Medical Rise of Cancer: Examining the Role of Sugar and Refined Carbs

[russ_watters]

Some more interesting articles.

http://www.time.com/time/health/article/0,8599,1914857,00.html

http://nymag.com/news/sports/38001/

Its surprising how we have accepted so many things as gospel without a shred of evidence.

Those are really terrrible articles. They take something that is true (and blindingly obvious) and twist it around to imply - completely incorrectly - that it's false, for the sake of sucking you into reading the article. Time does that all the time and IIRC, they got a huge amount of negative feedback for that article.

Exercise alone will make you lose weight.

That statement is true. It has to be. The human body's weight gain or loss is determined by the caloric balance: calories in - calories out = calories stored. If you increase the calories out while maintaining the calories in, you lose weight. Period.

What they are doing in those articles is applying faulty logic - and more importantly, faulty reading comprehension - to the thing that makes weight loss by exercise alone hard: when you exercise, your body demands more calories, so it is hard to not eat more. But look again at the statement in bold. Where in there does it addresses eating? It doesn't. It assumes all other factors including eating are held constant. So saying that the statement is wrong because exercise leads people to eat more is bad logic and bad reading comprehension.

The correct message that should be transmitted here is this: Exercise alone will cause you to lose weight, but it will cause you to want to eat more, so you have to be vigilant in maintaining your caloric intake. This really should not be hard to grasp, nor to do as long as you make yourself conscious of it. Eating habits are just that - habits. You should be able to control your caloric intake by eating what you normally do because you know what you normally eat. Ie, if you used to eat the "medium" extra value meal and now you're eating the "supersize", you're eating more. Obviously, this will cut into the weight loss, so you shouldn't do it.

Duh.

Here's a 5-part rebuttal:

The recent August 9th 2009 cover story from Time Magazine, "Why Exercise Won't Make You Thin" (Cloud, 2009) may be one of the most poorly researched and misrepresented articles about exercise and fitness. Not only did the author John Cloud misinterpret much of the exercise and health science literature--he has plenty of other articles where his seemingly lack of science and health knowledge is moot--and wrote an article that could potentially damage the public if they follow his misinformed advice, but Time Magazine has been completely irresponsible in publishing this article without seemingly proper fact checking. Cloud begins the article by touting his bitterness towards exercise and finds studies which seem to rationalize his disregard for proper exercise and nutrition. Cloud seems to lack comprehension in science, health, and fitness to accurately convey truthful information. The inaccurate and misleading conclusions he draws may make the metabolic syndrome (obesity, diabetes, heart disease, etc...) epidemic even worse if people believe his story.

http://www.examiner.com/diets-and-e...-why-exercise-won-t-make-you-thin-part-1-of-5

 

[Studiot]

Um ... have you read the posts?

That sort of response makes me sorry I bothered to post at all.

Yes I checked electronically and according to my browser ,my post was the first mention of Dr Cleave in this thread.

 

[mugaliens]

I am not so sure. Anthropologists who studied tribes untouched by the modern Western fast and processed food disease often did not find evidence for these.

References, please.

And given that Hippocrates described several cancers a couple thousand years ago (Moss, Ralph W. (2004). "http://www.cancerdecisions.com/speeches/galen1989.html" "), cancer is most certainly not caused by "the modern Western fast and processed food." Is there an increase caused by our diets? Possibly, although there are so many other factors out there including significantly changed levels of exercise and dietary composition, as well as exposure to sun, radiation, and man-made toxins, that's it's very difficult to definitively state cancers are due to x, y, or z.

peaking of dentists, anyone read Weston Price's work ? I don't mean the current WAPF, but the original works of Weston Price. Interesting stuff indeed.

I have Vols I & II of a rather thick medical text 1880's medical text which I find fascinating, both in terms of how much remains valid today, as well as how much was little more than heresay or anecdotal. They're in long-term storage, however. Otherwise, I'd share some tidbits!

 

[Siv]

That sort of response makes me sorry I bothered to post at all.

Yes I checked electronically and according to my browser ,my post was the first mention of Dr Cleave in this thread.

Thats not what you asked, specifically about Dr Cleave.

What you did was post 3 books and asked if anyone had read them. The first book (which I referenced while replying) was one about the modern evils of refined carbs and sugar, which we have extensively discussed.

 

[Proton Soup]

Some more interesting articles.

http://www.time.com/time/health/article/0,8599,1914857,00.html

http://nymag.com/news/sports/38001/

Its surprising how we have accepted so many things as gospel without a shred of evidence.

good grief. and nowhere above did i post that exercise alone would make you thin. the points were simply this, that a surplus of calories will be stored as some kind of weight (often fat, but can also be muscle (which is almost always accompanied by fat, too, but let's not get into that)), and that exercise will burn visceral fat preferentially. visceral fat acts as more of a short-term storage depot. it's rather easy to get rid of, especially for a *ahem* paleo guy that actually gets up off his rump to go find food instead of just driving to Publix.

for someone so concerned about gospels, it is a bit amusing to see you line up for the Flavor-Aid. anyhoo, i think i'll leave you to your delusions.

 

[Siv]

Those are really terrrible articles. They take something that is true (and blindingly obvious) and twist it around to imply - completely incorrectly - that it's false, for the sake of sucking you into reading the article. Time does that all the time and IIRC, they got a huge amount of negative feedback for that article.

Exercise alone will make you lose weight.

That statement is true. It has to be. The human body's weight gain or loss is determined by the caloric balance: calories in - calories out = calories stored. If you increase the calories out while maintaining the calories in, you lose weight. Period.

