What’s the difference between attending to a cause and treating a symptom?
A brown lawn, for example, is a symptom. It’s an unsightly, possibly embarrassing symptom that could get your neighbors shaking their heads and talking about you behind your back. “Look how he lets his lawn go,” they might mutter. “Why doesn’t he do something about it?”
So along comes the lawn-care specialist with a solution to your problem: green paint.
Voilà—problem solved!
Well, not exactly.
After painting the grass, your lawn will look green temporarily, but eventually the paint will wear or wash away, and then you have to call the lawn painter back in. The paint doesn’t do anything about the poor health of the grass that led to it turning brown in the first place. And if the paint is toxic, it can even make the health of the grass worse. If you really want a lush green lawn—a healthy lawn that is naturally green—you need to improve the soil: add nutrients, remove toxins, water appropriately, and use the right grass seed for your environment. In other words, focus on the root causes, not just the visible symptoms.
If you want to lose weight, focusing solely on weight loss—as the low-carb diet does—is as unproductive as painting your lawn green.
The low-carb diet’s first major flaw is that it’s short term. Over the long term, low-carb diets don’t fulfill their promise to dieters, which is that the diet will help them reduce their weight and sustain the change. Observation studies of populations overwhelmingly show that high-protein, high-fat diets, which reflect the long-term consumption of animal-based and highly processed food products, are associated with more health problems, many of which are associated with obesity.4
Americans are getting heavier and sicker, despite all the modern advances in medical care and technology. We’re making no significant inroads in reducing rates of cancer, heart disease, stroke, diabetes, and dozens of other diseases intimately connected with obesity. It’s just that, unlike diabetes or high blood pressure, obesity is a more visible symbol of the problem.
In truth, the obesity epidemic and the health crisis are two sides of the same coin. You can’t solve one without solving the other. That’s as true on an individual basis as it is for society as a whole. Obesity is a symptom, just like hypertension, clogged arteries, angina, chronic shortness of breath, belly pain, dizziness, constipation, and hundreds of others. Yet we largely, and wrongly, treat obesity as if it’s a separate thing—a separate disease.
While there’s a lot of overlap between a healthy body weight and overall health, they aren’t synonymous. You can lose a lot of weight by getting cancer, and you can keep it off by dying, but I don’t recommend that approach! Charitably, we could say that low-carb advocates are using weight loss as a Trojan Horse to get people to improve their diets and overall health—although there’s little evidence for this generous interpretation. As Atkins himself was both obese and quite ill from the known consequences of a high-protein, high-fat diet at the time of his death,5 it’s clear that this community isn’t taking seriously the damning data on long-term health outcomes.
Two original research papers reveal more about the consequences of the Atkins Diet than any others because they were published by supporters of the Atkins Diet and were funded by the Atkins organization. In one paper,6 users of the Atkins diet, when compared to control subjects of “low-fat” dieters (dieters who were getting “only” 30 percent of their calories from fat), suffered more constipation (68 vs. 35 percent), more headaches (60 vs. 40 percent), more halitosis (38 vs. 8 percent), more muscle cramps (35 vs. 7 percent), more diarrhea (23 vs. 7 percent), more general weakness (25 vs. 8 percent), and more rashes (13 vs. 0 percent)—even those Atkins diet users who were taking vitamin supplements. In the other paper,7 similar prevalences were seen for the Atkins dieters for constipation (63 percent), headaches (53 percent), and halitosis (51 percent).
These Atkins Diet side effects are consistent, and the research is quite convincing. That is, when compared with the already poor Standard American Diet (SAD), which is high in fat and protein, the Atkins Diet, even higher in fat and protein, leads to far more negative health outcomes, even in the short term.
So why do dieters still believe the low-carb hype? It has a lot to do with how convincing the low-carb movement’s arguments sound—even though those arguments are consistently contradicted by the science.
GARY TAUBES AND LOW-CARB SLEIGHT OF HAND
The best lies contain a kernel of truth, and that’s certainly the case with the work of journalist Gary Taubes, by far the most eloquent and influential present-day spokesperson for the low-carb movement. Taubes’ two bestselling books, Good Calories, Bad Calories (2007) and Why We Get Fat (2011), make the low-carb case in an entertaining and, to many, compelling fashion.
Taubes is not, of course, the only person who writes in support of the low-carb diet, but I’ve chosen to center my critique around Taubes’ writings because they represent the most comprehensive and evidence-rich expression of the low-carb idea. Taubes’ work also provides—inadvertently, no doubt—a survey of many of the errors, logical problems, and sleights of hand common to low-carb advocates. By pointing out Taubes’ errors and exposing his faulty reasoning, I hope to show the failures and intellectual poverty of the entire low-carb movement.
The first and perhaps most damning problem is the misreading of history and of the supposed link between low-fat diets and obesity. Taubes tackles this history in Good Calories, Bad Calories, a book billed as required reading for those interested in the evidence supporting a low-carb diet. While Taubes’ account is certainly comprehensive, his interpretation is, shall we say, creative.
WHERE TAUBES GETS IT RIGHT
Taubes begins with a kernel of truth, rightly pointing out that the effectiveness of counting calories is a myth. He also gets right some of the important history of the narrative on diet and health of the past five decades. And in his technical arguments on the underlying biochemistry of obesity, he gets some of these details right as well. But considered in isolation and spun into a narrative about the evils of carbs, these partial truths end up misleading rather than informing.
Taubes correctly points out that many early researchers, in the way they crafted their studies and reported their findings, were confusing the three main hypotheses for the causes of obesity and related illnesses: excess calories, excess fat, and excess carbs. According to the first hypothesis—by far the most common—we gain weight because we ingest more calories than we burn. This is the hypothesis I mentioned earlier, which you still hear being invoked today as if it’s the most obvious thing in the world: “eat less, exercise more.” Simple arithmetic. To his credit, Taubes does a masterful job of debunking this dangerous oversimplification.
Taubes goes on to argue, correctly, that creating long-term health by controlling calorie consumption does not work—a very important observation little understood by professionals and nonprofessionals alike. Most people cannot maintain significantly lower calorie consumption for long periods of time, even though they may be able to do so for a short while. That is, “diets” don’t work—not because our willpower isn’t up to it but because of our biological inability to healthfully maintain the substantially lower calorie consumption required to significantly decrease disease formation.8 In any case, Taubes says, generally it is not the amount of calories consumed that matters most but the way calories are metabolized and distributed throughout the body (something we’ll discuss in more depth in a few pages). In fact, Taubes argues that increased calorie consumption is the effect, not the cause of obesity—that we gain weight for other reasons and then require more calories to sustain that weight. Something else is causing obesity, and it is doing so by determining how our ingested calories are metabolized and used.
I applaud Taubes’ demolishing the calorie hypothesis. In fact, I have long said that we should be careful not to emphasize the “calories in; calories out” hypothesis or describe calories in precise quantities as if they are physical entities, like molecules, that have structure and form,