Create Your Very Own Biased Study

      25 Comments on Create Your Very Own Biased Study

A few weeks ago, the media were all abuzz about a new study published in the New England Journal of Medicine. The study’s conclusion: weight loss is all about the calories, period. High carb, low carb, high fat, low fat – it doesn’t matter.

Lead researcher Dr. Frank Sacks and his team put four groups of people on four different diets for two years. There was a high-fat/low-carbohydrate diet, a high-carbohydrate/low-fat diet, and two diets sort of in-between. At the end of the two years, the weight loss was about the same among all four groups.

Well, that settles it. Case closed. You can get off that silly, faddish, low-carb diet now. Drop the cheeseburger, pick up the whole-grain bun, and start counting your calories.

I was intrigued, because this study’s results don’t match my own. When I was on the Zone diet, I consumed about 1700 calories per day, which included about 175 carbs. I lost six pounds per month. On my fast-food diet, I consumed about 2000 calories per day, but limited myself to around 100 carbs. I lost 12 pounds in 28 days. That’s double the weight loss, despite an extra 300 calories per day. Exercise can’t explain the difference, because I walked the same number of miles each week on both diets.

At least that’s how I remember it. But according to Dr. Sacks, those numbers can’t be right. Either he’s wrong, or I’m a functional schizophrenic, walking around with memories of experiences that didn’t actually happen. I must have a beautiful mind. (My contact at the CIA, who has me decoding secret Al Qaeda messages in New England Journal of Medicine articles, does like the way I think.)

Or maybe, just maybe, there’s something else going on here. Ah, yes, that does seem to be the case.

I’ll spare you the details on the diets because Jimmy Moore and Mike Eades already did a full slice-and-dice on the numbers. But here’s the bottom line: Dr. Sacks and his fellow researchers got the result they wanted by coming up with a definition of “low-carb” that is, to put it charitably, rather creative: 35 percent of total calories.

If you consume 2000 calories per day, that’s 175 grams of carbohydrates. The Atkins diet recommends starting at 20 grams per day – barely one-tenth of the carbohydrate load Sacks calls a “low-carb diet.” Drs. Mike and Mary Dan Eades also advise dieters to start very low and gradually raise the carb count to perhaps 50 grams – less than a third of what Sacks calls a “low-carb diet,” and just 10 percent of the calories in a 2000-calorie diet.

In other words, Sacks didn’t bother to include a diet that would’ve actually restricted carbohydrates to the point where insulin levels would plummet and send the dieters into fat-burning mode.

After thinking long and hard about this little bit of scientific chicanery, I can only come to one conclusion: Dr. Sacks is brilliant! He’s given all the married men on earth what we need most – a clear demonstration of how to “prove” you are right even when you’re not. Speaking for married guys everywhere, I want to thank you, Dr. Sacks, from the bottom of our hearts.

Okay, gentlemen, wise up and follow this brilliant doctor’s example. From now on, when you need to prove a point, just change the definition of the terms so you can’t lose. Then conduct a quick study using the terms you created.

Suppose your wife accuses you of drinking too much beer. “What’s wrong with beer?” you ask. She then offers up some cockamamie theory about how beer makes you fat, stupid, and a dangerous driver. In the pre-Sacks era, you would’ve been roped into an argument that could last for days.

But thanks to the Sacks methodology, now you can disappear into the den for a couple of days, do some intense research, and re-emerge with a study like this:

Comparison of Weight, Cognitive Ability and Motor Skills In Moderate vs. Heavy Beer Drinkers.

No, the results were pretty straightforward.

We assigned one random husband to two groups of beer drinkers on random afternoons when the NCAA playoffs were on television. The first group, defined as the moderate-drinking group, consumed 1.0 bottles of Bud Light during the afternoon games. The second group, defined as the heavy-drinking group, consumed 2.0 bottles of Bud Light during the afternoon games. Both groups consumed the allotted bottles of beer well before half-time.

Both groups also consumed exactly 10 pepperoni Slim Jims during the games, and both groups participated in equal amounts of exercise, defined for the purposes of the study as 1) running to the bathroom during commercials and 2) occasionally jumping up from the couch and yelling, “What’s the matter, ref, are you BLIND?!!”

