know, you don't believe me. Great, come to my house and fix my weight. I DARE you. My doctor and a personal trainer can't seem to fix it, what makes you think you can? /proactive hurf durf) I get exercise (45 minutes on the treadmill if nothing else, and many days I get other exercise as well) five of seven days, eat carefully (staying under 1450 calories a day), and still weigh over 250 lbs. Atkins is the only thing that has ever worked for me, but I had to quit because we simply couldn't afford the extra in our food budget.

People eat crap because empty calories are cheap, cheap, cheap, and its hard, time consuming work to make all your meals from scratch. Its no accident that obesity and poverty go hand in hand. Fix this, and you'll fix a lot of the obesity problems in this country.
posted by anastasiav at 9:46 AM on May 12, 2010 [4 favorites]

If you can't lose your excess weight, you probably haven't reduced your calories enough (and perhaps you're sitting around too much when you should be up and active more, but mainly you probably just eat too much).

Yes, and no. I've experienced something known as a "plateau". That's when weight loss slows and stops, even with the same activity level and calorie intake from week to week. Sometimes reducing calorie intake a bit more starts the downward trend again. Sometimes it doesn't. If it doesn't, one of the things to try is adding a hundred or so calories a day for a while. I've had this actually work, and seen it work for other people. It really is not as simple as calorie reduction.
posted by Karmakaze at 9:47 AM on May 12, 2010

Plateaus are also sometimes known as "metabolic set points". And is another reason I also don't think a mechanistic interpretation of calories in -> fat on the body always works for everyone thinking about or trying to lose weight.

Sometimes folks' metabolisms do really strange things, and simple calorie calculations do not adequately explain what's going on there.
posted by kalessin at 9:55 AM on May 12, 2010 [1 favorite]

Also it's worth noting that calorie measurements are not always very objective either, both from the point of view of calories burned by specific activities (these change a lot based on the person being measured and if I'm not completely mistaken I believe it's known by nutritionists and doctors that these measurements are not always objectively reliable), as well as from the point of view of calories for particular foods as utilized and metabolized by either a standardized theoretical metabolism or by particular people's metabolisms.

The reasons for this fuzziness?

Lots of possible explanations. Off the cuff, I'd say that when we measure calories for foods we often use a test that measures the heat released by burning them or the heat required to heat them to a specific temperature (this is a very mechanical process and can apply equally to substances or components in food that we cannot digest or ones that we find easier to digest).

In sharp contrast considering the typical homo sapiens metabolic system, we have all sorts of biochemical cycles that differently make certain materials impossible for us to digest or other materials easy to digest. For more information, study enzymes as well as non-metabolizable materials.

So what I'm saying is the metrics that we are using for our mechanistic calculations are pretty vastly different from how our metabolic systems actually work, so there may be some room to question our mechanistic interpretation of metabolism and ask whether we think it is entirely accurate.
posted by kalessin at 10:04 AM on May 12, 2010

kalessin: "The White Hat, let me go meta on you a little and call your citations into question with the very reasonable BMJ discussion from 2007 that calls into question our ability to call our findings significant. BMJ's discussion seems to indicate that we can only really "know" that our statistics are indicative of anything if we are looking at a 2000% relative risk (i.e. 20 times the risk of the control population) between control and findings/conclusions[...] They're more like tilting at windmills or lashing out against the dark, and are little better than faith healing."

IAAE (I am an epidemiologist). Having read your linked summary (but unable to find the article being referenced, I think that you (and junkfoodkitchen) are severely misinterpreting what looks to me as a thought exercise in how we apply stats to public health and medicine. The summary states that

Such modest risks (RR=1.05 - 3.0) don’t go beyond a null finding by more than chance (the toss of a dice or random coincidence) or a mathematical or modeling error, even if they’re reported as “statistically significant” in an underpowered study.

First off, if you're going to wait for RR >= 20 before you admit association between a predictor and some chronic disease outcome, you're going to be waiting a very long time. Obesity, cardiovascular disease, cancer, and other chronic diseases are massively multifactorial. No individual contributor is going to increase risk within an order of magnitude of what you're expecting. For instance, Doll and Hill's groundbreaking epidemiological study on smoking and lung cancer only found an RR of ~2.51. Nobody disputes that association because of its magnitude, and to suggest that this level of science and stringent methodology is little better than faith healing is being willfully obtuse. Heck, most of the epidemiologists I work with get excited by an RR of 1.15.

P.S. Looked at your citations, White Hat, and of the three citations only one talks about (int he Abstracts, which is all I could see) RRs, which are sub-1.0 RRs, so yeah, not really worth talking about.

I don't think a sub-1.0 RR means what you think it means. A sub-1.0 RR (with a CI that excludes 1.0) indicates a protective effect. Indeed, neither you nor the jfk summary seem to understand the concept of the confidence interval, the prediction interval,, risk ratio, or how to apply them. Studies employ these statistical methods for the express purpose of making sure that the disparity in outcome rates among subpopulations is not the result of mathematical chance. All of these methods take into account sample size and variability, and an underpowered study will show it with a ridiculously wide CI that includes 1 (no disparity). That is what you should be looking for if you want to determine the significance of an association-- tight CIs on the RR or OR that exclude 1 indicate significance, not magnitude.

The human body is an immensely variable thing, and human behavior moreso. In real live epidemiological studies, genetic variation and patient adherence rates are huge effect modifiers. Seriously, has anyone heard of a lifestyle/dietary intervention that improves the likelihood of ANY outcome measure greater than 10-fold?
posted by The White Hat at 10:06 AM on May 12, 2010 [16 favorites]

My neighbor has three children. G. is eleven, VERY tall for his age, VERY thin for his height. He eats almost nothing, and the vast majority of what he does eat is junk food. B. is eight, muscular and strong, with a healthy child's complement of subcutaneous fat. She eats almost nothing, and the vast majority of what she eats is fruit and vegetables. M. is six, and has a physique that looks like he was built out of beef jerky and wire. (He's been this way his whole life; I had never before seen a four-year-old child with a six-pack.) He eats easily twice as much as both of his siblings put together, if not more; I personally watched him put away five corn dogs, a cup and a half of pasta salad, an entire bunch of grapes, four raw carrots, and a piece of pie at a picnic dinner. M. and B. both get quite a lot of exercise; G. much less so.

I no longer believe that calories in vs. calories out is the only thing that determines build.

(As for me, I've been fat for twenty years, and the only two things that work for me to lose measurable weight are either tons and tons of exercise or else being pregnant or breastfeeding. I'm 14 weeks pregnant, and I've lost 21 pounds since the stick turned pink. But when I quit eating HFCS and trans fats, my cholesterol and A1C both plunged.)
posted by KathrynT at 10:09 AM on May 12, 2010 [3 favorites]

A link that further explains how modern labs derive calorie counts and that sort of thing is here. (slate)

The White Hat, I'm not really interested in wanking with you, but I do think you are presuming a lot about my own background in epidemiology, statistical analysis and medical research that you perhaps shouldn't.

It is my contention that if we don't have RR data (with or without high confidence intervals, good prediction intervals, reliable risk ratios, or, for that matter, data that meaningfully differentiates incidence from prevalence) that has an outcome greater than 3, 10 or 20, maybe we are in the wrong business and at risk of pushing solutions to problems that we haven't actually proved exist.

Perhaps it is not a good moral or ethical choice to claim that we know something when our findings are not conclusive.
posted by kalessin at 10:11 AM on May 12, 2010

Regardless of the science here, I think a big problem is that many people want to believe that a certain diet works if it means they can continue to eat the things they really like. Then they apply a selective bias to any studies that support what they want.
posted by Soupisgoodfood at 10:13 AM on May 12, 2010 [1 favorite]

It does seem possible that nutrition (along with psychology, and possibly a number of other medical areas...) is not an entirely generalizable area of study. That is, maybe different bodies simply have different ideal diets.

I'm sure that nutrition can be generalized as much as almost any other area of human medicine can. More likely, it is that diet promoters are not held to very high standards. As long as the diet they recommend stays within fairly normal nutritional ranges (eat food) and they don't make crazily extravagant claims, a diet promoter can recommend just about anything. Low carbs. High cars. No meat. All meat. Tons of exercise. No exercise. And on and on. You can always find a nutritionist to support any wacky claim.

