Enter your mobile number or email address below and we'll send you a link to download the free Kindle App. Then you can start reading Kindle books on your smartphone, tablet, or computer - no Kindle device required.
To get the free app, enter your mobile phone number.
Other Sellers on Amazon
+ $4.15 shipping
+ $3.99 shipping
+ $3.99 shipping
Why We Get Fat: And What to Do About It Paperback – December 27, 2011
|New from||Used from|
"Rebound" by Kwame Alexander
Don't miss best-selling author Kwame Alexander's "Rebound," a new companion novel to his Newbery Award-winner, "The Crossover,"" illustrated with striking graphic novel panels. Pre-order today
Frequently bought together
Customers who bought this item also bought
Customers who viewed this item also viewed
9780307474254 Features: -Title: Why We Get Fat. -Sub title: And what to do about it. -Subject: Health and fitness / Weight loss. -General subject: Health and fitness. -Language: English. -ISBN: 0307474259. Subject: -Health & Fitness. Country of Manufacture: -United States. Age Group: -Adults. Dimensions: Overall Height - Top to Bottom: -0.75". Overall Width - Side to Side: -8". Overall Depth - Front to Back: -5.25". Overall Product Weight: -0.65 lbs.
Top customer reviews
There was a problem filtering reviews right now. Please try again later.
EVIDENCE THAT HUNTER GATHERERS ATE MEAT THAT WAS VERY DIFFERENT FROM WHAT MODERN AMERICANS EAT
On page 163 Taubes says, "The idea is that the longer a particular type of food has been part of the human diet, the more beneficial and less harmful it probably is---the better adapted we become to that food. And if some food is new to the human diets, or new in large quantities, it's likely that we haven't yet had time to adapt, and so it's doing us harm."
Yet he lets the reader assume that grain fattened meat is no problem even though it has been a staple in the American diet for less than 100 years (it increased during the same era that sugar and white flour increased.) It contains about 10.2 times as much palmitic, myristic and lauric acid as wild elk and about 5.4 times as much as lean grass fed meat. Stearic acid lowers LDL so it wasn't used in the calculation. And I adjusted for the fact that the t-bone had 22% refuse (leaving only 78 grams meat), the grass fed beef had 34% refuse (leaving only 66 grams of meat) and the elk was all meat. You can check T-bone, grass-fed beef and game meat elk in the USDA food composition database for yourself. Not only does grain fed meat contain more palmitic (16:O), myristic (14:O) and lauric acid (12:O), but it contains a lower percentage of LDL lowering stearic acid (18:O) and very little omega-3 or CLA and don't forget, added hormones and antibiotics. And the blubber of sea mammals that live in the arctic contains a much lower percentage of saturated fat than the fat of land animals.
On page 164 - 65 Taubes says, "The best we can do is what nutritional anthropologists began doing in the mid-1980s---use modern day hunter-gatherer societies as surrogates for our Stone Age ancestors. In 2000, researchers from the United States and Australia published an analysis of 229 hunter gatherer populations that survived deep into the twentieth century to have their diets assessed by anthropologists."
Taubes says this is "the best we can do", then he decides to ignore their findings on saturated fat, because they don't fit his preconceived ideas.
In his latest book, The Paleo Diet: Lose Weight and Get Healthy by Eating the Foods You Were Designed to Eat, published in December 2010, Professor Loren Cordain says that hunter gatherers ate about half the palmitic acid eaten in the modern American diet (this is the main saturated fatty acid that elevates LDL in the American diet.) This is in spite of the fact that they consumed the entire carcass of the animal. This is because they ate wild game (average of .89 grams saturated fat per serving) instead of grain fattened domestic animals (average of 7.04 grams saturated fat per serving). Cordain et al actually gathered the data and did the calculations. Modern HG diets ranged from very low to very high in saturated fat consumption. They were not uniformly high. Because one group can eat a high saturated fat diet proves nothing about people whose ancestors didn't do this. No one with basic knowledge of natural selection and genetics would assume we are all equally adapted to eat a high saturated fat diet. And according to Eaton et al (1988) the average cholesterol of the hunter gatherers they studied was about 124. This can't be achieved on a high diet high in grain fed meat and dairy, unless you have genetic hypocholesterolemia like the Masai.
