Tuesday, November 9, 2010

The Twinkie Diet for Fat Loss

The Experiment

I've received several e-mails from readers about a recent experiment by nutrition professor Mark Haub at Kansas State university (thanks to Josh and others). He ate a calorie-restricted diet in which 2/3 of his calories came from junk food: Twinkies, Hostess and Little Debbie cakes, Dorito corn chips and sweetened cereals (1). On this calorie-restricted junk food diet (800 calorie/day deficit), he lost 27 pounds in two months.

Therefore, junk food doesn't cause fat gain and the only thing that determines body fatness is how much you eat and exercise. Right?

Discussion

Let's start with a few things most people can agree on. If you don't eat any food at all, you will lose fat mass. If you voluntarily force-feed yourself with a large excess of food, you will gain fat mass, whether the excess comes from carbohydrate or fat (2). So calories obviously have something to do with fat mass.

But of course, the situation is much more subtle in real life. Since a pound of body fat contains roughly 3,500 calories, eating an excess of 80 calories per day (1 piece of toast) should lead to a weight gain of 8 lbs of fat per year. Conversely, if you're distracted and forget to eat your toast, you should lose 8 lbs of fat per year, which would eventually be dangerous for a lean person. That's why we all record every crumb of food we eat, determine its exact calorie content, and match that intake precisely with our energy expenditure to maintain a stable weight.

Oh wait, we don't do that? Then how do so many people maintain a stable weight over years and decades? And how do wild animals maintain a stable body fat percentage (except when preparing for hibernation) even in the face of food surpluses? How do lab rats and mice fed a whole food diet maintain a stable body fat percentage in the face of literally unlimited food, when they're in a small cage with practically nothing to do but eat?

The answer is that the body isn't stupid. Over hundreds of millions of years, we've evolved sophisticated systems that maintain "energy homeostasis". In other words, these systems act to regulate fat mass and keep it within the optimal range. The evolutionary pressures operating here are obvious: too little fat mass, and an organism will be susceptible to starvation; too much, and an organism will be less agile and less efficient at locomotion and reproduction. Energy homeostasis is such a basic part of survival that even the simplest organisms regulate it.

Not only is it clear that we have an energy homeostasis system, we even know a thing or two about how it works. Early studies showed that lesioning a part of the brain called the ventromedial hypothalamus causes massive obesity (3; this is also true in humans, when a disruption results from cancer). Investigators also discovered several genetic mutations in rats and mice that result in massive obesity*. Decades-long research eventually demonstrated that these models have something in common: they all interfere with an energy homeostasis circuit that passes information about fat mass to the hypothalamus via the hormone leptin.

The leptin system is a classic negative feedback loop: the more fat mass accumulates, the more leptin is produced. The more leptin is produced, the more the hypothalamus activates programs to reduce hunger and increase energy expenditure, which continues until fat mass is back in the optimal range. Conversely, low fat mass and low leptin lead to increased hunger and energy conservation by this same pathway**.

So if genetic mutants can become massively obese, I guess that argues against the idea that voluntary food intake and energy expenditure are the only determinants of fat mass. But a skeptic might point out that these are extreme cases, and such mutations are so rare in humans that the analogy is irrelevant.

Let's dig deeper. There are many studies in which rodents are made obese using industrial high-fat diets made from refined ingredients. The rats eat more calories (at least in the beginning), and gain fat rapidly. No big surprise there. But what may come as a surprise to the calorie counters is that rodents on these diets gain body fat even if their calorie intake is matched precisely to lean rodents eating a whole food diet (4, 5, 6). In fact, they sometimes gain almost as much fat as rodents who are allowed to eat all the industrial food they want. This has been demonstrated repeatedly.

How is this possible? The answer is that the calorie-matched rats reduce their energy expenditure to a greater degree than those that are allowed free access to food. The most logical explanation for this behavior is that the "set point" of the energy homeostasis system has changed. The industrial diet causes the rodents' bodies to "want" to accumulate more fat, therefore they will accomplish that by any means necessary, whether it means eating more, or if that's not possible, expending less energy. This shows that a poor diet can, in principle, dysregulate the system that controls energy homeostasis.

Well, then why did Dr. Haub's diet allow him to lose weight? The body can only maintain body composition in the face of a calorie deficit up to a certain point. After that, it has no choice but to lower fat mass. It will do so reluctantly, at the same time increasing hunger, and reducing lean mass***, muscular strength and energy dedicated to tissue repair and immune function. However, I hope everyone can agree that a sufficient calorie deficit can lead to fat loss regardless of what kind of food is eaten. Dr. Haub's 800 calorie deficit qualifies. I think only a very small percentage of people are capable of maintaining that kind of calorie deficit for more than a few months, because it is mentally and physically difficult to fight against what the hypothalamus has decided is in your best interest.

My hypothesis is that, in many people, industrial food and an unnatural lifestyle lead to gradual fat gain by dysregulating the energy homeostasis system. This "breaks" the system that's designed to automatically keep our fat mass in the optimal range by regulating energy intake, energy expenditure and the relative partitioning of energy resources between lean and fat tissue. This system is not under our conscious control, and it has nothing to do with willpower.

