Talk:Low-carb diet/Archive1

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Attentive reader pointed out that this article lacks references.-- -PalMD ^{--Trust me; I'm a doctor} 20:51, 30 July 2008 (EDT)

This topic is a bit complex -- -PalMD ^{--Trust me; I'm a doctor} 22:46, 30 July 2008 (EDT)

The article is certainly incredibly one-sided. The other wiki is far less simplistic and biased in its presentation. The German article even ends basically saying that many nutritionists and their organisation criticise the concept on theoretical grounds, but actual randomised studies could not confirm their points of criticism and instead found the efficacy of low-carb diets superior to rival approaches!

It's strange that the assumption "fat makes you fat" has never been questioned for all the failures of low-fat or other conventional approaches to remedy the obesity problem. That even though it is clear that fat is more satiating than sugar (or carbohydrates in general, presumably) even with identical energy content, and sugar is increasingly recognised as a major problem and cause of obesity (so you'd think there should be reason to think that perhaps the whole low-carb idea isn't so demented after all). Fat is still the main scapegoat. Epic fail.

That said, even the insistence that skinny = healthy, chubby = unhealthy is puzzling as there has been a study showing that the highest life expectancy is found in the group that is significantly above the recommended ideal weight (according to BMI), so it would seem that the recommendation is simply wrong and the ideal weight isn't at all ideal. One observation that lends credit to the idea that the War on Fat (and Plumpness) is significantly overblown is an analysis of old paintings depicting peasant families which determined that the average peasant, according to modern standards, was decidedly overweight, despite lots of hard physical outdoors labour, and presumably healthy (or at least not excessive or decadent) nutrition. It is true that recipes in old cookbooks and other evidence reveals that even 100 years ago the average diet in Europe was remarkably high-fat. Which brings us back to low-carb.

Nutrition science is both complicated and simple. There are lots of controversies and seemingly preciously few certainties. On the other hand people can survive and even stay healthy with rather extreme and unusual diets. But attempts to solve weight problems are frequently utter failures. So it's hard to make recommendations except very general and obvious ones such as a varied diet that doesn't omit any major food group entirely, and just to follow one's instincts. --84.151.185.90 (talk) 23:29, 30 June 2011 (UTC)

The BoN got it about right. The article cited by PalMD is pretty conservative, but, like a lot of recent publication, treats Atkins diets as possibly being useful. My comments on the flaws in their arguments, not to detract from the value of this report. quoting from the abstract:

• A systematic review of low-carbohydrate diets found that the weight loss achieved is associated with the duration of the diet and restriction of energy intake, but not with restriction of carbohydrates. The diet essentially restricts carb intake. What is being claimed here is that the diet operates by resulting in reduced energy intake. Note the contradiction with conventional wisdom, which is that high-fat diets are unwise because of the high energy content of fats. However, experience with Atkins shows that general appetite is suppressed when a diet is high-fat, so, certainly, it's quite possible that reduced energy intake, because of reduced appetite, is part of how the diet works! So what? Since the Atkins diet itself is ad libitem (generally) as to fat and protein, but only controls carbs, it is not as if the diet controls calories, and Atkins specifically says that calorie monitoring and control are not necessary. Apparently, absent large carb content in the diet, appetite does control caloric intake.

• Two groups have reported longer-term randomised studies that compared instruction in the low-carbohydrate diet with a low-fat calorie-reduced diet in obese patients (N Engl J Med 2003; 348: 2082—90; Ann Intern Med 2004; 140: 778—85). Both trials showed better weight loss on the low-carbohydrate diet after 6 months, but no difference after 12 months. Notice that the study was only about providing "instruction" in the low-carb diet. What that study showed was that Atkins did no worse than an otherwise well-regarded low fat diet. Since this is what doctors do, recommend diets, this simply showed that recommending an Atkins diet was not recommending suicide. Most diets, without continued support or dedication of some kind, ultimately result in relapse to old ways of eating, with, no surprise, return to previous weight levels (or worse). "Instruction" in Atkins could vary greatly, as well. Many people, because of the prevalence of propaganda about fat, will try to do Atkins with relatively low fat. And that won't work, because the diet will likely be unsatisfying, and the dieter will be hungry. Fat is a crucial part of it.

• The apparent paradox that ad-libitum intake of high-fat foods produces weight loss might be due to severe restriction of carbohydrate depleting glycogen stores, leading to excretion of bound water, the ketogenic nature of the diet being appetite suppressing, the high protein-content being highly satiating and reducing spontaneous food intake, or limited food choices leading to decreased energy intake.
• Atkins may lead to initial weight loss due to reduced water retention. Atkins does begin with relatively severe restriction of carb intake, the goal being to induce ketosis, as the article notes. Atkins is not, however, particularly high-protein, that's a common misconception. It is low carb, moderate protein, high fat (compared to standard diets).
• While limited food choices, readily available to the patient, may have some effect, that could not be a long-term issue, because the Atkins diet provides a wide variety of foods. The problem is that, go into a convenience market, and you will see almost nothing that fits a low-carb diet. Eventually, someone on an Atkins diet learns what to buy that works, even for snacks.

