Carbs Still Don't Make You Fat. But Taubes' Words May Make You Crazy

Don’t do it! Don’t dump your carb-rich foods because of yet another Gary Taubes’ article, which hand picks research to make for sensational headlines that successfully get propagated in the NY Times (albeit just in the Opinion section, not the Science one, thank God!) Yes, yet another news piece inappropriately attacks carbohydrate, failing to note the study’s limitations and the risks of jumping to irrational conclusions.  I’m no researcher but I’m a critical reader of research. And I find Taubes’ (and other such articles drawing false conclusions) simply appalling.

Serve with a Greek yogurt and include the nuts and the
glycemic load is lowered. Better than given this favorite up!

Taubes pulls from a recent study by Ludwig and colleagues at two well-respected Boston hospitals. The objective was to examine the effects of 3 diets with different composition of protein, fat, and carbohydrate and glycemic load, on metabolism. This was done on overweight and obese 18-40 year olds following a weight loss of 10-15%. Glycemic load refers to how much a food will raise blood sugar compared with a standard. It takes into account the amount of carbohydrate in a food, as well as the impact of that food on blood sugar.

Here are a few facts to consider. Taubes' carb-bashing article ignores some critical points, many highlighted by the study authors themselves:

• Total sample size of this ground-breaking study? 21—an embarrassingly small size to be drawing such global conclusions! Perhaps even more striking is that the study began with 32 participants--that's a 34% drop out, in spite of a $2500 financial reward for full participation. I am left wondering why such a high drop out rate? These were self-selected participants, in response to an ad. Were the results not as satisfactory in those that dropped out? We'll never know, but I could only guess that if they were satisfied with the weight loss and maintenance results they might have been inclined to stick with the study. If we had all 32 starting participants perhaps the results would be quite different.

Carb-rich wheatberry salad--a summer favorite!
One of 25 recipes at food-2-eat.com

• The study looked at the impact of three different diets after weight loss, which might be quite different than the impact on those whose weight has been stable. The body does act differently after being starved!

• 1 month per diet type only! That’s how long the study evaluated these various diets.

• Even if this were all valid, would the subjects actually gain weight? It is unclear, given these were not free-living conditions and resulting weight changes were apparently not explored. In fact, we have no evidence of how closely these diets were actually followed, given this was an outpatient setting. The study mentions likely predictors of future weight change (such as changes in metabolic rate), but no actual weight change data on each of the diets is described. Yet Taubes certain jumps to this conclusion.

• Even if they did gain more on a higher carbohydrate diet, there were 2 very negative effects of the lowest carb diet, that may result in long term serious consequences.  Both urinary cortisol levels (a hormonal measure of stress) and C-reactive protein (a marker for chronic inflammation) increased. And both of these are associated with increase risk of cardiovascular disease.

• With the most minimal effort on Pub Med, I found another study on the pediatric population exploring high and low glycemic load meals on energy intake, satiety and hunger. Guess what this study concluded? That there is no evidence for this population (of Hispanic youth) that changing the glycemic load effects short term hunger, fullness, satiety or energy intake. BTW, this one was also by Ludwig and colleagues. In fact, even in the study Taubes reports on, there is no advantage in terms of subjects sense of hunger on the three different diets.

• The authors of the study (not Taubes) state: 

Low carb? absolutely! But not without its risks.

"These findings suggest that a strategy to reduce glycemic load rather than dietary fat may be advantageous for weight-loss maintenance and cardiovascular disease prevention."  

Yes, reducing your intake of fat to very low levels is quite senseless. But no one is advocating for a diet rich in saturated fats, like those found in the meat above. Yes, fats are a welcome addition to diets, even for those watching their weight! And key words to note here are "glycemic load". In other words, think balance. Meals with a combination of protein, fat and carbohydrate will have only a moderate glycemic load, and that is what may be key--both for metabolic health, psychological well-being (think avoiding deprivation) and long term adherence. Yes, the study authors have the wisdom to add:

"Ultimately, successful weight-loss maintenance will require behavioral and environmental interventions to facilitate long-term dietary adherence." And they acknowledge that the study diets were not designed for long-term practicality, and that the very low carb plan would be difficult to follow long term.

Having worked with many thousands of individuals to manage their weight, I stand 100% behind including carbohydrate to do so. Carbohydrate-rich foods are a necessary, satisfying, and energizing part of a healthy diet. I urge caution to the public, which may be less experienced at reading such strong-stated opinions as Taubes' as if they were fact.

Beyond Glycemic Index and Radical Diets This New Year.