I suspect that if you put a group of children on this junk food diet for many years, and compared them to a group of children on a healthy diet, the junk food group would end up fatter as adults. This would be true if neither group paid any attention to calories, and perhaps even if calorie intake were identical in the two groups (as in the rodent example). The result of Dr. Haub's experiment does not contradict that hypothesis.

So do calories matter? Yes, but in a healthy person, all the math is done automatically by the hypothalamus and energy balance requires no conscious effort. In 2010, many people have already accumulated excess fat mass. How that may be sustainably lost is another question entirely, and a more challenging one in my opinion. As they say, an ounce of prevention is worth a pound of cure. There are many possible strategies, with varying degrees of efficacy that depend highly on individual differences, but I think overall the question is still open. I discussed some of my thoughts in a recent series on body fat regulation (7, 8, 9, 10, 11).


* ob/ob and db/db mice. Zucker and Koletsky rats. Equivalent mutations in humans also result in obesity.

** Via an increase in muscular efficiency and perhaps a decrease in basal metabolism. Thyroid hormone activity drops.

*** Loss of muscle, bone and connective tissue can be compensated for by strength training during calorie restriction. Presumed loss of other non-adipose tissues (liver, kidney, brain, etc.) is probably not affected by strength training.

85 comments:

Tuck said...

Great post as usual. Thanks, Stephan.

Jeremy said...

Great post. It seems similar to Matt Stone's post this evening on thyroid / metabolism issues.

http://180degreehealth.blogspot.com/2010/11/janie-bowthorpe-fail.html

Aaron said...

All I have to say is that if someone throws this anecdote in my face as evidence that whole foods versus junk foods are a non-issue, I'll just claim they are invoking the twinkie defense (i.e., defending their justification for continuing to eat twinkies).

Hans Keer said...

Sounds a lot like Good Calories Bad Calories to me.

Poisonguy said...

A nutrition professor with 27 pounds to lose--who would have thought? ;-)

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douglis said...
This comment has been removed by the author.
douglis said...

I believe the most amazing thing in professor Haub's experiment wasn't the weight loss(it was expect with a 800 calories deficit) but the improvement of health indicators.
While 2/3 of his calories were from junk food his LDL dropped 20 percent, his HDL increased by 20 percent and he reduced the level of triglycerides by 39 percent.

Marc said...

Stephan,

Thank you once again for making the "complicated stuff" straightforward and easy to grasp for us non scientific types.

Once again forwarding to my sister ;-)

Thank you.
Marc

Garrett Smith NMD CSCS BS said...

He had an 800-Calorie deficit from his "normal" intake.

He was on 1800 Calories a day.

Ned Kock said...

I think an important part of this equation are modern habits that dramatically decrease nonexercise activity thermogenesis:

http://healthcorrelator.blogspot.com/2010/09/low-nonexercise-activity-thermogenesis.html

http://healthcorrelator.blogspot.com/2010/08/nonexercise-activities-like-fidgeting.html

One of them is furniture that is too comfy, used all day.

john said...
This comment has been removed by the author.
john said...

Hi Stephan,

I did some basic calculations, and things don't add up (according to the calories in/out idea), unless I made an error. He weighed 201 w/ 33.4% body fat (67 lbs of fat) and became 174 w/ 24.9% (43.5 lbs fat) for 23.5 lbs fat loss. This equates to about 94000 calories (82250 if using 3500 Cal per lb of fat). Either way, 800 Cal deficit for 60 days is only 48000.

john said...

So, unless he simply excreted about 10lbs of fat or underestimated his pre-diet calorie intake by about 600 or increased his metabolic rate with supplements (thyroid, clenbuterol, dinitrophenol), I don't really buy this.

Also, a 23.5 lbs fat loss out of a 27 lbs loss (from pure calorie reduction) is suspect in and of itself without anabolic supplementation as well.

rps said...

Douglis: LDL cholesterol is in packets of fat marked to go into storage; ie, to make you fatter. HDL is the opposite - it marks fat taken out of adipose tissue to be burned. Of course somebody in the process of losing weight would have low LDL and high HDL, as there's no new fat to store, and old fat is being burned. If he had stuck with the diet until he reached an equilibrium weight, the LDL would have gone up and the HDL would have gone down.

Anand Srivastava said...

He probably was eating much less than 1800kcal. He was not counting any calories, and just eating what he felt was enough.

The good points of his diet was that he was getting a protein shake, which probably provided him with just enough protein, and vegetables that provided him some minerals and vitamins. He was also supplementing with a multi-vitamin.

I guess that is what helped him lose so much of fat, and not much muscles.

So the result of the experiment is that a protein shake and some vegetables can somewhat balance the junk for some time.

Anand Srivastava said...

@rps.

Thanks for a wonderful insight. It makes a lot of sense.

So a good way to get good lipid profile is to take a 24 hour fast prior to getting blood sample taken. I have heard that advice somewhere.

rajganpath said...

Here is my analysis on this which answers most of the questions posted here.

Professor Mark Haub stopped by comment on the post too.

http://hbfser.wordpress.com/2010/11/08/the-prof-mark-haub-nonsense/

hbfser said...

@ anand...
your protein shake hypothesis isn't true.

I've addressed that and your other points in the comments section here...

http://hbfser.wordpress.com/2010/11/08/the-prof-mark-haub-nonsense/

Geoff said...

