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In Dieting, Magic Isn’t a Substitute for Science (nytimes.com)
41 points by vellum on July 14, 2012 | hide | past | favorite | 68 comments



Oh come on

Yes, a calorie is a calorie (as long as dietary: macro/micro nutrients needs are supplied), still there may be advantages to the diet, as it is pointed in the article

"They report that people on the Atkins diet were burning off more calories. Ergo, the diet is a good thing." (it's not necessarily all good especially if you think low-carb diet==eating bacon at will, still)

Also, there may be other advantages, like hunger sensation in different diets.

Dieting is calorie balancing but there are several other aspects that should be considering and dismissing 'low-carb' diets because you're only focusing on the calorie balancing is naive.


"Ergo, the diet is a good thing" is what the proposers of that diet say. On the contrary, Dr. Hirsch says that "when carbohydrate levels are low in a diet and fat content is high, people lose water. That can confuse attempts to measure energy output" ergo, the measurements were mistaken and there is not advantage from a low-carbs diet (as proved from Dr. Hirschs's experiments in a controlled environment).


I think the snarky response would be that "in dieting unproven criticism of published scientific studies is no substitute for research."

I think it's fine to come up with such criticism as long as it leads to looking at and questioning the result and defining further studies, but......

One of my hobbies is history and archaeology. It's what I studied mostly in college (computing was just a hobby). One of the fascinating things is that diets where the primary calories come from carbs is associated in the archaeological record with both more dental problems (due to changes in the bacterial flora of the mouth) and shorter life expectancy than are lower carb diets.

So a diet where your main sources of calories are essentially a curdled milk, and dried fish with butter, and where your primary source of carbs (and use of grain) is from beer has a longer life expectancy, and a much lower dental problem rate than a diet where grains and breads are the primary source of calories.

One of the interesting things you can watch in the Scandinavian archaeological record is that during the conversion, grain production went up, life expectancy went down,and dental caries became far more common. Moreover the spread is sufficiently high that it cannot be accounted for by infant mortality. Average life expectancy at birth in the Viking Age (according to Else Roesdahl) was approx 45, though this probably did not include infanticides which poses some selection problem. But in France at the same time it was 20. Moreover the average life expectancy at age 20 in France at the time was only 35.

This doesn't mean that there weren't other factors involved such as changing standards of hygiene, or population changes that might not have had some impact. However I don't think one can say that diet had nothing to do with it.


Has anyone researched this and documented a correlation? I'm doubtful of your claims, and given your opening line, it's ironic that you go on to compare observations from your hobby against statements made by a doctor with 60 years of research behind him. His criticism is not unproven, there's no substantiation for that claim at all.

But you also make an interesting observation, if it has a basis in fact. It would seem to contradict the research of the Okinawan diet, which is almost exclusively plant-based, and 85% of calories are carb-derived.


Actually, a huge amount of archaeological research goes into trying to determine how we can tell what people ate from their bones, teeth, etc. The amount of information that can be gathered is pretty substantial. For example:

1) Tooth decay rates are still the largest indications of eating a carb-based diet. These are often also used as markers for cereal agriculture, naturally enough.

2) Societies that consume excessive quantities of milk develop bone abnormalities associated with anemia, because cow's milk interferes with absorbtion of iron.

3) Societies that consume lots of fish have bones that show up as a few centuries older when run through carbon dates. This is true both for consumption of salt-water and fresh-water fish.

The doctor is right about some things. A calorie is a calorie when you are looking at weight loss. A calorie in or out s a calorie in or out. But a lot of things impact how much energy we burn, and when we are hungry and these range from when and how long we sleep[1] to what we eat.[2]

Overly simplistic/reductionist approaches don't work.[3] Chemistry is not applied quantum physics even though our understanding of chemistry is informed by quantum physics. If you are trying to help people diet, arguing that calories are what you directly control rather than the end-game is just a recipe for misery.

[1] http://www.medscape.org/viewarticle/502825

[2] For example, the effects of what we eat on insulin production are well understood, but also there are effects of insulin production on appetite that are getting more attention now. See http://www.ncbi.nlm.nih.gov/pubmed/16933179 for example.

