When I switched to a mostly paleo diet this spring, I stopped needing willpower to prevent weight gain. I suspect I experienced other advantages, but don’t have good evidence for them.
It will be hard to tell what fraction have benefited, because people who found it hard or ineffective are less likely to write about it.
The anecdotes of a few people on this site mean very little to me in regards to the efficacy of a particular diet. There doesn’t seem to be any experimental evidence with a reasonable sample size to suggest that Paleo diets actually lead to weight loss (there is evidence that DASH leads to weight loss). The paleo diet is relatively high in saturated fat (and there is a scientific consensus that high saturated fat intake causes heart disease) while DASH is not. Omitting grain and dairy eliminates the sources of some nutrients and I would hypothesize that a significant percent of people switching to a paleo diet don’t actually compensate for that loss by getting those nutrients from other sources.
It just doesn’t make sense to advocate for a paleo diet when there is no evidence of it performing better in the aggregate than diets which are supported by the scientific consensus. If I’m mistaken please link me to some good quality studies.
There is a lot of really bad “science” out there on diet, there was a political decision made in the 1970s to promote low-fat diets, in spite of what most scientists thought. For a detailed story on this, and on what is known about fat and carbohydrates in diet, I suggest Gary Taubes’ Good Calories, Bad Calories.
While little about diet is certain, the bulk of the scientific evidence is that “high saturated fat intake,” in the context of a low-carbohydrate diet, does not increase real cardiac risk. On the contrary, high-fat low-carb diets, like the Atkins diet, lower cardiac risk factors.
The “scientific consensus” described above isn’t.
This isn’t about “paleo diet,” as such, except that paleo diets do tend to be high-fat and low-carb. We did not evolve eating grain, and then the grain may be highly processed to remove most fiber, creating rapid absorption of glucose into the bloodstream, requiring, then, fast insulin release to avoid toxic levels.
We can eat carbohydrrates, but they were a small part of our diet, generally mixed with fiber, which slows digestion. Fat also does this. It’s being claimed with substantial evidence that the “diseases of civilization,” i.e., heart disease, diabetes, and cancer, are largely caused by diets with high carb content, especially highly processed carbs. High natural fat content does not seem to be a problem, the opposite.
I did the research and am bettiing my life on this. And I wish we knew more than we do. Taubes has started a Nutrition Science Initiative.
Would you mind linking to this research that shows low carb diets lower cardiac risk factors? All I really know about the matter is that in the aggregate people who actually study diet generally conclude that Atkins-like diets are not optimal for health. In particular, the US Department of Health and Human Services, the Centers for Disease Control, the American Heart Association, and the World Health Organization all seem to conclude that saturated fats directly increase cardiovascular risk.
You’re also arguing against anything said by these organizations when discussing highly processed carbs. DASH specifically recommends making at least half of grains consumed whole, and the implication seems to be that the ideal would be eating no refined grains.
Okay, read Taubes’ article in the New York Times, “What if it’s all been a big fat lie?”. That’s ten years old, there has been research published since then, but nothing to change the basic conclusions.
I suggest reading it before the rest here!
The organizations are not “scientific.” They are largely political creatures, and how they are funded can be an issue. If cholesterol is not the problem, what happens to the statin drug market? But I don’t know that recommendations are driven by funding.
Taubes is a thorough science writer, a skeptic, and it is indeed science that he’s interested in. He is not selling a diet.
Taubes covers the history of diet recommendations in the U.S. It’s shocking.
Something brief:
In 1957, the American Heart Association opposed Ansel Keys (the author of the epidemiological study that got the whole fat=bad thing going), with a 15-page report, saying there was no evidence for the fat/heart disease hypothesis. Less than four years later, a 2-page report from the AHA totally reversed that, and, according to Taubes, that report included a half-page of “recent scientific references on dietary fat and atherosclerosis,” many of which contradicted the conclusions of the report, which recommended reducing the risk of heart disease by reducing dietary fat..
What happened? Did the science change that quickly? Read Taubes! (i.e, read the book, “Good Calories, Bad Calories.” Taubes also has a recent book, less technical, more popular, I think, but I haven’t read it.)
