Good Calories, Bad Calories: A Critical Review (part 1)

I have a special place in my heart for pop science books. They can be a great way for accomplished scientists to take a complex field of study and distill it down to its essentials. They can also be a great way for excellent science communicators to take what might seemingly be a dry and boring field and make it exciting. Several years ago I stoked my interest in nutrition with a pantheon of pop science books. I devoured these books as quickly and pleasurably as I would a delicious meal. However, now looking back with many advanced science and nutrition classes under my belt I view these texts as overly simplistic and usually presented with a heavy bias. I still think popular nutrition books are fine if you want a good yarn with some nutrition science thrown in or maybe you’re waiting in an airport somewhere for your plane to arrive, but I wouldn’t take any of them too seriously. Their claims will not be vetted well, if at all. The first amendment of the US constitution allows for virtually anything to be published. Textbooks and scholarly journal articles on the other hand are different animals because they experience more rigorous evaluations prior to publishing. Although they can be quite dry and contain more scientific jargon, textbooks and journal articles are the way to go if you are looking for cold hard facts.

With that out of the way let me introduce Good Calories, Bad Calories by Gary Taubes. I had heard the name of Gary Taubes some time ago, but I did not directly engage any of his writing until recently when he wrote a blog post that I found to be extraordinarily ideological.

I decided to read Taubes’s Good Calories, Bad Calories because it was apparent to me that, much like Ayn Rand’s Atlas Shrugged, it was hugely influential to a pocket of its readers. Also like Atlas Shrugged it is an awful, awful book.1

 

The Essentials

The title of this post includes the words “Part One” because GCBC is a seven-course meal. There is no way I would be able to address the entirety of the book in a single blog post; however, I do not plan to write a part two. I just don’t feel like it would be worth my time. Just know that a single post on GCBC is incomplete.

GCBC is truly one of the most researched and meticulously-referenced nutrition books out there. Unfortunately it’s also heavily biased as well, but I’ll get to that in a moment. Here are the main ideas presented in the book:

  • A Harvard epidemiologist named Ancel Keys fabricated some data linking heart disease to saturated fat intake. Taubes refers to this as the “Lipid Hypothesis”2 and was able to convince many scientists, the media, the public, non-governmental organizations (such as the AMA & AHA), and ultimately policy-makers at the highest levels of government to accept his flawed ideas.
  • Contrary to mainstream thinking saturated fats, especially those coming from animal sources are actually quite good for you.
  • Most diseases of modern civilization including obesity and cancer can be attributed to carbohydrates.
  • Consuming excess calories does not make one fat, nor do burning excess calories make one thin.

The Actual Science

Let’s tackle that last claim first: excess calories does not make one fat, nor do burning excess calories make one thin. Instead of citing the studies in the footnotes where they will probably be ignored I will plaster them right here.

  1. Metabolic effects of isoenergetic nutrient exchange over 24 hours in relation to obesity in women. Conclusion: “There were no large differences in energy expenditure between the two diets or between the groups…”
  2. Energy-intake restriction and diet-composition effects on energy expenditure in men. Conclusion: “There was no significant difference in 24-hour energy expenditure between the diet groups.”
  3. Nutrient balance in humans: effects of diet composition. Conclusion: “Total daily energy expenditure was not affected by the composition of the diet when caloric intake was fixed. Similarly, the different diet compositions did not alter SMR [sleeping metabolic rate], RMR [resting metabolic rate], or MRACT [energy expenditure due to activity or movement] of the subject.”
  4. Nutrient balance and energy expenditure during ad libitum feeding of high-fat and high-carbohydrate diets in humans. Conclusion: “Individual body weights fluctuated (by < 0.25 kg) throughout the study, but we did not observe any systematic increase or decrease in the body weight of any subject. Additionally, there was not a significant change in the average body weight of the group as a whole over the course of the study.”
  5. Substrate oxidation and energy expenditure in athletes and nonathletes consuming isoenergetic high- and low-fat diets. Conclusion: “The amount of energy expended in all activities … during the day was not significantly different among groups for either unadjusted … or adjusted data… The proportion of energy expended in activity did not differ among groups or among days… There were also no significant differences in sleep EE [energy expenditure] among groups…”
  6. Regulation of macronutrient balance in healthy young and older men. Conclusion: “Body mass, percentage fat, and fat-free mass were similar in the two groups. Twenty-four-hour energy expenditure (EE) and energy balance did not differ across diets or between groups…”
  7. The effect of protein intake on 24-h energy expenditure during energy restriction. Conclusion: “24-h EE [energy expenditure] and SMR [sleeping metabolic rate] declined on all three diets… Weight loss was similar on all three diets [high protein, high carbohydrate, and high fat].”
  8. Effects of dietary fat and carbohydrate exchange on human energy metabolism. Conclusion: ”Twenty-four-hour RQ [respiratory quotient] and 24-h EE [energy expenditure] were not significantly different between restrained and unrestrained eating subjects on the LF, M and HF [low-fat, medium-fat, and high-fat] diet…”
  9. Energy expenditure in humans: effects of dietary fat and carbohydrate. Conclusion: “In the nondiabetic group there was no decrease in 24-h energy expenditure or in any component of 24-h energy expenditure on the high-fat compared with the high-carbohydrate diet… In the diabetic group the high-fat diet did not result in a decrease in either 24-h energy expenditure or in any of the components of 24-h energy expenditure…”
  10. Failure to increase lipid oxidation in response to increasing dietary fat content in formerly obese women.Conclusion: “Although the study was carried out over a period of a year the subjects succeeded in maintaining a constant body weight so that no differences were present during the different diets. Twenty-four-hour EE was influenced by diet composition in postobese women but not in control women, but the group x diet effect was not significant.”
  11. Energy intake required to maintain body weight is not affected by wide variation in diet composition. Conclusion: “Even with extreme changes in the fat-carbohydrate ratio (fat energy varied from 0% to 70% of total intake), there was no detectable evidence of significant variation in energy need as a function of percentage fat intake.”
  12. Weight-loss with low or high carbohydrate diet? Conclusion: “Neither diet offered a significant advantage when comparing weight loss or other metabolic parameters over a 12 w period.”
  13. Effect of high protein vs high carbohydrate intake on insulin sensitivity, body weight, hemoglobin A1c, and blood pressure in patients with type 2 diabetes mellitus. Conclusion: “Patients in both the high-carbohydrate and the high-protein groups lost weight… The difference between groups was not significant…Initial REEs were similar in the two groups… and did not change during the study.”
  14. Is a calorie a calorie? Conclusion: “We conclude that a calorie is a calorie. From a purely thermodynamic point of view, this is clear because the human body or, indeed, any living organism cannot create or destroy energy but can only convert energy from one form to another.”
  15. Energy intake required to maintain body weight is not affected by wide variation in diet composition. Conclusion: “Even with extreme changes in the fat-carbohydrate ratio (fat energy varied from 0% to 70% of total intake), there was no detectable evidence of significant variation in energy need as a function of percentage fat intake.”