[3] http://www.sciencemag.org/content/177/4047/393.full.pdf or if you don't want to pay, read it at http://www.meso2012.com/pdfs/AndersonScience177,393,72.pdf


""when carbohydrate levels are low in a diet and fat content is high, people lose water"

This is not a bad thing, but it is a thing that has to be compensated.

And there is loss of water in all weight loss diets.

"the measurements were mistaken and there is not advantage from a low-carbs diet"

There is not an advantage from the calorie balancing point but there are several other aspects that are important in diets


He isn't saying that losing water is a bad thing, he says that how you lose it could explain the measured increased levels of calories burned from this new study, even if his own evidence says that you don't lose more weight from a hig fat diet.

"There is not an advantage from the calorie balancing point": what he says is that there are no advantages from a weight loss point, as the calories balance IS what creates long-term weight loss (according to him).


"what he says is that there are no advantages from a weight loss point"

A diet is much more than counting calories. It's about managing to maintain a set amount of food for your objective.

Here's an experiment you can do. Replace all your food (lunch/dinner) with chicken fillets (for the daily need of protein), top up calories with sweet potatoes and olive oil for fat needs.

See how long you can keep up with this diet. This is a nutritionally sound diet (except for micronutrients), and if you calculate your daily needs you will maintain your weight (or you can adjust for weight loss or gain)

But a regular person will probably lose weight because (s)he will get sick of it fast and eat less!

The calories matter, but two things can have an equal number of calories and one may make people feel hungry after 1h and the other may make people feel full for the whole day. Guess who's more likely to lose weight?!


He says that he can explain away the difference in calorie burning as an effect of the measuring method later in the article.


One thing is calorie burning (metabolism) and the other is weight loss (weight measurement), I don't think he would mix up the two naively


I seriously don't know how you come to that conclusion when the gist of the whole article is that there is no difference between a fat calorie and a carbonhydrate calorie.

He says the same amount of calories are burnt. Only the relation to lean body mass (because of less water) is higher. But notice that it is just an educated guess by him, as he criticizes another study.


I eat bacon at will and am steadily losing weight. Paleo, which is similar to Atkins in that you much reduce grains (as well as sugars), plus light exercise is working great for me because I am human.


Yes

But you won't lose weight (meaning fat or muscle) unless there is a caloric deficit. Period

What happens is that high-protein diet changes the fullness sensation/hunger, so that's why it shows results and is easier to keep.

Of course: less grains == less fiber meaning "you may have a hard time"


Counting calories can not be a long term solution for obesity. A workable solution must be based on easier to implement facts such as the more sweets one eats, the more one craves sweets. I would recommend the No S Diet: www.nosdiet.com "I would have them eat a lower-calorie diet. They should eat whatever they normally eat, but eat less. You must carefully measure this. Eat as little as you can get away with, and try to exercise more." -Dr. Jules Hirsch. This is incredibly poor advice, based in physics, and ignoring psychology.


What these ridiculous study cherry picking groups overlook is the satiating effects of high protein consumption. An attempt at a high protein body building diet ended with me losing 10kg of fat.

Eat lot's of protein and your appetite just dies, fat/carbs a lot of the time make no difference. It's just easy on the high fat diet to avoid high glycemic response carbs and fructose.

Plus palatability, sugar makes you over eat. Plain and simple, High levels of protein cause one to undereat. Take your pick.


Definitely. I, personally, can eat half a box of pasta and be extremely hungry again in a few hours. If I eat a bowl of lentils, I sometimes have difficulty finishing it.


This is taking dieting completely out of context. It's akin to saying that 1 gallon of fuel will result in the same amount of distance driven no matter how you drive.

There are advantages to cutting out high GI carbs, since they lead to a spike in insulin which results in food cravings, tiredness and hunger. Switch the sugary cereal for the oats in the morning and you'll experience this first hand.


Citation needed.


Just look up the affects of insulin, or why a low GI diet is good. Here you go: http://health.ninemsn.com.au/dietandnutrition/nutrition/6938...


The human body is the most complex piece of machinery in the history of the known universe, and is highly variable from one person to the next, with all sorts of evolutionary cruft and random aberrations.

I understand we all need actionable information to maximize our odds at life, but any attempt at science journalism that doesn't start from that premise and instead tries to tell you "X good, Y bad" can probably be ignored, or at least taken with a grain of salt.


