Atkins diet can kill you

I've never understood the nonchalant attitude many in the low carb community take towards some pretty serious side effects that you can experience with the diet.  It's not that this happens to everyone, or even most, but it does seem to occur more with LC diets than any other.  I, for one, never experienced my own symptoms of, likely hypoglycemia, ever before.  

So I was in the mood to torture myself further while on permahold the other day and listen to Gary Taubes' Walnut Creek Library lecture from April of this past year in it's entirety.  He was a bit more animated than usual so that helped, and I did make it through.

When they got to the Q&A my ears perked when he got to around the 2:30 minute mark here.  


Apparently when Gary first started the diet, he was passing out and -- his words -- crashed to the floor.  More than once.  He even relates a story of breaking a glass coffee table in a hotel once from one of those episodes.

Now to his credit, he ate a piece of toast and it went away ..... Hmmmmm, sounds more like hypoglycemia than blood pressure but whatever.

But I can't help but wonder -- besides from watching other parts of this session and thinking what the heck is in his pockets? -- does it not strike you as even remotely dangerous that a diet might send you crashing to the floor?   I've had some scary experiences with LC but never passed out!!  To joke that this is somehow something he's used to from his boxing days is absurd.  A diet that causes a presumably otherwise healthy relatively young man to pass out just from standing up is NOT good.

And let us not forget.  Atkins died from a slip and fall.  It isn't funny or something to dismiss lightly.

Comments

Anonymous said…
I remember this happening to me on Atkins induction. The most frightening thing ever, not understanding how I could just suddenly loose consciousness, and be in hospital in a matter of minutes. Now I know it must have been hypoglycemia.

Though probably not of much interest, just thought I would add that, since deciding to go by what I feel like eating, my appetite has increased quite a lot. So, I decided to get a blood glucose monitor, to see what effect might be reflected by the change in diet. I have checked over the last four days blood fasting levels, followed by the one and two hour test. This is how things looked yesterday eating a large bowl of porridge with plums and dash of milk:

Fasting 5.8 mmol/L
1 hour: 5.4 mmol/L
2 hour: 4.7 mmol/L.

I've set no limit on carbs, and my blood glucose seems to be quite low (in the healthy range). It'll be interesting to see if there's a big difference with low carb & high fat meals, which I haven't tried yet. I'm quite enjoying the experiment anyway.
Diana said…
By coincidence, I came across this study:

http://www.healthline.com/blogs/exercise_fitness/2007/07/high-fat-meals-hurt-lung-function.html

I wonder if it has any relevance to Atkins diet health issues?

I suppose Taubes would compare his blacking out to a heroin addict detoxing. Such delusions.
Mirtika said…
I have never done induction level low-carb, but when I went low-carb/Primarian, my blood pressure really took a dive. I've heard other stories of lowering starch/going Paleo and blood pressure dives. It's not just Atkins induction level per se.

And this is actually a beneficial side effect, if it's just in transition and one is careful. In my case, I added salt back in (I had reduced sodium intake at dietitian's recommendation, as i was a saltholic and when I was nearly passing out, both my doc and dietitian were okay with me re-salting in transition).

Now, if it's hypoglycemia, that's another thing to look at/test for. Enough low-carbers have those cheaper glucometers to find out. :D
Unknown said…
Yep, this happened to me too. Sent me to the ER. Really scary and expensive!
Kindke said…
Absurd speculation CarbSane,

so lets see, Gary's words are "i would get up in the middle of the night to go to the bathroom and take 2 steps and pass out"

this means prior to him moving, he was asleep and stationary for an extended period, not something i would associate with inducing hypoglycemia,

What does this infer then? Is the act of moving from lying down and taking 2 steps such an anaerobically demanding process that it rapidly drains blood sugar and causes hypoglycemia? lol please......
CarbSane said…
I don't know how absurd it is considering he said he ate a piece of toast to keep this from happening. That's more likely to up one's BG than BP. Hypo from the liver not making enough glucose when sleeping is not uncommon. But that's not even the point. Passing out, apparently several times, when he was first "experimenting" with the diet?

My symptoms were scary, but I'd be darned if I would have continued on any diet that had me crashing to the floor.
CarbSane said…
Welcome Mirtika! Yes, the BP lowering effects of LC are generally a good thing, but if they are this severe? It's odd. I've seen several folks see their BP go up on VLC. Their concerns tend to get ignored.

FWIW, my own issues came about around 6 months into LC that last time. Never had any "induction flu" or the like.
Muata said…
Evie, thanks for mentioning this because, and I've never posted this publicly, when I was doing a keto diet for close to a year, I passed out twice.

Both times happened right after I had finished urinating (sorry for being graphic), and it was the scariest thing I've ever experienced.

The first time, after I left the bathroom and walked into the living room, everything started to spin and I felt like a whirling dervish until I passed out (just missing the wall as I fell). The second time happened just as I flushed the toilet. I was so lucky that when I passed out, I fell straight down and ended up on the floor right in front of the toilet. If I had fallen forward, I would have done serious damage to my face ...

This is one reason that I refuse to drop my carbs to Atkins Induction levels again ... fainting is just not that fun ;)
Diana said…
http://www.ncbi.nlm.nih.gov/pubmed/20165863

Forgot to post the actual link to the study.

Since this is true confession time, I too had, if not blackout, greyout and brownout issues while low carbing. I was very low energy, grouchy and woozy. I know that Taubes would say I was detoxing like an addict detoxes (Remember The Man With the Golden Arm?) but I now know that is shid.

Doesn't Taubes look like death warmed over?

Catty comment: I checked out some site with pics of the Ancestral Health symposium. Saw some plump dude wearing plaid knee-length shorts and some t-shirt.

I strongly believe that if you want people to take you seriously, you should dress like an adult in public. Thank god, it is no longer the 1950s, but really guys, wear a pair of fitted slacks, and a nice Oxford shirt.
Tsimblist said…
Kindke's Traube quote sounds very much like what I have experienced. If I wake up in the night and get out of bed I may get very light headed & dizzy. And I am not doing LC.

It turns out that runners with a low resting heart rate can experience this. I learned about it from a running forum post by an injured runner. He was hospitalized and learned from his cardiologist that this was common for people with well conditioned hearts.

Now when I wake, I sit on the edge of the bed for a few seconds to let the BP stabilize. Then I can walk with no problem.
CarbSane said…
Well, Mr. Exercise just makes you hungry is a runner so this is possible. Folks don't make too much of random speculation here. I only picked up on his saying he ate toast at the time to remedy the problem. Now he drinks chicken broth? My impression of that rec is more for electrolyte balance as well.

In any case, passing out and falling can be deadly.

The nonchalant attitude was something that irked me about Kurt Harris' response to my own episodes. "Just eat some carbs" ... that's the point ... most LC "experts" will tell you elsewise and not to listen to your body and how that slice of toast that helped Taubes will tank fat loss b/c of the insulin spike, etc. yada yada.

BTW ... do we need to send out a search party for Kurt?
Melchior Meijer said…
Just check Melissa's latest post (Hunt Gather Love). Kurt makes some well reasoned comments there.
Anonymous said…
I haven't read any 'Protein Power' books lately. But I do have a pretty old copy of 'Protein Power.' 1996! Eades answers 'What should I do if I feel dizzy or light-headed?' (in section 'Questions Commonly Asked About the Program') with 'you probably need to increase your salt intake.'

Also, in the same section, he answers questions about how to deal with constipation, diarrhea, fatigue, aching legs, bad breath, and sleeplessness.

In Chapter 11, in a section, 'The Worst Will Be Over Soon,' he says:

'In Phase I and Phase II, when it's so critical to follow the program to the letter, it helps to adopt a boot-camp attitude. recruits go to boot camp knowing it's going to be strict, grueling, difficult, and probably not particularly pleasant. They also know it's going to be over. You need to think the same way.'

The above, and the 'consult your physician' caveat at the beginning of the book, made the low-carb diet sound like an exciting and somewhat dangerous adventure. Must admit: I liked the recipes in the book!
Chris said…
The descriptions of black-outs here are consistent with low blood pressure, not low blood sugar. Standing up and passing out is classic orthostatic hypotension. The beginning phases of low-carb diets result in loss of fluid, which would cause hypotension. People don't move and pass out or pee and pass out from low blood sugar. Passing out is an extreme response to low blood sugar that is usually preceded by other symptoms unless the person has chronic problems with low blood sugar.
Helen said…
I think Chris is right here. That doesn't make it less concerning. A sudden loss of blood pressure can be deadly, in fact.

Without insulin or insulin-stimulating medication, a normal person won't actually hypo.

Subjective "hypos" can be misleading. When I got my first glucose meter, during pregnancy, I was surprised that my subjective experience of hypos did not match the meter at all. When I felt "hypo" (hungry, faint, irritable, spacey), my BG was in the high 130's. (It could be that the sugar wasn't reaching my cells, causing the sensation of hypo - not sure.) The couple of times it got down to 50mg/dl - which is still just north of normal when pregnant - I didn't feel it *at all.* This is from someone who spent a lot of her life claiming to feel "hypoglycemic" many times throughout the day. Oy vey, diabetic it turned out to be.

That brings me to another point. When a person whose blood sugar is averaging high starts having normal blood sugars, it can cause a "false hypo." This can happen to diabetics when they first start normalizing their blood sugars.

