7 ms·

UCSF Endocrinologist debunks "Calories In / Calories Out" Model

71 points by ahoyhere 17y ago

chipsy 17y ago
Reposted: http://news.ycombinator.com/item?id=1006980 http://news.ycombinator.com/item?id=1006980 But it's such a huge PSA I'm upvoting anyway.
jerf 17y ago
I saw this literally after just finishing this video: http://video.google.com/videoplay?docid=4362041487661765149# http://video.google.com/videoplay?docid=4362041487661765149# Gary Taubes giving a presentation about his book Good Calories, Bad Calories. If you've never seen someone actually make the case for this stuff, but only let other people diss it for you, I encourage you in the strongest terms to actually listen to the case directly and make up your own mind. These are not the rantings of people who think fire can't weaken steel or that insist immunizations cause autism; indeed, they make a very strong case that the people who insist on the "calories in/calories out" model should be lumped right in with those folks. (Oh, guess I missed the party 18 days ago. Well, nobody linked that video that I saw. If you are interested in Good Calories, Bad Calories, but don't want to buy it, that video is a reasonable substitute for the scientific explanations in the book, which is very similar to the linked video. You don't get the huge sheaf of references in the back or the long exposition of history explaining how we got where we are, but if you're interested in that after the video I'm sure you can find the book.)
- glymor 17y ago
  Here's a review of Taubes' book by George Bray: http://www.proteinpower.com/drmike/wp-content/uploads/2008/07/bray-review-of-gcbc.pdf http://www.proteinpower.com/drmike/wp-content/uploads/2008/0... in case you do want someone dissing it for you. Also I don't think we should "make up [our] own mind" the biology on this is way beyond the layman. Hacker News has a pervasive conceit that somehow as programmers we can see the obvious truth that people with decades of experience are apparently (or deliberately) unable to. In fact it's the reverse most subjects are substantially more complicated than they appear. You can't encompass the biology of obesity in a pop-sci best seller.
  - gruseom 17y ago
    Also I don't think we should "make up [our] own mind" Although it's true that don't-think-for-yourself-and-don't-question-authority is standard practice, it's not often one hears someone explicitly argue in favor of it. I have three objections to what you're saying. The first is that it's ahistorical. You don't have to look back very far to see the insanity that human deference to experts can produce. ("Breast feeding is bad for babies", anyone?) Scientific consensus isn't nearly as stable or as true as you're implying; nor, for that matter, nearly as scientific. Which brings me to my second objection: it doesn't consider the economic and political interests that drive these things. There is a great deal of money being made from people being fat and sick. This has a huge influence on the research and regulatory systems surrounding this stuff. It follows that naive trust of consensus recommendations is foolish. Finally, everyone does make up their own mind whether they intend to or not. It's like Sartre said: not to choose is to choose not to choose. Everyone has a pool of their own judgment to allocate; if you like to invest yours completely in the expert consensus du jour, that's your perogative. I like to diversify mine, including putting a little into my "own mind", thanks. As far as I'm concerned, any discourse that penalizes people for asking simple questions is not to be trusted.
  - jerf 17y ago
    I have a simple metric for determining the validity of a scientific consensus: "Does it make true predictions?" It does not take much research to discover that it is an objective truth that the nutrition dogma does not make true predictions. It says if you eat less (of the same thing) and exercise more, you will lose weight. The peer review verdict on this is rock solid: False. It treats fat cells as passive bags: False. After that the logic flows pretty simply. (Including the flat-out evil of people still talking as if calorie-reduction diet and exercise is some sort of scientifically proved therapy when in fact the exact utter opposite is true.) People claiming that the dietary orthodoxy is false have plenty of fully credentialed experts on their side, and your implicit claim or belief that it's not supported by evidence or peer review is flat-out false. I commend to you the first few frames of the video linked in the topic, for instance. I can't beat PhD with years of actual field experience; can you? Because that PhD with years of field experience is not on the side of the orthodoxy.
  - 17y ago
- gruseom 17y ago
  I wanted to come back and thank you for the link to Taubes' lecture. I watched the whole thing (on an exercise machine, ironically) and it was definitely worth it. I'd never heard of Taubes, but he's an unusual and formidable character. Whoever heard of a science journalist thinking for himself!? I got a lot out of both his talk and Lustig's and am going to try out what they each say (they both agree and disagree). I don't find it hard to believe that Taubes is the only person who ever bothered to go back and thoroughly read the last hundred years of literature on this subject. Most specialists already "know" what's true, so why would they bother. Besides, it takes a very long time; Taubes spent five years doing it, and that only because he got a huge advance for his book. It's interesting to me that it took someone outside the scientific establishment to do this. Incidentally, there's a clip on youtube of Lustig asking Taubes a question at one of his lectures. Whoever posted it gave it the asinine title of "Lustig yells at Taubes about fructose". He doesn't in the least "yell", he simply asks a question politely (it's clear the two know each other). Kind of a fun crossing of streams.
pingswept 17y ago
Summary at 6:30 of section 9 of 9: http://www.youtube.com/watch?v=_tyaRnfGRV0 http://www.youtube.com/watch?v=_tyaRnfGRV0 The guy seems pretty sensible in his explanations earlier in the video series, but his style is inflammatory. If he left out the bitterness toward the industry players that he's arguing with, he'd be more convincing.
- neilk 17y ago
  He thinks he's uncovered a major medical emergency that affects maybe a third of American citizens, to the profit of giant corporations, with government agencies in collusion. I would doubt him more if (given his claims) he didn't feel strongly about it.
  - pingswept 17y ago
    If he's right, it does seem to be a major medical emergency, and so forth, as you describe. But it's not a sudden catastrophe, like an earthquake. He's surely held these same beliefs for at least a few months, right? Maybe I should be more specific. Calling sugar a poison is a good example. It may be true, in a sense, but it's definitely not true in the conventional usage. For example, if you call Poison Control and say you have eaten some sugar, they would not help you. That's what I'd call inflammatory. On the other hand, maybe it's just me. It's possible that I find dispassionate argument more convincing than most people.