The diet industry seems a bit like the herbal tea industry or even the homeopathy industry -- government regulators are too busy taking care of things that actually pose direct and immediate risks to users (active drugs, surgery techniques, etc.) to spend much time regulating tea that does nothing and homeopathic water that does nothing and diet schemes that do nothing.
posted by pracowity at 10:15 AM on May 12, 2010

Re. the several comments concerning changes in obesity and overall health during wartime, I recently came across the following:

"Nutritionally speaking, the British ate better during [WW II] than ever before or since: more wholemeal bread and vegetables, fewer sweets, small but regular amounts of meat and fish. In 1946, the [British] Chief Medical Officer reported that the 'vital statistics' of the nation for the war years had been 'phenomenally good'. Thanks in part to rations for children of orange juice, milk and rosehip syrup and better diets for pregnant women, child mortality rates dropped, even taking into account the deaths of 7,000 children during the Blitz. There were fewer anemic women and children and many more children had perfect sets of teeth. Rationally, people ought to have felt well fad after the war." Swindled: From Poison Sweets to Counterfeit Coffee - the Dark History of the Food Cheats.

Of course, my "rational" thinking goes out the window as soon as I smell that big juicy burger on the grill.
posted by webhund at 10:20 AM on May 12, 2010

The White Hat, I'm not really interested in wanking with you, but I do think you are presuming a lot about my own background in epidemiology, statistical analysis and medical research that you perhaps shouldn't.


kalessin--If you want to be taken seriously you might put your bona fides on display, or at least show your work. You appear to be attempting to claim expertise and understanding that you don't really have. The White Hat accepted your terms for debate, explained why you were incorrect to think as you do within those terms, and now you seem to be suggesting, without providing any of your reasoning, that you're right and he's wrong. You look weasely. Very weasely. I'm not saying your are weasely, but you might consider that if you've got reasoning beyond assertion to back up your claims now would be a good time to present it.
posted by OmieWise at 10:28 AM on May 12, 2010

(to further the thoughts inspired by kallesin's comment)
Nothing but dots all the way down.
A giant genocidal corpse-pile on the modern industrial agricultural system.

.
.
.
.
.
.
.
posted by symbioid at 10:29 AM on May 12, 2010

Everyone needs to stop overthinking it. Want to be healthy? Eat lean, healthy meats like fish, muscles, lots of colorful vegetables, a good portion of colorful fruits, avoid beans and breads.

Oh, and exercise. That helps.
posted by Malice at 10:30 AM on May 12, 2010

OmieWise, that really looks like a "have you stopped beating your wife yet?" sort of rhetorical approach, so I'm not really interested in responding to your request.
posted by kalessin at 10:31 AM on May 12, 2010

I don't understand the insistence that a single diet is simultaneously suited to fat loss and to cardiovascular health. I think it might come from some kind of puritan Anglo-righteousness complex that makes some foods sinful, and some pure. The kind of impulse that causes one to notice that the Russians only drink pure grain alcohol.

Is it not possible that Atkins will cause you to lose weight while clogging your arteries? Maybe we reject this because of the equivocation of thin with healthy.
posted by atrazine at 10:38 AM on May 12, 2010 [2 favorites]

mek is right. Sugar is just plain bad for our bodies and our American diet focused heavily on refined grains make it even worse. Toss in some good ole' fashioned high fructose corn syrup in just about anything and everything processed and you've got a recipe for disaster.

I assume you mean too much refined sugar (and too much sugar in general, of course). I'm pretty sure we evolved to make use of sugar, since there's plenty of it in fruits and many vegetables.
posted by Soupisgoodfood at 10:42 AM on May 12, 2010

Dude, sugar in your diet is like nitrous in your car.
A little goes a long, long way.
And if you run on it all the time, the engine goes SPANG.
posted by seanmpuckett at 10:45 AM on May 12, 2010 [1 favorite]

I no longer believe that calories in vs. calories out is the only thing that determines build.

It made sense to me - you said the child who ate a lot and exercised has a particularly muscular build, the child who eats little, though healthy food, and does exercise, has a somewhat muscular build, and the child who hardly eats, and doesn't exercise, is just super skinny. Doesn't that seem in basic accordance with what you'd expect?
posted by mdn at 10:49 AM on May 12, 2010

I'm really starting to hate nutrition "science".
posted by chairface at 10:50 AM on May 12, 2010

Dr. Melik: This morning for breakfast he requested something called "wheat germ, organic honey and tiger's milk."
Dr. Aragon: [chuckling] Oh, yes. Those are the charmed substances that some years ago were thought to contain life-preserving properties.
Dr. Melik: You mean there was no deep fat? No steak or cream pies or... hot fudge?
Dr. Aragon: Those were thought to be unhealthy... precisely the opposite of what we now know to be true.
Dr. Melik: Incredible.

posted by caddis at 10:50 AM on May 12, 2010 [2 favorites]

It made sense to me - you said the child who ate a lot and exercised has a particularly muscular build, the child who eats little, though healthy food, and does exercise, has a somewhat muscular build, and the child who hardly eats, and doesn't exercise, is just super skinny. Doesn't that seem in basic accordance with what you'd expect?

Nope. I wouldn't ordinarily believe that a child who ate little and exercised would actually outweigh her 3-years-elder-brother who ate little and didn't exercise.
posted by KathrynT at 10:53 AM on May 12, 2010 [1 favorite]

OmieWise, that really looks like a "have you stopped beating your wife yet?" sort of rhetorical approach, so I'm not really interested in responding to your request.

How so? You keep making assertions, both about the issue at hand and your own expertise. These assertions are cloaked in a sly wink that suggests that somehow your expertise or reasoning should be beside the point of science-based argument. I pointed out that you look as if you don’t actually have anything other than assertion to your argument when you exercise your right not to provide any evidence for your, apparently, erroneous views. There’s nothing question begging about any of that. I said you look like a weasel when you try to engage in discussion in that manner, and suggested that you reconsider your approach if you wanted people to take you seriously.
At this point, given your response to me, which, like your response to The White Hat, tries to paint the request for dialogue as somehow untoward or uncivil, I assume that you have an opinion that you cannot actually support and that you are more interested in that opinion than you are in actual inquiry into this subject.
posted by OmieWise at 10:55 AM on May 12, 2010 [1 favorite]

OmieWise, that really looks like a "have you stopped beating your wife yet?" sort of rhetorical approach, so I'm not really interested in responding to your request.

Right.
Got it.
Thanks.
*slams down phone*
posted by Floydd at 11:10 AM on May 12, 2010

OmieWise, maybe the fault is with your understanding of the scientific citation dance, which is not actually an objective dance but a dance about qualification and access. The fact is that I am no longer in a position where I have access to the papers that The White Hat does because I am no longer in academia. To some extent that already handicaps my ability to respond fruitfully to The White Hat's citation-wise criticisms,

In the scientific citation dance, which is also labor intensive (which I have already remarked I don't really have the time to spare to do), party A makes one or more citations to useful links and then, depending on whether party B's intention to participate is either in good faith or not, party B either:
1) (in good faith) goes and reads the citations, does the homework, double-checks the numbers, finds everything in a good state and says something like "Oh, sorry I bothered you."
2) (in good faith, but the study is not in such good faith) goes and reads the citations, does the homework, double-checks the numbers, finds things in a bad state and replies about the problems e found
3) (in bad faith) dismisses the citations out of hand and uses them to make unwarranted assumptions and rhetorical attacks to further their agenda.

Of course there are additional possibilities and finer granularities of faith, studies' faith, citers' faith and so on. I think it's clear from the interaction that The White Hat and I have had that we're not really working with each other in good faith (I think that's a shared responsibility, and I'm sorry for my part in it).

From the point of view of credentials-publishing. It's a mug's game. I don't care to provide my credentials. I don't think it matters. What matters is my literacy and my good faith, as well as The White Hat's literacy and his good faith. It doesn't matter that if I did publish my credentials and you might find them wanting or maybe you'd be amazed. Similarly, it doesn't matter to The White Hat. For that reason I find I am unable to answer your challenge at this time.

I can tell you, though, that assuming bad faith or assuming lack of credentials and qualifications is something that I consider to be in bad faith and I don't think it helps The White Hat's arguments that he has attempted to belittle both me and the author of Junkfood Science without really providing actual proof (which in the credentials dance would be difficult to do because - and this is to the author's discredit - she hasn't provided any citations for him to attack or to analyze). Without proof, The White Hat's assertions are equivalent to ad hominems (like yours), which is why I am at length able to say that I think your arguments that my arguments are bunk are bunk.
posted by kalessin at 11:13 AM on May 12, 2010

I've known about this for some time. I've got ankylosing spondylitis, and after trying everything else in conjunction with my rheumatologist, I cut starch out of my diet according to the London AS Diet. And it worked for me -- I went from a 6 to 8 on the pain scale to a 2 to 4 (1 or 2 since I started exercising regularly again!), and I've been there for more than five years now. It's not a cure, as there is no cure for this, but changing my diet has made a gigantic difference in my quality of life.

