Russ Roberts

Gary Taubes on the Case Against Sugar

EconTalk Episode with Gary Taubes
Hosted by Russ Roberts
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Case-Against-Sugar.jpg Sugar appears to have no nutritional value. But is it more than just empty calories? Is it actually bad for us? Author and journalist Gary Taubes talks with EconTalk host Russ Roberts about his latest book, The Case Against Sugar. Taubes argues that there is substantial circumstantial evidence suggesting that sugar is the underlying cause of a host of modern health problems including diabetes, heart disease, and obesity. Taubes concedes the evidence is not iron-clad or definitive and reflects along the way on the intellectual and personal challenges of holding a strong view in the face of significant skepticism.

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Podcast Episode Highlights

Intro. [Recording date: January 12, 2017.]

Russ Roberts: Before introducing today's guest I want to thank everyone who voted in the Survey for Top Episodes of 2016. I'll be announcing the results soon. My guest today is author and journalist Gary Taubes. Our topic is his latest book, The Case Against Sugar. Gary, welcome back to EconTalk.

Gary Taubes: Thank you for having me.

Russ Roberts: Now, this is an awkward interview for me. I really love Peanut M&Ms, chocolate chip ice cream, cherry pie, bear claws. And Creamsicles are my dreamsicles. What's wrong with sugar?

Gary Taubes: Well, possibly everything, except that it tastes great. I just want to say in advance, the title I would have preferred for this book was Stealing Christmas. Okay, [?]. I thought I should get it out there. It's not like I'm not aware that I'm playing this Grinch role. And my editor said, 'Keep it simple.' So, we ended up with just The Case Against Sugar. Okay. Traditionally, historically the argument has always been they are empty calories. So, they add calories to the diet; they don't have any vitamins, minerals, fiber, or anything else attached; so then you've got to get the vitamins, minerals, fiber from your other food. So you consume more of them and you end up over-consuming calories. And that's why you get fat. There's a whole world of problems with that thinking. But nonetheless, that's been ubiquitous for going on 100 years now. The argument that I'm making in this book is that sugar is at least the prime suspect, the cause of a condition called insulin resistance. And insulin resistance is the fundamental defect in Type 2 Diabetes, which is the common form of diabetes that associates with excess weight. And insulin resistance is so closely associated with obesity itself that you could at least hypothesize, as I do, that it's a fundamental cause of that. And obesity and diabetes are associated with an increased risk of every major chronic disease, including cancer and heart disease and dementia. And so, if sugar causes insulin resistance--that is, the dietary trigger of this condition called insulin resistance--then it is why we get fat. It's why we get diabetes. And it's at least an exacerbator or an increaser of the risk of cancer and dementia. And, excuse me, why we get heart--the primary reason, the primary dietary trigger of heart disease as well.


Russ Roberts: So, there's definitely a correlation, as you mention many times in the book--and you are very honest about it--between the rise of sugar consumption in Western countries and then throughout the world; and the prevalence of many of these diseases. And that's one of the reasons to be open to the possibility that sugar is the underlying cause. But let's talk about some of the magnitudes that we are dealing with here. How much sugar do we consume? How much did we consume? So, what are the kind of changes that we are talking about in sugar consumption? And also, you might want to remind listeners that we take sugar into our bodies in many different ways in the modern world.

Gary Taubes: Yeah. And this is--there's so many misconceptions and so many issues that need clarification about sugar. In the very first chapter, as you may have noticed, I grind the narrative to a halt by saying, 'Okay, let's clear up some things first, so we know what we're talking about.' The first thing is: What do we mean by sugar? And it's funny--even very informed commentators, even reviews of my book, still seem to get this wrong. Which clearly, I didn't clarify it enough. But, you know, all carbohydrates, all chemicals that end in--and the molecules that end in -'ose' are technically sugars. And when we talk about blood sugar, we are talking about glucose, which, when I'm talking about sugar is, what the FDA (Food and Drug Administration) calls caloric sweeteners, we're talking about you know, roughly 50-50 combinations of glucose or fructose--and fructose. And it's fructose that makes sugar sweet. Fructose is the sweetest of the carbohydrates. And there are sugars with more or less fructose content. But what dominates American diets are sucrose, which is a white stuff, or brown if you get it from Whole Foods [Whole Foods Markets, a supermarket chain], that we put in our coffee. And high-fructose corn syrup. So, when we call it--and there's a big debate about, 'Do you call these things added sugars? Do you call them refined sugars? Are they better or worse than the same sugars--you know, fructose, glucose, sucrose, when you get them naturally in fruits and potatoes?' and we can talk about that. Or fruits or other vegetables.

Russ Roberts: Honey.

Gary Taubes: Honey. The point is: Refined sugar was very expensive. And it came out of Indonesia, 6000 years ago. It spread to India and China--the Indian and Chinese started refining it 2000 years ago. Sugar cane, into sugar itself. And it's not basically until the creation of the Caribbean colonies in the 17th century that sugar consumption really starts to become big business. And kind of drives empires. It's the oil of that era. With the Industrial Revolution, sugar refining starts to get cheaper and cheaper; and then with the creation of then with the creation of the sugar beet industry. So, sugar cane can only be grown in tropical climates. Limited the amount, the availability. But once you got sugar beets, you can grow it in temperate climates as well--in Europe, in North America, in Russia. So, second half of the 19th century, sugar consumption and distribution explode. So, these numbers--two are confusing because your question is, 'How much sugar do we consume?' And the only--even vaguely accurate number I can give you is how much sugar does the food industry make available for use by the public?' So, food availability numbers are charted pretty carefully. We don't really know how much of the sugar that ends up, you know, because used in beverages, and cooked--used in baking--actually gets consumed; how much gets transformed in cooking; how much gets thrown out. So the FDA--the USDA (United States Department of Agriculture)--has a formula that it estimates that we can talk about.

Russ Roberts: Nah, we can't. Go ahead. It's not that interesting. But it does make the point that there's obviously some--it's a challenge to measure this with any precision.

Gary Taubes: It's a challenge even to talk about it. And sometimes I think the sugar industry tries to make it as challenging as possibly. So, they like to say--so, the baseline fact is, 200 years ago we were consuming--maybe the food industry or the sugar industry was making available about 5 pounds of sugar per capita per year. About the amount of sugar--

Russ Roberts: In Western countries.

Gary Taubes: In the United States and the United Kingdom. So, you are talking about the sugar equivalent of a 12-ounce can of Coke (Coca Cola) every 6 days. By 1999, when this trend peaked, it was up to 155 pounds of sugar per person, per day.

Russ Roberts: A modest increase.

Gary Taubes: A 30-fold increase in 200 years. Roughly 20% of our calories were coming from sugar. And I--one of the things that fascinated me in recreating the history of this is that, prior to the 1840s, sugar was still so expensive that it's a luxury. It's primarily a sort of head-of-the-household thing. 1840s, you get the--and in one decade you've got the founding of the candy industry and the chocolate industry and the ice cream industry. So, you begin to mass-produce, again, industrial--the Industrial Revolution, you begin to mass-produce sweets for children and women. Until then it's been exclusively men. And then in the 1870s, 1880s, the soft-drink industry begins to kick into gear with Dr. Pepper and Coca Cola, and then Pepsi. And even with chocolate candies--the candies that I grew up on: Snickers and Milky Ways and Mars Bars were all created from about the 1890s and 1920, 1930. And then there's still a couple of more industries to come. So, the fruit juice industry begins to kick in in the 1930s; and if you think about it, it's not till we've got--you know, in order to have to really saturate your diets with sugary beverages, you need a way to keep them cool, close by. So, it's not about going to the soda fountain at the drug store, which it was in the 1880s. By the 1930s, refrigerators and ice boxes and vending machines start getting to the point that they are cheap enough to be in most American household. And that allows fruit juices, now, to--and Coke and Pepsi and the soda beverage manufacturers start now, you know, putting Cokes in cartons and large bottles so that you could keep it at home in your refrigerator and drink it all day long. And then, finally, post-WWII, the sugary cereals come out[?]--the sugary--the cereal industry was founded by health fanatics. Post [Post Cereals] and Kellogg's both ran sanatoriums for the sort-of well-heeled dyspeptic. And cereal was a way to help their digestion--a high-fiber treat. So, all these industries had nutritionists who said, 'We can't put sugar in the cereal because we know sugar is bad for you.' But by 1848 [1948? --Econlib Ed.], I think it was, Post, introduced Sugar Crisps, the first one. And the rest of the industry--it's like, we see these internal struggles going on between the marketing people and the nutritionists; and the marketing people just completely won out. They were saying, 'We can't survive unless we can compete with Sugar Crisps.' So, one after another, it's the big cereal manufacturers started creating these sugary cereals--sugar-coated cereals. And by the 1960s you've got sugary cereals that are 50% sugar by calories. And the American breakfast has been transformed in this sort of low-fat version of dessert. And Americans are getting sugar--you know, and American kids are getting sugar from pretty much the moment they wake up to the moment they go to sleep, and I bet there was a large part of the population that--you know, didn't go 2 hours without a sugar hit.

Russ Roberts: Yeah--I think you said "1848" on Sugar Crisp--although maybe I misheard you. You meant 1948.

Gary Taubes: 1948. Yeah. 1948. Might have been 1947.


Russ Roberts: So, thinking about that story--tragically, or comically, or both, I think about my recent interview with Sam Quinones on Dreamland and the giving of heroin to young teenagers to get them hooked as a marketing technique--you know, here we are--I think about Willy Wonka--the romance that we have about childhood and candy, childhood and cake, childhood and cereal--is really sweet--literally. But it's perhaps tragic. Every family, I think has a story of some member of the family who tries to keep their kids from having sugar. And then a grandparent takes the kid on an outing and stuffs them with something that the kid goes nuts for, and 'love is all around, baby'. But--

Gary Taubes: But this is--yeah, the first--after the Prologue, the first chapter of the book, it's called 'Drug or Food,' but it's addressing this issue. And it starts with a thought experiment, actually, in the early versions: it's about how about a thought experiment. And I'm a big fan of thought experiments, because I have this physics background. When I'm feeling particularly pompous I call them gedankenexperiments.

Russ Roberts: Well, that's because you have a very deep weltanschauung; and so as a result of your worldview, you need to have a gedankenexperiment. Go ahead, Gary. Sorry.