Besides amazing pastries, I do love their tag line!

"You guys eat a lot of pastries", she noted, commenting to my husband, her brother. Not a strange observation, I might add. After all, there were the baked goods from the gourmet shop, purchased Thursday, the croissants—chocolate, sweet-cheese topped with plum, and raspberry-filled, fresh from the St. Lawrence market, and finally the long awaited Dufflet Bakery Dacquoise. Oh, and as blogger NewMe can attest to, part of a slice of a disappointing layer cake on Friday afternoon, which my sister-in-law didn't even know about (until reading about it now, that is). 

I think we were a bit of a puzzle to her. We appeared the same sizes we had been last we saw her, about 5 or 6 years ago. Well, I’m projecting now. We are the same sizes we were then, although I can’t exactly say that’s how we appeared.

Like the rest of the world, she gives a fair amount of thought to food, eating and weight. Expression of guilt regarding her carbohydrate consumption combined with questions about glycemic index of sweets engaged me in conversation, and got me going. I do wonder if I will be invited back!

An endless assortment of breads and croissants--
and happy customers!

I corrected the misinformation that carbohydrate is the culprit in weight gain. As for glycemic index (GI), I shared that a food’s GI has rather limited value in weight control. Defined as the impact of a carbohydrate-containing food on blood sugar, as compared to a standard food (typically sugar or white bread), this value was designed as a tool for helping with blood sugar control. 

GI may impact one’s sense of fullness—generally less processed, higher fiber items have a lower GI and tend to help us feel more satisfied. Yet focusing on GI for weight management has its faults. If anything, taking into account the portion of carbohydrate, a calculation known as glycemic load (GL), would be a lot more useful. Otherwise, foods like carrots come out looking like items to be avoided—which would be quite idiotic, if you ask me.

But truthfully, the GI and GL are overrated for weight management. Why? Because we don’t eat foods the way they are evaluated in the lab, as single items, by themselves. Rather, we eat foods as part of mixed meals, which alters the impact on everything from blood sugar rise, to how quickly food empties from our gut, and our sense of fullness. Perhaps that's more than she, or you, cared to learn about glycemic index.

While staying with my sister-in-law and enjoying having her cook for me, I encouraged using less saturated fat than she would otherwise use. I recommended brushing the homemade blintzes with melted butter, then baking, as opposed to frying them in a pan with a more generous amount of fat. And she did. And everyone loved them. I suggested (only when prompted for my input) use of a non-stick pan for scrambling the eggs—topped with a quick shmear of butter for some flavor; combined with the sautéed onions, the reduced amount of fat in the pan was clearly not missed.

Among the many overwhelming sights at the
St. Lawrence Market, Toronto

I discouraged sweetening the fresh and ripe berry fruit salad—neither with sugar or Splenda—as it struck me as unnecessary.

As for those pastries I mentioned above? I had a sampling of the three croissants, amounting to one whole one, for my breakfast the next morning. Was I tempted to consume them, all three of them, while strolling around the market Saturday? Of course! But was I hungry then? Absolutely not! And I knew I’d enjoy them all the more when I was hungry, and not overwhelmed by the sights and distractions, so that I might savor them.

Our first night, when my sister-in-law served some pastries she selected for dessert, I just wasn’t hungry. After our fashionably late dinner, it was easy to pass them up. Of course I knew it wouldn’t be my last chance to enjoy such delectable items.

Am I treated like royalty or what?

Saturday night, however, I looked forward to, even longed for eating the hand-picked baked goods. Think macaron layers (meringue with ground nuts), filled with buttercream, flavored with hazelnut or cappuccino, covered with chocolate ganache, and topped with a French name I can't begin to appropriately pronounce. It met my expectation, as I vividly remembered these delights before their reincarnation from raspberry buttercream, 6 years back.

Admittedly, I worked out when visiting in Toronto, although I did less than my usual workouts, as we had other things on our agenda to accomplish. And Mica wasn’t there having to be walked.

And no, I don’t typically eat pastries with such frequency in the course of a week. But I can trust that it’s not my only chance to include these delights, so it’s easy to have just as much as I need, and only when I really care for them. 

Remember that carrot cake? Believe it or not, there are still a few pieces remaining in the freezer. Really.

 So don’t be pulled to extremes this time of year, lured by food rules, diets, and radical eating. The New Year shouldn’t mean the end of what you enjoy—be it high glycemic white breads, or great tasting pastries—but a new way of embracing what you truly desire, regardless of your weight. Just do so with respect for your hunger and your fullness, with the trust that it’s not your last chance to eat.