Good Calories, Bad Calories, by Gary Taubes

Maybe we need to break this down into smaller pieces. You say in response to Taubes' claim that triglycerides are packaged into VLDL: The Wikipedia article on triglycerides says: Once we figure this one out we can move on to the next item.--Percy

I appreciate that you're going to a great deal of effort to make this clear for me, but I think the very long posts work against clarity. In addition, some of the things you're addressing have nothing to do with anything I or Taubes have said. I never mentioned chylomicron, that was just mentioned in passing in a paragraph of explanation about triglycerides from Wikipedia. And neither I nor Taubes ever claimed that (to use your words) "the FFAs that are used to produce the VLDL particles come from...carbs."If you can just respond to Message 31 so we can resolve that issue then we can move on to the next item.--Percy

No, I didn't, and neither did Taubes. You actually quoted Taubes not saying this, and I'm just echoing Taubes. Read the quote again. Taubes says triglycerides, not FFAs, are in VLDLs.And this is the question I asked in Message 31, concerning whether it is triglycerides or FFAs that are placed in VLDLs. You're disputing almost everything that Taubes says, and you're even rebutting things he didn't say, often at great length, and this is becoming such a big tangle that I think we need to start finding some common points of agreement. So if we can figure out the answer to this one issue then we can move on to the next item, which, if you like, can be whether glucose is involved at all in VLDL production.Note that what we're discussing now is related far more to heart disease than to obesity, but once we finish the heart disease issues we can move on to the obesity issues.--Percy

I'm sorry, Molbiogirl, but I cannot connect your answer to the question. I raised an issue concerning triglycerides, FFAs and VHDL, and your answer mentions none of those things. I will refrain from taking potshots at the people involved during what should be a technical discussion to the extent that you do the same, holding fast to my belief that the slowness with which this technical discussion is proceeding is due to its complexity and my unfamiliarity with the area, and ignoring hints that what might be going on is an attempt force concession by way of evasive answers and gallops through data.In other words, when it isn't easy sledding on either side there is a tendency to ascribe base motives to the other side, and participants in a discussion must resist giving expression to these feelings in order to maintain constructive and open communication.I'm looking for correct information, but I cannot accede to information I do not understand or that does not make sense to me. Independent of Taubes' accuracy in describing various facets of body metabolism, the evidence strongly suggests that the dietary fat hypothesis of heart disease, diabetes and obesity that has turned our grocery stores into huge repositories of specially produced low fat food while simultaneously in the general population heart disease hasn't abated while diabetes and obesity have reached epidemic proportions, indicates that the dietary fat hypothesis is not the answer, or at a minimum is not even close to being the full answer.The carbohydrate hypothesis may also be wrong, but Taubes makes a strong case that it has not been properly studied because of the hostility against it within the scientific community, of which you are currently providing a copious example.I'm only trying to learn what's actually so after years of frustration trying to lose weight through traditional diets. My doctor doesn't believe me when I tell him I can't lose weight on a diet of 1200 calories/day - he says I must be cheating, that I should be able to lose weight on 1600 calories/day. But I'm your traditional obsessive/compulsive engineer. This personality likes to be in control and tends to keep close track of everything. So when I say I'm consuming only 1200 calories/day (and am enormously hungry to the point of waking in the night with hunger pains) then you can take that to the bank.During the last decade or so, every 3 years or so I decide I've got to lose weight, so I've been on 3 diets in the last decade, the only 3 diets of my life. On the first one I lost the weight easily on 1400 calories/day. On the second one I lost the weight more slowly, but again on 1400 calories/day. On the latest one I did not lose any weight in over a year on 1200 calories/day. I'm obviously experiencing the common problem of finding it harder to keep weight off as I get older. But three weeks after cutting down on carbs I'm suddenly down 8 pounds, and I'm never hungry.So what explains not being able to lose weight on 1200 calories/day? Taubes explanation is that hunger, exercise and calorie intake/outgo are not independent variables. If you eat more you'll exercise more and maintain your weight. If you eat less you'll exercise less and maintain your weight. Certainly while I was eating only 1200 calories/day I was experiencing severe energy problems, especially in the afternoon, and this problem has suddenly completely disappeared. I used to roll into bed at the end of the day completely exhausted and would be asleep literally in less than a minute. Now I'm suddenly reading for a good hour before turning out the light, a habit I had kept up for years that I abandoned only in the past year when I couldn't keep my eyes open.My dietary experience is probably nearly the identical one that all older people have, and the dietary fat, calorie intake/outgo hypothesis of obesity completely fails to explain this experience. That it still survives is utterly amazing, but you and my own doctor are my personal evidence that is very much alive and kicking.The problem is that when anyone thinks they already have the answer they stop looking for the answer, and Taubes main point is that we have all the evidence we need to tell us that the dietary fat hypothesis is not the answer and that we should still be looking. It is true that there is much ongoing health research, but one of the answers that researchers already think they have is that the carbohydrate hypothesis has been disproven, but there is strong evidence that they're mistaken, that at a minimum it is a significant part of the equation.--Percy