Unfortunately, that's not true. Our body is far more complex than a simplistic calories in = calories out. The laws of theormodynamics are not violated (obviously!) but the set point changes depending on the type of calories.

For eg, if you feed 2 groups the same 2000 calories, but one where 80% are from carbs (mostly refined) and the other where 80% is fat, the 2 groups will gain different amounts of weight.

One simple factor is the energy the body uses in the digestion process, which is called the thermic effect of food. The thermic effect of protein is about twice that of carbohydrate or fat.

I will find the link later, but there was a study done at the City of Hope Medical Center in Duarte, California. Here they studied two groups of overweight people, both on medically supervised low-calorie liquid diets. One group added 3 ounces of almonds to their daily diet, while the other group added the same amount of calories from complex carbs like popcorn and Triscuit crackers. Both groups ate the same number of calories daily, about 1,000. During the 24-week study, the almond-eating group lost more weight even though they ate the same number of calories as the carb group.

There have been other studies done as well, I will need some time to dig them out.

Meanwhile, here's a nice article from Dr. Feinman
http://www.nutritionj.com/content/3/1/9

Quoting from the conclusion -

A review of simple thermodynamic principles shows that weight change on isocaloric diets is not expected to be independent of path (metabolism of macronutrients) and indeed such a general principle would be a violation of the second law. Homeostatic mechanisms are able to insure that, a good deal of the time, weight does not fluctuate much with changes in diet – this might be said to be the true "miraculous metabolic effect" – but it is subject to many exceptions. The idea that this is theoretically required in all cases is mistakenly based on equilibrium, reversible conditions that do not hold for living organisms and an insufficient appreciation of the second law. The second law of thermodynamics says that variation of efficiency for different metabolic pathways is to be expected. Thus, ironically the dictum that a "calorie is a calorie" violates the second law of thermodynamics, as a matter of principle.

Plus eating fewer than a certain threshold of calories puts your body in starvation mode and drastically reduces your metabolism too.

The correct message that should be transmitted here is this: Exercise alone will cause you to lose weight, but it will cause you to want to eat more, so you have to be vigilant in maintaining your caloric intake. This really should not be hard to grasp, nor to do as long as you make yourself conscious of it. Eating habits are just that - habits. You should be able to control your caloric intake by eating what you normally do because you know what you normally eat. Ie, if you used to eat the "medium" extra value meal and now you're eating the "supersize", you're eating more. Obviously, this will cut into the weight loss, so you shouldn't do it.

Duh.

Here's a 5-part rebuttal:

http://www.examiner.com/diets-and-e...-why-exercise-won-t-make-you-thin-part-1-of-5

Maybe this guy is a weirdo, but that does not matter. Resorting to ad hominem won't negative his evidence. And the evidence is there.

The Terry Wilkin study of childhood obesity, for e.g.
http://adc.bmj.com/content/early/2008/06/30/adc.2007.135012.abstract

There were no associations between physical activity and changes in any measure of body mass or fatness over time in either sex (e.g. BMI-SDS: r=-0.02 p=0.76). However, there was a small-to-moderate inverse association between physical activity and change in composite metabolic score (r=-0.19, p<0.01). Mixed effects modeling showed that the improvement in metabolic score among the more active compared to the less active children was linear with time (-0.08 z-scores/year, p=0.001).

Exercise is beneficial for lots of other things, but not weight loss.

Merely saying that if you starve and exercise you lose weight is no solution to anything. Its your bodies complicated homeostasis mechanism which makes you hungrier when you exercise. Which is what makes the calories in = calories out cliche a myth.

Exercise is not a useful method for weight loss. As Taubes says, the original Finnish report cited by most researchers for the benefit of exercise in weight loss is far from conclusive.

Yet the Finnish report, the most scientifically rigorous review of the evidence to date, can hardly be said to have cleared up the matter. When the Finnish investigators looked at the results of the dozen best-constructed experimental trials that addressed weight maintenance—that is, successful dieters who were trying to keep off the pounds they had shed—they found that everyone regains weight. And depending on the type of trial, exercise would either decrease the rate of that gain (by 3.2 ounces per month) or increase its rate (by 1.8 ounces). As the Finns themselves concluded, with characteristic understatement, the relationship between exercise and weight is “more complex” than they might otherwise have imagined.

The problem is that light exercise burns an insignificant number of calories, amounts that are undone by comparatively effortless changes in diet. In 1942, Louis Newburgh of the University of Michigan calculated that a 250-pound man expends only three calories climbing a flight of stairs—the equivalent of depriving himself of a quarter-teaspoon of sugar or a hundredth of an ounce of butter. “He will have to climb twenty flights of stairs to rid himself of the energy contained in one slice of bread!” Newburgh observed. So why not skip the stairs, skip the bread, and call it a day?

 

[Proton Soup]

Siv, there is a lot of confusion that seems to originate from differences in how much water people hold onto when they are on a keto diet, versus a higher carb diet that keeps them out of ketosis. people on a ketogenic diet can lose several kilograms of water weight, and unless you correct for this in your studies by doing something like a DEXA scan to measure body composition more directly, you're going to get screwy results. if you're just looking at a person's kg weight changes, then you don't really know what you're looking at. it is easy to misinterpret this as a change in "setpoint".

 

[Siv]

Siv, there is a lot of confusion that seems to originate from differences in how much water people hold onto when they are on a keto diet, versus a higher carb diet that keeps them out of ketosis. people on a ketogenic diet can lose several kilograms of water weight, and unless you correct for this in your studies by doing something like a DEXA scan to measure body composition more directly, you're going to get screwy results. if you're just looking at a person's kg weight changes, then you don't really know what you're looking at. it is easy to misinterpret this as a change in "setpoint".

