Wednesday, September 12, 2012

Nutrition Science Initiative (NuSI)

Some of you may have heard of an ambitious new nutrition research foundation called the Nutrition Science Initiative (NuSI).  In this post, I'll explain what it is, why it matters, and how I feel about it-- from the perspective of an obesity researcher. 

What is NuSI?

NuSI is a nonprofit organization whose stated goal is to "facilitate and fund experimental research in nutrition with the goal of reducing the economic and social burden of obesity and obesity-related diseases."  In other words, its goal is to understand obesity more thoroughly so it can be prevented and reversed more effectively.  NuSI was founded by Dr. Peter Attia and Gary Taubes, and is funded by the Laura and John Arnold foundation and other sources.  Dr. Attia is primarily responsible for running the organization, and he's also the author of the blog The Eating Academy

NuSI is attempting two main things at this point: 1) bring together top scientists; 2) give them the funding to do ambitious research that has never been done before, or test questions more rigorously than they have been tested previously.  I can attest to the fact that they're accomplishing goal #1.  Dr. Attia has told me who they've involved at this point, and it includes some of the top scientists in obesity research-- people who I strongly support.  Whether goal #2 happens remains to be seen, but if everything goes according to plan, NuSI may end up being a major new funding mechanism for obesity research.  Apparently, the potential for funding is significant enough that NuSI has been able to draw the attention of certain senior researchers.

Why I Support NuSI

Dr. Attia and Taubes have asked for my support on this project.  As everyone reading this knows, I've had high-profile disagreements with Taubes.  Dr. Attia and I have had a few positive exchanges, and although I don't know him well, he strikes me as a reasonable and constructive person.  Both of them are proponents of the low-carbohydrate diet, and they have both had personal successes with this eating style.  Dr. Attia also has clinical experience with diet, including but not limited to low-carbohydrate diets.

NuSI is proposing major funding for some very ambitious experiments that have never been conducted before.  I'll let Dr. Attia give more details on this, but suffice it to say that the project could be very exciting if it materializes as planned.  

So the question arises, should I support an organization that's run in part by a person whose approach to scientific inquiry I disagree with?  It would be remiss of me not to question the wisdom of putting a major science funding mechanism into the hands of a journalist who is, shall we say, very attached to his ideas.  To put my conscience to rest, I contacted Dr. Kevin Hall, an obesity researcher who is acting as lead scientist on this initiative.  He explained to me that NuSI will have no control over research design, conduct, or reporting, and in fact he's contractually obligated to the National Institutes of Health not to allow NuSI to have any control over these things.  So although NuSI will get to choose what experiments it funds, it has no control over what happens after that, and so its potential to compromise research integrity seems low.

I may not always agree with NuSI's funding priorities (although I suspect I often will), but the bottom line is that it will increase funding for top scientists in a tough economic/political climate, potentially make experiments possible that were formerly inaccessible due to excessive cost, and add to human knowledge about diet and health.  That's why I support it.

My Concerns about NuSI

NuSI was organized ostensibly with the goal of promoting high-quality, objective scientific research.  However, reading the information on the website and press releases, it's obvious that the organization has strong preconceived notions about diet and obesity. 

The language of the website suggests an attitude that rejects currently existing nutrition research as invalid.  I've seen this attitude before, and it's typically an effort to discredit contradictory evidence so it doesn't have to be incorporated into one's worldview.  Here are some examples of this:
If people had the correct information- based on rigorously produced scientific evidence- about which foods predisposed them to obesity and its related diseases, most would make the correct choices and lead happier and healthier lives.
Poorly controlled experiments are considered sufficient basis on which to form dietary recommendations on the belief that they are the best science can offer, not because they are inherently rigorous enough to establish reliable knowledge.
There is more than a grain of truth to this, but the reality is that we already know a lot about how to prevent obesity and type 2 diabetes, and a fair amount about how to combat existing obesity.  Much of this knowledge comes from well controlled experiments in humans and animals spanning decades of research.  The average person doesn't eat donuts and pizza, drink sweetened beverages, and sit in front of the TV for hours a day because she thinks they're going to promote a leaner, healthier life.  There are certainly gaps in our knowledge.  But the main reason we have an obesity epidemic isn't that we lack the right information, it's that most people don't apply the information we already have!  This doesn't apply to all individuals, but at a population level it does apply.

The NuSI website goes on to attribute the obesity epidemic to the US government dietary recommendations since 1977, when Americans were advised to reduce fat intake and replace it with unrefined carbohydrate (the fact that the recommendation was for unrefined carbohydrate is not mentioned).  This is inappropriate for an organization whose stated goal is to objectively support research on what causes obesity-- they should be keeping their personal opinions to themselves.  The way the website is written, it sounds like they already have their minds made up about what causes obesity, and they're simply looking to drum up confirmatory evidence. 

The press release states that "despite following current dietary recommendations- for example, reducing fat intake- Americans are getting more and more obese".  Then comes the familiar graph of macronutrient changes over the last 40 years showing a decline in the percent energy from fat, and an increase in the percent energy from carbohydrate.  Yet what escapes mention is that the only reason the percentage of fat went down is that total carbohydrate (and calorie) intake went up.  The absolute, total amount of fat intake in grams stayed the same or increased over that time period (depending on the data source-- USDA food disappearance or NHANES surveys).  Does that count as "reducing fat intake"?  Below is a graph of macronutrient intake in the US between 1970 and 2006, expressed as calories not percentages, from USDA data adjusted for loss.  You be the judge.


If we go back to 1909, a time when obesity was less common than in 2012 or even 1970, the US diet was 57 percent carbohydrate, as opposed to 49 percent today.  Total carbohydrate intake in grams was also higher than today, and most of it came from white flour (1).  Why would carbohydrate cause an obesity epidemic today when it didn't 100 years ago, and it continues not to cause obesity in numerous high-carbohydrate cultures throughout the world?

The reality is that the USDA dietary guidelines since 1977 didn't tell Americans to:
  • Increase our intake of sweetened soda by 41 percent
  • Replace fresh potatoes with french fries and potato chips
  • Increase added sugars by 16 percent
  • Increase our intake of refined instead of unrefined carbohydrate
  • Nearly double spending on fast food
  • Eat more than twice as many snacks
  • Increase total calorie intake by 20 percent
Are the USDA dietary guidelines perfect?  In my opinion, no.  Did they cause the obesity epidemic?  Absolutely not.  If everyone in this country ate strictly according to the USDA dietary guidelines, including the recommendation to favor unprocessed foods and avoid sweetened beverages, as a population we'd be leaner and healthier than we are right now. 

For these reasons among others, the materials released by NuSI do not scream "objectivity", which is troubling considering the organization's stated goals.  However, keep in mind that NuSI is a funding mechanism and will not have control over how research is conducted or reported in scientific journals.

The Bottom Line

I support NuSI, despite its flaws. It's hard to predict the long-term effects of something like this, but I think it has more potential to do good than to do harm.  I wish it well and I'm happy to help if help is requested.

96 comments:

Gites Dordogne said...

Very informative post. Thanks for taking the time to share your view with us.

Regards,
Yan Katsnelson

George Henderson said...

The obesity epidemic wasn't caused by strict adherence to the guidelines.
This doesn't mean that the guidelines had no influence.
And the guidelines certainly did not bring about the intended improvement in health.
There is surely a reason why junk food lobbyists approved the guidelines and continue to fund other bodies that promote similar ideas.

Tam said...

It's not actually possible to know whether the guidelines improved health relative to having no guidelines.

Most people have an idea about how they should be eating that really is better than how they do eat, but it seems nearly impossible for many of us to completely control our eating in this environment. I feel like one of the advantages of "paleo" is that it brings with it a strong philosophy of eating that makes it easier to adhere to, while of course being healthier than fast food and foods that come in boxes and so on.

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Roger Butler said...