That should take care of the ridiculous claim that excess calories do not make you fat. What about the carbohydrates v. fat issue at the heart of the book? Below are a few studies showing that high carbohydrate, moderate carbohydrate, and low carbohydrate diets are more-or-less the same when it comes to weight loss.3

  1. Long Term Effects of Energy-Restricted Diets Differing in Glycemic Load on Metabolic Adaptation and Body Composition Conclusion: “There was no statistically significant difference in metabolic adaptation to the HG [high-glycemic] and LG [low-glycemic] diets but adherence to the LG regimen apparently caused greater loss of body fat and less loss of FFM [fat-free mass] for the same amount of overall weight loss.”
  2. Long-term effects of 2 energy-restricted diets differing in glycemic load on dietary adherence, body composition, and metabolism in CALERIE: a 1-y randomized controlled trial. Conclusion: “There was a statistically significant decrease in mean percentage fat over time (P < 0.0001) consistent with body weight change; however, the difference between diet groups was not statistically significant over time.” And “[C]hanges in energy intake, body weight, body fat, and resting metabolic rate did not differ significantly between groups.”
  3. Efficacy and safety of low-carbohydrate diets: a systematic review. Conclusion: “At the end of both lower- and higher-carbohydrate diets, participants’ weight, BMI, and percentage of body fat decreased. In general, for both lower- and higher-carbohydrate diets, we found the greatest weight loss occurred among those participants receiving diets with the lowest caloric content and for those participants with the highest baseline weights.”
  4. Popular Diets: A Scientific Review Conclusion: “Data support the contention that those consuming low-fat, low-calorie diets are most successful in maintaining weight loss.”
  5. Effects of 4 weight-loss diets differing in fat, protein, and carbohydrate on fat mass, lean mass, visceral adipose tissue, and hepatic fat: results from the POUNDS LOST trial. Conclusion: “Fat loss or lean mass loss did not differ between diet assignments of high (25%) and average (15%) protein… high (40%) and low (20%) fat… or highest (65%) and lowest (35%) carbohydrate… at 6 mo. Between-diet differences remained nonsignificant at 2 y…”
  6. In type 2 diabetes, randomisation to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss. Conclusion: “There was no difference in weight reduction between the groups at 6 months … There were also no statistically significant differences in weight reduction between groups after adjustment for baseline carbohydrate or fat intake…”
  7. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. Conclusion: “Reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize.”
  8. Similar weight loss with low- or high-carbohydrate diets. Conclusion: “The results of this study showed that it was energy intake, not nutrient composition, that determined weight loss in response to low-energy diets over a short time period.”
  9. Effect of energy restriction, weight loss, and diet composition on plasma lipids and glucose in patients with type 2 diabetes. Conclusion: “Despite differences in dietary composition, weight loss was not significantly different between groups.”
  10. Effects of moderate variations in macronutrient composition on weight loss and reduction in cardiovascular disease risk in obese, insulin-resistant adults. Conclusion: “[P]atients lost weight in response to both the 60% carbohydrate (5.7 ± 0.7 kg) and 40% carbohydrate (6.9 ± 0.7 kg) dietary interventions… [T]he difference in the amount of weight loss was not significant when the 2 diet programs were directly compared.”
  11. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? Conclusion: “There is no clear evidence that Atkins-style diets are better than any others for helping people stay slim, and despite the popularity and apparent success of the Atkins diet, evidence in support of its use lags behind.”
  12. Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets. Conclusion: “At the end of the 6-wk trial, the total weight loss did not differ significantly between diet groups.”
  13. Lack of suppression of circulating free fatty acids and hypercholesterolemia during weight loss on a high-fat, low-carbohydrate diet. Conclusion: “Within both diet groups, patients lost weight… There was no significant difference in weight loss between the 2 diet groups…”
  14. Low-fat versus low-carbohydrate weight reduction diets: effects on weight loss, insulin resistance, and cardiovascular risk: a randomized control trial. Conclusion: “The results in Table 5 indicate that the mean weight loss from baseline was similar between the two diet groups … There was no significant difference in the change in either waist circumference (reflecting central adiposity) or percentage body fat (determined by DEXA) between the diet groups…”
  15. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. Conclusion: “[A]ll 4 diets resulted in modest statistically significant weight loss at 1 year, with no statistically significant differences between diets…”
  16. Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo. Conclusion: “[T]here was a significant reduction in weight (P < 0.001), but no significant difference between diets…”
  17. Weight and metabolic outcomes after 2 years on a low-carbohydrate versus low-fat diet: a randomized trial. Conclusion: “We found no statistically significant differences in weight loss at any time point between the low-carbohydrate and low-fat diet groups…”
  18. The effect of a plant-based low-carbohydrate (“Eco-Atkins”) diet on body weight and blood lipid concentrations in hyperlipidemic subjects. Conclusion: “No significant differences were found in any of the variables between the 2 groups.”
  19. Fat and carbohydrate overfeeding in humans: different effects on energy storage.Conclusion: “Excess dietary fat leads to greater fat accumulation than does excess dietary carbohydrate, and the difference was greatest early in the overfeeding period.”
  1. Macronutrient disposal during controlled overfeeding with glucose, fructose, sucrose, or fat in lean and obese women. Conclusion: “There was no significant difference in fat balance during controlled overfeeding with fat, fructose, glucose, or sucrose.”
  2. Effects of isoenergetic overfeeding of either carbohydrate or fat in young men. Conclusion: “No significant differences between the C[carbohydrate-rich]- and F[fat-rich]-group were observed.”

The above studies are focused on weight loss. Of course diets may be different when looking at other markers of health such as triglycerides, cholesterol, inflammation, C-reactive protein, insulin, glycosylated hemoglobin, blood pressure, etc. We can have a spirited debate about what diets might be best for overall health (and I’m sure we will in the comments section), but at least in terms of weight loss or weight gain calories matter far more than the macronutrient composition.

 

Not in Good faith?

GCBC was published in 2007. Knowing what I do about the publishing industry4 I imagine Mr. Taubes would have had to submit a final manuscript to his publisher in either 2006 or very early in 2007. In his epilogue on page 453, Taubes claims he spent five years researching and writing the book which would put the start date of his research at roughly 2001 or 2002. On page xxv of the prologue he mentions conducting over 600 interviews with different people as part of his research, which is an impressive number of people. However, there is one person featured prominently in the book that Taubes does not interview: Ancel Keys. If you have read the book you will notice that much ink is devoted smearing Dr. Keys and his work yet, according to Taubes’s references, not one interview was conducted with Keys. If one was interested in fair, objective reporting you would think that you would try to speak with a man that essentially invented and popularized the “lipid hypothesis.” Right?

Let’s try to think of reasons why Taubes did not interview Keys… Maybe Taubes repeatedly tried to obtain an interview with Keys, but was turned down or simply ignored. This is certainly possible, but I saw no mention of it in the book. I think Taubes would want to mention something like that, because that’s what good reporters do, plus it could add to the narrative that Keys’s work is indefensible.

Other reasons? Dr. Ancel Keys died in late 2004 at the age of 100, so perhaps he was too old and infirm to conduct any interviews. Maybe he had Alzheimer’s or dementia and could not speak intelligently about his past. It’s possible. Of course Taubes could speak to Keys’s surviving wife, Margaret, about her husband’s life and work. Taubes even writes a bit about her anyway because they did quite a bit of research together and even co-wrote How to Eat Well and Stay Well the Mediterranean Way that Taubes cites in GCBC. She would be a great interview! She’s probably full of interesting stories. But no, he did not interview Margaret Keys either. They also had a son that is now a doctor residing in New York state –Taubes also lives in New York state, it’s perfect! I’ll bet junior Keys has some great insight into his dear old dad. Welp, if he does Taubes was not interested in hearing them. It’s a shame. I bet any one of them could have provided some great information.

My theory? Taubes knew he was going to vilify Keys before he even began writing; after all the book would lose much of the spicy narrative about a mad scientist tricking the world into believing dietary nonsense. If Taubes is beholden to an ideology over evidence then any interview with a member of the Keys family is wholly unnecessary.

You Are Being Manipulated

Taubes uses subtle manipulation techniques to persuade his audience. Consider the following list of words.

These are the words Taubes uses to describe proponents of what he calls the “lipid hypothesis.” Even if you have never read the book or even know anything about its subject matter, a negative impression begins to form in your mind of the idea and its advocates. For instance you might feel that it’s nothing but speculation at best and at worst it’s a downright dangerous falsehood that is being shoved down our throats by religious zealots. I don’t blame you. That is some strong rhetoric Taubes is using. Now contrast this with the word choice used to describe those who espouse low-carb diets:

These people seem to be calmly and coolly presenting the facts. Instead of bombarding and crusading with a ridiculous dogma like the other guys, these people are merely skeptics suggesting an alternative hypothesis. Hell, you barely need to think for yourself or fact-check the author. Choosing the right side of this argument should be a no-brainer.

