In The News: Oh, Look... Calories!

CNN is reporting the findings of a new study published in the New England Journal of Medicine comparing the efficacy of four diets -- high-carb, low-carb, high-fat, and high-protein.

Although not based on popular diets (the high-protein diet, for instance, does not provide the same distribution of nutrients as Atkins), the four eating plans had their particular distinctions (i.e: one offered 35 percent of calories from protein, while another increased the amount to 65 percent of calories from protein).

The conclusion? "All produced weight loss and improvements in lipids [as well as] reduction in insulin. The key really is that it's calories, not the content of fat or carbohydrates -- just calories," summarizes study co-author Dr. Frank Sacks of the Harvard School of Public Health.

Or, as the study itself beautifully encapsulates it: "reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize."

No matter which of the four diets the 811 overweight participants were on, they all "had a[n average] 750-calorie reduction per day."

Not surprisingly, they all lost weight.

Note that even the higher-in-fat diets followed American Heart Association guidelines (mainly sufficient fiber intakes and limited saturated and trans fat intake).

Let this be even further proof to the "saturated fat is the healthiest fat; everyone is lying to you!" camp that diets rich in polyunsaturated and monounsaturated fat do indeed lead to improved lipid profiles and weight loss.

Adding to the uniqueness of this study is that it is one of the few that tracked participants on these diets for two entire years.

How will "calories don't matter, it's all about limiting carbohydrates"enthusiasts explain yet another study showing weight loss can be accomplished while eating a substantial amount of carbohydrates?

Leaving Out Vital Information

Vending and food service company Next Generation has introduced Vitalities, a sticker-based initiative which "provides customers the ability to make selection based on healthy snack and beverage alternatives, while still having the flexibility to select name brand product options."

In essence, products that meet certain health criteria -- created with the help of a Registered Dietitian -- get a sticker next to their item code.

On the food side, the following categories are offered: lower in fat, lower in sugar, lower in carbs, and "higher energy."

Why are they leaving out the most important concept-- CALORIE information?

Consider the following. To qualify as "low in sugar", a product must meet one of the following criteria:

* Sugar Free
* No Sugar Added
* Contains less than 4 grams of sugar

These divisions are very helpful for snack companies because they don't evaluate their products from a whole nutrition profile.

Per the above mentioned standards, something like Sugar-Free Reese's Peanut Butter Cups would receive a "low in sugar" sticker (and therefore seem like a healthy choice) despite offering 6 grams of saturated fat (30% of a day's worth) in one 180-calorie serving.

Similarly, a bag of Skittles can receive a healthy-sounding "low-fat sticker", all while offering 250 calories and 12 teaspoons of sugar!

I am also perplexed by the "lower in carbs" sticker. Unless someone has diabetes, there is no reason to believe that low carb figures by default indicate a healthier choice.

The beverage stickers are slightly better, as they are divided into these four categories: lower in fat, lower in calories (yay!), lower in caffeine, and higher in nutrients.

My concern here is the "lower in fat" label, which makes no mention of calories in its criteria:

* Less than 2.5 grams of fat per 8 ounce portion
* Skim and 1% milk
* Flavored waters
* Juices
* Energy drinks

Notice that soda can not qualify for this sticker. Fine and dandy, but sweetened flavored waters (often containing just as much sugar and as many calories as soda) can.

This initiative is a start, but I would much prefer vending machines post calorie information on items.

After all, unless people have those figures memorized, they are unable to see them until they have already made their purchase.

You Ask, I Answer: Hydrogenated Starch

I recently saw an ingredient called "hydrogenated starch."

What is it?

Is avoidance prudent?

-- Corey Clark
(Location withheld)

Let me guess -- you saw hydrogenated starch as an ingredient in a sugar-free product?

Althrough hydrogenation always conjures up thoughts of unhealthy fats, that same process is rather harmless when applied to starch.

Hydrogenating starch is one way of producing a calorically low sweetener (approximately two to three calories per gram, compared to sugar's four.)

It's technically a type of sugar alcohol (just like sorbitol, maltitol, and other ingredients ending in 'ol' that you can spot on most low-carb candy bars.)

First, starch -- usually corn or wheat -- is partially hydrolyzed (meaning molecular bonds are broken by reacting them with water.)

The resulting molecules are then hydrogenated (saturated with hydrogen).

End result? Sweetness, bulk, long shelf life, and the ability to develop products labeled "diabetic friendly" or "low carb."

Hydrogenated starch in and of itself does not pose any health risks.

In The News: Taking Back "the C Word"

Let's do this Vagina Monologues style. Ready?

Say it with me:

c-c-ca-ca-ca-calo.... calor-calor-caloriesssss!

How wonderfully liberating!

After a long period of foolishness where mainstream weight loss rhetoric focused on fat grams, carbohydrate grams, or what time of day you stopped eating, The New York Times -- in an article beautifully titled "Calories Do Count" -- reports that "good old calorie counting is coming back into fashion."

That's right -- after being dismissed by the likes of Gary Taubes and his ilk, calories are the new black!

Consumers are simply beginning to re-embrace the idea that successful, long-lasting weight loss comes with familiarizing themselves with calorie contents of foods, as opposed to eating unlimited amounts of foods that are simpy very low in carbohydrates or fats.

It is worth pointing out that this heightened caloric awareness is a direct result of labeling laws that take the guesswork out of ordering at many restaurant and takeout chains.

Meanwhile, restaurants -- profits firmly in mind -- are "jumping on the latest bandwagon."

"Dunkin’ Donuts recently added a low-calorie egg white breakfast sandwich, Così is using low-fat mayonnaise and McDonald’s large French fries have dropped to 500 calories this year from 570 last year."

Additionally, "Quiznos is testing smaller sizes and less-caloric sandwich fillings in its New York stores. At Le Pain Quotidien, which has 17 outlets in New York... the popular quiche Lorraine was trimmed to 6 ounces from 11, with extra salad filling out the plate."

Food manufacturers, meanwhile, will soon be catering to the "calorie trend" by printing calorie values on the front of their packaging.

Don't be surprised if, a few years down the road, mandatory chain restaurant calorie labeling laws go national.

You Ask, I Answer: Protein/Abs

One of my friends wants to lose some excess weight from his stomach and have visible abs, so last week he started eating pretty much nothing but lean protein, protein shakes, and steamed vegetables.

He doesn't work out or eat any kind of carbs (apart from the steamed vegetables.)

He says he is already seeing results.

What do you think?

-- Tom (last name withheld)
New York, NY

I think your friend is absolutely misguided and approaching the situation with very little thought.

While it is true that abs "are made in the kitchen" (meaning that your diet must be very carefully managed, since visible abs are the result of low body fat, rather than endless crunches), eating nothing but protein and steamed vegetables is not the answer.