Surely the point of this enterprise (NuSI) is that it may well lead to the settling of the argument between you and Taubes, either one way or another, or, just perhaps, to show that you are both partly right but there is something more not yet discovered.
For my part, I struggled with ever-increasing weight and an ever expanding waistline for about 35 years. I really tried to follow government advice (I’m English but the UK guidelines are pretty much the same as those in the US) but when I tried to cut calories I always found myself ravenously hungry and light-headed to the extent that I couldn’t drive a car safely or function at work. Then I picked-up a copy of Gary Taubes book about three years ago and on the basis of it began to cut carbohydrates in a half-hearted way and managed to lose a few pounds. Then after Christmas 2011 I decided to go the whole way with the low carb thing. I was then 262 lbs, today, about 84 weeks later, I am just over 220 lbs, so just over 40 lbs lost and probably ideally as much still to go. But here’s the thing: I have never been a calorie counter but I know what I used to eat and it amounted to between 4,000 and 4,500 calories a day, for the last 21 months or so it has been between 1,800 and 2,500 calories a day, so a daily difference of between 1,500 and 2,200 calories - on average 1,850 calories a day for 84 weeks. But let’s be conservative about this and assume the lower figure, 1,500, has been my average daily deficit over the period. And then let me be honest that I pretty much give up low carb eating over the month around Christmas, and for a week each Easter, and another week during my summer holiday, 7 weeks, lets round it up to 10. So 74 weeks, 518 days, of eating a diet 1,500 calories short of a diet that was maintaining my weight at 262 lbs. If a pound is roughly equivalent to 3,500 calories and weight loss is purely a matter of calories in versus calories out then I should have lost at least 222 lbs by now, rather than the measly 40 lbs I have lost .(518 x 1,500 /3,500). How does your understanding of what causes obesity and weight loss account for that? And how does your theory of weight loss help people like me to cope with the food cravings, the dizziness and other disabling features of straight calorie cutting. How do people like me do something practical with a theory that says it is actually all about leptin? And by the way I am now doing at least twice the amount of exercise I was doing before going low-carb so you cannot claim I have slowed my weight loss by becoming more sedentary.
Roger Butler

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thehealthhammer said...

Roger,
Metabolic rate isn't a passive thing, it's significantly affected by alterations in food intake. Losing weight commonly causes a marked reduction in the amount of calories you burn, which could very likely explain your situation. Perhaps Stephan will supply you greater insight into this particular quandary.

Ben said...

Interesting piece, and its admirable that you support the organization and highlight its potential despite its having some drawbacks, and Taubes' personal involvement.

Robert said...

thanks

German Kessler said...

i think that an organism as NuSI is very important these days, because we are dealing with more processed food and genetically engineered food. different studies have shown that diet composition is important and that it influences out weight and health.

Jane said...

Stephan, if this venture doesn't even recognise the difference between refined and unrefined carbs, I think you are very unwise to give it your blessing. The experiments will be designed to show all carbs are bad, and that's what they will show, to those who want it to be true. Then Taubes will say Guyenet agrees with me now.

But I don't see how you can refuse to give it your blessing. You are screwed whatever you do.

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Gretchen said...

Stephan, Congrats on supporting a group run by people you don't agree with. Good science is about having an open mind.

I think the reason for NuSci is that people wanting to do LC research can't get funding, except by Atkins, which makes people suspect the validity of results as there are Atkins products on the market. I would hope we don't see NuSci snack bars and drinks at the grocery store.

The playing field is currently not level. This is an attempt to level it. I would hope that they don't support research that is designed to produce a given result. That's not science. That's politics.

Gretchen said...

"Below is a graph of macronutrient intake in the US between 1970 and 2006, expressed as calories not percentages, from USDA data adjusted for loss. You be the judge."

Between 1980 and about 1998, calories increased and carbs increased, while fat remained constant. So who knows whether it was calories or carbs that were increasing weight during this period.

The question is *why* did carbs increase so much? Is it not possible that being told by Food Pyramid to eat mainly carbs made people think that carbs were "good" so they ate more of them, and more carbs without more fat raised blood sugar levels and then made them crash, causing hunger, which made them eat more carbs?

I think unless you've experienced the ravenous hunger caused *in some people* by low-fat diets it's hard to understand it.

Also, I don't think govt told people to eat more processed carbs. They just said more carbs, and consumers just ate more of the sugars and white flour they enjoyed.

Very few consumers calculate nutrient percentages when they eat. They hear that some food is good or bad and try to eat more or less of it. The food industry knows how to capitalize on this, with "heart healthy" snack bars and the like. The same is true of LC foods.

philippa said...

Further to what Gretchen wrote, I think the public has largely been taken for a ride when it comes to labelling of wholegrain products.

Take bread for example. Most people who buy grocery store wholewheat bread honestly believe this is a better nutritional choice than white bread and in line with the USDA's recommendations. Yet the amount of refined carbohydrate in it is so high that grocery store w/w bread is only marginally less refined than white.

Galina L. said...


"Are the USDA dietary guidelines perfect? ... Did they cause the obesity epidemic?"

The guidelines do little to curb the obesity epidemic, and the current obesity research has not find a really good and working solution yet.

The more research the better. I hope LC diets will be an acceptable medical approach in a future for different conditions. Right now people who may benefit from such diets are denied the option in medical facilities, period. It is unfair, and I hope in a future the research will make the diet field more leveled for the patients benefits.

Dan said...

I would like to echo Gretchen's observation. I think the typical "health" advice to restrict calories, eat primarily carbohydrates, and reduce cholesterol results in unhealthy eating.

Taubes didn't really say anything new and he said so in his book; he resurrected some ideas that were running counter to the official health advice and that's a pretty good thing. Of course he's attached to his pet hypothesis; so are you to food reward, which honestly is a fairly vague hypothesis. At least Taubes' hypothesis can be proven to be not universally valid.

If you have any influence on the structure of NuSI, I hope that you help shape it in a way such that proposed experiments remain scientific.

Todd said...

Great post, thanks for sharing your thoughts.

I do have to disagree with one comment however. You state, "But the main reason we have an obesity epidemic isn't that we lack the right information, it's that most people don't apply the information we already have!"

It may be obvious to you and me that certain foods and lifestyle choices promote obesity and metabolic derangement. However, when I talk to friends that are not particularly interested in the subject and who get their nutrition information primarily from blurbs in the media, a common refrain is, "well, there is a study that demonizes everything, so I can't win." Overwhelmed and mentally defeated, they just eat what they want because they feel that with no clear answers any "diet" will just be a temporary exercise in futility.

Maybe they do have the information buried in their brains, but they have no way of separating the good info from the bad. Ask the average person what is the better food choice, a 100 calorie, low-fat snack pack or 4 oz. of beef liver (with 400 mg of cholesterol!!!). I would not be surprised to find out most folks would say the snack pack is a healthier choice. As long as the conventional wisdom pushes more grains and low-fat food, it will be near impossible for the average public to embrace a whole foods diet that includes healthy animal products.

bentleyj74 said...

That's a misleading comparison though because people don't generally like liver. If you asked them whether the 100 calorie packet of cookies or 100 cals of carrots was healthier they'd be able to make the judgement call no problem. They want the cookies. They want the cookies with less feelings of guilt.

Todd said...

It's not a misleading comparison because I'm not looking to compare snack packs to veggies. Conventional wisdom has not demonized carrots. I'm looking to compare snack packs to an animal product.

In addition, I'm not asking them to tell me what they would rather eat, I'm asking them to tell me what is more nutritious.

How about asking them what is more nutritious, low fat snack pack or bacon? Bacon is more nutritious but people fear saturated fat more than processed sugar and flour so they make poor choices.

This indicates to me that the general public, in fact, does not have all the right information. They have some of it, e.g., carrots are good. But they don't have enough of it. And what they have wrong (e.g., cholesterol and saturated fat is always bad) is enough to significantly alter their diet in a negative way.

Sanjeev said...

> people wanting to do LC research can't get funding
_______
I've not read this from anyone actively applying for research funds.

