Sunday, April 18, 2010

Dinner with Taubes, Eades and Hujoel

Gary Taubes gave a lecture at UW last Thursday. Thanks to all the Whole Health Source readers who showed up. Gary's talk was titled "Why We Get Fat: Adiposity 101 and the Alternative Hypothesis of Obesity". He was hosted by Dr. Philippe Hujoel, the UW epidemiologist and dentist who authored the paper "Dietary Carbohydrates and Dental-Systemic Diseases" (1).

Gary's first target was the commonly held idea that obesity is simply caused by eating too much and exercising too little, and thus the cure is to eat less and exercise more. He used numerous examples from both humans and animals to show that fat mass is biologically regulated, rather than being the passive result of voluntary behaviors such as eating and exercise. He presented evidence of cultures remaining lean despite a huge and continuous surplus of food, as long as they stayed on their traditional diet. He also described how they subsequently became obese and diabetic on industrial foods (the Pima, for example).

He then moved into what he feels is the biological cause of obesity: excessive insulin keeping fat from exiting fat cells. It's true that insulin is a storage hormone, at the cellular level. However, fat mass regulation involves a dynamic interplay between many different interlacing systems that determine both overall energy intake and expenditure, as well as local availability of nutrients at the tissue level (i.e., how much fat gets into your fat tissue vs. your muscle tissue). I think the cause of obesity is likely to be more complex than insulin signaling.

He also offered the "carbohydrate hypothesis", which is the idea that carbohydrate, or at least refined carbohydrate, is behind the obesity epidemic and perhaps other metabolic problems. This is due to its ability to elevate insulin. I agree that refined carbohydrate, particularly white flour and sugar, is probably a central part of the problem. I'm also open to the possibility that some people in industrial nations are genuinely sensitive to carbohydrate regardless of what form it's in, although that remains to be rigorously tested. I don't think carbohydrate is sufficient to cause obesity
per se, due to the many lean and healthy cultures that eat high carbohydrate diets*. Gary acknowledges this, and thinks there's probably another factor that's involved in allowing carbohydrate sensitivity to develop, for example excessive sugar.

I had the opportunity to speak with Gary at length on Thursday, as well as on Friday at dinner. Gary is a very nice guy-- a straightforward New York personality who's not averse to a friendly disagreement. In case any of you are wondering, he looks good. Good body composition, nice skin, hair and teeth (apologies to Gary for the analysis). Philippe and his wife took us out to a very nice restaurant, where we had a leisurely four-hour meal, and Dr. Mike Eades was in town so he joined us as well. Mike has a strong Southern accent and is also a pleasant guy. Philippe and his wife are generous and engaging people. It was a great evening. The restaurant was nice enough that I wasn't going to be picky about the food-- I ate everything that was put in front of me and enjoyed it.


* I'm talking about prevention rather than cure here. I acknowledge that many people have had some success losing fat using low-carbohydrate diets, including two gentlemen I met on Thursday.

84 comments:

John said...

That sounds like quite a night. I wonder how nutrition conversations went, as Eades and Taubes seem to be less flexible (at least from their writing) than you regarding macronutrient proportions in a healthy diet.

Chris said...

Amazing you had the opportunity to wine and dine with them. Would be interesting to know what each of you guys ate.....
Also to know if Gary Taubes's views have changed at all since researching and writing GCBC?

Michael said...

As I noted on a yahoo group I belong to, I'm sorry I missed it all. I would have had a plethora of questions for Dr. Eades and Gary Taubes. Jimmy Moore was in town as well. If its not too personal, where did you have dinner?

Zbig said...

you guys are of different ages, my guess is roughly 30, 50 and 60.
maybe what a 30 yo can get away with easily is too much for a 60 yo.
My lean workmate, 34, lives on soda and snicker bars all day - who dares to tell him that sugar causes obesity problems? Guess one needs to wait 20 years or so.

BizJ said...

I'm starting to think that vegetable oils are the true problem, causing carbohydrate intolerance; what do you think, Stephan?

P,W, said...

BizJ,

I agree, take a look at Smith website :- www.healingmatters.com

P.W.

Jenny said...

Stephen,

Sadly, oversimplified explanations for health problems will always sell more books than nuanced ones that acknowledge the complexity of biological systems.

I agree with you totally. Damaged carbohydrate metabolism is a result, not a cause of the "obesity epidemic" and there are many different intersecting causes, starting with pesticide,s herbicides, water pollutants, HFCS, Omega 6 oils, soy in everything etc. etc.

But you only get the huge book advances if you come up with a theory that can be put into a few words and provide an easy fix. Unfortunately, people can cut carbs all they want but it won't stop their children being born with damaged metabolisms thanks to chemical exposures in the womb that change gene expression.

Thomas said...

Stephan-Do you agree that native diets keep people lean even at continuously high calorie intakes? If so, then refined foods are likely a huge contributor to excess adiposity-but what about those foods does it? the lack of nutrition? The insulin response? Or is the increase calorie load? Or all of the above?

I'm skeptical about the native diet/large calorie intake idea. Obesity develops over a long period of time-this requires sustained larger calorie intakes-months to years. It's very difficult to determine the ebb and flow of a diet over long periods. A huge intake one day may lead to much less intake over the next few days. Factoring in activity levels makes this even more complicated. It is just very tough to do and make generalized statements about. I think native diets probably lead to less hunger-but this would lead to less intake, going against the large intake idea.

Also, what do you think of Jenny's idea about obesity and chemicals/additives and pesticides and DNA expression? Sounds like info from a specialized diet book to me-the opposite of being too simplified-too complicated to apply to large groups and be generally effective. But who knows?

Melissa said...

"Also, what do you think of Jenny's idea about obesity and chemicals/additives and pesticides and DNA expression?"

If it were due to that, you would see more clustering of symptoms around pesticide sources.

I agree it can factor, but there is way more evidence for the epigenetic theory or the idea that a metabolism can be damaged when young. Particularly, maternal health and behavior when pregnant seems to have a great effect. If your mother had deranged blood sugar, it's going to affect you for the rest of your life.

Emily said...

jenny- what types of chemical exposure are you referring to? do you mean pesticides in food?

personally, I have read GCBC and found it be an intensely in depth analysis of the possible cause(s) of diseases of civilization.

