Turning Wisdom About Weight Gain On Its Head
Tuesday, January 4, 2011
As the new year begins, those who indulged over the holidays may resolve to put down the cookies and pick up the dumb bells. What roles do exercise and genetics play in weight gain and obesity? What foods should we eat, and what foods should we avoid? We'll speak to science writer Gary Taubes who questions what's making us fat-and how we can change in his new book, "Why We Get Fat And What To Do About It."
After days of holiday candies, cakes, snacks and cocktails, you may be wearing your belts a little tighter this season. Or, maybe that extra weight has been creeping up on you for quite some time, and now you've resolved to get lean and fit in 2011. In either case, why we get fat and why it's so difficult to lose weight remain two of the thorniest questions for Americans. Our obesity rate continues to climb, despite a huge weight loss industry.
Gary Taubes is author of "Why We Get Fat And What To Do About It." He is a contributing correspondent for Science magazine, and his writing has also appeared in The Atlantic, The New York Times Magazine, and Esquire. He is currently a Robert Wood Johnson Foundation Investigator in Health Policy Research at the University of California, Berkeley School of Public Health.
MAUREEN CAVANAUGH: I'm Maureen Cavanaugh, and you're listening to These Days on KPBS. After days of holiday candies, cakes, snacks and cocktails, you may be wearing your belts a little tighter this new year, or maybe that extra weight has been creeping up on you for quite some time, and now you've resolved to get lean and fit in 2011. In either case, why we get fat, and why it's so difficult to lose weight remain two of the thorniest questions for Americans of our obesity rate continues to climb despite a huge weight loss industry. My next guest says the answer to reliable weight loss is not a mystery. He claims it's not how much we eat but what we eat that holds the key. I'd like to welcome Gary Taubes. He is a contributing correspondent for Science Magazine, he is currently a Robert Woods Johnson foundation investigator and health policy researcher at the university of California Berkeley school of public health. And he's the author of the new book, why we get fat and what to do about it. Gary, welcome to These Days.
TAUBES: Thank you for having me, Maureen.
MAUREEN CAVANAUGH: And we would like to invite our listeners to join the conversation. Are you going on a weight loss regime to start the new year? What will you be doing to lose weight? Call us with your questions and your comments, 1-888-895-5727. That's 1-888-895-KPBS. You know, Gary, we hear a lot about, you know, this being our weight loss -- our weight gain problem or our obesity problem in this country being very contemporary or a very current kind of dilemma we find ourselves in. . But your book begins with observations by a German pediatrician just arrived in New York in the 1930s shocked to see how fat the children are. Now, why did you decide to start the story there?
TAUBES: Well, you know, this is the conventional wisdom is the reason there's an obesity epidemic is we have this huge food industry that's just pupping -- and the huge fast food industry that makes it all too easy for us to eat there's highly palatable foods and they're cheap, and we never have to work for it. So this was interesting because it's 1934, it's the height of the depression. Either four out of ten Americans were out of working there were soup lines, soup kitchens in New York feeding the poor, and here this young German pediatrician comes to New York and looks around in the streets and is stunned at how fat the children are. And actually starts a pediatric obesity clinic at Columbia University and becomes the leading expert in the United States on pediatric obesity. And you know, in part, what I was trying to do with this is I want experts to read this book, I want physicians to read it so they actually understand why we get fat and what to do about it. I want public health authorities to read it. And I'm trying, you know, we just were so engrained in the way we think.
MAUREEN CAVANAUGH: Right.
TAUBES: It's fast food. And there was no fast food in 1934. There was no McDonald's or Kentucky fried chicken or super sized drinks at 711.
MAUREEN CAVANAUGH: And there were no video games and nobody chauffeuring kids around from school to what they do after school. So I guess it doesn't have much to do with the amount of activity either.