Weight was measured by bathroom scale. Additionally, abdominal fat was recorded by employing a carpenter’s tape measure, which was extended and bent carefully around the waist.

Cognitive ability was determined by the participant’s ability to read the final scores displayed on the television screen and calculate which team’s score was higher. (In layman’s terms: who “won” the game.) Each participant’s conclusion as to the highest score was later compared to ESPN news reports to assess accuracy.

Motor skills were determined by recording each participant’s average highest score in three rounds of “Grand Theft Auto,” played on an Xbox 360 immediately following the game.

Weight gain was remarkably consistent among both the moderate-drinking and heavy-drinking groups (0.5 pounds vs. 0.7 pounds respectively, P=0.05). Abdominal circumference was identical in both groups, although the participant in the heavy-drinking group suffered a minor laceration due to a belching incident that occurred as the tape measure was being cinched around his waist.

Cognitive ability was also remarkably similar. Both groups correctly identified which team scored the most points in every instance (1.0 vs. 1.0, P=0.01). The participant in the heavy-drinking group was noticeably unsatisfied with the scores, despite correctly calculating which was higher, and indicated verbally that the referee was afflicted with near-sightedness.

Motor skills were similar, but not identical. The average Grand Theft Auto score was slightly higher among the moderate-drinking group than the heavy-drinking group (523 vs. 489, P=0.11) but was not a desired outcome and therefore classified as statistically insignificant. The Grand Theft Auto score was also impacted by the heavy-drinking subject’s need to urinate more often (Pee=2.5/hour vs. Pee=3.5/hour, P=0.22) which could be considered a distraction.

The commonly-held belief among many researchers and most wives that heavy beer-drinking will lead to obesity, stupidity, and an increased risk of traffic accidents and DUI arrests is not supported, but may require further research in other research environments, preferably during baseball season.


That’s it. Hand your wife a copy of the study and explain that according to carefully controlled research, it doesn’t matter how much beer you drink – the only risk is a slightly higher P score, which is no big deal because you always remember to put the seat back down. Then turn triumphantly towards the fridge to grab a cold one.

Of course, if your wife happens to be a real scientist – or is blessed with a functioning brain – she may stop you with one of those looks and say, “Frankly, my dear, this study Sacks.”

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25 thoughts on “Create Your Very Own Biased Study

  1. Willa Jean

    ROTFL. Thanks.
    Do you think the media who report this junk ever actually LOOK at the reports? More importantly, do you think they’re smart enough to read them?

  2. Tom Naughton Post author

    I think they read the abstract and that’s it. Unfortunately, researchers can (and do) put any conclusion they want in the abstract. Dr. Uffe Ravnskov has pointed out research papers where the conclusion in the abstract is completely unsupported by the hard data within the paper.

    In my younger days, working as a writer at a health magazine, I noticed a story in the newspaper that said that while smokers and non-smokers are involved in about equal numbers of traffic accidents, the smokers are more likely to die. The reporter speculated that the smokers are less able to survive because they’re already in bad shape from smoking.

    I called the researcher, who was hopping mad. He said something like, “That idiot! It’s right there in the data: smokers are less likely to wear a seat belt!”
    That’s probably typical of your average reporter’s ability to interpret a study.

    Glad you had a laugh. Hope the floor wasn’t recently polished. — TN

  3. kris

    Oh crap, another blog I will feel compelled to read. Thank you (I think). This was very funny… I laughed out loud.

    I am multitasking right now… reading your blog, drinking coffee and watching the tv show Sunday Morning. A segment came on about members of Mensa and interestingly almost every one of them, except for the kids is hugely, morbidly obese! This image alone might make your point – not the beer point, the other one.

    Just curious… I like the fact that your site has the fast food nutritional info listed – I can’t seem to stay away completely since here in the east we don’t have any of those nuance burger joints that wrap burgers in lettuce leaves that look like they are on steroids. Did you include this info because you indulge occasionally or just because fast food joints are a major focus in the Fat Head movie? BTW, really enjoyed the movie. If only we were fed the bologna, sans bread, when we were kids. Sorry… I couldn’t resist.

