Spirited exchange about caloric balance

May 27, 2010

CaloricBalanceFEH A little over a month ago I began an exchange with a blogger (James Krieger) who saw fit to award Gary Taubes with a mocking BullS*#tter of the day award. You see, James is an unwaveringly committed to the principle of caloric balance: the principal cause of fat storage is that we simply consume more calories than we burn. To refute the carbohydrate hypothesis (the principal reason we get fat is because of the consumption of easily-digestible carbohydrates) put forth in Gary Taubes’ Good Calories, Bad Calories, James creates his own ‘predictions’ he inferred from the hypothesis and, as one might expect, successfully dismantled each of the straw men he constructed. Touche.

As you may have seen in previous posts, I’m not convinced the simple caloric balance rubric works in cases where the calories that are consumed are in the form of easily-digestible carbohydrates (sugars, white bread, etc.). While he does acknowledge that different macronutrients work differently in the body, his point is that as long as there is a caloric deficit, we won’t have enough calories to make fat.

My bottom line on this line of reasoning is that there may well be some merit to the idea that as long as you live in a caloric deficit, you are not likely to retain fat. For the sake of this discussion, let’s accept this premise. For practical purposes, in an environment where there is relatively abundant, cheap sources of refined carbohydrates, it is TBU: True, but useless. The overwhelming majority of people are not going to voluntarily stay in caloric deficit their entire lives, so why orient your recommendations around an unsustainable approach? Especially since there is convincing and ever growing evidence that if one pursues long-term carbohydrate restriction it is possible to avoid getting fat without having to consciously restrict calories.

Since the original post is no longer up and the blog on which is was originally posted has been retired in favor of a new one (good move on his part, I’d say), I include the full exchange (very long, warts and all) here for posterity.

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Keith said…
Having read Good Calories back in 2008, and having read your blog, I’m puzzled by the ‘conclusions’ you extrapolate from the carbohydrate hypothesis. Since I was sure I hadn’t seen these conclusions stated, I re-read the portion of GCBC that laid out the hypothesis (pages 355 to 447, for those of you following at home) and was unable to find these ‘conclusions’ you state.

Now, it is fair to say that the carbohydrate hypothesis stated in the book was short on specific conclusions. For me, that was a good thing and apparently by design. The intent appeared to be to provide as much objectively verifiable information as possible and have that lead the way to re-thinking the conventional wisdom about caloric balance (among other things) so that the hypothesis may be tested clinically.

That said, it seems the burden would be first on you to provide the references for these ‘conclusions’ you offer. They may well be reasonable conclusions – as many other conclusions may be. But they are *your* conclusions, not the author’s because he didn’t state them. I submit if you are not able to find these conclusions stated by the author, then perhaps you did erect straw men to further your own rhetorical ends.

The other observation I have to share is a bit broader in scope. I find the notion of a self-appointed ‘bullshit detective’ (one wonders if this office comes with a sash … and huge epaulets) – especially on issues as complex and multi-faceted as human nutrition to be rather tedious. While I realize some find it good sport to leap to ad hominem attacks, I personally find it rather pointless.

You obviously have a lot of passion and a strong background in these issues. I am sure many people are helped in your practice. I’m at a loss, though, as to how personal attacks help us learn what we need to learn to help people get better or avoid falling into a state of disease in the first place.

Can’t we just argue the facts and leave the middle school stuff somewhere else.
April 26, 2010 1:02 AM

James Krieger said…
Keith,
They aren’t conclusions. They are predictions that naturally follow if the carbohydrate hypothesis were true. Then it’s a matter of whether those predictions hold under experimental conditions.

Regarding my style of blog, people have varying opinions on it. I will eventually be scrapping this blog and starting a couple other ones which won’t have the same style.
April 26, 2010 6:42 PM

Keith said…
I stand corrected. Predictions, not conclusions. Thank you.
The original question remains, however. Where does the author state the predictions you cite.

I still can’t find them.
April 27, 2010 3:54 PM

James Krieger said…
Keith,
That’s the whole point of my post…that Taubes doesn’t approach the carbohydrate hypothesis like a scientist and actually test the hypothesis by making testable predictions and seeing if they hold under experimental conditions. I came up with the predictions because they are predictions that must hold true if the carbohydrate hypothesis were true.