charliepark 17y ago
Here it is, all in one long (90 minute) video: http://www.youtube.com/watch?v=dBnniua6-oM http://www.youtube.com/watch?v=dBnniua6-oM
jackchristopher 17y ago
To steal a line, dietary science is younger than it looks. Don't be surprised if decade spanning long held beliefs start collapsing. Another good video. Stanford nutritionist and self-described vegetarian admits benefits of low carb diets: http://www.youtube.com/watch?v=eREuZEdMAVo http://www.youtube.com/watch?v=eREuZEdMAVo
dejb 17y ago
I'd prefer a written overview of the ideas rather than sitting through an hour lecture. The first ten minutes really didn't offer a lot of detail.
- charliepark 17y ago
  First, until there are comprehensive notes, it's worth watching the video. It really is excellent. That being said, here are the notes I've taken so far. I started these back in December, but didn't have time to finish the video. If anyone wants to continue where I left off, please feel free to. 16:30 - Introducing HFCS. 17:20 -Why use fructose? It’s sweeter. (Also, cheaper.) Should be able to use less. But drink manufacturers use it more. (Shows chart with different types of sugars and their positions on a sweetness index.) 18:20 - Chemical composition of fructose versus glucose versus sucrose. Fructose and glucose are not the same. Fructose and sucrose are exactly the same from a body processing perspective. Both dangerous. 21:50 - Slide: Secular trend in fructose consumption: Natural - 15g / day WWII - ~20g / day 1977 - ~37g / day 1994 - ~55g / day Current adolescents - ~73g / day It’s not that we’re eating more (although we are). It’s that we’re eating more sugar. 23:30 - How did this happen? Why did this happen? The politics perspective: three political winds that swirled at the same time, creating the perfect storm. 1. In 1972, Nixon makes food prices a “non-issue.” 2. 1966, HFCS invented, introduced to the US in 1975. This makes sugar CHEAP. “High fructose corn syrup isn’t evil because it’s metabolically evil, but because it’s economically evil. Because it’s so cheap, it’s found its way into everything.” 3. In the late 70s, the USDA, the AMA, and the AHA all call for the reduction of fat in diets. Why? To stop heart disease. Did it work? No. So why’d they tell us to stop eating fat? In the 1970s we discovered LDL. In the mid-1970s, we learned that dietary fat raises LDL. In the late 1970s, we learned that high LDL correlates to cardiovascular disease. So, the conclusion was that if A leads to B, and B leads to C, then A leads to C. But the premise is incorrect. Why? It suggests that it’s transitive. That isn’t the case. John Yudkin - Pure, White, and Deadly. Keys - performed multivariate regression analysis (running data to filter out what really caused what) on cardiovascular disease. Showed calories from fat correlated highly with cardiovascular disease. But he didn’t run a complete regression analysis. He showed that sugar comes along with the fat, and that if you hold saturated fat constant but increase sugar, it doesn’t show results. But he didn’t go the other way, holding sugar constant and showing that fat still has an effect. (around 35:00) So his results aren’t actually reliable, but we’ve been basing 30 years of nutrition education and policy on this incomplete study. 36:30 - Two types of LDL. Large/buoyant, and ...
thras 17y ago
You will lose weight on calorie restriction as long as you go low enough. Though I've been fat my entire life, after college, I was 150 pounds overweight. I lost the extra weight by eating 900 calories a day for a year and a half or so. At my normal healthy weight, I was starving. And weak as a kitten. I took up running, and stopped watching my diet. I literally could not keep up the willpower necessary to continue a 3000 calorie diet, even though 900 had been doable for so long. Despite running for an hour a day, I immediately started gaining 10-15 pounds a month. So I was convinced that it was all about calories. I was fat because I ate too much. Why my body was so hellbent on eating 4000-5000 calories a day, I didn't know. I seemed to have a lot more willpower than anyone else I knew. It was sort of confusing. Then about a year ago, I read Taubes' book. What if the human body is actually sort of complicated? What if hormonal regulation controls fat? What if the "trash bin" theory of body fat is actually a humongous oversimplification or just wrong? What if, after getting to a "healthy" weight by starving fat, muscle, and vital tissue, I wasn't healthy at all? What if it had also made me malnourished (hence the amazing hunger at my "healthy" weight)? Anyway, I cut the carbohydrates out of my diet last December. I made zero effort at calorie restriction. In fact, I ate a lot. I made very little effort to exercise more. After a year of this, I'm almost 100 pounds under my max weight. I recently started running again, for fun, not weight loss, and am up to 2-3 miles a day. And I am stronger than I've ever been in my life. Eating steak every day is probably more expensive than building the same muscle mass with steroids, but I'm pretty happy. I wasn't expecting it. It's good being a carnivore.
- FreeRadical 17y ago
  Just out of interest, have you had any tiredness from cutting carbs from your diet? Many people on who restrict carbs, such as on the Atkins diet, experience this from what I've read.
  - thras 17y ago
    No tiredness for me. There's the "induction flu" that people on Atkins get, and I felt that for the first few weeks. Apparently it's caused by sodium depletion (carbohydrates cause you to retain a lot of water/salt). Drinking non-sodium-reduced beef broth every day for that month will cure you. Wish I had known. I just toughed it out. As far as my energy levels nowadays...pretty much boundless. I'm ravenously hungry when I don't eat. But I'm told that's how it's supposed to work. When I was fat, I was hungry around the clock, even after eating.
jackfoxy 17y ago
Particularly noteworthy was the excerpt of how the government propagandized reduced fat and increased carb consumption starting in 1982, and the resulting behavior changes in the general population tracks so well with weight gain. And yet some people still believe that a handful of Congressional staff lawyers and lobbyists (that's who really write the legislation) should be trusted to engineer the entire health care industry.
- antipaganda 17y ago
  Works okay in other countries. And I know it's not because, say, Australian government folks are just less corrupt than American govt folks.
gort 17y ago
After watching this all, I think the take-home-message was that, for fairly complex biochemical reasons, fructose (which is also a component of sucrose) is a particularly bad sugar. For one thing, it doesn't cause satiety very well, and for another, it does some damage directly which glucose, nature's preferred sugar, does not.
- ahoyhere 17y ago