Chris Gardner mentioned that he wasn't interested AND he thought (not that he knew, he thought) he might not be able to get funding because there was not enough public interest to generate a good proposal.

So note the complaint was that the researcher was not interested in researching a fad diet, and he THOUGHT the funding agencies would not be interested, not that the funding sources are factually known to be biased against low carb.

Sanjeev said...

but the funds somehow did magically turn up.

Somehow the "can't get funding" became "the cheques cleared, easily & promptly"

Sanjeev said...

> if this venture doesn't even recognise the difference between
______
much worse than this is Taubes' proven predilection to rescuing his pet guess using any means necessary.

I can foresee NOTHING that will satisfy Taubes. He completely dismissed ASP as a fat storage hormone because insulin still exists in the body while ASP is working.

Well HELLOoooooo ... who is Taubes going to test his diet on if the only thing that will satisfy him is zero insulin? Do even cremated corpses of non-diabetics possess zero insulin?

Sanjeev said...

Roger Butler, Whoever you're arguing against ain't here.

Stephan does NOT claim

"it's all about Leptin"

Stephan does NOT claim

"3500 calorie deficit means you lose a
pound of fat"

Stephan does NOT claim

"low carbohydrate diet do not work"

Justin said...

"So although NuSI will get to choose what experiments it funds, it has no control over what happens after that, and so its potential to compromise research integrity seems low."

And if you believe that, I have a bridge to sell you. Researchers know who butters their bread (oils their vegetables?). You think scientists who promote reward, or low-fat, or anything other than Paleo/low-carb are going to get NuSi grants?

bentleyj74 said...

edPreso 20@ Todd, you are clearly comparing cookies to what would be considered by most an undesirable meal regardless of whether it was nutritious or not. But ok I'll play ball. Ask them whether cookies are healthier than yogurt :) That's an animal product is it not? I bet you a shiny nickle they can answer that correctly and STILL want the cookies.

Mario Vachon said...

Personally, I think its absolutely great. I think ultimately they will provide research that clearly shows we have erroneously demonized high saturated fat foods and high cholesterol foods and that we have been attacking the obesity epidemic and heart disease with diet recommendations that are at best "incomplete" and at worst unbelievably stupid.

The western world will bankrupt itself through health care costs if we don't make dramatic changes to peoples' eating habits particularly with respect to refined "manufactured" foods. Any organization that in whatever way helps to halt that trend has my support.

Dave said...

Please tell me they are going to test overfeeding on a keto diet. Tired of all the zealots claiming it is impossible to gain weight without eating carbs. Its one thing to favor LC because it helps you eat less by increasing satiety (although I'm doubting that and thinking that its more about increased protein and not eating micro-nutrient-free refined calories).

Stephan Guyenet said...

Hi Roger,

Are you aware that I think low-carb dieting can be helpful for some people? I think I've been labeled as anti-LC somewhere along the line, which is not correct. The "disagreement" between Taubes and the scientific community is about the underlying mechanism, not about whether or not LC helps some people lose weight.

Commenter "thehealthhammer" explained the reason for your experience. As you lose weight, your energy requirements go down, and so a caloric deficit will cause less and less fat loss over time until you reach an equilibrium of energy in:out. You can't assume that cutting 3500 kcal per week will cause 1 lb of fat loss per week indefinitely-- it doesn't work like that unfortunately.

Hi Jane,

Gary Taubes will not be designing the experiments; senior obesity researchers will.

Hi Gretchen,

I take your point, although I will note that there have been many NIH-funded studies on low-carbohydrate diets. I would like to see more research on low-carb diets, and particularly I think it would be very helpful to understand why certain people find them so helpful for appetite control and fat loss.

Hi Justin,

I have a more optimistic view than that. I spoke with Peter Attia, and he is interested in a broader investigation than just LC. In fact, he supports the food reward hypothesis and thinks it's also worthy of investigation, as do several other high-profile low-carb voices.

KKCorey said...
This comment has been removed by the author.
Galina L. said...

Sanjeev,
Regardless of what satisfies GT, such research could be a very positive change if LC diets just stopped being demonized as it is the case now.In my mind it is not about a particular journalist ideas or a particular researcher point of view, but about some shift in a standard medical advice.

In real life normally no one gets all what he/she wants, especially in the way he wants it (rephrased from Somerset Maugham), and every issue is more complex than anyone sees it.

KKCorey said...
This comment has been removed by the author.
Dave said...

Taubes is so wrong about the USDA guidelines its not even funny. The one truth is that grains should not be considered healthy and at the bottom of the pyramid. An optimal USDA pyramid would look more like the paleo diet, although I doubt the grain industry would have that.

Todd said...

Bentleyj74,

Well, I also brought up bacon in the second post. That is not an undesirable food to most people.

With regard to yogurt, most people don't know what yogurt tastes like. EVERY yogurt in my local grocery (without exception) is low fat or zero fat with added flavors and/or sweeteners to make it palatable. Frankly, I don't know that processed, sweetened, fat free yogurt is all that healthy.

If you're talking plain, full fat yogurt, I guarantee you there are people that genuinely think a "whole-grain!", "fat free!", "low calorie!" snack pack is a better choice because they have been told to keep saturated fat to a minimum.

Anyway, you're missing my point. I fully agree that people want cookies more than liver and carrots. Probably even more than bacon.

I'm not talking about what people want or don't want to eat. There are a segment of people that don't care about their health and they just want to eat what they like regardless of the consequences. That is their problem.

I'm referring to the people that would like to be healthy/lose weight, but are genuinely misinformed about what they should eat.

Yes, people will get it right sometimes. People know that fruits and vegetables are healthy. But normal people don't live on fruits and veggies alone. So, what else should they eat?

People have been sold on the idea that low fat and low cholesterol automatically means healthy. That snacking on a low fat processed "snack pack" is a "healthy option."

Look at the recent reports in the media just this past year demonizing red meat or claiming that eating egg yolks is equivalent to smoking. Those are the headlines that the average American remembers when making food choices.

So yes, people know that eating a whole pepperoni pizza and sitting on the couch all day is bad. But, in my experience, when friends/coworkers/etc want to get healthy they do not replace the pepperoni pizza with a whole foods diet that includes meat, eggs and full fat dairy. Rather, they avoid those "bad" foods and eat "Lean Cuisines," "Snackwells" and other low fat/low calorie processed foods.

Most people can identify clearly unhealthy behavior and foods, but many people have received so much conflicting info on how to construct a healthy diet and lifestyle that they often make significant poor choices in thier nutrition.

Galina L. said...

@Dave,
I eat less on a LC diet because it increased satiety. I didn't increase my protein intake, I actually decreased it because I seriously decreased the total amount of food and the amount of times when I eat. I need to be in ketosis or close for therapeutic reasons.
Jimmy Moore demonstrated the possibility to gain weight on a VLC diet by overeating protein(according to what his wife said in comments on the Tom Naughton blog).

Mario Vachon said...

Personally, I think the "food guidelines" should come down to a few sentences.

(1) Eat real food. That includes meat, vegetables, fruits, nuts, berries, cheese, eggs... It does not include flour based products.

(2) Do not eat "manufactured food". Processed food almost invariably has big drawbacks in one form or another

The rest is not all that important. Eat real food and the odds are you are going to be just fine.

KKCorey said...

This is a great blog - I really appreciate the way you present the position of the community of obesity researchers. However, I strongly disagree with your opinion that the USDA guidelines didn't cause the obesity epidemic. They might not be the only cause but they certainly contributed mightily and the piece of the world that I live in (basically the world of soccer mom's) would arguably be better off with out the USDA guidelines.

It is true that the USDA dietary guidelines since 1977 didn't tell Americans to:

• Increase our intake of sweetened soda by 41 percent

But it did recommend lowfat milk instead of whole, as you know without reasonable justification. Not only does it not taste as good and is not as filling, but it lacks the natural fat-soluble vitamins (some of which are replaced). By claiming that a common and nutritious food is unhealthy the USDA left a gap that arguably has been partly filled by soda, whether recommended or not. Also, there remains the question of whether components of dairy fats promote better metabolism.