I believe you, but clear for a biologist or a layperson?Anyway, because this message was short I think I can figure things out. TAGs are triglycerides? If so, what's with the "A"?I have it from Taubes and from a couple different articles at Wikipedia that VLDLs contain fat in the form of triglycerides, not FFAs. I'm sure the processes involving VLDL can be deconstructed into more and more detail and more and more steps, but at heart isn't it triglycerides that are contained in VLDL, not FFAs? Okay, I'm going to have to repeat a few things, because this pointedly ignores what I said as well as reality.First, I described my experiences with diets and weight loss because it is typical, not solitary, and I'm sure they echo your own dieting experiences. Almost everyone involved in obesity research, especially including the majority who adhere to the dietary fat hypothesis, will tell you that almost all diets fail because in a battle between willpower and hunger, hunger almost always wins. This isn't an issue about which there is any doubt or controversy.Second, I did not say that calorie reduction diets do not work. As I told you, I was able to make calorie reduction diets work twice, but as I got older they became less and less effective. They were also easy to fall off of, since obviously I gained the weight back. So I'm sure that you also have been able to make calorie reduction diets work, as have millions of other people. And the almost universal experience is that the loss is temporary and the weight comes back, because eventually you just can't stand being hungry anymore. Wow, diagnosis via discussion board! Can you tell my fortune, too?Seriously, water loss? I'm aware of the water loss period in the first week or two of the diet, but I'm not a single data point, you know that. You can't attribute all the significant weight loss reports from low carb diets to water loss, and even researchers who accept the dietary fat hypothesis grant the effectiveness of low carb diets. What they say about them is that they're nutritionally dangerous, or that they're low calorie diets in disguise due to the comparatively narrow range of food choices. They don't claim they're ineffective or just water loss.Low fat diets are at heart starvation diets. There is a higher tendency to lose protein on low fat diets, and hunger is almost always the impediment to permanent success.In contrast, low carb diets encourage the conversion of FFAs from triglycerides in fat cells, so there is an increased tendency to lose fat instead of protein, and there's no hunger. Are you talking about the carbohydrate hypothesis, or just diet and health in general? If you're talking about the carbohydrate hypothesis, then as an independent variable in large, long term gold standard studies (Framingham size and duration) with the requisite procedures and set up as single-blinded, no, it has not been and is not being exhaustively studied. It is broadly considered as already discredited, precisely the attitude you're exhibiting here, and it is very difficult getting funding for large studies for already discredited hypotheses.Interestingly and disappointingly, much of what I've read about low carb diets is that people gain that weight back, too. We'll have to see how I'm doing a year from now. No matter what the outcome, at least I won't have been hungry, because I just couldn't take any more of that.--Percy