TAUBES: Exactly, exactly. And that's what, you know, our conventional, our paradigm as a scientist would say about how we think about obesity. If you ask an obesity researcher or physician, that's the problem and they'll say, well, people take in more calories than they extend. So they eat too much and they're too sedentary. And that's why the way to treat it is to either get people to eat less or exercise more. And what I point out in this new book, and a spend a third of or a half of the book doing it is that this is nonsense. And you know, it was actually known to be nonsense prior to the second world war, again, when all meaningful medical research was done in Europe. The Germans and Austrians had a different theory of obesity, and they said, you know, fat accumulation is regulated by hormones and enzymes. And we know this because, you know, men and women fatten differently. So that tells you right this that sex hormones are involved in the accumulation and mobilization of fat. And boys and girls when they go through puberty, for instance, boys will go into puberty with about the same amount of fat, and boys will lose fat and put on muscle, and girls will gain fat and breasts and hips of and both of them have to over eat because they both get bigger. So both the boys and the girls have to take in more calories than they extend. And yet the boys put on muscle and the girls put on fat. And where they put on fat is very specific 678 soap it's obviously controlled by all these intricate hormones and enzyme systems just like everything else in the human body is.
MAUREEN CAVANAUGH: I'm speaking with Gary Taubes, he's the author of the new book, why we get fat, and what to do about it. . The number is 1-888-895-5727 if you'd like to join the conversation. So many thereof, what did he's weight loss researchers, these scientists in Europe before world war two and now recommend for people who actually want to lose fat?
TAUBES: Well, at the time, they didn't actually know what to do because they didn't know precisely what regulated fat accumulation. And the European school vanishes with the second world war, and after the war, they're more concerned about famine in Europe than obesity. And it's not until the late 1950s that the researchers needed to discover -- they needed to have two technologies before they could discover what regulates fat tissue in effect. And one was invented in 1956, and the other came in 1959. Of and by 1952, it's perfectly clear and noncontroversial that the hormone insulin controls the accumulation of fat in the human body. So you raise insulin, you increase human fat accumulation, and you lower insulin and you decrease fat accumulation, in fact, the first thing that you have to do to lower -- to get the fat out of fat tissues is to lower insulin levels. And the point is, insulin is fundamental regulated by the carbohydrate can at the point of our diet. So easily digestible refined carbohydrates and sugars raise insulin levels, and so it then causes the accumulation of fat in fat tissue and makes us fatter. And this was clear in the 1960s. And what was interesting, going back to your question, if you look, which I did -- you know, if you checked into a hospital and you were obese, and you know, the first two thirds of the 20th century, the diets for obesity, the first thick they got rid of were sugars and starches of soap no potatoes, no bread, no past, no rice. And the conventional wisdom in the public was that the carbohydrate rich foods make you fat. One of the German articles I quote in 1963 British Journal of Nutrition article, written by one of the two leading British dietitians, and the first sentence is every woman knows that carbohydrates make you fat.
MAUREEN CAVANAUGH: Ah, ha. Back then. Okay, so now we hear, we're hearing what you're saying with the low carb diet. And of course the specter of doctor Robert Atkins comes into the picture, and the fact that he promoted a diet, among others, of course, much like this in the second half of the 20th century. And basically was roundly vilified by the powers that be when it comes to health and nutrition.
TAUBES: Well, and so this is what happened. And also the other thing that's happening in the 1960s is we are beginning to believe incorrectly as it turns out that dietary fat causes heart disease. And because of this -- the experts aside dieting -- you know, if you're gonna be touting the low fat diets, what you're telling them to do is to eat high carbohydrate diets of that's why the base of the food guide pyramid is, pasta, potatoes, bread, rice, starches, all those exact same foods that used to be perceived as uniquely fattening. So Atkins and others read the same literature that I read, they read it 40 or 50 years earlier than I did, they said, hey, insulin makes you fat, carbohydrates drive insulin levels, so what happens if we remove the carbs from the diet. So now you're eating a high fat diet.
CAVANAUGH: Right. Exactly.