• Replace fresh potatoes with french fries and potato chips

I'm not sure this is a significant problem. What is your thinking here? If they were fried in lard, would they be a problem? Or is the problem that "You can't eat just one?" Mashed potatoes can be pretty darned addictive too.

• Increase added sugars by 16 percent

But they lump saturated fats which can be healthy and nutrient dense in the same category as sugars.

• Increase our intake of refined instead of unrefined carbohydrate

They recommend 6-10 servings of carbohydrate for an adult every day, half of which is recommended to be unrefined. That leaves 3-5 servings refined carbs.

• Nearly double spending on fast food

Culture certainly contributes to this but the USDA doesn't help by recommending against some easy alternatives like cheese, eggs (which they would limit to one a day without justification) and hamburger based dishes.

• Eat more than twice as many snacks

By recommending against dairy fat and more than one egg per day, the USDA recommendations leave many hungry, especially a couple hours after breakfast. It is my observation and experience that me and my family are less desperate for snacks when going against these recommendations.

• Increase total calorie intake by 20 percent

I believe that this an indirect result of their recommendations (among other things).


The guidelines, if strictly followed would be an improvement to the diets of most families, but in my observation, they are selectively followed. Cheese is out, bagels are in. Where is a child to get adequate K2 from?

I am thrilled by the goals of NUSi! Thank you for bringing it to my attention!

KKCorey said...
This comment has been removed by the author.
bentleyj74 said...

@ Todd,

I understand your point. My point is that they *want* the cookies. The 100 calorie snack pack of low fat fake sugar cookies probably is all things considered a healthier choice than the alternative cookie they would have eaten otherwise if you compare apples to apples.

At the very least it has a managed portion. People are not seeking "health" via processed convenience foods, they are seeking convenience and palatability.

This really flies in the face of all the victim mentality but if I went to any random grocery store and asked ten random people to choose most people could make most choices accurately.

There is no need to split hairs between animal foods and there isn't a consensus among people who do study them to suggest full fat IS better.

Nevertheless that people STILL can judge that the hot pink syrup called yogurt is less healthy than the unflavored plain yogurt whether full fat or no fat is without question.

No one mistakes cocoa puffs for rolled oats either, just in case you were wondering :)

The promises on the box are designed to help people feel better about what they already know are poor choices with regard to nutrition and expense. They know they paid the same price for a box of pop tarts as they would for a 5/10 pound bag of potatoes and that they could probably have purchased the bulk of their calories for a week with what they paid for 24 cans of soda. They want it anyway, it has nothing to do with thinking it is good for them.

Sanjeev said...

> such research could be a very positive change if LC diets just stopped being demonized as it is the case now
____
I'm not seeing the widespread misinformed mis-information I used to.

I cannot recall the last time I read "low carb diet ketosis will kill you like ketosis kills diabetics" (which used to be a common "argument".

It's mostly folks who have not kept up with the research or reporters pushing a sensational agenda who are still demonizing fat and cholesterol.

Even some skeptical blogs I follow that make no special claims to nutrition knowledge were skeptical of the recent egg slandering study.

Much of what i read these days that's critical of high fat/cholesterol takes a measured, non-dogmatic stance, very little can be classified as demonizing fat & dietary cholesterol.

I avoid extremist outlets these days though, so I don't know what militant vegans & others are claiming these days.

noval ellrizal said...

nice informations..
maybe this is his time improving my nutrition..
heheh ^_^

Galina L. said...

Sandgeev,
Yes, in a blogosphere opinions are more balanced nowadays, not so in a real world. LC diets are not appropriate in hospitals even for diabetics, lisenced dietitians can't advise it to their patients without being scared of professional troubles. Doctors still prescribed statines and margarine is still a healthy food. My husband just recently experiences a "Healthy challenge" campaign at his work place. The same low-fat-whole-grains propaganda, chicken breast is the perfect protein source, recipes of yams biscuits and fruit tarts for diabetics , the more fruits including fruit juices the better, even for diabetics.I saw in comments a registered dietitian mentioned how one of her fellow-dietitians got investigated for telling her patients that butter was more healthy choice than a margarine. If you request, I will provide a link.

Galina L. said...

Sandgeev,
Yes, in a blogosphere opinions are more balanced nowadays, not so in a real world. LC diets are not appropriate in hospitals even for diabetics, lisenced dietitians can't advise it to their patients without being scared of professional troubles. Doctors still prescribed statines and margarine is still a healthy food. My husband just recently experiences a "Healthy challenge" campaign at his work place. The same low-fat-whole-grains propaganda, chicken breast is the perfect protein source, recipes of yams biscuits and fruit tarts for diabetics , the more fruits including fruit juices the better, even for diabetics.I saw in comments a registered dietitian mentioned how one of her fellow-dietitians got investigated for telling her patients that butter was more healthy choice than a margarine. If you request, I will provide a link.

Dave said...

@Galina, I think low carb is very useful for the extremely overweight people, but for people who are of a normal weight, its effects are not that great and temporary at best. I know for me I was eating less for about 6 months, then I started binging on low carb foods and gained about 10 lbs back. While I gave the alternate hypothesis a chance, the more materials I read the more I'm finding compelling evidence that disputes it. I think Anthony Colpo's book, 'The Fat Loss Bible' was the nail in the coffin against the CIH.

Galina L. said...

@Dave,
I am not an extremely obese person, now my BMI is something like 27, when I started my diet almost 5 years ago , it was between 30 and 31. My health improved even more that my weight(it is a very long list). I based my diet strategy on the insulin theory of a weight loss which is not exactly the same as Gary's theory that all you need to do is eating less carbs. Before I started LCarbing, my appetite was always an issue all my life. It improved greatly with carbs limitation, but the major change was also caused by the adaptation to the intermittent fasting and practicing it. Just carb limitation is not enough for many. It order to experiment, I tried to reintroduce more root veggies and fruits, but VLC diet is optimal for me.

There are a lot of LCarbers who manage to binge on proteins instead of carbs.

Peter Attia said...

Stephan, and readers, this is a wonderful discussion of what I believe to be the most important set of questions our generation needs addressed. I thank you so much for your support of NuSI. Keep in mind, everyone, NuSI is not about Peter or Gary, or "low-carb," or "Paleo," or anything else I know it's temping to make it out to be. It's about getting the science done in a manner that leads to an unambiguous set of guidelines. There is no reason to believe one mechanism underlies the cause of obesity. As Stephan and I have discussed at length I actually find the combination of his hypotheses and Gary's very compelling. It's possible the most fattening foods are also very palatable. Tragically, such feedback systems exist elsewhere to describe negatively accretive phenomena.

Peter, Gary, and the entire NuSI team will never lose sight of the mission. Over 200 million Americans are afflicted with a condition that reduces their quality of life! We must help these people (I used to be one of them!). Gary, Stephan, myself and countless others -- who may agree or disagree to varying degrees on many things -- agree on this.

We can't solve this problem by looking back. If it were possible, it would have been done already. We need to try something new. Something forward looking. Let's be sure our children don't have to do what we're doing in 20 years.

Paleo Phil said...

Stephan Guyenet wrote: "Dr. Attia and Taubes have asked for my support on this project."

Fabulous, Stephan. It's nice to see both Gary Taubes and you put the advancement of science and peoples' health ahead of a past row. One would think that this would make it more difficult for LC dogmatists who have attacked you in the past to continue their misrepresentations of you, given that one of their top heroes has invited you on board. Good luck with it.

spughy said...

People aren't making the right food choices with the information they have - bingo. People know damn well that pop tarts (even whole-grain ones, if such things exist, and I'll bet they do) aren't healthy, but human brains are incredibly complex and crafty little buggers and don't honestly give a crap about what human bodies look like, down deep. They benefit most from the hit they get off extremely pleasurable food and go out of their way to rationalize poor choices. So in this respect, USDA guidelines that don't explicitly say "If it has added sugar, it's bad for you, will kill you, don't eat it" and helpful things like that and instead use wishy-washy language like "choose whole grains" DO allow for a lot of leeway when brains are cruising the middle aisles of the supermarket looking for tasties.

