Saturday 27 August 2011

Fat is a political issue.

Why We Get Fat - And What to Do About It.


Gary Taubes

Published by Knopf, 2011


About the author

Gary Taubes is no crank. He is an established science journalist, regularly contributing to Science magazine. He holds Robert Wood Johnson Foundation investigator post in health policy research at the University of California, Berkeley, School of Public Health. His articles about science, medicine and health have appeared in Discover, The Atlantic, and The New York Times Magazine. He is the only print journalist ever to receive a Science-in-Society Journalism Award from the National Association of Science Writers and he has received 3. He has also received awards from the Pan American Health Organization, the American Institute of Physics and the American Physical Society. His writing was selected for The Best American Science Writing 2002, The Best of the Best of American Science Writing, and The Best American Science and Nature Writing 2000 and 2003. He is also the author of Bad Science and Nobel Dreams, and Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease to which this book can be seen as an update

About the book

Nowadays I don’t often read non fiction books although as a child I would voraciously consume them, but I seem to be having a glut of  non-fiction at present.

Taubes’ “Why We Get Fat - And What to Do About a quick, if perhaps overly long rambling, account of how obesity became considered to be an eating disorder, how fattening carbohydrates became considered as fat free carbs, how scientific studies repeatedly mistook cause and effect, how prejudice post WW2 ignored German research, how obesity is inextricably linked to poverty. Yes all in all fat is a political issue.

I was intrigued by the title of this book, not because I have a weight problem (I am actually very happy with my weight),  but because I love my food, no, correction I love good food and like to eat well and hopefully remain healthy! Also, here in India everyone (me included), has a high (or higher than usual) carbohydrate content to their diet. When I was travelling on the boat – the only time in my life I felt constantly hungry! – the diet was again high in carbs. Everyone said it was because the physical work on the boat required more calories, more energy. Yeah, yeah, I thought it’s cheap, that’s why! Me, I just couldn't do the diet and stopped eating much of the meals on board and  all the snacks because the carb content was just overwhelming. Even so I came off the boat completely pasta-ed out, never to eat pasta again for almost over a year. At home I eat comparatively in the way of bread, potatoes.Now here in India, with limited sources of protein (chicken and river fish) , my carb content has been increasing again and much as though I like potatoes, pasta or rice,  and drink lots of fruit juices (sadly, water can get boring and beer is an exceptional treat !), such a high carb content is not my diet of choice and never will be – I am a meat eater, a fish eater, through and through, certainly not by nature a vegetarian. In fact, overall, I don’t like the food here (rice, dalh, beans, semolina and gram flours) and wouldn’t choose to eat it – Northern Indian food is much more me. I still cannot finish a plate of rice here – the volume is just enormous!

Taubes argues for a hunter gatherer style diet, one higher in animal meat and fat and lower in carbohydrates (“ketogenic” diet) than the now prevalent diet. He sees the global epidemic of obesity  and the rise of diabetes as inextricably linked in the “diabesity” problem. He looks at the prevalence of diseases such as heart disease, cancer. He cites examples of societies where fat and poverty can be seen hand in hand where carbs are cheap and protein expensive. He cites examples where societies have undergone the “nutrition transition” from traditional diets to Westernised modern diet and its concomitant “disease transition” e.g. the Kikuyu in Kenya, Southern Pacific Islanders for whom the introduction of sugar and white flour accompanied the rise in these diseases. Anecdotal evidence from here in India supports this where where the diet is now high in sugar (Indian sweets are so so sweet I find them inedible!) and the concern people express about the rise of diabetes in the local population. He cites examples of societies where there is little or no cancer, heart disease, diabetes, obesity e.g. Inuit, Masai – both meat &/or fish eaters – to dispel the illusion that meat eating is all bad – and examples of vegetarian societies where cancer is high e.g. Indian Hindus. Why then was all this ignored in favour of a “fat is bad, stop eating meat” philosophy – because of the idea of the “fattening carb” and a diet free of easily digestible carbs and sugars can make us lean clashed with the idea that dietary fat causes heart disease which had become the prevalent hypothesis of nutritionists in the 1970s.

