The Challenge of a Healthy Diet

Gary Taubes, who is a Science Writer for the NY Times, has a piece out called Is Sugar Toxic? (hat tip Daring Fireball for linking to it)

At first glance, the title sounds a bit hyperbolic, but don't let that stop you. Taubes has been writing about this stuff for a long time and has a lot of heavy research behind his opinions. When I was previously talking about some of the things I've been chasing in restructuring my lifestyle, a friend of mine suggested I read Taubes' books on the subject, which I have.I read Why We Get Fat, and then I went off into a corner to think about it for a while. I knew I wanted to talk about it, but I wasn't sure how.

Many things he says struck home, they sync up well with how I have come to feel given the research I've been doing.But the thing is, I can't point to this book and say "he's right". He's going against standard medical advice. Frankly, I'm not qualified to look at his data and say "believe him instead", and the universe is full of people who have the real answers that the "establishment' wants suppressed, so any time someone bucks the establishment, you need to be careful and understand the issues before buying into it.So having told you to be skeptical -- and that includes being skeptical of me -- I do encourage you to read this book and consider what he has to say. His opinions struck home to me, and align well with what my study independent of him was making me think; his opinions are well backed up by studies, and those studies he's using seem to be well-designed and well-implemented, their results seem consistent, and they come from reliable institutions.

And he's not selling a product (ALWAYS be extra skeptical when there's a product involved); this isn't a framework of studies based on 12 teenage girls from Cleveland looked at for four weeks.His research and data frankly impresses the hell out of me, and he reaches back into the past to unravel how we got here and how the medical establishment ended up recommending the current dietary protocols and why he thinks they're wrong.The basic underpinning of Taubes work is that the medical establishment made a leap of faith in deciding that fat was bad for humans and therefore, carbohydrates are good; that this dogma was established through a few key researchers that politically others weren't willing to challenge, and that unfortunately, there's basically no medical studies that can be found that prove they're right, and a growing body of evidence that the current idea of "fat bad" is flawed.

There are a growing number of people who are starting to take up this concept. It was recently written up on the Huffington Post by Kristin Wartman and she quotes a number of folks from Martha Rose Shulman (NY Times food writer) to Dr. Frank Hu (Harvard) with opinions that encourage moving away from the "low fat" movement.I encourage you to read the Taubes piece and the Wartman piece, and if they seem to make sense to you, grab a copy of Taubes book and read it and consider his arguments for yourself. I am not saying "he's right, do this"; but I do believe it is in your best interest to consider his arguments and make up your own mind.Having been chewing on this (sorry!) for a few weeks, here's my view of this. As a survivor of the 70's "pasta and bagel" diet mentality, I've long felt that the blind view that fat is bad for you so eat carbs instead was flawed. My personal reaction to the 70's diet was weight gain and a tendency towards blood sugar crashes because the carbs hit harder and fade faster. I've always tried to trend towards a more protein heavy diet over a classic "mediterranean" diet, and this whole "one size fits all" mentality for dietary regimes has always seemed over simplistic to me.

My genetic background (northern germanic) is one not well attuned to the mediterranean diet, and I've never really reacted well to it when I've tried, so even without all of the research that's been coming out the last few years, I've had personal reason to believe the dogma around dietary practices had flaws, if only because it doesn't take into consideration basic things like ethnic and regional genetic differences -- but then, it wasn't that long ago that drug testing was done almost exclusively on white males and the reality that drugs responded differently to blacks or women or other ethnics was kind of ignored. It's only been in the last couple of years that we've seen the first drugs come out specifically for blacks that take into consideration the genetic differences in how drugs are processed, and this is still a new part of the medical field.If you stop to think about it, this medical dogma has been eroding for decades. In the 70's, cholesterol was bad and to be avoided. Now, there are HDLs and LDLs and Triglycerides and some of these actually help the heart, and instead of tracking to a low total cholesterol number, you're encouraged to do things to raise HDL while lowering LDL, and so we've figured out reality is a lot more complicated than they told us. Eggs have even been brought back from exile.Ditto fat. Used to be, fat was bad. Now, the still yell FAT IS BAD, and then whisper "but monounsaturated fats are maybe kinda less bad"; sometimes they even admit that the poster child of the anti-fat establishment, that box of lard, is actually about 50% monounsaturated fats and maybe not as bad for you (in moderation) as they said. Especially if you swap it out for something that uses trans-fats.And yes, there are really three kinds of fats in our world today -- unsaturated fats, saturated fats, and trans-fats. The latter are manufactured by the food industry and increasingly, we seem to be finding out those are the least healthy of them all.(interlude: interestingly enough, this new study just hit my inbox, where a high fat, low carb diet seems to protect and repair kidney damage in diabetics.