In rhetoric this is known as Framing or sometimes as Priming. It’s a subtle manipulation technique leading you to implicitly associate two unrelated ideas with one another. In this case Taubes wants you to associate “lipid hypothesis” with “myth” and those who do not advocate low-carb diets, such as Ancel Keys, with religious zealotry. By the way, these words are from only the prologue & first chapter; the verbiage gets piled higher and deeper as you get further into the book.

Lies, Damned Lies, and Gary Taubes

I honestly did not expect to find near as many misleading quotes, misrepresentation of studies, or outright fabrication as I did in Good Calories, Bad Calories. I mean Taubes writes for The New York Times for Christ’s sake – arguably the most prestigious and most influential newspaper in the history of the world.

Nearly every single time I bothered to check a reference made in Good Calories, Bad Calories I found that Taubes had at best taken something out of context or at worst completely misrepresented a study. Not kidding. Here are a few examples beginning with the more anodyne.

  • Taubes takes Steven Jay Gould out of context.

On page 18 of the hardcover edition of GCBC, Taubes discusses Ancel Keys and the relationship between diet and heart disease and writes “Associations do not imply cause and effect or represent (as Stephen Jay Gould would later put it) ‘any magic method for the unambiguous identification of cause.’” While reading that paragraph, you might get the impression that SJG was responding to Keys’s work or perhaps making a more general critique of nutrition science, but you would be wrong. In fact that quote by SJG come from a book titled The Mismeasure of Man5 which is about racism, IQ, and evolutionary biology and had absolutely nothing to do with diet, fat intake, heart disease, Ancel Keys, or essentially anything discussed in GCBC. It’s a really strange and out-of-place quote, and I’m not sure why Taubes would use it. The only reason I can imagine would be in the hopes that some of SJG’s gravitas would be associated with Taubes’s own ideas in the reader’s mind. Although there is nothing technically dishonest here Taubes does take Gould out of context, and as Albert Einstein said “I agree with your remark.”6

  • Taubes completely lies about the results of a study

This is actually one of the juicier lies in GCBC and occurs on the very same paragraph as the above Gould remark. For a bit of context, Taubes is discussing a cross-sectional study by one Ancel Keys that demonstrates a relationship between a population’s fat intake and its rates of heart disease. Taubes writes “Many researchers wouldn’t buy it. [Yerushalmy and Hilleboe] co-authored a critique of Keys’s hypothesis, noting that Keys had chosen only six countries for his comparison though data were available for twenty-two countries. When all twenty-two were included in the analysis, the apparent link between fat and heart disease vanished.” This is not true.7 Let’s look at the actual Yerushalmy and Hilleboe study, shall we? (I apologize for the poor definition of these pictures. I did not scan them in. Long story.)

The top graph shows Keys’s data as presented by Yerushalmy and Hilleboe. It’s a very strong correlation, but Y&H are skeptical and decide to take similar data from the Food and Agriculture Organization of the United Nations that includes more countries than the measly six that Keys had. However, contrary to Taubes’s claim the correlation does not vanish. If I were to run a R2 coefficient analysis I may not get 1.0, but I would certainly get above 0.0. In other words, sure the association is not as strong as with Keys’s data, but there is a definitive relationship.

But Y&H don’t stop there. Just for kicks let’s read on and see what else Y&H have in store for us… What’s this? It appears that Y&H have separated out some dietary components for us and have done some statistical analyses. Let’s take a look at what they found.

It’s difficult to see because of the cheap scanner, but those are negative signs in front of the vegetable fat and vegetable protein numbers.

As you can see in the table if you separate animal fat from vegetable fat and do an individual analysis on each then vegetable fat ends up being negatively correlated with heart disease while animal fat has a strongly positive correlation with heart disease. This correlation is also true of animal protein and vegetable protein and even remains if you calculate total fat/protein intake or fat/protein intake as a percentage of calories.  Remarkable.

In the second picture you can see an association with mortality that becomes even tighter when examined with animal protein. I’ll leave it to you to imagine why Taubes might leave such highly relevant data so conspicuously absent from his book.

  • Taubes wildly exaggerates the results of a study

Page after page and chapter after chapter Taubes hammers away at the “lipid hypothesis” and on page 44 even goes so far as to claim that “polyunsaturated fats can cause cancer in laboratory animals.” This is supposed to be a devastating blow to anyone who might espouse a Mediterranean-style diet that advocates a limited consumption of fats from beef and lard in favor of fats from fish, seeds, and nuts. It probably would be a devastating blow if it were true. Considering I had never heard or read anything in all my graduate and undergraduate nutrition courses that would even approach authenticating this statement I decided to check his references for this bold claim.

He cites two references to support his claim. One is not even a study, but a 1973 New York Times article that is behind a paywall so I cannot read it in its entirety.8 The NYT website does provide a summary of the article that does not mention polyunsaturated fats, cancer, or laboratory animals.

Let’s give Taubes the benefit of the doubt here; let us assume that the article does go into detail about some studies that have been done on laboratory animals examining the potential link between polyunsaturated fats and cancer. Why not simply cite those studies? Why make your readers go through the trouble of unearthing an ancient NYT article, only to have them sleuth further to find the actual data? I have my own theory, but moving on…

The second reference he cites in support of his bold polyunsaturated-fats-cause-cancer-in-laboratory-animals claim is actually an original dietary study! It’s older even than the NYT article mentioned above, and it does not involve laboratory animals but rather elderly men.9 Ready for some details? Briefly, men were randomly assigned to a control diet or an experimental diet. The control diet consisted of 10% polyunsaturated fatty acids (PUFAs) and ~650 mg/day of cholesterol. The experimental diet consisted of 40% PUFAs and ~365 mg/day of cholesterol. Both groups, however, had the same total fat intake as a percentage of calories. Subjects were followed for eight years. So what were the results? Unsurprisingly to most the control group had the most “fatal atherosclerotic events” as the authors put it. But what about cancer? Turns out the experimental group did experience more cancer deaths than the control. This is certainly incongruous with most of the current evidence on the subject as well as the available evidence at the time when the study was published. The authors even mention this, stating, “The experience of other investigators using similar diets has not been the same” and “Many of the cancer deaths in the experimental group were among those who did not adhere closely to the diet. This reduces the possibility that the feeding of polyunsaturated oils was responsible for the excess carcinoma mortality observed in the experimental group…In both groups, the numbers of cancer deaths among the various adherence strata are compatible with random distribution.” I’ll let you decide whether or not this singular study provides sufficient backing for the claim that polyunsaturated fats can cause cancer.

Cognitive Dissonance

One major arc presented in Good Calories, Bad Calories is essentially a conspiracy theory. Taubes makes the argument that politicians, the press, and scientists are all in collusion to deceive the general public. The problem with this (aside from simply being absurd) is that Taubes tries to use scientific studies to make a positive case for why everyone should be eating low-carb diets and debunk any healthfulness of non-low-carb diets.  Yet almost in the same breath he will decry scientists and their studies for being mindless government minions bent on pushing nutrition propaganda. Is this rational?

For instance, on page 53 Taubes brings up four studies that show no significant association between dietary fat consumption and heart disease.10 This is done to bolster the narrative that the public has been sold a bill of goods when it comes to fat and heart disease. Then on the very same page he implies that they are corrupt by saying “[I]t’s hard to avoid the suspicion that once the government began advocating fat reduction in the American diet it changed the way many investigators in this science perceived their obligations… Now they no longer felt obliged to test any hypothesis.” I don’t know why Taubes would do this; the studies kind of helped him make a case, but then he shot himself in the foot by questioning the researchers’ ethics.

