The Dr. Oz Show: Cholesterol and Gary Taubes

It may surprise many but I actually agree with GT in large part on what he says about cholesterol.  Problem with that part of GCBC was that he wasn't really saying anything new.    My first cholesterol test was back in the days when just total cholesterol was your basic test.  Mine was slightly high - only moderately overweight at 20 or so years of age.  A few years later the LDL/HDL breakdown became more the norm and my HDL was high.  Now we all know the progression with particle numbers, sizes, etc that has developed over the years and with it less concern over some types, more over others.

So there's lots of moaning going on over at GT's blog and around the LC web over Taubes' appearance on the Dr. Oz TV show 3/7/12.   I'm no fan of Dr. Oz.  I don't watch any of that sort of TV on anything other than a passing basis in doc/dental waiting rooms and such   I did watch the YouTube videos of Dr. Oz with GT on Larry King back in 2007 (is there a part III?) and I'm well aware of Oz's relationship with Oprah.   I'm especially not fond of Dr. Oz after reading this post over at Yoni Freedhoff's Weighty Matters blog.

But the hair-pulling over the supposed sand-bagging of Taubes by Oz on the cholesterol test issue is rather annoying and I just have to comment on it!  Let's say you, me, or anyone with a strong opinion/conviction on the healthfulness of any WOE were to go on a nationally syndicated TV show hosted by a "mainstream cardiologist".  And let's additionally suppose the WOE was similar to that espoused by the "late great Dr. Atkins" himself, as it certainly is.  What has always been the A-number-one knock against or concern with the low carb high fat diet?  Huh?  That's right.  Cholesterol levels.  I would have been shocked were Oz to NOT have broached the issue whatsoever.   Why wasn't Taubes more prepared to answer to this?  

Yeah yeah.  TV.  Drama.  Oz's platform.  He ran the show.  Carby sponsors who you can't tick off.  Yada yada and uh huh.  He let Gary talk good and plenty through it all.  It was Gary who fumbled "big time", out of what seemed to be somewhat of a lack of forethought on what should have been a softball topic for him:  cholesterol.   Why was Taubes so apparently unprepared for the obvious?  Now, I've only watched this online, so I don't know if all of it this is what made it to air, but here's what I'm talking about:  Taubes on Oz - Part III

Oz:  What's your cholesterol?
Taubes:  Mmnnn I don't know  

If one is now advocating a WOE, as Taubes is in WWGF, rather than just countering conventional wisdom and proposing alternative explanations, as Taubes did moreso in GCBC, shouldn't they at least know their cholesterol level?  If for no other reason but to avoid this sort of embarrassing exchange where he comes off as coy and trying to hide something?                                                                                                                                                                                                                          

Further, Oz goes on to explain that they had asked Gary if he wanted to check his cholesterol behind the scenes.  Taubes should have been expecting the non-set up set-up Oz "pulled" on him.

Taubes explains to the audience that there are certain tests you can do TC, HDL, LDL - the bad cholesterol, and triglycerides.

Taubes:  Total cholesterol is meaningless, absolutely meaningless, and actually LDL cholesterol is meaningless ...

I wonder then, why Taubes emphasized that LDL is the "bad cholesterol" when describing the tests.
Oz:  Would you allow us to check your cholesterol, any way you want to check it?
Oz threw a huge door wide open here for Taubes to discuss other cholesterol tests besides the routine.  IOW the particle size testing and whatnot.  Why didn't he?

Taubes:  What I've said is for the past three months because my book's come out and I have two young children in my mid fifties  I've been getting about 5 hours sleep ... um and  I don't want a single measure in time to effect ... I have no idea what my cholesterol is.  The problem with finding out the stuff I've learned is that you don't want the normal tests to be done because they become meaningless.   You know, once you understand that total cholesterol is meaningless, you don't want a doctor checking your cholesterol and tell you to go on drugs.
Oz made a good point IMO, regardless of the sat fat nonsense he went on with afterwards.  That being, we should all at least know our numbers (and yours truly confesses being lazy about such things).

But here's my problem with this.  If low carbing is a sustainable and healthy lifestyle, then shouldn't it be "protective" against a "bad snapshot" during a stressful time?  No?  Many are keen to point out that Oz had a precancerous growth removed recently (no, he doesn't have cancer!) ... so n=1 how his "way" is no guarantee after all.  But I guess if Taubes' levels were not quite right, then it would have been because of the stresses or his age or genetics or whatnot.