I don't know what your friend's diet was like prior to this, but it is very likely he will lose weight with this particular way of eating, as I am sure his total daily caloric intake has decreased.

Remember, though, that low-carb diets get rid of water weight in the first few days, which is what I think he refers to when he claims he is "already seeing results."

The fact that he does not work out is a significant problem.

Building muscle tone helps speed up metabolism, thereby facilitating weight loss while maintaining muscle mass (this way, you are losing mostly fat.)

These kind of ultra low-carb diets are also impossible to sustain for more than a few weeks.

If your friend wants to have visible abs, he has to keep a few things in mind:

1) Genetics play a role. Some people have an easier time achieving a six pack, while others can "only" show off a "four-pack" with that same amount of effort.

2) We all have abs. They are invisible, though, when they are hidden by a layer of fat. If you'd like to proudly display them, you must get your body fat down to approximately 6 or 7 percent. That absolutely requires vigorous physical activity several times a week.

3) In order to engage in vigorous physical activity several times a week, he certainky needs to take in more carbs than he is now. Otherwise, he will not have sufficient endurance, and his body will start breaking down muscle to provide him with sufficient energy!

His goal should be to increase physical activity, eat as few processed foods as possible, and maintain a pre-determined caloric range.

Otherwise, I see him lasting two more weeks and then simply going to the other extreme -- declaring this "too difficult" and "not worth it."

You Ask, I Answer: Battle of the "Diets"

Andy, are you going to blog about [the study that concluded that a low-carb diet was more successful at helping subjects achieve weight loss and healthier blood cholesterol profiles than Mediterranean or low-fat ones]?

-- Anonymous
Via the blog

I was most certainly planning on commenting on this study, mainly because of some very distracting flaws I noticed.

Let's begin with some basic information.

The study -- partially funded by the Robert and Veronica Atkins foundation (potential bias, anyone?) -- took place over 2 years, during which 85% of the 322 participants stuck with their respectively assigned diets (low-fat, Mediterranean, and low-carb.)

Now with some of my "uh, wait a minute" impressions.

Firstly, when it came to weight loss, low-carb beat out low-fat by 4 pounds (10.3 lbs vs 6.3 lbs), but edged out a Mediterranean Diet (which includes higher carbohydrate consumption) only by 0.3 lbs.

And although the low-carb diet resulted in the best blood cholesterol profiles, it's important to note that for this study, researchers "urged [the] dieters [on the low-carb diet] to choose vegetarian sources of fat and protein."

In other words, although the low-carbers had the highest saturated fat intake out of the three groups, the majority of their fats came from plant sources.

There isn't anything groundbreaking here. Anyone keeping up with nutrition research knows that mono and polyunsaturated fats are recommended for heart health.

Hence, this study calls into question the belief so many low-carb fanatics like Gary Taubes fervently hold on to -- that saturated fat is the best for blood cholesterol levels.

The study specifically mentions that the blood cholesterol levels of the low-carbers is due largely to the consumption of monounsaturated fats.

Besides, I always wondered why low-carb enthusiasts even bother bragging about improved cholesterol profiles on their diets when, two seconds later, they turn around and say that the cholesterol-heart disease link is a lie and the result of "bad science." Which is it?

The study wasn't entirely a "low carb diets RULE!" piece, either.

For instance, the Mediterranean Diet -- which was highest in fiber -- proved to be the most effective at managing blood glucose levels.

Yet again, this goes against traditional low-carb beliefs (and, once again, those Gary Taubes loves to pontificate) that the research on fiber is "inconclusive at best" and that there is no need to have it in the diet.

Before anyone jumps down my throat about whether or not I read Good Calories, Bad Calories, Gary Taubes himself said at his New York University talk in March of this year that he didn't think high-fiber grains were any healthier than refined ones.

Speaking of fiber, I noticed that the low-fat group was only asked to consume "low-fat grains."

This struck me as odd, mainly because it is hard to find grains high in fat -- they are all low-fat.

Additionally, it's hard to overlook some bias.

The study does not urge low-fat dieters to consume the healthiest grains (whole grains), yet specifically requests that low-carb dieters eat the healthiest fats.

I also found it strange that for the majority of this study the low-carb group was consuming 120 grams of carbs a day. This is definitely higher than the much lower levels recommended by most low-carb advocates.

Atkins, for instance, usually calls for no more than 100 grams of carbohydrates per day during the maintenance phase.

Finally, take a look at the numbers and you see that although the low-carb group was not calorie-restricted, their caloric intake was lower compared to their pre-study diet.

So, as always, we are talking about weight loss as a result of reduced caloric intake.

In The News: A Case for Calories

Oh, what a great morning!

The weather is absolutely beautiful in New York City and I wake up to a story from Time Magazine in which Harvard School of Public Health Chair Walter Willett (pictured at left) reminds us what matters most when it comes to weight gain and weight loss -- calories!

I have never been a fan of the scapegoating targeted at specific nutrients.

I do not think eating fat causes people to become fat, nor do I think carbohydrates are sent up on an express elevator from hell.

This is why, if you are a reader of Small Bites, you know that the recipes I share are not "low fat" or "low carb."

"From many kinds of studies conducted over years, we are quite confident now that a calorie from fat will cause a similar amount of weight gain as a calorie from carbohydrate," Willett affirms.

And, no, he isn't pulling this theory out of thin air; there are plenty of studies showing that diet composition isn't as important as caloric intake in determining weight.

"The best way to get to the bottom line is to look at long-term studies where we randomize people to a high-fat/low-carb diet or to a low-fat/high-carb diet and follow them for at least a year or more.

That kind of study takes into account the possibility that one kind of diet provides more satiety; so, over the long run you would see more weight loss on that diet.

But those studies — half a dozen or more such studies have been done — show quite clearly that the percentage of calories from fat has very little effect on long-term weight loss."

What Dr. Willett does stress is that the quality of fats and carbohydrates are important (i.e.: whole grains, monounsaturated fats, and Omega-3 fatty acids are nutritionally superior to refined grains, saturated fats, and trans fats).

Let's cap this off with another great quote: "We've now looked at over 250,000 men and women for up to 30 years, and we [also] haven't seen that the percentage of calories from fat or from carbohydrates in your diet makes any difference in relation to heart attacks, various cancers, or stroke."

Let the Gary Taubes fanclub hatemail begin...

Speaking With...: Milton Stokes

Milton Stokes, MPH, RD, CDN is the owner of One Source Nutrition, offering a variety of private counseling and media consulting services.

He is also an American Dietetic Association National Media Spokesperson who has been featured in a plethora of publications, including Self, Cooking Light, Men’s Health, Fitness, and the New York Daily News.

I first met Mr. Stokes in January of 2007 when he served as an adjunct professor for New York University’s Department of Nutrition, Food Studies, and Public Health.

