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Why We Get Fat: And What to Do About It
 
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Why We Get Fat: And What to Do About It [Format Kindle]

Gary Taubes
5.0 étoiles sur 5  Voir tous les commentaires (3 commentaires client)

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INTRODUCTION

The Original Sin

In 1934, a young German pediatrician named Hilde Bruch moved to America, settled in New York City, and was “startled,” as she later wrote, by the number of fat children she saw—“ really fat ones, not only in clinics, but on the streets and subways, and in schools.” Indeed, fat children in New York were so conspicuous that other European immigrants would ask Bruch about it, assuming that she would have an answer. What is the matter with American children? they would ask. Why are they so bloated and blown up? Many would say they’d never seen so many children in such a state.

Today we hear such questions all the time, or we ask them ourselves, with the continual reminders that we are in the midst of an epidemic of obesity (as is the entire developed world). Similar questions are asked about fat adults. Why are they so bloated and blown up? Or you might ask yourself: Why am I?

But this was New York City in the mid- 1930s. This was two decades before the first Kentucky Fried Chicken and McDonald’s franchises, when fast food as we know it today was born. This was half a century before supersizing and high- fructose corn
syrup. More to the point, 1934 was the depths of the Great Depression, an era of soup kitchens, bread lines, and unprecedented
unemployment. One in every four workers in the United States was unemployed. Six out of every ten Americans were living in
poverty. In New York City, where Bruch and her fellow immigrants were astonished by the adiposity of the local children, one in four children were said to be malnourished. How could this be?

A year after arriving in New York, Bruch established a clinic at Columbia University’s College of Physicians and Surgeons to treat obese children. In 1939, she published the first of a series of reports on her exhaustive studies of the many obese children she had treated, although almost invariably without success. From interviews with her patients and their families, she learned that these obese children did indeed eat excessive amounts of food—no matter how much either they or their parents might initially deny it. Telling them to eat less, though, just didn’t work, and no amount of instruction or compassion, counseling, or exhortations— of either children or parents—seemed to help. It was hard to avoid, Bruch said, the simple fact that these children had, after all, spent their entire lives trying to eat in moderation and so control their weight, or at least thinking about eating less than they did, and yet they remained obese. Some of these children, Bruch reported, “made strenuous efforts to lose weight, practically giving up on living to achieve it.” But maintaining a lower weight involved “living on a continuous semi-starvation diet,” and they just couldn’t do it, even though obesity made them miserable and social outcasts.

One of Bruch’s patients was a fine- boned girl in her teens, “literally disappearing in mountains of fat.” This young girl had spent her life fighting both her weight and her parents’ attempts to help her slim down. She knew what she had to do, or so she believed, as did her parents—she had to eat less—and the struggle to do this defined her existence. “I always knew that life depended on your figure,” she told Bruch. “I was always unhappy and depressed when gaining [weight]. There was nothing to live for. . . . I actually hated myself. I just could not stand it. I didn’t want to look at myself. I hated mirrors. They showed how fat I was. . . . It never made me feel happy to eat and get fat—but I never could see a solution for it and so I kept on getting fatter.”

Like Bruch’s fine- boned girl, those of us who are overweight or obese will spend much of our lives trying to eat less, or at least eat not too much. Sometimes we succeed, sometimes we fail, but the fight goes on. For some, like Bruch’s patients, the battle begins in childhood. For others, it starts in college with the freshman twenty, that cushion of fat that appears around waist and hips
while spending the first year away from home. Still others begin to realize in their thirties or forties that being lean is no longer the effortless achievement it once was.

Should we be fatter than the medical authorities would prefer, and should we visit a doctor for any reason, that doctor is likely to
suggest more or less forcefully that we do something about it. Obesity and overweight, so we’ll be told, are associated with an increased risk of virtually every chronic disease that ails us—heart disease, stroke, diabetes, cancer, dementia, asthma. We’ll be instructed to exercise regularly, to diet, to eat less, as though the thought of doing so, the desire to do so, would never otherwise have crossed our minds. “More than in any other illness,” as Bruch said about obesity, “the physician is called upon only to do a special trick, to make the patient do something—stop eating— after it has already been proved that he cannot do it.”

The physicians of Bruch’s era weren’t thoughtless, and the doctors of today are not, either. They merely have a flawed belief system—a paradigm—that stipulates that the reason we get fat is clear and incontrovertible, as is the cure. We get fat, our physicians tell us, because we eat too much and/or move too little, and so the cure is to do the opposite. If nothing else, we should eat “not too much,” as Michael Pollan famously prescribes in his best-selling book In Defense of Food, and this will suffice. At least we won’t get fatter still. This is what Bruch described in 1957 as the “prevalent American attitude that the problem [of obesity] is simply one of eating more than the body needs,” and now it’s the prevalent attitude worldwide.

We can call this the “calories- in/ calories- out” or the “overeating” paradigm of excess fat—the “energy balance” paradigm, if
we want to get technical. “The fundamental cause of obesity and overweight,” as the World Health Organization says, “is an energy imbalance between calories consumed on one hand, and calories expended on the other hand.” We get fat when we take in more energy than we expend (a positive energy balance, in the scientific terminology), and we get lean when we expend more than we take in (a negative energy balance). Food is energy, and we measure that energy in the form of calories. So, if we take in more calories than we expend, we get fatter. If we take in fewer calories, we get leaner.