Actually the Atkins water weight thing is just a myth.
http://community.discovery.com/eve/forums/a/tpc/f/634109964/m/8011922838

Anyway I am not recommending any diet here, but just acknowledging the real harm that refined carbs and sugars do. Apart from busting the exercise weight loss myth.

 

[Proton Soup]

Actually the Atkins water weight thing is just a myth.
http://community.discovery.com/eve/forums/a/tpc/f/634109964/m/8011922838

Anyway I am not recommending any diet here, but just acknowledging the real harm that refined carbs and sugars do. Apart from busting the exercise weight loss myth.

no, it is not a myth. and the reason you gain water back on atkins is that atkins is only keto on the induction phase, and after you switch over to a more normal carb intake in later parts of the diet, the water comes back. have you read atkins? you realize it's got different phases and isn't the zero-carb caricature that the press makes it out to be?

 

[Siv]

no, it is not a myth. and the reason you gain water back on atkins is that atkins is only keto on the induction phase, and after you switch over to a more normal carb intake in later parts of the diet, the water comes back. have you read atkins? you realize it's got different phases and isn't the zero-carb caricature that the press makes it out to be?

Ok, if you can skip the patronising assertions, maybe we can have a more productive debate ?

 

[Siv]

The Omega-3/Omega-6 ratio is another thing increasing inflammation and inflammatory diseases, I had forgotten to mention that earlier.
An interesting blog post re: that from Dr. Stephan Guyenet.

http://wholehealthsource.blogspot.com/2010/02/corn-oil-and-cancer-reality-strikes.html

 

[russ_watters]

Unfortunately, that's not true...

Exercise is not a useful method for weight loss.

You failed to address the point I made even a little bit. Besides the irrelevancies you disucssed, like the effects of different types of food (which may be interesting, but have nothing to do with exercise), you used the same logical disconnect as the article did! The fact that eating affects weight gain/loss does not in any way imply that exercise doesn't. The fact that eating less works better doesn't change the fact that exercising more still works. The fact that people who exercise more tend to start eating more doesn't change the fact that if they exercise more while holding their food intake steady they lose weight.

Again: Exercise alone can make you lose weight as long as you really are just adding exercise and not adding extra eating as well.

I think part of the disconnect is that what is the better way to lose weight is different for different people. For most it is a combination of the two, but for many people, the eating is the much bigger problem and therefore the much easier to correct. Example:

Many studies have compared weight loss resulting from changing diet versus increasing activity. Most often, weight loss during programs focused on dietary change produced two to three times greater weight loss than programs focused on exercise.

http://www.msnbc.msn.com/id/13821677/

That's easy to believe. Particularly if you're out of shape, it is very difficult to burn more than a few hundred (say 300) extra calories a day. But 300 calories a day is equal to only two sodas, and that's not a difficult thing to cut out of a diet.

 

[Proton Soup]

Ok, if you can skip the patronising assertions, maybe we can have a more productive debate ?

very well. as for why atkins works (at least for some people), i think what you will find is that http://www.ajcn.org/cgi/content/full/87/1/44" . this results in people eating below their maintenance level of calories, they burn more than they eat, and start losing adipose mass. and because they also lose a lot of water in the beginning, the results appear more dramatic than they really are. losing adipose mass probably doesn't hurt your lipid profiles, either, as many people who unfat themselves find out.

 

[Siv]

You failed to address the point I made even a little bit. Besides the irrelevancies you disucssed, like the effects of different types of food (which may be interesting, but have nothing to do with exercise), you used the same logical disconnect as the article did!

Ok, very convenient way of dismissing all the info/links/research I presented.

I let moderator unpleasantness drive me away from PF once, but not again. I should have been able to develop a thick skin by now

Let me try again.

You said - "The human body's weight gain or loss is determined by the caloric balance: calories in - calories out = calories stored. If you increase the calories out while maintaining the calories in, you lose weight. Period."

To which I responded with - "Unfortunately, that's not true. Our body is far more complex than a simplistic calories in = calories out. The laws of theormodynamics are not violated (obviously!) but the set point changes depending on the type of calories.

For eg, if you feed 2 groups the same 2000 calories, but one where 80% are from carbs (mostly refined) and the other where 80% is fat, the 2 groups will gain different amounts of weight.

One simple factor is the energy the body uses in the digestion process, which is called the thermic effect of food. The thermic effect of protein is about twice that of carbohydrate or fat.

I will find the link later, but there was a study done at the City of Hope Medical Center in Duarte, California. Here they studied two groups of overweight people, both on medically supervised low-calorie liquid diets. One group added 3 ounces of almonds to their daily diet, while the other group added the same amount of calories from complex carbs like popcorn and Triscuit crackers. Both groups ate the same number of calories daily, about 1,000. During the 24-week study, the almond-eating group lost more weight even though they ate the same number of calories as the carb group.

There have been other studies done as well, I will need some time to dig them out.

Meanwhile, here's a nice article from Dr. Feinman
http://www.nutritionj.com/content/3/1/9

Quoting from the conclusion -

A review of simple thermodynamic principles shows that weight change on isocaloric diets is not expected to be independent of path (metabolism of macronutrients) and indeed such a general principle would be a violation of the second law. Homeostatic mechanisms are able to insure that, a good deal of the time, weight does not fluctuate much with changes in diet – this might be said to be the true "miraculous metabolic effect" – but it is subject to many exceptions. The idea that this is theoretically required in all cases is mistakenly based on equilibrium, reversible conditions that do not hold for living organisms and an insufficient appreciation of the second law. The second law of thermodynamics says that variation of efficiency for different metabolic pathways is to be expected. Thus, ironically the dictum that a "calorie is a calorie" violates the second law of thermodynamics, as a matter of principle.