I could point to studies; the Atkins diet in particular has been studied independently, and it improves cardiac risk factors, it does not make them worse. Yet it’s a high-fat diet. So what is the risk?
Yes. I’m arguing against a commonly-recommended diet. I’m suggesting that relying on these agencies and their recommendations, without understanding the science, is very dangerous.
Taube had written a book about salt, and when he was doing the research, he noticed nutritional “expert” after “expert” who had no clue how science works, who used extremely poor reasoning, conclusion-driven. And he noticed the same when he started working on fat.
When I started reading in the field, out of personal necessity, I could see it myself, really poor “science” being commonly asserted as if it were simple fact.
Such as “a calorie is a calorie.” I.e., it’s said there is no difference between fat calories and carb calories, and the claim of Atkins that fat had a “metabolic advantage” was allegedly preposterous, this would supposedly violate the laws of thermodynamics.
However:
various foods take different amounts of energy to metabolize, and some calories are excreted.
food calories are not thermodynamic calories, and this is not merely the “kilocalorie” thing, they are modified according to metabolic factors estimated from studies that were done about a century ago, and that may not be accurate under various dietary conditions.
carb metabolism (burning glucose) runs the body in a different way, and has behavioral effects, compared to fat metabolism. Appetite shifts (fat suppresses appetite, generally).
There never was good evidence that saturated fats increased cardiovascular risk, that was speculation from the highly flawed Keys study. It was thought “well, to really know will take very expensive trials, we can’t do that, so why not reduce fat? It can’t hurt!”
But it could and probably did hurt. Lower fat in the diet, you almost certainly raise carbs, and quite possibly increase obesity, diabetes, heart disease, and there is an effect on cancer, apparently.
Bottom line, the officially-recommended diets have very little science behind them.
This really is not the place to debate the issue. Read the literature! Taubes is an excellent door into it, the book GCBC is about a fourth footnotes.
It’s tempting to sit back and trust the official organizations. It’s a lot of work to actually read the evidence. However, is this important?
I thought it was, like, my life depends on it.
The AHA is a $600 million/year organization. If fat/heart disease hypothesis is as wrong as it appears to be, they may have cost Americans, in damage to health, a great deal more than that. Now, consider what we know about human organizations. When they get it spectacularly wrong, but before there is absolute proof, do they back up easily?
No. Their business is to be the experts, remember that $600 million per year.
The author is Harriet Hall, supposedly a skeptic, but what I can see in the review is a set of assumptions that are, for her, unchallenged. Small example: salt. A few people with high blood pressure may benefit from salt reduction. Most people don’t. Some people may be harmed.
This attitude that studies that go against prevailing beliefs should be ignored on the basis that, well, they go against prevailing beliefs, has been the norm for the anti-salt campaign for decades. Maybe now the prevailing beliefs should be changed. The British scientist and educator Thomas Huxley, known as Darwin’s bulldog for his advocacy of evolution, may have put it best back in 1860. “My business,” he wrote, “is to teach my aspirations to conform themselves to fact, not to try and make facts harmonize with my aspirations.”
These critics have in common that they misrepresent Taubes. He’s raising possibilities, not claiming proof.
However, what Taubes points to is the possibility that what they have been advocating for decades might be harming people. This is unthinkable.
He must be wrong, so they will find every flaw, real or imagined, ignoring the central problem, that sound research has never done more than imply possible harm, and that at best reduced salt, for normal people, may have a tiny effect on longevity, and, in the other direction, may have serious consequences, increasing mortality.
People whose entire livelihoods, long-term, depend on the “consensus” that they created and pushed, often against the evidence, often against strong scientific opposition, with retaliation against those with contrary opinions, then imply that Taubes is making it up to make money.
When an old pot calls the new kettle black, we may need to stand back and develop some perspective.
This pattern-matches exactly to everything else conspiracy theory related I have ever read, and by that I mean it misinterprets the relative incentives. You speak of organizations that apparently face financial loss if they turn out to be wrong, but you provide no convincing reason for why they would lose funding if they revised their positions due to new evidence. You also don’t mention the huge profits an organization would surely make if it provided compelling evidence for how to actually lower the risk of the largest cause of death in the United States. In particular:
-I’m not going to read a book rather than reading the results of randomized, controlled trials or meta-analyses of many such studies.