• 'Long-term studies are needed to measure changes in nutritional status and body composition during the low-carbohydrate diet, and to assess fasting and postprandial cardiovascular risk factors and adverse effects. Without that information, low-carbohydrate diets cannot be recommended.

• Very conservative.
• This ignores that people must eat something, and apparently, existing eating patterns are not working well. Were low-carb diets a new idea, the comment would make complete sense. They aren't, and there is lots of evidence that low-carb diets reduce diabetes, for example, and certainly they offer symptomatic relief, that's been well-known for a century or so. There is no evidence for harm from high-fat diets, it's all been theoretical, based on expectations from weakly-established theories, or just mere opinion, rather than on actual studies.
• Studies have shown that low carb diets, particularly Atkins, do not worsen "cardiovascular risk factors," properly understood. High total cholesterol and high LDL fraction are risk factors, but risk factor should not be confused with cause. However, within that population, there is also the effect of HDL fraction and specifically the HDL/LDL ratio. High saturated fat apparently does increase total cholesterol, and to a lesser extent LDL levels, but also increases HDL, the result being an improvement in HDL/LDL ratio, which is a better risk predictor than the total and raw LDL levels. The evidence is that an Atkins diet lowers cardiac risk, compared to other commonly recommended diets. --Abd (talk) 20:48, 25 February 2012 (UTC)

Pseudoskeptical woo

From the article: the real reason for the weight loss is low-carb diets are so restrictive that most people who try to follow them wind up drastically reducing their caloric intake.

This entirely misses the point, and is certainly incorrect. The reduction in appetite that takes place in low-carb diets may indeed be the major cause of weight loss, but the cause of that, in turn, is not that the diet is "so restrictive." It's practically the opposite.

Atkins claims that fat has a "metabolic advantage," i.e., that what we consider fat calories are less likely to end up as body fat than carb calories. This is controversial, but the common argument that this is woo because "a calorie is a calorie" is, itself, pseudoskeptical woo. Food calories are not thermodynamic calories, they are adjusted based on research that was done about a century ago, having to do with "utilization." Fiber, for example, has substantial thermodynamic caloric content, shown in a bomb calorimeter, but is mostly excreted instead of being absorbed. The context of diet (i.e, the body's operating metabolism, which varies with diet) was not considered in establishing the assumed food calorie utilization ratios. Atkin's claim is not impossible, in other words. Essentially, the Atkins argument may depend on the fact that food fat must go through more intermediate processes to end up as body fat, and is thus less efficient, whereas food carbs relatively easily are converted to blood glucose, and from there, from the effect of insulin, into body fat.

(And for this reason the estimation of caloric intake in studies which use "food calories" -- and I'd bet they all do -- may be inaccurate. If Atkins is right, the effective caloric intake may be even lower than calculated by adding up the food calories in the diet.)

But what is not controversial is that fat in the diet "sates." People who have learned to do an Atkins diet properly aren't hungry. There is no hypoglycemic crash; I've been on a quasi-Atkins diet for about six years now, and I don't get hungry, in the same way as I used to when eating a carb-based diet. But I do enjoy food, and don't feel deprived at all, the opposite. The Atkins diet is not as low-carb diets are described on the page. Carbs are not "evil," and the diet, in the maintenance phase, is not based on avoiding any food entirely. Rather, an individual balance has been set up, so that one remains at low levels of ketosis (which is often tested with Ketostix or the like). Humans have three basic food cycles based on what is being burned for fuel: carbs, fat, and protein. These cycles are not generally maintained at the same time, apparently. So if you are in one of the first two cycles, which is normal if you are not starving, you aren't burning much protein. Good thing, because burning protein means that your body is scavenging your body structures to survive.

Because high levels of glucose in the blood, which you will readily get from eating a "normal" meal (in America and in many other places), are toxic, i.e., the glucose levels must be reduced in order to maintain health, insulin is released, and insulin clears the blood of glucose, and that effect doesn't quickly stop, so blood sugar goes low, and one feels a loss of energy and one is hungry. Stereotypical Chinese food syndrome.

When the body has switched on the fat-burning metabolism, however, a normal healthy individual has plenty of fat. You could probably go for weeks without a serious problem, before you would start burning protein. In any case, not eating for a day seems to have little effect on me. This is probably normal for humans, if we evolved as hunter-gatherers. I'm motivated to eat, but not bothered by not eating, in the same way that people around me on high-carb diets seem to be.

In any case, low-carb dieters do reduce total caloric intake, generally. But it's not because the diet is so restrictive, that's been made up, as a way to dismiss the diet. It can seem that way, though, if you are buying food at a convenience market (in the U.S.), where there is aisle after aisle of high-carb foods and very little that is low-carb. At a regular market, there may be aisle after aisle of high-carb, highly processed foods, but also plenty of low-carb choices, and in a restaurant, for example, I can eat a cheese omelet for breakfast. Hold the toast, please. If I weren't a Muslim, I'd have some of that bacon.