The only other point that I think would be relevant to this discussion that isn't mentioned in this article is that overeating fat, at least up to a certain point, doesn't cause weight gain. The body has methods of substantially upregulating it's energy expenditure given the right environment, i.e. high fat diet well above the homeostasis level. Dr. Eades talks about this in his addendum here: http://www.proteinpower.com/drmike/metabolic-advantage/thermodynamics-and-the-metabolic-advantage/

Simon said...

Right on Stephan. Understanding hypothalamic BW regulation is the key to the death of the thrifty gene hypothesis, which is not adequate to explain our recent epidemic of obesity, and, if we're wise, will cause us to look at the food toxin/quality and psychosocial issues that lead to the deregulation of our BF set point.

Elizabeth Walling said...

I think there's no lack of evidence that most diets work in the short-term. Losing weight on Twinkies is no big deal. Maintaining the weight loss (and current state of health) over the course of five years, well I'd bet that's a result Twinkies can't deliver.

Roy said...

"But of course, the situation is much more subtle in real life. Since a pound of body fat contains roughly 3,500 calories, eating an excess of 80 calories per day (1 piece of toast) should lead to a weight gain of 8 lbs of fat per year. Conversely, if you're distracted and forget to eat your toast, you should lose 8 lbs of fat per year, which would eventually be dangerous for a lean person."

Intellectual dishonesty FTW! You know that a larger body has a higher maintenance level, and equilibrium will be reached LONG before gaining or losing 8lbs.

You're also willfully ignoring spontaneous adjustments in NEAT, which often accompany increases or decreases in caloric intake.

Stephan said...

Hi Douglis,

Those improvements were likely the result of fat loss. I also think it's worth noting that changes in blood lipid levels do not necessarily imply a reduced cardiovascular risk.

Hi John,

Thanks for pointing that out. It doesn't quite add up.

Hi Roy,

Wake up on the wrong side of the bed this morning? A fatter body does have a higher caloric maintenance level, but how can that be, because fat is metabolically almost inert? The reason is that the leptin secreted by excess fat increases the metabolic rate of lean tissues. It's part of the feedback system, which is exactly my point. When you remove leptin from the picture, such as in leptin deficient animals, fat mass no longer contributes to the metabolic rate:

http://www.ncbi.nlm.nih.gov/pubmed/20413511

I didn't discuss NEAT because it's just another facet of the homeostasis system and does not require specific mention. NEAT is increased/decreased by hypothalamic circuits in response to excess/insufficient energy stores, as many other aspects of energy expenditure are.

Roy said...

" A fatter body does have a higher caloric maintenance level, but how can that be, because fat is metabolically almost inert?"

How about simple physics? It takes more energy to move a larger mass than it does a smaller one.

And your reliance on rat studies is laughable. In case you haven't noticed, you are not a rat.

Stephan said...

The excess energy required to move a few extra pounds of body fat is negligible unless the person is performing heavy exercise. If it takes 270 calories for a 180 lb person to walk for an hour, how many excess calories will it require if that person gains 10 lb of fat? I'll let you do the math.

OK Mr. Nihilist, you can ignore all science that has come from rodents if you want to. Meanwhile, I'll be siding with the large majority of the biological sciences research community who find that research informative.

Roy said...

"Useful" does not equate to "directly applicable to humans". Rodent and human metabolism is vastly different, and you cannot use one to draw conclusions about the other.

Stephan said...

As I noted in my post, most of this rodent research has been replicated in humans. For example, Rudy Leibel's research has shown that underfeeding activates the hypothalamic energy conservation system in humans in a leptin-dependent manner:

http://www.ncbi.nlm.nih.gov/pubmed/11994393

It has also been shown in humans that overfeeding causes an increase in energy expenditure that cannot be accounted for by the thermic effect of feeding or moving extra mass:

http://www.ncbi.nlm.nih.gov/pubmed/1414963

The only part of the post that hasn't been directly confirmed in humans is the idea that industrial food perturbs the energy homeostasis system over a long timescale, which is why I called it "my hypothesis" and not a fact. However, given the fact that it perturbs energy homeostasis in a variety of species including primates, I think it's a logical speculation.

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Steve Cooksey said...

I personally do not adhere to the theory that a 3500 calorie deficit = one pound weight loss.

One note, I see calculations with people using 2600 calories per day...as if that never changed.

As he lost weight/fat... obviously this number would decrease.

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Jenny said...

One wonders about the longer term effect of eating all that fructose, though. Short term diet results tell us very little. But if he was building more intracellular liver fat (which once stored is almost impossible to budge, contrary to what diet-book-millionaire docs would have you believe )he would end up with increased insulin resistance (caused by that intracellular liver fat) and would find himself gaining on the diet that would have maintained his new weight had he not created the insulin resistance.

Bottom Line: Someone remind the professor to update us about his weight in five years. My prediction (and I'm maintaining a 30 lb loss 8 years in) is that his weight will be up. Possibly way up.

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Joe said...

Great blog, I shared the reversing dental cavities with everyone I can, and practice the brown rice soaking method to assist in the absorption of nutrients, as brown rice is one of my staples.

Your theory on fat disregulation does seem to be backed up by the so called milk shake effect experiments, which show that chemical triggers for satiety are suspended with the intake of 'delicious'(sugar+fat+salt) food.

http://www.youtube.com/watch?v=A7M_mqXzpr8

The question you seem to pose is how to reverse this situation of 'milk shake effect' fat gain and irregularly high body fat setpoints.