So maybe there are other reasons for obesity/ther modern health issues besides excessive, biologically inappropriate sugar and refined carb consumption? sure, but Taubes absolutely know something beyond the conventional wisdom on the subject and thank goodness for his research.

Tuck said...

@BizJ: I agree, I stopped eating vegetable oils several weeks ago, due to Stephen's writings.

Craving for starch and sugar immediately disappeared, and have not recurred. I saw a bunch of other benefits in the next few weeks as well.

But one of the discoveries I made was that I don't do well with gluten. Not eating any for a week and a half and then eating a sandwich on whole wheat bread was a surprising experience.

So there may still be an interplay between different factors, even if linoleic acid is driving it.

Tuck said...

Stephen, lucky you. That must have been an enjoyable evening.

Did you discuss your book project with this crew?

Stephan said...

Hi Chris,

I ate what was on my plate, because it's not every day I get to go to a restaurant like that.

Hi Michael,

Too bad you couldn't make it to the talk. We went to Rover's.

Hi Zbig,

Age may be one factor, but don't forget that most people my age are already overweight and semi-sick in the US.

Hi BizJ,

I wish I could say there's one single "true problem", but unfortunately I think it's more complex. I think chronic overconsumption of vegetable oils might contribute, but I can't say that with any certainty.

Hi Thomas,

What I meant is that certain cultures have access to an excess of calories, not that they eat an excess of calories. If you took a Pima indian from 1820 and stuffed her with 2,000 excess calories per day, she would gain fat. But without overfeeding, her calorie intake would be perfectly matched to her expenditure, without her having to think about it. Despite having access to enough food to cause fat gain. That's what happens when your body fat homeostasis system is working as it should.

I think Jenny's ideas on chemical contaminants may have some truth (or may not-- it's difficult for me to say), but it's not the whole story. Entire cultures were getting fat from refined carbs before most of the chemicals we use today existed. The Pima, for example, were obese by the early 20th century. Apparently under some conditions you can cause obesity in animals using some of these chemical contaminants.

Hi Tuck,

The conversation was mostly pretty light, but we did briefly talk about publishing options. If I end up writing a book, I'll probably self publish. But I haven't decided on that for sure yet.

Michael said...

Hi Michael,

Too bad you couldn't make it to the talk. We went to Rover's.


Yowsa, one of my favorite restaurants. That was quite a treat. I can see why you ate everything in front of you. :-)

Besides, he is a great chef. The first time I went in there he came out and personally talked to me. Wanted to meet the man who was asking all these specific questions about the ingredients he uses, lol!

Yes, I'm sorry I missed the talk. And I only live a few minutes down the road.

Joyful said...

What about stress and cortisol, in addition to the refined and excessive carbs and the chemicals? It's complex, no doubt about that.

Helen said...

Sounds like an all-star cast!

You're probably familiar with this, Stephan, but I thought I'd share an article an Newsweek about "obesogens," which are those same nasty plasticizers, pesticides, and industrial chemicals that do other bad stuff to us. I agree with you that it's not all of the story, but I do think it's part of it.

http://www.newsweek.com/id/215179/page/3

I read somewhere else, but can't find it now, that maternal diet can prevent some of these effects. For instance, enough folic acid helps in prevention, as folic acid acts as a methyl donor, negating some of the epigentic effects of the plasticizers, etc. (Then you become a skinny kid with allergies, like mine. ;)

Chris Kresser said...

Stephan,

Is the talk available anywhere online?

mike said...

I think Stephan is on to something about set points. I am 60, eat everything that the paleo and LC, and LF people hate, and I am not overweight (5'8"
~150lbs) or unhealthy at 60. I never go around hungry or feeling deprived. I eat sweets if the urge strikes. the only thing I can think of is we don't eat out more than 1-2x a week, and always real "fork and knife" food, not fast food.
I do not do aerobics, although I do some HIT style strength training.
Ditto my wife.
We have friends who are active, eat moderately and have been overweight since their 20's. I also know several fat teens. I am beginning to wonder if it's processed foods, or maybe something that happens at early childhood/adolescence.
It's not simply calories in/out.
Griff

Chris Kresser said...

What about dysregulated gut flora as another possible cause of the obesity epidemic?

Some great research has been done on this recently, which Stephan covered in his obesity setpoint articles.

It has been known for decades in the animal husbandry world that antibiotics, which disrupt gut flora, cause weight gain in animals.

The increase in antibiotic use in the late 70s and 80s coincides nicely with the increase in obesity - both in humans and animals.

Many other aspects of modern life are harmful to the gut flora, including a high-carb diet, chronic stress, medications (birth control and acid suppressing drugs in particular), formula feeding infants, and the disappearance of fermented food in most people's diets.

My sense is that the gut flora is one of the most significant, and up until recently, unexamined factors in the dysregulation of weight control.

Eric said...

I've been pondering the whole "carbs as the principal cause of obesity" issue for some time. I've also been quite intrigued by the concepts that Taubes presents in his books with regards to exercise having very little to do with weight loss and maintenance... I agree with most of what Gary presents, but I can't help but wonder, as you do Stephan, why are some native people on their traditional diet able to get away with a "higher carb" diet and of course, even people in our modern Western civilization (myself being one of those...)

Exercise might not, as Taubes points out, have any real bearing on the whole "calories in, calories out issue" but, I do believe that, similar to the idea he proposes that we need to pay attention to the endocrinological impact of food, the same can and should be said of exercise.

Ultimately, that may be the most underestimated reason why, even on high-carb diets (although never refined compared to the industrial world), native people are able to maintain their weight relatively stable. Sedentary levels seen in the US and Canada, among others, might not explain weight gain from the strict and conventional view of "calories in, calories out" but, it certainly has to have a significant influence on how much insulin and other fat-regulating hormones and mechanisms can act on the organism.

This is not to say of course that primitive people are necessarily training for marathons following the ingestion of a high-carb meal but, on the whole, I would suspect that they do expend more energy than the average American working at a desk job. Couple that with mostly refined carbs (and frankenoils, and...), and you witness an increase in obesity problems.

In our modern "metabolic milieu" thus (as Dr. Harris would call it), it might be wise to either a) reduce carbs to an appropriate level (and thus, increase fat and to a lesser level, protein), probably lower still if you are quite sendentary or trying to lose weight or carb-sensitive, or b) think of being more active if you do choose to eat a higher-carb diet, not on the basis of the "calories in, calories out" model, but mostly with the idea that it can serve as a insulin regulator...