Gary Taubes: Exactly. So, the thought-experiment: Imagine any drug. We are just going to create a drug that can be taken by mouth--so, it can be consumed orally and it's got no apparent sort of immediate side effects; and it's effective just to make you moderately happy. And when you give it to kids, it makes children moderately happy. So you don't have to inject it; you don't have to snort it; there's not a lot of preparation. You just buy this drug at the store and give it to your children; and if they are feeling pain, it will relieve their pain; and if they are feeling stress, it will distract them. And it will make them happy. And the question is, just with that concept, how long would it take until you get to a point where this drug becomes the way we communicate love? This drug becomes the way we reward success? Every family celebration, every holiday, every kid's soccer game--everything we do has to be, you know, sort of, capped off with this one drug, because it's so effective. And it's so easy. And if it's got side-effects, they don't show up for 30 or 40 years. And then by the time they do, by this time, our experimental population has no way to link the side-effects to the drug because everyone is consuming the drug. And has been for 30-40 years.

Russ Roberts: Just think how different human history would be if it had been kale-cycles. As a sign of--you know, you scored a goal; you deserve a kale-cycle. You got an A in math; here's a kale-cycle.

Gary Taubes: The media started noticing that a lot of Americans were on a diet in the 1950s. And it's interesting why this happened. And so, artificial sweeteners come along, and post-WWII the FDA is allowing cyclamates to be marketed to people with diabetes or who have some medical need for these drugs--they are kind of like marijuana now. Beginning in early 1950s, several manufacturers started making artificially sweetened sodas, soft-drinks; and they realized that they have a market far beyond people with diabetes. So, the industry starts growing, you know, wildly. And the media catches on that they are selling--soda is, clearly a lot of people are on diets so they start doing articles about how Americans are now on diets. And polls are taken, Gallup polls, about how many people. So, I think it was 1958, maybe, the New York Times Magazine has a cover story called, or had this article called 'The Great American Diet Mania,' or something like that. And the point is, at the end of the article it quotes a professor from Yale saying, 'The next thing you know, all Americans will be eating kale." Like, this is how crazy it's going to get.

Russ Roberts: Prescience. [?]


Russ Roberts: So, let's talk a little bit about the evidence: which is, as you often admit in the book: It's not perfect. It's highly suggestive to you. Less suggestive to others. But let's just start with the basics on obesity, which is something of a review of topics that you've discussed in your previous books and we've discussed in your previous episodes here. But the sugar industry's view has been--strangely enough--that, 'Hey, sure it's just calories. Calories are what make us fat. And people who eat sugar might even eat fewer calories elsewhere, because it fills you up. And so it's really no big deal. It's not a health risk. It's just a pleasant way to take in some calories in moderation, or even some larger amounts: It's not a big deal. What have we learned in the last, say, 100 years, about what might be problematic about that claim?

Gary Taubes: Well, so, and this claim is based on the nutritional consensus. This is a point--I have an Op-ed in the New York Times that will probably have run by the time you air this, where I am actually defending the sugar industry, because they--business for the past 50, 60 years has been to pay advertisers and to pay researchers to remind nutritionists and obesity researchers that what they believe applies to sugar, too. So, the conventional thinking since the--1920 has been that we get fat because we consume more calories than we expend. And this is based on the science from 1870-1920, which may be a mistake to base such a fundamental understanding on 100-year-old science. But it is what it is. And so, it's a caloric imbalance problem, as the NIH (National Institutes of Health) website will tell us. And, as such, the only way foods can make you fat--the only effect they can have--is through their caloric content, or their digestible caloric content. And, so sugar is no worse than any other food. There's no such thing as a fattening food or a reducing food: it's all about how much you eat; how many calories you consume and digest. Not about what foods those calories come from or what macro-nutrients those calories comes from. So, the sugar industry's defense through all this period has been 'Look, you know, there's nothing uniquely fattening about sugar. It's just a source of calories as any food is. And in fact if you do an epidemiologic study and you follow people'--this used to be true; I don't know if still it is--'but if you follow a population to see who eats a lot of sugar and how much weight they gain, you'll find that lean people tend to eat more sugar than obese people.' And this feeds into my criticisms of epidemiology over the years, because you would expect people who are lean to drink sugary Coca Cola because they can.

Russ Roberts: They can.

Gary Taubes: And people, the ones who easily gain weight might drink Diet Coke because they are trying to avoid the calories in the Coke. Because they gain weight so easily. And then you follow them; and lo and behold, they gained weight anyway. But they were the ones drinking the diet soda, so you've got a reverse causality you have to deal with. So, this has been the sugar industry defense. And the arguments I've brought up in my books because I happened to pay attention to the history--I was probably the first--I was the first journalist/historian who bothered to go back prior to WWII and recreate the history of thinking on, clinical history of thinking and research on obesity prior to WWII, back when all major medical science was being done in Europe; and the fields relative to obesity--metabolism, nutrition, genetics, endocrinology--were all sort of born and pioneered in Germany and Austria. And these clinical investigators who actually understood what endocrinology was and even what genetics was, which most physicians didn't, had concluded that clearly obesity must be some kind of hormonal, regulatory defect. And, people don't gain 100 pounds, accumulate 100 pounds of excess fat because they eat too much: they do it because somehow their body is telling them to accumulate fat. And that's going to be a hormonal, enzymatic phenomenon. This theory was lost with the war. And post-war obesity research was sort of recreated by young doctors, lean doctors, and nutritionists at the Harvard School of Public Health, and they thought it was simple and they thought it was a caloric imbalance: basically, [?] loss. And by the 1960s, obesity research was dominated by psychologists and psychiatrists who had concluded that obesity is a behavioral defect, in effect--that it's [?] both eating too much and exercising too little are behaviors. And so they were trying to come up with ways to change the behavior of the fat person so that they would do what lean people seemed to do naturally--which is, not accumulate excess fat: you know, eat less and exercise more. It's almost--it's hard to accept that this fundamental, bedrock concept of obesity research is simply wrong. And I keep thinking of different ways to communicate this to people. So, my latest attempt is to say, like: Imagine if, Russ, you were interviewing me about economics or finance or wealth accumulation instead of health and public health, and we were talking about Bill Gates, and you said, 'Why did Bill Gates get so rich?' And I said, 'Because he made more money than he spent.' You know, you would be wondering why you had ever developed a relationship with me to begin with. Right?

Russ Roberts: I always wondered [?], Gary. [*cough*].

Gary Taubes: Yes, true. And if we were talking about climate change and the question was: Why is the atmosphere heating up? And I said, 'Because it's taking in more energy than it expends'--which it clearly is--I'd basically insulted your intelligence. But in obesity, if you want to know why somebody is getting fat, then you tell them they take in more calories than they expend. And it's just almost incomprehensibly naive, to me, at this point. Clearly, if someone's gaining weight, they are taking in more calories than they expend. That's the laws--basically what you are saying is if they are accumulating energy, they are accumulating energy.


Russ Roberts: Well, the economics analog for me, and the reason I find these topics so interesting, besides the personal and intellectual content, is that, in economics people say things like this all the time. They say things like, 'Well, our national income is C+I+G--it's Consumption plus Investment plus Government Spending--so when government spends a dollar, income goes up by a dollar. And that's obvious. And my thought is: Whoa, whoa, whoa, whoa. Where did the dollar come from? Does it not have any other side effects? Does it matter then--can government just, say, add an extra zero to the money and we're that much richer? What about prices? It generates a lot of questions. But in the case of--and by the way, the thing I learned, the deepest thing I learned from your book, because of its honesty, is the same thing, for better or worse--and this may be my problem--it's the same thing for better or worse that I've learned about the economy: Boy, is the human body complicated. It's so challenging to parse out the independent effect of one, even dramatically increasing variable called sugar, because there's so many other things happening at the same time.

Gary Taubes: Right, but this gets--it's funny--two points. One is, I remember, I think my very first interview when we tried to decide which science was worse. I think you said the reason economists like me is I'm suggesting there's a more problematic field of research out there. Second point is: We tend to get confused: Because the human body is so complex and because it's so hard to tease out these different issues, people kind of lose sight of the fundamental question that we want to answer. And so they, one of the things you see written about all the time now is obesity and diabetes are multi-factorial, complex disorders. There's this whole slew of things that are involved--you know, genetics and maybe sleep deprivation, the absence of sidewalks, and maybe--

Russ Roberts: Stress.

Gary Taubes: Stress. And antibiotics that are being used in our cattle that make the cattle fat. They get into the rainwater. And to me this is an excuse for why we've completely failed to control these epidemics of obesity and diabetes that are worldwide, and we could and should talk about that failure shortly. But the thing to remember, the question is this: We have these epidemics that are worldwide: Every population that transitions to the Western diet and lifestyle, that goes through what's called a nutrition transition, eventually manifests these explosive increases in obesity and diabetes. In diabetes sometimes they do it quickly, in the course of a couple of generations; sometimes it's a little delayed. But it always manifests itself. And you see when people immigrate, emigrate, to the United States from, like for instance Asian populations and they come to the United States, within two generations they've got levels of obesity, diabetes, breast cancer similar to any other Western population. So that's what we're trying to figure out: What's the cause of those epidemics? They are worldwide; we could begin to understand; we could rule out causes by looking for populations that would manifest the epidemics without our suspected cause. The answer to that is probably simple. So, even though obesity and diabetes are considered multi-factorial, complex diseases. I mean, there's some people who think, 'Well, the answer to that question is Western diets and lifestyles: it's the whole shebang,' and, 'if it's food, it's everything that goes into processed foods.' To me, that violates Occam's Razor. Maybe because I grew up in the physics community I have a devotion to Occam's Razor that's more fierce than it should be. But if you don't start with a simple hypothesis, you'll never make progress. So, 'Never multiply hypotheses beyond necessity' is my favorite variation on Occam's Razor. Einstein's paraphrase, which was that 'The hypothesis should be as simple as possible but no simpler.' So, if you start with the simplest possible hypothesis, and the conventional one is that people just eat too much and exercise too little--so, they think diabetes is caused by obesity; obesity is caused by caloric imbalance--

Russ Roberts: With the sloth part, too--that we just are sedentary.

Gary Taubes: Yeah, exactly. You get a more mechanized society; there's less manual labor that's necessary; people don't walk as much because they have cars. This all goes with it. But the end result is caloric imbalance. Yeah. And then my version of it--again, in my earlier books I talk about the effect of refined grains and sugars in general. And now I'm just drilling down on sugar. Funny--I have an email waiting for me from somebody who went into my website and said, 'What about the carbs in beer?' And I want to say, 'Well, clearly beer is fattening, and I could have written a book called The Case Against Beer. And that would be a different story.'

Russ Roberts: Somebody already wrote that book. You wrote that book before: it was called The Case Against Carbs. [?] a special chapter.