Funky References

Gary Taubes has a strange way he cites references – well strange to me anyway. If Taubes makes a factual claim or quotes someone and you want to get the juice for the claim or the context for the quote then you have to read-over the sentence in question remember either the first few words the sentence starts with (like “The amazing thing about…”) or the subject of the paragraph (e.g. “Fiber and colon cancer”) and note the page you’re on. Then you flip to a series of pages titled “References” near the end of the book. Look for the page number and then the subject matter in question. Hopefully you can find it easily. So let’s say you find the beginning of your sentence then you’ll get one or more references, like “Keys 1975.” Then you hop over to another section of the book titled “Bibliography” and look for Keys. Once found look for a source published in 1975 since there are quite a bit of Keys references cited in the book. If you find more than one Keys 1975 reference (there are multiple) then you’ll just have to go with your gut (no pun intended) on which reference is actually the one you are looking for.

Another thing to note is that many (if not most) of Taubes’s sources are not available to the average Joe. You might be able to get the abstracts through NCBI, but with all of the studies that I decided to look up I had to go through my university’s library system to access the actual paper. Even then I had to order a couple of things via an interlibrary loan from Canada and Oregon to get the actual source because it was not available online or even in physical form in University of Washington’s vast physical archives. After a while I simply gave up on any source that was not available at UW. I’m not getting paid to fact-check this guy, after all. This, of course, does not even include things like personal one-on-one interviews that Taubes conducted which are only available to Taubes.

I was also interested in two books that Taubes cited, neither of which contained a page number in the reference.

If I was a more cynical man I would say Taubes is making it difficult for the reader to fact-check him.  You can trust this face. Would this face lie to you?

  1. To be fair, after my previous encounter with Taubes’s work I was predisposed to not like the book, but I approached it as impartially as could.
  2. despite the fact that I have never heard that term used by actual scientists, nutritionists, dietitians, professors, etc.
  3. I have to give credit where it is due. I did not do the leg-work when it comes to aggregating these studies. That goes to eric_twinge.
  4. Which is admittedly very little.
  5. Taubes cites the book as the source of the quote, but does not give a page number on where to find it in the book’s 352 pages. Incidentally the passage can be found on page 272 in the paperback version.
  6. On the Christian maxim “Love thy enemy”, in a letter to Michele Besso (6 January 1948)
  7. Yerushalmy J. and H. E. Hilleboe. 1957. Fat in the diet and mortality from heart disease. A methodologic note. New York State Med. Jour. 57:2343-2354.
  8. I’m not about to pay for the privilege of reading it nor do I want to wade through my university’s microfilm collection to look at it.
  9. Pearce ML and Dayton S. (1971) Incidence of Cancer in Men on a Diet High in Polyunsaturated Fat. The Lancet Vol. 297, Issue 7697, Pages 464-467.
  10. In actuality only three of the four studies show no association between dietary fat and heart disease, but at this point I am no longer surprised when Taubes exaggerates the science. Interestingly some of the studies do show carbohydrates providing a mild protective effect against heart disease. One wonders if Taubes even bothers to read the stuff he cites.
Advertisements

65 thoughts on “Good Calories, Bad Calories: A Critical Review (part 1)

  1. Pardon my anonymity; a close relative of mine became brainwashed by Good Calories, Bad Calories over a year ago and has grown very dogmatic and defensive about it, and I don’t want to create additional drama in case he stumbles upon my comment.

    This is an excellent blog post. I am baffled by the popularity of this book. First of all, I found it completely offensive to scientists of any kind. It disregards and disrespects evidence and research and even enters the realm of conspiracy theories.

    When my relative first become obsessed with this book, I began to read online to see if I could find it debunked. Instead, aside from some vegan-oriented sites which are biased in their own way, I mostly found people singing its praises and kissing its ass. The mountains of positive Amazon reviews were startling, but I think that can be attributed partially to confirmation bias, partially to the people who like the idea of losing weight while eating tons of bacon, and partially to the people who were impressed with his meticulous research.

    I don’t understand why Taubes’ followers are happy to blindly agree with everything he says in a “pop science book” while disregarding peer-reviewed research. I suppose they’ve bought into his conspiracies about the ebil guvmint and wheat?

    I think the book is ultimately dangerous. Have you read his piece from Newsweek a few months ago? He blathers on about how exercise doesn’t matter. How can someone with a background in physics deny calories in/calories out? Plus, don’t people study biochemistry for YEARS and YEARS? When did he study biochemistry? What even makes him qualified to write such a book?

    Good catch with the manipulative language, too. I hadn’t noticed that previously. Maybe I was too mad at everything else. 🙂

    I have to ultimately wonder what Gary Taubes’s motive is. Does he truly believe everything he’s written? Is he trying to create an empire like Atkins – cookbooks, snack bars?

    I worry about my relative, but he’s stopped being receptive to differing evidence because anything that goes against what Taubes says is wrong. How can all of that scientific research be RIGHT when Gary Taubes says they’re WRONG?

    Thanks for letting me rant.

    • Nice response. I found the book to be a page-turner (for nutrition geeks, it certainly is) and it did seem heavily referenced. But as I said in my own critique (posted below), Taubes is going too far with his ideas (and must have combed the research to support them). As an exercise physiologist with a weight management certification, I could talk endlessly about energy balance and how it matters.

      While writing my critique, I had to re-read Taube’s description of energy metabolism over and over again. I realized, while trying to sort out his argument, that his language was very ambiguous. It was frustrating, because I didn’t wan’t to misrepresent his work, but his arguments were not following. That was the moment I started to doubt the depth of his understanding of biochemistry.

    • You haven’t explicitly stated if you’ve actually read the book. I did not find it dogmatic in the least. Quite the contrary, it presented findings that are contrary to conventional thinking, much of which thinking has already been revised by the scientific community. We all remember the advice to avoid butter, eggs and stuff ourselves with fiber. He does assert that science is driven by funding and there are countless examples of this both good and bad. It presents an alternative to consider that should at least spur some good conversation and encourage people to question the popular view and be concerned about their health.

  2. What a load of BS. Nothing you’ve said here discredits a single word in GCBC. Taubes looked at all the historical literature on the subject and arrived at the conclusions outlined in the book, but whatever, follow the government guidelines for health and see we’re that gets you.

    • Interestingly, when I reviewed the references in this rebuttal to GCBC, many of the studies in my humble opinion did not support your view at all, and in fact did support the conclusions drawn in GCBC. Science has had to revise their dietary recommendations since the beginning of time. Why do we conclude that the scientific process is always correct at the present time, when in reality we will look back 10 years from now and be convinced of something entirely different.

  3. Thanks for this breakdown. The Da Vinci Code-esque tone of the book made me very suspicious, but as you point out, it has lengthy references and I don’t have the time to go through every one.

    It makes me think it might perhaps signal the dawn of a new genre in woo health books. When people like you and Ben Goldacre are merrily chopping through the jungle of bullshit, dietary tomes with obviously false information are getting easier and easier to see through. So how best for book pedallers to maintain the impression of credibility? Fill the back pages with hundreds and hundreds of references to obfuscate and confuse. Combined with the whole “Government conspiracy” angle AND the wish fulfilment of saying “Go ahead guys, eat as much fried chicken as you want!” it’s a potent mix.

  4. When I read Good Calories, Bad Calories I was struck by Taubes’ total exclusion of the vast research related to vegetarian and vegan diets (The China Study comes to mind as one account of original research. The Epic-Oxford studies are another example looking at both SAD and vegetarian/vegan diets). The research I’ve read over the past twenty years soundly contradicts Taubes’ premises about saturated fat and heart disease, as reflected in the Yerushalmy and Hilleboe data that you cited. In fact, the research on vegan diets is showing more and more advantages to long term health and even potential to mediate or reverse obesity, cardiovascular disease and some cancers, diabetes and other maladies, for example cataracts, macular degeneration, multiple sclerosis, etc. (See John McDougall, M.D., Neil Barnard, M.D., Michael Greger, M. D.’s website Nutrition Facts. org,, T. Colin Campbell, Caldwell Esselstyn, M. D., etc.).