In the context of leptin and the homeostatic effects of caloric deficits over the long term I believe the concept of the 'refeed', espoused by many excellent authors(and of course backed by the peer reviewed cited sources of those authors) seems to be key. Using the combination of a glycogen depleting heavy lifting session along with an 'at maintenance or above' carb loading day will assist in balancing leptin levels to prevent this negative feedback loop and allow for a stabilization of leptin. Which thus allows you to either maintain your lowered body fat percentage or continue to lose. Martin Berkham of leangains.com, of which you are familiar, seems to have applied this in practice. But it would seem the literature is not yet up to par on the scientific basis of it.

But the effects of leptin are known, and are almost completely accountable for the see-saw effect of dieting. And the only way to regulate leptin in the event of lower caloric intake is to refeed. It works for me, and I hope to continue to follow in the footsteps of Berkham in my maintenance of a lean body.

David said...

Interesting post. A few quibbles:

I imagine the whole-food eating rodents were not eating organ meats or soaking their grains...

In several articles I have read, Aubrey De Gray's diet is described as being comprised predominantly of junk food, such as snickers bars, and he is quite thin. I know some personal examples of people like this as well. Of course, they might be "exceptions" to the rule.

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kilton9 said...

And thus Roy faded back into the shadows. :-)

Kindke said...

I have a colleague at work who is of mayalsian ethinicity.

He is extremely lean and some may even say "ripped", even though he does not workout at all.

His diet is almost purely refined carbs, things like whitebread, noodles, rice, canned ready meals. He eats alot of bananna's too.

Hes in his late 20's aswell. One thing I would note however is that his diet is also quite low in fat but also low in protein.

I think this may be behind why Haub's diet made him loose alot of weight, low in fat AND protein.

Stancel said...

Kindke, his diet wasn't low in fat. Junk food snacks are high in sugar, but also high in fat.

blogblog said...

Stephan I simply can't accept that rodent dietary experiments are very relevant to humans. The fact that most rodent researchers think they are doesn't make it true.

Modern scientific research is more about getting published and getting funding than making truly meaningful discoveries. It is far better for a scientist's career to publish a lot of mediocre work than a few very high quality papers.

The real reason that rodents are used is because they are small, highly inbred, short-lived and virtually no one objects to them being experimented upon. The fact that they are such poor models is never seriously considered.

The only worse mammalian model of human dietary physiology than rodents would be ruminants.

Rats weigh 200g and only live 2-3 years. They are nocturnal and rely on hind-gut fermentation for their energy. The natural rat diet is only 2-5% fat - vastly lower than any real human diet.

If we feed rats a high fibre, low fat, low protein plant-based diet they thrive.

However dogs and cats fed a similar supposedly "healthy" low fat fibre-rich omnivore diet very rapidly develop obesity, diabetes, kidney disease, urinary tract infections IBS, eczema and depression. These are exactly the same diseases that humans develop on a similar diet.

So far from being useful rodent models have actually promoted a totally false model of the ideal human diet. Researchers have actually discovered what is a healthy diet for rats -grains, high fibre and low fat and then applied it humans.

If a far more realistic dietary model such as large dogs had been used unscientific ideas like dietary cholesterol and eating fruit and vegetables would never have developed.

blogblog said...

The Andean people seem to have Inuit-like physiques - short limbs and stocky torsos. This isn't surprising as they are fairly closely genetically related and both groups live in a cold climate.

Dr Karl Kruscelnicki, an Australian medical doctor and science journalist, gave a radio talk about about why modern westerners are so tall. It wasn't just nutrition. He said
that in the past most people had repeated infections which inhibit normal growth. This seems quite plausible.

Dutch men are now 18cm taller than in 1850 according to military records.

Ed said...

blogblog,

The natural rat diet is only 2-5% fat - vastly lower than any real human diet.

I can't comment on a rat's natural diet, but it is interesting what they will self-select in a lab.

http://www.ncbi.nlm.nih.gov/pubmed/14694219

Per Peter, the mice self-selected an 82% fat diet.

http://high-fat-nutrition.blogspot.com/2007/10/physiological-insulin-resistance.html

Also, I think Stephen will be the first to tell you some of the differences between mice and men, for example the fact that they produce phytase endogenously. So the digestion of a rat is pretty different from a human, as you note. However, they seem to have a pretty similar mechanism of metabolism. Liver, pancreas, hypothalamus, etc with their hormonal communication pathways seem awful similar to humans. Of course they can't "prove" anything about humans, but they provide an environment in which to perform small scale testing to generate or test hypotheses which you might then take to other animals, including humans.

blogblog said...

Hi Ed,

I'm a fan of the Hyperlipid blog but I know for a fact that wild rats don't eat chilli or cheese.

The natural diet of brown rats (which includes lab rats) is based largely on cereal grains.

Wild rats are notoriously hard to keep because they are extremely unwilling to try unfamiliar foods. This natural dietary caution has been bred out of domesticated rats.

Rats also learn what food is non-toxic by observing other rats. In this case the pet rat has seen other "rats" (people) eat certain food without getting sick. This informs the rat that the food is palatable.

Cattle on natural pastures derive around 98% of their energy from fatty acids and protein synthesised in the rumen. In fact it is very easy to induce ketosis dairy cows.