Gary Taubes: Yeah. Anyway, so that's--despite all of the complexity of the human body--when somebody gets cholera, it's a complex physiological response as well. And when somebody gets lung cancer from smoking cigarettes--and only 10% of the people who smoke are going to get lung cancer--that's a complex physiological response. But we can identify the agent. The question, 'What is the agent?' has a simple answer. And what I'm saying the agent is: The agent is sugar. You add sugar to every population, whatever their baseline diet is, you are going to trigger, eventually, obesity and diabetes epidemics through this insulin resistance mechanism, at least. And one of the reasons I'm not saying 'sugar and refined grains' in the answer to this question is that we had populations--Southeast Asia--that ate a lot of refined grains and didn't get obese--that had vanishingly small levels of obesity and diabetes until you added sugar to their populations' diets.


Russ Roberts: So, it could be that you're right. And I'm curious why--in your book, you say in the very, I think the first page, maybe the first--certainly in the first few pages--that this book is the prosecution: This is a prosecutor's one-sided case against sugar. Shouldn't there be a more nuanced? It's suggestive; and as you point out, we don't have large, randomized clinical trials on people who eat sugar for a long time and people who don't. And, so the evidence is always going to be somewhat imperfect. Why are you so convinced that it's sugar? And why aren't other people rallying to your cause, if it's so clear that it's the one thing?

Gary Taubes: Well, again, remember the--well, let me backtrack. I do, indeed--there's an Author's Note in the beginning saying that if this were a legal case, this book would be the prosecution's argument. In defense of my defensiveness, I've had people read the book and say, 'Oh, no, a prosecutor would never be so open about the--'

Russ Roberts: True. True, true, true.

Gary Taubes: [?] a diet, with the evidence. So, yeah, I do believe that anyone involved in the scientific endeavor has an obligation to be as honest as humanly possible about what can and cannot be interpreted from the evidence. So a thing that has always gotten in the way and still gets in the way, is this energy balance issue and calorie issues. So, clearly, one of the reasons this book is being embraced, if it is, is because as a society we are going after sugar now. The World Health Organization has sat relatively strict limits on the amount of sugar they believe should be in a healthy diet--like, 10% of calories; and then they advise 5% for further benefit. The USDA recently for the first time in the history of their dietary guidelines put a cap on the amount of sugar that they believe is healthy, or the percentage of sugar calories. But it's still always based on this idea that sugar is an empty calorie. And one of the things I point out, that I'm a little embarrassed I didn't notice in my earlier books, is how much this is dependent on the state of nutrition science of 100-150 years ago. So, when you go back to read history of nutrition books, modern nutrition science basically dates to the late 1860s and the invention by German researchers of room-sized calorimeters. So, these are devices that could measure the heat and energy expended by a human subject, or a dog. And up until then they knew how to measure the energy content of a food, by burning it in a small calorimeter and measuring the heat that comes out. But now they could actually measure the heat expended by humans. You could measure the energy in and the energy out. And from 1870-1920, virtually all of nutrition science was calorimetry--measuring this energy content of foods, and how much energy they expended by different types of, you know, kids, and soldiers, and [?] people and healthy people. And then you could also do studies on vito-mineral[?] content; and they were beginning to realize that vitamin- and mineral-deficient diseases, what vitamins were causing them. So all of nutrition science, was not--when we talk about sugar being empty calories, it's empty of vitamins and minerals. Which is the science of the 1870-1920. And it's calories, which is the science. And we couldn't actually understand the way sugar impacts bodies differently than that. And so, not until the first--insulin is discovered in 1921, 1920, I always forget--and growth hormone shortly thereafter, and the science of endocrinology, of hormones and hormone-related diseases, slowly begins to evolve. Like in the 1910-1920s, we still call it 'glands'--'ductless glands' was our word for endocrinological organs. And nobody really understood--doctors didn't understand it at all. I remember reading Graham Greene's brother was a premier British endocrinologist and he wrote an article in the British medical journal, I think it was in the 1950s about how nobody understood--none of his physician colleagues even knew that insulin did or what it meant. And that to disregard it on the basis of ignorance was a bad idea. And then, 1960, they finally have a technology available that cut the radium, you know, assay, by Roslin, Yalow and Solomin, Bersin[?], discovered it. And you can for the first time in history measure hormones in the bloodstream accurately. So, you can now really figure out--you can actually feed people and see the hormonal responses. And, you know, using this assay. If you want to. And you could see--so, 1920, all we know is the calorie content of food. Now, 40 years later we can see how the human body responds hormonally and enzymatically to foods, which is another effect they have, independent of calories. But by this time, again, we've got this theory that it's all about calories.


Gary Taubes: So, as long as it's all about calories, getting back to the evidence, to demonstrate that there's something unique about sugar, the case against sugar depends on demonstrating that it has effects independent--deleterious effects independent of its calories. That it's not just something we benignly over-consume and we get fat because we over-consume all calories. And that dis-association of the effects of sugar from the caloric content of sugar is excruciatingly difficult to do in a laboratory and an experimental setting. And what I've realized in the last 5 years of my life, tried, and to some extent failed to run a nutrition or, I co-founded a nutrition-science initiative, a non-profit that was going to fund and facilitate studies that could resolve these issues. And I completely under--you know, it was like a heart-beat[?] away--you know, getting involved in a nonprofit. And the revelation was how excruciatingly difficult these experiments are. How easy they are to screw up. And if you don't have people who have been thinking deeply about the hypotheses. So, if you take a whole world of people who for the past 50 years have thought a calorie is a calorie and obesity is a caloric imbalance problem, and you say, 'I want you to do an experiment in which we are going to test your fundamental belief based on this alternative hypothesis--that a calorie is not a calorie and obesity is a hormonal, regulatory disorder--and the way you are going to have to do it is you are going to have to disassociate the effect of the calories from the effect on the human body,' it takes an extraordinary amount of thought and dialogue and argument, and critique and critique and critique, before you are going to get an experiment that even begins to work to do this. And there is an absence of people who are capable of having those debates and the critiques, because nobody has been thinking about it.

Russ Roberts: So that leaves you--it seems--

Gary Taubes: Yeah. Which is a, sort of, that, so now, if you had a choice--I remember one of your economics colleagues at Yale called this the $100-bill on the sidewalk problem, right? I mean, what are you going to bet? You've got the entire nutritional obesity research community saying one thing. And you've got this journalist and a few friends, and you know, there is a guy, a professor at Harvard who agrees with us and also worked and independently came to the same conclusions. Who are you going to believe? I mean, if I were a betting man, who would I bet on? And I wake up at 3 or 4 in the morning thinking, 'I must be a quack. This is crazy.' But then I think back to the whole energy balance idea--you know, again, let's say we were--again, we never get to talk about a money-balance theory of wealth: You've got to make more money and spend less, that's how you get wealth--so why--then, I can put a stake on a few things that suggest that I'm at least half not wrong.


Russ Roberts: So, that leaves you with the possibility of having to admit that you are not sure, or that you don't know. For me, as an economist, the analogy is: 'We're in a Depression. What do we do? If government spending isn't what gets us out, what do we do?' And, you know, and I say, 'I'm not sure, but I don't think it's government spending,'--that nobody wants to listen to you. It's not a good selling point for getting attention.

Gary Taubes: Well, even historically, whenever researchers said, 'Look, we're not sure. We need more research,' they were perceived as being self-interested. Right. Because 'need more research' means 'need more funding'--

Russ Roberts: Yeah. For me.

Gary Taubes: to do the research. And for me, yeah. So, you know, there's a lot of natural traps that occur when we get into--that's why ideally you never screw up in the first place. Because once you've screwed up--once a discipline or an institution has embraced a dogma--and this is one of the revelations that I'm still trying to wrap my head around--it's almost virtually impossible--we have this concept of a Kuhnian paradigm shift, but once you get to the point where entire institutions are invested in a belief system, it might be beyond the point at which enough data will be allowed to accumulate to overturn that belief system. Certainly that's the case in nutrition, obesity research. If I'm right. And let me say right here, we could just assume that every sentence I say for the next remainder of interview is preceded by the clause, 'If I'm right.' Okay?

Russ Roberts: Fair enough.

Gary Taubes: But I've been--

Russ Roberts: I've been putting in front of it, the whole time.

Gary Taubes: Well, it's got to be in there, right? Because the odds--historically, the odds are, people like me are always wrong. Not always--99.9% of the time.

Russ Roberts: You've got ulcers. You've got the tectonic plates. You've got a bunch of places where a lone, crazy quack turned out to be a genius. So, this could be one of those.

Gary Taubes: They tend to--even those lone, crazy quacks--tend to be in the field. Although, you could argue, if you look at the times when paradigms shift, they are usually driven by some--they are often driven by people outside the field who have a different perspective or aren't trapped by the belief system of the field.

Russ Roberts: No--I go with Nassim Taleb, here: that the field that we're talking about, it's called Nutrition or it's called Epidemiology or it's called Medicine, but it's really Statistics. And most of the people who opine on these issues are not experts. They are faux-experts. It's the--Taleb's example is the: If you want to understand roulette, you don't talk to the carpenter who assembled the roulette wheel. And that person looks like the expert: 'He built the wheel. Come on, how could he not be the person who knows the most about it?' So, the people who--given that we don't really understand enough about how the human body works, a lot of it is--it's not clear who the experts are. So, I think the question of who is inside the field and outside the field, that may be not so pertinent.

Gary Taubes: But it's--what even here, it's interesting, because it's one of the things that you notice in the history. So, what I'm basically saying: Because it's a belief in caloric balance, and then gluttony and sloth, a like I said, by the 1960s, 1970s, when endocrinology was maturing as a science, was exploding in its maturation, the obesity research community was dominated by psychologists, who were looking for behavioral explanations.

Russ Roberts: Yep.