  My real takeaway was this: Everybody always treats science as if it's a sure thing. But you can have every statement you make be true, and still be wrong overall, because you missed something important. Like the 7 Countries study, where the author didn't regress with fat-vs-sugar. Everything he said was true, but he was wrong in the end. (Oh, yeah, and fructose is awful and mass food producers are poisoning us. But I knew that already. Many restaurants, not just fast food restaurants, even put high-fructose corn syrup in meat.)
viggity 17y ago
I've struggled with weight my entire life. After trying every diet and exercise plan under the sun, just to watch the pounds come rolling back. At the end of November I said enough was enough and had bariatric surgery (an adjustable gastric band, or lap band to be more specific). While it has only been 8 weeks, I'm already deeming it an overwhelming success. I can't tell you the feeling of utter relief when I feel completely satisfied after eating a single cup of food (8oz). It is almost euphoric. Living in my body before the op was almost like living in a prison, I was shackled to my ravenous hunger. It didn't matter how much I ate, I was never satisfied. I still have 80% more of my target weight loss to go, but I'm 100% confident I can make it there with this tool. If you've struggled for a long time and feel hopeless, please at least take a look into bariatric surgery. Don't feel hopeless. Don't blame yourself, morbid obesity is not something that 98% of people can handle on their own, there are factors that are simply out of your control. If you have any questions that you'd like to ask to a fellow hacker, please don't hesitate to contact me. I know what you're going through and would be more than happy to talk to you. v o n a t n i t r i q d o t c o m
- neilk 17y ago
  downvoted for signature
  - viggity 17y ago
    It isn't a signature. I put my email address on there so that if someone has a question about bariatric surgery, they could contact me. If HN had a way of private messaging people, I wouldn't have done it.
    - gojomo 17y ago
      You can put contact info in the 'about' section of your user page.
  - charliepark 17y ago
    A more elegant way for him to do it might be to put his e-mail address in his profile "about" section, and to reference that in his post. BUT, I appreciate viggity's candor in his post, and the success he's had with his surgery. Also, I think it perfectly appropriate that he offered his e-mail to people who might be depressed or otherwise unsure of what to do, who might be in a position to consider bariatric surgery. Good on you, viggity, for being open to helping people with that.
hugh_ 17y ago
I don't have time to spend a lovely Saturday morning watching a 90-minute video just to criticize it, but how can one "debunk" the calories-in calories-out model? Surely this is just plain old thermodynamics?
- pg 17y ago
  If you're that busy you should skip commenting too. The answer is that humans are not simple furnaces; different foods are metabolized in different ways, and affect appetite differently.
  - hugh_ 17y ago
    Heck, you're right, I should!
  - ellyagg 17y ago
    While that's true, the prime mover in weight gain is still calories. The type of calories is a secondary effect. Discussing diet is hard because everyone reasons from personal experience. E.g., in my experience, almost all my fluid intake is Dr. Pepper and I consume large quantities of the "worst" food, as a proportion of my diet, but I don't eat that much and I work out, so I'm strong and fit with low cholesterol.
- gruseom 17y ago
  Surely this is just plain old thermodynamics? Normally I'd be irritated at this obvious glib objection, but we have to make a physicist allowance in this case :) The other one you hear all the time is, "But how can fructose be bad? It's in fruit." Gee, do you think he might have thought of that?
- pohl 17y ago
  The submitter's sensational headline has very little to do with the lecture. You shouldn't watch it to criticize it. You should watch it because it is a very good presentation.
- neilk 17y ago
  He doesn't debunk it. He asks the question why the normal regulation of the body, that tells you to stop eating, isn't working. His answer is complex, but it all has to do with the introduction of fructose as a macronutrient after the 1970s.
keefe 17y ago
I think this is a bit of a misleading title. At one point in grad school, I had broke 225 @ 6'3 with little muscle mass and I've changed that to 188 with much more muscle mass. My understanding is that fat is used for storing food energy and that each pound of fat stores ~3500 calories. So, something like dFat/dt = (f(calories in) - caloriesBurned())/3500 = amount of fat gained for some period of time. f might include something about the structure of the calories coming in, but it makes sense and my experience supports it.
- natrius 17y ago
  I'm guessing you didn't watch the video. Sure, the lower your net caloric intake, the less weight you will gain. However, the types of food you eat have different effects on how much you want to eat. Therefore, if you eat different foods, you'll be more likely to lose weight.
  - keefe 17y ago
    It's a bit long, I read one of the supposedly accurate summaries... I'm OK with that idea, my main comment was on the title - doesn't exactly debunk the model, just some supplement regarding a "fullness factor" nothing new there imho.
    - natrius 17y ago
      Ah. Agreed.
      - keefe 17y ago
        plus I always WANT to eat. NOM NOM NOM NOM
yes_its_giles 17y ago
seriously, what's with you guys? I lost 75 pounds in 6 months. I couldn't have made my blog post about that more Hacker News bait than it already was. I know a lot of you saw it. and still the ratio of people talking about it to people doing it is like 10,000 to 1. and you'd still rather debate some tangentially relevant research. google "Dr Joel Fuhrman." I lost 100 points of cholesterol in three months. 75 pounds in six months. all you do is you eat vegetables. there's a little more to it, but not much. it's easy. the guy has reams of case studies and science backing him up. my 100-point cholestrol dip barely even blipped on his radar personally - didn't even raise his eyebrows - because he sees it all the time, but just for comparison, my dad and my uncle both got 100-point drops in their cholesterol too, over the course of ten years, and their cardiologists were happy, because normal nutrition is so bad that ten years is an acceptable time frame for that. so: ten years' progress in two months' time. seriously, this is a solved problem. this is like, "let's figure out how to get a computer into every home and office in America." they're already there! why are you trying to answer a solved problem? you could spend your whole life debunking invalid theories, or you could just find the theory that works and run with it. which sounds like a more effective use of time?
- pohl 17y ago