This particular article doesn't try to tell you "X good, Y bad", it's saying eat less, exercise more, or more specifically, if you want weight loss, as long as your diet leads to a caloric deficit, it doesn't matter _what_ you eat.


I should have been broader: I'm saying a simple narrative can't possibly tell the whole story of such complex chemical processes, whether it fits that particular snoclone or not, which includes "a calorie is a calorie". It's a leaky abstraction.


Surely on that argument, the body of almost any animal that is bigger than us is actually a more complex piece of machinery. Blue whales are massive, for instance and are made of far more cells than we are.


Well, not necessarily. The key factors are heterogeneity and complexity rather than size.

E.g., the difference between a stick of RAM (relatively homogeneous and simple) vs a CPU (highly diverse).

In fact, when it comes to brains, larger cetaceans seem to have simpler structures when compared to human brains, even though they're larger in absolute terms.


It's not about size. Human brains produce consciousness. Can't argue with that.


a. How do you know that other brains don't.

b. How do you know that consciousness is primarily a function of complexity.

c. Complexity need not give recognisable output.

d. The weather.


Since this is Hacker News, no discussion of diets can be complete without a reference to The Hacker's Diet <https://www.fourmilab.ch/hackdiet/>. Especially in this context, since it's basically calorie restriction designed to appeal to an engineer.

Personally, I lost 50 pounds using this approach, and my diet consisted mainly of Hot Pockets, microwaved White Castle cheeseburgers, and frozen pizza. Because they print the number of calories on the back of the box, it made it easier to control calories in. I didn't exercise and as a programmer spent most of my day sitting in a chair. Yet it was relatively straightforward to lose weight by simply eating less, with no particular regard to the composition of what was eaten.

My personal opinion is that all diets "work". Regardless of the magic or science involved, people on diets who have actually adopted the "I'm seriously trying to lose weight" mindset will eat fewer calories. Especially when it starts working: The Hacker's Diet involves a daily weight log and some math to extract the trend line from the noise. Now that we have WiFi scales and fit-tracking web sites, it's very easy to monitor the effect of cutting out soda, skipping dessert, and not having seconds at the dragon buffet.

Our brains are wired to make connections, and to some extent, to evangelize. So if you lose weight on the Tofu Diet, you're likely to go around telling everyone about the miracle benefits of tofu. Much like I'm convinced a simple calories-in/calories-out approach is all you need.



Though as he says, not to lose weight.


Dr Hirsch seems to be rather oversimplifying, to me. I'm not an expert, but what about -

1) Psychological factors and satiation? 2) Calorific uptake and excretion? 3) The mechanisms by which the body converts excess energy to fat, why and when they're triggered?


He does address those things, but he notes that when losing weight, calornies in < calories out is the primary factor for any weight loss diet. For maintenance diets, 1, 2, and 3 matter, because the types of calories play a role in metabolism, dietary function, and overall health.


#classic #Ornish diet / #lifestyle #Radical Change

Change or Die /

"All leadership comes down to this: changing people's behavior. Why is that so damn hard? Science offers some surprising new answers -- and ways to do better."

BY ALAN DEUTSCHMAN | MAY 1, 2005

http://www.fastcompany.com/magazine/94/open_change-or-die.ht...


"Reframing alone isn't enough, of course. That's where Dr. Ornish's other astonishing insight comes in. Paradoxically, he found that radical, sweeping, comprehensive changes are often easier for people than small, incremental ones. For example, he says that people who make moderate changes in their diets get the worst of both worlds: They feel deprived and hungry because they aren't eating everything they want, but they aren't making big enough changes to quickly see an improvement in how they feel, or in measurements such as weight, blood pressure, and cholesterol. But the heart patients who went on Ornish's tough, radical program saw quick, dramatic results, reporting a 91% decrease in frequency of chest pain in the first month. "These rapid improvements are a powerful motivator," he says. "When people who have had so much chest pain that they can't work, or make love, or even walk across the street without intense suffering find that they are able to do all of those things without pain in only a few weeks, then they often say, 'These are choices worth making.' ""

http://www.fastcompany.com/magazine/94/open_change-or-die.ht...


"There is an inflexible law of physics — energy taken in must exactly equal the number of calories leaving the system when fat storage is unchanged."