I had several bad symptoms during my low-carb experience, some of which I've mentioned on this blog before. One of the most striking was "low-carb rage." It was like having a subjective hypo all the time, and feeling uncontrollably angry at the slightest thing. I know that I wasn't really hypo, though. I was checking.
Anonymous said…
Chris, and Helen, thanks for the info, good to know!
Layla said…
I had the same things happening to me on a regular diet. Not on Atkins. The days I eat too many carbs are the days where I start to feel faint and can actually lose consciousness. I feel best on 20 gr of carbs a day.
I agree with Chris.

It is all related to salt and water, ie blood pressure.

The two ingredients are lost during sweating. And the problem can be increased due to peeing.

Causing dizzyness when getting up, and passing out while peeing.

Low carb diets raise body temperatures resulting in more sweating. Low carb also prevents water retention, which contributes to blood pressure.

Runners also have a higher metabolic rate, which I would expect to increase sweating. Sweating reduces water and salt both.

People with adrenal insufficiency have a similar problem, but due to adrenals not responding to movement fast enough.

The important thing for all three kinds of people is to eat more salt. This will increase retention of water, and will allow maintaining bood pressure even when sweating or peeing.

The toast would buy time, which would help the adrenal to raise the blood pressure.
Frosty said…
I had a real problem with orthostatic hypotension when I was zero carb. I would stand up and suddenly get tunnel vision and spots before my eyes. I passed out once while weeding. It got better when I started adding a lot of salt to my food.
CarbSane said…
Welcome Anand!

OK folks, here's what I said:
Now to his credit, he ate a piece of toast and it went away ..... Hmmmmm, sounds more like hypoglycemia than blood pressure but whatever.


Nothing definitive there and I'm a bit puzzled having a debate on this b/c it is silly to say that hypo doesn't cause fainting (Google fainting or passing out and hypoglycemia and you will find innumerable personal accounts). I'm not saying it wasn't BP either. But toast fixed it? That just seems to be more indicative of BG issues than BP.

In any case, this is irrelevant to the point, which is that a diet that has you passing out is dangerous. Falling down is never a desired thing ... and it can kill you.
Anonymous said…
'In any case, this is irrelevant to the point, which is that a diet that has you passing out is dangerous. Falling down is never a desired thing ... and it can kill you.'

Yeah, that is the point, isn't it... This is one strange diet that has so many warnings attached. Reading 'Protein Power' years ago, it didn't faze me at all, that's the power of the promise you will lose weight!.

Whether the effect is from hypoglycemia or low blood pressure, and all the 'falling down' aside, what if you're driving a car?

The Atkins website says this (for induction phase):

How do I avoid fatigue and weakness on Atkins?

It can take a few weeks in Induction for your body to adjust to burning primarily fat instead of primarily glucose (sugar) for energy. In the transition, you might encounter a few symptoms such as headaches, dizziness, weakness, fatigue—sometimes collectively referred to as Atkins flu—leg cramps and constipation.

Fortunately, all are pretty easy to avoid. Consuming lots of carbs makes you retain water, but shifting over to fat burning has a diuretic effect, meaning you excrete electrolytes and salt along with fluid.

(the solution: broth (not the low-sodium kind) and, in the case of a person on diuretics for hypertension, more leafy greens, nuts, or tomato juice.)
CarbSane said…
And let's not forget Eades telling of his leg cramps whilst maneuvering 2500+ lbs down the highway ...
Diana said…
If Taubes ate toast with butter then that proves the whole lie of "carb addiction." Who ever heard of giving a smoker just one cig during the first weeks of smoking cessation, or a heroin addict just one hit during detox? (Or alcohol...the list could go on).

@Jenna, I'm a little fuzzy on why people who aren't diabetic are checking their fasting glucose. Should I do this? I see these glucose meters real cheap at the drug store and I've always been interested. What gives?
Anonymous said…
Hi Diana, I bought one, just out of curiosity. And since reintroducing carbs my appetite has increased quite a bit. I had listened to Jimmy Moore's interview with Jenny Ruhl of Blood Sugar 101. She was saying how she had noticed how many of her clients(?) or just people contacting her for advice had normalized their eating and subsequently lost and maintained a healthy weight by using the blood sugar monitor. Admittedly these are people I think generally known to be diabetic. But, 'The Healthy Skeptic's' Chris Kresser also advices his patients to use one, to see how they react (objectively) to glucose, fat etc, or just different foods. I personally like this idea. But it appears that I do not have a problem with glucose, or high insulin response foods on blood sugar, but my appetite increases a lot, so I guess I should just listen to that. Like wheat I definitely have a problem with, and its interesting because depending on the kind of form it comes in my appetite reacts differently (this is the main reason I have had trouble ascribing to calories in versus calories out in total). So I guess I'm just going to use a method of deduction until I get to some kind of balance that I can maintain for the long hall! So the glucose monitor does seem to have been a complete waste of money! haha. But, I'm happy to experiment and actually I find it helpful to be able to acknowledge (somewhat objectively) that carbs aren't killing me! :)
Anonymous said…
Oh and just to add, I do think that my judgment of wheat's effect on my appetite for instance is all subjective, and so may have absolutely no basis in reality, as in its all down to my perception of wheat thats doing the harm rather than there being anything intrinsically wrong with wheat. I've thought about this problem, and I guess at some point you have to make that judgment call for yourself. I am aware that there are certain "camps" that deem gluten generally and wheat especially as "toxic", that we haven't evolved to process these foods, that they cause, or significantly influence "gut permeability", IBS, "mental health problems", retarded development of "grey matter" in the brain of children (regards wheat), etc. There are other camps that deem the evidence "flimsy", and the weakness of the "imagination of the masses" (not privileged to a certain level of education), particularly vulnerable to these beliefs because they can't sift through the crap thats enveloped by a complicated language we cannot hope to understand without someone translate it for us. (There are other camps who think that the chemicals and techniques used to process food are causing such harm (and certain popular food items just happen to be their carriers). There are other camps that think that even if these foods for example, are causing such harm, we are evolving and as part of our biochemical(?) evolution we must endure so that future generations do not suffer the same plight (for instance lactose tolerance is a result of our ability to endure). It's a difficult call to make, who, or what to pay more attention to, so I think we must observe, and consistently challenge our own beliefs, be open to differing viewpoints if we're not finding resolve to our problems by following a certain logic, or a certain trend of thought. (I hope this doesn't sound antagonistic, I just wanted to be as clear as possible with regards to why I bought a blood sugar monitor, haha; because there is always room to doubt, for me personally, which may prove part of the problem! Wasting money buying a blood glucose monitor; spur of the moment, and all that).
Unknown said…
Well, as far as my experience is, since a child I had problems with both weight and arterial hypertension. Now is very common for me to experience orthostatic hypotension.
Anonymous said…
Lucas, when experimenting with Atkins, I experienced some kind of paralysis at night time. I would fall asleep and wake up, as in I was conscious of being awake, but unable to move my limbs, my head, any part of my body. Very terrifying. Just wonder what you think of this, would this be related to blood pressure? I had that experience quite often on Atkins.
Alan said…
> I'd be darned if I would have continued on any diet that had me crashing to the floor


CS was the last person I thought would get fooled by randomness.

You know people, last year I ate an English Muffin, then just a mere three weeks later, there was an eclipse of the moon.

You can be sure I won't eat any more English Mufii !!
CarbSane said…
@Lucas: I would only ask this ... is there no middle ground? I can't imagine such a state and all the cramps and keto breath provided much of a survival advantage in paleo times! What say you?

@Alan: Apparently you missed where it was Taubes himself that ascribed his fainting spells to his "experimental" diet. And you also missed where he ate carbs (in the form of toast) to remedy the situation.
Helen said…
Evelyn -

I think the issue here is that if you are blacking out from hypoglycemia, you are on your way to death unless there's intervention. It's a late stage of extreme hypoglycemia (not that it can't happen quickly - enough exogenous insulin will do the trick) - I'm not sure the exact mg/dl - maybe 20. But a normal person doesn't produce that much insulin and their liver will produce sugar to normalize blood glucose, because being low is so dangerous. What's described here does sound more like orthostatic hypotension.

Jenna - Your experience sounds like sleep paralysis. I used to get it in my teens and twenties. I don't know what causes it, but I've never heard low blood pressure as a cause. It would happen to me when overtired, and only when sleeping on my back. I'm not sure why it would happen more on low-carb, except if it's related to increased stress hormones, which I think low-carb can cause in some people.
Anonymous said…
Alan, nice point! Some of us struggle (get stuck) on the minutia. The more I try to expand my understanding, the more I think diet effectiveness is all in the level of attention paid, and due tweaking. It seems there is no "one size fits all" some approaches work better than others and this differs on an individual basis according to genetic influences (ancestry), food sensitivities, psychology, environment etc, real or imagined. Such an interesting subject. I'm starting to think that trying Atkin's and being miserable and developing an eating disorder was most probably just that certain proportions, food types were not agreeing with me. So its not that there is anything necessarily wrong with high fat nutrition, just that it didn't work for me, because perhaps I just wasn't getting the right micro-nutrition. The talk of reasons for fainting is really interesting to me; if blood pressure is influenced by such things as electrolyte imbalance and this were to explain my episodes of fainting at a time I did not have an eating disorder, and I was not underweight. I was not consuming bone broths, I was not eating any fruits, I was eating like 20grams of carbs a day (non-starch veg), I ate mostly eggs, a lot of cheese, butter, meat, fish. Would you believe my binge foods were cheese, sausages, bacon and eggs. Then peanut butter (by the jar), wheat bread, cereals, and everything you can think of from then on (uncontrollable binge eating followed). So, thanks for that! i.e. Fooled by randomness: very interesting to reflect on.
Anonymous said…
Thanks helen! It could be entirely unrelated to diet even. But, I think I will stick to never doing Atkins again in any case! :)
Unknown said…
@Jenna: I have also experienced sleep paralysis, but I dont remember if it was a dream or it was true. Probably the former. If true, Im not sure what the cause is, although most likely not related to BP. Where you eating a "typical" Atkins or a more Paleoish-Atkins diet? Artificial sweeteners?