This way of thinking about our weight is so compelling and so pervasive that it is virtually impossible nowadays not to believe it. Even if we have plenty of evidence to the contrary—no matter how much of our lives we’ve spent consciously trying to eat less and exercise more without success—it’s more likely that we’ll question our own judgment and our own willpower than we will this notion that our adiposity is determined by how many calories we consume and expend.

My favorite example of this thinking came from a wellrespected exercise physiologist, a co- author of a set of physical-activity and health guidelines that were published in August 2007 by the American Heart Association and the American College of Sports Medicine. This fellow told me that he personally had been “short, fat, and bald” when he first took up distance running in the 1970s, and now he was in his late sixties and was “short, fatter, and bald.” In the intervening years, he said, he had gained thirty-odd pounds and run maybe eighty thousand miles—the equivalent, more or less, of running three times around the Earth (at the equator). He believed that there was a limit to how much exercise could help him maintain his weight, but he also believed he
would be fatter still if he hadn’t been running.

When I asked him whether he really thought he might be leaner had he run even more, maybe run four times around the planet instead of three, he said, “I don’t see how I could have been more active. I had no time to do more. But if I could have gone out over the last couple of decades for two to three hours a day, maybe I would not have gained this weight.” And the point is that maybe he would have anyway, but he just couldn’t wrap his head around that possibility. As sociologists of science would say,
he was trapped in a paradigm.

Over the years, this calories- in/ calories- out paradigm of excess fat has proved to be remarkably resistant to any evidence to the
contrary. Imagine a murder trial in which one credible witness after another takes the stand and testifies that the suspect was elsewhere at the time of the killing and so had an airtight alibi, and yet the jurors keep insisting that the defendant is guilty, because that’s what they believed when the trial began.

Consider the obesity epidemic. Here we are as a population getting fatter and fatter. Fifty years ago, one in every eight or nine Americans would have been officially considered obese, and today it’s one in every three. Two in three are now considered overweight, which means they’re carrying around more weight than the public- health authorities deem to be healthy. Children are fatter, adolescents are fatter, even newborn babies are emerging from the womb fatter. Throughout the decades of this obesity epidemic, the calories-in/ calories-out, energy-balance notion has held sway, and so the health officials assume that either we’re not paying attention to what they’ve been telling us—eat less and exercise more—or we just can’t help ourselves.

Malcolm Gladwell discussed this paradox in The New Yorker in 1998. “We have been told that we must not take in more calories than we burn, that we cannot lose weight if we don’t exercise consistently,” he wrote. “That few of us are able to actually follow this advice is either our fault or the fault of the advice. Medical orthodoxy, naturally, tends toward the former position. Diet books
tend toward the latter. Given how often the medical orthodoxy has been wrong in the past, that position is not, on its face, irrational. It’s worth finding out whether it is true.”

After interviewing the requisite number of authorities, Gladwell decided that it was our fault, that we simply “lack the discipline. . . or the wherewithal” to eat less and move more— although for some of us, he suggested, bad genes extract a greater price in adiposity for our moral failings.

I will argue in this book that the fault lies entirely with the medical orthodoxy—both the belief that excess fat is caused by consuming excess calories, and the advice that stems from it. I’m going to argue that this calories-in/ calories-out paradigm of adiposity is nonsensical: that we don’t get fat because we eat too much and move too little, and that we can’t solve the problem or prevent it by consciously doing the opposite. This is the original sin, so to speak, and we’re never going to solve our own weight problems, let alone the societal problems of obesity and diabetes and the diseases that accompany them, until we understand this and correct it.

I don’t mean to imply, though, that there is a magic recipe to losing weight, or at least not one that doesn’t include sacrifice. The question is, what has to be sacrificed?


The first part of this book will present the evidence against the calories-in/ calories-out hypothesis. It will discuss many of the observations, the facts of life, that this concept fails to explain, why we came to believe it anyway, and what mistakes were made
as a result.


The second part of this book will present the way of thinking about obesity and excess fat that European medical researchers came to accept just prior to the Second World War. They argued, as I will, that it is absurd to think about obesity as caused by overeating, because anything that makes people grow—whether in height or in weight, in muscle or in fat—will make them   overeat. Children, for example, don’t grow taller because they eat voraciously and consume more calories than they expend. They
eat so much—overeat—because they’re growing. They need to take in more calories than they expend. The reason children grow is that they’re secreting hormones that make them do so—in this case, growth hormone. And there is every reason to believe that the growth of our fat tissue leading to overweight and obesity is also driven and controlled by hormones.

So, rather than define obesity as a disorder of energy balance or eating too much, as the experts have for the past half-century, these European medical researchers started from the idea that obesity is fundamentally a disorder of excess fat accumulation. This is what a philosopher would call “first principles.” It’s so obviously true that it seems almost meaningless to say it. But once we do, then the natural question to ask is, what regulates fat accumulation? Because whatever hormones or enzymes work to increase our fat accumulation naturally—just as growth hormone makes children grow—are going to be the very likely suspects on which to focus to determine why some of us get fat and others don’t.

Regrettably, the European medical-research community barely survived the Second World War, and these physicians and their ideas about obesity weren’t around in the late 1950s and early 1960s, when this question of what regulates fat accumulation was answered. As it turns out, two factors will essentially determine how much fat we accumulate, both having to do with the hormone insulin.

