Q: What's worse than an education in Human Metabolism from a journalist?

A:  An education in Human Metabolism from a comedian.

Blogger stats are interesting things at times.  It's curious to see where people find this place from.  Following my Insulin Wars series, I was rather shocked to see the Tom Naughton, aka Fat Head, installment shoot up my most read posts list, where it remained for a very long time.  As that series went, that particular post was no big deal.   I had quite a lot of traffic coming from Tom's blog.  What this tells me is that a LOT of people are getting their information from a comedian!  This guy actually has a lecture DVD out now.

This isn't good folks!!

Now, a lay person can certainly teach themselves about metabolism and such.  There are many examples on the internet that I'll leave unnamed.  But whenever I hear folks like Tom talk about LC, I'm reminded of Judith Mazel and her Beverly Hills Diet.   I'd read parts of her book when friends of mine tried this diet.  (I thankfully spared myself at least this kooky scheme).   You see Mazel had you eating certain fruits, fruits like papaya my friend was basically having to choke down by the third day, because of the fat-burning enzymes they contained.  This confuses digestion with metabolism.  For weight loss (but not health) the goal would be to minimize digestion!

So anyway, I came across this interview with Naughton and just had to comment after reading this:

Interviewer:  Beyond “Fat Head,” you have also made one of your lectures available which is titled “Big Fat Fiasco.” Within that lecture you state that people are “as fat as they need to be.” Now, leaving the data and other scientific minutia to the lecture, could you succinctly define what that means? ...
Naughton:  It’s tough to explain it simply, but here goes:  Your body absolutely must keep blood sugar within a very narrow range.  If blood sugar goes too high, it’s toxic.  If it goes too low, you pass out and maybe slip into a coma.  Your body keeps blood sugar level by alternately storing and releasing fatty acids.
When blood sugar goes up, you store fat and burn glucose first to bring it down.  When blood sugar begins to drop, you release fatty acids to serve as a primary fuel and preserve the glucose for your brain. 

Now Naughton is describing the Randle cycle linking glucose-fatty acid metabolism, and what he states of the relative reciprocal levels of FA's and glucose is all factually correct.  But he is implying that the adipocytes, through regulation of the triglyceride/fatty acid cycle (TG/FA) are the prime regulators of blood glucose, and this is innacurate.  There are a number of things demonstrating the Randle cycle is far too simplistic to explain blood glucose control in higher animals.  For starters, while fatty acid levels can vary five fold, blood glucose varies only around 30% in the post-absorptive (basal) state.  Secondly, there are situations that elicit a rise in both glucose and fatty acid levels - for example cortisol raises both glucose and FFA levels.  Therefore it's fair to say there's a hormonal network that under most conditions regulates glucose and fatty acids (according to energy needs and energy sources available, I would add) in a reciprocal manner, but if anything, it's the glucose levels that regulate the fatty acid trafficking.

But it is the liver that bears the primary responsibility for regulating basal circulating glucose levels.  It does this through the interplay between glycogenolysis (breakdown of glycogen) or glycogen synthesis as well as gluconeogenesis.  Postprandially, our bodies regulate blood glucose levels by "disposing" of the exogenous glucose - the glucose is taken up by the cells and oxidized (oxidative glucose disposal = burning glucose) or stored as glycogen (non-oxidative glucose disposal).  In humans de novo lipogenesis is a relatively minor pathway for non-oxidative disposal and insignificant absent significant carb overfeeding.

The other issue with this is that elevated fatty acids - e.g. excessive supply - tends to lead to increased blood glucose levels, not decreased levels - especially in the postprandial state.  They do this by inhibiting clearance from circulation.

If your fat cells release fatty acids too slowly, which is what happens when you become insulin-resistant, they can’t provide you with enough energy to keep your glucose within the safe range.  So your body works to make them bigger, and they keep on getting bigger until they overcome the insulin resistance and are once again capable of releasing fatty acids at the necessary rate.
So yes, some people unfortunately need to become hugely fat to maintain a state of energy balance.  Otherwise, even though they’re fat, they end up starving at the cellular level.  Your body doesn’t care how much food you have in the pantry; if the pantry door is locked, you can still starve.
This is just wrong.  Wrong.  Don't believe me, though.  Read the works of Frayn, Boden and McGarry and others of that ilk that I've blogged on regularly here. 

Pathological insulin resistance is characterized by (1) failure to properly suppress NEFA release from adipose tissue and/or (2) failure of adipocytes to adequately clear and trap dietary fatty acids.  Furthermore, this leads to loss of blood glucose control in the fasting state because the liver becomes insulin resistant so insulin fails to adequately suppress gluconeogenesis.  Adipocytes get less sensitive to insulin as they grow.  They don't grow to restore insulin sensitivity!

Naughton is actually correct that the problem with IR begins in the adipocytes.  Hat tip there .... shhhhh ... don't tell Gary Taubes though.  But not in the manner in which he tells us.  The constellation of symptoms that comprises MetS includes amongst it elevated circulating fatty acid levels accompanying insulin resistance.  You're fat cells are simply not efficient enough at locking that pantry door.   