Michael said...

Ultimately, that may be the most underestimated reason why, even on high-carb diets (although never refined compared to the industrial world), native people are able to maintain their weight relatively stable.

That is interesting, though it would not explain a number of native groups, including the Kitavans, whose activity levels are rather modest.

guyberliner said...

one of the virtues of the "vegetable oil mucking things up" hypothesis, i would say, is that it's found in practically every frickin' thing under the sun and you can hardly avoid it unless you are pretty g*ddam fanatical about home cooking, reading labels always and everywhere, etc.

For example: BEWARE OLIVE BARS!

one of the things that drove this point home for me recently: i used to like sampling the different Divina brand olives and other mediterranean style delicacies at the olive bars in the gourmet markets now and then.

never bothered to look that close, even though i did quiz the staff sometimes about them, and they told me, "ah, they're all just in brine and/or olive oil." which is what i would have figured. well, turns out, several of their products are steeped in highly refined vegetable oils. including some i quite liked, like the stuffed cherry peppers.

really p*sses me off!

Eric said...

@Michael:

I agree Michael, especially in light of the various studies that have shown this... However, even the termw "rather modest", wouldn't you agree, would appear to be a gross "overestimation" of the level of activity of the typical modern Westerner?

I think it would warrant further study, if anything... The optimal ratio of "amount of carb one chooses to eat" vs "amount of calorie expenditure required to maintain a stable weight"... Obviously, this would probably end up being a variable that is quite different from individual to individual!

John said...

Stephan,

"Entire cultures were getting fat from refined carbs before most of the chemicals we use today existed."

Do you know if cultures exposed to refined carbs get obese without vegetable oils, or do they (carbs and oils) typically arrive at the same time?

Ned Kock said...

A couple of pieces of empirical evidence that directly support Taubes's main hypotheses:

1. Insulin responses to protein-rich foods are often 50 to 70 percent lower than responses to equivalent amounts of refined carbohydrate-rich foods. Also, insulin responses to unrefined carbohydrate-rich foods (e.g., potato, fruits) are often 70 to 90 percent lower than responses to equivalent amounts of refined carbohydrate-rich foods:

http://healthcorrelator.blogspot.com/2010/04/insulin-responses-to-foods-rich-in.html

2. There is a huge gap between glycemic loads of refined and unrefined carbohydrate-rich foods:

http://healthcorrelator.blogspot.com/2010/04/huge-gap-between-glycemic-loads-of.html

Having said that, I certainly agree that everybody is somewhat different in terms of their physiology and response to various types of food.

Some of those differences have a strong genetic basis, but not necessarily because they are associated with genetic defects. They may have evolved through selection or genetic drift:

http://healthcorrelator.blogspot.com/2010/01/how-long-does-it-take-for-food-related.html

trix said...
This comment has been removed by the author.
Alan said...

I've also tweeked my diet based on info from Stephan. No more mayonnaise or store bought vegetable oils to reduce excess omega-6 oils. I didn't comsume alot of them, but now it is none.
I aslo enjoy more butter and sour cream. I never really thought they were bad for me, but now I try to stress them more often. I've also reduced fruit consumption a bit to reduce the fructose.
Thanks Stephan for your blog.

Teddy said...

"However, fat mass regulation is much more complex than just insulin. There's a dynamic interplay between many different interlacing systems that determine both overall energy intake and expenditure, as well as local availability of nutrients at the tissue level (i.e., how much fat gets into your fat tissue vs. your muscle tissue)."

Obviously Taubes knows there are other methods to fat accumulation other than insulin, but these methods really do not matter for anything really.

Did you ask him if he thought otherwise?

I could just as easily say that besides insulin, your blood is actually filled with miniature Peyton Mannings that come off the bench and compress fat into small footballs and fire them into cells. The method of accumulation is basically pointless.

Yes most carbohydrates will not make you fat, but that once you are insulin resistant and nice and fat, it is possible that all carbs will continue to make you fat, which is what Taubes has been saying all along. Some people will have good insulin sensitivity their whole life and be able to eat carbs at will the entire time.

Stephan said...

Hi Joyful,

I wouldn't be surprised if that played a role as well.

Hi Chris,

About the lecture, I don't know. About the gut flora, yes I think they play a major role. I'm looking forward to the research unfolding further. It's a hot topic right now. I'm about to present a paper on it at my division's journal club that was published in Science.

Hi Eric,

I still maintain that exercise is a central part of a healthy lifestyle. Even though running on a treadmill isn't a very effective way to lose fat, exercise is important for overall health and well-being. Gary acknowledges that as well.

People in traditional cultures don't necessarily exercise a lot, but they do have a baseline level of daily physical activity in almost all cases.

Hi John,

That's a bit of a gray zone. The Pima received hydrogenated lard and perhaps seed oils. The Tokelauans that stayed on the island didn't eat seed oils as they gained fat, their PUFA intake stayed low. They did eat white flour and sugar. But their fat gain was pretty modest compared to the Pima. Many of the cultures Price studied became sick but apparently not fat when white flour and sugar were introduced.

Hi Ned,

I have to disagree that refined foods have a higher glycemic index than whole foods. If you compare similar foods, for example white bread vs. whole wheat bread, they have an almost identical GI. In any case, the controlled trials have shown that lowering the glycemic index for up to 1.5 years has practically no impact on body fat, glucose control or insulin sensitivity.

Chris Kresser said...

Here's a link to Taubes' talk online.

Stephan, is the paper you're presenting the Vijay-Kumar paper from Emory just published in Science?

Stephan said...

Yup, that's the paper.

Zooko said...

Stephan:

What are a few of the cultures that in your opinion make the strongest counter-examples to the hypothesis that dietary carbohydrates are the primary cause of obesity?

I remember you mentioned the Hunza once on your blog and I went and did some reading on them but they don't seem to be a strong counter-example to me as they may have been chronically or at least annually on significant caloric restriction.

(Which does make them interesting. It's too bad there is so much contradictory information about their traditional state.)

Tukki said...

Yes, the science of metabolism, obesity and overall health is complex.