I've also noticed a difference in fatigue (a symptom of AS), and especially in my ability to gain muscle -- before I switched diets, I was a heavy-on-the-carbs vegetarian, and it was a struggle to make good progress in exercise, when I could even do it due to the pain. On a meat-and-veggies diet, I've gained plenty of muscle. I don't get colds/flu/etc nearly as often, either. And, paradoxically, I'm eating more fresh veggies than I ever did as a vegetarian. At this point, I wouldn't touch potatoes or rice if you paid me.

I challenge the assertion that the diet is "boring", also. There are tons of things you can do with veggies, meat, dairy, and eggs, especially if you're willing to venture out of the beef/chicken/iceberg salad/carrots-or-green-beans paradigm of American cuisine. Indian, Greek, and French food is awesome, and doesn't have to contain starchy carbs unless you want it to. The same goes for Italian, Vietnamese, or Thai, with some modifications. All you need to make this diet delicious is spices and a willingness to try new things.
posted by vorfeed at 11:25 AM on May 12, 2010 [3 favorites]

Is it not possible that Atkins will cause you to lose weight while clogging your arteries? Maybe we reject this because of the equivocation of thin with healthy.

Did you read some of the linked articles? There's very little evidence that saturated fat causes clogged arteries or increased bad cholesterol levels and in fact it does the opposite. Also read Gary Taubes' NY Times article: What if it's all been a big fat lie?
posted by peacheater at 11:26 AM on May 12, 2010

Most people drive to work, sit in chairs, all day, and when they get home they sit in more chairs and watch television, then they go to sleep.

I sit in more chairs than that!

Sorry, always feel the need to prove myself.
posted by krinklyfig at 11:27 AM on May 12, 2010

A wee bit off topic, but I wanted to sound off over my frustrations with high fructose corn syrup. It's in everything. EVERYTHING. Even in the stuff I never would have imagined it would be in.

About 2 months ago I was using a can of diced tomatoes for my turkey chili. I figured the ingredients would be 'tomatoes' and maybe a preservative, but sure enough - HFCS right there on the label. Ditto on the canned black beans.

Last week I figured my plain dry roasted peanuts would be just, well... peanuts. Nope - HFCS included.

Next weekend's project is to empty out the cupboard, separate everything into HFCS and non-HFCS piles, and post the pics up on the net. I'm betting there's even more HFCS hiding in my presumably healthy cabinets than I thought possible.
posted by matty at 11:32 AM on May 12, 2010 [5 favorites]

avoid beans and breads.

Wait, what? Beans? Why would you avoid beans?

As to bread, well, you can have my bread when you pry it from my cold, prematurely dead body.
posted by Justinian at 11:36 AM on May 12, 2010 [2 favorites]

I think there is a conceit that beans are high in starch.
posted by kalessin at 11:37 AM on May 12, 2010

Beans are high in fiber. Anybody telling you fiber is bad is selling you something. Probably a crappy overpriced diet book.
posted by Justinian at 11:39 AM on May 12, 2010 [1 favorite]

Next weekend's project is to empty out the cupboard, separate everything into HFCS and non-HFCS piles, and post the pics up on the net. I'm betting there's even more HFCS hiding in my presumably healthy cabinets than I thought possible.

I have a friend who used to do what he called "the 7-11 challenge." The trick is to go into a convenience store and find a package of something that does not have corn syrup/sugar or an artificial sweetener added. Bottled water does not count.
posted by Karmakaze at 11:39 AM on May 12, 2010 [2 favorites]

The trick is to go into a convenience store and find a package of something that does not have corn syrup/sugar or an artificial sweetener added.

Rat poison?
posted by blucevalo at 11:44 AM on May 12, 2010

Wait, what? Beans? Why would you avoid beans?

Not all beans, I should have said don't make beans the majority of your diet. They're a bit hard to digest and high, high, high in carbs, like bread.

As far as prying your bread away, that's up to you. I love bread but it makes me fat. Also, I'm highly allergic to wheat and gluten.
posted by Malice at 11:44 AM on May 12, 2010

Literally overthinking a plate of beans.
posted by benzenedream at 11:48 AM on May 12, 2010 [1 favorite]

kalessin--I understand the “dance” of citation as you call it. You seem to be prepared to cite as long as the discussion is going your way, and no one reads and responds to your citations. I also understand just what qualifications are worth in a situation like this. It’s ok not to have them, but it’s kind of shitty to not have them and act like it’s only because you’re a better person that you won’t reveal them.

I haven’t engaged in ad hominen fallacies with you. I haven’t said your arguments are wrong because you’re so X or so Y, I’ve said I assume you don’t know what you’re talking about because you won’t back up your claims in the face of disconfirming evidence. In that sense, there is no argument to engage, and no argument to ad hominem. You made your assertions, predicated on a “meta” analysis you appear not to have understood, and since then have advanced no argument.

At any rate, thanks for explaining why you aren’t interested in responding further.
posted by OmieWise at 11:56 AM on May 12, 2010 [2 favorites]

So, nutritionists of mefi - what's the verdict on whole grains, particularly my morning bowl of quaker oats?

Noooooo! McCann's steel cut, please.
posted by Mental Wimp at 12:01 PM on May 12, 2010

I just reread my last comment, which sounds much more harsh than I had intended. Please excuse me. I’m not a huge fan of you style of discussion, but it takes all kinds.
posted by OmieWise at 12:07 PM on May 12, 2010

Not all beans, I should have said don't make beans the majority of your diet. They're a bit hard to digest and high, high, high in carbs, like bread.

True, I agree it would be strange to make beans the majority of your diet. I think you're not being fair comparing the carbohydrates in beans to that in bread, though. The carbs in beans are generally complex, slow-to-digest carbohydrates which don't cause an insulin spike. Additionally they contain a bunch of fiber which further helps to regulate insulin levels. On the list of things to worry about in terms of diet, I think the carbs in beans is way WAY down the list.

As far as prying your bread away, that's up to you. I love bread but it makes me fat. Also, I'm highly allergic to wheat and gluten.

I'm sure it isn't helping my waistline either. I'm not, however, gluten or wheat intolerant. I imagine I'd have to avoid bread as well if I were.
posted by Justinian at 12:16 PM on May 12, 2010 [1 favorite]

kalessin: "I can tell you, though, that assuming bad faith or assuming lack of credentials and qualifications is something that I consider to be in bad faith and I don't think it helps The White Hat's arguments that he has attempted to belittle both me and the author of Junkfood Science without really providing actual proof"

This is not a citations dance. I made sure in my second post that the articles to which I linked were publically-available (with the exception of the 50th anniversary BMJ article, which only summarizes the original Doll and Hill paper). Neither is this a credentials dance. I engaged your points and sources as best I could, and answered them with as much academic honesty as I'd use if this were peer-review. It's the substance of your argument that we're discussing here, not your CV. I didn't mean to belittle you, kalessin, and if I did then you have my apologies.

That said, your misinterpretation of risk ratios and unwillingness to accept well-established statistical norms betray a deficit in understanding that needs to be better explained if you want your statements to stand. Dismissing legitimate criticism as ad hominem is disingenuous at best.
posted by The White Hat at 12:24 PM on May 12, 2010 [4 favorites]

Next weekend's project is to empty out the cupboard, separate everything into HFCS and non-HFCS piles, and post the pics up on the net. I'm betting there's even more HFCS hiding in my presumably healthy cabinets than I thought possible.

So, what's the final verdict on HFCS? Is it really bad for you?
posted by zarq at 12:27 PM on May 12, 2010

It's roughly as bad for you as the equivalent amount of table sugar. But it's in almost everything.
posted by Justinian at 12:34 PM on May 12, 2010

A sweet problem: Princeton researchers find that high-fructose corn syrup prompts considerably more weight gain
posted by matty at 12:36 PM on May 12, 2010

Yeah, the biggest problem with HFCS is that EVERY FUCKING GODDAMN FOOD seems to have some HFCS in it.
posted by Pope Guilty at 12:43 PM on May 12, 2010 [1 favorite]

Agriculture is only 14,000 years old, or approximately 700 generations. Grass-based starches are even more recently added to our diet. Industrial refined sugars just a couple hundred years.

We're not optimized for that shit. I'll say it again. We are not optimized for that shit.

The fact that we can eat commercial starch and industrial fast-food isn't proof that it is good for us. It is proof that, as omnivores, we can eat almost anything and survive just long enough to breed the next generation. That's all that is important. If we can eat it, and breed, we've demonstrated our survival capabilities in adverse conditions.

Of course, our life expectancy has gone *up* and we're surviving much longer than simply to breed the next generation. Perhaps this will soon change-- but it hasn't yet.
posted by Maias at 12:50 PM on May 12, 2010 [1 favorite]

A sweet problem: Princeton researchers find that high-fructose corn syrup prompts considerably more weight gain

Except they gave the rats half as much HFCS as they did sugar. Other rat studies have shown rats given less sugar sometimes gain more weight then those given more sugar. Also, there are no actual figures comparing the results, we aren't told how much more weight was actually gained, just that it was "significant", do they only mean statistically significant?