Wild mammals convert their food into fatty acids and amino acids which are then absorbed into the bloodstream. So even though a wild rat obtains 80% of it's calories from starches it is really on a Very Low Carbohydrate (borderline ketogenic) diet.

Raw starches found in uncooked grains have very little effect on blood glucose. They must be fermented in the colon.

"Guppy" Honaker said...

Hey Stephan:

I appreciate your insights and information to balance "experimenters" like this professor.

Mr. Mark Haub sounds like a fool, and I'm glad he never taught me nor my daughter in our university experience.

- David

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SD Scientist said...

Big logic gap right at the beginning: "And how do wild animals maintain a stable body fat percentage (except when preparing for hibernation)"

Guess what: they don't! Zookeepers have to go to great lengths to make sure that their zoo animals don't end up obese. An adult red junglefowl (wild chicken) weighs 1.5-3 pounds. Domesticated chickens will pass 6 pounds by the age of 6 months, provided ample supply of food. A polar bear or a tiger can eat and digest a meal that weighs 10-15% of its own body weight, and send all the excess calories into body fat.

Storing calories and raising body fat percentage whenever there's an excess of food has an evolutionary advantage to for any animal that experiences occasional food shortages it its life. That includes humans.

Roy said...

@Ed
"However, they seem to have a pretty similar mechanism of metabolism. Liver, pancreas, hypothalamus, etc with their hormonal communication pathways seem awful similar to humans."

Nothing could be further from the truth. De novo lipogenesis is very efficient in rodents - but not at all efficient in humans.

Anna said...

Zoo animals? yes, they are wild, but only just barely, as they aren't living in their natural state any more. They are us, just the other side of the protective barrier.

Steve said...

Logic gap? you wrote yourself WILD animals, then ZOO animals. Big difference. The is no comparison to animals in the wild roaming, hunting etc. to animals living in tiny enclosures eating only what we think they should eat.

How does putting on body fat at every possible opportunity help any hunting animal (or prey) that relies on power/speed to eat/survive. Certain groups of 'wild' humans are recorded to have had an excess of food, and yet none were overweight. As opposed to most domesticated, urban humans!

Stephan said...

Hi SD scientist,

Are you talking about zoo animals eating a wild diet? Or eating food that is not what they would eat in the wild. I'd appreciate it if you could provide some details and support your statement with evidence. It doesn't need to be a scientific paper, I'm just curious where you got that info and what the details are because it sounds rather anecdotal.

I think you know quite well that domesticated chickens are not a good example, as they have been selectively bred for extremely rapid weight gain. Still, the gain is mostly muscle rather than fat in any case. The average roasting chicken has the body fat percentage of a lean-ish human.

I know that under lab conditions, rodents presented with literally unlimited food will not eat themselves obese as long as the food quality is decent. If provided with industrial food they will rapidly eat themselves obese. There is some body fat variation between individuals that appears with age, along with modest fat gain on average, but obesity is rare even under conditions where they really aren't allowed to exercise at all. Rodents that are allowed to exercise age better.

I think in a zoo it would also be difficult to tease apart the effects of diet from those of psychological stress, inactivity, etc. I think exercise probably helps prevent fat gain, not so much by burning calories but by maintaining the health of the neurocircuitry that regulates energy balance.

SD Scientist said...

http://www.tigerlink.org/husbandry/husman4.htm "obesity due to lack of activity in captivity is a major problem for zoo carnivores, including tigers.". http://www.2ndchance.info/bigcatdiet.htm "Feeding as much as the cat will eat leads to obesity." Also google obesity in zoo gorillas. The best way to prevent obesity in gorillas is to feed them diet with an extremely low caloric density (greens, vegetables such as cabbage, etc.) Given our caloric requirements, our choice is to eat 10 kg of vegetables per day or to find some other way to deal with the problem.

I don't think that rodents are a particularly good example. Rodents are animals of prey. For them, staying lean may be an evolutionary advantage. For primates (as for carnivores such as tigers), there's an evolutionary advantage to be able to survive without food for extended periods of time. In other words, to store body fat whenever an opportunity presents itself. Besides, as someone mentioned in comments already, there are significant differences between humans and many animals in the way we digest starches. We have lots of amylase, which starts breaking down starches into glucose in the mouth and finishes the job in the stomach. Most animals have to pass starches to their gut flora, which converts them into fatty acids. Big difference.

The way I see it, energy homeostasis is certainly there, but it's increasingly asymmetric in response as you move away from the equilibrium. Shortage of energy beyond a certain level presents itself as constant physical pain and craving for food (hunger), but there's no matching reflex that would make you averse to food when your body is in the process of building new fat cells, not once the blood glucose level falls somewhat from its after-meal levels. And then there's a problem of response time. Gorillas stay lean on the vegetable diet because their homeostatic mechanisms have ample time to react. If you're going to eat anything more calorie-dense (say, bananas), you can accidentally overeat a couple hundred calories per meal, and your body will store the excess. And even 200 calories per meal can add up to obesity in a very short time.

David said...

If you don't think "wild" humans can be fat take a look at the Waura:

http://www.greenpeace.org/brasil/ReSizes/OriginalWatermarked/Global/brasil/image/2009/11/kamirra-waura-l-der-das-mulhe.jpg

SD Scientist said...
This comment has been removed by the author.
SD Scientist said...