He is an intelligent, sharp, and charismatic entrepreneur who is a wonderful asset to the field of nutrition and dietetics and communicates his nutrition knowledge in a most effective manner.

On with the interview:

What shifts, if any, have you noticed with your clients over the past decade? Is nutrition education really more widespread?

Most people come to my office well-educated on nutrition and health.

They develop admirable knowledge from websites, like anything associated with NIH.gov, and certain consumer publications, like Eating Well and Cooking Light. Clients know all about MyPyramid and reading food labels. So it's not a knowledge gap.

Instead, the problem is that gray area of disconnect, that missing spark to motivate clients to implement their knowledge.

A lot of what we do in the practice is boost a client's self-efficacy. We simply point out "You say you want to achieve health, but you continue with this behavior."

From there we proceed by encouraging them to start with a specific change today or this week. Showing clients we believe they can do it helps enhance their sense of self belief, which is what self efficacy is all about.

What do you perceive as two of the most important behavioral modification changes people who are looking to lose weight can do?

Step one is getting proof of what a client's eating and drinking. Proof in the form of a simple food journal. It's amazing what a difference seeing food consumption on paper really makes. Subtle, but significant, patterns start to emerge.

Usually those patterns are enough to guide future work with the client. We work with eating disorders mostly, and as I said earlier, our patients are extremely educated in nutrition. But they do things, like sabotage themselves with unhealthy environments at home.

Premium ice cream and other binge foods don't crawl into the kitchen without help. With exercise, owning a treadmill is a good start, but you can't use it as a wardrobe station in the basement. Take those clothes off of it--or whatever items reside there--and have it ready.

This leads me to the next tip: plan. If you don't plan to exercise, you probably won't. Your sneakers and workout clothes won't magically appear if you don't take them out. Furthermore, take them with you in the morning. After work it's a little easier to get to the gym when you don't have to come home to change.

Once home, it's like pulling teeth to go back out. Home has dishes to be done, laundry to fold, mail to open, and so forth. Those are common distractions that become excuses. So I say bypass those and do the exercise first.

Planning is applicable to food as well.

Do most of your clients share a common obstacle/hurdle in reaching their health/nutrition/weight goals?

We see mostly females in our practice. And the adult women tend to prioritize everything but their health.

For one of many examples: They shop for food, they cook the food, and they clean up after it's all over. I say, "Hold up, why can't you farm out some of this work?" Give the list to your spouse; assign your 10-year-old the task of tearing lettuce for the salads and setting the table; each person clears his own dishes and loads the washer.

That the woman has to do all this is really old fashioned. And it's a common barrier to putting health first. If you aren't healthy, how can you take care of your family?

Finding ways to earn back 5 minutes here, 5 minutes there will add up. Soon you're at 20 minutes, which is enough for a brisk walk and some alone time to clear your head.

Are there two or three popular nutrition myths that most of your clients have interpreted as "truth"?

Eating breakfast makes me gain weight.

Stop eating after 6 pm or all the food turns to fat. But digested food isn't like Cinderella's carriage: at the stroke of midnight (or whatever time) it doesn't turn into a pumpkin....or into fat.

Holy grail of nutrition and feeding is some secret or mystical concoction. What's the minute, teeny tiniest thing I'm missing to make me whole?

Exogenous digestive enzymes....we would've died out ages ago.

As a nutrition educator, are there certain inaccurate messages in the mainstream media regarding nutrition that especially frustrate you?

In general, a lot of marketing jumps the gun on real benefits of specific nutrients or foods. This promotes adult food jags of sorts.

One day dried plums or blueberries or tomatoes are the rage. The next, it's some hideously bitter juice designed to extend life by 7 years.

Then just a pill crammed with all the nutrition of 10 fruits and vegetables. There is no secret or miracle to losing weight or preventing disease. Eating real food does the trick--but that message isn't sexy or provocative or profitable.

Having said that, let me also pause to recognize the work of researchers.

Nutrition is an evolving science, so what we know today may change tomorrow as research is completed. And that's okay. There's nothing wrong with continuing to pursue new findings.

I do wonder, though, what would become of human health if we diverted some of those research dollars to subsidize fruits, vegetables and whole grains? We know that eating this way works. Do we need more research, or can we go ahead and pay farmers with research dollars to deliver their products to all neighborhoods?

People could go to market several times a week, or whenever, and stock up. Farmers could be paid to go door-to-door. Consumers wouldn't pay a thing.

What particular direction would you like the nutrition field to embark in over the next 10 - 15 years?

Stop putting everything under a therapeutic microscope.

Stop hanging on the latest research finding that says a certain micronutrient might do this or might do that. Nobody eats solo nutritients. Clients tire themselves by getting carried away over headlines without understanding the full scope of the study.

Studies isolate single nutrients without considering synergy or total nutrient packages in whole food. This relates to what we talked about earlier: the message to eat more fruits and vegetables isn't glamorous or trendy.

I am concerned with incessant food scares over pathogens and improper food handling.

I'd like to see nutrition researchers partnering with sleep experts. Who isn't sleep deprived? Without enough sleep we know it's quite difficult to lose weight, and you're more likely to reward yourself with high-carbohydrate foods as way to feel better.

Vitamin D [is another subject that we need to look into further].

I might get in trouble for this, but we may have missed out on the opportunity to consider low-carb diets. First of all, I believe no single diet fits every person. I also believe low-fat isn't necessarily top dog.

Researchers, like Jeff Volek, have shown low-carb diets promote fat loss, preserve lean muscle mass, and improve lipid profiles. Am I saying we all need to eat low-carb? No. But we could let the scientific process show us what low-carb eating can do.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
A huge thank you to Milton for participating in this interview.

If you enjoyed this interview, be sure to visit his new blog for more information and tips.

Nutrition Highs and Lows

People regularly throw out the terms “low-fat”, “low-carb”, “high fiber” and “reduced sugar” liberally -- and often times inaccurately.

Although the terms “high” and “low”can be subjective (a 15-story building in Manhattan is relatively low compared to the surrounding skyscrapers), they are mostly defined by clear-cut boundaries in the world of nutrition.

When in doubt, here is a handy guide.

If you’re talking fats, a “very low fat diet” gets no more than 15 percent of total calories from fat.

A traditional low-fat diet, meanwhile, consists of no more than 30 percent of calories from fat.

Keep in mind this is a rather wide spectrum.

In reality, 16 to 25 percent is truly considered “low fat”. By the time you get to the 25 – 30 percent range, you are crossing into more moderate territory.

Hence, the latest mainstream recommendations for 30 – 35 percent of calories from fat can not be casted off as “low-fat” dogma.