Bocarsly et al. completed a 2010 study where rats were given 8% HFCS 12 hrs/day, 8% HFCS 24 hrs/day, 10% sucrose 12 hrs/day, all with ad libitum rodent chow, or only ad libitum rodent chow for a duration of 8 weeks. The rats on HFCS 12 hrs/day gained more weight than the rats on sucrose 12 hrs/day in young males, but not in adult females. They also reported that the rats on HFCS 24 hrs/day did not gain a statistically significant amount of weight when compared to the rats on sucrose or chow only. Additionally, no differences in blood-glucose levels were observed. Another study was conducted for 6-7 months, and fat pads were removed from the rats and weighed. Fat pads for rats on HFCS 12 hrs/day weighed significantly more than rats on chow only, but were not different from rats on sucrose. Fat pads for rats on HFCS 24 hrs/day did not have a statistically different weight than rats on chow only. [42]

So it seems like you could easily get the result you wanted by reducing HFCS intake compared to sugar. And anyway, NO ONE is suggesting that drinking nothing but sugary drinks, whether it's HFCS or Sugar is a good idea. The Princeton study was done by replacing all of the rat's water intake with sugared water! That means that the rats were getting sugar whenever they got thirsty. The Bocarsly test added sugar to their food, which is a little more realistic. (Although obviously some people do drink a lot of sugary pops, and that's not good)
posted by delmoi at 1:07 PM on May 12, 2010 [1 favorite]

kalessin actually knows far more about this subject than I think you can imagine.
posted by grouse at 1:24 PM on May 12, 2010 [1 favorite]

Beans are high in fiber. Anybody telling you fiber is bad is selling you something. Probably a crappy overpriced diet book.

Sometimes it helps to just look it up.
posted by Mental Wimp at 1:27 PM on May 12, 2010

So, what's the final verdict on HFCS? Is it really bad for you?

Yes, it's bad for you. No, it isn't worse than sucrose or honey or agave nectar or whatever.

A sweet problem: Princeton researchers find that high-fructose corn syrup prompts considerably more weight gain

This study had a number of methodological flaws. For one thing, they didn't actually compare sucrose to HFCS in the long-term study, which kind of makes the results useless by way of comparison. Here's the full text of the paper. The main point is that too much sugar makes you fat.


Yeah, the biggest problem with HFCS is that EVERY FUCKING GODDAMN FOOD seems to have some HFCS in it.

And if it didn't have HFCS in it, it would be replaced with sucrose, which is no healthier. If the majority of the food you eat contains HFCS, then you're probably eating too much processed food.
posted by lexicakes at 1:33 PM on May 12, 2010 [2 favorites]

Many people want to know what they should eat less of to lose weight, and many different theories are out there. Eat less carbs, eat less fat, eat less refined sugars, eat less HFCS.

Eating less of something doesn't mean you should eat more of something else. Most people need to eat less, period. It isn't everything, but it's a good start.
posted by caution live frogs at 1:37 PM on May 12, 2010

Malor: not having tigers to eat our asses, parasites to infect our brains, cholera to make us shit our guts out, in general being rather less warlike, and of course having some really fucking awesome medical care contributes immensely to our lifespan. If those things permit us to live perhaps 50 years longer, then we're still up overall if the carbo-heavy diet takes ten years off our lives.

Just think how much longer we'll live when we finally decide to eat properly AND have medical care TOO.
posted by seanmpuckett at 1:45 PM on May 12, 2010

A sweet problem: Princeton researchers find that high-fructose corn syrup prompts considerably more weight gain

I encourage anyone who has seen this headline to get and read the original paper. It doesn't prove what the headlines say it proves. Table 1 is a mish-mash of results, none of which prove that HFCS is any different than sucrose in driving weight gain. Sometimes the 12-hour HFCS group is higher than control, sometimes the 24-hour HFCS group, sometimes neither. In no cases does HFCS differ from sucrose signficantly. The figures are cherry-picked from the table, showing only the "significant" results. Nowhere do they explain the contradictory results where HFCS shows no difference or the lack of any difference with sucrose groups.

So, it may be true that HFCS is worse than plain table sugar, but this study certainly does not demonstrate it.
posted by Mental Wimp at 1:50 PM on May 12, 2010 [4 favorites]

On non-preview, I feel like my previous comment about processed food seemed judgmental. What I really mean to say is that the problem isn't that HFCS is added to a lot of foods; the problem is that sugar is added to a lot of foods. Often the sugar is an essential part of the food, like in ketchup, barbecue sauce, pickles, canned stewed tomatoes, or bread. But there are certainly many cases in which sugar is added unnecessarily to processed foods.
posted by lexicakes at 2:04 PM on May 12, 2010

The White Hat, now that the term "disingenuous" has been used to describe my criticisms, I'm out.

OmieWise, I didn't mean to imply that you had engaged in an ad hominem, but that assertions that I was unqualified or underqualified were equivalent to ad hominems.

If you want a debate that dissenters will participate in in good faith, then you should probably be prepared to be less confrontational and make those dissenters feel, to some extent, welcome. I don't feel welcomed by your or The White Hat's replies so I will not engage further with you. I don't see this as a failing in me, but as an intelligent decision based on how the discussion is going.

I still consider my points to be open questions that were not adequately addressed by you or The White Hat, but it is clear that you both differ and feel that my understanding of the other statistical measures of accuracy and confidence is inadequate. I am not entirely sure what to do about that. In the interests of getting this all out into the open, I give you my credentials.

Here're some credentials:
I can tell you that my formal education in statistics comes from undergraduate and graduate education in physical chemistry, general chemistry and biochemistry, that my doctoral research was in nano-biochemical sensors and raman spectroscopy with an emphasis on optical spectroscopy and optical characteristics lipid biolayers in polylayered systems using primarily indices of refraction and the optical characteristics of reflected polarized light. I attended a doctoral program at George Washington University (physical chemistry) and that while there, I helped prototype the aforementioned types of sensors in my research work. I also did some work on the side with scanning tunnelling microscopy, which oddly enough also includes a pretty heavy emphasis on statistical analysis. Coursework included quantitative analysis (which specializes in both statistical analysis and error propagation management and analysis - something I have always noted never or rarely gets treated in medical scientific studies, and I often think it may be why confidence intervals end up being sort of unbelievably "confident"), kinetics, thermodynamics, electronics design and analysis, and quantum mechanics. I can leave it to you to infer that I do have a pretty solid grasp of statistical analysis, methodologies and presentation of and interpretation of findings or I can tell you so. Either way I think I am qualified.

In professional life I have moved on from this stuff to IT which ended up being less threatening to my marriage and paying better. I don't have a lot to say about that, except that it really doesn't require any math or statistics whatsoever except when writing business cases and doing binary mathematics for network design tasks.

In personal life, I use my understanding of scientific publishing, statistics and statistical analysis to come up with complicated ways of saying "bullshit" when we're in the bullshit realm, like this discussion.
posted by kalessin at 2:07 PM on May 12, 2010

Dude. You should totally do a FPP about raman spectroscopy. I have no idea what it is, but it sounds so awesome I must know more!
posted by stoneweaver at 2:15 PM on May 12, 2010

Cool idea, thanks stoneweaver.

I actually still don't really understand it. Once we started talking about "virtual quantum states" which are quantum states that don't actually exist but atoms and electrons pretend that they do, I just started working with the math and not thinking about it in English.
posted by kalessin at 2:19 PM on May 12, 2010

I first thought he said "ramen spectroscopy" and I got a craving for fried noodles!
posted by vespabelle at 2:22 PM on May 12, 2010 [1 favorite]

Eating less of something doesn't mean you should eat more of something else.

Yep. And that is exactly the game everyone tries to play. "What can I eat tons of without getting fat?" (Answer: nothing you want to eat tons of.)
posted by pracowity at 2:26 PM on May 12, 2010

I distrust HFCS because when I was pregnant with my daughter I couldn't keep it down. Seriously, if I had a coke, I'd vomit it up still cold. Salad dressing with HFCS? Barfed up within minutes. We did double-blind taste tests with root beer, ketchup, and wheat bread, and although the sample size was small, the results were perfectly correlated.

It disappeared within hours of birth, but I've never trusted the shit since.
posted by KathrynT at 3:19 PM on May 12, 2010 [2 favorites]

""What can I eat tons of without getting fat?" (Answer: nothing you want to eat tons of.)"

Literally tons? No. But there are good reasons to suspect that diets like the Okinawan diet or a diet with lots of vegetables, ideally with most of them being raw, can help with hunger cravings.

"An Okinawan reaching 110 years of age has typically had a diet consistently averaging no more than one calorie per gram."