Basically my whole point is that Taubes never attempts to falsify the carbohydrate hypothesis, which is exactly what he should be doing. Instead he only looks for confirmatory data (and even some of his confirmatory data is flawed, like the data that uses self-report of food intake).
April 27, 2010 7:05 PM

Keith said…
Predictions out of whole cloth
Thank you, James. That does clarify. So you did not obtain these predictions from the author.

You take nearly 100 pages of carefully crafted and researched prose and condense it down to an elevator pitch. You construct predictions out of whole cloth predicated on an incomplete understanding of the hypothesis. You take care to construct these predictions to be imminently falsifiable and you dash your hastily-constructed straw men almost as quickly as to stand them up. By way of just one example, you assert a prediction about fructose that is in opposition to what the author clearly states in his hypothesis … and he does so only four pages in to the 90+ pages describing the hypothesis (you can look it up yourself – page 359). To say nothing of the more recent work by Dr. Robert Lustig on the lipogenic effects of fructose (hepatic synthesis of triglycerides, etc.). Hardly inspires confidence that you’ve really done your homework here.

It could be taken a bit more seriously if you had at least made some specific references to the text as you constructed your straw men, but you chose not to. What is most dismaying is that you clearly have the requisite cognitive ability to make a real go at challenging the hypothesis, but it doesn’t really matter if you don’t use what you have.

I don’t know if the whole of Taubes’ hypothesis is right – it has not been tested in any completely verifiable and conclusive way. The hypothesis he puts forth, however, is as complete, coherent and cogent a one on the causes of obesity that I’ve seen – and there is a large body of clinical research over many decades that comports well with the hypothesis. Moreover, the choices I have made in light of what I learned from "Good Calories, Bad Calories" have been more beneficial than I could have imagined – as has been the case for many others with whom I have shared this information.

I also know there are clinical results that support his hypothesis and some that do not. But your attempt at disproving the hypothesis fell short right out of the gate as you demonstrated an utter lack of understanding of the source material and a lack of seriousness in grappling with the issues in any depth.
April 28, 2010 11:56 PM

James Krieger said…
Keith,
*************
You take nearly 100 pages of carefully crafted and researched prose and condense it down to an elevator pitch.
****************
Carefully crafted?
Yes, maybe carefully crafted to tell a story. But a carefully crafted story that leaves out large amounts of conflicting information isn’t correct.
Keith, it takes me just a few minutes of reading his book to find glaring ommissions and errors in it. Maybe it’s because I’ve done over 75 lectures on obesity and obesity related research so that I’m intimately familiar with the work in the area.
For example, let’s take the very beginning of Chapter 14, where, down the page, Taubes states:
"Lean people will often insist that the secret to their success is eating in moderation, but many people insist that they at no more than the lean….surprising at it seems, the evidence backs this up."
But the EVIDENCE DOESN’T BACK THIS UP. There are dozens and dozens of studies that show that overweight people don’t accurately report their food intake and consume much more than they report. But Taubes says nothing about this. He took the self report data and assumed it was accurate, when it’s clearly not.
It took me a few minutes to find this major error in such a "carefully crafted" book.
Or how about page 273 where Taubes talks about the differing tendencies of people to gain weight, and then goes onto claim on page 274 that "something more is going on than mere immoderation in lifestyle – metabolic or hormonal factors in particular. Yet the accepted definitions of the cause of obesity do not allow for such a possibility."
Yet Taubes is wrong here as well. There are dozens of studies on the phenomena of Non-Exercise Activity Thermogenesis (NEAT) and how it plays a large role in people’s differing tendencies to gain weight, and it also fits in with the concept of energy balance. Yet Taubes says nothing about this work despite the large body of data out there.
Again, it only took me a few minutes to find this.
GCBC is nothing but a story….a story that leaves out information that doesn’t fit with the story.
*************
You construct predictions out of whole cloth predicated on an incomplete understanding of the hypothesis.
**************
If my understanding is incomplete, then please explain where and how. Please explain why each prediction wouldn’t follow from the carbohydrate hypothesis.
*****************
By way of just one example, you assert a prediction about fructose that is in opposition to what the author clearly states in his hypothesis … and he does so only four pages in to the 90+ pages describing the hypothesis (you can look it up yourself – page 359).
*******************
I discuss the issue of fructose here:
http://www.thebsdetective.com/2010/02/partial-bullsht-of-day-fructose-makes.html  
****************
To say nothing of the more recent work by Dr. Robert Lustig on the lipogenic effects of fructose (hepatic synthesis of triglycerides, etc.)
********************
Dr. Lustig unfortunately leaves out important information when discussing the effects of fructose. This is thoroughly discussed here:
http://www.alanaragonblog.com/2010/01/29/the-bitter-truth-about-fructose-alarmism/
**************
The hypothesis he puts forth, however, is as complete, coherent and cogent a one on the causes of obesity that I’ve seen
*****************
But it’s not complete. It’s horribly incomplete. When it takes me a few minutes to find major errors in the book, that’s a problem.
April 29, 2010 5:58 AM