The heart-healthy Mediterranean Diet, for instance -- which no one would ever describe as “low fat” due to the prevalence of olive oil, nuts, and fatty fish -- consists of approximately 30 - 35 percent of calories from fat.

It is worth pointing out that the Mediterranean Diet is high in monounsaturated fat and very low in saturated fats.

Mainstream dietitians have no qualms in recommending daily intake of heart-healthy foods like almonds, walnuts, olive oil, salmon, avocado, and flaxseed.

Although there is no true definition of what a “low carb” diet is, two numbers keep popping up in the literature.

Many clinical research trials define “low carb” as no more than 60 grams of carbohydrates per day.

More intense low-carb advocates, however, bring the number down to no more than 30 grams a day (as much as one large apple or one standard slice of bread.)

Food labels also have to abide by certain protocols (established by the Food & Drug Association) to make “high” and “low” claims.

In order for a product to be labeled “low fat”, for instance, it must contain no more than 3 grams of fat per serving.

The term “reduced calories” can only be used on a product that provides at least 25 percent fewer calories than the regular variety.

Similarly, any product describing itself as "reduced" sugar must offer at least 25 percent less sugar than the regular variety.

The statement “high in fiber” may only be used on products offering at least 5 grams of fiber per serving.

As for the term “good source of fiber” – you need at least 2.9 grams per serving to qualify.

Lastly, another interesting one: “light” can be used to describe a product that offers either at least 50% less fat, 33% less calories, or 50% less sodium than the regular variety

You Ask, I Answer: Saturated Fat

You mentioned that saturated fat is the "bad" fat and this definitely is the common understanding these days.

Have you read any conflicting evidence about this?

After reading the first half of Gary Taubes' Good Calories, Bad Calories I came to the conclusion that saturated fat really isn't a big deal unless you're in the extreme heart disease risk category, which, at 27 and with normal cholesterol levels, I don't think I am.

And, while I don't agree with Taubes' anti-carb approach, I found his evidence about regarding the fat-cholesterol link (and how research was so highly influenced by politics, guesswork, and some key personalities) very interesting, and moderately convincing.

It seems that cholesterol levels are only veeery minimally affected by saturated fat in one's diet.

I'm wondering how you feel about this aspect of his argument, or if you've seen other people calling the evilness of saturated fat into question recently.

I thought I had it all figured out, but this is the one thing I'm still not sure about.

Thanks so much.

-- Meredith (last name unknown)
Via the blog

Gary Taubes is certainly not the first -- or only -- person to question the saturated fat/heart disease connection.

Although some studies date as far back as the 1950s, Mr. Robert C. Atkins brought the research out of the scientific community and into the mainstream.

He -- along with his proteges -- claimed that eating endless amounts of steaks, butter, and bacon actually led to healthier lipid profiles than low-fat, high-carb diets.

And so we come back to the issue of flawed logic. Let me explain.

Like Atkins, Taubes and his ilk approach this scenario from a very narrow "black or white" perspective.

Firstly, they are quick to judge detractors as low-fat advocates.

This is grossly inaccurate. For instance, I strongly disagree with Taubes, but a quick browse through this blog makes it clear I do not advocate low-fat diets.

Instead, I believe that an adequate amount of the right fats is crucial for our health.

I fail to understand why Taubes and his supporters practically worship saturated fat but completely fail to mention the health benefits of monounsaturated fats and omega-3 fatty acids.

They aren't saying "fat is healthy; make sure to include almonds, olive oil, and wild salmon in your diet!" Instead, they pretty much push red meat and bacon.

Mind you, current guidelines do not call for a complete elimination of saturated fat from the diet; they simply suggest no more than 20 grams a day (assuming a daily intake of 2,000 calories).

Many dietitians -- myself included -- recommend a low intake of saturated fat, but simultaneously urge people to seek out the healthy fats found primarily in salmon, olive oil, walnuts, flaxseed, and avocados.

Although there are some professionals who advocate very low-fat diets -- Dean Ornish comes to mind -- many of the dietitians I know do not support skimping on healthy fats.

Now, when you compare a high-fat (in this case, saturated fat) low-carb diet to a high-carb (conveniently, high in refined carbohydrate), low-fat diet, the high-fat diet will lead to a better lipid profile (triglycerides, for instance, are related to refined carbohydrate intake, not dietary fat).

This, however, is misleading.

It's akin to only comparing bronze (diet high in refined carbohydrates and low in fat) and silver (diet high in fat, albeit saturated, but low in refined carbohydrates) and claiming silver to be the most expensive metal.

Yes, the most expensive of the two.

But, bring in platinum (a diet low in saturated fat but high in mono unsaturated fats and whole grains) and suddenly silver doesn't look quite as amazing.

I would like Gary Taubes to compare two high-fat diets (one high in saturated fats, one high in mono and polyunsaturated fats) and conclude, with a straight face, that the saturated fat-rich one is the healthiest.

There are literally hundreds of human clinical research studies showing a correlation between saturated fat intake and heightened coronary heart disease risk.

One interesting one was published in the July 2005 edition of the British Medical Journal.

Turns out that, in 1991, the Polish government stopped subsidising foods high in saturated fat.

Eleven years later, "deaths from coronary heart disease had dropped by over a third in the 45-64 age group - a 38 per cent drop for men and 42% for women."

During this time, saturated fat consumption fell by 7 percent, and -- more importantly -- polyunsaturated fat consumption increased by 57 percent!

We again come back to the notion that the key is not in reducing total fat intake, but in replacing saturated fats with healthier varieties.

Taubes happily bashes anyone recommending a low-fat diet, but what are his arguments against replacing saturated fats with Omega-3 fatty acids (a type of polyunsaturated fat) for improved lipid profiles?

Moving on to red meat, there is also a good deal of research showing that colon cancer risk is indeed affected by red meat consumption (this 2006 meta-analysis from the Pakistan Journal of Nutrition summarizes some major findings well).

A great Italian study by Talvani et al in 2000 also looked at red meat intake and cancer risk.

I recall Mr. Taubes scoffing and referring to all this evidence as "questionable" when he was on Charlie Rose several years ago.

How he came to that conclusion I do not know.

In my mind, sanctifying saturated fat and telling people to eat it liberally is irresponsible.

By the way, this idea that advice to eat less red meat is some sort of conspiracy relating to politics is rather laughable since, as Marion Nestle brilliantly explains in Food Politics, the national beef association threw a major hissy fit when Dietary Guidelines originally urged the public to simply "consume less red meat".

They were quickly changed to "choose lean cuts of meat," so as to not offend the powerful beef lobby.

We come back, as always, to the issue of moderation.

Have a slice of Swiss cheese here and there or pour a splash of whole milk into your morning coffee if it makes you happy; just don't make saturated fats the main players of your diet.