TAUBES: And their patients lost weight effortlessly. So they write diet books about it, and Atkins was the most successful and the most, sort of, outraged at how bad the science was in the community. So he writes this book, he's touting how you can eat bacon cheese burgers and Lobster Newburg to your heart's content and the medical community responds by trying to destroy his credibility.
MAUREEN CAVANAUGH: Right. And doing so to a large extent.
TAUBES: And they did to a large extent of and they equated this diet with quackery, and in order to equate the diet with quackery, they had to throw out the science underlying the diet. So one thing, it's funny, I lecture a lot in medical schools and obesity research centers, I'm constantly saying when you tell people that they get fat by overeating, you're ignoring the hormonal and enzymatic regulation of fat tissue. So the fat tissue has absolutely nothing to say in the matter. And again, if you look at the way these Europeans saw it prior to the second world war, they said obesity is primarily a disorder of excess fat accumulation. The only thing you want to know is how fat tissue is regulated. So in the 1970s, these leading experts in obesity which happened to be six, precisely six, seven, you know, men who knew virtually nothing about it, decided that in order to get rid of, sort of the Atkins' diet, which was the bath water, they had to get rid of the baby too, which was the science underlying fat accumulation.
MAUREEN CAVANAUGH: I'm speaking with author Gary Taubes, he is the author of why we get fat and what to do about it. We're taking your calls at 1-888-895-5727. And how here we are now after doctor Atkins wrote his first book about all this, and you're still with your new book, you're still coming up against some push back about this low carb idea.
TAUBES: Well, what's happened after since, you know, again, the message of science is that carbohydrates literally make you fat. And the metaphor I use several times in the new book is that just as surely as cigarettes give you lung cancer, carbohydrates make you fat. And the cure then is if you don't want to get lung cancer when you go into the doctor, and you're a smoker, the doctor says don't smoke. He doesn't care how much you love cigarettes or how addicted you are, or how hard it will be to quit, or how much less rewarding your life might seem without cigarettes. He just tells you to quit. And I'm trying to get the same with the science, the biochemistry and physiology of fat accumulation target carbohydrates as the cause. Then you have this hundred and 50 years of anecdotal, sort of conventional wisdom supporting it, as well as an obesity epidemic that started when we started to tell everyone to eat high carb diets. But the medical community still insists -- you know, they believe Atkins is quackery, and physicians will come up to me after these talks I've given, and they'll say, you know, I agree with everything you say, and I've read your books, but of course I would never prescribe the Atkins diet. But the Atkins diet is just a diet in which the fattening carbohydrates are removed. And in fact the point I make in the book is any diet can be improved, the idea is we get fat not because of the calories we consume or extend but because certain foods have an effect on the hormone insulin, which then disregulates our fat tissue so we accumulate too much fat. And those foods are carb hydrate rich foods.
MAUREEN CAVANAUGH: A lot of people might though, Gary, if eating a low carb diet is good for us in the sense that it will make us lose weight, and all around be healthier in that sense. Why is it so hard? If it's the kind of thing our body is looking for and wants, why is it so difficult to stay on a regimen like that?
TAUBES: Well, again, think about it, it's virtually impossible for cigarette -- not virtually impossible, but it's excruciatingly difficult for cigarette smokers to quit smoking. Before benefit so I understand the cravings, you upon, very years you miss the cigarettes and you are in danger of falling off the wagon. You know, again when I used to live in New York, I could be standing on the street next to a smoker and I could bum a cigarette before I even thought about it. Now you think about giving up carbs and you're living in this carb rich environments if you quit smoking your friends will actively try not to smoke around you. You know, they'll say, I don't want to invite Gary to this party at this bar because we're all gonna be smoking and we want to support his efforts. When you quit carbs, nobody does that. In fact you go to dinner and they push dessert on you, and you when you say you don't want to eat dessert because you're trying to stay away from these foods, they pooh-pooh you as being, you know, I don't know what. Somebody who's just no fun at all and doesn't understand how to live life in moderation like they do.