By shifting to a ketogenic diet, it seems to give the body a chance to repair the kidneys in mice. Whcih is interesting, because one thing the Atkins diet was criticized for was that it puts the kidneys into ketosis and that was considered bad for the kidneys. Except if you read Taube's book, one thing he talks about is a study of existing aboriginal hunter/gatherer societies like the australian aborigines and the Inuit, and if you study their traditional diets, they are heavy in protein and fat, not carbs, and are generally ketogenic -- and that the belief that the classic "historical" diet of our genetic predecessors as being carb-centric is wrong, and part of the evidence against our current dietary programs.. it's definitely worth reading Taube's take on this, but this study seems to reinforce this idea)

Carbs are no longer carbs. Carbs are now complex carbs and simple carbs, and simple carbs include sugars, and a subset of sugars are the fructoses, which include high yield corn fructose, another manufactured product that's been heavily adopted by the food industries. And even the medical establishment is telling people to eat complex carbs more than simple ones.So the reality is, even though the high level position of the medical industry hasn't changed, if you listen to the details, you can see how it's eroded over the years: Cholesterol is bad (well, some kinds of cholersterol); carbs are good (well, some kinds; other kinds aren't), and fat is bad (well, except for the kinds of fat that aren't bad for you). And more and more of the medical researchers are starting to question and poke holes in the standard dogma.Here's a quick thought on the question "Is it really possible that all of the experts on health and nutrition in medicine are wrong?" -- consider this. Look at the sheer numbers involved in the obesity and diabetes epidemics confronting us; they're estimating as many as 1 in 3 americans will be diabetic in 20 years.

Ask yourself "is it really possible that this large a percentage of the worldwide population is unable to follow the instructions for eating healthy?" (which is, really, what the medical establishment and the media that echoes their messaging basically tells us; it's our fault) -- or is it possible that the information being given to these folks is wrong? And if it really is societies inability to follow these directions, what changed in the last 40 years, because up until that point, we had hundreds (maybe thousands) of years where we could. Obesity and diabetes are fairly new epidemics, and, coincidentally enough (or not) coincide with the "low fat" healthy diet teachings that led to the "bagel and pasta" diets of the 70's and up to today. It also coincides nicely with the switch to more refined/industrial foods and the growth of high yield fructose over natural sugar, as well as the massive increase in intake of sugar as a percentage of diet.Now, to circle back to Taube's article on sugar for a bit: I think he's mostly right on, but with a caveat. I disagree with his premise that sugar is toxic in two aspects.

