A Diet Manifesto: Drop the Apple and Walk Away

NY Times ^ | December 27, 2010 | ABIGAIL ZUGER, M.D.

[neverdem]

Another year ends, and still the war drags on. In the final salvo of 2010, the combatants are lobbing fruit.

Not literally, of course, though they might like to: The long war of the weight-loss diets has aroused passions just about as overheated as those of any military conflict.

How is a person best advised to lose extra weight and retreat from diabetes and heart disease? Count calories, cut fat and fill up on fruits and vegetables? Or turn instead to a high-protein, high-fat...

--snip--

In the opposite corner we have Gary Taubes, the science journalist who has thrown in his lot with the high-fat, high-protein crowd, arguing in his new book that the overweight should just put down their apples and walk away: “If we’re predisposed to put on fat, it’s a good bet that most fruit will make the problem worse, not better.”

But those who are curious about the science behind it all could do worse than to pick up Mr. Taubes’s book “Why We Get Fat: And What to Do About It.”

--snip--

And the only one of these hormones under even a smidgen of voluntary control is insulin. At this point Mr. Taubes merges onto the narrative highway traveled by all low-carb advocates: The body’s insulin levels are largely determined by ingested carbohydrates, and for some people the high-carb foods that stimulate insulin secretion and cravings for more high-carb foods are, in this worldview, just so much poison.

So that apple — a filling package of fiber and vitamins to the Weight Watchers folks — is just a serving of fructose to Mr. Taubes. Fructose is the problematic sugar our bodies turn to fat the most readily, and if you are programmed to be fat, an apple will make you that much fatter...

[dsc]

“Most kids”

Even if we stipulate everything you say, that still doesn’t account for adults.

“they didn’t offer “super size” or “jumbo.”

The first MacDonald’s in my area sold burgers by the bag, five to a bag.

[Mase]

LOL.

I thought you were being serious with that absurd claim.

If you were being serious, be sure to ping me when you're able to prove that you can, in fact, get something from nothing. In the meantime, whatever you do, don't put your money where your mouth is. You'll lose whatever you have.

[Grizzled Bear]

Dude. If you want to stuff your face, sit on your butt and get fatter, it’s your own business.

You don’t have to justify it to the rest of us. We don’t even know you.

[Darnright]

>I was skinny as a rail until I was 20 or 21, then bam! Something changed. I couldn’t reduce my intake enough to lose weight. I had to run at least 18 to 24 miles per week, ***and*** reduce my intake of food to preposterous levels to lose weight at keep it off. Neither reduction of intake nor exercise alone sufficed—and there’s something fundamentally wrong with that. There has to be a third—or third, fourth, and fifth—element at work there.<

When you’re young, your pancreas can take care of the carbohydrate-laden food you eat. But at adulthood, many people develop a condition called insulin resistance. This condition causes your body to turn the starchy stuff you eat into fat instead of into energy.

In a large percentage of the population, insulin resistance leads to type 2 diabetes in later life.

Read Gary Taubes’ “Good Calories, Bad Calories for a more thorough explanation.

[Grizzled Bear]

How many American POWs returned home overweight? Weren't they all extremely thin? How about it, dsc; would you lose weight at the Hanoi Hilton?

How many fat quadriplegics have you seen? Weight loss results are often astounding when you can't sneak extra calories.

I could put away the food with no problems up until the age of forty. I think the biggest problem is, due to wear and tear, I can't really exercise as intensly as I had in the past.

[Yaelle]

I also don’t feed my dogs grain based foods. They seem to do much better.

Definitely! Our cats too. "Kibble" is not a normal food for a cat!

[Yaelle]

Bread is only sooooooo good while you are in the throes of it, and feel the cravings. Go off grains for a week and you will be able to forgo bread. It no longer interests me, and I used to adore it.

Oh, and cheesecake? Just don’t eat the bottom crust, and you can enjoy a few bites now and then = it’s full rich fat (though of course there is sugar in it too). I had a piece of cheesecake last week because it doesn’t have any grains - as long as you avoid the crust at the bottom!

[Yaelle]

Why not heated Olive oil? I use olive oil for cooking - not a good idea?

I used to cook with it too. I love olive oil. But it becomes toxic when heated. So save your really good olive oils for salads, or for drizzling over foods AFTER cooking is done.

For heating up, the best oil is coconut. It can take the heat. Get extra-virgin.