    1. Tom Naughton Post author

      Sorry to hook you on another blog. (At least I hope you’re hooked.) Glad you enjoyed the film.

      I included the fast-food menus for both reasons, actually. Fat Head demonstrates that you can eat fast food and still lose weight if you use your brain, so it made sense to provide access to some fast-food menus. And yes, I still eat fast food now and then, especially when I’m traveling.

  4. OhYeahBabe

    I did a study recently on my blog, too. I was inspired by the “study” that showed lowcarb makes you stupid.
    Reading your tips, I realize I could have done a much better job on my study. For sure, I could have used bigger words to amp up the ‘awethenticity’! Thanks for the great post! I’m looking forward to reading new posts here.

    I love your study! Frankly, yours is no more bogus than the study that said second-hand smoke causes lung cancer.

    The ‘cognition skills’ study had me spitting fire as well. In the past two weeks, I’ve learned WordPress, set up two blogs, written new posts, and starting programming in a rather beastly language I’m learning called C#. That’s in addition to my usual work programming in SQL Server and Visual Basic. Considering that I probably haven’t gone above 50 grams of carbs in two months, I’d say my brain is doing fine. (Maybe if I had some bread, I’d be a certified genius.)

  5. Morgan

    I really do appreciate your providing one more way to make married life easier. You nearly reach the heights achieved by our great past president, William Clinton, who showed us all how to avoid being accused of being an adulterer– by simply redefining the definition of adultery or more particularly what it means to “have sex.”

    “Yes,” says Humpty Dumpty to Alice in Wonderland, “When I say a low-carb diet, I mean one less bag of potato chips this week.”

    Best wishes on the new blog. I’m all ready a fan.

    K Morgan

    Yes, when someone asked me if this is really a low-carb diet, I asked him what his definiton of “is” is.

  6. Ramon

    You are one funny guy! Your pretty sharp too. I have to start reading your blog from now on. The media is just always looking to stir up something and create some kind of controversy or they are forced to report garbage to please any olitical knots. In any case the truth sucks and is crappy entertainment.

    The average media reporter is good with words, but illiterate in science. When I started researching this film, I was stunned at the amount of bad science I came across, usually badly reported as well. You can fool some of the people some of the time, all of the people some of the time — but you can fool the average reporter every time if you’ve got “PhD” after your name.

  7. Randy


    Are you still doing Dr. Mike’s recommended low-carb levels? I think I heard that you were trying his suggestions. Just wondering if you had reached your goal.

    I do indeed follow Dr. Mike’s guidelines. I consumed about 100 grams of carbs on my fast-food diet, but that’s because I wanted to demonstrate a diet most people would be willing to try. Not everyone is willing to toss the bun at every meal, but you can eat a couple of double quarter pounders with the bun and still keep the carbs under 100.

    My weight is stable. I ended the fast food diet at 194, then started doing Fred Hahn’s slow burn training method and went up to 210, without getting any fatter — in other words, it was all muscle. My legs and chest beefed up noticeably. I cut my carbs a bit more and limited my red-wine consumption to a night or two per week, and now I’m consistently at 200. If I’m hungry, I eat, and I don’t count calories, just the carbs.

    I’m not skinny and probably never will be, but if you saw the other men in my family, you’d know I’m much leaner than I would be if I didn’t follow a low-carb diet. And my health stats are great, which is what really matters.

  8. Dave Dixon

    The results of Sacks’ study are even “better” than his original plan, in the sense that the dieters didn’t actually adhere to the guidelines. I believe that in the end there was no statistically significant difference in macronutrient intake. Makes me wonder what kind of cronyism had to exist in order to get his study published in NEJM, since the actual conclusion should be something like “People who ate the same diet lost the same amount of weight”.

    I’m pretty sure I’ve got more mental quickness after going low-carb. Or maybe just less time being slow, as I no longer have to take 2PM naps after a carbo-binge lunch.

    C# beastly? Surely you jest, sir 🙂 It could be much worse. It could be C++. Or C. Or COBOL. Drop me a line if you have C# questions – I’ve been up to my eyeballs in it for the last 9 years or so.

    That means the husband in the moderate-drinking group could’ve had another beer. Wish I’d known.