First, when insulin levels are elevated, we accumulate fat in our fat tissue; when these levels fall, we liberate fat from the fat tissue
and burn it for fuel. This has been known since the early 1960s and has never been controversial. Second, our insulin levels are  effectively determined by the carbohydrates we eat—not entirely, but for all intents and purposes. The more carbohydrates
we eat, and the easier they are to digest and the sweeter they are, the more insulin we will ultimately secrete, meaning that the level of it in our bloodstream is greater and so is the fat we retain in our fat cells. “Carbohydrate is driving insulin is driving fat,” is
how George Cahill, a former professor of medicine at Harvard Medical School, recently described this to me. Cahill had done some of the early research on the regulation of fat accumulation in the 1950s, and then he coedited an eight-hundred-page American Physiological Society compendium of this research that was published in 1965.

In other words, the science itself makes clear that hormones, enzymes, and growth factors regulate our fat tissue, just as they do everything else in the human body, and that we do not get fat because we overeat; we get fat because the carbohydrates in our
diet make us fat. The science tells us that obesity is ultimately the result of a hormonal imbalance, not a caloric one—specifically,
the stimulation of insulin secretion caused by eating easily di - gestible, carbohydrate-rich foods: refined carbohydrates, including
flour and cereal grains, starchy vegetables such as potatoes, and sugars, like sucrose (table sugar) and high- fructose corn syrup. These carbohydrates literally make us fat, and by driving us to accumulate fat, they make us hungrier and they make us
sedentary.

This is the fundamental reality of why we fatten, and if we’re to get lean and stay lean we’ll have to understand and accept it,
and, perhaps more important, our doctors are going to have to understand and acknowledge it, too.

If your goal in reading this book is simply to be told the answer to the question “What do I do to remain lean or lose the excess fat I have?” then this is it: stay away from carbohydrate- rich foods, and the sweeter the food or the easier it is to consume and digest—liquid carbohydrates like beer, fruit juices, and sodas are probably the worst—the more likely it is to make you fat and the
more you should avoid it.

This is certainly not a new message. Until the 1960s, as I’ll discuss later, it was the conventional wisdom. Carbohydrate-rich foods—bread, pasta, potatoes, sweets, beer—were seen to be uniquely fattening, and if you wanted to avoid being fat, you didn’t eat them. Since then, it has been the message of an unending string of often best-selling diet books. But this essential fact has been so abused, and the relevant science so distorted or misinterpreted, both by proponents of these “carbohydrate-restricted” diets and by those who insist that they are dangerous fads (the American Heart Association among them) that I want to lay it out once more. If you find the argument sufficiently compelling that you want to change your diet accordingly, then all the better. I will give some advice on how to do so, based on the
lessons learned by clinicians who have years of experience using
these diets to treat their overweight and often diabetic patients.

In the more than six decades since the end of the Second World War, when this question of what causes us to fatten—calories or carbohydrates—has been argued, it has often seemed like a religious issue rather than a scientific one. So many different belief systems enter into the question of what constitutes a healthy diet that the scientific question—why do we get fat?—has gotten lost along the way. It’s been overshadowed by ethical, moral, and sociological considerations that are valid in themselves and certainly
worth discussing but have nothing to do with the science itself and arguably no place in a scientific inquiry.

Carbohydrate-restricted diets typically (if not, perhaps, ideally) replace the carbohydrates in the diet with large or at least larger portions of animal product—beginning with eggs for breakfast and moving to meat, fish, or fowl for lunch and dinner. The implications of that are proper to debate. Isn’t our dependence on animal products already bad for the environment, and won’t it just get worse? Isn’t livestock production a major contributor to global warming, water shortages, and pollution? When thinking about a healthy diet, shouldn’t we think about what’s good for the planet as well as what’s good for us? Do we have a right to kill animals for our food or put them to work for us in producing it? Isn’t the only morally and ethically defensible lifestyle a vegetarian one or even a vegan one?

These are all important questions that need to be addressed, as individuals and as a society. But they have no place in the scientific and medical discussion of why we get fat. And that’s what I am setting out to explore here—just as Hilde Bruch did more than seventy years ago. Why are we fat? Why are our children fat? What can we do about it?


From the Hardcover edition.

Revue de presse

“Well-researched and thoughtful . . . Reconsidering how our diet affects our bodies, how we might modify it to be healthier, and being less harsh with those who struggle with their weight are all worthy goals. Taubes has done us a great service by bringing these issues to the table.”
            -Dennis Rosen, The Boston Globe
 
“Less dense and easier to read [than Good Calories, Bad Calories] but no less revelatory.”
            -Jeff Baker, The Oregonian
 
“Taubes’s critique is so pointed and vociferous that reading him will change the way you look at calories, the food pyramid, and your daily diet.”
            -Men’s Journal
 
“Gary Taubes is a science journalist’s science journalist, who researches topics to the point of obsession—actually, well beyond that point—and never dumbs things down for readers.”
            -John Horgan, Scientific American
 
“Important . . . This excellent book, built on sound research and common sense, contains essential information.”
            -Larry Cox, Tucson Citizen
 
“This brave, paradigm-shifting man uses logic and the primary literature to unhinge the nutritional mantra of the last 80 years.”
            -Choice
 
