Good Calories, Bad Calories, by Gary Taubes

By golly, you're right. But... Except to note that your statement that "No link was provided to the original paper" was incorrect. Because you hadn't read the paper, I didn't address the points at all.The merit of the comparison of the Marantz position with the Surgeon General's report on smoking seems very much a side issue, so I won't address that.Concerning this from Message 187: This is a bit difficult to parse, and the paragraph ends with an incomplete sentence, so perhaps I'm not catching your meaning, but it seems possible that you're rebutting a position that wasn't anything I claimed, though I can't be sure. I won't comment since I'm not sure what you're saying. Because you were drawing your information from a rebuttal rather than the original paper, you drew incorrect conclusions about the paper's position on dietary fat. On page 6 the Marantz paper says quite clearly that they understand the health risks from dietary fat: Had you drawn your conclusions about what the paper said by reading the paper itself instead of just the rebuttal, you would not have made this mistake. This conclusion doesn't follow from what you presented, especially given the lack of clarity in that one paragraph and the error in the next.That paragraph I couldn't understand hints to me that you may think I'm saying something I'm not. The congruency between Marantz's and Taubes' views that I was noting was the possibility (not the conclusion) that dietary fat guidelines caused the obesity epidemic by increasing the intake of carbohydrates. Since Marantz is taking an epidemiological approach and focusing mostly on the issue of the advisability of dietary guidelines in light of ambiguous science, while Taubes is focusing through much of his book on specific metabolic processes, there isn't a whole lot of overlap. Taubes column from the journal Science, The Soft Science of Dietary Fat, *is* cited in the Marantz paper near the end of page 2, it is reference 13. If Marantz is citing a source incongruent with his own position he seems unaware of it.--PercyEdited by Percy, : Grammar.

Great, I won't comment further on your misdeeds, either. We're even.You see, Paul, once the slurs begin there's no way to get in the last word. On a discussion board it just becomes an endless back and forth with the two sides taking turns trading insults. Then that would be a misimpression. Taubes doesn't think there are no health risks associated with dietary fat. He talks about the risks of increasing levels of dietary fat for heart disease, but he also talks about how decreasing levels correlate with increased risk of colon cancer. There are risks in either direction.But Taubes does believe that the risks of dietary fat are far outweighed by those from carbohydrates, and that the attribution of the chronic diseases of western civilization to dietary fat is not supported by the research. Well, I guess we won't agree that your error is irrelevant. And actually, I still don't understand that passage. Perhaps you could express it in simpler terms? That would be another misimpression. Taubes didn't write a diet book, and the book doesn't contain any dietary recommendations, though naturally any reader who accepts his evidence and arguments will draw the conclusion that reducing carbohydrate intake levels is advisable. Taubes believes that it is increased carbohydrate intake at the expense of dietary fat that has contributed to the obesity epidemic. Yes, this would be true. There is nothing in the Marantz paper that argues for any health risks specifically related to carbohydrates. Yes, this would be true, too, and I made no other claim. Reread my Message 186 where I first mentioned the Marantz paper. Right above where I say "This is the same premise as Taubes" book there is this quote from the paper: That's the point on which I said Marantz supports Taubes. If you somehow interpreted that as arguing that the Marantz paper supports everything else Taubes claims, then let me be clear and say I was saying no such thing. The Marantz paper was focused on the advisability of government dietary guidelines in light of ambiguous science, and it simply makes no statements pro or con on the rest of Taubes' arguments, with the exception of attributing the obesity epidemic to increased caloric intake instead of carbohydrate related metabolic processes as Taubes does.--PercyEdited by Percy, : Minor clarification.