    C# is probably only beastly compared to VB.NET. I don’t like looking at all those braces, and I miss my “End If” and “End Sub” statements to finish a block. But I’ll adjust. Since we’re planning to move, I figured it’s best to have another skill on the resume, just in case I have to go get a real job.

    But I may call on your expertise, thanks.

  9. Jamie VanEaton

    I think, at least, some white bread makes you think about rhetorical things. That’s why it’s called Wonder Bread.

    Hadn’t thought of that. I know there’s a popcorn out there called Smart Food. I may have to eat a bag before writing my next post.

  10. Robert

    Is there a detailed synopsis of your 2000 calorie/100 carb diet around here including what you ate and what kinds of exercise you did? I would find that rather interesting to read.

    Yup, it’s in the Helpful Links section, titled Tom’s Food Log

  11. Roxann Higuera

    I loved your article! My results agree with yours. I just switched from NutriSystem to Atkins. I get to eat more calories and still lose weight. And I’m not hungry! I eat about 300 more calories per day now.

    Not being hungry is key. If you eat and you’re still hungry, it means your body is storing the calories as fat, and your cells are starving. That’s what happened to me when I tried the low-fat nonsense.

  12. TonyNZ

    I snorted with laughter when I read that abstract. Alarmed my fiancee to no end (she’s watching X-files). Reporting of science in the media is one of my pet peeves. So much so that whenever there is an article about some groundbreaking scientific research I always go to the source (primary literature) and make sure the reporting is legit. I havn’t encountered good reporting yet. As I get all my news online I can tag comments to the bottom of these articles and enlighten the public, which I do.

    Also, with the stats in your movie (average American 8lbs heavier or whatever), are ther any correlating stats on average height over that time? Cause that’s going up too. Food for thought.

    My wife has endured many an outburst from me after I’ve spotted yet another badly designed, badly reported study in the media.

    Funny you mention height, because that was one of them. There was a news story explaining that Americans are no longer the tallest people in the world, we’ve lost height relative to northern Europe, etc. The reporter speculated that it’s because our health system doesn’t offer free pre-natal care, among other “ain’t it awful” explanations.

    In the very last paragraph, we finally read: “Americans of European extraction are still as tall or taller than their European brethren.” Now, guess what’s been the biggest change in American society over the past 30 years? That’s right; we’ve seen a huge influx of immigration from Asian and Hispanic countries — people not known for their towering height. (Hispanics now comprise our biggest minority population; 30 years ago they barely registered a blip in population statistics.) Couldn’t have been more obvious.

    As I’m constantly telling my wife, “I can’t figure out if this reporter is intentionally dishonest, or just plain stupid.”

  13. dieting for idiots

    Yeah, it’s called Fat Loss for Idiots but that’s just to take advantage of the ‘…for Idiots’ popularity. Truly the program respects the individual and assumes they have tried other diets and will have the good sense to realize what makes this one difference. It really works.

  14. Matt

    The extra 6 pounds lost in the month when you were dieting at ketogenic levels was due to glycogen depletion and water loss. It seems you don’t care to distinguish weight loss from fat loss.

    I’m not sure if 100 grams of carbs per day is exactly ketogenic, but from what I’ve read, all weight-loss diets produce an initial water loss, which means some of my weight loss on the Zone diet would’ve also been water. According to the “it’s all about the calories” theory, if I lost 6 pounds per month on the Zone diet, I should’ve only lost 3.6 pounds per month on my fast-food diet, given the extra 300 calories per day. Would I really lose an extra 8.4 pounds of water by cutting carbs from 175 to 100? Perhaps, but I have my doubts, especially since I put lots of salt on my food. (Yes, I salt my McDonald’s burgers and salads, too.)

    Interestingly, with Spurlock’s super-high sugar/carb/sodium intake, he was certainly retaining water, but I’ve yet to hear anyone suggest his weight gain was exaggerated.