  I think it's pretty clear from your rant that you did not watch the presentation. The submitter did a great disservice to the speaker by framing this presentation as a debunking of the calories in/out model, because that is not, at all, the central point of this lecture. (I have watched it through twice now, and it is a phenomenal presentation; I recommend it highly.) In no way does the speaker attempt to turn thermodynamics on its head. Rather, he suggests that the storage of fat be perceived as the primary driver, and caloric intake & expenditure taking a back seat. He re-frames it this way because the real central thesis is about how fructose is a driver of obesity, which in turn leads to increased consumption. The caloric in/out slide only serves as motivation for why we should be wary of the fact that fructose is a chronic toxin (in particular, the effects thereof), and how HFCS is an economic evil as much as a metabolic one. It's ok to rail against the headline, though. The submitter took too much out of one slide, in my opinion.
yaroslavvb 17y ago
Slides from related presentation of his http://www.niehs.nih.gov/news/events/pastmtg/2007/cehr/docs/metabolicsyndromelustig.pdf http://www.niehs.nih.gov/news/events/pastmtg/2007/cehr/docs/...
nickyp 17y ago
It might be just me, but watching this felt like watching 'The Inconvenient Truth of the food industry'. So all we need now is a meeting of the leaders of the world in Copenhagen to ignore this huge problem with the processed food everybody buys and consumes for at least another 20 years. (potential problem, if you're not convinced something is wrong with the massive amounts of sugar in our processed food)
teach 17y ago
I mentioned this video to my wife, who is a registered dietitian and a PhD in nutrition science (the RD / PhD combo is relatively rare). She said, "Yeah, I'm uncomfortable just saying 'calories in / calories out' because human metabolism is just way more complicated than that." She's interested in watching the whole video herself; I'll post her thoughts if she does.
carbocation 17y ago
To be credible, you should not try to dispute the simple truth that derives from conservation of mass and conservation of energy. Cal in = cal out; however, I do agree that our bodies are wired in such a way that particular substances trigger 'calories in' without a concomitant immediate increase in 'calories out', thus leading to increased weight and a new homeostatic baseline. This is not merely a pedantic point: it is the difference between making a credible statement about human nutrition and looking like someone who rejects chemistry.
- pohl 17y ago
  It's worth noting again that this should reflect on the credibility of the submitter who chose the headline, not on the original presentation - which makes a different point entirely.
  - carbocation 17y ago
    Yes, I do not have a problem with the content of the video at all. In med school, we are already being taught the evils of fructose, so this well-done presentation is actually in line with what we are taught now.
gojomo 17y ago
While making his case against fructose, Lustig makes a few offhand positive comments about glucose -- but it's not clear if he'd actually recommend ingesting it from nearly-pure sources, or using it as a sweetener instead of sucrose/HFCS. (Others with similar dietary recommendations often view pure glucose as bad as any other sugar.) Sweettarts, Pixie Stix, Lik-m-Aid, and a few other brightly-colored super-sweet candies are almost entirely d-glucose, aka dextrose -- often with no other sugars listed as ingredients. I wonder if according to the Lustig analysis, these are relatively OK, or still have other problems (like triggering rollercoaster blood glucose/insulin levels) and so should be avoided.
- gruseom 17y ago
  I have been wondering the same thing since watching the video a week ago. Specifically, would it be good to use corn syrup (the old-fashioned glucose kind, not HFCS) as a replacement for fructose/sucrose?
dnsworks 17y ago
Medical reporting is by far the worst type of reporting in the modern media. Anything health related that a journalist sensationalizes today will be contracted by something they sensationalize two years later. 16 years of agonizing about weight, and still I have no clue what might work and what might not work.
steveplace 17y ago
Anecdotes are great, and they're fun to read. Just keep a slight lean towards actual data, please.
hedgehog 17y ago
A paper he wrote covering the same material: http://www.nature.com/nrendo/journal/v2/n8/full/ncpendmet0220.html http://www.nature.com/nrendo/journal/v2/n8/full/ncpendmet022...
apinstein 17y ago
The title is horrible. This should be called "How a diet rich in fructose makes us fat, poisons us slowly, and wastes billions of dollars on health care for self-inflicted chronic diseases, and what you can do about it NOW. Here's a brief summary of the salient points: 1) Consumption of fructose, sucrose (which is a glucose-fructose disaccharide), or alcohol (ethanol is metabolized by the same pathway as fructose) should be extremely limited. That includes HFCS and most fruit juices. Why? Because the way your body metabolizes fructose, eating a lot of it results in insulin resistance (type II diabetes), hypertension (high blood pressure), high triglycerides, high LDL cholesterol (the bad kind), and weight gain due to inability to self-regulate hunger. The combination of these effects is known as Metabolic Syndrome. There are two notable exception to this fructose prohibition: 1) it's ok to eat as long as it's in fruit because there's not much of it and it comes with lots of fiber, which makes it even more OK, and 2) if you're in the middle of (or have just completed) some seriously epic exercise and your are glycogen-depleted, fructose actually helps you restore glycogen much faster than regular carbs. See: Gatorade. 2) Do eat "food" as Michael Pollan would say. The closer to it coming out of the ground, the better. Google "paleolithic diet". 3) His research shows that you can begin reversing Type-2 Diabetes in a short number of weeks by eating an appropriate diet. 4) His research shows that the #1 factor causing most diets to fail is cheating on fructose consumption (even worse than cheating on exercise!). 4) Exercise is good for you, but not primarily due to calorie burning. It barely burns any calories relative to food intake. It's good for you because it reduces stress and helps your body maintain a "fast metabolism" on an ongoing basis. 5) Fructose is a major part of our food supply due to politics. It will take a while before the corruption that propagates the problem is broker. Thus, don't trust the government on this one. The full video is an amazing presentation by a talented presenter. It is worth watching the full thing especially if you struggle with obesity or don't understand how the body metabolizes food. The lecture is by a MD and/or PHD talking to a bunch of MDs and PHDs, so it's pretty high level. He covers a lot of biochemistry, but in a way that is pretty accessible. http://www.youtube.com/watch?v=dBnniua6-oM http://www.youtube.com/watch?v=dBnniua6-oM
skmurphy 17y ago
video also here http://www.ucsd.tv/search-details.aspx?showID=16717 http://www.ucsd.tv/search-details.aspx?showID=16717