[Yaelle]

My point is that we ate a lot and exercised but little in the 1950s and 1960s, but obesity was still rare.

But wasn't the eating constrained to mealtimes? When I lived in France in the early 80s, I noticed that the French were simply NOT FAT, although they are a lot for lunch and dinner. (Breakfast was often just coffee and a cigarette for them...)

I remember hanging out with a French friend and she would say "Oh, I am STARVING to death!" While in her home with a kitchen full of food. She would not consider going to get something to eat, like we Americans would, because it was NOT YET MEALTIME! She waited! Who does that here??

[warsaw44]

toxic? I had no idea.

Quick question: I usually brush olive oil on both sides of a thick steak, salt and pepper and then into the broiler the steak goes. The results are first rate but would the Olive oil be toxic in this instance as well?

[sauropod]

mark

[Dr. Scarpetta]

Fructose is the problematic sugar our bodies turn to fat the most readily, and if you are programmed to be fat, an apple will make you that much fatter.

I've been having a problem with Acid Reflux, and I just read that apples are very good for that problem.

[bert]

Imposing politics on science is as bad or worse than imposing religion on science

The solution was correctly stated. Eat less and exercise more. Too much eating and too little activity over a prolonged period causes health problems

[aruanan]

Fructose is the problematic sugar our bodies turn to fat the most readily, and if you are programmed to be fat, an apple will make you that much fatter.

If your caloric intake is not exceeding your caloric expenditures, an apple will have no effect on your fat. Besides, there is very little de novo lipogenesis in the human body. We're not like pigs and cattle. Fat gain is due almost entirely to dietary fats. Here is the order of storage capacity of the three macronutrients: fats > glucose > proteins. They range from comparatively unlimited storage for fats to no storage form for proteins. If your dietary intake exceeds your kilocalorie expenditure, the excess is stored. Since there is only about 3 days of storage for glucose in the form of glycogen, the so-called animal starch, and since there is no storage for proteins, the burn order for macronutrients is protein > glucose > fats. That is, proteins are preferentially metabolized over glucose (including all the other dietary sugars that are eventually converted to glucose unless, like fructose, they are used in DNA synthesis or they're metabolized in the glucose pathway). Glucose is preferentially metabolized over fats. When someone's energy intake consistently exceeds his energy output, the substrate oxidation shifts away from fats (the primary energy source your body runs on--even muscles, especially the heart) and toward carbohydrates. This is simply a matter of protection against too high a level of serum glucose. If your proteins get glycosylated, you get screwed up faster and worse than if you just put on weight. If you really pack in a huge amount of excess calories with a high percentage of carbohydrates, you may produce some fat via de novo lipogenesis, but it'll be a tiny fraction compared to stored dietary fat.

With respect to acid reflux, eat only very lightly in the evening. Going to bed with a mostly empty stomach will have a greater positive impact on acid reflux than almost anything else.

And, yes, I am an expert (Ph.D. Human Nutrition/Nutritional Biology, University of Chicago).

[Dr. Scarpetta]

Thank you...

[A Navy Vet]

"...the burn order for macronutrients is protein > glucose > fats."

I'm a little confused about this statement. Doesn't the burn order depend on the ratio of the nutrients in the your blood serum at a given time? I also thought it was glucose, protein, then fat. If no glucose, then your body starts to cannibalize it's muscles for protein, while converting fat also.

And where does the glycemic valuation of a given carb fit into your burn order - if at all? Weight lifters are told to eat more carbs then protein after workouts because of glycogen depletion and that certain carbs will restore the ATP quicker than protein. Of course, they need additional protein to repair the muscle fiber breakdown. Maybe I'm mixing up the terms or relying on old info.

[HungarianGypsy]

I may have to be porky forever. There is no way in hell that I will ever be a vegetarian. The mental results would be drastic.

[dfwgator]

A Diet Manifesto: Drop the Apple and Walk Away

More Microsoft FUD, oh wait, wrong Apple, nevermind.

[neverdem]

"Fructose is the problematic sugar our bodies turn to fat the most readily, and if you are programmed to be fat, an apple will make you that much fatter."

I've been having a problem with Acid Reflux, and I just read that apples are very good for that problem.