  15. Matt

    100 grams of carbs per day is EXACTLY ketogenic; it is the accepted barrier between ketogenic and non-ketogenic. And yes, all diets result in a limited amount of water loss, but low-carb diets result in an extremely large amount of water loss due to glycogen depletion in the muscles and in the liver, as glycogen binds with water to be stored. I’m not sure what you weigh, but 8.4 pounds of water is far from unreasonable on low-carb; I weigh 260 and lose 11-15 pounds when fully depleted. Another thing that happens when you lose all of this water is that your body flushes out excessive amounts of electrolytes, such as sodium and potassium; this explains why your excessive salting would have a minimal effect. In fact, upping your sodium and potassium intake on a low-carb diet is recommended.

    I equate Morgan Spurlock with Michael Moore. Avoiding fast food wouldn’t be a bad thing for most Americans, as the caloric density of the food makes it easy to overeat. Which is not to say it’s not possible to maintain or even lose weight on a diet consisting entirely of fast food, something you and several others have accomplished. It seems like there’s something that would make losing weight on fast food possible… Oh, counting calories.

    So if I understand you correctly, it’s all about the calories, period. There is no genuine extra fat loss caused by bringing down insulin levels, despite the fact that insulin encourages the body to store fat, and is in fact necessary for the body to store fat.

    Without insulin, type I diabetics lose massive amounts of weight no matter how much they eat and eventually die of emaciation, but it’s all about the calories.

    Jay Cutler of the Denver Broncos lost 30 pounds in a few months, despite eating like a horse and sitting around all day to try to keep his weight up, and only regained the weight after being diagnosed as a diabetic and going on insulin therapy, but it’s all about the calories, not the insulin level.

    Teenage diabetic girls will stop taking insulin, despite the obvious health risks, because they lose weight rapidly no matter what they eat, but it’s all about the calories, not the insulin.

    In the Women’s Health Initiative study, thousands of women went on a low-fat diet and reduced their caloric intake by an average of 360 calories per day for eight years, but only lost an average of two pounds while actually gaining abdominal fat — but losing fat is all about cutting calories, not reducing insulin levels.

    Meanwhile, my extra weight loss was all water and had nothing to do with cutting carbs specifically, despite the fact that the glycerol molecules that result from carbohydrate combustion are a necessary component for esterification (binding free fatty acids into triglycerides in the fat cells, the only form in which they can be stored), and despite the fact that the lipoprotein lipase activity that is triggered by rising insulin prevents those triglycerides from exiting the fat cell as free fatty acids so they can be burned for energy.

    Is that your position? Okay, I’m convinced. Back to counting calories.

  16. Matt

    Once again, you completely ignore weight loss vs fat loss. In addition to the fact that all of your retorts are anecdotal and therefore useless, they’re easily explainable. And by the way, insulin IS A FACTOR. I never said insulin wasn’t important; hell, it’s one of the more important hormones in the body.

    Type I diabetics and Jay Cutler lose/lost weight due to a lack of insulin, yes, but not just because insulin stores fat. Insulin also stores glucose (as glycogen) in muscle, and is an important part of protein synthesis, breakdown, and resynthesis. The massive weight loss in the aforementioned individuals is due to a lack of storage of energy in the muscle, which then causes tons of free fatty acids and ketones to flood the system, and a lack of the rebuilding of muscle. This applies to the teenage diabetic girls scenario as well; they’re not losing (just) fat, they’re losing serious muscle, and putting themselves at risk for diabetic ketoacidosis.

    When you take in less calories than you expend, your body’s natural mechanisms for starvation kick in, however slightly, and slow your metabolism down to compensate. In addition to this, your brain releases hormones that make you feel more tired than usual, and hormones that increase your appetite significantly. Also, if that study is based on self-reported caloric intakes, I’d bet serious money that a significant portion of those women were not being honest. Do you have any idea of the odds that thousands of women would stay at the exact same caloric intake for EIGHT YEARS? They more than likely didn’t take into account the protein intake for those women, the overall dietary practices of those women, and the exercise habits of those women.

    I never said all of your weight loss was due to water. I said water AND glycogen depletion, the rest of cutting down to the exact level of carbs that the brain alone needs to function every day (before the adaptions to ketosis take place). Unless your protein intake was rather high in the first couple of weeks on that diet (150g+), I’d wager that some of that loss was muscle, too.