The Atkins diet plan made low carb diets the target of those who accept the dietary fat hypothesis for many, many years, and the strong criticism continues right up to the present day. I do not dispute that you can find literally terabytes of words criticizing low carb diets.This is why we're approaching this from a technical perspective, so that we don't have to rely upon authority, and so that we have a better chance of establishing what is correct and what is incorrect about Taubes' descriptions of metabolic processes related to heart disease, diabetes and obesity, and (more importantly) what we think we know that we really don't.So we've now established that when Taubes described VLDLs as containing fat in the form of TAGs and not in the form of FFAs that he was correct (Taubes also describes the composition of triglycerides as being three FFAs bound together and also describes the conversion process back and forth with FFAs, something I've described in this thread myself).So let's move on to the next issue of how significant the role of glucose is in the production of VLDLs by the liver. You claim that while this is a process that can take place, in reality it occurs only rarely because the triggering mechanisms for it are complex and rare, typically happening only when the body is under some kind of stress. You also claim that this is the only available process by which the liver can produce triglycerides from FFAs.Taube's overall point is that high glucose levels encourage the production of VLDLs by the liver, and I think you disagree with this, too.You said this in Message 30: So why don't we start by exploring this process in greater detail. How do think it would be best to begin?Getting to the side issues now... What my rhetorical response was intended to indicate was that you're focusing on me as a way of avoiding addressing the body of data about the effectiveness of low carb diets for weight loss. As I said, I used myself as an example because I'm typical, and because I'm typical I can safely assume that I will continue to lose weight and continue to not be hungry which will allow me to continue to follow the diet. The fact that I personally am only in week 4 (not 3 anymore) can't be used as an argument against the large body of data.To deny that low carb diets work and to claim that it's all really just water loss flies in the face of reality. Even your fellow dietary fat believers disagree with you, since the effectiveness of low carb diets is widely conceded. As I said in my previous message, they criticize low carb diets for being unsafe or for being low calorie diets in disguise (and I imagine there are many other criticisms, but I think these are the main ones), not for being ineffective.Keep in mind that Taubes' book is not a diet book. I've never read a diet book in my life. I am not following any diet. I'm making my own diet based on the information I can find. Cutting down on calories didn't work, cutting down on carbs did. You asked how many calories I'm consuming now, and I'd say it's around 1500/day, up from 1200/day. Research appears to indicate the most reliable indicator of health and longevity is degree of obesity. The more obese, the worse the long term prognosis for health and longevity. Any approach that keeps us lighter longer is an improvement. Low carb diets with their lack of hunger and their ability to cause weight loss with higher calorie intakes are much more likely to achieve the goal of being lighter longer.--Percy

I intended to address these and somehow left them out. If you're the same weight you were in high school then you're not typical, are you. Your experience shares little with the general population, especially your diets. Losing a holiday weight gain over a few weeks is child's play compared to enduring hunger for a year while losing 40 pounds.I offered myself as an example because I am typical, a true representative of the broad body of data regarding diet and weight loss. Since you are not typical, you cannot offer yourself as an example. There were actually 3 diets. This latest diet, the low carb diet, is the 4th. I presume that the first two diets worked because the reduction in food intake cut both carbs and calories. But the second diet was more difficult than the first, I presume because I was older and my metabolism had changed (the specifics of the change cannot be known, of course, but whatever they were they are apparently typical with age). And I presume the third diet didn't work because my internal metabolism had changed to the point where the number of calories required to achieve weight loss was now so low that the corresponding hunger became an insurmountable barrier.So the three diets aren't actually evidence of much of anything because calories and carbs were not varied independently, and I kept no careful data away. And on the current diet I'm only tracking carbs, not calories, so my calorie estimates are probably not as reliable as they were for the previous diets.Here's the evidence we do have:

• Calorie reduction diet of 1200 calories/day, no weight loss in over a year, frequent hunger.
  ​
• Carbohydrate reduction diet,

--Percy

Okay, so far so good. But I think "excess carbs" *are* frequent with modern diets. Drink a Coke or eat an ice cream Sunday or a piece of chocolate cake and voil, you get excess carbs, a blood sugar spike, and a flood of insulin to deal with it. Happens all the time. Of course not the liver. Why on earth would any sighted person believe that a person's fat accumulates in the liver? I've already clarified this point a couple times, but once again, the conversation about the liver had to do with carbohydrates role in heart disease through the production of VLDLs, not with obesity. Blood sugar spikes cause the liver to produce triglycerides which eventually find their way into VLDLs. You've already agreed this happens, we're now just trying to understand if it happens through consumption of carbohydrate products that many people eat everyday, or if it's actually a once in a blue moon kind of thing that only occurs under rare circumstances. No. Once again, here are Taubes' own words as originally quoted in Message 27: Moving on: A different interpretation of your response that makes sense would be hard to find, but go ahead and try. Yes, this is the mantra of the dietary fat crowd. No one denies this is true, but it explains nothing about why two otherwise identical people on identical diets can have such different experiences with their weight. It ignores all the experiments showing that you can genetically create rats that grow fat on near-starvation diets.If you drink a Coke and cause a blood spike and the fat cells react to the resulting increased insulin levels by sucking up fatty acids in the form of TAGS and the muscle cells fail to absorb much glucose because they've developed some level of insulin resistance after years of blood sugar spikes, then you'll end up watching TV on the couch instead of going out and playing basketball. Exercise, hunger, diet and fat absorption by adipose tissue are not independent variables. If you exercise more you'll eat more because you get hungry more. If you eat less and endure the hunger then you'll exercise less because you have less energy. Then relax and stop being so shrill. If all the evidence is truly on your side then you're going to win this debate going away.--Percy