In metabolic ward trials where all variables are controlled and people live in the ward and eat meals prepared by the research staff, LDL is routinely increased by increasing dietary saturated fat when carbs are at a moderate level as well as when carbs are virtually eliminated. For example, Dr. Stephen Phinney conducted a normal caloric intake metabolic ward trial with nine healthy lean men, "The human metabolic response to chronic ketosis without caloric restriction: physical and biochemical adaptation." These men consumed nothing but meat, fish, eggs, cheese and cream for 35 days. Their carbohydrate intake was less than 20 grams a day. Their blood cholesterol went up from 159 to 208 on average in 35 days. That is a 31% increase. The average adult in this country has a cholesterol level of 199. A 31% increase would give 261. The high risk category is anything over 240.
Humans have always eaten saturated fat, but the average human has never eaten as much as they do now. Then along comes Dr. Atkins and Mr. Taubes who tell us to eat even more. If you are going to recommend a diet for life long consumption by the general public, the burden of proof is on you to show that it's safe. However, every long term study shows that high saturated fat diets are associated with more heart disease than the control. Therefore recommending this kind of diet to the general public seems reckless. Especially since there's no need to eat a lot of saturated fat in order to eat low carb.
HOW SOME BUT NOT ALL SATURATED FAT CONTRIBUTES TO ATHEROSCLEROSIS
Chemicals in the body have a healthy range. When they're too high or too low it makes us sick, whether it's glucose or LDL or something else. As long as you keep them in the healthy range, I guess it doesn't matter how you do it. Your body needs LDL, but if it's too low there is an increased risk of infection and stroke. If it's too high, there's an increased risk of atherosclerosis and heart attack. You could keep meat consumption moderate like the ECo-ATkins. Or you could eat a lot of meat as long as you avoid fatty cuts grain fattened meat like the Cordain Paleo.
Certain dietary saturated fatty acids (16:O, 14:O and 12:O) down regulate LDL receptors on the surface of your cells. This interferes with the cells ability to take in the LDL they need and causes the level of LDL in the blood to go up. In the blood, macrophages absorb oxidized LDL and become foam cells. They continue to grow and eventually rupture depositing plaque inside the artery walls.
People are different. Some have more LDL receptors than others which means that eating the same amount of saturated fat does not elevate their LDL as much. And people with too few LDL receptors have hypercholesterolemia and premature heart disease. Saturated fat is not the only risk factor for heart disease but the fewer LDL receptors a person has the more important it is for them.
According to a study by Nicholls et al in 2006, consumption of saturated fat impairs the anti-inflammatory properties of high-density lipoproteins as well as endothelial function. And according to a meta-analysis of 24 studies by Ip et al in 2009, higher LDL particle number was consistently associated with increased risk for cardiovascular disease, independent of size or density.
There are different kinds of saturated fat. Stearic acid lowers LDL. And the diets of HGs had a higher percentage of stearic acid and a lower percentage of palmitic acid than modern diets. Coconuts are rich in saturated fat, but Pacific Islanders consume the coconut water and coconut fiber which contain chemicals that lower LDL.
WHY UNCONTROLLED STUDIES CAN GIVE INCONSISTENT RESULTS
Heart disease has multiple risk factors. In uncontrolled studies we see a lot of inconsistent results. But associations or lack of associations in an uncontrolled study can only suggest, not prove cause and effect or lack of it. The results depends on:
1) CONFOUNDING VARIABLES. These include genetics of the population, smoking, sedentary lifestyle, hypertension, diabetes, trans fat, high glycemic index carbohydrates etc. For example, in an uncontrolled study lower saturated fat can be associated with either less heart disease or more heart disease depending on whether people replaced the saturated fat with olive oil or stick margarine with trans fat.
2) THE RANGE OF THE VARIABLE. Studies where the difference between the lowest level of saturated fat and highest level is very great have better resolution than studies with a smaller difference. When the difference is large, the effect of confounding variables is less pronounced. For example, in studies of very high saturated fat diets, even if they are not controlled, the harmful effects of saturated fat override the confounding variables and give consistent positive associations between saturated fat and heart disease. This is why the Seven Countries Study with large differences in saturated fat consumption showed a strong association and other studies where everyone was more or less similar didn't.
EVIDENCE THAT EATING LESS SATURATED FAT CAN BE HELPFUL
Since there's more than one risk factor for heart disease, it makes since that interventions to treat heart disease that reduce the most risk factors would be the most effective. And the most effective interventions usually involve eating less saturated fat and lowering LDL. For example:
In China and Japan where they eat less saturated fat and over 50% carbs, they have a low rate of heart disease and they don't have an obesity epidemic. They eat less sugar and white flour. That seems to be all the vast majority of us need to give up.