    Do you know what else raises insulin in the blood? Consuming meals of protein. Because, like I said, insulin is an extremely important part of protein synthesis, breakdown, and resynthesis. And, if you add fat to the mix, it gets even better: more insulin. The gluconeogenesis pathway more than compensates for the lack of glycerol from cutting carbohydrates; with glucose left in the bloodstream, more glucose can be made indefinitely by breaking down protein from muscle tissue.

    I’m not saying counting calories is everything, because you’re right, it’s not. You have to take into account individual hormones, metabolic rate changes, exercise patterns and types, etc. All I’m saying is, it sounds like you’re crediting insulin with being the god-hormone for weight loss, and that’s simply not true, to the extent that it will always be around for one reason or another, no matter what you do, unless you’re a diabetic. And you can’t discount the fact that calorie-counting is by far the easiest method for maintaining weight.

    Also, are you diabetic?

    I’m also not saying that low-carb diets don’t work, because they do. I LOVE them. They’re so easy to do and taste great, though I admittedly get sick of bacon and chicken and cheese after a while. They also cause a spontaneous drop in calories consumed due to a generally higher protein content. But unless you’re seriously eating carb-load levels of carbohydrates every day, they simply don’t change that much.

    If you want to name a god particle, hook yourself onto protein. That’s where the fat loss is.

    I agree that protein is a crucial component of a good diet. But it doesn’t raise insulin to the degree that simple carbs do, and it also raises glucagon, which encourages fat-burning. Insulin isn’t the whole story, but high insulin can certainly slow or stop any attempts to lose weight by calorie restriction alone.

    We would of course die without insulin, but it was never meant to be called upon several times per day to whack our blood sugar down.

    Personally, I don’t feel tired when I reduce calories as long as I’m keeping the carbs in check because then I burn body fat for fuel. The body doesn’t care if the fat it burns comes from the diet or the fat cells.

    But on low-fat diets, I felt awful when I cut calories, because little fat could escape my fat cells, and I ran out of fuel. I got sluggish and no doubt slowed my metabolism.

    As far as whether carb restriction leads to greater fat loss, we’ll have to agree to disagree. We probably agree more often than not on dietary issues in general. (But who can get tired of bacon?)

    Out of curiousity, have you read Taubes’ book?

  17. TonyNZ

    Ok, having observed this article a little bit, I will make a couple of comments.

    Matt, I don’t think Tom hails insulin as the be all and end all of weight loss, merely a tool to explain why carb-loading is not really a good thing.

    Tom, I don’t think Matt is arguing for calorie counting as a be all and end all of weight loss, just that it is more important that he thought you made out.

    I think you would both agree on a couple of points:

    1. The human body is a complex system. It is way too interconnected and interdependent to say that any one thing (likely any ten things) will be a sure fire way to weight loss. Too many extraneous factors confound any study and any anecdotal evidence, yet these are too often ignored.

    2: There is no set value that is good. Ideal calorie intake for any one person will vary on genetics, activity, diet, history, environment… I could rave on for pages. “100 grams is exactly ketogenic”. This is probably true for someone, but you cannot say that this is exactly the case for Tom. I would argue that the ketogenic effect of the Zone diet would have been minimised by his moderate carb restriction immediately before the diet, therefore the glycogen/water hypothesis, while a component of his weight loss, is not the entirety.

    3: Calorie restriction is in general, not great. Every doctor, nutritionist, dietician and personal trainer that I know or trust says that increasing exercise, choosing good food (unprocessed) and increasing metabolism are the key to healthy weight loss. This means eating enough for your body to not feel it is starving, exercising to burn fat and building muscle to increase your metabolic rate. The only people that seem to think calorie restriction is good seem to be non-professionals.

    People need to realise that everyone is different and only by considering ones own situation can one make a decision about the best diet. Hell, I’m on over 3000 calories a day at the moment, which would work for very few people, but it does for me.

    It seems we now have two relatively intelligent and informed people arguing semantics when they would probably agree on a number of points, mainly as outlined above.

    I’m pretty sure Matt and I would agree more often than not.

    As for the exact threshold of when a diet becomes ketogenic, even if it is 100 grams of carbs, that was only my average intake. There were days when I exceeded 120 or even 140 carbs (my food log is availabe in the links), so it’s unlikely I was in ketosis for 28 days.