  5. Apparently I’m not the only latecomer to this party: this entry was linked to a few days ago from a forum post at drmcdougall.com

    As to, “you might get the impression that [Stephen Jay Gould] was responding to Keys’s work or perhaps making a more general critique of nutrition science”. Eh? I can’t see how anyone who, like me, knows what SJG’s professional interests were could have that impression. And I think a goodly proportion of people interested in science would know that — too many for Taubes to count on the contrary. Actually, I see no reason even for people unfamiliar with SJG to draw such a conclusion as you suggest from Taubes’s use of the quote.

    Also, I think it’s unfair to fault Taubes for citing research (the full text of) which is not available to the general public. As a lay person who’s spent hundreds of hours on the net recently chasing down studies and references I can attest to the frustration of not having full text available, or having it available only at a hefty price. But that’s not Taubes’s fault, nor do I think authors should limit themselves, even in a popular book, to references which are easily available to the public.

    • The point about Steven Jay Gould is fair. I think this is one of my weaker criticisms of Taubes in this post. However, when I came across the quote in GCBC I thought it was quite out of place. I thought to myself “Wait… SJG is an evolutionary biologist, right? Why is he being quoted here? This makes no sense.” Perhaps I should have left it out of my blog post entirely, but when I was writing this I felt like I had to say something about it because it just stuck out to me so awkwardly.

      To your second point, I’m not saying he should only stick to freely available material (although there is quite a bit of high-quality nutrition research that is freely available). What I am saying is that a lot of the works cited by Taubes are very old and/or obscure. I am a graduate student and I work at a major research center, both of which have fairly substantial physical archives as well as subscriptions to nearly all the academic journals you would need to do research in the life sciences, and even I had great difficulty unearthing his references. And I rarely have trouble pulling up a paper. Unless it’s a Taylor &Francis journal, those are a pain in the ass, but even those only take an extra ten minutes.

      Now maybe it’s just the cynic within me, but when I had such trouble finding the sources of some of his bigger arguments my spider-sense began to tingle. I don’t know Taubes’s motives, but I figure one of a few things might be true. 1. Either he is deliberately choosing sources that are difficult to fact-check. (For the record I don’t believe this to be the case.) 2. It’s a conspiracy by the scientific community to bury the truth 3. Taubes is way off the mark and has to resort to reaching many decades into the past and to very obscure literature to find decent sources that help his argument.

  6. Hi Seth,

    Nice post. I think your comments on Taubes’s writing style are quite perceptive. Other techniques he uses to manipulate the reader are instilling a sense of outrage by only presenting a half-assed version of the opposing argument that makes it appear laughably flimsy, and flattering the reader by making him feel smarter than the “so-called experts”.

    I’m a postdoctoral obesity researcher at UW South Lake Union (an actual obesity researcher, not a fake one). So I’m right down the street from you. I also write a nutrition-health blog called Whole Health Source that focuses on obesity. I tried to get in touch with you but I couldn’t find your full name or e-mail address. Send me a message; my e-mail is wholehealthsource at yahoo dot com. We’ll have a lot to talk about.

    • Stephan, your views on the causes of obesity are pretty clear, but I am curious if you would share any of your thoughts on the ‘lipid hypothesis’.

  7. In your own words ‘Page after page and chapter after chapter Taubes hammers away at the “lipid hypothesis” ‘
    You have pointed out a tiny selection of mistakes made in this regard. Assuming (as it seems you would have us do) that the things you pointed out are a blatant misrepresentation, are we expected to dismiss Taubes’ claim that the lipid hypothesis is dubious at best if not completely misguided and bunk? Are said pages and chapters equally misleading? Thanks for your time.

    • Hi Ron,

      Many people continue to find big flaws as they delve deeper into his works.

      Take time to watch through this series. Don’t take the creators word for it though, actually pause and grab references and see for yourself. He has also done a lot of work on the lipid hypothesis that doesn’t involve Taubes.

      • Oh and please give it some time before you nit pick anything it takes a while to get going and get into the meat of it.

        I really hate that there is never and specific critisicms of this series big themes and references and I don’t want you to fall into that trap.

    • Your question is not a simple one, but I will try my best to answer it.

      It depends on what you mean by “lipid hypothesis.” Looking at the Wikipedia page on Lipid Hypothesis it states that it was proposed in 1856 and “proposes a connection between plasma cholesterol level and the development of coronary heart disease.” Today there is essentially no doubt that this is true, and it’s not at all controversial in the scientific/medical community. I can give you sources for this statement if you wish, but I’m sure you can easily find them.

      However, when Taubes speaks of the lipid hypothesis he is usually referring to Keys’s data that suggests dietary fat (specifically saturated fat) raises cholesterol levels and therefore increases heart disease risk. This was quite controversial in its time, but over the past few decades Keys has more or less been proven correct. However, it’s still kind of nebulous because not all saturated fats will raise cholesterol levels. Short and medium chain saturated fatty acids (such as those you find in coconut oil or palm oil) are processed differently than the long chain saturated fatty acids, and therefore don’t have the same effect on cholesterol levels. Of course, it gets even slightly more complicates when you realize that butter, olive oil, lard, fish oil, etc… contain varying amounts of trans, saturated, and unsaturated fatty acids. But I digress….

      To your point, yes, I believe Taubes is misleading. I only pointed out a few mistakes because (like I mentioned) I don’t have the time to do a point-by-point rebuttal of all of his points. So I just focused on the first few chapters. I was trying to make the case that Taubes misleads because he embraces a kind of nutritional dogma that is not fully supported by the facts, and he leaves out crucial information about the “other side” to make a more compelling story. After all, it would be less entertaining if the public wasn’t being systematically deceived by the authority figures, right?

      I certainly could have written more. I may still write more since this page gets way more traffic than all my other posts, but I’m trying to finish my master’s thesis and want to focus on that right now.

  8. So, here’s my question to anyone who cares to respond: What is the most compelling evidence for the causal relationship between dietary fat and heart disease? It sounds like it’s abundant, so picking the one (or a) study that absolutely nails it, shouldn’t be difficult.

    • Daniel Steinberg wrote a series of reviews on atherosclerosis where he examines the scientific history around it, and basically how we know what we know. I believe it is free to all so it shouldn’t be difficult to access on your own, but in case you cannot here is the five part series. I would encourage you to read all of them, but I think the answer to your question is in Part 2. http://ge.tt/9VafyxZ?c

      Let me know if you have trouble accessing these papers.

  9. I try to keep track of the scientific articles that speak against the idea that dietary total and saturated fat cause heart disease. Here it is for anyone who has lots of spare time and wants to dig further:

    Ramsden, Christopher, et al. Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis. British Medical Journal 2013; 346 doi: http://dx.doi.org/10.1136/bmj.e8707 (Published 5 February 2013).
    Cite this as: BMJ 2013;346:e8707 (Almost 500 middle-aged men with a recent coronary event were followed over time. Those who substituted saturated fat with omega-6 fatty acid (polyunsaturated fatty acid, mostly linoleic acid) had higher death rates (cardiac and overall deaths) than those who continued their habitual diet.) Also see editorial by Philip Calder in the same issue.