If you're hungry all the time, then it makes sense to fill up on things with less caloric density. Drink lots of water. Eat more foods with a combination of low caloric density and high fiber content. You can always try to trick yourself like a kid to eat your vegetables, if you want.

If you can't easily cut certain foods out entirely, then by all means, try to add certain foods in, making them a priority in your diet. The end result will likely be that you will consume less of the foods that you should've been avoiding in the first place.
posted by markkraft at 3:29 PM on May 12, 2010

Oh, I remembered the term from my research that I couldn't remember that is almost as cool as "raman", which is "plasmon". :)

(Yes, raman did make me think of ramen a lot.)

This is not my research group but their work looks similar to that part of the research that I was doing.
posted by kalessin at 3:31 PM on May 12, 2010

kalessin: "Here're some credentials:"

Well, I'll be ipse dixited (kidding, kidding-- I know you were just whipping it out to prove that folks shouldn't make assumptions based on the "occupation" field in your user profile, not to lend yourself a little credibility). Really, your background in pchem explains a lot about your unwillingness to believe public health statistics. Benchwork ill-prepares a person for the amount of uncertainty we encounter outside the lab, and measuring the population-based impact of such a vague intervention as "weight-loss coaching" on mortality, CVD, or other endpoints must be maddening to someone used to the certainty of PV=nRT (I simplify; I know).

Epidemiology is a completely different game, and it uses statistics in a completely different way than you used it working on STM at SEAS (Hail to the buff! Hail to the blue!). Our measures are built to take into account the astounding, multifactorial diversity of human experience and create reliable, reproducible measures that can prove relationships, detail their direction and magnitude, and provide robust analysis to rule out chance as best we can. Sometimes these relationships are impossibly small, but in those cases we try to be damn sure. This study shows that people with a certain allele are 1.24 times more likely to develop bladder cancer than those without. The OR is seemingly insignificant by your reasoning, but statistically there is only a 0.00000000099% chance that the correlation is specious. And this is with a biological, dichotomous predictor. It only gets more ambiguous as you jump into behavioral predictors. Maddening? Yes, but also robust.

But I'll hold on to the disingenuous comment. It clearly applied only to your dismissal of criticism, which has employed a number of pretty defensive techniques and misdirections (looking it up would take too much time, this is really an issue of bad faith, I don't want to wank with you, &c). These are hardly straightforward or candid, and they're certainly not in good faith. In a word, they are disingenuous. I'm not looking for a wank here, just a little academic rigor.
posted by The White Hat at 4:22 PM on May 12, 2010 [4 favorites]

Kalessin: I went and read the original article that your blog post claims to summarize. The blog's take is pretty garbled.

It's behind a paywall, but I can summarize:

The article specifically addresses medical intervention studies based on case series or nonrandomized cohorts, asking a simple question: when is evidence based on these study types effectively unequivocal, and when should a randomized controlled trial be performed? Risk of selection and several other bias types are increased in interventional studies. It is suggested in the article that RRs of greater than 10 be considered definitive in these contexts not because of statistical significance, which is unrelated to effect magnitude, but because in these cases likelihood of confounding is low that causation can be assumed. RR>10 is presented as a rule of thumb in this particular context to rule out the need for further RCTs of a medical intervention; the authors do not make the assessment that RRs less than 10 are meaningless. That the post you linked makes that claim is evidence of a grave misinterpretation at best.

So, do we have to worry about confounding in cohort study designs? Yes, of course we do. Matching helps, and multivariate techniques are used almost universally to control for available covariates and generate adjusted relative risks. This does not rule out the possibility of residual confounding by unmeasured variables or other uncontrolled biases, which is unavoidable in cohort studies and present even in RCTs. This does not mean, though, that the determined RRs are necessarily unreliable, even when they have a smaller magnitude. Careful attention to study design is a critical factor in determining the plausibility of a calculated relative risk.

There's a very interesting monograph that the BMJ article draws from that offers extensive comparison between interventional cohort studies and RCTs using real world data available here.
I think it's open access but can't tell from where I am right now.
posted by monocyte at 4:40 PM on May 12, 2010 [2 favorites]

About Davis' mastery of stochiometry: someone, perhaps a Mefite, has broached this on his blog, and the response is that nmol/l is the particle number measure and the conversion a rough estimate. This makes sense. I don't have a particular view of dude's expertise but I think he's off the hook on that one.
posted by i_am_joe's_spleen at 4:56 PM on May 12, 2010

Eating fat can make you fat. Fat is just storage of excess energy, in whatever form it arrives. OTOH, fat sedate's hunger and so you don't want to eat - a spoon of olive oil when your hungry can replace a meal. It's about calorie amounts.

What's the biological process that eating fat turns into body fat?
posted by gjc at 5:05 PM on May 12, 2010 [1 favorite]

The White Hat, I don't think you get me, and that's fine, so I'll hold to my judgment of your efforts as being in bad faith and you can do the same with me.

I do want to mention, though, that there are plenty of methodological aspects of rigorousness from the classics of the scientific method that I generally find wanting in the medical literature I have the occasion to review. What I mean is that commonly, medical articles don't:
- Adequately describe their methodology
- Provide the complete data set used for the analysis and findings
- Provide a writeup of error management and error propagation (nor include error information except as encoded in things like CI and sometimes standard deviation) as used in the study
- Use enough of a random sample or control to be statistically rigorous
- Use a method of data fitting that looks like it was based on a fair or rigorous fitting model

Add to that that most of the medical articles I review about the issues I research (endocrinology, pulmonary and diet/cholesterol/chd/vascular disease) seem to get a lot of their funding from entities that have a vested interest in specific types of results. While this is of course not a true indicator of bias, it does call that vector into question and I would generally wish to see a researcher publishing an article that would seem to support an obvious agenda of a research funder put a lot more effort into establishing that the work was done independently and not for hire.

I don't buy your claim that the multifactorial diversity of human diversity means that your chosen science can responsibly dismiss so much of the scientific method that it ascribes to and profits from. I just don't.

monocyte, the monograph that you're linking to is interesting, I agree! It's also from 2003, not 2007. I'll see if I can hit up JHU library for a copy of the discussions going on in BMJ during 2007 that JFS apparently so badly summarizes and see if I can come to my own conclusions. Thank you, though.
posted by kalessin at 5:06 PM on May 12, 2010 [1 favorite]

seanmpucket:

[N]ot having tigers to eat our asses, parasites to infect our brains, cholera to make us shit our guts out, in general being rather less warlike, and of course having some really fucking awesome medical care contributes immensely to our lifespan. If those things permit us to live perhaps 50 years longer, then we're still up overall if the carbo-heavy diet takes ten years off our lives.

Just think how much longer we'll live when we finally decide to eat properly AND have medical care TOO.


I don't believe that Maias's point was that our lengthening lifespans are proof of the superiority of the modern diet. I think he was trying to tell you why he found (and I find) your reasoning fallacious.


Agriculture is only 14,000 years old, or approximately 700 generations. Grass-based starches are even more recently added to our diet. Industrial refined sugars just a couple hundred years.

We're not optimized for that shit. I'll say it again. We are not optimized for that shit.

Antimicrobials and guns (for the tigers) are even more recent than agriculture is. We're not optimized for these things either. The thing is, we never were optimized for cholera or for tigers, and so these these technologies lengthen our lifespan. By the same token, the fact that we were for many years limited to certain food stuffs doesn't mean that those food stuffs are ideal for us. Evolution's cool and all, but it's got its limits. The evolution of an organism within a certain environment isn't evidence that that environment is the ideal for the organism in question.

The fact that we can eat commercial starch and industrial fast-food isn't proof that it is good for us. It is proof that, as omnivores, we can eat almost anything and survive just long enough to breed the next generation. That's all that is important. If we can eat it, and breed, we've demonstrated our survival capabilities in adverse conditions.

You're right on. But you forgot to extend that reasoning to the paleolithic diet. The paleolithic diet isn't proof that it is good for us. It is quite clearly proof only that we can eat the paleolithic diet "and survive just long enough to breed the next generation."

I'm not saying that you're wrong. My own feeling is that there is not enough scientific consensus on the questions we're asking in threads like this for me to be comfortable with any answer.
posted by nathan v at 5:14 PM on May 12, 2010 [3 favorites]

gjc, it's been a long time, but generally, either fat gets transported directly to fat storage (by a process I've forgotten) or the fat is metabolized (at some cost) into ATP which is later converted back to fat for long-term storage. I think. Maybe the direct transport is in my imagination. I can't seem to find even a non-rigorous, non-loony article about it on the Webs.
posted by kalessin at 5:15 PM on May 12, 2010

seanmpuckett is right: I challenge everyone here to try eliminating as many refined carbs as they can, cold turkey or phased, over a three week period. Some people can do the cold turkey route, others will go through some serious withdrawal and quit after three days, but ween yourself off of the stuff one way or another.