And, in place of the toast, at one local restaurant, I might substitute some fruit. Fruit? But, but ... that's high carb! Sure. But it's only a little, and there are other benefits. What I'm saying is that this idea that an Atkins diet is sooooo restrictive is only true in the induction phase, which is designed to quickly toss the body into ketosis, so that, possibly for the first time, the dieter is experiencing the state.

If Atkins only worked because of being very restrictive, the diet would quickly fail. Diets that over-restrict leave dieters dissatisfied, and sooner or later their instincts break through the control.

Someone following the "Atkins Nutritional Approach" will literally feel like a hunter-gatherer instead of a farmer. In part, eating vegetarians instead of being one. (The modern "normal diet" is more vegetarian than not.) (You can do a vegetarian version of Atkins, people do, using olive oil, etc., instead of animal fat. I do eat a lot of butter and drink cream or use it in my coffee, and some vegetarians allow milk products.)

That's just personal experience and analysis, though informed. The science, such as it is known, though, is not what is represented in the article. --Abd (talk) 15:16, 26 February 2012 (UTC)

That's nice. I stick with Mayo Clinic for our debunking, thanks. GodotGrow a vagina 16:02, 26 February 2012 (UTC)

Great. Reference? --Abd (talk) 16:38, 26 February 2012 (UTC)

This from the Mayo clinic isn't bad -- it's a lot better than our article -- though I could criticize some aspects of it. --Abd (talk) 16:44, 26 February 2012 (UTC)

that's just a summary of the diet itself, not a study of the diet. they are using atkins' own words. They include all kinds of diets on their page, because they want people to know what the diet is about. Doesn't change that most of ATKINS (not lower carb, but atkins itself) is dangerous, is high in SATURATED fats, puts a serious strain on your heart. oh yeah, and doesn't help you keep any weight off. GodotGrow a vagina 16:53, 26 February 2012 (UTC)

Depressing. You misrepresent the page, it is a review of the diet, not just a presentation of Atkin's words.

Atkins can be high in saturated fats, but you are contradicting yourself. You wrote that you preferred the Mayo clinic. So, where is a "debunking" from the Mayo clinic?

The very core of the issue is whether or not natural saturated fats are harmful, and that is precisely what is currently and seriously controversial. There never was sound evidence for the proposition. The Atkins diet does not worsen blood lipids, as far as is known, and that's quite contrary to assumptions that were promoted for over twenty years. And how else would saturated fat "put a strain on your heart"? Perhaps from increased heart rate from seriously loving that fat? I.e., could fun put a strain on your heart? I've been testing this one. Not enough.

From the Mayo page:

The Atkins Diet says that its eating plan can prevent or improve serious health conditions, such as metabolic syndrome, diabetes, high blood pressure and cardiovascular disease. In fact, almost any diet that helps you shed excess weight can reduce or even reverse risks factors for cardiovascular disease and diabetes. And most weight-loss diets — not just low-carb diets — may improve blood cholesterol or blood sugar levels, at least temporarily. One study showed that people who followed Atkins had improved triglycerides, suggesting better heart health. But there have been no major studies to show whether such benefits hold up for the long term or increase how long you live.

Some health experts believe that eating a large amount of fat and protein from animal sources, as allowed on the Atkins Diet, can increase your risk of heart disease or some cancers. However, it's not known what risks, if any, the Atkins Diet may pose over the long term because most of the studies about it have lasted for a year or less.

Your comment is assuming the outcome of the controversy as if it were an established fact. What the studies the Mayo clinic refers to showed was improvement in risk factors for CVD (not just triglycerides). Then the Mayo points out that long-term studies haven't been done, and that's true. However, if there is no short-term worsening (in a year), why would we expect long-term worsening, and couldn't one just try the diet and monitor the risk factors? And that's exactly what I did, plus I added, to my blood work, CRP, and had a cardiac CAT scan (both much more predictive of CVD). The Mayo clinic page is quite conservative, which is fine. As long as you know that.

Critical thinking. Don't leave home without it. --Abd (talk) 17:17, 26 February 2012 (UTC)

The slippery slope here is that long-term studies, which you acknowledge haven't been done, my prove the most important test. Would someone who smokes cigars on a daily basis, for example, show signs of cancer after just a 6 month trial? It's possible, but cancer can take years to develop. Same goes with heart disease and various other chronic conditions. Therefore, while you can take the short-term evidence at face value and say "Atkins has no risks", the evidence over the long-term may, in fact, prove otherwise. Remember FenPhen? That shows no short-term danger either. But then when long-term studies were completed, they found it was killing people and/or causing them severe heart damage. So to dismiss long-term scientific studies is silly at best and completely ignorant and stupid at worst. The Symphony of Punk ^{Can't sleep, clowns will eat me!} 11:34, 28 February 2012 (UTC)

Long-term studies on the Atkins Nutritional Approach, specifically, have not been done. But no long-term study is being "dismissed," except perhaps by the Atkins critics. I.e., there are long term studies on diet, per se, and they do not show the harm for fat in the diet that is being asserted. Atkins does not introduce new foods or truly new principles, it was all long-known, but largely ignored in the 1970s when the Fat Myth was invented, in a highly political process.