Moreover, the USDA has some 'splainin to do with regards to industry lobbyists, influence thereof. And why are dietary guidelines put out by the part of the government designed to get the most bang for the buck out of the nation's agriculture? Shouldn't they come from the health department or the Surgeon General or whoever? (This would obviously be futile as in my own country the guidelines come from Health Canada which is as susceptible to lobbying as anyone else in government, but it would at least look a bit better.)

Anyway, I think that as long as processed, highly palatable food is widely available, easy to obtain and consume, cheap and not outright condemned by health authorities (none of this namby-pamby "moderation" crap), we will have an obesity problem. The biggest, best swack that anyone could take at it would be to remove the subsidies and price controls on grain and other commodity crops, world-wide, but unfortunately that would have the rather negative side-effect of harming poor folks who had nothing to do with the obesity epidemic and who rely on cheap grain staples for food. However, I'm sure there are ways to phase out subsidies at the same time as local production is stepped up where needed - I'm not the expert on that, but if anyone cares, Raj Patel wrote a fantastic book called "Stuffed and Starved" that looks into the root causes of both first-world obesity and third-world hunger and it's well worth a read, particularly for researchers in the field.

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Jane said...

Hi Stephan
Yes I do appreciate scientists will be designing the experiments.

I think everyone here should suggest an experiment they would like NuSI to do. I doubt if they could come up with one that's feasible and hasn't already been done.

Consider what Gary Taubes says about NuSI.
'The experiments will be human trials; they’ll all be rigorously well-controlled, and they’ll all be aimed at identifying unambiguously the causes of obesity and type 2 diabetes, elucidating the underlying mechanisms involved.'

I find this frightening. A few new experiments can identify unambiguously the causes of obesity and type 2 diabetes? AND elucidate the underlying mechanisms? If this is possible, why on earth have all the thousands or millions of experiments that have already been done, been done?



Jane said...

@Peter Attia
Please could you tell me what this means:

'It's possible the most fattening foods are also very palatable. Tragically, such feedback systems exist elsewhere to describe negatively accretive phenomena.'

Jeff Consiglio said...

All the talk here seems to be about weight-control and treatment/prevention of obesity. And sure...most CAN "lose weight" on a high-carb diet if calories are low enough. But of course MANY will be ravenously hungry while doing so. Satiety tends to be much better with LC. Although I am open to the notion that a high-protein version of a high-carb diet may control appetite as well as LC. But I kinda doubt it.

But weight-control is not the only issue...ok so food-pyramid says to eat "more whole grains" - but can we really say eating lots of "heart healthy whole grains" is truly healthy? Better than coca puffs for sure, but I think still probably not ideal.

Is low-fat cheese, cottage cheese, etc really better for us just cause it's lower in calories? I have my doubts.

And why is pizza is always mentioned as the quintessential "bad" food? Most think of pizza as "bad" cause of all the fat from the cheese and fatty meats. But how much cheese will most of us eat if it isn't atop a nice white-flour crust?

How much oil would one drink? Not much right, as it'd make ya puke. But if I fry a tater or donut in that same oil, I will suddenly be able to consume lots of it.

Carbs serve as a delivery-system for MUCH of the excess fat folks eat. Carb-lipid combos such as burgers, fries, pizza, fried chicken, onion rings, etc, make it all too easy to really pound down scary amounts of high calorie fat.

But fat is MUCH harder to overeat within the context of an LC diet IMO.

@ Galina - You're kicking butt here in the comments. I work with real live people every day in my personal training business who really have been brainwashed to believe a 100-calorie snack pack if better for ya than bacon.

I constantly have overweight people come to me swearing they "eat a mostly healthy diet" - then when I ask them what they had for breakfast and lunch that day it is almost always something along the lines of raisin-bran cereal for breakfast, and some kind of carby low-fat lunch. People are brainwashed that fat is dietary evil number 1.

Todd said...

Bentley,

I understand your point too. And I agree with you, but ultimately I think you give people too much credit. Or maybe I just have a really low opinion of people. :)

A third of the public thinks the the U.S. Government had previous knowledge or involvement in the 9/11 attacks. A quarter of the American public thinks the president was born in another country. Millions of people think the moon landing was staged. Given this level of critical thinking, it is not far fetched (at least to me) to think that people who've heard that low-fat is the key to weight loss and good health genuinely believe that "Snackwells" and "Healthy Choice Entrees" are a good choice.

Gabriella Kadar said...

USDA guidelines have nothing to do with the obesity epidemic.

The same incentive has been applied to the purchasing of fastfood as to other non-food items.

For example, a customer is encouraged with sales advertising such as 'buy 2 T shirts and get another one for free'. Even if the customer entered the store with the intent to buy 1 T shirt, what is the likelihood that he or she leaves with three of them?


When the 'biggie size' is twice the 'regular size' but only a few pennies more in price, the customer clearly considers this to be a good deal. People don't want to feel ripped off by paying only a few cents less for half of a 'biggie size'.

Then, regardless of how much food the customer really needs to consume, the amount of food in the 'Biggie Size' will be eaten. It's not the better deal if the customer throws out uneaten food.

It's all a mindgame that the cheap food industry has mastered.

Then remember the Mary Poppins' song? "A spoonful of sugar helps the medicine go down"? These days there is sugar added to so many ready to eat foods.

Oftentimes the actual ingredients in these items may be substandard or lacking in flavour. Sugar is a flavour enhancer as is salt.

Salted foods increase thirst and when the 'Big Slurp' only costs one cent more....?

Cooked grains, regardless of form, require salt to make them palatable for most people. A high grain diet results in a greater thirst response, hence we see people with those plastic bottles of water. A low carb diet usually also translates to a lower salt intake and a reduced requirement for hydration.

Look even at Starbucks coffee? Holy Hannah! Who really needs to drink that much volume in a coffee beverage?

The human animal will always choose the easier option. If we didn't, we would have rejected the invention of the wheel.

The only way for people to avoid consuming excess calories is to exercise self control by a.) preparing their own food and b.) anticipating the need to eat thereby providing for themselves and not responding to the visual and olfactory cues from fastfood outlets or prepared packaged foods at supermarkets or foodstores.

Self control is not an extolled virtue in the modern world. We are encouraged through advertising, television programming, and movies to indulge ourselves in all things.

Obesity research appears to be more focused not so much on why people eat but why do they continue to eat. It's all very intellectually stimulating to decipher the molecular basis resultant from chronic overfeeding. But is it real world applicable?

bentleyj74 said...

@ Todd,

Conspiracy theories are used for recreation and there is no accountability or direct cost. How many of those people are actually taking viable rational action on their "beliefs"? Can the percentage even be measured in whole numbers?

People have to make decisions every day with their real dollars whether to do A, B, or C. Most of these people are able to drive cars, hold jobs, a considerable amount are college graduates...give me a break. There may be disagreement among the population whether fats are good or bad, grains/whole grains/no grains/etc...but it is not rampant opinion in the gen pop that cookies [even low fat whatever] and broccoli are equally nutritious. They have a different goal than you want them to have, and they may have an unrealistic goal fed by marketing [I'm inclined to think so] that they can effectively have their cake and eat it too but they are not stupid or incapable of making objective judgements. Executing/applying maybe is another story but that's not got much to do with the food pyramid.

Todd said...

Bentley, you're doing a great job arguing with a strawman. In my original post, I merely wanted to point out that there has been promulgated enough nutritional misinformation (from "official" sources, popular media, food manufacturers, etc.) that many in the general public would mislabel some healthy whole foods as unhealthy and conversely some unhealthy foods as healthy. (I've never said that people think cookies are as or more nutritious than "carrots" or "broccoli" or that they confuse cocoa puffs and rolled oats.)