Dr. Esselstyn used a 10% fat, high fiber diet plus low dose statins to arrest or reverse heart disease in 18 severely ill heart patients. We know it worked because of before and after coronary angiograms and cardiac PET scans. Some had been given less than a year to live by their referring cardiologist, yet are alive and healthier 20 years later. During 20 years only four patients died and none of them had a heart attack. There was no requirement to count calories or exercise to get these results. See Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure.
Dr. Ornish also reversed heart disease using a similar diet plus exercise and meditation but no statins. Since then Dr. Ornish has enrolled at least 3800 patients in demonstration projects (to demonstrate savings on surgery) which resulted in over 40 insurance companies including Medicare covering a program in diet and lifestyle for heart disease patients. According to Dr. Ornish, "In brief, we found that almost 80 percent of patients who were eligible for bypass surgery or angioplasty were able to safely avoid it for at least three years." See The Spectrum: A Scientifically Proven Program to Feel Better, Live Longer, Lose Weight, and Gain Health
The Mediterranean diet which is low in saturated fat is also associated with low rates of heart disease. Statins, exercise or meditation are not necessary to produce this result. See The Mediterranean Diet.
Statins alone or exercise alone or meditation alone can't achieve these results. So it appears that diet is partly, perhaps mostly responsible for the favorable results.
The book makes no mention of Dr. Esselstyn or that heart disease can be reversed consistently on a diet that restricts saturated fat and cholesterol or that taking fish oil with a high complex carbohydrate diet reduces triglycerides better than eating a high fat diet according to a study by Jiménez-Gómez et al in 2010.
All that the book shows conclusively about saturated fat is that it can't be the only cause of heart disease and everybody knows that already. And while high glycemic index carbs are associated with heart disease, low glycemic index, high fiber carbs are associated with reversal of heart disease.
The book uses the false dilemma logical fallacy to make it seem like you only have two choices if you're overweight; follow the USDA recommendations and continue to be part of the obesity epidemic or follow Atkins and lose weight and reduce your risk of heart disease. There are many things wrong with this characterization. First, there are at least two ways of eating low carb that don't require you to eat a lot of saturated fat (Eco-Atkins and the Cordain Paleo). Second, people who are not insulin resistant can effectively reduce blood glucose and insulin, lose weight and reduce the risk of heart disease by reducing high GI carbs and saturated fat, even if they eat 70% carbs. Third, while a few risk factors look good on a high saturated fat diet, many other risk factors are not even measured, and tests show that atherosclerosis is accelerated in the short run and there's more heart disease mortality in the long run. Also, the book uses the straw man logical fallacy to make it seem like the obesity edipemic is the result of eating less saturated fat. However, Americans have not been following the USDA guidelines about the kind of carbs to eat and they have been eating out (with large portions) more than ever, and they are not even close to following the Ornish diet or the Mediterrnaean diet.
EVIDENCE THAT EATING TOO MUCH SATURATED FAT CAN BE HARMFUL
Six long term studies show that high saturated fat diets are associated with more heart disease, cancer and/or all-cause mortality than the control. This may not seem like very many, but there are no long term studies that show otherwise. All the studies that some people think show otherwise are either short term and don't measure mortality or they only compare one moderate level of saturated fat with another moderate level.
First study: "Low-carbohydrate diets and all-cause and cause-specific mortality" by Fung et al published in 2010. A high-meat diet with about 20% saturated fat had 43% greater all-cause mortality and than an Eco-Atkins diet with 12% saturated fat. This was not an uncontrolled epidemiological study; it's the kind of study that can be used to establish cause and effect because confounding variables have been controlled. The high-meat group ate the same or less trans fat, omega-6 and refined carbs so there's no reason to think something other than the meat caused them to do poorly. This is an prospective cohort study, a kind of controlled observational study that's suitable for hypothesis testing, in spite of what critics say. This kind of study was used to establish the link between smoking a lung cancer. Critics are nihilistic about any evidence against animal fat. But when it comes to uncontrolled observational studies of other cultures (studies that don't have a control group or control for confounding variables), they accept them without critical thinking. The reason they devote so much effort trying to tear it down, is because the evidence against a high animal fat diet is so compelling.
Second study: "Low carbohydrate-high protein diet and mortality in a cohort of Swedish women" by Lagiou et al published in 2007. "CONCLUSIONS: A diet characterized by low carbohydrate and high protein intake was associated with increased total and particularly cardiovascular mortality amongst women."