Keith said…
I get it, now …
At least I think I do. It appears you have decided that every hypothesis that does not confirm the energy balance hypothesis is wrong. OK. I am not convinced of its correctness and, as I said in a previous comment, nor am I convinced that 100% of Taubes’ carbohydrate hypothesis is correct either. I’m still learning and despite my disagreement with you, I have gained from this exchange.

Your 100% surety produces its own blind spots in entertaining another points of view. The core reason why I decided to comment on your blog was the flippant nature of it – as if you are the only one in possession of the truth. Yes, I know you’ve said ‘it’s just a tone thing, get over it,’ but it does matter. Even in your own very long treatise on how fructose is processed by the liver, you admit that some lipogenesis takes place in the absence of an insulin response, and use a single 6-day study (http://www.ncbi.nlm.nih.gov/pubmed/11068955?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1)  to assert categorically that it is energy balance that is the key to whether fructose leads to lipogenesis. Isn’t that just another example of confirmation bias?

At the risk of conflating two issues here, my reading of Lustig is that he is very mindful of ‘dose and context’ in the context of fructose consumption, which is where he differs with Taubes’ hypothesis, instead emphasizing fructose in the presence of dietary fiber is a key element to whether the fructose becomes lipogenic (as well as the dose, of course).

Where I believe your own blinders have not allowed you to completely understand the carbohydrate hypothesis is that you (at least in this exchange) do not seem to take into account the key premise of the carbohydrate hypothesis which is that obesity is a disorder of fat metabolism which is engendered by metabolic and hormone imbalance (principally triggered by consumption of refined carbohydrates). Perhaps you have taken that on in other posts. Since I have not searched your blog exhaustively, I may have missed it. As long as you believe you have all the answers already and dismiss others points of view immediately when they disagree with yours, then decide to attack the person; it diminishes your argument for people like me. Maybe I’m just an outlier. I don’t watch ‘reality’ TV either.

Thank you for your time and I wish you – and those with whom you work to get and remain healthy – well.
April 30, 2010 9:55 PM

James Krieger said…
Keith,
*************
Even in your own very long treatise on how fructose is processed by the liver, you admit that some lipogenesis takes place in the absence of an insulin response, and use a single 6-day study (http://www.ncbi.nlm.nih.gov/pubmed/11068955?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1) to assert categorically that it is energy balance that is the key to whether fructose leads to lipogenesis. Isn’t that just another example of confirmation bias?
******************
I would contend that you are creating a strawman out of the argument I’ve made, and that’s probably partly my fault as I may have not been totally clear in my presentation.
First, of course lipogenesis can occur in the absence of an insulin response. In fact, that was one of the points of my original post on Taubes. Taubes likes to demonize insulin, and one of the points of my post was that you can get fat without it.
Second, lipogenesis is not a light switch. It’s not like fructose is non-lipogenic in an energy deficit and then suddenly switches to lipogenic in an energy surplus. These states exist on a continuum, with the degree of lipogenesis changing with shifts in the degree of energy status.
You also can’t just look at lipogenesis. You also have to consider fat oxidation rates at the same time. Again, it’s a matter of balance. Sure, fructose can be lipogenic, but if the rate of fat oxidation matches the rate of lipogenesis, then there will be no fat accumulation.
The body is constantly undergoing anabolic and catabolic reactions. Tissue mass only increases if the anabolic reactions, all summed up, exceeds that of the catabolic reactions, all summed up. In this case of fat, lipogenesis must exceed the rate of fat oxidation. And this is again a matter of energy balance.
**************
take into account the key premise of the carbohydrate hypothesis which is that obesity is a disorder of fat metabolism which is engendered by metabolic and hormone imbalance (principally triggered by consumption of refined carbohydrates)
****************
No, I certainly do take that into account. But there are two major problems with that tenet. First, all the hormones in the world can’t make you fat if they don’t have the substrate to work with. Hormones can’t trump energy balance. They are just signaling molecules. But they can’t cause the synthesis of new tissue if there is no substrate to build that tissue with. You can bark all the orders you want to construction men, but they can’t build a skyscraper unless they’ve got the materials to do it with.
The second problem with that tenet is the implication that obesity has a single primary cause. However, the scientific literature is quite clear that there are numerous factors all contributing to obesity. Even simple things like portion sizes have been found to be contributors. You could eliminate refined carbohydrates from the diet, and you will still have an obesity problem.
May 1, 2010 7:35 AM

