Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health Paperback – September 23, 2008

This is an incredible book that, for me, completely redefined what constituted a healthy diet.

I completely believed the calories in/calories out model of dieting: that is, if you consume more calories than you expend, you will put on weight, and that you lose weight by expending more calories than you consume. That model was simple and made a lot of sense. But, Taubes convincingly argues, it is not just too simplistic, it is wrong.

What matters isn't the quantity of calories consumed, but their quality. Rice, potatoes, flour (including cakes, bread, pasta, etc.), sugar, and other refined, easily digestible carbohydrates are converted to simple sugars in our digestive systems. In turn, this sugar enters our blood streams and raises our blood sugar levels. Since high blood sugar is dangerous and fatal if not addressed, our bodies respond by producing insulin which causes that blood sugar to be converted into fat and stored in our fat cells. This is all basic high-school biology, and completely uncontroversial. Taubes, however, goes further and cites study after study that implicate the recommended "healthy" low-fat, high-carb diets as a primary cause of obesity, coronary heart disease, type 2 diabetes, hypertension, certain cancers and a whole range of other health problems. He explains the mechanisms that lead to these diseases, and punches holes in the accepted wisdom behind recommended "healthy" dietary guidelines.

I was on a long, domestic flight when I read an in-flight magazine article by Taubes about this book back in early 2008. I was very skeptical, because what he had written flew in the face of what I had come to believe about health and diet, but I was intrigued because of the claims he made about the links between diet and hypertension. I had recently been diagnosed with hypertension (high blood pressure) and my doctor had put me on a course of medication to bring it under control. He had also told me to cut out as much sodium from my diet as possible. When I asked my doctor what I needed to do to come off the medication completely, he told me there was nothing I could do and that I probably needed it for the rest of my life. I was in my early 40's and didn't like the sound of that at all! So I bought a copy of this book and read it from cover to cover.

It was a revelation!

He cited studies which indicated that hypertension was caused by eating a diet rich in easily digestible carbohydrates. Such a diet raises blood sugar, which in turn raises insulin - in order to convert that sugar to fat, thereby reducing blood sugar, and storing the resulting fat in the bodies fat cells. However, the research indicated that insulin also had other effects on the body, one of which was to cause the kidneys to reabsorb more water back into the blood stream. In other words, insulin acted as an anti-diuretic. The resulting excess water increased blood pressure. (One of the drugs in my blood pressure medication was a diuretic, so it clearly worked by reducing the amount of water in my bloodstream.) At the same time, Taubes pointed out that blood sodium levels, which conventional wisdom claimed was the cause of that excess water (again, without a great deal of evidence to support it), was quite easily regulated by the kidneys and passed out of the body in urine.

This made a lot of sense to me, and so I started a diet that the book indicated would be healthier: one without starchy food, but with fish, meat, dairy products and green vegetables. Within days, I started getting muscle cramps and dizzy spells, and saw my doctor about the problem. It seemed that the combination of the diet and my hypertension medication was giving me low blood pressure and dehydration symptoms. He halved my medication dosage, instructed me to buy a blood pressure monitor, and to come off the medication altogether if my symptoms continued - but to check my blood pressure regularly. In the end, I stopped taking the medication, and my blood pressure was routinely around 118/75. So much for having to take the medication for the rest of my life.

But other effects were happening to me while I was on this diet. I started losing weight (I was, I'll admit, slightly obese when I started the diet), yet I never felt hungry, and could seemingly eat as much as I liked, without ever feeling bloated or full. This was supposedly one of the primary benefits of the diet and one of the main points of the book, but I was still surprised with the results.

Taubes' research also predicted that such a diet would do the following to my blood lipids: it would lower triglyceride levels, raise HDL ("good" cholesterol) levels and possibly raise LDL ("bad" cholesterol). Over the course of a year, the blood work performed by my doctor backed this up: I significantly lowered my triglyceride levels, significantly raised my HDL levls - both unequivocally good things - while slightly increasing my LDL levels. Taubes' studies had indicated that HDL levels had a strong inverse correlation with coronary heart disease incidence (that is, the higher the HDL levels, the lower the risk of coronary heart disease), while LDL had a weak, positive correlation, so I wasn't too concerned about the increase in LDL.