“Aggressive . . . An exhaustive investigation.”
            -Casey Schwartz, The Daily Beast
 
“Passionate and urgent . . . Backed by a persuasive amount of detail . . . As an award-winning scientific journalist who spent the past decade rigorously tracking down and assimilating obesity research, he’s uniquely qualified to understand and present the big picture of scientific opinions and results. Despite legions of researchers and billions of government dollars expended, Taubes is the one to painstakingly compile this information, assimilate it, and make it available to the public . . . Taubes does the important and extraordinary work of pulling it all together for us.”
            -Karen Bentley, Seattle Post-Intelligencer
 
“Clear and accessible . . . Taubes’s conviction alone makes Why We Get Fat well worth considering.”
            -Lacey Galbraith, Bookpage
 
“An enlightening treatise that is meticulously researched yet approachable by all, this will captivate anyone interested in the science of diet and disease.”
            -Starred review, Library Journal
 
“This is the book you can give to people who want to understand the science of why you’re finally losing weight . . . without being hungry and miserable doing it.”
            -Tom Naughton, FatHead
 
Why We Get Fat is nothing short of tremendous . . . This is a seminal book . . . What if the calories-in/calories-out hypothesis is wrong? What if we’ve spent two generations and billions of dollars re-engineering our food system and altering our eating habits away from fat . . . and making ourselves fatter and unhealthier as a result? That’s what Taubes convincingly argues with clear logic, specific evidence, and brilliant illustrations on every page.”
            -John Durant, Hunter-Gatherer
 
“Compelling . . . Gary Taubes has done it again . . . [Why We Get Fat] takes a hard look at the commonly held belief that the reason why we gain weight is because we consume more calories than we expend and turns it upside down . . . Packed with eye-opening information and elucidating studies.”
            -Diets in Review
 
“This is the book I knew was inside of Good Calories, Bad Calories . . . Why We Get Fat is the book to give to friends, doctors, congressmen, and anyone else who wants to understand the futility of our current nutritional advice . . . Clearly, obviously, succinctly, Taubes shows us how scientific theories that explained obesity as a hormonal rather than moral issue were abandoned during World War II for simplistic theories based on thermodynamics that work in physics, but make no sense when used to describe the behavior of complex biological systems.”
            -LowCarbConfidential
 
 
 




From the Hardcover edition.

Détails sur le produit


En savoir plus sur l'auteur

Gary Taubes est le plus célèbre journaliste scientifique américain. Il écrit pour le New York Times et le journal Science.

Ses articles et ses livres ont été récompensés par de nombreux prix, dont trois de l'Association des écrivains scientifiques.

Il intervient à l'Ecole de santé publique de l'université de Californie (Berkeley). FAT - pourquoi on grossit est bestseller aux États-Unis.

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2 internautes sur 2 ont trouvé ce commentaire utile 
5.0 étoiles sur 5 A must read 15 septembre 2012
Format:Format Kindle|Achat vérifié
I've struggled with my weight ever since I was about 11, as a young kid I was skinny, I have the pictures to prove it! then, along came the 1980's and the push to low fat, high fibre, whole grains. Out went the pot of dripping in the fridge, in came the brown bread, pasta, low fat margarines etc etc...That's when I started to put on weight, that's when my mum started to put on weight. Connecting these two things was a light-bulb moment for me.

About 12 years ago I tried the South Beach diet, low-carb eating and the weight dropped off, I stuck to it for about 2 years and the weight stayed off. The carbs crept back in after I met my husband and a series of stressful family events. Eventually about 2 years ago I was at my heaviest (14 stone) and diagnosed with breast cancer with 2 year old twins. I very slowly managed to loose some of the weight but it was hard going, running 3 times a week, Pilates twice a week and low fat, 'good' food. I'd maybe loose 2 pr 3lbs and then pile it all back on.

I've got through the cancer, the twins are still here but the weight is now coming off...I started low-carbing again after reading this book, the science now makes sense to me, I don't feel guilty for eating low-carb, I am not a crank, I want to take control of what happens in my body and this is one way to help it. Cutting out sugar reduces inflammation in the body, one of the causes of cancer, as someone who's been down that road before I'm not going there again if I can help it. I've lost about 7 or so lbs, not a massive weight loss but then I probably only need to loose 2 stones. This for me is about changing my life not a diet.