That would be incorrect because Taubes doesn't advocate a one-answer-fits-all-obesity-problems approach. Characterization of Taubes' views from the dietary fat crowd may need to be taken with a grain of salt.I seem to be spending a fair amount of time saying, in effect, "No, Taubes isn't saying that."But you don't have to make much of a change to render your statement more accurate, e.g.: Moving on: You really need to stop this "diagnosis by discussion forum." I offered myself as a typical example, which I am. Do you really want to argue that for the typical case there's an ideal caloric intake that will result in weight loss, but that taking in fewer calories than that will halt the weight loss? Gee, imagine that, it started at the same time that dietary fat was implicated as the primary culprit behind heart disease, diabetes and obesity, and the major health organizations began promoting carbohydrates as a healthy replacement for some proportion of dietary fat and the calories it contained.Before the development of agriculture about 10,000 years ago, grains were not a significant proportion of human diets. With the availability in modern western civilizations of cheap calories in the form of sugar and other refined carbohydrates, all the factors fell into place for dramatic increases in heart disease, diabetes and obesity. The greatest burden falls on the poor, who must rely upon cheap carbohydrate calories to survive, and it is why there is a higher incidence of obesity among those least able to afford food or poor health. Precisely. This evidence makes even more clear just how bad things have become since the dietary fat hypothesis became the accepted explanation.--Percy

I guess it *would* be straightforward if Taubes had mentioned insulin, but he didn't. I'm again having to respond to you with a, "No, Taubes isn't saying that." Again, Taubes didn't mention insulin.--Percy

I already understand that you disagree with Taubes' position. The point was that your statement of Taubes' position was a rather extreme caricature. That's an incredible stretch. First, the study doesn't even come close to supporting your position, which is that people have an ideal caloric intake for weight loss below which they will lose less weight. And second, if there *were* such a thing then you would have to concede either that "a calorie is not a calorie is not a calorie", or that exercise, diet, hunger and fat storage are not independent variables. At least one of them would have to give, probably both.--Percy

You don't have to take my word for it because I've quoted Taubes' very own words, and here they are again for a third time: The word insulin does not appear in that passage.If Taubes is wrong, it isn't because he said "insulin causes this," because, as I seem to have to keep repeating, Taubes really and truly didn't say this, at least not here.No one is perfect and correct in everything they say, including you, me and Taubes. But in order to rebut someone's position you have to rebut the positions they've actually taken. You can rebut the claim that insulin causes this until the cows come home, and you might be absolutely right, but it would have nothing to do with anything Taubes said in that passage. I think that's a good idea if you're really interested, but it takes a while to get through.--Percy

Uh, yes, of course, I've been promoting this point throughout this thread. Exercise, diet, hunger and fat storage are not independent variables. If you eat more you'll have more energy, will exercise more, and will maintain weight. If you exercise more you'll be hungrier, will eat more, and will maintain weight.But most important of all to obesity discussions is that if someone's metabolic processes are balanced too much toward the storage of fat in adipose tissue, then that comes at the expense of available energy and they will exercise less. Fat people eat too much and are too sedentary not because they are lazy and slothful gorgers, but because the tendency of their bodies to overemphasize the storage of fat making it unavailable as energy to the rest of the body leaves them feeling hungry and unenergetic.And this study still doesn't support your position that there's an ideal calorie intake level below which people will cease losing weight, certainly nothing applicable to normal diet situations.I've beginning to develop Molbiogirl citation resistance. You can't just keep throwing irrelevant citations at people hoping, well, I don't know what you hope, but if you're going to offer citations and excerpts then you have a responsibility to make sure they're apropos and actually support your position, otherwise people will eventually stop listening to you.--Percy