@CarbSane:
My opinion in this topic is that there is a difference between what could have been a paleoish ketosis state and therapeutic ketosis.

From my point of view, it is very unlikely that paleo men would have been in deep ketosis for most of the time. Probably the default state (or the natural state) was mild ketosis (up to 2-4mM). The diet was probably high protein (antiketogenic) and high calories (antiketogenic to an extent). Fast periods and physical activity would increase ketogenesis and balance the equation. Obviously, we are not talking about high carb eating populations.

The evolutionary advantage of using fat and ketones for energy is obvious. A high protein intake helps replenishing glycogen stores for high intensity bursts. There is evidence that glycerol is converted more readily into glucose during a low carbohydrate diet. The Cori cycle and lactate recycling are also involved. Low carbohydrates also spare glycogen.

Cramps and related symptoms are probably because of dehydration, and in some cases, I think they reflect inflammation. A low carbohydrate diet can sure be inflammatory. This is something many low carbers forget.

I dont get cramps much often, only the "normal cramping" observed in almost everybody. But I do get numbness in arms and legs when I keep in a certain position, compressing blood flow to the area. Something that was not common for me (might be due to low BP and low HR). My overall symptoms suggest me is not the ketogenic diet per se, but the effect of calorie restriction. My symptoms are more similar to that experienced by CRONERS, including lack of cold tolerance and decrease body weight. I fast daily and dont eat much calories (2000kcal in my best days, probably 1400-1600kcal most days). I eat mostly fat and eat by hunger, which has been supressed greatly since reducing protein and increasing fat intake. Since the switch (less protein, more fat) I have been constantly seeing my calorie intake being reduced, which conflicts with the satieting effect of protein.

Well I guess I went away from the subject (hehe). Overall, the only "notable" and constant side effect from my diet is orthostatic hypertension, which is not a big deal and totally predictable. And by the way, I dont have bad breath :).
CarbSane said…
Thanks Lucas. I am still a bit puzzled why there can't be a dietary middle ground with the blood pressure. I'm glad for your sake that the hypotension is entirely predictable. What GT was describing sounded a bit more concerning to me. I mean if you fall and break a glass coffee table in a hotel room, that sounds kinda serious and not predictable.

Helen, I never passed out from what I believe was my hypoglycemia (no BG monitor at the time when I had it the worst but BG in mid 60's when it was pretty rock steady in the 70's and 80's before my first meal the time I felt the weirdness) but I've just seen too many accounts of folks doing just that multiple times and the life-threatening aspect was more falling than imminent bodily shut down. It seems odd to me is all that toast would be a remedy for hypotension.
Melchior Meijer said…
It definitely looks like a classic case of orthostatic hypotension. The toast did probably nothing to remedy the situation. Like Helen says, real hypoglycemia almost never happens in people who are not injecting insulin. It just doesn't happen, not even after a month of fasting so to speak. People say they experience a 'hypo', but if you check their blood glucose, you'll seldom get a reading under 4 mM/l. Something else is going on and I suspect it has to do with stress hormones and/or neurotransmitters. If you feel terrible with a blood glucose of 5 and get relief from eating a handful of raisins, it might be that you are just giving your brain some much needed dopamine or serotonin (just speculating).

I read somewhere that people who are used to having (too) high blood sugars tend to get hypo symptoms when their bg starts falling. On the other hand, some diabetics lose the ability to sense real hypoglycemia, which brings with it the much dreaded risk of suddenly passing out (and in the worst case never waking up again). Normal people though, first become terribly ill when their bg really goes too low and before they really pass out glucagon, adrenalin etc will kick their glucose up.
Anonymous said…
Lucas, I ate "typical" Atkins, and I was really healthy, I felt very good, but 6 months in things started to change. Near to when I developed eating disorder problems I lived in Halls, (University), my diet changed, more low quality foods, a bit erratic, and I was quite stressed, but still I was consuming 20 grams carbs, high fat, but a lot more protein. I remember my appetite changing a lot in Uni. Which could be entirely unrelated to the diet, I don't know.

Sleep Paralysis after looking it up, sounds very much like my experience, I don't think it was a dream, I am quite aware of feeling panic and having to focus in a way that would make me feel less panic, it was typically as I was waking from sleep. But, who knows, maybe I was dreaming. Other things I remember being problems were restless legs at night, pain in my leg muscles, difficulty falling asleep, loss of menstruation, stuff like that. And I was a healthy weight when I lost my menstruation which makes me think that it must have been something about what I was not eating that was the problem.
Melchior Meijer said…
BTW, it is a common misconception that orthostatic hypotension means a (nice) low blood pressure. Many people with hypertension experience orthostatic hypertension, even to the point of fainting, many people with BP's in the 90/60 range jump out of bed without the slightest light headedness. Orthostatic hypotension has to do with not optimally functioning baroreceptors.
@CarbSane
Thanks for the welcome.

I am not advocating low carb. I couldn't survive on low carb due to the adrenal issue. I do eat a mixed diet. Not nearly paleo. Not low carb or low fat or high carb. I do eat a lot of rice and some lentils being an Indian. Small amounts of Meat/fish is almost everyday. Veggies are a big part. The important missing thing is the fermented foods, and I would like more greens.

I think everybody is different and some people do work very well on low carb, but some people need the carbs a lot. We can't really generalize that everybody needs to have carbs in their diet. It would definitely depend on their ancestry.

A point to add here is that traditional vegetarians in India, like my wife survive very well on a vegetarian diet. They have been living a long life as well. I guess they have adapted to that diet. But people like me who are from non-vegetarian background do not survive well on vegetarian foods only.

The reason why we where thinking it is hypotension rather than hypoglycemia is because it happened when getting up or peeing. If it happened during walking or exercising or even sitting, we would think it was hypoglycemic. Any way I will stop here.
CarbSane said…
Thanks for the background Anand! OK folks, I will bow to the knowledge and intelligence of my readers and accept that this was hypotension. Like I've tried to say, that wasn't the crux of my point, but I'm happy to concede nonetheless!

My frustration with this sort of thing is because I see a lot of folks who seem to suffer for longer than just some short keto-adaptation period. As I've shared, I never went through that so-called induction flu. My issue this time was mostly the occasional bouts of cramps, but those are quite debilitating and never happened except for LC'ing. I probably had ortho-hypotension back in my late teens/20's when I used to fast for days at a time and I weighed in the 110-120 range. I was refused to give blood b/c of low BP on more than one occasion. Still, never passed out. To me the thought of waking up on the floor is not appealing no matter how transient or seemingly benign the cause.
Melchior Meijer said…
CarbSane, orthostatic hypotension with low energy intake is well documented. Low carbers who get results (loss of excess fat and/or improved health parameters) have per definition reduced their energy intake.

This quote from a textbook might also provide a clue in the specific case that inspired you to write this post, ha, ha, ha.

"Both chronic anxiety and hostility decrease baroreflex sensitivity, that is, how well the baroreceptors work."

It would be interesting to know if Gary's fainting spells started before or after a certain blogger appeared on the scene ;-). But I still respect Gary. I agree with Kurt Harris: the man has done a massive job in stimulating folks to think. And though carbs drive insulin drive obesity has been proven to be too simplistic, he's probably still right on many things.
Diana said…
"he's probably still right on many things. "

What things?
Diana said…
Lucas, "The diet was probably high protein (antiketogenic) and high calories (antiketogenic to an extent). Fast periods and physical activity would increase ketogenesis and balance the equation. Obviously, we are not talking about high carb eating populations.."

Not so fast. I would call the paleolithic diet high opportunism. Whatever you could get your hands on. Maybe sometimes that was carbohydrates. Central African pygmies live to celebrate the honey harvest. Perhaps there were places and times when fruit was abundantly in bloom. Let's be a little cautious about assuming their macronutrient percentages.

http://news.discovery.com/history/flour-human-ancestors-neanderthals.html

Sure - they didn't eat bagels and candy, but they ate carbohydrates when they could.
Duffy Pratt said…
I did a quick google search on dieting light headed. The first results were from people on calorie restricted diets. It doesn't look like this effect is something that is exclusive to low carb dieting. So shouldn't there be some warning: "Calorie Restricted Diets Can Kill You"?

Of course, that's also pretty obvious. Stay on a zero calorie diet for long enough and see. But from these posts, even a 1200 calorie a day diet seems like it was enough to cause light headedness.

Also, Atkin's fall is irrelevant, and it might even be misleading. There's nothing to show that his fall had anything to do with his diet. He was fairly old, slipped on ice, and died of the complications from the concussion. Also, at the time of his death, he weighed 258 pounds. The more interesting question for me about him is whether he was still on his diet at that point (and it was failing him), or whether he had gone off it (and if so, why).

Yes, falling is dangerous. Taking showers is really dangerous, and many people die from falling in the shower each year. But that has as little to do with the Atkin's diet as his fall.
CarbSane said…
Hi Duffy & Welcome to the Asylum! My reference to Atkins was for the irony/stark reminder that a fall -- however precipitated -- can kill. His age may have been a factor in reacting to the fall or avoiding it's full impact, but hit head and it can be serious. Natasha Richardson anyone?