There are, I think, two big ways to approach scientific inquiry. The scientific method, which seeks to control variables and find 'that single thing that significantly effects outcome' is by its nature, reductionistic.

Science conducted in accordance with that method of inquiry produces "data bits." Even large-population based, longitudinal observational studies have limitations in meaningfulness. (So many uncontrolled variables!)But if a scientific field, as a whole, generates enough data bits, sometimes a whole picture emerges, like the pieces of a jigsaw puzzle put together makes a whole.

The other approach to science is the big leap, or paradigm shift. Quantum mechanics, the first models of the atom, etc., were all leaps off the Newtonian page, for example. Darwin's theory of evolution, another.

For those of us concerned about a good and proper way for the human animal to live, we seek the best of data-bit science and are guided, to one degree or another, by the paradigm shift of evolutionary health, or "What did we used to do and know that served us better than what we do and know now?"

I think that the modern human animal suffers from the disease of inappropriate scale. I think we are meant (biologically) to live in small bands and tribes. To know our neighbors. To regulate population by the richness of local resources. When resources are strained, the population splits and some migrate.

Most of the problems of 'civilization' are problems that stem from living on an inappropriate scale. It's as if ants suddenly stopped living in individual colonies and developed an ant nation, with systems of distribution like we humans have created.

Maybe if you live in a small, interdependent tribe, everything else works out.

Tukki

Helen said...

I've got worse news for you, guyberliner. Much, if not most, olive oil sold is adulterated with other, cheaper oils.

http://www.newyorker.com/reporting/2007/08/13/070813fa_fact_mueller

I think Italy may be cracking down on this now, but I'm not sure.

A way to tell if your olive oil is pure is to put it in the fridge. If it hardens, it's pure olive oil.

I buy organic olive oil, with the assumption that if it can be certified organic, it must be certified olive, too.

Robert Martini said...

Stephan,

I had a question for you regarding omega 3 and omega 6 fatty acids. What's important to good diet and health, is it the RATIO of omega 3/omega 6 or is the ABSOLUTE amount of omega3 and omega 6 what matters?

Jimmy Moore said...

Would have loved to met you Stephan! I wondered where Gary and Mike were on Friday night while the rest of us had dinner at the hotel. :)

Stephan said...

Hi Jimmy,

Sorry we weren't able to connect. I didn't know you were in town. If you let me know next time, I'd be interested in meeting up.

Robert Andrew Brown said...

You said "What's important to good diet and health, is it the RATIO of omega 3/omega 6 or is the ABSOLUTE amount of omega3 and omega 6 what matters?"

Both are important, but you need to consider the plant based 18 carbon fats separately from the long chain Omega 3s EPA and DHA.

In nature the supply of plant based Omega 3 alpha linolenic acid and Omega 6 linoleic acid on a year round basis is about balanced, abundant but limited in absolute quantity. Green plant material which is available for most of the year has maybe more 3 than 6, but only generally contains Omega 3 and 6 in parts per thousand. Plant reproductive material contains higher levels of Omega 6 but is scarce seasonal and competed for. Wild animal fat contains about 2% Omega 6 varying with the season.

Marine food contains much more long chain Omega 3 DHA and EPA than Omega 6, so as a shoreline gatherer in nature you could eat as much long chain Omega 3 as you could find in clams fish etc., and the body has ways of safely dealing with any excess when eaten as part of clams fish etc.

Stephan has posted on Professor Lands’ work, which shows that 1-4% of calories of Omega 6 LA in the diet (depending on the amount of competing Omega 3) will result in 80% repletion of the available space in the cell membranes.

Based on both biology and natural availability in the food chain we do not need much Omega 6 LA to be healthy maybe 1/2% to 2%. In nature Omega 3 ALA and Omega 6 LA are also over the year more or less balanced maybe between 2:1 and 1:2.

Excess Omega 6 LA will increase the pressures towards inflammation and oxidative stress.

Any Omega 6 LA : Omega 3 ALA imbalance will similarly increase pressure towards inflammation and oxidative stress.

guyberliner said...

Wow, Helen. Didn't know about the EVOO fraud! (and the New Yorker article you cited is already three years old!)

I still wonder, though, if you can really rely on the mere fact that the oil solidifies in the fridge like you say. Wouldn't a fake olive oil with a similar blend of mono-unsaturates behave much the same way? (eg, one adulterated with olive pomace oil, plus this or that vegetable oil, plus lowgrade hazelnut oil, for example)?

Have you considered trying one of the estate grown oils (eg, from California)? Though admittedly they're a lot more expensive.

guyberliner said...

Oh Helen, BTW, regarding USDA Organic truth-in-advertising, have you read this one yet?: http://industry.bnet.com/food/10001909/organic-regulators-discover-a-novel-concept-enforcement/

brian said...

Always liked listening to Taubes speak. Good for you. One question. Was zooming through the presentation and ended up at the Q & A. Someone asked a question and it appeared Taubes asked, "Are you Steven?" Think that might have been you he was thinking about?

Helen said...

Hi guyberliner,

I am sure there is sketchy stuff all around organic certification. I guess I just have to live, and figure stuff labeled organic is more likely to be organic that stuff not labeled as such. (Though I avoid "organics" from China.) But I have been thinking I should submit my olive oil to the fridge test. I did this a few months ago with a non-organic, major brand of olive oil and it did *not* solidify.

I think you're right that other oils with a similar fatty acid composition would also solidify in the fridge. The thing that test would tell you is whether the oil you're using is primarily polyunsaturated, something a lot of people visiting this site are trying to avoid.

I certainly hope they're not using nut oils! My daughter has a serious nut allergy. Those oils probably aren't cheaper than olive oil, so, hopefully that's some protection.

sverlyn said...

Best olive oil ever- California Olive Ranch olio nuovo. It comes out once a year. It's the first pressing that's bottled w/o letting the oil settle to filter out the sediment. Just full of flavor. And their prices are much cheaper than other boutique companies doing olio nuovo

Anna said...

I like California Olive Ranch EVOO too. I can get local San Diego EVOO, too, at local farmer's markets (avocado oil, too). I only use EVOO for salads etc now (not for cooking) so I use far less than i used to (no point in buying warehouse-sized bottles). I do buy some "pure" refined OO just for making mayonnaise, but that's only because EVOO makes a very strongly flavored mayo that is a hard sell with my family.