A Stroll Down Diet Lane

It may seem like a new diet is introduced to the masses every other day, but many of these are reheated versions of oldies.

I recently came cross a brief timeline of fad diets (dates and names only) compiled by The American Dietetic Association last year.

It's quite interesting to see many current bestsellers showing up in previous centuries!

The first documented low-carbohydrate diet, for instance, appeared in Jean Brillat-Savarin's Physiology of Taste back in 1825.

The no-frills (and no-nonsense) counting of calories was first written about in in Lulu Hunt Peters' 1917 book, Diet and Health, with Key to the Calories.

Food combining -- the idea that mixing carbohydrates and protein in the same meal results in weight gain -- originated in the 1930s.

The ever-popular grapefruit diet? It first appeared in the 1950s.

Then there are the truly bizarre fad diets.

My favorites?

There's Horace Fletcher's 1903 low-protein diet plan which urged dieters to chew food 32 times before swallowing.

Not surprisingly, he quickly became known as "The Great Masticator."

In 1925, the Cigarrette Diet came along, in which tobacco companies happily advertised the appetite-suppressing powers of their magic cancer sticks.

One such phrase? "Reach for a Lucky instead of a sweet."

1961 brought along Dr. Herman Taller's, don't laugh now, Calories Don't Count Diet.

According to the good doctor, all you had to do was eat as much as protein as you wanted (he claimed these calories literally "didn't count") and immediately follow that meal with one of his special vegetable oil pills.

The Sleeping Beauty Diet, which promoted heavily sedating patients so they slept for several days and therefore did not consume any calories, emerged from some sicko's mind in 1970.

The ridiculousness is far from over.

Just last year, Rhonda Byrne's The Secret claimed two keys to weight loss were ridding yourself of the belief that food makes you fat and taping a piece of paper with your ideal weight on it over your scale's display screen, in order to allow "the universe" to create a new reality for you.

You "Ask", I Answer: Jared's Subway Diet

It's important to note that when Jared went on his Subway diet, his overall consumption of carbohydrates dropped way down, despite the fact that the relative amount may have been 60% of total calories.

Jared's weight loss is consistent with [Gary] Taubes' ["obesity is caused by high carbohydrate intake"] views.

-- Anonymous
(Via the blog)

I do not intend for Small Bites to turn into a "low carb vs. calorie cutting" blog (that would have been "hot" five years ago).

Alas, many low-carb advocates and Gary Taubes worshippers have found this blog and love to leave, what else, anonymous comments.

I initially thought it made for great discussion, but the postings -- and my subsequent answers -- are starting to rehash previous Small Bites content.

The last thing I want to do is repeat myself, especially when archives of all previous posts are available.

So, unless there is a major development or news story relating to low-carbohydrate diets, this will be my last post actively refuting low-carb claims.

Although readers are more than welcome to leave comments and debate amongst themselves, consider this a closing statement of sorts from my end.

Jared's carbohydrate consumption decreased, but, more importantly, so did his calories.

Had he dropped his carbs to roughly 130 grams a day (as he did when he went on the Subway diet) but still consumed 10,000 calories, he would not have lost weight.

Based on the comments I have received, it seems like the Taubes supporters aren't too sure of their own views.

On the one hand, you say Jared would have lose weight while eating 130 grams of carbs since these 130 grams were lower than what he normally consumed.

However, a large number of Taubes fans have harshly criticized research studies showing low-carb dieting isn't effective because the carb amount used in these studies (45 or so grams) is "too high."

According to these people, true low carb diets consist of no more than 30 grams of carbs a day (anything else, they say, is "not low carb" and therefore does not have much of an impact on weight loss).

So, which is it?

Like I have said before, this is a case of flawed logic.

It's equivalent to somebody saying, "It rains because the sky turns gray."

No, it rains when air rises, expands, and cools (as air cools, it is unable to hold much water; this water often condenses and becomes rain).

Gray clouds themselves do not cause rain.

In that analogy, cutting calories is the equivalent to air rising, expanding, and cooling (the real cause of something), while cutting carbohydrates is parallel to gray clouds (a consequence that people erroneously attribute as a cause).

Jared's case is very simple: calories decreased, and, consequently, so did his weight.

You can attempt to make the "his carbs also decreased" argument, but don't you see that an advocate of a low fat or even a low protein diet could say the same thing? After all, almost every single nutrient decreased.

Someone could even attempt to make the argument that Jared lost weight "because he didn't eat fruits" or "only ate at restaurants starting with the letter S".

So, no, Jared's case (a hundred grams of carbohydrates a day for someone with a propensity to be obese resulting in weight loss) is not consistent with Taubes' views.

The Case Against Low Carb

Ever since I posted about low-carb fanatic and journalist Gary Taubes' talk at New York University, I have been receiving many e-mails and comments from low-carb advocates apparently eager to prove that there is no solid research demonstrating that all calories are created equal.

I direct you to Atkins Exposed -- a website started by Dr. Michael Greger, a semi-controversial player in the field of nutrition.

There are some positions Dr. Greger takes that I do not entirely agree with, but his website does have a rather interesting section that compiles several statements and studies that do not consider low carb diets to be the best thing since, pardon the pun, sliced bread.

I also want to remind you of Michael Fumento's excellent 2003 Reason article.

You Ask, I Answer: Jules Hirsch/Rudolph Leibel Obesity Research

I can't find [their studies].

I do have access to medical and nutrition journals - they are all online, and anyone can access them for about $8 per article - and I still can't find this report.

Nothing from Hirsch and Leibel in 1950s or 1960s.

I have just basic questions about the study - how big was the study (how many people tested) etc - but I can't find that out without finding the original report.

Have you read it?

-- "RicoVado"
Via the blog

I first came across the study two years ago, and was able to find it online for you to peruse -- be sure to download the PDF, rather than simply read the abstract.

In summary, Hirsch and Leibel published a paper in 1992 in the American Journal of Clinical Nutrition, in which they reviewed the records of patients at Rockefeller University's Lipid Laboratory between 1955 and 1965.

They specifically targeted patients -- a total of 16 -- fed different liquid formulas (for at least two weeks) containing an equal amount of calories, but varying fat:carbohydrate ratios.

Although 16 patients might not seem like a very large sample size, the confidence intervals, odds ratios, and power -- a statistical term -- figures of this study demonstrate statistically significant results.

It is worth nothing that none of the patients underwent significant weight changes when their formula was replaced by one of the same caloric amount but a much different (either higher or lower) carbohydrate content.

Gary Taubes has casted off this study as useless in rebutting his argument since none of the patients were obese (he claims to use carbs as the explanation for obesity in individuals already predisposed to it, although that was certainly not made clear in his talk at New York University last month).

Well, Hirsch and Leibel reference several other studies that came to similar conclusions.

