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The Diet Fix (sciencebasedmedicine.org)
41 points by tokenadult on Feb 27, 2014 | hide | past | favorite | 59 comments



It's unfortunate that we have two definitions of diet:

1. What we eat.

2. A temporary change to what we eat that will produce correspondingly temporary results.

Another thing that trips people up is the paralysis rational human beings often experience at the start of a monumental task. Changing your diet to be healthier is, for many people, such a huge undertaking that they can't get started. Like so many other things in life, the trick is to start small. Try putting one less sugar in your coffee or, every time you open a Pringles can, throw the first ten chips in the trash. If you keep doing small things one day you will laugh at how little they really were while being awed by how far you've come.


After reading some of sites' other posts I think it's just not a reliable source of information. The 'science' is hand picked to support the author's arguments. This is no different them the candida, sugar or vitamin proponents. They all have scientific explanations and plans of action.


His post about Taubes still being wrong does that http://www.sciencebasedmedicine.org/why-we-get-fat/

I'd like Taubes to be wrong on some points, but the author would rather argue against his misunderstanding of Taubes, which doesn't help.


His argument in this post is "The laws of physics are unavoidable". That makes no sense at all! There is no logical reason to believe that calories (a thermodinamic unity) is transformed in fat in our body.

This is the same as saying that all fat should go to the feet because of Gravity and the laws of physics are unavoidable. It is pure non-sense.

Do you know how to measure calories on food? You burn it and measure the heat it generates. How this apply to our body function is a mistery to me. To anyone actually.

Taubes theory is based on hormones, which is what the medicine proved for the last century that is what regulates all kind of function in our bodies. Make much more sense, no??

Calories in - calories out muchbe relevant to a thermal plant, no to our body producing fat.


Agreed, it reads like the same faddish, pseudo-science the author purports to debunk. "I tried all the diet books, and none of them worked, but finally here's one that does, because SCIENCE!"

It's the same old shopping channel and sideshow sales pitch people have peddling for hundreds of years, except it tries to play on a mark's trust for scientific authority instead of religious belief or new age mysticism, the same way some magicians pass off classic tricks as clever mentalism by exploiting people's belief in the power of modern psychology.

And the actual obesity cure it outlines is the same as every other mainstream diet: Reorient your whole life around planning, purchasing, preparing, eating and recording a weighed, calorie counted, macro-nutrient balanced diet, and try to get some more exercise as well.

Most people, particular in those groups most risk of obesity - those poor in time and money - will never be able to adopt such a strategy. Consider a single parent trying to raise three or four kids, while working a couple of jobs, and travelling everywhere via long public transport journeys. There's no way that they're going to be do all this.

Processed food is successful because it: - is cheap - tastes good - is easy to acquire - is easy to prepare

Any solution to widespread obesity needs to provide a source of healthy food that at the very least matches processed food in these regards.


This is a great article. I'm always in favor of flexible and scientific approaches to dieting. Lyle McDonald wrote a great series of articles on why diets fail (hint: it's a hormone called leptin) [1]. Caloric deficits lead to decreasing leptin, which explains why you feel like crap when dieting because this leads to metabolic slowdown by downregulating things like your immune system (why you get sick more when you diet) and reproductive system (why you lose your sex drive). Leptin's effects on the hunger-controlling hypothalamus explain why you may obsess over calorie-dense junk foods when you diet. It's your body's protection against starvation, but it goes all haywire in our obesogenic (obesity-causing) environment.

So what's the best way to acutely raise leptin levels when they're depressed from caloric restriction? Flexible diet solutions like the ones talked about in the article. High-carb "refeeds" - some people call them cheat days - are particularly helpful [2]. The trick is to binge on carbs (not fat!!!) while remaining at a caloric deficit, which is where a calorie journal definitely comes in handy. Things like sweet potatoes and pasta will fill you up and replete your leptin levels.

As an aside, while we're talking about leptin and flexible dieting, intermittent fasting is wonderful for flexible dieting. I'm working on a website right now that's based on the leangains method [3], which is great for folks in the moderately overweight category. For severely overweight or obese folks, Dr. Krista Varady (who I had the pleasure of speaking with on the phone recently), has published a ton of research on intermittent fasting over the past decade and just wrote a book called the Every Other Day Diet [4], which I highly recommend for anyone trying to lose a lot of weight quickly and safely and keep it off.