After reading this book I went on to reading Wheat Belly, another eye opener.
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1 internautes sur 1 ont trouvé ce commentaire utile 
5.0 étoiles sur 5 Excellent 1 avril 2014
Par RAS TOP 500 COMMENTATEURS
Format:Broché
Si vous avez réussi à lire son autre livre en anglais, non traduit celui-là, "Good Calories, Bad Calories" (publié sous le titre "The Diet Delusion" au Royaume-Uni et en Australie) ceci est un complément pratique beaucoup plus accessible. Si vous n'avez pas pu le finir, raison de plus d'essayer celui-ci. Gary Taubes est un journaliste scientifique très minutieux et il a l'air d'avoir tout lu sur le sujet, ce que les chercheurs professionnels n'ont pas toujours le temps de faire. Je conseille de consulter sur le site de son association Nutrition Science Initiative la revue de la littérature scientifique sur l'obésité, très complète et malheureusement fort révélatrice. Elle conclut qu'après 80 années d'expérimentation et plus de 80 études, on ne sait toujours pas avec certitude pourquoi on grossit. Et ceci parce que toutes les études ont des lacunes, qui rendent difficile toute conclusion.
Dans "Good Calories, Bad Calories", Taubes a longuement démonté la croyance installée depuis Keys et son étude des 7 pays voulant prouver que les graisses étaient coupables des maladies cardio-vasculaires. Il faut savoir que Keys avait omis 16 autres pays dont il avait les données, mais qui ne correspondaient sans doute pas à ses attentes. L'opération a notamment servi à innocenter les hydrates de carbones et surtout le sucre. Or, un régime très efficace était connu depuis 1863, année où William Banting publiait son petit livre "Letter on corpulence, Addressed to the Public".
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5.0 étoiles sur 5 Very useful 29 janvier 2014
Format:Format Kindle|Achat vérifié
To me (a struggling layman trying to deduce the pounds) it's an excellent thought-provoking read with solid references. An essential book to read, in conjunction with others.
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Amazon.com: 4.5 étoiles sur 5  1.280 commentaires
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5.0 étoiles sur 5 The Biochemistry text book agrees 4 novembre 2011
Par Laura M. Bangerter - Publié sur Amazon.com
Format:Format Kindle
I've read quite a few books that make some of the same points this one does about nutrition. I was already convinced saturated fat wasn't bad, and didn't cause heart disease. I was already convinced that sugar wasn't good for you--nor was a lot of bread and pasta. BUT I had never questioned the calories in/calories out theory. I knew plenty of people carrying extra pounds who exercised a lot and who didn't appear to eat any worse than I did (as a thin person), but I figured they must. I never questioned to think WHY do people eat more than need. The short answer is: glucose drives insulin drives fat. Taubes states that this is inarguable. I thought, well if it is inarguable than if I go read this Biochemistry, Fifth Edition: International Version (hardcover) book sitting on my bookshelf it will say the same thing. Sure enough it did, granted using a lot bigger words than Taubes does. Fatty acids will not be released into the blood stream to be used as energy if the glucose level is high. Thus it is logical to conclude that if you eat a diet that causes your blood sugar to frequently be high, all energy you consume that is not immediately needed will be stored in your fat cells and will not be released. You will not get to use all of the 800 calories you eat at one meal, only the 100 or so you need immediately, and thus you will soon be hungry again, and will overeat. And in contrast if your blood sugar is stable and you can access that stored energy you will not be hungry and won't overeat. Also it doesn't matter if you are eating fat or glucose your body will convert what its got to what it needs.

Another controversial claim he is that exercise does not help people lose weight permanently. I am a champion of exercise. How could this be? Honestly his arguments made sense, kind of, but didn't completely convince me. However when I pulled out the Biochem book it says, "Muscle retains glucose, its preferred fuel for bursts of activity...In resting muscle, fatty acids are the major fuel, meeting 85 percent of the energy needs." So there you go. If you are trying to lose weight, and are doing so by keeping your blood sugar stable, which is releasing fatty acids into your blood stream, and you want those fatty acids to be used, versus having your body (ie muscles) crave glucose, then intense exercise will not help you. Your body will more readily use those fatty acids if it is resting.

The other question is whether ketosis is a desirable state to be in. There is a bit of controversy on this and I haven't resolved an opinion one way or the other. I have epilepsy and know that a ketogenic diet is a viable treatment for epilepsy. I know that there are some societies, particularly the Inuits, that ate a mostly ketogenic diet, so it is not unheard of. Maybe humans are supposed to enter ketosis seasonally? Your brain and muscles do like glucose--can they run as well on a ketogenic diet? Some say they can, it just takes an adjustment period. Either way, I definitely think for a person who has excess weight Atkins is vindicated. Cut your carbs, drop significant amounts of weight (probably feeling crappy in the transition, but resting muscles can use the fuel better anyway so crashing on the couch is fine till you get used to it and end up having more energy than before). When you hit a desirable weight slowly add back a small amount of carbs until you start gaining again, and start an exercise routine with all your new found energy. As exercise is good for weight maintenance, and it's good for you brain (read Spark: The Revolutionary New Science of Exercise and the Brain by John Ratey). Then do that forever. I would really love to see a long term study where the participants stay on the diet.

I found the book very readable and engaging. How much fruit is too much? Will eating more fat really improve your cholesterol profile? How many carbs are too many? I don't know. Taubes makes some guesses, but nutrition is a very complex science that I don't think anyone completely understands. If you read vegan arguments they make many of the same claims that Taubes does (better cholesterol levels, weight management, etc). However it does seem that every major nutritional philosophy pegs sugar as being a major problem. It may be as simple as that. I'll process this information. Read Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health (Vintage). Experiment on myself (finger pokes here I come), and have increased anxiety about what I feed my kids--especially the pasta, bread, fruit and sugar loving one.

(*I edited this section after my initial review.)
1.767 internautes sur 1.873 ont trouvé ce commentaire utile 
5.0 étoiles sur 5 Not another "balanced eating and exercise" book 29 décembre 2010
Par maramaye - Publié sur Amazon.com
Format:Relié|Achat vérifié
The brilliant thing about science is that when something is disproved once, it's disproved forever. The not-so-brilliant thing about public health policy is that it has little to do with science.