Really? That's an inflexible law of physics? Only if fat is the only source of energy the body has. But it isn't. Simple sugars are a huge source of energy for the body. This is the main reason why the Atkins diet works for quick fat loss- basically eliminates the alternate sources of energy your body would usually use and forces it to start burning fat.


"Dr. Rudolph Leibel, now an obesity researcher at Columbia University, and I took people who were of normal weight and had them live in the hospital, where we diddled with the number of calories we fed them so we could keep their weights absolutely constant, which is no easy thing. This was done with liquid diets of exactly known calorie content."

Wow, how much does one get paid for agreeing to take part in something so terrible sounding?


You get paid by the fruits of progress and enlightenment, for which to nurture your soul. Or alternatively in dollars, if that doesn't cut it. To be honest, it sounds like what a lot of people seem to eat anyway, I know loads of people who appear to exist solely on vitamin milkshakes.


A consulted expert disses new research with a conjured, speculative flaw, because it contradicts his own research.

This is illogical, but not just because the expert has a conflict of interest; the studies measure different things.

The old study put people on appropriate maintenance diets of varying compositions and found that everybody maintained their weights regardless of what they ate. As it turns out, humans are very good at maintaining their weights; feed them more, within reason, and their bodies burn more; feed them less and the trim is adjusted to burn less.

The new study measures how easily people regain weight on various diets after their bodies have been kicked out of this mode by extreme calorie deflicts (resulting in weight loss). Not the same thing, at all.


We should eat well balanced diets that are tailored to each of us as individuals. I tried high fat high protein before and it didn't work very well with my metabolism, to spare you some details.

Listen to your body, and give it what it needs. Experiment a bit. That's what I learned after trying fad diets. The realization is we are individuals each with our own metabolism that is slightly different.

What I found is that low carb diets are a big sham. The key is not to avoid carbs, but to avoid SUGAR and HFCS. Lots of "carbs" we eat come from absolute garbage, like white bread.

Trust me, a diet of mostly high fiber green vegetables is NOT going to effect your health adversely. It will do only the opposite, no matter how many damn carbs are in it.


  > We should eat well balanced diets that are tailored to
  > each of us as individuals.
vs.

  > What I found is that low carb diets are a big sham.

?


by "low carb diet" I am specifically referring to carb-restriction type diets like atkins that advocate eating an extraordinarily low amount of carbohydrates.

carbohydrates are an important macronutrient. the problem is not with carbs, but with bad carbs.

go visit some third world countries where they eat primarily carbs and find me the obese people. (hint: you won't find any)


The problem isn't with carbs, protein, fat or subcategories of those, the problem is with more calories being eaten than calories being burned.

caloric intake > caloric burn -> weight gain

caloric intake = caloric burn -> weight stabilises

caloric intake < caloric burn -> weight loss

You can alter your caloric intake by changing the amount and type of food you eat. You can alter your caloric burn by changing the amount of exercise / labor you perform.


Those formulas have the appeal of simplicity, but it's more complicated than that. For starters, caloric burn is highly correlated with caloric intake. They're not independent variables by a long shot. Consume less and your metabolism will actually shift down to burn less. Burn more by exercise and your appetite will increase to partially compensate.

Also, exercise is actually a low load on our body calorically (for most types of exercise). The overwhelming majority of calories burnt are for maintaining homeostasis, and have nothing to do with aerobic exercise.

Here's an example that shows how people are deceived. If you're an average male, and you start using a high-tech treadmill, the calories/hour measure might say something like "120 calories/hour". Sounds great, right? Well, what it doesn't say is that 100 calories of that measurement are just due to your basal metabolic rate, the amount you would burn just sitting in a chair. Running (possibly the most efficient exercise) itself only burnt 20 calories an hour. A carrot is sufficient to cover that.

Plus, exercise is not the only output. Heat production is an even better one. The amount of calories expended in maintaining body temperature is way higher than exercise. There's also excretion, but luckily, nobody's advocating laxatives as a weight-loss regimen yet. :)


I absolutely agree that weight is regulated by calories consumed vs calories burned.

In practice though, trying to say that is the only important aspect is complete bull. Try getting all your calories from wood chips and let me know how that work.