[1] http://www.bodyrecomposition.com/fat-loss/the-hormones-of-bo...

[2] http://www.ncbi.nlm.nih.gov/pubmed/11126336

[3] http://www.leangains.com/2010/03/intermittent-fasting-set-po...

[4] http://www.amazon.com/The-Every-Other-Day-Diet-That-Weight/d...


Dieting does not fail, but dieting does not work how the author thinks.

For most, dieting is to maintain the status quo. Overweight or obese people drink and eat diet beverages/foods, or conform to some self-imposed diet, to maintain their current health. They know they can't give 100% into their desires, or they could have dire consequences (hospitalization, death), but they are not determined enough to take the actual steps to losing weight (significant diet change, routine exercise).

I see this everywhere. Family, friends, etc. They all say they're dieting, but year after year they are as out of shape as always. They are happy and content with themselves, because dieting to them does not mean "get fit like those gym guys on T.V."


"Freedhoff opens the book describing “Dieting’s Seven Deadly Sins”, which are commonly held, but dangerous, beliefs about dieting. Hunger is the first myth to go. Freedhoff argues that any diet plan that leaves you hungry won’t be sustainable. Sacrifice is next—perpetual sacrifice of anything you enjoy will make any diet fail. Willpower is important, but permanent resistance is almost certainly futile. Blind food restrictions are the next to go, and Freedhoff is adamant we need to manage, but not banish, certain food groups. Sweating is the next myth, with The Biggest Loser epitomizing the belief that exercise can contribute to significant weight loss. You can’t outrun your fork—not in the long run. Anticipating perfection is also a myth, so real diets must be flexible enough to accommodate setbacks. Denial is the last myth. “The diet was great—I just couldn’t stick with it” is a common refrain. As weight loss progresses, any suffering gets harder to sustain, and harder to deny."

Looks like a great beginning to a book.

One could write a great informational material only basing themselves on these myths.


There is claim that exercise contributing to significant weight loss is a myth. I beg to disagree, while exercise itself might not be significant contributor to weight loss, no exercise means lower metabolism and overall health.

As always there is no silver bullet, you need to have a balanced lifestyle to be healthy.


Where does he claim that exercise doesn't matter?

"Exercise: You can’t out-exercise a bad diet, but regular exercise helps keep weight off, and changes your attitude for the better. And exercise has enormous health benefits beyond any impact on weight. What exercise? Something. Anything. “Some is good, more is better, everything counts” Freedhoff suggests."


"Sweating is the next myth, with The Biggest Loser epitomizing the belief that exercise can contribute to significant weight loss."


Exercise can stimulate profoundly positive physiological changes, and that alone is a good enough reason to do it.

But people forget that they burn more calories during a single night of sleep than they do doing 3 hours of cardio a week. Balance is important, but shedding nutrition & health mythology is even more so.


The Gluten Free nonsense drives me the most crazy. Of course they don't have Celiac disease, but they are "Sensitive" to it, which there is no way to refute. There is so much pseudoscience crap floating around I'm glad there's one book out there refuting it, I just wish he was a nutrition researcher doctor or something instead of a pharmacist, which doesn't sound very impressive for a diet book.


There is one benefit from it, though: a much larger market of gluten-free products than would exist if the only people buying them were people who legitimately suffer from celiac. In that respect it's a net positive: stupid people are out some money, but it's hard to get too worked up about that since (being stupid) they would have probably found some other pointless thing to waste it on anyway, and at least this way their waste makes it possible for celiac sufferers to have a better quality of life.

The only hitch is that fads are by their nature transitory, so at some point the stupid people will flit away from gluten-free to some other fad, and the market of gluten-free products will collapse. Which will kind of suck for those who actually need them.


It's frustrating. But I've been there. First coupe years slow-carb, low-carb, plaeo, grain-is-poison. All diets work. But it was only after I got the fundamentals really down, and just did the work required that my body snapped into amazing shape, remarkably quickly. And it's possible for virtually everyone, at nearly any age.


I'm interested in what you mean by "fundamentals"?


I wish there was a way to answer that appropriately in the space of a comment. Regarding nutrition, this is what I tell people to start with: http://www.amazon.ca/Advanced-Nutrition-Metabolism-Sareen-Gr...

