Thursday, August 25, 2011

Still Fat?

I just finished reading Stephan Guyenet's post (and every associated comment) relaying some details about a disagreement he had with Gary Taubes at the Ancestral Health Symposium over, I believe, the cause of obesity.

Guyenet, who writes an excellent blog, has lately been endorsing a food reward theory of obesity.  I'll paraphrase: different foods have different reward value.  The reward value is, roughly speaking, some intersection of diversity (increasing variety increases reward value), taste (tastier food has higher reward value), fat and sugar (see taste) and ease of preparation.  People become obese because they eat high reward value food.  When they switch their diet to lower reward value food - almost regardless of the macronutrient ratio - they will lose weight.  When populations start eating higher reward value food they get fatter.  A potential cure for obesity is to eat blander food, with less variety, less seasonings, and cooked in an intentionally bland way.

Gary Taubes, in case you haven't heard of him, is a book author (Good Calories Bad Calories is an absolutely fantastic history of modern nutritional doctrine, even if you disagree with the dietary recommendations) and a journalist who endorses an excess carbohydrate theory of obesity.  To paraphrase, people get fat because they eat too many refined carbs and sugar, which causes disregulation of insulin, which leads their fat cells to accumulate fat.  A potential cure for obesity is to cut most or all carbohydrate, especially refined carbohydrates, sugars, and starch, from the diet.

The two got into a heated disagreement at some point during the AHS (I wasn't there, nor did I watch the video, so I'm going on what I've read in blogs).  I learned quite a bit from the debate, however - especially from the comments!  And I want to share my observations with you.
  1. There are different competing theories about nutrition and health (Paleo, low carb, high carb-low fat, vegan, vegetarian, ancestral, weight watchers).  Some are total crap.  Many (the better ones) have components that can explain away the evidence presented by the competitors (your vegan diet "works" because even though it doesn't include meat, at least it reduces the use of white flower; your low fat diet "works" because at least it restricts industrial seed oils along with the healthy saturated fats you demonize; your paleo diet "works" because even though you're still eating too much saturated fat at least you've increased your intake of fresh vegetables.)
  2. Each of the competing dietary philosophies are endorsed by plenty of people who saw drastic improvements in health - got leaner, felt better, etc. - when taking up that eating plan.
  3. Each of the competing dietary philosophies is derided by plenty of people who got fatter or sicker while taking up that diet plan over a range of time periods (some after years of compliance, some sooner). In some cases that may be a problem with implementation (some people go lacto-ovo-vegetarian by eating only pizza and beer; others concentrate on eggs from pastured chickens, dairy from grass fed cows, fresh vegetables, and no grains - they'll get very different results) or genetic or acquired differences in metabolism and tolerances of certain foods or food groups.  For every healthy, lean vegan you can find someone who got miserably sick on the diet for no obvious reason (not because they did it wrong) - and the same is true for paleo, low carb, low fat, etc.
  4. Strategies that work for whole populations (that is, you can find a group of people living on an island somewhere who eat that way and are healthy, lean, and long -lived) will not necessarily work for everybody.  Why not?  It could be that there are genetic differences that make the difference, lifestyle differences (that group that did well on diet X got lots of sunlight, you live in Alaska), or a metabolism damaged by a lifetime of Oreos and Coca Cola isn't the same as that of a hunter gatherer who's never tasted sugar.
  5. Whenever anybody figures out the thing that works for them - low carb, low fat, paleo, vegan, whatever - they seem incapable of accepting that it may not work for everybody.  Anybody who tells you they have the whole nutrition thing worked out is full of crap.   Look, cutting out gluten radically changed my health and, in fact, my life - that doesn't mean it will do the same for you.
So I've basically told you that you know even less than you thought you did - no matter what you're advising somebody to eat, you might be wrong - your advice might make them fat and sick, depending on the person.  And, perhaps worse, what you're eating might be wrong for you - in fact, you might be doing everything right, or so you think, and yet you're still fat.

What do you do?

1.  Start with the commonalities.

I've said this before, but there are, in fact, some commonalities among nearly all the diets that "work" for either health or fat loss:
  • Cut back on (at least) refined flour and sugar.  I can't find a legitimate diet that encourages white flour and sugar.
  • Drink enough fluid/ water (there's disagreement about how much you really need, but if you're thirsty and dry mouthed a lot you're definitely in trouble).  I don't believe that your fluid has to be from plain water, but you have to get at least some fluid in.
  • Whatever you eat, get the highest quality version of that food that you can manage: if you eat only beef, get grass fed beef.  Get eggs from pastured chickens.  For plants some need to be organic (generally, if there's an inedible skin or it grows underground, being organic is less important).
  • I am very sorry about this, but you're going to have to reduce your energy intake if you want to lose fat.  With some diets this is easier than others - I personally have a much easier time restricting calories when I avoid gluten - but you still have to, at the end of the day, consume less food if you want your body to burn fat.  But, and here's the real kick in the ass, if you reduce intake too much you'll stop fat loss.  Yes, the Flying Spaghetti Monster has a weird sense of humor.
2.  Give your current plan a chance.
  • Whatever you're doing - low carb, vegan, whatever - do it super strict for 30 days.  If you don't feel/ look better at that point, then it's time to move on.  When/ if you do move on, at least you'll know you gave it a real chance.
  • Stay away from fake foods that are aimed at your diet.  If you're gluten free, you shouldn't be eating anything that is advertised as gluten free.  Gluten free Bisquick is not real food - rice is real food, meat is real food, veggies are real, gluten free brownies are not.  Ditto for low fat, low carb, etc.  Invariably the processed products that are manufactured to meet some weird dietary requirement are substituting one evil for another.
3.  Maximize your chance of success by working on the non-dietary factors that are important.
  • Get plenty of the 3 S's for leanness:  sleep, sun, and sex.  (I should turn that into a book.)  Getting more of all 3 -but avoiding the excess of sleeping all day, burning, or acquiring an STD - will make you healthier and leaner.
  • Train hard but not too hard and enough but not too much.  Cortisol will keep the pounds packed on for most of us (not everyone responds the same to this).  Training too hard can make it just as hard to be lean as training too little.
  • Get in plenty of very low intensity movement.  Take long slow walks at night.  
  • Minimize the stress in your life.  Try meditating.
4.  If these strategies don't do the trick... MOVE ON!

I'd love to tell you that paleo will work for everyone.  I have strong philosophical and scientific reasons to think that it will.  But... I've been wrong before.  And you can easily find a hundred vegans who are just as certain that staying away from delicious animal products will optimize your health, longevity, and fitness.  So, if you've been giving any dietary strategy a real commitment and it's not working, try something else!  Eat some carbs.  Have a salad.  Whatever.  Just stick to the basic framework:  eat less, cut back on sugar and white flour, and eat higher quality food.

It took me 25 years to find the formula that works for me, and I'm still tinkering with it.  I'm not saying it will take you as long, but:  a) the end result is worth it; and b) the alternative, giving up, is kind of horrible.


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