Of particular importance is one from 1990 -- also published in the American Journal of Clinical Nutrition -- in which Gilbert Forbes concludes that "although obese individuals appear to deposit a larger proportion of excess intake energy as fat, the energy cost in either lean or obese subjects was not significantly influenced by the composition" of their diet.

Have a slice of whole wheat toast on me tomorrow morning!

You Ask, I Answer: Gary Taubes/Obesity

I was impressed by your line by line refutation of the Taubes supporter.

You quote Gina Kolata of the NYTimes - "[Gary Taubes] ignores definitive studies done in the 1950s and ’60s by Jules Hirsch of Rockefeller University and Rudolph Leibel of Columbia."

Maybe my research skills stink but I can't find any study done by Hirsch and Leibel dating to the 1950s or 1960s.

Have you read it yourself?

-- "RicoVado"
Via the blog

Allow me to point you in the right direction.

The actual studies are a little hard to access unless you have access to various medical and nutrition journals, but there are other ways to get informed.

This 2007 International Herald Tribune article excellently summarizes Hirsch's (pictured at left) research from the late 1950s.

This short article from the National Institutes of Health archives discusses Leibel's findings (the quintessential "a calorie is a calorie" philosophy that Taubes loves to refute).

You "Ask", I Answer: Gary Taubes/Low-Carb

It is hardly radical for Gary Taubes to recommend staying away from foods rich in simple carbohydrates.

Based upon the extensive and meticulously detailed evidence, I decided that avoiding sugar at all costs would provide the most benefit to my health.

I also decided to avoid products with refined grains and simple carbohydrates. This included for me bread, pasta, beer, and vegetables stripped of their nutrients (skinless mashed potatoes being a good example).

long and short of it is this: if you are a non-smoker the single-most important thing you can do for your health is: AVOID SUGAR.

Andy claims this is oversimplifying things, but Gary shows over and over in his book what a toxic substance sugar is and how the rise in obesity over the last 20 years is directly related to the introduction of high-fructose corn syrup into the American diet.

By 1999 we ate 30%more sugar than in 1983 - how could sugar NOT be causing the obesity epidemic?

I just noticed that Andy did not respond to a question posed to him about Michael Pollan, because he had not read the book.

I think in the future you should follow that rule with Gary. His book is 450 pages long - his articles and speeches are just a small summary of the vast and nuanced argument he provides in the book, so to me your responses have been inadequate and short on content.

Keep in mind that I found this blog, because I am actively seeking refutations of the science presented in Gary's book.

So far everything I have read is high on rhetoric and low on science.

-- Hugh (last name unknown)
Location Unknown

Alright, let's take this e-mail piece by piece.

First, you are absolutely right, it is not radical of Mr. Taubes to advocate a low-carbohydrate diet.

Robert Atkins brought this idea to the masses in the early 1970s.

Millions bought the hype and ate steak, butter, and cheese to their heart's content.

That clearly didn't work, since this country's weight problem only worsened.

In 2002, low carb was back with a vengeance.

Supermarkets offered low-carb everything: ice cream, cookies, pizza, crackers, yogurt, you name it. Talk about easy and convenient!

Again, millions of people shunned rice, bread, and pasta. And obesity rates did not decrease.

So, yes, Taubes isn't exactly breaking new ground.

I think it's wonderful that you have cut down the refined carbohydrates in your diet.

If you take a look at this blog's archives, you will see that I am constantly recommending high-fiber, nutritious carbohydrates.

I constantly suggest people consume whole grains and aim for a largely unprocessed diet.

I again want to make it clear that my position is not, has never been, and never will be, "refined carbohydrates and added sugar are the best things to eat if are looking to lose weight."

My position is that if we're talking about weight management, it's ridiculously naive to leave calories out of the conversation.

Gary Taubes makes it very clear that, in his opinion, "obesity is a disorder of excess fat accumulation, not overeating and not sedentary behavior."

As I have said in previous posts, then please show me someone who, for an entire month, consumes 1,000 extra calories a day -- without burning them off -- solely from fat and protein and does not gain a pound.

We come back to the issue of faulty logic.

The reason why low carb diets "work" is because protein and fat are very filling.

As I have said before, 500 calories of pure protein and fat will leave someone satiated for much longer than 500 calories of refined carbohydrates.

In turn, the person eating mostly protein and fat will end up consuming less total calories during the day than the person consuming the refined carbohydrates.

As far as your recommendation to avoid sugar, I'm assuming you are referring to added, and not naturally-occurring, sugars.

The issue once there is that sugar is not new. It was not launched in the early 1980s before the obesity boom.

Sugar has been around for thousands of years.

It is true that we are eating more of it.

The emphasis there is on "eating more of it" -- AKA consuming more total calories.

If sugar in and of itself, regardless of how much was consumed, is the cause of obesity, why have rates in the United States skyrocketed only over the past twenty years?

The thirty percent increase in sugar consumption you mention is significant because it points to excess CALORIES being consumed.

Keep in mind that between 1970 and 2,000, the average caloric intake for United States citizens increased by 24.5 percent (that's, on average, an excess 530 calories, per person, per day).

Pointing to one food, or ingredients, is completely irrelevant.

For example, total meat consumption per person in the United States in 2000 was 195 pounds. In the 1950s, this figure was much lower -- 130 pounds.

So, why are you singling out only an increase in sugar as the sole culprit for weight gain? People in this country are eating more of everything.

Calories have increased, and, logically, so has people's weight.

Now, if caloric intake over the past twenty years had NOT increased, and obesity rates had, then, yes, maybe this idea that calories are irrelevant would hold some weight.

By the way, Gina Kolata of The New York Times made an excellent point in her review of Good Calories, Bad Calories:

"[Gary Taubes] ignores definitive studies done in the 1950s and ’60s by Jules Hirsch of Rockefeller University and Rudolph Leibel of Columbia, which tested whether calories from different sources have different effects.

The investigators hospitalized their subjects and gave them controlled diets in which the carbohydrate content varied from zero to 85 percent, and the fat content varied inversely from 85 percent to zero. Protein was held steady at 15 percent.

They asked how many calories of what kind were needed to maintain the subjects’ weight. As it turned out, the composition of the diet made no difference.”

By the way, Mr. Taubes' talk at New York University laid out the main arguments of his book very explicitly.

His basic theory is that weight loss has nothing to do with overeating. I don't need to read his book in its entirety to counter that particular argument.

I also want to note that my post also specifically responsed to things he said during the question and answer session.

I am not assuming or guessing what his thoughts are; they were made perfectly clear in his presentation.

Is a diet high in refined carbohydrates and added sugars unhealthy? Of course it is.

But, as far as I'm concerned, telling people that calories don't matter as long as carbohydrates aren't being eaten is a giant disservice.