Plus eating fewer than a certain threshold of calories puts your body in starvation mode and drastically reduces your metabolism too."


Re: your exercise claim, I responded to that with - "Maybe this guy is a weirdo, but that does not matter. Resorting to ad hominem won't negate his evidence. And the evidence is there.

The Terry Wilkin study of childhood obesity, for e.g.
http://adc.bmj.com/content/early/200...35012.abstract
There were no associations between physical activity and changes in any measure of body mass or fatness over time in either sex (e.g. BMI-SDS: r=-0.02 p=0.76). However, there was a small-to-moderate inverse association between physical activity and change in composite metabolic score (r=-0.19, p<0.01). Mixed effects modeling showed that the improvement in metabolic score among the more active compared to the less active children was linear with time (-0.08 z-scores/year, p=0.001).

Exercise is beneficial for lots of other things, but not weight loss.

Merely saying that if you starve and exercise you lose weight is no solution to anything. Its your bodies complicated homeostasis mechanism which makes you hungrier when you exercise. Which is what makes the calories in = calories out cliche a myth."

The fact that eating affects weight gain/loss does not in any way imply that exercise doesn't. The fact that eating less works better doesn't change the fact that exercising more still works. The fact that people who exercise more tend to start eating more doesn't change the fact that if they exercise more while holding their food intake steady they lose weight.

Please read what I wrote. I said that exercise was not a useful method for weight loss. Period.

Precisely because you cannot eat the same if you exercise more. Our body's homeostasis works to ensure that we compensate by eating more too. Artificially and forcefully starving yourself will never work long term and is not sustainable. What is far more likely to work is something which keeps you full and makes you less hungry.

Also, I don't agree that if you eat the same number of calories, the more you exercise, the more weight you will lose. Show me a study which shows this linear or geometric relation. I also contest that the type of food you eat will also affect how much you lose. As stated above, the laws of thermodynamics have been incorrectly interpreted for too long w.r.t nutrition and weight loss.

 

[Siv]

Here are some media articles debunking the calories in = calories out myth (the dumbing down of the complex mechanism of our bodies).

http://migraineur.wordpress.com/2007/11/11/calories-in-calories-out/

http://www.naturalnews.com/027126_dieting_food_health.html.
Quoting from above -

The idea of calories in versus calories out is a complete myth. The body is far more complex than that. There are hundreds upon hundreds of activities performed in your body at any given time - it needs fuel to perform these functions. If your body is not receiving the materials it needs from your diet, then it has no choice but to take from its only other source - itself. Most people assume your body will only use its stored fat for its various needs, but this is not true. Your body will also draw from your bones, muscle tissue and organ tissue. You may lose some fat, but it will be at the sacrifice of vital living tissues. This is not a good state to be in, so your body slows down your metabolism to prevent its own destruction. After all, your body has one natural instinct - to survive.

http://www.dummies.com/how-to/content/busting-the-great-myths-of-fat-burning.html.
A quote from the above :

Technically, once you've been exercising for 15 or 20 minutes, your body has made the shift to using a higher percentage of fat for fuel. But again, if you're trying to lose weight, it's about the total number of calories burned, not necessarily the fuel source.
For example, say that at rest you burn up to 60 percent fat. When you enter the initial phases of intense exercise, the ratio changes. You may now burn only 30 percent fat because your body is using quick-energy carbohydrates. Once the exercise is sustained, the body switches back to using a higher percentage of fat to fuel the movement (up to 75 percent fat). In this aerobic phase of exercise, a higher percentage of fat is being used for energy. But if you aren't working out for a very long period, you may still burn more total calories and, therefore, more fat calories working out harder. Put another way, if burning as many calories as you can is the best way to lose weight, even a dummy can figure out which activity of the following is going to give the best results (answer: jogging and sprinting), even though their fat-burning quota is on the low end of the ratio.

So you see, not only is it not a linear relationship, it depends on the type of exercise as well. Makes us realize how dangerous it is to oversimplify anything.

 

[Siv]

Re: the water weight loss myth re: Atkins, here's an article which comprehensively debunks it.

http://www.diabeteshealth.com/read/2006/09/01/4838/losing-weight-on-a-lower-carb-diet/

Carbohydrates Can Cause Water Retention

Because stored glucose binds water, there is a diuretic effect during the first few days of the Induction phase of the Atkins Lifestyle, when carbs are limited to 20 grams daily. That’s why people on diuretic medications are cautioned when cutting carbs to do so with the supervision of their doctor to avoid overmedication.

For anyone following a lower-carb plan, it is important to stay properly hydrated. Most people do very well during the Induction stage. However, if help is needed to replace lost minerals because of an excessive loss of water, taking a multi-mineral every day or drinking two cups of salty broth daily works quite well for most people.

So its not that Atkins causes initial water weight loss but that high carb diets cause water retention.
Taubes also explains this beautifully in his book.

 

[Proton Soup]

Siv, please stop using blog articles to backup your assertions.

 

[Siv]

These 2 are not blogs.
http://adc.bmj.com/content/early/200...35012.abstract
http://www.nutritionj.com/content/3/1/9

Plus some of these health blogs are a wealth of information. Run by really clever and qualified scientists/doctors who keep up to date with the latest research.

BTW was looking at the link you posted re: ketogenic diets. And it does not really support your case much.