MAUREEN CAVANAUGH: Gary, it's easier in Southern California. Everybody has a crazy diet of one kind or another.
TAUBES: You know, I used to say it was easier when I quit smoking when I lived in LA, when I wanted to bum one, I had to honk my horn and ask somebody to roll down the window.
MAUREEN CAVANAUGH: We're taking your calls at 1-888-895-5727. And Nabil is calling us from San Diego. I hope I'm pronouncing that correctly. Good morning.
NEW SPEAKER: Good morning, thank you for taking my call. I'm a first year medical student at Wayne State University in Detroit, but I'm a San Diego native, and my question is concerning metabolism and nutrition. The reason I'm asking is that as a med student I'm appalled by the fact that the medical schools at my medical school, we have one month only that they teach us about nutrition, and then that's it for the rest of the medical school. So it doesn't really seem like most doctors that I talk to really have any clue about nutrition, which is something that the doctor was echoing. But my question is what role the doctor feels metabolism plays in people either gaining or losing weight, for example, I've noticed that a lot of obese people, they seem to eat, like you said, something in carbohydrate like rice or bread or something, and they gain weight very quickly, versus myself who's always been very thin, and I feel like my metabolism is very high, I can eat anything and I don't gain weight off of food unless I need an enormous amount.
MAUREEN CAVANAUGH: Thank you very much for that, and let's get a response to that. And first of all, you're a science writer, Gary, not a doctor.
TAUBES: That's what I was gonna say. Three points first to correct is I'm a journalist and not a doctor, and I don't profess to be. The second thing about teaching nutrition in med school, I agree a hundred percent. Although I also say, since the argument I'm making is that if the nutritionists have got it wrong, then the physicians will be even more dogmatic about the wrong answers than they are already. And then the issue of metabolism is interesting, the point I'm making in this book, when people think in terms of metabolism, like some people have a slow metabolism so they don't burn off enough energy, and that's why they get fat, and others like this young med student have a fast metabolism, so they do burns off the calorie it is. But again, that's thinking of the energy being extended and consumed as being the driving force. The people with the slow metabolism, the people who gain weight easier are predisposed to store the calories from carbohydrates that they consume. So they're more sensitive to insulin, their fat tissue is nor sensitive to insulin, and when they eat the carbohydrate rich diets, they go into storage mode. And because they're storing all these calories, they have less calories to extend so their metabolism runs slower.
MAUREEN CAVANAUGH: I see, I see.
TAUBES: So the slow metabolism is the effect. The storage of calories as fat is the cause. And for someone -- and I talk about this in the book, for someone like this young med student who can't gain weight. That's because her fat tissue doesn't want to accumulate fat. He body is regulated to burn the calories the expends.
MAUREEN CAVANAUGH: I'm sorry, did you want to finish your point.
TAUBES: No, I mean, that pretty much covered it.
MAUREEN CAVANAUGH: Fran is calling from San Diego. Fran, welcome to These Days.
NEW SPEAKER: Hi, good morning, thanks for taking my call. I'm in my mid 50s and I consistently just continue to gain about five pounds a year. And the only way I've been able to lose weight is on a high protein diet, low carb diet. But I'd like to know what does Gary -- how does he explain the difference in the Asian cuisine where they eat a lot of rice, and they're all thin all the time. You don't see fat Asians. How do you explain that?
MAUREEN CAVANAUGH: Thank you, Fran.