All great advice! I'll be sure to keep these hypotheticals in mind. Studies of the effects of low fat diets on heart disease show a beneficial effect, while those focusing on other factors show a deleterious effect. For example, low cholesterol levels correlate with an increased risk of stroke. And the Framingham study found a correlation between low cholesterol and premature mortality for men under 50, and in fact found that those whose cholesterol levels declined during the study were more likely to die prematurely, including of heart disease. In other words, the law of unintended consequences is waiting for the unwary, namely the US government. Taubes spends little space on the UK, but he does discuss it, and as in Iraq and other matters the UK has largely followed the US. You said at one point that you don't have our nutrition labeling requirements in the UK, but if you search images in Google for "nutrition labels" you'll see plenty of examples. These labels appear on almost every food sold in America. No kidding! Here's an example, note the "Calories from Fat" portion on line one: If you look at the Carbohydrate line you'll see that the 30 grams is 10% of the Daily Value, which means the US government recommends that a healthy diet include 300 grams of carbohydrates daily. Translated into more familiar units and and a very familiar food ingredient, that's equivalent to a half cup of table sugar. Thanks for trying to clarify. I've read through those three paragraphs several times now, and I just can't see the distinctions you're trying to draw, and in particular you make reference to things that I can't identify. What was "the argument you cited"? When you wrote the original paragraph you hadn't even read the original paper, so I can't imagine what you're talking about when you said, "where Marantz et. al. raise points damaging to the argument seen in this thread." Where you claim, "Marantz et al assert that even the weaker conclusion is only as well supported as the original recommendations," where is it that you interpret him doing this, and maybe this is just a UK/US thing, but the way you're expressing things when making and reexplaining this argument is very difficult for me to interpret. Perhaps you're drawing a type of distinction or using an explanatory style we're not familiar with here in the States, or at least that I'm not familiar with.In other words, sorry, but I'm still having difficulty understanding this argument. Yes, this is true. He and Taubes would probably disagree on this point. Okay, sure, but it's the major premise. Aw, shucks, there goes my claim to be God's gift to clear writing.Honestly, to me both my opening post and my first post about the Marantz paper still say what I intended them to say. They're a fair reflection of my ability, with whatever gifts and limitations I might have, to present and explain information.But enough about me.--PercyEdited by Percy, : Grammar.Edited by Percy, : Clarify.Edited by Percy, : Clarify next to last para.

Especially obvious will be who's living in denial.Again, see how this works, Paul? There's no way to stop the cycle of slurs at a discussion board. That's why we discourage such practices here at EvC Forum. I wouldn't call it a proxy, but there's a correlation between low fat consumption and low cholesterol levels. For example, in Japan when rice and fish were primary staples and fat consumption was very low, cholesterol levels were low and the rate of stroke was high.But that we know some of the potential negative consequences of following government dietary guidelines isn't what's important. Even if we knew of no health risks associated with reduced intake of dietary fat, we do know that our knowledge about such risks is insufficient. So the important point of the Marantz paper is that in the absence of sufficiently unambiguous scientific data, it is far better to provide diet/health information than to issue specific guidelines. You're right. What you actually said back in Message 174 was this: Given that I had just talked about how grocery stores and restaurants here in the US are now filled with an array of low fat food choices, I interpreted this as saying that your grocery stores have no such emphasis and that you only had things like "low fat" labels on food as promotional tools and not nutrition tables. So you have pretty much the same labels we have?Here in the states, "low fat" is a major promotional tool, and has been for quite some time. You can get skim milk, 1% milk, 2% milk, low fat cheese, low fat cream cheese, no fat cream cheese (tastes like cardboard), extra lean meat, low fat sausage, etc.The statistics do indicate that fat consumption has not declined but has actually increased slightly overall here in the states, which I of course accept, but it's hard to make sense of given all the low fat food in supermarkets, which wouldn't dominate shelf space if they weren't selling. I wonder what the explanation is. Well, I guess I just wasn't able to work it out. Without links or quotes or something else to go on, the references to things said elsewhere were too difficult to figure out and track down. Perhaps you could state your point all in one place? Actually, Message 186 is primarily about one document, the one I linked to right up front in the first paragraph. I provided links to the rebuttal and response near the end of the post as a sort of side note in the interest of completeness.If you get a chance you might want to listen to the interview with Marantz linked to at the end of Message 186. Marantz makes the same points he did in the paper, and half the interview is spent explaining the somewhat counterintuitive epidemiological issue where even dire health impacts at country population levels can almost never be observed in specific individuals. Very interesting.Anyway, the part of your argument I don't understand is how the Marantz paper is damaging rather than supportive of Taubes' premise that dietary guidelines related to fat have contributed to the obesity epidemic. The OP says that Taubes believes that the elevated levels of what are traditionally called the diseases of western civilization, namely heart disease, diabetes and obesity, are due to carbohydrates, not dietary fat. The Marantz paper, while touching only on obesity, is supportive of this premise. Well, I guess I can see what you're getting at, but I think expressing it this way makes misinterpretation too likely. The way I would explain it is that sugar *is* the worst carbohydrate because it contains both glucose and fructose. In lay terms, the glucose causes increased insulin levels, while the fructose causes increased fatty acid levels that the insulin converts to fat.Concerning carbohydrates and sugar, and keeping things simple while comparing apples to apples by only considering glucose, then to the body the glucose in carbohydrates is no different from the glucose in sugar.--Percy

