Note: In my www.nobodyeatslikeme.com blog series, Food Plans & Diets, I wrote about the often-controversial Atkins Diet, which I am now experimenting with, using their new vegetarian meal plan. However, my good friend Rhoda told me about Gary Taubesâ€™ book, reviewed below, which makes the concept behind Atkins Diet more understandable, if you agree with Taubes. It is a long review because this is an important book.
Reading and reviewing a book that challenges all my previous concepts of why we get fat (also Taubesâ€™ title) is in itself a challenge. For the last 30-40 years we have been â€œfedâ€ the concept ofÂ â€œcalories in/calories out,â€ or as Taubes so clearly writes in his Introduction:
â€œWe get fat when we take in more energy than we expend (A positive energy balance in scientific terminology) and we get lean when we expend more than we take in ( a negative energy balance).â€
Basically, this concept simply states that is we take in more calories than we use, we will gain weight. And if we eat fewer calories, we will lose weight. Sounds simple and logical, no?Â However, Taubes does an excellent job of the history before this concept became popular, citing early studies by doctors and investigating obesity before we considered it an epidemic. Thus, in Book 1, entitled “Biology, not Physics,” he pulls apart common arguments on gaining weight. For example, one chapter is called â€œThe Elusive Benefits of Exercise,â€ noting that despite all the hype about exercise and fitness in the last 30-40 years, people are still getting fatter. He claims that intense exercise creates a larger appetite, so we tend to eat more.
Book II is called “Adiposity 101,” and this section really caught my interest because Taubes discusses estrogen and fat cells. As a post-menopausal female, this relates directly to me. The author notes that in this section he is a little more technical, so you may have to read it a couple of times, as I did, but the concept is worth the reread. Drawing on a researcher from the University of Massachusetts, Taubes explains (with the help of a diagram called the Laws of Adiposity) that when estrogen levels are low, an enzyme called LPL (lipoprotein lipase) is â€œupregulatedâ€ on fat cells, resulting in more fat being pulled from circulation into that cell. When estrogen levels are high, the activity of LPL is suppressed, so the fat cells accumulate less fat.
Since we do need a certain amount of fat in our system so our bodies can operate at peak efficiency, fat in itself seems not to be the issue. Rather, with this scenario, we eat more because our fat cells are greedy, â€œhogging calories,â€ leaving less to be used elsewhere in the body. If we regulate body fat so that it goes to the cells that need it, we should be able to control weight gain. The chapter continues with more information that people who are thin normally have bodies that are programmed to remain lean.
But what if you are not so programmed? How do you stop the body from hogging the fat calories so we eat more to get the fat we need for the rest of our bodily functions? The answer lies in the last half of Part II, where Taubes discusses the practical aspects of getting and staying thin. He includes some of the earlier lists of foods to avoid from various schools of medicine, lists created before the â€œcalories in, calories outâ€ concept was promoted, starting in the late 1970s and continuing today.
Four different schools of medicine (HarvardÂ Medical School, Childrenâ€™s Memorial Hospital in Chicago, Cornell Medical School and New York Hospital) independently published their almost identical diets for their obese patients. The list directs the patient to eliminate/avoid: sugar, honey, jam, jelly and candy; fruits canned with sugar: cake, cookies, pie, puddings, ice cream or ices; foods with added cornstarch or flour as in cream sauces; potatoes, pasta, dried peas & beans; butter, lard, oil or butter substitutes; soda pop; and following the other guidelines on the diet. (I agree with most of the items on the list, but not the butter or oil, since I think we need some for flavor as well as good fats for the body. es)
Taubes then challenges the relationship between fat and heart disease, citing Jean Mayer, who started his nutrition career in 1950 at Harvard and then became president of Tufts University, and pioneered the concept that sedentary living is the cause of obesity and chronic diseases. Challenging the status quo is an uphill struggle, but Taubes does a more than credible job of convincing the reader where Mayer misleads us. The rules of thumb became to eat less fat and more carbohydrates. (Remember how we were told that pasta is now good for us?) The author writes, however, that easily digested carbohydrates (ex. white pasta) do make us fat, which are then the likely culprits in heart disease. He notes the paradox: â€œeither carbohydrates make us fat or dietary fat gives us heart disease but not both.â€ (p. 179)
The book concludes with dietary suggestions that resemble the Atkins Diet, which has also been the source of controversy since Dr. Robert Atkins introduced it. (See my article on Atkins in Food Plans & Diets in www.nobodyeatslikeme.com.) These dietary guidelines are based on the scientific information of the 1960s & 1970s promoting the fear of fatÂ (not the information he promotes from before the 1960s), claiming that these â€œnotionsâ€ just donâ€™t hold up under more recent research. Before the guidelines, Taube provides important information on â€œmetabolic syndrome,â€ which is the intermediate step before heart disease and a topic that has received a great deal of press in the last few years.
However, much of what the author writes about this topic is news to me. Taube states that the science of metabolic syndrome has actually been evolving since the 1950s, linking carbohydrate consumption first with high triglycerides and then linking high triglycerides with heart disease. A physician named Reaven recognized, at that time, that excessive insulin secretion and resistance (from too many carbs) were the root causes of this problem. But in the 1980s, the science community had problems with this concept, since it implicated carbohydrates, not fat. This is a very important section of the book and helped turn my head around to see carbohydrates, especially refines carbs, as the culprit, not â€œgoodâ€ fats.
In the very last section, “Following Through,” science writer Gary Taubes notes that there are now many more books and websites that promote carbohydrate restriction. He recommends that doctors and researchers keep an open mind to the concepts and research in his book. So long as they buy into â€œcalories in/calories outâ€ and ignore the idea of carbohydrate restriction, they will never understand why we get fat.
For me, this book was a turn around in my thinking and I am now experimenting with the Atkins Diet, which is similar to the diet in Taubesâ€™ Appendix. I think the â€œavoidâ€ list can be daunting, but if you have tried everything else and the guidelines have not worked, I suggest you look at Why We Get Fat for more answers. The book is packed with information, research, and challenges most doctorsâ€™ thinking about being fat. It is an important book to read and discuss with your health practitioner.Â You can order it directly from Amazon by clicking on the link below:
P.S. A brand new article called “Is Sugar Toxic?” by Taubes, printed in The New York Times, is available by going to: http://www.nytimes.com/2011/04/17/magazine/mag-17Sugar-t.html?pagewanted=1