Gary Taubes: So, they make no progress for 20 years. And 1993, I think it was, leptin is discovered. And now you've got an obesity gene. And suddenly, boom: molecular biology, industrial complex kicks in. And the field is swarmed by--it becomes a sub-discipline of molecular biology. And now you've got people looking for the effects of other obesity genes; and then the genomics and proteomics and everything else kicks in. And in the meanwhile, basic endocrinology was left behind. Okay? So, this 20-year period of sort of fundamental medicine--like, when you want to know why somebody is 8 feet tall, you explain it by basic endocrinology from the 1920s to the 1970s, you don't bother getting into whether or not he's got some tall-gene. Right? Or the micro-[?] that's involved in communicating between the insulin-like growth factor and his cells. I mean, it's not that relevant. It's like the guy is over-secreting growth hormone: Do an MRI (Magnetic resonance imaging), find the tumor, and it's: 'Pituitary gland, get it out of there before he becomes 9 feet tall.' And I'm saying that period, and when it came to obesity, was basically ignored. The people played around with the theory, and they didn't like the implications. The implications were that people like Robert Atkins was right. And so, they sort of buried it. And we came out--by 1980, we're discussing a science of excess fat accumulation. A disorder of excess fat accumulation. But the actual hormones and enzymes that regulate fat accumulation in the human body are considered irrelevant. Which, again, one of those things where I say: If nothing else, it should be discussed. Right? You should see it in the papers. When somebody writes a paper on the cause of obesity, it should at least be discussed in why it's not a hormonal or enzymatic issue. And you get to the point, so, last Fall I was doing a BBC (British Broadcasting Corporation) interview by Skype, with, on a program, with a host, with a very charming geneticist, I forget if it was Cambridge or Oxford; and he studied the genetics of obesity. And I said to him, 'Do you know what regulates the flow of fat into and out of fat cells?' And he said, 'Well, we don't know that.' And I responded that, 'No. You don't know that. Because you are a geneticist. And you don't read endocrinology texts. But this was worked out in the 1960s.' So, you've even got people study the experts, who are studying [?]in the long tail[?]--

Russ Roberts: What did he say back to you? Did he say, 'Oh'?' Or did he say [?]

Gary Taubes: He said, 'Oh.' That's an interesting--and then I actually sent him an email. I mean, maybe it didn't get through. But we got off the show, I sent him a long email, with references and pages from the--you know, Williams' textbook of Endocrinology and Lehninger's Biochemistry saying, 'Look, just go to a [?] site. Look it up.' And we know what the answer is. It's just not considered relevant to human obesity. Which, like I said, is another one of these areas where I think I'm not entirely crazy.

Russ Roberts: It's a comfort.


Russ Roberts: So, let's get personal here, for a minute. We'll start with me, and then we'll turn to you. I would, in theory, like to weigh 25 pounds less. Ten would be great. Twenty-five would be ridiculous. I weight--oh, I probably weigh 40 pounds, plus, more than I did when I finished a marathon in 1976. That's was when I was the fittest I've ever been. And so I weigh more than I did then.

Gary Taubes: You continued running through this period?

Russ Roberts: I did not. No, no, no. I ran for another few years. Then I stopped. But I knew that whenever I wanted to lose weight I could cut back on carbohydrates. And it would be like magic. And I got that from a great scientist--my Mom, who read the Atkins book, and it worked for her. So, she told me about it, and I thought, 'I'll try it.' And it works. So, in recent years, the only thing I have good to say about my weight is that it has not gone up. My attempts to keep it down have been successful; but it is not fallen. And what happens to me is the following. During the week, I pretend I don't eat carbs. It's not quite true. I pretend it's a snack on things like an enormous bag of almonds, or peanuts--because I think, 'Well, it's really kind of a low-carb food.' I eat cabbage and protein for lunch almost every day. I tend to skip breakfast. I keep the Jewish Sabbath--so, when Friday night comes around, I eat a couple of challahs, to--to balance my low-carb week. And--

Gary Taubes: That kind of loaves[?]

Russ Roberts: And that kind of ruins everything, as you might expect. And what I find is, if I say to myself, 'Well, I'll just taste the bread. I don't need to eat 4 slices or 6'; 'I'll just have one cookie, not 6,' on a Saturday afternoon. I find that very difficult to do. So, coming back to the calorie-in/calorie-out thing, I certainly accept the idea that what I eat matters as much as the calories. But what I find, is that when I eat what I know keeps my weight down, my body wants those other things, and enjoys them so much. So, if I wanted to get the 35-45 pounds less that I'd like to weigh, or certainly the 10 or 15 that would be pleasant, I know what I have to do. But I find it very difficult to do. And I think that's the challenge most of us face. And I'm going to finish--one more thing--this is my wife's question, which I promised her I'd ask, because every time I push your ideas on her, she says, 'Come on: it's just calories in, calories out. That's a fact.' And I say, 'Yeah, because my friend, who is a huge exercise guy, and who liked the China study, and so now he eats, he's a vegetarian; he eats a ton of carbs; and he's thin as a rail.' And she says, 'Yeah, that's because he doesn't eat very much.' It's not because he's not eating. You know, it's not because he eats carbs--he's not gaining weight. It's because he doesn't eat very many carbs. What are your thoughts on that potpourri of personal life experience?

Gary Taubes: Okay. So, there's a lot of issues buried in there.

Russ Roberts: Help me, Doctor. Help me.

Gary Taubes: Yeah. The contents of craving. One is--

Russ Roberts: Gary, I've got to tell you one more thing. I know there are listeners out there who heard your previous episode, and took it to heart. And they write me; and they've lost 40 pounds; and I think they have kept it off. So, those of you out there, you can write in again and comment on this episode and give Gary some comfort on this. Go ahead.

Gary Taubes: Okay. So, I have to--okay. Again, multiple issues. Let's start basically with dietary advice. So the argument I've been making is that this is, I had a Nature commentary to this effect--the headline was it's biology, not physics. Okay? So what we're worried about is biology. The question is--and often when I talk to researchers in my vain attempt to get them to either do science right or think like I do even though I'm wrong--I suggest that what they could do to their--it would be an interesting exercise for their students, and themselves, to create a theory of obesity being [?] from the fat cells' perspective. So, the problem in obesity is that fat cells are accumulating too much fat. Much of the excess 40 pounds are in fat cells. You could argue that the part that isn't--that is doing more damage. But what, we'll assume is we're worrying about the fat cell, excess fat storage. So, if I were a fat cell--I'm going to create a theory of obesity from here--the fat cell doesn't know how much we are eating or exercising. Okay? It's got no clue what your body's energy balance is. So, all it sees--it does see hormones. It sees--and it responds to those hormones. And that kind of stuff, we know was worked out in the 1960s, significantly in endocrinology textbooks. And, it sees, or it responds to, you know, blood sugar and fats in the blood and to lipoproteins like LDL (Low-Density Lipoprotein) and HDL (High-Density Lipoprotein). It's got some central nervous system enervation of the fat cell, so it's going to respond to some nerve signal to the brain. From what it sees, what would it take to accumulate excess fat? And the primary thing, what it would take, would be to have insulin over some baseline level. Because insulin is the hormone that is signaling that for it to take a fat that signals these enyzymes that regulate on the membrane and other enzymes to down-regulate inside the cell. So as long as there is, your insulin is elevated, your fat cell is working in a milieu in which it is working to take up fat. Whether or not you need those calories elsewhere in your body. Okay? So, from your position--so here's one of the kickers. When you look at the dietary tradition[?]--two factors. When you look at the dietary triggers of insulin, so we secrete insulin, more or less the carbohydrates in our diet, also some to the protein, because it's broken down into amino acids which are converted into glucose, and we secrete it to that: We don't secrete insulin to the fat content of the diet. Fat is--picked up from your gut by particles called Chylomicrons and taken off to your fat cells. And you don't need insulin to do that. So, insulin is not involved. So, the issue is, now, if you are going to have a dietary way to have insulin get as low as possible, you've got to replace the--get rid of the carbs. The protein should be, you know, enough. But you don't want to go crazy with protein. And then you replace the calories with fat. So, this is the idea that you can eat as much as you want. Although, even Atkins[?] didn't--you know, fully understand the science, but the idea is that you can eat as much as you want. But it should be more fat than protein. So, you are eating very fatty foods. You are living on butter. I mean, as we're talking--the reason I'm awake today--is because I'm very recently become addicted to bullet-proof coffee and I have no idea if it's killing me or not but it's got butter in it. And--you know, coconut butter. So, mentally, you have to accept that you can eat these high-fat foods, and they won't kill you. That's always been the challenge, because we decided in the 1960s, as we discussed, 5 or 7 years ago or whatever, whatever it was--

Russ Roberts: Previous episode--

Gary Taubes: Low fat diet is the way to go.


Gary Taubes: The second fact, is you actually look at insulin dynamics--and this was studied also in the 1970s, 1980s, and 1990s by a few research groups--there's a threshold. So, insulin levels come down in your bloodstream. And this is your--researchers would refer to the exquisite sensitivity of the fat cells to insulin. So, long after your lean tissue--at levels far below that which your lean tissue is resistant to insulin--your fat cells are still very sensitive to it. So what happens is if you eat a carb-rich meal and you start to eat the challah on Friday night, your blood sugar goes up, and you secrete a lot of insulin, started to tell your lean tissue basically to take up that blood sugar and oxidize it for fuel--it facilitates the, getting the glucose into the cell--eventually the lean tissue becomes resistant because it doesn't want more glucose. But you want the fat tissue to stay sensitive, so it could take care of the excess fuel that's floating around. As the insulin levels come down, the fat tissue continues to be sensitive to insulin. So, it continues to hold onto fat. And then there's a threshold. And below that threshold, basically, your fat tissue starts dumping. The, um, your fat that has accumulated into the bloodstream; and your cells will oxidize it for fuel, and you'll have this rush of energy; you'll convert some of it, maybe even to ketones; and you'll have this rush of energy, something that your body just burning this energy that it then had access to before. So, the problem is, you've got to get below the threshold. And if you are still accumulating fat, you are clearly above the threshold. I mean--the journalist without a Ph.D. or an M.D. giving you a simplistic concept of the science: This is how I understand it from 20 years or 15 years of research. So, in the case--many people can just cut back on carbs and cut back on sugar and they'll lose weight. Younger people can clearly do that. I was one of them, when I was 20. But, by the time I was 40 if I wanted to lose that weight, it required basically shifting over to something that's, you know, very much the Atkins Diet. So, you can't really cheat, because cheating is enough to keep you above the threshold.

Russ Roberts: Yeah. That's where I'm at--above the threshold. Which sounds good, by the way, but it's not.