Let's look at the "reality" so many often suggest I need to meet.  As folks get fatter and fatter, do their blood glucose levels eventually stabilize out?  Nope!  Quite the opposite.  Yes, there are the "metabolically obese thin people" that can be explained by the FA hypothesis (but that's a topic for other blog posts past and surely at some time in the future).  But the link between obesity and metabolic derangement flows from the fat cells.  You get fat then you (some not all) exhibit some degree of IR and impaired glucose tolerance, IGT.  As you get fatter and fatter do these conditions get better and alleviate the problem?  NO.  They get worse.  

So please folks.  If you're going to be your own armchair scientist, seek authoritative sources.  And I recognize that with my anonymity and such there's no reason to consider me to be one.  This is fine by me.  Allow me, instead, if you're reading my blog, to act as a channeler of sorts to real science.  It should not be about the "buy-in" (Mark Sisson) or hopelessly simplifying something "for Dummies".  As complicated as the science is, it serves no purpose to get "educated" in hopelessly inaccurate simplifications made up by those with absolutely no qualifications to do so.


James Krieger said…
Not to mention the pseudoscientific claims that you're "starving" at the cellular level. That's straight from Taubes. I've always shook my head when I've heard that nonsense.
Melchior Meijer said…
Hi CarbSane,

Did you see Michael Eades' new post about WWGF? He writes:

"I’m sure many will find these refutations helpful in their dealings with naysayers, who seem compelled to point out non-existent problems with carb-restricted dieting. There is one in particular that I plan to deploy at the next opportunity. Since I have my own arguments against the rest of the anti-low-carb idiocy, it annoys me greatly that I didn’t think of this one myself."

Hmmm, wonder what he means with non-existent problems... So far the low carb oriented scientists I asked about excess NEFA got angry or remained silent.
Mirrorball said…
Not to mention that he totally misses the point of Super Size Me -- that it's easy to overeat when all you have is a huge portion of junk food. Why is the low-carb community so enthusiastic about a pro-McDonald's film?

But I thought his first quote was all right, especially the part "When blood sugar goes up, you store fat and burn glucose first to bring it down." At least he knows that when insulin is up, fat is stored but glucose is burned, i.e. you are still burning the calories you consumed, first carbohydrate, then fat.
CarbSane said…
Ooooh Melchior! I'm going to deploy some Eadesiocies! LOL

Nothing's ever dull :D
. said…
Whatever the "truth" is, I believe the "health experts" that provide us with low-fat and low-cholesterol counseling are the greatest comediants. And given the great complexity of the human body, in a strict sense, everyone is an "armchair scientist".
Sanjeev said…
a journalist, a podcaster and a comedian walk into a research university ... and immediately out again

Taubes, Jimmy & Naughton

So anyway, I'm off to get psychiatric advice from Tom Cruise & John Travolta, advice on ECT from Jack Nicholson and Nurse Ratchett, and paleo diet advice from Kirk Cameron, Tim LaHaye & someone who claimed conservation laws cannot be used for troubleshooting, Kurt Harris.

PS and WWII history advice from David Irving and Ernst Zundel
Sanjeev said…
Or maybe that should be

"3 accomplished comedians walk into a research university ... and one would-be comedian posts on CarbSane's blog ... "


"3 axe-grinding absurdists walk into ..."
FredT said…
negative blog ... self, delete from bookmarks.
Sanjeev said…
This comment has been removed by the author.
Sanjeev said…
for a minute I thought you meant THIS blog, but since truth can't be negative, I realize you must be referring to the negativity of false information,

THEREFORE you're telling yourself to delete the blogs of Gary Taubes and Tom Naughton.

Only stands to reason, squire. Glad you're here.

You've got a good head on your shoulders ... is it yours? ; )
LynMarie Daye said…
My question is, where did these inaccurate notions come from? Naughton is very chummy with some of the big names in the LC community and I believe he credits them with much of his knowledge of human metabolism, yet there's no way any of them told him that fat cells become insulin sensitive by growing larger. Something got lost in translation somewhere.

On a somewhat related note, I came across a zero-carb blog post that made me LOL. Here's the pertinent quote: "Glucose cannot be burned directly in mitochondria. In order for this to happen, it must be converted to pyruvate but the burn is not a clean burn as fatty acids are. Fatty acids only have a byproduct of carbon dioxide and water. Pyruvate leaves lactic acid which turns our cells mammalian when they exchange their oxygen for lactic acid as a means of disposal. This weakens us and saps our endurance." http://blog.zeroinginonhealth.com/2009/04/07/high-blood-sugar-affects-millions/

And here I was under the delusion that lactic acid turned our cells reptilian... ;`)

Seriously though, I echo your sentiments CS; folks need to be a little more selective when choosing sources of information on complex topics like human metabolism. Don't rely on one source and please don't elevate anyone to the status of guru.
CarbSane said…
Oh LOLOL LynMarie! Charles is quite a character. I've seen where he teaches folks that all carbs are converted to fat before being burned for energy - that's what DNL is for.

Yeah, I'm not real sure where Tom gets this from either, but it's probably just an extension of Taubes' starving cells theory.