By the way, Atkins probably protects against the progression of certain cancers. I know the research that could lead to that claim fairly well, because I'm betting my life on it. I haven't begun to assert the evidence, but this is covered by Taubes, Good Calories, Bad Calories, probably the most authoritative source in the field. It's plausible. But unproven. --Abd (talk) 19:50, 28 February 2012 (UTC)

"Long-term studies on the Atkins Nutritional Approach, specifically, have not been done. But no long-term study is being "dismissed," except perhaps by the Atkins critics."

Except that you dismissed long-term studies in your earlier statements in defense of Atkins, right? The Symphony of Punk ^{Can't sleep, clowns will eat me!} 21:46, 28 February 2012 (UTC)

I don't think so. Where? --Abd (talk) 22:13, 28 February 2012 (UTC)

Some great thinking in a letter to Science

Science Nature published an article calling for sugar to be regulated, similarly to alcohol.

It inspired this authoritative response:

To describe sugar as “toxic” is extreme, as is its ludicrous comparison with alcohol (Nature 482, 27–29; 2012). Such sensationalism could damage the livelihoods of thousands of people working in the sugar industry worldwide, and will be felt in countries such as Australia, the United States, Fiji, Mauritius, Indonesia and India.

As the senator for Queensland, Australia, where sugar is the most significant agricultural crop, I wish to voice the industry's concerns. Consumers should be assured that sugar is a safe ingredient and suitable for consumption as part of a balanced diet.

Sugar is toxic, get over it. Humans have evolved to handle it, to convert it to fat, if the mechanism hasn't burned out due to long exposure to sugar. Whether or not sugar should be regulated is a separate issue, but sugar is not a purely safe ingredient, at least for large segments of the population. The problem is not simply the sugar that is the product of the "sugar industry," though, for many industrial foods (and "industry" here includes agriculture, the original mass-production industry), through the carbohydrate content, especially if the food is purified and refined in certain ways, produces as much rapid increase in blood glucose as does plain sugar, which isn't necessarily the most dangerous food.

Sugar is probably relatively safe for most children, unless they are diabetic (which would normally be Type I diabetes, from loss of pancreatic insulin secretion), which is why I haven't gotten draconian in keeping my kids from eating sugar. But as a habit, I'm concerned about it. The biggest problem with sugar for kids is that it can shove aside consumption of more broadly nutritive foods, and it can also easily lead to obesity, because the resulting spike in blood glucose must be cleared, and the body's mechanism for that is fat storage. And then when the glucose levels fall, the kid is hungry again, creating a cycle that accumulates fat if they have unrestricted access to high-carb foods, such as snacks, and many snack labels I look at give sugar as the number one ingredient. Good business for the senator's constituents or political supporters, but not so great for public health. --Abd (talk) 17:42, 29 February 2012 (UTC)

Sugar is a basic biological building block for any non-carniverous animal, including humans. It is possible by "sugar", you mean table sugar. But even that is not toxic. Toxic means deadly on consumption. not deadly if eaten in extreme amounts over a life time. virtually anything could be toxic by those standards. Sugar is not only perfectly healthy, it is fully biologically necessary, especially for children who burn calories at the rate of a forest fire. by the way, science did not publish the article you suggest, nature did. Godotoi, putain, genial, merci 15:59, 1 March 2012 (UTC)

Yes, Nature. Sheesh!

No, I don't mean table sugar, per se, though that is a major source. I mean whatever raises blood glucose to toxic levels. Blood glucose at low levels is not toxic. "Toxic" doesn't mean what you claim. It means "harmful." We are evolved to handle toxic levels of glucose by releasing insulin, which stimulates cells to convert the glucose to stored fat. As to "basic building block," and "fully biologically necessary," the truly necessary levels of glucose are handled by gluconeogenesis, and it's been known for a long time that carbs in the diet aren't necessary at all, some populations have had diets with practically no carb in them, and the diet has apparently been healthy. Children have a high need for energy, sure. So? Fat is higher in energy density than carbs. (But I don't push my kids to low-carb eating. There would be social problems, and the harm from high carb diets doesn't show up until much later, if the diet is continued without restraint. If my kids were obese, it would be different.)

The article's claim that carbohydrates are necessary for human nutrition is made-up, woo. That was refuted almost a century ago.

You are correct that "virtually anything could be toxic" in large quantities. The problem with glucose is that the immediate toxicity is handled by the body through insulin release, so everything seems okay, except maybe obesity, but if this is continued for a long time, insulin resistance can develop, and metabolic syndrome, leading to (or being) obesity, diabetes, heart disease, and, there is credible claim, cancer. The "diseases of civilization."