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7 Responses to “Spirited exchange about caloric balance”

  1. Chris Says:

    Thanks for taking the time to have a thoughtful discussion with James, Keith, and for posting the details here. I had wanted to have a similar discussion with James myself.

    I like that James references NEAT as a factor in weight regulation. I think that this fits nicely within a Taubesian world view. My personal understanding is that the amount of NEAT that occurs is a function of how much energy the body “wants” to burn, and that an overweight person will experience a great deal of NEAT once insulin is controlled via a low-carbohydrate diet. This is the body’s way of burning off what is now excess fat. Fat which had been necessary when chronically high insulin was preventing the fat stores from releasing enough energy to power the pody.

    I need to read up more on fructose and lipogenesis and fat oxidation… I wish that this 3-day weekend were instead a 5-day weekend!

    Like

    • KMT Says:

      Thanks for commenting, Chris.

      James does appear to be wedded to the ‘caloric balance explains all’ premise, while at the same time avoiding the issue of causation (why to overweight people consume more and expend fewer calories).

      Need to learn a bit more about the NEAT premise. It’s aligned very closely to Mark Sisson’s bromides (“Move around at a slow pace”). Lately, though, I’ve been musing a lot over questions about how more precise definitions of calorie expenditure might play into our thinking. For example, how many calories does respiration ‘cost?’ How about the caloric ‘cost’ building muscle (a la Body by Science methods – couldn’t tell by just looking at the person)? How about digestion – specifically the ‘cost’ of digesting energy-dense fats and protiens compared with easily-digestible carbohydrates. Goes back to a post from Dr. Michael Eades (Protien Power): http://www.proteinpower.com/drmike/metabolism/more-on-the-thermodynamics-of-weight-loss/. Basically says ‘good luck’ actually coming up with an empirical approach to computing energy balance in a living organism given all the variables. See the equation at the end of the post as a first pass attempting to do so.

      The whole ‘fructose to triglycerides via hepatic means’ discover is really intruiguing. That it is only now being given any serious consideration surprises me. There aren’t many references to find on the topic (Lustig is about it as far as I can tell).

      And to think hefty sums of our tax dollars are spent subsidising all manner of processed fructose-containing toxins.

      Like


  2. In response to KMT, I am “wedded” the the concept of energy balance *because all of the scientific data supports it*, despite Taubes’s attempts to spin it otherwise.

    I also do not avoid the issue of causation (“why” overweight people overconsume). In fact, quite the opposite….I am of the opinion that there are NUMEROUS causative factors that explain overconsumption, all working together to create a “perfect storm” that results in an obesity epidemic. It is naive and overly simplistic to consider carbohydrates as a cause.

    Because of the many accusations that had been leveled at me that I was creating a strawman and hadn’t read the book, I am posting a new, much more thorough, chapter-by-chapter critique of Taubes’s book. You will find that he is overly biased and selective in his presentation of the data, cherry-picks his research, and favors outdated, low quality data over more recent, higher quality (and more reliable) data.

    http://weightology.net/?p=251

    http://weightology.net/?p=265

    Like


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