An incorrect perception of *some* foods could lead people to make poor choices they otherwise would not have made. So, the issue is not just that people have the right information and are failing to apply it - yes, that is part of it, but not the end of the discussion. Believe it or not, people actually believe wrong information sometimes. Part of helping them change their behavior is making sure they have the right information.

Anyway, it seems the discussion is getting far afield from Stephan's original post about NuSi. So, I'll just have to agree to disagree. Cheers!

bentleyj74 said...

Will you dance and sing if I take you with me to OZ? [Reread your choice of phrasing and you'll get the joke]

The "misinformation" you actually used as evidence isn't really applicable or misinformation at all.

The jury is frankly still out as to whether sat fats are good/bad/neutral...whole grains...yadda yadda yadda. People who study it professionally disagree and context has to be considered.

An individual with hemochromatosis might really just be better off to go ahead and have the cookies instead of the liver. KWIM?

Regardless of the "information" people will always prefer high reward cookies to low reward liver [or eggs or broccoli] all things being equal and the marketers will always capitalize on that using any means possible including pictures of meadows and rainbows on the box.

I agree with Stephan that people have a considerable amount of viable, actionable information already and they choose not to act on it for a variety of reasons.

The confusion that exists may very well stem from information overload imo which is usually generated rather than resolved by hyper focused studies designed by fiscally interested parties and hyperbolic media.

There is no way this is off topic.

I do think Galina has a point about what is medically recommended for specific problems but again the application of what is already suggested rarely if ever looks much like what is practiced irl.

Dave said...

@Galina,

Where is your evidence that LCers like Jimmy Moore among others are binging on protein and not simply eating too many calories, or fat calories in particular? Do you believe its impossible to overeat fat when carbs and protein are low? Did you know there are over two dozen metabolic ward studies that basically prove carb intake and insulin levels have virtually no effect on weight when calories are held constant?

I don't understand why people have to believe that glucose->insulin is the cause of obesity when there is so much evidence that it is not.

Since it has been completely disproven that varying carbohydrates or insulin levels affect fat stores independent of calorie intake, and the idea that LC is more satiating has been almost completely destroyed by the confounders known as protein and removal of refined processed foods, what left does the insulin hypothesis have to stand on? Nothing really. People overeat because of lowered leptin levels, people overeat because of addiction in the brain, and people overeat because they are deficient of certain micro-nutrients. And of course insulin then plays a role in the unhealthiest people, but certainly not the gen pop.

Galina L. said...

@Dave,
I experienced several diet strategies during my life. While not being a classically obese person I have being on a chubby side all my life, when from time to time my BMI moved too close to 30, I went on a diet to loose enough pounds in order to look better. I lost approximately 50 lbs couple times on the regular "eat less" diet, I spent my childhood eating low-reward foods because in Russia it was the standard diet for people with an eczema, and still I prefer a food without an excess of flavor, 99.9 % of the time I cook my own food. All my life I had been struggling with an abnormal appetite and an excessive hunger I could not tolerate properly until I tried a LC diet nearly 5 years ago. It worked like a switch "off" for my excessive appetite. There are a lot of people who have similar experience for whom macrocomposition of food matters a big deal. I don't know what makes people like me different from thous who can't achieve a normal satiety on a LC diet, I don't know why I can't eat potatoes and stay thin like many who report such experience.It looks like people are different in their diet requirements. I hope the NuSI research will give more answers to such questions. I based my diet strategy on the insulin theory of a weight loss, but I never checked my insulin levels, so I can't prove anything. I don't know why avoiding carbs improved my satiety, but I can testify about such effect.

Galina L. said...

@Bentley,
Can you believe I actually prefer salty and hot food when I am hungry to any sweets? The only time when I want something sweet is after a meal, and it makes the avoidance of sweets easier.I know there are people with sweet tooth around, I had such aunt. Probably, I can't understand properly sweet toothers like naturally thin people can't understand why I can't eat like them and stay thin.

Dave said...

@Galina, the fact that research has failed miserably to pinpoint carbohydrate or protein's effect on insulin in particular as the primary arbiter of either fat loss or gain, or satiety, and the fact that there are countless people who do not benefit from LC diets in either weight management or satiety shows that the hypothesis is simply incorrect.

Its a mere coincidence that cutting carbs works, but its because cutting carbs makes it nearly impossible to eat the most unhealthy foods that are palatable enough to want to eat. If it was the carbs' effect on insulin that mattered, then people shouldn't feel satiated after eating plain baked potatoes, but many people do.

Galina L. said...

@Dave,
Your explanations why people don't feel hungry after cutting on carbs don't explain my case. I was never a junk eater. In my mom's cause exchanging big bowl of unsweetened still-cut oatmeal for eggs and cold cuts for a breakfast killed her appetite as well(and resulted in a weight loss, blood pressure normalization, and other things), while she wanted to eat after 2 hours after oatmeal. I also not satiated after eating plain potatoes for hours like you do. It looks like there is an underlying difference between the metabolism of different people that requires a diet different approach. I can't measure insulin levels,but I measured mom's blood sugar level after eating oats - it was 167 , after eggs/coldcuts- 114. For me eating plain carbs also causing a BS rise. It is logical to assume that the difference in the post-meal blood sugar could mean the difference in a post-meal insulin secretion.

Dave said...

In my case I have adapted after several months on a LC diet such that no food is really satiating to me anymore, with refined processed foods being particularly un-satiating. But whether I choose to eat fruits and starchy-vegetables or remain keto makes no difference anymore. My hunger and body weight is likely being influenced by leptin more than anything else.

But nobody's testimony on a forum can really be taken as evidence because all the wild claims people make about their dieting and success or failure never seems to be reproduced under metabolic ward conditions, which means they are incapable of objectively observing themselves accurately.

P2ZR said...

@Todd, Bentley

Spughy nails it above: 'People know damn well that pop tarts (even whole-grain ones, if such things exist, and I'll bet they do) aren't healthy, but human brains are incredibly complex and crafty...and go out of their way to rationalize poor choices.'

It is mentally and morally exhausting to be constantly aware that one is making suboptimal (or plain bad) food choices for themselves/their families.

So whole-grain/portion-controlled goodies are *less bad* than the regular/giant-serving ones. Less bad => not bad. Not bad => good. Thus we go from ordinally infinitesimally less likely to kill you, to categorically saintly.

Wait, really? It took Michael Pollan for the world at large to realize that food your great-grandmother would recognize (i.e., 'real food') is actually better than rainbow pellets that loudly proclaim their 'low-fat' status?

Avoiding crap is exactly shfifty-five million (point 975) times more important than eating a specified minimal amount of 'good' foods. People know in their heart of hearts what is crap. And believe it or not, they will not die from failing to eat copious amounts of saturated fats.

People who rationalize their consumption of manufactured foodstuffs because they're the 'healthified' versions are doing exactly that--rationalizing. They know perfectly well that they'd be better off avoiding those types of edibles in the first place.

Ironically, where this awareness seems to get lost is when people get converted to a 'healthy!!!' way of eating--vegan, paleo, whatever. Then the most 'decadent' concoctions become green-lighted because they are made with the 'right!!!' ingredients. Where almond-flour chocolate cake is just as healthy as steak because they're both equally primal.

People are cognitively fine until their hopes get conflated with their beliefs--and all it takes is some clever marketing and/or a guru to help that process along.

P2ZR said...

@Jeff Consiglio

'Although I am open to the notion that a high-protein version of a high-carb diet may control appetite as well as LC. But I kinda doubt it.'

I really wish that people with clients/patients/helpees would all do as Emily Deans does and acknowledge selection/self-selection bias.

I do my absolute bestest best on a highish-carb, highish-protein diet, thank you very much. Weight-wise AND in terms of all other health parameters.

But I guess I don't matter because I would never have numbered among your clients, who I'm presuming are struggling with significant excess weight. Come to think of it, the people who couldn't afford your services don't matter, either, as they wouldn't substantially inform your worldview as gathered from your client base.