Taubes stated he's been eating low carb for about 10 years, he looked fitter than I've seen him in his lecture videos, and yet he seems afraid to even have the cholesterol test.  ANY test.   What a let down for the "movement".  Better would have been to know his numbers and explain that his trigs are low even though his LDL is a bit higher than is commonly accepted.  I'm presuming that the LDL is his concern.

He can repeat that TC is meaningless, but he's telling the audience that "once they understand" this, they should essentially all not bother getting tested.  When in reality, he had a golden opportunity to discuss more informative tests available and/or about LDL particle size.

Even more disturbing when Oz went on his sat fat spiel, and discusses sustainability of a diet, Gary counters with:
But the question is are you going to lose weight doing it.
So much about health, right?  You can lose weight, as we've been shown, eating twinkies or McD's, etc.  Slimfast or Atkins shakes.  Weight Watchers or Kim Kins.  That doesn't make any of the plans sustainable or healthy for the long run.   Not to mention maintenance .....

Taubes fell down here.  Too bad, really.   What an opportunity he had to reach people on a national stage with a "mainstream" doctor on the whole cholesterol issue.  Even I would have had kind things to say about him had he made good use of it.  But he seems to want to blame Oz for his game-losing fumble, because Oz did indeed give him floor time to discuss the issues.  Instead we got a litany of excuses for why, even though he doesn't know his numbers, he suspects they're not favorable at this point in time.

One is left with the impression that he is becoming the new Atkins.  No, I'm no "Atkins died of a heart attack" conspiracy theorist, but Atkins was equally coy during his life on his own medical status, and then there's the autopsy or lack thereof of disclosure.  So how it came off with Taubes, as even comments left by his supporters point out.

So .... all together now:  Bash Oz!!! 


Muata said…
Good post CS; I walked away with the same questions and observations ...
Sanjeev said…
> Gary counters with:
> But the question is are you going to lose weight
> doing it.

(this is from memory)

FUNNY FUNNY FUNNY, since in his Jimmy interview "GT answers his critics", GT says he lives near the CDC staffer that first "discovered" the obesity epidemic, and that same staffer has shown at least moderate overweight is not unhealthy.

Near that part GT says Walter Willett is dead set against anyone who makes this claim (obesity = healthy)
Unknown said…
Taubes' cholesterol could very well be high, in which case Oz and all the low-carb bashers would have a field day. In my opinion he did the right thing.
CarbSane said…
This comment has been removed by the author.
CarbSane said…
Oz offered ANY kind of test. Why not have a VAP and explain the results? Too complex? I don't think so. In the time he went on about his age and kids and busy schedule he could have explained the importance of low VLDL & high HDL vs. LDL as predictor and/or LDL particle size.

The people who watch Oz are looking for information on how to be healthy. They may want to lose weight, but most don't want to risk their health more to do so. That is a legitimate concern that low carbers should counter with evidence like that laid out in the New Atkins. His response served to perpetuate the fad status of low carbing.

Taubes' actions came off as if he were hiding something - but once you're as smart as he is you will just ignore cholesterol entirely. It was a sort-of my way is healthy because I say so. I eat this way, look at me, but don't look at me right now because I've got all this stuff going on in my life. This is not the first time Taubes has been confronted with the sustainability of the diet either, and he seemed to be indicating he wasn't eating too healthily of late. Who knows. But isn't that also the point?

He came off implying that weight loss was the only thing that mattered. Cholesterol is totally meaningless, but he offered up nothing to back that despite the opportunity to do so. Frankly, he came off as someone who doesn't seem to care a lot about his own health. I don't think that's the case, but most of his audience on Oz isn't composed of Taubes' followers. They only saw this snapshot.

Welcome to the Asylum!
Unknown said…
The problem is that cholesterol tests, even ones that measure particle size, etc. really are only applicable through the lens of the SAD. Kitavans had low HDL, high trigs, most likely dense LDLs, but had no heart disease.
CarbSane said…
Hi Roger, this is a good point, but then why not just say so. Taubes is a master of the "obscure cultures" except for those that don't seem to fit his hypotheses ... those he knows nothing about seemingly.