-You say you “could point to studies.” Then do it.
I pointed to sources that contain huge lists of sources, including such studies. Some of what I pointed to is free. There is no need to reproduce this here. The relevance here is to cascades, which occur without “conspiracies.”
A common response to a cascade being pointed out is to call the observer a “conspiracy theorist,” and that happens even if no conspiracy has been alleged. That people might be unconsciously motivated by issues of reputation and “face” is just what’s so for human beings.
I mentioned funding and was explicit that I did not know if this had an actual effect on recommendations.
Taubes has laid out the history of the “official dietary recommendations,” and he makes a persuasive case that some serious errors were made, and that some are persisting in beliefs that are not consistent with what is scientifically known.
Anyway, aceofspades asks for studies. He didn’t specify the context, but it was that he had written
Would you mind linking to this research that shows low carb diets lower cardiac risk factors?
I linked to extensive coverage of that research, by science journalists. However, specifically, and just what I picked up quickly:
I was under forty when my doctor, whom I trusted greatly, recommended that I go on a low-fat diet because I had mildly elevated cholesterol. Over 20 years later, the results: I’d gained about 30 lbs, my cholesterol levels were a lot higher. Sure, I wasn’t terribly compliant, but I’d shifted the balance greatly toward low-fat. Turns out my experience was typical. Compliance with low-fat diets is commonly poor, and the effect of the recommendation is often weight gain and worsening lipids. So then statins are prescribed....
My new doctor suggested the South Beach diet (kind of a compromised lower-fat or lower-sat-fat Atkins diet, also by a famous cardiologist), but I did the research this time, and found that the science was stronger behind Atkins. I told him, and he led me into his office and handed me the standard textbook on diabetes, written in the 1920s, that described what was then the standard treatment for type II diabetes. A low-carb diet. Insulin had just been discovered, and insulin was considered a miracle drug for the rest, who didn’t respond to low-carb diets. Fast forward, the American Diabetes Association discourages low-carb diets. Why? It’s really a good question!
Well, why hadn’t this doctor told me straight out about low-carb, that my high cholesterol was not necessarily a problem? It’s a little thing called “standard of practice.” He could lose his job and/or his license. However, he could smile at me and tell me “whatever you are doing, keep it up.” (Because my lipids and other indicators of heart health improved greatly.)
And then I found from a biopsy that I have prostate cancer. Taubes describes a plausible mechanism for how high-carb diets can increase the incidence of prostate cancer.
My story is anecdotal, and there is much we don’t know about diet, but “experts” still confidently tell us what to eat and what not to eat, and it’s entirely possible that the advice given to me, in full good faith, 30 years ago, led me into a potentially fatal disease. And similar may be true for many others. And it is still going on.
I was referred to a radiation oncologist who advised radiation treatment, if not surgery. So, again, I did the research, and found that the latest advice for someone exactly my age and situation was “watchful waiting.” I’m still more likely to die from something else than prostate cancer.
So why the recommendation from the oncologist? Well, it’s what he does. Go to a carpenter, you are likely to get some advice that involves a hammer. But is he aware of the latest research? Probably, though possibly not. But he’s not about to recommend something based on that, because it is not yet the “standard of practice,” and he can get his ass sued. Even if the advice was right as to risks.)
Cascades are a real problem that dumb down social structures, and especially when they create a “scientific consensus” that isn’t rooted in science and the scientific method. Cascades, however, occur in all kinds of social situations.
I agree that low carb diets are an effective means of weight loss relative to low fat diets for people in the aggregate. I do not agree that they are in the aggregate better for reducing mortality than DASH, and I think my personal health is optimized by eating whole grains, fruits, vegetables, low fat dairy, and lean protein and avoiding all else.
When I switched to a mostly paleo diet this spring, I stopped needing willpower to prevent weight gain. I suspect I experienced other advantages, but don’t have good evidence for them.
It will be hard to tell what fraction have benefited, because people who found it hard or ineffective are less likely to write about it.
Maybe I should be more clear.