Gary Taubes: Yeah. So, in this case you want to be under it, because when you're under it--it's funny: I was looking at the--so, again, what sparked this research is understanding of the hormonal regulation, the fat accumulation--was this discovery, this invention by Yalow and Berson of the radium assay. And by 1965 they had made--you get a brand new technology; you get a rush of discoveries. Including--so, they realized that Type II diabetics didn't suffer from insulin deficiency: this was an insulin resistance problem. They actually had too much insulin floating around. And they realized that obese people also had too much insulin, had excess insulin in their circulation. And by 1965, Yalow and Berson are saying that the release of fatty acids from fat cells--the quote was, 'requires only the negative stimulus of insulin deficiency.' Okay? So, if you want to get fat--so, I had an argument recently, an email discussion where I got nowhere with. One of the major figures in the obesity research community for the past 50 years, [?]. He had written an article, co-authored with a woman whose husband runs my son's baseball/soccer team, in Oakland. Anyway, in his article he had said, 'Negative energy balance is the sine qua non of any successful weight-loss diet.' Negative energy balance being more energy out than in. And, I was thinking, you know, the endocrinological view would have been, 50 years ago, and should have been, that insulin deficiency is the sine qua non of a successful weight-loss diet. That's what Yalow and Bersin would have said: If you want to get fat out of your fat cells--which is what a weight loss diet should do--the way to do it is to get insulin as low as possible. And if you do, then you'll expend more energy than you take in, because you'll lose weight. And--so, you're not doing it. That's the answer. If you were to do it in a concerted manner that gets to the craving issue. Even back in the 1930s, a great, famous biologist at Hopkins named Curt Richter had demonstrated that animals sort of, when they have low fat diets, they crave carbohydrates. And if you jack up the fat, they'll lose the carbohydrate craving. So, I would argue that if you got under the threshold--and now, this is the step that stops the entire medical community dead in its track; and you jack up the fat you are eating and you become somebody like me who thinks or at least dearly hopes that butter and bacon are health foods, you will lose the craving for the carbs. And you won't want to eat--it will be much, much easier to avoid the challah on Friday night. And--

Russ Roberts: So, I just need--

Gary Taubes: the cookie on occasion--

Russ Roberts: So you are saying since the bacon doesn't work for me, I just need to go with more of the fatty pastrami--is what you are saying, with the challah.

Gary Taubes: Yeah, yeah. Fatty pastrami. It's funny, because I have this, the Center for Science in the Public Interest, in Washington, has been a sort of prime mover for the past 40 years. Sort of that fat is a killer, salt is a killer. So I've sort of been--much of the past, my professional career, writing about nutrition. Arguing that these people have done more [?] in their advocacy for the American public. They've done far more damage than they've prevented. But they are also anti-sugar.

Russ Roberts: hmmm-mmm

Gary Taubes: So, I recently had lunch, about a year ago, with the very charming, charismatic, intelligent head of the Center for Science Public Interest, this man, Mike Jacobson. We actually had a very wonderful lunch together in Oakland. And when we left, he was saying, asking me why I wasn't supporting his organization more, because, you know, we are both anti-sugar, and why I wasn't supporting sugar regulation more. And I said, 'Because after you are done taking away sugar, you will then go after my pastrami.'

Russ Roberts: Yeah.

Gary Taubes: And I happen to believe pastrami is a health food. So, you know.


Russ Roberts: So, that's my next question, actually, because when you said you have a lonely life because there are a few researchers who are sympathetic to you, although you did concede one of them was the head of the Harvard School of Public Health, which is--

Gary Taubes: No, he's not the head. He's--

Russ Roberts: A Harvard researcher. Which is usually--that's a good thing to have. The other people you have on your side--and this makes me a little bit uncomfortable; I'm sure it makes some listeners uncomfortable, so I want to get your response. The other people you have on your side are the Puritans--the people that H. L. Mencken said--he defined Puritanism as "The haunting fear that someone, somewhere, may be happy." And so, when some people hear, 'We need to get rid of sugar,' they hear, 'Oh, this is just the latest nanny state cause. It was tobacco; and then it was fat. And now it's sugar. And they just want to take all the fun out of life. And they are busybodies.' Some of them are well-intentioned; maybe all of them. But they are also tangled up with this desire to run other people's lives. Which is something that scares some of us. And I want you to reflect on that. As you've sort of hinted at, in that anecdote.

Gary Taubes: Well, and again--when I first got into this, I was fascinated. I think all my books are about, on some level, good science and bad science. That's my obsession: How hard it is to do science? How easy it is to screw up, to discover non-existent phenomena, to embrace incorrect theories. That's the passion that drives me; it's still the book I would like to write. But should I ever do it, it will not sell nearly as well as books about diets do.

Russ Roberts: Yeah. I want to write that book, too, Gary; and my agent says the same thing, 'What else are you thinking about?'

Gary Taubes: Well, that's a--yeah. Literally, we're trying to tie it onto book deals. Like, just give me a little money so I can justify the time I'm going to put into that one. Otherwise--anyway--I lost track. So, when I first got into this, it was because friends of mine in the physics community said, 'Look, you should look at the science in Public Health. It's terrible.' And indeed it was. So, everything I had learnt from the physicists in the 1980s when I was writing these books about bad science in high energy physics and the cold-fusion fiasco--so, I learned that you've got to be rigorous and methodical and critical and skeptical; and skeptical and the first principle of science, as Richard Feynman said, is you must not fool yourself, and you are the easiest person to fool; and if you cut a single corner, sweep a single uncomfortable fact under the rug, you are going to end up fooling yourself. And then I get into Public Health, and it's just so hard to do it. It's expensive, and you've got these messy experimental subjects called 'humans' and you've got these diseases that take 20, 30 years to manifest. So, the assumption was, we're just going to--all the things that the physicists had told me were required, we're going to treat as luxuries that we don't have. And we're going to assume that we could establish reliable knowledge without it. Whereas, my physicist friends said, 'You can't.' My physics experience said, 'You can't.' So, this was what I was confronted with, and when I got into nutrition, I thought, 'Okay, my long investigation was on salt and blood pressure; and my second was on this dietary fat dogma that a low-fat diet's a healthy diet. About two years of my life with the Journal of Science on those two articles. And I thought, 'I'm just going to knock down the food police.' And I came out of it thinking, 'I didn't eat an avocado or peanut butter in 15 years because of these people.' And I was mad. And, you know, I wanted to write a book on this; but I knew I couldn't get enough of an advance to prevent me from being in debt when I was done. And there was no self-help [?]--I just wanted to, you know, dig deeper, because it was fascinating. Then I did this infamous New York Times Magazine cover story in 2002: "What If It's All Been a Big Fat Lie?" And in the process of doing that, I began to realize that there was an alternative hypothesis. So remember, we still have to explain these explosions in obesity and diabetes. These are--we are back to this question--I said, 'We've come back to this.' They are pandemic. The numbers are unimaginable. In diabetes, from the mid-1950s there's like a 750% increase in prevalence. Okay? If you go back to, like, the 1890s, as I do in the book, or the 1860s, and you trust the numbers, it's probably been closer to, like, 2000% increase in prevalence. I mean, this is shocking. And these are diseases that are going to overwhelm healthcare systems worldwide, because they increase--you know. So: Why are, why don't we care? And in October, Margaret Chan, Director General of the World Health Organization (WHO), goes to Washington; there's an annual meeting of the National Academies of Science, which is dedicated to, I think what is called 'reversing the dramatic 30-year increases in obesity and diabetes.' And Chan says, she talks about this 400% increase from 1980 in diabetes worldwide. And prevalence. So that's not absolute numbers. Now, in her case that was--I think it was both--absolute numbers and prevalence. And then she calls these epidemics a slow-motion disaster. And she admits that the Public Health community has completely failed to control them. So, they've had 20 years now in which they've known of the existence of the obesity and diabetes epidemic; and they have made no inroads whatsoever in curbing them. And then she states that the chances of preventing bad--quote, "keeping a bad situation from getting much worse," unquote--is virtually zero. So, we have a situation in which the Director-General of the WHO is not only acknowledging that they've completely failed to curb these tragic ends--'slow-motion disasters'--but predicting future failure. And so, yeah, maybe I'm playing the grand troll and this is the food police. But, we have to understand what's causing this. And we are never going to control it without--I mean, again, maybe some day somebody will come up with a drug that works and the pharmaceutical industries can make trillions of dollars and we won't have to. But I'm pessimistic that any such drug is coming shortly. And that when it comes, it won't have unfortunate and unforeseen side effects. So, we have got to understand--that's what I'm trying to do, and I'm fortunate that, you know, the targets happen to be something we all love so much. But if we didn't love so much, we never would have let it saturate our diets and our lives. We never would have consumed it so much. And this wouldn't have happened. So it's a--you know, we're stuck.


Russ Roberts: Yeah. Well, you know, your honesty about the data--and we'll close on this--reminds me of when I passionately suggest we should try an alternative to the Public School system. I think we should try to allow more competition. Some people seem to think that means some business-based school system or for-profit as opposed to a government system. And of course, all I really want is a non-governmental system. There are many ways to have a non-governmental system. It could be for-profit. It could be non-profit. It could be run by donations. It could be all kinds of different things that could happen if we didn't have the government trying to monopolize through its 0-price system the public school system, which distorts our choices of where we live, the price of housing. And I see it as a really bad thing. And when I say that, people say things like, 'Well, what's the evidence that your system would be better?' And I say, 'Well, that's really hard to accumulate. There hasn't been, I don't think, in the last 200, 300 years, a wealthy-ish country that tried to have a private school system. We've had the occasional experiment. The results are ambiguous. And all I see is that we've now had 3 generations of inner city kids who don't get an education.' That's what I see. And your answer is, 'Well, we just need to do better.' And that's not acceptable to me. I find that totally unacceptable. And their answer is, 'But where's the evidence that yours will be better than that?' And the answer is, 'Well, I have some intuitions about it. They are imperfect. We can't measure the impact of private schooling very effectively because it's totally tangled up with who goes, and their parents, and all that. It's a big, messy, empirical problem. But I think we have to try something different, don't you think?' And so, I sympathize deeply, even though I love sugar. And I find that, while reading your book, it tempered some of the pleasure, unfortunately, that I get from sugar. But I do think it's an hypothesis that must be taken seriously. It's not an hypothesis to embrace, as perhaps quixotically as you have. And you are aware of--

Gary Taubes: Fundamentally, I'm arguing that what I need, what we need, is to take it seriously. So, the reason for writing this book began with--to lay out the case, as much as to prosecute it, so people could see what the stakes are and see what we should be taking seriously. I wanted to--what you've been telling reminded me--I'm going to fall back on one of everyone's favorite physicists, who thought most deeply about these issues, Richard Feynman, when he wasn't clowning around--he's the person to read on how to think critically about things in his field. And he said: science is about, often people say, like, he'd say, I'd be sitting on an airplane and somebody said, you know, 'What about flying saucers?' And he'd say, 'No, they're not real.' And they'd say, 'Well, how do you know they're not real? Can you prove they are not real?' And he'd say, 'Well, science isn't about proving what's true and what's false. Mathematics is. Science is about what's saying what's more or less likely.' So, what we're trying to do, you and I in different ways, we are trying to establish what facts are highly likely to be true, that we have to be--you know, if the public school system, if the education of our students is unacceptable on a population-wide level, then we can assume that the schools fail on a population-wide level, and we have to fix that. And we have to do everything we can to fix that. And here's a hypothesis that I believe is likely--well, I don't even know if it's likely to fix it because I can't define it well enough, but a likely good way to approach it. But unless we accept the failure and are willing to reject what's happened up until now, we're never going to make progress. And what I'm saying is a little bit--I'm saying the most likely hypothesis--clearly this energy-balance thinking is just fatally flawed and we have to get rid of it. And the null hypothesis, the most likely hypothesis we have left is sugar and refined grains. Not only do we have to take it seriously, and we have to study it, but do we have to realize that that's the hypothesis that we have to reject. Not that we have this port[?] with our studies, but we have to refute with our studies.