So read this book if you are interested in the history of diets, dieting and the treatment of obesity, our preoccupation with dietary fat reduction, why some weight loss diets work for some people  but for the majority they never work. The science content is appropriate, even his description of the role of insulin in fat metabolism is written in a straight forward enough way for the layman to understand. It is well referenced and researched.  Read this book if you are interested in how society changed from a pre 1960s “carbs are bad” philosophy to a post 1970s “carbs are good, fat is bad” fad, and we became totally preoccupied with the calories in/ calories out equation which fuelled the growth in the exercise industry  and forgot what our grandparents generation knew: we forgot the 1825 writings of Jean Anthelme Brillat-Savarin  ‘The Physiology of Taste’ where he wrote

oh Heavens!” all you readers of both sexes will cry out, “oh Heavens above! But what a wretch the Professor is! Here in a single word he forbids us everything we most love, those little white rolls…. and those cookies… and a hundred other things made with flour and butter, with flour and sugar, with flour and sugar and eggs! he doesn’t even leave us potatoes, or macaroni! Who would have thought this of a lover of good food who seemed so pleasant?” “What’s this I hear?” I exclaim, putting on my severest face, which I do perhaps once a year, “Very well then: eat! Get fat! Become ugly, and thick, and asthmatic, and finally dies in your own melted grease: I shall be there to watch it.”

It wasn’t until 2007 when Christopher Gardener(*), director of Nutrition Studies at Stanford Prevention Research Center, presented and published studies in the Journal of the American Medical Association comparing the holistic impact of the Atkins diet with its benefits of weight loss, a rising of HDL cholesterol, a lowering of triglyceride levels, a lowering of blood pressure, a lowering of LDL cholesterol, and a decrease in heart attacks that attitudes began to change. Even Gardner himself admits that he undertook the study because of concerns that the Atkins diet was dangerous because of it is rich in meat and saturated fat – he calls the results “a bitter pill to swallow”

(*) Gardner, C. D., A. Kiazand, S. Alhassan, et al. 2007. “Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women: The A TO Z Weight Loss Study, a Randomized Trial.” Journal of the American Medical Association. Mar 7;297(9):969–77.

And see his presentation on YouTube’s The Battle of Weight Loss Diets: Is Anyone Winning (or Loosing)?

For me this  book puts into words what I was intuitively doing by scouring the supermarket shelves for items which were NOT fat free, which were NOT highly sweetened, complaining bitterly of the fad to have fat free food and quietly bemoaning the death of lard. The book takes a long time to get to its point – that the quality and quantity of carbs we eat makes us sick with associated diseases such as obesity, heart disease, type 2 diabetes, metabolic syndrome, caner and Alzheimers. The author could have got to his point more quickly and succinctly, but he does put forth the argument and its an argument that needs to be heard if we are to counter our ever growing waist lines and the continual rise of diabesity world wide. This approach has implications for the world’s food production, it runs counter to the philosophy of vegetarianism, it has huge public health consequences and opens up a socio - political economic can of worms as the price of grain staples and food prices generally continue to rise and much of the world continues to not have enough to eat, never mind a well balanced diet.

Postscript: As I enter my last couple of months in India I can see my food ramblings, which have been remarkably well controlled so far (no haunting dreams craving cheese, cheese and more cheese that many volunteers have had!) may well become more focussed for my homecoming with thoughts of poached smoked haddock, a dripping juicy lamb rib, a thick slice of gammon, a crispy green salad, a slice of not too runny brie predominating and not a grain of rice in sight! But I’ll also be thinking of a pint of very cold dry cider, after all I’m not totally virtuous! I don’t know whether these thoughts made me read this book, or whether reading this book gave me my food thoughts – cause and effect – either way bring on the brie!

ashramblings verdict: 3* – skim read it for his thesis and supporting facts.

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