In order for consistent weight loss to occur, we need to eat healthy foods so that we feel good. Feeling lousy will cause you to overeat. Eating bad foods could also make you sick.


Well yes, of course your diet should be well-rounded and contain all the necessary vitamins, fibers, protein your body needs.

My comment was more a reaction to all the different kinds of diets, and how they're supposedly a better way to lose weight than the previous diet. If you want to lose weight, and you already have a varied diet that meets your body's daily intake requirements, it can be useful to calculate your calorie consumption and burn rate and try to tweak both of those so that you end up with a caloric deficit.

Of course this only directly affects your weight, and you need to also take care of your body's general health. I would hope it's obvious to most that you shouldn't start a wood chip diet.


My great-grandfather ate white bread regularly from before 1910 and stayed thin all the way into his 90's. He spent his last ten years or so living with my family starting about when I was in middle school, so I remember it well. AFIK, he'd been eating the same kinds of stuff for 50 years -- cornflakes and whole milk for breakfast, sandwiches for lunch and meat and potatoes with a few veggies for dinner.

Especially when looking at my own ancestors (all of whom were thinner than me 3 generations back), I tend to discount any sort of "oh they were just genetic freaks" kinds of arguments. None of them really dieted or deprived themselves, but they were used to pretty bland monotonous diets. I clearly remember ordering pizza in high school and they tried eating it with forks and knives and said they weren't big on "Italian food". The truth is it's the more recent generations who are the freaks. We're used to access to pretty much any kind of tasty, convenient food whenever we want it.


I suspect that taste has a lot to do with weight gain.

See for instance the Shangri La Diet: http://en.wikipedia.org/wiki/The_Shangri-La_Diet


Seth's blog is pretty awesome, also. The man is extremely inventive and clear thinking. That being said, I personally believe that most of what he's found can be accounted for by the placebo effect, but his ideas and reports from other people always make me think.


Seth is a very interesting fellow with some fascinating ideas (butter improves mental reasoning, standing on one leg can improve sleep, flavorless calories interfere with weight setpoints), but I think he's made a mistake in arguing against man-made climate change.


He isn't arguing against climate change. He is arguing that the people who do argue climate change are making arguments from religion, rather than science. And I tend to agree.


As near as I can tell from his writing, his key objection is the inaccuracy of climate models and their predictive failure. While it's a truism that any model with enough free variables can "fit" a data set, this does not render the exercise useless.

Nor are models the only reason we think people are driving the global temperature change. There are still large numbers of plausible biological/chemical explanations for man-made global warming, and fewer that involve random fluctuations.

In the end, though, I think the best argument is simply caution. There's no backup planet if people like you are wrong, so it's best to proceed as if we're tiptoeing on the edge of a cliff. If 99% of scientists are wrong, then all we'll have wasted are funding dollars as effort. If you're wrong, we might see the coasts become uninhabitable, and wars break out over things like water and land.


I should add, I also tried "juicing" which was popularized by films such as fat, sick, and nearly dead. What they don't tell you in that movie is that juicing the vegetables removes most of the fiber and results in you drinking what is essentially a somewhat fibrous cup of sugar and nutrients. After just a couple juices you will be bouncing off the walls....


You are contradicting yourself by stating that diets should be tailored to our needs but at the same time you slag off a diet that might fit someone else.


I am referring to extreme diets like atkins. My contention is that most "fad diets" aren't tailored to anyone's metabolism. What they're tailored to is profit.

Each of us needs to figure out a healthy ratio of carb/protein/fat.


Forgive my sense of humour, but just on the title alone....

....When is magic a substitute for science?

I mean, I read the title, and my response was, "Yeah, I know. And why is it prefaced with 'in dieting'?" Does it need further reading?

To be serious, from what I can tell, the problem is people in general will always look for the easy out. No matter the science or logic, if some one presents a "cure pill", they want it. Deep down they know its more hope than anything else, but because it looks easy, they are only too willing to part with cash. This article wont change that, it just reinforces those who already agree.


I may be old-fashioned, but the idea of any of these "extreme" diets scares me. I have always found that an approach with regular ( 2-3 times a week ) exercise and an conservative approach to eating is better.

My usual diet plans for eating is breakfast (some cereal), a big lunch at about 1 o clock (this is my dinner effectively), and perhaps something light, like pasta, rice when I get home, followed by a bowl of cereal for bedtime.

