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Triskjavikson

Uh Oh for Paleo

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There used to be a lot of discussion about the Paleo diet on this forum (and variants thereof) and the work of Gary Taubes who wrote a few exhaustive and thought-provoking books saying that fat has been unfairly vilified and that carbs and sugar specifically are the main cause of obesity.

Taubes went on to co-found an institute that has pushed to start really funding the big types of studies where we could really test some of that stuff.  Well, the biggest and best controlled study on this came out recently and seemed to more-or-less show that type of macronutrient (i.e., carb, fat) doesn't matter that much.

One of the best writups on the results is here.

Stephen Guyenet who has pretty big credentials and has been a Taubes antagonist has a take here

This doesn't necessarily hurt Taubes thesis that fat isn't the devil...I actually think that many experts are with him on that.  But it does seem to hurt the case that carbs are really the issue.  It seems to suggest that the calorie is a calorie is a calorie crowd is largely correct.

Food for thought, no pun intended, but part of why this is a big deal is that this is the biggest and best and most well-controlled study of this type that's ever been done.

I'm eating pasta all week.  

ETA:  I'm not sure if Taubes has responded yet, but my prediction is that he'll say that people left to their own devices outside of a controlled study like this would have an easier time reducing their calories if they avoid carbs.

Edited by Triskele

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Oh, interesting. Thank you.

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Quote

 I'm not sure if Taubes has responded yet, but my prediction is that he'll say that people left to their own devices outside of a controlled study like this would have an easier time reducing their calories if they avoid carbs.

He wouldn't be wrong, I think. Cutting out carbs targets some very particular, high-calorie stuff -- sweets, baked goods, soda, pasta, rice -- that is pretty easy to remember whereas low-fat diets strike me as being a bit harder to pin down. Cheese, sure -- but then some sauces (but not others), avoid stuff made with some oils (but not others), some meats (but not others), etc. 

Edited by Ran

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27 minutes ago, Ran said:

He wouldn't be wrong, I think. Cutting out carbs targets some very particular, high-calorie stuff -- sweets, baked goods, soda, pasta, rice -- that is pretty easy to remember whereas low-fat diets strike me as being a bit harder to pin down. Cheese, sure -- but then some sauces (but not others), avoid stuff made with some oils (but not others), some meats (but not others), etc. 

Carbs are often hidden, or people aren't aware of them. Lots of sugar in soft drinks, e.g. Ketchup and gravies, bread, potatoes, dairy products - all of that isn't really perceived as stuff that makes you fat.

I think the main benefit from all these diets is people having to learn what's in their food to begin with.

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Love the thread title, Trisk.

I agree with the consensus: Paleo's reasoning is a bunch of bunk, but adhering to a paleo diet makes people much more conscious of what they're eating and causes them to cut out a lot of crap. My main concerns about paleo are that I think it can lead adherents to substitute other unhealthy dietary decisions -- not that everything you eat has to be "healthy" -- for the ones they are stopping, like eating a jillion pounds of bacon a week, and that buying into paleo's poor reasoning seems, in my experience, to make people more susceptible to buying into other hokum. Overall, though, I think paleo adherents are eating far healthier than most of the rest of us. (Including me, I have been eating like crap for months for work-related reasons and it shows :().

Edited by Inigima

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yes, it is interesting. I have long suspected after reading some enthusiastic reports of paleo converts several years ago that these people would have benefitted in a very similar way (as they actually did) if they had cut all fast food, sweets, soft drinks etc. and switched to homecooked meals with "traditional" proportions of nutrients. If one eats crap one will benefit by almost any change that includes somewhat less crap.

However, I also have made the experience that more fat and protein keep one sated for a longer time and one does not get as hungry (I never ate anything close to paleo but I almost never drink soft drinks and eat little sweets and premade snacks).

It is also hardly surprising that if one has to snack, unsalted nuts are a more healthy option than crisps or sweets.

The other good thing is that some older "myths" have been dispelled: breakfast is not especially important, more small meals don't make it easier to keep the weight, eggs and butter are good unless in excess etc.

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This really highlights the dangers of basically ALL trendy diets/eating habits. People jump on board without waiting for a second to third opinion, and then defend their choices to the death.

The most important factor in any healthy diet is to consume fresh (and preferably locally sourced) fruits and veggies, avoid preservatives and chemicals, avoid fried food, stay well hydrated, and to stay aware to our your body and your digestive system react to what you are putting in. 