"How does putting on body fat at every possible opportunity help any hunting animal (or prey) that relies on power/speed to eat/survive. Certain groups of 'wild' humans are recorded to have had an excess of food, and yet none were overweight. As opposed to most domesticated, urban humans! "

An overweight carnivore will have a chance to get back to healthy weight before he dies of starvation. An underweight carnivore will just die. Polar bears, for example, have seals as their primary source of nutrition. Seals are notoriously hard to catch and kill. A polar bear may have to go hungry for months after killing a seal. If he does not store as much body fat as he can after each kill, he's at the increased risk of dying.


It is very unlikely for 'wild' humans or any non-prey animals to have an excess of food for extended periods of time. Population dynamics 101 a.k.a. malthusian equilibrium. In the equilibrium state, we have a bit of a paradox: animals are trying their best to put on body fat, but, because of the limited supply of food, on average, they are borderline underweight. The lucky ones survive and procreate, the unlucky ones die of starvation, malnutrition, or diseases. As far as I know, we modern humans are unique because we went through the agricultural revolution and the demographic transition. And by "modern" I mean the last 100 years or so (the last famine with significant mortality in Europe that was not caused by a war dates to 1866-1868). It took some time for food production to get ahead of population growth, from the point where poor harvest could wipe 10-20% of population, to the point where every person has unlimited access to food any time of day and night ... surprise surprise, instead of a hunger problem, we now have an obesity problem.

If you have counterexamples, let's take a look at them.

blogblog said...

SD Scientist I agree totally:

The argument that wild animals don't get fat is technically true. However this is because they tend to store excess calories as muscle rather than fat. So what you often get are very overweight animals with low bodyfat levels.

Big cats in zoos will literally do nothing except eat and sleep if allowed to ad lib feed - even on a meat based diet. They will quickly get very overweight.

Gauguin's paintings of Tahitian women show that they are all quite fat - even the teenagers. In Gauguin's time the Tahitians were still living a traditional lifestyle.

The explorer John Hanning Speke mentioned the extraordinary obesity of some of the African women he encountered in the 1850s.

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Todd Hargrove said...

I can give you an example of at least one predator that stays lean in an what appears to be an ad libitum situation. I visited the Everglades last year. Some of the crocs are our size but only need to eat about one fish or bird a week. They nap all day within easy reach of a smorgasbord of birds and fish. They are lean, and would appear to have some sort of feedback mechanism to preserve leanness. Surely there are many other examples of predators who rely on more than Malthusian balance to stay lean.

Anand Srivastava said...

@SD Scientist

I think you should look into what they feed zoo animals.
Do they feed organs to lions. Not really. They just feed them muscle meet. Lions and other carnivores don't get that fat easily, as the diet is not that far removed from their wild diet.

But look at the herbivores. Do you think that they feed them grass all the time. Not really they feed them the same kind of junk that we feed them in farms. High grains. In India they even feed them bread!!!

Stephan said...

Hi SD scientist,

Let me begin by qualifying my previous statement about obesity in wild animals. I acknowledge that I came off as a bit categorical. There are probably exceptions out there. However, most animals including humans most certainly do regulate energy balance in the positive (i.e. anti-obesity) direction.

You said "there's no matching reflex that would make you averse to food when your body is in the process of building new fat cells." For one thing, in adults fat is generally stored by enlarging existing fat cells. For another, this reflex most certainly does exist because it's what I study in the lab. I will acknowledge that the regulation seems stronger in the negative then the positive direction, however it's present in both directions.

I encourage you to look up human overfeeding studies, of which there have been several. I discussed one in my post "the body fat setpoint". Overfeeding beyond caloric need/desire causes fat gain, but it's miserable because the body decreases hunger to the point of nausea. Then as soon as the overfeeding stops, subjects will practically not eat anything for days until fat has decreased. You see the same thing in rodents, unless they are leptin deficient in which case they don't show that anorexic response to overfeeding.

Your example of the gorilla is perfectly consistent with my point. When you feed it a low calorie plant food diet such as it eats in nature, it will not become obese. What else should a gorilla eat, hamburgers and fries?

You said "If you're going to eat anything more calorie-dense (say, bananas), you can accidentally overeat a couple hundred calories per meal, and your body will store the excess. And even 200 calories per meal can add up to obesity in a very short time." Yes, that's precisely why energy balance is biologically regulated. Being obese is not adaptive, which is why you typically only see it in hibernators.

The fact that you can find obese non-Western individuals does not weaken the argument in my opinion. Pacific islanders in general culturally value obesity, and they deliberately overfed their chiefs as representatives of their societies so that other islands would see how well-fed they were. In parts of Africa, cultures deliberately overfeed women to make them fat because that's valued by men. Isolated examples like that are not very convincing, because the fact is traditional cultures were clearly leaner than we are today.

On the island of Kitava, Dr. Staffan Lindeberg remarked that there was only a single overweight person among thousands. That was an individual who had left the island to work in a city. Kitava has a perpetual food surplus. Lindeberg noted that a significant portion of cultivated food rotted on the ground because it wasn't eaten. The people there rarely experienced food shortage. This is all published in the scientific literature.

Stephan said...