You Ask, I Answer: Gary Taubes/Low-Carb

What's funny about this whole discussion is how nutrition experts are closer to Gary's ideas than they want to admit.

When people talk about Americans eating more processed foods, no one seems to want to make the connection that these processed foods are entirely high-carb. (go to a vending machine or fast food restaurant and find more than 1 item that is low-carb)

So, by saying Americans should eat fewer processed foods is to argue for a lower-carb diet.

Based upon reading this book I chose to stop eating simple carbohydrates (anything with white flour and white sugar).

I replaced this with copious amounts of green vegetables, eggs, cheese, and meat. I quickly dropped 20 pounds without exercising or EVER feeling hunger or thinking about portion control.

-- Anonymous
Via the blog

Gary Taubes' controversial views help certainly get discussion going, which I am absolutely thrilled about.

Yes, there is a small area in which conventional nutrition advice and Gary Taubes' views intermingle.

That being said, I ultimately consider his conclusions to stem from faulty logic.

It is indeed true that most processed (or "junk") foods consist of nutritionally void refined carbohydrates (mainly overly processed grains and sugar).

The bottom line, though, is that these processed foods are ultimately adding extra calories to people's diets.

A lot of these same processed foods (donuts, cookies, brownies, etc.) are also high in saturated fat and sodium.

They are not pure carbohydrates. So why isn't Mr. Taubes placing the blame on those two nutrients? Why just carbohydrates?

Allow me to present an analogy.

Imagine that I decide to study the health effects of strawberries.

For ten years, I have a group of people eat two cups of strawberries every day. The control group, meanwhile, doesn't eat any strawberries.

A decade later, I analyze the results and see that the strawberry eaters clearly had higher rates of cancer than the non-strawberry eaters.

Based on those statistics alone, a researcher might conclude, "strawberries increase your risk of developing certain cancers!"

Except it's not that simple.

What if it wasn't the strawberries themselves that had harmful health effects, but the fact that these strawberries had incredibly high levels of pesticides on them?

That is how I interpret Taubes' beliefs. I feel he is coming to a conclusion without considering all the information.

Mind you, the issue here is not "refined carbohydrates are chock full of nutrition" vs. Gary Taubes.

Dietitians are not saying -- and have never recommended -- "eat as much white flour, sugar, and processed food as you want!"

Glance through my blog and you will see numerous recommendations for whole grains, vegetables, legumes, and other high-fiber foods.

I distinctly say that nutrition isn't solely about calories, but also about nutrients. I also, though, think that sugar and white flour have a place in the diet as long as they are an exception to the rule and not the bulk of anyone's eating pattern.

That being said, keep in mind that many of the foods I suggest people consume often (chickpeas, kidney beans, oatmeal) are not low-carb; Gary Taubes believes they make you fat!

I also do not agree that calling for a diet "low in processed foods" is advocating a low-carb lifestyle. Legumes, fruits, vegetables, sprouted grains, and whole grains are not considered processed foods and are certainly not low in carbohydrates.

My main concern about refined carbohydrates is that, because they are low in fiber and protein, they do not satiate as well. The result? It takes more CALORIES to make you feel full.

Eating 400 calories of white rice, soda, and white bread for lunch will leave you feeling hungry, whereas 400 calories of steak will not have you raiding the pantry for a snack an hour later.

Ultimately, though, it comes down to calories. The 400 "empty carb" calories do not satiate you, so you end up eating more (consuming more calories).

There are two particular statements Gary Taubes make that raise my blood pressure, though.

The first is including potatoes in the same category as "processed foods."

As I have explained before, when cooked a certain way (ie: baked, with the skin on), a potato is highly nutritious. It is not junk food.

Second, his belief that fiber is overhyped tremendously weakens his stance for me. How anyone can ignore the health benefits of fiber is truly beyond me.

You "Ask", I Answer: Gary Taubes/Low-Carb

The low carb movement did not evaporate as suggested above. Just Google "low-carb" and visit some blogs and forums.

You'll find that there is a vigorous discussion taking place among numerous participants.

While many [people] seem to thrive on the low-fat diet that Tom Blogical is so enthusiastic about, a significant portion of the population cannot tolerate high carbohydrate intake no matter how much exercise they get.

These are the ones that Gary Taubes' book was wrote his book for.

So, to suggest that Taubes recommends the same low-carb approach for everyone seriously misrepresents his message.

-- David Brown
Via the blog

Keep in mind that a "low fat" diet can include up to 30 percent of a day's calories purely from fat.

Thereby, if you consume 2,000 calories a day, you can consume approximately 65 grams on a daily basis (roughly 600 calories' worth).

I understand that, due to a variety of reasons, one particular style of eating can not be applied universally.

In fact, this is precisely why I find Gary Taubes' ideas to be particularly narrow-minded and a product of tunnel vision.

He doesn't beat around the bush. In his mind, carbs are evil and they cause weight gain. Simple as that.

This is a man who places refined white flour and potatoes in the same category.

As I have mentioned in the past, potatoes can be eaten in many different ways. Peel off the skin and deep fry them and, sure, you're not getting much nutrition.

Leave the skin on, pop it in the microwave, and top it off with a teaspoon or two of olive oil and you have a nutritious side dish containing fiber, potassium, and vitamin C.

I am not sure what you refer to when mentioning that "a significant portion of the population not being able to tolerate" a high carbohydrate intake.

How many people are we talking about, and how is their intolerance defined?

As far as Gary Taubes not recommending a low-carb approach for everyone, I'll let his quotes speak for himself.

From a December 12, 2007 interview with AlterNet:

"Atkins almost assuredly had it right -- that we get fat because of the quantity and quality of the carbohydrates in the diet."

When asked what he believed were the three biggest myths about obesity, his response was:

"That the difference between calories consumed and calories expended tells us anything meaningful about why we get fat. That eating less or exercising more are viable treatments for obesity and overweight. That all nutrients -- fat, carbohydrates and proteins -- have equal effects on our propensity to gain weight -- in other words, that a calorie is a calorie is a calorie, as nutritionists are always telling us."

There still are -- and always will be -- followers of low-carb diets.

From a business and popularity standpoint, however, the low-carb movement has significantly tumbled from its 2003-2004 peak.

Let me make something very clear. I do not advocate that people subsist on refined grains and added sugars. I also do not think drinking two liters of soda a day is "harmless."

However, I am not going to oversimplify things and blame one single nutrient for rising obesity rates. That shallow tunnel vision does absolutely nothing but keep everyone in the dark.

You Ask, I Answer: Gary Taubes

I would very much appreciate any thoughts you have regarding Gary Taubes.

-- Karen Carabio
Reno, NV

This question arrived in my inbox on March 3, the same day I heard that Mr. Taubes was due to speak at New York University's Department of Nutrition, Food Studies, and Public Health on March 13.