Try it. Maybe it's only a placebo effect, but if it helps, so what? But that's not the first reference linking fructose to fat that I've read. Fructose metabolism produces glycerol with one less enzyme required than than glucose metabolism. Glycerol is the "spine" of triglycerides. This biochemistry and physiology isn't for everybody.

Table sugar, sucrose, is composed of equal parts of glucose and fructose, but the ratio of fructose to glucose in the high fructose corn syrup used in soft drinks is almost 4 to 3. The high fructose corn syrup used in baked goods is different from the high fructose corn syrup, HFCS, used in soft drinks. You can check the keyword, hfcs, threads by me if you're curious.

[aruanan]

"...the burn order for macronutrients is protein > glucose > fats."

I'm a little confused about this statement. Doesn't the burn order depend on the ratio of the nutrients in the your blood serum at a given time? I also thought it was glucose, protein, then fat. If no glucose, then your body starts to cannibalize it's muscles for protein, while converting fat also.

When you eat protein (and almost all Americans eat protein far in excess of amino acid needs for protein synthesis), the body uses what it needs for protein synthesis and metabolizes the rest for energy since there is no storage form for protein. The body is constantly recycling proteins to amino acids and synthesizing them back to proteins anyway. If your protein needs exceed the amount available in this recycled pool plus dietary protein, then your body will start using the protein in skeletal muscle to get what it needs. Some call skeletal muscles amino acid stores, but they're really not a storage form any more than a frame house is a lumber warehouse. This kind of wasting doesn't occur until you get into starvation territory (look at the Minnesota Starvation Experiment for some interesting reading). Protein metabolism involves both the glycolytic and lipolytic pathways since different amino acids can be oxidized in different ways. Because a typical American diet has excess protein, the portion in excess of amino acid needs is burned in the fuel cycle. Glucose can be stored via glycogen and doesn't necessarily have to be used immediately.

If you are consistently taking in more energy than you expend, the substrate usage shifts toward glucose use and away from fat use: you can store hundreds of pounds of fat; you can't store much glucose before starting to screw up your liver (think force-feeding of geese to make the special kind of liver used in pate).

If you entirely excluded glucose from your diet (or any other sugar that could be converted into glucose or an intermediate in the glycolytic pathway), you'd have to start using skeletal muscle to get the amino acids that can be burned in glycolytic pathway (so your brain can stay alive).

And where does the glycemic valuation of a given carb fit into your burn order - if at all? Weight lifters are told to eat more carbs then protein after workouts because of glycogen depletion and that certain carbs will restore the ATP quicker than protein. Of course, they need additional protein to repair the muscle fiber breakdown. Maybe I'm mixing up the terms or relying on old info.

The glycemic value of carbs is how quickly they are available as glucose. Saltine crackers have a really high glycemic index. Others, like grains of wheat, have lower glycemic index. This quickness of availability is in the gut during digestion. Starches are broken down into mono and disaccharides. Once monosaccharides are transported across the intestinal lumen, it's irrelevant where they originally came from. The only time it would make any real difference is if a diabetic is crashing from low blood sugar. You'd want to give something that required as few digestive enzyme steps as possible to get it into the bloodstream, so you wouldn't say, "Here's a baked potato." A glass of orange juice with some table sugar takes someone nearly passed out on the ground to up on his feet and bitching about how sweet it is in a matter of minutes because the fructose can be absorbed as soon as it reaches the brush border of the small intestine and sucrose (glucose + fructose) is almost as fast (I know this from experience with a friend who is a type 1 diabetic).

If someone is doing a workout to build muscles, he's using mostly aerobic, fat oxidation. The basic metabolism of muscles is fat oxidation. When you consider that long distance runners and cyclists expend far more energy over far longer periods of time than body builders without depleting their ATP (if they did, they'd die--think of why you die from cyanide), body builders are in no danger from this. And why would they think they have to quickly replenish ATP after a workout? Or else their muscles that they're trying to build will get catabolized to get the fuel to make the ATP? As long as they have any kind of nutrients in their last meal, it's going to be used to make ATP. This ATP synthesis is going on all the time. If you suddenly interrupt the process (think cyanide poisoning), you have enough ATP available for a few minutes of (unconscious) life. So their recently-exercised muscles aren't going to get eaten up to provide substrate for ATP synthesis. Of course, the necessary muscle tissue damage that ensues from the workout that triggers the synthesis of more muscle provides some amino acids that are used both for fuel and for amino acid synthesis.