Hi David,

You linked to a photo of people in a culture called the Waura that I'm not familiar with. First of all, they are not obese and I'm not even sure they'd be classified as overweight. Second, do you know what those people eat? Are they eating a traditional diet or have industrial foods replaced a part of their diet as in nearly all rural cultures today?

I'm not claiming that all traditionally-living humans are super lean and ripped. You can find individuals that are modestly overweight in some traditional cultures, and I think that can be compatible with health. What is rare however is obesity.

Hi blogblog:

You said "The argument that wild animals don't get fat is technically true. However this is because they tend to store excess calories as muscle rather than fat."

Say what?? Muscle would be a very inefficient way to store energy.

blogblog said...

"Say what?? Muscle would be a very inefficient way to store energy."

When you have an unlimited food supply efficiency of storage is irrelevant. Muscle is far more useful than fat because it also provides a protein store and increases strength and power. A 200kg lion with 1% body fat will be far stronger and faster than a 200kg lion with 20% body fat.

I suggest you visit farm where cattle graze on high quality pastures. The cows eat all day and gain a considerable amount of weight. Huge efforts have been made to breed cattle that actually deposit fat ain addition to muscle. The only effective way to increase fat in cattle is to place them in a feedlot where they are fed refined carbohydrates and are unable to exercise.

"On the island of Kitava, Dr. Staffan Lindeberg remarked that there was only a single overweight person among thousands."

Lindeberg's work on Kitiva seems to have been completely ignored by the medical community - I didn't notice any citations on Medline. You would think that other researchers would be eager to study these miraculous disease free people. Perhaps other researchers simply don't consider Lindeberg's Kitiva studies to be of high quality.

A study where you have no birth or death records, no post mortems, no death certificates and no comprehensive clinical histories of patients is close to anecdotal evidence. The Kitivans have never undergone any detailed medical examinations in a modern clinical setting. A resting ECG is practically worthless.

Uffe Ravnskov has stated that the only way of determining the cause of death death is a proper post mortem by a trained pathologist accompanied by full clinical notes. Lindeberg is relying on hearsay from relatives.

The exceptionally small physiques of the Kitivans tell us that something unusual is going on - a shortage of essential amino acids is very likely.

There is nothing surprising about Kitivans leaving food to rot. The traditional Melanesian/Polynesian sweet potato diet is widely considered to be exceptionally bland and boring. Sweet potatoes are considered a poor quality but reliable survival food in many parts of the Pacific. In the New Guinea highlands villagers prefer to feed their sweet potatoes to pigs.

blogblog said...

"You linked to a photo of people in a culture called the Waura that I'm not familiar with. First of all, they are not obese and I'm not even sure they'd be classified as overweight."

I don't know what they eat but the Waura in the photograph obviously have high body fat levels. I'd say an absolute minimum of 20% in the males and 30% in the females.

blogblog said...

"I think you should look into what they feed zoo animals.
Do they feed organs to lions. Not really. They just feed them muscle meet. Lions and other carnivores don't get that fat easily, as the diet is not that far removed from their wild diet."

Most zoos do feed their lions organ meats and bones. Some zoos even feed lions entire freshly killed animals such as chickens or young goats.

Medjoub said...

Blogblog,

I find it interesting (read: dubious) that you are comfortable citing a Gauguin as backing for your arguments, while decrying Lindeberg's observations as untenable.

And -- speculations about bodyfat percentage at a glance? --estimations of health based on stature without actual analysis?

Rigor and consistency, sir (or ma'am).

Stephan said...

Hi blogblog,

Now you're just making things up. Lindeberg published most of his Kitava papers in respected peer-reviewed journals such as the Journal of Internal Medicine and the journal Metabolism. You can bet his methods were carefully scrutinized.

His first paper has been cited 67 times in the scientific literature.

karl said...

I saw the article and have traded email with the author. I would make the following predictions.

His triglycerides are elevated compared to a low-carb diet of equal calories.

His oxLDL is elevated ( I'm not convinced that LDL is a useful indicator other than it tends to correlate with oxLDL).

I would also predict that he gains back the weight he lost.

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blogblog said...

"Now you're just making things up. Lindeberg published most of his Kitava papers in respected peer-reviewed journals such as the Journal of Internal Medicine and the journal Metabolism. You can bet his methods were carefully scrutinized.

His first paper has been cited 67 times in the scientific literature."

I'm not denying that some of Lindebergs papers have received many citations. However his actual published studies of Kitivans have largely been ignored.

I would go so far as to suggest that Lindeberg and Cordain appear to members of a small self-referencing mutual admiration club.

According to Medline

1)
Scand J Clin Lab Invest. 2003;63(3):175-80.
Determinants of serum triglycerides and high-density lipoprotein cholesterol in traditional Trobriand Islanders: the Kitava Study.

Lindeberg S, Ahrén B, Nilsson A, Cordain L, Nilsson-Ehle P, Vessby B.

1 citation


2) J Intern Med. 2001 Jun;249(6):553-8.
Large differences in serum leptin levels between nonwesternized and westernized populations: the Kitava study.

Lindeberg S, Söderberg S, Ahrén B, Olsson T.

2 citations


3) J Intern Med. 2004 Mar;255(3):373-8.
Serum uric acid in traditional Pacific Islanders and in Swedes.

Lindeberg S, Cordain L, Råstam L, Ahrén B.