No, that's okay, the mistake only caused me to again state what the primary focus of Message 186 was, I see no need to change that. About your Message 187, as I've said before, I found it fairly difficult to interpret. If there's an important point you'd like me to take from it then perhaps you could explain it again. Sure, when you retract yours, I'll retract mine.Again, see how this works, Paul? As I've said many times here at EvC Forum, usually as moderator, the nature of discussion boards somehow just seems to encourage people to feel that their opponents are engaged in purposeful misrepresentation, manipulation and even outright lies, and you seem to be consumed by such feelings. In order to keep discussion focused and constructive, EvC Forum asks that participants not give voice to these inevitable feelings. Rule 10 says:

10. Keep discussion civil and avoid inflammatory behavior that might distract attention from the topic. Argue the position, not the person.

You've been spending a lot of effort directing personal criticism at me, and I'm not the topic. I really wish you would stop, and I'm not the only one. As Adminnemooseus said in Message 202: AbE: I'll bring this back-and-forth to an end by committing to not responding to any personal comments directed at me in your next post. My hope had been that reflecting what you were doing back to you would get across the pointlessness of discussion focused upon recriminations, but this doesn't seem to be working, either. In any case, then we can move on with discussion of the topic.--PercyEdited by Percy, : Added AbE note.

You're correct, my comments aren't relevant since you actually intended to reference a different message, but the observations I made about Message 186 were not incorrect and there's no reason to change them.--Percy

I don't think we're going to agree about what the available evidence indicates. You make a number of points about how I could better organize the presentation of information, and while I can't really disagree, it's sort of beside the point since it was the best I could do given my talent and time available. Where I left some information out, I think many of my posts were already somewhat lengthy, an argument for hoping people might remember information from previous posts.--PercyEdited by Percy, : Typo.

Some might remember the food pyramid I posted about a week ago, it looked like this: This, of course, is the *old* food pyramid. A couple years ago the USDA (United States Department of Agriculture) revised the food pyramid and the new pyramid looks like this: The new pyramid is a symbol rather than a pictorial representation of which food groups to emphasize or minimize. In order to find actual recommendations you have to work at it. The easiest way that I've come across for finding recommendations is to first go to http://www.mypyramid.gov/ and click on "Inside the Pyramid" in the left hand navigation bar. In the pyramid on this page, the triangular portions of the pyramid correspond to food groups, as you'll see by clicking on each triangle in turn. The orange triangle is grains, the green is vegetables, the red is fruits, the blue is milk products, and the purple is meats and beans. The breadth of each triangle appears to be an indication of how "recommended" each food group is.Meat is still not favored, as the purple triangle is the smallest. If you click on the "Learn More" and then on the "Tips for making wise choices" in the right hand list of links, you'll see recommendations like "Start with a lean choice" and "Trim away all visible fat", so the USDA is still on the low-fat bandwagon concerning meat.And also concerning milk products. Click on the blue triangle, then "Learn More", then "Tips to for making wise choices." They recommend skim milk (fat-free milk) and low fat cheese.But they have changed their story on grains. Click on the orange triangle, then "Learn More", then "Tips to help you eat whole grains". They're recommending whole grains and deemphasizing refined products. This is definitely a positive development, because whole grains contain more fiber. Fiber is also a carbohydrate, but it's also indigestible - it makes no contribution to nutrition.The new pyramid is an improvement in two ways. First, the information is more accurate. Second, it's so hard to find the actual recommendations that few will bother.--Percy