  18. Dana

    That crack about second-hand smoke and lung cancer in nonsmokers rubbed me wrong. I don’t like the idea of being made to take a drug that I don’t want to take, which is what happens when someone smokes around me. And just because some study about the issue was flawed doesn’t mean the idea itself is. Think about it. A non-smoker gets the same smoke a smoker does if in the vicinity of one, and it is not filtered. It might take longer for lung cancer to kick in, but it could very well do so.

    We get lung disease from factory- and coal plant-polluted air, too. But the wind sometimes blows it away when you’re outside. There’s no wind in the house.

    Now for Matt. Wow. Sheesh.

    Atkins said that the ketogenic threshold was at 40 grams, not 100g. That’s why he set Induction at 20g. He wanted to make sure his dieters hit that threshold, and I’m sure he knew people fudge their carb counts (no pun intended), either because of natural variations in food or just because life happens. He did say that if you’re going to get a GTT while on his diet you should first up your carbs to 100g a day several days beforehand, otherwise you’d skew the results, but that doesn’t mean you’d achieve ketosis at 99g, necessarily. Maybe some very efficient glucose-burners would, I don’t know.

    What is this about eating protein raising your insulin? I know you can make glucose from protein via gluconeogenesis, but if your insulin is elevated you can’t do this. Insulin inhibits gluconeogenesis. Insulin also inhibits the release of fatty acids from adipose cells and the use of fatty acids and ketones for energy. If eating protein automatically causes insulin release then there’s no way in hell a low-carb diet would work to cause fat-burning, or it would not work consistently. I guess the big questions here are, Does protein cause an immediate insulin release? (Doubt it.) And, How quickly do insulin levels drop if the previous is true? (Irrelevant, I’d wager.) Too bad they don’t make home insulin test kits or we could verify this. I don’t have health insurance to go ask a doc to make me into a guinea pig, unfortunately.

    I hate calorie theory. Calorie theory assumes every bit of food you eat is either burned for energy or stored as fat. Or it looks that way, otherwise we wouldn’t be told to cut back on fat intake because fat’s nine calories a gram. Do these yo-yos really think we don’t use fat for anything else but the energy content? No wonder the SSRI and fertility drug makers are rollin’ in the dough now. By the way, high-fat/low-carb works just as well for my mental health as being on Lexapro, without the, ah, unpleasant side-effects.

    As for the idea that people get fat on fast food because it’s calorically dense, *bzzt* try again. What makes food easy to overeat isn’t its caloric content but whether it induces satiety. If I cut carbs way low and snack on things like cream cheese, I get full quickly. Cream cheese is calorically dense. Fried cheese, my low-carb chip substitute, is calorically dense. Steak is calorically dense. So is salad dressing. So are pork rinds. But eating these things in the absence of high carbs doesn’t put weight on me. Precisely the opposite. There are good biochemical reasons that eating fat + glycemic carbs causes more fat storage: you need both fat and sugar to make a triglyceride, which is the form in which fat is stored. Minus the sugar, you don’t have that central axis for forming the triglyceride and the fat just stays in fatty acid form for the most part and then gets burned for energy or used to make substances or tissues. Or excreted. I also found, for my part, that I have no problem with constipation on Atkins if I eat properly high-fat because fiber isn’t the only substance that keeps you regular. Go figure.

    I don’t like smoke either — when I was a road comedian, I’d leave a club with watery eyes and smelly clothes. But the research that supposedly linked second-hand smoke with lung cancer was agenda-driven and pretty awful. Here’s the stat that matters: non-smokers who live with a smoker have the same lung-cancer rate as non-smokers who don’t. I’m against bad science, whether it supports my goals or not.

    Satiety is the key, indeed. As Mike Eades pointed out in one of our interviews, he’s treated thousands of patients for obesity, and no one ever binges on steak or eggs. They feel too full, too fast.

  19. Matt

    @ Tom: Agreeing to disagree on the fat loss point would probably be best, as it’s clear we would likely agree on a host of other points, and we’re both quite cynical about anything the government dishes out regarding health and nutrition. I have not read Taubes’ book, I assume you’re talking about the “Big Fat Lie” one though, right?

