Thursday, March 28, 2019

Dr. Stephan Guyenet's references to the Joe Rogan Experience Debate with Gary Taubes

I was introduced to the principles of health by Dr. Stephan Guyenet who had a blog named WholeHealthSource (now http://www.stephanguyenet.com), more than 10 years ago. He was a student at that time. The first article I read was about Vitamin K2. He is a researcher working on the Neurobiology of Obesity. He recently had a debate with Gary Taubes of Good Calories Bad Calories on the Joe Rogan Experience. I have read that book and it is pretty good. But Gary Taubes is married to the Insulin drives obesity theory. Obviously there would be a lot of contentions between the two. Stephan has posted an article which links to all the research papers he has on all the contentious issues raised during the debate.

http://www.stephanguyenet.com/references-for-my-debate-with-gary-taubes-on-the-joe-rogan-experience/

TL;DR: Calorie is king, and brain is the regulator of fat, insulin has minimal effect on obesity, ease of getting tasty food and over indulgence is the basic problem.

Stephan has also shown several references where we can see that Gary Taubes is very willing to misuse data to forward his pet theories (Rigor section).

To quote regarding Low Carbohydrate diets.
For context, I am favorable toward low-carbohydrate diets, but the references below mostly reflect issues that Gary and I are likely to disagree on.

It is a huge article. Following are all the different subtitles of the sections in his article.

The brain

1. The brain regulates body fatness
2. The genetics of obesity point to the brain, not fat cells or insulin, as the primary determinant of body fatness
3. The brain regulates appetite
4. The determinants of appetite are complex and cannot be reduced to glucose and insulin
5. Lean people, and people with obesity, both “defend” their current level of body fatness against fat loss
6. Single-gene mutations that lead to obesity in humans act in the brain

Calories

7. People with obesity eat, and expend, more calories than lean people
8. Reducing the calorie intake of a person with obesity to that of a lean person causes weight loss
9. Calorie intake, not carbohydrate intake, is the main dietary determinant of body fat loss
10. Changes in body fatness as a result of diet depend primarily on calorie intake, not carbohydrate intake
11. Energy expenditure (metabolic rate) is scarcely affected by differences in carbohydrate and fat intake

Carbohydrate, sugar, and fat

12. Low-fat, high-carbohydrate diets cause weight loss, even without deliberate portion control
13. A low-calorie diet composed almost entirely of refined carbohydrate, including sugar, causes substantial weight loss
14. Dietary fat can be fattening in a variety of nonhuman species
15. Dietary fat can be fattening in humans
16. Fat and carbohydrate are equally fattening when overconsumed
17. Sugar intake has been declining for 20 years in the US and 50 years in the UK, while obesity and diabetes rates have risen
18. Carbohydrate, fat, and protein intake in the US over the last century
19. White flour intake was much higher in 1900 in the US than it is today
20. Sugar intake in the US, 1822-2016
21. Cultures with high intakes of sugar but otherwise healthy diets and lifestyles do not have obesity or diabetes
22. During the Cuban economic crisis, sugar intake rose, calorie intake declined, and obesity plummeted
23. Cultures with very high intakes of carbohydrate tend to be lean, even if the carbohydrate is white rice
24. In human randomized controlled trials, sugar is only fattening by virtue of its calories
25. In randomized controlled trials, low-carbohydrate and low-fat diets yield similar (unimpressive) long-term weight loss results
26. Meta-analyses of ketogenic diet studies
27. Adherence to ketogenic diets tends to be mediocre
28. The Virta Health study
29. Eating sugar does not impair weight loss on calorie-reduced diets

Diabetes

30. Weight loss greatly reduces the risk of developing type 2 (common) diabetes
31. Reducing fat intake, without reducing carbohydrate intake, causes weight loss and reduces type 2 (common) diabetes risk
32. Exercise substantially reduces the risk of developing type 2 (common) diabetes
33. Weight loss via a temporary very-low-calorie diet durably puts type 2 (common) diabetes into remission

Insulin and insulin resistance

34. Insulin resistance predicts a variety of age-related diseases
35. People with higher insulin levels don’t gain more weight over time than people with lower insulin levels
36. Weight loss increases insulin sensitivity, regardless of whether it’s achieved by a low-fat or low-carbohydrate diet
37. Insulin resistance is “an appropriate response to nutrient excess“
38. When fat cells “fill up” due to fat gain, energy spills over onto other tissues, causing insulin resistance
39. The impact of foods on blood glucose and insulin has little do with how filling they are
40. Insulin resistance is caused (in large part) by exceeding the unique storage capacity of your own fat tissue
41. Mendelian randomization studies on the impact of insulin level on body fatness
42. Of the three published studies funded by Taubes’s organization the Nutrition Science Initiative (NuSI), at least two, and possibly all three, refuted the carbohydrate-insulin hypothesis

Exercise

43. Exercise tends to cause weight and fat loss in people with excess body fat
44. Exercise increases insulin sensitivity
45. Sedentary behavior causes insulin resistance

Food reward

46. Fat and carbohydrate both cause dopamine release and increase eating drive, particularly when combined
47. The most commonly/intensely craved foods combine carbohydrate and fat together, while foods that are high in sugar or fat alone are less commonly craved
48. We eat more food when it tastes better

Rigor

49. Calling for more rigor in science does not necessarily make a person rigorous
50. Expert reviews of Taubes’s writing have uncovered extensive misuse of evidence
51. The Nutrition Science Initiative (NuSI), with Gary Taubes at its helm, attempted to interfere with the research that it funded once unfavorable results came in

Miscellaneous

52. The most fattening diet in animals and humans is human junk food, and its fattening effect cannot be explained by carbohydrate or fat alone
53. Obesity has a strong genetic component
54. Synthesis of fat from carbohydrate is negligible in humans eating typical Western diets
55. Partially suppressing the release of fat from fat cells (lipolysis) does not cause fat gain, hunger, or a slower metabolic rate
56. The fat tissue of people with obesity releases fat at a greater rate than that of lean people, not a slower rate