It's a great book, and more accessible than you might think.


my nick at gmail, I'd love to open a conversation on this if you're willing


These are an EXCELLENT resource - http://www.bodyrecomposition.com/articles

Read them all, or only the topics that matter to you; Lyle is one of the best in the world.


In my experience, it really is down to lifestyle choices. I've never been really overweight; the closest I've come is about 200lb (90kg), but I also had a 40in (100cm) waist. What helped is I did diet, then I got a septoplasty for borderline sleep apnea, then I joined a volunteer search and rescue organization in which I hiked every weekend. No special diets (just calorie restriction), no special workouts (just hiking in the mountains regularly).

I inherit high cholesterol (above 220 at one point), but I've managed to lower it through diet alone by drinking a lot of fruit juice (but I also have to watch out for diabetes . . . ), and I've also got it lower through very heavy exercise alone (but I also have to watch out for skeletal/joint injuries . . . ).

As I've gotten older, I've noticed more and more that what I eat has a noticeable effect on my mood, alertness and just physical feeling of well-being. I've also noticed that every time I exercise now, I feel really good afterwords.

I don't think that diet and exercise are a panacea, but they could at least go a very long way to alleviating symptoms and preventing illness. I also think there is way too much pseudoscience and BS going on around exercise and diet that it makes it that much harder, and a lot of programs (high intensity workouts like CrossFit and exclusionary diets like Paleo) are completely irresponsible and very likely worse for people in the long run. It also doesn't help that most of these programs are faddish and very dogmatic, with no tests to back them up.


The first line sort of agrees with what you are saying, but the second line paints a more clear picture:

>Sweating is the next myth, with The Biggest Loser epitomizing the belief that exercise can contribute to significant weight loss. You can’t outrun your fork- not in the long run.


Good point. If you eat shitty food, no amount of exercise or vitamins can help you. However, first sentence mentions that exercise contribution to weight loss is a myth. I disagree with that notion, in hindsight I should had been more more careful with my choice of words.

Edited my original comment to reflect this.


>no exercise means lower metabolism and overall health

For those who have a controlled weight already, is a higher metabolism actually something to aim for?

People who practice calorie restriction for life extension do seem to exercise but not to raise the metabolism, they view that as a tradeoff.


For those who have a controlled weight already, is a higher metabolism actually something to aim for?

Perhaps not; as I get closer and closer to my ideal weight, I wonder if I should taper off my exercise routine. The problem is that exercise has more benefits than just higher metabolism. There are hormones that get released by exercising, not to mention that functional fitness is necessary if you are trying to reach a goal.

I'm not an expert, nor have I seen any research along these lines, but I've heard arguments made that since exercise speeds up metabolism and gets the blood flowing, it should clean out things like histamine (reducing allergic reactions) and disease faster. There's all sorts of reasons to not take my experience as scientific, but I certainly seem to have less allergies, heal faster and get sick less often the more regularly I exercise. I also tend to be more relaxed, have higher clarity and am on more of an even keel emotionally after I workout (and it tends to last most of the day, so I prefer to workout first thing in the morning).


Science is a silver bullet or at least a bullet or at least a way of getting at the truth, but so far this field of science seems like a joke. How nice for them to use thermodynamics.


Is a high metabolism necessarily healthy?


I am not aware of any drawbacks aside from requiring more energy intake to maintain weight.


"In this book we obey the laws of thermodynamics"

Repeating a comment I made below, this makes no sense at all to me!!

His argument in his post saying Taubes is wrong is "The laws of physics are unavoidable". That makes no sense at all! There is no logical reason to believe that calories (a thermodinamic unity) is transformed in fat in our body - and no science to prove it either.

This is the same as saying that all fat should go to the feet because of Gravity and the laws of physics are unavoidable. It is pure non-sense.

Do you know how to measure calories on food? You burn it and measure the heat it generates. How this apply to our body function is a mistery to me. To anyone actually.

Taubes theory is based on hormones, which is what the medicine proved for the last century that is what regulates all kind of function in our bodies. Make much more sense to think how a diet affect hormones and how it affects are body producing fat, no??

Calories in - calories out must be relevant to a thermal plant, no to our body producing fat.


Come now. It's a matter of physics that you can't make stuff from nothing, and you can't do things without energy.

That's not to say that body fat is strictly dependent on caloric intake, but to certain extremes, there's no way around that fact.


Exactly!

What is calorie? Is is something? No! It is a unity of measuring heat. That's it! Doesn't matter at all.