Taubes makes this sound like it occurred a few times and laughs it off. OK. I say, no laughing matter.

There's the other irony here that if it's just calorie restriction, GT claims LC is NOT calorie restricted .......... Yeah ... the inconsistencies are too much to bear at times!

I do think LC adds an extra hypotensive component (in most) to that already induced by severe CR.
Duffy Pratt said…
I've only read Good Calories, Bad Calories. I don't remember Taubes claiming there that one could lose weight on a low carb diet without also changing the energy balance to net negative. On the contrary, he recognizes caloric balance as being "tautological." His criticism is that it is true, but fails to explain anything. (As Wittgenstein put it, the statement "Either it is raining or it isn't." doesn't tell you much about the weather.)

The other main criticism he has about the calorie in/ calorie out theory is that it generally fails to recognize that the variables are not independent of one another.

For me, the weight reducing aspects of a low carb diet are a nice side effect. I've gone back on one because I have low HDL, high triglycerides, high blood pressure, and acid reflux. All of those things come under control (or at least did last time) when I cut out the starches and sugars. And, with a significant carb reduction, I'm hoping the diuretic effect will allow me to reduce or maybe even eliminate my blood pressure meds.

Thanks for the welcome to the site. I may have some trouble at times with the over the top rhetoric, and I don't like the excessive use of uncommon acronyms. But overall it looks like a good place.
Sanjeev said…
> On the contrary, he recognizes caloric balance as being "tautological."

http://carbsanity.blogspot.com/2011/03/fasting-insulin-weight-loss.html

search down the page for "table full of examples"

It's NOT a tautology the way Gary Taubes uses the word.

Explaining a phenomenon by recourse to physical law simply canNOT be a tautology.

And if he meant "something everybody already knows", one, he's WRONG, two, he could choose a way of saying it that is not overloaded, different than "it's a tautology". Some may be impressed by the vocab, those who know anything see the poseur.
Sanjeev said…
> I don't remember Taubes claiming there that one could lose weight on a low carb diet without also changing the energy balance to net negative

On the contrary, he plays both sides of this issue and some seem not to realize it.

This is the launching point of the obesity discussion in Good Calories Bad Calories:

Gary Taubes: ... they eat no more than the lean—surprising as it seems, the evidence backs this up ...

GCBC chapter 14 paragraph 3

The more closely we look at the evidence and at obesity itself, the more problematic the science becomes. Lean people will often insist that the secret to their success is eating in moderation, but many fat people insist that they eat no more than the lean—surprising as it seems, the evidence backs this up—and yet are fat nonetheless. As the National Academy of Sciences report Diet and Health phrased it, “Most studies comparing normal and overweight people suggest that those who are overweight eat fewer calories than those of normal weight.” Researchers and public-health officials nonetheless insist that obesity is caused by overeating, without attempting to explain how these two notions can be reconciled. This situation is not improved by the prevailing attitude of many nutritionists, obesity researchers, and public-health authorities that it is evidence of untoward skepticism to raise such issues, or to ask questions that lead others into contemplating the contradictions themselves.
Duffy Pratt said…
I agree that he is not using "tautology" in the way it's used in logic. And it's also clear that there is an empirical component to the caloric balance hypothesis. Here's how I took his comments. Suppose someone wanted to know what causes a thunderstorm. A person then explains that lightning is the grounding of electrons from clouds, not much different from static electricity. That's true, but may not answer the question about what causes thunderstorms.

As for your second comment, of course I remember Taubes saying that there are obese people who eat in moderation. Are you saying this is false, or just that it might be misleading? There is a big difference between claiming that some fat people eat no more than their freinds who are lean, and claiming that low carb dieting will keep one thin no matter how many calories one consumes. He makes the former claim, but I don't recall seeing the latter claim in Good Calories, Bad Calories
Sanjeev said…
Or in math, or philosoply, or science, or the way the vast majority of people who actually know what it means use the word in english.

If one means "known" or "well trod" onb does NOT need to use "tautology", unless the aim is to confuse and muddy and to strike a faux intellectual pose instead of to communicate clarify.

And you'll note the 2 biggest parrots of that line on this forum, Kurt Harris and "Christian", who repeated it (felt like) infinite number of times did not even know what it meant and disappeared soon after their cluenessness was clear.

Like I wrote, he's playing both sides of the issue and is not being challenged enough to issue a clarification. He knows his fan base though, so even if everybody pushed for clarification I bet he wouldn't do it.

I've counted many many occasions he said or wrote

"no carb, no restriction needed for fat loss."

I have never read from him, and challenged folks to show me something to the effect

"if you cut carbs and still gain weight now you cut calories."

Even Eades occasionally takes pains to clarify that this is a point where he and Taubes split.

There's a REASON Taubes fans tell Jimmy to increase his fat and go zero carb.
Diana said…
I'm wondering if Duffy read the same book I read.

Regarding what Paleo folks ate, found this tidbit:

"Some foragers get truly ecstatic when you whisper the word 'cattail' into their ear. Their eyes glaze over and you'd better have some tissue handy in case they start drooling. I am not quite as enamoured with them, but I admit that they are a great all round (and all year round) foraging plant. Indeed, in times gone by some hunter and gatherers relied on it as one of their staple foods. Cattail offers two great advantages: a) it is an extremely rich source of starch and b) it is available throughout the year."

Hm.

http://www.sacredearth.com/ethnobotany/foraging/cattail.php

But of course we all KNOW that those paleo folks ate mostly protein, supplemented by some fibrous gristly plants? We KNOW that, don't we?
Sanjeev said…
mmmmm cattail muffins.

I vaguely remember a BBC documentary that showed around 40 foods that were used by various African and Brazilian tribes as staples that the rest of the world has never heard about.

Couple of insects (it's TV, I guess you gotta have shock value) but they were mostly starchy plants.
Sanjeev said…
>> I have never read from him, and challenged folks to show me something to the effect

"if you cut carbs and still gain weight now you cut calories."
________
Even Atkins wrote that in one of his books
Duffy Pratt said…
Sanjeev: The thing that puzzles me is why people here get so worked up over this misusage. He is very clear in the book that he accepts the proposition that whenever there is weight gain or loss, there will also be an associated caloric increase or deficit. Indeed, many of his arguments start with this premise (for example, the idea of averaging caloric intake over a long period of time to show the absurdity of "overeating" as a cause of obesity). His argument is that the association doesn't then show the "cause".

The standard line, he says, is that obesity is attributable to a failure of will. Will, of course, is not a thing that can be measured or quantified. Thus, if you take lack of willpower to be the cause, you have embraced a fundamentally unscientific explanation. It can't be tested because there is no baseline for measuring will in the first place.

The use of "tautology" may be misfortunate, but I just don't see it as earth shattering or deceptive as others seem to.

Diana: I'm pretty sure I read the same book. As I said, I'm not as interested in his theories about obesity as I was in the first section about heart health and diseases of civilization. I'd be very interested if someone showed me that the materials in those sections was also wrong or deceitful.
Melchior Meijer said…
"I'd be very interested if someone showed me that the materials in those sections was also wrong or deceitful."

Me too. This blog is a gem, it is of paramount importance that all questions be asked, but I don't understand the sheer hatred towards specifically Gary Taubes and Jimmy Moore that is expressed by some commenters. I'm actually not talking about CarbSane, but about a few militant groupies who show a tendency to lick her butt on every occasion (purely personal interpretation). Observations like 'Gary Taubes looks like death warmed over' are irrelevant and uncivilized and will immediately put off more scientifically inclined readers. The attacks on Jimmy - and especially on his physical appearance - make me sick. It might be a cultural thing, but on this side of the pond you just don't do that, unless it is extremely relevant. Regardless of his personal views and his supposed lack of objectivity, the man has done a hell of job to give a voice to insights and messages that seldom get a platform. Some of Taubes' conclusions are wrong. So what. Does that make him a complete asshole? Does anybody realize how many lives have been improved thanks to GCBC, despite the fact that carbs drive insulin drives fat accumulation is not entirely true? His 'attack' on Stephan was not smart to say the least, but Stephan is clever enough to set him straight, which he did. Taubes behaved like a dick because Stephan is challenging his core belief. This is very human and the resulting humiliation is usually followed by a review of ones insights.
@CarbSane: Want to add one more point. Doesn't matter what diet paradigm you are following, important thing is to be able to recognize when its not working for you. Without that you can't ever find the best one that works for you.

Many people in the paleo sphere come from a vegetarian or vegan past, and realized that it was bad, then swung to the very low carb world of Atkins, took another several years to realize that this doesn't work well too and now have found a middle point. People who will move faster to the ideal point are the people who are more receptive to their bodies needs.
CarbSane said…
@Melchior, hatred is a strong word and I don't really see a lot of it around here. Some, yes -- I believe the word has even been used -- but not a lot. I really take exception when folks describe me as a Taubes hater. I don't hate him. What purpose would that serve in my life? I think he's an arrogant dishonest jerk, and since I have had personal interaction with him I would have no inclination to meet the man in person. He's not that "who would you want to have a beer with" kinda guy. But his personality is not relevant to discussing his work. His honesty is.