The anecdotes of a few people on this site mean very little to me in regards to the efficacy of a particular diet. There doesn’t seem to be any experimental evidence with a reasonable sample size to suggest that Paleo diets actually lead to weight loss (there is evidence that DASH leads to weight loss). The paleo diet is relatively high in saturated fat (and there is a scientific consensus that high saturated fat intake causes heart disease) while DASH is not. Omitting grain and dairy eliminates the sources of some nutrients and I would hypothesize that a significant percent of people switching to a paleo diet don’t actually compensate for that loss by getting those nutrients from other sources.
It just doesn’t make sense to advocate for a paleo diet when there is no evidence of it performing better in the aggregate than diets which are supported by the scientific consensus. If I’m mistaken please link me to some good quality studies.
There is a lot of really bad “science” out there on diet, there was a political decision made in the 1970s to promote low-fat diets, in spite of what most scientists thought. For a detailed story on this, and on what is known about fat and carbohydrates in diet, I suggest Gary Taubes’ Good Calories, Bad Calories.
While little about diet is certain, the bulk of the scientific evidence is that “high saturated fat intake,” in the context of a low-carbohydrate diet, does not increase real cardiac risk. On the contrary, high-fat low-carb diets, like the Atkins diet, lower cardiac risk factors.
The “scientific consensus” described above isn’t.
This isn’t about “paleo diet,” as such, except that paleo diets do tend to be high-fat and low-carb. We did not evolve eating grain, and then the grain may be highly processed to remove most fiber, creating rapid absorption of glucose into the bloodstream, requiring, then, fast insulin release to avoid toxic levels.
We can eat carbohydrrates, but they were a small part of our diet, generally mixed with fiber, which slows digestion. Fat also does this. It’s being claimed with substantial evidence that the “diseases of civilization,” i.e., heart disease, diabetes, and cancer, are largely caused by diets with high carb content, especially highly processed carbs. High natural fat content does not seem to be a problem, the opposite.
I did the research and am bettiing my life on this. And I wish we knew more than we do. Taubes has started a Nutrition Science Initiative.
Would you mind linking to this research that shows low carb diets lower cardiac risk factors? All I really know about the matter is that in the aggregate people who actually study diet generally conclude that Atkins-like diets are not optimal for health. In particular, the US Department of Health and Human Services, the Centers for Disease Control, the American Heart Association, and the World Health Organization all seem to conclude that saturated fats directly increase cardiovascular risk.
You’re also arguing against anything said by these organizations when discussing highly processed carbs. DASH specifically recommends making at least half of grains consumed whole, and the implication seems to be that the ideal would be eating no refined grains.
Okay, read Taubes’ article in the New York Times, “What if it’s all been a big fat lie?”. That’s ten years old, there has been research published since then, but nothing to change the basic conclusions.
I suggest reading it before the rest here!
The organizations are not “scientific.” They are largely political creatures, and how they are funded can be an issue. If cholesterol is not the problem, what happens to the statin drug market? But I don’t know that recommendations are driven by funding.
Taubes is a thorough science writer, a skeptic, and it is indeed science that he’s interested in. He is not selling a diet.
Taubes covers the history of diet recommendations in the U.S. It’s shocking.
Something brief: In 1957, the American Heart Association opposed Ansel Keys (the author of the epidemiological study that got the whole fat=bad thing going), with a 15-page report, saying there was no evidence for the fat/heart disease hypothesis. Less than four years later, a 2-page report from the AHA totally reversed that, and, according to Taubes, that report included a half-page of “recent scientific references on dietary fat and atherosclerosis,” many of which contradicted the conclusions of the report, which recommended reducing the risk of heart disease by reducing dietary fat..
What happened? Did the science change that quickly? Read Taubes! (i.e, read the book, “Good Calories, Bad Calories.” Taubes also has a recent book, less technical, more popular, I think, but I haven’t read it.)
I could point to studies; the Atkins diet in particular has been studied independently, and it improves cardiac risk factors, it does not make them worse. Yet it’s a high-fat diet. So what is the risk?
Yes. I’m arguing against a commonly-recommended diet. I’m suggesting that relying on these agencies and their recommendations, without understanding the science, is very dangerous.