The significantly (P = 0.006) greater weight loss with the LC diet (1.99 kg) than with the MC diet was due, in part, to the difference in water loss with the ketogenic diet, although this difference did not reach significance (0.71 kg; P = 0.158) (Table 4). There also tended to be greater losses of fat mass (1.05 kg; P = 0.083) and fat-free mass (0.94 kg; P = 0.054) with the LC diet than with the MC diet. In the 4-compartment model used, glycogen is considered part of the fat-free mass, and it cannot easily be directly measured. Examination of the change in protein mass (rather than in fat-free mass), calculated from the 4-compartment model, indicated that there was a weight loss of 0.25 and 0.02 kg with the LC ketogenic and MC nonketogenic diets, respectively (P = 0.281; SED: 0.202).

0.71 kgs ?? The margin of error would have been higher, that's why its not statistically significant.

 

[Proton Soup]

These 2 are not blogs.
http://adc.bmj.com/content/early/200...35012.abstract
http://www.nutritionj.com/content/3/1/9

Plus some of these health blogs are a wealth of information. Run by really clever and qualified scientists/doctors who keep up to date with the latest research.

BTW was looking at the link you posted re: ketogenic diets. And it does not really support your case much.
0.71 kgs ?? The margin of error would have been higher, that's why its not statistically significant.

you know i specifically used that study for appetite suppression.

but if you want something with more significance, try this one: http://www.annals.org/content/140/10/769.full

if you want something really rigid (heavily controlled inpatient vs. outpatient), then this is interesting: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC333231/

 

[Ygggdrasil]

When studying the effects of various interventions on human health, it is notoriously difficult to glean actionable information from anyone single scientific study. Often these are observational studies that are subject to many confounding factors and limited by small sample sizes, poorly controlled conditions, and short observation periods. Even well-controlled, randomized clinical trials can often reach opposing conclusions.

We can reach better conclusions, however, by performing a systematic literature review: examining the scientific literature as a whole by using strict criteria to select the highest quality studies and evaluating the results of the all of the studies as a whole. Although there may be individual studies within the review that support either side of an assertion, if a large majority of the studies support one side of an argument, we can be much more confident about their conclusions.

The 2007 report, Food, Nutrition, Physical Activity, and the Prevention of Cancer by the World Cancer Research Fund and American Institute for Cancer Research does just this. I will summarize the relevant findings of the review below. The full report is available here: http://www.dietandcancerreport.org/

Because obesity is an established cause of cancer, the report examined the risk factors for weight gain, overweight, obesity. The systematic literature review of this area covered 207 publications investigating the determinants of weight gain, overweight and obesity. The report concludes:

"The epidemiological evidence on physical activity is substantial and consistent. There is robust mechanistic evidence, particularly in relation to its impact on appetite regulation and energy balance. Overall, the evidence that all types of physical activity protect against weight gain, overweight, and obesity is convincing. It has this effect by promoting appropriate energy intake. Conversely, the evidence can be interpreted as showing that sedentary living is a cause of weight gain, overweight, and obesity."​

The panel gives the evidence linking physical activity to a decreased risk of weight gain, overweight and obesity its highest ranking of convincing. The panel ranks the strength of evidence linking energy-dense foods, sugary drinks, and fast food to an increased risk of weight gain, overweight and obesity as probable.

Furthermore, while Siv has claimed that changes to appetite that accompany physical activity cancel the effects of exercise, the report claims otherwise:

"Control [of appetite] seems to be least effective at relatively low levels of physical activity, meaning that sedentary people tend to gain weight more readily than active people. Conversely, although high levels of physical activity increase energy requirements and appetite, the likelihood of consuming more than is needed is lower."​

Therefore, although some may be able to produce studies showing otherwise, the preponderance of high quality scientific evidence strongly supports the assertion that physical activity can prevent weight gain, overweight and obesity.

Since this topic was originally on cancer, I will quote the panel's conclusions about the effects of sugar consumption on the risk for cancer:

"The evidence is hard to interpret. There is limited evidence suggesting that sugar is a cause of colorectal cancer."​

This does not mean that there is convincing evidence that sugar is not a cause of cancer. Rather, the report concludes that there is not sufficient high quality evidence to reach a solid conclusion.

 

[bobze]

When studying the effects of various interventions on human health, it is notoriously difficult to glean actionable information from anyone single scientific study. Often these are observational studies that are subject to many confounding factors and limited by small sample sizes, poorly controlled conditions, and short observation periods. Even well-controlled, randomized clinical trials can often reach opposing conclusions.

We can reach better conclusions, however, by performing a systematic literature review: examining the scientific literature as a whole by using strict criteria to select the highest quality studies and evaluating the results of the all of the studies as a whole. Although there may be individual studies within the review that support either side of an assertion, if a large majority of the studies support one side of an argument, we can be much more confident about their conclusions.

The 2007 report, Food, Nutrition, Physical Activity, and the Prevention of Cancer by the World Cancer Research Fund and American Institute for Cancer Research does just this. I will summarize the relevant findings of the review below. The full report is available here: http://www.dietandcancerreport.org/

Because obesity is an established cause of cancer, the report examined the risk factors for weight gain, overweight, obesity. The systematic literature review of this area covered 207 publications investigating the determinants of weight gain, overweight and obesity. The report concludes:

"The epidemiological evidence on physical activity is substantial and consistent. There is robust mechanistic evidence, particularly in relation to its impact on appetite regulation and energy balance. Overall, the evidence that all types of physical activity protect against weight gain, overweight, and obesity is convincing. It has this effect by promoting appropriate energy intake. Conversely, the evidence can be interpreted as showing that sedentary living is a cause of weight gain, overweight, and obesity."​

The panel gives the evidence linking physical activity to a decreased risk of weight gain, overweight and obesity its highest ranking of convincing. The panel ranks the strength of evidence linking energy-dense foods, sugary drinks, and fast food to an increased risk of weight gain, overweight and obesity as probable.