Okay, you're welcome to your opinion. I like the provocative title, and I make clear in paragraph three the difference between glucose and fructose, though as I reread the message now I think I'd rewrite paragraph four like this: Moving on: But I don't think the dietary fat mafia would agree about what constitutes excess glucose. The daily value for carbohydrates in the US is 300 grams, which is the equivalent amount of glucose as a half cup of sugar. A common recommendation is for carbohydrate sources to comprise 60-70% of total diet. A more reasonable level would be in the neighborhood of about 25%.A certain proportion of the carbohydrates in most foods that contain them is fiber. Fiber is a form of indigestible carbohydrate that does not contribute to nutrition. Fiber is also often referred to as roughage. You can subtract the grams of fiber on the nutrition label from the grams of total carbohydrates to get a measure of the effective carbohydrate content.It is because of its higher fiber content that the USDA recommends whole grain as opposed to refined grain sources, but for the most part this recommendation is useless because the whole grain product you'll usually find in supermarkets and restaurants differs very little from the refined grain product. For example, the D'Angelo's website lists this information for their large regular and whole wheat sub rolls (D'Angelo is a popular sub sandwich chain in central New England, all units in grams, the glucose and fructose figures are my calculations): As you can see, the honey wheat sub roll provides very little advantage over the white, plus it has 3 more grams of sugar, half of which is fructose. Also keep in mind that this is just the roll. The contents of the sub roll adds another 90-130 grams of carbohydrates. If you want to limit yourself to 100 grams/day of carbohydrates then you can never eat a large D'Angelo sub. You could have a small one, but only if you'd had nearly zero carbohydrates at both breakfast and lunch.Why does D'Angelo offer a whole wheat sub roll that is almost the same nutritionally as its white? Well, it's an unfortunate fact that grain products that are significantly high in fiber have little appeal for modern palates. Some can be found in supermarkets, but truly high fiber products can usually only be found in health food stores or on the Internet. Most restaurants wouldn't think of including such products on their menu because the idea is to encourage people to eat. Placing such unappealing offerings on the menu would be counterproductive.Before the development of agriculture around 10,000 years ago, all human diets were relatively low in non-fiber carbohydrates. Grains in any substantial quantity simply did not exist, and it took thousands of years after that for refined carbohydrate products to become widely available. Combined with the ready availability today of refined sugar in soda and candy, the modern western diet has far too much carbohydrate, and far, far, far more than our ancestors over the last few million years of evolution. Our bodies did not evolve to deal with high carbohydrate intake levels. This is not just Taubes saying this, but many other respected diet/health writers who have managed to not alienate the mainstream diet/health medical establishment, like Michael Pollan, author of The Omnivore's Dilemma.Taubes makes a number of observations that taken together indicate that something important is going on with respect to carbohydrates that we do not yet understand:

1. The obesity epidemic has coincided with increased intake of carbohydrates.
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2. Human metabolism with respect to weight gain is nowhere near as simple as "a calorie is a calorie is a calorie," as can seen with otherwise identical people on the same diet having different weight gain experiences.
   ​
3. Transplantation of skin from a region of fat accumulation, such as the belly, to a region where fat accumulation is rare, such as the back of the hand, sees that tissue gain weight identically to where it came from throughout the subject's lifetime.
   ​
4. Emaciation and obesity has been observed in the same individual simultaneously. Women emaciated above the waist and obese below is one example. Clearly something related to tissue metabolism, not diet, is the significant factor.
   ​
5. Insulin regulation plays a key role in obesity because it encourages the conversion of fatty acids into triglycerides by adipose tissue (fat tissue), and insulin levels are strongly influenced by blood glucose levels, which are in turn influenced by carbohydrate intake.
   ​
6. The progression from normal to metabolic syndrome to diabetes type II hints that elevated carbohydrate intake has a wearing effect on body metabolism for susceptible individuals, primarily the pancreas and its production of insulin. Unfortunately, susceptible individuals represent a significant proportion of most populations.