A local store sells organic EVOO in a 3 liter box (like boxed wine). Has anyone tried it? Oil is spacked in Italy but the olives are from Tunisia and Italy. Once opened it should keep ,better than in a bottle or can, as it isnt exposed to light or oxygen. However, not sure about the plastic bag issues.

guyberliner said...

Robert Anton Brown: I'm glad there is somebody hammering away at this issue of excessive Omega 6. I think one of the issues that continues to cause confusion for most of us is this issue of enzyme competition that Bill Lands addresses in the talk you shared with us last year, put on by NIH, "Nutritional Armor for the Warfighter: Can Omega-3 Fatty Acids Enhance Stress Resilience, Wellness, and Military Performance?" (http://videocast.nih.gov/summary.asp?live=8107)

I'm referring here to the fact that omega 3 and omega 6 COMPETE for the same enzymes required for their metabolism, and that their behavior conforms to the "Michaelis Menten" enzyme kinetics, which implies a HYPERBOLIC rather than a linear relationship between omega 3 and omega 6 intake, such that consuming more than a certain threshold (often cited as 4%) of dietary calories as omega 6 puts you in the flatter, nonlinear regime of the hyperbolic curve, and means that, exceeding that dose, you can supplement with omega 3 til the cows come home, to little effect.

Somebody really needs to help get this information that Lands's research highlights out to the broader public, in a form that ordinary humans can understand! It really points to the dangerous, historically aberrant levels of omega 6 we are consuming -- and that there is no quick fix, like just gulping some fish oil or something.

Robert Andrew Brown said...

GuyBerliner

Thank you for your helpful comments.

Because of the complexities of the ways the various members of the Omega 3 and 6 fats families are metabolised in the body, increasing supplementation of long chain Omega 3 with rising Omega 6 intakes is likely to have net health benefits.

However restricting the intake of Omega 6 LA to levels seen in nature is a more effective option for very many reasons.

I attach below a link to useful paper.

http://www.ajcn.org/cgi/reprint/83/6/S1483

Healthy intakes of n–3 and n–6 fatty acids: estimations considering worldwide diversity


"The increases in world LA consumption over the past century maybe considered a very large uncontrolled experiment that may have contributed to increased societal burdens
of aggression, depression, and cardiovascular mortality."

Psalam 23 said...

"
Stephan has posted on Professor Lands’ work, which shows that 1-4% of calories of Omega 6 LA in the diet (depending on the amount of competing Omega 3) will result in 80% repletion of the available space in the cell membranes."

Interesting, what I find strange is that nut consumption appears to be associated with reduced oxidative stress and DNA damage, even though they contain large amounts of linoleic acid.
http://www.ncbi.nlm.nih.gov/pubmed/20064680

guyberliner said...

I presume that, because nuts have a lot of other stuff in them, like polyphenol antioxidants, etc, people eating more of them, UP TO A CERTAIN POINT, will enjoy better health, all other things being equal. That, however, does not necessarily mean that there are no health implications past a certain point from the LA in nuts. The question then is, where is that "certain point," if it does exist. And is it different for different people, and does it depend on the totality of one's diet, genetics, etc.

Michael said...

@Eric

However, even the term "rather modest", wouldn't you agree, would appear to be a gross "overestimation" of the level of activity of the typical modern Westerner?

That would be funny if it wasn't so sad.

In the case of the Kitavans, IIRC, their exercise level was about the same as the New Zealanders, while lacking any obesity issues.

Robert Andrew Brown said...

Psalam 23

Nuts are also a rich source of minerals.

1oz of nuts likely would not add an enormous amount of Omega 6 LA in comparison to their existing intake.

The nuts may also have added a significant amount of Omega 3 compared to their existing intake if walnuts were included.

It is likely that their Omega 6 LA intake was already way above 4%.

Ned Kock said...

Hi Stephan.

I agree with you regarding the GI, but not the GL of those foods.

Alan said...

Robert,

Thanks for the link to the paper
'Healthy intakes of n-3 and n-6 fatty acids: estimations considering worldwide diversity'

Since I am taking fish oil, I would like to know that it is actually doing me some good!
How easy is it to get Omega6 oils to less than 4% of total calories per day.
If you eliminate mayonnaise, store bought vegetable oils and rarely eat the white foods (cookies, donuts, cakes, etc) and comsume beef, chicken, canned salmon , canned tuna, minimize grains especially wheat, eat some brown rice , eat fruits (especially berries) and vegetables, sometimes white potatoes and sweet potatoes.
Am I in the realm of achieving the 4% number? Or do I have to maintain a food diary and do the calculation?

guyberliner said...

Alan:
Don't forget: avoid eating anything packaged without an ingredients list on it, or prepared in advance at a restaurant, or market, or what have you. Because all of those things can be and more often than not ARE loaded with omega-6 vegetable oils. And you won't know or be able to find out one way or the other. Unless you go to great lengths to quiz people. Assuming they even know, and that what they tell you is accurate.

I've read that it takes five years for a complete exchange of cell membrane lipids. You have to assume starting out that you are pretty far from the evolutionary norm for these ratios if you have eaten anything remotely resembling the standard American diet, ever go out to restaurants, etc.

On a 2000 calorie diet, it's only 80 calories. Not much at all really. More than three tablespoons of almond butter already gets you past there. You can exceed it hardly blinking. So I think you actually have to be pretty damned disciplined and almost fanatical.

I think it's goddam hard. I don't think anybody really knows what their omega 3/6 ratios are unless they've taken one of the emerging lab tests being offered out there (eg, omegaquant, nutrasource.ca, etc). And the trouble with those is that none of those tests is standardized yet, unlike, say, Framingham scores, and there is no way to compare numbers from one of them to those from another.

BizJ said...

It's not really that hard to keep your PUFA intake that low, on a paleo diet. For me, that just means favoring beef and lamb over chicken, and not eating nuts every day.

I already don't eat any processed or prepared foods, or eat out at any restaurants. Nuts are really the only food in my diet that contain significant PUFAs, so I limit my nut consumption to a couple of servings per week at the most.

Robert Andrew Brown said...
This comment has been removed by the author.
Robert Andrew Brown said...

Alan

It is difficult, given that the Omega 3:6 imbalance feeds through the food chain. At the end of the day one just has to be pragmatic consistent with one's lifestyle.