Taube had written a book about salt, and when he was doing the research, he noticed nutritional “expert” after “expert” who had no clue how science works, who used extremely poor reasoning, conclusion-driven. And he noticed the same when he started working on fat.
When I started reading in the field, out of personal necessity, I could see it myself, really poor “science” being commonly asserted as if it were simple fact.
Such as “a calorie is a calorie.” I.e., it’s said there is no difference between fat calories and carb calories, and the claim of Atkins that fat had a “metabolic advantage” was allegedly preposterous, this would supposedly violate the laws of thermodynamics.
However:
various foods take different amounts of energy to metabolize, and some calories are excreted.
food calories are not thermodynamic calories, and this is not merely the “kilocalorie” thing, they are modified according to metabolic factors estimated from studies that were done about a century ago, and that may not be accurate under various dietary conditions.
carb metabolism (burning glucose) runs the body in a different way, and has behavioral effects, compared to fat metabolism. Appetite shifts (fat suppresses appetite, generally).
There never was good evidence that saturated fats increased cardiovascular risk, that was speculation from the highly flawed Keys study. It was thought “well, to really know will take very expensive trials, we can’t do that, so why not reduce fat? It can’t hurt!”
But it could and probably did hurt. Lower fat in the diet, you almost certainly raise carbs, and quite possibly increase obesity, diabetes, heart disease, and there is an effect on cancer, apparently.
Bottom line, the officially-recommended diets have very little science behind them.
This really is not the place to debate the issue. Read the literature! Taubes is an excellent door into it, the book GCBC is about a fourth footnotes.
Or look at the Wikipedia article Saturated fat and cardiovascular disease controversy, (Do not trust Wikipedia articles to be neutral. They frequently are not. Use them to find other sources.)
It’s tempting to sit back and trust the official organizations. It’s a lot of work to actually read the evidence. However, is this important?
I thought it was, like, my life depends on it.
The AHA is a $600 million/year organization. If fat/heart disease hypothesis is as wrong as it appears to be, they may have cost Americans, in damage to health, a great deal more than that. Now, consider what we know about human organizations. When they get it spectacularly wrong, but before there is absolute proof, do they back up easily?
No. Their business is to be the experts, remember that $600 million per year.
For some of the other side, see a review of Taube’s latest book, “Why We Get Fat”.
The author is Harriet Hall, supposedly a skeptic, but what I can see in the review is a set of assumptions that are, for her, unchallenged. Small example: salt. A few people with high blood pressure may benefit from salt reduction. Most people don’t. Some people may be harmed.
Taubes again in the New York Times, Salt, We Misjudged You.
The summary:
This attitude that studies that go against prevailing beliefs should be ignored on the basis that, well, they go against prevailing beliefs, has been the norm for the anti-salt campaign for decades. Maybe now the prevailing beliefs should be changed. The British scientist and educator Thomas Huxley, known as Darwin’s bulldog for his advocacy of evolution, may have put it best back in 1860. “My business,” he wrote, “is to teach my aspirations to conform themselves to fact, not to try and make facts harmonize with my aspirations.”
What Taubes encounters:
Gary Taubes is a Blowhard
Center for Science in the Public Interest
These critics have in common that they misrepresent Taubes. He’s raising possibilities, not claiming proof.
However, what Taubes points to is the possibility that what they have been advocating for decades might be harming people. This is unthinkable.
He must be wrong, so they will find every flaw, real or imagined, ignoring the central problem, that sound research has never done more than imply possible harm, and that at best reduced salt, for normal people, may have a tiny effect on longevity, and, in the other direction, may have serious consequences, increasing mortality.
People whose entire livelihoods, long-term, depend on the “consensus” that they created and pushed, often against the evidence, often against strong scientific opposition, with retaliation against those with contrary opinions, then imply that Taubes is making it up to make money.
When an old pot calls the new kettle black, we may need to stand back and develop some perspective.
This pattern-matches exactly to everything else conspiracy theory related I have ever read, and by that I mean it misinterprets the relative incentives. You speak of organizations that apparently face financial loss if they turn out to be wrong, but you provide no convincing reason for why they would lose funding if they revised their positions due to new evidence. You also don’t mention the huge profits an organization would surely make if it provided compelling evidence for how to actually lower the risk of the largest cause of death in the United States. In particular:
-I’m not going to read a book rather than reading the results of randomized, controlled trials or meta-analyses of many such studies.