Furthermore, while Siv has claimed that changes to appetite that accompany physical activity cancel the effects of exercise, the report claims otherwise:

"Control [of appetite] seems to be least effective at relatively low levels of physical activity, meaning that sedentary people tend to gain weight more readily than active people. Conversely, although high levels of physical activity increase energy requirements and appetite, the likelihood of consuming more than is needed is lower."​

Therefore, although some may be able to produce studies showing otherwise, the preponderance of high quality scientific evidence strongly supports the assertion that physical activity can prevent weight gain, overweight and obesity.

Since this topic was originally on cancer, I will quote the panel's conclusions about the effects of sugar consumption on the risk for cancer:

"The evidence is hard to interpret. There is limited evidence suggesting that sugar is a cause of colorectal cancer."​

This does not mean that there is convincing evidence that sugar is not a cause of cancer. Rather, the report concludes that there is not sufficient high quality evidence to reach a solid conclusion.

Good post!

 

[Siv]

you know i specifically used that study for appetite suppression.

but if you want something with more significance, try this one: http://www.annals.org/content/140/10/769.full

if you want something really rigid (heavily controlled inpatient vs. outpatient), then this is interesting: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC333231/

You claimed that Atkins weight loss was mostly water loss, so I thought your links would support that. Anyway let's look at what you have now ...

Ok, this is what I have from your first study -

Changes in total body water explained most of the change in fat-free mass in both groups. The expected mean change in total body water was −2.4 kg (CI, −2.9 to −2.0 kg) in the low-carbohydrate diet group and −1.8 kg (CI, −2.3 to −1.3 kg) in the low-fat diet group (mean difference, −0.6 kg [CI, −1.3 to 0 kg]; P = 0.052). However, the low-carbohydrate diet group lost a greater amount of total body water in the first 2 weeks of the study than did the low-fat diet group (−1.1 kg versus −0.5 kg; mean difference, −0.6 kg [CI, −1.0 to −0.2 kg]).

The differences are again very marginal. - 2.4 kg vs 1.8 kg and 1.1 vs 0.6 kg.
Come on, its not even statistically significant, IMO.

And let's look at the actual results from that study, shall we ?

Results: A greater proportion of the low-carbohydrate diet group than the low-fat diet group completed the study (76% vs. 57%; P = 0.02). At 24 weeks, weight loss was greater in the low-carbohydrate diet group than in the low-fat diet group (mean change, −12.9% vs. −6.7%; P < 0.001). Patients in both groups lost substantially more fat mass (change, −9.4 kg with the low-carbohydrate diet vs. −4.8 kg with the low-fat diet) than fat-free mass (change, −3.3 kg vs. −2.4 kg, respectively). Compared with recipients of the low-fat diet, recipients of the low-carbohydrate diet had greater decreases in serum triglyceride levels (change, −0.84 mmol/L vs. −0.31 mmol/L [−74.2 mg/dL vs. −27.9 mg/dL]; P = 0.004) and greater increases in high-density lipoprotein cholesterol levels (0.14 mmol/L vs. −0.04 mmol/L [5.5 mg/dL vs. −1.6 mg/dL]; P < 0.001). Changes in low-density lipoprotein cholesterol level did not differ statistically (0.04 mmol/L [1.6 mg/dL] with the low-carbohydrate diet and −0.19 mmol/L [−7.4 mg/dL] with the low-fat diet; P = 0.2). Minor adverse effects were more frequent in the low-carbohydrate diet group.

Minor adverse effects at the initial stages aside (constipation, headache and the likes), the low carb results were spectacular !

Ok, your second study ... the period is for 50 days total, but in 3 10-day periods. That is very short, IMO. Even 24 weeks in the prev study were short but at least not as short as 50 days. So I don't really find anything significance in the very short term water weight loss.

In any case, the reason for the water loss has also been explained very well b Taubes and others. Carbs make people retain water, as I explained.

 

[Siv]

When studying the effects of various interventions on human health, it is notoriously difficult to glean actionable information from anyone single scientific study. Often these are observational studies that are subject to many confounding factors and limited by small sample sizes, poorly controlled conditions, and short observation periods. Even well-controlled, randomized clinical trials can often reach opposing conclusions.

That is true. But the whole problem with nutrition science (if you can call it science) is how people stretch epidemiological data to support their arguments.
Epidemiological data faces huge problems when it tries to take the place of scientific trials.

Here's an award winning article from Gary Taubes in the National Association of Science Writers on the limitations of epidemiology.
http://www.nasw.org/awards/1996/96Taubesarticle.htm

We can reach better conclusions, however, by performing a systematic literature review: examining the scientific literature as a whole by using strict criteria to select the highest quality studies and evaluating the results of the all of the studies as a whole. Although there may be individual studies within the review that support either side of an assertion, if a large majority of the studies support one side of an argument, we can be much more confident about their conclusions.

The 2007 report, Food, Nutrition, Physical Activity, and the Prevention of Cancer by the World Cancer Research Fund and American Institute for Cancer Research does just this. I will summarize the relevant findings of the review below. The full report is available here: http://www.dietandcancerreport.org/

Problem again, is that it is an epidemiological report. A meta analysis, but one based on epidemiological data nonetheless.

Therefore, although some may be able to produce studies showing otherwise, the preponderance of high quality scientific evidence strongly supports the assertion that physical activity can prevent weight gain, overweight and obesity.

High quality evidence ? No.
I will go through the link in detail later when I have time.

Meanwhile, people who have tried to actual clinical trials find quite the opposite results.