So, it worked for me.

However, this is not a book primarily about diet. It might be more accurate to say that it's a book about the science of diet, nutrition and health, and Taubes is happy to acknowledge that we still need to do a lot more research on the subject, but without any preconceptions. Indeed, throughout the book, Taubes points out the lies, errors, misinterpretations and failed critical thinking that led to the current dietary recommendations of a predominantly low-fat, high-carb diet. If those recommendations are right, he asks, why are we seeing such an explosion in obesity, hypertension and type 2 diabetes diagnoses?

He certainly doesn't claim to have all the answers, but he does put a lot of pseudo-scientific diet & health claims to the sword - and he explains why. He convincingly argues that Ancel Keys' "lipid hypothesis" - that diets that are high in fat, and high in saturated fat in particular, cause coronary heart disease - not only has no evidence to support it, but is contradicted by the evidence that is available. Taubes also demonstrates that in all likelihood saturated fat, far from being unhealthy, is actually an essential component of our diets.

I highly recommend this book!

I've worked in hospitals or have been in a teaching position in health care since 1972. That entire time I marched to the unceasing drum of dietary-fat-and-cholesterol-lead-directly-to-heart-disease, now called the lipid theory of heart disease. It never occurred to me to ask "Where is the hard evidence?" I assumed it had been irrefutably proven. Then factors in my own life led me to eventually question that ever present mantra.

My own mother had her first heart attack when she was just 48 years old. In her seventies she was put on a statin for elevated cholesterol and became someone I barely recognized; argumentative, irritable, forgetful, poor coordination and very depressed. Nothing in my own medical care education lead me to blame any of that on statin drugs. What was even more puzzling was that she had never been one to eat fatty foods or things laden with cholesterol. But I never stopped to think about that. I did know she struggled with weight her entire life and hence was vigilant in eating things low-fat, as well as only using polyunsaturated oils for cooking. But it is also true she had a problem with carbohydrates - they always were the majority of her diet. I lost her to a heart attack in 1995.

Three years ago, as my own cholesterol nudged up a bit, but still within traditional normal range, I did not hesitate to comply with my doctor's suggestion to begin a statin (Lipitor). If anything, I felt I was getting ahead of the danger of losing my life as my mother had. But also like her, I struggle with my weight and like her I gravitate to carbohydrates. I was strictly avoiding all saturated fats and dietary cholesterol, cooking with the supposedly "healthy" polyunsaturated oils and always choosing fat-free or low-fat dairy products. In all that time in hospitals and health education we had a two other mantras - "a calorie is a calorie" and its corollary "calories in calories out" as the only approach to weight management. But every calorie restrictive program I tried just left me hungry and with only short term weight loss.

I developed, in those three years, various aches and pains, initially too varied to form a pattern. I was aware that I was having a marked increase in short term memory problems, and my joints were getting so troublesome I was unwilling to do the exercise my doctor kept harping about to keep my weight under control. I found myself getting irritable, less interested in life and feeling O.L.D. @ 60. Out of frustration with both weight and how crummy I was feeling, I read a couple of food advice books, and one, "In Defense of Food" started making sense to me. Two other books were mentioned within that one, so I moved on to one of them - "Good Calories, Bad Calories." The author already had an excellent track record of science journalism.

Just imagine how startled I was while reading Gary Taubes book to find out there never has been definitive reproducible studies to prove the connection between consuming dietary saturated fat and cholesterol to the development of high blood cholesterol, nor to cholesterol numbers being a directly predictive factor in heart disease mortality. This was a jaw dropping revelation to me. Then I went on to read about the abundance of information revealing "healthy" seed oils, such as corn, safflower, sunflower, soy and canola, showed no evidence of lowering either heart disease itself or the mortality rate from heart disease. Then the came the real shocker.......the most consistent risk factor for developing heart disease, as far as diet is concerned, is the intake of carbohydrates. I was dumb struck. He also challenges, then destroys, the assumption that all calories are created equal and that saturated fat is harmful. One whole chapter is devoted just to how our bodies manufacture and use insulin and the stress that excess carbohydrate puts on our system, leading eventually to insulin resistance and finally type 2 diabetes.