Everyone in the developed world knows what's causing our obesity epidemic. BBC nailed it: "We eat too much, and too much of the wrong things," and Michelle Obama tells us "We have to move more." Clearly what we need is a balanced diet of lean meats, some good fats, and complex carbohydrates like fruit, vegetables and whole grain bread, and exercise of 30 to 90 minutes per day. Their prescription is completely reasonable and makes intuitive sense.

It is neat, plausible, and wrong. It has in fact been disproved, as nearly as "disproof" can exist in nutrition science.

In his previous book, Good Calories Bad Calories, respected science journalist Gary Taubes exhaustively researched and cited two centuries worth of research in nutrition. He came to the conclusion that none of those recommendations is supported by science, because the fundamental theory on which they're based is wrong. Why We Get Fat is an updated summary of that earlier work, much quicker and easier to read, with some significant points clarified.

The most important point of the book is that all those public recommendations -- the food pyramid, the "eat food, not too much" approach, everything we know about a balanced lifestyle -- is founded on the premise of Calories In vs. Calories Out. That we get fat because we eat too many calories, or we don't burn enough of them through movement. But this is nonsense. It's not just wrong, it is actually not a statement about what causes obesity at all (or heart disease, cancer or diabetes, for that matter.) It is, in Taubes' words, a "junior high level mistake," because it tells us nothing about fat accumulation. If we get fat, by definition we have taken in more calories than we've put out -- but WHY we took in those calories, or didn't burn them, is the key point.

Taubes reviews the scientific literature (rather than the popular press) and presents a conclusion that was common knowledge before WWII, and heresy afterward: we get fat because our fat cells have become disregulated and are taking nutrients that should be available to other tissues. Like a tumor, the cells live for themselves rather than in balance with the rest of the body. And since those nutrients aren't available, we become hungry and tired. Therefore we eat more, and move less.

For the chronic dieters among us, one passage about animal models will explain decades of frustration. Rodents with a particular part of the hypothalamus destroyed would become obese and/or sedentary *as a consequence* of their bodies putting on more fat. "After the surgery, their fat tissue sucks up calories to make more fat; this leaves insufficient fuel for the rest of the body...The only way to prevent these animals from getting obese is to starve them...they get fat not by overeating but by eating at all." Sound familiar?

The problem isn't one of gluttony and sloth, as Taubes refers to it, but of hormone balance. Simply put, some people are more sensitive to the hormone effects of insulin, cortisol, and a few other -ols, than other people are. The more sensitive you are, the more you're likely to get fat, and the more fat you're likely to get, in the presence of even small amounts of carbohydrate -- and in the absence of enough fat.

That's right, this book advocates eating fat. Not just moderately, but as much fat as possible, up to 78% of calories. Not lean meats, not Jenny-O 99.6% fat-free turkey, not skinless chicken breasts, but lard. Yes, lard. The healthy way of eating, according to Taubes, is moderately high protein and high fat. Yes, high fat. About a 3:1 ratio of fat to protein, and almost no carbohydrates. (Telling people to eat a balanced diet containing carbohydrates is, he says, equivalent to telling smokers to include a balanced serving of cigarettes.) And he demonstrates exactly why a high-fat, low-carbohydrate diet is the most heart-healthy approach, as borne out by several dozen recent studies.

While Taubes acknowledges that exercise seems to be good for us for a variety of reasons, weight control isn't one of them. Study after study conducted by proponents of exercise have admitted that they see no compelling evidence for exercise as a weight-loss tool. And it makes sense if you throw out the calories in/calories out model of why we get fat. If we're fat because our fat tissues are starving the rest of our cells of fuel, exercise is just going to make us hungrier and more tired, not leaner and more fit. (It's worth noting that according to Taubes, in the 1930s obese patients were treated with bed rest.)

[This review was edited to clarify the following point.] The main thrust of Taubes' argument, however, surrounds sugar and to a lesser extent any carbohydrate. Insulin is the primary hormone that fixes fat in the fat cells. This is why Type I diabetics lose weight: they're not producing enough insulin. Since insulin is manufactured in direct response to carbohydrates, if you don't eat them, you won't have a mechanism by which to store fat. (Taubes notes that this mechanism is not controversial; it simply hasn't had an impact on nutrition policy.) Taubes argues that any success in standard diets can be attributed directly to the dieter's reduced intake of carbohydrates, especially sugars and particularly fructose.

Once the underlying cause of obesity is understood (hormone balance, not gluttony/sloth) the recommendations on what to do about it are surprisingly simple and therefore brief. This is a book about the science of nutrition, not a diet book, but there is a list of recommended foods in the Appendix. The book does not tell you how to eat in a restaurant. But it does tell you that the issue isn't in your brain, your willpower, your character, your job, your environment or even (except to the extent that you're sensitive to carbohydrate) in your genes. The problem with fat is in your fat cells.

For a lay audience, this book is as good as it gets if you want to read actual science about health and nutrition. If you're of scientific or technical bent, read Good Calories Bad Calories first, then give Why We Get Fat to your parents.
398 internautes sur 426 ont trouvé ce commentaire utile 
5.0 étoiles sur 5 powerful, focused, and desperately needed 8 octobre 2011
Par Jon Norris - Publié sur Amazon.com
Format:Relié|Achat vérifié
Taubes' book is one of the most important books ever written on nutrition. There are thousands of books written on diet and obesity, and the overwhelming majority of them are deeply flawed at best. The so-called advice offered (and now even forcibly mandated by public and corporate powers) is also dead wrong, as will be most of those who trust said advice.