First is he lumps in "real" sugar (which is typically about 50% glucose and 50% fructose) as being as bad for you as high-yield corn syrup (which is typically 45% glucose and 55% glucose) is going to be proven wrong. There are studies coming out that show that we don't process glucose and fructose the same, and that the human body is genetically tuned to process sugars -- when that ratio is thrown off and there's extra fructose in the mix, the body doesn't adapt and things get out of balance. This is going to be the defining reason why the high yield stuff is going to be shown to be more damaging and more fattening than "real sugar", that ratio change is significant in how the human body processes and reacts to the food. So they aren't going to be equally damaging, high yield corn syrup is worse for the body than sugar is -- I believe. it's not proven, but the studies are coming out, and I believe it's a matter of time.The second aspect I don't agree with him on is the emotionally charged word "toxic" -- he is right, but only if the substance is abused. Right now, sugar seems to be going through the same demonization phase that alcohol went through. SUGAR IS BAD. Well...Yes, it is, if you eat too much of it. And just like eggs were demonized over cholesterol and have been returned from exile, and alcohol was demonized and has been sort of returned from exile (much of the medical establishment seems incomfortable admitting that moderate amounts of alcohol seems to be actually helpful, because they seem unwilling to admit that we all won't end up abusing it and going alcoholic; but small amounts of alcohol and certain types -- like red wine -- seem to be healthful in many ways), we're doing the same to sugar.My view is different; I think these things IN MODERATION are going to be fine.

The key is doing things in moderation. In the last 40 years or so, the typical american has gone from eating 40 pounds of sugar a year to over 90 pounds, and a chunk of that 90 pounds is the high yield stuff. There's a very close correlation on this increase in sugars in our diet and the growth of diabetes and obesity in the culture. The link isn't proven, but I'm convinced it will be. When we ate moderate amounts of this stuff within our diets, we didn't get fat, we didn't get diabetic. Now we eat way more than we should, and we do.So I'm uncomfortable promoting the "sugar is toxic" concept. I don't believe it is. I believe that abuse of sugars is bad for your health, and chronic abuse leads to chronic health issues. But eating a healthy diet in a healthy lifestyle (there we go, away from simple answers to complex solutions. sorry!) with this stuff in moderation within it is how to make this all work.What does that mean for how I'm trying to do this in my own life?I think the manufactured foods are evil; I try to minimize both trans-fats and high yield fructose corn syrup.

That's difficult to remove 100% from an american diet without extreme changes (please don't suggest vegetarian, not gonna happen) but I steer away from them, and they play very small parts  in my diet and I try to remove them where I find them and can.I try to aim FOR healthy fats and complex carbs and AWAY from saturated fats and simple carbs.  Which is tougher than it sounds, because white flours are a simple carb and you have to be careful even with "whole wheat" and how that term is used. I am not banning lard, or white sugar, or white flour from my life. But I am also not pulling out the tub of lard and a spoon. I believe if you use margarine instead of butter you're being foolish (and research is showing I'm probably right), but I try to be rational about how much butter I use.I try to be moderate about all this stuff. My goal diet is 40% protein, 30% carbs, 30% fat. I try to steer towards healthy stuff; the more processed foods are, the less you should eat them.

But I still drink alcohol (once or twice a week), I still eat sugar (I just don't bathe in it), I still eat breads (but I lean towards whole wheats and lower carb versions where I can); I still eat cheese (a lot, actually). I'm still not where I want the diet to be -- I'm more 35% protein, 40-45% carbs and the rest fat, and unfortunately, as a diabetic, I feel that's too high on carbs. But if I weren't diabetic, I'd feel comfortable taking my diet to any dietician in the universe. Which says a lot, given that five years ago, I was a burger-and-fries guy five or six times a week. Now? maybe once a month -- except I rarely eat more than a few fries, because I find them rather grainy and salty (I'm convinced most fast food fries are eaten by habit, not because they remotely taste good; I'm happy to say I've lost my taste for them).And having said my diet is 95% of where i want it to be, that last 5% is proving to be a terror. but I keep working on it. that's a discussion for later, though.So read Taubes' article, and think about getting and reading his book. See if you agree with his arguments, and what that means for your lifestyle and diet. And then we'll talk. This is a big, hairy, complex thing; if there's a real sin the medical establishment has committed,it's that they simplified this into something unintelligible, and then tried to solve all of the complex wrinkles off in the footnotes. Get yourself out of the footnotes and get informed and start figuring it out for yourself -- and Taubes is a good place to start.