Low levels of carb in the diet, especially if combined with fiber, which slow down the release of glucose, are not harmful. Thus the sensible emphasis on "unprocessed" foods, whole wheat, etc. Mixture with fat and protein apparently also slow down carb digestion, reducing the harm.

The article "warns" that not eating enough carbs can lead to ketosis, as if ketosis were toxic. It's not. It's a normal metabolic process, it means that fat is being burned. Very high levels of ketosis, ketoacidosis, are pathological, and are not caused by normal fat-burning. Someone on an Atkins diet is likely in continuous ketosis, per urine tests. It's part of the design, fat is being burned as fuel, and one common low-carb claim is that this may be the normal human state, i.e., what we were normally in, much or most of the time, before agriculture, which hasn't been around long enough to change our metabolism much. --Abd (talk) 16:41, 1 March 2012 (UTC)

Lower carbs + meat = Higher mortality

This claim is a section of the article, and it's based on a Harvard study. Our source for analysis is an editorial by Dean Ornish. Ornish is a competing "diet doctor," and presents a highly colored interpretation of the study.

Ornish presents as fact what is not scientifically known, and there is contrary evidence, i.e., the idea that saturated fat, per se, is bad for you. Obviously, if you are going to eat a carbohydrate-based diet, the recommendations he makes are sound. Fiber, unprocessed, etc. Atkins would (and apparently did) agree.

The study itself did not study Atkins. Rather, it assessed diet through a questionnaire. I have not read the study itself, I don't have access to it, but there is a major problem with these studies, which is that the effect of altering the proportion of a nutrient in the diet may depend greatly on what else is in the diet. If people simply increase their meat consumption, for example, but don't decrease carb consumption, I'd expect harmful effects. It's possible that there is a threshold, i.e., the Atkins diet operates on a ketogenic threshold, and people don't enter ketogenic metabolism immediately, it takes a few days. Definitely, the study does not assess the effect of an Atkins or similar true low-carb diet.

For some balance, here is a blog that addresses the study, and Ornish's editorial. It leads to some good sources with material pointing to the scientific method and how it hasn't been followed in a lot of analysis.

For starters, the "low-carb" diet in the study wasn't what anyone would sensibly call "low-carb" as these diets go. It was simply "lower carb." (Maybe, if people tell the truth on questionnaires.) This wasn't Atkins, for sure, so Ornish's headline, "Atkins Diet Increases All-Cause Mortality," is completely deceptive. --Abd (talk) 17:30, 1 March 2012 (UTC)

A snarky report that might provide some material for RW: New Study Shows that Lying About Your Hamburger Intake Prevents Disease and Death When You Eat a Low-Carb Diet High in Carbohydrates.

This seems to be a sober commentary. The author interviewed the study author.

this blog skewers Ornish and others, in their reporting of this study. It was deserved. The analyses were far from scientific, and they were highly misleading. The blogger assesses the issue of confounding factors, and points out that the significance of the correlation in this study was low. --Abd (talk) 17:51, 1 March 2012 (UTC)

Here's a media report covering some of the issues.

And here is the response of Atkins, the company. It's pretty solid, I don't see any woo there.

The section in our article then goes on to report the canard that Atkins was "obese" when he died. He was certainly overweight at death. The death certificate was illegally obtained by animal rights activists and published, and it showed his weight at death. However, he'd gained much weight in the hospital from retention of fluid, he wasn't overweight at admission, and there are photos of him, shirtless, shortly before his accident. The man was tall, and not obese. He died from the effects of a blow to the head when he slipped on ice in New York. See Wikipedia. That means, about his diet plan?

(The claim about his death being due to his diet is the province of IP vandals on Wikipedia.)

Basically, the authors of our article have swallowed deceptive polemic, wholesale. This isn't truly controversial, it's just propaganda that's been asserted by anti-meat activists. Vegetarian woo. --Abd (talk) 18:12, 1 March 2012 (UTC)

ablity to isolate factors in obesity and health

one of the single biggest problems with any diet or health woo, is the seemingly intentional willingness to ignore the single biggest change in modern human's life. we are not, by and large, eating all that differently that we always have. yes, we are eating more processed foods, but we have access to fresh vegies year round and eat them year round. even those who generally claim "not to eat vegies". meat, by and large, is not something we had as much access to, so we do eat more meat than we ever have in our human history. But the single biggest change is what you are doing right this second. sitting on your butt, reading a computer. We are inactive. even the most active of us, is less active than he would have been 20,50,100 years ago. We have elevators, escalators, 2 cars per household, video games, laptops, our jobs are less labor intensive than ever, even the "labor based" jobs. We have air powered hammers, and easy type keyboards. every single aspect of our lives is intentionally made to be "easier" to do. dish washers, vacuums, and "swiffers" make it so you dno't have to be on your hands and knees or climbing up ladders to do house cleaning. and every singel "easier" we make, ever tiny little change that give us "one less key stroke" is one less calorie we spend. We are not fat because we are eating too much. We are not fat because we eat sugar, or meat; we do not have heart disease cause of the whole milk, or the white flour. we have those things cause on average, teh human being spends 5-7 thousands less calories a day than our hunter gatherer ancestors, and 1-2 thousand less than our grandparents, just 50 years ago.