71 points by ahoyhere 17y ago

Reposted: http://news.ycombinator.com/item?id=1006980 http://news.ycombinator.com/item?id=1006980 But it's such a huge PSA I'm upvoting anyway.

jerf 17y ago

I saw this literally after just finishing this video: http://video.google.com/videoplay?docid=4362041487661765149# http://video.google.com/videoplay?docid=4362041487661765149# Gary Taubes giving a presentation about his book Good Calories, Bad Calories. If you've never seen someone actually make the case for this stuff, but only let other people diss it for you, I encourage you in the strongest terms to actually listen to the case directly and make up your own mind. These are not the rantings of people who think fire can't weaken steel or that insist immunizations cause autism; indeed, they make a very strong case that the people who insist on the "calories in/calories out" model should be lumped right in with those folks. (Oh, guess I missed the party 18 days ago. Well, nobody linked that video that I saw. If you are interested in Good Calories, Bad Calories, but don't want to buy it, that video is a reasonable substitute for the scientific explanations in the book, which is very similar to the linked video. You don't get the huge sheaf of references in the back or the long exposition of history explaining how we got where we are, but if you're interested in that after the video I'm sure you can find the book.)

glymor 17y ago
Here's a review of Taubes' book by George Bray: http://www.proteinpower.com/drmike/wp-content/uploads/2008/07/bray-review-of-gcbc.pdf http://www.proteinpower.com/drmike/wp-content/uploads/2008/0... in case you do want someone dissing it for you. Also I don't think we should "make up [our] own mind" the biology on this is way beyond the layman. Hacker News has a pervasive conceit that somehow as programmers we can see the obvious truth that people with decades of experience are apparently (or deliberately) unable to. In fact it's the reverse most subjects are substantially more complicated than they appear. You can't encompass the biology of obesity in a pop-sci best seller.
- gruseom 17y ago
  Also I don't think we should "make up [our] own mind" Although it's true that don't-think-for-yourself-and-don't-question-authority is standard practice, it's not often one hears someone explicitly argue in favor of it. I have three objections to what you're saying. The first is that it's ahistorical. You don't have to look back very far to see the insanity that human deference to experts can produce. ("Breast feeding is bad for babies", anyone?) Scientific consensus isn't nearly as stable or as true as you're implying; nor, for that matter, nearly as scientific. Which brings me to my second objection: it doesn't consider the economic and political interests that drive these things. There is a great deal of money being made from people being fat and sick. This has a huge influence on the research and regulatory systems surrounding this stuff. It follows that naive trust of consensus recommendations is foolish. Finally, everyone does make up their own mind whether they intend to or not. It's like Sartre said: not to choose is to choose not to choose. Everyone has a pool of their own judgment to allocate; if you like to invest yours completely in the expert consensus du jour, that's your perogative. I like to diversify mine, including putting a little into my "own mind", thanks. As far as I'm concerned, any discourse that penalizes people for asking simple questions is not to be trusted.
- jerf 17y ago
  I have a simple metric for determining the validity of a scientific consensus: "Does it make true predictions?" It does not take much research to discover that it is an objective truth that the nutrition dogma does not make true predictions. It says if you eat less (of the same thing) and exercise more, you will lose weight. The peer review verdict on this is rock solid: False. It treats fat cells as passive bags: False. After that the logic flows pretty simply. (Including the flat-out evil of people still talking as if calorie-reduction diet and exercise is some sort of scientifically proved therapy when in fact the exact utter opposite is true.) People claiming that the dietary orthodoxy is false have plenty of fully credentialed experts on their side, and your implicit claim or belief that it's not supported by evidence or peer review is flat-out false. I commend to you the first few frames of the video linked in the topic, for instance. I can't beat PhD with years of actual field experience; can you? Because that PhD with years of field experience is not on the side of the orthodoxy.
- 17y ago
gruseom 17y ago
I wanted to come back and thank you for the link to Taubes' lecture. I watched the whole thing (on an exercise machine, ironically) and it was definitely worth it. I'd never heard of Taubes, but he's an unusual and formidable character. Whoever heard of a science journalist thinking for himself!? I got a lot out of both his talk and Lustig's and am going to try out what they each say (they both agree and disagree). I don't find it hard to believe that Taubes is the only person who ever bothered to go back and thoroughly read the last hundred years of literature on this subject. Most specialists already "know" what's true, so why would they bother. Besides, it takes a very long time; Taubes spent five years doing it, and that only because he got a huge advance for his book. It's interesting to me that it took someone outside the scientific establishment to do this. Incidentally, there's a clip on youtube of Lustig asking Taubes a question at one of his lectures. Whoever posted it gave it the asinine title of "Lustig yells at Taubes about fructose". He doesn't in the least "yell", he simply asks a question politely (it's clear the two know each other). Kind of a fun crossing of streams.

pingswept 17y ago

Summary at 6:30 of section 9 of 9: http://www.youtube.com/watch?v=_tyaRnfGRV0 http://www.youtube.com/watch?v=_tyaRnfGRV0 The guy seems pretty sensible in his explanations earlier in the video series, but his style is inflammatory. If he left out the bitterness toward the industry players that he's arguing with, he'd be more convincing.

neilk 17y ago
He thinks he's uncovered a major medical emergency that affects maybe a third of American citizens, to the profit of giant corporations, with government agencies in collusion. I would doubt him more if (given his claims) he didn't feel strongly about it.
- pingswept 17y ago
  If he's right, it does seem to be a major medical emergency, and so forth, as you describe. But it's not a sudden catastrophe, like an earthquake. He's surely held these same beliefs for at least a few months, right? Maybe I should be more specific. Calling sugar a poison is a good example. It may be true, in a sense, but it's definitely not true in the conventional usage. For example, if you call Poison Control and say you have eaten some sugar, they would not help you. That's what I'd call inflammatory. On the other hand, maybe it's just me. It's possible that I find dispassionate argument more convincing than most people.

