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I’ve finally finished reading Gary Taubes’ Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health. Quite the read.  Worthy of a slow, considered reading.

Taubes, a journalist with a penchant for writing about public health, nutrition, and diet, spent five years researching the book.  It is an exhaustive look at disparate research across time and disciplines and it is a highly useful and sane synthesis of the same.

If you want to understand the research on which our ‘best dietary’ recommendations, those which are touted as in the best interests of public health, are based, read Taubes. If you are about nutrition, weight loss counseling, or dietary health, Good Calories Bad Calories best be on your reading list.

In the Epilogue of the book, Taubes states

As I emerge from this research…certain conclusions seem inescapable to me, based on the existing knowledge.

These conclusions he lists as:

  1. Dietary fat, whether saturated or not, is not the cause of obesity, heart disease, or any other chronic disease of civilization.
  2. The problem in the carbohydrates in the diet, their effect on insulin secretion, and thus the hormonal regulation of homeostasis — the entire harmonic ensemble of the human body.  The more easily digestible and refined the carbohydrates, the greater the effect on our health, weight, and well-being.
  3. Sugars — sucrose and high-fructose corn syrup specifically — are particularly harmful, probably because the combination of fructose and glucose simultaneously elevates insulin levels while overloading the liver with carbohydrates.
  4. Through their direct effect on insulin and blood sugar, refined carbohydrates, starches, and sugars are the dietary cause of coronary heart disease and diabetes.  They are the most likely dietary causes of cancer, Alzheimer’s disease, and the other chronic diseases of civilization.
  5. Obesity is a disorder of excess fat accumulation, not overeating, and not sedentary behavior.
  6. Consuming excess calories does not cause us to grow fatter, any more than it causes a child to grow taller.  Expending more energy than we consume does not lead to long-term weight loss; it leads to hunger.
  7. Fattening and obesity are caused by an imbalance — a disequilibrium — in the hormonal regulation of adipose tissue and fat metabolism.  Fat synthesis and storage exceed the mobilization of fat from the adipose tissue and its subsequent oxidation.  We become leaner when the hormonal regulation of the fat tissue reverses this balance.
  8. Insulin is the primary regulator of fat storage.  When insulin levels are elevated — either chronically or after a meal — we accumulate fat in our fat tissue.  When insulin levels fall, we release fat from our fat tissue and use it for fuel.
  9. By stimulating insulin secretion, carbohydrates make us fat and ultimately cause obesity.  The fewer carbohydrates we consume, the leaner we will be.
  10. By driving fat accumulation, carbohydrates also increase hunger and decrease the amount of energy we expend in metabolism and physical activity.

Normally a voracious reader, I have been slow creeping through books of late.  My work schedule is delightfully hectic and wonderfully demanding these days, providing me with long days and end-of-day sleeps which arrive fast and fierce.  Take for example last Sunday evening.  I was physically exhausted by early evening and thought an early curl in bed, deep under my old comforter, with my book (and 3 ounces of white wine) would give me great joy.  So at 7:30 I snuggled in, book at bedside; and that is precisely where it remained as I fell into an immediate rabbit hole of snooze oblivion.

I’ve been reading Good Calories, Bad Calories: Fats, Carbs and the Controversial Science of Diet and Health;  researched over a 7 year period, well documented and written by journalist Gary Taubes.  It is the type of book which I really enjoy reading and I appreciate the comprehensive review of the diet/nutrition/health literature which Taubes summarizes in the book with a critical eye to research which never made it into the mainstream knowledge base of the industry let alone the culture.

There are many good things in this book.  I just wanted to quote a section for today, one which in a small, perhaps tangential way reflects some of what I frequently wonder about this industry in which I am immersed.

How does my work fit or not fit in to the larger picture of health and wellbeing in our society?  Am I part of the solution or part of the problem? Do I contribute, in a sensible way, to a move toward improved quality of life or am I just one of many trickles which make up the deluge surrounding, and maybe integral to, declining health measures?  Do I feed an obsession with body image, calorie counting, weight loss/management and self esteem?  Do I provide a service which further fragments and compartmentalizes bits of our wholeness?  These are tough questions for me and I crave resolution of them, though I fear the same.

Why do we need a ‘fitness industry’ or a ‘diet industry’ or a ‘self esteem industry’? Can they only exist if somehow we contribute to their very perpetuation?  Why do we entertain proposals like Jamie Oliver‘s wish to use institutions (schools, governments, etc) to teach our children to recognize vegetables or learn to cook?  Why do I conduct workplace wellness presentations suggesting the workplace as an important setting for supporting physical activity?  Why do some believe a ‘sugar tax’  to be a viable means of shifting eating patterns?

I entertain a gnawing sensation that somehow I — we — are missing something.  I haven’t figured it out for myself, but I do spend regular time pondering what I believe to be a paradox, a misdirect, or perhaps a disconnect between a healthy world and the industries which have cropped up in response to our diminishing health.

So, now that I’ve yammered on about not much of anything, I’ll pass along a brief passage from Taubes’ chapter 14 ‘ The Mythology of Obesity.’ With respect to obesity and physcial activity, added emphasis mine:

Population-wide assessments of physical activity are also difficult to make in any meaningful way.  Those research agencies that traditionally study such things…have no evidence that would shed light on physical activity during the decade in which the obesity epidemic began.  They do have evidence suggesting that Americans were no less active at the end of the 199os than they were at the beginning of that decade, despite the continued rise in weight and obesity throughout this period.  We know, too, that the obesity epidemic coincided with what might be called an exercise or sports epidemic in America, accompanied by the explosion of an entire industry dedicated to leisure-time pursuits.  It’s worth remembering that in the 1960s Jack La Lanne was the nation’s only physical-fitness guru, Gatorade existed solely for the use of University of Florida football players, and skateboarding, in-line skating, snowboarding, mountain biking, power yoga, spinning, aerobics, and a host of other now relatively common physical activities had yet to be invented. To put this in numberical terms, this was an erea when the revenues of the health-club industry were estimated at $200 million per year; in 2005, revenues were $16 billion, and nearly forty million Americans belonged to such clubs.

Press reports also support this version of history.  By 1977, the New York Times was discussing the “exercise explosion” that had come about because the conventional wisdom of the 1960s that exercise was “bad for you” had been transformed into the “new conventional wisdom — that strenuous exercise is good for you.”  When the Washington Post estimated in 1980 that a hundred million Americans were now partaking in the “new fitness revolution,” it also noted that most of them “would have been derided as ‘health nuts’ ” only a decade earlier. “What we are seeing,” the Post suggested, “is one of the late twentieth century’s major sociological events.”

Another apparent contradiction of the notion that either sedentary behavior or prosperity or a toxic food environment is the cause of obesity is that obesity has always been most prevalent among the poorest and thus, presumably, harder-working members of society.  In developed nations, the poorer people are, the heavier they’re likely to be…In 1965, Albert Stunkard and his colleagues at New York Hospital reported that they had surveryed 1,660 New Yorkers and found that obese women were six times more common at the lowest socioeconomic level that at the highest.  Thirty percent of the poorest women were obese, compared with 16 percent of those of “middle status” and only 5 percent of the richest.  The poor men were twice as likely to be obese as the rich (32 percent to 16 percent).  These observations have been confirmed repeatedly throughout the world, in both children and adults.  Because poor and immigrant populations are considerably less likely than wealthier, more established populations to own labor-saving devices, and because they are more likely to work in physically demanding occupations, that poverty is a risk factor for obesity is another compelling reason to question the notion that sedentary behavior is a cause.

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