This with some running or other exercise leaves me at a desirable place without causing me too much pain.


Interesting. You realize though, that prior to agriculture, not a single human ate anything like what you describe, right? You list a lot of grains, and those are a relatively recent addition to the human diet.

"Extreme" is a function of time and place. What seems normal for modern America might be very abnormal relative to the historical record.


I have always wondered why the Adkins diet seems to work. The article basically says it is both more successful and yet has no physiological reason for being more successful. So why?

My first guess would be: carbs/bread is cheap and usually comes in large quantities, like unlimited bread baskets. Meat is expensive and comes in smaller quantities. So eating mostly meat just makes it easier to consume fewer calories by default. But again that's just a guess.


Probably true too, but:

1) fat takes much longer to digest

2) refined sugar/wheat is like a drug. Basically you get withdrawal symptoms that force you to eat more sugar soon. I bet that the food companies love it

3) ... and technically your body can't process over certain amount of protein per day (i think it was 300g). If you eat more than that for some reason, then you just pee it out.

I'm on "paleo diet" + cheese and have lost a lot of weight so far. I don't count carbs and I need to remind myself to eat (lack of hunger).


So eating mostly meat just makes it easier to consume fewer calories by default.

This is probably the most important statement in the entire thread. All of these fad diets basically trick the dieter into eating less calories. When Lustig, etc... cite various studies those studies never seem to account for overall caloric intake. Person A cut carbs, person B didn't, person A lost weight ergo carbs are bad. Yeah, it doesn't quite work that way. Saying that cutting calories will help a person lose weight doesn't sell books so authors have to pick something to demonize.

HFCS is a popular thing to demonize now. Is it surprising to anyone that if a person cuts out 4-6 sodas/day that had ~200 calories each that said person is going to lose weight? It had zero to do HFCS and everything to do with cutting out ~1000 calories/day. Again, that doesn't sell books or speaking engagements, but declaring X as evil does.


No it's a jump to a conclusion at least, and according to a recent study may be false. http://jama.jamanetwork.com/article.aspx?articleid=1199154.

The study seems to indicate that low carb diets actually do trigger more calories to be burned for the same level of activity, about 430 additional calories per day. It's too early to tell if this affect is real (larger study needed), but the results are interesting.


This is what drives me crazy about the dieting issue. People will cite a study that involves 21 people. 21! Think of all the pain caused by people being overweight, and the insane costs imposed on our healthcare systems. With all that pain and cost, we can't come up with studies with larger sample sizes? Show me a double-blind study with 10,000 people and I'll start to take it seriously.


Low carb diets also increase metabolic stress (specifically ketosis), which is one of the suspected reasons for the additional calorie burn. Ketosis over short periods is good, but scientists differ on whether it is safe in the long-term. For diabetics (Type I or II), ketosis is not safe, as the body does not have the proper insulin response to maintain safe levels of ketosis.


Are there any studies on ketosis and diabetes? Because one of the primary drivers of insulin resistance in type 2 diabetes is being overweight. So, even if ketosis were bad, if losing weight improved your insulin sensitivity, it might still be worth it. Obviously, this shouldn't apply to type 1 diabetics, though.


I'm sorry, this needs a citation. I'm not trying to be a jerk, it's just that with a subject this controversial you can't simply assert claims like this.


Of course a calorie is a calorie, but this is more than often used as a simplistic view of how the body processes food. Now it is clear that both the type and amount of food one consumes influences the hormonal system and gene expression. It is naive to keep thinking just in terms of calories.


What this articles says is any diet which says you can eat the same number of calories and lose weight is lying. Some diets may make you want to eat less calories, but you cannot eat the same number of calories and lose more weight without doing more exercise.


Not true, some diets raise metabolism relative to others according to recent studies, low carb diets burn about 430 more calories on average per day for the same level of activity. So that's another way of burning calories without "exercise" unless you consider sitting still exercise.


But that's precisely what this article argues is a falacy. He discusses a trial carried out in hospital conditions with regulated liquid meals of exactly the same number calories but differing carbs/ protein ratios. The results showed that given the same calories and exercise all the subjects maintained the same weight.

Unless I misunderstood anything.




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