Third study: "Mediterranean and carbohydrate-restricted diets and mortality among elderly men" by Sjogren et al published in 2010. The low carb, high meat group had 48% greater all-cause mortality and 81% greater heart disease mortality than the group eating a Mediterranean Diet.
Fourth study: "Low-carbohydrate-high-protein diet and long-term survival in a general population cohort" by Trichopoulou et al in 2007. "CONCLUSION: Prolonged consumption of diets low in carbohydrates and high in protein is associated with an increase in total mortality."
Fifth study: A study of patients on a high-meat diet by Fleming in 2000 showed a worsening of blood flow after one year with an overall 39.7% progression of coronary artery disease.
Sixth study: People are different. A high-meat Atkins is especially bad for people with the APOE4 allele. In a study by Corella et al in 2010, when saturated fat intake was greater than 10% of total calories in individuals carrying the APOE4 allele, the risk of heart disease was over 300% higher. About 25 to 30 percent of Americans carry this allele. And people with the metabolic syndrome are more likely to carry APOE4 than other people.
Taken together these six studies show that measuring the few risk factors that improve during the weight loss phase does not accurately predict what will actually happen after decades on the maintenance phase. They are giving people a false sense of security.
CONCLUSION : THERE ARE SEVERAL WAYS TO BE HEALTHY
People are different. People who are insulin resistant have a greater problem with carbs. People with fewer LDL receptors have a greater problem with saturated fat. People with the APOE4 allele are more likely to have problems with both. The Cordain Paleo diet, the Ornish diet and the Mediterranean diet all have less high GI carbs and less saturated fat than most Americans eat and they are all good for heart disease. The list of foods in the Appendix of WWGE only reduces carbs, while increasing saturated fat. It makes sense that the more risk factors you reduce the better results you will get.
1. Vegetarian Adventist men and women live an average of 87 and 89 years, respectively and have a typical cholesterol level in the 180s. They abstain from alcohol and tobacco, exercise regularly and eat nuts, eggs and dairy products.
2. In the 50's and 60's Crete had the best longevity in the world. They ate 40% fat mostly from olive oil, but only 8% saturated fat. The total red meat, poultry and fish consumed per-person, per-week in Crete was only about 371 grams (13 ounces). Ancel Keys and his wife followed a similar diet and he lived to be 100 years old and she lived to be 97 years old.
3. Japan has the best life expectancy of any country. The average man lives 79.4 years and the average women 86.1 years. They eat more carbs (about 59% versus 49%) and less fat (about 28% versus 38%) than the U.S. They eat more seafood than they do meat.
4. Iceland has the best longevity in Europe. The average man lives 80.1 years and the average women 83.5 years. They eat less carbs and more fat than the U.S. They eat more seafood than they do meat and their meat is grass fed. (In France they also eat grass fed meat.)
5. If you have heart disease, a low-fat diet with low glycemic index, high fiber carbs can save your life. This diet is associated with higher levels of telomerase, an enzyme that maintains telomere length which is associated with health and longevity. Skim milk and egg whites are allowed. People without heart disease can eat more fat including wild salmon.
6. If you have metabolic syndrome or can't eat grains, an Eco-Atkins diet with regular meat, that includes 12% or less animal protein and 12% or less saturated fat has been shown to be healthier than the standard American Diet. Lower values give even better lipid profiles.
7. The low carb diet of Dr. William Davis is good if you have metabolic syndrome or can't eat grains. But unless you eat wild game or grass-fed meat you are not likely to get good results for heart disease and cancer (even if you lose weight and lower your blood sugar.)
Two bad choices
1) Reduce saturated at a little bit but eat lots of sugar, white flour and fried potatoes and order large portions when you eat out. It will increase your risk of the obesity, metabolic syndrome and diabetes.
2) Eat low carb with fatty cuts of grain fed meat. It won't increase everyone's LDL or give everyone heart disease and cancer, but it will increase the risk for the average American.
Everyone in the developed world knows what's causing our obesity epidemic. BBC nailed it: "We eat too much, and too much of the wrong things," and Michelle Obama tells us "We have to move more." Clearly what we need is a balanced diet of lean meats, some good fats, and complex carbohydrates like fruit, vegetables and whole grain bread, and exercise of 30 to 90 minutes per day. Their prescription is completely reasonable and makes intuitive sense.
It is neat, plausible, and wrong. It has in fact been disproved, as nearly as "disproof" can exist in nutrition science.