I'm not sure where you've seen anything that could even be construed as hatred towards Jimmy Moore here. Pointing out that a person who made their name by losing weight is obese and has regained significant weight is highly relevant. Especially since he so actively promotes low carbing (and a more and more extreme version of it) as the answer to obesity using his success story and doles out advice on diet. He may not be an expert, but lots of people here the "healthy high fat, moderate protein, low carb diet" mantra and presume he knows what he's talking about b/c he's interviewed so many folks. Would Jimmy be a "have a beer with guy"? I'm sure it would be a pleasant enough experience, but the whole time I'd be wondering what the "other face" was thinking. By that I mean in our exchanges Jimmy has been a two-faced person. Jimmy's that guy who's a friend to your face but if his other friends didn't like you he'd have no problem having a laugh at your expense.

Does anybody realize how many lives have been improved thanks to GCBC

I don't think this excuses his behavior since being made aware of the various errors in his book. He's the one who would invite personal criticism b/c he's gone after personal aspects of each and every one of those critical of him (remember the college buddy whose girl Gary stole?). He has not answered ANY of the questions about the science and references I've raised. Rather he distracts with somehow if I can't get his evasive description of some sort of irrelevant chronology right, I can't possibly be right about insulin.

@Duffy: On that issue, I didn't spend much time on that part of the book because it was nothing new to me. He can be right about some stuff and wrong on others. His carb-insulin hypothesis is wrong. He knows it, but he's got two young kids to put through college some day. <-- his words not mine. I have some thoughts on the other stuff you've raised I'll hopefully get to later.
bentleyj74 said…
" I don't understand the sheer hatred towards specifically Gary Taubes and Jimmy Moore that is expressed by some commenters. I'm actually not talking about CarbSane, but about a few militant groupies who show a tendency to lick her butt on every occasion (purely personal interpretation). "

" The attacks on Jimmy - and especially on his physical appearance - make me sick. It might be a cultural thing, but on this side of the pond you just don't do that, unless it is extremely relevant."


Let's get this straight. You are too cultured and polite to endure the rudeness of commenting on the appearance of an obese man who just so happens to have built his franchise on his weight loss and the health promoting benefits of his diet but as for casually referring to commenters as butt lickers and militants...you're sort of fine with that.
Melchior Meijer said…
Yes anonymous, I'm sort of fine with that. Rudely critisizing the behavior of an anonymous crowd is another thing than rudely critisizing the physical characteristics of a named individual.
CarbSane said…
WOW Melchior.

I am very saddened to read this from you.

I had forgotten to address that "butt licker" remark of yours in my first response. Most of the comments here are not of that nature at all, although the expressions of support, thanks, etc. about me and this blog are always lovely to read. Still, my comments will never be mistaken for, say, those on the blogs of Eades and Taubes where just about every post is greeted with tens of posts expressing nothing but adulation. I think it's really cool that we actually discuss things here!

Jimmy Moore makes his living on promoting the diet plan that produced his physical characteristics. It is hardly rude to point out that Jimmy v. 2011 is not Jimmy v. 2005. And all of these low carbers who poke fun at folks eating low fat diets that "don't work" are fair game for scrutiny over what the diets they advocate are "working" for them.
CarbSane said…
Hit post too soon ...

I don't see how much more "extremely relevant" Jimmy's weight could possibly be!
bentleyj74 said…
"Yes anonymous, I'm sort of fine with that".


Gotcha. It's not about about rude, it's about rude on your terms. That's pretty universal. No culture clash at all. Thanks for explaining.
Sanjeev said…
Duffy Pratt said...
Sanjeev: The thing that puzzles me
______________
I'm not worked up about Tabues anymore, just "ho hum, there he goes again"

he uses invalid arguments, massive amounts of cherry picking and absolute BS to convince people they can eat infinite calories as long as it's zero carb.

I ask again: where is the sentence that reads "you ate zero carb and gained weight, now it's time to CUT CALORIES".

IMHO it can only be a deliberate campaign. He's had more than ample opportunity to clear up the situation.

Ten words. In a 500 page book, then a 300 page book, and interviews and articles and blog posts, and in all that, he can't write those words.

TEn words. Eades writes those words, why can't Taubes?

> The use of "tautology" may be misfortunate,
> but I just don't see it as earth shattering or
> deceptive as others seem to.

you're putting the shoes on the wrong horses. people gaining weight on low carb because they think they can eat unrestrictedly is misfortunate.

The fact that TAubes could have put in 10 words to prevent it is unethical.

I'm more critical of the fools who parrot it and obviously don't know what it means. But why do they do it? Because in a thousand pages of cherry picked studies supporting weak argumentation, many people turn off their critical thinking and become tape recorders playing back the message.
CarbSane said…
Ten words. In a 500 page book, then a 300 page book, and interviews and articles and blog posts, and in all that, he can't write those words.

He did worse than that. In his interview with Tom Naughton when WWGF came out he said this:

contd....
CarbSane said…
Fat Head: In Why We Get Fat, you wrote that some people might have to give up dairy products and nuts to lose weight. Dr. Mike Eades has also mentioned that nuts and cheese seem to inhibit weight loss in some low-carb dieters. What is it about those foods that can stall weight loss? Is it just that they’re so calorically dense, or do they produce a higher insulin response than their low carbohydrate content would suggest?
CarbSane said…
Gary Taubes: I think the caloric density thing is nonsense. Remember, I’m trying to get every last one of us away from thinking in terms of calories as the variable of interest. What we want to know is whether these foods stimulate insulin secretion, or cause insulin resistance, or have some other effect on the storage of fat in the fat tissue or the oxidation of fatty acids by other tissues in the body. So nuts still have carbs in them, and for some people they might contain too many carbs. Same is true for nut butters.

Dairy products can stimulate insulin secretion beyond what you would expect from the carbohydrate content. I don’t know if this is true of cheese because I’ve never seen data on this, but it is possible. And some cheeses could be better than others — hard cheeses, for instance, may be better than soft cheeses.

Outright dismissal that calories have anything to do with it.

(comment limits shorter than I remember with HTML!)
Diana said…
Evelyn,

I'm familiar with the way internet arguments go - all it takes is for one person to drag the conversation into the gutter, and then the mud flies.

In deference to you, I won't do that. I don't want your blog to become a place where pointless conflict occurs just for the sake of conflict.

I will however clear a few things up.

I take it from Melchior's comment that he thinks I am a "butt licker," [paraphrase of "lick her butt"] or one of that group. The reason I think that is because it preceded a quotation of my observation that Gary Taubes looks like "death warmed over." Which occurred in a context of how the man has BLACKED OUT as a result of VLCing.

I had not known that. I don't follow Taubes. Ever since getting the email from him, which sidestepped my questions about the Pima, I discounted him as a source of honest information. I forgot about him, until quite by accident, I discovered your blog.

When I read your blog, a lot of the doubts I had about the LC gurus crystallized. You voiced many of my issues and problems with them.

One of these is Jimmy Moore's weight issues. I frankly had not thought of it much before. But seeing someone extract the info and put it into stark relief was truly eye-opening. Again, context is important: I had not KNOWN that I was the only desperate LCer who went to Jimmy for guidance. I've done everything right! I'm still not losing weight! And Jimmy, who has gained and lost 60 pounds doing one crazyazz thing after another, has the nerve to offer himself as an example?

(continued)
Diana said…
Jimmy lives his entire life online. He talks about his fertility issues. He regularly videos his wife. He even video-taped her as she learned that she had lost a baby. We do not talk about that here, although I do actually think it's relevant to a consideration of his character. Melchior has unmitigated gall to criticize you for bringing up Jimmy's physical appearance. Which actually you have NOT. You have brought up his constant weight struggles, derived solely from insane eating and exercise habits, not his appearance. You have been very diligent about avoiding extraneous issues.

Regarding the "butt licking" charge, what a low, nasty, and vulgar charge. You and I have had, contine to have, disagreements with respect to exercise. Remember how I said that Taubes had a point here? I do think that hard, prolonged and difficult exercise will make you hungry. I'd like to discuss this further, if and when you choose to, because it's something that's really close to my heart.

Last, I want to say something about the slur on my American cultural patterns. My late father was a veteran of 4 years of hard combat liberating those miserable European wretches from the consequences of their own mistakes, so forgive me if I laugh their pretensions and delusions of cultural superiority.
Diana said…
Very last comment, promise.

"I'd be very interested if someone showed me that the materials in those sections was also wrong or deceitful. "

Sure, if you could pay me $50 per hour for 25 hours.

Duffy, mhb, and Melchior all have something in common: they are manipulative little pests who argue in bad faith.

You cannot discuss things rationally with a bad faith arguer, because facts don't exist and words have no fixed meaning to them. You say "tautology" I say "it means what I think it means." There is no basis of communication.

No matter how many examples you trot out of how Taubes has said that calories don't matter, that excluding carbs from one's diet will create the metabolic conditions for effortless fat loss, that carbs are addictive, that carbs cause cancer, that the Pima didn't really eat that many carbs and even if they did, it wasn't "optimal" and they would have been sprightlier and healthier if they'd eaten more meat, no matter how Taubes is basically wrong on the insulin theory of obesity, "he's probably still right on many things" and when you challenge them with a direct question: "what things?" they resort to abuse and scamper off and then have the balls to challenge YOU on irrelevant minutiae.

They are hopeless and immune to reason. As my ancestors used to say about the Tsar: "God Bless and keep the Tsar. Far away from me."

Diana, Butt Licker Extraordinaire
Anonymous said…
'Some of Taubes' conclusions are wrong. So what. Does that make him a complete asshole? Does anybody realize how many lives have been improved thanks to GCBC, despite the fact that carbs drive insulin drives fat accumulation is not entirely true?'

So far, losing weight by counting calories and reducing calorie intake has been the key to success for millions of dieters. How many lives have been improved by any successful weight loss program? WW. Jenny Craig. Even Ornish. ANY successful weight loss program.