-You say you “could point to studies.” Then do it.
I pointed to sources that contain huge lists of sources, including such studies. Some of what I pointed to is free. There is no need to reproduce this here. The relevance here is to cascades, which occur without “conspiracies.”
A common response to a cascade being pointed out is to call the observer a “conspiracy theorist,” and that happens even if no conspiracy has been alleged. That people might be unconsciously motivated by issues of reputation and “face” is just what’s so for human beings.
I mentioned funding and was explicit that I did not know if this had an actual effect on recommendations.
Taubes has laid out the history of the “official dietary recommendations,” and he makes a persuasive case that some serious errors were made, and that some are persisting in beliefs that are not consistent with what is scientifically known.
Anyway, aceofspades asks for studies. He didn’t specify the context, but it was that he had written
I linked to extensive coverage of that research, by science journalists. However, specifically, and just what I picked up quickly:
Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. (Blood lipids, i.e., cardiac risk factors, were studied.)
Comparison of the Atkins, Zone, Ornish, and LEARN diets for change in weight and related risk factors among overweight premenopausal women: the A TO Z Weight Loss Study: a randomized trial. (Lipid profile was studied.)
Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities. (This is a “systematic review,” very much on point as to cardiac risk.)
Part of my own experience:
I was under forty when my doctor, whom I trusted greatly, recommended that I go on a low-fat diet because I had mildly elevated cholesterol. Over 20 years later, the results: I’d gained about 30 lbs, my cholesterol levels were a lot higher. Sure, I wasn’t terribly compliant, but I’d shifted the balance greatly toward low-fat. Turns out my experience was typical. Compliance with low-fat diets is commonly poor, and the effect of the recommendation is often weight gain and worsening lipids. So then statins are prescribed....
My new doctor suggested the South Beach diet (kind of a compromised lower-fat or lower-sat-fat Atkins diet, also by a famous cardiologist), but I did the research this time, and found that the science was stronger behind Atkins. I told him, and he led me into his office and handed me the standard textbook on diabetes, written in the 1920s, that described what was then the standard treatment for type II diabetes. A low-carb diet. Insulin had just been discovered, and insulin was considered a miracle drug for the rest, who didn’t respond to low-carb diets. Fast forward, the American Diabetes Association discourages low-carb diets. Why? It’s really a good question!
Well, why hadn’t this doctor told me straight out about low-carb, that my high cholesterol was not necessarily a problem? It’s a little thing called “standard of practice.” He could lose his job and/or his license. However, he could smile at me and tell me “whatever you are doing, keep it up.” (Because my lipids and other indicators of heart health improved greatly.)
And then I found from a biopsy that I have prostate cancer. Taubes describes a plausible mechanism for how high-carb diets can increase the incidence of prostate cancer.
My story is anecdotal, and there is much we don’t know about diet, but “experts” still confidently tell us what to eat and what not to eat, and it’s entirely possible that the advice given to me, in full good faith, 30 years ago, led me into a potentially fatal disease. And similar may be true for many others. And it is still going on.
I was referred to a radiation oncologist who advised radiation treatment, if not surgery. So, again, I did the research, and found that the latest advice for someone exactly my age and situation was “watchful waiting.” I’m still more likely to die from something else than prostate cancer.
So why the recommendation from the oncologist? Well, it’s what he does. Go to a carpenter, you are likely to get some advice that involves a hammer. But is he aware of the latest research? Probably, though possibly not. But he’s not about to recommend something based on that, because it is not yet the “standard of practice,” and he can get his ass sued. Even if the advice was right as to risks.)
Cascades are a real problem that dumb down social structures, and especially when they create a “scientific consensus” that isn’t rooted in science and the scientific method. Cascades, however, occur in all kinds of social situations.
I agree that low carb diets are an effective means of weight loss relative to low fat diets for people in the aggregate. I do not agree that they are in the aggregate better for reducing mortality than DASH, and I think my personal health is optimized by eating whole grains, fruits, vegetables, low fat dairy, and lean protein and avoiding all else.