    @ Dana: The accepted ketogenic threshold is at 100g carbs. Atkins says it’s 40g because it forces you into ketosis a lot faster and gets you used to the low-carb lifestyle, which admitted is a little difficult to adjust to after years of carb obsession. Generally speaking (i.e. for a 150 lb average build person) 100g is the ketogenic threshold.

    Protein as a macronutrient does raise insulin in the bloodstream because, as I said, insulin’s not just the super-evil hormone that makes you fat, it also plays an extremely important role in protein synthesis, breakdown, resynthesis, and placement in the muscles and organs. Does it raise it as much as pure carbohydrates? No, especially if you’re insulin resistant, which most of the crowd that this website seems to target (overweight individuals) probably is. It does raise insulin a measureable amount, and raises it even more when paired with fat in a meal.

    As for the satiety issue, you’re absolutely right; I misspoke. Fast food is both calorically dense AND unsatisfying, primarily due to its low protein content, since protein is the most expensive macronutrient. The higher protein that generally occurs with a low-carb diet (higher protein than the average high-carb diet) is what keeps people feeling fuller, combined with the high fat content, which delays the emptying of the stomach.

    Incidentally, the reason high fat/low carb works well for your anxiety (and for mine, when I don’t have time to exercise in order to manage it) is that a heavy influx of carbohydrates causes a large release of seratonin into the bloodstream, another reason that carbs can be so “addictive.” All SSRIs do are prevent the reuptake of that massive dose of seratonin, which tends to cause anxiety.

    “Big Fat Lie” was a long article Gary published in the New York Times (linked on this site). I was referring to his book “Good Calories, Bad Calories,” in which he examines 100 years of dietary science and explains how the low-fat recommendation took hold. (Hint: not because the science backed it up.)

    He even found some amazing research on insulin and fat metabolism conducted in Germany and Austria pre-WWII. Unfortunately, that research was completely ignored in the U.S. after the war — not a popular time to read German journals.

    Since you’re interested in the topic and obviously not averse to pounding through some long explanations of biochemistry, I’m pretty sure you’d enjoy it. I’d also like to know what you think of it.

    I agree that low-protein meals aren’t satisfying. Unfortunately, much of what people buy at the grocery store falls into the same category.

    If you check my food log, you’ll see that I kept my protein intake high. I learned my lesson during my vegetarian phase, when I could down a big plate of pasta and still be hungry soon after.

  20. Matt

    No, I haven’t read GCBC, but interestingly enough I almost purchased it about 6 months ago. I’m currently strapped for cash (university’s not cheap), but I’ll put it on my list of things to read this summer. It actually looked very interesting.

    It’s out in paperback now. Pretty sure you’ll find it a fascinating read.

    I remember those tight-budget university days. I ate a lot of mustard sandwhiches.

  21. Trekkiemaiden

    Sorry just to add this discussion 4 years later, it’s actually the fat not the protein that keeps you satisfied – the right sort of fats ie not vegetable oils! Even though I suspect they’ll do the job just as well, just not so healthy on your organs! Am eating a diet composed of 80-90% fat and have lost 4 pounds in 5 days. It’s called a fat fast, have been doing a LCHF diet for about 10 years but gained about a stone in pleasure eating when I met my new man. Then reached a plateau for about 6 weeks when I started back on the wagon again, so tried this for a short term re-start. Atkins himself designed it, it’s obviously not a healthy long term diet, as virtually no carb, but gets your stalled or highly resistant metabolism going. The thing is it’s only 1000-1500 a day, so portions are very very small as fat is high in calories, but.. and the big butt (getting smaller as we speak LOl) is that because it’s so high in fat you don’t feel hungry like you would on any other low cal diet!! It’s the high fat that keeps you satidfied and full feeling , and once youre in ketosis, you can virtually forget about food LOL. PS Don’t know where Matt got his 100 grams of carb = ketosis, as everyone has a different CCL (critical carb level) where you come out of ketosis and stabilise or start to gain. Sadly mine appears to be very low, even 40 grams a day and I start to gain boo hoo. Nowhere near 100.

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