There are many thoughts on why this is the case, and many "conspiracy" theories as to how it came about, some with substantial evidence and outright smoking guns. This area of health is rife with disinformation, misinformation, ignorance, and outright lies.

Taubes does not deal with any of that directly. He does something quite different and important: he uses solid research from the hard literature to make his case in a very precise and focused way. The case he makes is airtight and irrefutable, even from the most hard-nosed skeptic's viewpoint.

The first thrust of this book is to show that the old "calories in - calories out" steam engine view of obesity is not only mildly incorrect, it is so very obviously wrong on so many levels as to completely defy rational thought. While he does not deal with the reasons behind this deadly myopia in the professional, corporate, and governmental world, he does systematically dismember this superstitious silliness with glorious logic and hard evidence.

From the misunderstanding of the application of thermodynamic "laws" in biological systems to the research on obesity and disease connections, he deftly leads the reader to a greater understanding of what the real research on obesity actually says, and what that means in terms of personal health and public policy.

His main concentration is on fat metabolism versus carbohydrate metabolism, and how carbs disturb the delicately balanced fat storage mechanism and cause obesity. He describes the research which backs this up, and has for decades and decades, while being totally ignored by most medical and public health officials. He discusses how long some of this research has shown these things and mentions how it has been consistently ignored.

That's right - carbs. Not dietary fat, not sloth, not moral weakness, not any other of the fad social mythology which passes for "evidence" driven policies and public stances. He details the increased understanding from more sensitive and better done research which essentially proves that our great-grandmothers had a better sense of healthy food than almost all the scientists, dieticians, health agency spokescritters, and gurus who have filled our heads with lies for at least 60 years. (And been accessories to the pain and death of millions of wrongly informed people, I hasten to add.)

His focus is completely on the science, and he does not venture into the politics or economic pressures which created this stupid state of affairs (the vitriol here is mine). While he does not discuss it directly, his book does point out the dangers of trusting science to give hard answers to questions of diet and health. As I point out in my review of Weston A.Price's "Nutrition and Physical Degeneration," science will not be able to give us solid answers to dietary questions for at least another 1,000 years, at the snail's pace and myopic style of current research, some of which is clearly discussed in this book.

I do have some quibbles with him: his statement about being about to get adequate vitamin D from exposure to sunlight is over-simplified to the point of being incorrect. He also advises people to use artificial sweeteners instead of sugars, which is extremely bad advice, given the dangers inherent in most of them. He does not mention the impact of MSG on obesity (it causes obesity - MSG is reportedly used to fatten lab animals for obesity experiments). He does not mention experiments on farm animals in the 1940s which showed that the diet which fattened mammals most quickly was one of grains and vegetable oil. He does not go into the differences in saturated fats, and how medium-chain fatty acids are handled differently in the body. He also does not mention that animal fat is a dense source of critical nutrients, and that saturated fat is crucial in triggering satiation, hence limiting appetite, cravings, and overeating.

Given all that, his work is still ironclad and irrefutable even in its narrow focus. Add in all the rest and you have a overwhelming body of evidence which is more than compelling enough to warrant a major investigation into the reasons why this information has been forcibly withheld from the public (causing untold suffering and death).

I gave it 5 stars, not because it is perfect, but because it is so powerful, so right, and so necessary.

Bottom line: everyone should read this book, period. The information here can literally save your life and that of those you love. Doctors, other medical people, dieticians, and others involved in the public sector dealing with nutrition should read this NOW, before they kill any more people through their ignorance.

As Weston A. Price once responded to a question about how to deal with the disinformation around the subject of a healthy diet; "You teach, you teach, you teach."

Get it and spread the word.
49 internautes sur 51 ont trouvé ce commentaire utile 
4.0 étoiles sur 5 The answer 10 janvier 2012
Par Corrie Snell - Publié sur Amazon.com
Format:Broché|Achat vérifié
Wow! What a fascinating book. I couldn't put it down, and have been telling everyone about it. I feel like I finally have "the answer."

I have two personal anecdotes that I'd like to tell about. First, in 2010, I hired a personal trainer and went from being a person who wasn't sedentary, but did not have a regular exercise routine, to someone who was whipped into shape three times per week, for one hour personal training sessions. I stayed at the gym after my session for another hour to do 40 minutes on the tread-climber, and then 20 minutes to cool down and stretch. At the end of three months of this, I felt great, and looked much better. However, I hadn't lost a single pound. And, at the end of month two, when my personal trainer tested my percentage of body fat, it had somehow gone up! I was furious. I decided then and there that something was wrong, but had no idea what it could be.

Then, last winter, I joined the new cocktail craze. I hosted a big cocktail party just before Christmas, and for it I went to the liquor store and bought a bottle of just about everything. At my cocktail party people drank mostly beer and wine, and so afterwards I had what amounted to a full bar left over. I proceeded to fill the long evenings of a Montana winter by mixing cocktails. I had a couple fun books, and tried a new cocktail three to four times per week. I knew I was putting on weight during that time, but didn't get on the scale to see how much. After about four months, I thought, alright, let's see what the damage is. My jaw dropped to see the number, 20 pounds higher than the last time I'd weighed myself! I had never gained so much, in such a short period of time. What the heck happened?!