This is another citation which doesn't support your position that the liver does not convert glucose to triglycerides as part of any common process of VLDL production.What your citation does focus on is insulin, which Taubes didn't mention as part of the process.Why don't you make some claim that you can actually support, like maybe that Taubes' description is incomplete or lacks sufficient detail and so can't really be analyzed as to whether it is correct or not, or that we can't really tell what specific metabolic process he's attempting to describe, or at least something else. The only things you can seem to find to rebut so far are things that Taubes never said.You can't disconnect the research from reality. I trust my doctor, but his obesity information did not jibe with reality. He in effect said, "It's not possible for you to live on 1200 calories/day, you must be cheating." This is the recourse of much obesity advice: When the advice doesn't work, blame the victim.So I eventually had to ignore my doctor's advice. While Taubes' book gave me specifics to focus on, I had already arrived at his general conclusions based upon my own experiences. I definitely accept that a calorie is a calorie is a calorie, the problem is that this is usually cited only as a way of ignoring that the process is not one of simple intake/outgo because the variables are interdependent, and a major factor is the degree to which anyone's metabolism encourages the storage of fat in adipose tissue. These issues seem to be recognized in the research, for instance one of your recent citations is consistent with the position that reduction in calorie intake causes a corresponding decline in energy levels, but they don't filter up to diet advice for the general population, who are only told "a calorie is a calories is a calorie."I think one could create an excellent diet based on the simple rule of eating only foods that were available more than 10,000 years ago (within practical limits, of course - for instance, it wouldn't be practical to only consume vegetable species available to stone age man, so you'd have to eat the contemporary versions of the vegetables that are available in supermarkets). This would eliminate soda, candy, bread, pasta, refined rice and potatoes. It would also unfortunately eliminate milk and cheese, so an exception would have to be made for these since they are definitely consistent with a low carbohydrate diet.--Percy

If I'm mistaken that they don't support your position then all that is probably needed is to explain in your own words at a layperson level how they support your position. The abstracts and excerpts you provided give no such indication to me, but perhaps if you explain the tie-in it will help.About your previous post, of course Taubes addresses the topic in other places in the book, but that was the only passage I found that describes in any detail that particular process. Maybe he adds more details in other places, but as you say, it's a long book, I don't know. Another pair of eyes on the text would certainly be helpful in ferreting out details.But I'm curious, given that that passage doesn't mention insulin, and given that you haven't read the book, why are you so certain that Taubes must elsewhere in the book make that particular error? That just seems incredibly, uh, I don't know, weird? You're so sure that Taubes is wrong that you're certain that if you read the book you'll find errors that you made up yourself?Why don't you just go back to trying to support the point you were originally trying to make, which is that the production of VLDL from glucose by the liver is an incredibly rare process?But as far as actual weight loss goes, this discussion is becoming academic for me. I'm down 9-1/2 pounds now after about 4 weeks, and I'm going to have to take a link out of my watchband soon because it's getting loose on my wrist.In other words, concerning weight loss, the problem for you is reality, which is the same problem creationists have. It doesn't matter what arguments you make or research you cite if the evidence from reality is that low carb diets cause weight loss without hunger at higher calorie intake levels than low fat diets.There is of course still the main question of whether the western diseases of heart disease, metabolic syndrome, diabetes and obesity are caused primarily by fat or carbohydrates, but here reality also runs against you. In the United States, the national health problem with these diseases worsened during the same period that the emphasis on low fat diets increased. This is nearly impossible to fathom if dietary fat is truly the cause.At one point you said that if you knew the answer to this crisis of western diseases you'd win an "FN Nobel", indicating your belief that the causes remain mysterious or at least unknown. This is again so reminiscent of creationists who when presented the contradictions between their position and reality say that it is a mystery. It's only a mystery because they refuse to follow the evidence where it leads because they believe they already have the answer.--Percy