Go about three weeks eating raw veggies, eggs (some say to eat all the yolks, I'll eat five eggs and only have one or two yolks), almond butter, chicken, fish, lean beef (strip steaks are good), quality bacon (no nitrates/nitrites), etc. Toss in some protein shakes (use the good protein powder, 8oz water, a few ice cubes, tablespoon of almond butter, 1/4 banana) and tell me how you feel. Good turkey, avocado, lean pork chops, too. It is not a cheap way to eat, but I've gone from mocking those organic foodies to adoring them. You really are what you eat, and that extends to the grass fed versus grain fed chicken, beef and pork. It's a good 30% more expensive, but worth every penny in my book.

I guaran-fucking-tee every one of you that you will feel one million times better at the end of three weeks. No food comas, no sugar crashes, better sleep, etc.

I started to change my diet seriously (after many, many, many false starts) about a year ago, slowly eliminating almost all refined carbs. The net result is for the first time in my life I'm actually waking up rested in the morning, I haven't been sick one day in the last year, my normal spring allergy death-spiral has not come to pass and I'm much more energetic than before.

I should add that I've added a decent amount of exercise, but the fact of the matter is: diet is a good 80% of the battle. I recommend making slow changes and phase out foods in lieu of trying to do it all suddenly. We have not bought a loaf of bread (and we only ate high-quality whole-wheat) in over a year, and consider our guilty pleasure to be the occasional whole wheat English muffin. Crazy! Crazy I tell you.

My only vice now is strawberries and blueberries. I have a bowl of Kashi Vanilla oatmeal, which is awesome because they fortify it with more fiber and protein (and I add another scoop of vanilla protein as well) with a few berries. I'm trying to cut that out of my daily routine, but it's my crack these days.

As to the issue of where to get good quality grass fed beef, pork and chicken: this is one of the advantages of living in the great Midwest. Here in Northeast Ohio you're never more than 30 - 45 minutes from an actual farm, and there's a rapidly growing organic/natural farming movement that is very lucrative. Most of these farms require you go there for your stock, but I would recommend going in with several friends and buying a cow (no joke), or ordering a years' worth of stock, which many of these farms permit.
posted by tgrundke at 5:48 PM on May 12, 2010 [7 favorites]

I distrust HFCS because when I was pregnant with my daughter I couldn't keep it down.

I don't understand this at all. Why would you not trust something that nauseated you while you were pregnant? When I was pregnant, I found the scent of my shampoo, soap, well, everything in my bathroom, nauseating. The smell of ketchup made me sick too, and I could smell it from across the room. That doesn't mean that there is something poisonous about ketchup or my shampoo. It just means it made me feel sick while I was pregnant, which is one of those things that happens while you're pregnant.
posted by lexicakes at 5:49 PM on May 12, 2010 [1 favorite]

Lexicakes, it wasn't that it nauseated me. It didn't. But if I ate anything that had it as an ingredient, I would throw up within minutes. Plain sugar didn't do the same thing. There was no scent to make me queasy, none of that "woog this was a terrible idea" sensation, not even a roiling stomach. I just would eat it, and then throw up two minutes later.

If HFCS is no different than plain sugar, why did I barf up American coke and not Mexican coke?
posted by KathrynT at 6:00 PM on May 12, 2010

This may just be a housekeeping issue, but I can't figure out his units at all. He writes: "LDL particle number 2620 nmol/L (which I would equate to 262 mg/dl LDL cholesterol) " ... I don't understand how 2620 nmol/L gets converted to 262 mg/dl. ... Can someone else help me out?
posted by OmieWise

What's going on here is a conversion from concentration (molarity, ie. number of particles per volume) to mass per volume (mg/dl), and the conversion factor will be different for every species of particle out there, and depend on the mass per particle. I use the handy relation (X (mg/mL) / Y MW (kDa) ) = Z (mM) all the time in my work and you can use it here to solve for the conversion factor that he's using. using (262 mg/dL = 2.62 mg / mL) and (2,620 nmol / L = 2,620 nM = 2.62 uM), it turns out that he's assuming that the molecular weight (mass per particle) is 1,000 kDa (kilodaltons). Now, LDL particles are a mixture of lipids and proteins, all different kinds of molecules, so the MW will be an average number. This report gives 550 kDa as an empirically determined average MW for LDL particles found in an adult male. Bottom line, he's off by only a factor of two at most. Possibly 1 MDa is an accepted MW for LDL particles?
posted by StrangerInAStrainedLand at 6:48 PM on May 12, 2010

If HFCS is no different than plain sugar, why did I barf up American coke and not Mexican coke?

I have no answer to this question. My first guess would be that it was a coincidence, as that is always my first guess. Or you have a corn allergy or intolerance. Or maybe you developed a taste aversion after the first time it happened. Who knows?

And just to clarify, HFCS and sucrose are different things, and no one is claiming otherwise. HFCS is a mix of glucose and fructose, while sucrose is a disaccharide in which the glucose and fructose are bonded together. Since the proportions of fructose and glucose are so similar, they are metabolized in pretty much the same way.
posted by lexicakes at 6:49 PM on May 12, 2010

My father, who is an organic chemist (not intended to argue from authority, just intended to point out that his guess is slightly more educated than mine would be) watched the repeatability of the barfing -- it was pretty damn repeatable, we did double-blind tests on three or four different products -- and he guessed that there was some trace protein left behind by the catalytic processes that my stomach decided it didn't like. I do not believe that my issues with HFCS have anything to do with the fructose, the glucose, or the ratio between them; however, I have zero confidence that fructose and glucose are the only substances in the stuff.

I certainly don't have a corn allergy or intolerance; I ate plenty of Fritos while pregnant, for example, and my HFCS aversion disappeared within hours of birth. The reaction happened even to things like salad dressing and hummus, where I'd be real surprised if anyone could taste the difference between added HFCS and added sucrose. And while coincidence is always a possibility, particularly in one subject who is self-reporting and with a minimum of scientific rigor, I will tell you that when I wiped HFCS out of my diet, I went from throwing up nearly every time I ate to throwing up once or twice a week.
posted by KathrynT at 7:03 PM on May 12, 2010

Thanks for posting this markkraft. I think heartscan blog is great and one of many that are suggesting similar things that have pretty large implications. I knew this would end up on MeFi and it got the snark and skepticism that I expected, which I completely understand. There is quite a bit of nonsense out there in the 'alternative health' world and the media likes to pick up stories that overemphasize things and/or conflict with something they published last week. Another problem I've noticed is that for some of the people I agree with can overemphasize the ability to cure diseases or undo damage, etc. I don't doubt this is possible with whatever the 'best' diet is (that no one knows yet), but I don't believe it yet either.

People can argue one way or another if we evolved to eat this or that or if the medical literature on these things are valid, but I think something that is not done enough is self testing. The most important ones being: A1c, HDL, VLDL, Triglycerides, CRP and to a lesser extent, VO2 Max, Vit D, bodyfat percentage Omega 3 vs omega 6 ratio (and of course if you feel any better.) Through what I've seen, people who practice paleo and raw veganism with smart supplementation will see these measures get better (some of these people are OCD about tweeking their diets and testing them, then repeating.) I'm glad these people exist since they are older than me so I can see if there are some unknown side effects from it. Most people judge a diet by if they lose weight or generally have more energy, but you can't really see your risk for health problems unless you start doing measurements like these. Hopefully, one day these will be cheaper and more accessible to people who aren't health fanatics. Or even better, we will know with far more accuracy what foods are good and bad for us so we can make informed choices (and maybe we'll stop subsidizing grain so much and start subsidizing vegetables and sustainable meat so more people can benefit.)

Of course, I think once we figure out an ideal diet, we should stick with it 80% of the time so we stay sane.
posted by SouthCNorthNY at 7:21 PM on May 12, 2010

I don't know why you barfed up the HFCS, but I don't think your dad's explanation makes sense. (But if you can get him to explain it, it could be really interesting and educational; I'm not an organic chemist.)

HFCS is free glucose and free fructose. When you ingest it, it's absorbed in your small intestine. Neither undergoes any catalysis there. The fructose gets changed into glucose in your liver. The entire process is relatively rapid. From my experience with hypoglycemics and soda-pop, blood sugar increases somewhere between five and fifteen minutes after ingestion. This isn't necessarily due to the fructose, so fructose metabolism could occur more slowly, but not more quickly.

Sucrose is a molecule that gets broken up by sucrase, in your small intestine, into glucose and fructose. Your small intestine can't absorb sucrose otherwise. It doesn't leave any byproducts. In fact, the process uses up water-- one molecule of water and one molecule of sucrose -> one molecule of glucose and one molecule of fructose. Sucrase breaks down, but it doesn't break down any faster from catalyzing reactions than from sitting around waiting for some sucrose to show up. According to my really basic knowledge of organic chemistry, at least :) The consumption of water via hydrolysis is a potential factor, but doesn't seem right to me. There's a lot of water in your small intestine, and a lot of reactions occurring that create or destroy water.