I've no idea how much weight Tom lost himself, but he frequently writes about how a potato or some such would send his blood sugar skyrocketing NOW. So ... his own experience doesn't seem to jibe with his theory.

I encourage all my readers not to take my word for it, even if I were to "come out" and present my credentials. I continue to be amazed at the number of posters who will smear and ridicule researchers and doctors ... then turn around and take on faith the words of ... researchers and doctors.
CarbSane said…
@OP: I do agree there, we all are our own armchair scientists. My point was that in being so, we need to choose our information sources wisely.

@Sanjeev: When are you launching your career? :)

@jdl: Ain't life in the echo chamber grand?
j said…
i enjoyed fathead simply because of what it proved:

people believe its okay to misrepresent facts and data so long as your intentions are noble.

accept mr. fathead lost weight and improved in a host of quantitative measures of health (the same ones used by spurlock to claim eating macdonalds made his ill) so it begs the question if macdonalds and the food industry are truly the problem or if our ideas about food and inability to stay away from super sized portions are.
Tonus said…
"Not to mention that he totally misses the point of Super Size Me -- that it's easy to overeat when all you have is a huge portion of junk food."

I think that Spurlock set out to make that point, and found that he couldn't do it within the restrictions he set for himself. So he broke his own rules in order to reach the 5,000 calorie mark that would guarantee that he would gain enough weight to make an impression on the audience.

Naughton's approach seems more politically motivated at the start of Fat Head. His primary concern is the idea that if we're incapable (or unwilling) to do what's best for us, then government should step in. While researching that angle, he came across Taubes and the Eades and it pushed the film in the direction it wound up taking.

I can't fault the basis of Naughton's approach in the film, that of taking initiative and responsibility for your own choices instead of blaming someone else and insisting that government step in and relieve us of the burden of making decisions for ourselves. I expect that some will find it ironic in light of his deferral to Taubes and Eades, but I think that might be a bit simplistic and unfair.

But in the end, I'm reminded of the old cliche that knowledge is a journey and not a destination. Fat Head started me on the road to understanding nutrition, diet and health better. That road led me through a number of sites. Taubes, Eades, Hahn, Colpo (you can imagine how that particular link went, heh) CarbSane and Krieger, among others. And I'm sure they'll lead me to other sites and more knowledge and better understanding.
Sanjeev said…
Don Matesz discussing another study - more dietary fat, more bodyweight for equal calories ("metabolic advantage to carbohydrate")


"Humans appear to respond in much the same way as rats to changes in dietary composition. Danforth (11) noted that lean subjects gained weight relatively easily when overfed fat but not when fed a mixed diet of carbohydrate and fat. In an earlier study by Miller and Mumford
CarbSane said…
I need to get around to looking into those studies. I posted some thoughts in comments but I think Don must be backlogged as his last published comment on that thread was on 5/6. One of my thoughts was whether this translates to adult humans who no longer grow in height. Dunno .... it's interesting stuff!
Sanjeev said…
> the same ones used by spurlock to
> claim eating macdonalds made his ill

Forcing himself to eat until he puked ...

I never thought Spurlock made his point at all, and that was at a time I was sympathetic to Spurlock's view.

And it amazed me that anyone believed that he made any kind of case against anyone.

@Sanjeev: When are you launching your career? :)

Way too risky a career.
I'm more likely to become an accountant.
Unknown said…

Your critical analysis of Taube's work has been fun to read but I think we can all agree with his fundamental message: that most people would stand to benefit from removing simple carbohydrates from their diets.

And, I'd rather listen to his advice, which at least attempts to be based on science rather than people like Dr. Oz (who basically says whatever he wants and doesn't seem to worry that there is virtually no evidence to support his ramblings).

Let's not lose sight some of the points that you attack Taubes on are so minute and imcomprensible to most people in the world who don't have science backgrounds and just want to know how to improve their diets.

Honestly, I feel bad for GT when I see him on TV. He is putting himself out there and going completely against conventional wisdom and saying things - that people in the blog world know - but are completely new (and offensive) to the lay public.

I guess what I'm trying to say is instead of attacking people like GT, who seem to have good intentions and honestly to try to back up their ideas with science, why not go after people like Dr. Oz? I can't tell you how these so called "gurus" make my blood boil every time I hear them speak....

CarbSane said…
Welcome Andrew! I'm not attacking anyone, I'm exposing lies. Think of me as a low carb whistle blower ;) The points are not minute, they are the core of his theories. Read the "toothpick" post.

To excuse his professional malfeasance because in the end we can all benefit from cutting refined crap from our diets is absurd IMO.
Sanjeev said…
why not go after people like Dr. Oz?

"the Secret" stuff had been declining for a while, BUT

The James Arthur Ray sweat lodge deaths didn't seem to accelerate that cr*pola's decline, or the volume of related internet spewage, or the careers of those various gurus - all of which leads me to believe reality will never intrude into the world of chOPRAH's mitotic diplones.

repeating the above in english ; )
The audience of the chOPRAH spinoffs, is probably immune to reality. At least the Taubesians give a passing nod[0]

[0] aka "lip service"