Anything can become fat on your body, but what decides it is the hormones saying to your body "this will become fat, this will become muscle or blood or etc, and this is pee or poo".

Counting calories is a proxy at most. But people started to treat the proxy as thing in itself, which it isn't.


What is a foot? is it something? No! It is a unit of measuring distance, That's it. Doesn't matter at all.


calories * X is proportional to weight loss, but X seems more important than calories in all but the most silly edge cases.


Nope. As far as having an effect on weight loss, net-energy balance (energy added - energy used) is several magnitudes more important than anything else, and the "energy added" side of this equation is entirely calories. Hormones are driven by your environment, and food is a huge environmental stimulus, especially when we're limiting our discussion to weight-loss. But don't conflate that with the idea that hormones are more important; they are subject to your environment (the food you eat), not the other way around.

Over 100 years of hospital-ward, double-blind, clinical trial weight-loss research have ALL shown the exact same thing; Nothing comes remotely close to the effect calorie intake has on weight. The macronutrient content of diet (ie. low-carb, mostly sugar, or high protein) and meal timing has NO significant effect and is completely drowned out by the influence of calorie intake.

But of course that's boring and difficult. What sells books and adverts on Dr. Oz is "calories don't matter".


Except for silly edge cases?

Okay then eat your recommended calories worth of cocopuffs for breakfast, since it's all about energy. Calorie counting oversimplifies the problem. Sure it might describe what is going on, but it can be a poor guide for a dieter trying to decide what to eat next.


Edge cases are exactly that; not typical and therefore need special consideration. But these are rare in the general public.

I didn't say its ALL about energy, just that nothing comes close to the contribution of calories in weight-loss. The type of food you eat is completely drowned out by how much food you eat. So you CAN eat only cocopuffs and lose the exact same weight you'd lose eating a "balanced diet" consisting of the same # of calories (which means both diets contain the same amount of energy), although you risk becoming malnourished over time.

If a dieter's goal is to lose weight, the amount of food they eat (or more precisely the amount of food + amount of activity) is most important. This fundamental principle makes it easy to decide what to eat next. However if the goal is long term health, athletic performance, or growing muscle, then we need to modify how we choose. But it's really not that complicated for almost everyone; just eat mostly whole foods.


But can't you use the same argument for mass? Why focus on calories and not kilograms?


Mass isn't very useful, because our bodies aren't powered by mass-to-energy reactions. Different foods have different energy densities with respect to what our bodies can digest and use. Calories seem to be the best measurement in that respect.


This article explains everything you need to know: http://www.bodyrecomposition.com/fat-loss/how-we-get-fat.htm...


He claims that Excess dietary fat is directly stored as fat, which is opposite of what Taubes claim, that when you eat things as bacon, the fat you eat isn't stored as fat in your body.

I read all related articles about fat and didn't find where he defends this claim (only general explanations about different types of fat and its relation to heart diseases).

Also I am no expert at this topic at all, and I wouldn't understand all the scientific study both sides claim to have. But make sense to me that the fat I eat isn't stored as the fat in my belly, as cow milk doesn't become milk for mothers, and as osteosporis (the lack of calcium on your food) isn't easily fixed by eating more calcium on your food.


Ok, people are downvoting my comment because I am not convinced by their arguments (or worse, just have a different opinion on a polemic topic). That's it, I quit, no more nutrition debate on HN for me.


Sounds promising. Calories in, calories out - the rest is just noise.


That times a thousand.

I've posted here about my experiences with weight loss before (tldr; I got involved with weight watchers, have personally been involved with hundreds of people losing hundreds of pounds each over ~10 years).

There is no person on this earth that can eat less calories than they use and not lose weight. It's not possible. So there are two very easy ways to lose weight.

1. Eat less calories (than you use).

or

2. Burn more calories (than you eat).

(or a combination of the two - as a lifelong program like Weight Watchers promotes.)

Obviously it can be hard for some people to eat less calories.

I'm not saying it's easy, I'm saying it's simple.


That's like saying: "flying is easy, just generate more lift than the airplane weighs - the rest is just noise." No shit, but life isn't so simple. At least for me, controlling weight (now that I'm pushing 30) has been about appetite management, and I've found that keto helps a lot. Not because it changes anything magic about the calorie balance, but because to me 500 calories of steak feels like a meal but 500 calories of pasta feels like a snack.