So there's no residue of either fructose or sucrose in your intestinal tract, and HFCS leaves the same metabolic byproducts as sucrose, because it's all about the metabolism of fructose. (I'm not familiar with the metabolic pathway for fructose, but I've heard diet advocates say it makes bad stuff.)

So that's why I doubt your dad. It's much more likely that you unconsciously detect the difference while the stuff is in your mouth, maybe even before that, when it's close to your nose, and your brain rejects it then, maybe with some latency.
posted by nathan v at 7:38 PM on May 12, 2010

That was me, i_am_joe's_spleen. I respect Dr. Davis and wanted to clear up the confusion for OmieWise and whoever it was who claimed that he shouldn't have a medical degree since he couldn't do stoichiometry.
posted by holympus at 9:04 PM on May 12, 2010

As a nutritionist, my verdict is: stop being so fucking neurotic about food.
posted by Ouisch at 9:36 PM on May 12, 2010 [3 favorites]

My dad's explanation -- explanation is the wrong word -- what's even less rigorous than a hypothesis? Anyway, my dad's SWAG had to do with what's in the stuff that is neither fructose, glucose, nor water. In order to turn regular corn syrup into HFCS, it goes through several catalytic processes in the factory; two of these involve special yeasts, and one involves a fungus. It's not inconceivable that these processes could leave trace organic compounds behind, and actually there are several examples of various trace contaminants like hydroxymethylfurfural and mercury compounds being found in HFCS. So, yeah, it has NOTHING TO DO with the sugars; it has to do with my distrust of the manufacturing process.

And really? You really think I could taste the HFCS in frickin Ranch Dressing and I was fooling myself into barfing it up? I should look for a job as an analytical taster.
posted by KathrynT at 10:14 PM on May 12, 2010

"As a nutritionist, my verdict is: stop being so fucking neurotic about food."

That reminds me of the following Onion headline:

Cool Dentist Doesn't Give A Shit About Patients' Flossing
posted by squeakyfromme at 10:41 PM on May 12, 2010 [2 favorites]

"Two leaves of lettuce with no filling can also be eaten as a lettuce sandwich."
posted by dirigibleman at 11:32 PM on May 12, 2010

raman spectroscopy

Eat...more...ramen. Got it.
posted by obiwanwasabi at 4:01 AM on May 13, 2010

Someone sent me the full text of the Feb 2007 BMJ article (thank you!) that Junkfood Science wrote about. I haven't had time to read it (only skim it) but it looks like JFS does the same thing everyone else does: use the most flattering figures for her agenda.

The rate ratio that the article suggests (for certain contexts) as a good threshold is 10 (or 1000% for those with trouble calculating). The BMJ article also suggests other tests and thesholds that might help us distinguish from noise and normal fluctuation.

There's a lot of other possible discussion that the BMJ article doesn't get into that I think would be fascinating to discuss, but unfortunately I just don't have the time to continue engaging about this and don't anticipate I will for the forseeable future. The time sink problem of rhetorical wanking about scientific articles is what I alluded to, partly, in my mention of being a research scientist being hurtful to my marriage.
posted by kalessin at 4:44 AM on May 13, 2010

Agriculture is only 14,000 years old, or approximately 700 generations. Grass-based starches are even more recently added to our diet. Industrial refined sugars just a couple hundred years.

Well, if I know one thing, it's that human beings like to eat stuff and that isn't new at all. And, a quick google search confirms something I vaguely remembered reading about: grindstones with adherent plant starch from before 160,000 years ago - when the first recognisably modern humans appear in the fossil record - may have been used to grind grass seeds. While the proportion of carbohydrates was undoubtably lower than the average modern diet, and the whole grains meant that there was more protein and fibre consumed with the grains than today when we strip wheat kernels of most of their nutrients, humans have most probably been eating carbs way, way before the advent of agriculture.

I like the idea of looking to evolution to determine an optimal diet, but I find it odd that so many paleo-advocates seem to completely ignore the gathering part of the 'hunting and gathering' diet.
posted by Kurichina at 7:43 AM on May 13, 2010 [1 favorite]

I like the idea of looking to evolution to determine an optimal diet

This would only be a profitable enterprise (and by profit I mean profit to the user, not monetary gains to diet book authors) if evolution produced organisms which are ideally adapted to their environments. It does not; it only produces organisms which are more adapted than those before them. That humans being are able to derive sufficient nutrition from the foods that were our primary diet years ago does not mean that those foods are optimal for us.
posted by Pope Guilty at 8:22 AM on May 13, 2010 [4 favorites]

I do want to say that unless you have citations that show a RR of higher than 20, I'm not really interested in discussing the relative merits of diet change, weight loss, cholesterol control, heart disease control therapies, pharmacologies, etc. I just don't think findings that have a lower RR than 20 are really worth talking about, especially in a general and largely theoretical discussion like this. They're not epidemiologically sound and from my perspective are not worth considering. They're more like tilting at windmills or lashing out against the dark, and are little better than faith healing.

If you're using that BMJ editorial by Glasziou to justify this thinking, you've really misread his point -- a point by the way, that many biostatisticians would disagree with. His point applies only to single cohort and case-series studies, not randomized trials. Moreover, he argues for a threshold of relative risks ranging from 5-10 to essentially take these studies as "definitive," not a threshold of 20.

Using an effect magnitude threshold to assess biomedical research is a very poor substitute for actually using good judgment in reviewing the methodology used, its limitations, and the potential for unaccounted for confounding that may exist. To justify doing this based on the notion of signal-to-noise makes no sense because the RR alone does little to capture "noise."

In fact, the conventional statistics (p-values, confidence intervals) are quite good metrics of precisely what might be described as signal-to-noise. Take the simple example of a one-sample t-test. The t-test Z is defined as the mean difference times the root of the sample size divided by the standard deviation of the difference. In other words, it is signal (mean difference or effect size) divided by noise (standard error). Most statistical approaches used are parallels of this. Even modern empirical approaches (bootstrapping, jackknife, permutation testing) provide statistics that are for all intents and purposes, a measure of signal-to-noise. If there is a demand for more critical vetting of study outcomes, a lower alpha level does a much better job of this than looking at the RR. RR is signal only -- no accounting for sample size, no accounting for variance. This makes no sense at all.

Consider the simple example of my case-series of two patients -- a man and a woman. I followed them for a few weeks and the man had a heart attack while the woman didn't. Are you satisfied with the conclusion that men have a RR of infinity for heart-attacks relative to women? Of course not. So you say "well, I'll look at the sample size. It sucks. I look at the sample size and the error statistics in making my judgment." Fine, but this is essentially captured in a rigorous quantitative way with the results of hypothesis tests typically presented in papers.

The magnitude of the relative risk is NOT a good reflection of a "real" effect despite or regardless of confounding. In other words effect size and confounding may be correlated on average, but they are poorly so. This is throwing out the baby with the bath water to the extreme. Consider the fact that an arbitrary high RR ignores the impact of baseline outcome incidence on potential results for a study. Not only is the example of a RR of > 10 or > 20 a bad idea, it's mathematically impossible in many circumstances. Take a disease in which 10% of patients consistently have spontaneous resolution and the other 90% die. If a drug for this condition yields a 90% cure rate, your true relative risk will be 9. Studies that sample populations treated and untreated with this agent will have a mathematical limit for the point estimate of RR that is <>always potential for confounding even after careful control of known confounders with appropriate statistical adjustments. Let me be clear though: establishing unequivocal causality in the absence of a randomization, adequate sample size, and blinding is near impossible, regardless of the magnitude of effects reported in such studies. In this sense, I'm more conservative than that BMJ article, because I don't assume truth or causality from any single study like that, regardless of the magnitude.

Lost in this is the fact that science is an empirical study -- it may always be seeking the "truth" but it will never find it. Best evidence evolves over time. In the case of biomedical research, that evidence is an accumulation of the results from an aggregate of studies of varying quality, in the context of pre-clinical data that often includes animal models and in vitro data. A single study is never definitive -- even large RCTs. That doesn't mean the results are valueless and to be ignored, and it doesn't mean that authors' conclusions from a study are also taken on faith. It means you do the best you can with the information you have. To do so with biomedical research in good faith requires educating yourself about the methodology in the first place.
posted by drpynchon at 9:29 AM on May 13, 2010 [8 favorites]

Sorry.. a less than or equal to garbled the output of that... it was to read:

Studies that sample populations treated and untreated with this agent will have a mathematical limit for the point estimate of RR that is less than 10, unless they use a drastically small sample size and get really lucky.