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1 hour ago, Relic said:

This really highlights the dangers of basically ALL trendy diets/eating habits. People jump on board without waiting for a second to third opinion, and then defend their choices to the death.

The most important factor in any healthy diet is to consume fresh (and preferably locally sourced) fruits and veggies, avoid preservatives and chemicals, avoid fried food, stay well hydrated, and to stay aware to our your body and your digestive system react to what you are putting in. 

I agree. Prepare your own food with stuff you buy fresh, if possible. My mom learned to do this during the Occupation of the Netherlands during the war. Growing your own also helps if you have the time. 

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As I understand it, any diet that gets one to largely eliminate particular foods one has been eating before, whether they are high fat, high carb, or defined in some other way, will usually result in weight loss simply because restricting the variety of foods one eats will lower the amount of calories one consumes. The more boring one's diet is, the fewer calories one consumes. 

This of course is also one of the main reasons why weight loss is hard to maintain, as very few people are willing to cut out entire categories of foods they enjoyed consuming forever. 

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very good to see this study, and I'm not surprised. 

I did paleo, low carb etc diets for quite a while years ago. They worked for me.

They worked because I was eating whole foods I cooked myself and close to zero processed food or restaurant food and zero fast food, and close to zero alcohol while going to the gym to lift free weights three times a week at least. and I was still fat, it was virtually impossible for me to get below 202, which was still 20 lbs overweight for me. or like 35 lbs overweight if you believe the BMI nonsense.

that meant it was effective calorie restriction, overall, but largely without hunger and cravings were under control.

I gave all of the above up after doing 1 week of the bulletproof coffee trend.

that 1 week ended with the worst constipation of my life. I never knew that a bowel movement could be so horrifically prolonged, large and painful.  

it was a cure for me following any sort of diet though, as my attitude after that was along the lines of "fuck you, I'm gonna eat a sandwich and have a beer and poop normally, you diet assholes"

of course that means six years later I've gained about forty-fifty pounds.

 

Edited by lokisnow

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Thanks for sharing Trisk.  I've seen other summaries of this study but they missed the additional nuance about the role of insulin being tested here.  Paleo was always a faddish concept, but Taubes' focus on insulin as the root of obesity just too a big knock, although he would probably point to added sugars declining steeply under both diets and claim it as a success anyway.

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Did you try intermittent fasting? It sounds like a new fad but some people have been skipping dinner or breakfast forever. I was/am only slightly overweight (BMI 26,6 or so, now 25) but I lost about 3-4 kilograms by not eating after 4-5 pm for a few months. (Most people prefer to skip breakfast, I went for a very early dinner or late lunch but usually eating three meals within ca. 8 a.m. - 4 p.m.) The nice thing is that it is secondary what one eats, the only point is the longer than usual fasting of ca. 16 hours.

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I actually thought about a different title because as best as I understand this study didn't really suggest that there was anything wrong with Paleo / low carb.  It's just that it strongly suggests that it isn't special in the way its adherents had argued.  

Another interesting thing (and I wonder if Taubes will gravitate towards this):  it sounds like the higher carb / lower fat group in the study focused on higher quality carbs.  That is to say, they ate carbs but largely avoided the processed crap that has the nutrients stripped out and the sugar added.  

So one might still be able to argue that processed foods which are often carb-based are a culprit. 

Edited by Triskele

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20 hours ago, Triskele said:

I actually thought about a different title because as best as I understand this study didn't really suggest that there was anything wrong with Paleo / low carb.  It's just that it strongly suggests that it isn't special in the way its adherents had argued.  

Another interesting thing (and I wonder if Taubes will gravitate towards this):  it sounds like the higher carb / lower fat group in the study focused on higher quality carbs.  That is to say, they ate carbs but largely avoided the processed crap that has the nutrients stripped out and the sugar added.  

So one might still be able to argue that processed foods which are often carb-based are a culprit. 

Yes, it still supports less processed foods, which typically contain sugar and trans fats.  It's not clear if it's because the processed foods are worse for you or because they are so calorie dense that they enable more unwitting calorie consumption.

Eating high quality carbs, especially fresh vegetables, reduces your caloric in-take because they're not calorie dense, especially if you still have enough fat in your diet to promote satiety.

Taubes' central claim is that sugar is the great evil via insulin spikes.  That may or may not be supported here.  It's possible that sugar is only evil because it delivers a lot of calories very quickly before you realize you've over-eaten.  