Russ Roberts: If that turns out to be the case.

Gary Taubes: No, if people--could come to the trouble of doing the studies right, yeah. But mostly again, science, all we can say is what's more or less likely; and then it's always going to be a judgment call based on who is doing the assessment. So, our job is to get them to understand that our assessment is valuable, and is thoughtful and balanced and valuable enough that it's got to be taken seriously. I'm going to step even from that--I got a wonderful review of my book from Dan Engber in the Atlantic--really thoughtful, and its criticisms were thoughtful. But there's one thing he said where, you know, he was asking this question whether I'm a zealot or scientist--even though I'm a journalist. And I was thinking about it, because actually both journalists and scientist should zealously pursue the truth. Right? Reliable knowledge, however you want to all it. That should be our job. See, it's one of my problems with the scientific community at large in these areas, is that they don't zealously pursue the truth. I don't know what they zealously pursue. Furthering their careers, maybe. But it certainly isn't reliable knowledge. And so you are allowed to be both. And in fact, in certain ways, you should be both. Just depends what the zealotry is: Is it for a cause or is it for pursuit of, you know, reliable knowledge about something that is--so critically important--in your case, the education of our children--or the health of our children?

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COMMENTS (37 to date)
jw writes:

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markOS writes:

Taubes is always value for money, even if you don't agree with him.

I would like to raise a couple of points.

firstly I believe that GT once again leaves himself open to the main thrust of his critics, which is cherry picking. Why should we be dismissive of old calorific science yet accept ancient endocrinology research?

Having read his previous works I have no doubt that he can justify such selections but it would be nice to hear them clarified. We can usually rely on Russ to hold his interviewees to account, especially the ones he seems to agrees with.

Secondly the book on Bad Science has been written by Ben Goldacre, It is called 'Bad Science" and is about the way that the Pharmacological industry functions. Goldacre is no Quack, he is an MD, lecturer in UK hospitals and an advisor to the UK government. I would love to hear Russ interview him.

As ever Econtalk provides food for thought. Always a good way to start the week.


John Saunders writes:

Came across this review of Taubes' book recently:

Thanks for the great podcasts!

Ron Toms writes:

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Jeremy writes:

What about the animal fat explanation? Diabetes and heart disease has been successfully treated on low fat, whole foods vegan diet. What about the China study?

You can cut the sugary soda and still get diabetes and heart disease from lots of fatty animal meat and fries. I can eat as much no oil, low fat, rice, beans, fruit, and green veggies and never get diabetes and probably reverse existing heart disease.

Obviously, you should avoid added sugars AND fat/oils. Is the former sufficient to make measurable change? Where are the specific studies? What about intramyocelluar lipids?

Mike Brady writes:

In a previous comment someone asked about Stephen Guyenet's disagreements with Gary Taub's ideas.

There were some recent back-and-forth posts by Guyenet and Taubes on Cato Unbound:

Conrad Barski writes:

Just want to put in a personal testimonial: I personally started following a diet along the lines of Taub's ideas about a year and a half ago and have lost ~40 lbs and kept it off so far. I eat primarily meats and green vegetables, as much as I want. I don't go hungry and I have a higher energy level than I did previously. It does not require much mental effort to maintain this diet after the first week. I did not change my exercise habits.

Julian writes:

Taubes is in love with the idea he is uncovering some big secret conspiracy, but that seems to have clouded his critical thinking skills.

People in the country are fat because they eat too much. Do they eat too much sugar? YES, but they are also eating too much everything else. He has very little research to dispute this claim, mostly just conspiracy theories between researchers and the sugar industry (as if the beef industry, the egg industry, the potato industry, etc. arent also funding research).

@Conrad, I am glad you have had success on your diet. Are you eating the same amount of calories under this diet as you did previously? Did you track this? Did you make any other changes in lifestyle during this time?

Like Conrad I have experienced large swings in my weight over the course of my life. I have intentionally moved my weight up and down by over 30 pounds 4 times in my life. The only thing I changed each time was the amount of food I ate. Surely my anecdote is as "powerful" as Conrad's.

Like others, I am disappointed in Russ' interview(s) of Taubes. Very little push back. Would love to see Russ interview someone like Guyenet who is on the other side of this.

Rob Wiblin writes:

Here is a rundown of a few articles critical of Taubes' theory and his response:

I also found this review of the carbs-obesity hypothesis interesting (though it's about carbs as a whole rather than refined sugar):

Michael Byrnes writes:

Julian wrote:

People in the country are fat because they eat too much.

People in the country are poor because they spend too much and earn too little.

Trivially true, but not helpful in addressing the problem.

Ryan writes:

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Todd Kreider writes:

1) At the end, Gary Taubes said "We have to explain these explosions in obesity and diabetes." Curiously, both diabetes and obesity rates in the U.S have essentially flattened together from 2009 to 2015 while sugar consumption has declined from 2000.

2) He then says "These are diseases that are going to overwhelm health systems worldwide..." and that Margret Chan from the WHO says that these epidemics are "a slow motion disaster" and that the "chance of keeping a bad situation from getting much worse is virtually zero."

3) Taubes says maybe someday there will be a pill that works where the pharmaceutical industry will make trillions of dollars...," adding "But I'm pessimistic that any such drug is coming shortly and when it comes, it won't have unfortunate and unforeseeable side effects." ... "so we're stuck."

4) I don't think Mr. Taubes has been reading enough on potential "anti-diabetes" pills that have been in development for years. One company, Elysium, co-founded by a biologist at M.I.T. with 7 Nobel laureate biologists have been selling a derivative of vitamin B3 found known as nicotinamide riboside (NR) in trace amounts in milk and bananas, along with pterostilbine that is found in blueberries as a supplement so does not need FDA approval as a natural supplement.

5) NR has been found to be safe at high doses and with no significant side effects in humans while also able to lower glucose levels in mice. Elysium conducted a double blind human study that lasted two months where glucose levels, cholesterol levels, blood pressure, heart rate, NAD+ levels that NR significantly boosts in humans (2015 study) and a six mile walk test.

Elysium says that it has submitted the results to a peer reviewed science journal, and we may learn how effective NR is at 250mg and 500mg with respect to the above tests within a few weeks or months.

6) Ultimately, a drug will likely end diabetes, and that day is not too far off - perhaps a few more years, but not a full decade away.

From an economic standpoint, NR, which can be bought from several vendors, not just Elysium, is potentially a fascinating supplement as it could replace many drugs already sold on the market.

Juan Carlos de Cardenas writes:

GT is way too dismissive of the caloric imbalance theory. It is true that not all foods are the same in terms of nutritional value and the way they interact with your body's endocrine system just like it is true that your genes (and genes expression that might be conditioned by the environment) have a big influence in how many calories your burn and storage but at the end there has to be a caloric deficit for you to lose weight.
If you are trying to lose weight or prevent gaining weight the nutritional value of the food you eat is paramount because you will have to limit your food intake, therefore empty calories of the kind that refined, added sugar provides are bad regardless of the (very plausible) effect it has on insulin levels and resistance but even if you eradicate sugar if you still eat too much you will gain and not lose weight.
I am roughly Russ age (61) and also had struggled with my weight as I went into my 40 and at one point in my early 50s my weight went up to 185 lbs so at 5'6" I was well overweight. I get back to the gym and cut back mainly on carbs and managed to go down to about 165 lbs before plateauing but it was only when I started measuring both the actual calories I burn (with a fitness band) and that I eat (with a food diary) that I actually got to 150 lbs with a 10% body fat going down to that over about 15 months.
The food diary in particular was an eye opener. As for my diet I eat everything, about half of my calories from carbs and the rest mostly split between fat and protein although I am more heavy on protein the days I workout. I also started running in addition to resistance training to increase the calories burned. So yes, caloric balance is ultimately what matters although the more you limit your calories the more important is the quality of what you eat.
Julian is right, Americans eat too much of everything and move too little and this situation is especially worrisome for the children that spend more time glued to screens that doing any physical activity.

Mads Lindstrøm writes:

Russ, I think there is a way to have your cookie and eat it too.

Your tastebuds don't really care about quantity, so you will get as much pleasure from a small piece of cookie as a large one. Therefore, eat your cookie in very small pieces and one cookie will last as long as five, with the same pleasure and 1/5 the calories. So bring out your scalpel...

A.G.McDowell writes:

Let's suppose Taubes is dead wrong. The human metabolism can deal effortlessly with sudden high-calorie inputs of fructose from quickly absorbed sucrose or HFCS. A calorie is a calorie and restricting energy input will, by the law of conservation of energy and the example of everybody who ever died of starvation, inevitably lead to weight loss.

What changes? virtually nothing in practice. HFCS and Sucrose are still highly concentrated energy sources, and foods high in them also tend to be high in fats as well. Most of the western population are carrying too much fat, and the way to reduce it - is to reduce calorie input, unless you have the time (very roughly 300 calories per hour - and physical fitness to expend significant calories by exercise, which most do not.

Avoiding ALL foods with added sucrose or HFCS or sugar under its many aliases will sharply reduce your calorie input, to the point where most people will need to seek out an alternate calorie source to avoid losing weight too fast. You can check this by experience, or by totaling up the calories in your own diet. Foods that are not such a concentrated source of calories are generally more filling and less addictive, so you will find it much easier not to eat excess calories. Avoiding all foods of a given class at all times and under all circumstances will form habits which will make it easier to maintain a healthy diet.

As Taubes points out, it is excruciatingly difficult to distinguish between problems caused by fructose and problems caused by general excess calories. This is largely because it is very difficult to reduce fructose consumption without also reducing calorie input, even when maintaining calorie input is an explicit goal - see Lustig's study at "Despite intensive efforts to maintain each participant's body weight at baseline levels, weight decreased by 0.9±0.2 kg (1%, p=0.001) over the 10 days of intervention. Of the 43 participants, consumption of the study diet ranged from 75% to 115% of calories assigned; 33 reported that they were unable to consume all of the food provided for weight maintenance.".

So I await the results of fructose studies with great interest, but I suggest that anybody not currently maintaining their ideal weight think hard about avoiding foods with added sugar - whether they believe Taubes or not.

Trent writes:

An interesting podcast as always.