I am not easily swayed, so it is important to me that when someone makes such revolutionary counter-to-accepted-belief statements, they had better be able to back it up. Taubes book has over 60 pages of just reference sources. It is exhaustively researched, going back through dietary research for the past century. His book led me to a few others that focused on carbohydrate dangers. cholesterol, fats and the harmful effects of statins. For those interested, here are some recommendations: Natural Health & Weight Loss,Deep Nutrition: Why Your Genes Need Traditional Food,The Statin Damage Crisis,The Modern Nutritional Diseases: And How to Prevent Them : Heart Disease, Stroke, Type-2 Diabetes, Obesity, Cancer,Cereal Killer,The Great Cholesterol Con: The Truth About What Really Causes Heart Disease and How to Avoid It and The Primal Blueprint: Reprogram your genes for effortless weight loss, vibrant health, and boundless energy Four of these are written by MDs - informed, well educated, science background people working with current research information.

Information I uncovered left me shocked about how manipulative Big Pharma is as far as pressuring doctors to use their drugs, (complete with "incentive" packages that can only be compared to flat out bribery) about how they fund their own studies and then get to interpret their own results to be sure they are favorable, and/or they can choose to fail to publish anything negative. Agribusiness is also enormously influential in getting studies done, with their own highly lucrative contracts with research groups, to "prove" that oils made from their excess harvest, that are cheap and highly profitable, must be part of our daily diet at the expense of traditional fats. The power the pharmaceutical industry and the agribusiness has on such supposedly trustworthy institutions such as the American Heart Association, the FDA and the NIH is not to be believed. So sad for all of us.The food pyramid is absolutely wrong for heart health, weight management and avoiding type 2 diabetes.

As I read these books, I began to have hope about finally managing my own weight. Taubes book is all about arming you with proper facts, about making intelligent choices for your own dietary direction. It is not focused on the use of statins (I found that informations in other related books listed above) - rather, he is making the point that while we have been concentrating on fats as the cause of obesity, diabetes and heart disease, it has really been the shift toward more carbohydrate and seed oil consumption for the last 60 years.

But Taubes is NOT offering "program" as such. Rather, for someone like me, who really wants to understand WHY things are the way they are, this is a wealth of information about how we went down the wrong path as far as national nutritional health advice and who was behind it all. He lets you connect the dots for yourself. If instead you would rather have help with a program for redesigning your nutrition, two of the books I listed are better for that, specifically "Deep Nutrition" by Dr. Shanahan, or Mark Sisson's "Primal Blueprint". Both books have at their core a target of total carbohydrate in a day of about 70 mg if you need to lose weight. Using these guidelines, I dropped 25 pounds in 11 weeks, without feeling hungry, and I feel excellent. I have also slowly tapered off, then stopped my Lipitor. I will not know my lab numbers for several months until my next check up, but I can report that my body aches have lessened, I have more energy, my short-term memory is better and my depressed mood has vanished.

I bought two extra copies of Taubes book and will be giving them to both my Family Practice doctor and my Endocrinologist. This information is vital. I believe my mother would have remained her normal self until her passing if she had not been given a statin and I also believe we may have had the joy of having her longer if any of us (including her doctors) had fully understood the implications of the carbohydrate laden low-fat diet she consumed for years.

Good luck to you. Be well.

P.S. - An eye-opening DVD is "Food Inc." that lays out the case for how we as citizens are at the mercy of only a handful of agribusiness companies. Profit, not our well being or the the survival of family farms matters to them. Their influence on our government's policies at all levels is truly shocking.