In his previous book, Good Calories Bad Calories, respected science journalist Gary Taubes exhaustively researched and cited two centuries worth of research in nutrition. He came to the conclusion that none of those recommendations is supported by science, because the fundamental theory on which they're based is wrong. Why We Get Fat is an updated summary of that earlier work, much quicker and easier to read, with some significant points clarified.
The most important point of the book is that all those public recommendations -- the food pyramid, the "eat food, not too much" approach, everything we know about a balanced lifestyle -- is founded on the premise of Calories In vs. Calories Out. That we get fat because we eat too many calories, or we don't burn enough of them through movement. But this is nonsense. It's not just wrong, it is actually not a statement about what causes obesity at all (or heart disease, cancer or diabetes, for that matter.) It is, in Taubes' words, a "junior high level mistake," because it tells us nothing about fat accumulation. If we get fat, by definition we have taken in more calories than we've put out -- but WHY we took in those calories, or didn't burn them, is the key point.
Taubes reviews the scientific literature (rather than the popular press) and presents a conclusion that was common knowledge before WWII, and heresy afterward: we get fat because our fat cells have become disregulated and are taking nutrients that should be available to other tissues. Like a tumor, the cells live for themselves rather than in balance with the rest of the body. And since those nutrients aren't available, we become hungry and tired. Therefore we eat more, and move less.
For the chronic dieters among us, one passage about animal models will explain decades of frustration. Rodents with a particular part of the hypothalamus destroyed would become obese and/or sedentary *as a consequence* of their bodies putting on more fat. "After the surgery, their fat tissue sucks up calories to make more fat; this leaves insufficient fuel for the rest of the body...The only way to prevent these animals from getting obese is to starve them...they get fat not by overeating but by eating at all." Sound familiar?
The problem isn't one of gluttony and sloth, as Taubes refers to it, but of hormone balance. Simply put, some people are more sensitive to the hormone effects of insulin, cortisol, and a few other -ols, than other people are. The more sensitive you are, the more you're likely to get fat, and the more fat you're likely to get, in the presence of even small amounts of carbohydrate -- and in the absence of enough fat.
That's right, this book advocates eating fat. Not just moderately, but as much fat as possible, up to 78% of calories. Not lean meats, not Jenny-O 99.6% fat-free turkey, not skinless chicken breasts, but lard. Yes, lard. The healthy way of eating, according to Taubes, is moderately high protein and high fat. Yes, high fat. About a 3:1 ratio of fat to protein, and almost no carbohydrates. (Telling people to eat a balanced diet containing carbohydrates is, he says, equivalent to telling smokers to include a balanced serving of cigarettes.) And he demonstrates exactly why a high-fat, low-carbohydrate diet is the most heart-healthy approach, as borne out by several dozen recent studies.
While Taubes acknowledges that exercise seems to be good for us for a variety of reasons, weight control isn't one of them. Study after study conducted by proponents of exercise have admitted that they see no compelling evidence for exercise as a weight-loss tool. And it makes sense if you throw out the calories in/calories out model of why we get fat. If we're fat because our fat tissues are starving the rest of our cells of fuel, exercise is just going to make us hungrier and more tired, not leaner and more fit. (It's worth noting that according to Taubes, in the 1930s obese patients were treated with bed rest.)
[This review was edited to clarify the following point.] The main thrust of Taubes' argument, however, surrounds sugar and to a lesser extent any carbohydrate. Insulin is the primary hormone that fixes fat in the fat cells. This is why Type I diabetics lose weight: they're not producing enough insulin. Since insulin is manufactured in direct response to carbohydrates, if you don't eat them, you won't have a mechanism by which to store fat. (Taubes notes that this mechanism is not controversial; it simply hasn't had an impact on nutrition policy.) Taubes argues that any success in standard diets can be attributed directly to the dieter's reduced intake of carbohydrates, especially sugars and particularly fructose.
Once the underlying cause of obesity is understood (hormone balance, not gluttony/sloth) the recommendations on what to do about it are surprisingly simple and therefore brief. This is a book about the science of nutrition, not a diet book, but there is a list of recommended foods in the Appendix. The book does not tell you how to eat in a restaurant. But it does tell you that the issue isn't in your brain, your willpower, your character, your job, your environment or even (except to the extent that you're sensitive to carbohydrate) in your genes. The problem with fat is in your fat cells.
For a lay audience, this book is as good as it gets if you want to read actual science about health and nutrition. If you're of scientific or technical bent, read Good Calories Bad Calories first, then give Why We Get Fat to your parents.