Wednesday, 25 February 2009
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Friday, 13 February 2009
Research Review
Title
Good Calories, Bad Calories by Gary Taubes ,Viewpoint by G.A. Bray
Abstract/Summary
Good Calories, Bad Calories has much useful information and is well worth reading. Gary Taubes’s tenets related to obesity can be summarized in four statements (i) He believes that you can gain weight and become obese without a positive energy balance; (ii) He also believes that dietary fat is unimportant for the development of obesity; (iii) Carbohydrate, in his view, is what produces obesity. Insulin secreted by the carbohydrate is the problem in obesity. However,some of the conclusions that the author reaches are not consistent with current concepts about obesity. There are many kinds of obesity, and only some depend on diet composition. Two dietary manipulations produce obesity in susceptible people: eating a high-fat diet and drinking sugar- or high-fructose corn syrupsweetenedbeverages. Insulin is necessary but not sufficient in the diet-dependentobesities. When diet is important, it may be the combination of fat and fructose (the deadly duo) that is most important. Regardless of diet, it is a positive energy balance over months to years that is the sine qua non for obesity. Obese people clearly eat more than do lean ones, and food-intake records are notoriously unreliable, as documented by use of doubly labelled water. Underreporting of food intake is greater in obese than in normal-weight people and is worse for fat than for other macronutrient groups. Accepting the concept that obesity results from a positive energy balance does not tell us why energy balance is positive. This depends on a variety of environmental factors interacting with the genetic susceptibility of certain individuals. Weight loss is related to adherence to the diet,not to its macronutrient composition.
Comment
Carbohydrates have taken quite a flack over the past decade. Atkins, South Beach and a number of diets have done well to propose and exploit an irrational understanding that carbohydrates, and not calorie intake is the biggest contributor to the obesity edpidemic.
Good Calories, Bad Calories by Gary Taubes is a scientific attempt to cement this ideal. Although I have not read the book, I am aware that it is a markedly different approach. Reviews comment on how it is exceedingly well written and extensively researched. With over 100 pages of notes and bibliography, a thesis low carbers have been waiting for. Now, the entire basis for Taubes thesis stems from this small secion of The Surgeon's General Report on Diet and Health Report 1988.
Overeating is clearly a prominent contributor to obesity. Yet, obese persons do not necessarily consume more calories for their weight than lean
NHANES I, did not correlate with the degree of obesity.
Taubes builds: This decrepancy between obesity and energy consumption neccesitates an explanation. Gray, a member of the original committee and solely responsible for the original report, tells us this conclusion, based entirely on a collection of personal testimonies on calorie intake, was incorrect. Until recently no reliable alternative to self-reports existed. In 1988 a new device for measuring energy expenditure, finds obese indiviuals to significantly expend more calories than lighter individuals. To maintain this weight they must consume more than lighter individuals. Combining this data with individual testimony, we know that we considerably underestimate how much we eat, with obese individuals under-reporting by up to 50 per cent of their intake. Revising his statement in the 1988 report, Gray concludes that overweight individuals do eat more than lean individuals. The surplus alone explains weight gained without cause to resort to some other factor. Taubes thesis is unnecessary.
The thesis, based entirely on anecdotal data, claims that low carbohydrate diets are more successful than their low fat counterpart, due to the high levels of the fat storing hormone insulin secreted in carbohydrate heavy diet. Gray points to a body of meta-analysis reviews which find no statistical difference in weight loss on either diet: the magnitude of weight loss attributed to drop in Calories, not the macro composition of their diet thereof. Not only is Taube's thesis unnecessary and unsubstantiated, it also contradicts what is a scientific concensus.