charliepark 17y ago

Here it is, all in one long (90 minute) video: http://www.youtube.com/watch?v=dBnniua6-oM http://www.youtube.com/watch?v=dBnniua6-oM

jackchristopher 17y ago

To steal a line, dietary science is younger than it looks. Don't be surprised if decade spanning long held beliefs start collapsing. Another good video. Stanford nutritionist and self-described vegetarian admits benefits of low carb diets: http://www.youtube.com/watch?v=eREuZEdMAVo http://www.youtube.com/watch?v=eREuZEdMAVo

dejb 17y ago

I'd prefer a written overview of the ideas rather than sitting through an hour lecture. The first ten minutes really didn't offer a lot of detail.

charliepark 17y ago
First, until there are comprehensive notes, it's worth watching the video. It really is excellent. That being said, here are the notes I've taken so far. I started these back in December, but didn't have time to finish the video. If anyone wants to continue where I left off, please feel free to. 16:30 - Introducing HFCS. 17:20 -Why use fructose? It’s sweeter. (Also, cheaper.) Should be able to use less. But drink manufacturers use it more. (Shows chart with different types of sugars and their positions on a sweetness index.) 18:20 - Chemical composition of fructose versus glucose versus sucrose. Fructose and glucose are not the same. Fructose and sucrose are exactly the same from a body processing perspective. Both dangerous. 21:50 - Slide: Secular trend in fructose consumption: Natural - 15g / day WWII - ~20g / day 1977 - ~37g / day 1994 - ~55g / day Current adolescents - ~73g / day It’s not that we’re eating more (although we are). It’s that we’re eating more sugar. 23:30 - How did this happen? Why did this happen? The politics perspective: three political winds that swirled at the same time, creating the perfect storm. 1. In 1972, Nixon makes food prices a “non-issue.” 2. 1966, HFCS invented, introduced to the US in 1975. This makes sugar CHEAP. “High fructose corn syrup isn’t evil because it’s metabolically evil, but because it’s economically evil. Because it’s so cheap, it’s found its way into everything.” 3. In the late 70s, the USDA, the AMA, and the AHA all call for the reduction of fat in diets. Why? To stop heart disease. Did it work? No. So why’d they tell us to stop eating fat? In the 1970s we discovered LDL. In the mid-1970s, we learned that dietary fat raises LDL. In the late 1970s, we learned that high LDL correlates to cardiovascular disease. So, the conclusion was that if A leads to B, and B leads to C, then A leads to C. But the premise is incorrect. Why? It suggests that it’s transitive. That isn’t the case. John Yudkin - Pure, White, and Deadly. Keys - performed multivariate regression analysis (running data to filter out what really caused what) on cardiovascular disease. Showed calories from fat correlated highly with cardiovascular disease. But he didn’t run a complete regression analysis. He showed that sugar comes along with the fat, and that if you hold saturated fat constant but increase sugar, it doesn’t show results. But he didn’t go the other way, holding sugar constant and showing that fat still has an effect. (around 35:00) So his results aren’t actually reliable, but we’ve been basing 30 years of nutrition education and policy on this incomplete study. 36:30 - Two types of LDL. Large/buoyant, and ...

thras 17y ago

You will lose weight on calorie restriction as long as you go low enough. Though I've been fat my entire life, after college, I was 150 pounds overweight. I lost the extra weight by eating 900 calories a day for a year and a half or so. At my normal healthy weight, I was starving. And weak as a kitten. I took up running, and stopped watching my diet. I literally could not keep up the willpower necessary to continue a 3000 calorie diet, even though 900 had been doable for so long. Despite running for an hour a day, I immediately started gaining 10-15 pounds a month. So I was convinced that it was all about calories. I was fat because I ate too much. Why my body was so hellbent on eating 4000-5000 calories a day, I didn't know. I seemed to have a lot more willpower than anyone else I knew. It was sort of confusing. Then about a year ago, I read Taubes' book. What if the human body is actually sort of complicated? What if hormonal regulation controls fat? What if the "trash bin" theory of body fat is actually a humongous oversimplification or just wrong? What if, after getting to a "healthy" weight by starving fat, muscle, and vital tissue, I wasn't healthy at all? What if it had also made me malnourished (hence the amazing hunger at my "healthy" weight)? Anyway, I cut the carbohydrates out of my diet last December. I made zero effort at calorie restriction. In fact, I ate a lot. I made very little effort to exercise more. After a year of this, I'm almost 100 pounds under my max weight. I recently started running again, for fun, not weight loss, and am up to 2-3 miles a day. And I am stronger than I've ever been in my life. Eating steak every day is probably more expensive than building the same muscle mass with steroids, but I'm pretty happy. I wasn't expecting it. It's good being a carnivore.

FreeRadical 17y ago
Just out of interest, have you had any tiredness from cutting carbs from your diet? Many people on who restrict carbs, such as on the Atkins diet, experience this from what I've read.
- thras 17y ago
  No tiredness for me. There's the "induction flu" that people on Atkins get, and I felt that for the first few weeks. Apparently it's caused by sodium depletion (carbohydrates cause you to retain a lot of water/salt). Drinking non-sodium-reduced beef broth every day for that month will cure you. Wish I had known. I just toughed it out. As far as my energy levels nowadays...pretty much boundless. I'm ravenously hungry when I don't eat. But I'm told that's how it's supposed to work. When I was fat, I was hungry around the clock, even after eating.

jackfoxy 17y ago

Particularly noteworthy was the excerpt of how the government propagandized reduced fat and increased carb consumption starting in 1982, and the resulting behavior changes in the general population tracks so well with weight gain. And yet some people still believe that a handful of Congressional staff lawyers and lobbyists (that's who really write the legislation) should be trusted to engineer the entire health care industry.

antipaganda 17y ago
Works okay in other countries. And I know it's not because, say, Australian government folks are just less corrupt than American govt folks.

gort 17y ago

After watching this all, I think the take-home-message was that, for fairly complex biochemical reasons, fructose (which is also a component of sucrose) is a particularly bad sugar. For one thing, it doesn't cause satiety very well, and for another, it does some damage directly which glucose, nature's preferred sugar, does not.