Taubes and the mainstream diet/health establishment part company over the implications of these observations regarding carbohydrates. They especially part company regarding Taubes' support of the possibility that carbohydrates are also implicated in heart disease because of their contribution to small, dense LDL production, but that's another matter.--Percy

Sure it's true. It's true that the body needs glucose, but it does not require dietary carbohydrates. You can't live without dietary protein, you can't live without dietary fat, but you can live just fine without dietary carbohydrates.--Percy

One of the questions I asked early in this thread, and that still hasn't been answered, is where glucose comes from on low-carbohydrate diets. I now think I have the glimmer of an answer. A process called gluconeogenesis is employed by the liver to produce glucose from amino acids and glycerol obtained from fats.That's the short answer. There's a longer answer at Wikipedia (see the Wikipedia article on Gluconeogenesis). I sort of slogged my way through it, but I didn't get much out of it, it would be nice if someone could put it in lay terms. I'm particularly interested in the parts of the process that are exercise-induced.Evidently gluconeogenesis is often associated with ketosis, another liver process that produces fatty acids for use as energy by the body. So in the absence of carbohydrates, the liver produces both glucose and fatty acids. This would explain why carbohydrates are not a necessary nutrient.An aside: I've been able to answer another question that came up earlier in the thread concerning where the triglycerides produced by the liver are stored. Taubes states on page 175: I assumed the triglycerides were stored in the liver, and Molbiogirl objected that this couldn't possibly be true, and in that she was correct. The storage medium for the triglycerides produced by the liver appears to be the bloodstream.--Percy

Carbohydrates range from the extremely simple (e.g., sucrose, better known as table sugar) to the very complex (e.g., potatoes and rice).Very simple carbohydrates like sucrose are approximately 50% glucose and 50% fructose. Almost no digestive effort is required for sucrose to become glucose and fructose in the bloodstream. Food products like candy, pastry and soda are responsible for spikes in blood sugar due to the rapid increase in glucose in the bloodstream, while the liver is flooded with fructose that it converts to triglycerides. Elevated blood sugar causes increased insulin levels which in turn cause overproduction of triglycerides and their subsequent uptake by adipose tissue. This is the primary process by which the sugar in candy and soda makes you fat.The advantage of very complex carbohydrates is that they take time to digest and so do not result in blood sugar spikes, but they are broken down by digestive processes into various forms of very simple carbohydrates, mostly glucose, which is the source of the message title "Carbohydrates are Sugar" that you didn't like. While the insulin response isn't dramatic, the increased insulin levels still encourage the uptake of triglycerides by adipose tissue.But a meal of complex carbohydrates can be just as fattening as one of simple carbohydrates. One common example is Chinese pork fried rice. High in both fat and carbohydrate, the fat elevates triglyceride levels while the carbohydrate elevates insulin levels, causing adipose tissue to suck up the fat. Sure. The very complex carbohydrates in starchy foods are preferable to the very simple carbohydrates in sugar. No carbohydrates are even better.--Percy

Yeah, it would probably be better phrased as, "Sucrose is an example of a very simple carbohydrate that is approximately 50% glucose and 50% fructose." So am I. The important issue underlying this entire thread is that the current conventional wisdom about diet and health is not supported by the available research. Teasing out diet/health relationships is proving incredibly difficult. So when you go on to say: It is true that advocates of the dietary fat hypothesis question the advisability of diets that encourage ketosis. But they're probably confusing ketosis, a perfectly normal metabolic process, with ketoacidosis, a potentially dangerous condition often associated with diabetes. Given that some human populations have survived generations on meat-only diets (Eskimos, for example), the more serious questions would be about diets that include elevated levels of carbohydrates, particularly refined carbohydrates.This passage from Taubes is relevant: There's more that you might find interesting, but Taubes book is not on-line in any complete form and I have to type this in by hand.--Percy