Losing weight is not hard. Keeping weight off is hard. You can spin Taubes' message any way you want and try to make him sound - for a journalist - more authoritative. But: live your life eating more calories than you expend. See where Taubes brings you with that. He's right there with you. Do it and hold HIM accountable...
LeonRover said…
Shore do love a Row, Artemis.
Duffy Pratt said…
Just a point of clarification from a "manipulative little pest who argues in bad faith": The only exposure I have to Gary Taubes is from a guest appearance on Dr. Oz, and from reading Good Calories Bad Calories. I found this blog because I was skeptical that Taubes might be guilty of the same sort of obfuscations and distortions he deplores in other scientists. I didn't have the time or the inclination to go back and check the primary sources myself.

As I said before, from a selfish standpoint, I'm mostly interested in the material in the first part of the book. I have slightly low HDL, high triglycerides, and high blood pressure. My wife has high total cholesterol, good HDL, and a low thyroid condition. I've been aware for awhile that the standard line on cholesterol and fat consumption is probably bullshit. The first part of Taubes book crystalized that story for me. Even though CarbSane found it old hat, I learned a bunch of things I did not know, and it's that part of the book that is most relevant for me. Thus, when I say that I would be really interested to here about deceptions in that part of the book, particularly as it relates to heart disease and blood pressure, I'm telling the truth, not trying to squirm out of an argument.

The whole issue of cause and effect in science interests me because of my background in philosophy. It's basically a practical aspect of the ideas of David Hume. Moreover, I'm totally fascinated by the idea of scientists blaming a condition on free will. From a philosophical point of view, will almost by definition has to lie outside of the realm of physical causes. It's the ability to alter the chain of physical causation by exercising some power that no-one can explain or define.

Finally, I don't know why Taubes won't say that calories can matter to someone who is gaining weight on a low carb diet. But I don't think that the ten words would really help a whole lot of the people who do gain weight that way. For me, eating low carb naturally leads to undereating, at least in the short run (up to 6 months, which was how long it took to reach my goal 12 years ago). Of course, people who are gaining weight on a low carb diet must be consuming too many calories. That's not interesting to me. The interesting question for me is why they eat so much, or why they move so little. On this point, I agree with Taubes: gluttony and sloth are not satisfactory answers for a problem that seems to persist as much as it does. Blaming vices and an absence of willpower, in the long run, isn't going to help many people.
Unknown said…
Diana,

You said:

"Not so fast. I would call the paleolithic diet high opportunism. Whatever you could get your hands on. Maybe sometimes that was carbohydrates. Central African pygmies live to celebrate the honey harvest. Perhaps there were places and times when fruit was abundantly in bloom. Let's be a little cautious about assuming their macronutrient percentages."

Maybe my answer wasnt so clear, but I stated "Obviously, we are not talking about high carb eating populations.." There is no A paleolithic diet. I was just theoretically answering CS question, as wether ketosis observed in paleolithic times (if it really occured) would have been advantageous. I was not suggesting that all paleolithic men were in ketosis nor using that statement to imply any macronutrient distribution.
Anonymous said…
'I don't know why Taubes won't say that calories can matter to someone who is gaining weight on a low carb diet. But I don't think that the ten words would really help a whole lot of the people who do gain weight that way.'

If you want to read those ten words, you have to go to the Atkins website. The Phase 1 support section tells you:

'A daily minimum for women losing weight on Atkins typically ranges from 1,500 to 1,800 calories; for men, the minimum range is 1,800 to 2,000 calories.

...

There's no need to count calories unless you don't start (or stop) losing weight, in which case you're probably consuming too many; or if you feel tired all the time, in which case, you're not consuming enough...'
Sanjeev said…
> If you want to read those ten words, you
> have to go to the Atkins website

I don't question that Atkins wrote it. I should have added Atkins to "Eades takes pains" above. Atkins did, in the book I purchased in 1992. We're discussing Taubes though.

And this is another point of contention: Eades can write it, Atkins wrote it ...
Sanjeev said…
difficulty and failure rates do not prove incorrectness. If they did, then going by the numbers in the general population who abandoned it, Atkins style dieting has been proven just as incorrect as Pritikin and Lappe and the 10,000 high carb books from the late 70s to today. The vast majority on the weight control registry are still low fat, and going by that metric, Atkins is even worse.


> gluttony and sloth are not satisfactory answers for a problem that
> seems to persist as much as it does

As bad as that explanation is, it's light years ahead of Taubes' "explanation"

They're more than sufficient, IMHO. Look at any other area of human endeavour and note how few manage permanent change.

habit; how many people who proclaim they will change some habit or other succeed in changing one, much less the dozens of habits that constitute the components of becoming obese?

gullibility: how many get conned over and over again and THEN AGAIN? Take the woman who was an Indigo mother and is now a rabid anti-vaxer. Do you think she won't take up a woo-woo cudgel after she kills "x" number of kids and abandons the anti-vax movement?

Personality(many factors, but consider one); introverts stay introverted their whole lives.

affect; those who get easily depressed remain that way their whole lives
work; few rise really far

learning a new language, romance, money, smoking, drinking, social circle, parenting - look at any long term endeavour and note how few that want change succeed in changing it in any significant way. Many of these do have large genetic components, but not all.

> scientists blaming a condition on free will

If this were true, would it be unique to obesity? They blame Herpes and Gonorrhoea and Syphilis on free will in many cases. Learning a new language - "they" probably blame that on will too.

But besides, I do not think this is the case - scientists are trying to quantify the forces that lead to obesity. Wansink's "Mindless Eating" and Stephan's rewards theories are just the tip of the iceberg of scientists that DO NOT blame explicit free will. If the answer were a cut and dried "it's your free will" why is all this research going on?

The standard stance is that the only currently valid solution is to create a deficit.

Some ways are easier than others FOR SOME PEOPLE. Some can do this unconsciously by following rules ... "eat this, avoid that". Many vegans can do it, many seemingly easily. Many on low carb can do it, some seemingly easily. There's nothing magical about that - no magic pixie fairy dust theories about insulin and carbohydrate. Unfortunately, most fail at that, and we're left with the one way that works for everyone if they can follow it ... few claim it's easy. It's simple, but NOT easy.

These things work NOT because of magic Insulin pixie dust but because of the deficit.
Sanjeev said…
(continued)
Some ways are easier than others FOR SOME PEOPLE. Some can do this unconsciously by following rules ... "eat this, avoid that". Many vegans can do it, many seemingly easily. Many on low carb can do it, some seemingly easily. There's nothing magical about that - no magic pixie fairy dust theories about insulin and carbohydrate. Unfortunately, most fail at that, and we're left with the one way that works for everyone if they can follow it ... few claim it's easy. It's simple, but NOT easy.

These things work NOT because of magic Insulin pixie dust but because of the deficit.

Taubes's claims are extraordinary and he should have offered extraordinary proof. The best case he could make falls apart IF YOU FOLLOW HIS OWN REFERENCES. He was criticized for cherry picking data, and in an interview his response was "from that Frayn book I could have taken a couple of figures to support my case."

(?????????????????)

Could you repeat that please Gary?

GT: my response to the accusation that I pick cherries is to REGRET THE CHERRIES I MISSED PICKING !!!!!!!! (?????????????????) (!!!!!!!!!!!!!!!!!) (?????????????????)

> Blaming vices and an absence of willpower

Some do; Shock jocks. Or well meaning folks thinking they'll motivate through rudeness.

Pain tolerance is harder for some than others, and I believe most of those I have come to trust in this area maintain that losing and keeping weight off is difficult and hunger is a difficult beast to struggle with. They keep abreast of the research hoping to make it easier for their clients. I've seen these folks change their opinion when the studies come out warranting it. They don't dig themselves a deeper hole (how could anyone have read "all successful diets are low carb diets ... really" without going to the wiki page for cognitive biases and ego defense mechanisms? That still amazes me)


> Blaming vices and an absence of willpower,
> in the long run, isn't going to help many people.

Axe-grinding, cherry-picking bad science will help far fewer, and probably already has hurt many

> will almost by definition has to lie outside of the realm of physical causes

proof? (Despite my own prejudices, unfortunately linking to a B. Alan Wallace lecture ain't proof, it's comedy)

Not my area of expertise but the neurology folks working on "executive function" (google it) seem to be getting a good handle on it, including location, activities to improve it, and so forth ...
Sanjeev said…
> Some ways are easier than others FOR SOME PEOPLE

some ways of creating a deficit are easier than others FOR SOME PEOPLE
Sanjeev said…
> GT: my response to the accusation that I pick cherries is to REGRET THE CHERRIES I MISSED PICKING !!!!!!!! (?????????????????) (!!!!!!!!!!!!!!!!!) (?????????????????)

(emphasis was not in the original, emphasis added for ... well, emphasis)
Duffy Pratt said…
Sanjeev: I agree with much of what you have posted. The main thing I disagree with has to do with blaming the problem on a lack of willpower. Taubes hypothesis, as I see it, has the virtue that it can be tested and disproved. As such, at least it is a scientific hypothesis.