TAUBES: Yeah, that's a typical question. I mean issue I've been getting that question. And I've asked them myself, the experts over the years. The key is, first of all, the Asians issue they didn't -- we're talking about the key variable here is how quickly we digest these carbohydrates and how sweet they are, which to speak to the contest of a particular carb called fructose. So the more refined a carbohydrate is, like white rice, we digest quicker than brown rice because brown rice still has the fiber and the shell, the carbs are bound up in such a way that they take longer to digest. So far the first thing is the Asians didn't eat in Asian they didn't eat refined, you know the ones who are eating really high carb diets weren't eating white rice, they weren't eating highly refined wheat. So they're -- you know the way the nutritionists would say, the carbs they were eating had a lower glycemic index, it wasn't digested as quickly, and that resulted in a more measured insulin response. The other key factor is they eat virtually no sugar. So the Japanese, the Chinese, the Koreans, the Vietnamese, the way it's talked about often is these people don't have a sweet tooth. But their sugar consumption was tiny compared to ours, until, of course, coke is Pepsi moved to Asia. And then it starts go you go upon and you start seeing obesity epidemics in these countries. And when the Asians come here, they get heavier and fatter, they get taller also, and they start getting the diseases that tend to associate with excess fat accumulate. Including their heart disease rates go up, their diabetes rates go up, their breast cancer rates go up. And the argument I'm making is that it's all due to both the, you know, the refinement of the carbohydrates here, but probably even more personal the sugar, by which I mean sugar and high fructose corn syrup.
MAUREEN CAVANAUGH: Now, Gary in your book, why we get fat, you make a point that there's a certain amount of urgency in understanding nutrition and what makes us fat. Why do you see that urgency?
TAUBES: Well, obesity rates have gone up about two and a half fold since the early '70s, diabetes diagnoses in American have tripled, we see what used to adult onset diabetes is common in children, and all of this is going to over whelm the healthcare system, and we talk about healthcare reform, you know, one of the reasons we need healthcare reform is all these negative sequelae that go along with obesity and diabetes, including increased heart disease, cancer, gout, you name it. And something has to be done. And meanwhile, our medical establishment is hooked on the idea that it's all about eating too much and not exercising. And the fact that they've been telling us to eat less and exercise more for 40 years, and obesity and diabetes rates have gone up and up, you know, doesn't deter them in the least from convincing themselves that their advice is right, their understanding is right, but lo and behold, we're just not listening to them.
MAUREEN CAVANAUGH: I'd like to get your take on the popularity of bariatric surgeries for people who are morbidly obese. What do you think about that?
TAUBES: Well, I mean, I think it's kind of tragic that we've gotten to the place where surgically rearranging and shortening a patient's gastrointestinal tract is considered an appropriate measure to deal with obesity, but putting them on a diet that simply removes the cause of their obesity and helping them to stay on that diet is not. And so, you know, again, the Atkins diet, an obese person goes into their doctor, they think the Atkins diet is quackery and will kill these people, but they say, hey, since you can't stay on another diet, and the other diets don't work because they're not addressing the fundamental causes, therefore we're just gonna rearrange your gastrointestinal tract. And the interesting thing is, when you do the barrio met Rick surgery, one of the fundamental effects it has is to drastically reduce the amount of carbohydrates these patients can eat. And often patients aren't allowed to get the surgery until they have gone through these psychological tests that have convinced the physician that after the surgery, they'll stay away from things like fruit juices and sodas that would deter partially the cause.
MAUREEN CAVANAUGH: We're almost out of time, Gary. But I'm just wondering that this low carb -- do you expect it to gain any credence.
TAUBES: Well, I hope so. I wrote the books to make my arms more easily readable to the lay public but also to get doctors and public health authorities and obesity researchers to understand that there's been this sort of, you know, gross miscarriage of science that's gone on. And you know, we'll see what happens. I mean, it's -- it's not easy to convince, for a journalist to convince an entire medical research establishment that they're wrong and he's right.
MAUREEN CAVANAUGH: Well, I tell you, if everyone wants to check out the thesis, let me tell them once again, the book is called why we get fat and what to do about it, and the author is Gary Taubes, and I want to thank you so much for speaking with us today.
TAUBES: Well, thank you for having me again, Maureen.
MAUREEN CAVANAUGH: If you would like to comment, please go on-line, it's KPBS.org/These Days. Coming up, finding heaven in the midst of hell in Iraq of that's as These Days continues here on KPBS.
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