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Taubes  follow up book from a few years ago, around the time he launched NUSI , “why we get fat” certainly focused more on the role of added sugars, sucrose I think, or maybe it was fructose (I can’t be bothered to care about the difference anymore), and he acknowledged that rice etc high carb diets were not indicators of obesity the way that sugar was. 

Personally i think there’s an awful lot to the hyperpalatability hypothesis of guyunets, that the problem is that through the combination of fat sugar and salt (and other exciting flavors) we can make just about anything taste good.

in others words if all our bread tasted like communion wafers (nothing but water and flour), we would eat a hell of a lot less of it, but because bread tastes good from added salt sugar and fat, we eat more bread.

Salt makes you want to consume more, sugar makes you want to consume more, so those two in particular are vicious cycle ingredients that dictate a continual unstoppable pattern of self reinforcing over consumption.

in other words, if you have always been fat and you want to lose weight, eat unseasoned food and nothing processed, eat nothing in combination (for example, butter on bread or jam on bread is a combination that encourages excessive and continual consumption(and bread is a processed food don’t forget)). The blander the better. Never enjoy food again sort of thing, that’s the life that skinny people want us fatties to live until we die. :)

 

 

Edited by lokisnow

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On 2/26/2018 at 5:49 PM, Triskele said:

There used to be a lot of discussion about the Paleo diet on this forum (and variants thereof) and the work of Gary Taubes who wrote a few exhaustive and thought-provoking books saying that fat has been unfairly vilified and that carbs and sugar specifically are the main cause of obesity.

Taubes went on to co-found an institute that has pushed to start really funding the big types of studies where we could really test some of that stuff.  Well, the biggest and best controlled study on this came out recently and seemed to more-or-less show that type of macronutrient (i.e., carb, fat) doesn't matter that much.

One of the best writups on the results is here.

Stephen Guyenet who has pretty big credentials and has been a Taubes antagonist has a take here

This doesn't necessarily hurt Taubes thesis that fat isn't the devil...I actually think that many experts are with him on that.  But it does seem to hurt the case that carbs are really the issue.  It seems to suggest that the calorie is a calorie is a calorie crowd is largely correct.

Food for thought, no pun intended, but part of why this is a big deal is that this is the biggest and best and most well-controlled study of this type that's ever been done.

I'm eating pasta all week.  

ETA:  I'm not sure if Taubes has responded yet, but my prediction is that he'll say that people left to their own devices outside of a controlled study like this would have an easier time reducing their calories if they avoid carbs.

I do think it's largely true that you tend to reduce your overall calorie intake in a way that you don't have to think specifically about calories if you go low carb. And the other benefit of low carb is that most, or nearly all, junk food is high or moderately high carbs, so a low carb diet tends to point you away from junk food and more towards single ingredient foods, and probably fresh foods too. 

I do think there is a metabolic basis for low carb though. You can't be in two metabolic states at the same time. So, if your body is burning fat for energy, it cannot possibly also be laying down fat in your fatty tissue. And this is an interesting finding in the study:

Quote

It’s possible some in the low-carb group may have been in ketosis during these first two months due to the very low carb intake prescribed. While the low-carb group was able to achieve reduced carb intake throughout the trial (≈115 g/day), only a very small minority reported consuming ≤50 g/day — the intake threshold typically required to stay in ketosis.

So if most or all of the low carb group were not in sustained ketosis then the main mechanism for effective weight loss on low-carbs was missing for the majority of the trial. In that case, most trial participants were more on the "maintenance" type low carb diet which is not a weight loss diet but a no weight gain diet. So I question the fundamentals of this trial comparing low-carb to low fat for weight loss, if the trial participants were not in sustained ketosis for most of the trial period.

Also worth noting is the dietary instructions given to the participants:

Quote

While no caloric intake targets were given, both groups were instructed to consume high-quality whole foods and drinks. Specifically, they were instructed to “maximize vegetable intake ... minimize intake of added sugars, refined flours, and trans fats; 

Note that the low-carb group would be naturally avoiding added sugar and refined flour, and trans fats are to be avoided because they are generally unhealthy, not because they are a major weight gain problem. So technically the dietary advice is biased in that the low-fat group is being steered away from specific carbs that are regarded as facilitating weight gain (and stimulating an insulin response), but the low carb group is not really being given any meaningful advice.

I think this trial does suffer from some problems in it's design and methodology.