'Is low-fat cheese, cottage cheese, etc really better for us just cause it's lower in calories?'

Not necessarily, but it is if it enables one to eat more, to greater satiety and psychological satisfaction. Sometimes, you're not hankering for cave-aged Gruyere, but simply something cheesy to melt atop your chicken breasts--and you want more cheesiness (bang) for the calories (buck). Are you going to judge someone for that?

'fat is MUCH harder to overeat within the context of an LC diet'

You've never had a client bingeing on nuts? I could go to town on an entire 2 bars of dark (85%) chocolate, and THEN polish off half a large canister of macadamia nuts. And THEN have my full-sized dinner a few hours later.

P.S. I'm sure your clients are at least mildly aware that raisin bran cereals contain an absurd amount of sugar. You need neither a magnifying glass nor >50% functioning taste buds to realize that the raisins are candied beyond recognition, never mind the flakes (how do those compare to hot cracked wheat cereal?).

Jane said...

I just looked up the board of directors at NuSI.

Jonathan Lim, M.D. | Director
Jonathan is the Managing Partner and Founder of City Hill Ventures, LLC, a health care investment firm established in 2010. Previously, he was President, CEO, and Board Director of Halozyme Therapeutics, Inc.

John Schilling, M.D. | Chairman of the Board
John is an Operating Director and leads the Healthcare Operations at TPG Capital, a leading global private equity firm. Prior to joining TPG, John was a Corporate Officer and Vice President of Sales and Marketing for the US Pharmaceutical business at Abbott Laboratories.

Saum Sutaria, M.D. | Director
Saum is a senior Director of McKinsey & Company. His area of expertise is the healthcare sector with a special emphasis in healthcare delivery and financing.


Peter and Gary are the other two directors. Now I realise if you want to do expensive experiments to find what causes obesity and diabetes you have to involve people with money. But do you really need people with a clear monetary interest in NOT finding the causes?

Dave said...

Its probably better to have people with conflicting agendas as a check and balance.

comrade_stalin said...

Stephan, looking at the USDA graph of macronutrient intake in the US between 1970 and 2006 total calories add up to around 2,300 calories per day per person.

Is this correct? I've always heard that the US daily per capita calorie consumption was 3,600.

Ed said...

Stephan,

Do you think that, everything else being equal, substituting whole wheat (germ and bran retained) bread and pasta for refined (germ and bran removed) versions would have a material impact on obesity?

It strikes me as pissing in the wind (other than the impact on palatability, I suppose).

Eva said...

P2ZR, you gave me a good chuckle. You've described how my brother thinks. When his kid wants a rainbow sprinkle cookie, he thinks he is a being a good and responsible father by limiting her to a (just as sweet) outmeal raisin cookie instead. Cuz raisins are healthy!

As for this org, as long as they are allowed to fund only whom they want, they could easily choose to only fund those whose conceptual leanings agree with their preconceived notions and whose past research supports what they want to see. That's the same as what we have already with govt and big pharma running the show. The ones with the money have most of the power and the researchers know if they don't tout the party line, they will lose funding. I have seen many researchers repeatedly tweak preliminary trials until they find the parameters that will yield the results that their benefactors want to see. Only at that point do they run a full experiment and only if the results came out as they want will they publish. NUSI will likely just yield more of the same since they are making no secret of their biased agenda right from the start.

Ivan Nikolov said...
This comment has been removed by the author.
Ivan Nikolov said...

Stephan, I was one of those, who subscribed to the notion that carbs are the culprit and the government's recommendations are a major reason for the obesity epidemics in this country.. until I started reading your blog and resolved to trust raw data and do my own critical thinking. Thank you for that! I still have a lot to read (and digest), but my philosophies are undergoing transformation by the day.

And, it's all nicely summed up in this article in your bullet point paragraph "Starting 1977 did the USDA tell us to...". Very well said!

(my apologies, I had to remove my comment above to edit it as I saw I'd misspelled your name :-/ )

Jane said...

@Dave
Yes, checks and balances are good. But this goes further. Why do you think NuSI avoids mentioning empty calories?

Supposing someone were to suggest a study giving one group exactly the same diet as another group but with unrefined ingredients. Would NuSI fund such a study? No, they'd say it wasn't properly controlled for micronutrient differences.

And in a way, they'd be justfied. People do not want their illnesses to be due to food, they want PILLS. They pay their taxes for scientists to find new PILLS. Or alternatively, for scientists to tell them grains are peasant food and not good enough for them. NuSI will be very popular with the public.

Mario Vachon said...

Peter and Gary have absolutely no interest whatsoever in getting people to take pills. They are interested in finding nutritional truths.

Stephan Guyenet said...

Hi Jeff Consiglio, P2ZR, and Galina,

Emerging evidence is suggesting that for the "average person", increasing protein is more important for fat loss than lowering carb, and even more so for fat loss maintenance. High-protein, high-carbohydrate diets may be at least as effective as traditional LC diets, although I don't think the case is closed yet.

That being said, I know multiple people who say that carbohydrate per se triggers their appetite and fat gain independently of how much protein they eat. I've heard this enough times that I take it seriously, even though it's anecdotal. I'd love to see this phenomenon investigated-- in other words, look at individual variability to see if there really is a subset of people who react differently to carbohydrate per se. My guess is that this does exist, and we can demonstrate it scientifically if we look for it.

Galina L. said...

Thank you, Stephan,
It also puzzles me why I got improved health issues on LC . I can speculate that asthma and allergies could get better because I excluded wheat and I was allergic or sensitive to wheat or gluten without knowing it.Migraines are better because on ketones brain functions differently. But why seasonal flues don't affect me any longer? As a realistic person, I don't think that everybody should eat a LC diet, I don't advise my son to do it, but if he feels like he is going to develop some flue, he is eating LC and trys to sleep more at the same time.

Gretchen said...

Some research shows that if you're insulin sensitive, it doesn't matter if you go on a high-carb diet or a LC diet. If you reduce calories, you'll lose weight.

But if you have insulin resistance, the LC diet works much better.

This could explain why different people have different results with diets. The problem is when someone of one type assumes that everyone else will react the same way.

Dave said...

Stephan,

I'm sure you know better but I'd be wary about those anecdotes because after spending many months on some of the LC forums I've seen some pretty ridiculous claims. I can think of at least 10 cases of people claiming they were well under 1000 calories a day, low-fat diet, and not losing weight. Then they switch to LC and eat 2000 calories and are losing weight. When you try to reconcile that with the scientific literature (ie. metabolic ward studies) it simply doesn't add up. I really think the majority of people are incapable of being objective enough about their own diet to know that carbohydrates per se are affecting them. The problem is most people who cut carbs are certainly cutting grains, sugar, and even omega-6 PUFAs, yet they can tell that its carbs per se that has been the improvement? Yeah right.

Sanjeev said...

IMHO there's some of the snackwells phenomenon, just in reverse:

some folks had such good results with Atkins in the past that their view of some pundits is excessively elevated. If these pundits tell them carbs cause hunger then the first instance of hunger after carb consumption is worse than any hunger on a low carbohydrate diet.

IMHO I did some of this myself when I was trying to get off my Atkins phase.

Jane said...

If there really is a subset of people who react differently to carbohydrate per se, how would you investigate this? I imagine it's what NuSI will be doing. Perhaps you give lots of people purified carbohydrate and see what happens. Or you give them bread, potatoes, fruit, sugar etc and see how they react.

If you find some people react badly to these things, what would you conclude? Perhaps that their gut bacteria don't like carbs. Maybe they don't like refined carbs because they don't have the minerals they need. Or maybe they don't like UNrefined carbs because they've never encountered them before.

Some people will have a bigger blood sugar spike after carbs than others. These people 'react differently' to carbs. But this only means their pancreas isn't working too well and needs to repair itself.