    Astrup, A., et al (including Ronald Krause, Frank Hu, and Walter Willett). The role of reducing intakes of saturated fat in the prevention of cardiovascular disease: where does the evidence stand in 2010. American Journal of Clinical Nutrition, 93 (2011): 684-688. (The authors believe that replacing saturated fats with polyunsaturated fats (but not carbohydrates) can reduce the risk of coronary heart disease (CHD). For the last four decades, low-fat diets replaced fat with carbohydates. So they believe saturated fatty acids cause CHD or polyunsaturated fatty acids prevent it. I see no mention of total fat intake in this article written by major names in nutritional epidemiology and lipid metabolism. “In countries following a Western diet, replacing 1% of energy intake from saturated fatty acids with polyunsaturated fatty acids has been associated with a 2–3% reduction in the incidence of CHD.” “Furthermore, the effect of particular foods on CHD cannot be predicted solely by their content of total saturated fatty acids because individual saturated fatty acids may have different cardiovascular effects and major saturated fatty acid food sources contain other constituents that could influence coronary heart disease risk.”) A Feb. 19, 2012, press release from the Harvard School of Public Health covered much of the same ground. It’s titled “Time to Stop Talking About Low-Fat, say HSPH Nutrition Experts.”

    Siri-Tarino, Patty, et al. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. American Journal of Clinical Nutrition, January 13, 2010. doi:10.3945/ajcn.2009.27725

    Skeaff, C. Murray and Miller, Jody. Dietary fat and coronary heart disease: Summary of evidence from prospective cohort and randomised controlled trials. Annals of Nutrition and Metabolism, 55 (2009): 173-201.

    Halton, Thomas, et al. Low-carbohydrate-diet score and the risk of coronary heart disease in women. New England Journal of Medicine, 355 (2006): 1,991-2,002.

    German, J. Bruce, and Dillard, Cora J. Saturated fats: What dietary intake? American Journal of Clinical Nutrition, 80 (2004): 550-559.

    Ravnskov, U. The questionable role of saturated and polyunsaturated fatty acids in cardiovascular disease. Journal of Clinical Epidemiology, 51 (1998): 443-460.

    Ravsnskov, U. Hypothesis out-of-date. The diet-heart idea. Journal of Clinical Epidemiology, 55 (2002): 1,057-1,063.

    Ravnskov, U, et al. Studies of dietary fat and heart disease. Science, 295 (2002): 1,464-1,465.

    Zarraga, Ignatius, and Schwartz, Ernst. Impact of dietary patterns and interventions on cardiovascular health. Circulation, 114 (2006): 961-973.

    Mente, Andrew, et al. A Systematic Review of the Evidence Supporting a Causal Link Between Dietary Factors and Coronary Heart Disease. Archives of Internal Medicine, 169 (2009): 659-669.

    Parikh, Parin, et al. Diets and cardiovascular disease: an evidence-based assessment. Journal of the American College of Cardiology, 45 (2005): 1,379-1,387.

    Hooper, L., et al. Dietary fat intake and prevention of cardiovascular disease: systematic review. British Medical Journal, 322 (2001): 757-763.

    Weinberg, W.C. The Diet-Heart Hypothesis: a critique. Journal of the American College of Cardiology, 43 (2004): 731-733.

    Mozaffarian, Darius, et al. Dietary fats, carbohydrate, and progression of coronary atherosclerosis in postmenopausal women. American Journal of Clinical Nutrition, 80 (2004): 1,175-1,184.
    Related editorial: Knopp, Robert and Retzlaff, Barbara. Saturated fat prevents coronary artery disease? An American paradox. American Journal of Clinical Nutrition, 80 (2004): 1.102-1.103.

    Yusuf, S., et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet, 364 (2004): 937-952. (ApoB/ApoA1 ratio was a risk factor for heart attack, so dietary saturated fat may play a role if it affects this ratio.)

    Hu, Frank. Diet and cardiovascular disease prevention: The need for a paradigm shift. Journal of the American College of Cardiology, 50 (2007): 22-24. (Dr. Hu de-emphasizes the original diet-heart hypothesis, noting instead that “. . . reducing dietary GL [glycemic load] should be made a top public health priority.:)

    Oh, K., et al. Dietary fat intake and risk of coronary heart disease in women: 20 years of follow-up of the Nurses’ Health Study. American Journal of Epidemiology, 161 (2005): 672-679.

  10. So then please tell me, after all the research he did, what was Taubes’s motivation for being misleading?

    On a purely anecdotal level, I am a 66 year old man who has been on a primarily “paleo” diet for over three years. When I started on this “lifestyle” diet I needed medication (metformin) to keep my glucose levels under control (I was diagnosed with type 2 diabetes about 15 years ago), I was somewhat overweight, I had high blood pressure (sometimes as high as 170/100), and I had a long history of high Cholesterol, as high as 330 at one point. Today, after eating a high fat/low carb diet for 3 years, along with exercise (interval training and weight lifting), I no longer need the metformin to keep my fasting blood sugar levels at 100 or lower, I’m 30 pounds lighter (5’8, 165), my blood pressure is under control, and my cholesterol was 205 at last check about 2 months ago. It is also somewhat interesting to note that my doctor tried to put me on statin drugs anyway. What does that tell you?

    One more anecdotal note: my father suffered a massive heart attack at 55 even though his cholesterol measured in the 170s at the time. I don’t know this for sure but I don’t think his cholesterol level was ever over 200.

    I’m not a scientist, but I am a skeptic. So I don’t just blindly accept the prevailing belief that keeping one’s cholesterol level very low, while maintaining a low fat diet, is the medically proven best way to go. Fact is millions are severely limiting their fat intake, and millions more are on cholesterol lowering drugs, and yet incidence of heart disease is still incredibly high. In fact, heart disease is still far and away the number one killer in the country. So how can that be?

    As to the excessive calories makes one fat argument, I too believed that for most of my life. It makes perfect sense. Well, it does until you realize that the body uses calories from different sources in different ways. To oversimplify, some calories sources are readily processed by the body for energy, while others are more likely to be stored as fat. So it is not just simply counting calories. I know this from personal experience. I lost 30 pounds without being concerned one iota about my caloric intake.

    Bottom line is that I don’t want to get into a debate about the physiological functions of calories and cholesterol or anything else. I probably wouldn’t understand it anyway. And I sure don’t want to discuss how studies can or should be interpreted because you proved that Taubes can interpret them them one way, while you and others can interpret them another. So what is to be gained through arguing which is right? But what I do want to know is what I asked originally: please tell me, after all the research he did, what was Taubes’s motivation for being misleading?

    • I don’t want to get in the habit of speculating on the motives of people I don’t know, but if I had to guess his motivation it would be money and fame.

      Throughout the 80s and 90s Taubes was essentially an unknown writer. He wrote books and articles, but none of them gained him much attention. That is until he wrote a NYT piece in 2002 called “What if It’s All Been a Big Fat Lie?” It was quite popular, if controversial. After it’s publication Taubes made the media rounds defending his piece and was offered a book deal that eventually became GCBC. I read the offer was very financially generous to Taubes, but I can’t remember my source for that info. The book ended up being a NYT best-seller, and is regarded as a kind of sacred text among low-carb enthusiasts. Taubes himself seems to be thought of as a kind of prophet in these circles as well, but of course that’s just my opinion.

      Now he gets paid to lecture all over the country. Recently he re-packaged GCBC into another book titled Why We Get Fat. Taubes has said that it’s basically a Reader’s Digest version of his previous book. He also managed to convince a wealthy hedge-fund manager to bankroll an organization he started that is supposed to conduct “real” nutrition research, since you can’t really trust all the other research. However, as far as I know the organization has not conducted any experiments.

      I have noticed that even on this humble blog my posts about low-carb or Paleo nutrition get FAR, FAR more web traffic than anything else I publish. So I can see how one could make a nice living if they were to really ride this Paleo wave with books, articles, media appearances, advertising, supplements, T-shirts, or any other product you can think of.

      But let me say congratulations to you for getting your health under control. It’s not easy, and anyone who can make beneficial change deserves to be commended.

      You said you did not want to get into a debate on how studies should be interpreted, but I don’t think it’s a matter of interpretation. Take some examples from my post. One is the Yerushalmy and Hilleboe paper. Here is the whole thing

      http://ge.tt/6swX9Di

      You can read it for yourself and see if it is sufficient evidence for Taubes to claim that his Seven Countries data was fraudulent.