Dr. Timothy Church for eg.
At http://www.plosone.org/article/info:doi/10.1371/journal.pone.0004515

This was a 6 month study. But the surprising finding was that, the control group had a better outcome than the high exercise group

The primary finding from this large exercise intervention trial in postmenopausal women is that the difference between actual weight loss and predicted weight loss (compensation) increases with exercise dose. We confirmed the findings of previous studies that a relatively high dose of exercise (12 KKW or 194 minutes per week) results in compensatory mechanisms that attenuate weight loss in previously sedentary women. However, a dose of exercise consistent with the exercise prescription for general health (8 KKW or 136 minutes per week) did not result in compensation as the actual weight loss closely matched the predicted weight loss. An exercise dose of 4 KKW (72 minutes per week) also resulted in weight loss that slightly exceeded the predicted weight loss. Our findings are important because most exercise guidelines for weight loss recommend 200–300 minutes per week and we provide evidence that this amount of exercise induces compensation that results in significantly less weight loss than predicted.

So 10-15 mins exercise per day (the most sedentary of the 3 groups) seems the most beneficial !

Please also see the Terry Wilkin study re: childhood obesity that I posted earlier.
http://adc.bmj.com/content/early/200...35012.abstract
There were no associations between physical activity and changes in any measure of body mass or fatness over time in either sex (e.g. BMI-SDS: r=-0.02 p=0.76). However, there was a small-to-moderate inverse association between physical activity and change in composite metabolic score (r=-0.19, p<0.01). Mixed effects modeling showed that the improvement in metabolic score among the more active compared to the less active children was linear with time (-0.08 z-scores/year, p=0.001). Again, this is an actual trial, not an epidemiological analysis.

Other studies are mentioned in this article
http://www.cbc.ca/health/story/2009/05/07/school-exercise-obesity-child.html

Rather than relying on epidemiological evidence, if you end up doing actual studies, however faulty they may be, the results are far more accurate and practical.

Blaming our sedentary lifestyles for obesity without any actual evidence is something for which Jean Mayer requires the most credit. And he promoted his pro-exercise message with a religious zeal like a moral crusade.

People are exercising far more today than they did several decades ago. So, has the obesity declined or gone up ?!

 

[bobze]

That is true. But the whole problem with nutrition science (if you can call it science) is how people stretch epidemiological data to support their arguments.
Epidemiological data faces huge problems when it tries to take the place of scientific trials.

Here's an award winning article from Gary Taubes in the National Association of Science Writers on the limitations of epidemiology.
http://www.nasw.org/awards/1996/96Taubesarticle.htm

Problem again, is that it is an epidemiological report. A meta analysis, but one based on epidemiological data nonetheless.

High quality evidence ? No.
I will go through the link in detail later when I have time.

Meanwhile, people who have tried to actual clinical trials find quite the opposite results.

Dr. Timothy Church for eg.
At http://www.plosone.org/article/info:doi/10.1371/journal.pone.0004515

This was a 6 month study. But the surprising finding was that, the control group had a better outcome than the high exercise group
So 10-15 mins exercise per day (the most sedentary of the 3 groups) seems the most beneficial !

Please also see the Terry Wilkin study re: childhood obesity that I posted earlier.
http://adc.bmj.com/content/early/200...35012.abstract
There were no associations between physical activity and changes in any measure of body mass or fatness over time in either sex (e.g. BMI-SDS: r=-0.02 p=0.76). However, there was a small-to-moderate inverse association between physical activity and change in composite metabolic score (r=-0.19, p<0.01). Mixed effects modeling showed that the improvement in metabolic score among the more active compared to the less active children was linear with time (-0.08 z-scores/year, p=0.001). Again, this is an actual trial, not an epidemiological analysis.

Other studies are mentioned in this article
http://www.cbc.ca/health/story/2009/05/07/school-exercise-obesity-child.html

Rather than relying on epidemiological evidence, if you end up doing actual studies, however faulty they may be, the results are far more accurate and practical.

Blaming our sedentary lifestyles for obesity without any actual evidence is something for which Jean Mayer requires the most credit. And he promoted his pro-exercise message with a religious zeal like a moral crusade.

People are exercising far more today than they did several decades ago. So, has the obesity declined or gone up ?!

3 quick points because I'm running late. Firstly, as Ygg pointed out Systematic/Meta-Reviews>>>>>> case-controls, cohorts or any other primary literature findings. Because, systematic reviews offer to us a summation of findings from many different sources, we are able to derive trends in them. As Ygg's review also points out that trend is to show that when you exercise a long with watching your diet you lose weight.

Secondly to your underlined sentence above. Many people do exercise more, however people also eat larger meal portions than they did in say the 50's or 60's. A serving of meat for most people should be about a deck of cards, when was the last time in America you've seen a correct portion of meat on the menu? Being a medical student, I eat out a lot--Restaurants take the "American dream" (more for less) approach to advertising. In fact, that approach to advertising is everywhere around us in the food industry--"More for less".

And finally, can you propose a biochemical mechanism whereby different types of carbohydrates are preferentially stored as fat? Without being able to show this any evidence of differential carb storage is anecdotal and more likely attributed to confounding factors (even if the confounder is a food specific factor, for example something else in the food with those "bad" carbs which promotes more fat storage)Thanks

Edit: Your BMJ link isn't working by the way.

 

[Siv]

3 quick points because I'm running late. Firstly, as Ygg pointed out Systematic/Meta-Reviews>>>>>> case-controls, cohorts or any other primary literature findings. Because, systematic reviews offer to us a summation of findings from many different sources, we are able to derive trends in them. As Ygg's review also points out that trend is to show that when you exercise a long with watching your diet you lose weight.

