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13Dec 2012

Science reporter turns activist: Gary Taubes helps launch a nutrition research institute.

Credit: Kirsten Lara Getchell

Gary Taubes is the author of two of the most controversial and potentially explosive articles that The New York Times Magazine has published in the past decade. One appeared in 2002 under the headline, "What if It's All Been a Big Fat Lie?" The other was published in April, 2011, with the cover language "Sweet and Vicious: The case against sugar."

The first challenged the notion that low-fat diets are the way to lose weight. He quoted researchers who said that "low-fat weight-loss diets have proved in clinical trials and real life to be dismal failures, and that on top of it all, the percentage of fat in the American diet has been decreasing for two decades. Our cholesterol levels have been declining, and we have been smoking less, and yet the incidence of heart disease has not declined as would be expected."

The second reports on the case against sugar as a "toxin" or a "poison," as simply "evil." One of the researchers he talks to describes sugar as "the most demonized additive known to man." Taubes is not shy.

Taubes is a smart, seasoned, and talented reporter. Yet I have expressed some hesitation about his writing, arguing that while it was provocative, I was never entirely convinced by his arguments. I've had trouble explaining why that is; the best I can say is that when I finished each of these articles, I felt Taubes had not quite made his case.

Now Taubes is back with a surprising and interesting announcement. In an article in Nature, he reports that he has co-founded an organization called the Nutrition Science Initiative to encourage research on what he and his colleagues believe are the real causes of obesity--sugar and refined carbohydrates, not fat and lack of exercise.

The headline of the Nature piece is "Treat obesity as physiology, not physics." In other words, get rid out of the calories-in, calories-out idea that, in order to lose weight, we must consume less than we burn. "The alternative hypothesis — that obesity is a hormonal, regulatory defect — leads to a different prescription," he writes. "It is not excess calories that cause obesity, but the quantity and quality of carbohydrates consumed." He continues:

This conclusion is based on endocrinology that has been understood for 50 years: insulin regulates fat accumulation, and blood levels of insulin are effectively determined by carbohydrate intake. The more easily digestible are the carbohydrates we eat (the higher their glycemic index) and the sweeter they are (the higher their fructose content) the higher are our blood insulin levels, and the more fat accumulates.

Taubes and his colleagues at the Nutrition Science Initiative searched the scientific literature for all relevant studies on these questions but could not find "the rigorous experimental evidence necessary to establish definitively the truth or falsehood of either hypothesis," Taubes reports.

The new initiative "aims to fund and facilitate the trials necessary to rigorously test the competing hypotheses," he writes.

While I've expressed some concerns about Taubes's writing, I have no hesitation here. Taubes is taking his writing reporting in a fascinating and unexpected direction, and I wish him and his colleagues well.

-Paul Raeburn




I agree with your description of Taubes' writing appearing somewhat agenda-driven. It's possible, though, to mistake genuine lack of evidence on one side of a question for imbalanced reporting.

The BMJ article summarized in the New Scientist piece you cited does provide evidence that reducing fat intake results in weight reduction, but I take issue with NS's wording: "[t]he pounds fell off" when they ate less fat. As NS notes, the mean weight change (with the median measurement interval being 6 years after diet initiation) was -1.6 kg (-3. 5 lbs). The low end of the 95% confidence interval was -2.0 kg (-4.4 lbs). This means that 97.5% of participants in this very large meta-analysis lost fewer than 4.4 lbs over 6 years of dieting.

In their sensitivity analysis, the authors attempt to control for confounding variables such as the effects of intervention or increased dietary advice in the experimental (low fat) groups, but in a meta-analysis this is impossible to do thoroughly.

We're in the midst of an obesity epidemic, and I think when we're desperate we're more likely to be optimistic about findings such as the one cited above. But really, does 4.4 lbs (at most, effectively) over 6 years of dieting seem like it's going to solve our obesity problem? Americans are, on average, somewhere between 25 and 50 lbs overweight. Should they continue a diet like this for 30-60 years? Or further decrease fat intake by a factor of 5 - 10?

I agree with you that there is an opportunity for a good science journalist to do some thorough investigation of the research marshalled by the numerous dietary polemicists out there. I'm reading "Why We Get Fat" right now, and I'm tending to think that Taubes has already done this.

An activist? How can someone be an activist who advocates that everyone eat from the top of the food chain? Where are the science journalists who actually check the science? You can find loads of papers illustration the effects of high levels of plasma FFAs on insulin receptor signaling. HIgh levels of plasma FFAs block glucose uptake. Gary Taubes advocates a diet that essentially drives insulin resistance. And why is he suddenly against refined carbohydrates? In his book, he goes against all carbohydrates. Rice is equivalent to soda, never mind the data. Taubes calls insulin the "fattening hormone," never mind that you need it to live, to take up glucose from the blood so that muscle can make glycogen, etc. How can someone who uses language like "fattening carbohydrates" be an advocate for anyone but a wealth elite who won't benefit form adopting a diet free from exercise and high in fat?

Good point about the confirmation bias, Charles. I think Taubes has a right to go after evidence that he thinks might be there, but, as you say, we ought to be careful until he or NuSI have made their case.

I think your hesitation about Taubes' writing and activities in this area is wise. He seems to have too much of an agenda and a taste for the "everything you know is wrong" style of advocacy.

He's trying to push a case that "low-fat weight-loss diets have proved in clinical trials and real life to be dismal failures". According to whom? Gary Taubes?

Here's an account of a very recent review of research that comes to a very un-Taubsian conclusion:

The confirmation that you can lose weight without eating less comes from a review of studies involving nearly 75,000 people – none of whom were trying to lose weight. The pounds fell off when they changed to a diet containing less fat.

How objective is this new "Nutrition Science Initiative" really going to be, if they've already reached a conclusion? Confirmation bias, much?

Seems like there's a great opportunity for a good health science journalist to do some in-depth sleuthing to examine the agendas of all sides in the controversy. That includes the "low-fat is best" contingent.

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