Grain fed animals tend to have a significant Omega 3:6 imbalance. Lamb tends to have a better Omega 3:6 profile. Grain fed chicken products can be surprisingly high in Omega 6.

Per Nutrition Data a whole chicken including giblets and neck 1kg contains almost 30 grams of Omega 6 and 2 grams of Omega 3.

http://www.nutritiondata.com/facts/poultry-products/640/2

Fish is often canned in Omega 6 high oils. This means the product ends up containing a significant amount of Omega 6 LA even when drained. Some of the long chain Omega 3 is dissolved out of the fish into the oil and ends up down the sink, probably along with other fat soluble nutrients.

Tuna 100 gr canned in oil contains 2683mg Omega 6 and 202mg Omega 3.

http://www.nutritiondata.com/facts/finfish-and-shellfish-products/4145/2

Fish canned in water can mean you loose soluble nutrients like taurine.

The above issues apply to cooking processes too.

Jack C said...

Psalam 23,

Take another look at your reference on nuts (pubmed 20064680)

The reference states those those who consumed 30 grams of mixed nuts per day had less DNA damage than controls, but, contrary to your statement,there was NO DIFFERENCE IN oxLDL.

All subjects had metabolic syndrome and their LA consumption was likely higher than the average intake of about 9% of energy intake. Thirty grams of mixed contain about 12 grams of LA which equates to only 0.6% of energy intake of a 2000 cal/day diet. Nuts most likely replaced some other snack food which may have had equal LA content, so there may have been little or no increase in LA consumption.

As Robert pointed out, nuts have high mineral content. Thirty grams of mixed nuts contain over 40% of daily the copper requirement of 0.9 mg per day, so the increased copper intake could have resulted in reduced DNA damage.

Anna said...

It is possible to buy canned tuna without any added oil OR water. It is expensive though, compared to national supermarket tuna brands. Wild Planet skipjack light tuna is one brand (wild caught). The small amount of liquid is merely juices from the tuna itself and can be stirred back into the tuna while flaking (no draining necessary). There are other brands too, but they may not be stocked at typical supermarkets. I found this type at a local "natural" food store. I've also tried a brand called American (I think) that I purchased at a farmer's market, but it was also available online.

Richard Nikoley said...

Anna:

You might check out this company for canned tuna.

http://www.highseastuna.com/index.html

Looks pretty good. Young, troll caught, no oil or water.

Eric said...

Correct Anna!

Here in Canada for example, you can buy this kind of tuna from Raincoast Trading. I also know that in the US (also now available in Canada through shipping), one of the better choices comes from VitalChoice, either packed in nothing or with extra-virgin organic olive oil (i.e., low in PUFA). As you mentioned, these are expensive, but well worth it in my opinion! Also important is that these companies only cook their fish once (as opposed to twice for most commercially-available fish; once before canning and again, during canning), preserving the natural oils (and TASTE) and, maybe more importantly, come from wild and sustainable fishing operations.

Garry said...

Stephan,

Perhaps you could someday comment on the Vijay-Kumar paper and some of the other related research looking at the link between gut flora and metabolism/obesity? That would be most helpful. Thanks for your efforts.

Apolloswabbie said...

Interesting post, would have picked you as a guy who would largely agree with Taubes and the Carb Hypoth. Granted that we're all working on a hypothesis that explains all known data, and none of us is likely to see a study that will adequately test same - but for me, I can't imagine finding a type II diabetic who ate too much steak. Or lard. Or broccoli. Or macadamias. It the sugar/wheat/corn/potato/rice/milk carbs that makes the insulin system get jacked up - or can someone point me in the direction of evidence to the contrary? As for the genetic expression/cultural generational issues with insulin issues, no doubt that's a factor, but again - it's not happening because we eat too much bacon. Is it even possible to overeat bacon?

Alan said...

Hello Anna,

I am presently eating tuna from Carvalho Fisheries. It is low mercury, and no added water or oil.
I think it has a great taste.

I use Vital Choice for Wild Alaskan Sockeye Salmon.
Neither is cheap,but I think worth it.

Apolloswabbie said...

"Entire cultures were getting fat from refined carbs before most of the chemicals we use today existed. The Pima, for example, were obese by the early 20th century." I really appreciate this point. Obesity may be a complex issue, but it does not have to be a complex issue if one is simply eating a diet of 50% refined carbs.

Apolloswabbie said...

Eric - Taubes' points about exercise and weight loss go like this. First, we know beyond doubt that a normal human has feedback systems that ensure that appetite increases to match work; else all lumberjacks would have starved. Taubes notes that many studies show no benefit to weight management with exercise. It may be the case that exercise is helpful in maintaining a desirable body weight, but such has yet to be proved. Considering the relationship between hunger/workload, I've begin to think the notion that we're just a few hundred calories/day overfed and can fix that with a few hours of cardio is darned near an absurd conclusion. It simply does not make sense to me that anyone can know how much they eat, how much energy they consume/excrete and then magically balance the formula through exercise.

I have the experience of a year of eating seriously low fat, working out six times a week, and often 2x/day, including martial arts, cardio and resistance training, and became as fat as I've ever been. But also inflamed (high doses ibuprophen to control knee pain I deal with now on no meds), unable to get quality sleep, and subject to huge hypoglycemic crashes. Right or wrong, my experience shapes my hypothesis.

David said...

Richard Nikoley said...
Anna:

You might check out this company for canned tuna.

http://www.highseastuna.com/index.html

Looks pretty good. Young, troll caught, no oil or water.
-------

I think the cans have bisphenol A in the lining

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Eric said...

Apolloswabbie:
"Considering the relationship between hunger/workload, I've begin to think the notion that we're just a few hundred calories/day overfed and can fix that with a few hours of cardio is darned near an absurd conclusion. It simply does not make sense to me that anyone can know how much they eat, how much energy they consume/excrete and then magically balance the formula through exercise."

Believe me, I couldn't agree more!

However, I can't help but wonder if exercise might not have a role in this whole equation and, if so, to what extent... As I said, not purely from a "calories in, calories out" point of view but, just as ratios of macronutrients can have a similar impact, maybe on a hormonal level?

Just think of it from the simplest standpoint: you eat a high-carb meal, blood sugar goes up, and so does insulin. Now, go exercise at the proper intensity, and actively influence that hormonal response. See what I'm getting at?