Had to chuckle at about 1/3 of the way through the podcast, Mr. Taubes comments on climate change. I'd commented a while back that it seemed every EconTalk guest managed to work in comments on global warming/climate change (side note - before this podcast, Econtalk was on a nice run of no comments on this issue).

I was going to suggest a derivative of the old "The Bob Newhart Show" game in which viewers drank a shot every time one of the characters said "Hi, Bob." This was apparently quite the rage in the 1970s. So I was thinking of suggesting something like eating a cookie whenever the guest mentioned global warming/climate change. However, after listening to the content of this podcast, I suppose I shouldn't suggest doing this with anything sugary....

Mark writes:

Hi Russ,

You asked listeners who took up the zero carb high fat diet to "weigh in" on the discussion, so to speak. (A note to fellow commentators, I know the following is personal anecdote, please don't reply back pointing that out. Russ asked for it).

I heard you interview Gary about 5 or 6 years ago and, after a bit of reading on my own, I took up the zero carb high fat diet. I lost 5 notches on my belt over the first few months and have stayed that way ever since. I'm 57 now, weigh about 15 lbs more than I did in my early 20's and still fit in my wedding suit, though it's a bit loose. I make sure I eat lots of saturated animal fats and avoid any carbohydrate except milk and alcohol. I'm never hungry, and have ridiculous 'stamina'. I'm capable of working hard for a whole day on a cup of coffee with butter and coconut oil and not needing dinner. During the last 5 years I have had three comprehensive blood workups done particularly checking lipids, blood glucose, insulin and my liver and kidney functions. All results have been excellent. BMI is low, blood pressure is 65/110, you can see my stomach muscles and I'm staying off carbs until I see evidence that this particular diet is not working for me.

For downsides, I can attest to a horrible first 6 weeks where I felt like I had a constant hangover, I get leg muscle cramps if I don't keep my various salt intakes up and I get mild constipation occasionally. I'm also sick of explaining to people at parties why I don't want the canapes, bread, rice, mashed potato or desserts and why I eat so much fat and no fruit.

Greg writes:

Hi Russ,

I too will comply with your request and chime in with a personal anecdote.

As background, I'm a 35 year old male, 5'10 and 170lbs, ~10% bodyfat. In my early 20's, I was fat (not sure on bodyfat %, but weighed 205).

I began experimenting with Paleo/Primal and low-carb diets beginning in 2007 and quickly dropped to my current weight/bf%. The two commonalities to all variations of the diets I've tried is low-carb and the removal of refined sugars (with rare exceptions).

Whatever the reason, I can effortlessly maintain this weight/bf%, even if I eat some carbs from legumes and root vegetables. I can also have a few beers or glasses wine throughout the week without gaining weight.

Recently, I've been trying to tone down protein consumption and experiment with multi-day fasts for health reasons not pertaining to weight.

Daniel Barkalow writes:

I'm 6'2", 135 lbs, and I eat pretty much the diet that Taubes would suggest for someone trying to avoid losing any weight (i.e., the opposite of what he suggests under the assumption that people should lose weight).

My experience is that fat suppresses my appetite. I have to avoid having too much fat if I'm going to eat enough sugar. I've occasionally lost a few pounds when my snacks were too fatty. When I eat a burger, I have to drink a sugary soda, to compensate for the fact that I have a hard time eating enough cookies afterwards.

I'd be interested to hear if Russ's challah consumption could be reduced by requiring that it be eaten with a thick layer of butter. I bet he'd take in fewer calories that way, despite not intentionally depriving himself of a second piece or making the first piece repulsive.

Jim Glass writes:

I'm an anecdotal case of having lost 75 pounds and kept it off for five years so far with no problem, my weight now takes care of itself. (My doctor says I've regenerated into a new person, 'like Doctor Who', and 'turned every risk factor into an anti-risk factor').

My beliefs based on personal experience and study of the subject are strongly contra-Taubes and much more in line with the Guyenet criticisms. E.g., while losing weight I ate Oreos and chocolate ice cream every day, as part of a pretty-high-carbs diet. But it's not just me, the great majority of successful weight losers at the National Weight Control Registry (average loss 66 pounds for 5+ years) follow high-carb diets too -- for a reason that is pretty simple if one thinks about it. I wrote about this in a too long comment under the EconLog post. FWIW.

My fundamental issue with Taubes and all other "diet mavens" of all stripes is that reams of research now coming in say weight control is behavioral, brain science, a function of cognitive processes and self-operant conditioning. Aerobic exercise is critical to successful weight loss...

Registry participants ... engage in about 60 minutes per day of moderate intensity physical activity, or the equivalent. Wiki

... not because it burns calories (it doesn't burn anywhere near enough to matter) but because it literally, not figuratively, re-wires the brain and makes the brain grow larger -- which makes it far easier to 'wire in' positive new habits and bypass old bad ones, creates "positive addictions" to healthy behavior ("runner's high", sound sleep), suppresses excess appetite, and sets a new body-weight equilibrium that maintains itself.

But Taubes is oblivious-to-outright hostile to all growing evidence on this, see interview here, and quoting Guyenet...

Taubes argued at length that food reward has nothing to do with obesity, and (remarkably) that the brain itself is unimportant.

... which I find very disheartening. But then, anyone who is committed to the idea that any kind of diet is *by itself* key to weight control must say this.

All my personal experience and observation tells me that anyone who tries any kind of "deprivation" diet -- trying to forever give up sugar, carbs, fat, anything the person enjoys -- faces a 95% chance of failure (pretty much confirmed by data) because few can endure deprivation forever, and there are a host of cognitive triggers of failure.

Much more likely to succeed is a plan of investing efforts into modifying behaviors into constructive new healthy habits one enjoys, to reap good feelings from them forever (creating "positive addictions"), and then in time let the details of diet fall into place on their own. Worked for me, and still is.

jw writes:

Taubes almost single handedly reversed public opinion about fat and salt and is now rightly after sugar. Notes:

- I first heard of Taubes from Econtalk and will be forever grateful to Russ for having him on. I have read all of Taubes’ books and thousands of other pages on LCHF. Besides Taubes, the best popular explanation of the history and politics of the science is Teicholz’s “Big Fat Surprise”.

- Yes, politics. As many have documented, the obesity epidemic may be set squarely on the shoulders of government, particularly the McGovern committee on nutrition in 1977. Despite many doctors testifying against its conclusions, it launched the modern anti-fat crusade. As mentioned in this podcast, people still find it hard to accept that they may need to eat far more fat.

- Again politics, the sugar industry is a perfect example of government rentier lobbying. We all pay a few un-noticable cents per pound more for sugar, but due to sugar tariffs, US sugar producers reap hundreds of millions of additional profit.

- Nutritional research is, as Taubes said, extremely poor. I have read many original papers and wondered how they ever saw the light of day, let alone in major medial publications. The reporting on nutritional research is even poorer.

- For everyone claiming that you “just have to change behavior”, please watch the brilliant Dr. Peter Attia’s Ted Talk here (16 mins).

- Also pay attention to Attia becoming insulin resistance DESPITE hours a day of exercise and being a world class endurance swimmer. And note that his physique at that time and currently is based on a majority of his calories coming from fat. Many top ultramarathoners have also switched to LCHF.

- Taubes touched on the challenges of doing research at NUSI. Following NUSI for a while, I am sure that there is a very interesting book on the politics of research and the challenges of recruiting open minded counter-theory researchers.

- Like the “Dreamland” Econtalk, once you have established that there is an addiction crisis, how do you cure the people addicted? Like opioids, some are never addicted, some become addicted and can stop, some can never stop.

- With respect to the various pro and anti LCHF/no sugar diet anecdotes, diet is highly personal, based on your genes, exercise, age, starting weight, gut biome, etc. But there are trends in large populations and LCHF may help a lot of people.

- With respect to vegetarians, it is possible to eat LCHF (low carb/high fat) as a vegetarian, but it is more difficult. It is extremely difficult for vegans. Vegetarians live no longer than the general populace and there are many counterfactuals to the evidence presented by vegetarians as to the health benefits, but it does not seem to do harm either (as long as they keep taking their B12). It doesn’t work for everyone just as LCHF doesn’t work for everyone. Confirming Taubes, most vegetarians eat much less sugar than the average American.

- Jeremy, for a complete dissection of the China Study, see Minger here (not for the statistically faint of heart, but valid). Also see Westman vs Campbell here (80 mins). Westman has gotten thousands of Type 2 diabetics completely off of insulin by simply switching them to LCHF. Also, Ornish’s heart disease reversal claim is based on a small study of n=22, included other confounding lifestyle factors besides diet and has never been duplicated.

jac writes:

From reading and listening to Taubes there a few things that have really changed the way I think about diet and exercise.

In my mind I use an analogy very similar to the Bill Gates one. It seems to me that telling an overweight person that they need to eat fewer calories and burn more calories is like giving advice to a failing business that it needs to increase revenue and decrease expenses. Both points are certainly true. The problem is that in both cases the variables are not independent.

In business it is fairly easy cut costs, but if you cut the wrong costs the quality of your product will suffer and soon revenue will go down. Also most of the things you can do to raise revenue are going to have associated costs.

With diet it is pretty easy to reduce the amount of calories you eat, but your body will respond by slowing your metabolism. If you cut a lot of calories you will probably feel lethargic and hungry. Similarly exercising more will likely lead to increased hunger. You can increase calorie burn and decrease calorie consumption but the longer your try the harder it is to do.

The other way that Taubes changed my thinking is in how I view the role of body fat. Prior to reading Taubes I thought of fat as a calorie dumping ground. I did not realize the role it plays in metabolism.

Now I look at body fat more like a battery. It takes up energy when we eat and and releases energy as it is needed through out the day and night. Some people have fat that is very efficient at releasing energy. They need less fat to function normally. Other people have fat that is inefficient at releasing energy. Their bodies need more fat to compensate.

Changing the caloric balance is indeed the key to weight loss. A strategy that involves incredible amounts of willpower is usually not a great strategy in the long run. I think Taubes offers some good insight into how one can achieve that goal.

Robert Swan writes:

Unconvincing. There was no step by step rationale, just pooh poohing the (trivially true) energy balance reasoning and replacing it with "sugar is the root of all evil" dogma. Gary Taubes comes across as evangelical and utterly wedded to his idea.

Throughout, I was thinking "But it's more complicated than that". He invoked Ockham's Razor and it dawned on me that people invoking it are often making a preemptive strike to defend an oversimplification. I've added a new rule to my personal sophistry detector.

Of course the low fat zealots are equally oversimplifying, as are all the other single-cause boosters. Replacing one simplistic solution with another is absurd.