Telling someone that they are fat because they lack willpower cannot similarly be tested, at least as far as I am aware. To do so, you would first need to have some test to determine a person's willpower that in no way took account their weight, the amount of exercise they did, or the amount of food they consumed. I don't know of any accepted definition of willpower that could lead to such a test or experiment. Rather, it seems clear that in this area we judge a person's willpower by that person's success in dieting. If I'm right about that, then saying willpower is the cause of the success is nothing more than circular reasoning.
CarbSane said…
Duffy, why does positive energy balance have to be willpower? I contend most of the obesity in industrial nations can be attributed to passive overeating. The CAF rats don't have different amounts of willpower than the other rats but they get fat. And the obese tend to eat similarly in our culture:
WWGF Lessons from CAF Rats
WWGF Lessons from Obese Humans
Anonymous said…
Blame it on the brain

Article link, via J. Stanton.
Duffy Pratt said…
CarbSane: I've been saying that willpower is not a good explanation, so the answer to your question is not only that it does not have to be willpower, but that that "explanation" is not scientific.

I will add this, which might seem at odds with my point, or at least contradictory. I have two beautiful Samoyed dogs. I have almost complete control over what they eat. There is no way that they are going to get fat. I have often told people that if I exercised the same discipline over myself that I have over them, then I would be lean too.

In this loose sense, I believe in will and discipline as much as anyone else. And I'm perfectly happy to admit that forced starvation will work over a period of time (and not because of carb restriction). My objection is to willpower as a possible explanation in science. As I've already explained, I don't think its a valid concept for science to deal with. I used to think this as a matter of principle, but I now think that it's at least possible that this sort of idea might simply not have a viable definition (in the way that Newton gave the word "force" a precise and scientifically useful definition). I also think its a bad word to be used when formulating policy recommendations. Asking large groups of people to exercise more willpower tends to be futile. i wasn't a fan of the "Just Say No" program of Nancy Reagan's, as one example.

I may have more to say after I read your links.
Anonymous said…
'We're discussing Taubes though.'

Right. I'm guessing that Taubes is different because he's a journalist. He writes books and articles in newspapers and magazines. He's not responsible for anyone's health.
Sanjeev said…
Taubes is different because HE DIDN'T WRITE THOSE WORDS, and to this day refuses to acknowledge much of the science that goes against him.

> If you want to read those ten words, you have to go to the Atkins website

what an interesting evasion. Taubes should not be held liable for his words because of something that Dr. Atkins wrote ...

I've personally never criticized Taubes for being a journalist[0]. I was equally critical when I criticized PhDs and MDs earlier in my life for parroting the notion that ketosis in non-diabetics is equivalent to ketoacidosis.

I agree with Taubes on the saturated fat and cholesterol demonization

AND

I don't recall ever reading until Taubes

"no carbs, no restriction needed"

"no carbs, no fat storage. Nada. Zip. Zippo. Can't happen. Nil. pas de l'obésité. Eat, eat, eat, eat, EAT!!!. Without carbs, you don't need to worry about it."

but not only did he write it, he gave a lot of people "scientific" license, "had their back" to spew it all over the internet, ad infinitum.

And when the scientifically sound advice (that Atkins took to heart and Eades sometimes does) bit Taubes on the tuckus, he had to somehow minimize and diminish it, and along he comes with

"it's a tautology"

and

"all successful diets are low carb diets"

Again, there's a REASON Jimmy's forum advisors told him to increase fat, reduce carbs even more, and don't exercise. They share irresponsibly in not checking up Taubes' references or holding him up to some minimal standard, but Taubes is a large part of it too.

> He's not responsible for anyone's health.

You're right, no one's healthy because of Taubes. I bet plenty are sick because of him though (and don't even know it).

Certainly a lot are sick OF him ... ; )

[0] and he didn't even follow the ethics of that profession as I've read of them over the years - he propagandized his own pet theories using cherry picked data instead of presenting fair and balanced analysis
Sanjeev said…
Thanks for the link Jenna. I've read all of RW's books (even those he wrote under the "Phil Plait" pseudonym ; ) )

A good sampling and summary of the stuff I've been reading in the lay press.
Archibald said…
@Diana,

This comment section has gotten kind of long and rambling, but I wanted to thank you, if you see this, for your citation, way above, of the high-fat/lung-inflammation study. It made my jaw drop -- and I still want to take a closer look at the study -- because last summer, at the end of my year of livin' low carb, quite VLC by that point, I suddenly, out of the blue, came down with bacterial pneumonia. It scared me because of my age, 68, but I responded quickly to the antibiotics. Coincidence? Probably, but I'm wondering if my lungs were at a heightened level of vulnerability because of eating high-fat. P. Jaminet also talks about impaired mucosae due to insufficient starch. That's not the only really unfortunate thing that happened to me during that year, but that's another story for, possibly, another time. Thanks again, Archie.
Diana said…
Sanjeev,

At the risk of sounding like a bootlicker, a word I much prefer to buttlicker, I agree with almost everything you say, except the bit about gluttony & sloth. I am with Taubes and Duffy on this. Bear with me, I will explain.

IMO the issue of obesity isn't at all an issue of willpower as I explain in my intro on the discussion boards section of the Asylum. It's a question of getting the right information. Sure it is also a question of being willing to listen to the right information, but the fact is, there's a lot of crap info out there which is very confusing and very debilitating.

In addition to latest pack of lies (Low Carb), there is the myth that 95% of all diets fail (completely ridiculous non-verifiable statistic); it's in your genes; there's something in the environment, what have you. Gary Null wrote a book called IT'S NOT YOUR FAULT YOUR FAT, in 1998. Not surprisingly it was a best seller.

So Taubes is hardly the only one to remove the onus of gluttony and sloth from the shoulders of the obese. It's been going on for quite a while now. Problem is, he's only continuing the debacle by advising people to disregard calories. And exercise, too, for that matter.

(Although my feelings on exercise are "nuanced" I think it's rotten advice to tell people not to exercise. I exercise myself - but I have to be very careful not to overcompensate with the calories.)
Diana said…
"Finally, I don't know why Taubes won't say that calories can matter to someone who is gaining weight on a low carb diet."

OK, so now calories don't matter, except when they do. DING!!

"But I don't think that the ten words would really help a whole lot of the people who do gain weight that way."

Ya don't? I do. Taubes wrote a book, actually two, whose purpose was to provide a scientific theoretical underpinning for Atkins. He stated this clearly somewhere, I can't be arsed to find it, so don't ask. But it is clear from the the obesity parts of GCBC, and WWGF. If he were to say, "calories matter" (that's two words) to the desperate low carbers on all those forums who keep screaming that they are VLCing and not losing weight, it damn well would matter. Of course, he be admitting he's a fake phony fraud, so that'll never happen.

"For me, eating low carb naturally leads to undereating, at least in the short run (up to 6 months, which was how long it took to reach my goal 12 years ago)."

I'm happy for you. Low carbing led to years of misery for me, confusion, dead ends, possible thyroid problems, higher cholesterol, and eventually a 16 pound weight gain.

Your mileage varied. But the reason you lost weight was because you ate less.

"Of course, people who are gaining weight on a low carb diet must be consuming too many calories. That's not interesting to me."

And you know what? The fact that you benefited from the other irrelevant to weight loss aspects of GCBC isn't interesting to me. You truly do sound like one of the more arrogant putzes I've encountered on the web, and that is saying a lot.

Have you read Carbsane's "You Need to Check in IF..." which is a serious of humorous questions about the inanities and insanities of low carb dogma. That's what we are here to discuss, and that's what Taubes is wrong about. He may be right about some things (again, I've said that he makes some good points about hunger and exercise) but the basic theoretical framework is a pack of lies, based on misrepresenting the data. You might want to read my deconstruction of Taubes treatment of the Pima. He lied about them, pure and simple.

"The interesting question for me is why they eat so much, or why they move so little."

Because they are being lied to by people like Taubes, with your approval.

"On this point, I agree with Taubes: gluttony and sloth are not satisfactory answers for a problem that seems to persist as much as it does. Blaming vices and an absence of willpower, in the long run, isn't going to help many people."

See above. I agree with your words, but not your sentiment, which is the sentiment of a bullshit artist.

I speak from personal experience: where there is no vision, the people perish. Where there is a goal and proper information and motivation, you can do it. CarbSane has given an example of diabetics who have been cured by sticking to a 600 calorie a day diet. Eating 600 calories a day sucks, but diabetes sucks worse, and the choice to me is a no-brainer. If I were diabetic I would do it in a flash.

Now, I have lost most of the 16 pounds I gained BECAUSE I GOT IT THROUGH MY THICK SKULL THAT I HAD TO EAT LESS AND MOVE MORE. Once I accepted the diagnosis, it wasn't so hard. It's not so hard. You just control your portions and stop stuffing your spoiled piehole with junk. Walk. Look up body weight calisthenics on the net and try some out. This is truly not brain surgery. If I could do it, anybody could. It works.
Diana said…
@ Archibald,

You are quite welcome. I hope nothing is seriously (or even unseriously) wrong with you.

I have another study that I think is interesting and will bring it up on the scientific discussions board.

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0013352

Eventually I think we will tease all of this out via more sophisticated understanding of the genome.
Duffy Pratt said…
Diana: We agree on more than you think we do. But so far you've called me an "arrogant putz", a "manipulative little pest" and a bullshitter. Maybe so. But I think that you quickly projected onto me a whole range of opinions and beliefs that I don't hold.

Here are a couple of things that I've never claimed, but you seem to think I have:

1) That Taubes has been completely honest in his reporting of the science in Good Carbs Bad Carbs. As I said above, I found this site mainly because I was skeptical of Taubes.

2) That calories in/ calories out doesn't matter. I don't believe this and have never said it.