so while it's fine to talk about how sugar is toxic, and how high staturated fat diets are "just fine", maybe people should be more aware that what diets are trying to do, is adjust for a life that our bodies were simply not designed for. --Godotoi, putain, genial, merci 18:22, 1 March 2012 (UTC)

(edit conflict with below) WfG, I agree with a great deal of what you have written, but it's still misleading. Sure, there is a serious problem from lack of exercise. However, there was a huge change in our diet when we became "settled" farmers, and, when civilization started providing highly processed versions of farmed foods (which makes it easier to store and distribute them), an even bigger change. You are correct that we are not fat "because we are eating too much." If you really want to know more about this, read Taubes, Good Calories, Bad Calories. Taubes is a science writer, famous for debunking popular ideas. He started with Cold fusion, by the way, but he also, later, debunked unscientific myths about salt and fat. One of the things he points out is that exercise doesn't make you lose weight; rather, it makes you hungry. Exercise is good for you for other reasons. Taubes is thorough, and he looked into salt and fat when he noticed that "experts" were not basing their recommendations on science.

A moderately sedentary life style doesn't cause heart disease, though. If extreme, inactivity will cause congestive heart failure. Nor does it cause diabetes and obesity. Carbs in the diet do cause these, but diet is complex. I have no opinion that "high saturated fat diets" are "just fine." It depends! If that's a high saturated fat and high carbs (which must mean low-protein), it will make you sick. What I wrote was that the claim that saturated fats are, per se, bad for you is just woo. They aren't, not saturated fats in general, and not intrinsically. Butter consumption, in a long-term study, was not correlated with heart disease, for example. Now, add a lot of saturated fat to a diet high in carbs, what well you get? Probably obese, which then leads to diabetes and heart disease. If the diet is very low in carbs, you will lose weight, very likely. This has been known for a very long time. It was a classic treatment for diabetes, I've read the original authoritative book on diabetes, written just after insulin was introduced as a drug. It recommended eliminating "starches" from the diet, and said this would work for most patients, but ... for others, there was now insulin.

Insulin, then, was eventually sold as allowing you to eat whatever you like. It's still sold that way. A friend of mine had a daughter who developed type I diabetes, and the instructional materials she got did not explain anything about limiting carbs. It was all about figuring out how much insulin to take. But long-term insulin use is pretty risky. She had to find better doctors and better advice. The American Diabetic Association doesn't teach what's long been known, and could this have anything to do with being funded by drug manufacturers? There are lots of reports of seriously ill diabetics controlling it with diet, according to that old advice, it simply means that they must avoid carbs, beyond small amounts. No, they can't eat whatever they like, which was the slogan of the drug companies. A low carb diet cannot repair a demolished pancreas, so these people don't have a choice. Most type II diabetics have some pancreas left!

The Atkins diet is called a "Nutritional Approach." What Atkins discovered was that, for most people, if carb intake is controlled, weight can be controlled, seemingly from that alone. His advice was to control the carbs, and, given a variety of foods -- which includes fiber and vegetables -- you can "eat what you like," i.e, ad libitem.

He was not saying that if you gorge yourself on pork rinds, or whatever, that you would be fine. He was saying that the natural regulation of appetite works much better if carbs are controlled, and that for most people it was not necessary to count calories, that takes care of itself. The Atkins diet is individualized, it is not a fixed diet plan. As such, it is "scientific," i.e., it uses experimental evidence from the dieter's own self-study to determine what level of carbohydrate results in maintenance of an ideal weight. Atkins is VLC (below about 20 g/day) only in the induction phase, to kick-start ketosis. Most people seem to settle on about 40-60 grams per day, which allows a fair amount of "indulgence" in carbs. Atkins used to eat a baked potato on occasion, and I do the same. With lots of butter and sour cream! Yum! --Abd (talk) 19:00, 1 March 2012 (UTC)

It'd be interesting to find out how average metabolisms have changed along with the times. Lots of people blame their weight on metabolism, but I doubt the std dev for the population is very high. Occasionaluse (talk) 18:27, 1 March 2012 (UTC)

Well, if by "metabolism" you are also includng the fact that 1 hour of hard exercise increases your metabolism noticably for about 12 hours , and 50 years ago, you were likely to get an hour just doing your normal day to day life, 300 years ago, you got 5 or 10 (totally made up, but i'm thinking you had to work the farm for your food, or haul in your own coal for heat, etc), odds are the metabolisms are lower. Also, there are some prelimmiary, fully inconclusive studies that the pill lowers women's metabolism over time. Hell, my office even moved a "kureg" coffee maker to our cubical area. we don't even have to walk down to the cafetera for coffee now. pretty soon, we'll just have food and drink piped via our computers. :-) Godotoi, putain, genial, merci 18:40, 1 March 2012 (UTC)