I'm certainly not claiming that exercise has an impact on absolute number of calories ingested (since the hunger/energy expenditure feedback loop is probably more complex than we can ever imagine), but we also can't deny that it does/might have an impact.

Compare eating a bag of Doritos with a large soda (refined carbs) and sitting at your desk (highly sedentary), to eating yams or tropical fruits (unrefined carbs) and then maybe going fruit picking (low-intensity activity)... In the latter, how can we really be sure which one has the most impact?

I'm blessed with a metabolism that, in the past, allowed me to live off a high-carb diet (was vegetarian and vegan for over 12 years) and doing ABSOLUTELY inhumane levels of aerobic activities for most of my life. So, my stumbling upon the paleo/WAPF type of diet 8 years ago came strictly from a desire to be healthy on the cardiovascular level (men in my family drop like flyes come the tender age of 50). Thus, for me, I maintain a health weight and bodyfat (always under 8%) whatever I do. But, I gather from my personal research that, on the whole, the last 8 years of my life have GREATLY enhanced my chances of escaping the inescapable!?!?!

Kindke said...

From watching the lecture its certain that Taubes views havent changed at all since GCBC, but Stephen I think Taubes is spot on with idea of obesity coming from chronic insulin elavation.

I'm not forgetting about Leptin (ofcourse Leptin is important ) but I believe the problems with leptin only start because of the already done damage by insulin and carbs.

I mean how do you get around the whole point that fat burning is essentially bottlenecked aslong as insulin is up.

I think its also important to remember that the rules that govern weight gain are not the same as those that govern weight loss. For example over-eating 0 carb diets will not result in body fat gain.

But at the same time even on low-carb diets you still have to watch the calories if you want to loose body fat.

Taubes is certainly right about exercise though, its useless for weight loss and only increases hunger by a disproportional amount to the calories burned during said exercise.

Oh and about those rural groups who are 'healthy' on high carb diets. This begs more examination. What % of thier carbs eaten is actually digestible? How frequent are thier meals?

I would imagine the half-life of insulin in serum is quite a bit different across ethnic groups.

Lastly I also think that the gut flora is playing a much bigger part than people realise. One can only begin to imagine the kind of evolution that is going on with your gut flora week after week depending on the food your giving them.

Matthew said...

Kindke:
"Taubes is certainly right about exercise though, its useless for weight loss and only increases hunger by a disproportional amount to the calories burned during said exercise."

Don't be so sure about exersice. Exercise does increase insulin-independent glucose uptake by muscles and increases muscle cell insulin sensitivity.

So regular activity is likely to mean less insulin in the blood and less insulin resistance. While diet is most imporatant, any extra reduction in insulin and blood sugar from exercise would only be a good thing.

Apolloswabbie said...

Eric, enjoyed that post, thanks.

Stephan said...

Hi Kindke,

The tissue response to insulin doesn't just depend on the level of insulin in the blood-- it also depends on the tissues' sensitivity to that insulin. And insulin does many things, so the same tissue can actually be insulin resistant and insulin sensitive at the same time, depending on what you're measuring. You see that in the livers of diabetics-- insulin doesn't suppress glucose production but it still suppresses VLDL secretion.

So even the assumption that high insulin prevents fat release from fat cells in humans isn't obvious. It's true in a cell culture dish, but is it true in an insulin-resistant human? I don't even know. I should look into it.

I'm not aware of any evidence, beyond the hypothetical argument that high insulin causes obesity by keeping fat in fat cells, that insulin signaling has anything to do with obesity. Diabetes, yes, but obesity, I just haven't seen any evidence for it.

But let's assume it does, for the sake of argument. You still couldn't get fat from just hyperinsulinemia, because once your fat mass started to increase, your leptin system should prevent it from rising further. There has to be a defect in the negative feedback system; I see no way around it. The only way to implicate insulin would be to say that insulin signaling defects end up altering the fat mass negative feedback system (likely leptin signaling), which is what Gary argues. But the indirect evidence we have doesn't currently support that hypothesis in my opinion.

Even if hyperinsulinemia/insulin resistance did cause obesity, that still doesn't implicate carbohydrate, because starch per se doesn't cause either one. All it does is transiently elevate insulin, after which it goes back down and, in a properly functioning metabolism, allows an appropriate amount of fatty acids out of fat tissue between meals and at night such that a balance is maintained.

You said "overeating 0 carb diets will not result in body fat gain". That has never been demonstrated. People on LC diets spontaneously reduce their calorie intake. There are no controlled zero carb overfeeding studies. Gary is pushing for that to be done. I'd also be interested to see the result.

I agree with you about gut flora.

Stephan said...

Here's a paper looking at fat release from fat cells in obese hyperinsulinemic people:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC303803/

It's actually higher than in lean people. In other words, obese people with high insulin actually release more fat from their fat tissue than lean people. The reason they don't end up lean in a hurry is that it's also entering fat tissue at the same rate.

Stargazey said...

When mice are bioengineered to lack the insulin receptor in skeletal muscle, they provide an extreme example of muscle insulin resistance. As shown by Bruning et al., A muscle-specific insulin receptor knockout exhibits features of the metabolic syndrome of NIDDM without altering glucose tolerance.

The abstract states, "These mice display elevated fat mass, serum triglycerides, and free fatty acids, but blood glucose, serum insulin, and glucose tolerance are normal."

There appears to be some evidence that carbohydrate consumption is positively correlated with insulin resistance (see here for a recent reference.) Therefore, it is at least possible that carbohydrate, particularly refined carbohydrate, could be one of the causes of obesity.

Patrick said...

Stephan :"You said "overeating 0 carb diets will not result in body fat gain". That has never been demonstrated. People on LC diets spontaneously reduce their calorie intake. There are no controlled zero carb overfeeding studies. Gary is pushing for that to be done. I'd also be interested to see the result."

Purely anecdotal but I know people on the ALC forum who are All Meat eaters and they can grow fatter if they overeat muscle meat.

Patrick

Stephan said...

Hi Stargazey,

True, they do have a modest body fat phenotype (40% increase), as do the brain-specific insulin receptor knockouts. But it's the equivalent of me going from 10% body fat to 14%... it hardly qualifies as obesity or even overweight.

Stephan said...