It can't just be sugar because I have for many years eaten whatever I felt like whenever I felt like it. This has included plenty of sugar. For 30 years my weight sat rock steady on 62 kg, though over the last half-dozen or so I confess it has drifted up to 65.

Have found the comments interesting. Lots of push back and personal testimonials. I usually heartily agree with jw, but not so much this time. Did find his linked TED talk worth watching, though Dr Attia was hamming it up a bit much at the end with the faux tears.

In the end I think commenter Jim Glass has the best handle on the cause: That blob of goo between our ears. It is intimately bound up with the endocrine system that Taubes has at the heart of his causal pathway. It is also the centre of control of voluntary actions like, you know, eating.

Taubes does point out that psychologists made no progress in 20 years of behavioural studies. Well of course they did, they're psychologists. OK, sorry, flip comment.

I don't claim to have an answer for everyone. For my own part, my enjoyment in life is tied up in other things; I like food, but eating has generally been time away from greater pleasures. The best way to avoid boredom eating isn't to only keep unappetising food in the fridge, or to wire your jaws shut, it's to not get bored in the first place.

And with that little pleasure out of the way, time for breakfast.

jw writes:

Robert Swan,

This was a 60 minute podcast and couldn't possibly cover everything in Taubes' book.

For more in depth science on LCHF, see Taubes' "Good Calories, Bad Calories" or Volek and Phinney's "The Art and Science of Low Carbohydrate Living". There are also a lot of formal studies and papers as well.

As above, if whatever you are doing works for you, that's great. There is a lot of variety in what works, but there are also a lot of people that have been helped by LCHF (which includes low/no sugar).

I have never met Dr. Attia, but over the years I have watched hours of videos and listened to hours of podcasts as well as read everything on his site. FWIW, I have never perceived him to be capable of insincerity.

Jeremy writes:

jw: Thank you for the links and information. I look forward to reviewing.

It would be nice to have an Econtalk on vegan/ plant-based diet science and trends. A lot of money is going into plant-based startups across the world (food alternatives, grocery and restaurant, etc)

Eric Schmidt from Google/Alphabet named plant-based meats one of the top tech trends.

On the size of the study, replication, and lifestyle changes, I’d recommend Dean Ornish’s response below.

He references the below study which had almost 3K participants.

The effectiveness and efficacy of an intensive cardiac rehabilitation program in 24 sites.

On lifestyle factors, he mentions the original study had 1 person smoking at baseline and no studies (so far) showing walking and stress management alone can reverse heart disease.

Robert Swan writes:


I wouldn't expect the talk to cover everything in the book, but I was left with only the vaguest sketch of this supposed case for the prosecution.

I ought to have said that I have no doubt that the LCHF diet is a good way to lose weight. My father, a doctor, told me he had good success in the 1950s recommending what he called a "ketosis" diet. He maintained his preference for it despite the vogue of umpteen high complex carbohydrate diets in later decades.

For most people though, weight loss diets shouldn't be necessary. If you are the right weight and healthy, sugar is not a problem. Nor starch. Nor fat. Nor protein. Healthy people who keep a focus on a high fat (or high carb, paleo, etc.) diet seem to me to have a screw loose. Much better to get on with living and stop obsessing about eating.

On Dr Attia's TED Talk, I didn't mean he was insincere (i.e. that he didn't believe what he was saying -- FWIW, I believed what he was saying), but I watched that last couple of minutes again and his quavering voice and weepiness still comes across to me as him hamming it up. I suppose, having asserted that I'm not overweight, maybe I need to face the possibility I'm a tad heavy on the cynicism. Not sure how to trim it down -- could be that it's merely a symptom of something else.

Kevin writes:

I really appreciate GT because I found his research in the midst of graduate studies at one of the major homes of the lipid hypothesis of heart disease, which helped me question some of the work being done.

Ultimately I do not agree that sugar alone, even processed sugars, account for the problems we see. People who exercise regularly and maintain a normal weight seem entirely unaffected by their diet composition. They do not develop the metabolic syndrome. If you chew complicated carbohydrates a little longer they are almost metabolically processed sugars by the time they hit your stomach.

I think people who do not exercise and start to gain weight exhibit many pathologies that are exacerbated by sugars but sugars alone in moderation will almost never bring them about.

As others have pointed out, we have increased process sugars and increased everything else as well as physical activity and labor have dramatically decreased.

I think sugars are trouble for simpler reasons than that we cannot deal with them metabolically (which I think we can in normal amounts). Sugars are not satiating. I can eat an incredible amount of ice cream or cookies before my body says enough is enough. I cannot eat that much fruit, vegetables, or meat. Part of that is signalling from my body and some is the actual texture and structure and how long it takes to eat the bites. Sugars are also cheap, convenient, and relatively calorie dense. They dissolve in water, protein and lipids do not.

The experiments that need to be done to separate the causes here are very challenging as GT acknowledges, but I will be interested in the results if ever done.

Kevin writes:

One additional comment regarding Jim Glass and others.

In the majority of diet studies long term success in losing weight is essentially non-existent. The 2-5% of people who lose weight and keep it off are almost 100% type-A personality who change their lives significantly. I lost 93 pounds and though wax and wane alot but have kept the majority off and fit the data, an extremely type A personality. I don't eat a specific diet other than minimize calories.

Losing weight will never happen for the majority of people because it is rare psychologically hard. Jim above keeps a daily calorie count and exercises and generally keeps to his self imposed restrictions. The majority of people cannot do that until they have an MI, get DM2, etc and then the numbers rise to 10-25%.

I think we are probably 10-20 years away from having drugs that will essentially wipe out obesity by resetting our metabolisms and weight set-points. Then alot of these discussions will be meaningless. Better living through chemistry.

Michael McEvoy writes:

Special thanks to Saunders and Brady above for the links they supplied . I found them quite helpful to look at the case against Taubes.
Thanks to others for weighing in(sic) . I am a primary care doc and I try to listen to various opinions - especially from a group who are sceptical by nature .
And finally thanks Russ for bringing back Taubes. I was not aware of the NuSi/Arnold Foundation/Econ Talk connection until it was brought out in the comments above.

Dr. Duru writes:

Here is my testimonial...

About 5 years ago, my previous general physician told me about metabolic syndrome. I was quite alarmed to learn that sugar was essentially "poisoning" me. I went cold turkey on eating sweets. Much to my amazement, I lost weight immediately and quickly. Within 2 months, I lost about 15 pounds and dropped below 200 for the first time in a long time (I think I got to 195). Note that for about 10 years prior, I had already put limits on the amount of carbs I eat by banning most carbs at dinnertime.

Within in another year, I was essentially back to my old sugar habits and regained the weight. Since then, I have tried twice to make the pounds melt away again by abstaining from "extra sugar" and have largely been unsuccessful. My metabolism definitely keeps shifting on me! I have to work harder and harder to just stay where I am..and this with exercising more than I have ever done over the last 10 years.

So, I believe sugar intake has a direct impact on *my* weight, but I am a little baffled by my apparent on-going metabolic changes.

Gary Mullennix writes:

After reading the comments, I can appreciate GTs sense of frustration. It would appear that for many, the belief is that sugar doesn't matter. Oreos and fudge are the mechanism by which we control our weight and do away with the diseases of the West. To many, observations like a 750% to 2,000% increase in diabetes must not even indicate a correlation to sugar's increased consumption as Taubes claims in his book. Maybe it's a virus??

Since I listened to the first Taubes' talk on Fat with Roberts as I was walking for exercise and had been poorly following a lower carb diet, I greatly improved my adherence and knowledge and my weight loss has totaled 54# (certainly not my top...I avoided scales).

However, what I've noticed is the number of fat people and kids keep going up. I was saddened to see a kid's cooking show this week. They were making cookies and cupcakes. Each of the contestants was overweight and substantially so. And, they are active, growing kids who should easily be lean at 10-12 years of age. I watch large numbers of large people at the grocery store...packaged, processed foods is what I see in the carts.

For those who believe the hour+ interview of GTs is a full summary of his book on isn't. The case is clearly built and deserving to reading.

Talukdar k c writes:

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Matt writes:

There was a meta analysis in JAMA a couple of years ago--no statistically significant difference between different diets at 1 year

gj writes:

For a thorough deconstruction of Taubes and NuSi, check out There is more than an hour's worth of material there -lots of detail, lots of references...
(and which I found on the very first page returned by typing 'taubes skeptic' into google)

aaron luchko writes:

I'd really like if Robert's would try to interview someone like Stephen Guyenet, a legitimate researcher in the field who has addressed many of Taubes' claims.

I feel like Russ has a tendency to sometimes cover fields by interviewing outsiders who have a very atypical view of the field, and that gives that contrary opinion a very authoritative weight.

I don't think someone like Gary Taubes, who is convinced that nutrition science is full of elementary mistakes, can really be counted on to give an accurate account of the science. Even as a layman I could spot numerous errors and strawmen in the claims he was making, I think an interview with a mainstream expert would be valuable.

jw writes:


Science usually doesn't progress much via anonymous bloggers.

I read a few of the posts and was unimpressed by the quality of the arguments.

aaron luchko,

Guyenet is a legitimate neuroscientist who tends to look at these issues from that perspective.

Taubes is not a medical researcher per se, but one who has read more on this than either of us ever will, directs nutritional medical research at NUSI (with a far more open minded protocol than anyone else that I have come across), and is a very clear communicator of the science that he finds. As above, he changed the world with his writing on fat and salt; and the case against sugar is far more obvious. I wouldn't bet against him.

gj writes:

jw, is your confidence in Taubes not in the least bit shaken after watching the video titled 'The Journalist Gary Taubes 2: A Parajournalism Paradox' at plantpositive?
Does it not appear that Taubes is to some degree engaging in motivated reasoning in his claims regarding the 'paradox' of Dwight Eisenhower's heart attack?
Is his omission of the fact that Eisenhower suffered from Crohn's disease, smoked 3-4 packs of cigarettes a day, and ate a high fat diet (including steak for breakfast),
not in any way troubling to you?
In his chronicling of the events surrounding Eisenhower's heart attacks, are you still convinced that Taubes is a 'clear communicator' who has brought to light a real mystery -
a mystery which challenges the Diet-Heart hypothesis?
Quoting straight from that plantpositive video:
'Eisenhower also had various other illnesses, including type II diabetes at the end of his life.
This also could have been gleaned by Taubes from that book he referenced, but he ignored it because he wanted you to believe in the existence of a paradox.
Those who praise Taubes for his thoroughness as a researcher should know that this book was in his hands at some point.
Had he been a little more curious and open-minded, he wouldn't have had reason to propose that we have a paradox here


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