The Carb-Sane Asylum

I thought in the interim of doing something more formal, I'd bump this post from October of 2010.  Keith Frayn, for newer readers, is recently retired prominent Oxford scientist who wrote one of the books Gary Taubes likes to use pictures from these days in his lectures (you're welcome Gary, if only you'd read the book more thoroughly).     Metabolic Regulation.    {as textbooks go this one is relatively economical though I probably wouldn't recommend it unless you've got some scientific background in the subject ... or a lot of patience, because it should be manageable if tackled in smaller doses } He lays out the basics of Adiposopathy - pathological fat - sick fat - though doesn't use the term.  The evidence for this is overwhelming, and although this is just an outline of sorts, it only needs some clarifications and fleshing out with evidence of various components and the mechanisms involved.  In that regard, much progress has been made enfor...

A bump of sorts to an Asylum Classic.  Yes folks, the evil $ appeared in Gary Taubes name for ... what? ... the second time and second-to-last if not the last time, way back when.   I think the title of this post holds ;-) Since that time, Dr. Eades has used the same analysis in his AHS11 presentation :  Nouvelle Paleo: Caving in to Carbs?   (this begins at the 22:44 mark in the video) .  More recently, and the reason for this bump, Nina Teicholz shows this study on a slide in her TEDx East talk   (18:50 mark as she says "a tremendous amount of research done") , and makes multiple references to it in her book,  The Big Fat Surprise .    I'll be discussing this egregious misuse of science here shortly.  So without further ado, "you can't eat carbs, you can basically exercise as much gluttony as you want as long you're eating fat and protein"     ~ Gary Taubes

This post updated slightly 6/22/2012.   Original publication date 1/23/11 In the comments at Jimmy's blog on my interview podcast, several comments either directly or by inference say I failed to make my case against Taubes.  Well, I think I did pretty much get to what I consider the four prongs of Taubes carb/insulin hypothesis, but I've decided to try and summarize this in a blog post.  Another common comment is that I'm somehow nit-picking at minutia, basically if folks lose weight on low carb, it doesn't matter the details of why.  To those, if they are reading this, I would say that any objective view of my arguments would lead to the conclusion that these are NOT minor details, they are the sum total of Taubes' evidence in support of his hypothesis.  Not only has he NEVER debunked the calorie-based theories on obesity, but almost all evidence in support of his "alternate" theory HAS been.   I will not be referencing this post, it's all...

Thanks to a certain journalist, much of the discussion of fat tissue metabolism on the internet presents a very myopic view of things taken out of context.  One example of this, is that in Chapter 22 of GCBC, Taubes lists all of the hormones acting on adipocytes.  The caption on the graphic reads: In 1965, hormonal regulation of adipose tissue looked like this: at least eight hormones that worked to release fat from the adipose tissue and one, insulin, that worked to put it there. Let's leave aside for a moment that in the four subsequent decades preceding the writing and publication of his book, probably the most potent regulatory hormone of fat mass, leptin, was discovered.  Let's also leave aside all of the other adipokines (the term for the collection of hormones and peptides produced by adipocytes most of which appear to be secreted).   There's a lesson to be learned solely from Taubes' narrow, outdated view.  Under the title "Hormones that promo...

Glyceroneogenesis and the Triglyceride/Fatty Acid Cycle     (TAG/FA) JBC Papers in Press, June 4, 2003, DOI 10.1074/jbc.R300017200 Lea Reshef, Yael Olswang, Hanoch Cassuto, Barak Blum, Colleen M. Croniger, Satish C. Kalhan, Shirley M. Tilghman , and Richard W. Hanson The above paper is referenced in Good Calories, Bad Calories , and is a paper I believe one cannot read thoroughly and still believe that dietary carbohydrate is required in order to "fix" fat and become obese.  It has been quite a while since I read it in its entirety.  Doing so in recent days I've noticed even more information in this paper that counters the whole notion that more dietary carb leads to more glycerol-3-phosphate leads to more esterification of fatty acids to the storage triglyceride form.   More specifically, these four paragraphs/excerpts were somewhat drowned out for me in my first reading:

Vacation bump!  Original Post Date:  3/9/11 One of the more interesting things (to me) to come out of the "cafeteria rat study"  is what the composition of the diet eventually chosen by the rats came out to be.  I'm just going to focus on the SC (standard chow) and CAF (SC + human snack foods) diets in this post. To recap, the SC had a composition F/C/P of 10/64/26.  When offered this chow along with a rotating selection of three human snack foods from the following list, the rats only ate 15% of their diet as chow (the wording of this is unclear, but their total consumption is ultimately what's important).  The composition of the diet they ended up eating?  CAF was F/C/P of 44/46/10  (note: I've detected slight discrepancies in the numbers here that involve a 1-2% swing in either direction) .  One might think the rodies were only offered fatty snacks, but this is not the case as can be seen in the table below:

Since he has the new book out, I've decided to use a new label to categorize posts that refute various Taubesianisms:  Gary Taubes Fact Check.  Taubes hasn't disappointed from the get go with Why We Get Fat (WWGF) - that thanks to a benevolent reader, I now have a copy of! I hope any who find this place from links to my old label will see this post and check out the new label link below for more updated information.  Cheers! Gary Taubes Fact Check

In a recent post , following up on discussion of Grey & Kipnis as  in the Fasting Insulin & Weight Loss  post,  I noted that G&K was  but one study (of many) where calories were controlled that demonstrated definitively that it was calories, and only calories, and not carbohydrates or any hormonal effect thereof, that determined weight loss/stability. Taubes made the slanderous claim on his blog : ... the value of controlling variables in a scientific experiment is something that a reasonably well-educated child supposedly understands. And what I want to know is why don’t nutritionists understand it and those researchers out there doing diet trials and studying obesity and weight regulation. Because their failure to do so — and I would argue that it may be a willful failure — has led to what may be another of the great misconceptions in modern nutrition research. I ended my post with the following:

previously:   Fasting Insulin & Weight Loss  I finally found a study that demonstrates a correlation between fasting insulin levels and weight loss.  In this study, they manipulated fasting insulin levels through macronutrient composition an diets administered at various caloric levels.   Below is the scatter plot of the data for all subjects:   Horizontal axis = change in fasting insulin level between time points Vertical axis = change in weight  See the correlation?

It was inadvertently (I think) brought to my attention that, while constructing my Fasting Insulin & Weight Loss post, I had "in my hand" the perfect study to discuss the title of this post. Does that title sound familiar?  It should!  Because this was the title of Gary Taubes' second blog post: Calories, fat or carbohydrates? Why diets work (when they do) As I've stated many times, unless someone provides me with a complimentary copy of Why We Get Fat, I'll not be reading the dumbed down version of GCBC, even for the groundbreaking new information it is purported to contain.   Reportedly, one of those groundbreaking items is a chapter on the very topic of that blog post.  A blog post that was a sort of preview teaser in advance of his book release.  But that post wasn't the first time he discussed this novel idea that he claims supports his alternate carbohydrate/insulin hypothesis.   Most of my readers are probably aware of when ol' CarbSane he...

J. Denis McGarry's Banting Lecture ~ 2001 Dysregulation of Fatty Acid Metabolism in the Etiology of Type 2 Diabetes This post is fast fowarding to the final contribution to the field by JD McGarry.  I'll back track and be posting works in between in coming weeks.  According to this  tribute to McGarry , he was quite ill by this point, and indeed he was unable to deliver the lecture, but was present at its delivery.  It is unfortunate that Taubes has misrepresented McGarry's work, because as I read more and more about this man and from this man, he really was a scientist in the vein of bucking conventional wisdom ... something that should have perked Taubes' interest.

"Over the years, prominent diabetologists and endocrinologists -- from Yalow and Berson in the 1960's through Dennis McGarry in the 1990's -- have speculated on this train of causation from hyperinsulinemia to Type 2 diabetes and obesity.   Anything that increases insulin, induces insulin resistance, and induces the pancreas to compensate by secreting still more insulin, will also lead to an excess accumulation of body fat.     ~Gary Taubes (p. 409 Sony ebook version of GCBC) Now, before you click below and go on to read what I interpret this excerpt from GCBC to mean, and  some works of McGarry, write down what that statement means to you.

Thanks to Mirrorball for "putting a bug in my ear" regarding the impact of exercise on insulin levels.  The basic thought being that if Taubes' theory that lowering insulin makes you lose weight, then exercise should be very effective, especially if you couple it with carbohydrate restriction.  Because, if you "overeat" protein and fat calories those don't impact body weight right? So I found this study: Effects of Aerobic or Resistance Exercise and/or Diet on Glucose Tolerance and Plasma Insulin Levels in Obese Men   Basically they took three groups of men averaging 40-47 years of age, ~100kg weight, ~32 BMI and did 3 interventions:  DO = diet only DA = diet + aerobic exercise DR = diet + resistance exercise

Thanks to MM, I now have the full text of the following study.  I'm going to do a test for sharing this with y'all through Google Docs.  Please let me know if it doesn't work: Acute compensatory eating following exercise is associated with implicit hedonic wanting for food   (I'm going to intersperse quotations from all over this paper) The efficacy of exercise to promote weight loss could potentially be undermined by its influence on explicit or implicit processes of liking and wanting for food which in turn alter food preference. The present study was designed to examine hedonic and homeostatic mechanisms involved in the acute effects of exercise on food intake.