      Also here are the two citations Taubes gives for claiming that polyunsaturated fat causes cancer in laboratory animals.

      http://ge.tt/4oWWADi
      http://ge.tt/8RLxBDi

      Again, you’re a skeptic so I’ll let you decide for yourself if it’s a matter of interpretation or obfuscation.

  11. I believe Taubes’ work is excellent; may not be 100% accurate but damn good. My physican and friends who are physicians support his work and conclusions but most can not say it as advice to patients due ot prevailing legal, medical and insurance constraints – but the basis for the findings is sound. Book is very good and Atlas Shrugged blows chuncks

  12. I read a lot of this book, but not all of it, and I’ll assume you are right in some of your criticism. For me though, what this book is about is saying that some of the assumptions we have about our diets today are based on some non-consistent studies 30-40 years ago.

    He challenges the low-fat bullshit you still have in the US. I think his opinions are needed, because he points his finger at many things which have been taken for facts, but which just aren’t concrete enough to conclude at.

    You got to have some incredibly solid-shut evidence to draw conclusions about human food and health, because there’s so many other variables at play in a normal life. You’d need a biosphere environment to be sure enough almost. That is to me, a sensible skeptical mind the important part that shines through in his book.

    For me it was incredibly boring though, it drones on and on about things that I feel could be said way more easily.

    Another point for me, a raving cocaholic, is that low-carb diets deserve attention. Hopefully without the “hip/fashion” tag it has now. I just know that a diet with good fats and less starch/flour was amazing for me, always full, never craved food. I have tried a lot, and I lost weight without even excersising with that diet, while other diets with low calories and 3xworkout a week did nothing.

  13. At the end of the day….what he says is right…..and peoples results from following what he,and Atkins and others have said are proving it in the thousands….Meanwhile the low fat dogma continues to fail as it always has…..game to Taubes. 😉

    • I’ve read the book twice and everyone I’ve recommended it to has loved it. I’ve put a lot of the knowledge in this book to practice and it has absolutely worked. Taubes explains the biology behind carbohydrates and triglycerides in the body and their effects in a very factual way. I have switched my diet to a high fat high protein diet and I have never felt better. I’ve lost weight, my skin has cleared up, and I have more energy now than I have ever had. A lot of the studies you have posted go no lower than 25% in carbohydrates for the diet and some even say the low carb would be more beneficial in the long run. The book also points out the chronic issue of carbs over many years and a lot of these studies go no further than a year and people do cheat in these studies because we live in a carb happy society. Gas stations, restaurants, grocery stores, convenience stores etc. are made up of mostly high carb foods you can’t escape. Did we not learn at a young age in biology that triglycerides are the preferred energy source of the mitochondria in all cells? Is that not what a high fat diet provides? does high blood sugar not cause a high insulin response which causes weight gain? There is a reason the atkins diet has an empire and it’s simple because it works. This GCBC in practice in my life has answered all of my questions about why half my clients when I was a personal trainer weren’t losing weight. Taubes starts the book saying he has a bias towards fats and than throughout the book explains the different ways to look at studies which is exactly what a peer review would do. Not mentioned in the book is how atkins was smeared as dying overweight with heart disease caused by his diet. When I did the research I found atkins died from slipping on the ice and while in a coma gained all his weight and his heart attack from a bacterial infection not from his diet. A vegan doctor got a whole of this information and smeared atkins for being a meat lover. A doctor who is supposed to be a man of science who did all of this against atkins because he was an animal rights activist with a flawed idealouge. All these animal rights activists are the ones who are brainwashed. Paleo, atkins, pennington, Taubes etc. They all give the other side and a differing point of view and it works. The only reason I’ve seen it fail is because people cheat on it. They sneak cookies,beer,chips,milk shakes, brownies etc. This blog post has made my viewpoint on GBGC even stronger. As soon as I read the Ayn Rand comment I knew this blogger was worse in his bias than Taubes because you are playing at being neutral when every word in this article is a slam on Taubes.

  14. Pingback: Good Calories, Bad Calories: A Critical Review (part 1) | Höf-day
  15. There are a ton of people who fall on one side or the other when it comes to books like GCBC. People seem to either accept it as if it were the Word of God, and assume Taubes can do no wrong, or they dismiss it as a “conspiracy theory” and read it with the sole intent to pick out the falsehoods within rather than the truths.

    In the initial blog post here, two points were covered early on: whether increased cholesterol and saturated fat lead to heart disease, and whether calories in / calories out actually works. I skimmed through these sections lightly, because I completely agree that Taubes oversteps when it comes to them. Generally, there’s a higher risk of heart disease with a diet higher in saturated fats…period. And calories in, calories out DOES work, though there are (arguably) valid arguments about how different macronutrients affect satiety, metabolism, etc.

    What I’ve gotten from the book so far (reading with a skeptical eye, mind you), is that studies in the last half-century or so have taken for granted that because saturated fat leads to greater chances of heart disease, and heart disease is bad, that there must be an effort to circumvent this by changing fat types, lower fat intake, etc, etc. Research backing these things up commonly follows people who have already had a cardiac event, intervenes in the diet, and tracks recurrence. Results are then applied to the population as a whole in the form of dietary suggestions.

    In many of these studies, subsequent deaths via stroke, cancer, diabetic complications, etc are not taken into account, according to the research cited by Taubes. When they are taken into account, he claims, mortality does not decrease along with cholesterol and decreased dietary fat (saturated or otherwise). THAT is the most interesting point I have taken from the book.

    Beyond that, anecdotal evidence has probably tainted me a bit, as I have watched people with low fat, low sodium cholesterol-busting diets die young from cancer and heart failure, I have watched friends struggling with their weight descend into diabetes and obesity after repeatedly trying and failing to follow the standard recommendations…And I have seen people do wonderfully on diets high in animal fat, moderate in protein, and low in carbohydrates. These anecdotal data points don’t prove anything, of course, but they make me suspicious of the recommendations as they stand.

    So yes, Taubes is hypocritical in making some of the same mistakes of confirmation bias, selectively presenting research, and ignoring contrary data points…He does, however, have some solid points that can stand well. Don’t know if that’s worth reading through that beast of a book though.

  16. Hey Seth –

    I appreciate your efforts in keeping alive a continuing conversation. Nutrition is a very complex subject.

    I came across your blog as I was reading GCBC for my own education. I am a primary care physician in private practice since 1986.

    I have no publications to my name since my undergrad years when I published just a paper or two in basic biochem.

    I find GCBC a rather interesting review of the history of the science and the public policy. I remember so well that as a young and newly minted MD I was overtaken by a blitz of media from something called the NCEP( the National Cholesterol Education Program) . I recall having a sense then that this emphasis on the villain of cholesterol was …well….some sort of media blitz. I came to believe that the pharm industry funded it. I still believe that.

    I wanted to write to ask if you have ever heard of Gary Taubes business partner, Peter Attia? Have you ever seen Peter’s blog and website, eatingacademy.com?

    I actually learned about GCBC via Peter – not b/c it was a bestseller. I can tell you that not a single patient ever mentioned GCBC to me.( I live and practice in central Maryland )

    In addition, I do think that GCBC overstates the requirement to rely on RCTs. If forced to rely only on RCTs, I could barely function. Our world is too big and complex . There is not enough time or resources to rely strictly on RCTs. As a patient and as a primary care doc, one must go forward with very incomplete and imperfect information.

    Keep the conversation going,

    Michael McEvoy , MD

    • Dr. McEvoy,

      Thank you for commenting. I appreciate your thoughtful and reasonable addition to the discussion.

      I have seen Peter Attia’s name a few times when looking up NuSI. Although I have not been to his website, but I will check it out.