Unfortunately, whether its one study or a meta analysis, if its epidemeliogical data, its pretty much often always misleading. Did you read the link I posted with Taubes award winning article on that ?

And finally, can you propose a biochemical mechanism whereby different types of carbohydrates are preferentially stored as fat? Without being able to show this any evidence of differential carb storage is anecdotal and more likely attributed to confounding factors (even if the confounder is a food specific factor, for example something else in the food with those "bad" carbs which promotes more fat storage)

Its been beautifully explained, by Taubes and others. Carbs drive insulin drive fat storage (and other bad things). Read the book, its hard for me to summarize an entire book with tons of studies into one post. As I was telling someone else on this forum, the book is like pubmed, so its hard reading. But the plethora of evidence is worth it.

Your BMJ link isn't working by the way.

Oops, sorry. It was working yesterday. Let me check.

 

[mtc1973]

Not sure why there seems to be so much sure footed posturing in this thread. Obesity - is evidently a spectrum disorder - not a single disease. And as a spectrum disorder will have a spectrum of causes. Until we are in a position to ascribe the different causes of obesity to their respective populations - none of these studies will be in a position to make specific claims. All that remains is statistical correlation and postulation.

 

[Proton Soup]

Not sure why there seems to be so much sure footed posturing in this thread. Obesity - is evidently a spectrum disorder - not a single disease. And as a spectrum disorder will have a spectrum of causes. Until we are in a position to ascribe the different causes of obesity to their respective populations - none of these studies will be in a position to make specific claims. All that remains is statistical correlation and postulation.

i suppose you could make the same argument about alcoholism and drug use, but it's not helpful for explaining what is going on in the majority of the population. it's really just excuse-making for a population whose primary problem is they enjoy continuing their behavior more than they dislike the negative side effects.

the really interesting thing about this "disease" of obesity is that if you take away their freedoms and only allow them to consume a healthy amount of calories, they will lose weight.

 

[Proton Soup]

You claimed that Atkins weight loss was mostly water loss, so I thought your links would support that. Anyway let's look at what you have now ...

Ok, this is what I have from your first study - The differences are again very marginal. - 2.4 kg vs 1.8 kg and 1.1 vs 0.6 kg.
Come on, its not even statistically significant, IMO.

And let's look at the actual results from that study, shall we ? Minor adverse effects at the initial stages aside (constipation, headache and the likes), the low carb results were spectacular !

Ok, your second study ... the period is for 50 days total, but in 3 10-day periods. That is very short, IMO. Even 24 weeks in the prev study were short but at least not as short as 50 days. So I don't really find anything significance in the very short term water weight loss.

In any case, the reason for the water loss has also been explained very well b Taubes and others. Carbs make people retain water, as I explained.

where did you explain that carbs make people retain water?

and yes, low-carb diets (temporary diets for fat reduction(my fave would be the protein-sparing modified fast, with almost no fat at all)) can be spectacular for a number of reasons. as mentioned before, ketosis can have a significant appetite-suppressive effect, and this makes it easier for people stay on the diet. it also makes it easier for them to control their intake and consume fewer calories. and that is the important point I'm trying to get across. there is nothing magical about carbs making you fat, it's an excess of calories consumed that makes you fat.

and look again at the inpatient study. i think what you will see is that when you actually control what people eat (they can't cheat by sneaking candy and lying about it - skewing your results), fat loss on either a low or med. carb diet is similar.

the other thing to remember is that these studies are primarily about dieting for fat loss, and really don't make a case for eating a ketotic diet on a chronic basis. for that, go look up the papers where they mention the problems with keeping epilepsy patients on keto diets.

 

[mtc1973]

Agree totally Proton - its the only approach that works. I just find it strange that people want to ascribe it to all these different specific things - what's the point. We don't know - but as you say - what we do know is that if you limit intake and expend more energy - its a solution - irresepective of the specifics of the problem.

Of course people don't want to hear that because it means that they can control the problem - it just takes a heck of a lot of effort and fighting against what our evolutionary biology has dictated we do! In a world of scarcity it was wise to crave fatty sugary food! The scenario has changed!

Manufacturers also don't want to hear it because they can't make money out of people by selling supplements, plans, pills etc

I always am amazed at the amount of money spent on diabetes and CV research - when in fact if we changed attitudes at a young age - we could prevent themajority of these diseases even occurring. Prevention is ultimate, cure is an expensive band aid.

 

[bobze]

Unfortunately, whether its one study or a meta analysis, if its epidemeliogical data, its pretty much often always misleading. Did you read the link I posted with Taubes award winning article on that ?

Its been beautifully explained, by Taubes and others. Carbs drive insulin drive fat storage (and other bad things). Read the book, its hard for me to summarize an entire book with tons of studies into one post. As I was telling someone else on this forum, the book is like pubmed, so its hard reading. But the plethora of evidence is worth it.

Oops, sorry. It was working yesterday. Let me check.

No I don't mean how carbohydrates drive insulin regulation and vise-versa. I'm well versed in that.

However, you claimed that various types of carbohydrates promoted this more than others, if I'm remembering correctly (a couple pages back I believe).

What I was asking for is, what is the biochemical mechanism or hypothesis that would explain this. Otherwise, as I pointed out, its just as likely that other confounding factors associated with those 'types of carbs' are the culprit in the up-regulation of insulin and not the 'type' of carb itself.

For example. You claimed that HFCS (a mix of fructose and glucose) is 'worse' for you than sucrose (fructose and glucose). What is the proposed biochemical mechanism for this? And on what basis do you discard the hypothesis that foods with HFCS may contain another factor that promotes obesity over sucrose based ones (if it does at all)?