ahoyhere 17y ago
My real takeaway was this: Everybody always treats science as if it's a sure thing. But you can have every statement you make be true, and still be wrong overall, because you missed something important. Like the 7 Countries study, where the author didn't regress with fat-vs-sugar. Everything he said was true, but he was wrong in the end. (Oh, yeah, and fructose is awful and mass food producers are poisoning us. But I knew that already. Many restaurants, not just fast food restaurants, even put high-fructose corn syrup in meat.)

viggity 17y ago

I've struggled with weight my entire life. After trying every diet and exercise plan under the sun, just to watch the pounds come rolling back. At the end of November I said enough was enough and had bariatric surgery (an adjustable gastric band, or lap band to be more specific). While it has only been 8 weeks, I'm already deeming it an overwhelming success. I can't tell you the feeling of utter relief when I feel completely satisfied after eating a single cup of food (8oz). It is almost euphoric. Living in my body before the op was almost like living in a prison, I was shackled to my ravenous hunger. It didn't matter how much I ate, I was never satisfied. I still have 80% more of my target weight loss to go, but I'm 100% confident I can make it there with this tool. If you've struggled for a long time and feel hopeless, please at least take a look into bariatric surgery. Don't feel hopeless. Don't blame yourself, morbid obesity is not something that 98% of people can handle on their own, there are factors that are simply out of your control. If you have any questions that you'd like to ask to a fellow hacker, please don't hesitate to contact me. I know what you're going through and would be more than happy to talk to you. v o n a t n i t r i q d o t c o m

neilk 17y ago
downvoted for signature
- viggity 17y ago
  It isn't a signature. I put my email address on there so that if someone has a question about bariatric surgery, they could contact me. If HN had a way of private messaging people, I wouldn't have done it.
  - gojomo 17y ago
    You can put contact info in the 'about' section of your user page.
- charliepark 17y ago
  A more elegant way for him to do it might be to put his e-mail address in his profile "about" section, and to reference that in his post. BUT, I appreciate viggity's candor in his post, and the success he's had with his surgery. Also, I think it perfectly appropriate that he offered his e-mail to people who might be depressed or otherwise unsure of what to do, who might be in a position to consider bariatric surgery. Good on you, viggity, for being open to helping people with that.

hugh_ 17y ago

I don't have time to spend a lovely Saturday morning watching a 90-minute video just to criticize it, but how can one "debunk" the calories-in calories-out model? Surely this is just plain old thermodynamics?

pg 17y ago
If you're that busy you should skip commenting too. The answer is that humans are not simple furnaces; different foods are metabolized in different ways, and affect appetite differently.
- hugh_ 17y ago
  Heck, you're right, I should!
- ellyagg 17y ago
  While that's true, the prime mover in weight gain is still calories. The type of calories is a secondary effect. Discussing diet is hard because everyone reasons from personal experience. E.g., in my experience, almost all my fluid intake is Dr. Pepper and I consume large quantities of the "worst" food, as a proportion of my diet, but I don't eat that much and I work out, so I'm strong and fit with low cholesterol.
gruseom 17y ago
Surely this is just plain old thermodynamics? Normally I'd be irritated at this obvious glib objection, but we have to make a physicist allowance in this case :) The other one you hear all the time is, "But how can fructose be bad? It's in fruit." Gee, do you think he might have thought of that?
pohl 17y ago
The submitter's sensational headline has very little to do with the lecture. You shouldn't watch it to criticize it. You should watch it because it is a very good presentation.
neilk 17y ago
He doesn't debunk it. He asks the question why the normal regulation of the body, that tells you to stop eating, isn't working. His answer is complex, but it all has to do with the introduction of fructose as a macronutrient after the 1970s.

keefe 17y ago

I think this is a bit of a misleading title. At one point in grad school, I had broke 225 @ 6'3 with little muscle mass and I've changed that to 188 with much more muscle mass. My understanding is that fat is used for storing food energy and that each pound of fat stores ~3500 calories. So, something like dFat/dt = (f(calories in) - caloriesBurned())/3500 = amount of fat gained for some period of time. f might include something about the structure of the calories coming in, but it makes sense and my experience supports it.

natrius 17y ago
I'm guessing you didn't watch the video. Sure, the lower your net caloric intake, the less weight you will gain. However, the types of food you eat have different effects on how much you want to eat. Therefore, if you eat different foods, you'll be more likely to lose weight.
- keefe 17y ago
  It's a bit long, I read one of the supposedly accurate summaries... I'm OK with that idea, my main comment was on the title - doesn't exactly debunk the model, just some supplement regarding a "fullness factor" nothing new there imho.
  - natrius 17y ago
    Ah. Agreed.
    - keefe 17y ago
      plus I always WANT to eat. NOM NOM NOM NOM

yes_its_giles 17y ago

seriously, what's with you guys? I lost 75 pounds in 6 months. I couldn't have made my blog post about that more Hacker News bait than it already was. I know a lot of you saw it. and still the ratio of people talking about it to people doing it is like 10,000 to 1. and you'd still rather debate some tangentially relevant research. google "Dr Joel Fuhrman." I lost 100 points of cholesterol in three months. 75 pounds in six months. all you do is you eat vegetables. there's a little more to it, but not much. it's easy. the guy has reams of case studies and science backing him up. my 100-point cholestrol dip barely even blipped on his radar personally - didn't even raise his eyebrows - because he sees it all the time, but just for comparison, my dad and my uncle both got 100-point drops in their cholesterol too, over the course of ten years, and their cardiologists were happy, because normal nutrition is so bad that ten years is an acceptable time frame for that. so: ten years' progress in two months' time. seriously, this is a solved problem. this is like, "let's figure out how to get a computer into every home and office in America." they're already there! why are you trying to answer a solved problem? you could spend your whole life debunking invalid theories, or you could just find the theory that works and run with it. which sounds like a more effective use of time?