  17. Pingback: Good Calories, Bad Calories: A Critical Review; Chapter 1 – The Eisenhower Paradox | The Science of Nutrition
  18. Excellent read. I have a knee-jerk reaction to dogma so have always been suspicious of GCBC and its zealots. In any event, you criticize Taubes for apparently not speaking to Keys. Did you attempt to reach Taubes for this blog post?

  19. Where calories don’t matter is if you’re eating a high fat low carb diet. This is because this combination is so satisfying that you will eat less and your weight will gradually lower to what your natural weight is, so you won’t overeat.
    Neither do they matter if you are on another dietary regime which is not low carb, because regardless of your willpower, you will be so overcome by hunger that you will crack and your calories will be to no avail.
    So, knowing the third law of thermodynamics, or whatever it is, is like being aquainted with an intimate knowledge of the surface tension of urine when you want a pee. Quite useless.
    Hormones, hunger, insulin.

    • Oh jeez. Of course calories matter in that case too. Better satiety doesn’t contradict that. And the idea that higher carb diets cannot be satiating is an odd one as low calorie content combined with a lot of fiber promotes satiety too. It’s just the matter of picking your carbs.

      However, in the long run, low carb high fat diets don’t seem to be related to better weight control than any other healthy diet options: the weight just creeps back in. Just see these long trials.

      http://www.nejm.org/doi/full/10.1056/NEJMoa0708681

      http://www.nejm.org/doi/full/10.1056/NEJMoa0804748

      http://www.ncbi.nlm.nih.gov/pubmed/16875041

      • The weight only creeps back in when one ventures too far from the high fat/low carb model. I started a high fat/low carb diet (actually, not really a diet, just a way of eating) 5 years ago without any real concern for losing weight; I was just interested in eating more naturally. The result was a 30 pound weight loss without counting a single calorie, or even caring about how many calories I consumed. As added bonuses my cholesterol, blood pressure, and blood sugar all fell into the normal range ( I was previously on medication for blood pressure and blood sugar). So five years later I’m still eating as much as I want and haven’t gained anything back. Those are just facts.

  20. Ron,

    “The weight only creeps back in when one ventures too far from the high fat/low carb model.”

    Perhaps, perhaps not. These studies have shown that people in general either tend to do this and/or cannot reach the very low carb intake in the first place.

    Congrats on your weight loss, by the way. 🙂

  21. I think myself as a guy with a fairly IQ, but when Gary Taubes writes , he is not doing it for the likes like me or the educated people , he is writing for the people that are ignorant or that do not want to think for themselves. And sadly he lies to make money, probably he knows he is totally wrong but the money, Well? it is money.

    • David,
      If you would like to be taken at your word with a ‘fairly IQ’, you really must work on your grammar. Have you actually ready the book in it’s entirety? It’s a tough read, and certainly not for the casual reader. I’m on my second read, referencing studies where I can and have found the evidence worthy of adapting my perspective.

  22. Pingback: Cholesterol, Saturated Fat, Grains, Meat, and Other Diet Controversies: why are There so Many People Challenging Conventional Wisdom? | Seita's Place
  23. Thanks Seth for a great review and discussion.

    One thing that I have not seen mentioned anywhere at all is the difference between RAW fats and HEATED fats. There is a massive difference between the two in how they affect the human body. Heated fats are known to be unhealthy and produce various carcinogenic substances. So whereas saturated fat is not necessarily bad for you, when we heat it that’s when it becomes dangerous.

    There is also a difference between raw PLANT fats and raw ANIMAL fats. I don’t advocate eating a lot of animal flesh for various reason – it’s not healthy in large quantities, it’s expensive and it’s not sustainable in today’s world.

    Can Gary Taubes point us to ANY culture ANYWHERE in the world who has eaten his diet and has longevity and optimal health? The Inuits and the Massai might have a diet high in animal products but they don’t live very long or healthy lives.

    I haven’t read Taubes’ book so can anyone tell me if he refers to existing cultures/nations who eat his way and who are healthy and have long lives?

  24. Pingback: GaryTaubesiana « De omnibus dubitandum / neoLITE
  25. Hi,
    I agree with a C’s advice to watch Plant Positive videos. All 45 hours of them. Plus stopping and checking the references. Some of them to “double check” if blogger is lying and if Taubes is! 🙂

    Why I watched all 45hours? Because I know now Taubes is really really good at what he is doing. Selling fad diet. The way he is misleading, covering and rephrasing actual text in studies he referenced is awesome. This videos will show you how Taubes is doing that by showing you actual text in the studies. And yes, you can always look into the real studies yourself (for some you have to pay).

  26. Pingback: Good Calories, Bad Calories: A Critical Review; Chapter 9 – Triglycerides and the Complications of Cholesterol | The Science of Nutrition
  27. Pingback: Good Calories, Bad Calories: A Critical Review; Chapter 3 – Creation of Consensus | The Science of Nutrition
  28. Pingback: Good Calories, Bad Calories: A Critical Review; Chapter 4 – The Greater Good | The Science of Nutrition
  29. Pingback: Good Calories, Bad Calories: A Critical Review; Chapter 2 – The Inadequacy of Lesser Evidence | The Science of Nutrition
  30. Pingback: The U.S. Doesn’t Have Enough Of The Vegetables We’re Supposed To Eat | Nutrition Business Plans' Blog
  31. Pingback: The U.S. Doesn’t Have Enough Of The Vegetables We’re Supposed To Eat | Stepanie Byler's Blog
  32. Pingback: The U.S. Doesn’t Have Enough Of The Vegetables We’re Supposed To Eat | Michelle Sweet's Blog
  33. Pingback: Fats vs Carbs: Clarifying Conspiracies, Controversies, and Confusion - Sheila Kealey
  34. Pingback: Good Calories, Bad Calories: A Critical Review; Chapter 23 – THE FATTENING CARBOHYDRATE DISAPPEARS | The Science of Nutrition
  35. Every well written book uses rhetorical devices to be plausible and convincing, it’s a skill we all possess even when we talk. We include what supports and excludes what doesn’t support the point we are trying to make. Analysing it as if it was some conspiracy, as if Taubes is the only
    one that uses rhetoric and that being convincing is somehow ‘wrong’ makes me question this review quite seriously. If the author here understood how the text and language work, he would not be making such childish claims.
    I could do – if I could be bothered – a similar pseudo analysis of this work and show that the author is dismissive, patronising and biased. And so we could go on and on. But it would have nothing, absolutely nothing to do with the diet and how it affects human body.
    In other words, criticism of someone’s skilled writing does not discredit their work.
    I am neither for not against GCBC, I have only started reading it, also read other books, including China study mentioned here. It seems that, for the first time in history we live with all the possible dietary choices amd it seems that different things, often quite contrasting, work well. It would be good to see research investigating why low fat (less than 10% of calories derived from fat) as well as high fat (more than 60-70%) diets work so well for people who stick to them and why some people thrive on large amounts of meat and others on primarily vegan diets. Rather than arguing who is right, it is time we looked at the reality of what people actually do that works for them. And wy it works. It is time we give up on trying to find a solution that fits all.
    And maybe it is time for research into diet to become more of a humble and curious discussion and less of an ego driven battle to be right. Way too many egos and not enough open mindedness. A pity really.
    From my own research career, I know that there is a piece of research somewhere to support every argument, no matter how odd. So throwing some random pieces of references is not helpful without building some rhetorical argument. But building such argument would be a conspiracy, so the author doesn’t even bother. But it doesn’t make this review easy to digest.
    I don’t think this review add anything new to the discussion of why different dietary approaches work and why there is so much contradicting research around food and diet. and what’s worse, it reads more as a tantrum than a review. As if the author is throwing the evidence at us because he just couldn’t be bothered to explain what it says. Too precious to build a convincing argument of his own?

  36. Pingback: The case for eliminating sugar. All of it. – Blog 5 star

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s