I'm sure every single person, except those, perhaps, who are lean and stay lean without effort, will have episodes from their lives that were perplexing because they seemed to go against what we've all been taught, that are explained by the information in this book. I feel like now I have "the answer."

I just read it a couple days ago, but I do plan to adopt a low-carb lifestyle, once I have a plan. That's why I gave this book four stars instead of five. The, "And What to Do About It," from the title left a lot to be desired.

Another thing, like a lot of people, I've tried an "Atkins" style diet here or there, two or three times, and had results. However, I always felt guilty while I was on that plan, "Surely, this isn't good for me...bacon every day?" And, I never looked at it as a permanent change. After dropping 10 pounds for an upcoming vacation, going off the diet for the vacation, I came home to find that I'd gained it all back. After reading this book, I understand why that happened, and maybe more importantly, why the diet works, and I can go ahead with the low-carb plan without feeling guilty about the bacon.

Update: 1/20/12

My husband read the book, too, and was just as blown away as I was. He was about 3/4 of the way through it last Thursday afternoon when he said, "forget Monday, I want to start today!" And so we did. I lost 4.3 pounds in the first week. Today is day one of week two.

We cleared ALL the carbs out of our house. Our big dining room table, and one of our kitchen counters were full of stuff from the pantry. It kind of felt like handing out poison to all the friends and family members who took the stuff, though. Cupboards nearly bare, we came up with a menu. We're following the "new" Atkins plan, simply because it's so popular and so accessible.

Let me put this in perspective: I am an almost 33 year old woman who's put on about 50 pounds in the last 13 years. I'm a foodie, I went to pastry school in Paris, I have invested thousands in specialty baking supplies, and thousands more in baking books. To find out that I need to give up life as I've known it is HARSH. I'm going through mourning...without craving sweets, if you can believe it (at least not this first week, anyway).

Second Update: 9/20/12

Well, here I am eight months later. Over the first several weeks of eating low-carb, I continued to do research online. Somehow, I stumbled across the Paleo Diet. I checked out a couple books on the subject from the library, and after reading them, felt as if I'd found more of "The Answer." My husband and I have adopted this diet, and have both been very successful with it. I am now down 30 pounds, and my husband is down the 20 pounds he needed to lose. I have about 20 more pounds to lose, and my goal is to do so by the end of the year, making 2012 "The Year Of Becoming The New Me." We'll never go back to our old ways, and couldn't be happier with our new lifestyle.
126 internautes sur 141 ont trouvé ce commentaire utile 
4.0 étoiles sur 5 Addressing comments about Asians and carbs 28 décembre 2011
Par T. Boc - Publié sur Amazon.com
Format:Relié
There are lots of responses about Asians and carbs so I thought I'd share my experiences from living in Japan.
Yes, they eat rice BUT....
There is a BALANCE of foods in the average packaged lunchbox.
A serving of rice is measured, not a free for all ~ it is nutritionally CALCULATED.
They don't eat bread, cereals, pancakes, sweets, candy, ice cream etc as part of meals. Snacking is not common. Cars don't have coffee holders, people never walk and eat (except at festivals). Soft drinks are a treat and they don't seem as sweet there. Cold UNSWEETENED green tea is very very popular and is in every vending machine.
The average breakfast contains: fish, miso soup, vegetables (some steamed and some pickles), green tea, rice, maybe egg. It's very different from what we try to pass off as food. Eating nutella chocolate spread with white bread and a glass of milk for breakfast would be incredulous to an average Japanese. That's not food!
The average lunch box is (in a variety of small portions): meat, fish, vegetables (steamed and pickled), tempura veggies or shrimp, seafood, rice balls with sea weed, sausages, meat balls, fish cakes, tofu cakes, omelet, chicken nuggets etc. All groups are represented and you are expected to EAT EVERY BITE! Veggies are not garnish.
If you Google "japanese bento lunch box" images you'll see a little box full of little portions of an eye pleasing variety of foods. Pickles lower the glycemic value of the rice. There is lots of fiber from the veggies. Oily foods and eggs are represented. But again, no sugar or flour in the box at all. No cake for dessert. Bento boxes are available for pick up everywhere - you can run to the bento store and be back at your desk in 15 minutes with a balanced meal. The meals at the grocery store and even convenience store are really good (for about $5!). You aren't left desperately searching for real food on the go - it's just there for you. Food is made with care and there are so many options.
I should add, I lost 30 pounds after living in Japan for 2 years.
It also helped that there was no Tim Horton's with rows and rows of crack sugar to temp me. And cookies are individually wrapped so you'll look like a real tool unwrapping a dozen of them at a time. People eat meals instead of snacks all day. In short, they don't live on a refined carb roller coaster because they eat a balanced diet that they've been eating for thousands of years (we shouldn't just look at their diet for the brief period after WWII because that's not the real picture).
It's also a mixed bag that the working culture doesn't leave much time for watching tv and snacking.
There are so many nuances. It's hard to express them all in a book review.
Sadly, after I moved back to Canada, I gained back the weight plus 10 pounds within a year.
Sigh.
When I hear the Japanese diet is changing to Western style, I feel so sad. But on the other hand, it's still pretty good there!
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