It's OK with me if you hate me. But I would prefer that you hated based on things that I actually said or believed.
Duffy Pratt said…
One other thing. I haven't read the post You Need To Check In IF... I did a blog search, but those words are so common that it yielded 8 pages of hits, and none of those seemed like they were obviously the one. I'd appreciate it if you could point me to that post.
Sanjeev said…
> except the bit about gluttony & sloth

I have no problem with gluttony and sloth. I enjoy and recommend both on occasion (gluttons and sloths would be among my best friends, if I had any friends ; ) )

I just like to point out lots of scientists who suggest calorie restriction to lose weight don't say conscious free will caused the overweight, and using those terms introduces things into the conversation that could be avoided, if we want to keep communicating clearly.

Yes, I suggest this after I've flown off the proverbial handle several times myself and eaten crow.
Sanjeev said…
you need to check in

Near the top of the page, 3rd button from the left

or

http://carbsanity.blogspot.com/p/you-need-to-check-into-asylum-if.html
or click
Diana said…
"We agree on more than YOU think...." emphasis added.

How do you know what I think?

Are you God?

A mind-reader?

You only know what I've written. You have no idea what I think. Wouldn't it be more polite and to say nothing of being more accurate to say, "It may be that we agree on more than it seems."

In comment after comment, you have either supported Taubes' dismissal of energy balance as the explanation for obesity. There was an entire exchange about it. I don't care what YOU think. I care what Taubes thinks. Really you and Taubes are a match for gall, because at the end, you tacitly admit that Taubes is wrong, but it's of "no interest to you."

This is the very definition of bad faith arguing, and I'm just not interested in it.

From the start, you've twisted facts and said ridiculous things.

"Also, Atkin's fall is irrelevant, and it might even be misleading. There's nothing to show that his fall had anything to do with his diet. He was fairly old, slipped on ice, and died of the complications from the concussion. Also, at the time of his death, he weighed 258 pounds. The more interesting question for me about him is whether he was still on his diet at that point (and it was failing him), or whether he had gone off it (and if so, why).

This jumble of sentences contains so many internal contradictions it must set a record for most inconsistencies in fewest words, but let me focus on this:

"There's nothing to show that his fall had anything to do with his diet. He was fairly old, slipped on ice, and died of the complications from the concussion. Also, at the time of his death, he weighed 258 pounds."

So his weighing 258 pounds had NOTHING to do with his diet?

It's obvious to me that words mean nothing to you, except as means of manipulation to win an argument, so I'm just going to ignore your comments from now on. I don't run this Asylum.

"That's not interesting to me."

And you are not interesting to me.

Bye.
Duffy Pratt said…
Diana:

I said his fall had nothing to do with the Atkins diet. Since he weighed 258 pounds at the time, he probably wasn't on his diet at the time. Even if he was on his diet, anyone can slip on the ice and get a concussion, especially a 68 year old man.

Please note that I also said that I'd be much more interested in whether he was still on his diet when he died, because he weighed 258 pounds at the time. That would say quite a bit. The fact that he weighed so much when he dies shows that he was either a hypocrite, that the diet did not work for him, or that there was something else going on that we don't know about.

My position on caloric balance has been the same from the start. It's true, but its not an explanation of the cause of obesity. If someone asks why a refrigerator gets cold on the inside, telling them that it follows the first law of thermodynamics isn't really that good an explanation. That's basically what calories in/ calories out says to answer the question why some people get fat.
Duffy Pratt said…
Sanjeev: Thanks for the pointer. I feel dumb for not looking at the banner. I guess I've visited too many blogs to pay attention to formatting. Doh.

There's some funny stuff on that post. I'm guilty of only three, so I guess I'm lucky.
Alan said…
>>> they are fat because they lack willpower cannot similarly be tested, at least as far as I am aware. To do so, you would first need to have some test to determine a person's willpower that in no way took account their weight, the amount of exercise they did, or the amount of food they consumed.



Heisenberg taught us that altho we cannot simultaneously measure A and B, we can measure their product.

How fat a wannabe-skinny person is, is in one-to-one correspondence with their amount of willpower. Which is to say, we have a way of measuring their willpower.

CS didnt complete 4 semesters of calculus by accident; she did it with willpower. She also didnt lose so much girth by accident; she did it with willpower.
Dr J said…
I hesitate to comment here because I find the tone and content of many posts and some of the host's material troubling. I do, however, feel compelled to correct one misconception that has been mentioned more than once, ie that Atkins was overweight when he died. He suffered a closed head injury and languished in a coma for several days in the ICU before dying. In that condition, multi-organ failure is not uncommon which leads to fluid retention which is exacerbated by IV therapies. On autopsy, his recorded weight would more likely be a result of that than excess body fat as some would have you believe.
CarbSane said…
@Dr J ... I don't know why you should hesitate. Are you someone recognizable? Your blogger profile is unavailable. Sorry to trouble you so.

In any case, the numbers of people willing to swallow that Atkins gained more than 60 lbs of water weight in several days prior to his death is mind boggling. I've got a magic pill for effortless weight loss to sell these folks!

Welcome in any case. Do take some time to read this blog before passing judgment.
Dr J said…
@ Evelyn - I have read a lot of this blog. I find that you have good analytical skills and some of the discussion is informative and provocative (in a good way) but that the frequent lapses into needless nastiness is counterproductive and off-putting and the consistent agenda seems to be that any angle at all, no matter how far-fetched, can be used to discredit LC dieting. Yes, I am somewhat known in this area, I have done some research on LC diet, I have a blog and am friends with some of the people who are pilloried here like Taubes, the Eades, etc. I am perhaps best known for a documentary of a study I did, "My Big Fat Diet". I have also personally benefited enormously from sticking to a VLC diet for almost nine years, now. I am one of those who can eat without regard to calories as long as I avoid carbs. If I eat even too many nuts, I will start to gain fat and see my metabolic markers go sideways. I was profoundly diabetic when I started this and now maintain normal values consistently on LC. I have also maintained a weight loss of about 30 lbs. My waist went from 36" to 32" and I probably should be buying 30" jeans these days.

This particular post is an example of what is objectionable here. Yes, people can experience orthostatic hypotension on LC, especially at the beginning. Not everyone understands that natriuresis can be profound and that continuing to restrict salt and drink lots of water - the typical advice - is exactly the wrong thing to do. If they continue with antihypertensive meds when starting LC they can certainly get into trouble. To address this by stating that "the Atkins diet can kill you" is disingenuous at best, especially for someone as capable of understanding the physiology as you apparently are. I see my friend Andreas has engaged in a debate with you on another thread. I am not inclined to do that.
CarbSane said…
Ah Jay Wortman. OK. That explains a lot. My husband went from wearing 44" pants to 36" pants in about 6 months after finding new employment. So? Should we say that his weight is proof anything about his diet?

Now, to the subject of this post. Can you not recognize humor and hyperbole for effect? Am I not allowed to use that when others (e.g. Wheat Belly) do it routinely?

Falling down and cracking your head open is serious business. It should be a serious warning at the very least, not a little section on what to do *if* you have problems.

Have you really read a lot here? If so, why? ... considering I'm so off-putting. I'm not the one being disingenuous at every turn, nor am I accusing you of being.

Thanks for your assessment of my intellectual capabilities. I feel validated now to blog another day. Sheesh.
CarbSane said…
PS Dr. J: Do you believe it is possible for someone to gain SIXTY THREE POUNDS of water weight in several days??
Dr J said…
OK - now you are doing a great job of validating my concerns. If your arguments are based on the science, why the need for the nastiness? A respectful discussion would get you much further. Claiming it is harmless humour and hyperbole is what I would call disingenuous, again. Your example encourages the commenters to follow suit with your tacit endorsement as you have the power to delete their posts. Altogether, it serves no useful purpose and makes it hard to take you seriously. You may have something to contribute to the discussion but it will be lost because of these tendencies.
CarbSane said…
Oh lordy lordy. My post title was intended as harmless humor and tongue in cheek hyperbole. But the meat of the post was about a very serious issue. Where's your problem there, and for crying out loud, where did I get nasty?? Compare this with posts from Dr. Davis equating oatmeal with battery acid. Not just a provocative title, but the whole darned post trying to convince people that oatmeal will eat out their innards. I do not delete comments here unless they are very derogatory (I think two have come to that level) or spam (and one certain spamilicous blog commenter). And I have proven to make good on that. Go bitch to some of your LC "friends" (I'll name names here so you don't accuse me of anything because graciously Taubes does not censor. But Jimmy Moore and Tom Naughton do) about that.
CarbSane said…
Dr J, I repeat the question. Do you think it is possible for someone to gain 63 pounds of water weight in about a week?
Dr J said…
The use of humour when making an argument can be constructive if done properly. When it is misinterpreted by your audience it becomes counterproductive and is a signal to stop. If, as you claim, these things you say are merely intended as harmless humour, the rational response on getting that signal would be to take corrective action. Your persistence in not doing so (here and in other threads) suggests to me that, again, disingenuousness is the real issue. I have said my piece; I have nothing to gain from prolonging a rancourous discourse so I am out of here. Adios.
CarbSane said…
I'll not let you or anyone dictate the content of this blog. Read and learn at your own risk I suppose. Rancor is, ultimately in the eye of the beholder as I've been nothing but courteous in response to your unsolicited critique of my work here. The 63 pound question remains unanswered. Telling.

You are entitled to your opinion of course, but not to your own facts. Or, for that matter, definition of what is not genuine in nature. I stand by facts presented here whether or not some in the audience get offended by learning the truth.

So long, farewell, Auf wiedersehen, adieu,
Adieu, adieu, to yieu and yieu and yieu.
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