The highlighted conclusion in the examine.com link

Quote

The results of this study contribute to a large body of evidence indicating that, for weight loss, neither low-fat nor low-carb is superior (as long as there’s no difference in caloric intake or protein intake).

I think is possibly not fully validated for the specific reason that the study did not look at weight loss for people in sustained ketosis. In that respect I conclude that the study does not fully support the assertion that a calorie is a calorie is a calorie. It supports this assertion IF you are not in sustained ketosis, but it cannot make any definitive conclusion where a person is in sustained ketosis.

In my view, with a low fat diet you have to be thinking about and managing calorie intake. With low carb the calorie thing is self-limiting. So low carb is easier, in that you only have to manage one discipline (i.e. avoid (or limit) carbs), whereas with low fat you need to manage 2 disciplines (avoid fat AND keep an eye on calorie intake). Actually you probably have to manage 3 disciplines with low fat, because you also have to be careful about what carbs (low vs high GI) you consume.

My own anecdata (which includes a before and after blood test) indicates that a low-carb regime, for me, significantly improves all of my physical and metabolic markers. The only problem is sticking to it.

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11 hours ago, lokisnow said:

...

in others words if all our bread tasted like communion wafers (nothing but water and flour), we would eat a hell of a lot less of it, but because bread tastes good from added salt sugar and fat, we eat more bread.

...

Bread already tastes great with the basic ingredients: flour, water, yeast, salt. If they come out like communion wafers there are many things going wrong (amongst them proofing time and/or development time for sourdough).

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I am pretty sure that the bad reputation bread (and other grains) have acquired in the last few years is partly or mainly due to bad factory made bread that has not had enough time for the fermentation process of sourdough or similar agents. The difference between "like homemade" German rye sourdough bread and the pre-sliced sandwich breads in US supermarkets is at least as large as between homemade oat porridge and some puffy corn loops coated with sugar.

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11 hours ago, The Anti-Targ said:

My own anecdata (which includes a before and after blood test) indicates that a low-carb regime, for me, significantly improves all of my physical and metabolic markers. The only problem is sticking to it.

Same for me.  Cutting back significantly on sugar and high glycemic carbs like rice, potato, bread (I still eat lots of whole fruit of many varieties, even relatively sugary ones) has helped me lose weight and reduce blood sugar, although not by huge amounts because they never got all that high in the first place. But it reversed a trend that would have eventually led to being overweight and pre-diabetic.

Now I find that if I do occasionally indulge in junk food like a large dessert, then it leaves me with real digestive discomfort for several hours.  It helps renew my resolve to steer clear or at least keep the portion size small.  I assume it’s because my gut flora got used to less sugar in my diet and now gets distorted by any large influx. A banana and scoop of almond butter will satisfy a dessert craving without similar problems. 

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On 2/25/2018 at 11:49 PM, Triskele said:

There used to be a lot of discussion about the Paleo diet on this forum (and variants thereof) and the work of Gary Taubes who wrote a few exhaustive and thought-provoking books saying that fat has been unfairly vilified and that carbs and sugar specifically are the main cause of obesity.

Taubes went on to co-found an institute that has pushed to start really funding the big types of studies where we could really test some of that stuff.  Well, the biggest and best controlled study on this came out recently and seemed to more-or-less show that type of macronutrient (i.e., carb, fat) doesn't matter that much.

One of the best writups on the results is here.

Stephen Guyenet who has pretty big credentials and has been a Taubes antagonist has a take here

This doesn't necessarily hurt Taubes thesis that fat isn't the devil...I actually think that many experts are with him on that.  But it does seem to hurt the case that carbs are really the issue.  It seems to suggest that the calorie is a calorie is a calorie crowd is largely correct.

Food for thought, no pun intended, but part of why this is a big deal is that this is the biggest and best and most well-controlled study of this type that's ever been done.

I'm eating pasta all week.  

ETA:  I'm not sure if Taubes has responded yet, but my prediction is that he'll say that people left to their own devices outside of a controlled study like this would have an easier time reducing their calories if they avoid carbs.

Utter garbage. Embarrassing, really.

This comparison is about weight loss, not health improvement. The scale number doesn't tell us anything useful. 

Calorie = calorie people are ALWAYS paid for by Coca Cola. 

 

Furthermore, Gary Taubes has written the best books on nutrition ever concocted, and you ignore him at your peril. (Literal peril.)

Edited by Stego

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