Still, I'll concede the point that there is at least some basis for the idea that defects in insulin signaling can lead to body fat accumulation.

Zooko said...

"People on LC diets spontaneously reduce their calorie intake. There are no controlled zero carb overfeeding studies. Gary is pushing for that to be done. I'd also be interested to see the result."

There was a study on LC vs LF diet in the last few years in which the researchers weighed the plates of the subjects after meals to measure consumption. If I recall correctly the low-carb dieters were eating 300 calories per day more (mean) than the low-fat dieters but they still lost more weight during the course of the study (which if I recall correctly was 6 months).

IIRC the LF diet was calorie-restricted and the LC diet was ad libitum.

Does anyone else recognize the one I'm talking about? I don't have notes here -- this is just from memory. I remember the researchers expressing wonderment in the resulting press release about how such a result was even possible. :-)

Tom A said...

Some items pertaining to vegetable oils:

http://www.members.shaw.ca/hsri/newdiscoveries.jpg

http://www.members.shaw.ca/healthsciences/autism.htm

Be sure to see the studies listed in this second item.

anarcho-"mercantilist" said...

Intermittent fasting will help you lose weight, even if you eat the same number of calories in the long-term. It does this by temporarily lowering insulin levels during the fasting session, so the fat-burning hormones can be available.

This may be correct if the theory that insulin prevents fat burning is correct.

Helen said...
This comment has been removed by the author.
Razwell said...

The First Law of Thermodynamics does NOT "prove" the caloric hypothesis, BECAUSE A HUMAN BEING IS NOT A CLOSED SYSTEM. Matter and energy enter from the enviornment and escape back into it.

The question of how much of what is ingested is packed away in fat cells, as opposed to used t power physiological processes or eliminated as waste matter and energy is NOT answered by The First Law of Thermodynamics.

The First Law demands that no matter or energy be created or destroyed, and in sum, as far as we can tell, none is, but that's the end of the First Law's reach.

And it might not even reach that far. Much remains to be learned about energy and matter, and we have reason to suspect the First Law might be a special case, applying only under certain circumstances. It's even possible the enitire First Law might be discarded, eventually.

Gary Taubes is absolutely correct in his attack on the energy balance hypothesis. The only thing is that insulin levels are the same everywhere in the body, so the insulin theory cannot explain why subjects had obese lower bodies and rail thin upper bodies in the photos he showed.This is nto a criticism however. I like Gary Taubes A LOT.


Linda Bacon, another Ph.D. like Stephan, has a whole bunch of YouTube videos explaining why deiting fails and that dieting raises the bodyfat setpoint, to protect us from future dieting .

Matt Mezgar , another Ph.D. also has some every good articles on his blofg about the failure of dietin for the long term successful treatment of obesity.

If there is one thing that is crystal clear in the scientific literature it is that dieting does NOT work.

"The Biggest Loser" is farcical advice and someone should confront Jillian Michaels.

Also someone should show these points to Lyle McDonald. He is wrong.

Agent Of Calm said...

I would like to float an overarching theory that is consistent with the Taubes/WAPF/Paleo etc. etc. thinking.

Let us call it "The General Theory of Human Health"?

The name might sound derivative of Einstein but why be overly humble?

1. It is the natural state of our species to be "healthy" just as it is the natural state of any species. Accidents, violent death or invasive species and organisms might diminish our likely longevity but we are evolved to live for 80-100 years untroubled by degenerative disease. Degenerative disease is teh result of environmental factors.

2. Because civilization and the attendant changes in our environment are recent (albeit high-stress) events they have yet to become natural. We might be in a period of rapid adaptation to the changes wrought by civilization but our transition is not complete. And the stresses of a civilized environment are themselves rapidly changing making the pursuit of adaptation even harder.

3. The single near-universal change wrought by civilization to our species is the transition to agricultural and, now, industrial food production, a generally accepted major factor in human health. A second wide effect is lower levels of physical activity but this is far from universal and higher levels of activity rarely result in intrinsically healthier people (the famous lumberjack example).

4. If one's pre-historic ancestors resided in Europe (as did mine) then one is still best adapted to the then prevailing natural diet. It would have been largely carnivore in nature. Plant food would have been only seasonally available and, therefore, an unreliable food source. Plant life would have been supplemental. The plants would have been very different from modern agricultural produce just as wildlife is very different from factory-farmed animals as a food source.

5. Our lagging adaptation to the fast-changing nature of the "food" we eat is in itself all the explanation we need for the diseases of civilization we suffer.

6. Revert to genuinely natural food consistent with our evolutionary state and you will become healthy.

Is there more than this really?

My warmest regards. Please be kind.

trinkwasser said...

My theory, based on this and many other blogs, forums, papers etc. is that the key concept is "anatomically correct".

At the one end anatomically correct quantities of macronutrients, at the other anatomically correct quantities of micronutrients. Get either wrong and chaos ensues.

The problem is that "anatomically correct" varies a lot, both for genetic and environmental reasons.

One side of my family converts carbs into lipids with alacrity, but fails to stash the lipids as body fat. Therefore we should reduce our carb consumption until this no longer occurs. My aunt was told at 80 she had the blood pressure of a thirty year old whereas at thirty I already had the BP of an eighty year old. A cousin took until 60 to disintegrate in the way I did in childhood, one of his daughters (an athlete!) is going the same way in her thirties. Like me she has an overreaction to wheat.

OTOH there do appear to be a small minority of people who make a low fat high carb diet work. So "snatomicslly correct" msy vary a lot, depending.

The same environmental factors may have distinctly different effects on different genesets, which is what makes finding the One True Path so difficult. Insulin resistance is an obvious familial characteristic but does not lead to obesity, just the metabolic consequences of obesity in normal weight people: in our case an anatomically correct carb load is a fraction of what we are told is essential, I "work" best on the edge of ketosis. Maybe if I hadn't been broken by some specific environmental factor in my past this wouldn't be true.

Maybe different environmental factors affect others in the same way. Dogmas are generally inapplicable. IMO the best way to find your specific approach is testing, I rely on my BG meter and lipid panels and I'd like to get various other tests to confirm or deny that I'm heading in the right direction, such as CRP. My intention is to approach "normal" numbers whatever it takes. Taubes' concepts work for me/us and probably for a majority of the population, but not for the rest.squalign