I'm talking basal rates. What it takes to exist. Occasionaluse (talk) 18:44, 1 March 2012 (UTC)

Ohhh. Like you said, "why would those be different?"Godotoi, putain, genial, merci 18:54, 1 March 2012 (UTC)

The was a Horizon programme just 2 days ago dealing with exercise and it presented some new findings about exercise and metabolism. I'd recommend watching it if you can. Генгис^{Our ignorance is God; what we know is science.} 18:56, 1 March 2012 (UTC)

Yeah, i saw that out there, and umm... have... um "acquired" it. But not yet watched it. the summary said that one study shows that even 3 minutes a day of intense activity might be helpful! cant wait to see this. The BBC horizion show on "losing weight" was pretty informative. it was 3 or four years ago, i think, but looked at things from "our perception of what we were eating", to how effective exercise can be long term, to the reason eating foods a soup is more hunger satisfying than eating them as just dinner. it was pretty surprizing, but very informative. The "perception" thing is really an issue with me. I think i've eaten a normal portion and find it's way way more... or forget that i ate a cookie, and eat "my alloted suger", etc. so easy to misdirecct ourselves. Godotoi, putain, genial, merci 19:05, 1 March 2012 (UTC)

One thing that's a must when you want to lose weight is identifying portion sizes. For me, this involved taking anything I might normally eat, weighting it out and looking at how much it actually was. Do you realize how much cereal you pour? How much that chicken breast actually weighs? Some of that shit is mind blowing. Occasionaluse (talk) 19:12, 1 March 2012 (UTC)

(edit conflict with below) It certainly is. And that's why Atkins is much simpler for a lot of people. The method only "counts" carbs, and one gets a pretty good idea of how to get within range. It doesn't have to be exact, if one overeats, the weight will start to creep up, so one simply sets the level lower. I eat some regular carbs, often left-overs from my kids. These are not large portions! For anyone who tries Atkins or the like, I highly recommend: be sure to have foods you can eat readily available. Enjoy what you eat, pay attention to how you feel, eat slowly and chew it. To me, on a low-carb diet, a piece of bread is like a piece of cake. Dessert. Yum! (I taste the glucose converted from starch, in the mouth, by pytalin in saliva.) Just not too much dessert, eh? --Abd (talk) 19:29, 1 March 2012 (UTC)

It's one of the main reasons I laugh at these low-carb diets which suggest "you don't have to be hungry". So much of losing weight is learning what normal people eat (or what you USED to eat). but to deny there are other very real factors is to not help the millions of people trying to lose weight and failing. I am supposed to eat 1200 cals a day max. (mostly, cause i'm about as sedintary as you can get...). I can't do that. No matter how much lettuce i use to buffer my food to actually get something to feel filling, 1200 cals means no pleasure - ever. Once I get to a point (if i get to a point) where I can walk 30 minutes a day, that's 100 cals, which is a small peice of chocolate, or a snack, or a glass of wine. but most of my failure comes from the reality that I cannot do 1200 cals. I eat about 1500 a day, which is still lower than most people. so i'm no longer gaining, but whooptie! most men who diet, diet on 1800 cals a day, which is a huge difference in what you can eat, how much you can eat, how full you feel, and if you can have any treats. IT's sooo much fun. I did really well on a modified south beach, but then put it all back again, the minute I blinked. mostly because i've never added back the hours of exercise I was doing before the irridation. Godotoi, putain, genial, merci 19:23, 1 March 2012 (UTC)

(edit conflict) You want to feel full? Eat some fat. If you are normal, you will feel satisfied. South Beach was recommended by my doctor, and I started on it, then I read the science. Atkins was solid, South Beach was a compromise, so I went back to my doctor and complained. He agreed with me. He was being "conservative." I found that, on Atkins, I'm not hungry in the same way as I used to be eating carbs. And that makes complete sense. I'm burning fat, all the time, and I have plenty of it around! (I'd have to lose a lot of weight to not have enough fat to keep me okay.) When you are burning carbs for fuel, and have high blood glucose levels (which is highly likely when you have just eaten major carbs), insulin is released, blood sugar goes down and continues to go down until the insulin is cleared. The symptom: weakness and hunger. So you eat more carbs, perpetuating the cycle.