I wanted to attend that event before answering Karen's question, so as to truly familiarize myself with his theories and viewpoints.

If you are not familiar with Gary Taubes, he is a journalist and physicist who has contributed articles to Science magazine since the 80s.

He became a semi household name in August of 2002 when his article "What If It's All Been A Big Fat Lie?" made the cover of The New York Times Magazine.

Its main point? Carbohydrates -- and only carboydrates -- are to blame for rising obesity rates in the United States.

Cut out carbs from your diet, Taubes claimed, and you won't gain weight. And when he says "carbohydrates", he's even referring to whole grains.

His article paved the way for the 2002 rebirth of the Atkins diet.

And what a rebirth it was! Six hundred low-carb products were launched in 2003.

Even common products like oils, cheese, and diet sodas included large "Low Carb!" stickers on their packaging, capitalizing on consumers' growing interest in shunning carbohydrate-rich foods.

By 2005, however, the hype died down, the Atkins company filed for bankruptcy, and "low carb" was out (thank goodness!).

That certainly didn't change Taubes' mind, though.

Last year, he pubished Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease.

Its main point? Dietitians are blaming the wrong guy for this country's increasing weight problems.

Obesity, Taubes claims, is not caused by overeating. Not only that -- calories have nothing to do with weight gain or loss!

So what is the cause? Taubes attributes it to insulin.

The more insulin you produce, he believes, the more weight you gain.

Therefore, it follows that carbohydrates (which raise blood glucose levels more than fat or protein, thereby signaling the body to release more insulin) cause weight gain.

At his March 13 NYU talk, Taubes presented a few more points.

He first referred to animal studies demonstrating that when animals overfeed themselves, their metabolism revs up and burns more energy than usual; when they underfeed, their metabolism slows down.

Taubes went on to explain that the same concept can be attributed to humans.

If we overeat, he explained, our bodies are smart enough to know to burn more calories. If we undereat, our metabolism slows down.

In Taubes' view, calories in and of themselves are irrelevant because our bodies can handle what comes their way.

Fair enough -- one of the main flaws behind very low calorie diets is that they end up slowing metabolism down, thereby making it easier to gain weight when regular eating patterns are resumed.

And while it is true that our metabolisms can compensate if we overeat by 50 or so calories, don't count on it to balance things out if you overeat by 300, 500, 1,000 or 1,200 calories.

Taubes claims that all overweight people are in such a state simply because of high carbohydrate consumption.

Okay, but can he point to examples of people overeating calories and NOT gaining weight?

Taubes believes that "portion control" only works because people are eating less carbohydrates.

Yes, but they are also eating less fat and protein, thereby discrediting his entire argument.

After the talk, a member of the audience asked Taubes how he explains many Asian cultures subsisting on "bad carbs" like white rice and having lower obesity rates than the United States.

His response? "Well, they've been eating rice for thousands of years, so their bodies are just used to it." Huh?

At one point in his talk, Taubes claimed that sugar and refined carbohydrates are only approximately a hundred years old or so in much of Europe and North America.

I would love to know where he got that information from, since the most basic of research on sugar points to its existence in Persia around 650 AD, and its delivery by European Crusaders to their continent in 1100 AD.

Sugar is not new. It has been consumed by civilizations around the world for centuries. Following his logic then, why aren't most humans "immune" to calories from sugar?

Overweight and obesity are clearly linked to a higher consumption of calories.

If you are skeptical, do me a favor and eat 1,000 more calories than usual (solely from pure fat or protein sources; absolutely no carbs) every day for a month.

Then, get on a scale.

Or, try the reverse and subsist on 400 calories of pure carbohydrates every single day for a month. According to Taubes, you would still gain weight.

Taubes was also asked by an audience member if he thinks it is possible for humans to live healthfully without consuming a single gram of carbohydrates.

His answer? A resounding "yes."

At one point in his presentation, he even referred to fiber as "insignificant." I thought my eyebrows were going to reach the ceiling.

I seriously wonder how he came to this conclusion; a thorough review of the evidence-based research on fiber consumption and its role in decreading cancer risks (particularly colon and prostate ones) clearly demonstrates the important role it plays in overall health.

Once again, this theory can easily be disputed by trying it out yourself.

If you think fiber is irrelevant to your health, go two weeks on a fiber-free diet -- no laxatives allowed! I'm pretty sure you'll soon realize just how crucial fiber is.

By the way, Taubes' infamous 2002 article quickly received a response from the Center for Science in the Public Interest and Washington Post health reporter Sally Squires (I am unable to find her excellent article online -- can anyone help?).

Michael Fumento of Reason magazine also added his two cents at the time.

Gary Taubes fired back a response, which in turn was replied to by Fumento.

I have provided links to all these articles to enable you to read and form your own conclusions.

I would love to hear everyone's thoughts on this.

You Ask, I Answer: Splenda

[I just read your posting on sorbitol and am wondering:] what about Splenda?

I have about a tablespoon (not full) a day with coffee.

Is it just better to have sugar and forget about it?

-- Anonymous
Via the blog

Splenda -- the brand name for sucralose -- was first launched during the peak of the Atkins revival in 2004.

Originally appearing in low-carb sweet treats like granola bars and ice cream, it was launched in supermarkets across the country for at-home beverage sweetening and baking.

So, how safe is it?

Well, on the one hand, the Food & Drug Administration has approved it as a GRAS (generally regarded as safe) food additive.

As I mentioned in a December 2007 posting about fat-replacer Olestra, though, the FDA seal of approval isn't always the most reassuring.

All we know for sure at this point is that Splenda doesn't appear to cause immediate harm.

Since it is a relatively new mass-consumed alternative sweetener, there are no long-term studies indicating what happens if it is consumed every day for 20 years.

There isn't even a study detailing the effects of regular Splenda consumption over a FIVE year period.

Interestingly enough, the Japanese Food Sanitation Council reported that some sucralose is actually absorbed by the body and hones in on the liver and kidneys. Consequently, they theorize that regular intake of Splenda could result in the enlargement of these organs.

My strategy with sucralose is to tread cautiously.

Having three cups of coffee with two packs of Splenda in each day in, day out is not the smartest of choices.

However, having two teaspoons with your morning coffee each day -- and no additional amounts in other foods -- doesn't strike me as particularly alarming.

Keep in mind that obesity rates and ridiculously high sugar intakes in the United States are not coming from people stirring a teaspoon of sugar in their latte every morning.

Rather, they are the result of the cookies, brownies, cakes, pies, flavored lattes, and monstruous ice cream sundaes that are constantly available to us.

Your overall goal should be decrease your sugar consumption to roughly 30 - 40 grams a day (one pack of sugar contains four), not to replace high sugar intake with high artificial sweetener consumption.