Yes, that's one of the important points. It's a point that both Taubes and Marantz make (though of course Taubes 450+ page book makes many more points, having a far broader scope than the 6 page Marantz paper). They both believe the current level of diet/health research is inadequate for making recommendations.But in assessing the current state of research it should be realized that there is increasing recognition on the part of both researchers and those responsible for diet/health recommendations at the National Institutes of Health, FDA, USDA, and so forth, that the current consensus about dietary fat is looking increasingly suspect, and that the potentially significant role of carbohydrates is becoming increasingly appreciated.You also cannot forget the list of some of the key supporting observations for the carbohydrate hypothesis that I provided in Message 215, and here it is again:

1. The obesity epidemic has coincided with increased intake of carbohydrates.
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2. Human metabolism with respect to weight gain is nowhere near as simple as "a calorie is a calorie is a calorie," as can seen with otherwise identical people on the same diet having different weight gain experiences. Laboratory genetic experiments have duplicated this effect by producing strains of animals that are naturally fat and that get much fatter on the same diet as normal ones. There are clearly other factors at work beyond calories that are at present not well understood.
   ​
3. Transplantation of skin from a region of fat accumulation, such as the belly, to a region where fat accumulation is rare, such as the back of the hand, sees that tissue gain weight identically to where it came from throughout the subject's lifetime.
   ​
4. Emaciation and obesity has been observed in the same individual simultaneously. Women emaciated above the waist and obese below is one example. Clearly something related to tissue metabolism, not diet, is the significant factor.
   ​
5. Insulin regulation plays a key role in obesity because it encourages the conversion of fatty acids into triglycerides by adipose tissue (fat tissue), and insulin levels are strongly influenced by blood glucose levels, which are in turn influenced by carbohydrate intake.
   ​
6. The progression from normal to metabolic syndrome to diabetes type II hints that elevated carbohydrate intake has a wearing effect on body metabolism for susceptible individuals, primarily the pancreas and its production of insulin. Unfortunately, susceptible individuals represent a significant proportion of most populations.

At a bare minimum these observations indicate that current dietary recommendations regarding dietary fat and carbohydrates are flawed, and that there is much we don't understand about body metabolism. And Taubes presents a great deal of evidence in his book that the interplay between various body hormones, most significantly insulin, has a great deal to do with obesity. I'm not familiar with any such studies, but subsistence usually means physically demanding and that dietary intake is just sufficient to survive. A diet meager in quantity, even if high in the proportion of carbohydrates, and combined with rigorous physical activity cannot produce obesity.But I'm not endorsing a carbohydrate-free diet. No one is. I was simply noting that when it comes to the three sources of calories, protein, fat and carbohydrates, only protein and fat are essential.The larger point is getting lost in detail. Taubes argues that the dietary fat hypothesis is not very well supported by the available evidence, and he presents a lot of evidence that the carbohydrate hypothesis is a better fit. But he also points out that the research is insufficient to reach a conclusion in either direction, and he concludes his book with a plea for more research.--PercyEdited by Percy, : Change title.

Sorry if you've picked up the wrong impression. In the passage from me that you quoted I say, "But I'm not endorsing a carbohydrate-free diet," and I'm not. I don't know anyone who advocates cutting out all carbohydrates. Since you've read through the thread you should be aware that I've set personal goals of less than 100 grams/day of carbohydrates, and preferably 70, though I find that rather difficult to achieve. Taubes' book makes no dietary recommendations at all - it isn't a diet book.Concerning saturated fat specifically, this is discussed in Taubes book more in the context of heart disease than obesity. Taubes and Dr. Ron Krauss were interviewed together on Talk of the Nation last November (see Message 109 for a link and more discussion). Dr. Krauss is featured prominently in Taubes book. At one point Dr. Krauss speaks about LDLs, of which their are two primary types, large, fluffy LDLs, and small dense LDLs.Krauss and Taubes disagree about the risks of large fluffy LDLs. Certainly large, fluffy LDLs are essential for delivering fatty acids in the form of triglycerides throughout the body. You woudl die without them. But perhaps Krauss was referring to elevated levels of large, fluffy LDLs. In any case, he wasn't specific about the hazards in the interview.But he was very specific about small, dense LDLs. See the previously referenced information for a more complete quote, but about small, dense LDL's he says, "...it's just a matter that the major impact, we feel, comes from pathways that result in the smaller LDL particles, and that's where carbohydrates and not saturated fat play a role."--Percy