pohl 17y ago
I think it's pretty clear from your rant that you did not watch the presentation. The submitter did a great disservice to the speaker by framing this presentation as a debunking of the calories in/out model, because that is not, at all, the central point of this lecture. (I have watched it through twice now, and it is a phenomenal presentation; I recommend it highly.) In no way does the speaker attempt to turn thermodynamics on its head. Rather, he suggests that the storage of fat be perceived as the primary driver, and caloric intake & expenditure taking a back seat. He re-frames it this way because the real central thesis is about how fructose is a driver of obesity, which in turn leads to increased consumption. The caloric in/out slide only serves as motivation for why we should be wary of the fact that fructose is a chronic toxin (in particular, the effects thereof), and how HFCS is an economic evil as much as a metabolic one. It's ok to rail against the headline, though. The submitter took too much out of one slide, in my opinion.

yaroslavvb 17y ago

Slides from related presentation of his http://www.niehs.nih.gov/news/events/pastmtg/2007/cehr/docs/metabolicsyndromelustig.pdf http://www.niehs.nih.gov/news/events/pastmtg/2007/cehr/docs/...

nickyp 17y ago

It might be just me, but watching this felt like watching 'The Inconvenient Truth of the food industry'. So all we need now is a meeting of the leaders of the world in Copenhagen to ignore this huge problem with the processed food everybody buys and consumes for at least another 20 years. (potential problem, if you're not convinced something is wrong with the massive amounts of sugar in our processed food)

teach 17y ago

I mentioned this video to my wife, who is a registered dietitian and a PhD in nutrition science (the RD / PhD combo is relatively rare). She said, "Yeah, I'm uncomfortable just saying 'calories in / calories out' because human metabolism is just way more complicated than that." She's interested in watching the whole video herself; I'll post her thoughts if she does.

carbocation 17y ago

To be credible, you should not try to dispute the simple truth that derives from conservation of mass and conservation of energy. Cal in = cal out; however, I do agree that our bodies are wired in such a way that particular substances trigger 'calories in' without a concomitant immediate increase in 'calories out', thus leading to increased weight and a new homeostatic baseline. This is not merely a pedantic point: it is the difference between making a credible statement about human nutrition and looking like someone who rejects chemistry.

pohl 17y ago
It's worth noting again that this should reflect on the credibility of the submitter who chose the headline, not on the original presentation - which makes a different point entirely.
- carbocation 17y ago
  Yes, I do not have a problem with the content of the video at all. In med school, we are already being taught the evils of fructose, so this well-done presentation is actually in line with what we are taught now.

gojomo 17y ago

While making his case against fructose, Lustig makes a few offhand positive comments about glucose -- but it's not clear if he'd actually recommend ingesting it from nearly-pure sources, or using it as a sweetener instead of sucrose/HFCS. (Others with similar dietary recommendations often view pure glucose as bad as any other sugar.) Sweettarts, Pixie Stix, Lik-m-Aid, and a few other brightly-colored super-sweet candies are almost entirely d-glucose, aka dextrose -- often with no other sugars listed as ingredients. I wonder if according to the Lustig analysis, these are relatively OK, or still have other problems (like triggering rollercoaster blood glucose/insulin levels) and so should be avoided.

gruseom 17y ago
I have been wondering the same thing since watching the video a week ago. Specifically, would it be good to use corn syrup (the old-fashioned glucose kind, not HFCS) as a replacement for fructose/sucrose?

dnsworks 17y ago

Medical reporting is by far the worst type of reporting in the modern media. Anything health related that a journalist sensationalizes today will be contracted by something they sensationalize two years later. 16 years of agonizing about weight, and still I have no clue what might work and what might not work.

steveplace 17y ago

Anecdotes are great, and they're fun to read. Just keep a slight lean towards actual data, please.

hedgehog 17y ago

A paper he wrote covering the same material: http://www.nature.com/nrendo/journal/v2/n8/full/ncpendmet0220.html http://www.nature.com/nrendo/journal/v2/n8/full/ncpendmet022...

apinstein 17y ago

The title is horrible. This should be called "How a diet rich in fructose makes us fat, poisons us slowly, and wastes billions of dollars on health care for self-inflicted chronic diseases, and what you can do about it NOW. Here's a brief summary of the salient points: 1) Consumption of fructose, sucrose (which is a glucose-fructose disaccharide), or alcohol (ethanol is metabolized by the same pathway as fructose) should be extremely limited. That includes HFCS and most fruit juices. Why? Because the way your body metabolizes fructose, eating a lot of it results in insulin resistance (type II diabetes), hypertension (high blood pressure), high triglycerides, high LDL cholesterol (the bad kind), and weight gain due to inability to self-regulate hunger. The combination of these effects is known as Metabolic Syndrome. There are two notable exception to this fructose prohibition: 1) it's ok to eat as long as it's in fruit because there's not much of it and it comes with lots of fiber, which makes it even more OK, and 2) if you're in the middle of (or have just completed) some seriously epic exercise and your are glycogen-depleted, fructose actually helps you restore glycogen much faster than regular carbs. See: Gatorade. 2) Do eat "food" as Michael Pollan would say. The closer to it coming out of the ground, the better. Google "paleolithic diet". 3) His research shows that you can begin reversing Type-2 Diabetes in a short number of weeks by eating an appropriate diet. 4) His research shows that the #1 factor causing most diets to fail is cheating on fructose consumption (even worse than cheating on exercise!). 4) Exercise is good for you, but not primarily due to calorie burning. It barely burns any calories relative to food intake. It's good for you because it reduces stress and helps your body maintain a "fast metabolism" on an ongoing basis. 5) Fructose is a major part of our food supply due to politics. It will take a while before the corruption that propagates the problem is broker. Thus, don't trust the government on this one. The full video is an amazing presentation by a talented presenter. It is worth watching the full thing especially if you struggle with obesity or don't understand how the body metabolizes food. The lecture is by a MD and/or PHD talking to a bunch of MDs and PHDs, so it's pretty high level. He covers a lot of biochemistry, but in a way that is pretty accessible. http://www.youtube.com/watch?v=dBnniua6-oM http://www.youtube.com/watch?v=dBnniua6-oM

skmurphy 17y ago

video also here http://www.ucsd.tv/search-details.aspx?showID=16717 http://www.ucsd.tv/search-details.aspx?showID=16717