I've been having a little discussion of this over at Taubes' forum based on his comments on the Dr. Oz show .  He basically regurgitated two points that he's never really offered up much scientific proof of: 1.  Exercise just makes you hungry, and 2.  You'll compensate for the increased activity during exercise by lazing around the rest of the day. On point 1, Taubes loves to use the "have you ever heard the phrase working up an appetite" line.  At least he sounded a little less condescending asking that this time as compared to when he asked Jillian Michaels in his 2007 Larry King appearance.   In a "I think I gotcha moment", one commenter posted this study as evidence of eating more :  (I only have the abstract for this one):

It may surprise many but I actually agree with GT in large part on what he says about cholesterol.  Problem with that part of GCBC was that he wasn't really saying anything new.    My first cholesterol test was back in the days when just total cholesterol was your basic test.  Mine was slightly high - only moderately overweight at 20 or so years of age.  A few years later the LDL/HDL breakdown became more the norm and my HDL was high.  Now we all know the progression with particle numbers, sizes, etc that has developed over the years and with it less concern over some types, more over others. So there's lots of moaning going on over at GT's blog and around the LC web over Taubes' appearance on the Dr. Oz TV show 3/7/12.    I'm no fan of Dr. Oz.  I don't watch any of that sort of TV on anything other than a passing basis in doc/dental waiting rooms and such   I did watch the YouTube videos of Dr. Oz with GT on Larry King b...

Yes folks, if you go to any Biochemistry or Endocrinology text, you will find that insulin's action is to put fat into fat cells and suppress its release.  Therefore insulin makes us fat.  Lower insulin, lose weight.  Raise insulin, get fat.  Right? I've recently posted on two rat studies ( here and here ) that demonstrate unequivocally that it is not so simple.  I've also previously addressed the study that is the focus of this post in my Insulin Wars series with Todd Becker.  But wanted to further highlight that study here in a separate post.   The Effect of Diet Composition on the Hyperinsulinemia of Obesity

Ketogenic diet-fed rats have increased fat mass and phosphoenolpyruvate carboxykinase activity This study looked at body weight, fat mass, blood lipid and glucose levels and PEPCK (rate limiting enzyme in glyceroneogenesis pathway for G3P production for esterification of fatty acids - fat deposition) activity in the liver and fat cells.  Two ad libitum diets were compared, a control standard chow and a ketogenic zero carb chow.  This study was in normal, young (30 days old at start) Wistar rats and lasted 6 weeks. The diet compositions are shown below:

This article is a bit heady, and I won't go into a detailed analysis but will try instead to present some relevant excerpts to the gist of this post.   That being, adipocyte metabolism, the continual cycling of fats in and out of adipose tissue, the continual cycle of esterification and hydrolysis, is mediated by more than just insulin. Atrial natriuretic peptide contributes to the physiological control of lipid mobilization in humans According to the save date on my computer, I found this one a year ago.  Ever heard of atrial natriuretic peptide?  Me neither.   According to Wikipedia, ANP is: .... a powerful vasodilator, and a protein ( polypeptide )  hormone  secreted by heart muscle cells. [1] [2]  It is involved in the  homeostatic  control of body  water ,  sodium ,  potassium  and fat ( adipose tissue ). It is released by muscle cells in the upper chambers ( atria ) of the heart ( atrial myocytes ), in respo...

If you haven't read the discussion thus far, or just to recap, here are the links: Insulin Wars IV: Todd Becker of Getting Stronger blog Insulin Wars IV.1: Todd Becker of Getting Stronger blog responds More Todd Becker (Getting Stronger blog) on Insulin  (this last one links to his piece on his blog) {Todd quoted the relevant prior exchanges in his email, so most can probably follow along just with this post} I've been putting off posting this for too long, mostly because in its entirety it is very lengthy (15 pages!) and I haven't had the length of uninterrupted time to devote to a thorough point by point response to the entire email.  So I decided to break this installment (IV.2) up into parts (a,b..., however many) so we can keep this discussion alive and continuing.  I'm also likely to address some topics out of order from Todd's email response.   Eventually it will all get up here :-)  I very much appreciate all the hard work Todd put into his response...