2 citations


J Intern Med. 1994 Sep;236(3):331-40.
Cardiovascular risk factors in a Melanesian population apparently free from stroke and ischaemic heart disease: the Kitava study.

Lindeberg S, Nilsson-Ehle P, Terént A, Vessby B, Scherstén B.

4 citations


Am J Clin Nutr. 1997 Oct;66(4):845-52.
Age relations of cardiovascular risk factors in a traditional Melanesian society: the Kitava Study.

Lindeberg S, Berntorp E, Nilsson-Ehle P, Terént A, Vessby B.

2 citations


Metabolism. 1999 Oct;48(10):1216-9.
Low serum insulin in traditional Pacific Islanders--the Kitava Study.

Lindeberg S, Eliasson M, Lindahl B, Ahrén B.

4 citations

Stephan said...

Hi blogblog,

You are way off base. Being in a "small self-referencing mutual admiration club" does not get you published in good peer-reviewed journals. Would you mind explaining how he got his papers published in the Journal of Internal Medicine and the journal Metabolism if his data are as poor as you claim and his peers don't respect him? Have you actually read his papers or are you talking out of thin air?

The numbers of citations you listed for his papers are way low; have a look on Google scholar. As I said, his first paper has been cited 67 times. Sorry but that qualifies as well cited.

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Dana Seilhan said...

Twinkie Dude has his data posted on his Facebook page. I looked at his body composition results. He did lose lean mass during the two and a half months of his diet. He had a fat loss of 8 percent in the same time period--and I looked up the relevant bodyfat percentage charts, and he's just a hair this side of obese going by bodyfat percentage, age, activity level and gender.

His labs are also just a little bit off. HDL's in normal range but on the low end. Total cholesterol under 200 which only delights a conventional physician, and only if he's turned off his brain and not read any recent non-industry-funded research on the subject. Fasting glucose was 74, kind of low. No number for triglycerides. It would have been useful for him to record a few postprandial sugars and maybe his HgA1C but he did neither.

On top of that he supplemented with a multivitamin and protein shakes. And he ate vegetables.

The mainstream are all going "wow, it IS the calories" but not looking at his overall health picture. I thought the goal in weight loss was fat loss, not losing bone and muscle as well. I wish he'd done a bone density scan before and after, then we'd really have reason to be scared.

Catman said...

Fantastic post, and issues well dealt with.

The question I always return to, is that of why the incidence of obesity has increased so greatly in the last 30 years ?

Have our hypothalmuses changed ? Obviously not. In the unlikely event that natural selection came into play, we would be getting slimmer.

My view is that marketing has become expert in overriding our instincts, along with social attitudes and the low cost of food.

These things all have to do with conscious efforts of will. Nobody wants to admit to being weak-willed, so have come up with any number of excuses, such as the calorific content of food, metabolism etc. The good professor has pretty conclusively removed these excuses.

"Do you want to go large on that ?"

owenmunger said...

Great post, thanks for the information! I seriously doubt that this experiment would work for everyone and I don't recommend trying. Instead, I think the diet worked because he was burning more calories than he was consuming in a day. He probably kept a food journal to record how many calories he had eaten that day, to see how long he needed to exercise.

Jeff_in_Montreal said...

@stephan, @blogblgo, @SD Scientist:
Stephan, i read your blog regularly and have to say how much I appreciate the quality of the posts - very well written, well researched and well nuanced. I really appreciate how you make an effort not to overstate your case, and to consistently underline the limitations of the data. I also appreciate your effort in responding to comments.
@blogblog, @SD Scientist - I really appreciate some of your points, and i think healthy scepticism and dialogue are very well appreciated. On the other hand, both of you have been using an unjustifiably and unnecessary aggressive tone, and casting aspersions rather than contributing ideas. Let's stick to constructive dialogue. Whether or not Lindeberg has been cited, what is your beef with his METHODS AND CONCLUSIONS?

Jacob Aziza said...

Really good article overall.
Important points, well simplified.

One problem though:
http://www.themedguru.com/20101107/newsfeature/overweight-kids-eat-healthy-food-study-86141584.html

Healthy bodyfat kids eat at least as much junk food as overweight kids, and overweight kids eat at least as much vegetables, (at least in the sample this study looked at)

So, not only is it more complicated than just "calories in / calories out", it is also more complicated than "processed foods = fat, whole foods = healthy.

Stephan said...

Hi Jacob,

Yes, that doesn't surprise me. When you put a population on a poor diet, only some of them will develop obesity, some will develop hypertension, some will develop diabetes. Most will get sick in some way, but not all. There's definitely a component of individual susceptibility.

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Anthony said...

Great post.

Reminds me of the guy that ate a Big Mac every day for 40 years and counting. (http://en.wikipedia.org/wiki/Don_Gorske)

More interestingly - a famous figure who eats a "child-like" diet of Cheeseburger and Cherry Soda constantly is Warren Buffet. Maybe not lean but does not look obese by any standard.

The Buffet example, anecdotally, fits into Food Reward - Buffet is well known, by his own account, and by behavioural and financial track record, to not be susceptible to the 'normal' addictive/compusive/gambling behaviour as the 99.999% of other investors.. Hence his "edge" in investing and his fortune. It could be that this same psychological/genetic predisposition is what allows him to consume Rewarding food, but yet not get carried away with it.