Thanks for posting a meaningless aphorism. Might as well have said "A penny saved is a penny earned" in a thread discussing poverty.


The forest is calories, so don't lose that.

However, the trees are macros.

Macros are important for goals. If your goal is simply "lose weight", sure, just care about calories. But if you have a more refined goal (recomp, spare muscle, lose bodyfat, athletic performance, build muscle etc), the macros are vital.

I do think people lose the forest from the trees. However, I find that people lose sight of the path through the trees just as often. Both are important.


Was a bit concerned with weight until I plateaued. Now I realize I am in a lot better shape, including blood sugar and lipids, even though I am stuck at this weight. I keep up the exercise and don't worry about the waistline so much. It is funny when I workout though. All these skinny people around the gym not sweating at all. If you don't sweat, I don't see why they bother.


I dunno. I know people who've lost 100lbs and kept it off doing keto.


I bet if you counted the calories in/calories out it would show the calorie deficit accounting for it. The thing with low carb, in my experience, is that it does make it easier to eat less if you have the right attitude about it. I do it AND count calories. Also, just the fact that it cuts out most of the foods in the universe helps to make it an easy decision whether or not to eat something, whereas with just calorie counting all foods are available and that one bite can become 10 bites so easily. I believe those two things account for it's success rather than some trick subverting thermodynamics.


> I bet if you counted the calories in/calories out it would show the calorie deficit accounting for it

By definition it would have to be true that you consumed fewer calories than expended. Calories in/calories out is not wrong, it's just not useful (or at least it's not a nearly complete picture).

Calories in/out are not independent variables. The type of calories you consume dictate at least: 1) how your body processes the calories you consume, 2) the energy you will have to expend, and 3) the hunger you will feel.


I lost 50 pounds eating ~500 calories more on keto than I did before.

Unfortunately I wasn't completely comfortable with the types of meals I ate with that lifestyle.

But it did make me feel as though the whole calories in - calories out was nonsense. Especially after trying (and failing) diets based around that (weight watchers) multiple times.


>I lost 50 pounds eating ~500 calories more on keto than I did before

>But it did make me feel as though the whole calories in - calories out was nonsense.

As a diet methodology, calories in vs calories out is not very effective for the general public. I too have lost more weight via keto.

But when I really tracked what I was eating I found keto simply kept my appetite under control better. This is extremely valuable but ultimately it was still down to calories.

(You also tend to drop a ton of water weight when you first start keto which makes it seem super effective at first)


Comparing how I felt doing keto with the keto flu vs. just plain calorie counting, I think the unique metabolism of ketosis makes your body not use everything you eat during keto. It's very hard to keep under 20g of carbs and not eat too much protein also. Much easier to just go to chipolte/subway and calorie count. If your lifestyle makes you make all 3 meals already, then keto is great. If you don't, then it's a lot of work.


Have you tried slow carb? Avoids dairy and adds legumes. I've found it easier to do and it's (probably) healthier.


Slow carb worked great for me for 6 months, lost 25 lbs!

But alas I got so sick of chicken for dinner and eggs for breakfast, and I guess just got too bored with the meals. Gained it all back :-(

(I actually haven't eaten an egg since then. And I avoid chicken now. I'm wondering if some people develop an aversion to foods they eat too regularly?)


I know people who have lost 100lbs and kept it off by starving themselves. Just because a method gets you results doesn't mean it is healthy.


To me this is like telling someone that wants to grow carrots that carrots are just atoms arranged in a certain way. It may be true, but it's not helpful. There are a ton of factors that influence both calories in and calories out, they aren't just noise.

(This is just a response to your comment, I didn't come away from the post thinking the book treats everything else as just noise.)


The devil is in the details.


It would sound more promising if he didn't have to write a book to explain it even better.


The book sounds interesting, but unfortunately it won't be published and available for purchase until March 4th. I don't understand the point of reviews and marketing like this when you can't actually buy the book. I suppose 5 days isn't that much time, but after reading this article I am interested in the book right now. Are they really still changing parts of the book right now, this close to the publishing date? If not, why not just release it now? Perhaps it takes more time to get all the physical books ready at bookstore points of sale, but surely the e-book version is good to go.

I am also interested in how many people read the article, get interested in the book, find they cannot purchase it, and then never bother coming back to check it.




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