I've speculated many times that the reduced trigs on low carb may well not be as great a development as is oft celebrated, but he could have done so nonetheless. I also have to go back through my history one time and see if I can't relocate a study showing elevated HDL on low carb wasn't necessarily a good thing. After all, alcohol increases HDL too!

For any one individual, however, I think lipid panels can be informative so Taubes apparently not even knowing or seemingly wanting to know his is rather puzzling.
Melchior Meijer said…
Exactly. The 'atherogenic' lipoprotein profile reflects a high carb intake. In western populations this generally means a diet predominated by wheat and sucrose, accompanied by boatloads of LA-rich plant oils. In folks like the Kitavans, the same 'atherogenic' lipoprotein profile reflects nothing more than a high carb intake. So in our culture low HDL, high sd LDL and high trigs are a reliable marker for the wrong kind of insulin resistance, hyper insulinaemia and the whole ugly metabolic shebang that follows, while in most non agriculturists (and western folks eating high carb sans wheat, sugar and concentrated plant fats) it probably means exactly nothing.

We should really focus more on the physiological effects of certain 'neotlithic' food items. Enter wheat, sucrose, plant oils (in sufficient amounts) and milk (I don't say dairy) and things go wrong. Compare the lab works of a raw vegan and a meat centered paleo adept, and I bet you could hardly tell who is who. The reason is obvious, they both exclude mentioned culprits. (CarbSane, just curious, have you ever really excluded wheat, sugar, milk and plant oils?)

I have been fascinated by this DurianRider guy. He looks like a ghost on his diet of banana's. In fact, the majority of the raw vegan zealots look like AIDS victims (but I know quite a lot of overweight vegetarians). This directly contradicts the carbs drive insulin drive fat accumulation paradigm, assuming the man is eating to his hearts content. However weird this way of eating may be, I bet this DR-guy has low basal insulin levels and needs little insulin to get the jobs done. Just like most paleo's. It can't be too good for the brain though ;-).
CarbSane said…
Hi Melchior, On the exclusions let's see. Milk? Never a milk drinker ... I think the last time I had a glass was that time I did the cookie diet ;) I do take half and half in my coffee and eat cottage cheese. I've been putting off a dairy free lots of coconut fat challenge while family issues settle out. Sugar? I've gone without for months on end at times. Until summer 09 I ate no fruit on VLC. Wheat? Not totally, but I haven't had more than an LC wrap for months. Veggie oils? Was still using those during my weight loss. I wouldn't fully drain my tuna and used canola on salads. Now I rarely use canola and even olive oil lasts a long time here. Most of my fat comes with my food, I add very little.

Never heard of DR, looks like an interesting fella!
Melchior Meijer said…
Re this Australian fruit cake, Julianne Taylor ran an analysis of his diet:

Regarding your diet: maybe you should go raw vegan. Just kidding. Seriously, I'm surprised when people don't spontaneously decrease their energy intake (and lose fat mass) sans wheat, sugar, dairy and excess LA.
RRX said…
That's unfortunate how he flubbed that one when he had the opportunity to reach the Oz audience. Robb Wolf did a far better job discussing the issues with the cholesterol tests on Jimmy Moore's show. Maybe Taubes needs to spend a little more time discussing these topics in real-time where he has to be on his toes and better capable of handling conversation. That was a lost opp.


Is it me or is anyone else tired of Taubes going on about his kids and his job? I'm not interested in hearing about how busy he is. I listen/read for information on the topic of diet. I prefer he stick to that.
CarbSane said…
For anyone skeptical or concerned about the fat in a low carb diet, as many in Oz's audience no doubt were, the take-away feeling they got would be one of Taubes being defensive about it as if there were something to hide. How amazing would it have been for him to say let's both do our lipids on a VAP and discuss them! It would help more people to avoid the dangerous statins. Rather he's hung up on carbs make us fat and exercise is useless for weight loss which many will use as an excuse to exercise even less.

You're not the only one who finds his personal life comments distracting. It's irrelevant. Apparently he's upset at what was edited out of that segment ... but he gave them the footage they used! Why even go into that? Worse comes to worse, he should have just said this is not about my lipid profile, look at the results of Shai & Foster & etc.
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