Randomization asymptotically accounts for unknown confounders, and a review of large randomized trials (to which Glasziou would not apply the same effect magnitude threshold) would make it abundantly apparent that the "real effect" of virtually any intervention is very unlikely to reach an RR of 20. Even the limits of the confidence intervals would fail to meet that standard in most cases for RCTs. So to apply a high threshold to effect size in the interpretation of non-randomized studies, is essentially not a method of confirming what is "real." It is a way of confirming lucky sampling.

Moreover bad methodology can easily lead to alarmingly good results. Without training and knowledge about the appropriate statistical approaches to employ in a given study, the limitations and assumptions of commonly employed hypothesis tests, the potential for confounding on a case-by-case basis given best understanding of the subject, and a global feel for the risks of harm and potential for benefit that might relate to either type I or type II error, readers have little hope of gleaning information from any studies (including RCTs), and using effect magnitude thresholds for accepting study conclusion is a rather inadequate substitute.

In the case of cohort, case-control, or god-forbid case-series, there is always potential for confounding even after careful control of known confounders with appropriate statistical adjustments. Let me be clear though: establishing unequivocal causality in the absence of a randomization, adequate sample size, and blinding is near impossible, regardless of the magnitude of effects reported in such studies. In this sense, I'm more conservative than that BMJ article, because I don't assume firm truth or causality from any single study like that, regardless of the magnitude.

Lost in this is the fact that science is an empirical study -- it may always be seeking the "truth" but it will never find it. Best evidence evolves over time. In the case of biomedical research, that evidence is an accumulation of the results from an aggregate of studies of varying quality, in the context of pre-clinical data that often includes animal models and in vitro data. A single study is never definitive -- even large RCTs. That doesn't mean the results are valueless and to be ignored, and it doesn't mean that authors' conclusions from a study are also taken on faith. It means you do the best you can with the information you have. To do so with biomedical research in good faith requires educating yourself about the methodology in the first place.
posted by drpynchon at 9:36 AM on May 13, 2010 [2 favorites]

Maias: "Of course, our life expectancy has gone *up* and we're surviving much longer than simply to breed the next generation. Perhaps this will soon change-- but it hasn't yet."

Actually, although the life expectancy of the American population as a whole has continued to increase, life expectancy for significant subsets of the American population began declining quite quickly beginning in the 1980s. The greatest declines in life expectancy are among the poor and minorities, these groups also have seen higher than average increases in obesity.
posted by jefeweiss at 10:30 AM on May 13, 2010

Determining whether a given food is good or bad for us is the job of empirical scientific investigation, not of teleological misinterpretations of evolution.

That humans being are able to derive sufficient nutrition from the foods that were our primary diet years ago does not mean that those foods are optimal for us.

Agreed. But I think absence of "diseases of civilization" like obesity and diabetes in hunter-gatherers suggests that we could learn something from studying their diets.
posted by AceRock at 11:22 AM on May 13, 2010 [1 favorite]

We might learn something useful, but only if we are studying their diets as part of an examination of their circumstances and context. To simply compare our diets to theirs and think that we have learned something is laughably simplistic and teaches us nothing.
posted by Pope Guilty at 11:25 AM on May 13, 2010

drpynchon, you seem to have missed some of my later replies and clarifications, but that's okay.

I don't mean that all medical scientific research and publication is valueless and should be ignored. Mostly what I am arguing for is better statistical processing and publishing and more context when research papers are published.

I also do get what the scientific method gives us as outputs, believe me. I know that we are always working with doing the best you can with the information you have.

With respect to educating myself about the methodology, I would love to do so, given more time, more access and also more opportunity. By which I mean, as I said before, that many of the articles I am able to read seem to miss the opportunity to differentiate themselves from the norm by actually publishing good, accurate, reliable information about their methodology and interpretation/data processing methodology.
posted by kalessin at 11:33 AM on May 13, 2010

Dude, sugar in your diet is like nitrous in your car.
A little goes a long, long way.
And if you run on it all the time, the engine goes SPANG.

Indeed, a little can go a long way.

A better analogy is that too much sugar is like putting nitrous (or perhaps just too much nitrous) in your car, since all nitrous does is increase the amount of oxygen.

My point was that it's silly to look at one type of nutrient and point it out as bad. Diets are all about balance.
posted by Soupisgoodfood at 9:55 PM on May 13, 2010

You have totally misinterpreted this study. Saturated fat is a very dangerous. Have you ever seen the landmark Framingham study? I don't care how many people are in this trial, its a meta-analysis. This study is NOTHING compared to the Framingham study.

Anyway, the dietary recommendations that were made based on the Framingham study involve keeping saturated fat under 6% of calories consumed.

I want to emphasize this as clearly as I can:

THIS STUDY SAYS NOT THAT SATURATED FAT IS NOT HARMFUL, BUT THAT UNSATURATED FAT IS AN IMPORTANT PART OF YOUR DIET. UNSATURATED FATS CAN LOWER YOUR LDL AND HDL. CARBOHYDRATE DOES NOT HAVE THAT BENEFIT. SO, BY ALL MEANS LOWER YOUR SATURATED FAT INTAKE SINCE IT IS ONE OF THE MOST DEADLY INGREDIENTS IN FOOD BEHIND SALT. BUT, REPLACE THAT SATURATED FAT WITH FOODS HIGH IN UNSATURATED FATS LIKE AVOCADOS.

THIS IS NOT A FREE PASS TO EAT ENORMOUS AMOUNTS OF DEADLY ANIMAL FAT!

This is truly a terrible, terrible misinterpretation of an evidence-based trial. Don't let people who are not in the medical profession near these unfiltered studies.
posted by candasartan at 7:13 AM on May 14, 2010 [1 favorite]

Don't let people who are not in the medical profession near these unfiltered studies.

I think you overestimate the power of the medical degree. Most physicians don't understand the research. Ask an epidemiologist.
posted by Mental Wimp at 8:02 AM on May 14, 2010 [1 favorite]

It's really not supposed to be this complicated. IANAnutritionist, but can you really go wrong that easily if you stick to using meat as a condiment and using whole foods? It's harder to eat unhealthy than to eat healthy when you stick to those rules.

It may cost more than White Castle, but it's an investment in your health, your greatest asset. We still have a for-profit healthcare system, so it's worth it for fiscal reasons, too.
posted by mccarty.tim at 8:06 AM on May 14, 2010

This study does not advocate eating deadly saturated fats, but it does support eating unsaturated fats.

A meat industry lobbying group called The Weston A Price Foundation has been spreading the idea that saturated fat is harmless. The trouble is, the study they reference doesn't say anything like that. The study actually says that we should cut intake of saturated fat, and replace that saturated fat with unsaturated fat. Don't eat that steak! Have an avocado!

The authors state very clearly that unsaturated fats (the kind in avocados and nuts) can reduce your bad cholesterol (LDL) and raise your good cholesterol (HDL). Carbohydrate does not have that benefit. Reduce your saturated fat intake, but please DO eat lots of healthy, unsaturated fats sourced from plants like nuts, olives, and avocados. You CAN eat lots of unsaturated fat, eat very little saturated fat, be a heavy person, and still be very healthy. Just look at the Mediterranean diet.

Also, the study does not distinguish between refined and unrefined carbohydrates, so any discussion of that is unsubstantiated.
posted by candasartan at 9:40 AM on May 14, 2010

I don't think the WAPF is a meat industry lobby group. For one thing, they don't like grain-fed beef. They do take money from small producers they approve of. But they were hardly going to get donations from soy farmers, were they....

If anything what worries me about them is:
- they write about the good Dr Price as though his work was authoritative and all other subsequent work has to be made to comply with it
- their board of directors has some truly kooky sounding people on it. Eg "Geoffrey Morell , ND, JP, (Secretary), is a practicing naturopath, specializing in the past 20 years in the field commonly called magnetic, intuitive, spiritual or psychic healing."

I think they're good old fashioned food cranks.

It does surprise me how uncritical people like Pollan and Taubes are of the WAPF in their books. I think the story of Weston Price and his gentleman scientist endeavours travelling among primitive people are too irresistibly romantic.

Apropos the Framingham study: funnily enough, if you google, you get pages and pages of results from people of varying levels of obvious kookery who are very skeptical. References to Taubes are about half of them. I think this is my favourite one. cardansan, can you point to an online resource that lays out the correlation between CVD and saturated fat intake and the Framingham study?
posted by i_am_joe's_spleen at 2:18 PM on May 14, 2010 [1 favorite]

You just don't get it. The study referenced here doesn't say anything like what this poster is claiming it says. The study says not to replace your saturated fat with carb calories, but to replace your saturated fat calories with beneficial unsaturated fat... I'm having a hard time believing nobody actually read the study. Whatever
posted by candasartan at 9:04 PM on May 19, 2010