Here I think is the crux of the problem. I don't think Taubes would have concluded carbs cause obesity and diabetes if he had known about maintenance and repair. Critical enzymes in repair pathways are dependent on micronutrients that get removed from refined carbs. He thinks the problem is glycemic index, but it isn't.

Unknown said...

Todd was spot on...There is so much conflicting information out there that people don't know what is healthy. Eggs are a prime example: For 20 plus years we were told that eggs are bad for us....Some people are not aware that this has changed.

I feel that Todd's example of bacon highlights this very well...I still hear all the time how bad for us bacon is.

Stephan Guyenet said...

For the record, I still think bacon is unhealthy, and I think the paleo obsession with bacon has more to do with being contrarian and macho than anything.

Bacon is basically deep-fried cured (processed) meat. It's highly palatable and energy dense. I don't see how it could possibly be healthy. Just because you can eat bacon in the context of a paleo or low-carb diet and still maintain leanness does not mean that bacon itself is healthy or slimming.

You can mitigate some of these problems by buying uncured bacon and cooking it more gently, but I don't think it's ever going to be a health food.

I've never heard of any ancestral population eating anything resembling bacon.

Todd Hargrove said...

"For the record, I still think bacon is unhealthy, and I think the paleo obsession with bacon has more to do with being contrarian and macho than anything."

Yes!

Sanjeev said...

Stephan's obviously being paid under the table by the beef & chicken lobby.

John said...

Hi Stephan,

I'm wondering where you found that the USDA recommended unrefined carbohydrates. The original USDA Food Pyramid recommended 6-11 servings of bread, cereal, rice and pasta. Even in 1977, the majority of bread and pasta was made with refined white flour, and the pyramid was based on the guidelines. The recent MyPlate gives more than a quarter of the plate to grains, again with no mention of refined or whole.

I still think the USDA guidelines are partially responsible for the decline in health and the increase in obesity in this country. They were driven by the fear of saturated fat and cholesterol, and drove more people to eat processed foods (even if this wasn't the intention, or explicitly stated). Even if the guidelines weren't a cause in the rise of obesity, they were completely ineffective in preventing it.

Lumi said...

Stephen:

I'm a bit troubled by the continued use of "unrefined" vs. "refined"--I think seeing the world of carbs in those terms actually contributed to the obesity epidemic as many "unrefined" grains are quite insulinogenic (i.e., high GI).

Just look at the GI of short-grain brown rice versus long-grain white rice as one example.

And there are some mentions of a tiff between you and Taubes--do you not accept his basic idea that obesity is due to a metabolic derangement (which is exacerbated by eating high-GI carbs without sufficient protein and fat)?

Dave said...

Stephan,

Do you agree with me that if Nusi wants to make an impact, they need to focus on studying how various food ingredients and micro-nutrients affect ad lib consumption of calories?

Seems to me the problem of obesity is not one of calories being partitioned for storage instead of being expended likes Taubes claims, but it seems the entire problem is related to increased consumption due to some environmental factors.

Dan said...

Hi Stephan,

Since reading your blog, I had decided to introduce more unrefined carbs into my diet and see how that works out. The food I most missed after eating in a paleo way were white potatoes. So I've been adding some potatoes to my stews recently.

Reading your comment about bacon makes me wonder how potatoes fit into the food rewards theory. They're highly palatable to me (I find myself hunting for them in my stew), and they are energy dense. They're also a New World food, so they weren't available in the paleolithic.

Sanjeev said...

After you've eaten to fullness say a meal with no sugar, low fat, high fiber (a kilo of spinach maybe), eat some MORE (so now you're more than full), NOW could you eat more plain boiled potatoes?

Plain, NOTHING on it ... no salt, spices/seasonings, any kind of flavour enhancer (MSG, butter, coconut oil) or smell enhancer or mouth feel enhancer (for smoothness or crunchiness)

Compare how much potato you could eat with with other foods; maybe make your own chart/spectrum, from the low end to the high end

spinach [0]
kale [0]
onions

skor chocolate bars, Indian sweets like Jalebi (the fried orange-colored pretzel-looking one) and rusgule (the worst food for me, hands down),
Baklava, ice cream.

Put potato in that spectrum - there's your answer (probably - there are probably path dependencies - what you've eaten in the last little while will affect your reading)

[0] what's the difference between spinach and snot[1]? Kids will eat snot

[1] my grossest footnote[2] to date

[2] someday I'll work in a foot fungus joke into some footnootes.

Stephan Guyenet said...

Hi Dan,

Potatoes are not very energy dense-- they have an energy density lower than lean meats and most other starches. They are palatable enough to be satisfying, but no more, unless you're adding things to them to make them more palatable.

The lower carb your diet is, the more palatable they will be however. Your body seeks the restricted nutrient.

Almost none of the foods we eat today were available in the Paleolithic. Our African HG ancestors were not eating carrots, cows, onions, almonds, broccoli, lettuce, apples, chickens, etc. The Paleo diet is not about eating mongongo nuts, warthogs and marula berries-- it's about eating from the TYPES of foods that would have been available during the Paleolithic. For example, starchy tubers, a category that includes potatoes. If you are going to exclude new world foods then you'll have to exclude sweet potatoes, chocolate and peppers as well.

Tamica's Thoughts said...

I just want to add that I agree with Todd about the level of misinformation and ignorance out there. My overweight family went to a dietician when I was in middle school and I was given 12! starch "exchanges" to eat per day. The diet didn't work at all despite me doing everything I could to eat all 12 starch servings per day (wonder why). For the next 10 years I thought that eating healthy meant eating carbs. Meats and cheese were the devil. It took me reading Atkins book and actually trying out low carb to realize that I don't need 12 starches per day. I can't be the only one with this experience. My family was deeply concerned when I first tried Atkins because it was the opposite of what the dietician and told us to do. When I lost weight and felt great, however, they relented that maybe it could be good for me. They were not convinced enough to try it for themselves. They still reach for carbs when they try to eat healthy. They will until some official source tells them there is another way to eat healthy.

Gretchen said...

Warning: annecdotal information.

I'm reading a book by a woman who grew up during the Cultural Revolution in China. Because her parents were intellectuals, she was considered tainted and was sent to learn from the peasants a long distance from any towns. It was too cold in the mountains to grow many vegetables and meat was precious and not apt to be "wasted" on tainted students.

They did hard manual labor from dawn to dusk (plenty of exercise) and ate mostly rice (monotonous diet). When she got permission for a short visit with her parents, her mother was shocked to see that she'd gained weight and was lethargic and tried to feed her lots of vegetables, which did cure the lethargy. She doesn't mention the weight.

Now, this weight gain might have been edema from protein lack and not an increase in fat.

But it suggests that it's not good to carry any theories to extremes. (Not that she had a choice.)

Chris Wilson said...

Following on some of the comments here, especially Jane's skepticism, I think it's too early to tell what NuSi is going to be all about.

I am skeptical of anything involving Taubes, at this point. I've dealt with similar anti-academic-science *personalities* (not that there aren't many legitimate criticisms of academia), and they tend to have a shaky grasp on experimental methods, scientific rigor, etc. That said, Stephan already said that some of his serious senior colleagues are guardedly optimistic about this project.

Whatever results emerge, I am certain that they'll never demonstrate that high carb diets based on healthy starches and whole foods are unhealthy. Eventually, "low carb" is going to go bye-bye-- it will stop being a fad, and will be recognize as a tool that is sometimes useful for some people...

Chris


DrDavis Griffin said...

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Dr Davis Griffin

James R Shaw said...

Stephen,
You are on the right track. The guidelines are not the problem. This is a behavior problem. I'm a perfect test case. A few months back I introduced a new processed food to my diet. I eat it regularly. My weight has started to slowly creep up. It is hard to stop--like an addictive behavior. I'm still within various good weight guidelines. I know the secondary cause for the unhealthy weight gain. Is it now worth the time and trouble to determine the primary cause? It makes sense to me that if a researcher figured out WHY this behavior is being triggered, many people with similar conditions could benefit.