I'd urge you to look at this "feeling full" thing. Do you need to feel full? How about just satisfied? Many people eat for reasons other than real hunger and nutrition. It's like smoking. Something to do. "Full" means "Stop! Too much!" So if you are looking to feel full, rather than satisfied, of course you will eat too much. --Abd (talk) 19:41, 1 March 2012 (UTC)

1,200 sounds good. One thing that helped me (and my metabolism) immensely was eating more often. I eat 6 meals a day for a total of ~2,500 calories. I'd say four meals a day would be good for you, 250 each. That's 6oz chicken breast, 4oz broccoli and a half a cup of brown rice. Or an (low cal) english muffin, 3 egg whites, two slices of turkey bacon and a serving of oatmeal. You get the picture. And you still have 200 for snacks/overflow. You get hungry quite often, but you're never hungry for long because it's almost time to eat again! Occasionaluse (talk) 19:33, 1 March 2012 (UTC)\

See, i'm physically hungry on that small an amount of food. Which is what kills me. At the size I am, my doc said "stop counting vegies as cals (well, non-starchy), and eat a huge salad full of lettus and summer squash and green peppers, with each meal). That helps a lot. but it's still only 1/2 lb a week or two. so it's so daunting to say "this is what you get to eat for nearly 2 years". the reality, if i can get my mind around it, is that every 5 or 10 lbs you take off is exponentially better for your knees, so you can walk that much more. but reminding myself that is really hard. right now, you are getting the whining me. lol. It would have been much nicer if the docs had set me on a diet at 21 saying "you will have no metabolism for about one year, so here's what you need to eat". but noooo.... lol. gaining 60 lbs in one year, when you are tiny and 5 foot tall, was just... anyhow, i'm whining. i normally don't talk weight cause i whine. :-) Godotoi, putain, genial, merci 19:44, 1 March 2012 (UTC)

A half pound a week ain't bad! With your size and stature, it's not exactly healthy to run a deficit of much more than what you're already doing. 1,000 calories a day is a joke. This isn't the gulag. It sounds like you're totally on the right track, it's just a very long one. Occasionaluse (talk) 19:54, 1 March 2012 (UTC)

Edit con - by the way, ABD, you keep telling me all things things to "try". You can trust that being an academic who is diagnosed with a medical condition, and then trying to lose weight, i'm about as well read on nutrition as i can be, and have tried, with careful precision, diets that are "all you need to eat", and know what "hungry" vs "full" vs "over full is. I am hungry. 1200 cals is a miniscule amount. most diets for most people are in teh 1500 range. But i'm tiny (and huge), and have no activity level right now. Trust me. it's not as simple as just "try this way of eating". I'm over 40. i lost my thyroid at 21. I've been doing this quite a while. and at 1/2 lb a week, i'll be doing it a long time more. if i can hack it. Godotoi, putain, genial, merci 19:44, 1 March 2012 (UTC)

Great, WfG, and I noticed "irradiation." However, being an academic is irrelevant, it only indicates a possible disposition to be sedentary. Whatever diet you tried "with careful precision," that didn't allow you to eat enough to be satisfied, wasn't Atkins, almost certainly. Having no thyroid, though, I have no idea what effect that would have, I'd guess you are taking thyroid medications to replace the natural hormone, and I believe they can affect appetite.

Have you done a VLC diet? For how long, and what did you actually eat? Some people try to do low carb diets with low fat, and it's not tolerable. You'd be hungry all the time!

With no thyroid, I wouldn't suggest Atkins unless you've been satisfied that it would do no harm, but if your weight is as you imply, a VLC diet for a while might kick you into serious ketosis (but not ketoacidosis -- and this can easily be monitored). (Atkins recommends VLC for certain stubborn cases.) If you are still hungry then, well, maybe it's the thyroid issue.

The suggestions I made were generic, based on certain things you had written, and may or may not have any actual application to you. That is why you are in charge of you, and not me.

The number of calories you eat a day isn't a total representation of your diet. What you eat has an effect. Atkins claimed that fat has a "metabolic advantage," i..e, you can eat more fat calories than carb calories, for constant weight, and there is some evidence for this. By the way, I'm 67, and I got much more serious about low-carb when I was diagnosed with prostate cancer. I'm symptom-free, other than mildly elevated PSA, and I'd like to stay that way. So far, so good, on an LC diet, my PSA levels have gone down, which was a possible -- not certain -- outcome. It may depend on the exact cancer, but cancers are hungry for glucose, typically, they need it for the rapid reproduction. I'm starving my cancer, but not myself. I feel great. --Abd (talk) 20:18, 1 March 2012 (UTC)

Looking about, there is some chat that going below 30 g/day of carbs doesn't work well with people with no thyroid. I didn't find anything authoritative. WfG, I'm assuming you have looked at all this. I also found a lot of nonsense out there, repeated as if it was simple fact.... That's the internet. --Abd (talk) 21:59, 1 March 2012 (UTC)

I find myself in the curious position of agreeing in part with what Abd is saying. Lowering carbs and replacing those calories with healthy fats and protein can actually have significant positive effects if you don't have other conditions that would make a ketosis-inducing diet harmful (the usual huge I-am-not-a-doctor-this-is-not-professional-advice disclaimer). The problem is that woo quickly takes over in the interest in making the most money for the least amount of expensive science research and review. Ochotonaprinceps^{not a pokémon} 10¹³ points 07:17, 7 August 2012 (UTC) ^{— Unsigned, by: Pibot / talk / contribs} 06:34, 20 January 2013 (UTC)